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EMT 1 > Module 5 - Medical Emergencies I > Flashcards

Module 5 - Medical Emergencies I Flashcards

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1
Q

Identify the age ranges associated with the following terms:

Neonate, Infant, Toddler,
Pre-schooler, School age, Adolescent, Early adulthood, Middle adulthood, and Late
adulthood

A

Neonate : birth - 1 month
Infant: 1 month- 1 year
Toddler: 1-3 yo
Pre-schooler: 3-5 yo
School aged: 6-11 yo
Adolescent: 12-15 yo
Early adulthood: 20-40
Middle adulthood: 41-60
Late adulthood: 61

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2
Q

What are some chronic changes in elderly patients that may affect Chief Complaint, Mental Status, and the ABCs?

A
  • Respiratory system changes diminish ability to cough, lung capacity, and gas exchange
  • memory problems
  • Cardiovascular system changes increase the myocardial workload
  • depression, isolation and loss of independence can affect mental status
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3
Q

In Pediatric patients, summarize age-related anatomical and physiological for vital
signs, gastrointestinal systems, and special senses.

A
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4
Q

In Geriatric patients, summarize age-related anatomical and physiological for vital
signs, gastrointestinal systems, and special senses.

A
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5
Q

What are the essential features & associated aspects of PTSD?

A
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6
Q

List the signs and symptoms of respiratory distress in pediatrics versus respiratory
failure.

A
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7
Q

Describe the anatomy of menstrual cycle :

A
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8
Q

Describe the stages of labor:

A

1st Stage: Dilation Phase

  • Most painful stage for mother and baby.
  • Longest and hardest stage.
  • Cervix begins to dilate and Uterus is contracting
  • contractions start at 5-30 minutes apart
  • contractions become 3-5 minutes

2nd Stage of labor: Expulsion Phase

  • Shortest stage of labor
  • Mother is fully dilated and baby will be crowning
  • Contractions are 2-3 minutes apart (60-90 seconds each)
  • Baby will be delivered

3rd Stage of Labor: Placenta Phase

  • Once baby is done, placenta will detach from uterine wall and be expelled
  • Happens within 5-20 minutes after birth of baby
    Signs:
  • Increase bleeding in vagina
  • uterus becomes smaller in size
  • umbilical cord begins to lengthen
  • Mother has urge to push to again
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9
Q

Describe the steps of assisting with a normal prehospital obstetric
deliver:

A
  1. Select a suitable location away from public view (first Surface PT can lay on)
  2. administer oxygen (2-4 lpm nasal cannula)
  3. Have the PT lay on her back with knees drawn up and spread apart
  4. Place towels under PT buttocks
  5. As head begins to emerge, apply gentle pressure with a gloved hand to prevent explosive delivery
  6. Support the head as it exits the vaginal canal
  7. Once head is out, instruct PT to stop pushing
  8. Inspect baby’s neck to make sure umbilical cord is not wrapped around the neck (nuchal cord)
  9. Suction airway only if obvious obstruction exist
  10. Instruct PT to began pushing again
  11. As the shoulders and full body is delivered, support baby with both hands
  12. DO NOT pull on umbilical cord
  13. Dry, wrap, and warm baby
  14. Clamp umbilical cord, Approximately 6 inches away from baby’s abdomen and again at 3 inches part first clamp
  15. Once cord has stopped pulsating, cut cord between clamps
  16. Observe for delivery of the placenta
  17. If placenta delivers, transport it with PT to hospital
  18. Place sanitary pad over vagina opening
  19. Record time of birth and transport to hospital
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10
Q

Define gravida and para:

A

Gravida:
Refers to pregnancy

Para:
Refers to # of times PT has completed pregnancy (livebirth or stillborn) after 20 weeks of pregnancy

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11
Q

Describe assessment and emergency care of supine hypotensive syndrome.

A
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12
Q

Describe accommodations and modifications to patient assessment and
management required for patients dependent on genitourinary devices

A
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13
Q

Describe palliative care in regards to hospice:

A
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14
Q

What are the different types of Antepartum Emergencies?

A
  • Spontaneous abortion
  • Placenta Previa
  • Abruptio placentae
  • Rupture uterus
  • Ectopic pregnancy
  • Preeclampsia
  • Supine hypotensive syndrome
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15
Q

What is the cause and findings of Spontaneous Abortion?

A

Cause:

Delivery of the fetus and placenta before it is viable

Findings:

  • Cramp like abdominal pain
  • vaginal bleeding
  • passage of tissue and blood clots
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16
Q

What is the treatment of Spontaneous Abortion?

A
  • ABC’s
  • Place a pad over vaginal opening
  • Treat for shock
  • Transport on her side
  • Ask patient when last menstrual period began
  • Emotional support
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17
Q

What is the cause and findings of Placental Previa?

A

Cause: Abnormal implantation of the placenta over or near the opening of the cervix

Findings:

  • predisposing factors:
  • Multiparity
  • age 35 and up
  • Previous placenta previa
  • History of vaginal bleeding
  • Bleeding after intercourse
  • 3rd trimester painless bleeding
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18
Q

What is the treatment of Placental Previa?

A
  • ABC’s
  • Place pad over vagina
  • Treat for shock
  • Transport on her side
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19
Q

List and describe the 3 classifications Placental Previa may be listed as and

A
  • Total: placenta completely covers cervical opening and blocks birth canal
  • Partial: Placenta partially covers cervical opening
  • Marginal : Placenta is implanted near neck of cervix and may tear
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20
Q

What is the cause and findings of Abruptio Placentae?

A

Cause:

  • Separation of the placenta from the uterine wall prior to birth of baby

Findings:

  • Abdominal pain
  • Vaginal bleeding
  • Uterine contractions
  • Abdominal tenderness on palpation
  • Signs of hypovolemic shock
  • NOTE: Bleeding may not be visible if unable to exit uterus
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21
Q

What is the treatment of Abruptio Placentae?

A
  • ABC’s
  • Place pad of vagina
    -Treat for shock
  • Transport of her side
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22
Q

What is the cause and findings of Ruptured Uterus?

A

Cause:

  • Uterus tears as it enlarges during pregnancy possibly release fetus into abdominal cavity

Findings:

  • Vaginal bleeding
  • Tearing, sever abdominal pain
  • Sings of hypovolemic shock
  • Cessation of uterine contractions
  • Ability to palpate the infant in the abdominal cavity
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23
Q

What is the treatment of Ruptured Uterus?

A
  • ABC’s
  • Place pad over vagina
  • Treat for shock
  • Transport on her side
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24
Q

What is the cause and findings of Ectopic Pregnancy?

A

Cause:

  • Fertilized egg implants somewhere other then the uterus
  • symptoms occur within 4-8 weeks of conception

Findings:

  • Predisposing factors
  • Previous ectopic pregnancies
  • Pelvic inflammatory disease
  • Adhesions from surgery
  • Tubal surgery
  • Intrauterine device use
  • assessment findings
  • vaginal bleeding
  • poorly localized pain that becomes sudden and sharp
  • abdominal pain that radiates to shoulder
  • Bloating
  • Signs of shock
  • Discoloration around navel
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25
Q

What is the treatment of Ectoptic Pregnancy?

A
  • ABC’s
  • Place a pad over vagina
  • Treat for shock
  • Transport on her side
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26
Q

What is the cause and findings of Preeclampsia?

A

Causes:

  • Multisystem disorder not well understood
  • Characterized by High blood pressure and swelling in extremities

Findings:

  • abdominal pain
  • History of hypotension
  • Sudden weight gain
  • Altered mental status
  • Blurred vision
  • Excessive swelling in the face, fingers, legs or feet
  • Severe headache
  • Elevated blood pressure
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27
Q

What is the treatment of Preeclampsia?

A
  • ABC’s
  • Transport on her side
  • Be prepared to suction or to ventilate patient if needed
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28
Q

What is the cause and findings of Supine Hypotensive Syndrome?

A

Causes:

  • Complication late in pregnancy due to weight of fetus compressing the inferior vena cava when patient is lying supine

Findings:

  • Dizziness of light headiness
  • Decrease in blood pressure
  • Tachycardia
  • Pale, cool, clammy skin
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29
Q

What is the treatment of Supine Hypotensive Syndrome?

A

Transport patient either seated, on her side, or elevate her right hip if lying supine

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30
Q

When cutting the umbilical cord , it should be cut ____inches from the infant.

A

6 inches

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31
Q

What signs indicate delivery is going to happen within a few minutes?

A
  • Crowning
  • Contractions, every 2 minutes apart or less
  • Urge to defecate
  • Strong urge to push
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32
Q

List the 10 types of Abnormal Deliveries:

A
  • Prolapsed cord
  • Breech/Limb presentation
  • Multiple Births
  • Meconium Staining
  • Premature Birth
  • Post-Term Pregnancy
  • Precipitous Delivery
  • Shoulder Dystocia
  • Pre-Term Labor
  • Premature Rupture of membranes
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33
Q

What is the Explanation and findings of Prolapsed cord?

A

Explanation:

  • Presentation of the umbilical cord after amniotic sac ruptures prior baby’s head emerging causes compression of the cord during delivery and can cause hypoxia for infant

Findings:

  • Umbilical cord emerging from vaginal opening
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34
Q

What is the treatment of Prolapsed Cord?

A
  • ABC’s and O2 prn
  • Place PT in “Knee-chest” or supine position with hips elevated
  • Insert Gloved hand into vaginal canal to remove pressure on the cord (It should be pulsating)
  • Keep cord moist with wet to dry dressing
  • Immediate transport
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35
Q

What is the Explanation and findings of Breech/Limb Presentation?

A
  • When arm/leg or buttock is first instead of head through birth canal

Findings:

  • Buttocks or arm/leg presentation
  • Position mother in “Knee-chest” position, pelvis elevated
  • Insert gloved hand into vaginal canal to create space for respirations if the head cannot be delivered
  • Immediate transport
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36
Q

What is the Explanation and findings of Multiple Births?

A

Explanation:

  • Mother may or may not be aware of multiple birth
  • Typical multiple births

Findings:

  • Continued strong uterine contractions after the birth of 1st infant
  • Possible breech birth for subsequent deliveries
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37
Q

What is the treatment of Multiple Births??

A
  • ABC’s and O2 prn
  • Same guidelines as normal birth, except if additional infant has delivered within 10 minutes immediately
  • consider requesting back, to assist with additional patient(s)
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38
Q

What is the Explanation and findings of Meconium Staining?

A
  • Fecal material in the amniotic fluid
  • indicates fetal stress (hypoxic event) during gestation or delivery

Findings:

  • Greenish to brownish amniotic fluid
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39
Q

What is the treatment of Meconium Staining?

A
  • ABC’s and O2 prn
  • Suction if meconium is present in infant’s airway or if infant is depressed prior to drying to stimulation
40
Q

What is the Explanation and findings of Premature Birth?

A

Explanation:

  • Delivery of an infant before 38th week of gestation or
  • Neonate weighing less then 5 pounds
41
Q

What is the treatment of Premature Birth?

A

Treatment:

  • ABC’s and O2 prn
  • Keep infant Warm
42
Q

What is the Explanation and findings of Post-Term Pregnancy?

A

Explanation:

  • Gestation extend past 42 weeks
  • potential for decline in suitable environment for fetus

Findings:

  • Increased risk of hypoxic incident, difficult delivery, meconium staining
43
Q

What is the treatment of Post-Term Pregnancy?

A

Provide same care as normal delivery

44
Q

What is the Explanation and findings of Precipitous Delivery?

A

Explanation:

  • Birth of fetus in less then 3 hours

Findings:

  • Increased risk of trauma to the fetus and mother
45
Q

What is the treatment of Precipitous Delivery?

A

Provide same care as normal delivery

46
Q

What is the Explanation and findings of Shoulder Dystocia?

A

Explanation:

  • Fetal shoulders are larger then head caused a “Turtle sign” presentation
  • upper shoulder cannot pass through pelvic opening

Findings:

  • Common with post term gestation and gestational diabetic mothers
47
Q

What is the treatment of Shoulder Dystocia?

A
  • Place mother in McRobert’s Position
  • Attempt normal delivery
48
Q

What is the Explanation and findings of Pre-Term labor?

A

Explanation:

  • Onset of labor prior to 37th week of gestation
49
Q

What is the treatment of Pre-Term labor?

A
  • Keep mom calm and prevent mother from pushing
  • Immediate transport
50
Q

What is the Explanation and findings of Premature Rupture of membranes?

A

Explanation:

  • Spontaneous Rupture of amniotic sac prior to onset of labor and the end of 37th week gestation
  • Increase risk of infection to infant
51
Q

What is the treatment of Premature Rupture of membranes?

A
  • Keep mom calm and prevent mother from pushing
  • Immediate transport
52
Q

What are the two types of postpartum complications?

A
  • Postpartum Hemorrhage
  • Embolism
53
Q

What is the Explanation and findings of Postpartum Hemorrhage?

A

Explanation:

  • Blood loss of more then 500 ml following delivery
    -Most often seen in multigravida patients or delivery of large baby
  • Caused by Uterus failing to regain its muscle tone
54
Q

What is the Treatment of Postpartum Hemorrhage?

A
  • O2 therapy
  • Allowing baby to nurse on mothers breast
    (Stimulates and causes release of oxytocin which causes uterine contractions)
  • Fundal massage (Place palm of hand just above the symphysis pubis and apply pressure in a circular or kneading motion)
  • Immediate Transport
55
Q

What is the Explanation and findings of Embolism?

A

Explanation:

Pulmonary embolism (PE)- formed from blood clot in venous system that gets stuck in the lungs

Findings:

  • Shortness of breath
  • syncope
  • Tachycardia
  • sharp chest pain
  • hypotension
  • cyanosis
  • pale, cool, clammy skin
56
Q

What is the Treatment of Embolism?

A
  • Managing ABC’s
  • Provide O2 at 15 lpm NRB
  • If ventilations are inadequate, provide PPV
  • Expedite transport to hospital
57
Q

Explain PT who has Gravida of 2, Para 1

A

PT has been pregnant two times but only given birth once

58
Q

Describe what interventions would be needed if the neonate upon birth HR is between 60-100 and below 60?

A
  • Between 60-100: Administer supplemental O2
  • Below 60: Start chest compressions
59
Q

What is the normal pulse rate for a Newborn child?

A

Between 100-180 BPM

60
Q

What is the sequence of events that follow the delivery of a neonate?

A
  1. Delivery the child
  2. Suction the airway
  3. Cut Umbilical cord
  4. Dry the infant
  5. Calculate the first APGAR score
61
Q

What is the APGAR score and what’s it used for ?

A

An Apgar score is a clinical assessment of a newborn’s health condition within minutes after birth. Measures 5 characteristics:

Skin color
Pulse
Breathing
Muscle tone
Reflex irritability

62
Q

What is the order of interventions for a new born ?

A
  1. Suction, dry, warm, stimulate, position
  2. Oxygen
  3. BVM ventilation
  4. Chest compression
  5. Beyond the scope of care
63
Q

What is the compression rate for a neonate?

A

Compression is 3:1

64
Q

What are the potential signs of malfunction in a CSF Shunt:

A
  • Irritability
  • Increased sleep
  • Nausea and vomiting
  • Fever
  • Headache
  • Blurred vision
  • Seizures
  • Altered mental status
  • Signs of increasing ICP (Bradycardia, abnormal respiratory patterns)
65
Q

What are the differences with pediatric airways:

A
  • Head: In the supine position, a young child’s head will cause a natural flexion of the neck due to its large size. This neck flexion can create a potential airway obstruction.
  • tongue is proportionally larger in the mouth then adults
    Larynx: a child larynx is higher up than in an adult, creating a more anterior location
  • Epiglottis: The adult epiglottis is flat and flexible, while a child’s is U-shaped, shorter and stiffer
  • Vocal cords: The anterior attachment of a pediatric patient’s vocal cords is lower than the posterior attachment, which creates an upward slant, whereas in adults, the vocal cords are horizontal
  • Trachea: The trachea is shorter in pediatric patients, which increases the likelihood of right mainstem intubation.
  • Cartilage of upper airway and trachea are softer
  • Airway diameter: A child’s airway is narrowest at the cricoid ring.

-Residual lung capacity: Smaller lung capacity in pediatric patients means that a child can become hypoxic more quickly than an adult

66
Q

What are the 4 guidelines from the CDC that state the MOI are a serious injury:

A
  1. Falls from over 10 feet or 2-3X times the height of the child
  2. Auto vs Pedestrian or bicyclist
  3. Motorcycle crashes at over 20 MPH
  4. High risk auto crashes: (ejection, Death of other occupant in same vehicle)
67
Q

What is the Pediatric Assessment Triangle or “PAT” and its 3 main elements:

A

Hands of evaluation conducted entirely through visual observation of patients behaviors involving 3 elements:

  • appearance
  • work of breathing
  • circulation
68
Q

Under appearance in the “PAT” triangle, what is the “tickles” pneumonic :

A

T- Tone (how the child looks)
I - Interactiveness ( are they alert and interactive)
C - Consolability
L - Look /glaze
S - Speech or cry

69
Q

What are the different Respiratory Rates for Infant, Toddler, Preschooler, School-age, and Adolescent:

A

Infant: 30-60 breaths per min.

Toddler : 24-40 breaths per min.

Preschooler: 22- 34 bpm

School-age : 18-30 bpm

Adolescent: 12-16 bpm

70
Q

What are the different Pulse Rates for Infant, Toddler, Preschooler, School-age, and Adolescent:

A

Infant: 100-160 BPM

Toddler : 90-150 BPM

Preschooler: 80-140 BPM

School-age : 70-120 BPM

Adolescent: 60-100 BPM

71
Q

How long should the capillary refill take in a child?

A

2-3 seconds

72
Q

What vital signs are apart of the secondary assessment with pediatrics?

A
  • Measured level of consciousness
  • Skin findings
  • Pulse rate and quality
  • Breath rate and quality
  • Blood pressure (3 YO and older)
  • Pupillary response
  • Temperature
  • Quantitated measure of pain
  • Pulse ox, end-tidal CO2, blood glucose, cardiac rhythm monitor if needed
73
Q

What are the pulse Oximeter values for normal rate, mild, moderate and severe hypoxemia?

A

95-99 % :normal
91-94% : mild hypoxemia
86-90% : Moderate hypoxemia
<86% : severe hypoxemia

74
Q

What are the two different type of pain assessment scales

A

Wong- baker faces scale : Faces are used to describe pain

Flacc scale : used for younger then 4 Yo

75
Q

What is the Wong-Baker scale?

A

Pain scale that is meant for 4-12 yo using faces and numbers for pain

76
Q

What is the FLACC scale?

A

Faces, Legs, Arms, Cry , Consolablity scale is used for PT under 4 yo old to determine the pain of the PT

77
Q

What are the common Pediatric medical conditions?

A
  • Croup
  • Epiglottitis
  • Asthma
  • Bronchiolitis
  • Pneumonia
  • Congenital Hearth Disease
  • Shock
  • Cardiac Arrest
78
Q

What is Croup? Signs and symptoms?

A

Croup - Common infection of the upper airway in children between 6 mo. - 4 yo

S/S: PT Sounds Hoarse and harsh “seal bark, Stridor upon inhalation, nasal flaring, tachycardia and cyanosis

79
Q

What is Epiglottitis? Signs and symptoms?

A

Life threatening condition caused by bacterial infection of the epiglottis accompanied by rapid onset and high fever

S/S:

  • Pain when swallowing
  • High fever >102 F
  • Drooling
  • Tripod position
  • Chin thrust forward
  • Stridor
  • Respiratory distress
80
Q

What is Asthma? Signs and symptoms? Emergency care

A

uncurable condition that is an inflammatory process that is characterized by the lower airways (swelling of bronchioles)

S/S:

  • Wheezing
  • Shortness of breath
  • Wheezing
  • nonreproductive cough
  • Tripod position

Emergency Care:

  • Administer O2
  • May need medication with severe attacks
81
Q

What is Bronchiolitis? Signs and symptoms? Emergency Care?

A

Viral infection that causes swelling in the mucosal layers because of Bronchioles

S/S:

  • Low grade fever
  • Tachycardia
  • Shortness of breath
  • Wheezing
  • Coughing

Emergency Care:

  • Administer O2
  • Position of comfort
82
Q

What is Pneumonia? Signs and symptoms? Emergency care?

A

lung infection that causes the air sacs in the lungs to fill with fluid or pus, making breathing difficult

  • Shortness of breath
  • chest tightness
  • diminished chest sounds
  • Dry, Hacking, productive-sounding cough
  • Tendency for child to lie on their side

Emergency Care:

  • administer O2
  • Position of comfort
83
Q

What is Congenital Heart Defect? Signs and symptoms? Emergency care?

A

problem with the structure of the heart that is present at birth

S/S:

  • cyanosis
  • hypoxia
  • shock
  • Respiratory distress
84
Q

What is Febrile Seizures?

A

Seizures that are result of a quick spike of fever

  • common of children less then 6 yo.
85
Q

What is emergency care for seizures?

A
  • Maintain open airway
  • administer O2
  • Position PT on their side
  • Transport
86
Q

What is the emergency care for altered mental status?

A
  • Maintain open airway
  • administer O2
  • Put PT on side and prepare to suction
  • Transport
87
Q
A
88
Q

What is the mammalian dive reflex?

A

Response from the body in cold water that allows blood perfusion and metabolism to slow down thus allowing oxygen to stay in the body longer for brain and vital organs to use .

89
Q

What are some wanting signs of meningitis?

A

A recent ear or respiratory tract infection

High fever

Lethargy and irritability

Vomiting

Loss of appetite

Bulging fontanelle unless the child is dehydrated

Pain on movement (infants crying when picked up)

Rash may or may not be present

90
Q

What is Gastroenteritis?

A

Gastroenteritis is an infection of the gastrointestinal tract that is a leading cause of diarrhea in children

91
Q

What are the S/S of appendicitis?

A
  • Nausea and vomiting
  • Low grade fever
  • Diffuse cramping pain around the umbilicus
  • Localized pain to the right lower quadrant
92
Q

What is “BRUE” and the S/S of it ?

A

“BRUE” = Brief resolved unexplained events.
Describes a brief but now resolved event in a infant

S/S:

  • Infant <1 yo
  • Cyanosis or pallor
  • Breathing that is irregular, decreased or absent
  • Changes in muscle tone (flaccid or limp)
  • Altered level of consciousness
93
Q

What is the narrowest portion of the pediatric airway?

A

Cricoid cartilage

94
Q

What is hypovolemia?

A

Hypovolemia is a condition where the body has a low volume of circulating fluids, such as blood, water, or lymphatic fluid

95
Q

What are the S/S of hypovolemia?

A

Weakness
fatigue
dizziness
increased thirst
low blood pressure
high heart rate
little to no urine production

96
Q

Explain the difference between the airway anatomy in a child and an adult?

A
  • Head: In the supine position, a young child’s head will cause a natural flexion of the neck due to its large size. This neck flexion can create a potential airway obstruction.
  • Tongue is proportionally larger in the mouth then adults
  • Larynx: a child larynx is higher up than in an adult, creating a more anterior location
  • Epiglottis: The adult epiglottis is flat and flexible, while a child’s is U-shaped, shorter and stiffer
  • Vocal cords: The anterior attachment of a pediatric patient’s vocal cords is lower than the posterior attachment, which creates an upward slant, whereas in adults, the vocal cords are horizontal
  • Trachea: The trachea is shorter in pediatric patients, which increases the likelihood of right mainstem intubation.

-Airway diameter: A child’s airway is narrowest at the cricoid ring.

-Residual lung capacity: Smaller lung capacity in pediatric PT

EMT 1 (13 decks)

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