EMT


Symptoms, causes, general pathophysiology, and treatment of:


Behavioral disturbances including suicidal ideation


Hallucinations: A sensory perception that seems real and is not based on any external stimulus 

Signs/symptoms: 

  • Confused thinking

  • Anxiety, loneliness, and guilt 

  •  Obsessive thoughts 

  • Reduced attention span 

  • Deficit in verbal memory 

Causes 

  • Schizophrenia, bipolar disorder, depression, delirium, substance abuse, 

Medical conditions- brain tumors, seizures, infections, fever, stroke, and parkinson's disease  

Pathophysiology 

  • Neurologic conditions like schizophrenia, dementia, parkinson’s, epilepsy , and stroke 

Treatments: 

  • Medications 

  • Therapy 

  • Lifestyle changes 


Altered mental status: a noticeable change in a person's cognitive function or level of consciousness indicating a disruption on how their brain is functioning 

Signs/symptoms: 

  • Confusion 

  • Memory problems 

  • Hallucinations 

  • Delusion 

  • Speech problems 

  • Slow responses 

  • Sleep problems

  • Behavioral Changes

  • Emotional Disturbances

  • Reduced Awareness

Pathophysiology: 

  • Structural damage metabolic derangements

  • toxin exposure

  •  impacting brain function and consciousness.

Causes:

  • Infections

  • Metabolic imbalances

  • brain injuries

  • Alcohol withdrawal

  • TBI(Traumatic brain injury)

  • Pharmaceutical drugs

  • Stroke

  • Seizure

  • Hypothermia

  • Hypoglycemia

  • Carbon monoxide poisoning

Treatments:

  • Spinal Motion Restriction

  • Airway and ventilation support

  • Transport

  • AEIOU TIPS


Seizures (common types and stages): A neurologic episode caused by a surge of electrical activity in the brain.


Generalized Seizures- results from abnormal electrical discharges from large areas of the brain 

Causes

  • epilepsy, 

  • head injuries,

  • brain infections, 

  • strokes, brain tumors, 

  • metabolic issues, 

  • drug or alcohol withdrawal, 

  • and fevers

Signs and Symptoms

-severe twitching lasting several minutes or longer 


Absence Seizure- brief lapse of consciousness in which the patient seems to stare and not respond 

Cause

  • Usually genetic cause otherwise unknown 


Partial (Focal) Seizure- Focal-onset aware seizure 

Cause:

  • brain injuries, 

  • infections, 

  • strokes, 

  • tumors, 

  • development abnormalities 

Signs/Symptoms 

-brief lapse of memory 

  • Numbness

  • Weakness 

  • Dizziness

  • Visual changes 

  • Unusual smells and changes 

  • Twitching and Brief paralysis 



Epileptic Seizures

Causes:

  • Congenital origin. 

  • genetic brain abnormalities, 

  • metabolic disorders, 

  • infection, 

  • trauma, 

  • drug abuse 

Structural- Tumor,infection, scar tissue from injury, head trauma, and strokes

Metabolic

Causes- Hypoxia, abnormal blood chemical values , hypoglycemia, poisoning, drug overdose, sudden withdrawal from alcohol or medications 


Treatments (All)

Can be controlled by medications 

Protect patient from harm





Allergic reactions

Cause: when exposed to something they are allergic or have remote allergies too.

Symptoms- hives, trouble breathing, redness, swelling, itching, rash development, runny or stuffy noses, sneezing, wheezing, coughing, or shortness of breath.

Pathophysiology- an overreaction of the immune system through a harmless substance leading to the releases of inflammatory histamines, causing swelling, and potential life threatening anaphylaxis 

Treatment

Epinephrine

Oxygen 

Position in place of comfort 



Hypo/hyperglycemia (including DKA)

Hyperglycemia: a condition in which the blood glucose(sugar) are too abnormally high 

Causes:

  • Stress

  • Extra exercise

  • eating too much

  • Medication

  • Insulin deficiency

  • Infection

  • Illness

  • Pancreatitis

  • Cushing’s syndrome

  • Overweight

  • Physical inactivity

  • Surgery

  • type 2 diabetes

  • Pregnancy

Pathophysiology:

  • Results of genetic, environmental, immunologic factors

Treatments:

  • Contact ALS

  • Rapid transport


Hypoglycemia: occurs when your blood glucose levels drop below the healthy range, typically below 70 mg/dL

Causes:

  • Diabetes

  • Insulin producing tumors

  • Alcohol consumption

  • Certain medications like

  • beta blockers

  • Hormonal imbalances

  • Kidney disease

Pathophysiology:

  • Causes hypothalamus to stimulate the sympathetic nervous system to release adrenaline from adrenal glands

Treatments:

  • Oral glucose






Stroke/TIA- Interruption of blood flow to an area within the brain 

BEFAST

Ischemic Stroke 

Signs/Symptoms- from to nothing at all or complete paralysis 

Cause- Atherosclerosis in the blood vessels is often the cause 


Hemorrhagic Stroke - bleeding inside the brain 

Causes:

  • High BP

  • Drug abuse

  • Aneurysms

  • Head trauma

  • Brain tumors

  • Alcohol abuse

  • Cigarette smoking

  • Liver disease

  • Bleeding disorders

  • Blood vessel abnormalities

  • Infection

  • Ischemic strokes

  • Anticoagulants

Pathophysiology:

  • Blood vessel ruptures, leading to blood accumulation and pressure on tissue, causing damage and potential death

Treatments:

  • Airway management

  • Prompt transport

  • Medications to counteract, if present


Blood disorders like sickle cell and anemia

Causes:

  • Genetic mutations

  • Infections

  • Nutritional deficiencies

  • Autoimmune disorders

  • Clotting disorders

  • Medications

  • Liver disease

  • Kidney Disease

  • Bone marrow disorders

  • Trauma

  • Surgery

  • Pregnancy

  • Obesity

  • Certain cancers

Pathophysiology:

  • Abnormalities in structure and functions of blood cells, proteins, and the processes of blood clotting in the immune system that leads to disease.

Treatments:

  • Rapid transport 

  • airway management

  • Pain management




Headaches - Can be a symptom of another condition or a neurologic condition Tension Headache, Migraine, Sinus Headache 


Tension Headache- caused by muscle contractions in the head and neck 

Description- Squeezing, dull, or an ache 

Treatment- does not require medical attention 


Migraine Headache-Changes in blood vessel size in the base in the brain 

Pain- pounding, throbbing, and pulsating 

Signs/Symptoms- Nausea and vomiting, preceded by visual changes

Can last for several hours or days 


Sinus Headaches 

Causes- pressure that is the result of fluid accumulation in the sinus cavities 

Signs/Symptoms- cold like symptoms of nasal congestion, cough, and fever 

Treatment- prehospital care is not requires 


Stimulant and narcotic OD -

Stimulant OD - occurs when, someone is experiencing effects stimulants to sever that their health or safety may be at risk 

Narcotic OD - An overdose the occurs from narcotics 


When to perform:

Primary assessment- immediately upon arriving on the scene encountering patient 

Determine the severity of the patient's condition 

  • Obtain a general impression 

  • Assess the level of consciousness 

  • Determine any life threats 

  • Do not assume a conscious, alert, and oriented patient is in stable condition 

Airway and Breathing 

  • Ensure that the patient has an open airway and adequate ventilation 

  • If patient has difficulty breathing or an inhalation injury, begin oxygen therapy

  • Have suction available; these patients are susceptible to vomiting 

Circulation

  • Assess the pulse and skin condition 

  • Will vary depending on the substance 

Transport Decision 

  • Consider prompt transport for patients with obvious alterations in the XABCs or for patients you have determines have a poor general impression 

  • Everyone who is exposed to the hazardous material must be thoroughly decontaminated by the hazmat team before leaving the scene 


Secondary assessment- after completing your primary assessment and addressing any immediate life threatening conditions



Physical Examinations- during the primary assessment to identify immediate life threats and during the secondary assessment for a more details evaluation 

  • Focus on the area of the body involved with the poisoning or the route of exposure 

  • A general review of all body systems may help to identify systemic problems 


A complete set of baseline vital signs is important 

Detailed Exam- after rapid trauma assessment or initial assessment, and before transport 


Focused exam-after the entail assessment( primary survey) and after identifying a specific problem or area of concern 


Rapid physical exam-on patients with a significant MOI or those who are unconscious or unresponsive with an unknown MOI, to quickly identify life threatening- injuries  


Appropriate transport positioning

Lay them on their side 

If conscious strap them down