Emergency Health Care Flashcards
what are the 4 primary duties for a first responder?
safely gain access to pt, determine problem & provide care, lift / move pt, and let trained professionals know status of scene and pt.
what is the role and education required for a emergency/trauma physician?
role: access, treat, admit, & discharge pt. that seeks medical attention
education: medical degree, residency, & pass USMLE
what is the job of a emergency/trauma physician?
job: take full history, perform physical exam, & obtain results that will determine care (result: treat / refer to appropriate follow up care)
what are the duties for a flight nurse?
duties: provide in flight EMS to pt. (evaluate pt, provide proper care / tx until pt reaches hospital. administer meds / injection to ease pain / suffering
what is the education required to be flight nurse?
previous experience working in ICU as RN (many organization want 5 yrs of experience as RN & bachelor’s degree)
what are the 3 different paths for an EMT?
EMT- Basic (B), EMT-Intermediate, & EMT-Paramedic (P)
what can an EMT-B do?
oral / nasal airways; c-spine immobilization, AED’s, administer pt’s own meds, and immobilization of arm / leg injuries
what can an EMT-Intermediate do?
start IV’s, perform intubation, interpret ECG’s, use defibrillators, & administer certain meds
what education does an EMT-I need?
300-400 training course hours including classroom, practical, clinical, & field internship
what does an EMT-P do?
previous B and I skills + administering meds all routes, advanced airway techniques, using monitors, & making decisions in seconds when life slipping away
what education does an EMT-P need?
≥ 1000 hours of paramedic training & maybe Associate
what is the definition of first aid?
immediate care given to victim to minimize effects of injury / illness til experts take over
first aid can mean the difference between _ vs. _, or _ vs. _
…mean the difference b/w life vs. death, or recovery vs. permanent disability
what are the basic principles for first aid?
remain calm, evaluate situation thoroughly, have reason for every decision, & tx. based on injury/illness/environment/bystanders/equipment or medical personal available
what is the first step of first aid?
1: recognize that an emergency exists (use all sense: sight, hearing, and smell). sometimes the signs are obvious and sometimes not
what is the second step of first aid?
2: take actions to assist victim(s). check if scene is safe and avoid danger while providing care. (if not safe, call EMS)
what does triage mean?
determine which injuries are life-threatening and treat those first
what do you report to EMS?
situation, actions taken, phone #, exact location, assistance needed, and # of people involved and their conditions
what are 3 ways to obtain info. about injury/illness/accident?
victim, bystanders, or items present
- obtain _ _ asap
- avoid _ victim
- _ victim
- if unconscious/vomiting, _
- obtain qualified help asap
- avoid moving victim
- reassure victim
- if unconscious/vomiting, avoid giving anything to eat or drink
- protect against _; avoid _
- work _
- don’t make _ or _
- avoid further _
- protect against cold; avoid overheating
- work quickly & in efficient/organized manner
- don’t make diagnosis/ discuss condition with others
- avoid further injury
what is the basic roles of EMT?
role: access, take infection control precautions, provide appropriate out of hospital care, and transport pt.
what is the education required for basic for EMT?
education: basic (minimum 120 hrs. in approved training program & 10 hr. internship)
what does each letter in CPR stand for
C: cardio (heart)
P: pulmonary (lungs)
R: resuscitation (remove from apparent death)
what is the purpose of CPR?
keep oxygenated blood flowing to brain & vital organs (performed until heart & lungs work or medical help arrives)
what is the difference between clinical and biological deaths?
clinical: heart stops & pt. stops breathing
biological: death of body cells (4-6 mins after clinical)
what does CABD stand for?
C: circulation
A: airway
B: breathing
D: defibrillation
when you check for carotid pulse, how long should you check for?
check for less than 10 seconds
what is the ratio for compression to breaths for one and two rescuers for adult?
one person: 30:2
what is the criteria for infants?
birth to 1 year
what is the criteria for children?
1 year to puberty
if victim is choking and CPR started, continue unless:
victim starts breathing, qualified help arrives, physician orders you to discontinue, rescuer exhausted, scene unsafe, or DNR provided
wound is ____
injury to soft tissue
what does a closed wound mean?
no break in skin / mucous membrane, but in underlying tissue (bruise/hematoma)
what does an open wound mean?
break in skin / mucous membrane
what is an abrasion?
skin scraped off; bleeding limited, but infection can occur with dirt / contaminants that enter
what is an laceration?
tearing of tissue w/ excessive force; jagged edges and bleeding heavy. when deep, contamination possible
what is an incision?
cut caused by sharp object & has smooth edges. deep cut leads to heavy bleeding. damage to nerve, tissue, etc can occur
what is a puncture?
caused by object w/ pointed tip (gunshot also). external bleeding limited, but internal bleeding can occur (chance of infection / tetanus high)
what is an avulsion?
tissue torn/separated from body. results in piece of tissue hanging from ear, nose, hand, etc. bleeding heavy & important to preserve body part
what is an amputation?
body part cut off. bleeding heavy & important to preserve part because surgeon may reattach it. (part wrapped in cool, moist dressing- sterile or normal saline- & placed in plastic bag. bag kept cool/placed in ice)
what does arterial bleeding look like?
spurts from wound & results in heavy loss. bright red & life-threatening
what does venous bleeding look like?
slow, steadier, and dark red/maroon. constant & can lead to pool of blood, but controlled easier)
what does capillary bleeding look like?
oozes from wound and less red than arterial. clots easily
what is the order in which controlling bleeding should be performed?
- direct pressure
- elevation
- pressure bandage
- pressure points
(each step adding to other step)
what are the signs of infection?
swelling, heat, redness, pain, fever, pus, & red streaks
what wounds are most common for tetanus bacteria?
puncture wounds & wounds with damage to the tissue underneath skin
what do you do if the object embedded is superficial?
gently remove with sterile tweezers
what are the signs of internal bleeding?
pain, tenderness, swelling, deformity, cold clammy skin, BP drop, restlessness, excessive thirst, vomiting, blood, blood in urine/feces, and rapid/weak pulse
what are the basic principles for a closed wound?
check breathing, check for shock, avoid unnecessary movement, & avoid giving fluids/food
what is the definition of shock?
clinical set of symptoms associated with inadequate supply to body organs (heart/brain)
what are the causes of shock?
hemorrhage, excessive pain, infection, heart attack, stroke, chemical/gas/drug poisoning, lack of O2, psychological trauma, & dehydration from burns/vomiting/diarrhea
what are the symptoms of shock?
skin pale/cyanotic; skin cool/cold to touch; diaphoresis; rapid & weak pulse; rapid/shallow/irregular respiration; BP very low/unobtainable; general weakness; anxiety & extreme restlessness; excessive thirst/nausea/vomiting; blurred vision/change in appearance in eye/pupil
what is the definition of diaphoresis?
excessive perspiration
what do you do for shock?
reduce effects or eliminate cause; improve circulation; cover pt. from cold; and avoid giving food/drinks
what are the ways you can be poisoned?
ingestion, inhalation, injection, and skin contact
if a rash or sore develops from contact poisoning, what do you use?
calamine, caladryl, or paste of baking soda & water
what does the skin of a superficial (1st degree) burn look like and causes?
skin: reddened/discolored; mild swelling; painful
causes: sunburn, brief contact w/ hot objects/steam, & exposure to weak acid/alkali
what does a partial thickness (2nd degree) burn look like and causes?
skin: blister/vesicle forms; red/mottled skin; swelling; surface of skin appears wet; painful
causes: excessive exposure to sun/sunlamp; artificial radiation; hot/boiling liquids; fire
what does a full thickness (3rd degree) burn look like and causes?
skin: white/charred appearance; extremely pain/no pain
causes: fire/flame, prolonged contact w/ hot objects, contact w/ electricity, immersion into boiling liquid
what is the treatment for burns focused on?
removal of source of heat; cool affected area; cover burn; relieve pain; observe for/treat shock; prevent infection
when should you obtain medical help for burns?
if burn covers more than 15% of adult or 10% of child
what are heat cramps and the treatment for them?
def: muscle pain & spasm from loss of water & salt
tx: firm pressure on cramp; rest & move to cooler area; sips of water/electrolyte
what are the symptoms of heat exhaustion?
pale & clammy skin; diaphoresis; fatigue; weakness; headache; muscle cramp; nausea/vomiting; dizziness/fainting (body temp. normal/slightly elevated)
what is the treatment for heat exhaustion?
move to cooler area; remove excess clothing; apply cool, wet cloth, laying pt. down & elevating feet 12 inches; giving sips of water (can develop into heat stroke if not treated)
what are the signs of heat stroke?
red, hot, & dry skin; pulse rapid, but strong; may lose unconsciousness (internal temp raise to 105 F)
what is the treatment for heat stroke?
tub of cool water/skin sponged with cool water; ice/cold packs placed on wrists, ankles, axillary, and groin
what are the signs of hypothermia?
shivering, numbness, weakness/drowsiness, low body temp. (<95 F), poor coordination, confusion, and unconsciousness
what is the treatment for hypothermia?
moving pt. to warm area; remove wet cloths; slowly warming pt.; giving warm, non-caffeinated liquid
why is it important to warm slowly?
rapid warming can cause arrhythmias
what are the signs of frostbite?
early: redness & tingling; later on: pale, glossy skin that’s white/grayish yellow; blisters; skin cold to touch; numbness; pain that subsides
continued: confusion, lethargic, incoherent; shock->unconsciousness->death
what is the treatment for frostbite focused on?
maintaining respiration, treating shock, warming affected part (100-104 F water), & preventing injury
what parts of the body are commonly affected by frostbite?
fingers, toes, ears, nose, and cheeks
what are the common bone injuries?
fractures, dislocations, sprains, and strains
a closed or simple fracture means?
no break in skin
a open or compound fracture means?
there is a break in the skin
what are the common signs of a fracture?
deformity, limited motion/loss of motion, pain & tenderness at site, swelling & discoloration, protrusion of bone through skin, victim hears break/snap/grating sensation (crepitation)
what are the basic principles for a fracture and dislocation?
- maintain respiration 2. treat shock 3. keep bone from moving 4. prevent further injury 5. use devices to prevent moving 6. get help
what are the signs of a dislocation?
deformity, limited/abnormal movement, swelling, discoloration, pain & tenderness, and shortening/lengthening of affected part
what are the signs of a sprain?
swelling, pain, discoloration, & maybe impaired movements (resemble fractures, so if in doubt, treat as fracture)
what is the 1st aid for sprain?
cold application to decrease swelling & pain; elevate; encourage rest; apply elastic bandage for support, but avoid stretching bandage too tight; obtain help if severe
what are the signs of a strain?
sudden pain; swelling; and bruising
what is the first aid for strain?
encourage rest while providing support; bedrest w/ backboard for strained back; cold app.; after swelling decreases, apply warm wet compress
1) must be _ enough to immobilize joint _ & _ injured area to prevent injury
2) should be _, especially at _ area & _ site of injury
3) _ in place
4) apply without _
5) if open wound is present, _ _before
1) long enough, immobilize joint above & below
2) padded, bony area, over site of injury
3) tie
4) pressure
5) control bleeding before
1) never replace _ _ or _ _. Don’t _ victim
2) observe _ when using pneumatic splint
3) after splint application, check _
1) broken bone/ reduce fracture. Don’t move victim
2) precautions
3) note circulation & effects on nerve endings; splint not too tight; check skin temp; check skin color; note swelling/edema; note numbness/tingling; check pulse
what do traction splints do?
provide pulling/traction effect on injured area; frequently used on fractures of femur/thigh bones
what are slings used for?
support arm, hand, forearm, and shoulder. provide immobility
what are the basic principles for a sling?
- sling positioned so hand higher than elbow
- circulation & nerve ending check. check skin temp, color, swelling, amount of pain, & tingling/numbness
- limit movement of limbs
- if using triangular w/ knot at neck, check knot placement & use gauze padding under knot
- consideration for shoulder injury
what do you do for neck & spine injury?
don’t move. wait for backboard and adequate help to arrive
what are the signs of a foreign object in eye?
redness, burning sensation, pain, water/tearing, and presence of visible object in eye
what is 1st aid for something in eye?
don’t rub eye. wash hands & gently draw upper lid over lower lid (stimulates tears and creates wiping action). grasp upper eyelid and tell pt. to turn head toward injury side & tilt head down. flush or remove with gauze
what is a blow to an eye?
fish, explosion, and accident may cause contusions/black eye as result of internal bleeding & torn tissue. examined by specialist
what is 1st aid for blow to eye?
apply sterile dressing/eye shield; lay flat; cover both eye to prevent movement of injured
what is the 1st aid for penetrating eye injuries?
apply dressings to both eyes. avoid pressure while dressing. keep pt. laying flat to prevent fluid from draining out of eye. obtain help
what factors can affect the degree of injury by the cold?
wind velocity, humidity, and length of exposure to cold
what can ear injuries result in?
rupture or perforation of eardrum
what is the basic principle of a ear injury?
- lay down, but raise head
- place sterile gauze loosely in outer ear canal if eardrum broke.
- if clear/blood tinged CSF, keep lay down, but turn to side and elevate head & shoulders
what are the signs of a head or skull injury?
clear/blood-tingled CSF draining from nose & ear; loss of consciousness; headache; visual disturbances; unequal pupils; muscle paralysis; bad speech; convulsions; nausea & vomiting
what is the basic principles of a head or skull injury?
- seek help quick
- lay down & treat for shock. if no neck/spinal injury, elevate head and & shoulders slightly
- watch 4 respiratory distress & provide artificial if needed
- don’t attempt to stop flow of fluid
- don’t give liquid (use rag to moist lip if complaints)
- report how long pt. was unconscious
what are the causes of epistaxis?
change in altitude, strenuous activity, high BP, and rupture of small blood vessels after cold
what is the treatment for epistaxis?
keep victim calm & quiet. place in sitting position with head forward. apply pressure by pressing bleeding nostril(s) toward midline; apply tissue to nose; apply cold compress; obtain help if it doesn’t stop
what is a sucking chest wound?
deep, open chest wound that allows airflow in & out with breathing (partial vacuum in pleura destroyed, so lung collapsed)
how should you wrap a sucking wound chest?
non-porous (aluminum/plastic wrap) dressing placed over wound. tape/bandage 3 sides & leave 4th open so air can escape when victim exhales. inspiration will create airtight seal. maintain open airway
how should you position someone with sucking chest wound?
placed on injured side and elevate head & chest to prevent pressure on injured and allow uninjured to expand more
what is the first aid for penetrating injuries to chest?
don’t remove. immobilizing by placing dressing around it & taping. place in comfortable position, maintain respiration, and obtain help
what is the first aid for crushing chest injury?
comfortable position, elevate head & shoulders to help breathing
what are the signs of an abdominal injury?
severe abdominal pain/tenderness; protruding organs; open wounds; nausea & vomiting; abdominal muscle rigidity; & symptoms of shock
what is the 1st aid for abdominal injury?
position on back & roll thing under knee to bend knees slightly; elevate head & shoulders; remove clothing around wound; use sterile dressing to cover area
why should you roll something under the knee for abdominal injury?
bent knees relaxes abdominal muscles
how should you dress an abdominal injury?
cover dressing with plastic wrap then cover with aluminum foil/folded towel to keep area warm
what is a 1st aid for genital injuries?
control bleeding with direct pressure; treat for shock; don’t remove object; save any torn tissue; use cold application; obtain help
what are the signs of an allergic reaction?
redness & swelling, itching, hives, pain, swelling throat, difficult/labored breathing, and changes in level of consciousness
what are the signs of a heart attack?
painful pressure in left side of body; shortness of breath; skin becomes pale/cyanotic; weak; anxious; apprehensive; sweating; lightheartedness/dizziness; fainting; feeling of fullness
what is the 1st aid for heart attack?
encourage to relax, treat for shock, prevent stress & excessive movement; reassure victim; get help ASAP, maintain airway, and given aspirin if qualified
what are the names for a cerebrovascular accident?
stroke, apoplexy, and cerebral thrombosis
what are the signs of stroke?
varies depending on side; include numbness, paralysis, unequal pupil; mental confusion; sudden severe headache; loss of balance/coordination; slurred speech; nausea; vomiting; difficulty breathing/swallowing; and unconscious
what do you think of if you suspect a stroke victim?
F- face (smile)
A- arms (raise)
S- speech
T- time
what is the 1st aid for stroke victim?
maintain respiration; laying pt. flat on back/side; avoid fluid in mouth; reassure; prevent stress & movement; get help ASAP (first 3 hours can prevent brain damage)
what do doctor do if its a clot in the brain?
thrombolytic or clot-busting drug (tissue plasminogen activator (TPA) or angioplasty of arteries
what is the 1st aid for fainting?
prevent injury, supine position (elevate feet 12 inches if no neck/spine injury), loosen tight cloth, maintain airway, cool water on face, victim remains quiet & flat until color returns
what are the signs of fainting?
dizziness, extreme palor, diaphoresis, coldness of skin, nausea & numbness, and tingling in arms and feet
what can the causes of convulsions be?
high body temperature, head injuries, brain disease, and brain disorders
what is the 1st aid for convulsions?
prevent self injury, maintain airway, pillow/cushion under head, nothing b/w teeth, position on side if fluid in mouth, get help if it lasts more than a few mins
what is a diabetic coma/hyperglycemia and causes?
high glucose, low insulin
causes: excess intake of sugar, failure to take insulin, and low production of insulin
what are the signs of diabetic coma?
confusion; weakness/dizzy; nausea/vomiting; rapid & deep respiration; dry & flushed skin; fruity oder to mouth; then unconscious and die
what is a insulin shock/hypoglycemia and causes?
high insulin and low glucose
cause: failure to eat recommended amount, vomiting after insulin, and excessive insulin
what are the signs of insulin shock?
muscle weakness; confusion; restlessness/anxiety; diaphoresis; pale & moist skin; hunger pains & palpitations; may coma & convulse (onset sudden)
what is the treatment for insulin shock?
if conscious, give sweet drink (sweetened orange juice) /cube or teaspoon of granulated sugar/glucose tube. if unconscious, nothing
