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Medical: 5 Pulmonary: 1

      • c)

        History

        • (1)

          Sudden onset

        • (2)

          Identification of risk factors

      • d)

        Physical findings

        • (1)

          Normal breath sounds or, in severe cases, rales

        • (2)

          Pleural fiction rub

        • (3)

          Tachycardia

        • (4)

          Clinical evidence of thrombophlebitis (found in less than 50%)

        • (5)

          Tachypnea

        • (6)

          Hemoptysis (fairly rare)

        • (7)

          Petechiae on upper thorax and arms

    • 5.

      Management - prevention has major role in management

      • a)

        Depends on the size of the embolism

      • b)

        Airway and ventilation

        • (1)

          Intubation if necessary

        • (2)

          Positive pressure ventilation if required

        • (3)

          High flow oxygen

      • c)

        Circulation

        • (1)

          CPR if required

        • (2)

          IV therapy; hydration based on clinical symptoms

      • d)

        Pharmacological

        • (1)

          Thrombolytic therapy may be appropriate if the diagnosis of pulmonary embolus is confirmed, however, this is rare - especially in the out-of- hospital setting

      • e)

        Non-pharmacological therapy

        • (1)

          Support body systems

        • (2)

          Most severe cases will be managed as a cardiac arrest of unknown origin

      • f)

        Transport considerations

        • (1)

          Rapid transport

        • (2)

          Appropriate mode

        • (3)

          Appropriate facility

      • g)

        Psychological support/ communication strategies

  • F.

    Neoplasms of the lung

    • 1.

      Epidemiology

      • a)

        Incidence

        • (1)

          150,000 have cancer

        • (2)

          Typical age between 55 to 65

        • (3)

          Morbidity/ mortality

          • (a)

            Most die within one year

          • (b)

            20% local lung involvement

          • (c)

            25% spread to lymph

          • (d)

            55% distant metastatic cancer

      • b)

        Prevention

        • (1)

          Prevent starting smoking in youth

        • (2)

          Smoking cessation in smokers

        • (3)

          Avoidance of environmental hazards, particularly asbestos

        • (4)

          Cancer screening programs

    • 2.

      Anatomy and physiology review

    • 3.

      Pathophysiology

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United States Department of Transportation National Highway Traffic Safety Administrati

on

Paramedic: National Standard Curriculum

23

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