RS Notes Flashcards
What are the four types of brain bleeds?
Epidural bleed
Subdural bleed
Subarachnoid bleed
Intracerebral hemorrhage
Define Epidural hematoma.
Accumulation of blood between dura mater and the cranium.
Usually associated with a laceration or tear of the middle meningeal artery.
Define Subdural hematoma.
A collection of blood between the dura and the surface of the brain in the subdural space.
This injury usually results from bleeding of the veins in that bridge the subdural space.
Define subarchnoid hematoma.
A collection of blood in the subarachnoid space.
Bleeding into the cerebrospinal fluid.
50% of patients with BLANK hematoma have a transient loss of consciousness, followed by a lucid interval (6-18 hours) in which neurological status returns to normal.
Epidural hematoma.
Signs and symptoms of BLANK hematoma are similar to those of BLANK hematoma and include headache, nausea and vomiting, decreasing level of consciousness, coma, abnormal posturing, paralysis, and, in infants, bulging fontanelles.
These findings are maybe subtle because of the slow development of the hematoma location and chronic phases.
Subdural hematoma.`
Characteristics of BLANK hematoma
sudden and severe HA dizziness neck stiffness unequal pupils vomiting seizures LOC
subarachnoid hematoma
Define intracerebral hematoma
an accumulation of blood or fluid within the tissue of the brain. More than 5 mL
Common causes penetrating trauma, MVC, ICP as a result of compression
Define Virchow’s Triad.
As it is has come to be known today, the triad consists of stasis, vessel damage, and hypercoagulability, and is used to describe the etiology and assess the risk of thrombosis, especially of deep vein thrombosis (DVT.)
S+S of DVT
pain edema warmth erythmea or bluish discoloration tenderness
Risk factors for DVT?
Recent lower extremity trauma recent surgery advanced age recent MI inactivity confinement to bed CHF Cancer previous thrombosis oral contraceptive therapy sickle cell disease obesity
What is Beck’s Triad?
3 D’s
Decreased heart sounds (muffled)
Distended Jugular Veins
Decreased BP
Rule of Nines
A method to estimate burn injury that divides the total body surface area into segments that are multiples of 9%.
Using the rule of nines what is the adult body (or child greater than 9 years old) percentage look like?
Head 9 Upper chest 9 Abdomen 9 Upper Back 9 Lower back 9 L arm 9 R arm 9 Groin 1 L thigh 9 around L calf around 9 R thigh 9 around R calf around 9
What does Nitroglycerin do?
Reduce preload.
NTG dilates arterioles and veins in the periphery (and coronary arteries in high doses). The resultant reduction in preload, and to a lesser extent in after load, decreases the workload of the heart and lowers myocardial oxygen demand. NTG is lipid soluble and is thought to enter the body from the GI tract through the lymphatics rather than the portal blood.
Contraindications for the use of Nitroglycerin?
Hypo tension
Erectile dysfunction drug use
Allergy
Define gestational hypertension
Hypertension that occurs during the latter stages of pregnancy (>20 weeks) without any other features of preeclampsia, and resolves during postpartum period’ recognized by BP greater than 140/90.
Thought to result from rejection of the pregnancy by the immune system and can be an early indication of preeclampsia.
Define preeclampsia
an abnormal disease disease of pregnancy characterized by the onset of acute hypertension associated with proteinuria after the twentieth week of gestation.
Can be mild or severe - diastolic BP >110 mmHg
Define eclampsia
a grave form of pregnancy-induced hypertension, characterized by convulsions, coma, proteinuria and edema.
Most common in patients with severe preeclampsia.
What are the three Blast Injury Phases
Primary - caused by heat of explosion and over pressure wave
Secondary - caused by blast projectiles
Tertiary - caused by personnel displacement and structural collapse.
Brady Volume 2 page 37
List the organs in the abdomen.
Stomach Gallbladder Pancreas Liver Spleen Large intestine Small intestine Colon Bladder R and L Kidney Ovaries - females
Peritoneal Space definition
division of the abdomen cavity containing those organs or portions of organs covered by the peritoneum.
Retro-peritoneal Space definition
division of the abdomen cavity containing those organs posterior to the peritoneal lining.
Which is in the RUQ?
Gallbladder - always under stomach*** R kidney most of the liver some small bowel small portion of the pancreas portion of the ascending and transverse colon
What is in the LUQ
Stomach - Mnemonic eating with R hand guarding full stomach with L hand*** Spleen*** L kidney most of the pancreas portion of the liver small bowel transverse and descending colon
What is in the RLQ?
Appendix*** portions of the urinary bladder small bowel ascending colon rectum female genitalia
What is in the LLQ?
sigmoid colon potions of the urinary bladder small bowel descending colon rectum female genitalia
What are the six rights of drug administration?
Patient Drug Route Time Dose Documentation
Signs of Diabetes?
polydipsia
polyphagia
polyuria
electric shock can cause?
internal damage
v-fib
cardiac irritability
smoldering clothes
What are the four pharmacokinetics are?
absorption
biotransformation
distribution
elimination
Mnemonic A B (no C) D E
define pharmacokinetics
how drugs are moved in and out of the body
what is the primary function of nitro when treating angia?
reduced preload
what kind of shoulder dislocation presents with a patient in the “squared off” position
anterior dislocation
what is the most common age group to experience febrile seizure?
6 months - 6 years
what breathing pattern is associated with DKA?
kussmaul’s
frothy red blood at a wound site my suggest
open pneumothorax
subglottic thermal burns are most likely caused by
superheated steam
hyperresonance in the chest can be caused by?
pneumothorax or emphysema
anesthetics are which?
medications that induce loss of sensation to touch or pain
the buccal route is
between the cheek and the gums
patient has palms turned upwards. if the patient rotates palm facing downward this is called?
pronation?
unconsciousness followed by a lucid interval with deteriorating LOCK later is caused by?
concussion and epidural hematoma.
a neck laceration can cause?
subcutaneous emphysema
air embolism
external/internal jugular or carotid laceration
which vital sign would you expect with Cushing’s reflex?
increased blood pressure
decrease heart rate
irregular respirations
Mnemonic S + S opposite of shock
skull and crossbones picture
unified command is?
a coordinated effort involving several jurisdiction. single command is a single individual responsible in single jurisdiction incident.
expect ecg artifact with all except?
an enlarged heart
which is not a cause of dysthymia?
hypertension
which is not a common cause of tachycardia?
hypothermia
what are the two branches of the Left coronary artery?
anterior descending and circumflex
which of the following causes pulmonary edema?
left sided heart failure
what are open ended questions?
questions that permit unguided spontaneous answers
which of the following is subjective
patients chief complaint
different field diagnosis is?
list of possible causes for your patients condition
O2 may cause respiratory distress in which patient?
COPD
car accident patient is experiencing a “tearing sensation” in the chest with pain radiating to the back. what is the most likely cause?
aortic aneurysm
blunt trauma in a pediatric patient, because of flexibility suspect injury to?
spleen
what are the lead placements for lead II?
+ left leg
- right arm
what is considered passive during respiration?
expiration
is the pressure in the thorax during expiration greater or less then the environment/.
greater
urticaria is caused by?
vasodilation
what is bioequivalence?
relative therapeutic effectiveness of chemically equivalent drugs.
a child asthma attack without wheezing is
an ominous sign
obese female patient complains of RUQ pain radiating to the shoulder after consuming greasy food. what could be the cause?
cholecystitis
which occurs during hyperventilation?
CO2 levels lower as a result of increased RR
what pH is considered alkalosis?
greater than 7.45
symptoms of meningitis?
stiff neck
fever
lethargy
irritability
when your partner complains of fever, chills, malaise, aches, and cough. what do you suspect?
influenza
hypertonic solution moves water?
into the vascular space
female patient, 36 weeks pregnant, presents with altered LOC and recent seizures. what is most likely?
eclampsia
supine hypotensive syndrome in a pregnant patient is caused by?
gravid uterus compresses the inferior vena cava when the mother is supine
hypotension can develop with severe anaphylaxis due to?
increased vascular permeability and vasodilation
during cardiogenic shock, the body compensates by?
increase contractile force, increases preload, lowers vascular resistance
alkalosis and hyperventilation may produce?
carpal and pedal spams (Cramping)
what is tidal volume?
the average volume of gas inhaled or exhaled in one respiratory cycle, 500 ml
where do internal respiration occur?
peripheral capillaries
put the upper airway anatomy in order from superior to inferior?
nares nasopharynx larynx laryngopharynx trachea
bronchodilators are which of the following?
beta 2 selective
what is beneficence?
doing good for the patient
what is ethics?
determines how one should live
what is ethical relativism?
each person decides how to behave and whatever decision the person makes is acceptable
what does NOCP do?
serve as a reference point for provincial or territorial bodies seeking to facilitate the mobility of paramedics between provinces and territories. NOCP may become the blueprint for national exam. NOCP is key to defining a national space of practice. All the above
what does primum non nocerre mean?
first do no harm
what is required for a patient refusal?
a witness
suspect cardiac tamponade when?
after a recent CPR
which are causes of cardiogenic shock?
tension pneumothorax cardiac tamponade pulmonary embolism prosthetic valve malfunction trauma
PPV is good for an apneic stroke patient because?
hyperoxygenation will eliminate excessive CO2 levels
16-20 per min
what are the properties of cardiac cells?
excitability automaticity conductivity contractility elasticity
which of the following will cause altered LOC and metabolic acidosis?
status epilepticus
what is myoclonus?
temporary involuntary twitching of muscle
what is fremitus?
a palpable vibration in the body may be caused by a partial airway obstruction
what is pre eclampsia?
characterized by an increase in systolic BP by 30 mmHg and diastolic by 15 mmHg above baseline on at least two occasions within 6 hours, most common in the last 10 weeks gestation, during labor, or 48 hours postpartum.
what does breathing through pursed lips do?
eases SOB by helping to splint the alveoli open during exhalation
what are the three mechanisms that remove hydrogen from the blood?
bicarbonate buffer system, respiration, kidney fuction
where is appendicitis pain initially felt?
periumbilical
what are biot’s respirations?
repeated episodes of gasping followed by periods of apnea caused by increased intracranial pressure,
what is skin tugor?
a tension in the skin
what are the three layers of the heart from inner most to outer most layer?
endocardium
myocardium
epicardium
which of the following is not an enteral route of med admin?
umbilical
compartment syndrome is most commonly found where?
lower leg
what does the P wave represent on an ECG?
atrial depolarization
what is visceral pain?
dull, poorly localized pain that originates in the walls of hallow organs
seizure patent represents with muscles tensing and prolonged muscle contractions. this period is known as?
tonic phase
pediatric patient represents with flushed skin, crying warm to the touch, and barking cough. what is most likely?
croup
an avulsion occurs when?
skin and tissue are pulled back
how many vertebrae are in the thoracic section of the spine?
12
