EMT FINAL
List treatment for low blood pressure in an adult
Administer high flow oxygen, treat for possible shock, and elevate feet (Trendelenburg position)
Suctioning tip devices for all ages
Adults & Children Catheter or "yankaure" Infants - Bulb suction
Signs, Symptoms, and Vitals of stroke patient (adults and children too)
Adults- S&S: numbness, facial droop trouble speaking or understanding speech, trouble walking/ lack of coordination. Vital signs: high heart rate, slightly high bp. Children- S&S: difficultly talking, vomiting, stiffness, sudden collapse, loss of consciousness, weakness of face arms or legs.
Classification of Albuterol
Albuterol is in a class of medications called bronchodilators. It works by relaxing and opening air passages to the lungs to make breathing easier.
Biggest cause of adult drownings?
Alcohol
Identify risks for adult drowning
Alcohol consumption, underlying condition, preexisting seizure disorders, geriatric patients with cardiovascular disease, and unsupervised access to water.
List ways in which an allergen can enter the body
Allergens can enter the body by inhalation, injection, absorption, and ingestion.
List signs and symptoms of a closed head injury
Altered mental status, dazed, confused, disoriented, headache, nausea, vomiting, fatigue or drowsiness, problems with speech, difficulty sleeping, dizziness or loss of balance.
List signs and symptoms of shock in an adult
Altered mental status, diaphoretic, pale cool, rapid and weak pulse, low blood pressure, shallow breaths, and cyanosis.
List conditions likely found on a medical identification bracelet.
Alzheimer's, asthma, autism, celiac disease, Diabetic, bleeding disorders, blood disorders, drug allergies, DNR
Define Avulsion
An injury in which soft tissue is torn completely loose or is hanging as a flap.
Are AIDS airborne?
No
Is it the EMT's job to determine depths of wounds such as stabbing?
No
List treatment for an abdominal evisceration
Occlusive, moist dressing over the wound, don't push on abdomen and don't try to put the organs back into the body.
Hypothermia
Occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Normal body temperature is around 98.6 F (37 C). Hypothermia occurs as your body temperature falls below 95 F (35 C).
Describe airway management for an adult with a suspected spinal injury
Open airway with modified jaw thrust maneuver, suction mouth no more than 15 seconds if need be, if unconscious insert an OPA, give high flow oxygen.
List applications of an occlusive dressing
Open chest wound, abdominal evisceration, neck wound, penetrating back wounds.
What is the first assessment step of a fracture?
PMS
List components of scene size up
PPE, Scene safety, number of patients, MOI/NOI, call ALS and transport, consider C-spine stabilization.
List steps for transporting an amputated hand
PPE, control bleeding either direct pressure or tourniquet, place hand in plastic bag and keep the bag cool.
List signs and symptoms of appendicitis
Pain in your lower right quadrant, nausea, vomiting, anorexia, fever, chills.
List signs and symptoms of an allergic reaction caused by an insect sting.
Pain, swelling, localized heat, widespread urticaria (hives) and redness in light skinned people at site of injury. In more severe allergic reactions (anaphylactic) cases, Broncho spasms and wheezing, chest tightness and coughing dyspnea, anxiety, gastro complaints, and hypotension. Occasionally respiratory failure.
What patients should be put into "recovery position"?
Patients with no life threatening conditions, breathing, and are unconscious.
List parts of the pelvis
Pelvis: Ilium, iliac crest, ischium, ischial tuberosity, pubic bone
Define Perfusion
Perfusion - the ability of the body to take in oxygen and deliver it to every single cell in the body, pick up waste products, dispose of them.
Define BSI precautions
Personnel protective equipment and body substance isolation.
List signs and symptoms of narcotic use
Pinpoint pupils, hypotension, sedation or coma, altered mental status, shallow breathing, needle marks.
Describe function of the platelets and white blood cells.
Platelets: Tinv. disc-shaped elements that is much smaller than the cells, essential in the initial formation of a blood clot. White Blood Cells: plavs a role in the bodv's immune defense mechanism against infection.
Define a Precipitous Delivery
Precipitous labor is defined as expulsion of the fetus within less than 3 hours of commencement of regular contractions.
Define Preeclampsia and S&S
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy and a woman his blood pressure has been normal. Symptoms include severe headaches, upper abdominal pain, nausea, shortness of breath. Causes can range from insufficient blood flow to uterus, immune system problems, damage to blood vessels.
List the characteristics of extraction and rescue
Preparation, En route to the scene, arrival and scene size up, hazard control, support operations, gain access, emergency care, removal of patient, transfer of patient, termination.
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complication/side effects of: Aspirin,
Prevents platelets from clumping makes them slippery. Classifications Anacin, Excedrin, chewable aspirin. Administration: chewing rather than swallowing. Side effects: nausea and vomiting, stomach pain, bleeding, allergic reaction. Standard supply: 81 MG children's/adults low dose tablet or 325MG tablet. Dosage: Adult: 162 to 325 MG (two to four 81 MG tablets or one 325MG tablet)
List complications of delivery
Prolapsed umbilical cord, breech presentation, nuchal cord, and premature birth
Describe characteristics of extraction
Proper equipment scene size up, scene safety, hazard control, support operations, gaining access. emergency care, removal of patient, transfer, termination.
Describe function of the National Registry of EMTS
Provides the EMT their National certification and the ability to get hired on with EMS.
List treatment for a limb presentation during delivery
Put towel over baby's limb; give high flow oxygen and rapid transport. Position with pelvis up.
Define Radial, Brachial, arteries and locations
Radial: The radial artery is a major artery in the human forearm. The artery supplies the arm and hand with oxygenated blood from the lungs. Brachial: The brachial artery is the major blood vessel of the arm. It continues down the ventral surface of the arm until it reaches the cubital fossa at the elbow. It then divides into the radial and ulnar arteries which run down the forearm.
List signs of chronic bronchitis
Really bad coughs, difficulty expelling air from lungs, long expiration phases, wheezing, shortness of breath, DRY lung sounds, crackles, and excessive mucus.
Select the patient, among others involved in a motor vehicle, to receive the highest priority for treatment
Red Tag first priority; airway and breathing, severe bleeding, severe medical problems, severe burns, open chest or abdominal wounds.
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complication/side effects of Bronchodilators-
Relax bronchial smooth muscle resulting in bronchodilation. Classification: bronchodilator Administration: Metered-dosed inhaler that delivers unit dosage or aerosolized inhalation of the medication by small volume nebulizer (SVN) Side effects: restlessness, anxiety, tachycardia, irregular heartbeat, sweating, headache, muscle tremors, chest pain, hypertension, palpitations, nausea, vomiting, increased myocardial oxygen demand. Standard supply: Rescue inhaler, Nebule, polyurethane Dosage: Adult: follow the manufactures instructions and medical direction to administer the specific adult dosage. Pediatric: follow the manufactures instructions and medical direction to administer the specific pediatric dosage.
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complications/side effects of Nitroglycerin
Relaxes the muscular walls of coronary arteries and veins. Relaxes arteries throughout the body, results in less blood retum to the heart, decreases blood pressure. Classification: vasodilator, antianginal Administration: sublingual Side effects: hypotension, tachycardia, headache, dizziness, syncope, nausea, vomiting, burning under the tongue. Standard supply: 0.4 Mg tablet or multi-dose spray bottle (0.4 MG/ single metered spray) Dosage: Adult: 0.4 mg Tablet or 0.4 mg/single metered spray. Pediatric: NOT INDICATED FOR USE IN PEDIATRIC PATIENTS.
List treatment associated with splinting
Remove clothing, check pulse, motor, and sensory then cover open wound with a dry sterile dressing, attach splint to affected area to stabilize in order to prevent further damage. Re check pulse motor sensory after splint is applied. Secure joint above and below.
First treatment for Hyperthermic patients?
Remove them from the conditions
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complications/side effects of; Oxygen
Reverses hypoxia, increases arterial oxygen concentration, increases hemoglobin saturations, increases tissue oxygenation Classification: Natural gas, medicinal gas Administration: inhalation: nasal cannula, simple face mask, partial nonrebreathing mask, nonrebreathing mask, venturi mask, tracheostomy mask. Ventilation: mouth to mouth mask device, BVM with reservoir. Side effects: Rare respiratory depression in the patient with chronic obstructive pulmonary disease. Oxygen that is not humidified can dry or irritate mucous membranes. Standard supply: Cylinders of varying sizes containing compressed gas Dosage: Nasal cannula 1 to 6 l/min 24-44% 02. BVM 15 L/min up to 100%. Nonrebreather mask 10 to 15 L/min 80-90%
List causes of jugular vein distention
Right side heart failure (fluid backs up into the body) cardiac tamponade.
Define JVD causes
Right sided heart failure, Pulmonary Hypertension, Superior vena cava obstruction, Cardiac Tamponade
Indicators and vital signs of Hypoxia (In order of treatment)
S&S includes bluish fingernails, lips or skin, cough, difficulty breathing, decreased heart rate, and sweating. Should assess respiratory rate, lung sounds, mental status first.
Identify what each letter in the SLUDGEM Memory aid represents
S- Salivation L- Lacrimination (excessive tearing) U- Urination D- Diarrhea, drooling, defecation G- Gastric upset and cramps E- Emesis (vomiting) M- Muscle twitching/miosis (pinpoint pupils)
Identify what each letter in the SAMPLE memory aid represents
S- Signs and Symptoms A- Allergies M-Medications P- Past pertinent history L-Last oral intake E- Events leading up
Describe the EMTS priority at a hazardous materials incident
Scene safety, incident stabilization, preservation of the property and the environment.
List signs and symptoms of croup
Seal bark cough/stridor, cold coughs, low grade fever. Humidified air will treat patients with croup.
Proper applications of the KED board
Seated patients (in a vehicle, chair etc...)
Describe the second stage of labor
Second stage of labor consists of crowning and delivery of the baby.
Hyperthermia
Severe hyperthermia occurs when your body can't cool your core body temperature anymore and your body is above 104°F (40°C). Symptoms excessive sweating, nausea, headaches, red skin, muscle cramps or spasms
List parts of the skull
Skull: Frontal, parietal, occipital, temporal, mastoid process
Define body mechanism
The relationship between the body's anatomical structures and the physical forces associated with lifting, moving, and or carrying the ways in which the body moves to achieve a specific action. Keep weight close to your body so you don't mess your back up.
Define radiation (in loss of body heat) as well as the other forms of heat loss
The transfer of heat to cooler obiects in the environment bv radiant energv like a person standine in a cold room and losing body heat then starting to shiver because your body is trying to warm your body back up.
Describe the use of a oropharyngeal airway
This is a device used to open and maintain airway by preventing tongue from relaxing and blocking the airway. No gag reflex.
Describe function of the prehospital care report
To ensure oncoming crew or hospital knows what the patient is complaining of and what the treatments have been done. Legal documentation, continuation of care for patient, billing purposes.
Describe the use of a nasopharyngeal airway
To open the airway by going through the nose. If the patient has a gag reflex then this would be best to do.
List causes of low blood sugar
Too much insulin, overexertion, inadequate food intake, and medications
List modes of transmission associated with AIDS
Transmitted through bodily fluids (blood) such as intercourse, contaminated drugs, needles, syringes, blood or blood products.
List causes of shock in infants and children
Traumatic injury with blood loss, dehydration, severe infection, neurological injury, severe allergic reaction, disease of the heart, a collapse lung, fluid around heart, hypothermia, loss of fluid.
List treatment for low blood sugar
Treatment for low blood sugar is giving the patient glucose and something to eat such as a PB&J because the bread is a complex carb. Oral glucose does great for patients out in the field.
Define Trimester
Trimester is 3 months which pregnancy is divided.
Define implied consent
Type of consent in which the patient is unable to give consent for treatment under the legal assumption that they would want treatment.
Define abandonment
Unilateral termination of care by the EMT without the patients consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient. Transfer of care to someone who does not have equal or higher training than you.
Up to what age group do you do back blows?
Up to 1 years old
Identify what each letter in the OPQRST memory aid represent
0- Onset P- Provocation Q- Quality R- Radiation S- Severity T- Time
Identify all 4 chambers of the heart and how blood flows in and out of it
A: Right Atrium: The right atrium receives oxygen-poor blood from the body and pumps it to the right ventricle. A: Right Ventricle: The right ventricle pumps the oxygen-poor blood to the lungs. A: Left Atrium: The left atrium receives oxygen-rich blood from the lungs and pumps it to the left ventricle. A: Left Ventricle: The Left Ventricle pumps the oxygen-rich blood to the body.
Review what rec drugs do to pupils (Heroine, cocaine, etc...)
A:Heroine= pinpoint pupils, Cocaine= dilated pupils, Methamphetamine= dilated
List the range of oxygen concentration delivered by a nasal cannula at 1 to 6 liters per minute.
24%-44%
List the range of oxygen concentration delivered by a nonrebreather mask at 15 liters per minute
80%-100%
Define congestive heart failure
A disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart and usually resulting in a backup of fluid in the lungs. Post heart attack. It is called "congestive" heart failure because the lungs become congested with fluid.
Describe features of the bag-valve-mask (BVM)
A disposable self-refilling bag, no pop-off valve, an outlet valve, oxygen reservoir, a one-way no jam inlet valve system that provides 15L.min oxygen flow, a transparent face mask, and the ability to perform under extreme environmental conditions 1,000-1,200 ML bag that can give 100% Oxygen.
Define Positional Asphyxia
A form of asphyxia which occurs when body position prevents adequate gas exchange, such as a limitation in chest wall expansion
Define Gallbladder
A sac on the undersurface of the liver that collects bile from the liver from food in your intestine. Bile helps break down fat and cholesterol
dentify what each letter in the AVPU memory aid represents
A- Alert/awake V- Verbal stimuli P- Pain stimuli U-Unresponsive
Identify what each letter in the APGAR scoring system represents
A- Appearance P- Pulse G- Grimace A- Activity R- Respiration
Define body substance isolation
A: Actions taken by healthcare workers to reduce transmission of disease or other bacteria. Typically consists of gloves (aprons, masks etc... when necessary)
Review what all systems in the body are controlled by
A: Central nervous system: includes the brain and spinal cord. The brain and cord are protected by bony structures, membranes, and fluid. The brain is held in the cranial cavity of the skull and it consists of the cerebrum, cerebellum, and the brain stem. A: The endocrine system is a control system of ductless glands that secrete hormones within specific organs A: Cardiovascular System: The heart and blood vessels make up this system. The heart is a pump forcing blood into a network of blood vessels allowing it to travel to organs and delivery sites requiring oxygen gas for respirationnutrients and the removal of waste substances. A: Respiratory System: In this process cells use oxygen gas and produce carbon dioxide gas - a waste product that must be removed from the body. The process of breathing allows these gases to be exchanged between the blood and lungs
List treatment for a closed fracture of the arm
Assess motor function, splint arm in a sling, reassess for motor function and pulse, ice pack, and transport. If you mobilize the bone you splint joint above and below. If it is a joint then you immobilized the bone above and below to stabilize. More padding use more relief the patient has
What is PSAG used for?
Bilateral femur fractures
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complication/side effects of: Activated charcoal,
Binds with and inactivates toxic substances in the gastrointestinal tract. Classification: adsorbent. Administration: oral Side effects: nausea and vomiting. Standard supply: 15, 25, 50 grams premixed suspension in bottle. Dosage: Adult: 1.0 to 2.0 grams/kg (50 to 100) pediatric: 1.0 to 2.0 grams/kg (25 to 50 grams)
List devices used to suction an infant
Bulb Syringe
Define CISD (Critical Incident Stress Debriefing)
CISD, is a method of crisis intervention that addresses the sometimes overwhelming effects of a crisis, or critical incident, on first responders.
List treatment for restraining and immobilizing an adult with bizarre and threatening behavior
Call PD if needed, secure face up, multiple straps, estimate range of motion, have one arm above the head.
List the types of muscles found in the human body
Cardiac, smooth (involuntary, most tubular structures of the body such as gastrointestinal tract and blood vessels), Skeletal (striated, voluntary)
What are the causes of low blood pressure in an adult
Cardiogenic shock: inadequate heart function disease of muscle tissue impaired electrical system disease or injury. Signs and symptoms include low blood pressure, chest pain, weak pulse, crackles, and cyanosis. Septic Shock: severe bacterial infection and the signs and symptoms are warm skin or fever, tachycardia, low blood pressure. Neurogenic Shock: Damaged cervical spine, which causes widespread blood vessel dilation. Signs and symptoms include bradycardia (slow Pulse) low blood pressure, signs of neck injurv.
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complication/side effects of epinephrine
Causes bronchodilation, increases heart rate, constricts blood vessels causing increased blood pressure. Classification: Bronchodilator, sympathomimetic Side effects: chest pain, increased myocardial oxygen demand, nausea, restlessness, anxiety, tachycardia, irregular heartbeat, palpitations, hypertension, vomiting, sweating, headache, muscle tremors. Administration: Intramuscular injection (IM) by auto-injector into the lateral mid-thigh and hold in place 10 seconds to allow complete delivery of the medication Standard supply: Adult EpiPen auto injector or EpiPen auto injector Jr. Dosage: Adult: 0.3 MG DO NOT REPEAT DOSAGE, Pediatric: 0.15 MG DO NOT REPEAT DOSAGE
List the descending order of the divisions of the spine
Cervical, Thoracic, Lumbar, Sacrum, and coccyx
List treatment for an open chest wound
Check airway, put an occlusive dressing over wound, taped on all 4 sides, check for an exit wound, rapid transport on high flow o2 and treat for shock.
Situations that call for mandatory reporting
Child abuse, stabbings, shootings,
List treatment for a closed chest injury
Closed chest injury is when the skin is not broken. This injury is generally caused by blunt trauma such as when a person strikes the steering wheel. Maintain manual stabilization of the head in a neutral, in-line position until spine injury is ruled out, stabilize chest with padding, bulking dressing transfer to a level 1 trauma facility.
List common medical disorders/conditions found in children and the elderly
Common medical disorders, asthma, Pneumonia, croup, epiglottis, pertussis, seizures, meningitis.
Describe how a blocked coronary artery causes heart problems
Coronary arteries are the blood vessels that supply blood to the heart muscle they start at the first part of the aorta. A blocked coronary artery causes heart problems because calcium and cholesterol build up inside the walls of the coronary blood vessels, causing an obstruction in blood flow to the heart.
Identify what each letter in the DCAP-BTLS memory aid represents
D-Deformities C- Contusions A- Abrasions P- Punctures - B- Burns T- Tenderness L-Lacerations S- Swelling
List treatment for an impaled object in the hand
DO NOT try to remove object, stabilize impaled object, control bleeding, tape ridge area and stabilize for transport.
Define sudden infant death syndrome (SIDS)
Death of an infant or young child that remains unexplained after a complete autopsy
Causes of hypovolemic shock
Dehydration, Burns, excessive urination, diarrhea, or vomiting.
List stages of death and dying
Denial, anger, bargaining, depression, acceptance.
Identify risks for suicide
Depression, previous suicide attempts, current expressions of wanting to commit suicide, specific plan for suicide, family history of suicide, people older than 40 particularly if single widowed, divorced, alcoholic, recent loss of spouse, chronic debilitating illness, financial setback, alcohol and substance abuse, withdrawal from family and friends.
Define diastolic blood pressure
Diastolic blood pressure is the pressure of that remains in the arterial walls during the relaxing phase of the hearts cycle when the left ventricle is at rest.
List treatment for external bleeding
Direct pressure with trauma pad, tourniquet, pressure points, high flow oxygen.
List treatment for suspected child abuse
Don't accuse anyone in the field or on scene, follow local and state regulations, document objective information, and report to the appropriate agency.
Effects of dehydration in children
Dry mouth, few tears when crying, sunken eyes, dry cool skin, dizziness
What dressing is used on thermal burns?
Dry sterile dressings
Who do you report child abuse to?
ER Nurse
Define Emphysema
Emphysema is a disease of the lungs in which there is extreme dilation and destruction of the pulmonary alveoli with poor exchange of 02 and C02. It is one form of chronic obstructive pulmonary disease (COPD). Lungs lose elasticity
Define each way the body loses heat
Evaporation - Body heat turns sweat into vapor Convection - Heat loss by air or water moving across the skin surface. Conduction - Direct contact with an object. Radiation - The body radiates
Identify conditions for rapid extraction
Extreme weather, shock, patients with an altered mental status of consciousness, inadequate ventilations, vehicle or scene is unsafe, explosives or other hazmat are on scene, there is a fire or danger of a fire, patients cannot be properly assessed before removed from the vehicle, needs immediate intervention that requires supine position, rapid transport due to life-threatening injuries. Patient blocks access to another serious injured person.
List the signs and symptoms of stroke
Facial drooping, sudden weakness or numbness in the face, arm, leg or one side of the body, decreased or absent movement and sensation on one side of the body, lack of muscle coordination or loss of balance, sudden vision loss in one eye, blurred or double vision, difficulty swallowing, decreased level of responsiveness, speech disorders, expressive aphasia (difficulty expressing thoughts or inability to use the right words), receptive aphasia (difficulty understanding spoken words), slurred speech (dysarthria), confusion, dizziness, weakness, combativeness, restlessness, tongue deviation, coma.
Define Kussmauls breathing pattern
Fast and deep breathing in an attempt to reduce the acid level by releasing more carbon dioxide. Diabetic ketoacidosis (DKA) Hyperglycemia
Identify location of the femoral artery
Femoral artery lies midway between the anterior superior iliac spine and symphysis pubis, can be felt in the groin area.
Common positions for abdominal pain
Fetal
List treatment for a burned eye or eyelid injury
Flush eye if chemical burn with sterile saline, from the inside of the eye towards the outside and place a dry dressing. Thermal burns cover both eyes with a sterile dressing moistened with sterile saline. Light burns, cover each eye with sterile dressing and eye shield. Eyelid, applies no pressure to the eye, gently apply moist sterile dressing, cover eye with protective dressing, both eyes.
List treatment, using the AED, for an adult in cardiac arrest.
For an Adult 30; 2 compressions, full chest recoil, 100-120 compressions, limit interruptions, everyone is safe and away from the patient before giving the shock. After shock is delivered attach AED and let analyze heart rhythm, will provide shock if its needed, ensure your safe and continue chest compressions till ALS arrives.
Define critical burn injury
Full thickness burns and partial burns greater than 20%, face and neck burns, circumference burns, groin.
List signs and symptoms of abdominal pain in a child
GI distress and bruising. Guarding.
What age group has the highest suicide rate?
Geriatrics
What age group is Anginas typically found in?
Geriatrics
List treatment for severe hyperthermia caused by environmental exposure
Get patient out of environment, ice packs underneath arm pits, groin, high flow oxygen, loosen tight close or take them off, ice bath if possible, and get this patients shirt soaked and place on back of neck.
What is the hardest part about using a BVM?
Getting a good seal
Describe difficulty in use of a BVM
Getting a tight seal with one hand while squeezing the bag and getting good compliance with rise and fall of the chest.
Describe side effects of rescue breathing
Giving the patient too much air will fill the stomach up and give distention/ vomiting. The stomach can only take so much air.
Identify the most common cause of seizures in infants and children
HIGH FEVER
Identify common special needs devices used by infants and children
Hearing aids, medical ventilators, tracheostomy tube, apnea monitor, or internal cardiac pacemaker
List treatment for severe asthma
High flow 02, call medical control to get permission to assist patient with their inhaler, rapid transport, possible use of a BVM.
List treatment for cardiogenic chest pain
High flow oxygen, aspirin 325mg or 4 81mg, Nitroglycerin 0.4mg up to three sprays as long as pain persists
List signs and symptoms of low blood sugar
Hunger, seizures if it gets really low, respirations are normal to rapid, pulse is weak and skin is typically pale, clammy, and diaphoretic
Patients altered that've taken insulin, haven't eaten are
Hypoglycemic
List causes of Hypoxia
Hypoxia is inadequate oxygen in the tissue to sustain bodily function. Pulmonary edema, Hay Fever, Pleural effusion, obstruction of airway, hyperventilation syndrome, drug overdose, carbon monoxide poisoning.
Identify the location where emergency vehicles are commonly involved in crashes
INTERSECTONS
Rules for splinting (all splints)
If a bone is broken, joints above and below should be immobilized. If a joint is broken, above and below the joint should be splinted. (do not attempt to set back in place)
Obstructed airways and suctioning
If object is lodged in the trachea and visible with the patient on his side you can attempt to pull it out but only when easily visible (possibility of pushing in back down into the trachea) Suction for no more than 15 seconds in a circular motion on your way out of the mouth
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complications/side effects of; Oral glucose
Increases glucose level in the blood and provides glucose for cellular metabolism. Classification: carbohydrate, oral hyperglycemic Administration: Oral glucose gel is placed between the cheek and gum or takes tablets that are chewed and swallowed. Side effects: nausea and vomiting Standard supply: 15 grams tube, tablet, or pouch 25 grams tube, tablet, or pouch Dosage: Adult: 15 to 50 grams Pediatric: 5 to 50 grams
Calculate the percentage of a thermal burn, based on the rule of nines, for an infant, child, and adult
Infant - Head -18 Front -18 Back -18 Arms -9 Legs -13.5 Groin -1 Child - Head -12 Front -18 Back -18 Ams -9 Legs -16.5 Groin -1 Adult - Head -9 Front -18 Back -18 Arms -9 Legs -18 Groin -1
List normal vital signs (BPS, pulse rates, and respiratory rates) for an infant, child, and adult
Infant: BP: 70-95 systolic; Pulse: 100-160, respiratory: 25-50 Child: BP: 80-110 systolic; Pulse 80-140, Respiratory 20-25 Adult BP: 90-140 systolic; Pulse 60-100, Respiratory 12-20
List basic life support treatment for an infant, Child, or adult in cardiac arrest.
Infant: Check pulse and breathing for at least 5 seconds but no more than 10 seconds. Open airway using head tilt chin lift or jaw thrust, ventilate with 1 breath every 3 to 5 seconds, check pulse at brachial. Compressions; one rescuer- 2 fingers, just below the nipple line 30; 2 2 or more rescuers- 2 thumbs with fingers encircling the chest 15; 2. Depth of compressions about 1/3 to ½ depths of chest. You can use AED if needed but do CPR first then call. Child: Check pulse and breathing for at least 5 seconds but no more than 10 seconds. Open airway, 1 breath every 3-5 seconds, check pulse at carotid. One rescuer compressions 30; 2, 2 or more rescuer 15; 2 at a depth of 1/3 to ½ depth of chest. Use child pads when using the AED. Adult: Check pulse and breathing for at least 5 seconds but no more than 10 seconds. Open the airway, 1 breath every 5 to 6 seconds. Check pulse at carotid. Compressions are 30; 2 no more than 2 inches deep. Us adult pads with AED. Call then CPR.
List treatment for a thermal burn
Move patient away from burn area, give high flow oxygen, and remove all jewelry. Apply dry sterile dressing to help maintain body temperature, prevent infection, and provide comfort.
List treatment for an infant, child, and adult with a complete airway obstruction
Infant: Hold face down with body resting on forearm and deliver 5 back slaps between the shoulder blades using the heal of your palm turn over and deliver 5 chest thrusts in the same manner as chest compressions. If become unresponsive begin CPR Child: Kneel behind child and circle both arms around the child's body and give abdominal thrusts. Fist should be placed above the umbilicus and well below the xiphoid process. Thrusts should be in an upward direction. Repeat till clear or child becomes unresponsive, and then begin CPR. Adult: Abdominal thrusts until free or unresponsive, then give CPR
List signs and symptoms of inadequate breathing for an infant ,child, and adult
Infant: Sleepy, respiratory rate too fast or too slow, cyanosis, muscle retraction, nasal flaring, and head bobbing Child: Altered mental status, irregular breathing pattern, skin is cool, pale, clammy, cyanotic, wheezing, gurgling, snoring, crowing, stridor Adult: Respiratory rate less than 12 Breaths/min or more than 20, irregular rhythm, absent or noisy osculated breathing sounds, unequal OR inadequate chest expansion, use of accessory muscles, shallow depth, pale, cyanotic, cool, moist to the touch
List equipment used to splint
Inflatable vacuum, cardboard, plastic, foam covered wire or aluminum alloy, paddle board, bandages, short backboard, short immobilization device, long backboard.
Most common route of allergic reactions
Inhalation
Describe the mechanism of action, classifications, administration, dosing amounts, characteristics, and complication/side effects of Naloxone
Inhibits binding of a narcotic (opioid) to a cellular receptor site, reverses central nervous system depression, and reverses respiratory depression. Classification: Narcotic (opioid) antagonist Administration: Intranasal (MAD) Side effects: Withdrawal, symptoms include nausea, vomiting, restlessness, seizures, dyspnea, pulmonary edema, cardiac arrest, hypotension, hypertenstion. Standard supply: 2.0 mg/2.0 ml prefilled syringe with a mucosal atomizer devise (MAD) or 2.0 MG auto-injector Dosage: Adult: 2.0 MG (1.0 mg sprayed in each nostril using a MAD) repeated every 2 minutes to achieve desired effects Pediatric; 5 years of age or younger 0.1 MG/KG (1.2 dose sprayed in each nostril using a MAD) 5 years or older 2.0 MG (1/2 dose sprayed in each nostril using a MAD)
Describe features of the ongoing assessment
Initial Assessment - immediate life threats, the initial assessment, (It is assumed all life threats would have been found and taken care of) Secondary Assessment - A focused history and physical exam should be performed, treat any other injuries found. Reassessment -Detect changes in patient's condition, after any intervention is made, 3-5 min on a critical patient.
List signs and symptoms of an ectopic pregnancy
Internal bleeding, lower abdominal pain, previous ectopic pregnancies (PID)
What injuries would the "sling and swathe" method be used on
Is used for injuries when moving your shoulder joint could cause harm and holds your arm slung close to the chest.
Identify function of the Kendrick Extraction Device (KED)
KED is designed to immobilize the patient until he or she is moved from a sitting position to a supine position on a backboard.
After assisting a childbirth, first action is to?
Keep the child warm (mainly the head)
How do you treat psychogenic shock?
Lay the down and put their feet up (shock position)
Describe the function of the left ventricle and the right ventricle
Left Ventricle: receives fresh oxvgenated blood from left artia through the mitral valve, flls to approx. 70%of the ventricular stroke volume during diastole, contracts and moves the oxygenated blood through the aortic valve through the aorta to the rest of the body, Right Ventricle: the right side of the heart receives oxygen-poor blood from the venous circulation.
Describe considerations for an adult who refuses treatment and transport
Legally have the right to refuse if AOX4, fully informed about possible outcomes by not being treated, signed a refusal.
Describe assessment for a closed chest injury
Look for obvious deformities (bruising of the lung tissue), palpate all four quadrants on the abdomen, auscultate for lung sounds, maintain C-spine, apply high flow o2, blood pressure, check for altered level of consciousness and transport.
List common causes of hypovolemic shock in an adult
Low fluids, loss of blood, thermal burns, dehydration, heat exhaustion, vomiting, diarrhea, amputation
List treatment for seizure
Maintain ABCS, provide oxygen, check for trauma and immobilize spine if needed, protect patient from their surroundings, encourage transport to hospital
List treatment for a rattlesnake bite (Poisoning)
Make sure you calm the patient, mark the bite with a pen to see if swelling increases clean gently, immobilize with pressure, and look for anaphylactic shock. DO NOT give anything orally get a set of vitals and bring snake if dead if not take picture. Rapid transport.
List treatment for near-drowning
Manage ABCS, suction vomit or water if needed, possible spinal trauma reassess the lungs, treat for shock and rapid transport.
List treatment for an open fracture of the leg
Manage all bleeding with direct pressure, assess motor functions, correct any gross deformity by applying gentle longitudinal traction to the heel, and apply a splint, rapid transport.
Know steps to insert NPA
Measure a correctly sized NPA, lubricate the NPA with water-soluble jelly, insert into the nostril with the bevel facing the nasal septum
At the end of the day who is an EMTs boss
Medical Director
Identify the most important assessment finding in a hypothermic patient
Mental Status, core temperature of the body, shock, skin color, skin, temperature, skin moisture, radial pulse, treats for shock and transport.
Define Miscarriage
Miscarriage is the spontaneous passage of the fetus and placenta before 20 weeks; also called spontaneous abortion.
Define Smooth Muscle: Skeletal Muscle: Cardiac Muscle:
Smooth Muscle: is tissue in the walls of internal organs such as the stomach and intestines, when smooth muscle in the stomach contracts, it squeezes the food inside the stomach, which helps break the food into smaller pieces. Contractions of smooth muscle are involuntary. Skeletal Muscle: Muscle tissue that is attached to bone, it is voluntary, when skeletal muscle contacts bones move. Cardiac Muscle: is found only in the walls of the heart. When cardiac muscle contracts, the heart beats and pumps blood. Involuntary like smooth muscle.
Define all 3 stages of labor
Stage 1- cervix dilates (contractions begin) Stage 2- Infant crowns and is delivered Stage 3- Placenta is delivered
Define good Samaritan laws
Statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is a wanton, gross, or willful negligence
List treatment for an amputated arm
Stop bleeding by using direct pressure, if that doesn't work use a tourniquet, treat for hypovolemic shock, secure and maintain airway, apply high flow oxygen, reassess every 3 to 5 Min.
Define Stridor
Stridor is a high pitched respiratory sound, generally heard during inspiration that is caused by partial blockage or narrowing of the upper airway may be audible without a stethoscope. Also has a very harsh sounding.
Describe management of newborn
Suction the baby's mouth with bulb syringe if necessary; dry the newborns head, back, and body. If the baby is not breathing after 10 to 15 seconds begin CPR efforts, quickly calculate Apgar score, stimulation should result in an immediate increase of respirations rate, if breathing well check brachial pulse. Assess newborn oxygenation via pulse oximetry, request second unit because you now have two patients.
List treatment for severe facial injury
Suctioning and maintain an airway by inserting an OPA/NPA, stop all major bleeds.
Define TIA
TIAS are caused by a clot or blockage in the brain. The blockage is short term. The clot usually dissolves on its own or gets dislodged, and symptoms usually last for a short time. (warning stroke)
Describe ways an EMT should deal with personal strong emotional reactions
Talk to another first responder, support groups, talking with family, joins clubs and or activities
Describe function of the Aorta
The Aorta is the body's main artery; receive the blood ejected from the left ventricle and delivers it to all the other arteries so they can carry blood to the tissue of the body.
Describe function of the autonomic nervous system
The Autonomic Nervous system regulates involuntary activates in the body, such as heart rate, blood pressure, and digestion of food
Describe function of the epiglottis
The Epiglottis is a thin leaf shape flap of cartilage that acts as a valve that allows air into the trachea and stops food and liquid from entering the airway.
Define the Federal Communications Commission
The Federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite communications, all of which may involve EMS activity.
Pathophysiology of gall bladder, liver, and kidneys
The Gallbladder; is a small hollow organ about the size and shape of a pear. Its a part of the biliary system (a series of ducts within the liver).The gallbladder is where bile is stored and concentrated. It lays in the right upper quadrant of the abdomen affixed to the undersurface of the liver which produces bile and is drained into the gallbladder and stored until needed for digestion. The Liver; is the storage location for fat-soluble vitamins and handles cholesterol homeostasis. It stores iron and copper. It plays a role in hematology with clotting factor and protein synthesis, and produces carrier protein for the reproductive system. The Kidneys; The kidneys act as very efficient filters for ridding the body of waste and toxic substances, and returning vitamins, amino acids, glucose, hormones and other vital substances into the bloodstream. The kidneys receive high blood flow and this is filtered by very specialized blood vessels.
Define systolic blood pressure
The increased pressure in an artery with each contraction of the ventricles (systole)
Define paradoxical chest wall movement
The motion of the portion of the chest wall that is detached in a flail chest; the motion-in during inhalation, out during exhalation- is exactly opposite of normal chest wall motion during breathing. More than 2 ribs broken in more than 2 places.
Define Medical Director
The physician who authorizes or delegates to the EMT the authority to provide medical care in the field.
Define Triage
The process of sorting patients based on severity of an injury and medical needs to establish treatment and transportation priorities.
Deference between Ventilating and Oxygenating
Ventilating is when you're breathing FOR the patient. Oxygenating is when you're just giving them oxygen but the patient is still controlling respirations.
Define Epiglottitis and the age group it effects
When the small cartilage "lid" that covers your trachea swells, blocking the flow of air into your lungs... typically affects children
Describe the log roll
While maintain manual in-line stabilization of the spine with one person, at least two others will grab the patient and on the headman's count at the same time roll the patient on their side allowing for the backboard to be placed underneath the patient.. On the headman's count again, they will roll the patient back supine position onto the backboard.
Define Advance Directive
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will or health care directive.
Define Jaundice
Yellowish tint of the skin or sclera that is caused by liver disease or dysfunction.
Is Anaphylaxis considered a bad/severe allergic reaction?
Yes, its a progression from normal allergic reactions to multi system stressor
Can you suction the airway of a baby that is still in the mother (except the head)
Yes, use a bulb syringe and suction the mouth first
Describe Encircling chest compressions for an infant in cardiac arrest.
cardiac arrest. Position yourself at the Infants feet and wrap your hands around the infant and give compressions with both of your thumbs.
Describe purpose of the AED
delivering appropriate electrical shock out of irregular rhythm. The purpose of the AED is to get the heart from V-FIB or V-TACH to asystole rhythm by
Patients altered with a need for insulin is
hyperglycemic
Describe Function of the pulse oximeter
noninvasive, real time manner. Normal pulse Oximeter readings should be at 98% to 100% while The pulse oximeter measures the percentage of hemoglobin saturation in a rapid, reliable, breathing room air.
Hypo-perfusion
reduced amount of blood flow to an organ, includes low blood pressure, and high pulse rate
