Paramedic Pathophysiology

What are the signs and symptoms of anaphylactic shock?

hypotension, tachycardia, rapid breathing with wheezing early, difficult breathing, palpatations, dizziness, stridor, hives, ALOC, nausea and vomiting.

What are the signs and symptoms of beta blocker overdose?

include difficulty breathing, blurred or double vision, dysrythmias, hypotension, heart failure, confusion, convulsions and weakness.

What are the signs and symptoms of calcium channel blocker overdose?

may experience chest pain, palpitations, syncope, diaphoresis, dyspnea, seizures, confusion, bradycardia and hypotension. Overdoses of CCB may suppress insulin thereby causing hyperglycemia and lactic acidosis.

What are the signs and symptoms of alcoholism?

nausea, vomiting, dysphagia, slurred speech, disorientation, combativeness. In severe cases of acute alcohol ingestion, seizures and death may occur. Chronic alcoholism can mask some of the above signs making it difficult to diagnose.

What is the treatment for GI bleed?

o2, IV fluids to maintain systolic pressure >90, pain medication may be given if appropriate.

What is the treatment for ureterolithiasis?

o2, IV fluids, pain medication.

What is the treatment for alcoholism?

o2, protect airway in the event of vomiting, IV bolus fluids, thiamine, Zofran and obtain glucose level.

What is the treatment of tuberculosis?

providers use N95 masks, maintain ABC's, treat Pt chief complaint.

What is the treatment for Hepatitis C (HCV)?

use standard precautions with all Pt contact, maintain ABC's, treat Pt chief complaints.

What is the treatment for HIV?

BSI, Maintain ABC's, Be compassionate, understanding and nonjudgmental.

What is beta blocker overdose?

Beta blockers are primarily used in the treatment of high blood pressure. They do that because the main ingredient is a beta-adrenergic blocking substance that blocks the effects of the hormone, epinephrine.

What is Hepatitis C (HCV)?

Bloodborne transmission through IV drug use and unprotected sexual contact. Invades liver cells and causes inflammation and progressive fibrosis which may lead to liver cirrhosis.

What are the signs and symptoms of a lightening strike?

Burn marks may be present. Patient may present apenic and pulseless

What is the treatment for Hepatitis B (HBV)?

3 series immunizations have 90% effectiveness, use standard precautions with all Pt contact, Maintain ABC's, Treat Pt chief complaint.

What are the signs and symptoms of Hepatitis B (HBV)?

60-80% are asymptomatic, joint pain, rash, jaundice, fatigue, nausea/vomiting, abdominal pain, dark urine, poor appetite.

What are the signs and symptoms of Hepatitis C (HCV)?

70-80% are asymptomatic, joint pain, rash, jaundice, fatigue, nausea/vomiting, abdominal pain, dark urine, poor appetite, fever.

What is septic shock?

A medical condition as a result of severe infection that may be systemic or localized to a particular site. It can cause multiple organ dysfunction syndrome and death.

What are the signs and symptoms of organophosphate overdose?

A person may experience nausea, vomiting, diarrhea, irritability, compromised airway, hypoxia, paralysis, extrapyramidal effect and cardiac issues with respiratory distress.

What are lightening injuries?

A strike itself consists of up to 100,000 volts, 10,000 amperes, and up to 50,000*F, which on lasts a fraction of a second. A direct strike will divert that energy to a person but most strikes occur on nearby objects which can cause the current to either move sideways or radiate outward thus lowering the voltage.

What is the treatment for esophageal varices?

Aggressive airway management (suction, orotracheal intubation)

What is alcoholism?

Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing. It is medically considered a disease, specifically an addictive illness. Social environment, stress, mental health, family history, age, ethnic group, and gender all influence the risk for the condition. Significant alcohol intake produces changes in the brain's structure and chemistry, though some alterations occur with minimal use of alcohol over a short term period, such as tolerance and physical dependence. Misuse has the potential to damage almost every orgain in the body.

What is a petite mal siezure?

Also known as an absence seizure, is caused by abnormal communication with each other by sending electrical and chemical signals across the synapses that connect the cells. In people who have seizures, the brains usual electrical activity is altered.

What is tuberculosis?

An airborne respiratory illness transmitted via droplets from an infected person. The bacteria enters the lungs.

What is anaphylactic shock?

Anaphylaxis is a life-threatening type of allergic reaction. When the person is exposed to an allergen, an allergic reaction may occur to which that person has produced a specific IgE antibody. Anaphylaxis happens quickly after the exposure, is severe, and involves the whole body. Tissues in different parts of the body release histamine and other substances. This causes the airways to tighten and leads to other symptoms. Common causes include drug allergies, food allergies or Insect bites/stings.

What is a anemia?

Anemia is low iron in the blood caused by a few different things most common are poor nutrition or hemorrhage. The problem associated with anemia is the inability of the blood to carry oxygen and perfuse the body.

What is appendicitis?

Appendicitis is a condition in which the veriform appendix located in the lower right quadrant of the abdomen becomes inflamed and infected. The appendix is a small tube attached to the cecum which can easily be plugged with feces, foreign bodies or tumors which can cause bacteria to collect and grow leading to infection. If the infection is not treated rapidly, the appendix can rupture and cause more life threatening conditions like peritonitis.

What is the treatment for epiglottitis?

Appropriate airway management and O2 administration by a face mask or blow by. The oxygen should be humidified so the airway doesn't dry out. Two rescuer BVM is effective should the airway become obstructed. Have intubation equip readily available as well. Try not to aggitate the patient as this may worsen the childs condition.

What is the treatment for croup?

Appropriate airway management with the child in a position of comfort and cool oxygen at 4 to 6 lpm by face mask or blow by. If the attack is severe enough, medical control may allow the use of albuterol or racemic epinephrine. Try not to agitate the patient as it may worsen the croup and rapid transport are high priority. Cool air will often releive the symptoms.

What is the treatment for a hemorrhagic stroke?

Assess airway (titrate SPO2 >90%), IV, fluids TKO, do FAST and determine if symptoms <4 hours, transport.

What is the treatment for an ischemic stroke?

Assess airway (titrate SPO2 >90%), IV, fluids TKO, do FAST and determine if symptoms <4 hours, transport.

What is the treatment for insulin shock?

Assess airway and provide oxygen as needed. If patient is awake and alert enough can give oral glucose. IV, d50, if unable to obtain IV give glucagon. Reassess patient blood glucose.

What is the treatment for a petite mal seizure?

Assess airway, IV, check glucose levels, d50 25g IV, lorazapam IV. If no IV access than may give glucagon 1mg IM, midazolam IM.

What is the treatment for a grand mal seizure?

Assess airway, titrate SPo2 > 90%, protect patient from external injury, check glucose level, IV, benzodiazapine per protocol, rectal diazapam may be used in unable to establish IV.

What is calcium channel blocker overdose?

Calcium channel blockers (CCB) are widely prescribed drugs that are used to treat angina, hypertension and dysrhythmias and as well as to treat for the prevention of migraines. CCBs function by binding to the L-subtype, voltage-sensitive, slow calcium channels in cell membranes by decreasing the flow of calcium into the cells of the cardiac conduction pathway. The effects on the cardiovascular are peripheral arterial vasodialation, negative chronotropy, negative dromotropy and negative inotropy.

What is cardiogenic shock?

Cardiogenic shock is when the heart has been damaged so much that it is unable to supply enough blood to the organs of the body. The most common causes are serious heart complications, many of which these occur during or after a heart attack (myocardial infarction). These complications include: A large section of heart muscle that no longer moves well or does not move at all, rupture of the heart muscle due to damage from a heart attack, dangerous heart rhythms, such as ventricular tachycardia, ventricular fibrillation, or supraventricular tachycardia, pericardial tamponade, tear or rupture of the muscles or tendons that support the heart valves, tear or rupture of the septum, bradycardia or heart block.

What are the signs and symptoms of heat stroke?

Cessation of sweat, hot and dry skin, core temp usually >105*F, fluxuating pulse and respirations, ALOC and seizures are possible.

What are the signs and symptoms of heat exhaustion?

Core body temp >= 100*F, pale and clammy skin with heavy perspirations, rapid and shallow breathing, weak pulse, muscle cramps, headache, anxiety and imparied judgement.

What is croup?

Croup is a viral infection of the upper airway most common in children 6 months to 4 years of age and is more prevalent in the fall and winter. It causes inflammation of the upper respiratory tract. It can lead to edema under the glottis and larynx which can narrow the airway. Spasmodic croup occurs in the middle of the night without any prior infection.

What is the signs and sysmptoms of insulin shock?

Dizziness, irritability, hunger, shakiness, sweating, tachycardia. If severe enough it can lead to seizures, coma or death.

What is a generic drug overdose?

Drug overdose can occur by intentional or unintentional means, but each of these types of drug overdose occur when a person takes more medication than is the prescribed dose, recommended dose or is the misuse of an illegal drug. This can happen to a person of any age and will affect each person differently, especially when the drug or drugs taken are considered. When the body can not metabolize the drugs fast enough, side effects happens and can be deadly.

What is the treatment of organophosphate overdose?

Establish large bore IVs, administer atropine sulfate. May need to call for additional supplies of atropine sulfate. Monitor for potential airway compromise.

What are the signs and symptoms of HIV?

Fatigue, Fever, Sore throat, with later signs being Purplish skin lesions, Dementia, Psychosis, Peripheral neurological disorders. Life-threatening secondary infections can occur.

What are the signs and symptoms of anemia?

Fatigue, hypoxia, hypotension

What are the signs and symptoms of meningitis?

Fever, Chills, Headache, Nuchal rigidity with flexion, lethargy, Malaise, Altered mental status, Vomiting, Seizures, 10% develop septic shock, Death can occur in 6-8 hours.

What are the signs and symptoms of septic shock?

Fever, hypotension, tachycardia and ALOC.

What are the signs and symptoms of ureterolithiasis?

Flank pain on the affected side and may radiate to the groin, nausea, vomiting, hematuria. Patients may also have issues with standing or walking.

What is the treatment for lightening injuries?

Follow local CPR protocols and treat any burns as necessary.

What is GI bleed?

GI bleeds are classified as either upper or lower depending on where the complications occur in reference to the ligament of Treitz. GI bleeds is the general term used to describe any bleeding involving the GI system and is usually caused by some other process.

What are the signs and symptoms of esophageal varices?

Hematemesis with bright red blood, Difficulty swallowing, Burning/tearing sensation as varices continues to bleed, Classic signs of shock.

What are the signs and symptoms or an ischemic stroke?

Hemiparesis, difficulty speaking and/or slurred speech, blurred and/or double vision, loss of coordination, severe headache, ALOC, numbness, weakness or dizziness.

What is hemorrhagic shock?

Hemorrhagic shock is a condition that occurs when a person experiences extreme blood loss that results in the body's inability to perfuse tissues adequately. This blood loss can occur internally or externally such as from a ruptured aorta, a gunshot wound or a femoral artery laceration among many other causes.

What are the signs and symptoms of a hemorrhagic stroke?

Hypertension (usually SBP >220 mmHg is highly suspicious), hemiparesis, difficulty speaking and/or slurred speech, blurred and/or double vision, loss of coordination, severe headache, ALOC, numbness, weakness or dizziness.

What are the signs and symptoms of hypovolemic shock?

Hypotension, tachycardia, tachypneia, pallor and ALOC.

What is the treatment of appendicitis?

IV fluids, pain medication and rapid transport. Monitor for sepsis.

What is the treatment for heat stroke?

Interventions should focus on rapid cooling and fluid replacement, high flow o2 and EKG monitor.

What is Hepatitis B (HBV)?

Is a bloodborne transmission that invades the liver cells and causes inflammation and progressive fibrosis. May lead to liver cirrhosis or cancer.

What is hypovolemic shock?

Is a condition that occur when a person losses 20% or more of their blood volume and is considered an emergency. This condition can occur because of direct blood loss from cuts, lacerations or internal injuries or from indirect fluid loss due to burns, vomiting or diarrhea which is pulled from the patient's blood volume.

What is diabetic ketoacidosis (DKA)?

Is a life threatening condition that develops when cells in the body are unable to get the sugar they need for energy. When the cels do not receive sugar, the body begins to break down fat and muscle for energy. When this happens, ketones are produced and enter the bloodstream causing metabolic acidosis.

What is neurogenic shock?

Is caused by the sudden loss of signals from the sympathetic nervous system that maintain the normal muscle tone in blood vessel walls. The blood vessels relax and become dilated, resulting in pooling of the blood in the venous system and an overall decrease in blood pressure. Neurogenic shock can be a complication of injury to the brain or spinal cord and often associated with blunt force trauma.

What is Insulin Shock?

Is when there is too much insulin in the body thereby causing hypoglycemia. When a patient becomes hypoglycemic, the body is unable to fuel its cell and give energy that is needed to those cells. It can occur anytime there is an imbalance between the insulin in your system, the amount of food eaten, or the level of activity.

What is a grand mal seizure?

It is also known as a tonic-clonic seizure which is characterized by loss of consciousness and violent muscle contractions. It is caused by abnormal electrical activity throughout the brain. It can be triggered by epilepsy but may also be caused by stroke, hypoglycemia and / or trauma.

What is Heat Exhaustion?

It is considered an acute reaction to heat exposure. An individual can lose up to 1 to 2 liters of water an hour which balances out to 20 to 50Meq's of sodium. This loss in combination with vasodilation leads decreases in blood volume, venous pooling, and reduced cardiac output. If this individual goes untreated, it will most certainly lead to heat stroke.

What is a hemorrhagic stroke?

It results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding tissue.

What is the treatment for hemorrhagic shock?

Keep the patient warm, establish large bore IVs and replace fluids to maintain systolic pressure >90mmHg.

What is the treatment for hypovolemic shock?

Keep the patient warm, establish large bore IVs and replace fluids to maintain systolic pressure >90mmHg.

What is the treatment for heat exhaustion?

Large bore IV and fluid ressuciatin to maintain systolic pressure >90, high flow o2 and manage shock patient per protocol.

What are the signs and symptoms of hypothermia?

Lethargic, shivering, lack of coordination, pale cool skin. If severe enough cessation of shivering, dysrhythmias, loss of voluntary muscle control and pulse and respirations may be undetecable.

What are the signs and symptoms of bites and stings?

Localized pain, redness, swelling, skin wheal, itching. If severe can cause tachycardia, hypotension, bronchospasm and laryngeal edema.

What is the signs and symptoms of a grand mal seizure?

Loss of consciousness with sudden muscle contractions followed by rhythmic convulsions. Patient may experience an aura feeling, incontinence to bowel and / or bladder, confusion, fatigue and headache.

What is the treatment for heat exhaustion?

Move the patient to a cooler area, place patient in supine position, allow patient to drink fluids if appropriate otherwise replace fluids with IV therepy and cool patient avoiding to chill the patient.

What is the treatment for calcium channel blocker overdose?

Obtain EKG, IV fluids, calcium chloride, glucagon, vassopressors, glucose reading. Pacing may be necessary.

What is an ischemic stroke?

Occurs when an artery to the brain is blocked. If an artery is blocked, the brain cells cannot make enough energy and will eventually stop working. If the artery remains blocked for more than a few minutes, the brain cells may die. Ischemic stroke can be caused by several different kinds of diseases.

What is organophosphate overdose?

Organophosphate poisoning occurs when a person is overexposed to pesticides, insecticides or nerve gas. Children and people in high risk areas of being exposed to these substances, which can affect a person after they are absorbed subcutaneously, inhaled, ingested or injected, are more likely to develop organophosphate poisoning. Organophosphates binds to the A ChE enzyme and inactivate it into an unusable A Ch, which then binds to the nervous system affecting the central nervous system, the autonomic nervous system and skeletal muscles by overstimulation.

What are the signs and symptoms of neurogenic shock?

Patient may present with a different heart rates and blood pressures depending on the site of the injury. The patient may also have varying skin symptoms in relation to the site of the injury. Neurological symptoms may be present and urine may even cease.

What are bites and stings?

People most often die from allergic reactions from bites and stings. Local treatment is usually all that is necessary unless an allergic reactions occurs which may result in anaphylaxis.

What is the treatment for generic drug overdose?

Pre-hospital treament is limited to the use of narcan to reverse the effects from an opiod overdose. Monitor for potential airway comprimse and treat as need. EKG tracing should be obtained as well as glucose.

What is the treatment for neurogenic shock?

Pre-hospital treatment is to ensure the airway is protected and give oxygen as needed, stabilize the spin to reduce further injury, establish large bore IVs for fluid resuscitation, and cover the patient to reduce heat loss. Dopamine may be needed to sustain proper profusion and Atropine to maintain an adequate heart rate.

What is esophageal varices?

Pressure in the portal vein increases causing blood starts to build up in the nearby blood vessels, including those of your esophagus, and cause the veins to dilate and swell. Bleeding esophageal varices occur when swollen veins (varices) in your lower esophagus rupture and bleed due to excess pressure. Bleeding occurs because the veins of the esophagus have thin walls that aren't capable of handling high pressure.

What is the treatment of anaphylactic shock?

Priority should be on protecting the airway. Give o2, establish Iv, administer fluids, 0.3mg 1:1000 epinephrine IM, 125mg SoluMedrol, SVN Albuterol may also be given.

What is the treatment of hypothermia?

Remove any wet clothing, use passive external warming, keep patient horizontal, avoid sudden movements of patient and monitor cardiac rhythm.

What are the signs and symptoms of appendicitis?

Right lower quadrant pain with rebound tenderness, nausea, vomiting, anorexia, fever, decreased bowel sounds.

What are the signs and symptoms of hemorrhagic shock?

Tachycardia, tachypneia, hypotension, ALOC, anxious, urine output will decrease and the patient may have dilated pupils and tremors of arms and legs.

What are the signs and symptoms of croup?

The child may have a mild cold or other infection and present fine until evening time. A harsh barking (seal bark) or brassy cough will develop. There will be inspiratory stridor on physical examination as well as nasal flaring, tracheal tugging, and retraction. The child can develop tachycardia, restlessness, and cyanosis if the croup is severe enough

What are the signs and symptoms of epiglottitis?

The child will typically go to bed with what most parents think is mild infection but will awake with a high temperature and brassy cough. There will be pain on swallowing, high fever, sore throat, difficult shallow breathing, drooling, and inspiratory stridor. The child can appear acutely ill and agitated. The epiglottis will be swollen and cherry red in color. As the airway becomes more obstructed, nasal flaring, retractions and pulmonary hyperexpansion will occur as well. The patient will try and sit in the tri-pod position to maximize the airway for if the lie back, full airway obstruction can occur from the epiglottis.

What are the signs and symptoms of a petite mal seizure?

The patient may present with a vacant stare, absence of motion, lip smacking, eyelid flutter, hand movements. After the seizure, the patient has no confusion but does not remember the incident.

What are the signs and symptoms of cardiogenic shock?

They are the result of the underlying cause.

What is epiglottitis?

This is an acute infection and inflammation of the patient's epiglottis. This is caused by a bacterial infection, Haemophilus influenza type B. It appears in preschool children and kids 3 to 7 years old.

What is heat stroke?

This occurs when the hypothalamic temperature regulation of the body is lost which will cause uncompensated hyperthermia. Cell death as well as damage to the liver, brain, and kidneys occurs in this stage. Even though there is no set core temperature for heatstroke, if the body's temp is at 105*F, there are CNS disturbances, and sweating has stopped, the patient is experiencing a heatstroke emergency.

What is meningitis?

Transmitted by respiratory droplets which peaks in winter months. Infection grows in the respiratory tract, gastrointestinal or skin and eventually gains access to CNS through the bloodstream. The blood brain barrier becomes disrupted and blood vessels become leaky which causes swelling and decreased blood flow to the brain.

What is HIV?

Transmitted through unprotected sexual contact, sharing contaminated needles or contact of infected body fluids through mucus membranes, breaks in skin, or eyes. Produces cellular immune deficiencies, depletes helper T lymphocytes.

What is the treatment for anemia?

Treat symptoms as necessary and transport to appropriate facilty.

What is the treatment for cardiogenic shock?

Treat the underlying cause first.

What is the treatment for meningitis?

Use standard precautions with masks on self and patient, Maintain ABC's , Oxygen administration, IV access.

What are the signs and symptoms of generic drug overdose?

Vital signs may be seen as decreased, increased or not existent. A patient may be sleepy, confused, be in a coma and be at risk for aspiration. A patient may have chest pain, rapid or shallow respirations, nausea, vomiting, diarrhea, hematemesis, cardiac dysrhythmias, and abdominal pain.

What are the signs and symptoms of GI bleed?

Vomiting blood, bloody stool, hypotension, tachycardia and other signs of hypovolemic / hemmorhagic shock.

What is the treatment for bites and stings?

Wash the area, remove stinger if present, apply cool compress, EKG monitor, IV, 25 to 50mg diphyenhydramine. 0.3 1:1000 epi may be given IM. Provide o2 as needed and monitor airway.

What is hypothermia?

When the core body temperature is below 95*F, the patient is considered hypothermic. There will be peripheral vasoconstriction with an increase in cardiac output and respiratory. This is all in an attempt to warm up the body however as the body temperature continues to fall, so does the cardiac output and metabolic rate. Hypothermia is classified as either mild which is a core temp greater than 90*F or severe which is a core temp less than 90*F.

What is ureterolithiasis?

a condition in which one or more urinary calculus, kidney stone, is present in one or both ureters of the urinary system. This renal calculus may have been formed in the kidney, dislodged and traveled into the ureter, or it may have formed in the ureter itself. Most calculi are mineral stones and they can vary in size and shape. Calcium deposits in the kidneys are often responsible for the stones which travel and can become trapped in the lumen of the ureter.

What is the treatment for beta blocker overdose?

activated charcoal, NG/OG tube. EKG tracing should be obtained. It may be necessary to support efforts of breathing as well as increasing heart rate and blood pressure.

What are the signs and symptoms of tuberculosis?

chills, fever, fatigue, chronic cough (productive or non-productive), weight loss, night sweats, hemoptysis.