EMT signs and Symptoms

Mild shock

rapid thread pulse, rapid shallow breathing, pale skin, cool clammy, sweaty skin, weakness, dizziness, confusion, decrease in mental status

Moderate shock

Anxiety, agitation, Nausea, Thirst

Late shock

Vomiting, glassy eyes, decrease in mental status(further), Drop in blood pressure, Altered respirations, cyanosis, dilated pupils, coma

Status Asthmaticus

anxiety, wheezing, tachypnea, tachycardia, dyspnea, possible chest tightness(usually no pain), accessory muscle use, prolonged expiratory phase -forcing each breath out, "pursed lip breathing", coughing, does not respond to usual treatment

Acute Asthma attack

anxiety, wheezing, tachypnea, tachycardia, dyspnea, possible chest tightness(usually no pain), accessory muscle use, prolonged expiratory phase -forcing each breath out, "pursed lip breathing", coughing,

COPD

anxiety, may "tripod, dsypena, has trouble getting air in, accessory muscle use, pursed lip breathing, prolonged expiratory phase, abnormal breath sounds (wheezes, or rhonci), cyanosis or ruddiness, barrel chest

Pulmonary Edema

typically starts as mild or pronounced agitation, tachycardia, pale, cool, clammy skin, persistent cough usually non productive, crackles (in the lung base), severe dyspnea especially when lying down, eventually develop cyanosis, productive cough and poss

Pulmonary Embolus

sudden onset of dramatic agitation, Aphrension, sudden dramatic hyperventilation, sudden and dramatic dyspnea with congestion and shortness of breath, pleuretic chest pain (stabbing) especially on inhalation, tachypnea, tachycardia, hemoptysis, cyanosis,

Pneumonia

history of respiratory infection, fever, productive cough (possibly rust colored or greenish mucus) possibly some wheezing, chest discomfort of chest pain

FLU

sudden onset of fever and chills (out of nowhere 102-104), sever headache (photophobia), severe muscle aches and pain (legs and back mostly) cough (with substernal burning), worst symptoms last for 3-7 days but feel dragged down for weeks

Hyperventilation syndrome

usually severe agitiation, anxiety or fright, hyperventilation, progressive signs and symptoms of alkalosis, (light headedness dizziness, numbness, feeling of tightness, muscle twitching, carpal-pedal spasms, tetany, seizures, loss of consciousness

Epiglottis

fever, sore throat (difficulty swallowing, drooling) dyspnea, accessory muscle use, coughing

pleurisy

pleuritic chest pain, cough, history of respiratory infection

Adult Respiratory Distress Syndrome

Dyspnea and tachycardia,crackles

Angina Pectoris

Brought on by exercise, stress or eating to much, Feels like pressure or chest tightness, usually substernal or epigastric, sudden onset (usually 3-5 minutes) not past 10

Myocardial infarction

brought on by exercise, activity or stress (but sometimes nothing), feels like pressure or chest tightness , a weight on the chest, usually feels substernal or epigastric (usually on the left), usually lasts 30 minutes or longer, nausea, diaphoresis, dysp

Left-Sided CHF

slow onset, often over several days- may not be noticed till acute
Dyspnea, Shortness of Breath (SOB), productive cough
Orthopnea difficulty breathing when lying straight (supine)
Sitting up- often found propped p on pillows- may have spent the last eveni

Right sided CHF

Dependent Edema (pedal edema)
Jugular Vein Distention (JVD)
Liver engorgement (ascites)

Hypertensive Crisis

Hypertension with Angina, Pulmonary Edema, Pregnancy or signs of cerebral edema (such as usually severe headache blurred vision/visual disturbances, nausea and vomiting, altered mental status, focal neurological sign or deficits, paresthesias, dizziness,

Hypertensive Emergency

Pulse that is strong bounding
Tinnitus
headache
nosebleed
nausea/vomiting

Dissecting Aortic Aneuryism

P-Lifting heavy weights straining
Q-tearing knife like
R- pain on anterior chest but boring through the back
S very severe, and hits maximum at onset
T Sudden onset

CVA

altered level of cosiousness
hemiparesis, hemiplegia
ataxia, asymmetry of face
unequal pupils, dysarthria
aphasia, dysphagia
incontinence, sudden blurred vision
intense vertigo, hypertension

Bell's Palsy

One sided facial droop
Alert and Oriented
No other neurological deficiets

Grand Mal Seizure

They may have an "aura"
Tonic-Clonic phase
Loss of consciousness
clenched teeth, biting the cheek or tongue, incontinence
post-itcal phase

Absence Seizure

staring into space
little to no body movement (beyond an eye flutter exc)
1-3 seconds "lapses in awareness" but no falling down usually

Focal Motor Seizure

Starts in a group of muscles a "focus"
May progress to include the whole entire arm
May progress to a Grand Mal Seizure

Complex Partial Seizure

attacks of confusion,& loss of awareness with semi purposeful movements, often refusion

Gastric ulcer

persistent pain in the upper abdomen, often described as burning
pain is somewhat or completely relieved by eating bland foods
often have hematernesis or melana

Abdominal Aortic Aneurysm

P-Lifting heavy weights straining
Q-tearing knife like
R- pain on Abdomen but boring through the back
S very severe, and hits maximum at onset
T Sudden onset

Appendicitis

Fever
Anorexia
Nausea/or vomiting
sharp right lower quadrant pain, guarding rebound tenderness
increases over several hours

Esophageal Varices

Massive hematemesis
dramatic hemoptysis- bright red blood
life threatening hypovolemic

Gallbladder inflammation/ cholecystitis

history of recent ingestion of a meal with a lot of fat
gradual onset of sharp pain in right upper quadrant, possibly the right shoulder area after fatty meal

Kidney stone

tremendous pain in the lower quadrants, radiating in pulse-like waves from the rear flank, downward toward the pubic symphysis worsens as the stone is pushed along
anxiety, restlessness
nausea and or vomiting
hematuria

bowel obstruction

crampy pain in the abdomen, usually diffuse
often has abdominal distention
anorexia, nausea and or vomiting
fever

Chronic liver disease

jaundice, ascities, pedal edema, muscle atrophy, decreased clotting, petechiae, varicose veins

pacreatitis

sudden severe LUQ epigastric pain -steady boring through to the back
usually with a history of chronic alcohol abuse
may have abdominal tenderness and or distention
nausea/vomiting
may develop shock

Irritable Bowel syndrome

Abdominal pain, abdominal cramping, gas, bloating, diarrhea or constipation. The pain is described as "worse than childbirth" "a sudden knife like pain that can double you over" can bring you to your knees

Diverticlitis

Abdominal pain (usually LLQ)
Fever
Vomiting
Constipation

GERD

Presents as heartburn

Type 1 diabetes

The patient needs to inject insulin several times per day
an auto immune disease where the body produces antibodies that attack and destroy the pancreatic islet cells
these produce no insulin

Type 2 diabetes

pateints control their disease through diet and exercise and weight loss (they are usually obese or through oral medications that increase the pancreas production of insulin

Diabetic Coma

Gradual onset- often over several days
flushed- dry warm skin (mild fever)
intense thirst dry mouth (if he complains at all)
rapid weak pulse (tachycardia)
hypotension
kussmaul respirations
decreased level of consciousness
nausea, vomiting, abdominal pain

Insulin shock

Rapid onset (often too sudden to react)
headache
pale, cool, wet skin (often soaking wet)
tachycardia pulse may be strong/bounding
weakness, dizziness
agitated restless, uncooperative abnormal behavior, syncope, ALOC

Anaphylaxis

tachypnea, tachycardia, hypotension
red or pale, itchy
dyspnea, wheezing, stridor from bronchospasm
respiratory distress (wheezes)
sigs of hypovolemic with normal skins

Hymenoptera

pain, located swelling, redness
"bully's eye" mark
itching
watch for airway swelling

Asprin Overdose

mild overdose-tinnitus
Larger overdoes it produces gastrointestinal pain & cramping ad hyperventilation to blow of the acidosis

Tylenol overdose

Acute- Few if ay symptoms (possibly a good night's sleep)
Later phase (after a few days maybe a week) general malaise, anorexia possibly cyanosis, followed by acute liver failure

Tricylic Antidepressants

Decreased LOC
Seizures
Cardiac Dysrhythmia

Beta blockers

Cardiac dysthymias
hypotension, bradycardia, cardiac arrest

Narcotics/opiates

decreased LOC
respiratory depression/ hypoventilation
pinpoint pupils
hypotension
Nausea/vomiting

Depressants

decreased LOC
respiratory depression/hypoventilation
loss of muscle coordination
slurred speech
nystagmus (especially alchohol)
bradycardia/hypotension

Stimulants

increased LOC
Tachycardia/HTN
rapid speech
dilated pupils or normal
seizures, muscle twitching, tremors
Chest pain

Hallucinogens

Altered LOC,
tachycardia/ HTN
Visual halluctinations
Seizures
Nystagumus -especially with PCP
hot flashes

Hydrocarbons

Altered LOC
coughing choking

Toxic inhalations

dyspnea, tachypnea
nausea/vomiting
aloc
airway irritation, wheezes or crackles
sore throat, cough

Smoke inhalation

Dyspnea, tachypnea
cough
abnormal breath sounds- stridor, wheezes crackles
watery, irritated eyes
singed facial hairs, eyebrows, nasal hairs

Carbon Monoxide Inhalation

headache- rapid onset out of nowhere
ALOC, confusion, coma
nausea/vomiting
dyspnea, tachypnea, tachycardia
flushed skin
dizziness

Cyanide Gas Inhalation

sudden onset-within minutes of inhalations, within 30 minutes of ingestion
the patient becomes rapidly uncounscious, often falling
respirations are rapid and convulsions at first then slow and gasping
hypotension, seizures, incontinence, cardiovascular co

Chlorine Gas Inhalations

instant onset of burning in lungs and mouth
dyspnea, tachypnea
sever cough
abnormal breath sounds, stridor wheezes
watery, irritated eyes

Phosgene Gas inhalation

An extremely corrosive gas from burning plastics. Does tremendous tissue damage/total destruction of lung tissue and eyeballs on contact

Ammonia Inhalation

A corrosive or irritating gas (used in manufacturing ) and some refrigerator units, tanker trucks on the freeway or railcars.

organophosphate poisoning

Constricted Pupils, Diarrhea, urination, Muscle weakness, Bradycardia, Bronchospasm, Bronchorrhea, Emesis, Lacrimation, Sweating, Salivation, Seizures, GI cramping

Pelvic Inflammatory Disease

Tremendous pain in the lower quadrants
often has a fever
anxiety, restlessness
Nausea/vomiting
abnormal vaginal discharge

Ectopic Pregnancy

abrupt onset of sever, stabbing pain in lower quadrants
abdominal distention, guarding, rigidity
may or may not know she is pregnant
signs/symptoms of shocks
nausea/vomiting
vaginal bleeding may occur

Abrasion

Small amounts of blood loss, with a large amounts of tissue damage

Puncture

Usually very little external blood loss, but there may be significant internal bleeding

Avulsion

A torn loose or torn off piece of flesh (partial or complete avulsion) Often with considerable blood loss Although the vessels pinch off quickly

Incision

A smooth edged cut, typically done with a sharp blade, often they bleed a lot

laceration

A jagged-edged cut, typically done with a somewhat duller blade or piece of metal, ripping the skin rather than cutting it, often they bleed alot

Evisceration

a type of laceration where internal body parts are exposed on the surface of the body(like intestines)

Fractured larynx/ trachea

Obvious signs of injury, edema, hoarseness, stridor, subcutaneous emphysema

1st degree burn

Thermal damage to the first layer of skin only (epidermis), lower layers heated and react by turning red and becoming tender and uncomfortable to touch

2nd degree burn

thermal damage to the first & second layers of the skin (epidermis and dermis) Blisters will appear, and may break making the skin appear moist. Can be red or white color depending on the thermal agent. (hot water may make them appear pale)

3rd degree burn

thermal damage to all three layers of the skin, also cooks blood vessels, so it appears to be dry and leathery- color depends on agent

Minor Burns

No critical areas burned
No respiratory involvement
2nd degree burns to less than 15% of BSA or
3rd degree burns to less than 2% of BSA

Moderate Burns

No Critical areas burned
No Respiratory involvement
2nd degree burns to 15%-25% of BSA
3rd degree burns to 2%-10% of BSA

Severe Burns

Respiratory involvement or inhalation injury
Involvement of "Critical Areas"
2nd degree burns to greater than 25% of BSA
3rd degree burns to greater than 10% of BSA

Airway Burns

burns around face, mouth
Singed facial hair- eyebrows, eyelashes, nasal hair
productive cough-sooty sputum
hoarseness when they try to talk
dyspnea
Dysphagia
history of a burn in an enclosed area

Electrical Burns

frequently associated with significantly greater internal injuries than would be suspected from the appearance of entrance and exit wounds. May cause arrest through ventricular fibrillation activity

Concussion

usually with a transient decrease in level of consciousness followed by complete, and prompt recovery Often the patient will complain of a headache, some light-headedness, dizziness, "grogginess" and some nausea. Patient recovery is measured in minutes an

Cerebral contusion

All those present for a concussion except they are more sever here, and tend to last longer. Usually there are also some of the sign/symptoms of increased intracranial pressure. Patient recovery is measured in hours or more likely days. There may be perma

Epidural hematoma

All the signs of a concussion
ALOC with a lucid interval
S/s may be delayed 1-4 hours
S/s of ICP

Subdural hematoma

All the signs of a concussion
S/s may be delayed up to 2-4 Weeks
Signs of ICP

Intra-cerebral hemorrhage

Sudden onset of an extremely severe headache (sometimes described as the worst headache they have ever felt) then rapid losss of consciousness without regaining it- suddenly falling out of their chair
s/s of ICP

ICP

-increasing systolic blood pressure
-Widened pulse pressure
-Brady cardia (Baroreceptor reflex)
-Altered, abnormal Respiratory patterns
-Deteriorating level of consciousness
-Nausea/Vomiting
-Severe, Persistent Headache
-Pulpillary changes, unequal or dil

Cervical spine trauma

-pain especially upon palpation
-swelling deformity at injury site
-neck muscle spasm and stiffness
-neurological deficits
respiratory compromise
neurogenic shock
loss of bowel control
priapism

Rib fracture

sharp stabbing pleuritic CP, made worse by inspiration
may have an abrasion or contusion (seatbelt)
patient will attempt the splint his own arm
may be hypoventilating due to pain

Flail chest

dyspnea, tachypnea
Floating chest wall segment
cyanosis
subcutaneous emphysema

Pneumothorax

dyspnea, tachypnea
diminished breath sound on one side
sharp stabbing chest pain

Tension Pneumothorax

progressive dyspnea, tachypnea
absent lung sounds on the affected side
JVD
narrow pulse pressure
unequal chest expansion seen on deviation
tracheal deviation

Pericardial tamponade

distended neck veins
dyspnea
narrow pulse pressure
muffled heart sounds

myocardial contusion

CP
bruising over sternum
dyspnea, tachypnea
irregular pulse, dysrthymia
signs of shock

commotion cordis

Sudden death directly following blunt force trauma

Pulmonary contusion

CP
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
hemoptysis
irregular pulse-dysrthymia

tracheobronchial rupture/laceration

severe respiratory distress
stridor, hoarsness (if able to talk)
subcutaneous crackling sensations to touch
decreased or unequal breath sounds
hemotypsis
tachycardia, hyptension
cyanosis

hemothorax

signs of severe shock
respiratory distress
decreased or absent breath sounds on one side

Blunt abdominal trauma

pain and tenderness often diffuse, sometimes local "point" tenderness
abdominal "guarding" abdominal rigidity
abdominal distention
signs of surface wounds abrasions, discoloration, bruising
nausea and or vomiting
s/s of shock

Sprain

May have "heard" the injury
Pain and tenderness often significant enough to prevent walking
swelling often significant especially of the ankle
discoloration often delayed sometimes by 24 hours

strains

may have "heard" the injury
Pain and tenderness can be significant but usually "discomfort" is more likely- extreme point tenderness

Dislocation

Usually dramatic deformity
Pain usually extreme
swelling occurs but takes time, and may be masked by the deformity
discoloration occurs but may take time possibly many hours
Inability to move

Fracture

Deformity often present, but not always
pain and tenderness usually significant pain
swelling edema occurs but takes time
discoloration occurs but takes time
Usually can be moved, it isn't moved because it hurts to much to do so
Crepitus
Patient heard it

Frostbite

pale, waxy appearing cold skin
usually painless(clubbing= using their hand as a club beating it against their thigh)
very delayed or more likely, no capillary refill
usually also hypothermic