Healthy Transitions Prezi

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Week 7 Signs and Symptoms of Chest Cavity Injuries

What are some of the signs and symptoms of injuries within the chest cavity?  List each injury with sign and symptom. Also respond to 2 other students posts.

Types/Signs/Symptoms of Injuries within the Chest Cavity:

1.Pneumothorax and tension pneumothorax

* Signs/Symptoms of Pneumothorax:

-respiratory difficulty/jugular vein distension

-uneven chest wall movement

-absent or diminished lung sounds from the affecting side

*Signs/Symptoms of tension Pneumothorax:

-increasing respiratory difficulty

-shock signs and symptoms (rapid or weak pulse, cyanosis, low blood pressure)

-jugular vein distension

-tracheal deviation

-absent or diminished lung sounds from the affecting side

2. Hemothorax and Hemopneumothorax:

*Signs/Symptoms:

-coughing frothy blood

3. Traumatic Asphyxia:

Signs/Symptoms:

-Distended neck veins

-Head, neck and shoulders appearing dark or blue, bloodshot and bulging eyes

-Swollen and blue tongue and lips

-Chest deformity

4. Cardiac temponade:

*Signs and Symptoms:

-distended neck veins

-super weak pulse

-low blood pressure

-steadily decreasing pulse pressure

5. Aortic Injury and Dissection

*Signs and Symptoms:

-horrible chest pain radiating to the back

-different pulses on either side of the patient (left and right extremities between the arms and legs)

-palpable pulsating mas (if the aorta is involved)

-cardiac arrest

Week 7 Levels and Types of Shock

Shock (aka: HYPOperfusion) is the caused by poor blood flow to the different organ systems in the body which, in turn, results in the insufficient usage of tissues. Instead of the tissues being rich with oxygen, nutrients, and acting in the removal of metabolic waste products, it is, instead, insufficient in carrying out the most pertinent processes. This may cause organ systems to shut down and lead to probable death. There are different types of shock including Hypovolemic shock, Cardiogenic shock, and Neurogenic shock. The difference between the Categories of Severity of Shock and the Types of Shock is that the Cateories of Severity focus on the three levels of shock that cause stress to the body whereas the Types of Shock focus on the causes/what brought about the shock which gives them their own identification. Ways to treat shock include airway maitenace, administration of high-concentration oxygen, load-and-go so the patient can get surgically treated. On-scene assessment and care should consist of the ABCs with spinal precautions, a rapid trauma exam, immobilization, and moving the patient to the ambulance. Gather the rest of the information in the ambulance because time is precious, especially in this circumstance.

Three Categories of Severity:

1.Compensated Shock: It is the primary/first phase of shock. This is when the body appears to be working efficiently, but the patient is still suffering symptoms related to shock. The body is experiencing low perfusion so it reacts by compensation. To reverse the low circulation of blood flow, then the body will increase its heart rate and respirations in hopes of achieving greater circulation of blood flow and oxygenation of that blood. When the body is going into shock, it will transport blood to the major, vital organs in hopes of sustaining life for as long as possible. This requires the amount of blood in the body to leave other parts of the body and tend to the vital organs which is shown in some signs such as pale, cool skin. For pediatric patients, there will be an increased capillary refill time.

2. Decompensated shock: At this point, the body is experiencing late signs of shock such as a decreasing blood pressure due to lack of perfusion due to low blood volume.

3. Irreversible shock: This is the most severe point of shock because the body is actually shutting down beginning with the different organ systems, especially the liver and kidneys. The shock is so evident that it may result in a damage so traumatic that the body cannot recover from.

Types of Shock:

1.Hypovolemic Shock/Hemorrhagic Shock: Hypovolemic shock is due to the lack of perfusion of blood circulation to the organ systems and throughout the body. Hemorrhagic Shock is similar except arises due to specifically uncontrolled bleeding or hemorrhages of all sorts (internal, external, or a combination of both). Both are brought about either by a trauma, crush injuries, or dehydration which makes it one of the most commonly seen types of shock.

2. Cardiogenic Shock: When we think “Cardio” we think “Heart.” So, this would be the inadequate pumping of blood by the heart. Congestive Heart Failure (CHF), heart attacks, myocardial infraction, other heart failures, etc. can bring about this shock which, as a result, damages the heart somewhat. The body may experience poor strength heart contractions, irregular electrical impulses, etc.

3.Neurogenic Shock: This is caused by spinal injuries which results low blood pressure due to the dilation of blood vessels. Although it is uncommon, it is highly dangerous and may by instigated by sepsis (massive infection), anaphylactic (allergic reaction), and vasodilation (increased dilation in hopes of increased blood pressure).

EMT- Week 6- Physical Causes of Altered Mental Status

When dealing with a behavioral or psychiatric emergency or suicide,what are some of the physical causes of altered mental status and explain why?  Are patients in this state of mind allowed to refuse medical care or transport? (NO!) Also respond to 2 other students posts.

When dealing with a behavioral or psychiatric emergency or suicide, then it’s important to consider that maybe their state of being is due to a physical cause than just assuming it’s just part of their chronic condition.  Some physical causes of altered mental status include low blood sugar, lack of oxygen, stroke or inadequate blood to the brain, head trauma, mind-altering substances, excessive cold, and excessive heat. If the patient is experiencing low blood sugar, then they may experience frustration, profuse sweating, light headedness, hunger, a rapid pulse, etc. which would make anyone, even if they don’t suffer a psychological problem, to have an irritable behavior and altered mental status. A lack of oxygen may create for an altered status because the lack of O2 can cause the brain cells to start dying off which may increase the risk for confusion, restlessness, and cyanosis may come as a result. Stroke or inadequate blood to the brain may obviously cause confusion and impair a lot of the motor skills needed to sustain an alert and conscious status. Since the blood leaking in a certain part of the brain is leaking, then the muscle is dying creating that part of the brain to be destroyed and incapable of operating/sending messages to the body. Head trauma will cause personality changes such as amnesia, for example. It doesn’t just stop at the brain though, this trauma can disrupt respiratory patterns, blood pressure, and pulse, as well. An overdose or abuse of substances can result in an altered mental status due to the chemical reaction and overload of toxins within the body that puts the body in shock. Temperature control is important. If the patient is overheated then they may become deprived of H20 and suffer heat stroke resulting in confusion, fainting, respiratory distress, etc. If the patient is too cold, then the lack of heat may result in drowsiness, shivering, altered mental status, slow breathing, and slowing heart rate. Patients who are suffering an altered mental status are not able to refuse medical care or transport because they are unable to adequately think for themselves. So, EMTs are required to go under a sort of implied consent due to their inability to think rationally. 

EMT- Week 6- Drugs

Pick 2 different abused drugs and list the signs and symptoms associated with them.  What are some of the effects of the drugs to the patient?  Will all patients show the same signs and symptoms? Also respond to 2 other students posts.

When I was reading through Chapter 23 I came across Downers and Narcotics and became interested. I thought they were the same type of drug, but I read more and understood the difference. The book didn’t give enough information, in my opinion, to fully understand the chemical process of how Downers and Narcotics effect the body so I researched these drugs some more. Here’s what I found:

Downers are sedation drugs that act through inhibiting muscle, mental, and emotional action. So, it’s easy to say Downers slow down the central nervous system and brain function, but obviously it’s not that simple. This type of drug falls into two categories; tranquilizers and sedative-hypnotics. Tranquilizers depress physical and emotional stress while Sedative-Hypnotics induce sleep.

Three types of downers include opiates/opioids, sedative-hypnotics, and alcohol. Skeletal muscle relaxants, antihistamines, over-the-counter sedatives and lookalike sedatives are considered downers, as well. It is actually a pretty common type of drug and is easy to overdose on. A family friend died at 26 from overdosing on sleeping pills which is a type of downer. Rapists may use a downer called Rohypnol (flunitrazepam) or “Roofies” as an odorless, tasteless, colorless date rape drug that can easily be slipped in a drink. According to Jim Parker, author of Downers: A New Look at Depression Drugs, Downer Drugs are one of the top used and abused drugs in two countries; USA(600 million prescriptions for minor tranquilizers) and Canada mainly, but addiction still continues around the globe. While it sounds like they can be used as a simple answer to relaxation, the action of the drug can be harmful. In the process, Downers are obstructing inhibitions, dulling reflexes, and slowing coordination. Continued use of this drug can lead to permanent “dull thinking, reduce judgment, and interfere with memory, all serious liabilities on the road, at work, or other settings that call for clear thinking and fast reactions.” It’s not a day at the spa using this drug although it may sound like it on the label. In reality, the drug has side-effects relative to a Sunday morning hangover. Since the drug is centering towards the part of the brain that focuses on slowing motor skills, nearby, it is also influencing respirations which can be really scary if an overdose was to occur. Hallucinations can occur due to the production of euphoria by the downer drug, GHB (Gamma- Hyroxybutyrate) aka: Georgia Home Boy or goop. The body eventually learns to depend on the drug and may not become as effective as the primary first use so that is why people are more likely to OD on downers. Obviously, not everyone reacts the same with different drugs, but most suffer the same symptoms and effects. Here’s a link for more information on Downers:

http://www.doitnow.org/pages/137.html

Narcotics, on the other hand, relieve pain and act as a sleep inducer. They are directed towards relieving the central nervous system that are experiencing stress to induce a more relaxed, drowsy state. Oxycodone (used for chronic pain) and Heroin (used as an illegal narcotic) are the most commonly abused modern day drugs, not to mention marijuana, too. Signs and symptoms of an overdose of narcotics include a coma, super miosis (aka: pinpoint pupils/tiny pupils), and respiratory dysfunction. Symptoms include Analgesia (feeling no pain), sedation, euphoria (feeling high), respiratory depression, small pupils, nausea, vomiting, itching or flushed skin, and constipation. Do you still want to take this drug? The list keeps going…

You can classify Downers and Narcotics as Opiates. Opiates are used to treat pain by depressing different parts of the brain and nervous system. Chemically, opioids attach to proteins called opioid receptors inducing a type of relief and relaxed state. Opioid receptors are found all over the body like in the gastrointestinal track, spinal cord, etc. Once the opiates attach to the opioid receptors, then the body creates a new perception of pain which sends a message to the brain communicating that the pain is gone.

EMT- Week 5- Seizures

What are the 3 phases of a seizure and what happens during these phases?  List 3 possible causes of a seizure? Also respond to 2 other students posts.

3 Phases of a Seizure:

1.       Tonic Phase: The body stiffens for less than a minute. This rigidity restricts lung and chest expansion due to the tight hold which may eliminate breathing for that duration of time. Patients often hold the arms stiff in an uppercut position close to their chest, urinate on themselves, and/or bit their tongue due to the clenching of the jaw muscle.

2.       Clonic Phase: This is the phase where the body participates in a jerking, violent motion for about 60 to 120 seconds (possibly even five minutes). It is best to wait out the seizure and care treat the patient thereafter. Some signs include the active shaking/uncontrollable jerking, foaming/drooling mouth, and possible cyanosis. The patient is unable to swallow saliva during their seizure due to the muscle contractions and well as the tongue possibly blocking access to the trachea, so the saliva often times turns into a foam as it collects and sits in the oral cavity. Cyanosis occurs due to lack of circulation of blood flow containing oxygen to the brain.

3.       Postictal Phase: After the convulsions stop, then the patient begins the postictal phase. After all, seizures occur due to the misfiring in the brain so the patient may experience an altered, confused, drowsy, unconscious state and/or experience a headache.

Some Causes of a Seizure Include:

1.       Stroke: caused by clots and bleeding in the brain.

2.       Traumatic Brain Injury: which could result in a rupture causing internal bleeding allowing glucose to eat away at the muscle tissue and kill the brain-to-body signal

3.       Hypoglycemia: low blood sugar (below 70mg/dL). The body is suffering from limited insulin which turns glucose into energy putting the body in a state of shock (aka: insulin shock). Without enough insulin, then the body collects excessive amounts of glucose in the blood instead of turning that glucose into energy.

4.       Congenital Brain Defects: hereditary and often seen in infants and young children

5.       Metabolic: caused by irregularities in the patient’s body chemistry/unbalanced chemical composition 

EMT- Week 5- Cardiac Conditions

Pick 2 of the many "Causes of Cardiac Conditions" and explain the differences between them.  What are some of the signs and symptoms that you may see when caring for these type of patients? Also respond to 2 other students posts.

Two of the many Causes of Cardiac Conditions include Coronary Artery Disease and Aneurysm. Coronary Artery Disease (CAD) occurs when the coronary arteries are narrowed or blocked, blood flow is reduced, thereby reducing the amount of oxygen delivered to the heart. CAD can be hereditary and age can influence the risk of developing CAD. Other risk factors include: hypertension, obesity, lack of exercise, elevated blood levels of cholesterol and triglycerides, and cigarette smoking. Obviously, maintaining a heathy diet and activity level is likely to lower the chances of falling victim to this disease. Physical activity and stress can instigate this condition by increasing the heart rate as well as the demand for oxygen. Causes for this disease include fatty deposits (plaque which then somewhat solidifies due to calcium) on the inner walls of arteries which then limits the volume of the coronary arteries; compromising the ability to supply oxygen to the heart efficiently and in the correct quantity. This collection of solidified plaque/calcium build up within the narrowing diameter of the arteries (aka: thrombus) creates the perfect opportunity for blood to clot which makes the condition even worse because now the arteries aren’t able to circulate blood due to the additional blockage. A thrombus is dangerous and cause either 1) an occlusion: complete cut off of blood flow or 2) embolism: where the thrombus detaches from the residential area within that artery to travel and get stuck in a smaller artery. Without oxygen, muscle dies. So, when either of these things happen, then the oxygen supply beyond the blockage may die. Heart attacks and strokes may result from this sort of blockage that restricts O2 blood flow to the heart and/or brain. Possible signs include: stroke activity, respiratory rate/pulse rate quality, and rhythm abnormalities, cyanosis, altered state possibly, heart attack, etc.  Symptoms include: chest pain. Related conditions: include: angina pectoris (chest pain), acute myocardial infarction (heart attack), and congestive heart failure.

Another cause of cardiac conditions includes Aneurysm. Aneurysm is the inflation of the arterial walls that dilates due to weakness in that specific area. The dilation can be due to an independent variable or due to other cardiac related problems. So, if the blood flow is compromised due to a blockage, then it is lacking in oxygen and the muscle dies/weakens like I mentioned as an action of CAD which makes the wall weak. The swelling is probable to burst which allows for the release of blood (aka: internal bleeding just like my trauma case in class). As we have learned before, glucose is in blood and destroys muscle tissue when in contact with it. In addition to the destruction of the muscle, the blood flow and circulation to the heart is absent. The bigger the rupture of the artery, the bigger the problem and stronger the shock to the body/likeliness of death. Ruptures may occur in the artery of the brain (stroke, diabetic patients, altered state), the aorta (caused from possible abdominal injuries). Signs: vomiting, seizure, drooping eyelid, altered state, loss of consciousness, etc. Symptoms: headache, nausea, stiff neck, sensitivity to light, chest pain, etc.

In other words, Coronary Artery Disease has to do with the actual disease caused from continuous build-up of plaque which then calcifies forming a thrombus/blockage in the arteries or an embolism which moves to occlude the flow of blood elsewhere. This blockage restricts the amount of O2 being circulated to the heart and brain. The result of this blockage is the inflammation of the arterial walls known as Aneurysm which normally bursts resulting in internal bleeding, stroke or heart attack, and/or possible death.