Based off chaper 18-19 of Nancy Caroline's emergency medical care in the streets
Localized myocardial ischemia
Any condition that causes increased preload
Decompensated congestive heart failure
Damage to more than 10% of the left ventricle
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Dehydration
External bleeding
Diabetic ketoacidosis
Plasma loss from burns
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Postural syncope when standing up
A furrowed tongue or shrunken eyes
Tenting of the skin when it is pinched
A decreased pulse rate upon standing
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Profound vomiting and diarrhea cause by bacterium
Increased microvascular permeability and capillary leakage
Widespread vasoconstriction and preferential blood shunting
Persistent fever that results in internal loss of body fluids
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An absence of sweating
A rapid, bounding pulse rate
Cool, clammy, and pale skin
Hemiplegia or hemiparalysis
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Experiences urticaria and rhinorrhea after exposure to an allergen
Reacts violently to a substance to which he or she has been sensitized
Experiences a mild allergic reaction after initial exposure to an allergen
Develops a heightened reaction to a substance deemed foreign by the body
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The precapillary sphincters remain constricted
Oxygen cannot diffuse across the cellular membrane
The postcapillary sphincters remain constricted
Of aerobic metabolism and carbon dioxide production
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Inhibits hemoglobin in the red blood cells from binding with and carrying oxygen
Results in potent vasoconstriction and constriction of the postcapillary sphincters
Immediately depresses respiratory system function, resulting in severe hypoxemia
Causes a decrease in hydrogen ion production and an increase in the pH of the blood
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Noncardiogenic pulmonary edema
Increased lactate metabolism by the liver
Marked decrease in cardiac ejection fraction
Decreased surfactant production by the alveoli
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The patient's level of consciousness is a poor indicator of perfusion, because he or she is generally restless
An increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset metabolic acidosis
Chemical mediators released by the autonomic nervous system result in significant increase in blood pressure
Pulse pressure widens as the sympathetic nervous system releases catecholamines in response to poor perfusion
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Anxiety or agitation
Dilation of the pupils
Absent peripheral pulses
Response to painful stimuli
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A marked increase in cardiac afterload
A systolic BP that is less than 90 mm Hg
Vascular dilation and decreased blood flow
Sympathetic nervous system compensation
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Establishing a patient airway
Forming a general impression
Vascular dilation and decreased blood flow
Sympathetic nervous system compensation
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Pale, cool, clammy skin
Sluggishly reactive pupils
An altered mental status
An increased diastolic blood pressure
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Applying warm blankets
Controlling major bleeding
Establishing a patent airyway
Following BSI precautions
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In a semi-sitting position
Supine with the legs elevated
In the trendelenburg position
On the left side with the legs elevated
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They remain in the vascular compartment for up to 4 hours
You should give 2-3 times the volume of blood lost
They improve tissue perfusion by carrying oxygen to the cells
20% of the solution quickly diffuses out of the intravascular space
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Administer a 1000 mL crystalloid bolus if the patient's lungs are clear
Dopaine infusions greater than 10 mcg/kg/min often cause bradycardia
Norepinephrine is the vasopressor of choice for prehospital blood pressure support
Prolonged efforts to stabilize the patient in the field are not recommended
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Diphendydramine
Epinephrine
Ipratropium
Albuterol
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Antidepressants
Acetaminophen
Antihypertensives
Corticosteroids
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An obese patient
A bedridden patient
A hypertensive patient
A patient with diabetes
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8
10
12
18
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Tetanus
Gangrene
Fasciitis
Lymphedema
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Inflammation of the injured blood vessels
Ruptured of large blood vessels in the dermis
Aggregation of platelets to the injured site
Leakage of fluid into spaces between the cells
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How the wound is managed
The location of the wound
The patient's medical history
How large the open wound is
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Is limited because the skin is unbroken
Generally requires surgical intervention
Is not significant enough to produce shock
Can usually be controlled with direct pressure
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Lacerations are linear cuts that tend to heal well due to their relatively even wound margins
The seriousness of a laceration depends on its depth and the structures that have been damaged
The first priority in treating a laceration is to cover it with a sterile dressing to prevent infection
A laceration must be sutured or otherwise closed within 8-10 hours following the injury
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Is initially treated by applying a proximal tourniquet and retrieving any detached body parts
Causes less blood loss than expected because the blood vessels retain their ability to constrict
Cannot be surgically reattached due to the severe vascular and soft tissue damage that accompanies it
Can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly
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Rhabdomyolysis
Myoglobinuria
Hyperphosphatemia
Necrotizing fasciitis
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Compartment syndrome is more likely to occur with closed injuries
Compartment syndrome is caused by increased pressure within the bone
Definitive treatment almost always includes amputation of the affected limb
Local tissue death occurs after 2 hours of persistent compartment syndrome
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The patient is thrown against a solid object
The pressure wave damages air-filled cavities
Full thickness flash burns occur to the body
Flying shrapnel may cause penetrating injuries
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Paxil
Procrit
Plavix
Tylenol
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Irrigate with sterile water and apply a sterile dressing
Apply a pressure bandage and elevate the extremity
Elevate the extremity and administer 100% O2
Gently pick out any foreign bodies with hemostats
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Their use may result in severe hypothermia
They are of no value in providing pain relief
Their sterility cannot be maintained in the field
They provide a medium for pathogens to grow
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Pressure stimulates the release of fibrin
Direct pressure facilitates vasoconstriction
It allows platelets to seal the vascular walls
Pressure shunts blood away from the injury
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Most patients do not keep the extremity still when asked to do so
Most open soft tissue injuries are associated with a fracture
Splinting is an excellent means of providing relief from pain
Motion of the extremity may disrupt the blood clotting process
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Apneic patient with a shard of glass impaled in the center of the chest
Pulseless and apneic patient with a knife impaled in the lower abdomen
Cardiac arrest patient with an ice pick impaled in the center of the back
Semiconscious patient with a screwdriver impaled in the side of the head
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Airway compromise
Hypovolemic shock
Injuries to the eyes
Preventing contamination
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Assess perfusion and sensory and motor functions every 5 minutes
Make every effort to treat the patient before removing the crushing object
Infuse 2 liters of lactated ringers solution to combat hyperkalemia
Give sodium bicarbonate immediately after removing the crushing object
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Nerve damage
Infection
Disfigurement
Hemorrhage
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Providing the immune response for the body
Protecting the underlying tissue from injury
Sensing changes in the external environment
Assisting in the regulation of body temperature
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Fibrin
Elastin
Collagen
Melanin
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Causes a decrease in the production of macrophages and lymphocytes, thus increasing the risk of infection
Commonly destroys the stratum corneum, the deep dermal layer of the skin, and causes nerve damage
Promotes cutaneous vasoconstriction, which shunts blood away from the injury and manifests as pallor around the injury site
Triggers mast cells to degranulate and synthesize special chemical mediators, which causes the injured area to become warm and red
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Sebum
Elastin
Collagen
Ground substance
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Results in minimal external bleeding and typically heals spontaneously within 2-3 hours
Generally remains closed and does not require suturing or other methods of wound closure
Often remains open, heals more slowly, and is more likely to result in abnormal scar formation
Does not disrupt the body's blood-clotting process and tends to heal without the formation of a scar
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Permanently stops the wound from bleeding and facilitates healing
Is a physiologic process in which the body's platelets are destroyed
Occurs when the bone marrow transiently produces more red blood cells
Temporarily stops bleeding via vasoconstriction and platelet aggregation
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New blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue
Histamine makes the capillaries more permeable, resulting in swelling in and around the injury site
Collagen provides stability to the damaged tissue and joins wound borders, thereby closing the open tissue
Microscopic vasculature damaged by the injury is digested by macrophages through a process called phagocytosis
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The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passess
Injuries from a shotgun blast are most devastating when the distance between the gun and the target is more than 100 yards
Wounds to lower extremities that are not associated with a fracture or neurovascular compromise are always explored surgically
Tissue of high elasticity, such as muscle, is less able to tolerate temporary cavitation than tissue of low
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