Exam 4: Chapter 14 & 15

Question 1

What is a medical patient?

Answer 1

a patient with one or more medical disease or conditions.

Question 2

What is a trauma patient?

Answer 2

a patient suffering from one or more physical injuries

Question 3

What is the history of present illness (HPI)?

Answer 3

information gathered regarding symptoms and nature of patient’s current concern

Question 4

What is past medical history (PMH)?

Answer 4

information gathered regarding patient’s health problems in past

Question 5

What is a sign?

Answer 5

something regarding patient’s condition that you can’t see ex. extremely deformed from trauma such as swollen ankles from fluid accumulation

Question 6

What is a symptom?

Answer 6

something regarding patient’s condition that the patient tells you ex. might be abdominal pain or diffiuclty breahting something patient feels and tells you about

Question 7

What is a reassessment?

Answer 7

a procedure for detecting changes in a patient’s condition. it involves four steps: repeating the primary assessment, relating and recording vital sings, relating physical exam, and checking interventions

Question 8

What is an open-ended question?

Answer 8

a question requiring more than just a “yes” or “no” answer

Question 9

What is a close-ended question?

Answer 9

a question requiring only a “yes” or “no” answer use for necessarily immediate questions answer

Question 10

What is SAMPLE?

Answer 10

memory aid in which letters stand for elements of past medical history: signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to injury or illness

Question 11

What is OPQRST?

Answer 11

a memory aid in which letters stand for questions asked to get a description of present illness: onset, provocation, quality (describe it), radiation, severity, time

Question 12

What is the jugular vein distention (JVD)?

Answer 12

bulging of the neck veins

Question 13

What is crepitation?

Answer 13

grating sound or feeling of broken bones rubbing together

Question 14

What is rapid trauma assessment?

Answer 14

rapid assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of body to detect signs and symptoms of injury

Question 15

What is distention?

Answer 15

a condition of being stretched, inflated or larger than normal

Question 16

What is priapism?

Answer 16

persistent erection of penis may result from spinal injury and some medical problems

Question 17

What is a detailed physical exam?

Answer 17

an assessment of the head, neck, chest, abdomen, pelvis, extremities and posterior of body to detect signs and symptoms of injury. differed form rapid trauma assessment only in that also includes examination of face, ears, eyes, nose, and mouth during examination of the head

Question 18

What is trending?

Answer 18

changes in a patient’s condition over time, such as slowing respirations or rising pulse rate, that may show improvement

Question 19

What is diagnosis?

Answer 19

description or label for a patient’s condition that assists a clinician in further evaluation and treatment

Question 20

What is differential diagnosis?

Answer 20

list of potential diagnoses compiled early in assessment of patient

Question 21

What is a base station?

Answer 21

two-way radio at a fixed site such as a hospital or disptach center

Question 22

What is mobile radio?

Answer 22

two-way radio that is used or affixed in a vehicle

Question 23

What is watt?

Answer 23

the unit of measurement of the ouput power of a radio

Question 24

What is a portable radio?

Answer 24

handheld two-way radio

Question 25

What is a repeater?

Answer 25

two-way device that picks up signals from lower- power radio units, such as mobile and portable radios, and retransmits them at a high pwoer. it allows low=power radio signals to be transmitted over long distances

Question 26

What is a cell phone?

Answer 26

phone that transmits thorugh air instead of over wires so phone ca be transported and used over a wider area

Question 27

What is telemetry?

Answer 27

process of sending and receiving data wirelessly. may include ECG, vital signs or patient-related data.

Question 28

What is a drop report?

Answer 28

abbreviated form of PCR that an EMS crew can leave at hospital when there is not enough time to complete the PCR before leaving

Question 29

What is secondary assessment?

Answer 29

series of examinations based on hands-on (feel for injuries, listen to abnormal sounds, look for swelling), patient history (current condition or complaint and past history) and vital signs (pulse, respiration, blood pressure, pulse oximetry) where we find out what is wrong with the patient performed scene size-up and primary assessment

get on same level as patients and show empathy and listening carefully ask many questions to have patient give in own words

Question 30

What questions do you ask your patient?

Answer 30

what is nature of problem? signs and symptoms? events before? do they have medical problems, take medications? any allargies? last eat?

Question 31

What do you do in a physical examination?

Answer 31

Observe (for patient’s chest for expansion and symmetry), ausculatate (listen for equal air movement and abnromal sounds using stethoscope)), and palpate (for tenderness by injury)

Question 32

What do you ask about the respiratory system?

Answer 32

dypsnea on exertion, weight gain (fluid buildup heart failure), orthopnea (patient difficulty breathing when lying down- heart failure.) physical exam- mental status (decreased oxygen), level of respiratory distress (accessory muscle use and work of breathing), observe chest wall motion (expand significantly and evenly if not trauma), auscultate lung sounds (presence and absence of lung sounds (abnormal sounds wheezing- airway narrowing or popping/crackling sounds- rhonchi and rales with fluid in airway), pulse oximetry, observe edema (hear for in lungs and check ankles), fever

Question 33

What do you ask about the cardiovascular system?

Answer 33

description and characteristics of pain and dos it change with posiiton, breathing or movmeent. signs include- conditions may be severe including skin color, temperature, and condiiton with pale, cool and/or moist skin is more serious condition. obtain pulse be aware for high or low rates, blood pressure- do on both arms in transport and if significant difference may be aortic aneurysm, pulse pressure (difference between systolic and diastolic may indicate shock), palpate chest- is it tender may be trauma, posture and breathing- guarding chest and shallow breathing indicates injury

Question 34

What do you ask about the nervous system?

Answer 34

determine mental status (person, place, time and purpose), determine normal state (may have alzherimer’s and determine change), note speech (slurring inability to speak, or inappropriate words). use stroke scale, check peripheral sensation and movement checking extremities should be equal, gentle palpate spine for tenderness or deformity, check extremity strength- have them squeeze hand and raise and lower foot should be equal may be spinal, check pupil for equality and reactivity,

Question 35

What do you ask about the endocrine system?

Answer 35

diabetes mellitus or thyroid disease, when eaten and quality of food, kind of exertion, insulin pump? patient’s mental status, with cool moist skin occurs in hypoglycemia, get blood glucose level.

Question 36

What do you ask about the gastrointestinal system?

Answer 36

oral intake recently if varied, pain and when, history of issues, vomiting how much and frequently what look like, bowel movement when and how often compared to normal dark tarry may be blood, posiiton such as fetal, palpate into quadrants where it hurts or bowel, inspect as appropriate, look at vomit or feces noting volume and color for bleeding

Question 37

What do you ask about the musculoskeletal system?

Answer 37

prior inuries to area, blood thinning meds? inspect the patients for injury and deformity, swelling or bruising, palpate area with injury gently if obvious, compre sides or body an dnote assymetry, beware crepitation, palpate major body areas and extremities with multiple injuries may be unresponsive.

Question 38

What do you ask your patients about and look for in regards to the immune system?

Answer 38

ex. hives on skin, wheezing, etc. allergies any exposure have they been severe? tightness in chest or throat, difficulty breahting or swelling around face mouth or tongue. do you see stinger, look for hives, inspect for swelling, lung for breathing with no wheezes.

Question 39

What do you do if the person is awake and able to tell you patient history?

Answer 39

dont interview family until patient unless unresponsive and try to ask open ended questions not one that u think you know already has the answer ask about acompannying things find out personal physician

Question 40

What is a rapid physical examination and what do you look for in one?

Answer 40

based on information gathered at scene looking at head, neck (jugular vein distention), chest (presence and equality of breath sounds), abdomen (distention, firmness, or rigidity), pelvis (incontinence of urine or feces), extremities (pulse, motor function, snesation, oxygen saturation, and medical idetification devices), and posterior then take vital signs of respriation, pulse, skin color temperature conditions (capillary refill), pupils, blood pressure, and oxygen saturation. check pupils when patients eye is closed. call ALS,

Question 41

What is trauma?

Answer 41

means injury and can range from slight to severe

Question 42

If a patient is not seriously injured what does it mean?

Answer 42

determine cheif complaint, and elicit information about how patient was injured (history of present illness), perform physical exam based on chief complaint and mechanism of injury, assess baseline vital signs, and obtain past medical history

Question 43

If a patient is seriously injured what does it mean and what happens?

Answer 43

determine chief complaint, and rapidl elicit information about how patient was injured (history of present illness), continue manual stabilization of head and neck, consider requesting advanced life support personnel, perform rapid trauma assessment, assess baseline vital signs, and obtain past medical history

Question 44

What do you do if the person is a trauma patient?

Answer 44

nature of force involved (blunt from hitting steering wheel penetrating like knife or saw like heavy falling), direction and strength of force, equipment used to protect the patient, actions taken to prevent or minimize injury, areas of pain and injuries resulting form incient

Question 45

What is palpitating?

Answer 45

press on injured area to determine abnormalities in shape, termpeature (hot vs. ool), texture (smooth,wet, abraded), and sensation (tenderness ability to detect touch)

Question 46

What does DCAP_BTLS stand for?

Answer 46

deformities, contusions, abrasions, punctures and penetrations, burns, tenderness, lacerations, and swelling

Question 47

What are deformities/

Answer 47

parts of body that no longer ahve normal shape such as broken or fractured bones that push up skin over bone ends

Question 48

What are contusion?

Answer 48

medical term for bruises

Question 49

What are abrasions?

Answer 49

scrapes most common

Question 50

What are punctures and penetrations?

Answer 50

holes in body, frequently result of gunshot wounds an dstab wounds when small easy to overlook

Question 51

What are burns?

Answer 51

reddened, blistered, or charred-looking areas

Question 52

What is tenderness?

Answer 52

means area hurts when pressure is applied to it and when it is palpated

Question 53

What are lacerations?

Answer 53

cuts, open wounds sometimes cause significant blood loss

Question 54

What is swelling?

Answer 54

a very common result of injured capillaries bleeding under skin

Question 55

What is the difference between signs and symptoms?

Answer 55

signs are what you observe whereas symptoms are what the patient tells you how he feels

Question 56

What do you expect if there is significant force on upper body tissue or injury to face, head or neck from trauma?

Answer 56

(cut or bruise from thrown), then suspect there is posisble cervical spine injury. prevents further spinal injury while taking longer and providing discomfort

Question 57

What does pain in one area mean?

Answer 57

painful injury in other places limits patient’s ability to sense pain and communicate so use cervical collar for tht and when people complain of neck ppain. those with pentrative damage dont put on C-collar unless effect neurological. if no collar put towel around neck and tape patients head to backboard check patients head before putting it on no large earrings or necklaces

Question 58

When do you do rapid assessment?

Answer 58

patient that is stable or potentially unstable and need to trasnport do rapid assessment.

Question 59

What is a high risk autocross?

Answer 59

intrusion greater than 12 inches to occupant site or greater than 18 inches to any site, ejection (partial or comlete from automobile), death in same passenger compartment, vehicle telementry data consistent with high risk or injury, auto vs. pedestrian/bicyclist thrown, run over, or with significant (greater than 20 mph) impact or motorcycle crash greater than 20 mph.

Question 60

What does seat belt and steering wheel injuries do?

Answer 60

wearing seat belts high velocity collisions find that the force of being thrown foward causes injuries to bowel and other abdominal organs and on neck and heart affects major artries in neck supplying brain
look at stearing wheel if damaged under air bag person probabley has significany mechanism of injury

Question 61

What order do you check the body?

Answer 61

head to toe?

Question 62

What do you check the face for?

Answer 62

then face for wounds an ddeformities, cheekbones, forehead, and lower jaw, fragile and may break with significant force,
open mouth and look for wounds, tendernenss, and deformtities such as loose or broken teeth, obstruction lacerations tongue, unsuual breath odor, and discolaration

Question 63

What do you check the head for?

Answer 63

Palate head for wounds, tenderness, and deformities, sound or feel of broken bones rubbing (crepitation), run through hair, from top of neck over head if no blood on ground dont need to bind right away.

Question 64

What do you check the ears for?

Answer 64

ears same thing as well for drinage and bruising behind ear indicating skull injury. blood or clear fluid (runny nose) or cerebrospinal fluid dont let get any diertier so

Question 65

What do you check the eyes for?

Answer 65

assess eyes for usua and discoloartion, unequal pupils, foreign bodies, and blood in front of eye and if so eye sustained frorce and bleeding inside.

Question 66

What do you neck the head for?

Answer 66

jugular vein deformities when patient neck bulging means blood back up in veins (unusual when sitting up normal laying down) because heart isnt pumping effectivelyfrom tension pneumothorax (air trapped in chest) or cardiac tamponade (blood filling sac around heart). flat neck veins in patient who is patient is lying down may be sign of blood loss not enough blood to fill them flat vein in flat patient problem.

Question 67

What do you extremities the chest for?

Answer 67

for crepitation, breath sounds, and paradoxical motion (movement part of chest in opposite direction from rest of chest, sign of serious injury. when ribs broken at two ends and are floting free- flail chest move inward when lungs expand and outward when empty so a great deal of force was applied to break ribs platate the clavicles then put hands on either side of sternum and feel for equal expansion as well as ribcage listen for brath sounds undr clavicles and at base of lungs in mid-axillary line if breath sounds hard to hear ay have collapsed lung

Question 68

What do you posterior body the head for?

Answer 68

posterior body and immobilization- roll patient onto side assessing posterior body, puplating in area of spine, buttocks and posterior extremities, put backboard next to patient, form pelvic wrap from folded sheet

Question 69

What do you vital signs and past medical history the head for?

Answer 69

vital signs and past medical history- tell patient what you are going to do and that it may hurt stress importance of examination buidling confidence ask if they understand and explain as you do tell them if u must remove any article of clothing. do toe to head oon kid or comfort

Question 70

What do you check the abdomen for?

Answer 70

firmeness, softness, and distention or larger than norma caused by internal bleeding may have coleostomy or illeostomy- surgical opening to collect excretions leave in place. press down on each quadrant make sure warm, usually soft and if firm may be sign of injury to organs in abdomen and internal bleeding. may be pulpating mass or an enlarged aorta dont press any further.

Question 71

What do you check the pelvis for?

Answer 71

may observe bleeding or penal erection do so gently stop when patient says pain, gently press on unconscious paitent to detect tenderness (flinch or groin) motion of bones (instbaility of bones)

Question 72

What do you check the extremities for?

Answer 72

distal circulaiton, sensation, and motor function whether pulse present, patient has bfeeling and can move hands and feet or squeeze or push

Question 73

What do you do after a physical exam?

Answer 73

reasses after physical exam and interventions only dont reassess if doing lifesaving otherwise always do repeating primary assesment (mental status, open airway, breathing for rate and quality, pulse, skin color and temperature, and reestablish priorities) , reasses vital signs, repeat pysical exam to patien’ts specific complaint or inuies and check interventions. ask patient but not hint at suggestions of what they should feel.
check intervemtion: ensure adequate oxygen cgechk entire path, management of bleeding. more serious the patient is the more time you check

Question 74

How long do you check for an unstable patient?

Answer 74

5 minutes- for unstable or potentially unstable patient with altered mental status, diffuclt airway, breathing or circulation

Question 75

How often do you check for a stable patient?

Answer 75

stable patient- check every 15 minutes alert, normal vital signs, no serious injury

Question 76

What is critical thinking?

Answer 76

critical thinking- anayltical process that can help someone think through a problem in an organized and efficient manner. reflective, reasonable, and focused on deciding what to do in a particular situation.

Question 77

What does critical thinking do?

Answer 77

rule out some of diagnoses on the differential diagnosis most important is to start ruling out life threatening conditions

Question 78

What is heuristics?

Answer 78

speed up process of reaching diagnosis by making shortcuts base don pattern recognition

Question 79

What is representative bias?

Answer 79

encounter patient with group of signs and smyptoms assume patient has condiiton. but patterns dont always present with typical signs and symptoms of condition when doesnt fit someone can mistakenly say they dont have that

Question 80

What is availability bias?

Answer 80

urge to think of things because more easily recalled because of recent exposure overstating frequency

Question 81

What is overconfidence bias?

Answer 81

thinking oyu know more thatn you really do can cause problems so be aware of limits of knowledge and ability being careful in assessment.

Question 82

What is confirmation bias?

Answer 82

looks for evidence that support diagnosis already on mind overlooking evidence that refutes probability when many many possibility easier to go with one than look for others so look for data that reutes it

Question 83

What is illusory correlation bias?

Answer 83

correlationone thing causes another and one event may appear to cause another even if coincidiental or both cause by same thing. be skeptical about when one thing appears to cause annother

Question 84

What is anchoring and adjustment bias?

Answer 84

considres particular condition likely anchoring to that hypothesismay adjust but not as much as needed because of starting point such as drunkeness.

Question 85

What is search satisfying bias?

Answer 85

once figure it out very easy to stop looking for other causes of problems missing secondary diagnosis or other problem evaluate each before accepting

Question 86

What are some thinks EMT must learn to do to think like a physician?

Answer 86

love ambiguity- just wont know answer
limitations of technology and people- people may be wrong device subject to failure
no one strategy always works- be flexible
form strong foundaiton of knowledge- keep up to date on newest conditions and information
orgaize data in head- presence or severity of particular sign or symptom changes probability of particular disease or condition focus on few and work from signs and symptoms back to problem
change way oyu think
learn form other
reflect on what you learned

Question 87

What are the principles of a radio system?

Answer 87

make sure radio on and volume properly adjusted
reduce background noise by cosing vehcile window when possible
listen to frequency and ensure that it is clear before beginning transmission
press the “press to talk” (PTT) button on radio, then wait one second before speaking prevents cutting off first few words of transmission
speak with lips 2-3 inches form microphone
when calling another unit or based station use unit number or name followed by yours
if unit u call tells you “stand by” wait until they tell u they are ready to take trasnmission
speak slowly and clearly
keep transmission brief stop after 30 seconds pause and go
plain english avoid codes
dont say “be advised”
courtesy assumed, dont say please, thank you and you’re welocme
unclear number give number then repeat individual digits.
anything said over radio can be heard on scanner, dont use patient’s name no profanities or slander
use we instead of I
affirmative or negative preffered over yes and no
assessment informaiton about patient avoiding field diagnosis of patient’s problem
avoid slang or abbrevaitons
use EMS frequencies only

Question 88

What do you do on a medical radio report?

Answer 88

radio again for reassment
unit identification and level of provider
estimated time of arrival
patient’s age and sex
chief complaint
brief, pertinent hisotry of present illness
major past illness
mental status
baseline vital signs: pulse rate and rhythm, respirations and kind, skin, blood pressure, spO2
pertinent findings of physical exam: what you found
emergency medical care given: how it has changed
response to emergency medical care
contact medical direction if required or have questions - report order from physican word for word and repeat denial

Question 89

What happens when you hand over a patient to the hospital?

Answer 89

say name, chief complaint, history said and not given previously, treatment said and additional treatment oen route, vital signs and addiitonal vital signs taken en route

Question 90

What are some tips to use when communicating?

Answer 90

use frequent eye contact (interested and attentive), position and body language dont be higher than patient so position below eye level use open stance, only change when needed. dont use medical languages, be honest do as much as possible to reduce pain, use their proper name, lisren

Question 91

What is a PCR?

Answer 91

Prehospital care report- record produce during a call dopo on computer and print out hrd copy. functions as legal document, provides information for administrative functions (insurance and billing info), aids educaiton and research, and contributes to quality improvement. allows emergency department to see status of patent after radio and when you arrive on scene, care given, and how status changed.

Question 92

What is a written report?

Answer 92

those that have proitiosn with narrative areas, areas to record vital signs in written number form and check boxes servinvg as backup if compuer unavailable

Question 93

What is the run data part of the report?

Answer 93

agency name, date, times, call number, unit personnel, levels of certification, time of incident report, time unit notifiied, time of arrival of patient, time unit left scene, time of arrival at destination, time of trasnfer of care using times from dispatcher

Question 94

What is the patient information part of the report?

Answer 94

patient’s name, address, phone number, sex, age, date of birth, weight, raace and/or ethinicity, billing and insurance information.

Question 95

What is the general impression of the patient part of the report?

Answer 95

narrative summary of events, chief complaint, HOPI, past medical historu, phuysical exam and care, paior aid, physical exam results, vital signs, ECG results, procedures and treatments, medicaotns administered, transport info.

Question 96

What is the narrative part of the report?

Answer 96

include objective and pertinent subject informstion, pertinent negatives (no difficult with… so u checked areas but patienr denied , no radio codes or nonstandard abreviations, avoid subjective statments that are opinions. if not pertinent or verifiable put uestion mark put in other peoples words and describe as such. if not written down didnt do it.

Question 97

What is the refusals part of the report?

Answer 97

document actions taken when refused noting patient competency, informed raytionak decision. full secondary assessments and do what upoi can. if refuses to sign form get witnesses maje alternative care suggestions make sure sineone there if worsens can change mind

Question 98

What is commission?

Answer 98

imporant part of assesmsent or care was left out such as oxygen when chest pain document only vital signs taken

Question 99

What is commission?

Answer 99

actions performed on patient that are wrong or imporper such as incorrect administration of medicaitons tell medical direction and document incident

Question 100

What is falsification or misrepresentation?

Answer 100

leads to poor patient care because facts not documented and misled about conditions lead to revocaiton of license. if at later date added write date and different color pen

Question 101

What is a triage tag?

Answer 101

tag affixed to patient and used to record patient’s chief compliant and injuries, vital signs, and treatments given at multipel causalty incident

Question 102

What is CCABCD>

Answer 102

c-spine (, conscientious (oriented to person place time event AVPU), airway (LLF- look listen feel), breathing, circulation, decision

Question 103

What do we do in primary assessment?

Answer 103

CCABCD

Question 104

What is the importance of vital signs?

Answer 104

Importance of vital signs: outwards signs of what is going on inside the body, identify important states or trends in patient’s condiiton, attempt to gather on every EMS patient (patient severity and treatment priorities may prevent acquisiton). certain conditions will use 1 or more giving clues to pathology going on (like to get on everyone and like to see at least two).
when is that not possible if a trauma with a lot of things to stabilize.

Question 105

What are the vital signs?

Answer 105

pulse (if unresponsive carotid) RRQ- rate rhythm and quality
ventilation RRQ- respiratory rate in and out
lung sounds
blood pressure (oscaltation-oprefered method and palpitation)
skin-CTC
CRT (always in less than 8 year old) adults as well but not as reliable
pupil response- PERRL (pupils equal round reactive to light are or arent)
occasionally body temperature will be measured (hand on belly if cold
multi assistant trauma patient on evaluated with clothes off

Question 106

What is pulse?

Answer 106

heart rate cant tell what is being generated can only tell what is passing through vascular system. if dont hear baby say in position that i cant hear. anything not regular listen to for full minute

Question 107

What is the pulse rate of adults?

Answer 107

60-100

Question 108

What is the pulse rate of a child?

Answer 108

60-140

Question 109

What is the pulse rate of an infant?

Answer 109

80-140

Question 110

What is the pulse rate of a neonate?

Answer 110

(newborn up to 30 days): 120-160

Question 111

What are the different kinds of rhythms?

Answer 111

regular- same every time
irregular- PVC pre-ventrilcular contractions come every once in a while get normally over 50. physcially fit- when breathe in heart slows down and breathe out heart slows down. once in a while have funky beat
regularly irregular- respiratory dysrhthmia not concerning
irregularly irregular- funky beat ventricular fibrillation very bad. tons of caffeiene or stimualnts that is natural.

Question 112

What is the different kind of pulse quality?

Answer 112

strong- easy to find
weak- gotta putse around
bounding- HBP, really easy to find
thready- hard time finding it and it goes away seen in elderly elderly

Question 113

Where can pulse be felt?

Answer 113

central- carotid and femoral
peripheral- radial, poplateal, pedal (if difficult cant feel and see),
record it as beats per minute regular and full/strong or thready. document all things

Question 114

What is tachycardia?

Answer 114

excercise, fear, pain, cafeeine, stimulants/drugs, diet pills, cigarette smokers (10-20 beats per minute higher) fever, compensated shock. 140-160 healthy person fine and unhealthy person is worrisome. congestive heart failure paitnets MI originally

Question 115

What is bradycardia?

Answer 115

less than 60 beats per minute runner, sleeping, medications, marijuana (decreased heart rate can go into arrest), hypothermic, MI finally bad. Pediatric patient- BAD hypoxic. depressents, benadryl, morphene rahipnal- date rape drug, beta and calcium channel blockers- heart rate is a little slow.

Question 116

What is the ventilation rate of adults?

Answer 116

12-20

Question 117

What is the ventilation rate of child?

Answer 117

15-30

Question 118

What is the ventilation rate of infant?

Answer 118

25-50

Question 119

What is the ventilation rate of neonate?

Answer 119

25-50

Question 120

What influences respiratory rate?

Answer 120

age, sex, size, physical conditioning, and emotional state infleunce breathing rates

Question 121

What are the different kinds of breathing rhythms?

Answer 121

regular
irregular
patterned
terminal (last few gaps)

Question 122

What are the different quality types of breathing?

Answer 122

normal (no effort whatsoever- eupnea)
shallow (no chest rise seeing)
labored (tripodding leaning forwards, intercostal retractions)
noisy

Question 123

What is tachypnea?

Answer 123

fast and shallow

Question 124

What is bradypnea?

Answer 124

slow

Question 125

What is apnea?

Answer 125

no breathing

Question 126

What is hyperpnea?

Answer 126

increase rate and depth anxiety attack

Question 127

What is agonal breathing?

Answer 127

last few breaths before dying

Question 128

What is cheyne strokes?

Answer 128

increased rate, increased depth, decrease rate decreased depth apnea internal pressure from brain stem injury

Question 129

What is BIOTS?

Answer 129

rapid deep respirations with period of apnea found in head injury and spinal meningitis usually CNS disorder

Question 130

What is russmaul?

Answer 130

diabetic ketoacidosis renal failures with metabolic acisosis high blood glucose overdose

Question 131

What is agnostic?

Answer 131

terminal breahting in deep and releaseing only a little till a point cant breath anymore brain stem injury.

Question 132

What are upper airway sounds?

Answer 132

snoring (tongue), gurgling (fluid), stridor (something stuck)

Question 133

What are lower airway sounds?

Answer 133

wheezing (constriction of bronchi asthma and COPD), ronchi (phlegm when coughing), rails or crckles (fluid fine and coarse how full it is)

Question 134

What is blood pressure?

Answer 134

the force against the vessel walls during ventricular contraction (systolic) and relaxation/filling (diastolic)

Question 135

What can bp indicates?

Answer 135

changes in bp can tell about physiological changes occuring in the body- systolic, diastolic, and pulse pressure (shock patients)

Question 136

What is the normal bp for adults?

what is bad/

Answer 136

120/80 (140/90 higher diastole means more restricted blood more likely to clot). systolic less than 110 shock. when 110+ diastolic bad and 200 systolic

Question 137

What are the blood pressures for infants and children?

Answer 137

difficult to obtain on infants and children younger than three years. more useful informaiton about the condition of an infant or very young hcild comes from observing for conditions such as sick appearance, respiratory distreess, or unconciousness use of the PAT serves as better indicator. SBP 80+ (2x age), normal DBP ⅔ SBP, “shock” 70+(2x age))

Question 138

What is skin etc?

Answer 138

color temperature, and condition of skin can provide valuable information regarding circulation and perfusion

Question 139

What is the best place to assess skin color?

Answer 139

nail beds, inside of cheek, inside of lower eyelids. pale or palor from fear as with shock severe dehydration. hypoxia- blue or gray. flushed or red- embarassment, fever, carbon monoxide poisoning-late, blotchy skin- kids shock.

Question 140

How do you feel the person’s temperature?

Answer 140

feel patient’s skin with back of hand, not if skin feels nromal (warm), hot, cool, or cold

Question 141

How do you test the skin condition?

Answer 141

dry, wet-diaphoretic

Question 142

What are pupils?

Answer 142

black center of the eye. in a dim enviornment the pupil will dilate, in a bright enviornment the pupil will constrict.

Question 143

What do you do when assessing pulse?

Answer 143

note baseline size, cover one eye and shine a light into corner of eye with both responding in same way, if head trauma- repeat with other looking for size, equality, and reactivity. noting equal, unequal (head injury or stroke), dilated (sleep apnea) , and constricted.

Question 144

What is body temperature?

Answer 144

narrow range of temeprature allows chemical reactions and other activiites to take place inside body with core temperature reflecting level of heat inside trunk

Question 145

What are you looking for when you take body temperature?

Answer 145

ooking for -2 degrees from 98.6oF and normally depdns on time of day, activity, level, temperature outside

Question 146

What is common in high blood sugar patients?

Answer 146

high blood sugar, polys- hungry, thirsty have to pee a lot.

Question 147

What are the different set of vital signs?

Answer 147

first set of vital signs are baselines after that is trending.

Question 148

What is FCC?

what does it do?

Answer 148

federal communications commission- responsible for all radio airway communications. Dont swear, name person, only supposed to use codes if both the sender and receiver are knowledgeable of the code terminology. some things allowed but should not be said like SOB- short of breath not in back.

Question 149

What are scanners and what problems do they face?

Answer 149

scanner- ⅓ households have scanner or other device.

Question 150

What is enhanced 911?

Answer 150

display on screen where call coming from land-line perfect and cell phone difficult in two separate locations and doesn’t always tell based on location with newer phones better

Question 151

What can dispatcher do?

Answer 151

will remain on line and ask you to hold dispatch units that you need

Question 152

What are the orders of communication?

Answer 152

call dispatch, dispatch alls people, talk to patient, other units?, call say leaving scene, calling hospital person doing patient care unless doing it out straight, driver- call dispatch saying at hospital and if intercept with ALS call again and state when re-in route, at hospital: turning over patient care give all information, restock and do patient report say out of service (if no suppplies) in service if fine and that you are coming back

Question 153

What are some things to tell hospital en route/ ?

Answer 153

(want to know what they have to be prepared for- critical or serious sex age mental status significant findings and treatments changing trauma or automobile restrained or unrestrained air bag or no air bag if given medication and no signfiicant chnage)

Question 154

What things must you say and what order to hospital en route?

Answer 154

if critical let know code coming in say important things up front if saying ETA (estimated time of arrival) say up front if critical. if not good say at end

Question 155

What do you do when handing over care?

Answer 155

introduce patient to nurse and giving with patient knowledge right there if delicate or things concerned about do it outside room

Question 156

What is trauma?

Answer 156

(boo-boo calls, falls gunshot, fights, automobile accidents)

Question 157

What is medical?

Answer 157

(illness pathology, nausea, vomiting, stroke heart attack

Question 158

What are mobile radios?

Answer 158

in fire truck, ambualnce

Question 159

What are portable radios?

Answer 159

ither you or partner have some way of communicating on scene need osme method of communciation

Question 160

What is a base station?

Answer 160

major dispatch center, firehouse, and hospital

Question 161

What are repeaters?

Answer 161

boost signal with higher mountains to pick up signals

Question 162

What are some tips for using the radio?

Answer 162

count for three seconds to make sure person before you is done, know what person going to say again one time, PTT on side when going to call push dont talk right away, confirm that they actually here you or receive you before giving report

Question 163

What are some things that you have to identify in calls?

Answer 163

unit identificaiton and level of provider, estimated time of arrival (ETA), patient’s age and sex, chief complaint, brief pretinent history of present illness/injury, major past illnesses, mental status, baseline vital signs, pertinent findings of physical exam, emegency care given, response to medical care, contact medical direction if have question

Question 164

What are some things that have to be in the verbal report?

Answer 164

report given to nurse, chief complaint, history not given preivously, assessment tratment given en route and their medications, addtitional vital signs taken en route

Question 165

What are some tips to work with patients?

Answer 165

use patient’s proper name dont call hon or dearie clal mr. and mrs. if older and they say call me by first name then do it, listneing to what they have to say, dont yell at all orderly patient. pediatric patients come down to their level for 6 and under and use their name (give stickers, happy face on bandaids), dont lie to anyone or tell them its not going to work,

Question 166

what is a PCR?

Answer 166

prehospital care report given to hospital, legal document once placed in medical record and is permanent be as thorough, neat and efficient as possible, if put in there better have done it, if didnt do it dont put it in. used for education, research, billing, and administration. every call is reviewed by medical director or service under department transportation.

Question 167

What is falsification?

Answer 167

covering up errors, recording something you forgot to do, with correction of errors one line through error, corrected up above, and innitials

Question 168

What are patient refusals?

Answer 168

high liability must do a refusal report