NREMTP Review-Raphael 🚒🚑 Mixed Topics
Collapsed Lungs
Pneumothorax (Simple or Closed)
Open Pneumothorax=Sucking Chest Wound
Tension Pneumothorax
Hemothorax
Tension Pneumothorax
Tracheal shift
JVD
Hypotension
Subcutaneous emphysema
Hemothorax
Hypo resonant sounds
Flattened neck veins
Hypotension
Signs of hypovolemic shock
When do we give High flow oxygen vs PPV w/ a BVM
If they are shallow or have a low tidal volume=PPV
If the RR is less than 10/min=PPV
If the RR is greater than 36/min=PPV
If they are unresponsive=they cannot protect their own airway
Absent gag reflex=PPV
prioritization
determine differential diagnosis
Safety
Treat immediate threats=STOP any external bleeding
Airway
Breathing/Oxygenation
Circulation
Transport Decision
If there are no immediate findings in the primary exam, then treat the pts. symptoms, and get them feeling better
2 Types of Strokes
Hemorrhagic Stroke
Ischemic Stroke
Ischemic Stroke
Due to a blood clot in the vessels of the brain
80%
causes-obesity, CAD, blood clots, HTN, diabetes
No rapid unconsciousness
Slurred speech
hemiparesis
facial droop
NO signs of ICP!!!!!
Hemorrhagic Stroke
Is due to a ruptured aneurysm (swelling of an artery)
ICH-Intracerebral Hemorrhage
SAH-Subarachnoid Hemorrhage
#1 causes=Uncontrolled HTN!!!!!!!!!!!
Rapid unconsciousness
Massive ICP!!!
Cushing's Triad (HTN, Bradycardia, Depressed & Irregular respirations)
Unequal pupils
Traumatic Bleeds
Epidural Hematoma
Subdural Hematoma
Asthma Attack
High flow oxygen
or PPV depending on how bad they are
Albuterol
Ipratropium (Atrovent)
Mag Sulfate
Epinephrine
Levalbuterol (Xopenex)-used for cardiac patients, it does not spike the HR
Corticoid Steroids (Solu Medrol, solu cortef, Dexamethasone)
Your patient is having an acute asthma attack. They have taken their MDI inhaler of albuterol 3 times without relief. What would be your next appropriate intervention?
A. Epinephrine 0.3 mg 1 to 1000
B. 1-2 gm of Mag Sulfate
C. Nebulized levalbuterol
D, Solumedrol 125 mg
Epinephrine
Cardiac arrest
Anaphylaxis
Severe asthma
Symptomatic Bradycardia-1st line in peds
Shock and Hypotension
Epinephrine MOA
Decreases laryngeal spasms and opens the upper airway
vasoconstriction=Raise BP
bronchodilation
+ Inotropic-Increases the strength of the hearts contraction
+ Chronotropic-Increases the HR
Racemic (nebulized) Epi
benzodiazepines
Midazolam-Versed
Diazepam-Valium
Lorazepam-Ativan
Shivers=Rebounds the temp!!!
Passive Cooling
Remove from warm area
Remove the clothing
AC on in the truck
Active Cooling
Cold packs in the groin, axillary, chest
Chilled IV fluids
Stable SVT
Vagal maneuvers (Bear down, Diving Reflex (Cold packs or face in a bowl of cold water, CSM-Carotid sinus massage)
A. Administer 6 mg of adenosine
B. perform the diving reflex
C. Immediate cardioversion
D. CSM-carotid sinus massage
Pituitary Gland=Located in the BRAIN
Master Gland
Controls the Thyroid, adrenal glands, kidneys, uterus, bones/muscles
Raphael starts to run
Then hands the baton to Justin, and now he can run
Thyroid Gland=Regulates Metabolism
Secretes T3, T4, Calcitonin
Hyperthyroidism-everything is up and elevated, except their weight
Tachycardia
Tachypnea
HTN
Increased Temp
Goiter
Increased GI motility=Diarrhea
Weight loss
Monitor ABCs
12 lead EKG
Check BGL
Passive or active cooling
Antihypertensive med