What is Xanaz

Xanax is a benzodiazepines, so it works by relaxing our muscles through slowing down the movement of chemicals in the brain. Xanax is used to treat anxiety disorders, panic disorders, and anxiety caused by depression. If taken correctly, Xanax is a great drug, for those that truly need it. Unfortunately, sometimes Xanax is misused.

As with every other drug out there, their is always going to be side effects, that patients should watch for. Some of the common side effects include, but not limited to, depressed mood, thoughts of suicide, confusion, agitation, hostility, urinating less that usual/not at all, chest pain with/without feeling of a racing heartbeat. sleeping problems, and more.

Misused Xanax included, but not limited to, taking to much of the drug (overdose), or taking the drug and it is not prescribed to you. For overdose, some signs/symptoms include drowsiness, confusion, muscle weakness, loss of balance, light-headedness, and fainting. In more serious cases, to much Xanax can cause respiratory depression, which may lead into respiratory arrest, which can turn into cardiac arrest.

For an overdose of Xanax, where the patient is unresponsive, or symptomatic, the patient need to transported priority 1, to the floes appropriate facility. You need to treat the patients signs/symptoms. For examples, is they are not breathing, you need to ventilate the patient; if they are in cardiac arrest, you need to perform CPR. If the overdose is minor, EMS care is usually just supportive care for the patient. As with all drug overdoses, close patient monitoring is vital.

If someone takes the drug, and it is not prescribed to them, always take that extra caution. Their is no way of knowing the effects the patient will present with. Xanax has different dosages, and they may take to much Xanax, thinking they would be a different dose than what would be actually prescribed.

Overall, monitor these patients, and treat with what they present with. If in doubt, rapid transport to the closest appropriate facility. Med-control can usually also guide you on what to do for these patients. In addition, make sure to follow local protocol.

**Disclaimer**
I am not knocking Xanax, or saying anything bad about Xanax. The sole purpose of this post, is to inform EMS providers, on what Xanax is. Recently, I have been getting a lot of questions about Xanax and Adderall (see different post for Adderall).  Xanax has been proven to help patient's, who need it. 

Prehospital Drug Cards

I have created a PDF of the commonly used drugs, that are used in the prehospital setting, by paramedics.

These drugs cards cover everything that you need to know about the drug. Due to packaging differences, supplied dose, is not provided.

PDF Link: Prehospital Drug Cards for the Paramedic

Visit the website, www.paramedicstudentcentral.webs.com, for more documents and pictures.

S1, S2, S3, S4 Heart Tones

For us, working in the prehospital setting, listening to all the heart tones may be not as desired, as it is in the hospital setting. Yet, it is still important to understand heart tones. By understanding these, one will be able to figure out if their is an issue with the aortic valve, pulmonic valve, tricuspid valve, and the bicuspid valve.

By knowing what is normal sounding, will make abnormal sounds easier to identify. If an abnormal sound is detected, it is possible that the valve is failing in some way. A failing valve can be fatal to patients. In some cases, patient's may live with an abnormal sounding valve (valve issues), and have no side effects of the valve, until the valve fails to point where they need surgery to fix the failing valve.

In addition, their are many great videos on youtube® to help explain heart tones, S1, S2, S3, S4 a whole lot more and with more detail.


Let's break down what each valve does.
   -Aortic Valve
       >Valve that allows blood to enter into the aorta
   -Pulmonary Valve
       >Valve that allows blood to enter into the pulmonary arteries
   -Tricuspid Valve
       >Valve that allows blood to enter the right ventricle from the right atrium
   -Bicuspid Valve
       >Valve that allows blood to enter the left ventricle from the left atrium

Now, let's go over S1, S2, S3, S4 heart sounds.
   -S1
       >First heart sound, heard
       >"lub" of lub-dub
       >Caused by the sudden block of reverse blood flow due to closure of the AV valves
       >Beginning of ventricular contraction (systole)
   -S2
       >Second heart sound, heard
       >"dub" of lub-dub
       >Caused by the sudden block of reversing blood flow due to closure of the semilunar valves
       >End of ventricular systole and beginning of ventricular diastole
   -S3
       >Rarely heard, but can still be present
       >Considered the "third" heart tone
       >AKA protodiastolic gallop, ventricular gallop
       >AKA the "Kentucky" gallop
            =Caused by stress of S1 followed by S2 and S3 together
            =S1-"Ken" ; S2-"tuck" ; S3-"y"
       >Occurs are the beginning of diastole after S2, but lower pitch than S1 or S2
            =This is because it is not of valvular origin
       >Usually occurs later in life, and can signal cardiac problems
            =CHF
       >Caused by the oscillation of blood back and forth between the walls of the ventricles
   -S4
       >Rarely heard
       >Considered the "fourth" heart tone
       >AKA presystolic gallop or atrial gallop
            =Produced by blood being forced into a stiff hypertrophic (enlarged cells) ventricle
       >AKA "Tennessee" gallop
            =S4-"Ten-"
            =Best heart at the apex, while patient is holding their breath, while supine
       >Signals a failing or hypertrophic (enlarged cells) in the left ventricle, systemic HTN
            =Others: Valvular aortic stenosis, hypertrophic cardiomyopathy (heart muscle is enlarged)
       >Occurs just after atrial contraction, immediately before S1
       >Side note: atrial contraction must be present for production of S4
            =Not present in atrial fibrillation
            =Or in other rhythms where atrial contraction does not precede ventricular contraction

Lung Sounds Reference Chart

A common issue that a lot of EMS personnel have issues with, is checking lung sounds. Lungs sounds can be a vital tool to identifying what is going on with your patient, and how to treat them.

One thing that we need to discuss, is the difference between Respiratory Arrest, Dyspnea, and Respiratory Failure. Respiratory arrest is when their a total stop in all respirations. Dyspnea, is when the patient is still breathing, but they are struggling to breath. With respiratory failure, oxygen and CO2 cannot transfer properly, thus sending the patient is respiratory distress, which leads to arrest.

Failure is characterized by tachypnea, increased CO2, air hunger, and cyanosis in the lips, eyelids, and fingernail beds.

Now let's discuss the types and description of lung sounds.
  -Stridor --- upper airway obstruction --- heard over the trachea
  -Wheezing --- bronchoconstriction --- heard where the bronchi are constricted
  -Rhonchi --- air is trapped in the airway --- heard over the larger airways
  -Rales --- fluid in the lungs (alveoli) --- heard in the smaller airways --- aka crackles

For examples of what each lung sound sounds like, visit youtube.com and type on the specific lung sound.

I have made a picture, to help with the identification of lung sounds, based on where you will hear them.

(click on picture to enlarge)

PVC, PAC, PJC Quick Reference Tool

I've been assisting with a paramedic class recently, and it has been brought to my attention, that a lot of students still don't fully understand the difference between the PVC, PAC, and PJC. So, in explaining to them about each, I have created this quick reference tool.

I hope that this quick reference tool will help everyone out.

You can also visit one of my older posts about PVC, PAC and PJC's. Click here.

Click on picture to enlarge it

Triads

Click on the picture to enlarge it

Week of May 5-May 9

Hello my viewers,

This week is my last week of the fire academy. We have our finals and state testing all this week. I am going to try to post at least one post, but if I am unable to, I want to apologize now.

I will start posting again, by the end of the week, beginning of the next week. I have some pretty good posts in mind, that I would like to post on here, to help everyone out.

Also, don't forget to "suggest a post" for my to put on here. Remember, this blog is to help everyone succeed in the paramedic program and to help those already a paramedic, gain more knowledge.

Sincerely,

Brandon A.
Owner

mylifeasparamedicstudent.blogspot.com
paramedicstudentcentral.webs.com