Ch.15 Medical Overview Flashcards
Emergencies that are the result of physical forces applied to the body; injuries
Trauma emergencies
Involve illnesses or conditions caused by disease. Emergencies that are not caused by an outside force; illnesses or conditions
Medical emergencies
__ emergencies occur when patients have trouble breathing or when the amount of oxygen supplied to the tissues is inadequate. Diseases that can lead to___ emergencies include asthma, emphysema, and chronic bronchitis.
Respiratory emergencies
___emergencies are caused by conditions
affecting the circulatory system. The most common examples that require EMS intervention include heart attacks (myocardial infarction) and congestive heart failure.
Cardiovascular emergencies
__ emergencies involve the brain and may be caused by a seizure, stroke, or fainting (syncope).
Neurologic emergencies
Many ____ conditions can result in a call to EMS for help. A well-known gastrointestinal condition is appendicitis, although there are many others, including diverticulitis and pancreatitis.
Neurologic emergencies
A __ emergency can involve kidney stones or a bladder infection
Urologic emergency
The most common __ emergencies are caused by complications of diabetes mellitus
Endocrine emergencies
___ emergencies may be the result of sickle cell disease or various types of blood clotting disorders such as hemophilia
Hematologic (blood) emergencies
____emergencies involve the body’s response to foreign substances.
When the body overreacts to a foreign substance, it is commonly referred to as an allergic reaction. Allergic reactions are a type of___ medical emergency that can range from fairly minor to life threatening.
Immunologic emergencies
__ emergencies, including poisoning and substance abuse, result in other types of medical emergencies with various presentations.
Toxicologic emergencies
__ emergencies may be especially difficult to manage because patients often do not present with typical signs and symptoms. Alzheimer disease, schizophrenia, depression, suicide
Behavioral emergencies
___ conditions are a special category of medical emergencies that involve the female reproductive organs. Vaginal bleeding, sexually transmitted disease, pelvic inflammatory disease, ectopic pregnancy
Gynecologic emergency
Assessment of a medical patient is similar to the assessment of a trauma patient but with a different focus. Whereas trauma assessments focus on the mechanism of injury or physical injuries, some of which can be detected on a physical examination, medical patient assessment focuses on the___, symptoms, and the patient’s chief complaint.
When you are assessing a patient, establish an accurate medical history. Information received from dispatch can help you anticipate what you might find when you arrive on scene, but it is conceivable that what appears to be a traumatic emergency may in fact be a medical emergency, or vice versa.
nature of illness (NOl)
__ occurs when you become focused on one aspect of the patients condition and exclude all others, which may cause you to miss an important injury or illness
Tunnel vision
Loss of bowel and/or bladder control; may be the result of a generalized seizure
Incontinence
Evaluation of the NOl for a medical patient will provide you with an___ for different types of serious and/or life-threatening underlying illnesses. The___ is your awareness and concern for potentially serious underlying and unseen injuries or illnesses. Initiate spinal stabilization if indicated
index of suspicion
On entering the residence, your __ will tell you if the patient is “sick or not “. This determination will guide the speed and detail of your on scene assessment
General impression
During the reassessment, repeat the__ and reassess the__
primary assessment and reassess the chief complaint
Finally, the__ includes reviewing all treatments that have been performed. Reassess oxygen delivery, any
bandages or splints applied, and any other treatment that has been performed.
Document any changes that have developed as a result of the treatments, and, if needed, adjust any of the treatments accordingly.____ is an important step in patient assessment; it allows you to modify care as needed and ensures you have the most current information on the patient’s condition when you arrive at the hospital.
reassessment
Most medical emergencies require a level of treatment beyond that available in the prehospital setting. Also, the treatments depend on an accurate diagnosis of the exact medical condition, which may require advanced testing that is only available in a hospital. The primary prehospital treatments for medical emergencies address the__ more than the actual disease process.
symptoms
A medication that increases cardiac perfusion by causing blood vessels to dilate; EMTs may be allowed to assist the patient to self-administer this medication
Nitroglycerin
A miniature spray canister used to direct medications through the mouth and into the lungs
Metered-dose inhaler
Administration of medications that are stored in the ambulance is also limited for EMTs and is dependent on state and local protocols. A few of these protocols include administering aspirin for patients having chest pain, administering ora glucose to a patient with diabetes and a low blood glucose level, and possibly administering albuterol to a patient with respiratory difficulty. The administration of activated charcoal to a patient who has ingested a poison is also allowed when it may be beneficial. Each of these situations and any other administration of medication by an EMT require direct permission from__. The process of obtaining permission includes completing a thorough assessment of the patient before calling__. After you give a report to the physician and obtain permission, the medication may be administered.
Never administer any medication without first obtaining permission from__, and always follow your state and local protocols.
medical control
In many cases, the time on scene may be longer for __ patients than for trauma patients
Medical patients
__patients include those with altered mental status, airway or breathing difficulties, or any sign of circulatory compromise. In addition, a patient who is very old or very young may be considered critical even if the patient appears to be relatively stable.__ patients often need expeditious transport. The time on scene should be limited to 10 minutes or less for these patients.
Critical patients
Differentiating a high-priority transport from a low-priority transport is a skill developed with experience, but it is a skill that
can be learned. A general rule for determining the priority of transport is to consider the results of the patient’s primary assessment. Patients with an altered mental status, especially if it is still present at the completion of your assessment and treatment, should be considered a__ transport. Patients with circulatory compromise, including signs and symptoms of shock, should also be considered a___ transport. Most patients with circulatory problems cannot be stabilized in the prehospital setting and need to undergo treatment at a hospital quickly but safely. Patients with difficulty breathing often require high-priority transport. However, if the patient has responded well to your initial treatment, such as oxygen and albuterol administration, lights and siren may not be necessary.
high-priority transport
Modes of transport ultimately come in one of two categories:
Ground or air
___ transportation Ems units are generally staffed by EMTs and paramedics.
Ground
__ transportation Ems units or critical care transport units are generally staffed by critical care transport professionals such as critical care nurses and paramedics
Air transportation
In rural areas with long ground transport times, patients who have possibly experienced a heart attack, stroke, or complication of pregnancy could benefit from__ transport. Children with serious medical conditions can also benefit from__ transport.
When you are considering ALS support for a patient, compare the total time for a ground ALS unit to respond and transport to the time required for an ALS helicopter to respond and transport as well as the urgent resources needed by the patient.
Follow local protocols and medical direction.
air transport
Is a medical condition caused by the growth and spread of small, harmful organisms within the body.
Infectious disease
Is a disease that can be spread from one person or species to another
Communicable disease
Sharp, stabbing pain in the chest that is worsened by a deep breath or other chest wall movement; often caused by inflammation or irritation of the pleural
Pleuritic chest pain
An __Occurs when new cases of a disease in a human population substantially exceed the number expected based on recent experience
Epidemic
A __is an outbreak that occurs on a global scale. A flu__ occurs when a new influenza virus for which people have little or no immunity emerges. The disease can spread easily from person to person, cause serious illness, and be found in multiple countries in a short time. Because it is a new virus, there would be no specific vaccine immediately available.
pandemic
___,commonly known as flu, is primarily an animal respiratory disease that has mutated to infect humans. It can affect all people, but those with chronic medical conditions, compromised immune systems, the very young, and the very old are particularly susceptible to complications of the disease. All strains of____ are transmitted by direct contact with nasal secretions and aerosolized droplets from coughing and sneezing by infected people.
influenza
A virus that has crossed the animal/human barrier and infected humans and that kills thousands of people every year
Influenza
The__ virus, which was initially identified as the swine flu in 2009, is a specific form of influenza. Other viruses of concern include Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), COVID-19, which are discussed later. The__ virus has been present for years in animals. Many deaths have been caused by the__ virus, although deaths caused by other influenza viruses have also occurred. The most positive effect of the outbreak of the__ virus has been the general public’s greater awareness of the routes of transmission of contagious diseases. This increased awareness could result in a reduction of all communicable diseases, not only___.
H1N1 virus
Wear a ___or an___ mask during any aerosol-generating procedures such as suctioning of airway secretions, performing cardiopulmonary resuscitation, or assisting with endotracheal intubation.
HEPA respirator or an N95 mask
A common virus that is asymptomatic in 80% if people carrying it, but characterized by small blisters on the lips or genitals in symptomatic infections
Herpes simplex
__is a common virus strain carried by humans. Eighty percent of people carrying the virus are asymptomatic, but symptomatic infections cause eruptions of tiny fluid-filled blisters called vesicles that often appear on the lips or genitals.
__can cause more serious illnesses like pneumonia and meningitis in very young, very old, and immunocompromised patients. The primary mode of infection is through close personal contact, so standard precautions are generally sufficient to prevent spread to or from health care workers.
Herpes simplex
Acquired immunodeficiency syndrome (AIDS) is caused by __, which damages the cells in the body immune system so that the body is unable to fight infection or certain cancers
HIV
Fortunately,__ is not easily transmitted in your work setting. For example, it is far less contagious than hepatitis B although immunization for hepatitis B is important.__ infection is a potential hazard only when deposited on mucous membranes or directly into the bloodstream. Transmission can occur via sexual contact or exposure to blood or body fluids, meaning your risk of infection is limited to exposure to an infected patient’s blood and body fluids. Exposure can take place in the following ways:
• The patient’s blood is splashed or sprayed into your eyes, nose, or mouth or into an open sore or cut, however tiny; even a microscopic opening in the skin is an invitation for infection with a virus.
• You have blood from the infected patient on your hands and then touch your own eyes, nose, mouth, or an open sore or cut.
• A needle used to inject the patient breaks your skin. The risk to you from a single injection, even with a hollow-bore needle, is small, probably less than 1 in 1,000. However, this is by far the most dangerous form of exposure.
• Broken glass at a motor vehicle crash or other incident penetrates your glove (and skin), which may have already been covered with blood from an infected patient.
HIV
Inflammation of the liver, usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function
Hepatitis
The severity of__ hepatitis depends on the amount of agent absorbed and the duration of exposure. ___hepatitis is not contagious. There is no definitive way in the prehospital environment to tell which patients with hepatitis have a contagious form of the disease and which do not.
toxin-induced hepatitis
Hepatitis __ can be transmitted only from a patient who has an acute infection, whereas hepatitis B and C can b transmitted from long term carriers who have no sign of illness
Hepatitis A
Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury
Index if suspicion
A _ is a person (or animal) in whom an infectious organism has taken up permanent residence and may or may not cause any active disease. ___ may never know that they harbor the organism; however, they can infect other people
Carrier
On entering the residence, your __ will tell you if the patient is “sick or not.” this determination will guide the speed and detail of your on-scene assessment
General impression
Characteristics of hepatitis ___
Route of infection : fecal-oral infected food or drink. Incubation period is 2-6 wks. Chronic condition does not exist. Vaccine is available; no specific treatment is available; body will clear infection on its own. Mild illness; 2% of patients die; after acute infection, the patient has lifelong immunity
Hepatitis A
Characteristics of hepatits _
Blood, sexual contact, saliva, urine, breast milk. Incubation period 4-12wks. Chronic infection affects up to 10% of patients and up to 90% of newborns who have the disease. Vaccine is available;treatment is minimally effective. Up to 30% of patients may become chronic carriers; patients are asymptomatic and without signs of liver disease, but they may infect others; 1-2% of patients die
Hepatitis B
Characteristics of hepatitis __
Blood sexual contact. Incubation period 2-10wks. Chronic infection affects 90% of patients. No vaccine is available; treatment is costly but effective for many strains of hepatitis _. Cirrhosis of the liver develops in 50% of patients with chronic hepatitis _; chronic infection increases the risk of cancer of the liver
Hepatitis C
Characteristics of hepatitis __
Blood, sexual contact. Incubation period 4-12wks. Chronic infection is common. No vaccine available;no treatment available. Occurs only in patients with active hepatitis B infection; fulminant disease may develop in 20% of patients
Hepatitis D
Characteristics of __ hepatitis
Type : medications, drugs, and alcohol. Inhalation, skin or mucous membrane exposure, oral ingestion, or intravenous administration. Incubation period within hours to days following exposure. Some chemicals may initiate an inflammatory response that continues to cause liver damage long after the chemical is out of the body. No vaccine is available ; treatment is to stop exposure ; in patients with an overdose of acetaminophen, certain drugs may minimize liver injury if given early enough. This type of hepatitis is not contagious ; patients with __ hepatitis may have liver damage and jaundice; not every exposure to a toxin will cause liver damage
Toxin-induced hepatitis
Causes of infectious disease
Organism : ___
Grow and reproduce outside the human cell in the appropriate temperature and with the appropriate nutrients. Example: salmonella
Bacteria
Causes of infectious disease
Organism: __
Smaller than bacteria; multiply only inside a host and die when exposed to the environment. Example : influenza
Viruses
Causes of infectious disease
Organism: __
Similar to bacteria in that they require the appropriate nutrients and organic material to grow. Example : mold
Fungi
Causes of infectious disease
Organism:___
Single-celled microscopic organisms, some of which cause disease. Example: amoebas
Protozoa(parasites)
Causes of infectious disease
Organism:___
Invertebrates with long, flexible, rounded, or flattened bodies
Example: worms
Helminths (parasites)
Hepatitis __ is transmitted orally through oral or fecal contamination. Generally, you must eat or drink something that is contaminated with the virus.
Hepatitis A
Is the presence of an infectious organism on or in an object
Contamination
The organisms that cause hepatitis_ and__ are transmitted through vehicles other than food or water. For example, these organisms may enter the body through a transfusion or needlestick with infected blood, which puts health care workers at high risk for contracting hepatitis B, the more contagious and virulent form.
Hepatitis b and c
Is the strength or ability of a pathogen to produce disease
Virulence
Patients with track marks are at high risk for hepatitis_, hepatitis_, and_.
Hepatitis b, c, and HIV
__is an inflammation of the meningeal coverings of the brain and spinal cord. Patients with meningitis will have signs and symptoms such as fever, headache, stiff neck, and altered mental status. It is an uncommon but very frightening infectious disease.__ can be caused by viruses or bacteria, most of which are not contagious.
Meningitis
__, one form of meningitis, however, is highly contagious.__ is an inflammation of the meningeal coverings of the brain and spinal cord. The bacteria that cause __can be spread by the exchange of respiratory secretions through coughing and sneezing. The effects are lethal in some cases.
Victims who survive can be left with brain damage, hearing loss, or learning disabilities. Patients may present with flulike symptoms, but high fever, severe headache, photophobia (light sensitivity), and a stiff neck in adults are symptoms that are highly suggestive of meningitis. Patients sometimes have an altered level of consciousness and can have red blotches on the skin. Use respiratory protection, provide rapid transportation, and provide early notification to the ED so they can make specific preparations for accepting a highly contagious patient.
Meningococcal meningitis
Only laboratory tests can sort out the different forms of meningitis; therefore, you should take__ with any patient who is suspected of having meningitis.
standard precautions
A chronic bacterial disease, caused by mycobacterium tuberculosis, that usually affects the lungs but can also affect other organs such as the brain and kidneys; it is spread by cough and can lie dormant in a persons lungs for decades and then reactivate
Tuberculosis
Although tuberculosis is often hard to distinguish from other diseases, patients who pose the highest risk almost invariably have a cough. Therefore, for your safety, you should consider respiratory tuberculosis to be the only contagious form because it is the only one that is spread by__. The droplets produced by coughing are not the rea problem. The real problem is the droplet nuclei, which are the remnants of the droplets after the excess water has evaporated. These particles are tiny enough to be invisible and can remain suspended in the air for a long time. In fact, as long as these particles are shielded from ultraviolet light, they can remain alive for decades. Particles that are the size of droplet nuclei are not stopped by routine surgical masks. Inhaled, they are carried directly to the alveoli of the lungs, where the bacteria may begin to grow. N95 or HEPA masks are required to stop droplet nuclei
airborne transmission
The spread of an organism via droplets or dust
Airborne transmission
If you are exposed to a patient who is found to have pulmonary tuberculosis, you will be given a tuberculin skin test. This simple skin test determines whether a person has been infected with M tuberculosis, A positive result means that exposure has occurred; it does not mean that the person has active tuberculosis. It takes at least 6 weeks for the bacteria to show up in the laboratory test. So if you are tested for the disease within a few weeks of the exposure and your results are positive, this means that you were exposed to tuberculosis at an earlier time from somebody else. You will probably never identify the source. Most transmissions occur silently, so it is necessary that you have tuberculin skin tests regularly. If the infection is found before you become ill, preventive therapy is almost 100% effective. Usually, a daily dose of the medication__ will prevent the development of active infection.
isoniazid
___, also called pertussis, is an airborne disease caused by bacteria that mostly affects children younger than 6 years. Signs and symptoms include fever and a “whoop” sound that occurs when the patient tries to inhale after a coughing attack
Whooping cough
Also called whooping cough, An airborne bacterial infection that affects
mostly children younger than 6 years. Patients will be feverish and exhibit a “whoop” sound on inspiration after a coughing attack; highly contagious through droplet infection.
Pertussis
An infectious disease in which a pseudomembrane forms, lining the pharynx; this lining can severely obstruct the passage of air into the larynx
Diphtheria
__is a bacterium that causes infections and is resistant to many antibiotics.
In health care settings,___ is believed to be transmitted from patient to patient via unwashed hands of health care providers. Studies have shown that 5% to 15% of health care providers carry___ in their nares. Up to 65% of people presenting with hand infections from the community have_. In addition, children with no health care exposure present with_. The pathogen can subsequently be transferred to skin and other areas of the body through a break in the skin.
Surfaces contaminated with__ do not seem to be important in transmission. Factors that increase the risk for developing __ include antibiotic therapy, prolonged hospital stays, a stay in an intensive care or burn unit, and exposure to an infected patient. The incubation period for__ appears to be between 5 and 45 days. The communicable period varies, as patients who
have active infection may carry__ for months.__ results in soft-tissue infections. Its signs and symptoms may involve localized skin abscesses, and sepsis may be found in older patients with the infection.
Methicillin-resistant Staphylococcus aureus (MRSA)
A respiratory disease caused by the virus SARS-CoV-2. The virus is a coronavirus, similar to the one that causes the common cold
COVID-19
__is a virus most commonly found in bats and camels living in the Middle East. The first human case of__ was discovered in 2012 in Saudi Arabia. Although most clusters of human infections are found in the Middle East, reported cases of __have been found in Europe and the United States. Common patient symptoms include high fever, cough, muscle aches, vomiting, and diarrhea. In some cases, renal failure, respiratory failure, and death have been reported. There is currently no cure or vaccine for this virus. If you suspect your patient might have_, place a surgical mask on him or her, and notify the receiving facility.
MERS coronavirus (MERS-CoV)
The period of time between a person being exposed to an agent and the time when symptoms appear
Incubation
In 2014, an outbreak of the__ virus in West Africa caused international concern. Several infected people with the virus traveled to other countries, including the United States, motivating EMS and health care facilities to prepare for further outbreaks. The incubation period is approximately 6 to 12 days after exposure; however, symptoms may not begin to appear for as long as 21 days after infection. Symptoms include watery diarrhea, vomiting, fever, body aches, and bleeding. The fatality rate can be as high as 70% if effective supportive treatment in an intensive care unit is not initiated promptly. If you suspect your patient may have this condition, place a surgical mask on him or her and follow PPE precautions as outlined by local protocols and the CDC. Immediately notify the receiving facility that your patient may have or may have been exposed to the__ virus.
Ebola
