Be still my beating heart...
Well, actually... don't!
There's no doubt that we've got to master the signs and symptoms, and associated interventions, of both respiratory and cardiac emergencies. Every situation we face starts with assessing the ABC"s -- Airway, Breathing, and Circulation -- as these represent true emergencies, where it really can be a matter of life-or-death.
Respiratory and cardiac emergencies are very closely related, as issues in one area can have a detrimental, even fatal, impact to the other.
While the heart is responsible for pumping blood through the lungs for oxygenation, and then moving the oxygenated blood itself to the tissues and organs throughout the body, it is itself a muscle that also requires oxygenated blood to effectively pump. So any disruption in how the body is obtaining and utilizing air through the upper and lower airways (including the lungs) can cause issues for the heart as well.
And things roll downhill quickly from there on... Because having to perform CPR means that someone is having a really, really, really bad day....
Taking a breather
With the first set of EMT written and practical tests behind us (Ashley, our Cadet member, and myself both scored very well...thanks to all who offered their well wishes!), our classwork moves on to a more focused set of lectures on medical emergencies, and their associated care and treatment options.
While we are told not to diagnose underlying causes of illness, in practice, EMTs play a very key role in uncovering critical signs and symptoms of those underlying medical issues through our history-taking activities (the aforementioned "million questions"), which we provide to medics and hospital staff as part of our transfer of patient care. The questions also guide us in developing an index of suspicion for what may be happening with our patient, allowing us to be more aware of the risks for cardiac, respiratory or neurological issues that may develop while we are in transport.
Classwork this week focused on the various causes of respiratory distress. If you love to read a good detective story, this set of coursework is for you. The textbook almost reads like a good mystery novel, filled with similar signs and symptoms for many different potential causes of dyspnea (or shortness of breath).
And only by combining the practical lung sound skills we're learning to listen for, with other vital signs (including pulse rate and blood pressure), key medical history, and signs and symptoms from our observations and the patients own behaviors and expressed issues, can we reach a clear index of suspicion on key underlying possibilities to be aware of.
Part of the practical skills we've been focusing on in class are the primary and secondary assessments that EMTs do on patients. While the primary assessment is done on scene, and focuses on managing life threats, the secondary assessment can be done on scene or in the back of the ambulance while we are transporting a patient to the appropriate medical center.
The secondary assessment, if we aren't still actively managing life threats (like performing CPR), allows for a more through inspection of the patient, either for a specific injury or illness symptom (assuming they are conscious and alert enough to talk with us), or a full-body scan intended to ensure we don't miss any additional injuries (which is especially important with an unconscious or unresponsive patient, or even a conscious one with an altered mental status).
This also includes taking critical vital signs, including pulse and blood pressure, in order to determine if our interventions are producing the right positive results, or whether our patients are sliding towards dangerous grounds, such as shock.
So ... Who would have thought that one of the best study aids I could get for this stuff would be my 8-year old son and his imagination?
The keys to providing effective care, however, requires us to understand human anatomy and how all the systems within our bodies both work and inter-relate. And while it is a major amount of stuff to learn, it's probably not much more than the average 8th grade health class or high school biology class.
Jon Alperin, one of our MFAS volunteers, shares his journey to becoming an NJ certified EMT.
from the Start
Here is Jon's journey, presented in time order: