Disease Types Overview

Disease Types

• Infectious diseases spread from person to person via pathogens like bacteria, viruses, fungi, or parasites.
• Examples of infectious diseases include influenza, tuberculosis, malaria, and COVID-19.
• Chronic diseases develop and persist over a long period; examples include diabetes, hypertension, COPD, and arthritis.
• Autoimmune diseases occur when the body's immune system attacks its own tissues; examples are rheumatoid arthritis, lupus, multiple sclerosis, and type 1 diabetes.
• Genetic diseases are caused by abnormalities in genes or chromosomes, inherited or resulting from mutations; examples include cystic fibrosis, Down syndrome, sickle cell anemia, and Huntington's Disease.
• Degenerative diseases involve the progressive degeneration of organs or tissues over time; examples include Alzheimer's disease, Parkinson's disease, and osteoarthritis.
• Nutritional deficiency diseases are caused by a lack of essential nutrients in the diet; examples include scurvy (vitamin C deficiency), rickets (vitamin D deficiency), and pellagra (niacin deficiency).
• Neoplastic diseases involve uncontrolled cell growth leading to tumors; examples include lung cancer, breast cancer, and leukemia.
• Metabolic diseases result from abnormal chemical reactions in the body, often related to enzyme deficiencies; examples include gout and diabetes mellitus.

Disease Processes

• Inflammation is the body's immune response to infection or injury, causing symptoms like redness, swelling, and pain.
• Cell death can occur through programmed cell death (apoptosis) or due to injury or disease (necrosis).
• Tumor formation involves abnormal cell growth that can be cancerous (neoplastic).
• Immune response is the body's defense mechanism against harmful agents, but can malfunction, leading to autoimmune diseases.

Disease Vectors

• A disease vector is an organism that transmits a pathogen like a virus, bacteria, or parasite from one host to another, facilitating its spread.
• Vectors are typically unaffected by the pathogen but play a crucial role in transmission.
• Mosquitoes transmit pathogens causing malaria and Zika virus.
• Ticks can transmit Lyme disease and Rocky Mountain spotted fever.
• Fleas transmit plague.
• Flies transmit tularemia
• Lice transmit typhus and trench fever.
• Vectors typically do not get sick from the pathogens they carry.
• Transmission occurs through biting or indirect contact.
• Environmental factors like climate, humidity, and host presence influence vector populations.

Persistent vs. Non-Violent Chemicals

• Persistent chemicals resist degradation and remain active for a long time (e.g., certain pesticides or chemical warfare agents).
• Non-violent chemicals do not cause harm or injury to living organisms or the environment, often serving neutral or beneficial purposes (e.g., certain food additives or industrial chemicals).
• Persistent agents can remain on a surface for long periods, such as 24 hours.
• Non-persistent/volatile agents evaporate relatively quickly when left on a surface in the optimal temperature range.

Treatment for Hazmat Victims

• The first priority is decontamination to remove the victim from the hazardous environment.
• Firefighters or paramedics ensure the area is safe.
• The victim's clothes should be removed to eliminate further exposure.
• Washing the skin with copious amounts of water removes chemicals, preventing absorption.
• Eyes should be irrigated if chemical contact occurred.
• Check the patient's ABCs (Airway, Breathing, Circulation).
• Hazmat team members typically provide care to those exposed.
• Perform the simplest assessment and essential care in the hazard and decon zone.
• Do not apply bandages or splints unless applying pressure.
• Maintain the airway, and provide O2 at 12 to 15 L/min if distress occurs.
• After decontamination, treat injuries as normal and promptly transport.
• In case of an undecontaminated patient, increase PPE along with SCBA.

Storage and Shipment Containers

• Secondary containment is an engineered method to control spilled or released product if the main vessel fails.
• Bulk storage containers include fixed tanks, highway cargo tanks, rail tank cars, totes, and intermodal tanks.
• Bulk containers are used to store large quantities of a particular chemical.
• Intermodal tanks are both shipping and storage vessels, used for gaseous substances chilled until they liquefy.
• Non-bulk storage vessels range from a few ounces to 119 gallons.
• Drums are barrel-like containers used for food-grade materials, corrosive substances, flammable liquids, and grease.
• Bags are used to store solids and powders like cement, sand, pesticides, soda ash, and slaked lime, and are labeled with specific information.
• Carboys often store corrosive or other chemicals, and are usually glass, plastic, or steel containers holding 1-15 gallons.
• Cylinders are typically used to hold liquids or gases.

The Triage Process

• Triage is prioritizing patients based on the severity of their condition.
• The goal of triage is to maximize the number of survivors by efficiently allocating limited resources (medical personnel, equipment, and time).
• Immediate (Red Tag): Patients with life-threatening injuries needing immediate medical attention who can survive with prompt intervention (e.g., severe bleeding, airway obstruction, shock).
• Delayed (Yellow Tag): Patients with serious injuries but not immediately life-threatening conditions who can wait for medical treatment without significant risk of death (e.g., fractures, moderate burns).
• Minor (Green Tag): Patients with minor injuries not requiring urgent medical care, often able to walk and self-manage their injuries (e.g., small cuts, bruises, minor sprains).
• Deceased (Black Tag): Patients who are either deceased or have injuries so severe that they are unlikely to survive even with treatment; comfort care may be provided, but no resources are allocated for treatment.
• Primary triage allows quick and accurate categorization of patients.
• Secondary triage involves treatment.

Treatment for Trauma Patients

• Treatment involves an organized approach to manage life-threatening injuries properly.
• Control hemorrhaging and protect the c-spine in all trauma patients.
• Ensure the airway is open; intubation may be necessary.
• Treat for shock.

Vehicle Extrication

• Before extrication, ensure the safety of everyone involved, including victims, rescuers, and bystanders.
• Stabilize the vehicle to prevent shifting or rolling during the extrication, using chocks, stabilizing tools, or insurance.
• Inspect the vehicle for hazards like airbags, fuel leaks, and electrical issues.
• Assess the condition of trapped individuals quickly, prioritize medical needs, and determine the best approach for extrication based on injuries and vehicle condition.
• Simple removal involves assisting or guiding the patient out of the vehicle with minimal risk of exacerbating injuries through an open door.
• For vehicles with extensive damage, responders may need to create space by displacing parts of the vehicle with hydraulic rescue tools (jaws of life), saws, or axes.
• Maintain spinal immobilization if the patient has suspected spinal injuries.
• Carefully remove the patient from the vehicle once space has been created.
• Proper PPE includes turnout gear, glasses, gloves, helmets, and boots.

Arrival and Scene Size-Up

• The first responder should position the ambulance 100 ft before the incident to block traffic and create a barrier.
• Use only essential warning lights.
• Request assistance from law enforcement and fire personnel to close the road.
• Assess for hazardous materials.
• Complete a 360 walk, assessing the MOI, downed power lines, leaking fuels or fluids, smoke or fire, broken glass, trapped or ejected patients, the number of patients/vehicles, and simple vs. complex access.
• Simple access involves getting the patient out as quickly and simply as possible without tools or force like opening doors or rolling down windows.
• Complex access requires special tools and training like brake and gas pedal displacement, dashboard roll-up, door removal, roof opening, seat displacement, and steering wheel cutting.
• Emergency care includes primary assessment and care, addressing bleeding, providing manual stabilization of the spine, opening the airway, providing high-flow O2 if indicated, assisting or providing ventilation, and treating all critical injuries.
• Coordinate with the rescue team to determine the best way to get the patient out of the vehicle onto the backboard and then to the gurney.

Moving a Patient Out of the Wilderness

• Moving requires careful planning and effective teamwork.
• Evaluate the patient's condition quickly, assessing injuries, level of consciousness, and overall medical status to determine transport safety and urgency.
• Check for life-threatening conditions and stabilize the patient if necessary.
• Choose the appropriate method of transport based on the patient's condition and the environment.
• A straddle-carry technique is good for short distances if the patient is unable to walk.
• A two-person carry is using a variety of methods, which are requirements carry or by using a stretcher this technique can help distribute the weight and make transport easier.
• In situations where commercial structure isn't available you can create an improvised structure using materials found in the wilderness.
• Secure the patient on a wheelbarrow to move the patient particularly in a flat terrain.

Use of Humidified Oxygen During Transport

• Humidified oxygen is generally recommended for patients requiring long-term oxygen therapy to prevent mucous membrane drying and airway irritation.
• Use is often limited in pre-hospital settings due to logistical constraints.
• Use if patients receiving high-flow oxygen for extended periods like prolonged transport times.
• Use for pediatric patients (especially infants) to prevent airway dryness.
• Use for patients with croup, epiglottitis, or upper airway infections to maintain airway moisture.
• Use for patients with chronic respiratory conditions (e.g., COPD) who are sensitive to dry oxygen.
• Use for burn patients (especially inhalation injuries) to keep airway secretions from thickening.
• Generally used for transports longer than 30 minutes to 1 hour.
• More common in interfacility transfers rather than emergency scene responses.
• In short EMS transports, dry oxygen is typically sufficient, and humidification is not usually necessary.

Helicopter Safety and Landing Zones

• Helicopter transports can be lifesaving, but safety is critical when setting up a landing zone (LZ) and working around the aircraft.
• The minimum LZ size should be 100 ft x 100 ft (recommended), but an absolute minimum is 60 ft x 60 ft in tight conditions.
• The LZ surface should be flat, firm, and free of debris (avoid sand, loose gravel, or tall grass).
• Clear obstacles like power lines, trees, vehicles, and people at least 200 feet from the LZ.
• Use cones, flashlights (pointed down, not up), or strobes at night—no flares (fire risk!).
• Helicopters prefer to land into the wind for stability.
• Keep bystanders at least 200 feet away.
• Wait for the pilot or flight crew's signal before approaching.
• Always approach from the front or side, staying in the pilot’s line of sight.
• Never approach from the rear—danger zone due to the tail rotor (nearly invisible when spinning).
• Keep a low stance when near the aircraft, especially if on uneven terrain.
• Secure loose objects (hats, sheets, IV bags, blankets, etc.) during takeoff and landing.
• Keep all personnel and equipment outside the LZ until the helicopter has fully landed.
• Do not shine bright lights at the aircraft during approach or departure (e.g., flashlights, vehicle headlights).
• Loading is typically done from the side of the aircraft.
• Ensure IV lines, monitors, and equipment are secure before transferring the patient.
• Uneven or Hazardous Terrain prepare for brownout/whiteout conditions—limit movement in the LZ to prevent disorientation if landing in snow, dust, or tall grass.
• In case of a helicopter emergency, stay at least 500 feet away from fire.
• If a crash only approach when cleared by the crew; keep all electronics off due to risk of igniting fuel vapors.
• If rotors are still moving stay away until instructed by the flight crew.

Portable Oxygen Cylinders

• Oxygen cylinders come in different sizes, primarily classified by letters.
• D cylinders have a capacity of ~350 liters, are used for short-term portable use, and are carried in jump bags.
• E cylinders have a capacity of ~625 liters and are often mounted on stretchers or in ambulances for portable oxygen supply.
• M cylinders have a capacity of ~3,000 liters and are used for onboard oxygen in ambulances for long-term O2 transport.
• H/K cylinders have a capacity of ~6,900 liters, used for stationary use in hospitals, clinics, or ambulance stations and are not used for transport.
• Adjust the oxygen flow rate based on patient needs (e.g., 2-6 LPM for nasal cannula, 10-15 LPM for NRB, 15+ LPM for BVM).
• Regulators control the flow and pressure of oxygen from the tank.
• The Pin Index Safety System (PISS) prevents connecting the wrong gas to an oxygen regulator.
• A full cylinder is about 2,000 psi; replace when it falls below 500 psi.
• Always keep cylinders upright and secured—never leave them lying loose in an ambulance.

Mechanical Ventilator Malfunction Response

• Immediately assess the patient for signs of distress; cyanosis, decreased SpO₂, altered mental status
• Listen to breath sounds for abnormalities.
• Check chest rise and fall to ensure adequate ventilation.
• Disconnect the ventilator from the patient’s airway.
• Attach a BVM to the oxygen supply (15 LPM).
• Manually ventilate at the appropriate rate: adult 10-12, child 12-20 and infant 20-30 breaths per minute
• Ensure a good seal with the mask or ET tube (if patient is intubated).
• Monitor SpO₂, chest rise, and breath sounds.
• Have another provider identify the unit is properly connected, oxygen supply, inspect tubing and assess ventilator alarms.
• If unable to fix the ventilator: Continue BVM ventilation with supplemental oxygen.
• Key: Ventilator alarms don’t always mean patient distress and always be prepared to switch to BVM if a ventilator fails.

Care of Elderly Patients with Hearing Impairments

• Adjust your approach to ensure clear communication and effective care.
• Make eye contact and ensure they can see your lips.
• Speak slowly, clearly, and slightly louder—but don’t shout.
• Use short, simple sentences to avoid confusion.
• Reduce background noise; turn off sirens, move to a quieter space.
• If they wear hearing aids, ensure they are on and working.
• Use written communication if needed like whiteboard, pen & paper, and phone.
• Pointing, nodding, or hand signals can reinforce what you’re saying.
• Many elderly patients have anxiety in emergencies.
• Explain each step before doing it to maintain trust.
• Older adults get cold easily
• Ask them to repeat instructions to ensure they heard you correctly and if they don’t understand, rephrase rather than repeat louder.

Medical Procedure for Waste Elimination

• Colostomy is Opening from the large intestine (colon) to the abdominal wall.
• Ileostomy has an Opening from the small intestine (ileum) to the abdominal wall.
• Monitor & Manage Complications; look for signs of complications, Infection, Obstruction, Bleeding Dehydration
• Do not remove the bag unless necessary.
• Be gentle when moving the patient to avoid dislodging the bag.
• If patient has abdominal pain, transport in a position of comfort.
• Do not remove the ostomy bag unless medically necessary.
• Provide comfort and transport carefully to prevent leaks or discomfort.

Down Syndrome

• Down syndrome is a genetic disorder that can lead to intellectual disabilities, characteristic physical features, and various medical complications
• Use a jaw thrust maneuver instead of head tilt-chin lift (if C-spine risk).
• Be aware of larger tongue & smaller airway → Prepare for BVM if needed. Suction as needed to clear secretions & prevent aspiration.
• Limit excessive neck movement due to atlantoaxial instability. If spinal immobilization is needed, use extra padding to maintain neutral alignment.
• The Risk of obstruction from a large tongue & small airway
• Use spinal precautions carefully—avoid excessive neck movement.

Shock

• Shock is a life-threatening condition where there is inadequate tissue perfusion, leading to organ failure if not treated quickly.
• Signs of shock: Altered mental status, Tachycardia, Hypotension, Weak or absent pulses, Cool, pale, and clammy skin, Tachypnea, Delayed capillary refill
• General EMT Shock Treatment; Control external bleeding Airway & Breathing, use Positioning Maintain the patient warm, and ensure Rapid Transport
• Elevate legs for hypovolemic or distributive shock (unless contraindicated).

Treatment for COPD vs. CHF (EMT Level)

• Cause of COPD involves chronic lung disease and acute or chronic episodes while cause for CHF is Pump for failure.
• Look at the breathing pattern (Prolonged exhalation while the other use shortness of breath) and which oxygen is needed and their sputum of each to know which one to treat.

AAA is

• An Abdominal Aortic Aneurysm (AAA) is a weakening and bulging of the abdominal aorta that can rupture, leading to massive internal bleeding and death if not treated quickly.
• Signs include Gradual abdominal pain, Pulsating mass in the abdomen, Back or flank pain and Unequal or weak femoral pulses
• Symptoms of rupturing AA includes Sudden, severe abdominal or, Shock symptoms ( Pale, cool, diaphoretic skin, tachycardia, hypotension.
• DO NOT palpate aggressively – it could cause rupture!
• Keep patient warm, Rapid transport to a hospital with vascular surgery capabilities, treat DO NOT give fluids in the field

Pulmonary & Hypertension

• Pulmonary can be fixed with Oxygen – High-flow oxygen Monitor vital signs and ECG for signs.
• Hypertension Keep the patient in a calm position. Observe for any signs of organ damage.

Hypotension and Atrial Fib

• Keep patient supine with legs elevated and if allowed give fluids as well.
• Atrial fib monitor ECG and keep the patient in a comfortable position. Transport to a hospital for rate control or possible anticoagulation therapy.

Type 1 & Type 2 Diabetes

• if conscious and alert, give oral glucose and if they are unconscious or unable to swallow, Administer glucagon and Transport for insulin and further care.
• Recognition for Hyperglycemia (High Blood Sugar) can happen when they are Increased thirst and urination. Transport to a hospital for insulin and further care with Monitoring
• Symptoms of Glaucoma; Severe eye pain, Blurred vision nausea and a possible headache

Cardio Arrest & Choking for Pediatrics

• Signs of the child that has a Airway/Respiratory issue and the treatment and steps for it as well.
• Know the recognition for Children who are choking and how to respond or what to expect if unconscious
• Know the signs and symptoms of burns for children.

Emergency (EMT Level)

• Eclampsia can be treated ensuring the patient is safe as possible.
• Symptoms for labor; Check Dilation , Contractions and deliver the baby if need it with full attention
• Pelvic Inflammatory Disease (PID) make sure you give support with transport

Taking the first breath

• Make sure that it usually happens within 30 seconds and know the key notes if the child needs help from that and how to respond.

Burns

• Make sure that you always focus always the most important thing is Airway.
• Make sure IV fluids for large burns

Signs & Symptoms abdominal

• Check symptoms of shock and immediate steps

Suicidal patients

• Recognize the verbal and physical cues of each patient
• How you would react

The XABC’s approach

• The XABC’s approach with the steps and what to provide.

Fractures

• Remember for pelvic fractures you check signs and symptoms with the key steps on what to do and what not to do.

Stabs and Gun wounds

• Remember when you must keep and wound covered and the steps to protect each patient.