1. 3 General Symptoms of the Body Fever Shock Pain

2. Fever An increased temperature by the body to destroy invading pathogens. – Life is protein-dependent, soooo……. Denature them.

3. Clinical Manifestations/Etiologies of Fever Infections – Viral, bacterial, fungal, rickettsial FUO – Fever of Undetermined origin CNS – CVA, Head injuries Neoplasms – tumors Cardiovascular – MI, Bacterial Endocarditis, CHF, Tachycardias

4. Clinical Manifestations/Etiologies of Fever Physical Agents – Heat Stroke, Radiation, Surgery Chemical Agents – Drugs, Anesthesia, Anaphylaxis Psychogenic Fluid Imbalances

5. Fever Treatments Remove Root Cause – Sometimes Difficult Increased fluid intake Alcohol sponging Cold Baths/Ice Baths Antipyretic Drugs (Aspirin, Acetaminophen) – Prostaglandin inhibition (hypothalamus)

6. Shock Low blood perfusion through vessels. – Thus, tissue delivery is low. – Any change in flow, distribution, reduction in blood flow will cause shock.

7. Shock Signs and Symptoms Ashen pallor Cold, Moist Skin Rapid Pulse Thirst Decreased Urine Output Acidosis

9. Shock Syndromes Neurogenic Shock: Psychogenic, Fainting, Syncope – Pain, trauma, unpleasant sights “Faint at the sight of blood” Hypovolemic: Loss of blood volume – Large wounds, progressive dehydration Sepsis: Shock due to infection

10. Shock Syndromes Cardiogenic – MI, Tachycardias Metabolic – Fluid alteration/Electrolyte imbalance – Uremia (First Azotemia) Kidney Failure Uremia take a long time to develop. Azotemia is measurable, without symptoms. Allergic - Anaphylaxis

11. Shock Treatment Position head lower than feet Warmth (cover up) Maintain Airway (esp. in anaphylaxis) Pain Killers Fluids Vassopressor Drugs – Bring up BP Diuretics (for urine increase)

12. What do YOU do? Position head Warmth No administration of fluids without trained first aiders, doctors, medical professionals.

13. Pain “Discomfort” Subjective Experience Nociception – Stimulation of neural pathways that causes pain to be sensed. Treatment: Painkillers – narcotic or non-narcotic

15. Physical – osteopathy, physiotherapy, chiropractic Meds – Painkillers, anti-inflammatory, muscle relaxers, steroid injections (joints or muscles). Nerve Blocks – Drug combo. At spinal column (painkillers, steroids). Long acting. Joint injections – Spine, shoulders, hip http://www.painclinic.uk.com/multidisiplinary.htm

16. Radiofrequency Treatments – Needle carries electric pulse to destroy sensory nerves to an area (Spine, neck, back). Pulsed radiofrequency – Similar procedure as Radiofrequency. – “Stuns” nerve – no permanent damage. Stimulation Therapy – TENS ( Trans-Cutaneous Electrical Stimulation) – Acupuncture Psychological/Pain management program – Relaxation, Information, Education, Phys. Therapy, Reconditioning.