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FINAL VERSION For review only. Do not cite, quote, or publish.

Medical: 5 Gastroenterology: 6

      • a.

        Escherichia coli

      • b.

        Klebsiella pneumonia

      • c.

        Enterobacter

      • d.

        Campylobacter jejuni

      • e.

        Vibrio cholera

      • f.

        Shigella

        • (1)

          Not part of normal intestinal flora

      • g.

        Salmonella

        • (1)

          Not part of normal intestinal flora

    • 3.

      System affected - GI system

    • 4.

      Modes of transmission

      • a.

        Fecal-oral

      • b.

        Ingestion of infected food or non-potable water

    • 5.

      Susceptibility and resistance

      • a.

        Travelers into endemic areas are more susceptible

      • b.

        Populations in disaster areas, where water supplies are contaminated, are susceptible

      • c.

        Native populations in endemic areas are generally resistant

    • 6.

      Signs and symptoms - nausea, vomiting, fever, abdominal pain and cramping, anorexia, lassitude, and frank shock

      • a.

        Diarrhea of enteric bacteria - different clinical pictures depending on the degree of intestinal invasion

      • b.

        Chronic gastritis and ulcers with abdominal pain, nausea, and Aheartburn@ are caused by Helicobacter pylori infection

    • 7.

      Patient management and protective measures

      • a.

        EMS personnel - do not work when ill if your job involves patient contact

      • b.

        Focused on environmental health and development/ availability of clean water reservoirs, food preparation and sanitation

      • c.

        Disaster workers and travelers to endemic areas must be vigilant in knowing the sources of their water supplies or drink hot beverages that have been brisk-boiled or disinfected

      • d.

        Health care workers treating gastroenteritis patients must be careful to avoid habits that facilitate fecal-oral/ mucous membrane transmission, observe BSI and effective hand washing

      • e.

        Selected organisms may be sensitive to antibiotics

      • f.

        Epidemic treatment is normally symptomatic

    • 8.

      Immunizations are unavailable for many of the enteric bacteria, which are part of the normal intestinal flora

  • F.

    Diverticulitis

    • 1.

      Epidemiology

      • a.

        Incidence

      • b.

        Mortality/ morbidity

      • c.

        Risk factors

      • d.

        Prevention strategies

      • e.

        Anatomy and physiology review

      • f.

        Pathophysiology

        • (1)

          Inflammation in or around the diverticula

        • (2)

          Retention of undigested food residue and bacteria

    • 2.

      Assessment

      • a.

        History

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────────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

10

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