| Term | Definition |
| CO2 Drive | Alert/Awake, Verbal, Pain, Unresponsive |
| Coup Contrecoup | brain insjury on the opposite side of the impact |
| Epidural Hematoma | bleeding beneath skull but above the dura mater - significant arterial bleeding -dangerous increase in intercranial - Brief loss of consciousness Worsening LOC, headache, seizures, vomiting, posturing, hypertension, bradycardia, pupillary changes |
| Prone | lying flat face downward |
| Intercranial pressure | rise in systolic blood pressure, widened pulse pressures, bradycardia, irregular breathing, heart rate increase, breathing shallow, apnea will occur, and blood pressure will begin to fall. agonal rhythm followed by respiratory arrest and cardiac arrest. |
| Absence Seizures | – petit mal seixures
o PT doesn’t interact with environment |
| Sedative Hypnotic Drugs | |
| Abruptio Placenta | Premature separation of placenta from the uterine wall
O2 and nutrients to fetus is compromised
Maternal blood loss can be severe
Fetus will not survive a complete abruption
Painful vaginal bleeding in 3rd trimester
Assess S+S of shock |
| Cystic Fibrosis (CF) | Genetic disorder leading to thick mucus production and chronic lung infections - often causes death prior to entering adulthood
S&Sx – asthmalike symptoms and gastrointestinal problems |
| Oropharyngeal Airway | Indications: Unresposive pts without gag reflex
Contraindications: Consious pts or any pt with gag reflec
Sizing - mouth to earlob |
| Status epilepticus | o Prolonged (30 min) or recurring without pt. regaining consciousness in between
o Dangerous – lead to permanent brain damage or death |
| DCAP - BTLS | rapid trauma assessment - soft tissue injuries - Deformities & Discolorations
Crepitus & Contusions
Abrasion & Avulsion
Penetrations & Punctures
Burns
Tenderness
Lacerations
Swelling & Symmetry |
| CPR | Emphasis on high quality compressions -Rate at least 100/ min
Depth - 2 in for adults - At least 1/3 of chest for infants and pedis - 2 in for pedis - 1.5 inches for infants
Minimum interruptions - Max is 10 sec
30 COMPRESSIONs: 2 BREATHS — Always |
| Type 1 - Insulin Dependent Diabetes Mellitus (IDDM) | Must (inject) supplemental insulin - Develops in pedis -genetic in most cases- present with the three Ps and high glucose levels
• Type 1 are high risk for diabetic ketoacidosis (DKA) if untreated
• High risk for insulin shock due to overdose |
| Acute Myocardial Infarction (AMI or MI) | death to an area of the myocardial muscle due to lack of oxygenated blood flow through the coronary arteries - dead myocardial tissue becomes scar tissue and cant contribute to cardiac contraction. Time is criritcal to restore blood flow and minimize car |
| Tredelenburg | |
| • Laceration | – jagged cut |
| Generalized Seizures | – Grand Mal
o Pt unresponsive and experiences full-body convulsions |
| Subdural Hematoma | – bleeding above the brain (beneath the dura mater and above the arachnoid meningeal layer) - caused by venous bleeding following cerebral contusion Vomiting, decrease LOC, pupillary changes, unilateral weakness or paralysis, hypertension, changes in resp |
| Nasopharyngeal Airway | Indications - Unresponsive pt without gag reflex or pts with decreased level of conciousness but with intact gag
Contraindications - concious pts who can protect their own airway - head or facial trauma - resistance to insertion - pts less then 1 year |
| Angina Pectoris | - Transient Chest pain caused by a lack of 02 to the hearth muscle
• Usually caused by atherosclerosis ( buildup of plaque in a blood vessel that restricts or obstructs flow) in the coronary arteries
• Usually occurs during physical activity or stress a |
| Rotation | – extreme lateral (side to side) movement |
| Beta- Blockers | Prevent heart from speeding up, or beating harder, - used for the management of cardiac arrhythmias, protecting the heart from a second heart attack MI after a first heart attack, used to be used for high blood pressure |
| Uterine Rupture | • Thins as it grows – increasing risk for rupture
• Danger to mother and fetus
• Classic presentation – abdo pain and vaginal bleeding |
| Rotational Spins | – increase risk of c-spine injury |
| Seizures | Causes by disorganized electrical activity in the brain- Phases – varies for pt- Aura phase – warning – pt may sense seizure - Tonic – muscle rigidity – incontinence - Tonic-clonic – uncontrolled muscle contraction and relaxation (pt. may be apneic) - Po |
| Thermal Burns | heat from water, steam or fire - Stop burning with moist sterile burn sheet until skin is no longer hot to touch - Replace with dry sterile burn sheet reduce risk of hypothermia infection, Remove clothing that trap heat +Jewelry – massive swelling |
| Blast Injuries | Primary – injuries dues to pressure wave of blast - Secondary – injuries due to flying debris - Tertiary – injuries from being thrown against stationary object - Miscellaneous – burns, inhalation etc |
| Inhalation Injury | – chemical inhalation or inhales hot gases due to fire in a confined space
• S+S include stridor, dyspnea, coughing, wheezing, facial burns, hoarse voice, airway edema, singed facial hair or soot in mouth or nose |
| Hematemesis | – vomiting blood |
| Chronic Obstructive pulmonary Disease (COPD) | Slow chromic disease that obstructs and damages the lower airways and alveoli – COPD includes chronic bronchitis and emphysema
Largely due to cigarette smoking – often on home or portable Ox |
| Eclampsia | • When mother seizes following preeclampsia
• Life threatening |
| Glucagon | |
| Syncope | – fainting – temporary loss of blood to brain
• Cardiac Emgr, hypotentsion, neuro problems, stress, diabetes, pregnancy, anemia, meds or toxic exposure
• Pts regain consciousness when they are supine and blood flow returns to brain
Assessment and Manag |
| Impaled Object | • Should be stabilized
• Indications for removal
o Object creates airway obstruction or inability to manage airway (cheek)
o Object is in the chest and prevents CPR for pt in cardiac arrest |
| Cardiogenic shock | pump problem – backup of fluid, pulmonary edema and hypotension – caused by reduced preload, high afterload or poor myocardial contracality S+S hypotension, cardiac hx, chest pain, respiratory distress, pulmonary edema, altered LOC |
| 3 Ps of Diabetes | • Polyuria – excessive urination due to excess glucose in the urine
• Polydipsia – excessive thirst due to dehydration
• Polyphagia – excessive hunger due to cell starvation |
| Distributive shock | – pipe (blood vessel) problem – widespread vasodilation - causes blood pooling or relative hypovolemia – Analphylactic shock, neurogenic, septic, psychogenic |
| Specific Interventions for Ingested Toxins | • Activated charcoal
• Contact med direction or a positon control center |
| inhalation the diaphragm and intercostal muscles are contracting. There is a drop in pressure within the thorax and air is pulled in, not pushed. | the diaphragm and intercostal muscles are contracting. There is a drop in pressure within the thorax and air is pulled in, not pushed. |
| • Abrasion | scrape to the skin due to surface friction |
| Scene Size Up | • Scene Satey – Precautions (BSI)
• Determine # of pts and need for additional resources
• Consider MOI or NOI |
| Cincinnati Prehospital Stroke Scale | • Facial Droop – ask pt to smile
• Arm drift – close eyes while holding arms out front palms up (one arm will drift)
• Speech - ask pt. to repeat a given sentence - speech is slurred, pt unable to speak |
| APGAR | • Buttocks or legs are presenting
• Transport Immediately – if delivery occurs high risk head will become stuck in birth canal
• If the head is tick use fingers to form a V along the vaginal wall to create space to allow the baby to breath |
| ABC | |
| Epistaxis | Bleeding from the nose |
| Ectopic Pregnancy | • Egg is implanted outside of the uterus – usually fallopian tube
• Can lead to rupture and severe bleeding
• Classic Presentation – severe abdo pain without vaginal bleeding
• Assess S&S of shock |
| Assessment and Management Cardiogenic SHock | • Chest pain or other symptoms cardiac emergency should be high transport priority
• Consider nitroglycerin and aspirin
• Consider CPAPC or BiPAP for CHF |
| Normal Respiratory Rate & Rhythm | Adults - 12 to 20 BPM
Children - 15 to 30 BPM
Infants - 25 to 50 BPM |
| Somatic/ Parietal Pain | Sharp / Easily localized pain |
| Glucose Levels | • - Normal 80 – 120
• After eating 120-140
• Hypoglycemia – less then 60
• Hyperglycemia - > 120 |
| Atypical Presentations of MI | o Not all pts have chest pain – silent MI
o Some complain of epigastic pain or indigestion
o Pt groups who experience atypical MI presentations
• Geriatiric
• Women
• Diabetic |
| Subarachnoid Hemorrhage | - bleeding in subarachnoid space
• Allows blood to enter cerebrospinal fluid (CSF)
• Due to trauma or a ruptured aneurysm
• S+S
o Headache, stiff neck
o Neuro impairment, decreased LOC and seizures |
| Peritonitis | • Caused by inflammation of the peritoneum (membrane lining the abdominal organs and cavity)
• S+S
o Nausea vomiting, loss of appetite, diarrhea, fever |
| Croup | (laryngotracheobronchitis) – inflammation of the pharynx, larynx and trachea - hignly infectious and occurs in children of up to 3 years of age
S&Sx
Ususally proceeded by a cold and occurs in winter
“barking” cough
Presents with stridor a high-pitche |
| PT Assessment | SCENE SIZE UP
• Scene Satey – Precautions (BSI)
• Determine # of pts and need for additional resources
• Consider MOI or NOI
PRIMARY ASSESSMENT
• Assess and manage ABCs (CABs if pt is unresponsive)
• Simultaneious manual c-spine if precautions are |
| Insulin | pancreatic hormone – move glucose out of bloodstream and into cells - W/out insulin glucose can’t enter cells - cells starve look for other fuel – brain cells cant -Brain cells starve if no glucose/not starve if glucose is present regardless of insulin |
| CAB | Unresponsive Pts |
| Gastroenteritis | • Infection with associated diarrhea, nausea and vomiting
• Due to contaminated food or water – not contagios
• Prolonged vomiting and diarrhea can lead to hypovolemic shock
• Common cause of shock in children |
| Hypertension (High BP) | – systolic greater then 140 mmHG and a Diastoluc above 90 mmHG
• Hypertensive Crisis – Systolic over 160 and diastolic over 94
o Pt might have associated symptoms or asymptomatic
o Asymptomatic pts should be evaluated by a physician
• S+Sx:Headache, |
| Cause Seizures | Congenital problems, trauma, med conditions, alchoho, brain injury, tumor, diabetic emergency, epilepsy, fever, infection, insulin, poisoning/toxic exp., stroke, bio/chem weapons - Febrile seizures common in pedi pts. – typically do not present significa |
| Head on Motor Vehicle Collisions (MVC) | up and over or down and under the dash – head, spinal chest, abdo, hip and lower extremity injuries – unrestrained pts are ejected |
| Control External Hemmorrhage | 1 Method - Direct pressure with dry, sterile dressing, Elevate extremity above heart if possible, apply pressure dressing if bleeding is controlled
2nd - Direct pressure does not control bleeding – apply a tourniquet proximal to the source of blood |
| Type 2 | – non insulin dependent diabeties mellitus
• Don’t typically require supplemental insulin
• Combo of lifestyle and genetics |
| Conduction | direct transfer of heat through contact with colder structure |
| Deep Vein Thrombosis (DVT) | • Blood clot in a large vein usually the leg
• Loose clot can cause pulmonary embolism
• Long term immobility (travel, hospitalization, sedentary lifestyle) increase risk |
| Upper Airway Issue | Stridor |
| Congestive Heart Failure (CHF) | – when ventricles aren’t able to keep up with the flow of blood coming to them
• RIGHT VENTRICLE - if pumps ineffectively blood backs up in the venous system that feeds the right heart
o Signs – JVD and Pedal Edema
• LEFT VENTRICLE – backs up the lun |
| Ulcers | • Open wounds along the digestive tract – often the stomach
• S+S
o History of ulcers
o Abdominal pain in the left upper quadrant
o Nausea and vomiting
o Elicits increase in pain before meals and during stress |
| Cushings Triad | hypertension, bradycardia and apnea. |
| Chemical Burns | • Chemicals require immediate and continuous irrigation
• Avoid moving from one eye to the other |
| Ventilation | Patients with inadequate, slow, or shallow ventilations should be ventilated |
| Acute Coronary Syndrome (ACC) | • Myocardial ischemia
• Angina pectoris and acute MI |
| Psychogenic Shock | – sudden temoporary vasodilation that leads to syncope (fainting) – doenst present a sustained problem – sudden vasodilation intterrups blood flow to brain leading to syncopal episode |
| Heatstroke | Body looses ability to regulate heat lead to death if untreated
Altered LOC,Skin hot and dry or wet, Seizures, Move cool enviro, If alert water can be administered, Expose pt – cool with water, wet towels cold packs in groin, neck and armpit, transport |
| Extension | – extreme backward movement of head (eg rear impract accident) |
| Pneumonia | Infection in the lungs – leading cause of pedi deaths worldwide – concern for any patient that aspirates
S&Sx
History of chronic or termina illness, productive cough, weekness, chest pain, fever, low pulse ox reading |
| Distraction | – stretching of spinal column (hanging) |
| Risk Factors CVA | • Nonmodifiable – RASH Races, Age, Sex Heredity
• Modifiable - SHEDS Smoking Hypertension Exercise Diet and Diabetes, Stress |
| Kidney Stones | • Crystals formed in the kidneys that cause an obstruction in the urinary tract causing severe pain
• Males more likely to develop
• Signs and Symptoms
o Severe abdo pain, groin pain
o Pain urination, fever, nausea and vomiting |
| Signs and Symptoms of Diabetic Ketoacidosis | high blood glucose above 350 - Deep Rapid Breaths -Kussmauls - The 3 Ps - Polydipsia – excessive thirst - Polyphagia – excessive hunger - Polyuria – excessive urination - Unusual odor on breath – fruity or acetonelike - Incontience - Tachycardia -Coma |
| sympathetic nervous system | Dilated pupils, dry mouth, and hypertension, increased cardiac output, increased respirations, peripheral vasoconstriction, and decreased blood flow to the GI tract |
| Preeclampsia – toxemia of pregnancy | • Occurs 3rd trimester
• Cause not completely understood
• S+S – sudden weight gain, visual disturbances, sudden swelling in face, hands, feet, headache, hypertension |
| Appendicitis | – Inflammacion of the appendix
• Life threatening infection and septic shock
• S+S
o Nausea, vomiting, diarrhea, loss of appetite, fever
o Pain begin as diffuse Pain starts periumbilical and the moves to RLQ |
| Hypovolemic Shock | fluid problem-Loss off blood, Dehydration from vomiting, diarrhea or burns- Common pedi and geriatric pts- S&Sx - Trauma, blunt or penetration - Bleeding, change LOC, nausea, vomit, diarrhea, Tachycardia pale cool skin, Week peripheral pulse, hypotension |
| Moderate Burn Injuries | • Full thickness burns covering 2 to 10% o
• Partial thickness nurns covering 15 to 30%
• Superficial Burns covering more than 50% |
| Narcotics - opiods | |
| Cholecytitis | Inflammation of the gall bladder often due to gallstones - Females 30-50
S+S - Right upper quadrant pain - Increased pain at night - Increased pain after eating fatty foods - Referred pain in the shoulder is common - Nausea and vomiting |
| Diverticulitis | Develops when small pouches (fiverticula) along the wall of the intetestine fill with feces abd become inflamed/ infected
over 40 and low fiber diet - S+S - Abdo pain in the lower left quadrant, Fever, Weakness, Nausea, vomiting, Bleeding not common |
| Transient Ischemic Attack | • TIAs have same signs and symptoms as CVA but signs and symptoms self-correct within 24 hours - no permanent brain damage
o Mini strokes – warning sign for impending CVA |
| A nonrebreather mask | is indicated for spontaneously breathing patients with adequate ventilations and signs of hypoxia |
| Pneoumothorax | Accumulation of air in the pleural space
Occurs spontaneously or as a result of trauma
Astham patients are at a high risk of spontaneous pnt
S&Sx
Hx of respiratory problems or thoracic trauma
Diminished or absent lung sounds in affected area |
| The foramen magnum | is a large opening at the base of the skull that allows the brain and spinal cord to connect. |
| Neurogenic Shock | – spinal cord damage, typically in cervical region – interrupts normal communication pathways between nervous systems – S+S – MOI:c-spine, hypotension, warm, normal skin, HR NOT tachycardic, Paralysis +resp paralysis |
| Ischemic Strokes | – bloodflow is compromised due to blockage
• Due to atherosclerosis (build up of plaque)
• Most strokes are ischemic |
| • Avulsion | flap of skin being torn partially or completely loose |
| Rear- Impact Motor Vehicle Collisions (MVC) | C-spine injury due to hyperextension is common |
| UTI – Urinary Tract Infection | are intended to cause disease |
| Compression | –Compression of head against body (diving injury) |
| chemical agents | Nerve agents and choking agents are examples of chemical agents |
| Respiratory Syncytial Virus (RSV) | – respiratory infection commin in infants and children – extremely contagious
S&Sx coldlike symptoms, poor fluid intake, signs of dehydration |
| Flexion | – extreme forward (chin to chest) movement of head |
| Pelvic Inflammatory Disease (PID) | • Painful and requires treatment – non emergency transport is recommended
• S+S
o Abdominal pain
o Fever
o Pain during urination
o Increased pain while walking
• Vaginal Bleeding
o Causes – spontaneous abortion, PID, STDS |
| chest compressions, | is indicated for unresponsive children with a pulse rate below 60 |
| Primary Assesment - | Assess and manage ABCs (CABs if pt is unresponsive)- manual c-spine if precautions are needed - Administer 02 and ventilate if needed - Rapid Scan – less then 90 seconds (inspection, palpation and auscultation as needed) - Determine Tranpsort priority |
| Minor Burn Injuries | • Full thickness burns covering less than 2%
• Partial Thickness burns covering less than 15%
• Superficial Burns covering less than 50% |
| Lateral Impact (T-bone) Motor Vehicle Collisions (MVC) | –injuries along the side of impact are common |
| RLQ | Appendix - late |
| Nitro | • Weakening of the wall of the aorta in the abdominal region, prone to rupture - will cause rapid fatal bleeding - S+S, common in geriatric Males, Tearing back pain, S+S of hypovolemic shock, pulsating abdominal mass
o Transported without delay |
| Supine Hypotensive Syndrome | Fetus compresses inferior vena cava – cause severe drop in blood pressure, Occurs later stages when mother is supine- Dizziness, hypotension, pale skin, altered LOC- keep fetus off of vena cava Put pt in seated position, left or right side, if pt is supin |
| Glasgow Coma Scale | Eye opening - Spontaneous 4,speech3,pain 2,None 1
Verbal - A&O 5, Confused 4, Inappropriate 3, Incomprehensible 2, None 1 Motor - Obeys 6, Localizes Pain 5, Withdraws from pain 4, Abnormal Flexion – 3, Abnormal Extension – 2, None 1Total – min3 max – 15 |
| Spontaneous Abortion | • Prior to the 20th and 22nd week of pregnancy
• Classic presentation - cramping, lower abdo pain, vaginal bleeding, passage of tissue or clots
• Assess s+s of shock |
| Hematoma | a solid swelling of clotted blood within the tissues |
| • Depressed | – may be noticeable on palpation - increased risk of brain injury due to bone displaced from tissue |
| Rollover MVC | - injury patterns are difficult to predict – high risk of ejection |
| Evisceration | |
| Intracerebral Hemorrhage
• | Bleeding within brain tissue
• Pts can deteriorate rapidly
• High mortality rate |
| Hyperflycemic Hyperosmolar Nonketotic Syndrome | |
| Prolapsed Cord | - When the cord is presenting in the birth canal
• Can become compressed and cut of 02
• Instruct Mother not to push – decrease pressure
• Place mother in knee to chest position
• Push presenting part of baby away from cord
• Transport Immediately |
| Visceral Pain | Dul, poorly localized |
| Nuclear and radiological agents | are intended to cause injury by blast, radiation, or thermal burns |
| Insulin Shock | Rapid - brain damage can occur rapidly - treatment must be rapidl - Low BG - Altered LOC – confusion, irritability - Seizures and coma - Restless, anxious - Diaphoresis, tachycardia -Pale, cool skin tremors
misdiagnosed intox or behavioral EMRG |
| Secondary Assessment | • Head to Toe
• SAMPLE / OPGRST
• Vitals |
| cardiac tamponade | fluid accumulates within the pericardial sac and compresses the heart S+S (JVD, narrowing pulse pressure, hypotension) |
| Anaphylactic Shock | allergic reaction – vasodilation, widespread (fluid leakage), bronchoconstriction – causes meds, foods bites stings enviro allergens skin:hives, swelling, itching flushed or cyanotic, cardio:weak pulse, low bp resp:severe dyspnea, wheezing, failure |
| Impaled Objects | • Don’t remove from eye
• Stabilize in place
• Keep both eyes closed to prevent passive movement of impaled object |
| Aspirin | - pancreatic hormone works opposite of insulin – increases blood glucose |
| Supine | face upward |
| Abdominal Aortic Aneurysm (AAA) | • Similar to DKA but without the build up of ket0nes
• Occurs more frequently with type 2 |
| SVN | machine is used to nebulize bronchodilator medications |
| Right Heart Failure | JVD and Pedal Edema |
| LUG | Primary regulation of Breathing in our bodies - Monitors C02 levels in our bodies |
| Chemical Burns | Eyes and respiratory system are at high risk - scene safety first – Remove contaminated clothing, jewelry - Brush off any dry chemical on skin - Irrigate f water
o Avoid contaminating unaffected areas with runoff
• Treat as thermal burn |
| AVPU | air enters chest cavity due to lung injury - pressure compresses lungs and great vessels – S+S include JVD, resp. distress, diminished absent lung sounds, poor BVM compliance, tracheal deviation toward unaffected side |
| Evaporation | – loss of heat through evaporation of water from the skin |
| • Incission – | sharp, clean cut |
| Cincinnati Prehospital Stroke Scale | acial droop, slurred speech, and arm drift |
| Heath Cramps | – local emergency
• Occur during prolonged exertion and are likely caused by electrolyte imbalance and dehydration
• Management – rest, rehydrate, restore electrolytes |
| Severe Burn Injuries | compromise respiratory, 3rd circumferential burns
2nd covering > 30%
3rd covering> 10%
Burns with associated trauma
Full thickness burns to airway, hands, face, feet or genitalia
A moderate burn criteria for pts under 5 and over 55 |
| Rapid Scan | part of the primary assessment - meant to identify any lift-threatening conditions - not used to identify low priority injuries - pt with the potential for life threatening conditions, conscious or unconscious, receive a rapid scan. |
| Diabetic Ketoacidosis (DKA_ | Occurs with type 1- BG is> 350 mg - Brain cells use glucpse rest of the bodys cells starve -spills glucose into urine - dehydration - Use of alternate fuel sources - anaerobic metabolism production of ketones and acidosis -Acidosis threatens brain |
| Partial thickness (second-degree) burn | • Epidermal and partial dermal injury
• Paintful blisters present |
| Falls MOI | o >10 ft by pedi or any fall with loss of conciousness
o greater then 15 ft or three times patient’s height is significant
o Surface Struck
o Body part landed on |
| Congestive Heart Failure | heart doesn’t pump effectively and leads to back up of fluid and pulmonary edema |
| Tension pneumothorax | open abdo injury with externam organs (ususally intestines) protruding
• Cover with moist sterile dressing
• Cover that dressing with an occlusive dressing
• Flex legs to reduce abdominal contraction
• Treat for Shock
• High Priority Transport |
| Septic Shock | infection- damages blood vessels and increases plasma loss out of vascular space - fever, chills, weakness, recent illness infection or surgery, altered LOC, increased RR, tachycardia, low bp, pale cool skin, weak peripheral pulses, no appetite |
| LLQ | Class: anti-inflammatory, anti-platelet aggregate, antipyretic 3. Mechanism of action: reduces inflammation, decreases platelet aggregation, reduces fever |
| Diamond Placards | Blue – health hazard 4 deadly, 0 normal material
Red – fire hazard – flash points – 4 below 73F – 0 will not burn
Yellow – Reacticity – 4 may detonate – 0 Stable
Whitel specific hazard |
| Breech | • Sedative Hypnotics are CNS depressants
• Calming effect and induce sleep – taken orally but can be injected
• Barbiturates – amytal seconal and luminal
• Benzodiazepines – valium, Xanax and Rphypnol |
| Kussmaul breathing | is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. |
| Skull fx | • S+S
o Battle’s Sign - bruising behind the ears
o Raccoon Eyes – bruising under the eyes |
| Corneal Abrasion | • Caused by Direct trauma and foreign objects
• Cornea transparent covering over the iris and pupil
• S+S – pain, tearing, sensation of something in eye |
| • Basal Skull Fx | - occur base of skull - fluid may leak from nose or ears |
| Hemorrhagic Stroke | – bleeding within the brain
• Bleeding robs brain of O2 and can ply pressure to surrpinding brain tissue – further limiting O2
• Limited options for interventions – prevention through modification of risk factors is key |
| Supine hypotensive syndrome | occurs when the weight of the fetus and uterus compresses the inferior vena cava.This reduces the return of blood to the heart, reducing cardiac output and blood pressure. |
| TICLS | – abnormal findings indicate neuro problem, Tone – movement, muscle tone, listlessness, Interactivity – alertness, reactivity to stimulus, interaction with enivro, Consolability – can be consoled Look – able to fixi gaze
Speech or cry – assess |
| Left Lateral Recumbant | Back Flat - Feet Up |
| Biological agents | - widely abused - ingested or injected - Morphine, codeine, heroin, oxycodone, -CNS depressants - Bradypnea,shallow respirations, and pinpoint pupils - case coma and severe respiratory depression
• ALS providers able to administer Narcan |
| Linear skull fx | – most skull fxs – don’t present deformity or depression |
| Transected Severed Cord | Paralysis below injury, Loss of bladder/ bowel control, Respiratory arrest if high cervical injury – C5 +, Neurogenic shock ,Hypotension without tachycardia, Priapism (involuntary penile erection – spinal shock can present but resolves with 24 hours |
| Left Heart Failure | Pulmonary edema |
| • Pelvic Fracture | 1 in 5 hip fx pts dies within one year
Risk of hypovolemic shock, embolism, pneumonia and sepsis
Most hip fractures occur in geriatric pts
Pelvic binders are commercial splints used in some EMS systems to stabilize pelvic fx and reduce bleeding |
| Radiation | - transfer from radiant heat |
| Convection – | loss of heat to passing air |
| Cerebral Contusion | - accompanied by edema and/or concussion injury
• S+S
o Signs of concussion
o AND decreased mental status, unresponsive, pupillary changes, changes in vital signs, obvious behavioral abnormalities |
| Periotoneal | membrane that forms the lining of the abdominal cavity. produces somatic/ parietal pain - sharp and easily localized |
| The hypoxic drive | is the body’s backup system to the CO2 drive. It monitors oxygen levels in the blood |
| Acids and Alkalis | Caustic substances
• Acids – low pJ and burn on contact
• Alkalis have a very high pH and tent to burn deeper the acids – pain may be delayed - Activated charcoal is contraindicated with caustic or hydrocarbon ingestion. |
| Lateral bending | – (extreme bending of head to side (ear to shoulder) |
| • Femur Fx | o Single femur fx can cause hipvolemic shock
o Increased risk of embolism
o Fxs to multiple smaller long bones can combine to cause hypovolemic shock |
| Flail Chest | Responsive Pts. -
AIRWAY - Manual airway maneuvers, suction, mechanical adjuncts
BREATHING - Assess respiratory rate, quality, and auscultate lung sounds. Give O2 or ventilations
CIRCULATION - Pulses, bleeding, and skin condition |
| Adventitious Breath Sounds | are abnormal sounds that are heard over a patient's lungs and airways. These sounds include abnormal sounds such as fine and coarse crackles (crackles are also called rales), wheezes (sometimes called rhonchi), pleural rubs and stridor. |
| RUQ | Cholecytitis |
| Open Neck Injury | cover open neck wounds with an occlusive dressing to prevent air embolism |
| Sprain | – injury to a ligament
• Involve shoulder, knee or ankle joints
• S+S
o Pain and tenderness – immediately
o Swelling and discoloration – delayed |
| Hyperventilation Syndrome | – rapid breathing and often associated with distraught patients
Can be sign of serious underlying medical problems
Attempt to calm patient and move from stressful situation
Never have a patient breathe in to a paper bag or O2 mask without O2 |
| Orbital Fx | • Signifcant MOI – consider spinal trauma
• S+S
o Visual disturbances, double vision
o Deformity around the orbit
o Loss of sensation around the orbit
o Inability to move eye in upward gaze |
| • RICES | o Rest, Ice, Compression, Elevation Splinting |
| Semi Fowlers | position of a patient who is lying in bed in a supine position with the head of the bed at approximately 30 to 45 degrees. Upright at 90 degrees is full or high Fowler's position. |
| Pedi Assessment Triangle | Appearance, Breathing, Circulation |
| Full thickness (third degree burn) | • Injury completely through dermal layer
• Dry Leathery Skin – no pain |
| Superficial Burn | • Epidermal damage only
• Painful, red, no blisters |
| Stroke | - death to brain tissue due to interruption in blood flow - Cerebrovascular Accident CVA - Ischemic, Hemorrhagic
S+Sx - Severe headache, slurred speech, Facial Droop, drooling, Unilateral numbness, weakness, paralysis, Altered LOC, Vision Problems |
| Lower Airway Issue | Rales, rhonchi and wheezes |
| Regulation of Sugar | • Food consumed – glucose increases
• Insulin released – glucose goes into cells
• Blood sugar levels fall – glucagon is released
• Glucagon temporarily maintains sugar levels
• Etc |
| Electrical Burns | scene safety – don’t remove pt without proper training -Significant unseen injury have occurred entrance and exit points on body - Electrical burn pts are high risk of respiratory and cardiac arrest -All pts require transport and evaluation by physician |
| parasympathetic nervous system | exerts control over digestive functions |
| Pulmonary Edema | – accumularion of fluid in the lungs
Causes – CHF, toxic inhalation, disease trauma
S&Sx – cardiac hx, rales, pedal edema, orthopnea (dificulyry brearhing while lying down |
| Herniation Syndrome
• | brain is compressed due to excessive ICP - Will force brain down toward foramen mangnum
o Cushings response/ reflex – hypertension, bradycardia, altered respiratory patern -Mortality rates high – attempt to reduce dangerously high ICP higher ventilation |
| Fowlers | Sitting - The upper half of the patient's body is between 60 degrees and 90 degrees in relation to the lower half of their body. |
| Strain | – stretching injury to a muscle or tenden
• S+S pain and tenderness
• Usually little bleeding with a strain so swelling and discoloration will likely be minimal |
| Asthma | acute condition caused by bronchoconstriction & Excess mucus production – triggered by exercise. Allergic response and illness – wheezing on exhalation, abselt lung sounds in severe cases and coughing |
| Emergency Response Guide | • Signs and Symptoms
o Abdo pain
o Hematuria – blood in urine
o Painful or frequent urination
o Fever, nausea, vomiting |
| Primary Assessment | Determine the transport priority. |
| Obstructive Shock | – pump problem caused by mechanical obstruction of the heart muscle - cardiac tamponade and tension pneumothorax |
| Espophageal Varices | • Weakening of the blood vessels lining the esophagus
• Frequently addociated with alcoholism
• S+S
o Vomiting large amounts of bright red blood
o Hx of alcohol abuse or liver disease
o S+S of hypovolemic shock |
| SLUDGEM | drug overdose, nerve gas pathological effects indicative of massive discharge of the parasympathetic nervous system - Salivation, Lacrimation(tearing), Urination, Defecation Gastrointestinal upset, Emesis (Vomiting) Miosis pupillary constriction |
| Five Factors of Burn Severity | • Depth, • Amount of body surface area burned • Burns to critical areas• Associated trauma or preexisting medical conditions, poor health and certain meds complicate bodies ability to handle a burn injury
• Age |
| Respiration | – loosing heat from your breath |
| CO2 Poisoning | Leading cause of death due to fires, home heating devices and vehicle exhaust -Inhibits bodys ability to transport and use O2 - greater risk in confined space – tasteless, colorless, odorless non irritating
Headache, nausea, vertigo weakness |
| Amputated Parts | should be protected and transported in dry cool setting. Putting directly on cold pack could freeze the part |
| GI Bleeding | Often middle age pts, Most often fatal in geriatric pts
•Upper GI bleeds – ulcers
•Lower Gi Bleeds – due to diverticulitis
• S+S vomiting blood, bloody stool
o Dark Tarry Stool
o Signs and symptoms of hypovolemic shock |
| Sedatives Narcotics Barbiturates | o Decreased LOC, respiratory depression
o Pupillary constriction
o Respiratory arrest seizures coma and death |
| Partial Seizures | o No change in LOC, possible twitching/ sensory changes (no ful body convulsions
o Complex Partial Seizures – altered LOC, isolated twitching and sensory changes possible |
| Hematochezia | – bloody stool |
| Plancenta Prvia | • third trimester – placenta attaches to the uterus over the cervical opening
• cervix dilates - placenta is torn and bleeds
• Classic presentation – painless vaginal bleeding third trimester
• Asses for S+S of shock |
| Heat Exhaustion
• | Systemic heat emrg
• Combo of heat exposure and hypovolemia
• S+S
o Hx of exertion in warm environment
o Dizziness, weakness
o Nausea vomiting
o Headache
o Muscle and abdo cramps
o Thirst
o Tachycardia
o Changes in orthostatic vitals |
