EMT Medical Fisdap Study Guide Ateriovenus shunt - ✔Artificial device allows an artery to flow to a vein without moving through capillaries. Complications of renal dialysis - ✔Hypotension, muscle cramps, nausea and vomiting, hemorrhage from the access site, and infection at the access site. What does insulin do - ✔When you eat, insulin is secreted from the pancreas. Insulin opens up the cell for sugar. Hypoglycemia - ✔Lack of sugar in the blood. Can be deadly. Treatment for low blood sugar - ✔Oral glucose. Hyperglycemia (Diabetes) - ✔An excess amount of sugar in the blood. Too little insulin makes cells unable to absorb glucose. Cell switch from normal metabolism to abnormal metabolism. It begins to breakdown fat. It begins to create Ketone in the body. Ketone is very acidic. And patient will have a fruity smell to their breath. Treatment for Hyperglycemia - ✔Rapidly transport to the hospital. Diabetic ketoacidosis (DKA) Pathophysiology - ✔Causes Kussmaul Respirations (Rapid, Deep breaths) Increased blood sugar, fruity smelling breath. Acidosis - ✔The accumulation of acids in the body High Blood Sugar long term effects - ✔Blindness, Neuropathy(Nerve Damage), Necrosis(tissue death), Lose Limbs, Kidney Problems Commonly silent MIs Hypoglycemic Crisis Blood Sugar level - ✔Blood sugar Below 40 Hypoglycemia blood sugar level - ✔Blood sugar 40-80 Normal Blood Sugar - ✔Blood sugar 80-120 Hyperglycemia blood sugar level - ✔Blood sugar 120-400 Diabetic Ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic coma (HHNC) blood sugar level - ✔Blood sugar 400-800 Hyperglycemic Crisis blood sugar level - ✔Blood sugar 800-up
Hyperglycemia Signs & Symptoms - ✔Kussmaul respirations (rapid, deep respirations), Dehydration, as indications of dry warm skin "tenting". Sunken eyes. A sweet or fruity odor or the breath, caused by Ketones. A rapid, weak pulse (tready) A normal or slightly low blood pressure. Varying degrees of unresponsiveness. Weakness, nausea, and vomiting. Polyuria (excessive urination), Polydipsia (excessive thirst), Polyphagia (excessive eating) Restlessness, possibly progressing to coma; abnormally slurred speech; unsteady gait(movement). Hyperglycemia Caused by - ✔Patient is not under medical treatment Takes an insufficient amount of insulin, Excessive eating Undergoing stress that may cause infection, illness, overexertion, fatigue, or drinking alcohol. #1 cause of diabetic death in pediatrics - ✔Cerebral edema caused by hyperglycemia Hypoglycemia Signs and symptoms - ✔Pale, moist skin (Clammy Diaphoresis sweating), Dizziness, headache, Rapid pulse, Normal to low blood pressure, altered metal status, (Acting drunk mean, aggressive, confused, lethargic, or unusual behavior.) Anxious or combative behavior, Hunger, Seizure, fainting, or coma, weakness on one side of the body (may mimic stroke) Rapid changes in mental status. Hypoglycemic Crisis caused by - ✔Taken too much insulin, Taken a regular dose of insulin but has not eaten enough food, Had an unusual amount of activity or vigorous exercise and used up all available glucose Diabetes patients Commonly - ✔Do not take their insulin when they get sick and go in to hyperglycemic crisis. What is required to give oral glucose. - ✔Patient can hold a glass of water and sip it. Make sure the tube of glucose is intact and has not expired. Aplastic crisis - ✔A condition in which the body stops producing red blood cells; typically caused by infection. Diabetic Ketoacidosis (DKA) - ✔A form of hyperglycemia in uncontrolled diabetes in which certain acids accumulate when insulin is not available.
Endocrine Glands - ✔Glands that secrete or release chemicals that are used inside the body. Endocrine System - ✔Regulates metabolism and maintains homeostasis Glucose - ✔One of the basic Sugars; it is the primary fuel, in conjunction with oxygen, for cellular metabolism. Hematology - ✔The Study and prevention of blood-related disorders Hemolytic crisis - ✔A rapid destruction of red blood cells that occurs faster than the body's ability to create new cells. Hemophilia - ✔A congenital abnormality. Body is unable to produce clots, which results in uncontrollable bleeding Hormone - ✔A chemical substance produced by a gland that regulates the activity of organs and tissues. Hyperglycemia - ✔An abnormally high glucose level in the blood Hyperglycemic Crisis - ✔A state of unconsciousness resulting from several problems, including ketoacidosis, dehydration because of excessive urination, and hyperglycemia. Hypoglycemia - ✔An abnormally low glucose level in the blood Hypoglycemic Crisis - ✔Sever lack of sugar in blood resulting in changes in mental status. Insulin - ✔A hormone produced by the islets of langerhans (endocrine gland in pancreas) That enables glucose in the blood to enter cells; used in synthetic form to treat diabetes mellitus. Kussmaul Respirations - ✔Deep Rapid Breathing; usually the result of an accumulation of certain acids when insulin is not available in the body. Hyperglycemia Polydipsia - ✔Excessive eating. Polyphagia - ✔Excessive thirst. Can be caused by result excessive urination. Polyuria - ✔Excessive urination Sickle cell disease - ✔A hereditary disease that cases normal, round red blood cells to become oblong, or sickle shaped.
Splenic sequestration crisis - ✔Painful enlargement of the Spleen, hard bloated abdomen. Caused by sickle cell disease where sickle cells get stuck get stuck inside and leading out of the spleen. Thrombophilia - ✔A tendency to develop blood clots. Caused by abnormal system of coagulation. Thrombosis - ✔A blood clot Type 1 Diabetes - ✔The type of diabetic disease that typically develops in childhood and requires synthetic insulin for proper treatment and control. Do not produce insulin Type II Diabetes - ✔The type of diabetic disease develops in adulthood and may be controlled by diet and oral medications. Produce some Insulin. Medications: Insulin or other Diabetes Meds. Insulin resistance Vaso-Occlusive Crisis - ✔Ischemia and pain caused by sickle shaped cells that obstruct blood flow to a portion of the body. Egress - ✔Way to exit Evaluation for causes of an altered mental status with an unknown origin. ✔AEIOUTIPS AEIOUTIPS Ð Alcohol, Epilepsy, Infection, Over Dose (OD), Uremia Kidney Failure, Trauma, Insulin/Blood sugar, Psych, Stroke, Seizure and Syncope Indications to check a blood glucose level - ✔Altered mental status, If they are diabetic. Pathophysiology of anaphylaxis - ✔An extreme, life threatening systemic allergic reaction that may include shock and respiratory failure. Envenomation - ✔The act of injecting venom Epinephrine - ✔A substance produced by the body (commonly called adrenaline), and a drug produced by pharmaceutical companies that increases the pulse rate and blood pressure; the drug of choice for an anaphylactic reaction. Histamine - ✔Substances released by the immune system in allergic reactions that are responsible for many of the symptoms of anaphylaxis, such as vasodilation. Immune Response - ✔The body's response to a substance perceived by the body as foreign,
Immune system - ✔the body system that includes all the structures and processes designed to mount a defense against foreign substances and disease-causing agents. Leukotriene's - ✔Chemical substances that contribute to anaphylaxis; released by the immune system in allergic reactions. Differentiate between anaphylaxis and allergic reaction - ✔If patient is going into shock or any involvement of the airway they have anaphylaxis. Allergen - ✔Substances that cause an allergic reaction Allergic reaction - ✔The body's exaggerated immune response to an internal or surface agent Toxin - ✔A poison or harmful substance Urticaria - ✔Small spots of generalized itching and/or burning that appears as multiple raised areas on the skin; hives. Causes of anaphylaxis - ✔Foods(peanuts, shellfish, berries), Insects(bees, Wasps)/ creatures, Medications(Penicillin/Antibiotics), Plants (Burning poison oak). Wheal - ✔A raised, swollen, well defined area on the skin resulting from an insect bite or allergic reaction Anaphylaxis Signs and symptoms - ✔Increased pulse, Increased respiratory rate(Wheezes and stridor), blood pressures decreased (blood vessels dilate and leak). Hives(Urticaria), Skin pale, Altered mental status, Low blood pressure. Treat anaphylaxis - ✔Epinephrine. Assist with EPI Adult .3mg Peds .15mg (give one does and revaluate.) last about 20-30 min Mechanism of action of epinephrine - ✔Alpha 1 (Vasoconstriction), Beta 1 increases force and frequency of contractions, Beta 2 Dilates bronchioles. Pathophysiology of sickle cell anemia - ✔A hereditary disease that causes normal rounded blood cells to become oblong, or sickle shaped. Sickle cells are poor oxygen carriers Sickle cell anemia Causes - ✔Hypoxia, Blood cells to lodge in spleen or blood vessels Causing organs to swell and rupture Sickle Predominately affects - ✔African Americans.
Sickle cell Crisis - ✔Vaso-Occlusive Crisis, Aplastic Crisis, Hemolytic crisis, Splenic Sequestration Crisis Vaso-Occlusive Crisis Ð - ✔Blood flow to an organ becomes restricted causing pain, ischemia and often organ damage. Spleen is often affected Aplastic Crisis Ð - ✔A condition in which the body stops producing red blood cells; typically caused by infection(parvovirus). Causes tachycardia, pallor and fatigue. Hemolytic crisis Ð - ✔Drop in hemoglobin level, caused by blood vessels breaking down at a faster than normal rate. (Common with glucose 6-phosphate dehydrogenase deficiency Complications of Sickle cell - ✔Cerebral vascular attack, Gallstones, Jaundice, Avascular necrosis, Splenic infections, Osteomyelitis, Opiate tolerance, Leg ulcers, Retinopathy, Chronic pain, Pulmonary hypertension, Chronic renal failure. Signs and symptoms of meningitis - ✔Fever, headache, stiff neck, bending neck causes extreme pain, altered mental status, Fear, ALOC, confusion lethargy, ALOC inability to understand commands or interact appropriately. Signs and symptoms of a narcotics overdosing - ✔Pinpoint pupils Constrict Ð Tiny pupils, Slow respiratory rate, slow pulse (14), Altered, Cold. Treatment Over Dose(OD) - ✔Give patient Oxygen BVM - OPA or NPA supplemental oxygen. Rapid TXP Treatment Hypothermia - ✔Remove wet clothing, Place dry blanket over and under the patient with hypothermia; give warm, humidified oxygen, if available; assess the pulse before considering CPR. Passively warm patient. Therapeutic communication - ✔Verbal and nonverbal communication techniques that encourage patients to express their feelings and achieve a positive relationship. Seizures Signs and symptoms - ✔Trauma to the mouth or around mouth, Incontinence, Witness that says patient had seizure 1 cause for adults to have seizures - ✔lack of anti seizure medication or they don't have enough anti seizure medication. 1 cause of pediatric seizure - ✔febrile, because the get hot very quickly Treatment child with febrile seizure - ✔Take the child to the hospital. Cool patient off with a cool towel.
Causes for Seizure - ✔Fever, Lack of meds, Withdrawal from substances, Trauma, Stroke, Lack of oxygen, Infection. Seizures and diabetes - ✔Seizures are dangerous because they consume a lot of oxygen, sugar and raise the patient temperature. Low Blood sugar(could be cause or effect) Generalized seizure - ✔whole body has contractions Partial Seizure(Simple, focal) - ✔Localized twitching EX hand is twitching Partial Seizure (complex) - ✔one side of the body seizes Tonic-clonic seizure - ✔patient exhibits bilateral movement Characterized by muscle rigidity and relaxation usually lasting 1-3 minutes Status epilepticus - ✔(Greater than 5min) Seizures that last more than 5 min usually move to Status epilepticus. Seizures that continue every few minutes without the person regaining conscious or last longer than 30min Auras - ✔Ð Sensation a patient notices before a seizures Postictal - ✔(5-30min) Patient is unresponsive at first and gradually regains consciousness. Ends when patient is at a normal level of conscious. Postictal Ð waking up from super deep sleep. Different seizure phases - ✔Auras, seizure, postictal Treatment for seizure - ✔High flow oxygen, recovery position, bite stick if necessary Evaluate scene safety with a psychiatric population - ✔Be prepared to spend extra time, Have a definite action plan, Identify yourself calmly, Be Direct, Access the scene, Stay with patient, Encourage purposeful movement, Express interest in patients story, Do not get too close. Avoid fighting, Be honest and reassuring, do not judge. Recognize a traumatic brain injury(TBI) - ✔Signs and symptoms Ð Brain is directly injured. Shot, stabbed or penetrated. Motor Vehicle accident. Seizures and convulsions may occur. Bruising around eyes, different pupil sizes. No fine motor skills. Cerebral spinal fluid, coming out of the ears. budging eyes, vomiting. TBI Treatment - ✔Oxygen, C-spine(brain needs a lot of oxygen.)
A traumatic brain injury - ✔A traumatic injury to the brain capable of producing physical, intellectual, emotional, social and vocational changes Primary Injury - ✔An Injury to the brain and its associated structures that is a direct result of impact to the brain. Secondary (indirect) Injury - ✔The after effects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoxia, and infection. Onset is often delayed after the traumatic brain injury. Hypoxia and Hypotension common cause of death. Coup-Contrecoup Injury - ✔Dual impacting of the brain into the skull; coup injury occurs at the point of impact; Contrecoup injuries occur on the opposite side of impact, as the brain rebounds. Cerebral Edema - ✔Swelling of the brain. Treatment for a patient with a snakebite. - ✔Calm Patient, Semi Fowlers position, Document Bite time and Time In route Clean bite with soapy water or mild antiseptic. Splint area and place bite area below the heart(if applicable). Be alert for vomiting, Do not give anything by mouth, Monitor vital signs and mark skin on proximal side of swelling, If there are signs of shock place patient in shock position and administer o2, Bring snake if killed. Notify hospital, Rapid Transport Treat for gastrointestinal (GI) Bleeding - ✔Oxygen, Place in fetal position Rapid Transport. Treat for heat stroke - ✔Heat stroke actively cooled and transported immediately. Treat for heat exhaustion - ✔Heat exhaustion remove cloths. Remove your patient from the hot environment give fluids and passively cool patient. Signs and symptoms of severe dehydration - ✔Increased pulse (160+ is a sign of impending shock), Hypertensive, Level of activity - Weak to unresponsive, Urine output None, Skin dry hot; poor turgor; delayed capillary refill time, Mouth is dry mucous membranes, Eyes are sunken, Sunken fontanels. Altered level of consciousness, Lethargic. Blurred vision. Not hungry, Skin dry hot; poor turgor; delayed capillary refill time, Mouth is dry mucous membranes, Eyes are sunken, Sunken fontanels. Altered level of consciousness, Lethargic. Blurred vision. Not hungry,