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High Yield NREMT Flashcards

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1
Q

Appendix is in the

A

Right Lower Quadrant

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2
Q

Transverse/horizontal

A

top/bottom

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3
Q

Relationship b/t SVR and BP and constriction

A

constriction ↑ SVR ↑ BP

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4
Q

Pulsus paradoxus

A

A drop in systolic BP of 10 mmHg or more on inhaling

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5
Q

Kussmaul Respirations

A

deep and labored breathing pattern often associated with severe metabolic acidosis, DKA and kidney failure

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6
Q

most common cause of cardiogenic shock

A

AMI

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7
Q

Differentiate sprain and strain

A

A sprain is the stretching or tearing of ligaments.

A strain is a stretching or tearing of muscles or tendons

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8
Q

Preload

A

Preload = The force exerted on the ventricle walls at the end of diastole

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9
Q

Right ventricular failure
what happens
S/S

A

Right ventricular failure
• Blood backs up into the venous system that feeds into the right heart
• S/s: JVD, pedal edema

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10
Q

Types of bleeding:

Capillary

A

oozing, dark red

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11
Q

Normal HR for toddler (1-3 yo)

A

Toddler HR

80-130 bpm

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12
Q

Infants BVM volume

A

150-240 mL

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13
Q

Nuchal cord vs prolapsed cord

A

in the nuchal cord, the umbilical cord has wrapped itself around the newborn’s head and in prolapsed cord, the umbilical cord precedes the baby in the birth canal

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14
Q

Type of shock with:

  • hypotension
  • cool, clammy skin
  • rapid, weak pulse
  • tachypnea
A

hypovolemic

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15
Q

Simple face mask
Flow rate
FdO2
best used when x

A

Simple face mask (NRB without O₂ reservoir)
Flow rate: 6-10 LPM
FdO2: 40-60 %

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16
Q

Implied consent vs expressed consent

A

Implied = assumption of care; unresponsive or incompetent patient

Expressed = if you say yes to A it means you’re saying yes to B and C and D within reason

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17
Q

Differentiate between DKA and HHS

A

DKA is absolute insulin deficiency and is usually seen in type I diabetics and develops over hours to 1-2 days.

HHS is relative insulin deficiency and is usually seen in type II diabetics and develops over days to weeks.

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18
Q

How to measure an NPA?

A

tip of the nose to the earlobe

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19
Q

differentiate between placenta previa and abrupto placenta

A

placenta previa occurs when the placenta attaches to the uterus over the cervical opening and results in painless vaginal bleeding.

Abrupto placenta occurs when the placenta prematurely separates from the uterine wall and results in painful vaginal bleeding.

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20
Q

Pink puffers
smoking
lower airway disease
wheezing

A

Emphysema

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21
Q

Normal RR for infancy (birth to 1 year)
first born
first few minutes
by one year

A

Infant RR
40-60 at first
30-40 after first few minutes
20-30 by 1 year

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22
Q

Orthopnea

A

inability to breathe unless in an upright position

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23
Q

Normal RR for toddler (1-3 yo)

A

Toddler RR

20-30

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24
Q

Burn type for blisters and wet

A

2ⁿᵈ degree

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25
Q

Types of bleeding:

Venous

A

Steady flow, dark red

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26
Q

How to measure an OPA?

A

corner of the mouth to the earlobe

corner of the mouth to angle of jaw

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27
Q

Dehydration and burns are examples of ____ ____ shock

A

Dehydration and burns = non-hemorrhagic hypovolemic shock

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28
Q

ADULT BVM volume

A

1200-1600 mL

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29
Q

Hot zone

A

contamination zone; limited # of rescuers; PPE; bystanders never allowed

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30
Q

Normal RR for adulthood

A

Adulthood RR

16-20 (12-20 normal)

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31
Q

BP and CO equations

A 
BP = SVR x CO
CO = HR X SV
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32
Q

Cardiac Tamponade s/s

A

JVD, narrow pulse pressure, hypotension

Becks Triad

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33
Q

Tension pneumothorax—tracheal deviation towards

A

Tension pneumothorax—tracheal deviation towards unaffected side

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34
Q

blue bloaters

A

Chronic bronchitis

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35
Q

Respiratory distress vs. respiratory failure

A

respiratory distress = abnormal respiratory rate/effort

respiratory failure = clinical state of inadequate oxygenation, ventilation, or both

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36
Q

Carina

A

where the trachea branches into left and right mainstem bronchi

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37
Q

NRB
Flow rate
FdO2
best used when

A

NRB
Flow rate : 10-15% (high flow)
FdO2 can be 100%
best used when: breathing w/o aid but hypoxic

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38
Q

Use this type of move when the Scene is dangerous and pt needs to be moved in order to provide care
Give examples if applicable

A 
Emergency moves
includes:
armpit-forearm drag
shirt drag
blanket drag
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39
Q

Hypotension calculation

A

systolic BP <70+2(age)

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40
Q

Liver quadrant

A

RUQ

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41
Q

Common injuries for the Down-and-under pathway

A

injuries to knees, femurs, hips, acetabulum, and spine

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42
Q

Left ventricular failure
what happens
S/S

A

Left ventricular failure:
• Blood backs into the heart
• S/s: pulmonary edema, pulmonary veins fill due to back pressure, pressure ↑ in the pulmonary capillaries, water leaks from pulmonary capillaries into the alveoli
• Left HF frequently leads to Right HF

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43
Q

Normal BP for preschool age (3-5 yo)

A

Preschool BP

80-110 mmHg

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44
Q

Normal RR for Adolescence (13-18 yo)

A

Adolescence (13-18) RR

12-20

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45
Q

Gallbladder quadrant

A

RUQ

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46
Q

SV vs. SVR

A 
SVR = total resistance of arterioles to flow of blood
SV = amount of blood pumped by the heart each cycle
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47
Q

Normal RR for preschool age (3-5 yo)

A

Preschool RR

20-30

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48
Q

Subcutaneous emphysema

A

air flowing upward and being trapped under the skin; cracking sensation upon palpation of the patient’s neck

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49
Q

Normal BP for toddler (1-3 yo)

A

Toddler BP

70-110 mmHg

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50
Q

Normal BP for school age (6-12 yo)

A

School age 6-12 BP

80-120 mmHg

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51
Q

Normal HR for Adolescence (13-18 yo)

A

Adolescence (13-18) HR

55-105 bpm

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52
Q

Common injuries for the Up-and-over pathway

A

injuries to abdomen, chest, face, head, and neck

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53
Q

Steps of secondary assessment for a:

Responsive medical pt, no AMS

A

Responsive medical pt, no AMS

(1) history, (2) modified secondary, (3) baseline vitals

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54
Q

differentiate between frank and complete/incomplete breech presentations

A 
frank = legs extended
incomplete/complete = legs are flexed
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55
Q

Right-sided heart failure causes blood to back up into the body, causing pitting edema throughout the body

A

Cor Pulmonale

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56
Q

Atelectasis

A

condition in which the lungs have collapsed or are airless

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57
Q

Residual tank pressure

A

200-300 psi

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58
Q

Types of bleeding:

Arterial

A

spurting, bright red

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59
Q

Type of shock that is hypotension, bradycardia, warm dry skin

A

neurogenic

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60
Q 
Rule of nines- peds
head
chest front
chest back
arm
leg
genital
A 
Rule of nines- peds
head = 18
chest front = 18
chest back = 18
arm = 9
leg=14
genital=1
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61
Q

BVM
Flow rate
FdO2
best used when

A 
BVM
Flow rate: 15 LPM
FdO2: 21% w/o O₂ attached; 90-95% with O₂ 
best used when: pt need help ventilating
600 mL delivery for 1 sec ventilation
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62
Q

PE, tension pneumo, or cardiac tamponade = ____ shock

A

obstructive

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63
Q

Normal HR for infancy (birth to 1 year)
first born
settling

A

Infant HR
HR = 100-160 (first 30 mins)
After = 120 bpm

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64
Q

Normal BP for Adolescence (13-18 yo)

A

Adolescence (13-18) BP

100-120 mmHg

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65
Q

Venturi mask
Flow rate
FdO2
best used when

A

Venturi mask
Flow rate: ≤15 LPM
FdO2: 24-60%
Venturi masks are especially helpful for COPD patients

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66
Q

At what age group does temp usually stay 98.6

A

school age children (6-12) and on

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67
Q 
Explain the process of inhalation
active or passive process
what happens to the diaphragm
intercostal muscles
thoracic cavity (contracts/expands)
pressure in chest cavity
A 
Inhalation
Active process
Diaphragm contracts
intercostal muscles contract
thoracic cavity expands 
negative pressure
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68
Q

Normal Temp for toddler (1-3 yo)

A

Toddler Temp

96.8-99.6

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69
Q 
hypovolemic shock
BP
Skin
Pulse quality
Breathing rate
LOC
A 
hypovolemic shock
BP: hypotension
Skin: cool, clammy
Pulse quality: rapid, weak
Breathing rate: tachypnea
LOC: AMS
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70
Q

Beck’s Triad consists of what 3 signs?

A

Muffled heart tones, hypotension and jugular vein distension

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71
Q

PEDS BVM volume

A

500-700 mL

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72
Q

Hollow organs do what when injured and they include what? (6)

A

Hollow organs:

Leak

Include:
Stomach, intestines, gallbladder, urinary bladder, ureters, uterus

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73
Q 
Rule of nines- adult
head
chest front
chest back
arm
leg
genital
A 
adult
head = 9
chest front = 18
chest back = 18
arm = 9
leg = 9
genital = 1
74
Q

Steps of secondary assessment for a:

Trauma pt no sig MOI no AMS

A

Trauma pt no sig MOI no AMS

(1) modified secondary, (2) baseline vitals, (3) history

75
Q

Normal temp for infancy (birth to 1 year)

A

Infant Temp

98-100

76
Q

Distributive shock includes 3 types of shock:

A

distributive shock: neurogenic, septic, anaphylactic

77
Q

deficiency in insulin; urine contains glucose

A

diabetes mellitus

78
Q 
Explain the process of exhalation
active or passive process
what happens to the diaphragm
intercostal muscles
thoracic cavity (contracts/expands)
pressure in chest cavity
A

Exhalation
passive process
Diaphragm and intercostal muscles relax
Creates a positive pressure in the thoracic cavity
air flows out until pressure is equalized

79
Q

Deficiency in vasopressin; excessive thirst, large amounts of extremely dilute urine

A

diabetes insipidus

80
Q

Type of diabetes where the body cells are resistant to insulin

A

type ii diabetes

81
Q

Cold zone

A

Safe zone Normal triage, stabilization, and treatment performed; SHED PPE before entering

82
Q

Normal HR for school age (6-12 yo)

A

School age 6-12 HR

70-110 bpm

83
Q

Normal HR for preschool age (3-5 yo)

A

Preschool HR

80-120 bpm

84
Q

Warm zone

A

control zone = prevents spread of contamination; PPE; lifesaving emergency care is performed

85
Q

type of diabetes where the body lacks insulin

A

type 1 diabetes

86
Q

Nasal cannula
Flow rate
FdO2
best used when

A

Nasal cannula
Flow rate-: 6 LPM
FdO2: 20-40%
best used when: pt not able to tolerate face mask

87
Q

Commotio cordis

A

an often lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (

88
Q

Frontal/coronal plane

A

anterior/posterior

89
Q

Normal BP for adulthood

A

Adulthood BP

120/80 mmHg

90
Q

Solid organs do what when injured and they include what? (4)

A 
Solid organs BLEED when injured
Include: KLOPS
Kidneys
liver
(ovaries)
pancreas
Spleen
91
Q

Steps of secondary assessment for a:

Trauma pt / Medical pt + AMS

A

Trauma pt / Medical pt + AMS

(1) rapid secondary, (2) baseline vitals, (3) history

92
Q

Estimating BP: Normal systolic
Adult male:
Adult female:
Child

A

Estimating BP: Normal systolic
Adult male:100+age (≤140)
Adult female: 90+age (≤130)
Child: 80+2 (age) [only for children 1-10]

93
Q

Midline/medial/sagittal

A

left/right

94
Q

Cheyne-Stokes

A

progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in apnea

95
Q

Stomach quadrant

A

LUQ

96
Q

Spleen

A

LUQ

97
Q

shock that is from widespread vasodilation

A

distributive shock

98
Q

type of shock that is hypotension, tachycardia, weak thready pulse, cool, moist, pale skin

A

cardiogenic

99
Q 
Cardiogenic shock
BP
Skin
Pulse quality
Breathing rate
LOC
A

Cardiogenic shock
BP: hypotension
Skin: cool/clammy
Pulse quality: weak, irregular, tachycardia
Breathing rate: tachypnea, shallow, dyspnea
LOC: restless and anxiety

100
Q

Afterload

A

Afterload is the resistance the heart must overcome during ventricular contraction.

101
Q

Use this type of move when the PT has potentially life-threat injuries/illness and must be moved quickly for evaluation and transport
Give examples if applicable

A

Urgent moves

102
Q

Cushing reflex
BP
HR
Breathing

A

↑Systolic BP↓HR, irregular breathing

103
Q

Right-sided vs. left-sided Heart failure

A

Right sided = dependent edema, JVD, enlarged liver; COR PULMONALE

Left side = crackles, dyspnea, hypoxia, fluid in lungs (pulmonary edema)

104
Q

Estimating normal diastolic pressure:
Adult
Children

A

Estimating normal diastolic pressure:
Adult: 60-85 mmHg
Children: 1-10 yrs
80 + 2(age) /0.66 systolic

105
Q

Recovery position is recommended for patients who are (conscious/unconscious) and (breathing spontaneously / not breathing spontaneously)

A

Recovery position = unconscious + breathing spontaneously

106
Q

Normal RR for school age (6-12 yo)

A

School age 6-12 RR

20-30

107
Q

Differentiate between the different types of blast injuries

A

primary blast injury is due from the sudden change in environmental pressure
secondary blast injury is from being struck by a flying object
in the tertiary blast injury, it results from the victim being thrown through the air and striking the ground or other objects

108
Q

fluid accumulates w/in the pericardial sac, compressing the heart

A

Cardiac Tamponade

109
Q

Normal BP for infancy (birth to 1 year)
at birth
at 1 year

A

Infant BP systolic
70 @ birth
90 @ 1 yr

110
Q

type of shock that is hypotension, tachycardia, tachypnea, pink, warm flushed skin

A

septic shock

111
Q

Normal HR for adulthood

A

Adulthood HR

60-100 (NEMSES says 70)

112
Q

Type of shock Due to inadequate amount of fluid or volume in the circulatory system

A

Hypovolemic shock

113
Q

Type of shock where the Heart lacks enough power to maintain an adequate cardiac output

A

cardiogenic shock

114
Q

Cor Pulmonale

A

Right-sided heart failure causes blood to back up into the body, causing pitting edema throughout the body

115
Q

Hypoglycemia HR and BP

A

Hypoglycemia
HR = tachycardic
BP = hypertensive

116
Q

Hyperglycemia HR and BP

A

Hyperglycemia
HR = tachycardic
BP = hypotensive

117
Q

How long will a patient go without breathing before it is likely that irreversible brain damage has set in?

A

6-10 minutes

118
Q

Appendix

A

RLQ

119
Q

Anterior circulation stroke

A

blockage of cerebral artery that perfuses the cerebrum and cerebral cortex

120
Q

posterior circulation stroke

A

blockage of cerebral artery that perfuses the brainstem and cerebellum

121
Q

RUQ pain and jaundice

A

hepatitis

122
Q

LUQ pain, N/V, abdominal distention

A

pancreatitis

123
Q

cholecystitis

A

inflammation of the gallbladder

124
Q

RUQ pain which increases at night, referred shoulder pain

A

cholecystitis

125
Q

RLQ pain, N/V, decreased appetite

A

appendicitis

126
Q

calculate cardiac output

A

stroke volume x heart rate

127
Q

normal stroke volume =

A

SV = 70 mL

128
Q

Calculate BP

A

BP = CO x SVR

129
Q

SV vs. SVR

A

SV = stroke volume and is the volume of blood ejected with each ventricular contraction (normal = 70)

SVR = systemic vascular resistance and is the resistance of blood to flow throughout the body (increases with constriction)

130
Q

Pulmonary artery

A

The artery carrying blood from the right ventricle of the heart to the lungs for oxygenation. Note: This is the only artery in the body that carries deoxygenated blood.

131
Q

Pulmonary vein

A

A vein carrying oxygenated blood from the lungs to the left atrium of the heart. Note: This is the only vein in the body that carries oxygenated blood.

132
Q

Vasoconstriction effect on SVR and BP

A

Vasoconstriction ↑ SVR and ↑ BP

133
Q

Pharmacodynamics

A

biological effects (therapeutic or adverse) of drug administration

134
Q

parenteral drugs are those that are

A

injected or inhaled

135
Q

enteral drugs are those that are

A

ingested

136
Q

tidal volume

A

normal volume of gas inhaled during one respiration cycle (~500 mL)

137
Q

inspiratory reserve volume

A

volume of air inhaled greater than the tidal volume during forced deep inhalation (<3000 mL)

138
Q

Vital capacity

A

the maximum volume of air exhaled during forceful exhalation

139
Q

Minute volume define and equation

A

Minute volume = volume of gas expelled from the lungs in one minute
= respiratory rate x tidal volume

140
Q

normal tidal volume

A

500 mL

141
Q

Total lung capacity define and equation

normal amount

A

the total volume that the lungs can contain
Total lung capacity: vital capacity + residual volume
Usually ∼ 6000 mL for adults

142
Q

what 2 oxygen tanks do emts use the most? and what are their volumes?

A

D tank @ 350 (M15) factor 0.16

E tank @ 650 (M24) factor 0.28

143
Q

which node is the heart’s natural pacemaker

A

SA node

144
Q

Cystitis vs cholecystitis

A

cystitis is inflammation of the bladder whereas cholecystitis is inflammation of the gallbladder

145
Q

Chemoreceptors vs. baroreceptors

A

chemoreceptors respond to pH ∆ and monitor levels of CO₂ in the blood whereas baroreceptors respond to pressure changes (blood pressure)

146
Q

Hypothermia levels

A 
mild = >93.2
moderate = 86-93.2
sever = <86
147
Q

temp cut off for heat stroke

A

> 104F + AMS

148
Q

Differentiate the different types of headaches in the 3 types of brain bleeds

A

epidural headache = sudden, severe, intense
Subdural = progressive and worsening over time
Subarachnoid = thunderclap severe headache, abrupt onset, may be worse @ the back of the head

149
Q

subdural hematoms occur between

A

subdural = dura mater and arachnoid layer

150
Q

epidural hematomas occur between

A

skull and dura mater

151
Q

RUQ main organs (2) and diseases (3)

A

RUQ
liver, gallbladder
hepatitis, cholecystitis, peptic ulcer

152
Q

RLQ main organs (2) and diseases (1)

A

RLQ
appendix, ascending colon
appendicitis

153
Q

LUQ main organs (3) and diseases (1)

A

LUQ
stomach, spleen, pancreas
intestinal malrotation

154
Q

LLQ main organs (3) and diseases (5)

A

LLQ
descending colon, sigmoid colon, female stuff, ileum

ABD pain, peritonitis in LLQ =
colitis
diverticulitis
ureteral colic
ovarian cysts or PID
155
Q

Difference between alpha and beta adrenergic medications

A

alpha drugs mostly cause vasoconstriction

beta 2 drugs relax bronchi smooth muscle

156
Q

Components of the LAPSS screening

A

Age > 45 years
No history of seizure disorder
New onset (past 24 hrs) of neurologic symptoms
Patient was ambulatory at baseline (prior to event)
Serum glucose level 60-400

157
Q

Examination of the LAPSS screening

A

Facial smile or grimace
Grip
Arm weakness

158
Q

Disturbances in O2 diffusion, carrying, offloading, or use is ____ shock

A

metabolism/respiratory shock

because inadequate breathing for long periods causes abnormal cellular metabolism, resulting in the buildup of metabolic products.

159
Q

Normal minute volume for adult at rest

A

6000 mL

160
Q

Differentiate between epidural and subdural bleeds

A

Epidural is low-velocity impact/deceleration injury bleeds; almost always is associated w/ a skull fracture, commonly in the temporal region

Subdural bleeds are low-pressure venous bleeding; common association is cerebral contusion

161
Q

Visceral vs. parietal pleura

A 
visceral = innermost layer which contacts the lung
Parietal = outermost layer; contacts the thoracic wall
162
Q

the scope of practice which determines what an EMT can and cannot do is determined by the

A

state legislature

163
Q

Arteriosclerosis vs atherosclerosis

A

Arteriosclerosis is the stiffening or hardening of the artery walls.

Atherosclerosis is the narrowing of the artery because of plaque build-up. Atherosclerosis is a specific type of arteriosclerosis.

164
Q

when you see “urticaria” think

A

allergic reaction

165
Q

rales vs. rhonchi

A

rales = crackles = fluid in lungs; bubbling/popping sound, pneumonia, copd, lung infections

rhonchi = rattling = chronic lung problems (chronic smokers)

166
Q

Diverticulitis
definition
who’s at risk
S/s

A

Small pouches (diverticular) along the wall of the intestine fill w/ feces and become inflamed & infected
People > 40 w/ low fiber diet
S/S: LLQ pain

167
Q

Distributive shock includes

A

neurogenic, septic, and anaphylactic

168
Q

In proving negligence, what is “causation”

A

“proximate cause” The injury to the plaintiff was, at least in part, directly due to the EMT’s breech of duty.

169
Q

arterial, venous, capillary
epidural bleeding is____
subdural bleeding is ____

A

epidural bleeding is arterial

subdural bleeding is venous

170
Q

Differentiate primary, secondary, and tertiary blast injuries

A

Primary blast injury is due to the sudden change in environmental pressure.
Secondary injury is due to being struck by a flying object.
Tertiary injury is due to the victim being thrown through the air and striking the ground or other objects.

171
Q

ligaments connect _____
while tendons connect ____

sprains happen in ____
Strains happen in ____

A

Ligaments = bone::bone
Tendons: muscle::bone

sprain = ligaments
strain = muscle + tendon
172
Q

hyphema

A

Blood in the anterior chamber of the eye

173
Q

The umbilical cord is made up of
__ artery/arteries
__vein/veins

A

2 arteries

1 vein

174
Q

pale skin, dilated pupils, narrow pulse pressure, tachynpea = ___ shock

A

hypovolemic shock

175
Q 
Class II hemorrhage 
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
A 
Class II Hemorrhage
Blood loss: 15-30%
BP: orthostatic hypotension
HR: 100-120
RR: 20-30
Urine output: 20-30cc/h
CNS status: agitated
Capillary refill: slight delay / cool
176
Q 
Class I hemorrhage 
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
A 
Class I hemorrhage 
Blood loss: <15%
BP: normal
HR: <100
RR: normal
Urine output: >30cc/h
CNS status: normal
Capillary refill: normal
177
Q 
Class III Hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
A 
Class III Hemorrhage
Blood loss: 30-40%
BP: marked decrease
HR: >120
RR: 30-40
Urine output: 5-15cc/h
CNS status: confused
Capillary refill: significant delay/cool
178
Q 
Class IV Hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
A 
Class IV Hemorrhage
Blood loss: >40%
BP: profound decrease
HR: >140
RR: >35
Urine output: <5cc/h
CNS status: obtunded
Capillary refill: significant delay/cold
179
Q

gland that is both exocrine and endocrine

A

pancreas

180
Q

Differentiate b/t type 1 and type 2 respiratory failure

A

type 1 = blood O₂ less than 60

type 2 = blood CO₂ greater than 50

EMT (4 decks)

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