Professional Documents
Culture Documents
Study Notes
Breathing .......................................................................................................................................................................... 15
Integumentary System ......................................................................................................................................................... 16
Urinary System ..................................................................................................................................................................... 16
Gastrointestinal System........................................................................................................................................................ 17
Reproductive System ............................................................................................................................................................ 17
Maternity .......................................................................................................................................................................... 17
Child Birth ......................................................................................................................................................................... 18
Maternity Pack .............................................................................................................................................................. 18
Stages of Labour ............................................................................................................................................................ 18
Antenatal Haemorrhage ................................................................................................................................................ 19
Post-partum Haemorrhage ............................................................................................................................................ 19
Paediatrics ................................................................................................................................................. 37
Ages ..................................................................................................................................................................................... 37
Medical Problems ................................................................................................................................................................. 37
Epiglottitis ......................................................................................................................................................................... 37
Croup ................................................................................................................................................................................ 37
Page 5
Medical Terminology
Prefixes Direction & Quantity
a, an
absence
ab
away from
ad
adduction
bi
two
tri
three
brady
slow
tachy
fast
hemi
half
peri
around
heart
cerebro -
brain
cephalo -
head
dermo -
skin
gastro -
stomach
neuro
nerves
myo
muscle
osteo
bone
pneumo -
air
rhino
nose
thoraco -
chest
in the head
itis
inflammation of
paresis -
weakness
plegia
paralysis
uria
urine
rrhea
profuse
Examples
pneumothorax = pneumo (air) + thorax (chest) : air in the chest
pharyngitis = pharynx + (g)itis : inflammation of the pharynx
acute myocardial infarction = heart attack
Page 6
front surface
posterior
back surface
midline
midclavicular line -
midaxillary line
Directional Terms
left & right
superior
inferior
lateral
bilateral
medial
towards midline
superficial
on the top
Movement Terms
flexion
extension
abduction
adduction
Anatomical Positions
prone
supine
lying face up
Fowlers Position -
recovery position -
patient lying lateral with head resting on arm and one leg bent
shock position
Trendelenburgs Position -
Page 7
Body Systems
Cell
Tissue
Organ
System
Integumentary: skin
Lymphatic/Immune System
Cardiovascular System
This system consists of:
Heart
Blood Vessels (veins & arteries)
Blood
Heart
Page 8
Electrical Cycle
Bundle of His
Pukinje Fibres
Stroke Volume
This is the amount of blood that the heart pushes out through the ventricles per contraction measured in millilitres.
Cardiac Output
The amount of blood being pushed out by the ventricles per minute measured in millilitres.
CO = SV x HR (cardiac output = stroke volume x heart rate)
Blood Pressure
Systolic Pressure: Maximum pressure against arterial walls when the heart contracts.
Diastolic Pressure: Minimum pressure in the arteries when the heart is at rest.
Hypotension: When systolic pressure is below 90mmHg
Hypertension: When diastolic pressure is above 90mmHg
Pulse Points
Carotid: 50mmHg systolic
Femoral:60mmHg systolic
Brachial:70mmHg systolic
Radial: 80mmHg systolic
Pedal: 90mmHg systolic
Heart Rate
Adult heart rate should be between 60 100bpm (<60 = bradycardia / >100 = tachycardia)
Page 9
Nervous System
Consists of the brain, spinal cord, nerves and sense organs.
Cells within these organs use electro-chemical signals called nerve impulses. These impulses communicate with muscles
and glands.
The nervous and endocrine systems maintain homeostasis the balance within the body.
Brain
Spinal cord
Meninges
Cerebrospinal fluid
Brain
Cerebrum (Grey Matter)
o Largest part
o Divided into 2 hemispheres (right: controls left body, left: controls right body)
o Corpus callosum (multitasking)
o Divided into 4 lobes:
Frontal lobe
controls voluntary movement
concentration
Cerebellum
o Little brain
o Consists of two hemispheres
o Helps maintain posture
o Aids with fine motor skills (writing, knitting, kicking a ball, etc.)
Brain Stem
o The brain stem connects the brain to the spinal cord
o Consists of the:
pons
these work together
to control respiration
medulla oblongata
Page 10
autonomic
nervous system
somatic
nervous system
sympathetic
nervous system
parasympathetic
nervous system
afferent:
takes messages
to the brain
efferent:
takes impulses away
from the brain
Reflex Arch
Sensory nerve
Connecting nerve
Motor nerve
reflex arch
This occurs when an automatic reflex response takes place. A nerve itself basically decides to initiate a response based on
information it receives and triggers the skeletal muscles to react if it thinks the brain will take too long to respond. Eg. placing a
finger on a hot plate and removing it before it really gets burned.
Page 11
Digestive System
In descending order:
Mouth
Saliva
mastication
breaks down food
Bolus
ball of food
Tongue
Oesophagus
Cardiac sphincter Stomach
-
rectum
anus
Muscular-Skeletal System
Consists of the muscles and skeleton.
Hold the body together to provide structure
Muscles
Used for:
Movement
Protection
Stabilisation
Types of muscles:
Page 12
Skeleton
Used for:
Protection
Structure
Erythropoesis
Page 13
Respiratory System
The respiratory centre consists of the following structures:
nasopharynx
oropharynx
laryngopharynx
epiglottis
trachea
carina
primary bronchi
secondary bronchi
Gaseous Exchange
Page 14
Lungs
Pleura (x2)
o parietal (around chest cavity)
o visceral (around the lungs)
o pleural space (between layers)
Breathing
masks:
o
o
o
o
o
nebuliser
venturi
rebreather
non-rebreather
BVMR
40% @ 4 6lpm
40% @ 8lpm
60% @ 10 12lpm
95% @ 10 12lpm
100% @ 15lpm
Page 15
Integumentary System
Used for:
Protection from elements
Temperature regulation (by sweating)
Production of vitamin D
Consists of:
Epidermis:
o Outer layer of skin
o Has 5 layers of cells
Dermis:
o Hair follicles
o Sweat glands
o Nerves
o Sebaceous glands (oil)
o Blood vessels (capillaries)
Hypodermis/Subcutaneous Layer:
o Fatty tissues
Urinary System
Consists of:
o 2x kidneys
o 2x ureters
o bladder
o urethra
The kidneys sit in the posterior abdominal wall at the level of T12 L2
o Each kidney contains around 1 million filter units known as nephrons.
o Blood is filtered through the kidney to remove waste and produce urine from it.
o Lying above each kidney is an adrenal gland.
The ureters carry urine from the kidney to the bladder and are about 30cm long.
The bladder lies in the pelvic cavity.
o Its muscular walls can dilate to store more urine and contracts to expel it.
The urethra provides a passage for urine to the exterior.
Page 16
Gastrointestinal System
Approximate organ locations:
RUQ
LUQ
Liver
Gallbladder
Kidney
Large & small intestine
Stomach
Spleen
Pancreas
Kidney
Large & small intestine
RLQ
LLQ
Appendix
Bladder
Reproductive
Large & small intestine
Bladder
Reproductive
Large & small intestine
Reproductive System
Function is to reproduce
Maternity
Page 17
2nd: 13 28 weeks
breast enlargement
abdominal enlargement
organs start moving
heartburn
constipation
cravings
rd
3 : 29 40 weeks
(possible) morning sickness
more everything
fundus drops
lactation
Child Birth
Maternity Pack
sterile gloves
blanket
linen savers
cord clamps
surgical blade
mucus extractor
sterile gauze
plastic apron
safety glasses
sanitary towels
Stages of Labour
Stage 1:
o onset of contractions, until full dilation of cervix
o 10 30secs mild contractions
o 15 20mins contraction interval
o membranes rupture
o bloody show
Stage 2:
o crowning, until full delivery of baby
o 60 90secs contractions
o 60sec interval
Stage 3:
o delivery of placenta
o 5 30mins
Page 18
Antenatal Haemorrhage
Placenta Abruptia:
o dark red blood
o severe abdominal pain
o placenta separates from uterus wall
o can lose between 500ml 2000ml blood
o check vitals
Placenta Previa
o partially or completely covers the cervix
o bright red blood
o no pain, no contractions
Pre-eclampsia:
o 20th + n weeks
o can cause hypertension
o 140/90mmHH
o affects kidneys
o high concentration of protein in urine (proteinuria)
o blurred vision, headaches, abdominal pain
Eclampsia:
o 20th + n weeks
o 160/110mmHG
o can cause eclamptic seizures
o urine test +++ ++++
o youll want an ALS backup
o transport lateral (to prevent pressure on inferior vena cava)
Post-partum Haemorrhage
Page 19
Patient Assessment
Primary Survey
Hazards
Make scene safe for you and your partner, patient, infection and protection.
SETUP
o
o
o
o
o
Hello
Approach patient from the front
AVPU
If conscious:
o Introduce/identify yourself
o Ask if you can help them (expressed consent)
If unconscious:
o Adult: treat immediately (implied consent)
o Minor: get guardian permission if possible, if not, treat (implied consent)
Help
Call for backup:
o ILS, ALS, SAPS, Traffic, Fire, Hazmat, NSRI, AMS, Disaster Management, etc.
AABC
o Align spine
o Airway
o Breathing
o Circulation
Airway
Open airway:
o Head-tilt, chin-lift (if no suspected c-spine injuries)
o Jaw-thrust manoeuvre (if suspected c-spine injuries)
Maintain airway:
o Insert OPT (if unconscious)
o Suction (if needed)
Protect airway:
o Turn patient lateral (if possible)
Page 20
Breathing
Chest Exam
Expose chest (after acquiring permission)
Inspect chest
o rise and fall
o check for paradoxical motion (opposite inflation/deflation)
o fractured ribs
o contusions (bruises)
o bleeding
o sucking chest wounds
o central cyanoses
o JVD (jugular vein distension)
Auscultate chest
o Listen for any abnormalities
o L & R apex (intersection of midclavicular line and Angle of Louis)
o L & R base (diagonal from nipple line on midaxillary line or bra strap)
o Heart sounds
Palpate chest
o fractures: crepitus
o subcutaneous emphysema (air entrapment)
o tracheal deviation
Percuss chest
o hyperresonance (too much resonance, hollow sound)
o hyporesonance (too little resonance, liquid/solid sound)
Page 21
Circulation
Page 22
Secondary Survey
SAMPLE History
Cardiac
Respiratory
Endocrine
Neurological
Surgeries
Occupation/Obstetrics
Ask if in pain:
Vital Signs
Blood pressure
Pupils: PERRL pupils equal & round & responsive to light
Page 23
4
3
2
1
5
4
3
2
1
6
5
4
3
2
1
Deformities
Contusions
Abrasions
Punctures
Burns
Tenderness
Lacerations
Swelling
Page 24
Assessment of Emergencies
Respiratory Emergencies (pg 369 397)
HHH
ABC
Look for cyanosis
o mucus membranes (nose, mouth)
o central (chest area)
o peripheral (fingers & extremities)
Shape of the chest
o barrel chest
o equilateral shape
Jugular vein distension (JVD)
o veins standing out in neck
Auscultate the chest:
o Rales caused by flow of air through liquid in the lungs
o Rhonchi course breath sounds, flow of air through mucus
o Stridor high pitched inspiratory sound (upper airway obstruction)
o Wheeze expiratory whistling breath sound, air travelling through narrow air passages (asthma, C.O.P.D.)
Treatment
Accumulation of fluid in the space between the alveoli and the pulmonary
capillaries.
congestive heart failure
heroin overdose
liver sclerosis
pneumonia
some forms of asthma
neurogenic shock/spinal shock
tachycardia
dyspnea
rales
pink sputum from nose and mouth
oxygenate
take HGT
place in Fowlers position
A slow process of dilation and disruption of the alveoli and airways, caused by
chronic bronchial obstruction.
smoking
constant inhalation of toxic gasses
Chronic bronchitis with mucus lasting more than 3 months within 2 years.
low-flow oxygen or nasal cannular
reassure patient can become combative
transport to hospital
Page 25
Asthma
Definition
Cause
Treatment
none
abdomen
normal
+ wheezing by
auscultation only
speaks in
sentences
none
20-30bpm
any
flushed
++ audible by ear
blue/pale
+++ audible by
ear
speaks in words
speaks in phrases
anxiety
anxious
respiratory rate
30-40bpm
position of pt. on
tripod
arrival
level of care
BAA/AEA
AEA
patient knows their treatment best
nebulise with 5ml saline, oxygen @ 4-6lpm for 10min
reassess (auscultate)
nebulise again if necessary
take HGT
transport in semi-Fowlers position
panic
40-60bpm
tripod/supine
CCA
Pnumothorax
Definition
Cause
Signs & Symptoms
Treatment
Anaphylactic Reaction
Definition
Cause
Signs & Symptoms
Treatment
Page 26
Hayfever
Definition
Cause
Signs & Symptoms
Treatment
Pleural Effusion
Definition
Cause
Treatment
Choking
Definition
Cause
Signs & Symptoms
Treatment
Blockage of airway
as above
obvious discomfort
hands to throat
use of all muscles to breathe
Heimlich manoeuvre
CPR if unconscious
Pulmonary Embolism
Definition
Cause
Signs & Symptoms
Treatment
Page 27
Hyperventilation Syndrome
Definition
Cause
Treatment
Rapid or deep breathing that lowers blood carbon dioxide levels to below normal
panic attack
high sugar levels
OD on aspirin
severe infection
anxious
tachypnea
dyspnea
dizziness
numbness or tingling in hands and feet
take HGT
oxygenate
coach breathing
transport to hospital
Treatment
tracheal tugging
tripod position
recession
use of accessory muscles
paradoxical motion (uneven movement of chest)
anxiety
head bobbing
oxygenate
transport to hospital if needed
Page 28
HHH
ABC
Brief SAMPLE history
Take note especially of OPQRST questions
Ask:
o had heart attack before
o has heart problems
o has risk factors: smoking, high blood pressure, high stress
o takes medication
Use AED if no pulse
Transport to hospital ASAP
Angina Pectoris
Definition
Types
Treatment
Page 29
Treatment
Sudden death of cells in the heart. After 30mins cells start to die, after 2hrs 50%
of cells are dead and after 4-6hrs 90% of cells are dead.
sudden weakness
sweating
crushing/squeezing chest pain
radiating pain on left arm, jaw and back
sudden arrhythmias causing syncope/fainting
shortness of breath
pulmonary edema
initially have tachycardia then possibly bradycardia
BP can be initially high, cardiac output can then cause low BP
dyspnea
appearance: greyish in colour
agonal agoni
if not treated ASAP = sudden death
high flow oxygen
ALS backup
use AED if necessary/if heart stops
transport to hospital PFQ
ANGINA
P
Q
R
S
T
associated
signs & symp.
AMI
This occurs when the heart is damaged (due to AMI or hypertension) and unable to pump powerfully enough (and fast
enough) to empty the chambers.
Page 30
Types
Treatment
An interruption of blood flow to the brain that results in the loss of brain
function.
Thrombus: blood clot
Embolis: mobile thrombus, air, fibre, plastic
Aneurism: burst blood vessel
o disseminating aneurism: small tears form on the artery (from
meds), becomes weak and ruptures
o berry aneurism: the wall of the artery begins to bulge and as
the heart beats, it becomes larger and then bursts.
Hemorrhagic:
Bleeding in the brain; can be caused by disseminating or berry
aneurism.
With berry aneurism, patient gets super headaches.
With a disseminating aneurism, 90% of the time its fatal.
Ischemic Stroke:
Blood is cut off from an area of the brain; can be caused by thrombus or
embolism.
Pupil is dilated on affected side
Opposite side of body is affected/weakened
check motor response; one side
sight disturbances
weaker or paralysis
hearing disturbances
decreased level of consciousness
balance affected
convulsions
anesecoria/unequal pupils
hemiplegia
diaphoresis (profuse sweating)
facial drooping
skin colour change
dysphasia
pri-prism
paresis/weakening
loss of co-ordination
parasthesia/pins & needles
increased HGT
tachy/bradycardia
memory loss
high flow oxygen
cover with blanket
calm & reassure
transport lateral on affected side
NB: check HGT for hypo/hyperglycaemia as can cause CVA
Page 31
Convulsions Seizures
Definition
Causes
Types
Phases of Grand
Mal Seizure
Treatment
Status Epilepticus
This is when seizures last longer than 30mins or the patient has many consecutive seizures in a short space of time.
Causes of Unconsciousness
Head Injury
Anoxia
Bleeding
Infection
Temperature
Seizure
Cardiac/CVA
Hyper/hypoglycaemia
Allergies/Alcohol
Medical
Poison
Page 32
Causes
Treatment
Page 33
Types
Developing Signs
Differences
Treatment
Page 34
Hypothermia
Loose heat by
o Radiation
o Convection
o Conduction
o Respiration
o Evaporation
Stages
o 35-33C shivering
o 33-30C lethargic, slow/stop shivering, cyanosis
o 30-<27C coma, hypotensive, bradycardia, everything slows down
Treatment
o Warm them up slowly
o remove from area
o remove clothing
o cover patient
Levels of damage
o frost nip
chilly, red skin no cell damage
o frostbite
superficial or deep
dead/damaged tissue/cells
wrap extremities individually
o gangrene
dead cells, irreversible damage
black in colour
Hyperthermia
Heat Cramps
o lack of electrolytes or the lack of distribution
o give water, stretch out muscles
Heat Exhaustion
o > 38C
o non-ventilated areas
o mines
o become very dehydrated
o tachycardia
o dizziness
o remove from area
o fan/cool them
Heat Stroke
o 40C
o dry and flushed skin
o hypotensive
o tachycardia
o possibly decreased LOC
o call for ALS backup
Page 35
Submersion (Drowning)
panic wave hits more panic swallow water laryngospasm hypoxia decreased LOC glug glug glug dead...
Near Drowning
As above, but patient survives.
Concern for secondary drowning where the salt content now in the lungs draws water from body into lungs causing pulmonary
oedema.
Diving Injuries
760mmHg = 1atmos.
every 10m decent in water is +1atmos.
Dangers:
o Decent:
tympanic membrane rupture (ear drum)
mask compression on face
o Bottom:
no real dangers
o Ascent:
air embolus
decompression illness (bends)
Page 36
Paediatrics
Ages
Medical Problems
Epiglottitis
Can go cyanotic
If left untreated, can die
Use nebuliser @ 5ml saline for 10mins
Croup
Page 37
What happened
Scene: where are you
o Car:
damage where?
wearing seatbelt?
airbags deployed?
windshield condition
steering column damaged?
pedal conditions
o Motorbike:
helmet damage?
clothing damage?
General Environment
o rain/shine
o day/night
Index of Suspicion
o the gut feeling as to what is wrong
When to Immobilise:
o MVA
frontal impact (whiplash, etc.)
rear impact
roll-over (most dangerous)
t-bone
o PVA
legs hit first
can have other upper body injuries
o Fall from a height
mostly leg injuries
o Sport injuries
high tackle (rugby)
stepping wrong
o Blunt force trauma
cricket/baseball bats, pots, etc
o Penetrating trauma
knives
guns
o Environmental
diving
lightning
Page 38
Shock
The inability of the microcirculation to adequately perfuse the organs due to a breakdown of the cardiovascular system.
A breakdown in the heart, blood vessels, or fluid in the blood can lead to shock.
Signs & Symptoms:
o weak, tachycardia
o cold, clammy skin
o pale
o hypotensive/drop in BP
sympathetic nervous system
o cyanosis
o delayed capillary refill
o pupils dilated
o anxious (depending on LOC)
Hypovolemic Shock
The loss of volume in the vessels due to:
diarrhoea
emesis (vomiting)
Cardiogenic Shock
Basically an AMI
Neurogenic Shock
The loss of volume in the vessels due to spinal cord damage (usually) in the cervical area.
Above injury:
o cold & clammy
o sympathetic nervous response
Below injury:
o flushed & dry
o parasympathetic nervous response
o vessels dilate
bradycardia
possible pria prism
Septic Shock
The vessels dilate due to damage to vessel walls from toxins in the blood. Vessels then begin to leak causing:
low BP
tachycardia
yellow skin colour (liver cant filter toxins)
Anaphylactic Shock
This is due to an allergic reaction. Bronchioles constrict causing wheezing and dyspnea.
Treatment: call for ALS and nebulise
Page 39
Stages of Shock
INITIAL
hypoxia
damage to cell
membrane
metabolic acidosis
organs deprived of O2
COMPENSATING
hyperventilation to rid
body of CO2 levels
hypotension leads to
adrenaline &
noradrenalin release
leading to
increase in HR and
vasoconstriction leading
to
increase in BP
Page 40
DECOMPENSATING
failure of bodys
mechanisms
vital organs are
compromised
endotoxic shock due to
bacteria
HR + BP decrease
less perfusion
REFRACTORY/IRREVERSABLE
brain damage
cell infarction
death due to vital organ
failure
Bleeding
Internal
o Cavities
chest
abdomen
femur
pelvic
External
o Anything out of the body
Types of Bleeding
o Arterial
bright red
pulsates
o Venous
dark red
flows
o Capillary
red
oozes
To stop Bleeding:
o direct pressure
o indirect pressure (bandages)
pressure bandage
first aid dressing/trauma pad
roller bandages
gauze
o elevation
o pressure points
o tourniquet
Basically stop the red stuff from coming out!
Abrasion (graze)
o painful, burns, epidermal layer is removed
Contusion (bruise)
o capillaries under the skin break
Laceration (cut)
Avulsion
o a flap of skin
o often from head injuries (scalp)
Puncture (hole)
Haematoma
o severe contusion (more vessels are broken)
o swelling involved
Eccymosis
o mastoid process/head injuries
o small blue contusion
o a.k.a.: battle signs
Bites
Page 41
Abdominal Injuries
Hollow organs
o stomach, intestines, ureters, bladder
Solid organs
o liver, spleen, pancreas, kidneys
Abdominal Injuries
Closed
o peritonitis
soft organs spill contents into peritoneal cavity
intense inflammatory reaction and possible infection
intense pain
tenderness
muscular spasm
can become life threatening
o blunt abdominal wounds
severe bruising
laceration of liver or spleen
intestine rupture
kidney rupture or avulsion from arteries and other vessels
bladder rupture (especially if distended at time of injury)
intra-abdominal haemorrhage
be ready to treat for shock (hypovolemic)
seatbelt injuries (rib fractures, organ compression)
airbag injuries
Open
o penetrating injury
usually have obvious external bleeding
suspect large amounts of internal bleeding
very painful
nausea, vomiting
be ready to treat for hypovolemic shock
o abdominal evisceration
organs or fat protrude through the wound
never try to replace
cover with moist sterile gauze and secure in place with bandages and tape
keep the organs as warm as possible
get to hospital asap
Genitalia
o always very painful
o rarely life threatening, but can be a great concern to the patient
o managing blood loss is top priority
o calm and reassure patient, make them feel as comfortable as possible
Rectal bleeding
o can be caused by sexual assault, haemorrhoids, colitis or ulcers in the intestine tract or stomach
o large amounts of blood loss can lead to hypovolemic shock
Page 42
Facial Injuries
Treatment
o control & manage breathing as far as possible (OPT, lateral, etc.)
o control bleeding
o transport to hospital
Types of Injuries
Nose
o
o
o
o
o
o
Ear
Facial Fractures
o usually a result of blunt force trauma
o most major blows to the facial region results in fractures
o possible signs & symptoms of facial fractures:
bleeding in the mouth
inability to swallow or talk
absent or loose teeth
movable bone fragments
patient says it doesnt feel right
o bleeding can cause respiratory problems
o swelling can cause airway obstruction
o remove dislodged teeth and/or dentures (false teeth) and transport in container with patient
Throat/Neck
o Blunt injuries:
usually involve the trachea or larynx
cartilage does not spring back after crushing therefore major airway obstruction
subcutaneous emphysema can occur if air leaks into the soft tissue
o Penetrating injuries:
can cause profuse bleeding (carotid artery & jugular vein) or air embolism
always maintain cervical spine stabilisation
Page 43
Eye Injuries
Types of Injuries
Foreign objects
o Small: e.g. sand, dust, etc.
can cause severe irritation
usually stuck in the conjunctiva causing redness and swelling
eyes begin to water to flush object out
irrigate with saline solution (from nose outward)
o Large: e.g. metal, fish hook, pencil, etc.
severe pain and irritation
must be removed by a professional (doctor)
stabilise object and transport to hospital
Burns
o
Chemical
caused by acid/alkali substance
flush eye with saline for 5-20mins asap (depending on strength of substance)
transport to hospital
continue flushing with saline during transport if possible
Thermal
eyes usually closed in fire but eyelids burnt
do not attempt to do anything with the eye
cover with moist, sterile dressing
transport to hospital immediately
Light burns (e.g. sunlight, laser, infrared)
damages sensory cells
usually no pain, but permanent damage to vision usually occurs
apply moist, sterile dressing
transport to hospital
Lacerations
do not apply pressure
cover with moist, sterile gauze
transport to hospital
Blunt trauma
usually forms a black eye (bleeding into the orbits)
may see hyphema (bleeding into the anterior chamber of the eye)
transport to hospital if patient experiences pain, double vision or decreased vision
Page 44
Chest Injuries
Blunt
Penetrating
Pneumothorax
Cause
Signs & Symptoms
Treatment
Haemothorax
Cause
Signs & Symptoms
Treatment
Due to ruptured blood vessels and blood entering the pleural space. There is
more blood than air. Usually caused by fractured ribs piercing pleura and vessels.
decreased air entry
hyporesonance
can become hypovolemic
hypotension
tachycardia
ALS backup
transport to hospital
Pericardial Tamponade
Cause
Signs & Symptoms
Treatment
Fluid leaking into the space between the myocardium and pericardium.
tachycardia
Becks Triad:
narrowing pulse pressure
muffled heart sounds
JVD
ALS backup
oxygenate
transport to hospital
Page 45
Flail Chest
Cause
Signs & Symptoms
Treatment
Two or more fractures in two or more places on two or more adjacent ribs.
paradoxical motion
intense pain
contusions
crepitus
very shallow dyspnea
guarding
oxygenate
transport to hospital
take careful note of haemo or pneumothorax
Contusions
Pulmonary Contusion:
o haemoptysis
o pain
o dyspnea
Myocardial Contusion:
o irregular rhythm
o some chest pain
Fractures
Please
Drop
Six
Cents
In
Uncle
Teds
Cup
Dankie
- Pain
- Deformation
- Swelling
- Crepitus
- Inflammation
- Unequal
- Tenderness
- Contusions
- Discolouration
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How to Treat
expose
check open/closed
check for distal pulse
capillary refill
sensation
motor response
skin colour
temperature
medial rotation
treatment:
o
same assessment
traction first
then strap
reassess vitals
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Head Injuries
Concussion
Cause
Signs & Symptoms
Treatment
Inter-cranial Haemorrhage
Cause
Signs & Symptoms
Treatment
Base of Skull #
Cause
Signs & Symptoms
Treatment
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coup/contra-coup motion
Cushings Reflex:
decrease in pulse rate
increased blood pressure
irregular respiration
oedema
increased cranial pressure
bleeding
decreased LOC
projectile vomiting
seizures
hypoxia
Treatment
oxygenate
transport to hospital PFQ
Snakes
Cytotoxic
o Causes blood cells do stop doing their job and begin disintegrating causing intense pain and swelling
Neurotoxic
o This causes neurons in the brain to die causing the body to stop functioning. The first system to shut down is
usually the respiratory system (located at the top of the spinal cord).
Haemotoxic:
o Prohibits the forming of platelets and the clotting of blood. Its an anti-coagulant that basically liquidises the
internal organs.
Organophosphates
Burns
Types
o superficial (epidermis red, sore)
o partial thickness (epidermis + dermis red, blisters, very sore)
o full thickness (all layers charred, site of burn not sore (no nerves))
Critical locations
o hands
o feet
o inhalation
o genetailia
o 20 30% full thickness (based on rule of 9s)
Treatment
o 1. Burnshield
o 2. Saline
o 3. Water
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