Category Archives: Health care

Major Chest Injury

The thoracic cavity can best be described as the area that starts at the bottom of the neck and extends down to the diaphragm. The contents of the thoracic cavity include the heart, lungs and the great blood vessels. All of these vital components of the thoracic cavity are protected by the ribs. The muscles of the thoracic cavity assist in breathing but also offer a partial protection to the organs.

Injuries that are concentrated to directly or around the thoracic area are considered to be in most cases life threatening or at the very least an important factor in deciding transport decisions in pre-hospital settings. This is due to the heart for one is contained in the thoracic cavity as well as the diaphragm that assists us in our breathing via inhale and exhale.

A thoracic injury may be of blunt force trauma rather than penetrating trauma, meaning that the injury may not be visible from the exterior or with the naked eye. A check of the vitals of a patient will be able to assist you in seeing some of these changes from a blunt force trauma in some cases. In other cases you may not know until it is too late. This is why like we mentioned earlier that most thoracic injuries are considered life threatening in nature.

Thoracic trauma can affect the heart as much to cause cardiac output to decrease, therefore decreasing blood pressure which then in turn will decrease the amount of oxygen, blood, and other needed substances reaching certain parts of the body such as cells and organs that need the substances to maintain adequate perfusion. Once this happens the patient can go into shock. At this point a pre hospital care provider must correct the apparent life threats if possible or to the best of their abilities and this is only if said apparent life threats are visible.

Rib fractures are another injury related to the thoracic area that is considered or I should say in most cases should be considered life threats especially in the elderly. A fractured rib is considered a life threat due to the fact that not only can the rib be fractured causing pain but it can also affect breathing as well as puncture an organ or other vital part of the body. This is another example of some of the not so visible life threats of the thoracic area.

Of course you can have penetrating punctures that are apparent and even though they are apparent it does not necessarily mean that they are able to be maintained or controlled at the scene. All of this goes along with patient assessment and transport decision in the pre hospital setting.

Panic attacks

Panic attacks are episodes where intense emotional anxiety triggers a physical reaction. These reactions may come on quickly, peak, and then subside within a few minutes or hours. Panic attacks may arise in children and adults.
Causes for panic attacks vary from person to person. Some causes for panic attacks may be out of the control of a panic attack sufferer. Some panic disorders may be hereditary passed down while other triggers may be biologically related such as post traumatic stress disorder (PTSD), obsessive compulsive disorder (ODD), hypoglycemia, or hypothyroidism. Phobias also may contribute to anxiety that triggers panic attack. These phobias may be from childhood which causes a problem when trying to suppress panic attack triggers. Childhood physical or sexual abuse also may contribute to the fear and stress that trigger a panic attack.

Other causes for panic attacks may be short term and induced by environmental or situation-ally emotional events. Causes such as: medications, alcohol or drug withdrawal, personal tragedy or loss, or overly stressful situations can create enough fear or stress that a panic attack ensues.
Some of the symptoms of a panic attack may present themselves as much more serious conditions, and first time sufferers may call for medical help because they think that they are experiencing a heart attack or stroke. Symptoms of panic attacks include many of the following: rapid heart rate, shortness of breath, chest pain, dizziness, nausea, sweating, hyperventilation, chills, trembling, and trouble swallowing.

The majority of the population experience one or two panic attacks in their life; however, when panic attacks are recurrent or frequent, a patient may be diagnosed with panic disorder. Panic disorders are different from other anxiety disorders in that panic disorders are typically unprovoked and come on very suddenly. Calming a panic attack could be as simple as trying to control the breathing pattern. Diverting your mind is another way to calm the fear or panic that may have triggered the attack. Using positive talk such as “I am okay, and I can get through this,” may make it easier to lower the heart rate.

Recurrent panic attacks when left untreated may lead to more serious social and emotional issues such as substance abuse, depression, problems at work or school, and development of specific phobias. It is important to see a physician and bring up the symptoms and type of panic attack you experienced.

Chronic Obstructed Pulmonary Disease

Pulmonary means “ pertaining to the lungs”.  COPD “ Obstructive Pulmonary Disease” What is this? Well it is a lung disease usually caused by many years of damaging the lungs by smoking and makes it very difficult to breath. Other factors can put someone at risk such as breathing dangerous chemical fumes, air pollution over a long period of time, and if you suffered many lung infections as a child.

Chronic Obstructed Pulmonary Disease is usually a combination of two diseases, Chronic Bronchitis and Emphysema. With chronic bronchitis the bronchial tubes make mucus which can block airways making it almost it very difficult to breath.  With Emphysema they is hardly any air coming back out of the lungs when you breath exhale. Chronic Obstructed Pulmonary will often get worse over time and although the damage to the lungs is irreversible you can do something to prevent anymore damage from being done.   COPD is more common in people over 60 because it takes many years to damage the lungs.

 

Death and Dying

Death is referred to as the cessation of the biological functions that support a living organism. Death is an inevitable occurrence but can be hastened or prolonged due to certain lifestyle choices such as eating habits, drug/alcohol abuse, physical activity, and certain medications. Some causes of death can be inherited such as diseases and other health issues. Death can occur naturally, by accident, and intentionally. Infectious diseases are the most common cause of death. Some of these are tuberculosis, malaria, and AIDS. These specific diseases cause approximately more than 300 million illnesses a year and more than 5 million deaths each year.

In other countries lack of sanitary living conditions and limited or no access to modern medical technology and medications heighten the results of death from infectious diseases. Other health concerns that can cause death are tobacco use, malnutrition, bad eating habits, and lack of physical activity. In many cases after a death an autopsy is performed. This is an examination of a human corpse in an effort to determine such things as cause of death and to evaluate if any disease or injury is present. This is very beneficial in unexplained deaths and deaths in which the circumstances are suspicious as in murder and suicide.

Dying is a process of death in which your body is shutting down and you are reaching a state in which biological functions are going to cease. Dying is a natural part of our society and is sometimes known by the person that they are dying but can also be unexpected. Dying sometimes involves a grieving process by the person dying and by family members and friends. This process includes denial/shock (usually at the beginning stages where you have difficulty accepting your own or a loved one’s death), anger (the second stage when you are asking questions like “why me”, or “why this person” and can sometimes displace your anger on others), bargaining (the third stage where you or a loved one vows to give something up in exchange for the dying persons health), guilt ( fourth stage of death; finding guilt in things you did or didn’t do in life), depression (the fifth stage of death where you have feelings of isolation, and mood fluctuations), and acceptance(final stage where you accept death and have dealt with it, but does not always mean happiness).

Death and dying is something we all will face in our lives. Dealing with it can be very difficult and sometimes the comfort of others such as a family member, friend, and a clergyman i.e. priest, reverend, or minister can help to cope with the process whether you or someone you love is dying. Talking sounds simple but sometimes it is hard in these circumstances.

Cardiac Care

If the physician finds that the cholesterol levels are high, then he/she may order medications, such as Lipitor, Pravachol, and Vytorin just to name a few.  But if the cholesterol level is borderline the physician will usually instruct the patient on a low-fat diet and to increase exercise.  Exercise will decrease the levels of the triglycerides, which will clog the arteries.  The ACLS renewal course is extremely informative about cardiac arrhythmias, Acute Coronary Syndrome, and Stroke.

Also, to have a healthier outcome if you are experiencing the symptoms (numbness, tingling, can’t talk, can’t understand, loss of balance, drooping of one side of the face,etc.)  always call 911 at the first sign of the stroke.  There is a medication that is given via IV route, but it can only be given in a certain time frame of 3 hours from the first symptom.  Always listen to your body and pay attention, it can tell us what is happening, it is up to us to act on it.

How to Child Proof Your Home

Is your child about to start crawling? Or do you have a child that is almost walking? Or maybe your child is already walking and is getting into more things than you can keep up with. If the answer is yes to any of these, here are some tips on how to child-proof your home.
If your baby is just beginning to crawl, your job is still pretty easy. Make sure that there are no objects on the floor that they can put in their mouth and choke. I haven’t come across a baby yet that doesn’t go for their mouth when they get something in their hands. Another  thing to do at this stage is to put plugs in all of the exposed outlets. You would be surprised  what will fit in those little holes. Also, if you have a fireplace, buy a fireplace screen to put in front of it so your child isn’t tempted to get close. But your job won’t stay easy for long. Once babies learn to crawl, it doesn’t take long before they look like they are running on their hands and knees.
Once your baby has mastered crawling, child proofing your home gets a little more detailed. By this time they are usually pulling up to things. One way to figure out what they can get into is by crawling around on your hands and knees and reaching one arm up as you go around the house. No, they won’t be able to reach up as high as you, but it will give you an idea about how high to put the breakables. If you have stairs, put a baby gate at the bottom so they can’t crawl up. They make baby gates that will attach to the wall if you need to keep a baby from going down the stairs, but even with these you really need to keep a close eye on the child. Keep toilet lids down and bathroom doors shut. Kids seem to think that everything can float. Also, you might want to consider attaching anything that could tip over, ex. a bookcase, to the wall. And still, make sure to objects that are easy to swallow out of reach.
Now that your child is a toddler, and running everywhere, you will need to walk around your house on your knees with one arm. Anything that is breakable or that could be harmful if swallowed needs to be put out of your reach when you are on your knees. If your child is like mine, they will try to get into cabinets and drawers in the kitchen. You can install latches on both cabinets and drawers . You can even put a latch on the fridge.
I’m sure there are quite a few other ways to child-proof your home that I didn’t cover, but this is a pretty good start. Most everything that you will need to do all that you need to do will be at your local baby store, like Babies-R-Us.

MRSA

In the ICU some of the patients have such sever infections that some medications do not kill the germs.  They become resistant to the medicine in turn the patient gets worse.  Only take medications that are prescribed to help decrease the risk of your body becoming immune to the medication (antibiotics).  It seems most days that everyone gets a little sniffle and they get antibiotics.  Colds are viruses and viruses do not respond to antibiotics.   All health care personnel have  responsibility to decrease the spread of germs from patient to patient.  Cleaning of the stethoscope will also help decrease the risk.

More patients and families today have been educated that they should ask about medications they are receiving, understand their diagnosis and treatment, and inform the health care team members to WASH their hands before touching you.  Personal protective equipment should be and is required to be worn when their is a risk of becoming contaminated with blood, body fluids,etc. Practice hand washing technique as recommended by the CDC, which will provide the patients with a healthier overall outcome.

ACLS Instructor

The American Heart Association has been offering Emergency Cardiac Care courses for nearly 60 years. They have been very proactive in getting highly trained individuals to become ACLS Instructors to pass on the message of excellent Advanced Cardiac Life Support. Remember to rely on the new ACLS standards the Instructors are teaching at your local hospital. The ACLS Instructor has to be highly trained and ready to provide his or her expertise to guide new healthcare providers as we move into the new era of medicine.

As a health care provider myself, I have become an ACLS Instructor so that I may give back to our EMS community. Please, If you have the time to dedicate, Become an Instructor and be part of a winning team. The ACLS Course is available through your local American Heart Association Training center.

ECG Pharmacology

The new American Heart Association new curriculum has challenged many Physicians and Nurses when working a mega code. ACLS has made significant changes since the inception of the algorithms in the early 1970s. The ECG and Pharmacology has been the culprit that has been confusing many health care providers.

The AHA has developed a DVD that explains the concepts of ECG and Pharmacology. The need for  education and training in these areas are ever increasing to accommodate the needs of the medical community. We are excited to help educate the Physicians and Nurses on the new medical and ACLS standards that are coming down the line. Our Atlanta ACLS Refresher Course is available to all of the health care professionals in the area. The training is of the utmost importance in increasing the outcome for the cardiac patient.

Staph Infection

There are so many kids who are contracting staph infections. We must prevent the spread of this disease if we are to protect our children. The school system will not be a reliable source due to the shortage of nurses. The American Heart Association has requested that all health care providers be supportive in helping parents in understanding staph infection.  They are dealing with an increase of strep throat as well. Many young children need to be tested at least once a month for the viral infection.

Many Emergency Room Doctors are prescribing Penicillin to most of the patients. This is a great danger due to the possibility of an allergic reaction. The staph infection is painful, but it does not compare to pediatric cardiac arrest in the field setting. Please take control of your child’s health and make informed decisions on how to keep them very healthy.