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thx simon Flashcards

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1
Q

burn degrees

- by layer

A

Superficial = 1st degree burns, red skin, painful

Partial thickness burns = 2nd degree burns: blister formation, very painful

Full thickness burns = 3rd degree burns : nerve endings burns, painless, Eschar formation, black or waxy look

Full thickness - 4th degree burns: involves bone destruction

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2
Q

burn degrees

- by percentages (minor vs moderate)

A

Minor burn criteria:
3rd degree: <2% BSA; 2nd degree <15% BSA or <10% ped; 1st degree <20% BSA

Moderate burn criteria:
3rd degree 2-10% BSA, 2nd degree 15-30% BSA or 10-20% ped, excluding hands, face, feet, genitalia, without complicating factors

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3
Q

pediatric vs geriatric burns

A

Pediatric burns: thin skin, large surface/volume ratio, immature immunological response

Geriatric burns: decreased myocardial reserve, peripheral vascular disease, diabetes, COPD, poor immunological response

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4
Q

ECG heart rhythm

A

P wave (depolarization of SA node; related to atrial contraction); upright, well rounded

QRS complex: ventricular depolarization; along with pulse (same timing)

    • Q: first negative deflection from isoelectric line
    • R: first positive deflection from isoelectric line
    • S: second negative deflection from isoelectric line

T wave- ventricular repolarization

Line between P and Q- represents AV node stalling the electrical signal

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5
Q

contra/indications for activated charcoal

A

Indications: oral overdose of certain medications/pills

Contraindications: unresponsive PT, absent gag reflex, refusal by medical control, certain medications, intake greater than 1 hour prior to administration

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6
Q

define the following:

  • false motion
  • position of function for hand
  • diving reflex
A

False motion: movement that occurs in a bone where there is no joint; indicates fracture

Hand position of function: wrist is slightly dorsiflexed, all finger joints are moderately flexed

Diving reflex: slowing of HR caused by submersion in cold water

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7
Q

what is reverse triage and when would you use it

A

used in treating multiple victims of a lightning strike, focus efforts on those in respiratory and cardiac arrest

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8
Q

treatment of patient w TIA

  • what is it
  • conscious
  • unconscious
A

Transient Ischemic Attack (TIA)- small clots temporarily block circulation to part of brain, stroke-like symptoms, resolves when clots break up within 24 hours

Conscious: calm/reassure, monitor airway, high conc o2, transport in semi-sitting position (semi-Fowlers)

Unconscious: maintain airway, high conc O2, transport with PT lying on affected side

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9
Q

questions to ask during a poisoning incident (8)

A

Medications, petroleum products, cosmetics, pesticides, plants, food

What substance was involved

When did poisoning occur

How much was ingested

Over how long a time

What interventions have been taken

What is patient’s weight

What effects has Pt experienced?

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10
Q

Symptoms of nerve agents: SLUDGEM

A

Salivation, lacrimation, urination, defecation, gastric upset, emesis, miosis

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11
Q

3 types of agents + examples

B2 P2 M2

A

Blister agents: mustard, lewisite

Pulmonary agent: phosgene, chlorine

Metabolic agents: hydrogen cyanide and cyanogen chloride

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12
Q

mandatory reporting is required of what circumstances (10)

A 
domestic violence
child/elder abuse
criminal acts
gunshot wound
stabbing
assault
animal bites
communicable diseases
out of hospital deaths
possession of controlled substances
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13
Q

Skin color and what they mean

A

Pink = normal

pale / white / gray = shock

Flushed (red) = CO, B/P, fever

Blue = hypoxia

Yellow / jaundice = liver injury / failure, hepatitis, cirrhosis

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14
Q

Pressure of CO2 vs O2 in the blood

A

Pressure of CO2 in blood

    • in arteries: 35 - 45 mmHg
    • in veins: 40 - 50 mmHg

O2

    • in arteries: 75 - 100 mmHg
    • in veins: 30 - 40 mmHg
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15
Q

Types of irregular breathing (4)

A

Cheyne Stokes: period of increased RR, apnea, period of decreased RR (increased ICP)

Kussmaul: rapid, deep breathing; commonly observed in cases of metabolic acidosis

Biot’s: periods of normal/shallow breathing interspersed with apnea, stroke

Ataxic: complete irregularity with periods of apnea

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16
Q

SAMPLE mnemonic

A

Signs and symptoms—What signs and symptoms occurred at the onset of the incident?

Allergies—Is the patient allergic to any medication, food, or other substance?

Medications—What medications is the patient prescribed?

Pertinent past medical history—Does the patient have any history of medical, surgical, or trauma occurrences?

Last oral intake—When did the patient last eat or drink?

Events leading up to the injury or illness—What the key events that led up to this incident?

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17
Q

routes of administration (8)

A

Intravenous injection: into the vein, fastest delivery

Intraosseous injection: into the bone, reach bloodstream through bone marrow

Subcutaneous (SC, SQ, sub-Q) injection: under the skin; absorb more slowly

Intramuscular injection (IM): into the muscle – eg. epipen

Inhalation: aerosols, fine powders, sprays

Sublingual: under the tongue

Transcutaneous (transdermal):
Through the skin – eg. nicotine patches

Intranasal (IN): medication is pushed through a mucosal atomizer device (MAD) that aerosolizes the liquid for delivery into the nostril

18
Q

Basic medication forms (7)

A
  1. Tablets and capsules
  2. Solutions and suspensions
  3. Metered-dose inhalers (MDIs)
  4. Topical medications
  5. Transcutaneous medications
  6. Gels
  7. Gases for inhalation
19
Q

dyspnea is commonly caused by… (3)

A

always some form of obstruction:

a. Mucus and secretions obstructing airflow in major passages (cold, diphtheria)
b. Swelling of soft tissues in upper airways (epiglottitis, croup)
c. Impaired exchange of gases in the alveoli (pneumonia)

20
Q

AHA chain of survival

A

Recognition and activation of emergency response system

Immediate, high-quality CPR

Rapid defibrillation (AEDs)

Basic and advanced emergency medical services

Advanced life support and post-arrest care

21
Q

Once you begin CPR, continue until one of the following occur (using the mnemonic STOP)

A

S—Patient Starts breathing and has a pulse

T—Patient is Transferred to another provider of equal or higher-level training

O—You are Out of strength

P—Physician directs you to discontinue

22
Q

narrowest part of female reproductive organs

A

cervix, which opens into the vagina

during first stage of labor, max dilation is 10 cm

23
Q

blast injuries (4)

A

Primary blast injury is a direct result of the overpressurization wave’s impact on the body

Secondary blast injuries result from flying debris and bomb fragments – the fragmentation effect

Tertiary blast injuries occur as a result of individuals being thrown by the blast wind.

Quaternary blast injuries are defined as any explosion-related injury or illness not due to any of the above such as burns and inhalational injuries; can exacerbate pre-existing conditions.

24
Q

define the following:

  • abrasion
  • laceration
  • avulsion
  • penetrating wound
A

Abrasion is a wound of the superficial layer of the skin, caused by friction when a body part rubs or scrapes across a rough or hard surface.

Laceration is a jagged cut caused by a sharp object or a blunt force that tears the tissue.

Avulsion separates various layers of soft tissue (usually between the subcutaneous layer and fascia) so that they become either completely detached or hang as a flap.

A penetrating wound is an injury resulting from a piercing object

25
Q

Treat a closed soft-tissue injury using the RICES mnemonic

A 
rest
ice
compression
elevation
splinting
26
Q

Remove an impaled object only in two circumstances

otherwise

A

The object is in the cheek or mouth and obstructs the airway

The object is in the chest and directly interferes with CPR.

otherwise, secure for transport using bandages

27
Q

rule of nines ; burns
ADULTS

9% for 8 locations
4.5% x 2 for 3 locations
1% for 1 location

A 
9% each for the following:
Chest
Abdomen
Upper back
Lower back
Front left leg
Back left leg
Front right leg
Back right left

9% total bc 4.5% for front + 4.5% for back
Head
Left arm
Right arm

1% total
Genitalia

28
Q

rule of nines ; burns
CHILDREN

9% for 6 locations
7% for 4 locations
4.5% x 2 for 2 locations

A 
9% each for the following:
Front of head
Back of head
Chest
Abdomen
Upper back
Lower back
7% each
Front left leg
Back left leg
Front right leg
Back right left

9% total bc 4.5% for front + 4.5% for back
Left arm
Right arm

29
Q

what’s in each quadrant . of the body

A

RUQ: liver, gallbladder, duodenum, small portion of pancreas

RLQ: appendix, ascending colon, right half of transverse colon

LUQ: stomach, spleen

LLQ: descending colon, left half of transverse colon

30
Q

define the following:

  • fracture
  • dislocation
  • sprain
  • strain
A

A fracture is a break in the continuity of the bone, often occurring as a result of an external force.

Dislocations: A disruption of a joint in which the bone ends are no longer in contact

Sprain: joint is twisted or stretched beyond its normal range of motion.

Strain: pulled muscle

31
Q

three types of fractures

A

A nondisplaced fracture (also known as a hairline fracture) is a simple crack of the bone that may be difficult to distinguish from a sprain or simple contusion.

A displaced fracture produces an actual deformity, or distortion, of the limb by shortening, rotating, or angulating it.

Suspect fracture: deformity, tenderness, guarding, swelling, bruising, crepitus, false motion, exposed fragments, pain, locked joint

32
Q

when do you splint the limb in the position of deformity

A

When the deformity is severe

When you encounter resistance or extreme pain when applying gentle traction to the fracture of a shaft of a long bone

33
Q

Fractures about the knee

A

If there is an adequate distal pulse and no significant deformity, splint the limb with the knee straight.

If there is an adequate pulse and significant deformity, splint the joint in the position of deformity.

If the pulse is absent below the level of the injury, suspect possible vascular and nerve damage, and contact medical control.

Never use a traction splint if you suspect a fractured knee.

34
Q

Compartment syndrome

A

most often occurs with a fractured tibia or forearm of children.

Pain that is out of proportion to the injury, pain on passive stretching of muscles within compartment, pallor, decreased sensation, decreased power

If you suspect that a patient has compartment syndrome, splint the affected limb, keeping it at the level of the heart, and provide immediate transport.

35
Q

define the following

  • hyperthermia
  • heat emergency
  • heat cramps
A

Hyperthermia is a core temperature of 101°F (38.3°C) or higher. [LOOK FOR HOT AND DRY SKIN -> RAPID TRANSPORT]
– patients will present as tachycardic and tachypneic

Heat emergency: heat cramps, heat exhaustion, heat stroke

Heat cramps: painful muscle spasms after vigorous exercise [due to electrolyte deficiency]
– Cramps in lower limbs and abdomen, normal temp

36
Q

heat exhaustion

A

most common; hypovolemia due to loss of water and electrolytes from heavy sweating; vigorous exercise;

other symptoms: dizziness / weakness, muscle cramps, thirst, normal vitals except pulse is often rapid and weak

Severe cramps in lower extremities and abdomen, moist pale skin

37
Q

Heat stroke

A

least common but most serious

Hot dry flushed skin, skin may be moist, rising body temp (106>), falling LOC, behavior change, unresponsive, seizures, strong rapid pulse at first becoming weaker with falling BP, increased RR, lack of perspiration

may result in convulsions, coma, muscular twitching, hot/dry/moist skin

38
Q

APGAR

A

used to assess state of newborn within 1 minute of birth, then again at 5 minutes

Appearance-: 0 for cyanosis; 1 for blue body but cyanotic extremities; 2 for pink

Pulse: 0 for no pulse; 1 for under 100; 2 for over 100

Grimace/irritability; 1 for weak; 2 for strong cry

Activity/muscle tone; 0 for no response; 1 for weak response; 2 for strong response to action

Respirations; 0 for no respirations; 1 for weak; 2 for strong

39
Q

heart rate for each age group

A

neonate: 100 to 205 bpm
infants: 100 to 190
toddler: 98 to 140

pre school age: 80 to 120

school age: 75 to 118

adolescent / adult: 60 to 100

40
Q

croup

A

infection of the airway below the level of the vocal cords, usually caused by a virus.

stridor and a seal-bark cough

Croup often responds well to the administration of humidified oxygen.
– Bronchodilators are not indicated for croup and can make the child worse.

41
Q

define the following:

  • cleaning
  • disinfection
  • highlevel disinfection
  • sterilization
A

Cleaning: the process of removing dirt, dust, blood, or other visible contaminants from a surface or equipment

Disinfection: the killing of pathogenic agents by directly applying a chemical made for that purpose to a surface or equipment

High-level disinfection: the killing of pathogenic agents by the use of potent means of disinfection

Sterilization: a process, such as the use of heat, that removes all microbial contamination

42
Q

types of WMD or WMC

B-NICE mnemonic (ironically)

A

weapons of mass destruction / casualty

B-NICE: biological, nuclear, incendiary, chemical, explosive

NREMT (7 decks)

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