Valeria Reyes1
Signs and symptoms
● Emphysema:
Pathophysiology: Destruction of the airways distal to the bronchiole, (loss of elasticity in lungs),
Destruction of the pulmonary capillary bed, decreased ability to oxygenate the blood, lower cardiac output
and hyperventilation, development of muscle wasting and weight loss.
Signs and symptoms:use of accessory muscles, thin appearance with barrel chest, puffing(pursed lips),
Tripod position, cyanosis, wheezing
Risk factors: Smoking, age, air pollution, second hand smoke.
National Emt Scope Treatment:oxygenation, bronchodilators,cpap rapid transport>
● Chronic Bronchitis:
Pathophysiology: Rsv infection excessive mucus production with airway obstruction, Pulmonary
capillary bed undamaged,compensation by decreasing ventilation and increasing cardiac output, poorly
ventilated lungs leading to hypoxemia, increased carbon dioxide retention, use of accessory muscles
Signs and symptoms:difficulty with expiration,chronic cough,wheezing,Rhonchi, cyanosis,tachypnea.
Risk factors: smokers, patients with copd, older patients 40s, alpha-1 antitrypsin deficiency
National emt scope treatment: oxygenation, inhaler of steroids, bronchodilators
● Simple Pneumothorax:
Pathophysiology:air leaks into space between the pleural surfaces from an opening in the chest wall or
the surface of the lung, lung collapse,sucking chest wound, fractured ribs, air escaping from a lacerated
lungis leaking into chest wall, free from significant physiologic changes and does not cause drastic
changes in vital signs.
Signs and symptoms: dyspnea, increased work of breathing,tachypnea,accessory muscle
use,decreasing spo2, crackling sensation
Risk factors;sucking chest wound,chest trauma, rib fractures, contusions and abrasions, cystic fibrosis,
patients with lung diseases( asthma emphysema)
National emt scope treatment: high flow oxygenation careful can lead to tension , monitor oximeter
readings and breath sounds, rapid transport, fowler position, bandage any chest wounds
● Spontaneous Pneumothorax
Pathophysiology: tissue rupture air leakage into pleural space causing lung to collapse,Respiratory
distress, increased dyspnea, hypotension, jugular vein distention,cyanosis
Signs and symptoms:respiratory distress pleuritic chest pain(sharp stabbing pain felt while inhalation
and exhalation), absent breath sounds
Risk factors: medical conditions, lung infections,emphysema, asthma,tall thin men, young people born
with weak areas of lung
National emt scope treatment: reassess for anxiety,supplemental oxygen NRM, prompt
transport,sitting/fowler position,support airway and ventilations and cpr if needed.
● Asthma
Pathophysiology: (allergic reaction) Acute spasm of the bronchioles associated with excessive mucus
production and swelling of the mucus lining in the respiratory passages, affects all ages but usually from
ages 5- 17
Signs and symptoms: wheezing, cyanosis, respiratory arrest,Bronchospasm
Risk Factors: anaphylaxis,emotional stress, allergens,exercise.,
National emt scope treatment:inhaler or nebulizer, albuterol, sitting position
● Pulmonary embolism
Pathophysiology:Blood clot that occurs in pulmonary circulation and blocks the flow of blood through the
pulmonary vessels, can't go into the heart.
Signs and symptoms: obstructive shock,crackles/wheezing, sharp chest pain,sudden onset,
dyspnea,tachycardia,clear breath sounds,cyanosis, tachypnea, hypoxia degree,hemoptysis (coughing up
blood)
, Valeria Reyes2
Signs and symptoms
Risk factors: slow blood flow in legs, like immobilized legs following fracture or surgery, pregnancy,
active cancer, and being on bed rest
National emt scope treatment: Suction airway if any hemoptysis is covering air way, provide oxygen via
NRM if not use nasal cannula, and rapid transport, fowler position, or comfort position of patient
● Pneumonia
Pathophysiology: An infection the affects the exchange of gases between the alveoli and capillaries,
impairing the lungs ability to oxygen and carbon dioxide( secondary infection)
Signs and symptoms: cold sore throat. Children- rapid or labored breathing, grunting or wheezing, lips
and nails may be gray), if phenomena is in lower part of the lungs then you'll see fever abdominal pain,
and vomiting( bacterial pneumonia dry skin, decreased skin turgor,exertional dyspnea, productive
cough,chest discomfort,headache, nausea,musculoskeletal pain,weight loss,Febrile, tachycardia,
hypotensive, wheezing, crackles, rhonchi)
Risk factors:Institutional residences (nursing home or long term facilities), recent hospitalization, chronic
diseases processes: such as renal failure following dialysis,immune system compromise: receives chemo
and or diseases such as hiv, history of COPD,high fever
National emt scope treatment: Airway support,supplemental oxygen ,assess temperature,, ,and prepare
for deterioration in patients condition.immediate transport and transport in Fowler position.
● Tuberculosis
Pathophysiology: Chronic mycobacterial disease that strikes lungs, shortly after infection, contagious
through cough,restrains to antibiotics, affects: lungs,kidney,spine, lining of brain,spinal cord.also can
remain inactive.
Signs and symptoms: active tb in lungs- fever,coughing,night sweats,fatigue, and weight loss,sever
infection-shortness of breath,coughing productive sputum, and chest pain
Risk factors: contagious, can reactivate,cough, bronchial sounds, anyone that breathes,people who live
in close contact- prison inmates nursing home residents, homeless shelters, people who abuse drugs or
alcohol, and compromised immune systems like HIV.
National emt scope treatment: N95 mask PPE and BSI, high flow oxygenation, let the hospital know of
tuberculosis patients. Sitting in comfort of a patient.
● Pulmonary Edema
Pathophysiology:backup builds up fluid within the pulmonary tissue,fills alveoli and separates the
capillaries from the alveolar wall, interfering with exchange of oxygen and carbon dioxide. abnormally
large amounts of fluids between cells in body tissues, causing swelling of the affected area,
Signs and symptoms: immpaired respiratory,increased respiratory rate,abnormal lung sounds,frothy
pink sputum at nose and mouth.,cool diaphoretic, crackles, and wheezing,tachycardic
Risk factors: high cardiac output triggers ,respiratory distress, rapid shallow breathing,sick, frightened
worrisome, heart disease,inhalation of smoke or chemicals, trauma to chest,high altitudes.
National emt scope treatment:cpap
● Myocardial infarction (MI)
Pathophysiology: heart attack,blood pressure decreased narrowing or blockage in a coronary artery
blocks blood flow to a section of the heart muscle, oxygen cant flow to heart and muscle will die.
Signs and symptoms: sudden pain in chest and or pressure,fast/abnormal heart rate,dyspnea,weakness
and nausea,pink frothy sputum,
Risk factors: older people, geriatic patient,cigar smoke, hyper tension,diabetes,genetic history of
arterclerotic coronary artery disease, race ethnicity, male sex, stress, excessive alcohol, and poor diet
National emt scope treatment: nitroglycerin, highflow oxygen nbm,transport immediately, and or cpr,if
necessary
, Valeria Reyes3
Signs and symptoms
● Hypertensive Emergency
Pathophysiology: systolic blood pressure greater than 180 mm hg or rapid rise in systolic blood
pressure.
Signs and symptoms: severe headache= cerebral hemorrhage,strong bounding pulse, ringing in ears,
nausea, vomiting, dizziness,skin warm= dry or moist,nosebleed, altered mental status,
Risk factors: diabetes, hypertension,pericardial effusion, development of pulmonary edema,stroke, and
or dissecting aortic aneurysm,
National emt scope treatment: make patients comfortable, monitor blood pressure regularly,position
patient with head elevated, and transport rapidly, consider als.
● Aortic Dissection(AAA and Thoracic)
Pathophysiology: inner layer of larger blood vessel bursts into aorta( if bursts/ruptures into thoracic
cavity- Thoracic)( if ruptures into abdomen than it is now an AAA)
Signs and symptoms: chest pain and or pressure in upper part of body,hypertension, throbbing/
pulsating in abdomen, low pulse
Risk factors: age, past aneurysms, atherosclerosis,
National emt scope treatment: high flow oxygen, hypertension, immediate transport and cranport bia
comfort position.
● Obstructive shock
Pathophysiology: inadequate volume of blood to fill the heart chambers shock resulting from blocked
blood flow back to or through the heart, pump failure can be from tension pneumothorax, cardiac
tamponade pulmonary embolism
Signs and symptoms:Dyspnea, rapid/weak pulse,rapid shallow breaths, decreased lung
compliance,decreased or absent breath sounds,hypotension,jugular vein distention,subcutaneous
emphysema, cyanosis,tracheal deviation toward unaffected side,beck triad(cardiac
tamponade),Narrowing pulse pressure, muffled heart tones
Risk factors: cardiac tamponade, tension pneumothorax, pulmonary embolism,
National emt scope treatment: high flow oxygen, rapid transport and als if needed.
● Angina Pectoris
Pathophysiology: heart tissue is not getting enough oxygenation, spasm of an artery, oxygen exceed is
supply causing a pain
Signs and symptoms: crushing squeezing pain, shortness of breath nausea,sweating
Risk factors: artherosclerotic coronary artery disease, eating a large meal, exercise,cardiac rhythm
problems,AMI
National emt scope treatment: treat like you are treating an AMI, nitroglycerin, resting promptly
● Anaphylactic shock
Pathophysiology: poor vessel function, person reacts violently to a substance to which is sentized,
causing an allergic reaction, develops within minutes or seconds and can be second phase reaction 1-8
hours later.
Signs and symptoms:mild itching or rash, burning skin vascular dilation,generalized edema, coma ,
rapid death, cyanosis, blood pressure drops
Risk factors: injections, stings ingestion,inhalation, life threatening allergic reaction
National emt scope treatment: manage airway, assist ventilations,high flow oxygen,determine cause,
administer epinephrine, transport promptly.