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Questions and Answers

Which of the following symptoms is a common sign of MDMA overdose?

Increased motor activity (correct)

Impaired coordination

Decreased energy

Small pupils

What potential consequence can result from severe hyperthermia due to MDMA overdose?

Cardiovascular failure (correct)

Improved blood circulation

Enhanced cognitive function

Increased appetite

Which of the following is a common effect of Valium overdose?

Euphoria

Involuntary eye closure (correct)

Sharp increase in body temperature

Increased heart rate

What is the main risk associated with frequent use of 'Street Valium' or potent benzodiazepines like Etizolam?

Anxiety and depression Signup and view all the answers

Why have tricyclic antidepressants (TCAs) like those introduced in the 1950s seen decreased usage?

Availability of less toxic alternatives Signup and view all the answers

Which parameter of the NEWS2 scoring system does not focus on respiratory function?

Pulse rate Signup and view all the answers

Which symptom is NOT typically associated with Valium overdose?

Increased sweating Signup and view all the answers

What is one of the major side effects of using Etizolam compared to diazepam?

Stronger potency Signup and view all the answers

What is the aggregate score range indicating low risk in NEWS2 scoring?

1 to 4 Signup and view all the answers

Which symptom is NOT typically associated with a chest infection?

Frequent urination Signup and view all the answers

What action should be taken for overdose treatment, according to the specific substance management guidelines?

Follow JRCALC guidelines Signup and view all the answers

What indicates a high risk in the NEWS2 scoring system?

An aggregate score of 7 or over Signup and view all the answers

Which aspect of a urinary tract infection (UTI) is TRUE?

Most UTIs involve the lower urinary tract. Signup and view all the answers

What is a common treatment guideline followed for patients with chest pain?

Non-traumatic chest pain guideline Signup and view all the answers

Which of the following signs typically indicates a chest infection?

Chesty cough Signup and view all the answers

How long do symptoms of a chest infection usually last?

About 7 to 10 days Signup and view all the answers

Which symptom is NOT typically associated with a urinary tract infection?

Fever greater than 38°C Signup and view all the answers

What is a major consequence of untreated sepsis?

Organ failure Signup and view all the answers

Which of the following correctly describes neutropenic sepsis?

Frequently seen in patients receiving anti-cancer treatment Signup and view all the answers

What is the primary treatment approach for sepsis?

Antibiotics and hydration Signup and view all the answers

Which condition is most often linked to bacterial infections causing peritonitis?

Appendicitis Signup and view all the answers

What is the leading symptom indicative of a urinary tract infection in patients?

Burning sensation during urination Signup and view all the answers

What is the primary reason for the difficulty in diagnosing neutropenic sepsis?

Chemotherapy causes vague and differing side effects Signup and view all the answers

Which of the following signifies a serious complication of sepsis?

Rigors Signup and view all the answers

What is a common sign of kidney stones?

Blood in the urine Signup and view all the answers

Which symptom is indicative of appendicitis?

Pain that worsens if you cough or walk Signup and view all the answers

What is a symptom associated with chronic liver failure?

Upper right quadrant abdominal pain Signup and view all the answers

Which of the following symptoms is NOT typically associated with hepatitis?

Ascites Signup and view all the answers

What is a common treatment guideline for abdominal pain?

Follow JRCALC Abdominal Pain Guideline Signup and view all the answers

Which of the following is a symptom of portal hypertension?

Bleeding varices Signup and view all the answers

What symptom is commonly associated with cirrhosis?

Redness to palms Signup and view all the answers

Which symptom occurs with both acute and chronic liver failure?

Drowsiness and confusion Signup and view all the answers

Where is scabies most often found on adults and older children?

Between the fingers and toes Signup and view all the answers

What is a key characteristic of chickenpox?

It causes a characteristic skin rash with small blisters. Signup and view all the answers

What is the risk factor associated with developing shingles?

Advanced age Signup and view all the answers

What is the sequence of events after the rash appears in shingles?

Vesicles form and then burst over time. Signup and view all the answers

How should scabies be treated effectively?

Application of a cream or lotion over the whole body. Signup and view all the answers

Which of the following is not a symptom typically associated with chickenpox?

Increased heart rate Signup and view all the answers

What defines Guillain-Barre Syndrome?

It is a rare and serious nerve condition. Signup and view all the answers

What is a common duration for chickenpox symptoms to last?

Five to seven days Signup and view all the answers

What is the primary cause of Guillan-Barre syndrome?

Immune system attacking nerves Signup and view all the answers

Which of the following symptoms is commonly associated with Guillan-Barre syndrome?

Numbness and weakness Signup and view all the answers

How long does recovery from Guillan-Barre syndrome typically take?

6-12 months Signup and view all the answers

In what demographic is Guillan-Barre syndrome most likely to occur?

More common in adults and males Signup and view all the answers

What immediate treatments are commonly provided to Guillan-Barre syndrome patients in the hospital?

Intravenous immunoglobin and plasma exchange Signup and view all the answers

What symptom might indicate a severe case of Guillan-Barre syndrome?

Difficulty breathing Signup and view all the answers

Which of the following is NOT a red flag symptom to review in Guillan-Barre syndrome?

Excessive memory loss Signup and view all the answers

What long-term problems can patients experience after recovering from Guillan-Barre syndrome?

Numbness and weakness Signup and view all the answers

Study Notes

Paramedic Science - Health & Human Development 2

Topic: Poisoning/Overdose/Infection
Course: Health & Human Development 2
Institution: University of the West of Scotland (UWS)

Overdose

Opioid Overdose

Opioids are compounds extracted from poppy seed, as well as semisynthetic and synthetic compounds, with similar properties that interact with opioid receptors in the brain.
Opioids are commonly used for pain treatment, including morphine, fentanyl, and tramadol.

Opioid Overdose Signs & Symptoms

Pupils constrict and appear small.
Muscle tone reduced.
Skin itching, causing scratching.
Speech may be slurred.
Altered levels of consciousness.
Breathing very slow, shallow, erratic, or stopped.
Cyanosis and pale pallor.
Airway noises like stridor or choking.
Vomiting.
Fingernails and lips turn blue or purplish black.
Pulse (heartbeat) slow, erratic, or absent.

Opioid Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Paracetamol Overdose

Paracetamol overdose is the most common intentional overdose calls attended by pre-hospital clinicians.
Overdose can occur after excessive ingestion of paracetamol or paracetamol-containing medication as an acute or staggered overdose, or a therapeutic excess.
Patients are often asymptomatic or have only mild gastrointestinal symptoms at initial presentation.
Untreated paracetamol poisoning may cause varying degrees of liver injury over 2 to 4 days after ingestion, including fulminant hepatic failure.
In rare cases, massive overdose may initially present with coma and severe metabolic acidosis.

Paracetamol Overdose Signs & Symptoms

Nausea.
Vomiting.
Pain and tenderness in the right upper abdomen.
Confusion.
Jaundice (yellow-tinged skin).
Low blood sugar (hypoglycemia).
Unexpected bleeding (normal blood clotting is impaired).
Encephalopathy (damage to the brain).

Paracetamol Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

MethyleneDioxy-MethAmphetamine (MDMA) Overdose

Also known as ecstasy, MDMA comes in pill or powder form. Pills come in various logos and colours.
Street names include Adam, Beans, Biscuit, Clarity, Disco Biscuit, E, Eve, Go, Hug Drug, Lover's Speed, MDMA, Molly, Peace, STP, X, and XTC.

MDMA Overdose Signs & Symptoms

Increased motor activity, alertness, and heart rate.
Blood pressure increase, muscle tension, tremors.
Teeth clenching, nausea, and sweating.
Euphoria, empathy, reduced inhibition, chills, and blurred vision.
Confusion, anxiety, depression, paranoia, and severe dehydration.
Sharp increase in body temperature (hyperthermia) can lead to liver, kidney, and cardiovascular failure, and death.

MDMA Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Valium Overdose

Street Valium is a benzodiazepine-type tablet, which may be known as blues, valleys, benzos, scoobies, and diazepam.
Often white or blue in color. Texture may vary from fuzzy to smooth, depending on quality.
Users may confuse it with diazepam, however, it may be a more potent benzodiazepine, such as etizolam.
Etizolam acts quickly, with side effects lasting several hours.
It's approximately 10 times stronger than diazepam.
Daily use of etizolam can have serious consequences for mental and physical well-being, including anxiety, depression, and sleep problems.
High quantities or mixing with alcohol increases the risk of overdose and death.

Valium Overdose Signs & Symptoms

Decreased energy, heart rate, appetite.
Blurred vision, small pupils, and involuntary eye closure.
Impaired coordination, relaxed muscles, headaches, and dry mouth.
Nausea and vomiting, sleepiness, and yawning.
Mental confusion, short-term memory loss, low mood, anxiety, and lowered inhibitions.
Sedative effect.

Valium Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Tricyclic Overdose

Tricyclic antidepressants (TCAs) were introduced in the late 1950s for depression treatment.
With the advent of selective serotonin reuptake inhibitors (SSRIs) and other new antidepressants, the use of TCAs has decreased.
Still used to treat depression not responding to less toxic agents.
In adults, TCAs are used for migraine headache prophylaxis, treatment of neuralgic pain, including the pain associated with Ciguatera poisoning, and obsessive-compulsive disorder.

Tricyclic Overdose Signs & Symptoms

Central nervous system excitability, confusion, blurred vision, dry mouth, fever.
Pupil dilation; convulsions; decreased level of consciousness; arrhythmias, hypotension; tachycardia; respiratory depression; Rapid changes in physical condition.

Tricyclic Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Poisoning

Caustic Agent Poisoning

Worldwide, 80% of caustic ingestions occur in young children.
Accidental ingestions of small amounts are typically not harmful.
Ingestions by adults are often intentional and involve larger amounts; life-threatening.
Common caustic sources include drain and toilet bowl cleaners, battery acid, and hydrochloric acid for swimming pools.
Industrial products are usually more concentrated and more damaging than household products.

Caustic Agent Poisoning Signs & Symptoms

Strong acids or alkalis causing pain, blistering, penetrating necrosis, and coagulating burns.
Cardiovascular collapse and metabolic acidosis can occur secondary to extensive corrosive injury.

Caustic Agent Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Carbon Monoxide Poisoning

Carbon monoxide poisoning occurs when carbon monoxide builds up in the bloodstream.
Replacing oxygen in red blood cells leads to serious tissue damage and potentially death.
Colourless, odourless, tasteless gas produced by burning gasoline, wood, propane, charcoal, or other fuels.
Improperly ventilated appliances and engines in tightly sealed/enclosed spaces can cause high levels of carbon monoxide to accumulate.

Carbon Monoxide Poisoning Signs & Symptoms

Disorientation, decreased consciousness, unconsciousness, and unexplained headaches.
Characteristic cherry-red skin coloration is rarely seen and usually precedes mortality.

Carbon Monoxide Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Rat Poisoning

Rat poisoning is rare in humans and typically accidental in children or a suicide attempt in adults.
Zoocoumarins (anticoagulants) disrupt vitamin K metabolism in the liver.
Vitamin K is crucial for the synthesis of coagulation factors (VII, IX, X, prothrombin).
Prevents blood clotting, leading to a hemorrhagic syndrome.
Anticoagulants are rapidly absorbed almost completely after ingestion.

Rat Poisoning Signs & Symptoms

Intense headache, pale mucous membranes and skin, epistaxis, bleeding gums, haematuria, gastrointestinal bleeding, tachycardia, hypotension, dizziness, severe weakness, and lack of appetite.
Rat poisoning can be lethal.

Rat Poison Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Paraquat Poisoning

Paraquat is a highly toxic chemical herbicide (weed killer).
Ingestion or inhalation can cause fatal poisoning, with over 70% of cases resulting in death.
Symptoms develop quickly following ingestion/inhalation.

Paraquat Poisoning Signs & Symptoms

Swelling and pain in mouth and throat, nausea, abdominal pain, vomiting, diarrhea (possible blood), epistaxis, hypotension, dehydration, and difficulty breathing.
Severe symptoms include confusion, muscle weakness, seizures, respiratory failure, tachycardia, and coma.
Potentially causes acute kidney failure, liver failure, lung scarring, pulmonary edema, and respiratory failure.

Paraquat Overdose Treatment

Follow JRCALC Overdose and Poisoning in Adults and Children guidelines.
Specific substance management.

Infection

NEWS2 Scoring

A system for scoring physiological measurements routinely recorded at a patient's bedside.
Used to identify acutely ill patients (especially those with sepsis) in English hospitals.
Measures 6 physiological parameters: respiration rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness, and temperature.

NEWS2 Scoring (Continued)

A score of 0, 1, 2, or 3 is assigned to each physiological parameter based on how far it deviates from the normal range.
Higher scores indicate a higher risk of serious illness.
Clinical responses for threshold (or trigger) levels are reviewed locally.

Chest Infection

An infection of lungs or large airways.
Mild infections often resolve independently; severe infections are life-threatening.
Typically a deterioration of a cold or flu.

Chest Infection Signs & Symptoms

Chesty cough (with green/yellow mucus).
Wheezing and shortness of breath.
Chest pain/discomfort.
High temperature.
Headache.
Aching muscles.
Tiredness.
Symptoms usually resolve in 7-10 days; cough and mucus can last up to 3 weeks.

Chest Infection Treatment

Follow the JRCALC Dyspnoea Guideline.
If patient experiences chest pain, follow the Non-Traumatic Chest Pain guideline.

Urinary Tract Infection (UTI)

Infection of any part of the urinary system (kidneys, ureters, bladder, urethra).
Most often affects the lower urinary tract (bladder and urethra).
Women are at higher risk than men.
Bladder infections are typically painful but not life-threatening.
Kidney infections can lead to serious health complications.

UTI Signs & Symptoms

Pain/burning during urination, increased urinary frequency, and nocturia.
Foul-smelling urine, cloudy/bloody urine.
Nausea, vomiting, lethargy, irritability, poor feeding, jaundice, and fever.
Kidney infection symptoms include increased temperature (>38°C), fatigue, and rigors.

UTI Treatment

Follow the JRCALC Abdominal Pain Guideline.

Sepsis

Immune system's overreaction to an infection or injury.
Body's own organs and tissues may be attacked, potentially leading to organ failure and death.
Timely treatment with antibiotics is essential.
5 UK deaths per hour from sepsis.

Sepsis Signs & Symptoms (in children/adults)

See page 40 for details; specifics vary.

Sepsis Signs & Red Flags (specific indicators)

See page 41 for details; specifics vary.

Sepsis Treatment

Follow the JRCALC Sepsis Guideline.

Neutropenic Sepsis

Occurs when a patient's neutrophils (white blood cells) are diminished.
Neutrophils fight infection.
Low neutrophil levels increase susceptibility to infection, potentially leading to life-threatening neutropenic sepsis.
Commonly associated with anti-cancer treatments like chemotherapy, especially those affecting the bone marrow (e.g., leukemia, lymphoma, myeloma).
Diagnosis can often be challenging due to the side effects of chemotherapy.

Neutropenic Sepsis Treatment

Follow the JRCALC Sepsis Guideline.

Peritonitis

Inflammation of the peritoneum, a thin membrane lining the abdominal cavity.
Tissues become inflamed when exposed to irritating or infected body fluids (often through leaks or breaks).
Infection is the most common cause; it can be extremely dangerous.

Peritonitis Signs & Symptoms

See details on page 46.

Peritonitis Treatment

Follow the JRCALC Abdominal Pain Guideline.

Diverticulitis

Infection of small bulges or pockets (diverticula) in the lining of the large intestine (colon).
Bacteria trapped inside these diverticula can trigger more severe symptoms.
Can lead to complications, like abscesses near the intestine.

Diverticulitis Signs & Symptoms

More severe abdominal pain, especially on the left side.
High temperature (fever) of 38°C or higher.
Diarrhea or frequent bowel movements.

Diverticulitis Treatment

Follow the JRCALC Abdominal Pain Guideline.

Crohn's Disease

Inflammatory bowel disease (IBD) involving inflammation in various areas of the digestive tract.
Frequently affects the small intestine; inflammation can spread to deeper layers of the bowel.
Characterized by inflammation and swelling, leading to significant abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition.

Crohn's Disease Signs & Symptoms

See details on page 53 .

Crohn's Disease Treatment

Follow the JRCALC Abdominal Pain Guideline.

Irritable Bowel Syndrome (IBS)

Common digestive disorder that affects the stomach and intestines.
Symptoms can include cramping, abdominal pain, bloating, gas, diarrhea, or constipation, or a combination of these conditions.
Generally a long-term chronic condition that can be managed with dietary changes, lifestyle modifications, and stress reduction.

IBS Signs & Symptoms

Abdominal pain/cramping eased by bowel movement.
Changes in bowel habits (diarrhea or constipation).
Swelling of the abdomen.
Excessive flatulence.
Urgency to evacuate the bowels

IBS Treatment

Follow the JRCALC Abdominal Pain Guideline.

Kidney Stones

Hard object formed from minerals and chemicals in the urine, including calcium oxalate, uric acid, struvite, and cystine.
Symptoms include severe lower back pain, blood in the urine, nausea, vomiting, fever, and chills, or foul-smelling / cloudy urine.
Stones may lodge in the kidney, ureter, bladder, or urethra, causing blockage.
Treatment can vary from passing the stone through the urine stream to surgical procedures.

Kidney Stones Signs & Symptoms

Severe pain in the lower back.
Vague pain or stomach ache that doesn't subside.
Blood in the urine.
Nausea or vomiting episodes.
Fever or chills.
Urine that smells bad or looks cloudy.

Kidney Stones Treatment

Follow the JRCALC Abdominal Pain Guideline.

Appendicitis

Inflammation of the appendix, a finger-like pouch that extends from the colon.
Usually located on the lower right side of the abdomen.
Infection is the primary cause of appendicitis.
Left untreated, appendicitis can cause complications; often requiring surgery.

Appendicitis Signs & Symptoms

Sudden abdominal pain on the right side, potentially migrating towards the navel and worsening with movement or jarring activities .
Nausea and vomiting, loss of appetite.
Low-grade fever.
Constipation or diarrhea.
Abdominal bloating and flatulence.

Appendicitis Treatment

Follow the JRCALC Abdominal Pain Guideline.

Liver Conditions

Liver conditions range from scarring (cirrhosis) to inflammation (hepatitis) to liver failure.

Liver Conditions - Signs & Symptoms

Details on page 67.

Liver Conditions Treatment

Follow the JRCALC Abdominal Pain Guideline.

Scarlet Fever

Bacterial illness, usually developing from strep throat.
Symptoms including a bright red rash, sore throat, and high fever.

Scarlet Fever Signs & Symptoms

Red rash (often on the face, neck, trunk, limbs).
Red lines in body folds (groin, armpits, elbows, knees).
Flushed face, pale area around the mouth.
Strawberry tongue.

Scarlet Fever Treatment

Antibiotic treatment is often effective.

Scabies

Contagious skin condition caused by burrowing mites.
Intense itching, usually worse at night.
Skin rash where mites burrow.

Scabies Signs & Symptoms

Itching, often severe, usually worse at night.
Thin, wavy tunnels of tiny blisters or bumps on the skin.
Often found in skin folds, including between fingers/toes, armpits, waist, inside wrists, inner elbows, soles of feet, chest, around nipples, belly button, genitals, groin, and buttocks.

Scabies Treatment

Cream or lotion application over the whole body, often recommended by a pharmacist; treat all individuals in the household.

Chicken Pox (Varicella)

Highly contagious viral disease.
Characterized by small, itchy blisters which eventually scab over.
Starting on the chest, back, and face, spreading throughout the body.

Chicken Pox Signs & Symptoms

Rash with small, itchy blisters.
Blisters typically scab over.
Fever.
Tiredness
Headaches.
Complications include bacterial infections, pneumonia, and an inflammation of the brain.

Shingles (Herpes Zoster)

Viral infection affecting a specific nerve and its associated skin area (dermatome).
Reactivation of the varicella-zoster virus which also causes chicken pox.

Shingles Signs & Symptoms

Prodromal phase with skin sensations pain and abnormalities.
headache, photophobia; malaise.
maculopapular rash, progressing to clustered vesicles, which burst and scab over, typically within 7-10 days..

Guillain-Barré Syndrome

Rare and serious nerve condition.
Characterised by the immune system mistakenly attacking and damaging nerves.
It can develop after a respiratory or gastrointestinal infection.
Symptoms include numbness, pins and needles, muscle weakness, pain, and coordination/balance problems; worsening over time, often in limbs.

Guillain-Barré Syndrome Treatment

Treatment often requires hospitalization and supportive therapy to maintain essential body functions as well as pain and symptom relief.
Intravenous immunoglobulin (IVIG), plasma exchange (PLEX), and pain relief.

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