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B's Flashcards 2000-2500

1
Q

Open the airway gently. Infants can be placed in a _____ position and children only require _____.

A

Neutral position; slight extension of the neck

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2
Q

In suctioning infants and children, use a ____ but be careful not to ____.

A

Rigid tip; touch the back of the airway

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3
Q

The gag reflex is tied to what other reflex?

A

The swallow reflex

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4
Q

What are the two essential functions that breathing accomplishes?

A

Brings oxygen into the body and eliminates carbon dioxide

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5
Q

Your body will tolerate the buildup of ____ longer than it will tolerate the lack of ____.

A

Carbon dioxide; Oxygen

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6
Q

Inhalation is a ____ process. While exhalation is a ____ process.

A

Active; Passive

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7
Q

Because it is passive, exhalation typically takes slightly ____ than inhalation.

A

Longer

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8
Q

A normal tidal volume is typically ___.

A

5-7 mL per kg of body weight

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9
Q

What parts of the respiratory system make up dead air space?

A

Trachea, bronchioles, and other parts of the airway

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10
Q

What term refers to how much air actually reaches the alveoli?

A

Alveolar ventilation

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11
Q

Alveolar ventilation depends very much on ____.

A

Tidal volume

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12
Q

Alveolar ventilation can be altered through changes in ____ and changes in ___.

A

Rate and volume

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13
Q

Exceptionally fast breathing will actually ____ minute volume and alveolar ventilation

A

Reduce

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14
Q

The movement of gases from high concentration to low concentration

A

Diffusion

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15
Q

The movement of gases between the cells and the bloodstream is called ____

A

cellular respiration

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16
Q

the respiratory system and the circulatory system working in concert are often referred to as the cardiopulmonary system, or the _________

A

Ventilation-perfusion match

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17
Q

What are 3 mechanical failures of the cardiopulmonary system that may occur?

A
  1. Mechanics of breathing disrupted.
  2. Gas exchange interrupted.
  3. Circulation issues.
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18
Q

What are 4 ways that the mechanics of breathing can be disrupted?

A
  1. Stabbed in chest (sucking wound).
  2. Loses nervous control of respiration (muscular dystrophy and multiple sclerosis).
  3. Painful chest wall injuries.
  4. Bronchoconstriction.
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19
Q

____ is a disease that causes low amounts of hemoglobin in the blood.

A

Anemia

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20
Q

A patient whose body pH becomes _____, sufficient hemoglobin may be present but may have difficulty in holding oxygen.

A

Very acidotic

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21
Q

What is internal respiration?

A

Gas exchange between the blood and the cells

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22
Q

In most people, the urge to breathe is caused by the buildup of ____.

A

Carbon dioxide

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23
Q

The body of a person complaining of shortness of breath will respond by engaging the ____ nervous system.

A

Sympathetic (fight or flight)

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24
Q

Define respiratory distress.

A

increased work of breathing; a sensation of shortness of breath

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25
Q

Most mechanisms of compensation, such as increased muscle tone use, come at a cost of ____.

A

Increased oxygen demand

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26
Q

Inadequate breathing is also called ___.

A

Respiratory failure

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27
Q

In inadequate breathing, either the ____ or the ____ (or both) falls outside of the normal ranges.

A

Rate of breathing or depth of breathing

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28
Q

EMT intervention when pt is breathing adequately but needs supplemental oxygen due to a medical or traumatic condition.

A

Oxygen by nonrebreather mask or nasal cannula

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29
Q

When a pt has inadequate breathing and needs assisted ventilations, which device can be used?

A

pocket face mask, bvm, or FROPVD

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30
Q

Breathing rate for artificial ventilations for somebody in respiratory arrest.

A

10-12 per minute for adult and 20/minute for an infant or child

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31
Q

Is it ok to use oxygen powered ventilation devices on infants and children?

A

NO

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32
Q

What is the patient’s respiratory condition when speaking 3-4 word sentences?

A

Increasing respiratory distress

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33
Q

What is the patient’s respiratory condition when speaking 1-2 word sentences?

A

Severe respiratory distress

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34
Q

FROPVD?

A

Flow-restricted Oxygen powered ventilation device

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35
Q

If compensatory mechanisms are working, will you see blue skin?

A

NO

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36
Q

If a patient has an obviously serious respiratory problem, ______.

A

Expose and visually inspect the chest

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37
Q

Adequate breathing - Normal rates

A

Adult - 12-20 per minute.
Child - 15-30 per minute.
Infant - 25-50 per minute.

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38
Q

What do prolonged inspirations indicate?

A

A possible upper airway obstruction

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39
Q

What do prolonged exhalations indicate?

A

A possible lower airway obstruction

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40
Q

Where do retractions in children occur?

A

Above the clavicles and between and below the ribs

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41
Q

Will a person in respiratory distress have an adequate minute volume?

A

YES, respiratory failure will have an inadequate minute volume

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42
Q

Often patients in respiratory failure will be ___ and ____.

A

Breathing and conscious

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43
Q

If a patient will allow you to intervene with a BVM, it generally means ___.

A

He needs it

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44
Q

What are the three negative side effects of positive pressure ventilation?

A
  1. Decreasing cardiac output/dropping blood pressure.
  2. Gastric Distention.
  3. Hyperventilation.
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45
Q

The risk from positive pressure can be minimized by using ____ to raise the chest.

A

Just enough volume

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46
Q

_____ can be minimized by using airway adjuncts when ventilation and also by establishing proper head position and airway opening techniques.

A

Gastric Distention; Cricoid pressure can also help with gastric distention

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47
Q

Too much carbon dioxide being blown off causes ____.

A

Vasoconstriction

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48
Q

To determine the signs of adequate ventilation, you should: (2 things)

A
  1. Watch the chest rise and fall with each ventilation.

2. Ensure that the rate is sufficient (Adult 10-12 Child 20 Infant Minimum of 20/minute.

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49
Q

What are two examples of noninvasive positive pressure ventilation (NPPV)?

A

CPAP and BiPAP

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50
Q

NPPV can be used only by patients who are still _____.

A

Breathing on their own

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51
Q

Do some pocket masks have oxygen inlets?

A

YES

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52
Q

What O2 concentration can a pocket mask connected to O2 deliver?

A

50 percent

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53
Q

What is the oxygen percentage in exhaled air?

A

16 percent

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54
Q

Does a strap on a pocket mask replace the need for proper hand position?

A

NO

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55
Q

Where should you position yourself when using a pocket mask with a person with suspected spine injury?

A

Position yourself directly above (at the top of) the patient’s head

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56
Q

Each ventilation should be delivered over ____ in adults, infants, and children and be of just enough volume to make the chest rise

A

1 second

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57
Q

Can a pocket mask deliver higher volumes of air than a BVM?

A

YES, if the rescuer has an adequate expiratory capacity.

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58
Q

What are some requirement of a BVM device?

A

Must be self-refilling shell that is easily cleaned and sterilized (a lot of them are disposable now)

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59
Q

Where on a patient’s face do you position a BVM mask if it is the large, round style mask?

A

Centered first on the patient’s mouth as opposed to the nose and lower chin

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60
Q

What type of standard fitting is used on most BVMs?

A

15/22 fitting

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61
Q

BVM systems without a O2 reservoir deliver approx. ____ percent oxygen.

A

50 percent

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62
Q

What is the bag capacity of a BVM?

A

1,000 to 1,600 mL of air

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63
Q

What is the most difficult part of delivering BVM artificial ventilations?

A

Obtaining an adequate mask seal so that air does not leak out around the edges of the mask

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64
Q

The AHA recommends that how many rescuers are used when providing BVM artificial ventilations?

A

TWO

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65
Q

Studies have shown that ____ may prevent adequate ventilations. BVM systems with ____ should be replaced

A

Pop off valves

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66
Q

How many hands should a rescuer use to squeeze the bag?

A

two hands

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67
Q

How do you find the cricoid ring?

A

Palpate the adam’s apple and then identify the ring just inferior

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68
Q

Applying cricoid pressure should be limited to ___.

A

Unconscious patients or those that have a severely impaired mental status

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69
Q

Is it ok to apply cricoid pressure if the pt is vomiting?

A

NO

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70
Q

What is the last choice of artificial ventilation?

A

BVM by a single rescuer

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71
Q

In one rescuer CPR, it is preferable to use a ___ instead of a BVM.

A

Pocket mask

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72
Q

Do you need to position the patient’s airway when providing artificial ventilations to a stoma?

A

NO, leave the head and neck in a neutral position

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73
Q

Use a _____ to establish a seal around the stoma.

A

Pediatric sized mask

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74
Q

An FROPVD has a peak flow rate of ____ percent O2 at up to ___ lpm.

A

100 percent; 40 LPM

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75
Q

When does the inspiratory relief valve operate on an FROPVD?

A

60 cm of water pressure

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76
Q

Is an FROPVD rugged?

A

YES

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77
Q

In a patient with suspected spine injury, is it ok to immobilize the head between your knees?

A

Yes, if no assistance is available

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78
Q

When do you need to be careful using an FROPVD?

A

When using on a patient with chest trauma be careful not to overinflate

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79
Q

Can you use an FROPVD on children?

A

Maybe, only if you have a child FROPVD unit and special training in its use by your medical director

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80
Q

Oxygen administration has changed in recent years mainly due to ____.

A

the 2010 AHA guidelines

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81
Q

Oxygen is a drug. All other medications are given based on ____ and ___.

A

Need and therapeutic benefit

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82
Q

Current research indicates that oxygen can actually cause harm in ____.

A

Reperfusion situations at the cellular level

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83
Q

Patients with O2 sat less than ____ should receive O2 based on severity.

A

94%

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84
Q

In a significant number of cases a ____ will be enough to raise saturation.

A

nasal cannula

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85
Q

Always remember to ____ rather than oxygenate patients in respiratory failure or arrest.

A

Ventilate

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86
Q

What pressure are most O2 bottles under when full?

A

2000-2200 psi

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87
Q

What size and larger O2 cylinders are used for fixed systems?

A

M and above. (M, G, H, and K)

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88
Q

____ cylinders are also used for O2.

A

Unpainted stainless steel and aluminium

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89
Q

What is the safe residual for and O2 cylinder?

A

200 psi

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90
Q

D cylinder capacity

A

350 liters

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91
Q

E cylinder capacity

A

625 liters

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92
Q

M cylinder capacity

A

3000 liters

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93
Q

G cylinder capacity

A

5300 lites

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94
Q

H cylinder capacity

A

6900 liters

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95
Q

Oxygen wrenches should be ____.

A

Nonferrous

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96
Q

Oxygen must not be allow to get how old?

A

5 years

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97
Q

Open an O2 valve fully and then close it ____.

A

A half turn

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98
Q

How often do O2 bottles need to be hydrostatically tested

A

5 years; however some can be 10 years if there is a star after the date

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99
Q

What is the working pressure of the O2 pressure regulator set to?

A

30-70 psi

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100
Q

On cylinders of ___ size and smaller, the regulator is secured to the cylinder valve assembly by a yoke assembly.

A

E size

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101
Q

What is the yoke pin system referred to as?

A

The pin-index safety system

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102
Q

A pressure compensated flow meter uses gravity and ___.

A

indicates the actual flow at all times, even though there may be a partial obstruction to gas flow.

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103
Q

A constant flow selector valve flowmeter can be used with what size O2 cylinder?

A

Any size

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104
Q

What will low pressure flowmeters flow?

A

15 or 25 lpm

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105
Q

What type patients will be more comfortable with humidified O2?

A

COPD and children

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106
Q

Why are humidifiers no longer used in many EMS systems?

A

Short transports and infection risk

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107
Q

Air sac collapse due to O2 toxicity is ___.

A

Extremely rare in the field

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108
Q

When does infant eye damage occur?

A

When premature infants are given too much O2 over a long period of time (days)

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109
Q

Flow rate NRB and oxygen concentration

A

12-15 lpm; 80-90 percent (another spot in the book says 80-100 percent)

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110
Q

Flow rate and oxygen concentration NC

A

1-6 lpm; 24-44 percent

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111
Q

Flow rate and oxygen concentration Partial rebreather mask

A

9-10 lpm; 40-60 percent

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112
Q

flow rate and oxygen concentration venturi mask

A

Varied flow rate, up to 15 lpm; 24-60 percent

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113
Q

Tracheostomy mask flow rate and O2 concentration

A

8-10 lpm; percent is recommended by home care agency

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114
Q

How much can a non rebreather be allowed to deflate when the patient inhales?

A

Cannot deflate by more than one third

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115
Q

What situations need higher O2 concentrations than can be provided by NC? (4 things)

A

Chest pain, signs of shock, hypoxia, or other more serious problems

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116
Q

What if a patient will not tolerate a NRB mask?

A

The cannula should be used only when a patient will not tolerate the mask

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117
Q

How much air does a patient rebreath with a partial rebreather mask?

A

About one third of his exhaled air

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118
Q

Some venturi masks have a set percentage and flow rate whereas other have an _____. These devices are most commonly used on patients with ____.

A

adjustable Venturi port; COPD

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119
Q

How much faster do children burn O2 compared to adults?

A

Twice the rate

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120
Q

What can an EMT do to further success of advanced airway insertion?

A

Assure a patent airway and quality ventilations prior to insertion of the advanced airway device

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121
Q

What are the limitations when trying to hyperoxygenate the patient?

A

Do not administer more than 20 breaths/minute for more than 2-3 minutes nor administer breaths forcefully

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122
Q

Does passing an ET tube through a person’s nose require visualization?

A

NO

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123
Q

What size syringe to use when filling the cuff of ET tube?

A

10cc

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124
Q

Two methods to assure proper tube placement

A

Auscultate lungs and epigastrium and End tidal CO2

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125
Q

How long should intubation take?

A

Less than 30 seconds

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126
Q

A patient with an ET tube offers less resistance to ventilations, so you may not need ____ to work the bag

A

Two hands

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127
Q

What is increased bagging resistance one of the first signs of?

A

Air escaping through a hole in the lungs and filling the space around the lungs, which is a very serious problem

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128
Q

What should you do with the bag when defibrillating?

A

Carefully remove the bag from the tube

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129
Q

Blind insertion devices usually do not require the head to be placed in the ____.

A

Sniffing position

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130
Q

Scene size up is ____ to the first part of the assessment process.

A

Not confined

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131
Q

Further observations of the scene are likely to reveal more important information about the ___

A

Mechanism of injury

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132
Q

What are the 5 steps of scene size up?

A
  1. Identify hazards.
  2. Examine for M O I and N O I.
  3. B S I precautions.
  4. Determine the number of patients.
  5. Radio for additional resources early.
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133
Q

An ambulance should ___ be parked in the danger zone.

A

NEVER

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134
Q

When there are no apparent hazards what is the danger zone?

A

Danger zone extends at least 50 ft in all directions from the wreckage

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135
Q

Danger zone when fuel has been spilled

A

Danger zone extends a min of 100 ft in all direction of wreckage and fuel. Park upwind. If parking uphill is not possible position the ambulance as far from the flowing fuel as possible.

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136
Q

Danger zone when vehicle is on fire.

A

100 ft in all directions

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137
Q

Danger zone when wire are on the ground.

A

Any area where the wires could pivot around the pole and make contact with people or vehicles

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138
Q

How hot can the catalytic converter get?

A

1000 degrees F

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139
Q

Who publishes the ERG?

A

USDOT, Transport Canada, and the Secretariat of communications and transport of Mexico

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140
Q

How far away might you be warned to park if explosives may detonate?

A

2000 ft

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141
Q

Where should you park if gases or fumes may rise?

A

The same level

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142
Q

A call that is ____ should raise your suspicions.

A

Too quiet

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143
Q

When a pt is suspected of having TB or another disease spread through the air, wear an ___ or ___.

A

N-95 or HEPA mask

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144
Q

The ____ is what causes the injury.

A

Mechanism of injury

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145
Q

What are the three collisions in an MVC?

A
  1. Vehicle to object
  2. Body to interior of vehicle
  3. Organs to interior of body
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146
Q

Define the law of inertia

A

A body at motion will remain in motion unless acted upon by an outside force

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147
Q

Head on collisions have great potential for injury to ___.

A

All parts of the body

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148
Q

Rear end collisions are common causes of ____.

A

Neck and head injuries

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149
Q

In what type of collision will the head remain still as the body is pushed laterally causing injuries to the neck?

A

Side impact collisions

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150
Q

What type of collision is the most serious because of the potential for multiple impacts?

A

Rollover collision

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151
Q

Rotational impact collisions can cause ____

A

multiple injury patterns

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152
Q

What are important factors to consider when somebody has fallen? (4 things)

A

The height they fell, the surface they fell onto, the part of the patient that hit the surface, and anything that interrupts the fall

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153
Q

It is likely that you will find additional injuries if you assess along the ___.

A

path of the energy

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154
Q

What is considered a severe fall by the CDC and US dept of health and human services?

A

Adult - greater than 20 ft.

Child - Greater than 10 ft for a child under age 15 or more than two to three times the child’s height

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155
Q

How are penetrating wounds classified?

A

By the velocity of the item that caused the injury

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156
Q

Penetrating trauma velocity definitions

A

Low - propelled by hand, injury limited to the area penetrated.
Medium - handguns and shotguns, arrow from a compound bow, ballistic knife.
High - assault rifle; cause pressure related damage also.

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157
Q

Signs of blunt force trauma are often ____ and ___.

A

Subtle and easy to overlook

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158
Q

Define index of suspicion

A

awareness that there may be injuries

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159
Q

As a call progresses and you get more involved in patient care, it is ____ that you will remember to call for the additional help.

A

Less likely

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160
Q

What is the portion of patient assessment during which you will focus exclusively on life threats?

A

Primary assessment

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161
Q

What are other terms for primary assessment?

A

Primary survey or initial assessment

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162
Q

What order should the ABC’s be in if the patient appears lifeless and has no pulse?

A

C-A-B

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163
Q

What are the six parts of primary assessment?

A
  1. General impression.
  2. Assessing mental status.
  3. Airway.
  4. Breathing.
  5. Circulation.
  6. Determining the priority of the patient for treatment and transport to the hospital
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164
Q

In cases where there appears to be _____ you should check for a pulse and begin CPR if necessary.

A

No breathing or only very occasional, ineffective breaths (agonal breathing)

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165
Q

What do the initial steps of the primary assessment depend on?

A

Your initial impression of the patient

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166
Q

What is the general assessment based on?

A

Your immediate assessment of the environment and the patient’s chief complaint and appearance

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167
Q

In cases of suspected trauma, you will match this information with the ____, ___, and ____.

A

Mechanism of injury, the patient’s complaint, and assessment findings.

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168
Q

What can disrupt normal adequate breathing when the chest is injured? (3 things)

A

rib injury, collapsed lungs, and bleeding from the major blood vessels within the mediastinum

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169
Q

What does Levine’s sign indicate?

A

Significant chest pain or discomfort

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170
Q

What is the reason EMS was called, in the patient’s own words?

A

The chief complaint

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171
Q

What do you do to form a general impression?

A

Look, listen, and smell

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172
Q

What is judgement based on experience in observing and treating patients?

A

Clinical judgement

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173
Q

Most EMS systems document that a person is oriented to ____.

A

Person, place, and time

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174
Q

If the level of responsiveness is lower than alert, ____.

A

Provide high-concentration oxygen by nonrebreather mask and consider the patient a high transport priority

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175
Q

What are the two purposes of performing the primary assessment?

A
  1. Identify and correct life threats with the airway, breathing and circulation
  2. Gather information
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176
Q

Four general situations that call for assistance with breathing from more severe to less severe.

A
  1. Respiratory arrest (perform rescue breathing).
  2. Not alert and breathing is inadequate (positive pressure).
  3. Patient has some level of alertness and breathing is inadequate (synchronize assisted ventilations).
  4. Breathing is adequate, but signs of respiratory distress or hypoxia are present (provide O2)
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177
Q

How long to check a carotid pulse.

A

No longer than 10 seconds

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178
Q

3 things to assess when evaluating circulation

A

Pulse, skin, and bleeding

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179
Q

Where do you check the skin if a patient is dark skinned?

A

Lips or nail beds, which should be pink

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180
Q

Do you need to check the pulse for 30 seconds during the primary assessment.

A

No, just long enough to determine if it is slow, fast, or normal

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181
Q

What are the 3 patient classifications to help determine priority?

A

Stable, potentially unstable, or unstable

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182
Q

To be stable a patient needs to have vital signs, that are _____ or ____.

A

In the normal range or just slightly above abnormal

183
Q

Are stable vital signs necessary to classify a person as stable?

A

YES, but they are not the only requirement

184
Q

A threat to ABC’s, either actual or imminent, rules out ____.

A

Stable

185
Q

When a patient does not have immediate life threats, but you believe he may deteriorate, this patient classification should be ___.

A

Potentially unstable, you should not delay transport, but you may not use lights and sirens to get to the ER

186
Q

List high priority conditions (9 things)

A
  1. Poor general impression.
  2. Unresponsive.
  3. Responsive, but not following commands.
  4. Difficulty breathing.
  5. Shock.
  6. Complicated childbirth.
  7. Chest pain consistent with cardiac problems.
  8. Uncontrolled breathing.
  9. Severe pain anywhere.
187
Q

What position should you place an unresponsive medical patient?

A

Position patient on side

188
Q

At what age should you assess cap refill for a responsive medical patient?

A

Infants and children under 6

189
Q

What things does a responsive medical patients priority depend on?

A

Chief complaint, status of ABCs and other factors

190
Q

An unresponsive patient is ____ a high priority for immediate transport.

A

Automatically

191
Q

To evaluate circulation of blood, In an infant or small child with small nail beds____.

A

Press the back of the hand or top of the foot instead of normal nail bed cap refill check

192
Q

Is capillary refill a reliable sign for circulation in adults?

A

NO

193
Q

How is the mental status of infants typically checked?

A

Talking to the infant and flicking the feet

194
Q

If a patient has depressed mental status and breathing (slower than ___ per minute) how do you ventilate?

A

8 per minute; positive pressure with 100% O2

195
Q

What do you do if a patient is breathing more than 24 times a minute and is alert?

A

100 % O2 by NRB

196
Q

The most important part of patient assessment is the ____.

A

Chief complaint, the reason the patient called for EMS

197
Q

Why would you be unable to collect vital signs on a patient?

A

You are too busy treating immediate threats to life

198
Q

Which part of the assessment process will vital signs be collected?

A

Secondary assessment

199
Q

What are the two factors you should be concerned with when taking a patient’s pulse?

A

Rate and quality

200
Q

What factors affect pulse rate? (7 things)

A

Age, physical condition, degree of exercise just completed, medications or other substances being taken, blood loss, stress, and body temperature.

201
Q

Normal pulse rate Adult

A

60-100

202
Q

8Normal pulse rate Adolescent 11-18

A

60-105

203
Q

Normal pulse rate School age 6-10

A

70-110

204
Q

Normal pulse rate Preschooler 3-5

A

80-120

205
Q

Normal pulse rate Toddler 1-3

A

80-130

206
Q

Normal pulse rate Infant 6mo-12mo

A

80-140

207
Q

Normal pulse rate 0-5mo

A

90-140

208
Q

Normal pulse rate newborn

A

120-160

209
Q

Possible causes for a rapid, regular, and full pulse (5 things)

A

Exertion, fright, fever, high blood pressure, first stage blood loss

210
Q

Possible causes for a rapid, regular, and thready pulse (2 things)

A

Shock, later stages of blood loss

211
Q

Possible causes for a slow pulse (5 things)

A

Head injury, drugs, some poisons, some heart problems, lack of oxygen in children

212
Q

A high pulse in an infant or child is not as great a concern as a low pulse. A low pulse may indicate ____.

A

Imminent cardiac arrest

213
Q

An athlete may have a normal at-rest heart rate between ___.

A

40 and 50 beats per minute

214
Q

In an emergency, it is not unusual for a heart rate to temporarily be between ___.

A

100-140

215
Q

If the pulse rate is higher than __, or if consistently above ___ or below ___ consider this a sign that something may be seriously wrong with the patient and transport as soon as possible.

A

150; Above 120 or below 50

216
Q

What two factors determine pulse quality?

A

rhythm and force

217
Q

You should initially find a radial pulse in a patient that is ___ year of age and older.

A

ONE

218
Q

The thumb side of the forearm is also referred to as ___.

A

The lateral side

219
Q

Where do you look for a pulse in an infant 1 year old and less?

A

Brachial pulse

220
Q

Can you assess carotid pulses on both sides at the same time?

A

NO

221
Q

How many fingers should you use when trying to measure a radial pulse?

A

Three, first 3 fingers

222
Q

How long should you count when measuring pulse or respirations?

A

30 seconds

223
Q

What two factors are you concerned with when assessing respiration?

A

Rate and quality

224
Q

What factors can influence breathing rate? (5 things)

A

Age, sex, size, physical conditioning, and emotional state

225
Q

What are the four categories of respiratory quality?

A

Normal, shallow, labored, and noisy

226
Q

What is especially serious in an unconscious patient?

A

Shallow breathing

227
Q

Many resting people breathe more with their ____ than with their ____.

A

Diaphragm; chest muscles

228
Q

Normal respiratory rate Adult

A

12-20; Above 24 and below 8 indicates SERIOUS

229
Q

Normal respiratory rate Adolescent 11-18

A

12 to 20

230
Q

Normal respiratory rate School age 6-10

A

15 to 30

231
Q

Normal respiratory rate Preschooler 3-5

A

20 to 30

232
Q

Normal respiratory rate Toddler 1-3

A

20 to 30

233
Q

Normal respiratory rate Infant 6mo-12mo

A

20 to 30

234
Q

Normal respiratory rate 0-5mo

A

25 to 40

235
Q

Normal respiratory rate newborn

A

30 to 50

236
Q

What is an intervention if Crowing respiratory sound are heard?

A

Prompt transport; this is a medical problem that cannot be treated on the scene

237
Q

Give signs of labored breathing (7 things)

A
  1. Increase in the work of breathing.
  2. The use of accessory muscles.
  3. Nasal flaring.
  4. Retractions above the collarbones or between the ribs (especially in infants and children).
  5. Stridor.
  6. Grunting in expirations (especially in infants).
  7. Gasping.
238
Q

What things affect regularity of an awake patients breathing? (3 things)

A

Speech, mood, and activity among other things

239
Q

When might you see mottled skin?

A

Occasionally in patients with shock

240
Q

What are the three best places to assess skin color?

A

Nail beds, inside of cheek, and inside of the lower eyelids

241
Q

What are the best places to assess skin for an infant or child?

A

palms of the hands or soles of the feet

242
Q

Who is more susceptible to mottling?

A

Children and elderly who are in shock

243
Q

If a patient’s forehead feels cold what should you do?

A

Further assess by placing the back of your hand on the abdomen beneath the clothing

244
Q

What is clammy?

A

Both cool and moist

245
Q

Cool/Clammy skin can be a sign of ____.

A

Shock or anxiety

246
Q

Cold moist skin

A

Body is losing heat

247
Q

Cold dry skin

A

Exposure to cold

248
Q

Goose bumps

A

Possible causes - Chills, communicable disease, exposure to cold, pain or fear

249
Q

Is cap refill in children reliable if they have been exposed to the cold?

A

NO

250
Q

What should you look for when assessing pupils

A

Size, equality, and reactivity

251
Q

Under ordinary conditions, pupils are neither large nor small, but ___.

A

Midpoint

252
Q

How should you evaluate eyes when examining in the sun?

A

Cover both eyes and after a few seconds uncover one eye and examine it

253
Q

Causes of dilated pupils (3 things)

A

Fright, blood loss, drugs, prescription eye drops

254
Q

Causes of constricted pupils (2 things)

A

Drugs, prescription eye drops

255
Q

Causes of unequal pupils (5 things)

A

Stroke, head injury, eye injury, artificial eye, prescription eye drops

256
Q

Causes of pupil lack of reactivity (2 things)

A

Drugs, lack of oxygen to the brain

257
Q

Normal blood pressure range Adult

A

Systolic - Less than 120 Diastolic - Less than or equal to 80

258
Q

Normal blood pressure range Infants and children

A

Systolic - approx. 80 + 2 x age Diastolic - 2/3 the systolic

259
Q

Normal blood pressure range Adolescent 11-14

A

Systolic - average 114 (88-120) Diastolic - average 76

260
Q

Normal blood pressure range School age 6-10

A

Systolic - average 105 (80-115) Diastolic - average 69

261
Q

Normal blood pressure range Preschooler 3-5

A

Systolic - average 99 (78-104) Diastolic - average 65

262
Q

Blood pressure is usually not taken on a child under ___.

A

3 years

263
Q

In cases of blood loss or shock, a childs BP will remain within normal limits until ___.

A

The near the end, then fall swiftly

264
Q

Define the limits for hypertension.

A

Sys greater than 140 or diastolic greater than 90

265
Q

What is it when systolic BP is between 121-139 or diastolic between 81-89

A

prehypertension

266
Q

Define the limits of serious low blood pressure.

A

When the systolic drops below 90

267
Q

What’s the first step when taking a bp with a sphygmomanometer?

A

Put the stethoscope around your neck like a real hero

268
Q

How much of the arm should the BP cuff cover?

A

two thirds of the upper arm

269
Q

Is it ok to have clothing under a bp cuff?

A

NO

270
Q

Where should the bp cuff be placed in reference to a patient’s elbow?

A

1 inch above the crease of the elbow

271
Q

What are the 3 ways to take a bp?

A

Auscultation, palpation, or blood pressure monitor

272
Q

Where should you position the diaphragm of the stethoscope?

A

Directly over the brachial pulse or over the medial anterior elbow (front of elbow) if no brachial pulse can be found

273
Q

How fast should you allow the pressure to fall when taking a bp?

A

5-10 mm per second

274
Q

Blood pressure is reported in even numbers. If the reading falls between two lines on the guage, use the ___.

A

Higher number

275
Q

How long should you wait to re-inflate the cuff if you need to retake the bp?

A

1 minute, if you don’t wait you will get and erroneously high number

276
Q

Is MAP typically used in the prehospital setting?

A

NO

277
Q

What gives you more information about a child or infant rather than BP? (3 things)

A

Sick appearance, respiratory distress, or unconsciousness

278
Q

What is one very important use for temperature of a patient?

A

Screening for influenza

279
Q

How fast will an electronic thermometer usually provide a reading?

A

In just a few seconds

280
Q

Rectal temperatures are ____.

A

Not usually practical or necessary in the field

281
Q

Are tympanic thermometers accurate enough for EMS use?

A

NO

282
Q

What does a person’s normal temperature depend on? (5 things)

A

Time of day, activity level, age, where the temperature is measured, and simple genetics

283
Q

Older people tend to have ___ temperatures than younger people.

A

Lower

284
Q

A rectal temp is often ___ than an oral temp and an axillary temp is frequently ___.

A

1 degree higher for rectal and 1 degree lower for axillary

285
Q

In general a healthy normal person will have a temperature greater than ___ and less than ___.

A

96 and 100 degree F

286
Q

What is the monitor called that can measure CO and O2?

A

CO-oximeter

287
Q

A pulse ox can help you assess the effectiveness of ___. (3 things)

A

artificial respirations, oxygen therapy, and bronchodilator therapy

288
Q

Pulse ox hypoxia ranges

A

91-95 percent Mild hypoxia
86-90 percent - significant or moderate hypoxia
85 percent or less - severe hypoxia

289
Q

You should try to get the SpO2 up to at least ___

A

96 percent

290
Q

Should you withhold O2 if the patient’s saturation is above 96?

A

No

291
Q

When is the oximeter inaccurate?

A

in patients with shock or hypothermic

292
Q

What type of pulse ox readings will somebody with CO exposure show?

A

Falsely high readings

293
Q

Smokers may have ____ percent of their hemoglobin bound to carbon monoxide

A

10-15 percent

294
Q

Anemia, hypovolemia, and certain types of poisoning can give ___

A

Falsely high O2 sat readings

295
Q

People with diabetes may test their blood sugar as often as

A

5-6 times a day

296
Q

Some glucose meters can take blood from the __ instead of the finger

A

forearm

297
Q

Milligrams per deciliter can also be called ___

A

milligrams percent

298
Q

A normal blood glucose level is usually at least ___ and no more than ___.

A

60-80; 120-140

299
Q

After you prick a person’s finger, you should ___

A

wipe away the first drop of blood that appears

300
Q

A glucometer may take up to ___ seconds to provide a reading

A

15-60 seconds

301
Q

Some areas recommend that the blood glucose measurements be done while ___.

A

En route to the hospital

302
Q

Often you will not be able to see the injury or how serious it is, especially if ___.

A

It is internal

303
Q

Signs of major injury (5 things)

A
  1. Serious bleeding.
  2. penetrating injury to the neck, chest, or abdomen.
  3. Altered mental status.
  4. Lack of patent airway.
  5. Pallor, tachycardia, other signs of shock (in another spot in the book).
304
Q

What is included in a secondary assessment of a trauma patient with no significant Mechanism of injury?

A
  1. History of present illness
  2. Physical exam
  3. Set of baseline vitals
  4. Past medical history
305
Q

Frequently in health care the word illness means both ___.

A

nontrauma medical problems and injuries from trauma

306
Q

Secondary assessment steps for trauma patient with significant MOI

A
  1. Determine chief complaint and rapidly how the patient was injured
  2. manual c-spine
  3. Consider requesting ACLS
  4. Perform rapid trauma assessment
  5. Baseline vital
  6. Obtain past medical history
307
Q

What is a more important question if a person was shot?

A

How many shots did you hear?

308
Q

What are three techniques of physical exam that an EMT must master?

A

observe, palpate, and auscultate

309
Q

What 4 things do you look for when inspecting a pt?

A

Symmetry, color, shape, and movement

310
Q

What 4 things do you look for when palpating a pt?

A

Abnormalities in shape, temperature, texture, and sensation

311
Q

DCAP-BTLS

A

Deformities, contusions, abrasions, punctures and penetrations, burns, tenderness, lacerations, swelling

312
Q

What are some of the most common injuries you will see?

A

Abrasions

313
Q

Swelling is a common result of ___.

A

Capillaries bleeding under the skin

314
Q

What is a simpler classification for DCAP-BTLS?

A

Wounds, tenderness, and deformities

315
Q

A sign is ___ while a symptom is ____.

A

Objective; subjective

316
Q

Which things do you base your decision to place a c-collar?

A

Any patient that may have injury to the spine based on mechanism of injury, history, or signs and symptoms

317
Q

Do gunshot wound automatically get a c-collar?

A

No, only if there are signs or symptoms of neurological injury or if the patient is unconscious and cannot be fully assessed for these findings

318
Q

What is an alternative if a proper size c-collar is not available?

A

Rolled towel around the neck and tape patient’s head to backboard

319
Q

Do you perform primary assessment and treat life threats before or after applying the c-collar?

A

Before

320
Q

Use the ____,___ and ____ to determine the need for cervical immobilization.

A

MOI, level of responsiveness, location of injuries

321
Q

Does a proper sized c collar depend more the the width or length of the patient’s neck?

A

Length

322
Q

The front height of the collar should fit between the point of the chin and the chest at the ___.

A

Suprasternal (jugular) notch

323
Q

If a c collar is supporting the chin it is ___

A

Too short

324
Q

A trauma patient with significant MOI gets a physical exam focused on the area of injury and also receives a ___.

A

Head to toe rapid trauma assessment

325
Q

A child may sustain the same injury as an adult, but from ___.

A

Less force

326
Q

For falls, transport to trauma center if:

A

Adults: fall greater than 20 ft (one story = 10 ft).

Children under 15 yo, fall greater than 10 ft or two to three times the child’s height

327
Q

For high risk auto crash, transport to trauma center if:

A

Intrusion greater than 12 inches to occupant side or greater than 18 inches to any site.
Ejection.
Death in same vehicle.
Vehicle telemetry data consistent with high risk injury.
Motorcycle crash greater than 20 mph

328
Q

When inspecting a vehicle in which an airbag has been deployed, you should look at the ___.

A

Steering wheel

329
Q

Does determining a significant MOI when a patient has an obvious critical injury make a difference in your decision making?

A

NO

330
Q

Many local clinics would not be able to provide additional care that is worth a delay in transport for ___.

A

Awake trauma patients

331
Q

Even if a patient is a high priority transport, the RTA should ___.

A

Be performed at the scene, before loading the patient into the ambulance

332
Q

A bruise behind the patient’s ear is a ____.

A

Battle sign; important sign of skull injury

333
Q

Additional things to check when examining the head

A

Crepitation

334
Q

Additional things to check when examining the neck

A

JVD and crepitation

335
Q

Additional things to check when examining the chest

A

paradoxial motion, crepitation, breath sounds

336
Q

Additional things to check when examining the abdomen

A

firmness, softness, distention

337
Q

Additional things to check when examining the pelvis

A

pain, tenderness, motion

338
Q

Additional things to check when examining the extremities

A

distal circulation, sensation, motor function

339
Q

Blood in the ___ chamber is not common.

A

Anterior

340
Q

What is a concern if an ear of nose is leaking CSF?

A

Try to keep the area clean so bacteria don’t get in

341
Q

What is the most common unusual breath

A

Alcohol

342
Q

The neck veins are usually ___ when the patient is sitting up.

A

not visible

343
Q

JVD may be caused by ___ or ___.

A

tension pneumothorax or cardiac tamponade

344
Q

Flat neck vein in a patient who is lying down may be a sign of ___

A

blood loss

345
Q

Can you check for crepitation and paradoxial motion of the chest at the same time?

A

YES

346
Q

What are the two things to look for with breathing when performing a rapid assessment of the chest in the trauma patient?

A

presence and equality

347
Q

What are the two type of poop bags that may be in the abdomen?

A

colostomy or ileostomy

348
Q

How deep should you press when palpating the abdomen?

A

about 1 inch with the palm side of your fingers

349
Q

Does continuing to palpate the pelvis after the patient has already expressed pain necessary?

A

NO

350
Q

If you find a deformity, diminished function, or other indication of injury to an extremity in a patient who is a high priority for transport, you will ___.

A

Not splint the extremity at the scene but will treat it en route

351
Q

You may place a ____ on the board before you roll the patient onto it if they have a pelvic injury.

A

pneumatic anti-shock garment (PASG)

352
Q

one method of stabilizing an injured pelvis is forming a ___.

A

Pelvic wrap from a folded sheet

353
Q

Where should you check for distal pulses in a lower extremity?

A

Posterior tibial pulse just behind the medial malleolus of the ankle or the dorsalis pedis pulse at the top of the foot

354
Q

Always assume that the unconscious trauma patient has a ___.

A

spine injury

355
Q

Young children may be less frightened if you begin your assessment at the ___ and work towards the ___ instead of proceeding in the normal ____.

A

Toes to head rather than head to toe direction

356
Q

If you are not on a transporting unit and the ambulance has not arrived, you may do the ____ at the scene

A

detailed physical exam

357
Q

The detailed physical exam is performed most often on the trauma patient with a ____. Seldom on a ____.

A

Significant injury or MOI; medical patient

358
Q

You should perform the detailed physical exam only ___ you have performed all critical interventions

A

After

359
Q

Performing a detailed physical exam is always a ___ priority that addressing life threatening problems

A

lower

360
Q

The detailed physical exam usually takes place ___.

A

In the ambulance, en route

361
Q

JVD is always ___ in a seated patient.

A

Abnormal

362
Q

What should you do when trying to reassess the posterior of a patient on a backboard.

A

Simply reassess the flanks and as much of the spinal area as you can touch without moving the patient.

363
Q

Should you call the hospital before or after the detailed physical assessment?

A

Normally after, but depending on how far you are from the hospital and what your local protocols say, you may do this step before the detailed exam

364
Q

Does a trauma patient with no significant MOI need a detailed assessment?

A

This kind of patient received all the assessment he needed while still at the scene. He does not generally need a detailed physical exam.

365
Q

The detailed physical exam is most appropriate for the trauma patient who is ___.

A

unresponsive or has a significant injury or unknown MOI

366
Q

What is the most important source of information about a medical patient’s condition?

A

What the patient can tell you

367
Q

When the patient is awake and responsive, what comes first?

A

Obtaining patient history

368
Q

What are the four parts of the secondary assessment for a medical patient? This is also the order you do them in for a responsive medical patient

A
  1. History of the present illness.
  2. Past medical history.
  3. Physical exam.
  4. Baseline vitals.
369
Q

What is a good mnemonic for gathering the history of the present illness in a medical patient?

A

OPQRST, onset, provocation, quality, radiation, severity, and time

370
Q

What order are the parts of a secondary assessment of a medical patient if they are unresponsive?

A
  1. Rapid physical exam head to toe.
  2. Obtain baseline vitals.
  3. Gather history of present illness (OPQRST).
  4. Gather past medical history from family or bystander.
371
Q

What does a conversational information gathering effort get you other than info about the present illness?

A

It will also reduce the patient’s fear and promote cooperation

372
Q

Although relatives and bystanders can be good sources of info the most important source is the ___

A

patient

373
Q

After finding out the patient’s age, you should then get ___ and ___.

A

The rest of the past medical history and the name of his personal physician

374
Q

When an illness or other non traumatic condition occurs, it frequently affects not just one particular organ or part of the body but a ___

A

system of the body

375
Q

A patient with difficulty breathing you should also assess for signs of ___.

A

fluid build up (this may be seen in the ankles - or in the lower back of a bedridden patient

376
Q

If the type of complaint is respiratory what additional history should be attained? (5 things)

A

Cough, Fever or chills, dyspnea on exertion, weight gain (indicates fluid), have a prescribed bronchodilator?

377
Q

FAST for neurological testing

A

F - face, A - Arms, S - speech, T- test oxygen saturation

378
Q

Most of the useful information for medical patients comes from the ___.

A

history

379
Q

A complete set of baseline vital signs taken during the ___ is essential to the assessment of a medical patient

A

secondary assessment

380
Q

What is on a medic alert identification device?

A

Star of Life, the patient’s medical problem along with a phone number (ankle wrist or neck, also look for wallet cards)

381
Q

The most important time to check the pupils are when the patient’s eyes are ___

A

Closed

382
Q

What should you use instead of the word drugs when finding out what a patient takes

A

medicines or medications

383
Q

Where might you see a vial of life sticker?

A

main outside door, closest window to the main door, or the refrigerator door

384
Q

There is not usually much information gained from the secondary assessment of an ____ that will change treatment in the field.

A

Unresponsive medical patient

385
Q

The information you gather in your assessment of unresponsive medical patients will be particularly helpful to the ____

A

Staff in the emergency department

386
Q

You will perform reassessment on every patient after you have ___.

A

Finished performing lifesaving interventions and often after you have done the detailed physical assessment

387
Q

What should you do during a reassessment? (4 things)

A
  1. Repeat primary assessment.
  2. reassess vital signs.
  3. repeat physical exam related to the patient’s specific complaint or injuries.
  4. Check any interventions you have performed.
388
Q

The abdomen may become distended, a sign that you are especially likely to see if you have ___.

A

A long transport

389
Q

What determines just how often you will conduct the reassessment?

A

The patient’s condition as well as the length of time you spend with the patient. General rule every 15 minutes for stable and 5 minutes for unstable or potentially unstable

390
Q

Whenever you believe there may have been a change in the patient’s condition, repeat at least the ___

A

Primary assessment

391
Q

____ is the last step in your patient assessment

A

Reassessment

392
Q

Interventions you need to check during a reassessment include ___ (4 things)

A

oxygen, bleeding, spine immobilization, & splints

393
Q

The EMT is governed by which guidelines?

A

Medical, Legal, and ethical

394
Q

What defines what skills and medical interventions an EMT can perform?

A

Legislation

395
Q

What is the primary ethical consideration?

A

To make patient care and well-being a priority

396
Q

Scope of practice refers to

A

What you should do

397
Q

Standard of care refers to

A

How you should perform care

398
Q

What is practiced with the aim of maintaining the standards you would wish to have provided for you or your family?

A

Quality improvement

399
Q

Consent given by adults who are of legal age and mentally competent to make a rational decision.

A

Expressed consent

400
Q

Presumed consent that a parent would give for a child

A

Implied consent

401
Q

What are the 3 types of consent?

A
  1. Expressed.
  2. Implied.
  3. Consent to treat minors or incompetant patients
402
Q

Expressed consent must be

A

Informed consent

403
Q

Is informed consent a legal requirement?

A

YES

404
Q

What is the latin term for the daycare situation?

A

In loco parentis

405
Q

3 ways to enforce involuntary transport.

A
  1. Police.
  2. Mental health worker.
  3. Court order
406
Q

What are reasons a patient may refuse care? (3 things)

A
  1. Denial or fear.
  2. Failure to understand the seriousness of the situation.
  3. Intoxication.
407
Q

Can a patient refuse care if they have unstable vital signs?

A

No

408
Q

What 4 things are needed for a patient to refuse care? Even if a patient does these 4 things an EMT may still be held liable.

A
  1. Able to consent.
  2. Mentally competant.
  3. Fully informed.
  4. Sign a release.
409
Q

Define battery.

A

Causing bodily harm or restraining

410
Q

Define assault.

A

Placing a person in fear of bodily harm.

411
Q

Is an advance directive a DNR order?

A

Yes

412
Q

Who is the person whom the signer names to make health decisions if he is unable to?

A

Proxy

413
Q

Living wills and proxies usually pertain to situations…

A

In the hospital, not in the field

414
Q

What 3 circumstances must be proved to determine negligance?

A
  1. EMT had a duty to the patient.
  2. EMT did not provide standard of care.
  3. There was proximate causation, which means the EMT caused physical OR pshychological harm.
415
Q

Is a tort civil or criminal?

A

Civil

416
Q

What is latin for “It speaks for itself”? Used in tort law.

A

Res ipsa Loquitor

417
Q

Two of the most significant causes for lawsuits against EMT’s

A

Patient refusals and vehical accidents

418
Q

Who should you contact if you have a question regarding the validity of a legal document?

A

Supervisor or agency attorney

419
Q

Can you supply information to insurance companies?

A

Yes

420
Q

Libel is

A

written

421
Q

Slander is

A

verbal

422
Q

How far should you cut from bullet or knife holes?

A

6 inches

423
Q

What is the entryway for air, especially in an emergency?

A

The mouth

424
Q

What are common foreign body obstructions?

A

Small toys, food, blood, or vomit

425
Q

What can cause swelling of the tissues around the glottic opening?

A

Blunt force, burns, and certain infections

426
Q

Is stridor an obstructed upper or lower airway?

A

Upper

427
Q

Swelling of the upper airway is usually due to?

A

Infection

428
Q

How far should you insert an OPA before rotating it?

A

Past the uvula or until you meet resistance against the soft palate

429
Q

Name the 4 parts of a suction unit.

A
  1. Suction source.
  2. Container.
  3. Tubing.
  4. Suction tips or catheters
430
Q

Can suction catheters suction vomit?

A

No, they will kink

431
Q

3 manual techniques for clearing an airway

A
  1. Abdominal thrusts.
  2. Chest thrusts.
  3. Finger sweeps
432
Q

Does the diaphragm expand or contract during inhalation?

A

Contracts

433
Q

Of a 500 mL tidal volume, how much actually reaches the alveoli?

A

350 mL

434
Q

What is the first step for BVM to stoma ventilations?

A

Clear mucus plug or secretions

435
Q

Humidifier water can become a breeding ground for.

A

Algea, harmful bacteria, or fungal organisms

436
Q

When should you adjust the flowmeter when administering O2?

A

Before and after placing the device on the patient

437
Q

Use orange traffic cones during daylight and these at night.

A

Reflective triangles

438
Q

Regarding scene safety, the specific actions tou should take depend on…(3 things)

A

Local protocols, type of danger, and help available

439
Q

After BSI and scene safety what should you do?

A

Identify mechanism of injury or nature of illness

440
Q

What does the amount of damage from a bullet depend on? (3 things)

A

Size, path, and if it fragmented

441
Q

General impression is based on (3 things)

A

Environment, chief complaint, and appearance

442
Q

Oxygen saturationa and mental status are

A

not considered vital signs

443
Q

When palpating a bloop pressure, what pulse should you use?

A

Radial or brachial

444
Q

How much higher should you inflate the blood pressure cuff after the pulse sounds disappear?

A

30 mmHg

445
Q

If you determine a high diastolic reading, wait __

A

1-2 minutes and take another reading

446
Q

Describe some examples of symptoms.

A

Pain, dizziness, and nausea

447
Q

What is a surgical incision held open by a metal or plastic tube?

A

Tracheostomy

448
Q

Repeat the primary assesment before a

A

detailed assessment is performed

449
Q

Which approach can you use to tailor the physical exam for a specific chief complaint?

A

Body systems approach

450
Q

Additional history to gather for allergic reactions.

A

Time of exposure and time of sympton onset

451
Q

What is an additional history item to check when assessing abdominal or GI issues?

A

Fever

452
Q

How many people wear medic alert tags?

A

Over 1 million

453
Q

When should you record vital signs?

A

As soon as they are taken

454
Q

What is a means of determining trends?

A

Reassessment

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