Emergency 1st Responder Book Flashcards
Insert the NPA into the
Right nostril 1st
Water soluble lubricant
KY Jelly is good
The recovery position
Patient laying on left side
What lubricant should you never use when inserting a OPA
Vaseline
Any petroleum based lubricant
What is Dyspnea
Difficulty breathing
As a patient gets closer to respiratory failure pulse and even respiratory rates
Will drop as the patient exhibits increased fatigue and hypoxia. Bluish skin color
Which method is the most effective way to insure your mouth to mask breaths are reaching the trachea
Chest rise and fall
The tube through which food passes from the mouth to the stomach is the
Esophagus
The flap of tissue that protects the entrance to the trachea is the
Epiglottis
The tube through which air passes from the nose and mouth into the lungs (windpipe) is called the
Trachea
The tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged with the blood are
Alveoli
When the diaphragm moves down, creating negative pressure ( a vacuum) inside the chest, air moves into the lungs. This process is known as
Inspiration/Inhalation
Normally the respiratory rate increases when there is not enough ____
In the blood or when there is too much _______ in the blood
Oxygen
Carbon Dioxide
When the muscles of an unresponsive person relax, this often causes the airway to be obstructed by the
Tongue
The best way to open the airway of an uninjured, unresponsive person is the
Head tilt/chin lift
A simple device placed in the mouth of an unresponsive patient without a gag reflex in order to help keep their tongue from obstructing the airway is the
OPA
A patient who is responsive but who requires an adjunct to maintain his airway should have what adjunct placed
Nasopharyngeal
Upper airway obstruction is indicated by
Stridor
The medical term for difficulty breathing is
Dyspnea
What would indicate that a patient is not breathing at all
Apneic
The most effective oxygen delivery device is the
Bag valve mask
A person who is choking but is ABLE to speak or cough has an
Partial/Incomplete airway obstruction
A conscious patient who is choking and CANNOT speak requires the use of
Abdominal thrusts to remove the obstruction
When performing rescue breathing for an infant or small child, what should the first responder do to make sure that the neck is not hyperflexed because of the large size of the head, since hyper-flexing will close off the airway
Place a folded towel under the shoulders
An emergency first responder may be asked to assist other EMS providers with more advanced airway adjuncts. Once such device can be inserted blindly only in unresponsive patients who are over 16 years old. This is call an
Dual Lumen Airway Device
What does DOTS stand for
Deformities
Open wounds
Tenderness
Swelling
What does SAMPLE stand for
Signs Allergies Medications Past medical history Last oral intake Events leading up to symptoms
A non critical patient should be reassessed every ______ minutes. A critical patient should be reassessed every _____ minutes
15 minutes
5 minutes
In an adult the normal rate of breathing is
12-20 times per minute
In an adult the normal pulse rate is
60-100 times per minute
The radial pulse is found at
The wrist
The patient who is not breathing should receive oxygen via the
BVM
What would be a sign of shock
Dry, pale mucous membranes
The prices of sorting patients into categories is called
Triage
Vital signs contain
Pulse
Respirations
Blood pressure
The upper 2 chambers of the heart are called the
Atria
The lower 2 chambers of the heart are called the
Ventricles
The tiny blood vessels in the body tissues and around the air sacs in the lungs are called
Capillaries
The blood vessels that carry blood away from the heart are called____. The blood vessels that carry blood back to the heart are called_____.
Arteries
Veins
No breathing and no pulse the patient is in
Cardiac arrest
The organ that is most sensitive to a lack of oxygen, which may suffer irreversible cell death after 8 minutes of apnea, is the
Brain
The sequence of events in the chain of survival is
Early recognition
Early CPR
Early defibrillator
Early ALS
What will actually increase the amount of air delivered to the esophagus when using a bag valve mask
Squeezing to quickly and forcefully
When a AED advises “no shock indicated” the first responder should check the patients
Pulse
Often cardiac arrest patients will exhibit reflexive, ineffective, gasping attempts to breathe. These are called ______ respirations and just not be mistaken for effective breathing
Agonal
When checking the circulation of an unresponsive adult patient, the first responder should check which pulse
Carotid
In an unresponsive infant, the first responder should check the pulse located at which location
On the inside of the upper arm
You witness someone collapse on the floor right in front of you. What is your first move
Make sure someone is calling 911
The landmark for chest compressions for all ages is the
Nipple line
Looking for signs of circulation include
Pulse
Normal breathing
Coughing
Movement
You are a line rescuer who arrives at the scene with an AED. A 45 tear old man is in cardiac arrest. Bystanders relay that he collapsed 4 or 5 minutes earlier with no bystander CPR. Your first move is
Open his airway
An unresponsive medical patient should be placed in the
Recovery position
List 3 findings evaluated in the Cincinnati Stroke Scale
Facial droop
Speech
Palmer Drift
A true emergency caused by fluid accumulation in the lungs resulting in severe Dyspnea and noisy, wet respirations is
Pulmonary Edema (CHF)
Diabetics may experience hypoglycemia by
Taking too much insulin
Indication of a possible stroke
Inability to speak
What is appropriate when caring for a seizure patient
Move objects away from the patient
What is appropriate care for a patient with chest pains
Administer oxygen
Obtain a history
Call ALS
What is the most important consideration for the patient with an altered mental status
Airway management
What is a common sign or symptom of a myocardial infarction
Pain that radiates down the arm
The medical term for bleeding is
Hemorrhage
Uncontrolled bleeding may lead to
Shock
List in order of use the 4 methods to control bleeding
1) Direct pressure
2) Pressure bandages
3) Elevation
4) Arterial pressure points
When a dressing over a bleeding wound becomes saturated with blood, the first responder should
Apply more dressing over the existing dressing. Do not remove the existing dressing
The 6 signs or symptoms of shock
Rapid pulse Rapid breathing Pale, cool, sweaty skin Altered mental status Thirst Obvious bleeding
Am early indication of shock is
Altered mental status
What is appropriate burn care (NY state)
Cover with dry, sterile dressing
What is avulsion
The skin or an organ such as an ear is completely torn away from the body or may be left hanging from a flap
What is contusion
A discoloration of wound to the skin as a result of blood collecting under the skin when the skin is not broken but small blood vessels beneath it are crushed
When somebody gets electrocuted your primary concern should be
The patients heart may have stopped
The disruption of a joint such that the bone ends are no longer in contact with each other
Dislocation
The movable part of your jaw is called the
Mandible
What composes the shoulder
Scapula
Clavicle
Humerus
Once you manually stabilize the head and neck of a trauma patient this manual stabilization must be maintained until
The patient is completely secured to the long backboard
An injury to the spinal chord at the level of the cervical spine may paralyze the diaphragm, impairing the patients ability to
Breathe
Your assault patient has what you believe is a basal skull fracture, judging from the bloody fluid draining from his ears. The most appropriate management would include
Applying a C collar and delivering oxygen
The lower portion of the sternum which could cause damage to the liver if compressed during CPR is called the
Xiphoid Process
The 2 bones of the forearm are called
Radius
Ulna
The large strong bone of the thigh is called the
Femur
What bones when fractured can lead to massive internal bleeding, shock and even death
Femur
Pelvis
The fibrous tissue that connects bone to bone is
Ligament
The grinding, grating sound that may be noted when there is movement of a broken bone is called
Crepitus
When should the emergency first responder attempt to straighten out an injured extremity that is abnormally angled or bent
Never
The best way to stabilize a musculoskeletal injury of an extremity is to
Manually stabilize with the hands
A traction splint is a special kind of splint that is only used for certain injuries of the
Thigh
You are treating a crash victim who has an apparent open fracture of the L tibia. What is appropriate care
Cover with a sterile dressing and control bleeding
A life threatening condition in which a fertilized egg, implanted outside of the uterus, ruptures, resulting in severe abdominal pain and massive bleeding is called
Ectopic pregnancy
The opening into the birth canal that dilates to allow for passage of the fetus is called the
Cervix
When a baby’s head can be seen in the opening of the vagina, either with contractions or constantly, this is called
Crowing
A breach birth is when the baby’s
Feet or buttocks emerges from the vagina first
Describe the appropriate positioning of the mother in preparation for delivery
The mother should be on her back with her head and shoulders supported by pillows or significant other; her knees should be bent and her feet apart. There should be a folded towel or blanket under the buttocks
As the baby’s head begins to emerge from the vagina, the emergency first responder must control the emergence of the head by
Placing a gloved hand over the baby’s head and applying gentle pressure to allow the head to emerge slowly
After the baby’s head is delivered, the emergency first responder should clear the baby’s airway by
Build syringe
1st the mouth
2nd the nostrils
Before the umbilical chord is clapped or tied, the baby should remain at the level of the
Vagina
The umbilical chord may be clamped or cut after it
Stops pulsating
The newborn should be dried and wrapped in a blanket or towel because they
Lose heat very fast. When properly wrapped in a blanket the only part of the baby that should be exposed is the face
The loss of pregnancy before 20 weeks of pregnancy is called a miscarriage or an
Spontaneous abortion
List 3 special considerations in assisting with delivery of multiple births
Babies are smaller
May be born earlier
Delivery may take more rapidly
Babies are more prone to heat loss
You are on scene of an imminent delivery when you see the umbilical chord protruding out of the vagina ahead of the baby. Your best course of action is
Place mother in the Knee-Chest position
If the baby is born with the amniotic sac intact, you must
Tear it away
If a newborn baby is not breathing or is only making weak efforts to breathe or cry, what is the first thing we should do
Stimulate the baby by rubbing his back
CPR is indicated for a newborn when the pulse rate is
Less than 60 per minute
In what location should the pulse of a newborn be checked
Inside the upper arm
What would be cause for alarm in a newborn baby
Body, face and extremities are ALL blue
In NYC a DNR that is expired is
Still valid
In NYS a DNR
Can’t be expired
Must have doctors signature
Trachea divides the
Upper and lower respiratory tract
Pallor means
Pale
Change the oxygen cylinder at
200 PSI
Pressure needed for suctioning device
300 MGM
Set it at 350
How long do you suction for
15 seconds
NPA facts
Measure for middle of nose to tip of ear
Width of pinky finger
Water base lubricant only
Right nostril insertion
Postdictal means
Appears sleepy
OPA is measured
Corner of mouth to tip of the ear
Nasal cannula set at
2-6 LPM
In NYC a DNR that is expired is
Still valid
In NYS a DNR
Can’t be expired
Must have doctors signature
Trachea divides the
Upper and lower respiratory tract
Pallor means
Pale
Change the oxygen cylinder at
200 PSI
Pressure needed for suctioning device
300 MGM
Set it at 350
How long do you suction for
15 seconds
NPA facts
Measure for middle of nose to tip of ear
Width of pinky finger
Water base lubricant only
Right nostril insertion
Postdictal means
Appears sleepy
OPA is measured
Corner of mouth to tip of the ear
Nasal cannula set at
2-6 LPM
A life threatening condition in which a fertilized egg, implanted outside of the uterus, ruptures, resulting in severe abdominal pain and massive bleeding is called
Ectopic pregnancy
The opening into the birth canal that dilates to allow for passage of the fetus is called the
Cervix
When a baby’s head can be seen in the opening of the vagina, either with contractions or constantly, this is called
Crowing
A breach birth is when the baby’s
Feet or buttocks emerges from the vagina first
Describe the appropriate positioning of the mother in preparation for delivery
The mother should be on her back with her head and shoulders supported by pillows or significant other; her knees should be bent and her feet apart. There should be a folded towel or blanket under the buttocks
As the baby’s head begins to emerge from the vagina, the emergency first responder must control the emergence of the head by
Placing a gloved hand over the baby’s head and applying gentle pressure to allow the head to emerge slowly
After the baby’s head is delivered, the emergency first responder should clear the baby’s airway by
Build syringe
1st the mouth
2nd the nostrils
Before the umbilical chord is clapped or tied, the baby should remain at the level of the
Vagina
The umbilical chord may be clamped or cut after it
Stops pulsating
The newborn should be dried and wrapped in a blanket or towel because they
Lose heat very fast. When properly wrapped in a blanket the only part of the baby that should be exposed is the face
The loss of pregnancy before 20 weeks of pregnancy is called a miscarriage or an
Spontaneous abortion
List 3 special considerations in assisting with delivery of multiple births
Babies are smaller
May be born earlier
Delivery may take more rapidly
Babies are more prone to heat loss
You are on scene of an imminent delivery when you see the umbilical chord protruding out of the vagina ahead of the baby. Your best course of action is
Place mother in the Knee-Chest position
If the baby is born with the amniotic sac intact, you must
Tear it away
If a newborn baby is not breathing or is only making weak efforts to breathe or cry, what is the first thing we should do
Stimulate the baby by rubbing his back
CPR is indicated for a newborn when the pulse rate is
Less than 60 per minute
In what location should the pulse of a newborn be checked
Inside the upper arm
What would be cause for alarm in a newborn baby
Body, face and extremities are ALL blue
Decompensated shock
Any adult having a systolic blood pressure below
90 mm Hg
Contractions begin in the
Uterus
Muscular organ where fetus grows
Placenta is the
Afterbirth
Provides nourishment to the fetus
Amniotic sac
Bag of water
Offers protection to the fetus
Vagina/cervix
Lower portion of the birth canal
Where the newborn will deliver
Pregnant female should be laid on her
Left side
Spotting during pregnancy may be
Normal
Mucal discharge with a small amount of bleeding may mean
Delivery Is imminent
Hypertension during pregnancy
Keep mother calm
Dim light
No Loud noises
Supine hypertensive syndrome
Left lateral recumbent position
If immobilization nec. Prop up long board
Braxton hicks/false pregnancy
Contractions felt
Delivery may not be imminent
Bloody show
Cervix begins to dilate
Mucous plug is discharged
Sign of labor
Ruptured amniotic sac
Contractions at regular intervals and at closer intervals
1st stage of labor
Begins with 1st contraction
Continues until fetus enters the birth canal
Contractions intensify
2nd stage of labor
Cervix fully dilated
Bulging occurs
Crowning occurs
Ends with delivery of baby
3rd stage of labor
Begins when baby is born
Ends with delivery of placenta (may take 30 minutes)
Preparing for delivery
Elevate the buttocks
As soon as the baby’s head comes out check for the
Umbilical chord making sure it is not around the baby’s neck
Bulb syringe is inserted into a baby
1-1 1/2 inches
In NYS only suction airway if baby does not spontaneously breath
In NYC following delivery of the head suction
NYS protocol
1st clamp 8-10 inches away from baby
2nd clamp 3 inches from 1st clamp
NYC clamping of chord
1st clamp 8-10 away from baby
2nd clamp is approx 4 inches from baby
Spontaneous breaths should take place in
30 seconds
Normal vital signs > 100 min
Respirators > 30 min
Ventilation of a newborn at least
40-60 min
Heartbeat < 60 per minute in newborn
Start CPR
Prolapsed chord
Umbilical chord comes out 1st
300-500 ml of blood
Normal following delivery
To gain the trust of a pediatric patient you should be
At the children’s level
To minimize patient anxiety when assessing a pediatric patient who does not have an immediate life threatening problem the 1st responder
Should start at the patients
Feet first instead of the head
Often the on,y indiscriminate of illness or injury is a decrease or change in the infants
Mental status or loss of consciousness
What is the injury as a result of shaken baby syndrome
Brain injuries
What is the leading cause of death in children
Trauma
A child who is restrained only by a slap belt in a motor vehicle crash is most likely to have
Abdominal injuries
In caring for an ill or injured child what is your highest priority
Managing airway and ventilation
Children lose body heat
More rapidly than adults
What is the appropriate action for stating a proper airway in a child
Placement of a folded towel under their shoulders
The pulse rate for a child is
Faster than an adult
What should be done for an INFANT with a complete airway obstruction
Back blows and chest thrusts
When should the first responder perform a finger sweep on an INFANT with an obstructed airway
Only if the object can be seen in the mouth
What can you do for a CHILD with a complete airway obstruction
Abdominal thrusts
The most common cause for seizures in children is
Fever
SIDS occurs in what age groups
0-1 years old
A certain age group of children will make up “magical” explanations for things they don’t understand. What age group is this
3-6 years old
Preschoolers
