Midterm EMRG 1130 Flashcards
(122 cards)
1
Q
Supine
A
lying on back
2
Q
Prone
A
lying on stomach
3
Q
Trendelenburg position
A
Feet up
4
Q
Left lateral
A
patients lie on their left side, with their left leg straight out on the bed, and the right leg bent up but also lying on the bed
5
Q
Semi-prone
A
when a person lies on their side, with their upper body slightly tilted forward or backward.
6
Q
Stable vital signs mean what?
A
Vitals signs are remaining the same as base line set
7
Q
Coffee-ground emesis
A
Digested blood that is vomited out and is sign of upper GI bleeding
8
Q
Melena
A
Dark sticky feces, covered in digested blood. Sign of upper GI bleeding
9
Q
Hematochezia
A
stool containing bright red blood ie hemorrhoids
10
Q
Hematuria
A
Blood in pee caused by renal injury or illness
11
Q
Ecchymosis
A
Purple bluish colouring under the skin, localized blood collection
12
Q
Hematoma
A
A localized collection of blood in the soft tissues after injury
13
Q
Peripheral pulses
A
Peripheral pulses are the places where you can feel your heartbeat in your body, like your wrist or neck. Heart strength is related to stroke volume and pulse pressure
14
Q
Pulse pressure
A
the difference between the systolic and diastolic pressures
15
Q
What is the first number in BP
A
Systolic
16
Q
What is the last number in BP
A
Diastolic
17
Q
Stroke volume
A
the volume of blood pumped forward with each ventricular contraction
18
Q
Cardiac output
A
amount of blood pumped by the heart per minute
SVxHR=CO
19
Q
Golgi complex
A
synthesis and packaging of various carbohydrates and protein molecules (enzymes)
20
Q
Lysosomes
A
contain digestive enzymes
21
Q
Ribosomes
A
contain RNA and protein
22
Q
Peroxisomes
A
neutralize toxins, such as alcohol. Found in liver
23
Q
The body relies on what to maintain its delicate acid base balance?
A
Buffers
24
Q
One of the main buffers is
A
Bicarbonate HCO3
25
H20 combines with CO2 to make
Carbonic acid
26
In the lungs carbonic acid breaks down into
water and carbon dioxide
27
In the kidneys the H2CO3 breaks down into
H+ and HCO3
28
Baroreceptors
respond to changes in blood pressure, located in carotid artery, aorta, and kidneys
29
A blood pH greater than 7.45 is
Alkalosis
30
A blood pH less than 7.35 is
acidosis
31
A patient is breathing at a rate of 6 per minute, shallow and laboured. What type of acid base imbalance would you expect
Respiratory acidosis
32
A patient who has been experiencing severe diarrhea for several days. What type of acid base imbalance would you expect?
Metabolic acidosis (loss of sodium bicarb)
33
A patient who has been experiencing severe vomiting for several days. What type of acid base imbalance would you expect?
Metabolic alkalosis ( loss of stomach acids)
34
A patient who is hyperventilating due to anxiety may experience what type of imbalance?
Respiratory alkalosis(blowing off CO2)
35
A patient in diabetic ketoacidosis or sepsis may be experiencing this imbalance?
(Metabolic acidosis)
Patients with DKA often experience Kussmaul respirations (deep, rapid, sighing ventilations) in an attempt to blow off the CO2 and decrease acidosis
36
Explain the process of the breakdown of glucose to ATP
Glucose is broken down into pyruvic acid
Anaerobic Pathway- the absence of oxygen -> lactic Acid. Oxygen can later convert Lactic acid back to Pyruvic acid otherwise it diffuses to the liver and is metabolized Aerobic Pathway with oxygen -> Acytel Coenzyme A -> Citric Acid Cycle (releases CO2, NADH to the ETS)
Kreb’s Cycle -> ATP is the by-product of the breakdown of CoA, NAD, FAD released and combine with energized electrons -> ETS
37
What is a virus?
Takes over metabolic process of a host cell and uses the host cell to replicate it.
38
What is apoptosis?
Normal cell death
39
What are pyrogens?
Released by white blood cells and causes fever to develop
40
What is bacteria?
Single cell organisms. That when enter the body reproduce rapidly They possess a capsule that protects them from ingestion and destruction
41
What structures are part of your immune system?
Tonsils
Spleen
Lymphoid tissue
(Thymus gland and bone marrow- T-lymphocytes mature here)
(Lymph nodes)
skin
Stomach acid
cilia
42
Basophils
Is a white blood cell contain histamine granules released during inflammatory and allergic response.
43
Eosinophils
Is a white blood cell release substances that damage or kill parasitic invaders
44
Neutrophils
Is a white blood cell Most abundant white blood cell, protect against infection, destroy and foreign antigens
45
Monocytes
Is a white blood cell mature in blood where they differentiate into macrophages. (scavengers for the tissues)
46
Lymphocytes
Is a white blood cell mediate the acquired immune response. 2 types B lymphocytes and T lymphocytes
47
Mast cells
Is a white blood cell that plays a role in allergic reactions, immunity and wound healing
48
What is native immunity
natural immunity, non specific cellular and antibody response that operates as the first line of defense against pathogens
49
Acquired immunity
acquired immunity, arises when the body is exposed to a foreign substance or disease and produces antibodies to that invader (vaccine or getting the disease)
50
What is Cell-mediated immunity
T-cell lymphocytes recognize antigens and contribute to the immune response by either secreting cytokins or becoming cytotoxic and killing infected cells
51
What is Humoural immunity
B-cell lymphocytes produce antibodies, react with a certain antigen, have a compliment of 20 proteins circulating untill needed
52
Define perfusion
Delivery of oxygen and nutrients and removal of wastes for the cells, organs and tissues by circulatory system.
53
Define hypoperfusion
Occurs when the level of tissue perfusion decreases below normal
54
Define Shock
Shock is a medical condition characterized by an abnormal state in which the body fails to receive an adequate supply of oxygen and essential nutrients required for proper cellular metabolism. This results in a disturbance of normal cell functioning and can lead to insufficient blood circulation to vital organs.
55
What are the two types of shock
Central and peripheral
56
What are the 2 types of central shock
Cardiogenic and obstructive
57
What are the two types of peripheral shock
Hypovolaemic and distributive
58
What is cardiogenic shock
When a heart is unable to pump enough, blood for the bodies needs. Poor, cardiac output.
59
What is Hypovolaemic shock
Depleted, intravascular volume. Hypovolemic shock occurs when there is a significant loss of blood or fluids from the body, leading to a decrease in the volume of blood circulating in the bloodstream.
60
What is obstructive shock?
Obstructing tissue perfusion. Obstructive shock is a type of shock that occurs when there is an obstruction in the flow of blood through the circulatory system, preventing the heart from effectively pumping blood.
61
What is distributive shock?
Distributive shock is when vasodilation occurs, blood vessels open up too wide, causing blood to spread out everywhere. The heart and brain do not get enough blood, leading to low BP and tachycardia.
62
What are the three kinds of distributive shock?
Septic shock, anaphylactic, shock, and neurological shock
63
What are symptoms of the first phase of shock 
1. Compensated shock 2. Agitation, anxiety, and restlessness. 3. Sense of impending doom. 4. Weak and rapid pulse. 5. Cool clammy or pale skin. 6. Shortness of breath. 7. thirst 8. Normal BP
64
What are the symptoms of the second face of shock?
1. decompensated shock 2. Altered LOC
3. laboured breathing. 4. Weak or no pulse. 5. ashen skin. 6. hypotension 7. impending cardiac arrest.
65
What are the symptoms in the last phase of shock?
Irreversible damage or Death
66
What is hypotension
Low BP
67
What is hypertension
High BP
68
What is the first step of patient care
EMCA
69
What is the second step of patient care
General impression, uncontrolled bleeds, and
c-spine
70
What is the third step of patient care?
Initial assessment, ABC’s, and skin
71
What is the fourth step of patient care?
Make a transport decision (is it load and go or stay and play)
72
What is the fifth step of patient care?
- Is this a load and go or focused assessment?
- If it is a load and go, we do rapid trauma assessment
- If it is a focused assessment
OPQRST
5 p’s
Treatment, splint etc
73
If patient needs a load and go, we do what?
Rapid trauma assessment
74
If patient needs a focussed assessment, what do we do?
OPQRST, 5 P’s, treatment, splint, etc.
75
A full set of vitals are done when
During a focused exam
During a medical assessment
After going mobile during your ongoing exam
After your rapid trauma survey IF you decided it was not a load and go
76
Once you go mobile your first action is?
your ongoing assessment, LOA, ABC’s, recheck interventions
77
Once you go mobile, what is your second step of action?
Radio patch
78
Once you go mobile, what is your third step of action?
Detailed physical exam
79
First paragraph of SMR considerations
a. any trauma associated with complaints of neck or back pain,
b. sports accidents (impaction, falls).
c. diving incidents and submersion injuries.
d. explosions, other types of forceful acceleration/deceleration injuries,
e. falls (e.g. stairs).
f. pedestrians struck.
g. electrocution,
h. lightning strikes, or
i. penetrating trauma to the head, neck or torso;
80
Second paragraph of SMR qualifications
a. neck or back pain,
b. spine tenderness.
C. neurologic signs or symptoms.
d. altered level of consciousness.
e. suspected drug or alcohol intoxication,
f. a distracting painful injury (any painful injury that may distract the patient from the pain of a spinal injury).
g. anatomic deformity of the spine,
h. high-energy mechanism of injury, such as.
1. fall from elevation greater than 3 feet/5 stairs.
2. axial load to the head (e.g. diving accidents).
3. high speed motor vehicle collisions (a100 km/hr). rollover, ejection,
4. hit by bus or large truck.
5. motorized/ ATV recreational vehicles collision, or 6. bicyclist struck or collision,
I. age ≥65 years old including falls from standing height;
81
Oxygen Therapy standard qualifications paragraph one
a. confirmed or suspected carbon monoxide or cyanide toxicity or noxious gas exposure.
b. upper airway burns.
c. scuba-diving related disorders.
d. ongoing cardiopulmonary arrest.
e. complete airway obstruction, and/or
f. sickle cell anemia with suspected vaso-occlusive crisis; and
82
Oxygen therapy standard paragraph 2
a. age-specific hypotension.
b. respiratory distress,
c. cyanosis, ashen colour, pallor.
d. altered level of consciousness, and/or
e. abnormal pregnancy or labour.
83
What vitals shall a paramedic take
a. heart rate,
b. respiration rate,
c. blood pressure (BP),
d. Pulse oximetry (SpOz),
e. Glasgow Coma Scale (GCS),
f. pupils, and
g. skin colour and condition;
84
types of calls typically warrant a cardiac monitor
All vital signs absent (VS) patients, except those who are obviously dead as per the Deceased Patient Standard
• Unconscious or altered level of consciousness
• Collapse or syncope
• Suspected cardiac ischemia
• Moderate to severe shortness of breath
• Cerebrovascular accident (CVA)
• Overdose
• Major or multi-system trauma
• Electrocution
• Submersion injury
• Hypothermia, heat exhaustion or heat illness
• Abnormal vital signs as per the ALS PCS
If requested by sending facility staff (for inter-facility transfers)
85
haemorrhage control
1. apply well-aimed, direct digital pressure at the site of bleeding.
2. apply a tourniquet. if tourniquet fails to stop bleeding completely or cannot be used for any reason then apply a second tourniquet. Or
3. pack the wound with hemostatic dressing if appropriate and available or standard gauze if contraindicated or unavailable, maintain pressure and secure with a pressure dressing:
86
Where can you not pack hemostatic dressing?
the skull, chest or abdomen.
87
Where can we pack hemostatic dressing?
if the wound is located in a junctional location (e.g. head, shoulders. armpit, neck, pelvis, groin) and extremity’s
88
How to asses amputations
A. assess the injury site for circulation, sensation and movement, and
B. assess distal pulses, circulation, sensation and movement:
C. control hemorrhage as per the Soft Tissue Injury Standard,
D. cleanse wound of gross surface contamination,
E. if partial amputation or avulsion, place remaining tissue or skin bridge in as near-normal anatomical position as possible,
F. if complete amputation, cover the stump with a moist. sterile pressure dressing, followed by a dry dressing, while taking care not to constrict or twist remaining tissue,
G. immobilize affected extremity, and
H. if possible, elevate
I. with respect to the amputated/avulsed part, if located prior to ambulance transport,
J. preserve all amputated tissue,
K. if the part is grossly contaminated, gently rinse with saline.
L. wrap or cover the exposed end with moist, sterile dressing, and
M. place the part in a suitable container / plastic (water-tight if possible)
bag and immerse in cold water, if available.
1) If not able to locate part prior to ambulance transport,
i. attempt to engage others at scene (e.g. allied agencies, bystanders) to look for the amputated/avulsed part and advise them to have it transported to receiving facility if found, and do not delay transport.
89
Adult normal HR, BP, ETCO2, SPO2, and Temp
Normal values
HR = 60-100 b/min
NIBP = 120/80
ETCO2 = 35-45 mmHg
SPO2 = 95-100%
Temp = 37 degrees C
90
Normal RR for Pediatrics
0-6 months 30-60
6-12 months 25-45
1-5 years 20-30
6 -9 yr 16-24
10 yr 14-20
91
Normal HR for paediatrics
0-3 months 90- 180
3-6 months 80-160
6-12 months 80-140
1-3 yr 75-130
6 yr 70-110
10 yr 60-90
92
Before signs of puberty BP
Hypotension: SBP <70mmHg + (2 x age in years)
Normotension: SBP ≥ 90mmHg + (2 x age in years)
93
Normal temp
Normal range is 36.1-37.2 degrees C
Fever- generally >38 degrees Celsius
94
Normal SPO2
97% - 100%
95
What is Bariatric equipment used for
Obese patients
96
What weight would we use the pedi mate
10-40 ibs
97
How much can the manta mat hold
800ibs
98
How much weight can a stretcher hold loading and bottom height?
Loading: 700 ibs Bottom: 1100
99
How much can a KED hold?
500 ibs
100
How much weight can a scoop hold
500 ibs
101
How much weight can a canvas stretcher hold?
350 ibs
102
How much can a stair chair hold
500 ibs
103
What is a nasal cannula?
Nasal canula is a low concentration device attaches to nose around the ears. Leader flow from 1 to 6 LPM
104
What is a nebulizer mask? 
Nebulizer mask allows administered medication with oxygen through the mask. This mask runs 4 to 6 LPM
105
What is a nonrebreather mask?
This allows the patient to inhale from Reservoir bag. This ensures the patient is not exhale back into the bag. This must be run at 12 to 15 LPM.
106
What is a filtered 02 mask
I filtered O2 mask protects providers from patients illnesses, but still can deliver any concentration of oxygen.
107
Look at pelvis picture number one
Lateral Compession Fracture
Visual presentation: Impacted side rotates around sacrum
108
Pelvic picture number 2
Open book fracture
Visual presentation : Pelvis spreads apart
109
Pelvic picture number 3
Vertical shear
Visual presentation: pelvis pointing inward
110
Pelvic picture number 4
Straddle Fracture
Visual presentation: inferior and superior ramus are moved.
111
The skin has 2 layers
Epidermis
dermis
112
RUQ
• Liver
• Gallbladder
• Right kidney
• Portions of small and large intestine
• Part of the pancreas
113
Left Upper Quadrant (LUQ):
Stomach
• Spleen
• Left kidney
• Portions of small and large intestine
• Part of the pancreas
114
Right Lower Quadrant (RLQ):
• Appendix
• Part of the large intestine (cecum and ascending colon)
• Right ovary and fallopian tube (in females)
• Right ureter
115
Left Lower Quadrant (LLQ):
Part of the large intestine (sigmoid colon and descending colon)
• Left ovary and fallopian tube (in females)
• Left ureter
• Part of the small intestine (lower part of the ileum)
116
Hemopoiesis
The process of creating blood cells that occurs in the bone marrow of certain bones in the body. This includes the production of red blood cells, white blood cells, and platelets essential for oxygen transport, immunity, and clotting
117
Greenstick fracture
Incomplete fracture not fully through the bone
118
Spiral fracture
In circles the bone 
119
comminuted fracture
Two fracture fragments located in the same area
120
Transverse fracture
Straight across the bone
121
Compound fracture
Fracture that causes break in the skin
122
What are the five rights?
Right drug
Right time
Right patient
Right route
Right dose
