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EMT > EMT Review Sessions > Flashcards

EMT Review Sessions Flashcards

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1
Q

Standard of Care may change based upon:

A 
The situation (MCI for example)
What the medical director dictates
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2
Q

Conditions under which a patient may refuse treatment:

A

Alert and oriented x4 (person, place, time, event)
Adult (or emancipated minor)
Do they understand the nature of their condition and the consequences of refusal
Unimpaired (i.e. no alcohol)

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3
Q

The MOLST has two sides that includes:

A

CPR

Life Sustaining Treatments

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4
Q

Four aspects of Negligence

A

Duty to Act
Breach of Duty
Injury
Causation

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5
Q

Ways duty can be breached (under negligence) which results in a violation of the standard of care

A

Omission

Commission

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6
Q

Breach of duty where you did something poorly

A

Commission

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7
Q

Breach of duty where you did not do something

A

Omission

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8
Q

Abandonment

A

Termination of Care without the patient’s consent

Failure to transfer care to someone of equal or higher standard (exception ALS back to BLS)

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9
Q

Infection

A

A host is invaded by a pathogen

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10
Q

Pathogens

A

Virus, bacterial, fungus, parasite

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11
Q

Routes of transmission

A

Airborne, direct, vector, indirect (vehicle transmission)

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12
Q

Factors contributing to infection:

A

Virulence
Dose
Immunity
Portal of Entry

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13
Q

Normal blood pressure ranges, systolic:

A

Adult male 100+age (max 140)
Adult female 90+age (max 130)
Child (under 10) 80 + (2x age)

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14
Q

Normal blood pressure ranges, diastolic

A

Adult male 60-90 (<100)
Adult female 50-80 (<90)
Child (under 10) 2/3 SBP

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15
Q

BP for children is (higher/lower) for children than adults

A

Lower

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16
Q

BP is (higher/lower) for pregnant women. How much higher or lower?

A

10-15 mmHg lower

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17
Q

Widening pulse pressure is indicative of?

A

Increasing ICP

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18
Q

Narrowing pulse pressure in indicative of?

A

Chest injury (tension pneuothorax, pericardial tamponade) or early shock

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19
Q

Pulse pressure is

A

Systolic blood pressure-diastolic blood pressure

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20
Q

Narrowing pulse pressure is when the DBP is within ___of the SBP

A

25%

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21
Q

Widening pulse pressure is when DBP is great than ___of SBP

A

50%

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22
Q

Pulses paradoxes is indicative of

A

Cardiac or respiratory injury

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23
Q

Pulses paradoxes-

A

BP changes during respiration

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24
Q

Pulse is (faster/slower) during pregnancy. By how much?

A

Faster, 10-15 beats faster

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25
Q

Pulse rates

A

Adult: 60-100
Children: 80-100
Newborn: 140-160

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26
Q

An irregularly irregular pulse is indicative of

A

atrial fibrillation

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27
Q

An irregular pulse is indicative of

A

ischemia

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28
Q

When the pulse is weak or thready that means the body is ?

A

Compensating

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29
Q

Breathing rates

A

Adults: 12-20
Children: 15-30
Infants: 25-50

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30
Q

The inspiratory and expiatory ratio is

A

2/3

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31
Q

Prolonged expiatory period is indicative of

A

bronchoconstriction

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32
Q

Ineffective gasping

A

Agonal respirations

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33
Q

Mottled skin is indicative of____, especially in____

A

Poor perfusion, children

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34
Q

One can assess level of consciousness using the ____and ____

A

Glasgow coma scale

Pupils

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35
Q

Unequal pupils indicate

A

ICP

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36
Q

Glasgow coma scale: Eye opening response

A

4-spontaneously
3-to speech
2-to pain
1-no response

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37
Q

Glasgow coma scale: verbal response

A 
5-Oriented x 4 (person, place, time, event
4-Confused
3-Inappriopate words
2-Incomprehensible sounds 
1-No response
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38
Q

Glasgow coma scale: Motor response

A 
6-Obeys commands
5-Moves to localized pain
4-Flexion withdrawal to pain 
3- Abnormal flexion (decorticate)
2- Extension withdrawal to pain (decerebrate)
1-No response
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39
Q

What is the landmark between the upper and lower airway?

A

Vocal cords

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40
Q

Pharynx contains:

A

Nasopharynx, oropharynx, hypopharynx (larynopharynx)

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41
Q

What is the largest, most palpable part of the layrnx?

A

Thyroid cartilage

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42
Q

What is the lowest part of the larynx?

A

Cricoid cartilage

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43
Q

The vocal cords are embedded in the ?

A

Thyroid cartilage

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44
Q

The trachea is made of ____ and protected by____

A

Smooth muscles

C shaped cartilaginous rings

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45
Q

The trachea is located in the ____

A

mediastinum (along with the heart and great vessels)

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46
Q

Which lung is aspiration more likely to happen? Why?

A

The right lung because it is larger and less angled

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47
Q

Gas exchange happens at the aveoli via ___

A

Diffusion

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48
Q

Diffusion is a ______

A

Concentration gradient

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49
Q

The _____ pleura covers the lung

A

Visceral

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50
Q

The ____pleura covers the chest wall

A

Parietal

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51
Q

Nerves that control the diaphragm are the

A

Phrenic nerves

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52
Q

Nerves that control the intercostal muscles

A

Intercostal nerves

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53
Q

Part of the brainstem that is responsible for breathing

A

Pons and medulla

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54
Q

Signs of a foreign body airway obstruction

A

stridor, cyanotic, sudden onset, pale, cool

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55
Q

Signs of an anatomic obstruction

A 
infection or inflammation (edema)
gradual/rapid onset-not sudden
febrile, urticaria
tongue swelling (anaphylaxes)
Epiglottitis
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56
Q

Treatment for a FBAO

A

Conscious adult: abdominal thrusts
Unconscious adult/infant: CPR
Infant: back blows, chest thrust

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57
Q

Treatment for an anatomic obstruction

A

Humidified O2, epi pen

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58
Q

Signs of a respiratory infection

A

Rhonchi, febrile, gradual onset, cough, productive cough

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59
Q

Bronchitis leads to damaged type __ cells

A

Type I (where gas exchange occurs)

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60
Q

Bronchitis is:

A

Inflammation of the bronchi which leads to hyper-secretion of mucus. This blocks the airways, leasing to a decrease of gas exchange

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61
Q

Emphysema cause

A

Inhaled toxins leasing to scar tissue. Leads to damaged Type I and II cells. Loss of elasticity. Air is trapped

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62
Q

Signs of COPD

A

Rhonchi and wheezing

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63
Q

Arteriosclerosis

A

Stiffening of atrial wall as age results in calcium deposits

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64
Q

Atherosclerosis

A

Cholesterol getting stuck in arteries

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65
Q

Ischemia and infarction lead to:

A

Acute coronary disease

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66
Q

Two types of acute coronary disease:

A

Angina, myocardial infarction

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67
Q

What types of cardiogenic shock is more concerning? Left Ventricular MI or conductivity issue?

A

Left ventricular

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68
Q

S/S Left Ventricular Event

A 
Pulmonary Edema
Rales
Increase HR
Decrease BP
Pale, cool, diaphoretic (due to adrenaline dump)
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69
Q

S/S Conductivity Issue

A

Decreased HR
Normotensive
No pulmonary edema (clear and equal)
Pale, cool, diaphoretic (due to adrenaline dump)

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70
Q

When would you apply 02 for an MI?

A

02 sat <94%
Respiratory distress
Poor perfusion

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71
Q

CHF is usually due to left or right sided failure?

A

Left sided failure

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72
Q

S/S of CHF (left side)

A 
BP way up
HR increase
pulmonary edema (rales)
JVD
Pale, cool, diaphoretic
DOB
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73
Q

Right side CHF and how it differs from Left side CHF

A

No pulmonary edema

Peripheral edema

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74
Q

What is the #1 case of right sided CHF?

A

Left sided CHF

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75
Q

Syncope in the elderly should be considered a sign of ____ until proven otherwise

A

Cardiac

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76
Q

Hemiplegia

A

Inability to move half of the body

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77
Q

Monoplegia

A

Inability to move one limb

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78
Q

Paresis

A

Weakness

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79
Q

Types of occlusive events?

A

Types of strokes: embolus and thombosis

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80
Q

Embolus

A

Clot

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81
Q

Thrombosis

A

Gradual narrowing of cerebral arteries. No seizure/no pain

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82
Q

What may lead to a hemorrhagic stroke?

A

Aneurysm

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83
Q

Aneurysm

A

Weakened cerebral vessel

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84
Q

S/S Hemorrhagic stroke

A 
Rapid onset
Headache
Increase ICP (unequal pupils)
Posturing (flexion/extension)
Cushing's response (increase BP, decreased, irregular breathing)
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85
Q

FAST ED

A 
Facial droop (0-1)
Arm Drift (0-2)
Speech (0-2)
Time (0-2)
Eye Deviation (0-2)
Denial/Neglect (0-2)
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86
Q

Should be concerned about an emergent large vessel occlusions with a FAST ED score equal or larger than ___

A

4

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87
Q

Seizure

A

Chaotic discharge of electricity in the brain

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88
Q

The types of seizure is dependent upon?

A

The location

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89
Q

Transient Ischemic Attacks are similar to CVA’s but resolve within ___

A

24 hours

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90
Q

How long does a seizure last?

A

Typically 1-2 minutes, less than 5

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91
Q

Jacksonian march is associated with what type of seizure?

A

Simple partial

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92
Q

Automatism is associated with what time of seizure?

A

Complex partial

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93
Q

Complex partial are what type of seizures?

A

Psychomotor

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94
Q

Treatment of Generalized grand mal seizure

A

Positioning (lateral recumbent), airway (OPA/NPA), 02, transport (do not wait until the seizure is over), prevent injury

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95
Q

Treatment for status epilepticus

A

Aggressive airway management
Ventilation
ALS

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96
Q

When would you involve ALS for a seizure?

A

Status epilepticus and first time adult seizure

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97
Q

Insulin

A

Hormone that triggers cell membrane to allow glucose

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98
Q

What part of the body does not require insulin and why?

A

The brain because glucose can flow across the blood brain barrier

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99
Q

Short and long term stores of glucose are called?

A

Glycogen

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100
Q

Short term stores of glycogen are where?

A

Muscles, Liver

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101
Q

Long term stores of glycogen are where?

A

Liver, fatty tissue

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102
Q

What turns glycogen into glucose?

A

Glucagon

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103
Q

Types of diabetes where the individual produces no insulin?

A

Type I

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104
Q

Type of diabetes where the individual produces insufficient insulin?

A

Type II

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105
Q

Frequent urination

A

Polyuria

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106
Q

Frequent thirst

A

Polydipsia

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107
Q

Frequent hunger

A

Polyphagia

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108
Q

Normal blood sugar range

A

70-120 (fasting)

80-140 (after eating)

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109
Q

Rapid, deep, sighing respirations

A

Kussmaul respirations

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110
Q

Do you need to be diabetic to be in insulin shock?

A

No, it is anyone who is hypoglycemic

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111
Q

Insulin shock-onset?

A

Rapid

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112
Q

Is DKA-onset rapid or gradual?

A

Gradual

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113
Q

Parts to maintain adequate perfusion?

A

1) Adequate pump
2) Adequate blood volume
3) Adequate vessels
4) Adequate gas exchange

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114
Q

Pump issue is a type of ___shock

A

Mechanical

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115
Q

Types of pump (mechanical) shock issues?

A

1) Cardiogenic issues (MI)

2) Obstructive shock (tension pneumothorax, pericardial tamponade)

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116
Q

Blood volume issues

A

Low space or absolute hypovolemia

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117
Q

Vessel issue

A

Distributive shock (high space or relative hypovolemia)

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118
Q

Metabolic shock

A

Gas exchange issue-hypoxia, hypoglycemia

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119
Q

Early Shock=

A

Compensatory Shock (1st stage)

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120
Q

S/S of compensatory shock

A 
Tachycardia
Tachypnea
Vasoconstriction
BP may stay or increase (if neurogenic BP decreases)
Altered mental status (anxiety)
Adrenaline dump-sympathetic response
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121
Q

2nd stage of shock

A

Progressive shock

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122
Q

S/S of progressive shock

A

Changes in mental status (irritability, confusion, anxiety)
Tachypnea
Tachycardia with weakened pulses
Vasoconstriction increases

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123
Q

3rd/last stage of shock

A

De-compensated shock

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124
Q

S/S of de-compensated shock

A 
Tachycardia with thready pulses
Worsening mental status
Rapid, shallow respirations
Hypotension 
Mottling
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125
Q

Location of tourniquet

A

3-6” proximal to injury

Never over joint

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126
Q

when is the tourniquet tight enough?

A

No distal pulse and bleeding stops

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127
Q

Closed injuries

A

Contusions, hematoma (maybe crush injury)

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128
Q

Treatment for close injuries

A

Ice, compression, elevation

129
Q

Open injuries

A

Abrasions, lacerations, avulsion, amputation, punctures

130
Q

What is the flap of an avulsion?

A

Pedicle

131
Q

What do you do with pedicles (complete avulsions) and amputated parts?

A

Dry dressing, waterproof bag, and keep part cool

132
Q

5 P’s of compartment syndrome

A 
Pain out of proportion
Pallor
Pulselessness
Parathesia 
Paralysis
133
Q

Crush injuries lead to ___ metabolism

A

Anaerobic

134
Q

ICES (immobilizing injuries)

A

Ice
Compression
Elevation
Splint

135
Q

Severely angulated longbone fracture-how do you splint?

A

You apply gentle traction to attempt to bring into place (once), then you split

136
Q

How do you splint a joint?

A

You should not attempt to put a joint back into place (unlike a longbone fracture). Splint in place

137
Q

Sprain is associated with the

A

Soft tissue that surrounds the joint capsule, usually a ligament

138
Q

Strain is associated with

A

muscle (due to stretching/tearing)

139
Q

Muscle to bone

A

Tendons

140
Q

Fascia

A

Connective tissue that surrounds muscle fibers

141
Q

Compartment syndrome

A

Edema and hemorrhage increase pressure in fasical compartments

142
Q

What fractures are young individuals prone to?

A

Greenstick fractures/epiphyseal fracture

143
Q

Greenstick fracture

A

Partial break of the bone. Usually because the bones of the individual are not calcified

144
Q

Epiphyseal fracture

A

Growth plates-proximal and distal end of long bones

145
Q

What fractures are old people prone to?

A

Pathological fractures, because of brittle bones and osteoporosis

146
Q

Pathological fractures

A

Underlying medical issue

147
Q

Fracture

A

Loss of continuity in the bone

148
Q

Dislocation

A

A joint is forced out of its normal position

149
Q

Type of fracture where the break is at a right angle to the long plane of the bone.

A

Transverse

150
Q

Fracture where the break is on an angle through the bone

A

Oblique

151
Q

Fracture that occurs occurs due to a rotational, twisting, force

A

Spiral fracture

152
Q

Fracture in which one of the fragments is driven into another fragment

A

Impacted fracture

153
Q

Fracture in which the broken ends of the bone are shattered into many pieces

A

Comminuted

154
Q

Fracture of the distal forearm in which the broken end of the radius is bent backwards

A

Colles’

155
Q

In splinting an injury when are CSM’s assessed?

A

Before and after splinting

156
Q

What is in the arachnoid layer?

A

CSF and small vessels

157
Q

What is in the dura mater?

A

Large arteries

158
Q

What is the most sensitive indicator of a head injury?

A

Altered mental status

159
Q

Retrograde

A

Do not remember what happened

160
Q

Anterograde

A

Ability to form new memory is impacted (repetition is a good indicator)

161
Q

S/S of a head injury

A

Altered mental status
Nausa/Vomiting
Seizure
Dizziness
Unequal pupils (increasing ICP)
Cushing’s Response (bradycardia, hypertension, abnormal respiratory pattern)
Posturing (decorate-flexion-, decerebrate-extension-)
Numbness, tingling
Diplopia (seeing double)
Hearing, taste, smell
Visual complaints (occipital lobe is the visual center of the brain)

162
Q

Concussion presentation

A

LOC at time of event but rapid recovery

S/S Nausea/vomiting, decreased ability to concentrate, headaches, blurred vision, confusion, irritable

163
Q

Intracerebral bleeding-contusion presentation

A

Similar to concussion but without improvement. Additional signs- mentation down, ICP up, personality change
Mimic stroke and are difficult to manage

164
Q

Diffuse axonal injury

A

Injury due to forces on brain shearing, stretching, compression of tissue
Injury to nerves that make up brain due to energy involved in mechanism

165
Q

In diffuse axonal injury you will probably see:

A

Cerebral edema

166
Q

Epidural hematoma presentation

A

Very serious (this is where your large arteries are)
Rapid onset
LOC resolves then there is a lucid period after which a rapid decrease in LOC
Mental status declines with increasing ICP

167
Q

What is the most common type of hematoma?

A

Subdural hematoma

168
Q

Subdural hematoma presentation

A

Slowly evolves into declining stage. Due to small vessels therefore, slower to evolve

169
Q

Subarachnoid bleeding presentation

A

Headache and nuchal rigidity (stiff neck)

Bleeding vessels in tissue of arachnoid layer

170
Q

Temporal impact is where?

A

Underneath the middle meningeal artery

171
Q

Treatment for head injury

A

Patient needs 02 >95
May want to consider ventillation
Spinal motion restriction-SMR
Assist if hypotensive (patient may be a multi-trauma patient)-may be an injury that can be addressed

172
Q

SMR

A

Spinal motion restriction

173
Q

C
T
L
S

A

Cervical 7
Thoracic 12
Lumbar 5
Sacral 5

174
Q

What acts as a cushion between discs?

A

intraertebral disc

175
Q

Type of breathing associated with spinal injuries:
C1-C2
C3-C5
C6-C7

A

Respiratory arrest
Impaired use of diaphragm
Diaphragmatic breathing (phrenic nerve is spared)

176
Q

Neurogenic shock presentation

A 
Priapism
Bradycardia
skin warm, dry and flushed
hypotension
Possible Posterior midline pain/tenderness
Possible Neck pain
177
Q

For which of the below is recovery possible?
Severed spinal cord
Cord impingement
Cord inflammation

A

Severed spinal cord-not possible
Cord impingement -possible
Cord inflammation-possible

178
Q

When considering a spinal cord injury, what may make someone an unreliable witness which would cause concern?

A

Altered mental status, because may not remember or feel injury
alcohol

179
Q

Who is an age group of concern for a spinal injury?

A

Old people, brittle bones

180
Q

S/S Chest injury

A 
Paradoxical movement
Pleuritic chest pain
JVD
Tracheal deviation
Hypotension
Breath sounds-unequal
Narrowing pulse pressue
181
Q

Hemoptysis

A

Blood in spit

182
Q

Air in the pleural space

A

Pneumothorax

183
Q

Closed versus open pneumothorax

A

Closed-air coming from lung

Open-sucking chest wound

184
Q

A pneumothorax can evolve into a____

A

Tension pneumothorax

185
Q

Type of breath sounds associated with a tension pneumothorax

A

hyperresonance (hollow breath sounds)

186
Q

Tension pneumothorax presentation

A 
Tracheal deviation
JVD
Narrowing pulse pressuer
hyperresonance 
Unilateral breath sounds
Bulging intercostals
Subcutaneous air
187
Q

What type of shock does tension pneumothorax lead to?

A

Mechanical shock (obstructive shock)

188
Q

What type of shock does pericardial tamponade lead t?

A

Mechanical shock (obstructive shock)

189
Q

Blood in pleural cavity

A

Hemothorax

190
Q

Hemothorax presentation

A

Unilateral breath sounds
Hyporesonance
NO JVD (because so much blood loss, cannot fill veisn)

191
Q

What type of shock does a hemothorax cause?

A

Hypovolemic

192
Q

Blood in pericardial sack

A

Pericardial tamponade

193
Q

Pericardial tamponade presentation

A

Beck’s Triad: JVD, narrowing pulse pressure, muffled heart sounds

194
Q

Injury due to a circumferential injury to the chest

A

Traumatic asphyxia

195
Q

Traumatic asphyxia presentation

A

JVD, cyanosis of the head and neck, scleral hemorrhage

196
Q

Bruise to the lung tissue

A

Pulmonary contusion

197
Q

Myocardial contusions present as

A

Heart attack

Leads to an irregular pulse

198
Q

Cordis commotio

A

Sudden cardiac arrest due to low force impact to chest at the perfect time. Puts you into V-Fib. Treated as an electrical event

199
Q

Puts you into V-Fib. Treated as an electrical event

A

Cordis Commotio

200
Q

Solid organs

A

Liver, spleen, kidney, pancreas, ovaries

201
Q

Hollow organs

A

Stomach, intestines, uterus, gallbladder

202
Q

Solid organs, you are concerned about

A

Hemorrhage

203
Q

Hollow organs, you are concerned about

A

Hemorrhage and leakage

204
Q

Stomach location

A

Upper left quadrant (some in right)

205
Q

Spleen location

A

Upper left (retropetineal)

206
Q

Pancreas location

A

Upper left (some in right)

207
Q

Liver location

A

Upper right (some in left)

208
Q

Gallbladder location

A

Upper right

209
Q

Intestines location

A

All four quadrants

210
Q

Kidney location

A

Flank-retropetineal space

211
Q

Inflammation of the Periteneum is a concern, why

A

Life threatening event

Leakage, bleeding, infectious

212
Q

Ways to test for rebound tenderness

A

Heel jar test, markle signs

213
Q

Contradictions for MDI

A

Exceeds dosing

214
Q

Indications for MDI

A

Presence of bronchoconstriction, history of bronchoconstrictive disease, prescribed emergent inhalter

215
Q

Dose for MDI

A

As prescribed

216
Q

Albuterol contraindications

A

Ischemic cardiac disease

217
Q

Alburterol indications

A

Presence of bronchoconstrictive diseas

218
Q

Albuterol indications

A

Presence of bronchoconstrictive disease
History of bronchoconstrictive disease
Perscribed emergent inhaler

219
Q

Nitroglycerin contraindications

A

SBP<120
Recent head trauma
Children

220
Q

Albuterol dose

A
  1. 5 mg in 3 cc saline (Adult >2 years old)

2. 5 mg in 6 cc saline/1.25 mg in 3 cc saline (Pedi 6 months-2 years)

221
Q

Baby aspirin contraindications

A 
ASA allergy
Anticoagulation therapy 
Recent GI bleed
Recent surgery/trauma
pregnancy
222
Q

Baby aspirin dose

A

162-325 mg

223
Q

Medical direction for MDI

A

Standing order

224
Q

Medical direction for Alburterol

A

1st dose: Standing order

2nd dose: Medical control

225
Q

Nitroglycerin medical direction

A

Standing order

Medical direction: erectile dysfunction meds in the last 48 hours

226
Q

Medical direction baby aspirin

A

Standing order

227
Q

Epinephrine medical direction

A

Standing order: 6 months-65 years

Medical control: <6 months; >65 years, 2nd dose to pedi

228
Q

Narcan contraindication

A

Considerations:
HR>100, abnormal breath sounds, nasal obstructions, seizures or history of recent seizure, trauma, cardiac arrest, chronic opiates for pain control

229
Q

Epinephrine dose

A

.3 mg (Adults >25 kg; 55 lbs)

.15 mg (Pedi <25 kg; 55 lbs)

230
Q

Narcan dose

A

1 mg/ml per nostril

2-4 mg, repeat once

231
Q

Narcan indication

A

Suspected opiate OD

RR<8

232
Q

Glucose contraindications

A

No gag reflex

233
Q

Glucose medical direction

A

Standing order

234
Q

Glucose indication

A

Altered mental status

Documented blood glucose <70mg/dl

235
Q

What is administered in lieu of glucose if patient is unconscious or does not have a gag reflex

A

Glucagon

236
Q

How is glucagon administered?

A

1 mg IM

237
Q

What is administered in conjunction with albuteral?

A

Ipratriopium

Atrovent

238
Q

Ipratriopium/Atrovent is a____

A

Anticholinergics

239
Q

What do anticholinergics do?

A

Block the action of acetylcholine

240
Q

Repository of eggs, contained in sacs called follicles

A

Ovaries

241
Q

Where does fertilization occur?

A

Fallopian tubes

242
Q

Where does implantation occur?

A

Uterus

243
Q

Area between the urethra and anus

A

Cervix, vagina, perineum

244
Q

What is the purpose of the placenta?

A

Oxygen (exchange happens between placenta and endometrium) and nutrients from mother to fetus

245
Q

Purpose of the umbilical cord?

A

Connect placenta to the fetus

246
Q

The primary drive to breathe is?

A

CO2 drive-the more CO2 the higher the RR

247
Q

The secondary drive to breathe is?

A

Hypoxic drive (02)

248
Q

Why should you be careful when giving oxygen to COPD patients?

A

If there is poor gas exchange because C02 is building up, eventually the brain only listen to the 02 drive because C02 is too high. If give 02, must be careful because you may knock out 02 drive if give too much 02

249
Q

Three components of asthema?

A

1) Bronchospasm
2) Hypersecretion of mucus
3) Inflammatory response-airway swells

250
Q

Wheezing trend in asthma patients

A

End expiratory-expiratory-inspiratory/expiratory-silent chest

251
Q

Treatment of asthma

A

High flow 02
Bronchodilator
pedi with arrest-epi

252
Q

Common causes of pulmonary edema

A

Cardiogenic-heart failure, massive MI, CHF (#1 cause)
If not cardiogenic-renal failure, inhalation injury, salt water drowning (secondary drowning), HAPE (high altitude pulmonary edema), hypotherma

253
Q

Breath sounds associated with pulmonary edema

A

Rales

254
Q

Risk factors for pulmonary embolus

A

Sedentary, history of deep vein thrombosis, history of a-fib, smoker, birth control, pregnancy, long bone fracture

255
Q

Treatment for pulmonary embolus

A

High flow 02

Positioning

256
Q

S/S spontaneous pneumothorax

A

Unequal breath sounds

Pleuritic chest plain

257
Q

S/S pulmonary embolus

A 
Sudden onset pleuritic chest pain
Hemoplysis (blood in sputum when cough)
Equal, clear breath sounds
Syncope
Agitation
258
Q

Allergy versus anaphylaxis

A

Allergy is local

Anaphylaxis is a systemic reaction

259
Q

Antigen

A

Foreign substance

260
Q

When the antigen enters the body , the ___ releases ___. The ____ binds to the antigen and makes a ____.

A

White blood cells (lymphocytes)
Antibodies
Antibody
Ag-Ab complex

261
Q

What eats the Ag-AB complex?

A

Macrophage (phagocyte)

262
Q

What allows the body to respond faster the next time an antigen enters the body?

A

Memory cell

263
Q

What causes antibody production and then causes the body to go wild with antibody production?

A

Sensitizing exposure

264
Q

How does anaphylaxis arise after sensitizing exposure

A

Sometimes Ab circulates in bloodstream or they bind to mast cells/basophils. They can stick to mast cells/basophils permanently. Issue occur when body encounters antigen again. This next time antigen binds to the antibody, making the ag-ab complex, the mast cells/basophils explode (b/c too much stuff in them). Release histamines.

265
Q

S/S of anaphylactic reaction

A 
Stridor
Wheezing
Facial edema
Abdominal cramps
Urticara
Tachydysrhymthias 
Hypotension (due to vasodilation-leaky blood vessels)
266
Q

Epinephrine counters the most dangerous parts of anaphylaxis which are:

A

Bronchoconstruction and vasodilation

267
Q

Epinephrine is a -

A

Sympathomemtic

268
Q

Reaction due to the antigen, not antibody

A

Anaphylactoid reaction

269
Q

V minute

A

Vtidal x RR

270
Q

Layer that surrounds the heart

A

Fibrous pericardium

271
Q

Double self reflecting layer surrounding the heart

A

Serous pericardium

272
Q

Part of the serous pericardium that covers the heart

A

Visceral

273
Q

Part of the serous pericardium that covers the inside of the fibrous pericardium

A

Parietal

274
Q

P wave

A 
Atrial depolarization
atrial contraction (mechanical)
275
Q

QRS complex

A

Ventrical depolarization
Ventricle contraction
Systole

276
Q

T wave

A

Ventricle repolarization

Ventricle relaxation

277
Q

QRS=

A

Systole

278
Q

S-T-P-Q (everything but QRS)

A

Diastole

279
Q

Coronary arteries are at base of the aorta, perfuse the heart during diastole ____ allows coronary arteries to be filled

A

Backflow

280
Q

Cardiac Output

A

CO=stroke volume x HR

281
Q

Stroke volume

A

Amount of blood pushed out per beat

282
Q

Critical areas for burns

A 
Face
Airway
Hands
Feet
Gonads
Circumferential burns
283
Q

Factors determining burn severity

A 
Involving critical areas
Pre-existing medical problems/associated trauma
Age (<5, >55)
Depth of burn
Body surface area
284
Q

Considerations for burns

A

Inhalation injury-first 1/2 hour
Hypothermia (cannot vasoconstrict)-first 1/2 hour
Hypovolemia (third spacing may cause edema and shock-fluid in institual space)
Infection

285
Q

Body surface area measurements for burns-adults

A 
Adults-multiples of 9
head:9
arm:9
Back of torso:18
torso:18
leg:18
286
Q

Body surface area measurements for burns-children

A 
Head:18
arm:9
torso:18
back of torso:18
leg: 13 1/2
287
Q

Chemical burns decontamination protocol

A

Disrobe
Dust
Dilute (20 minutes)

288
Q

What type of dressing is used for burns?

A

Dry sterile dressing because concerned about hypothermia

289
Q

Minor burn determination-adult

A

3rd degree <2% BSA
2nd degree <15% BSA
1st degree <50% BSA

290
Q

Moderate burn determination-adult

A

3rd degree 2 to 10% BSA (excluding critical areas)
2nd degree 15 to 25% BSA
1st degree >50% BSA

291
Q

Critical burn determination-adult

A 
Respiratory injury
Critical area (2nd or 3rd degree)
3rd degree >10% BSA
2nd degree > 25% BSA
Circumferential burn
Trauma
Pre-existing illness
Moderate burns on patients < or >55
292
Q

Minor burns-children

A

2nd degree <10% BSA

293
Q

Moderate burns-children

A

2nd degree 10 to 20% BSA

294
Q

Critical burns-children

A

Critical areas (1st, 2nd, 3rd degree)
2nd or 3rd degree >20% BSA
Moderate burns for adults

295
Q

Eschar is associated with

A

3rd degree burns

296
Q

Blisters, painful, involves epidermis and the dermis

A

Partial thickness/2nd degree burn

297
Q

Painless and eschar

A

Full thickness burn/3rd degree

298
Q

A colorless, odorless and tasteless flammable gas that is slightly less dense than air

A

Carbon monoxide CO

299
Q

S/S of CO poisoning

A 
Multiple people are affected (pets and children are usually first)
Headache
Nausea/vomiting 
Altered mental status
Cherry red skin
300
Q

Treatment for CO poisoning

A

Get out of the location
Non-rebreather mask
High flow O2
Hyperbaric chamber (also used for the bends)

301
Q

Headache, dizziness, tachycardia, SOB, vomiting followed by seizures, bradycardia, hypotension, LOC and cardiac arrest. Common in fires as it is used for pressure treated wood

A

Cyanide

302
Q

Antidote for cyanide

A

Amyl nitrate (poppers)

303
Q 
Difficulty swallowing or breathing
Drooling
Cramps
Severe vomiting 
Chemical burns to skin and throat
A

Caustic toxin

304
Q

What causes delirium tremens and timeline

A 
Alcohol withdrawel
Stages
1-8 hours from last intake
2-8-72 hours-seizure, vomiting, visual hallucinations, auditory hallucinations
3-status seizures
4-delrium tremens
305
Q

Amphetamine, methamphetamine and cocaine are examples of

A

Sympathomimetics

306
Q

The main psychoative part of ___ is tetrahydrocannabinol (THC)

A

Cannabis

307
Q

What nerve agent affects the neurotransmitter acetylcholine? How?

A

Sarin

Inhibitor of acetylcholinesterase (which degrades acetylicholine after it is released into the synaptic cleft)

308
Q

What is a treatment for sarin?

A

Atropine

309
Q

What does atropine do?

A

Blocks the parasympathetic nervous system

310
Q

Ipatropium (Atrovent) blocks the action of

A

Acetylcholine

311
Q

Imminent Delivery

A

Contractions are 2 minutes apart

30-60 minutes in duration

312
Q

What is the difference between placenta abruptio and a uterine rupture? s/s of both

A

Fetal parts are palpable in a uterine rupture

Tearing pain, vaginal bleeding

313
Q

Ways to help the placenta come out

A

Fundal message

Breat feeing

314
Q

Three stages of delivery

A

Dilation
Expulsion
Placental (uterine contractions continue, within 30 minutes placenta will expel)

315
Q

What position should the mother be in a for a prolapsed cord?

A

Knees to chest

Gloved hand to push baby off of cord

316
Q

What should do with mother for a limb presentation

A

knees to chest
breath through contractions
may need to used a gloved hand to physically prevent birth

317
Q

In which delivery complications would you attempt to deliver?

A

Breech presentation

318
Q

What delivery complications are undeliverable?

A

Limb presentation
Prolapsed cord
Placenta previa
(probably placenta abruptio/uterine rupture)

EMT (2 decks)

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