CH 1-16 Flashcards
Consent
Permission to render care
Implied consent
Applies only when a serious medical condition exists and should never be used unless there is a threat to life or limb
Informed consent
You have explained the nature of the treatment being offered, along with the potential risks, benefits, and alternatives to treatment, as well as potential consequences of refusing treatment, and the patient has given consent
Expressed consent
when the patient verbally or otherwise acknowledges that he or she wants you to provide care and transport.
Involuntary consent
Applies to patients who are: mentally ill, in a behavior crisis, developmentally delayed. Obtain consent from guardian or family, if possible.
Minors and Consent
Parent or legal guardian gives consent. In some states, minors may give consent (depending on age and maturity, emancipated minors (married, armed service, parents). If true emergency is present, treat the patient it is implied.
Anatomical Position
Position of reference is when the patient stands facing you, arms at side, with the palms of the hands facing towards you
Frontal (coronal) plane
Divides the body front and back (anterior and posterior)
Sagittal (lateral) plane
Divides the body left and right
Transverse (axial) plane
Divides the body superior and inferior
Midsagittal plane (midline)
Divides the body into equal left and right halves
Anterior
Front side
Posterior
Back side
Superior (Cephalic)
Top portion
Inferior (Caudal)
Bottom portion
Medial
More towards the center of the body
Lateral
More towards the extremities
Tidal Volume-
amount of air moved in and out of the lungs in one relaxed breath (about 500 ml)
Inspiratory Reserve Volume
amount of air that can be inhaled after normal inhalation (amount in addition to tidal volume)
Expiratory Reserve Volume
amount of air that can be exhaled following normal exhalation (average is 1200ml)
Residual Volume
air that remains in the lungs after maximal expiration
Dead Space
portion of airway that does not contain air and can not participate in gas exchange, such as the trachea and bronchi
Red Blood Cell (RBC)
erythrocytes carry oxygen and carbon dioxide
White Blood Cell (WBC)
leukocytes fight infection
Platelets
clouts blood
Plasma
water proteins (Oxygen, carbon dioxide, Nitrogen) Nutrients Cell Waste (Lactic Acid, Carbon Dioxide) hormones
Sympathetic-
activates body in an emergency situation (fight-or-flight)
Parasympathetic
controls non-emergency functions (generally slows down the body, when eating blood moves to stomach processing, allows HR and respirations to slow for digestion)
Sensory Nerves
afferent (eyes, skin, muscle, joint, lungs)
Motor Nerves
Efferent (effect) from brain to muscles
Agonists
medication that causes stimulation of receptors
Antagonists
medication that binds to the receptor and blocks other medications
Enteral
Medications that enter the body through the digestive system
(Sublingual SL, Per Rectum PR, By Mouth PO)
Parenteral
medication that enters the body by a route other than the digestive system; skin or mucous membrane, usually liquid injections
(Intravenous IV, Intraosseous IO, Inhalation , Intranasal IN, Intramuscular IM,
subcutaneous SC, transcutaneous)
Unintended effects
effects which pose little risk to patient such as a headache after taking nitro
Untoward effects
effects that can be harmful like hypotension after taking nitro
Medication 6 Rights
Right Patient Right Medication Right Dose Right Route Right Time Right Documentation
Peer-Assisted Medication
when the EMT administers medication to him or herself or to their partner
Patient-Assisted Medication
when the EMT assists the patient with the administration of his or her own medication
EMT-Administered Medication
administration of medication by the EMT directly to the patient
Asthma-
acute spasm of smaller air passages bronchioles associated with excess mucous production and swelling of the mucous lining of respiratory passages
Atelectasis
collapse of the alveolar air spaces of the lungs
Bronchiolitis-
inflammation of bronchioles usually occurs in children younger than 2 and often caused by RSV
Bronchitis
acute or chronic inflammation of lung may damage lung tissue, usually associated with cough and sputum also fever
Carbon Dioxide Retention
condition characterized by chronically high blood level of CO2 in which the respiratory center no longer responds to high blood levels of C02
COPD
chronic obstructive pulmonary disease, slow process of dilation and disruption of airways and alveoli caused by chronic bronchial obstruction
Crackles
crackling/rattling breath sounds signaling fluid in the air space of the lungs (RALES)
Croup
Inflammatory disease of upper respiratory system may cause a partial airway obstruction and is characterized by a barking cough usually seen in children
Diphtheria
infectious disease in which a membrane forms, lining the pharynx. This lining can severely obstruct the passage of air into the larynx
Dyspnea
shortness of breath or difficulty breathing
Embolus
blood clot or other substance in circulatory system that travels to a blood vessel where it causes a blockage
Emphysema
disease of the lungs in which there is extreme dilation and destruction of pulmonary alveoli with poor exchange of oxygen and CO2, one form of COPD
Epiglottis
epiglottis becomes inflamed and enlarged and may cause an upper airway obstruction
Hay Fever
allergic response usually due to outdoor airborne allergens such as pollen or sometimes indoor allergens such as dust mites or pet dander also called allergic rhinitis
Hyperventilation
Panic Attack, with absence of other problems respirations as high as 40 shallow breaths/min or as low as 20 very deep breaths/min
Hypoxia
body’s cells and tissues do not have adequate oxygen
Hypoxic Drive
chronically low levels of oxygen in the blood, which stimulates respiratory drive. Seen in patients with chronic lung disease.
Orthopnea
severe dyspnea experienced when lying down and relieved when sitting
Pandemic
An outbreak that occurs on a global scale
Paroxysmal nocturnal dyspnea
severe shortness of breath, especially at night after several hours of reclining, person is forced to sit up to breathe
Pleural Effusion
collection of fluid between the lung and chest that is worsened by a deep breath or other chest wall movement often caused by inflammation or irritation of pleura
Pneumothorax
partial or complete accumulation of air in the pleural space
Pulmonary Edema
build up of fluid in the lung usually as a result of congestive heart failure
Pulmonary embolism
blood clot that breaks off large vein and travels to blood vessels of lung causing obstruction of blood flow
RSV
virus that causes infection of the lungs and breathing passages can lead to other serious illnesses that affect lungs or the heart, highly contagious and spread through droplets
Rhonchi
coarse breath sounds heard in patients with chronic mucus in airways
Stidor
harsh, high pitched, barking inspiratory sound often heard in acute laryngeal obstruction
Wheezing
high pitched, whistling breath sound characteristically heard on expiration in patients with asthma or copd
Signs of Adequate respiration:
Normal Respiratory Rate Ranges
Adults- 12-20 breaths/min
Children- 15-30 breaths/min
Infants- 25-50 breaths/min
Compensated Shock
early stages of shock, while the body can still compensate for blood loss
Signs and Symptoms of compensated shock
Agitation
Anxiety
Restlessness
Feeling of impending doom
Altered mental status
Weak, rapid (thready) or absent pulse
Clammy (pale, cool, moist) skin
Pallor, with cyanosis about the lips
Shallow, rapid breathing
Air hunger (shortness of breath) especially if there is a chest injury
Nausea or vomiting
Capillary refill of longer than 2 seconds in infants and children
Marked thirst
Narrowing pulse pressureDecompensated Shock
late stages of shock, when blood pressure is falling
Signs and Symptoms of decompensated shock
Falling blood pressure (systolic blood pressure of 90 mm Hg or lower in an adult)
Labored or irregular breathing
Ashen, mottled, or cyanotic skin
Thready or absent peripheral pulses
Dull eyes, dilated pupils
Poor urinary output
Shock(hypoperfusion)
describes a state of collapse and failure of the cardiovascular system (when the circulation of blood in the body becomes inadequate, the oxygen and nutrient needs of the cells cannot be met).
Obstructive Shock
caused by a mechanical obstruction which prevents an adequate volume of blood to fill the heart chambers. Three of the most common examples of obstructive shock are cardiac tamponade, tension pneumothorax, pulmonary embolism
Cardiac tamponade
compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output
Tension pneumothorax
is the accumulation of air in the pleural space, which eventually compresses the heart and great vessels
Pulmonary embolism-
a blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow
Distributive Shock
a condition that occurs when there is a widespread dilation of the small arteriales, small venules, or both. As a result, the circulating blood volume pools in the extended vascular beds and tissue perfusion decreases. The four most common types of distributive shock are septic shock, neurogenic shock, anaphylactic shock, and psychogenic shock.
septic shock
shock caused by severe infection, usually a bacterial infection.
neurogenic Shock
circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
Anaphylactic shock
severe shock caused by an allergic reaction
sensitization
becoming sensitive to a substance that did not initially cause a reaction.
Psychogenic Shock
shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope)
Hypovolemic Shock
shock caused by fluid or blood loss. Result of an inadequate amount of fluid or volume in the circulatory system. There are hemorrhagic and non-hemorrhagic cause of hypovolemic Shock.
dehydration
loss of water or fluid from body tissues, can cause or aggravate shock.
Cardiogenic Shock
caused by inadequate function of the heart, or pump failure (circulation of blood throughout the vascular system requires the constant pumping action of a normal and vigorous heart muscle).
Edema
the presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
Preload
the pressure that is accumulated inside of the ventricles as the heart relaxes, letting blood in to fill the chambers. (Precontraction pressure)
Afterload
the resistance against the heart as it contracts for it to overcome and eject the blood out through the aorta and pulmonary arteries.
ACS
(Acute Coronary Syndrome)
(Myocardial Infarction)- “Heart attack”
Chest pain (Men)
- “L” arm, shoulder, jaw
- Dyspnea “difficulty breathing”
- Pale, cool, diaphoretic
- N/V/D
AED
be aware of surface that patient is lying on.
- what is the age of patient
- does patient have medication patch
- does patient have pacemaker
If patient is unresponsive and does not have a pulse apply AED and push analyze
If resuscitation is possible ROSC Monitor for spontaneous respirations provide 02 via BVM at 10-12 breaths/min assess bp if ALS is not on scene being transport
L-Sided vs R-Sided Heart Failure
Right-Sided
Back-ups in the area that collects “used” blood
L-Sided vs R-Sided Heart Failure
Left-Sided
The left ventricle can’t pump blood out to the body as fast as it returns from the lungs which begins to back up in the blood vessels of the lungs (Pulmonary Edema)
Congestive heart failure
Fluid backs up into the lungs and tissues
Arrhythmias leading to cardiac arrest
- Ventricular Fibrillation (V-fib) - Disorganized, ineffective quivering of the ventricles, no blood is being pumped through the body
- Ventricular Tachycardia (V-tach) - Rapid heart rhythm that doesn’t allow the chambers to refill
Pertinent Negatives
-Negative findings that indicate no care or intervention
Finding out the signs and symptoms that the patient does not have
-Helpful in identifying a patient’s problem and choosing an appropriate treatment
Pulse Oximetry
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds
Oxygen saturation is the measure of the % of hemoglobin molecules that are bound in arterial blood
GCS (with particular emphasis on what responses garner which point score)
Best Eye Response:
Spontaneous- 4
In response to speech- 3
In response to pain- 2
Unresponsive- 1
GCS (with particular emphasis on what responses garner which point score)
Best Verbal Response:
Oriented conversation- 5 Confused conversation- 4 Inappropriate words- 3 Incomprehensible sounds- 2 Unresponsive- 1
GCS (with particular emphasis on what responses garner which point score)
Best Motor Response:
Obeys commands- 6 Localize pain- 5 Withdraws to pain- 4 Abnormal flexion- 3 Abnormal extension- 2 Unresponsive- 1
