-
Asthma
- Vitals: BP: Elevated due to anxiety / beta 2 agonist Pulse: Elevated due to anxiety / b-2 agonist Respirations: labored / rapid SPO2: low ETCO2:
- Breathing: distressed w/ wheezing. tightness. dry cough if any
- Temperature: Normal
- BGL: Normal
- AMS: Only in cases of severe hypoxia
- Posture: Tripod / Accesory muscle use
- Skin:Pale usually dry
- Lung Sounds: wheeze / diminished
- Meds: Albuterol (beta 2 agonist), smooth muscle relaxant, steroids
- Treatments: Oxygen, Albuterol (nebulizer: .083%- 2.5mg in 3mL N/S), Mag Sulfate (pregnancy: 1-2gm in 50ml over 20 min), steroid (Solu-Medrol 125-250mg over 5-10 min)
- Stable: Usually Not
-
Bronchitis
- Vitals: BP: Normal Pulse: Normal Respirations: Labored SPO2: Low ETCO2: High
- Breathing: Productive Cough with normally labored breathing
- Temperature: Normal
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Tripod / accessory muscle esp after exhertion
- Skin:Normally cyanotic
- Lung Sounds: Wet
- Meds: Albuterol, Oxygen
- Treatments: Oxygen, Albuterol (nebulizer: .083%- 2.5mg in 3mL N/S)
- Stable: Usually except in cases of exaserbation
-
Bronchiolitis
- Vitals: BP: Normal Pulse: Rapid Respirations: Tachy / Labored SPO2: Low ETCO2: High
- Breathing: Labored / Cough (usually unproductive)
- Temperature: Normal or elevated
- BGL: Normal
- AMS: In cases of hypoxia
- Posture: comfort-
- Skin: Pale
- Lung Sounds: Wheezing / crackles
- Meds: Oxygen (albuterol not proven to give sig. relief)
- Treatments: Supportive
- Stable: Not in cases of low SpO2
-
Pneumonia
- Vitals: BP: Varies Pulse: Usually slightly rapid Respirations: Shallow / labored SPO2: Low ETCO2: High
- Breathing: Labored / Productive cough / yellow brown sputum
- Temperature: Febrile
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Tripod / Accessory muscle use
- Skin: Pale / moist
- Lung Sounds: Wet / crackles / one side only in some cases
- Meds: Antibiotics / Oxygen / Bronchodilators
- Treatments: Supportive / suctioning / oxygen / bronchodilators (Albuterol (nebulizer: .083%- 2.5mg in 3mL N/S))
- Stable: Depends
-
Emphesema
- Vitals: BP: Varies Pulse: Norm to fast Respirations: Labored / Rapid SPO2: Low ETCO2: High
- Breathing: Labored with barrel chest productive cough sometimes
- Temperature: Normal
- BGL: Normal
- AMS: Except in hypoxia cases
- Posture: Tripod / Accesory muscles
- Skin:Pale
- Lung Sounds: Crackles / Wheeze
- Meds: Bronchodilators Oxygen
- Treatments: Oxygen, Albuterol (nebulizer: .083%- 2.5mg in 3mL N/S)
- Stable: Sometimes
-
Chronic Bronchitis
- Vitals: BP:Norm / Elevated Pulse: Norm / Elevated Respirations: Fast / Labored SPO2: Low ETCO2: Fast
- Breathing: Labored / productive cough (for 2 years or more)
- Temperature: Normal
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Tripod in exhaserbation
- Skin: Pale
- Lung Sounds: Wet Crackles / Wheeze
- Meds: Cardiac Meds (heart failure), Oxygen, bronchodilators
- Treatments: Supportive / Oxygen / Bronchodilators Albuterol (nebulizer: .083%- 2.5mg in 3mL N/S)
- Stable: Varies
-
Guillain-Barre Syndrome
- Vitals: BP: Normal to Abnormal Pulse: Fast at times Respirations: Normal to Apnea SPO2: Normal / Low ETCO2: Normal to High
- Breathing: Normal except in cases where condition has progressed to diaphram
- Temperature: Normal
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Unable stand. Paralysis from feet upward
- Skin:Normal
- Lung Sounds: Normal except in cases of apnea
- Meds: N /A
- Treatments: Supportive / Transport / Airway management
- Stable: Unstable
-
Posterior Cord Syndrome
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal
- BGL: Normal
- AMS: Unable to percieve the positiion and movement of ones body, sensitive to light, vibration
- Posture: C-Spine imobilized
- Skin: Normal
- Lung Sounds: Normal
- Meds: N/A
- Treatments: Stabilization
- Stable: No, extra caution
-
Anterior Cord Syndrome
- Vitals: BP: Normal / Low Pulse: Normal / Low Respirations: Normal / Absent SPO2: Normal / Low ETCO2: Normal / High
- Breathing: Normal / Absent (depends on where fragments lodged and point of injury)
- Temperature: Normal
- BGL: Normal
- AMS: Loss of sensation below injury site
- Posture: See above
- Skin:Normal
- Lung Sounds: Normal / Absent
- Meds:N/A
- Treatments: C-Spine
- Stable: Unstable
-
Brown Sequard Syndrome
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal
- BGL: Normal
- AMS: 1 sided loss of sensation
- Posture: In positiion of injury / C-Spine
- Skin: Normal
- Lung Sounds: Normal (but could be absent on effected side)
- Meds:N/A
- Treatments: C-Spine
- Stable: Unstable
-
Pericardial Tamponade
- Vitals: BP:systolic drop of 10mmHg or more Pulse: alternating strong and weak Respirations: distressed SPO2: low ETCO2: high
- Breathing: distressed
- Temperature: Normal to elevated(infection)
- BGL: Normal
- AMS: in cases of hypoxia / poor cardiac output
- Posture: upright
- Skin:pale / hypoxic
- Lung Sounds: muffled heart sounds, equal breath sounds
- Meds:cardiac / resp meds
- Treatments: transport / supportive (IV/O2/Monitor) (pericardial sentesis is required)
- Stable: Unstable
-
Tension Pneumothorax
- Vitals: BP: poss low Pulse: rapid Respirations: shallow / tachy SPO2: low ETCO2: high
- Breathing: extremely labored / absent
- TemperatureL Normal
- BGL: Normal
- AMS: Normal except w/ hypoxia
- Posture: Severe diff breathing
- Skin:Shocky
- Lung Sounds: unequal. diminished on one side
- Meds:N/A
- Treatments: needle decompression where indicated, intubation if required
- Stable: Not stable
-
Hemothorax
- Vitals: BP:Low in Shock cases Pulse: Tachy Respirations: Rapid SPO2: Low ETCO2: High
- Breathing: Body Sputum Possible
- Temperature: Normal
- BGL: Normal
- AMS: Anxiety, agitation
- Posture: Resp Distress
- Skin: Pale / Clammy
- Lung Sounds: Fluid sounds on one side, possible absent on one side. No tracheal deviation or jugular vein distention
- Meds: N/A
- Treatments: Large Bore IV's, Treat for shock
- Stable: No
-
Pneumothorax
- Vitals: BP:Normal Pulse: Rapid severe cases Respirations: rapid SPO2: Low ETCO2: High
- Breathing: Severe Dyspnea, Absent breath sounds on effected side
- Temperature: Varies (Normal in trauma, but may have underlying illness
- BGL: Normal
- AMS: Agitation and anxiety can occur from hypoxia
- Posture: Severe Dyspnea
- Skin: Pale in cases of severe hypoxia
- Lung Sounds: Absent / diminished on one side with severe pleural pain upon inspiration
- Meds: N/A
- Treatments: Watch for progresssion to tension pneumo. Supportive care including oxygen
- Stable: No
-
Pericardial Contusion
- Vitals: BP: Low in cases of shock Pulse: Usually fast (depending on arryhthmia) Respirations: Vaires SPO2: Varies ETCO2: Varies
- Breathing: Crackles or rales usually found due to left ventricular dysfunction
- Temperature: normal
- BGL: Normal
- AMS: Normal except in cases of shock
- Posture: Varies
- Skin: Shock signs
- Lung Sounds: Crackles / Rales
- Meds: N/A
- Treatments: Supportive. Consult Med Control before giving anti arrhythmics
- Stable: N0
- Notes; Occurs after trauma and may cause arrhythimias (usually tachycardia or A-Flutter). Do not treat arrhythmias without consultation to medical control
-
Epidural Hematoma
- Vitals: BP: Hypertension Pulse: Bradycardia Respirations: Erratic SPO2: Varies / Low ETCO2: Varies / High (Cushings Triad)
- Breathing: Erratic
- Temperature: hyperpyrexia can develop (fever like condition)
- BGL: Normal
- AMS: Altered
- Posture: Posturing
- Skin: Shock
- Lung Sounds: Varies
- Meds: N/A
- Treatments: C-Spine / Maintain Airway / Transport to an appropriate facility
- Stable: No
- Notes: Occurs with blood between skull and dura mater after trauma to temporal area. Always associated with a linear fracture to the thin temporal bone usually disrupting meningeal artery. Rapidly declining patient
-
Subdural Hematoma
- Vitals: BP:Hypertension Pulse:Bradycardia Respirations:Erratic SPO2:Varies / Low ETCO2: Varies / Low
- Breathing: Erratic
- Temperature: Normal / Hyperprexia (fever like) in some cases
- BGL: Normal
- AMS: Altered
- Posture: Posturing
- Skin:Shocky
- Lung Sounds:
- Meds: N/A
- Treatments: C-Spine / Airway management / transport
- Stable: Not
- Notes: Blood beneath the dura mater but outside the brain. Occurs in rapid deceleration forces and 5% of all head injuries
-
Croup / Laryngotracheolbronchitis
- Vitals: BP: Normal Pulse: Normal Respirations: Labored / Tachypnic SPO2: Low ETCO2: Normal / High
- Breathing: Seal Like Barking Cough
- Temperature: High
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Upright / Resp distress
- Skin:Pale in cases of hypoxia
- Lung Sounds: Loud upper airway sounds
- Meds: N/A
- Treatments: Oxygen, do not manipulate airway, Racemic Epinephrine (.25-.75 ml of a 2.25% solution in 2.0ml of N/S)
- Stable: No
- Notes: Usually occurs in children and in cool night air (spring and fall)
-
Tonsilitis
- Vitals: BP:Normal Pulse: Normal Respirations: Dyspnea SPO2: Normal / Low ETCO2: Normal / High
- Breathing: Dyspnea in upper airway with loud barking cough
- Temperature: High
- BGL: Normal
- AMS: Normal except in cases of hypoxia
- Posture: Dyspnea
- Skin:Hot / Moist
- Lung Sounds: Loud upper airway sounds
- Meds:May be on antibiotics
- Treatments: Oxygen / Airway management
- Stable: No
- Notes: Similar to croup. Monitor airway diligently
-
Epiglotitis
- Vitals: BP: Normal Pulse: Normal Respirations: Normal / Fast SPO2: Normal / Low ETCO2: Normal / High
- Breathing: Hoarse voice / attempted painful cough
- Temperature: High
- BGL: Normal
- AMS: No execpt in cases of hypoxia
- Posture: Purposeful hyperextention / dyspnea
- Skin: Hot
- Lung Sounds: Hoarse voice, loud upper airway sounds
- Meds: May be on antibiotics / etc
- Treatments: Monitor Airway
- Stable: No
- Notes: Look for hoarse cough. True emergency, swelling can cut off airway
-
Pulmonary Embolism
- Vitals: BP:Normal Pulse:Fast Respirations:Fast SPO2:Low ETCO2: High
- Breathing: Sudden Dyspnea that does not get better with oxygen
- Temperature: NOrmal
- BGL: Normal
- AMS: In cases of hypoxia
- Posture: Dyspnea
- Skin: Pale
- Lung Sounds:Clear
- Meds: N/A (Look for Coumadin / Etc. Recent bone breaks, IV's, ETC)
- Treatments: CPR Where needed, Oxygen, Transport
- Stable: NO
- Look for: Chest pain and low SPo2 levels that do not increase with oxygen
-
Multiple Sclerosis
- Vitals: BP:Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal to high
- BGL: Normal
- AMS: Normal to altered in severe cases
- Posture: Ataxia / weakness / lack of touch senses
- Skin:Normal to Hot
- Lung Sounds: Normal
- Meds: Unk
- Treatments: Supprotive
- Stable: Varies
- Notes: Breakdown of myelin sheath
-
Parkinson's Disease
- Vitals: BP:Normal Pulse: Normal Respirations: Normal / Rapid SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal
- BGL: Normal
- AMS: Normal
- Posture: Tremors / inability to move
- Skin: Normal
- Lung Sounds: Normal
- Meds: Levodopa in hospital setting
- Treatments: Supportive
- Stable: Mostly
- Notes: Lack of dopamine in the brain
-
Bells Paulsy
- Vitals: BP:Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal to High (due to underlying infection)
- BGL: Normal
- AMS: Normal
- Posture: Normal but paralysis of facial nerve (7th cranial nerve)
- Skin: Normal
- Lung Sounds: Normal
- Meds:Corticosteroids may be given for unlying viral infection
- Treatments: Supportive / Rule out CVA
- Stable: Yes
- Notes:
-
A.L.S / Amyotrophic Lateral Sclerosis / Lou Gehrig's Disease
- Vitals: BP: Normal Pulse: Normal Respirations: Normal (early) SPO2: Normal ETCO2: Normal
- Breathing: Normal (Late stages include inability to breath on own)
- Temperature: Normal
- BGL: Normal
- AMS: Inability to speak in some cases
- Posture: INabilty to support themselves or move
- Skin: Normal
- Lung Sounds: Normal to absent in some cases
- Meds: N/A
- Treatments: Supportive care
- Stable: Yes
- Notes: Usually fatal in 3-5 years. May have many apparatus to maintain life. Death usually results from an infection.
-
Myostenium Gravis
- Vitals: BP: Normal Pulse: Normal Respirations: Normal / Labored in attack SPO2: Normal ETCO2: Normal
- Breathing: Normal to absent in attack
- Temperature: Normal
- BGL: Normal
- AMS: Normal but can have inability to speak
- Posture: Normal but severe weakness
- Skin:Normal
- Lung Sounds: Normal
- Meds:N/A
- Treatments: Supportive / Support respiratory function
- Stable: Varies
- Notes: Destruction of acetylcholine resulting in weakness
-
Hypoglycemia
- Vitals: BP: Normal Pulse: Rapid Respirations: Normal to low SPO2: Normal to low ETCO2: Normal to high
- Breathing: Normal / Shallow
- Temperature: Normal
- BGL: LOW; less than 45
- AMS: Altered in severe cases
- Posture: n/a
- Skin:Cool and moist
- Lung Sounds: Clear
- Meds: Diabetic Meds / Insulin / Glucophage / etc
- Treatments: Oxygen and respiratory assistance. Oral glucose if gag reflex, IV (18g or larger) and admin of D50 (25gm in 50ml). If no IV available admin of Glucagon (1 unit IM)
- Stable: No- brain starved of oxygen
-
Diabetic Ketoacidosis
- Vitals: BP: Normal to Low (dehydration) Pulse: Rapid (dehydration) Respirations: Kussmaul (Rapid and Deep) SPO2: varies ETCO2: varies
- Breathing: Kussmaul Deep and Rapid
- Temperature: Normal (warm dry skin)
- BGL: Greater than 300
- AMS: Yes but usually not fully comatose
- Posture: N/A
- Skin: Warm / Dry
- Lung Sounds: Clear
- Meds:Diabetic Meds
- Treatments: IV- 1L of Normal Saline over 1st half hour. Monitor cardiac rhythm. Treat shock. Oxygen / Transport
- Stable: No
- Notes: Ketone release will usually give fruity odor on the patient's breath
-
Anaphylaxis
- Vitals: BP: Low Pulse: High Respirations: Dyspnea / Tightness SPO2: Low ETCO2: High
- Breathing: Wheezing / Swelling of face and tounge / stidor / hoarseness / bronchoconstriction (wheeze / crackles)
- Temperature: Normal
- BGL: Normal
- AMS: Possible due to hypoxia / hypotension / shock
- Posture: N/A
- Skin: Uticaria / Pruritis (itching) / flushed skin
- Lung Sounds: Wheeze / Crackles / Stridor
- Meds: N/A but check for allergies
- Treatments: Airway: Consider Cricothyrotomy. Administer IV Epi: .3-.5mg for adults (.01mg /kg for pediatrics) Admin Diphenhydramine 25-50mg IV/ IM, Admin Solumedrol 125-250mg
- Stable: NO
-
Addison's Disease
- Vitals: BP: Low Pulse: Normal to High Respirations: Normal SPO2: Normal / Low ETCO2: Normal / High
- Breathing: Normal
- Temperature: Can be elevated
- BGL: Low or Normal
- AMS: Lethargy, confusion, Loss of consciousness
- Posture: N/A
- Skin: Hot
- Lung Sounds: Clear
- Meds:N/A
- Treatments: IV and infuse up to 1L of N/S. Correct Hypoglycemia with D50 (25g)
- Stable?
- Notes: Steroid Withdrawl is most common cause
-
Cushing's Disease
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal
- BGL: Low
- AMS: Normal / Depression / fatigue
- Posture: Normal
- Skin: Thinning of skin, easy brusing, pink purple stretch marks (straie) on abdoman thighs breasts and shoulders
- Lung Sounds: Normal
- Meds: N/A
- Treatments: Supportive: Monitor glucose and vitals
- Stable: Yes
-
Appendicitis
- Vitals: BP: Normal Pulse: Normal to fast Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Hot in cases of infection / impedning sepsis / rupture
- BGL: Normal
- AMS:Normal
- Posture: Gaurding possible
- Skin:Hot / Dry
- Lung Sounds: Clear
- Meds: N/A
- Treatments: Supporitve / Transport
- Stable: No
- Note: Periumbilical pain that migrates to right lower quadrant. Rebound tenderness
-
Cholecystitis
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Normal
- BGL: Normal
- AMS: Normal
- Posture: Gaurding possible
- Skin:Normal
- Lung Sounds: Clear
- Meds: N/A
- Treatments: Supportive, Pain medication (use Meperidine rather than morphine because morphine is thought to cause a contraction of the sphincter of Oddi) Control nausea. Fluids if patient is vomitting
- Stable: Yes
- Notes: Upper right quadrant pain. Normally from gallstones (obstruction of cystic duct). Normal patient is: Fair / Fat / Female / Fifty
-
Esophageal Varicies
- Vitals: BP: Normal to Low Pulse: Normal to High Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal (watch for aspiration)
- Temperature: Normal
- BGL: Normal
- AMS: N/A except in cases of hypoxia and shock
- Posture: Normal
- Skin: Normal
- Lung Sounds: Normal
- Meds: N/A
- Treatments: Fluid resusitation, suctioning, airway management
- Stable: No
- Notes: Caused by increase in pressure of vessels around esophagus and the portal system.
-
Peptic Ulcer
- Vitals: BP: Normal to low Pulse: Normal to low Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal (watch for aspiration)
- Temperature: Normal
- BGL: Normal
- AMS: Normal
- Posture: Abdominal guarding possible
- Skin: Normal
- Lung Sounds: Normal
- Meds:Normal (abuse of NSAIDS possible)
- Treatments:Treat hypotension
- Stable: No
- Notes: Look for abdominal pain, nausea, vomitting, belching, heartburn, gastric bleeding
-
Hep A
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: High
- BGL: Varies
- AMS: Normal
- Posture: Abdominal guarding possible
- Skin: Hot / Jaundice
- Lung Sounds: Clear
- Meds: N/A
- Treatments: Supportive, protect yourself
- Stable: No, requires treatment
- Notes: From fecal oral transmission, most people immunized.
-
Hep B / Serum Hepatitis
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Low grade fever
- BGL: normal
- AMS: normal
- Posture: normal (with generalized abdominal / joint pain
- Skin: hot / juandice
- Lung Sounds: warm
- Meds: n/a
- Treatments: supportive
- Stable: Depends
- Notes: From shared IV needes / sexual interaction / etc
-
Hep C
- Vitals: BP: Normal Pulse: Normal Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Low grade fever
- BGL: normal
- AMS: normal
- Posture: normal (with generalized abdominal / joint pain
- Skin: hot / juandice
- Lung Sounds: warm
- Meds: n/a
- Treatments: supportive
- Stable: Depends
- Notes: Most common type. blood to blood contact. can live outside the body
-
Thyroidoxicosis / hyperthyroidism
- Vitals: BP: Normal Pulse: Tachy in severe cases Respirations: Normal SPO2: Normal ETCO2: Normal
- Breathing: Normal
- Temperature: Hot
- BGL: Normal
- AMS: Normal to altered in severe cases
- Posture: Normal
- Skin: Hot
- Lung Sounds: Heart failure possible
- Meds: N/A
- Treatments: Supportive / manage airway
- Stable: Fatal in severe cases
-
Myxedema / Hypothyroidism
- Vitals: BP: NOrmal Pulse: Normal Respirations: Normal to labored SPO2:Low ETCO2: High
- Breathing: (cough?)
- Temperature: Often Low
- BGL: Normal to low
- AMS: Altered in Coma situation
- Posture: N/a
- Skin:Cool Dry
- Lung Sounds: Clear
- Meds:N/A
- Treatments: Oxygen, Correct hypoglycemia (25g D50), Treat hypothermia (warming). Avoid narcotics, sedatives, anesthetics because of delayed metabolism
- Stable?
|
|
