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OCHT Term I > PCTH I - Term Test II > Flashcards

PCTH I - Term Test II Flashcards

1
Q

What is a cardiac cycle?

A

Refers to all the events that occur beginning from one heart to the beginning of the next

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2
Q

What are the 4 stages of the cardiac cycle?

A

1) Passive filling
2) Atrial contraction
3) AV valves close - ventricles are getting ready to contract
4) Ventricular contraction

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3
Q

What happens during P wave?

A

Atrial depolarization (atria is contracting)

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4
Q

What is the PR interval?

A

the time at the beginning of P wave to the beginning of the QRS complex

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5
Q

What happens during the QRS complex?

A

Ventricular depolarization (this happens more specifically during R-S apparently but google says otherwise but anyways)

Atrial repolarization (aka relaxing) also occurs but it’s hidden because QRS complex is too big

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6
Q

What happens during T wave?

A

Relaxation (aka repolarization) of ventricles - ventricles refill with blood

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7
Q

What does the defibrillator actually do for a patient when providing a shock?

A

uses an electrical current to “wipe slate clean” any current rhythms in hopes that the body will pick up natural rhythm again

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8
Q

Which of the cardiac monitor models is the most common?

A

Zoll X Series

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9
Q

Describe 5-lead placement

A 
Right upper - white
Left upper - black
Right lower - green
Left lower - red
Middle - brown

Easier way to remember: white is right, red to bed, smoke over fire (so black over red), green is last, and poop comes from your stomach (brown)

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10
Q

How many leads are in a 12-lead ECG?

A

10 (6 on the chest, 4 to the limbs)

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11
Q

What are the two shockable rhythms?

A

Ventricular Tachycardia

Ventricular Fibrillation

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12
Q

True or False: You can shock a V-Tach patient even when they have a pulse because their heart is beating abnormally fast

A

NO - FALSE do not shock. Only shock if V-Tach patient has no pulse

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13
Q

If a patient was hypoventilating, would their ETCO2 increase or decrease?

A

Increase - decreased breathing means more CO2 accumulating in lungs which causes more CO2 to be excreted with each breath

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14
Q

Normal range of patient’s ETCO2?

A

35-45 mmHg

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15
Q

Define atelectasis

A

Collapse of alveolar sacs due to loss of partial pressure of nitrogen in the lungs

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16
Q

True or False: Oxygen delivery can lead to formation of free radicals

A

True

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17
Q

How does oxygen toxicity lead to atelectasis?

A

Constant high flow oxygen delivered to patient will push all the nitrogen out of the lungs and nitrogen keeps the alveolar sacs open. therefore when there is no nitrogen left, the alveolar sacs collapse

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18
Q

What is the oxygen therapy standard in BLS?

A

Administer oxygen therapy using oxygen delivery system and flow rate to maintain O2 saturation between 92-96% (unless specified otherwise in the Standards)

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19
Q

CPR: compression to ventilation ratio for:

1) Adult
2) Child
3) Infant - 1 person CPR
4) Infant - 2 person CR
5) neonate - 1 or 2 person CPR

A

Adult, child, infant (1 person CPR: 30:2)

2-person CPR for infant (15:2)

neonate - 3:1

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20
Q

What is the definition of a paramedic?

A

Someone who is trained to do medical work, especially in emergency first aid, but is not fully a qualified doctor

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21
Q

Depth of compressions for the following patients:

1) Adult
2) Child
3) Infant

A

1) 5 cm, 2 inch
2) 1/3 chest depth
3) 1/3 chest depth

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22
Q

Name three situations in which you would re-ax ABCs and LOC?

A

1) patient status changes
2) a critical Ix provided
3) a series of Ix have been provided

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23
Q

What does a pleth wave for an SpO2 reading correspond to?

A

Waveform that corresponds to blood flow (should be evenly spaced waves of equal amplitude - good waveform)

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24
Q

What is BP?

A

Blood pressure is the pressure exerted by ciruclating blood upon the vessel walls

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25
Q

Name 2 additional measures that the NiBP provides besides blood pressure.

A

mean arterial pressure, heart rate

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26
Q

How does the NiBP work? 4 steps.

A

1) inflation of cuff to pre-determined pressure (180mmHg)
2) Deflates incrementally to allow blood flow to limb
3) as blood flows through, it creates pressure oscillation transmitted through hose
4) unit measures sys, diastole, MAP, and HR

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27
Q

When you use cuffs that are too loose/too small, what happens to BP reading?

A

higher BP reading

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28
Q

The BP reading ________ when the BP cuff is too large

A

decreases

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29
Q

When the BP cuff is placed too high on the arm, it generates a (high/low) BP reading. When BP cuff is placed too low on the arm, it generates a (high/low) BP reading

A

low; high

30
Q

Define cardiac conduction

A

A network of cells, nodes, and signals that control your heartbeat

31
Q

Define: automaticity (re: cardiac cells)

A

the property of cardiac cells generating spontaneous action potentials

32
Q

Describe artifact in an ECG

A

Electrocardiographic alterations not related to electrical activity of the heart resulting in random fluctuations/not interpretable ecg readings

33
Q

Provide 5 examples of artifacts that may disrupt ECG reading

A

Rmb: contact is everything!

  • lotion, diaphoretic, water, boney processes (avoid), hair
34
Q

List 5 situations in which a cardiac monitor is warranted.

A

Any of these:

  • All VSA patients - unless obviously dead
  • Altered LOC
  • hypothermia/heat related illness
  • CVA
  • SOB (mod/severe)
  • OD
  • if requested by facility staff
  • suspected cardiac ischemia
  • submersion injuries
  • collapse/syncope
  • electrocution
  • major/multi-system trauma
  • abnormal vital signs as per ALS PCS
35
Q

If patient is breathing too slow, would ETCO2 increase or decrease?

A

Increase (more CO2 is accumulated in the lungs therefore more CO2 would be excreted with each breath

36
Q

If patient is breathing too quickly (hyperventilating), would ETCO2 increase or decrease?

A

Decrease (blowing off lots of Co2 so there’s none left = less Co2 with each breath = ETCO2 goes down

37
Q

Constant __________ and ___________ are required for an ETCO2 reading

A

air movement, blood flow

38
Q

List the 6 situations in which continuous high flow O2 is required REGARDLESS of SpO2 reading?

A

1) scuba-related injuries (usually due to pressure on gases)
2) upper airway burns
3) CO/noxious gas poisoning, or cyanide toxicity
4) sickle-cell anemia ppl (with suspected vasoocclusive crisis)
5) ongoing cardiopulmonary arrest (CPR/resp arrest)
6) complete airway obstruction

39
Q

If pulse ox equipment was not functioning properly, administer high flow O2 to what kind of patients (excluding populations where continuous high flow oxygen is always warranted). There are 5 types in total

A

1) age specific hypotension (adults < 100 sys), (peds: 8 or younger is 2 x age + 70 TO 2 x age + 90)
2) respiratory distress
3) cyanosis, ashen colour, pallor
4) altered LOC
5) abnormal pregnancy/labour

40
Q

COPD is mostly dx in people who are __ and older. 80-90% of the cases are due to _________.

A

40; smoking

41
Q

What is chronic bronchitis?

A

inflammation of the bronchi, swollen airways that is filled with mucus making it hard to breathe (aka blue bloaters)

42
Q

What is emphysema?

A

Damaged alveoli (typically due to toxic inhalation) leading to increased difficulty breathing (aka pink puffers) - tends to be barrel chested due to air trapped in chest (they present as flushed and pursed-lip breathing)

43
Q

In a typical healthy human, increase in arterial CO2 causes an (increase/decrease) in RR and resp. depth

A

Increase breathing rate and depth to rid of CO2

44
Q

In a typical healthy human, decrease in arterial CO2 causes an (increase/decrease) in RR and resp. depth

A

Decrease breathing rate and depth to maintain level of CO2 balance in blood

45
Q

COPD-ers have chronically (high/low) arterial CO2 levels and (high/low) O2 levels.

A

high; low

46
Q

Why is high flow oxygen provided to a COPD patient a risk?

A

Because patients with COPD use low O2 levels to stimulate receptors to breath more or less, so when there is high levels of O2, it tells them to slow down their breathing which may lead to resp. arrest

47
Q

What are the 5 steps in Oxygen Therapy Standards for COPD patients?

A

1) titrate O2 to be maintained at 88-92% (if pulse ox not working, administer O2 by NC at 2L/min above their home O2 level or 2L/min if not on home O2)
2) Re-ax vitals every 10 minutes
3) If patient status improves, maintain flow rate
4) If patient status worsens, increase 2L/min flow rate every 2-3 minutes
5) Be prepared to ventilate

48
Q

What is the formula to determine someone’s kg, followed by minimal tidal volume (volume required for perfusion to occur) in accordance to the Respiratory Failure Standard?

A

lbs/2 - 10% = ~ weight in kgs (and then x5 to get minimum mL of air)

49
Q

As per Respiratory Failure Standards, attempt to maintain ETCO2 values of ___ to __ mmHg unless indicated otherwise in the standards. For COPD or asthma patients who have initial ETCO2 > ______ mmHg, attempt to maintain ETCO2 between __ to __ mmHg.

A

35 - 45 mmHg
50 mmHg
50-60 mmHg

50
Q

As per Respiratory Failure Standards, which of the following are true?

The paramedic shall:
1) observe chest rise and auscultate lung fields to assess adequacy of ventilation (ventilation just sufficient to observe chest rise is adequate)

2) minimize interruptions to ventilations
3) continue assisted ventilations until patient’s spontaneous respirations are adequate
4) all of the above

A

all of the above

51
Q

According to SOB standard, what are the three categories that paramedic shall consider that are considered as potential life/limb/function threats?

A

1) acute resp disorders
2) acute CV disorders
3) other disorders (CVA, toxiological effects, metabolic acidosis)

52
Q

List the 7 conditions that are considered as acute respiratory disorders, as per the Shortness of Breath Standard.

A

1) anaphylaxis
2) asthma
3) partial airway obstruction
4) inhalation of toxic gases/smoke
5) pneumothorax
6) COPD
7) resp infections

53
Q

List the 4 conditions that are considered as acute CV disorders as per the SOB standard.

A

1) CHF
2) PE
3) pulmonary edema
4) acute coronary syndrome/MI

54
Q

What are the 6 steps within the Shortness of Breath standard? The paramedic shall:

A

1) assess for potential life/limb/function threats
2) assume all hyperventilation is due to underlying causes
3) perform at minimum a secondary survey to assess: chest, head/neck (cyanosis, nasal flaring, excessive drooling, trach deviation, JVD), extremities (cyanosis, pitting edema)
4) if patient is on home O2, ask history re: changes of use
5) position patient in position of comfort
6) assist ventilations if patient is apneic or resps are inadequate

55
Q

Full oxygen tank at _______ psi? At what psi should use exchange tank for a new one?

A

2000; 500

56
Q

Indications for use of humidified oxygen? 5 points

A
  • hypothermia patients
  • drownings
  • peds cardiac arrest
  • burns
  • patients with unstable chronic SOB emergencies needing high flow O2
57
Q

NRB delivery flow rate and percentage?

A

Flow rate: 10-15 LPM, 80-95% O2 delivered

58
Q

Simple face mask flow rate and percentage?

A

Flow rate: 8-10LPM, 40-60% O2 delivered

59
Q

NC flow rate and percentage?

A

Flow rate: 1-6 LPM,, 24-44% O2 delivered

60
Q

What are the BVM max volumes for the following BVMs?

1) Adult - 2 hands
2) Adult 1 hand
3) Child size BVM - one hand
4) Infant size BVM - one hand

A

1) 1100 mL
2) 800 mL
3) 450 mL
4) 150 mL

61
Q

What are two types of supraglottic airways?

A

King LT, I-gels

62
Q

What are supraglottic airways

A

A group of airway devices that can be inserted into airway and sits above the glottis (slit-like opening on the floor of the pharnyx)

63
Q

When are supraglottic airways used?

A

Only in cardiac arrest patients (unless otherwise indicated by MD)

64
Q

What are the suction settings for infant, child, and adult for powered suction?

A

infant: 100 mmHg
child: 200 mmHg
adult: 500 mmHg

65
Q

What are the 7 main vital signs that are assessed on all patients?

A

1) HR
2) resp rate
3) BP
4) SpO2
5) GCS
6) Skin
7) Pupils

66
Q

List all the locations you can assess for a pulse

A

carotid, radial, temporal, brachial, apical, popliteal, femoral, posterior tibial, dorsal pedis

67
Q

What is pulse oximetry measuring?

A

The saturation of Hb

68
Q

How does the pulse oximeter work?

A

It uses light emitter with red and infrared light to shine through a site with good blood flow and is based on the red/infrared absorption of oxygenated and deoxygenated Hb

69
Q

Oxygenated Hb would absorb more ________ light which allows for ______ light to pass through.

A

infrared; red

70
Q

Deoxygenated Hb would absorb more ______ light which allows for _______ light to pass through.

A

red; infrared

71
Q

What are the four factors that may affect SpO2?

A

1) Site
2) Temperature - need good perfusion
3) sensor - difference sizes may lead to inaccurate readings
4) Pleth wave

72
Q

What is pulse pressure deficit?

A

Systolic pressure - diastolic pressure

OCHT Term I (14 decks)

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