Health and Medical Question

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Introduction

Individual who have witnessed paramedics working will always confess that there is an aspect that is highly admirable about the profession. When observing how these healthcare givers work in teams is an adequate inspiration that awes tremendous admiration. Before paramedics sign up for their jobs, they are always enlightened about their profession. The paramedic profession is quite demanding and requires greater focus and concentration to deliver effective care to all patients. Paramedics have different roles. Various individuals always assume that being a paramedic about being available in the scenes of accidents and scoping up multiple individuals to ensure they get to the hospital. The profession, however, is more than that. Even though paramedics are always at the forefront to assist patients in accident scenes, they play other roles like attending to emergencies and accidents that require an advanced system of life support. As a result, they always have to be swift and responsive every time. They also work with patients who have mental conditions and document the condition of different patients as soon as they get to the hospital. Paramedics take a longer time to study as they prepare for their role, which is relatively complex compared to other healthcare givers. That is why their training is quite rigorous compared to that of other healthcare givers. The paper examines case studies that relate to U.K paramedics and responds to questions that relate.

1.The Life Span As Relevant To Paramedic Practice. Analyze And Apply The Key Concepts Of Anatomy And Physiology Across

Provide a clear explanation referring to relevant anatomy and physiological theory of the standard inflammatory response mechanisms within the body concerning fighting off infection

Inflammation is a response technique for immune systems to harmful stimuli like toxic substances, damaged cells, pathogens, and damaged cells. It acts via the removal of any harmful stimulus and initiates the healing process in any patient. When there is an acute response of the inflammatory system, the cellular and molecular interactions and events enhance the minimization of all the impending injuries and infections. Such mitigation approaches strengthen the restoration of homeostasis of tissues and resolution to different forms of chronic inflammatory illnesses. In tissues, swelling is always characterized by some swelling, pain, heat, the loss of the functions of other tissues, and redness (Burini et al., 2020, p.2). All this results from local immune, inflammatory and vascular responses to different injuries and infections. The significant microcirculatory aspects that may occur in the inflammatory process are changes in vascular permeabilities, recruitment of leukocytes and their accumulation, and also release of an inflammatory mediator. There are various pathogenic aspects like infections, injuries of tissues, and cardiac infractions, which may help reduce inflammations that damage different tissues. The signals activate all the leukocyte chemotaxis from a general circulation point to the sites which are damaged. The leukocytes are activated after generating cytokines that induce varying inflammatory responses in the human body.

In the first case study, the healthcare giver was called because the patient was vomiting. The patient’s present condition is that the patient is generally unwell and has a reduced level f consciousness. According to the parents, the patient reported back home with flu-like symptoms, and the following day, he was vomiting in the bathroom. Afterward, they heard a loud thud from the room where the patient fell and collapsed (Burini et al., 2020, p.3). Even though the patient’s history indicates a nil PMH, allergies, and DHx, the O/E noted some purpuric rashes all over the patient’s torso. The conditions suggest that anatomically and physiologically, the systems of the patient were not functioning well.

Mechanisms of Inflammatory Response

Inflammatory responses involve activation of all the signaling pathways seeking to regulate the inflammatory mediator levels within the resident tissues and the inflammatory cells that were previously recruited within the blood. Inflammation is a prevalent form of pathogenesis for most chronic diseases which affect human beings (Burini et al., 2020, p.4). A good example is bowel disease, cancer, arthritis, or cardiovascular illnesses, among others. Even though the inflammatory response process relies on fundamentals of all the primary stimuli and their position within the human body, they stake a universal mechanism that involves the pattern of the cell receptors on the surface of the cell. It also involves the pathways of inflammation activated, the release of the markers of inflammation, and the recruitment of inflammatory cells.

Recognition Of the Patterns and Activation Of Receptors

The microbial structures related to molecular patterns may trigger inflammatory responses via activation of germline-encoded pattern recognition receptors (PRR). Some of the PRRs have signals activated when a cell or tissue is damaged. This is referred to as the dangerous molecular patterns that host biomolecules and initiate or perpetrate different forms of non-infectious inflammatory responses (Burini et al., 2020, p.5). The cells which are disrupted may equally recruit innate inflammatory cells when there are no pathogens by releasing.

Activation Of the Pathways of Inflammation

The inflammatory pathways always impact highly on pathogens and various other chronic diseases. They involve some common regulatory and mediator ways (Burini et al., 2020, p.5). The inflammatory stimuli always activate the intracellular signaling of pathways and later trigger the production of other mediators of the respiratory systems.

Inflammatory Markers

The markers are always used as indicators of normal and biological pathogenic processes. They also enhance the assessment of patient response to various therapeutic intercessions. The markers of inflammation tend to be extrapolative of other inflammatory illnesses, and they always correlate with the different causes and impacts of an inflammatory disease like circulatory disease (Burini et al., 2020, p.5). Such stimuli trigger the provocative cells like adipocytes and macrophages. They also initiate the production of other provocative proteins, enzymes and cytokines. The molecules always act as the significant biomarkers for diagnosing disease, prognosis, and decision making in therapy.

Resolution to inflammations

Prevention of the progression of inflammation from chronic to persistent requires suppression to ensure the prevention of any additional damages to different tissues. Resolution of inflammation is a process that involves all the temporary and spatially controlled mediators of production which dilute the chemokine gradients over some time. The method of inflammation resolution ensures there is a rectification of the homeostasis of tissues and reduces the infiltration of tissues via apoptosis (Burini et al., 2020, p.5). Chronic inflammation is joint when there is a failure of the inflammatory mechanisms to eliminate injuries of different tissues. As a result, the body gets to host various diseases.

Part 2

2. Explore and Apply the Key Concepts Related to The Pathophysiology of Disease And Injury To The Body Systems, Within The Sphere Of Paramedic Practice

With Relation to The Case Study, Please Explore the In-Depth Disease Process of Meningococcal Septicaemia. Within This, You Should Discuss the Full Pathophysiology Associated with the Development of Hypotension, Purpuric Rash and Meningeal Irritation

There are various organisms such as fungi, bacteria, or viruses that may cause meningitis. However, the main one is Neisseria Meningitidis which is the primary cause of bacterial meningitis across the globe. Meningococci may also result in sepsis, focal infections, and pneumonia. The geographic distribution of the disease is different according to serogroups, and it varies in other regions. There are no reliable estimates of the global burden of the disease. However, it is common in the sub-Saharan areas (Kato and Gleeson, 2019, p.61). The pathophysiology and pathogenesis of meningococcal septicemia involve a very complex interplay between various virulence factors of different pathogens and the host system of the immune response. The more significant damage resulting from the infection results from the cytokines released in the CSF while the host mounts different inflammatory responses. The disease affects humans, and the bacteria spread from a single carrier person to another via droplets of respiratory and throat secretions. Some behaviors that promote the spread of the virus are smoking, prolonged contact through kissing, coughing, sneezing, or staying in an area close to a carrier. Sometimes, the bacteria may overwhelm the body’s defense mechanisms, which will allow bacteria to spread within the bloodstream to the brain. After infection, the virus takes about four days of incubation. The days may, however, range from two to ten depending on the condition of the patient. After pregnancy, the patient will start displaying symptoms such as confusion, headaches, hypotension, vomiting, blurred vision, passing out, meningeal irritation, and purpuric rashes displayed by the patient in case one.

Since the patient’s situation is an emergency, a paramedic will make the initial diagnosis by conducting a thorough clinical examination that involves lumbar puncture exams that reveal the purulent fluid in the spinal cords. Sometimes the bacteria may be observed via a microscopic exam of the spinal fluids. The diagnosis is always confirmed and supported via various bacteria from different specimens of special fluids, the blood, agglutination tests, and polymerase chain relations. Such identifications of the serogroups and the susceptibility of testing to antibiotics are significant to healthcare givers because it enables them to identify practical control approaches to different diseases (Puthra et al., 2020, p.11). Once the case is detected, there is surveillance where healthcare givers can detect and monitor various outbreaks, estimate the burden of the disease and monitor the profiles of antibiotic resistance. Also, healthcare givers may evaluate the impacts of the strategies seeking to control meningitis, especially the preventive programs through vaccination. The disease is fatal. That is why suspected patients are always handled by paramedics who have specialized in emergency healthcare services. The healthcare givers ensure the patients start antibiotics as soon as possible. Some of the antibiotics are ceftriaxone, penicillin, and ampicillin.

3. Analyse the Key Concepts of Pharmacology to Paramedic Science

Describe The Mechanism of Action, Including the Pharmacokinetics and Pharmacodynamics, Of Each of The Pharmacological Agents Listed Below Which Can Be Used to Manage Meningitis and Associated Symptoms in The Pre-Hospital Setting.

Benzylpenicillin 1.2g IV

The drug is a very narrow antibiotic spectrum used to treat infections that result from susceptible bacteria. The patient has a bacterial infection based on an assessment of their symptoms. That is why a drug is a viable option. It is among the natural forms of penicillin antibiotics administered intravenously because it has very poor oral absorption. The pharmacodynamics of the disease indicate that Penicillin G is a form of penicillin beta-lactam antibiotic used by healthcare givers to treat different conditions of bacterial infections caused by gram-positive and susceptible organisms. The term penicillin refers to all the variants of penicillin available or various antibiotics (Wang et al., 2020, p.101). the bactericidal activities of penicillin G always originate from incubation of the synthesis of the walls of different cells via penicillin G binding to the proteins that bind other penicillin. Penicillin G is very stable against other hydrolysis forms via various beta-lactamases like penicillinases and an extended plectrum of beta-lactamases. The pharmacokinetics of the drugs involve binding to the penicillin-binding proteins located within cell walls of the bacteria. Penicillin G prevents the third and the final phase of different cell wall synthesis. The cell walls of bacteria and the autolytic enzymes like autolysins mediates the cell lysis. That is why penicillin G can interfere with the available autolysin inhibitors.

Ondansetron 4mg IV

The drug is a serotonin 5-HT3 antagonist receptor that enhances the prevention of vomiting and nausea among chronically ill patients. The pharmacodynamics of the drug indicate that it is a particular and selective antagonist. It does not have activities over other serotine receptors known for having a lower affinity for the dopamine receptors. Serotonin 5-HT₃ receptors situated within the terminus of the nerves, which have a vagus periphery and are central to the chemoreceptors, trigger regions of postrema (Li et al., 2018, p.278). The existing temporal relationship between emetogenic drugs and actions and serotonin release and the efficiency of the antiemetic agents. The agents indicate that the agentsof chemotherapy always secrete serotonin from the enterochromaffin cells situated in small intestines. They later cause changes that are degenerative within gastrointestinal tract. Serotine subsequently excites splanchnic and vagal nerve receptors which project the medullary center of vomiting, and that causes a reflex action that initiates causing vomiting or nausea. That is why the drug is effective for the patient because he was vomiting.

The pharmacodynamics of the drug indicate that it is a very selective antagonist of the serotonin receptor subtypes (Li et al., 2018, p.278). The cytotoxic chemotherapies and radiotherapies associated with serotine release from the enterochromaffin cells of the small intestines presumably initiate a reflex in voting via stimulation of the serotine receptors, which are located in different vagal afferents. Ondansetron may sometimes block initiations of such a reflex. The initiation of vagal afferents equally generate a significant secretion of serotonin from various trigger zones of chemoreceptors of posttrauma, which are located on the floors of the fourth ventricle. Even though the mechanisms of action in treating postoperative vomiting and nausea and the cytotoxic induced vomiting and nausea always share a similar pathway, the roles of ondansetron in emesis that is opiate-induced have never been established.

250mls 0.9% NaCl (Sodium Chloride) IV

The drug is an ingredient available in various nutritional products as a source of water and electrolytes. The pharmacodynamics of the drug indicate that sodium is a significant caution of extracellular fluids that function primarily in controlling the distribution of water and balance of different liquids. It also contains the osmotic pressure of various fluids within the human body. Sodium is related to bicarbonates and chloride in the regulating acid-base equilibriums of fluids in the body, chloride and other major anions always follow sodium metabolism and the changes in the balance of acids and bases within the body which are reflected by changes in concentration of chloride (Mathur et al., 2020, p.151). The pharmacokinetics of the drug are chloride and sodium are the main electrolytes of fluid compartments which are outside different cells—the two work hand in hand to control extracellular volumes and pressure of the blood. Any disturbances in concentrations of sodium within the extracellular fluids are always associated with some disorders in balancing body fluids. Sodium chloride is suitable for this patient because it will balance the patient’s body fluids.

Case Study 2

Concerning The Specific Observations Given In This Case, Describe the Body’s Physiological Response to Significant Blood Loss

The case study indicates that the patient must have incurred severe bleeding because of the accident. Having been extricated out from under the lorry, there is obvious evidence of bruises over the patient’s lower abdomen. There is very significant pain and apparent symmetry in their pelvis. Upon arrival to the hospital, the patient displays some pieces of evidence of agitation. However, he responds to questions when prompted by the healthcare provider. The immediate physiological responses to such bleeding are significant constrictions of the patient’s blood vessels and the formation of huge clots (Ludwig and Koryllos, 2017, p.177). Both mechanisms work concurrently to reduce the level of blood loss in any patient. Whenever the human body detects some disruption in the blood vessels walls, the response is homeostasis. Physiologically, when the blood loss is less than 15% of the entire blood volume, there will be a slight increase in an individual’s heartbeat. However, there won’t be any significant changes in the pressure of the arteries when the blood loss is more important than 15% and up to 40%, the pulse pressures and mean arterial decrease. However, the heart rate increases relatively with a greater magnitude of such changes related to the volume of blood that a patient loses.

Critique The Evidence Around The Use Of Needle Thoracocentesis In The Management Of Tension Pneumothorax. Give Your Rationale For Its Use In This Patient, Relating To Your Knowledge Of ‘Gas Laws.’ You Should Use Only Relevant And Up-To-Date Journal-Based Evidence Within Your Critique

Needle thoracostomy is significant in managing of tension pneumothorax. The disease is encountered in a trauma and other environments that offer life-threatening care to different patients. The approach is used in pre-hospital settings and in acute resuscitation to temporize affected persons before placing a definitive tube thoracostomy. Since it maneuvers invasively and is emergent, the disease is associated with various complications. Some of the conditions are threatening to the lives of the patients. Because of the relatively common use of the approach, paramedics must familiarize themselves with the procedure. The paramedics should also be ready to deal with any potential complications that may emerge in the treatment of patients (Flower et al., 2020, p.12). The needle thoracocentesis is among the practical approaches used in the treatment of pneumothorax. Even though the procedure is not very definitive in treating the tension for pneumothorax by paramedics, it may prevent deterioration and enhance restoration of some of the cardiopulmonary roles the bilateral pleural decompression is highly spontaneous breathing patients may generate a significant compromise of the respiratory systems.

The treatment approach enhances the saving of lives by inserting a cannula with a wide bore in the second intercostal spaces of the midclavicular lines that are above ones third rib. Such enhances the reduction of any tension pneumothorax according to the guidelines by the advanced life support trauma. Even though needle decomposition is widely accepted as a very effective treatment and first-line intervention plan for treating tension pneumothorax, the approach has not been validated to date (Brown et al., 2020, p.25). The system is highly effective for the patient because one of the significant characteristics of pneumothorax is dyspnea and pain in the chest. All the pain originates from the chest and lungs, and it may sometimes interfere with the normal respiratory activities of the patient owing to the availability of gas bubbles within the pleural cavities or retention of gases in pleural spaces that occur after the rapturing of the bullae.

Conclusion

In conclusion, Physiology and anatomy offer basic information about the body of human beings. It enhances clearing the fundamental aspects of how different parts of the body operate. With the assistance of physiology and anatomy classes, an individual will understand various theoretical aspects and functional roles of the human body. The concept of physiology and anatomy is vital in healthcare and understanding the internal body of human beings. Most healthcare professionals may not be in a position to evaluate, diagnose and treat different diseases. Physiology, however, involves the functioning of individual body parts and the systems of their body. Anatomy is a scientific study of all the structures that are associated with the body of human beings. Psychology, on the other hand, involves understanding the roles and critical functions of the systems. Paramedics view the human body as a highly complex machine. The machine can only work when all the parts are functioning optimally. If the organization and the organ systems are not in the proper function, the patient is considered to be having a disease. The concept is applicable in both case studies, and that is why paramedics had an easier time of diagnosis and proposing the best treatment plans.

References

Brown, S.G., Ball, E.L., Perrin, K., Asha, S.E., Braithwaite, I., Egerton-Warburton, D., Jones, P.G., Keijzers, G., Kinnear, F.B., Kwan, B.C. and Lam, K.V., 2020. Conservative versus interventional treatment for spontaneous pneumothorax. New England Journal of Medicine. 23-35. https://www.nejm.org/doi/full/10.1056/NEJMoa1910775

Burini, R.C., Anderson, E., Durstine, J.L. and Carson, J.A., 2020. Inflammation, physical activity, and chronic disease: An evolutionary perspective. Sports Medicine and Health Science, 2(1), pp.1-6. https://www.sciencedirect.com/science/article/pii/S2666337620300081.

Flower, L., Carter, J.P.L., Lopez, J.R. and Henry, A.M., 2020. Tension pneumothorax in a patient with COVID-19. BMJ Case Reports CP, 13(5), p.e235861.11-20. https://casereports.bmj.com/content/13/5/e235861.abstract

Kato, K. and Gleeson, T.A., 2019. Splenic necrosis requiring ultrasound-guided drainage following meningococcal septicemia. Oxford Medical Case Reports, 2019(3), p.omz020 60-65. https://academic.oup.com/omcr/article/2019/3/omz020/5423014?login=true.

Li, K., Vo, K., Lee, B.K., Addo, N., and Coralic, Z., 2018. Effect of a single dose of iv ondansetron on QTc interval in emergency department patients. The Bulletin of the American Society of Hospital Pharmacists, 75(5), pp.276-282. https://academic.oup.com/ajhp/article-abstract/75/5/276/5102316.

Ludwig, C. and Koryllos, A., 2017. Management of chest trauma. Journal of Thoracic Disease, 9(Suppl 3), p.S172-189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392544/

Mathur, A., Johnston, G. and Clark, L., 2020. Improving intravenous fluid prescribing. Journal of the Royal College of Physicians of Edinburgh. 151-165. https://aura.abdn.ac.uk/bitstream/handle/2164/15050/Mathur_etal_jrcpe_Improving_intravenous_VOR.pdf?sequence=1

Puthra, S., Selladurai, P., Chandrasiri, N.S. and Sugathapala, A.G.H., 2020. Meningococcal septicemia reported in an immunocompetent adult: A Case Report. Sri Lankan Journal of Infectious Diseases, 10-21. https://sljid.sljol.info/articles/abstract/10.4038/sljid.v10i2.8280/

Wang, P., Shen, C., Cong, Q., Lu, J. and Wang, X., 2020. Degradation of Penicillin G by Visible Light Irradiation-Assisted Biotransformation by Whole-Cell paracoccus sp. 100-131. https://assets.researchsquare.com/files/rs-105403/v1/1abc00d0-a186-4d8c-8e0e-0b49a79a90ca.pdf?c=1609591946