EMR-NAT Flashcards
ADULT (18 >) Rates
Breath/pulse/systole
Breath Pulse Systole
12-20 60-100 120/80
Adolescent (13 - 17) Rates
Breath/pulse/systole
Breath Pulse. Systole
12 - 20. 55-105 120/80
School age (6 - 12) rates
Breath / pulse /rates
Breath Pulse. Rate
20-30 70-110 120/80
Teenager (4-15) Rates
Breathing / pulse / systole
Rates. Pulse. Systole
20-30 70-110 110/80
Toddler (1-3) rates
Breath / pulse /systole
Breath. Pulse. Systole
20-30 80-110 100/70
Infant (<1) rates
Breath Pulse Systole
30-40 80-130 80/60
Neonate rates (28 days)
Breath Pulse Systole
40-60 110-160 80/60
Pregnant rates
Breaths/systole
Breaths Systole
15+ 140/90
Ventilations for ADULTS
1 every 5-6 sec
10/12 pm
Ventilations for INFANTS
1 every 3 to 5 seconds
12/20 pm
Ventilations for NEONATES
I breath every 2-4 seconds
15/30 pm
Ventilations for STOMA
1 breath every 4 - 5 seconds
12/15 pm
SUCTIONING time for ADULTS
15 seconds
SUCTIONING for a CHILD
10 seconds
SUCTIONING for an INFANT
5 Seconds
Compression rates for ADULTS
2 - 2.4 inches
Compression for a CHILD
2 inches
COMPRESSION for an INFANT
1.5 inch
Steps for SCENE SIZE-UP
- BSI/ Scene Safe
2.MOI/NOI - consider spinal Injury - # of patients
- Call 911
PRIMARY ASSESSMENT (stabilize)
- AVPU, A&Ox……
- Chief Complaint
- ABC —> + Oxygen
- Transport/ Treatment Priority
Patient HISTORY
- OPQRST
- SAMPLE
3.Baseline Vital Signs
SECONDARY ASSESSMENT
- HEAD TO Toe (MOI)
2.BP-DOC (NOI)
REASSESSMENT
Airway DIAGRAM
From top:
Nose - mouth - Pharynx - Larynx - left /right Bronchus - Bronchiol - Alveoli - Diaphragm
What does BPDOC stand for and when is it used?
B - bleeding 🩸
P - Pain 😖
D - Deformities
O - Open Injuries
C - Creptus
CREPTUS
Grating sound or sensation produced by friction within bones and Cartilage or the fractured part of the bone 🦴
EMS systems
Emergency Medical Services (EMS) Systems
*The CHAIN OF HUMAN RESOURCES and services linked together to provide continuous emergency care at the scene and during TRANSPORT to a medical facility
MEDICAL DIRECTOR
A physician who assumes the ULTIMATE responsibility for medical oversight of the patient care aspect of the EMS
Scope of Practice
The care that and EMR is ALLOWED and SUPPOSE to provide according to the regulations and Statutes. It’s also known and SCOPE OF CARE
PROTOCALS
WRITTEN GUIDELINES that direct the care of EMS personnel provide for patients
Standing orders
A component of a protocol that allows the EMS personnel to provide specific interventions to a patient
Standard of Care
The care that should be provided for any level of training based on local laws, administrative orders, and guidelines or protocols established by the local EMS systems
NEGLIGENCE
Failure to provide an expected standard of care
Duty to act
A requirement that an EMR, at-least while on duty, must provide care to a set standard
Abandonment
To leave a sick or injured patient before an equal or highly trained personnel can assume responsibility for care
HIPAA and it’s definition:
Health Insurance Probability and Accountability Act
A law that dictates the extent to which protected health information can be shared
Mandated reporter
Any individual required by law to report financial, physical, sexual or any other types or abuse or neglect have been observed or suspected
Critical incident
Any situation that causes a rescuer to experience strong emotions that interfere with the ability to function either during the incident or after a highly stressful incident
METABOLISM
Conversion of GLUCOSE into energy
Tidal volume
The volume of air moved in our breathing cycle, which consist of One inhalation and One exhalation, approximately 500ml in the average adult
Stroke volume
The Volume of BLOOD 🩸 ejected from the heart in one contraction
Cardiac output
The amount of blood 🩸 ejected from the heart in one minute
Direct carry
A carry performed to move patient with NO SUSPECTED spine injury from BED TO A STRETCHER
Recovery position
A position in which a patient WITH NO suspected spine injury will be placed, on his left side
Log roll
Method used to move a patient from prone position to the supine position
Transfer of care
Verbal or physical handing off of care from one health care provider to another
What is HYPOXIA
Condition which there is INSUFFICIENT SUPPLY OF OXYGEN in the blood or tissues
Respiratory Compromise
A general term used to describe when a patient IS NOT BREATHING ADEQUATELY
Respiratory distress
Breathing that becomes different or labored (DYSPNEA)
Respiratory failure
Inadequate respiratory rate and volume secondary to poor oxygenation
Respiratory arrest
The obscure of breathing. Also known as APNEA
DYSPNEA
Difficulty or Labored breathing
Rescuer breathing
Providing MANUAL VENTILATIONS for a patient who is not breathing or adequately NOT breathing on his own. Also known as PULMONARY RESUSCITATION
What is PULMONARY RESUSCITATION
The act of breathing for a patient who is unable to breath for themselves. It’s also called RESCUE BREATHING OR ARTIFICIAL VENTILATIONS
What is a CHAIN OF REACTION and what are the five links:
5 critical component that’s affect the chances of survival from a cardiac arrest
1:Early recognition and ACCESS TO EMS
2:Early CPR
3: Early Defibrillation
4: EARLY Advance Life Support
5:integrated post cardiac arrest care
Fibrillation
Disorganized electrical activity within the heart that render the heart unable to pump blood 🩸
Ventricular fibrillation
Disorganized electrical activity, causing ineffective contractions of the lower heart chambers (ventricles)
Ventricular Tachycardia
Abnormally RAPID contractions of the heart’s ventricles, resulting in poor circulations
Asystole
NO electrical activity in the heart. Also called “FLATLINE”
Basic life support
Externally supporting the circulation and respiration of a patient in respiratory or cardiac arrest through CPR
Mental status
General condition of a persons consciousness and awareness
Primary assessment
A quick assessment for the patient’s ABC and bleeding to detect and correct any immediate life threatening problems
Secondary assessment
A complete head to toe physical exam, including medical history
Reassessment
LAST part of patients assessment that includes REPEATING primary assessment
Focused secondary assessment
An examination conducted on a STABLE PATIENT, focusing on a specific injury or medical complain
Rapid secondary assessment
A head to toe assessment of the MOST CRITICAL patients
Tracheal Deviation
Shifting of the TRACHEA to either side of the midline of the neck caused by build up pressure inside of the chest (TENSION PNEUMOTHORAX)
Jugular Vein Distention
An ABNORMAL bodging of the vein on the neck indicating cardiac compromise or possible injury to the chest
Angina
Pain on the chest caused by a lack of sufficient blood and oxygen to the heart muscle
Heart attack (MI)
A condition that occurs when the blood supply to a portion of the heart is interrupted
Heart failure
A condition that develops when the heart is UNABLE TO PUMP BLOOD 🩸 efficiently., causing a back up of blood and other fluids within the circulatory system. It’s also called CONGESTIVE HEART FAILURE
Hypercarbia
ABNORMALLY HIGH level of Oxygen in the blood 🩸
Chronic Obstructive Pulmonary Disease
(COPD)
General term used to describe a group of lung 🫁 diseases that cause distress and shortness of breath. BRONCHITIS and EMPHYSEMA are examples.
Emphysema
Progressive condition of the lung characterized by the distraction of the AVLVEOLI; a form of COPD 🫁
Altered mental status
State characterized by disease 🦠 in the patient’s alertness and responsiveness to his surroundings
Tonic muscle activity
STIFFENING of the muscle during a GENERALIZED SEIZURE. Most evident in arms and legs
Clonic muscle activity
The violent muscle jerking during a generalized seizure. Most evident in arms and legs
Generalized seizure
A type of seizure characterized by a loss of consciousness and generalized muscle contractions
Partial seizure
A seizure characterized by a TEMPORARY LOSS OF AWARENESS
Partial Epilepticus
A life threatening condition that occurs when an individual HAS VERY LONG SEIZURES that occur in quick succession
Stroke
Conditions that occur when an area of the brain 🧠 doesn’t receive adequate supply of blood 🩸
HYPERglycemia
Abnormally HIGH blood sugar 🎂
HYPOglycemia
An ABNORMALLY LOW blood sugar level 📉
Heat cramps
Muscle cramps on the Lower limbs and abdomen associated with the LOSS OF FLUIDS AND ELECTROLYTES while ACTIVE IN A HOT 🥵 ENVIRONMENT
Heat EXHAUSTION
Prolonged exposure to heat, which creates MOIST, PALE SKIN that may feel NORMAL OR COOL TO THE TOUCH
Heat STROKE
Prolonged exposure to heat, which creates DRY OR MOIST SKIN that may feel WARM or HOT 🥵 TO THE TOUCH
Shock
A condition that occurs when there is an inadequate supply of well-oxygenated blood to all the body systems.
It’s also called HYPERFUSION
What is HYPOPERFUSION
Failure of the body’s circulatory system to provide an adequate supply of well oxygenated blood and nutrients to all vital organs
Pulmonary Embolism
Blockage of an artery in the lung 🫁
Pericardial Tamponade
A condition that occurs when fluid accumulates in the sack surrounding the heart restricting the hearts ability to expand and contract
Decompensated shock
A condition in which the body in no longer able to compensate for a lack of adequate perfusion
Spinal motion restriction
The practice of using alternate methods of using spinal immobilization based on mechanism of injury and patient presentation
Miscarriage
The spontaneous natural loss of the embryo or fetus before the 20th week of pregnancy
Supine Hyposensitive syndrome
An abnormally low blood pressure that results when the mother is supine and the fetus puts pressure on the Vena Cava
Preeclampsia
A potentially life threatening condition that affects the mother during the 3rd trimester and is characterized by high blood pressure and fluid retention
Eclampsia
A life threatening condition for pregnant women characterized by seizures, coma and eventually death of both the mother and fetus
Placenta previa
A condition that results when the placenta grows and develops over the cervix
Placenta abruptio
A premature separation of the placenta from the uterus
Pediatric assessment triangle
(PAT)
Tool used to form a general impression of a pediatric patient; the element of a PAT are Appearance, Work of breath, and circulation (perfusion)
AWC
retractions
The inward movement of the soft tissue between the ribs when a child breaths in
Due regards
The appropriate care and concern for the safety of others
Incident command system (ICS)
A model tool for the command, controls and coordination of resources at the scene of a large-scale emergency involving multiple agencies. Also known as INCIDENT MANAGEMENT SYSTEM
Incident commander
Individual responsible for all aspects of all emergency response
START triage system
A system that uses respirations, perfusion and mental status assessment to categorize patients into one of four different categories.
What does START stand for:
Simple Triage and Rapid System
SALT triage system
Triage system used for determining patient treatment priority during mass casualty incidents.
What does SALT stand for:
Sort, assess life saving Interventions and treatment/transportation
Emphysema
Progressive condition of the lung characterized by the distraction of the Alveoli; a form of Chronic Obstructive Pulmonary Disease 🦠 (COPD)
Symptoms of Emphysema:
-moderate to severe shortness of breath
-very thin appearance
-barrel chest
-nonproductive cough
-extended exhalation
-pursed-lip breathing
Hyperventilation symptoms
-Moderate to severe shortness of breath
-anxiety
-numbness or tingling of fingers, lips or toes
-chest discomfort
Altered Mental Status (AMS)
-confusion
-incoherent speech
-drowsiness
-abnormal behavior
-lack of awareness of surrounding
-combativeness
-repetitive questions
-syncope (collapse or fainting)
-unresponsive
What is Syncope
Fainting
Diabetes
Usually refers to as diabetes mellitus, a disease that prevents individuals from producing enough insulin or from using insulin appropriately
Diabetes signs and symptoms
-gradual onset of signs and symptoms over hours or days
-dry mouth and intense thirst
-abnormal pain and vomitus 🤮
-gradual increase in restlessness and confusion
-unresponsive with deep respirations, weak rapid pulse, dry red warm skin, shrunken eyes and fruity smell breath
Heart failure
Develops when the heart is unable to pump blood 🩸 efficiently, causing a back up of blood and other fluids within the circulatory system
Signs and symptoms for heart failure
-shortness of breath
-chest pain/discomfort
-rapid pulse rate
-edema on the lower extremities
-jugular vein dissension
-pale, moist skin
-AMS due to
Low due perfusion to the brain 🧠
Increased difficulty breathing while lying flat
Signs and symptoms of COPD
-history of smoking
-persistent cough
-chronic shortness of breath
-pursed lip breathing
-tripod position
-fatigue
-tightness in the chest
-wheezing
-barrel chest
Bronchitis
A condition of the lung characterized by the inflammation of the bronchial airway with mucus formation, a form of COPD
Bronchitis sign and symptoms
-Overweight
-MILD TO MODERATE shortness of breath
-pale complexion
-productive cough
-wheezing
Asthma
Condition affecting the lungs 🫁, characterized by narrowing of the airway passage and wheezing
Asthma signs and symptoms
-Moderate to severe shortness of breath
-wheezing
-anxiety
-nonproductive cough
Stress signs and symptoms
-irritation
-inability to concentrate
-difficult sleeping and nightmares
-loss of appetite
-low libido
-anxiety
-indecisiveness
-guilt
-isolation
-loss of interest in work or poor performance 🎭
Partial airway obstruction
-increased work of breathing and cyanosis
-suorius
-gurgling
-strider
-wheezing
Complete airway obstruction
UNABLE to 🗣️ SPEAK, BREATH OR COUGH 😷
Grabs the neck and open mouth
Myocardial Infraction
-pain in chest and upper abdomen
-heartburn sensation
-pain behind the sternum
-vomitus
-general weakness
Define shock
Condition that results when there is inadequate supply of well-oxygenated blood to all the systems
Define stroke
Conditions that occur when an area of the brain 🧠 doesn’t receive adequate supply of blood 🩸
Causes of cerebrovascular stroke area:
- Cerebrothrombosis (clot)
- Cerebral hemorrhage (rupture)
What are ways for caring for a baby?
1.clearing the airway
2.make sure the baby is breathing
3.perform a quick assessment
4.clamp and tie off umbilical cord
5. Keep the baby warm
Neonate vital signs
Breath, pulse and systole
Breath Pulse. Systole
40-60. 120-160 60-80
For injury, you will use what account and what does it stand for:
DOTS
DEFORMITIES
OPEN WOUNDS
TENDERNESS
SWELLING
How to access a vehicle:
-open the door
-through the window
-pry open the door
-cut through the metal
Radiation
Without contact
Conduction
With contact
Convection
Air replacement surroundings
Convection
Air replacement surrounding
Evaporation
Perspiration, sweating
Respiration
Breathing
Temperature loss
Radiation
Conduction
Convection
Evaporation
Respiration
Abrasion
Skin, elbows and knees
Laceration
-Smooth cuts or incisions
-jagged cuts
Punctures
Penetrating trauma 🗡️
Avulsions
Tearing off of a large flap of skin 🥞
Crash injuries 💥
Body parts pressed between 2 surfaces
Hazard respond phrases
1.preparations
2.dispatch
3.en route to scene
4.at scene
5.transfer of care
6.postcall preparation
Info need to provide during transfer
-nature and location
-type of material
-identification of products
-name of manufacturer
-type of container
-weather conditions
-estimate portable victims
-other problems at the scene
Types of shock
Cardiogenic
Neurogenic
Hemorrgenic
Anaphylactic
Psychologic
Septic
Cardiogenic shock
Pump failure of the heart
Neurogenic shock
Damage of the spinal cord
Hemorrgenic shock
Loss of blood
Anaphylactic shock
Allergic reaction
Psychologic shock
Fear, nervous, fast dilation of vessels, faint
Septic shock
Body infection
CATEGORIES of shock. (4)
Cardiogenic
Distributive
Hypovolemic
Obstructive
Cardiogenic
Pump failure of the heart
Distributive
Excess dial at ion if vessels
Hypovolemic
Low fluid volume
Obstructive
Obstruction of the vessels
Steps to caring for shock
- Primary assessment, open airway and adequate breathing
2.control external breathing
3.administer oxygen
4.keep the patient supine
5.reassure the patient and maintain temperature with a blanket
6.continue to monitor and support ABCs
7.DONT give anything by mouth 👄 and prepare for vomit 🤮
8.monitor patients vitals EVERY 5 mins
Types of burns
Heat burns 🥵 fire, hot object, steam
Chemical burns 🧪
Electrical burns 💡
Lightening burns ⚡️
Radiation burns ☢️ -nuclear source
Light burns - lazer, UV burns
For chemical burns, you should flash water 🚿 for how many mins?
20 mins
Position of comfort
-Cardiac compromise
-Respiratory compromise
-Stroke
Recovery position
-AMS
-no suspected spinal injury
Fowler and semi- Fowler position
-Chest pain
-Nausea
-Difficulty breathing
Shock position is used when:
There is no injury
Trendelenburg position is used for
-Shocks
-faints
-hemorrhage
Administering rescue breaths
With pulse and NO BREATHING, administer 2 rescue breaths and then 10 - 20 breaths/min
Adult 👩 1 breath = 5 to 6 seconds
Infants 👶 = 1 breath every 2 - 3 seconds
Ventilation
Endotracheal tube 8-10 —> 1/ 7’ - 6’
Adult/adolescent 10-12—> 1/6’ - 5’
Child/infant 12-20—> 1/5’ - 3’
Neonate 20-30 —-> 1/3’ - 2’
How do you Handle Airway obstruction on a RESPONSIVE patient:
-Confirm the obstruction
-Position for Heimlich maneuver
-GIVE 5 abdominal thrusts
Dealing with airway obstruction for an UNRESPONSIVE patient:
1.BSI/ scene safe
2.check for response
3.if unresponsive, activate 911
4.begin CPR
5.after each set of 30 compressions, check airway and remove object if visible
6.attempt 2 rescue breaths, if they don’t go, continue CPR with chest compressions
When will you administer OXYGEN?
Cardiac arrest
Altered mental status
Abnormal vital signs
Significant MOI
Increased level of distress
Respiratory distress
Heart attack
Shock
Allergic reaction
Methods to deliver OXYGEN
BLOW BY method - 15 LPM
NASAL CANULA - 1-6 LPM
Nonrebreather mask 😷 10-15 LPM
Administer CPR if
No pulse
No breathing
Cardiac compromise assessment
- ABC
2.activate ALS and 911
3.position of comfort (sitting position)
4.administer oxygen if possible - Reassure patients
Use AED only if patient is
UNRESPONSIVE
NO CAROTID PULSE
No normal breathing
AED helps correct what?
Ventricular tachycardia
Ventricular fibrillation
What is ventricular tachycardia
Conditions where lower chambers of the heart (ventricles) beat very fast
Ventricular fibrillation
Life threatening heart rhythm that results in a rapid, inadequate heartbeat
Don’t stop _______ even for Endotracheal, stoma (advanced airways)
Compressions
Steps for performing CPR
General impression
Check for responsiveness
ABC
Activate 911 and get AED
Begin chest compressions (5 cycles)
*advanced airway (Endotracheal, stoma) don’t stop compressions
Respirations for infants and adults
1 breath every 2-3 seconds
1 breath every 6 second
General principles for patient assessment
Don’t harm
Neutral status > important
Patients condition may change fast
Always assume spine injury
Monitor vital signs every 5 minutes
It it hurts, look at it
Apneic
Stop breathing 😮💨
DOTS
Deformities, open injuries, tenderness, swelling
Ecchymosis
Discoloring of skin resulting from bleeding 🩸.. typically from underneath
Periorbital echymosis
A good indicator that a skull fracture may be possible
What causes STRIDOR
High pitch sound caused mostly by a foreign object
Internal respiration
The transfer of oxygen and carbon dioxide between the capillary, red blood cells and tissue
Hyponatramia
Levels of sodium in blood is too low. Ex. When athlete is lucking electrolytes
Dysphagia
Difficulty swallowing
ATaxic
A term for a group of disorder that’s affect coordination, balance and speech
Orothpnea
Sensation of breathless in the recumbent position, relieved by sitting or standing
3 stages of birth
Uterus contracts and relax, pushing down cervix ends with birth, delivery of placenta
Full term
38-40 weeks
Trimester
3 months or pregnancy
Gestation
Process of period of developing inside the womb between conception and birth
When you are the first arriving unit, it is important to park the unit ____ feet before the MVA (motor vehicle accident)
50 ft
You are responding to an accident with possible hazardous material involvement, hoe should EMS profession approach the area?
From upwind of the incident
Caponometry
Non invasive measure if CO2 levels
Supine hypo-sensitive syndrome
Gravid uterus compresses the inferior vena cava when the pregnant woman is supine position, leading to decrease Venus return centrally
SLUDGEM
Salivation, lacrimation (tears) urination, defamation,gastroenteritis, emesis and mitosis (pupil constriction)
Nitroglycerin
Decreases blood pressure to the heart
NFPA Chemical hazard chart
Red-flammability
Yellow- reactivity
Blue-health hazard
White-special considerations