EMT signs and Symptoms

Mild shock

rapid thread pulse, rapid shallow breathing, pale skin, cool clammy, sweaty skin, weakness, dizziness, confusion, decrease in mental status

Moderate shock

Anxiety, agitation, Nausea, Thirst

Late shock

Vomiting, glassy eyes, decrease in mental status(further), Drop in blood pressure, Altered respirations, cyanosis, dilated pupils, coma

Status Asthmaticus

anxiety, wheezing, tachypnea, tachycardia, dyspnea, possible chest tightness(usually no pain), accessory muscle use, prolonged expiratory phase -forcing each breath out, "pursed lip breathing", coughing, does not respond to usual treatment

Acute Asthma attack

anxiety, wheezing, tachypnea, tachycardia, dyspnea, possible chest tightness(usually no pain), accessory muscle use, prolonged expiratory phase -forcing each breath out, "pursed lip breathing", coughing,

COPD

anxiety, may "tripod, dsypena, has trouble getting air in, accessory muscle use, pursed lip breathing, prolonged expiratory phase, abnormal breath sounds (wheezes, or rhonci), cyanosis or ruddiness, barrel chest

Pulmonary Edema

typically starts as mild or pronounced agitation, tachycardia, pale, cool, clammy skin, persistent cough usually non productive, crackles (in the lung base), severe dyspnea especially when lying down, eventually develop cyanosis, productive cough and possibly foam appearing at the mouth (pink, frothy)

Pulmonary Embolus

sudden onset of dramatic agitation, Aphrension, sudden dramatic hyperventilation, sudden and dramatic dyspnea with congestion and shortness of breath, pleuretic chest pain (stabbing) especially on inhalation, tachypnea, tachycardia, hemoptysis, cyanosis, possibly abnormal breath sounds, calf or leg pain

Pneumonia

history of respiratory infection, fever, productive cough (possibly rust colored or greenish mucus) possibly some wheezing, chest discomfort of chest pain

FLU

sudden onset of fever and chills (out of nowhere 102-104), sever headache (photophobia), severe muscle aches and pain (legs and back mostly) cough (with substernal burning), worst symptoms last for 3-7 days but feel dragged down for weeks

Hyperventilation syndrome

usually severe agitiation, anxiety or fright, hyperventilation, progressive signs and symptoms of alkalosis, (light headedness dizziness, numbness, feeling of tightness, muscle twitching, carpal-pedal spasms, tetany, seizures, loss of consciousness

Epiglottis

fever, sore throat (difficulty swallowing, drooling) dyspnea, accessory muscle use, coughing

pleurisy

pleuritic chest pain, cough, history of respiratory infection

Adult Respiratory Distress Syndrome

Dyspnea and tachycardia,crackles

Angina Pectoris

Brought on by exercise, stress or eating to much, Feels like pressure or chest tightness, usually substernal or epigastric, sudden onset (usually 3-5 minutes) not past 10

Myocardial infarction

brought on by exercise, activity or stress (but sometimes nothing), feels like pressure or chest tightness , a weight on the chest, usually feels substernal or epigastric (usually on the left), usually lasts 30 minutes or longer, nausea, diaphoresis, dyspnea or orthopnea, irregular pulse, sudeen onset of weakness or lightheadedness, Denial

Left-Sided CHF

slow onset, often over several days- may not be noticed till acute

Dyspnea, Shortness of Breath (SOB), productive cough

Orthopnea difficulty breathing when lying straight (supine)

Sitting up- often found propped p on pillows- may have spent the last evening in a chair

Pulmonary edema- from excessive pulmonary capillary pressure and increased respiratory effort= greater inspiratory vacuum

Right sided CHF

Dependent Edema (pedal edema)

Jugular Vein Distention (JVD)

Liver engorgement (ascites)

Hypertensive Crisis

Hypertension with Angina, Pulmonary Edema, Pregnancy or signs of cerebral edema (such as usually severe headache blurred vision/visual disturbances, nausea and vomiting, altered mental status, focal neurological sign or deficits, paresthesias, dizziness, vertigo or tinnitus

Hypertensive Emergency

Pulse that is strong bounding

Tinnitus

headache

nosebleed

nausea/vomiting

Dissecting Aortic Aneuryism

P-Lifting heavy weights straining

Q-tearing knife like

R- pain on anterior chest but boring through the back

S very severe, and hits maximum at onset

T Sudden onset

CVA

altered level of cosiousness

hemiparesis, hemiplegia

ataxia, asymmetry of face

unequal pupils, dysarthria

aphasia, dysphagia

incontinence, sudden blurred vision

intense vertigo, hypertension

Bell's Palsy

One sided facial droop

Alert and Oriented

No other neurological deficiets

Grand Mal Seizure

They may have an "aura"

Tonic-Clonic phase

Loss of consciousness

clenched teeth, biting the cheek or tongue, incontinence

post-itcal phase

Absence Seizure

staring into space

little to no body movement (beyond an eye flutter exc)

1-3 seconds "lapses in awareness" but no falling down usually

Focal Motor Seizure

Starts in a group of muscles a "focus"

May progress to include the whole entire arm

May progress to a Grand Mal Seizure

Complex Partial Seizure

attacks of confusion,& loss of awareness with semi purposeful movements, often refusion

Gastric ulcer

persistent pain in the upper abdomen, often described as burning

pain is somewhat or completely relieved by eating bland foods

often have hematernesis or melana

Abdominal Aortic Aneurysm

P-Lifting heavy weights straining

Q-tearing knife like

R- pain on Abdomen but boring through the back

S very severe, and hits maximum at onset

T Sudden onset

Appendicitis

Fever

Anorexia

Nausea/or vomiting

sharp right lower quadrant pain, guarding rebound tenderness

increases over several hours

Esophageal Varices

Massive hematemesis

dramatic hemoptysis- bright red blood

life threatening hypovolemic

Gallbladder inflammation/ cholecystitis

history of recent ingestion of a meal with a lot of fat

gradual onset of sharp pain in right upper quadrant, possibly the right shoulder area after fatty meal

Kidney stone

tremendous pain in the lower quadrants, radiating in pulse-like waves from the rear flank, downward toward the pubic symphysis worsens as the stone is pushed along

anxiety, restlessness

nausea and or vomiting

hematuria

bowel obstruction

crampy pain in the abdomen, usually diffuse

often has abdominal distention

anorexia, nausea and or vomiting

fever

Chronic liver disease

jaundice, ascities, pedal edema, muscle atrophy, decreased clotting, petechiae, varicose veins

pacreatitis

sudden severe LUQ epigastric pain -steady boring through to the back

usually with a history of chronic alcohol abuse

may have abdominal tenderness and or distention

nausea/vomiting

may develop shock

Irritable Bowel syndrome

Abdominal pain, abdominal cramping, gas, bloating, diarrhea or constipation. The pain is described as "worse than childbirth" "a sudden knife like pain that can double you over" can bring you to your knees

Diverticlitis

Abdominal pain (usually LLQ)

Fever

Vomiting

Constipation

GERD

Presents as heartburn

Type 1 diabetes

The patient needs to inject insulin several times per day

an auto immune disease where the body produces antibodies that attack and destroy the pancreatic islet cells

these produce no insulin

Type 2 diabetes

pateints control their disease through diet and exercise and weight loss (they are usually obese or through oral medications that increase the pancreas production of insulin

Diabetic Coma

Gradual onset- often over several days

flushed- dry warm skin (mild fever)

intense thirst dry mouth (if he complains at all)

rapid weak pulse (tachycardia)

hypotension

kussmaul respirations

decreased level of consciousness

nausea, vomiting, abdominal pain, and possibly anorexia

blurred vision

Insulin shock

Rapid onset (often too sudden to react)

headache

pale, cool, wet skin (often soaking wet)

tachycardia pulse may be strong/bounding

weakness, dizziness

agitated restless, uncooperative abnormal behavior, syncope, ALOC

Anaphylaxis

tachypnea, tachycardia, hypotension

red or pale, itchy

dyspnea, wheezing, stridor from bronchospasm

respiratory distress (wheezes)

sigs of hypovolemic with normal skins

Hymenoptera

pain, located swelling, redness

"bully's eye" mark

itching

watch for airway swelling

Asprin Overdose

mild overdose-tinnitus

Larger overdoes it produces gastrointestinal pain & cramping ad hyperventilation to blow of the acidosis

Tylenol overdose

Acute- Few if ay symptoms (possibly a good night's sleep)

Later phase (after a few days maybe a week) general malaise, anorexia possibly cyanosis, followed by acute liver failure

Tricylic Antidepressants

Decreased LOC

Seizures

Cardiac Dysrhythmia

Beta blockers

Cardiac dysthymias

hypotension, bradycardia, cardiac arrest

Narcotics/opiates

decreased LOC

respiratory depression/ hypoventilation

pinpoint pupils

hypotension

Nausea/vomiting

Depressants

decreased LOC

respiratory depression/hypoventilation

loss of muscle coordination

slurred speech

nystagmus (especially alchohol)

bradycardia/hypotension

Stimulants

increased LOC

Tachycardia/HTN

rapid speech

dilated pupils or normal

seizures, muscle twitching, tremors

Chest pain

Hallucinogens

Altered LOC,

tachycardia/ HTN

Visual halluctinations

Seizures

Nystagumus -especially with PCP

hot flashes

Hydrocarbons

Altered LOC

coughing choking

Toxic inhalations

dyspnea, tachypnea

nausea/vomiting

aloc

airway irritation, wheezes or crackles

sore throat, cough

Smoke inhalation

Dyspnea, tachypnea

cough

abnormal breath sounds- stridor, wheezes crackles

watery, irritated eyes

singed facial hairs, eyebrows, nasal hairs

Carbon Monoxide Inhalation

headache- rapid onset out of nowhere

ALOC, confusion, coma

nausea/vomiting

dyspnea, tachypnea, tachycardia

flushed skin

dizziness

Cyanide Gas Inhalation

sudden onset-within minutes of inhalations, within 30 minutes of ingestion

the patient becomes rapidly uncounscious, often falling

respirations are rapid and convulsions at first then slow and gasping

hypotension, seizures, incontinence, cardiovascular collapse

Chlorine Gas Inhalations

instant onset of burning in lungs and mouth

dyspnea, tachypnea

sever cough

abnormal breath sounds, stridor wheezes

watery, irritated eyes

Phosgene Gas inhalation

An extremely corrosive gas from burning plastics. Does tremendous tissue damage/total destruction of lung tissue and eyeballs on contact

Ammonia Inhalation

A corrosive or irritating gas (used in manufacturing ) and some refrigerator units, tanker trucks on the freeway or railcars.

organophosphate poisoning

Constricted Pupils, Diarrhea, urination, Muscle weakness, Bradycardia, Bronchospasm, Bronchorrhea, Emesis, Lacrimation, Sweating, Salivation, Seizures, GI cramping

Pelvic Inflammatory Disease

Tremendous pain in the lower quadrants

often has a fever

anxiety, restlessness

Nausea/vomiting

abnormal vaginal discharge

Ectopic Pregnancy

abrupt onset of sever, stabbing pain in lower quadrants

abdominal distention, guarding, rigidity

may or may not know she is pregnant

signs/symptoms of shocks

nausea/vomiting

vaginal bleeding may occur

Abrasion

Small amounts of blood loss, with a large amounts of tissue damage

Puncture

Usually very little external blood loss, but there may be significant internal bleeding

Avulsion

A torn loose or torn off piece of flesh (partial or complete avulsion) Often with considerable blood loss Although the vessels pinch off quickly

Incision

A smooth edged cut, typically done with a sharp blade, often they bleed a lot

laceration

A jagged-edged cut, typically done with a somewhat duller blade or piece of metal, ripping the skin rather than cutting it, often they bleed alot

Evisceration

a type of laceration where internal body parts are exposed on the surface of the body(like intestines)

Fractured larynx/ trachea

Obvious signs of injury, edema, hoarseness, stridor, subcutaneous emphysema

1st degree burn

Thermal damage to the first layer of skin only (epidermis), lower layers heated and react by turning red and becoming tender and uncomfortable to touch

2nd degree burn

thermal damage to the first & second layers of the skin (epidermis and dermis) Blisters will appear, and may break making the skin appear moist. Can be red or white color depending on the thermal agent. (hot water may make them appear pale)

3rd degree burn

thermal damage to all three layers of the skin, also cooks blood vessels, so it appears to be dry and leathery- color depends on agent

Minor Burns

No critical areas burned

No respiratory involvement

2nd degree burns to less than 15% of BSA or

3rd degree burns to less than 2% of BSA

Moderate Burns

No Critical areas burned

No Respiratory involvement

2nd degree burns to 15%-25% of BSA

3rd degree burns to 2%-10% of BSA

Severe Burns

Respiratory involvement or inhalation injury

Involvement of "Critical Areas"

2nd degree burns to greater than 25% of BSA

3rd degree burns to greater than 10% of BSA

Airway Burns

burns around face, mouth

Singed facial hair- eyebrows, eyelashes, nasal hair

productive cough-sooty sputum

hoarseness when they try to talk

dyspnea

Dysphagia

history of a burn in an enclosed area

Electrical Burns

frequently associated with significantly greater internal injuries than would be suspected from the appearance of entrance and exit wounds. May cause arrest through ventricular fibrillation activity

Concussion

usually with a transient decrease in level of consciousness followed by complete, and prompt recovery Often the patient will complain of a headache, some light-headedness, dizziness, "grogginess" and some nausea. Patient recovery is measured in minutes and hours

Cerebral contusion

All those present for a concussion except they are more sever here, and tend to last longer. Usually there are also some of the sign/symptoms of increased intracranial pressure. Patient recovery is measured in hours or more likely days. There may be permanent disability.

Epidural hematoma

All the signs of a concussion

ALOC with a lucid interval

S/s may be delayed 1-4 hours

S/s of ICP

Subdural hematoma

All the signs of a concussion

S/s may be delayed up to 2-4 Weeks

Signs of ICP

Intra-cerebral hemorrhage

Sudden onset of an extremely severe headache (sometimes described as the worst headache they have ever felt) then rapid losss of consciousness without regaining it- suddenly falling out of their chair

s/s of ICP

ICP

-increasing systolic blood pressure

-Widened pulse pressure

-Brady cardia (Baroreceptor reflex)

-Altered, abnormal Respiratory patterns

-Deteriorating level of consciousness

-Nausea/Vomiting

-Severe, Persistent Headache

-Pulpillary changes, unequal or dilated

-Seizures

-Brainstem posturing in severe cases

Cervical spine trauma

-pain especially upon palpation

-swelling deformity at injury site

-neck muscle spasm and stiffness

-neurological deficits

respiratory compromise

neurogenic shock

loss of bowel control

priapism

Rib fracture

sharp stabbing pleuritic CP, made worse by inspiration

may have an abrasion or contusion (seatbelt)

patient will attempt the splint his own arm

may be hypoventilating due to pain

Flail chest

dyspnea, tachypnea

Floating chest wall segment

cyanosis

subcutaneous emphysema

Pneumothorax

dyspnea, tachypnea

diminished breath sound on one side

sharp stabbing chest pain

Tension Pneumothorax

progressive dyspnea, tachypnea

absent lung sounds on the affected side

JVD

narrow pulse pressure

unequal chest expansion seen on deviation

tracheal deviation

Pericardial tamponade

distended neck veins

dyspnea

narrow pulse pressure

muffled heart sounds

myocardial contusion

CP

bruising over sternum

dyspnea, tachypnea

irregular pulse, dysrthymia

signs of shock

commotion cordis

Sudden death directly following blunt force trauma

Pulmonary contusion

CP

bruising over sternum

Progressive dyspnea

decreased breath sounds on one side

hemoptysis

irregular pulse-dysrthymia

tracheobronchial rupture/laceration

severe respiratory distress

stridor, hoarsness (if able to talk)

subcutaneous crackling sensations to touch

decreased or unequal breath sounds

hemotypsis

tachycardia, hyptension

cyanosis

hemothorax

signs of severe shock

respiratory distress

decreased or absent breath sounds on one side

Blunt abdominal trauma

pain and tenderness often diffuse, sometimes local "point" tenderness

abdominal "guarding" abdominal rigidity

abdominal distention

signs of surface wounds abrasions, discoloration, bruising

nausea and or vomiting

s/s of shock

Sprain

May have "heard" the injury

Pain and tenderness often significant enough to prevent walking

swelling often significant especially of the ankle

discoloration often delayed sometimes by 24 hours

strains

may have "heard" the injury

Pain and tenderness can be significant but usually "discomfort" is more likely- extreme point tenderness

Dislocation

Usually dramatic deformity

Pain usually extreme

swelling occurs but takes time, and may be masked by the deformity

discoloration occurs but may take time possibly many hours

Inability to move