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.  

EMT- Week 5- Breathing

During the patient assessment, what are the 3 items you check for while checking for inadequate breathing?  What is the memory aid to use for assessing breathing difficulty?  Ensure you list what each letter stands for to ensure you remember the memory aid.  Also respond to 2 other students posts.

3 Items to Check for While Checking for Inadequate Breathing:

1.       Rate: Rates of breathing that are considered normal vary by age. For an adult, a normal rate is 12-20 breaths/minute. For a child, it is 15 -30 breaths/minute. For an infant it is 25-50 breaths/minute. A patient who is suffering very slow breaths and very rapid breaths isn’t allowing enough air to enter the lungs resulting in the scarce oxygen being distributed throughout the body. Agonal respirations are an example of a irregular rate of breathing/inadequate breathing that are normally very random/sporatic and commonly occur before respiratory arrest.

2.       Rhythm: Normal breathing rhythm will usually be regular. Breaths will be taken at regular intervals and will last for about the same length of time. Remember that talking and other factors can make normal breathing slightly irregular. Rhythm, although listed, isn’t always an absolute indicator of adequate or inadequate breathing because when people are aware that their breathing pattern is being examined, then they often will have slight irregularities just from being self-conscious and distracted. On the other hand, there can be circumstances when the patient has a regular pattern/rhythm, but is breathing inadequately. So, they might be exceeding the normal rate of breathing, but at a constant rhythm which doesn’t define their health properly. That’s why it is important for the EMT to consider all three items when evaluating inadequate breathing.

3.       Quality: Breath sounds, when auscultated with a stethoscope, will normally be present and equal when the lungs are compared to each other. When observing the chest cavity, both sides should move equally and adequately to indicate a proper air exchange. The depth of the respirations must be adequate. It is actually a good thing having trouble hearing breathing sounds because that could mean that they have potential adequate breathing. The depth of respirations (tidal volume) should be shallow if they have inadequate breathing. Chest expansion should be observed and noted, too. Since the muscles are somewhat deprived of oxygen if the patient is an inadequate breather, then this would effect circulation (aka: skin may appear pale or cyanotic and may even be cold/clammy). Snoring and/or gurgling are important indications of a serious airway problem and should be heard for when listening to breathing.

By using our stethoscope, we are able to answer the rate, rhythm, and quality of the patient’s breathing, and determine their breathing status. Inadequate breathing, obviously, is the type of breathing that isn’t able to support life. It’s not sufficient and if left untreated, the patient will surely die. By identifying this medical emergency, then we are able to better help the patient. 

EMT- Five Rights of Medication Administration

What are the 5 rights of medication administration?  Why is it important to follow these rights every time that you go to administer a medication to the patient?  Also respond to 2 other students posts.

Five Rights of Medication Administration:

1.       Right Patient (Does this medication belong to the patient? Is this the same patient medical direction approved a medication order for?)

2.       Right Time (Have I made the right decision to administer the medication based on what I am seeing? Is it appropriate under these circumstances to give this particular medication?)

3.       Right Medication (Did I pick up the right bottle? Am I sure this is the correct medication?)

4.       Right Dose (Have I double checked? Am I sure I am giving the correct amount?)

5.       Right Route ((oral/swallowed, sublingual/dissolved under the tongue, Inhaled, Intravenous/injected into a vein, intramuscular/injected into the muscle, Subcutaneous/injected under the skin, intraosseous/injected into the bone marrow cavity, endotracheal/sprayed directly into a tube inserted into the trachea)

It is important to follow these rights every time I go to administer a medication to the patient because it is beneficial to the patient as well as the EMT administering the medication due to legal purposes from documentation. As simple and logical as these 5 Rights appear to be, one missed right could amount to a life. I understand the responsibility of needing to cognate the information given on the medication to determine the correct patient is being given the correct drug. It is easy to assume the patient will become more critical if given the wrong drug so right number one helps prevent the occurrence from happening. Timing has been a reoccurring stress, worry, theme, and topic of discussion in EMS because it is so critical. Time is irretrievable and therefore, highly important to consider when administering medication. Maybe the patient is stable and just having trouble breathing, but you know from their past medical history and the fact that they get short of breath when doing physical activity that they have cardiac distress. Although they might be stable at that moment, you should identify and apply their need for their current heart medication, nitroglycerin, aspirin, etc. to plan ahead of time before their condition descends. Choosing the right medication sounds simple, but I can imagine how it could easily be an issue due to most prescription medications being in similar orange bottles with labels. The correct dose administration of medication is essential. Some things to consider include the patient’s height and weight. If the patient is 100 pounds and 5 ft., then the drug will be more powerful and active in their body compared to a 300 pound man who is 6ft. 2in. The pill might need to even be split in half or diluted in water in order to properly treat the patient. Determining the correct route of medication into the patient is essential. You can’t be putting a pill intraosseously. It just doesn’t work that way. You need to not only use common sense, but be smart and read the label as well as the patient’s state. Some routes are more efficient, handy at that time, or create a stronger effect if done one route compared to another. It depends on the patient’s state and how the medication is supposed to be administered.

EMT- Trauma

You arrive on scene to a roll over car accident where a passenger has been thrown from the car and the driver is trapped.  The fire department has not yet arrived on scene, but the police are on scene.  People are starting to gather around both victims.  How should you handle the scene and who is a priority to take care of first?  Also respond to 2 other students posts.

In the case of a trauma such as this one given, I would wait until the scene and call for additional resources/back up while waiting for the scene to be safe and the crowd has been managed. I would be aware of traffic, ensure the ambulance is parked in the safest location, be observant of any glass, debris, broken power lines, spilled/leaking gasoline or fluids, etc. for the sake of me and my crew’s safety. My first priority is to ensure my safety and my next priority would be the patient evicted from the vehicle. I would make sure I have the appropriate  BSI worn properly (usually a helmet and vest). Then I would do a scene size-up as I mentioned earlier which would include determining whether or not the scene is safe, determining the MOI/NOI from the dispatcher and the observations made when pulling up to the scene, determining the number of patients (in this case two) which would then call for additional resources, ALS/EMS assistance, and bring the backboard for C-spine precautions (which are very much needed in this case, obviously.) I would medically tend to the patient evicted from the car while the firefighters are assisting the other patient/driver trapped in the car. For my primary survey, I would get a general impression of the patient and determine their alertness/ responsiveness. Since they were thrown out of the car, I would assume they are probably unconscious. At the same time I would do my ABCs and begin my Head to Toe body examination. First, cutting off the patient’s clothes then begin my Trauma Examination: Rapid Trauma Exam. While doing my trauma examination then I would be looking for DCAPBTLS (Deformities, contusions/bruises, abrasions/scraped skin, penetration/punctures, burns, tenderness, lacerations/cuts, and swelling). I would feel the head, check airway and ears patency, palpate trachea, chest palpitation down the center of the chest with my hands in the shape of a knife, check sides by pushing in to see if ribs are fractured, palpate the four quadrants of the stomach checking for distension and rigidity, place pals on inner hips while using my body weight to rotate the hips (aka: “open and close the book” motion), check broken bones by palpating with alternating pressure down the arms and legs, checking pulses both palmer and radial, turn on back while stabilizing spine with EMT partner to check for any step-offs, chepidice (not sure if I spelt it right, but it’s bone on bone), and palpating/inspecting the thorax, lumbar, and buttocks areas. , etc. Since the patient is unconscious, then I’d check for any medical/sample history by checking their wallet, pockets, and/or purse or bags (essentially any available resources) to see if the patient has any allergies, essential medical history that could be valuable when treating them, etc. I’d check for vital signs and tend to any wounds or secondary injuries properly while stabilizing the patient. I would choose to load and go while reassessing my patient every five minutes. The patient should be on oxygen and cared for appropriately with whatever their condition is at that time. As for the patient who was the driver, the firefighters would hopefully be trying to get the patient from out of the car to a safer area on scene. That would allow myself, my partner, or any other back up team to medically tend to that patient. I would assist them in the same procedure (Rapid Trauma Exam most likely) like I had with the patient evicted from the vehicle. If the scene was safe enough for me to help the patient in any way I could while they were trapped in the car, then I would, but only if it was safe enough. There are several things to consider when approaching a tumbled car like leaking fluid, possible random explosion, fire, etc. that would all need to be taken into account to ensure my safety. It would be desirable that the scene is safe enough to medically service the patient and do everything I could, while ensuring the safety of myself, my crew, and others, to help the patient medically and emotionally. 

EMT- Scene Safety and Scene Size-Up

When doing a scene size up, when should you call for help and what are three possible reasons you will need additional help?  What are some ways to determine the mechanism of injury and what type of injuries will there possibly be to take care of?  Also respond to 2 other students posts

An EMT should call for help when doing a scene size up if he/she thinks they will need additional resources like an ALS unit for more serious calls or a medical emergency concerning more than one patient. MOI and NOI is the information given to the EMT concerning the patient which gives the EMT a heads up as to what they will be expecting so that they can prepare. Some ways they will prepare include determining whether or not they will need to call for additional resources/back-up or whether or not to bring a backboard for C-Spine precautions. Some possible reasons the EMT will need additional help would include a multiple casualty incident, medical and trauma calls, if the scene is unsafe due to animals, gas leakage, fire, outraged family members, and just anything that could be hazardous/unsafe to the EMS crew,  (the scene should be safe anyway, but in the case that it isn’t, then you would need to call for scene safety/police), and/or in the case the patient is stuck in machinery and you’d need another professions with expertise in that field of area to help lift, move, or detach that industrial machinery such as a firefighter. Some ways to determine the mechanism of injury (MOI) include being given the information by the dispatcher before you arrive on scene, observing/analyzing the scene while driving/pulling up in the ambulance, and just in your overall scene size up. Some types of injuries that might be there to take care of include a patient in cardiac distress complaining of chest pain (put ALS on standby), patient with their hand stuck in a machine (need for firefighters), anxiety calls, shortness of breath patients, lacerations, burns, cuts, etc. There maybe cases when the EMT may need to call for backup once actually on scene with the patient, but the point of scene size up and MOI/NOI is to prepare so that the patient is in the best care with all the correct staff and resources to help them.

EMT- Oxygen Administration

Two conditions that would require oxygen could include:

1.Cardiac Arrest:

-The patient is unconscious and is not breathing, but has a slight pulse. At this point, the body has about 5% Oxygen available which could last about 5 minutes. By the time the EMT arrives, they will need to start compressions which will circulate the oxygen in the body. While doing the compressions, the EMT should maintain correct form with knees by the patient’s side, arms/elbows straight, overlapping hands just above the nipples towards the median, and performing compressions with full recoil of about ½ the diameter of the patient’s torso. They must follow the 30/2 ratio performing 30 compressions with 2 pumps oxygen with the Bag-Valve-Mask (BVM) until the AED is available and ready for activation. Once the AED is placed properly on the patient, then it will stop the heart and any abnormal electrical activity in hopes the body will restart with a regular, stable beating rhythm. Before performing compressions and using the BVM, then the EMT should look to make sure the airway is patent. This could explain why the patient isn’t breathing. For example, maybe the patient choked and that is how they became unconscious, but not in this case. The EMT should also look at the chest and stomach for breathing, listen for breathing, and feel the patient’s pulse. Throughout the EMT’s procedure, they should be examining vital signs to see if there is any progress in the patient’s health.

2.Anxiety

-In the case of anxiety, the patient is experiencing a rapid heart rate which is resulting in limited Carbonic Acid that is supposed to be in the body. If the patient’s respiration rate is above 40/minute, then it is appropriate to use the BVM. By using the Bag-Valve-Mask (BVM), the EMT can force Oxygen and slow the breathing to a breathing pattern appropriate (12-20/minute). While using the BVM, the EMT should talk the patient through the procedure to calm the patient down and communicate that they will be forcing them to take bigger breaths by using this BVM mask and to breathe when instructed in hopes of achieving deeper breaths.

In order to provide an open airway, the EMT can use the Head-Tilt Chin Lift or the Jaw Thrust. The Head-Tilt Chin Lift can be performed on normal patients that aren’t experiencing any trauma like spinal injury, for example. However, the Jaw Thrust is designed specifically for trauma patients to ensure the correct posture of the patient without having to move the neck. 

EMT- Different Phases of Life- Compare and Contrast

It was eye opening getting a more educational, analytical perspective on the similarities and differences between the Toddler Phase (ages 12-36 months) and the Adolescence Phase (ages 13-18 years).  As an 18 year old, I could relate to the characteristics, both physiological and psychosocial. Then, reading about the Toddler Phase, I grew somewhat quite. It was humbling understanding that this age is understood by science to be known as an age of development in mental, emotional, and physical maturity, much like 12-36 month olds. Teenagers commonly develop an image with the purpose of being “popular,” “cool,” and/or different from all other stages in life. We’ve even developed a language of slang, text lingo, etc. that is visualized by society as a completely different stage in life compared to all others. What I found was, despite the obvious differences between toddlers and adolescent teens, teenagers aren’t so advanced and act/grow very much like babies. It’s a very self-consumed age for toddlers and adolescent teenagers.

Toddler and Adolescence Similarities & Differences:

*Experience Rapid Growth

-Toddlers:

-grow 4.4 pounds/year

-systems develop and advance: pulmonary (airways grow and alveoli increases), nervous system (90% development of brain/develop motor skills), musculoskeletal (muscle mass and bone density increase), immune system (becomes more resistant/stronger), teeth (have all primary teeth)

-Adolescence:

                -growth spurt lasting 2-3 years (girls done by age 16 and men by age 18)

                -reach reproductive maturity

-heart rate: 55-105/minute, respiratory rate: 12-20/minute, systolic blood pressure: 80 120mmHg

*Body Temperature

-Toddlers:

                -96.8-99.6 Degrees Fahrenheit

-Adolescence:

                -97.8-99 Degrees Fahrenheit

*Develop own Individuality:

-Toddlers:

-As Toddlers are developing their physical strength and new body form, they become more curious and want to become more adventurous. They are often times called “curtain climbers” or “rug rats” due to this curiosity that results in “occasional” mischief (aka: “terrible twos” stage).

-Adolescence:

-Teenagers develop their individuality or identity through curiosity, as well. However, their curiosity sometimes results in home conflict with parents/guardians, self-destruction, drugs, sexual curiosity/identity, etc. As they crawl closer to Early Adulthood, they desire more independence. Toddlers may find their independence through crawling away or wanting to explore the backyard, but adolescent teens strive for independence, usually from their parents.

*Increasing Cognitive Development

-Toddlers:

-Toddlers are developing their understanding of cause and effect. By 12 months, toddlers will begin to grasp what words actually “mean” by putting names with faces, for example. From 18-24 months, toddlers begin to understand cause and effect like when they are dropped off at daycare, they understand their mom is leaving and will develop separation anxiety. (Total opposite of teens who want less time with their parents, normally). 24-36 month olds begin to be more creative and by 3-4 years old, they have basic language down.

-Adolescence:

-Teens are developing their cognitive skills more and more, but in a different way that prepares them for Early Adulthood which includes college, work, responsibilities, etc. They are understanding the consequences of their actions through cause and effect which is explanatory for the obvious tension and constant disapproval between parent and teen. Teenagers are learning abundantly through their high school experience (hopefully) in preparation of flying off into a suited life stage requiring more responsibility and are applying those morals and themes learned through life actions/experience and interpreting/applying those principles as their maturity progresses. 

EMT Stress Management Discussion Question

Knowing the causes of stress will help the EMT understand how to handle the various levels of stress that they will encounter.  List 1 of the causes of stress and the ways to handle it. Also respond to 2 other students posts about other ways to handle the stressful situation that they identified.  Use your own experience in dealing with stress.

One of the causes of stress is the scarcity of time. EMTs are expected to report to the medical emergency within minutes. Upon arrival, time is sacred in using the educational knowledge and training to the best of their abilities. There isn’t any time to forget which tool to use or how to use it, ask for a break so you don’t vomit in response to the amount of blood from the patient, or try and remember where the switch is on the machine, for example. I have volunteered for the hospital for four years and participated as an intern for Marian Medical’s Physician Mentorship Program. I remember observing a gastrointestinal surgery and watching the blood squirt into the air and onto the surgeon’s mask. This was a common surgery that he had done several times before and felt prepared, but in this one instance, something went wrong. There wasn’t time to clean up or wash off, there was only time to find the source of bleeding and provide compression, etc. There are ways to prepare for the job; however, sometimes preparation is necessary even for the most common tasks which is important to remember. In times of stress, like when the patient won’t stop bleeding out, or blood comes in contact with your eye, etc., then it’s important to stay calm, assess the situation, and perform accurately and attentively.

                My personal experience in dealing with stress stems from my sister’s Severe Crohn’s Disease. I remember when my sister was in surgery (this one out of the hundreds of others she has had) and hearing the doctor tell my parents we needed to say our goodbyes because her condition was critical. It was at that moment that I understood the responsibility of stress management. I was five years old, wanting to cry, but I knew that I needed to stay calm and be supportive of my parents as it was their daughter that was dying. Selflessness, sincerity, compassion all came along with dealing with stress. I responded to that stress by referring to prayer and remembering my priority here on Earth; to serve God and others.

                Time is precious and therefore makes for stressful situations. It causes EMTs to be better at their jobs by making it a necessity to prepare for the worst and be educated. Ways to deal with stress in these timely circumstances is by preparing, as an EMT, whether it be studying an EMT text book while off-duty or waiting for a call, communicating with other EMTs concerning your emotional suffering/stress, exercising so that time won’t have to delay based off of poor physical health, and/or participating in spirituality whether it be worship, prayer, meditation, confession, etc. as a form of expression and as an outlet.  

                 

EMT Personal and Physical Characteristics Discussion Question

EMTs should possess enumerated skills due to their medical intervention and attention among society. Personal and physical traits vary significantly including being pleasant, sincere, cooperative, resourceful, a self-starter, emotionally stable, leadership, neat and clean, moral/respectful character, control of personal habits, communication/listening skills, physical strength, etc. Considering the statistics, the U.S. had around 58 documented fire/EMS suicides in 2014 (likely only a fraction of the actual count, according to the Statistician). Therefore; I conclude the most important traits as an EMT would go as followed (3 personal, 1 physical):

1.       Cognitive/Analytical/Observational Skills: ability to process information, reason, remember, and relate new information to medical knowledge to be able to perform medical duties.

-There isn’t a statistic needed to say that 100% of the job requires this skill. Upon arrival, the EMT is required to observe the surrounding environment, thus acquiring information plausible to make a personal diagnosis of the patient and prepare. Identifying and familiarizing the setting could mean for better resourcefulness, as well. This awareness is carried through to the connection with the patient. It is essential to identify and analyze the many vital signs signifying the patient’s current state of being. Once all observations and information is acquired, then comes decisiveness. “Which hospital should we bring the patient to?” For some cases, this decision could mean life or death. If the patient is in critical condition, then the EMT is required to decide, by the use of his cognitive skills, whether to bring the patient to a specialty hospital even though it could mean a longer drive or transport the patient to a general hospital that might not have the purposeful supplies needed to better care for the patient, but could save precious time, for example.

2.       Communication Skills: able to convey information to people clearly and simply, in a way that means things are understood and get done. It's about transmitting and receiving messages clearly, and being able to read your audience.

-Communication skills are essential in all aspect of life and the global workforce whether it be through verbal words, physical touch, literary communication, eye contact, etc. Communication comes in many forms. EMTs have the responsibility to acquire appropriate communication skills whether it be asking questions concerning the patient’s current state, writing down medical documentation, contacting a doctor for further guidance, making eye contact with other drivers on the road while operating the ambulance, and/or in unfortunate circumstances, informing the family that their loved one, communicated by name, that they have died. Not only does this apply during the course of action taken to medically assist patients, but in assisting the EMT themselves. Talking about emotional distress concerning EMT employment can be a stress reliever. An EMT will be better able to medically assist if they are at a healthy state themselves.

3.       Stable/Static Physical Health and Wellness: physically fit to carry out duties as an EMT involving coordination, flexibility, strength, dexterity, etc.

-It is obvious to say that an EMT is expected to be appropriately physically fit in the case needed to carry a 200 pound human, for example. However, with the physical support and teamwork of your co-workers on cite, the physical aspect of the job should be somewhat controlled, predetermined, and realistic/doable. What are commonly overlooked and taken for granted are the importance of eyesight while performing EMT duties. Color vision can be used to identify vital signs such as skin color, for example. You also need to be able to easily see the written instructions and identify machinery for use in the proper fashion. Hearing is essential while driving the ambulance, obtaining information from the patient and society, instruction, etc. Our vital signs are important in identifying other’s vital signs which makes them extremely important in being able to carry out the job.

4.       Correct balance of Teamwork/Leadership: combined action of a group of people, especially when effective and efficient. Leadership: the action of leading a group of people or an organization.

-Direction, cooperation, management, control, etc. are all part of this job. Leading in the sense of taking necessary guidance to control a scene, organize crowds are essential in emergency medical care for the well-being and safety of the patient, yourself, and the rest of society. Teamwork allows for a more efficient approach to care and establishes confidence in the patient and society who are overseeing that all medical staff on duty is using their knowledge combined to better provide for their friend or loved one suffering.

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Jesus's Rising and My Awakening

      I was in church today for the Easter Mass with my family. During the minister's lecture, I looked over and saw my young nephew playing a video game. As his Godmother, let alone, his aunt, I feel the responsibility of serving as his spiritual guide during the transitions through his youth and beyond. I explained to him that, although mass could get boring at times and it might be confusing to understand the message of the Bible, we still attend mass with the purpose to honor our Lord. I suggested praying when he's bored and thanking Jesus for dying for our sins and asking for guidance on how to obtain from sin. He bowed his head and we prayed together during the service. Quite frankly, the minister had such a thick accent that it was hard for me to understand what he was saying, let alone understand the message he was trying to get across so I sympathized with my nephew. 
      I learned from the experience all the same. My nephew was distracted from playing his video game during church; however, isn't everyone distracted in life? It is socially unacceptable to be distracted in church, but it's acceptable to be distracted in our daily lives outside of mass? God made the Earth. He is the architect of the entire universe. The church is not his only home. He rests in our soul, as well. He is omniscient. I was distracted in church, yet I learned my greatest lesson. I need to be better by being more aware. I need to be cautious with the time I have and more understanding. I need to sing and celebrate life like I do in church and live the word outside of those stained-glass windows and tall, white walls. I need to experience life awake to the discovery of consciousness of the world around me.
      I turned eighteen last week and looked back on my short-lived life thinking I did pretty good. I've never done drugs or drank alcohol. I've maintained my purity even after a two year relationship. My grades have always earned me a 4.0 and above... Gone to church, tended to my parents, cared for my sick sister, danced, etc. Now I look at my life and think of all the things I could have done with the time I wasn't achieving success. I have flaws of procrastinating, taking the easy way sometimes, watching The Kardashians and Grey's Anatomy, going to parties to socialize, being critical of others, etc. I haven't fully out to use the talent God has given me,either. 
      It's an awakening. I've been dead like Jesus was for three days except I've been dead for the last 18 years. It is now that I've awakened and risen to the challenge of living life without a moment of wasted time. In my every day, will I thank God and sing the glory of his name while living His Word. I will not take naps in life where I shut my brain off and wait to be inspired. I'll use my positivity and mindset to initiate energy. No more dosing off and walking away from reality. Life is here, there's no time to wait, He needs us. 

Counterbalancing Modern Life

Life is all about balancing. We try and be dynamic students by balancing our academics with extracurricular activities, volunteer work, family, friends, religion, etc. and we try and be successful while managing all these different parts of our life at the same time as being successful in every aspect and every activity. Well, Modern Dance is a great example of that. I'm in five inch heels and a skirt; an outfit neither meant for dancing, nor balancing; however, dancers dance through life despite the circumstances. I have to find a medium balance between holding Katie (left) and Baily (right). This resembles my life and the responsibility and dependability expected of me as well as the rest of the world. I can't pull to hard on Katie or else she would fall forward and Baily would fall back. Yet, I can't give all my weight to Katie or else her lunge would turn more into a far portequor and Baily would be in the splits. God, I believe, gave us a population to live with. We are here to interact and celebrate together, in the glory of His name. We are meant to live by supporting one another while depending on one another through friendships, relationships, etc. No one is meant to be alone is this dance called Life. It's all about finding the balance and the beauty will display itself in the victory of your success.

Dance Spectrum 2015

I remember Mrs. Byrne asked my Honors English class whether physical pain hurt more than emotional pain. Dance, once again, has proven the answer to that one. Physical pain is nothing compared to emotional pain. My feet are just an example of the joy dance has served in my life. It's made an impression on my body, as well as my soul. How do we stay away from emotional pain? Is the only way by getting physically hurt? Not always. There are other ways to live happily and painlessly. A brisk hike early in the morning can clear your mind and ease stress. Maybe even just a deep breath can make that test-stress go away. For me, personally, dance has given me both pain and joy. However, knowing that Sunday was my last time performing at Allen Hancock College left me with the worst pain I've felt in a while. Could you imagine losing something that was once there for you through everything? That one person or thing that got you through the deaths of loved ones, breakups, friendship dramas, family fights, and never let you down. The one thing that let you be anything you wanted to be, do anything you wanted to do, and granted you the feeling of feeling the most beautiful... that was dance for me. I graduated from Dance yesterday and while my feet are bleeding, I'd rather my tears be from the physical pain than the crushing reality of losing my best friend, Dance.

Ballet Lessons... Life Lessons... My Masterpiece

This picture has many meanings. The little girl separated from the rest of the girls is little Sakoya. She's one of the best dancers in Beginning Ballet One. Her success often times separates her from the rest of the girls. She possesses a strong sense of maturity and poise. She learns quick, cooperates, loves her Mommy, and does what she is told. Most importantly, though, she has a passion that drives her and that is her love for dance. I find elements of myself in little Sakoya. It's easy to plan out her life and who she'll grow up to be someday. I was the girl in class who was attentive and wanted to learn as much about my body as was possible. This separated me from my age group. Not only was I surrounded by a home full of college students and teens, but I spent my extracurricular activities with them, too. This early maturity gave way to a new found respect and understanding of my body and life itself. Every movement brought beauty and a stronger mind, body connection. No longer was I simply standing in first position, but I was feeling my toes press through the floor, my knees lift, my circulatory system flow, spine elongate, and heart beat to the tapping of my toes. Dance brought a new feeling of life. In the end, I found the departure from my short-lived youth to be a graduation of a new life, new feeling that set forth my dancing success.

Vocabulary #4

 Interior Monologue: a form of writing which represents the inner thoughts of a character; the recording of the internal, emotional experience(s) of an individual; generally the reader is given the impression of overhearing the interior monologue.

Inversion: words out of order for emphasis.

Juxtaposition: the intentional placement of a word, phrase, sentences of paragraph to contrast with another nearby.

Lyric: a poem having musical form and quality; a short outburst of the author’s innermost thoughts and feelings.

Magic(al) Realism:  a genre developed in Latin America which juxtaposes the everyday  with the marvelous or magical.

Metaphor(extended, controlling, and mixed): an analogy that compare two different

things imaginatively.

Extended: a metaphor that is extended or developed as far as the writer

wants to take it.

Controlling: a metaphor that runs throughout the piece of work.

Mixed: a metaphor that ineffectively blends two or more analogies.

Metonymy:  literally “name changing” a device of figurative language in which the name of an attribute or associated thing is substituted for the usual name of a thing.

Mode of Discourse:  argument (persuasion), narration, description, and exposition.

Modernism:  literary movement characterized by stylistic experimentation, rejection of tradition, interest in symbolism and psychology

Monologue:  an extended speech by a character in a play, short story, novel, or narrative poem.

Mood:  the predominating atmosphere evoked by a literary piece.

Motif:  a recurring feature (name, image, or phrase) in a piece of literature.

Myth:  a story, often about immortals, and sometimes connected with religious rituals, that attempts to give meaning to the mysteries of the world.

Narrative:  a story or description of events.

Narrator:  one who narrates, or tells, a story.

Naturalism: extreme form of realism.

Novelette/Novella: short story; short prose narrative, often satirical.

Omniscient Point of View:  knowing all things, usually the third person.

Onomatopoeia: use of a word whose sound in some degree imitates or suggests its

meaning.

Oxymoron: a figure of speech in which two contradicting words or phrases are combined to produce a rhetorical effect by means of a concise paradox.

Pacing:  rate of movement; tempo.

Parable:  a story designed to convey some religious principle, moral lesson, or general truth.

Paradox:  a statement apparently self-contradictory or absurd but really containing a possible truth; an opinion contrary to generally accepted ideas.

Vocabulary #3

Exposition: beginning of a story that sets forth facts, ideas, and/or characters, in a detailed explanation.

Ex: Earlier, I alluded briefly to Dennis 's integration of his theory of verdict legitimacy with his exposition of the rules of evidence.

 Expressionism: movement in art, literature, and music consisting of unrealistic  representation of an inner idea or feeling(s).

Ex: Dance is a form of expressionism.

 Fable: a short, simple story, usually with animals as characters, designed to teach a moral truth.

Ex: All this appears in the ritual in the form of a story or fable, called an allegory.

 Fallacy: from Latin word “to deceive”, a false or misleading notion, belief, or argument; any kind of erroneous reasoning that makes arguments unsound.

Ex: It is also both bad manners and the ad hominem fallacy to impugn the honesty of a critic to avoid his arguments.

 Falling Action: part of the narrative or drama after the climax.

Ex: The falling action is always one of the more interesting parts of the storyline because you get to see how everything panned out after the climax.

 Farce: a boisterous comedy involving ludicrous action and dialogue.

Ex: The farce get more anarchic with every turn of the plot.

 Figurative Language: apt and imaginative language characterized by figures of speech

Ex: An example of figurative language is when Paula says to the singer that they sounded like Beyoncé.

 Flashback: a narrative device that flashes back to prior events.

Ex: Before I passed out, I had a flashback of my time in the Great Alps.

 Foil: a person or thing that, by contrast, makes another seem better or more prominent.

Ex: In other places the piano provides a foil to the bassoon, with sparkling arpeggios in a high register.

Folk Tale: story passed on by word of mouth.

Ex: My great grandmother had a million folk tales she would tell me that she remembered from her mother’s bedtime stories she’d tell at night.

 Foreshadowing: in fiction and drama, a device to prepare the reader for the outcome of the action; “planning” to make the outcome convincing, though not to give it away

Ex: Well, now I know that she will die in the end because that event in the movie is obviously being used as a literary device; foreshadowing.

 Free Verse: verse without conventional metrical pattern, with irregular pattern or no rhyme.

Ex: Walt Whitman’s “I’d dream in a dream” uses free verse.

 Genre: a category or class of artistic endeavor having a particular form, technique, or content.

Ex: My favorite genre of music is country.

 Gothic Tale: a style in literature characterized by gloomy settings, violent or grotesque action, and a mood of decay, degeneration, and decadence.

Ex: My favorite mystery books are often gothic tales.

 Hyperbole: an exaggerated statement often used as a figure of speech or to prove a point.

Ex: Don’t be scared. The world won’t collapse. They were just using that hyperbole to scare you.

 Imagery: figures of speech or vivid description, conveying images through any of the senses.

Ex: Imagery consists of the five senses and is used in every book in the world.

 Implication: a meaning or understanding that is to be arrive at by the reader but that is not fully and explicitly stated by the author.

Ex: His text message is an implication that he wants a burger over a taco.

 Incongruity: the deliberate joining of opposites or of elements that are not appropriate to each other.

Ex: Nothing is the same. It’s so incongruent and so, therefore, we will never agree.

 Inference: a judgement or conclusion based on evidence presented; the forming of an opinion which possesses some degree of probability according to facts already available.

Ex: From my inference, I know that he is the killer.

 Irony: a contrast or incongruity between what is said and what is meant, or what is expected to happen and what actually happens, or what is thought to be happening and what is actually happening.

Ex: Wow! It’s ironic to see you here. 

Vocabulary #2

Circumlocution: a roundabout or evasive speech or writing, in which many words are used but a few would have served

Ex: The con man tried to use circumlocution to avoid explaining his real intentions to the wealthy couple.

Classicism: art, literature, and music reflecting the principles of ancient Greece and Rome: tradition, reason, clarity, order, and balance

Ex: Like his beloved Italy his etchings are suffused with a classicism that nonetheless appeals to a contemporary esthetic.

Cliché: a phrase or situation overused within society

Ex: Come up with something new because your argument is just a cliché I’ve heard a thousand times.

Climax: the decisive point in a narrative or drama; the pint of greatest intensity or interest at which plot question is answered or resolved

Ex: The week came to its shuddering climax with President Bush 's speech to the UN General Assembly.

Colloquialism: folksy speech, slang words or phrases usually used in informal conversation

Ex: The Pelican has used an English colloquialism which has a similar meaning.

Comedy: originally a nondramatic literary piece of work that was marked by a happy ending; now a term to describe a ludicrous, farcical, or amusing event designed provide enjoyment or produce smiles and laughter

Ex: I don’t know if the comedy was actually funny or if the wine made it funny.

Conflict: struggle or problem in a story causing tension

Ex: The conflict of the story really drove the plot and gave the story such drama. I loved it!

Connotation: implicit meaning, going beyond dictionary definition

Ex: Increasingly it has acquired a negative connotation, implying excessive demand or pressure.

Contrast: a rhetorical device by which one element (idea or object) is thrown into opposition to another for the sake of emphasis or clarity

Ex: The true believer, in contrast, has eternal life and will abide forever.

Denotation: plain dictionary definition

Ex: We now work toward a theoretical description of the denotation of the sentence as a whole.

Denouement: loose ends tied up in a story after the climax, closure, conclusion

Ex: And that's obviously what the denouement of the film is about.

Dialect: the language of a particular district, class or group of persons; the sounds, grammar, and diction employed by people distinguished from others.

Ex: The kind of old English dialect the characters spoke made the setting really come to life.

Dialectics: formal debates usually over the nature of truth.

Ex: Dialects of Scots Scots has a wide range of dialects.

Dichotomy: split or break between two opposing things.

Ex: This dichotomy has recently been questioned by some linguists who have argued that the distinction is an artificial one

Diction: the style of speaking or writing as reflected in the choice and use of words.

Ex: Tired diction here, inappropriate register there; natural, unforced cadence here, resonant phrasing there.

Didactic: having to do with the transmission of information; education.

Ex: The aim of the periodicals was didactic, but it was a broad-minded type of didacticism.

Dogmatic: rigid in beliefs and principles.

Ex: The author 's dogmatic assertion of his hero 's heterosexuality gives some idea of the respect accorded homosexuals in the West.

Elegy: a mournful, melancholy poem, especially a funeral song or lament for the dead, sometimes contains general reflections on death, often with a rural or pastoral setting.

Ex: This completed, twelve chieftains rode around the barrow, reciting an elegy and speaking of their heroic king.

Epic: a long narrative poem unified by a hero who reflects the customs, mores, and aspirations of his nation of race as he makes his way through legendary and historic exploits, usually over a long period of time

Ex: The Nine Sisters and the Axis Mundi New ideas on the axis mundi in northern epic tales by Alby Stone.

Epigram: witty aphorism.

Ex: The moral aspect has been given by Mr Swinburne in an epigram: - " Alfred was a terrible flirt and George did not behave as a perfect gentleman." 

Welcome Second Semester!

I had so many ideas of what I wanted to focus on this semester and I got completely sidetracked with college acceptances, my new job as a ballet instructor, dance grants, rehearsals, dance performances, my music, etc. Now that things have calmed down, I'm ready to fully invest myself in my masterpiece. From this point on, there will be new transitions. Righetti's Graduating Class of 2015 will be transitioning into summer with a broad spectrum of new opportunities including internships, volunteering, traveling, maybe some tutoring to help prepare for college... who knows? After summer hits the next four years that will create our entire future and career. As we wait anxiously to fulfill our dying wish to explore and adventure out into the world, I want to give some guidance as to how to make that transition healthy and beneficial for our mind, body, and soul. For me personally, my goal is to dive into educating myself more on the Bible and Catholicism, my religion. I'd like to fully invest myself into a healthy diet that will be easy to maintain while transitioning into college. This will consist of new, easy recipes that I will be able to bring with me to college since I can't bring Mom to college with me. Along with a healthy diet, comes physical activity (aka: work out sessions) that I will need to dedicate myself to when dance eventually ends. A healthy mind and body will do great things for my academics and I hope that I will inspire and help guide my former "co-workers" (aka: classmates) with a healthy transition guidebook, if you will.