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.

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.

Symptoms with Pulmonary Fibrosis can vary depending on the severity of the condition.  Some symptoms are shortness of breath, coughing, and running out of steam while exercising.  This condition can be diagnosed by a Pulmonologist.  The testing to diagnose this condition would be a variety of test such as a complete family history, chest x-ray, and possibly a CT scan.    The chest x-ray may or may not be abnormal but a CT scan is a high resolution scan that will show definite abnormalities in the lungs and chest.  If the condition is not treated, symptoms will worsen over time, which could cause even more serious issues.  Unfortunately, the treatment options for Pulmonary Fibrosis are very limited.  When scarring of the lung occurs it is permanent.  Lung transplantation is the only therapeutic option available.  As far as medications, it has not been proven for all to be successful.  Some patients have tried corticosteroids, such as prednisone, to decrease the process of fibrosis.  Treatment responses vary with each patient, depending on the severity and progression.  Pulmonary Fibrosis causes decreased oxygen levels in the blood. A decrease in the blood oxygen level can lead to increased pressure in the pulmonary artery, which can lead to failure in the right ventricle of the heart.  Most patients with this disease are treated with supplemental oxygen to prevent this from happening.  There is also evidence that patients suffering with this disease are at risk for blood clots the travel to the lung, in this case a blood thinning therapy may be needed.

Is there a way to prevent ever developing the disease? Research has shown Pulmonary Fibrosis has shown an increase in cigarette smokers.  This is just one more reason not to smoke or if you do. Unfortunately, the prognosis of this disease is dismal.  There has not been any proven evidence that special diets or supplements have helped the disease in any way.

The symptoms of menopause can last up to 5 or more years. The first couple of years are generally the worst. The symptoms are caused by changes in estrogen and progesterone levels. The severity of the symptoms varies from woman to woman. A slow decrease of estrogen allows your body to slowly adjust to the hormonal changes. Some of the most common symptoms are night sweats and hot flashes. These are normally worse during the first year and if severe enough can be controlled with estrogen. In most cases the symptoms will cease over time. Other common symptoms are skin flushing, sleeping problems, and heart racing. Most but not all women may experience forgetfulness, headaches, decreased interest in sex, vaginal dryness, mood swings, and irregular menstrual periods. Treatment with hormones may be helpful if your symptoms become severe especially with mood issues, vaginal dryness, hot flashes, and night sweats. You should discuss hormone therapy thoroughly with your doctor and learn the risks of hormone therapy. Your doctor should know your full history and help you to make the right decision for you. Not all women have success with this type of therapy.

Some major health studies have questioned the health benefits and risks of hormone therapy. In fact some studies have shown the risk of developing breast cancer, heart attacks, strokes, and blood clots. Women who qualify for this treatment can only use it if they have recently entered menopause. It is not recommended for patients who started menopause years ago. Women taking the HT should be at low risk for heart attack, breast cancer, blood clots and strokes. The HT medicine should also not be taken for more than five years.

If you are experiencing any of these symptoms you should be seen by your physician. Your physician can perform some tests to see if you are in fact entering menopause. Blood and urine tests can be used to measure changes in hormone levels some examples of these tests are LH, FSH, and Estradiol. Although it is not something women look forward to going through, you should be aware of symptoms and treatments. This could make it a lot easier for you when it happens.

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.

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.

There are algorithms such as ventricular fibrillation as well as symptomatic bradycardia which require the administration of epinephrine. The medication or the drug has great benefits as we all know. The drug helps to increase automaticity, conductivity as well as contractility. This helps to emphasize Dr. Starlings Law that indicates that heart rate times the stroke volume equals cardiac output. Without the use of the epinephrine medication we would not be able to increase myocardial contractility or automaticity and as result we would have no perfusion. Finally, much of this information may be located via our website. Feel free to search around and find the information you need to give you full clarification on the medication known to many as adrenaline.

The emergency medical community should be instrumental in helping to implement these new algorithms that will be used for the cardiac arrest victim. The American Heart Association has provided many years of training for the emergency and acute care setting for the emergency care provider. The pediatric advanced life support credential will help to increase the level of care that is provided at the pediatric level. Should anyone feel concerned or disagree with the our rhythms, they should notify their medical director are there registered nursing administrator immediately. Finally, the mega code is designed to help you better treat your patient and to provide better results as well. Thank you for participating in the American Heart Association PALS certification update for 2010.

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.