Module 4

The accumulation of fluid in the space between the alveoli and the pulmonary capillaries

Rapid beating of the heart 100 beats/min or more

An arterial disease characterized by the elevation of the blood pressure, especially the diastolic pressure

Fluid into the interstices of cells in the tissue spaces or into the body cavities

Lowered blood pressure. A disease or condition characterized by this symptom

Swelling or enlargement of part of an artery, resulting from weakness of the arterial wall

Usually slow beating of the heart, 60 beats/min or less

Pain caused by the heart tissue not getting enough oxygen

Shortness of Breath

• Epi-Pen
• Actiated Charcol
• Oral Glucose
• Aspirin
• Nitroglycerin
• Oxygen
• MDI

• Activated Charcol
• Oral Glutos
• Oxygen
• Epi Pen
• Aspirin

Reason for administering

Condition that makes it not used

Effects of the drug

The safe amount of the drug that can be administered

Method in which the drug is given

Actions of the drug other than the main effect or "Mechanism of Action"

Meter Dose Inhaler

A tube that is applied between the inhaler and the patient for proper intake of the medication

Chest pain, Doctor prescribed, Medical Control approved

Blood pressure below 100 systolic, head injury, child or infant, 3 doses have been taken

1 tablet or spray under the tongue, maye repeaded 3 to 5 minutes if no relief, Blood pressure remains greater than 100 systolic, Medical Control must approve

Vessel dilation, headache, drop in blood pressure, pulse rate change

Altered Mental Status, History of Diabetes, Ability to swallow

Unconscious, unable to swallow

One tube

Airway obstruction without gag reflex

Sever allergiv reation, prescribed by doctor, orders from Medical Control

None, For Life threating allergic reactions

Auto injector, Adult = .3mg Child & Infant = .15mg

Increassed heart rate, pale skin, dizziness, chest pain, headache, nausea, vomitting, excitablility, anxiousness

Poison by mouth, administer after orders from Medical Control or Poison Control

Altered Mental Status, swallowed acids or alkalis, unable to swallow

• 1 gram per kilogram of body weight
• Adult = 25-50 grams
• Infant/child = 12.5 - 25 grams

Blackening of Stool, possible vomitting

Chest pain suggestive of Acute Myocardia Infarction

Bleeding ulcer, hemorrhagic state, hemophilla

160 - 325 mg (2-4 peds 81mg each)

Caution in paitents with Asthma

Signs & Symtoms of breathing difficulty, patient has prescibed inhaler from doctor, Medical Control Approved

Not responsive to use, not prescribed, Max dose has been reached, denied by Medical Control

Delivers precise dose, Number of puffs can be determined by prescription or Medical Control

Tachycardia, Tremors, Shakiness, Nervousness, Dry Mouth

• Distress is difficulty breathing - blockage of the airway
• Failure is the inability to exchange gases - Infection of the airway

• Endocardium - Inner
• Myocardium - Middle
• Pericardium - Outer

• SA Node
• AV Node
• Bundle of His

• A blood clot blocking the lumen of the artery, causing tissue downstream from the clot to loose oxygen adn possible die.
• A classic heart attack

• Chest pain, dizziness, sense of doom or death, swetting, polmenary edema,
• pain/discomfort/pressure in
• lower jaw,
• arms,
• back,
• abdomen, or neck

• Breathing rate slower than 12 breaths/min or faster than 20 breath.min
• Unequal chest expansion
• descreased breath sounds on 1 or both sides of the chest
• Muscle retraction above the clavicle, between the rib cage, especially in children
• Pale or cyanotic skin
• Cool, damp, (clammy) skin
• Shollow or irregular respirations
• pursed lips
• nasal flaring

• The right side recieves blood from the veins of the body, blood enters from the superior and inferior canea into the right antrium, passes through the tricuspid valve to the right venticle, then flows into the pulmonary artery and the pulmonary circulation.
• The left side recieves oxygenated blood from the lungs the the pulmonary viens into the left atrium, passes through the mitral valve in to the left ventricle, then pumps into the aorta and then to the arteries of the body.

Death of tissue

When ventricular heart muscle is so damaged that it can no longer keep up with the return of blood from the atria

• Easier to breath sitting up
• Mild or severely agitated
• chest pain may or may not be present
• Distended neck veins that do not collapse when sitting
• swolloen ankles from dependant adema (back-up of fluids)
• High blood pressure, rapid heart rate, rapid respirations
• use of accessory breathing muscles of the neck & ribs
• Rale sounds of the lungs

The heart lacks the proper power to force the volume of blood through the circulatory system

• Anxiety or restlessness as the brain becomes starved of oxygen, "Air hunger"
• Pale, clammy skin
• pulse rate will be higher than normal, possibly 120 beats/min or higher
• rapid or shallow breathing
• nausea and vomiting
• decrease in body temp
• late stage the bllod pressure will fall below 90 systolic

• Oxygen by NRB mask or PPV with 15 lpm high flow
• Positioning the patient'
• possible OPA or NPA

• Huidified oxygen
• sucction the ariway
• Insert an OPA
• get patient in position of comfort
• Transport promptly

• Pulseless
• unresponsive patient

• A moving patient by transport
• responsive with rapid heart rate
• pulse

Immediatly or witin 2 minutes from the cariac arrest, depending on when it is ready.

After 5 sysles of CPR, to prime the pump and remove the metabolic waste

• Adult = Upper right of the sternum, just below the clavicle, left lower chest 2" to 3" below the armpit
• Child = Anterior of the right chest, posterior of the left chest

• The patient regains a pulse
• Six to nine shocks are deliverd
• AED gives 3 consecutive messages (seperated by 2min of CPR) that no shock is advised

• Stop the vehicle
• perform CPR until AED is available
• Analyze rythm
• Deliver shock
• Continue resuscitation
• repeat
• continue transport

• Normal or rapid respirations
• pale, moist, clammy skin
• diaphoresis (sweating)
• dizziness, headache
• rapid pulse
• normal to low blood pressure
• altered mental status
• anxiuos or combative behavior
• hunger
• seizure, fainting, comma
• weakness on one side of the body

• Automated is faster, has stick on pads to deliver the shock
• Semi has paddles that the EMT has to hold to administor the shock and is slower to analyze

• Diabetic Ketoacidosis - An accumulation of certain acids accurs when insulin is not available in the body
• Vomitting
• abdominal pain
• deep, rapid breathing called Kussmaul respirations

• Hypoglycemia, Insuficiant glucose in the blood
• Normal or rapid respirations
• pale, moist skin
• Diophoresis (sweating)
• dizziness, headache
• rapid pulse
• normal to low blood pressure
• altered mental status
• anxious or combative behavior
• hunger
• seizures, fainting, coma
• weakness on one side of body

• Unconsiousness
• Diabetic coma
• death

• DKA - Is uncontrolled diabettes and may be reversed over hours of hospilization
• Insulin Shock - is insuficient glucose in the blood and can be quickly reversed

• Hypoglycemia - Below normal, low glucose level in the blood
• Hyperglycemia - Above normal, high glucose level in the blood

80 - 100 mg/dl

• Type I - Do not produce insulin at all, they are insulin dependant (100m)
• Trype II - Inadequate production of insulin or they produce normal amounts but the insulin does not function properly

• Symptoms = respitory destress, or cardiovascualr distress in the form of shock, anxious and the feeling of death, itching or burning, chest tightness, abdominal cramps
• Signs = wheezing, urticaria, hives, wheals, swelling or lips & tongue, broncho spasm, dysphea, anxiety, hypotension, respitory failure

• Treat the ABC's
• Focused exam or rapid assessment
• SAMPLE history
• Mental status
• Skin condition
• Epinephrine and ventilation supprot
• Treat shock
• ice area of bite of sting
• transport

• Reaction is an exaggerated ammune response to any subatance. It's reaction by the body's ammune system to combat the stimulus
• Anaphylaxis is an extreme allergic reaction that is usually like threatening and typically involves multipule organ systems

• Insect bites
• medications
• plants
• food
• chemicals

• Inhalation
• aborption
• ingestion
• injection

• Dilute or decontamiate
• oxygen
• flush with water
• remove contaminated clothing
• use activated charcol
• transport
• manage ABC's

• Hypoventilation
• pinpoint pupils
• sedation or coma
• hypotension

• Hypertension
• tachycardia
• dilated pupils
• agitation or seizures
• hyperthermia

• Slurred speech
• sedation or coma
• hypovenilation
• hypotension

• Tachycardia
• hyperthermia
• hypertension
• dialted pupils
• dry skin and mucous membranes
• sedation, agitation, seizures, coma, or delirium
• decreased bowel sounds

• Excess defecation or urination
• muscle fasciculations
• pinpoint pupils
• excess lacrimation (tearing) or salvation
• airway comprimise
• mausea or vomiting

• It diolates the vessels to bring blood to the skin in order to cool it
• It speeds up rate until it can't handle the heat and then fails slowing the heart rate and blood pressure

• It constricts the blood vessels at the skin to retain heat
• The metabolic rate slows to protect the organs

• Conduction - Contact
• Convection - Air
• Evaporation - Sweating
• Radiation - Invisble light that transfers heat
• Respiration - warm air in lungs is expelled to the atmophere and cooler air is inhaled

• Local are injuries
• Systemic are illnesses

Mild = shivering, rapid pulse and respirations, red pale cyanotic skin

• Shivering stops
• musclar activity ceases
• Eventually all muscle activity stops

• Transport or move to warmer place
• Don't allow patient to walk, eat or use stimulants
• remove any wet clothing
• place dry blanket uners and over patient
• give warm humidified oxygen
• * Do not message extermities

• Remove any jewelry from injuried body part
• cover injury loosely with a fry sterile dressing
• transport

Loss of water and electrolytes from heavy sweating

• Dizziness, weakness, or fainting
• nausea or headache
• sweating heavily
• cold, clammy skin with ashen pallor
• dry tongue and thirst
• normal vitals
• rapid pulse with diastolic BP low
• Normal or slightly elevated body temp

Body is subjected to more heat that it can handle and normal mechanisms are overwhelmed

• Change in behavior
• unresponsive
• pulse becomes weak & BP goes down

• Move patient
• Max air conditioning
• remove clothing
• give oxygen
• apply cool packs
• cover with wet towels or sheet
• aggresively fan
• transport
• notify hospital

• Remove from water
• C-spine
• artificial ventilations
• trun patient on left side for water to drain
• abdominal trusts if needed
• keep warm
• transport
• vitals

• Provide BLS
• ABC's
• Transport
• Vitals
• Bring the spider or snake

• Interruption in daily routine
• Job loss
• Divorce
• Social
• Genetic
• Physical
• chemical
• biologic disturbances

• Spend extra time
• definite plan of action
• identify youself calmly
• be direct
• assess the scene
• stay with patient
• encourage purposeful movements
• express intrest in patient story
• don't get to close
• aviod fighting
• be honest and reassuring
• do not judge

• To protect yourself or others from bodily harm
• to prevent the patient from harming themselves
• * PD should always be present

Monitor for vomiting, airway obstruction, cardiovascular stability, and ABC's

• Unsafe objects
• is the enviornment unsafe
• is there evedence of self-distructive behavior
• imment treat to patient or others
• underlying medical problems

• When they show signs or state the have diabetes
• Heart disease
• visual disturabnaces
• renal failure
• stroke
• ulcers
• infections of feet or toes
• seizures
• altered mental status

• Chief complaint
• vitals
• side effects

• Congestive heart failure
• easier to breath when sittingup
• mild or severly agitated
• distended neck veins
• high blood pressure
• rapid heart rate
• rapid respirations
• use of accessory muscles (Neck & ribs)
• rail sounds - crackles

• Acute myocardiac infraction
• sudden weakness
• nausea
• sweating without obvious cause
• chest pain/discomfort/pressure that does not change with each breath
• sudden arrhythmia with synocope/fainting
• shortness of breath/dyspnea
• pulmonary edema
• sudden death

• Ventricular tachycardia
• ventricular fibrillation

• its faster
• can be delivered within 2 minutes
• its easier
• can be given through remote, adhesive pads
• pad area is larger than paddles
• more efficiant
• pictures when the pads are to placed
• voice prompts

Cerebrovascular accident - loss of blood flow to the brain resulting in the loss of brain function

Unconsiousness and generalized severe twitching of all body muscles lasting several minutes or longer

Seizure that continues every few minutes without regaining consciousness or last longer that 30 minutes

• Aura - a warning phase
• Tonic - Bilateral movement by muscle rigidity and relaxation
• Postictal state - unresponsive at first and gradually regains consiousness

• Facial Droop
• Arm drift
• Speech
• to assess if a patient is haveing a stroke

• Transient Ischemic Attack
• Mini stroke - stroke symptoms that go away on there own within 24 hours

• A - alcohol
• E - electrolytes
• I - insulin
• O - opiates
• U - uremia - kidney failure
• T - trauma
• I - infection
• P - psychogenic causes
• S - Seizure, syncope

• Seizure resulting from a high fever particularly in children
• Transport to hospital
• Protect the patient
• Assess vitals

• Brief lapse of consiousness without the loss of composure which the patient stares without response
• Also, lip smacking
• eye blinking
• isolated convulsion or jerking

vessels conrtact and BP goes down

• check the AVPU scale
• Assess ABC's
• treat any life threats
• inspect and paplate the 4 quaderants
• Transport

It could be there normal menstrual cycle or an ectopic pregnancy

Narrowing of the airway that occurs in Asthma attacks

A widening of the lumen of the bronchi, allowing increased airflow to and from the lungs

Arms and legs bend toward the abdomin to be comfortable and guard the area of pain