AMLS QUESTIONS Flashcards
Anaphylaxis
SxSy - Itching, urticaria, nausea, stridor, bronchospasm, severe abdominal pain, respiratory distress, tachycardia, shock, edema of lips, tongue or face. Treatment- IM - IV Epi, Benadryl, Corticosteroid, O2
Epiglottitis
SxSy - Sore throat,pain on swallowing, muffled voice, tripod positioning, fever,stridor,noted pain of larynx, low spo2.Treatment- Humidified O2,Antibiotics.
Asthma
SxSy - Dyspnea, shark fin waveform, expiratory wheezes, tripod positionTreatment- IM - IV Epi, Beta2 agonists, steroid if needed, Needle decompression if warranted
Bronchiolitis
SxSy - coughing, wheezing, diff breathing, runny nose, fever, tachypneaTreatment- SPO2, ETCO2 monitoring, racemic epi, steroids if needed
Chronic Obstructive Pulmonary Disease (COPD)
SxSy - cyanosis, fatigue, dyspnea, chronic cough, producing increased sputum, , wheezing, frequent respiratory infectionsTreatment- supplemental o2, duoneb (albuterol 2.5 mg and ipratropium bromide 0.5mg), methylprednisolone (125mg), mag sulfate (1-2G) if impending respiratory failure, epinephrine (0.01 mg-kg max 0.3mg) if impending respiratory failure
Pneumonia
SxSy - Cough, dyspnea, pleuritic chest pain, increased WOB, crackles and rhonchi.Treatment- Antibiotics, CPAP
Pneumothorax-Tension Pneumothorax
SxSy - Diminished or absent breath sounds, tracheal deviation, hypotension, dyspnea, JVD.Treatment- Needle Decompression
Pulmonary Edema
SxSy - Crackles, rhonchi, pink frothy sputum, dyspnea, HTN.Treatment- CPAP, diuretics, NitroPaste, Morphine
Pulmonary Embolus
SxSy - “S1Q3T3”, dry air hunger, sudden onset chest pain, Decreased SpO2Treatment- IV 02 Monitor
Tuberculosis
SxSy - Persistent cough, night sweats, weight loss, hemoptysis, chest pain. (incubation period of 4-12 weeks.)Treatment- Surgical mask for Pt, N95 for the provider. Routine Pt care
Paroxysmal Nocturnal Dyspnea-acute onset SOB at night
SxSy - Early sign of Left heart failureTreatment-
Acute Myocardial Infarction- Necrotic heart tissue as a result of an occlusion of a Coronary artery or its subdivisions.
SxSy - Classic, Atypical, Anginal Equivalents (see question 14)Treatment- STAMP, Primary PCI
Angina Pectoris- Chest pain caused by an inadequate blood supply from narrowed coronary arteries filling with plaque.
SxSy -Anginal Equivalents (See Yellow Sheet),Treatment- STAMP,
LEFT HEART FAILURE
SxSy: pulmonary EdemaTreatment: CPAP, Nitro, morphine
RIGHT HEART FAILURE
SxSy: Dry SOB, hypotension, JVD, peripheral edemaTreatment: NO NITRO-NO MORPH- right EKG, fluids support preload
Cardiac tamponade
SxSy - Electrical Alterans, Muffled heart tones, narrowing pulse pressure, JVDTreatment- Rapid Transport, Pericardiocentesis “Tap the Sac”
Pulmonary Edema
SxSy - Crackles, rhonchi, pink frothy sputum, dyspnea, HTN.Treatment- CPAP, diuretics, NitroPaste, Morphine
Pulmonary Embolus
SxSy - “S1Q3T3”, dry air hunger, sudden onset chest pain, Decreased SpO2Treatment- IV 02 Monitor
Paroxysmal Nocturnal Dyspnea-acute onset SOB at night
Sx-Sy- SOB awakens pt at nightTreatment: sit upright
Ectopic Pregnancy- implantation of the fertilized ovum outside the uterus.
SxSy - Vaginal bleeding with-without abdominal pain. Belly pain in women of childbearing age should be considered ectopic until proven otherwise.Treatment- O2,IV,Monitor- TRANSPORT
Epidural Hematoma- an accumulation of blood between the inner table of the skull and the dura mater. Frequently associated with a skull fracture.
SxSy - Cushing’s Triad ( Systolic Hypertension, Bradycardia, Irregular Respiratory Pattern), AMS,Unilateral pupil dilation, N-V, DizzinessTreatment- maintain an Spo2 of 94% ,Systolic of 90
Encephalitis-general inflammation of the brain that causes focal or diffuse brain function.
SxSy -Headache,N-V,Fever, AMS,Behavioral changes, Stiff neck,photophobia.Treatment- Diuretics (Osmotic & Loop), Corticosteroids, Surgical Shunt.
Seizure
SxSy - convulsions- blank stare- altered LOCTreatment- Control Seizure - treat the cause (i.e BDZ, Mag Sulfate, Temp control, Glucose)
Stroke (ischemic)
BLOCKAGE- Sx-Sy: hemiparesis, numbness in body, AMS, dissiness, N-VTreatment- ABC’s, last known normal, stroke scale, do they meet fibrinolytic therapy indications, check bgl (treat only if blg less than 60 mg-dL), 12 lead, o2 sat 94-98%, hx (is pt on blood thinners)
Stroke (hemmorhagic)
BLEED Sx-Sy: SUDDEN ONSET headache, LOC, irregular breathing, weakness, N-V, Sz, AMS, gaze, neck pain, visual disturbanceTreatment- ABC’s, last known normal, stroke scale, do they meet fibrinolytic therapy indications, check bgl (treat only if blg less than 60 mg-dL), 12 lead, o2 sat 94-98%, hx (is pt on blood thinners)
Gastrointestinal Bleed
SxSy - Hypotension, blood in stool, horrible smellTreatment- Treat for shock-
Appendicitis-infection or fluid build up within the appendix.
SxSy -localized RLQ pain or R lower back originating at the periumbilical region. Pain begins to travel as infection worsens. Fever, N-V, Positive Psoas sign.Treatment- IV, Analgesics, Antiemetics
Bowel Obstruction
SxSy - Nausea-Vomiting-Abdominal pain, cramping feeling like a knot, irregular eating and bowel regimen, auscultation of bowel shows high-pitched or absent. Percussion sounds: hollow, palpation may cause pain, firm, distended.Treatment- IV access, IV-IO no PO meds, treat for N-V-D and pain managment. CT scan, full lab panel, nasogastric tube, surgical intervention.
Pancreatitis-Inflammation of the Pancreas
SxSy - Flank - Epigastric pain, N-V-D, jaundice, ABD distentionTreatment- Supportive care, Pain management, FLD,
Hyperosmotic Hyperglycemic Nonketotic Syndrome (HONK)
SxSy - Hyperglycemia, AMS, Partial paralysis - muscle weakness, Comatose, Sz, NormocapniaTreatment- Fluid administration
Hypoglycemia-Hyperglycemia
SxSy - ↓ BgL < 45mg-dl, AMS, Decreased LOC, Rapid,Weak Pulse Rx Glucacon, dextrose. ↑ BgL > 150mg-dl, Tachycardia, Tachypnea, AMS, diaphoresis, Polyphagia, Polydipsia, PolyuriaTreatment- Rx ↑ Insulin, fluid bolus 500ml, followed by 250 ml-hr
Pancreatitis-Inflammation of the Pancreas
SxSy - Flank - Epigastric pain, N-V-D, jaundice, ABD distentionTreatment- Supportive care, Pain management, FLD,
Diabetic Ketoacidosis (DKA)-BGL over 350 mg-dL.an acute endocrine emergency in which insulin deficiency and excessive glucagon levels combine to create a hyperglycemic, acidotic,volume-depleted state.
SxSy - Tachycardia, Tachypnea, AMS, diaphoresis, Polyphagia, Polydipsia, Polyuria, Fruity breath, Fever, HypercapniaTreatment- Insulin, fluid bolus 500ml, followed by 250 ml-hr
Diabetes Mellitus-Defective insulin production or utilization
Type 1-pancreatic beta-cell destruction resulting in the body being incapable of producing insulin. Daily insulin is required.Type 2-cellular insulin resistanceStrict dietary control
Rhabdomyolysis-Breakdown of muscle tissue resulting in myoglobin being released into the bloodstream. Common in athletes, and prolonged falls and crush injuries.
Sx-Sy- dark urine output, localized muscle weakness, painRx- Calcium chloride 1 gram IV, Nebulized Albuterol (up to a max dose of 20 mg).
Addison’s Disease (Adrenal Insufficiency)-failure of the adrenal cortex to produce a sufficient amount of cortisol
RECENT USE OF CORTICO Sx-Sy-Fatigue, Anorexia, salt craving, increased pigmentation, muscle-joint pain-Rx-Glucocorticosteroids
Cushing Syndrome-Excess cortisol production or corticosteroid hormones
Sx-Sy- “Moon Face”, “Buffalo Hump”, Muscle wasting, bone thinning, weight gain or obesity, stretch marks, easy bruising, thin extremities, high blood pressure, hyperglycemia, thinning of skinRx- Supportive Care
Hypoparathyroidism- low serum levels of PTH or resistance to its actions.
Sx-Sy-Muscle spasm,paresthesia, tetany, Sz ( as a result of hypocalcemia)Rx-O2,IV,Monitor, BDZ for Sz, Calcium Chloride
Troussea Sign
pulling hand down like a bird hand puppet- LOW CALCIUM
Chostek Sign
abnormal face twitch- LOW CALCIUM
kussmaul resp
deep labored- keto acidosis
Hyperthyroidism-Hyperactivity of the thyroid gland
Sx-Sy- apprehension, agitation,edginess, heart palpitations, weight loss, heat intolerance, excessive sweating.SOB,Disorientation, ABD pain, Diarrhea, Chest pain, Palpable goiters, Cardiac failure,Fever,AMS,Jaundice,WeaknessRx-Supportive Care (O2,IV,Monitor)
Hypothyroidism- Decreased or absent function of the thyroid.
Sx-Sy- cool, dry, yellow skin and thin eyebrows, coarse hair, ataxia, altered mental, delayed reflexesRx- Supportive Care
Metabolic Acidosis- deficiency of Bicarb and excess hydrogen within the body.
Sx-Sy-N-V,ABD pain, rapid deep respiratory pattern,AMS,Shock, kussmaul respirationsRx-Supportive Care, Bicarb
Metabolic Alkalosis-the body retains bicarb in response to hydrogen and chloride loss, or renal impairment preclude the excretion of bicarb.
Sx-Sy-Anorexia,N-V,confusion, AMS,hypotension,paresthesia, weakness Rx-Supportive Care
Hyponatremia (Levels below 135 mEq-L)
Sx-Sy-agitation, dehydration,hallucination,weakness,lethargy,Sz,ABD pain,cramps,headacheRx- Fluid Resuscitation
Hypokalemia- Low Potassium (less than 3.5mEq-L)
Sx-Sy- FLAT T, ST depression, Weakness, N-V, lethargy, confusion, paresthesia,hypotension, dysrhythmiasRx-O2,IV,Monitor, IV Potassium
Hyperkalemia- (levels greater than 5.5 mEq-L)
Sx-Sy- TALL T WAVES- WIDE QRS-generalized weakness, muscles cramps, tetany,paralysis,palpitations, dysrhythmia.Rx-Sodium Bicarbonate 44mEq-L, Albuterol 5-20mg
Hypocalcemia-Low Calcium ( less than 4 mEq-L)
Sx-Sy- Sz, Hypotension, tetany, Dysrhythmia, Trousseau sign, chvostek sign.Rx- Calcium Chloride 100-300mg
Hypomagnesemia-Low Mag Levels (1.2 mg-dl or less), Common Electrolyte imbalance
Sx-Sy-Tremors,hyperreflexia,tetany,N-V-D, AMS, Sz, Torsades de Points, PVCs, cardiac arrestRx- Mag Sulfate 2 g IVPB
H1N1 influenza (Swine Flu)
SxSy - fever, chills, nonproductive cough, weakness, headache, sore throat.Treatment- Antiviral medication, supportive care.
Malaria
SxSy - Pain in abdomen or muscles, chills, fatigue, fever, night sweats, shivering-sweating. N-V-D. Fast heart rate, headache, mental confusion-pallorTreatment- Antiparasitic- Antibiotics. Prior to going to areas with high malaria cases, antimalarial drugs given.
Meningitis
SxSy - petechial rash, purpura, fever, headache, stiff neck, photophobia, AMS, LOC, N-V-D, tirednessTreatment- Vaccination for bacterial,
Chicken Pox (varicella)
SxSy - Blister, scab, ulcers, red spots, fatigue, fever, loss of appetite, headache, itching, sore throat, swollen lymph nodesTreatment- Analgesic, antiviral cream-powder, antihistamine
Mononucleosis (MONO)- Viral infection
SxSy - Pain when swallowing, fatigue, fever, chills, malaise, body aches. Sore throat, swollen lymph nodes-tonsils, headache, nausea.Treatment- Fluid replacement, NSAIDS-Analgesic. (No antibiotics)
Clostridium difficile (C. DIF)-A colon infection that thrives as a direct result of antibiotic suppression of normal gut flora.
SxSy -diarrhea that is not bloody but has a characteristic foul odor.Treatment- Stopping current antibiotics, fecal transplant
Tuberculosis
SxSy - Persistent cough, night sweats, weight loss, hemoptysis, chest pain. (incubation period of 4-12 weeks.)Treatment- Surgical mask for Pt, N95 for the provider. Routine Pt care
Influenza
Sx-Sy-nonproductive cough,sore throat,nasal discharge,fever,headache,Rx-Supportive Care, Antiviral in Hospital
Pneumonia-A viral,bacterial,fungal infection of the lungs
Sx-Sy-Cough,pleuritic chest pain,SOB,Increased WOB, Pulmonary crackles and rhonchi.Rx-Supportive Care
Respiratory Syncytial Virus (RSV)
Sx-Sy-Fever,wheezing,cough,decreased appetite, nasal congestionRx-Supportive Care, Monitor Respirations
Human Immunodeficiency Virus (HIV)
Sx-Sy-Headache,rash,swollen lymphs, mouth ulcers,Rx-Antivirals
Hep B
Sx-Sy: 1st- flu like symptoms. 2nd: whitish stool, jaundice, brown urine.Rx- Pharmacologic Interventions
Hep C- Commonly associated with dirty tattoo- piercing practices, needle sticks.
Sx-Sy- flu like Sy, ABD pain,fatigue, enlarged liverRx-12 weeks of oral medications
Norovirus- Winter Vomiting disease
Sx-Sy- GI complaints, N-V-D, projectile vomiting,fever - 2 daysRx-Supportive care, fluid resuscitation,antiemetics
Hep A - “Oral-Anal Transmission”
Sx-Sy-malaise,fatigue,V-D,fever, ABD discomfort, jaundice, whitish stool, brown urineRx-Supportive care, fluids, proper nutrition
E.Coli- illness brought upon by consuming improperly cooked food products
Sx-Sy-ABD pain-discomfort, myalgia,headache, watery, yellow-green stool, bloody stool, or stool that contains pusRx- Supportive care
Scabies-an infestation of parasitic mites
Sx-Sy- Nocturnal itching,rash on the hands, axillary folds, ankles,buttucks, genitals, buttocks.Rx-topical Permethrin and Lindane ointments.
Pediculosis (Lice)
Sx-Sy-Moderate to severe itching anywhere hair may grow, visible nits clinging to hair.Rx-Manual removal, lindane shampoo treatments for 7-10 days
Rabies- acute viral infection of the CNS
Sx-Sy-fever,malaise,headache, bite from an animal displaying unusual behavior.- adverse to water-cause throat spasmRx-Thoroughly cleaning of the wound, rabies shots.
Hantavirus-Rodent borne disease,
Sx-Sy-Hemorrhagic fever with renal syndrome signs lasting 3-8 days, followed by headache, ADB pain, N-V,facial flushing, petechial rash- ALBUMIN PRESENT DAY 4 (has person been near rodents?Rx-Supportive Care
Tetanus (Lockjaw)- when tetanus spores contact a wound via animal fecal matter, street dust, or soil
Sx-Sy-Painful muscle contractions of the neck and truck muscles, spasm of the jaw inhibiting the patient to open their mouth (Lockjaw), ABD spasmRx-Surgical debridement, Antibiotics
Lyme Disease
Sx-Sy: Early bulls eye rash around tick bite, NEXT lesions, fever, chills, enlarged spleen and lymph notes, LATE, arthritis, intermittent joint painRx- Antibiotics
Rocky Mountain Spotted Fever
Sx-Sy tickborn, fever NVM, headache, rash of small pink spots- could be fatalRx: antibiotics
Methicillin- Resistant Staphylococcus aureus (MRSA)
Sx-Sy: fever, redness, localized pain, red bumps,Rx- multiple meds
Rubeola (Measles)-
Sx-Sy- KOPLICK SPOTS (white gray on buccal mucosa) high fever, diarrhea, conjunctivitis, cough, nasal congestion and discharge,blotchy red rashRx-Supportive care with emphasis on Fld, antibiotics for ear and eye infections, and Vitamin A x2 t
Rubella (German Measles)
Sx-Sy-low grade fever, swelling of glands behind the ears and at the base of the neckRx-Supportive Care
Mumps-systemic illness caused by mumps virus
Sx-Sy-swelling-tenderness of the parotid glands, feverRx-Supportive care, analgesia, antipyretic medications
Pertussis (Whooping Cough)-Insidious respiratory tract infection.
Sx-Sy- WHOOPING - Fever, malaise, sneezing, paroxysmal spasmodic coughing fitsRx-Supportive Care, Respiratory support, Antibiotics,Tdap vaccine
Mild, moderate, severe hypothermia
SxSy - Shivering, low, slow respirations, low Sp02, low B-P, slow pulse, low core temp [68F-84F 20C-28C], [82.5F- 89.6F 28C-32C], [89F-95F 32C-35C] (severe to mild)Treatment- Remove from cold source passive warming, 02- Active warming, hot packs, warming blankets, warm fluids, reassess every 5 minutes.
Deep Frostbite
SxSy - Hemorrhagic blisters, diminished range of motion, necrosis, gangrene, cold, mottled, immobile tissueTreatment- Active rapid rewarming by immersion in water 104F 40C
Carbon Monoxide poisoning
SxSy - Sp02 saturation will be inaccurate. SpCO monitors, headache, N-V, cyanosisTreatment- High volume 02, Cyanokit
Cocaine Overdose-Partying Too Hard
Signs-Symptoms- dilated pupils, tremors, hyperthermia, polydipsia,Treatment-Supportive Care ( O2,FLD,BDZ)
Cyanide Poisoning
SxSy - “Cherry Red” Skin, Dyspnea, FALSE SPo2 readingTreatment- CyanoKit (Hydroxocobalamin). (NO AMYL NITRATE IN CO EXPOSURE)
Sepsis- Systemic infection that causes massive fluid shifts and 3rd spacing
SxSy - Temperature less than 96.8 ° F or greater than 100.4 ° F, Heart Rate greater than 90 bpm, Respiratory rate greater than 22 bpm, Systolic BP less than 90 mmHg OR Mean Arterial Blood Pressure (MAP) less than 65mm Hg, New-onset altered mental status OR increasing mental status change with previously, altered mental status. Serum Lactate level greater than 4 mmol-l, ETCO2 less than or equal to 25 mmHgTreatment- IV 0.9% NaCl 500 ml boluses up to 30cc-kg followed by a 250ml-hr infusion, Pressors (Epi, Norepi)
- Identify the complications of meningitis.
It is bacterial, viral or fungal infection of the meningesof the brain. Although not GI, SxSy nausea and vomiting. Bacterial has 20-50% mortality rate, is highly contagious and requires aggressive antibiotic treatment. Viral calls for supportive care. It is critical to wear PPE - MASK- impossible to discern between them in prehospital setting
- Identify a systematic approach to treatment for altered mental status presentations.
AEIOU-TIPPS - alcohol, epilepsy, insulin, overdose, underdose, trauma-tox, infection, psychiatric, poison, stroke, seizures, shock, sepsis
- Identify the etiologies and classifications of shock.
Hypovolemic: bleed (hemorrhagic) no bleed (non hem, dehydration). Distributive: Sepsis, Anaphylaxis, neurogenic. Cardiogenic: too fast, too slow, ACS. Obstructive: Cardiac tamponade, pulmonary embolism, tension pneumothorax
What are the three stages of shock?
Compensated, Decompensated, and irreversible
Compensated Shock
Compensated: Vitals ok, slight increase HR, delayed cap refill. Vasoconstriction maintains blood flow to essential organs, but ischemia occurs in less essential areas
Decompensated Shock
Decompensated: BP drops, Tachycard>120, Tachyp>30-40, Pulse Pressure up (sys-dias). BP drops as vascular tone decreases. Dysfunction to all organs is imminenet. Anaerobic metabolism ensues causing lactic acidosis
Irreversible shock
Irreversible: profound hypotension, lactate level >8 meq-L. Metabolic acidosis cuses postcapillary sphincters to open and release stagnant and coagulated blood. Excessive potassium and acid cause dysthythmias. Cellular damage is irreversible. Free radicals released.
Hypoglycemia: BGL< 45 mg-dL
·altered AMS; trembling, rapid pulse, sweat, and hunger; unexplainable agitation, irritability, combative behavior; nausea; weakness; cool clammy skin; headache; memory loss; incoordination; slurred speech; irritability; dilated pupils; Sz and coma in severe cases. TREATMENT- DEXTROSE, GLUCOSE,
Hyperglycemia: BGL > 350 mg-dL
AKADKA- Rapid heart rate; nausea-vomiting; vision problems; altered mental, fruity-smelling breath; dry mouth; weakness; abdominal pain; tachypnea-hyperpnea; increased diuresis; orthostatic hypotension; cardiac dysrhythmia; hemodynamic shock in severe cases. Immediate FLUID BOLUS (3-6 liters). RAPID VENTILATION, antiemetics, insulin therapy.
Hyperosmolar Hyperglycemic Nonketotic Coma (HONK)(HHNS): BGL > 600 mg-dL
· Fever; dehydration; vomiting and abdominal pain; hypotension; tachycardia; rapid breathing; thirst, polyuria or oliguria, polydipsia; focal Sz; altered LOC; focal neurological deficits
- Compare and contrast the signs and symptoms and treatment for respiratory distress and respiratory failure.
distress- struggling to breath, pale, abnormal sounds, failure - effort gone, poor to no air movement, coma-stupor, tachy to brady, cyanosis
Respiratory Distress
SxSy: tachypnea, nasal flaring, effort, inadwquate effort, abnormal sounds, pale cool skin, AMS, accessory muscles - as effort and function deteriorate- pt slips into resp failure.
Respiratory Failure
Sx-Sy: marked tachypnea, bradypnea, apnea, NO RESP EFFORT-exhaustion, poor or no air movement, tachycardia into bradycardia, cyanosis, stupor-coma.
- Identify the signs-symptoms of organophosphate poisoning.(SLUDGEM)
runny nose, cough, sweating, twitching, abdominal cramping, Drooling, weakness, Sz, AMS, apnea, weakness, localized sweating, eye pain, trouble seeing, wheezing, NVD,
SLUDGEM
Salivation, Lacrimation (secretion of tears), Urination, Defecation, Gastroenteritis, Emesis, and Miosis (pupil constriction).
- Define and give examples of various types of abdominal pain (visceral, somatic, referred, pleuritic).
Visceral: Deep, persistent, ache. Typically from the stomach, liver, or pancreas.Somatic: Sharp, discrete, localized. Caused by irritation of nerve fibers in the parietal peritoneum. Referred: Pain that originates from a different location. Cholecystitis, spleen, AMI. Pleuritic: Caused by irritation of the pleura. Sharp, stabbing, ribbing pain.
Visceral abdominal
Visceral: Deep, persistent, ache. Typically from the stomach, liver, or pancreas.
Somatic abdominal
Somatic: Sharp, discrete, localized. Caused by irritation of nerve fibers in the parietal peritoneum
Referred Abdominal
Referred: Pain that originates from a different location. Cholecystitis, spleen, AMI
Pleuritic abdominal
Pleuritic: Caused by irritation of the pleura. Sharp, stabbing, ribbing pain.
- Identify the components of the AMLS Pathway as it relates to patient assessment.
- Primary (sick - not sick, WOB, C&C, A&A), Secondary (H.P.V), Interventions
- Identify the differences in the signs-symptoms and treatment for an acute myocardial infarction (AMI) and angina pectoris presentations. Identify which parts of history are most important.
Angina pectoris is literally “CHEST PAIN.” it is caused by inadequate blood supply to heart. Stable angina pain, from exercise or stress, can be treated with nitroglycerin and rest, but could lead to AMI. With an AMI, the heart muscle begins to die, ischemia, from lack of oxygen supply. STAMP (no nitro or morphine if IWMI or RVI). This is treated at a cath lab. This is your traditional heart attack.
Classic Anginal Chest Pain- Typically Middle-Aged Men
central,anterior, pressure, tightness, crushing, radiate to arm, neck, back, jaw
Atypical Chest Pain- Typically Middle age women
epigastric discomfort, musculoskeletal, positional, pleuritic complaint, unilateral, sharp or stabbing
Anginal Equivalents
dyspnea, palpitations or fainting, syncope, DKA, general weakness
- Identify the most common means of prevention of transmission of infectious diseases.
Handwashing, proper PPE, vaccines, DECON equipment, post exposure protocols
- Identify communication barriers that affect obtaining thorough medical history.
Attitude of EMS provider, language barrier, hearing loss, LOC, conditions that inhibit speech-hearing (stroke, AMS)
- Identify the treatment for the unresponsive patient.
XABC’s, Glucose administration, opiod suspected, NALOXONE
- Identify the signs and symptoms of gastroenteritis.
Fever, ABD-GI pain, NVD, infection by microorganisms
- Identify the signs-symptoms and treatment of salicylate poisoning.
Gastric irritation, vomiting, pain, tinnitus, AMS, Hyperthermia, Hyperpnea, tachypnea, WIDE qrs, sine waves, AV block, GIVE ACTIVATED CHARCOAL!
- Describe the signs-symptoms of an opiate overdose.
constricted pupils, resp distress, bradypnea, gurgling-snoring, hypoxia, cyanosis, cool-pale-clammy, vomiting, LOC, hypercapnea- RX NALOXONE
- Contrast the signs-symptoms of hypoventilation and hyperventilation.
Hypoventilation: RR <10bpm, hypercapnia, cyanosis, May be to correct alkalosisHyperventilation: RR >20bpm, hypocapnia, May be to correct acidosis
Cerebrum
Cerebrum - cortex-subcortex (neural cortex or gray matter) outmost layer, highest functioning part of the brain. Right-Left hemispheres - controls opposite sides of the body. Lobes Frontal motor function, personality, elaborate thoughts, and speech. The Parietal bodily sensations, Temporal store long term memory and interprets sounds. Occipital sight.
FRONTAL LOBE
motor function, personality, elaborate thoughts, and speech.
Parietal lobe
The Parietal bodily sensations
Temporal lobe
Temporal store long term memory and interprets sounds.
Occipital lobe
Occipital lobe, sight
Cerebellum
Cerebellum - lower backside just above brain stem. movement, balance, posture
Diancephalon
Diencephalon - Thalamus-Hypothalamus, Thalamus - connects sensory input between the spinal cord, maintaining homeostasis
Thalamus
sleep wake transitions
Hypothalamus
hypothalamus controls homoestasis- houses the Pituitary and pinneal glands- releases hormones to control- sleep, hunger, thirst, emotions, BGL, and others
Brainstem
Brainstem - (Medulla) physiologic functions, (Midbrain) regulation of vision, hearing, body movement, and (Pons) connects the cerebellum to the medulla and is involved in posture and movement, sleep cycle.
Medulla
breathing and heart rate
Midbrain
regulation in vision, hearing, body movement
Pons
connects cerebellum to medulla- posture, movement and sleep
- Describe the components of the Cushing’s Triad.
· Hypertension, Bradycardia, Irregular breathing pattern· This indicates increased ICP and that death is imminent
Cullen’s sign
Cullen’s Sign-Bruising around the umbilicus. (Pancreatitis)
Kehr’s sign
Kehr’s Sign-Pain in shoulders when lying down and legs are elevated. (Ruptured spleen)
Rovsings sign
Rovsing’s Sign-Right lower quadrant abdominal pain when pressure is applied to the LLQ. (Appendicitis)
Murphy’s sign
Murphy’s Sign-Pt stops breathing in when palpation of the Right upper quadrant. (Cholecystitis)
Psaos Sign
Psoas Sign-Exacerbation of pain when the right leg is elevated while lying down. (Appendicitis)
STAMP
STAMP-Primary Assessment, Secondary Assessment, Serial 12 Leads, MONA-FONA PRN, 12 Q, Cardiac POE, Primary PCI
