Emergency Medical Procedures (Passage 5) Flashcards

1
Q

Who performs pre-hospital EMS? (3)

A
  1. Paramedics
  2. EMTs
  3. Medical First Responders (MFRs)
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2
Q

What is CPR designed to do? (2)

A
  1. To restore normal breathing and

2. assist with circulation after cardiac arrest.

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3
Q

What does CPR do with regard to cardiac output?

A
  1. It does not maintain normal cardiac output
  2. but does support delivery of oxygen to the heart and brain.
  3. Buys time until defibrillation and advanced care can restore normal heart action.
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4
Q

What was the difference in survival of cardiac arrest with defibrillation between immediate bystander CPR and no bystander CPR?

A

Those with bystander CPR were twice as likely to survive.

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5
Q

What does “ABC” stand for in terms of EMS?

A

A - first open the airway
B - check for normal breathing and give rescue breaths
C - check circulation

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6
Q

If you provide mouth-to-mask ventilation without supplemental oxygen, how should the rescue breaths be delivered?

A

Slowly over 2 seconds.

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7
Q

What provides the best possibility of survival after sudden cardiac arrest?

A

Immediate CPR and prompt defibrillation.

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8
Q

What skills does Paramedic training allow? (2)

A
  1. Advanced airway skills

2. Advanced cardiac life support

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9
Q

What are 2 examples of advanced airway skills?

A
  1. airway tube placement

2. emergency creation of an airway (crichothyrotomy)

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10
Q

What is a “Mega-code” training scenario?

A

Usually multiple medical or trauma scenarios wrapped into one large training scenario.
They are typically acute, dynamic, rapidly evolving scenarios based on the use of many various acute care EMS protocols.

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11
Q

What are 2 examples of practical therapeutic manipulation?

A
  1. CPR

2. the Heimlich maneuver

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12
Q

What simple axiom is the basis of the Mega-code scenario?

What is a strong example of this?

A

Certain medical modalities must be accomplished before certain others would be effective.
The simple order of Airway, Breathing, and Circulation.

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13
Q

What references can be used to identify standards related to Mega-codes? (2)

A
  1. AHA literature

2. National Association of EMT testing standards

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14
Q

How do you know the AED has detected a cardiac rhythm and an electric shock is indicated?

A

The AED will signal audibly and visually.

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15
Q

At what levels does the AED deliver shocks at increasing wattages?

A

120 Joules
150J
200J

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16
Q

What is the significance of an algorithm, decision tree, or flow chart in operating an AED?

A

An algorithm defines each step in an orderly manner and,
one step must be completed and,
the rescuer must evaluate the outcome of that step prior to,
moving to the next appropriate step.

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17
Q

How is the AED algorithm self-limiting?

A

It requires the rescuer to return to previous described steps, to repeat and re-evaluate the step to determine if a change in the direction of care must be made.

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18
Q

AED ALGORITHM
Assess Airway and Breathing –> Not Breathing
Then what?

A

Give 2 breaths;

Check pulse

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19
Q

AED ALGORITHM

If No Pulse, then what?

A
Begin chest compressions;
Apply AED;
Stop CPR;
Stand clear;
Analyze
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20
Q

AED ALGORITHM
Shock indicated and the AED charges.
Then what?

A

AED delivers shocks @ 120J, 150J, 200J;

Check pulse

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21
Q

AED ALGORITHM
You check pulse and there is NO pulse.
Then what?

A

CPR for 1 minute;

Stop CPR, stand clear, analyze

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22
Q

AED ALGORITHM

If there is a pulse (< = 30), then what?

A

CPR for 1 minute;

Check pulse

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23
Q

AED ALGORITHM

If there is a pulse (> 30), then what?

A

Monitor pulse

Evaluate for < = 30 or > 30 {and act accordingly}

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24
Q

AED ALGORITHM
Assess Airway and Breathing, BREATHING ADEQUATE
What next?

A
Check pulse;
Pulse present, ANY RATE;
Ventilate for 1 minute
Re-check pulse after 1 minute
{act accordingly}
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25
Q

What is the first step in the AED algorithm?

A

Assess Airway and Breathing

26
Q

Who is considered a patient? (4)

A

a. They have a chief complaint or suspected illness or injury; or
b. They are not oriented to person, place, time and event; or
c. They request/require field treatment/transport; or
d. They are a minor who is not accompanied by a parent or legal guardian, and are ill or injured or appears to be ill or injured.

27
Q

What are the 3 things to do when you arrive on scene?

A
  1. Note the conditions
  2. Use the tactical channel to communicate
  3. Locate your patient(s)
28
Q

Who is ultimately responsible of all patient care and related documentation regardless of whether that care is being provided by paramedics?

A

Company Officers

29
Q

What dictates the transfer method of moving a patient to the gurney?

A

The patient’s medical condition.

30
Q

What should be carefully noted when considering transferring patients to a gurney? (5)

A

a. Is the patient ambulatory / non-ambulatory?
b. Is a c-spine stabilization required?
c. Is the patient stabilized?
d. What personnel are available to assist?
e. Are there any hazards / rough terrain to consider?

31
Q

What is as important as any part of the patient’s medical treatment when transferring patients to the gurney?

A

The selection of the correct lift.

32
Q

What is a must on this job?

A

Physical fitness

33
Q

When moving the gurney, which end goes first?

A

The foot end except when loading.

34
Q

What is a major benefit of using gurneys?

A

They can be placed in or adjusted to a variety of positions to accommodate the condition of the patient.

35
Q

Generally, in what position should a patient with chest pain and/or dyspnea be transported?

A

Generally, place the patient in a semi-reclining or fully upright position. Ask what position feels best.

36
Q

In what position should a cardiac patient in shock usually be transported?

A

Supine with the legs elevated.

37
Q

What is of the greatest concern with an unconscious patient?

A

Management of the airway.

38
Q

In what position should an unconscious patient be transported?

A

Left lateral recumbent position.

39
Q

In what position should an unconscious patient be place if they need resuscitative measures?

A

Supine position on a long backboard.

40
Q

In what position should patient with abdominal pain be transported?

A

Supine or left lateral recumbent position with the knees drawn up. Patient comfort will determine the position.

41
Q

In what position should patient with upper body extremity fractures be transported?

A

Semi-fowlers position.

42
Q

In what position should a patient with lower body extremity fractures be transported?

A

Elevate the limbs whenever possible. (semi-fowlers?)

If splints are used, be sure they are placed securely on the gurney mattress.

43
Q

In what position should patient with an isolated head injury (no c-spine injury) be transported?

A

Semi-fowlers position.

44
Q

What is the benefit of transporting a patient with an isolated head injury (no c-spine injury) in a semi-fowler’s position?

A
  1. Reduces intercranial pressure

2. Decreases the possibility of cerebral edema

45
Q

In what position should an unconscious or altered mental state patient with an isolated head injury (no c-spine injury) be transported?

A

Left lateral recumbent position

46
Q

How should a patient with a head injury AND a spinal injury be transported? (3)

A
  1. Place the patient on a long backboard;
  2. Use full c-spine precautions;
  3. Pay close attention to airway management
47
Q

In what position should a pregnant patient in the second or third trimester or involved in severe trauma usually be transported? (1, 1a)

A

Left lateral recumbent position. NOT supine.

If the patient prefers, the semi-fowlers is also a comfortable position.

48
Q

If a pregnant patient is transported in a semi-fowlers position, what other positioning details should occur? (3)

A
  1. Place the patient in a supine or semi-reclining position
  2. With the knees bent, and
  3. The legs spread apart.
49
Q

If a paramedic is riding in the back of the medic rescue unit, what is the responsibility of the EMT rescue attendant?

A
  1. Assist the paramedic with patient treatment;

2. Carefully carry out the paramedic’s instructions.

50
Q

Who is responsible for patient transport and transfer?

A

Rescue personnel

51
Q

Which medical facility will the patient be taken? (3)

A
  1. One that the patient has chosen or
  2. that the patient’s condition dictates or
  3. rerouting if the patient condition changes for the worse during transport as requested by the EMT attendant.
52
Q

If you are transporting 2 stable patients, who is unloaded first?

A

In reverse order of how they were loaded.

So the gurney is unloaded first and then the patient on the bench seat.

53
Q

What is the Fire Department’s philosophy on how the patient should be cared for?

A

In a gentle, caring manner.

54
Q

When a patient’s condition deteriorates during transport making ALS necessary, what should be evaluated before deciding to reroute? (4)

A

a. How close are you to the medical facility?
b. How long will it take an ALS unit to arrive?
c. What personnel are available to assist?
d. Can airway, breathing and circulation of the patient be maintained?

55
Q

What should be done if your patient deteriorates and airway, breathing and circulation cannot be maintained? (3)

A
  1. Pull over immediately
  2. Contact Dispatch for an ALS unit
  3. Have the driver assist until the ALS unit arrives.
56
Q

Who should you notify should you decide to change dest.inations while transporting?

A

Fire Dispatch via the radio.

57
Q

Who alerts the new receiving facility should you decide to change destinations while transporting?

A

The Dispatcher will alert the new receiving facility

58
Q

What precautions should be followed when driving the medic rescue unit to the hospital with a patient? (4)

A

a. Reduce speed when crossing railroad tracks, speed bumps and curbs.
b. Turn with a wide berth.
c. Apply the brakes gradually.
d. Realize that everything feels exaggerated when riding in the rear of a medic rescue unit.

59
Q

What are key when driving the medic rescue unit? (2)

A
  1. Safety and

2. Comfort

60
Q

On what will personnel be evaluated per the “patient transfer at a medical facility” section? (3)

A
  1. Proper positioning of the patient on the gurney.
  2. Continual assessment reports of the patient’s condition.
  3. Completeness of their reports.
61
Q

When wheeling the gurney in to the receiving facility, on what must medic rescue personnel be prepared to provide? (7)

A

A report of the patient’s

  1. Chief complaint
  2. Mechanism of injury
  3. Level of consciousness
  4. Treatment(s) performed
  5. Patient’s responses to treatment
  6. Vital signs
  7. Any changes that have occurred while en route to the medical facility