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60 Cards in this Set
- Front
- Back
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Describe the pathophysiology fo anaphylactic shock?
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An Antigen enters the body, it is attacked by an antibody. In Anaphylaxis, however the Antibody does not destroy the antigen. Instead they react, causing shock. Because a white blood cell called a mast cell releases chemicals, the most important substance is histamine. Histamine cuase Severe Bronchoconstriction/spasm (airway compromise) Intense vasodilation, leaking fluid from vessels due to change in permaebility, and reponses can range from milde to extreme, Death.
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Anaphylaxis?
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A severe allergic reaction; may cause breathing difficulty, circulatory problems, and ultimately, shock.
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Antigen?
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A Foreign Substance.
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Antibody?
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A substance in the body that functions to destroy foreign substances.
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Mast Cell?
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A specialized white blood cell that releses histamine into the body.
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Histamine?
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Released into the body during anaphylactic shock; may cause airway comprommise and vasodilation.
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List common signs and symptoms of anaphylactic shock?
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Sense of Uneasiness or agitation, first noticed by patient.
Swelling of soft tissues (hands, tongue, pharynex Skin flushing with hives Coughing sneezing, Wheezing - upper and lower airway spasms, rales, rhonchi, no breath sounds. Abdominal Pain Tachycardia Weak, thready pulse, |
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Describe the treatment of anaphylaxis?
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Aggressive airway management
Ventilatory support O2 Circulatory support IV large-bore Epi-pen if patient has one reassureance to the patient position of comfort |
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Asthma?
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A common respiratory disease that causes sufferers to experience acute airflow obstruction in the lower portion of the airway.
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Describe the pathophysiology of asthma.
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involves the lowwer airway, beyond the level of the trachea and minstem bronchi. It occurs when the bronchial airways narrow and make breathing difficult.
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Describe the signs and symptoms of asthma and list those that indicate a very serious condition.?
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Sitting upright, tripod position, using accessory muscles to breathe.
Short of breath Wheezing abnormal sounds Hyperinflated chest Coughing Tachycardia Hypertension Tachypnea Cyanosis Decreased O2 sat Answers short sentences For Severe - Altered Mental Status Silent Chest, no air moving Marked Diaphoresis Cyanosis. Too Tired to breathe anymore |
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Identify the treatment for a patient experienceing an acute asthma attack.
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Combitube them
Reassure patient Provide O2 if in distress Position of comfort Timely transport IV lifeline Assist with Medicanes if Medical Direction approves. |
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Status Asthmaticus?
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Is a severe prolonged asthma attack that does not respond to standard medications. Its onset may be sudden or insidious and is frequently precipitated by Viral Resp. infection. Rapid Transport.
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Chronic Obstructive Pulmonary Disease
(COPD) |
A respiratory disease that causes decreased inspiratory and expiratory function.
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List 3 priorities of care for COPD?
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Transport in sitting position
Give O2 per protocol Loosen restrictive clothing Encourage the patient to cough up secretions. Start IV at TKO rate Administer Nebulized bronchodilator as per local protocol. |
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Hyperventilation
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Is a respiratory rate greater than that required for normal body function.
Hyperventilation causes an excessive elimination of carbon dioxide. |
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Identify 5 conditions that may cause hperventilation?
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Asthma Attack
COPD MI Pulmonary embolism Spontaneeous pneumothorax Congestive heart failure others. |
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Describe the care given to patients who hyperventilate?
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Assume that there is an underlying medical cause of hyperventilation.
Give O2 -Nasal/Non-rebreather Control breathing/calm patient. If Chest Pain, EKG/IV Transport |
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Recall three patients who are at risk for pulmanary embolism?
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Inactive lifestyle - long hospital stays, long trips (car/airplane)
Obesity Thrombophlebitis, inflammation of the veins birth control pills Long bone fracture Pregnancy Surgery Blood diseases |
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Identify four signs/symptoms of plumonary embolism?
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Massive - Cardiac arrest or syncopal spell
Smaller - Sudden unexplained chest pain, with deep breathing, Respiratory distress - Rate increased, Wheezing, coughing up blood, Anxiety, Tachycardia, shock, hypotension |
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Spontaneous pneumothorax?
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is a sudden accumulation of air in the pleural space. Due to a rupture of a weak area on the lung surface.
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Describe the mechanism of spontaneous pneumothorax
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Due to a ruptured weak are on the lung surface. Air enters the pleural space, the lung on the involved side collapses. Common cause of shortness of breath and chest pain in young individuals, More men then women.
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Cerebrovascular accident (CVA)
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A stroke - is a condition that results from a disruption of circulation to the brean, causing ischemia and damage to brain tissue.
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List 5 signs and symptoms of stroke?
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Gradual or rapid onset.
paralysis, usually one side of body affected. Damage to one side of brain affects opposite side of body. Face droop, sagging muscles beneath eye and cheek, slurred speech, month not working, decreased sensation. Elevated Blood pressure. |
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Describe the importance of airway management in the stroke patient.
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Airway problems are common in stroke; maintain airway and give high flow O2 by nonrebreather.
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Transient ischemic attack (TIA)
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sometimes called a mini-stroke, is a stroke like neurologic deficit that completely resolves within minutes to hours.
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Coma
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is a state of unresponsiveness characterized by the absense of spontaneous eye movements and responses to painful stimuli and vocalization. The comatose person cannot be aroused. Describe patient as unresponsive to pain and verbal stimulus.
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Five intracranial causes of coma
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Intracranial bleeding
stroke tumor infection - meningitis, encephalitis Seizure |
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Identify five causes of coma that originate outside the nervous system?
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Blood chemistry abnormalities
Hypertensive crisis kidney or liver failure abnormalitties of the endocrine gland Vitamin deficiencese Drugs Psychiatric problems Use the AEIOU-TIPS for causes of coma A-Acidosis, alcohol E-Epilepsy I-Infection O-Overdose U-Uremia -(kidney failure T-Trama I-Insulin P-Psychosis S-Shock, stroke |
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Describe the patient care priorities for Coma?
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Airway
O2 C-spine VS every 5 minutes suction/vomit/airway IV, TKO= Blood sugar Call ALS |
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What is seizure?
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A sudden, intense episode of heightened electrical activity in the brain.
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List four types of seizures?
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Grand mal seizures
Focal Motor Seizure Behavioral seizure Status epilepticus |
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Status Epilepticus
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A series of seizures with no responsive intervals. Seizures without an interval of wakefulness between them.
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Postictal State
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A period following a seizure whereby the sufferer gradually returns to a normal state.
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FACTS for seizure patient:
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F-Focus - Was there a single initiating movement
A-Activitiy - What movements took place during the event? C-Color - Did patient become cyanotic? Cocaine T-Time how long did it last S-Secondary information - before the seizure what happened, Aura? incontinence occure, bite tongue, history of seizures, antiseizure medicine. |
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Aura
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patients will notice the presence of an aura, is a warning sign that consists of seeing, hearing, or smelling somthing unusual before losing responsiveness.
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Describe the patient care priorities for seizure-
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Airway
Assist ventilation in postictal state Suction High-Flow O2 IV afer seizure bystanders back transport |
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List four causes of headache?
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brain tumors
Intracranial bleeding Hypertensive crisis Meningitis Poisoning |
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Gastrointestinal Bleeding?
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refers to hemorrhage anywhere in the GI tract from the moutn to the anus
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List four causes of gastrointestinal bleeding?
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Upper and lower types
Lower GI bleeding results from bleeding due to a lesion of the GI tract below the level of the duodenum. Diverticulosis, tumors, hemorrhoids, polyps Upper GI bleeding - Peptic ulcer disease, Gastritis, Esophagitis |
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Describe the patient care priorities for gastrointestinal bleeding?
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Airway
High O2 Care for Shock IV 500 to 1000 CC bolus prepare for vomitting/suction Nothing by mouth Life-threating |
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Diabetes Mellitus
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A disease whereby an insufficient amount of insulin is produced to regulate blood sugar levels in the body.
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Hypoglycemia?
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is an abnormally low blood sugar level. Sometimes called insulin shock.
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Describe five signs and symptoms of hypoglycemia.
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Rapidly, over a few minutes to few hours.
shakiness, weakness Diaphoresis Rapids pulse and RR Altered mental status Slurred speech Neurologic deficit Seizures- unusual in adults more in kids. |
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Describe the care given to patients with hpoglycemia
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Control Airway and assist breathing
Give O2 by nasal 6L If responsive oral glucose IV Blood sugar check |
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Hyperglycemia
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is an elevation of the blood sugar level above normal. The most common cause of hyperglycemia is diabetes.
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Diabetic ketoacidosis
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is a metabolic condition consisting of hyperglycemia, dehydration and the accumulation of abnormal compounds called ketones and ketoacides in the body.
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List five signs and symptoms of diabetic ketoacidosis
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slow onset -
Weakness Nausea and vomiting Abdominal pain Frequent urination Thirst Rapids, deep sighning repirations Alterations in the level of responsiveness A fruity, acetone-like odor to the breath Normal to decreaed BP Rapid, weak pulse |
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Describe the most common presentation of hyperosmolar hyperglycemic nonketotic coma
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Over 60
poor health, Nursing home Over four or five days of being sick Infectin, extreme cold, dehydration |
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Describe the care given to patients with hyperglycemia
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Airway, O2, Blood sugar, IV, VS and EKG
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Identify four routes of exposure to poison?
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Ingestion - Month
Inhalation Absorption Injection |
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List four items of information needed when assessing a patient who ingested a poison?
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What was taken?
How much was ingested? When the poisioning occurred? What if anything, has been done for the patient? |
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Identify five areas to assess with a poisoned patient?
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Pulse, RR, Tempterature, Blood pressure. and body systems
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Heat cramps
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are cramps and pains in the muscles, expecially the muscles of the abdomen and lower extremities, which occure in hot enviroment. Most common in heat injury syndromes.
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Describe care provided for patients with heat cramps, heat exhaustion, and heat stroke.
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Cool environment.
sips of cool water IV 500 to 1000 CC O2 - 15 L Transport |
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Heat exhaustion -
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is more severe los of fluid and salt than occurs in heat cramps, ususally follwoing exertion in a hot, humid environment.
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Heat stroke -
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or sun stroke, a failure of the body's tempterature regulation mechanisms, is an extreme mediacl emergency. Heat stroke develops when the body is no longer able to get rid of heat.
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Frostbite
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is the formation of ice crystals within the tissues.
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List the care for frostbite.
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Rule out total body hypothermia, fractures, bleeding and intoxication.
Transport Protect Cover with dry sterile dressings |
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Describe care for hypothermia
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Gently handle patient
CPR as necessary, check pulse a long time. 02 high flow warm fluids IV - warmed to 104 Dress and protect Frostbite Remove wet clothes warming protocels. |
