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Bio 1 > EMT Exam 1 > Flashcards

EMT Exam 1 Flashcards

1
Q

Physical traits of good EMT

A
  • Ability to lift and carry equipment and patients
  • Good eyesight
  • Good communication skills
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2
Q

Personal traits of good EMT

A
  • Pleasant
  • Sincere
  • Cooperative
  • Resourceful
  • Self Starter
  • Emotionally Stable
  • Leader
  • Neat and Clean
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3
Q

Medical Director

A

A physician that has ultimate responsibility for patient care aspects of EMS system
- All patient care performed under their direction
- Oversees training
- Develops treatment protocols

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4
Q

Examples of off-line medical control

A

Standing orders, protocols

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5
Q

Examples of on-line medical control

A

Orders by phone or radio

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6
Q

Pnea

A

Breath, respiration

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7
Q

Arthr

A

Joint

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8
Q

Dys

A

Difficulty

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9
Q

Febrile

A

Fever

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10
Q

De

A

Away from

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11
Q

A

A

Not

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12
Q

Iac

A

Has

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13
Q

Itis

A

Inflammatory

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14
Q

Intra

A

Between

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14
Q

Endo

A

Within

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14
Q

Infra

A

Below

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14
Q

Hemato

A

Pertaining to blood

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14
Q

Nas(o)

A

Nose

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15
Q

Tachy

A

Fast

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16
Q

Thorax

A

Chest cavity

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17
Q

+LOC

A

Positive loss of consciousness

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18
Q

Extra

A

Outside

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19
Q

GSW

A

Gunshot wound

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20
Q

“Fell out”

A

Lost consciousness

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21
Q

MVC

A

Motor vehicle collision

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22
Q

Emesis

A

Vomit

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23
Q

Superior vs Inferior

A

Top vs Bottom

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24
Q

Mid-axillary

A

Runs along armpit line

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25
Q

S/P

A

Status Post

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26
Q

Anatomy

A

Study of body structure

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26
Q

Physiology

A

Study of body function

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27
Q

Supine

A

Lying horizontal with face and torso up

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28
Q

Prone

A

Face down

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29
Q

Recovery Position

A

AKA left lateral recumbent position; side (allows things like vomit to drain out of mouth)

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30
Q

Fowler/Semi Fowler

A

Upright

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31
Q

Three main functions of musculoskeletal system

A
  • Gives the body shape
  • Protects internal organs
  • Provides for body movement
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32
Q

How many vertebrae do humans start off with in the spinal column vs have in adulthood

A

33, 24 in adulthood

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33
Q

What is the spinal column essential for

A

Movement, sensation, and vital functions

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34
Q

What does the thorax contain

A

Contains the heart, lungs, and major blood vessels

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35
Q

What does the thorax protect

A

Protects the heart, lungs, and major blood vessels

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36
Q

Parts of the spinal column

A

Cervical (1-7), Thoracic (1-12), Lumbar (1-5)

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37
Q

Joints

A

Formed when bones connect to other bones

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38
Q

Types of muscles

A

Voluntary (skeletal), involuntary (smooth), cardiac

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39
Q

Which two areas does the pharynx include

A

Oropharynx and the nasopharynx

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40
Q

Larynx

A

Voice box containing the vocal cords; cricord cartilage forms the lower portion

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41
Q

Is inhalation an active or passive process?

A

Active

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42
Q

Is exhalation an active or passive process

A

Passive

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43
Q

Process of inhalation

A

Diaphragm and intercostal muscles contract, diaphragm moves downward, ribs move upward and outward; negative pressure pulls air into lungs

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44
Q

Process of exhalation

A

Diaphragm and intercostal muscles relax; positive pressure pushes air out of lungs

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45
Q

How does the process of ventilation occur in lungs?

A

The alveoli allows for CO2/O2 to exchange

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46
Q

Respiration

A

Exchange of gases between cells and bloodstream or alveoli and blood

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47
Q

Pathway of blood through heart

A

Right atrium –> right ventricle –> left atrium –> left ventricle

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48
Q

What is blood made of

A

Plasma, RBCs, WBCs, platelets

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49
Q

What makes up more than half the volume of blood

A

Plasma

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50
Q

What do platelets help with

A

Clotting

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51
Q

Pulse

A

Pressure wave of blood flowing down an artery when the left ventricle contracts; can be felt by compressing artery over a bone

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52
Q

Blood Pressure

A

Force blood exerts against the walls of blood vessels

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53
Q

Systolic

A

Upper blood pressure reading; arterial pressure when left ventricle contracts

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54
Q

Diastolic

A

Lower blood pressure reading; pressure when left ventricle refills

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55
Q

Perfusion

A

Adequate circulation of blood and exchange of oxygen and waste products

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56
Q

Hypoperfusion

A

Shock; when flow becomes inadequate

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57
Q

Functions of lymphatic system

A
  • Captures fluid
  • Maintains balance of fluid
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58
Q

Parts of central nervous system

A

Brain and spinal cord

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59
Q

Parts of peripheral nervous system

A

Sensory nerves and motor nerves

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60
Q

Parts of autonomic nervous system

A

Involuntary motor functions

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61
Q

What does the digestive system provide

A

It provides the mechanism by which food travels through the body and is digested

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62
Q

Functions of the integumentary system

A
  • Protection
  • Water balance
  • Temp regulation
  • Excretion
  • Shock impact
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63
Q

Layers of the skin

A

Epidermis, dermis, subcutaneous layer

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64
Q

Function of endocrine system

A

Produces hormones that regulate many body activities and functions

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65
Q

What do adrenal glands secrete

A

Epinephrine

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66
Q

Function of renal system

A

Helps the body regulate fluid levels, filter chemicals, and adjust body pH

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67
Q

Bladder

A

Fluid reservoir for urine

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68
Q

Ureters

A

Transports urine to bladder from kidneys

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69
Q

Urethra

A

Excretes urine from the bladder to external environment

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70
Q

Pathophysiology

A

Study of how disease processes affect function of body

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71
Q

Cell membrane

A

Protects; allows water/other substances in and out of cell

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72
Q

Mitochondria

A

Converts glucose and other nutrients into ATP; fuel for other cell functions

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73
Q

Glucose

A

Building block for energy; supply of insulin must match body’s glucose requirement

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74
Q

Aerobic metabolism

A

Cellular functions using oxygen

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75
Q

Anaerobic metablism

A

Cellular functions not using oxygen; creates less energy and more waste; body becomes acidic, impairing many body functions

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76
Q

How does disease affect the membrane and therefore the body?

A

Many diseases alter membrane permeability; allows substances into cell that shouldn’t be there which can interfere with regulation of water

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77
Q

Homeostasis

A

Regulated in the brain; maintained through nervous system feedback and messaging

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78
Q

Parasympathetic nervous system

A
  • “Feed or breed” functions
  • Neurotransmitters regulate digestion and reproduction
  • Reduces heart rate and blood pressure
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79
Q

Sympathetic nervous system

A
  • “Fight or flight” response
  • Epinephrine and norepinephrine
  • Enhances body’s ability to protect itself
  • Increase heart rate and blood pressure
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80
Q

Cardiopulmonary system

A

Respiratory and cardiovascular systems work together to bring oxygen into body, distribute it to cells, and remove waste products; breakdown means system failure

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81
Q

Airway/bronchial tree

A

Each mainstem bronchus enters a lunch and branches into smaller bronchi, ending with smallest bronchioles

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82
Q

What are the alveoli (airs acs) connected to

A

Bronchioles

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83
Q

Airways

A

Must have open (patent) airway for system to function

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84
Q

Tidal volume

A

Volume of air moving in and out during each breath cycle

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85
Q

Minute volume

A

Amount of air moved in and our of lungs in one minute

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86
Q

Minute volume equation

A

Tidal volume * respiratory rate = minute volume

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87
Q

What happens when something interferes with minute volume

A

Respiratory dysfunction

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88
Q

What part of the brain controls respirations

A

The medulla oblongata

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89
Q

What can affect minute volume

A
  • Any event impacting function of medulla oblongata such as infection, drugs, toxins, trauma
  • Disruption of pressure through thorax being compromised (through punctures, rib fractures); ability to inhale/exhale is impacted and minute volume is reduced
  • Air/blood accumulating in chest (pleural space) also compromises respiration
  • Disruption of lungs tissue through alveoli being compromised; can result in hypoxia and hypercapnia
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90
Q

Hypoxia

A

Low oxygen levels

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91
Q

Hypercapnia

A

High carbon dioxide levels

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92
Q

Respiratory Compensation

A

-Body attempts to compensate for gas exchange deficits which chemoreceptors detect; body stimulates respiratory system to increase rate/tidal volume

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93
Q

Plasma oncotic pressure

A

Proteins in plasma attract water away from around cells and pulls it into bloodstream

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94
Q

Hydrostatic pressure

A

Water pushed out of blood vessels towards cells

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95
Q

True of false: problems with proteins concerning plasma oncotic pressure and hydrostatic pressure can cause an imbalance

A

True

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96
Q

True or false: without enough blood, oxygen and carbon dioxide can’t be properly moved around

A

True

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97
Q

What controls pressure in blood vessels

A

Blood vessels need adequate pressure to make cycle work; pressure controlled by changing diameter of blood vessel

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98
Q

What is blood vessel pressure monitored by

A

Stretch receptors; pressure can be increased/decreased depending on situation

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99
Q

What causes blood vessel dysfunction

A
  • Loss of tone which affects ability to constrict and dilate
  • Pressure drops
  • Trauma, infection, allergic reaction
  • Excessive permeability; capillaries leak; caused by severe infection, high altitude, disease
  • Hypertension caused by abnormal constriction of vessels
  • Loss of regulation caused by blockage of chemical signals; can cause shock
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100
Q

Stroke volume

A

Volume of blood pumped out by left ventricle during each cardiac contraction; usually about 70mL per contraction

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101
Q

Stroke volume is based on

A
  • Preload (amount of blood returning to heart)
  • Contractility (how hard heart squeezes)
  • Afterload (pressure the heart has to pump against to force blood into system)
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102
Q

Cardiac output equation

A

Stroke volume * bpm = cardiac output

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103
Q

Pediatric compensation

A

Fast heart rate indicates compensation

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104
Q

What causes heart dysfunction

A
  • Mechanical problems (physical trauma, squeezing forces, cell death (MI))
  • Electrical problems (can’t regulate rate)
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105
Q

What must there be a balance of for cardiopulmonary system to work

A

Balance between ventilation and perfusion

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106
Q

Hypoperfusion

A

AKA shock; breakdown in system; can result in death

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107
Q

What are the 4 categories of shock

A

Hypovolemic, distributive, cardiogenic, obstructive

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108
Q

Hypovolemic Shock

A

One category of shock; caused by low blood volume

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109
Q

Distributive shock

A

One category of shock; caused by low blood vessel tone

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110
Q

Cardiogenic shock

A

One category of shock; caused by failure of heart to pump

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111
Q

Obstructive shock

A

One category of shock; caused by blood not being able to flow

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112
Q

Signs of compensated shock

A
  • Slight mental status change
  • Increased heart rate
  • Increased respiratory rate
  • Delayed capillary refill time
  • Pale, cool, clammy skin
  • Sweating
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113
Q

When does decompensated shock occur

A

When compensatory measures fail; characterized by decreased blood pressure and altered mental status

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114
Q

When does irreversible shock occur

A

When inadequately perfused organ systems begin to die; death commonly follows

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115
Q

Body fluid precentages

A
  • Body is 60% water
  • Intracellular: 70%
  • Intravascular: 5%
  • Interstitial: 25%
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116
Q

What regulates thirst and elimination of excess fluid

A

Brain and kidneys

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117
Q

What pulls fluid into the bloodstream

A

Blood plasma proteins

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118
Q

Disruptions of fluid balance

A
  • Fluid loss/dehydration (decrease in total water volume)
  • Poor fluid distribution (water doesn’t go where its supposed to eg. edema)
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119
Q

What are the skull and spine covered by

A

Several protective layers (meninges) and a layer of shock absorbing fluid (cerebrospinal fluid)

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120
Q

What are the brain and spinal cord protected by

A

The skull and spine

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121
Q

What causes nervous system dysfunction

A
  • Trauma (mvc, falls)
  • Medical dysfunction (strokes, infection, low blood sugar)
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122
Q

What is the purpose of the endocrine system

A

Glands secrete hormones; hormones sends chemical messages to the body

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123
Q

What causes endocrine system dysfunction

A
  • Organ or gland problems
  • Present at birth or result of illness
  • Too man hormones (graves disease)
  • Problems with heart rate and temp regulation
  • Not enough hormones (diabetes)
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124
Q

What is the purpose of the digestive system

A

Allows food, water, and other nutrients to enter the body

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125
Q

What causes digestive dysfunction

A
  • Gastrointestinal bleeding
  • Vomiting and diarrhea may occur
  • Impacts hydration levels and nutrient transfer
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126
Q

What is the purpose of the immune system

A

Responsible for fighting infections; responds to specific invaders by identifying them, marking them, destroying them

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127
Q

Hypersensitivity

A

AKA allergic reaction; result of exaggerated immune response; results in rapid drop in blood pressure

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128
Q

Why are vital signs important

A

Outward signs of what goes on in body; can identify conditions/trends in patients

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129
Q

What is reported with pulse

A

Rate, quality, regularity, equality

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130
Q

Normal findings for pulse

A
  • 60-100 bpm
  • Strong (not thready/bounding)
  • Regular
  • Equality: central and peripheral equal
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131
Q

Tachycardia

A

Pulse that is too fast

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132
Q

Bradycardia

A

Pulse that is too slow

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133
Q

Central vs peripheral pulses

A
  • Central: Carotid and femoral
  • Peripheral: Radial and brachial
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134
Q

What is reported with respirations?

A

Rate, rhythm, and quality

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135
Q

Normal findings with respiratory rate

A
  • Around 12-20 breath per minute, above 24 or below 8 are potentially serious findings
  • Normal and non-labored
  • Regular intervals
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136
Q

Best places to assess skin color

A
  • Nail beds
  • Inside of cheek
  • Inside of lower eyelids
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137
Q

Normal findings for skin color

A

Pink

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138
Q

Abnormal findings for skin color

A
  • Pale
  • Cyanotic
  • Flushed
  • Jaundiced
  • Mottled/blotchy
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139
Q

How to check skin temperature

A

Feel back of patient’s hand

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140
Q

Normal findings with skin temperature

A

Warm and dry

141
Q

When do you evaluate capillary refill

A

With patients 6 years old and younger

142
Q

How to check capillary refill

A

Press on nail bed and observe how long it takes normal pink color to return

143
Q

Normal vs abnormal findings for capillary refill

A

Normal is less than 2 seconds, longer is abnormal

144
Q

What to assess with pupils

A

Size, equality, and reactivity

145
Q

How to check pupils

A

Cover eye, shine light, repeat with other eye

146
Q

Normal findings with pupil

A
  • Midpoint
  • Pupils are equal size
  • Reactive to light
147
Q

Normal findings for blood pressure

A

Systolic no greater than 120 mmHg; diastolic no greater than 80 mmHg

148
Q

What is the palpation method and when is it used

A

In noisy environment when you are unable to auscultate a blood pressure; you only receive the systolic blood pressure

149
Q

Possible locations to check temperature

A
  • Temporal (forehead)
  • Rectal
  • Oral
  • Tympanic (ear)
  • Axilla (armpit)
150
Q

Normal findings for temperature

A

98.6 F or 37 C; above 100.4 F is considered fever

151
Q

Oxygen saturation (SpO2)

A

Ratio of amount of oxygen present in the blood to amount that could be carried; measured using pulse oximeter

152
Q

Normal findings for oxygen saturation

153
Q

Blood glucose level

A

Measures quantity of glucose in the bloodstream; measured by glucometer

154
Q

Normal findings for blood glucose level vs abnormal

A

Normal: 60-140 mg/dL; anything above or below is abnormal

155
Q

True of false: Permission from medical direction or by local protocol is required to perform blood glucose monitoring

156
Q

Capnography

A

Measures amount of carbon dioxide exhaled; indirectly indicates how well tissues are using oxygen and performing other functions

157
Q

Normal levels for capnography

A

35 to 45 mmHg

158
Q

What to do before beginning a lift

A
  • Estimate patients weight and then add weight of equipment
  • Know your limitations
  • Plan and communicate with partner
159
Q

Rules for lifting

A
  • Position feet properly
  • Use legs
  • Never twist or turn
  • Do not compensate when lifting with one hand
160
Q

Power grip

A
  • Use as much hand surface as possible
  • Hands ten inches apart
161
Q

Rules for reaching

A
  • Keep back in locked-in position
  • Avoid twisting while reaching
  • Avoid reaching more than 15-20 inches in front of body
  • Avoid prolonged reaching when strenuous effort required
162
Q

Stretcher rules

A
  • Always have two providers holding stretcher
  • Don’t move around at load height
  • The person in the front steers
  • Person in rear pushes
163
Q

Moving patients with suspected spinal injury

A
  • Keep spine in straight line
  • Immobilize head, neck, and spine before move
164
Q

Emergency move

A

One of the three types of moves; should only be used when absolutely necessary; try to move patient in line with long axis of the spine

165
Q

Three situations that may require the use of an emergency move

A
  • Hazardous scene
  • Care of life-threatening conditions that require repositioning
  • The necessity to reach other patients
166
Q

Urgent move

A

One of the three types of moves; required treatment can only be performed if patient is moved; patients condition rapidly deteriorating; performed with precautions for spinal injury

167
Q

Urgent move: onto long spine board

A

Used if immediate threat to life and suspicion of spine injury; place spine board next to body and log-roll patient onto stretcher

168
Q

Non-urgent move

A

Patient is stable; no immediate life threat; patient can be treated and moved in normal way; take all required precautions not to aggravate existing conditions

169
Q

Dead space air

A

Air moved in ventilation not reaching alveoli

170
Q

Alveolar ventilation

A

Air actually reaching alveoli

171
Q

Ventilation

A

Both inhaling and exhaling

172
Q

Diffusion

A

Movement of gases from high to low concentration

173
Q

External respiration

A

Diffusion of oxygen and carbon dioxide between alveoli and circulating blood; aka alveolar respiration

174
Q

Internal (cellular) respiration

A

Exchange of gases between blood and cells

175
Q

Oxygen from blood diffuses into

176
Q

Carbon dioxide diffuses from the cell into

177
Q

Types of ventilation/respiratory problems

A
  • Mechanics of breathing disrupted
  • Gas exchange interrupted
  • Circulation problems
178
Q

When evaluating respiration, what are the signs of compensation for hypoxia or hypercapnea

A
  • Shortness of breath
  • Increased respiratory rate and depth
  • Increased heart rate
179
Q

What are the three stages that the body goes through when respiratory compensation is needed

A
  • Respiratory distress
  • Respiratory failure
  • Respiratory arrest
180
Q

Respiratory distress

A

First stage of respiratory compensation; body compensating for a respiratory challenge and meeting metabolic needs

181
Q

Signs of respiratory distress

A
  • Relatively normal mental status
  • Relatively normal oxygen saturation and end tidal carbon dioxide
  • Relatively normal skin color
  • Shortness of breath
  • Increased respiratory rate and heart rate
  • Accessory muscle use and position changes
182
Q

Respiratory failure

A

AKA inadequate breathing; second stage of respiratory compensation; occurs when compensatory steps can no longer continue

183
Q

Signs of respiratory failure

A
  • Signs of respiratory distress with evidence that compensation is no long effective; signs of decompensation include:
  • No/poor air movement
  • Diminished breath sounds
  • Breathing rate irregular
  • Patient can’t speak
  • Unusual noises
184
Q

Respiratory arrest

A

Third stage of respiratory compensation; breathing completely stops

185
Q

When to intervene during respiratory failure

A

When breathing is inadequate

186
Q

Positive Pressure Ventilation (PPV)

A

One type of respiratory intervention; forcing air into lungs when a patient has stopped breathing/inadequate breathing; uses force which is opposite of how body usually draws air into lungs

187
Q

Negative side effects of PPV

A
  • Decreasing cardiac output/dropping BP
  • Gastric distention
  • Hyperventilation
188
Q

Mouth to mask ventilation

A

One type of PPV; performed using a pocket face mask

189
Q

Bag-Valve Mask (BVM)

A

One type of PPV; handheld ventilation device

190
Q

Types of respiratory failure/arrest intervention tools

A

PPV through mouth to mask ventilation, bag-valve mask, Flow restricted oxygen powered ventilation device, or ATV

191
Q

Two rescuer BVM ventilation

A

Recommended by AHA because its hard to obtain adequate mask seal while squeezing bag at the same time

192
Q

Key concerns with PPV

A
  • Don’t ventilate vomiting patient; can force into lungs
  • Watch chest rise and fall with each ventilation
  • Ensure rate of ventilation is sufficient
193
Q

What to do when there is no chest rise during BVM ventilation

A
  • Reposition head
  • Check for escape or air around mask/reposition fingers
  • Check for airway obstruction in body/BVM
  • Use another method
194
Q

Ventilating a breathing patient

A

After explaining, seal mask on patient’s face and squeeze bag with patient’s inhalation

195
Q

Ventilation of a stoma breather

A
  • Clear mucus or secretions, leave head and neck in neutral position
  • Use pediatric mask to seal around stoma
  • If it doesn’t work, seal stoma and attempt ventilation through mouth and nose
196
Q

Flow restricted oxygen powered ventilation device

A
  • One type of PPV
  • Aka manually triggered ventilation device
  • Adults only
  • Follow same procedures for mask seal as for BVM, trigger device until chest rises, repeat every 5 seconds
197
Q

Automatic transport ventilator

A
  • Provides automated ventilations
  • Can adjust ventilation rate and volume for patient’s size and condition
198
Q

What prevent of air is oxygen

199
Q

In what cases can patients benefit from a higher percentage of inhaled oxygen

A
  • Respiratory/cardiac arrest
  • Shock
  • Respiratory distress and lung diseases
  • Head injuries
200
Q

Nonrebreather mask use, concentrations, and flow rate

A
  • A type of oxygen delivery device
    -The best way to deliver high concentration of oxygen to a breathing patient
  • Provides oxygen concentration of 80%-100%
  • Minimum flow of 8lpm, normal flow rate of 12-15lpm
201
Q

Nasal Cannula use, concentrations, and flow rate

A
  • A type of oxygen delivery device
  • Best choice for patient who refuses to wear an oxygen face mask or for titration
  • Provides oxygen concentrations of 24%-44%
  • Should no provide flow rate higher than 2-6lpm
202
Q

Partial rebreather mask use, concentrations, flow rate

A
  • A type of oxygen delivery device
  • Very similar to nonrebreather mask except no one-way valve opening to reservoir mask
  • Delivers 40%-60% oxygen
  • 9-10lpm
203
Q

Venturi Mask

A
  • A type of oxygen delivery device
  • Delivers specific concentrations of oxygen by mixing oxygen with inhaled air
  • Some have set percentage/flow rate, others have adjustable venturi port
204
Q

Tracheostomy Mask

A
  • A type of oxygen delivery device
  • Placed over stoma or tracheostomy tube to provide supplemental oxygen
205
Q

What type of advanced airway device requires direct visualization

A

Endotracheal Intubation (ET)

206
Q

Humidifier use and purpose

A
  • Connected to flowmeter
  • Provides moisture to dry oxygen from supply cylinder
  • Important for long term oxygen user because of dry mucus membranes
207
Q

Advanced airway devices that are inserted blindly

A
  • iGel
  • King
  • LMA
208
Q

Where does the upper airway begin

A

It begins at the mouth and nose; air is warmed and humidified in nasal turbinates

209
Q

Where does the upper airway end

A

The glottic opening

210
Q

Three parts of the pharynx in (in order)

A

Oropharynx, nasopharynx, and laryngopharynx

211
Q

Where does the lower airway begin

A

The glottic opening

212
Q

Where does the lower airway end

A

Alveoli which is surrounded by pulmonary capillaries

213
Q

What can cause airway obstruction

A
  • Foreign objects (food, toys)
  • Liquids (blood, vomit)
  • Swelling from infection, allergy, etc
  • Poor muscle tone caused by altered mental status
214
Q

Bronchoconstriction

A

Disorder of lower airway where the smooth muscle constricts internal diameter of airway and affects the ability to move air

215
Q

What two questions are asked when assessing airway

A
  • Is airway open?
  • Will airway stay open?
216
Q

How to check if airway is open with conscious vs unconscious person

A

Conscious: Look for signs of open airway like being alert, talking, crying
Unconscious: Look, listen, feel

217
Q

Signs of inadequate airway

A
  • Foreign bodies in airway
  • No air felt or heard
  • Absent/minimal chest movements
  • Abnormal breathing sounds
218
Q

How to open patients airway?

A
  • Head-tilt, chin-lift maneuver
  • Jaw thrust maneuver
219
Q

How to achieve neutral pediatric airway position

A

Pad behind patients shoulders (lying flat may cause hyperflexion of neck and airway occlusion

220
Q

General way to manage airway

A
  • Make it: Open airway with either maneuver
  • Check it: Check for signs of obstruction
  • Keep it: If needed, use airway adjuncts
221
Q

Airway Adjuncts

A

Airway adjuncts provide longer term air channel as opposed to maneuvers; the two types are Oropharyngeal airway and nasopharyngeal airway

222
Q

Oropharyngeal Airway (OPA)

A
  • Type of airway adjunct used to KEEP airway
  • Device used to move tongue forward as it curves back to pharynx
223
Q

How to size OPA

A

Size from the corner of the patient’s mouth to the tip of the earlobe

224
Q

Nasopharyngeal Airway (NPA)

A
  • Type of airway adjunct used to KEEP airway
  • Flexible tube inserted through nostril and into hypopharynx
  • Moves tongue ad soft tissue forward to provide air channel
  • Can be used in patients with intact gag reflex or clenched jaw
225
Q

How to size an NPA

A

Size from the patient’s nostril to the tip of the earlobe/angle of the jaw

226
Q

Rules for using airway adjuncts

A
  • Use OPA only on patients without gag reflexes
  • Open patient’s airway manually (with maneuvers) before using adjunct
  • Don’t continue inserting if patient gags
  • Don’t push patient’s tongue into pharynx
227
Q

Why do you suction a patient’s airway and what do you suction

A
  • Suction obvious liquids (blood, secretions, vomit)
  • These liquids can cause aspiration in lungs
228
Q

Rigid pharyngeal suction tip

A
  • Aka hard cath
  • Larger bore than flexible catheters
  • Suction only as far as you see, don’t lose sight of distal end
229
Q

Flexible suction catheter

A
  • Designed to be used when rigid tip can’t be used
  • Not usually large enough to suction vomit or thick secretions
  • Can be passed through a tube (like endotracheal tube)
  • Can be used to suction nasopharynx
230
Q

Suctioning Rules

A
  • Suction no longer than 10 seconds at a time unless patient is vomiting for longer than 10 seconds
  • In event of thick secretions, consider using rigid suction tube
  • Suction on the way out, moving catheter side to side
231
Q

What can prolonged suctioning cause

A

Hypoxia and bradycardia

232
Q

What are some manual techniques that can remove objects from the airway

A
  • Abdominal thrusts, chest thrusts, finger sweeps
233
Q

Should you/when should you remove dental appliances during airway procedures

A

Leave dental appliances in place when possible during airway procedures (gives mouth structure); prepare to remove if it endangers the airway

234
Q

Parts of scene size up

A
  • BSI (Body substance isolation)
  • Scene safety
  • Nature of illness (NOI)/mechanism of injury (MOI)
  • Number of patients
  • Additional resources
  • C-spine consideration
235
Q

Scene safety consideration

A

(1) Keep yourself safe
(2) Keep your partner/rescuers safe
(3) Keep bystanders safe
(4) Keep patient safe

236
Q

Scene safety consideration upon approaching scene

A
  • Look for other emergency units
  • Look for signs of collision related power outage
  • Observe traffic
  • Look for smoke
237
Q

Scene safety consideration when within sight of scene

A
  • Look for hazardous materials
  • Look for victims
  • Look for smoke not seen at distance
  • Look for broken utility poles and downed wires
  • Look for other emergency personnel
238
Q

Scene safety considerations as you reach the scene

A
  • Follow instructions of incident commander
  • Don appropriate PPE
239
Q

Staging

A
  • Parking away from scene until it is secure
  • Certain calls call you to advise to stage, but can always make that decision for yourself
240
Q

Mechanism of injury (MOI)

A
  • Apart of nature of the call
  • Forces that caused the injury
  • Can help predict patterns/injury
241
Q

What is considered a severe call in adults vs children

A

Adults: More than 20 feet
Child: More than 10 feet (or 2-3 times child’s height)

242
Q

What are the important factor of a severe fall

A
  • Height from which patient fell
  • Surface patient fell onto
  • Part of patient that hit the ground
  • Anything that interrupted the fall
243
Q

Low-velocity (knife) injuries

A
  • Type of penetrating trauma
  • Damage limited to area penetrated but there may be multiple wounds
244
Q

Medium and high velocity (handgun/shotgun) injury

A
  • Type of penetrating trauma
  • Damage from a bullet itself and damage from cavitation
245
Q

Blunt-force trauma

A
  • Injury caused by a blow that strikes body but doesn’t penetrate skin or other body tissues
  • Signs are often subtle and easily overlooked
  • Maintain index of suspicion based on mechanism of injury
246
Q

Nature of illness (NOI)

A
  • Apart of nature of call
  • Reason the person calls EMS
  • Essentially evaluates the chief complaint
  • More commonly used for med calls
247
Q

Nature of the call

A

Determining why EMS has been called; determined by MOI and NOI

248
Q

What are additional resources/in which situations would we need them

A
  • More than one ambulance
  • Fire
  • Technical rescue
  • Hazardous materials response
  • Bariatric patient
248
Q

What to consider for number of patients

A
  • How many patients present
  • Are there sufficient resources on hand to care for all patients
249
Q

C-Spine consideration

A

Based on the info obtained so far in scene size-up, start to consider if there MAY be a need for cervical spine precautions at the scene

250
Q

Primary Assessment Steps

A
  • General impression
  • C-spine decision
  • Assessing mental status (aka LOC) (AVPU)
  • Assessing airway (Abc)
  • Assessing breathing (aBc)
  • Assessing circulation (abC)
  • Determining patient priority/transport decision
251
Q

How to determine order of ABC

A
  • Apart of primary assessment
  • Depends on initial impression of patient
  • ABC if patient has signs of life
  • CAB if patient appears lifeless, no pulse
252
Q

General impression

A
  • Part of primary assessment
  • Assesses environment, chief complain, and appearance
  • Helps determine severity and set priorities for care and transport
  • Look, listen, smell
253
Q

C-Spine decision

A
  • Apart of primary assessment
  • Decision should be formed once you get general impression
  • If any possibility of c-spine injury, get provider to hold manual c-spine
254
Q

Findings that indicate a critical patient during general impression

A
  • Altered mental status
  • Anxiety
  • Pale, sweaty skin
  • Obvious trauma to head, chest abdomen, pelvis,
  • Specific positions indicating distress
255
Q

Level of consciousness/metal status

A
  • Apart of primary assessment
  • Mental status is assessed by using AVPU (alert, verbal, painful, unresponsive)
256
Q

A of AVPU

A
  • Apart of assessing LOC during primary assessment; stands for alert
  • The patient is alert if they are awake, answering questions
  • Determine orientation by asking questions like person, place, time, event
  • A patient who is alert and completely oriented is documented as CAOx4
257
Q

V of AVPU

A
  • Apart of assessing LOC during primary assessment; stands for verbal
  • Patient is only responsive to verbal stimuli and may appear appear lethargic
258
Q

P of AVPU

A
  • Apart of assessing LOC during primary assessment; stands for painful
  • Patient is responsive to tactile stimuli; they may withdraw of localize pain
259
Q

U of AVPU

A
  • Apart of assessing LOC during primary assessment; stands for unconscious
  • If the patient does respond to any of the previous AVPU stimuli, they are unresponsive
260
Q

A of ABC

A
  • ABC is part of primary assessment; A stands for airway
  • If airway isn’t open or is endangered, take measures to open it (make it, check it, keep it)
261
Q

B of ABC

A
  • ABC is part of primary assessment; B stands for breathing
  • Situations that call for breathing assistance are:
    (1) Respiratory arrest
    (2) Not alert, inadequate breathing
    (3) Some alertness, inadequate breathing
    (4) Adequate breathing but signs suggest respiratory distress and hypoxia
262
Q

C of ABC

A
  • ABC is part of primary assessment; C stands for circulation
  • Assess pulse
  • Assess skin: Normal circulation would have warm, pink, dry skin; shock would have pale, clammy skin
  • Assess bleeding: Check for signs of major bleeding; do gross blood sweep
  • Consider shock; If patient is in shock: Shock position, keep patient warm, deliver oxygen
263
Q

Determining patient priority

A
  • Apart of primary assessment; determine stability
  • Stable: No threats to ABCs found and gen impression not concerning
  • Potentially stable: Potential for deterioration can indicate potentially being unstable
  • Unstable: Threat to ABCs
264
Q

Priority transport

A
  • Apart of primary assessment
  • Initiate priority transport if a life-threatening problem can’t be controlled or threatens to recur
  • Continue assessment and care en-route
265
Q

How is history of patient obtained

A
  • By talking to patient
  • If patient is unable to respond, gather history from: Family, bystsanders, meds, other thing observed at scene
265
Q

History-taking techniques

A
  • Develop rapport with patient
  • Ask open-ended questions unless immediate answer is needed
266
Q

History of the present illness (HPI)

A

Info gathered regarding the symptoms and nature of the patient’s current concern; obtained using OPQRST(-AS/PN)

267
Q

Past medical history

A

Info gathered regarding the patient’s health problems in the past; obtained using SAMPLE(R)

268
Q

OPQRST(-AS/PN)

A
  • Used for history of present illness
  • Onset
  • Provocation
  • Quality
  • Region; Radiation
  • Severity
  • Time
  • Associated Signs
  • Pertinent Negatives
269
Q

SAMPLE(R)

A
  • Used for past medical history
  • Signs and symptoms
  • Allergies
  • Meds
  • Pertinent past history
  • Last oral intake (incase of surgery)
  • Events leading up to injury/illness
270
Q

When is a physical exam performed

A

Before, during, or after patient history

271
Q

What are the three primary techniques for performing a physical examination

A
  • Observe: Look at patient for an overall sense of patient condition
  • Auscultate: Listen for sounds of an abnormal condition
  • Palpate: Feel an area for deformities or other abnormal findings
272
Q

Respiratory system history and physical exam

A

History:
- Obtain history of existing resp conditions and meds
- Determine if meds have been taken as prescribed
- Determine if signs and symptoms of this episode match previous episodes
Physical Exam:
- Mental status
- Level of respiratory distress
- Chest wall motion
- Auscultate lung sounds
- Use pulse ox
- Observe edema
- Fever

273
Q

Cardiovascular system history and physical exam

A

History:
- Existing cardiac conditions and meds
- Signs and symptoms of episodes
- Description of chest pain using OPQRST
- Determine specific characteristics of discomfort
Physical exam:
- Look for signs condition may be severe
- Obtain pulse, bp, pulse pressure
- Look for jugular vein distention (JVD)
- Palpate chest
- Observe posture and breathing

274
Q

Nervous system history and physical exam

A

History:
- Determine patient’s mental status
- Determine patient’s normal state of mental functioning
- Obtain history of neurologic conditions
- Note patient’s speech
Physical exam:
- Perform stroke scale
- Check peripheral sensation and movement
- Gently palpate spine
- Check extremity strength
- Check patients pupils
- Examine patients gait

275
Q

Endocrine system history and physical examination

A

History:
- Diabetes mellitus or thyroid disease history
- Current meds, being taken properly
- Has patient eaten or exerted unusual level of energy
- Whether patient is sick
- Whether patient has taken blood glucose or uses insulin pump
Physical exam:
- Evaluate patient’s mental status
- Observe the patient’s skin
- Obtain blood glucose level
- Look for insulin pump and medical jewelry

276
Q

Gastrointestinal system history and physical exam

A

History:
- Pain/discomfort
- Oral intake
- History of GI issues
- Vomiting
- Bowel movements
Physical exam:
- Observe patient’s position
- Assess the abdomen and other GI parts
- Inspect vomit or feces

277
Q

Immune system history and physical exam

A

History:
- History of allergies, reactions
- History of asthma
- Tightness in chest or throat
- GI distress, itchiness, or rash
- Meds for allergic reaction
Physical examination:
- Inspect point of contact with allergen
- Inspect skin for rashes/hives
- Inspect for swelling
- Listen to patient speak
- Listen to lungs; ensure adequate breathing

278
Q

Musculoskeletal system history and physical exam

A

History:
- Prior injuries
- Whether patient takes blood-thinning meds
- Underlying conditions that makes fractures more common
- History to determine if med problem caused traumatic injury
Physical Exam:
- Inspect for signs of injury, like deformity
- Palpate areas of suspected injury; compare sides for symmetry
- Be alert for crepitation
- Assess patient head-to-toe if multiple injuries or unresponsive

279
Q

EMS approach to diagnosis

A
  • Must be efficient
  • Work in uncontrolled environment
  • Limited tools and skillset
  • Narrow educational focus
  • Considers most serious conditions associated with patient and rules them in or out to create diagnoses
280
Q

Heuristics

A

Aka shortcuts; based on pattern recognition and narrowing possibilities to reach diagnoses more quickly

281
Q

Common heuristics biases

A
  • Representativeness
  • Availability
  • Overconfidence
  • Confirmation bias
  • Illusory correlation
  • Anchoring and adjustment
  • Search satisfying
282
Q

When to do rapid trauma exam vs focused exam for trauma pathway of secondary assessment

A

Rapid trauma exam:
- Un-responsive or AMS
- Significant MOI
- Multiple injuries
- Multiple body system involved
Focused exam:
- No significant MOI
- Responsive/Alert and oriented
- Single injury

283
Q

When to do rapid medical exam vs focused exam for medical pathway of secondary assessment

A

Rapid medical exam:
- Un-responsive or AMS
- Unknown issues
Focused exam:
- No significant distress
- Responsive/ alert and oriented

284
Q

What to do for secondary assessment if faced with trauma patient that has significant MOI and AMS

A
  • C-spine
  • Perform rapid trauma assessment (DCAP/P-BTLS)
  • SAMPLE (bystanders)
  • Baseline vitals in route
  • Care based on findings
285
Q

What to do for secondary assessment if faced with trauma patient with no significant MOI and CAO

A
  • Baseline vitals
  • SAMPLE hx
  • OPQRST
  • Additional hx
  • Preform physical exam
  • Care based on findings
286
Q

What to do for secondary assessment for a medical patient who’s responsive

A
  • Establish C/C
  • SAMPLE hx
  • OPQRST hx
  • Additional hx
  • Perform a focused medical assessment
  • Baseline vitals
  • Care based on findings
287
Q

What to do for secondary assessment for a medical patient who’s unresponsive

A
  • Rapid medical assessment
  • Baseline vitals
  • Position patient to protect airway
  • SAMPLE hx
  • Consult medical command as needed
  • Care based on findings
288
Q

How to do rapid physical exam

A
  • Similar to physical exam for trauma patient
  • Assess head, neck, chest, abdomen, pelvis, extremities, and posterior
  • Consider ALS backup
289
Q

What are important physical findings when doing a rapid physical exam

A
  • Neck: JVD, med ID devices
  • Chest: Breath sounds
  • Abdomen: Distention, firmness/rigidity
  • Pelvis: Incontinence
  • Extremities: Pulse, motor function, sensation, ox saturation, med ID devices
290
Q

Focused physical exam

A
  • Usually brief
  • Examines areas of concern based on chief complaint
  • For secondary assessment for patients with no significant MOI and who are oriented
291
Q

DCAP-BTLS

A
  • Used for rapid trauma physical exam for secondary assessment of trauma patient with significant MOI and AMS
  • Deformities
  • Confusions
  • Abrasions
  • Punctures/Penetrations
  • Burns
  • Tenderness
  • Lacerations
  • Swelling
292
Q

General principles for rapid trauma physical exam

A
  • In all areas look for DCAP-BTLS
  • Assume spinal injury
  • Stop/alter assessment in process to provide care
293
Q

How to do rapid physical exam for each part of body

A
  • Head: Check head, face, neck
  • Chest: Start at clavicle, sternum, apply c-collar (assume c-spine injury), complete sternum, check high and wet, check for paradoxical motion, crepitation
  • Pelvis: Compression, flexion
  • Genitals: As needed, check for priapism
  • Extremities: DCAP-BTLS each extremity; when reaching distal portion of each extremity, check circulation, sensation, and motor function (CSM)
294
Q

Three techniques for focused physical exam

A

Inspection: Look for abnormalities in symmetry, color, shape, movement
Auscultation: Listen for decreased or absent breath sounds
Palpation: Feel for abnormalities in shape, temp, texture, sensation

295
Q

How to position infants head for airway

A

Keep head in neutral position

296
Q

Detailed physical exam

A
  • Usually done on way to hospital
  • Gather additional info
  • Complements primary and secondary assessments
  • After all critical interventions completed
  • Primary assessment re-evaluated again before initiated
297
Q

What does reassessment Identify

A
  • Changes
  • Trends (deterioration, improvement)
  • Guides priorities
298
Q

What to repeat during reassessment

A
  • Primary assessment
  • Vital signs
  • Repeat physical exams to identify any changes
  • Check interventions (airways, bleeding interventions, etc)
299
Q

How often do we reassess

A
  • Every 15 minutes for stable patient (Q15)
  • Every 5 minutes for potentially unstable patient (Q5)
  • If there may have been a change in patient’s condition, repeat at least primary assessment
300
Q

How to maintain well being as an EMT

A
  • Maintain personal relationships
  • Exercise
  • Sleep
  • Eat well
  • Limit alcohol and caffeine
  • Have regular check ups and vaccines
301
Q

What are standard precautions

A
  • Equipment and procedures that protect against blood and body fluids
302
Q

When do you wear a gown

A

If patient has arterial bleeding, is in childbirth, or has multiple injuries; can also wear gown to protect self from fluids

303
Q

Types of masks and when to wear them

A
  • Surgical-type mask: Wear when there will be blood or fluid splatter
  • N-95/high-efficiency particulate air respirator: Wear in cases when tuberculosis is expected
  • Face shields: Offers entire face protection
304
Q

What provides info on what PPE/BSI precautions to take

A

Scene size-up and protocols; when in doubt, wear it

305
Q

How often should you wash your hands

A

After every patient encounter

306
Q

Hepatitis B and C

A
  • Disease of concern
  • Infection that causes inflammation of the liver
  • Can live in dried blood for several days
  • Hep B has vaccine and hep C doesn’t; both are deadly
307
Q

Tuberculosis

A
  • Disease of concern
  • Often infects lungs
  • Highly contagious and spread through airs
  • Consider precautions with any patient having a productive cough
308
Q

HIV/AIDS

A
  • HIV attacks immune system leaving patient unable to fight off infection
  • AIDS is the set of conditions that results when immune system has been attacked by HIV
  • Contact with blood is usual route of infection
  • Lower risk for health care workers than hep or TB
309
Q

Ryan White CARE Act

A

Allows EMS providers to find out if exposure to infectious disease has occurred, the agency’s infection control officer gathers facts about exposure and notifies EMS provider; agency refers EMS provider to health care professional

310
Q

True or false: immunizations for hep B and other infectious diseases should be available through agency

311
Q

Stages of stress

A
  • 1st Alarm reaction: Fight/flight
  • 2nd Resistance: Coping
  • 3rd: Exhaustion: Loss of ability to resist or adapt to the stressor
312
Q

Types of stress reactions

A
  • Acute stress reaction
  • Delayed stress reaction
  • Cumulative stress reaction
313
Q

Acute stress reaction

A
  • One of the three stress reactions
  • Often linked to catastrophe
  • Signs and symptoms develop quickly
  • Normal reactions to extraordinary situation
  • May require intervention from mental health professional
314
Q

Cumulative Stress Reaction

A
  • One of the three types of stress reactions
  • Early signs include vague anxiety, emotional exhaustion
  • Progresses to physical complaints/loss of emotional control
  • May present as severe withdrawal/suicidal thoughts
315
Q

Delayed stress reaction

A
  • PTSD
  • Signs and symptoms not evident until long after incident
  • Delay makes dealing with reaction harder
  • Requires intervention
316
Q

Critical incident stress management (CISM)

A

A system that includes education and resources to both prevent and deal with stress appropriately

317
Q

What is patient consent; what are the types

A
  • Permission from patient to assess, treat, and transport
  • Expressed consent: must be informed
  • Implied consent: assumed consent
318
Q

Consent for children

A

Minors are not permitted to provide consent for treatment without permission from parent or guardian; possible exceptions

319
Q

What are the exceptions for children needing a parent or guardian to consent for treatment

A
  • In loco parentis (teacher or other adult gives permission if parent is not available)
  • Emancipated minors
  • Life-threatening illness or injury
320
Q

Consent for mentally incompetent adults

A

State and local laws permit transport of such patients under implied consent

321
Q

When do you involuntarily transport someone

A
  • When a patient is considered a threat to themselves or others
  • Usually requires a decision by a mental health professional or a cop; needs court order
322
Q

What happens if a patient refuses care/transport

A
  • They must be legally able to consent and mentally competent
  • The EMT must inform them of risks
  • They must sign a release form
  • EMT may still be held liable
323
Q

What to do if in doubt about refusal

A
  • Discuss the decision with the patient and listen to why they refuse care
  • Ensure the patient understands risks
  • Consult medical direction
  • Ask to contact family member
  • Contact law enforcement
324
Q

Things to consider during patient refusal

A
  • Have witness to refusal
  • Inform patient that if they change their mind, they can call back
  • If possible, have a friend/relative remain with the patient
  • Document refusal
325
Q

Advance directives

A

Legal document expressing patient’s wishes if patient is unable to speak for self

326
Q

Types of advance directives

A
  • DNR
  • Living will: Legal document where person specifies what actions can be done to save their life
  • Health care proxy: Document in which a person appoints someone else to legally make healthcare decisions on behalf of them if they can’t
  • Power of attorney: Legally gives you power of health care proxy
327
Q

Scope of practice vs standard of care

A

Scope of practice is what you can do as your position; standard of care is how you should do it

328
Q

What is duty to act, how does it relate to an EMT

A

Duty to act is the obligation to provide care; while on duty, an EMT is obligated to provide care if there is no threat to safety

329
Q

Negligence

A

Something was not done, or was done incorrectly; a negligent EMT may be required to pay damages

330
Q

What does someone need to prove to show that an EMT was being negligent

A
  • EMT had duty to act
  • Breach of duty (EMT failed to act or provide standard of care)
  • Proximate causation: Patient suffered harm because of EMT action/inaction
331
Q

Res ipsa loquitur

A

The thing speaks for itself; legal concept that is used to argue that the occurrence of an accident implies negligence

332
Q

Abandonment

A

Once care if initiated, it may not be discontinued until the patient is transferred to a medical personnel of equal or greater training; if not it may count as abandonment

333
Q

Good samaritan laws

A
  • Grants immunity from liability if a person acts in good faith within their level of training
  • Rarely applies to on-duty personnel
  • Doesn’t protect people from gross negligence or violations of the law
334
Q

Confidentiality (HIPAA)

A

Information on patient’s history, condition, and treatment if considered confidential and may only be shared with other health care personnel as part of patient care; otherwise this information must be obtained via subpoena

335
Q

Organ donor

A
  • Person with completed legal document allowing donation of organs and tissues in event of death
  • Must be identified by family, donor card, or driver’s license
  • The hospital or medical direction should be advised
336
Q

Safe haven laws

A
  • Allows a person to drop an infant/child to any fire, police, or EMS station
  • Protects children who may be abandoned or harmed
337
Q

Crime scenes

A

Location where crime was committed OR anywhere evidence may be found; EMT’s priority is patient care but you should know what evidence is and take steps to preserve it

338
Q

Mandatory reporting

A

Mandatory reporters must report witnessed or suspected:
- Abuse
- Sexual assault
- Stab/gunshot would
- Animal attacks

339
Q

Ethics

A

Morals or standards governing actions that aren’t always required by law

340
Q

What type of communication systems does EMS use

A
  • Radios
  • One-way pagers
  • Cell phones
  • Traditional telephones
341
Q

What do EMS radio stations consist of

A
  • Base station
  • Mobile radios
  • Portable radios
  • Repeaters
342
Q

FCC roles in radio communication

A
  • FCC regulates EMS radio communication
  • Assigns and licenses designated radio frequencies
  • Prevents interference
  • Prohibits profanity
343
Q

True or false: if two units transmit simultaneously, only one will be heard

A

True; dispatch will confirm transmission of what they heard by repeating it back

344
Q

What is a hospital notification and what are its components

A

It is the report given to the destination hospital so it can prepare for arrival; only important details:
- Unit ID/level of provider
- ETA
- Patient age/sex
- C/C
- Brief history of present illness/injury
- Major past illness
- Mental status
- Baseline vitals
- Pertinent physical exam findings
- Emergency care given and response to care
- Medical direction if required

345
Q

Medical command consult

A

On line medical direction from physician; possible reasons why it is needed could be medication administration, destination assistance, or patient refusal

346
Q

What to do when requesting medical command consult

A
  • Give patient info clearly
  • Repeat orders from physician back word for word
  • Ask physician to repeat if order unclear
  • If order seems inappropriate, question physician
347
Q

Verbal/bedside report

A

Given upon arrival at destination, introduce patient by name and give complete and detailed report

348
Q

Elements of detailed verbal/bedside report

A
  • C/C
  • History of present illness/injury
  • Assessment findings, including pertinent negatives
  • Treatment given and response
  • Complete vital signs
349
Q

Prehospital care report (PCR)

A

Written documentation of everything that happened during the call; can be handwritten or electronic

350
Q

Functions of PCR

A
  • Assessment and treatment
  • Conveys picture of scene
  • Entered into patient’s medical record
  • It is a legal document and can be subpoenaed and used against you
  • Administrative (insurance info)
  • Used in research
  • Quality improvement
351
Q

What is included in PCR

A
  • Run data
  • Agency info
  • Use official time given by dispatch
  • Patient info/demographics
  • Info gathered during call (history, general impression, etc)
  • Narrative summary of call
  • Transport info
352
Q

What is narrative summary and what is included in it

A
  • It is apart of PCR
  • Includes objective info and subjective info (often reported by patient), c/c, pertinent negatives
  • Approved abbreviations, legible, appropriate med terminology
  • If it happened, record
353
Q

Documentation issues

A
  • Confidentiality: Covered by HIPAA
  • Refusals: High liability
  • Falsification: Covering up errors, recording something you forgot
354
Q

How do you fix and error in documentation or add something you forgot

A

Add it at the end; don’t cover up error

355
Q

What counts as special situation reports

A
  • Multiple casualty incidents (logistical problem, many patients, care and evaluation by several providers)
  • Provider exposures/injuries
  • Hazardous/unsafe scenes
  • Referrals to social service agencies
  • Reports of abuse

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