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Medical Guide


415 Man

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Medical Guide

Created by 415 Man


 

Hello, as a member of FD, I thought I'd create this guide to give everyone a quick and easy way to learn a little bit more about medical and how to roleplay types of conditions. I hope to maintain this guide and keep it as up-to-date as possible, introducing new contents when I see feasible based on my experience in server. 

 

 

Table of Contents


 

  • Vital Signs*
    • Heart Rate (Pulse)*
    • Respiratory Rate (Breathing Rate)*
      • Lung sounds and breathing quality*
    • Blood Pressure*
    • Oxygen Saturation (SPO2)*
    • Blood Glucose Levels*
    • Pupil Reaction*
  • Medical Conditions / Emergencies
    • Heart Attack*
    • Cardiac Arrest*
    • Respiratory Arrest*
    • Stroke*
    • Seizures*
    • Asthma*
    • Shock*
    • Overdoses*
    • Chemical Exposure
    • Carbon Monoxide Exposure
    • Allergic Reactions
    • Fever / Illness
    • Dehydration
    • Hypo/hyperthermia
  • Minor injuries (small/insignificant)
    • Cuts / Scrapes
    • Bruising
    • Burns (1st degree)
    • Muscle strain pains
    • Insect / Animal bites
  • Traumatic Injuries
    • Broken bones
    • Gunshot wounds
    • Stab wounds
      • Impalement
    • Burns (2nd and 3rd degree)
    • Lung Collapses 
    • Crush injuries
    • Facial Trauma
    • Spinal Cord Injury
  • Understanding Medical Roleplay
  • Other Information
    • How the body reacts to death
    • Automotive Safety Devices
    • Less-lethal control devices
  • Change Log

 

 

NOTE: This is a to-do list for me to complete. Not even half of the stuff listed in the table of contents are in the guide yet. Only sections marked with a asterisk (*) are completed sections.

 

Vital Signs


Vital signs are measurements of the body's most basic functions. The four main vitals signs are Heart Rate (Pulse), Blood Pressure, Respiratory Rate (Breathing Rate) and SPO2 (Oxygen Saturation). Secondary vitals include Blood Glucose Levels, Body Temperature and Pupil reactions. 

 

Heart Rate (Pulse)

[Bradycardia: <60 BPM] [Normal: 60-100 BPM] [Tachycardia: >150 BPM] [Supraventricular Tachycardia (SVT): >200 BPM]

A heart rate is the number of times the heartbeats within one minute, thus the measurement is 'beats per minute' or 'BPM'. The average pulse of an adult at rest is between 60 and 100. The reason why the range is so large is due to one fitness level, activity level, medical conditions, mental state, or if the person has medications that help regulate heart rate of blood pressure. It is possible to have a pulse under 60 and down to 50 at rest if you are a very well-conditioned athlete. On the other hand, if you have medical conditions and/or are overweight, a pulse under 50 or over 120 when not active or sleeping is cause for alarm. 

 

  • If one is sleepy, resting or on some kind of depressant (downer) drugs, their heart rate will decrease.
  • If one is active, excited or on some kind of stimulant (uppers) drugs, their heart rate will increase.

 

Symptoms of bradycardia:

  • Pulse of below 60 BPM.
  • Chest pain;
  • Confusion or memory problems;
  • Dizziness or light-headedness;
  • Easily tiring during physical activity;
  • Fatigue;
  • Fainting (syncope) or near-fainting;
  • Shortness of breath.

 

Symptoms of tachycardia:

  • Pulse of above 150 BPM;
  • Sensation of a racing, pounding heartbeat or flopping in the chest (palpitations);
  • Chest pain;
  • Fainting (syncope);
  • Light-headedness;
  • Shortness of breath.

 

Symptoms of supraventricular tachycardia:

  • Pulse of above 200 BPM;
  • A fluttering or pounding in the chest (palpitations);
  • A pounding sensation in the neck;
  • Weakness or feeling very tired (fatigue);
  • Chest pain;
  • Shortness of breath;
  • Light-headedness or dizziness;
  • Sweating;
  • Fainting (syncope) or near fainting.

 

 

Respiratory Rate (Breathing Rate)

[Bradypnea: <60 RPM] [Normal: 12-20 RPM] [Tachypnea: >20 BPM]

Respiratory or breathing rate is the number of times a person take a breath (cycle) in one minute. Thus, it is measured in breaths/respirations per minute (RPM). Similar to one's heart rate, the average rate varies based on age, fitness level, activity, etc.  

 

  • If one is sleepy, resting or on some kind of depressant (downer) drugs, their respiratory rate will decrease.
  • If one is active, excited or on some kind of stimulant (uppers) drugs, their respiratory rate will increase.

 

Lung sounds and breathing quality:

This is determined by the cadence of how a person inhales of exhales. Is it calm or sharp, quick or slow? Is is strained? The sounds of the lungs and airway when one is breathing and there is an obstruction will cause wheezing or whistling.

 

 

Blood Pressure

[Hypotension: <100/70 mmHg] [Normal: 100/70 mmHg - 140/90 mmHg] [Hypertension: >140/90 mmHg]

Blood pressure is the force of blood pushing on the walls of your arteries. Is is directly linked to your heart rate. It indicates how much and how hard your blood is circulating your body. Blood pressures are measured using a two number system: Systolic 'over' Diastolic. The first/top number comes first and is always higher than the second/bottom number. Blood pressure is measured in millimetres of mercury (mmHg). 

 

  • Significant blood loss can lead to a low blood pressure but a higher pulse.

 

Symptoms of hypotension:

  • Dizziness or light-headedness;
  • Fainting;
  • Blurred or fading vision;
  • Nausea;
  • Fatigue;
  • Lack of concentration;
  • Confusion, especially in elderly people;
  • Cold, clammy, pale skin;
  • Rapid, shallow breathing;
  • Weak and rapid pulse.

 

Symptoms of hypertension:

  • Blurred vision;
  • Nosebleeds;
  • Shortness of breath;
  • Chest pain;
  • Dizziness;
  • Headaches.

 

 

Oxygen Saturation (SPO2)

SPO2 is an estimate of the amount of oxygen in the blood. Levels are measured using percent (%) and can be checked using a pulse oximeter, a small electronic device which clips onto one's finger.

95% - 100% is a normal SPO2 level in a healthy adult.

90% - 94% is low, but not of severe concern. These levels are something to get checked but is not an emergency. These levels may be caused by poor air quality, mild smoke exposure, smoking cigarettes or slight shortness of breath.

80% - 89% are low and are of concern and supplement oxygen is required. At these levels, you may start to feel dizzy, light-headed, nauseated and slightly confused.

<79% is dangerously low and are a severe concern. At these levels you will begin to be disoriented, unable to think properly and acting as if you were mildly intoxicated. This is because your brain isn't getting the required oxygenated blood that it needs.

 

 

Blood Glucose Levels

[Hypoglaecmia: <60 mg/dL] [Normal: 60 mg/dL - 120 mg/dL] [Hyperglycemia: >120 mg/dL]

In adults who are not diabetic, your body naturally regulates your blood glucose level. For example, after eating some sweets your blood glucose levels may become elevated and if you haven't eaten in a while it will be a little lower. However, depending if you are a type 1 or type 2 diabetic, your body will need help to regulate glucose. Blood glucose level is measured in mg/dL.

 

Symptoms of Hypoglaecmia:

  • Initial signs and symptoms of diabetic hypoglycaemia include:
    • Shakiness;
    • Dizziness;
    • Sweating;
    • Hunger;
    • Tachycardia;
    • Inability to concentrate;
    • Confusion;
    • Irritability or moodiness;
    • Anxiety or nervousness;
    • Headache.

 

  • If diabetic hypoglycaemia isn't treated, signs and symptoms of severe hypoglycaemia can occur. These include:
    • Clumsiness or jerky movements;
    • Inability to eat or drink;
    • Muscle weakness;
    • Difficulty speaking or slurred speech;
    • Blurry or double vision;
    • Drowsiness;
    • Confusion;
    • Convulsions (uncontrollable muscle contractions) or seizures;
    • Unconsciousness.

 

Symptoms of Hyperglycemia: 

  • Early symptoms:
    • Frequent urination;
    • Increased thirst;
    • Blurred vision;
    • Fatigue;
    • Headache;

 

  • Later symptoms - if Hyperglycemia goes untreated it can cause toxic acids (ketones) to build up in the blood and urine (ketoacidosis😞
    • Fruity-smelling breath;
    • Nausea and vomiting;
    • Shortness of breath
    • Dry mouth;
    • Weakness;
    • Confusion;
    • Coma;
    • Abdominal pain.

 

If blood glucose levels drop below 15-20 mg/dL, one can go into Diabetic shock.

 

 

Pupil Reaction

DilationThis is the widening of the pupil which can be caused by adrenaline, anticholinergic agents or drugs such as MDMA, cocaine, amphetamines and some hallucinogens. 

ConstrictionThis is the narrowing of the pupil, which may be caused by drugs such as opiates/opioids. 

Slow or uneven: Will happen in cases of drinking large amounts of alcohol or on depressant (downer) drugs. This can also be caused from a trauma brain injury (TBI) such as a fall, motor vehicle accident or being struck on the head by an object. 

Cloudy of blocked: Caused by blindness of glaucoma

Bloodshot: You may have red or watery eyes due to dust, allergens, dry air, smoke, chemical exposure, infection, being hit in the eye, recent eye surgery, little to no sleep, exhaustion or drinking too much alcohol (the more alcohol you drink, the more visible the red and tiny blood vessels in your eyes appear).

 

In the case of a traumatic brain injury, pupils will become blown out on one side and constricted on the other. Basically small on one side and giant on the other. 

 

 

Medical Conditions / Emergencies


 

Heart Attack (Myocardial Infarction)

A heart attack (myocardial infarction or MI) is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. A lack of blood to the heart may seriously damage the heart muscle and can be life threatening.

 

When blood flow decreases or stops at a part of the heart it causes damage to the heart muscle. Heart attacks occur when plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. The most common symptom is chest pain, which may travel into the shoulder, arm, back, neck or jaw. 

 

Symptoms of a heart attack:

  • Pressure, tightness, pain or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back;
    • It's important to know that not everyone experiences chest pain. This is particularly the case with many women, where heavy pain is felt in the limbs. 

  • Nausea, indigestion, heartburn or abdominal pain;
  • Shortness of breath;
  • Cold sweat;
  • Fatigue;
  • Light-headedness or sudden dizziness.

 

 

Cardiac Arrest

A cardiac arrest is the abrupt loss of electrical stimulation to the heart. The leading cause of cardiac arrests are decreased heart function due to age or other medical conditions, mainly congestive heart failure.

 

Symptoms of cardiac arrest: 

  • Sudden collapse;
  • No pulse;
  • Not breathing;
  • Loss of consciousness;
  • Chest discomfort;
  • Shortness of breath;
  • Weakness;
  • Fast-beating, fluttering or pounding heart (palpitations);

 

 

Respiratory Arrest

Loss of the of near loss of breathing due to difficulties with breathing such as a closed airway or obstructed airway. Respiratory arrests are similar to cardiac arrests, however with respiratory arrests, one's heart would still be beating for a limited time, which would then lead to a cardiac arrest. 

 

Symptoms of respiratory arrest:

  • Severely slow or shallow breathing;
  • Very low SPO2 level (<70%);
  • Not breathing;
  • Face turning blue.

 

 

Stroke

Strokes occur when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot, burst or rupture. When this happens, part of the brain cannot get the blood and oxygen that it needs. Hypoxia is one of the leading causes of strokes.

 

Symptoms of a stroke:

  • Complete paralysis of 1 side of the body;
  • Sudden loss or blurring of vision;
  • Dizziness;
  • Confusion;
  • Difficulty understanding what others are saying;
  • Problems with balance and co-ordination;
  • Difficulty swallowing (dysphagia);
  • A sudden and very severe headache resulting in a blinding pain unlike anything experienced before;
  • Loss of consciousness.

 

 

Seizures

Seizures are changes in the brain's electrical activity. These changes can cause dramatic and noticeable symptoms, or in some cases no symptoms at all. Symptoms of severe seizures include violent shaking and loss of control. Usually when a person is having convulsions (seizures), they are not alert but may look awake, their breathing is interrupted, and once awake usually feel very tired. 

 

 

Asthma

When a person has an asthma attack, inflamed lungs experience bronchospasm, the tightening of the bands of muscle surrounding the airways. This causes the lungs' airway to become narrow or blocked, making it difficult to breath. 

 

Symptoms of asthma:

  • Difficulty breathing;
  • Gasping for air;
  • Wheezing or whistling sounds in lungs;
  • Anxiety;
  • Attempting to take large breaths;
  • Low SPO2 level (<70%) if left untreated for 10+ minutes.

 

 

Shock

Shock is a life-threatening condition that occurs when a body is not getting enough blood flow. Lack of blood flow means the cells and organs of the body do not get enough oxygen and nutrients to function properly. Many organs can be damaged as a result of shock. 

 

Symptoms of shock:

  • Cool, clammy skin;
  • Pale or ashen skin;
  • Bluish tinge to lips or fingernails (or gray in the case of dark complexions);
  • Rapid pulse;
  • Rapid breathing;
  • Nausea or vomiting;
  • Enlarged pupils;
  • Weakness or fatigue.

 

 

Overdoses

An overdose is a biological response to when the human body receives too much of a substance or mix of substances. An overdose can be intentional or accidental. People can overdose on illicit drugs, alcohol, prescription medications and many other substances. In many cases, overdoses are fatal, although most individuals who have overdosed can be saved if medical treatment is provided quickly enough. In terms of drugs, there are a few different ways your body can become overwhelmed by substances. However, the most common cause of death during any chemical overdose is respiratory failure.

 

Depressant Overdose

Depressants that affect the central nervous system (CNS) include Opioids, Benzodiazepines and alcohol. Drugs that are CNS Depressants will lower blood pressure and body temperature and slow the heart rate and breathing. This is why these drugs cause sedating effects, which in turn results in the reduction of anxiety and increase in a calm and euphoric effect. When too high of dosages of Depressants are used, it can lead to adverse side effects, such as respiratory failure, overdose, coma, or even death.

 

Opioid Overdose

Opioids are one of the easiest substances to overdose on, given how they function once consumed. The human body has Opioid receptors in several different areas, including the brain, central and peripheral nervous systems and the gastrointestinal tract. When someone uses an Opioid, these receptors are activated and slow the body down. When the body becomes overwhelmed by Opioids, all of these receptors are blocked and it can’t perform other functions. This will then lead to a high risk of overdosing, which may slow down a person’s breathing to the point of stopping it. Different Opioids can be more or less severe. Where it may take a few minutes for someone who just took Heroin to feel the effects of an overdose, someone who uses Fentanyl will feel it within seconds.

 

Alcohol Overdose

An alcohol overdose happens when you drink more alcohol than your body can safely process. Generally, the body can safely process around 1 unit of pure alcohol per hour (estimated to be the amount of alcohol in a small shot of liquor, a half pint of beer or a third of a glass of wine). If an individual consumes more alcohol than this in shorter time periods, the alcohol builds up in the body due to the body not being able to metabolize the alcohol fast enough and an accumulation of alcohol spreads throughout the body. This may lead to an alcohol overdose, better known as alcohol poisoning.

 

Symptoms of alcohol poisoning include:

  • Mental confusion;
  • Vomiting;
  • Seizures;
  • Slow breathing (fewer than 8 breaths per minute);
  • Irregular breathing (10 seconds or more between breaths);
  • Hypothermia, bluish skin colour, paleness.

 

Additional risks that can occur due to consuming larger amounts of alcohol than the body can metabolize are:

  • The slowing down or cessation of breathing, heart rate and gag reflex;
  • Cardiac arrest due to a decrease in body temperature (hypothermia);
  • Seizures as a result of low blood sugar levels;
  • Overdose Statistics.
Edited by 415 Man
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Well made, I would however add two things;

 

1) The Cincinnati Stroke Scale in order to properly RP a stroke. Things like arm sway and inability to reiterate sentences are a key factors medical professionals look for when checking for signs and symptoms of a stroke!

 

2) Shock, types of shock, and the difference between compensated and non compensated. At least hypovolemic shock since that would probably be the most rp'd out on the server. Things like the difference between elevated BP and lowered heart rate, or low BP and fast heart rate, and what they mean in terms of shock. As well as the interaction it has on the body, ex: the body's core temperature, vasodilation, etc. 

 

All in all, great guide for those that want to take their medical rp serious!

Edited by Stes
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  • 4 weeks later...

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