SYMPTOMSBy far the most common com-
plaint is sudden onset of dyspnea. Pleuritic pain
is common in moderate to severe embolisms.
Hemoptysis, rales, pallor, foul breath, increased
respirations, and shock may or may not result.
In some cases of pulmonary embolism, a lung
infarction with resulting abscess formation may
TREATMENTOxygen therapy in high con-
centration (preferably 100 percent) is essential to
overcome anoxia. Administer meperidine for
pain, treat for shock, and hospitalize as soon as
An acute illness in which nitrogen bubbles are
forced into the bloodstream. It sometimes occurs
in persons flying at high altitudes and following
rapid reduction of air pressure in persons who
have been breathing compressed air while diving.
SYMPTOMSThis illness is characterized by
joint pains, neurological symptoms, loss of con-
sciousness, and sudden onset.
TREATMENTAs soon as symptoms are
reported, oxygen is given with the patient prone
and the head slightly lowered. Refer immediately
to the nearest recompression facility.
This is an acute medical emergency. It may
be caused by drugs such as heroin, irritant gases,
burns, or blast percussion, causing injury to the
alveolar-capillary membrane. However, it is
usually the result of left ventricular failure
or mitral stenosis.
SYMPTOMSOnset may be abrupt or in-
sidious, Cough, asthmatic wheezing, dyspnea, and
orthopnea (inability to breathe except in an
upright position) occur in the early stages. Later
marked anxiety; gasping for breath; pink, frothy
sputum; terror; anguish; profuse sweating;
cyanosis; paroxysmal coughing; rales; thin, rapid
pulse; and falling hood pressure occur.
TREATMENTPlace the patient in an
upright position to relieve orthopnea. Morphine
has long been the sovereign drug in the initial
emergency treatment and many mild to moderate
episodes have been relieved by morphine alone.
Oxygen, intermittent positive pressure breathing,
rapid venesection (to reduce circulating blood
volume) or rotating tourniquets, and pulmonary
drainage with maintenance of the airway
are used in severe progressive forms. Rapid
digitalization is indicated once heart failure has
been established and after it has been determined
that the patient has not been completely or over
digitalized. Digitalk intoxication may cause acute
DISEASES OF THE
GASTROINTESTINAL (GI) TRACT
The following are some of the more commonly
encountered diseases of the GI tract.
Diarrhea may be caused by a wide variety of
intestinal disorders, such as viral enteritis,
salmonellosis, or amebiasis, or it may be
psychogenic in origin. It may also be caused by
metabolic diseases, dietary factors, or food
TREATMENTEliminate any specific
causes. Place the patient on a liquid diet for the
first 24 hours and then, if tolerated, a soft diet.
Antidiarrheal agents such as Kaopectate® or
Lomotil® should be used with caution. In cases
of bacterial infection, antidiarrheal agents may
prolong the infection and/or carrier states of the
Pyrosis (heartburn) is a burning substernal
pain resulting from irritation of the distal
TREATMENTTreatment normally consists
of antacids and a bland diet. Elevating the head
of the bed, weight redtiction, avoiding tight
clothing, and other symptomatic treatment have
Constipation is the result of lesions of the
colon and rectum, hypometabolism, neurosis,
improper fluid intake, and drug ingestion.
Constipation should be considered only in patients
who have been unable to move their bowels for
several days or if the stools are very hard or dry.