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EMRG1242 > EMRG1242 final- theory > Flashcards

EMRG1242 final- theory Flashcards

1
Q

Routine practice

A

Infection prevention and control that is used with every patient prevent transmission of micro-organisms
Risk assessment, hand hygiene, appropriate cleaning

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2
Q

Contact precaution (direct contact)

A

Used in addition to routine practices
gloves and surgical mask

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3
Q

Droplet precaution

A

In addition to routine precaution for patients with infections that are transmitted through respiratory droplets
Gloves, surgical mask, eye wear, gown

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4
Q

Airborne precautions

A

In addition to routine precautions for patients with illnesses transmitted through air
N95, gloves, gown, eye protection

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5
Q

Good Samaritan law

A

legal protection against individuals who provide care to injured people from being liable for any harm caused while attempting help

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6
Q

Speed splint

A

Fast immobilization
Used for hands, wrists, arm, foot, ankle, lower leg, knee
X-ray safe
Needs to be padded

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7
Q

Malleable splint

A

Strong enough for pre/post cast care while being light/ portable
Can bend back to previous form or remolded

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8
Q

Buddy Splint

A

Quick splinting when no times available
Femurs, fingers, toes

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9
Q

AVPU

A

Alert Verbal Pain Unresponsive

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10
Q

Triangular splint

A

Collar bone, shoulder dislocation
Used to sport in place to remove tension

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11
Q

Pillow splint

A

Limits movement of injured area
Ankles, knees, wrist, lower legs, arms, elbows
Needs to be secured around the injury

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12
Q

Penetrating object

A

Build a log cabin around it
Don’t remove unless compromises breathing
can cut object if stuck but stabilize remaining piece

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13
Q

EMCA

A

Environment, Mechanism, casualties, Additional resources

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14
Q

Compression ratio for a neonate

A

3 compression 1 breath

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15
Q

How deep do you go during CPR for a neonate

A

1/3 diameter of the chest

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16
Q

Compression ratio for an infant

A

30:2 or 15:2

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17
Q

Compression ratio for a paediatric aged child

A

30:2 or 15:2

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18
Q

Compression rate for an adult

A

30:2 or 15:2

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19
Q

What is the age for a neonate

A

<30 days

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20
Q

What is the age group for an infant

A

> 30 days to <1 year

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21
Q

What is the age group for paediatric

A

1 year until puberty

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22
Q

What is the age group for an adult

A

Puberty and older

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23
Q

How many compressions per minute for an adult

A

100-120 compressions per minute

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24
Q

Obvious signs of death

A

Rigor mortis, dependent lividity, transection, decomposition, DNR

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25
Q

What is the sizing for adult pads and paediatric pads

A

adult: >8 years
pediatric: <8

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26
Q

What are body mechanics

A

The way the body moves during daily activities
Can help to avoid injuries and muscle fatigue and increase amount of weight lifted

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27
Q

What are the principles of body mechanics

A

Assess environment, plan the move, avoid stretching/ twisting, ensure proper body stance, stand close to object being moved, face direction of movement, avoid lifting, reduce friction b/w surfaces, bend knees, push objects rather than pull, use assistive devices, work with others

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28
Q

Portable stretcher

A

Not on land ambulances, easy to clean, portable, max weight of 350lbs, back rest has 8 positions

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29
Q

Scoop stretcher

A

Can hold 500lbs, wipeable, 4 required straps with 4 adjustable positions, easy storage, good for SMR and pelvic injuries, MOH mandated

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30
Q

Manta mat

A

No SMR, can hold 800lbs, fire retardant, wipeable, minimum 4 carriers but up to 6-8, good for confined spaces and bariatric patients

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31
Q

Canvas stretcher

A

max weight 350lbs, needs to be laundered, No SMR, hard to maneuver in tight spaces

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32
Q

Stair chair

A

Can hold 500lbs, wipeable, 5 adjustable bars, straps to restrain patients

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33
Q

Proflexx stretcher

A

Can hold 700lbs- bariatric 1100lbs, 9 adjustable heights w/ adjustable head b/w 0-65 degrees, wipeable, 5 point harness and two leg straps

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34
Q

fore and aft

A

one medic behind patient grabbing opposite wrists while other grabs below knees and lifts

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35
Q

Stand and pivot

A

patient must be able to stand (no stroke/fractures) and doesn’t violate BLS

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36
Q

Sheet pull

A

transfers pt from stretcher to bed.
High injury rate due to the unnatural leaning when pulling

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37
Q

Transfer/slider board

A

thin flexible board good for heavier pts that’s found in all ERs- use like a sheet pull just slide board underneath sheet

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38
Q

Helmet removal

A

take it off for head assessments (are they alert, talking, breathing?), airway management, secure c-spine, and apply collar

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39
Q

Log roll

A

To check the back and then move to spinal board
Stabilize c-spine then roll pt to the side and check back and then slide a board on an angle under back and put pt back on the ground and strap pt in

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40
Q

Wheel chair transfer

A

like a stand and pivot but from a wheelchair

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41
Q

why must medics be careful with the elderly

A

if they are handled rough they can get skin tears, fractures (severe arthritis), and dislocations (shoulders most common)

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42
Q

Stryker power stretcher

A

Complies with MOH equipment
Max weight of 700lbs
Siderails have 7 locking positions

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43
Q

Rescue seat

A

In place of fore and aft
Easy to clean and resists blood/bodily fluids
Can remain under patient to avoid additional transfer
Not MOH mandated

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44
Q

PediMate

A

Used for patients 10-40lbs
5 point harness that attaches to the stretcher
Wipeable

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45
Q

Cervical Collar

A

Keeps neck/head/spine in neutral alignment for suspected c-spine injuries

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46
Q

Sizing a collar

A

Put your hand in a salute motion and place hand on the base of the patient’s shoulder- pinky down) and count amount of fingers, measure against the collar for sizing

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47
Q

KED

A

Great for tough extrications
Color coded straps
Wipeable
Radiolucent
good choice for patients who can’t lie flat (asthma/dyspnea/kyphosis (curvature of the spine in the neck))

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48
Q

When can you not use a KED

A

on an unstable patient

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49
Q

How to decide to use a KED, Scoop, Spinal board

A

KED: SMR, can’t lie flat, conscious/stable, tough extrication, confined space
Scoop: SMR, pelvic fracture, multi system trauma, no roll req’d
Spinal board: roll req’d, visualizes back, basic SMR

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50
Q

What is a rapid Ex

A

Technique used to move a patient from sitting in a car to lying supine on a backboard in approx. 2 minutes

51
Q

When would you use a Rapid Ex

A

Load and go: critical pts requiring immediate intervention in supine and transportation
Scene safety: scene is unsafe and you can get pt out without risking medics
Multiple patients: limited resources, pt. condition, pt blocks access to another seriously injured pt.

52
Q

Common pelvic fractures

A

Lateral compression: most common and occurs when lateral forces are applied to the pelvis
AP compression: disrupts symphis pubis and dangerous as pelvic volume increases- stores more blood
Vertical shear: most unstable and often associated with axial loading injuries

53
Q

Symptoms of pelvic fractures

A

Pain, swelling/ bruising, broken skin, instability with palpation, blood in urine, difficulty urinating, incontinence, bleeding from rectum or vagina

54
Q

what is hemodynamically unstable

A

hypotension, altered LOC, increased heart rate

55
Q

in how many pelvic fractures does hemodynamic instability occur

A

10%

56
Q

what other injuries can occur from a pelvic fracture

A

neurological and urologic

57
Q
A
58
Q

what urologic injuries happen from pelvic injuries

A

Approx 5% of pelvic fractures
Assess for blood

59
Q

What amount blood loss occurs

A

500-1500ml

60
Q

symptoms of a femur fracture

A

pain, limb shortening, potential open skin, edema, bruising, crepitus, muscle spasm

61
Q

Hip fractures

A

Involves femoral head, femoral neck, inter trochanter area or femoral shaft
Fall is leading MOI

62
Q

Symptoms of hip fractures

A

pain, inability to bear weight, heard/felt snap, external rotation/ shortening to leg, tenderness on palpation, swelling, deformity

63
Q

treatment for hip fractures

A

support injured extremity in position found, minimize movement, assess for analgesia, no sager

64
Q

posterior hip dislocation

A

hip rotates inwards

65
Q

anterior hip dislocation

A

hip rotates outwards

66
Q

external bleeding

A

occurs due to break in the skin, extent and severity is often a function of the type of wound/ types of blood vessels, managed with direct pressure, arterial bleeding can take more than >5 minutes to form a clot

67
Q

signs and symptoms of internal bleeding

A

pain, tenderness, tachycardia, pallor, hypotension

68
Q

how much acute blood loss can the body not handle

A

body cannot tolerate an acute loss of more than 20% of total blood volume

69
Q

what are the load and go findings in advanced wounds

A

airway obstruction, cardiac arrest/respiratory arrest, de creased LOA with inadequate respirations, sucking chest wounds, impaled objects, external hemorrhage, unstable pelvis

70
Q

types of wounds

A

amputations, penetrations, eviscerations, burns, avulsion, flail chest

71
Q

amputations/avulsions

A

assess site for distal pulses, circulation, sensation, movement

72
Q

how long do you hold the hemostatic dressing on to see If bleeding stops

A

3 minutes

73
Q

signs and symptoms of a sucking chest wound

A

hemoptysis, decreased/absent breath sounds, SOB, anxiety, bubbling at the site, unequal chest movement, cyanosis, tachycardia, tachypnea

74
Q

types of pneumothorax’s

A

closed pneumothorax, open pneumothorax, tension pneumothorax

75
Q

flail chest

A

3 or more ribs broken in 2 or more places that creates a free floating sections of ribs
Paradoxical bleeding is the common sign
Treat with an internal splint via BVM

76
Q

how to cover an evisceration

A

cover with moist, sterile, bulky dressings or plastic wrap

77
Q

burns

A

dress digits individually, remove jewelry, leave finger/toe tips exposed, elevate

78
Q

how to transport a pt with an eye injury

A

semi sitting (head elevated to 30 degrees)

79
Q

required vital signs

A

heart rate, respiratory rate, blood pressure, GCS, skin, pupils, SPO2, temperature

80
Q

normal heart rate for adults

A

60-100

81
Q

respiratory rate can be altered by:

A

fever, illness, chronic conditions, drugs/alcohol

82
Q

bradypnea

A

slow RR

83
Q

tachypnea

A

fast RR (>28)

84
Q

blood pressure

A

the force of blood against he artery walls during contraction/relaxation of the heart

85
Q

systolic

A

pressure in he heart when the artery contracts and pumps blood

86
Q

diastolic

A

pressure inside the artery when the heart relaxes and fills with blood

87
Q

Adult BP ranges

A

Hypotension: <90mmHg
Normotension: >100mmHg

88
Q

pediatric BP ranges

A

Hypotension: SBP <70mmHG + (2 x age)
Normotension: SBP > 90mmHG = (2 years)

89
Q

what causes an abnormal pupillary response

A

drugs, trauma, stroke, brain/ brain stem injury, inadequate perfusion/ oxygenation

90
Q

temperature

A

36.1-37.2 degrees C
fever is >38 degrees celsius (>38.5 for medics)

91
Q

what can alter an SPO2 reading

A

nail polish, hypovolemia, CNS depression, respiratory distress, respiratory disease

92
Q

lung sounds are assessed in 4 fields:

A

upper (apices) left, upper (apices) right, lower (base) left, lower (base) right

93
Q

abnormal lung sounds

A

Rhonchi, wheezing, stridor,, crackles, pleural rub

94
Q

Rhonchi

A

continuous low pitched sounds w/ expiration that’s associated w/ presence of mucus

95
Q

wheezing

A

continuous high pitched hissing sounds as air passes through a narrow space
can be inspiratory or expiratory

96
Q
A
97
Q

stridor

A

continuous high pitched whistle or squeaking sound usually with inspiration

98
Q

pleural rub

A

rough grating sounds of lungs on the lining, heard w/ inspiration or expiration

99
Q

crackles

A

generally discontinuous rattling, bubbling, or clicking sounds that can be fine or coarse. associated with fluid

100
Q

what does the cardiac monitor monitor?

A

cardiac rhythm, BP, ETCO2, SPO2, defibrillator

101
Q

NIBP

A

MOH states must need adult and paediatric

102
Q

SPO2

A

indication of oxygenation (measures % of O2 bound to hemoglobin) and is found as a finger probe or tape/sticker

103
Q

ETCO2

A

measures amount of CO2 in expired air in real time
measured by nasal prongs or inline with BVM

104
Q

4 lead

A

limb leads: white right arm, black left arm, green right leg, red left leg
ensure not to place on bone, dry skin, no excessive hair, and good contact with skin
lead 11 for rhythm interpretation

105
Q

12 lead

A

must have 4 lead + additional 6 wires
used on calls for chest pain, SOB, weakness/dizziness, syncope, any call ,edits think hearts involved

106
Q

placement of the 12 lead wires

A

RA- right forearm/wrist
LA- left forearm/wrist
LL- left lower leg
RL- right lower leg
V1- 4th intercostal right of sternum
V2- 4th intercostal left of sternum
V3- midway b/w V2 and V4
V4- 5th intercostal mid clavicular line
V5- anterior axillary line straight w/ v4
V6- mid axillary line in straight w/ v4/v5

107
Q

D tank

A

425L of air
2000-2200 PSI
needs regulator

108
Q

M tank

A

3450 L compressed air
2000-2200 PSI
secured in ambulance- not portable

109
Q

PISS

A

pressure index safety system

110
Q

portable flow meter

A

allows adjustments from 0.5 LPM to 25LPM
connected to regulator

111
Q

safe residual pressure

A

MOH states 500 PSI
common practice:
M tank: 200 PSI
D tank: 500 PSI

112
Q

standard tank conversion factors

A

D tank: 0.16
M tank: 1.56

113
Q

formula for oxygen tank life

A

tank PSI- safe residual pressure X factor/ litre flow = tank duration in min

114
Q

oxygen concentrations formula

A

FiO2=(l/min x4%) + 21%

115
Q

low flow oxygen devices

A

21-50% oxygen
nasal cannula- 1-6 lpm, don’t use on pts w/ apnea or severe dyspnea
simple face mask- 6-10 lpm,
nebulizer- 4-6 lpm, exception of croup

116
Q

high flow oxygen devices

A

50-100% O2
NRB- 12-15 LPM 90-100% O2
filtered O2 mask- low flow high concentration mask that delivers 30-99% O2

117
Q

OPA

A

Holds tongue of posterior wall of the pharynx
Used on patients with no gag reflex needing airway ventilatory support

118
Q

BVM air volumes

A

Adult: 1600 ml
Child: 500 ml
Infant: 300 ml

119
Q

Tidal volumes

A

Adult: 500 cc/breath
Child: 8 ml/kg
Infant: 4-6 ml/kg

120
Q

Ventilation rates

A

Adult: 1 every 6 seconds
Child: 1 every 3 seconds
Infant: 1 every 3 seconds

121
Q

Oral suctioning pressures

A

Adult: 500-550 mmHg
Child: 200-220 mmHg
Infant: 80-100 mmHg

122
Q

Deep suctioning pressures

A

Adult: 100-150 mmHg
Child: 100-120 mmHg
Infant: 60-100 mmHg

123
Q

definition of a tracheostomy reinsertion

A

insertion of the cannula into the tracheostomy

124
Q

what degree is the patient sitting in for a trach reinsertion

A

30-90 degrees

EMRG1242 (1 decks)

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