WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ......
Transcript of WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ......
![Page 1: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/1.jpg)
WHAT IS BETWEEN YOUR HEAD AND YOUR ASS?
Presenter: Doug Wildermuth
![Page 2: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/2.jpg)
Abdominal Issues
■ Mostly the result from understanding the digestive process tied to inherent risk factors:– Alcohol consumption
– Excessive smoking
– Increased stress
– Ingestion of caustic substances
– Poor bowel habits
– Poor eating habits
![Page 3: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/3.jpg)
What goes in…
On average…2,500 ml a day
60% by drinking
30% by eating
10% by cellular
metabolism
![Page 4: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/4.jpg)
Must come out…■ 60 % out via urine
■ 28 % out via the lungs & skin
■ 6% out via feces
■ 6% out via sweat
![Page 5: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/5.jpg)
What does water do for you?
![Page 6: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/6.jpg)
• Intracellular Fluid – Fluid inside the cells
• Extracellular fluid:
–Intravascular Fluid – Fluid within the vascular space
–Interstitial Fluid – Fluid outside cells and outside the vascular space
![Page 7: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/7.jpg)
75 % Intracellular 17.5% Interstitial 7.5%Intravascular
![Page 8: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/8.jpg)
■Lack of Glucose
■Lack of Oxygen
■Lack of energy–Sodium/Potassium pump shutdown–Cell membrane rupture–Cellular Death
![Page 9: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/9.jpg)
Abdominal A& P
Solid or Hollow Organs???
Where does it start?
Where does it end?
![Page 10: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/10.jpg)
The DigestiveSystem
![Page 11: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/11.jpg)
Saltine Challenge
Can you eat 6 Saltines crackers in 60 seconds?
![Page 12: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/12.jpg)
![Page 13: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/13.jpg)
Duodenum
![Page 14: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/14.jpg)
The Endocrine System
Function
– To secrete chemicals, such as insulin and adrenalin, responsible for regulating body activities and functions.
Adrenal Glands
– Secrete Epinephrine & Norepinephrine
![Page 15: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/15.jpg)
Insulin allows sugar to
pass from the
bloodstream into the
cells.
The brain needs the
glucose to operate.
The Endocrine System
The Pancreas
![Page 16: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/16.jpg)
Islets of Langerhans
■ Insulin is produced normally by the Beta cells (here).
■ Insulin levels rise while eating as well decrease while resting.
■ Average daily secretion is 0.6 units per kg of insulin to stabilize a glucose level that is typically 70-120.
■ Facilitates glucose metabolism when working properly.
![Page 17: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/17.jpg)
When The Glucose Isn’t Working
■ When glucose can not be used (for whatever reason) cellular starvation begins.
■ Body responds by breaking down stored fats and protein to provide energy.
■ These fatty acids metabolize in the liver and produce ketones.
![Page 18: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/18.jpg)
Pancreatitis■ Inflammation of the pancreas – chronic or acute
cases
■ The digestive enzymes of the pancreas do not reach the duodenum and interact with the pancreatic cells resulting in destruction of the pancreas.
■ Common in alcoholics.
![Page 19: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/19.jpg)
Cholecystitis■ Blockage of the cyst duct…where is the cyst duct?
■ Cyst duct is the gallbladder duct.
AKA – Gallstones!
![Page 20: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/20.jpg)
Cholecystitis
■ Can be inflamed, distended or blocked.
Signs & Symptoms:
■ Upper right quadrant pain.
■ Referral pain to the right shoulder.
■ Acute cases will have nausea and vomiting.
■ Onset could be hours after eating a fatty meal which emulsifies the fats in the duodenum.
■ High risk – women with pregnancy “Fat, Fair, Female & Fertile”, Pima Indians & Hispanics.
![Page 21: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/21.jpg)
Toxic Poisonings■ Methods
– Ingestion – Most common
– Absorption
– Injection
– Inhalation
■ Ingestion – Household products, Petroleum based, cleaning agents, cosmetics, plants, foods, drugs (prescription and illicit)
■ Poison Control Centers?
![Page 22: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/22.jpg)
Poisoning Treatments
■ Decontamination
■ Gastric Lavage
■ Activated Charcoal
■ Whole bowel irrigation
■ Antidotes?
![Page 23: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/23.jpg)
![Page 24: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/24.jpg)
Disorders of the Intestines
■ Gastroenteritis – inflammation of the stomach or intestines due to a pathogen
■ Diverticulitis – abnormal path (or pocket) of the colon (large intestine). More common in people over 50.
■ Inflammatory Bowel Disease (IBS) – inflammation of the inner lining of the digestive tract
– Ulcerative colitis
– Crohn’s disease
![Page 25: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/25.jpg)
Crohn’s Disease■ Idiopathic inflammatory bowel disorder
■ Associated with the small intestine
![Page 26: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/26.jpg)
Gastric Bleeding
■ Upper GI Bleeds– Gastroenteritis may present itself– Type of bleeding noted:
■ Bright red, coffee ground like in nature■ Can be hemodynamically unstable if not noted
■ Lower GI Bleeds– Gastroenteritis may present itself– Type of bleeding noted:
■ Dark Tarry stool in color
![Page 27: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/27.jpg)
Appendicitis■ Inflammation of the appendix
■ Unknown structure
■ Appendectomy?
![Page 28: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/28.jpg)
![Page 29: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/29.jpg)
![Page 30: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/30.jpg)
Hiatal Hernia/Acid Reflux (GERD)
![Page 31: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/31.jpg)
Esophageal Varices■ Distended, varicose veins in the esophagus due to
portal vein hypertension.
■ The portal vein carries blood back from the abdominal organs to the liver.
■ Common untimely death among alcoholics:
– “Drink to Death”
![Page 32: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/32.jpg)
Hepatic Disorders■ Hepatitis – inflammation of the liver
– Types A, B, C, D, E, G
■ Cirrhosis of the liver – scarring of the liver– As tissue is lost, the liver can not metabolize appropriately
resulting in RBC breakdown, ineffective glycogen storage, clotting factor issues.
– Common amongst chronic alcohol abusers
![Page 33: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/33.jpg)
Vascular Issues■ Descending Aortic Aneurism
![Page 34: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/34.jpg)
Vascular Issues
■ Traumatic Tears?
■ Are these operable?
![Page 35: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/35.jpg)
The Renal System
![Page 36: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/36.jpg)
Loop of Henle
![Page 37: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/37.jpg)
Dialysis
• Hemodialysis – shunt, fistula or graft
• BP specific – before and after treatment
![Page 38: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/38.jpg)
![Page 39: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/39.jpg)
Peritoneal Dialysis
An artificial way to remove waste
products and extra fluid from your
blood. With peritoneal dialysis, the network of tiny
blood vessels in your abdomen
(peritoneal cavity) is used to filter
your blood.
![Page 40: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/40.jpg)
Dialysis Emergencies
• Support ABCs
• Stop bleeding from shunt as needed
• Position appropriately
– Flat if Shockey
– Upright if pulmonary edema
![Page 41: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/41.jpg)
Urinary Tract Disorders
■ Acute Urinary Retention:
– Young Waitresses?
– Benign Prostatic Hypertrophy (BPH)
– Exam – Uncomfortable, Nausea, Vomiting
– Require… Foley Catheter to relieve
■ Renal Calculi
– Renal Colic – the pain of a calculi – AKA “Stone”
![Page 42: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/42.jpg)
Renal “A Stone”
![Page 43: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/43.jpg)
Urinary Track Infection■ Common in elderly – may go unnoticed for some
time, can cause sepsis and confusion.
■ If Foley catheter is in, look at urine for appearance.
■ Suspect problems in Foley catheter.
■ Can occur naturally.
![Page 44: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/44.jpg)
Urinary Catheter Management• Why may patients have catheters?
• Issues?
![Page 45: WHAT IS BETWEEN YOUR HEAD AND YOUR ASS? · 2019. 1. 10. · – Ingestion of caustic substances ... the duodenum and interact with the pancreatic cells resulting in destruction of](https://reader036.fdocuments.us/reader036/viewer/2022071405/60fa5f5167ca611b143779aa/html5/thumbnails/45.jpg)
Doug WildermuthNREMT Paramedic
NAEMSE & NAEMT Member
NYS Program Coordinator
NYSDOH-Certified Instructor Coordinator
79 Glenwood AvenueQueensbury, NY 12804Phone: 518-361-0218