Chapter 15: Medical Overview

Introduction

• Focus: Proper assessment techniques for patients with medical emergencies.
• Types of Emergencies:
  • Medical: Illness or conditions caused by disease.
  • Trauma: Injuries from physical forces.
  • Patients may experience both simultaneously.

Types of Medical Emergencies

• Respiratory: Breathing issues or inadequate oxygen supply.
• Cardiovascular: Affects circulatory system.
• Neurological: Involves the brain.
• Gastrointestinal: Appendicitis, diverticulitis, pancreatitis, etc.
• Urologic: May involve kidney stones.
• Endocrine: Complications of diabetes.
• Hematologic: Sickle cell disease, clotting disorders like hemophilia.
• Immunologic: Body’s response to foreign substances.
• Toxicological: Poisoning and substance abuse.
• Psychological/Behavioral: Difficult to assess due to atypical symptoms.
• Gynecological: Involves female reproductive organs.

Patient Assessment

• Focus: Nature of illness, symptoms, chief complaint.
• Assessment Steps:
  • Scene Safety: For EMS personnel and patients.
  • Nature of Illness: Awareness of serious conditions.
  • Primary Assessment: Rapid exam to identify life threats.
  • Airway/Breathing: Ensure open airway and adequate breathing.
  • Circulation: Check pulses, skin condition, manage shock.
  • Transport Decision: Rapid transport for serious conditions.
  • History Taking: Use SAMPLE and OPQRST mnemonics.
  • Secondary Assessment: Physical exam and vital signs.
  • Reassessment: Continue throughout transport.

Transport and Destination

• Scene Time: Longer for medical patients to gather information.
• Type of Transport:
  • Ground or air transport based on patient’s condition.
  • Lights and sirens for critical patients.
• Destination Selection: Closest or most appropriate hospital.

Infectious Diseases

• General Assessment: Scene size-up, history taking, and vital signs.
• Management Principles: Focus on life-threatening conditions and comfort.
• Epidemic and Pandemic: Understand scope and precautions.

Specific Infectious Diseases

• Influenza: Spread by droplets; PPE required.
• Herpes Simplex: Close contact transmission.
• HIV: Risk from blood and bodily fluids.
• Hepatitis: A, B, C with different transmission modes.
• Meningitis: Stiff neck, red blotches; some contagious.
• Tuberculosis: Airborne; chronic lung disease.
• Whooping Cough (Pertussis): Affects young children.
• MRSA: Antibiotic-resistant; transmitted by unwashed hands.
• COVID-19: Symptoms include fever and cough; CDC updates.
• MERS-CoV: Respiratory syndrome from Middle East.
• Ebola: High fatality; incubation 6-12 days.

Travel Medicine

• Be aware of travel-acquired infections in patients.

Conclusion

• Medical assessments can vary and require careful consideration of symptoms and history.
• Proper transport and continued reassessment are crucial.
• Maintain calm and use skills to assess, treat, and transport medical patients effectively.