General Discussion

Endocrine System

• Made up of all glands and 1 organ (Pancreas), that secrete hormones into the bloodstream

Hormones

• Chemicals that are released from 1 area of the body, that travel to another area to help carry out certain functions

Think of the endocrine system as a relay race!!!!!

• Pituitary Gland-(Brain)"Master Gland"-It secretes the greatest number of hormones in the body

• Thyroid Gland

• Adrenal Glands (Top of each kidney)

• Pancreas

Thyroid Gland       

• Regulates Metabolism

• T3 (Thyroxine 3)

• T4 (Thyroxine 4)

• Calcitonin (Lowers calcium levels in the blood)

 Remember 3 and 3

• 3 conditions on the high end

• 3 conditions on the low end

Hyperthyroidism (Idiopathic, genetic, pregnancy, meds)

• Overproduction of T3/T4

• Everything is up and elevated, except their weight

• Tachycardia

• HTN

• Tachypnea

• Intolerant to heat-High temp

• Exophthalmos-Bulging eyes***

• Goiter (swollen thyroid gland)-Airway concern

• Tremors

• Agitation

• Weight loss and muscle loss

Autoimmune Disorder

• The WBCs are attacking a certain area of the body, mistaking that area for a foreign invader

Grave's Disease (Hyperthyroidism)

• Autoimmune disorder

• Same exact signs as regular hyperthyroidism

Thyroid Storm (Thyrotoxicosis)

• Severe HTN-In the 200's

• tachycardic rhythms (V-tach, V-fib SVT)

• Hyperthermia=Temps >105 F

Paramedic Treatment

• O2 as needed or PPV as needed

• 12 lead EKG

• IV fluids for signs of dehydration (dry skins,

• Passive Cooling-remove from hot area, remove their clothing, AC on in the rig

• Active Cooling-Cool packs, Chilled IV fluids

• Beta Blockers-Metoprolol

• Benzos for agitation

• Check BGL

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Hypothyroidism

• LOW production of T3/T4

• Everything is low and slow except their weight

• Hypotension

• Bradycardia

• Cold intolerant-Hypothermia

• Slow GI motility-Constipation

• Low energy

• Weakness

• Weight Gain

• They have this condition for LIFE!!!!

• Must take Synthroid or Levothyroxine

Hashimoto's Thyroiditis

• Same as Hypothyroidism

• Autoimmune Disorder

Myxedema Coma

• NO production of T3/T4

• Profound hypotension

• Severe Bradycardic rhythms

• Severe Hypothermia

Paramedic Treatment

• O2 as needed

• Passive warming-remove from cold area, blankets, Heat on

• Active warming-warm packs, warmed IV fluids

• Check BGL

• They need Synthroid or levothyroxine

• IV fluids

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Adrenal Glands (4 functions)

1. Regulate the Sympathetic NS (Fight or Flight)

2. Regulates Sexual Function

3. Regulates Stress Response

4. Regulates Fluid balance/BP

Sympathetic NS

• Epi

• Nor-epi

Sexual Function

• Testosterone

• Estrogen

Stress Response (Glucocorticoids=Steroids=Immunosuppressants)

• Cortisol

• Cortisone

Fluid balance/BP (Mineralocorticoids)

• Aldosterone

ADDisons Disease

• A is for Adrenals

• The opposite of ADDition is subtraction

• LOW production of Glucocorticoids (Cortisol & Cortisone)

• EVERYTHING is LOW!!!!!!!

• Hypoglycemia

• Hypotension

• Low weight

• Severe weakness

• Massive Dehydration

• "BRONZE discoloration of the skin (Hyperpigmentation or Ruddy appearance)

Cushing's Disease

• Overproduction of Glucocorticoids (Cortisol/Cortisone)

• The pt. will be very CUSHY

• Heavy and Overweight

• HTN

• Hyperglycemia

• Moon face

• fat pad on the back

• Purple striae (Stretch marks)

• Petechiae

• Thin bruised skin

• Ecchymosis

Insulin (Secreted by the BETA Cells of the Pancreas)

1. Lowers BGL

2. Lock & Key-Opens up the cells, to allow them to use glucose for energy (ATP)

Type I D.M

• Autoimmune disorder

• Juvenile onset

• Born with it!!!!

• The pancreas produces NO Insulin

• On Insulin for LIFE!!!!

Type II D.M

• Adult Onset

• Either the pancreas produces LOW amounts of insulin OR they are insulin resistant

• Causes-Obesity, sedentary, poor diet, HTN, kidney disease

• Curable and reversible

• Controlled w/ diet, exercise, weight loss, and Oral medications

GLUCOSE is a dehydrating agent!!!!!!!

3 Ps of Diabetes

Polydipsia

• Increased thirst

Polyuria

• Increased urination

Polyphagia

• Increased hunger (Cells are starving because there's not enough insulin)

DKA-Occurs in Type 1 Diabetics

1. BGL increases to 250-550 mg/dl (non-compliant w/ Insulin)

2. The cells begin to STARVE (No insulin to open up the cells)

3. The cells start using FATS for energy

4. The biproduct of FAT breakdown=KETONES

5. Ketones are ACIDS!!!!

6. Metabolic Acidosis

HHS=HHNS=HHNK-Occurs in Type 2

• BGL increases-600-1200 mg

• No ketones

• No Kussmaul

• No fruity breath

• No Acidosis

• MASSIVE DEHYDRATION!!!!!!!!