EMR Written Exam Flashcards
What are levels of EMR responders
1) EMR
2) EMT
3) AEMT
4) Paramedic
Role of EMR is to …
♣ EMR’s should be professional, calm, good communication, controls fears, works within their scope of knowledge, seek additional help
Most common Blood Bourne Pathogens
Bacteria and viruses
What are examples of PPE’s you should always wear
Gloves, mask, gown if possible
DNR =
Do not resuscitate
When would you DNR
mortal wounds, rigor mortis, tissue decay, situation endangering to EMR’s life
Stages of Grief are DABDA, which =
Denial, anger, bargaining, depression, acceptance
When you arrive on any emergency scene, what should you do first
1) Is the scene safe?
2) Check for responsiveness / consciousness (LOC)
IF UNCONSCIOUS:
- PPE
- ABC’s
- Start CPR
- Call 911
- Manage scene
IF CONSCIOUS:
- Introduce yourself
- State training
- Ask if you can help (consent)
- Explain what you will do
- Communicate, manage scene
T or F: If patient is conscious, you must obtain consent to help?
True
When is implied consent ok?
If they are unconscious or can’t talk
Is HIPPA important as an EMT?
When is it not necessary?
Yes, of course.
If passing info on to other EMT’s, calling 911, etc.
Supine vs. prone
Supine is face up
Prone is face down
Fowlers Position is
Sitting up
Cephalic vs. caudal
Cephalic is superior, and caudal is inferior
What is Right Lateral Recumbent (RLR)
Laying on right side
Proper ways to lift or move a patient safely would be …
- Lift with legs and buttocks
- Maintain good posture, keep weight close to body, push rather than pull
- Clothes or blanket drag, shoulder or ankle drag, firefighters drag or carry, walking assist or two person seat carry,
T or F: you should always operate within your knowledge and skill base
True
It’s ok if you don’t know
Should you move someone?
When would you?
Never move anyone, unless you need to for their safety.
LOC =
Level of consciousness
MOI =
mode of injury
ABC’s =
Airway, Breathing, Circulation
Remember steps when you arrive on scene what to do:
- Scene safety
- Mechanism of injury (MOI) / nature of illness
- Number of patients involved
- Resources needed
When would you call 911?
If you don’t know / not sure.
But if they are unconscious, breathing issues, chest pain, no pulse, seizures, major injury, severe bleeding, open fracture
What is AVPU:
- A: Alert (they are alert and good)
- V: Verbal (they are verbalizing, but not making sense)
- P: Painful (just responds to / groans in pain)
- U: Unresponsive (not responsive)
What are steps to determine if they are breathing
LOOK, LISTEN, FEEL
Areas to check pulse:
radial artery (most unintrusive) brachial artery carotid artery femoral artery posterior tibial artery
For CPR, if there is not a head injury, how do you position their head for CPR. How do you with a suspected head/spinal injury?
No injury: tilt head and chin lift
Injury: jaw thrust
Normal respiratory rates for adults, children, and infants:
o Adults: 12-20 breaths per min
o Children: 15-30 breaths per min
o Infants: 25-50 p/m
Abnormal respiratory rates for adults, children, and infants:
o Adults is less than 8 or more than 20
o Children is less than 10 or more than 30
o Infants is less than 20 or more than 60
How many compressions and ventilations for adult and child and infant with ONE PERSON
30 compressions, 2 ventilations
How many compressions and ventilations for adult and child and infant with TWO PEOPLE
30 compressions, 2 ventilations for adults
15 compressions, 2 ventilations for children and infants
What are the signs of shock
Irritible, Losing responsiveness, heart rate goes up or down, confused/dizzie, pale, weakened pulse
How can you control shock:
Control bleeding, give extra oxygen, lay patient flat, don’t let them get cooled/overheated, comfort/distract/calm patient
Lack of oxygen is called:
Hypoxia
Oxygenation is:
Level of oxygen in bloodstream
NORMAL RESPIRATORY RATE: If person is breathing, the breaths for normal respiratory rate is what for adults, children, and infants:
- Adults … Need 8-10 breaths per minute. They should be doing about 1 ventilation about every 5-6 seconds
- Child … Need 12-20 breaths / pm. They should be doing about 1 Ventilation about every 3 seconds
- New born … Need 30-60 breaths / per / minute. They should be doing about 1 ventilation every 1-2 seconds
1 killer in the U.S. is:
Cardiovascular disease
Coronary Heart Disease is:
Is when plaque buildup occurs in arteries
Signs and Symptoms of Heart Attack
- Persistent chest discomfort or pain
- Pain that comes and goes
- Difficulty breathing
Cardiac Chain of Survival is:
- Early recognition and early EMS system
- Early CPR
- Early defibrillation
- Early advanced medical care
Explain one person CPR on an adult vs. child vs. infant
Adult & Children: two hands, center of chest, 2 inches deep compressions, 30 compressions to 2 ventilations
Infant: 2-3 fingers middle of chest below nipple line, 1.5inches deep, 30 compressions to 2 ventilations
Explain 2 person CPR on an adult vs. child vs. infant
Same things. But, with child and infant, now do 15 compressions, 2 ventilations. And switch off by calling “change” every 2 minutes.
If there is a suspected spinal injury, do you still do CPR
Yes, absolutely. Better they live and possibly mess up their spine a bit more.
Just use Jaw Thrust when moving them.
When do you do rescue breathing versus CPR
If person has pulse but not breathing, do rescue breathing of ventilations (adult every 5-6 seconds, child every 3 seconds, infant every 1-2 seconds). If no breathing and no pulse, do CPR with compressions and ventilations.
With a suctioning device, it should measure how long
From ear to side of the lip
Proceedure for using a suctioning device to remove object from throat
First, make sure device works
Second, measure from ear to side of mouth
third, place person slightly on their side
Fourth, look and clear mouth of anything, then put suction in mouth and suction
Fifth, sweep with index or little finger
Swipe no longer than 15 seconds for adult, 10 for child, and 5 for infant
Review “Oxygen Delivery” proceedure in the steps PDF
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Steps for what to do with an excessive bleeding incident
1) Go through primary assessment
2) Introduce yourself, ask permission, communicate
3) Get gauze, apply pressure, use bandage
4) Get pulse before and after you bandage (ask if too tight). Especially check for pulse beyond injury.
5) Call 911 if necessary
6) Control shock
7) Keep applying gauze, don’t take stuff off
Where to place a turnicate, and where not to
Place turnicate slightly above where injury happened.
Don’t place it below or over a joint
If you come across person lying with epi pen, what do you do
Is scene safe? Primary Assessment. Call for help.
Clear clothing around thigh if possible, check to make sure it is their epi pen. Remove cap. Place on thigh. inject epi pen into thigh for 10 seconds. Keep monitoring. Wait for help.
Review hand positions, depth of compressions, ventilations for adults, children, infants - one person vs. 2
Two hands on adult and child. 30 compressions, 2 ventilations. 2 inches deep
2-3 fingers on infant, 30 compressions and 2 ventilations. 1.5 inches deep.
IF 2 PERSON RESCUE:
Child and Infant get 15 compressions and 2 breaths, switch “change” every 2 minutes
When is it ok to stop CPR
- AED arrives
- EMS arrives
- Too exhausted
- Situation becomes unsafe
- Dead
- Life
Tachy =
Brady =
Too fast
Slow
Process for using a mask
Position mask, seal mask, blow into mask
T or F: With a BVM, one person does compressions, the other person does bag?
False. One person does compressions and presses bag / ventilations. The other seals mask.
Chocking infant vs. adult
Infant: face down, 5 back blows, turn over and do 5 chest compressions (3 fingers, 1.5 inches deep).
Adult: One arm in front, bend over, 5 back blows, 5 abdominal thrusts, repeat until dislodged or CPR needed.
Do you need to count out loud doing CPR?
Yes
START DOING FLASHCARDS FOR DAY 2 NOTES
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How far should you reach for equiptment
20 inches
What lift for person with spinal injury (and how many people at least do you need):
If you have a hurt leg, what lift should you use?
Log roll (at least 4 people)
Squat lift
What is the body’s most effective natural defense against infection
What is best way to prevent spread of disease
intact skin
wash hands
Explain HA.IN.ES position
Put farthest arm up, other arm bent across chest, furthest leg bent - roll head then body over
What is in blood that helps stop bleeding / causes clotting
platlets
With a squat lift, explain what you do
Lead with weaker foot forward. Bend down. Move upper body before hips. Lead with head.
In an AED, after shock is delivered, what do you do next?
Keep doing CPR
Steps for using a ventilation mask
1) Position mask
2) Seal Mask
3) Open Airway
4) Blow into mask
When giving chest compressions, obviously don’t use fist or arms on an adult, but what about fingers?
Dont let fingers touch when doing compressions on an adult. Use palm, not fingers.
When fire trucks and ambulances arive on scene, remember this:
Fire truck blocks intersection/traffic/lanes at an angle. Ambulance parks in shadow of fire truck. Set up flares 10-15 feet around. Create radius 50 feet around scene for safety.
When using an oropharyngeal airway tool, what are steps to determine if and how to use it?
1) Are they unresponsive (FIRST)
2) Evidence of airway obstruction
3) Is there a gag reflex
4) Measure from corner of mouth to ear.
What is choking and blocking when it comes to cars with patients in them at scene
Choking: put blocks of wood in front / behind tires
Blocking: Fire engine blocks off traffic.
If an adult patient shows signs of heart attack, give them what medication
asprin
An oxygen cylinder holds about how many psi?
2000 lbs/psi is full, about 200 lbs/psi is its getting low.
So if it is at 1200 lbs/psi, you are good.
State ages of kid in these stages:
1) Infant
2) Toddler
3) Preschooler
4) School age child
1) 0-1
2) 1-3
3) 3-6
4) 6-12
In older aged persons, what signs would you noticed as they age:
- Their heart muscle would thicken
- Decreased lung elasticity
- Slower movement through digestive system
- They can still learn
There are different phases of EMS response. List them
- Preparation for an emergency call. (PREPARE KIT)
- Dispatch.
- En-route to the scene.
- Arrival at the scene and patient contact.
- Transferring the patient to the ambulance.
- En-route to the receiving facility.
- Arrival at the receiving facility.
- Clear medical facility.
- Available for next emergency call.
T or F: symptoms of multiple sclerosis appear and disappear over a period of years
True
What delivers more oxygen, a nasal cannula or a non-rebreather mask?
The non-rebreather mask (or BVM) delivers much more … about 90% oxygenated air.
How do you tell if Oxygen is flowing in oxygen tank
You should hear audible hissing. Remember that pressure gauge of 200-1200 lbs/psi tells you how much is in, and the flowmeter should stay constant if oxygen is flowing. The o-ring gasket seals the regulator to the tank (and never carry it by the regulator)
If you come across a hazmat scene, what do you do?
Go to uphill or upwind area, don’t be the hero. Call for help. Stay in cold zone.
If a child has a high high fever (103+), what do you do, and in what order?
1) Call 911
2) try to cool down
3) Calm and assure
Remove blankets and cool them down. Get a sponge and get them wet or wet towel. Do NOT put them in an ice bath or alcohol
In a HAZMAT situation, explain these types of decontamination:
- dilution
- gross
- absorption
- neutralization
- Dilution: Dilute liquid
- Gross: Enters the zone
- Absorption: Soak up or hold contaminents
- Neutralization: Chemically altering a substance to render it harmless
How long does it take for the placenta to be delivered after the baby?
30 mins