(EMT book CH.15) Essential Guidelines for Medical Emergencies

May 6, 2025

Chapter 15: Medical Overview - Emergency Care and Transportation of the Sick and Injured (12th Edition)

Introduction

  • Objective: Understand proper assessment techniques for patients with medical emergencies.

Types of Emergencies

  • Trauma Emergencies: Injuries from physical forces.
  • Medical Emergencies: Illnesses caused by diseases.
  • Patients can have both medical and trauma conditions.

Types of Medical Emergencies

  • Respiratory: Breathing troubles or inadequate oxygen supply.
  • Cardiovascular: Affecting the circulatory system.
  • Neurological: Brain-related issues.
  • Gastrointestinal: Includes appendicitis, pancreatitis, etc.
  • Urologic: Kidney stones, etc.
  • Endocrine: Mainly complications from diabetes.
  • Hematologic: Sickle cell disease, blood clotting disorders.
  • Immunologic: Body’s response to foreign substances.
  • Toxicological: Poisoning, substance abuse.
  • Gynecological: Female reproductive organs.

Patient Assessment

  • Focus: Nature of illness, symptoms, chief complaint.
  • Avoid Tunnel Vision: Don’t get locked into preconceived ideas.
  • Professional Attitude: Stay calm, non-judgmental, avoid bias.

Scene Size-Up

  • Ensure safety and use standard precautions.
  • Determine number of patients and need for additional help.
  • Establish the nature of illness and initiate spinal immobilization if needed.

Primary Assessment

  • Develop a general impression and perform rapid patient exam.
  • Use the AVPU scale for consciousness.
  • ABCs: Airway, Breathing, Circulation.
    • Check airways, breathing adequacy, and apply oxygen if needed.
    • Check circulation via pulse and skin assessment.
  • Transport Decision: Rapid transport for serious conditions (unconscious, altered mental status, airway/breathing problems, shock).

History Taking

  • Determine and investigate the chief complaint.
  • Use SAMPLE: Signs/Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events leading up to.
  • Use OPQRST for pain: Onset, Provocation, Quality, Radiation, Severity, Time.

Secondary Assessment

  • Perform physical exams based on consciousness and complaint.
  • Full-body assessment for unconscious patients.

Vital Signs

  • Check pulse rate, rhythm, and quality.
  • Assess respirations and blood pressure.
  • Consider blood glucose and pulse oximetry.

Reassessment

  • Continue reassessment throughout transport.
  • Reassess chief complaint and obtain vital signs every 5-15 minutes based on stability.

Transport and Destination

  • Emergency Treatment: Often beyond pre-hospital scope. Requires medical control.
  • Scene Time: Longer for medical cases to gather information.
  • Transport Types: Ground or air, based on patient condition.

Infectious Disease Assessment

  • Perform scene size-up and take precautions.
  • Gather history with emphasis on recent travel and contacts.
  • Management: Focus on life-threatening conditions, comfort, and warmth.

Epidemic and Pandemic Considerations

  • Definitions: Epidemic (local excess cases), Pandemic (global outbreak).
  • Communicable Diseases: Influenza, Herpes Simplex, HIV, Hepatitis, Meningitis, Tuberculosis, Whooping Cough, MRSA, COVID-19, MERS-CoV, Ebola.
    • Use protective equipment and follow guidelines for exposure prevention.

Conclusion

  • Medical assessments are complex due to non-obvious conditions compared to trauma.
  • Use calm and thorough assessment and transport safely.

Review Questions Highlights:

  • Seizure = Neurologic emergency.
  • Avoid tunnel vision; don't assume based on frequent flyer history.
  • Scene stay: Gather comprehensive info.
  • Respiratory difficulty requires emergency transport.
  • Infectious disease: Start with standard precautions.
  • Hepatitis C = Likely with liver cirrhosis symptoms.
  • Meningitis = Stiff neck, red blotches.
  • Tuberculosis exposure warrants a TB test.

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