State Review Flashcards
Binds to narcotic receptor sites in the brain to reverse narcotic - opiate OD
Narcan
Narcan to an addict =
Withdrawal reaction
Narcan Adult dose
0.4 - 2mg
Narcan pedi dose
0.1 mg/kg
Fastest administration route =
Sublingual
Intradermal injections are done at what degree?
10-15 degrees
What are the Central lines in the body?
Internal jugular, femoral, subclavian, GO FOR EXTERNAL JUGULAR
IV therapy complications are?
Hematoma, infiltration, cellulitis, air embolism, thrombus formation/infection and phlebitis ( which is infection ) NOT SEPSIS.
Destruction of RBC during venipuncture is?
Hemolysis
Elevating an arm will not?
Distend vein for venipuncture
Medications combined with fat and oils is what?
Emulsion
Mini drip is used for what?
Med-line IV’s
KVO = what drip rate?
10 gtts/min
1 pint of blood = how many CC’s?
500
1 oz = how many CC’s?
30
60mg = how many grain?
1
Med-I =?
463,000
Time required for 1/2 of radio active substance to lose activity =
1/2 life
1/2 life =
Radio active decay
Routes of medication from slowest to fastest absorption
PO, SQ, IM, ET, IV
Parenteral routes of drug administration are?
SQ, IM, IV, ET, IO
SQ injections are contraindicated with a pt in what?
Hypovolemic shock
Parenteral routes =
SQ, IM, IV not oral (Enteral)
5% dextrose in H2O should not be given to a pt with what?
Pulmonary edema
5% dextrose and H2O is used for what conditions?
Dehydration, Med infusion, and AMI
Never give D5w to a pt with what?
Head injury or normal glucose levels
IV set with 15 gtts/ml to administer 50ml an hr =
13 drops per min
Order 25G dextrose from 100cc amp of 50% dextrose, how many CC’s will be given?
50 CC’s
20 drop set in 30 min running at 50 gtts =
75 ml
60 drop set in 30 min running at 20 gtts=
10 ml
Colloids increase intravascular space the most but take longer to get in due to protein size and molecular weight is what?
Hespan/dextran
Homeostasis AKA?
Dynamic steady state
IV solution closest to plasma is?
Lactated Ringers
Reduces the portability of blood transfusion reaction
Fresh frozen plasma can be used and does not have to be cross matched
Hemorrhagic shock best fluid =
Blood ( definitive ) Lactated ringers in the field 3x blood loss
Universal blood donor
O neg
O Negative =
Negative AB antigens
Universal blood recipient is?
AB
Schedule 1 drugs
Heroin, Mescaline, LSD - NOT Cocaine
Increased amount of a drug to reach a desired effect =
Tolerance
Tricyclic Overdose =
Sodium Bicarbonate
Drug of choice for hyperkalemia (increase potassium) is?
Calcium chloride
Benzo overdose (Valium) reversal is?
Romazicon/ flumazanil
Morphine is given by what routes?
IV and IM
Morphine OD causes what symptoms?
Hypotension and Resp depression ( same for all opiates, benzo/barbiturates)
Clinical signs of shock do not give?
SQ injection
Major problems with catheter thru the needle system is?
Catheter embolus
Bretylium dose
5mg/kg
Benadryl dose
25-50 mg (IVP)
First compensatory mechanism to maintain homeostasis is?
Bicarbonate buffer then Resp and renal
Hydrogen protons that make pH balance is located where?
Kidneys
Hydrogen Ions are eliminated by what?
Kidneys
Decreased O2 in blood
Hypoxemia
Decreased O2 in the lungs
Hypoxia
Hyperventilation syndrome in a pt is what state?
Resp Alkalosis
The use of energy to move particles across a membrane
Active transport
Major extra cellular cation
Sodium
Major intracellular cation is
Potassium
Magnesium , calcium help with
Electrical and nerve conduction
Sodium helps with
Fluid regulation
Excretory function of blood is to remove
Urea, creatine, lactic acid and waste ; primarily lactic acid from cells
Normal stimulus to breath is
Increased PACO2, Arterial
pH less than 7.35 and pCO2 greater than 40 is
Resp acidosis
pH less than 7.35, pCO2 greater than 40 and HC03 or PO2 less than 24
Metabolic acidosis
pH greater than 7.45 and pCO2 less than 40
Resp Alkalosis
Need blood gases for anion gap; should not see as an answer
Metabolic Acidosis
Primary treatment of a near drowning victim
Management of Hypoxia and Acidosis
Battle signs and raccoon eyes are a contraindication for what airway?
NPA
Pulmonary ventilation =
Remove excess CO2 (normal balance)
One of the major purposes of pulmonary ventilation is
The ability to retain or eliminate CO2
Intubation of a child under 8 =
Uncuffed
Macintosh blade is inserted
Between epiglottis (vallecula) and base of tongue
Miller blade lifts
Epiglottis
(Mean) =
15-17 Resp per min adult RR
Is not an airway sound?
Cough
Crichothyroid performance =
Laryngeal edema and facial trauma
The EGTA is used on a
Comatose adult
Complications of a BVM
Abd distention, pushes diaphragm down and leads to vomiting
Air in the stomach makes intubation difficult because of
Vomiting and also aspiration risk
O2 delivered via NC =
22-44%
Narrowest part of adult airway is
Glottic opening
Contraindication for EOA (combitube) is
Less than 16 y/o , esophageal varices, ingestion of caustic substances, positive gag reflex, less than 5’ or over 6’8”
Civil wrong doing such as medical negligence
Tort law
If your dispatched to a scene, you have a ?
Duty to act
Comparing your actions under same/similar circumstances with that of other similar trained medics.
Standard of Care
All refusals must be what type of consent?
Informed consent
Physicians with the most authority on scene
On line physician
Negligence =
Breech of duty
Duty to act
Proximate cause, damages or harm
* intent not needed
The greatest threat for false imprisonment is
Psychiatric pt’s
Granting privileges by Dr’s to medics to perform skills is called
Delegation of authority
Malpractice term where cause direct injury to a pt is called
Proximate cause
Labor and negligence law is
Tort law
Standards governing a group of people or profession is called
Ethics
Who are ethical standards developed for?
Pt’s
Indirect medical control is called
Standing orders
If a medic is charged with negligence they are the
Defendant
Directly caused harm or injury in a negligence case is what?
Proximate cause
Assessment of calls begin when?
When the call is dispatched
Ambulance crashes, court will try to prove?
Lack of due regard
Difficult or painful breathing
Dyspnea
Prevents over expansion of the lungs
Hearing-Breuer reflex
Decrease oxygen in the lungs
Hypoxia
Decrease partial pressure of O2 in the blood
Hypoxemia
Increased PACO2 ,Aterial
Normal stimulus to breath
Hypoxic drive or a pt with COPD’s stimulus to breath is
Decreased O2 levels
Medications for COPD pt is
Aminophylline, albuterol, bronkosol
Vasoconstriction causes this condition
Skin pallor
Whistling sound during exhalation consider
Asthmatic bronchiolitis
Fluid/ mucous in LARGE airway will have what sound?
Rhonchi
Stridor at night with seal type bark is what condition
Croup
Poor airway compliance seen in
Sucking chest wounds / tension pneumothorax / flail chest NOT pleurisy or pleuritis
One of the major purposes of pulmonary VENTILATION
Ability to retain or eliminate CO2
One of the major advantages of RESPIRATION is
To increase absorption of O2 by the cells
Classic sign of Anaphylaxis is
Hypotension
Chronic bronchitis, an acute exacerbation =
Resp acidosis and tachycardia
Fever , rhonchi, hot and dry skin NO PEDAL EDEMA
Pneumonia
20 yr old asthmatic pt has not reacted to normal treatment, use what?
Aminophyline
Blue bloater, fat, increased mucous production, chronic cough, NOT A PINK PUFFER
Chronic bronchitis
Pink puffer, Barrel chest, thin, pursed lip breathing to create back pressure to open alveoli, SOB, cough generally in the morning with increased mucous
Emphysema
Coughing up blood
Hemoptysis
Cough up pink tinged sputum is
Hemoptysis and s/s of Left sided HF / pulmonary edema
Left sided ventricular damage is
CHF
IV for COPD pt is
KVO 55 dextrose in Sterile water
Use N/C or Venturi mask in a pt with?
Emphysema
Air trapped in the pleural space
Pneumothorax
Neurogenic/ anaphylactic and septic shock cause what due to VASODILATION?
Hypotension
Neurogenic, anaphylactic and septic shock are all what type of shock?
Distributive shock
Responsible for the transport and delivery of O2
Hemoglobin
Rumbling sound, fever, no edema is what condition?
Pneumonia
What is a side effect of hyperventilation
Carpal pedal spasms
Underlying cause of R sided heart failure
Cor pulmonade
Hypertension and JVD
Emphysema
Treatment for pulmonary edema / CHF =
LMNO
Lasix (40mg) slow IVP
Morphine sulfate (2mg) slow IVP
Nitro (0.4mg) sublingual
O2
Salt water drowning =
Respiratory alkalosis, CO2 retention and pulmonary edema
Fresh water drowning =
Hemodilution or hemolysis
Escape of fluid from vascular space into pleural space = pleural friction rub lung sounds
Pleural effusion
20 to 30 y/o thin smokers and males more prone to
Spontaneous pneumothorax
Pt 70 y/o with SOB and Orthopnea can’t lie flat DRIED BLOOD on LIPS is
Pulmonary edema
Bright red frothy blood at mouth w/ each exhalation =
Lung damage
Long bone fx at risk of what?
Fat embolism
RR x tidal volume in one minute is
Minute volume
Inflammation of the bronchioles with expiratory wheezing.
Bronchiolitis
Sudden onset of wheezing in ONE LUNG / Lobe is
Foreign body aspiration ( especially if just finished eating)
Decrease in intrathoratic pressure relative to environment (Active) CONTRACTION OF MUSCLES.
Inhalation
As volume in the thoracic cavity increases = pressure decreases
Exhalation (passive)
Amount of air inhaled and exhaled during one respiratory cycle
Tidal volume
Irregular breathing pattern with periods of apnea gradually increasing and decreasing
Biots breathing
Aminophylline aka Theophylline dose
5-6 mg/kg
Average tidal volume in one respiration is
500cc
Smooth muscle relaxant used with bronchial asthma is what?
Aminophylline
Knife like pain describes what condition
Spontaneous pneumo
Treatment in order for pulmonary edema is
- O2
- Monitor
- IV
- Nitro .4 mg
Collapsed alveoli with decreased ventilation =
Atelectasis
Respiratory drive- hypoxic drive aka back up drive is what type of disease
COPD
Decreases ventilatory effectiveness
Collapse of alveoli
Exchange of gasses between internal and external environment
Respirations
Ventilation / perfusion mismatch is called what
ARDS
Transports O2 ( iron containing component of RBC)
Hemoglobin
Ventilation problem , thoracic injury which leads to Resp pattern
Ataxic respirations
Asthmatics pt’s main treatment is to what?
Relieve bronchospasms
Signs and symptoms of respiratory distress is
Nasal flaring, tracheal tugging, sternomastoid muscle use, intercostal retractions
Tension pneumothorax treatment is?
O2, decompress, transport, IV en route
Pulmonary Emboli S/S is?
Dyspnea, SOB, pleuritic pn, tachycardia
No JVD with ?
Pulmonary embolism
Tx for anaphylactic shock is ?
Epi 1 mg 1:10,000 IV and Benadryl 25-50mg
Bee,hornet, wasp stings / PCN injection are the fastest and most frequent cause of?
Anaphylaxis
Left sided ventricular damage is called ?
CHF
Use a NC or Venturi mask in pt’s with
Emphysema
Hyperventilation helps to correct
Respiratory acidosis
Air trapped in the pleural space is called?
Pneumothorax
Neurogenic/ Anaphylactic & septic shock cause hypotension due to?
Vasodilation
Underlying cause of Right sided HF
Cor pulmonade
Carpal pedal spasms are a side effect of?
Hyperventilation
Hypertension and JVD are S/S of ?
Emphysema
Primary concern for a near drowning is?
Hypoxia and acidosis
Difficulty breathing while lying down is
Orthopnea
70 y/o pt. with SOB and Orthopnea, can’t lie flat with dried blood on his lips
Pulmonary edema
Bright red frothy blood at mouth with each exhalation =
Lung damage
Orthopnea S/S =
Pulmonary edema and suggests right sided HF or CHF
Long bone fx at risk of?
Fat embolism
RR x tidal volume in one minute =
Minute volume
Inflammation of bronchioles with expiratory wheezing is ?
Bronchiolitis
Sudden onset of wheezing in one lung / lobe is ?
Foreign body aspiration ( especially if just finished eating )
Salt water drowning S/S
Respiratory alkalosis, CO2 retention and pulmonary edema
Average tidal volume in one respiration is?
500cc
Irregular breathing pattern with periods of apnea gradually increasing and decreasing is what kind of breathing pattern?
Biots
Atelectasis means ?
Lack of surfactant
Transports O2 ( iron containing component of RBC )
Hemoglobin
Pulmonary edema can be caused by what?
Over Hydrating your pt
O2 saturation in peripheral tissue
Pulse Oximetry
Aminophylline aka Theophylline dose=
5-6 mg/kg
Smooth muscle relaxant used for bronchial asthma
Aminophylline
Spontaneous pneumothorax description =
Knife like pain
Collapsed alveoli with decreased ventilation =
Atelectasis
Complete or partial collapse of a lung or lobe is called ?
Atelectasis
Exchange of gases between internal and external environment is called?
Respiration
Thrombus formation in deep veins of legs that travel to pulmonary artery are called ?
Pulmonary embolus
Recent delivery of a child can cause a?
Pulmonary embolus
Best tool for exposing a cars locking mechanism
Air chisel
Repeater in a Telemetry system increases?
Transmitting and receiving range
Telemetry system in which voice and ekg can be transmitted at the same time is called?
Multiplex system
Radio transmissions can be reduced due to?
Holding the radio vertically , no repeater, weak battery
The ability to listen and speak at the same time is what type of telemetry system?
Duplex
Group of frequencies close together are called a
Band
VHF and UHF are bands used for?
Medical communications
EKG’s transmitted and decoded is called ?
Oscilloscope
Malicious writing is called
Libel
Malicious words spoken is called
Slander
Established policies and procedures of EMS system is called?
Protocol
Most fatalities of rescuers happen in ?
Confined space rescues
First step of extrication is?
Gaining access to pt
Cannot transmit or receive data at the same time is what type of telemetry system?
Simplex
One of the first signs of hypovolemic shock is?
Tachycardia
Earliest sign of any type of shock is?
AMS ( Altered Mental Status )
Factor common to all forms of shock?
In adequate tissue perfusion
Most reliable indicator of severity of injury in Trauma is
MOI ( Mechanism of Injury )
Damage to tissue due to high speed bullet
Cavitation
Swollen/ protruding / bulging tongue would indicate what?
Traumatic asphyxia
Traumatic asphyxia is most commonly caused by what?
Crush injury to chest or abdomen
When surveying the scene initially of an MCI you do not have to report ?
Life threatening injuries
For trauma in the field give 3 times estimated blood loss of ?
Lactated ringers
Abdominal evisceration tx consist of what?
Treat for shock, O2, cover organs with a moist stable saline soaked dressing. DO NOT PUT ORGANS BACK
Tension pneumothorax S/S
Dyspnea, mediastinal shift away from affected area / JVD
Explosion tx consist of?
Asses airway, ventilate, oxygenate, stop arterial bleeding and treat closed femur fx
Blast injury primary phase is?
Rupture of large intestines / hollow organs
S/S of Neurogenic shock
Hypotension, bradycardia, warm/dry skin below level of injury following trauma
ICP, bradycardia, irregular Resp, elevated BP are S/S of what?
Cushings triad
S/S of ICP include?
Bradycardia, vomiting, irregular or unequal pupils ( NOT HYPOTENSION )
Trauma victim w pulse of 40, BP 200/120 and increased ICP S/S of what condition?
Cushings triad
High cervical fracture impairs what?
Respirations
Anaerobic metabolism means?
Without O2
Atropine pediatric dose?
0.02 mg/kg
Atropine adult dose
.5-1.0 mg
Pediatric sodium bicarbonate dose?
1 meq/kg
Adult sodium bicarbonate dose?
1 meq/kg
Bretylium pedi dose?
5 mg/kg
Bretylium adult dose?
5 mg/kg
Epi 1:1000 pedi dose?
.01 mg/kg
Epi pedi dose for a CODE?
0.1 mg/kg
Epi 1:10,000 adult dose?
.3-.5 mg
Epi pediatric dose 1:10,000 CODE only
.01 mg/kg
Haldol adult dose
2-5 mg
Lidocaine pedi dose?
1.0 mg/kg
Lidocaine adult dose?
1.0-1.5 mg/kg
Mag Sulfate adult dose?
1-2 g over 1-2 min
Morphine adult dose?
2-5 mg
Narcan pedi dose?
0.1 mg/kg
Narcan Adult dose?
0.4-2 mg
Oxytocin adult dose?
10-20 units
Valium adult dose?
2-10 mg
In an adult with a partial FBAO what would be your first intervention?
Encourage or to cough
Thin shaped valve covering the trachea?
Epiglottis
Landmark for a cricoid stick is?
Cricoid cartilage or depression inferior to Adam’s apple
Contraindication for crichothyrotomy is?
Crush injury to the larynx
Sellicks maneuver/ cricoid pressure is used for what purpose?
Displaces esophagus posterior and increases vocal chord visualization.
Narrowest part of an adult airway?
Glottic opening
Good Samaritan act offers protection when?
While off duty
The FDA governs what?
The safety of drugs
Granting privileges by Dr’s to paramedics to perform skills is called what?
Delegation of authority
Malpractice term where direct injury has been caused to a pt is called ?
Proximate cause
JVD beat evaluated in what position?
Semi fowlers @ 45 degrees
Device that transfers electrical energy into sound waves is called?
Transmitter
Proper radio procedure?
Speak clearly and keep message brief
First phase of EMS is?
Public access to 911
Best way to avoid anaphylactic reaction is to?
Ask allergy hx
One man carry that’s not used often due to pt’s weight on rescuer is called what?
Firemans carry
Technique used with a LSB in narrow spaces as an alternative to the four man roll is called what?
Four man straddle slide
What is the maximum amount of a crystalloid fluid given to an adult trauma victim?
2000-3000 mL
How long do abdominal bleeds take to occur?
2-3 hours
In a stab wound to the neck at the jugular vein, what should you expect and what would your treatment be?
Suspect an air embolism and apply pressure to the wound and position on left side.
Ecchymosis behind the ear or mastoid process is called what from what type of injury?
Battle signs form basilar skull fx
Electrical burns cause what type of of burns?
Superficial and deep burns
Route of passage for electrical burns is determined by ?
Entrance and exit wounds
In electrical burns entrance and exit wounds, the current follows?
Nerve pathways and may cause V-Fib and more internal than external damage
MAST/PASG inflation order?
L leg, R leg then abd
MAST/PASG deflation order?
Abd, R leg then L leg
AAA stands for what?
Abdominal Aortic Aneurysm, femoral pulses in scenario “ do not give nor Epi “
For needle decompression place needle where?
2nd or 3rd intercostal space mid clavicular or 4th or 5th intercostal space midaxillary
Sequence pleural decompression order is?
O2, decompress, transport and IV in route
MVA pt with HR 120, BP 40 palp what condition is pt in?
Hypovolemic shock
Left femur, spleen or chest injury and right sides head injury is what condition?
Wadell’s triad
Pinching or cutting of nerves and blood vessels is cause by what type of fracture?
Severely angulated fx
Spinal injury with intercostal retractions suspect?
Cervical spine
15ft fall, pt with flat neck veins /chest Dull to percussion is ?
Hemothorax
Muffled /distant heart sounds , narrowing pulse pressure decreased BP (NOT FLAT NECK VEINS) is what condition?
Becks triad
Becks triad indicates what?
Cardiac tamponade
Flat neck veins are seen with what conditions?
Dehydration, hypovolemia, hemothorax ( NOT CARDIC TAMPONADE )
Alkali burns (strong base) strongest and most severe caused from?
Drano or oven cleaner
A pt with major burns has hypovolemic shock due to?
Plasma loss , interstitial fluid shift
Paradoxical respirations is cause by what?
Flail chest ( 3+ ribs in 2+ places )
In an MVA with a collapsed steering wheel look for?
Flail chest
Most serious complication of a joint injury is?
Nerve damage
Fracture straight across shaft of bone is what type of fracture?
Transverse
Most common fracture in the body?
Clavicle
Childs most common fx?
Green stick
Spiral fx in a child suspect?
Abuse
Fx at the elbow, immobilize in what position?
Position found
Sprain=
Torn
Strain =
Stretched
Affective nerve pathways send what type of messages to the brain?
Sensory ( affective = ascending )
Effector nerve pathways send what type of messages from the brain to the body?
Motor ( descending sends down )
Most commonly injured abdominal organ from blunt trauma is?
Liver ( RUQ )
Motor cycle crash with 3” scalp lac, pt A&Ox3, tachy and low BP treatment is what?
Normal saline KVO ( not LR wide open )
Trauma with fascia separation is what?
Avulsion
Most common type of MVA in rural areas are?
Frontal or head-on collision
The kidneys rely on what for perfusion?
Stroke volume
Exsanguinate means?
Loss of blood to the point that life cannot be sustained / bleeding out
Closed head injury tx?
Lactated Ringers only ( do not use NS or D5W )
Cold windy night, alcoholic unarousable , V-fib, no respiration. Treatment would consist of ?
Airway, defib x 3 , CPR and transport
Single vehicle MVC, one person dead and another ejected with a badly lacerated scalp and unconscious. Treatment would consist of ?
Open airway and stabilize C-spine
Pupil response if from what cranial nerve?
Cranial nerve #3
Upper area of uterus is called?
Fundus
When does the placenta deliver?
End of the third stage of labor
During a pregnancy the females blood volume increases by how much?
40% with relative anemia ( most blood increase is plasma )
Oxytocin is released by what?
Pituitary gland
Acetylcholine is also released by what?
Pituitary gland
Small pea shaped glands are called?
Parathyroid gland
Normal pregnancy length is what?
280 days, 9 mos , 10 lunar months and 40 normal weeks
Word used to describe a woman’s first pregnancy?
Prima gravida
Woman who has delivered her first child is called what?
Prima para
What do you do with a clamped and cut cord that continues to bleed?
Clamp again
Fertilization of ovum outside the uterus , may stay in the tube is what type of pregnancy?
Ectopic
Most common Fallopian tube?
Ectopic pregnancy
The usual place of fertilization in a female pregnancy?
Fallopian tubes
The umbilical cord has how many veins and arteries?
2 arteries and one vein. ( LARGER OPENING ) umbilical cannulation via vein
Heimlich in pregnancy is performed by what means?
Chest compressions
In an MVA save the mom or child?
Mom
Mom gave birth 24 hrs ago, now sudden onset of SOB/ dyspnea and chest pain suspect what?
Pulmonary embolism
26 y/o multi gravida with prior c-sections, C/C full term with contractions 3-4 min apart, tearing pn, no signs of bleeding, suspect what?
Abruptio placenta
Premature separation of placenta from wall of uterus is what?
Abruptio placenta
Minimal dark red bleeding, rigid uterus and shock, can also be described as a tearing pn is what?
Abruptio placenta
Placenta covers the cervical opening is ?
Placenta previa
Bright red blood and painless is the classic differentiation of ?
Placenta previa
APGAR stands for?
Appearance, pulse, grimace, activity, respiratory rate ( score under 6 intervention required )
APGAR is check at what specific times?
1 min and 5 minutes
40 y/o female with loss of appetite and RUQ tenderness, urine is TEA color is what?
Hepatitis
22 y/o female with severe pn LRQ, no appetite with constipation, suspect what?
Appendicitis
Do not allow to clean perineum with this type of pt?
Rape victim : tx all major trauma/ emotionally support and allow a family member to be present : female medic is best if available
Hypertension, edema, proteinuria are s/s of what?
Pre eclampsia ( not seizures )
Treatment for eclampsia use what?
Mag sulfate (first choice) or 5-10 mg Valium
Usually in the 9th month of pregnancy but can occur at anytime during the 3rd trimester.
Toxemia of pregnancy
Seizures from Toxemia ( Eclampsia ) occur when?
In the 9th month but can occur anytime during 3rd trimester.
What is the main characteristic of Eclampsia?
Seizures
What is the primary cause of the transmission of AIDS?
Unprotected sex
Purple and blue lesions in the mouth and other areas of the body are called what and are a complication of what disease?
Karposi’s Sarcoma, HIV
32 y/o with excruciating head ache while working out and lost consciousness, unresponsive with bilateral dilated pupils is what condition?
Cerebral Aneurysm
Common cause of uterine bleed in the first trimester?
Threatened abortion, incomplete abortion, ruptured ectopic pregnancy.
Amenorrhea of less than 12 weeks/sharp sudden unilateral lower abdominal pain with severe shock NOT 3rd trimester bleeding is what?
Ectopic pregnancy
22 y/o RLQ pain radiating to RT shoulder, no menses w/ spotting today is what?
Ectopic pregnancy
Blood and other matter discharged from the uterus during menstruation is called what?
Menses
BP decreases during what month of pregnancy?
Third
Time from conception to delivery is called?
Prenatal period
Before birth AKA prenatal period?
Antepartum
A baby born within the first few hours is considered?
Newborn
Birth through one month of age is considered?
Neonate
Neonates lose body heat mostly via?
Evaporation
Contractions to dilation is what stage of labor?
First stage
Dilation to crowning full dilation is what stage of labor?
Second stage
Delivery of fetus to placenta delivery is what stage of labor?
Third stage
If you suspect abruptio placenta your treatment would be?
High flow O2, Lactated ringers and monitor VS every 5 min
Serous membrane covering abdominal organs?
Visceral
If you suspect abruptio placenta your treatment would be?
High flow O2, Lactated ringers and monitor VS every 5 min
Medication that stops uterine contractions?
Brethine
Medication that encourages uterine contractions to decrease bleeding?
Pitocin
Most common UTI is?
Cystitis
Hyperglycemia in pregnancy is called?
Gestational diabetes
PPE for delivery of a baby?
Gloves/mask/gown/protective eyewear
Most common cause of PID?
Gonorrhea
All s/s kidney stones except?
Frequent urination
Frequent urination is a s/s of what?
UTI
Definite delivery imminent encourage pt to?
Push, crowning, contractions 1-2 min apart
Retroperitoneal =
Kidneys
Arm and leg presentation what would you do?
Transport immediately PERIOD
Normal “fight or flight response” would be?
- Alpha and Beta stimulation
- Sympathetic Nervous System : clammy skin, tachycardia, peripheral vasoconstriction , dilated pupils, slowed digestion/ constriction of sphincter muscles
- sympathomimetic
Bilateral dilated pupils usually indicates?
Cerebral hypoxia
Lower extremity check for paralysis consist of asking pt to do ?
Wiggle toes
Damage in the brain stem causes what?
Decerebrate posturing
Damage can be above brainstem, can cause what?
Decorticate posturing
Body extremities upper comes to the core meaning?
Corticate
Posturing indicates what?
Cerebral injury
23 y/o working out in the gym with an explosive headache, what could be the cause of these symptoms?
Subarachnoid Aneurysm
Eyes don’t move in unison?
Dysconjugate gaze
Failure of the eyes to rotate simultaneously in the same direction or the eyes gazing in different directions?
Conjugate / dysconjugate gaze
Extended extremities would indicate what?
Decerebrate posturing
Epidural hematoma description
Fast arterial bleed
Subdural hematoma description
Slow venous bleed ( problems can occur hours/ days later )
Brief period of unconsciousness followed by a return to complete function?
Concussion
Part of the brain that controls posture?
Cerebellum
Severed C4 vertebrae would cause what damage to the body?
Total paralysis, motor and respiratory paralysis, can’t breathe on their own= quadriplegic
Increased ICP should be hyperventilated for?
20-24 and mannitol given for ICP
Series of increased and decreased respirations followed by apnea is what?
Cheyne-stokes
Rapid, irregular in rate and volume with periods of apnea is ?
Cheyne-Stokes respirations
Pt fell from the 3rd floor, R lung sounds absent, fractured leg what’s your tx?
Open airway, BVM w/O2, decompress R side, PASG device then transport w/ 2 large bore IV’s
Injury to the opposite side of the head or opposite side of injury is called?
Countercoup
Balance, coordination and motor control all controlled by what part of the brain?
Cerebellum
Drug used for ICP?
Mannitol
Halo test checks for what?
CSF
21 y/o male with C/C of severe headache
Aneurysm
Unequal pupils suggest?
CNS injury or a neurological crisis
T4 injury would cause paralysis where?
Below the nipple line
T10 injury would cause paralysis where?
Below the umbilicus
Thought, intelligence and higher brain function is controlled by what part of the brain?
Cerebrum
Slow venous bleed?
Subdural
Fast Arterial bleed?
Epidural
Treatment of a pt with a syncopal episode?
EKG, IV KVO and accucheck, DO NOT PLACE IN FOWLERS POSITION
DO NOT give 5% D5W wide open to a pt who has suffered?
CVA or seizure
Treatment for a pt who has had a CVA or seizure?
O2, airway, EKG
Seizures w/o regaining consciousness between 2 or more seizures is called?
Status epilepticus
Classic S/S of a stroke?
Aphasia, loss of memory, hemiplegia
Aphasia means?
Language disorder, unable to speak properly
Hemiplegia means?
Paralysis of one side of the body
Increased carbon dioxide in the blood is called what?
Hypercarbia
One pupil slow and non reactive, other slow to respond is what?
Neurological crisis
Transport stroke pt in what position?
Left lateral recumbent
Blood under dura?
Subdural
Outside skull to brain in order?
Dura, arachnoid, pia
Inside brain to skull?
Pia, arachnoid, dura
Part of the brain that effects vision?
Occipital / injury causes the vision to be affected.
If old, Pt’s medical hx: diabetic, stroke, aphasic, syncopal episodes, dementia, recent surgery, immobilized in warm comfortable environment, cool, pale, diaphoretic w/ no apparent or obvious chest pn. Accucheck wnl, consider?
Silent MI, monitor for ekg changes
Medication and dosage used for seizures?
Valium/ diazepam 5-10 mg
Status epilepticus treatment?
NPA, O2, IV with NS, keep safe DO NOT INTUBATE: medical emergency and priority pt
Seizure pt’s deemed a priority if?
No response between seizures or in status state.
Seizures common in children?
Febrile
Seizures mistaken for daydreaming?
Absence
Seizures found in children of short duration w/no LOC can occur 100 times per day are?
Focal motor
Clonic movements of one hand, one arm, one leg, or one side of the face are what?
Focal motor
Major contraindication of thrombolytic tx?
Bleeding out
Major complication of thrombolytic therapy is?
Recent surgery
Scenario: with a syncopal pt, do all EXCEPT?
Lift pt in sitting position
EKG-No P waves, SA node is not the pacemaker, assume what rhythm?
A-Fib
Increased HR ( + chronotrope ) and blood vessel constriction ( Increased PVR peripheral vascular resistance ) fills the tank =
BETA receptor stimulation or stimulation of the sympathetic nervous system
JVD, narrowing pulse pressure, clear lungs, muffled distant heart sounds is what condition?
Cardiac Tamponade
A late sign of a tension pneumothorax and cardiac tamponade is what?
Tracheal deviation
Most unstable or lethal ectopic beats originate where?
Ventricles
Most deaths after an MI occur within what time frame?
2 hours
Tricyclic OD shows all irregularities on an EKG except?
Inverted T waves
Part of the heart most commonly damaged?
Left ventricle
A pain in the chest that has a searing/ tearing sensation that radiates to the neck with no pedal pulses is what?
Aortic Aneurysm
Stable angina responds to what?
Rest and Nitro
Stable angina occurs when?
During exercise and stress
Unstable angina may not subside with rest, if not consider?
AMI
(DVT) Thrombi in deep part of the legs migrates where?
Right Ventricle ( venous side )
Pink frothy sputum, cyanosis, rales, tachycardia consider?
Pulmonary edema
Pulmonary arteries carry deoxygenated blood to the lungs, which portion of the heart has the lowest amount of oxygen?
Right atrium
Pulmonary veins carry oxygenated blood to the heart, which portion of the heart has the highest amount of oxygen?
Left atrium
Arteries carry blood?
Away from the heart
Veins carry blood?
To the heart
PEA=
Not pneumonia
Pressure of blood against the Arterial wall during heart beats is the definition of what?
Systolic BP
Pressure of blood against Arterial walls BETWEEN heart beats?
Diastolic BP
Adrenal glands secrete?
Epinephrine
The amount of blood EJECTED from the heart during each contraction (systole)
Stroke volume
If stroke volume does not change but HR decreases?
Cardiac output decreases
What do coronary arteries do?
Perfuse the heart
Coronary arteries empty via?
Coronary sinus
Coronary occlusion =
Thrombosis
Peripheral vasoconstriction =
Pallor
Wide bizarre look on the monitor is?
V-Tach
EKG paper large blocks =
.20 seconds
EKG paper small blocks =
.04 seconds
P-R interval greater than .20 sec is a diagnostic for?
Heart block
P-R interval is measured from the beginning of?
P wave
P waves get wider until QRS drops =
Wenkebach mobitz I
Re-entry may cause premature beats meaning?
Tachydysrythmias (ex. PAC )
Wide QRS rhythm w/ no p waves is what type of rhythm?
Idioventricular
V- Fib will occur if cardioverted on?
T wave
Calcium channel blockers decrease?
HR
Medulla, Pons and aortic arch are all?
Chemoreceptors
Regulates BP/RR/Pulse?
Medulla Oblongota
The parasympathetic Neurotransmitter is?
Acetylcholine
Stimulation of the vagus nerve produces?
Acetylcholine
Neurotransmitter of the vagus nerve produces?
Acetylcholine
Side effect of Bretylium is?
Postural / Orthostatic hypotension
Two sided heart failure =
Pulmonary edema
85 y/o w/ severe headache, nausea/ vomiting, dizziness BP 210/120 =
Hypertensive crisis
Epinephrine causes all of the following :
Increased automaticity, HR, BP
*NOT DECREASED SYSTEMIC RESISTANCE **
Ability of heart to generate its own electrical impulses is what?
Automaticity
Hypotensive pt treatment?
Dopamine, fluid bolus, Epi drip, trendelenburg
* NOT FOWLERS*
60 y/o pt, 110 lbs, heart palpitations, pulse 145, BP 110/60, RR 24, EKG = wide complex tachycardia. Treatment would be?
Lidocaine 1-1.5 mg/kg or 50 mg IVP
Epi stimulates the heart in?
Asystole
Causes vasoconstriction ( alpha 1 property )
Nor Epi
Decreased workload and decreased preload is caused by what?
CHF
JVD=
Increased venous pressure
Right heart failure ( man sitting at 45 degrees ) causes what?
JVD
Adult female who’s tachycardic, VS are WNL, she does not meet cardioversion criteria, what would you do?
Try to calm her, O2 and vagal
Central venous pressure is aka?
Right Arterial pressure
Procainamide is a?
Antiarythmic
Used for PVC’s, V-Tach, maintenance of NSR after conversion from A-Fib and A-Flutter
Procainamide
Adrenal glands release?
Epi and Nor Epi ( sympathetic nervous system “fight or flight” )
Norepinephrine is what stimulant?
Alpha and Beta
Atropine given to slow causes?
Paradoxical bradycardia
Atropine works by blocking what?
Parasympathetic nervous system
Atropine side effects:
Tachycardia, blurred vision, dry mouth
** NOT SWEATING ***
Blocks the effects of the vagus nerve?
Atropine
Used to treat asystole, bradycardia, 2nd degree heart block?
* NOT PSVT*
Atropine
Alpha 1 stimulation causes what?
Increased HR, skeletal muscle contraction and Arterial constriction
* NOT BRONCHODILATION**
If pt is in V-Tach, unconscious, No VS, defib at?
200j / 300j / 360j
Pt’s with PVC’s and Bradycardia do not give ?
Lidocaine
Early s/s of lidocaine toxicity is?
Muscle twitching or tremors/ parasthesia ( numbness and tingling )
Lidocaine overdose S/S?
Hypotension and seizures
If the question says toxicity or OD they are looking for
Seizures, hypotension, tremors, paresthesia ( numbness and tingling )
Side effects of lidocaine are?
Hypotension and bradycardia
A build of lactic acid during cardiac arrest causes the body to be in what state?
Metabolic acidosis
Lidocaine dose for pulseless v-tach is?
1 mg/kg then 1.5 mg/kg
Lidocaine can be administered via what routes?
ET,IV,IO
Lidocaine dose for a code is
1.5 mg/kg followed by 1.5 mg/kg
Next drug after lidocaine for multifocal PVC’s is?
Procainamide
A lidocaine drip using 60 gtts/min at 20 gtts/min will deliver what amount in 30 min trip to the hospital?
10 ml
Lidocaine drip of 2 G in 250 ml bag of D5W is ?
15 drops
Lidocaine drip 2 G in 500 ml bag of D5W is?
30 drops
Lidocaine drip 2 G in 1000ml bag of D5W is ?
60 drops
Lidocaine dose for a pt that weighs 110lbs would be?
50 mg then 2-4 mg/min
Lidocaine dose for an 80 kg pt with PVC’s is?
100 mg
Intubate a cardiac arrest pt when?
Right away
R on T phenomenon can cause?
V-tach / V-fib
Synchronized cardioversion occurs on what point of an EKG?
R wave
On fast patches, the Gel on the patches decreases what?
Defibrillation/ paddle resistance to increase conduction
Gallop heart sound classified as S3 is a S/S of what?
CHF
If you shock a pt with a pacemaker, where would you not place the fast patch and at what joules would you set the monitor?
200 j and not over the pacemaker
Rhythm strip on the monitor shows some kind of indiscernible block what would your treatment be?
O2/ monitor and transport
Morphine is a ?
Vasodilator
A major side effect of certain diuretic treatments is what?
Hypokelemia
Ascites means?
Fluid in the abdomen
Fluid in the lungs ( ascites ) is usually a result of what medical conditions?
CHF or liver dysfunction
Verapamil side effects are?
Hypotension, coronary artery dilation, bradycardia.
NOT TACHYCARDIA
Other names for verapamil are?
Isotopin/ Calan ( calcium channel blockers )
Treatment of a pt with pulmonary edema?
LMNO :
Lasix, morphine, nitro, O2
* NOT SOLUMEDROL
All are vasopressors except?
- Levephed
- Nor Epi
- Intropin
- Atropine
Atropine
Beta blockers are used to treat what?
Cardiac dysthymia, hypertension
When beta blockers are stimulated the heart rate is increased causing the body to do what?
Vasodilation, increased myocardial o2 demand
* NO BRONCHOCONSTRICTION*
A beta agonist natural normal response is what?
Increased HR, chronotrope,
Verapamil is contraindicated in pt’s with what?
Wolf Parkinson’s white
Side effects of verapamil?
Tachycardia (WPW problems)
Rapid A-Fib, A-flutter and SVT are all rhythms that can be treated with what drug?
Verapamil
Wolfe Parkinson’s white with no S/S treat with O2, if hemodynamically unstable in PSVT treat with?
Adenosine 6mg if no change 12mg/12mg fast IV push
Pathophysiology of adenosine?
Slows conduction through the AV node, slows all cations
Pulseless V-tach defibrillate at?
200j/300j/360j
Symptoms due to tachycardia are related to ?
Decreased ventricular filling, time and stroke volume
Drug with positive inotrope will cause?
Contractility, increased force of the contraction
Epi given IV during cardiac arrest does all of the following :
Increased myocardial blood flow, increases peripheral resistance
Side effects of Epi SQ or IV can be?
Palpations and hypertensions
The Dr. Needs present complaints and history on a pt with ?
MI
Elevated T waves is what?
Hyperkalemia
Works in loop of henle, is a loop diuretic, decreases pre load, prevents reabsorption of sodium, causes vasodilation within 5 minutes
Lasix
You draw up 800 mg of dopamine which comes 25mg/CC. How many CC’s will you put in the IV bag?
32 CC’s
Medication first given for SVT?
Adenosine
Adenosine side effects?
SOB/ chest pn/ dizziness
TACHYCARDIA IS NOT A SIDE EFFECT
Isoproterenol dose?
2-20 mcg/min
Causes blurred vision , dizziness , decreased HR, positive chronotropic is what?
Digitalis
Any diuretic treatment can cause?
Hypokalemia
Digitalis is contraindicated in?
Heart blocks
Do not shock a pt that is taking what medication?
Digitalis
Amount of blood ejected in one contraction?
Stroke volume (500 ml)
Heart rate x stroke volume =
Cardiac output
Do not shock a pt that is taking what medication?
Digitalis
Cardiac output x peripheral vascular resistance =
Blood pressure
If a pt is taking digitalis and is weak, dizzy, vs wnl treatment would be?
Monitor, IV and transport
If a pt has chest pain, your questions should include questions about what?
GI problems and muscular skeletal issues
If pt has a bundle branch block you should?
Transport, can’t rule out cardiac event
Normal cardiac output per heartbeat is what?
500 ml
Systolic pressure minus diastolic pressure or difference between systolic and diastolic is what?
Pulse pressure
Intrinsic ventricular firing rate is?
20-40
Treatment for a pt suffering a heat stroke would be?
Aggressive cooling methods, 2 IV’s wide open
Failure of heat regulating mechanisms causes what condition?
Heat stroke
TB S/S include?
Weakness and weight loss, night sweats , fever, hemoptysis, and SOB
No substernal cheat pn with?
TB
Contamination via dirty linens is considered?
Indirect contamination
Fast ascents from diving causes joint pain, tingling in legs and abd pn. All components of what?
Decompression sickness
Hot dry skin, summer, pt’s temp 106 and unconscious. Pt is suffering from what condition?
Heat stroke
Profuse sweating indicates what condition?
Heat exhaustion
Salt and water loss via sweating and evaporation is what?
Heat exhaustion
Legs cramp from lactic acid accumulation is what condition?
Heat cramps
Most neurotoxic venom is from what type of snake?
Corral snake
Compression of hollow organs particularly small intestines/ bowel and ear drum problems is from what?
Blast injuries
Lungs are the least likely to collapse in what?
Blast injury
DT’s occur how long after decreasing or no longer consuming alcohol in a chronic alcohol abuse case?
48-72 hrs
Green tongue is an indication of what?
Chronic alcohol abuse
If pt is tachy and talking very fast consider?
Amphetamine use, look for pin point pupils
CAGE questionnaire is used for what?
ETOH evaluation
Transport scuba diver in what position?
LLR
If flying with a scuba driver pt you must?
Fly as low as possible
Most common route of poisoning is what?
Ingestion
Caisson disease or the bends is a diving illness from what?
Ascending to fast
Absorption of toxins occur within where?
Small intestines
Most common route for toxins/ hazmat is?
Respiratory and absorption through the skin
Tricyclic overdose antidote?
Sodium bicarbonate , crucial EKG monitoring, Torsades commonly seen
Tricyclic and lithium and salicylate overdose antidote?
Sodium bicarbonate, alkalinize urine and hasten elimination process
Cyanide poisoning antidote?
Amyl nitrate + sodium nitrate solution + sodium thiosulfate solution
Benzodiazepine overdose antidote?
Flumazenil
Opiates overdoses antidote?
Narcan
Acetaminophen overdose antidote?
Mucomyst
Nitrates overdose antidote?
Methylene blue
Atropine overdose antidote?
Physostigmine
Pt with IDDM requires what?
Insulin on a daily basis
Weak and rapid pulse, weakness and incoordination, seizures, cool and clammy skin are S/S of what condition?
Hypoglycemia
Obvious diabetic ketoacidosis S/S is what?
Warm and dry skin
Deep and gasping respirations seem in DKA/Hyperglycemia
Kussmauls respirations
Stupor, slurred speech, bizarre behavior, cool/clammy skin are all S/S of what?
Hypoglycemia
Pediatric dose for D50W =
12.5 G also termed D25W
Body cannot use glucose over what range?
180 mg/dl
Normal glucose range
80-120 mg/dl
All are S/S of DKA except , no kussmaul respirations and no fruity breath is what?
HHNK
Osmotic diuresis with no ketones being used/ burned for energy is what?
HHNK
Scenario: diabetic pt with headache what’s the most important question to ask pt?
How long have you had this headache
DKA can be caused by a pt who does not ?
Take their insulin
Administering glucose stimulates the release of?
Glucagon
Releases glycogen from liver?
Glucagon
Psychiatric condition with wide mood swings is called what?
Manic depression
Mood swings from euphoria to depression is what condition?
Manic depression
Drug taken for bipolar disorder aka manic depression?
Lithium
If pt is disoriented, try to get pt to focus on?
Person, place, time and situation
Medications used for psychiatric pt’s particularly schizophrenia are what?
Thorazine, Mellaril, Haldol
Reversal of tricyclic OD is what?
Sodium bicarbonate
Psychotic pt vs. neurotic pt main difference is what?
Psychotic pt not in touch with reality
Extrapyramidal reaction to antipsychotic Med’s treatment would be?
Benadryl 25-50 mg
Elderly, dementia, deterioration of mental status with neuro disease are all S/S of what?
Alzheimer’s
Most common cause of injury in elderly pt’s is ?
Falls
Increase fall injuries in elderly pt’s?
Dementia
If pt is delusional, having hallucinations or a lack of reality it is important that EMS personnel do not?
Feed into delusions etc.
Most common form of abuse in the elderly is?
Neglect
Most common form of child abuse is?
Physical
If an infant has rib fractures, suspect?
Abuse
If a baby is lethargic with no other S/S, do not rule out?
Shaken baby syndrome
Most likely person to abuse children is?
Caregiver
Most likely to abuse elderly parents?
Son
If the story does not match the injury to a person of any age suspect?
Abuse
If a pt is healing in various stages suspect?
Abuse
Scalding circumferentially with no splash marks consider?
Abuse
Look directly at pt, do not yell and speak slow are all things that should be considered when working with what type of pt?
Deaf
Lower tones are better heard by pt’s that are what?
Hard of hearing ( best to use a male medic )
Discrimination against AIDS/Communicable disease pt’s is a violation of?
Americans with disabilities act.
Unreasonable confinement in elderly pt’s is considered?
Elderly abuse
If you use the fireman’s drag, sit pt up. Do not?
Tie hands together
Crying spells, anorexia, unkempt, lethargic with physical exam showing no abnormalities is considered what condition?
Depression
28 y/o with depression history, unconscious, sweating, pinpoint pupils, skin and fine motor fasciculations and tearing excessively are all S/S of what?
Lithium OD
Management of suicide crisis?
Every attempt needs to be evaluated by physician
Valium routes of administration:
Rectal, IV, IM
If a psychiatric pt is violent you should?
Wait for assistance / call LE
Experience a sense of deed or fear, distress over real or imagined threat to one’s own mental or physical well being is considered what?
Anxiety
Old lady thinking neighbors are out to get her, you should?
Remove her from the situation and keep her talking
Person witnesses a murder, he appears paralyzed while PE reveals no injury/ abnormality consider what?
Conversion hysteria
Woman threatening to kill herself with barbiturates, she is willing to talk but not with the door open, you should?
Conduct the interview outside door and call police
Someone that is frightened by heights, can’t ride an elevator. This is a?
Phobia
How to deal with the effects of a pt’s behavior during a physical exam?
Modify the exam if necessary
You have A pt that is exhibiting hostile aggressive behavior, you would?
Contact police and remove bystandards from scene
Dealing with a hostile pt, you and your partner should?
Stand apart from each other at an equal distance
Distraught elderly person urinates while on the stretcher and does not inform you until he/she is finished. This type of behavior is considered?
Regression
How to restrain a pt:
Lay pt in the prone position, 1 arm at their side and the other arm above their head with ankles together
Part of the lymphatic system, found in the LUQ?
Spleen
Committing if green/ yellow bike… fatty meals will also cause this?
Choleosystitis
Enzyme produced in the liver and stored in the gall bladder is what?
Bile
Pouch like herniations through the muscular layer of the colon, usually found in the LLQ?
Diverticulitis
Colored portion of the eyeball that surrounds the pupil?
Iris
Sclera white of the eye yellows due to?
Jaundice
Transmits sight to back of the eye for brain interpretation?
Optic nerve
Neurological findings during or after dialysis as a result of imbalance of intracellular and extracellular fluids in the brain is?
Disequilibrium syndrome
Hyperthyroidism which increases thyroid hormone circulating in the bloodstream is AKA?
Grave’s disease
Master gland, secretes oxytocin and ACTH
Pituitary gland
Duct glands excrete directly through ducts to epithelial cells ( sweat/ salivary)
Exocrine glands
Removal of toxins from blood through a semi-permeable membrane is called what?
Dialysis
Toxins in the blood are called?
Hemotoxins
Hormone released by beta cells in the pancreas ( isles of lagerhans )
Insulin
You will not see a decreased HR in what type of pt?
Dehydrated
Activated charcoal dose?
1g per kg
Hands placed on abdomen for what maneuver?
Heimlich
Not a sign of dehydration?
Polyuria
Fever, chills, nausea, vomiting ( common in blood transfusion )
Pryrogenic reaction
Prophylactic HIV treatment to begin in ?
48 hours
Female, fat and in her 40’s having RUQ pain after eating fatty foods, what would cause this condition?
Cholecystitis
Measles, mumps and chicken pox are all spread by what means?
Droplets
Hepatitis A is spread by what route?
Fecal to oral
Very virtulant and can stay on surfaces for days?
Hepatitis B
Fungus, bacteria and viruses are examples of what?
Microorganisms
Stiff neck, high fever, headache and backache are all S/S of?
Meningitis
Newborns are obligatory breathers through what?
Nose
At what age do kids have magical thinking?
3-5
This condition is caused by sudden temperature changes, usually self limiting and require minimum treatment. Treatment should include gentle cooling measures such as remove clothing / blankets and tepid water used. Should be transported to the hospital, what condition would this be?
Febrile seizures
Merconium staining is caused by what?
Fetal distress
Treatment for a newborn that has merconium staining?
First intubate and suction prior to first breath.
Seizures, convulsions are most common in children from what age to what age?
6 mos to 6 yrs due to febrile illness
Single indicator of neonatal distress is?
Bradycardia
Pediatric lidocaine dose?
1 mg/kg
Pedi dose of lidocaine for a 20 lb child is?
9 mg
Vomiting, diarrhea, dehydration, diaphoresis, clammy can lead to metabolic acidosis all S/S of what type of OD?
ASA
Pediatric pt that weighs 67 lbs needs SQ Epi, what is the dose?
.3 mg
Pediatric dose of SQ Epi for allergic reaction is?
.01 mg/kg
Pediatric pt with bradycardia, first line drug would be?
O2
Unilateral chest wheeze in a 6 y/o child consider?
FBO
In general DO NOT lie any child flat if
Dyspneic or drooling (epiglottis) or w S/S of Croup
Positive pressure ventilations are given to infants with a HR less than?
100 bpm
Rapid onset of fever higher than 101 degrees usually indicates what?
Epiglotitis
Slow onset of fever usually between 100-104 degrees is a sign of what?
Croup
Ominous sign of respiratory failure in a 6 y/o
Hypothermic breathing 6x/ minute
Makes intubation easier and can be used with infants?
Stylet
A single important indication in neonatal distress is?
Bradycardia
Best way of delivering O2 to an asthmatic child in acute distress?
Humidified O2
Placement of IO in pediatrics?
Proximal Tibia
Infant not breathing for 1-2 minutes then suddenly begins spontaneous respirations. What would you do for this pt?
Assist ventilations
Bones not yet fused, slightly sunken and may pulsate, Normal.
Anterior fontanelle
What does a sunken fontanelle usually indicate?
Possible Dehydration
ICP, over hydration, traumatic injury, coup -counter coup, shaken baby syndrome are indicated by what?
Bulging fontanelle
If a pediatric ingests lye what would you give?
Milk
Vomiting, diarrhea,Fever, burns are all signs of what in a child?
Dehydration
Location for IO in a ped?
2 fingers Below tibial tuberosity on medial surface of tibia
What to expect in a child that inhales freon?
PVC’s, VTach, VFib
The escape of fluid into a cavity
Effusion
Connects bone to muscle?
Tendon
Connects bone to bone?
Ligaments
Connects descending aorta to spine
Ligamentum Arteriosum
Subluxation mean what?
Partial dislocation of a joint that remains in place but is deformed
The liver produces?
Bile
The gallbladder stores?
Bile
