terms to know Flashcards
the amount of a drug that enters central circulation and is able to cause an effect
bioavailability
administration of medication in a single dose (as opposed to an infusion)
bolus
for calculation purposes, this is the total amount of medication as packaged (total amount of a drug in the syringe, ampule, etc)
concentration
the drug amount intended for administration
dose
delivery of medication through the GI tract (oral, sublingual, rectal)
enteral
period of time required for concentration of drug in the body to be reduced by one half
half life
the amount of an ingested substance (in mg/kg) that kills 50% of a test sample
LD (lethal dose) 50
delivery of a medication outside of the GI tract (IV, IO, IM, SQ, intranasal)
parenteral
movement of a drug through the body, includes absorption, bioavailability, distribution, metabolism, excretion)
pharmacokinetics
the mechanism of action of a medication
pharmacodynamics
the range between minimum effective dose of a medication and the maximum safe dose. The narrower the therapeutic index, the more risk associated with the medication
therapeutic index
for calculation purposes, this is the total amount of fluid available as packaged (total amount of fluid in the syringe, ampule, etc)
volume
related to the sympathetic nervous system
adrenergic
*think adrenaline
unintended effect of a medication administration
adverse effect
medication that stimulated a specific response
agonist
medication that reduces pain
analgesic
medication that inhibits a specific action
antagonist
single dose of a medication, given all at once
bolus
related to the parasympathetic nervous system
cholinergic
*think acetylcholine
circumstance when a medication should not be used
contraindication
repeated administration of a medication that produces effects that are more pronounced than the first dose
cumulative effect
categorization of medications with similarities or uses
drug class
tremors, slurred speech, restlessness, muscle twitching, anxiety side effects
extra pyramidal
diminishing of a physiological or emotional response to a frequently repeated stimulus
habituation
undesirable reactions produced by the normal immune system, including allergies and autoimmunity
hypersensitivity
solution that has a greater concentration of solutes on the outside of a cell when compared with the inside of a cell, causing fluid to move out of the cell
hypertonic solution
solution that has a lesser concentration of solutes on the outside of a cell when compared with the inside of a cell, causing fluid to move into the cell
hypotonic solution
circumstance when a medication should be considered
indication
sodium concentration same as intracellular fluid
isotonic solution
pharmacological effects of a medication
mechanism of action
interaction between two or more medications causing a response greater than the sum of of each individual medication
potentiation
resistant to treatment
refractory
any unwanted side effect of medication administration
side effect
desirable effects of medication administration
therapeutic effect
reduced response to a medication due to repeated use
tolerance
adverse or harmful side effects of medication administration
untoward effect
cellular processes that convert energy from nutrients into adenosine triphosphate (ATP), and then release waste products
cellular respiration
the passive part of breathing
exhalation
oxygen exchange between the lungs and circulatory system
external respiration
oxygen deficiency
hypoxia
the active part of breathing
inhalation
oxygen exchange between blood and the cells of the body
internal respiration
volume of gas inhaled or exhaled per minute
respiratory rate x tidal volume
minute ventilation
delivery of oxygen to the blood
oxygenation
the physical movement of moving air in and out of the lungs
ventilation
abdominal swelling
ascites
*consider liver disease, CHF, renal failure
bruising around the umbilicus
cullens sign
*consider intra-abdominal bleeding
a field conclusion of the patients problem based on the clinical presentation and the exclusion of other possible causes through considering the differential diagnosis
field impression
bruising over flank area
grey turners sign
*consider intra-abdominal bleeding
depression left by pressure of finger
pitting edema
*consider CHF or renal failure
measure or monitoring of exhaled CO2
capnography
area of necrosis or death
infarct
non-invasive measurement of oxygen saturation of hemoglobin
pulse oximetry SpO2
non-invasive measurement of carbon monoxide saturation of hemoglobin
pulse CO-oximetry SpCO
non-invasive measurement of methemoglobin
SpMet
swelling of the lower layer of skin and underlying tissue. Swelling may occur in the face, tongue, larynx, abdomen, arms and legs. Often associated with urticaria
angioedema
early shock where the body still maintains adequate perfusion
compensated shock
later shock where the body can no longer maintain adequate perfusion
decompensated shock
severe bleeding, leading to death
exsanguination
bleeding
hemorrhage
stage of shock leading to inevitable death
irreversible shock
MAP
mean arterial pressure
*DBP+1/3 (SBP-DBP)
progressive failure of at least two organ systems
multiple organ dysfunction syndrome
*MODS
hives
urticaria
resistance the left heart overcomes during contraction
afterload
a weakening in the wall of an artery
aneurysm
edema in the abdomen
ascites
enlargement of the heart, often due to hypertension
cardiac hypertrophy
volume of blood ejected by left ventricle in one minute
cardiac output
*stroke volume x heart rate
rate of cardiac contraction
chronotrope
speed of cardiac conduction velocity
dromotrope
an infection of the endocardium, usually involving the heart valves
endocarditis
percentage of blood ejected from a filled ventricle
ejection fraction
ventricles fail to respond to an impulse. On an ECG, the pacemaker spike will appear, but it will not be followed by a QRS complex
failure to capture
pacemaker malfunction that occurs when the pacemaker does not detect the patients myocardial depolarization. May be seen on an ECG tracing as a spike following a QRS complex too early
Failure to sense
force of cardiac contraction
inotrope
difficulty breathing while supine
orthopnea
acute onset of difficulty breathing at night, usually while sleeping
paroxysmal nocturnal dyspnea
inflammation of the pericardium
pericarditis
volume of fluid returning to the right heart
preload
variable angina caused by coronary artery spasms
prinzmetals angina
the more the heart is stretched (within limits), the greater the resulting force of contraction
starlings law
amount of blood ejected by the left ventricle during one contraction
stroke volume
non cardiogenic pulmonary edema
acute respiratory distress syndrome
*ARDS
right heart failure
cor pulmonale
coughing up blood
hemoptysis
uses an impedance valve to increase volume of air remaining in lungs at end of expiration to improve gas exchange
positive end-expiratory pressure
*PEEP
crackling under the skin upon palpation due to trapped air. Typically found in chest neck or face
subcutaneous emphysema
volume of air inhaled or exhaled with each breath
tidal volume
difficulty with coordinated movement
ataxia
arms and legs extended
posturing
decerebrate
arms flexed and legs extended
posturing
decorticate
*think drawing arms to core
difficulty swallowing
dysphagia
unilateral weakness
hemiparesis
unilateral paralysis
hemiplegia
involuntary eye movement
nystagmus
brain damage due to lack of vitamin B1
wernickes encephalopathy
deep rapid respirations
kussmaul respirations
excessive thirst
polydipsia
excessive hunger
polyphagia
excessive urination
polyuria
reactions that present like anaphylaxis but are not lgE-mediated
anaphylactoid reaction
life threatening allergic reaction.
unlike anaphylactoid reactions, this requires the patient to be sensitized, and mediated through lgE antibodies
anaphylaxis
immune cells produced by body to attack invading substances
antibodies
any substance that can produce an immune response
antigen
invading substance that can trigger an allergic or anaphylactic response
pathogen
immune response that occurs when an antigen comes into contact with the immune system for the first time
primary response
immune response that occurs after development of specific antibodies following primary response
secondary response
red, raised bumps across the body
hives/urticaria
inflammation of the coiled tube (epididymis) at the back of the testicle
epididymitis
blood in the stool
hematochezia
lacerated esophagus, usually due to vomiting
mallory-weiss syndrome
dark, tarry stool
melena
inflammation of one or both testicles
orchitis
inflammation of the peritoneum
peritonitis
pain felt somewhere other than where it originates
referred pain
sharp localized pain
somatic pain
twisting of a testicle
testicular torsion
vague, diffuse, dull, cramp like pain
visceral pain
dependence on a drug that may be physiological or psychological
addiction
pupillary constriction
miosis
pupillary dilation
mydriasis
need for progressively increased amount of a drug to achieve desired effects
tolerance
group of signs and symptoms for a specific group of toxins
stimulants, narcotics
toxidromes
physiological or psychological effects of discontinuing an abused substance
withdrawal
inadequate RBCs. can be chronic or acute. Can be caused by inadequate RBC production, destruction, hemorrhage, or dilution of RBCs
anemias
immune system attacks bodys own tissues
autoimmune disease
infectious disease commonly found among a particular group
endemic
widespread occurrence of an infectious disease
epidemic
RBCs. transports oxygen
erythrocytes
WBCs. fights infection
leukocytes
parasitic infestation of skin under hair on the head, body, or pubic area
lice
tick borne illness causing fatigue and flu like symptoms
lyme disease
disease prevalent over an entire country or world
pandemic
fluid component of blood
plasma
skin infestation with microscopic mites that burrow. spread by close contact with infected person
scabies
platelets, bleeding control
thrombocytes
inability to recognize objects or stimuli (not due to impaired sensory function)
agnosia
loss of ability to express or understand speech
aphasia
impaired motor activity (not due to impaired sensory function)
apraxia
behavior considered abnormal enough that it requires intervention and alarms the patient or another person
behavioral emergency
acute onset of disorganized thought, often due to correctable causes
delirium
firmly held beliefs despite being contradicted by what is generally accepted as real or rational
delusions
slow onset of cognitive deficits, usually irreversible
dementia
difficulty swallowing
dysphagia
sensory perceptions with no basis in reality, often “hearing voices”
hallucinations
delusions of serious physical illness
hypochondriasis
death due to obstruction of breathing, related to body position
positional asphyxia
overindulgence in or dependence on an additive substance, especially alcohol or drugs
substance abuse
membrane covering the eye and inside of eyelid
conjunctiva
transparent anterior portion of the eyes
cornea
inflammation of the epiglottis
epiglottitis
nosebleed
epistaxis
inflammation of the nose
rhinitis
infection or inflammation of the sinuses
sinusitis
inflammation of the tonsils
tonsillitis
infection of the skin and soft tissue
cellulitis
inflammation and infection of the fascia (connective tissue)
fasciitis
tissue death, often causing black or blue discoloration
gangrene
osteomyelitis
infection of the bone
bone fracture caused by disease
pathological fracture
bruise
contusion
systemic complications of a crush injury
crush syndrome
injury where bone is displaced from the joint
dislocation
fractured ends move from their normal position
displaced fracture
collection of blood beneath the skin
hematoma
the bodys attempt to control bleeding
hemostasis
bones remain aligned after a fracture
non-displaced fracture
airtight dressing
occlusive dressing
syndrome due to muscle necrosis and release of toxins into the bloodstream
rhabdomyolysis
ligament injury
sprain
muscle or tendon injury
strain
the amount of skin involved in burn injury. expressed in percentages
BSA body surface area
a burn around the full circumference of an area
circumferential burn
leathery, inelastic skin due to full thickness burn injury
eschar
unequal pupils
anisocoria
inability to remember events that occurred after the injury
anterograde amnesia
bruising to mastoid region (behind ears) indicative of possible basal skull fracture
battles sign
abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea
biots respirations
deep rapid respirations
without acetone breath found in kussmaul respirations
central neurologic hyperventilation
CPP
central perfusion pressure
increasing then decreasing tidal volume followed by a period of apnea pressure
cheyne-stokes respirations
brain injury away from primary point of impact
contrecoup injury
hypertension, bradycardia, altered respiratory pattern indicating increased ICP
cushings triad (triad)
posturing with arms extended and toes pointed
decerebrate (extensor) posturing
body extended and arms flexed
decorticate (flexor) posturing
*indicates brainstem injury
bleeding between dura mater and skull
epidural hematoma
bleeding within the brain
intracerebral hemorrhage
pressure within the cranium
intracranial pressure (ICP)
Le fort fracture progression
- slight instability to maxilla
- fracture of maxilla and nasal bones
- fracture of entire face (zygoma, nasal bone, maxilla)
persistent penile erection
priapism
bruising around both eyes
raccoons eyes
*possible indication of orbital fracture or basal skull fracture
inability to remember events that occurred before the injury
retrograde amnesia
bleeding beneath the dura matter, within the meninges (above the brain)
subdural hematoma
open abdominal wound with protruding organs
evisceration
segment of thorax moves independently due to three or more adjacent ribs fracturing in at least two places
flail chest
vomiting blood
hematemesis
blood in urine
hematuria
coughing up blood
hemoptysis
accumulation of blood within pleural space
hemothorax
large penetrating thoracic trauma that allows air to enter pleural space
open pneumothorax
accumulation of fluid in pericardial sac that compromises cardiac filling
pericardial tamponade
tissue covering abdominal cavity, small bowel, and internal organs
peritoneum
inflammation of the peritoneum
peritonitis
bruise to lung tissue
pulmonary contusion
drop in systolic pressure of at least 10mmHg during inspiration
pulsus paradoxus
closed pulmonary injury where air leaks into pleural space
simple pneumothorax
pneumothorax causing progressive build up of air within pleural space
tension pneumothorax
severe compression of the chest that compromises blood flow
traumatic asphyxia
an antiserum, also known as antivenom, containing antibodies against specific poisons especially those in the venom of snakes, spiders, and scorpions
antivenon
injury caused by changes in pressure
barotrauma
medical conditions resulting from changes in ambient pressure
dysbarism
presence of medical problems
morbidity
mortality
death
alveolar substance that keeps alveoli open
surfactant
generation of heat
thermogenesis
loss of heat
thermolysis
ringing in the ears
tinnitus
prior to delivery
antepartum
passage of a small amount of blood or blood tinged mucus near the end of pregnancy
bloody show
sporadic uterine contractions that can occur prior to active labor
braxton hicks
infection of the uterine lining
endometritis
distance in cm from pubic symphysis to top of uterine fundus.
fundal height
*each cm = one week of gestation
total number of pregnancies
gravida
severe nausea and vomiting during pregnancy
hyperemesis gravidarum
the first occurrence of menstruation
menarche
unilateral lower quadrant abdominal pain that occurs midway through a menstrual cycle
mittelschmerz
a woman who has had at least two pregnancies
muiltigravida
a woman who has never given birth
nullipara
total number of pregnancies reaching viable gestational age (live births and child births)
para
after delivery
postpartum
a woman who is pregnant for the first time
primigravida
rupture of amniotic sac
ruptured membranes (ROM)
cyanosis of the hands and feet due to poor perfusion
acrocyanosis
time form conception to birth
gestation
fecal matter in amniotic fluid from babys first bowel movement
meconium
newborns from birth to one month old
neonate
ductus arteriosus fails to close during embyonic development causing aortic blood flow into pulmonary artery
patent ductus arteriosus
infant delivered prior to 37 weeks gestation
preterm
telescoping of intestines into themselves. usually occurs in patients 6 months to 6 years. requires surgery
intussusception
abnormal skin coloring due to vasoconstriction and poor circulation
mottling
failure of caregiver to provide basic necessities
neglect
small purple non blanching spots on skin
petechiae
apnea
respiratory arrest
increased rate and effort of breathing
respiratory distress
inadequate oxygenation and ventilation
respiratory failure
poor skin turgor indicating possible dehydration
tenting
loss of ability to independently meet daily needs
functional impairment
someone who is at least 65 years of age
geriatric
the study of the effects of aging on humans
gerontology
accidental urination or defecation
incontinence
concurrent use of multiple medications
polypharmacy
ability to perceive or sense movements and position of ones own body independent of vision
proprioception
science of providing healthcare for extremely obese patients
bariatrics
surgical opening between colon and abdominal wall to allow passage of feces while bypassing part of colon
colostomy
CHF due to pulmonary hypertension
cor pulmonale
surgical connection between an artery and vein for dialysis
fistula
end of life care for the terminally ill
hospice
removing visible contaminants from a surface
cleaning
utilization of safe practices for vehicle operations in spite of surrounding conditions and actions of others
defensive driving
use of a chemical to kill pathogens
disinfection
emergency vehicle operators are expected to drive safely at all times and may be held to a higher standard than other drivers
due regard
removal of all microbial contamination
sterilization
uses data to anticipate demand for emergency services and adjusts staffing levels and staging locations accordingly
system status management
contained incident, where injuries have already occurred prior to arrival of rescue personnel
closed incident
takes place during early incident when patients are first encountered
primary triage
monitors all on scene activities to prevent harmful conditions
safety officer
ongoing triage completed throughout incident
secondary triage
single individual has command of incident
singular command
number of people or tasks that one individual can manage
span of control
positioning of resources
staging
sorting based on severity of incidents
triage
multiple personnel from different jurisdictions share command
unified command
poisonous substance produced by living organism
biotoxin
CBRNE
chemical, biological, radiological, nuclear, explosives
nuclear weapon improvised from radioactive nuclear waste material and conventional explosives
dirty bomb
movements of currents over a uniform obstruction
recirculating currents
blistering chemical agent, such as mustard gas, lewisite, and phosgene oxime
vesicant