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EMT CLASS > CHAPTER 9 > Flashcards

CHAPTER 9 Flashcards

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1
Q

The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles

A

Accessory muscles

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2
Q

Any deviation from alert and oriented to person, place, time and eventm or any deviation from a patient’s normal baseline mental status; may signal disease in the central nervous system or elsewhere in the body

A

altered mental state

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3
Q

To listen to sounds within an organ with a stethoscope

A

auscultate

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4
Q

A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process

A

AVPU scale

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5
Q

A slow heart rate, less than 60 beats/min

A

bradycardia

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6
Q

An indication of air movement in the lungs, usually assessed with a stethoscope

A

breath sounds

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7
Q

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure

A

Capillary refill

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8
Q

A noninvasive method to quickly and efficiently provide information on a patients ventilatory status, circulation, and metabolism; effectively measures the concentration of carbon dioxide in expired air over time

A

capnography

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9
Q

A component of air that typically makes up 0.3% of air at sea level; also a waste product exhaled during expiration by the respiratory system

A

carbon dioxide

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10
Q

The reason a patient called for help; also, the patient’s response to questions such as “What’s wrong?” or “What happened?”

A

Chief complaint

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11
Q

In incident management, the position that oversees the incident, established objectives and priorities, and develops a response plan

A

Command

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12
Q

The delicate membrane that lines the eyelids and covers the exposed surface of the eye

A

conjunctiva

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13
Q

Crackling, rattling breath sounds signaling fluid in the air spaces of the lungs; formerly called rales

A

crackles

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14
Q

A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sounds or crinkly feeling

A

crepitus

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15
Q

A blue-gray skin color that is caused by a reduced level of oxygen in the blood

A

cyanosis

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16
Q

A mnemonic for assessment in which each area of the body is evaluated for deformities, contusions, abrasions, punctures/penetrations, burns, tenderness, lacerations and swelling

A

DCAP-BTLS

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17
Q

Characterized by light or profuse sweating

A

diaphoretic

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18
Q

The pressura that remains in the arteries during the relaxation phase of the heart’s cycle (diastole) when the left ventricle is at rest

A

diastolic pressure

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19
Q

Any injury that prevents the patient from noticing other injuries he or she may have, even severe injuries; for example, a painful femur or tibia gracture that prevents the patient from noticing back pain associated with a spinal fracture

A

distracting injury

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20
Q

Shortness of breath or difficulty breathing

A

dyspnea

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21
Q

A disease of the lungs in which there is extreme dilation and eventual destruction of the pulmonary alveoli with poor exchange and carbon dioxide; it is one form of chronic obstructive pulmonary disease

A

emphysema

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22
Q

A type of physical assessment typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. The type of examination is based on the chief complaint and focuses on one body system or part

A

focused assessment

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23
Q

Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts

A

frostbite

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24
Q

The overall initial impression that determines the priority for patient care; based on the patient’s surroundings, the mechanism of injury, signs and symptoms, and the chief complaint

A

general impression

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25
Q

The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best; also called Golden Period

A

Golden Hour

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26
Q

Involuntary muscle contractions (spasms) of the abdominal wall to minimize the pain of movement and protect the inflamed abdomen; a sign of peritonitis

A

guarding

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27
Q

A step within the patient assessment process that provides detail about the patient’s chief complaint and an account of the patient’s signs and symptoms

A

history taking

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28
Q

Blood pressure that is higher than the normal range

A

hypertension

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29
Q

Blood pressure that is lower than the normal range

A

hypotension

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30
Q

A condition in which the internal or core body temperature falls below 95 degrees (35 Celcius)

A

hypothermia

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31
Q

Yellow skin or sclera that is caused by liver disease or dysfunction

A

jaundice

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32
Q

The forces, or energy transmission, applied to the body that cause injury

A

mechanism of injury

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33
Q

Widening of the nostrils, indicating there is an airway obstruction

A

nasal flaring

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34
Q

The general type of illness a patient is experiencing

A

nature of illness

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35
Q

A mnemonic used in evaluating a patient’s pain: Onset, Provocation/palliation, Quality, Region/radiation, Severity and Timing

A

OPQRST

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36
Q

The mental status of a patient as measured by memory of a person (name). place (current location), time (current year,month and approximate date) and event (what happened)

A

orientation

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37
Q

To examine by touch

A

palpate

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38
Q

The motion of the portion of the chest wall that is detached in a flail chest; the motion – in during inhalation, out during exhalation - is exactly the opposite of normal chest wall motion during breathing

A

Paradoxical motion

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39
Q

Negative findings that warrant no care or intervention

A

Pertinent negatives

40
Q

A painful, tender, persistent erection of the penis; can result from spinal cord injury, erectile dysfunction drugs, or sickle cell disease

A

Priapism

41
Q

A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats

A

primary assessment

42
Q

An assessment tool that measure oxygen saturation of hemoglobin in the capillary beds

A

pulse oximetry

43
Q

A step within the patient assessment process performed at regular intervals during the assessment process to identify and treat changes in a patient’s condition. This should occur every 5 minutes for a patient in unstable condition and every 15 minutes for a patient in stable condition

A

Reassessment

44
Q

The way in which a patient responds to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli

A

responsiveness

45
Q

Movements in which the skin pulls in around the ribs during inspiration

A

retractions

46
Q

Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways

A

rhonchi

47
Q

A brief history of a patient’s condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to injury or illness

A

SAMPLE history

48
Q

A step within the patient assessment process that involves a quick assessment of the scene and surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care

A

scene size-up

49
Q

The tough, fibrous, white portion of the eye that protects the more delicate inner structures

A

sclera

50
Q

A step within the patient assessment process in which a systematic physical examination of the patient is performed. The examination may be a systematic exam or an assessment that focuses on a certain area or region of the body, often determined t hrough the chief complaint

A

secondary assessment

51
Q

Respirations characterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion

A

shallow respirations

52
Q

Knowledge and understanding of one’s surroundings and the ability to recognize potential risks to the safety of the patient or EMS team

A

situational awareness

53
Q

The ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics to manage an emergency

A

size-up

54
Q

An upright position in which the patients head and chin are thrust slightly forward to keep the airway open; the optimum position for the uninjured child who requires airway management

A

sniffing position

55
Q

Breathing that occurs without assistance

A

spontaneous respirations

56
Q

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope

A

stridor

57
Q

A characteristic sensation felt on palpation of the skin, caused by the presence of air on soft tissues

A

subcataneous emphysema

58
Q

Subjective findings that the patient feels but that can be identified only by the patient

A

sympton

59
Q

The increased pressure in an artery with each contraction of the ventricles (systole)

A

Systolic pressure

60
Q

A rapid heart rate, more than 100 beats/min

A

tachycardia

61
Q

Longitudinal force applied to a structure

A

traction

62
Q

The process of sorting patients based on severity of injury and medical need to establish treatment and transportation priorities

A

triage

63
Q

The upright position in whicch the patient leans forward onto outstretched arms with the head and chin thrust slightly forward

A

tripod position

64
Q

A severe breathing problem in which a patient can speak only two or three words at a time without pausing to take a breath

A

two-to three-word dyspnea

65
Q

The narrowing of a blood vessel, such as with hypoperfusion or cold extremities

A

vasoconstriction

66
Q

The key signs that are used to evaluate the patient’s overall condition, including respirations, pulse, blood pressure, level of consciousness, and skin characteristics

A

vital signs

67
Q

A high pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma, bronchiolitis, and chronis obstructive pulmonary disease

A

wheezing

68
Q

5 steps to the assessment process:

A
  1. Scene size-up
  2. Primary assessment
  3. History taking
  4. Secondary assessment
  5. Reassessment
69
Q

Scene Size up:

A

Ensure scene safety
Determine mechanism of injury/nature of illness
Take standard precaustions
Determine number of patients
Consider additional/specialized resources

70
Q

Primary assessment:

A

Form a general impression
Assess level of consciousness
Assess the airway: identify and treat life threats
Assess breathing: identify and treat life threats
Assess circulation: identify and treat life threats
Perform primary assessment
Determine priority of patient care and transport

71
Q

History taking:

A

Invesigate the chief complaint (history of present illness)

Obtain SAMPLE history

72
Q

Secondary Assessment: Medical:

A

Systematically assess the patient

Assess vitals signs using the appropriate monitoring device

73
Q

Seconday Assessment:

Trauma

A

Systematicall assess the patient

Asses vital signs using the appropriate monitoring device

74
Q

Reassessment:

A 
Repeat the primary assessment
Reassess vital signs
Reassess the chief complaint
Recheck interventions
Identify and treat changes in the patient's condition
Reassess the patient
-unstable patients every 5 min
-stable patients every 15 min
75
Q

True or False: The order in which assessment is performed is fixed?

A

False. It is dictated by the patient’s condition

76
Q

What type of hazards can you encounter?

A 
Physical (sharp objects and broken glass)
Slip and fall hazards (spills or leaking fluids)
Motor vehicle biohazards 
Blood and body fluids
Chemical hazards
Electrical hazards
Water hazards
Fires
Explosions
Physical violence
77
Q

blunt trauma

A

force of injury occurs over a broad area, and the skin is sometimes not broken but the tissues and organs beneath may be damaged

78
Q

penetrating trauma

A

the force of the injury occurs at a specific point of contact between the skin and injury. The object pierces the skin and an open wound carries a higher potential for infection

79
Q

LOC - level of conscious

ABS’s - Airway, breathing, and circulation

A

Primary Assessment

80
Q

When are vitals taken?

A

Secondary Assessment

81
Q

Indications for spinal immobilization:

A

Blunt or penetrating trauma with neck or spine, paralysis or numbness, tingling. Priaprism
Blunt trauma with altered mental status, intoxication, difficulty or inability to communicate
Distracting injuries

82
Q

Signs of airway obstruction in an unconscious patient:

A
  • obvious trauma, blood, or other obstruction.
  • noisy breathing, snoring, bubbling, gurgling, crowing, stridor, or other abnoraml sounds
  • extremely shallow or absent breathing
83
Q

Goal for oxygenation for most patients is an oxygen saturation of

A

94%-99%

84
Q

Signs of respiratory distress and failure

A

Agitation, anxiety restlessness (lethargy, difficult to rouse
Stridor, wheezing (tachypnea with periods of bradypnea or agonal respirations)
Accessory muscle use; intercoastal retractions, neck and muscle use (stenomastoi) (inadequate chect rise/poor excursion
Tachypnea (inadequate respiratory rate or effort)
Mild tachycardia (bradycardia)
Nasal flaring, seesaw breathing, head bobbing (diminished muscle tone)

85
Q

If you cannot palpate a pulse in an unresponsive patient what do you do?

A

CPR or AED (NEVER use CPR or AED on a responsive patient)

86
Q

If a patient has a pulse but not breathing, what do you do?

A

Provide ventilations at a rate of 10-12 b/m for adults and 12-20 for infants

87
Q

What is a high priority patient that should be transported immediately

A 
Unresponsive
Poor general impression
Difficulty breathing
Uncontrolled bleeding
Responsive but unable to follow commands
Severe chest pain
Pale skin or other signs of poor perfusion
Complicated child birth
Severe pain in any area of the body
88
Q

What are some challenges you might face with patients when dealing with obtaining patient history?

A 
Silence
Overly talkative
Multiple symptoms
Anxiety
Anger or hostility
Intoxication
Crying
Depression
Confusing behavior or history
Limited cognitive abilities
Cultural challenges
Language barriers
Hearing problems
Visual impairments
89
Q

How to perform a secondary assessment of a patient with no suspected spinal injuries:

A 
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
90
Q

Normal Ranges for Respirations:

A 
Adults 12-20
Adolescents 12-16
School aged children 18-30
Preschoolers 22-34
Toddlers 24-40
Infants 30-60
91
Q

Characteristics of respirations

A

Normal - breathing is neither shallow or deep
Equal chest rise and fall
No use of accessory muscles

Shallow - decreased chest or abdominal wall motion

Labored - increased breathing effort
Use of accessory muscles
Possible gasping
Nasal flaring, supraclavicular and intercostal retractions in infants and children

Noisy - increase sound of breathin, including snoring, wheezing, gurgling, crowing, grunting and stridor

92
Q

Normal pulse ranges

A

Adults and children older than 10 years - 60-100

Preschoolers and school aged children (2-10) 60-140

Infants and toddlers (3months - 2 years) 100-190

Infants (up to 3 months) 85-205

93
Q

Normal range for blood pressure

A

Adults 90-130 systolic

Adolescent 110-131 systolic

Child 7 years 96-115 systolic

Child 2 years 88-106 systolic

Infant 85-104 systolic

Neonate 60-84 systolic

94
Q

Glasgow Coma Scale

A 
Eye opening
4 spontaneous
3 in response to speech
2 in response to pain
1 none
Best verbal response 
5 oriented conversation
4 confused conversation
3  inappropriate words
2 incomprehensible sounds
1 none
Best motor response
6 obeys command
5 localizes pain
4 withdraws to pain
3 abnormal flexion
2 abnormal extension
1 none
95
Q

PEARRL

A 
Pupils
Equal
And
Round
Regular in Size
React to Light

EMT CLASS (19 decks)

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