Hormones - Differing levels of estrogen, testosterone, and progesterone create legitimate differences in how men and women think and act - Four key points to remember in pharmacokinetics: ->Absorption: -->Ask women the date of their last menstrual period --->While women have less acid in their stomachs and slower emptying times, their absorption rates increase during menstruation, so drug metabolism rates will be very different preceding this period -->Women can overdose on smaller amounts of fentanyl than men might -->>They absorb alcohol differently because they only have 1/5 of alcohol dehydrogenase, the enzyme that breaks down alcohol ->Distribution: -->Drug dosing for women is generally lower due to higher percentage of body fat, which helps guard the uterus during pregnancy -->Ask if they’re taking any oral contraceptives, which compete against some drugs such as antibiotics—this makes the birth control less effective -->Oral contraceptives make women more prone to conditions like brittle bones, deep vein thrombosis (DVT), and pulmonary embolism (PE) -->Women who smoke and take oral contraceptives are 60 times more likely to develop PEs and DVT ->Metabolism: -->Biotransformation and drug metabolism mostly take place in the liver (though during pregnancy, biotransformation may occur in the fetal tissues and placenta) -->Seizures are more frequent prior to menstruation due to changes in hormones ->Elimination: -->Mostly happens in the kidneys but also through the skin and lungs, where elimination can occur more quickly for women -->Hormonal-based medications like antibiotics, benzodiazepines, and steroids may impact rate of elimination The Brain - Both men and women repair tissues and organs with estrogen which also protects the brain and maintains its plasticity - Because women’s estrogen decreases over time, especially after menopause, their ability to restore weakens; e.g. More aggressive treatment may be needed for elderly women for sepsis, hemorrhage, and kidney injury - Strokes ->Occur more frequently among men but are more fatal in women, who are more likely to delay seeking treatment ->Worse neurological outcomes lead to higher suicide rates after strokes Lungs - COPD is more common; women respond well to early oxygen during periods of exacerbation - Asthma attacks are more likely during menstruation - Smaller lungs = less reserve - Lower hemoglobin levels = less oxygen - Lung cancer is the #1 cancer killer among women GI Tract - Moves more slowly than in men until menstruation, at which point it speeds up - Increased need for glucose while prepping for pregnancy creates a breeding ground for infections and other breakdowns, causing a predisposition to Type 2 diabetes Esophagus (shorter) - GERD is more common - Persistent cough shouldn’t be thought of as just a respiratory issue—antacid is a good treatment Trauma - Despite having increased inflammatory responses because of their hormones, women get under-triaged - Young, healthy males get different treatment—women are often observed for less time - Women handle and express pain differently than men Heart - For women over the age of 65, taking aspirin daily is more likely to cause bleeds than provide protection from heart disease - Higher heart rates and lower cardiac outputs - Testosterone shortens Q-Tc = more likely to develop early or premature beats and arrhythmias Coronary Artery Disease - #1 killer of American women - Symptoms are different and often ignored ->20% of women experience upper abdominal pain, back pain, shortness of breath, nausea, sweating - Having diabetes increases risk of CAD by 4-6 times in women vs. 2-3 times in men ->Women have a higher death rate and worse prognosis after AMI ->Kidney disease hits harder in women than in men due to less elimination and fluid challenges so responses to medications are poorer Assessments in Women - Keep differential diagnoses broad ->“Believe their symptoms and understand you may have to advocate for them at the hospital,” said Quick. - Have higher suspicions about underlying causes of their condition - “Denial ain’t just a river in Egypt.” Just because they deny it, it doesn’t mean it’s not happening" />
Dentsville EMS & Auxiliary

2020 EMS Calls
Jan 95
Feb 76
Mar 79
Apr 59
Total 309

2020 Fire Calls
Jan 28
Feb 23
Mar 17
Apr 21
Total 89

Past Responses
Year EMS Fire
2019 1077 87
2018 919 345
2017 883 -
2016 787 -
2015 808 -
2014 738 -
2013 549 -
2012 655 -
2011 590 -
2010 517 -
Total   432

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