1338 Exam Flashcards
What is normal pH in the body?
7.35 - 7.45
What pH range is considered an acidosis?
7.35 and under
What pH range is considered an alkalosis?
7.45 and greater
What is quality assurance?
monitoring a particular procedure or a process in order to ensure that they are up to the expected levels of quality standards.
What does quality improvement refer to?
Refers to the techniques used by the organizations for continuous quality improvements.
Aspects of quality improvement
leadership, info, strategic planning, HR management
EMS process management
EMS system results
Satisfaction
High potassium
Hyperkalemia
Low potassium
Hypokalemia
High Calcium
Hypercalcemia
Low Calcium
Hypocalcemia
What are the physiological stressors?
Stressor, Eustress, Distress, Burnout.
Stressor
a stimulus that causes stress
Eustress
Good stress; ex. seeing loved one for 1st time in years
Distress
Bad stress; negative effects
Burnout
Extreme endpoint of stress.
Anxiety disorder that develops following exposure to traumatic events
PTSD
Where is Epi made in the body?
Adrenal gland - adrenocorticotropic hormone
Hormone made by the pituitary gland that controls the production of the hormone Cortisol and Epi
adrenocorticotropic hormone
Where is cortisol made in the body?
adrenal glands
What does BSI refer to?
Refers to the type of PPE that should be worn.
Gloves, masks, eyewear, n95, gowns, resuscitation equipment, and hand washing supplies all constitute:
PPE
PPE for TB exposure:
Must wear HEPA/N95 mask
PPE recommendations come from:
the CDC
Standard precautions (PPE)
Blood and body fluid precautions
BSI:
Body substance isolation
Reasonably careful man performing similar duties and under the same circumstances, would act in the same manner.
Due Regard
Points of consideration taken in to account by courts when determining due regard:
Was it reasonably necessary to use the signaling equipment, given the circumstances?
Was the signaling equipment actually used?
Was the signal audible and/or visible to motorists and pedestrians?
Exercise reduces levels of the body stress hormones, such as:
Adrenaline and Cortisol
Exercise also stimulates the production of ____, chemicals in the brain that are the body natural pain killers and mood elevators.
endorphines
The granting of permission to treat and touch
consent
Type of consent called emergency doctrine; unconscious; this stops whenever pt regains competence or no longer needs care.
Implied consent
Type of consent given based on full disclosure of info; most refusals fall into this category.
Informed consent
Consent that directly grants permission to treat; verbal/nonverbal/writing most common.
Expressed consent
Consent in which the police or power of attorney make decisions for the patient.
Involuntary consent
prevents lawsuits on the front end; completed promptly
Documentation
addition or supplement to the original report
addendum
Known as “moral philosophy” and addresses what is right/wrong in conduct
ethics
Preauthorized protocols are called
standing orders
More explicit and specific in detail than guidelines; in that they specify who does ‘what,’ ‘when,’ and ‘how.’
Protocols
Common type of advance directive signed by patient and their representative
DNR
Who can rescind DNR on scene?
Family
Legislative law. Law created by lawmaking bodies
Statutory law
Administrative law; enacted by admin or government agency. Ex. OSHA
Regulatory Law
Example of regulatory law body. (regulatory compliance group.)
Texas Department of State Health Services
Case law; adaptive laws to meet customs and norms.
Common law
Crime and punishment; violations against society; prison/fine
Criminal law
noncriminal issues (personal injury, contract disputes, and matrimonial issues)
Civil law
Person in court who is the recipient of the complaint
Defendant
Person in court who has made the complaint.
Plaintiff
Civil wrongdoing committed by 1 person to another; ex. negligence, medical malpractice, assault, battery, and slander.
Tort law
Unlawfully placing a person in apprehension (fear) of immediate bodily harm without consent. (verbal threat)
Assault
Unlawful touching of another individual without consent.
Battery
Need ____ for assault, stabbing, and GSW calls.
Police
recognition granted to an individual who has met predetermined qualifications
Certification
process used to regulate occupations
license
What to use to decontaminate directly after TB exposure:
Medium level disinfectant. Cleaning w/ disinfecting agent directly on surfaces.
PPE used for TB (all of it, not just mask)
gloves, masks, eyewear, n95, gowns, resuscitation equipment, hand washing supplies.
What is the most important piece of PPE for TB?
Mask
the amount of blood delivered to the heart during diastole; defined as tension of cardiac muscle fiber at the end of diastole; amount of blood coming into vena cava in right side.
Preload
The resistance a contraction of the heart must overcome in order to eject blood; defined as the tension of cardiac muscle during systole; resistance in systemic system when left ventricle pumps
Afterload
the amount of blood ejected by the heart in one contraction.
stroke volume
What reduces your contact/chances of catching sickness compared to a mouth to mask?
BVM
What kind of bone makes up your ribs?
flat bones
Cation charge
positive
anion charge
negative
practices and procedures used to minimize disease
infection control practices
Notify ____ If exposed to infection disease.
infectious control agency
Only report ____ when documenting.
facts
Report all ____ to police.
assaults
KKK standards came from
DOT
___ increases risk for injury.
weight
If exposed to an infectious disease, notify ___.
infection control supervisor.
____ based practice is how EMS advances
evidence
Changing things to meet the new standards is an example of?
CQI
Levels of EMS providers
EMR, EMT, AEMT, Paramedic
Landmark paper that started organized pre-hospital care
1966 accidental death and disability: the neglected disease of modern society.
Term that means not to discuss anything in a run report.
Confidentiality
Organization that creates and produces tests for certification.
NREMT
Airborne pathogens are blocked by
masks
It is difficult to get EMS ____ going.
research.
Compensated shock (reversible)
Change in LOC, increased pulse and respirations, cool pale skin, normal to slightly increased BP (increase due to initial vasoconstriction.)
Uncompensated shock (irreversible)
Decrease in LOC or unconscious, decreased HR, decreased respirations, Cyanosis, Hypotension.
Neurogenic shock (spinal cord injury)
Warm dry flushed skin and normal capillary refill, neurologic deficit, change in respiratory pattern (diaphragm breathing), hypothermia, hypotension, HR normal or bradycardia.
Most commonly injured part of the spine?
Cervical Vertebre
What nerve controls the chest wall? (C2-C4)
Phrenic nerve.
Anaphylactic Shock:
itching flushing hives, swelling of eyelids face and tongue, chest tightness (SOB and wheezing), severe dyspnea, abdominal cramps, N/V, diarrhea, tachycardia, hypotension.
Causes immunoglobin E response which causes histamine release (dilates blood vessels and bronchoconstriction)
Antigen
How are antigens introduced to the body?
injected, inhaled, transdermal, mucus membranes, ingested.
Allergic reaction with only skin symptoms.
local reaction
allergic reaction with airway symptoms but BP is normal.
Moderate reaction.
Allergic reaction with low BP
Severe reaction
How to treat local allergic reaction
benadryl
how to treat moderate allergic reaction
SQ epi and benadryl
how to treat severe allergic reaction
IV epi push, Benadryl, fluid bolus, steroids.
Psychogenic shock
Fainting with no sign of serious injury or illness,
SOB,
anxious,
increased HR respirations and BP.
Respiratory alkalosis due to hyperventilation. Normal SpO2
Septic shock
elevated temp initially
decreased temp late
petechaie
decreased LOC
Septic shock
elevated temp initially
decreased temp late
petechaie
decreased LOC
creeping mottling
tachycardia and hypotensive from vasodilation
Treat with fluids and consider dopamine.
Prehospital treatment for anaphylactic shock
fluids 20mg/kg total bolus
start w/ range of 250-500ml of fluid then evaluate pulses, lung sounds, LOC
For controlled bleeding maintain systolic BP of 90 palpable or total bolus
For uncontrolled bleeding total bolus of 20ml/kg or to maintain radial pulses - do not want to overfill vascular space because it will lead to more bleeding.
Cardiogenic shock
Dyspnea
rales
tachycardia and decreased BP
increased respirations, diaphoresis, and arrhythmias
increased blood volume in lungs and liver due to pump failures (CHF)
Treatment consider dopamine to increase bp 2-20mcg/kg/min
