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Medical: 5 Pulmonary: 1

      • a)

        Significant variety in the cell types, and the growth rates associated with each type

    • 4.

      Assessment findings

      • a)

        Signs of severe distress

        • (1)

          Altered mentation

        • (2)

          1-2 word dyspnea

        • (3)

          Severe or uncontrollable hemoptysis

      • b)

        Chief complaints

        • (1)

          Cough

        • (2)

          Hemoptysis

        • (3)

          Dyspnea

        • (4)

          Hoarseness or voice change

        • (5)

          Dysphagia

      • c)

        History

        • (1)

          Diagnosed history of cancer

      • d)

        Physical findings

        • (1)

          Signs and symptoms vary according to location of the tumor

    • 5.

      Management

      • a)

        Airway and ventilation

        • (1)

          Intubation if required

        • (2)

          Assisted ventilation if necessary

        • (3)

          Oxygen - flow rate based on symptoms and pulse oximetry

        • (4)

          Supportive care

      • b)

        Circulation

        • (1)

          Many patients with diagnosed lung cancer with have an indwelling catheter in place. Local protocols vary regarding whether this catheter may be used for IV infusion in the field.

        • (2)

          IV infusion may be required to improve hydration or thin/ mobilize sputum

      • c)

        Pharmacological

        • (1)

          Out-of-hospital therapy for lung cancer patients is symptomatic, and may include the following

          • (a)

            Bronchodilators

          • (b)

            Corticosteroid

          • (c)

            Continuation of hospital-initiated antibiotics

      • d)

        Transport considerations

        • (1)

          End stage patients may have advance directives or DNR

        • (2)

          Supportive care

      • e)

        Psychological support/ communication strategies

        • (1)

          If diagnosed end stage

          • (a)

            Death and dying patient

          • (b)

            Family support

  • G.

    Upper respiratory infection

    • 1.

      Epidemiology

      • a)

        Incidence

        • (1)

          80 million cases in 1975

      • b)

        Morbidity/ mortality

        • (1)

          Rarely life threatening

        • (2)

          Often exacerbates underlying pulmonary conditions

        • (3)

          Often become significant infections in patients with suppressed immune

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United States Department of Transportation National Highway Traffic Safety Administrati

on

Paramedic: National Standard Curriculum

24

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