Chapter 22 Part 4 Flashcards
Nonjudgmental attitude
Maintain an open and accepting demeanor.
Patient reassurance
Confirm condition is drug-related, temporary.
Verbalization assistance
Help patient express their experiences.
Event timeline
Outline expected sequence of occurrences.
Concrete statements
Use clear, simple language for communication.
Orientation
Help patient recognize time, place, and people.
Self-identification process
Assist patient in recognizing familiar objects.
Forewarning about drug effects
Prepare patient for changing mental states.
Talk-down technique
Avoid using with PCP-affected patients.
Substance abuse emergencies
Result from recent or cumulative substance use.
Alcohol abuse treatment
Address acute intoxication and related conditions.
Drug withdrawal
Symptoms occur when drug use is reduced.
Drug tolerance
Increased doses needed for same effects.
Psychological dependence
Compulsive behavior focused on drug acquisition.
Physical dependence
Physiological changes require drug to avoid withdrawal.
Commonly addictive drugs
Include narcotics, alcohol, sedatives, cocaine.
Withdrawal symptoms onset
Begins when next dose is due.
Withdrawal symptoms peak
Usually peaks 24-48 hours after cessation.
Signs of withdrawal
Include anxiety, agitation, confusion, tremors.
Alcohol use disorder
Characterized by problem drinking and addiction.
Signs of intoxication
Odor of alcohol on the breath.
Caution with alcohol breath
May indicate other medical conditions.
Seizure risk in withdrawal
Withdrawal can lead to seizures and complications.
Swaying and unsteadiness
Loss of balance often seen in intoxication.
Slurred speech
Impaired verbal communication due to alcohol effects.
Nausea and vomiting
Common physical reactions to excessive alcohol consumption.
Flushed face
Redness of the face indicating possible intoxication.
Drowsiness
State of reduced alertness often caused by alcohol.
Erratic behavior
Unpredictable actions often linked to intoxication.
Self-injury
Harmful actions towards oneself, often unrecognized.
Alcohol as a depressant
Substance that slows down brain function and reaction.
Respiratory center paralysis
Severe alcohol overdose can stop breathing.
Vital signs monitoring
Constant assessment of patient’s health indicators.
Aspiration prevention
Positioning to avoid inhaling vomit during unconsciousness.
Alcoholism forms
Includes beer, wine, hard liquor, and other substances.
Sedative dependency
Common co-occurrence of alcohol and sedative abuse.
Withdrawal symptoms
Physical reactions after stopping alcohol intake.
Delirium tremens (DTs)
Severe alcohol withdrawal syndrome with confusion and tremors.
Blackout periods
Loss of memory during excessive drinking episodes.
Wernicke-Korsakoff syndrome
Brain disorder from alcohol toxicity and malnutrition.
Chronic gastric ulcer
Long-term stomach sores often related to alcohol.
Upper gastrointestinal hemorrhage
Severe bleeding in the esophagus due to varices.
Hypoglycemia
Low blood sugar levels, common in alcoholics.
Subdural hematoma
Blood accumulation between the brain and its outer covering.
Withdrawal syndrome
Symptoms occurring after reducing alcohol intake.
Cirrhosis of the liver
Severe liver scarring from long-term alcohol abuse.
Cardiomyopathy
Heart muscle disease linked to chronic alcohol consumption.
Alcohol Withdrawal Syndrome
Symptoms from abrupt cessation of alcohol use.
Dose-Dependent
Severity increases with higher alcohol consumption.
Delirium Tremens
Severe, life-threatening alcohol withdrawal stage.
Alcoholic Tremulousness
Stage 1 symptoms include tremors and insomnia.
Alcoholic Hallucinosis
Stage 2 characterized by visual and auditory hallucinations.
Withdrawal Seizures
Stage 3 seizures with alternating muscle rigidity.
Stage 1 Symptoms
Nausea, insomnia, sweating, and tremors.
Stage 2 Symptoms
Worsening symptoms with added hallucinations.
Stage 3 Symptoms
Major seizures occurring after last drink.
Stage 4 Symptoms
Delirium tremens with confusion and hyperirritability.
Mortality Rate of DTs
Approximately 15-20% if untreated.
Onset of DTs
Occurs 48-72 hours after last drink.
Duration of DTs
Lasts 1-5 days, can recur.
Signs of DTs
Severe confusion, tremors, and hallucinations.
Common Symptoms of Withdrawal
Insomnia, nausea, sweating, and hypertension.
Hyperthermia
Elevated body temperature during withdrawal.
Tachycardia
Rapid heartbeat often seen in withdrawal.
Opioids
Agents mimicking morphine effects, natural or synthetic.
Opiate
Natural agents derived from opium.
Narcotic
Broad term for agents inducing sleep.
Heroin
Naturally occurring opiate acting on opiate receptors.
CDC Overdose Data
Estimated overdose deaths increased significantly in 2021.
Opioid Overdose Deaths
Estimated 75,673 deaths in 12 months ending April 2021.
Increase in Opioid Deaths
Overdose deaths rose by 15% from previous year.
Synthetic Opioids
Man-made drugs mimicking natural opioids’ effects.
Fentanyl
Synthetic opioid, 50-100 times stronger than morphine.
Methamphetamine
Psychostimulant linked to increased overdose deaths.
Tramadol
Another commonly abused synthetic opioid.
Nitazenes
New class of synthetic opioids identified in forensics.
Carfentanil
Opioid used as anesthetic for large animals.
CNS Depression
Reduced central nervous system activity and responsiveness.
Respiratory Depression
Decreased respiratory rate and tidal volume.
Miosis
Constricted pupils, common in opioid toxicity.
Seizures
Can occur due to hypoxia from respiratory depression.
Dysarthria
Speech disturbance from facial muscle paralysis.
Ataxia
Incoordination resulting from hypoxia and cell injury.
Tremors
Involuntary muscle contractions due to hypoxia.
Crackles
Sounds from pulmonary edema related to hypoxia.
Hearing Loss
Altered metabolism affecting ear function.
Hypotension
Low blood pressure due to CNS depression.
Bradycardia
Slow heart rate resulting from CNS effects.
Nausea
Vomiting due to decreased gastrointestinal motility.
Urinary Retention
Inability to urinate from urethral sphincter spasm.
Pruritus
Itching caused by histamine release.
Naloxone
Medication used to reverse opioid overdose effects.
Emergency Medical Care
Focus on reversing respiratory and CNS depression.
Opioid Poisoning
Severe reaction to opioid drugs requiring emergency care.
Naloxone
Opioid antagonist used to reverse overdose effects.
Patient Care Goals
Rapid recognition and prevention of respiratory arrest.
Inclusion Criteria
Decreased mental status and respiratory depression present.
Exclusion Criteria
Altered mental status from non-opioid causes.
PPE
Personal protective equipment to prevent exposure risks.
Therapeutic Interventions
Support airway, breathing, and circulation before naloxone.
Medication Identification
Determine specific opioid taken and time of ingestion.
Cardiovascular History
Document patient’s cardiovascular and medication history.
Needle Stick Risk
Increased risk of exposure to blood-borne pathogens.
Intravenous Route
Preferred for naloxone due to predictable bioavailability.
Intranasal Route
Alternative naloxone delivery method for opioid overdose.
Intramuscular Route
Another option for administering naloxone effectively.
Assessment Steps
Evaluate airway, breathing, circulation, and mental status.
Oxygen Administration
Provide supplemental oxygen to support respiratory function.
Transdermal Opioids
Opioids delivered via adhesive patches should be removed.
Critical Resuscitation
Immediate airway and circulation support before naloxone.
Respiratory Depression
Condition warranting naloxone administration in overdose cases.
Titration of Naloxone
Incremental dosing until respiratory function is restored.
Adult Naloxone Dose
Typical initial dose ranges between 0.4-2 mg.
Pediatric Naloxone Dose
Pediatric dose typically 0.1 mg/kg for overdose.
Maximum Naloxone Dose
Maximum adult dose is 10 mg IM or ETT.
ETT Route
Endotracheal route used in dire overdose situations.
ETT Route
Endotracheal tube route for naloxone administration.
Adult Dose
Typical initial dose for adults, IM or ETT.
Pediatric Dose
Naloxone dose for children, IM, IN, or ETT.
Maximum Dose
Highest allowable dose for IM or ETT use.
Naloxone Access
Provided to laypersons via public access programs.
Auto-Injector
Pre-measured naloxone dose in an auto-injector.
Nasal Spray
Single-use bottle containing naloxone for intranasal use.
Mucosal Atomization Device (MAD)
Device for administering naloxone via needleless syringe.
Nasal Administration
Divide dose equally between nostrils, maximum per nostril.
Titration of Naloxone
Adjust naloxone dose until respiratory effort improves.
Cardiac Arrest Treatment
Naloxone ineffective; prioritize chest compressions and ventilations.
High-Potency Opioids
Require higher naloxone doses for respiratory depression.
Airway Management Goal
Ensure adequate oxygenation and ventilation during overdose.
Clinical Duration of Naloxone
Effect lasts about one hour; opioids longer.
Recurrent Respiratory Depression
Monitor patients post-naloxone for respiratory issues.
Opioid Withdrawal Symptoms
Agitation or violence may follow naloxone administration.
Scene Safety Measures
Prepare for potential violence post-naloxone use.
EMS Airway Management
Initiate airway support during naloxone administration.
Respiratory Depression
Key feature of opioid overdose requiring EMS intervention.
Opioid Toxic Effects
Some opioids cause additional toxicities like seizures.
Opioid Combinations
Opioids mixed with acetaminophen or aspirin.
Example of Opioid Combination
Vicodin: acetaminophen and hydrocodone.
Example of Opioid Combination
Percocet: acetaminophen and oxycodone.
Example of Opioid Combination
Percodan: aspirin and oxycodone.
Example of Opioid Combination
Suboxone: buprenorphine and naloxone.
Fentanyl Potency
Fentanyl is more potent than morphine.
Fentanyl
A potent synthetic opioid used medically and illegally.
Carfentanil
An opioid more potent than morphine, used for sedation.
Fentanyl analogs
Synthetic opioids similar to fentanyl, often illegal.
Intranasal route (IN)
Administration method avoiding needle stick injuries.
Miosis
Pinpoint pupils, a sign of opioid overdose.
Respiratory depression
Decreased breathing rate, common in opioid overdose.
Naloxone
Opioid antagonist used to reverse opioid effects.
Positive end-expiratory pressure (PEEP)
Ventilation technique to improve oxygenation in overdose.
Analgesia
Primary indication for opioid medications, pain relief.
Hypoxia
Low oxygen levels in the blood, dangerous condition.
Hypercarbia
Excess carbon dioxide in the bloodstream.
Pediatric considerations
Opioid overdose signs may appear in newborns.
Suction airway
Emergency step to clear obstructed breathing.
Positive pressure ventilation
Technique to assist inadequate breathing.
Oxygen administration
Providing supplemental oxygen to maintain adequate levels.
Intramuscular injection
Common route for naloxone administration.
Mucosal atomizer device
Device for intranasal naloxone delivery.
Respiratory distress
Difficulty breathing, requiring immediate medical attention.
Bradycardia
Slow heart rate, a potential opioid overdose symptom.
Hypotension
Low blood pressure, often seen in overdose cases.
Acetyl fentanyl
A fentanyl analog associated with illegal drug use.
Synthetic opioids
Man-made opioids, often more potent than natural ones.
Chest wall rigidity
Stiffness in chest muscles, common in fentanyl overdose.
Naloxone trade name
Narcan, used for opioid overdose treatment.
Contraindication
Known hypersensitivity to naloxone only.
Medication Form
Liquid form for various administration routes.
Administration Routes
Intranasal, intravenous, subcutaneous, intramuscular, endotracheal.
Intranasal Route
Commonly used route by EMTs for naloxone.
Naloxone Auto-Injector
Device for easy naloxone administration.
Typical Dose
Dosage varies by administration route.
Mucosal Atomization Device (MAD)
Device for intranasal naloxone delivery.
Patient Restraint
Consider restraining aggressive patients post-administration.
Reassessment
Monitor airway, respirations, and vital signs post-naloxone.
Opioid Receptors
Naloxone competitively binds to block opioid effects.
Side Effects
Includes headache, hypertension, and nasal inflammation.
Acute Opioid Withdrawal
Possible side effect after naloxone administration.
Respiratory Depression
Primary concern to monitor after naloxone use.
Hypotension
Low blood pressure to assess post-naloxone.
Bradycardia
Slow heart rate monitored after naloxone administration.
Redosing
Repeat naloxone if respiratory depression persists.
PCP
Dangerous hallucinogen with multiple street names.
Emergency Consequences
Unique effects of commonly abused drugs.
Commonly Abused Drugs
Includes PCP, cocaine, amphetamines, and MDMA.
Monitoring During Transport
Carefully observe patient for stability en route.
Naloxone Administration Steps
Follow specific steps for effective naloxone delivery.
Local Protocol
Follow regional guidelines for naloxone use.
PCP
A cheap drug causing severe psychological effects.
Body Fat Storage
PCP is stored in body fat, releasing upon weight loss.
Cocaine
Commonly used drug with serious medical complications.
Forms of Cocaine
Inhaled, injected, smoked, or free-based forms exist.
Crack Cocaine
Almost pure cocaine that is smoked.
Cocaine Addiction
Cocaine is highly addictive and can cause fatal overdoses.
Amphetamines
Stimulants available in tablets, powders, or crystals.
Methamphetamines
A potent form of amphetamines, often smoked or injected.
Street Names for Methamphetamines
Known as crank, go, ice, or crystal.
Hallucinogenic Amphetamines
Cause hallucinations and are often ingested.
Street Names for Hallucinogens
Includes Adam, ecstasy, Eve, and tranquility.
Central Nervous System Stimulant
Amphetamines stimulate the CNS, causing excitement.
Methamphetamine Effects
Can cause hyperthermia, muscle rigidity, and hallucinations.
Skin Sensation
Users may feel bugs crawling under their skin.
PABS (Bath Salts)
Synthetic drugs with stimulant properties, not hygiene-related.
PABS Effects
Similar to methamphetamine and cocaine, causing severe symptoms.
Tolerance and Withdrawal
Long-term use of PABS leads to tolerance and cravings.
PABS Administration Routes
Users can snort, inject, smoke, or ingest PABS.
Sympathetic Stimulation
PABS can cause tachycardia, hypertension, and hyperthermia.
Altered Mental Status
PABS use leads to paranoia, agitation, and hallucinations.
MDMA (Ecstasy)
Psychoactive drug producing empathy and euphoria.
MDMA Street Names
Also known as E, X, XTC, and Smarties.
MDMA Usage
Typically taken orally, effects last several hours.
Rave Culture
MDMA is popular in clubs and festivals.
Dehydration
Loss of body water, often from sweating.
Hyperthermia
Dangerously high body temperature.
Bruxism
Clenching and grinding of teeth.
Insomnia
Inability to sleep or stay asleep.
Increased perspiration
Excessive sweating beyond normal levels.
Tachycardia
Abnormally rapid heart rate.
Hypertension
Elevated blood pressure above normal.
Loss of appetite
Reduced desire to eat food.
Nausea
Feeling of sickness with an urge to vomit.
Diarrhea
Frequent, loose, or watery bowel movements.
Mydriasis
Dilated pupils, often due to drug use.
Anxiety
Intense worry or fear about future events.
Paranoia
Irrational distrust or suspicion of others.
Restlessness
Inability to remain still or calm.
Memory impairment
Difficulty recalling information or events.
Depression
Persistent feelings of sadness and loss of interest.
Intracranial hemorrhage
Bleeding within the skull, can be life-threatening.
Acute respiratory distress syndrome
Severe lung condition causing breathing difficulties.
Cerebral edema
Swelling of the brain due to fluid accumulation.
Hyperpyrexia
Extreme elevation of body temperature.
Cheyne-Stokes respirations
Pattern of breathing with cycles of apnea.
Tetrahydrocannabinol (THC)
Main psychoactive component in cannabis.
Cannabis
Plant used recreationally or medicinally for psychoactive effects.
Short-term memory decrease
Loss of recent memory function.
Dry mouth
Reduced saliva production leading to thirst.
Impaired motor skills
Decreased coordination and physical control.
Reddening of the eyes
Increased blood flow causing eye redness.
Tachycardia
Increased heart rate above normal.
Decrease in blood pressure
Lowered blood pressure levels.
Auditory illusions
False perceptions of sounds.
Visual illusions
False perceptions of visual stimuli.
Pseudohallucinations
Vivid sensory experiences recognized as unreal.
Ataxia
Lack of muscle coordination during voluntary movements.
Onset of effects
Begins within minutes when smoked.
Duration of effects
Effects can last several hours.
Medical marijuana
Used to alleviate symptoms of specific diseases.
THC toxicity
Low toxicity, not directly fatal.
Synthetic cannabinoid
Manufactured chemical mimicking THC effects.
New psychoactive substance (NPS)
Unregulated substances with mind-altering effects.
Herbal incense
Dried plants sprayed with synthetic cannabinoids.
Synthetic marijuana
Legal alternative to natural marijuana.
Common brand names
Includes K2, Spice, Joker, and others.
Addictive nature
Regular use leads to dependence and withdrawal.
Cannabinoid Hyperemesis Syndrome
Recurrent nausea and vomiting in chronic users.
Hot shower relief
Temporary symptom relief from hot showers.
Cessation effects
Stopping cannabis use eliminates symptoms.
Acute episode duration
Typically lasts days to weeks.
Hypothalamus role
Regulates body temperature and digestive function.
Cannabinoid Hyperemesis Syndrome
Condition causing severe nausea from long-term cannabis use.
Long-term cannabis use
Daily to weekly marijuana use over several years.
Cyclic vomiting
Vomiting occurs in a repeated pattern over months.
Colicky abdominal pain
Crampy abdominal pain associated with cannabinoid hyperemesis.
Periumbilical pain
Pain located around the umbilical area.
Epigastric pain
Pain in the upper central region of the abdomen.
Symptom relief with hot showers
Hot baths alleviate symptoms temporarily.
Symptom elimination after cessation
Stopping cannabis use resolves symptoms completely.
Emergency care focus
Ensure adequate airway, ventilation, oxygenation, circulation.
Signs of dehydration
Vomiting and frequent hot baths cause fluid loss.
Acute renal failure
Severe complication from untreated cannabinoid hyperemesis.
Medication overdose
Excessive intake of prescription or over-the-counter drugs.
Intentional overdose
Patient overdoses to achieve a desired effect.
Accidental overdose
Unintentional excessive drug intake due to misunderstanding.
Synergistic drug interactions
Combined effects of multiple medications can be dangerous.
Common overdose medications
Includes cardiac, psychiatric, OTC pain relief drugs.
Bradycardia
Slow heart rate, often seen in beta blocker overdose.
Hypotension
Low blood pressure, common in certain overdoses.
Acetaminophen overdose
Initially asymptomatic but can cause severe liver damage.
Huffing
Inhaling substances to achieve psychoactive effects.
Toluene
Common chemical used in huffing, found in paints.
Effects of huffing
Causes pleasure, muscle coordination issues, altered mental status.
Hypoxia
Oxygen deficiency due to inhaled toxins displacing oxygen.
Physical exam indicators
Look for paint or residue on lips or nose.
Huffer
Individual who inhales substances to get high.
Toluene
Chemical commonly found in paints and glues.
Freon
Refrigerant gas often misused for inhalation.
Gas Propellants
Substances used to propel aerosol products.
Inhaled Poisons
Substances that cause immediate systemic effects.
Respiratory Compromise
Condition where lung function is severely impaired.
Decontamination
Process of removing toxins from the body.
Toxidrome
Clinical syndrome associated with specific poison exposure.
Organ Impairments
Damage to heart, brain, or kidney functions.
Antidote
Substance that counteracts poison effects.
Patient Care Goals
Objectives for treating poisoning and overdose cases.
Absorption Symptoms
Nausea, vomiting, and altered mental status.
Ingestion Symptoms
Chemical burns, nausea, and respiratory depression.
Vital Function Loss
Deterioration of airway, breathing, or circulation.
Emergency Transport
Rapid transfer to medical facility for treatment.
Systemic Effects
Widespread effects throughout the body from toxins.
Respiratory Distress
Difficulty breathing due to lung damage.
Seizures
Neurological episodes caused by toxin exposure.
Dilated Pupils
Enlarged pupils indicating potential poisoning.
Chemical Burns
Tissue damage from exposure to harmful substances.
Sweating
Excessive perspiration often linked to poisoning.
