Medical Emergencies

Question 1

What is type 1 diabetes?

Answer 1

insulin dependent that is genetic and starts early in life

Question 2

What is type 2 diabetes?

Answer 2

can be insulin dependent or not, usually develops later in life and can be managed with diet changes or can progress to have insulin administered

Question 3

DKA presents in what type of diabetes?

Answer 3

Type 1

Question 4

Hyperosmolar Hyperglycemic Syndrome presents in what type of diabetes?

Answer 4

Type 2

Question 5

What is the primary issue with an adrenal crisis?

Answer 5

low or no production of cortisol

Question 6

What is addison’s disease/ an addisonian crisis?

Answer 6

Addison’s disease is when there is low or no production of cortisol.

Addisonian crisis is when there is a stressor on the body to a pt. that has addison’s disease. The pt. typically has a prescription fro hydrocortisone

Question 7

What is cortisol and what does it do?

Answer 7

Is a endogenous corticosteroid steroid

-Decrease inflammation
-During stress response it is released to maintain high alert on fight or flight
-helps with catabolic mechanisms to provide energy during stressful situation
-increases the amount of BGL circulating

Question 8

What treatment is given for a pt. in adrenal crisis?

Answer 8

100mg IV bolus of hydrocortisone

Question 9

What is BRASH?

Answer 9

acronym used for pt. that have suspected hyperkalemia as they would have the symptoms that BRASH stands for.

Bradycardia
Renal Failure
AV nodal blockade
Shock
Hypotension

Question 10

Is clinical suspicion of hyperkalemia enough to treat in the pre-hospital setting?

Answer 10

No, To warrant out-of-hospital intervention, patients must present with significant hemodynamic or arrhythmogenic instability, alongside a suspicion of hyperkalemia as the likely cause.

Question 11

What can cause hyperkalmeia?

Answer 11

-increased intake of potassium supplements
-increased metabolic demand such as rhabdomyolysis, extensive burns, intense physical activity or crush injuries that have been crushed >4hrs
-decreased excretion of k+
-beta blocker and digoxin

Question 12

What clinical features on an ECG would you see if a pt. was hyperkalemic?

Answer 12

-Tall, tented T-waves
-Flattened or absent P-waves-
-Prolonged PR Interval
-Wide QRS
-Bradycardia

Question 13

Treatments for hyperkalemia?

Answer 13

-10-20mg salbutamol nebulizer
-1g of Ca+Cl- IV over 10 mins repeat once after 10mins
-1mEq/kg of Na+Bi- followed by .5mEq/kg after 10-15mins

Question 14

What does tenting mean in a patient?

Answer 14

Or skin trigger or also known as tenting means that the patient is dehydrated

Question 15

What should ACP’s be on the lookout when dealing with a patient with abdominal pain?

Answer 15

Most late threatening ideologies that correspond with abdominal pain are:
Acute aortic dissection, Utay coronary syndrome, a perforated abdominal viscous, ectopic, pregnancy, mesenteric, ischemia, pancreatitis, and gastrointestinal haemorrhage

Question 16

What medications do ACP have to deal with pain in the prehospital setting?

Answer 16

Fentanyl ketamine morphine

Question 17

What is the main state treatment for anaphylaxis?

Answer 17

Im epi is indicated in all anaphylaxis patients and should never be substituted for any other medication

Question 18

Can ACP’s give IV Epi or nebulized Epi in anaphylaxis?

Answer 18

Yes, however, both methods should not come before Im epi

Question 19

What is the criteria to determine if a patient is an anaphylaxis?

Answer 19

Two or more systems involved or one system involved with a known allergin contact

Question 20

what is the dosage for IM epinephrin and anaphylaxis?

Answer 20

.5 mg every 5 to 20 minutes

Question 21

What is the dosage for IV epinephrin in anaphylaxis?

Answer 21

50 to 100 µg and repeat as necessary

Question 22

what is the preferred induction agent in anaphylaxis?

Answer 22

Ketamine

Question 23

what other antihistamine medication can ACP give an anaphylaxis?

Answer 23

Diphenhydramine

Question 24

if an ACP is unable to pass a ET tube what is the last procedure they can do?

Answer 24

A surgical cricothyroidotomy

Question 25

should epinephrin be administered to minor allergic reactions that only involve the integumentary system?

Answer 25

No