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Medical Emergencies Paramedic Unit Exam FIsdap

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Understand the Concepts: Acid-base balance and buffering system of PH: Although the pH scale is concerned with acidity and alkalinity relative to pure water, for biological purposes, acidity and alkalinity relative to the typical range of the pH of blood is the primary focus. Blood has a normal pH range of 7.35-7.45. A pH that deviates far outside this range can be lethal. If a person has a blood pH of 7.35 the person is said to be acidotic or have acidosis, if a person has a blood pH of 7.45 the person has alkalosis or is alkalotic. The bicarbonate buffer system minimizes the impact on a systems pH from the onslaught of an acid or a base. Buffers are reactions in a dynamic equilibrium that can neutralize bases and acids without meaningfully affecting the pH. The maintenance of acid-base balance is crucial for survival. The body is relatively adroit at compensating for variations in pH by employing the acid-base buffer reaction.

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Medical Emergencies Paramedic Unit Exam
FIsdap



Understand the Concepts:
Acid-base balance and buffering system of PH: Although the pH scale is concerned with acidity
and alkalinity relative to pure water, for biological purposes, acidity and alkalinity relative to the
typical range of the pH of blood is the primary focus. Blood has a normal pH range of 7.35-7.45. A
pH that deviates far outside this range can be lethal. If a person has a blood pH of <7.35 the
person is said to be acidotic or have acidosis, if a person has a blood pH of >7.45 the person has
alkalosis or is alkalotic. The bicarbonate buffer system minimizes the impact on a systems pH
from the onslaught of an acid or a base. Buffers are reactions in a dynamic equilibrium that can
neutralize bases and acids without meaningfully affecting the pH. The maintenance of acid-base
balance is crucial for survival. The body is relatively adroit at compensating for variations in pH
by employing the acid-base buffer reaction.

Airway infections: Croup (laryngotracheobronchitis) is a common, primarily pediatric viral
respiratory tract illness. It is caused by swelling of the upper airways and is often preceded by
cold or flu like symptoms until the airway begins to swell. It is hallmarked by the barking seal like
cough. The treatment for this infection is often as simple as a change in environment. Epiglottitis
is a severe and often life threatening emergency characterized by swelling of the epiglottis caused
by infection with the flu virus. The typical presentation of the pt with epiglottitis is sitting bolt
upright to allow for the straightest pathway of air into the lungs, sore throat, drooling, hoarse
voice. The best treatment practice for these pt is eliminating sources of anxiety and providing a
calm environment. Be prepared to aggressively treat the airway in the event it becomes
completely closed off but do not manipulate the airway in any way unless absolutely necessary.

Bleeding disorders and the coagulation process: anemia is a deficiency in red blood cells or
hemoglobin. Iron deficiency anemia is the most common and is most frequently associated with
some other disease process. It can be from slow, long term blood loss, a decrease in overall
production of cells or an increase in red blood cells recycling in the liver or spleen. Red blood
cells can also be destroyed by an autoimmune disorder. Patients with anemia will complain of
feeling weak, tired and possibly SOB, especially with even minimal exertion. They may appear
pale in color. Treatment includes closely monitoring vital signs and ECG through transport and
treating any other symptoms as they arise. Polycythemia is the condition in which the patient has
an excess of red blood cells. This can be caused by several things such as hypoxia secondary to
high altitudes, COPD or overproduction of erythropoietin. The overall result is thickening of the
blood which can put the patient at risk for strokes, MI, DVT and PE. Hemophilia is a genetic
disorder that results in poor or no blood clotting. It is far more common in men than in women
because it is x-linked. Any bleeding in a hemophiliac should be treated as severe until proven
otherwise because even small lacerations or abrasions can bleed them into a life-threatening
situation. Falls or other accidents can be catastrophic for patients with hemophilia.

Differences between upper and lower GI bleeds: Gastrointestinal bleeding can be classified as
upper GI or lower GI depending on the location of the bleed. Generally speaking, upper GI is
considered everything through the small intestine and lower GI the lower intestine, rectum and
anus. The appearance of blood from a GI bleed can appear in any of four forms, hematemesis of




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, bright red blood, hematemesis of coffee ground looking blood, fully digested blood in the stool or
bloody diarrhea with red blood present and a smell like no other. Upper GI bleeds can be caused
by esophageal varices which is a condition in with the beins found in the inferior portion of the
esophagus are larger than normal due to a pressure in those veins primarily the result of
alcoholism or hepatitis C, and one of them ruptures, resulting in copious amounts of blood being
thrown up. Slower bleeds are often the cause of coffee ground like blood. Another common upper
GI bleed is Mallory-weiss syndrome which is a tear in the junction between the esophagus and the
stomach as a result of forceful, projectile vomiting. Lower GI bleeds are often caused by
hemorrhoids and anal fissures. Hemorrhoids are swelling and inflammation of the blood vessels
surrounding the rectum. They develop over time as a result of straining stool, chronic
constipation or pregnancy. Irritation can cause them to rupture and bleeding can be quite profuse.

Endocrine disease: Graves disease, or hyperthyroidism is the most common and most severe
form of hyperthyroidism, which can be fatal if left untreated. In Graves disease, the thyroid
increases in size as its activity increases. This enlarged thyroid is called a goiter and is visible on
the anterior neck of the patient. Patients suffering from graves have an increased appetite
combined with weight loss, polydipsia from excessive sweating and diarrhea. If graves is left
untreated it can cause a condition known as thyrotoxicosis or thyroid storm. In this condition,
excessive circulating thyroid hormones increase metabolism to unmaintainable high levels,
resulting in a critically ill patient. Here the patient will have a high fever, diaphoresis, tachycardia
and possibly nausea and vomiting. Patients can also be irritable, be in an agitated delirium, have
seizures or be unconscious.

Generic and trade names of meds:
Adenocard = adenosine
Proventil/ventolin = albuterol
Cordarone = amiodarone
ASA = aspirin
Midazolam = versed
Diazepam = valium
Cardizem = diltiazem
Diphenhydramine = benadryl
Nalaxone = narcan
Ondansetron = zofran
Amidate = etomidate
Haloperidol = haldol
Hydromorphone = dilaudid
Toradol = ketorolac
Methylprednisolone = solu medrol
I dunno how many you wanted us to put so I just thought of 15 off the top of my head lol

Pathophysiology of angioedema: a common manifestation of severe allergic reactions and
anaphylaxis is angioneurotic edema. It is marked edema of the skin and usually involves the head,
neck, face and upper airway. HIstamine acts by activating specialized histamine receptors present
throughout the body.

Pathophysiology of cranial nerve inflammation: there are 12 pairs of cranial nerves, and each one
serves a different function such as touch, pain, taste, sight, smell or motor. A cranial nerve
disorder is one that affects the connection between the cranial nerves centers of the brain and the



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