PAAM Exam 2 Flashcards
What is always your number one priority on any call:
When is scene safety assessed:
When would you use NOI versus MOI?
Do you have a legal obligation to enter a unsafe scene:
= yourself
= when you first get the call
= After you make your GI of the PT
= NO
What is known as “action circle” at the scene of an accident?
What is the safe (minimum) radius of the action circle?
What is the purpose of the “Circle Survey”?
= circular area extends out from accident vehicles & 50ft (min) radius
= 50ft
= Survey all 360 degrees of accident
Dangers of performing rescue in confined space?
Dangers of performing a rescue in a farm silo?
Order which you should conduct a water rescue?
= Gases & Collapsing
= Sinking, only up & down
= Reach (with long pole), Throw (flotation device), Row (boat), Go (water entry)
Distance to park w/ 1 of cars on fire at road incident?
Position of vehicle approaching potential hazard?
Book most used to identify hazard materials:
Must be worn working scene of vehicle accident:
= 100ft or>
= Uphill & Upwind
= Emergency Response Guidebook
= Reflective vest
What info do you obtain w/ general impression?
What is the purpose of the primary assessment?
= Immediate life/death signs/hemorrhaging, PT info
= Fix any life threatening problems
Assessed during PT assessment?
Something wrong in primary assessment, what are you to do?
Type of hemorrhage cause interruption of ABCs:
= 1. SS/sizeing, M/NOI, 2. PT assess, 3. LOC, 4A, 5B, 6C
= Stay & Play
= squirting/arterial
Assessed during “A” phase of primary assessment?
Assessed during “B” phase of primary assessment?
Assessed during “C” phase of primary assessment?
= Airways all possible & best airways
= Breathing; quality, rate, rhythm, symmetry,
= Circulation; CTC, quality, rate, rhythm, regularity, strength
How do you use the AVPU scale?
GCS- E points:
M points:
S Points:
= Alert, Verbal, Pain, Unresponsive
= 4 Alert, 3 Verbal, 2 Pain, 1 Unresponsive
= 5 Oriented, 4 Confused, 3 inappropriate words, 2 sounds, 1 no audiation
= 6 Obeys comands, 5 localizes to pain, 4 withdraws w/ pain, 3 flextion, 2 extension, 1 no response
Systolic BP estimates for following pulse sites- Radial
Femoral:
Carotid:
= 80
= 70
= 60
How long to conduct a primary assessment?
= 60secs
Goal of therapeutic communication?
What is therapeutic communication?
= PTs feel heard & understood; can help reduce anxiety, build trust, & improve quality of care provided.
= Specific techniques & strategies to establish a positive rapport, convey empathy, & effectively gather info from PTs.
Active communication consists of what 4 things?
What actions can you take for a good 1st impression?
= sender, a message, a receiver, and feedback
= Introduction, Open stance, eye contact, ect
PT distance in intimate zone?
You assess for what in what zone?
PT distance in person space?
where most our PT assessment occurs
Distance for social space?
Distance for public space?
= 0-1.5 feet
= Internal signs in intimate zone
= 1.5-4ft
= Personal zone
= 4-12ft
= 12ft or more
3 different relative Lvls mean to a PT:
1. Remaining at eye level:
2. Standing above/over PT:
3. Dropping below eye level indicates:
= eye contact Lvl
= equality
= authority & can be intimidating
= Willing for PT have some control (w/ elderly&PEDI)
Eye contact 50/70 rule- 50%:
70%:
helps interaction by making it by creating a :
= maintain eye contact 50% of the time= speaking
= Maintain eye contact 70% of the time= listening.
= comfortable & engaging w/o making other uneasy
Be familiar with the parts of active listening:
Silence, Reflection, Facilitation, Empathy, Clarification, Confrontation, Interpretation, Asking about feelings, Explanation, Summarization,
SAMPLE history:
OPQRST-ASPN:
AEIOU-TIPS:
DCAP-BLS-TIC:
= Sign/Symptoms, Allergies, Meds, Past med/ Hx, Last oral intake, Events leading up
= Onset, Provocation/Palliation, Quality, Radiating, Severity, Timing - Associated Sign/Symptoms & Pertinent Negatives
= Alcohol, Epilepsy, Insulin (hypo/hyperglycemia), Overdose, Uremia (kidney failure), Trauma, Infection, Psychosis, Stroke
= Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Lacerations, Swelling, Tenderness, Instability, Crepitus
Goal of the secondary assessment?
4 techniques when assessing PT in 2nd assessment?
=more through exam objective & measurable (quantifiable) info is taken from PT’s health condition: vitals, SAMPLE, ect
= 1st. Visual, 2nd. Palpation, 3rd. Percussion, 4th. Auscultation
2nd. Palpation inspection:
= Fingers for sensations EX pulse, Ball of hand(calluses) for vibrations (tactile fremitus- vibration in back when talking)
3rd. Percussioning:
= striking surface of body; Direct EX sinus taping listening for hypo-rresonant dull sound means filled sinuses, Indirect= tap on top of own fingers (percussing for pneumo) Blunt percussion= hitting hard EX kidneys hitting & listening for pain response
Erb’s point @:
&means:
= 3rd ICS L-sternal border.
= heart murmurs can be heard more distinctly.
4th. Auscultation:
= Diaphragm hyper-sounds lungs bell= (held at stem), BP & heart sound
Percussion sounds:
Tympany sound:
Hyperresonance sound:
Resonance sound:
Dull sound:
Flat sound:
= tone’s resonance/lack of indicates if region is filled w/ air, air under pressure, fluid, or normal tissue
= “drumlike” , loud intensity, High pitched, Medium duration, located in stomach “teeter-totter”
= “Booming” ,loud intensity, Low pitched, long duration, located in Hyperinflated-Lung “Hums of mongolian”
= “Hallow” , loud intensity, low pitched, long duration, located in a normal lung “Ringing tornado”
= “thud” , Medium intensity, medium pitched, medium duration, in solid organs “Dumb down-syndrome”
= “Extremely dull” , Soft intensity, High pitched, short duration, in muscle & atelectasis “fly flying by”
dysarthria:
dysphonia:
aphasia:
expressive aphasia:
Receptive aphasia:
PT w/ aphasia be mistaken for:
= defective speech caused by motor deficits
= voice changes caused by vocal cord prob/s
= defective language from brain damage
= words will be garbled
= words will be clear but unrelated to your questions.
= a psych disorder b/c such difficulty speaking
(ODERS) Fruity breath:
Urine or ammonia:
Bitter almonds:
General bad breath:
Fishy vaginal/penis odor:
Fecal breath:
= DKA
= UTI
= cyanide poisoning
= hygiene and/or infection
= infection and/or Ghonearrhea
= GI obstruction
Pulse Deficit:
Pulse Deficit indicates:
Pulsus Alternans:
Pulsus Alternans indicates:
= difference in HR w/ auscultation & PR w/ palpation.
= not all heartbeats make palpable pulse, often A-Fib
= Alternation of strong & weak pulses, typically
=L-ventricle dysfunc/or H-failure & often chronic condition of the heart.
Cardiac Output formula:
HR:
SV:
Formula for BP:
Calculate a PT’s MAP:
= CO=HR×SV
= Heart Rate (beats per minute)
= Stroke Volume (amount of blood pumped per beat)
= BP= SVR x (SV x HR)
= DBP+ ⅓(SBP-DBP) SBP-SystolicBP & DBP-DiastolicBP
(Korotkoff sounds & in order) 1st sound:
2nd sound:
3rd sound:
4th sound:
5th sound:
Mnemonic:
= snapping
= swooshing
= tapping
= thumping (muffling)
= silence
= “Sounds Silly That They Sing”
(skin signs) Pallor:
Cyanosis:
Jaundice:
Erythema:
Petechiae:
Purpura:
Mottling:
Ecchymosis:
Vesicle:
Cyst:
Bulla:
Telangiectasia:
Excoriation:
Scale:
Lichenification:
Atropy:
=Abnorm/ pale; hypoxia by shock or hypothermia.
= Blue: hypoxia
= yellow: liver failure
= Red: carbon monoxide
= small flat purple spots by cap/blood/;many etiologies
= purple spots by minor cap/ bleeding
= purplish patches; poor circu/oxygen/seen near-death
= Bruising
= elevated area <1cm w/ serous fluid
= elevated palpable area w/ liquid or viscous matter
= “bulb” Vesicle diameter >1cm
= Red/blue threads “spider”
= linear epidermis loss leaving dermis exposed
= excessive exfoliation white-silver-tan
= thickening/hardening epidermis w/ emphasize lines
= thin “clear” epidermis
Skin turgor test:
Norm/ skin tugor:
Decreased skin mobility suggests:
“Tenting” Poor turgor:
= pulling skin fold over bony area then releasing it
= immediately returns to its original state.
= edema or scleroderma, a progressive skin disease.
= results from dehydration
(Abnormal Nails) Clubbing:
Paronychia:
Onycholysis:
Terry’s nails:
Transverse/Beau’s lines:
Psoriasis:
= “finger clubs” distal phalanx of fingers rounded/ bulbous & Proximal nail feels spongy; from chronic hypoxia in COPD & lung cancer.
= inflamed nail; can be acute trauma or chronic & Cuticle isn’t visible
= Separation of nail from nail bed; can be from fungal infections, psoriasis, or trauma.
= white w/ narrow pink band @ tip; can indicate liver disease, diabetes, or heart failure
= horizontal grooves; nail growth disruption from illness, trauma, or nutritional deficiencies
= small pits; can be an early sign of psoriasis
Medical word for unequal pupils >1mm:
Unequal pupils alert you to:
Medical word used for pinpoint pupils:
Medical word used for dilated pupils:
Name of eye chart used to test visual acuity:
Bitemporal hemianopsia:
Left/Right Homonymous Hemianopsia:
Homonymous Quadrantic Defect:
Medical word for ecchymosis around eyes& sign of:
= anisocoria
= Brain trauma!!!
= Miosis
= Mydriasis
= Snell chart
= loss of vision in the outside half of each eye
= loss of vision in right or left half of both eyes
= loss of vision in the same quadrant of both eyes
= Periorbital ecchymosis & basilar skull fracture
3 parts of the ear:
What part contains the three ossicles:
= Outer, middle, Inner
= Middle ear
Outer Ear consists:
= Auricle, External Acoustic Meatus “Ear canal”, & Tympanic membrane “eardrum”
Inner ear contains:
Names of 3 ossicles:
= Vestibule, Semicircular canals, Cochlea, Labyrinth
= “Hammer” malleus, “Stirup” incus, “Anvil” stapes
“Hammer” of ear:
= Malleus “both have M”
“Stirup” of ear:
= Incus
“Anvil” of ear:
= Stapes
Medical word for ecchymosis behind ears & a sign of: What can be assessed using an otoscope:
= Retroauricular- ecchymosis
= Typmanic membrane for Otitis media
Name/meaning for increased JVD during inhalation:
Kussmaul’s sign & Hemothorax
Pressure in the jugular veins approximate:
Elevated jugular venous pressure can indicate:
= central venous pressure (CVP)indicator of body’s overall blood volume & venous return
= R-sided heart failure or fluid overload.
PT w/ subcutaneous emphysema:
= Air leaking from respiratory into tissues of neck ;indicating a serious neck/chest injury.
Presence of Carotid bruit:
What is a carotid bruit:
= usually means= atherosclerosis
= sound of turbulent blood flow around partial vessel obstruction
Aortic Valve auscultate @:
Pulmonic Valve auscultate @:
Erb’s Point auscultate @:
Tricuspid Valve auscultate @:
Mitral Valve (Apex) auscultate @:
= 2nd ICS, Right Sternal border.
= 2nd ICS, Left Sternal border
= 3rd ICS Left sternal border.
= 4th ICS Left Sternal border
= 5th ICS, Left Midclavicular line
