EMT Study Guide Flashcards
0
Q
Negligence
A
-Failure to provide the same care that a person with similar training would provide.
1
Q
Duty to Act
A
-The EMT had an obligation to respond and provide care.
2
Q
Breech of Duty
A
-The EMT failed to assess, treat, or transport patient according to the standard of care.
3
Q
Abandonment
A
-Abandonment is the termination of care without transferring the patient to an equal or higher medical authority
4
Q
Medical Direction
A
-Physician oversight of patient care
5
Q
Advocacy
A
-Someone who works on behalf of the patient and their family
6
Q
Quality Assurance/Quality Improvement
A
-Continuous audit and reviews of all aspects of the EMS system to identify areas of improvement
7
Q
Denial
A
-1st stage of the grieving process. Or. May experience a “not me” stage
8
Q
Systole
A
-Is the top number of the BP, the BP exerted during contraction of the left ventricle.
9
Q
Diastole
A
-Is the bottom number of the BP, the BP in between contraction.
10
Q
Perfusion
A
-Is the flow of blood throughout the body
11
Q
Hypoperfusion
A
-AKA shock, means blood flow has been compromised to the point the entire body is at risk
12
Q
Cyanosis
A
-Cyanosis/cyanotic is a bluish color that may indicate a lack of oxygenated blood. Often appear in the nail beds or around the mouth first. Late finding.
13
Q
Jaundice
A
-Yellow skin that may indicate liver problems
14
Q
Head tilt-chin lift
A
-The preferred manual method of opening the airway, do not use on patients with suspected c-spine injury
15
Q
Modified Jaw Thrust
A
-Used on patients with suspected c-spine injury, do not used on conscious patients
16
Q
Seesaw Breathing
A
-Chest and abdomen moving in opposition and is a sign of accessory muscle usage
17
Q
Blow by Oxygen
A
-A technique used to apply oxygen when children may be frightened.
18
Q
Bronchoconstriction
A
-(Asthma) is the constriction f the airways in the lungs due to tightening of the surrounding smooth muscle, with consequent coughing, wheezing, and shortness of breath.
19
Q
OPQRST
A
-To help obtain information about the patients symptoms. Onset Provocation Quality Radiation Severity Time
20
Q
DCAP-BTLS
A
-Used to assess trauma patients head to toe. Deformities Contusions Abrasions Punctures Burns Tenderness Lacerations Swelling
21
Q
SAMPLE
A
-Used to help in obtaining history. Signs/Symptoms Allergies Medications Past Medical History Last Oral Intake Events Leading Up To Incident
22
Q
Hypoxia
A
-Inadequate delivery of oxygen to the cells. Early indications of hypoxia are restlessness, anxiety, irritability, dyspnea, tachycardia.
Late indications of hypoxia are altered or decreased LOC, severe dyspnea, cyanosis, bradycardia(especially in pediatric pts)
23
Q
Status Epilepticus
A
-Prolonged seizure for approximately 30 minutes or recurring seizures without the patient regaining consciousness in between. Very dangerous and possibly leading to brain damage and death.
24
Syncope/Syncopal Episode
-Is fainting. Typically caused by a temporary loss of blood flow to the brain.
Causes include cardiac emergency, hypotension, neurological problem, stress, diabetes, pregnancy, anemia, medications, toxic exposure.
25
Dislocation
-The movement of a bone out of its normal position in a joint
26
Drowning
-The process of experiencing respiratory impairment from submersion or immersion in liquid.
27
Near Drowning
-Same as drowning but pts that survive at least temporarily for 24 hours.
28
Bipolar Disorder
-Manic depression, characterized by drastic mood swings
29
Schizophrenia
-A state characterized by disorganized speech and thinking
30
Depression
-Deep sadness not associated with an event
31
Phobia
-Unusual level of fear about specific things
32
Crush Injury
-An injury that occurs when a great amount of force is applied to the body
33
Concussion
-A temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain
34
Avulsion
-An injury in which soft tissue is torn completely loose or is hanging as a flap
35
Evisceration
-The displacement of organs outside of the body
36
Minor Burn
1. Full-thickness burns covering less than 2% of TBSA
2. Partial-thickness burns covering less than 15% of TBSA
3. Superficial burns covering less than 50% TBSA
37
Moderate Burn
1. Full-thickness burns covering 2 to 10% of TBSA
2. Partial-thickness burns covering 15 to 30% of TBSA
3. Superficial burns covering more than 50% TBSA
38
Critical Burn
1. Burns with respiratory compromise
2. Full-thickness circumferential burns
3. Partial-thickness burns covering more than 30% of TBSA
4. Burns with associated trauma, such as fractures
5. Full-thickness burns to the airway, hands, face, feet, or genitalia
6. Full-thickness burns covering more than 10% of the TBSA
7. All moderate burn criteria for patients under 5 or over 55 years of age
39
Circumferential Burn
-A burn that goes all the way around a body part.
40
Superficial Burn
-(1st degree) involve only the top layer of skin, the epidermis. Skin turns red but does not blister or actually burn through. Ex. Sunburn
41
Partial Thickness Burns
-(2nd degree) Involves the epidermis and some portion of the dermis. Typically the skin is moist, mottled, white to red. Blister are present.
42
Full Thickness Burns
-(3rd degree)Extended through all skin layers and may involve subcutaneous layers, muscle, bone, or internal organs. The burned area is dry and leathery and may appear white, dark brown, or even charred. May feel hard to the touch.
43
AVPU
```
-The AVPU scale can be used to rapidly determine the patient’s general responsiveness.
Awake and Alert
Voice responsive
Pain responsive
Unresponsive
```
44
Incision
-A sharp, smooth cut
45
Abrasion
-Loss or damage of the superficial layer of skin as a result of a body part rubbing or scrapping across a rough or hard surface.
46
Laceration
-A jagged, open wound
47
Guarding
-A sign detected during physical pain whereby the patient involuntarily contracts muscles second to pain.
48
Rebound Tenderness
-A state in which pain is felt on the release of pressure over a part. specifically, such a sensation in the abdomen, considered a sign of peritonitis.
49
Decorticate Posturing
-Is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest. Is a sign of severe damage to the brain.
50
Decerebrate Posturing
-Is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backwards. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the brain.
51
Informed Consent
-Is required from allow patients that are alert and competent.
52
Expressed Consent
-Requires that the patient be alert and competent to give expressed consent. Can be given web ally or nonverbally. Expressed consent is similar to Informed Consent but not usually as in depth.
53
Implied Consent
-Allow assumption of consent for emergency care for an unresponsive or incompetent patient. Can be used for a patient that originally refused treatment but later became unconscious or incapacitated.
54
Minor Consent
-Can not accept or refuse care. Not needed for emancipated minors. Criteria for emancipation usually is married, pregnant, already a parent, in armed forces, financially independent, emancipated by the courts.
55
Involuntary Consent
-Used for mentally incompetent adults or those in custody of law enforcement. Consent must be obtained from the entity with the appropriate legal authority.
56
Negligence
-The EMS provider is accused of unintentional harm. Duty to Act, Breech of Duty, Damage, Causation all have be proved in order to be convicted of negligence.
57
Duty to Act
-The EMT had an obligation to respond and provide care.
58
Breech of Duty
-The EMT failed to assess and treat or transport patient according to the standard of care.
59
Damage
-The patient/plaintiff experienced damages or injury recognized by the legal system as worthy of compensation.
60
Causation
-AKA proximate cause. The injury to the patient/plaintiff was, at least in part, directly due to the EMT's breech of duty.
61
Good Samaritan Law
-Designed to protect someone who renders care as long as he or she is not being compensated and gross negligence is not committed.
62
Steps in Patient Assessment
1. Scene size up
2. Primary Assessment
3. Patient History
4. Secondary Assessment
5. Reassessment
63
Signs/Symptoms of Inadequate Breathing
- Abnormal respiratory rate or breathing pattern
- Nasal flaring
- Abnormal, diminished or absent lung sounds
- Paradoxical motion(flail chest segment moves in opposite direction of the thorax)
- Unequal rise and fall of the chest
- Dyspnea, accessory muscle use, retraction
- Cyanosis
- Agonal respiration(dying gasp) or apnea(no breathing)
64
Infants Normal Vital Signs(1year of age)
- Respirations 25-50 bpm
- Pulse 100-140
- BP 90 systolic
65
Normal Vital Signs for Pediatric(birth to 1 month)
- Respirations 30-60
- Pulse 140-160
- BP 70 systolic
66
Normal Vital Signs for Adults(20>)
- Respirations 12-20
- Pulse 60-100
- BP 110/70 to 130/90
67
Early Signs/Symptoms of Shock
- ALOC(restlessness, anxiousness, irritability, hypoxia)
- Tachycardia
- Pale, cool, clammy,
- Weak peripheral pulses
- Increased Respiratory rate
- Thirst
- Delayed capillary refill(>2seconds)
68
Late Signs/Symptoms of Shock
- Falling Blood Pressure
- Irregular Breathing
- Mottling or cyanosis
- Absent peripheral pulses
69
Cardiogenic Shock
-Is a pump problem, the heart muscle cannot pump effectively, causing a backup of fluid, pulmonary edema, and hypertension. Caused by low cardiac output due to reduced preload, high afterload, or poor myocardial contractility.
70
Obstructive Shock
- Is a pump problem caused by mechanical obstruction of the heart problem called cardiac tamponade is a form of obstructive shock.
- Signs/Symptoms are JVD, narrowing pulse pressures(systolic and diastolic pressures moving closer together), hypotension.
71
Three Primary Causes of Shock
-1. Pump (heart) Problem
Ex. Myocardial Infarction, Cardiac Trauma
2. Pipe (blood vessel) Problem
Ex. Anaphylaxis, Spinal Trauma, Infection
3. Fluid (blood volume) Problem
Ex. Bleeding, Vomiting, Diarrhea
72
Three Stages of Shock
- 1. Compensated Shock(body is still able to fight)
2. Decompensated Shock(body can no longer fight and BP start to fall)
3. Irreversible Shock(pt will not recover and will die)
73
Distributive Shock
-Is a pipe (blood vessel) problem. It occurs due to widespread vasodilation, which causes blood pooling and relative hypovolemia(low volume relative to the size of the vascular size).
74
Anaphylactic Shock
-AKA anaphylaxis, a life threatening form of severe allergic reaction due to three factors: MASSIVE VASODILATION, WIDESPREAD VESSEL PERMEABILITY(fluid leakage), BRONCHOCONSTRICTION.
75
Neurogenic Shock
-Is caused by spinal cord damage, typically in the cervical region.
76
Septic Shock
-Is caused by severe infection, which damages blood vessels and increases plasma loss out of the vascular space.
77
Psychogenic Shock
-Is a pseudo shock caused by sudden, temporary vasodilation that leads to syncope(fainting)
78
Hypovolemic Shock
-Fluid problem, loss of whole blood is one cause and dehydration.
79
Normal pupil reaction in response to light?
-Pupils should constrict or get smaller
80
Safe lifting technique?
-Power lift. Keep object close to the body. Use legs to lift not back. Use power grip. Position the stretcher to reduce height of the lift.
81
How long to Suction an airway?
```
-Adults = 15sec
Peds. = 10 sec
Infants = 5 sec
-Apply suction while withdrawing the catheter
-Suction babies mouth first
```
82
Oxygen concentration delivered by different devices.
- BVM: more than 90%
- Pocket Mask: 16%
- Simple face mask: 8-10 L/minute. 24-44%
- Non-rebreather: 15 L/minute. 95%
- Nasal cannula: 1-6 L/minute. 24-44%
83
Signs of adequate ventilation.
-Equal chest rise and fall, 35-45 CO2, 100% O2
84
How to measure an OPA and NPA?
- Measure from the corner of the mouth to the earlobe. (OPA)
| - Measure from the tip of the nose to the earlobe. (NPA)
85
EMT use of epinephrine
-Requires medical direction, hold in place for several seconds to allow medication to enter the patient.
86
How to treat an obstructed airway
-Head tilt-chin lift(jaw-thrust maneuver if neck injury is suspected), finger sweep if you see any objects, suction, abdominal thrust, if PT. goes unresponsive begin CPR
87
How to administer nitroglycerin
-Is administered sublingually(under the tongue)
88
Signs and symptoms of anaphylaxis
-Skin: hives, swelling, itching, flushed or cyanotic color
— Cardiovascular: weak pulses, hypotension
— Respiratory: severe dyspnea, wheezing, respiratory failure
89
Side effects of nitroglycerin
- Reflex tachycardia
- Hypotension
- Headache
- Burning under the tongue
- Nausea, vomiting
90
Effects of Carbon Dioxide levels in the blood being too high or too low
- High CO2 levels will stimulate an increase in respiratory rate and tidal volume.
- Low CO2 levels
91
How to perform CPR step by step for an adult, child, and infant including AED use
--First, restore circulation by means of chest compressions to circulate blood through the body.
-After performing 30 high-quality compressions at least 2" deep in adult and at the rate of at least 100 per minute, open the airway with the jaw-thrust or head tilt-chin lift maneuver.
-Last, restore breathing by means of rescue breathing (mouth to mouth ventilation, mouth to nose ventilation, or the use of mechanical ventilation device)
AED-place 1" to the side of the pacemaker.
- dry the chest if any patient that is wet
- can be used on children(1month-1year manual defibrillator is preferred to AED)
92
EMT treatment of ventricular fibrillation
-CPR and early application of AED
93
Types of diabetes
- Type 1 Diabetes = insulin dependent diabetes mellitus. Patient must takes supplemental insulin(usually injected)
- Type 2 Diabetes = non-insulin diabetes mellitus. Typically do not require supplemental insulin. More common than type 1 and is based on lifestyle and genetics.
94
Signs and symptoms of diabetic ketoacidosis
-Weakness, nausea, vomiting, abdominal pain, a weak and rapid pulse, and a type of deep, rapid breathing called Kussmaul Respirations. ALOC, sweet smell to their breaths.
95
Signs and symptoms of hypoglycemia
-Below 60, Any patient with an altered or decreased level of consciousness, Any patient with a known or suspected diabetic history
96
Generalized Seizure
-Also called grand mal seizure, patient is unresponsive and experiences full body convulsions.
97
Causes of seizure in adults and pediatrics
- (Adults)Seizures can be caused by congenital problems, traumatic injuries, or medical conditions, including alcohol, brain injury, tumor, diabetic emergency, epilepsy, fever, infection, insulin or other medications, poisoning or toxic exposure, stroke, or biological or chemical weapons.
- (Infants)Febrile seizures are a common cause of seizures in pediatric patients. Caused by high fevers that develop rapidly, they do not typically present significant risk to the patient. The child should, however, be transported and evaluated by a physician
98
EMT treatment for seizures
-If possible, position postictal patient in the lateral recumbent position to protect airway. If vomiting occurs while in cervical-spine precautions, tilt the long board, give O2.
99
Types of fractures
- Open fracture: a fracture with an associated open soft tissue injury
- Closed fracture: a fracture where the skin is not broken
100
How to treat fractures
-Splint above and below the fracture and assess pulses before and after splinting. Attempt to realign deformed injuries with absent distal pulses. Do not delay transport of high priority pt.
101
How to treat dislocations
-apply a sling and swathe to immobilize the dislocation, transport priority
102
Treatment for near drownings
-Treatment for hypothermia, near-drowning patients may also suffer from shock, soft tissue injury, spinal injuries, or internal or external bleeding. These patients should be treated as a trauma patient with a thorough assessment conducted.
103
The five basic mechanism for the body to loose heat
- Conduction
- Convection
- Evaporation
- Respiration
- Radiation
104
How to deal with a violent or disturbed patient
- 1. Give patient adequate space, and be prepared for rapid changes in behavior.
2. Don’t block the patient’s means of exit or display a judgmental attitude.
3. Listen actively and don’t interrupt.
4. Don’t leave the patient alone. Don’t leave your partner alone with the patient.
5. Don’t give ultimatums
105
Pre-delivery emergencies and management
- 1. Prepare obstetrical (OB) kit.
2. Position the mother—not supine: semireclined, knees drawn, bottom slightly elevated, feet planted.
3. Expose vaginal opening, assess for crowning, and apply clean sheets around birth area.
4. Tear the amniotic sac if it has not already ruptured
106
Delivery emergency and management
- Breech Delivery: Rapid transports, prepare everything as a normal delivery and allow buttocks and legs to deliver spontaneously with support. Allow head to deliver spontaneously and insert two fingers making a V into the vagina to prevent the vagina walls from compressing the airway.
- Limb Presentation: Usually must be delivered surgically so rapid transport, if limb is protruding then cover it with sterile towel(never push limb back in or pull on it), place pt. on her back with her head down and pelvis elevated with high flow O2.
- Prolapse of the Umbilical Cord: Rapid transport and prevent the infants head from compressing the cord. Place pt. in a backboard in the Trendelenburg position with her hips elevated or knee-chest position: kneeling and bent forward facedown. Carefully and gently push the infants head away from the umbilical cord. Wrap sterile towel, moistened with saline around exposed cord, give pt. high flow O2.
107
Management and treatment of neonates
-
108
Signs and symptoms of internal bleeding
- Bruising, hematoma, hematemesis, fractured bones
- Mechanism of injury (MOI), abdominal distention
- Bloody or dark, tarry stool or signs and symptoms of shock
109
Treatment of an open neck wound
-Cover open neck wounds with an occlusive dressing to prevent air embolism.
110
Treatment of an open chest wound
-Penetrating thoracic injuries should be covered with a three-sided occlusive dressing to prevent air from entering the chest cavity.
111
Treatment of an open abdominal wound
- Cover with moist sterile dressing
- Cover moist dressing with occlusive dressing
- Flex legs if possible to reduce abdominal contraction
- Treat for shock
- This is a high-priority
112
Treatment of an impaled object
-Impaled objects should be stabilized in place
-There are only two indications for removing an impaled object:
The object creates an airway obstruction or inability to manage the airway, such as an impaled object in the cheek.
The object is in the chest and prevents CPR for a patient in cardiac arrest.
113
Principle of bandaging and splinting
SPLINTING
-Assess Pulse, Motor, Sensation(PMS or DNVF) before and after splinting. Immobilize injured bone and joints above and below. Attempt one time to realign deformed injuries with absent distal pulses. No pulse present then treat as high priority.
BANDAGING
-Apply direct pressure and elevate the injured area. Apply a dressing and bandage. Continue to elevate as needed. Apply a tourniquet for uncontrolled hemorrhage
114
Signs and symptoms of skull fracture
-Head appears deformed, visible crack with scalp laceration, ecchymosis(bruising) that develops under the eyes(raccoon eyes), or behind one ear over the mastoid process(battle's sign), decreased LOC, irregular breathing pattern, widening pulse pressure, slow HR, clear or pink CSF leakage from scalp wound and nose and ear, pupils fail to respond to light or unequal, loss of sensation and/or motor function, amnesia, seizure, numbness/tingling in the extremities, dizziness, visual complaints, combative or other abnormal behavior, nausea or vomiting, posturing(decorticate or decerebrate)
115
Review the HazMat section of the EMT book
-
116
How to assist a patient with a metered dose inhaler
-We are allowed to help administered MDI but need medical direction either online or offline.
“The “Six Rights” of Drug Administration
1. Right patient. Make sure the drug is administered to the right patient.
2. Right drug. Make sure the patient receives the correct drug.
3. Right route. Make sure the drug is administered properly.
4. Right amount. Make sure the patient receives the correct dose.
5. Right time. Make sure the patient receives the drug at the right time.
6. Right documentation. Make sure the PCR accurately documents the relevant information about the drug administration and response.
117
EMT treatment of hypoglycemia
-Consider oral glucose if the patient is hypoglycemic and able to swallow. Consult medical direction and follow local protocols for blood glucose testing and administration of oral glucose.
118
Signs and symptoms of IV infiltration and EMT treatment for IV infiltration
- Edema or swelling at the catheter site, extremely low IV flow, patient complaint of tightness and pain around the IV
- To correct, stop flow, remove IV catheter, and reinsert it at an alternative site. Apply direct pressure over the swollen area.
119
IV fluids approved for monitoring(inter-facility) by the EMT
-NS or LR but they had to be previously started by the hospital staff.
120
Structures that make up the airway and respiratory system including, larynx, pharynx, oropharynx and vocal chords
- Upper Airway=nose and mouth, Nasopharynx, Oropharynx, larynx, epiglottis.
- Lower Airway=trachea, carina, left and right mainstem bronchi,bronchioles, alveoli.
121
Structural difference between the pediatric and adult airway and respiratory system
-Smaller mouth and nose, larger tongue in proportion to the airway, lungs are smaller
122
Structures of the heart
-Left and right pump, septal wall, three layers of heart muscle(endocardium, myocardium, epicardium), pericardium, 2 Atrium and 2 Ventricles
123
Structures of the cardiovascular system
-Consists of 3 Parts: A pump(Heart), a set of pipes(blood vessels or arteries that act as the container), contents of the container(the blood)
124
Absence Seizure
-Also called petit mal seizure, patient does not interact with the environment but no convulsion activity.
125
Partial Seizure
- Simple partial seizure: no change in level of consciousness (LOC); possible twitching or sensory changes, but no full-body convulsions
- Complex partial seizures: altered LOC; isolated twitching and sensory changes possible
126
Status Epilepticus
- Prolonged seizure (about 30 minutes) or recurring seizures without the patient regaining consciousness in between
- Highly dangerous, possibly leading to permanent brain damage and death
127
Conduction
-direct transfer of heat through contact with a colder structure. Example: bare feet on a cold floor
128
Convection
-loss of heat to passing air. Example: standing in a cold breeze
129
Evaporation
-loss of heat through “evaporation of water from the skin. Example: getting out of the pool or shower
130
Respiration
-in a cold environment, exhaled air has been warmed within the body. That heat is lost on exhalation
131
Radiation
-transfer of radiant heat. Example: entering a walk-in freezer
132
First Stage of delivery?
- Begins with the onset of contractions and ends with full cervical dilation.
- The cervix is fully dilated at 10 cm, allowing the infant’s head to enter the birth canal.
- Contractions initially occur at widespread intervals and become more severe and closer together over time.
- The mucus plug that seals the uterine opening passes
- The amniotic sac may rupture spontaneously.
- Stage one typically lasts longer for first-time pregnancies
133
Second stage of delivery?
- Begins with full cervical dilation and ends with delivery of the baby.
- Contractions are close together.
- Mother feels intense pressure and the urge to push
134
Third stage of delivery?
- Begins once baby is delivered and ends with delivery of the placenta.
- Placenta typically delivers within 30 minutes after delivery of the baby.
- There will be an increase in vaginal bleeding shortly before the placenta delivers, and the mother will feel the urge to push again
135
Respiration
-The process of exchanging oxygen and carbon dioxide.
136
Hyperventilation
-Rapid or deep breathing that lowers the blood carbon dioxide level below normal.
137
Capillary Refill Time
- A test that evaluates distal circulatory system function by squeezing(blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.
- CapRefill Time = <2 seconds(normal)
138
Fowler's Position
-Pts. placed in semi-reclining position with the head elevated to help them breath easier and to control the airway. Knees up.
139
Concentration of oxygen in inhaled air and in exhaled air?
-21% inhaled and 16% exhaled
140
Symptom
-Subjective findings that the patient feels but can be identified only by the patient.
141
Sign
-Objective findings that can be seen, heard, felt, smelled, or measured.
142
Bradycardia
-A slow heart rate, less than 60 beats/min.
143
Tachycardia
-A rapid heart rate, more than 100 beats/min.
144
Radiating Pain
-
145
Referred Pain
-Causes pain in an area of the body other than the source.
146
Pertinent Negative
-Negative findings that warrant no care or intervention.
147
Jugular Vein Distention
-A visual bulging of the jugular veins in the neck that can be caused by fluid overload, pressure in the chest, cardiac tamponade, or tension pneumothorax.
148
Pulmonary Edema
-A build up of fluid in the lungs, usually as a result of congestive heart failure.
149
Angina
-Angina is transient chest pain caused by a lack of oxygen to the heart muscle. The heart’s oxygen demand temporarily exceeds its supply.
150
Acute Myocardial Infarction
-A heart attack; death of heart muscle following obstruction of blood flow to it. Acute in this context means "new" or "happening right now."
151
Ulcers
-Ulcers are open wounds along the digestive tract, often the stomach.
152
Glucose
-One of the basic sugars; it is the primary fuel, in conjunction with oxygen, for cellular metabolism.
153
Organic Brain Syndrome
-Temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiologic fun ting of brain tissue.
154
Glasgow Coma Scale
-An evaluation tool used to determine level of conscious, which evaluates and assigns point values(scores) for eye opening, verbal response, and motor response, which are then totaled; effective in helping predict patient outcomes.
155
Cardiac Tamponade(pericardial tamponade)
-Compression of the heart as the result of build up of blood or other fluid in the pericardial sac, leading to decreased cardiac output.
156
APGAR Score
- A scoring system for assessing the status of a newborn that assigns a number value to each of the five areas of assessment.
- Appearance
i. 0 points: cyanotic all over
ii. 1 point: core pink, but hands and feet cyanotic
iii. 2 points: pink all over
3. Pulse
i. 0 points: no pulse
ii. 1 point: heart rate under 100
iii. 2 points: heart rate over 100
4. Grimace (stimulation reflex)
i. 0 points: no response to stimulation
ii. 1 point: minimal (facial grimace) response to stimulation
iii. 2 points: responds vigorously, such as crying
5. Activity (extremity movement)
i. 0 points: limp
ii. 1 point: limited active movement
iii. 2 points: actively moving
6. Respirations
i. 0 points: not breathing
ii. 1 point: slow or irregular breathing
iii. 2 points: adequate breathing
157
Dissecting Aortic Aneurysm
-Is a weakness in the wall of the aorta. The aorta dilates the weekend, which makes it susceptible to rupture. Occurs when the inner layers of the aorta become separated allowing blood at high pressures to flow between the layers.
158
How to treat chest pain?
-
159
-Signs and Symptoms of respiratory failure in a pediatric patient
-Bradycardia and poor muscle tone, ALOC, head bobbing and grunting in exhalation, seesaw breathing
160
Stages of grief
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
161
How to treat a patient with CHF
-Congestive heart failure (CHF). CHF is a cardiac emergency in which the heart does not pump effectively, leading to a backup of fluid and pulmonary edema.
162
How to administer Aspirin
-Administer orally for chest pain
163
Most common cause of cardiac arrest
-A-Fib
164
Types of brain injuries
1. CONCUSSION-A concussion causes brain function to be disrupted in some manner.
2. CEREBRAL CONTUSION-Cerebral contusion is often accompanied by edema and/or concussion injury.
3. EPIDURAL HEMATOMA-Bleeding beneath the skull but above the dura mater
4. SUBDURAL HEMATOMA-Bleeding above the brain (beneath the dura mater and above the arachnoid meningeal layer)
5. SUBARACHNOID HEMORRHAGE-Bleeding within the subarachnoid space
6. INTRACEREBRAL HEMORRHAGE-Bleeding within the brain tissue
7. HERNIATION SYNDROME-The pressure within the skull is called intracranial pressure (ICP). Herniation is when the brain is compressed due to excessive ICP.
165
How to prevent transmission of HIV
-
166
How to demonstrate empathy, courtesy and professionalism
i. Show respect and empathy for patient and family.
ii. Serve as a patient advocate.
iii. Be supportive and keep the patient and family informed.
iv. Do not use platitudes or offer false hope.
v. Allow family to be with the patient whenever possible.
vi. The family may need you even after there is nothing more you can do for the patient
167
The designation and duties of each of the ICS positions
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168
What constitutes privileged health information (PHI), including PCR's
-
169
How to operate at a crime scene
1. Ensure scene safety.
2. Provide patient care as needed.
3. Avoid any unnecessary disturbance of scene.
4. Remember and note the position of patient(s).
5. Remember and report everything you touched at the scene.
6. Cut around (not through) holes in clothing when exposing the patient
7. Note anything or anyone suspicious on or near the scene.
8. Discourage sexual assault patients from changing clothes or showering.
9. Try to get a same-sex provider to assist with sexual assault patients.
10. Leave once you are no longer needed on the scene.
170
How to properly transfer care of a patient
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171
Effects of a sympathetic nervous system stimulant
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172
All of the effects of epinephrine
- Mechanism of action: peripheral vasoconstriction, increased heart rate, bronchodilation
- Side effects: Tachycardia, hypertension, increased myocardial oxygen demand, restlessness and anxiousness
173
Reasons to not label patients
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174
Signs and symptoms of liver dysfunction
- Jaundice: yellow skin; may indicate liver problems.
- Signs and symptoms of abdominal injury include pain or tenderness distention; bruising; guarding (patient stiffens abdominal muscles)
- Hemorrhagic Shock
175
Proper use of a pulse oximetry
-
176
Proper use of a Combitube
-
177
When to use air medical transportation
-Transport time is to long by ground, road conditions, traffic, environmental conditions limit or completely prohibit the use of ambo, pt requires advanced care that I can not give.
178
Signs and symptoms of emphysema(include pathophysiology)
- Signs/Symptoms=thin appearance with barrel chest, use of accessory muscle and tripod position, puffing(pursed lip) style of breathing, usually pink skin. No mucus, little to no cough, wheezing, dry lungs.
- Pathophysiology=destruction of the airways distal to the bronchiole, destruction of the pulmonary capillary bed, decreased ability to oxygenate the blood, lower cardiac output and hyperventilation, development of muscle wasting and weight loss.
179
Proper administration of activated charcoal
-Orally
180
Indications for use of a tourniquet
-Second method. If direct pressure does not control bleeding, apply a tourniquet proximal to the source of bleeding.
181
The rule of "9"s
Head-Chest-Back-Arms(L/R)-Groin-Leg(L/R)
INFANTS=18-18-18-9/9-1-13.5/13.5%
CHILDREN=12-18-18-9/9-1-16.5/16.5%
ADULT=9-18-18-9/9-1-18/18%
*Quick way of estimating amount of surface area that has been burned.
182
Classification of burns
- Severe Burn Injuries
1. Burns with respiratory compromise
2. Full-thickness circumferential burns
3. Partial-thickness burns covering more than 30% of TBSA
4. Burns with associated trauma, such as fractures
5. Full-thickness burns to the airway, hands, face, feet, or genitalia
6. Full-thickness burns covering more than 10% of the TBSA
7. All moderate burn criteria for patients under 5 or over 55 years of age
- Moderate Burn Injuries
1. Full-thickness burns covering 2 to 10% of TBSA
2. Partial-thickness burns covering 15 to 30% of TBSA
3. Superficial burns covering more than 50% TBSA
- Minor Burn Injuries
1. Full-thickness burns covering less than 2% of TBSA
2. Partial-thickness burns covering less than 15% of TBSA
3. Superficial burns covering less than 50% TBSA
183
Treatment for heat stroke
1. Move pt. out of environment and into ambo
2. AC to max
3. Remove pt. clothing
4. High flow O2
5. Apply cool packs to neck, groin and armpits.
6. Cover pt. w/wet towels or spray with cool water and fan pt.
7. Aggressively and repeatedly fan pt.
8. Immediate transport to hospital
9. Notify hospital
184
Treatment for hypothermia
1. Manage life-threatening conditions
2. Remove patient from cold environment
3. Remove wet clothing; prevent further heat loss
185
Treatment for a breech presentation
1. A breech birth occurs when the baby’s buttocks or legs are the first presenting part in the birth canal.
2. Transport immediately. Breech births present significant dangers for mother and baby.
3. If delivery occurs, there is a high risk the head will become stuck in the birth canal.
4. If the head is trapped, use fingers to form a “V” along vaginal wall to create space allowing the baby to breath.
186
Treatment for a Nuchal Cord
-As the head delivers, check if the cord is wrapped around the baby’s neck (nuchal cord). If the cord is around the neck, gently remove it from around the neck.
187
Structures of the skeletal system
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188
Structures of the brain in the biological process they are responsible for
- Cerebrum: largest part of the brain; controls “thought, memory, and the senses
- Cerebellum: coordinates voluntary movement, fine motor function, and balance
- Brain stem: includes midbrain, pons, and medulla; controls essential body functions, such as breathing and consciousness
189
Structures found in the abdominal quadrants
- RUQ=Liver, Gallbladder, portion of the colon
- LUQ=Stomach, spleen, portion of the colon
- RLQ=Two portions of the large intestine (cecum) and the ascending colon, portion of the small intestine (ileum), appendix
- LLQ=Descending and sigmoid portions of the colon, small intestine
190
Know the EMT scope practice with Endotracheal tubes
-
191
Know the EMT scope practice with glucagon
-Oral glucose with ability to swallow
192
Know the EMT scope practice with chest decompression
-
193
Know the EMT scope of practice with the use of an AED
-May utilize an AED
