Download Disease Name

Acute Myocardial Infarction
Pathophysiology
Portion of the heart muscle dies due to lack of adequate supply of oxygenated
blood due to narrowing or blockage within the coronary artery. After 20-30
minutes without adequate perfusion the heart muscle begins to die.
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Signs
Pulse
Respirations
Blood Pressure
O2 sat
Skins
Special Questions
SAMPLE
OPQRST
Do you have a history of any
cardiac problems or past surgeries?
Do you take nitro or aspirin?
How long has your pain been
present for?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Nitro assistance if not taken more
than 3 and is not on hormones and
systolic pressure is greater than 100
per SD county protocol
 Position of comfort
 Transport
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Symptoms
Chest Pain
Diaphoresis
Shortness of breath
Anxiety
Sense of impending doom
Pertinent Negatives
Chest pain that lasts longer than 10
minutes
Positive Levine’s sign
Chest pain that is not relieved with
nitroglycerin administration
Pale gray skins, nausea, dizziness
Unstable Angina
Pathophysiology
Inadequate oxygen supply to the heart muscle or myocardium generally occurs
during periods of stress, physical or emotional activity. Relieved after 2-15
minutes.
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Signs
Pulse
Respirations
Blood Pressure
O2 sat
Skins
Symptoms
 Pressure or tightness to the center
of the chest
 Pain radiating to shoulders, arm,
neck, jaw, back, or epigastric pain
 Cool, clammy skins
 Chest pain that occurs greater than
20 minutes
Special Questions
Pertinent Negatives
SAMPLE
 Chest discomfort is relieved with
OPQRST
the administration of nitroglycerin
Have you been exercising or
or rest
recently been under stress?
 Chest pain that lasts longer than 20
Have you taken any nitroglycerin? If
minutes and occurs at rest
you have has it helped to relieve
 Chest pain that awakes them at
your pain and how many have you
night (nocturnal angina)
taken?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Nitro assistance if not taken more
than 3 and is not on hormones and
systolic pressure is greater than 100
per SD county protocol
Position of comfort
Transport
Congestive Heart Failure (Left)
Pathophysiology
The heart cannot pump blood out of the left ventricle effectively. Blood pressure
begins to build up in the left atrium and eventually into the lungs.
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Signs
Blood Pressure
Pulse
Respirations
02 sat
Skins
Special Questions
SAMPLE
OPQRST
Are you taking a water pill?
Have you noticed an increase in
swelling to your legs, face or
hands?
 Do you take any medications for
your heart?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Place the patient in position of
comfort preferably sitting up
Transport
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Symptoms
Dyspnea/ dyspnea on exertion
Tachypnea
Tachycardia
Diaphoresis
Pertinent Negatives
 Normal to low systolic blood
pressure
 Inspiratory Rales
 Poor capillary refill
Congestive Heart Failure (Right)
Pathophysiology
Right side failure results in fluid build up in the lower legs and eventually pitting
edema occurs.
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Signs
Blood Pressure
Lung Sounds
02 sat
Skins
Special Questions
SAMPLE
OPQRST
Are you taking a water pill?
Have you noticed an increase in
swelling to your legs, face or
hands?
Do you take any medications for
your heart?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Place the patient in position of
comfort preferably sitting up
 Transport
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Symptoms
Dyspnea/ dyspnea on exertion
Tachypnea
Edema to the lower extremities
Tachycardia
Diaphoresis
Pertinent Negatives
 Normal to high systolic blood
pressure
 JVD
 Edema to the lower extremities
Pulmonary Embolism
Pathophysiology
Blood clot becomes lodged in the pulmonary arteries or one of its branches.
Embolism may be caused by blood clot, air bubble, fat particle, foreign body or
amniotic fluid.
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Signs
02 sat
Blood Pressure
Pulse
Respirations
Lung Sounds
Special Questions
SAMPLE
OPQRST
Do you take any blood thinners?
Have you had any recent surgeries?
Do you have a history of any
previous deep venous thrombosis?
If female, do you take birth control
or recently given birth?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Position of comfort
Transport
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Symptoms
Sudden onset of dyspnea
Tachypnea
Chest Pain/Chest wall tenderness
Anxiety
Pertinent Negatives
Peripheral edema
Dyspnea
JVD (late sign)
Decrease in blood pressure (late
sign)
Thoracic Aortic Aneurysm
Pathophysiology
Abnormal widening of the aorta as a result of weakness in the wall of a blood
vessel.
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Signs
Blood Pressure
Pulse
02 sat
Lung sounds
Skins
Special Questions
SAMPLE
OPQRST
Do you have a history of any
cardiac problems or past surgeries?
Do you have a family history of any
cardiac problems?
How long have you been
experiencing your discomfort?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Position of Comfort
 Transport
Symptoms
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Dysphagia
Swelling of the neck
Chest or back pain
Nausea/Vomiting
Pertinent Negatives
 Pain to the neck, jaw or upper back
 Dyspnea
 Hoarseness
AAA
Pathophysiology
Tearing of the aortic wall begins with a small tear of the inner vessel structure
and blood leaks between the walls of the aorta. There is an increasing amount of
pressure until the outer wall is damaged and blood leaks out behind the
peritoneum or into the abdominal cavity.
Signs
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Pulse
Blood pressure
Respirations
Skins
Special Questions
 SAMPLE
 OPQRST
 Have you taken anything to help
relieve your discomfort?
Symptoms
 Gradual onset of abdominal pain
 Nausea/ Vomiting
 Pale, cool, clammy skins
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Keep the patient warm, in a supine
position
Transport
Pertinent Negatives
Soft, pulsating abdominal mass if it
has not ruptured
Severe abdominal pressure/ tearing
sensation that radiates to the lower
back, flank or pelvis (testicles in
males)
If burst the abdomen will be rigid
and tender
When starting the rupture the skins
below the waistline will be cyanotic,
cold, and mottled, due to drop in
blood flow
Appendicitis
Pathophysiology
Inflammation of the appendix, and is usually caused by a blockage in the
intestines and results in inflammation and irritation.
Signs
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Pulse
Respirations
Blood Pressure
Skins
Special Questions
 SAMPLE
 OPQRST
 Have you had your appendix
removed?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
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Symptoms
Abdominal Pain
Nausea/Vomiting
Low grade fever/Chills
No appetite
Pertinent Negatives
 Positive McBurney’s point
 Tenderness to the RLQ
 Abdominal guarding
Pancreatitis
Pathophysiology
Inflammation of the pancreas.
Signs
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Pulse
Respirations
Blood Pressure
Skins
Symptoms
 Abdominal pain
 Nausea/Vomiting
 Abdominal tenderness and
distention
Special Questions
Pertinent Negatives
SAMPLE
 Pain in the middle of the upper
OPQRST
quadrants that may radiate to the
Do you have a history of gallstones?
back
Do you drink alcohol/ when was the  Gallstones or past history
last time you did? Do you have a
 History of alcohol abuse
history of excessive drinking?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
Esophageal Varices
Pathophysiology
Bulging, engorgement, or weakening of the blood vessels in the lining of the
lower part of the esophagus.
Signs
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Pulse
Respirations
Blood Pressure
Skins
Special Questions
 SAMPLE
 OPQRST
 Do you have a history of liver
disease?
 Do you drink alcohol regularly or
have a history of consumption?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
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Symptoms
Hematemesis
Dyspnea
Rapid pulse
Pale, cool, clammy skins
Pertinent Negatives
 Bright red emesis
 No abdominal pain
 Signs of shock
Cholecystitis
Pathophysiology
Inflammation of the gallbladder, commonly with the presence of gallstones.
Blockage causes an increase in pressure inside the gallbladder.
Signs
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Pulse
Respirations
Blood Pressure
Skins
Special Questions
 SAMPLE
 OPQRST
 Have you taken anything to help
relieve your discomfort?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
Symptoms
 Abdominal Pain to the RUQ
 Belching or Heartburn
 Nausea and Vomiting
Pertinent Negatives
 Sudden onset of pain localized to
the RUQ and can be referred to the
right scapula
 Belching or Heartburn
 Occurs in women more than men
between the ages of 30 and 50
Seizures (Grand Mal)
Pathophysiology
Abnormal electric activity low in the cerebral cortex that spreads upward
affecting both the cerebral hemispheres and downward affecting the reticular
activity system.
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Signs
Level of consciousness
Respirations
02 sat
Pulse
Blood Pressure
Special Questions
 SAMPLE
 Did the patient fall or hit their head
when the seizure began?
 Does the patient take medications
regularly if they have epilepsy and if
they do have they taken them
today?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
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Symptoms
Jerky, convulsive motor activity
Altered level of consciousness
Confusion
Headache
Fatigue
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Pertinent Negatives
Aura, if have history of epilepsy
Jerky, convulsive motor activity
Altered level of consciousness
Loss of bowel or bladder functions
Septic Shock
Pathophysiology
Result of an infection that releases bacteria or toxins in the blood, causing blood
vessels to dilate and become permeable.
Signs
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Respirations
Pulse
Blood Pressure
02 Sat
Skins
Special Questions
SAMPLE
OPQRST
Do you have a history of a recent
infection?
Have a recent surgery or medical
procedure?
Do you have a weakened immune
system?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Keep the patient warm
 Transport
Symptoms
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Chills
Lightheadedness
Shortness of breath
Rapid heart rate
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Pertinent Negatives
Low blood pressure
Rapid heart rate
Shortness of breath
Pale, cool, clammy skins
Anaphylactic Shock
Pathophysiology
Distributive shock that causes chemical mediators cause massive systemic
vasodilatation and permeability, leaking capillaries. Whole body allergic reaction.
Signs
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Respirations
Pulse
Blood Pressure
02 Sat
Skins
Special Questions
SAMPLE
OPQRST
Have you been exposed to any new
foods or know of an ingestion of
something you know you are
allergic to?
Have you been stung by any
insects?
Do you have a self prescribed MDI
or epi pen?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Assistance of self prescribed
epinephrine or MDI one time
Keep the patient warm
Transport
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Symptoms
Hives, itchiness
Palpitations
Difficulty breathing
Difficulty swallowing/ Wheezing
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Pertinent Negatives
Hives, itchiness
Swelling of the mucosal membranes
Exposure to new foods
Bee Stings
Psychogenic Shock
Pathophysiology
Sudden and temporary loss of consciousness, due to a lack of blood flow to the
brain and the brain is deprived of oxygen for a brief period of time
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Signs
Level of Consciousness
Blood Pressure
Pulse
Respirations
Special Questions
 SAMPLE
 Did you experience any chest pain
or shortness of breath prior to the
fall?
 Did you fall, and if so did you hit
your head?
 How long were you unconscious
for?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Place the patient in a supine
position
Transport
Symptoms
 Lightheaded
 Dizzy
 Sudden loss of unexplained
unconsciousness
Pertinent Negatives
 Sudden loss of unexplained
unconsciousness
 Cool, moist and pale skins
 Weakness
Neurogenic Shock
Pathophysiology
Spinal cord injury. Spinal cord injuries may damage the sympathetic nerve fibers
that control vessel tone below the level of injury.
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Signs
Blood pressure
Pulse
Skins
Level of Consciousness
Eyes
Special Questions
SAMPLE
Have you suffered from any recent
falls or suffered any trauma to the
neck?
Ask any family or bystanders if
there has been a change in the
patient’s mental status?
Are you taking any blood thinners?
BLS Treatment
 Maintain ABC’s
 C-Spine
 High Flow 02 15lpm via nonrebreather mask
 Transport
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Symptoms
Neck Pain/Injury
Shortness of breath
Weakness
Altered Mental Status
Pertinent Negatives
 Injury to the cervical or thoracic
spine
 Altered Mental Status
 Low blood pressure
Hemorrhagic Hypovolemic Shock
Pathophysiology
Loss of whole blood from the intravascular space, from a traumatic injury or
medical illness.
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Signs
Blood Pressure
Pulse
Skins
Level of consciousness
Special Questions
SAMPLE
OPQRST
Do you take any blood thinners?
Are you experiencing a headache or
feeling lightheaded?
 Ask family or bystanders if there
has been a change in the patient’s
mental status?
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BLS Treatment
Maintain ABC’s
Stop bleeding
High Flow 02 15lpm via nonrebreather mask
Keep the patient warm
Transport
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Symptoms
Injury with blood loss
Altered Level of Consciousness
Headache
Shortness of Breath
Pertinent Negatives
 Injury with blood loss
 Lightheadedness/Headache
 Altered Level of Consciousness
Nonhemorrhagic Hypovolemic Shock
Pathophysiology
Water, plasma proteins and electrolytes are lost from the intravascular space.
Due to severe diarrhea, vomiting, excessive sweating or excessive urination.
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Signs
Blood Pressure
Pulse
Skins
Level of consciousness
Special Questions
SAMPLE
OPQRST
Have you suffered from any recent
illness or flu?
Have you been drinking a lot of
fluids?
BLS Treatment
Maintain ABC’s
Try to give the patient fluids per os
High Flow 02 15lpm via nonrebreather mask
Transport
Symptoms
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Malaise
Diarrhea
Vomiting
Excessive sweating
Excessive urination
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Pertinent Negatives
Malaise
Diarrhea
Vomiting
Excessive sweating
Excessive urination
Cardiogenic Shock
Pathophysiology
The heart is unable to supply enough blood to the organs of the body as a result
of damage to the heart.
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Signs
Blood Pressure
Pulse
Respirations
02 sat
Skins
Level of Consciousness
Special Questions
SAMPLE
OPQRST
Have you experienced anything like
this in the past?
Do you take any medications for
your heart?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Keep the patient warm
Transport
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Symptoms
Chest pain/pressure
Shortness of breath
Diaphoresis
Altered mental status
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Pertinent Negatives
Chest Pain
Pale, cool and clammy skins
Dyspnea
Altered mental status
Local & Systemic Allergic Reaction
Pathophysiology
Massive systemic vasodilatation and permeability, leaking capillaries. Whole body
allergic reaction.
Signs
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Respirations
Pulse
Blood Pressure
02 Sat
Skins
Special Questions
SAMPLE
OPQRST
Have you been exposed to any new
foods or know of an ingestion of
something you know you are
allergic to?
Have you been stung by any
insects?
Do you have a self prescribed MDI
or epi pen?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Assistance of self prescribed
epinephrine or MDI one time
Keep the patient warm
Transport
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Symptoms
Hives, itchiness
Palpitations
Difficulty breathing
Difficulty swallowing/ Wheezing
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Pertinent Negatives
Hives, itchiness
Swelling of the mucosal membranes
Exposure to new foods
Bee Stings
Diabetic Type 1
Pathophysiology
Most often occurs at a young age, the pancreas does not produce enough insulin
to properly control blood sugar levels.
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Signs
Level of Consciousness
Skins
Blood Pressure
Pulse
Respirations
Special Questions
 SAMPLE
 BRIM/AVPU
 Have you experienced anything like
this before?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Adminster oral glucose of the
patient’s glucomater reads <60 per
SD protocol, you may give 3 oral
tablets or 15Gm total, give the
patient something to eat as well,
patient must be awake and have
gag reflex
Transport
Symptoms
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Headache
Increased thirst and urination
Fatigue
Vision changes
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Pertinent Negatives
History of diabetes
Insulin dependent
Extreme thirst
Altered Mental Status
Diabetic Type 2
Pathophysiology
High levels of glucose, lack of insulin.
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Signs
Level of Consciousness
Skins
Blood Pressure
Pulse
Respirations
Special Questions
 SAMPLE
 BRIM/AVPU
 Have you experienced anything like
this before?
 Ask family or bystanders when the
patient was last seen in a normal
state.
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
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Symptoms
Gradual onset
Excessive urination
Polydipsia
Polyphagia
Pertinent Negatives
 Weak/ Rapid Pulse
 Kussmaul respirations
 Fruity acetone breath
TIA
Pathophysiology
Brief episode of stroke-like symptoms caused by an oxygen deficit in the brain
tissue.
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Signs
Level of Consciousness
Blood Pressure
Pulse
Eyes
Skins
Symptoms
 Sudden onset of weakness, tingling
or paralysis in the face, arm, leg
especially to one side of the body
 Altered Mental Status
 Headache
Special Questions
SAMPLE
Are you experiencing a headache,
and if so on a scale from 1-10, 1
being no pain and 10 being the
worst headache you’ve ever had
how would you rate it?
Where are you experiencing
weakness, tingling or paralysis?
Have you experienced anything like
this in the past?
Pertinent Negatives
 Symptoms that last 10-15 minutes
or no longer than an hour and
subside on their own
 Weakness, tingling or paralysis
 Altered Mental Status
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Place the patient in a supine
position
Immediate transport
CVA
Pathophysiology
Blood supply from a part of the brain is disrupted, causing brain cells to die.
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Signs
Level of Consciousness
Blood Pressure
Pulse
Respirations
Eyes
Special Questions
SAMPLE
BRIM/AVPU
Ask family or bystanders if there
has been a change in the patient’s
mental status?
When was the patient last seen in a
“normal” state?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Place the patient in a supine
position
Immediate Transport
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Symptoms
Sudden numbness or weakness to
the face, arm or leg preferably to
one side of the body
Altered Mental Status
Loss of Coordination
Headache
Pertinent Negatives
Positive Cincinnati Pre-hospital
Stroke Scale
Sudden onset of numbness or
weakness to the face, arm or leg to
one side of the body
Headache
Altered Mental Status
Syncope
Pathophysiology
Sudden and temporary loss of consciousness, due to a lack of blood flow to the
brain and the brain is deprived of oxygen for a brief period of time
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Signs
Level of Consciousness
Blood Pressure
Pulse
Respirations
Special Questions
 SAMPLE
 Did you experience any chest pain
or shortness of breath prior to the
fall?
 Did you fall, and if so did you hit
your head?
 How long were you unconscious
for?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Place the patient in a supine
position
Transport
Symptoms
 Lightheaded
 Dizzy
 Sudden loss of unexplained
unconsciousness
Pertinent Negatives
 Sudden loss of unexplained
unconsciousness
 Cool, moist and pale skins
 Weakness
Chronic Bronchitis
Pathophysiology
Inflammation, swelling, and thickening of the lining of the bronchi and
bronchioles as well as excessive mucous production. Associated with cigarette
smoking.
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Signs
Lung Sounds
02 sat
Respirations
Blood Pressure
Pulse
Skins
Special Questions
SAMPLE
OPQRST
Do you have a history of COPD?
Do you smoke cigarettes?
Do you have prescribed MDI that
you use?
BLS Treatment
 Maintain ABC’s
 Assist patient with prescribed MDI if
they have one
 High Flow 02 15lpm via nonrebreather mask/ no distress apply
nasal cannula 2-6lpm
 Position of comfort
 Transport
Symptoms
 Productive cough
 Difficulty breathing
 Fatigue
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Pertinent Negatives
History of COPD
History of cigarette smoking
Overweight
Blue complexion
Productive cough
Asthma
Pathophysiology
Sensitivity to the lower airways to irritants and allergens that cause a
bronchospasm.
Signs
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02 sat
Respirations
Lung sounds
Blood Pressure
Pulse
Special Questions
SAMPLE
OPQRST
Do you have a prescribed MDI and
if yes, have you used it?
How long have you been
experiencing this attack?
BLS Treatment
Maintain ABC’s
Assist the patient with prescribed
MDI one time only if they have not
used it, if they have obtain a BHO
High Flow 02 15lpm via nonrebreather mask
Position of comfort
Immediate Transport
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Symptoms
Shortness of breath
Wheezing
Anxiety
Chest tightness
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Pertinent Negatives
History of Asthma
Wheezing
Shortness of Breath
Anxiety
Pneumothorax
Pathophysiology
Collection of air in the pleural space that eventually builds up and collapses a
lung.
Signs
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Lung Sounds
Blood Pressure
Pulse
Respirations
Special Questions
 SAMPLE
 OPQRST
 Have you experienced anything like
this in the past?
 Were you doing anything that may
have provoked this sudden
discomfort?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Position of comfort
Transport
Symptoms
 Sudden sharp chest pain
 Shortness of Breath
 Chest tightness
Pertinent Negatives
 Absent lung sounds to one side
 Severe respiratory distress
 Chest pain worsened with cough or
deep breath
Tension Pneumothorax
Pathophysiology
Result of a pneumothorax that continues to trap air in the thoracic cavity with no
relief or escape.
Signs
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Lung Sounds
02 sat
Respirations
Blood Pressure
Pulse
Special Questions
 SAMPLE
 OPQRST
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Immediate Transport
Symptoms
 Severe respiratory distress
 Severe hypoxia
 Cyanotic skins
Pertinent Negatives
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JVD
Tracheal deviation
Respiratory distress
Absent lung sounds to one side
Emphysema
Pathophysiology
Loss of elasticity to lung tissue, alveoli become distended and with trapped air
and alveoli walls are destroyed. Permanent disease process characterized by
cigarette smoking.
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Signs
02 sat
Respirations
Lung sounds
Blood Pressure
Pulse
Skins
Special Questions
SAMPLE
OPQRST
Do you smoke cigarettes?
Do you have prescribed MDI that
you use?
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask/no distress apply
nasal cannula 2-6lpm
Position of comfort
Transport
Symptoms
 Dyspnea
 Cough
 Diaphoresis
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Pertinent Negatives
History of COPD
History of cigarette smoking
Thin-barrel chest appearance
Pink complexion
Tripod position
Croup
Pathophysiology
Infection of the upper airway caused by a virus. Causes swelling beneath the
glottis and narrows the airway.
Signs
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02 sat
Respirations
Lung sounds
Blood Pressure
Pulse
Special Questions
 SAMPLE
 OPQRST
 Has the patient seen a doctor
recently for this probkem?
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BLS Treatment
Maintain ABC’s
Humidified 02 via non-rebreather
Position of comfort
Transport
Symptoms
 “seal bark” cough
 Dyspnea
 Restlessness
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Pertinent Negatives
“seal bark” cough
Stridor with inhalation
Retractions when breathing
Tachycardia
Multi- System Trauma
Pathophysiology
A patient that is involved in a trauma that has multiple injuries or involvement of
more than one body system.
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Signs
Level of Consciousness
Blood Pressure
Pulse
Lung Sounds
Respirations
02 sat
Skins
Special Questions
 AVPU/BRIM
 Chief complaint of pain/discomfort
 Palpate the body and ask if the
patient is experiencing any pain
when doing so
 Past medical
history/surgeries/medications
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BLS Treatment
Maintain ABC’s
Place the patient in C-spine
High Flow 02 15lpm via nonrebreather mask
Immediate transport
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Symptoms
Multiple chief complaints of pain
Pertinent Negatives
Involved in a traumatic incident
with obvious multiple injuries or
complaints
Pulmonary Contusion
Pathophysiology
Bruising of the tissue of the lung, which may cause fluid and swelling inside of
the lung.
Signs
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Lung Sounds
Respirations
Blood Pressure
Pulse
Special Questions
 SAMPLE
 OPQRST
 Have you suffered any recent
trauma that may have provoked
this discomfort?
 Where is your chest wall discomfort
located?
 Are you experiencing any shortness
of breath?
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Position of comfort
 Transport
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Symptoms
Chest Wall pain
Dyspnea
Coughing up blood or sputum
Dizziness/Lightheadedness
Pertinent Negatives
 Recent trauma, MVA, CPR or fall
 Bruise to the chest wall
 Chest wall tenderness to palpation
Evisceration
Pathophysiology
Abdominal organs protruding through the skin.
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Signs
Level of Consciousness
Blood Pressure
Pulse
Respirations
02 sat
Special Questions
 SAMPLE
 What happened?
 Is there any other injuries?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Apply moist dressing to the exposed
organs
Immediate transport
Symptoms
 Trauma to the abdomen with
organs protruding through the skin
 Abdominal pain
Pertinent Negatives
 Presentation of abdominal organ
through the skin
 Pain
Cardiac Contusion
Pathophysiology
Bruise to the heart from trauma.
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Signs
Blood Pressure
Pulse
Respirations
02 sat
Symptoms
 Chest wall tenderness
 Shortness of Breath
 Palpitations
Special Questions
SAMPLE
OPQRST
Have you suffered any recent
trauma that may have provoked
this discomfort?
Where is your chest wall discomfort
located?
Are you experiencing any shortness
of breath?
Pertinent Negatives
 Recent trauma, MVA, CPR or fall
 Bruise to the chest wall
 Chest wall tenderness to palpation
BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Position of comfort
Transport
ICP Epi & Subdural
Pathophysiology
Increased pressure within the skull.
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Signs
Level of consciousness
Blood Pressure
Pulse
Respirations
02 sat
Special Questions
 SAMPLE
 OPQRST
 Have you experienced anything like
this in the past?
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BLS Treatment
Maintain ABC’s
High Flow 02 15lpm via nonrebreather mask
Position of comfort
Transport
Symptoms
 Headache
 Nausea/Vomiting
 Altered Mental Status
Pertinent Negatives
 Severe headache
 Altered Mental Status
ICP Subdural
Pathophysiology
Signs
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Symptoms
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Special Questions
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Pertinent Negatives
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BLS Treatment
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Cardiac Tamponade
Pathophysiology
Blood or fluid build up in the space between the myocardium and the
pericardium, which prevents the heart from functioning adequately.
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Signs
Blood Pressure
Pulse
Respirations
Level of Consciousness
Special Questions
 SAMPLE
 OPQRST
 Have you experienced anything like
this before?
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Symptoms
Chest Pain sharp and stabbing
Dyspnea
Palpitations
Feeling faint-like
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Pertinent Negatives
Anxiety
Altered mental Status
Weak or absent pulse
Levine’s sign
BLS Treatment
 Maintain ABC’s
 High Flow 02 15lpm via nonrebreather mask
 Transport
Ruptured Ectopic Pregnancy
Pathophysiology
The egg is implanted outside the uterus either in the fallopian tube, abdominal
peritoneal covering, outside wall of the uterus, on an ovary or on the cervix.
Signs
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Pulse
Respirations
Blood Pressure
Skins
Special Questions
SAMPLE
OPQRST
Have you been pregnant before?
And if so have you had an ectopic
pregnancy?
How far along are you in your
pregnancy?
BLS Treatment
 Maintain ABC’s
 Oxygen via non-rebreather mask
15lpm
 Immediate transport
Abruption
Symptoms
 Sudden sharp lower abdominal pain
 Vaginal bleeding that may be light,
heavy or absent
 Shoulder pain
Pertinent Negatives
 Pregnancy with sharp abdominal
pain
 Tender abdomen to palpation
 Signs of shock
Pathophysiology
When small arteries located in the lining between the placenta and uterus
rupture, blood accumulates, tearing and separating the placenta from the uterine
wall. There are two kinds, partial and complete.
Signs
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Pulse
Blood pressure
Respirations
02 sat
Skins
Special Questions
 SAMPLE
 OPQRST
 Have you been pregnant before?
And if so how many times?
 Do you have a history of diabetes?
 Do you have a history of high blood
pressure?
BLS Treatment
 Maintain ABC’s
 Oxygen via non-rebreather mask
15lpm
 Immediate transport
Symptoms
 Vaginal bleeding
 Constant abdominal pain
 Lower back pain
Pertinent Negatives
 Abdominal pain and vaginal
bleeding with known pregnancy
 Contractions
 Tender abdomen to palpation
Placenta Previa
Pathophysiology
Abnormal implantation of the placenta over or near the opening of the cervix.
There are three types: Total, Partial, and Marginal.
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Signs
Blood Pressure
Pulse
Respirations
Skins
Special Questions
 SAMPLE
 OPQRST
 Have you been pregnant before?
And if so how many times?
BLS Treatment
 Maintain ABC’s
 Oxygen via non-rebreather mask
15lpm
 Rapid transport
Toxemia
Symptoms
 Vaginal Bleeding in the third
trimester
 Possible uterine cramping
Pertinent Negatives
 Vaginal Bleeding with known
pregnancy in the third trimester
 History of early vaginal bleeding
 Signs of Hypovolemic shock
Pathophysiology
Also known as preeclampsia. Placental disorder that causes vessels throughout
the body to spasm leading to reduction of blood flow to organs. Typically occurs
in the last 10 weeks of pregnancy.
Signs
 Blood Pressure
 Pulse
 Respirations
Special Questions
 SAMPLE
 OPQRST
 Have you experienced any vaginal
bleeding or discharge?
 How far along are you in the
pregnancy?
 Have you been pregnant before?
BLS Treatment
 Maintain ABC’s
 Oxygen via non-rebreather mask
15lpm
 Normal transport NOT rapid
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Symptoms
Sudden weight gain
Headache
Abdominal Pain
Decreased urinary output
Pertinent Negatives
 Patient is in their 20’s with first
pregnancy
 Family history of ecclampsia
 High blood pressure