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EMT-B > Final Exam Review > Flashcards

Final Exam Review Flashcards

1
Q

The parietal peritoneum lines the:

Medical

  1. Walls of the abdominal cavity
  2. Surface of the abdominal organs
  3. Retroperitoneal space
  4. Lungs/chest cavity
A

Walls of the abdominal cavity

Pathophysiology

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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

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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

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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

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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

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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

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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

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8
Q

atorvastatin (Lipitor) & amlodipine (Norvasc) suggest a history of:

Medical

A

cardiovascular disease

Patient Medications

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9
Q

Pulmonary edema + impaired ventilation occur during which type of shock?

Medical

A

cardiogenic shock

Types of Shock

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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

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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

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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

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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

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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

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15
Q

The upper jawbones are called:

Trauma

A. Mastoid
B. Maxillae
C. Zygoma
D. Mandible

A

maxillae

Anatomy & Physiology

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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

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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

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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

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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

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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

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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

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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

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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

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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

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25
Q

Which of the following structures does NOT reside within the mediastinum?

Trauma

A. Lungs
B. Vena cavae
C. Esophagus
D. Trachea

A

lungs

Anatomy & Physiology

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26
Q

An organ/tissue might better resistant damage from hypoperfusion if:

Trauma

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

A

body temp is considerably < 98.6°F

Pathophysiology & Perfusion

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27
Q

Irritation/damage to the pleural surfaces that cause sharp chest pain during inhalation:

Trauma

A. Dyspnea
B. Pneumonitis
C. Pleurisy
D. Pneumothorax

A

pleurisy

Injuries of the Chest

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28
Q

You should be MOST suspicious that patient has experienced significant head injury if pulse is:

Trauma

A. Rapid
B. Irregular
C. Slow
D. Weak

A

slow

Patient Assessment

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29
Q

Which of the following interventions may be used to help reduce intracranial pressure?

Trauma

A. Maintaining SpO2 at 90%
B. Supine with legs elevated
C. 30° elevation of head
D. Increasing body temperature

A

30° elevation of head

Patient Assessment

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30
Q

When assessing an elderly patient who fell, it is important to remember:

Trauma

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

A

osteoporosis can cause fracture as result of fall from standing position

Blunt Trauma

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31
Q

The mesentery is:

Trauma

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

A

membraneous fold that attaches intestines to walls of body

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32
Q

Which of the following is an early sign of pit viper envenomation?

Special Populations

A. General weakness + diaphoresis
B. Syncope + bleeding at distal sites
C. Local swelling + ecchymosis
D. S/S of hypoperfusion

A

local swelling + ecchymosis

Bites & Envenomation

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33
Q

A newborn infant will usually begin breathing spontaneously within ___ seconds

Special Populations

A. 3-5
B. 15-30
C. 5-10
D. 30-60

A

15-30 sec

Neonatal Assessment & Resuscitation

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34
Q

Burns associated with lightning strikes are typically:

Special Populations

A. 3rd degree
B. Full-thickness
C. Partial-thickness
D. Superficial

A

superficial

Lightning

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35
Q

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

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

A

direct your partner to begin ventilatory assistance

Fundamentals of Extrication

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36
Q

Febrile seizures are MOST common in children between:

Special Populations

A. 8 months — 8 years
B. 6 months — 6 years
C. 18 months — 10 years
D. 3 months — 4 years

A

6 months - 6 years

Neurologic Emergencies & Management

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37
Q

Which of the following chemicals requires identification with placard, regardless of how many pounds the shipment weighs?

EMS Operations

A. Nonflammable gases
B. Flammable liquids
C. Air-reactive solids
D. Water-reactive solids

A

water-reactive solids

Recognizing a Hazardous Material

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38
Q

Immediate transport is indicated for a child when:

Special Populations

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

A

has history compatible with serious illness

Patient Assessment

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39
Q

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:

Special Populatios

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

A

report exactly what the patient signs + not add any comments

Sensory Disabilities

40
Q

Under what circumstances is a left-ventricular assisst device (LVAD) used?

Special Populations

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

A

as a bridge to heart transplantation while donor heart is being located

Patients with Medical Technology Assistance

41
Q

An infant is premature if:

Special Populations

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

A

weighs < 5 lbs or born before 36 weeks

Complicated Delivery Emergencies

42
Q

Surgical procedure that creates opening between intestines & surface of body that allows for elimination of waste products:

Special Populations

A. Colostomy
B. Gastrostomy
C. Intestinal shunt
D. Gastric stoma

A

colostomy

Patients with Medical Technology Assistance

43
Q

Which of the following conditions is would MOST likely be encountered in a patient with cerebral palsy?

Special Populations

A. Paralysis
B. Brain tumors
C. Type 2 diabetes
D. Seizure disorder

A

seizure disorder

Physical Disabilities

44
Q

Syncope in an older patient is:

Special Populations

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

A

caused by an interruption of blood flow to the brain

Changes in the Nervous System

45
Q

Trench collapses usually involve large areas of falling dirt that weigh approximately ___ per cubic foot.

EMS Operations

A. 100 lbs
B. 50 lbs
C. 200 lbs
D. 150 lbs

A

100 lbs

Specialized Rescue Situations

46
Q

Cardiogenic shock

Medical

Causes, S/S, Treatment

A

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
Q

Obstructive shock

Medical

Causes, S/S, Treatment

A

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
Q

Septic shock

Medical

Causes, S/S, Treatment

A

Causes:
Severe infection

S/S:
1. Warm skin/fever
2. Tachycardia
3. Low BP

Treatment: BOLT

49
Q

Neurogenic shock

Medical

Causes, S/S, Treatment

A

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
Q

Anaphylactic shock

Medical

Causes, S/S, Treatment

A

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
Q

Psychogenic shock (fainting)

Medical

Causes, S/S, Treatment

A

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
Q

Hypovolemic shock

Medical

Causes, S/S, Treatment

A

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
Q

Pelvic inflammatory disease (PID)

Medical

Definition, S/S

A

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
Q

PID Risk Factors

Medical

A
  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
Q

Planes of the body

Medical

Coronal, sagittal, midsagittal, transverse

A
  1. Coronal (frontal) = front/back
  2. Sagittal (lateral) = L/R
  3. Midsaggital (midline) = equal L/R halves
    4.** Transverese** (axial) = top/bottom

CH 6: Human Anatomy

56
Q

Directional Terms

Medical

  1. Anterior
  2. Posterior
  3. Superior
  4. Inferior
  5. Proximal
  6. Distal
  7. Medial
  8. Lateral
  9. Deep
  10. Superficial
A
  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
Q

Compensated vs. Decompensated Shock

Medical

A

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
Q

Abnormal Respiratory Patterns

Medical

  1. Kussmaul respirations
  2. Cheyne Stokes
  3. Biots
  4. Ataxic
  5. Agonal gasps
A
  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
Q

Diabetic ketoacidosis (DKA)

Medical

Mechanism, S/S, Treatment

A

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
Q

Type 1 vs. Type 2 Diabetes

Medical

Mechanism, Onset/diagnosis, Treatment

A

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
Q

New-onset Type 1 Diabetes S/S

Medical

A
  1. Polyuria = frequent urination
  2. Polydipsia = increased thirst
  3. Polyphagia = severe hunger
  4. Weight loss
  5. Fatigue

CH 20: Endocrine Emergencies

62
Q

Symptomatic Hyperglycemia

Medical

Mechanism, Effects in Type 1 vs. 2 DB & Long-term

A

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
Q

Symptomatic Hypoglycemia

Medical

Mechanism, Common Causes, Concerns

A

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
Q

Hyper- vs. Hypo-
Glycemia S/S

Medical

  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
A

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
Q

AEIOU-TIPS

Medical

Altered mental status

A

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
Q

Hematologic Emergencies - Mechanisms

Medical

  1. Sickle cell disease
  2. Hemophilia
  3. Thrombophilia
  4. Deep vein thrombosis (DVT)
  5. Anemia
A
  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
Q

Hematologic Emergencies - Complications

Medical

  1. Sickle cell disease
  2. Hemophilia
  3. Thrombophilia
  4. DVT
  5. Anemia
A

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
Q

Sickle Cell Crisis Indicators

Medical

Physical & Vital Signs

A

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
Q

Organic vs. Functional Disorders

Medical

A

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
Q

Psychosis

Medical

Definition/characteristics, Causes

A

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
Q

Excited Delirium

Medical

eDelirium, Agitation, S/S, Suddn Death

A

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
Q

Warning Signs & Risk Factors of Suicide

Medical

A

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
Q

Posttraumatic Stress Disorder (PTSD)

Medical

Definition, S/S, Dissociative PTSD

A

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
Q

Describe sound + associated conditions

Abnormal Lung Sounds

Medical

  1. Wheezing
  2. Crackles
  3. Rhonchi
  4. Stridor
  5. Decreased/absent
A

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
Q

Continuous Positive Airway Pressure (CPAP)

Medical

Mechanism, Indications, Contraindications

A

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
Q

Early vs. Late S/S of Hypoxia

Medical

A

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
Q

Signs of Normal Breathing (adults)

Medical

A
  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
Q

Signs of Abnormal Breathing

Medical

A
  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
Q

Causes of Inaccurate Pulse Oximetry Readings

Medical

A
  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
Q

Ventilation Rates of Apneic Patient with a Pulse

Medical

Adult, Child, Infant

A

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
Q

Foreign Body Airway Obstruction Emergency Care

Medical

A
  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
Q

Brain Regions & Functions

Medical

Cerebrum, Cerebellum, Brainstem

A

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
Q

Devices/Techniques to Assist Circulation

Medical

  1. Active compression-decompression CPR
  2. Impendance threshold device
  3. Mechanical piston device
  4. Load-distributing band CPR or vest VPR
A
  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
Q

Causes of Respiratory Problems Leading to Cardiac Arrest in Children

Medical

A
  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
Q

When to STOP CPR

Medical

STOP acronym

A

S - starts breathing
T - transferred to another provider
O - out of strength
P - physician directs to discontinue

CH 14: BLS Resuscitation

86
Q

Possible Causes of Vaginal Bleeding

Medical

A
  1. Abnormal menstruation
  2. Trauma
  3. Ectopic pregnancy
  4. Spontaneous abortion
  5. Cervical polyps
  6. Cancer

CH 24: Gyncecologic Emergencies

87
Q

Emergency Care - Poisoning

Medical

  1. Inhalation
  2. Absorption
  3. Ingestion
  4. Injection
A

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
Q

Specific Poisions

Medical

  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
A
  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
Q

Food Poisoning

Medical

  1. Salmonella bacterium
  2. Staphylococcus bacterium
  3. Botulism
A
  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
Q

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

  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
A

GCS score of < or equal to 13 with mechanism attributed to trauma

CH 25: Trauma Overview (Transport & Destinations)

91
Q

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

  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
A

GCS score of < or equal to 13 with mechanism attributed to trauma

CH 25: Trauma Overview (Transport & Destinations)

92
Q

Factors that should be considered when assessing patient who has fallen include all of the following, EXCEPT:

Trauma

  1. Speed of fall
  2. Surface struck
  3. Primary impact point
  4. Height of fall
A

speed of fall

CH 25: Trauma Overview (Blunt Trauma)

93
Q

Signs of pulmonary blast injury include:

Trauma

  1. Irregular pulse
  2. Vomiting blood
  3. Multiple rib fractures
  4. Coughing up blood
A

coughing up blood

CH 25: Trauma Overview (Blast Injuries)

94
Q

When the speed of a motor vehicle doubles, the amount of kinetic energy:

Trauma

  1. doubles
  2. is not affected
  3. quadruples
  4. triples
A

Quadruples

CH 25: Trauma Overview (Energy & Trauma)

95
Q

When treating a patient who experienced pulmonary blast injury, you should:

Trauma

  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
A

avoid giving O2 under positive pressure

CH 25: Trauma Overview (Blast Injuries)

EMT-B (4 decks)

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