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Paramedic > 118 Final Review > Flashcards

118 Final Review Flashcards

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1
Q

Atropine is what type of drug?

and what is it for?

A

Anticholinergic

Bradycardia

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2
Q

Midazolam (lam) is what type of drug?

and what is it for?

A

Benzodiazepine (Benzo)

Seizure/Sedation

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3
Q

Lidocaine is what type of drug?

and what is it for?

A

Na Channel Blocker (sodium)

and Class 1 Anti dysrhythmic

VTACH

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4
Q

Epinephrine is what type of drug?

and what is it for?

A

Alpha & Beta Agonist

1000 = Allergic Rx

10,000 = Cardiac Arrest

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5
Q

Dextrose is what type of drug?

and what is it for?

A

Carbohydrate

Hypoglycemia

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6
Q

Adenosine is what type of drug?

and what is it for?

A

Class 5 antidysrhythmic

SVT

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7
Q

Diltiazem is what type of drug?

and what is it for?

A

Ca Channel blocker (class 4 antidysrhythmic)

AFIB

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8
Q

Ondansetron is what type of drug?

and what is it for?

A

(zofran) Anti-emetic

nausea/vomitting

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9
Q

What degree angle is a
subcutaneous IV

what is the max

A

45 degrees

3mL max

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10
Q

What degree angle is a
Intramuscular IV

what is the max

A

90 degrees

5mL max

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11
Q

What are 3 Enteral (GI)
routes

A

G-tube

Oral

NG Tube

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12
Q

What are 5 Parenteral routes

A

SQ

IV

IM

Transdermal

IO

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13
Q

What is the right locations to do an I/O

A

Proximal humural head

Distal tibia

Proximal tibia

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14
Q

What FDA drug category should you not give to a pregnant woman

A

Category X

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15
Q

What is the dividing line between upper and lower airway

A

Glottis/glottic opening

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16
Q
A

a. vallecula
b. epiglottis
c. vocal cords
d. piriform fossae
e. arytenoid

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17
Q

Define
External Respirations

also known as

A

oxygen and carbon dioxide exchanging in the alveoli and the blood in the pulmonary capillaries

aka
pulmonary respiration

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18
Q

Define
Internal Respiration

also known as

A

exchange in the systemic circulation and the cells of the body

aka
cellular respiration

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19
Q

Define Biots

caused by?

aka?

A

Irregular breathing with periods of apnea

caused by ICP

aka Ataxic

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20
Q

Define Cheyne-Stokes

A

Gradual increase in resp rate (more rapid than biots) and depth followed by decrease with periods of apnea

caused by Brainstem injury

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21
Q

What is a normal ETCO2

A

35-45

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22
Q

How should you breath for someone with HIGH
ETCO2

A

Increase respirations

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23
Q

How should you breath for someone with LOW
ETCO2

A

Decrease respirations

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24
Q

How do you find

Minute Volume

A

TIDAL VOLUME

X

RESP RATE

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25
Q

What is normal resp rate for adult

A

12-20 RR

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26
Q

What is a Mallampati Score

What is the worst

A

Grades opening of airway on scale 1-4

4 is the worst

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27
Q

What is the 3-3-2 rule

what indicates difficulty

A

Using fingers assess

hyoid bone to the chin 3
thyroid cart to chin 2

Any measurement less than 332 indicates potential difficulty with airway managment

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28
Q

Define Hypoxic drive

A

The body’s backup for resp control based on if the amount of OXYGEN in the blood
instead of NORMALLY C02 in the blood.

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29
Q

Define PEEP

A

the amount of pressure the patient EXHALES against

positive end expiratory pressure

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30
Q

Hyper/hypo capnia

A

Hyper/excess
hypo/low

CO2 levels in the blood

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31
Q

How can you tell if you have poor lung compliance

A

you will have
increased resistance
during vent attempts

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32
Q

What is DOPE

A

A mnemonic for intubated patients

Displacement
Obstruction
Pneumothorax
Equipment fail

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33
Q

Max suction time without oxygenating

A

10 seconds

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34
Q

What are 2 non invasive mechanical vents

A

CPAP and BiPAP

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35
Q

What is the normal range of

PH - define

PaCO2 - define

HCO2 - define

What amount is acid/alk

A

ph - potential hydrogen
acid - alk
7.35 - 7.45

paco2 - respiratory
ALK - ACID
35 - 45

hco3 - metabolic
acid - alk
22 - 26

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36
Q

ph is a measurement of

A

equilibrium

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37
Q

How does acidosis and alkalosis effect the CNS

A

acidosis SUPPRESSES CNS

alkalosis IRRITATES CNS

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38
Q

What are the 3 main regulators of the system (fast to slow)

A
  1. chemical buffers (fast)
  2. respiratory system
  3. renal system (slowest)
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39
Q

What are the 4 main buffer systems

A
  1. bicarb
  2. phosphate
  3. hemoglobin
  4. protein
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40
Q

What are the two parts of the Peripheral nervous system

A

Somatic and Autonomic

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41
Q

What are the two parts of the Autonomic system

A

Sympathetic and Parasympathetic

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42
Q

What are the two parts of the CNS

A

Brain and Spinal cord

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43
Q

Midrysis vs
Miosis

A

Midrysis - Dilated

Miosis - Constricted

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44
Q

What are the

NTM
Receptors
Sub-receptors

of the SYMPATHETIC sys

A

Sympathetic

NTM - Norepi, Epi

Receptors - Adrenergic

Sub-recp - A1, A2, B1, B2

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45
Q

What are the

NTM
Receptors
Sub-receptors

of the PARASYMPATHETIC sys

A

Parasympathetic

NTM - Acetylcholine

Receptors - Cholinergic

Sub-Recp- Nicotinic, Muscarinic

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46
Q

PharmacoKINETICS

vs

PharmacoDYNAMICS

A

Kinetics - what the body does to the drug

Dynamics - what the drug does to the body

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47
Q

Dysphagia vs

Dysphasia

A

gia - (Gulp) swallowing

Sia - Speech

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48
Q

Define Efficacy and
Affinity

A

Efficacy - Initiating cell activity

Affinity - How much the drug LIKES receptor

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49
Q

Define Agonist vs Antagonist

A

Antagonist - PREVENTS from receptor

Agonist - INITIATES cell activity

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50
Q

What is brand name for Diltiazem

and what does it do

A

Cardizem

Ca Ch Blocker

Antihypertensive

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51
Q

What is brand name for Captopril

and what does it do

A

Capoten

Ace Inhibitor

Antihypertensive

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52
Q

Epi 1,000 vs 10,000

how much fluid and what is it for

A

1,000 - 1mg/1mL alergic

10,000 1mg/10mL cardiac

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53
Q

What does Morphine do

A

It is an Opioid Agonist

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54
Q

What route is Bucal/Sublingual

and Rectal considered

A

Parenteral - subL / Bucal

Enteral - Rectal

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55
Q

What are signs/symptoms of

Opioid

and causes

A

s/s - Miosis, low RR, low cns, Nodding out

causes - Fentanyl, Oxy, Heroin, etc.

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56
Q

What are signs/symptoms of

Sedative

and causes

A

s/s - lethargy, ataxia, low cns, dysarthria

causes - (lams/pams) Midazolam, Diazepam, sleep aids

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57
Q

What are signs/symptoms of

Anticholinergic

and causes

A

s/s - mad, blind, dry, red, hot

causes - atropine, antihistamines

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58
Q

What are signs/symptoms of

Cholinergic

and causes

A

s/s - SLUDGE/DUMBELLS

causes - Sarin, Insecticides, Organophosphates

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59
Q

What are signs/symptoms of

Sympathomimetics/Stimulants

and causes

A

s/s restlessness, agitation, high rr, mydriasis

causes - cocaine, diet pills, amphetamines, decongestants, bath salts

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60
Q

Ataxia and Dysarthria

A

Ataxia - difficulty walking

dysarthria - difficult mouth movement

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61
Q

Hepatitis inflammation affects what part of the body first

A

RUQ pain (liver)

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62
Q

Define Ascites

A

Fluid collects in spaces within your abdomen

can affect your breathing

sign of heart failure if in lungs

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63
Q

Which part of the heart do pulses come from

A

The LEFT ventricle

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64
Q

What is a Cholecystectomy

A

Removal of the GALL Bladder

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65
Q

Define Bruits and Thrill

A

Bruit - turbulent blood flow

Thrill - palpated sensation

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66
Q

Which Cranial Nerves effect the eyes

A

3/4/6
make eyes do tricks

3 - oculomotor
4 - trochlear
6 - Abucens

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67
Q

What is the mnemonic
for remembering all the Cranial Nerves

and Sensory or Motor

A

oh oh oh to touch and feel a green vegetable a heaven

Oh - olfactory
Oh - Optic
Oh - oculomotor
To - Trochlear
Touch - Trigeminal
And - Abducens
Feel - Facial
A - Acoustic
Green - Glossopharygeal
Vegetable - Vagus
A - accessory
Heaven - hypoglossal

Some Say Money Matters But My Brother Says Big Brains Matter More

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68
Q

Define the words

Encephalo
Cephalo
Oto
Chole
Hepato

A

Encephalo - brain
Cephalo - head
Oto - ear
Chole - bile/gall bladder
Hepato - liver

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69
Q

Where is the Spleen located

A

LUQ

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70
Q

Define Erythema

A

Redness

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71
Q

Name 3 hollow organs in the stomach

A

Small intestine
Large intestine
and Pancreas

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72
Q

What does AVPU stand for

A

Alert and Oriented
Verbal
Pain
Unresponsive

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73
Q

TB infection vs disease

A

infection - bacteria lies dormant

disease - at least 1 symptom, can transmit

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74
Q

Where does the patient Hx and Rx (and what patient says) go in SOAPE

A

Subjective

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75
Q

Where does the patient V1 (and what you see) go

A

Objective

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76
Q

Where does the what you think is wrong and rule outs go

A

Asessment

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77
Q

Where does what was done for the patient (along with patient belongings) go

A

Plan

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78
Q

Where does effects of your treatment (2nd/3rd set of vitals) go

A

Evaluation

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79
Q

Define Tort

A

Wrongful act giving rise to a civil lawsuit

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80
Q

Define Libel vs Slander

A

Libel - WRITTEN false

Slander - ORAL false

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81
Q

Define

NPO
PO
CABG
qd
PRN

A

Npo - nothing by mouth

po - by mouth

CABG - coronary artery bypass graft

qd - every day

PRN - as needed

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82
Q

What drip set do you use if there is none in math

A

60 gtts

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83
Q

What is the formula for drug calc

A

Have
Time

divided by

Desired
Weight kg
Fluid
Drip

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84
Q

What are the intrinsic rates of the heart

A

SA 60 -100
AV 40 - 60
Ventricles 20 - 40

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85
Q

What does PRI represent

and QRS

T
and first half of T
and back half of T

A

pri - Atrial Depolarization

qrs - vent depolarization

T - vent repolarization
q- t - absolute refractory

back half of t - relative

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86
Q

During

Polarization

Depolarization

Repolarization

where is sodium and potassium

A

Polarization - ready state

na outside / k inside

DEpolarization (QRS) - discharge

they SWITCH k outside / na inside

REpolarization (T) - recovery

switch back to na outside / k inside

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87
Q

What are the 4 E’s

A

Economic
Engineering
Enforcement
Education

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88
Q

What makes a good goal

A

It can be measured

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89
Q

An airbag is considered what type of prevention

A

Primary / passive

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90
Q

Define the 4 types of consent

A

informed -
expressed -
implied -
involuntary -

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91
Q

Define the 4 types of Negligence

A

Duty to Act
Breach of Duty
Proximate Cause
Harm

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92
Q

Base and Apex

of Lungs vs Heart

A

Base (top)/Apex (bottom) - heart

Apex (top)/ Base(bottom) - lungs

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93
Q

When do you get a set of vitals

A

during the secondary assessment

you get hx/sample/opqrst

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94
Q

Name the 3 lower airway sounds

A

Wheezing (whistling)
Crackles
Rales

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95
Q

Name the 3 lower airway sounds

A

Wheezing (whistling)
Crackles
Rales

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96
Q

Name 2 upper airway sounds

A

Stridor
Plura Friction Rub

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97
Q

Define Becks Triad

A

Beck’s triad - excess fluid or air around the heart.
1 low blood pressure,
2 bulging neck veins,
3 muffled heartbeats.

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98
Q

What does the S2 sound indicate

A

the semi-lunar valve closing

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99
Q

Define (tropys)

Chrono -
Ino -
Drono -

A

Chrono - HR (SA)

INO - Contractility (Vent)

Drono - Conductivity (A/V)

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100
Q

What does OLD BEN stand for with GCS

A

Obeys - 6
Localizes - 5
Draws from pain - 4
Bends - 3
Extends - 2
None - 1

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101
Q

What does VOICE stand for with GCS

A

Eloquent - 5
Confused - 4
Incomprehensible - 3
Oohh - 2
Voiceless - 1

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102
Q

What does Amiodarone do

A

K+ channel blocker

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103
Q

Which organ elementate and which biotransfers

A

Kidneys eliminate
Liver bio transfer

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104
Q

Transport Decision is part of what assessment

A

primary

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105
Q

Define Reflexes

Moro
Palmar
Rooting
Sucking

A

Moro - startled
Palmar - object in palm
Rooting - cheek
sucking - sucking, lips

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106
Q

Breathing

what is active

what is passive

A

active - inhalation

passive - exhalation

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107
Q

what does fio2 measure

A

fraction of inspired oxygen % of oxy inhaled during ventilation

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4
5
Perfectly
108
Q

Define V/Q mismatch

A

Vent and Perfusion must match

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109
Q

bpm for

Junctional escape
Accelerated junctional
junctional tachycardia

A

junctional escape 40-60
accelerated junc 60-100
junc tachy 100-180

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110
Q

What size needle do you use for I/O

A

o 15mm
3-39kg patients

o 25mm
over 40kg patients

o 45mm
Excessive subcutaneous tissue & Humeral IO insertion

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111
Q

What are IV site reactions and complications

A
  • Infiltration
  • Occlusion
  • Vein Irritation
  • Thrombophlebitis
  • Hematoma
  • Nerve, tendon, or ligament damage
  • Arterial puncture
112
Q

Define Isotonic, Hypertonic, and Hypotonic

A
  • Isotonic
    0.9% sodium chloride (normal saline), Lactated Ringers
  • Hypertonic
    Greater concentration of sodium, water drawn out of cells, and cell may collapse
  • Hypotonic
    Lower concentration of sodium, water drawn into cells, cells may swell & possibly burst
113
Q

What are the needle sizes for Intradermal, SQ, and IM

A

Intradermal
- 25-27 gauge
- 3/8” to 1” long
- 10–15-degree angle w/ bevel up

Subcutaneous
- 24-26 gauge
- ½” to 1” long
- 45-degree angle w/ bevel up
o Up to 3mL

Intramuscular
- 21 gauge
- 1-2’ long
- 90-degree angle
o Up to 5mL

114
Q

What are the 10 rights

A
  • Right Patient
  • Right Medication
  • Right Dose
  • Right Route
  • Right Time
  • Right Education
  • Right to Refuse
  • Right Evaluation
  • Right Assessment
  • Right Documentation & Reporting
115
Q

Define A1,A2,B1,B2

A
  • A1 – Vasoconstriction
  • A2 – Gatekeeper for endogenous stuff
  • B1 – Heart rate, contract, conduct all increase
  • B2 – Broncho smooth muscle dilation
116
Q

Define the sub-receptors of the Parasympathetic sys

A

 Sub Receptors: Nicotinic & Muscarinic

  • Nicotinic – Skeletal muscle contraction
  • Muscarinic – SLUDGEM/DUMBBELLS
117
Q

What are the classes of Antidysrhythmic Meds

A

Class 1: Sodium Lidocaine
Class 2: Beta Blockers Beta Blockers
Class 3: Potassium Channel Blockers Amiodarone
Class 4: Calcium Channel Blockers Diltiazem

118
Q

Define Dose Response, Threshold, and Potency

A

Dose-Response Curve: Relationship with does and efficacy

Threshold level: dose at which cellular activity begins

Potency: The relationship of concentration and the cellular response

119
Q

What are the processes when a med enters the body

A
  • Absorption
  • Distribution
  • Biotransformation
  • Elimination
120
Q

Where do meds come from (sources)
(and what are they also categorized as i.e. natural…)

A
  • Sources of medications
    o Plant
    o Animal
    o Microorganism
    o Mineral
  • Medications are either
    o Natural
    o Semisynthetic
    o Synthetic
121
Q

Which side of the heart is the mitral valve and the tricuspid valve

A

mitral - left side

tricuspid - right side

122
Q

Define Babinski sign

A

toes move up (positive) or down (negative) In pediatrics under 2 years old the positive sign is normal,

but in adults the positive sign suggests central nervous system disorder or injury.

123
Q

Define Orthostatic Hypotension

A

o Systolic down 20, diastolic up 10, pulse up 20 = positive finding for Orthostatic Hypotension

124
Q

Cullens Sign vs Grey Turners

A
  • Cullen sign – blue discoloration periumbilical area
  • Grey Turners sign – blue discoloration along flanks
125
Q

Define Korotkoff Sounds

A

o Sounds related to a patient’s blood pressure

 5 phases, but only 1 & 5 are clinically significant
* 1st Phase: Faint tapping that increases in intensity, correlates to systolic contractions

  • 5th Phase: all sounds disappearing, correlates to diastolic pressure
126
Q

Define the heart sounds S1, S2, S3, S4

A

o S1
 Represents: Aortic Region, closure of AV valves
 Where heard: 2nd-3rd intercostal space at right sternal boarder

o S2
 Represents: Pulmonic Region, closure of Semilunar valves
 Where heard: 2nd-3rd intercostal space at left sternal boarder

o S3
 Represents: Tricuspid Region
 Where heard: 4th, 5th & 6th intercostal space at left sternal boarder

o S4
 Represents: Mitral Region, closure of Mitral valve
 Where heard: Apex of the heart, 5th&6th intercostal space at midclavicular line

127
Q

Define Egophony vs Pectoriloquy

A

o Whispered Pectoriloquy
 Preformed in the same manor but ask the patient to whisper “ninety-nine”. Should be muffled and indistinct, if loud and clear, positive sign.

o Egophony
 Place stethoscope over suspected area of consolidation and ask the patient to say a drawn out “eeeeeeee”. A normal response will be a muffled long vowel sound. However if there is any consolidation, the sound will sound like an “A”.

128
Q

Brassy crowing sound

A

o Stridor – brassy crowing sound often heard without stethoscope, upper airway, obstruction

129
Q

Define Differential Diagnosis

A

is the list of possible diagnoses based on patient assessment findings, and the working diagnosis is the one diagnosis from the differential list which you are basing your treatment plan

130
Q

What are the ages of Infants, Toddlers, Preschoolers, School Age, Adolescents, Early Adults, Middle Adults, Late Adults

A
  • Infants: 1 month – 1 year
  • Toddlers: 1-2 years old
  • Preschoolers: 3-5 years old
  • School Age: 6-12 years old
  • Adolescents: 13-19 years old
  • Early Adults: 19-40 years old
  • Middle Adults: 41-60 years old
  • Late Adults: 61+ years old
131
Q

Define Bioavailability

A

the percentage of unchanged substance that is present in the systemic circulation.

132
Q

Define Half-Life

A

the amount of time needed for the average person to metabolize or eliminate 50% of a substance in the plasma. The half-life of a drug is commonly expressed in minutes, but it is possible for the half-life to last for hours or even days.

133
Q

Where does most absorption take place?

A

the small intestine

(little absorption occurs in the stomach)

134
Q

What are the 5 major toxidromes

A

narcotic,
sympathomimetic,
sedative-hypnotic,
cholinergic,
anticholinergic

135
Q

Give examples and signs of Cholinergic Toxidrome

A

Ex. Organophosphates

Signs: DUMBELS: diarrhea, Urination, Miosis (constrict), Muscle weak, Brady, Emesis, Lacrimation (tearing of eyes) Seizures, respiratory depression, apnea (not breathing)

136
Q

Define Wernicke Korsakoff Syndrome

A

is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism. Damages nerve cells, part of the brain involved with memory.

137
Q

Define Nystagmus

A

Double vision, eyelid drooping

138
Q

Define DT’s

A

Delirium Tremens, withdrawal from alcoholism, fever sweating, agitation, seizures, can be fatal.

tremors, diaphoresis, confusion, fever, reslessness, and tachy

139
Q

Define SSRI

A

Selective Serotonin Reuptake Inhibitors

A class of anti-depressants that inhibit the reuptake of serotonin

140
Q

Acid vs Alkalis with water

A

Acid is more water soluble
(diluted quick)

Alkalis needs water continually flowing (takes longer)

141
Q

Signs- cold dry skin

could be…

A

sedative overdose

or alchol

142
Q

signs - resp slower 12 shallow

could be…

A

Sedative overdose

143
Q

signs - Pupils dilated and not reactive to light, shallow breathing, sluggishness, drowsy, lack of consciousness

could be…

A

Barbituate overdose

144
Q

Define Obtunded

A

Dulled or reduced level or alertness

145
Q

Define Labile

A

Rapidly shifting among different emotional states

146
Q

Metformin

A

class - anti-diabetic
for - type 2 diabetes
trade name - glucophage

147
Q

Atorvastatin

A

class - statin
for - high cholesterol
trade name - lipitor

148
Q

Omeprazole

A

class - proton-pump inhibitor
for - gerd, ulcers, heartburn
trade name - prilosec

149
Q

Define Agnosia

A

Failure to recognize objects

150
Q

Define Cataonia

A

Immobility and stupor

151
Q

What Does Sharkfin Wave form Indicate

A

Bronchospasm/Bronchoconstriction

Difficulty during the exhalation phase with incomplete alveolar emptying

COPD, asthma

152
Q

What are the Phases of the waveform?

A

Phase 1 (AB) Respiratory Baseline - initial exhalation
Phase 2 (BC) EXPIRATORY Upslope
Phase 3 (CD) Alveolar Plateau
Phase 4 (DE) INSPIRATORY Downstroke

153
Q

What are the 3 primary buffer systems in order of speed

A

1 Bicarbonate (Chemical) Buffer
2. Respiratory
3. Renal (kidneys)

154
Q

Name the parts

A

A. Vallecula
B. Epiglottis
C. Vocal Cords

D. PIRIFORM Fossae
E. Arytenoid/Corniculate

155
Q

Name the parts

A

A. Hard Palate
B. Oral Cavity
C. Tongue
D. Larynx
E. Thyroid Cartilage
F. Cricoid Cartilage
G. Nasopharynx
H. Soft Palate
I. Oropharynx
J. Epiglottis
K. Esophagus
L. Trachea

156
Q

Define Hypoxic Drive

A

Brain (CSF) starts using oxygen chemoreceptors to control breathing instead of normally CO2 receptors

usually end-stage COPD

157
Q

What is the normal total lung capacity of an adult man?

what is it broken into (4) ?

A

6,000mL total

  1. Inspiratory - 3,000 mL
  2. Expiratory - 1,200 mL
  3. Residual - 1,200 mL
  4. Tidal Volume - 500mL
158
Q

What is Tidal volume?

A

The amount of air that is moved into or out of the lungs during a single breath.

159
Q

What is Dead Space?

A

The area of the lung that has little or no gas exchange

usually 150mL

160
Q

Define Oxygenation

A

loading oxygen ONTO HEMOGLOBIN in the blood stream

161
Q

Define Respiration

A

Actual GAS EXCHANGE of oxygen and CO2 in the alveoli

162
Q

Define Ventilation

A

PHYSICAL act of MOVING air in/out of lungs

163
Q

Which cervical nerves control the diaphragm

A

C3 thru C5 keep the diaphragm alive

164
Q

The diaphragm is both a ________ and _________ muscle

A

voluntary (skeletal)

and

involuntary (smooth)

165
Q

Oxygenation _____________ occur without ventilation.

Ventilation is possible _________ Oxygenation.

A

Oxygenation __cannot__ occur without ventilation.

Ventilation IS possible without Oxygenation.

166
Q

Sedative drug and Dose (used for RSI)

A

Ketamine IV/IO

2mg/kg over 1 min

167
Q

Paralytic and Dose

(Dep and Non-Dep)

A

Dep-

SUCCS 1.5mg/kg IV/IO (rapid)

Non-Dep -

VECURONIUM 0.1mg/kg IV/IO

168
Q

Dose for Midazolam as a sedative (RSI)

A

18-68 y/o - 5mg IV/IM

69 (or over) - 2.5mg IV/IM

consult for repeat dose

169
Q

CPAP vs BiPAP Differences

A

CPAP:
Increases PRESSURE IN lungs, opens collapsed alveoli

PUSHES O2 across alveolar membrane, and forces interstitial fluid back into the pulmonary circulation

BiPAP:
Two Pressures (Ins iPAP/ Exp ePAP)
iPAP higher pressure for bases
ePAP lower pressure to keep bases open

170
Q

Define RHINORRHEA

What conditions may be associated

A

Thin, clear nasal discharge

Asthma,
Pneumonia,
Chronic BRONCHITIS,
COVID, RSV
(wet respiratory conditions)

171
Q

What are the 2 types of Respirations (which EXTERNAL or INTERNAL) ?

A
  1. PULMONARY Resp is EXTERNAL (alveoli)
  2. CELLULAR Resp is INTERNAL (in cells)
172
Q

Define Intrinsic and Extrinsic

A

Intrinsic (internal)
extrinsic (external)

pertaining to airway obstructions

173
Q

Anoxia

A

Absence of oxygen

174
Q

Define Peak Expiratory Flow

A

Estimate of the extent of bronchoconstriction, to determine if therapy is working

175
Q

Decrease the number of H+ (hydrogen) ions the more __________

A

Alkaline

Raises the PH

176
Q

Removal of Acids is performed by

A

Lungs and Kidneys

177
Q

What regulates the bicarbonate buffer

A

the kidneys

178
Q

What is the ratio of buffers to acids (bicarb to carbonic)

A

1:20

179
Q

What cells line the airways and produce mucous

A

Goblet Cells

180
Q

Alveoli function best when they are

A

partially inflated

181
Q

What causes a person to cough if too deep a breath is taken (prevents lungs from over inflating)

A

Hering-Breuer Reflex

182
Q

How can you assess gag reflex

A

Use eyelash reflex

183
Q

Name 4 uses of CAPNO

A

detection of ROSC
Effective CPR
Correct Airway placement
Detect hypo/hyper vent

184
Q

Term for positional dyspnea

A

Orthopnea

difficulty breathing while laying down

sign of heart failure or lung disease

185
Q

Define PACO2

A

its the partial pressure of co2 in ARTERIAL blood

186
Q

What is the Adult/ped dead space

Infant/neonate dead space

A

Adult/ped - 6.6mL
(et tube greater than 4.5mm)

Infant/Neo - 0.5mL

187
Q

What is the dip at the top of the wave form called (during exhalation)

A

Curare Cleft

during phase 3 C-D plateu

can be sign of bucking the tube, spontaneous resp effort (movement of the diaphragm)

recovering from paralytics

(needs more sedation)

188
Q

ph 7.6
co2 28
HCO2 29

A

Mixed Alkalosis

ph over 7.45 alk
co2 under 35 alk
hco2 over 26 alk

189
Q

ph 7.44
co2 37
hco3 25

A

normal

no acid/base disturbance

190
Q

Ph 7.2
CO2 37
HCO3 21

A

Metabolic Acidosis

uncompensated (no change in co2, resp)

7.2 - ph under 7.35 acid
co2 normal
21 - hco3 under 22 acid (metabolic)

191
Q

ph 7.6
co2 42
hco3 30

A

Metabolic Alkalosis

uncompensated (no change in co2, resp)

7.6 - ph over 7.45 alk
co2 normal
30 - hco3 over 26 (metabolic)

192
Q

The Renal system is also known as the

A

Metabolic System

(HCO3 measures it)

193
Q

pH 7.1
co2 26
hco3 19

A

7.1 acid
27 low alk (system thats compensating)
19 acid META

Partially Compensated Metabolic Acidosis

194
Q

pH 7.6
co2 25
hco3 20

A

7.6 alk
co2 25 low alk RESP
hco3 20 acid (system that’s compensating)

Partially Compensated Respiratory Alkalosis

195
Q

What defines a COMPENSATED

A

the co2 and the hco3 are opposite

but

the pH level is normal but FAVORING one side

so because its still normal is not partially.

196
Q

pH 7.42
Co2 24
hco3 19

A

Compensated Respiratory
Alkalosis

197
Q

Increase of H+ makes it more

Decrease of H+ makes it more

A

increase - acidic

decrease - alk

198
Q

What vol-control mode of vent kicks on when a patient takes a spontaneous breath with full tidal volume

A

assist control

199
Q

What are two volume control modes of vent

A

Assist control AC
CMV
SIMV
Pressure support

200
Q

How does the blood move from heart to the lungs

A

The Pulmonary Artery

201
Q

What is Polycythemia

A

Excessive red blood cell production

202
Q

How many lobes are in the L and R lungs

A

L - 2

R - 3

203
Q

The Diaphragm _________ during inhalation

A

flattens

204
Q

What is Atelectasis

A

Colapse of the aveoli

205
Q

How does an Emphysema patient present

A

Pink Puffer

Barrel chest, pursed-lips, tachypnea

206
Q

How does a Chronic Bronchitis patient present

A

Sleeps upright
Productive cough - waste basket full of used tissues, secretions

207
Q

Grunting is a _______ airway obstruction

A

lower

208
Q

Pink frothy sputum is an indication of

A

Heart failure

209
Q

Two most common UPPER ped airway emergencies

A

Croup and Pneumonia

210
Q

Which cranial nerve is major for the parasympathetic nervous system

A

X the vagus nerve

211
Q

Treatment for Epiglotitis

A

BVM,and poss ET tube (1-2 sizes smaller)

Limit agitation

212
Q

Treatment for Croup

A

IM Epi
Dex - corticosteroids
Neb Epi

IF ET needed use 0.5-1mm smaller

213
Q

What are the 3 Inherent rates of the conduction system

A

SA Node 60-100 bpm
AV Junction 40-60 bpm
Ventricles 20-40 bpm

214
Q

Parasympathetic Stimulation causes

A

Decreased:
Slows DOWN HR
AV conduction
Decreased Irritability

only affects the atria

215
Q

List the (6) areas of the conduction system in order which the impulse travel through the heart

A
  1. SA Node
  2. Intratrial and Intrernodal Pathways
  3. AV Node
  4. Bundle of His
  5. Bundle Branches
  6. Purkinje Fibers
216
Q

What are the 6 H’s

also known as

A

Hypovolemia
Hypoxia
Hydrogen Ions (Acidosis)
Hypo and Hyper Kalemia
Hypothermia

probable causes

217
Q

What are the 5 T’s

also known as

A

Tension Pneumo
Tamponade Cardiac
Toxins
Thrombosis Coronary
Thrombosis Pulmonary

probable causes

218
Q

Treatment for Hydrogen Ion (Acidosis)

A

Sodium BiCarb

airway management
CPR

219
Q

Treatment for Hypo-HyperKalemia

A

Hypo - not much (needs potasium)

Hyper -

CA- SIGH - K

1 Calcium Chloride

2 Albuterol
Hco3 - sodium bicarb
I insulin
G glucose (dextrose)

3 Hemodialysis
Kayexelate

1 Stablize/ 2shift /3excrete

220
Q

Treatment for Toxins

1 organophosphate
2 beta blocker OD
3 TCA OD
4 opioid OD

A

1 Atropine for organophosphate poisoning

2 beta blocker OD = glucagon

3 TCA OD = sodium bicarb

4 opioid OD = naloxone

221
Q

H and T are most important with

A

PEA
Cardiac Arrest

222
Q

What is the hr of brady

A

less than 50 (for treatment)

223
Q

When should you avoid Atropine

A

When there is a high degree block
(2nd type II, 3rd Degree)

go right to pacing

224
Q

What class intervention is Dopamine and Epinephrine Infusions

A

Class IIb

225
Q

For Brady what is the quick treatment atde

A

All
Trained
Dogs
Eat

Atropine
TCP
Dopamine
Epinephrine

226
Q

with ROSC

wide QRS (H’s and T’s)

narrow QRS (H’s and T’s)

A

wide - toxins, metabolic

narrow - obstructive, tamponade, tension pneumothorax

227
Q

What are the 2 shockable rhythms to DEFRIBRILLATE

A

V- Fib (squiggly worms)

Pulseless V-Tach (no pulse) (tombstones)

228
Q
A

Accelerated Junctional with unifocal PVC’s

PVC - early ventricular, unifocal because they look the same

junctional originates from av junction,

Junctional and hr is 60-100 so it’s accelerated junctional!

229
Q

-

A

Ventricular Tachycardia

100-250 bpm

wide tall bizarre QRS

230
Q
A

3rd Degree AV Block

Complete heart block no relationship between P and QRS

QRS can be both narrow or wide

P-R interval varries

231
Q

-

A

A Fib

fast atrial activity, lots of f waves R_R irregular,

232
Q
A

Sinus with PAC

early atrial activity
early p wave looks different

233
Q
A

SVT

hr 160-250

cant see P waves so fast

vagal then cardiovert

234
Q
A

Sinus with Atrial Pacing

235
Q
A

Accelerated Junctional

Can’t see the p waves so it’s junctional and the hr is 80

60-100 accelerated

40-60 junctional escape

100-180 junctional tachy

236
Q
A

Idioventricular Rhythm

Here are the rules for Idioventricular Rhythm (Figure 78):
Regularity: usually regular
Rate: 20–40 bpm; can drop below 20 bpm
P Waves: none
PRI: none
QRS: wide and bizarre; 0.12 second or more

237
Q

What lead are we looking at when placing PADs

A

Lead 2

238
Q

how many small boxes is a 6 second strip

A

150

239
Q

What are the 3 types of pacemakers & how do we know the difference when viewing these EKG’s?

A

a. Atrial- Pacer spike followed by p wave & normal QRS

b. Ventricular-Pacer spike followed by wide QRS

c. AV Sequential/ Dual-Pacer spike followed by p wave AND pacer spike followed by wide QRS

240
Q

My rate is 30bpm. My complexes are regular (they all march out). I have NO P waves and my QRS is >.18s

A

idioventricular

241
Q

My rate is 30bpm. My complexes have a ‘normal’ morphology of P, QRS & T waves that all look the same. I am a regular rhythm.

A

Sinus Brady

242
Q

The AV node is my gate keeper. I am throwing a lot of signals at it from all different foci in both atria. The AV node will let 152 signals through in one minute.

A

Uncontrolled a-fib (A-fib with RVR (rapid ventricular response))

243
Q

My rate is 80. I have a complex with ‘normal’ morphology (P, QRS & T waves) followed by a complex with a QRS of .14s and no p wave! This pattern continues.

A

Ventricular Bigeminy

244
Q
A

SVT with a wide QRS

245
Q
A

Atrial Fibrillation (controlled) with 2 unifocal PVC’s

246
Q
A

Sinus Brady with 1 PVC

247
Q

how much time is between the two heavy lines on a graph

A

0.20 seconds

248
Q

What must occur for the heart to contract

A

muscle cells must receive electrical stimulus

249
Q

What is the atrial rate in a-flutter

A

250-350 bpm

250
Q

To get the accurate rate you would count small squares between R-R and divide by

A

1500

251
Q

What is the drug dose of Lidocaine

and when do you give?

A

0.5-0.75mg/kg

Tachy

252
Q

what is the drug dose of cardizem

when do you give

A

.35mg/kg IV

tachy

253
Q
A

Junctional Tachycardia

inverted P wave
rate 101-180

254
Q
A

Accelerated Junctional

inverted P wave

rate 61-100

255
Q
A

Junctional with P waves after QRS

rate 40-60 bpm

256
Q
A

Atrial Flutter

F waves, saws,

QRS narrow
atrial rate 250-350

257
Q

Where is sodium and potassium during ready state

A

Sodium is outside and potassium is on the inside

258
Q

Define R on T

A

situation where stimulation could put heart into v-tach

  • PVC hits on relative refractory
  • Vulnerable to sending into v-tach
259
Q

What is 1 beat of the heart called

A

stroke volume (ejection fraction)

260
Q

How do you find cardiac output

A

Stroke volume x HR

261
Q

Define

Excitability
Automaticity
Contractility
Extensibility
Conductivity

A

Excite = response to electric

Contractility = squeeze

Auto = create impulse

extense = stretch,expand

conduct = pass electric

262
Q

What are the ECG rules

A
  • Are there p-waves
    o Are they present?
    o Are they 1:1 QRS?
    o Are they upright?
    o Do they look the same/ alike?
  • Regular or irregular
    o R-R the same?
    o Extra beats? Are they early or late?
    o Are PRIs the same?
  • Rate
    o R-R interval, count the boxes / 1500
    o Count complete cycles x 10 (if 6 sec strip)
    o Triplicate method (least accurate)
    o Are the p-waves the same rate as R waves? (3rd deg.)
  • QRS
    o Wide or narrow?
    o What do they look like? Do they look alike?
    o Equal duration?
  • PRI
    o 0.12 – 0.20
263
Q

Define PVC

A
  • Premature ventricular complex
  • Has compensatory pause
  • If all match = unifocal; if they don’t match = multifocal
264
Q

Define PJC

A
  • p wave inverted
  • or p-wave missing
  • underlying rhythm needs to be mentioned
265
Q
A

Sinus Tachycardia

Hr 100

266
Q
A

SVT (no P waves seen)

267
Q
A

A-Fib

f waves, irregular R-R
350-600 bpm Atrial rate

multiple sources trying to fire in the atrium other than SA Node

lots of squiggles

268
Q
A

A flutter

instead of P waves there are F waves,

sawtooth or sharkfin f waves

269
Q
A

A fib, with bigeminy of PVC’s

afib - f waves, irregular R-R
350-600 bpm Atrial rate

multiple sources trying to fire in the atrium other than SA Node

lots of squiggles

PVC - premature ventricular contractions, wide bizarre, early

270
Q
A

A-fib with 2 unifocal PVCs

271
Q
A

V-Tach

wide, bizarre QRS

272
Q

Define Coast Map

A

C - consciousness
O - orientation
A - activity
S - speech
T - thought

M - memory
A - affect
P - perception

273
Q
A

Sinus with Trigeminy of PVCs

274
Q
A

Sinus with a PJC

275
Q

You can’t see my P-wave, nor can you determine my PRI. My QRS-duration is 0.10 seconds. My R-R intervals are regular, and my rate is 146.

A

Junctional tachy

276
Q

P-waves than QRS-complexes. My PRI gets progressively longer until one of my PRIs doesn’t want to show up to the party. My QRS-duration is 0.11 seconds. My R-R intervals are irregular.

A

2nd Degree Type 1

Paramedic (24 decks)

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