Chapter 14 Flashcards
… emergencies: injuries resulting from physical forces applied to the body
… emergencies: illnesses or conditions caused by disease
trauma; medical
… emergencies: patients have trouble breathing or the amount of oxygen supplied to the tissues is inadequate
respiratory
… emergencies: caused by conditions affecting the circulatory system
cardiovascular
.. emergencies: involve the brain
neurologic
… conditions: appendicitis, diverticulitis, pancreatitis, and many others
gastrointestinal
… emergencies: most commonly caused by complications of diabetes mellitus
endocrine
a … emergency can involve kidney …
urologic; stones
.. emergencies: may be the result of sickle cell disease or blood-clotting disorders such as hemophilia
hematologic
… emergencies: involve the body’s response to foreign substances and can range from fairly minor to life-threatening
immunologic
… emergencies: include poisoning and substance abuse, result in other types of medical emergencies
toxicologic
… emergencies: involve female reproductive organs
gynecologic
some medical emergencies are caused by … or … problems–> patients may not present with typical signs and symptoms
psychological; behavioral
patient assessment--> assessment of the medical patient is similar to assessment of the trauma patient, but with a different ... focused on: ... ... ...
focus
nature of illness (NOI)
symptoms
chief complaint
patient assessment:
establish an accurate …: use dispatch info to guide your initial response, but do not get locked into a … idea of the patient’s condition–> injuries may distract from the underlying condition: … occurs when you become focused on one aspect of the patient’s condition and exclude all others, which may cause you to miss an important injury or illness
medical history; preconceived; tunnel vision
assessment may be difficult with uncooperative/hostile patients. maintain a professional, calm, nonjudgmental demeanor. Refrain from … patients and displaying personal biases. A frequent caller may have a different complaint this time
labeling
Scene size-up:
scene safety–> ensure the scene is safe, use standard precautions and determine the number of patients and when you need additional help.
Determine NOI: the … is your awareness and concern for potentially serious underlying and unseen injuries or illness.
Initiate spinal immobilization if indicated
index of suspicion
primary assessment:
develop a general impression–> perform a … of the patient to identify life threats. Quickly determine the patient’s LOC using the AVPU scale
rapid examination
primary assess cont:
airway and breathing
in conscious patients, ensure the airway is open and they are breathing adequately.
Check the .., …, and …
consider applying oxygen if breathing has been affected.
for unconscious patients, make sure to open the airway using the proper technique for their condition, and take several seconds to evaluate their breathing
respiratory rate, depth, and quality
primary assess cont: apply oxygen to patients if necessary; unconscious patients may need … and … assistance with a BVM
airway adjuncts; ventilatory
primary assess cont:
circulation:
assess in a conscious patient by checkng the … and observing the patient’s skin color, temperature, and condition
for unconscious patients, assess at the …
radial pulse; carotid artery
primary assess cont: transport decision–>
patients who are in need of rapid transport:
patients who are … or who have an …
patients with … or … problems
patients with obvious … problems such as … or signs of …
if the patient does not meet the criteria for rapid transport, continue your assessment on scene and prepare for transport when you have completed the assessment and treatment
unconscious; altered mental status; airway; breathing; circulation; severe bleeding; shock;
History taking:
determine what the problem is or what may be causing the problem
gather a thorough history
investigate the NOI by inquiring about the …
for an unconscious patient, survey the scene for … or …
chief complaint; medical containers; medical devices
History taking cont:
obtain a … history and use the .. mnemonic
record any .., … and …
some patients take numerous medications; take the medications with you to the hospital or list them in your report
the mnemonic … can be helpful in identifying conditions that may be complicating a patient’s chief complaint or affecting medications
SAMPLE; OPQRST; allergies; medical conditions; medications; TACOS
Secondary assessment:
may occur on scene or en route to the ED. in some cases you may not have time.
Physical exam:
all conscious patients should undergo a limited/detailed physical exam. for … patients, always perform a secondary assessment of the … or head-to-toe. A full body assessment should help you obtain clues and it should be performed quickly so it does not … transport
unconscious; entire body; delay
secondary assessment cont: physical exam cont: examine the ..., ..., and ... examine the ... closely assess the ... and ... palpate the ... and ... examine the patient's ... treatment will depend on the conditions found and your local protocols
head; scalp; face; neck; chest; abdomen; legs; arms; back
secondary assess cont:
vital signs:
assess the pulse for …, …, and …
identify the rate, quality, and regularity of the … and any difficulties that may be apparent
obtain an …, measuring both systolic and diastolic pressures
consider using the automatic blood pressure cuff for future assessments at regular intervals.
consider obtaining a … level and a … reading
rate; quality; regularity; respirations; initial blood pressure; blood glucose; pulse ox
Reassessment:
performed once the … and … have been completed; begins and continues throughout …–> repeat the primary assessment and reassess the chief complaint. consider the need for ALS backup. Repeat your … to identify and treat changes in the patient’s condition
Review all … that have been performed
… any changes that have developed as a result of the treatments, and, if needed, adjust any of the treatments accordingly
assessment; treatment; transport; physical exam; treatments; document
management: transport and destination
most medical emergencies require a level of treatment beyond that available in the prehospital setting: may be beyond EMT scope to administer medications to a patient–> any administration of medication by an EMT requires direct permission from …
EMTs can use an AED on a patient who is pulseless and apneic
medical control
management cont
scene time:
scene time may be longer for … patients than for … patients
gather as much info as possible to transmit to the ED
critical patients always need … transport. they include:
patients with an …
patients with … or … difficulties
patients with any sign of … compromise
patients who are very … or very …
medical; trauma; rapid; altered mental status; airway; breathing; circulatory; old; young
management cont:
type of transport–> life-threatening condition: … and …
non life-threatening condition: consider … transport
lights; sirens; nonemergency
modes of transport ultimately come in one of two categories: … or …
ground transport EMS units are generally staffed by .. and ..
air transport EMS units are generally staffed by … professionals and …
ground; air; EMTs;; paramedics; critical care transport; paramedics
management cont:
destination selections: generally, the … hospital should be your destination
sometimes the patient will benefit from going to another hospital that is capable of handling his/her particular condition
closest
infectious diseases: ‘
general assess principles:
approach like any other medical patient
perform scene size-up, take standard precautions, and complete primary assessment
gather patient history using OPQRST to elaborate on the patient’s chief complaint. obtain a SAMPLE history and a set of baseline vitals; pay particular attention to … and the events leading up to today’s problem
ask whether the patient has recently … or has come in … with someone who has …
medications; traveled; contact; traveled
infectious diseases cont:
general management principles:
focus on any … conditions identified in the primary assess.
be empathetic
place the patient in the position of … on the stretcher and keep them …
use standard precautions –> always follow your agency’s exposure control plan in cleaning equipment;; properly discard any disposable supplies and wash linens
life-threatening; comfort; warm
epidemic and pandemic conditions:
…: new cases of a disease in a human population substantially exceed what is expected
…: a disease outbreak that occurs on a global scale
epidemic; pandemic
influenza:
those with chronic medical conditions, compromised immune systems, and the very young/old are most susceptible to complications of influenza
transmitted by … with … secretions and … droplets from coughing/sneezing by infected people
direct contact; nasal; aerosolized
influenza cont:
for diseases that can be passed by the respiratory route:
always wear ppe (gloves, eye protection, and a HEPA respirator)
wash hands frequently.
place a … on patients with suspected/confirmed respiratory disease
annual … is important for EMS personnel to protect providers and patients
surgical mask; influenza immunization
Herpes Simplex:
common virus strain carried by humans
… infections cause tiny fluid filled blisters called … that appear on the lips/genitals
can cause more serious illnesses like pneumonia/meningitis in the very young/old and immunocompromised patients
primary mode of infection is through .., so standard precautions are generally sufficient to prevent spread to/from health care workers
symptomatic; vesicles; close personal contact
HIV infection:
emts face a risk of exposure to the virus that causes AIDS
AIDS can still be …; however, with treatment, patients can expect a .. lifespan
HIV infection is a potential hazard only when deposited on … or directly into the … –> it is not easily transmitted in the work setting. Your risk of infection is limited to exposure to an infected patient’s … and …
fatal; near-normal; mucous membranes; bloodstream; blood; body fluids
HIV infection cont:
many patients with HIV show no … –> always wear the proper type of gloves
take great care in handling and properly disposing of … and other sharp objects
cover any … that you have whenever you are on the job.
If you think a patient’s blood/secretions may have entered your system, seek medical advice as soon as possible and notify your infectious disease officer
symptoms; needles; open wounds;
Hepatitis:
inflammation (and often infection) of the …
… hepatitis is not contagious
there is no sure way to tell which hepatitis patients are contagious
Hep A can be transmitted only from a patient who has an …, whereas hep B and hep C can be transmitted from … who have no signs of illness
liver; toxin-induced; acute infection; long-term carriers;
hep cont:
a … is a person (or animal) in whom an infectious organism has taken up permanent residence and may/may not cause an active disease
hep A is transmitted … through … or … contamination
hep B is far more contagious than …
Hep B vaccine is highly recommended for EMTs
orally; oral; fecal; HIV
Meningitis:
inflammation of the … coverings of the … and …
most forms aren’t contagious; however, one form, … meningitis, is highly contagious
take standard precautions–> gloves and a mask will go a long way to prevent the patient’s secretions from getting into your nose & mouth. Vaccines rarely used;
Meningitis can be treated at the ED with …
after treating a patient with meningitis, contact your employer health rep
meningeal coverings; brain; spinal cord; meningococcal; antibiotics
Tuberculosis:
many infected patients are well most of the tiem
a chronic myobacterial disease that usually strikes the …
disease that occurs shortly after infection is called … tuberculosis–> … tuberculosis is common and can be much more difficult to treat
lungs; primary; reactive
Tuberculosis cont.:
patients who pose the highest risk almost always have a ….
Consider … tuberculosis to be the only contagious form because it is the only one spread by … transmission
…: the remnants of the droplets produced by coughing after the excess water has evaporated
… or … masks are required to stop droplet nuclei
cough; respiratory; airborne; droplet nuclei; N95; HEPA
tuberc. cont:
absolute protection from the tubercle bacillus doesn’t exist. mechanism of transmission isn’t efficient.
… of world’s pop is infected with tuberculosis
have tb skin tests regularly. if infection is found before you become ill, …. therapy is almost 100% effective
1/3rd; preventive
whooping cough:
also called …, is an … disease caused by bacteria that mostly affects children younger than 6
the best way to prevent exposure is to be … with the DPT or TDaP; you can also place a mask on patient and yourself
pertussis; airborne; vaccinated
Methicillin-Resistant Staphylococcus aureus (MRSA):
MRSA is a bacterium that causes infections
resistant to many …
in health care settings, MRSA is transmitted from patient to patient by health care providers’ …
antibiotics; unwashed hands
Factors that increase risk of MRSA: … therapy prolonged … a stay in an … or … unit exposure to an … MRSA results in … infections incubation period: btwn 5 and 45 days
antibiotic; hospital stays; intensive care; burn; infected patient; soft-tissue
(global health issues) MERS-CoV (Middle East respiratory syndrome coronavirus):
first human case discovered in 2012 in Saudia Arabia
most infections found in …
cases have been found in Europe and US
no cure/vaccines rn
if suspected, place a … on patient and …
Middle East; surgical mask; notify the receiving facility
(global health issues) ebola:
incubation period: … to … days after exposure
symptoms may not appear for as long as … days after infection
fatality rate can be as high as … if treatment in an ICU is not promptly initiated
if suspected, place a … on patient, and notify receiving facility
6; 12; 21; 70%; surgical mask
Travel medicine: important questions to ask include: ‘
… did you recently travel?
did you receive any … before your trip?
were you exposed to any …
is there anyone else in your travel party who is ..
what types of … did you eat
what was your source of …
where; vaccinations infectious diseases sick foods drinking water
