Archive for November 2010
Emergency workers often face many emotional situations, especially around the holidays. This is especially true for the first responders on the scene. Car accidents are common and can range from an accident with minor injuries to a severe accident with horribly injured or dead victims- infants to elderly. When serious situations occur, emergency workers have to be able to separate their own personal shock to care for the needs of the patients they are caring for. With time and experience, emergency workers become more accustomed to severe or traumatic situations. However, it is important for every emergency worker to remember that the patients they treat are usually not familiar with injury, illness and death.
When dealing with dying patients and their families, emergency workers should treat all involved with dignity and respect. Communication is important. As much as possible, an emergency worker should explain what you he is doing when treating the patient and respect the patient’s wishes. This will help the patient feel more confident and trusting of his care.
Although emergency workers are familiar with traumatic situations, they can experience extreme stress when responding to major incidents. This is especially true of incidents involving mass casualties, infants and children, amputations, abuse, suicide, or injury, illness or death of a co-worker or family member. The effects of stress can be immediate or delayed over time.
There are several common warning signs associated with stress. Irritability with family, friends and co-workers is possible. Other signs include an inability to concentrate; nightmares or difficulty sleeping; guilt; indecisiveness; loss of appetite; physical exhaustion; and a lack of interest in physical intimacy.
There are several things that can be done to manage stress. Talking with a trusted friend or counselor is helpful. Getting regular exercise and eating a balanced diet as well as refraining from alcohol and smoking are beneficial at reducing or preventing stress. It is always a good idea to have a healthy balance between work, family and recreation. Also, getting adequate sleep is important.
There are three types of inflammatory heart conditions- endocarditis, pericarditis and myocarditis.
A smooth layer of connective tissue lines the chambers of the heart and the heart valves. This smooth connective tissue is called the endocardium. Sometimes microbes in the blood stream can carry infection into the endocardium. When this happens, the heart valves are most often affected. This infection and resulting inflammation is called endocarditis. Endocarditis frequently occurs in combination with rheumatic diseases, and a few weeks after an infection, such as rheumatic fever. The symptoms of endocarditis are usually nonspecific, such as exhaustion, racing heart, fever and feelings of constriction. It is common for scars to form on the endocardium when it heals. These scars can permanently affect how the heart valves function. Endocarditis is usually treated with antibiotics and corticosteroids. Surgery is required when there is damage to the heart valves.
Pericarditis is caused from acute or chronic inflammation of the pericardium. It is often accompanied by a pericardial effusion containing blood or pus. An x-ray can show this inflammation. Breathlessness, heart pain when breathing and fever are common symptoms of pericarditis. Viral, bacterial or fungal infections can cause the inflammation. It may also be the result of a myocardial infarction, inflammation of the myocardium, severe rheumatic disease, lung disease or tumors growing from neighboring organs into the pericardium. Inflammation caused by infections can be treated with drugs. In other cases, the underlying disease, like tumors or lung disease must be treated directly.
Myocarditis is the acute or chronic inflammation of the heart muscle. Bacterial infections or viruses that affect the heart muscle directly or via toxins in the blood can cause the inflammation. Possible symptoms include heart rhythm disturbances, a weak heart, and fever. Antibiotics are often used to treat the inflammation.
The heart is the strongest muscle in the body and is responsible for transporting oxygen rich blood to the organs and extremities and returning oxygen depleted blood back to the lungs. This process happens approximately 70 times a minute. Ideally, when the heart is working properly blood flows throughout the cardiovascular system rhythmically. Unfortuantely, genetic disorders, poor diet and lack of exercise can cause the heart to work less than optimally creating several heart conditions.
An aneurysm is a balloon-like bulge in an artery wall that does not disappear on its own. Some aneurysms are congenital but in most cases they develop where there is previous damage to the artery- most often after vascular surgery, arteriosclerosis or after a myocardial infarction. Aneurysms are dangerous because they can burst causing hemorrhaging. A special ultrasound or a computed tomography can be used to diagnose an aneurysm which should be bypassed or removed surgically.
An aortic aneurysm can also be a congenital malformation or can arise because calcified arteries or inflamed vascular walls. Aortic aneurysms that occur in the upper section of the aorta can cause problems with swallowing, coughing, hoarseness or unequally sized pupils. It is important that aortic aneurysms be removed immediately because they can burst and cause internal bleeding which can lead to death.
Cardiac aneurysms are bulges in the heart wall usually found in the left ventricle. Severe myocardial infarctions can cause cardiac aneurysms. The heart function becomes impaired when the affected part of the heart wall is weakened. Small blood clots, called thrombi, can form in the bulge increasing the risk of embolism.
The facial skeleton is made up of 14 bones. Of the 14, only two- the mandible and the vomer are unpaired. The paired bones are the maxillae, zygomatics, nasal, lacrimal, palatines, and inferior nasal conchae. The mandible is U-shaped and is also called the lower jawbone. It is the largest, strongest bone of the face. The lower teeth are anchored into the mandibular body. The alveolar body is located in its superior border, called the alveolar margin. The alveolar margin contains sockets where the teeth are embedded. The maxillary bones form the upper jaw and central portion of the facial skeleton. They are fused medially and are considered the keystone bones of the facial skeleton. This is because all of the facial bones, with the exception of the mandible, articulate with the maxillary bones. They zygomatic bones are irregularly shaped and are also called the cheekbones. They form the prominence of the cheek bones and part of the inferolateral margins of the orbits. The nasal bones are thin and rectangular. They form the bridge of the nose. The lacrimal bones are delicate and fingernail-shaped. Each bone contains a deep groove that helps form a lacrimal fossa. The lacrimal fossa contains a lacrimal sac. This is the passage way tears take to drain from the eye surface into the nasal cavity. The palatine bones are L-shaped and are fashioned from a vertical and perpendicular plate. These bones are important to the structure of the hard palate and the posterolateral walls of the nasal cavity. Vomer bones are slender and plow-shaped. They lie in the nasal cavity and from part of the nasal septum. Inferior nasal conchae are thin, curved bones located in the nasal cavity. They are the largest of the three pairs of conchae and help to form part of the lateral walls of the nasal cavity.
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How to Become a Paramedic or EMT: Shock Treatment
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When the body’s ability to deliver blood to every organ is hindered cell death and organ failure can result. The loss of blood volume, decreases profusion to many body tissues causing hypoperfusion, otherwise known as shock. When learning how to become an EMT in your EMT or paramedic classes, it is paramount that you learn to identify and treat all different stages of shock.
Shock is a life-threatening condition. The delicate tissues of the body become damaged by the lack of oxygen and a buildup of waste products. The brain, heart, lungs and kidneys are especially affected by hypoperfusion. Death will result if these organs do not receive adequate blood circulation.
When administering to a patient it is important to determine what stage of shock the patient is in. Recognizing the early signs and symptoms of shock is vital. Emergency care providers should transport the patient to the hospital before late shock develops. If not addressed early, the cause of hypoperfusion can require surgical intervention. The early recognition and transport of a patient in shock can save the patient’s life.
Hypovolemic shock is caused by an inadequate volume of blood. Dehydration, excessive vomiting, diarrhea, and internal or external blood loss can cause hypovolemic shock. Hemorrhagic shock is caused by bleeding only. It is the most common type of shock seen in trauma patients.
Shock will occur when there is a problem with the heart, the vessels or the blood. Minute changes in any one of these areas can lead to shock. Even small changes in the blood flow to the brain can cause a change in a patient’s mental state. Restlessness, anxiety, and combativeness can occur in a patient. These are early signs of shock and should be monitored closely. It is especially important to monitor patients with internal bleeding because change in mental status and vital signs can indicate that the patient is experiencing a life-threatening blood loss.
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Things to Consider When Taking Prescription Medication
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Most people have been taught either by parents or doctors that prescription medication should not be shared. It may seem silly but there are several reasons why you shouldn’t offer to share your prescription medicines.
Reason 1: Absorption
Not everyone will absorb a medication the same way. Most medication is absorbed in the GI tract. A person who is vomiting or has diarrhea will not be able to absorb certain medication properly.
Reason 2: Distribution
After medication is absorbed it must be distributed throughout the body. Some drugs need to bind with a protein in order to be carried through the veins and arteries. If they are unable to bind to a protein they become free drugs that can create toxicity in the body. You may not know your body’s protein levels and could cause more harm to yourself than help by taking unperscribed medications.
Reason 3: Metabolism
The liver is tasked with breaking down drugs to be excreted out of the body. If your liver is not working properly, you will not be able to metabolize the drugs and excrete the particles out of your system. Liver dysfunction is not always because of liver disease. Age can affect liver function. Newborns typically have immature livers and elderly people typically have decreased liver function.
Reason 4: Excretion
The kidney is the organ primarily responsible for excreting medications. Medications are often excreted in bile, feces respiration, saliva and sweat. If your kidneys are not working properly, you will have a difficult time excreting them from your system. Taking only prescribed medications is best because your doctor will be sure you use drugs that your body will be able to process and excrete.
Herbs are plants or plant parts that are used for medicinal qualities. Like all living organisms, once they are taken from their source of nutrition, they have a very short life. As soon as they are harvested, the enzymes in the herbs cause immediate decay. Certain steps should be taken to ensure their therapeutic qualities are not lost. One of the best ways of maintaining an herbs therapeutic benefits is to dry it in sunlight or with an alternative heat source. Drying effectively removes moisture and slows down enzymatic activity. Dried herbs can retain their therapeutic quality for up to six months. When studying how to become a pharmacologist, herbal extractions will be a subject you will learn more in depth. Here is a brief overview.
Depending on the herb, it can be used whole or in parts. Aloe is an example of an herb that can be used whole. Fresh inner aloe leaf is often used topically to treat burns and minor cuts. Other herbs, especially those that are ingested, may need to be transformed either by tincture, steeping, extraction or blending.
Extraction is used to remove the most therapeutic material from an herb. It is important to isolate the therapeutic part of the herb. Is it the root, leaves, flowers, fruit, seed, bark or stem? Once determined, the part of the herb that contains the therapeutic material is soaked in alcohol or water.
Oils are a form of extraction. Herbal oils are made by soaking the dried herb in olive or vegetable oil. This mixture is heated for a period of time. This is a slow process and should not be rushed. Maximum concentration can be reached over an extended period of time. Oils can provide a concentrated from of an herb and can also extend the therapeutic benefits of the herb for several months.
