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Vital Education We go to the hospital because we want to get better, but sometimes healthcare is needed before we get to there. When a 65 year old man has a heart attack at his house, when two cars are involved in a serious traffic collision on the freeway, and when a child is drowning after swimming in the pool, all of these individual may be dead before they ever arrive to the hospital.
All of these situations stated above would require the emergency health care system which can also be labeled as prehospital care. Its employees range from paramedics, fire fighters, to lifeguards, and everything else in-between.
Its singular goal is to protect and to provide citizens with the best prehospital healthcare. These citizens are known as patients who can be put in two categories: trauma and medical.
Trauma patients are those who have any physical damage to the body, some examples are traffic collisions or a gunshot wound. Medical patients can be stated as any patient who is sick from an illness such as diabetes or a heart attack. There are many treatments a patient needs before they even step foot in a hospital such CPR, breathing assistance, epinephrine shots, spinal stabilization, and many more.
Before any person can learn these techniques, they must first master three fundamentals of the emergency medical system.
Education is important in the emergency medical system because workers must know the basics of vital signs, patient assessment, and treatment. Vitals signs are required to know in the medical field because they are insight to what is happening to the body, gives you a guideline to assess, and they all relate to each other in a specific ways. There are five central vital signs taught: the pulse, blood pressure, the skin, pupil reaction, and respirations.
The blood pressure in simple terms is the force on the arterial walls when the left ventricle pumps, which is ready by two numbers. The first number, systolic blood pressure is defined by the American Heart Association as “The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts)”. The second or bottom number, known as diastolic blood pressure, is the pressure of the heart atrial walls between heartbeats (American Heart Association).
Blood pressure typically rises with age. The next vital sign is the pulse, which in essence can be explained as “The pulse is one of the quickest vitals to change and one of the most important to obtain during initial patient assessment” (Penwell). It is usually read for a minute. For the skin we determine the color and temperature. The skin is warm and pink, and if it is cool, cold, or hot it is considered abnormal. The fourth vital sign is the bodies’ temperature. An adult’s body temperature is 98. 6 degrees. The final vital sign is respirations.
It can be defined by EMS world as “In order for a patient to be breathing adequately, he must have a respiratory rate that is adequate and an adequate tidal volume” (Mistovish). All the age groups have different vital signs for breathing. Not everybody breathes the same rate. For example, infants and young children breathing will occur between 20 and 60 breaths per minute, which is a much faster rate than in an adult. Vital signs offer us a view of the body physiology. Most adults fall under the same umbrella for vital signs. The average adult blood pressure should normally be 120/80(American Heart Association).
The pulse for any adult is between 60 and 100 (Fire Engineering). The normal temperature for the human body is 98. 6 degrees Fahrenheit. Also according to Penwell, the normal ranges for breathing for the adult patient are 8-24 breaths per minute. In accordance, the chest should have full tidal volume, while also having clear lung sounds when being auscultated. Vital signs offer us an important part of the picture that the patient assessment can complete. Every patient will receive a patient assessment from one of the following: SAMPLE history, OPQRS assessment, or the Glasgow coma scale.
Ryan Gloman describes SAMPLE patient assessment as “The SAMPLE history can be used on the scene of an incident and it can also be used in the emergency room after the patient has been transported. In fact, the patient will usually be questioned several times on the same topics by different individuals. This assures that the health care providers will get a clear picture of the problem”. The letters in SAMPLE stand for Signs and symptoms, Allergies, Medications, Pertinent History, Last Oral Intake, and Events Prior. Another acronym used in the prehospital setting is “OPQRST”. This acronym can be summarized as, “OPQRST comes in handy.
It’s a memory aid to help EMTs ask the questions they should ask a medical patient about signs and symptoms”(Heavenly Manna). The “O” stands for onset, as in when did the pain occur. The “P” stands for provoke asked as “did anything provoke this pain. ” While the “R” stands for radition, as where is the pain radiating throughout the body. The letter “S” stands for severity, which is asked on a scale of one to ten to describe the pain. “Q” is the quality of pain, in where you ask the patient to describe the pain. The last letter “T” stands for time, where you ask the patient how long the condition has been going on.
One of the most useful tools for assessing the mental status of a patient is the Glasgow coma scale. It is the “The Glasgow Coma Scale is based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others” (Traumtic Brain Injury). There are four tiers a patient can fall under according to Glasgow coma scale, Mild (13-15), moderate disability (9-12), severe disability (3-8), and vegative state (1-3). The three categories to score under the Glasgow come scale are motor response, eye opening, and verbal response.
The next step after patient assessment is treatment. Vital treatments which are common for any patient is oxygen therapy, spinal immobilization, and CPR. According to Mike Smith, twenty five percent of all calls are related to a form of respiratory distress. Generally, oxygen will benefit all patients who receive this therapy. Cardiac arrest, respiratory arrest, and major trauma are just some examples where oxygen therapy would be needed. To be illustrated, a few ways oxygen can be applied are with a nasal cannula, nonrebreather mask, and a bag valve mask (Smith). Another common treatment option is spinal immobilization.
A few signs and symptoms for spinal cord injuries are tingling sensation of the extremities, extreme pain in the neck, back, or head, and the partial or complete loss of control over any part of the ones body (nspnvt. org). When a spinal injury is suspected, a patient must be fully immobilized. The Cochrane Collaboration summarizes this process as “Spinal immobilization involves the use of a number of devices and strategies to stabilize the spinal column after injury and thus prevent spinal cord damage. The practice is widely recommended and widely used in trauma patients with suspected spinal cord injury in the pre-hospital setting”.
Damage to the spinal cord causes long term disability, for this reason such care is given to the immobilization of the spine. The main the method of spinal immobilization is through the use of splints and backboards with secondary devices such as cervical collars and straps (Cochrane Collaboration). Additionally, CPR is one of the most important techniques that every EMS worker must know. When the body can no longer breathe and pump blood for itself, CPR is needed. CPR is the acronym for cardio pulmonary resuscitation. Doctor Joseph Sciammarella states that earlier CPR is given, the greater chance of resuscitation is.
CPR stalls the process of dying by allowing oxygenated blood to travel through the body while oxygen is being ventilated into the mouth and lungs (Sciammarella). When a 65 year old male patient suffers a heart attack and he has stopped breathing, it is important for that individual to receive immediate CPR so that he can make it to the hospital where his greatest chance of survival will be. When two cars on the freeway are involved in a traffic collision, chances are that someone in those two cars will receive have to receive spinal immobilization.
When a little girl at a swimming pool party is drowning, immediate CPR is needed to save her life. Everyone stated above will have benefited from the emergency medical system. For this reason is important that every emergency medical system employee know have the education of their vital signs, patient assessment, and treatment. To make sure the 65 year old man comes home to his worried wife. To make sure the victims of the traffic collision come home to their families. To make sure that little girl’s life is not cut short.