tag:blogger.com,1999:blog-16478571668016355122024-03-13T20:59:32.978-04:00Paramedic Student CentralReference and rescource material for paramedic students and licensed paramedics.Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.comBlogger113125tag:blogger.com,1999:blog-1647857166801635512.post-24179314482900408252018-06-20T21:49:00.000-04:002018-06-20T21:49:27.457-04:00Brain Function BreakdownHello everyone. It has been a long time since I had posted on the blog, but I have been working, updating and formatting the website, creating new documents, teaching, running my business, and being back in the classroom! I know, it's crazy to be back in school, again. But, I love it!<br />
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I am currently enrolled in my Critical Care Paramedic course. This course is kicking my butt, but I can't wait to get this certification so I can take the most critical patient's from hospital A to hospital B, and completely know what to do for these patients.<br />
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While we were covering the euro chapter, we came across the function of the brain. We broke the parts down, and outlines what each part of the brain does. I have been doing this for over 6 years, and I think I was dropped a few too many times, because I can never remember which part controls what in the brain: I think I have had some temporal lobe trauma.<br />
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Anyway, so I created this picture to help me, and I hope it helps you too. It breaks down each part of the brain, and what it is responsible for. Please click on the picture, to enlarge it.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhaHNZfwilvtGB2JKch_j8OAgVTneYkrMW75md8ByLdUjjx3VCdaJoErd-E5rMZf-INobWytDvx-MZmNsWOkZwxt-ZKGauu5sstnoeZvSvHZCf-WCiI3P_1Ylx9u-tLMTr20eVOiMYFjZ4/s1600/Screen+Shot+2018-06-20+at+9.42.23+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="869" data-original-width="1600" height="215" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhaHNZfwilvtGB2JKch_j8OAgVTneYkrMW75md8ByLdUjjx3VCdaJoErd-E5rMZf-INobWytDvx-MZmNsWOkZwxt-ZKGauu5sstnoeZvSvHZCf-WCiI3P_1Ylx9u-tLMTr20eVOiMYFjZ4/s400/Screen+Shot+2018-06-20+at+9.42.23+PM.png" width="400" /></a></div>
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Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-65495197573507933092016-05-03T21:46:00.004-04:002016-06-15T16:08:47.333-04:00DIY NRB Capnography Device for the ParamedicIn today's times, money is tight. Agencies cannot always afford to buy the nasal cannula EtCO2 device. Because of this, it is important that you have an understanding on how make your own EtCO2 device.<br />
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For this particular post, I am going to focus on the use of a non-rebreather with the EtCO2 device.<br />
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Capnography is a critical tool in patient treatments. Capnography can used in various situations, to help guide the diagnosis, how well the treatments are working, and overall how the patient is doing. For example, if you run on a difficulty in breathing patient, Capnography can be used to determine the patients real-time respiratory rate, their exhaled CO2 level (EtCO2), and even provides a waveform, to help determine the respiratory status of the patient.<br />
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This particular post is not going to go into detail on the entire usage of capnography, indications, etc., but this post is geared to show you how to make your own capnography device using four simple tools. If you would like to read more about EtCO2, visit paramedicstudentcentral.webs.com for the PDF PowerPoint presentation.<br />
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To start, you will need a non-rebreather (NRB), EtCO2 capnography device (the device used for ET Tubes), oxygen, and a capnography capable monitor.<br />
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I have personally tried a few different ways, on how to set up the capnography device for the best reading and waveform outcome. The method that I prefer to use is where you stick the capnography tube into the NRB.<br />
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Place the patient on a NRB, with high-flow oxygen. Never withhold oxygen, in order to do this. To do this, take the capnography device, and cut off the end where the attachment is to attach it to the ET Tube. Now, you will have the attachment that goes into the monitor, and just a long tube. Attach the attachment device to the monitor. Now, take the other end of the capnography tube and slide it into one of the small holes on the NRB (where the rubber valve is). It should come out to looking like this:<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiXCMhnq07gtKjKI2YKGmode-_MPYFHmVyGLSJezFuV7iXAtllCsp4hZ4hNGk2PVYl_aN29kebY5DExOvmj4i9GVinXas-SSYv7_q0Z1Uw-mrLVLTRWXUvTMU6sUrlodkTAkQwpPgJXVU/s1600/IMG_20160503_021856191.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiXCMhnq07gtKjKI2YKGmode-_MPYFHmVyGLSJezFuV7iXAtllCsp4hZ4hNGk2PVYl_aN29kebY5DExOvmj4i9GVinXas-SSYv7_q0Z1Uw-mrLVLTRWXUvTMU6sUrlodkTAkQwpPgJXVU/s320/IMG_20160503_021856191.jpg" width="180" /></a></div>
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<i><span style="font-size: xx-small;">(click photo to enlarge)</span></i></div>
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You want to try to get the capnography tube to be as close to the pt's lips are possible. Personally, I set it up so that the end of the capnography tube sits just inside the lip. After you have your placement, if needed, you can place a piece of tape on the tube and tape it to the NRB.<br />
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The capnometry and respiratory rate may no be as accurate as it would be with a real commercial device, but the waveform itself will be easily identifiable. Here is an example waveform of the DIY NRB Capnography with oxygen at 15-lpm:<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxxU8i8yhaRIbOqA7xDWNyrY1nH6nqhWduV9n4CazabZDVzfkCZo86c-RV5A7NWjgohhzTeUiD0a47woT2UAeTZNfZEZWyvjqFj5CrjdEAEDjOm9ovFNeCJUawSfJXxygr0miKgdS33BA/s1600/IMG_20160503_021842255.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxxU8i8yhaRIbOqA7xDWNyrY1nH6nqhWduV9n4CazabZDVzfkCZo86c-RV5A7NWjgohhzTeUiD0a47woT2UAeTZNfZEZWyvjqFj5CrjdEAEDjOm9ovFNeCJUawSfJXxygr0miKgdS33BA/s320/IMG_20160503_021842255.jpg" width="180" /></a></div>
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A second way that you can do this, is by following the same steps and equipment as above, but instead of cutting off the EtCO2 ET Tube attachment, you cut a hole into the NRB (preferably cut out one of the valves), and slip the capnography device into the NRB. It should look like this:</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj30FhlnoZAXQ6LjzGOLGexNTtl3Y7xEud6g4g6CqJBvcim8EMZgE5DF1jwUUKmDQH7Tyb-yCOVngSsZVI4YYRubR6p4qn0HElqoziWYJRQOOGNt2GGeiIS6n0xM8piqFao4syVfTbNRPo/s1600/IMG_20160503_021549413_HDR.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj30FhlnoZAXQ6LjzGOLGexNTtl3Y7xEud6g4g6CqJBvcim8EMZgE5DF1jwUUKmDQH7Tyb-yCOVngSsZVI4YYRubR6p4qn0HElqoziWYJRQOOGNt2GGeiIS6n0xM8piqFao4syVfTbNRPo/s320/IMG_20160503_021549413_HDR.jpg" width="180" /></a></div>
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The main issue that I have with this method, besides the capnometry number may not be accurate, is that the waveform doesn't seem to be as clear as compared to the first method.</div>
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Notice how the waveform is choppy, when you compare it to the first method:</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9nYSMDXfgT96iMfDsHkNBANMcG1qjqwXqjjaIbLDMzUNt-P7SiOTng2FIOLMRnGryvgkPt1EFrZQ5dcEUxK7m3Aip0GzjGDxaKENSglAw31E_r2fCRcGtUz1UhJH0EghdZEQNliUGskY/s1600/IMG_20160503_021737232.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9nYSMDXfgT96iMfDsHkNBANMcG1qjqwXqjjaIbLDMzUNt-P7SiOTng2FIOLMRnGryvgkPt1EFrZQ5dcEUxK7m3Aip0GzjGDxaKENSglAw31E_r2fCRcGtUz1UhJH0EghdZEQNliUGskY/s320/IMG_20160503_021737232.jpg" width="180" /></a></div>
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I am not sure if the waveform is so choppy because of the oxygen back flowing into the capnography tubing, or if I just am not placing the device deep enough into the NRB. I will be running more trial runs (on my less critical patients, since I like the first method the most), to see if I can come up with a good way to run the second method.<br />
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I have tried different methods to DIY NRB capnography, but to me, the first method seems to work the best. As always, follow your companies and medical control authorities protocols.<br />
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<b style="background-color: lime;">NEVER WITHHOLD OXYGEN FROM A PATIENT WHO NEEDS OXYGEN, JUST TO DO THIS DIY SETUP.</b></div>
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*NOTE: My posts are usually always sourced. However, this entire post is a "my opinion" post. Their are videos on youtube to show you how to do this DIY, but I have yet to see actually research performed. Again, this post is my opinion, based on my experience. ALWAYS follow your company policies and procedures, as well as your medical control authorities protocols.Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-73484558730724566102016-02-02T20:19:00.002-05:002016-02-02T20:19:59.084-05:00Vertebrae and Their Functions <div class="separator" style="clear: both; text-align: left;">
Break down on the vertebrae and their functions in the human body.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBavTVxj2i7PU7tyWxdOzVVKxCHfmisHC4Ivf5I3pY1z7eXxjeTq4i7UJ-EhYXfxOTGjpUQLTuBPtC179YC6OvZIAAk1qVJx7rfVSq6HLmA0LZiBK0RPQiCAdYpYrwtNtiBNYG715SFqM/s1600/VertebralSubluxationandNerveChart_0.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBavTVxj2i7PU7tyWxdOzVVKxCHfmisHC4Ivf5I3pY1z7eXxjeTq4i7UJ-EhYXfxOTGjpUQLTuBPtC179YC6OvZIAAk1qVJx7rfVSq6HLmA0LZiBK0RPQiCAdYpYrwtNtiBNYG715SFqM/s320/VertebralSubluxationandNerveChart_0.jpg" width="227" /></a></div>
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Source: http://mercerislandchiropractic.com/wp-content/uploads/2012/02/VertebralSubluxationandNerveChart_0.jpg</div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-32269776591250844262016-02-02T20:09:00.002-05:002016-02-02T20:09:53.882-05:00Dopamine Cheat Sheet Chart<div class="separator" style="clear: both; text-align: center;">
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Here is a Dopamine cheat sheet that I had found online, while trying to learn the Dopamine calculation again.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiySCOl9oukFPTracV5XrGEzBdpsWz1xeTe0pMNsieD2cBVH2PH3vdxtBYiaJ3Dk6r20ucjXHmR6kzhixRTdFumdbOcZdXpxThqvfDtoEt7ZwIim6eckZizFEDv1seMw5W55K__RgEl_C4/s1600/Screen+Shot+2016-02-02+at+8.08.45+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="199" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiySCOl9oukFPTracV5XrGEzBdpsWz1xeTe0pMNsieD2cBVH2PH3vdxtBYiaJ3Dk6r20ucjXHmR6kzhixRTdFumdbOcZdXpxThqvfDtoEt7ZwIim6eckZizFEDv1seMw5W55K__RgEl_C4/s320/Screen+Shot+2016-02-02+at+8.08.45+PM.png" width="320" /></a></div>
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Source:http://cchealth.org/ems/pdf/phcm_drug2012.pdfAnonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-35744687264439980492016-02-02T20:03:00.002-05:002016-02-02T20:03:38.896-05:00Ketones vs. Lactic AcidKetones and Lactic Acid are important lab values when trying to determine the chemistry of a patient. Both Ketones and Lactic Acid can help to guide your thinking, on what is wrong with a patient, and what you need to do, in order to try to resolve the diagnosis of the patient. However, in the prehospital setting, there is nothing that we can do for these patients. The hospital is able to help the patient more, because they are able to obtain the lab values and have an endless supply of medications that they can administer to the patient. During an ALS transfer (hospital to hospital), the paramedic may need to monitor the medications that are being administered to the patient. At the same times, if a paramedic is transferring a patient from a nursing home, where the labs have been drawn, and taking the patient to the ER, the paramedic should have an understanding on what Ketones and Lactic Acid is and how they effects the body. In some cases, Ketones and Lactic Acid labs values can help to determine how severe the patient is, and if they need more advanced care and be transported at a higher-level of priority.<br />
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First, let's look at Ketones. Ketones is a substance that is made when the body has to break down fat, in order to make energy. Normally, the body will break down carbohydrates, but in some cases (diabetics, lack of carbohydrate intake, anorexia, dieting, dehydration), the body has to break down the fat in the body, in order to get the energy that it need to continue.<br />
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Ketones can be tested via the blood and the urine. Normally, their should be no ketones noted in the body (MedlinePlus 1). However, if there are Ketones in the body, the labs can be broken down into three different categories: small, moderate, and large (MedlinePlus 1). Small value would be <20mg/dL; Moderate value would be 30-40mg/dL; and a Large value would be >80mg/dL (MedlinePlus 1).<br />
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Now, lets talk about Lactic Acid. Lactic Acid is an acid that is produced when the carbohydrates in the body are broken down. The common causes of a high Lactic Acid is when their is a lack of oxygen in the body, thus causing the body to breakdown the carbohydrates for energy (MedlinePlus 2). In a normal case, when oxygen levels are normal, the body will break down the carbohydrates into water and CO2. Lactic Acid build up is caused by strenuous exercise, sepsis, heart failure, and liver issues (MedlinePlus 2). Unlike Ketones, Lactic Acid will always be in the body. The normal value of Lactic Acid in the body is 4.5 - 19.8 mg/dL (MedlinePlus 2). If a Lab Value is greater than 19.8mg/dL, than the patient is in lactic acidosis.<br />
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Both Ketones and Lactic Acid lab values are vital to help with the diagnosis and severity of a patient. Even though lab values do not do much for paramedics in the prehospital setting, they are still vital components to know when taking a patient to the ER (say from a nursing home), or performing an ALS transfer (from hospital to hospital); these lab values will help guide the paramedic in determining how critical the patient is, and if they needed higher level of care, and a higher level of priority.<br />
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<b>Sources:</b><br />
Ketones: https://www.nlm.nih.gov/medlineplus/ency/article/003585.htm<br />
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Lactic Acid: https://www.nlm.nih.gov/medlineplus/ency/article/003507.htm<br />
<br />Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-40299127942491334242015-12-09T23:49:00.001-05:002015-12-09T23:49:26.583-05:00Renin-Angiotensin System<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaO9y8LcRndKAKrINPkEzfHipkvLLX9xiOgH7xnK58xMe2FeX4q1Cx3ItQsHRlF9exvlGb4Es1-hB-Tan3dx0PBeO-klV_nrkazhLQP1ECLD8rtSJtq-0IuDyFuTfEMdxIGA_At2ZuZ1k/s1600/renin-angiotensin-aldosterone-reflex-system.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="230" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaO9y8LcRndKAKrINPkEzfHipkvLLX9xiOgH7xnK58xMe2FeX4q1Cx3ItQsHRlF9exvlGb4Es1-hB-Tan3dx0PBeO-klV_nrkazhLQP1ECLD8rtSJtq-0IuDyFuTfEMdxIGA_At2ZuZ1k/s320/renin-angiotensin-aldosterone-reflex-system.jpg" width="320" /></a></div>
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http://antranik.org/the-renin-angiotensin-aldosterone-reflex/Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com1tag:blogger.com,1999:blog-1647857166801635512.post-69089663605014334722015-12-09T23:46:00.002-05:002015-12-09T23:51:30.896-05:00Five Types of ShockTheir are five types of shock: cardiogenic, hypovolemic, neurogenic, anaphylactic, and septic. We will break down each type of shock and provide greater detail.<br />
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<b><span style="color: lime;">Cardiogenic Shock</span></b><br />
Inability of the heart to pump enough blood throughout the body. This is a result of left ventricular failure (caused by an MI or CHF). Due to the reduced BP caused by cardiogenic shock, the heart muscle becomes more damaged due to the lack of coronary artery perfusion...this can eventually lead to complete pump failure. Cardiac output, as well as the cardiac ejection fraction, is also decreased.<br />
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During the assessment, rales or rhonchi will be heard in the lungs, and white- or pink-tinged foamy sputum may be present.<br />
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Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Obtain IV access, cardiac monitoring, and 12-lead ECG.<br />
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<b><span style="color: lime;">Hypovolemic Shock</span></b><br />
Patient goes into shock due to a loss of intravascular fluid volume caused by: internal/external bleeding, traumatic injury, long bone or open fractures, dehydration, diarrhea, vomiting, plasma loss from burns, excessive sweating, and DKA.<br />
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During assessment, the patient may alerted, unresponsive, pale, cool, diaphoretic, normal to hypotensive, pulse normal to rapid (bradycardia in late stage), decrease in urine output, cardiac dysrhythmias.<br />
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Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Control and major bleeding. Obtain IV access, fluid bolus (NS or LR), cardiac monitoring, and 12-lead ECG.<br />
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<b><span style="color: lime;">Neurogenic Shock </span></b><br />
Results from an injury to the brain or spinal cord, which results in an interruption of the nerve impulses to the arteries. The arteries will lose tone and dilate, causing hypovolemia; no change in volume, just that the container is now larger.<br />
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Assessment may reveal warm, red skin, and dry skin (due to malfunction of the sweat glands). Hypotension and bradycardia.<br />
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Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Spinal immobilization, obtain IV access, fluid bolus (NS), cardiac monitoring, and 12-lead ECG.<br />
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<i>Cushing Triage: Hypertension, Bradycardia, Irregular Respirations</i><br />
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<b><span style="color: lime;">Anaphylactic Shock</span></b><br />
When an allergen enters in the body, the immune system respond to try to rid of that allergen. However, in some cases, the immune response is so great, that it is called anaphylactic.<br />
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Assess for dyspnea, tachypenia, wheezing, laryngeal edema, rashes, edema, hives, cyanosis, tachycardia, seizures, altered LOC.<br />
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Patient's in anaphylactic shock needed immediate and aggressive treatment. Ensure open and patent airway. ADM oxygen. Epi 1:1000 should be adm IM. Benadryl to help prevent any more histamine to be released int he body, Solu-medrol for steroid response, albuterol for the bronchioconstriction.<br />
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<b><span style="color: lime;">Septic Shock</span></b><br />
When an infection enters into the body, causes a system wide failure or dysfunction of the organs.<br />
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During assessment look for, fever, tachycardia, hypotension, tachypnea, altered LOC.<br />
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Ensure an open and patent airway. ADM oxygen. IV access with fluid bolus of NS. ECG monitoring and 12-lead ECG. Dopamine may need to be adm in order to maintain a blood pressure.<br />
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In the elderly and very young, a fever may not be present. Try to identify if the patient had a fever or if they are hypothermic...both are indicative of sepsis when combined with the other criteria listed above.<br />
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<i><span style="color: #999999; font-size: xx-small;">Information obtained from: Essentials of Paramedic Care. Second Edition - UPDATE.</span></i>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-77199380675129299622015-12-09T22:28:00.001-05:002015-12-14T00:01:57.637-05:00Acid Base?My Wednesday parter is currently in his medic class. Today, during shift, he pulled out him homework, and asked if I knew anything about acid base. Now, I have been out of school for about 3 years now, so of course I had forgotten a lot of the material that was covered. I had to reread part of the section in his medic book. After reading the sections, and looking some other information up, I am now able to recall how to determine acid base based on the lab values.<br />
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You know how it goes, respiratory acidosis/alkalosis and metabolic acidosis/alkalosis...blah blah blah. We never really understand how important this is, on the medic level, unless we work in the ER or on a SCT/CCT truck. However, acid base is very important, because if the patient is acidic, than we either have to change the way that they breathing or we need to administer sodium bicarb. On the other side, if they are alkalosis, than we need to change the way that they are breathing; in EMS we can't fix alkalosis patients.<br />
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If you are in metabolic acidosis/alkalosis, you go into respiratory compensation. Where if you are in respiratory acidosis/alkalosis, than your kidney's take over, trying to compensate.<br />
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Since today's topic with my partner was interesting, and since I learned some tricks, and it made me think, I felt that a post was needed, because I am sure that I am not the only one who forgot about acid base.<br />
<br />
<span style="color: lime;">----------------</span><br />
<br />
Normal pH: 7.35 - 7.45<br />
Normal pCO2: 35 - 45 mmHg<br />
Normal HCO3: 21 - 25 mEq/L<br />
Normal CO2: 35-45<br />
<br />
<br />
If <span style="color: #6fa8dc;">pH is >45</span> and <span style="color: lime;">pCO2 is decreased</span>....then you are in respiratory alkalosis<br />
If <span style="color: #6fa8dc;">pH is <35</span> and <span style="color: lime;">pCO2 is elevated</span>...then you are in respiratory acidosis<br />
If <span style="color: #6fa8dc;">pH is >45</span> and <span style="color: lime;">HCO3 is elevated</span>...then you are in metabolic alkalosis<br />
If <span style="color: #6fa8dc;">pH is <35</span> and <span style="color: lime;">HCO3 is decreased</span>...then you are in metabolic acidosis<br />
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<br />Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-78106629807005213922015-07-14T15:58:00.000-04:002015-07-14T15:58:17.148-04:00Excited Delirium Pneumonic <div>
It can be hard to identify a patient who is experiences excited delirium. However, an emergency physician and medical director, Dr. Michael Curtis, has developed a pneumonic to help emergency providers identify those patients who are suffering from excited delirium - NOT A CRIME.</div>
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<br /></div>
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N - patient is naked</div>
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O - violence against objects</div>
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T - tough, unstoppable</div>
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<br /></div>
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A - acute, "just happened"</div>
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<br /></div>
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C - confused</div>
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R - resistant and won't follow commands</div>
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I - incoherent, patient is often loud</div>
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M - mental health conditions or makes you feel uncomfortable</div>
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E - EMS should transport to ED</div>
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<br /></div>
<div>
Excited Delirium patients are not acting themselves. Excited Delirium is a true medical emergency, and needs to be dealt with accordingly. In order to provide the best possible care to these patients, remember that you still need to treat them as a human being. Do not get "tunnel vision" and just think they are a PSY patient...they are a person who has family and friends, who is just not acting themselves. Remember, it is important to always be professional. </div>
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<br /></div>
<div>
Depending on your local protocol, EMS providers are allowed to treat patients who are suffering from excited delirium. In my state, our local protocol allows us to administer 10mg Versed IM for a patient who meets the excited delirium protocols outlines signs/symptoms. However, you should always try to talk to your patient BEFORE you move into medication sedation. </div>
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<br /></div>
<div>
If the person meets the requirements, and the last resort is to administer the Versed, based on my experience, have a NPA/OPA ready, as well as a BVM. Always put your patient on oxygen, and use EtCO2 is able, in order to best monitor their airway. Transport your patient high priority and code them into the ED. </div>
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<br /></div>
<div>
Versed is a benzodiazepine which means that is it a muscle relaxant. In order for us to breath, we rely on our diaphragm and other respiratory muscles...so if you administer the bento, you are causing these muscle to relax. In some cases, I have had one patient, the patient will stop breathing, and BVM ventilation will need to be performed. </div>
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<br /></div>
<div>
Remember to always use caution when dealing with patients who are not acting in the right frame on mind. Always watch your back and your partners back. If the scene is not safe, or become unsafe, back away and call for PD. </div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-28527363538976030872015-05-11T14:48:00.000-04:002015-05-11T14:49:40.276-04:00Hormones of the BodyOur bodies are composed of different glands, that secrete hormones, that help to regulate the body. These hormones are released into the body, into the bloodstream, and activate to control metabolic activities, growth, and development.<br />
<div>
<br /></div>
<div>
<b>Endocrine Glands (ductless glands)</b></div>
<div>
<br /></div>
<div>
<u>Anterior Lobe of the Pituitary Gland</u></div>
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<ul>
<li>Growth Hormone (GH)</li>
<ul>
<li>Regulates the growth of the body</li>
</ul>
<li>Adrenocorticotropic Hormone (ACTH)</li>
<ul>
<li>Stimulates the adrenal cortex</li>
</ul>
<li>Thyroid-Stimulating Hormone (TSH)</li>
<ul>
<li>Stimulates the Thyroid Gland</li>
</ul>
<li>Gonadoptropic Hormones</li>
<ul>
<li>Affect the male and female reproductive systems</li>
</ul>
<li>Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH)</li>
<ul>
<li>Regulates development, growth, and function of the ovaries and testes</li>
</ul>
<li>Proloactin-Releasing Hormone (PRH), Lactogenic Hormone</li>
<ul>
<li>Promotes the development of glandular tissue during pregnancy and produces milk after birth of an infant</li>
</ul>
</ul>
<div>
<u>Posterior Lobes of the Pituitary Gland</u></div>
</div>
<div>
<ul>
<li>Antidiuretic Hormone (ADH)</li>
<ul>
<li>Stimulates the kidney to reabsorb water</li>
</ul>
<li>Oxytocin </li>
<ul>
<li>Stimulates uterine contractions during labor and postpartum</li>
</ul>
</ul>
<div>
<u>Thyroid Gland</u></div>
</div>
<div>
<ul>
<li>Triiodothyronine and Thyroxine</li>
<ul>
<li>Body cell metabolism </li>
</ul>
</ul>
<div>
<u>Parathyroid Gland</u></div>
</div>
<div>
<ul>
<li>Parathyroid Hormone (PTH)</li>
<ul>
<li>Helps to maintain a level of calcium int he blood</li>
</ul>
</ul>
<div>
<u>Islets of Langerhans</u></div>
</div>
<div>
<ul>
<li>Clusters of endocrine tissues found throughout the pancreas which help to facilitate digestion</li>
</ul>
<div>
<u>Adrenal Glands</u></div>
</div>
<div>
<ul>
<li>Cortisol</li>
<ul>
<li>Aids the body during stress by increasing glucose levels to provide energy</li>
</ul>
<li>Aldosterone</li>
<ul>
<li>Regulates the electrolytes used for body function</li>
</ul>
<li>Epinephrine</li>
<ul>
<li>Help the body deal with stress by increasing HR (heart rate), BP (blood pressure), HB (heart beat), and Respirations </li>
</ul>
<li>Norepinephrine</li>
</ul>
</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<b>Exocrine Glands (duct glands)</b></div>
<div>
<ul>
<li>Saliva </li>
<ul>
<li>Used to break down food in the mouth</li>
</ul>
</ul>
<div>
<br />
<br />
<br />
<br />
<br /></div>
<div>
<b>Male/Female sex hormones</b></div>
</div>
<div>
<ul>
<li>Testosterone</li>
<ul>
<li>Principle male sex hormone</li>
<li>Development of the reproductive organs and secondary sex characteristics such as facial hair</li>
</ul>
<li>Estrogen</li>
<ul>
<li>Principle female sex hormone</li>
<li>Helps control and guide sexual development</li>
</ul>
</ul>
</div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-63842686367641904872015-03-12T18:37:00.000-04:002015-03-12T18:37:37.486-04:00MDCH Updated 2015 Protocols ImplementationThe Michigan Department of Community Health has sent out their paperwork on the Updated 2015 Protocols.<br />
<br />
All Michigan EMS providers are encouraged to read and complete and required training/tests.<br />
<br />
<a href="http://paramedicstudentcentral.webs.com/MDCH%20Updated%20Protocols%202015%20Implementation%20(2)-2.pdf">http://paramedicstudentcentral.webs.com/MDCH%20Updated%20Protocols%202015%20Implementation%20(2)-2.pdf</a>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-59056153956125256042014-10-09T16:42:00.003-04:002014-10-09T16:43:14.877-04:00PHTLSRecently my employer put me through the Prehospital Trauma Life Support course. I was a little hesitant on attending the course, but I will tell you, that it was very informational. I would recommend that at least take the PHTLS course once, so you have a better understanding on trauma and trauma patients. You can renew the certification every three years.<br />
<br />
<a href="http://www.naemt.org/education/PHTLS/phtls.aspx"><span style="color: #999999;">http://www.naemt.org/education/PHTLS/phtls.aspx</span></a>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-24824844981022092762014-10-08T23:54:00.001-04:002014-10-09T16:24:43.690-04:00Epi with Asthma Patients<i><span style="font-size: x-small;">UPDATE: 10/9/14 at 1624 hrs</span></i><br />
<br />
So, you have your 22 year old female who is complaining of difficulty breathing. As you walk into the residence, you note the female sitting in a tripod position, and in obvious respiratory distress. Upon auscultation, you note wheezing in all fields. Patient is unable to communicate in full sentences, and gets winded very quickly. The patient's boyfriend stated that the patient had been feeling short of breath all day, and took two albuterol treatments, periodically throughout the day. He stated that the patient had little relief with her treatments.<br />
<br />
The patient's Spo2 reading is 99% on room air. Being the great medic that you are, you know that the reason that her SpO2 is so high, is because the air is trapped within her lungs, and cannot get out. With that being said, and continuing on with being a great medic, you administer albuterol and atrovent via nebulizer mask. Patient is moved to the ambulance and an IV is establish. Patient is having no improvement. You decide that it is now time to administer Epi, because you feel that your patient is about to go into respiratory failure/arrest. You select Epi 1:1,000 and administer 0.3mg IM. You are currently transporting your patient priority 1, to the local emergency department.<br />
<br />
During transport, the patient seems to be improving. Due to a somewhat short transport time, the updraft is still running. Patient care is turned over to ED staff.<br />
<br />
--------<br />
<b>Review Questions</b><br />
<br />
What is the medical emergency?<br />
-Patient is having an asthma attack<br />
<br />
What was the patient's SpO2 so high?<br />
-Due to the bronchial constriction, the air is trapped within the patient's lungs, and is unable to be removed, so you will have the high Spo2 reading. When you start to notice the Spo2 to decrease, than the patient is in severe respiratory distress, and will probably go into respiratory arrest.<br />
<br />
Should you use capnography (EtCo2 monitoring) with this patient? Why? What will you see?<br />
-Yes! You should always use EtCo2 with asthma patients. This will help you to determine an accurate reparatory rate and what their Co2 levels are. On the monitor, you will notice a shark-fine style waveform, due to the bronchial constriction.<br />
<br />
Why use Epi 1:1,000?<br />
-Since their is not relief, it may be time to consider administering Epi 1:1,000 IM. In addition to being a vasoconstrictor, Epi is a bronchial dilator.<br />
-You wan to get the eli on board, when you suspect the patients going to go into respiratory failure and/or arrest, because you want to do a "hard" bronchodilation to prevent the failure/arrest.<br />
-You want to give Epi 1:1,000 IM because it will be absorbed over a longer period of time.<br />
<br />
What is another drug you can administer?<br />
-You can always administer Mag Sulfate, as long as medical control authorizes you to do so. Mag Sulfate is a smooth-muscle relaxer.Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-32529714575744047312014-09-03T21:50:00.001-04:002014-09-03T21:50:39.991-04:00Asthma Patient?This is a really great article, that I was reading o JEMS.com. Very informative, and makes you think.<br />
<br />
Please note, that clicking the link below, you will be redirected to JEMS.com for the article. All information within the article is the sole property of the writer and/or their affiliates. Paramedic Student Central has no part in JEMS.com, the writer, its affiliates, or article. The sole purpose of this article is to keep us on our feet, and for us to learn something new.<br />
<br />
Enjoy.<br />
<br />
<b><a href="http://www.jems.com/article/patient-care/vocal-cord-dysfunction-puzzling-asthma-m"><span style="color: lime;">http://www.jems.com/article/patient-care/vocal-cord-dysfunction-puzzling-asthma-m</span></a></b>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-66788688236473401662014-08-27T09:48:00.003-04:002014-08-27T09:48:57.918-04:00Heat Related EmergenciesThe past few days, it has been extremely hot with high heat index. Over the past few days, I have run into many heat-related 911 calls. All ranging from heat cramps to even a few heat strokes. It is important, as paramedics, that we recognize the different types of heat-related emergencies, so we are able to treat our patients, and hopefully, if possible, prevent the patient from suffering a heat stroke.<br />
<br />
To start off, when a patient is working in the heat, or just in the heat in general, they need to stay hydrated. The problem with this is, that some people do not realize that alcoholic beverages, soda pop, juices, and what have you, are not "hydration" drinks. In turns, these people become patients. The best thing that patients need to drink is water and even Poweraide or Gatoraid. But, they need to drink the Poweraide and/or Gatoraide in moderation, because water is the best drink to stay hydrated. For a detailed dehydration post, <a href="http://mylifeasaparamedicstudent.blogspot.com/2014/07/dehydration-adult.html">click here</a>.<br />
<br />
Their are three types of heat-related emergencies: heat cramps, heat exhaustion, and heat stroke. Each one is a medical emergency, and should not be ignored. But, heat stroke is the most severe heat-related emergencies, and should be treated as such, but we will discuss this later. Heat cramps are usually the first signs of a heat-related emergencies. This consists of cramps, diaphoresis, weakness, dizziness, lightheadedness, tiredness. The best method for heat cramps is to administer water PO (by mouth), IV access with fluid bolus, and place ice packs where the cramps are located. We are not to concerned with "cooling the patient" more as hydrating the patient and relieving the cramps.* The second emergencies is heat exhaustion. This is when the body has been sweating for a long period of time, and the body is extremely dehydrated. Patients will experience weakness, excessive diaphoresis, lightheadedness, confusion, possible LOC, and tiredness. Management includes IV access with fluid bolus, cooling of patient with ice packs and A/C, and removing any clothing that you can (within reason). Thirdly, the most severe heat-related emergency is heat stroke. Heat stroke is when the body of severely dehydrated; the body has been sweating for so long, that the body has no more fluid to sweat out. In addition, patients can and/or will experience a seizure, and have an extremely elevated temperature. Patient's can become unresponsive and possibly go into cardiac arrest. Quick diagnosis and treatment is vitals for survival of heat stroke patients. two large bore IV accesses with fluid boluses, cooling of patient with ice packs and A/C, removing of all clothing (within reason), ECG monitoring, and rapid transport.*<br />
<br />
It is important that all heat-related emergencies are treated, so that patient's will not continue into the next stage(s). Early diagnosis and treatment is vital to patient survival.<br />
<br />
<br />
<span style="font-size: xx-small;">*Follow local protocol </span>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-25951914622481647752014-07-30T18:55:00.001-04:002014-07-30T18:55:17.159-04:00Dehydration - AdultLately, dehydration can been becoming a leading call, when I'm at work. I am pulling about two dehydration calls a shift. Since this is the case, let's talk about how one gets dehydrated, how it effects our body, why it causes hypertensive, and how it is treat.<br />
<br />
Dehydration is caused by a loss of water in our system. If one does not drink enough water, or someone is suffering from diarrhea, vomiting, excessive sweating, fever, excessive urination, too much alcohol consumption, diabetes, DKA, and some other ways, than our body is not able to compensate. The longer one goes without replacing that lost water, the more dehydrated they will get.<br />
<br />
Dehydration can effect our body in different stages. Most commonly, dehydration can cause an increase in thirst, dry mouth, weakness, dizziness, confusion, syncopals, inability to sweat, decrease urine output and hypertension. In addition, dehydration will effect our urine output and color. Dehydration will reduce the urine output and turn the urine deep yellow. Dehydration can also lead to a fever, headaches, and chest or abdominal pains. With our geriatric population, don't forget you can always use the turgor test.* This test is used to help determine the dehydration status of your patient.<br />
<br />
Now, let's talk about the hypertension effect. Dehydration causes hypertension. The reason for this, is because our body is losing the water, which is causing our blood to become "thick." Due to the "thickness" of the blood, our heart will have to pump harder and harder to get the blood throughout our cardiovascular system. The harder the heart has to work, the high the blood pressure. Also, this can cause an increase in heart rate, because the heart has to pump faster to help compensate. But, not in all patient's, will the tachycardia be noted.<br />
<br />
Their is a simple way for us, prehospital providers, to try to treat patient's suffering from dehydration. Normal Saline. Simple as that. IV access, with a large bore IV catheter, should to inserted into the most central site (like the antecubital area), and hanging a bad of Normal Saline. Run the bag wide open, and reassess the patient. Make sure to check lung sounds often, to ensure that you are not putting to much fluid into their body, that it is causing the fluid to enter into the lungs. For me, I like to do it in 250mL increments.** Recheck vitals every five minutes. As always, depending on the patient condition, transport priority may vary.***<br />
<br />
<br />
<span style="font-size: x-small;">*The reason this tool is best used in the geriatric patient, is because their body is less able to compensate for fluid loss, so the loner they are dehydrated, the longer the skin turgor will last. </span><br />
<span style="font-size: x-small;">**Personally, I like to reassess my patient every five minutes, or after each 250mL fluid bolus has been admitted. I also like to check lung sounds every few minutes to make sure that I am not pushing fluids into the patient's lungs. </span><br />
<span style="font-size: x-small;">***ALWAYS, ALWAYS reference your local protocol. </span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Here is also a good reference site for why patient's are hypertensive when they are dehydrated: </span><span style="font-size: x-small;">http://www.optimumhealth.ws/Dehydration_High_Blood_Pres.html</span>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-65072496593920108902014-07-03T16:02:00.000-04:002014-07-03T16:03:25.104-04:00Inflamed Vocal Cords - Anaphylaxis Unit: Alpha 198<br />
Time: 1600 hrs<br />
Dispatch Info: 42 year old male with DIB<br />
<br />
ATF 42 y/o M supine on the floor. Pt is unresponsive to all stimuli. Pt is not breathing. Pt does have a pulse. BVM ventilation are initiated. You are getting decent compliance with the BVM. Per family, pt was eating some cookies, when he start to have trouble breathing. They stated that that pt than just went unresponsive. Sinus rhythm on monitor.<br />
<br />
History: None<br />
Medications: EpiPen<br />
Allergies: Peanuts<br />
<br />
IV access have been established. Your partner prepares intubation equipment. When he goes to intubate, he inserts his laryngoscope blade into the pt's airway, when this is noted:<br />
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Your partner immediately pulls back, and tells you that the pt's vocal cords and larynx are inflamed. He resume BVM ventilation, since it was working decently.<br />
<br />
At this time, you have already ADM 0.5mg EPI 1:10,000 IV. You also ADM 50mg Benadryl IV. Next you ADM 125mg SOLU-MEDROL IV.<br />
<br />
You immediately load this pt onto the stretcher, and initiate transport. Your hospital is 6 minutes away, and you transport priority 1.<br />
<br />
During transport, pt continues to have a pulse. BVM ventilation's are still being performed, and they are working, decently.<br />
<br />
-------------------------------------------<br />
<br />
1) What is the medical emergency?<br />
- Anaphylactic Shock<br />
2) Why was his vocal cords inflamed?<br />
- Histamine release in the body, which caused larynx inflammation.<br />
3) Why did your partner immediate pull the blade out?<br />
- To prevent laryngeal spasm<br />
4) Why should you NOT try to intubate this patient?<br />
- Laryngeal spasm could result, which would completely occlude his airway<br />
- If BVM ventilations are working fine, than keep using that. BLS before ALS.<br />
5) If his airway was already occluded, or became occluded, how would you have to maintain an airway<br />
- Surgical cric<br />
6) Why EPI 1:10,000 and not 1:1000<br />
- This pt is at high risk, to go into cardiac arrest, so he needs the faster absorbed EPI<br />
7) Why use the following drugs: Epi, Benadryl, Solu-Medrol?<br />
- Epi: Causes bronchodilation<br />
- Benadryl: Prevents the release of histamine, which reduces edema<br />
- Solu-Medrol: Reduces inflammationAnonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-75132540940379504452014-06-25T14:27:00.001-04:002014-07-27T01:04:27.955-04:00Parts of the Spine, Effects Parts of our Body<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: xx-small;">I found this chart, while on Facebook. I saved the picture, so I could upload it to my blog, for everyone else to enjoy. Unfortunately I forgot to save the Facebook address to the page that I found this off of. So, here is my disclaimer: "I, Brandon, did not create this chart, and I take no responsibility for the information posted on the chart. I did however, find this chart to be extremely helpful. All rights belong to it's respectable owner(s)."</span></div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-84232670611984706762014-06-25T14:26:00.001-04:002014-06-25T14:26:11.768-04:00Viral Infections<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidM8OrTtLrsg9YzSl56r4O4TfAGcR1-bN5u4d7pa6j8UmzvCSyzOHblU8jlxqBOR8G6FlscB6YOaspZA_u_KXxqvYe038BhQWN1FX3lG1_y9SeJwHlbtQuTG3OwZS8q0GUdvaidR58fzE/s1600/IMG_569367041009504.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidM8OrTtLrsg9YzSl56r4O4TfAGcR1-bN5u4d7pa6j8UmzvCSyzOHblU8jlxqBOR8G6FlscB6YOaspZA_u_KXxqvYe038BhQWN1FX3lG1_y9SeJwHlbtQuTG3OwZS8q0GUdvaidR58fzE/s1600/IMG_569367041009504.jpeg" height="305" width="320" /></a></div>
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<span style="font-size: xx-small;">(click on picture to enlarge)</span></div>
<div style="background-color: #141414; color: white; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13px; line-height: 18px; text-align: center;">
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<div style="background-color: #141414; color: white; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13px; line-height: 18px; text-align: center;">
<span style="font-size: xx-small;">I found this chart, while on Facebook. I saved the picture, so I could upload it to my blog, for everyone else to enjoy. Unfortunately I forgot to save the Facebook address to the page that I found this off of. So, here is my disclaimer: "I, Brandon, did not create this chart, and I take no responsibility for the information posted on the chart. I did however, find this chart to be extremely helpful. All rights belong to it's respectable owner(s)."</span></div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-45461879211728800412014-06-25T14:23:00.003-04:002014-06-25T14:23:59.938-04:00Neurotransmitters and Their Effects<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaHmPPN7erHPGGuPRWoRx-CI4lOPoo-Y3NuPBeOjbiOH4XTFEzW55uwCbXBx5o-iLNhxBRewAZmvRnRL404JTYVan6X42O75HSnfGAK55y1VA0Vw6iBKKMNjQ8FI7OYolEqLF2rmmfCJM/s1600/IMG_710705969702735.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaHmPPN7erHPGGuPRWoRx-CI4lOPoo-Y3NuPBeOjbiOH4XTFEzW55uwCbXBx5o-iLNhxBRewAZmvRnRL404JTYVan6X42O75HSnfGAK55y1VA0Vw6iBKKMNjQ8FI7OYolEqLF2rmmfCJM/s1600/IMG_710705969702735.jpeg" height="320" width="259" /></a></div>
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<div style="text-align: center;">
<span style="font-size: xx-small;">I found this chart, while on Facebook. I saved the picture, so I could upload it to my blog, for everyone else to enjoy. Unfortunately I forgot to save the Facebook address to the page that I found this off of. So, here is my disclaimer: "I, Brandon, did not create this chart, and I take no responsibility for the information posted on the chart. I did however, find this chart to be extremely helpful. All rights belong to it's respectable owner(s)."</span></div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-38171487630218708582014-06-24T17:37:00.000-04:002014-06-24T17:38:15.503-04:00How A-fib Effects the Body (third party site)<span style="background-color: black; color: white; font-family: arial, sans-serif; font-size: x-small;">I have received an e-mail from a person, who informed me about their website. On this site, they have a great tool, to explain how a-fib effects different parts of your body. </span><br />
<span style="background-color: black; color: white;"><span style="font-family: arial, sans-serif; font-size: x-small;"><br /></span>
<span style="font-family: arial, sans-serif; font-size: x-small;">I take no responsibility for anything posted on the third party website. I have included most the e-mail that was sent to me from the person, so that they get full credit.</span></span><br />
<span style="background-color: black; color: white;"><br />
<span style="font-family: arial, sans-serif; font-size: 13px;"><br /></span>
<span style="font-family: arial, sans-serif; font-size: 13px;">"Hello,</span></span><br />
<span style="background-color: black; color: white;"><br style="font-family: arial, sans-serif; font-size: 13px;" />
<span style="font-family: arial, sans-serif; font-size: 13px;">Healthline just designed a virtual guide of how atrial fibrillation affects the body. You can see the infographic here: </span><a href="http://www.healthline.com/health/atrial-fibrillation/effects-on-body" style="font-family: arial, sans-serif; font-size: 13px;" target="_blank">http://www.healthline.com/<u></u>heal<wbr></wbr>th/atrial-fibrillation/<u></u>effects<wbr></wbr>-on-body</a></span><br />
<span style="background-color: black; color: white;"><br style="font-family: arial, sans-serif; font-size: 13px;" />
<span style="font-family: arial, sans-serif; font-size: 13px;">This is valuable med-reviewed information that can help a person understand the effects of afib of their body. I thought this would be of interest to your audience, and I'm writing to see if you would include this as a resource on your page:</span><a href="http://mylifeasaparamedicstudent.blogspot.com/2012/11/tcp-and-cardioversion.html" style="font-family: arial, sans-serif; font-size: 13px;" target="_blank">http://<u></u>mylifeasaparamedicstude<wbr></wbr>nt.<u></u>blogspot.com/2012/11/tcp-<wbr></wbr>and-<u></u>cardioversion.html</a></span><br />
<span style="background-color: black; color: white;"><br style="font-family: arial, sans-serif; font-size: 13px;" />
<span style="font-family: arial, sans-serif; font-size: 13px;">Thanks so much for taking the time to review. Please let me know your thoughts and if I can answer any questions for you.</span></span><br />
<span style="background-color: black; color: white;"><br style="font-family: arial, sans-serif; font-size: 13px;" />
<span style="font-family: arial, sans-serif; font-size: 13px;">All the best,</span></span><br />
<span style="background-color: black; color: white; font-family: arial, sans-serif; font-size: 13px;">Maggie Danhakl * Assistant Marketing Manager"</span><br />
<span style="background-color: black;"><span style="color: #222222; font-family: arial, sans-serif; font-size: 13px;"><br /></span>
<span style="color: #222222; font-family: arial, sans-serif; font-size: 13px;"><br /></span>
</span><br />
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<span style="font-family: arial, sans-serif; font-size: 13px;"><b><span style="background-color: black; color: lime;">BY CLICKING THE LINK BELOW, YOU ARE GOING TO BE DIRECTED TO A THIRD PARTY WEBSITE</span></b></span></div>
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<a href="http://www.healthline.com/health/atrial-fibrillation/effects-on-body" style="background-color: black; color: #1155cc; font-family: arial, sans-serif; font-size: 13px;" target="_blank">http://www.healthline.com/<u></u>heal<wbr></wbr>th/atrial-fibrillation/<u></u>effects<wbr></wbr>-on-body</a></div>
Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com1tag:blogger.com,1999:blog-1647857166801635512.post-36692157314995741222014-05-30T08:54:00.002-04:002014-05-30T08:54:33.709-04:00What is XanazXanax 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.<br />
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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.<br />
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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.<br />
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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.<br />
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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.<br />
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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.<br />
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<i><span style="color: #eeeeee;">**Disclaimer**</span></i><br />
<i><span style="color: #eeeeee;">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. </span></i>Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-43629435462831789572014-05-26T20:13:00.001-04:002014-05-26T20:13:44.015-04:00Prehospital Drug CardsI have created a PDF of the commonly used drugs, that are used in the prehospital setting, by paramedics.<br />
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These drugs cards cover everything that you need to know about the drug. Due to packaging differences, supplied dose, is not provided.<br />
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PDF Link: <a href="http://paramedicstudentcentral.webs.com/resources">Prehospital Drug Cards for the Paramedic</a><br />
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Visit the website, <a href="http://www.paramedicstudentcentral.webs.com/">www.paramedicstudentcentral.webs.com</a>, for more documents and pictures.Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-62666793278566206952014-05-21T23:14:00.001-04:002014-05-21T23:15:41.930-04:00S1, S2, S3, S4 Heart TonesFor 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.<br />
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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.<br />
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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.<br />
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Let's break down what each valve does.<br />
-Aortic Valve<br />
>Valve that allows blood to enter into the aorta<br />
-Pulmonary Valve<br />
>Valve that allows blood to enter into the pulmonary arteries<br />
-Tricuspid Valve<br />
>Valve that allows blood to enter the right ventricle from the right atrium<br />
-Bicuspid Valve<br />
>Valve that allows blood to enter the left ventricle from the left atrium<br />
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Now, let's go over S1, S2, S3, S4 heart sounds.<br />
-S1<br />
>First heart sound, heard<br />
>"lub" of lub-dub<br />
>Caused by the sudden block of reverse blood flow due to closure of the AV valves<br />
>Beginning of ventricular contraction (systole)<br />
-S2<br />
>Second heart sound, heard<br />
>"dub" of lub-dub<br />
>Caused by the sudden block of reversing blood flow due to closure of the semilunar valves<br />
>End of ventricular systole and beginning of ventricular diastole<br />
-S3<br />
>Rarely heard, but can still be present<br />
>Considered the "third" heart tone<br />
>AKA protodiastolic gallop, ventricular gallop<br />
>AKA the "Kentucky" gallop<br />
=Caused by stress of S1 followed by S2 and S3 together<br />
=S1-"Ken" ; S2-"tuck" ; S3-"y"<br />
>Occurs are the beginning of diastole after S2, but lower pitch than S1 or S2<br />
=This is because it is not of valvular origin<br />
>Usually occurs later in life, and can signal cardiac problems<br />
=CHF<br />
>Caused by the oscillation of blood back and forth between the walls of the ventricles<br />
-S4<br />
>Rarely heard<br />
>Considered the "fourth" heart tone<br />
>AKA presystolic gallop or atrial gallop<br />
=Produced by blood being forced into a stiff hypertrophic (enlarged cells) ventricle<br />
>AKA "Tennessee" gallop<br />
=S4-"Ten-"<br />
=Best heart at the apex, while patient is holding their breath, while supine<br />
>Signals a failing or hypertrophic (enlarged cells) in the left ventricle, systemic HTN<br />
=Others: Valvular aortic stenosis, hypertrophic cardiomyopathy (heart muscle is enlarged)<br />
>Occurs just after atrial contraction, immediately before S1<br />
>Side note: atrial contraction must be present for production of S4<br />
=Not present in atrial fibrillation<br />
=Or in other rhythms where atrial contraction does not precede ventricular contraction<br />
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<br />Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0tag:blogger.com,1999:blog-1647857166801635512.post-14078580208329091772014-05-20T01:13:00.002-04:002014-08-08T02:55:36.388-04:00Lung Sounds Reference ChartA 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.<br />
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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.<br />
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Failure is characterized by tachypnea, increased CO2, air hunger, and cyanosis in the lips, eyelids, and fingernail beds.<br />
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Now let's discuss the types and description of lung sounds.<br />
-Stridor --- upper airway obstruction --- heard over the trachea<br />
-Wheezing --- bronchoconstriction --- heard where the bronchi are constricted<br />
-Rhonchi --- air is trapped in the airway --- heard over the larger airways<br />
-Rales --- fluid in the lungs (alveoli) --- heard in the smaller airways --- aka crackles<br />
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For examples of what each lung sound sounds like, visit youtube.com and type on the specific lung sound.<br />
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I have made a picture, to help with the identification of lung sounds, based on where you will hear them.<br />
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Anonymoushttp://www.blogger.com/profile/12936154626309078088noreply@blogger.com0