Combo with "EMT Practice Final Examination" and 21 others Sue R
A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the most appropriate to ask him?
"Do you have any heart problems or take any medications?"
critical burns
* with injuries to respitory tract, soft tissue, bones * Full thickness burns > 10% * partial thickness burns > 30% * burns with painful, swollen, or deformed extremity * moderate burns in young or elderly * burns to face, hands, feet, or genitalia * burns encircling any body part
Nasal Cannula
*for patients NOT in respiratory distress *low concentration device, delivers 30-40% Oxygen concentration *2-6 L/M
Non Rebreather Mask
*for patients in respiratory distress *high concentration device, delivers up to 90% O concentration *10-15 L/M
Early Signs and Symptoms of Shock
- Altered level of consciousness - restlessness, anxiety, irritability - Tachycardia - Pale, cool skin due to increased peripheral vasoconstriction - Week peripheral pulses due to increased peripheral vasoconstriction - Increased respiratory rate - Thirst - Delayed capillary refill in kids
Hypovolemic Shock
- Fluid problem - Trauma shock - Dehydration due to diarrhea, burns, vomiting, excessive urination, cholera - Hemorrhagic Hypovolemic Shock - loss of whole blood from intravascular space - Non-hemorrhagic Hypovolemic Shock from burns, loss of body fluids, abrasions
Obstructive Shock - Pulmonary Embolism
- Pulmonary embolism is a pump problem - Traveling clot gets caught in the lungs
Psychogenic Shock
- Self-Reversing shock - Sudden, temporary neurogenic shock causing vasodilation that interrupts blood flow to the brain
8 steps in patient care for impaled objects
1. expose the wound 2. control bleeding 3. stabilize object 4. secure dressing 5. treat shock 6. provide oxygen 7. keep patient at rest 8. transport and reassure
8 soft tissues
1. skin 2. fatty tissues 3. muscles 4. blood vessels 5. fibrous tissues 6. membranes 7. glands 8. nerves
7 ways to check cyanosis
1. skin color 2. fingernails and lips 3. mouth 4. eyelids 5. palms of hands 6. soles of feet 7. ask the family
How much air does a full Oxygen tank contain?
2,000 psi
How much O2 is in the air we breathe?
21%
Infant resp rate is?
25 to 50
How many types of suction are there?
3! Mounted, Portable and Manual
Typically, how long does the pain from angina last?
3-8 minutes
What is the usual KVO rate for an IV?
30 drops per minute
how many bones are in the lumbar part of the spine?
5
how many bones are in the sacral part of the spine?
5
The body holds how many liters of blood?
5-6 liters.
Normal BP in infants:
50-95 systolic
crepitus
A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling
crepitus
A grating sensation caused by fractured bone fragments rubbing against each other
stridor
A harsh, high-pitched inspiratory sound that is often heard in acute laryngeal obstruction; may sound like crowing and be audible without a stethoscope
Heart:
A hollow organ that consists of 2 atrias and 2 ventricles. It is an involuntary muscle, controlled by autonomic nervous system.
SAMPLE history
A key brief history of a patient's condition to determine Signs/Symptoms, Allergies, Medications, Pertinent past history, Last oral intake, and Events leading to the illness/injury
Which of the following scene size-up findings is LEAST suggestive of an unsafe environment? A. A large man standing in his yard awaiting your arrival B. Liquid draining from a car that struck a telephone pole C. screaming and yelling coming from inside a residence. D. The sound of breaking glass as you approach a residence
A large man standing in his yard awaiting your arrival
solution
A liquid mixture that cannot be separated by filtering or allowing the mixture to stand.
Normal Blood pressure of: Adult, 10 yr old, 5 yr old.
Adult 120/80, 10yr 100/60, 5yr 90/50
How frequently should you ventilate a(n); adult child infant
Adult: 1 breath every 5 seconds Child: 1 breath every 3-5 seconds Infant: 1 breath every 3 seconds.
advanced life support (ALS)
Advanced lifesaving procedures, some of which are now being provided by the EMT.
You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation? A. inform the parents of your suspicions B. Call the police so the parents can be arrested. C. Advise the parents that the child needs to be transported D. Transport the child to the hospital regardless of the parents wishes
Advise the parents that the child needs to be transported
When exhaling becomes more difficult during an Asthma attack, and you notice expiratory phases are prolonged after auscultating the patient, what is this called?
Air Trapping
The ___ only require a minimal blood supply when at rest: A: lungs B: kidneys C: muscles D: heart
C: muscles
Blood leaves each chamber of a normal heart through a: A: vein B: artery C: one-way valve D: capillary
C: one-way valve
Blood enters into the right atrium from the: A: coronary arteries B: lungs C: vena cava D: coronary veins
C: vena cava
In what manner should you act and speak with a patient?
Calm and confident.
Spine consists of:
Cervical (7), Thoracic (12), Lumbar (5), Sacrum (5), Coccyx (4)
As you are attempting to resuscitate an adult man with cardiac arrest, you receive a "o shock advised" message from the AED. What should you do next? A. continue CPR B. Check for a pulse C. Assess for breathing D. Reanalyze the rhythm
Check for a pulse
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should: A. apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once. B. apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. C. assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
The scope of practice is?
Descriptionof what assessment and treatment skills and EMT may legally perform.
ecchymosis
Discoloration of the skin associated with a closed wound; bruising
What are the 5 Rights when giving medications?
Do I have the right patient? Is it the right time to administer this medication? Is it the right medication? is this the right dose? Am I giving this medication by the right route?
Duties include:
Duty to: -Respond -Obey laws and regulations -Operate an emergerncy vehicle reasonably and prudently -Provide care and transportation to expected standard -Provide care and transport consistent with the scope of practice and local medicine protocol -Continue and transport through to its appropriate conclusion
Capillaries allow:
Exchange of oxygen and CO2.
What 5 triggers are listed in the book for Asthma?
Exercise Allergens Respiratory Viruses Aspirin Nonsteroidal Ant-inflammatory Drugs (NSAIDs)
The femoral head forms a ball-and-socket joint with the:
Femoral condyle
nasal flaring
Flaring out of the nostrils, indicating that there is an airway obstruction
Stokes Basket
For high/low angle rescue, caves, etc.
Blankets
For small spaces or when it is hard to get other equipment into the area.
Upper Extremities
Inspects and palpates each arm Do PMS
guarding
Involuntary muscle contractions of the abdominal wall in an effort to protect the inflamed abdomen; a sign of peritonitis
Which of the following assessment findings would most likely indicate cardiac compromise? A. Tachypnea B. Tachycardia C. Irregular pulse D. Sudden fainting
Irregular pulse
Which side of the heart receives oxygenated blood from the lungs?
Left
Which of the following chambers of the heart has the thickest walls? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle
Left ventricle
What organ does acetaminophen overdose damage?
Liver
The RUQ contains:
Liver, gallbladder, bile duct, colon, pancreas
topical medications
Lotions, creams, and ointments that are applied to the surface of the skin and affect only that area; a medication delivery route.
Stroke
May cause hypoxia due to facial drooping or may damage respiration center of the brain.
prescription medications
Medications that are distributed to patients only by pharmacists according to a physician's order.
parenteral medications
Medications that enter the body by a route other than the digestive tract, skin, or mucous membranes.
enteral medications
Medications that enter the body through the digestive system.
over-the-counter (OTC) medications
Medications that may be purchased directly by a patient without a prescription.
Pathogens
Microorganisms such as bacteria and viruses that cause disease.
When suctioning:
Must keep airway clear so that pt can be ventilated properly. If it is not clear, fluids will be forced into the lungs and possibly cause a lung infection.
Explain the process of breathing.
O2 reaches body tissues and cells through two seperate but realted processes - breath and circulation. As we inhale, O2 moves from the atmosphere into the lungs then passes from the alveoli in the lungs into the capillaries to oxygenate the blood. At the same time, CO2 produced by the cells in the tissues in the body, moves from the blood into the alveoli. The blood enriched with O2 travels through the the body by pumping of he heart. On exhalation, CO2 is expirated.
What is the first part of the secondary assessment?
Obtaining vitals!
Definite signs of death include:
Obvious mortal damage, dependent lividity, rigor mortis, putrefaction.
Skull (cranium) contains:
Occiput temporal regions, parietal region, mandible, zygomas, maxillae, orbit
Shock
Occurs as a result of injuries that affect the circulatory system. When the circulatory system fails, hypoxia being to set in.
When a patient is hypoxic or in danger of becoming hypoxic, what medication should you administer?
Oxygen
Arteries carry?
Oxygenated blood
What is the function of the red blood cell?
Oxygenation
Types of suction devices include:
Plastic, rigid suction tips (Tonsil or Yankauer) Nonrigid plastic catheters call French or Whistle-tip.
Which of the following parameters would be LEAST reliable when assessing the perfusion status of a 2-year old child with possible shock? A. Distal capillary refill B. Systolic blood pressure C. Skin color and temperature D. Presence of peripheral pulses
Systolic blood pressure
jaw-thrust maneuver
Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.
Medial
Towards middle
When is the OPA used?
Unconscious and NO gag reflex
Urgent movement/lifting is:
Used for pts with AMS, inadequate ventilations, or shock.
Oropharyngeal adjunct Indications:
Used on unconscious pts who have no gag reflex and used with BVM.
Disinfecting
Using a disinfectant such as alcohol or bleach to kill microorganisms
occlusive dressing
any dressing that forms an airtight seal
The myocardium receives its blood supply from the coronary arteries that branch directly from the A. aorta B. vena cava C. left atrium D. right ventricle
aorta
Ventricular Fibrillation
disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest.
In a patient with cardiac compromise, you would be LEAST likely to encounter A. anxiety B. dyspnea C. headache D. chest pain
headache
Prone
lying horizontal face down
Pulmonary vein
oxygenated blood travels through this
bone marrow
soft tissue inside of bones which produce red and/or white blood cells
Acute
sudden onset, severe
irreversible shock
the final stage of shock, resulting in death
Angina Pectoris
transient (short-lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle.
(Contraindications:) Aspirin (ASA)
(Contraindications:) GI bleed, allergy.
(Mechanism of Action:) Albuterol
(Mechanism of Action:) Bronchodilator, stimulates ß-₂ adrenergic receptors of bronchial smooth muscle and lungs.
(Mechanism of Action:) Aspirin (ASA)
(Mechanism of Action:) Decreases platelet aggregation, decreases clotting.
(Mechanism of Action:) Nitroglycerin
(Mechanism of Action:) Dilates coronary arteries and veins, improves blood flow. Decreases oxygen demand of the heart.
(Mechanism of Action:) Oxygen (O2)
(Mechanism of Action:) Reverses hypoxia.
(Precautions:) Aspirin (ASA)
(Precautions:) Anemia, Hodgkin's lymphoma, gastritis
epidural hematoma
* above the dura mater * usually rapid bleeding * bleeding between skull and protective covering of brain
immobilization of seated patient (low priority)
* use short spine board * extrication vest * transfer to long spine board
Managing Shock
- Control bleeding - Place patient in Trendelenburg position - Keep warm - Rapid transport - Platinum 10 minutes
Obstructive Shock
- Obstructive shock is a pump problem caused by mechanical obstruction of the heart muscle
Stair Chair
Can be used for small areas or hallways.
oral
By mouth; a medication delivery route.
indications
The therapeutic uses for a specific medication.
Thromboembolism
a blood clot that has formed within a blood vessel and is floating within the bloodstream.
Syncope
a brief loss of consciousness
concussion
a bruiselike injury of the brain that occurs when the soft tissue of the brain collides against the skull (mild, no detectable damage, may/may not lose consciousness, headache)
full thickness burn
a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third-degree burn.
partial thickness burn
a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence. (Also called second-degree burn).
hypovolemic shock
a condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion
Dissecting Aneurysm
a condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.
hemophilia
a congenital condition in which the patient lacks one or more of the blood's normal clotting factors
Acute Myocardial Infarction (AMI)
a heart attack; death of heart muscle following obstruction of blood flow to it. Acute in this context means "new" or "happening right now".
When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your most appropriate initial action should be to A. ask the patient to sign a release form. B. ask a female EMT-B to attempt to assess the patient. C. explain to the patient that she must be examined. D. transport the patient without performing an assessment.
ask a female EMT-B to attempt to assess the patient.
4 steps in patient assessment of bleeding
1. estimate amount of external blood loss 2. triage 3. predict potential shock 4. control external bleeding *****important to find the bleed and stop it*****
8 signs of internal bleeding
1. injuries to surface of body 2. bruising 3. painful, swollen, or deformed extremities 4. bleeding from mouth, rectum, vagina, etc 5. tender, rigid, or distended abdomen 6. vomiting 7. dark, tarry stools or bright red blood 8. signs and symptoms of shock
3 steps in emergency care for shock
1. maintain airway 2. oxygenate 3. transport
universal dressing
A bulky dressing.
What is hemophilia?
A genetic disorder where the body is not able to control bleeding by developing clots as normal
scene size-up
A quick assessment of the scene and the surroundings made to provide information about its safety and the mechanism of injury or nature of illness, before you enter and begin patient care
jaundice
A yellow skin color that is seen in patients with liver disease or dysfunction
Epinephrine
Action: Sympathomimetic Indications: Sever allergic reactions Contraindications: hypersensitivity to sympathomimetic amines, narrow angle glaucoma, hemorrhagic, traumatic, or cardiac shock, coronary insufficiency, dysrhythmias, organic brain or heart disease, or during labor Precautions: elderly, debilitated patients, hypertension, diabetes, hyperthyroidism, parkinson's disease, tuberculosis, asthma, emphysema, and in children <6 yo Side effects: Tachycardia, pallor, dizziness, chest pain, headache, N/V, excitability, anxiety Dose: Adult 0.3 mg (≥30 kg (≥66 pounds)) Ped 0.15 mg (15-30 kg (33-66 pounds))
unintended effect
Actions that are undesirable but pose little risk to the patient.
Following a call in which a 6-week old infant in cardiac arrest did not survive, your partner is exhibiting significant anxiety and irritability. How can you most effectively help her? A. Allow her to voice her feelings to you. B. Tell her that she needs psychiatric help. C. Tell her to go home and get 12 hours of sleep D. Report her behavior to the medical director
Allow her to voice her feelings to you.
During your assessment of a 20-year old man with a severe headache and nausea, you ask him when his headache bagan, but he does not answer your question immediately. You should:
Allow him time to think about the question and respond to it.
How soon does Naloxone take affect on a patient that overdosed on narcotics?
Almost immediately if administered effectively
Striated muscle:
Also called skeletel muscles
List three medical emergencies that may be caused by or mistaken for diabetes.
Altered mental status, intoxication, seizures
open extremity injury
An extremity injury in which the skin has been broken or torn through.
breath sounds
An indication of air movement in the lungs, usually assessed with a stethoscope
In most states; the EMT-Basic is required to report which of the following occurrences? A. Animal bite B. drug overdose C. Injury to a minor D. Motor vehicle crash
Animal bite
Tibia
Anterior bone in the lower leg
Critical Incident
Any situation that causes unusually strong emotions that interfere with the ability to function
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. Epinephrine possesses which of the following effects when it is used to treat anaphylaxis? A. As a vasodilator, it increases the blood pressure. B. As a vasoconstrictor, it lowers the blood pressure C. As a bronchodilator, it facilitates adequate breathing D. As a bronchoconstrictor, it inhibits the release of chemicals that cause the reaction.
As a bronchodilator, it facilitates adequate breathing
When is it most appropriate to complete your prehospital care report for a critically ill patient? A. During the initial assessment phase B. During the ongoing assessment phase C. As soon as all patient care activities are completed D. After the ambulance has been restocked at the station
As soon as all patient care activities are completed
You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions regarding her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that:
As you physically get closer to the patient, a greater and greater sense of trust must be established.
A middle-aged woman has acute shortness of breath and respirations of 30 breath/min. How should you first manage this patient? A. Assess respiratory quality B. Begin assisting ventilations. C. Apply supplemental oxygen D. Perform a detailed examination
Assess respiratory quality
At 0345, you receive a call for a woman in labor. upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby "now". This man escorts you into the living room where a 25-year old woman is lying on the couch in obvious pain. The woman states that her contractions are occurring every 4 to 5 minutes and lasting approximately 30 seconds each. Which of the following questions would be most appropriate to ask at this point? A. has your bag of waters broken yet? B. have you had regular prenatal care? C. At how many weeks gestation are you? D. how many other children do you have?
At how many weeks gestation are you?
How should you ventilate a patient who has had a laryngectomy and has a tracheal stoma?
Attach the BVM directly to the stoma or place a small, infant or child's, mask over the stoma. Cover the patients mouth and you may need to pinch the patients nose to properly ventilate.
skeletal muscle
Attached to the bones of your skeleton and provide the force that moves your bones
Skeletal muscle (voluntary):
Attaches to the skeleton
History:(trauma assessment)
Attempt to obtain SAMPLE
index of suspicion
Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury
___ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs for oxygen, nutrients, and waste removal: A: anatomy B: Perfusion C: Physiology D: conduction
B: Perfusion
A contusion to a patient's forehead along with a spiderwebbed windshield suggests possible injury to the: A: nose B: brain C: face D: heart
B: brain
The ___ link(s) the arterioles and the venules: A: aorta B: capillaries C: vena cava D: valves
B: capillaries
An organ or tissue that is considerably ___ is much better able to resist damage from hypoperfusion: A: warmer B: colder C: younger D: older
B: colder
Air bags decrease injury to all of the following, except: A: chest B: heart C: face D: head
B: heart
What is hypoxic drive?
Backup system to control respirations when O2 levels fall.
What are three causes listed by the book for Anaphylaxis?
Bee Stings Peanut Butter Medication Allergies
hemothorax
Blood in the chest (pleural cavity) surrounding the lungs.
Which artery should you palpate when assessing for a pulse in an unresponsive 6-month old patient? A. Radial B. Carotid C. Femoral D. Brachial
Brachial
Which of the following signs would LEAST suggest a diabetic emergency? A. Bradycardia B. Tachycardia C. Combativeness D. Fruity breath odor
Bradycardia
inhalation
Breathing into the lungs; a medication delivery route.
When using an air splint to control bleeding in a fractured extremity, you should reassess the ___ frequently: A: airway B: breathing C: circulation in the injured extremity D: fracture site
C: circulation in the injured extremity
The process of blood clotting and plugging the hole is called: A: conglomeration B: configuration C: coagulation D: coalition
C: coagulation
smoke inhalation/toxic fumes
Causes pulmonary edema and destroys lung tissue, causing problems with gas exchange.
RLQ contains:
Cecum, small intestines, appendix
What are the two main components of blood?
Cells and plasma
What three types of names does every drug have?
Chemical Name Generic Name Trade (Brand) Name
COPD
Chronic irritation of the lungs and passageways produces alveolar damage and poor gas exchange.
The large, flat, triangular bone that overlies the posterior thoracic wall is called the:
Clavicle
What is the purpose of an OPA
Clears the airway by lifting the tongue out of the oropharynx.
rhonchi
Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways
Intermittent
Coming and going; not consistent
Confidentiality is?
Communication between you and the patient is considered confindential and can only be released to other medical staff or with a court order.
Which of the following describe the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest? A. Compress the chest to a depth of 1 1/2" to 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions. B. Allow full recoil of the chest after each compression, compress the chest to a depth of 2", deliver compressions at a rate of at least 80/min C. Do not interrupt chest compressions for any reason, compress the chest to a depth of 1 1/2" to 2", allow partial recoil of the chest after each compression D. Minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min
Compress the chest to a depth of 1 1/2" to 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions
Which of the following statements regarding 2-rescuer child CPR is correct? A. The chest should not be allowed to fully recoil in between compressions as this may impede venous return. B. Compress the chest with one or two hands to a depth equal to one-half to one third the diameter of the chest. C. The chest should be compressed with one hand and a compression to ventilation ratio of 30:2 should be delivered. D. A compression to ventilation ratio of 15:2 should be delivered without pauses in compressions to deliver ventilations
Compress the chest with one or two hands to a depth equal to one-half to one third the diameter of the chest.
What does the book list as 9 different forms medications can come in?
Compressed Powders or Tablets Parenteral Liquids Oral Liquids Vaporized Liquids Gels Suspensions Fine Powder for Inhalation Gases Sublingual Sprays
The cardiovascular system consists of: A: a pump B: a container C: fluid D: all of the above
D: all of the above
T/F Energy can be both created and destroyed
F
T/F The energy of a moving object is called potential energy
F
Which of the following organs is not part of the endocrine system? A. Thyroid B. Pituitary C. Pancreas D. Gallbladder
Gallbladder
Smooth muscle (involuntary):
Gastrointestinal tract, urinary systems, blood vessels, bronchi
What are the contraindications to the administration of activated charcoal?
If the patient ingested an acid, an alkali, or petroleum. Decreased level of consciousness and can't protect airway. Unable to swallow.
Pelvis consists of:
Illium (crest), ischium (butt bone), and pubis.
Midline
Imaginary line drawn vertically from middle of the forehead through the umbilicus floor
What is the role of insulin?
It enables Glucose to enter the cells
What does the term tolerance mean?
It means the person has the need for increasing amounts of a substance to achieve a result
What do you do if a patient's blood pressure drops suddenly after administering nitro to them?
Lay them flat on their back and contact medical direction for additional guidance
In which ventricle is an AMI more prone to occur?
Left ventricle
What 5 things should your documentation of drug administration include?
Name of the Medication (Spelling Counts) Size of the Dose Route the Medication was Administered Time the Medication was Administered Any Effects Noticed in the Patient
What is the trade name for Naloxone?
Narcan
True or False: Diabetic coma can be caused by too little glucose in the blood?
No
decompensated shock
Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.
neurogenic shock
Occurs when the nervous system is unable to control the diameter of the blood vessels. Often seen with brain and spinal injuries
What two ways can an EMT be authorized to administer medications?
On-line Medical Direction Off-line Medical Direction
Unilatral
One side
Cardiac Muscle
Only in the heart.
You arrive at the scene shortly after a 3-year old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5 degrees F. What is the MOST appropriate treatment for this child? A. Oxygen via pediatric nonrebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport B. Oxygen via the blow-by technique, remove clothing and cool the child with towels soaked in tepid water, and transport. C. Oxygen via pediatric nonrebreathing mask, avoid any measures to lower the child's body temperature, and transport at once. D. Oxygen via the blow-by technique, transport at once and request a paramedic rendezvous so that an anticonvulsant drug can be given
Oxygen via the blow-by technique, remove clothing and cool the child with towels soaked in tepid water, and transport.
During the rapid trauma assessment of a patient with multiple injuries, you expose the chest and find an open wound with blood bubbling from it. What should you do next? A. Apply 100% supplemental oxygen. B. Provide rapid transport to the hospital C. Prevent air from entering the wound. D. Place a porous dressing over the wound.
Prevent air from entering the wound.
Which of the following actions is most important when immobilizing a patient with a suspected spinal injury? A. Immobilize the patient using a vest-style device B. Secure the patient's head prior to immobilizing the torso. C. Select and apply the appropriate size of extrication collar. D. Assess for range of motion by asking the patient to move the head
Select and apply the appropriate size of extrication collar.
Nasopharyngeal adjunct indications:
Semiconscious or unconscious pt with itnact gag reflex, pts who will not tolerate an oral airway.
Dorsal
Spinal side of the body
Which of the following statements best describes a mass-casualaty incident? A. More than 5 patients are involved B. At least half of the patients C. The number of patients overwhelms your resources D. More than three vehicles are involved
The number of patients overwhelms your resources
generic name
The original chemical name of a medication (in contrast with one of its "trade names"); the name is not capitalized.
general impression
The overall initial impression that determines the priority for patient care; based on the patient's surroundings, the mechanism of injury, signs and symptoms, and the chief complaint
Plantar
The soles of the feet
periosteum
Tough, tight-fitting membrane that coves a bone's surface and contains blood vessels that transport nutrients into the bone
What type of diabetes is characterized by an absence of insulin production?
Type I diabetes
In what government publication can you find a listing for every drug?
US Pharmacopoeia (USP)
Aspirin Oral Glucose Oxygen Activated Charcoal
What 4 medications will the EMT carry on the ambulance?
compensated shock
When the patient is developing shock but the body is still able to maintain perfusion.
Rapid Extrication is required in what situation?
When the pt is in an unsafe vehicle, pt cannot be properly assessed, pt needs immediate intervention/transport, pt requires supine position, or pt blocks access to another seriously injured pt.
Ventricular Tachycardia
a rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest.
An awake and alert 92-year-old woman with chest pain is refusing EMS treatment and transport to the hospital. Her family insists that you transport her. This situation is most appropriately managed by A. transporting the patient as the family wishes. B. advising the patient of the risks of refusing care C. obtaining a signed refusal from a family member D. transporting the patient as you explain your actions.
advising the patient of the risks of refusing care
Systemic
affecting the whole body
Flexion
bending of a joint
Following blunt injury to the anterior trunk, a patient is coughing up bright red blood. You should be most suspicious of A. intra-abdominal bleeding B. gastrointestinal bleeding C. bleeding within the lungs D. severe myocardial damage
bleeding within the lungs
Hypertension
blood pressure above normal
Cyanosis
bluish grayish discoloration of the skin in response to decreased oxygen
vertebrae
bones of the spinal column
Contusion
bruise
You are administering oxygen to a woman with asthma who took two puffs of her prescribed inhaler without relief prior to your arrival. Your next action should be to A. contact medical control for further advice B. administer one more puff from the inhaler C. provide immediate transport to the hospital D. confirm that her inhaler is prescribed to her
contact medical control for further advice
While a man was using a chainsaw to trim branches from a tree, it slipped and caused a large laceration to his left forearm. Bright red blood is spurting from the wound. The patient is conscious, alert, and talking. You should first A. copen the patient's airway B. control the active bleeding C. apply supplemental oxygen D. thoroughly cleanse the wound
control the active bleeding
autonomic nervous system
controls automatic processes
Comatose
deep unconsciousness
Each pelvic bone is formed by the fusion of the:
ilium, ischium, and pubis.
Dysrhythmia
not regular; rhythm other than sinus
Chronic
occurring over time
A 34-year old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her A. on her left side. B. in the prone position C. in the supine position D. in a semi-sitting position
on her left side.
How long does it take the body to pump the entire supply of blood?
one minute.
epidermis
outer layer of skin
strain
overexertion of muscle
cerebellum
part of the brain that controls balance and coordination
Certain injury ___ occur with certain types of injury ___
patterns, events
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. Suspecting an allergic reaction, your first action should be to A. ask the patient if he has an epinephrine auto-injector B. remove the patient's shirt to inspect his chest for urticaria C. obtain a set of baseline vital signs and a SAMPLE history D. place a nonrebreathing mask set at 15 L/min on the patient.
place a nonrebreathing mask set at 15 L/min on the patient.
How do you maintain the airway in a pt who is not injured and breathing on his/her own wit hnormal rate and adeqaute tidal volume?
place in the recovery position.
When managing a patient with chest pain, you should first A. administer high-concentration oxygen B. place the patient in a position of comfort C. request an ALS ambulance to respond to the scene. D. measure the blood pressure and administer nitroglycerin
place the patient in a position of comfort
joint
place where two or more bones meet
Your assessment of a mother in active labor reveals that a limb is protruding from the vagina. Management of this condition should include A. positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport B. positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport. C. applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord. D. giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur.
positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport.
A 56-year old man has labored, shallow breathing at a rate of 28 breaths/min. He is conscious, but extremely restless. Airway management should consist of a. a nasal cannula b. a simple face mask c. a nonrebreathing mask d. positive pressure ventilation
positive pressure ventilation
preload
precontraction pressure in the heart that increases as blood volume piles up
Prior to applying a nonrebreathing mask on a patient with difficult breathing you should A. set the flow rate to no more than 10 L/min. B. prefill the reservoir bag to ensure delivery of 100% oxygen C. insert a nasopharyngeal airway to maintain airway patency. D. perform a complete physical examination to determine the degree of hypoxia.
prefill the reservoir bag to ensure delivery of 100% oxygen
Congenital
present at birth
Assessing Circulation Steps
1. Asses and controls major bleeding 2. Check for pulse, radial first then carotid 3. Skin, CTC (Color, Temp., Condition)
Assessing Breathing steps
1. Asses and maintain airway 2. Initiate appropriate oxygen therapy 3. Assures adequate ventilation 4. Manages life threats
How you Assess the Scene?
1. BSI scene and safety 2. Determine if the scene is safe 3. Determine the # of patients 4. Determine the MOI or NOI 5. Request additional help if needed 6. Consider c-spine stabilization
10 steps in patient care for ankle/foot injury
1. assess distal CMS 2. stabilize and lift limb 3. place 3 cravats on ground and put pillow on top 4. leg onto pillow 5. tie pillow to ankle/foot 6. 4th cravat loosely at arch of foot 7. elevate with 2nd pillow or blanket 8. reassess distal CMS 9. check for shock 10. apply ice pack
7 steps in patient care for knee injury
1. assess distal CMS function 2. padded board splints 3. pillow 4. reassess distal CMS funtion 5. immobilize with padded board splint 6. pad the voids 7. reassess distal CMS function
5 steps in patient care for shoulder girdle injuries
1. assess distal PMS function 2. rigid splint is not practical 3. sling and swathe 4. do not attempt to straighten or reduce dislocations 5. reassess distal PMS function
5 factors about burns in a pediatric patient
1. at greater risk 2. body surface area 3. higher risk of shock 4. severity differs in less than 5 years old 5. consider child abuse
10 signs and symptoms of electrical burns
1. burns 2. disrupted nerve pathways 3. muscle tenderness 4. respiratory difficulties 5. irregular heartbeat 6. elevated BP 7. restlessness or irritability, loss of consciousness 8. visual difficulties 9. fractures 10. seizures
4 steps for treating avulsions
1. clean the wound surface 2. fold skin back to normal position 3. control bleeding 4. apply bulky pressure dressing
5 types of abdominal injuries
1. closed 2. open 3. blunt trauma 4. internal bleeding 5. protruding organs
5 steps in patient care for femoral shaft fracture
1. control any bleeding with direct pressure 2. manage patient shock 3. assess distal PMS function 4. apply a traction splint 5. reassess distal CMS function
3 additional steps for open injuries
1. control external bleeding 2. do not touch or try to replace eviscerated organs 3. do not remove impaled objects
4 facts about a tourniquet
1. device that closes off blood flow to and from an extremity 2. controls life-threatening bleeding 3. commonly used in military and tactical settings 4. direct pressure and elevation are usually successful
3 steps in controlling external bleeding
1. direct pressure 2. elevation 3. tourniquet
5 things to do with impaled objects
1. do not remove 2. stabilize in place 3. pad around object 4. use hacksaw if needed 5. consult medical control
3 meninges
1. dura mater 2. arachnoid 3. pia mater
4 steps for trending vital sign when treating shock
1. elevated pulse 2. elevated respiratory rates 3. identifies patient's condition 4. unstable vital signs taken every 5 minutes
7 steps in patient care for neck wounds
1. ensure airway open 2. gloved hand over wound 3. apply occlusive dressing 4. place dressing over occlusive dressing 5. apply pressure as needed 6. bandage dressing 7. immobilize cervical spine
7 steps in patient care of an impaled cheek wound
1. examine wound site 2. remove object 3. position the patient 4. monitor the airway 5. apply dressing to the site 6. provide o2 7. treat for shock
9 steps in patient care for open wounds
1. expose the wound 2. clean the wound surface 3. control bleeding 4. provide care for shock 5. provide o2 6. prevent further contamination 7. bandage after bleeding is controlled 8. keep patient lying still 9. provide reassurance
9 possible injuries to face and jaw
1. fractures 2. bone fragments 3. dislocations 4. airway management 5. suction 6. jaw thrust 7. control bleeding 8. c-spine precautions 9. treat shock
3 rules for realignment
1. grasp distal extremity for support 2. splint in position found (realign if extremity is cyanotic or lacks pulse) 3. manual traction ( * resistance - stop realignment and splint in position * no resistance - maintain traction until splint applied)
3 types of penetrating trauma
1. gunshot wound 2. stab wound 3. impaled wound
5 steps in controlling nosebleeds
1. have patient sit down and lean forward 2. apply or instruct patient to apply direct pressure 3. keep patient quiet and calm 4. do not let patient lean back 5. position patient on side if unconscious *****encourage to spit blood out, don't swallow it*****
3 steps in the development of shock
1. heart fails as a pump 2. blood volume is lost 3. blood vessels dilate
6 indications of when to leave the helmet in place
1. helmet is snug 2. no impending airway or breathing problems 3. no resuscitation needed 4. removal would cause further injury 5. immobilization can be done with it in place 6. no interference with airway and breathing assessment
4 steps for patient care for burns to the eyes
1. immediately flood eyes with water 2. flow from nose to outside corner of the eye 3. transport and continue washing eye 4. cover both eyes
4 causes of shock
1. inability of heart to pump 2. decreased supply of blood 3. lack of integrity in blood vessels 4. failure of vessels to dilate and constrict
6 indications of when to remove the helmet
1. interferes with assessment 2. airway and breathing issues 3. improperly fitted 4. interferes with immobilization 5. cardiac arrest 6. per medical direction
9 steps in patient care for pelvic injuries
1. limit patient movement 2. determine CMS distally 3. straighten and stabilize lower limbs 4. apply pneumatic anti-shock garment (PASC) when BP less than 90 5. immobilize on long spine board 6. reasses 7. provide 02 and treat shock 8. transport 9. monitor vital signs
4 steps of patient care of internal bleeding
1. maintain ABCs 2. administer high flow o2 via NRB 3. control external bleeding 4. prompt transport *****surgery is the only way to save the patient*****
6 steps of patient care for chest injury
1. maintain open airway 2. provide o2 3. follow local protocols 4. care for shock 5. transport asap 6. consider ALS intercept
6 steps of patient care for open chest wounds
1. maintain open airway 2. seal open chest wound 3. apply occlusive dressing 4. provide o2 5. treat shock 6. transport
7 steps in patient care for spinal injury
1. manual in-line stabilization 2. asses ABCs 3. rapid trauma exam 4. asses sensory and motor function 5. apply spinal immobilization device 6. provide o2 7. reassess motor function
5 factors about burns in a geriatric patient
1. minor to moderate burns are fatal to old people 2. tissue healing is lessened 3. time of healing is increased 4. consider other illnesses and injuries 5. moderate burns become critical when older than 55
Diffuse
scattered, spread out; not pertaining to one location
The wall that separates the left and right sides of the heart is the A. carina B. septum C. pericardium D. mediastinum
septum
anaphylaxis
severe allergic reaction
hemorrhagic shock
shock resulting from blood loss
distributive shock
shock that arises from widespread dilation of arterioles, venules, or both
Myocardium
the heart muscle.
Inflammation
tissue reaction to infection or unury characterized by redness, pain, swelling, or heat
Defibrillate
to shock of celebrating (chaotically beating) heart with specialized electrical current and attempt to restore a normal rhythmic beat.
Catheter
tube for evaluation
You are interviewing a 52 year old man who compails of chest discomfort. The patient is a registered paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate to say?
"It is possible that you are experiencing a heart attack. I am going to give you for baby aspirin to chew and swallow.
(Administration concerns:) Epinephrine 1:1,000 (Epi)
(Administration concerns:) Pregnancy, cardiac disorders, hypertension, geriatrics, medication only lasts approx. 5 minutes.
(Adverse reactions and side effects:) Albuterol
(Adverse reactions and side effects:) Paradoxic bronchospasm, tremors, anxiety, palpitations, tachycardia , hypertension.
(Contraindications:) Nitroglycerin
(Contraindications:) Cerebral hemorrhage, sexual enhancement drugs, hypotension-systolic blood pressure < 100.
(Contraindications:) Meter Dosed Inhaler (MDI)
(Contraindications:) Hypersensitivity, tachycardia, MI.
(Contraindications:) Albuterol
(Contraindications:) Hypersensitivty to this drug and peanuts, tachydysrhythmias.
(Contraindications:) Activated Charcoal
(Contraindications:) Lowered LOC, OD of corrosives, caustics, or petroleum substances
(Contraindications:) Oral Glucose/Glutose
(Contraindications:) Lowered LOC, nausea, vomiting, inability to swallow/no gag reflex.
(Contraindications:) Epinephrine 1:1,000 (Epi)
(Contraindications:) MI, hypothermia, hypertension.
(Contraindications:) Oxygen (O2)
(Contraindications:) Very rarely in patients with COPD. DO NOT use near open flames as O2 will support combustion. Never withhold O2 from a patient.
(Indication:) Oxygen (O2)
(Indication:) Hypoxia or suspected hypoxia.
(Indications:) Oral Glucose/Glutose
(Indications:) Altered mental status, blood sugar lower than 80 - hypoglycemia
(Indications:) Epinephrine 1:1,000 (Epi)
(Indications:) Anaphylaxis/severe allergic reactions. s/s of shock, hypotension, airway swelling or dyspnea.
(Indications:) Albuterol
(Indications:) Asthma or acute bronchospasm assoc.
(Indications:) Meter Dosed Inhaler (MDI)
(Indications:) Asthma/difficulty breathing with wheezing, must be prescribed.
(Indications:) Aspirin (ASA)
(Indications:) MI and angina as approved by medical direction.
(Indications:) Activated Charcoal
(Indications:) Most oral poisonings, overdoses.
(Indications:) Nitroglycerin
(Indications:) Treatment of angina pain and acute myocardial infarction, must be patient's prescribed dosage and as approved by medical direction.
(Mechanism of Action:) Activated Charcoal
(Mechanism of Action:) Adsorbs toxic substances in the digestive tract.
(Mechanism of Action:) Epinephrine 1:1,000 (Epi)
(Mechanism of Action:) Stimulates nervous system, causing vasoconstriction and bronchodilation.
(Mechanism of Action:) Meter Dosed Inhaler (MDI)
(Mechanism of Action:) Stimulates the nervous system, causing bronchodilation.
(Mechanism of Action:) Oral Glucose/Glutose
(Mechanism of Action:) When absorbed, provides glucose for cell use.
(Precaution:) Oxygen (O2)
(Precaution:) NO open flames nearby; DO NOT withhold O2 from patients in respiratory distress.
(Precautions:) Meter Dosed Inhaler (MDI)
(Precautions:) Cardiac disorders, diabetes, hypertension, seizures.
(Precautions:) Albuterol
(Precautions:) Cardiac disorders, hypertension.
(Precautions:) Oral Glucose/Glutose
(Precautions:) Patient must have control of the airway and be awake and able to follow commands.
(Precautions:) Nitroglycerin
(Precautions:) Severe liver disease.
(Precautions:) Activated Charcoal
(Precautions:) Vomiting
(Route and Dosage) Epinephrine 1:1,000 (Epi)
(Route and Dosage) Adult SQ/IM 0.1 - 0.5 mg. Epi-pen dose 0.3 mg.
(Route and Dosage:) Oral Glucose/Glutose
(Route and Dosage:) By mouth (PO); 10 - 30g, max dose 30g.
(Route and Dosage:) Activated Charcoal
(Route and Dosage:) By mouth (PO); Adult and child; 50 grams, 1 - 2g/kg
(Route and Dosage:) Aspirin (ASA)
(Route and Dosage:) By mouth, dosage 3 - 4 81mg chewable tablets, max dose 324mg.
(Route and Dosage:) Meter Dosed Inhaler (MDI)
(Route and Dosage:) MDI/Inhalation.
(Route and Dosage:) Albuterol
(Route and Dosage:) Nebulized inhaler; 2.5 - 5 mg (in 2.5 mL NS 'fish')
(Route and dosage:) Nitroglycerin
(Route and dosage:) Sublingual, 0.4 mg q 5 min. max dose 3 tabs.
(Route:) Oxygen (O2)
(Route:) Inhalation.
(Side effects:) Nitroglycerin
(Side effects:) Headache, flushing, dizziness, hypotension, and tachycardia.
(Side effects:) Meter Dosed Inhaler (MDI)
(Side effects:) Hypertension, tachycardia, anxiety, restlessness.
(Side effects:) Oxygen (O2)
(Side effects:) Lowered respiratory drives in some patients with COPD.
(Side effects:) Activated Charcoal
(Side effects:) Nausea, vomiting, constipation, black stool.
(Side effects:) Oral Glucose/Glutose
(Side effects:) Nausea, vomiting.
(Side effects:) Aspirin (ASA)
(Side effects:) Seizures, coma, GI bleeding, hepatitis and anaphylaxis.
(Side effects:) Epinephrine 1:1,000 (Epi)
(Side effects:) Tremors, anxiety, dizziness, palpitations, tachycardia, dysrhythmias, anorexia, N/V, dyspnea, increases oxygen demand of the heart.
(Type of drug:) Albuterol
(Type of drug:) Adrenergic ß-₂ agonist, sympathomimetic, bronchodilator
(Type of drug:) Activated Charcoal
(Type of drug:) Adsorbent
(Type of drug:) Aspirin (ASA)
(Type of drug:) Antiplatelet
(Type of drug:) Meter Dosed Inhaler (MDI)
(Type of drug:) Bronchodilator
(Type of drug:) Epinephrine 1:1,000 (Epi)
(Type of drug:) Bronchodilator, vasoconstrictor.
(Type of drug:) Oxygen (O2)
(Type of drug:) Gas/Inhaled
(Type of drug:) Oral Glucose/Glutose
(Type of drug:) Glucose.
(Type of drug:) Nitroglycerin
(Type of drug:) Vasodilator.
Common Characteristics of Priority Patients
* Difficulty breathing * Severe Pain *Chest Pain * Uncontrolled Bleeding *Complicated childbirth *Exhibiting signs of shock *Unresponsive and does not respond to pain stimuli
signs and symptoms of hip dislocation
* anterior - lower limb rotated outward and hip flexed * posterior - lower limb rotated inward, hip flexed, knee bent, foot may hang loose
subdural hematoma
* below the dura mater * bleeding due to tearing of blood vessels on the surface of brain * 3 types (acute, subacute, chronic)
scalp injury
* blood vessels * bleeds profusely * control bleed * dress and bandage * caution when applying pressure
kinds of chest injury
* blunt trauma (blow to chest) * severe blunt trauma * penetrating object (bullets, knives, steel rods) * compression (motor vehicle collision)
non-traumatic brain injuries
* caused by internal brain events (hemorrhage or blood clot) * no evidence of trauma * no mechanism of injury
kinds of closed chest injury
* closed (skin not broken) * open (skin is broken) * flail chest (fracture of 2 or more consecutive ribs in 2 or more places) * paradoxical motion (opposite movement of flail verses chest cavity)
cartilage
* connective tissue outside of the bone (epiphysis) * surface for articulation * smooth movements of joints * less rigid * forms flexible structures (septum of nose, external ear, trachea, connections between ribs and sternum
skull injury
* cranium and facial fractures * open and closed
signs of cardiac tamponade
* distended neck veins * weak pulse * low blood pressure * decreasing pulse pressure
treatment of specific chemicals
* dry lime - do not wash with water (brush away) * carbolic acid - does not mix with water * sulfuric acid - heat is produced when water is added * hydrofluoric acid - flood with water
pediatrics
* have efficient compensating mechanisms * when BP drops, it is due to their body has tired out (serious problem) * consider shock and treat early
splinting
* immobilize adjacent joints and bone ends * decreases pain and movement * prevents additional injury
signs of hemopneumothorax
* increased respiratory difficulty * rapid and weak pulse, cyanosis, low blood pressure * uneven chest wall movement * decreased breath sounds * blood tinged sputum
signs of pneumothorax
* increased respiratory difficulty * rapid, weak pulse, cyanosis, narrowing pulse pressure, low blood pressure * distended neck veins * tracheal deviation * uneven chest wall movement * decreased or absent breath sounds
load and go
* initial assessment reveals unstable patient * address ABCs * use long spine board * do not splint individual extremities
signs and symptoms of hip fracture
* localized pain (sometimes in the knee) * sensitive to pressure laterally (greater trochanter) * discolored tissue * swelling * unable to move limb * unable to stand * foot rotated outward * injured limb appears shorter
brain
* master organ * sends and receives messages * susceptible to injury * cerebral spinal fluid
peripheral nervous system
* nerves enter and exit spinal cord between vertebrae * 12 pairs of cranial nerves * motor and sensory nerves
flutter valve
* occlusive dressing that is taped on 3 sides * allows air out, but not in * used for sucking wounds
femoral shaft fracture
* pain * open fracture with deformity * closed fracture with deformity * injured limb shortened
tibia or fibula injury
* pain and tenderness * swelling * deformity
knee injury
* pain and tenderness * swelling * deformity with obvious swelling
immobilization of seated patient (high priority)
* rapid extrication * immobilize manually * transfer to long board
kinds of open chest injury
* sucking chest wound open to atmosphere * signs of severe difficulty breathing (wound to the chest, characteristic sucking sound, gasping for air)
signs of traumatic asphyxia
* sudden compression of chest * severe pressure exerted on heart and lungs * blood forced out of right atrium into jugular veins * blood vessels rupture * neck and face darker color * bulging eyes, distended neck veins
signs of aortic injury or dissection
* tearing chest pain radiating to back * differences in pulse and blood pressure between right and left arms and legs * cardiac arrest
After assessing the appropriate body system, what are the final steps of the patient assessment?
*Re-state the general impression *Verbalize appropriate interventions and treatment options *State how often you will do the re-assessment * Then FINALLY end with a report of what's wrong with the patient and what you've done!
Cardiogenic Shock
- Cardiogenic shock is a pump problem. - The heart muscle cannot pump effectively, causing a backup of fluid, pulmonary edema, and hypotension. - Pulmonary edema: accumulation of fluid in the lungs - Caused by low cardiac output due to reduced preload, high afterload, or poor myocardial contractility - Altered level of consciousness
Late Signs and Symptoms of Shock
- Falling blood pressure - Irregular breathing - Mottling or cyanosis - Absent peripheral pulses
Anaphylactic Shock - Anaphylaxis
- Life threatening form of severe allergic reaction with 1 or more of the following: 1 - Anxiety or loss of consciousness 2 - Low blood pressure - hypotension 3 - Respiratory difficulty - shortness of breath, wheezing - Distributive shock component - Massive vasodilation - Widespread vessel permeability (fluid leakage) - Bronchoconstriction - Skin flushed or cyanotic
Obstructive Shock - Tension Pneumothorax
- Lining of lungs separates and air enters the chest cavity due to lung injury or sucking chest wound. Accumulating pressure compresses the lungs and great vessels - JVD - Respiratory distress - Diminished lung sounds - Poor compliance during artificial ventilations with BVM - Trachael deviation towards unaffected side (late sign) - Apply bandage tape on three sides
Neurogenic Shock
- Neurogenic shock is a pipe problem - Distributive shock - Caused by spinal cord damage, typically in cervical region - Interrupts normal communication pathways between central nervous system and peripheral nervous system. - Interferes with body's normal compensatory mechanisms - Low blood pressure, Low heart rate, Low respiratory rate - Skin is warm, pink and dry - Smooth muscle relaxes causing vasodilation - Priapism
Metabolic Shock
- Preeclampsia - Diabetes - Respiratory acidosis.
Septic Shock
- Septic shock is a pipe problem - Caused by severe infection which damages blood vessels and increases plasma loss out of the vascular space - Distributive component - vasodilation leads to hypovolemia due to vessel permeability, fever, increased respiratory rate - tachycardia, hypotension, pale, cool skin, weak peripheral pulses, altered level of consciousness
Respiratory Shock
- Trauma Shock resulting from failure of the respiratory system to supply oxygen to the alveoli or remove CO2 from them. - Lungs are unable to supply enough Oxygen to the circulating blood - Asthma
What is the usual dose of activated charcoal for an adult or child?
1 gram per kilogram for adult and child
A 45-year-old woman calls EMS because of severe chest pain. When you arrive, she advises you that she has taken two of her husband's nitroglycerin tablets without relief. What is your most appropriate course of action? A. Attach the AED, administer 100% oxygen, and contact medical control for advice. B. Apply supplemental oxygen and transport the patient to the hospital without delay. C. Call medical control and request permission to assist the patient with one more nitroglycerin tablet. D. Obtain the patients's blood pressure and administer one more nitroglycerin tablet if her blood pressure is greater than 100 mm Hg systolic.
Apply supplemental oxygen and transport the patient to the hospital without delay
When is it most appropriate to clamp and cut the umbilical cord? A. As soon as the cord stops pulsating B. After the placenta has completely delivered C. Before the newborn has taken its first breath D. Immediately following delivery of the newborn
As soon as the cord stops pulsating
Which of the following actions should be carried out during the initial assessment of an unconscious patient? A. Assessing the skin B. Palpating the cranium C. Auscultating the lungs D. Obtaining a blood pressure
Assessing the skin
Small airways become reactive and constrict when what condition becomes active?
Asthma
In what condition does plaque build up in the walls of blood vessels
Atherosclerosis
What is the most common type of Force Protection Medication?
Atropine
5 key points in treating puncture wounds
1. object may be embedded to the bone 2. look for exit wound 3. gunshot wounds can fracture bones 4. seriousness connot be determined by caliber 5. stab wounds (head, neck, chest, abdomen, or groin)
7 signs of internal bleeding
1. pain, cramps, nausea 2. weakness, thirst 3. lacerations and punctures 4. bruising, developing shock 5. coughing up or vomiting blood 6. rigid and/or tender abdomen 7. distended abdomen
3 indications for using traction splint
1. painful 2. swollen 3. deformed thigh with no joint or lower leg pain
4 steps of patient care for flail chest
1. perform initial assessment 2. provide o2/assist ventilation 3. apply bulky dressing to stabilize flail segment 4. monitor respiratory rate and depth
5 functions of the skin
1. protection 2. water balance 3. temperature regulation 4. excretion 5. shock absorption
8 steps of patient care for puncture wounds
1. reassure patient 2. search for exit wound 3. occlusive dressing on chest wounds 4. assess need for ALS 5. care for shock 6. provide o2 7. immobilize the spine 8. transport
6 steps in patient care for chemical burns
1. requires immediate care 2. wash away chemicals with water for at least 20 minutes 3. if chemical is dry, brush away 4. apply sterile dressing or burn sheet 5. treat for shock 6. transport
4 signs and symptoms of shock
1. restlessness, AMS 2. pale, cool, and clammy skin 3. nausea and vomiting 4. vital sign changes (pulse and respirations increase, blood pressure drops, inaccurate pulse oximetry)
5 steps of application for tourniquet
1. select site 2. tighten tourniquet 3. attach notation to patient 4. BP cuff may be used 5. contact medical direction
7 steps in patient care for eye impalement
1. stabilize 2. apply rigid protection 3. stabilize dressings 4. dress and bandage uninjured eye 5. provide o2 6. care for shock 7. reassure patient
how to apply traction splint
1. standard precautions 2. expose 3. stabilize injury site 4. assess pulses and circulation, motor function, and sensation 5. check for disability 6. realign if deformed or if distal extremity is cyanotic or pulseless 7. measure or adjust the splint 8. maintain manual stabilization or traction 9. apply or secure the splint 10. reassess CMS
7 steps in patient care for injuries
1. standard precautions 2. initial assessment (ABCs) 3. rapid trauma exam 4. apply cervical collar 5. splint 6. apply dressing to wounds 7. cold pack/elevate
9 steps of patient care in a trauma
1. standard precautions 2. maintain open airway and assess respiratory rate 3. control external bleeding 4. apply and inflate PASG 5. elevate legs 8-12 inches (no spine injury) 6. splint bone injuries or joints 7. prevent heat loss 8. transport 9. reassure patient
8 steps on patient care of a closed wound
1. standard precautions 2. manage ABCs 3. high flow o2 via NRB 4. assume internal bleeding 5. shock management 6. splint extremities 7. stay alert for vomiting 8. monitor for deterioration
side effects
Any effects of a medication other than the desired ones.
bandage
Any material used to hold a dressing in place.
10 guidelines for traction splints
1. standard precautions 2. manual stabilization and traction 3. assess CMS 4. adjust splint to proper length 5. apply proximal securing device (ischial strap) 6. apply distal securing device (ankle hitch) 7. apply mechanical traction 8. position and secure support straps 9. reevaluate 10. secure torso and traction splint to long board
5 steps of patient care for external bleeding
1. standard precautions 2. open airway 3. monitor respirations 4. ventilate if necessary 5. control bleeding *****airway is ALWAYS the main concern*****
9 steps in patient care for head injuries
1. standard precautions 2. stabilize c-spine 3. evaluate breathing 4. provide o2 5. control bleeding 6. keep patient at rest 7. emotional support 8. treat shock 9. transport
8 steps in patient care to treat internal bleeding
1. stay alert for vomiting and keep airway open 2. patient supine with legs flexed 3. provide o2 4. care for shock 5. apply anti-shock garments 6. nothing by mouth 7. monitor vitals 8. transport
3 reasons to remove an impaled object
1. through the cheek 2. interferes with breathing or ventilation 3. interferes with transport
ways to treat bone injury
1. treat life - threats first 2. expose 3. assess distal pulse, motor function, and sensation before and after 4. align long bone to anatomical position 5. choose method to be used 6. do not push protruding bones 7. immobilize both injury site and adjacent joints 8. pad voids
5 steps to elevation
1. used at the same time as direct pressure 2. above the level of the heart 3. gravity helps 4. slows bleeding 5. do NOT use with impaled objects or spinal injury *****works better for veinous bleed than arterial bleed*****
Following penetrating trauma to the abdomen, a 50 year old woman has a large laceration with a loop of protruding bowel. How should you manage this injury? A. Carefully replace the bowel and apply an occlusive dressing. B. Carefully replace the bowel and cover the wound with a moist, sterile dressing. C. Apply a dry, sterile dressing covered by an occlusive dressing. D. Apply a moist, sterile dressing, covered by a dry, sterile dressing.
Apply a moist, sterile dressing, covered by a dry, sterile dressing
You respond to a call for a shooting at a local bar. You arrive at the scene and find a young man sitting against the wall, screaming in pain, with bright red blood spurting from a wound near his groin. What should you do first? A. Ensure an open airway B. administer 100% oxygen C. Apply pressure to the wound D. Transport the patient at once.
Apply pressure to the wound
7 procedures for avulsions
1. wrap avulsed part in dry sterile gauze 2. place in plastic bag or aluminum foil 3. label 4. document approximate time 5. keep cool 6. no dry ice 7. do not immerse in ice, cooled water, or saline
In a macro drip chamber, 1cc/1ml is equal to how many drips?
10 to 15 Drips
Normal infant heart rates are:
100 to 160
how many bones are in the thoracic part of the spine?
12
Adult resp rate is?
12 to 20
What is the maximum amount of time you should be suctioning?
15 seconds.
Child resp rate it?
15 to 30
How much O2 is in the air that we exhale?
16%-17%
If mouth-to-mask without O2 attatched is given, how much air is the pt receiving?
16%-17%
A 6 year old male, who weighs 40 pounds, ingested a bottle of aspirin approximately 20 minutes ago. Medical control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal will you administer? A. 12 g B. 14 g C. 18 g D. 24 g
18 g
While removing a hot radiator cap, a young man sustained partial-thickness burns to the anterior chest and both anterior arms. Based on the Rule of Nines, what percentage of his body surface area (BSA) has been burned? A. 18% B. 27% C. 36% D. 45%
18%
In a micro drip chamber, 60 drops equals how many cc/ml?
1cc/1ml
The Twinject Epinephrine auto injector carries how many doses of epinephrine?
2 Doses in Each Auto Injector
If an alkaline is in the eye, how long should the eye be irrigated?
20 minutes
A 40-year old patient sustained full=thickness burns to the entire head, anterior chest, and both anterior upper extremities. Using the adult Rule of Nines, what percentage of the patient's body surface area has been burned? A. 18% B. 27% C. 36% D. 45%
27%
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. As you are performing one-rescuer CPR, your partner prepares the AED. The appropriate compression to ventilation ratio for this child is A. 3:1 B. 5:1 C. 15:2 D. 30:2
30:2
how many vertebrae are there?
33
how many bones are in the coccygeal part of the spine?
4
The brain can function for how long before the brain may become severly damaged?
4-6 minutes
What percentage of AMI patients do not reach the hospital due to sudden death?
40%
in which of the following patients would nitroglycerin be contraindicated? A. 41-year-old male with crushing chest pressure, a blood pressure of 160/90 mm Hg, and sever nausea B. 53-year old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Cialis C. 58-year old male with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol D. 66-year-old female with chest pressure of 6 hours' durationi, lightheadedness, and a blood pressure of 110/58 mm Hg
53-year old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Cialis
Normal heart adults are:
60 to 100
You are assessing a 33 year old male's Glasgow Coma Scale (GCS) score. The patient opens his eyes in response to pain, is speaking with incomprehensible words, and withdraws from pain by flexing his upper extremities. What is his GCS score? A. 6 B. 7 C. 8 D. 9
7
how many bones are in the cervical part of the spine?
7
Normal child heart rates are:
70 to 150
Which of the following patients would MOST likely present with atypical signs and symptoms of acute myocardial infarction? A. 72-year old female with diabetes and hypertension B. 64-year old male with renal disease and depression C. 59 year old male with alcoholism and angina pectoris D. 55-year old female with COPD and frequent infections
72-year old female with diabetes and hypertension
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. A paramedic unit arrives at the scene to provide assistance. After one of the paramedics intubates the child, you should deliver ventilations at a rate of A. 6 to 8 breaths/min B. 8 to 10 breaths/min C. 10 to 12 breaths/min D. 12 to 20 breaths/min.
8 to 10 breaths/min
What is the normal blood glucose range?
80 to 120 mg/dl mg/dl=miligrams per deciliter
Normal systolic BP in a child:
80-110 systolic
Normal Systolic BP in an adult:
90 to 140 systolic.
Which of the following situations would necessitate treatment using implied consent? A. A 16 year old pregnant girl with an isolated extremity injury B. An 18-year old man who is now alert after receiving oral glucose C. A 25 year old man who is restless and has severe chest pain and diaphoresis D. A 65-eyar old man who is semiconscious and suspected of having a severe stroke
A 65-eyar old man who is semiconscious and suspected of having a severe stroke
What device can be attached to an inhaler, usually used for pediatric patients, that makes it easier to inhale the medication?
A Spacer
artery
A blood vessel, consisting of three layers of tissue and smooth muscle that carries blood away from the heart
coup-contrecoup brain injury
A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of the original impact
contusion
A bruise, or ecchymosis
air embolus
A bubble of air in the blood stream.
pressure dressing
A bulky dressing held in position with a tightly wrapped bandage to apply pressure to help control bleeding.
medication
A chemical substance that is used to treat or prevent disease or relieve pain.
load-distributing band (LDB)
A circumferential chest compression device composed of a constricting band and backboard that is either electrically or pneumatically driven to compress the heart by putting inward pressure on the thorax.
head tilt-chin lift maneuver
A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.
hypoglycemia
A condition characterized by a low blood glucose level.
gastric distention
A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.
shock
A condition in which the circulatory system fails to provide sufficient circulation so that every body part can perform its function; also called hypoperfusion
hypothermia
A condition in which the internal body temperature falls below 95 degress F after exposure to a cold environment
Burnout
A condition resulting from chronic job stress, characterized by a state of irritability and fatigue that can markedly decrease effectiveness
Which of the following patients with diabetes should receive oral glucose? A. A confused patient who has cool, clammy skin B. A confused patient who has suspected C. A semiconscious patient with pale skin D. An unconscious patient who took too much insulin
A confused patient who has cool, clammy skin
Hemophilia
A congenital condition in which a patient lacks one or more of the blood's normal clotting factors
intranasal (IN)
A delivery route in which a medication is pushed through a specialized atomizer device called a mucosal atomizer device (MAD) into the naris.
mechanical piston device
A device that depresses the sternum via a compressed gas-powered plunger mounted on a backboard.
mucosal atomizer device (MAD)
A device that is used to change a liquid medication into a spray and push it into a nostril.
tourniquet
A device used for bleeding control that constricts all blood flow to and from an extremity.
Americans with Disabilities Act (ADA)
A federal law passed in 1990 that protects individuals with a documented disability from being denied initial or continued employment based on their disability
Which of the following situations is an example of abandonment? A. An EMT--Paramedic givers a verbal report to any emergency nurse. B. An EMT--Intermediate assumes patient care from an EMT-Basic C. An EMT--Basic transfers care of a patient to patient to an EMT-Paramedic D. A first responder assumes patient care from an EMT-Intermediate
A first responder assumes patient care from an EMT-Intermediate
oxygen
A gas that all cells need for metabolism; the heart and brain, especially, cannot function without oxygen.
During the triage process, which of the following injuries or conditions would classify a patient as a high priority? A. Pulselessness and apnea B. Unilateral femur fracture and tachycardia C. Partial-thickness burns with no respiratory difficulty D. A large avulsion to the arm and an altered mental status
A large avulsion to the arm and an altered mental status
Which of the following patients would be at most risk for suicide? A. A woman who quit her job for one that pays more B. A man who is in the midst of losing a significant relationship C. A man who is planning a family trip, but gets called away to work D. An EMT who saved a drowning child and receives a lot of media attention
A man who is in the midst of losing a significant relationship
antagonist
A medication that binds to a receptor and blocks other medications.
agonist
A medication that causes stimulation of receptors.
nitroglycerin
A medication that increases cardiac perfusion by causing arteries to dilate; you may be allowed to help the patient self-administer the medication.
aspirin (acetylsalicylic acid or ASA)
A medication that is an antipyretic (reduces fever), analgesic (reduces pain), anti-inflammatory (reduces inflammation), and potent inhibitor of platelet aggregation (clumping).
AVPU
A method of assessing a patient's level of consciousness by determining whether a patient is Awake and alert, responsive to Verbal stimulus or Pain, or Unresponsive; used principally in the initial assessment
Standard Precautions
A method of preventing infection based on the concept that all blood and body fluids are infectious
metered-dose inhaler (MDI)
A miniature spray canister used to direct medications through the mouth and into the lungs.
suspension
A mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve.
DCAP-BTLS
A mnemomic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, and Swelling
multisystem trauma patient
A patient who experienced trauma that affects more than one body system
cavitation
A phenomenon in which speed causes a bullet to generate pressure waves, which cause damage distant from the bullet's path
gel
A semiliquid substance that is administered orally in capsule form or through plastic tubes.
Critical Incident Stress Debriefing (CISD)
A session where counselors help emergency personnel process emotions from a critical incident
two-to three-word dyspnea
A severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath
recovery position
A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.
oral glucose
A simple sugar that is readily absorbed by the bloodstream; it is carried on the EMS unit.
pressure point
A site where a main artery lies near the surface of the body and directly over a bone. Pressure on such a point can stop distal bleeding.
During a soccer game, a 20 year old man collided shoulder to shoulder with another player. He has pain and a noticeable anterior bulge to the left shoulder. What is the most effective method of immobilizing this injury? A. An air-inflatable splint with the left arm immobilized in the flexed position B. A long board splint with the left arm immobilized in the extended position C. A sling to support the left arm and swathes to secure the arm to the body D. A sling to support the left arm and swathes to maintain downward traction
A sling to support the left arm and swathes to secure the arm to the body
traction splint
A splint that applies constant pull along the lenght of the lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. Traction splints are used primarily on femoral shaft fractures.
Which of the following mechanisms of injury would necessitate performing a rapid trauma assessment? A. A 5'8" tall adult who fell 12' from a roof and landed on his side B. A stable patient involved in a car crash, whose passenger was killed C. Amputation of three toes from the patient's left foot with controlled bleeding D. An impaled object in the patient's lower extremity with minimal venous bleeding
A stable patient involved in a car crash, whose passenger was killed
epinephrine
A substance produced by the body (commonly called adrenaline), and a drug produced by pharmaceutical companies that increases pulse rate and blood pressure; the drug of choice for an anaphylactic reaction.
What is the rigid hard piece at the end of suction tubing?
A suction catheter. If it is rigid and hard like the question asks, the it is specifically a Yankauer Catheter. If it is soft then it is a French catheter (used on children and Infants)
Quality Improvement (QI)
A system of internal and external reviews and audits of an EMS system to ensure a high quality of care
capillary refill
A test that evaluates distal circulatory system function by squeezing blood from an area such as a nail bed and watching the speed of its return after releasing the pressure
Purified Protein Derivative (PPD) Tuberculin
A test to determine the presence of a tuberculous infection based on a person's positive reaction to tuberculin, a substance prepared from the tubercle bacillus
impedance threshold device (ITD)
A valve device placed between the endotracheal tube and a bag-mask device that limits the amount of air entering the lungs during the recoil phase between chest compressions.
Which of the following patients would be the best candidate for the administration of nitroglycerin? A. A woman who has taken 3 doses of prescribed nitroglycerin without relief of chest pain B. A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg C. A man with chest pain, a bottle of expired nitroglycerin, and a blood pressure of 110/80 mm Hg D. An elderly man with crushing chest pain and a blood pressure of 90/60 mm Hg
A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg
AVPU
A- Alert, responds to your presence and answers questions with little difficulty. May be disorientated. V- Verbal, responds to your voice but may not acknowledge your presence. No eyecontact, just sits there, but when spoken to speaks or moves to acknowledge listening P- Painful, responds to pain stimuli U- Unresponsive, does respond to any of the above, including pain. Priority patient.
During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 7. B. 8. C. 9. D. 10.
A. 7
The foreign substance responsible for causing an allergic reaction is called a(n): A. allergen. B. antibody. C. histamine. D. leukotriene.
A. allergen.
You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include: A. assisted ventilation, naloxone (Narcan), and rapid transport. B. oxygen via a nonrebreathing mask and rapid transport. C. assisted ventilation, flumazenil (Romazicon), and rapid transport. D. oxygen via a nasal cannula, atropine, and rapid transport.
A. assisted ventilation, naloxone (Narcan), and rapid transport.
A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should: A. contact medical control if needed, transport the patient, and monitor him for signs of deterioration. B. ask him if he has epinephrine and request approval from medical control to administer it to the patient. C. avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe. D. begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.
A. contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: A. is significantly hyperglycemic. B. has a low blood glucose level. C. has a urinary tract infection. D.has overdosed on her insulin.
A. is significantly hyperglycemic.
You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying high-flow oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should: A. leave him in a sitting position, keep him warm, and prepare for immediate transport. B. place him in a supine position, elevate his lower extremities, and transport at once. C. treat for shock and request a paramedic unit to respond to the scene and assist you. D. perform a detailed secondary assessment and then transport him to a dialysis center.
A. leave him in a sitting position, keep him warm, and prepare for immediate transport.
You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include: A. oxygen via a nonrebreathing mask, left lateral recumbent position, and transport. B. assisted ventilation with a bag-mask device, right lateral recumbent position, and transport. C. an oral airway, assisted ventilation with a bag-mask device, Fowler's position, and transport. D. oxygen via a nonrebreathing mask, supine position with legs elevated 6″ to 12″, and transport.
A. oxygen via a nonrebreathing mask, left lateral recumbent position, and transport..
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. advise her that she cannot clean herself up because this will destroy evidence. C. ask her if there is anyone you can contact, such as a friend or relative. D. perform a limited hands-on assessment to detect life-threatening injuries.
A. provide emotional support and visually assess her for obvious trauma.
You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. B. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly.
A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.
The two MOST common signs of anaphylaxis are: A. wheezing and widespread urticaria. B. watery eyes and localized itching. C. expiratory stridor and tachycardia. D. hypertension and swollen hands.
A. wheezing and widespread urticaria.
___ is a condition in which low blood voume results in inadequate perfusion and even death: A: Hypovolemic shock B: Metabolic shock C: Septic shock D: Psychogenic shock
A: Hypovolemic shock
When applying a bandage to hold a drssing in place, stretch the bandage tight enough to control bleeding, but not so tight as to decrease ___ to the extremity: A: blood flow B: pulses C: oxygen D: CRTs
A: blood flow
In a motor vehicle crash, as the passenger's head hits the windshield, the brain continues to move forward until it strikes the inside of the skull resulting in a ___ injury: A: compression B: laceration C: lateral D: motion
A: compression
Significant clues to the possibility of severe injuries include: A: death of a passenger B: a blown out tire C: broken glass D: a deployed airbag
A: death of a passenger
Potential energy is mostly associated with the energy of: A: falling objects B: motor vehicle crashes C: pedestrian vs. bicycle crashes D: gun shot wounds
A: falling objects
The only artiers in the body to carry deoxygenated blood are the: A: pulmonary arteries B: coronary arteries C: femoral arteries D: sublavian arteries
A: pulmonary arteries
IF bleeding continues after applying a pressure dressing, you should do all of the following, except: A: remove the dressing and apply another sterile dressing B: apply manual pressure through the dressing C: add more gauze pads over the first dressing D: secure both dressings tighter with a roller bandage
A: remove the dressing and apply another sterile dressing
___ is inadequate tissue perfusion: A: shock B: Hyperperfusion C: Hypertension D: Contraction
A: shock
A Bx3 Cx3 D E F
A=Airway/C-spine B= 1. Breathing? 2. Air moving 3. O2 C= 1. Pulse Present 2. Skin condition 3. Major bleeds D= different diagnosis E= expose F= flee?
Activated charcoal
ACTION: Adsorbent INDICATIONS: most acute oral poisonings; overdose CONTRAS: decreased LOC, airway that cannot be controlled, overdose of corrosives, caustics, or petroleum substances. Precautions: Administer only after emesis or in those cases where emesis is contraindicated. Route: PO Side effects: nausea, vomiting, stomach pain, bleeding, allergic reactions, constipation, diarrhea, temporary darkening of stool. Dose: 50 gms (1-2g/kg); 1g/kg, max 25 gms peds
Acetaminophen
ACTION: analgesic, antipyretic INDICATIONS: For pain and fever control CONTRAS: hypersensitivity, children <3yo PRECAUTIONS: Pts w/hepatic (liver) disease, alcoholism, malnutrition, thrombocytopenia, children <12yo w/arthritic conditions. ROUTE: PO SIDE EFFECTS: allergic reactions, used appropriately-rare. Liver damage with large doses. DOSE: 500-1000mg every 4 hours as needed; 10mg/kg PO
Who can start an IV in the field?
ALS
Aspirin
Action: Analgesic, antipyretic, platelet inhibitor, anti-inflammatory Indications: Chest pain suggestive of an MI. Contras: hypersensitivity to salicylates, active ulcer disease, asthma Precautions: Allergies to other NSAIDs, bleeding disorders, children or teens with chicken pox or influenza-like symptoms. Side effects: N/V, heartburn, bleeding, bronchospasm and wheezing if patient is allergic. Route: PO Dose: Adult 4 chewable baby aspirin (81mg each) (160-325 mg) Peds Not indicated
Diphenhydramine
Action: Antihistamine Indications: Anaphylaxis and allergic reactions Contraindications: asthma and other lower respiratory diseases Precautions: May induce hypo-tension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination Side Effects: Sedation, tiredness, sleepiness, dizziness, disturbed coordination, drying and thickening of oral and other respiratory secretions and stomach distress. Route: PO Dose: Adult 25-50 mg Peds No PO dose indicated
Ibuprofen
Action: NSAID Indications: Reduce fever and relieve minor to mod pain Contras: allergies to aspirin/NSAIDs, pts currently taking anticoagulants Precautions: hypertension, cardiac decompensation Side effects: rash, ringing in the ear, headaches, dizziness, drowsiness, abdominal pain, nausea, dirrhea, constipation, and heartburn, increased bleeding. Route: PO Dose: Adult 400-800 mg Ped 10 mg/kg
Albuterol
Action: Sympathomimetic bronchodilator Indications: Bronchospasm and asthma in COPD Contras: Hypersensitivity, history cardiac disease, heart rate >150 in adults, >200 in peds Precautions: Vitals isngs and breath sounds must be monitored, use caution with elderly, cardiac, or hypertensive patients. Side Effects: Tachycardia, anxiety, nausea, cough, wheezing, tremors, and/or dizziness Route: MDI/Inhalation Dose: Adult 2.5-5.0 mg (3cc) via nebulizer continuously, X3 doses if no history cardiac disease and HR </= 150 Peds 2.5 mg (3cc) via nebulizer continuously, X3 doses, if no history cardiac disease and heart rate </= 200
Glucose
Action: carbohydrate Indications: Patients with altered mental status and known history of diabetes mellitus. Contras: Unconsciousness; known diabetic who has not taken insulin for days, pt who is unable to swallow Precautions: assure pt has control of swallowing and airway. Side effects: none with given properly Route: PO Dose: Adult one tube, repeat based on BGL Ped one tube, repeat based on BGL, min age 3.
Pralidoxime
Action: cholinesterase reactivator indications: organophosphate poisoning contras: carbamate insecticides (Sevin), inorganic phosphates, and organophosphates having no anticholinesterase activity, asthma, peptic ulcer disease, sever cardiac disease, or pt receiving aminophylline, theophylline, morphine, succinylcholine, reserpine, or phenothiazines Precautions: rapid administration may result in tachycardia, larynospasm, and muscle rigidity Side effects: blurred or double vision, difficulty in focusing eyes, difficulty in speaking, difficult or rapid breathing, dizziness, tachycardia, muscle stiffness/weakness, pain at place of injection Route: IM Dose: Adult 600 mg Ped per medical control only
Naloxone
Action: narcotic antagonist Indications: Narcotic and synthetic narcotic overdose, coma of unknown origin Contras: hypersensitivity, non-narcotic-induced respiratory depression Precaution: possible dependency Side effects: Abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, tachycardia, hypertension, tremulousness, seizures, and cardiac arrest Route: nasally Dose: Adult 1-2 mg nasally via atomizer Peds: 0.1 mg/kg nasally via atomizer (max 2mg), repeated in 5 min if no effect
Nitroglycerin
Action: nitrate Indication: chest pain associated with angina and acute myocardial infarction Contras: hypersensitivity, tolerance to nitrates, sever anemia, head truma, hypotension, increase ICP, pts taking ED medications, glaucoma, and shock precautions: may induce headache that is sometimes severe. side effects: hypotension, headache, pulse rate changes route: SL Dose: Adult: 1 tablet or spray (0.4mg) every 5 min until pain-free or 3 doses, If SBP <100, contact med control Peds not indicated
Oxygen
Action: oxidizing agent Indications: hypoxia or anticipated hypoxia, trauma, improve respiratory efficiency Contras: None Prcautions: COPD and very prolonged administration of high concentrations in the newborn Dose/Route: 1-6 LPM via NC, 10-15 via NRB, 15 LPM via BVM
Atropine
Action: parasympatholytic (increases heart rate) Indications: Organophosphate poisoning (insecticides, pesticides, cyanide, mustard gas, Sarin) Contras: None in emergency setting Precautions: AMI, glaucoma Route: PO Dose: Adult 1 to 2 mg IM, otherwise as directed by med control Ped Per medical control only
Nasal Spray
Action: vasocontrictor Indications: epistaxis (nose bleed), nasal intubation contras: significant hypertension side effects: sneezing or burning, stinging, dryness, or irritation of the nose. Precautions: None Route: Nasally Dose: adult 2 sprays in affected nostril ped 1-2 sprays in affected nostril
untoward effects
Actions that can be harmful to the patient.
When a patient has swallowed poison or drugs, what medication can you give them to help prevent the body from digesting the harmful toxins?
Activated Charcoal
At 0345, you receive a call for a woman in labor. upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby "now". This man escorts you into the living room where a 25-year old woman is trying on the couch in obvious pain. After determining that delivery is not imminent, you begin transport. While en route, the mother tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What is your most appropriate first action? A. Allow the head to deliver and check for the location of the cord. B. Advise your partner to stop the ambulance and assist with the delivery. C. Tell the mother to take short, quick breaths until you arrive at the hospital. D. Prepare the mother for an emergency delivery and open the obstetrics kit.
Advise your partner to stop the ambulance and assist with the delivery.
Which of the following natures of illness is most consistent with a patient with low blood glucose level who is acting bizarre and breathing shallowly? A. Cardiac compromise B. Altered mental status C. Behavioral emergency D. respiratory emergency
Altered mental status
Give an example of a sympathomimetic
Amphetamine and methamphetamine - Cocaine
Which of the following statements regarding the use of an escort vehicle when en route to an emergency call is true? A. an escort vehicle will allow you to arrive at the scene quicker. B. To avoid getting separated from the escort vehicle, you should closely follow it. C. An escort vehicle should be used only if you are unfamiliar with the patients location. D. With an escort vehicle, the risk of an accident at an intersection is reduced significantly.
An escort vehicle should be used only if you are unfamiliar with the patients location.
closed extremity injury
An extremity injury with no opening in the skin.
blunt trauma
An impact on the body by objects that cause injury without penetrating soft tissues or internal organs and cavities
body substance isolation (BSI)
An infection control concept and practice that assumes that all body fluids are potentially infectious
pneumatic antishock garment (PASG)
An inflatable device that covers the legs and abdomen; used to splint the lower extremities or pelvis or to control bleeding in the lower extremities, pelvis, or abdominal cavity
intravenous (IV) injection
An injection directly into a vein; a medication delivery route.
intramuscular (IM) injection
An injection into a muscle; a medication delivery route.
open wound
An injury in which the skin is interrupted, exposing the tissue beneath.
closed wound
An internal injury with no open pathway from the outside.
evisceration
An intestine or other internal organ protruding through a wound in the abdomen.
Duty to Act is?
An obligation to provide care.
sucking chest wound
An open chest wound in which air is "sucked" into the chest cavity.
puncture wound
An open wound that tears through the skin and destroys underlaying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit wound.
Defusing
An opportunity to vent emotions and get information before the CISD
activated charcoal
An oral medication that binds and adsorbs ingested toxins in the gastrointestinal tract for treatment of some poisonings and medication overdoses. Charcoal is ground into a very fine powder that provides the greatest possible surface area for binding medications that have been taken by mouth; it is carried on the EMS unit.
In which of the following patients would an oropharyngeal airway be indicated? A. Any patient suspected of having hypoxia B. A semiconscious patient with an intact gag reflex C. A semiconscious patient who took an overdose of propoxyphene D. An unconscious patient with fluid drainage from the ears
An unconscious patient with fluid drainage from the ears
When Naloxone is administered to a patient and is affective, what emotional state is the patient often in?
Anger and Confusion
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. Skin will become cyanotic with A. an increase in the amount of venous oxygen B. an increase in the amount of arterial oxygen C. a decrease in the amount of arterial oxygen D. a decrease in circulating red blood cells
a decrease in the amount of arterial oxygen
Atherosclerosis
a disorder in which a cholesterol and calcium build up inside the walls of blood vessels, forming plaque, which eventually leads to partial or complete blockage of blood flow.
Congestive Heart Failure (CHF)
a disorder in which the heart loses part of his ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in backup of fluid into the lungs.
Syncope
a fainting spell or transient a loss of consciousness,often caused by an interruption of blood flow to the brain.
Emergency Medical Technician (EMT)
EMS practitioner who provides basic emergency medical care
Paramedic
EMS practitioner who provides the highest level of prehospital care
Emergency Medical Responder (EMR)
EMS practitoner likely to be the first person on the scene with emergency care training
Advanced Emergency Medical Technician (AEMT)
EMT with some additional qualifications for advanced care, the level of EMS practitioner who performs the responsibilities of an EMT with the addition of the use of advanced airway devices, monitoring of blood glucose levels, initiation of intravenous and intraossseous infusions, and administration of a select number of medications
Management of stress includes:
Eliminate stressors, change partners, get rid of negative personalities, change work hours, reduce overtime, change your attitude, don't obsess over what you can't change, excercise, diet.
Prehospital Care
Emergency medical treatment given to patients before they are transported to a hospital or other facility
What route of drug administration is sprayed directly into a tube inserted into the trachea?
Endotracheal Route
What drug helps to constrict the blood vessels and relax the airway passages?
Epinephrine
What medication can you give to a patient that is having an allergic reaction to something and is having difficulty breathing?
Epinephrine
Personal Protective Equipment (PPE)
Equipment worn to protect against injury and against spreading infectious disease
palpate
Examine by touch
hemorrhage
Excessive bleeding; bursting forth of blood
Which of the following conditions would most likely cause flushed skin? A. Shock B. Hypoxia C. Exposure to heat D. Low blood pressure
Exposure to heat
What forms can nitro come in?
Extended Release Capsules Sprays Sublingual Tablets Gels Patches
Which of the following findings would indicate that a patient is in decompensated shock? A. Diaphoresis and pallor B. Falling blood pressure C. Restlessness and anxiety D. Heart rate greater than 130 beats/min
Falling blood pressure
If insulin is unavailable for glucose to enter cells, what will the body use for fuel?
Fat
Irreversible Shock
Final stage of shock. The body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure. - Profound hypotension - Skin cool, pale, and clammy
Which technique of artificial ventilation should never be used on children?
Flow restricted oxygen powered ventilation device, because it is too strong and will cause lung and tissue damage.
Pulmonary Edema
Fluid accumulates in the lungs, making the exchange of )2 and CO2 in the alveoli less efficient.
Obstructive Shock - Pericardial Tamponade
Fluid accumulates within the pericardial sac and compresses the heart. Also called Cardial tamponade - JVD - Jugular venous distention - filling of jugular veins - Narrowing pulse pressure - systolic and diastolic moving closer together - Hypotension
compound fracture
Fracture in which the bone is broken and bone extends through the skin
Preferred nasopharynx suctioning device is:
French whistle.
How do you correctly measure the size of a nasal airway?
From the tip of the nose to earlobe.
Anterioir
Front side of body
At 0345, you receive a call for a woman in labor. upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby "now". This man escorts you into the living room where a 25-year old woman is trying on the couch in obvious pain. Which of the following statements regarding crowning is true? A. Crowning represents the end of the second stage of labor. B. Crowning always occurs immediately after the amniotic sac has ruptured. C. It is safe to transport the patient during crowning if the hospital is close. D. Gentle pressure should be applied to the baby's head during crowning.
Gentle pressure should be applied to the baby's head during crowning.
After identifying priority what is the next "step" according to the grading sheet?
Give a brief report to responding EMS units
The carpal bones form the:
Hand
Control and prevention of contamination include?
Hand washing, gloves, eye protection, gowns, masks, mask, respirators, barrier devices, and immunizations.
Which of the following are side effects of nitroglycerin? A. Nausea B. Anxiety C. Headache D. Hypertension
Headache
What type of hemoglobin do normal red blood cells contain?
Hemoglobin A
What is the primary route for IV drugs to be administered in the field by ALS?
Heparin or Saline Lock
What natural body-made substance causes vasodilation, shock, and bronchoconstriction during Anaphylaxis?
Histamine
What substance does the body release when Anaphylaxis takes place?
Histamine
For Trauma Assessments, after the ABC's what do you do?
History Head Neck Chest Abdomen/Pelvis Lower Extremities Upper Extremities Posterior (the patients back side) Thennnnnn Vitals.
What must you understand about medications before you can administer them in the field?
How they will effect your current patient under the current circumstances
The supporting bone of the arm is the:
Humerus
neurogenic shock
Hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dialation of blood vessels that increses the volume of the circulatory system beyond the point where it can be filled.
Symptom
a manifestation of a disease of malfunction that is reported by the individual but cannot be perceived by an observer
Signs
a manifestation of a disease that can be perceived by an observer
hematoma
a mass blood in the soft tissues beneath the skin
NOI vs MOI
If EMS was called for a Medical Illness, determine the nature of the illness. (NOI) If EMS was called for an Injury Incident, determine the mechanism of injury. (MOI)
hypoperfusion
Inability of the body to adequately circulate blood to the body's cells to supply them with oxygen and nutrients.
Shock or Hypoperfusion
Inadequate tissue perfusion. The cells of the body do not get oxygen and nutrients they need from the circulatory System
What two things commonly occur after a patient takes Epinephrine?
Increased Heart Rate Increased Blood Pressure
S/S of stress include:
Increased respiratory rate, heart rate, and B/P, vasodilation, dialted pupils, tensed muscles, increased glucose levels, perspiration, deacreased blood flow to gastrointestinal tract, irritability, inability to concentrate, difficult or increased sleeping, anxiety, guilt, loss of appetite, decreased sexual activity, loss of interest in work, alcholism, drug use.
What is it called when an IV needle goes through the vein and out the other side?
Infiltrated IV
What route of drug administration is breathed into the lungs?
Inhaled Route
What medications are prescribed to patients that EMTs can assist with?
Inhalers Nitroglycerin Epinephrine
subcutaneous (SC) injection
Injection into the tissue between the skin and muscle; a medication delivery route.
___ are the leading cause of death and disability in the U.S. among children and young adults
Injuries
Obvious mortal damage:
Injuries such as decapitation or non survivable injury.
penetrating trauma
Injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs
Which of the following describes the most correct method for inserting a nasopharyngeal airway A. Insert the device with the bevel facing the septum B. Insert the device with the bevel facing the lateral aspect of the nose. C. Rotate the device as you insert it into the right nostril D. Apply firm, gentle pressure if you meet resistance during insertion.
Insert the device with the bevel facing the septum
Chest:(trauma assessment)
Inspect and palpate chest Auscultate (listen using stethoscope) left and right side of chest
Lower Extremities
Inspect and palpate each leg Do PMS
Posterior
Inspect and palpate thorax, lumbar and butt.
Head:(trauma assessment)
Inspect mouth and nose Inspect & palpate scalp, ears and facial area Assesses eyes
Abdomen/Pelvis
Inspects and palpates abdomen Assesses pelvis Verbalize the assessment of genitalia
intraosseous (IO)
Into the bone; a medication delivery route.
What route of drug administration is injected into the muscle?
Intramuscular Route
What route of drug administration is sprayed into the nostrils?
Intranasal Route
What route of drug administration is injected into the bone marrow?
Intraosseous Route
What route of drug administration is injected into a vein?
Intravenous Route
When assessing a patient with a complaint of chest pain, which of the following questions would you ask to assess the R in OPQRST? A. Did the pain begin suddenly or gradually B. What were you doing when the began? C. Is there anything that makes the pain worse? D. Is the pain in one place or does it move around?
Is the pain in one place or does it move around?
Why do you need to wear BSI (gloves) when administering nitro to a patient?
It can be absorbed through the skin and cause the EMT to get a massive headache among other negative side effects
Which of the following statements regarding the automated external defibrillator is true? A. It should be applied to patients at risk for cardiac arrest B. It will analyze a patient's rhythm while CPR is in progress C. It should not be used in patients with an implanted pacemaker D. It can safely be used in children between 1 and 8 years of age.
It can safely be used in children between 1 and 8 years of age.
Pulmonary surfactant serves which of the following functions? A. It carries fresh oxygen from the lungs to the left side of the heart B. it dilates the bronchioles in the lungs and enhances the flow of air C. It lubricates the alveolar walls and allows them to expand and recoil D. It facilitates the transport of oxygen-poor blood from the right ventricle to the lungs.
It facilitates the transport of oxygen-poor blood from the right ventricle to the lungs.
Which of the following statements regarding the function of insulin is most correct? A. it stimulates the liver to produce glycogen B. it promotes the entry of glucose from the cell into the bloodstream C. It facilitates the uptake of glucose from the bloodstream into the cell. D. it causes the pancreas to produce glucose based on the body's demand
It facilitates the uptake of glucose from the bloodstream into the cell.
How does alcohol affect the system?
It impairs the capacity to think and function rationaly
What makes Naloxone special in the medical field as far as a drug that treats s specific condition?
It is an antidote
How far should you reach into the patients mouth with a catheter?
It should never go past the base of the tongue and into the throat.
The formula from calculating kinetic energy is ___
KE=1/2 MV^2
What are the rapid, deep respirations seen with diabetic ketoacidosis called?
Kussmaul Respirations
Which of the following findings would indicate an altered mental status in a small child? A. Recognition of the parents B. Fright at the EMT-B's presence C. Lack of attention to the EMT-B's presence D. Consistent eye contact with the EMT-B
Lack of attention to the EMT-B's presence
Lower airway consists of:
Larynx, trachea, alveoli, bronchioles, bronchi, carina, lungs
Decompensated Shock
Late or "progressive" shock. The body can no longer compensate for the hypovolemic state due to low blood volume and lack of perfusion. - Decreasing blood pressure
Cardiac Output
a measure of the volume of blood circulated by the heart and 1 min., calculated by multiplying the stroke line of the heart rate.
Calming and reassuring an anxious patient can be facilitated by:
Maintaining eye contact with the patient whenever possible.
Physician who authorizes/delegates authority to provide medical care in the field.
Medical Control
During transport of a patient with a head injury, what assessment factor will provide you with the most information regarding the patient's condition? A. Pupil size B. Heart size C. Mental status D. Blood pressure
Mental status
What 2 types of drip chambers are there?
Micro Macro
When communicating with an older patient, it is important to remember that:
Most older people think clearly and are capable of answering questions.
What are 4 techniques for Artificial Ventilation?
Mouth to mouth, Mouth to mask, Bag valve mask (BVM), Flow restricted oxygen powered ventilation.
retractions
Movements in which the skin pulls in around the rubs during inspiration
Emergency movement/lifting is:
Moving a pt before initial assessment. *Clothes drag, blanket, arm and arm-to-arm drag
Adduction
Moving towards midline
What causes chest pain?
Muscle injury
Inadequate signs of breathing in adult include:
Muscle retractions, pale or cyantoic, cold and damp skin, tripod position, and noisy breathing.
What medication is used to treat a patient who overdosed on narcotics?
Naloxone
Unconsciousness, shallow breathing, and constricted pupils are most indicative of what type of drug overdose? A. Narcotic B. Marijuana C. Barbiturate D. Amphetamine
Narcotic
Asthma
Narrowing of the respiratory passages and buildup of mucus causes trapping of air and poor gas exchange.
What are the oxygen delivery devices?
Nasal Cannula, Non Rebreather Mask
Upper airway consists of:
Nasopharynx, nose, pharynyx, mouth, oropharynx, epiglottis
Provides national standards for EMT testing and certification.
National Registery
Which of the following signs or symptoms is more common in Children than adults following head trauma? A. Nausea and vomiting B. Altered mental status C. Tachycardia and diaphoresis D. Changes in pupillary reaction
Nausea and vomiting
What medication, other than aspirin, is carried by patients with recurring chest pain and/or history of myocardial infarction?
Nitroglycerin
Can EMTs start an IV?
No
Can you assist a patient in using an inhaler if it was not prescribed to them?
No
Signs of adequate breathing in an adult include:
Non-labored, normal rate, regular rhythm, good audible breath sounds, regular rise and fall of chest, movement of abdomen.
basic life support (BLS)
Noninvasive emergency lifesaving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest.
rule of palm
a method for estimating the extent of a burn. The palm of the patient's hand, which equals about 1% of the body's surface area, is compared with the patient's burn to estimate its size
rule of nines
a method of estimating the extent of a burn. For an adult, each of the following surfaces represents 9% of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region. For an infant or child the percentages are modified so that 18% is assigned to the head, 14% to each lower extremity.
epistaxis
a nosebleed
Inadequate breathing means:
a person cannot move enough air into the lungs with each breath, thus not meeting metabolic needs.
How soon can you administer medications to a patient?
Only after a thorough patient assessment or to treat a life threatening condition
What route of drug administration is taken by mouth and digested?
Oral Route
The two Airway Adjuncts
Oropharyngeal airway (OPA) and the nasopharyngeal airway (NPA)
Where is Epinephrine administered to the patient?
Outer Thigh
Chest Injury
Pain interferes with full chest expansion, thus limiting ventilations. Lung damage itself is secondary to pulmonary contusion, can also prevent gas exchange.
Which of the following assessment findings would LEAST suggest cardiac compromise? A. Tachycardia B. An irregular pulse C. Palpable pain to the chest D. nausea and epigastric pain
Palpable pain to the chest
Neck:(trauma assessment)
Palpates trachea Checks jugular veins Palpate C-Spine
When opening the airway, the jaw thrust maneuver should be applied to.....
Patients who may have suffered trauma because it carefully moves the jaw forward without moving the neck.
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. You have given high concentration oxygen to the man and completed the remainder of your initial assessment. What should you do next? A. Obtain baseline vital signs B. Perform a rapid trauma assessment C. Conduct a detailed physical examination D. Immobilize the patient with a vest-style device
Perform a rapid trauma assessment
Perfusion
Perfusion is the adequate circulation of oxygenated blood throughout the body. Adequate perfusion is necessary to maintain homeostasis
Informed consent is?
Permission for treatment given by a patient after the potential risks, benefits, and alternatives to treatment have been explained.
Medical Director
Physician who is legally responsible for medical oversight of an EMS system.
___ of the crash scene may provide valuable information to the staff and treating physicians of the trauma center
Polaroids
Medical Direction
Policies, procedures, and practices available either off-line (as protocols or standard orders) or on-line (by phone or radio)
Fibula
Posterior bone in lower leg
During the initial assessment of a trauma patient, you note massive facial injuries, weak radial pulses, and clammy skin. What should be your most immediate concern? A. Potential obstruction of the airway B. Internal bleeding and severe shock C. Applying 100% supplemental oxygen D. Providing rapid transport to a trauma center
Potential obstruction of the airway
Evidence-Based Medicine
Practice based on evidence that procedures, medications, and equipment improve patient outcome
systolic blood pressure
Pressure against the walls of the arteries as the heart contracts.
Diastolic blood pressure
Pressure against the walls of the blood vessels as the heart relaxes.
Initial attempts at providing artificial ventilation should be accomplished using A. the one-person bag valve mask technique B. the two-person bag valve mask technique C. a pocket mask with supplemental oxygen D. a flow-restricted oxygen-powered ventilation device
a pocket mask with supplemental oxygen
pressure point
a point where a blood vessel lies near a bone; useful when direct pressure and elevation do not control bleeding
Tachycardia
a rapid heartbeat, more than 100 beats/minute.
Signs of inadequate breathing in an unconscious patient include A. a fast heart rate B. warm, moist skin C. equal breath sounds D. a rapid respiratory rate
a rapid respiratory rate
Bifercation
a separation into two separate branches
Bradycardia
a slow heart rate, less than 60 beats/minutes.
Cardiogenic Shock
a state in which not enough oxygen is delivered to the tissues of the body caused by low output of blood from the heart. This can be a severe complication of large acute myocardial infarction, as well as other conditions.
Cardiac Arrest
a state in which the heart fails to generate effective and detectable blood flow; pulses are not palpable and cardiac arrest, even if muscular and electrical activity continues in the heart.
Which of the following descriptions MOST accurately portrays emergency medical services (EMS)?
a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured.
Acute Coronary Syndrome
a term used to describe a group of symptoms caused by myocardial ischemia; includes angina and myocardial infarction.
Premature Birth
Pulmonary surfactant is decreased in some premature infants, therefore, prematurity is often associated with hypoxia. The more premature an infant, the worse the hypoxia.
Freshly oxygenated blood returns to the heart via which of the following blood vessels? A. Aorta B. Vena cava C. Pulmonary vein D. Pulmonary artery
Pulmonary vein
Which vital sign is the best indicator of cardiac output during the initial assessment? A. Pulse rate and quality B. Systolic blood pressure C. Quality of the respirations D. Condition and color of the skin
Pulse rate and quality
Three Primary Causes of Shock
Pump (heart) problems Pipe (blood vessel) problems Fluid (blood volume) problems
capillary
a tiny blood vessel where substances are exchanged between the blood and the body cells
tension pneumothorax
a type of pneumothorax in which air that enters the chest cavity is prevented from escaping
concussion
a violent shaking up or jarring of the brain that may result in a temporary loss of awareness and function
Aortic Aneurysm
a weakness in the wall of the aorta that makes it susceptible to rupture.
A young man fell and landed on his outstretched hand, resulting in pain and deformity to the left midshaft forearm. Distal circulation should be assessed at which of the following pulse locations? A. Radial B. Brachial C. Pedal D. Popliteal
Radial
Which of the following bones is affected with a swollen, painful deformity to the lateral bone of the left forearm? A. Ulna B. Radius C. Clavicle D. Humerus
Radius
The bones of the forearm are called the
Radius and humerus
Although limited, what is a possible side effect of a patient using an Bronchodilator such as Albuterol?
Rapid Heart Rate
The police summon you to a residence for a domestic dispute. When you arrive, you are advised by a police officer that a man, who is now in custody, shot his wife. When you enter the residence, you see a woman lying supine. She is conscious, but very restless, and is in obvious respiratory distress. During which part of your assessment would you be most likely to discover a small caliber gunshot wound, with minimal bleeding, to the back? A. General impression B. Initial assessment C. Rapid trauma assessment D. Detailed physical examination
Rapid trauma assessment
What is the next step after you administer medication to your patient?
Reassessment of the Patient
Midaxillary
Referring to middle of armpit parallel to the midline
Midclavicular
Referring to the middle of the clavicle parallel to the midline
Ipsilateral
Refers to the same side of the body
Acute narcotic or sedative overdose
Resp may decrease and become shallow.
Minute Volume=
Respiratory Rate x Tidal Volume
Which of the following signs would you expect to see in the early stages of shock A. Hypotension B. Restlessness C. Thready pulses D. Unconsciousness
Restlessness
Thoracic contains:
Ribs (12), spine, sternum, clavical, scapula, lungs, heart, diaphragm.
What are two symptoms that a patient may show when an inhaler is used?
Rise in Heart Rate Jitteriness
What is a fast IV flow rate called?
Runaway IV
Who primarily uses a drugs chemical name?
Scientists and Manufacturers
Abrasion
Scrape of the skin
Nasopharnygeal adjunct contraindications
Sever head injury wit hblood draining from the noise, hx of fx nasal bones.
What is the medical problem related to opioids that is a concern for responders?
Sever respiratory depression, vomiting, hypotension
hypovolemic shock
Shock resulting from blood or fluid loss.
cardiogenic shock
Shock, or lack of perfusion, brought on not by blood loss, but by inadequate pumping action of the heart. It is often the result of a heart attack or congestive heart failure.
Which of the following structures is the primary pacemaker, which sets the normal rate for the heart? A. Bundle of His B. Purkinje fibers C. Sinoatrial node D. Atrioventricular node
Sinoatrial node
What is the term used for administering medication by placing it under the tongue?
Sublingual
What route of drug administration is taken under the tongue?
Sublingual Route
Which position is most appropriate for a mother in labor with a prolapsed umbilical cord? A. Left lateral recumbent B. Left side with legs elevated C. Supine with hips elevated D. Supine with legs elevated
Supine with hips elevated
What is the primary intervention for patients suffering from hematologic crises?
Supportive care
skeletal system
Supports and protects the body
T/F Injuries are the leading cause of death and injuries among 1- to 34-year-olds in the U.S.
T
T/F Rear-end collisions often cause whiplash injuries
T
T/F The cervical spine has little tolerance for lateral bending
T
T/F Work is defined as force acting over distance
T
Which of the following assessment findings would most suggest a systemic reaction following ingestion of a poison? A. Nausea and vomiting B. Burns around the mouth C. Tachycardia and hypotension D. Difficulty swallowing and burning in the mouth
Tachycardia and hypotension
Which of the following actions would most likely cause a sudden drop in a patient's blood glucose level? A. Mild exertion after eating a meal B. Eating a meal after taking insulin C. Taking too much prescribed insulin D. Forgetting to take prescribed insulin
Taking too much prescribed insulin
What is trending?
Taking vitals more than once to see how your pt is doing.
What does the primary assessment of a patient consist of?
The General Impression The Assessment of the patient's Mental Status The Assessment of ABC's Then Identifying the priority.
Tidal Volume
The amount of air a person inhales and exhales in a single breath. The normal tidal volume for an adult is 500mL.
dose
The amount of medication given on the basis of the patient's size and age.
tourniquet
The bleeding control method of last resort that occludes arterial flow; used only when all other methods have failed and the patient's life is in danger
veins
The blood vessels that carry blood from the tissues to the heart
Primary respiratory drive is?
The brain
central nervous system
The brain and spinal cord
trade name
The brand name that a manufacturer gives a medication; the name is capitalized.
Which of the following statements regarding one-rescuer CPR is correct? A. you should assess the patient for a pulse after 3 cycles of CPR. B. A compression to ventilation ratio of 15:2 should be delivered C. Ventilations should be delivered over a period of 1 to 2 seconds D. The chest should be allowed to fully recoil after each compression.
The chest should be allowed to fully recoil after each compression
cardiopulmonary resuscitation (CPR)
The combination of rescue breathing and chest compressions used to establish adequate ventilation and circulation in a patient who is not breathing and has no pulse.
Standard of care is?
The degree of medical care and skill that is expected of a resonably competent EMT acting in the same or similar circumstances.
conjunctiva
The delicate membrane that lines the eyelids and covers the exposed surface of the eye
Ethics
The discipline dealing with what is good and bad.
Compensated Shock
The early stage of shock. The body is still able to compensate for the hypovolemic state through defense mechanisms, such as: - Increased heart rate - Peripheral vasoconstriction
intended effect
The effect that a medication is expected to have on the body.
kinetic energy
The energy of a moving object
mechanism of injury (MOI)
The forces of energy transmission applied to the body that cause injury
coagulation
The formation of clots to plug openings in injured blood vessels and stop blood flow
nature of illness (NOI)
The general type of illness a patient is experiencing
What is the cause of cardiogenic shock?
The heart lacks enough power to force proper volume of blood through the circulatory system
shock
The inability of the body to adequately circualte blood to the body's cells to supply them with oxygen and nutrients. A life-threatenting condition.
aorta
The main artery, which receives blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body
orientation
The mental status of a patient as measured by memory of person, place, time, and event
paradoxical motion
The motion of the chest wall section that is detached in a flail chest; the motion is exactly the opposite of normal motion during breathing
Palmar
The palms
detailed physical exam
The part of the assessment process in which a detailed area-by-area exam is performed on patients whose problems cannot be readily identified or when more specific information is needed about problems identified in the focused history and physical exam
ongoing assessment
The part of the assessment process in which problems are reevaluated and responses to treatment are assessed
focused history and physical exam
The part of the assessment process in which the patient's major complaints or any problems that are immediately evident are further and more specifically evaluated
initial assessment
The part of the assessment process that helps you to identify any immediately or potentially life-threatening conditions so that you can initiate lifesaving care
Non-urgent movement/lift is used when:
The patient and scene are safe.
abdominal-thrust maneuver
The preferred method to dislodge a severe airway obstruction in adults and children; also called the Heimlich maneuver.
subcutaneous emphysema
The presence of air in soft tissues, causing a characteristic crackling sensation on palpation
pharmacodynamics
The process by which a medication works on the body.
absorption
The process by which medications travel through body tissues until they reach the bloodstream.
manual traction
The process of applying tension to straighten and realign a fractured limb before splinting. Also called tension.
adsorption
The process of binding or sticking to a surface.
triage
The process of establishing treatment and transportation priorities according to severity of injury and medical need
Cleaning
The process of washing a soiled object with soap and water
chief complaint
The reason a patient called for help; also, the patient's response to general questions such as "What's wrong?" or "What happened?"
Diastolic is?
The residual pressure that remains in the artiers during the relaxing phase of the heart's cycle, when the left ventricle is at rest.
polypharmacy
The simultaneous use of multiple medications by a patient as typically seen in elderly people.
OPQRST
The six pain questions; Onset, Provoking factors, Quality, Radiation, Severity, Time
deceleration
The slowing of an object
capillaries
The small blood vessels that connect arterioles and venules; various substances pass through capillary walls, into and out of the interstitial fluid, and then on to the cells
arterioles
The smallest branches of arteries leading to the vast network of capillaries
sprain
The stretching and tearing of ligaments.
pharmacology
The study of the properties and effects of medications.
perfusion
The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries.
amputation
The surgical removal or traumatic severing of a body part, usually an extremity.
action
The therapeutic effect of a medication on the body.
Golden Hour
The time from injury to definitve care, during which treatment of shock or traumatic injuries should occur because survival potential is best
responsiveness
The way in which a patient responds to external stimuli, including verbal stimuli, tactile stimuli, and painful stimuli
mechanism of injury (MOI)
The way in which traumatic injuries occur; the forces that act on the body to cause damage
sclera
The white portion of the eye; the tough outer coat that gives protection to the delicate, lightsensitive, inner layer
How soon does Naloxone take affect on a patient that has not overdosed on narcotics?
There is no effect on patients that receive Naloxone that have not overdosed on narcotics
accessory muscles
These condary muscles of respiration.
How do the majority of poisons enter the body?
Through ingestion
per os (PO)
Through the mouth; a medication delivery route; same as oral.
per rectum (PR)
Through the rectum; a medication delivery route.
transcutaneous (transdermal)
Through the skin; a medication delivery route.
Which of the following techniques represents the most appropriate method of opening the airway of an infant with no suspected neck injury? A. Lift up the chin and hyperextend the neck. B. Tilt the head back without hyperextending the neck C. Gently lift the chin while maintaining slight flexion of the neck. D. Perform the technique as you would for an older child or adult.
Tilt the head back without hyperextending the neck
Apex
Tip of a structure
Heart Attack
Tissues begin to die from lack of O2, weakened heart then pumps blood poorly to rest of body, resulting in systemic shock.
Weight Conversion
To convert lbs to kgs: Lbs/2.2=Kg Divide weight in lbs by half then subtract 10%
coagulate
To form a clot to plug an opening in an injred blood vessel and stop bleeding
Why would a department/squad carry Atropine Auto Injectors?
To help EMTs that have been exposed to certain weapons of mass destruction such as nerve gas
Inferior
Towards the feet
Superior
Towards the head of the body
Lateral
Towards the outside
___ ___ occurs to the body when the body's tissues are exposed to energy levels beyond their tolerance
Traumatic injury
You are called to treat a male patient who overdosed on heroin and is unconscious with shallow breathing and cyanosis to the face. The patient suddenly begins to vomit. What should you do first? A. Suction the oropharynx B. Turn the patient onto his side. C. Insert an oropharyngeal airway. D. Assist ventilations with 100% oxygen.
Turn the patient onto his side.
sublingual (SL)
Under the tongue; a medication delivery route.
The normal blood glucose level, as measured by a glucometer, is between: A. 60 and 80 mg/dL. B. 80 and 120 mg/dL. C. 130 and 150 mg/dL. D. 160 and 200 mg/dL.
B. 80 and 120 mg/dL.
What are causes of error with an AED?
Usually human error. Most common error is batter is not charged. When the AED is connected to a moving a patient, if it is applied to a responsive patient with a rapid heartbeat.
Nitroglycerin possesses which of the following effects when administered to patients with suspected cardiac chest pain? A. Vasodilation and increased myocardial oxygen supply B. Vasodilation and decreased myocardial oxygen supply C. Vasoconstriction and increased cardiac workload D. Vasoconstriction and increased cardiac oxygen demand
Vasodilation and increased myocardial oxygen supply
You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: A. acute hypoglycemia. B. a ruptured cerebral artery. C. a complex partial seizure. D.an occluded cerebral artery.
B. a ruptured cerebral artery.
A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. vigorously palpate the abdomen to establish pain severity. B. administer oxygen and prepare for immediate transport. C. place the patient in a sitting position and transport at once. D. request a paramedic unit to give the patient pain medication.
B. administer oxygen and prepare for immediate transport.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: A. perform a detailed secondary assessment. B. maintain his airway and assist his ventilations. C. ask his wife if he has any known allergies. D. apply the automated external defibrillator (AED) in the event that cardiac arrest occurs.
B. maintain his airway and assist his ventilations.
You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: A. determine if the patient is a known alcohol abuser. B. obtain a description of how the seizure developed. C. determine when he was last seen by his physician. D. ask her how long the patient has been taking his medication.
B. obtain a description of how the seizure developed.
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? A. assisted ventilation with a bag-mask device and a head-to-toe exam B. oxygen via nonrebreathing mask and a focused secondary assessment C. positive-pressure ventilations and immediate transport to the closest hospital D. oxygen via a nasal cannula, vital signs, and prompt transport to the hospital
B. oxygen via nonrebreathing mask and a focused secondary assessment
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: A. defibrillate with the AED while continuing transport to the hospital. B. stop the ambulance, begin CPR, and attach the AED as soon as possible. C. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. D. alert the receiving hospital and perform CPR for the duration of the transport.
B. stop the ambulance, begin CPR, and attach the AED as soon as possible.
The body will not tolerate an acute blood loss of greater than ___ of blood volume: A: 10% B: 20% C: 30% D: 40%
B: 20%
A fall from more than ___ times the patient's height is considered to be significant: A: 2 B: 3 C: 4 D: 5
B: 3
A lack of one or more of the blood's clotting factors is called: A: a deficiency B: hemophilia C: platelet anomaly D: anemia
B: hemophilia
___ impacts are probably the number one cause of death associated with motor vehicle crashes: A: Frontal B: lateral C: rear-end D: rollover
B: lateral
Blood enters into the left atrium from the: A: coronary arteries B: lungs C: vena cava D: coronary veins
B: lungs
The amount of kinetic energy that is converted to do work on the body dictates the _____ of the injury: A: location B: severity C: cause D: speed
B: severity
You should consider bleeding to be serious if all of the following conditions are present, except: A: blood loss is rapid B: there is no mechanism of injury C: the patient has a poor general appearance D: assessment reveals signs and symptoms of shock
B: there is no mechanism of injury
The following are concepts of energy typically associated with injury, except: A: potential energy B: thermal energy C: kinetic energy D: Work
B: thermal energy
What should an EMT do immediately before and after suctioning an unresponsive patient?
Because suctioning removes oxygen, the emt should administer oxygen immediately before and after suctioning.
You assess a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do next? A. Resuction the mouth. B. Briskly dry off the infant. C. Begin chest compressions D. Begin artificial ventilations
Begin artificial ventilations
Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn? A. Begin positive pressure ventilations. B. provide blow-by oxygen with oxygen tubing C. assess the newborn's skin condition and color. D. start chest compressions and contact medical control
Begin positive pressure ventilations.
Ventral
Belly side of the body
Where can oral glucose be administered to the patient?
Between the cheek and gum Under the tongue
What does the memory device "B-NICE" stand for?
Biologics - Nuclear, Incendiary, chemical, and explosive
venous bleeding
Bleeding from a vein, which is characterized by dark red or maroon blood and as a steady flow, easy to control.
arterial bleeding
Bleeding from an artery, which is characterized by bright red blood and as rapid, profuse, and difficult to control.
capillary bleeding
Bleeding from the capillaries, which is characterized by a slow oozing flow of blood.
Which of the following injuries or conditions should be managed first? A. Fluid drainage from both ears B. Bleeding within the oral cavity C. A large open abdominal wound D. Bilateral fractures of the femurs
Bleeding within the oral cavity
Passageway through the heart:
Blood arrives via the inferior/superior vena cava. It enters the right atrium, goes through the triscuspid valve and into the right ventricle, and then goes through the pulmonary valve to the lungs. The blood then reenters the heart through the pulmonary vein into the left atrium, through the mitral valve, then the left ventricle through the aortic valve.
Dependent lividity
Blood settling to the lowest part of the body. "Pooling"
cyanosis
Bluish-gray skin color that is caused by reduced oxygen levels in the blood
Ulna
Bone in forearm "on the little finger side", larger in the distal forearm.
Radius
Bone in forearm "on the thumb side", larger in the proximal forearm.
Femur
Bone located in the thigh
Tarsals
Bones in the ankle
Metacarpals
Bones in the foot leading to the phalanges
Carpals
Bones in the wrist
When uncoiling an IV tube, what must not hit the ground?
Both Ends of the Tubing Cannot Hit The Ground
Bilateral
Both sides
Which of the following mechanisms cause respiratory and circulatory collapse during anaphylactic shock? A. Bronchodilation and vasodilation B. Bronchodilation and vasoconstriction C. Bronchoconstriction and vasodilation D. Bronchoconstriction and vasoconstriction
Bronchoconstriction and vasodilation
Albuterol is an example of what type of medication?
Bronchodilator
What device should you use to suction blood from the mouth of an unresponsive 4 month old?
Bulb Syringe and or a French Catheter.
Which of the following patients has experienced the MOST significant fall? A. a 4′8″ patient who fell 13′ B. a 5′0″ patient who fell 13′ C. a 4′6″ patient who fell 13′ D. a 5′9″ patient who fell 14′
C. a 4′6″ patient who fell 13′
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. After you attach the AED and analyze this patient's heart rhythm, the machine states, "shock advised." What cardiac rhythm is the patient most likely in? A. Asystole B. Ventricular fibrillation C. Ventricular tachycardia D. Pulseless electrical activity
Ventricular fibrillation
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: A. rapid swelling of the upper airway tissues. B. a significant amount of fluid in the alveoli. C. narrowing of the bronchioles in the lungs. D. enlargement of the bronchioles in the lungs.
C. narrowing of the bronchioles in the lungs.
Before moving onto the ABC's during the primary assessment what 3 things most you do?
Verbalize the general impression of the patient, Do AVPU an determine the chief complaint and/or life threats.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: A. monitor her en route to the hospital and call medical control if she worsens. B. crush up an antihistamine tablet and place it in between her cheek and gum. C. request permission from medical control to give another dose of epinephrine. D. administer a nebulized bronchodilator to improve the status of her breathing.
C. request permission from medical control to give another dose of epinephrine
You respond to a 25-year-old man who has cut his arm with a circular saw. The bleeding appears to be bright red and spurting. The patient is alert and oriented and converses with you freely. He appears to be stable at this point. What is your first step in controlling his bleeding?: A: direct pressure B: Maintaining the airway C: BSI precautions D: elevation
C: BSI precautions
The energy of a moving object is called: A: potential energy B: Thermal energy C: Kinetic energy D: Work
C: Kinetic energy
Significant blood loss demands your immediate attention as soon as the ___ has been managed: A: fractures B: extrication C: airway D: none of the above
C: airway
Blood contains all of the following, except: A: white cells B: plasma C: cerebrospinal fluid D: platelets
C: cerebrospinal fluid
Energy may be: A: created B: destroyed C: converted D: all of the above
C: converted
You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach the patient he is pale and there appears to be a lot of blood on the floor. The wound continues to bleed massively. You consider applying a tourniquet but know they are rarely needed and often: A: resolve the problem B: decrease the problem C: create more problems D: all of the above
C: create more problems
The term ___ means constantly adapting to changing conditions: A: perfusion B: conduction C: dynamic D: autonomic
C: dynamic
The most common life-threatening event in a ollover is ___ or partial ejection of the passenger from the vehicle: A: "sandwiching" B: centrifugal force C: ejection D: spinal cord injury
C: ejection
The three collisions in a frontal impact include all of the following, except: A: car vs. object B: passenger vs. vehicle C: flying objects vs. passengers D. internal organs vs. solid structures of the body
C: flying objects vs. passengers
The mechanism of injury provides information about the severity of the collision and therefore has a(n) ___ effect on patient care: A: direct B: positive C: indirect D: negative
C: indirect
Signs of most injuries sustained in a motor vehicle crash can be found by simply inspecting the ___ during extrication of the patient: A: head and neck B: chest C: interior of the vehicle D: torso
C: interior of the vehicle
Your quick initial assessment of the patient and the evaluation of the _____ can help to direct lifesaving care and provide critical information to the hospital staff: A: scene B: index of suspicion C: mechanism of injury D: abdominal area
C: mechanism of injury
You are giving a presentation to a group of laypeople on the importance of calling EMS immediately for cardiac arrest patients. What point should you emphasize the most? A. Laypeople are incapable of providing adequate CPR B. Rapid transport significantly reduces patient mortality C. CPR and defibrillation are key factors in patient survival D. Cardiac drug therapy is the most important EMS treatment
CPR and defibrillation are key factors in patient survival
Upon arriving at the scene of a multiple vehicle crash, you can see that at least two patients have been ejected from their vehicles. What should you do next? A. Begin triage B. Treat the most critical patient first C. Gather all of the patients together D. Call for at least one more ambulance
Call for at least one more ambulance
Ambulance stretcher (wheeled)
Can be used for most situations when there is room and it can roll easily.
You are called to a local knife-throwing contest, where a 42-year old man has a large dagger impaled in the middle of his chest. Your assessment reveals that he is pulseless and apneic. How should you manage this patient and his injury? A. Carefully remove the knife, control the bleeding, and begin CPR B. Carefully remove the knife, control the bleeding, and attach an AED to the patient. C. Secure the knife in place with a bulky dressing and transport immediately D. Make sure that the knife is secured, initiate CPR and transport immediately
Carefully remove the knife, control the bleeding, and begin CPR
zygomatic bone
Cheek bone; also called malar
Main difference between adult and children airway?
Children have smaller and less rigid airways.
contraindications
Conditions that make a particular medication or treatment inappropriate; for example, a condition in which a medication should not be given because it would not help or may actually harm a patient.
When is the NPA used?
Conscious patients with lubrication!
Oropharyngeal adjunct contraindications:
Conscious pt, any pt who has a gag reflex.
Implied consent is?
Consent in which a patient is unable to give consent and is provided treatment under the implication they would want treament.
A 4 year old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:
Consider asking the father to hold the child so you can assess him while your partner tires to calm the mother
Recognition, patient assesment, continued assesment and stabilization in hospital, definitive care.
Continuum of Care
When inspecting the fluids bag for an IV, what three things should you check?
Correct Fluid Expiration Date Clear and Free of Particles
rales
Crackling, rattling, breath sound that signals fluid in the air spaces of the lungs; also called crackles
Types of stress include:
Cumulative, post-traumatic stress reaction, eustruss, acute stress, and chronic stress
List the terms for the mnemonic DUMBELS.
D-Defacation U-Urination M-Miosis B-Bronchorrhea E-Emesis LLacrimation S-Salivation
What are three common names for erectile dysfunction medications to be on the look out for before you administer nitro to a patient?
Viagra Levitra Cialis
After all of that, what are the last steps to a trauma assessment?
Vitals, managing secondary injuries, verbalizing interventions and treatments, re-assessment times and then the REPORT
Aspirin Oral Glucose Oxygen Prescribed Inhalers Nitroglycerin Epinephrine Activated Charcoal
What are the 7 medications EMT's can administer or assist in administering in the field?
Which of the following questions would be most appropriate to ask when assessing a patient with chest pain? A. What does the pain feel like? B. Does the pain radiate to your arm? C. Would you describe the pain as sharp? D. Is the pain worse when you take a deep breath?
What does the pain feel like?
Aspirin
What medication is given to patients with chest pain of a suspected cardiac organ?
Allergic to Aspirin Gastrointestinal Bleeding
What two reasons does the book state not to give aspirin to a patient?
When does Anaphylaxis begin in the body?
When an antigen meets antibodies within the body
Medications
When dealing with the public, do you use the term drugs or the term medications?
peer-assisted medication
When the EMT adminsters medication to him or herself or to a partner.
patient-assisted medication
When the EMT assists the patient with the administration of his or her own medication.
EMT-administered medication
When the EMT directly administers the medication to the patient.
irreversible shock
When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.
How do you open the airway if there is no trauma? & if there is?
When there is NO trauma you use the head tilt chin-lift. When there IS trauma you use the jaw thrust.
When is the best time to perform a detailed physical examination? A. While enroute to the hospital B. After all life threats have been ruled out C. Immediately after taking baseline vital signs D. Following the initial assessment of a trauma patient.
While enroute to the hospital
Preferred oropharynx suctioning device is:
Yankauers (tonsil tip)
While managing a patient in cardiac arrest, you turn the AED on and attach the pads to the patient. When you push the analyze button, the machine signals "low battery" and then ceases to function. The patient subsequently dies. Which of the following statements regarding this case is most correct? A. You and your partner may be held liable for negligence. B. The crew that preceded you may be held liable for negligence. C. The manufacturer of the AED may be held liable for negligence. D. Most errors associated with the AED involve equipment failure.
You and your partner may be held liable for negligence.
In the event that you are exposed to a weapon of mass destruction such as nerve gas, who do you administer the Atropine to first?
Yourself, because your safety is always the highest priority
Occlusion
a blockage, usually of a tubular structure such as a blood vessel.
superficial burn
a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn. Also called a first-degree burn.
Cardiac arrest in the adult population most often is the result of A. myocardial infarction B. respiratory failure C. a cardiac arrhythmia D. accidental electrocution
a cardiac arrhythmia
Hypovelmic shock
a condition in which low blood volume results in inadequate perfustion
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: A. hypoglycemia. B. an acute stroke. C. hyperglycemia. D. a heart attack.
D. a heart attack.
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: A. the bee venom itself. B. adrenaline and histamines. C. leukocytes and epinephrine. D. histamines and leukotrienes.
D. histamines and leukotrienes.
A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: A. nitroglycerin for her chest pain. B. ventilations with a bag-mask device. C. oxygen at 4 L/min via nasal cannula. D. placing her in an upright position.
D. placing her in an upright position.
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
The brain and spinal cord usually cannot go for more than ___ minutes without perfusion, or the nerve cells will be permanetly damaged: A: 30-45 B: 12-20 C: 8-10 D: 4-6
D: 4-6
At the arterial end of the capillaries, the muscles dilate and constrict in response to conditions such as: A: fright B: a specific need for oxygen C: a need to dispose of metabolic wastes D: all of the above
D: all of the above
Contraindictions to the use of the PASG include: A: pulmonary edema B: pregnancy C: penetrating chest injuries D: all of the above
D: all of the above
Even though the body is very efficient at controlling bleeding on its own, it may fail in situations such as: A: when medications interfere with normal clotting B: when damage to the vessel may be so large that a clot cannot completely block the hole C: when sometimes only part of the vessel wall is cut, preventing it from constricting D: all of the above
D: all of the above
If the typical adult loses more that 1L of blood, significant changes in vital signs such as ___ will occur: A: increased heart rate B: increased respiratory rate C: decreased blood pressure D: all of the above
D: all of the above
Motor vehicle crashes are classified traditionally as: A: frontal B: rollover C: lateral D: all of the above
D: all of the above
Significant mechanisms of injury include: A: moderate intrusions from a lateral impact B: severe damage from the rear C: collisions in which rotation is involved D: all of the above
D: all of the above
The function of the blood is to ___ all of the body's cells and tissues: A: deliver oxygen to B: deliver nutrients to C: carry waste products away from D: all of the above
D: all of the above
When properly applied, seat belts are successful in: A: restraining the passengers in a vehicle B: preventing a second collision inside the motor vehicle C: decreating the severity of the third collision D: all of the above
D: all of the above
Your index of suspicion for the presence of life-threatening injuries should automatically increase if you see: A: seats torn from their mountings B: collapsed steering wheels C: intrusion into the passenger compartment D: all of the above
D: all of the above
The ___ is the thickest chamber of the heart: A: right atrium B: right ventricle C: left atrium D: left ventricle
D: left ventricle
Who sets the curriculum for all EMS courses?
DOT
frostbite
Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts
What can cause problems when administering Naloxone into the patient's nose using an atomizer?
Damaged Mucous Membranes
What is hypoxia?
Dangerous condition in which the the body's tissues and cells do not have enough oxygen Without interventions, the pt will die within minutes.
putrefaction
Decomposition of body tissue. Occurs between 20-96 hours.
Veins carry?
Deoxygenated blood
Proper size for BP cuff:
Designed to wrap around the arm 1 to 1 1/2 times and take up 2/3 of the length of the arm from armpit to elbow. Small cuff=false high reading, large= false low reading.
The ______________ is a muscular dome that forms the inferior boundary of the thorax, separating the thorax from the abdomen.
Diaphragm
What controllable risk factors place a person at high risk for myocardial infarction?
Diet, weight, and exercise
What effects does nitro have on the patient's body?
Dilates the coronary vessels that lead to the heart Causes severe headaches for the patient
Routes of transmission include:
Direct - touch or droplets Indirect - spread by inanimate objects Mechanical (vector born) - by insects Biological - Transmissions by which the germs live or grow Airborne - sneezes, coughs Dust - may carry pores, may remain for long periods.
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining - a traditional Asian healing practice in which hot coins are rubbed on the back. You should:
Document this on your patient care report and advise the emergency department staff of what the child's parents told you.
Which should you do first? AMPLE OR OPQRST
Doesn't really matter but if you want a more natural conversation with the patient do OPQRST first then AMPLE.
What are the three important parts to the IV?
Drip Chamber Flow Regulator Drug or Needle Port
Fight or Flight response:
During an acute stress response, the autonomic nervous system is activated and the body increases level of cotricol, adrenilen, and other hormones that produce an increased heart rate, quick breathing, and higher BP. Blood is shunted from extremities to the big muscles to "fight or flight".
While assessing a patient with chest pain, you note that the patient's pulse is irregular. This most likely indicates A. acute myocardial infarction or angina pectoris B. a dysfunction in the left side of the patient's heart C. high blood pressure that is increasing cardiac workload D. abnormalities in the heart's electrical conduction system
abnormalities in the heart's electrical conduction system
You are called to treat a 25-year-old man who is alert and having difficulty breathing. After making contact with your patient, he extends his arm out to allow you to take his blood pressure. This is an example of A. actual consent B. informed consent C. implied consent D. formal consent
actual consent
Management of a patient with severe abdominal pain includes A. administering 100% oxygen B. auscultating for bowel sounds C. giving the patient sips of water D. placing the patient in a supine position
administering 100% oxygen
Following delivery of a newborn, you note that the mother has a moderate amount of vaginal bleeding. The mother is conscious and alert and her vital signs are stable. The most appropriate management of the mother includes A. massaging the uterus if signs of shock develop B. administering oxygen and massaging the uterus C. placing a sanitary pad in the vagina and administering oxygen D. treating her for shock and providing immediate transport
administering oxygen and massaging the uterus
Immediately upon leaving the scene with a patient, you should A. contact medical control B. notify the receiving facility C. advise dispatch of your status D. can't read the answer
advise dispatch of your status
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. As you are loading the man into the ambulance, the police officer advises you that the woman is refusing EMS treatment and transport. You should next A. ask the police officer to obtain a signed refusal from the patient as you proceed to the hospital B. ask the police officer to administer a breathalyzer test to determine if the patient has been drinking alcohol C. advise the patient that she should be transported to the hospital because of the seriousness of the crash D. obtain a signed refusal from the patient and ask the police officer to transport her to the hospital
advise the patient that she should be transported to the hospital because of the seriousness of the crash
pneumothorax
air in the chest
You are called to a local park for a 7-year old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has wide-spread hives and facial edema. What should you suspect has occurred? A. Heat emergency B. allergic reaction C. Acute asthma attack D. Exposure to a poisonous plant
allergic reaction
After removing a patient from the water, your assessment reveals that the patient is breathing inadequately and is continuously regurgitating large quantities of water. You should manage this patient by A. alternating suctioining with artificial ventilations B. performing abdominal thrusts to remove the water. C. placing the patient on the side and press in on the abdomen. D. initiating artificial ventilations after the patient stops regurgitating
alternating suctioining with artificial ventilations
Seizures in children most often are the result of A. a life-threatening infection B. a temperature greater than 102 degree F C. an abrupt rise in body temperature D. an inflammatory process in the brain.
an abrupt rise in body temperature
A soft-tissue injury that results in a flap of torn skin is referred to as A. an incision B. an avulsion C. an abrasion D. a laceration
an avulsion
Which of the following patients would be most in need of a rapid trauma assessment? A. an awake and alert 19-year-old man with a small caliber gunshot wound to the abdomen B. A conscious 25-year-old woman who fell 12' from a roof and landed on her side C. A 43-year-old woman with a unilaterally swollen, painful deformity of the femur D. a 60-year old man who fell from a standing position and has an abrasion on his check
an awake and alert 19-year-old man with a small caliber gunshot wound to the abdomen
A 30 year old woman has sever lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect A. a normal pregnancy B. an ectopic pregnancy C. a spontaneous abortion D. a ruptured ovarian cyst
an ectopic pregnancy
Hypertensive Emergency
an emergency situation created by excessively high blood pressure, which can lead to serious complications such as stroke or aneurysm.
Hypoxia
an inadequate amount of oxygen
abrasion
an injury caused by rubbing or scraping off the skin
crush injury
an injury caused when force is transmitted from the body's exterior to its internal structures. Bones can be broken, muscles, nerves, and tissues damaged, and internal organs ruptured, causing internal bleeding
dislocation
an injury in which a bone comes out of its joint
Infection
an invasion of microorganisms that causes inuurious effects on the body or specific areas
Management of an unconscious, breathing patient with a significant cardiac history would include all of the following, EXCEPT A. analyzing the rhythm with an AED B. providing ventilatory support as needed C. requesting the presence of an ALS ambulance D. obtaining a SAMPLE history from the patient's spouse
analyzing the rhythm with an AED
Arrhythmia
and the regular or abnormal heart rhythm.
dressing
any material (preferably sterile) used to cover a wound that will help control bleeding and help prevent additional contamination
A 50-year old man presents with "crushing" chest pain of sudden onset. He is diaphoretic and nauseated. You should A. obtain baseline vital signs B. apply supplemental oxygen C. ask him if he takes nitroglycerin D. perform a focused physical exam
apply supplemental oxygen
Rapid extrication of a patient from an automobile is most appropriately performed by A. applying an extrication collar and removing the patient from the car using the direct carry method B. applying an extrication collar, sliding a long spine board under the patient's buttocks, and removing the patient from the car. C. applying a vest-style extrication device and sliding the patient out of the car onto a long spine board for full immobilization. D. maintaining support of the head, grasping the patient by the clothing, and rapidly removing the patient from the car.
applying an extrication collar, sliding a long spine board under the patient's buttocks, and removing the patient from the car.
Basic shock management consists of A. applying and inflating the PASG, applying oxygen, and providing warmth. B. elevating the lower extremities, applying and inflating the PASG, and applying oxygen C. applying oxygen, elevating the upper body, and providing warmth D. applying oxygen, elevating the lower extremities, and providing warmth
applying oxygen, elevating the lower extremities, and providing warmth
The scene size up includes all of the following components, EXCEPT A. determining scene safety B. applying personal protective gear C. assessing the need for assistance D. evaluating the mechanism of injury
applying personal protective gear
A 19 year old man was struck in the side of the head with a steel pipe during a gang altercation. Blood-tinged fluid is draining from the ears and bruising appears behind the ears. The most appropriate management for this patient includes A. elevating the lower extremities and providing immediate transport B. applying 100% oxygen and packing the ear with sterile gauze pads C. controlling the drainage from the ear and applying spinal immobilization D. applying spinal immobilization and oxygen while monitoring the patient for vomiting
applying spinal immobilization and oxygen while monitoring the patient for vomiting
In addition to ensuring your own safety, your primary responsibility when functioning at the scene of a violent crime is to A. preserve any potential evidence B. appropriately manage the patient C. notify medical control prior to initiating care D. obtain police permission before providing patient care
appropriately manage the patient
The automated external defibrillator (AED) should NOT be used in patients who A. are between 1 and 8 years of age B. experienced a witnessed cardiac arrest C. are apneic and have a weak carotid pulse D. have a nitroglycerin patch applied to the skin
are apneic and have a weak carotid pulse
Oral Adjuncts:
are used to keep the tongue from blocking the upper airway. Use to make it easier to suction the oropharynx if neccesary.
The police summon you to a residence for a domestic dispute. When you arrive, you are advised by a police officer that a man, who is now in custody, shot his wife. When you enter the residence, you see a woman lying supine. She is conscious, but very restless, and is in obvious respiratory distress. After ensuring a patent airway, your next course of action should be to A. apply 100% oxygen B. assess respiratory quality C. compare carotid and radial pulses D. check the condition of the patient's skin
assess respiratory quality
After the delivery of the defibrillation with the AED, the patient has a return of a pulse. You should next A. provide rapid transport to the hospital B. reanalyze the rhythm for confirmation C. assess the airway and ventilatory status D. remove the AED and apply 100% oxygen
assess the airway and ventilatory status
The most effective method for determining whether you are providing adequate artificial ventilation is A. assessing the chest for adequate rise B. assessing the pulse for a improving heart rate C. checking the pupils for increased reactivity D. checking the skin for improvement of cyanosis
assessing the chest for adequate rise
At the scene of a mass-casualty incident, you notice a bystander who is clearly emotionally upset. An appropriate action to take would be to A. tell the bystander to leave the scene at once. B. have the bystander assist you with patient care C. notify the police and have the bystander removed D. assign the bystander a simple, non-patient-care task
assign the bystander a simple, non-patient-care task
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. The patient's respirations are at a rate of 26 breaths/min and shallow. The most appropriate management includes A. a nasal cannula set at 1 to 6 L/min B. assisted ventilations with 100% oxygen C. a simple face mask set at 10 to 12 L/min D. A nonrebreathing mask set at 15 L/min
assisted ventilations with 100% oxygen
Accessory
assisting
Indications that artificial ventilations in an apneic adult are ineffective include A. a normal heart rate B. improvement of skin color C. asymmetrical rise of the chest D. ventilations given at 12 breaths/min
asymmetrical rise of the chest
According to the United States Department of Transportations EMT-Basic National Standard Curriculum, minimum staffing for a basic life support ambulance includes A. an EMT-Basic who functions as the driver B. at least one EMT-Basic in the patient compartment C. at least two EMT-Basics in the patient compartment D. a minimum of two EMT-Basics in the ambulance
at least one EMT-Basic in the patient compartment
You have completed your prehospital care report and left a copy at the hospital when you realize that you forgot to document a pertinent finding on the front of the report. Your most appropriate action would be to A. attach an addendum to the original run report. B. write the information on the original run report. C. complete a new run report and add the information. D. take no action and report the event to your supervisor
attach an addendum to the original run report
Posterior
back of the body
An EMT-B's failure to obtain consent to treat a patient could result in allegations of A. battery B. negligence C. abandonment D. breach of duty
battery
Consciousness
being aware and having perception
Hemorrhage
bleeding
hemorrhage
bleeding
hemopneumothorax
blood and air in the chest
temporal bone
bone that forms parts of the side of the skull and floor of the cranial activity. There is a right and left temporal bone.
cranium
bony structure making up the forehead, top, back, and upper sides of the skull
orbit
bony structures around the eyes; eye sockets
fracture
break (a bone)
Ecchymosis
bruising
Objective
can be observe by others
Which of the following parameters would be most reliable as an indicator of perfusion in a 1 year old child? A. Heart rate B. capillary refill C. Blood pressure D. Respiratory rae
capillary refill
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. Cardiac arrest in the adult population is most often the result of A. an acute stroke B. respiratory failure C. cardiac arrhythmias D. myocardial infarction
cardiac arrhythmias
subsystems of nervous system
central nervous system and peripheral nervous system
arachnoid
cerebral spinal fluid flows through this middle meninges layer.
You are called to a residence for a "sick" 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of A. 100% oxygen via a nonrebreathing mask and rapid transport. B. positive pressure ventilations with a BVM device and rapid transport. C. chest compressions, artificial ventilations, and rapid transport D. back blows and chest thrusts while attempting artificial ventilations
chest compressions, artificial ventilations, and rapid transport
Perfusion
circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.
perfusion
circulation of blood within an organ or tissue in adequate amounts to meet the current needs of the cells
In the patient with diabetes, hypoglycemia typically presents with A. dry skin and a slow onset B. dry skin and a rapid onset C. clammy skin and a slow onset D. clammy skin and a rapid onset
clammy skin and a rapid onset
decompensated shock
classification of shock when blood pressure falls, Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.
compensated shock
classification of shock when heart rate and respiration are increased and constriction of periphery , Body senses decrease in profusion and tries to compensate for it. Increased heart rate, increased respirations, constriction of peripheral circulation results in pale, cool skin. Increased capillary refill in infants.
irreversible shock
classification of shock when unable to maintain perfusion of vital organs and cell damage occurs, When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.
What three bones make up the shoulder girdle?
clavicle, scapula, humerus
the most important initial steps of assessing and managing a newborn include A. suctioning the airway and obtaining a heart rate B. clearing the airway and keeping the infant warm C. keeping the infant warm and counting respirations D. drying and warming the infant and obtaining an APGAR score
clearing the airway and keeping the infant warm
Firefighters have rescued a man from his burning house. he is conscious and in considerable respiratory distress. He has a brassy cough and singed nasal hairs. The most immediate threat to this patient's life is A. hypothermia B. severe burns C. sever infection D. closure of the airway
closure of the airway
A 75 year old man has generalized weakness and chest pain. He has a bottle of prescribed nitroglycerin and he states that he has not taken any of his medication. After initiating oxygen therapy, you should next A. apply the AED and prepare the patient for immediate transport B. perform a detailed physical examination to located any other problems. C. contact medical control for permission to assist the patient with his nitroglycerin. D. complete a focused physical examination, including obtaining baseline vital signs.
complete a focused physical examination, including obtaining baseline vital signs.
Immediately following a generalized motor seizure, most patients are A. apneic B. confused C. hyperactive D. awake and alert
confused
Ethnocentrism is defined as?
considering your own cultural values as more important when interacting with people of a different culture
Prior to administering nitroglycerin to a patient with chest pain, you must A. complete a detailed physical examination of the patient B. contact medical control and obtain proper authorization C. make sure that the systolic blood pressure is at least 120 mm Hg D. make sure that the nitroglycerin is prescribed to the patient or a family member
contact medical control and obtain proper authorization
As you are performing CPR on an elderly man, his wife presents you with a "do not resuscitate" order. Your most appropriate course of action is to A. ignore the document and continue the CPR B. comply with the document and stop CPR C. continue CPR until medical control is notified D. withhold CPR until medical control validates the order
continue CPR until medical control is notified
You are called to a residence for a woman in cardiac arrest. As you are initiating CPR, the patient's husband presents you with an unsigned document that states "do not resuscitate". Your most appropriate action in this case should be to A. stop all resuscitative efforts in accordance with the document. B. stop CPR until the document can be validated by a physician C. continue CPR until you have contacted medical control for guidance D. contact medical control prior to beginning any resuscitation measures.
continue CPR until you have contacted medical control for guidance
You are called to a local nightclub for an injured patient. Upon arrival, you see a young man who is lying on the ground screaming in pain, bright red blood is spurting from an apparent stab wound to his groin area. Your first action should be to A. control the bleeding B. apply 100% oxygen C. ensure an open airway D. elevate the patient's legs
control the bleeding
Initial care of a large avulsion includes A. cleaning the wound. B. controlling any bleeding C. assessing distal circulation D. immobilizing the injured area.
controlling any bleeding
autonomic nervous system
controls the involuntary actions of the body (heartbeat, breathing, control of diameter of vessels, sphincter muscles)
nervous system
controls thought, sensations, and motor functions (brain and spinal cord)
Snoring respirations are most rapidly managed by A. suctioning the oropharynx B. initiating assisted ventilations C. correctly positioning the head D. inserting an oropharnygeal airway
correctly positioning the head
An elderly woman who was removed from her burning house by firefighters has sustained full-thickness burns to approximately 50% of her body. Appropriate management for this patient should consist of A. applying moist, sterile dressings to the burned areas and preventing hypothermia. B. cooling the burns with sterile saline and covering them with dry, sterile burn pads. C. covering the burns with dry, sterile dressings and preventing further loss of body heat. D. peeling burned clothing from the skin and removing all rings, necklaces, and bracelets
covering the burns with dry, sterile dressings and preventing further loss of body heat.
Laceration
cut
laceration
cut, open head injury, caused by sharp bony ridges, object penetrates cranium
Infarction
death of a body tissue, usually caused by interruption of blood flow.
Air bags provide the final capture point of the passengers and decrease the severity of ___ injuries
deceleration
During your assessment of a 34-year old man with a gunshot wound to the chest, you note that his skin is pale. This finding is most likely caused by A. a critically low blood pressure B. increased blood flow to the skin C. decreased blood flow to the skin D. peripheral dilation of the vasculature
decreased blood flow to the skin
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. Shallow respirations will result in A. decreased tidal volume B. increased tidal volume C. increased oxygen intake D. increased carbon dioxide removal
decreased tidal volume
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. In infants and children, the most detrimental effect of gastric distention is A. increased ease of ventilations B. decreased ventilatory volume C. acute rupture of the diaphragm D. less effective chest compressions
decreased ventilatory volume
The ultimate goal of any EMS quality improvement program should be to A. deliver a consistently high standard of care to all patients who are encountered B. make sure that all personnel receive an adequate number of continuing education credits. C. provide EMS protocols to all EMTs and hold them accountable when protocols are not adhered to. D. provide recognition to all EMT's who have demonstrated consistency in providing competent patient care
deliver a consistently high standard of care to all patients who are encountered
After applying the AED to a 56-year old female in cardiac arrest, you analyze her cardiac rhythm and receive a "shock advised" message. First responders, who arrived at the scene before you, tell you that the patient was without CPR for about 10 minutes. You should A. perform 2 minutes of CPR and then defibrillate B. detach the AED and prepare for immediate transport C. deliver the shock as indicated followed immediately by CPR. D. notify medical control and request permission to cease resuscitation.
deliver the shock as indicated followed immediately by CPR
During your initial assessment of an unconscious adult patient, you find the patient is apneic. You should next A. assess for a carotid pulse B. begin chest compressions C. deliver two rescue breaths d. place an oropharyngeal airway
deliver two rescue breaths
Pulmonary artery
deoxygenated blood travels through this
baroreceptors
detect decreased blood pressure; alert adrenals
sensitization
developing a sensitivity to a substance that originally caused no allergic reaction
The safest ambulance driver is one who A. is physically fit B. has a positive attitude C. drives with due regard D. drives with lights and siren
drives with due regard
compensated shock
early stages of shock, where the body can still recover without help if the problem is resolved
When assessing breathing, breathing should appear:
easy, not labored. You should not be able to see or hear a pt breathing.
Damaged small blood vessels beneath the skin following blunt trauma manifests as A. mottling B. cyanosis C. hematoma D. ecchymosis
ecchymosis
The most effective means of preventing the spread of disease is A. effective handwashing B. up-to-date immunizations C. wearing gloves with all patients D. wearing a mask with all patients
effective handwashing
Cavitation
emanationof pressure waves that can damage nearby structures
Kinetic energy
energyof moving object
The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is indicated. You should A. deliver the shock and resume CPR B. ensure that nobody is touching the patient C. perform CPR for 2 minutes and then deliver the shock D. push the analyze button to confirm that the shock is indicated
ensure that nobody is touching the patient
A 56-year-old man with a history of cardiac problems reports pain in the upper midabdominal area. This region of the abdomen is called the A. peritoneum B. epigastrium C. mediastinum D. retroperitoneum
epigastrium
General guidelines when assessing a 2-year old child with abdominal pain and adequate perfusion include A. examining the child in the parent's arms. B. palpating the painful area of the abdomen first. C. placing the child supine and palpating the abdomen D. separating the child from the parent to ensure a reliable examination
examining the child in the parent's arms.
Dilate
expansion of a vessel or orifice
syncope
fainting
Febrile
fever
work
force acting over a distance
A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect A. croup B. epiglottitis C. lower respiratory infection D. foreign body airway obstruction
foreign body airway obstruction
Coagulation
formation of clot to plug opening in injured blood vessel and stop blood flow
flail chest
fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment.
A 42- year old man was ejected from his car after it struck a bridge pillar at a high rate of speed. You find him lying approximately 50' from the car. After manually stabilizing his head, your next action should be to A. assess the quality of his breathing B. grasp the angles of the jaw and lift C. administer high-concentration oxygen D. determine the patient's level of consciousness
grasp the angles of the jaw and lift
The bony prominence on the lateral/superior aspect of the thigh is called the:
greater trochanter.
bone
hard but flexible living structures that provide support for the body and protect vital organs
you receive a call for a 3 year old girl with respiratory distress. When you enter her residence, you see the mother holding the little girl, who does not acknowledge your presence. This finding indicates that the child a. has hypoxia B. probably is sleeping C. is afraid of your presence d. is reacting normally for her age.
has hypoxia
You arrive at a residence where you find a man lying unconscious in his front yard. There were no witnesses to the event that caused the unconsciousness. In assessing this man, you must assume that he A. has sustained an injury B. is having a heart attack C. is having a diabetic reaction D. is having a heat-related emergency
has sustained an injury
You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. When performing two-rescuer CPR on this patient, you should A. slowly compress the chest to a depth of about 1" to 1 1/2". B. not attempt to synchronize compressions with ventilations. C. have your partner pause after 30 compressions as you give two breaths. D. continue ventilations as the AED analyzes the patient's cardiac rhythm.
have your partner pause after 30 compressions as you give two breaths.
You are responding to a call for a 2 year old child who fell from a second story window. With the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's A. head B. chest C. abdomen D. lower extremities
head
A common side effect of nitroglycerin is A. nausea B. headache C. hypertension D. chest discomfort
headache
Heart
hollow muscular organ
perfusion
homeostasis
The information that would be of LEAST pertinence when educating the public on injury prevention is A. how to provide rescue breathing. B. the proper usage of child safety seats. C. building a childproof fence around a pool. D. teaching children to wear bicycle helmets.
how to provide rescue breathing.
Mechanism of injury
how trauma occurs
Patients with closed head injuries often have pupillary changes and A. paralysis B. paresthesia C. hypertension D. tachycardia
hypertension
An elderly man is found unconscious in his kitchen. The patient's wife tells you that her husband has diabetes and that he took his insulin, but did not eat anything. You should suspect A. ketoacidosis B. diabetic coma C. hypoglycemia D. hyperglycemia
hypoglycemia
Secondary respiratory drive is?
hypoxic drive. (When oxygen falls, this will stimulate breathing)
realignment
if extremity is cynotic or lacks pulse * restores effective circulation * splint may be ineffective otherwise * decreases circulatory compromise * reduction in pain
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. After attaching the AED, you push the analyze button and receive a "shock advised" message. After delivering the shock, you should A. assess for a carotid pulse B. immediately perform CPR C. reanalyze the cardiac rhythm D. open the airway and ventilate
immediately perform CPR
Blunt trauma
impact on the body by objects that cause injury without penetrating soft tissue or internal organs and cavities
As you are providing initial ventilations to a patient with apnea using a bag-valve-mask device, you note minimal rise of the chest. You should next A. initiate the mouth-to mask technique B. increase the volume of the ventilations C. switch to a smaller mask for the BVM device D. ensure that a reservoir is attached to the BVM device
increase the volume of the ventilations
cushing triad
increased blood pressure, decreasing pulse, and sometimes irregular breathing
What is the most detrimental effect that tachycardia can have on a patient experiencing cardiac compromise? A. increased blood pressure B. increased oxygen demand C. increased stress and anxiety D. decreased cardiac functioning
increased oxygen demand
Involuntary
independent or without conscious choice
Which of the following is the most common cause of shock (hypoperfusion) in infants and children? A. infection B. Cardiac failure C. Accidental poisoning D. sever allergic reaction
infection
After an initial attempt to ventilate a patient fails, you reposition the patient's head and reattempt ventilation without success. You should next A. assess for a carotid pulse and initiate CPR if necessary B. use a flow-restricted oxygen-powered ventilation device C. initiate airway obstruction removal techniques and provide transport D. continue to reposition the patient's head at the scene until you are able to secure a patent airway
initiate airway obstruction removal techniques and provide transport
During the initial assessment of an unconscious trauma patient, you find that the patient is breathing inadequately, has a weak radial pulse, and is bleeding from a lower extremity wound. You should direct your partner to A. radio for an ALS ambulance to respond to the scene. B. apply direct pressure to the bleeding as you assist ventilations. C. initiate positive pressure ventilations as you control the bleeding. D. prepare the long spine board and straps for rapid immobilization.
initiate positive pressure ventilations as you control the bleeding.
Penetrating trauma
injury caused by objects that pierce the surface of the body
contusion
injury that doesn't break the skin, characterized by pain, swellin, and discoloration; bruise
pia mater
innermost layer of the brain
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. After performing a head tilt-chin lift maneuver on this patient, you should next A. assess her respirations B. determine the need for oxygen C. insert an oropharyngeal airway D. insert a nasopharyngeal airway
insert a nasopharyngeal airway
hypothermia
internal body temperature is below healthy levels (95 degrees)
LLQ contains:
intestines
How can naloxone be administered to the patient?
intranasal through a syringe with an atomizer attachment injected into the patient through a syringe
smooth muscle
involuntary muscle found in internal organs
After clearing the airway of a newborn who is not in distress, it is most important for you to A. apply free-flow oxygen B. clamp and cut the chord C. keep the newborn warm. D. obtain an APGAR score.
keep the newborn warm.
As an EMT-Basic, your primary responsibility is to A. provide competent patient care B. ensure the safety of your partner C. keep yourself as safe as possible D. transport all patients to the hospital
keep yourself as safe as possible
Proper body mechanics when lifting and moving a patient include A. maintaining a slight curvature of your back B. using the muscles of your lower back to lift C. keeping the weight as close to you as possible D. twisting at the waist when moving a patient around a corner
keeping the weight as close to you as possible
KED
kendrick extrication device
Pallor
lack of color; pale
Ischemia
lack of oxygen that deprives tissues of the necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because pertinent injury has not yet occurred.
Aorta
largest artery in body
decompensated shock
late stages of shock, where blood pressure is falling and the body needs medical help to recover
supine
laying on back face up, palms up. etc.
When monitoring a patient with a head injury, the most reliable indicator of his or her condition is the A. pupillary reaction B. level of consciousness C. systolic blood pressure D. rate and depth of breathing
level of consciousness
An 80-year old woman has pain in the right upper quadrant of her abdomen and a yellowish tinge to her skin. You should suspect dysfunction of the A. liver B. spleen C. pancreas D. gallbladder
liver
The immobilization device most appropriate to use for a patient with multiple injuries and unstable vital signs is a A. scoop immobilization device B. vest-style immobilization device C. short spine board immobilization device D. long spine board immobilization device
long spine board immobilization device
To obtain the most reliable assessment of a patient's tidal volume, you should A. assess for retractions B. listen for airway noises C. count the respiratory rate D. look at the rise of the chest
look at the rise of the chest
When assessing a patient with a gunshot wound, you should routinely A. apply ice directly to the wound B. determine why the patient was shot C. look for the presence of an exit wound D. evaluate the pulses proximal to the wound
look for the presence of an exit wound
What are 5 common symptoms of a patient that has overdosed on narcotics?
loss of Consciousness Patient Unable to Protect Their Airway Patient Can Go Into Respiratory Failure w/Slow Shallow Breathing Slow Patient Respiratory Drive Respiratory Distress
dehydration
loss of water from tissues
Ventricle
lower chamber
You are managing a 10-month old infant who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. You have initiated supplemental oxygen therapy and elevated the lower extremities. En route to the hospital, you note that the child's work of breathing has increased. What must you do first? A. lower the extremities and reassess the child B. Begin positive pressure ventilations and reassess the child C. Place a nasopharyngeal airway and increase the oxygen flow. D. Listen to the lungs with a stethoscope for abnormal breath sounds.
lower the extremities and reassess the child
Your first action in managing a patient with an altered mental status should be to A. give the patient oral glucose B. administer 100% supplemental oxygen C. make sure that the patient is breathing adequately D. try to determine the cause of the altered mental status
make sure that the patient is breathing adequately
To ensure delivery of the highest concentration of oxygen to your patient using a nonrebreathing mask, you should A. set the flow rate to at least 12 L/min B. securely fasten the mask to the patient's face C. make sure that the reservoir bag is pre inflated D. cover the one-way valves on the oxygen mask
make sure that the reservoir bag is pre inflated
You are caring for a 6-year old child with a swollen, painful deformity to the left forearm. As you communicate with the parents of this child, you should A. ask them repeatedly how the child was injured B. use appropriate medical terminology at all times. C. make sure that they remain aware of what you are doing. D. tell them that the child will be transported to the hospital
make sure that they remain aware of what you are doing.
You arrive at the scene of a fall where you encounter a male patient who fell approximately 30' and landed on his head. He is unconscious with an open head injury and exposed brain matter. Upon identifying this patient as an organ-donor, you should A. request authorization from medical control not to initiate care. B. manage the patient aggressively and provide rapid transport C. recognize that the patient's injuries disqualify him as an organ donor. D. provide supportive care only because the patient likely will not survive.
manage the patient aggressively and provide rapid transport
During a soccer game, an 18 year old woman injured her knee. You note that the knee is in the flexed position and is obviously deformed. Your first action should be to A. assess her distal circulation B. straighten the knee to facilitate immobilization C. manually stabilize the leg above and below the knee D. immobilize the knee in the position in which it was found
manually stabilize the leg above and below the knee
As you begin your assessment of an unresponsive man who fell approximately 20' from a roof, you should first A. gently shake the patient to confirm unresponsiveness B. gently tilt the patient's head back to assess for breathing C. assess the rate, depth, and regularity of the patient's breathing D. manually stabilize the patient's head and perform a jaw-thrust maneuver
manually stabilize the patient's head and perform a jaw-thrust maneuver
Hematoma
mass of blood in the soft tissues beneath the skin
You are caring for a 66-year-old woman with sever pressure in her chest. As you initiate oxygen therapy, your partner should A. notify medical control B. obtain a SAMPLE history C. measure the blood pressure D. gather the patient's medications.
measure the blood pressure
cardiac tamponade
mechanical compression of the heart resulting from large amounts of fluid collecting in the pericardial space and limiting the heart's normal range of motion
Abuse
misuse; excessive or improper use
At the peak of the inspiratory phase, the alveoli in the lungs contain A. high quantities of carbon dioxide B. minimal levels of oxygen and carbon dioxide C. equal levels of oxygen and carbon dioxide D. more oxygen than carbon dioxide
more oxygen than carbon dioxide
The role of triage officer at a mass-casualty incident should be assumed by the A. most knowledgeable EMS provider B. EMS provider with the most years of experience. C. first EMS provider who is willing to perform the task D. EMS medical director via telephone communication
most knowledgeable EMS provider
paradoxical motion
movement of ribs in a flail segment that is opposite to the direction of the rest of the chest cavity.
Abduction
moving away from midline
Signs of inadequate breathing in an pedi include:
muscle retractions, pale or cyanotic, cold and damp skin, tripod position, nasal flaring, and seesaw respirations.
Ataxic
muscular in coordination
The middle, muscular layer of the heart is called the A. epicardium B. pericardium C. myocardium D. endocardium
myocardium
Signs of adequate breathing in a pedi include:
non-labored, normal rate, regular rhythm, good audible breath sounds, regular rise and fall of chest, and movement of the abdomen.
epistaxis
nose bleed
Epistaxis
nosebleed
Benign
not causing harm
Subjective
not perceptible to an observer
A sudden onset of respiratory distress in a 5 year old child with no fever most likely is the result of A. infection of the lower airways B. inflammation of the upper airway C. a progressive upper airway infection D. obstruction of the airway by a foreign body
obstruction of the airway by a foreign body
neck wound
occlusive dressing to prevent and air embolism
Following an apparent febrile seizure, a 4 year old boy is alert and crying. His skin is warm and moist. The most appropriate management of this child includes A. rapidly cooling the child in cold water B. allowing the parents to transport the child C. offering oxygen and providing transport D. keeping the child warm and providing transport
offering oxygen and providing transport
As you step out of the ambulance at the scene of a nighttime motor vehicle crash on the highway, your immediate concern should be A. oncoming traffic B. whether the car will catch on fire C. placing safety flares by the ambulance D. quick assessment of the patients in the car
oncoming traffic
Atrium
one of two (right and lef upper chambers of the heart. The right atrium receives blood from the vena cava and delivers it to the right ventricle. The left atrium receives blood from the pulmonary veins and delivers it to the left ventricle.
Ventricle
one of two (right and left) lower chambers of the heart. The left ventricle receives blood from the left atrium (upper chamber) and delivers blood to the aorta. The right ventricle receives blood from the right atrium and pumps it into the pulmonary artery.
mandible
only movable bone of the skull
Patent
open
As you are assessing an elderly man who is complaining of chest pain, the patient suddenly loses consciousness. Your first step should be to A. attach the AED B. open the airway C. assess for a pulse D. assess for breathing
open the airway
Care for an alert 4-year old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color includes A. back blows, abdominal thrusts, transport B. oxygen, avoiding agitation, transport C. assisting ventilations, back blows, transport D. chest thrusts, finger sweeps, transport
oxygen, avoiding agitation, transport
Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include a. oxygen, uterine massage, and transport. B. oxygen, placement on the left side, and transport C. oxygen, treatment for shock, and uterus massage during transport D. oxygen, internal vaginal pads, and treatment of shock during transport.
oxygen, treatment for shock, and uterus massage during transport
The most appropriate management of a patient who has sustained widespread full-thickness burns following an explosion should consist of applying A. oxygen; dry, sterile dressings; warmth; and providing rapid transport B. oxygen; dry; sterile dressings; burn ointment; and providing rapid transport C. oxygen; moist; sterile dressings; warmth; and providing rapid transport D. oxygen; moist; sterile dressings; burn ointment; and providing rapid transport
oxygen; dry, sterile dressings; warmth; and providing rapid transport
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. the most reliable indicator of injury to the spinal vertebrae is A. lack of pain at the site of the injury. B. palpable pain at the site of the injury. C. decreased movement on one side of the body D. decreased grip strength in the upper extremities
palpable pain at the site of the injury.
The effectiveness of chest compressions are most effectively assessed by A. listening for a heartbeat with each compression B. carefully measuring the depth of each compression C. palpating for a carotid pulse with each compression D. measuring the systolic blood pressure during compressions
palpating for a carotid pulse with each compression
A 5 year old boy complains of pain to the right lower quadrant of his abdomen. Correct assessment of this child's abdomen includes A. avoiding palpation of the abdomen B. palpating the left upper quadrant first C. auscultating bowel sounds for 2 minutes D. palpating the right lower quadrant first
palpating the left upper quadrant first
As you assess a 56-year old man, you note that he is pulseless and apneic. As your partner gets the AED from the ambulance, you should A. obtain a medical history from the wife. B. place the patient in the recovery position C. perform CPR until the AED is ready to use D. conduct a detailed examination of the patient.
perform CPR until the AED is ready to use
Dermis
pertaining to skin
Gastric
pertaining to stomach
Pedal
pertaining to the foot
Peripheral
pertaining to the outer parts or surface of the body; away from the center
Postural
pertinent to or affected by body position
The bones that comprise the fingers and toes are called?
phalanges
While caring for a critically injured patient, you remove blood-soaked clothing in order to manage injuries. You should dispose of the clothing by A. leaving it at the scene B. leaving it at the hospital C. placing it in a biohazard bag D. placing it in the ambulance trash can
placing it in a biohazard bag
Management of an 18-year old woman with severe vaginal bleeding includes all of the following, EXCEPT A. high concentrations of oxygen B. elevation of the lower extremities C. placing sterile dressings into the vagina D. covering the vagina with a trauma dressing
placing sterile dressings into the vagina
After assisting a patient with her epinephrine auto-injector, you should dispose of the device by A. giving it to the patient to have it refilled B. placing the device in a red biohazard bag. C. placing the device in a puncture proof container D. replacing the cover and putting it in a trash can
placing the device in a puncture proof container
cerebrospinal fluid (CSF)
plasma like clear fluid circulationg in and around the brain and spinal cord
extremity
portions of the skeleton that includes the clavicles, scapulae, arms, wrists, and hands (upper extremities) as well as the pelvis, thighs, legs, ankles, and feet (lower extremities)
You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. As your partner confirms cardiac arrest and begins one-rescuer CPR, you should A. notify medical control B. insert an airway adjunct C. prepare the AED for use D. obtain a SAMPLE history
prepare the AED for use
The chest pain associated with cardiac compromise often is described as A. sharp B. stabbing C. pressure D. cramping
pressure
The police summon you to a residence for a domestic dispute. When you arrive, you are advised by a police officer that a man, who is now in custody, shot his wife. When you enter the residence, you see a woman lying supine. She is conscious, but very restless, and is in obvious respiratory distress. Upon discovering an open chest wound, your first action should be to A. prevent air from entering the open wound B. begin assisted ventilation and prepare for transport C. immediately reassess the patient's ventilatory status D. cover the wound with a trauma dressing and reassess the patient's ventilatory status
prevent air from entering the open wound
Potential energy
product of mass, gravity, and height
Diaphoretic
profuse sweating
the initial treatment of choice for ventricular fibrillation of short duration, such as a witnessed cardiac arrest is A. 100% oxygen delivery B. prompt defibrillation C. CPR for 2 minutes D. cardiac drug therapy
prompt defibrillation
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. the patient tells you that he does not have his own epinephrine; however, his wife is allergic to bees and has a prescribed epinephrine auto-injector. you should next. A. provide transport and consider an ALS rendezvous B. assist the patient with the wires prescribed epinephrine C. obtain consent from medical control to give the wife's epinephrine to the patient D. assist the patient with one half the usual dose of the wife's epinephrine.
provide transport and consider an ALS rendezvous
Prevention of cardiac arrest in infants and small children should focus primarily on A. keeping the child warm B. avoiding upsetting the child C. providing immediate transport D. providing airway management
providing airway management
You are providing care to a male patient at the scene of a shooting. the police are at the scene collecting evidence Your actions should include A. limiting your care to the initial assessment. B. beginning care when the police authorize you to C. beginning immediate care as you would with any other patient D. providing care to the patient while manipulating the scene minimally.
providing care to the patient while manipulating the scene minimally.
A 60-year-old woman is experiencing severe respiratory distress. When you ask her a question, she can only say two words at a time. You should manage this patient by A. inserting a nasopharyngeal airway B. providing positive pressure ventilations. C. applying a nasal cannula set at 2 to 6 L/min. D. applying a nonrebreathing mask set at 15 L/min.
providing positive pressure ventilations.
You are managing a conscious patient who you believe is having an acute ischemic stroke. After administering oxygen, your next priority should include: A. providing prompt transport for possible fibrinolytic therapy. B. determining whether the patient has prescribed nitroglycerin C. closely monitoring the blood pressure D. completing a detailed physical examination before providing transport.
providing prompt transport for possible fibrinolytic therapy.
you should suspect potential abuse of a 4 year old child when you encounter A. bruises to the anterior tibial area B. curious siblings who are watching you C. purple and yellow bruises to the thighs D. clinging to the parent during your assessment
purple and yellow bruises to the thighs
tachycardia
rapid heart beat
While managing a patient with acute shortness of breath, you prepare and apply a nonrebreathing mask set at 12 L/min. The patient pulls the mask away from his face, stating that it is smothering him. You should next A. increase the oxygen flow and reapply the mask B. securely tape the oxygen mask to the patient's face C. reassure the patient and apply a nasal cannula instead D. inform the patient that refusing oxygen might result in his death
reassure the patient and apply a nasal cannula instead
in addition to oxygen therapy; the most effective way to minimize the detrimental effects associated with cardiac compromise is to A. give the patient up to 4 doses of nitroglycerin B. reassure the patient and provide prompt transport C. transport the patient rapidly, using lights and siren D. request ALS support for all patients who have chest pain.
reassure the patient and provide prompt transport
List 4 risk factors for increased clotting of the blood
recent surgery, congestive heart failure, impaired mobility, cancer
Anemia
reduction in the number of circulating red blood cells
Prescribed inhalers, such as albuterol (Ventolin), relieve respiratory distress by A. constricting the bronchioles in the lungs. B. contracting the smaller airways in the lungs. C. relaxing the smooth muscle of the bronchioles. D. dilating the large mainstem bronchi of the airway.
relaxing the smooth muscle of the bronchioles.
While performing a visual inspection of a 30-year-old woman in active labor, you can see the umbilical cord at the vaginal opening. After providing high concentration oxygen, you should next A. massage the uterus to facilitate delivery of the fetus. B. relieve pressure from the cord with your gloved fingers. C. place the mother on her left side and provide rapid transport D. elevate the mother's lower extremities and provide immediate transport.
relieve pressure from the cord with your gloved fingers.
You have applied a pressure bandage and additional dressings to a large laceration with severe arterial bleeding. The bandages are quickly blood-soaked. You should next A. elevate the extremity and apply a proximal arterial tourniquet B. apply pressure to the pulse point that is most distal to the injury C. place additional dressings on the wound until the bleeding stops D. remove the bandages and apply pressure at the site of the bleeding
remove the bandages and apply pressure at the site of the bleeding
During a bar fight, a 22-year old man was stabbed in the chest with a large knife. The patient is pulseless and apneic, and the knife is impaled in the center of his chest. management should include A. stabilizing the knife, starting CPR, and providing rapid transport B. stabilizing the knife, applying an occlusive dressing and providing rapid transport C. removing the knife, starting CPR, and providing rapid transport D. removing the knife, applying an occlusive dressing, and providing rapid transport.
removing the knife, starting CPR, and providing rapid transport
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. While en route to the hospital with the male patient, you begin a detailed physical exam. During the exam, you note that the patient's respiratory rate has increased. You should A. immediately notify the receiving facility B. count the number of respirations per minute C. assess his oxygen saturation with a pulse oximeter D. repeat the initial assessment and treat as needed
repeat the initial assessment and treat as needed
Medical control has ordered you to administer one tube of oral glucose to your patient suspected of having hypoglycemia. Immediately after receiving this order, you should A. document the order on the prehospital care report B. administer the medication and reassess the patient C. ask medical control to repeat the order word for word D. repeat the order back to medical control word for word
repeat the order back to medical control word for word
When you arrive at a mass-casualty incident at which other ambulances already have arrived, you should first A. repeat the triage process B. report to the incident commander C. initiate care for the most critically injured patients D. obtain information from the fire service commander
report to the incident commander
You arrive at the scene of a traffic accident in which multiple vehicles are involved. You see at least two patients who appear to be unconscious. Your first action should be to A. begin triaging the patients B. begin immediate patient care C. notify medical control for advice D. request an additional ambulance
request an additional ambulance
hypovolemic shock
results from fluid volume loss after severe hemorrhage or loss of plasma in burn patients.
A set of regulations and ethical considerations that define the extent or limits of an EMT-Basic's job is called A. a duty to act B. confidentiality C. scope of practice D. the Medical Practices Act (??? can't read this for sure)
scope of practice
dermis
second layer of skin, holding blood vessels, nerve endings, sweat glands, and hair follicles
When applying a vest-style spinal immobilization device to a patient with traumatic neck pain, you should A. immobilize the head prior to securing the torso straps. B. secure the torso section prior to immobilizing the head. C. ask the patient to fully exhale as you secure the torso. D. gently flex the head forward as you position the device.
secure the torso section prior to immobilizing the head.
A 7-year old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for A. vomiting B. seizures C. combativeness D. respiratory distress
seizures
The position of comfort for a patient with nontraumatic chest pain most commonly is A. semisitting B. lateral recumbent C. on the side with the head elevated D. supine with the legs elevate slightly
semisitting
aortic dissection
separation of the layers of the aortic wall, inner layer tears, most occur because artery's wall deteriorates due to high blood pressure
When assessing a patient with a reduction in tidal volume, you would expect the respirations to be A. deep B. labored C. shallow D. dyspneic
shallow
hypoperfusion
shock
obstructive shock
shock caused by a block to blood flow in the heart, causing insufficient nutrient transfer to the cardiac tissues
anaphylactic shock
shock caused by anaphylaxis
hypovolmeic shock
shock caused by fluid or blood loss
septic shock
shock caused by severe infection, typically bacterial
psychogenic shock
shock caused by sudden, temporary reduction of blood to the brain
cardiogenic shock
shock caused pump failure
Bradycardia
slow hear rate (below 60)
Deceleration
slowing
Prior to your arrival at the scene, a near-drowning victim was removed from the water. You should manage the patient's airway appropriately while considering the possibility of A. spinal injury B. hyperthermia C. internal bleeding D. airway obstruction
spinal injury
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. After taking body substance isolation precautions, you begin your initial assessment of the man. Your first action should be to A. apply an extrication collar B. stabilize his head manually C. evaluate the patency of his airway D. roll him to a supine position
stabilize his head manually
What physical findings are associated with hyperglycemia?
staggering, intoxicated appearance, unresponsiveness, kussmaul respirations, dehydration, sweet, fruity odor on breath, rapid-weak heartbeat.
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. Your first action in the management of this patient should be to A. attach an AED and analyze the cardiac rhythm. B. check the effectiveness of the CPR in progress. C. insert an oropharyngeal airway and continue CPR D. stop CPR so you can assess pulse and breathing
stop CPR so you can assess pulse and breathing
Distend
stretch
tendon
strong connective tissue that attaches muscle to bone
ligament
strong connective tissue that holds bones together in movable joints
Parasympathetic Nervous System
subdivision of the autonomic nervous system, involved in the control of involuntary, vegetative functions, mediated largely by the vagus nerve to the chemical acetylcholine.
Seat belts that buckle automatically at the shoulder but require the passengers to buckle the lap portion can result in the body ___ forward underneath the shoulder restraint when the lap portion is not attached
submarining
Immediately upon delivery of a newborn's head, you should first A. dry the face B. cover the eyes C. suction the nose D. suction the mouth
suction the mouth
A 4-year old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, you should A. suction the oropharynx B. insert a nasopharyngeal airway C. initiate positive pressure ventilations D. CANT READ it
suction the oropharynx
traumatic asphyxia
sudden compression of the chest
musculoskeletal
support, protection, movement of body, protection of blood cells
edema
swelling because of an abnormal amount of fluid intercellulary
Dependent Edema
swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure.
aneurysm
swelling of an artery because of a weakened arterial wall
Hematoma
swelling which contains blood
During your rapid trauma assessment of a critically-injured patient, you should assess the chest for A. symmetry and pain B. rigidity and guarding C. crepitus and distention D. distention and guarding
symmetry and pain
homeostasis
systemic balance
neurogenic shock
systemic vasodilation caused by a damage to the spinal cord
You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. After successfully resuscitating the patient, you provide immediate transport. While en route to the hospital, the patient goes back into cardiac arrest. Your next step should be A. tell your partner to stop the ambulance. B. Begin CPR and proceed to the hospital C. contact medical control for further advice. D. analyze the patient's rhythm with the AED.
tell your partner to stop the ambulance
Ischemia
temporary decrease or lack of the oxygen circulation
Malignant
tending to threatening to produce death
Automaticity
the ability of cardiac muscle cells to contract without stimulation from the nervous system.
myocardial contractility
the ability of the heart to contract
Posterior
the back surface of the body; the software from you in the standard anatomic position.
Coronary Arteries
the blood vessels that carry blood and nutrients to the heart muscle.
cyanosis
the blueish tinge to the skin resulting from poor oxygen circulation
Patella
the bone located at the knee
nasal bones
the bones that form the upper third, or bridge, of the nose.
Metatarsals
the bones that lead to the toes. Also called phalanges
spinous process
the bony bump on the bottom of the spine
The EMT-B should consider performing 2 minutes of CPR prior to attaching the AED to adult victims of cardiac arrest when A. the arrest is caused by a traumatic injury B. the patient's cardiac arrest was witnessed C. the call-to-arrival time is more than 5 minutes. D. the patient has known coronary artery disease
the call-to-arrival time is more than 5 minutes
hematoma
the collection of blood within the tissue from damaged blood vessels. (names bases on location in brain - subdural, epidural, and intracerebral)
Asystole
the complete absence of any electrical cardiac activity, appearing as a straight line or almost straight line on an ECG strip.
afterload
the force of resistance against which the heart pumps
Anterior
the front surface of the body; the side facing you in the standard anatomic position.
Systolic is?
the increased pressure that is caused along the artery with each contraction of the ventrical pulse.
Lumen
the inside diameter of an artery or other hollow structure.
subcutaneous layer
the layer of fat and connective tissues below the dermis of the skin
brachial artery
the main artery of the upper arm
Aorta
the main artery that receives blood from the left trenchcoat and delivers it to all other arteries that can carry blood to the tissues of the body.
femoral artery
the major artery supplying the leg
temporomandibular joint
the movable joint formed between the mandible and the temporal bone, also called the TMJ.
cardiac muscle
the muscle tissue of the heart
Aortic Valve
the one-way valve that lies between the left ventricle and the aorta and keeps blood from flowing back into the left ventricle after the left ventricle ejects its blood into the aorta;one of four heart valves.
Inferior
the part of the body or any body part nearer to the feet.
Superior
the part of the body or body parts closer to the head.
Autonomic Nervous System
the part of the nervous system that regulates involuntary functions, such as heart rate, blood pressure, digestion and sweating.
Origin
the source of anything; starting point
avulsion
the tearing away or tearing off of a piece or flap of skin or other soft tissue. Also, an eye pulled from its socket or a tooth dislodged from its socket
maxillae
the two fused bones forming the upper jaw
dura mater
thick, outermost layer of the meninges surrounding and protecting the brain and spinal cord
artery
thick-walled muscular blood vessel that carries blood away from the heart
You are at the scene where a man panicked while swimming in a small lake. As you attempt to rescue this patient, you should first A. throw a rope to the patient B. row a small raft to the patient C. swim to the patient to rescue him D. attempt to grab the patient with a stick
throw a rope to the patient
muscle
tissue composed of fibers that can contract, causing movement of an organ or part of the body
Infaction
tissue death after the blood supply has been blocked
When providing care to multiple patients at the scene of a mass-casualty incident, your goal should remain focused on A. transporting patients to the hospital B. immobilizing all patients at the scene C. initiating CPR for those in cardiac arrest D. keeping all bystanders at a safe distance
transporting patients to the hospital
Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. You should manage this situation initially by A. clamping and cutting the umbilical cord B. gently pulling on the cord to facilitate removal C. trying to remove the cord from around the neck. D. keeping the cord moist and providing rapid transport
trying to remove the cord from around the neck.
What are the contraindications to administering oral glucose?
unconscious - inability to swall
Cells in the kidney can live how long without oxygen?
up to 45 minutes
Atrium
upper chamber
Backboard:
usde for most situations, needs multiple people to make it safe
Scoop Stretcher
used when log rolling is not an option
vein
vessel that carries unoxygenated blood to the heart from body tissues
Emesis
vomit
Systole
when the heart chambers empty by muscular contraction
When dealing with an emotionally disturbed patient, you should be concerned with A. providing safe transport B. whether the patient could harm you C. obtaining a complete medical history D. gathering all of the patient's medications
whether the patient could harm you
Dilation
widening of a tubular structure such as a coronary artery.
Afebrile
without fever
Asymptomatic
without symptoms
General care for an amputated body part includes A. Immersing the amputated part in cold water to prevent further damage B. thoroughly cleaning the amputated part and wrapping it in a sterile dressing. C. wrapping the amputated part in a moist, sterile dressing and placing it on ice. D. wrapping the amputated part in a moist, sterile dressing and keeping it warm.
wrapping the amputated part in a moist, sterile dressing and placing it on ice.
What four qualifications does a patient have to have to receive oral glucose?
Conscious Able to Swallow History of Diabetes Altered Mental Status
signs of bone injury
1. Pain and tenderness 2. deformity or angulation 3. grating or crepitus 4. swelling 5. bruising 6. exposed bone ends 7. joints locked in position 8. nerve and blood vessel compromise
Compensation Mechanisms
1. Tachycardia - If loss of circulating blood volume, increased heart rate and force of contraction. 2. Peripheral vasoconstriction - Body will constrict peripheral blood vessels to try and increase blood pressure and increase perfusion to vital organs 3. Body will increase respiratory rate to improve oxygenation 4. Falling blood pressure is a late sign of shock. It indicates the body's defense mechanisms are no longer working. - Assume any patient with suspected shock and hypotension is in decompensated shock. Treat as a high transport priority
6 types of open wounds
1. abrasions 2. lacerations 3. punctures 4. avulsions 5. amputation 6. crush
6 important factors in determining the severity of burns
1. agent or source 2. body region involved 3. depth 4. extent 5. age of patient 6. other illness or injury
3 ways to classify a burn
1. agent or source 2. depth 3. severity
8 steps in patient care for electrical burns
1. airway 2. basic life support 3. manage shock and provide o2 4. care for spine and head injuries 5. evaluate electrical burns for entrance and exit wounds 6. cool burn if still hot 7. apply dry sterile dressings 8. transport
3 steps in patient treatment for amputations
1. apply pressure dressing to stump 2. pressure points 3. care for amputated part
4 steps in direct pressure
1. apply pressure to wound 2. hold pressure firmly 3. bandage 4. don't remove dressing
7 steps in patient care for hip
1. asses distal CMS 2. apply long spine board 3. immobilize limb with pillows or blankets 4. secure patient 5. reassess distal CMS 6. treat shock and provide o2 7. transport
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. assist her ventilations with a bag-mask device, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.
C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. determine the underlying cause of her problem. B. ask questions related to her gynecologic history. C. maintain her ABCs and transport without delay. D. keep assessment and treatment to a minimum.
C. maintain her ABCs and transport without delay.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: A. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.
C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine
What route of drug administration is injected under the skin?
Subcutaneous Route
Sterilization
Subjecting an object to chemical or physical substances (typically, superheated steam in an autoclave) that kill all microorganisms
Humerus
Sopporting bone of the forearm
A 9-year-old girl was struck by a car while she was crossing the street and is displaying signs of shock. During your assessment, you note a large contusion over the left upper quadrant of her abdomen. Which of the following organs has most likely been injured? A. Liver B. Kidney C. Spleen D. Pancreas
Spleen
Rigor mortis
Stiffening of body muscles caused by chemical changes in the body. Develops in the face and jaw, gradually extending downward. Onset is affected by body's ability to lose temp (thin=fast, fat body=slow). Occurs between 2-12 hours after death
LUQ contains:
Stomach, spleen, pancreas, colon
Extension
Straightning of a joint
Proximal
Structures closer to the trunk
Distal
Structures further from the trunk