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Emergency Medical Technician > Patients with Special Challenges > Flashcards

Patients with Special Challenges Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

A group of conditions that may impair development in the areas of physical ability, learning, language development, or behavioral coping skills

A

Developmental disability

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2
Q

An intellectual disability characterized by deficits in social communication and interactions along with restricted, repetitive patterns of behavior, interests, and activities

A

Autism spectrum disorder

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3
Q

ASD

A

Autism spectrum disorder

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4
Q

Characterized by a genetic chromosomal defect resulting in mild to severe intellectual impairment

A

Down syndrome

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5
Q

The normal human somatic cell contains ___ pairs of chromosomes

A

23

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6
Q

Down syndrome is also known as ___

A

Trisomy 21

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7
Q

When does Down syndrome occur?

A

The two 21st chromosomes fail to separate, so that the ovum or sperm contains 24 chromosomes. When fertilization occurs, a triplication (trisomy) of chromosome 21 occurs

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8
Q

Where the first two cervical vertebrae meet

A

Atlantoaxial joint

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9
Q

Two most common causes of deafness

A
  1. Sensorineural deafness
  2. Conductive hearing loss
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10
Q

What causes sensorineural deafness?

A

Nerve damage results from a lesion or damage to the inner ear

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11
Q

What causes conductive hearing loss?

A

Faulty transmission of soundwaves

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12
Q

Hearing aid types

A
  1. Behind the ear
  2. Conventional body
  3. In the canal and completely in the canal
  4. In the ear
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13
Q

Group of disorders characterized by poorly controlled body movement

A

Cerebral palsy

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14
Q

Cerebral palsy is the the result of ___

A

Damage to the developing fetal brain in utero, oxygen deprivation at birth, traumatic brain injury at birth, or infection such as meningitis during early childhood

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15
Q

Unsteady gait

A

Ataxia

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16
Q

Adequate maternal intake of ___ reduces the risk of spina bifida

A

Vitamin B9 (folic acid)

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17
Q

Increased sensitivity

A

Hyperesthesia

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18
Q

Three main components of a standard tracheostomy tube

A
  1. Outer cannula with a flange
  2. Inner cannula within the outer cannula
  3. Rigid obturator
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19
Q

Flange on the outer cannula helps ___

A

Support and stabilize the device as it passes through the neck

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20
Q

The outer cannula may have a cuff that ___

A

Seals the trachea off from the upper airway

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21
Q

The cuff is inflated through ___

A

A pilot balloon and valve on the outside of the device

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22
Q

The inner cannula has a ___ that allows for a bag-mask device or ventilator circuit to be attached

A

15-mm adapter

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23
Q

Mnemonic to remember the possible causes of an airway obstruction with a tracheostomy tube

A

DOPE

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24
Q

DOPE

A

D. Displaced, dislodged, or damaged tube
O. Obstructed tube
P. Pneumothorax
E. Equipment failure

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25
Q

Some patients with tracheostomy tubes and special health care needs may have ___ that will not allow you to place them in the typical semi-Fowler position

A

Muscle contractions

26
Q

If suctioning of the tracheostomy tube is necessary, first attempt ___

A

To use the patient’s suction device

27
Q

How to estimate the size of the suction catheter for a tracheostomy tube

A

Double the inner diameter of the tracheostomy tube. To get the length, ask of measure a spare tube

28
Q

If the length of the tracheostomy tube cannot be determined, insert the suction device no more than ___

A

1 - 2 inches

29
Q

How to suction tracheostomy tube

A

Suction unit set to 100 mm Hg. May need to instill 2 - 3 mL of saline before suctioning thick tracheal secretions. Do not suction for more than 10 seconds. Oxygenate before and after. Call for ALS backup

30
Q

Two types of oxygen delivery systems that patients use

A
  1. Compressed oxygen cylinders
  2. Home oxygen concentrator
31
Q

Home oxygen concentrators max oxygen supply generally

A

10 L/min

32
Q

Portable oxygen concentrators max oxygen supply generally

A

1 to 3 L/min

33
Q

Questions to ask someone on home oxygen supply

A
  1. Why they are on home oxygen
  2. How long they have been on home oxygen
  3. What their baseline home oxygen requirement is
  4. Whether their requirement has changed recently
34
Q

An apnea monitor is used for ___ after birth of these high-risk infants

A

2 weeks to 2 months

35
Q

A typical episode of apnea may last for ___, during periods of sleep

A

About 15 to 20 seconds

36
Q

The apnea monitor is designed to ___

A

Sound an alarm if the infant experiences bradycardia or an episode of apnea occurs

37
Q

The apnea monitor is attached with ___

A

Electrodes or a belt wrapped around the infant’s chest or stomach

38
Q

Pacemaker placement

A

Nondominant side of the chest, or the abdomen if the patient is small or thin

39
Q

VAD

A

Ventricular assist device

40
Q

Device that regulates the heart rate

A

Pacemaker

41
Q

Medical equipment that takes over the function of one or both ventricles

A

VAD

42
Q

Most common VAD

A

Left ventricular assist device

43
Q

How to assess perfusion in patient with a VAD

A

Note level of consciousness, skin color, temperature, moisture, and BP

44
Q

Risk factors associated with a VAD

A
  1. Excessive bleeding following surgery
  2. Infection
  3. Blood clots leading to strokes
  4. Acute heart failure
45
Q

How to tell if an external defibrillator vest has already delivered a shock

A

Look on the upper back for a blue gel

46
Q

A catheter that has its tip placed in the vena cava to provide venous access

A

Central venous catheter, or central line

47
Q

Central venous catheters are often located ___

A

In the chest, upper arm, or subclavicular area

48
Q

If bleeding occurs with a central venous catheter ___

A

Apply direct pressure to the tubing and provide prompt transport to the hospital

49
Q

Placed into the stomach of patients who cannot adequately ingest fluids, food, or medication by mouth

A

Gastrostomy tubes (gastric tubes or G-tubes)

50
Q

Patients with gastric tubes who have difficulty breathing should be transported while ___

A

Sitting or lying on the right side with the head elevated 30° to prevent the contents of the stomach prom passing into the lungs

51
Q

Patients with diabetes who receive insulin and gastric tube feedings may become ___ quickly if the gastric tube feedings are discontinued

A

Hypoglycemic

52
Q

Patients with chronic neurologic conditions may have ___ in place

A

Shunts

53
Q

Tubes that drain excess cerebrospinal fluid from the ventricles of the brain to keep pressure from building up in the brain

A

Shunts

54
Q

A shunt will likely be felt ___

A

On the side of the head, behind the ear

55
Q

Drains excess fluid from the ventricles of the brain into the peritoneum of the abdomen

A

Ventriculoperitoneal (VP) shunt

56
Q

Drains excess fluid from the ventricles of the brain into the right atrium of the heart

A

Ventriculoatrial (VA) shunt

57
Q

Infections as a result of the shunt placement may occur within the first ___ after shunt insertion

A

2 months

58
Q

If the shunt is unable to drain ___

A

ICP may increase

59
Q

Stimulate the ___ at predetermined intervals to prevent seizure activity

A

Vagus nerve

60
Q

Surgical procedure that creates an opening from the small or large intestine to the surface of the body that allows for elimination of waste products

A

Colostomy or ileostomy

61
Q

The special opening for a colostomy is called ___

A

A stoma

62
Q

Surgically created connection between the urinary system to the surface of the skin that allows urine to drain through a stoma in the abdominal wall instead of the urethra

A

Urostomy

Emergency Medical Technician (100 decks)

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