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Comprehensive Flashcards

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1
Q

The average human body holds _________ liters of blood

A

5

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2
Q

Signs and symptoms of Pediatric dyspnea

A

Chest pain, cough (productive with phlegm, Blood, sputum), acute abdomen, speaking in 1-2 words at a time.

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3
Q

Field impression differential diagnosis for PEDS dyspnea?

A

Asthma, anxiety, allergic reaction, acute abdomen, Congenital heart disease, pneumonia, respiratory infection, chest injury

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4
Q

Cranial Nerve 1 and test

A

Olfactory: pinch one nostril and close eyes, take breath.

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5
Q

Cranial Nerve 2 and test

A

Ocular: visual acuity, Morgan lens.

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6
Q

Cranial Nerve 3 and test

A

Ocular motor: H patter and pupil check for symmetry, reactivity to light and roundness. PERRL.

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7
Q

Cranial Nerve 4 and test

A

Trochlear: “H” pattern

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8
Q

Cranial nerve 5 and test

A

Trigeminal: clench teeth

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9
Q

Cranial nerve 6 and test

A

Abducens: “H” pattern

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10
Q

Cranial nerve 7 and test

A

Facial: raise eyebrows, smile, check for drooping eyes.

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11
Q

Cranial nerve 8 and test

A

Acoustic: occlude one ear

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12
Q

Cranial nerve 9

A

Glossopharyngeal: listen for hoarseness

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13
Q

Cranial nerve 10

A

Vagus: say ahhh

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14
Q

Cranial nerve 11

A

Accessory: place pressure on pt shoulders while they shrug them up against

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15
Q

Cranial nerve12

A

Hypoglossal: pt must stick out their tongue

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16
Q

Abandonment

A

The termination of a paramedic-pt relationship without providing for the appropriate continuation of care while it is still needed or desired by the pt.

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17
Q

Libel

A

The act of injuring a persons reputation, character, or name by false statements made in writing or thru the mass media with malicious intent or reckless disregard for the falsity of those statements.

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18
Q

Slander

A

Act of injuring a a persons character, name or reputation by false or malicious statements spoken with malicious intent or reckless disregard for the falsity of those statements.

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19
Q

False imprisonment

A

Intentional and unjustifiable detention of a person without his consent or that of other legal authorities.

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20
Q

Rhonchi

A

Continuous sounds with a lower pitch and a snoring quality.

Commonly found in Chronic Bronchitis, COPD, Pneumonia

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21
Q

Rales/Crackles

A

Light crackling, popping, non musical sounds.

Heard during inspiration, at the bases of the lungs. Associated with Chronic Bronchitis, Congestive Heart Failure and Interstitial lung disease.

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22
Q

Wheezes

A

Continuous high pitched musical sounds similar to a whistle.

Usually appears at the end of exhalation.

Commonly caused by asthma, bronchospasm and foreign bodies.

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23
Q

Absent/Diminished lung sounds

A

Air or fluid in or around the wall that increases thickness of the chest wall.

Associated with pneumonia, heart failure, emphysema, and pleural effusion.

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24
Q

The purpose of the Primary/Initial assessment…

A

To identify and manage immediately life threatening conditions of the pt’s airway, breathing, and circulation.

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25
Q

Components of the primary survey… (7)…

A
  1. General impression
  2. Stabilize C-spine
  3. Assess baseline mental status
  4. Assess/manage airway
  5. Assess/manage breathing
  6. Assess/manage circulation
  7. Determine transportation priority
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26
Q

Importance of vital signs

A

Help give a baseline of the pt and can help show the paramedic if the pt is stabilizing or deteriorating. V/s include BP, O2 saturation, HR, ventilations (rate, quality and rhythm), body temp, and glucose levels.

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27
Q

Importance of OPQRST and SAMPLER

A

OPQRST- mnemonic that is used to find more information and hx in detail about the chief complaint

SAMPLER- mnemonic that is used to find more information about the pt’s past medical hx and events leading up to calling EMS.

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28
Q

Pulse oximetry

A

A non invasive method of monitoring the O2 saturation in a patient’s hemoglobin. It has a sensor and monitoring unit. The sensor shines a light through arterial blood flow spots such as fingertips and earlobes.

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29
Q

ETCO2

A

A reflection of cellular metabolism, circulation, and ventilation. It is typically used to confirm placement of the ET tube in the trachea. The presence of adequate CO2 levels, confirms that the tube is in the trachea. Gold/yellow is good. Purple is bad placement.

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30
Q

Blood glucose

A

Used to measure the glucose extricated from the interstitial fluid of the skin

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31
Q

Cardiac monitoring used via…

A

4 lead or 12 lead to monitor the electrophysiology of the heart

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32
Q

What does a refusal of care consist of?

A
  1. Make sure the pt is of age, mental capacity, and aware of the risks and implications of refusing care.
  2. The paramedic must attempt several times to convince the pt to receive care.
  3. Inform the pt that they can call again.
  4. Call medical control for refusal confirmation and approval.
  5. Proper and detailed documentation
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33
Q

Percussion is…?

A

A method of tapping body parts with fingers, hands, or small instruments, as part of a physical examination.

Done to determine size, consistency, borders of body organs, or the presence/absence of fluid in body areas.

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34
Q

Inspection

A

Important to look for obvious signs of medical or trauma situations. Several problems can be identified just by looking at a patient. It is also important to expose trauma patients for hidden injuries that can be inspected as well.

35
Q

Palpitation

A

This method can be used to take a patients pulse or blood pressure without the use of any tools. Also important in trauma to check for any tenderness, deformities and crepitus.

36
Q

Auscultation

A

The technique primarily used to listen to lung, bowel, and heart sounds. You can at times determine what kind of airway problem a pt is having by listening to lung sounds. Primary source of auscultation for paramedics

37
Q

The pt presentation that must be reported to law enforcement…

A

Abuse/neglect of children, elderly, invalids.

38
Q

Presentation of patients that must be reported to law enforcement…

A
  1. Injuries that are inconsistent with the story given.
  2. Injuries that embarrass you patient.
  3. Delay between the time of injury and seeking help
  4. A past history of “accidents”.
  5. Suspicious behavior of abuser
39
Q

The “first” stage of grief per Kübler- Ross

A

Denial- “not me, this can’t happen to me”

The inability/refusal to believe the reality of impending death. A defense mechanism.

40
Q

The “second” stage of grief per Kübler- Ross

A

Anger- “why me, why not someone else?”
The pt’s anger is really frustration related to his/her inability to control the situation. The anger can focus on anyone and anything.

41
Q

The “third” stage of grief per Kübler- Ross.

A

Bargaining- “ok, but first let me…”

A negotiation process in which the pt attempts to postpone or distance themselves from the reality of the situation.

42
Q

The “fourth” stage of grief per Kübler- Ross

A

Depression- “okay, but I haven’t…”

The pt is Sad and despairing, often mourning things not accomplished and dreams that will not come true. The pt withdraws into themselves- unwilling to communicate with others.

43
Q

The “fifth” stage of grief per Kübler- Ross

A

Acceptance- “okay, I’m not afraid”

The pt may come to realize his/her fate and achieve a reasonable level of comfort with the anticipated outcome. At this stage the family may need more support than the pt. The pt achieves a feeling of stability or resignation.

44
Q

Define delegated practice

A

Prehospital care provided by non physicians is a delegated practice of the medical director.

Prehospital care providers are the designated agents of the medical director, regardless of who their employers are. The medical director is a physician that is legally responsible for all clinical and patient care aspects of the system. The medical director gives the prehospital provider authority to practice under their physicians license.

45
Q

Define medical direction, off-line and on-line.

Define medical director

A

The medical policies, procedures, and practices that a system medical director has established.

Off-line: standing medical orders

On-line: when a qualified physician gives orders to a prehospital care provider via radio or telephone.

Medical director- responsible for educating personnel, selecting personnel and equipment, developing clinical protocols, participating in quality improvement, providing direct input into direct pt care, advocate within the medical community, and interfacing btwn the EMS system and other health care agencies.

46
Q

What is the role of a paramedic in research?

A

To generate and collect data.

47
Q

What is HIPAA?

A

Health Insurance Portability and Accountability Act of 1996

Federal law that created national standards to protect sensitive medical information.

48
Q

Carina

A

The location where the trachea divides into the right and left mainstem bronchi.

49
Q

Ventilation.

A

The mechanical process of moving air in and out of the lungs. Requires the use of the chest wall, neural pathways, diaphragm, pleural cavity, and brain stem.

50
Q

Diffusion

A

The process by which gases move between the alveoli and the pulmonary capillaries. Gases flow from areas of high concentrations to areas of low concentrations.

51
Q

Crackles

A

high pitched. Heard on inspiration. Not cleared by cough

52
Q

Rhonchi

A

Loud, low course sounds, like a snore during inspiration or expiration may clear with cough

53
Q

Anaphylactic reaction

A

Rapid onset, sweating, feeling of apprehension, tightness in throat, Broncho spasms, tingling in mouth, face, throat. Itching, weakness, loss of consciousness

54
Q

Pulsus Paradoxus

A

A fall in systolic BP of > 10 mmHg during the inspiratory phase, most commonly seen during an asthma attack

55
Q

Exhalation

A

The diaphragm and intercostal muscles relax and positive pressure is produced in the lungs

56
Q

Inhalation

A

The diaphragm contracts pulling the ribs and thoracic cavity up and out. The diaphragm pulls down creating negative pressure to cause air to be pulled into the lungs.

57
Q

Rhonchi

A

Continuous low pitched, rattling long sounds that often resembles snoring, obstruction or secretions in larger airways are frequent causes of rhonchi

58
Q

Rales/crackles

A

Light crackling, popping,nonmusical sounds
Heard during inspiration,at the bases of the lungs

Associated with chronic bronchitis, congestive heart failure and interstitial long disease

59
Q

Hemoptysis

A

Coughing up blood

60
Q

BVM rates

A

Newborns: 2-3 seconds
Infants: 3-5 seconds
Children: 3-5 seconds
Adults:5-6 seconds

61
Q

Hering-Breuer reflex

A

inflation and deflation reflexes that help regulate the rhythmic ventilation of the lungs thereby preventing overdistention and extreme deflation

62
Q

Cushings triad

A

Widening pulse pressure (increasing systolic/decreasing diastolic)
Bradycardia
Irregular respiration’s

Indication of increasing intracranial pressure.

63
Q

Acute pulmonary embolism

A

A blood clot that lodges into a pulmonary artery blocking blood flow through that vessel

64
Q

Pulmonary embolism S/S

A 
sudden onset dyspnea
Possible pleuritic chest pain
Cough with possible blood
Labored breathing
Tachycardia 
Tachypnea 
Possible crackles/wheezing
DVT in lower extremities
65
Q

Pulmonary embolism

A

Maintain airway
Assist ventilations as needed
Supplemental oxygen
ET intubation

66
Q

Anaphylaxis

A

An acute, potentially fatal multi organ system reaction caused by the release of chemical mediators from mast cells and basophils.

67
Q

Anaphylaxis S/S

A 
Hypotension 
Rash, itching, hives, flushed/pale skin
Broncho constriction
Upper airway edema
Wheezing/ stridor
Weak/rapid pulse
Nausea and vomiting
Diarrhea 
Dizziness
Fainting
68
Q

Anaphylaxis treatment

A

0.3 mg epi IM (1mg/ml)
50 mg diphenhydramine (Benadryl) IM
Albuterol 2.5 mg/ Ipratropium 0.5 mg Nebulizer

69
Q

Sympathetic nervous system

A

Causes tachycardia, vasoconstriction, bronchodilation. Fight or flight.

70
Q

Cardiogenic shock

A

Usually the result of severe left ventricular failure due to MI or severe CHF- this results in the loss of cardiac output and cellular perfusion and oxygenation and hypoxia.

71
Q

Chronotropic drug

A

Affects the heart rate
Negative will decrease heart rate
Positive will increase heart rate

72
Q

Adrenergic drug

A

Affects the sympathetic nervous system
SNS, adrenaline the neurotransmitter
Sympathomimetic drugs increase HR, increase contractility of heart

73
Q

Beta adrenergic blockers

A

Bind and block adrenergic receptors
Prevent beta agonists from stimulating the receptor
Selective beta blocker- bind to either beta 1 or 2
Nonselective- bind to both
Negative chronotropic effect- decreases HR
Negative inotropic effect- decrease contractility/squeeze of heart.

74
Q

Cholinergic

A

Affects parasympathetic nervous system
Comes from acetylcholine neurotransmitter
Pertains to striated/smooth muscle, brain, glands
Cholinergic agonist- decrease saliva, bronchodilator, dilates pupils
Cholinergic antagonist- increase secretions if dry mouth= acetylcholine, digoxin

75
Q

Inotropic

A

Affect the squeeze of the heart muscle, HR and the electric activity
Positive inotropic- dopamine, epi
Negative- beta blockers, calcium channel blockers, sympatholytic for HTN
(Epi is inotropic and chronotropic)

76
Q

Dromotropic

A

Affect the speed of the electrical conduction in AV node.
Positive dromotropic- phenytoin
Negative- verapamil

77
Q

All the “Rights”

A 
Right patient
Right drug/right indications
Right dose
Right route
Right time
Right therapeutic effect
Right documentation
78
Q

Pharmacokinetics

A

How the drug is absorbed, distributed, and eliminated; typically includes onset and duration of action.

79
Q

Side effects/ adverse reaction

A

The drugs untoward or undesired effects

80
Q

Dosage

A

The amount of drug that should be given

81
Q

Schedule I drugs

A

High abuse potential; may lead to severe dependence; no accepted medical indications; used for research, analysis, or instruction only.

Ex: heroin, LSD, mescaline

82
Q

Schedule II drugs

A

High abuse potential; may lead to severe dependence; accepted medical indications.

Ex: opium, cocaine, morphine, codeine, methadone

83
Q

Schedule III drugs

A

Less abuse potential than Schedule I and II, may lead to moderate or low physical dependence or high psychological dependence; accepted medical indications.

Ex: limited opioid amounts or combined with noncontrolled substances; acetaminophen with codeine, buprenorphine.

84
Q

Pharmacodynamics

A

The was that the drug causes its effects. Mechanism of action.

paramedic school (1 decks)

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