Final Exam Review Flashcards
1
Q
The parietal peritoneum lines the:
Medical
- Walls of the abdominal cavity
- Surface of the abdominal organs
- Retroperitoneal space
- Lungs/chest cavity
A
Walls of the abdominal cavity
Pathophysiology
2
Q
Symptomatic hypoglycemia will MOST likely develop if a patient:
Medical
A. Misses 1 or 2 prescribed insulin injections
B. Takes too much of prescribed insulin
C. Markedly overeats + misses insulin dose
D. Eats regular meal followed by mild exertion
A
Takes too much of prescribed insulin
Endocrine Emergencies
3
Q
Separation is especially an issue with medicine used as a(n):
Medical
A. Suspension
B. Solution
C. Gel
D. Elixir
A
suspension
Medication Forms
4
Q
What is the MOST common cause of airway obstruction in an unconscious patient?
Medical
A. Blood clots
B. Tongue
C. Aspirated fluid
D. Vomitus
A
tongue
Opening the Airway
5
Q
The topographic term used to describe the parts of the body that are nearer to the feet is:
Medical
A. Dorsal
B. Inferior
C. Superior
D. Internal
A
inferior
Common Direction, Movement, & Position Terms
6
Q
Diabetic ketoacidosis occurs when:
Medical
A. Cells rapidly metabolize glucose
B. Blood glucose levels rapidly fall
C. Insulin is not available in the body
D. The pancreas produces excess insulin
A
Insulin is not readily available in the body
Endocrine Emergencies
7
Q
Which of the following is NOT a facial bone?
Medical
A. Maxilla
B. Mastoid
C. Zygoma
D. Mandible
A
Mastoid
The Skeletal System: Anatomy
8
Q
atorvastatin (Lipitor) & amlodipine (Norvasc) suggest a history of:
Medical
A
cardiovascular disease
Patient Medications
9
Q
Pulmonary edema + impaired ventilation occur during which type of shock?
Medical
A
cardiogenic shock
Types of Shock
10
Q
Which O2 flowmeter is NOT affected by gravity & can be used in any position when attached to an O2 tank?
Medical
A. Ball-and-float flowmeter
B. Pressure-compensated flowmeter
C. Bourdon-gauge flowmeter
D. Vertical-position flowmeter
A
Bourdon-gauge flowmeter
Supplemental O2
11
Q
The most basic functions of the body (breathing, BP, swallowing) are controlled by:
Medical
A. Cerebral cortex
B. Brain stem
C. Cerebellum
D. Cerebrum
A
brain stem
Anatomy & Physiology
12
Q
A 5-year-old boy has fallen + has severe deformity of forearm near wrist. He has probably sustained a fracture of the __ forearm
Medical
A. Dorsal
B. Proximal
C. Distal
D. Superior
A
distal
Common Direction, Movement, & Position Terms
13
Q
What is the minimum number of chest compressions that should be delivered per min to a 4-month-old infant?
Medical
A. 110
B. 120
C. 90
D. 100
A
100
Infant & Child CPR
14
Q
Hypovolemic shock caused by burns is the result of a loss of:
Medical
A. Plasma
B. RBCs
C. Whole blood
D. Platelets
A
plasma
Types of Shock
15
Q
The upper jawbones are called:
Trauma
A. Mastoid
B. Maxillae
C. Zygoma
D. Mandible
A
maxillae
Anatomy & Physiology
16
Q
The presence of tachycardia following a significant abdominal injury:
Trauma
A. Is always accompanied by hypertension
B. Is most commonly caused by severe pain
C. Should be assumed to be a sign of shock
D. Indicates a state of decompensated shock
A
should be assumed to be a sign of shock
Patient Assessment of Abdominal Injuries
17
Q
A person who experiences a calcaneus fracture after jumping/landing on feet would MOST likely experience an accompanying fracture of the:
Trauma
A. Coccygeal spine
B. Thoracic spine
C. Lumbar spine
D. Symphysis pubis
A
lumbar spine
Specific Musculoskeletal Injuries
18
Q
What is the function of the sternocleidomastoid muscle?
Trauma
A. Allows movement of the head
B. Connects the scapulae together
C. Allows flexion of the neck
D. Provides respiration
A
allows movement of head
Anatomy & Physiology
19
Q
Epidural hematoma is MOST accurately defined as:
Trauma
A. Bleeding between dura mater & brain
B. Bleeding between skull & dura mater
C. Venous lacerations that occur within brain
D. Injury caused by damaged cerebral artery
A
bleeding between the skull & dura mater
Head Injuries
20
Q
External bleeding from a vein is relatively easy to control because:
Trauma
A. Veins hold smaller blood volume
B. Veins are under less pressure
C. Blood typically oozes from a vein
D. Veins carry deoxygenated blood
A
veins are under less pressure
External Bleeding
21
Q
Rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of:
Trauma
A. Myocardial contusion
B. Pericardial tamponade
C. Tension pneumothorax
D. Ruptured aorta
A
myocardial contusion
Other Chest Injuries
22
Q
Partial-thickness burn involves the outer layer of skin + a portion of the:
Trauma
A. Dermal layer
B. Epidermis
C. Muscle fascia
D. Fatty layer
A
dermal layer
Burns
23
Q
Which of the following is a severe burn in a 35 y/o patient?
Trauma
A. Partial-thickness burn to 20% of body surface area
B. Superficial burn covering 50% of body surface area
C. Full-thickness burn to 5% of body surface area
D. Circumferential partial-thickness burn to chest
A
circumferential partial-thickness burn to chest
Burns
24
Q
A “hip fracture” is actually a fracture of the:
Trauma
A. Pelvic girdle
B. Proximal femur
C. Pubic symphysis
D. Femoral shaft
A
proximal femur
Specific Musculoskeletal Injuries
25
Which of the following structures does NOT reside within the mediastinum?
| Trauma
## Footnote
A. Lungs
B. Vena cavae
C. Esophagus
D. Trachea
lungs
| Anatomy & Physiology
26
An organ/tissue might better resistant damage from hypoperfusion if:
| Trauma
## Footnote
A. Body temperature is considerably < 98.6°F
B. HR maintained at > 100 bpm
C. Systolic arterial BP at least 60 mmHg
D. Body’s demand for O2 markedly increased
body temp is considerably < 98.6°F
| Pathophysiology & Perfusion
27
Irritation/damage to the pleural surfaces that cause sharp chest pain during inhalation:
| Trauma
## Footnote
A. Dyspnea
B. Pneumonitis
C. Pleurisy
D. Pneumothorax
pleurisy
| Injuries of the Chest
28
You should be MOST suspicious that patient has experienced significant head injury if pulse is:
| Trauma
## Footnote
A. Rapid
B. Irregular
C. Slow
D. Weak
slow
| Patient Assessment
29
Which of the following interventions may be used to help reduce intracranial pressure?
| Trauma
## Footnote
A. Maintaining SpO2 at 90%
B. Supine with legs elevated
C. 30° elevation of head
D. Increasing body temperature
30° elevation of head
| Patient Assessment
30
When assessing an elderly patient who fell, it is important to remember:
| Trauma
## Footnote
A. Bilateral hip fractures usually occur when elderly person falls
B. Elderly patients who fall usually have secondary injury
C. Any fall in elderly considered high-energy trauma
D. Osteoporosis can cause fracture as result of fall from standing position
osteoporosis can cause fracture as result of fall from standing position
| Blunt Trauma
31
The mesentery is:
| Trauma
## Footnote
A. Membraneous fold that attaches intestines to walls of body
B. Complex network of blood vessels that supply blood to liver
C. Layer of thick skeletal muscles that protects abdominal organs
D. Point of attachment between small & large intestines
membraneous fold that attaches intestines to walls of body
32
Which of the following is an early sign of pit viper envenomation?
| Special Populations
## Footnote
A. General weakness + diaphoresis
B. Syncope + bleeding at distal sites
C. Local swelling + ecchymosis
D. S/S of hypoperfusion
local swelling + ecchymosis
| Bites & Envenomation
33
A newborn infant will usually begin breathing spontaneously within ___ seconds
| Special Populations
## Footnote
A. 3-5
B. 15-30
C. 5-10
D. 30-60
15-30 sec
| Neonatal Assessment & Resuscitation
34
Burns associated with lightning strikes are typically:
| Special Populations
## Footnote
A. 3rd degree
B. Full-thickness
C. Partial-thickness
D. Superficial
superficial
| Lightning
35
A 19 y/o female has just been extricated from her severely damaged car. She is on a long backboard + has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow/shallow respirations, & bilateral closed femur deformities. You should:
| EMS Operations
## Footnote
A. Apply O2 via non-rebreathing mask
B. Stabilize her legs with long board splints
C. Obtain baseline vital signs + transport at once
D. Direct your partner to begin ventilatory assistance
direct your partner to begin ventilatory assistance
| Fundamentals of Extrication
36
Febrile seizures are MOST common in children between:
| Special Populations
## Footnote
A. 8 months — 8 years
B. 6 months — 6 years
C. 18 months — 10 years
D. 3 months — 4 years
6 months - 6 years
| Neurologic Emergencies & Management
37
Which of the following chemicals requires identification with placard, regardless of how many pounds the shipment weighs?
| EMS Operations
## Footnote
A. Nonflammable gases
B. Flammable liquids
C. Air-reactive solids
D. Water-reactive solids
water-reactive solids
| Recognizing a Hazardous Material
38
Immediate transport is indicated for a child when:
| Special Populations
## Footnote
A. Falls from height > 4-5 ft
B. Has possible closed fracture of radius
C. Has history compatible with serious illness
D. Experiencing mild-moderate pain
has history compatible with serious illness
| Patient Assessment
39
When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:
| Special Populatios
## Footnote
A. Avoid any kind of lip movement while he/she is signing
B. Document answers to the questions that the patient has responded to
C. Report exactly what the patient signs + not add any comments
D. Voice what he/she is signing while communicating with patient
report exactly what the patient signs + not add any comments
| Sensory Disabilities
40
Under what circumstances is a left-ventricular assisst device (LVAD) used?
| Special Populations
## Footnote
A. To reduce ventricular pumping force with aortic aneurysm
B. As a bridge to heart transplantation while donor heart is being located
C. To permanently replace function of one or both of ventricles
D. Ensure that ventricles contract at adequate/consistent rate
as a bridge to heart transplantation while donor heart is being located
| Patients with Medical Technology Assistance
41
An infant is premature if:
| Special Populations
## Footnote
A. Weighs < 5.5 lbs or born before 37 weeks
B. Born before 40 weeks or weighs < 7 lbs
C. Born before 38 weeks or weighs < 6 lbs
D. Weighs < 5 lbs or born before 36 weeks
weighs < 5 lbs or born before 36 weeks
| Complicated Delivery Emergencies
42
Surgical procedure that creates opening between intestines & surface of body that allows for elimination of waste products:
| Special Populations
## Footnote
A. Colostomy
B. Gastrostomy
C. Intestinal shunt
D. Gastric stoma
colostomy
| Patients with Medical Technology Assistance
43
Which of the following conditions is would MOST likely be encountered in a patient with cerebral palsy?
| Special Populations
## Footnote
A. Paralysis
B. Brain tumors
C. Type 2 diabetes
D. Seizure disorder
seizure disorder
| Physical Disabilities
44
Syncope in an older patient is:
| Special Populations
## Footnote
A. Most commonly caused by silent MI
B. Caused by interruption of blood flow to brain
C. Generally of no concern unless patient injured
D. Rarely life threatening but should be evaluated by physician
caused by an interruption of blood flow to the brain
| Changes in the Nervous System
45
Trench collapses usually involve large areas of falling dirt that weigh approximately ___ per cubic foot.
| EMS Operations
## Footnote
A. 100 lbs
B. 50 lbs
C. 200 lbs
D. 150 lbs
100 lbs
| Specialized Rescue Situations
46
Cardiogenic shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
1. Inadequate heart function
2. Disease of muscle tissue
3. Impaired electrical system
4. Disease/injury
**S/S:**
1. Chest pain
2. Irregular/weak pulse
3. Crackles (rales)
4. Pulmonary edema
**Treatment: BOLT**
47
Obstructive shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
Mechanical obstruction of cardiac muscle causing decreased in cardiac output
1. Tension pneumothorax
2. Cardiac tamponade
3. Pulmonary embolism
**S/S:**
1. Dyspnea
2. Decreased lung compliance
3. Unilateral, decreased, or absent lung sounds
4. JVD
5. Subcutaneous emphysema
6. Tracheal deviation
7. Beck triad
**Treatment: BOLT**
48
Septic shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
Severe infection
**S/S:**
1. Warm skin/fever
2. Tachycardia
3. Low BP
**Treatment: BOLT**
49
Neurogenic shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
Damaged cervical spine (widespread blood vessel dilation)
**S/S:**
1. Bradycardia
2. Low BP
3. Neck injury
**Treatment:**
1. Spinal immobilization
2. BOLT
50
Anaphylactic shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
Life-threatening allergic reaction
**S/S:**
1. Itching/rash
2. Burning skin
3. Vascular dilation
4. Generalized edema
5. Coma
6. Rapid death
**Treatment:**
1. BOLT
2. Epinephrine
51
Psychogenic shock (fainting)
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
1. Temporary, generalized vascular dilation
2. Anxiety, bad news, sight of injury/blood, prospect of med treatment, severe pain, illness, tiredness
**S/S:**
1. Rapid pulse
2. Normal or low BP
**Treatment:**
1. Determine duration of unconsciousness
2. Supine
3. Vital signs + metnal status
4. Suspect head injury
5. Transport
52
Hypovolemic shock
| Medical
## Footnote
Causes, S/S, Treatment
**Causes:**
Loss of blood/fluid
**S/S:**
1. Rapid/weak pulse
2. Low BP
2. Change in mental status
3. Increased RR
4. Cyanosis
**Treatment: BOLT**
53
Pelvic inflammatory disease (PID)
| Medical
## Footnote
Definition, S/S
Infection of upper organs of reproduction
**S/S:**
1. Generalized lower abdominal pain (usually starts during/after normal menstruation)
2. Pain worsens with walking (shuffling)
3. Abnormal/foul vaginal discharge
4. Fever/chills
5. Pain/burning on urination
6. Increased pain with intercourse
7. Nausea/vomiting
*Nonemergency transport recommended*
| Chapter 24: Gynecologic Emergencies
54
PID Risk Factors
| Medical
1. Multiple sex partner &/or partner with multiple sex partners
2. Untreated STD
3. Past history of PID
4. Sexually active
5. < 26 y/o
6. IUD
| CH 24: Gynecologic Emergencies
55
Planes of the body
| Medical
## Footnote
Coronal, sagittal, midsagittal, transverse
1. **Coronal** (frontal) = front/back
2. **Sagittal** (lateral) = L/R
3. **Midsaggita**l (midline) = equal L/R halves
4.** Transverese** (axial) = top/bottom
| CH 6: Human Anatomy
56
Directional Terms
| Medical
## Footnote
1. Anterior
2. Posterior
3. Superior
4. Inferior
5. Proximal
6. Distal
7. Medial
8. Lateral
9. Deep
10. Superficial
1. **Anterior** (ventral) = front surface
2. **Posterior** (dorsal) = back surface
3. **Superior** = closest to head
4. **Inferior** = closest to feet
5. **Proximal** = closest to point of attachment
6. **Distal** = farthest from point of attachment
7. **Medial** = closest to midline
8. **Lateral** = farthest from midline
9. **Deep** = farthest from surface of skin
10. **Superficial **= closest to surface of skin
| CH 5: Medical Terminology
57
Compensated vs. Decompensated Shock
| Medical
**Compensated:**
1. Agitation, anxiety, restlessness, impending doom
2. Weak/rapid (thready) pulse
3. Pale, cool, moist skin
4. Cyanosis
5. Shallow/rapid breathing
6. Nausea/vom
7. Thirst
8. Narrowing pulse pressure
**Decompensated:**
1. Falling BP (< 90 mmHg)
2. Declining mental status
3. Labored/irregular breathing
4. Ashen, mottled, cyanotic skin
5. Thready/absent peripheral pulses
6. Dilated pupils
7. Poor urinary output
| CH 13: Shock (Table 13-3 Progression of Shock)
58
Abnormal Respiratory Patterns
| Medical
## Footnote
1. Kussmaul respirations
2. Cheyne Stokes
3. Biots
4. Ataxic
5. Agonal gasps
1. **Kussmaul** = rapid, deep, labored
*(DKA/diabetic emegency)*
2. **Cheyne stokes** = irregular, shallow/deep, spaced by apnea
*(hypoxia, drug use)*
3. **Biots** = shallow/normal depth, spaced w/ apnea
*(stroke, opiod OD, damage to pons)*
4. **Ataxic** = irregular/disorganized, long pauses of apnea
*(stroke, trauma to medulla oblongata - brainstem)*
5. **Agonal gasps** = slow/gasping
*(cardiac arrest)*
| CH 11: Airway Management
59
Diabetic ketoacidosis (DKA)
| Medical
## Footnote
Mechanism, S/S, Treatment
**Mechanism:**
1. Glucose unavailable to cells → body burns fat
2. Produces acid waste (ketones)
3. Kidneys saturated & cannot maintain acid-base balance
**S/S:**
1. Abdominal pain
2. Body aches
3. Nausea/vom
4. Altered mental status/unconsciousness
5. Sweet/fruity breath
6. Dry/warm skin
5. Kussmaul respirations
6. BGL > 400 mg/dL
**Treatment:** O2 + monitor ventilations (assist if indicated)
| CH 30: Endocrine Emergencies
60
Type 1 vs. Type 2 Diabetes
| Medical
## Footnote
Mechanism, Onset/diagnosis, Treatment
**DB Type 1:** autoimmune disorder in which immune system produces antibodies against pancreatic beta cells
* Onset = early childhood though 4th decade of life
* Most common metabolic disease of childhood
* Treatment = implanted insulin pump
**DB Type 2:** resistance to effects of insulin at cellular level
* Often diagnosed at yearly med exam (recurrent infection, change in vision, numbness in feet)
* Treatment = oral meds, injectable meds/insulin, exercise, diety
| CH 20: Endocrine Emergencies
61
New-onset Type 1 Diabetes S/S
| Medical
1. **Polyuria** = frequent urination
2. **Polydipsia** = increased thirst
3. **Polyphagia** = severe hunger
4. Weight loss
5. Fatigue
| CH 20: Endocrine Emergencies
62
Symptomatic Hyperglycemia
| Medical
## Footnote
Mechanism, Effects in Type 1 vs. 2 DB & Long-term
*Very high BGL (120-400 mg/dL) → altered mental status*
* **Type 1** → ketoacidosis + dehydration (excessive urination)
* **Type 2** → nonketotic hyperosmolar state
**Long-term**:
1. Wounds that don't heal
2. Numbness in hands/feet
3. Blindness
4. Renal failure
5. Gastric motility problems
| CH 20: Endocrine Emergencies
63
Symptomatic Hypoglycemia
| Medical
## Footnote
Mechanism, Common Causes, Concerns
*Acute emergency in which BGL drops (50-0 mm/dL)*
**Common causes:**
1. Correct insulin dose + change in routine
2. Too much insulin
3. Correct insulin dose + not enough food
4. Correct insulin dose + acute illness
Develops quickly (altered mental status) → unconsciousness + permanent brain damage
| CH 20: Endocrine Emergencies
64
Hyper- vs. Hypo-
Glycemia S/S
| Medical
## Footnote
1. Onset
2. Skin
3. Infection
4. Thirst
5. Hunger
6. Vom/abdom. pain
7. Breathing
8. Breath odor
9. BP
10. Pulse
11. Consciousness
12. Treatment response
**Hyperglycemia:**
1. Onset = gradual (hours-days)
2. Skin = warm/dry
3. Infection = common
4. Thirst = intense
5. Hunger = present + increasing
6. Vom/abdom. pain = common
7. Breathing = Kussmaul
8. Breath odor = sweet/fruity
9. BP = normal/low
10. Pulse = rapid/weak/thready
11. Consciousness = restless, abnormal/slurred speech
12. Treatment response = gradual (6-12 hours)
**Hypoglycemia:**
1. Onset = rapid (mins)
2. Skin = pale/cool/moist
3. Infection = uncommon
4. Thirst = absent
5. Hunger = absent
6. Vom/abdom. pain = uncommon
7. Breathing = normal (unless severe)
8. Breath odor = normal
9. BP = normal/low
10. Pulse = rapid/weak
11. Consciousness = irritable, confusion, seizure
12. Treatment response = immediate
| CH 20: Endocrine Emergencies
65
AEIOU-TIPS
| Medical
## Footnote
Altered mental status
**A** - alcohol
**E** - epilepsy, endocrine, electrolytes
**I** - insulin
**O** - opiates/other drugs
**U** - uremia (kidney failure)
**T** - trauma, temperature
**I** - infection
**P** - poisoning, psychogenic causes
**S** - shock, stroke, seizure, space-occupying lesion, subarachnoid hemorrhage
| CH 20: Endocrine Emergencies
66
Hematologic Emergencies - Mechanisms
| Medical
## Footnote
1. Sickle cell disease
2. Hemophilia
3. Thrombophilia
4. Deep vein thrombosis (DVT)
5. Anemia
1. **Sickle cell disease**: mishapen RBCs → dysfunction in O2 binding + unintentional clot formation → vasooclusive crisis (ischemia/hypoxia, pain organ damage)
2. **Hemophilia**: decreased ability to create clot → life-threatening
3. **Thrombophilia**: disorder in ability to maintain smooth flow of blood → clogging/blockage issues
4. **DVT**: clot formation in sendentary partients (injury/surgery) → can travel to lungs → pulmonary embolus
5. **Anemia**: abnormally low RBCs → inadequate O2 delivered to tissues
| CH 20: Hematologic Emergencies
67
Hematologic Emergencies - Complications
| Medical
## Footnote
1. Sickle cell disease
2. Hemophilia
3. Thrombophilia
4. DVT
5. Anemia
**Sickle cell disease:**
1. Anemia
2. Gallstones
3. Jaundice
4. Splenic dysfunction
5. Vascular occlusion w/ ischemia
6. More susceptible to infections
**Hemophilia:**
1. Long-term joint problems
2. Bleeding in brain
3. Thrombosis (due to treatment)
**Thrombophilia:**
1. Spontaneous clot formation
**DVT:**
1. Pulmonary embolus
**Anemia:**
1. Pulse oximetry may indicate adequate saturation even though tissues hypoxic
| CH 20: Hematologic Emergencies
68
Sickle Cell Crisis Indicators
| Medical
## Footnote
Physical & Vital Signs
Physical signs:
1. Swelling of fingers/toes
2. Priapism
3. Jaundice
Vital signs:
1. Normal - rapid respirations
2. Weak/rapid pulse
3. Pale/clammy skin
4. Low BP
| CH 20: Hematologic Emergencies
69
Organic vs. Functional Disorders
| Medical
**Organic brain syndrome:** temporary or permanent dysfunction of brain caused by disturbance in physical/physiologic functioning of brain tissue
**Functional disorders:** physiologic disorder that impairs bodily function when body seems to be structurally normal
| CH 23: Behavioral Emergencies
70
Psychosis
| Medical
## Footnote
Definition/characteristics, Causes
State of delusion in which person is out of touch with reality (live in own reality of ideas/feelings)
Causes:
1. Substances
2. Intense stress
3. Delusional disorders
4. Schizophrenia
| CH 23: Behavioral Emergencies
71
Excited Delirium
| Medical
## Footnote
eDelirium, Agitation, S/S, Suddn Death
**Delirium:** impairment in cognitive function that can present with disorientation, hallucinations, or delusions
**Agitation:** characterized by restless/irregular physical activity
**S/S:**
1. Hyperactive irrational behavior
2. Vivid hallucinations
3. Hypertension
4. Tachycardia
5. Diaphoresis
6. Dilated pupils
**Can lead to sudden death from:**
1. Sudden cardiopulmonary arrest
2. Physical agitation (metabolic acidosis?)
3. Physical control measures (tasers)
4. Stimulant drugs/alcohol withdrawal
5. Positional asphyxia
| CH 23: Behavioral Emergencies
72
Warning Signs & Risk Factors of Suicide
| Medical
**Warning signs:**
1. Sadness, deep despair, hopelessness
2. Appearing detached from situation
3. Inability to talk about the future
4. Suggestions of suicide
5. Specific plans for committing suicide
**Risk factors:**
1. Presence of unsafe object
2. Unsafe environment
3. Self-destructive behavior
4. Imminent threat to patient/others
5. Underlying medical problems
6. Cultural, religious, or social beliefs promoting suicide
7. Recent physical/psychological trauma
*Depression = most significant contributing factor*
| CH 23: Behavioral Emergencies
73
Posttraumatic Stress Disorder (PTSD)
| Medical
## Footnote
Definition, S/S, Dissociative PTSD
Occurs after exposure to/injury from traumatic event
**S/S:**
1. Helplessness
2. Anxiety
3. Anger
4. Fear
5. Avoid things that remind of trauma
6. Constant NS arousal not easily suppressed
7. Flashbacks
**Dissociative PTSD:** occurs when person attempts to find escape from constant internal distress or disturbing event
| CH 23 Behavioral Emergencies
74
# Describe sound + associated conditions
Abnormal Lung Sounds
| Medical
## Footnote
1. Wheezing
2. Crackles
3. Rhonchi
4. Stridor
5. Decreased/absent
**Wheezing** → constriction/inflammation in bronchus
* Heard on EXHALATION
* High-pitched whistling sound
* *Associated: asthma & COPD*
**Crackles (rales)** → air trying to pass through fluid in alveoli
* Crackling/bubbling on INHALATION
* Fine crackles = high-pitched
* Coarse crackles = low-pitched
* *Associated: CHF or pulmonary edema*
**Rhonchi** → low-pitched rattling sounds caused by secretions/mucus in larger airway
* Junky lung sounds
* *Associated: infections (pneumonia/bronchitis), aspiration, COPD*
**Stridor** → air tries to pass through obstruction in upper airway
* High-pitched sound heard on INHALATION
* Partial obstruction of trachea
* *Associated: Croup, Epiglottitis, foreign body obstruction*
**Decreased/absent sounds** → partial/complete obstruction
* *Associated: asthma, COPD, pneumonia, hemothorax, pneumothorax, atelectasis*
| CH 16: Respiratory Emergencies
75
Continuous Positive Airway Pressure (CPAP)
| Medical
## Footnote
Mechanism, Indications, Contraindications
**Mechanism:**
1. Increases pressure in lungs
2. Opens collapsed alveoli
3. Pushes O2 across alveolar membrane
4. Forces interstitial fluid back into pulmonary circulation
**Indications:**
1. Moderate-severe resp distress (pulomary edema, COPD, bronchospasm)
2. Resp distress after submersion incident
3. Overall minute volume affected by rapid breathing
4. SpO2 < 90%
5. Alert/able to follow commands
**Contraindications:**
1. Respiratory arrest/agonal resp
2. Hypoventilating
3. Unresponsive/unable to follow commands/can't protect airway
4. Hypotension
5. Pneumothorax/chest trauma
6. Tracheostomy
7. GI bleeding/vom
8. Facial trauma
9. Cardiogenic shock
10. Can't sit upright
| CH 11: Airway Management
76
Early vs. Late S/S of Hypoxia
| Medical
**Early:**
1. Anxiety/restlessness, irritability, apprehension
2. Tachycardia
**Late:**
1. Mental status change
2. Weak/thready pulse
3. Cyanosis
4. Dyspnea
| CH 11: Airway Management
77
Signs of Normal Breathing (adults)
| Medical
1. 12-20 breaths/min
2. Regular pattern of inhalation/exhalation
3. Bilateral/clear/equal lung sounds
4. Regular/equal chest rise/fall
5. Adequate depth (tidal volume)
| CH 11: Airway Management
78
Signs of Abnormal Breathing
| Medical
1. < 12 or > 20 breaths/min
2. Irregular rhythm
3. Reduced fow of expired air at nose/mouth
4. Unequal/inadequate chest expansion
5. Labored breathing (increassed effort + accessory muscle use)
6. Shallow depth
7. Pale/cyanotic/cool/moist skin
8. Retractions (ribs/clavicles)
| CH 11: Airway Management
79
Causes of Inaccurate Pulse Oximetry Readings
| Medical
1. Hypovolemia
2. Severe peripheral vasoconstriction
3. Time delay in detecting respiratory insufficiency
4. Dark/metallic nail polish
5. Dirty fingers
6. CO posioning
| CH 11: Airway Management
80
Ventilation Rates of Apneic Patient with a Pulse
| Medical
## Footnote
Adult, Child, Infant
**Adult** = 1 breath per 5-6 sec
**Child** = 1 breath per 2-3 sec
**Infant** = 1 breath per 2-3 sec
| CH 11: Airway Management
81
Foreign Body Airway Obstruction Emergency Care
| Medical
1. Head tilt-chin lift maneuver (or jaw thrust)
2. Sweep out large pieces with gloved finger
3. Suction
4. Responsive - adominal thrusts (dislodge)
5. Unresponsive - chest compressions (check in mouth)
6. Facial bleeding - direct pressure + suction
| CH 11: Airway Management
82
Brain Regions & Functions
| Medical
## Footnote
Cerebrum, Cerebellum, Brainstem
**Cerebrum** = higher brain function
1. Frontal lobe
2. Parietal lobe
3. Occipital lobe
4. Temporal lobe
**Cerebellum** = balance, muscle coordination, posture
**Brainstem** = basic life functions *(cardiac, respiratory, consciousness)*
1. Midbrain
2. Pons
3. Medulla oblongata
4. Reticular activating system (RAS) - consciousness
| CH 6: Human Body
83
Devices/Techniques to Assist Circulation
| Medical
## Footnote
1. Active compression-decompression CPR
2. Impendance threshold device
3. Mechanical piston device
4. Load-distributing band CPR or vest VPR
1. **Active compresion-decompression CPR:** compressing chest then actively pulling it back up to its neutral position or beyond (increases blood returning to heart)
2. **Impendance threshold device (ITD):** valve device placed between ET tube & bag-mask device to limit air entering lungs during recoil phase (ngetive pressure draws more blood to heart)
3. **Mechanical piston device:** depresses sternum via plunger mounted on backboard (frees rescuer)
4. **Load-distributing band CPR** or **vest CPR:** circumferential chest compression device
| CH 14: BLS Resuscitation
84
Causes of Respiratory Problems Leading to Cardiac Arrest in Children
| Medical
1. Injury (blunt/penetrating)
2. Infections (resp. tract or other organ)
3. Foreign body obstruction
4. Submersion (drowning)
5. Electrocusion
6. Poisoning/drug OD
7. SIDS
| CH 14: BLS Resuscitation
85
When to STOP CPR
| Medical
## Footnote
STOP acronym
S - starts breathing
T - transferred to another provider
O - out of strength
P - physician directs to discontinue
| CH 14: BLS Resuscitation
86
Possible Causes of Vaginal Bleeding
| Medical
1. Abnormal menstruation
2. Trauma
3. Ectopic pregnancy
4. Spontaneous abortion
5. Cervical polyps
6. Cancer
| CH 24: Gyncecologic Emergencies
87
Emergency Care - Poisoning
| Medical
## Footnote
1. Inhalation
2. Absorption
3. Ingestion
4. Injection
Inhalation:
1. Move to fresh air
2. Give O2
3. Immediate transport
Absorption:
1. Remove substance
2. Flush/wash skin
Ingestion:
1. Protect from aspirating vom
2. Activated charcoal
Injection:
1. Give O2
2. Be alert for nausea/vom
3. Remove accessories around inject site (swelling)
| CH 22: Toxicology
88
Specific Poisions
| Medical
## Footnote
1. Alcohol
2. Opioids
3. Sedative-hypnotic drugs
4. Abused inhalants
5. Hydrogen sulfide
6. Sympathomimetics
7. Synthetic cathinones
8. Marijuana
9. Hallucinogens
10. Anticholinergic agents
11. Cholinergic agents
1. **Alcohol** → CNS depressant
2. **Opioids** → narcotic for pain
3. **Sedative-hypnotic drugs** → CNS depressant (barbituates + benzodiazepines)
4. **Abused inhalants** → displace O2 in brain + euphoria rush
5. **Hydrogen sulfide** → highly toxic, colorless, flammable gas with rotten egg odor
6. **Sympathomimetics** → stimulants that mimic effect of sympathetic NS
7. **Synthetic cathinones** → euphoria, mental clarity, sexual arousal (similar to MDMA)
8. **Marijuana** → euphoria, relaxation, drowsiness
9. **Hallucinogens** → alter sensory perveptions ("trip")
10. **Anticholinergic agents** → block parasympathetic NS (block ACh)
11. **Cholinergic agents** → overstimulate parasympathetic NS (ACh)
| CH 22: Toxicology
89
Food Poisoning
| Medical
## Footnote
1. Salmonella bacterium
2. Staphylococcus bacterium
2. Botulism
1. **Salmonella bacterium** → severe GI symptoms within 72 hours of ingestion
2. **Staphylococcus bacterium** → sudden GI symptoms 2-3 or 8-12 hours after ingestion
3. **Botulism** → fatal neurolgic symptoms 1-4 days after ingestion (blurred vision, weakness, difficulty speaking/breathing)
| CH 22: Toxicology
90
According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level. of trauma center if he/she:
| Trauma
## Footnote
1. Has a bleeding disorder or takes anticoagulant medications & has any blunt/penetrating injury
2. Has a systolic blood pressure of < 100 mmHg or HR > 110 bpm
3. Has a GCS score of < or equal to 13 with a mechanism attributed to trauma
4. Was involved in. amotor vehicle crash in which another patient in the same vehicle was killed
GCS score of < or equal to 13 with mechanism attributed to trauma
| CH 25: Trauma Overview (Transport & Destinations)
91
According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level. of trauma center if he/she:
| Trauma
## Footnote
1. Has a bleeding disorder or takes anticoagulant medications & has any blunt/penetrating injury
2. Has a systolic blood pressure of < 100 mmHg or HR > 110 bpm
3. Has a GCS score of < or equal to 13 with a mechanism attributed to trauma
4. Was involved in. amotor vehicle crash in which another patient in the same vehicle was killed
GCS score of < or equal to 13 with mechanism attributed to trauma
| CH 25: Trauma Overview (Transport & Destinations)
92
Factors that should be considered when assessing patient who has fallen include all of the following, EXCEPT:
| Trauma
## Footnote
1. Speed of fall
2. Surface struck
3. Primary impact point
4. Height of fall
speed of fall
| CH 25: Trauma Overview (Blunt Trauma)
93
Signs of pulmonary blast injury include:
| Trauma
## Footnote
1. Irregular pulse
2. Vomiting blood
3. Multiple rib fractures
4. Coughing up blood
coughing up blood
| CH 25: Trauma Overview (Blast Injuries)
94
When the speed of a motor vehicle doubles, the amount of kinetic energy:
| Trauma
## Footnote
1. doubles
2. is not affected
3. quadruples
4. triples
Quadruples
| CH 25: Trauma Overview (Energy & Trauma)
95
When treating a patient who experienced pulmonary blast injury, you should:
| Trauma
## Footnote
1. administer large amounts of IV fluid
2. avoid giving O2 under positive pressure
3. suspect an sccompanying cardiac tamponade
4. use demand valve to ventilate
avoid giving O2 under positive pressure
| CH 25: Trauma Overview (Blast Injuries)
