Final Exam study guide pt.1 Flashcards
Lets finish strong
normal vitals for each age group
Newborn, P: 100-170, RR: 30-60, BP: 50-70
Infant, (birth-1 year) P: 90-160, RR: 30-60, BP: 90
Toddler, (12-36months)P: 80-140, RR: 24-40, BP:90+
Preschoolers, (3-5) P: 70-120, RR: 22-34, BP:90+
school age, (6-12)P: 65-120, RR: 18-30, BP:90+
adolescence (13-18), P: 60-100, RR: 12-20, BP: 107-117
Adult, (19-61+)P: 60-100, RR: 12-20, BP: Less than or equal to 120
patient positioning and when would you use each
Prone: face down and it helps with respiratory distress
Supine: lying on the back, this is used for procedures or physical exams
Recovery (lateral recumbent): patient lying on either left or right side, used for any unconscious trauma patient for mouth drainage.
Fowler: a sitting position, usually used when transporting and putting a patient on a stretcher
2 types of stroke s/s?
Ischemic stroke: Certain trouble speaking, confusion, trouble walking, loss of balance coordination, severe headache with no cause.
Hemorrhagic stroke.: Weakness of one side of the body, or paralysis of one side of the body, seizures, sensitivity to light.
What is a TIA
This stands for a transient ischemic attack or mini stroke. The symptoms are very similar to stroke. but doesn’t cause permitted damage.
What is DCAP-BTLS
Used when performing a head to toe Or focused physical exam:
Deformities
Contusions
Abrasions
Punctures
Burns
Tenderness
Lacerations
Swelling
A deep cut or tear into skin exposes skin tissue and or muscle
Laceration
treatment:
1. direct pressure over a dressing (do not pull apart edged of a laceration)
2. bandage dressing in place using wound closure strips
3. place a gauze dressing and bandage over the laceration where wound strips were applied
A scratch or scrape
Abrasion
treatment: keep area clean and apply gauze also reduce wound contamination
Then tearing away or tearing off of a piece of flap or skin or other soft tissue.
Avulsion
Treatment:
1. clean wound surface of gross contaminants (only)
2. Fold skin back into normal position
3. control bleeding and dress the wound with bulky dressing
A surgical cut made in skin or in flesh
Incision
Surgical removal or traumatic severing of a body part
Amputation
treatment:
1. Apply direct pressure and then use a tourniquet if direct pressure fails or not possible
2. wrap amputated part in sterile dressing secure dressing with self-adhesive gauze bandage
3. Wrap or bag amputated part in a plastic bag keep it cool by using cold packs (do not immerse part in ice water or salin)
An intestine or other internal organ protruding through a wound in the abdomen
evisceration
treatment:
1. cut away clothing from the wound
2. soak a sterile dressing with sterile saline
3. place moist dressing over wound
4. apply occlusive dressing over the moist dressing if protocols recommend cover dressed wound to maintain warmth. Secure the covering with tape or cravats tied above and below the position of the exposed organ
routes of exposure
inhalation, ingestion absorption, injection
treatment of different chemical burns
Mixed or strong acids or unidentified substances: play safe and continue washing even after the patient claims the patient is no longer experiencing pain
Dry lime: brush off the lime then use water once the lime has been brushed off the body
Carbolic acid(phenol): use alcohol for initial wash of unbroken skin, followed by a steady wash with water
Sulfuric Acid: still wash with water rather than leave on skin
Hydrofluoric acid: flood with water do not delay care or transport to find neutralizing agents
Inhaled vapors: provide high concentration oxygen transport as soon as possible
hyper and hypoglycemia, treatment?
hyperglycemia is high blood sugar treatment short acting insulin
Hypoglycemia is low blood sugar treatment would be eating or drinking something with sugar in it or if indicated oral glucose
type 1 and 2 diabetes
diabetes is a condition when your blood glucose is to high
type1: pancreas creates little to no insulin
type2: body has a hard time controlling blood sugar and using it for energy
s/s of respiratory distress treatment
visibly short of breath
speaking 3-4 word sentences
increasing anxiety
Treatment: nonrebreather 10-15l/min
s/s of respiratory failure treatment?
spo2 lower than 95%, shallow ventilations, patient has some breathing but not enough to live
treatment: pocket mask or bag valve mask
what is respiratory arrest, treatment?
When the patient is not breathing at all
treatment: pocket face mask or bag valve mask 10-12/min for adult 12-20.min for infant or child
The supplier of oxygen tool and removal from the body cells and tissue was as a result of the flow of blood through the capillaries
perfusion
The body’s inability to adequately Circulate blood to the body cells and has a problem with oxygen and nutrients.
hypoperfusion
Shock resulting from blood or fluid loss.
Hypovolemic shock.
shock resulting from blood loss
Hemorrhagic shock.
Shock or lack of fraction brought on not by blood loss, but by the hearts inadequate pumping action often the result of an MI or CHF.
cardiogenic
hypoperfusion due to the lack of blood vessel tone, blood vessel dilation leads to decreased pressure within the circulatory system.
distributive shock
hypoperfusion caused by spinal cord injury that results in systemic vasodilation
neurogenic shock
shock when the flow of blood is locked
obstructive
compensated vs decompensated shock
Compensated is when shock is developing but the body is still able to maintain perfusion
Decompensated is when the body can no longer compensate for low blood volume or lack of perfusion
A professional telecommunicator tasked with the gathering of information related to medical emergencies.
EMD
A medical emergency that involves a transient disturbance in consciousness and cognition. signs and symptoms are unexpected physical strength, violence towards others, paranoia
excited delirium
When the patient has thoughts or experiences that seem out of touch with reality
schizophrenia
s/s: Hallucination, amnesia, mental confusion, paranoia, fear, incoherent speech
high energy injuries to the femur
Midshaft femur fracture
s/s: inability to stand or walk, bone pushing through the skin, bruising swelling
s/s of anterior hip dislocation
the patient’s entire lower limb is rotated outward, and the hips are usually flexed
S/S of posterior hip dislocation
the patient’s lower leg is rotated inward, the hip is flexed, and knees are bent. patient is unable to lift foot or flex toes
treating a musculoskeletal injury
- take and maintain appropriate standard precautions
- perform primary assessment
- during secondary assessment apply cervical collar if you suspect spinal injury
- after life threatening conditions have been addressed, splint fractures
5.cover wounds with sterile dressing, elevate the extremity and apply a cold pack to the area to reduce swelling
the significance of a femur and pelvic fracture
femur fractures cause 2-pint blood loss while pelvic fractures cause 3-4 pints of blood loss also it sometimes can be hard to tell a fractured pelvis from an upper femur fracture
how does a fracture affect the growth of a bone in peds
since their bones are more flexible, they break easier, also in fractures you lose blood and if there is not enough blood circulation it can lead to deformity and stunted growth of that bone
s/s of pneumothorax, tension, spontaneous and hemothorax
pnuemo: air in the chest cavity
Tension: buildup of air puts pressure on the heart and vena cava causing shock
spontaneous: lung collapses without any obvious cause
Hemo: the chest cavity fills with blood
Hemo pnuemo: chest cavity fills with air and blood
s/s: Respiratory difficulty, uneven chest wall movement, reduction or absence of breath sounds
tension specifically: signs of hypoxia and cyanosis, indications of shock, distended neck veins unless hypovolemic, tracheal deviation to uninjured side
hemo specifically: coughed up frothy red blood
How do we treat chest pain
chewable baby aspirin 162-324 mg
Dizziness and a drop in blood pressure caused when the mother is in a supine position and the weight of the uterus, infant, placenta and amniotic fluid compresses the inferior vena cava
Supine hypotensive syndrome (vena cava compression syndrome)
Treatment: lay mother on the left recumbent side a pillow or rolled blanket should be placed behind the back to maintain position (if the patient is in cardiac arrest and can’t be moved manually and gently displace the uterus by pulling it toward the patients left side
a medical condition that causes seizures
epilepsy
what are the different types of seizures
Partial: affects only one part or one side of the brain
types of partial: complex partial (patient appears to be drunk or on drugs). simple partial(stiffining and tingling in one part of the body).
Generalized: affects both sides of the brain
Types of generalized: Absence (no dramatic motor activity instead temporary loss of consciousness and awareness. Tonic-clonic (patient loses consciousness and has jerking movement of paired muscle groups)
inflammation of the meninges, the membranes that surround the brain and spinal cord
meningitis
s/s: nuchal rigidity (neck stiffness), photophobia (sensitivity to light)
A headache that can cause severe throbbing pain or a pulsing sensation on one side of the head
Migrane
the use of positive pressure to force air or oxygen into the lungs
positive pressure ventilation or artificial ventilation
When should you use a NRB over BVM
NRB when the patient shows signs of respiratory distress but can manage their airway and is consciousness
Use a BVM when the patient cannot manage their own airway
BVM usage scenario
15L/min cannot manage their own airway
ex: RR:8/min SPO2:86% and unresponsive
Nasal canula when to use and scenario
Use a nasal canula when the patient RR and SPO2 are not far off from normal readings
Ex:(1-6L/min) RR: 22/min, SPO2: 92% W:3-4
NRB usage and scenario
10-15L/min Ex: RR:26 SPO2: 90% W:1-2
An irregular and often very rapid heart rhythm
Atrial fibrilation
When an EMT acts with proper care and concern
due regard
4 abdominal quadrants and what organs are in each
RUQ: right portion of liver, gallbladder, right kidney, small portion of the stomach, duodenum, part of small intestine
RLQ: appendix, part of the small intestine right ureter, and right half of the female reproductive system
LUQ: left portion of liver, larger portion of the stomach, pancreas, left kidney, spleen, part of small intestine
LLQ: Large intestine, left ureter, left female reproductive system
A dressing that is used to form an airtight seal when caring for wounds to the abdomen, for external bleeding from large neck veins and for open wounds to the chest
occlusive dressing
The record you produce during a call
PCR prehospital care report
A burn that only includes the epidermis, characterized by reddening of the skin and perhaps some swelling
superficial burn or first-degree burn
A burn in which the epidermis is burned through, and the dermis is damaged. this burn causes reddening, blistering and molted appearance
Partial thickness or second-degree burn
a burn in which all the layers of the skin are damaged. usually, charred areas black or dry areas that are dry and white
Full thickness burns or third-degree burn
treating thermal burns
- stop the burn
- Ensure open airway assess breathing
- Look for signs of airway injury
- complete primary assessment
- treat for shock
- do not clear debris remove clothing and jewelry
- wrap with sterile dressing
s/s of smoke inhalation
Shortness of breath, wheezing, coughing, chest pain headache, trouble speaking
A method for estimating the extent of a burn. The palm and fingers of the patient’s own hand, which make up about 1% of the body’s surface area, are compared with the patient’s burn to estimate its size.
rule of palm
A method for estimating the extent of a burn for an adult. Each of the following areas represents 9% of the body’s surface. The head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks. The front of each lower extremely and the back of each low extremity. The remaining 1% is assigned to the genital region.
rule of nines
What is CHF s/s?
congestive heart failure
s/s: JVD dyspnea, tachycardia
A condition when a patients airway becomes inflamed, narrow and swell, produces extra mucus which makes it harder to breath
Asthma (Bronchial Asthma)
The result of an infection by any one of a number of different microbes.
pneumonia
A class of drugs that affects the nervous system and changes many normal body activities
Opioids
treatment for overdose
- perform primary assessment
- treat for shock
perform physical exam - protect patient from self-injury and injury to others
transport ASAP - perform reassessment
- continue to reassure the patient throughout course of care
A brain injury or another medical condition that can cause growing pressure inside your skull
ICP (Intercranial pressure)
s/s headache, blurred vision, vomiting, lack of energy or sleepiness
A command organization in which a single agency controls all resources and operations
Single incident command
command organization in which several agencies work independently but cooperatively
unified command
A subset of NIMS designed specifically for management of MCI’s
(ICS) Incident Command System
a bacterial infection that mainly infects the lungs
tuberculosis
s/s: chronic cough or with blood and swollen lymph nodes
abnormally low RBC’S in the circulation due to SCD
Sickle cell anemia, types of issues that result from this is their hemoglobin is an abnormal structure which leads to blood clots, acute chest syndrome
irritation and inflammation of the stomach and intestines. This causes diarrhea, vomiting and nausea.
Gastroenteritis (stomach flu)
inflammation of the pancreas
pancreatitis
inflammation of the appendix
appendicitis
S/S: nausea and sometimes vomiting, initial pain in the umbilicus, followed by persistent pain in the RLQ
When do you use CPAP
You can use CPAP when there are indications of COPD, Asthma and Respiratory distress, Pulmonary Edema and drowning
What is the compression rate for CPR
100-120/min
A_issue is usually the cause of cardiac arrest in peds
steady decompensation
what is the usual cause for cardiac arrest in adults?
Acute coronary syndrome
what order do we use an AED
- Verify patient is unresponsive, apneic, and pulseless
- provider 1 gives chest compressions while provider 2 readies aed
- Turn on AED
- Bare and prep chest, attach pads
- clear patient for analysis when prompted by AED
What do we do after shock from the AED
- Verbally clear and press shock button
- immediately perform CPR
- If no ROSC analyze and shock again if indicated
- Immediately resume CPR. Repeat analyzation and shock two times if indicated
- If no ROSC, prepare for transport follow protocol
When to recheck pulse during CPR
If prompted by AED or if ROSC occurs
When an injury to the heart causes blood to flow into the surrounding pericardial sac and to compress the heart
cardiac tamponade
s/s: distended neck veins, very weak pulse, hypotension, steadily decreasing pulse pressure
Fracture of two or more adjacent ribs, and two or more places that allow for free movement of the fractured segment
flail chest
Movement of the ribs in a flail segment that is opposite to the direction of movement of the direction of movement of the rest of the chest wall
Paradoxical motion
A hole in the muscle layers of the abdominal wall, allowing tissues usually intestines to protrude up against the skin
Hernia
A bruise on the lungs caused by chest trauma
pulmonary contusion
bruise of the heart muscle caused by blunt chest trauma
cardiac contusion or myocardial contusion
When should a patient need full spinal immobilization?
blunt trauma, spinal tenderness or pain, altered level of consciousness
Ballooning or weakening of the wall of the aorta as it passes through the abdomen
Abdominal Aortic Aneurysm
S/S: sharp or tearing pain that radiates to the back
6 Branches of EMS in a large MCI
Extrication strike teams (in cases of entrapment)
Staging area
Triage area
Treatment area
Transportation Area
Rehabilitation area
What is the different lung sounds what do they indicate?
Wheezes: High-pitched sounds, common in asthma and sometimes COPD (chronic bronchitis and emphysema)
Crackles: a fine crackling or bubbling sound heard on inspiration, indicates fluid in the alveoli or the opening of closed alveoli
Rhonchi: lower pitched sound that resemble snoring and rattling, can indicate pneumonia or bronchitis
Stridor: high pitched sound heard on inspiration, indicates partial obstruction of the trachea or larynx
Vertebrae of the spinal column
Cervical: neck has seven vertebrae
Thoracic: ribs and upper back has 12
vertebrae
Lumbar: Lower back has 5 vertebrae
Sacral: back wall of pelvis has 5 vertebrae
Coccyx: Tailbone has 4 vertebrae
collarbone
clavicle
shoulder blade
Scapula
bone of the upper arm between shoulder and elbow
Humerus
lateral bone of forearm
radius
medial bone of forearm
ulna
Superior and widest portion of the pelvis on both sides of the pelvis (wing shaped)
Ilium
lower posterior portion of the pelvis
Ischium
Medial anterior portion of pelvis
Pubis
Long bone of thigh
Femur
medial and anterior larger bone of the lower leg
Tibia
Lateral and smaller bone of the lower leg
fibula
kneecap
patella
bony structure of the head
Skull
top and back sides of the skull
Cranium
lower jawbone
Mandible
Two fused bones forming the upper jaw
Maxillae
Bones that compromise the nasal cavity
Nasal Bones
The bony structures around the eyes orb
Orbits
Bones that form the structure of teeth
zygomatic arches
breastbone
sternum
superior portion of sternum
Manubrium
Inferior portion of sternum
Xiphoid process
Heel bone
Calcaneus
Bony protrusions seen on ankle joints
Malleolus
S/S of suicide what situations increase risk
- Depression
- High current or recent stress levels
- Age the most is between ages 15-25 and over age 40
- Alcohol and drug abuse
- threats of suicide
- Suicide plan
- Previous attempts or suicide threats
8.Sudden improvement from depression
Situations that increase risk are threats of suicide plan and previous attempts
how to stimulate an infant?
stimulate by flicking soles of feet and /or rubbing the back
signs that an infant is not getting enough oxygen
retractions
sickle cell issues?
- Destruction of spleen: spleen becomes blocked by abnormal RBC’S during filtering
- Pain crisis: sludging of sickled RBCs in capillaries
- Acute chest syndrome: when blood vessels in the lungs become blocked
- Priapism: painful prolonged erections
- Stroke: occurs when sludging RBC’s block blood vessels that supply the brain
- Jaundice: liver get overwhelmed by the breakdowns of RBC’s results in yellow pigmentation of body tissues
How to treat sickle cell anemia
- Administer supplemental oxygen
- Monitor patient with acute chest syndrome
- Monitor patients with high fever for hypoperfusion treat for shock if necessary
- Transport with acute stroke symptoms to designated stroke center
