medical emergencies limmer

Allergy

An exaggerated immune response to a normally harmless substance

Allergen

A substance that triggers an allergic reaction

Antigen

A foreign substance that stimulates an immune response

Histamine

Chemical released by mast cells that causes vasodilation, increased capillary permeability, and bronchoconstriction

Mild allergic reaction

Localized symptoms such as itching, hives, or mild swelling without respiratory compromise

Severe allergic reaction (Anaphylaxis)

A life

Common signs of anaphylaxis

Hives, itching, facial swelling, wheezing, stridor, hypotension, tachycardia, difficulty breathing, nausea, vomiting

Upper airway swelling signs

Stridor, hoarseness, difficulty swallowing, swollen tongue or lips

Lower airway involvement signs

Wheezing, prolonged exhalation, shortness of breath, decreased breath sounds

Why does blood pressure drop during anaphylaxis

Massive vasodilation and leaky capillaries reduce circulating blood volume

Primary EMT treatment for anaphylaxis

Maintain airway, administer oxygen, assist with epinephrine, rapid transport

Adult epinephrine dose

0.3 mg IM of 1 mg/mL (1:1000) solution

Pediatric epinephrine dose

0.15 mg IM of 1 mg/mL (1:1000) solution if appropriate

How does epinephrine work

Stimulates alpha

Contraindication to epinephrine in true anaphylaxis

There are no absolute contraindications in life

Common allergens

Foods, insect stings, medications, latex

Angioedema

Swelling of deeper tissues, often involving the face, lips, tongue, and airway

Urticaria

Hives caused by histamine release

Difference between allergic reaction and anaphylaxis

Anaphylaxis involves respiratory compromise, hypotension, or both

Repeat epinephrine

Per local protocol if symptoms persist and medical control approves or protocol allows

Recovery position for vomiting allergic patient

On the side if no spinal injury is suspected

Abdominal quadrants

Right upper, left upper, right lower, left lower

Referred pain

Pain felt in an area different from the injured organ

Visceral pain

Dull, poorly localized pain from internal organs

Parietal pain

Sharp, localized pain caused by irritation of the peritoneum

Peritoneum

Membrane lining the abdominal cavity and covering abdominal organs

Peritonitis

Inflammation of the peritoneum, usually causing severe abdominal pain and guarding

Guarding

Tensing of abdominal muscles to protect painful organs

Rigidity

Involuntary stiffening of abdominal muscles indicating serious irritation

Distention

Abnormal swelling of the abdomen

Common causes of abdominal pain

Appendicitis, gallbladder disease, ulcers, bowel obstruction, kidney stones, pancreatitis

Signs of internal bleeding

Abdominal pain, distention, bruising, tachycardia, hypotension, altered mental status

GI bleed signs

Hematemesis, coffee

Hematemesis

Vomiting bright red blood

Coffee

ground emesis

Melena

Black, tarry stool indicating upper GI bleeding

Hematochezia

Bright red blood in stool indicating lower GI bleeding

Appendicitis pain progression

Begins near the umbilicus and migrates to the right lower quadrant

AAA

Abdominal aortic aneurysm, enlargement of the abdominal aorta that can rupture

Signs of AAA

Sudden severe abdominal or back pain, pulsating abdominal mass, hypotension, shock

Pancreatitis pain

Severe epigastric pain radiating to the back

Gallbladder pain

Right upper quadrant pain often after fatty meals

Kidney stone pain

Severe flank pain radiating toward the groin

EMT treatment for abdominal emergencies

Airway management, oxygen if needed, position of comfort, treat for shock, rapid transport

Do not give food or drink to abdominal emergency patients

In case surgery becomes necessary

Behavioral emergency

A situation in which behavior puts the patient or others at risk

Psychiatric emergency

An acute disturbance in thought, mood, or behavior requiring immediate intervention

Medical causes of altered behavior

Hypoglycemia, hypoxia, stroke, head injury, intoxication, infection

Scene safety in behavioral emergencies

Ensure law enforcement if necessary and maintain an escape route

First priority in psychiatric emergencies

Rule out medical causes

Psychosis

Loss of contact with reality

Hallucination

False sensory perception without an external stimulus

Delusion

Fixed false belief despite evidence to the contrary

Agitation

Excessive motor activity associated with emotional distress

Excited delirium syndrome

A medical emergency involving extreme agitation, hyperthermia, and sudden cardiovascular collapse risk

Suicidal ideation

Thinking about ending one's own life

Suicide attempt

An intentional act to end one's life

High

risk suicide factors

Best approach to suicidal patient

Be calm, nonjudgmental, empathetic, and direct

Should you ask about suicide

Yes. Asking does not increase suicide risk

Never leave a suicidal patient alone

Continuous observation is essential

Restraints should only be used

When necessary for safety and according to protocol

Physical restraint considerations

Use the minimum force necessary, monitor airway and circulation continuously

Communication with psychiatric patients

Speak calmly, honestly, simply, and respectfully

Avoid arguing with delusions or hallucinations

Do not reinforce or challenge them

acknowledge the patient's feelings

When can a psychiatric patient refuse care

Only if they have decision

Poison

Any substance that harms the body

Toxin

A poison produced by a living organism

Routes of poisoning

Ingestion, inhalation, injection, absorption

Activated charcoal

Binds many ingested poisons to reduce absorption

When should activated charcoal be given

Only if indicated by protocol or poison center and patient can protect their airway

When should activated charcoal NOT be given

Decreased LOC, caustic ingestion, petroleum products, inability to swallow

Poison Control resource

Contact Poison Control for treatment recommendations

Opioid overdose signs

Pinpoint pupils, respiratory depression, altered mental status

Naloxone

Reverses opioid overdose by blocking opioid receptors

Primary problem in opioid overdose

Respiratory depression

Carbon monoxide poisoning signs

Headache, dizziness, nausea, altered mental status

Carbon monoxide treatment

Remove from source and administer high

Organophosphate poisoning signs

SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis

Sympathomimetic overdose signs

Tachycardia, hypertension, dilated pupils, sweating, agitation

Alcohol is classified as

A central nervous system depressant

Hematology

The study of blood and blood disorders

Anemia

Decreased oxygen

Sickle cell disease

A genetic disorder causing abnormally shaped red blood cells

Signs of sickle cell crisis

Severe pain, fever, shortness of breath, weakness

Hemophilia

A disorder in which blood does not clot normally

Leukemia

Cancer of blood

Dialysis

A treatment that removes waste products when kidneys fail

Renal failure

Loss of kidney function leading to waste buildup

Common signs of renal failure

Edema, hypertension, fatigue, decreased urine output

Kidney stone signs

Severe flank pain, nausea, blood in urine

Urinary tract infection signs

Burning urination, frequency, urgency, fever

Pyelonephritis

A kidney infection causing flank pain, fever, and nausea

EMT treatment for renal emergencies

Supportive care, pain management through positioning, oxygen if needed, transport

Hematuria

Blood in the urine

Oliguria

Abnormally low urine output

Anuria

Complete absence of urine production

Hyperkalemia

High potassium level that can cause dangerous cardiac dysrhythmias

Patients with dialysis fistulas

Never take blood pressure or start an IV in that arm