Atelectasis
The collapsing of the alveoli
List Orlowski predictors
- Patient is under three years old
- Patient has been submerged for less than five minutes
- Resuscitation begins within 10 minutes of submersion
- Patient is not comatose at hospital
- Patients pH acidity does not fall below 7.1
Any patient who meets three or more of these criteria has less than a 5% chance of survival
What is a dry drowning
The lyrics spasms and closes and does not allow for water to go into the lower airway
What is surfactant
A substance that maintains surface tension in the alveoli to keep them from collapsing
Body temperature of hypothermia
Court temperature of 95 Fahrenheit or 35 Celsius
Can an AED be used on a Hypothermic patient?
Yes
Mammalian
diving
reflex
Water colder than 70°F it’s the face and causes mammals to peripheral vasoconstriction , heart rate slows , tightening of the larynx and sending all the bodies oxygen to the brain and heart
Define dependent lividity
Purpleish color caused by blood pooling in the lowest areas of a dead body
When do You place your hand over the epigastric area of the amp demand and apply firm pressure to a drowning patient
When they have gastric distention that impedes their ability to ventilate properly
What is
dysbarism?
A medical condition that results from the effects on the body from changes in ambient pressure
Boyles law
At a constant temperature the volume of a gas is inversely related to the pressure
Dalton’s law
The total pressure of a mixture of gases equals the sum of the partial pressures of the individual gases that make up the mixture.
For example the air we breathe is approximately 78% nitrogen the air pressure at sea level is 760MMHG to pursue the pressure of nitrogen at sea level is 78% of 760 which equals 593, as a diver goes deeper the pressure of each component gas in the air increases proportionally the pressure of the inhaled Nitrogen increases, the nitrogen begins to dissolve into the blood Dash other gases in the mixture do not have this action. Nitrogen in the blood affects the electrical properties of the brain and at 50 feet of depth is equivalent to one alcoholic drink called nitrogen narcosis
What is
nitrogen
narcosis
What causes it
It is a drunken feeling that deep divers get at 50+ feet it’s caused by nitrogen being forced and dissolved into the blood which then affects the electrical properties of the brain
Henry’s law
At a constant temperature of the amount of gas that dissolves in a liquid it is in contact with is proportionate to the pressure of the gas around it.
What is decompression sickness or DC S
Also known as the bins, divers disease or Kyson disease is caused by dissolved gases in the body’s blood primarily plasma and body fat forming bubbles as the diver ascends.
The bubbles have two primary effects on the body: first they act as emboli causing obstructions in circulation and secondly they compress or stretch the blood vessels and nerves the bubbles can also cause coagulation of blood to occur as a result the vessels and tissue release substances like in an allergic reaction the substance is produce signs and symptoms similar to those of an allergic reaction
For one person CPR on a newborn what is the ratio of compressions to vent elation
Three compressions to one Malaysian
What is the ratio of compressions to been elation for one person CPR in an infant
30 compressions at a rate of at least 100 per minute and no greater than 120 per minute to ventilations
Ratio of compressions to ventilation for a child one year of age to adolescent
30 compressions at a rate of at least 100 per minute or no greater than one20 per minute to two violations
five types
of consent
Informed expressed implied minor and involuntary
4 tems must be demonstrated what are they
EMT had duty to act
Breached the duty
Harm
Link established between breach and harm
What is the
perineum
Soft tissue between the vagina in the rectum
What is the fundus
Top portion of the uterus
Describe the cervix
Nero tapered neck of the uterus that meets the birth canal
What is the
bloody show
The mucous plug is discharge from the cervix win the service dilates the expulsion of the plug signals the first stage of labor
Hyperemesis gravidarum
Severe nausea morning sickness and severe vomiting typically Lasting throughout the entire pregnancy
Placenta previa
The placenta completely covers the cervix locks the birth canal can prevent delivery as the cervix dilate significant bleeding there are three types total partial and marginal
Abruptio
placentae
Premature separation of the placenta from the uterine wall prior to the birth of the baby
List of physiologic changes pregnancy
At the end of pregnancy uterus weighs 2 pounds and holds 5000 mL of fluid
- The uterus contains 16% of the total blood volume of the mother
- Hormones cause smooth muscle dilation in the respiratory track
- Tidal volume increases by 40% we are functional reserve volume decreases leaving the mother with respiratory reserve
- Increase and O2 consumption approximately 20%
- Maternal blood volume increases by 45% also increases in red blood cells which delays the signs and symptoms of shock in a pregnant patient
- Mom’s heart rate increases by 10 to 15 bpm
- Blood pressure decreases slightly during the first and second trimester returns to normal in the third
- Bladder is displaced superiority and anteriorly increasing the risk of injury
Predisposing factors for Abruptio placentsee
Hypertension, use of cocaine or other Vasoactive Drugs, preeclampsia, multi party several births, previous abruption, smoking, short umbilical cord, premature rupture of the amniotic sac, diabetes mellitus, trauma
Preeclampsia
A form of hypertension and pregnancy less severe than eclampsia in which seizures or, may develop both are life-threatening
Hypertension
High blood pressure
Hallmark sign and symptom of abruptly placental
Vagina bleeding with abnormal pain and tenderness in the second half of pregnancy
- Vagina bleeding can be severe, minimal, or absent, depending on the location of the head
- Abdominal tenderness upon palpation
- Constant abdominal pain uterine muscle spasms can be mild or sharp and acute Payne will be even between contractions when giving birth
- Signs of hypovolemic shock if bleeding is severe or occurs over a longer period
- Pain in the lower back
Hypovolemic shock
Shot caused by the loss of blood or fluid from the intravascular space resulting in a low blood volume
How much blood can be concealed in the uterus
2.5 L
Assessment findings that should alert you to a ruptured uterus
History of previous uterine rupture
History or findings of abdominal trauma
History of a large fetus
Having born more than two children
History of prolonged and difficult labor
Tearing or sharing sensation in the abdomen
Constant and Severe abdominal pain and nausea
Signs of hypovolemic shock
Vagina bleeding can be minimal or severe
Stopping of noticeable uterine contractions
Ability to palpate the infant in the abdominal cavity especially an arm or leg
Hypercarbia
Increased carbon dioxide in the blood stream
How is pregnancy induced hypertension measured
Blood pressure in a pregnant woman that is greater than 140/90 on two or more occasions at six hours apart
Also
If the patient has low blood pressure prior to pregnancy an increase in the systolic greater than 30 and a diastolic greater than 15 above baseline
Women at the highest predisposition for a clamp Sia have these traits
Women with a history of diabetes, heart disease, kidney problems or high blood pressure or at greatest risk
Signs and symptoms of preeclampsia
Elevated blood pressure 140/90 or a systolic increase of over 30 and or diastolic increase of more than 15
Blood pressure of 160/110 or higher
Pulmonary edema such as cracks upon auscultation respiratory distress and SPO2 reading of below 94
AMS
Right upper quadrant pain
Nausea and vomiting
A decrease in urine output
Severe persistent headache
Respecters and pregnant patients for developing preeclampsia
Pregnant for the first time
Pregnant with multiple gestation’s twins triplets or more
History of previous preeclampsia
Obesity
Diabetes mellitus
Connective tissue disorders
Pre-existing hypertension
Diabetes mellitus
Changes in patient’s mental status from alterations in blood glucose brain cell damage and death can occur if blood glucose which is a little level
Treatment for emergency medical care of a pre-delivery emergency
High concentration oxygen 15 PM by nonrebreather regardless of SPO2 levels if seizure begins administer PPV during the seizure reduce noise and movement is this can bring on seizures transport without lights and siren
Supine hypotensive
Second or third trimester complication occurs when the weight of the fetus compresses the Pierier vena cava when the patient is supine reducing blood flow to the right atrium which decreases the preload
How do you perform a tilt test
Placed patient in supine position take heart rate and blood pressure wait two minutes stand the patient up take the heart rate and blood pressure a second time if the heart rate increases greater than 10 to 20 bpm in the systolic blood pressure decreases by 10 to 20 mmHg do you have a positive orthostatic or tilt test indicate significant loss of blood or Fluid volume
Gravida
The number of pregnancies usually reported as grabbed it and then, a primagravida is your patients first pregnancy
Para
Refers to a woman who has given birth to a fetus of 20 weeks of gestation or or greater regardless of whether it was a live birth or still born
Para one would indicate a mother who gave birth for the first time or wants to one or more children
Signs and symptoms of antepartum emergencies
Abdominal pain nausea vomiting
Vagina bleeding passage of tissue
Weakness dizziness
Altered mental status
Seizures
Excessive swelling of the face and extremities
Abdominal trauma
Hypovolemic shock
Hypertension blood pressure greater than 140/90 or greater than 30 systolic and 15 diastolic over her baseline
Normal labor is divided in three stages
Dilation, expulsion, placental delivery
What happens in effacement
When does the cervix fins to allow the fetus to come through and delivery
When does the dilation stage end
The dilation stage is when contractions are a regular 3 to 4 minute intervals last at least 60 seconds each and feel intense
How is the interval of contractions measured
From beginning to beginning
Braxton Hicks contractions
Painless short a regular can of her early 13th week of gestation thought to be a Conditioning process for the uterus no cervical dilation or effacement
Cephalic
Delivery
Also called a vertex presentation this is the normal presentation delivery the face position downward with the occiput of the head facing upward which is referred to as occiput anterior
What determines pregnancy induced hypertension
Blood pressure greater than 140/90 on two or more occasions six hours apart
The signs that the delivery of the placenta or eminent
1-Set an increase in bleeding from the vagina
2-Uterus become smaller in size
3-Umbilical cord lengthens
4-Urge to push
Describe rule of thumb for gestational period by looking at the mothers anatomy
Bulger reaching to the umbilicus is 20 weeks, reaching to the xiphoid process is 38 weeks then dropping in Whiting is 40 weeks and ready to birth
Indicators of
eminent
Birth
Crowning
Contractions less than two minutes apart in tents and last from 60 to 90 seconds
Mom feels babies head moving down the birth canal I E urge to poo
Mom has strong urge to push
Abdomen extremely hard
What do you do if delivery is eminent but the head does not come through the cervix within 10 minutes
Contact medical directive and prepare to transport
What is your assumption if the head is presented in the cervix and then disappears in the mother complains of sharp intense constant abdominal pain
Possible uterine rupture the fetus may be expelled into the abdominal cavity
Nuchal cord
When the cord is wrapped around the baby’s neck
Prolapsed
Cord
Cord presents before the baby at the cervix
Knee chest
Position
Kneeling in the bent forward face down head down chest to knees and place the stretcher in a steep Trendelenburg position
Breech
Birth
But or lower extremities present in the cervix
Describe the three types of breech birth
Frank breach- But first knees extended against the abdomen
Complete breach- But first flexed hips bent knees
Incomplete breach- One or both feet are the presenting part
Compound
When the arm or leg into the birth canal and presents with the head or buttocks
Turtle sign
When the fetal shoulders are larger than the head to head delivers but then retracts into the vagina because the shoulders are caught
Terms
For
A
Baby
Newly born
At the time of birth
Newborn
Within the first few hours of birth
Neonate
Within the first 28 to 30 days after birth
Infant
From 28 to 30 days to one year of age