Terms Flashcards
reduction of oxygen carrying capacity of the blood
hypoxia
3 types of poisons
ones inhaled, ingested, direct contact
Priority Action Approach
you must QUICKLY
- find out who is injured
- give first aid
- inform BC EHS
- make sure patient gets to hospital
- ABC
- resitrct spinal movement if you think you need to
- rapid transport decision
it requires EFFICIENT USE OF TIME. major issues cannot be resolved in the field. get them to the hospital
- know your workplace, ins and outs, evacuation routes, where first aid stuff is, train others, keep procedures updated, review plans,
hypoglycemia
not enough sugar in blood; associated with diabetes and insulin
hyperglycemia
too much glucose in blood; no production of insulin
head to toe examination
it is inpection and palpation; look and feel
- proceed downwards from head (neck, chest, abdomen, pelvis, back, extremeties)
- methodical, focused, takes several mins
- look for injuries, painful areas that are not obvious
- watch for sharp objects
- any open wounds, lacerations, swelling, deformities (do NOT probe open wounds)
- difficulty in breathing, stridor, hoarseness
- breathing chest looks normal?
hydroxocobalamin
antidote to cyanide given intravenously by physician trained to do so
what is priapism, what is it assoacated with
persistent erection
spinal cord injury
syncope
fainting
trunk
torso of body (chest, abdomen, pelvis)
prone
lying on stomach
anterior
front of body
posterior
back of body
medial
closer to the midline
superior
closer to head
inferior
below, or closer to bottom of feet
distal
away from trunk
used only with respect to a limb
proximal
on limbs, toward the trunk
scene assessment
look for hazards
what was the mechanism for injury
number of patients
4 stages of PAA
scene assessment
primary survey
transportation decision
secondary survey
3 options for transportation decision
- RTC (ambulance)
2, medical aid (needs aid, but not as quickly as possible. can use company car or taxi) - return to work
the only interventions performed during primary survey
cardiac arrest
airway obstruction
severe bleeding
severe respiratory distress
what is AVPU
alert - is patient aware of surroundings, time, date, name
verbal - can they respond, do eyes open
pain - do they move or cry out in pain
unresponsive
agonal respiration
sporadi, ineffective, gasping, unusual rbreathing
common with cardiac arrest
dyspnea
shortness of breath
systole
conctraction of right and left ventricles
diastole
relaxation of heart while ventricles fill with blood
good amount of heart beats per minute
60 - 80, can change if theyre pregnant or athletes
definition of shock
state of inadequate perfusion of cells (not enough oxygen, too much CO2)
cells stop working, start to die, tissue dies, organs die
perfusion
flow of blood to and from the body cells
it carries nutrients, oxygen, gets rid of CO2
tachypnea
increased respiratory rate between 20 - 30 breaths per minute
pleuritic pain
pain made worse by breathing - sign of chest injury
closed pneumothorax
closed injury
lung tissue is torn and air leaks from lung into pleural space. its in thoracic cavity but outside lung
leads to lung collapse
hemothorax
blood collects within pleural space
can be form open or closed wounds
shock
pulmonary contusion
bruise of the lung
from blunt injury
blood vessels are injured, blood is lost into tissue
hypothermia
core body temp less than 35 C
3 Ps of hemorrhage Control
Pressure
patient position at rest - lying down
prevent movement
ecchymosis
bruise or discolouration of the skin
sprain
stretching and or partial or complete tearing of a ligament at a joint
very in severity
should be treated as fracture if unsure
how to tell a sprain from fracture
mechanism of injury (how it happened)
was it from usual lifting and twisting? probably sprain
ASTD
activity related soft tissue disorder
tendonitis
inflammation of the tendon
synovitis
inflammation of the sheath surrounding tendon
hyphema
bleeding within eyeball
atherosclerosis
arteries become narrower; build up of fatty deposits in inner wall of artery (plaque)
embolus
clot breaks off and forms a plug
nomarl pulse rate
60-80
pulse in anterior neck
carotid pulse
pulse felt at wrist on flexor surface at base of thumb
radial pulse
what controls blood pressure
blood volume and capacity of veins
what happens when blood pressure drops
organs no longer adequately perfused; cells not getting oxygen and removing CO2
what is shock
inadequate perfusion of cells
does shock = RTC?
yes
what is perfusion
flow of blood to and from body cells
3 main causes of inadequate perfusion
less blood volume (blood loss, fluid loss)
damaged heart (cardiogenic shock)
blood vessels dilate excessively
blood pressure depends on
volume of blood
resistance to flow of circulating blood by arterioles
arteriole resistance
back pressure exerted by arterioles on blood flow (like a nozzel on hose)
cardiogenic shock
heart muscle doesnt pump enough blood to peripheral tissues, mainly due to heart attack
other name for heart attac
myocardial infarction (MI)
distinct sign of septic shock
confusion, high fever with warm flushed skin, later cool and pale
when does a neurogenic shock occur
presence of cord injury with complete paralysis
rare
what causes heart attack commonly
sudden obstruction of coronary artery or one of its branches
loss of blood supply and )2 to heart muscle
hypoxia of heart cells, then death
what causes heart attack commonly
sudden obstruction of coronary artery or one of its branches
loss of blood supply and )2 to heart muscle
hypoxia of heart cells, then death
leader of hearts electrical system
sinoatrial node (SA)
the pacemaker, 60 -100 impulses a minute
ventricular fibrillation
uncoordinated electrical impulse across heart
no pumping action or pulse
heart quivvers
life threatening
ventricular tachycardia (VT)
heart rhythm is so fast that heart may not have time to fill with blood
asystole
no electrical or mechanical activity in the heart
will AED work on VF?
yes
will AED work on asystole?
no
respiratory system
airway (nose, mouth, pharynx, trachea, bronchi)
lungs (bronchioles, alveoli, pleura)
thoracic muscles (intercostal moscules, diaphragm)
thoracic bones (ribs, sternum)
what is pharynx
throat
2 parts of pharynx
seperated by what at top
esophagus (food) and trachea (air to lungs)
seperated by epiglottis
bronchi
left and right bronchus
2 main air tubes carry air to lungs from trachea
bronchioles
branches in lung, subdivide again and again, forming smaller tubes. smallest are called bronchioles
alveoli
cluster of sacs at the end of bronchioles
thin walls, many tiny capillaries, passageway for oxygen and CO2
pleura
double walled sac surrounding lungs
one layer divides inside of chest cavity and other layer covers lungs
between them is pleural space
pneumothorax
collection of air in plueral space
interferes with efficient respiration
mediastinum
thoracic space between lungs
contains heart, major blood vessels, trachea, esophagus
3 processes essential for transfer of oxygen to blood through lungs
- ventilation (air moves in and out of lungs)
- diffusion (spontaneous movement of gases between gas in alveoli and blood capillaries in lungs)
- perfusion (cardiovascular system pumps blood throughout lungs)
what does it mean if patient is unresponsive and not breathing/agonal breathing? what should you do?
its cardiac arrest probably
CPR AED is initiated
an early sign of partial airway obstruction?
other signs?
stridor; high pitched noise present on inspiration or expiration or both
gurgling, noisy, congested breathing
hoarseness
early signs of complete airway obstruction?
cyanosis, no movements of chest
no air in and out of mouth
unable to vocalize (if conscious)
most common cause of airway obstruction? next common? next?
tongue blockage; it falls backwards and obstructs airway
then its foreign objects
then swelling from injury of soft tissue of throat or larynx
common causes of tissue damage in neck
direct blows to anterior of neck
facial fractures
smoke or chemica inhalation
techniques for opening, clearing airway
cough (if conscious)
finger sweep; visual check first, lift jaw and tongue. may need to move neck, but be mindful of spinal injury
head tilt chin lift (if unresponsive)
backblows (if standing)
abdominal thrusts (only on conscious)
chest thrusts
chest compressions (unrepsonsive)
when are backblows not affective
obstruction is due to swelling, secretions, bleeding, smoke, blunt neck or facial trauma
what are not helpful if airway obstruction due to swelling, secretions, bleeding, smoke, blunt neck or facial trauma?
chest compressions, backblows, abdominal thrusts
are patients with partial or complete airway obstruction RTC?
yes
when should chest thrusts be used
if patient is too obese or pregnant
what do you do once obstruction is cleared and breathing resumes for unresponsive patient
place in 3/4 prone and complete primary survey (circulation would be next)
how would you know if partial obstruction has cleared
patient breathing normally
mouth is clear of fluids
what to do if airway doesnt clear and patient still not breathing?
initiate CPR and AED
roll patient later, sweep to clear airway between sets of chest compressions
T or F: leave patient in supine position unattended with a decreased level of consciousness
F: put in 3/4 prone
causes of dyspnea
inadequate oxygen in air obstruction to flow in airway, trachea, bronchi trauma inhalation injury, asthma injury to chest wall collapsed lung emphysema (lung tissue loses elasticity, no longer respond to breathing) lungs full of fluid infected lung tissue
how to manage dyspnea
follow PAA, but
- ensure open airway
- if responsive, position for comfort (semi sitting, sitting, lying)
- assess adequacy of patients respiration, coach patient to focus on breathing
- complete primary survey (any wounds? chest injury?)
- update BC EHS
signs, symptoms of chest injury
pain at injury site pleuritic pain (hurts to breath) shortness of breath failure of one or both sides of ches to expand coughing blood rapid and weak pulse cool, moist skin cyanosis subcutanous emphysema anxiety, fear
subcutanous emphysema
air under the skin tissues
2 broad types of chest injury
closed (skin intact) , crush etcinjuries
and
open ( chest wall has been penetrated), rib fracture
T or F; air should be allowed to excape from open chest wund
T
signs, symptoms of rib fractures
history of blow, compression to chest pain at fracture site pleural pain patient leaning on injured side patient wants to remain still rib deformity chest wall bruising
manage rib fractures?
follow PAA
cannot do too much
position for comfort if not at risk to neck, back, internal bleeding
they likely have other injuries
you dont wrap, strap or tape
flail chest
2 or more consecutive ribs are fractured in 2 or more places, or detached from the sternum
when patient inhales, flail part doesnt respond, and extrudes upon exhalation
causes bleeding of the lungs, very serioes, reduces volume of air into lungs
closed pneumothorax
lung tissue is torn, air leaks form lung into pleural space
its still in thoracic cavity, but outside lung
reduces volume of lungs
hypoxia ensues
usually caused by rib fracture
signs, symtoms of closed pneumothorax
history of chest trauma bruising at site pain at site pleuritic pain hard to breathe cyanosis rapid, weak pulse subcutanous emphysema
open pneumothorax
penetrating wound of chest wall, collapses lung
air passes back and forth
tension pneumothorax
accumulation of air in pleural space under pressure
collapses lung on side of injury, then displaces mediastinum away from air filled pleural space
can be from blunt or penetrating wound
increased pressure on heart and lung, leads to dyspnea and shock
signs, symptoms of tension pneumothorax
severe progressive respiratory distress
distended neck veins due to obstruction of superior vena cava
marked overexpansion of chest on affected side
agitation and restlessness
deviation, shift of trachea away from side of tension
hemothorax
blood collects within pleural space, caused by open or closed chest injury
hidden, severe
leads to shock
has general signs of chest injury
pulmonary contusion
bruise of lung
associated with blunt injury
can mean significant blood losss into lung tissue
may lead to respiratory distress
blast injury
sudden changes in air pressure in lungs leads to widespread damage and bleeding
alveoli fill with blood, prevent normal exchange of gases
signs symptoms of smoke inhalation
inflammation of mouth, larynx, trachea sore throat, hoarseness, shortness of breath cough headache or dizziness, restlessness, confusion cyanotic, pale facial burns fluid formation in lower airway, alveoli can be delayed effects
info important in smoke inhalation
location of worker when exposed
duration of exposure
presence of toxic substances
decreased level of consciousness?
asthma
narrowing of airways that occur intermittently
can be mild shortness of breath to profound respiratory failure and death
causes bronchospasm
bronchospasm
caused by asthma
contraction of smooth muscles of walls of airways (bronchi, bronchioles), leads to airway constriction
severe prolonged asthmatic attack, doesnt respond to medications
status asthmaticus
chronic obstructive pulmonary disease
COPD
long standing obstructive airway diseases
diffuse obstruction to airflow within lungs and dyspnea, both due to destruction of lung tissue
it is like emphysema and chronic bronchitis
usuallu caused by smoking
chronic bronchitis
repeated infection of bronchial tree
usually caused by smoking
its inflammation, swelling, excesive mucus in airways
pneumonia
dieases; exudation of serum and cels into alveolar spaces and small bronchioles
slows down blood supply surrounding alveoli, thickeing of alveolar walls by fluid and cells
causes hypoxia
pulmonary edema
accumulation of fluid within alveoli
causes impairment of flow of oxygen from alveoli into the blood
usually caused by left ventricular failure
heat is lost through 4 ways
evaporation
radiation
convection
conduction
hyperthermia is above what temperature
another name for hyperthermia
41C
heatstroke
your brain, heart, kidney are unable to survive, organ dysfunction occurs
due to heat, not enough fluids and salts and some medications
heat cramps
salt imbalance in muscle
occurs when you sweat alot
onset is usually delayed
replenish salts and fluids!
not salt tablets; theyll make you puke
heat exhaustion
depletion of water and salt during long periods of exertion
signs of heat exhaustion
shallow respiration increased respiratory rate weak rapid pulse cool, pale clammy skin sweating weakness, fatigue, dizziness headache, nausea fainting
how to tell difference between heat exhaustion and heat stroke
absence of sweating is in heatstroke
same with hot, dry skin
signs of heat stroke
hot, dry flushed skin no sweating agitation, confusion DLOC headache nausea, vomiting seizures, increased respiratory rate irregular pulse shock cardiac arrest
is heatstroke RTC?
yes
what to do with heat stroke
RTC
do all you can do to lower body temp (cool spot in shade, supine unless vomiting)
- apply cold water by dousing or wet sheets
- fan patient
- oral fluids if not vomiting and conscious
immersion foot
prolong exposure to cold water
pale and cold skin
basic responses to cold injury
remove wet, cold clothing
get to warm space
rewarm affected part
frostnip vs frostbite
nip: minor cold injury, no soft tissue damage
bite: damage to soft tissues
who is more vulnerable to cold injuries?
those with pre existing circulatory disorders
if you wear constrictive clothing
working in cramped conditions (reduced blood flow)
signs, symptoms of frostbite
pain, redness at first (body is trying to raise temp by pushing blood to area)
injury then becomes pale, numb, tingling
may appear white, mottled with blue and white patches
management of frostbite
PAA; ABCs are priority
frostbite not as serious as hypothermia
remove wet cold clothing
limit exposure
apply dressing, wrap extremity in dry blankets
dont rub!
lightly cover affected part with sterile gauze dressings
dont break blisters
handle limb gently, immoboloize with splint
rewarm as quickly as possible
PAA for hypothermia
should extract to safe environment
ABCs, stuff as usual
assess breathing for 30 seconds, as their metabolix demands are lower
hypothermia and rough handling can lead to cardiac arrest, but patient is less vulnerable to this in this state
RTC
adrenalin and noradrenalin cause
increased heart rate, more forceful contraction
constriction of arterioles in non vital organs (skin, liver, kidneys, guts), redistributes blood to vital organs
profuse sweating; increases fluid loss, makes shock worse. key sign of shock
