• Patients that are apneic and have weak pulses that are pulled from cold
water with unknown submersion time should be provided rescue breathing,
remove his wet clothing, immobilize his entire spine, keep him warm, and
...
• Patients that are apneic and have weak pulses that are pulled from cold
water with unknown submersion time should be provided rescue breathing,
remove his wet clothing, immobilize his entire spine, keep him warm, and
transport carefully.
Hypothermia is diagnosed when the core temp of the body –the temp of the
heart, lungs, and vital organs-falls below 95*F (35*C)
Never assume that a cold, pulseless PT is dead. PTs may survive severe
hypothermia if proper emergency care is provided. It is critical that you
perform an extended pulse check (up to a full minute). Asses at the carotid or
femoral pulse. A PT in apparent cardiac arrest from hypothermia should not
be considered dead until aggressive rewarming has been attempted, along
with resuscitation. No one is dead unless they are warm and dead.
• Patients that are hypotensive and have bilateral femur fracture; their
legs should be bound together on the backboard, kept warm, and transported
immediately.
The most common life-threatening musculoskeletal injuries are multiple
fractures, open fractures with arterial bleeding, pelvic fractures, bilateral
femur fractures, and limb amputation. All PTs with a hip fracture (fractures
of the proximal femur) may have a significant amount of blood loss.
Therefore, you should treat with high-flow O2, monitor vital signs
frequently, and be alert for S/S of shock. Following a fracture, the large
muscles of the thigh spasm in an attempt to “splint” the unstable limb. The
muscle spam often produces significant deformity of the limb, with severe
angulation or external rotation at the fracture site. If the fracture is open
(fragments of bone protruding through the skin) never attempt to push the
bone back into the skin. After a femur fracture there is usually a significant
amount of blood loss, thus it is not unusual for hypovolemic shock to
develop. Handle these PTs with care because any extra movement or fracture
manipulation may increase the amount of blood loss. If there are no distal
pulses or PMSCs are off, apply gentle longitudinal traction to the deformed
limb in line with the long axis of the limb. Gradually turn the leg from the
deformed position to restore the limb’s overall alignment. Often this restores
or improves circulation to the foot. If it does not, the PT may have sustained
a serious vascular injury and may be in need of prompt medical attention. Afracture of the femoral shaft is best stabilized with a traction splint, such as a
Sager splint.
• Patients that are kicked or punched in the abdomen, have stable vital
signs, and do not have any c-spine injuries should be transported in the
position you find them (aka: position of comfort). / And keep them warm..
Pain in the abdomen can often be deceiving because it is often diffuse
in nature and may be referred from the site of injury to another location in
the body. In PTs with liver and spleen injuries, and bleeding into the
peritoneal space, pain is referred to the shoulder. Bleeding from an injury to
the spleen can result in referred pain to the tip of the left shoulder. when a
PT reports pain that is tearing and describes it as going from the abdomen
posteriorly, he or she is often describing symptoms of an abdominal
aneurysm that is dissecting. pain that is following the angle from the lateral
hip to the midline of the groin can be the result of damage to the kidneys or
the ureters. Pain in the right lower quadrant can indicate an inflamed or
ruptured appendix. A PT who sustained a blunt abdominal injury should be
log rolled to a supine position unto a backboard.
• Suction the oropharynx for 15 seconds maximum.
Suction with the appropriate suction tip, suction while moving out of the
mouth.
• When one eye is injured, cover both eyes to minimize movement and
damage to the injured eye.
• Patients in anaphylactic shock should be administered a dose of
epinephrine with an auto-injector, record the time of the injection, and
transport immediately.
Also note PTs condition before use of drug, including if possible VS, note
why you used the drug, dose, route, and time used. Then note condition PT
condition after use of drug, and vital sings after, and response to drug.
• When a patient becomes unresponsive, pulseless, and apneic during
transport, you should stop the ambulance, begin CPR, and attach the AED as
soon as possible.
• If a metal object such as a bicycle kickstand impales a patient, it would
be best to unbolt the kickstand from the bike frame and stabilize it with
bulky dressings.• The palm of the patient's hand is equal to one percent of his or her total
BSA 2//// for an infant, the head is equal to 18% and legs are 13.5%. for a
small child the head is 12% and legs are 16.5%. Adult head is 9% and legs
are 18%. Front and back are 18% arms are 9% and groin is 1%
• Many patients with Down syndrome also have heart conditions.
Is characterized by a genetic chromosomal defect resulting in mild to
severe intellectual impairment. The normal human somatic cell contains 23
pairs of chromosomes. In most cases, Down syndrome, also known as
trisomy 21, occurs when the two 21st chromosomes fail to separate, so that
the ovurym or sperm contains 24 chromosomes. Also have thyroid
problems; and hearing and vision problems. Increased risk for medical
complications, including those that affect the cardiovascular, sensory,
endocrine, musculoskeletal, dental, and gastrointestinal systems, as well as
neurologic development. airway management is difficult because most have
larger tongs, and small oral and nasal cavities.
• The most likely cause of a depressed skull fracture of a patient who
suffered a blast injury would be the stationary object they hit when thrown.
Result from high-energy direct trauma to the head with a blunt object. The
frontal and parietal bones of the skull are most susceptible to these types of
fractures because the bones in these types of fractures because the bones in
these areas are relatively thin. As a consequence, bony fragments may be
driven into the brain, resulting in injury. The scalp may or may not be
lacerated. PTs with depressed skull fractures often present with neurologic
signs. Loss of consciousness.
• Respiration is the process of gas exchange, whereas ventilation is the
movement of air between the lungs and the environment.
• Patients that are partially immune to a particular disease may develop
illness from germs that lie dormant from the initial infection.
Sepsis or secondary infection.
• Two pieces of equipment to take with you, in addition to your red bag,
should be an AED and portable suction unit.
• Hyperglycemia can only be corrected in the hospital setting
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