Final Study Guide Flashcards
Define integrity
the quality of being honest and having strong moral principles; moral uprightness.
Define empathy
the ability to understand and share the feelings of another.
Define self motivation
the force that keeps pushing us to go on – it’s our internal drive to achieve, produce, develop, and keep moving forward
Define communication
the imparting or exchanging of information or news.
Define teamwork
the combined action of a group of people, especially when effective and efficient.
Define respect
due regard for the feelings, wishes, rights, or traditions of others.
Define patient advocacy
offer independent support to those who feel they are not being heard and to ensure they are taken seriously and that their rights are respected.
Define injury prevention
an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur.
Define careful delivery of service
Mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.
Define professionalism
the competence or skill expected of a professional.
How does cortisol affect the body in relation to stress response?
It is released during times of stress, increasing heart rate, blood pressure, blood glucose, respiration and muscle tension in response. It also temporarily shuts down the body’s systems that aren’t needed in the face of crisis, such as digestion and reproduction.
Define critical incident stress
refers to the range of physical and psychological symptoms that might be experienced by someone as a result of being involved in a traumatic critical incident.
What are the S/S of critical incident stress?
poor concentration, nightmares, blaming attitude, anxiety, guilt, anger, depression, emotional outbursts, change in activity level, easily startled, withdrawal, substance use, change in sleep pattern.
Define burnout
a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.
What are the S/S of burnout?
fatigue, insomnia, excessive stress, sadness, irritability, substance misuse, high blood pressure, vulnerability to illnesses
Define PTSD
a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.
What are the S/S of PTSD?
- Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
- Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
- Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.
Define beneficence
an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation.
Define non-malfeasance
there is an obligation not to inflict harm on others
Define autonomy
the right or condition of self-government.
Define justice
just behaviour or treatment.
Define emergency moves
When you must move a patient before making an assessment or immobilizing the spine due to hazards on the scene, a need to reposition the patient in order to provide life saving care, or in order to reach critical patients.
Define patient positioning
properly maintaining a patient’s neutral body alignment by preventing hyperextension and extreme lateral rotation to prevent complications of immobility and injury.
Define nonverbal communication
refers to gestures, facial expressions, tone of voice, eye contact (or lack thereof), body language, posture, and other ways people can communicate without using language.
What is the importance of eye contact?
a meaningful and important sign of confidence, respect, and social communication.
How do you actively listen?
Pay Attention. Give the speaker your undivided attention, and acknowledge the message Show that you're listening Provide feedback Defer judgment Respond appropriately
What are pertinent negatives?
a sign or symptom that might be expected based on the patient’s chief complaint that the patient denies having
How is AIDS transmitted?
through AIDS or HIV infected blood via IV drug use, semen, or vaginal fluids, blood transfusions, or needle sticks.
Also, mothers to their unborn children
How long is the incubation period for AIDS?
several months or years
How is hepatitis A transmitted?
fecal-oral route -unsafe water or food -inadequate sanitation -poor personal hygiene oral-anal sex
How long is the incubation period for hepatitis A?
14-28 days
How is hepatitis B transmitted?
mother to child at birth exposure to infected blood and body fluids: needlestick tattooing piercing saliva menstrual, vaginal, and seminal fluids
How long is the incubation period for hepatitis b?
1.5-6 months
How is tuberculosis transmitted?
respiratory secretions, airborne or on contaminated objects
How long is the incubation period for tuberculosis?
2-6 weeks
How is bacterial meningitis transmitted?
oral and nasal secretions
How long is the incubation period for bacterial meningitis?
2-10 days
How is pneumonia transmitted?
oral and nasal droplets or secretions
How long is the incubation period for pneumonia?
several days
How is influenza transmitted?
airborne droplets, or direct contact with body fluids
How long is the incubation period for influenza?
1-3 days
How are staphylococcal skin infections transmitted?
contact with open wounds or sores or contaminated objects
How long is the incubation period for staphylococcal skin infections?
several days
How is chicken pox transmitted?
airborne droplets, or contact with open sores
How long is the incubation period for chicken pox?
11-21 days
How is rubella transmitted?
airborne droplets
Mothers may pass it to unborn children
How long is the incubation period for rubella?
10-12 days
How is whooping cough transmitted?
respiratory secretions or airborne droplets
How long is the incubation period for whooping cough?
6-20 days
What is an incubation period?
the number of days between when you’re infected with something and when you might see symptoms
What are the PPE requirements for Contact Precautions?
gloves
gown
What are the PPE requirements for Droplet Precautions?
mask on the patient
mask
face shield/ safety glasses
What are the PPE requirements for Airborne Precautions?
mask on the patient
N95
Define pharmacology
the branch of medicine concerned with the uses, effects, and modes of action of drugs
Define pharmacokinetics
the branch of pharmacology concerned with the movement of drugs within the body
Define pharmacodynamics
the branch of pharmacology concerned with the effects of drugs and the mechanism of their action
What is the onset of action for IV medication
30-60s
What is the onset of action for IO medication?
30-60s
What is the onset of action for inhalation medications?
2-3 minutes
What is the onset of action for SL medications?
3-5 minutes
What is the onset of action for IM medications?
10-20 minutes
What is the onset of action for SQ medications?
15-30 minutes
What is the onset of action for PO medications?
30-90 minutes
How do you calculate IV flow rate?
volume to be infused x set rate (gtts)
____________________________
time in minutes
What are the 6 Rights of Drug Administration?
Right person Right drug Right route Right time Right dose Right documentation
What is an example of an anti inflammatory drug?
NSAIDs
aspirin, ibuprofen, naproxen
What is an anti-infective drug?
a general term used to describe any medicine that is capable of inhibiting the spread of an infectious organism or by killing the infectious organism outright.
What is an example of an anti-infective drug?
antifungals or antibiotics
amoxicillin
What is an example of a corticosteroid?
prednisone, cortisone
What are analgesics?
a class of medications designed specifically to relieve pain.
What is an example of an analgesic?
acetaminophen, entonox
What are vasodilators?
medications that open (dilate) blood vessels.
What is an example of a vasodilator?
ramipril, nitro
What is an antiemetic drug?
a drug that is effective against vomiting and nausea.
What is an example of an antiemetic?
gravol
What is an anticonvulsant drug?
a diverse group of pharmacological agents used in the treatment of epileptic seizures.
What is an example of an anticonvulsant drug?
clonazepam, diazepam
What are antipsychotic drugs?
a class of medication primarily used to manage psychosis, principally in schizophrenia but also in a range of other psychotic disorders.
What is an example of an antipsychotic drug?
haldol, risperidone
What are antispasmodic drugs?
a pharmaceutical drug or other agent that suppresses muscle spasms.
What is an example of an antispasmodic drug?
atropine
What are antiarrhythmic drugs?
prevent and treat abnormal heartbeats
What is an example of an antiarrhythmic drug?
amiodarone
What are sedative/hypnotic drugs?
commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and for the treatment of insomnia (sleeplessness), or for surgical anesthesia.
What is an example of a hypnotic drug?
ambien
Define cumulative effect
The state at which repeated administration of a drug may produce effects that are more pronounced than those produced by the first dose.
Define synergistic effect
when two or more “unlike” drugs are used together to produce a combined effect.
Define drug tolerance
when a regular user of a drug gradually becomes less responsive to the drug.
Define drug incompatibility
an undesirable reaction that occurs between the drug and the solution, container or another drug
Define antagonistic effect
The effect produced by the contrasting actions of two (or more) chemical groups.
Define adverse reaction
any unexpected or dangerous reaction to a drug.
Define drug toxicity
the level of damage that a compound can cause to an organism.
Define 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 patients, and develop mostly unpredictably in susceptible individuals only.
Define drug allergic reaction
the abnormal reaction of your immune system to a medication.
Define anaphylaxis reaction
a sudden, life-threatening, whole-body reaction to a drug or other allergen.
Define additive effect
the effect of two chemicals is equal to the sum of the effect of the two chemicals taken separately.
Define side effect
an effect, whether therapeutic or adverse, that is secondary to the one intended
What are the indications for IV initiation?
replace fluid and electrolytes due to hypovolemia and burns
administer medications
What equipment is required for starting an IV?
catheter device IV solution IV administration set IV tubing tape tegaderm tourniquet alcohol swabs
What are the steps to setting up an IV?
- Gather and prep equipment:
- select and inspect catheter device
- select and inspect the IV solution and administration set
- prime the IV tubing - Choose and prepare an appropriate site
- Initiate IV
- Connect IV tubing and infuse solution
- Calculate and maintain an appropriate flow rate
- Secure the IV
What are some aseptic techniques used with IV administration?
- disinfecting a patient’s skin using antiseptic wipes
- sterilizing equipment and instruments before a procedure
- keeping sterilized instruments inside plastic wrappers to prevent contamination before use
- use appropriate PPE
What are the s/s of an air embolism after you start an IV?
respiratory distress with unequal breath sounds
cyanosis (even in the presence of high flow o2)
s/s of shock
loss of consciousness
respiratory arrest
What is the treatment of an air embolism after you start an IV?
place the patient on their left side with the head down to trap any air inside the right atrium or right ventricle
administer 100% o2
RTC
be prepared to assist in ventilations.
What are the s/s of circulatory overload after you start an IV?
dyspnea JVD HTN crackles (rales) acute peripheral edema
What is the treatment of circulatory overload after you start an IV?
slow the IV rate TKVO
raise the patient’s head
high flow O2
What are the s/s of thrombophlebitis?
pain, swelling, tenderness, warmth, and the arm or leg is restless.
What is the treatment for thrombophlebitis?
stop the infusion
discontinue the IV at that site
warm compresses
What are the s/s of infiltration after you start an IV?
edema at the cannula site
continued IV flow after occlusion of the vein above the IV site
patient reports tightness and pain around the IV site
What is the treatment for infiltration after you start an IV?
discontinue IV line
reestablish IV in the opposite extremity or in a more proximal location on the same extremity
apply direct pressure over the swollen area
do not wrap tape around the area
What are the s/s of an allergic reaction after you start an IV?
pruritis SOB edema of face and hands hives bronchospasms wheezing
What is the treatment for an allergic reaction after you start an IV?
discontinue IV line remove the solution leave the cannula in place as an emergency medication route attach a saline lock notify medical control maintain ABCs
What are the s/s of catheter shear after you start an IV?
sudden dyspnea
SOB
diminished breath sounds
What is the treatment for catheter shear after you start an IV?
left lateral recumbent position with the legs down and the head up
these patients need continued IV access, you must try to obtain an IV start in the other extremity.
What is the classification of ASA?
platelet inhibitor
antiplatelet
What are the indications for ASA?
chest pain or atypical symptoms consistent with cardiac ischemia /AMI
What are the contraindications for ASA?
known hypersensitivity or allergy to ASA or other NSAIDs
asthma
pediatric patients with viral symptoms
What is the onset of ASA?
20 minutes-1 hour if chewed
What is the dose of ASA?
160mg PO
What are the cautions of ASA?
recent internal bleeding known bleeding diseases patient is currently taking anticoagulants recent surgery possibility of pregnancy
What is the classification of D10W?
antihypoglycemic agent
carbohydrate substrate
What are the indications for D10W?
suspected or known hypoglycemia
altered level of responsiveness
coma or seizure NYD
What are the contraindications for D10W?
none
What is the onset of D10W?
immediate
What is the dose of D10W?
10-25g (100-250ml of 10% solution)
What are the cautions for D10W?
extravasation causes tissue necrosis
What is the classification of Nitro?
vasodilator, antiaginal
What are the indications for Nitro?
Chest discomfort that appears cardiac in nature
What are the contraindications for Nitro?
SBP <90mmHg
Known allergy or sensitivity to nitrates
Patient has used Viagra or Levitra in the past 24 hours
Patient has used Cialis in the past 48 hours.
What is the onset and duration of Nitro?
60 seconds with a 30 minute duration q3min
What is the dose of Nitro?
0.4mg in one spray
What are the cautions for Nitro?
Hypotension is common in older adults, so ensure the patient is not at risk to fall.
What can you do if chest pain is completely relieved for more than 5 minutes after giving Nitro, and then comes back?
restart the chest pain protocol
How many times can you repeat the Nitro dose?
Repeat vitals and drug until pain is relieved, to a max dose of 3 in any 30 minute period.
What is the classification of dimenhydrinate?
Anti-emetic
Anti-histamine
Anti-cholinergic
Anti-vertigo
What are the indications for dimenhydrinate?
Prevention or control of nausea, vomiting, and vertigo.
What are the contraindications for dimenhydrinate?
hypersensitivity or allergy to dimenhydrinate
What is the onset of dimenhydrinate?
IM 20-30 minutes
IV immediate
What is the route and dose of dimenhydrinate?
IM/IV 1mg/kg to a max dose of 50mg
IM undiluted
IV dilute with NS and inject over 2 inutes. Draw up 50mg of gravol using a 10ml syringe then draw up an additional 9ml NS.
Elderly-12.5mg
What are the cautions for dimenhydrinate?
Glaumcoma Asthma/COPD CVD Prostatic hyperplasia and urinary obstruction Elderly Pregnancy
What is the classification of glucagon?
Glucose elevating agent
What are the indications for glucagon?
Hypoglycaemia
When IV access attempts have been unsuccessful
What are the contraindications for glucagon?
Allergy or hypersensitivity to glucagon
What is the dose for glucagon?
IM 0.5mg-1mg
What is the onset for glucagon?
IM 8-10 minutes
What are the cautions for glucagon?
N/V Hypokalemia Urticaria Respiratory distress Hypotension
What is the classification for TXA?
Hemostatic agent
Antifibrinolytic agent
What are the indications for TXA?
Major trauma patients after initiation of the hypovolemia protocol
Signs of shock in association with MOI or physical findings suggestive of occult or ongoing bleeding.
What are the contraindications for TXA?
Known hypersensitivity or allergy to TXA
If time is greater than 3 hours after injury
Patient is less than 12 years old.
What is the dose and route for TXA?
IV piggyback 1g in 50ml NS, 60gtts/min
IVP 1g in 10ml NS, deliver over 10 minutes.
What is the onset of TXA?
immediate
What are the cautions for TXA?
Further hypotension if administered too quickly.
What is the classification of Entonox?
Non narcotic analgesic
What are the indications for Entonox?
Relief of moderate to severe pain
Cardiac related chest pain where nitro will be of no value or is contraindicated
Isolated extremity injuries.
What are the contraindications for Entonox?
Decompression illness Inhalation injuries Ventilation Inability to comply Nitro in the last 5 minutes Embolism or pneumothorax
What is the route and dose of Entonox?
Inhalation-self administered
What is the onset of Entonox?
rapid
What are the cautions for Entonox?
COPD Facial injuries Abdominal distension Depressant drugs Shock
What is the classification of diphenhydramine?
Anti-histamine
What are the indications for diphenhydramine?
Adjunct treatment of allergic reactions
Motion sickness
What are the contraindications for diphenhydramine?
Known hypersensitivity or allergy to antihistamines
Neonates
What is the route and dose for diphenhydramine?
PO 25-50mg
IV 25-50mg
What are the cautions for diphenhydramine?
Narrow angle glaucoma
stenosing peptic ulcer
What is the classification of Salbutamol?
Bronchodilator
Sympathomimetic
What are the indications for Sabutamol?
Bronchospasm associated with asthma, bronchitis, or emphysema
Bronchospasm and wheezing secondary to other causes, such as anaphylaxis
What are the contraindications for Salbutamol?
Known hypersensitivity or allergy to Salbutamol.
Hemodynamically significant tachyarrhythmia
What are the routes and doses for Salbutamol?
5mg in 5ml NS nebulized (with O2 at 6-8lpm)
100mcg/spray MDI
Nebulized:
< 1 year 2.5mg
> 1 year 5.0mg
MDI:
<20kg: 5x100mcg per round, repeat up to 3 rounds.
>20kg: 10x100mcg per round, repeat up to 3 rounds.
<10kg: not indicated.
What are the cautions for Salbutamol?
Coronary disease
COPD patients with degenerative heart disease
diabetes
What is the onset for Salbutamol?
5 minutes
What is the dose for Naloxone?
1st Dose: 0.4 mg
2nd Dose: 0.4 mg (after 3 mins if needed)
3rd Dose: 0.8 mg (after 3 mins if needed)
4th Dose: 2 mg (after 3 mins if needed)
What is the classification of Naloxone?
Narcotic antagonist
What are the indications for Naloxone?
To reverse respiratory depression/depressed mental status secondary to actual or suspected narcotic overdose
What are the contraindications for Naloxone?
Allergy or known hypersensitivity
What are the pediatric doses for Naloxone?
0.1 mg/kg (max 2 mg/dose)
Maximum total of 2 mg/dose
Repeat q3 mins as needed to reverse respiratory depression
Higher dose prescribed as pediatric patients are unlikely to experience withdrawal
What is the onset for Naloxone?
IV-1 minute
IM- 3-5 m minutes
What are the cautions for Naloxone?
Patient combativeness
May precipitate withdrawal symptoms
What is respiratory acidosis?
an acid-base balance disturbance due to alveolar hypoventilation. Production of carbon dioxide occurs rapidly and failure of ventilation promptly increases the partial pressure of arterial carbon dioxide
What are the s/s of respiratory acidosis?
headache, confusion, anxiety, drowsiness, and stupor
What is respiratory alkalosis?
a primary decrease in Pco2 (hypocapnia) due to an increase in respiratory rate and/or volume (hyperventilation). Ventilation increase occurs most often as a physiologic response to hypoxia
What are the s/s of respiratory alkalosis?
light-headedness, confusion, peripheral and circumoral paresthesias, cramps, and syncope.
What is metabolic acidosis?
Metabolic acidosis occurs when either an increase in the production of nonvolatile acids or a loss of bicarbonate from the body overwhelms the mechanisms of acid–base homeostasis or when renal acidification mechanisms are compromised.
What are the s/s of metabolic acidosis?
Confusion Fast heartbeat Feeling sick to your stomach Headache Long and deep breaths (hyperpnea) Not wanting to eat Vomiting Feeling tired Feeling weak
What is metabolic alkalosis?
a metabolic condition in which the pH of tissue is elevated beyond the normal range
The most common causes of metabolic alkalosis are:
Volume depletion (particularly when involving loss of gastric acid and chloride [Cl] due to recurrent vomiting or nasogastric suction)
Diuretic use
What are the s/s of metabolic alkalosis?
headache, lethargy, and neuromuscular excitability, sometimes with delirium, tetany, and seizures.
What are hypotonic solutions?
Less solutes than ICF Fluid shifts INTO cells 0.33% NaCl 2.5% Dextrose in water Hydrates cells causing them to swell
What are isotonic solutions?
Same tonicity as ICF No fluid shifts Normal Saline Lactated Ringer’s D5W
What are hypertonic solutions?
More solutes than ICF Fluid shifts OUT of cells 5% NaCl D10W Dehydrates cells causing them to shrink
What are baroreceptors?
located primarily in the carotid artery, aorta, and kidneys; sense and regulate changes in blood pressure.
What is the renin-angiotensin aldosterone system?
complex feedback system responsible for the kidneys’ regulation of sodium in the body
What are volume-sensitive receptors?
located in the atria; stimulate release of proteins when the IVF volume decreases.
What are osmoreceptors?
sensors are primarily located in the hypothalamus; stimulate production of anti-diuretic hormone (ADH) when ECF osmolarity is high.
What is the acid-base balance?
The body’s balance between acidity and alkalinity.
What is the acid-base balance controlled by?
lungs, kidneys, buffer systems.
What is cellular injury?
a variety of changes of stress that a cell suffers due to external as well as internal environmental changes.
What is cellular adaptation?
changes made by a cell in response to adverse or varying environmental changes.
What is fluid distribution?
Intracellular fluid is approximately 40% of the total body weight
extracellular fluid comprises approximately 20% of total body weight and further subcategorizes as plasma at approximately 5% of body weight
interstitial space is approximately 12% of body weight
What are the electrolytes in your body?
Sodium, calcium, potassium, chloride, phosphate, and magnesium
What is the bicarbonate buffer system?
an acid-base homeostatic mechanism involving the balance of carbonic acid (H2CO3), bicarbonate ion (HCO − 3), and carbon dioxide (CO2) in order to maintain pH in the blood and duodenum, among other tissues, to support proper metabolic function.
What is a differential diagnosis?
the process of differentiating between two or more conditions which share similar symptoms
What is a provisional diagnosis?
medical diagnosis by a professional based on the information provided at the time
What is clinical decision making?
a contextual, continuous, and evolving process where data are gathered, interpreted, and evaluated in order to select an evidence-based choice of action
What is hypoperfusion?
a reduced amount of blood flow
What are the vital trends for compensated shock?
normal BP increased HR increased RR Pale, cool, moist skin altered mental status Restlessness, anxiety
What is the treatment for compensated shock?
high flow O2
treat the underlying cause of shock
blankets
RTC
What are the vital trends for decompensated shock?
Decreased BP Increased HR Increased and irregular RR Decreased temperature Decreased mental status Dilated pupils Ashy or cyanotic pallor
What is the treatment for decompensated shock?
high flow O2 treat the underlying cause of shock blankets RTC lay flat with legs slightly elevated
What are the vital trends for irreversible shock?
Confusion, slurred speech, unconscious Slow, irregular, thready pulse Falling BP; diastolic goes to zero Cold, clammy, cyanotic skin Slow, shallow, irregular respirations Dilated, sluggish pupils Severely decreased body temperature
What is FBAO?
foreign body airway obstruction
What is the pathophysiology of an FBAO?
choking due to inhalation of a foreign body-asphyxia
What are the key features of an FBAO?
patient is clutching at throat
sudden onset
patient is unable to speak and has difficulty breathing
attempts at coughing that are quiet or silent
What are the principles of management for an FBAO?
encourage the patient to cough
5 back blows, 5 abdominal thrusts
help them to the ground if they lose consciousness
initiate CPR if loss of consciousness
after 30 compressions, check the airway
attempt to give two breaths and continue with cycles of chest compressions, checking airway.
finger sweep or suction when FB appears.
What is the pathophysiology of croup?
Croup causes swelling of the larynx, trachea, and large bronchi due to infiltration of white blood cells. Swelling results in partial airway obstruction which, when significant, results in dramatically increased work of breathing, and the characteristic turbulent, noisy airflow known as stridor.
What are the key features of croup?
cold symptoms like sneezing and runny nose. fever barking cough heavy breathing hoarse voice
What are the principles of management for croup?
position of comfort
supplemental O2
transport
What is aspiration?
Breathing in a foreign object
What are the key features of aspiration?
coughing or wheezing after eating
chest discomfort
pneumonia
What are the principles of management for aspiration?
often no symptoms immediately
encourage to cough
What is the pathophysiology of COPD?
poorly reversible airflow obstruction and an abnormal inflammatory response in the lungs.
increased resistance to airflow in the small conducting airways, increased compliance of the lungs, air trapping, and progressive airflow obstruction
What are pink puffers?
Emphysema (pink puffers): characterized by an abnormal enlargement of the air spaces distal to the terminal bronchioles accompanied by the destruction of their walls.
What are pink puffers?
Emphysema (pink puffers): characterized by an abnormal enlargement of the air spaces distal to the terminal bronchioles accompanied by the destruction of their walls.
What are blue bloaters?
Chronic Bronchitis (blue bloaters): characterized by inflamed and edematous airways filled with secretions. Copious respiratory secretions contribute to expiratory obstruction.
What are the principles of management for COPD?
high flow O2
4 x 100 mcg dose via MDI Salbutamol
CPAP as required (call CliniCall before)
What is the pathophysiology of asthma?
the linings of the airways become congested with swollen cells and the mucous produced from those cells.
What are the key features of asthma?
respiratory distress
wheezing
difficulty speaking more than one or two word sentences
What are the principles of management for asthma?
high flow O2
4 x 100 mcg dose via MDI Salbutamol
CPAP as indicated (call CliniCall first)
What are the key features of an upper respiratory infection?
runny nose, nasal congestion, sneezing, cough, and mucus production
What is the pathophysiology of an upper respiratory infection?
direct invasion of the mucosa lining the upper airway. Inoculation of bacteria or viruses occurs when a person’s hand comes in contact with pathogens and the person then touches the nose or mouth or when a person directly inhales respiratory droplets from an infected person who is coughing or sneezing.
What are the principles of management for an upper respiratory infection?
supplemental O2
transport
What is the pathophysiology of pneumonia?
a breakdown in your body’s natural defenses allows germs to invade and multiply within your lungs. To destroy the attacking organisms, white blood cells rapidly accumulate. Along with bacteria and fungi, they fill the air sacs within your lungs (alveoli).
What are the key features of pneumonia?
Chest pain when you breathe or cough.
Confusion or changes in mental awareness (in adults age 65 and older)
Cough, which may produce phlegm.
What are the principles of management for pneumonia?
supplemental O2
transport
What is the pathophysiology of atelectasis?
a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
What are the key features of atelectasis?
recent surgery SOB Increased heart rate Coughing Chest pain Skin and lips turning blue
What are the principles of management for atelectasis?
High flow O2
Transport
CPAP if indicated
What is the pathophysiology of cancer?
dysregulated proliferation of cancer cells that grow and divide in an uncontrolled manner, invading normal tissues and organs and eventually spreading throughout the body.
What are some key features of cancer?
Unexplained weight loss
Non-healing wounds
Blood tinged mucus
Lumps under skin
What are the principles of management for cancer?
pain management
supplemental O2
transport
What is the pathophysiology of toxic inhalation?
Inhaled toxins that affect the conducting airways induce airway edema, inflammation, and airway obstruction, in part because of bronchoconstriction.
What are the key features of toxic inhalation?
Eye irritation
Coughing
SOB
What are the principles of management for toxic inhalation?
decontamination transport PPE airway management high flow O2
What is the pathophysiology of a pulmonary embolism?
occurs when deep venous thrombi detach and embolize to the pulmonary circulation.
What are the key features of a pulmonary embolism?
Acute dyspnea Pleuritic chest pain Hemoptysis tachycardia tachypnea
What is the pathophysiology of pulmonary edema?
the heart is not able to pump efficiently and blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
What are the key features of pulmonary edema?
Shortness of breath, especially if it comes on suddenly. Trouble breathing or a feeling of suffocating (dyspnea)
A bubbly, wheezing or gasping sound when you breathe. Pink, frothy sputum when you cough
What is the pathophysiology of ARDS?
occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
What are the key features of ARDS?
SOB
Laboured and unusual rapid breathing
Low blood pressure
Confusion and extreme tiredness
What are the principles of management for ARDS?
supplemental O2
transport
What is the pathophysiology of a pneumothorax?
occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse.
What are the key features of a pneumothorax?
sudden chest pain SOB reduced unilateral breath sounds hyper resonance subcutaneous air JVD tracheal deviation
What are the principles of management for a pneumothorax?
supplemental O2
RTC
IV access
What is the pathophysiology of hyperventilation?
During hyperventilation the rate of removal of carbon dioxide from the blood is increased. As the partial pressure of carbon dioxide in the blood decreases, respiratory alkalosis, characterized by decreased acidity or increased alkalinity of the blood, ensues.
What are the key features of hyperventilation?
rapid, deep breathing
What are the principles of management for hyperventilation?
coach the patients breathing
What are the indications for CPAP?
>13 years old in significant respiratory distress Awake and following commands Exhibits all of the following: -RR > 24 -SpO2 < 94% -Accessory muscle use
What are the contraindications for CPAP?
Decrease LOC Respiratory arrest –hypoventilation Vomiting –risk of aspiration Unable to fit mask Traumatic cause of SOB Pneumothorax SBP < 90 mmHg
What are the three layers of the heart, and which level are they at?
Outer: epicardium
Middle: myocardium
Inner: endocardium
What is the route that blood makes through the body?
blood enters Right Atrium Right ventricle lungs to be oxygenated pulmonary veins left atrium left ventricle rest of body
What are the four valves of the heart?
pulmonic
tricuspid
aortic
mitral
What is coronary circulation?
the circulation of blood in the blood vessels that supply the heart muscle. Coronary arteries supply oxygenated blood to the heart muscle, and cardiac veins drain away the blood once it has been deoxygenated.
What is peripheral circulation?
concerned with the transport of blood, blood flow distribution, exchange between blood and tissue, and storage of blood (venous system)
What is the primary function of the lymphatic system?
to transport lymph, a fluid containing infection-fighting white blood cells, throughout the body.
What are the other functions of the lymphatic system?
protecting your body from illness-causing invaders, maintaining body fluid levels, absorbing digestive tract fats and removing cellular waste
Which body parts are associated with the lymphatic system?
bone marrow thymus tonsils lymph nodes spleen appendix
What is happening in the heart during systole?
the heart is contracting to pump blood out
What is happening to the heart during diastole?
The heart is relaxing after contraction
What is Starling’s Law?
the heart will eject a greater SV if it is filled to a greater volume at the end of diastole.
What is preload?
the initial stretching of the cardiac myocytes prior to contraction.
What is afterload?
the force or load against which the heart has to contract to eject the blood.
What is contractility?
innate ability of the heart muscle to contract.
What is the pathway of conduction in the heart?
SA node internodal pathways AV node bundle of His Purkinje fibres
What is the pathophysiology of angina?
caused by reduced blood flow to your heart muscle. Your blood carries oxygen, which your heart muscle needs to survive. When your heart muscle isn’t getting enough oxygen, it causes a condition called ischemia.
What are the key features of angina?
radiating chest discomfort
bloating or gas
chest pain that goes away
What are the principles of management for angina?
high flow O2 position of comfort ASA Nitro 0.4mg Entonox RTC
What is the pathophysiology of myocardial infarction?
irreversible damage of myocardial tissue caused by prolonged ischemia and hypoxia
What are the key features of an MI?
Chest pain
SOB
nausea
What are the POM for an MI?
high flow O2 position of comfort ASA Nitro 0.4mg Entonox RTC
What is the pathophysiology of CHF?
the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion.
What are the key features of CHF?
peripheral edema
SOB
white or pink-tinged frothy phlegm
persistent cough/wheezing
What are the POM for CHF?
High flow O2
RTC
Prepare to suction
What is the pathophysiology of cardiac tamponade?
blood or fluids fill the space between the sac that encases the heart and the heart muscle. This places extreme pressure on your heart. The pressure prevents the heart’s ventricles from expanding fully and keeps your heart from functioning properly.
What are the key features of cardiac tamponade?
SOB
JVD
Beck’s Triad (low BP, muffled heart sounds, jvd)
What are the POM for cardiac tamponade?
High flow O2
RTC
IV TKVO
monitor for shock
What is a hypertensive emergency?
diastolic blood pressure greater than or equal to 120 mmHg or systolic blood pressure greater than or equal to 180 mmHg.
What are the POM for a hypertensive emergency?
supplemental O2
IV TKVO
contact EPOS
What is the pathophysiology of cardiogenic shock?
decreased blood flow and oxygen delivery to vital organs caused by a sustained reduction in cardiac output.
What are the key features of cardiogenic shock?
peripheral edema increased RR increased HR bulging neck veins severe SOB
What are the POM for cardiogenic shock
supplemental O2
IV TKVO
ECG
fluids PRN to increase BP
What is atherosclerosis?
disease of large and medium-sized arteries characterized by endothelial dysfunction, vascular inflammation and accumulation of lipids, cholesterol, calcium and cellular debris within the intima of the vessel wall
What is an aneurysm?
widening of an artery that develops from a weakness or destruction of the medial layer of the blood vessel.
What is an AAA?
an enlarged area in the lower part of the major vessel that supplies blood to the body (aorta).
What are the key features of an AAA
deep, constant pain in abdomen or side of abdomen
back pain
pulse near bellybutton
What are the POM for an AAA?
supplemental O2 RTC maintain ABCs IV TKVO monitor for shock
What is an acute arterial occlusion?
occurs when blood flow in a leg artery stops suddenly. If blood flow to your toe, foot, or leg is completely blocked, the tissue begins to die.
What are the POM for an acute arterial occlusion?
place leg in a dependent position (dangling)
keep leg warm
supplemental O2
IV TKVO
What is DVT?
clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis
What are the key features of DVT?
warmth, redness, and swelling of the affected leg
What are the 6 steps for reading an ECG strip?
Rate (tachy/brady/normal) QRS interval (wide/narrow) Rhythm (regular/irregular) P waves (present/not present) Axis (normal/deviated to the left or right) ST changes (elevated/depressed)
What are the shock-able rhythms?
ventricular fibrillation
ventricular tachycardia
What is the function of the spleen?
- clearance of microorganisms and particular antigens from the blood stream.
- creates lymphocytes.
- removal of abnormal RBCs.
- stores blood.
What is the pathophysiology of an allergic reaction?
After allergen exposure, inflammatory mediators, including large quantities of histamine, are released from mast cells on the mucosal surfaces. Histamine causes immediate bronchoconstriction and bronchospasm, resulting in narrowing of the small airways (bronchioles).
What is anaphylaxis?
an acute, potentially fatal, multiorgan system reaction caused by the release of chemical mediators from mast cells and basophils. The classic form involves prior sensitization to an allergen with later re-exposure, producing symptoms via an immunologic mechanism
What is the function of the hypothalamus?
maintaining homeostasis
What is DKA?
occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic.
What is Grave’s disease?
an immune system disorder that results in the overproduction of thyroid hormones
Is DKA from high or low blood sugar?
occurs when blood sugar levels are very high and insulin levels are low.
What is Cushing’s syndrome?
occurs when your body is exposed to high levels of the hormone cortisol for a long time.
