EMS 108 - Exam One

What is the Involuntary Nervous System and what does it control?

(Autonomic Nervous System)- controls the many body functions that occur without voluntary control - Ex/ digestion, dilation and constriction of BV, sweating, etc.

What are common questions asked by patients with a serious illness or injury?

- "Am I going to die?"- "What are you doing to me?"- "Will I be permanently disabled?"

Repeater Station Radio

- A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency - Can receive lower power signals, such as those from a portable radio, from a long distance

The BEST way to reduce your risk of contracting a work-related disease following exposure is to?

- Activate your departments infection control plan as soon as possible- Assume every patient is infected- Use BSI

Paramedic

- An individual who has extensive training in ALS, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills - 1000-1300 hours

EMT

- An individual who has training in basic life support (BLS), including AED, and use of definitive airway adjunct, and assisting patients with certain medications - 150 hours

AEMT

- An individual who has training in specific aspects of ALS, such as intravenous therapy, and the administration of certain emergency medications - 200-400 hours

Base Station Radio

- Any radio hardware containing a transmitter and receiver that is located in a fixed place

What are the different sections of the spine and how many vertebrae are in each section?

- Cervical - 7 - Thoracic - 12 - Lumbar - 5 - Sacral - 5 (fused) - Coccyx - 4 (fused)

What are the stages of grief?

- Denial -Anger - Bargaining - Depression - Acceptance

The continuous quality improvement (CQI) process is designed to?

- Do continuous internal and external reviews and audits of all aspects of the EMS System - Discuss any areas of care that need change or improvement

Portable Radio

- Hand-held device that operates at 1 to 5 watts of power- Transmission range is more limited- Essential in helping to coordinate EMS activities at the scene of an MCI- Helpful if away from ambulance and need to communicate with dispatch, another unit or medical control

Physiologic manifestations of stress include?

- Increased respiration and heart rate- Increased blood pressure- Cool, clammy skin- Dilated pupils- Tense muscles- increased blood glucose levels- Perspiration- Decreased blood flow to GI tract

Signs of adequate breathing in the adult include?

- Normal rate and depth (tidal volume)- Rhythm or pattern of inhalation and exhalation- Clear, audible breath sounds on both sides of chest- Regular rise and fall movements on both sides of chest- Movement of abdomen

The hepatitis B vaccine program, a component of the infection control plan, addresses all of?

- Postvaccine antibody titers- Vaccine safety and efficacy- Record keeping and tracking - Does not: Address family history of hepatitis

What are the anatomical positions?

- Prone - lying face down - Supine - lying face up - Fowler - sitting upright - Semi-Fowler - sitting with the back of a stretcher at a 45 degree angle - High-Fowler - sitting at a 90 degree angle

The criteria to be licensed and employed as an EMT include?

- Proof of immunizations- High school diploma- Completion of background check and drug screening- Valid drivers license- CPR card- State approved EMS Course- State recognized written certification exam- State recognized practical certification exam- Demonstrate the mental and physical ability necessary to safely and properly perform all the tasks and functions described in the defined role of an EMT- Compliance with other state, local and employer provisions

What are noticeable characteristics of a 9 month old infant?

- Pulls up to stand- Places objects in mouth to explore them

The standards for prehospital emergency care and the individuals who provide it are typically regulated by the?

- Standards for each state are different- Standards are regulated by the state office of EMS

What is the Central Nervous System and what does it control?

- The brain and spinal cord- Controls: voluntary body activities, perception of surroundings, reactions to environment, transmit messages between the brain and the body (spinal cord)

Situations in which you should use the rapid extrication technique include?

- Unsafe scene- Explosives or hazardous material on scene- Fire or danger of fire- Patient cannot be properly assessed- Immediate intervention requiring supine position- Require rapid transport to hospital- Patient blocks access to another seriously injured patient

Common factors that influence how a patient reacts to the stress of an illness or injury are?

-History of chronic disease- Mental disorders- Fear of medical personnel

What is adequate breathing?

-Normal rate, rhythm, quality - Good breath sounds bilaterally - Equal chest rise and fall - Pink, warm, dry skin

The most effective way to preserve your own body heat when functioning in cold, wet weather is to?

1. Thin inner layer2. Thermal middle layer3. Outer layer resisting chilling winds and wet conditions

At what age does separation anxiety typically peak in infants and small children?

10-18 months

At rest, the normal adult heart rate should not exceed?

100 beats per minute

You should not attempt to lift a patient who weighs more than 250 pounds with fewer than ___ rescuers, regardless of individual strength.

4

Together, the right and left lungs contain how many lobes?

5 lobes

The average adult has approximately ___ of blood in his or her vascular system.

6 liters (L)

During each heartbeat, ___ of blood is ejected from the adult heart, an amount called the stroke volume.

70-80 mL

A critical incident stress debriefing should be conducted no more than ___ hours following the incident.

72 hours- Within 24-72 hours after the incident and they're held by the CISM (critical incident stress management)

The anterior fontanelle fuses together between the ages of?

9-18 months

Shortly after you load your patient, a 50 year old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. What should you do?

A competent adult can withdraw consent at any time- Encourage going but don't force because the patient can say no

In what situations would a direct ground lift be the MOST appropriate method of moving a patient?

A conscious patient complaining of abdominal pain

What is a ball and socket joint?

A joint that allows internal and external rotation, as well as bending

Bile is produced by the liver and concentrated and stored in the?

Gallbladder

The official transfer of patient care does not occur until the EMT?

Gives an oral report to the lead physician or nurse

Which form of transmission signal is LEAST likely to be heard by the party being called?

Hand-held portable radio

The elbow is an example of a ___ joint.

Hinge

Obtaining continuing medical education is the responsibility of the?

Individual EMT

The diaphragm and intercostal muscles contract during?

Inhalation

What is the function of platelets?

Initial formation of blood clots

The diaphragm is unique because it?

Is an involuntary and voluntary muscle

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor?

Is emancipated - Is married- Has a child- Is a part of the armed forces

What is a hinge joint?

Joints that can bend and straighten but cannot rotate; they restrict movement to one plane

The vocal cords are located?

Larynx

An 81 year old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is MOST appropriate method of immobilizing this patient?

Leave her on her side and use blanket rolls to immobilize her to the backboard

Know the locations of all parts of the respiratory system and what they are.

Lungs --> bronchi --> bronchioles --> alveoli

Continuing education in EMS serves to?

Maintain, update and expand your knowledge and skills

The person who is responsible for authorizing EMT's to perform emergency medical care in the field is the?

Medical director- "The physician who authorizes or delegates to the EMT the authority to provide medical care in the field"

When caring for a 65 year old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of?

Negligence

What are agonal respirations?

Occasional, gasping breaths that occur after the heart has stopped; seen in a dying patient

Trauma to the ___ lobe of the brain would likely result in visual disturbances.

Occipital

Which type of medical direction do standing orders and protocols describe?

Off-line- "Written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care (protocols)

According to Occupational Safety and Health Administration (OSHA) regulations, an employer must?

Offer a workplace that reduces risk for exposure

Which of the following patients has decision-making capacity and can legally refuse emergency medical treatment?

One who has the ability to understand and process information and make a choice regarding appropriate medical care

An EMS provider who has extensive training in various aspects of advanced life support (ALS) is called a(n)?

Paramedic

Cardiac monitoring, pharmacologic interventions, and other advanced treatment skills are functions of the?

Paramedic

The circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called?

Perfusion

You are treating a man who was assaulted and has a closed head injury. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should?

Proceed with treatment and utilize law enforcement if necessary

To minimize the risk of litigation, the EMT should?

Provide competent care that meets current standards

The left side of the heart receives oxygenated blood from the lungs through?

Pulmonary veins

An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma and is complaining of neck and back pain. Before removing him from his car, you should?

Put him in C-spine to secure the spinal cord

The bones of the forearm are called?

Radius and ulna

After receiving online orders from medical control to perform a patient care intervention, you should?

Repeat the order to medical control word for word

Which of the following is MOST characteristic of adequate breathing in an adult?

Respiration of 20 breaths/minute and bilateral chest movement

You are assessing a 13 month old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, what would you most likely find?

Responds to her name but is fearful of your presence

Which set of nerves is responsible for carrying information from the body to the central nervous system?

Sensory nerves

The axial skeleton is composed of the?

Skull, face, thorax, vertebral column

The primary organ responsible for absorption of the products of digestion is the?

Small intestine

Activities such as walking, talking and writing are regulated by the?

Somatic Nervous System

What stimulates the Parasympathetic Nervous System and how do you know it's stimulated?

The Parasympathetic Nervous System relaxes the body and controls the autonomic functions during nonstressful times

In relation to the wrist, the elbow is?

The elbow is proximal to the wrist

An infant or small child's airway can be occluded if it is overextended or overflexed because?

The occiput is proportionally large and the trachea is flexible

Twelve pairs of ribs attach to which section of the spinal column?

Thoracic vertebra

You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. What would be the most appropriate action?

To leave the residence and call for additional resources such as the fire department and HAZMAT

A positive TB skin test indicates that?

A patient was exposed to TB

Stimulation of the parasympathetic nervous system would result in?

A slower heart rate

As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the?

Alveoli

The final stage of death and dying MOST commonly takes the form of?

Acceptance

The major artery that supplies all other arteries with blood is?

Aorta

When performing the rapid extrication technique to remove a patient from his or her vehicle, you should?

Apply a cervical collar and remove the patient on a long board

As an EMT, it is important to remember that the signs and symptoms of cumulative stress are?

As an EMT, it is important to remember that the signs and symptoms of cumulative stress are? - Irritability with coworkers, family and friends- Inability to concentrate- Difficulty sleeping and nightmares- Anxiety- Indecisiveness - Guilt - Loss of sexual desire and interest- Loss of interest in work- Isolation

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under the circumstances, you should?

Assess whether the patient's mental condition is impaired

According to the National EMS Scope of Practice Model, an EMT should be able to?

Assist a patient with certain prescribed medications

To avoid injury when pushing a patient or other object, you should?

Avoid pushing with your elbows fully extended

Which of the following skills would a layperson MOST likely be trained to perform before arrival of EMS?

Bleeding control using a tourniquet

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should?

Begin two-rescuer CPR and apply AED as soon as possible

All critical life functions are coordinated in which part of the brain?

Brain stem

The most distal four spinal vertebrae, which are fused together, form what?

Coccyx

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should?

Call for additional resources

Critical Incident Stress Management (CISM)

Can occur at an ongoing scene, except when patients are actively being assessed and treated

The exchange of oxygen and nutrients for waste products of metabolism occurs at the cellular level in the?

Capillaries

The muscle tissue of the heart is called the?

Cardiac muscle

The largest portion of the brain is the ___, which is commonly referred to as the "gray matter."

Cerebrum

If an EMT candidate has been convicted of a felony or misdemeanor, he or she should?

Contact the state EMS office and provide them with the required documentation

An appropriate demonstration of professionalism when your patient is frightened, demanding or unpleasant is to?

Continue to be nonjudgmental, compassionate and respectful

The phase of the cardiac cycle in which the ventricles fill with blood is called?

Diastole

The leaf-shaped flap of cartilage that prevents food and liquid from entering the trachea during swallowing is called?

Epiglottis

You suspect that a pregnant 16 year old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which type of consent is her agreement considered?

Expressed

Which of the following MOST accurately defines negligence?

Failure to provide the same care that a person with similar training would provide

The bones that constitute the fingers and toes are called?

Fingers - phalangesToes - metatarsals

You and your partner are attempting to resuscitate a middle-aged female in cardiac arrest. Because of the remote geographic location, you are unable to contact medical control. What should you do?

Follow locally established protocols or standing orders

At the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should?

Use the mobile radio in the ambulance to contact dispatch

When carrying a patient up or down stairs, you should avoid?

Using a wheeled stretcher whenever possible

If you use a waterless handwashing substitute in the field, it is important to?

Wash your hands with soap and water at the hospital

Capillary sphincter closure during internal or external bleeding is detrimental because?

Waste products are not removed and nutrients are not delivered to the cells

When would an extremity lift NOT be appropriate to use on a patient?

When damage to the spinal cord is suspected

What type of scenarios involve the use of ALS?

Where an IV is needed or anything that outweighs the resources of 1 ambulance/crew

The inferior cartilaginous tip of the sternum is called the?

Xyphoid process

Worn-out blood cells, foreign substances, and bacteria are filtered from the blood how?

spleen