NREMTP Review-Yaya/Emma/Daniel 🚑🚒 Immunology & Hematology
Hematology/Immunology/Infectious Diseases
3 Types of Blood Cells-Produced in the bone marrow
RBCs (Erythrocytes)-Carry Hgb & Oxygen-Live for 120 days
WBCs (Leukocytes)-Fight infections. Immune response-Live for 14 days
Platelets (Thrombocytes)-Blood clotting
Blood clotting
Platelets
13 different clotting factors (Found in the plasma of the blood)
Vitamin K
Plasma
Liquid portion of blood (High % of water/protein)
It contains clotting factors
Why do we not give excessive IV fluids for trauma or bleeding?
It dilutes the blood and washes away clotting factors (worsens bleeding)
250-500 ml of N.S, with the exception of Burns (parkland burn formula)
IV Fluids
Colloids
Crystalloids (NS, isotonic, Hypotonic, Dextrose)
Colloids-Blood products & Plasma expanders
Whole blood
PRBCs
FFP-Fresh Frozen Plasma
Albumin
Platelets
IMMUNOLOGY
Immune System
WBCs (leukocytes)
Spleen
Lymphatic (Lymph nodes & Lymph Fluid)
Function of the immune system
Fights infections (pathogens)-Bacteria, Virus, Fungus, Parasites
Immunity
Antibodies
Inflammation
Allergic reactions/Anaphylaxis
Pathogen-a foreign infectious cell (bugs) which causes an immune response & ultimately infection
Bacteria (Epiglottitis, Pneumonia, meningitis)
Virus (Influenza, Croup, Common cold, HIV/AIDS, hepatitis)
Fungus
Parasite (worms)
Antigen
A foreign invader or a toxin which causes an immune response (Causes histamine, WBCs to release)
if someone is allergic to peanuts, and eats a peanut, the peanut is the antigen
Toxins, venom (bee stings, jelly fish, snake bites), hymenoptera (insect), certain foods
WBCs-Leukocytes (Immune system)-
Fight infections (pathogens)
Immunity/Immune response (Antibodies)
Inflammation
Histamine release (Antigen)
A RBC is an RBC, we don't have different types
Platelets are platelets, we don't have different types
We do not have only 1 type of WBC!!!!!!
If I said to you, I got a new truck
Ford
Chevy
Dodge
Toyota
Composition of Blood
RBCs (Erythrocytes)
WBCs (leukocytes)-Neutrophils, Lymphocytes (T-cells, B-cells, NK cells), Monocytes, Eosinophils, Basophils
Platelets
Plasma (Liquid portion, clotting factors)
WBCs (Leukocytes)
"Never Let Monkeys Eat Bananas (5 types of WBCs)
Neutrophils-most numerous (50-60%) *******
First responders of bacterial (Fungal) infections (Pathogens)
Helps w/ phagocytosis (Pac-mans-Ingestion of foreign pathogens)
Lymphocytes-20%*******In the lymphatic system-Seen on the exam!!!
T-cells (CD4 Cells) (Thymus Gland)-Humoral Immunity
B-cells (Bone marrow)-Cell mediated immunity (Mast Cells)
NK Cells (Natural Killer)
Monocytes-8-10%
Responsible for phagocytosis (Ingestion of foreign bacteria)
"Think of Pac-Mans
Eosinophils-5-6%********Seen on the exam!!!!
Allergic Rx & Anaphylaxis
Histamine response
Basophils-1-2%
Onset of Inflammation
Small function in allergic Rx, w/ eosinophils
2 types of appearances of WBCs
Granulocytes
Neutrophils
Eosinophils
Basophils
Remember-NEB treatment
Agranulocytes
Monocytes
Lymphocytes
Mast Cells
produced in the bone marrow, but they start to mature in our connective tissue
Responsible for Innate immunity & Acquired immunity
Responsible for histamine release
Immunity
****There are 3 Main types of Immunity*****
Innate Immunity
Built in immunity, from birth
Passive Immunity----"Think-PASS, it must be passed to you"
Passed into someone
Breast milk
Vaccines/Immunizations
Placenta to baby
2 Types of Acquired/Active Immunity
Strongest type of immunity!!!!!!!!
HUMORAL Immunity-Adaptive/Acquired Immunity
Acquiring & adapting throughout life, from getting infections and being exposed to antigens
T-Cells (Type of Lymphocyte)
CELL-MEDIATED Immunity-Adaptive/Acquired Immunity
Immunity from B-Cells (Type of Lymphocyte)
WBCs play a role in immunity and our immune system. What type of cells are responsible for adaptive humoral immunity
A. Lymphocyte T-cells
B. Phagocytes
C. Basophils
D. Lymphocyte B-cells
Example-Someone gets Covid for the first time (the body has never seen Covid before), once the body gets an infection, they now develop antibodies (memory cells), to fight it immediately, next time the body gets an infection
WBCs (leukocytes)
5 main types
Antibodies
IG-5 types
Specific antibodies=IGs-Immunoglobulins
Antibodies (memory cells)
Cells produced by the immune system, which identify foreign invaders. Produced after coming into contact w/ an antigen or receiving an immunization
Immunoglobulins (IGs) (Specific Types of Antibodies)-Common test topic!!!!!
**** Often seen on the exam
Remember, there are 5 types of IGs
IgA****
Found in mucus, saliva, tears, breast milk
Protects against pathogens (Bacteria, Virus, fungus, parasites)
The paramedic would be aware that the type of antibody a newborn receives from breast feeding is known as what?
A. IgA
B. IgM
C. IgE
D. IgD
IgD
Found in B-cells (Type of lymphocyte)
Activates basophils
IgE**************
Allergic Rx, anaphylaxis
Parasitic infection
IgG*****
Found in blood plasma
Crosses the placenta into the fetus (Passive immunity)
IgM
Found on a B-cell (Type of lymphocyte)
Early stages of immunity
The paramedic would be aware that the type of antibody responsible for passive immunity while a fetus is in utero is which IG?
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Communicable Infectious Diseases
Infections
Bacterial Infections (T.B, Whooping Cough, Epiglottitis, Meningitis, Pneumonia)
Viral Infections (HIV, AIDS, Hepatitis, Meningitis, Pneumonia, Varicella, Shingles)
Bacterial infections-easier to kill, and are treated w/ antibiotics
Viral infection-LOW GRADE FEVER
Bacterial Infection-HIGH GRADE FEVER
Viruses
Replicate FAST w/ RNA
Enveloped (Outer force field)
3 Levels of Infectious/communicable Diseases
Airborne (Gloves, Eye protection, N95) Remember MTV!!!!!
Measles/Mumps
T.B
Varicella (Chicken Pox & Shingles)-Herpes Zoster Virus
Droplet (Gloves, Eye protection, Surgical mask)
Meningitis
Influenza
Covid
Pneumonia
Epiglottitis
Pertussis (Whooping Cough)
Parvo Virus
Contact (Gloves, Gown, eye protection)
HIV & AIDS
Hepatitis
MRSA
C-Diff (Clostridium Difficile)
Scabies
In what order would the Paramedic Doff their PPE?
Drag and drop the steps from first to last
Airborne
The infectious particles remain suspended in the air
Droplet
Droplets from a sneeze or a cough have to land on you or something, then we touch our face and they enter through the mouth or nose
Contact
Transmitted via blood or feces
HIV, AIDS, C-Diff, Hepatitis
Evolution of inflammation/infection
Localized inflammation
Localized infection
SIRS (Systemic Inflammatory Response Syndrome)
Sepsis (Systemic infection)
Septic Shock
MODS (multi organ dysfunction syndrome)-2 or more organs are failing
DEATH!!!!!
Procainamide
Used for V-Fib or V-tach unresponsive to Amio or Lidocaine, or you have maxed them out and they are still in V-fib/V-tach
Cardiogenic Shock
Dopamine-spikes the HR
Dobutamine-used for CHF patients in cardiogenic Shock-It does NOT spike the HR
CHF
HR-118, BP-72/48
Heart failure=CHF=VENTRICULAR FAILURE
Left sided
Right sided
Biventricular
Croup (Laryngotracheitis)-Affects peds ages 6 months-3 years
Viral Infection of the larynx (Vocal cords) and upper trachea
Seal bark cough
Low grade fever
Stridor
Hoarseness in the voice
Rhinorrhea
Irritability
Poor feeding
Tachycardia
Mild Croup (NO Stridor)
Humidified oxygen
get them into a steamed-up bathroom
get them outside into the night air
Moderate Croup (Stridor w/ activity)
Humidified Oxygen
Racemic Epi
Corticosteroids
Severe Croup (Stridor at rest w/ severe respiratory distress)
Humidified o2
Racemic Epi
PPV as needed