Entry ticket 15 Flashcards
Tension pneumothorax signs
Tracheal deviation - Very very late sign Difficult to ventilate Unequal breath sounds History of trauma, asthma, COPD Pt has shortness of breath Possible JVD Hyperresonant chest wall from percussion
What do SSRI’s treat?
SSRI - Selective serotonin reuptake inhibitors
Prescribed to treat: depression
Anxiety disorders
Panic disorders
OCD
Page 1478-1479
Management of Hypothermic cardiac arrest
- Avoid rough and excessive movement cause it could cause the heart rhythm issues
- Severely hyperthermia may cause defibrillators to not be effective
- Intubation could cause pt to go into VTAC
- Metabolism normally works at a specific temperature and can delay medication taking effect - mainly epinephrine
GABA
Gamma-amino butyric acid
It causes the post synaptic cleft to remain open longer to allow chloride in. The chloride makes it so that there needs to be more stimulation to continue down the nerve
Vaughn-Williams class 1
Sodium channel blocker
Lidocaine
Vaughn-Williams class 2
Beta blocker
Metoprolol
Vaughn-Williams class 3
Potassium channel blocker
Amiodarone
Vaughn-Williams class 4
Calcium channel blocker
Cardizem - atrial type problems
Vaughn-Williams class 5
Miscellaneous
Adenosine - we don’t fully understand how it works
Heat cramps S&S, management
page 1893-1895
S&S: slight ABD cramping, tingling in extremities, severe pain in extremities and ABD, nausea. Pt is alert. Skin pale, moist, temp normal
Management: -Move pt to cool environment.
-If able, give pt some electrolyte liquid slowly PO.
-NS IV if pt is too nauseated.
-Do not massage the cramping muscles as this may aggravate the pain.
Heat exhaustion S&S, management
page 1896
S&S: headache, fatigue, weakness, dizziness, nausea, vomiting, (sometimes) ABD cramping.
Management: -Remove pt to cool environment, remove excess clothing and place supine
-If pt’s temp is elevated, get pt slightly damp then fan pt. Do not over cool.
-If pt is able, give fluids PO. 1teaspoon salt, 2tablespoons sugar in 1 quart water
-NS IV if pt is nauseous
-If able, determine electrolyte and sodium levels
-If CBT is elevated, treat pt for heatstroke
Heat stroke S&S
page 1897-1898
Confused, Delirious, Comatose
Change in behavior; irritability, combativeness
signs of pt is hallucinating – this can confuse EMS by thinking its bahavioral or substance related emergency
Suspected stroke S&S – trouble walking, talking or using an arm or leg
Seizures, Constricted pupils, Tachycardia,
Hyperventilation, Low ETCO2
Low peripheral vascular resistance
Dry, red, hot skin for classic heatstroke
Pale, sweaty for exertional heatstroke
Heat stroke management
page 1898-1899
Management: If uncertain what is causing elevated temp, treat as heat stroke
Remove pt from hot environment
Start rapid cooling - total immersion of the body in cold or ice water
Spray water on pt and have air blowing on them to promote convection
Evaluate ABCDE
Start IV, administer NS, check sugar levels. Be careful with giving to much fluids
Monitor cardiac rhythm and be prepared to treat seizures
Mild hypothermia S&S, management
page 1903-1906
95F
S&S: Shivering, Fumbles – fine motor control problems
Stumbles, Mumbles
Crumbles – incoherence, hemodynamic collapse
Vague S&S: Increased heart rate, Increased resp rate
Management: Passive rewarming - removing wet clothes, drying skin, taking out of cold environment
If pt is able and depending on condition, consider letting the pt eat something to help the body generate heat
Keep the ambulance warm but not overly hot
Two types of heatstroke
Classic heat stroke
Usually occurs during heat waves
Most likely to strike very old, very young or people with reduced mobility
Exertional heatstroke
Typically an illness of young people exercising in hot and humid conditions
Afterdrop
Afterdrop is the continued lowering of the CBT even after the pt is removed from the cold. This happens from the body warming up and vasodilating which brings the cold fluids/blood back to the core.
Moderate hypothermia management
82-90F
Management:
Active external rewarming - heating blankets, focused hot air
Warmed IV fluids
Heated and humidified oxygen can help rewarm while using another method
Severe hypothermia management
Less than 82F Management: This really can only be treated in hospital Warm IV fluids Warm, humidified oxygen Cardiopulmonary bypass
Pharmacodynamic
Pharmacodynamic
The study of a drug’s molecular, biochemical, and physiologic effects or actions
Pharmacokinetic
Pharmacokinetic
The study of the time course of drug absorption, distribution, metabo- lism, and excretion
Dopaminergic receptors
Is an Alpha 1 agonist
When stimulated Vasoconstriction occurs
Dystonic reaction
Dystonic - muscle twitching/spasm
This is an Atypical allergic reaction to a medication
Treat with benadryl
Anticholinergics
Drugs that block the action of acetylcholine
Acetylcholine
Chief neurotransmitter of the parasympathetic nervous system, part of the autonomic nervous system that contracts smooth muscles, dilates blood vessels, increases bodily secretions, and slows heart rate
Anticholinergic toxicity S&S
S&S: Agitation, dry mucous membranes, flushed skin, hyperthermia, tachycardia, dilated pupils, blurred vision, mild hallucinations, dramatic delirium
“Hot as hell, blind as a bat, dry as a bone, red as a beet, and mad as a hatter”
Teratogenic drug
Drug that can cause birth defects.
Medical science cannot always predict how exposure to a teratogenic drug will affect a developing fetus.
Idiosyncratic reaction
Adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most pts, and develop mostly unpredictably in susceptible individuals only
Therapeutic index
A ratio that compares the blood concentration at which a drug becomes toxic and the concentration at which the drug is effective
Vaughn-Williams classification
Used to categorize antiarrhythmic drug therapy into classes based on mechanism of action
Inotropy
Increasing or decreasing the force of musclar contractions
Chronotropy
Adjective. affecting the rate or timing of a physiologic process
Dromotropic
Affects the conductivity of cardiac muscle - used of the influence of cardiac nerves
Snakebite management
Fluids
Immobilize where the snake bite is
Try to keep pt calm
Hymenoptera order
Stinging insects Yellow jacket Fire ants Bees Wasps Hornets
page 1927
Simple pneumothorax S&S
Difficulty breathing Diminished/unequal breath sounds Agitation AMS Tachypnea Tachycardia Cyanosis Lowered pulse oximetry Lower BP Absent breath sounds on affected side
Tension pneumothorax
Absent breath sounds on affected side Unequal chest rise Lower BP Tachycardia Dysrhythmias JVD (late sign) Narrow pulse pressure Tracheal deviation (very late sign) Difficult to ventilate Hyperresonant chest wall from percussion
Major thermal burn care
Fluids to replenish the plasma that can leak out of burns
Keep pts warm
Cover burn with something dry that will not stick to the wound to help reduce infection
Meds for pain management
insensible fluid loss
is the term for fluid loss from the respiratory system
SLUDGEM
Symptoms of nerve agents
Salivation Lacrimation - the flow of tears Urination Defecation / Diarrhea Gastrointestinal distress Emesis - throwing up Miosis - pupils constriction
Affinity
An attractive force between substances or particles
The attraction between two things
Efficacy
The ability of an intervention (for example, a drug or surgery) to produce the desired beneficial effect
Duration of action
The length of time that particular drug is effective
Half life
The time needed in an average person for metabolism or elimination of 50% of a substance (medication) in the plasma.
CCB
calcium channel blocker
Schedule 1 medication
High abuse potential; no recognized medical purpose
Ex: Heroin, marijuana, LSD
Schedule 2 medication
High abuse potential; legitimate medical purpose
Ex: Fentanyl, methylphenidate, cocaine
Schedule 3 medication
Lower potential for abuse than schedule 2 meds
Ex: Hydrocodone, acetaminophen with codeine, ketamine
Schedule 4 medication
Lower potential for abuse than schedule 3 drugs
Ex: diazepam, lorazepam (ativan)
Schedule 5 medication
Lower potential for abuse then schedule 4 drugs
Ex: narcotic cough meds
Med profile
The med profile describes all about the drugs
TCA
Tricyclic antidepressant
Used to treat depression, neuropathy, and chronic pain syndromes
