Respiratory
Audible wheezing on inspiration/expiration
Bronchospasms
Usually presents with a hx of this condition
Commonly treated with albuterol inhaler
Asthma
Pt is a 59 y/o male presents diaphoretic w/ nausea and generalized weakness. He complains of constant chest pain described as "crushing" that radiates into his neck and to his left arm.
Acute Myocardial Infarction
Pt. is a 38 y/o female w/ a C/C of "throbbing" headache. She endorses N/V and photophobia. States she has a hx of these headaches.
Migraine Headache
Pt. is a 14 y/o female who complains of dull umbilical abdominal pain. States the pain radiates to her RLQ . She is nauseas. When you palpate her abdomen, she is guarding. No hx of abdominal surgeries.
Appendicitis
In a patient with a hx of DM, what are 3 signs that they may be experiencing a hyperglycemic episode?
AKA the "3 P's"
Name and define them
Polyuria - more frequent urination
Polydipsia - increased fluid consumption
Polyphagia - increased food intake
Child presents with a fever, barking cough, and stridor
Croup
Pt with a hx of HTN, presents w/ a severe headache described as "the worst headache of my life", tinnitus, and a bounding pulse. There BP is 208/114.
Hypertensive Emergency
Pt. family states the pt. started to slur their words and told them there left arm went numb. Pt. has a hx of HTN. States the patient is not acting right.
CVA - Stroke
Patient is 45 y/o male who complains of right-sided flank pain. States he feels warm to the touch and the pain has gotten worse since this morning. States he feels like he has to urinate but is unable to and it hurts when he attempts to use the bathroom.
Kidney stone
If you patient has a hx of DM, and is experiencing AMS, what is your index of suspicion and what medication (in your scope of practice) can you administer ?
State the 7 Rights as well
Hypoglycemic episode
Blood glucose < 60 mg/dL
Oral glucose - 15 grams (full tube), PO
do not give if pt. is unable to swallow
Adult patient with a hx of tobacco use weighing 60 kg presents with dyspnea on exertion. Associated barrel chest and pursed lip breathing, appears cyanotic
Emphysema
Your patient needs a medication (within your Scope of Practice) to relive there chest pain. What two medications would fall into this category? What is the correct dose? Route? Name two indications and contraindications for each?
Aspirin (ASA) - 81 mg chewable tablets x 4(324 mg)
PO
Chest pain, hx of MI,
Allergies, or hx of GI bleed
Nitroglycerin - 0.4 mg every 5 min, MAX (1.2 mg)
sublingual
Chest pain, ASA given with no relief
PDE-5 inhibitors within 24 hrs, systolic BP < 100
Your pt. called 911 themselves because they woke up on the ground very confused and it appears they have urinated on themselves. They do not remember what happened and are breathing fast. What is this pt. most likely experiencing?
Postictal state after a seizure.
Pt. is a 63 y/o female who states she has a "problem with her kidneys". States she missed "some appointment" because her car is broken down. Pt. is a poor historian. What can you infer about this pt's hx? What should you be looking for on this patient?
What is the tx for you as an EMT?
ESRD - end stage renal disease or kidney failure
Pt. is on dialysis
Pt. should have a shunt or fistula
Provide the patient with O2 and transport to a hospital with dialysis capability.
You arrive at a pts home who is complaining of a pain in the back of her calf. Pt. states her leg appears swollen to her. States she recently had a Total Knee Replacement done 2 days ago. Pt. takes no medications and has no significant medical history.
What is your DDx?
Deep Vein Thrombosis (DVT)
Pt presents with BLE pitting edema. Crackles are heard in the lungs bilaterally. Patient complains of difficulty breathing while laying flat.
Congestive Heart Failure (CHF)
These two heart rhythms are the two shockable rhythms identified by an AED during a cardiac arrest event
Ventricular Fibrillation
Pulseless Ventricular Tachycardia
You are asked by Professor Ayala to assess a Pt. for a stroke, what is your next course of action?
B - assess the gait of the pt.
E - Vision changes? loss?
F - any facial droop? smile!
A - Pronator drift?
S - Slurring words? aphasia?
T - LNK?
Pt states she has been having painful BM and states her stool is maroon in color.
Name the overlying possible Dx (be specific)
Name a reason for this symptom
Lower GI bleed
1. Diverticulitis
Name 3 blood disorders that you may encounter in the field and define each of them.
1. Sickle Cell anemia
odd shaped RBCs that lead to disfunction in oxygen binding
2. Hemophilia
decreased ability to create clot after injury
3. Thrombophilia
inhibits the body's ability to maintain the viscosity of blood, leading to spontaneous, harmful clots in these patients bloodstream.
Pt presents with sudden chest pain with dyspnea. Unilateral decreased breath sounds. Subcutaneous emphysema is present. Bystander states pt fell off her bike.
Pneumothorax
Your patient is complaining of constant chest pain and SOB. They just returned home from a 6 hour plane ride. They have a history of DVT and are taking Eliquis. What is your Ddx on scene?
Pulmonary Embolism
You are called to a Phlebotomy lab where a 89 y/o female is laying on the ground. She appears pale. Commonly known as a "VasoVagal" response, what is our pt. most likely suffering from?
BONUS:
Gather a pt assessment from Professor Ayala
Syncopal episode
Pt. is a 63 y/o male with a history of ETOH use. He complains of epigastric abdominal pain. States he is having a hard time swallowing and has been vomiting blood. His wife tells you he has been to the doctor before because his abdomen has been distended for a year, he has been losing weight, and he is always tired and the doctor told him to stop drinking.
Esophageal Varices
Patient is very ill-appearing on scene. They are breathing fast and deep. They appear altered and fatigued. You find out the patient has a hx of DM, you obtain a blood glucose level of 500 mg/DL. What is your DDx ?
Bonus:
What is the name of this breathing pattern?
What else would you expect to see from this pt?
DKA - Diabetic ketoacidosis
Kussmaul respirations
Fruity breath