Sign and Symptoms - Block 4

What is a Concussion, and what are the risk factors?

A temporary loss or alteration of part or all of the brain's ability to function without actual physical damage to the brain

Risks: Head injuries (assaults, falls, car crashes, etc)

What are the signs and symptoms of a Concussion, and how can we treat it?

Signs and Symptoms:

- dizziness/ weakness

- change in vision

- ringing in the ears

- inability to focus

- nausea/ vomiting

- lack of coordination

Treatments:

- advise patient to get a CT scan and be evaluated by a physician

- stabilize spine if needed

- transport

What is a Contusion, and what are the risk factors?

A bruise from an injury that causes bleeding beneath the skin without breaking the skin; also see ecchymosis

Risks: blunt force trauma, use of blood thinners, bleeding disorders

What are the signs and symptoms of a Contusion, and how can we treat it?

Signs and Symptoms:

- pain, tenderness

- swelling

- discoloration (blue, yellow, purple)

- warmth over the area

Treatment:

- rest the area and elevate if possible

- transport if severe

What is an Epidural Hematoma, and what are the risk factors?

An accumulation of blood between the skull and the dura mater

Risks: blow to the head that produces a linear fracture of the thin temporal bone (falling, trauma, assault)

What are the signs and symptoms of an Epidural Hematoma, and how can we treat it?

Signs and Symptoms:

- immediate loss of consciousness

- brief period of consciousness

- pupil on affected side becomes fixed and dilated

- death follows rapidly if no surgery

Treatment:

- spinal immobilization

- rapid transport

- high O2

What is a Subdural Hematoma, and what are the risk factors?

An accumulation of blood beneath the dura mater, but outside the brain

Risks: fall/injury involving strong deceleration forces, skull fracture, older people

What are the signs and symptoms of a Subdural Hematoma, and how can we treat it?

Signs and Symptoms:

- fluctuating level of consciousness

- slurred speech

- venous bleeding

- unequal pupil size

- nausea/vomiting

Treatment:

- rapid assessment

- stabilization

- transport

What is a Subarachnoid Bleed, and what are the risk factors?

Bleeding into the space between the brain and the arachnoid membrane

Risks: ruptured cerebral aneurysm, trauma, hypertension, history of aneurysms/hemorrhage stroke

What are the signs and symptoms of a Subarachnoid Bleed, and how can we treat it?

Signs and Symptoms:

- "worst headache of my life"

- nausea/vomiting

- stiff neck

- seizure

- LOC/AMS

Treatments:

- high oxygen

- rapid transport

What is a Myocardial Contusion, and what are the risk factors?

Bruising of the heart muscle; typically caused by blunt trauma

Risks: motor vehicle collision, fall, direct blow

What are the signs and symptoms of a Myocardial Contusion, and how can we treat it?

Signs and Symptoms:

- chest pain

- shortness of breath

- palpitations/skipped beats

- lightheadedness/syncope

Treatments:

- ABCs and high flow oxygen

- rapid transport

- consistently monitor

What is Traumatic Asphyxia, and what are the risk factors?

A pattern of injuries seen after a severe force is applied to the chest, forcing blood from the great vessels back into the head and neck

Risks: pedestrians who are compressed between a vehicle and wall, patient pinned under a car

What are the signs and symptoms of Traumatic Asphyxia, and how can we treat it?

Signs and Symptoms:

- distended neck veins

- cyanosis in face and neck

- hemorrhage in sclera

Treatments:

- provide ventilation with supplemental oxygen

- monitor patients vital signs

- rapid transport

What is Cardiac Tamponade and what are the risk factors?

Compression of the heart as the result of buildup of blood or other fluids in the pericardial sac, leading to decreased cardiac output

Risks: blunt/penetrating trauma, patients with cancer/autoimmune disease

What are the signs and symptoms of Cardiac Tamponade, and how can we treat it?

Signs and Symptoms:

- presence of JVD

- muffled heart sounds

-narrowing pulse pressure

- chest pain/pressure

Treatments:

- rapid transport to trauma center

- high oxygen

What is Decompression Sickness, and what are the risk factors?

A painful condition seen in divers who ascend too quickly, in which gas, especially nitrogen, forms bubbles in blood vessels and other tissues; called bends

Risks: too rapid ascent from a dive, too long of a dive and too deep, repeated dives within short periods of time

What are the signs and symptoms of Decompression Sickness, and how can we treat it?

Signs and Symptoms:

- abdominal or joint pain so severe that patient is bent/doubled over

- symptoms appear within minutes to hours

- numbness or tingling

- headaches

Treatments:

- remove patient from scene

- 100% oxygen via NRB

- supine/recovery position

- rapid transport to hyperbaric chamber

What is Air Embolism, and what are the risk factors?

The presence of air in the veins, which can lead to cardiac arrest if it enters the heart

Risks: common in scuba divers, divers holding breath during a descent (rapid)

What are the signs and symptoms of Air Embolism, and how can we treat it?

Signs and Symptoms:

- blotching (mottling of skin)

- froth (pink/bloody) at the nose or mouth

- severe muscle, joint, or abdominal pain

- dyspnea, nausea, vomiting

- cyanosis

Treatment:

- high oxygen

- rapid transport

What is a Burn, and what are the risk factors?

Injuries in which soft-tissue damage occurs as a result of thermal heat, friction heat, toxic chemicals, electricity, or nuclear radiation

Risks: thermal (flame), chemical (acid), electrical, radiation (sun), and inhalation (smoke, heat)

What are the signs and symptoms of Burns, and how can we treat it?

Signs and Symptoms:

Superficial (1st): red, painful, dry (only epidermis)

Partial (2nd): blisters, intense pain, moist, red/white (epidermis and part of dermis)

Full (3rd): dry, leathery, white, charred, painless (epidermis and dermis)

4th: blackened, necrotic tissue, painless (muscle and bone)

Treatment:

- different treatment per burn

- sterile water for

What is Cushing Reflex, and what are the risk factors?

Late and ominous sign of increased intracranial pressure (ICP)

Risks: severe brain injury, hemorrhage, brain swelling, stroke

What are the signs and symptoms of Cushing Reflex, and how can we treat it?

Signs and Symptoms:

- hypertension (widening pulse)

- bradycardia

- irregular respirations (cheyne-stroke, ataxic breathing)

What is Becks Triad, and what are the risk factors?

Clinical signs of cardiac tamponade, a life-threatening condition where fluid fills pericardial sac, compressing the heart and preventing it from filling and pumping effectively

Risks: blunt/ penetrating trauma, pericarditis

What are the signs and symptoms of Becks Triad, and how can we treat it?

Signs and Symptoms:

- JVD

- muffled heart sounds

- hypotension

- tachycardia

- shortness of breath

Treatment:

- ABCs

- rapid transport

- oxygen via NRB

What is Hemothorax, and what are the risk factors?

A collection of blood in the pleural cavity

Risks: blunt/penetrating chest trauma

What are the signs and symptoms of Hemothorax, and how can we treat it?

Signs and Symptoms:

- signs of shock without any obvious bleeding

- decreased breathing sounds on affected side

- low respiration rate

Treatment:

- rapid transport

- high-flow oxygen

What is Tension Pneumothorax, and what are the risk factors?

An accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest and that interferes with cardiac function, with potentially fatal results.

Risks: chest injury, closed, blunt injury which fractured ribs lacerates a lung or bronchus

What are the signs and symptoms of Pneumothorax, and how can we treat it?

Signs and Symptoms:

- chest pain

- tachycardia and resp distress

- signs of shock

- low/rapid dropping oxygen

-absent/severely decreased lung sounds

- JVD, cyanosis, tracheal deviation (late signs)

Treatments:

- patient sits at 45 45-degree angle

- call ALS

- oxygen and rapid transport

What is Hemopneumothorax, and what are the risk factors?

The accumulation of blood and air in the pleural space of the chest

Risks: penetrating/ blunt chest trauma, rib fracture, lung lacerations

What are the signs and symptoms of Hemopneumothorax, and how can we treat it?

Signs and Symptoms:

- chest pain

- shortness of breath

- decreased breathing sounds

- hypoxia/ cyanosis

- tachycardia and tachypnea

- signs of shock

Treatment:

- oxygen via BVM

- use occlusive dressing or vented chest seal

- rapid transport

What is Commotio Cordis, and what are the risk factors?

A blunt onset injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat

Risks: blunt chest injury (direct blow over the heart), usually occurs in sports with athletes

What are the signs and symptoms of Commotio Cordis, and how can we treat it?

Signs and Symptoms:

- immediate cardiac arrest

- unconsciousness/unresponsiveness

- no pulse/ breathing

Treatment:

- CPR and rapid transport

What is Flail Chest, and what are the risk factors?

A condition in which two or more adjacent ribs are fractured in two or more places or in association with a fracture of the sternum so that a segment of the chest wall effectively detached from the rest of the thoracic cage

Risks: fractured ribs from blunt trauma, elderly with brittle bones

What are the signs and symptoms of Flail Chest, and how can we treat it?

Signs and Symptoms:

- painful and ineffective breathing

- hypoxemia

- cyanosis

Treatments:

- maintain ABC and provide respiration support

- oxygen via BVM

- rapid transport

What is Abdominal Evisceration, and what are the risk factors?

Internal abdominal organs protrude through an open wound in the abdominal wall

Risks: penetrating/blunt trauma, animal attack/industrial accident

What are the signs and symptoms of Abdominal Evisceration, and how can we treat it?

Signs and Symptoms:

- visible lops of bowl or organ protruding

- severe abdominal pain

- nausea or vomiting

- bleeding from wound

- signs of shock

Treatments:

- ABCs

- supine position

- gently cover exposed organs with a moist, sterile dressing and keep loose

- rapid transport

What is Pulmonary Contusion, and what are the risk factors?

Injury or bruising of the lung tissue that results in hemorrhage

Risks: blunt trauma, patient with flail chest. rib fractures, blast injury, and child abuse

What are the signs and symptoms of Pulmonary Contusion, and how can we treat it?

Signs and Symptoms:

- chest pain

- shortness of breath

- coughing

- rales

- tachycardia and tachypnea

- hypoxia/ cyanosis

- respiratory distress

Treatment:

- provide oxygen and PPV

- transport

What is Compartment Syndrome, and what are the risk factors?

Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue

Risks: open/closed injuries, swelling from a restrictive immobilization device, blunt force

What are the signs and symptoms of Compartment Syndrome, and how can we treat it?

Signs and Symptoms:

- pain that worsens with movement

- impaired circulation (delayed cap refill)

- nutrient and oxygen = poor delivery

- pallor (pale skin)

Treatment:

- try not to splint too tightly

- transport