6 Flashcards
When checking Lower Extremities for Paralysis; Paramedics should ask the patient to
Wiggle their Toes
When doing a halo test; what are you looking for
CSF
When moving a patient by the Four Man Log Roll; the First step of the paramedic should be to
Stabilize C – Spine
When Palpating the Abdomen
Palpate Quadrant that Hurts Last
When starting a tourniquet; it is applied so
It occludes Venous return but allows arterial flow
When Triaging; the highest priority is
Sucking chest wound
When using a chair to carry the patient down the stairs; you must first
Test the chair to make sure it is strong
When ventilating a patient with a head injury; the ventilation rate should be
20 - 24 BPM
Which Drowning causes Hemodilution
Fresh Water
Which is Not a normal emotion for a patient at a MCI
Paranoia
Which of the following is the responsibility of the paramedic when Triaging MCI
Prioritizing Casualties
Which of the following would you expect Fattened Neck Veins
Hypovolemia
Which one of the following is the Responsibility of the Paramedic when Triaging Mass Casualty
Prioritizing Casualties
Which soft tissue injury causes the most bleeding
Avulsion
Which would you treat last
Spinal; Arterial hemorrhaging; Airway Obstruction; Sucking Chest Wound?
While on site of a plane crash with multiple casualties; the person that would Not receive a high priority is the person in
Cardiac Arrest
Who would be the one in charge of a medical MCI scene
Incident Commander
Why does spinal injury cause No Diaphoresis
Because it lost its stimulation of sympathetic
Worst critical patient at MCI
Amnesia; Crying; LOC
You find clear fluid coming out of patients ears; you suspect
Basilar Fracture
You have a patient with head trauma and signs of shock
You look elsewhere; Shock is Not due to head trauma
You have arrived on the scene of a building collapse involving at least 30 patients. One patient in cardiac arrest. The first paramedic on the scene should classify the patient as
Lowest Priority
You should Palpating the Abdomen
Area that hurts goes last
Your index of suspicion is based on mechanism of injury in regards to what
Extent of patient injuries
Your Job in Triage
To Prioritize patients
Re-entry may cause premature beats or Tachydysrhythmias
(PACs)
CHF
left ventricle damage
Drug that is a positive inotrope
increases the force of cardiac contractions; contractility
Maternal blood volume increases
0.4
On-line radio contact between medic and medical control DOC
direct medical control
Major complication of thrombolytic therapy
bleeding out
Pulmonary ventilation to remove excess CO2
normal balance
Hemoglobin
iron containing compound; transport O2
Civil wrong
tort
Epidural hematoma
LOC; regains consciousness then fades away towards AMS
Drugs go through a
mini-drip set
Syncope is associated with
heart blocks
P waves get wider until QRS drops
Mobitz II; wenkebach
GCS
eye opening4; verbal response5; motor response
Palpate ABD quadrant with
pain; injury last
Clear fluids from nose
poss. basilar skull fracture
Anaerobic
lactic acid
Chemical mediator for parasympathetic
acetylcholine
Near drowning
manage hypoxia/acidosis
Eyes don’t move in unison
dysconjugate gaze
Increased ICP
decreasesed pulse; increasesed BP; decreasesed respirations; Cushing’s reflex
Prolonged P-R interval
1st degree block
Reciprocity
agency recognizes certification/comparable standards from another agency
Burn victims lose
plasma; fluid
Adrenal glands secrete
EPI and NorEpi
Visceral pleura covers
the lungs
Acetycholine and oxytocin are secreted by the
pituitary gland
Elavil and Tofranil are two common
tricyclic antidepressants
Duplex system
simultaneous transmission and reception
Encourage coughing with a
partial airway obstruction in adults
Abruptio placenta
premature separation of the placenta from the uterine wall
Cerebrum controls
Thought; personality; speech; motor control; learning; posture; memory
Glucagon releases/breaks down glycogen from the
liver
Droplets spread
measles; mumps; chicken pox
Excretory function of the blood is to remove
waste; lactic acid; from the cells
Pull EOA out when
the ET is in placed with the cuff inflated
Decerebrate posturing
extended extremities
Blood loss replacement
3 times the volume lost
Half-life
time it takes for half of a radioactive substance to lose its radioactivity
PaCO2 regulates
respiration (Partial pressure of CO2 in the blood)
Spontaneous pneumothorax S/S
sudden pain of short duration and SOB
Concussion
brief LOC followed by complete return of function
Do not stop bleeding from ears/nose due to head injury
because the bleeding relieves pressure
MVC patient with HR 120; BP 40 palp
hypovolemic shock
Frequent urination is NOT a sign of
kidney stones (UTI sign)
Deep regular respirations are NOT a sign of
shock
If you lose 300 mL of blood replace with
900mL or ringers
Abdominal muscle flexion on palp
guarding
IV complications
phlebitis and emboli
Contraindications for Verapamil
PE; Cardiogenic shock
Homeostasis
body’s tendency to stay constant
For an adult having an asthma attack the treatment is to
stop bronchial spasms
On-line DOC in charge unless on-scene DOC agrees to
accompany the patient
Seizure patient is a priority if
they do not respond between seizures
Adenosine is used for
PSVT
Durable power of attorney
someone else can make decisions for you
Patient in PE; IV started next you administer
0.4mg of nitroglycerine
Asthma is NOT a contraindication for
Verapamil
MCI first to go
thirsty and anxious
MCI last to go
spinal injury
Ascites
fluid in the abdomen
The Good Samaritan Law protects the
Paramedic off-duty
Responsibility of a paramedic is the
Duty to Act
Intent NOT required to prove
negligence
Elements of negligence
duty; breech; cause; and damage
Pulse is the quickest way to check
circulation
Kussmauls respirations
rapid deep gasping breathing associated with DKA
Battle’s signs
Ecchymosis over the mastoid process
Cerebral hypoxia SX
bilateral dilated pupils
Central venous pressure
right arterial pressure
Baby delivers in a “bag of water”
puncture the bag with your fingers and uncover the baby’s face
Fluid bolus for a neonate
10-20mL per kg
COPD patient with hypoxia drive’s breathing is triggered by
decreasing O2 in the blood
2nd stage of labor begins with
the dilation of the cervix and ends with delivery of the fetus
Immobilize a shoulder injury with
a sling and swath
Patient left unattended at the ER to respond to another call
abandonment
Emphysema SX
pink puffer
AAA treatment
2 big IV’s
Disadvantages of thrombolytic therapy
cost and uncontrollable bleeding
Flattened neck veins
possible hypovolemia
MVC; airbag did not deploy
disconnect battery cables
Patient with rales; SOB; no pedal edema
pulmonary edema
Hypercarbia
increasesed CO2 in the blood
Carotid artery perfuses
the head
Nasal Cannula delivers
28% O2
BP decreases during
pregnancy
C1 vertebrae is known as
the atlas
The upper area of the uterus is the
fundus
Where to cut the cord
8 inches from navel; then 2 inches
Anaerobic metabolism is caused by
lack of O2
Heat cramps SX
cramps; hot; sweaty; normal BP; tachy
Heat exhaustion SX
cool; clammy; nausea; vomiting; orthostatic BP
Heat stroke SX
dry skin; syncope; weak pulse; hypotension
Patient is tachy and talking fast suspect
amphetamines
Pink puffers
emphysema
Blue bloaters
Chronic bronchitis
Both pink puffer and blue bloaters
COPD
ASA overdose SX
tinnitus; headache; hyperventilation; agitation; confusion; lethargy; diarrhea; sweating
Boy held dry ice for 5 minutes; treatment
immerse in warm water (100-105)
Medic gives med’s per who’s orders
written protocols or on-line direction
The incident commander is in charge of
an MCI
Index of suspicion is based on
mechanism of injury (MOI) in relation to the extent of patient injuries
Adult male sitting at a 45 degree angle with distended neck veins
possible right heart failure
Beta 2 stimulation
increased respirations/Bronchodilation
The glottic opening is the narrowest part of the
adult airway
Ventilate a head injury
20-24 times a minute
Grava
number of pregnancies
Para
number of births
EPI does not increase
myocardial O2 demand
Amenorrhea (absent of menstruation) is an early sign of
pregnancy
Atropine can cause
blurred vision
Tendons connect
muscle to bone
Dialysis is the removal of
toxins through a semi-permeable membrane
Hemotoxin
toxin in the blood
White pallor to skin color
peripheral vascular constriction
Atelectasis
collapse of alveoli
Adenosine slows conduction where
in the AV node
Wide bizarre QRS in monitor
V-Tach
Saltwater drowning can cause
PE and CO2 retention
Sympathetic stimulation
vasoconstriction and increased HR
Effusion
the escape of fluids into a cavity
DT’s time frame is
24-48 hours
Bicarb is the body’s
principle buffer
Death generally occurs
1 hour after MI (maybe 2-3)
OSHA regulates
disease control
In PED’s start the assessment from
Toe to Head
PH above 7.45
alkalosis
The most common type of rural MVC is
frontal
The alveoli are kept open by
surfactant
Toxemia of pregnancy treatment
Mag sulfate
Transport of a scuba diver
in the left lateral recumbent position
Restrain a patient prone
one arm overhead; one by the side and ankles together
Braxton-hicks or false labor cannot be determine where
in the field
TB SX
weakness; night sweats; fever; rapid weight loss; cough w/blood
To check for paralysis ask patient to
wiggle toes
Karposi’s sarcoma
purplish/blue lesions associated with HIV
The triage nurse is responsible for
sorting patients in the ER
Psychotic patients are not in touch with
reality
NPA inserted rapidly
bypasses tongue; used with gag reflex NOT with basilar skull FX
If a medic affected by an MCI
assign him a different single simple task
Decon patients in the
warm zone
Delivery imminent if
contractions are 1-2 mins apart
Primapara
1st delivered child
Ectopic pregnancy
implantation of a fertilized ovum outside the uterus. SX…….shoulder pain
Placenta previa
attachment of the placenta low in the uterus so it covers the internal cervical opening
Mania is a mood characterized by
great excitement/activity
Subluxation
dislocation of a joint
Cerebellum
motor control; balance; coordination
Medulla oblongata
pulse rate; respiration; BP
Narcan reverses the respiratory depression of
darvon
Arm muscle for IM injection
deltoid
Head injury with left pupil dilated; right pupil slow to respond to light
neuro crisis
Use the jaw thrust to open the airway of a
trauma/C-Spine patient
Epiglotitis SX
rapid onset; no bark; drooling; painful swallow; high grade fever; bacterial
Croup (Laryngotracheobronchitis) SX
slow onset; barking cough; low fever; viral
Newborn treatment
position; suction; stimulation (Do What Seems Sensible—Dry; Warm; Suction; Stimulate)
Gel for paddles
decrease resistance
Babies double birth weight in
6 months
SIDS most prevalent from
1-12 months
Gestational diabetes
diabetic problems during pregnancy
Antepartum
prior to delivery
Diffusion
substance from high to low
Osmosis
fluid from low to high
SQ injection goes into the
fatty tissue
Flail chest
free movement of a segment of ribs
SX respiratory distress
nasal flaring; tracheal tugging
Contrecoup injury occurs
opposite the side of impact
Parenteral route of med administration
SQ; IM; IV; IO; ET
A thrombus from deep in the leg veins could migrate to the
lungs. DVT; P embolus
Diving air embolism SX
joint pain; tingling in the legs; abdominal pain
Organophosphate poisoning SX
SLUDGEM
Occipital lobe controls
vision
Ped c/o headache; stiff neck; vomiting
meningitis
T4 injury
paralysis below the nipple line
T10 injury
paralysis below the umbilical line
Increasing drugs to achieve desired effect
titrated
Unable to Defib because you forgot to replace the battery
negligence
Primagravida
1st pregnancy
Chloecystitis SX
upper quadrant pain after eating fatty foods
Mid-asthma treatment
Albuterol 2.5mg
Eye injury treatment
cover both eyes
Over hydrating due to IV therapy complication
pulmonary edema
AIDS primary transmission
sexual contact
Red dangerous placard
over 5000lbs. HAZMAT
JVD is SX of
tension pneumo; right heart failure; cardiac tamponade
Hypovolemic shock prehospital treatment
2000-3000mL fluid
Federal food drug and cosmetic act
ensures safe manufacture of drugs
Band
group of similar frequencies
Intrinsic ventricular rate
20-40 BPM
Intrinsic Junctional rate
40-60 BPM
Intrinsic AV node rate
60-100 BPM
EPI stimulates the heart in
asystole
CHF treatment
decrease preload; decrease workload
EGTA
esophageal gastric tube airway
Rye syndrome
unexplained viral illness in children
NorEpi causes
vasoconstriction
Liver produces
bile
Bile stored in the
gallbladder
To give fluids to a neonate use the
umbilical vein
START system
Resp.; Pulse; Motor/mental function
BVM complications
distended abdomen; pushes diaphragm; causes vomiting
Start compressions on an infant if
HR<60 BPM
Ventilate infant if
HR<100 BPM
Prior to birth
prenatal; Antepartum
Shingles is not
contagious
Pulse oximetry measures O2 sat in
Peripheral tissues
The urge to push is a sign of
imminent delivery
Penetrating wound to the abdomen treatment
wet; sterile; occlusive dressing
There is no such thing as a
slow code
Causes of dehydration in a child
vomiting; diarrhea; fever; burns
Rescue breathing pushes
the diaphragm; increases ventricular rate
SQ EPI…
0.3-0.5mg 1:1000
Delusions
false beliefs
SX of hyperglycemia
polyphagia; Polyuria; polydipsia
Morphine is a
vasodilator
Common ped long bone FX
greenstick
Endocrine system acts by releasing hormones into the
bloodstream
Decreased HR is NOT a sign of
dehydration
Verapamil AKA
Calan; Isoptin
Tricyclic antidepressant OD treatment
Sodium Bicarb
American with disabilities act protects those with
communicable disease
The master endocrine gland is the
pituitary gland
Valium routes
rectal; IV; IM
Earliest detectable sign of shock
tachycardia
Cardiac output
blood pumped in one minute
Increased then decreased Resp followed by apnea
Cheyne-Stokes
Complication of knee or elbow DX
loss of distal circulation
Place for decompression
2nd and 3rd intercostals Midclavicular; or 4th or 5th intercostals Midaxillary
Sellick maneuver
pressure on the cricoid cartilage
Lung compliance
stiffness or elasticity
Patient taking valium required a larger dose
tolerance
Severed C4
total paralysis and respiratory paralysis
Reasonable confinement is NOT
elderly abuse
Size of ET tube for an infant
size of little finger
Routes of med administration from slowest to fastest
PO; SQ; IM; ET; IV
Spontaneous abortion SX
bright red blood and cramping in first trimester
Wernicke’s syndrome
chronic alcoholism and thiamine deficiency
Hep A is an
oral/fecal disease
1000 grams in a kilogram
???
Bronchoconstriction is NOT a
beta effect
Use the talk down method on an
LSD PT
For CP after O2 morphine gives
the most pain relief
Aminophylline dose…
5-6mg/kg
Ped w/flu; not acting right; nausea; vomiting
possible Reye’s syndrome
Wide QRS with no P waves
idioventricular
EOA removal can cause
vomiting
Most critical PT at an MCI
amnesia; crying; AMS
Cribbing
is used to stabilize things
Before administrating D50
check glucose; consider thiamine
Piece of glass stuck in the neck TX
stabilize glass and transport
Routes for EPI
IV; ET; SQ
In a ambulance crash the court will try and prove
lack of due regard for the ambulance driver
Chest compression for a child
1-1 ½ inches
6 y/o w/unilateral wheezes
FBAO
Gave birth 24 hours ago; sudden dyspnea and chest pain
pulmonary embolism
A repeater
retransmits
A simplex system cannot transmit and receive
at the same time
20 y/o cardiac arrest at an MCI
continue triage
Chief extracellular cation
sodium
Chief intracellular cation
.potassium
IO placement
tibial tuberosity; anterior tibia
Liable
writing something derogatory
No DNR
.start CPR
Percentage of RBC in blood
Hematocrit
PED Defib at
1 joule/kg
Cardiac tamponade SX
JVD; narrowing pulse pressure; clear lung sounds
The stylet
makes intubation easier
ECG over the radio
biotelemetry
Most unstable rhythms start in the
ventricles
3 systems that regulate acid-base balance
buffer; respiratory; renal
No SQ in
hypovolemic shock
Tricyclic OD SX
anticholinergic; coma; seizure; tachy
Atropine is not used for
sinus tachycardia; pulse 120
Which of the following is not a component of the START triage system
pupil size
You have been called to the scene of a GSW and you are told by dispatch that the patient has been shot twice in the chest. Your first concern will be
scene safety
Select the correct order for assessing a patient after scene size up
initial assessment; focused assessment; complete assessment; ongoing assessment
You and your partner; an EMT; have been called to the scene of a head-on collision on a rural road. There are five patients listed below. Prioritize the five PT’s
33 y/o w/snoring resp.; 29 y/o w/a sucking chest wound; 16 y/o diabetic who is tachy and confused; 55 y/o w/compound femur FX; 2 y/o w/no pulse or resp.
What is the Pedi dose of SQ EPI for asthma
0.01 mg/kg
You are treating a 3 y/o asthma PT. The PT weighs 33 lbs. Calculate the SQ EPI dose using the recommended 0.01 mg/kg
0.15 mg (notice this question answered question 2813…look out for those questions on the TEST.)
Your PT has suffered a head injury; which of the below signs would indicate increased ICP
decreased pulse; increased B/P
Which of the following most correctly identifies the signs and symptoms of Hemorrhagic shock
N/V; pupils dilates; pale
Emergency Medical Service Act
Chapter 401
Rules and regulations of the State EMS
64J-2
If a patient loose blood what do they need
BLOOD (if not an answer then Colloid-pre-hospital setting crystalloid)
Mitochondria
energy source of cell
Homeostasis
maintain internal balance; equilibrium
Metabolic acidosis
cardiac or resp. arrest; DKA; aspirin overdose; try increased ventilation with O2 and if not resolved; use Bicarb; treat the underlying cause
Metabolic alkalosis
too much Bicarb; let it wear off; treat the underlying cause
You have a 15gtts/ml drip set; you must infuse medication for ONE HOUR; and you are running it at 45gtts/min
180cc
Orthostatic hypotension can be taken
supine and seating or seating and standing up
A pt suffering from orthostatic hypotension will best benefit from
put them in sitting position
Pt in a MVA with soft tissue injury; and excessive pain in the LUQ; what injury you expect and how you treat it
spleen injury; hold cervical spine; put an IV etc…
Pt with Unilateral wheezing; most probable condition
F.B.A.O.
Which is a sign of UNCOMPENSTATED shock
?decreased BP
Which one is a contraindication of a nasal gastric tube
basilar skull FX
Complications of nasal gastric tube
it makes intubations more difficult
In a MVA there is a MULTITRAUMA pt; what is the FIRST thing to control
HEMORRHAGE (other choices: airway)
PPE is the same as
BSI or Assumption that all blood and other body fluids are infectious. ??? tricky
Man was cleaning the bathroom with bleach and fainted; a co-worker pulled him out and upon arrival you notice the man has RALES. What is his condition
Pulmonary Edema
S/S of HYPERglycemia
deep; rapid; gasping respirations associated with Ketoacidosis.
High pitch MUSICAL sound heard on Expiration due to bronco-constriction from mucus plugging
wheezing
Harsh; high pitch sound heard on inspiration that indicate partial airway obstruction
stridor
Burn pt with anterior chest and abdomen; and one whole arm
0.27
Burn pt with anterior chest and abdomen; and both arms
0.36
Pediatric with broncholitis; do all except
DO NOT Lay Supine
What is the LOWEST APGAR score
0 (highest 10)
All ambulance in a MCI should report to the
command post
Put 1gm in 250cc of D5W; how much do you give
4mg/ml
The EOA (combitube) causes
vomiting
What happens in the 3rd trimester
?Decreased BP
Occipital part of the brain controls
vision
You expect to see FLAT NECK veins on what
hypovolemia
When you see CLEAR FLUIDS coming out from nose and mouth; you expect
basilar skull FX
Transporting a pregnant pt in 3rd trimester
LEFT lateral recumbent supine 10-15°
PT in a pool hall has a Right Orbital Eye injury; what do you do
cover both eye
21 y/o wheezing and asthma; you give
Albuterol 2.5mg via nebulizer
What is the best med for hypotensive pt
give Dopamine 5mcg/kg/min or Dobutamine 2-20mcg/kg/min
Rapid cooling for heat stroke pt to prevent
irreversible brain damage
Diabetic Ketoacidosis S/S
?HYPERglycemia; dizziness; HOT and DRY skin
Compensated shock (1st Tachycardia; Increased pulse; cool; clammy; anxious)
?Increased blood and ?Decreased Peripheral Perfusion
Decompensated shock (begins with decreased BP; unpalpable pulse; resp slows; lethargic)
Falling BP; thirst; decreased LOC
Epinephrine causes
?increased BP; palpitation; tachycardia
Pt in a MVA has a lacerated scalp and low BP; what should you do
Lactated Ringers IV WIDE OPEN
Replacement prehospital fluid for bleeding
Ringers Lactated
Enlarged liver; distended neck veins and PE
heart failure
Treatment for COPD PT is
nasal cannula or venture
Pregnant women say she has only one kid; and two miscarriages
Gravida 4; Para 1; Abortions 2
Laryngotracheobronchitis presents with
stridor
Pt with Dyspnea; Urticaria; Tachypnea; BP 80/60 has
Anaphylactic Shock
Pediatric with SPo2 78%; breathing 40bpm you should
assist ventilation
Pt with chest pain; P-72 10 mins later Pulse decreases to 38. If stroke volume DOESN’T change
cardiac output DECREASES
Narcan for what type of OD
Opioids (EXCEPT: VALIUM)
In S.T.A.R.T. system a PT breathing 40bpm
critical PT
Which one is true about Coral Snake
Neurotoxin “Black; Yellow; Red” (other INCORRECT choices: black; white; red)
Blood that lacks in oxygen
hypoxemia
ICP S/S
?Increase BP; ?Decrease pulse
6 P’s for Musculoskeletal test
the answer is PRESSURE
Spinal Injury to C4
Quadriplegic and pt wont breath on his own (C3; C4; C5 keep the diaphragm ALIVE!)
Injury to the Xiphoid Process; what region of spinal cord will it affect
Thoracic or Lumbar
Routes from SLOWEST to FASTEST
PO; SQ; IM; ET; IV
What is true about HIV pt
they appear NORMAL; can’t tell
Measles; Mumps; Rubella are spread by
airborne droplets
Which one is part of the narrative PCR
S.O.A.P. (other choices SAMPLE; OPQRST)
When intubating you hear absent lung sounds on the left due to
RIGHT Mainstem Bronchus
IV complications EXCEPT
slow infusion on site (other choices pain on site; air embolism)
Pt in am MVA has a head injury; BP 80/60; Pulse 132; you suspect
HYPOvolemia
Pt has scalp wound; BP 80/50; Pulse 120 the best IV choice is
LR Wide Open
Pt has back tearing pain; has upper pulse and NO pedal pulse
Abdominal Aortic Aneurysm
Writing malicious in the PCR
Libel
Which one is NOT a sign of stroke
HYPOTENSION (correct choices: headache; aphasia; facial drooping)
Fibrinolytic Therapy time frame
3 Hours
Upper part of the uterus
fondus
Guy went on vacation; and was diving
BLS Question
In burn PT
there is fluid shift into the interstitial SPACE
False statement referring to burn PT
there is INSIGNIFICANT damage to underlying tissue
Absent P wave in lead ll means
SA node is not the pacemaker
Heat stroke PT will have
temp 104°; HOT and DRY skin
Signs of kidney stones EXCEPT
frequent urination (Polyuria)
Child playing with ice for more than 5 minutes; what should you do
Immerse in warm water 100-105°
The paramedic communicates all of the information to the doctor EXCEPT
Pt name and insurance policy
To make changes in the PCR
draw a single line and Initial and make a notation at the end of report
Pt was exposed to radiation once the PT is decontaminate; PT will have
Little or NO threat to paramedics
Pt has angulated leg; LOW BP; high pulse; cool and clammy; you suspect
HYPOvolemia
Starting an IV and interpreting ECG means you are using
Standing Orders
Traumatic Asphyxia PT give
Sodium Bicarb 1 Meq/kg
Pt MVA air hunger; confusion; JVD; ?pulse; ?BP (narrow); muffled heart sounds; may be suffering from
Pericardial Tamponade
Heart cells that conduct electrical activity causing depolarization and contraction
Automaticity
Glucagon
releases glycogen from the liver
The spleen is located
LUQ
All happens during the aging process EXCEPT
increase thirst
Abdominal pain patients present in what position
FETAL
What is a sign on organophosphate poisoning
abdominal cramping (GI disorders)
Male at the gym feels an explosive HEADACH
.subarachnoid Aneurysm
Kidneys relay on perfusion of what
Systolic BP
In spinal injury it causes no diaphoresis below the level of injury because
loss of stimulation of sympathetic
Catecholamines cause
cause ?increase vasoconstriction; ?increase heart rate
Head trauma with signs of shock
shock is rare to see in head trauma alone
Largest percentage of injury for 75 y/o PT and over
FALLS
Traumatic Asphyxia occurs from what type of injury
CRUSH
Apply Sellick Maneuver by
gentle pressure on the cricoid cartilage
JVD are best observed by
SEMI Fowlers 45°
What is correct about nasogastric tube on intubation
CANNOT get a good face seal
Pulmonary Embolism
sudden chest pain and dyspnea
The difference between Systolic and Diastolic is
Pulse Pressure
What does QRS means on an ECG
Ventricular Depolarization
You attempt to intubate FOUR times and was unsuccessful in a cardiac arrest PT; what should the paramedic do
Attempt other advance airway device by other means or Cricothyrotomy
R on T phenomena can cause
V-Fib
V-Tach presents how
Wide Bizarre QRS; Irregular
Pt in MVA says he has radiating pain on left shoulder; you suspect
spleen injury
Pt has stroke like signs & symptoms; but then they RESOLVE and become better; this is what
TIA (transient Ischemia Attack)
Pt in an MVA develops peritonitis from what
spill of gastric juice content making lining irritated.
Morphine help the pulmonary edema PT by doing what
Vasodilation
Behavior emergency PT; you should
try to orient the PT
“Man abused on CHILD” your partner knows the man; because the man is a friend of his father. The child has cigarette marks; multiple stages of healing and bruises. The man says; “He will NEVER DO IT AGAIN” what do you do
leave and do an anonymous call to the Child Abuse Hotline (other incorrect choices: take the child and transport to hospital; leave the scene and do nothing)
Large amount of Lidocaine will cause
seizures
Diabetes develop during pregnancy is called what
.Gestational Diabetes
Family has a valid DNR; what treatment can you offer as a paramedic
comfort measures
Early signs of shock
tachycardia (?HR)
Pt suspected to taken Narcotics; has PIN POINT PUPILS
give Narcan and you can expect to see combative; aggressive behavior
Part of the scene size up includes
number of PT on scene
You are enroute to a scene of 2 ambulatory PT; and 1 injured PT; police secured the scene; there is a hospital nearby; what do you do in the meantime
Call 2 ambulance for back up or start rapid triage & provide rapid transport. (TRICKY!!!!!)
A guy in an MVA; PT has subcutaneous emphysema on the right neck side; DYPNEA; ABSENT lung sounds on the right side and diminish lung sounds on the Left side
Tension Pneumothorax
Tourniquet (Venous Constricting Band…as some like to call it) does what
restrict venous blood flow but allows Arterial blood flow
At a crime scene; you have a PT that is viable; what do you do
treat the PT; and cooperate with law enforcement….”DO NOT DISTURB THE SCENE”
What kind of stress is the type that builds up later; after in days
POST TRAUMATIC
Breech presentation
BUTTOCK presents First of Baby
When delivering a baby; if the umbilical cord is still bleeding; what do you do
clamp the cord AGAIN proximal to the last clamp
Bus loaded with kids; bus crashes into Hazmat truck; what do you do first
scene safety
Elderly PT mask MI
because they have DECREASED sensation to pain
Excess thyroid hormone; ?increase metabolic rate; tachycardia; weakness; goiter
Grave Disease (incorrect choices: Myxedema “?level of thyroid hormones; HYPOthermia; bradycardia;” Thyrotoxic Crisis “Hyperthermia; Tachycardia; Nervous symptoms; Hypotension; High Fever.”
The use of NPA intubation for who
PT with INTACT GAG REFLEX
What is the best method to use on LSD PT
Talk down
What is the Neurotransmitter for the Parasympathetic Nervous system
Acetylcholine
3 types of Aphasia
Expressive (motor); Receptive (sensory); Global
ST elevation on lead ll; lll; AVF
Inferior Wall MI “Firefighter Boot”
ST elevation on V1-V6; l; AVF
Anterior Wall MI
NORMAL PH balance
7.35-7.45 (7.45-base “ALKALOSIS”
Chief Extracellular CATION
Sodium “Sweat Tastes SALTY on skin”
Chief Intracellular CATION
Potassium “In my Pot”
% of RBC in the whole Blood
Hematocrit (45%)
For stroke PT use
”FAST” F-Facial Droop; A-Arm Drift; S-Smile or Speech; T-Time 3 hrs or AAOx4
Early access; early CPR; Early Defibrillation; Early ACLS
Fast
Contraindication for AED
<1 y/o infant and wet PT
Bipolar leads
l; ll; lll
Unipolar
AVR; AVL; AVF
P wave
Atrial depolarization
QRS wave
ventricular depolarization
T-wave
repolarization of ventricles
Chest lead
V1; V2; V3; V4; V5; V6
Combitube
100ml of air-Blue; 15ml of air- White(clear)
Enteral Routes
per Oral; Buccal; SL; GI Tube; Rectal
Parenteral Routes
IV; IO; IM; SQ
Pit Vipers
Rattle; Copper Head; Water Moccasin
COPD
(ACE-Chronic Bronchitis; Emphysema; Asthma)
Phases of stress
(“ARE”- Alarm; Resistance; Exhaustion)
Types of shock
(“MR. C.H. SNAP”) M-Metabolic; R-Respiration Insufficiency; C-Cardiogenic; H-Hypovolemic; S-Septic; N-Neurogenic; A-Anaphylactic; P-Psychogenic
Grieving PROCESS
(“DABDA”)D-Denial; A-Anger; B-Bargaining; D-Depression; A-Acceptance
As you assess your trauma patient; you determine his GCS. He is awake but confused; he obeys commands; but when not stimulated; he falls to sleep. He responds to voice by opening his eyes. What is his GCS?
13
According to OSHA; what must be available on site where Hazardous Materials are stored?
MSDS
Flat neck veins are common to all of the following except:
Dehydration; Hypovolemia; Cardiac Tamponade; Hemothorax
The EGTA
is used on a comatose PT.
Input must equal output to maintain
homeostasis.
Enlarged liver; distended neck veins and edema are signs of
heart failure.
Administration of a hypertonic solution to a hydrated PT will
draw water from the PTs cells into the vascular space.
A sealed flashlight is not an
ignition source.
Vital signs are NOT part of
a primary survey.
Hypoxemia
reduces partial pressure of O2 in the blood.
An avulsion
is a soft tissue injury involving the SQ and fascia w/lots of blood loss.
Pt fell from 3rd floor; (R) lung sounds absent; FX leg; after airway TX
BVM w/O2; decompress (R) side; PASG; IVs enroute.
Orthostatic BP
prone; sitting; standing at 2mins intervals.
Narcan can cause
withdrawal symptoms.
Pulse is the best way to check
if the heart is pumping.
Rule of thumb for HAZMAT
keep a safe distance.
Low BP in shock is due to
vasodilation.
Decerebrate posturing
brainstem injury.
Decorticate posturing
injury above brainstem.
The fundus is a muscular structure located
behind the cervix.
Pulmonary Edema TX
O2; 40mg Lasix; 2mg morphine
17 y/o male w/extreme headache enroute
possible aneurysm
The Ligamentum Arteriosun connects
the Aorta to the spine
Vomiting is
the most common problem w/BVM’s
The 401 emergency services act provides
legislation governing all pre-hospital EMS
In a MCI paralysis below the waist is a
LOW PRIORITY
Voice and ECG can be transmitted to the hospital at the same time
multiplex system
The organization that establishes qualifications for EMS providers nationally
NHTSA
Normal systolic BP in males is
age plus 100
Bright red frothy blood from the mouth (hemoptysis)
lung damage
