1d • Paramedic Talk
As seen on the National
Pre-eclampsia
A pregnancy complication characterized by hypertension after 20 weeks gestation with signs of organ involvement.
Key Findings
- BP ≥ 140/90
- Protein in urine (proteinuria)
- Headache
- Visual disturbances
- Edema (face/hands)
- Epigastric or RUQ pain
EMS Concerns
- May progress to eclampsia (seizures).
- Monitor airway and blood pressure.
- Magnesium sulfate is the treatment for seizures.
Hydrocephalus (Children)
Hydrocephalus is the accumulation of cerebrospinal fluid (CSF) in the brain’s ventricles.
Key Signs in Infants
- Enlarged head circumference
- Bulging fontanelle
- “Sunsetting eyes” (downward gaze)
- Irritability
- Vomiting
Causes
- Congenital defects
- Infection
- Brain tumors
- Intraventricular hemorrhage
Many children are treated with a ventriculoperitoneal (VP) shunt.
Delta Wave
A delta wave is an ECG finding associated with Wolff-Parkinson-White (WPW) syndrome.
ECG Characteristics
- Short PR interval
- Slurred upstroke of the QRS complex (delta wave)
- Wide QRS
Why it Happens
An accessory pathway allows electrical signals to bypass the AV node.
Clinical Risk
Can cause supraventricular tachycardia (SVT).
Osborn Wave (J Wave)
An Osborn wave is a positive deflection at the J-point on an ECG.
Most Common Cause
Hypothermia
Other Possible Causes
- Hypercalcemia
- Brain injury
ECG Clue
Small “camel hump” or notch at the end of the QRS complex.
J-Point
The J-point is the location where the QRS complex ends and the ST segment begins.
Why It Matters
ST elevation or depression is measured starting at the J-point.
Clinical Relevance
Used to identify STEMI or ischemia.
Lead Poisoning in Children
Lead poisoning is most common in children exposed to old paint or contaminated environments.
Symptoms
- Developmental delay
- Abdominal pain
- Irritability
- Learning problems
- Seizures in severe cases
Sources
- Old house paint
- Contaminated water pipes
- Soil contamination
Children absorb lead much more easily than adults.
Testicular Torsion
A medical emergency caused by twisting of the spermatic cord, cutting off blood flow.
Symptoms
- Sudden severe testicular pain
- Nausea and vomiting
- Swollen testicle
- High-riding testicle
Treatment
Immediate surgical intervention is required to save the testicle.
Neurogenic Shock vs Spinal Shock
Neurogenic Shock
Occurs after spinal cord injury (usually above T6).
Findings
- Hypotension
- Bradycardia
- Warm, dry skin
Cause: loss of sympathetic tone.
Spinal Shock
Temporary loss of spinal cord function below the injury.
Findings
- Loss of reflexes
- Flaccid paralysis
- Loss of sensation
Spinal shock is neurological, not circulatory.
Cushing’s vs Addison’s
Cushing’s Syndrome
Caused by excess cortisol.
Symptoms
- “Moon face”
- Weight gain
- Hypertension
- Hyperglycemia
- Fat redistribution
Often caused by long-term steroid use.
Addison’s Disease
Caused by insufficient cortisol production.
Symptoms
- Hypotension
- Fatigue
- Weight loss
- Hyperpigmentation
- Hypoglycemia
Can lead to Addisonian crisis, a life-threatening emergency.
Uterine Rupture
A tear in the uterine wall, often during labor.
Risk Factors
- Previous C-section scar
- Trauma
- Obstructed labor
Signs
- Sudden severe abdominal pain
- Vaginal bleeding
- Loss of fetal station
- Fetal distress
This is a life-threatening obstetric emergency.
Uterine Inversion
Occurs when the uterus turns inside out, usually after delivery.
Causes
- Excessive traction on the umbilical cord
- Uterine atony
Signs
- Severe postpartum hemorrhage
- Shock
- Visible uterine mass in vagina
EMS Priorities
- Treat hemorrhagic shock
- Rapid transport
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As seen on the National
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