EMT Chapter 3 Diseases/Illnesses

meds EMTs can administer (on the registry)

aspirin, oral glucose, oxygen, activated charcoal, naloxone

medications EMTs can assist with if prescribed (on the registry)

bronchodilator inhaler, nitroglycerine, epinephrine

medical “rights” (for medication)

right patient

right time

right medication

right dose

right route

rhonchi

lower-pitched sounds that resemble snoring or rattling caused by secretions in larger airways

wheezing

high-pitched, musical sounds created by air moving through narrowed lower airway passages (bronchoconstriction)

stridor

high-pitched sound heard on inspiration indicating partial obstruction of the trachea/larynx

rales/crackles

crackling/bubbling sound heard on inspiration caused by fluid in the alveoli or by the opening of closed alveoli

what would pulse ox <90% be called and what is the treatment

moderate to severe hypoxia; administer high-concentration oxygen by nonrebreather or BVM

what would pulse ox 91-95% be called and what is the treatment

mild respiratory distress; administer low-concentration oxygen by nasal cannula

asthma

chronic disease with episodic exacerbations, where bronchioles narrow and mucus is overproduced

emphysema

a form of copd; walls of the alveoli break down, reducing surface area for respiratory exchange

put patient on supplemental oxygen and transfer to hospital

chronic bronchitis

a form of copd; bronchiole lining is inflamed and excess mucus is formed

treated with atrovent/albuterol

pneumonia

infection in the lungs caused by bacteria, viruses, or fungi

care is mostly supportive, provide duoneb (atrovent) to clear mucus

congestive heart failure (chf)

pulmonary edema (fluid in lungs), typically occurs because of damage to the L side of heart; symptoms will develop suddenly

administer ventilation and possibly cpap

spontaneous pneumothorax

lung collapses without injury or other obvious cause

pulmonary embolsim

blood, clot, air, or fat gets stuck and blocks an artery in the lungs

typically caused by lying/sitting in the same position for a long time

epiglottitis

an infection that occludes the airway through swelling, significant in kids

do not inspect/aggravate throat, administer oxygen

croup

inflammation in bronchi and trachea characterized by barking cough

if patient is in respiratory distress, administer oxygen and initiate transport

cpap - what it stands for, what it does, indications, contraindications, side effects

continuous positive airway pressure

indications - pulmonary edema, drowning, asthma/COPD

contraindications - severely altered mental status, inability to sit up/breathe, hypotension/shock, nausea/vomiting, chest/facial trauma, GI bleeding/surgery, spontaneous pneumothorax

side effects - hypotension, pneumothorax, increased risk of aspiration, dry corneas

acute coronary syndrome

blanket term that refers to any time when the blood supply to the cells of the heart is blocked or disrupted, where cells lack oxygen and die

coronary artery disease

conditions that narrow or block the arteries of the heart, caused by the buildup of fatty deposits

angina pectoris (definition, s/s, treatment)

• pain in the chest where coronary artery disease has narrowed the arteries that supply the heart

• chest discomfort, shortness of breath, nausea, sweating, syncope

• nitroglycerine (dilate blood vessels)

• symptoms will subside when exertion stops

acute myocardial infarction (AMI) (definition, s/s, treatment)

• blocking of a coronary artery by the formation of a thrombus or embolism

• ischemia, dysrhythmia, mechanical heart problems (cardiogenic shock/hypotension), JVD, swelling/pedal edema, pulmonary edema

• transport asap, aspirin/nitro as indicated

congestive heart failure (CHF) (definition, s/s, treatment)

• heart is still pumping, but unable to pump blood with normal efficiency

• inability to perfuse tissues (weakness), breathing problems, JVD, pedal edema, pulmonary edema

• contact als/consider cpap if pulmonary edema is present

aneurysm

rupturing of a coronary artery, leading to shock

transport asap

ventricular tachycardia

both ventricles pump so rapidly they have no time to fill

ventricular fibrillation

quivering motion of the heart (poor mechanical response) that fails to pump blood

commotio cordis

sudden cardiac arrest caused by sudden blunt trauma to the anterior chest

asphyxial cardiac arrest

the heart has stopped pumping due to issues related to systemic hypoxia

type 1 diabetes

lack of insulin; pancreatic cells fail to function and insulin is not secreted normally, so glucose cannot move into cells

type 2 diabetes

insulin insensitivity; cells fail to use insulin properly and is controlled by diet/medications

hypoglycemia (causes, onset speed, s/s, body response)

• patient takes too much insulin, patient not eating, vomiting

• very rapid

• confusion, stupor, unconsciousness, seizures, pale/sweaty skin, increased pulse/respiratory rate

• sns is activated

hyperglycemia (causes, onset speed, s/s, body response)

• lack of sufficient insulin/insulin injection forgotten

• develops over days/weeks

• profound change in mental status, increased pulse/respiratory rate, warm/red/dry skin, hypotension, acetone breath, increased urination

• cells break down fats/proteins, can lead to diabetic ketoacidosis

partial seizure (definition, s/s, stages)

• only affects one part/side of brain

• aura, rising sensation in stomach, confusion, no memory of episode

  • affects just one part of body, no loss of consciousness

tonic-clonic seizure (definition, s/s, stages)

• unconsciousness and major convulsions

• tonic phase - body becomes rigid

• clonic phase - body jerks about violently

• postictal phase - convulsions stop, may regain a drowsy/confused consciousness

status epilepticus

patient has 2+ seizures in a row or single seizure lasting longer than 10 min

absence seizure

brief, usually less than 10 sec with no dramatic motor activity/memory of episode

stroke (definition, s/s, stroke scale)

• death or injury of brain tissue that is deprived of oxygen

• aphasia, headache, eye deviation, seizure, vomiting

• F - facial droop

• A - arm drift

• S - speech

• T - time