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Medical: 5

Cardiology: 2 ════════════════════════════════════════════════════════════════════════════════════ ══════════════════════════

F.

G.

  • (1)

    Pitting versus non-pitting

  • (2)

    Extremities

    • (a)

      Localized in ankles

    • (b)

      To the midcalf

    • (c)

      To the knees

    • (d)

      Obliteration of pulses

  • (3)

    Ascites

    • (a)

      Engorged mass(es) in upper abdominal quadrants

  • (4)

    Sacral

Complications

  • 1.

    Pulmonary edema

    • a.

      Signs and symptoms

      • (1)

        Tachypnea

      • (2)

        Wheezing

      • (3)

        Rales at both bases

      • (4)

        Elevated jugular venous pressure

      • (5)

        Pulsus paradoxus

      • (6)

        Rapid "thready" pulse

      • (7)

        Pulsus alternans

      • (8)

        Abnormalities of apical pulse

        • (a)

          Due to displaced cardiac apex

        • (b)

          Abnormal bulges

      • (9)

        Cyanosis in advanced stages

      • (10)

        Frothy sputum

Management

  • 1.

    Position of comfort

  • 2.

    Pharmacological

    • a.

      Gases

    • b.

      Afterload reduction

    • c.

      Analgesia

    • d.

      Diuresis

    • e.

      Other

3.

Transport

a. b .

Refusal No other indications for no-transport

X.

  • H.

    Support and communications strategies

    • 1.

      Explanation for patient, family, significant others

    • 2.

      Communications and transfer of data to the physician

Cardiac tamponade

  • A.

    Pathophysiology

    • 1.

      Defined as impaired diastolic filling of the heart caused by increased intrapericardiac pressure

    • 2.

      Precipitating causes

      • a.

        Gradual onset with neoplasm or infection

      • b.

        Acute onset with infarction

      • c.

        Trauma

        • (1)

          Can occur with CPR

        • (2)

          Penetrating injury

───────────

─────────────────────────────────────────────────────────────────────────

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

27

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