121-2 Study Guide Flashcards
- When do you start scene size UP?
From the moment you are dispatched
What constitutes hazards on a scene
Environmental, physical, chemical,electrical,water, fire,explosion,threat of physical violence
What situations require additional resources.
Patient needs ALS,hazardous materials,complex extrication,any situation that puts you or your partner at risk
What additional resources are available
Law enforcement,fire,hazmat teams,search and rescue,ALS, medi-vac
Purpose of primary assessment
To identify and begin treatment of immediate or imminent life threats
Components of primary assessment
*general impression
*look for uncontrolled excessive bleeding
*Assess loc
* identify life threats
* ABC’s
* rapid exam
When do you form a general impression
As you approach a patient
How do you form a general impression
Notice things like age, sex, race, level of distress, and overall appearance
Level of consciousness vs orientation
Loc = avpu
Orientation= person, place, time, event
What are the various methods of airway management
*chin lift head tilt
*jaw thrust
*BVM
*suction
* NPA
*OPA
* supraglottic
* ETT
NPA and its contraindications
Nasopharengial airway
Contraindications: severe head injury with blood drain from the nose, history of fractured nasal bone, facial fractures
OPA and its contraindications
Oraipharengial airway
Contraindications:conscious patients, anyone with an intact gag reflex
Supraglottic contraindications
Any patient who is consious or has intact gag reflex
When can you not use the head tilt chin lift
Any time spinal trauma is suspected
When do you use the jaw thrust maneuver
When a spinal injury is possible
Types of supragiottic airways
I gel
King tube
LMA
I gel
Heat activated forms to body, measure by weight
King tube
Measure by height, 2 balloons
When is a nasal cannula needed
For comfort care in patients with mild hypoxia 1-6 liters
When is a non rebreather needed
In patients with severe hypoxia who are otherwise breathing adequately
Artificial ventilation
Patients in respiratory arrest, unconscious
CPAP
Continuous Positive airway pressure: use in patients who are alert and displaying obvious signs of respiratory distress from underlying pathology such as c0pd or chf
How should you perform assisted ventilations
- Explain procedure to patient
- Place mask over nose and mouth
- Squeeze bag each time patient breathes
4.after the initial 5-10 breaths slowly adjust rate and deliver an appropriate tidal volume 5. Adjust tidal volume to maintain adequate min volume
Normal vital sign ranges
RR 12-20
HR 60-100
BP 90-120systolic
When is the appropriate time to receive vitals
secondary assessment every 5 min for an unstable patient every 15 for stable patient
When should you provide assisted ventilations
When a patient is in severe respiratory distress and is not breathing adequately
What does cyanosis indicate
Insufficient air exchange and low oxygen levels
What does pale, white, ashen, or grey skin indicate
Poor peripheral circulation
What does a bluish tint around the mouth or finger tips indicate
Cyanosis
What does a yellowish tint to the skin indicate
Jaundice
What causes jaundice
Liver disease or dysfunction
How does a pulse ox work
Measures the percentage of molecules that are bound to arterial blood
What might cause false pulse ox readings
The pulse ox can’t differentiate CO from 02
Respiratory system anatomy superior to inferior
Nasopharynx, nasal air passage, pharynx,oropharynx, mouth,epiglottis, larynx, trachea carina,, bronchi, bronchioles pulmonary capillaries, alveoli, diaphragm
What are the accessory muscles used when a patient nas has difficulty breathing
Sternocleidomastoids( neck muscles), pectoralis( major muscles of the chest),and abdominal muscles
What is the difference between respiratory distress, arrest, and failure
Distress:abnormal respiratory rate or effort
Failure: inadequate oxygenation,ventilation,or both
Arrest: absence of breathing
What does sample stand for
S: signs and symptoms
A: allergies
m: medications
P: pertinent past medical history
L: last oral intake
E: events leading up to injury or illness
What does opqrst stand for
O: onset
p: provocation
Q: quality
R: region/radiation
S: severity
T: timing
AVPU
A: awake and alert
v: responsive to verbal stimuli
P: responsive to pain
u: unresponsive
AA0x4
Person, place, time, event
Sign vs symptom
Sign: an objective finding
Symptom: subjective experience reported by a patient
When is reassessment done
After secondary assessment
What is the difference between base station, mobile radio, portable radio, and repeater
Base station:contains transmitter and receiver is located in a fixed place
Mobile: installed in a vehicle
Portable: hand held
Repeater: special base station radio that receives messages and signals on one frequency then automatically retransmits them on a second frequency
What to communicate and in what order
Acknowledge call
En route to call
On scene
On route to hospital
Arrival to hospital
Return to service
What is included in a pcr
Cneif complaint
History
Assessments
Treatments (rx)
Transport
Subjective vs objective
Subjective: perceived by the patient
Objective: definite findings
What is cardiogenic shock
Inadequate heart function
Disease of muscle tissue
Impaired electrical system
Disease or injury
What conditions cause cariogenic shock
CHF
MI
What does CHF stand for
Congestive heart failure
What does MI stand for
Myocardial infarction
What is obstructive shock
Obstruction of the cardiac muscle due to an outside source
What conditions cause obstructive shock
Pulmonary embolism
Cardiac tamponade
Tension pneumothorax
What is a pulmonary embolism
A blood clot in the lungs
What is a tension pneumothorax
A collapsed lung
What is cardiac tamponade
Buildup of fluid in the paricardial sac
What are the 3 types of distributive shock
Septic shock
Anaphylactic shock
Neurogenic shock
What is happening in distributive shock
Abnormal vasodilation
What is septic shock
Infection in the bloodstream
What is anaphylactic shock
Severe allergic reaction that effects at least 2 body systems
Neurogenic shock
Damaged cervical spine causes widespread vasodilation
What is hypovelimic shock
Low Volume; Loss of fluid
Massive hemorrhage
Severe dehydration
Explain the process of inhalation
- Air enters through nose/mouth
- Volume in the plural cavity increases and pressure decreases
3.diaphragm and intercostal muscles contract
4.In the alveoli co2 and oxygen are exchanged
5.Oxygen molecules move into the capillaries where they bind with hemoglobin
6.Hemoglobin carries and delivers oxygen to the cells and tissues of the body
Explain the process of exhalation
- Diaphragm and intercostal muscles relax
- Volume decreases and pressure increases
- Co2 is exhaled
Decompensated shock
The late stage of shock when blood pressure is falling
Compensated shock
The early stage in shock where the body can still compensate for blood loss
What is a sign in septic shock that differs from all other types of shock
Warm skin/fever
What is pulse pressure
The difference between systolic and diastolic pressure
What is preload
The precontraction pressure in the heart as the volume of blood builds up
What is after load
The force or resistance against which the heart pumps
What is hypoperfusion
Low flow of blood through the body’s tissues and vessels
What is shunting
Blood moved away from organs that can last longer without oxygen and moved to vital organs
What is capnography
Measures the concentration of co2 being expelled
What is the golden hour
The time from injury to definitive care during which treatment of shock and traumatic injuries should occur because survival potential is best
What is tidal volume
The amount of air in mL that is moved in and out of lungs in 1 breath
Aerobic metabolism
Metabolism that can proceed only in the presence of oxygen
Anaerobic metabolism
The metabolism that takes place in the absence of oxygen: main byproduct is lactic acid
Minute volume
Volume of air that moves in and out of lungs in one min
What is the primary cause of cardiac arrest in infants
Respiratory arrest
Visceral pleura
Thin membrane that covers the lungs
