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NREMT Part I + II Flashcards

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1
Q

9-8-8

history, public health, EMT role

A

National suicide and crisis lifeline

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2
Q

EMD

history, public health, EMT role

A

Emergency medical dispatcher

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3
Q

Quality Improvement (QI)

history, public health, EMT role

A

continuous review and auditing of all aspects of the Ems system to identify areas of improvement

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4
Q

EMS is also designed for what?

history, public health, EMT role

A

public health education and prevention efforts

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5
Q

EMS system evolved from what?

history, public health, EMT role

A

Battlefield medicine, ambulance operated by funeral homes and volunteers

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6
Q

EMS quality varied until what year

history, public health, EMT role

A

1970s

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7
Q

white paper

history, public health, EMT role

A

published in 1966. “accidental death and disability; the neglected disease of modern society” beginning of modern EMS

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8
Q

DOT

history, public health, EMT role

A

US department of transportation

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9
Q

EMT NSC

what is? and when was it developed?

history, public health, EMT role

A

EMT National Standard Curriculum first developed in 1970s by DOT

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10
Q

AHA

history, public health, EMT role

A

American Heart Association. increases emphasis on heart disease prevention, science, education in 1980s

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11
Q

NHTSA

history, public health, EMT role

A

National Highway Traffic Safety Administration. 1990s started work on EMS Agenda for the future

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12
Q

Public Access defibrillation started when/

history, public health, EMT role

A

1990s

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13
Q

NEMSES

When did it start

history, public health, EMT role

A

National EMS Education Standard. 2000s

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14
Q

What major additions did NEMSES add in 1990s

history, public health, EMT role

A

Administration of beta agonist meds, anticholinergic meds, OTC analgesics, BGL monitoring, CPAP, SPo2, Assisting higher level providers

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15
Q

Clinical Care

history, public health, EMT role

A

Outlines the scope of practice and associated equipment

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16
Q

Highest risk of harm

Reasons EMS is called

history, public health, EMT role

A
  1. Airway obstruction
  2. Respiratory distress/arrest
  3. Cardiac arrest
  4. Hypovolemic shock
  5. anaphylaxis
  6. stroke
  7. inhalation injury
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17
Q

EMT scope

whats in it?

history, public health, EMT role

A
  • Everything in EMR scope
  • Oral OTC analgesics (Aspirin, Narcan.Others not in our CO scope? )
  • Anticholinergic meds (Not in Colorado right?exmpl: Atropine for poisoning)
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18
Q

Routine EMT activites that are high risk for patients

history, public health, EMT role

A
  1. transfer of pt care
  2. lifting and moving pts
  3. transportation
  4. Spinal Precautions
  5. Medication administration
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19
Q

QI or CQI

history, public health, EMT role

A

quality improvement
continuous quality improvement
1.review/auditing of EMS to identify areas of improvement
2.medical director responsible for this

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20
Q

Integrated public health examples

history, public health, EMT role

A

1.immunization clinics
2.prevention education
3.saftey and wellness events
4.public CPR training

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21
Q

Priority of saftey after yourself

workforce saftey/wellness/moving pt/pt restraint

A

1.partner
2.patient
3.bystanders

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22
Q

Stages of grief

workforce saftey/wellness/moving pt/pt restraint

A

1.Denial
2.Anger
3.Barganing
4.Depression
5.Acceptance

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23
Q

Acute stress

workforce saftey/wellness/moving pt/pt restraint

A

immediate physiological and psychological reaction. triggers “fight or flight response”

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24
Q

Delayed stress

workforce saftey/wellness/moving pt/pt restraint

A

stress reaction that developes after event. PTSD is an example

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25
Q

Cumulative Stress

workforce saftey/wellness/moving pt/pt restraint

A

1.exposure to stress over long period of time.
2.leads to burnout

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26
Q

Signs of stress or burnout

workforce saftey/wellness/moving pt/pt restraint

A
  1. Anxiety/irritability
  2. HA. Poor concentration
  3. loss of appitite, hard to sleep
  4. loss of interest
  5. increased alcohol/drug use
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27
Q

CISM

workforce saftey/wellness/moving pt/pt restraint

A

Critical Incident Stress Management

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28
Q

CISM componants

workforce saftey/wellness/moving pt/pt restraint

A
  1. diffusing sessions (4 hours after incident)
  2. debreifing sessions (24-72 hours after incident)
  3. trained peer councilors and mental health professionals
  4. NOT for pt care crituiqe or performance evaluation
  5. information is confidential
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29
Q

Pathogens

workforce saftey/wellness/moving pt/pt restraint

A

Cause infections diseases

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30
Q

Viral infections

workforce saftey/wellness/moving pt/pt restraint

A

Resistance to antibiotics

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31
Q

Epidemic vs Pandemic

workforce saftey/wellness/moving pt/pt restraint

A

epidemic: widespread disease in community at certain time
pandemic: outbreak of disease across several countries or conitents

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32
Q

OSHA

workforce saftey/wellness/moving pt/pt restraint

A

Occupational saftey and health administration
1.oversees woreplace saftey and infections disease precautions

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33
Q

where do you report exposure to?

workforce saftey/wellness/moving pt/pt restraint

A

Designated infection control officer

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34
Q

Single most important way to prevent infection spread

workforce saftey/wellness/moving pt/pt restraint

A

Handwashing

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35
Q

minimum PPE

workforce saftey/wellness/moving pt/pt restraint

A

Gloves
Eyeprotection

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36
Q

PPE for significant body fluid contact

A

gown
mask
faceshield

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37
Q

PPE for suspected airborne disease

A

HEPA or N95

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38
Q

Staging for PD

A

being called to a scene but maintain a clear distance until snece is cleared for saftey

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39
Q

Power grip

A

palms up and fingers wrapped

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40
Q

Emergency Moves

A

scene is dangerous and pt must be moved before providing care

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41
Q

Emergency move examples

A

1.armpit forearm drag
2.shirt drag
3.blanket drag

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42
Q

urgent move

A

when pt has potentially life threatening injury/illness must be moved quickly for evaluation

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43
Q

Rapid extraction

A

type of urgent move
1. for pt in motor vehicle
2. multiple rescuers and long backboard

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44
Q

Non-urgent moves

A
  1. direct ground lift
  2. extremity lift
  3. direct carry
  4. drawsheet method
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45
Q

log roll min people to perform

A

3

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46
Q

Hipaa law is?

A

Federal law requires the creation of national standards to protect sensitive patient health information from being disclosed

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47
Q

Cultural competence

A

Ability to provide care to patients with diverse values, beliefs, and behaviors

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48
Q

HIPAA

A

Stands for health insurance portability and accountability act.
Established in 1966

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49
Q

4 components necessary to prove negligence

A

Duty to act
Breach of duty
Damage
Proximate cause

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50
Q

Negligence

A

Deviation from the standard of care that a reasonable person would use in a particular set of circumstances
- type of tort
- no intent to harm the pt
- breach of duty to act

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51
Q

Standard of care vs scope of practice

A

Scope is what you are allowed to do care is how well you need to be able to do it

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52
Q

5 types of consent

A

Expressed
Implied
Minor
Involuntary
Informed

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53
Q

Informed consent
Define

A

For patients who are alert and competent. They have to be informed of care plan and associated risks of accepting or refusing

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54
Q

Expressed consent
Define

A

The patient must be alert and competent. Can be given verbally or non verbally. Not as indepth as informed consent. For more basic assessments or procedures

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55
Q

Implied consent

A

Assumption of consent for an unresponsive or incompetent patient. Incopentancy may be due to alcohol, drug, head injury, hypoxia, hypoglycemia, or mental incompetence. Can be used for patients who refused care then passed out

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56
Q

Minor consent

A

Consent required from parent or guardian. It’s implied consent if unable to reach parent or guardian. Not required for emancipated minors who are married or pregnant, already a parent, member of the armed forces, emancipated by court.

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57
Q

Involuntary consent

A

Mentally incompetent or in custody of law. Consent must be obtained from the entity of appropriate legal authority

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58
Q

Hospital destination

A

Patients ability to pay should not figure into where they are transported
Document why the facility was chosen
When in doubt, consult medical direction

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59
Q

Components of a competent patient that can refuse transport

A

A&o x4
Legal age
No communication barriers (language or hearing)
Not impaired by drugs/alcohol
Not impaired by illness or injury

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60
Q

When can an emt release confidential patient information

A

Continuity of care
Billing
Emt has received a supenia
Reporting crime, abuse, assault, negligence, certain injuries, communicable diseases

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61
Q

Crime scene

special reporting considerations

A

Document position of patients and everything you touched
Report anyone or anything that seems suspicious

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62
Q

Emts professional ethics should reflect what?

A

Emt code of ethics published by national association for emts

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63
Q

E-PCR

A

Electronic patient care report

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64
Q

FCC

A

Federal communications commission
- regulates all radio operations in the U.S
- Alocated specific frequencies for EMS

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65
Q

Portable radios

A

Hand held vary limited range unless used with a repeater system

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66
Q

Mobile radios

A

Vehicle mounted greater range than portable radios repeater system is still required

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67
Q

Base station

A

Transmitter/receiver fixed location in contact with all components of radio system

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68
Q

Repeater

A

Type of base station low powered transmissions rebroadcast at higher power to improve range

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69
Q

MDC’s

A

Mobil Data Computers
- digital information reduces radio traffic
- displays information such as address of call, routing info, and call details

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70
Q

Guidelines for radio communications

A

Notify dispatch when en route, on scene, en route to hospital, at hospital, back in service

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71
Q

Do’s for radio communication.

A
  • correct radio/frequency
  • insure no other radio traffic before transmitting
  • push to talk button for 1 sec before speaking
    -state who you are talking to then who you are THEN speak
  • use clear text, not radio codes (unless approved locally)
  • use affirmative and negative instead of yes and no
  • use copy to confirm receipt of transmission
  • always repeat orders for med direction to ensure accuracy
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72
Q

Do NOT’s of radio communications

A
  • please or thank you
  • protected information (patients name)
73
Q

Who is subpoenaed to give a deposition or testify in court

A

The person who wrote the PCR

74
Q

Documentation rule (4)

A

-if you did it document if you didn’t do it don’t say you did
- it’s better to document well than to explain why you didn’t do it later
- if your times are inaccurate, the rest of your PCR may be called into question
- spelling counts

75
Q

Minimum data set for PCR

A
  • times
  • patient information (at least 2 sets of vitals + a lot more)
  • administrative info
  • narrative
76
Q

FACT

For documentation

A
  • factual (objective information Fancy word)
  • accurate
  • complete
  • timely
77
Q

SOAP documentation

A
  • Subjective
  • Objective
  • Assessment
  • Plan
78
Q

CHART documentation

A
  • CC
  • history
  • assessment
  • treatment
  • transport
79
Q

HEENT

A

-Head
-Ears
-Eyes
-Nose
-Throat

80
Q

Pertinent negatives

A

S/S you expect, but the patient denies
E.X. patient experiences trauma but denies neck pain
E.X. patient has chest pain but denies dyspnea

81
Q

Associated symptoms

A
  • patient complaints that are in addition to cheif complaint
    E.X. cheif complaint is chest pain patient also complains of mild difficulty breathing
82
Q

Errors of ommision

A
  • something that should have been included on the PCR but was left out
83
Q

Errors of commission

A
  • something was included on the PCR that was incorrect
84
Q

Special reporting situations

A
  • death
  • MCI
  • suspected abuse or neglect
  • suspected crime
  • animal bites
    -disease outbreak
85
Q

S in SOAP Componants

A

Subjective
-CC
-HPI (History of present illness)
-Hx
-Medications
-Allergies

86
Q

O in SOAP componants

A

Objective
-Vitals
-physical exam
-Diagnostic data

87
Q

A in SOAP compantants

A

Assessment
- combines objective and subjective
- possible problems, field impression

88
Q

P in SOAP componants

A

Plan
-treatment initiated
-response to treatment

89
Q

Shock

Basic definition

A

Inadequate perfusion

90
Q

Axial skeleton

A

skull
spinal column
thoracic cavity

91
Q

How many vertabrae in the spinal column

A

33 (9 fused)

92
Q

What does the thoracic cavity store?

A

Heart
lungs
trachae
esophagus
great vessels

93
Q

What is the Appendicular skeleton

A

Arms
Legs
Pelvis
Shoulder girdle

94
Q

What forms the shoulder girdle

A

Clavial
scapula
humerus

95
Q

what bones form the pelvis

A

Illium
Ischium
Pubis

96
Q

Basic joint types (3)

A

Symphasis: joint with limited motion
Ball and socket: distal end is capable of free motion (Shoulder)
Hinge joint: bones can move only uniaxially (knee)

97
Q

Componants of upper airway

A

-Nose and mouth
-Nasopharynx
-oropharynx
-larynx
-Epiglottis

98
Q

What is the most common cause of upper airway obstruction

A

tongue

99
Q

Componants of lower airway

A

-trachea
-Carina
-left and right mainstem bronchi
-bronchiols
-alveoli

100
Q

Carina

A

where trachea branches into left and right mainstem bronchi

101
Q

Surfactant

A

substance that helps keeps the alveoli from collapsing

102
Q

intercostal muscle location

A

inbetween ribs

103
Q

O2 % in atmospheric air

A

21%

104
Q

O2 % in exhaled air

A

16%

105
Q

External respiration

A

exchange of O2 and Carbon dioxide between alveoli and pulmonary capillaries

106
Q

Internal respiration

A

Gas exchange between bodies cells and systemic capillaries

107
Q

Cellular respiration

A

Aerobic metabolism
-uses O2 to break downglucose to create energy

108
Q

Carbon dioxide drive

A

-Main mechanism of breathing control
-brain stem monitors CO2 levels in blood and CSF

109
Q

Tidal Volume

A

amount of air inhaled or exhaled in one breath

110
Q

Normal tidal volume of healthy adult at rest

A

400 - 500 mL

111
Q

Residual volume

A

amount of air in lungs after completely exhaling (keeps the lungs open)

112
Q

Inspiratory/expiratory reserve volume

A

the amount of air you can still inhale or exhale after a normal breath

113
Q

Dead space (VD)

A

the amount of air in the respiratory system not including the alveoli
-where air collects but no gas exchange is involved

114
Q

Average adult Dead Space volume

A

150ml

115
Q

Minute ventilation

A

Respiratory rate x tidal volume

116
Q

Which side of the heart is stronger (has a greater workload)

A

Left (receiving O2 blood from lungs and sends to body)

117
Q

Layers of the heart (Inner to outer)

A

-Endocardium (Smooth thin lining)
-Myocardium (thick middle muscular)
-Epicardium (outer most layer of heart & inner most layer of pericardium)

118
Q

Atrial kick

A

atria pumps blood into the ventricals just before the ventricals contract

119
Q

What action of the heart causes the pulse

A

Left ventricular contraction

120
Q

When do the hearts valves close

A

during ventricular contraction

121
Q

heart electric nodes and impulse rates

A
  • Sinoatrial (SA) : 60-100
  • Atrioventricular (AV) : 40 - 60
  • Bundle of His : 20 - 40
122
Q

Contractility

A

Hearts ability to contract

123
Q

Preload

A
  • created by blood volume in left ventrical after diastole
  • based on the amount of blood coming back to the heart
124
Q

What does increased preload lead to

(think basic anatomy)

A
  • increased stretching of ventricals
  • increased myocardial contractility
125
Q

Afterload

A
  • Resistance heart must overcome during ventricular contraction
126
Q

What does increased afterload lead to

(Dont over think it sweet thang)

A

decreased cardiac output

127
Q

what is the one artery in the heart that carries deoxygenated blood

A

Pulmonary artery

128
Q

what is the one vein in the body that carries oxygenated blood

A

Pulmonary vein

129
Q

Systemic Vascular Resistance (SVR)

A

Resistance of bloodflow throughout the body (excluding pulmonary system)

130
Q

SVR is determined by the size of what

A

Blood vessels

131
Q

what do constricted/ dialated blood vessels do to the SVR

A
  • Constriction: increases SVR and BP
  • Dialation: Decreases SVR and BP
132
Q

Componants of blood (4)

A
  • plasma
  • red blood cells
  • white blood cells
  • Platelets
133
Q

Plasma

A

liquid componant of blood; made mostly of water

134
Q

Red blood cells

A

Erythrocytes
- O2 carrying component of blood

135
Q

White blood cells

A

Leukocytes
-fight infection
defend against invading organisms

136
Q

Platelets

A

Essential for clot formation to stop bleeding

137
Q

Systolic blood pressure

A

pressure exerted during left ventrical contraction

138
Q

Parts of epidermis

(its okay, this wasnt in our textbook)

A

Germinal layer: produced new skin cells
Stratum corneal layer: Top epidermal layer, consists of dead skin cells

139
Q

Dermis contains what structures

A
  • blood vessels
  • nerve endings
  • sweat glands
  • hair follicles
140
Q

subcutaneous tissue

A
  • Fatty tissue
  • deepest layer of skin
  • layer above muscle
141
Q

ATP

A

Andenosine Triphosphate
- Cellular energy
- body uses O2 to convert nutrients into ATP
- cells recieve exponentially moreATP if there is adequate O2 supply

142
Q

Waste products of Aerobic metabolism

A
  • water
  • carbon dioxide
143
Q

Anaerobic Metabolism

A

Creation of energy without an adequate O2 supply
- by product is lactic acid

144
Q

Ventilation

A

pulmonary ventilation
- movement of air in and out of lungs

145
Q

neonate

A

Birth to one month of age

146
Q

Infant

A

one month to one year

147
Q

Toddler

A

one to 3 years of age

148
Q

Preschooler

A

3 to 6 years of age

149
Q

Typical newborn weight

A

6-8 lbs (3-3.5 kilograms)

150
Q

Newborn head makes of what % of weight

A

25%

151
Q

Most significant source of heatless on newborns body

A

Head

152
Q

What is lost then gained in the first couple weeks of neonate

A

weight

153
Q

when are newborns fontanels fully fused

A

18 months

154
Q

Depressed fontanelles indicates

A

hypovolemia (Dehydration)

155
Q

Bulging fontanelles indicates

A

Infection or increased ICP

156
Q

Infants are obligate ___ breathers

A

Nose

157
Q

Rapid breathing in an infant can lead to

A

fluid and body heat loss

158
Q

Hyperventilation in infants presents an increased risk of

A

barotrauma

159
Q

barotrauma

A

Injury to tissues in bodies air cavities

160
Q

4 typical reflexes of neonates

A
  • startle
  • grip
  • rooting
  • sucking
161
Q

Development milestones at 6 months

A
  • teething
  • sit upright
  • track objects visually
162
Q

Development milestones at 12 months

A
  • know own name
  • recognize parents/caregivers
  • walk with assisstance
  • speak a few words
  • still communicate distress primarily through crying
163
Q

Toddler development milestones

A
  • walk
  • climb
  • distinguish basic shapes/colors
  • potty trained
164
Q

Preschooler development milestones

A
  • physically coordinated
  • communicate well verbally
  • know name and address
  • dress themselves
  • can count to 10 or beyond
165
Q

Toddler/preschooler special communicaiton recommendations

A
  • seperation anxiety is common
  • speak to caregiver and child directly
  • words taken literally
  • Do not lie
166
Q

School age children

A

6 - 12 years

167
Q

School age physiology

A
  • permanent teeth grow in
  • musculoskeletal system growing rapidly
168
Q

School age development milestones

A
  • read and write
  • develope basic problem solving
  • establishing self image and morals
  • large social cirlce
  • understand concept of death
  • look up to authority figures
169
Q

School age communication considerations

A
  • use understandable terms
  • do not talk down to them
  • respect privacy rights for this age group
170
Q

Adolescents

A

12 to 18 years

171
Q

Adolescent physiology

A
  • Puberty occurs
  • significant physical growth over 3 year period
  • eating disorders are common (Up to 25) more common in females
172
Q

Adolescent developmental milestones

A
  • argumentative
  • hypercritical
  • egocentric
  • do not anticipate consequences of own actions
  • peer pressure
  • high risk of depression/suicide
  • preoccupied with body image/physical appearance
  • become sexually active
173
Q

Adolescent communication recommendations

A

talk about sensitive matters without caregivers present if possible

174
Q

Adulthood stages

A
  • Early adulthood: 20 - 40
  • Middle adulthood: 40 - 60
  • Late adulthood: over 60
175
Q

What is the leading cause of death in young adults

A

accidental trauma

176
Q

mild physical decline usually developes at what age

A

middle adulthood

177
Q

continued physical and mental decline is common at what age

A

late adulthood

178
Q
A

emt (42 decks)

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