The Disease States in Emergency Care - Essay Example

Disease s in emergency care affiliation Disease s in emergency care Hypoxia Hypoxia is the condition where there is insufficient oxygen supply to meet the needs of the body. Hypoxia exists in four different types. Firstly, there is the hypoxic hypoxia which happens when there is a shortage of exchange of oxygen in the lungs. This is often encountered with mountain climbers, pilots and individuals staying in high altitude areas as a result of reduced atmospheric pressure. Other causes of this condition include illnesses like drowning, asthma, pulmonary edema, and pneumonia which block the flow of oxygen in the alveolar-capillary; and reduced oxygen partial pressure present at altitude (Lu & Kang, 2010). Secondly, there is the anemic or hypemic hypoxia which comes about when either the whole amount of hemoglobin is minimal to convey oxygen requirements, after severe bleeding or in anemia, or when the hemoglobin that is available is considered nonfunctional. Instances of the latter situation are metho-globinuria and carbon monoxide poisoning, in either of which the hemoglobin is changed through toxic agents until it becomes inaccessible for the transport of oxygen and, therefore, there is no respiratory significance. Other causes are sickle cell disease, and medications such as nitrates, sulfonamides, and aspirin also bring about these ailments. Stagnant hypoxia, is the condition where the flow of blood in capillaries is inadequate to supply the tissues, it may be local or general. Local stagnant hypoxia is caused by any ailment that blocks or reduces the blood circulation to any part of the body. Examples include Buerger’s disease and Raynaud’s disease, which limit flows to the extremities, ergot poisoning, and the use of a bandage to control bleeding, exposure to cold, and vast systemic contamination with shock. In general, it might come from the trauma that induces shock or heart disease that damages the venous return of blood, and damages the circulation (Wheaton & Chandel, 2011). Lastly, there is histotoxic hypoxia; this is when the body cells are not able to use the oxygen available though the level of oxygen in the blood may be standard and under normal pressure. Even though cyanide typically makes it, any cause that minimizes cellular respiration might cause it. An example of these agents includes formaldehyde, narcotics, acetone, alcohol, and some anesthetic agents. Whatever the causes of hypoxia, it is significant to know the symptom and potential for hypoxia early (Kumar, 2011). Hemolytic transfusion A hemolytic transfusion reaction is an adverse complication that takes place after a patient has undergone a blood transfusion. There exist different types of transfusion reactions. To start with, there is the acute hemolytic reaction which is caused by human mistakes like mislabeled pre-transfusion specimen, clerical mistakes inside the blood bank, or the transfusion of correctly labeled blood to the incorrect individual. These mistakes lead to the transfused red blood cells to react with flowing antibody in the receiver with subsequent intravascular hemolysis. This reaction mostly happens when a group O recipient is wrongly induced with group AB, B or A blood. The effects involve an ache in the lumbar region, constricting ache in the chest, hypotension, tachycardia, and hemoglobinemia with consequent hyperbilirubinemia and hemoglobinuria. Secondly, delayed hemolytic reaction which happens in patients had developed antibodies from previous pregnancies or transfusions, however at the period of pre-transfusion analysis, the antibody in interrogation is very weak to be detected by normal procedures. Consequent transfusion by red blood cells containing the matching antigen leads to an anamnestic antibody reaction and hemolysis of transfused red cells. The effects are a falling hematocrit which arise due to the extravascular demolition of the red blood cells transfused and a direct positive antiglobulin test. A slight rise of the serum bilirubin and hemoglobinuria may also be an effect (Pandey & Vyas, 2012). Additionally, allergic-urticaria is brought about by foreign plasma proteins. The effects are allergic reaction related to bronchospasm and laryngeal edema. Another transfusion reaction is allergic-anaphylaxis, the existence of anti-IgA in an IgA lacking receiver is a probable source of anaphylactic transfusion reactions. The effects of this reaction are that they bring about cardiovascular inability which comprise of shock, cardiac arrest, cardiac arrhythmia, loss of consciousness, tachycardia, and hypotension. Trail is another reaction caused by transfusion. It is related to the availability of antibodies in the plasma of the donor that is reactive to the receiver’s leukocyte antigens or with the manufacture of inflammatory intermediaries in the storage of cellular plasma constituents. Its effects are the sudden onset of non-cardiogenic pulmonary edema. Furthermore, non-immune hemolysis may occur because of the improper handling, transfusion, or storage conditions. Also, the storage and mishandling of blood components is a cause. Non-immune hemolysis leads to hemoglobinuria and hemoglobinemia transient hemodynamic, renal and pulmonary impairment may take place, and cardiac arrhythmia caused by hyperkalemia might occur, specifically in renal failure patients (Bracker & Drellich, 2005). In Post-transfusion purpura (PTP), the patient forms an alloantibody in reaction to platelet antigens present in the transfused plasma that for a duration of times brings destruction of autologous antigen negative platelets. This reaction brings about thrombocytopenia that is often deep, bleeding, or purpura. Another one is Graft-vs-HOST disease, this is when possible T lymphocytes in plasma constituents are transfused, engraft and react alongside the tissue of the receiver and he or she is not able to reject the donor lymphocytes due to immunodeficiency, shared, or severe immunosuppression HLA antigens. This leads to cytopenia, diarrhea, fever, rash, and dysfunction of the liver for 3-4 weeks (Bux & Sachs, 2008). Stroke Stroke is the impairment to the brain from disruption of its blood supply. It is good to know the prehospital treatment so as to reduce brain injury. Though the call might arrive as a stroke, it can also arrive as a seizure, a fall, and an individual with problems speaking, or any additional categorizations. Every single minute of delay to action is said to kill 1.9 million cells of a patient (Bray et al., 2005). Emergency Medical Service (EMS) dispatchers using urgency dispatch systems are taught to place stroke indications as high-priority calls where minutes matter. As a matter of fact they do. When the EMS land at a scene, patients having a stroke can show different signs and symptoms, as well as paralysis. This weakness or numbness can appear in the legs, arms, or face. It is commonly on the side of the body that is opposite to the side of the brain that is impaired by the stroke. It is known as hemiplegia if it comprises complete incapability to move and hemiparesis if it comprises weakness. As with all the casualties in the prehospital location, assessment of the circulatory, airway, and breathing status of the patient suffering from stroke is essential. Administer oxygen if suitable and acquire a set of significant signs. Gather patient medications and history, giving specific attention on whether the casualty is being treated with antiplatelet or anticoagulant drugs. Try to note the time the symptoms started since that will be the start time from which now you can calculate the three hours for fibrinolysis treatment. Attain IV access and a glucometer reading since hypoglycemia can imitate stroke but it is much easier to cure in the prehospital setting. Stroke assessment tools like the Los Angeles Prehospital Stroke Screen or the Cincinnati Prehospital Stroke Scale were formed to upsurge the accuracy of field assessments of possible stroke patients (Brandler, Sharma, Sinert, & Levine, 2014). The use of stroke evaluation tools upsurges prehistorical triage in patients suffering from a stroke. These assessments can be done in not more than one minute. With normal training in recognition of stroke, paramedics have shown an understanding of 61 to 66 percent for identifying a stroke patient. However, this understanding improved to 86 to 97 percent after being taught how to use the stroke assessment tool. Emergency, medical services personnel, should adhere to their local service procedures with detail to assessment tools for stroke and triage in the alleged stroke patients to the healthcare facility best capable of taking care of them. Assessment of three aspects of abnormal speech, arm drift, and facial droop can help the EMS in quickly recognizing the likely stroke patients. To assess hemiparesis, request the patient to stretch out both arms with their palms up and close their eyes for ten seconds to observe if one arm points down or does not move. Speech can be assessed by requesting the patient to repeat a common expression. When the brain’s left is affected, patients suffer from right-sided hemiparesis and language effects like apraxia, aphasia, and dysphasia in addition to ataxia and facial droop. Unexpected blindness may also be an indication of stroke (Bray, Coughlan, Barger, & Bladin, 2010). Antibiotics Dissimilar antibiotics have diverse modes of action due to the nature of their arrangement and level of similarity to particular target sites in bacterial cells. Penicillin’s, vancomycin, bacitracin, and cephalosporin are said to be the obstructers of cell wall synthesis (Mangione-Smith, Elliott, Stivers, McDonald, & Heritage, 2006). While the cells of animals and human do not contain cell walls, this component is vital for life and existence of bacterial species. A medication that targets the cell walls can thus selectively inhibit or kill bacterial organisms. Another set of antibiotics includes colistin and polymyxin B. this set of antibiotics inhibit the functioning of the cell membrane. Cell membranes are significant barriers that regulate and segregate the extra- and intracellular movement of substances. Additionally, tetracyclines, chloramphenicol, streptogramins, lincosamides, macrolides, and aminoglycosides which prevent protein synthesis. This process of protein synthesis is significant to the survival and multiplication of all bacterial cells. Quite a few types of antiseptic agents aim infectious protein synthesis by tying together 50s or 30s subunits of the intracellular ribosomes. This process brings about the disruption of the typical cellular metabolism of the microbes and subsequently leads to the demise of an organism or the inhibition of its multiplication and growth. Quinolones, rifampin, and metronidazole are the obstructers of nucleic acid synthesis (Wright, 2012). Deoxyribonucleic acid (DNA) and Ribonucleic acid (RNA) are important to the reproduction of all living organisms, inclusive of bacteria. These antibiotics work by connecting to constituents involved in the procedure of RNA and DNA synthesis. This leads to the interference with the typical cellular processes thus compromising bacteria survival and multiplication. Sulfonamides and trimethoprim inhibit the pathway of folic acid which is a significant step for microbes to produce precursors for DNA synthesis. Antibiotics do not kill viruses, and that’s the main reason one cannot be prescribed for whenever he or she is suffering from viral infections. A majority of infections to the chest, ears, sinuses, throat, and nose are brought about by germs known as viruses. During this infections antibiotics are not needed because they kill bacteria, not viruses, they may also cause side effects like feeling sickly feeling, rashes, and diarrhea, among others. Lastly, the overuse of these antibiotics, whenever they are not required, may cause some bacteria to become resistant to them (Dantas, Sommer, Oluwasegun, & Church, 2008). References Bracker, K. E., & Drellich, S. (2005). Transfusion reactions. Compendium, 10, 500–512. Brandler, E. S., Sharma, M., Sinert, R. H., & Levine, S. R. (2014). Prehospital stroke scales in urban environments: A systematic review. Neurology. Bray, J. E., Coughlan, K., Barger, B., & Bladin, C. (2010). Paramedic diagnosis of stroke: Examining long-term use of the melbourne ambulance stroke screen (MASS) in the field. Stroke, 41, 1363–1366. Bray, J. E., Martin, J., Cooper, G., Barger, B., Bernard, S., & Bladin, C. (2005). Paramedic identification of stroke: Community validation of the Melbourne ambulance stroke screen. Cerebrovascular Diseases, 20, 28–33. Bux, J., & Sachs, U. J. H. (2008). Pulmonary transfusion reactions. Transfusion Medicine and Hemotherapy. Dantas, G., Sommer, M. O. A., Oluwasegun, R. D., & Church, G. M. (2008). Bacteria subsisting on antibiotics. Science (New York, N.Y.), 320, 100–103. Kumar, G. K. (2011). Hypoxia. 3. Hypoxia and neurotransmitter synthesis. American Journal of Physiology. Cell Physiology, 300, C743–C751. Lu, X., & Kang, Y. (2010). Hypoxia and hypoxia-inducible factors: Master regulators of metastasis. 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