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Medical: 5

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

          • (3)

            Non-penetrating injury

        • d.

          Secondary to renal disease

        • e.

          Hypothyroidism

    • B.

      Morbidity/ mortality

      • 1.

        Death if not relieved

    • C.

      Initial assessment

      • 1.

        Airway/ breathing

        • a.

          Labored breathing may or may not be present

      • 2.

        Circulation

        • a.

          Peripheral pulses

          • (1)

            Quality

          • (2)

            Rhythm

        • b.

          Changes in skin

          • (1)

            Color

          • (2)

            Temperature

          • (3)

            Moisture

    • D.

      Focused history (as in precipitating causes)

    • E.

      Detailed physical examination

      • 1.

        Airway/ breathing

        • a.

          Dyspnea

        • b.

          Orthopnea

      • 2.

        Circulation

        • a.

          Pulse rate and rhythm

        • b.

          Chest pain

        • c.

          Tachycardia

        • d.

          Ectopy

        • e.

          Elevated venous pressures (early sign)

        • f.

          Decreased systolic pressure (early sign)

        • g.

          Narrowing pulse pressure (early sign)

        • h.

          Pulsus paradoxus

        • i.

          Heart sounds normal early on, progressively faint or muffled

        • j.

          ECG changes

          • (1)

            Low voltage QRS and T waves

          • (2)

            ST elevation or non-specific T wave changes

          • (3)

            Electrical alternans of PQRST

          • (4)

            Usually inconclusive - should not be used as a diagnostic tool

    • F.

      Management

      • 1.

        Airway management and ventilation

      • 2.

        Circulation

      • 3.

        Pharmacological

      • 4.

        Non-pharmacological

      • 5.

        Rapid transport for pericardiocentesis

    • G.

      Support and communications strategies

      • 1.

        Explanation for patient, family, significant others

      • 2.

        Communications and transfer of data to the physician

  • XI.

    Hypertensive emergencies

    • A.

      Epidemiology

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

28

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