NREMT/ Medical/ Gynecological/ OB

• Vulva- Visible external genitalia
• Mons pubis- fatty tissue that makes up the vulva
• labia majora-outer lip
• minora-the inner lip

• Clitoris-small erectile body hidden by the labia minora.
• Vestible-small space at the beginning of the vagina and its glands.
• prepauce-foreskin

Intial is Menarche which happens in puberty adn its termination is called menopause.

Caused by an acute chronic infection of the organs of the female pelvic cavity.

treatment-Lower ab pain,fever, discharge, and dyspareunia. guard abdomen. and walk shuffled. put in position of comfort and transport.

One of the most common conditions. in this, normal bacteria growth is replaced by overgrowth of of other bacterial forms.

**symptoms are itching burning pain, and a fishy foul smelling odor. can lead to premature birth or low birth-weight.

An infection with the bacterium haemophilus ducreyi . causes sore and swollen genitals, swollen lymph and buboes in the groin area.

symptoms are usually mild or absent. some people have had lower back pain and nausea, fever and pain during intercourse. can progress to PID

a member of the herpes family. has no cure and can stay in you for many years.

• **symptoms are High fever, chills , enlarged spleen, and extreme fatigue.
• ***really bad for the pregnant, babys and people on chemo

• Infection to the groin buttons or anal area caused by the herpes simplex virus type 1 or 2.
• Type 1- is usually on the mouth and lips.
• type 2- is on genitals and can still be on the mouth.

in woman the infection usually happens on the outside of the genitals. small red bumps and then blisters

caused by neisseria gonohoeae a bacteria that can grow rapidly and multiply in the warm moist warm areas of the reproductive tract. (cervix, fallopian tubes) it can also grow in the mouth, throat or eyes.

Women: can go for months and not know. Symptoms are yellowish of bloody vaginal discharge and a foul oder. more severe is cramping abdominal pain.

the most common STD. Usually no symptoms other than growths in the genital area. in pregnant woman warts can grown big enough to impede urine. Laryngeal papilomatosis (warts blocking the airway)

• caused by the virus treponema by contact with open sores called the great imitator. can be asymtomatic for years and manifests in three different phases.
• Primary - Appearance of a single sore
• secondary -Development of mucous membranes and a rash that does not itch. then fever, swollen lymph nodes,
• Late- stage is no symptoms but all the internal damage is taking place.Brain nerves,

Caused by a single cell protozoan parasite and transmitted thru sexual contact. may be asymptomatic and may secrete a yellow green frothy discharge with a foul oder.

caused by the candida albicans fungus they normally live on the outside of the vagina. the normal acidic environment prevents the bacteria from growing.

less acidic and they start growing. stress, lack of sleep, and poor diet are other contributing factors. symptoms are itching burning and soreness in the vagina, cottage cheese discharge.

A fluid filled sac attached to the inside or outside of an ovary. it fills up and bursts and may need to be surgically removed.

its a pregnancy that happens outside the uterus. vaginal bleeding may be the only sign or symptoms. its the leading cause of maternal death in the first trimester.

you should suspect this when a woman has missed their period and they have stabbing  lower abdominal pain unilaterally.

Treatment-lights and sirens.orthostatic vitals, establish a second line, place in shock position and transport

Bleeding that occurs during the first or second trimester of a known or possible pregnancy. especially if the last period was more than 60 days.

a condition where the placenta develops over or occuldes the cervix. usually presents with bright red bleeding.

may show signs of shock depending how much blood is lost.

is premature separation of the placenta from the uterine wall. usually presents with dark red blood.

patient may say that they feel a tearing pain in the abdomen.trauma is the leader of this condition.

from 24 hours to the first four weeks following birth. will present with hypertension and seizures.

The fundus is the Uppermost part of the uterus. furthest from the cervical opening

the myometrum is the muscular wall of the uterus

• give oxygen,Start a line and use a isotonic crystalloid solution like normal saline or lacted ringers. if you notice signs of hypovolemia go 20 ml/kg bolus and start a 2nd line.
•      Place in lateral recumbant position. and place on the left side so that the paitent is faceing you.

Your Human Chorionic Gonadotropin levels. Its a hormone that stimulates the corpus luteum to secrete progesterone.

its gray.It has two arteries and one vein.The umbilical arteries carries deoxygenated blood away from the heart. oxygenated blood is carried back by the umbilical vein.

Its really pregnancy induced hypertension. but its really called (PIH) after the 20th week of pregnancy. the

is a seizure of a pregnant woman who has preenclamsia and no other cause of the seizure. May happen before, during, or after the delivery or even several weeks after.

is when the vena cava is compressed. and can be an issue when the mother has to be immobilized.

when RH factor is absent. when a woman who is Rh negative becomes present by a man who has the Rh factor. when that happens the mother makes an antibody for the positive factor for the fetus.

women who may be predisposed a diabetic state may have chemical diabetes. during the pregnancy insulin is secreted by the pancreas very quickly and the cellular sensitivity decreases.

also gestational diabetes or diabetes mellitus predisposes the fetus to HYPOtension. If hypotention in the fetus is present give 25 mg of D50

Always on the left side unless there is spinal injury. if supine elevate the right hip 6 inches. fetus may already be in shock so be aggressive with fluids.

• 1-Maintain an open airway
• 2-Give high flow o2
• 3-Ensure ventilation
• 4-assess circulation
• 5-provide IV fluids
• 6-Transport.

• Primigravida-pregnant for the first time
• multi gravida-2 or more pregnancies
• nullipara-never delivered a viable baby
• multipara-a woman who has delivered 2 or more viable newborns
• grand multi para- 7 or more viable newborns.

• 1-delivery is in a few mins
• 2-crazy shit makes it impossible to get to the hospital
• 3- no transport available.
• 4- if contractions are under 5mins

• 1-Keep the woman in left recumbent position on her left side.
• 2-administer 100% O2 via NRFM at 15 Lpm
• 3-transport
• 4-Start a line and fluids.
• 5-baseline set of vitals
• 6-trauma pads to stop bleeding
• 7-call additional resources

refers to the to the movement of the baby moving down the pelvis prior to birth.

**Usually happens before contractions

• Place her on NRFM high flow.
• 2- start a line
• 3- check for crowning.
• 4-place the patient on a firm surface and in semi-Fowler position. and elevate the hips with a pillow.
• 5- create a sterile feild with blankets over the abdomen,under buttoks, over the vagina

Needs surgical intervention should the cord be around the kids pelvis or if the cord comes out before the kid. place the mom in trandelmburg position or place her down doggie style to keep the pressure off of the cord. insert your fingers inside to try to push the cord away.

slip it over the shoulder. if its on too tight then cut the cord before the delivery. even if its wrapped around multiple times its still just the two clamps and one cut.

• Prepare like it was a normal delivery.
• if the butt cheeks are presenting then you must deliver.
• when it gets to the head, if its not coming out then stick your hand inside the vagina and make a V with your fingers and keep the airway clear. its a true medical emergency and you should wrap the newborns body for warmth and provide rapid transport.

post partum embolisim.

developmental defect in which a portion of the spinal cord or meninges develops outside of the vertebrae and possible outside the body.

Trying to prevent it. Give a bolus of isotonic crystalloid solution?

Keep the ambulance warm and use blow by oxygen at less than 4 liters per min. and keep warm and dry.

The ductus arterious is a small artery that diverts the circulation away from the fetal lungs by connecting the left pulmonary artery to the aorta. as o2 increases the infant looks less cyanotic.

Do what probably seems simple

Drying, warming, positioning, suction, stimulation

Positive pressure ventilation with 100% o2 ventilations should be at 40 - 60 a min

** even if respirations are normal, if a newborn is breathing less than 100 times a min than you should still treat with 100% o2. also the same if central cyanosis is present.

symptoms are fever, headache, stiff neck and altered mental status.

its a chronic mycobaterial disease that usually affects the lungs. the neucli can live after water evaporates for decades.

whopping cough. Usually affects kids younger than 6. Totally airborne and the signs and symptoms include a Fever and a whoop sound when they try to INHALE after a coughing attack. place a mask on the patient and yourself.

In older people it can cause a severe upper airway infection that can last for weeks.

It is a bacterium that causes infections resistant to antibiotics. Its believed to be passed from patient to patient.

its the amount of air that can be breathed in on top of your normal tidal volume.

• 3000 ml for men
• 2300 for adult female

its the amount of air that can be exhaled after a normal exhalation.

S&S- audible Wheezing on inspiration exhalation and bronchospasm

Treatment- patient may have appropriate medication at home.

**status asmaticus is a true prolonged asthma attack that cannot be broken with conventional treatment

S&S- flushed skin or hives generalized edema or just general edema, decreased blood pressure and dyspnea. may have widespread itching.

S&S- Chronic cough, wheezing and cyanosis, productive cough

• Is when the left side of the heart cannot remove blood from the lungs as fast as the right side delivers it.
• then fluid builds within the alveoli and in the lung tissue between the pulmonary capillaries.
• S&S- Dependent edema, Rales, Nocturnal dyspena.Cool, sweaty, cyanotic skin.adendivous breath sounds and tachy

Treat with oxygen adjuncts appropriate for their condition. try cpap. (dont use if they have chest trauma, a trach, and pneumothorax and low blood pressure or a GI bleed)

S&S- Fever, Barking cough, Mostly seen in pediatric patients.

treat with humidified oxygen. position of comfort and give nebulized epinephrine is you can.

S&S- Barrel chest , pursed lip breathing, difficulty breathing out.

S&S- Dyspena, Chills and fever, cough and dark sputum.

treatment- provide high flow o2 and vent support if needed. give fluids. cool the paitent down and trasport.

S&S- sudden chest pain with dyspena decreased lung sounds on a specific side. can be caused by medication or trauma.

**patients with asthma and emphysema are more likely to get a spontaneous pneumothorax .

S&S- sharp pinpoint pain,dyspena, sudden onset,after childbirth or surgery.

treatment-provide 100% oxygen. Start CPR if hes pulseless and apnic. start aline and give fluids.

S&s-progressive shortness of breath, increasing SOB,neck and vein distention,and tracheal deviation.

A genetic disorder of the endocrine system that primarily tagets the digestive systems. a defective gene that makes it difficult for chloride to get thru the cells.

usually dies in Childhood.

an infection in the lungs and breathing passages. can cause bronchiolitis and pneumonia.

* look for signs of dehydration in infants. humidified oxygen is helpful.

** rsv is highly contagious and spread thru droplets.

Asthma, COPD, CHF, pneumonia, bronchitis and or anaphylaxisis.

Copd, Pneumonia, bronchitis

**expect a productive cough,fever, and some kind of chest pain.

CHF and Pneumonia

**expect fever, pink frothy sputum,some king of chest pain.

Croup and Epiglottis

**expect a fever and barking cough

Cheyenne- rhythmic breathing pattern characterized followed by periods of rapid and slow respiration's alternating with apnea.


Kussmal is-deep rapid respiration's followed by fruity oder on their breath.

if they are able to talk and breathe then transport them in a position of comfort. provide oxygen and transport.

• Chron- state of contraction
• Drom- state of electricity
• ion- strenth of contraction.

Preload is the amount of blood returned to the heart to be pumped out directly affects the after load.

after load is what the left ventricle has to pump against.

• 1- aura- feeling its coming
• 2-LOC
• 3-tonic phase- body wide rigidness
• 4-Hypertonic phase- arched back
• 5-clonic phase-Biting, teeth clenching, lip smacking
• 6-post seizure- major muscles relax, nystagmus
• 7-Potictal- maybe incontinent,and the brain rests

have little or no movement. and usually last only several sentences. and no postical phase.

Hypoglycemia. postictal of a tonic clonic seizure. and subdural bleeding.

focal motor seizure. but its tonic clonic activity but on one side of the body. no aura or loss of consciousness.

causes changes in mood or behavior. and preceeded by an aura. This only lasts 1-2 min and the paitent usually rebounds quickly. has no postictal phase.

Decoriate=arms and wrists flexed inwards and toes pointed

De cerebrate= points the toes again but the arms are at the side and wrist pronate. this one is much worse

Vital signs- Blood pressure rises and Hr and RR fall its know as cushings reflex

• 4-spontaneous
• 3-voice
• 2-Pain stimulation
• 1-None

• 5-Orientated conversation
• 4-Confused conversation
• 3-inapproprate words
• 2-incomprehensible sounds
• 1-none

• 6-Obeys commands
• 5-localizes pain
• 4-withdraws from pain
• 3-decoriate posture
• 2-decrebrate posture
• 1-none

• Give 100% oxygen. Start a line and bring to a local facility. give D50 only is sugar is low. give fluids at KVO if you do no suspect hypovolemia.
•   If the paitent is Hypovolemic give a 20 ml/kg bolus.

• -If They Dont breathe in 30 Seconds then give ventilation's. spinal immobilization if trauma happened.
• -Give 100% oxygen to everyone.
• -start a line

** for kids moisen the area with lukewarm water and fan the moistened area.

check blood sugar. give oxygen,start a line, and orthostatic vitals if you can.

• -Clear the airway and anticipate vomiting and place in lateral recumbent (recovery position)
• -100% o2....assist ventilation's if shallow.
• -NPO
• -check blood pressure to check on hypovolemia. if the patient is hypovolemic give 20 mg/kg bolus of isotonic crystalloid.
• -if not just start the line at KVO

When the protective peptic layer of the organ is destroyed and the acid. Most are Stomach infections. another cause is NSAIDS and alcohol.

• **the symptoms is usually a gnawing pain in the stomach that usually stops after you eat and then starts up in 2-3 hours.
• severe cases you will see melena

Gallstones block the opening of the gallbladder causeing pain. and lead to cholecystitis.

** cholecystitis usually causes nausea vomiting bloatng. the pain usually refers to the right upper part of the back, shoulder,flank. sometimes increase or come and go.

can be caused by obstructing gallstone, alcohol abuse and other diseases. you will get severe pain in the upper left and right quadrants and may radiate to the back.

other symptoms are nausea,vomiting, abdominal distention and tenderness. severe cases will show tachycardia and fever.

When the appendix is inflamed. The pain feels like its all over at first but then it goes to the right lower quadrant and refereed to the naval. the classic symotom is rebound tenderness. they will feel the pain when you ease off of it.

happens when the amount of pressure around the vessels increase. The esophageal blood vessels deposit its blood into the portal system.

industrialized alcohol are usually the cause for portal hypertension. looks like liver disease first then then sudden rupture which you will feel in your throat.

in this condition the junction between the stomach and the esophagus. usually happens due to alcohol and eating disorders. paitents in bad shape will feel upper abdominal pain, shock,melena, hematemisis

happens when a lot of insoluble salts or uric acid builds up in the urine. the most common stone is the calcium stone. starts as a vague pain then in 30 to 60 mins becomes much more intense.

* if the stone sinks lower you will have signs and symptoms of a UTI. get all history from the patient.

• -Symptomatic hypoglycemia below 70
• -Altered LOC
• -unresponsive with no history
• -cardiac arrest with PEA or asystole.
• -coma
• -Hypothermia

• Be alert for vomiting!,
• start a line and give20 ml/kg of normal saline over the first half hour
• add oxygen

• - check airway pat ency and placing them on their side if no spinal precaution is in play.
• - give oxygen and start a line and transport.

• -make sure airway is clear
• -oxygen

is the tendency to develop blood clots. they normally give you something like warfin to control that down.

its a genetic disorder where the blood does not clot.

Hemophilla A-most common type its due to a low levels of factor 8

hemoohillia B-the second most common  with a deficiency in factor 9

• 1-Oxygen
• 2-fluids- take iv
• 3-transport
• 4-pharmacology
• 5-psycolagical

• Remove the offending agent
• 2-position
• 3-oxygen
• 4-start a line, get fluids going
• 5-give epi
• 6-trasport
• 7-reassess

Restlessness, agitation, incessant talking, insomnia,anorexia, dilated pupils.

tachycardia, tachypnea, paranoia, seizures, Cardiac arrest.

Pinpoint pupils, respiratory depression,drowsiness, drowsiness, stupor, coma.

Hypertension, tachycardia, dialated pupils, agitations, seizures, hypermedia.

drowsiness, disinhibitation, ataxia, slurred speech mental confusion, hypo tension, respiratory depression.

increased salivation, lacrimation, excess defacation, and urination, nausea and vomiting, seizures, coma.

tachycardia, hypothermia, dry skin, dilated pupils, blurred vision, sedation, agitation, seizures coma delirium.

Oxygen via NC, establish a line. manage the hypotention with normal saline bolus.

they are usually hypoventilating so place an OPA and start assisting ventilation with 15l a min of supplemental O2. start a line and give narcan .4 up to 2mg

start a line and give fluids if needed for hypotension. protect the airway, give max oxygen and prevent seizures with good sedation.

• give high flow o2
• start a line
• if shock is there then 1-2lit bolus of saline
• if it gets really bad try activated charcoal.

Check the symptoms with sludge (salivation,lacrimation,urination,defecation, gastric upset and emisis.

Check airway. give high flow O2, start a line, give a pulse ox. call for back up and transport.

• Establish airway
• -Give high flow oxygen
• -start a line
• -keep patient quiet
• -Note the LOC
• -transport- hyperbaric preffered
• -

• -maintain an airway
• -call back up
• -start a Activated charcoal
• -High flow O2
• -start a line
• -give a saline bolus for hypotension
• -give D50 is hypo glycemic
• -transport

• Establish airway
• -administer high flow o2
• -start a line
• -call for back up
• -single dose of activated charcoal
• -transport

• Adult- 1 per 6 to 8
• child - 1 per 3 to 5
• infant- 1 per 3 to 5

Irregular pattern rate and volume with intermittent periods of not breathing because of increased ICP.

usually because of some kind of hypo-ventilation.

**s&s= headaches, red flushed skin,bradypnea, cerebral vasodialation

COPD creates respiratory acidosis overtime. hypoxic drive will be the only thing left to stimulate breathing.

usually cause of hyperventilation.

usually drug overdoses, fevers,forceful bvm ventilation's.

** the treatment focuses on decreasing the respiratory rate to normal.

S&S- Chest tightness, tingling in lips and face, confusion, decreased cerebral perfusion.

Any acidosis that is not related to the respiratory system is considered metabolic. the respiratory system tries to restore balance by eliminating Co2.

This is usually caused by lactic acidosis due to hypoperfusion, aspirin overdose, alcohol ingestion, diarrhea.

S&S- Hot red flushed skin, tachypnea, arrhythmia, vasodialation, and CNS depression.

• formed from excessive loss of acid from excessive urination or decreased acid level in the stomach.
•  excessive vomiting, excessive water intake, nasogastric suctioning, eating disorders.

** S&S- confusion, muscle tremors and cramps, bradypnea, and hypotension.

Starts with Complete dialation of the cervix and ends with the delivery of the fetus.

• performed at 1 and 5 min after birth
• 7-10 is an active baby that needs normal care
• less than 4 is severely distressed and need resussitation

it could be possible of fetal respiratory distress. aspiration can cause an inflammation and or pnumonia in neonates.

rare heart condition where the tricuspid valves is not formed too well. so blood ends up backing up inside the the right atrium.