4 Flashcards
Occipital
Part of brain that controls vision
OD of tricyclic’s will cause all except
Inverted P wave
Of the following, the most neurotoxic snakebite comes from the
Coral Snake
Of the following, the one that is not a vasopressor is
Atropine
Of the following, the one that is Not Highly Contagious is
Shingles
Old lady thinking neighbors are out to get her
Remove her from the situation and keep talking to her.
One Sx / Sx of Hypoglycemia is
Polyuria
One of the first signs of shock
Restlessness, Elevated Heart Rate
One of the following may occur during the aging process Except
Feel or Thirst
One of the least important things to assess neurological status is if the patient has
Deep Tendon Reflexes
One Pupil Blown, other Sluggish
Neuro Crisis
Oral / Fecal disease
Hepatitis A
Organophosphate poisoning
Atropine
Organophosphate poisoning
Vomiting, Sweating, Diarrhea, (SLUDGE) Salivation, Lacrimation, Urination, Diarrhea
Orthostatic
Taking the patients BP while patient is laying down, sitting up, then standing at 2 minute intervals
Osmosis
Lesser Concentration to a Greater Concentration
Over hydration can of a patient can cause
Rales
Overdose of trycyclics causes all Except
Inverted P -Wave
Over hydrating IV therapy
Pulmonary edema
Pain in Chest and Back, Tearing / Shearing Pain Towards the Neck, Negative Brachial Pulse
Dissecting Aortic Aneurysm
Pain in chest, “tearing and shearing” pain towards neck with no pedal pulses
Dissecting Aortic Aneurysm
Pale skin (pallor) caused by
Vasoconstriction
Palpate abdominal quadrants in what order
UL, UR, LR, LL, Unless with pain in specific area then palpate away from that area moving into the area slowly
Paranoid patients should Not be dealt with by
Going along with the delusions
Parasympathetic Stimulation causes
Slowing of the Heart Rate
Parasympathetic Neurotransmitter
Acetylcholine
Peritoneum
Surrounding ABD wall
Part of Brain that Controls Posture
Cerebellum
Pathways to the brain
Sensory
Patient Choking, has Partial Obstruction, you
Encourage him to Keep Coughing
Patient complains of weakness, taking digitalis daily, awake, alert with vitals WNL you should
Monitor / Transport
Patient drooling with obvious Epiglottitis
Transport sitting up
Patient has ___ Gaze
Eyes Not Working Together
Patient has been decontaminated from radiation, comes to you
Low Threat
Patient has one blown pupil & the other reacts slowly to light
Neurological crisis
Patient in Diabetic Ketoacidosis will have
High Blood Sugar, Grossness in the Heart, Dry Skin
Patient in Diabetic Ketoacidosis will most likely have
Increased BP & Hot dry skin
Patient in Irreversible Shock, most likely have
Pulse Lower than Normal
Patient in nursing home has More Output then Input
Electrolyte Imbalance
Patient is Diabetic with a BS of 40. Which action would you Not do
IV Insulin
Patient is jaundice
Viral Hepatitis
Patient is numb from Zyphoid Process down
T - 4 / Thoracic
Patient is over hydrated, may have
Rales or Edema
Patient is talking very fast “suspect OD on”
Amphetamines
Patient lying down with S.U.B
Orthopnea
Patient presents with Jaundice, coke colored urine, etc
Hepatitis
Patient presents with Rhonchi and fever with no edema, etc.
Pneumonia
Patient presents with Urticaria, BP 80/40, P 120, Tachypnea, Wheezing
Anaphylaxis
Patient says “I hear bells in my head”
Aspirin OD
Patient shows signs of PE, 2 IV’s have been started, Next you
Administer 0.4 mg of Nitro
Patient sitting at 45 degrees with JVD
Heart Failure
Patient sitting up with Pink, Frothy Sputum
Left Heart Failure
Patient taking Digoxin and is in V Tach, Why would it Not work
Because patient is taking Digoxin
Patient trying to commit suicide with grass detergent agent (Organophosphate) is
Atropine
Patient Unconscious with return to Normal in 3 - 5 minutes
Concussion
Patient unconscious, does Not respond to verbal or pain what is GCS
3
Patient who had a syncopal episode do all except
Lift patient in sitting position
Patient with A Fib, takes Dig, Unstable with rapid ventricular response, Problem to Sync, Why?
Prone to Clots and therefore Embolism
Patient with DKA Presents
Warm & Dry Skin
Patient with high fever
Use tepid towels
Patient with history of (WPW (Wolfe-Parkinson White) in PSVT, with No Sx/Sx
Adenosine 6 mg rapid IV bolus
Patient with history of WPW in PVST, with no Sx / Sx
Adenosine 6 mg rapid IV bolus
Patient with increased ICP, Expect
Increased BP and Decreased Pulse
Patient with Intracranial pressure. First treatment should be
Hyperventilate
Patient with JVD, Put patient in a
Semi- Fowlers at 45 degree angle
Patient with Low BP, Warm & Dry Skin, and with Bradycardia
Neurogenic Shock
Patient with Orthopnea, place him is a
Sitting position
Patient with pH -7.30, PCO2 - 50, PO2 - O2
Respiratory Acidosis
Patient with productive cough, fever, weight loss
Tuberculosis
Patient with pulsating mass in abdomen, obvious AAA threat: all Except
NorEpi IVP
Patients with chronic bronchitis are called
Blue bloaters
Pea - Shaped Gland
Pituitary
PEA
No heart rate with electrical activity
People with AIDS, how do most people present
Normal, unable to tell
Percentage of Blood consisting of Red Blood Cells
Hematocrit
Person Experiencing Mood Swings
Maniac Disorder
Ph Above 7.45
Alkalosis
PH below 7.35
Acidosis
Phrenic Nerve
Responsible for controlling the Diaphragm
Physician can best prepare for Pt. with what information
Chief Complaint, History & Interventions taken so far
Pink Puffers and Blue Bloaters are associated with what type of patient
Emphysema, Chronic Bronchitis
Pink Puffers have
Emphysema
Place for decompression
2nd or 3rd Intercoastal space, Midclavicular line, or 4th or 5th Midaxillary
Pneumonia
Patient presents not feeling well, fever, productive cough
Poisonous Neuro Toxic
Coral Snake
Position a patient with Abdominal Pain in
Lateral Recumbent
Possible Abdominal Aortic Aneurysm
All except Norepinephrine
Pre-hospital treatment for fever
Remove clothing
Primary concern in treating a near drowning victim is
Hypoxia & Acidosis
Primary problem with asthma attack
Bronchoconstriction
Principal Buffer
Bicarb
Process by which cell size decreases
Atrophy
Pryrogenic reaction
Fever, chills, nausea & vomiting
Psychotic patients are
Not in touch with reality
Pt. is Diabetic with a blood sugar of 40, which action would you Not do
IV Insulin
Pt. sitting up with pink frothy sputum
Left heart failure
Pt. with increased intracranial pressure should be
Hyperventilated
Pulse Oximetry Measures
O2 Saturation in Peripheral Tissue
Pursed lips and Barrel chest
Emphysema
Pryrogenic Reaction
Fever, Chills, N & V
Rapid cooling of a heat stroke patient is done to prevent
Irreversible Brain Damage
Rapid onset of this condition will cause brain damage
Hypoglycemia
Red, purple or blue lesions on AIDS patient
Kaposi’s Sarcoma
Reentry may cause
Premature beats or Tachydysrhythmias (i.e. PAC)
Regarding a psychiatric patient, it is advisable to
Wait for assistance if the patient is violent
Regulates breathing, etc
Medulla
Rescue breathing pushes diaphragm
Increasing ventricular rate
Respirations of DKA
Kussmauls Respirations
Responding to a call, you get Clammy / Tachy
Sympathetic nervous system stimulated the pancreas
Restrain
Prone, One arm above head, Other by side, ankles together
Reye’s syndrome could cause all of the following except
Dehydration
Rhonchi
Fluid in the larger airways
Rhythm strip shows some type of block you
O2, Monitor and transport
Rule of 9’s, (adult) Chest (18). Abdomen (part of chest) and ANT of both upper extremities (4 - 5 each)? 27%
Burn
Rumbling sound, Fever, No Edema
Pneumonia
S / S anxiety
Increase Heart Rate
S / S of Anaphylaxis
Uticaria
Scenario: Muffle Heart Sound Left Chest Trauma
Do Not Decompress Right Side
Secondary assessment includes all, Except
Determining life threatening injuries
Seizure of one body part
Focal Motor
Seizure with Muscles Contracting and Relaxing, Unconscious, Incontinent
Grand Mal
Seizures without gaining consciousness in between 2 or more episodes
Status Epilipticus
Seizures without regaining consciousness in between
Status Epilipticus (Diazepam 2.5 mg (or 5mg) Incremental Dosing to 10 mg total IV dose)
Sellick’s Maneuver is
Pressure on cricoid cartilage
Semi Fowler
45 degree angle JVD
Serious Membrane Covering Abdominal Organs
Visceral Peritoneum
Severing the Spinal Cord at C3 - 4 Causes
Total Paralysis and Can Not Breathe on Their Own
Shingles
Not Contagious
Side effect of Diuretic Therapy
Hypokalemia
Side effect of Hyperventilation
Carpopedal Spasms
Signs & symptoms of dehydration, Except
JVD
Signs / Symptoms of TB
Weakness, Night Sweats, Fever, Rapid weight loss, Cough with blood
Signs of Dehydration, Except
JVD
Signs of Kidney Stone Except
Frequent Urination
Signs of Pneumothorax is
Distended neck veins
Signs of Renal Calculus, all Except
Increased Urination ( low UTI)
Single Most Important of Brain Function
LOC
Sodium Bicarb
Is Main Buffer in Body
Spinal Cord Ends
Lumbar
Spinal Injury cause No Diaphoresis
Because Lost Stimulation of Sympathetic
Spleen is located, where
Left Upper Quadrant LUQ (Liver RUQ)
Spontaneous Pneumothorax sx/sx
Sudden pain of short duration, Shortness of breath, Knife like pain
Stable Angina
During Exercise and Stress
Stages of Stress
Stress, Resistance, Exhaustion (page 46)
Status Epilipticus
No break between seizures
Stenosis
Abnormal narrowing of opening of passage way in a body structure
Stimulus of sympathetic nervous system
Blood vessel constriction / increased heart rate
Strain
Muscle over stretching
Stroke
Inadequate Tissue Perfusion
Stroke
No Fluid Bolus
Suctioning a Tracheotomy
3 - 5 inches
SX / SX Anaphylaxis
Uticaria
Sx / Sx Heat Exhaustion
101 temp. Athlete
Sx / Sx of Anaphylaxis
Increase Heart rate, Decrease Blood Pressure, Flushing, Itching
Sx / Sx of Anxiety
Increase Glucose (Hyperglycemia)
Sx / Sx of Asthma
Agitation, Anxiousness, Hypoxia, & Wheezing
Sx / SX of Croup
Slow onset, generally wants to sit up, barking cough, no drooling, fever of 100 - 101 degree
Sx / Sx of Croup includes all except
Bacterial (it’s a viral infection)
Sx / Sx of Epiglottitis
Rapid onset, prefers to sit up, no barking cough, drooling, painful to swallow, fever between 102 - 104 degree, Occasional stridor
Sx / Sx of Tuberculosis (TB)
Weakness, Night Sweats, Fever
Sympathetic Nervous System Causes
Blood Vessels Constriction, Rapid Heart Rate, Constriction of Sphincter Muscles
Symptoms due to Tachycardia are related to
Decreased Ventricle Filling, Time & Stroke Volume
T - 10
Umbilicus down
T - 4
Nipple line down
Taking a Palpable Blood Pressure only gives you
Systolic Pressure
Tall, thin 21 yr. old male with chest pains after coughing
Spontaneous Pneumothorax
TB is Transmitted by
Air Droplets
Tendons connect
Muscles to the bone
Term associated with 3rd degree burns
Eschar
The best characterization of an alcoholic would be a person that
Likes to drink alone, Goes on binges, and drinks in the early day
The best description of a crisis intervention technique it that it is
Suitable for application in many situations faced by the medic
The bodies primary respiratory drive is based on
Increase P Co2
The chemical mediator for the parasympathetic nervous system is
Acetylcholine
The common Tricyclic antidepressants are
Elavil & Tofranil
The end of the Femur which is toward the foot is referred to as
The Distal End
The following is “false” about treating a paranoid patient
Don’t take the family aside to talk
The Intelligence Part of the Brain (Learning, Memory, Analysis)
Cerebrum
The iron containing pigment of the red blood cells
Hemoglobin
The main distinguishing characteristics between the psychotic patient and the neurotic patient is that
The Psychotic patient is Not in touch with reality
The Major Extracellular Cation
Sodium
The medical term for coughing up blood (pink, blood filled sputum) is
Hemoptysis
The most common cause of coronary occlusion is
Thrombus
The most common cause of PID is
Gonorrhea
The Most Common Urinary Tract Infection is
Cystitis
The most effective drug (after oxygen) in a patient with an acute MI is
Morphine Sulfate
The most sensitive indicator of progressive disorder of the nervous system is
Change in mental status
The movement of water across a membrane from an area of lower concentration to higher is
Osmosis
The order in which a primary survey is conducted to search for immediate life threatening emergencies is to check
ABC’s - Breathing, pulse, bleeding
The Oxygen Delivery Device used for Emphysema is the
Nasal Cannula or Ventura Mask
The part of the brain that controls respirations / heart rate
Medulla
The part of the brain that controls vision
Occipital (back)
The patient has blood gases of pH - 7.15, PCO2 - 60, PO2 -60. The patient is in
Respiratory Acidosis
The patient has blood gases of pH - 700, PCO2 - 35, PO2 - 95, HCO3 - 12. The most appropriate immediate action is to give
Sodium Bicarbonate
The patient has blood gasses of pH - 7.15, PCO 2 - 95, PO2 - 60. The patient is in
Respiratory Acidosis
The patient is cyanotic, comatose and has agonal breathing, so we
Initiate BLS (ABC’s)
The patient that depends on Hypoxic Drive to trigger breathing and might experience respiratory arrest from high flow O2 would have
COPD
The patient with Increased ICP Varies from the expected in that
Pulse Decreases and Blood Pressure Increases. (Cushing’s Response)
The patient with the greatest chance of false imprisonment is the
Psychiatric patient
The physician can best prepare a patient with MI with what info
Complaint & history of present illness
The primary buffer system is
Bicarbonate
The primary concern in treating a near drowning victim is
Hypoxia and Acidosis
The primary spread of Varicella, mumps & rubella
Respiratory Droplets
The purple colored lesions on the face and body from AIDS is called
Karposi Sarcoma
The purpose of Kussmauls Respirations in a Diabetic person is to
Combat Metabolic Acidosis
The senior citizen has a special problem inherent to the aging process. The correct description of body change due to the aging process is
Diminished Vision
The single most important indicator of the patient’s brain function is
Level of consciousness
The Spleen is located in the
Left Upper Quadrant
The statement that best describes how to deal with the effects of the patients behavior on the performance of the physical exam is to
Modify the exam if necessary
The Systolic Portion of the Blood Pressure is the
Pressure of Blood Against the Atrial Wall During the Heartbeat
The way to treat a person on a bad LSD trip is to use the
Talk Down Method
Thorazine and Mellaril
Antipsychotic
Thrombi arising in deep veins of the legs are most likely to migrate to the
Lungs
TIA
Temporary memory Loss
Time Frame Fibrolytics
3 Hours
Tissue anoxia from diminished blood flow, caused by narrowing or occlusion of the arteries
Ischemia
Tonic Clonic
Grand Mal
Toxic Blood in the Liver
Hepatoxin
Toxic Blood is called
Hemotoxin
Transient Loss of Consciousness, followed by a Lucid Interval
Epidural Hematoma
Transport SCUBA diver
Left lateral recumbent position & fly as low as possible
Treat Hyperkalemia
Calcium Chloride
Treating a patient in mid July with hot, dry skin, has a temperature of 106, and is unconscious is having a
Heat Stroke
Treatment for pre - hospital fever
Remove clothing
Treatment for Pulmonary Edema after O2, IV
NTG 0.4 mg (1 / 150 grain) SL
Treatment of heat stroke victim, you should first
Rapid cooling en route
Treatment with Diuretics can have what as a side effect
Hypokalemia
Two sided heart failure results in
Pulmonary Edema
Types of Muscles, Except
Involuntary (Connective)
Universal Blood Donor
O
Universal Blood Recipient
“AB” ( Universal Donor “O”)
Unresponsive baby with frantic mother
Never use restraint for mother
Urticaria is
Hives
Use caution to restrain
Psychotic Patient
Vagus Nerve Neurotransmitter
Acetylcholine
Venipuncture causes
Air Embolism
Violent LSD withdrawal
Utilize “talk down” technique
Visceral Pleura
Covers the Lungs
Volume in the thoracic cavity increases
Pressure decreases
Voluntary muscles
Move bones
Vomiting Green like substance is a sign of rupture to the
Gallbladder
Waddell’s Triad includes
Left femur, spleen or chest, and right sided head injury
Water Movement from Low Concentration to High
Osmosis
What airway problem will cause stridor
Croup
What connects Descending Aorta to Spine
Ligamentum Arteriosun ( Ligamentum Teres - Liver)
What Controls Respirations and Blood Pressure
Medulla Oblongata
What happens in Acute Inflammatory Response
Vascular Permeability Increases
What is a priority for transporting a seizure patient
When Not responsive in between seizures
What is Not a sign of Epiglotitis
A febrile
What is Not a sign of Meningitis
Depressed Fontanels
What is a sign of Meningitis
Stiff neck, fever
What is Not transmitted through the blood
Hepatitis A
What is the best method to use on an LSD patient
Talk down
What is the neurotransmitter for the parasympathetic nervous system
Acetylcholine
What is the primary concern with a patient suffering from Status Epilipticus
Hypoxia may result from impaired respiration
What must occur to Maintain Relative Homeostasis
The Input must be Equal to the Output
What organ excretes excesses H + Ions
Kidney
What Organ Produces Bile
The Liver. It is stored in the Gall Bladder
What should you do for asthma patients
Relieve bronchospasms
What to do before admin. Of D50
Glucose check
What to expect in an aspirin OD, causes
Tinnitus, Headache, Hyperventilation, Agitation, Mental Confusion, Lethargy, Diarrhea & Swearing.( Don’t recall choices )
When a patient is vomiting green like substance that is a sign of rupture to the
Gallbladder
When beta-receptors are stimulated
The heart rate increases
When dealing with a patient exhibiting a hostile, aggressive behavior, appropriate action would be to
Contact the police department and remove bystanders from the scene
When do you do a Slow Code
Never it’s All or Nothing
When does a Seizure Patient Qualify as a Priority
If it does Not Respond between Seizures
When encountering a patient that is disoriented, you should try to
Reorient the patient
When evaluating the symptoms of a patient with a real complaint, one must quickly establish several important factors, except
Last physicians appointment
When exporting Diabetic in Coma that has Not taken Insulin do all, Except
Administer Insulin via IV
When managing a suicide crisis
Every attempt needs to be evaluated by a physician
When patient is Vomiting Green Like Substance it’s a Sign of
Ruptured Gallbladder
When transporting diabetic in coma that has not taken insulin, do all except
Administer Insulin IV
When you get old, you get Thirsty because
Decrease in Bone Mass, Skin Turgor, Decrease in
When you stimulate the vagus nerve, it produces
Acetylcholine
Where are the hydrogen protons that makes the PH balance
Kidneys
Which do you Not expect to see in Organophosphate Toxicity
Dilated Pupils
Which drowning causes Hemodilution or Hemolysis
Fresh Water
Which is Not a Beta Effect
Bronchoconstriction
Which is Not a characteristic problem in old people
Increased Thirst
Which is Not “fight or flight” response Sympathetic Stimulation
Pupils Constricted
Which is not an organic cause of an altered LOC
Death of family member
Which is Not blood to blood transmitted
Hepatitis A
Which Lobe Controls Vision
Occipital
Which of the following do you Want to Induce Vomiting if patient Ingests
Toadstools
Which of the following is Not associated with COPD
Viral Pneumonia
Which of the following is Not considered a Muscle Type
Connective
White or Pallid Skin Color Indicates
Peripheral Vasoconstriction
Women faints after seeing (you) at a bad accident
Vasovagal
You are called to the scene of a drug user. Friends tell you he is a heavy cocaine user and has snorted and injected coke 30 minutes prior. He is experiencing a Grand Mal Seizure and is Cyanotic. He has remained unresponsive. The first step to management is
Airway
You can expect organophosphate poisoning in which types of patients most
Farmers
You can transfuse blood into a patient w / out cross checking with
Frozen Plasma
You encounter a non-combative, emotionally disturbed patient. You should
Identify yourself to the patient & interview the patient in front of the rest of the crew
You give 25 gm of dextrose from a 100 cc amp of 50% dextrose
50 cc’s of dextrose will be given
You have a patient that is tachy and talking very fast, you suspect what
Amphetamines
1 cause of death in children over 1 year
Trauma
1 cause of pediatric cardiac arrest is
Respiratory Arrest
10 yr. Old male, who parents say he is not himself. Patient has flu like symptoms, sudden onset of N/V, personality changes, and irrational behavior
Reye’s Syndrome
17 lb pediatric patient, what is the Lidocaine dose
8 mg
2 yr. old with very high fever, you should
Cover in towels soaked in Tepid water
2nd week pregnancy
Ectopic Pregnancy
3 yr old with Barking (brassy) Cough
Croup
3rd trimester changes
B/P down, CO up, blood volume up 40 - 50%
3rd Trimester Pregnancy
Toxemia
40 lb patient is in V - Fib, Defibrillate at
40 Joules
5 yr. old Dyspneic / Drooling
Don Not Lay Flat
A 22 yr. old female with LLQ pain. She is 2 weeks late on her period & shocky. She is diagnosed as having
An Ectopic pregnancy
A 23 yr. old female that is obese and approximately 8 months pregnant just had a grand mal seizure. P +145, BP 240/130, and has Edema of Extremities. She can be diagnosed with
Eclampsia
A 3 yr. old is suffering from an asthma attack. The dose of Epinephrine 1:1000 is
0.01 mg / kg
A 6 yr. old was burned. He has blisters on arms and hands, blistered chest and abdomen. The rule of nine states that his burn percentage is
0.27
A baby is born, delivery finds its Body is Pink, Extremities are blue, Pulse120, Crying lustily while jerking arms / legs. The APGAR score is
9
A child complains of “bells ringing in his head” and is hyperventilating. This can be caused by an
Aspirin Overdose
A child has stridor & Dyspnea. The following that is Not a cause is a
Pneumothorax
A child that has a headache, stiff neck, vomiting, high fever, lethargic, and pale has
Meningitis
A life threatening infection that causes upper airway in small children accompanied by reluctance, pain upon swallowing, high fever, and drooling
Epiglottitis
A pediatric is seated upright, drooling, and has fever of 104. The patient has
Epiglottitis
A single important indication in neonatal distress is
Bradycardia
A typical 1 year old baby should weigh about
21 pounds
Abdominal pain and dark bleeding is characterized by
Abruptio Placenta
Abruptio Placenta
Premature separation of the placenta from the wall of the uterus
Abruptio Placenta Characterized by
Abdomen Pain and Dark Red Bleeding
Acute viral infection of upper and lower airways that occur primarily in infants, and young children up to the age of 4 yrs.
Croup
After delivery, women has sudden Dyspnea, SOB
Pulmonary Embolis
All are causes of Dehydration in an infant except
Polyuria
All of the following possible cause for uterine bleeding during the first trimester, Except
Placenta Previa
All of the following would cause a bulging fontanel except a
Linear Skull Fracture
Along with Pitocin to help control Postpartum Hemorrhage, you should
Massage the Fundus and place the baby on the mother’s breast
An aspect Not evaluated by the APGAR score is
The Pupils
An early sign of pregnancy in the first trimester is
Amenorrhea
An inappropriate action when dealing with a child is to
Refuse the Mother and Father to travel with the baby
An O.B patient BP will
Decrease
An obese patient w/ Eclampsia treat with all of the following, Except
Attempting to open her mouth with a padded tongue depressor.
Antepartum
Prior to the delivery of the fetus
Anterior fontanel
Infant where bones are Not fused yet, Slightly sunken, May pulsate
APGAR
Appearance, Posture, Grimace, Heart Rate, Respirations & #’s
APGAR scores are assessed at
One and five minutes after birth
APGAR 9
Neonates
Appropriate pre-hospital treatment for child with fever
Tepid (mild warmth) water towels
Baby at 1 minute, Pink with Blue extremities, HR 130, Active and Crying, etc
APGAR 9
Baby born, body pink & extremities blue, pulse 120, crying lustily, jerking it’s arms and legs
APGAR 9 (1+2+2+2+29)
Baby’s weight should double
In 6 months
Barking Cough
Croup
Best way to assess a child is from
Toe to Head
Braxton - Hicks or False Labor
Cannot be determined in the field
Breech Presentation
Buttock first
Bright Red Blood with Cramping in the 1st Trimester
Spontaneous Abortion
Bronchiolitis is an
Inflammation of the Bronchioles
Care must be given when examining a child with a swollen Epiglottitis because this may cause
Laryngospasms that are common in children with Epiglottitis
Causes of Dehydration in a Child
Vomiting, Diarrhea, Fever, Burns
Child (up to 18 yrs.) complains of headache, stiff neck, vomiting
Meningitis
Child abuse
Notify (1) social worker at ER or (2) Document & report to proper authority
Child Compressions Depths
1 - 1.5 inches
Child has fever and is drooling, do all Except
Lay Him Down
Child has Stridor & Dyspnea. The following that is Not a cause is
Pneumothorax
Child Hearing “Bells Ringing” suspect
ASA Overdose
Child in Cardiac Arrest is usually from
Respiratory Arrest or Respiratory Problems
Child in Shock
Crystalloid Fluid Replacement 20 ml / kg
Child Inhales Freon, What is the common Side Effect
PVC’s, V-Tach, V-Fib
Child presents with Tinnitus, Fever, Vomiting
ASA Overdose
Child presents with wheezing on one side
Foreign Body
Child very Quiet, Tripod, Drooling
Do Not Lay Down (Epiglottitis)
Children playing with dry ice, boy held a piece in his hand for 5 minutes, treatment?
Immerse with warm water (100 - 105 degree)
Clamp Cut Cord, if Still Bleeding
Clamp it Again
Common Fracture of Pediatric Long bone
Greenstick
Common place for IO Placement
Proximal Tibia
Concern with Prolapsed Cord
Fetal Circulation
Croup
Inflammation of the upper & lower respiratory tract ( 3months - 3 years) Sx /Sx are Hoarseness, fever, harsh, brassy cough, inspiratory stridor (Laryngotracheobronchitis)
Croup
Racemic epinephrine
Defib. Pediatric
2 J / kg
Definition of Antepartum
The time interval prior to delivery of the fetus
Definition of Spontaneous Abortion
Loss of Fetus during First Trimester
Delivery imminent
Contractions 1 - 2 minutes apart
Delivery with Meconium staining present
Suction, Position, Stimulate
Developed Diabetes during Pregnancy
Gestational Diabetes
Do Not Give Fluid Challenge to Pregnant with
Edema to Feet
Drooling Child
Epiglottis
Drug of choice for Pediatric Asthma
0.01 mg / kg 1:1000 EPI SQ
During pregnancy, this decreases
Blood pressure
Early sign of pregnancy
Amenorrhea (absence of period)
Eclampsia
3rd Trimester
Ectopic
Implantation of fertilized ovum outside uterus
Ectopic pregnancy
Shoulder pain
Epiglotitis
Drooling kid, Inflammation of epiglotitis, Sore throat, croupy cough
Epiglottitis
Drooling kid
ER birth - You have to separate the child from the mother, What do you do
Clamp 10” then 3” back towards the baby from the 10” clamp & Cut , Deliver Placenta and No cut
Facilitates in Child Intubation
Finger Pressure on Larynx
Female with pain & Minor Bleeding
Abruptio Placenta
Fluid resuscitation of neonate baby
5 mg /kg
Fracture when bone is bent but only broken on outside bet, common in kids
Greenstick
Fundal Massage
Women still bleeding after birth
Gestational Diabetes
Diabetic problem during pregnancy
Giving Fluids to Neonate
Umbilical Vein
Gravidity
Total number of pregnancies
Healthy kid with No lung sound on one side
Foreign Obstruction
How many joules do you shock a 16 lb. Neonate or infant
2 J / kg 16 J
How Much Fluid to a Neonate
10 cc /kg
How much Lidocaine do you administer to a 17lb child / infant / neonate
8 ml
How to Measure Pediatric ET
Size of Smallest Finger
If a baby delivers in a “Bag of waters” you should
Puncture the bag with your fingers and remove the membrane from the baby’s mouth and nose
If a baby is having difficulty with shoulder delivery, assist by
Gently pressing the baby downward
If a mother is bleeding after delivery, what do you do
Fundal Massage
If Baby and Mother must be Separated
Tie Cord at 7” and 10”, Cut Cord Between
In 4 - 6 months a baby
Doubles weight
In delivering a child with Meconium Staining, you first
Intubate and Suction
In Eclampsia what symptoms can be seen
Seizures
In normal delivery of a baby, the head should be
Face down
In pediatric arrest, the initial dose of Sodium Bicarbonate is
1mEq / kg
In the field, how can you tell if it’s real or false labor
You can’t, treat as if it were real
Infant
Position, Suction, Stimulation
Infant born and APGAR checked at 1 min
Score of 9
Infant Not breathing after 1 - 2 min. begins spontaneous respirations
Assist ventilations (think BLS)
IO
Below the Tibia Tuberosity
IV drugs are administered to a premature infant in the field should
Administer only if the HR remains < 60 bpm. Tracheal route is generally the most rapidly accessible route for drug administration during resuscitation: the umbilical vein is the most rapidly accessible venous route
IV drugs are administered to a premature infant in the field should
Incubate and Suction
IV Fluid Bolus for Neonate is
10 cc to 20 cc/kg
Kids playing with Dry Ice, how do you rewarm the body
Warm Water 101 / 105 degree F
Know APGAR
A couple of questions
Laryngotracheobronchitis (croup) is characterized (one of many) by
Nighttime Stridor
Location for IO
Below the Tibia tuberosity
Maternal blood volume increases
0.4
Measles, Mumps, Chicken Pox
Respiration Droplets
Meconium staining is a sign of
Fetal distress
Minimal Bleeding, Rigid Uterus, and Shock
Abruptio Placenta
Most common place for IO infusion
Proximal Tibia
Mother is bleeding after delivery. What do you do?
Fundal massage
Mother gave birth 24 hours ago, Now has Sudden Onset of Sharp Dyspnea
Pulmonary Embolism
Mother gave birth 24 hrs. ago, now has sudden onset of Dyspnea and chest pain
Pulmonary Embolism
Mother of 3 gave birth 24hrs. Ago, now has sudden onset of Dyspnea
Pulmonary Embolism
Muscular structure located below (behind) the cervix
Fundus
Neonate Fluid Bolus, Challenge
10 ml/ kg
Neonate Inverted Pyramid
1690
Newborn, Body Pink, Extremities Blue, P 120, Crying Lustily, Jerking it’s Arms and Legs, APGAR Score
9
Normal delivery of a full term infant 1 min. after delivery finds that it’s body is pink, extremities are blue, P 120, and is crying lustily while jerking it’s arms and legs. The APGAR score is
9
Normal pregnancy length
280 days, 9 months, 40 weeks, 10 lunar months
Not a sign of infant Dehydration
Polyuria (frequent urination)
Nuchal Cord
Umbilical cord wrapped around baby’s neck
Ominous sign of Respiratory Failure in 6 yr old
Hypothermic Breathing 10 x p/min
Parents say there 10 yr. old male is Not himself, patient has flu, sudden onset of N / V. Personality change, and Irrational behavior
Reyes Syndrome
Patient drooling with obvious Epiglotitis
Transport sitting up, Do Not inspect throat
Patient is 6 yrs. Old with Unilateral chest wheezing
Foreign Body Obstruction
Patient is 8 months pregnant, with Seizures, Edema, HTN
Eclampsia
Patient is Most likely to Suffer from Toxemia
Female during 3rd Trimester
Patient is suffering from abruption placenta you
Administer: O2, IV Ringers, Monitor vital signs
Patient presents Prolapsed Cord
Sterile Gloved Hand in Canal, Hold Babies Face Away from Cord, Transport
Patient with Spasmodic LLQ pain Radiating to shoulder, Vaginal bleeding
Ectopic Pregnancy
Ped 104 Temp lethargic
Transport
Pedi with Flu, “Not acting right” is
Reyes Syndrome
Pediatric Assessment
Toe to Head
Pediatric Atropine dose
0.02 mg / kg
Pediatric cardiac arrest is most commonly from
Respiratory arrest
Pediatric Ingested Lye
Give milk
Pediatric patient in bradycardia, first line drug
Oxygen
Pediatric patient with flu, not acting right, nausea, vomiting
Reye’s Syndrome
Pediatric weight in 6 months should be
Be double the birth weight
Pediatric with headache, stiff neck, Petechia
Meningitis
Pediatrics should double their weight by
6 months
Placenta Abruption
Separate prematurely from wall
Placenta Previa
Attachment of the placenta low in the uterus, so it covers the internal cervical opening
Placenta Previa is
Placenta covers cervical opening and patient bleeds bright red blood and is painless
Postpartum Bleeding, do what
Fundal Massage
PPE during delivery
Gloves, Mask, Gown, Protective eyewear
Pregnancy Vaginal Bleeding
Massage Fundus
Pregnant patient
Transport left side @ 10 - 15 degree tilt
Pregnant patient in eclampsia having seizures, how much valium
2.5 - 10 mg
Pregnant patient usually has vitals of
Low BP, Elevated pulse, Low blood volume
Pregnant patient with seizures
5 - 10 mg Valium IV ( Magnesium Sulfate)
Pregnant patient, what change occurs in body 1st trimester
Low Blood Pressure
Primagravida
First Pregnancy
Primapara
Women who has delivered her first child
Prior to Birth is called
Prenatal, Antepartum
Prolapsed Cord Concern
Fetal circulation
Prolapsed Cord
Gloved hand stuff and transport
Rapidly Progressing, Life Threatening Swelling of Upper Airway Structure in Children
Epiglottis (Avoid lying down)
Reye’s Syndrome could cause all of the following, Except
Dehydration
Routes of Administration of Valium to a 4 yr. old
IV, IO, Rectal
Rye Syndrome
Unexplained viral sickness in children
Sac around baby’s face
Puncture and Pull Amniotic Sac from Baby’s Face
Scenario: Pregnant on Backboard
Tilt Backboard 10 - 15 on Left Side
Second Stage of Labor
Begins with Full Dilation, Ends with Delivery of the Baby
Separate child from mother
Clamp 8” & then 2” and cut
Separation of Placenta from Uterine Wall
Abruption Placenta
SIDS occurs between
2 week and 1 year, Most occur between 2 - 4 months
Sign that Patient is about to deliver baby now
Urge to Push
Signs & Symptoms: Minimal bleeding, Rigid uterus and shock,
Abruptio Placenta
Size of ET Tube for Infant
Infants Smallest Finger
So newborn can breathe
Puncture & Pull Amniotic Sac from Mouth and Face
Sodium Bicarb pediatric dose
1 mEg / kg
Station of Labor
1) Onset of contraction to cervix fully dilated. 2) Dilated to expulsion of baby. 3) Baby out to placenta delivery
Superior Position Bulge of Uterus
Fundus
Suspect patient is suffering from Abruption Placenta you
High O2, IV Ringers, Monitor V/S
The best way of delivering oxygen to an asthmatic child in acute distress is
Humidified Oxygen
The Best way to assess a child is from
Toe to Head
The characteristics of an Ectopic Pregnancy can be all, Except
Third Trimester Pregnancy
The common cause of convulsions in a child 6 months - 6 yrs is
Febrile Illness
The correct landmark for the IO in Infants is
2” - 3” below the Tibial Tuberosity ( Medially)
The Fundus is Massaged after Placental Delivery in order to
Control Bleeding
The Hand Position on an Infant for CPR is
Two fingers One finger length Below the Nipple Line
The least important care of a newborn is
EKG monitoring
The Most dangerous Disorder causing Upper Airway Stridor
Epiglottitis
The normal time of labor for a women having her first baby is
18 hours
The number one cause of child death is
Trauma
The Number One Cause of Pediatric Cardiac Arrest
Respiratory Arrest
