nremt_exam_20230205144429 Flashcards

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1
Q

National Highway Traffic Safety Administration (NHTSA)

A

The lead agency for coordinating and promoting evidence-based emergency medical services (EMS) and the 911 system.

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2
Q

Public Safety Answering Point (PSAP)

A

The designated call-receiving site that directs high-priority calls to the apporpriate emergency services.

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3
Q

Hand-Off Procedure

A
  • S = Situation (Overview of Present Issue)* B = Background (Patient History)* A = Assessment (Pertinent Findings)* R = Recommendations (Actions Needed)
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4
Q

CBNRE Agents| Terrorism

A
  • C = Chemical* B = Biological* N = Nuclear* R = Radiological* E = Explosive## FootnoteThe CNBRE agents are technologic hazardous agents (i.e. “weapons of mass destruction”) that are intended to cause widespread harm and/or fear amongst a population.
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5
Q

TRACEM-P Harms| Exposure

A
  • T = Thermal* R = Radiological* A = Asphyxiation* C = Chemical* E = Etiological* M = Mechanical* P = Psychological## FootnoteThe TRACEM-P harms are types of hazards that EMS personnel may be exposed to (during terrorist incidents).
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6
Q

SLUDGEM| Nerve Agents

A
  • S = Salivation (Stimulation of Salivary Glands)* L = Lacrimation (Stimulation of Lacrimal Glands)* U = Urination (Relaxation of Internal Sphincter of Urethra)* D = Defacation (Relaxation of Anal Sphincter)* G = Gastrointestinal Upset (Changes to GI Muscle Tone)* E = Emesis (GI System Effects)* M = Miosis (Contraction of Pupil)## FootnoteSLUDGEM is a mnemonic that refers to the common signs/symptoms of nerve agent poisioning.
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7
Q

Maximum Visibility of Emergency Vehicles| Night Operations

A
  • On: Red Warning Lights* Off: Headlights* Off: Fog Lights* Operating: Traffic Directional Boards
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8
Q

NFPA 704 Placard| HAZMAT

A
  • Blue = Health Hazard* Red = Fire Hazard* Yellow = Reactivity* White = Specific Hazard## FootnoteNFPA = National Fire Protection Assocation
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9
Q

Triage| Mass Casualty Incidents (MCI)

A
  • Priority 1 (Red): Treatable Life-Threatening Illnesses/Injuries* Priority 2 (Yellow): Serious, Non-Fatal lllnesses/Injuries* Priority 3 (Green): “Walking Wounded”* Priority 4/0 (Black): Dead or Fatally Injured
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10
Q

Priority 1 (Red)| Triage

A
  • Airway/Breathing Difficulties* Uncontrolled/Severe Bleeding* Decreased/Altered Mental Status* Severe Medical Problems* Shock (Hypoperfusion)* Severe Burns## FootnotePriority 1 = In Critical Condition
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11
Q

Priority 2 (Yellow)| Triage

A
  • Burns w/o Airway Difficulties* Major/Multiple Bone or Joint Injuries* Back Injuries w/ or w/o Spinal Cord Damage## FootnotePriority 2 = In Need of Ambulance Support
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12
Q

Priority 3| Triage

A

Patients with minor musculoskeletal injuries or minor soft-tissue injuries.## FootnotePriority 3 = Likely NOT in Need of Ambulance Support

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13
Q

Priority 4/0| Triage

A
  • Exposed Brain Matter* Cardiac Arrest (for >20 Minutes)* Decapitation* Severed Trunk* Incineration## FootnotePriority 4/0 = Too Late to Save
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14
Q

START| Triage

A
  • R = Respiration* P = Pulse* M = Mental Status
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15
Q

Privileges of Ambulatory Driving| Vehicle Operations

A
  • Able to park the ambulance anywhere (if no harm is done to property/people).* Able to proceed past red stop signals, flashing red stop signals, and stop signs.* Able to exceed the posted speed limit (if people/property are not endangered).* Able to pass other vehicles in no-passing zones after properly signaling.* Able to disregard regulations for direction of travel and turning in certain directions.
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16
Q

DCAP–BTLS

A
  • D = Deformities* C = Contusions* A = Abrasions* P = Penetrations/Punctures* B = Burns* T = Tenderness* L = Lacerations* S = Swelling
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17
Q

Past Medical History (PMH)| Secondary Assessment

A
  • S = Signs/Symptoms* A = Allergies* M = Medications* P = Pertinent Past History* L = Last Oral Intake* E = Events Leading to Illness
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18
Q

History of Present Illness (HPI)| Secondary Assessment

A
  • O = Onset* P = Pain/Palliation* Q = Quality* R = Radiation* S = Severity* T = Time* AS = Associated Signs* PN = Pertinent Negatives
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19
Q

Beck’s Triad| Cardiac Tamponade

A
  • Hypotension (Narrowing Pulse Pressure)* Muffled Heart Sounds* Jugular Vein Distention (JVD)## FootnoteBeck’s Triad represents the three hallmark signs/symptoms of cardiac tamponade.
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20
Q

Cushing’s Triad| Intracranial Pressure (ICP)

A
  • Hypertension (Widening Pulse Pressure)* Bradycardia* Irregular Respirations## FootnoteCushing’s Triad represents three hallmark signs/symptoms of increased intracranial pressure.
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21
Q

Ryan White CARE Act

A

The law that established a procedure by which emergency response personnel can seek to find out if they have been exposed to potentially life-threatening disease while providing patient care.

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22
Q

Stress Reactions

A
  • Acute Stress Reaction (Soon After Incident)* Delayed Stress Reaction (Long After Incident)* Cumulative Stress Reaction (Years of Low-Level Stressors)
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23
Q

Situations Requiring Emergency Moves

A
  • The scene is hazardous.* Care of life-threatening conditions requires patient re-positioning.* It is necessary to reach other patients.## FootnoteEmergency moves should be performed only when absolutely necessary.
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24
Q

Urgent Move

A
  • The patient’s condition is deteriorating.* The required treatment can be performed only if the patient is moved.
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25
Q

Requirements of Refusal of Care

A
  • Legally Able to Consent* Mentally Competent/Oriented* Fully Informed of Risks* Signed Release Form
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26
Q

Requirements of Negligence

A
  • The EMT had a duty to act.* There was a breach of duty.* There was proximate causation.## FootnoteBreach of Duty: The EMT failed to act OR failed to provide care at the standard expected.
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27
Q

Types of Shock

A
  • Cardiogenic: The heart fails in its ability to pump blood.* Hypovolemic: Loss of blood volume via severe bleeding or dehydration.* Distributive: Loss of blood vessel tone (leading to hypotension).* Obstructive: Blood is physically prevented from flowing.## FootnoteDistributive shock encompasses neurogenic shock, anaphylactic shock, and septic shock.
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28
Q

Compensated Shock

A
  • Slight Mental Status Changes (e.g. Anxiety; Feelings of Impending Doom)* Increased Heart Rate (Tachycardia)* Increased Respiratory Rate (Tachypnea)* Delayed Capillary Refill Time* Diaphoresis (i.e. Pale, Cool, Moist Skin)## FootnoteCompenstated shock occurs when the body is able to sustain normal physiological function despite hypoperfusion.
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29
Q

Causes of Obstructive Shock

A
  • Tension Pneumothorax* Cardiac Tamponade* Pulmonary Embolism
30
Q

Decompensated Shock| Hypotensive Shock

A
  • Decreased Blood Pressure (Hypotension)* Altered Mental Status## FootnoteDecompensated shock occurs when the physiological compensatory mechanissm failed in their effort to sustain perfusion.
31
Q

Irreversible Shock

A

The state in which inadequately perfused organ systems begin to die, which is commonly followed by patient death.

32
Q

Infant Physiologic Reflexes| Life Span Development

A
  • Moro Reflex: The infant throws out arms, spreads fingers, and grabs with fingers/arms when startled.* Palmar Reflex: Infant grasps when object is placed in palm.* Rooting Reflex: Infant turns head toward the side touched, when cheek is touched while hungry.* Sucking Reflex: Infants starts sucking when lips are stroked.
33
Q

Pediatric Repiratory Anatomy Considerations| Airway Assessment

A
  • The mouth and nose are smaller (i.e. more easily obstructed).* The tongue take up proportionally more space within the oral cavity.* The trachea is softer (i.e. more flexible) and narrower (i.e. more easily obstructed).* The chest wall is softer (i.e. less rigid).
34
Q

Compsensation for Hypoxia| Respiratory Assessment

A
  • Shortness of Breath* Increased Respiratory Rate (Tachypnea)* Increased Heart Rate (Tachycardia)* Use of Accessory Muscles
35
Q

Stages of Respiratory Compensation

A
  • Respiratory Distress: Body’s compensating mechanisms are meeting increased metabolic demand (and characterized by increased work of breathing).* Respiratory Failure: Body’s compensating mechanisms fail to meet elevated metabolic needs (and characterized by severe hypoxia and hypercapnia).* Respiratory Arrest: The complete stoppage of breathing.## FootnoteRepiratory failure is indicative of inadequate breathing.
36
Q

Respiratory Failure

A
  • No/Poor Movement of Air* Diminished/Absent Breath Sounds* Rapid/Slow/Irregular Ventilation Rate* Inability to Speak* Unusual Breathing Noises (Wheezing, Crowing, Stridor, Snoring, Gurgling, Gasping)
37
Q

Oxygen Therapy Devices

A
  • Nonrebreather Mask: O2 @ 12–15 LPM* Bag-Valve Mask: O2 @ 12–15 LPM* Nasal Cannula: O2 @ 2–6 LPM* Tracheostomy Mask: O2 @ 8–10 LPM
38
Q

Pulse| Vital Signs

A
  • Adult/Adolescents: 60–100 BPM* Preschooler/School-Age: 70–110 BPM* Toddler: 90–130 BPM* Infant/Newborn: 110–160 BPM
39
Q

Brachial Pulse vs. Radial Pulse

A
  • Measure the brachial pulse for infants of 1 year old or younger.* Measure the radial pulse for patients of 1 year old or older.## FootnoteThe carotid pulse should be measured if the radial pulse nor brachial pulse can be measured/accessed.
40
Q

Respiration| Vital Signs

A
  • Adult/Adolescents: 12–20 BPM* Preschooler/School-Age: 20–32 BPM* Toddler: 24–40 BPM* Infant/Newborn: 30–60 BPM
41
Q

Respiratory Sounds| Vital Signs

A
  • Snoring: Patient’s airway is blocked/obstructed.* Wheezing: Medical condition involving bronchocontriction.* Gurgling: Fluids are present in the airway.* Crowing: Medical condition that cannot be treated on-scene.
42
Q

Skin Abnormalities| Vital Signs

A
  • Pale: Poor Circulation (due to Blood Loss, Hypotension, Shock, or Distress)* Cyanotic: Hypoxia (due to Inadeuate Breathing or Heart Dysfunction)* Flushed: Heat Exposure* Jaundiced: Liver Abnormalities* Mottled: Shock
43
Q

Pupil Abnormalities| Vital Signs

A
  • Dilated: Drug Usage; Blood Loss* Constricted: Narcotics Consumption* Unequal: Stroke; Head Injury; Eye Injury* Unreactive: Drug Usage; Brain Hypoxia
44
Q

Blood Pressure| Vital Signs

A
  • Adult: Systolic ≤ 120 mmHg* Adolescent Systolic @ 110–120 mmHg* Infant: Systolic @ 90 mmHg* Birth: Systolic @ 50–70 mmHg
45
Q

Common Medications| Secondary Assessment

A
  • Hypertension: Captopril, Lisinopril, HZTC* Diabetes (Insulin): Humalog, Humalin, Lantus, Metformin* Mental Disorders: Xanax, Celexa, Lexapro, Paxil, Seroquel
46
Q

Verbal Report| Communications

A
  • Patient’s Chief Complaint* History of Present Illness/Injury* Treatment Administered En Route + Patient Response* Vital Signs taken *En Route** Assessment Findings (+ Pertinent Negatives)
47
Q

Elements of Prehospital Care Report| Documentation

A
  • General Impression of Patient* Narrative Summary of Events throughout the Call* Patient History; Assessment Findings; Treatments Administered* Transport Information
48
Q

Six Rights of Medication Administration| Pharmacology

A
  • Right Patient* Right Medication* Right Route* Right Dose* Right Time* Right Documentation
49
Q

Routes of Administration| Pharmacology

A
  • PO = Oral* SL = Sublingual* INH = Inhalation* IN = Intranasal* IM = Intramuscular* SubQ = Subcutaneous* IO = Intraosseous* ET = Endotracheal* IV = Intravenous
50
Q

Administerable/Assistable Medications

A
  • Oxygen* Aspirin* Nitroglycerin* Naloxone (Narcan)* Activated Charcoal* Oral Glucose* Albuterol/Inhaler* Epinephrine Pen
51
Q

Pediatric Inadequate Breathing| Respiratory Emergencies

A
  • Nasal Flaring* Retractions* Grunting* Seesaw Breathing
52
Q

Pathophysiological Indications of C-PAP| Respiratory Emergencies

A
  • Congestive Heart Failure (CHF)* Pulmonary Edema* Drowning* Asthma* Chronic Obstructive Pulmonary Disease (COPD)* Respiratory Failure
53
Q

Sign/Symptom Indications of C-PAP| Respiratory Emergencies

A
  • Pulse Oximetry < 90%* Respiratory Rate > 25 BPM* Use of Accessory Muscles during Breathing## FootnoteAt least two of these conditions must be experienced for C-PAP to be indicated.
54
Q

Contraindications of C-PAP

A
  • Severely Altered Mental Status* Inability to Protect Airway* Inability to Follow Commands* Inability to Sit Up* Lack of Normal/Spontaneous Respirations* Hypotension (< 90 mmHg)* Inability to Maintain Mask Seal* Nausea/Vomiting* Chest Trauma (Tension Pneumothorax)* Shock* Upper Gastrointestinal Bleeding (or Gastric Surgery)
55
Q

Side Effects of C-PAP

A
  • Hypotension* Pneumothorax* Increased Risk of Aspiration* Drying of Corneas
56
Q

Dosage of C-PAP

A
  • 5–10 cm H2O## FootnoteThe dosage of C-PAP should be gradually increased from 5 cm H2O to 10 cm H2O.
57
Q

Lung Auscultation Abnormalities

A
  • Wheezing: Narrowed Air Passageways in Lungs (e.g. Asthma; Emphysema; COPD)* Crackles/Rales: Fluid in the Alveoli* Rhonchi/Snoring: Secretions in Larger Airways (e.g. Pneumonial Bronchitis)* Stridor: Partial Obstruction of Trachea/Larynx
58
Q

Asthma

A
59
Q

Congestive Heart Failure (CHF)

A

An inability to pump blood out of the heart that results in increased pressure within the pulmonary capillaries (and the lungs)## FootnoteCHF results in pulmonary edema.

60
Q

Pulmonary Edema (PE)

A
61
Q

Signs/Symptoms of CHF/PE| Congestive Heart Failure + Pulmonary Edema

A
  • Respiratory Distress (Dyspnea)* Anxiety* Pale + Diaphoretic Skin* Tachycardia* Hypertension* Hypoxia* Crackles/Wheezes* Pink/White Sputnum* Pulmonary Edema
62
Q

Signs/Symptoms of Pneumonia

A
  • Coughing (w/ Green Mucus)* Shortness of Breath* Fever + Chills* Sharp/Pleuritic Chest Pain* Headaches* Confusion* Fatigue* Pale + Diaphoretic Skin## FootnotePneumonia is an infection of one or both lungs caused by bacteria/viruses/fungi.
63
Q

Signs/Symptoms of Spontaenous Pneumothorax

A
  • Sharp/Pleuritic Chest Pain* Decreased/Absent Breath Sounds on Injured Lung* Shortness of Breath (Dyspnea)* Hypoxia + Cyanosis* Tachycardia* (Jugular Vein Distension)* (Hypotension)
64
Q

Spontaneous Pneumothorax

A

A collapse of the lung without injury or any other obvious cause.## FootnoteIndividuals who are thin, tall, or smoke are at highest risk of experiencing a spontaneous pneumothorax.

65
Q

Signs/Symptoms Pulmonary Embolism

A
  • Sharp/Pleuritic Chest Pain* Shortness of Breath (Dyspnea)* Hypoxia + Cyanosis* Tachycardia * Tachypnia* Anxiety* Cough (w/ Bloody Sputnum)## FootnotePulmonary embolism is the blockage of blood supply to the lungs that often results from Deep Vein Thrombosis (DVT)
66
Q

Epiglottitis

A
  • Sore Throat* Difficulty/Painful Swallowing (Drooling)* Muffled Voice* Sick Appearance* Fever* Tripod Position* Stridor## FootnoteEpiglottitis is the obstruction of the glottic opening due to infection (and subsequent inflammation/swelling) of the epiglottis.
67
Q

Croup

A
  • Loud Seal-Bark Cough* Hypoxia* Altered Mental Status* Fever* Dyspnea/Stridor (w/ Relief when Upright)* Restlessness## FootnoteCroup is a viral illness that results in inflammation of the larynx, trachea, and bronchi (and the constriction of the lung airways).
68
Q

Bronchiolitis

A
  • Cold-Like Symptoms (Runny Nose; Fever; General Illness)* Hypoxia* Dypnea## FootnoteBronchiolitis is a viral illness (often caused by RSV) that results in the inflammation/constriction of small airways.
69
Q

Cystic Fibrosis

A
  • Coughing (w/ Blood and Mucus)* Fatigue* Pneumonia (i.e. Fever, Coughing, Dypnea, Green Sputnum, Loss of Appetite)* Abdominal Pain + Distention* Nausea* Weight loss## FootnoteCystic Fibrosis is a genetic disease that causes thick, sticky mucus to accumulate in the lungs and digestive system.
70
Q

Cardiac Implants

A
  • Cardiac Pacemaker: An implanted pacemaker that enables the heart beat in a normal, coordinated fashion (when the body’s natural pacemaker fails).* Implanted Defibrillator: A miniature defibrillator surgically implanted in the chest/abdomen that detects lethal cardiac rhythms and shocks the patient.* Ventricular Assist Device: A mechanical device that pumps blood for the heart when one or both ventricles are weak/incompetent.
71
Q

Causes of Altered Mental Status

A
  • S = Sugar, Stroke, Seizure* N = Narcotics* O = Oxygen* T = Temperature, Toxins, Trauma