2 Prehospital Equipment Flashcards
`4 basic questions regarding efficacy of EMS equipment:
- Does it do the job?
- Is it safe?
- Can it be applied to the field environment?
- Can it be used effectively by prehospital personnel?
Exposure to hazardous material or biologic or chemical weapons of mass destruction requires more protective equipment. Minumum PPE for such exposure include:
a high-efficiency particulate air filter mask the filters 99.97% of airborne particles 0.3 um in diameter
(or an acceptable alternative for the purpose, such as M95 military gas mask),
googles, gloves, and protective clothing
protective clothing should be nonabsorbent and puncture resistant
some urban EMS providers wear soft body armor as a standard part of the uniform. Although each service must consider such variables as comfort, heat, weight, and cost, for EMS providers, _______ is optimal
a combination of ballistic/stab protection
most important factor in surviving a cardiac arrest
early defibrillation
AEDs are designed only to shock the following rhythms:
ventricular fibrillation
very fast ventricular or supraventricular tachycardias (usually >180 bpm)
remarks on biphasic defibrillators
these defibrillate and cardiovert at lower energy levels and thus decrease myocardial injury
TRUE or FALSE
prehospital 12L ECG showing STEMI leads to reduced door-to-balloon time and reduced mortality
TRUE
simplest devices for airway management after manual airway maneuvers
oropharyngeal and nasopharyngeal airways
These basic airway adjuncts usually are paired in the field with a simple bag-valve mask device for ventilation and will work quite well together.
Combitube is used for adults and adolescents that are:
> 48 inches tall or age >14 y/o
Which of the following may not prevent aspiration:
A. Combitube
B. LMA
C. King LTS-D
LMA
Combitube and King-LTS-D prevent/minimize aspiration
Which of the following will still allow ventilation even if inadvertently placed in trachea:
A. Combitube
B. LMA
C. King LTS-D
Combitube and King-LTS-D
LMA can cause respiratory obstruction if incorrectly placed
Which of the following cannot be used if gag reflex are present:
A. Combitube
B. LMA
C. King LTS-D
all three
other features of King-LTS-D
has port for gastric decompression tube
TRUE or FALSE
Supraglottic airways may decrease hands-off time during resuscitation, but there is limited prehospital evidence to suggest that any advanced airway offers a neurologic survival benefit compared to simple bag-valve mask use
TRUE
the “gold standard” for airway management in all patients
endotracheal intubation
and is especially used in patients in whom the other airway adjuncts are not satisfactory
the majority of ALS systems use endotracheal intubation as the airway of choice for patients in respiratory failure or with an unprotected airway
Guidelines for cervical spine clearance in the field
absence of neck pain, tenderness, or discomfort
age between 11 and 65 y
no altered sensorium
no intoxication
no distracting injuries
remarks on spinal immobilization in the field
the first person to assess the patient should immobilize the cervical spine immediately,
and if necessary, simultaneously perform a modified jaw thrust to open the airway.
*Manual stabilization of the neck is not released until the patient has been transferred and securely strapped to a board.
The responder may also clear the spine in the field.
TRUE or FALSE
Once the patient is well secured to the board, the collar does not add a significant amount of stabilization and actually can be removed without compromise of the spine
TRUE
however, it is often left in place for added protection.
For adequate immbilization, the patient needs to be strapped on the backboard and secured with head blocks and head straps
TRUE or FALSE
Soft cervical collars are not adequate or appropriate for prehospital care.
TRUE
If the patient is sitting in a car after an accident and is stable from respiratory and circulatory standpoints, what is the sequence of spinal immobilization?
a **short spine board* and rigid cervical collar are first used to get the patient out of the vehicle safely and onto a long spine board
If the patient is sitting in a car after an accident and the situation is critical (patient’s condition or the threats of hazard), what is the sequence of spinal immobilization?
the patient can be extricated more rapidly using only the cervical collar.
After applying the cervical collar, the patient is carefully rotated out and slid onto the waiting long board
other remarks on spinal immobilization and clearance
Immobilization on a rigid board produces midline cervical pain and tenderness, so examination and radiographs should be performed promptly on arrival
In general, patients should not be removed from immobilization until the spine has been cleared clinically and radiographically
preferred device for stabilization of femur fractures
femoral traction splint
traction splints for the tibia should be reserved for the
angulated or displaced
otherwise, an air splint or a pillow splint would suffice
simplest stabilization method for the pevlis
a sheet wrap, applied aroun the patient at the level of the trochanter and fastened with a clamp or hemostat
