EMS exam flashcards
Sign of increased intracrainial pressure
Non-reactive pupils
What position is used to place a patient in respiratory distress
Fowler position
What can epinephrine treat
Counteracts allergic reactions/anaphylaxis and is used when there are signs of stridor, angiodema and wheezing
What drug type would cause a unconsciousness with shallow breeding, slow pulse and constricted pupils and cyanosis
Narcotics
Acute coronary syndrome (ACS)
group of symptoms caused by myocardial ischemia: Most notable symptom is chest pain pressure
Hypertensive emergency
defined as systolic blood pressure greater than 180 mmHg with impending organ damage.
Signs and symptoms include
Bounding pulse
Altered mental status
Ringing of the ears
Severe headaches
Warm skin
Emergency conditions that may be a result of scuba diving?
Arterial Gas Embolism (AGE),
decompression sickness (the “bends”),
descent pains (the “squeeze”)
A full-term pregnant female is delivering her baby. What may be required to deliver the lower (second) shoulder?
Upward guidance of the head
Hypervolemia
When you have too much fluid volume in your body
Main purpose of the OPA
Keep tongue from blocking upper airway
Stable angina pectoris
Temporary cardiac chest pain relieved by rest, supplemental oxygen and nitroglycerin
Unstable angina pectoris
Characterized by cardiac chest pain that is not relieved by rest or taking a nitroglycerin tablet
Acute myocardial infarction
Medical emergency that includes heart muscle being damaged within 30 minutes. Can cause chest pain/discomfort and go on for several hours
3 treatments for AMI is aspirin, nitroglycerin, and oxygen
Pulmonary embolism
blockage of an artery in the lungs
What method of airway opening is suited for an unknown mechanism of injury
Jaw-thrust maneuver
What organ is involv3ed in costovertebral angle pain
Kidneys
What is a cause of angina pectoris
Lack of adequate oxygenation to the heart
Postictal state
Altered state of consciousness following a seizure, commonly lasts from 5 to 30 minutes
Nitroglycerin
vasodilator for patients with cardiac chest pain. Contrindicted for patients who have a systolic blood pressure below 100 mm, patients with heart rate below 50/min and heart rate above 110 a min.
Should be assessed before the administration of initial or repeated nitroglycerin
Common side-effect is headaches
Seizure
Burst of uncontrolled electrical activity between brain cells
The common cause of seizures is poisoning
What is considered altitude illnesses
AMS, HACE, HAPE
Causes of hypovolemic shock
Inadequate fluid intake, diarrhea, vomiting
Septic shock
Type of shock that begins with an infection in the bloodstream
Common cause is severe infections
Diastole
Period when the ventricles are relaxed and filling with blood
Systole
Contraction period of the cardiac cycle
Perfusion
Circulation of blood in an organ or tissue adequately
Epiglottitis
Life threatening infection of the soft tissue above the vocal cords. Swells to 2-3 times its normal size
More common in infants and children
Bacterial infections are the common cause
Asthma
Condition in which bronchioles are inflames and swollen and produce excessive mucus.
Characterized by wheezing
Appropriate method of immobilizing a shoulder injury
Sling and swathe
THREAT mnemonic
Threat suppression
Hemorrhage control
Rapid Extrication to safety
Assessment by medical providers
Transport to definitive care
Parasympathetic nervous system
Part of the autonomic nervous system and generally slows the body down.
This causes bradycardia and a decreased force of heart contraction
Sympathetic nervous system
fight or flight response
Ventricular fibrillation or ventricular tachycardia
Shock will be advised for these rhythms
Asystole
Pulseless electrical activity
Stroke Chain of Survival
Rapid recognition and reaction to stroke warnings
Rapid use of 911 and EMS dispatch
Rapid EMS recognition of stroke, triage, transport and pre-hospital notification to the receiving hospital
Rapid diagnosis and treatment in the hospital
Hyperventilation
Over breathing that causes arterial carbon dioxide to fall below normal levels.
Happens in response to buildup of acid within the body (metabolic acidosis) hypoxia from asthma and from a panic attack
Subdural hematoma
Collection of blood due to rupture of bridging veins between dura mater and the arachnoid membrane (surrounding the cerebral cortex).
An sign of it is altered mental status.
Rule of 9s
Standardized measure that is used to assess how much BSA has been burned on a patient
Rule of 9s for adults: 9% for head, 18% for chest, 17% for back, 18% for each leg, and 1% for genitalia
Rule of 9s for children: 18% for head, 18% for chest, 18% for back, 9% for each arm, 13.5% for each leg, and 1% for genitalia
Retinal detachment
When the retina pulls away from the choroid. Symptoms are flashes of light
Deep vein thrombosis
Common medical problem in sedentory patients or patients who have had recent surgery
Risk factors are
Going recent joint replacement surgery
Being bed ridden
Traveling while sitting for extended periods
What can cause cyanosis
Chronic bronchitis, hypothermia and hypoxia
Anemia
Lack of red blood cells or hemoglobin in blood.
Myocardial contusion
Blunt force trauma to the anterior heart, causing damage within the myocardium.
Signs are irregular pulse, chest pain and ausculation of crackles in the lungs.
Hypothermia
Defined as core body temperature below 95 F
Signs are shivering, rapid breathing, and redness or cyanosis
Carbon monoxide poisioning
Colorless, odorless, tasteless, highly poisonous gas. High-flow oxygen is the best treatment for conscious patients once removed from the environment
Hypothermia
Caused by prolonged exposures to very cold temperatures
When should CPR be given to an infant
Should be given to an infant without a palpable pulse and a pulse below 60 beats per minute
Humidified oxygen
Used for extended transport or specific conditions, such as a croup
Cardiogenic shock
a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs
Treatments: Emergency treatments may include delivering enriched oxygen via a tube or mask; breathing assistance, using a ventilator; and intravenous (IV) fluids and medications to support blood pressure or heart function.
Cardiac compromise
Refers to anytime the heart is not getting enough oxygen
Signs are chest pain/discomfort or bradycardia
Cardiac tamponade
Filling of blood or fluid past the pericardium into the pericardial sac
Cardiac chain of survival
- Recognition of early warning signs and immediate activation of EMS
- Immediate CPR with high quality chest compressions
- Rapid defibrillation
- Basic and advanced EMS
- ALS and post-arrest care
Which of the following may cause erroneous pulse oximeter readings
Bright ambient light
Low perfusion
Nail polish
What are the effects of positive pressure ventilation
Decreased blood return to the heart
Decreased blood pressure
Endotracheal Intubation
Secures airway and protects
HAZMAT scene
Hot zone: only trained responders with PPE is allowed
Warm zone: where decontamination corridor is examined
Cold zone: command zone is established here and triage as well
CPAP and contradictions
CPAP provides pressure to keep alveoli open and reverse atelectasis caused by pulmonary edema.
Pulmonary edema
Life threatening condition caused by too much fluid in the lungs.
If a patient is unable to maintain airway, has mental status, hypotension, closed head injury, signs of pneumothorax, or recent upper GI surgery, CPAP is contradicted.
Spina bifida
Birth condition caused by incomplete closure of the spinal column during fetal development. They often have a latex allergy
Basket stretcher
Used to carry a patient across an uneven terrain from a remote location
Scoop stretcher
Fit around patients in the supine position
What is early and late signs of hypoxia
Restlessness, irritability, tachycardia and anxiety
Late signs: Altered mental status, weak and thready pulse and cyanosis
When facing a person with chemical burns to his hands and face what should be done first
Brush the remaining dry chemical from skin and clothes
How to find how much activated charcoal to administer to a patient
Convert weight to grams by dividing by 2.2 lb
Sterilization
Process that removes all microbial contamination
START triage system
Green: Ambulatory patients can walk, minor fractures, soft tissue injuries
Yellow: If respiration, pulse and mental status are within normal limits. Burns without airway compromise, major bone injuries, back injuries with or without spinal damage
Red: Respiratory rate of <10 or >30 , pulse of > 100, or altered mental status. Severe bleeding, shock, airway breathing issue, open chest wound
Black: Non survivable injury, pulseless, cardiac arrest
Diabetic Ketoacidosis (DKA)
A life threatening condition that happens when blood sugar levels rise above 350 mg and is caused by a complete absence of insulin.
Signs are a fruity odor, increased thirst, urination, hunger, tachycardia, altered mental status
There may be deep respirations in the body’s attempt to relieve CO2
Treatment is fluids or insulin
Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
Result of elevated glucose levels of 600 mg/dl. Very similar to DKA and the only difference is that blood glucose levels are higher here and ketones are only found in DKA
Carina
Cartilaginous ridge where the trachea divides into the right and left main-stem bronchi
Terminology used to describe motor vehicle parts
A post, B post and C post
Signs of overstimulation of the parasympathetic nervous system
Bradycardia, increased saliva, broncho spasm, bronchorrhea, sweating and abdominal pain
SALT triage
(Sort, Assess, Lifesaving Interventions, Treatment/Transport)
Allows for limited interventions such as auto injector
Diaphoresis
Sweating to an abnormal degree
Nuchal Cord
Wrapping of umbil9ical cord around a baby’s neck on delivery
Mechanisms of blast injury
Primary-type injuries: Caused by impact of a supersonic blast wave
Secondary-type injuries: Result from impact of blast debris striking the body, such as penetrating or blunt injuries
Teritiary type injuries result from being hurled by the blast onto environmental surfaces or other debris.
Quatemary-type injuries: Do not overlap with primary, secondary or tertiary blast injuries
Where does the right side of the heart receive deoxygenated blood
Deoxygenated blood fows from the body to the right atrium via superior and inferior vena calva
Inhalation phase
Diaphragm contracts and move down slowly, enlarging the chest cavity, creating negative pressure
Exhalation phase
Diaphragm and intercostal muscles relax, decreasing chest cavity, increasing pressure within the lungs
RICE mnemonic
Rest, ice, elevation, splinting
How to determine the appropriately sized OPA for a pediatric patient
Measure using a length-based resuscitation tape
Percentage of total body surface area a pediatric is considered to be severe
> 10% partial thickness burn
APGAR score
System that is used to assess the status of a newborn. Five components scored are
A = appearance
P = pulse
G = grimace
A = activity (muscle tone)
R = respirations
Proximal
Nearer to the center of the body
Distal
Away from the center of the body
Air embolism
When air exists in the vascular system and the vein is punctured within the neck, it can be sucked through the heart
Trending
Comparison of previous and current vital signs
AEIOU-TIPS
Mnemonic helpful in remembering the possible caused of altered mental status
Alcohol
Epilepsy
Insulin (hypoglycemia)
Opiates
Uremia (kidney failure)
Trauma
Infection
Poisoning
Shock, stroke, seizure, syncope
Epiglottis
Flap-like structure that closes the trachea during swallowing. Protecting airway by preventing food and liquid from entering the airway
Pericardium
Fibrous sac around the heart
Sign of increased pressure within the chest, secondary to a cardiac tamponade
jugular vein distention
Tension pneumothorax
Collapsed lung as a result of drowning or near drowning
What do pelvic binders do
Provide temporary stabilization and reduce internal bleeding
What chamber of the heart pumps oxygenated blood to the body
Left ventricle to the body via the aorta
3 layers of the heart
Epicardium
Myocardium
Endocardium
Neurogenic shock
Due to spinal cord damage
It can cause bradycardia and hypotension
Opioid overdose effects
causes sedation/unconsciousness, bradypnea, cyanosis, hypotension and pinpoint pupils
Cholinergic agents and their effects
Medications that overstimulate normal body functions controlled by the parasympathetic nervous system
Exhibit excessive salivation or drooling, excessive urination, excessive tearing of eyes, abnormal heartrate
Larynx
Marks the end of the upper airway and beginning of the lower airway
Allergic reaction
Occurs when the immune system overreacts to a harmless substance.
Anaphylaxis
Serious life-threatening allergic reaction. Presented with tachycardia, bronchospasms, wheezing, chest tightness, coughing, dyspnea
Incident Command System (ICS)
Command, operations, planning, logistics and finance/administration
What can be caused by upper GI bleeding
Mallory-Weiss syndrome and esophageal rupture
What are complications of CPAP
Hypotension, Gastric distention and Claustrophobia
What is oral glucose indicated for
hypoglycemia
Signs and symptoms of cholecystitis
Vomiting referred pain to the right shoulder, upper-right-quadrant abdominal pain
Standard-sized O2 cylinders and their constant flow rates
D = 0.16
E = 0.28
M = 1.56
G = 2.41
H= 3.14
K = 3.14
Normal blood glucose range for an adult
80-120 mg/dL
Thromboembolism
Portion of a blood clot that breaks from its original position and occludes a smaller vein or artery
Infarction
Death of a body tissue
How many liters of blood is in an average adult’s body
Six liters
Treatments for pulmonary edema from congestive heart failure
Nitroglycerin, CPAP, Supplemental oxygen
Where does oxygenated blood return from the lungs from?
Left atrium via the pulmonary veins
Antidote kits that may be used after exposure to a nerve agent
DuoDote
Anitdote Treatment Nerve Agent Auto-Injector
Splenic injury
Left upper abdominal pain can indicate this
Gallbladder injury
Causes pain in the right upper quadrant of the abdomen
What is indicative of a kidney injury
Hematuria (blood in the urine)
Dependent lividity
When blood settles at the lowest point of the body, causing a decoloration of the skin. This is a definitive sign of death
Endotracheal tube complications
Sudden drop in end-tidal CO2 levels
Increased resistance when ventilating
What blood vessel provides oxygenated blood to the heart muscle
Coronary arteries provide oxygenated blood to the heart. They are the branches from the aorta
Aorta
Main artery of the body, supplying oxygenated blood to the circulatory system
Ecchymosis
Buildup of blood in the dermis
Compensated shock
Occurs when one or more of the three fundamentals of perfusion can adequately adjust to maintain major organ perfusion
Signs and symptoms are tachycardia, tachypnea, and cool, pale, diaphoretic skin
Blood pressure may be within the normal range during compensated shock
Mental status is also normal
Decompensated shock
Occurs when the compensation mechanisms fail, creating a deterioration in the patient’s condition
A hallmark sign is a significant reduction in blood pressure
What are signs of inadequate breathing
Adventitious breathing sounds, nasal flaring and inadequate chest expansion
What to do is attempted ventilation is unsuccessful
Reposition the head and if that does not work check for an airway obstruction
Three opioid drugs used to treat pain
Oxycodone, Morphine, Fentanyl
Sign of a ruptered spleen
Kehr’s sign
Sympathomimtic substances
Cocaine, MDMA, Methamphetamine
Signs of endotracheal tube complications
Sudden drop in end-tidal CO2 levels and increased resistance when ventilating
Pleural effusion
accumulation of fluid between the viscerol and parietal pleura, making it difficult to ausculate breath sounds
hemothorax
accumulation of blood in the pleural space
Signs of increased chest pressure
jugular vein distention, hypotension, collapse of the lung
Which of the following conditions is often associated with an increased likelihood of a latex allergy
Spina bifida
SOAP
subjective, objective, assessment, and patient care
Normal oxygen saturation
ACS: 90%
Stroke: 95% to 98%
Post-cardiac-arrest core: 92% to 98%
Three effects of overventilation
Barotrauma, vomiting, gastric distention
What conditions can cause changes in breath sounds
Hemothorax, pleural effusion, tension, pn eumothorax
What is the ideal position in which to place a child’s head for the delivery of adequate ventilation?
neutral sniffing position
Types of cranial fractures
Depressed, Linear, Basilar
