Exam 4: Chapter 14 & 15 Flashcards
1
Q
What is a medical patient?
A
a patient with one or more medical disease or conditions.
2
Q
What is a trauma patient?
A
a patient suffering from one or more physical injuries
3
Q
What is the history of present illness (HPI)?
A
information gathered regarding symptoms and nature of patient’s current concern
4
Q
What is past medical history (PMH)?
A
information gathered regarding patient’s health problems in past
5
Q
What is a sign?
A
something regarding patient’s condition that you can’t see ex. extremely deformed from trauma such as swollen ankles from fluid accumulation
6
Q
What is a symptom?
A
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
7
Q
What is a reassessment?
A
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
8
Q
What is an open-ended question?
A
a question requiring more than just a “yes” or “no” answer
9
Q
What is a close-ended question?
A
a question requiring only a “yes” or “no” answer use for necessarily immediate questions answer
10
Q
What is SAMPLE?
A
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
11
Q
What is OPQRST?
A
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
12
Q
What is the jugular vein distention (JVD)?
A
bulging of the neck veins
13
Q
What is crepitation?
A
grating sound or feeling of broken bones rubbing together
14
Q
What is rapid trauma assessment?
A
rapid assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of body to detect signs and symptoms of injury
15
Q
What is distention?
A
a condition of being stretched, inflated or larger than normal
16
Q
What is priapism?
A
persistent erection of penis may result from spinal injury and some medical problems
17
Q
What is a detailed physical exam?
A
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
18
Q
What is trending?
A
changes in a patient’s condition over time, such as slowing respirations or rising pulse rate, that may show improvement
19
Q
What is diagnosis?
A
description or label for a patient’s condition that assists a clinician in further evaluation and treatment
20
Q
What is differential diagnosis?
A
list of potential diagnoses compiled early in assessment of patient
21
Q
What is a base station?
A
two-way radio at a fixed site such as a hospital or disptach center
22
Q
What is mobile radio?
A
two-way radio that is used or affixed in a vehicle
23
Q
What is watt?
A
the unit of measurement of the ouput power of a radio
24
Q
What is a portable radio?
A
handheld two-way radio
25
What is a repeater?
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
26
What is a cell phone?
phone that transmits thorugh air instead of over wires so phone ca be transported and used over a wider area
27
What is telemetry?
process of sending and receiving data wirelessly. may include ECG, vital signs or patient-related data.
28
What is a drop report?
abbreviated form of PCR that an EMS crew can leave at hospital when there is not enough time to complete the PCR before leaving
29
What is secondary assessment?
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
30
What questions do you ask your patient?
what is nature of problem? signs and symptoms? events before? do they have medical problems, take medications? any allargies? last eat?
31
What do you do in a physical examination?
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)
32
What do you ask about the respiratory system?
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
33
What do you ask about the cardiovascular system?
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
34
What do you ask about the nervous system?
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,
35
What do you ask about the endocrine system?
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.
36
What do you ask about the gastrointestinal system?
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
37
What do you ask about the musculoskeletal system?
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.
38
What do you ask your patients about and look for in regards to the immune system?
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.
39
What do you do if the person is awake and able to tell you patient history?
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
40
What is a rapid physical examination and what do you look for in one?
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,
41
What is trauma?
means injury and can range from slight to severe
42
If a patient is not seriously injured what does it mean?
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
43
If a patient is seriously injured what does it mean and what happens?
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
44
What do you do if the person is a trauma patient?
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
45
What is palpitating?
press on injured area to determine abnormalities in shape, termpeature (hot vs. ool), texture (smooth,wet, abraded), and sensation (tenderness ability to detect touch)
46
What does DCAP_BTLS stand for?
deformities, contusions, abrasions, punctures and penetrations, burns, tenderness, lacerations, and swelling
47
What are deformities/
parts of body that no longer ahve normal shape such as broken or fractured bones that push up skin over bone ends
48
What are contusion?
medical term for bruises
49
What are abrasions?
scrapes most common
50
What are punctures and penetrations?
holes in body, frequently result of gunshot wounds an dstab wounds when small easy to overlook
51
What are burns?
reddened, blistered, or charred-looking areas
52
What is tenderness?
means area hurts when pressure is applied to it and when it is palpated
53
What are lacerations?
cuts, open wounds sometimes cause significant blood loss
54
What is swelling?
a very common result of injured capillaries bleeding under skin
55
What is the difference between signs and symptoms?
signs are what you observe whereas symptoms are what the patient tells you how he feels
56
What do you expect if there is significant force on upper body tissue or injury to face, head or neck from trauma?
(cut or bruise from thrown), then suspect there is posisble cervical spine injury. prevents further spinal injury while taking longer and providing discomfort
57
What does pain in one area mean?
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
58
When do you do rapid assessment?
patient that is stable or potentially unstable and need to trasnport do rapid assessment.
59
What is a high risk autocross?
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.
60
What does seat belt and steering wheel injuries do?
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
61
What order do you check the body?
head to toe?
62
What do you check the face for?
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
63
What do you check the head for?
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.
64
What do you check the ears for?
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
65
What do you check the eyes for?
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.
66
What do you neck the head for?
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.
67
What do you extremities the chest for?
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
68
What do you posterior body the head for?
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
69
What do you vital signs and past medical history the head for?
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
70
What do you check the abdomen for?
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.
71
What do you check the pelvis for?
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)
72
What do you check the extremities for?
distal circulaiton, sensation, and motor function whether pulse present, patient has bfeeling and can move hands and feet or squeeze or push
73
What do you do after a physical exam?
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
74
How long do you check for an unstable patient?
5 minutes- for unstable or potentially unstable patient with altered mental status, diffuclt airway, breathing or circulation
75
How often do you check for a stable patient?
stable patient- check every 15 minutes alert, normal vital signs, no serious injury
76
What is critical thinking?
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.
77
What does critical thinking do?
rule out some of diagnoses on the differential diagnosis most important is to start ruling out life threatening conditions
78
What is heuristics?
speed up process of reaching diagnosis by making shortcuts base don pattern recognition
79
What is representative bias?
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
80
What is availability bias?
urge to think of things because more easily recalled because of recent exposure overstating frequency
81
What is overconfidence bias?
thinking oyu know more thatn you really do can cause problems so be aware of limits of knowledge and ability being careful in assessment.
82
What is confirmation bias?
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
83
What is illusory correlation bias?
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
84
What is anchoring and adjustment bias?
considres particular condition likely anchoring to that hypothesismay adjust but not as much as needed because of starting point such as drunkeness.
85
What is search satisfying bias?
once figure it out very easy to stop looking for other causes of problems missing secondary diagnosis or other problem evaluate each before accepting
86
What are some thinks EMT must learn to do to think like a physician?
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
87
What are the principles of a radio system?
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
88
What do you do on a medical radio report?
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
89
What happens when you hand over a patient to the hospital?
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
90
What are some tips to use when communicating?
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
91
What is a PCR?
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.
92
What is a written report?
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
93
What is the run data part of the report?
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
94
What is the patient information part of the report?
patient’s name, address, phone number, sex, age, date of birth, weight, raace and/or ethinicity, billing and insurance information.
95
What is the general impression of the patient part of the report?
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.
96
What is the narrative part of the report?
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.
97
What is the refusals part of the report?
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
98
What is commission?
imporant part of assesmsent or care was left out such as oxygen when chest pain document only vital signs taken
99
What is commission?
actions performed on patient that are wrong or imporper such as incorrect administration of medicaitons tell medical direction and document incident
100
What is falsification or misrepresentation?
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
101
What is a triage tag?
tag affixed to patient and used to record patient’s chief compliant and injuries, vital signs, and treatments given at multipel causalty incident
102
What is CCABCD>
c-spine (, conscientious (oriented to person place time event AVPU), airway (LLF- look listen feel), breathing, circulation, decision
103
What do we do in primary assessment?
CCABCD
104
What is the importance of vital signs?
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.
105
What are the vital signs?
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
106
What is pulse?
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
107
What is the pulse rate of adults?
60-100
108
What is the pulse rate of a child?
60-140
109
What is the pulse rate of an infant?
80-140
110
What is the pulse rate of a neonate?
(newborn up to 30 days): 120-160
111
What are the different kinds of rhythms?
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.
112
What is the different kind of pulse quality?
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
113
Where can pulse be felt?
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
114
What is tachycardia?
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
115
What is bradycardia?
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.
116
What is the ventilation rate of adults?
12-20
117
What is the ventilation rate of child?
15-30
118
What is the ventilation rate of infant?
25-50
119
What is the ventilation rate of neonate?
25-50
120
What influences respiratory rate?
age, sex, size, physical conditioning, and emotional state infleunce breathing rates
121
What are the different kinds of breathing rhythms?
regular
irregular
patterned
terminal (last few gaps)
122
What are the different quality types of breathing?
normal (no effort whatsoever- eupnea)
shallow (no chest rise seeing)
labored (tripodding leaning forwards, intercostal retractions)
noisy
123
What is tachypnea?
fast and shallow
124
What is bradypnea?
slow
125
What is apnea?
no breathing
126
What is hyperpnea?
increase rate and depth anxiety attack
127
What is agonal breathing?
last few breaths before dying
128
What is cheyne strokes?
increased rate, increased depth, decrease rate decreased depth apnea internal pressure from brain stem injury
129
What is BIOTS?
rapid deep respirations with period of apnea found in head injury and spinal meningitis usually CNS disorder
130
What is russmaul?
diabetic ketoacidosis renal failures with metabolic acisosis high blood glucose overdose
131
What is agnostic?
terminal breahting in deep and releaseing only a little till a point cant breath anymore brain stem injury.
132
What are upper airway sounds?
snoring (tongue), gurgling (fluid), stridor (something stuck)
133
What are lower airway sounds?
wheezing (constriction of bronchi asthma and COPD), ronchi (phlegm when coughing), rails or crckles (fluid fine and coarse how full it is)
134
What is blood pressure?
the force against the vessel walls during ventricular contraction (systolic) and relaxation/filling (diastolic)
135
What can bp indicates?
changes in bp can tell about physiological changes occuring in the body- systolic, diastolic, and pulse pressure (shock patients)
136
What is the normal bp for adults?
| what is bad/
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
137
What are the blood pressures for infants and children?
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))
138
What is skin etc?
color temperature, and condition of skin can provide valuable information regarding circulation and perfusion
139
What is the best place to assess skin color?
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.
140
How do you feel the person's temperature?
feel patient’s skin with back of hand, not if skin feels nromal (warm), hot, cool, or cold
141
How do you test the skin condition?
dry, wet-diaphoretic
142
What are pupils?
black center of the eye. in a dim enviornment the pupil will dilate, in a bright enviornment the pupil will constrict.
143
What do you do when assessing pulse?
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.
144
What is body temperature?
narrow range of temeprature allows chemical reactions and other activiites to take place inside body with core temperature reflecting level of heat inside trunk
145
What are you looking for when you take body temperature?
ooking for -2 degrees from 98.6oF and normally depdns on time of day, activity, level, temperature outside
146
What is common in high blood sugar patients?
high blood sugar, polys- hungry, thirsty have to pee a lot.
147
What are the different set of vital signs?
first set of vital signs are baselines after that is trending.
148
What is FCC?
| what does it do?
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.
149
What are scanners and what problems do they face?
scanner- ⅓ households have scanner or other device.
150
What is enhanced 911?
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
151
What can dispatcher do?
will remain on line and ask you to hold dispatch units that you need
152
What are the orders of communication?
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
153
What are some things to tell hospital en route/ ?
(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)
154
What things must you say and what order to hospital en route?
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
155
What do you do when handing over care?
introduce patient to nurse and giving with patient knowledge right there if delicate or things concerned about do it outside room
156
What is trauma?
(boo-boo calls, falls gunshot, fights, automobile accidents)
157
What is medical?
(illness pathology, nausea, vomiting, stroke heart attack
158
What are mobile radios?
in fire truck, ambualnce
159
What are portable radios?
ither you or partner have some way of communicating on scene need osme method of communciation
160
What is a base station?
major dispatch center, firehouse, and hospital
161
What are repeaters?
boost signal with higher mountains to pick up signals
162
What are some tips for using the radio?
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
163
What are some things that you have to identify in calls?
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
164
What are some things that have to be in the verbal report?
report given to nurse, chief complaint, history not given preivously, assessment tratment given en route and their medications, addtitional vital signs taken en route
165
What are some tips to work with patients?
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,
166
what is a PCR?
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.
167
What is falsification?
covering up errors, recording something you forgot to do, with correction of errors one line through error, corrected up above, and innitials
168
What are patient refusals?
high liability must do a refusal report
