1 Flashcards
Atropine: Pedi
0.02mg/kg
Atropine: Adult
0.5-1.0mg
Bicarb: Pedi
1mEq/kg
Bicarb: Adult
1mEq/kg
Bretylium: Pedi
5mg/kg
Bretylium: Adult
5mg/kg
EPI 1:1000: Pedi
0.01 mg/kg………CODE 0.1 mg/kg
EPI 1:10,000: Adult
0.3-0.5 mg
EPI 1:10,000 Pedi
CODE ONLY 0.01 mg/kg
Haldol: Adult ONLY
2-5mg
Lidocaine: Pedi
1.0 mg/kg
Lidocaine: Adult
1.0-1.5 mg/kg
Mag sulfate: Adult ONLY
1-2 grams over 1-2 minutes
Morphine: Adult ONLY
2-5mg
Narcan: Pedi
0.1mg/kg
Narcan: Adult
0.4-2.0mg
Oxytocin: Adult ONLY
10-20 units
Valium: Adult ONLY
2-10 mg
IV Tourniquet (Venous constricting band)
occludes venous return but allows arterial flow
Colloids increases intravascular space the most but take longer to get in due to protein size and molecular weight
hespan/dextran
IV solution closest to plasma
Lactated Ringers (LR)
Hemorrhagic shock best fluids
blood (definitive), field-lactated ringers 3x loss
Fluid replacement adult trauma
20 ml/kg or 3x estimated blood loss
Tric OD
sodium bicarbonate
Asthma
Albuterol 2.5 mg, EPI 0.3-0.5mg 1:1000 solution SQ, Bronkosol…NO BENADRYL (adult doses)
Heroin Demerol, and organophosphates
constricted pupils
Administration of a HYPERtonic solution in a hydrated PT
draws water from cells to intravascular space
Movement of gas from higher concentration to lower concentration
diffusion
Decreased O2 in blood
hypoxemia
Decreased O2 in lungs
hypoxia
Hyperventilation syndrome in PT
resp. ALKALOSIS
RESP. acidosis is corrected with
hyperventilation of PT
Excretory function of blood is to
remove urea/creatine lactic acid and wastes; particularly lactic acids form cells
Hypoxic drive or PT’s with COPD, stimulus to breathe
decreased O2 levels
Normal CO2 levels
35-45
pH above 7.45
alkalosis
pH below 7.35
acidosis
RESP. ACIDOSIS
pH less than 7.35 and pCO2 greater than 40
METABOLIC ACIDOSIS
pH less than 7.35, pCO2 greater than 40 & HCO3 or PO2 less than 24
RESP. ALKALOSIS
pH greater than 7.45 and pCO2 less than 40
METABOLIC ALKALOSIS
pH greater than 7.45 and pCO2 less than 40 & HCO2 or PO2 greater than 24
EXAMPLE: Blood gas
pH 7.15, pCO2, 60 and PO2 Resp. acidosis
Resp. Acidosis
CNS/COPD/Narcotics/Asthma/Cardiac Arrest & Drowning
Resp. Alkalosis
Sepsis/Cirrhosis/ASA OD/Anxiety & Pregnancy or Hyperventilation Syndrome
Metabolic Alkalosis
Vomiting/Diuresis, sodium bicarb, Crushing dz (disease)
Acidosis
not breathing or below normal rate (cardiac arrest)
Alkalosis
breathing to fast (Hyperventilation syndrome)
Fresh water drowning
hemodilution, electrolyte imbalance and hypoxia with resp. acidosis
SCENARIO: Fresh water drowning
NOT RESP. ALKALOSIS
Primary concern in treating a near-drowning victim
mgmt. of HYPOXIA and ACIDOSIS
Intubation of a child under 8 years of age
uncuffed
Intubation
check lung sounds, AFTER check cuffs for leaks, BEFORE ventilate via other means prior to intubation
Kussmaul resp.
rapid breathing assoc. with DKA
Not an airway sound
Cough: Stridor/wheezing/snoring are airway sounds
Size of ET for Pedi
Pinky diameter of PT ET diameter
Ventilation via other means
hyperventilate prior to intubation, if unsuccessful after 30 seconds of attempted intubation ventilate again
Left the PT in the ER without turning over to equal or higher medical personnel
abandonment
Negligence
breech of duty/duty to act/proximate cause, damages or harm; INTENT not needed
Legal document that indicates end of life request regarding resuscitation
DNR; WHAT COLOR PAPER DOSE IT HAVE TO BE PRINTED ON YELLOW
Malicious writing
libel
Malicious spoken terms
slander
Dyspnea
difficulty or painful breathing
The Hering-breur reflex
prevents overexpansion of the lungs
Hypoxia drive or PT’s with COPD, stimulus to breathe
decreased O2 levels COPD
Wheezing
whistle sound on inspiration (lower airway)
Wheezing
constriction
Whistling sound during exhalation
consider asthmatic broncholitis
Rhonchi
fluid/mucous in LARGE airway
Croup
stridor at night with seal bark
Rales usually heard in
lower airway (alveoli) fluid
Tension pneumothorax treatment
O2, decompress, transport, IV enroute
Pulmonary Emboli s/s
Dyspnea/SOB/pleuritic pain/Tachycardia
Anaphylaxis
Classic sign is HYPOTENSION
Anaphylaxis
Uticaria/SOB/facial swelling/tachypnea and HYPOTENSION hallmark of anaphylaxis
Pneumonia
Fever/rhonchi/hot and dry skin NO PEDAL EDEMA
EPI dose for asthma
0.3-0.5 mg SQ 1:1000
Chronic bronchitis
blue bloater, fat, increased mucous production, chronic cough
Emphysema
SOB, barrel chest/thin and pursed lip breathing pink puffer
Cough up pink tinged sputum
s/s Left sided heart failure/Pulmonary edema
CHF
Left sided ventricular damage
Pink puffers (emphysema) and Blue Bloaters (Chronic bronchitis)
COPD
Upper airway sound produced with inspiration difficulty
stridor
Lung sounds to bronchoconstriction
wheezing
Neurogenic/anaphylactic & septic shock cause HYPOtension due to
vasodilation
Smaller airway sound with fine crackling
Rales
Rumbling sound/fever/no edema
pneumonia
Treatment Pulmonary edema
LMNO
LMNO
O2, Lasix (40 mg) slow IVP, Morphine sulfate (2 mg) slow IVP and Nitro (0.4 mg) sublingual
Primary concern near drowning
hypoxia and acidosis
Fresh water drowning
Hemodilution or hemolysis
21 y/o with chest pain after coughing
Spontaneous Pneumothorax
**REMEMBER: 20-30 y/o, thin, smokers and males more prone to spontaneous pneumothorax**
prone to spontaneous pneumothorax
Orthopnea
difficulty breathing while lying down
As volume in thoratic cavity increases
pressure decreases exhalation (PASSIVE)
Respirations
exchange of gases between internal/external environment
Pink-puffer
increase RBC production to increase hemoglobin capacity to breathe, Skin color is pink not BLUE
JVD best evaluated in
semi-fowler position @ 45 degrees
Due to bronchiolar spasm a PT with asthmatic bronchiolitis will show
expiratory wheezing
As approach any scene
make sure scene is safe
Libel
malicious writing
Slander
malicious spoken
Triage
sort
Last (Black) priority in MCI
is Cardiac Arrest
START
Triage simple triage and rapid transport
Separate the walking wounded
in MCI
MCI
Can you walk, breathing, pulse, circulation
In any MCI scenario you
treat airway, bleeding, AMS, and then FX’s. Immediate life threats are first except cardiac arrest/major burn PT (tagged dead/black) then potential life threats…BLS before ALS…
First Medic on scene with MCI
Triage
MCI- Most critical PT
person walking around aimlessly repeating things over & over with AMS
MCI START System
RR greater than 30, Cap Refill less than 2 seconds- R to painful Stimulus/unconscious/alert & disoriented are all Critical, immediate PT’s (Key is any AMS)
One of first signs hypovolemic shock
Tachycardia
Earliest sign of any shock
AMS
Jaw thrust or Modified jaw thrust
trauma PT to open airway
Trauma
Give 3 times estimated blood loss of LR or 20 ml/kg
Traumatic asphyxia most commonly caused
crush injury to chest or abdomen
Tension pneumothorax s/s
dypnea/madiastinal shift away from affected area/JVD
S/S Neurogenic shock
hypotension/bradycardic/warm/dry skin BELOW level of injury following trauma
ICP will also see
bradycardia/vomiting/irregular or unequal pupils NOT HYPOTENSION CUSHINGS
Trauma victim pulse 40 & BP 200/120
increased ICP Cushing’s triad
Clear fluid leaking from ears/nose
Basilar skull fx
Allow CSF/blood to drain from ears/nose with head trauma because
the bleeding relieves pressure and will decrease chance of ICP
Glascow Coma Scale (GCS)
Motor (6), Verbal (5), Eye Opening (4) GCSscale 15
Scenario Burn to Anterior chest and abdomen and anterior upper extremities (2)
rule of nines27
Place for decompression
2nd or 3rd intercostals space (midclavicular line)
Scenario
MVA PT. with HR 120, BP 40 palp, PT Hypovolemic shock
a severly angulated fx
pinching or cutting of nerves and blood vessels
Beck’s triad
Muffled/distant heart sounds, narrowing pulse pressure, decreased BP (NOT FLAT NECK VEINS)
A PT with major burns has hypovolemic shock
due to plasma loss
23 y/o sharp chest pain & increasing SOB
spontaneous pneumothorax
Delivery of placenta
end of 3rd stage of labor
26 y/o multi gravid with prior C-Sections, C/C
full term with contractions 3-4 minutes apart/TEARING pain, little amount of bleeding abruptio placenta
Abruptio placenta
DARK red blood and Pain classic differentiation
Abruptio placenta
minimal dark red bleeding, rigid uterus & shock/ can also be described as tearing pain
Placenta previa
placenta covers cervical opening
Placenta previa
BRIGHT red blood and Painless classic differentiation
Placenta previa
placenta covers cervical opening
Primary concern with prolapsed cord
Compromised blood supply to fetus
APGAR
0-2 scale for appearance, pulse, grimace, activity, resp. rate (under 6 intervention required)
APGAR
1 and 5 minutes
OB PT over 3 months transport
On left at least 15 degrees to avoid SUPINE HYPOTENSIVE SYNDROME or pressure on inferior vena cava from uterus
Seizures from TOXEMIA (ECLAMPSIA)
9th month (can occur all of 3rd trimester!) Tx: 5-10 mg valium Toxemia of pregnancy usually in 9th month pregnancy but again, can occur any time in 3rd trimester
Preeclampsia presentation
Hypertension, edema
Common cause uterine bleeding 1st trimester
Threatened abortion/incomplete abortion/ruptured ectopic pregnancy… NOT PLACENTA PREVIA
1st Stage
contractions to dilation
2nd Stage
dilation to crowning full dilation/delivery
3rd Stage
delivery to placenta delivery
Serous membrane covering abdominal organs
Visceral
All s/s kidney stones
frequent urination
Bilateral dilated pupils usually
cerebral hypoxia
23 y/o working out in gym with explosive headache
subarachnoid aneurysm
Severed C4
total paralysis motor and resp. paralysiscan’t breathe on own
Countercoup
injury to opposite side of the head/or opposite side of impact
T4 injury
paralysis below nipple line
T10 injury
paralysis below the umbilicus PT loss of feeling below the nipple lineT4 spinal injury
Part of the brain that effects vision
Occipital/injuryvision affected
Seizures
valium/diazepam 5-10 mg
Stimulation of Sympathetic NS
Increased HR and blood vessel constriction INCREASES Peripheral vascular resistance BETA RECEPTOR STIMULATION
Cardiac Tamponade
JVD, narrowing pulse pressure (systolic closer to diastolic), clear lungs, muffled distant heart sounds
Pain in chest that is searing and tearing with radiation to neck and No Pedal Pulses
Aortic Aneurysm
If stroke volume does not change, but HR decreases
Cardiac output decreases
Rapid Wide Bizarre
V-TACH
Inotropic
contractility
85 y/o with severe headache, NV, dizzy, BP 210/120
Hypertensive crisis
60 y/o PT weighs 110 lbs., heart palpitations P-145, BP-110/60, RR-24, EKG-Wide complex tachycardia TREATMENT
Lidocaine 1-1.5 mg/kg or 50 mg IVP
Rhythm strip shows some kind of 2nd degree type 2 block
O2/monitor and transport
Adenosine
slows conduction through AV node… slows all cations
Digitalis toxicity
A-Fib
PT takes digitalis is weak/dizzy, VS WNL (WNL means we never looked in court do not use)(VS normal range)
monitor, IV and transport
Pulse pressure
difference between systolic and diastolic
Heat stroke
Aggressive cooling methods then 2 IV’s WIDE OPEN
Profuse sweating
heat exhaustion
Burns cause massive generalized swelling
due to plasma movement into interstitial tissues
Best method on LSD PT
talk down/reorient
Hypoglycemia S/S
weak and rapid pulse, weakness and incoordination, seizures cool and clammy
Kussmauls
deep and gasping respirations seen in DKA/Hyperglycemia
Hypoglycemia
stupor, stumbles, slurred speech, bizarre Bx, cool/clammy skin
DKA
Kussmaul respirations-deep, rapid, gasping
Tricyclic OD what is not treatment
Ipecac 30 mg
Story does not match injury
suspect abuse (ALL AGES)
Valium routes of administration for 17 lb seizure Pedi
RECTAL, IV & IM
Bile
enzyme produced in liver and stored in gall bladder
Occipital lobe
vision
Orthopnea
place PT in sitting position
Uticaria
Hives
Pryrogenic reaction
fever, chills, nausea, vomiting (common in blood transfusions)
Best defense
hand washing
Hep-A
Fecal/oral route
Fever/chills/night sweats and blood in cough
TB without hemotypsis-HIV
Children (1-8) fluid replacement
20cc/kg (one year and up as 20cc/kg-adult fluid bolus dosage)
Croup aka LARYNGOTRACHEOBRONCHITIS
occurs at night, seal bark, stridor… Do not lay flat and keep calm. Do not examine throat or laryngospasm can occur. Use humidified oxygen. THE MOST DANGEROUS DISORDER CAUSING UPPER AIRWAY STRIDOR—CROUP
Life threatening infection…bacterial that causes upper airway obstruction with reluctance to swallow due to pain and high fever
Epiglotitis (DROOLING)…Do not lay flat. Keep calm. Do not examine throat or laryngospasm can occur. O2 humidified
Epiglotitis scenario will say sitting upright/fever/drooling
don’t lay supine
20 lbs. Pedi how you measure ET tube answers were 6 Cuff, 6 Uncuffed, Diameter of index finger, and length based tape. I picked 6 uncuffed, Broslow Tape
weight based tape
Infant
uncuffed due to till 8 y/o-narrowest area of airway crichoid
Pediatric Lidocaine dose
1 mg/kg of body weight
Child 18 y/o or under C/C headache, stiff neck, vomiting
MENNINGITIS
Asthma attack
primary problem-Bronchoconstriction with bronchospasms
Epiglotitis
rapid ONSET fever higher than 101 degrees usually
Croup
Slow onset fever usually between 100-104 degrees
Spinal cord injury occurs above C4, what happens to the PT. I put quadriplegic with no ability to breathe.
0
If a child burns their head, according to the rule of nines, what percentage is burning
18%.
There were a couple of triage questions. One was which patient needs to be treated first
a 30 y/o with a sucking chest wound
There was only one drug concentration question. It was about putting 1 gm of Lido into a 250cc bag
The answer is 4 mg/cc
What kind of O2 should you give to a COPD PT
NON-REBREATHER
You should expect what in an elderly patient that has had excessive fluid loss
an electrolyte imbalance.
Shock
inadequate tissue perfusion.
There is a question about a PT with a head injury that goes into shock;
the answer is organ damage and bleeding.
Endotracheal intubation will NOT cause
dehydration
COPD PT main treatment goal
Relieve hypoxemia or rapid transport??
Crime scene with viable PT
treat PT and work with law enforcement.
1 y/o with wheezes and normal temp
Asthma or bronchiolitis??????
Pink puffer question,
emphysema.
Responding to vehicle accident SO advises 1 serious PT, and 2 ambulatory.
Prepare for size up and rapid transport
If PT loses 1L of blood give them
3L
Lead II, II, and AVF
inferior MI.
LBS. to KG question answers were a little off 86 lbs.
answer was 41 KG
Main concern when treating heat stroke.
Rapid cooling
RSI not indicated in:
HEAD INJURY WITH ICP
Question PT on ventilator with resp distress,
remove vent and BVM
Tearing chest pain with absent pedals
Aortic aneurism
Pulse pressure
difference between systolic and diastolic.
Sight controlled by occipital lobe?????
YES
Blunt face trauma with epistaxis and Diplopia consider,
orbit fracture???
Second stage of labor
Dilation to deliver of baby.
Being old doesn’t increase
thirst
Pink torso pulse blue Extremities P-130 strong crying cough sneezing active movement
APGAR approx. 9
Rapid speech sign of
amphetamine
QRS
0.12
25 y/o 1st trimester bright red blood
Spontaneous abortion
65 y/o male chest trauma, BP-80/64, HR-120 JVD, Muffled heart sounds
Tamponade
1 concern with Status asthmaticus
Hypoxia
Generalized muscle contraction & relaxation unconscious, incontinent
Grand Mal Seizure
Anaphylaxis, septic, & neuro Shock what causes BP to drop
dilation of vessels
Interfacility transport, flush face weak pulse BP 80/40
stop blood transfusion
How to take orthostatic BP
sitting, standing, supine
Infant having seizure route of valium
IV, IO, PR
Pyruvic & Lactic acid causes what kind of condition in Cardiac Arrest
was not sure but Respiratory Acidosis
Conscious alert & VS Normal refuse treatment due to religious Paramedic Treat PT
BATTERY
PT refused treatment Paramedic starts IV
BATTERY
Football Fan watching game C/C Nausea, stiff neck AMS
heat exhaustion
BP 80/40 HR 120
Hemo VS Phenmo
15 gtts macro in 1 hour @ 45 gtts/min how many ML administered
180cc
Obese PT Resp Distress, cyanotic (BLUE Bloater)
Chronic Bronchitis
SO on scene of MVA scene is safe SO advises 6 PTs 1st Paramedic on scene
scene size up
PT loses 750cc of blood 3 Xs of blood lose
2250
What does not cause pupil dilation
heroin
PT @ gym states he felt ill VS Normal, enroute to ER PT complains of explosive headache
Aneurysm
If a trauma PT loses a lot of blood, what fluids does he need?
Blood….not LR cause it does not specify were this PT is at if Scene or Hospital and this pt needs blood to replace blood.
You are treating a patient with a compound femur fracture. The wound is actively bleeding. How would you treat this patient?
Control bleeding, bandage, splint
According to OSHA, what must be available on site where hazardous materials are stored?
MSDS
What is the correct hand position for CPR on an infant?
1 finger below the nipple line
A hyperglycemic condition that only occurs during pregnancy is known as:
Gestational diabetes
All of the following refer to chronic bronchitis except:
Pink puffer
In a patient who has right-sided heart failure, which of the following S/S are characteristic?
JVD, pedal edema, hepatomegly
What is the best way for a paramedic to prevent an anaphylactic reaction when giving medications to a patient?
ask about allergy history
A telemetry system in which voice and an EKG can be transmitted from the field to the hospital at the same time is an example of a
multiplex system
Malicious writing in a report is-
libel
The less a paramedic uses a skill:
review of it should be more frequent
Which of the following patients would not receive care based upon implied consent?
The severe asthmatic who refuses care
What PPE should be worn during delivery?
gloves, mask, gown, protective eyewear
Which of the following is true regarding bile?
An enzyme produced in the liver & stored in the gall bladder
The colored portion of the eyeball which surrounds the pupil is called the:
Iris
You have just delivered a newborn whose mother was hypovolemic due to blood loss. What is the recommended fluid replacement for the newborn?
10cc/kg
The most frequently fractured bone due to its position & weakness is the:
clavicle
All of the following are ignition sources for a hydrocarbon spill except: circular saw, sealed flashlight, match, air chisel……..ANSWER:
sealed flashlight
You are treating a child hit by a car, the mother is screaming at you and appears emotionally OUT OF CONTROL. What is the best method to handle the situation?
KNOCK THAT BITCH OUT……(JK)…..Assign a crew member to calm the mother
A head injury patient is presenting with a breathing pattern of several short, shallow breaths followed by irregular periods of apnea. This breathing pattern is called:
Biots
Which of the following is NOT a normal part of the “fight-or-flight” response? skin becomes clammy, pupils constrict, heart rate increases, digestion slows………..ANSWER:
pupils constrict
Laryngotracheobronchitis is characterized by:
drooling , tripod position
You are called to treat a 22 y/o f with sudden onset of LLQ pain. She is 2 weeks late for her period, and is shocky. What is the most likely diagnosis?
Ectopic pregnancy
The established policies and procedures of an EMS system are known as:
protocols
A physician at an EMS scene who is not the patient’s doctor, is known as a (n):
intervener physician
You are called to a home of a 23 y/o obese f approximately 8 months pregnant that has just had a Grand Mal Seizure. You observe the patient is still having seizure activity. Rapid pulse 145/min., BP-240/130, 3+ edema of extremities. No history of epilepsy or head injury can be obtained. The most likely diagnosis is:
eclampsia
A life threatening infection that causes upper airway obstruction in young children accompanied by a reluctance or pain on swallowing and a high fever and drooling:
epiglotitis
The paramedic offers support to an upset family member. This is an example of:
empathy
If a paramedic is charged in a negligence case, he/she is considered the:
defendant
If a paramedic directly causes an injury or harm, that is known as
proximate cause in negligence case.
The degree of care that would be expected of any reasonable paramedic acting under similar circumstances is known as the:
standard of care
Abruptio placenta is a true emergency. It is characterized by:
abdominal pain and dark red bleeding
When opening the airway of an infant, do not exaggerate the head tilt because:
it may obstruct the breathing passages
A legal document that indicates a PT’s end of life request regarding resuscitation is known as:
DNR order
After completing a PCR, the paramedic realizes that he forgot to enter the drug dose. What should he do?
Add a dated and signed written addendum
You are treating a patient in July with hot, dry skin, a temperature of 106 degrees, and unconsciousness. What is the most likely diagnosis?
Heat stroke
All of the following are elements of Cushing’s Triad except: elevated B/P, decreased pulse, irregular respirations,
decreased peripheral vascular resistance
Maintaining equilibrium can be characterized as:
homeostasis
All of the following are Schedule I drugs EXCEPT
heroin, mescaline, LSD, cocaine
Which of the following bite is most neurotoxic?
Coral snake
The most common cause of PID is:
gonorrhea
The ability of the heart to generate its own electrical impulses is known as:
automaticity
All of the following are signs or symptoms of organophosphate poisoning except:
dry mouth
A 62 y/o female is taking digitalis. She complains of being weak and dizzy. She is awake and alert and her vitals are within normal limits. What is the most appropriate treatment:
monitor, IV, transport
A PT presents with pulmonary edema. She should be given:
nitroglycerine to reduce preload
A 55 y/o PT has a pulse rate of 50. There is a P for every QRS and the P-R interval is .16. The PT is cold and clammy and the B/P is 70/50. Indicate the rhythm and the initial treatment.
Sinus bradycardia and Atropine 0.5mg
The local alcoholic found on a cold, windy night is unarousable, in V-Fib, and without respirations. Treatment by the Paramedic includes:
airway management, defibrillation x3, CPR, transport
Which one of the following is not a central vein:
femoral veins, external jugular veins, subclavian veins, internal jugular veins
Minidrip tubing is indicated for which of the following PT:
a 68 y/o in cardiac arrest, a 24 y/o in 24% burns, a 77 y/o in pulmonary edema, a 17 y/o stab wound
Blood is administered with which IV solution?
Normal saline
Which of the following is not a complication of an IV?
Thrombus formation, cellulitis, hypotension, infection
Pharmacologic treatment of anaphylactic shock should include:
EPI and Benadryl
Which one does not produce small pupils?
Heroin, Demerol, organo phosphate, valium
All of the following are true regarding Lasix except
: works in the loop of Henle, increases preload, prevents reabsorption of sodium, causes venodilation within 5 minutes
Medications that are combined with fat or oil are:
emulsions
An intramuscular injection is given at a:
90 degree angle
A 16 y/o fell while playing basketball. He injured his right ankle. The skin is warm and dry. B/P-110/80 and P-50. All of the following are appropriate except:
atropine 0.5mg IV, EKG monitor, splint leg, frequent circulation checks
A PT was hit in the head with a board and fell down the steps. Vitals are P-120, B/P-40/P, and RR-10. These vitals indicate that the PT most likely:
has bleeding from other than the head
What classification is Haldol?
Antipsychotic
Hyperthyroidism which causes an increase in thyroid hormone circulating in the blood is also known as:
Graves’ disease
Which of the following is not a cause of PEA?
Pneumonia
The term ”pink puffer” refers to:
emphysema
You are called to the workplace of a 20 y/o male who came to work feeling ill. He is c/o a stiff neck, high fever, headache and backache. He is most likely suffering from:
meningitis
A 16 y/o male was hit in the head with a baseball bat and has suffered a closed head injury. Which IV fluids are appropriate for this PT?
NS & LR
Patients with major burns may have massive generalized swelling. What causes this swelling?
Plasma movement into the interstitial tissues
Atropine works by:
blocking the effects of the vagus nerve
Ocular medications should be placed in the:
inner canthus
The destruction of red blood cells during Venipuncture is:
hemolysis
Which of the following is the most effective way of immobilizing a fractured foot?
A pillow
Which of the following S/S are most indicative of shock?
Dizziness, thirst, cool skin, agitation
All of the following are categories of the Glascow Coma Scale except:
pupils response, eye opening, movement, verbal response
One way to build trust and rapport with a PT is to:
use a professional, but compassionate tone
Rescue arrives on the scene of a one-car accident. The driver of the accident vehicle is dead. The passenger has been thrown from the car, has a badly lacerated scalp, and is unconscious, but breathing. Initial treatment should be
open the airway and stabilize C-Spine
Critical burns consist of all of the following except: burns complicated by respiratory tract injuries and fractures, third degree burns involving the critical area of the face hands and feet, third degree burns covering more than 10% of the body surface
second degree burns involving 10-15% of the body surface
A PT has lost feeling below the nipple line. This would indicate a spinal injury at the level of
T4
By 4 to 6 months, a child should have
double the birth weight
Which of the following are is not considered a part of the lower airway
Bronchi, larynx, trachea, alveoli
A PT complains of SOB. He has, upon assessment, a barrel chest and pursed lips. What is the most likely diagnosis
Emphysema
The pulmonary artery carries
deoxygenated blood to the lungs
Which of the following is not a sign of dehydration
JVD
A PT is presenting with a rapid onset dyspnea, Uticaria, tachypnea, and B/P-80/50. What is the most likely diagnosis
Anaphylactic shock
The blue and purple colored lesions found on the face, mouth and other parts of the body of the AIDS PT is usually
Kaposi’s sarcoma
A PT with blood gas values of pH
7.15, PCO260, PO260 is suffering from
The movement of gas from an area of higher concentration to an area of lower concentration is
diffusion
Decreased oxygen in the blood is called
hypoxemia
The major drawback of mouth-to-mouth ventilations is
potential exposure of the rescuer to communicable disease
A whistling sound heard in inspiration and expiration while auscultating lung fields is called
wheezing
Paradoxical chest wall movement that lessens respiratory efficiency may suggest a
flail chest
Extreme caution should be used when suctioning a tracheal stoma in order to avoid
soft tissue swelling
All of the following drugs can be administered through an Endotracheal tube, except
Lidocaine, adenosine, atropine, EPI (REMEMBER WHAT NAVEL STANDS FOR Narcan, Atropine, Vasopressin, EPI, Lidocaine)
The most common indication for a surgical cricothyrotomy is
massive facial or neck trauma
When an endotracheal tube is inserted too far, it usually tends to enter the
right mainstem bronchus
In a narcotic addict, Narcan can cause:
a withdrawal reaction
Tissue anoxia from diminished blood flow, caused by narrowing or occlusion of the artery to the tissue is a definition of
ischemia
An individual with known drug abuse is in respiratory distress, hypotensive, and stuporous. He has pinpoint pupils. The paramedic might suspect
morphine overdose
Which of the following routes of administration is fastest
IM, ET, subcutaneous, sublingual
The best protection of a paramedic is
proper training
Order: Give 25gm of dextrose from a 100cc ampule of 50% Dextrose. How many cc’s of Dextrose will be given
50cc
The main difference between the psychotic and neurotic PT is
Psychotic PT is not in touch with reality
A PT in V-Tach, unconscious and no vital signs, you should first
defibrillate
What types of frequencies are used for medical communications
UHF, FM
The master gland responsible for excreting oxytocin and ACTH is
pituitary
A PT has been burned on the entire anterior trunk of the body, both arms (front and Back) and the face and anterior neck; what % burn is it
40.5% (18 for the trunk, 9 for each arm 4.5 for the face and neck)
Two common Tricyclic antidepressants are
Elavil and Tofranil
Early signs of Lidocaine toxicity are
tremors and parasthesia
You are called to the scene of a construction site accident. A 31 y/o male was working in a trench when the walls collapsed and he was completely covered by dirt. His co-workers have freed his abdomen, chest, and head, but he is still trapped from the waist down. The PT appears to be purple from the shoulders up and is having marked difficulty breathing. His eyes are bulging, and his lips appear swollen. You suspect
traumatic asphyxia
The permission to provide care obtained from the PT after the nature and risk of care are explained is called
informed consent
Dilated pupils means
cerebral hypoxia
A child has overdose on ASA. You would expect to see all of the following except
hypoventilation, metabolic acidosis, vomiting and dehydration, diaphoresis and fever
When do you not give Lidocaine
V-Fib, Bradycardia with PVC’s, V-Tach, PVC’s
What do you do if during transmission you lose radio contact with the hospital
Continue to transport and follow standing protocol
A crackling sensation in the neck due to air under the skin is called
SQ emphysema
Of the following, which is not required for a successful legal action of negligence
proximate causation, breech of duty, intent, harm
The pediatric dose of Lidocaine is
1mg/kg
After a normal delivery of a full-term infant, the one-minute APGAR score is made. The baby has a pink body but the extremities are blue. Her pulse is 120/min. and she is crying lustily and jerking her arms and legs. The one-minute APGAR score is
9
When performing CP on a infant, the paramedic should use
fingertip pressure and a faster compression rate than for an adult
Which of the following is least important in the care of a newborn
monitor respiration, clear airway, monitor EKG, maintain body temperature
When assessing a PT for hypovolemic shock, which of the following would you expect before the others
Hypotension, hypertension, tachycardia, cyanosis
Your trauma patient is exhibiting signs of as tension pneumothorax. What would be your order of treatment
Oxygen-plural decompression-transport-IV
Which of the following is not a type of muscle
Skeletal, cardiac, Involuntary, smooth
Fluid replacement for an adult trauma PT is based on
20cc/kg bolus
The universal donor blood type is
O-
220lbs equals
100kg……………(220 divided by 2.2 100)
When encountering a PT who is disoriented, the paramedic should
attempt to keep the PT aware of the time, place, person, and situation.
Cardiac output
rate x stroke volume
The Florida Emergency Medical Services Act, providing legislation governing all pre-hospital emergency medical services is known as Florida Statutes Chapter
401
The major extracellular cation is
sodium
Endocrine glands do what
Excrete hormones into blood stream
Front windshields are made from
laminated safety glass
Prior to entering a paramedic program, the student should be competent in
mathematics
Mr. G has Orthopnea. What is the best position to transport him in
sitting
Ms. J is in DKA. Her breathing pattern is hypernea and tachypnea. What is this respiratory pattern called
Kussmauls
Blood under the dura is described as
subdural
Joe, a 3 y/o, has a barking cough. The most likely diagnosis is
Croup
The primary concerns in treating a near-drowning victim are management of
hypoxia and acidosis
What is Urticaria
Hives
A Minidrip IV set delivers how many drops per mL of solution
60
An extrapyramidal reaction is caused by what classification of drugs
Antipsychotics
A PT presents as follows-bizarre acting, cool, clammy skin, slurred speech, and staggers. The diagnosis for this PT is
hypoglycemia
Radio frequencies are measured in
megahertz
Which of the following do not have P waves?
A-Fib, sinus tach, PAC’s, 1st degree block
If the heart rate increases, but the stroke volume remains the same, what happens to the cardiac output
Increases
A traumatic thoracic injury caused by a puncture to the chest wall that permits exchange of air between the pleural cavity and the outside environment is called a
sucking chest wound
Verapamil and Adenocard are both used for
SVT
Stable angina normally occurs
during exercise or stress
During a fire your partner falls down a flight of stairs. What method would you use to remove him from the burning building
Clothes drag
When assessing an unconscious patient with a head injury, you note that the left pupil is dilated and nonreactive. This may indicate: could be
upward pressure on the left side of the brain or –pressure on the vagus nerve
What is the appropriate dose of EPI for asthma in an adult
0.3 to 0.5mL of a 1:1000 solution administered SQ
You are using an IV set with 15 drops per mL to administer 50mL per hour. How many drops per minute do you give
13
All of the following are true regarding electrical burns except:
there is an entrance and exit wound, it may cause V-Fib, path of electricity may follow nerve pathways, there is more external than internal damage
What type of cerebral hemorrhage usually occurs slowly due to a venous bleed
Subdural
The paramedic should assume that a patient wishes to be treated even though the patient is not conscious or has an altered mental status is
Implied Consent
A patient was left by the paramedics unattended at the ER to respond to another call. The patient was unattended for 20 min. The paramedics are guilty of
Abandonment
The permission to provide care obtained from the patient after the nature and risk of care are explained to the patient is
Informed Consent
The best protection a paramedic has against legal involvement is
Proper Training
Providing care equal to or that of similarly trained is
Standard of Care
The Good Samaritan Law offers some protection to the paramedic
While off Duty
Having essential supplies and equipment at the scene can be insured by
Developing an Inventory and replenish truck supplies after every run.
Information to include on the patients report is the
Concise report of the patient’s condition
The Emergency Medical Service Act, providing legislature governing all prehospital emergency medical services, is knows as
401
Responsibility of the paramedic who is dispatched to the scene of a medical or trauma emergency is
The Duty to Act
Paramedics that elect to help a patient and leaves without other help may be sued for
Abandonment
In a multiple casualty vehicle accident, the patient with the lowest priority (this scenario) is the
Patient with paralysis from the waist down
The issue not required for successful legal act of negligence is
Intent
In cases of malpractice, courts compare the actions of the defendant to that of the actions of his peers would have taken, under the same circumstances. This comparison
Standard of Care
When a paramedic is confronted with a patient who has a serious medical emergency and refuses to allow the paramedics to treat him, the paramedic should first
Try to explain to the patient the seriousness of his condition.
The physician with the most scene authority is the
On Line Physician
The final element that must be present for negligence to occur is
Proximate Cause
The patient in the greatest chance of false imprisonment is the
Psychiatric Patient
Which of the following patients would not receive care under implied consent is
The severe asthmatic that refuses treatment——(14 y/o AAOx3 who refuses, combative head trauma, cardiac patient whose friend says the patient has a DNR were other choices)
If you cannot defibrillate because of a dead battery and the family of the patient learn this, you are considered
Negligent
When surveying the scene, initially you do not have to report the
Life threatening injuries
When confronted with a true emergency with a minor without parents and/or legal guardians present and cannot be contacted, you should
Consider consent for care to be implied and begin care
Intent of the Good Samaritan Law is to
Protect a person who stops at a scene from a lawsuit
The organization that establishes the qualifications for emergency medical service personnel on a national basis is the
National Registry EMT’s
Upon the arrival of a disaster scene, the patient who should receive the lowest priority (of the following) is……..3rd degree burns over 80% of body (pt will die soon anyway) (Mid-sternal chest pain, 2nd degree burn over 20-30%, penetrating chest wound, were other choices).
0
The process that sorts patients is called
Triage
You have arrived on the scene of a building collapse involving at least 30 patients. One patient is in cardiac arrest. The first paramedic on the scene should classify the patient as
Lowest Priority
A patient with a fractured clavicle typically sits or stands with
The injured shoulder forward
The first step in immobilizing a patient on a short spine board is to
Maintain manual stabilization of patients C-Spine
A patient found unconscious at the scene of a fire should be suspected to have
Carbon Monoxide Poisoning
Paradoxical respirations are a result of a
Flail Chest
A car accident victim that has pain and deformity to both thighs may suffer from
Hemorrhagic or Hypovolemic Shock
A fracture in which a break is straight across the bone shaft is called a
Transverse Fracture
A fractured elbow should be immobilized
In the position found
Some signs and symptoms of shock are
Dizziness, thirst, cool skin, and agitation
A patient with a head injury suddenly has a left pupil that is fixed and dilated which now reacts slowly to light. This is considered a
Neurological crisis
An injury with torn ligament, usually from motion forced beyond the normal range of the joints is called a
Sprain
A patient is conscious, we should apply traction (when indicated)
Until the patient feels relief
A patient has a pulse of 40, B/P of 200/20. This patient most likely has
ICP
A situation that is indicated for the use of MAST suit is a
Ruptured, abdominal aortic aneurysm (AAA)
All are part of GLASCOW scale except
Pupil response (eye opening, movement, and verbal response were other choices)
The most common organ injured in blunt trauma to the RUQ is the
Liver
A sign that is not associated with an aortic aneurysm is
Groin pain
The mechanism of injury can tell the medic about the patient’s condition. If the steering column is collapsed, the patient is most likely to have a
Flail segment
In a cricoid stick, the landmark used to determine the proper insertion location is
The depression just inferior to the Adam’s Apple
a patient in a MVA has a head injury, B/P 80/60, P 132, and is suspected to be in
Hypovolemic shock
The shorting of an extremity (leg) could be caused by an injury to the
Hip
A patient has fallen from 15’ roof. When assessed, the patient has dyspnea, flat neck veins, and his chest was dull to percussion. This most likely to be a
Hemothorax
Cardiac Tamponade causes the following except
Flat neck veins (normal pulse pressure, decreased BP, and muffled heart sounds were other choices)
A 23 y/o male with sharp chest pain of short duration and increasing shortness of breath is suspected to have
Spontaneous Pneumothorax
The 1st thing to do when called to an MVA is to
Triage the patients and find the extent of the injuries
Of the following chemicals, the ones that would cause the most burns are
Oven cleaners and Drano (alkaline)
A patient has spinal injury and intercostals retractions. The site of the injury is in
C-Spine (C3 and C4)
A finding that receives attention during the primary survey is an
Exsanguinating Hemorrhage
A patient is AAOx4, has a 3” scalp wound, BP 80/50, P 120. The best IV choice would be
Lactated Ringers (or NS) wide open
The most major complication of a joint injury is
Blood Vessel Damage (NOT nerve damage if both answers appear)
Traumatic asphyxia is caused by a
Crush injury to the chest or abdomen
When ventilating a patient with a head injury, the ventilation rate should be
20-24 breaths per min.
A 35 y/o patient has a sudden, sharp; severe headache becomes unconscious and unresponsive. She is suspected to have a
Subarachnoid Hemorrhage
A 16 y/o fell while playing basketball and has injured his right ankle. His skin is warm and dry, BP 110/80, P 50. The appropriate action would be all except
Giving 0.5mg/kg Atropine
Fluid replacement of the hypovolemic patient is
2000cc to 3000cc normal saline (or LR)
A false statement referring to burns is that
There is insignificant damage to underlining tissue
It is contraindicated in elbow fractures in elbow fractures to
Attempt one time to straighten the elbow
A drug used to decrease intracranial pressure is
Mannitol
When evaluating the symptoms of a patient with real complain, one must quickly establish several important factors except
Last physician’s appointment
The patient is cyanotic, comatose, and has agonal breathing, so we
Initiate BLS (ABC’s)
Best way to determine if the heart is pumping is to
Check for a pulse rate
The single most important indicator of the patient’s brain function is his
Level of Consciousness (LOC)
The most sensitive indicator of progressive disorder of the nervous system is
Change in mental status
Kussmaul Respirations are described as
Rapid breathing (deep, gasping) associated with diabetic ketoacidosis
The upper airway sound produced with inspiration difficulty is called
Stridor
Lower airway obstruction
Wheezing
Smaller airway, fine crackling
Rales
Larger airway, fluid (mucus) in lungs
Rhonchi
Bilateral, dilated pupils indicated
Cerebral Hypoxia
The spleen is located in the
LUQ
Central venous pressure is the same as
Right Atrial Pressure
Cardiac Tamponade is indicated by
Distant Heart Sounds
When checking lower extremities for paralysis, paramedics should ask the patient to
wiggle her toes
Tendons connect
Muscles to bone
The order in which a primary survey is conducted to search for immediate life-threatening emergencies is to check
Breathing-Pulse-Bleeding (A B C’s)
Initial emergency evaluation directs towards all of the following except
Significant Internal Hemorrhage
The systolic portion of the blood pressure is the
Pressure of blood against the atrial wall during the heartbeat
Taking a palpable blood pressure only gives you
The systolic pressure
Normal pulse rate of an adult is
60-100 beats per minute
Death of tissue is called
Necrosis
Normal breathing rate of an adult is
12-20 breaths per minute
A patient complains of SOB. On assessment he has pursed lips and barrel chest which indicates
Emphysema (“Pink Puffers”) Chronic Bronchitis is called “Blue Bloaters”
Blood pressure levels may vary according to age and sex. Normal systolic pressure in males is
100+his age
The end of the femur which is toward the foot is referred to as
The distal end
If the patient is laying face down on the floor, he is
Prone
Ecchymosis over the mastoid bone (process) is known as
Battle signs
Cardiovascular assessment involves determining the pulse and blood pressure. In the secondary survey, it also involves assessing venous pressure. Increased venous pressure is assessed by
Checking for JVD
Homeostasis is the
Stability of the Internal environment
During the Heimlich maneuver, the rescuer places his hand on the
Epigastrium
In order to insert an ET tube properly, it is necessary to visualize the
Vocal Cords
Due to bronchiole spasm, a patient with asthmatic bronchitis exhibits
Expiratory Wheezes
A light image is changed into an electrical message that goes to the brain via the
Optic nerve
Irregular breathing patterns with periods of apnea gradually increasing and decreasing is called
Biots Respirations
One of the least important things to assess neurological status is if the patient has
Deep tendon reflexes
Dyspnea is
Difficulty or painful breathing
A victim is found with bright red, frothy blood bubbling from the mouth with each exhalation. This is an indication of
Lung damage
