Pocket Prep 2-5 Flashcards
abruptio placentae
premature separation of the placenta from the uterine wall. The most common causes are hypertension and trauma. Severe pain is common; the degree of vaginal bleeding is dependent upon the severity of the separation. If blood loss is severe, the patient may exhibit signs of shock (e.g., weak, rapid pulse and pale, cool, diaphoretic skin).
short backboard
eg. Kendrick extrication device
may be used to immobilize a seated patient with a suspected spinal injury until the patient can be placed on a long backboard
Hyperventilation
+ hyperventilation syndrome
overbreathing (above a normal respiration rate) to the point of a lower-than-appropriate level of arterial carbon dioxide
hyperventilation syndrome (panic attack) assoc w anxiety, dizziness, numbness/tingling and painful spasms in the hands and feet
what happens in the second trimester of pregnancy
Rapid uterine growth occurs during the second trimester.
As the uterus increases in size, it displaces the diaphragm from its normal position; a subsequent decrease in tidal volume occurs, causing an adaptation of increased respiratory rate.
Additionally, the metabolic demand for oxygen and workload increase occurs to support the developing fetus.
what affects how a patient tolerates environmental changes
Physical condition (e.g., illness and poor physical condition), age (e.g., very young or very old), nutrition and hydration (e.g., lack of food/water, alcohol consumption), and environmental conditions (e.g., temperature, humidity, wind)
not usually anxiety (unless . paired w a physical issue)
define the following:
- ischemia
- cerebral palsy
Ischemia is defined as the “lack of oxygen that deprives tissue of necessary nutrients, resulting from partial or complete blockage of blood flow”; ischemic strokes should have a timeline established
Cerebral palsy is a group of disorders characterized by poorly controlled body movement. Common causes include damage to the fetal brain while developing, oxygen deprivation at birth, traumatic brain injury at birth, or infection (e.g., meningitis).
electrocardiogram
- definition
- requirements
form of cardiac monitoring that can be used in the prehospital setting
requires electrodes + leads to be placed in appropriate positions
electrocardiogram
- electrode position
white (placed on the right arm)
black (placed on the left arm)
green (placed on the right leg or lower right abdomen)
red (placed on the left leg or lower left abdomen)
electrocardiogram
- leads placement
V1: fourth intercostal space, right sternal border
V2: fourth intercostal space, left sternal border
V3: between V2 and V4
V4: fifth intercostal space, left midclavicular line
V5: fifth intercostal space at the anterior axillary line
V6: fifth intercostal space (V4, V5, and V6 are all on the same horizontal level) in the midaxillary line
venous vs arterial vs capillary bleeding
Venous bleeding is dark red and flows steadily from the wound.
Arterial bleeding is bright red and often spurts in time with the patient’s pulse; the spurting makes arterial bleeding more difficult to control.
Capillary bleeding is dark red and oozes steadily but slowly from wounds.
AED equipment varies by age how
For an infant (age 1-12 months), a manual defibrillator is the preferred method of defibrillation. If unavailable, an AED equipped with a pediatric dose attenuator is preferred. If neither is available, an adult-sized AED may be used.
For pediatric patients under the age of eight years old, an AED equipped with a pediatric dose attenuator is preferred. If this is not available, an adult-sized AED may be used.
more sounds to know
- snoring
- gurgilng
- crackles
Snoring is an indication that the upper airway is partially obstructed.
Fluid or secretion in the upper airway will manifest as gurgling, which requires suctioning. If the bronchi are constricted, wheezing will be heard.
Crackles (formerly rales) are the sounds of air trying to pass through fluid in the alveoli. Crackles are a result of congestive heart failure or pulmonary edema.
Carbon monoxide
colorless, odorless, tasteless, and highly poisonous gas that can cause permanent brain damage
flu like symptoms: headache, dizziness, fatigue, nausea, vomiting, dyspnea on exertion, chest pain, impaired judgment, confusion, or even hallucinations
– best treated w oxygen
If more than one patient in the same environment presents with these signs, carbon monoxide should be suspected. Once patients have been removed from the environment, their condition should improve.
types of stretchers
- basket (2)
The aluminum Stokes, or basket stretcher, is most useful for mountain or cliffside rescue applications for a number of reasons: it breaks down into two sections and it is light and compact enough to be carried by one person on a backpack. It provides solid support for vertical lifts and drops.
A Ferno/Thomson is a basket stretcher like the Stokes, but it is plastic basket with a metal frame. A primary advantage is that it slides easily over snow and is also solid enough for technical rescues.
types of stretchers
- scoop
- flexible
- vacuum mattress
Scoop stretchers are used to fit around patients in the supine position.
Flexible stretchers assist in moving patients through narrow openings or down steep staircases, and in handling unruly patients.
A vacuum mattress is a variation of a flexible stretcher in which the patient is placed on a mattress, air is removed from the mattress, and the device molds around the patient.
what diseases indicate use of a nasal cannula over NRB
COPD, bronchopulmonary dysplasia
continuous quality improvement
vs quality control
Continuous quality improvement is a system of internal and external reviews and audits of all aspects of an EMS system. Periodic run review meetings are held with those involved in patient care to review reports and discuss areas of care that may need changing or improvement.
Quality control is the assurance that the appropriate medical care standards are met on each call; this is the responsibility of the medical director.
Hypothermia risk factors
+ hyperthermia too
Risk factors for the increased likelihood of issues related to environmental exposure are poor physical condition, very young or very old patients, poor nutrition/hydration, and very cold or hot conditions.
However, it should be noted that hypothermia cases may occur between 30°F (-1.1°C) and 50°F (10.0°C) and hyperthermia cases may occur at temperatures above 80°F (26.7°C) with humidity at 80%.
infants should begin breathing spontaneously within …
fifteen to thirty seconds after birth
If respirations are not observed (or crying is not heard), gently tap or flick the soles of the newborn
how long should you take to check pulse and breathing
This should take no more than 10 seconds, if done simultaneously
To check for breathing, scan the victim’s chest for rise and fall for no more than 10 seconds.
To perform a pulse check in an adult, palpate a carotid pulse.
what causes constricted vs dilated vs no change in pupil size
Constricted pupils = opiate / opioid
Dilated pupils: sympathomimetic, anticholinergic, hallucinogenic
No change: sedative-hypnotic
unstable patient assessment timeline
An unstable patient will require rapid transport; thus, a quick assessment and treatment of life-threatening conditions along with a set of baseline vitals is taken at the scene, and the patient is loaded into the ambulance for transport before any further assessment/interventions are performed.
what will an AED analyze and shock / not shock
AED will analyze electrical heart rhythm
An automatic external defibrillator (AED) will advise a shock if it analyzes ventricular fibrillation or ventricular tachycardia; it is rare that a shock is advised without one of these rhythms.
Asystole (“flatline”), pulseless electrical activity, and atrial fibrillation and/or atrial flutter are not shockable rhythms.
what is an indicator of adequate oxygenation in the field
In the field, where direct measurement is not practical, a normal level of consciousness and good skin color are among the best indicators of adequate oxygen perfusion. While ventilation may be adequate, it is important to remember that respiration (the exchange of oxygen and carbon dioxide at the tissue level) may be compromised.
ICP symptoms
Other signs of increased intracranial pressure are headache, altered mental status (lethargy, obtundation, nonreactive pupils), decerebrate posturing, bradycardia, nausea, vomiting, and changes in respiration (Cheyne-Stokes, ataxic rhythms).
Also, Cushing’s triad.
jellyfish sting symptoms + treatment
Envenomation (ie. a sting from a jellyfish) causes painful, red lesions extending in a line from the site of the sting. Some patients may complain of headache, dizziness, muscle cramps, and fainting.
Treatment of a sting from a jellyfish should begin with removing the patient from the water, followed by the scraping of remaining tentacles with the edge of a stiff object (e.g., credit card), soaking the affected area in hot water for thirty minutes, and transport.
common AED errors
+ less common errors
The most common causes for error when using an AED are the presence of fine ventricular fibrillation, use of an AED on a moving patient (physically or moving during transport), and turning off the AED before analysis/shock is completed.
Other less common reasons include battery failure, application of the AED to a patient not in cardiac arrest, not pushing the analyze/shock button when instructed to do so, or pushing the power button in lieu of the analyze/shock buttons.
three types of radiation burns
Radiation burns occur when the body has been exposed to ionizing radiation.
There are three types of ionizing radiation: alpha, beta, and gamma. Alpha particles have little penetrating power. Beta particles can penetrate the skin but can be blocked by simple protective clothing. The threat from gamma radiation is directly proportional to its wavelength. Gamma radiation is very penetrating and passes easily through the body and solid materials.
thermal vs chemical vs electrical burns
Thermal burns are caused by heat.
Chemical burns are from contact with a toxic substance. Strong acids and strong alkalis are common causes. Hazardous materials (HazMat) teams may be required.
Electrical burns involve any contact with electricity. The burn from electricity will have an entrance and exit wound.
solid vs hollow organs
Solid organs, such as the liver, spleen, diaphragm, kidneys, and pancreas, can bleed significantly and cause rapid blood loss.
Hollow organs, such as the gallbladder, stomach, urinary bladder and small and large intestine (including the appendix and rectum), are more likely to lead to infection if damaged.
