Boards

Question 1

croup

Answer 1

seal-like bark = stridor

• Breath cool moist air for 5 minutes
• If no improvement after 5 minutes continue to monitor
• If condition worsens transport to hospital

*always assume the worst, airway compromise!

Question 2

xray finding of croup

Answer 2

steeple sign

Question 3

epiglottitis

Answer 3

cause by H. influenza

drooling

Question 4

drooling seen ing epiglottitis …what NOT to do? what TO do?

Answer 4

DONT MOVE KNECK OR OPEN MOUTH

EMS transport to ER (don’t sent to ER in parent car because they don’t have airway management)

Question 5

xray finding of epiglottitis?

Answer 5

thumbprint sign

Question 6

when should oxygen be given in an adult?

Answer 6

fewer than 12 breaths or more than 20 breaths per minute

Question 7

when should oxygen be given in a child?

Answer 7

fewer than 15 breaths or more than 30 breaths per minute

Question 8

when should oxygen be given in an infant?

Answer 8

fewer than 25 breaths or more than 50 breaths per minute

Question 9

nasal cannula

Answer 9

slow flow rate and low percent oxygen

• flow rate 1-6 LPM,
• 24-44 percent oxygen concentration,
• breathing victims only (minor breathing problems)

Question 10

Resuscitation mask

Answer 10

moderate flow rate and low percent oxygen

• flow rate 6 -15 LPM,
• 35-55 percent oxygen concentration,
• breathing and non-breathing victims

Question 11

Non-rebreather mask

Answer 11

good flow rate and high percent oxygen

• flow rate 10-15 LPM,
• 90+ percent oxygen concentration,
• breathing victims only

Question 12

Bag valve mask (BVM)

Answer 12

high flow rate and highest percent oxygen

• flow rate 15 LPM or more,
• 90+ percent oxygen concentration,
• breathing and non-breathing victims

Question 13

upper airway obstruction- what does it look like?

Answer 13

• inspiratory and/or expiratory Stridor (high pitched sounds)
• Possible retractions of the thorax
• Intercostal, suprasternal, supraclavicular
• Cyanosis (later stage)
• Drooling (common in pediatrics)
• LOC with full obstruction

Question 14

upper airway obstruction- what to do?

Answer 14

• Determine if obstruction is mechanical or infectious!
• If mechanical; Do Heimlich procedure
• If infectious; consider Epiglottitis (drooling, tripod position)

Question 15

Choking - causes?

Answer 15

• The tongue is the most common obstruction in the unconscious victim
• Vomit
• Foreign body
• Balloons
• Foods
• Swelling (allergic reactions/ irritants)
• Spasm (water is inhaled suddenly)

Question 16

How To Recognize Choking

Answer 16

• Can you hear breathing or coughing sounds?
• High pitched breathing sounds?
• Can’t speak, breathe or cough
• Universal distress signal (clutches neck)
• Turning blue

Question 17

Conscious Choking 
(Adult Foreign Body Airway Obstruction)

Answer 17

• Give 5 abdominal thrusts (Heimlich maneuver)
• Place fist just above the umbilicus (normal size)
• Give 5 upward and inward thrusts
• Pregnant or obese? 5 chest thrusts, Fists on sternum
• If unsuccessful, support chest with one hand and give back blows with the other
• Continue until successful or victim becomes unconscious

Question 18

If Victim Becomes Unconscious After Giving Thrusts

Answer 18

• Call 911
• Try to support victim with your knees while lowering victim to the floor
• Assess
• Begin CPR
• After chest compressions, check for object before giving breaths breaths

Question 19

you enter a room and find an unconscious victim..what to do?

Answer 19

Assess patient
Perform CPR
(after compressions check airway before giving breaths)

Question 20

chocking infant…what to do?

Answer 20

• position downward on arm facing floor
• 5 back blows (check airway)
• 5 chest thrusts (check airway)
• repeat

Question 21

Signs of Shock

Answer 21

• Tachycardia (Earliest signs of shock)
• Hypotension (Late sign of shock)
• Adrenergic responses (Restless, agitated, cool clammy skin, “livedo reticularis”-mottled skin)
• Altered Mental Status
• Orthostatic Vital Signs
• Problems occur in standing position, often resolve supine

Question 22

most important indicators of anaphylaxis?

Answer 22

tachycardia and falling BP

Question 23

if allergy… how to treat? (no signs of respiratory or CV shock)

Answer 23

benadryl (diphenhydramine)

Question 24

if anaphylaxis …how to treat? (respiratory and/or CV shock)

Answer 24

Epinephrine, benadryl and steroids

Question 25

assessing peripheral blood pressure (emergency)

Answer 25

Radial pulse = AT LEAST 80 Systolic Femoral pulse = AT LEAST 70 Systolic Carotid pulse = AT LEAST 60 Systolic

Question 26

ratio of epi for IM/SubQ and intratrachial?

Answer 26

1:1000

Question 27

ratio of epi for IV?

Answer 27

1:10,000

Question 28

dose of diphenhydramine IV?

Answer 28

50 mg (1 mL)

Question 29

epilepsy is a dx of exclusion, first rule out which conditions?

Answer 29

Infection Mass / CA Electrolyte imbalance Toxic ingestion

Question 30

all people with head injury should be treated as if they have what condition by default?

Answer 30

cervical spinal injury

Question 31

All head injury patients require which intervention?

Answer 31

100% O2 therapy | Also (C-spine immobilization, Cervical Collar, Head blocks, Long board)

Question 32

hyphema vs subconjunctival hemmorage

Answer 32

hyphema = can cause acute glaucoma | subconjunctival hemmorage = looks bad but isn't

Question 33

chemical burn...what to do?

Answer 33

IRRIGATION and emerg referral

Question 34

flash burn...what to do?

Answer 34

common in welders....potato poultice

Question 35

whats worse? Corneal abrasion or corneal ulceration?

Answer 35

An ulcer is worse---blindness! | In cases of abrasion you must rule out foreign body before sending home!

Question 36

Survey the scene and RAP...stands for?

Answer 36

``` R = responsiveness (tap and shoulder "are you OK?" A = activate EMS (if unresponsive) P = position on back (keep head and neck in same position) ```

Question 37

CAB..stand for?

Answer 37

``` C = compression A = airway (head tilt chin lift) B = breathing (pinch nose, seal lips with yours) ``` (if pulse not felt within 10 sec, advance to CPR and AED is available)

Question 38

in doing CPR, should you give breaths or compressions first???

Answer 38

Compressions! (C-A-B rather than A-B-C)

Question 39

ratio of compressions to breaths?!

Answer 39

30:2 for all ages if one rescuer

Question 40

ratio of compression to breaths if two rescuers?

Answer 40

Adults- 30:2 | Infant/Child- 15:2

Question 41

don't move a victim until after CPR is given and qualified help arrives EXCEPT in the following case::

Answer 41

-threat of fire/explosion

Question 42

most victims even with CPR won't exist unless they have ACLS..what does it stand for?

Answer 42

Advanced cardiac life support which includes oxygen, defibrillation, drug therapy

Question 43

when can I stop giving CPR?

Answer 43

victim revives EMS arrives too exhausted to continue unsafe scene

Question 44

delivering emergency birth...when to clear airways?

Answer 44

after head is out but not shoulders...this is done because once shoulders are out they take their first breath and would aspirate meconium

Question 45

after baby is delivered what should you do?

Answer 45

``` place baby on or next to mom and... clear airway towel dry and wrap in blanket if not breathing (crying) clear airway again and flick soles of feet if still not breathing perform CPR ```

Question 46

APGAR stands for?

Answer 46

``` A = appearance P = pulse G = grimace (reflex) A = activity (muscle tone) R = respiration ```

Question 47

ointment given to newborns prophylactically to prevent transmission of GC/CT?

Answer 47

0.5% erythromycin base or 1% tetracycline hydrochloride

Question 48

when giving an IM injection what do you want to make sure to do?

Answer 48

aspirate to make sure you aren't injecting into blood supply

Question 49

angle for IM SQ ID

Answer 49

``` IM = 90 SQ = 30-45 ID = 5-10 ```

Question 50

when administering IV solution what is the pH range you want? what's idea?

Answer 50

5-9 | ideal 6.6 - 7.6

Question 51

when administering IV solution what osmolality is low, moderate and high risk of phlebitis?

Answer 51

low- 150-450 mod-450-600 high- >600

Question 52

isotonic solution

Answer 52

250 – 375 mOsm/L Normal Saline (0.9% Sodium Chloride / NS) 5% Dextrose in Water (D5W) Ringer’s Lactate (Balanced electrolyte solution) NEVER NEVER give sterile water

Question 53

syncope...what to do?

Answer 53

- Patient in recumbent position - DO NOT D/C THE I.V. LINE!!! - Slow (stop) infusion rate - Talk to them (if conscious) - Have them move their feet

Question 54

glycemic crisis...what to do?

Answer 54

typically due to high dose Vit C infusion or EDTA chelation - D5W infusion (as a base solution for prevention) OR - slow push of D-50 [50% Dextrose] (5 – 50 mL D50) will reverse.