The document discusses hematology and provides information on blood components, blood disorders, and their management in the prehospital setting. It covers red blood cell disorders like anemia and sickle cell disease. White blood cell and platelet disorders are also reviewed. Physical exam findings and treatment focus on maintaining ABCs, oxygenation, volume replacement, and transporting appropriately.
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide. According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide. According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
Our body is made up of millions of cells, which group together to form different organs. Some cells function in their individual form and move throughout the body via blood. Complete Blood Count (CBC) is all about these cells present in the blood, which can help determine health problems.
A complete blood count (CBC) is a group of tests that provide information about blood cells like Red Blood Cells (RBC), White Blood Cells (WBC) and platelets. It is routinely performed to provide an overview of a patient's general health status.
Reference: https://www.1mg.com/labs/test/complete-blood-count-1717
Our body is made up of millions of cells, which group together to form different organs. Some cells function in their individual form and move throughout the body via blood. Complete Blood Count (CBC) is all about these cells present in the blood, which can help determine health problems.
A complete blood count (CBC) is a group of tests that provide information about blood cells like Red Blood Cells (RBC), White Blood Cells (WBC) and platelets. It is routinely performed to provide an overview of a patient's general health status.
Reference: https://www.1mg.com/labs/test/complete-blood-count-1717
Basic approach to a case of anemia. Investigations to do and to arrive at the diagnosis. (Management not discussed). Peripheral smear findings with pictures are included.
The study of the blood flow is called hemodynamics.
Thus hemodynamics deals with the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms, much as hydraulic circuits and are controlled by control systems.
Hemodynamic response continuously monitors and adjusts to conditions in the body and its environment. Thus hemodynamics explains the physical laws that govern the flow of blood in the blood vessels.
Disorders of Cardiovascular Function.pptxgadnyabuto1
Cardiovascular disorders, also known as cardiovascular diseases (CVDs), refer to a group of conditions that affect the heart and blood vessels. These disorders can range from mild to severe and can have a significant impact on an individual's health and quality of life. Here is a detailed description of some common cardiovascular disorders:
Coronary Artery Disease (CAD): CAD is the most prevalent cardiovascular disorder and occurs when the blood vessels that supply the heart muscle with oxygen and nutrients become narrowed or blocked. This narrowing is usually caused by the buildup of plaque consisting of cholesterol, fat, and other substances. CAD can lead to chest pain (angina), heart attack (myocardial infarction), or heart failure if the blood flow to the heart is severely restricted.
Hypertension (High Blood Pressure): Hypertension is a chronic condition characterized by elevated blood pressure levels. It puts additional strain on the heart and blood vessels, increasing the risk of heart disease, stroke, and other complications. Hypertension often has no noticeable symptoms, which is why it is often referred to as the "silent killer." Lifestyle modifications, such as a healthy diet, regular exercise, and medication, are commonly used to manage hypertension.
Heart Failure: Heart failure occurs when the heart is unable to pump blood efficiently to meet the body's needs. It can result from various underlying conditions, including CAD, high blood pressure, heart valve disorders, or previous heart attacks. Symptoms of heart failure may include fatigue, shortness of breath, fluid retention (edema), and reduced exercise tolerance. Treatment options include medications, lifestyle changes, and in severe cases, surgical interventions such as heart transplantation.
Arrhythmias: Arrhythmias are abnormal heart rhythms that can occur due to disruptions in the electrical signals that coordinate the heartbeat. This can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly. Common types of arrhythmias include atrial fibrillation, atrial flutter, and ventricular tachycardia. Some arrhythmias may not require treatment, while others may be managed with medications, electrical cardioversion, or other procedures.
Stroke: Although not exclusively a cardiovascular disorder, strokes often occur due to problems with blood vessels supplying the brain. Ischemic strokes are the most common type and are caused by blockages in the arteries leading to the brain. Hemorrhagic strokes occur when a blood vessel in the brain ruptures. Strokes can lead to long-term disability or even death, emphasizing the importance of recognizing and managing risk factors such as hypertension, smoking, and high cholesterol.
Peripheral Artery Disease (PAD): PAD occurs when the blood vessels outside the heart, usually those supplying the legs and arms, become narrowed or blocked. This can result in reduced blood flow, causing pain, numbness, or weakness in
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
3. Hematology
The Study of Blood and Blood-Forming Organs
Includes study of blood disorders.
Red blood cell disorders
White blood cell disorders
Platelet disorders
Coagulation problems
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8. Components of Blood
Red Blood Cells
Hemoglobin
Oxygen transport
Bohr effect
2,3 DPG
Oxygen–hemoglobin
dissociation curve
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9. Red Blood Cells
Average life-span of Red Blood Cells ~120 days
Due to wear and tear on plasma membranes as they squeeze
through capillaries.
A healthy male has about 5.4 million RBC’s/mm3
A healthy female has about 4.8 million/mm3.
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10. Red Blood Cells
Red blood cell production
Erythropoiesis
Hemolysis
Sequestration
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16. White Blood Cells
Immunity
Subpopulation of lymphocytes known as T cells and
B cells
T cells develop cellular immunity.
B cells produce humoral immunity.
Autoimmune disease
Alterations in the immune process
Inflammatory process
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23. Blood Products and
Blood Typing
Blood Types
Antigens
A, B, AB, O
Universal donors
Rh factor
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24. Transfusion Reactions
Donor’s RBC and Recipient’s Plasma
Recipient
Type A
Donor - RBC A antigens
B antibodies
Type B
B antigens
A antibodies
Type A
A antigens
B antibodies
Type B
B antigens
A antibodies
Type AB
A+B antigens
O antibodies
Type O
O antigens
A+B
antibodies
No reaction
Major
reaction
Major
reaction
No reaction
Minor
reaction
Major
reaction
Major
reaction
Major
reaction
No reaction
Major
reaction
Minor
reaction
Minor
reaction
Minor
reaction
No reaction
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Type AB
Type O
A+B antigens O antigens
O antibodies A+B
antibodies
Minor
Major
reaction
reaction
26. Transfusion Reactions
Hemolytic Reactions
Signs & Symptoms
Facial flushing, hyperventilation, tachycardia, hives,
chest pain, wheezing, fever, chills, and cyanosis
Treatment
Stop transfusion, change all IV tubing, and initiate IV
therapy with normal saline or lactated Ringer’s.
Consider furosemide, dopamine, and diphenhydramine.
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27. Transfusion Reactions
Febrile Nonhemolytic Reactions
Signs & Symptoms
Headache, fever, and chills
Treatment
Stop transfusion, change all IV tubing, and initiate IV
therapy with normal saline or lactated Ringer’s.
Consider diphenhydramine and an antipyretic.
Observe closely to ensure reaction is nonhemolytic.
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28. General Assessment
and Management
Scene Size-up
Initial Assessment
Focused History and Physical Exam
SAMPLE history
Hematological disorders are rarely the chief
complaint.
Physical exam
Evaluate nervous system function.
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34. Managing Specific
Patient Problems
Diseases of the Red Blood Cells
Diseases of the White Blood Cells
Diseases of the Platelets/Blood Clotting
Abnormalities
Other Hematopoietic Disorders
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36. Anemias
Pathophysiology
Morbidity/ mortality
Can be self-limiting disease
Must be confirmed by laboratory diagnosis
Precipitating causes
Blood loss (acute or chronic)
Decreased production of erythrocytes
Increased destruction of erythrocytes
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37. Anemias
Pathophysiology cont.
Hemolytic
Hereditary
Sickle cell
Thalassemia
Glucose-6-phosphate dehydrogenase deficiency
Acquired
Immune
Drug
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38. Anemias
Signs and symptoms may not be present until
the body is stressed.
Treat signs and symptoms.
Maximize oxygenation and limit blood loss.
Establish IV therapy if indicated.
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39. Anemias
Initial assessment findings
Airway/ breathing
Labored breathing may or may not be present
Circulation
Peripheral pulses
Quality
Rhythm
Changes in skin
Color
Temperature
Moisture
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41. Anemias
Focused History Complaints
Complaints secondary to leukopenia
Infections
Fevers
Complaints secondary to thrombocytopenia
Cutaneous bleeding
Bleeding from mucous membranes
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42. Anemias
Management
Airway and ventilation
Circulatory support
Pharmacological
Analgesics
Fluid volume replacement
Control of bleeding
Non-pharmacological
Position of comfort
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43. Anemias
Transport considerations
Appropriate mode
Indications for rapid transport
Significant changes in LOC
Hypotension/ hypoperfusion
Appropriate facility
Support and communication strategies
Explanation for patient, family, significant others
Communications and transfer of data to the physician
Dutchess Community College EMS
46. Sickle Cell Disease
Epidemiology
Highest incidence in blacks, Puerto Ricans and
persons of Spanish, French, Italian, Greek and
Turkish origin
Pathophysiology
A congenital hemolytic anemia
A chemical defect within the hemoglobin of red
blood cells
Morbidity/ mortality
Sepsis
Shock
Death
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47. Sickle Cell Disease
Initial assessment findings
Levels of consciousness
Airway/ breathing
Circulation
Peripheral pulses
Changes in skin
Pallor, Cool, Clammy
Hypotension/ hypoperfusion
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48. Sickle Cell Disease
Focused history
Chief complaint
Sudden onset develops into a condition called
“crisis”
Thrombotic crisis (painful)
Aplastic
Hemolytic
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49. Sickle Cell Disease
Detailed physical exam
Airway / Breath sounds
Circulation
Skin
As above
Temperature may vary
ECG findings
Tachycardia
Ectopy
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50. Sickle Cell Disease
Detailed physical exam continued
Increased weakness
Aching
Chest pain
Sudden, severe abdominal pain
Bony deformities
Icteric sclera
Abdominal pain
Fever
Arthralgia
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51. Sickle Cell Disease
Management
Position of comfort
Pharmacological
Analgesia
Fluid volume replacement
Transport for reperfusion
Indications for no transport
Refusal
Support and communication strategies
Explanation for patient, family, significant others
Communications and transfer of data to the physician
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52. Polycythemia
Epidemiology
Overabundant production of red blood cells, white
blood cells and platelets
Rare disorder seen in persons over 50 years of age
Pathophysiology
Thrombosis
Death from thrombosis
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53. Polycythemia
Initial assessment findings
Levels of consciousness
Airway/ breathing
Labored breathing is common
Circulation
Peripheral pulses
Quality
Tachycardia
Changes in skin
Color - red-purple complexion
Red hands and feet
Pruritic
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54. Polycythemia
Focused history
Dyspnea
Generalized pruritus
Detailed physical exam
Airway / Breath sounds
Circulation
Skin
As above
Temperature may vary
ECG findings
Tachycardia
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56. Polycythemia
Transport
Indications for no transport
Refusal
Referral
Support and communication strategies
Explanation for patient, family, significant others
Communications and transfer of data to the
physician
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57. Diseases of the White
Blood Cells
Leukopenia/Neutropenia
Too few white blood cells or neutrophils.
Follow general treatment guidelines and provide
supportive care.
Leukocytosis
An increase in the number of circulating white
blood cells, often due to infection.
Leukemoid reaction
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59. Leukemia
Initial assessment findings
Levels of consciousness
Airway/ breathing
Labored breathing may or may not be present
Circulation
Peripheral pulses
Quality
Tachycardia
Changes in skin
Color
Temperature
Moisture
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60. Leukemia
Focused history
Complaints
Fatigue, bone pain, diaphoresis
Elevated body temperature
Sternal tenderness
Heat intolerance
Abdominal fullness
Bleeding
Contributing history
Recurrent bleeding
Increasing frequency and/ or duration
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62. Leukemia
Management
Position of comfort
Pharmacological
Analgesia
Increase or decrease heart rate
Fluid volume replacement
Electrical
Constant ECG monitoring
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63. Leukemia
Transport
Criteria for rapid transport
No relief with medications
Hypotension/ hypoperfusion
Significant changes in ECG
Indications for no transport
Refusal
Referral
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64. Lymphomas
Epidemiology
Hyperplasia of the lymphoreticular system
Pathophysiology
Morbidity/ mortality
Blood loss
Pain
Death
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65. Lymphomas
Initial assessment findings
Levels of consciousness
Airway/ Breathing
Circulation
Focused history
Complaints
Fever
Night sweats
Generalized pruritus
Anorexia
Weight loss
Fatigue, bone pain, diaphoresis
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66. Lymphomas
Detailed physical exam
Airway / Breath sounds
May be clear to auscultation
Congestion in bases may be present
Circulation
Skin
Pallor during the episode
Temperature may vary
Diaphoresis is usually present
Blood pressure may low
ECG findings
Tachycardia
Ectopy
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67. Lymphomas
Management
Position of comfort
Pharmacological
Analgesia
Increase or decrease heart rate
Fluid volume replacement
Electrical
Constant ECG monitoring
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68. Lymphomas
Transport
Criteria for rapid transport
No relief with medications
Hypotension/ hypoperfusion
Significant changes in ECG
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69. Diseases of the Platelets
Thrombocytosis and Thrombocytopenia
Thrombocytosis
Thrombocytopenia
An abnormal increase in the number of platelets
An abnormal decrease in the number of platelets
Management
Provide supportive care and follow general treatment
guidelines.
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70. Hemophilia
Epidemiology
A hereditary disorder transmitted by the female to
the male
In true hemophilia A factor VIII is nearly absent
In hemophilia B there is a deficiency in factor IX
The ability to produce thrombin is severely impaired
by deficiency or absence of these factors
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72. Hemophilia
Initial assessment findings
Levels of consciousness
Airway/ breathing
Labored breathing is common
Circulation
Peripheral pulses
Weak and thready
Tachycardia
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73. Hemophilia
Changes in skin
Pallor, Cool, clammy
Bleeding
From body orifices
Knees, Wrists, Elbows
Hematuria
Epistaxis
Hemoptysis
Hematemesis
Melena
Hypotension/ hypoperfusion
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74. Hemophilia
Focused history
Dyspnea
Bleeding
Detailed physical exam
Airway / Breath sounds
May be clear to auscultation
Congestion in bases may be present
Circulation
ECG findings
Tachycardia
Ectopy
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75. Hemophilia
Management
Position of comfort
Pharmacological
Analgesia
Fluid volume replacement
Transport for reperfusion
Indications for no transport
Refusal
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76. Blood Clotting Abnormalities
Von Willebrand’s Disease
Deficient component of factor VIII
Generally results in excessive bleeding.
Generally is not serious; provide supportive care.
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78. Disseminated Intravascular
Coagulopathy
Epidemiology
A complication of severe injury, trauma or disease;
acute bleeding disorder resulting from defibrination
First phase characterized by free thrombin in the
blood, fibrin deposits and aggregation of platelets
Phase two is hemorrhage caused by depletion of
clotting factors
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82. Disseminated Intravascular
Coagulopathy
Detailed physical exam
Airway / Breath sounds
May be clear to auscultation
Congestion in bases may be present
Circulation
Skin
As above
Temperature may vary
ECG findings
Tachycardia
Ectopy
Dutchess Community College EMS
83. Disseminated Intravascular
Coagulopathy
Management
Position of comfort
Pharmacological
Analgesia
Increase or decrease heart rate
Fluid volume replacement
Support and communication strategies
Explanation for patient, family, significant others
Communications and transfer of data to the physician
Dutchess Community College EMS
84. Multiple Myeloma
Epidemiology
A plasma cell dyscrasia characterized by neoplastic
cells that infiltrate bone marrow
Eventually plasma cells become malignant leading to
tumor formation within the bone
Pathophysiology
Morbidity/ mortality
Fractures
Bleeding
Shock
Death
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85. Multiple Myeloma
Initial assessment findings
Levels of consciousness
Airway/ breathing
Labored breathing is common
Circulation
Peripheral pulses
Weak and thready
Tachycardia
Changes in skin
Pallor, Cool, clammy
Bleeding
Hypotension/ hypoperfusion
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88. Multiple Myeloma
Management
Position of comfort
Pharmacological
Analgesia
Fluid volume replacement
Transport for reperfusion
Indications for no transport
Refusal
Support and communication strategies
Explanation for patient, family, significant others
Communications and transfer of data to the physician
Dutchess Community College EMS