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Basic Life Support (BLS/BAA

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Study Notes

Basic Life Support (BLS/BAA)
Table of Contents
Medical Terminology ................................................................................................................................... 6
Prefixes – Direction & Quantity .............................................................................................................................................. 6
Combining Words – What Organ or Substance ....................................................................................................................... 6
Suffixes – What’s Going On..................................................................................................................................................... 6
Examples ............................................................................................................................................................................. 6
Planes of the Body .................................................................................................................................................................. 7
Directional Terms ................................................................................................................................................................... 7
Movement Terms ................................................................................................................................................................... 7
Anatomical Positions .............................................................................................................................................................. 7

Body Systems ............................................................................................................................................... 8
Cardiovascular System............................................................................................................................................................ 8
Heart................................................................................................................................................................................... 8
Electrical Cycle..................................................................................................................................................................... 9
Stroke Volume ..................................................................................................................................................................... 9
Cardiac Output .................................................................................................................................................................... 9
Peripheral Vascular Resistance ............................................................................................................................................ 9
Blood Pressure..................................................................................................................................................................... 9
Pulse Points ......................................................................................................................................................................... 9
Heart Rate........................................................................................................................................................................... 9
Nervous System .................................................................................................................................................................... 10
Central Nervous System ..................................................................................................................................................... 10
Brain ................................................................................................................................................................................. 10
Peripheral Nervous System ................................................................................................................................................ 11
Reflex Arch ........................................................................................................................................................................ 11
Digestive System .................................................................................................................................................................. 12
Muscular-Skeletal System ..................................................................................................................................................... 12
Muscles ............................................................................................................................................................................. 12
Skeleton ............................................................................................................................................................................ 13
Respiratory System ............................................................................................................................................................... 14
Upper Respiratory Tract ..................................................................................................................................................... 14
Lower Respiratory Tract ..................................................................................................................................................... 14
Gaseous Exchange ............................................................................................................................................................. 14
Lungs ................................................................................................................................................................................ 15
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Breathing .......................................................................................................................................................................... 15
Integumentary System ......................................................................................................................................................... 16
Urinary System ..................................................................................................................................................................... 16
Gastrointestinal System........................................................................................................................................................ 17
Reproductive System ............................................................................................................................................................ 17
Maternity .......................................................................................................................................................................... 17
Child Birth ......................................................................................................................................................................... 18
Maternity Pack .............................................................................................................................................................. 18
Stages of Labour ............................................................................................................................................................ 18
Antenatal Haemorrhage ................................................................................................................................................ 19
Post-partum Haemorrhage ............................................................................................................................................ 19

Patient Assessment .................................................................................................................................... 20
Primary Survey ..................................................................................................................................................................... 20
Hazards ............................................................................................................................................................................. 20
Hello.................................................................................................................................................................................. 20
Help .................................................................................................................................................................................. 20
Airway ........................................................................................................................................................................... 20
Breathing ...................................................................................................................................................................... 21
Circulation ..................................................................................................................................................................... 22
Secondary Survey ................................................................................................................................................................. 23
SAMPLE History ................................................................................................................................................................. 23
Vital Signs ......................................................................................................................................................................... 23
Head to Toe Survey ............................................................................................................................................................ 24

Assessment of Emergencies ....................................................................................................................... 25
Respiratory Emergencies (pg 369 – 397) ............................................................................................................................... 25
APE (acute pulmonary edema) ........................................................................................................................................... 25
COPD (chronic obstructive pulmonary disease) ................................................................................................................... 25
Asthma.............................................................................................................................................................................. 26
Pnumothorax..................................................................................................................................................................... 26
Anaphylactic Reaction ....................................................................................................................................................... 26
Hayfever............................................................................................................................................................................ 27
Pleural Effusion ................................................................................................................................................................. 27
Choking ............................................................................................................................................................................. 27
Pulmonary Embolism ......................................................................................................................................................... 27
Hyperventilation Syndrome................................................................................................................................................ 28
General Respiratory Problems ............................................................................................................................................ 28
Cardiovascular Emergencies (pg 402 – 437) .......................................................................................................................... 29
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Angina Pectoris ................................................................................................................................................................. 29
AMI (acute myocardial infarction)...................................................................................................................................... 30
Congestive Heart/Cardiac Failure ....................................................................................................................................... 30
Left Ventricular Failure................................................................................................................................................... 30
Right Ventricular Failure ................................................................................................................................................ 31
Neurological Emergencies (pg 440 – 479) ............................................................................................................................. 31
Cerebrovascular Accident (CVA) or Stroke .......................................................................................................................... 31
Transient Ischemic Attack .................................................................................................................................................. 32
Convulsions – Seizures ....................................................................................................................................................... 32
Status Epilepticus........................................................................................................................................................... 32
Causes of Unconsciousness ............................................................................................................................................ 32
Acute Abdomen (pg 466 – 479) ............................................................................................................................................. 33
Diabetic Emergencies (pg 482 – 497) .................................................................................................................................... 34
Environmental Emergencies (pg 546 – 581) .......................................................................................................................... 35
Hypothermia ..................................................................................................................................................................... 35
Hyperthermia .................................................................................................................................................................... 35
Submersion (Drowning) ..................................................................................................................................................... 36
Near Drowning .................................................................................................................................................................. 36
Diving Injuries.................................................................................................................................................................... 36

Paediatrics ................................................................................................................................................. 37
Ages ..................................................................................................................................................................................... 37
Medical Problems ................................................................................................................................................................. 37
Epiglottitis ......................................................................................................................................................................... 37
Croup ................................................................................................................................................................................ 37

Trauma (pg 630 – 911) ............................................................................................................................... 38
Mechanism of Injury ............................................................................................................................................................. 38
Shock .................................................................................................................................................................................... 39
Hypovolemic Shock ............................................................................................................................................................ 39
Cardiogenic Shock ............................................................................................................................................................. 39
Neurogenic Shock .............................................................................................................................................................. 39
Septic Shock ...................................................................................................................................................................... 39
Anaphylactic Shock ............................................................................................................................................................ 39
Stages of Shock..................................................................................................................................................................... 40
Bleeding ............................................................................................................................................................................... 41
Soft Tissue Injuries ................................................................................................................................................................ 41
Abdominal Injuries ............................................................................................................................................................... 42
Abdominal Injuries............................................................................................................................................................. 42
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Facial Injuries ....................................................................................................................................................................... 43
Types of Injuries................................................................................................................................................................. 43
Eye Injuries ........................................................................................................................................................................... 44
Types of Injuries................................................................................................................................................................. 44
Chest Injuries ........................................................................................................................................................................ 45
Pneumothorax................................................................................................................................................................... 45
Haemothorax .................................................................................................................................................................... 45
Pericardial Tamponade ...................................................................................................................................................... 45
Flail Chest.......................................................................................................................................................................... 46
Contusions......................................................................................................................................................................... 46
Fractures .............................................................................................................................................................................. 46
How to Treat ..................................................................................................................................................................... 47
Head Injuries ........................................................................................................................................................................ 48
Concussion ........................................................................................................................................................................ 48
Inter-cranial Haemorrhage ................................................................................................................................................ 48
Base of Skull # ................................................................................................................................................................... 48
Raised Intracranial Pressure............................................................................................................................................... 49
Poison, Bites and Stings ........................................................................................................................................................ 49
Snakes............................................................................................................................................................................... 49
Organophosphates ............................................................................................................................................................ 49
Burns .................................................................................................................................................................................... 50

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an - absence ab - away from ad - adduction bi - two tri - three brady - slow tachy - fast hemi - half peri - around Combining Words – What Organ or Substance cardio - heart cerebro - brain cephalo - head dermo - skin gastro - stomach neuro - nerves myo - muscle osteo - bone pneumo - air rhino - nose thoraco - chest Suffixes – What’s Going On emia - in the head itis - inflammation of paresis - weakness plegia - paralysis uria - urine rrhea - profuse Examples pneumothorax = pneumo (air) + thorax (chest) : air in the chest pharyngitis = pharynx + (g)itis : inflammation of the pharynx acute myocardial infarction = heart attack Page 6 .Medical Terminology Prefixes – Direction & Quantity a.

Planes of the Body anterior - front surface posterior - back surface midline - an imaginary line dividing left & right midclavicular line - a line middle of the clavicle parallel to midline midaxillary line vertical line middle of axilla (armpit) parallel to midline - Directional Terms left & right - patient’s left & right superior - top half of body inferior - lower half of body lateral - away from midline bilateral - both sides of midline medial - towards midline superficial - on the top Movement Terms flexion - bending (of a joint) extension - extending (of a joint) abduction - motion away from midline adduction - motion towards midline Anatomical Positions prone - lying face down supine - lying face up Fowler’s Position - sitting up with knees bent recovery position - patient lying lateral with head resting on arm and one leg bent shock position lying flat with just inferior body raised 15 – 30cm - Trendelenburg’s Position - body lying flat with feet raised 15 – 30cm above head Page 7 .

spinal cord and nerves  Digestive System: stomach and intestines  Muscular-skeletal System: muscles and skeleton  Endocrine System: hormones  Respiratory System: lungs and diaphragm  Integumentary: skin  Urinary System: kidneys and bladder  Gastrointestinal System: lower abdomen  Reproductive System: genitals  Lymphatic/Immune System Cardiovascular System This system consists of:  Heart  Blood Vessels (veins & arteries)  Blood Heart Page 8 . veins and arteries  Nervous System: brain.Body Systems Cell Tissue Organ System  Cardiovascular System: heart.

Hypotension: When systolic pressure is below 90mmHg Hypertension: When diastolic pressure is above 90mmHg Pulse Points Carotid: 50mmHg systolic Femoral:60mmHg systolic Brachial:70mmHg systolic Radial: 80mmHg systolic Pedal: 90mmHg systolic Heart Rate Adult heart rate should be between 60 – 100bpm (<60 = bradycardia / >100 = tachycardia) Page 9 . CO = SV x HR (cardiac output = stroke volume x heart rate) Peripheral Vascular Resistance The resistance of the blood in the veins. Diastolic Pressure: Minimum pressure in the arteries when the heart is at rest. It is directly related to blood pressure. Blood Pressure Systolic Pressure: Maximum pressure against arterial walls when the heart contracts.Electrical Cycle Bundle of His Pukinje Fibres Stroke Volume This is the amount of blood that the heart pushes out through the ventricles per contraction measured in millilitres. Cardiac Output The amount of blood being pushed out by the ventricles per minute measured in millilitres.

kicking a ball. Central Nervous System  Brain    Spinal cord Meninges Cerebrospinal fluid Brain  Cerebrum (“Grey Matter”) o Largest part o Divided into 2 hemispheres (right: controls left body. etc. knitting.Nervous System  Consists of the brain.  The nervous and endocrine systems maintain homeostasis – the balance within the body.  Cells within these organs use electro-chemical signals called nerve impulses. These impulses communicate with muscles and glands. nerves and sense organs. spinal cord.)  Brain Stem o The brain stem connects the brain to the spinal cord o Consists of the:  pons these work together to control respiration  medulla oblongata Page 10 . left: controls right body) o Corpus callosum (multitasking) o Divided into 4 lobes:  Frontal lobe  controls voluntary movement     concentration  planning and problem solving Temporal lobe  memory  hearing Parietal lobe  sensations of touch. temperature and pressure Occipital lobe  vision  Cerebellum o “Little brain” o Consists of two hemispheres o Helps maintain posture o Aids with fine motor skills (writing.

flight. A nerve itself basically decides to initiate a response based on information it receives and triggers the skeletal muscles to react if it thinks the brain will take too long to respond. Meninges (pg 874) o Dura mater – closest to the scull o Arachnoid mater – middle layer o Pia Mater – closest to the brain o Cerebrospinal fluid  bathes the brain and spinal cord  acts as a shock absorber  filters impurities Peripheral Nervous System   Somatic nervous system Autonomic nervous system   Cranial nerves (12 pairs) Spinal nerves (31 pairs) Peripheral Nervous System autonomic nervous system somatic nervous system sympathetic nervous system parasympathetic nervous system fight. Eg. fright rest & digest afferent: takes messages to the brain efferent: takes impulses away from the brain Reflex Arch   Sensory nerve Connecting nerve  Motor nerve reflex arch This occurs when an automatic reflex response takes place. placing a finger on a hot plate and removing it before it really gets burned. Page 11 .

Digestive System In descending order:   Mouth Saliva - mastication breaks down food  Bolus - ball of food  Tongue - helps swallow bolus    Oesophagus Cardiac sphincter Stomach -   Pyloric sphincter valve to small intestines small intestines o ileum o jejunum o duodenum large intestine o cecum o ascending colon o transverse colon o descending colon    peristalsis (muscle “wave”) to move food down valve before stomach hydrochloric acid breaks down food and stores food rectum anus Muscular-Skeletal System  Consists of the muscles and skeleton.  Hold the body together to provide structure Muscles Used for:  Movement  Protection  Stabilisation Types of muscles:  Skeletal: lie parallel to each other  Smooth: group together  Cardiac: attach to each other Page 12 .

Skeleton Used for:  Protection  Structure  Attachment point for muscles  Erythropoesis Page 13 .

Respiratory System The respiratory centre consists of the following structures:       medulla oblongata – respiratory system in the brain phrenic nerve – branch of nerves that control breathing (C3C4C5 keep the diaphragm alive) upper and lower respiratory tract lungs diaphragm – expand and contract the lungs and does 70% of breathing intercostal muscles – expand and contract chest area and control other 30% of breathing Upper Respiratory Tract In descending order:  mouth and nose  nasopharynx    oropharynx laryngopharynx epiglottis Lower Respiratory Tract In descending order:  larynx (voice box)   trachea carina   primary bronchi secondary bronchi   tertiary bronchi (bronchioles) alveoli (for gas exchange) Gaseous Exchange Page 14 .

Lungs  Pleura (x2) o parietal (around chest cavity) o visceral (around the lungs) o pleural space (between layers) Breathing    12 – 20 breaths per minute < 12bpm = bradypnea > 20bpm = tachypnea  masks: o o o o o  nebuliser venturi rebreather non-rebreather BVMR 40% @ 4 – 6lpm 40% @ 8lpm 60% @ 10 – 12lpm 95% @ 10 – 12lpm 100% @ 15lpm when assessing breathing. check: o rate (how fast) o rhythm (whether it’s regular or not) o volume (how much air – shallow or deep) Page 15 .

 The ureters carry urine from the kidney to the bladder and are about 30cm long. o Blood is filtered through the kidney to remove waste and produce urine from it.  The urethra provides a passage for urine to the exterior.  The bladder lies in the pelvic cavity. o Its muscular walls can dilate to store more urine and contracts to expel it. o Lying above each kidney is an adrenal gland. Page 16 .Integumentary System Used for:  Protection from elements  Temperature regulation (by sweating)  Production of vitamin D Consists of:  Epidermis: o Outer layer of skin o Has 5 layers of cells  Dermis: o Hair follicles o Sweat glands o Nerves o Sebaceous glands (oil) o Blood vessels (capillaries) Hypodermis/Subcutaneous Layer: o Fatty tissues  Urinary System  Consists of: o 2x kidneys o 2x ureters o bladder o urethra  The kidneys sit in the posterior abdominal wall at the level of ± T12 – L2 o Each kidney contains around 1 million filter units known as nephrons.

Gastrointestinal System Approximate organ locations: RUQ LUQ Liver Gallbladder Kidney Large & small intestine Stomach Spleen Pancreas Kidney Large & small intestine RLQ LLQ Appendix Bladder Reproductive Large & small intestine Bladder Reproductive Large & small intestine Reproductive System  Function is to reproduce Maternity   40 weeks = full term 3 trimesters: o 1st: 1 – 12 weeks  breasts get tender  morning sickness (hypermesisgravaduram)  fatigue  amenorrhea  uterus enlargement  lower abdominal cramping  lower BP higher HR Page 17 .

until full dilation of cervix o 10 – 30secs mild contractions o 15 – 20mins contraction interval o membranes rupture o bloody show  Stage 2: o crowning.o o 2nd: 13 – 28 weeks  breast enlargement  abdominal enlargement  organs start moving  heartburn  constipation  cravings rd 3 : 29 – 40 weeks  (possible) morning sickness  more everything  fundus drops  lactation Child Birth Maternity Pack  sterile gloves     blanket linen savers cord clamps surgical blade  bag (for afterbirth)  mucus extractor   sterile gauze plastic apron   safety glasses sanitary towels Stages of Labour  Stage 1: o onset of contractions. until full delivery of baby o 60 – 90secs contractions o 60sec interval  Stage 3: o delivery of placenta o 5 – 30mins Page 18 .

no contractions Pre-eclampsia: o 20th + n weeks o can cause hypertension o 140/90mmHH o affects kidneys o high concentration of protein in urine (proteinuria) o blurred vision. abdominal pain Eclampsia: o 20th + n weeks o 160/110mmHG o can cause eclamptic seizures o urine test +++  ++++ o you’ll want an ALS backup o transport lateral (to prevent pressure on inferior vena cava) Post-partum Haemorrhage  This is any bleeding after birth/placenta Page 19 . headaches.Antenatal Haemorrhage     Placenta Abruptia: o dark red blood o severe abdominal pain o placenta separates from uterus wall o can lose between 500ml – 2000ml blood o check vitals Placenta Previa o partially or completely covers the cervix o bright red blood o no pain.

Hello  Approach patient from the front  AVPU Alert: do they follow with their eyes o Verbal: do they respond to verbal communication o Pain: do they react to pain (tap on shoulder/pinch ear) o Unresponsive: patient has no response o  If conscious: o Introduce/identify yourself o Ask if you can help them (expressed consent)  If unconscious: o Adult: treat immediately (implied consent) o Minor: get guardian permission if possible. AMS. hot/cold? Traffic: protect against cars and human traffic (barrier tape if needed) Unexpected: expect the unexpected and plan for it (eg: remove animals) Protection: gloves. reflective gear. safety glasses. helmet. Traffic. Disaster Management.  SETUP o o o o o Stop: and think Environment: night/day. infection and protection. etc. rain/sun. SAPS. etc. treat (implied consent) Help  Call for backup: o ILS.  AABC o Align spine o Airway o Breathing o Circulation Airway    Open airway: o Head-tilt.Patient Assessment Primary Survey Hazards  Make scene safe for you and your partner. chin-lift (if no suspected c-spine injuries) o Jaw-thrust manoeuvre (if suspected c-spine injuries) Maintain airway: o Insert OPT (if unconscious) o Suction (if needed) Protect airway: o Turn patient lateral (if possible) Page 20 . Fire. ALS. if not. Hazmat. patient. NSRI. boots.

Breathing      Look. just pretend to take pulse while assessing) Rate: o how fast is breath:  < 12bpm – bradypnea: needs ventilation  12 – 20bpm – normal: no intervention required. liquid/solid sound) Page 21 . just administer oxygen  > 20bpm – tachypnea: needs breath coaching (if conscious) Rhythm: o is the rhythm steady:  check for abnormal breaths  normal = 1 breath every 5-6 seconds Volume: o how much air:  check that the chest rises and falls sufficiently enough Oxygenate patient (if safe to do so) Chest Exam  Expose chest (after acquiring permission)  Inspect chest o rise and fall o check for paradoxical motion (opposite inflation/deflation) o fractured ribs o contusions (bruises) o bleeding o sucking chest wounds o central cyanoses o JVD (jugular vein distension)  Auscultate chest o Listen for any abnormalities o L & R apex (intersection of midclavicular line and Angle of Louis) o L & R base (diagonal from nipple line on midaxillary line or bra strap) o Heart sounds  Palpate chest o fractures: crepitus o subcutaneous emphysema (air entrapment) o tracheal deviation  Percuss chest o hyperresonance (too much resonance. Listen. hollow sound) o hyporesonance (too little resonance. 30 or 60secs  don’t tell patient you’re looking at breathing (eg. Feel o Look for any chest rising o Listen for chest sounds o Feel for breath o Unconscious:  10secs  head close to patient and looking at chest o Conscious:  15.

Circulation       Conscious patient: use radial pulse Unconscious patient: use carotid pulse Rate: o how fast is heart rate:  < 60bpm – bradycardia  60 – 100bpm – normal  > 100bpm – tachycardia Rhythm: o is the heart rate steady. no arrhythmias Volume: o is the heart rate shallow or strong Check for any profuse bleeding Page 22 .

rhythm. volume   Blood pressure Pupils: PERRL – pupils equal & round & responsive to light  Respiratory rate: rate. colour. rhythm. stabbing? Radiation/Region: where does it go? where is it? Severity: how bad is it? (scale of 1 – 10: ask patient for work pain ever and base answer on that) Timing: does it come and go or is it constant? Vital Signs  Pulse: rate. condition Capillary refill SATS Glasgow Coma Scale Glasgow Coma Scale  Eye Opening: o Spontaneous o Verbal o Pain o None  Verbal Response o Orientated o Confused o Inappropriate words o Incomprehensible sounds o None  Motor Response o Obeys commands o Localises pain o Withdraws from pain o Abnormal flexion o Abnormal extension o None Page 23 4 3 2 1 5 4 3 2 1 6 5 4 3 2 1 . volume  Haemoglucose Test (HGT): blood glucose level     Skin: temp.Secondary Survey SAMPLE History       Signs and Symptoms Allergies Medication Past medical history Last oral input/output Events leading up to       Cardiac Respiratory Endocrine Neurological Surgeries Occupation/Obstetrics Ask if in pain:       Onset: what were you doing before it started? Provocation/Palliation: what makes it better/worse? Quality: what type of pain? crushing.

Head to Toe Survey         Deformities Contusions Abrasions Punctures Burns Tenderness Lacerations Swelling Page 24 .

P. mouth) o central (chest area) o peripheral (fingers & extremities)  Shape of the chest o barrel chest o equilateral shape  Jugular vein distension (JVD) o veins standing out in neck  Auscultate the chest: o Rales – caused by flow of air through liquid in the lungs o Rhonchi – course breath sounds.Assessment of Emergencies Respiratory Emergencies (pg 369 – 397)  HHH  ABC  Look for cyanosis o mucus membranes (nose. flow of air through mucus o Stridor – high pitched inspiratory sound (upper airway obstruction) o Wheeze – expiratory whistling breath sound.D. air travelling through narrow air passages (asthma.O. caused by chronic bronchial obstruction.) APE (acute pulmonary edema) Definition Cause Signs & Symptoms Treatment Accumulation of fluid in the space between the alveoli and the pulmonary capillaries. C. smoking constant inhalation of toxic gasses Chronic bronchitis with mucus lasting more than 3 months within 2 years. congestive heart failure heroin overdose liver sclerosis pneumonia some forms of asthma neurogenic shock/spinal shock tachycardia dyspnea rales pink sputum from nose and mouth oxygenate take HGT place in Fowler’s position COPD (chronic obstructive pulmonary disease) Definition Cause Signs & Symptoms Treatment A slow process of dilation and disruption of the alveoli and airways. low-flow oxygen or nasal cannular reassure patient – can become combative transport to hospital Page 25 .

not heart) on auscultation you’ll hear decreased or absent air entry on percussing you’ll hear hyperresonance/hollow sound high flow oxygen TLC transport in semi-Fowlers or lateral on affected side Anaphylactic Reaction Definition Cause Signs & Symptoms Treatment Severe allergic reaction to a substance. oxygen @ 4-6lpm for 10min reassess (auscultate) nebulise again if necessary take HGT transport in semi-Fowlers position panic 40-60bpm tripod/supine CCA Pnumothorax Definition Cause Signs & Symptoms Treatment Partial or complete accumulation of air in the plural space (collapsed lung). With coughing. as above airway swelling wheezing blood vessels dilate ∴ low blood pressure obvious dyspnea uticeria/rash hives/welts severe itching ALS backup nebulise calm & reassure get to hospital PFQ Page 26 .Asthma Definition Cause Signs & Symptoms The narrowing of bronchioles and build-up of mucus in alveoli forming a mucus plug. on tripod arrival level of care BAA/AEA AEA patient knows their treatment best nebulise with 5ml saline. allergens dust smoking wheezing on inspiration severity: MILD MODERATE SEVERE use of accessory muscles colour of skin wheezing speech Treatment none abdomen all muscles used normal + wheezing by auscultation only speaks in sentences none 20-30bpm any flushed ++ audible by ear blue/pale +++ audible by ear speaks in words speaks in phrases anxiety anxious respiratory rate 30-40bpm position of pt. (usually found in asthma patients or those with COPD) sudden onset of dyspnea/shortness of breath chest pain (pleuratic. the visceral pleura gets thinner and then ruptures allowing air into the pleural space.

etc. infection cancer congestive heart failure decreased or absent air entry on affected side on percussing you’ll hear hyporesonance/solid sound dyspnea high flow oxygen transport in semi-Fowlers position Choking Definition Cause Signs & Symptoms Treatment Blockage of airway as above obvious discomfort hands to throat use of all muscles to breathe Heimlich manoeuvre CPR if unconscious Pulmonary Embolism Definition Cause Signs & Symptoms Treatment Foreign body in lung. dyspnea acute chest pain haematosis/coughing up of blood cyanosis tachypnea varying degrees of consciousness high flow oxygen ventilate if needed transport to hospital Page 27 . can cause death or death of lung can be from blood clots from broken bones.Hayfever Definition Cause Signs & Symptoms Treatment Irritation of upper airway mild allergic reaction to a substance (usually pollen) itchy and watering eyes itchy nose anti-histamine Pleural Effusion Definition Cause Signs & Symptoms Treatment Fluids collect in pleural space usually due to infection.

Hyperventilation Syndrome Definition Cause Signs & Symptoms Treatment Rapid or deep breathing that lowers blood carbon dioxide levels to below normal panic attack high sugar levels OD on aspirin severe infection anxious tachypnea dyspnea dizziness numbness or tingling in hands and feet take HGT oxygenate coach breathing transport to hospital General Respiratory Problems Signs & Symptoms Treatment tracheal tugging tripod position recession use of accessory muscles paradoxical motion (uneven movement of chest) anxiety head bobbing oxygenate transport to hospital if needed Page 28 .

high stress o takes medication  Use AED if no pulse  Transport to hospital ASAP    Arteriosclerosis – found in obese people.  The patient will then have a decrease in blood and O2 supply to the heart.  Lasts about 15mins.  They will have a vasospasm of the arteries.  There will be vasodilation increasing the blood and O2 supply to the heart. geriatrics. high flow oxygen ALS backup transport to hospital in semi-Fowlers position Page 29 . Unstable Angina:  The patient knows they suffer from angina.  Treat as if patient is having a myocardial infarction.  Lasts longer than 15mins. high blood pressure.  The nerves in the heart will become irritable causing chest pain. smokers Ischemia – lack of O2 Infarction – death of tissue Angina Pectoris Definition Types Treatment Brief period of time when the heart doesn’t get enough O2 Stable Angina:  Sharp.  There will be a change in pain to a crushing pain.  There will be a decrease in blood and O2 supply to the heart.  Platelet aggregation takes place causing even more narrowing of the already narrowed artery.  The pain doesn’t go away.Cardiovascular Emergencies (pg 402 – 437)      HHH ABC Brief SAMPLE history Take note especially of OPQRST questions Ask: o had heart attack before o has heart problems o has risk factors: smoking.  They then get a tear in the plaque build-up.  The patient will take meds and/or rest. stabbing pain  The patient will be doing something physical.  Nerves will relax and pain will subside.

meds crushing jaw. cardiac output can then cause low BP dyspnea appearance: greyish in colour agonal agoni if not treated ASAP = sudden death high flow oxygen ALS backup use AED if necessary/if heart stops transport to hospital PFQ ANGINA P Q R S T associated signs & symp. grey skin. anxiety. left arm. pale skin. dyspnea Congestive Heart/Cardiac Failure  This occurs when the heart is damaged (due to AMI or hypertension) and unable to pump powerfully enough (and fast enough) to empty the chambers. jaw and back sudden arrhythmias causing syncope/fainting shortness of breath pulmonary edema initially have tachycardia then possibly bradycardia BP can be initially high. tachycardia.AMI (acute myocardial infarction) Definition Signs & Symptoms Treatment Sudden death of cells in the heart. stabbing. sudden weakness sweating crushing/squeezing chest pain radiating pain on left arm. Left Ventricular Failure Information Signs & Symptoms damaged left ventricle leads to a decrease in stretch right side pumps normally – normal volumes of blood delivered to the pulmonary circulation left ventricle not able to pump out blood leading to a backup of blood therefore pressure increases in the left atrium and pulmonary veins this causes serum to leak into the alveoli pulmonary edema occurs decrease in exercise tolerance shortness of breath nocturnal dyspnea Rales and Rhonchi peripheral cyanosis tachycardia & tachypnea increased BP frothy pink sputum Page 30 . left arm. neck 10/10 anytime diaphoesis. After 30mins cells start to die. neck 1-5/10 doing something cold & clammy. after 2hrs 50% of cells are dead and after 4-6hrs 90% of cells are dead. AMI exercise / rest. agonal agoni. tachypnea anytime / rest. burning jaw. meds sharp.

one side sight disturbances weaker or paralysis hearing disturbances decreased level of consciousness balance affected convulsions anesecoria/unequal pupils hemiplegia diaphoresis (profuse sweating) facial drooping skin colour change dysphasia pri-prism paresis/weakening loss of co-ordination parasthesia/pins & needles increased HGT tachy/bradycardia memory loss high flow oxygen cover with blanket calm & reassure transport lateral on affected side NB: check HGT for hypo/hyperglycaemia as can cause CVA Page 31 .  Thrombus: blood clot  Embolis: mobile thrombus. patient gets super headaches. it becomes larger and then bursts. 90% of the time it’s fatal.  With a disseminating aneurism. Ischemic Stroke:  Blood is cut off from an area of the brain. can be caused by thrombus or embolism. plastic  Aneurism: burst blood vessel o disseminating aneurism: small tears form on the artery (from meds).  Pupil is dilated on affected side  Opposite side of body is affected/weakened check motor response. air. fibre.Right Ventricular Failure Information Signs & Symptoms often occurs as a result of left ventricular failure blood backs up from left side of the heart into the lungs right heart must now work harder to pump blood into the engorged pulmonary vessels right ventricle is unable to keep up leading to failure blood begins to back up in the right atrium increase in pressure in the systemic circulation distended jugular veins shortness of breath pedal and sacral edema tender liver Neurological Emergencies (pg 440 – 479) Cerebrovascular Accident (CVA) or Stroke Definition Causes Types Signs & Symptoms Treatment An interruption of blood flow to the brain that results in the loss of brain function. becomes weak and ruptures o berry aneurism: the wall of the artery begins to bulge and as the heart beats. Hemorrhagic:  Bleeding in the brain. can be caused by disseminating or berry aneurism.  With berry aneurism.

tumours. congenital – epilepsy febrile – sudden high temperature structural – head injuries. Convulsions – Seizures Definition Causes Types Phases of Grand Mal Seizure Treatment Uncoordinated muscular activity that can last several minutes. You should treat as if the patient has had a full ischemic attack but warn them to go to hospital. It lasts about 24hrs. infections (meningitis) metabolic – abnormal blood chemistry hypoglycaemia alcohol drugs poisons focal localisation general whole body – patient is aware petit mal – blank out. no muscle contractions grand mal – full muscle contractions. heightened senses 2) Tonic – flexion  patients muscles are affected. patient is not aware 1) Aura – blurred vision.Transient Ischemic Attack This is a blood clot that has gone to the brain but the body has resolved the problem by itself. including the 3) Clonic – extension diaphragm and intercostals  patient is not aware  can last 10sec – 5mins  sphincters relax  skeletal muscles are affected 4) Post Ictal:  recovery stage  unconscious  conscious  sleepy  emotional  embarrassed  aggressive  hot  confused turn lateral in recovery position high flow oxygen take HGT transport to hospital Status Epilepticus This is when seizures last longer than 30mins or the patient has many consecutive seizures in a short space of time. and then all signs and symptoms disappear. Causes of Unconsciousness       Head Injury Anoxia Bleeding Infection Temperature Seizure      Cardiac/CVA Hyper/hypoglycaemia Allergies/Alcohol Medical Poison Page 32 .

pressure.  patient can identify and locate source of irritation Visceral:  colicky. poorly localised pain  supplied by autonomic nervous system  pain results from stretch of nerve fibres that surrounds the hollow organs (dissention/contraction) Referred Pain: pain felt at a location away from diseased organs kidney – stones peritonitis – inflammation of layer surrounding intestines liver – jaundice bladder – cystitis reproductive – gynae aorta – aneurism (can have visible pulse in abdomen) guarding pain distention tenderness nausea vomiting loss of appetite diarrhoea constipation fever hypotension rebound tendinitis . Can perceive some sensations: pain. touch. sharp. etc. localised pain  spinal cord nerve that also supplies the skin of the abdomen. cold. Parietal:  somatic. dull.Acute Abdomen (pg 466 – 479) Definition Types Causes Signs & Symptoms Treatment A condition of sudden onset of pain within the abdomen.appendicitis nothing to eat or drink high flow oxygen transport to hospital Page 33 .

dry pale.Diabetic Emergencies (pg 482 – 497) Definition Types Developing Signs Differences Treatment Full name: diabetes mellitus (sweet diabetes)  Metabolic disorder in which the body cannot metabolise (energy made use of for the organism) glucose – usually because of a lack of insulin. clammy breath keto (smells like acetone – normal nail polish remover) HGT > 7.2 = hyperglycaemic Diabetic Coma:  this is hyperglycaemia (too much glucose)  takes hours/days to go into a coma  cause: insufficient insulin. sunken eyes. varying degrees of consciousness Insulin Shock:  this is hypoglycaemia (too little glucose)  cause: lack of insulin.2mmol/l HGT  < 3. transport to hospital Insulin Shock: 25ml/g glucogel in oral mucosa. another 25ml/g glucogel.2mmol/l < 3. sweet fruity odour. drinking of alcohol. vomiting after meal. overexertion  signs & symptoms: dehydration.5 – 7.5mmol/l respiration Kussmauls normal time of coma hours – days mins – days mental state aggressive combative/anxious pulse rapid. cold clammy skin. cold. DIABETIC COMA INSULIN SHOCK skin hot. hunger. will lead to wasting of body tissue and death Type I:  insulin dependent diabetes mellitus  onset: child  the body doesn’t produce any insulin  patient takes daily injections of synthetic insulin and on a special diet  keeps the person in a hyperglycaemic state  this can cause damage to the nerve endings and blood vessels Type II:  Non-insulin dependent diabetes mellitus  onset: adult  the pancreas does produce insulin but not enough for the body to function properly  controlled by diet  may require non-insulin medication to stimulate the pancreas to produce more insulin polyphasia/excessive eating polydepsia/excessive drinking polyuria/excessive urinating diabetic keytone acidosis/eating of own fatty acids vomiting abdominal pain Kussmauls respiration if untreated. altered mental state. The result: wasting of glucose in the urine  If left untreated. not eating  signs & symptoms: normal rapid pulse. call for backup Page 34 . unconscious diabetic coma. flushed. then death normal sugar levels: 3. seizures. weak (“thread”) pulse tachycardia BP normal to low normal to low Diabetic Coma: high flow oxygen. rapid weak pulse. wait 5mins. reassess HGT. weakness on one side. if still low.5 = hypoglycaemic  > 7.

Environmental Emergencies (pg 546 – 581) Hypothermia     Loose heat by o Radiation o Convection o Conduction o Respiration o Evaporation Stages o 35-33°C – shivering o 33-30°C – lethargic. everything slows down Treatment o Warm them up slowly o remove from area o remove clothing o cover patient Levels of damage o frost nip  chilly. stretch out muscles  Heat Exhaustion o > 38°C o non-ventilated areas o mines o become very dehydrated o tachycardia o dizziness o remove from area o fan/cool them  Heat Stroke o 40°C o dry and flushed skin o hypotensive o tachycardia o possibly decreased LOC o call for ALS backup Page 35 . red skin – no cell damage o frostbite  superficial or deep  dead/damaged tissue/cells  wrap extremities individually o gangrene  dead cells. slow/stop shivering. irreversible damage  black in colour Hyperthermia  Heat Cramps o lack of electrolytes or the lack of distribution o give water. bradycardia. hypotensive. cyanosis o 30-<27°C – coma.

Submersion (Drowning) panic  wave hits  more panic  swallow water  laryngospasm  hypoxia  decreased LOC  glug glug glug  dead.  Dangers: o Decent:  tympanic membrane rupture (ear drum)  mask compression on face o Bottom:  no real dangers o Ascent:  air embolus  decompression illness (bends) Page 36 . Diving Injuries   760mmHg = 1atmos.. Concern for secondary drowning where the salt content now in the lungs draws water from body into lungs causing pulmonary oedema. but patient survives. Near Drowning As above. every 10m decent in water is +1atmos..

go down to their level leave them with a parent or someone they know give them a toy to play with control your tone of voice. fever/pyrexia    Present like cold and flu in first 6-8hrs Drooling Red and inflamed  Stridor sounds when breathing  Abdominal muscle use.Paediatrics          when arriving on scene. bronchi 6 months and up Dry cough (sounds like dog barking)    Can have respiratory distress or cyanosis Pyrexia Use nebuliser @ 5ml saline for 10mins Page 37 . can die Use nebuliser @ 5ml saline for 10mins Croup    Trachea. nasal flaring    Can go cyanotic If left untreated. and keep calm let them look at your equipment before using it on them warm up your steth explain everything to them in the most simple terms and make it fun for them build up as much trust as possible Ages   few hours: new born 1 day – 1 month: neonate    1 month – 1 year: infant 1 – 3 years: toddler 3 – 5 years: pre-schooler   6 – 12 years: primary schooler 13 – 19 years: adolescent Medical Problems Epiglottitis   Inflammation of the epiglottis Night sweat. remove unnecessary gear when approaching child. larynx.

Trauma (pg 630 – 911) Mechanism of Injury      What happened Scene: where are you o Car:  damage – where?  wearing seatbelt?  airbags deployed?  windshield condition  steering column damaged?  pedal conditions o Motorbike:  helmet damage?  clothing damage? General Environment o rain/shine o day/night Index of Suspicion o the gut feeling as to what is wrong When to Immobilise: o MVA  frontal impact (whiplash. etc o Penetrating trauma  knives  guns o Environmental  diving  lightning Page 38 .)  rear impact  roll-over (most dangerous)  t-bone o PVA  legs hit first  can have other upper body injuries o Fall from a height  mostly leg injuries o Sport injuries  high tackle (rugby)  stepping wrong o Blunt force trauma  cricket/baseball bats. etc. pots.

tachycardia o cold. or fluid in the blood can lead to shock.Shock  The inability of the microcirculation to adequately perfuse the organs due to a breakdown of the cardiovascular system.  Signs & Symptoms: o weak. Vessels then begin to leak causing:  low BP   tachycardia yellow skin colour (liver can’t filter toxins) Anaphylactic Shock This is due to an allergic reaction. blood vessels.  A breakdown in the heart. Treatment: call for ALS and nebulise Page 39 .  Above injury: o cold & clammy o sympathetic nervous response  Below injury: o flushed & dry o parasympathetic nervous response o vessels dilate bradycardia possible pria prism   Septic Shock The vessels dilate due to damage to vessel walls from toxins in the blood. Bronchioles constrict causing wheezing and dyspnea. clammy skin o pale o hypotensive/drop in BP sympathetic nervous system o cyanosis o delayed capillary refill o pupils dilated o anxious (depending on LOC) Hypovolemic Shock The loss of volume in the vessels due to:   blood loss (can be internal or external) diaphoresis (profuse sweating)   diarrhoea emesis (vomiting) Cardiogenic Shock  Basically an AMI Neurogenic Shock The loss of volume in the vessels due to spinal cord damage (usually) in the cervical area.

Stages of Shock     INITIAL hypoxia damage to cell membrane metabolic acidosis organs deprived of O2      COMPENSATING hyperventilation to rid body of CO2 levels hypotension leads to adrenaline & noradrenalin release leading to increase in HR and vasoconstriction leading to increase in BP      Page 40 DECOMPENSATING failure of body’s mechanisms vital organs are compromised endotoxic shock due to bacteria HR + BP decrease less perfusion REFRACTORY/IRREVERSABLE  brain damage  cell infarction  death due to vital organ failure .

: battle signs Bites Page 41 .Bleeding      Internal o Cavities  chest  abdomen  femur  pelvic External o Anything out of the body Types of Bleeding o Arterial  bright red  pulsates o Venous  dark red  flows o Capillary  red  oozes To stop Bleeding: o direct pressure o indirect pressure (bandages)  pressure bandage  first aid dressing/trauma pad  roller bandages  gauze o elevation o pressure points o tourniquet Basically stop the red stuff from coming out! Soft Tissue Injuries  Abrasion (graze) o painful. epidermal layer is removed  Contusion (bruise) o capillaries under the skin break   Laceration (cut) Avulsion o a flap of skin o often from head injuries (scalp) Puncture (hole)     Haematoma o severe contusion (more vessels are broken) o swelling involved Eccymosis o mastoid process/head injuries o small blue contusion o a. burns.a.k.

organ compression)  airbag injuries Open o penetrating injury  usually have obvious external bleeding  suspect large amounts of internal bleeding  very painful  nausea. vomiting  be ready to treat for hypovolemic shock o abdominal evisceration  organs or fat protrude through the wound  never try to replace  cover with moist sterile gauze and secure in place with bandages and tape  keep the organs as warm as possible  get to hospital asap Genitalia o always very painful o rarely life threatening.Abdominal Injuries  Hollow organs o stomach. kidneys Abdominal Injuries     Closed o peritonitis  soft organs spill contents into peritoneal cavity  intense inflammatory reaction and possible infection  intense pain  tenderness  muscular spasm  can become life threatening o blunt abdominal wounds  severe bruising  laceration of liver or spleen  intestine rupture  kidney rupture or avulsion from arteries and other vessels  bladder rupture (especially if distended at time of injury)  intra-abdominal haemorrhage  be ready to treat for shock (hypovolemic)  seatbelt injuries (rib fractures. ureters. but can be a great concern to the patient o managing blood loss is top priority o calm and reassure patient. spleen. pancreas. make them feel as comfortable as possible Rectal bleeding o can be caused by sexual assault. intestines. bladder  Solid organs o liver. colitis or ulcers in the intestine tract or stomach o large amounts of blood loss can lead to hypovolemic shock Page 42 . haemorrhoids.

test for CSF and suspect cranial damage ear can become avulsed Ear  Facial Fractures o usually a result of blunt force trauma o most major blows to the facial region results in fractures o possible signs & symptoms of facial fractures:  bleeding in the mouth  inability to swallow or talk  absent or loose teeth  movable bone fragments  patient says “it doesn’t feel right” o bleeding can cause respiratory problems o swelling can cause airway obstruction o remove dislodged teeth and/or dentures (false teeth) and transport in container with patient  Throat/Neck o Blunt injuries:  usually involve the trachea or larynx  cartilage does not spring back after crushing therefore major airway obstruction  subcutaneous emphysema can occur if air leaks into the soft tissue o Penetrating injuries:  can cause profuse bleeding (carotid artery & jugular vein) or air embolism  always maintain cervical spine stabilisation Page 43 . etc.) o control bleeding o transport to hospital Types of Injuries  Nose o o epistaxis (nosebleeds) can occur spontaneously or as a result of trauma two types of epistaxis:  anterior     originate from the septum slow bleeding  self-limiting and resolves quickly posterior  blood can drain into the throat o  can cause vomiting and nausea if there is major nasal deformity you should suspect fractures of the basilar skull and possibly cervical spine injuries o o o o provides sense of hearing and balance tympanic membrane rupture can occur when the inner and outer ear pressures are not equal usually no liquid comes from ear when damaged.Facial Injuries   Facial injuries usually lead to partial or complete obstruction of the airway Can lead to clotting in the airway    Take note of false teeth/dentures Usually profuse bleeding Suspect brain and/or spinal injuries  Treatment o control & manage breathing as far as possible (OPT. lateral. if liquid is present.

g.g. dust. infrared)  damages sensory cells  usually no pain. laser.  severe pain and irritation  must be removed by a professional (doctor)  stabilise object and transport to hospital  Burns o o o o o Chemical  caused by acid/alkali substance  flush eye with saline for 5-20mins asap (depending on strength of substance)  transport to hospital  continue flushing with saline during transport if possible Thermal  eyes usually closed in fire but eyelids burnt  do not attempt to do anything with the eye  cover with moist. pencil. sterile dressing  transport to hospital Lacerations  do not apply pressure  cover with moist. sterile gauze  transport to hospital Blunt trauma  usually forms a “black eye” (bleeding into the orbits)  may see hyphema (bleeding into the anterior chamber of the eye)  transport to hospital if patient experiences pain.  can cause severe irritation  usually stuck in the conjunctiva causing redness and swelling  eyes begin to water to flush object out  irrigate with saline solution (from nose outward) o Large: e. sand.Eye Injuries  Normal. etc. sterile dressing  transport to hospital immediately Light burns (e. etc. double vision or decreased vision Page 44 . but permanent damage to vision usually occurs  apply moist. fish hook. uninjured eyes: o round o equal in size o react equally when exposed to light o move simultaneously Types of Injuries  Foreign objects o Small: e.g. metal. sunlight.

There is more blood than air. decreased air entry hyporesonance can become hypovolemic hypotension tachycardia ALS backup transport to hospital Pericardial Tamponade Cause Signs & Symptoms Treatment Fluid leaking into the space between the myocardium and pericardium.Chest Injuries   Blunt Penetrating Pneumothorax Cause Signs & Symptoms Treatment Air in the pleural space surrounding the lungs dyspnea pain tachycardia decreased BP JVD tracheal deviation palpating: will hear subcutaneous emphysema auscultation: will hear decreased or absent air entry ALS/ILS backup use a 3-way pad over the wound with the opening in the direction of gravity Haemothorax Cause Signs & Symptoms Treatment Due to ruptured blood vessels and blood entering the pleural space. Usually caused by fractured ribs piercing pleura and vessels. tachycardia Becks Triad:  narrowing pulse pressure  muffled heart sounds  JVD ALS backup oxygenate transport to hospital Page 45 .

Contusions .Inflammation .internal Types: o hairline o greenstick o comminuted o pathologic o epiphyseal  Signs & Symptoms o o o o o o o o o Please Drop Six Cents In Uncle Teds Cup Dankie .Tenderness .Flail Chest Cause Signs & Symptoms Treatment Two or more fractures in two or more places on two or more adjacent ribs.Unequal .Discolouration Page 46 .Crepitus . paradoxical motion intense pain contusions crepitus very shallow dyspnea guarding oxygenate transport to hospital take careful note of haemo or pneumothorax Contusions  Pulmonary Contusion: o haemoptysis o pain o dyspnea  Myocardial Contusion: o irregular rhythm o some chest pain Fractures    Compound # .Deformation .Pain .Swelling .bone sticking out/skin broken Closed # .

no pulse/sensation) shape/measure splint splint above and below fracture reassess vitals Mid-shaft femur fractures:   there will be: o medial rotation o shortening of the leg/unequal lengths treatment: o same assessment o check size and shape of splint o apply traction to leg o apply traction splint o  traction first  then strap reassess vitals Page 47 .How to Treat     expose check open/closed check for distal pulse capillary refill  sensation  motor response   skin colour temperature     realign only if limb is threatened (i.e.

Head Injuries Concussion Cause Signs & Symptoms Treatment due to brain contusion or swelling confused slurred speech headache anesecoria nystagmus (flutter of eyes) amnesia immobilise oxygenate full vitals transport to hospital TLC keep them calm Inter-cranial Haemorrhage Cause Signs & Symptoms Treatment subdural haematoma (below the dura mater) epidural haematoma (above the dura mater) patient can become aggressive/combative vomiting dizziness anesecoria potential seizures confusion immobilise oxygenate place lateral Base of Skull # Cause Signs & Symptoms Treatment trauma to the head ottorrhoea (blood coming out of the ears) rhinorrhoea (blood coming out of the nose) eccymosis of the mastoid process (battle signs) periorbital haematomas (racoon eyes) (can happen up to 14hrs later) decorticate/decerebrate movements immobilise oxygenate Page 48 .

Raised Intracranial Pressure Cause Signs & Symptoms coup/contra-coup motion Cushing’s Reflex:  decrease in pulse rate  increased blood pressure  irregular respiration oedema increased cranial pressure bleeding decreased LOC projectile vomiting seizures hypoxia Treatment oxygenate transport to hospital PFQ Poison. Haemotoxic: o Prohibits the forming of platelets and the clotting of blood. Bites and Stings   no legs: snakes. ticks many legs: centipedes Snakes  Cytotoxic o Causes blood cells do stop doing their job and begin disintegrating causing intense pain and swelling  Neurotoxic o This causes neurons in the brain to die causing the body to stop functioning. The first system to shut down is usually the respiratory system (located at the top of the spinal cord). cats.    6 legs: scorpions. bees. It’s an anti-coagulant that basically liquidises the internal organs. bronchorrhoea o Excitation o Lacrimation o Salivation Treatment: o call hazmat o remove clothing and rinse patient for 5 – 20mins o double glove o often have to use BVMR Page 49 .  Organophosphates    Over stimulate the sympathetic nervous system causing: o miosis o bradypnea o bradycardia Signs & Symptoms o Defecation o Urination o Miosis o Bradypnea. etc. sharks 2 legs: humans  4 legs: dogs. insects 8 legs: spiders. bradycardia.

site of burn not sore (no nerves)) Critical locations o hands o feet o inhalation o genetailia o 20 – 30% full thickness (based on rule of 9’s) Treatment o 1. Water   Page 50 . Saline o 3. Burnshield o 2. sore) o partial thickness (epidermis + dermis – red.Burns  Ways of being burnt o chemical o thermal burns (direct heat) o electrical o radiation  Types o superficial (epidermis – red. very sore) o full thickness (all layers – charred. blisters.