Final Review Flashcards
What is the EMT (Emergency Medical Technician) do?
Everything a EMR can do plus:
- Limited medication administration
- Advanced O2 therapy (Supraglottic airways)
- Monitoring blood glucose levels
What does a EMT, AEMT, and Paramedic do?
EMT: Provide basic care and transportation from critical emergent response
AEMT: Provides basic and limited ALS skills
Paramedic: Focuses on advanced life saving techniques
What was the “white paper” in 1966 and what did it do for EMS care?
it was the paper published by National Academy of Sciences National Research Research council titled “Accidental death and Disability: The Neglected Disease of Modern Society”
- detailed the # of deaths and injuries related to MVA
- identified severe decencies in the delivery of pre-hospital care in US
- Recommended changes to ambulance systems, training req., and preparation of prehospital care
What is important to remember about scene safety ?
Scene safety is not set
Scene can always become unsafe
What the basic level of certification needed for a ambulance to be classified?
EMT
When is necessary to restrain a patient?
Whenever they pose potential harm to the EMT’s or PD
What level of disinfectant kills TB:
Medium level disinfectant
Define Sterilization:
A process, such as the use of heat, that removes microbial contamination
List and define the 3 levels of consent:
- Expressed Consent: Verbalization of consent
- Informed consent: Consent given by a patient once PT has been explained all necessary information about treatment.
- Implied Consent: Consent given by an unconscious person and the EMT assumes that consent would be given if the patient was conscious.
What is needed for a “Refusal of Care?”
Informed consent must be gained and the risks and benefits must be told to the patient before a refusal of care form is signed
What is negligence?
Any wrongful act, injury, or damage, and where there is no intent to do any harm to the patient
Define HIPPA:
Health insurance portability and accountability act
Define PHI:
Protected health information covered by HIPAA mandates
List the 7 C’s:
Clear
Concise
Concrete
Correct
Coherent
Complete
Courteous
What are the 4 types of Communication:
- Verbal
- Nonverbal
- Visual
- Written
Which agency regulates all radio operations in the US?
FCC (Federal Communications Commissions )
Define Body mechanics:
The proper use of your body
When can a Emergent move be done?
- When there is a Clear hazard or life threat to PT
- C spine can be forgotten
What should a “Urgent Move” be done?
- When factors cause PT to decline
- C Spine precautions should be used
Define nonurgent move:
patient can be taken care of in the place they were found
What is “IC” and when can it be transferred?
- Incident command
- if transferred over must be face to face
What is First step for a MCI?
- Establish IC and Scene size up
(Find out how many patients there are and needed resources)
When is Air medical necessary?
When your transfer time exceeds 30 minutes or an hour
What is NIMS (National incident management system)
A department of homeland security system designed to enable federal state and local governments and private sector and nongovernmental organizations to effectively and efficiently prepare for, prevent, respond to and recover from domestic incidents regardless of cause size or complexity.
What are the 3 planes of the body?
- Coronal (Frontal): Separates the front and back of the body
- Sagittal (Longitudinal)l: Separates the left and right sides of the body
- Transverse (Axial): Separates the upper and lower halves of the body
What do the following directional anatomical terms mean?
Superior (cranial)-
Inferior (caudal) -
Anterior (ventral) -
Posterior (dorsal) -
Medial -
Lateral-
Proximal -
Distal -
Anterior (ventral) - front
Posterior (dorsal) - back
Medial - toward the midline of body
Lateral - away from midline
Proximal - toward trunk or point of origin
Distal - away from trunk or point of origin
Define Abduction, adduction, flexion and extension:
Abduction:
This is a movement of a body part away from the midline of the body
Adduction:
This is a movement of a body part toward the midline of the body
Flexion:
This bending motion moves the extremity toward the body
Extension:
This bending motion moves the extremity away from the body
What organs are in the RUQ (Right upper Quadrant)?
Liver, gallbladder, pancreas, the right lobe of the liver, and parts of the small and large intestines
What organs are in the LUQ (Left upper Quadrant)?
stomach, pancreas, spleen, left lobe of the liver, and parts of the small and large
What organs are in the LLQ (Left Lower Quadrant)?
left ureter, left ovary and Fallopian tube, and parts of the small and large intestines
What organs are in the RLQ (Right Lower Quadrant)?
appendix, right ureter, right ovary and Fallopian tube, and parts of the small and large intestines
What are the 4 quadrants?
Right Upper Quadrant (RUQ)
Right Lower Quadrant (RUQ)
Left Upper Quadrant (LUQ)
Left Lower Quadrant (LLQ)
When does Right sided heart failure typically happen?
Generally comes after left sided failure as a result of advanced left side heart failure
What causes Right sided heart failure and what are the S/S?
- volume and pressure overload
S/S
- chest discomfort
- dyspnea
- palpitations
- body swelling
- peripheral edema
Left sided heart failure typically is caused by?
by coronary artery disease (CAD)
What causes Left sided heart failure and what are the S/S?
- The heart no longer pumping enough blood around the body.
As a result blood builds up in the pulmonary veins
S/S
- shortness of breath
- trouble breathing or coughing exacerbated with physical activity
JVD (Jugular Vein Distension) is a typically a late sign of ?
Right sided heart failure
What is pneumonia and what is the S/S?
- Infection in one or both lungs that causes the air sac alveoli of the lungs to fill up with fluid
- Pneumonia can be life threatening to anyone, but especially infants, children, people over 65, and PT with Airway disease (COPD, Asthma).
- S/S:
Chest pain, cough the produces phlegm, fever, tachycardia, tachypnea, crackles in one of the lungs
What are the 4 lung sounds and where are they located?
Crackles
Wheezing
Stridor
Rhoncus
- Crackles:
Lower lung bases - Wheezing:
Lower airway (bronchioles) - Stridor:
Larynx and trachea (upper airway) - Rhonchus:
Bronchi
***Stridor is the only upper airway sound
What does the The pulse oximeter or pulse ox measure?
Measuring the percentage of saturated hemoglobin
What are the Risk factors for pulmonary embolism?
- recent surgery, DVT, pregnancy
- Patients whose legs are immobilized following a fracture or recent surgery are at risk for pulmonary embolism for days or weeks after the incident.
- rarely do pulmonary embolism occur in active healthy individuals.
What is Pulmonary Embolism?
A blood clot formed in the vein, (usually in legs or pelvis) that breaks off and circulates through the venous system that makes it to the lungs
What may cause Pulmonary Embolism?
- Blood collecting or “pooling” in a certain part of your body (usually an arm or leg)
- injury to vein
- cardiovascular disease
- An increase or decrease in your blood’s clotting factors
Signs and symptoms for PE (Pulmonary Embolism)?
- dyspnea
- acute chest pain
- hemoptysis ( coughing up blood)
- cyanosis
- tachypnea in varying degrees
Define Oxygenation:
the delivery of oxygen to the tissues of the body
(Different from ventilation)
Oxygenation is the process of ______________.
delivering oxygen to the body’s tissues
“Refers to how well oxygen is being absorbed into the bloodstream and transported to the cells throughout the body”
The upper airway consists of?
Nasal cavity, pharynx, larynx
The upper airway ends at the _________.
the larynx where it is protected by the epiglottis
What is the Epiglottis and what does it do?
leaf shaped valve diverts Food and fluid into the esophagus and air into the trachea
What should be done for
Mild airway obstruction patients ?
- patients should be left alone, they should be encouraged to cough.
- Do not give them abdominal thrust
For choking what is done for PT under 1 YO and over 1 YO old?
- Under 1 YO: back blows and chest compressions
- Over 1 YO: Heimlich maneuver
Explain the gas exchange that happens in the lungs:
- In the areola, there is a capillary that wraps around it.
- The blood entering the areola is low in O2 and High in CO2
(low O2 because it has entered the cells, high in CO2 because cells have created it making energy and released it into the blood)
- Air entering the lungs is High in O2 and low in CO2
- Through a process of diffusion, the O2 moves from the lungs into the blood and the CO2 leaves the blood and enters the lungs to be expelled (capillary and alveoli walls are thin)
Patient becomes unresponsive during choking you should initiate :
CPR
Define Inspiration/Inhalation :
- The active phase of ventilation, Breathing in air.
- The diaphragm contracts and the thoracic cavity increases in volume
Define Expiration/Exhalation
Air leaving the lungs, the passive phase, the diaphragm and thoracic cavity relaxes.
Normal pulse ranges (Infants, Preschool, adults):
- Adults: 60-100
- Preschool: 80-120
- Infants: 100-180
Normal Blood pressure ranges (Infants, preschool, adults) :
- Adults: 120/80
- Preschool: 89/46 - 112/72
- Infants: 72/37 - 104/56
Normal Respiration ranges (Infants, preschool, adults) :
- Adults : 12-20
- Preschool (3-5 years) : 20-28
- Infants: 30-53
Define Aura:
- sensation prior to a seizure
Signs and symptoms for hypoglycemia:
“The anxious dish”
- tachycardia
- anxiousness
- dizziness
- irritability
- shaking sweating nervousness
- hunger
Signs and symptoms for hyperglycemia
- excessive urination
- excessive thirst
- feeling tired
- frequent hunger
- dry mouth
- blurred vision
- unexplained weight loss
- fruity smelling breath
Aortic aneurysm:
a bulge in the aorta or peripheral artery
Aorta dissection:
Tear of the aorta or its branches occurs when the inner lining of the arteries begins to separate from the rest of the arterial wall
Define Anaphylaxis
life threatening systemic allergic reaction may include shock and respiratory failure
Allergic reaction
The body’s exaggerated immune response to an internal or surface agents.
What is the most common sign of anaphylaxis ?
Wheezing
Kehrs sign:
Referred pain to the left shoulder due to a ruptured spleen injury
List the 9 examples of hollow organs?
appendix
bladder
common bile duct
fallopian tubes
gallbladder
intestines
stomach
uterus
ureters
What are 5 examples of solid organs?
kidneys
liver
ovaries
pancreas
spleen
What are the 4 main functions of the skin?
- act as a quick protective barrier against mechanical thermal and physical injury and hazardous substances
- prevents lost of moisture
- acts as a sensory organ
- reduces harmful effect of UV radiation
How do you care for a amputated body part?
Place body part in the bag and keep it cool
When is the only time you remove an impaled object?
When it affects the Airway or CPR
How do you treat eye injuries?
- cover injured eye with protective object
- other eye with dressing
What kind of MVC yields the greatest index pf suspicion for injury or death?
Rollover
What counts as a soft tissue injury?
- avulsion
- abrasion
- hematoma
Define Avulsion:
- A forcible tearing off of skin or another part of the body such as an ear or a finger
- Layers of skin have been torn off to expose muscles tendons and tissues
- An amputation such as getting a limb caught in a piece of heavy machinery is also called an avulsion.
Define Abrasion:
- A superficial rub or wearing off of skin, usually caused by a scrape or a brush burn
- Abrasions are usually minor injuries that can be treated at home
- Skin may bleed or drain small amounts at the time of the injury or at times over the next few days if rubbed or scratched
Define Hematoma:
- A bad bruise
- it happens when an injury causes blood to collect and pool under the skin the pooling blood gives the skin a spongy rubbery lumpy feel
- A hematoma usually is not cause for concerts
What are the 3 basic categories of “SMART” ?
RPM
R- Respiratory status
P - Perfusion status
M - Mental status
What are the 4 different Tags in “START” triage and what qualifies for each?
Black
Red
Yellow
Green
What is the treatment for burns?
- Dry sterile dressings
- treat for shock
- Remove any restrictive items, clothing or jewelry
When a patient dives in the water always begin _____________.
c-spine precautions
Define compensated shock :
the early stages of shock while the body can still comp for blood loss
***all vital signs are elevated
Define Decompensated shock:
Decomp the late stage blood pressure is falling
**all vital signs are extremely low
Define Irreversible shock:
The last stage, when shock has progressed to a terminal stage
If there injury open to the airway sign and what is the treatment
- Bubbling or sucking sound will occur
- Place an occlusive dressing taped on three sides.
PPV with open airway wounds - Pediatric
Managing airway pad behind the shoulders in sniffing position
What should be done for pediatrics to help open the airway?
you should pad the shoulders for their airway
Signs and symptoms of compensated shock
- Agitation
- anxiety
- restlessness
- feeling of impending doom
- altered mental status
- weak rapid or absent pulse
- clammy skin
- Pallor skin
- shallow rapid breathing air
- hunger
- nausea
- vomiting
- capillary refill
Pediatric patients requiring non rebreather and cant hold tolerate the mask what can be done?
blow by oxygen by parent
Define Braxton hicks and Signs of it
False contractions
- contractions are inconsistent
- contractions that cause mild similar to menstrual cramps
- Contractions that come and go and don’t get stronger over time
- Contractions that subside with a change of position, movement, rest or a glass of water
Preeclampsia:
Form of hypotension in pregnancy
Eclampsia :
more severe form of preeclampsia that comes with seizures
what are the 5 main antepartum emergencies?
- Spontaneous Abortion
- Ectopic Pregnancy
- Placenta previa
- Abruptio Placentae (placental abruption)
- Supine Hypotensive Syndrome
what is Ectopic pregnancy?
- the egg is implanted outside the uterus in one of the following locations:
- in a fallopian tube, on the abdominal peritoneal covering, on the outside wall of the uterus, on an ovary, or on the cervix
*** everywhere except the uterus
What is Spontaneous abortion “Miscarriage”
unexpected termination of the pregnancy before 20 weeks by the body
What is Placenta previa?
abnormal implantation of the placenta over or near the opening of the cervix
what is Abruptio Placentae (placental abruption) ?
the premature separation of the placenta from the uterine wall
what is the pathophysiology and treatment of Supine hypotensive syndrome?
- inadequate return of blood to heart, reduced cardiac output, and lower BP resulting from pressure on the inferior vena cava
Treatment:
- lay the PT on the left lateral recumbent position (left side)
- on back, elevate right hip 15 degrees
- manual displacement of the fetus to the right
What is Post partum hemorrhaging?
Bleeding that goes past 6 weeks post delivery
Why a patient should be placed on the left side:
Decreased pressure to the vena cava
what is APGAR stand for?
A - Appearance
P - Pulse
G - Grimace
A - Activity
R - Respiration
How do you get an APGAR score, whats the highest score and lowest score?
see chart
- 0 is lowest
- 10 is the highest
In regards to a newborn patient after delivery, at what point do you start CPR
When there PT (newborn) is below 60
What should you do for the PT before extrication?
Cover PT with blanket to protect them from glass and other debris
Which phase of breathing requires ATP and is active?
Inhalation
What are the 3 types of heat related injuries?
- Heat cramps
- Heat exhaustion
- Heat Stroke
What is the difference between TIA and stroke?
TIA resolve. Stroke stays. Same symptoms
What are the signs and symptoms of TIA and stroke?
- Decreased consciousness
- Facial drooping
- Low blood sugar (hypoglycemic)
- Arm drift
- Inability to speak
- Pupils unequal in size
- Sudden weakness in face, arm, legs
- Nausea or vomiting
- Loss of bowel or bladder control
- Paralysis or weakness on one or both sides of body
- Severe headache
What happens with heat stroke that becomes dangerous?
The body stops sweating
At what vertebrae will your PT no longer be able to breath
C5 and above
*** anything below C5 ( C6, C7, etc) they will be able to breath
“C5 stay alive”
What are the 2 types of Pneumonia and what are the S/S?
- Bacterial
- Viral
What are the S/S and treatment for both types of pneumonia?
S/S:
- coughing
- phlegm
- crackles
- difficulty breathing
Treatment:
- CPAP
- O2
What is Pink frothy sputum and what causes it?
- Bleeding in the alveoli
- Can be caused by Pneumonia , CHF (Congestive heart failure), Pulmonary edema, etc.
Which poison smells like cut grass and which smells like almonds
- Cyanide (Almonds)
- Phosgene (Fresh cut grass)
