EMT-B National Registry Study
Scene Size-up includes evaluating which important things?
1). scene safety (personal, partner, patient, bystander safety) 2). mechanism of injury or nature of illness 3). Number of patients 4). Need for additional resources
What elements should be evaluated (list in the proper order) when considering the MOI of a car vs. pedestrian accident?
1). speed of the vehicle 2). the path the victim took after striking the vehicle 3). how much damage was done to the vehicle 4). apparent injuries
Routes of medication administration
1). sublingual 2). oral (swallowed) 3). inhalation 4). injection
The larynx has what two parts?
1). thyroid cartilage (Adam's apple); anterior/superior to 2). cricoid cartilage; anterior/inferior to
What are the two passageways at the end of the pharynx?
1). trachea (air) 2). esophagus (food)
Ventilating an apneic patient with a BVM (ensure what 2 things?)
1). use of an OPA or NPA 2). rate of 10-12 breaths per minute
Glasgow coma scale is rated from ___ to ___
1-15
The 1st stage of labor is when the _____. The 2nd stage is when the _______. The 3rd stage is when ______.
1st stage- dilation of the cervix 2nd stage- baby enters the birth canal 3rd stage- from delivery of the infant to the delivering of the placenta
The pressure in on O2 cylinder is approximately ____ psi in a full tank.
2,000 psi
Once blood glucose levels reach _______ mg/dL, excess glucose is excreted by the _____ ?
200 mg/dL, kidneys
Rescue breaths for adults and children based on 2005 AHA CPR guidelines are?
2005 AHA CPR Guidelines specify that adults should get 10-12 breaths per minute (one breath every 5-6 seconds). Children should get between 12-20 breaths per minute (one breath every 3-5 seconds).
As the time of delivery nears, certain complications can occur, preeclampsia or pregnancy-induced hypertension, a condition that can develop after the ____ week of gestation.
20th week
Placenta previa and abruptio may occur in which stage of pregnancy?
2nd and 3rd trimester
Placenta previa and abruptio may occur in which stage of pregnancy?
2nd or 3rd trimester
What is the ideal number of EMTs to ventilate a patient using a BVM?
3, 1-holding mask seal, 2-squeezing the bag, 3-providing cricoid pressure
M cylinders contain about ____ liters of oxygen.
3,000
Normal respiratory rate for infants is ___ to ____.
30 to 60 per minute
Pressure regulators supply a safe working pressure of about ___ to ___ psi.
30 to 70 psi
A "silent heart attack" happens in approximately _____% of the elderly population.
30%
D cylinders contain about ____ liters of oxygen.
350
Infants born before ____ weeks are considered premature.
37 weeks
Petit mal seizure typically occurs in children ___ to ___ y/o
4-12 years old
G cylinders contain about _____ liters of oxygen.
5,300
Nitro has a ____ minute lifespan in the body.
5-10 minute
Excessive bleeding occurs when the bleeding exceeds _____ mL.
500 mL
The fetus develops inside a fluid-filled bag-like membrane called the amniotic sac or bag of waters and contains ____ - _____ mL of fluid.
500-1,000 mL
What is the average tidal volume for an adult?
500-600 mL
H cylinders contain about _____ liters of oxygen.
6,900
The diaphragm is responsible for ______ % of the ventilation effort?
60-70%
E cylinders contain about ____ liters of oxygen.
625
The optimal pH of blood is normal at?
7.4
What size of ET tube would you choose to fit an average sized man or woman?
7.5
Under what patient age should you not use an automatic ventilator?
8 y/o
Normal blood glucose levels are?
80-120 mg/dL
When transporting a premature infant, keep the temperature of the ambulance at ______.
90 to 95 degrees F (32.2-35.9 degrees C)
Skeletal muscle makes up ____% of the body.
90%
Cardiac arrest in the adult population is most often the result of?
A cardiac arrhythmia.
Define a "drug".
A chemical substance used to treat or prevent a disease or condition.
Respiratory alkalosis is?
A condition marked by low levels of carbon dioxide in the blood due to breathing excessively.
Define a "medication".
A drug or other substance used as a remedy for illness.
What is an intervertebral disc?
A fluid pad of tough elastic cartilage between each vertebrae. It acts as a shock absorber & allows for movement of spine.
Aphasia is a condition that may result from ________.
A head injury where the patient is unable to speak or understand what is being said.
Cardiovascular problems can relate to one or a combination of?
A pipe, pump or fluid problem.
Hemostasis is _______?
A process which causes bleeding to stop.
Pulmonary emboli
A pulmonary emboli is a piece of foreign material that has traveled from another part of the body and is lodged, blocking the pulmonary artery. It is common and underdiagnosed as it is the 3rd leading cause of death in the United States. Causes include obesity, infection, long bone fractures, pregnancy, surgery, prolonged inactivity, blood diseases, and cancer.
A short barrel gun would be ______ energy wound. While a hunting rifle would be _____ energy wound and an ice pick would be ______ energy wound.
A short barrel gun would be medium energy wound. While a hunting rifle would be high energy wound and an ice pick would be low energy wound.
A _________ ________ is often caused by a ruptured bleb or air sac on the lung
A spontaneous pneumothorax
What is a stoma?
A surgical opening
Pertinent negative is _____?
A symptom you would expect to find under certain circumstances but is not present with the current patient. Example: Patient denies chest pain.
A shunt is what?
A tube running out of the brain cavity used to drain fluids.
A _____ device would NOT be appropriate for a rapid extrication because why?
A vest-style device such as a K.E.D because it takes too long to apply.
Cheyne-stokes breathing pattern is described as?
Abnormal breaths with periods of apnea.
Three glands of the endocrine system are?
Adrenal, gonads, thyroid
Bradycardia is considered what in an adult? Child?
Adult- less than 60 BPM Child- less than 80 BPM
Normal respiratory rates for adults, children and infants are?
Adults 12-20 Children 18-30 Infants 30-60
Plasma contains large molecules of _______ that keep the water portion of plasma from leaking outside the vessel.
Albumin
Name the oxygen cylinders and how many liters are in them at what PSI?
All cylinders are at 2,000 PSI -D tank: 350 liters -E tank: 625 liters -M tank: 3,000 liters -G tank 5,300 liters -H tank 6,900 liters
Seizures are caused by an overload of electrical activity in the brain. Which of the following answers is capable of causing this electrical overload? -Epilepsy -Medication -Head injury
All of the above. Many things can cause a seizure. Electrical impulses in the brain can be set to overload.
What is a laryngectomy?
All or partial removal of the larynx.
Epinephrine stimulates four receptors, what are they?
Alpha 1 & 2, Beta 1 & 2. These properties make up the sympathetic nervous system. **Beta 1- speeds up heart rate
List from the most ominous to the least severe signs of potentially life threatening respiratory problems in adults.
Altered mental status, severe cyanosis, absent breath sounds, audible stridor, 1-2 word dypsnea, tachycardia >130, diaphoresis, accessory muscle use.
Ritalin and Adderall are examples of _____ drugs.
Amphetamines
Septic shock is the result of?
An infection; treat for shock, rapid transport.
Which assessment finding would most likely indicate cardiac compromise?
An irregular pulse
Exposure to nerve agents has become a very real threat for today's EMS personnel. Antidote kits are now being carried on some BLS units. What are these antidote kits called?
Antidote kits for nerve agents are called Mark 1 kits or NAAK (Nerve Agent Antidote Kits). They consist of two auto injectors of medication. The first is atropine and the second is 2-PAM chloride (pralidoxime). Use of these kits are based upon local protocols.
The Pediatric Assessment Triangle is a visual assessment tool used to assess what?
Appearance, work of breathing and circulation to the skin.
You arrive on scene with your partner Dave to find a woman complaining of abdominal pain. She said it started around her belly button and has moved to the right. It started about 3 days ago and has continually gotten worse. What does the patient likely have?
Appendicitis
Bones have both ______ & ______.
Arteries and vessels.
Oxygenation is the ______ by which the ______ become saturated in oxygen and is the result of ________.
Process by which blood and cells become saturated in O2, is the result of respiration.
Benzodiazepines (BZD) are drugs used to ______. What are they classified as?
Produce sedation, induce sleep, relieve anxiety & muscle spasms and prevent seizures. This drug is classified as a depressant.
Depth perception is something that can be affected by either or both of the ______ lobes or the ______ lobes.
Occipital or frontal lobes
Glasgow Coma Scale (Eyes) Describe the rating scale.....
(1 point) Does not open eyes (2 points) Opens eyes in response to painful stimuli (3 points) Opens eyes in response to voice (4 points) Opens eyes spontaneously
Glasgow Coma Scale (Motor) Describe the rating scale.....
(1 point) Makes no movement (2 points) Extension to painful stimuli ---> Decerebrate response (3 points) Abnormal flexion to painful stimuli --->Decorticate response (4 points) Flexion/withdrawal to painful stimuli (5 points) Localizes painful stimuli (6 points) Obeys commands
Glasgow Coma Scale (Verbal) Describe the rating scale.....
(1 point) Makes no sound (2 points) Incomprehensible sounds (3 points)Utters inappropriate words (4 points) Confused and disoriented (5 points) Oriented, converses normally
Of the following vitals, which would you hope to find in a 7 y/o child? -BP 104/60, respirations of 16 per minute and a pulse of 98 -BP 108/64, respirations of 20 per minute and a pulse of 100 -BP 100/58, respirations of 14 per minute and a pulse of 125 -BP 116/70, respirations of 27 per minute and a pulse of 130
-BP 108/64, respirations of 20 per minute and a pulse of 100
You come upon a victim of asphyxial cardiac arrest. What is the correct sequence of events for your actions?
-CPR for 5 cycles (approx. 2 minutes) -Activate the emergency response system -Retrieve the AED
Serious burns have 3 different areas that often appear as a bulls eye.... name the zones.
-Coagulation: most severely damaged -Stasis: contains cells still potentially viable -Hyperemia: outer edge of burn that's inflamed
Types of abdominal pain
-Colicky pain= cramping; comes and goes -Parietal pain= stabbing -Referred pain= travels -Visceral pain= vague or dull
Stages of shock?
-Compensated -Decompensated -Irreversible
Care for soft tissue injuries includes?
-Controlling bleeding -Check PMS -Dress/bandage the wound -Check PMS again
NREMT spinal immobilization skill sheet
-Direct assistant to maintain manual immobilization of the head - Check pulse and motor sensory - Apply c-collar
Methods of controlling bleeding include?
-Direct pressure -Elevation -Air splints -Application of ice -Application of clotting agents -Tourniquet
Name the 4 principles of "body mechanics".
1). keep weight of object as close to body as possible 2). use hip, leg, gluteal muscles to lift 3). "stack" (shoulders, hips, feet) 4). reduce height/distance which object must be moved (lift in stages if needed).
Describe the attachment of the ribs.
-First 7 pair (true ribs) are attached to the sternum by cartilage. -Next 3 pair are attached to the ribs above them with cartilage. -Last 2 pair are not attached to the sternum (false or floating ribs).
Name a list of several narcotic (opiates) and what effect they have on the CNS....
-Hydrocodone (Vicodin) -Propoxyphene (Darvon) -Heroin, morphine, codeine, meperidine (Demerol) These type of drugs suppress the CNS, depressing the respiratory system, heart rate and blood pressure.
What are the types of shock?
-Hypovolemic -Distributive -Obstructive -Cardiogenic -Anaphylactic -Sepsis -Neurogenic
Contraindications for Nitro are....?
-NEVER give a patient w/a suspected head injury -NEVER give to children -Patients taking erectile dysfunction drugs -NEVER give to a patient with a systolic LESS than 90 BP (outside LA county) or LESS than 100 BP (LA county)
Common places to check skin signs
-Nail beds -Mucous membranes (inside lips or eyelids)
OCAM stands for what?
-Open the airway -Clear the airway of secretions -Assess respirations -Manage airway accordingly
Chewable aspirin is ____ the dose of swallowable.
Half
List the haz-mat placards
-class 1-explosives -class 2-gases -class 3-flammable & combustible liquids -class 4-flammable solid spontaneously combustible-dangerous when wet -class 5-oxidizer & organic peroxide -class 6-poison & poison inhalation hazard -class 7-radioactive -class 8-corrosive -class 9-miscellaneous
Pharmacology terminology
-classification (use of drug) -action (what it's used for, most drugs have several uses) -indication (why we use the drug) -contraindication (why we won't use the drug) -dosage -integrity -clarity
Name the components of the LLQ (left lower quadrant).
-colon -small intestines -major artery & vein to the left leg -ureter
Name the components of the RLQ.
-colon -small intestines -major artery & vein to the right leg -ureter -appendix
Obstructive shock (blocked flow)
-embolism, thrombus -aneurysm -pneumothorax -cardiac tamponade
Name some of the general guidelines of lifting.
-have an even number of rescuers -heavy loads carry no more than 1 minute -back locked; don't hyperextend (lean back) -know your limitations
Upper G.I. bleeds
-hematemesis (vomiting bright red blood) -coffee ground emesis (digested blood in vomit, dark red/purple)
Lower G.I. bleeds
-hematochezia (acute rectal bleed, bright red) -melena (digested blood in stool, dark red/purple)
Distributive shock (pipe problems)
-hypothermia -drug overdose -anaphylaxis
Some possible causes of "colicky pain" are?
-kidney stones -gallstones -chronic lead poisoning -choledocholithiasis
Name the components of the RUQ.
-liver -right kidney -colon -pancreas -gallbladder
Name the components of the LUQ.
-liver -spleen -left kidney -stomach -colon -pancreas
What two forms of oxygen dosage are there?
-passive (the patient inhales it themselves) -active (positive pressure ventilation via BVM)
Name the vital signs.
-respirations (rate, depth, quality) -pulse (rate, rhythm, quality) -skin (CTC- color, temperature, condition) -pupils (PERL?- equality, reactivity, size) -blood pressure -pulse oximetry
Noisy Breathing (Sound & Potential Cause)
-snoring: tongue partially blocking upper airway -wheezing: constriction of bronchioles in lungs -gurgling: fluid in UPPER airway -stridor/crowing: partial UPPER airway obstruction
Burn management consists of?
-stopping the burn process -support of ABC's -applying a DRY sterile dressing OR burn pads -preventing hypothermia -remove rings or other jewelry ONLY if there's severe swelling -NEVER peel off clothes, cut around them
Name the components of the midline area (abdominal quadrant).
-the aorta -pancreas -small intestines -bladder -spine
Name the components of the pelvis.
-the sacrum & coccyx of the spine -the iliac crest -pubis -the ischium
A hypotonic solution usually consists of ____ or _____% saline.
0.25 or 0.45%
Name the 6 types of joints and an example of each.
1). Ball & socket- shoulder, hip 2). Hinged- elbow, knee, finger 3). Pivot- wrist, head, neck (permits a turning motion) 4). Gliding- bones in hand and feet 5). Saddle- the ankle (permits combination of limited movement) 6). Condyloid- the wrist can move up/down & side/side but not rotate completely. (modified ball & socket type joint that permits motion in 2 directions)
The skeletal system serves 4 main functions, what are they?
1). Gives the body shape. 2). Provides protection of vital internal organs. 3). Allows for movement. 4). Stores minerals and produces blood cells.
Name the 6 main components of the skeletal system.
1). Skull 2). Spinal column 3). Thorax 4). Pelvis 5). Upper extremities 6). Lower extremities
Name the possible positions in which to place a patient.
1). Supine 2). Prone 3). Fowlers: (sitting up) patient's upper body is at a 45-60 degree angle. 4). Semi-fowlers: patient's upper body is at less than a 45 degree angle. 5). Trendelenberg: patient's legs are elevated higher than the head. 6). Shock position 7). Lateral recumbent: (recovery position) patient is laying on their left or right side.
What are the 5 special considerations for the pediatric airway vs. the adult airway?
1). a child has a smaller nose & mouth 2). in a child, more space is taken up by the tongue 3). child's trachea is narrower 4). cricoid cartilage is less rigid and less developed 5). the child's airway structure is more easily obstructed
Medication name types
1). chemical name 2). generic name 3). trade (brand) name 4). official name
Name the forms of medication (hint- there's 8)
1). compressed powder/tablet 2). liquid injection 3). gel 4). suspension (must shake!) 5). gas 6). spray 7). fine powder for inhalation (i.e. MDI's) 8). liquid vaporized fixed dose nebulizer (compressed gas)
A woman with preeclampsia will _____?
Have swelling in the feet, hands and or face.
What is the depth compression for a child in CPR?
1/3- 1/2 an inch.
What is the goal for on scene time when caring for a trauma or shock patient?
10 minutes (the platinum ten)
Your patient is a 33 year old female who fell off the back of a motorcycle going approximately 20 MPH. Her respirations are irregular at 8 a minute. An OPA has been inserted and ventilations are being assisted with a BVM and 100% O2 at a rate and tidal volume of________________________. C-Spine precautions have been taken and she is packaged and moved to the ambulance where she stops breathing and there is no palpable pulse. CPR is started and the lead paramedic does a rapid sequence intubation. The BVM is attached to the ET tube and ventilations are restarted at a rate of ______________________________________________.
10 to 12 breaths per minute. Tidal volume of just enough air to give adequate chest rise. 8 to 10 breaths per minute without pauses in compressions.
Smooth muscle makes up ___% of the body.
10%
How long is an EPI injection shot usually effective for?
10-20 minutes
Only around ___ - ___ % of the epinephrine gets injected into the patient, the rest stays in the auto-injector.
10-20%
AHA Guidelines specify that for all children, a rescue breath rate of ___ to ____ is to be used.
12 to 20
You are assisting your partner who is preparing to intubate a 79 year old woman. You are managing the BVM and begin ventilating and preoxygenating the patient at what rate?
12-20 breaths a minute for 1-2 minutes
Pre-oxygenating and hyperventilating a patient prior to intubation should be done at a rate of __________ per minute for _____ minutes with ______ attached.
12-20 breaths per minute for 1-2 minutes with high flow O2 attached.
Name the skeletal components of the face.
14 bones, 13 of which are immovable & interlocking. Includes: orbits, nasal bones, the maxillae (upper jaw), the zygomatic (cheek) bones, the mandible (lower jaw, strongest bone in the face).
Anything less than ____% oxygen concentration won't allow for cellular diffusion.
16%
Rule of Nines for Children
Head (entire)- 18% Chest & Abdomen (front & back)- 18% Entire Arm- 9% Genitals- 1% Entire Leg- 14% (13.5%)
If the AED gives you a "no shock advised" message, what should your next move be?
Assess the pulse.
What is the air pressure for both inhalation and exhalation?
At inhalation, pressure is negative. At exhalation, the pressure is positive.
Biot's breathing is often also referred to as ______.
Ataxic respirations
You and your partner Bob are called to the scene of a man down. The report said the man has no pulse and that family members are doing CPR. Upon arriving at the scene what 3 things are you going to do first?
Attach the AED, tell everyone to stand back, and hit the analyze button.
The brain stem affects ________.
Awareness
BURP is supposed to help you remember what?
BACK- UP- RIGHT- PRESSURE. Used when giving cricoid pressure to help visualize the cords and prevent gastric distention.
What are baroreceptors?
Baroreceptors sense changes in BP from vasoconstriction and vasodilation.
A 6 y/o was struck by a car while crossing the street. You would suspect what type of injuries on this patient?
Because of their size and relationship to the height of cars, children's injuries most often include head, chest, abdomen, and pelvis.
You are off duty at a college football game when you see a man at the concession counter fall to the ground. A doctor standing in line behind the man begins to assess and yells, "Call 911, he doesn't have a pulse!" You scan the area for an AED and see nothing. What should you do?
Begin CPR and ask a bystander to locate an AED. You would only call 911 yourself if you were the lone healthcare provider and the collapse was asphyxial in nature, but in this case the attack was most likely coronary in nature.
You are providing life support and performing CPR on a 53 year old male who had an unwitnessed collapse. The defibrillator was attached, an analysis was performed, and a shock was delivered. What should you do next?
Begin CPR with chest compressions.
If the infant is below 60 beats per minute, you should?
Begin chest compressions
If your patient is unconscious as a result of an FBAO (foreign body airway object), you should _______ after verifying _______.
Begin chest compressions after verifying an occluded airway.
"Buccal" refers to ______.
Between the cheek and gums. (Route administration)
Where is the pleural space/cavity? At what pressure is it at?
Between the parietal (rib/outer) pleura and the visceral (lung/inner) pleura space. At negative pressure.
A pulmonary embolism is a _____?
Blockage of the main artery of the lung (the pulmonary artery) or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream. This is usually due to embolism of a thrombus (blood clot) from the deep veins in the legs.
Ligaments connect ______ to ______.
Bone to bone.
______ is an early sign of hypoxia in ________.
Bradycardia is an early sign of hypoxia in infants.
"Biot's" or cluster breathing is when the patient is _________. This type of respiratory pattern is indicative of _______.
Breathing very fast, but not very deep with periods of apnea. It is indicative of a head wound and injury to the medulla oblongata. It can also be caused by strokes and uncal or tentorial herniations.
Beta 2 agonist drug causes ______ to dilate.
Bronchioles
Pulmonary edema?
Can affect both the alveoli and interstitial spaces of the lungs. Pulmonary edema is the filling of the lungs with fluid caused by either an increased hydrostatic pressure or a high permeability in the lung's tissues. It is not a disease, but a pathophysiological condition caused by both disease process, neurotoxin injection, brain injury, diving accidents, and cardiac problems.
Carbon monoxide _____ to the hemoglobin in red blood cells displacing the oxygen molecule and _______ perfusion.
Carbon monoxide binds to the hemoglobin in red blood cells displacing the oxygen molecule and inhibiting perfusion
Electrolyte imbalances (sodium or potassium) in the body can cause _____ ______.
Cardiac irregularity
Prescribed inhaler overdose can cause ______ _______.
Cardiac ischemia
Rule of Nines for Adults
Head (entire)- 9% Chest (front)- 9% Chest (back)- 9% Abdominal (front)- 9% Abdominal (back)- 9% Entire Arm- 9% Genitals- 1% Entire Leg-9%
A 73 y/o woman was in her backyard gardening when she collapsed to the ground. Her husband told 911 that "she is breathing very fast and will not talk to me." You arrive to find the woman lying on her side in the grass. She is breathing at 7 breaths per minute and her pulse is irregular and very thready. Her lungs also present with crackles upon auscultation As you are taking a blood pressure (88/66) the husband tells you that the woman has been having jaw pain and some weakness for approximately 3 days. What is the most likely cause of this woman's condition and how would you treat her?
Cardiogenic shock, assist ventilations and transport. The woman is likely experiencing pump failure and is hypoperfusing.
An elderly patient has adequate respiratory depth, rate and good quality but her SpO2 reading is at 90% What's causing the low reading and how will you treat her?
Chemoreceptors slowing down because of advanced age, put patient on a nasal cannula at 5 lpm
CPR chest compressions are at ____ per minute and about _____ breaths per minute.
Chest compressions: 100 per minute Breaths: 5-6 per minute
A rare side effect of an inhaler would be _____ but can be mitigated by O2 administration.
Chest pain
You can expect what type of side effects following the administration of an MDI?
Common side FX of a beta agonist drug are: -tachycardia -tremors -nervousness -nausea -vomiting -dry mouth
What do the submandibular muscles do?
Control the tongue.
What skin sign temperature is a likely indicator of significant blood loss?
Cool (shock, hypoperfusion)
What is the treatment for an injured eye?
Cover the eye with a paper cup and bandage WITHOUT pressure. Goal is to prevent further injury to eye without pressure. You'll want to cover the uninjured eye as well.
Epithelial tissue ________.
Covers the whole surface of the body.
Your 57 year old patient was a chain smoker for 35 years and is pursing their lips during exhalation. This is likely to?
Create a back pressure on collapsed alveoli. Breathing with pursed lips is a sign that a COPD patient is trying to keep the alveoli open with back pressure on their lungs.
What would you use to remove a bee stinger in a patient?
Credit card (or similar). Using a tweezer could rupture the venom sac injecting more venom.
The lower airway extends from the ______ to the ______.
Cricoid cartilage to the alveoli of the lungs.
Indications for Nitro are....?
Crushing/dull like chest pain, or patient describes pain that is indicative of cardiac chest pain.
What is a late sign of hypoxia?
Cyanosis
A patient with severe bleeding may not show signs of ________ because _________.
Cyanosis, because hemoglobin must be present in blood to change its color.
Fractures of the tibia and fibula commonly include?
Damage to the vessels.
Define "ischemia".
Damaged cell tissue due to a lack of oxygen.
With regard to the heart..... Decrease in volume= _______ in pressure. Increase in volume= ________ in pressure.
Decrease in volume= increase in pressure. Increase in volume= decrease in pressure.
The parasympathetic nervous system is responsible for _______ ?
Decreased breathing and slowing heart rate.
A patient with heart failure will have a ____ stroke volume (SV) and a ______ heart rate (HR).
Decreased stroke volume and to offset, will have an increased heart rate.
You are intubating a 53 year old woman who is unconscious and has no gag reflex. Just after placing the tube and inflating the cuff you auscultate the epigastrum and lungs. You are unsure if tube placement is correct as there were conflicting sounds in the epigastrum. You should?
Deflate the cuff and take the ET tube out. If you are not sure if tube placement is good and the airway is patent you must immediately remove the tube and prepare to try again. (While your partner returns to ventilations and hyper oxygenation.)
After an unsuccessful attempt at opening the patient's airway with the jaw thrust maneuver, you should then use the _______.
Head tilt chin lift maneuver
Unequal pupils are associated with _______________.
Head trauma cerebral hemorrhage.
You come upon a victim of asphyxial cardiac arrest. Which of the following is the correct order of action?
Do CPR for 5 cycles or approximately 2 minutes and then activate the emergency response system and retrieve the AED. 2005 AHA CPR Guidelines specify that treatment for asphyxial cardiac arrest should begin with 5 cycles of CPR prior to activating the emergency response system or retrieving the AED.
What path do head-on/front end collisions usually take on the body?
Down & under/up & over
Symptoms of a pulmonary embolism include?
Dyspnea, chest pain on inspiration.
A tell-tale sign that a patient has sustained a fracture is?
Ecchymosis at the site of the injury.
List the layers of skin from most outer to inner.
Epidermis, dermis, subcutaneous layer.
A collapsable tube that is approximately 10 inches in length?
Esophagus
Respiratory acidosis occurs when?
Exhalation is inhibited. The lungs cannot remove all the carbon dioxide the body is producing.
Adipose tissue is what?
Fat (loose connective tissue composed of adipocytes).
Seizures in children are most often the result of?
Fever (febrile seizures)
For delivery of a baby, the first clamp should be put approximately ____ inches from the babies umbilicus and the second clamp should be placed _____ inches from the first towards the _____.
First clamp: 3-4 inches Second clamp: 2-4 inches towards mom.
Describe 1st degree burns.
First degree burns, or Superficial, involve only the epidermis and are the result of short exposure to high heat sources, or longer exposure to weaker heat sources, as in a sunburn.
What history and physical exam would you choose for a patient who is in respiratory distress and has no signs of trauma?
Focused; focused. You know their chief complaint and life threat is likely the respiratory distress so you can FOCUS on gathering history of breathing difficulty as well as do a FOCUSED exam of the affected body system which in this case is the lungs and airway.
What is the preferred position of comfort for patients in respiratory distress?
Fowler's (sitting up)
Medications like _____ which is a ____ can be administered by a paramedic to help clear fluid in the lungs.
Furosemide, a diuretic
Your 34 y/o patient is breathing on their own at a rate of 18 breaths per minute and an approximate volume of 150 mL. What should you do?
Give positive pressure ventilation with high flow O2. Tidal volume of 150 mL is INEFFECTIVE at oxygenating tissues at any rate. 150 mL is what air resides in the "dead space" of the airway and NEVER reaches the alveoli, therefore if the patient is only taking in 150 mL of air, the oxygen is never reaching the alveoli.
Brain cells only use ______ for energy.
Glucose
_______ denotes the number of pregnancies and ______ denotes the number of live births.
Gravida/para
With a conscious patient you should obtain _____ first, and then a _____, followed by _____
HX first, then a focused assessment, followed by baseline vitals.
Diabetics often suffer from medical complications such as?
Heart disease, visual disturbances, renal failure, stroke, ulcers or infections to the feet or toes.
In some situations the postical state may be characterized by?
Hemapharesis or weakness on one side of the body, resembling a stroke.
________ is often seen in stroke patients. It is paralysis of one side of the body as nerve fibers cross in the brainstem.
Hemiplegia is often seen in stroke patients. Damage to one side of the brain produces opposite side paralysis.
Your patient is a 3 year old girl who has attempted to ingest a penny. She is pale and has nasal flaring and intercostal retractions during inhalation that is accompanied by stridor. Her pulse is 70 and her movements are sluggish. With regard to respiratory arrest, which of the above signs is the most ominous?
Her pulse is 70. Anything below 80 for a child or below 100 for an infant is considered life threatening.
The glottic opening (vocal cords) of a child is ______ in the airway than that of an adult.
Higher
Cardiac output is?
How much blood flows through the entire circulatory system in 1 minute.
Healthy people breath on a _________ drive.
Hypercarbic drive
Lack of insulin will produce?
Hyperglycemia
Preeclampsia is characterized by what?
Hypertension and fluid retention
If you inject a patient with too much of a _________ solution the red blood cells will begin to draw so much water in that they can swell up and burst releasing potassium into the body.
Hypotonic solution
If you don't know what type of shock, but there's trauma, assume it's _______ shock.
Hypovolemic
What is the most common cause of cardiac arrest in kids?
Hypoxia
Hypoxia= Ischemia= Infarction=
Hypoxia= decreased oxygen Ischemia= hypoxia 2nd degree (blocked flow) Infarction= cell death 2nd degree (ischemia)
COPD patients breathe on a _______.
Hypoxic drive
What causes air to enter the lungs during inhalation?
Negative pressure due to diaphragm contraction.
Cephalic presentation is _____ ?
Normal position of childbirth where the head enters the pelvis first.
In a ________ solution, the RBCs will swell and pop. In a _________ solution, the RBCs will shrink, and in an _________ solution, they will appear to be the same.
In a hypotonic solution, the RBCs will swell and pop. In a hypertonic solution, the RBCs will shrink, and in an isotonic solution, they will appear to be the same.
Central chemoreceptors are located ________?
In the medulla of the brain stem.
Beta receptor stimulation will cause the patient's heart rate to _____ and the vessels to ______.
Increase & constrict
What is the most detrimental effect that tachycardia can have on a patient experiencing cardiac compromise?
Increased oxygen demand.
Post delivery care of the umbilical cord is important because?
Infection is easily transmitted through the cord to the baby.
Cricoid cartilage is located in the _____ portion of the _____.
Inferior portion of the larynx.
Potassium (electrolytes) are found mostly _____ the cell.
Inside
What two important hormones are produced by the pancreas to regulate blood sugar?
Insulin & glucagon
Type 1 diabetes is associated with people who do not produce any ______. They may also suffer from metabolic problems & ______.
Insulin/organ damage Type 1 diabetes is a result of the body's inability to produce insulin and may eventually result in organ failure due to the body literally eating itself.
Name the skeletal components of the skull.
Interlocking bones: the occipital, two parietal, two temporal, the frontal.
What should you suspect from a patient that has just fallen from a significant height? (Hint: something you can't see)
Internal injuries
What is serous fluid?
It is a fluid within the pleural space that acts as a lubricant to reduce friction during the breathing process.
Pulse rule? Example: Radial= 80, brachial=70, carotid=60
It takes more pressure to get blood further out from the heart.
Most of the stomach is within the _____ quadrant, as is the entire _____.
LUQ (left upper quadrant); spleen
The trachea (aka "windpipe") extends from the _____ to the ______.
Larynx to the carina.
A drop in BP is a ____ sign of shock.
Late sign
In severe hypoxic patients, tachycardia could ________.
Lead to dysrhythmias and eventually bradycardia.
The release of histamines can cause?
Leaking of fluid from the vessels.
An SaO2 saturation of ________ % is considered hypoxic.
Less than 95% however patients with COPD will have a lower SPO2 reading.
The respiratory systems stimulus to breath, responds primarily to ________ ?
Levels of carbon dioxide in the body.
The bronchioles are lined _______ and _______.
Lined with smooth muscle and mucous membranes.
Plasma is the _____ portion of the blood that carries everything else.
Liquid
A major organ located in the RUQ is the?
Liver
You assess a young man who has yellow colored sclera. You would suspect he is suffering from?
Liver failure
A steroid inhaler is used for ______ ______ reduction of needed use.
Long term
Anaphylaxis will likely produce a _____ BP.
Low
A person suffering from an allergic reaction will likely have ______________.
Low BP, high pulse rate.
There is ____ pressure in the veins and _____ pressure in the arteries.
Low pressure in veins, high pressure arteries.
Define "hypopnea".
Low volume breathing
Allergic reactions generally _____ the BP and _____ the pulse rate.
Lower the BP, speed up pulse rate.
Trachea posterior wall is _________ ?
Made up of muscle therefore not a rigid structure.
Ventilation is a ______ process.
Mechanical process that creates pressure changes in the lungs to draw air in/force it out.
Describe the percentage breakdowns of burns.
Minor- less than 10% Moderate- 10-20% Critical- full thickness burns of any % along with partial thickness above 20% of the body
Meperidine (Demerol) is a drug used to treat ______.
Moderate to severe pain.
Your patient is a 62 year old female who has fallen approximately 4 feet from a ladder while decorating her Christmas tree. She has obvious kyphosis and is complaining of back pain and numbing in her left leg. Which of the following choices contains the most appropriate treatment?
Move her to a backboard while maintaining c-spine stabilization. Pad under the patient's head as needed. A person who has kyphosis, and a suspected back or cervical spine injury, should be secured to a backboard while utilizing appropriate padding to fill the void created by the curvature in the vertebrae.
Tendons connect ________ to ______.
Muscle to bone.
_____ is a drug that a paramedic can administer to reverse the effects of narcotic drugs.
Naloxone (Narcan)
You and your partner Ingo arrive on scene to find a 55 year old man who is showing signs of aphasia. He shows positive for right arm drift and the right side of his face is drooping slightly when he tries to speak. This patient should be transported?
On their right side. Patients who show signs of a stroke should be transported with the affected side down with the head elevated 6 inches.
According to 2005 CPR and AED guidelines, a patient with a VF rhythm should be shocked how many times before CPR is resumed?
One
1Hb ----> 4 hemes
One hemoglobin has 4 subsections called "hemes"
When is the "Sellick maneuver" (cricoid pressure) used? What is it effective for? How many people must you have to do it?
Only in an unresponsive patient not protected by endotracheal tube (ET tube). It is effective in reducing gastric inflation, regurgitation and aspiration of gastric contents. You need 2 EMTs for this.
You are the only responder to arrive on the scene of an unconscious patient that has no pulse and no sign of trauma. What should you do?
Open the airway and begin CPR.
The cerebellum affects _______.
Orientation
What does the prefix ecto- mean?
Outside
Sodium (electrolytes) are found mostly _____ the cell.
Outside (extracellular)
Rescue breaths in an adult should be delivered over a period of _____ and with _____.
Over a period of 1 second with just enough volume to get visible chest rise.
Electrical impulses traveling through the ATRIA produce the ________. These impulses originate at the ______.
P wave/SA node
What is Para and Gravida?
Para= # of live births Gravida= # of pregnancies
______ is localized pain in the parietal peritoneum or stomach lining. ______ is diffused pain, dull and poorly localized. ________ is pain felt in another location other than where it originates.
Parietal is localized pain in the parietal peritoneum or stomach lining. Visceral is diffused pain, dull and poorly localized. Referred pain is pain felt in another location other than where it originates.
_______ _______ is a part of being an EMT but not part of the EMT's Duty to Act.
Patient advocacy
Patient with orthostatic hypotension will be ________. This is a result of ________.
Patients with orthostatic hypotension have low BP's that is tolerable when lying down but results in hypoxia and dizziness when the patient stands up because of the inability of the system to pump blood efficiently to the brain at current pressures. This is a result of poor pump function.
During the initial assessment you are unable to ventilate an unresponsive infant after already repositioning the airway twice. What is your next action?
Perform 5 rapid back blows followed by 5 quick chest thrusts. ***Never do abdominal thrusts!!!
_________ __________ is a rare condition in which the heart is impeded by fluid in the pericardium, will result in a low BP and muffled heart sounds with a very weak pulse as the heart struggles to pump.
Pericardial tamponade
Dispatch has called you and your partner Weston to a domestic dispute that has resulted in the wife stabbing the husband in the chest with an ice pick. The woman is in custody when you arrive and you enter the residence to find the husband lying on the floor with a bloody shirt on. He is conscious and alert with respirations around 26 per minute. His pulse is weak at approximately 130 beats per minute and his lungs sounds are clear and bilateral. His jugular veins are distended and removal of his shirt reveals 2 small holes just lateral of the sternum. His blood pressure is 94/60 and he is becoming increasingly distressed. This patient is likely suffering from? __________________________. Treatment would include_____________________.
Pericardial tamponade/ C-spine stabilization, O2, and an IV set, using a large bore catheter. his patient is exhibiting the signs of pericardial or cardiac tamponade. A tension pneumothorax, sucking chest wound, or hemopneumothorax are not likely, as lungs sounds are clear and bilateral. Additionally, there is no tracheal deviation.
______ _______ is when the placenta prematurely separates from the wall of the uterus and _______ ______ is when the placenta is blocking the cervix and presenting before the baby. They are best managed by transporting the patient on her _____ _______ to prevent supine hypotension.
Placenta abruptio is when the placenta prematurely separates from the wall of the uterus and placenta previa is when the placenta is blocking the cervix and presenting before the baby. They are best managed by transporting the patient on her left side to prevent supine hypotension.
Air that collects in the space between the visceral and parietal pleura is termed what?
Pneumothorax
No breath sounds on one side is a characteristic of _____ or a _____.
Pneumothorax or collapsed lung.
Your patient is an 86 year old female who is complaining of difficulty breathing. She says it has been getting worse for the last few hours. She has a cough that she says, "has been..(breath) a companion(breath) for years." During your assessment you find that she has a rapid pulse and diminished breath sounds on her right side. She also says her chest hurts every time she coughs. What is the likely cause of this woman's complaint?
Pneumothorax. This woman likely has COPD, but the absence of breath sounds and the pain when she coughs is a sign that she has a spontaneous pneumothorax. Pulmonary Effusions is a made up term (it's pulmonary EMBOLISM and Pleural Effusion). People with weakened lung tissue can cough and cause a spontaneous pneumothorax.
Carbon monoxide poisoning may result from ______.
Poorly ventilated wood stoves.
In geriatric patients you should consider a headache as ________ ?
Potentially serious
Stroke is a common cause of brain disorder that is ______ ?
Potentially treatable
Treatments for Shock ("The 4 H Club")
Prevention of: -Hypoxia (oxygen therapy; high flow O2) -Hypothermia (passive warming) -Hypotension (backboard- supine, no backboard- supine or 'shock position') Higher care (ALS, emergency department)
PVR stands for?
Pulmonary vascular resistance
Parasympathetic NS response overview
Pulmonary: bronchioconstriction (slowing breathing) Heart: Decreased HR & stroke volume Blood Vessels: Vasodilation Skin Signs: pink, warm, dry Mental Stats: lethargic, relaxed, calm G.I. Tract: increased activity
Sympathetic NS response overview
Pulmonary: bronchodilation (faster breathing) Heart: Increased HR & stroke volume Blood Vessels: Vasodilation to skeletal muscles, vasoconstrict periphery Skin Signs: cool, pale, sweaty Mental Stats: (ALO x3) scared, pissed, anxious, confused G.I. Tract: decreases activity, shuts down the gut
A child 3-6 y/o will have a range of ____ for pulse, _____ for respirations, and _____ systolic BP.
Pulse: 80-120 BPM Respirations: 20-30 Systolic BP: 98-110
_________ is when the systolic pressure will drop by more than 10 mmHg when the patient inhales.
Pulsus paradoxus
You and your partner are having lunch at a city park when you hear a woman on the playground screaming. Several adults and children are gathered around and you decide to investigate. As you approach the playground you can see the frantic woman holding an approximately 4 year old child in her arms. As you get closer you can see that the child has a laceration to the foot that is actively bleeding. Upon seeing you and your partner, the screaming woman comes running toward you. What would be the best course of action?
Put direct pressure on the child's bleeding foot with a sterile dressing. While moving to the ambulance talk to the mother and encourage her to calm down. Let her and the child know that you are taking care of the cut on the foot.
When doing a child assessment, remember to _______ before you lay them on their back.
Put padding such as a folded towel under their shoulders to keep the airway aligned (they have bigger heads than their body).
Describe the treatment for a spider bite.
Put patient on O2 and lightly cleanse the bite with soap & water.
Hypoglycemia (Insulin Shock)
RAPID ONSET! S/S Include: -cool, sweating -hunger -weakness -tingling/numbness -cranky/aggressive -fast pounding heart -blurred vision
The liver and gallbladder lie within ____ quadrant.
RUQ (right upper quadrant)
What sort of signs & symptoms would a patient with heat stroke demonstrate?
Rapid respirations, rapid weak pulse, little to no sweat, dilated pupils, and seizures may all be seen in heat stroke.
What is the correct compression depth and rate for an adult in 2 rescuer CPR?
Rate- 30:2 Depth- 1.5 to 2 inches
What is the correct ratio and depth for 2 person rescuer CPR compressions?
Ratio- 15:2 Depth- 1/3 to 1/2 the depth of the chest
The ongoing assessment consists of?
Repeating the initial assessment, repeating vitals, repeat focused assessment, check interventions
Hyperventilating results in what?
Respiratory alkalosis. The body is getting rid of too much CO2
Always document patient's ____ to glucose after administration.
Response
A patient who responds to you when you speak to them is considered what?
Responsive to verbal stimuli. You do not yet know if they are oriented.
Multiple sclerosis (MS) is a disease that ______________.
Results from the destruction of the myelin coat of the CNS.
Newborns being administered oxygen therapy can potentially be caused _____?
Retinal damage and blind the baby.
Atrioventricular valves on both sides of the heart are called?
Right AV= tricuspid Left AV= bicuspid (aka mitral)
The ____ lung is slightly larger than the ______ lung.
Right lung, larger than the left.
Exposure to nerve gas (S.L.U.D.G.E)
S- salivation L- lacrimation (crying) U- urination D- defecation G- G.I. pain E- emesis (vomit)
Hyperglycemia (DKA, Diabetic Coma)
SLOW ONSET S/S Include: -warm, dry skin -dry mouth -kussmal respirations -acetone/fruity breath -polyuria (frequent urination) -polyphagia (frequent hunger) -polydipsia (frequent thirst) -blurred vision
Describe 2nd degree burns.
Second degree or partial thickness burns involve the epidermis and dermis. They are often very painful and accompanied by blistering.
When immobilizing with a vest-style device such as a KED, you must first _____ prior to ______.
Secure the patient's torso prior to immobilizing the head. ***Also, prior to securing the torso, have the patient inhale as much as possible to permit air when they breathe.
Nitro comes in a spray form, NEVER _____ the bottle, it will cause the drug to start breaking down.
Shake
A 6 year old girl is having trouble breathing. Her parents state she has never had any breathing problems before. The mother says the child has been sick for a few days and the breathing problems started happening this morning. Upon assessment, you notice the child is flaring her nostrils and has a hoarse voice when talking to you. What is she most likely suffering from and what should you do?
She could have epiglottitis and needs to be transported with high flow O2 on an NRB
A woman is cool, sweaty and wants a donut.... what is likely wrong with her?
She is hypoglycemic and suffering from an overabundance of insulin in her system. (Insulin shock)
Frostbitten extremities should not be ____ if there is a chance they could _____.
Should not be rewarmed if there's a chance they could refreeze after you've rewarmed them.
A sign is ______ while a symptom is ______.
Signs are objective while symptoms are subjective. Objective truths are capable of proof.
What components are a part of the integumentary system?
Skin, hair, nails, sweat glands.
Injuries to the shoulder are most effectively immobilized with use of a?
Sling to support the arm and a swathe to secure the arm to the body. ***Patients with a dislocated or fractured shoulder will not let you extend their arm.
What is "kyphosis"?
Slouch back (shoulders roll forward)
Hyperglycemia is a ______ onset.
Slow (usually takes several hours or days)
Dysarthria is a condition that stroke patients may exhibit and is characterized by?
Slurred speech
Arterioles are ______?
Smaller arteries
The sympathetic nervous system is responsible for ______ ?
Speeding up the heart rate and the breathing.
The greater the volume of blood that enters the heart during diastole, the greater the output and force during systole. This cause and effect is termed?
Starling's Law
What is a tracheostomy?
Stoma in the neck
CVA means?
Stroke
Cheyne-stokes breathing pattern is most often associated with?
Stroke and metabolic problems.
Subcutaneous injections should be done at a _____ degree angle.
Subcutaneous injections should be done at a 45 degree angle.
The first few levels of bronchi are ________ ?
Supported by rings of cartilage.
What is "lordosis"?
Swayback (the butt sticks out)
A woman with preeclampsia will have what signs & symtoms?
Swelling in the feet, hands or face. This condition can result in the patient having seizures and coma. She will also be hypertensive.
What nervous system causes the constriction of the pupils?
Sympathetic
_______ is your first sign of shock.
Tachycardia
Signs of a pulmonary embolism include?
Tachycardia, tachypnea, low SpO2, cyanosis.
End tidal CO2 monitor is to verify what?
That there is CO2 coming OUT of the lungs.
The ____ ribs are ______ arches of bone, which are arranged in _____ and are attached by ______ to the ________.
The 24 ribs are semi-flexible arches of bone, which are arranged in 12 pairs and are attached posteriorly by ligaments to the 12 thoracic vertebrae.
The carpals are ________ ?
The 8 bones that form the wrist.
The SA has a normal intrinsic rate of ______ and the AV junction has a rate of _______.
The SA has a normal intrinsic rate of 60-100 and the AV junction has a rate of 40-60.
The SA node has an inherent rate of?
The SA has a normal intrinsic rate of 60-100 and the AV junction has a rate of 40-60.
What is the pubis?
The anterior & inferior portion of the pelvis.
The tarsals are __________ ?
The bones of the ankle, hind foot and mid foot.
The metacarpals are ________ ?
The bones of the hand.
Metatarsals are _______ ?
The bones that form the arch of the foot.
Use of an SpO2 monitor on a person suffering from carbon monoxide poisoning will be inaccurate because ___________.
The carbon monoxide molecule displaces the oxygen molecule inhibiting oxygen delivery. The carbon monoxide molecule has a stronger bond to the hemoglobin and displace oxygen molecules leaving them essentially stranded in the blood. While the monitor may show a number in the mid 90's?it does not mean that oxygen is reaching the tissue and perfusing correctly.
You have requested helicopter transportation of a critical burn patient. The remote nature of the accident will force the helicopter to land on an incline. From which direction should you approach the helicopter?
The downhill side.
This can relax with the tongue in an ALOC patient and cause a non-visible airway obstruction.
The epiglottis
The esophagus lies anterior to the ______ and posterior to the ______.
The esophagus lies anterior to the spine and posterior to the trachea.
When reconsidering the mechanism of injury in the Focused History & Physical Exam you should determine whether ______?
The further evaluation of the mechanism of injury met criteria to be considered significant.
Post delivery care includes drying the baby off and wrapping it in a blanket or towel, as well as placing it on one side with..... ?
The head slightly LOWER than the rest of the body.
Burns to children are considered to be critical when it involves?
The head, face, feet or genitals; or a significant portion of the body being burned.
Blood enters the right atrium from where?
The inferior and superior vena cava.
What muscles are used in breathing?
The intercostal and diaphragm muscles.
What is the acromion?
The lateral triangular projection of the scapula that forms the point of the shoulder.
The fibula is the _______ ?
The lateral, smaller long bone of the lower leg.
Where does the upper airway extend from?
The nose, to the mouth, to the most inferior portion of the larynx (cricoid cartilage).
"Contralateral" refers to _______ ?
The opposite side.
The pancreas creates ______ which stimulates the _____ into converting stored _____ into glucose and releasing it into the bloodstream.
The pancreas creates glucagon which stimulates the liver into converting stored glycogen into glucose and releasing it into the bloodstream.
What is the iliac crest?
The part of the pelvis that forms the "wings".
The phrenic nerve, which exits the spinal column between the _____ & ______ cervical vertebrae, transmits the electrical impulses that cause the ______ to contract.
The phrenic nerve, which exits the spinal column between the 3rd & 5th cervical vertebrae, transmits the electrical impulses that cause the diaphragm to contract.
What is the ischium?
The posterior & inferior portion of the pelvis.
When assessing the breathing of an infant or child, you should look for?
The presence or absence of breathing (based on 2005 AHA guidelines)
Define "hypoxia".
The reduction of oxygen delivery to tissues.
The resistance offered by the ______ _____ is known as the systemic vascular resistance (SVR), while the resistance offered by the _____ _______ is known as the pulmonary vascular resistance (PVR).
The resistance offered by the peripheral circulation is known as the systemic vascular resistance (SVR), while the resistance offered by the vasculature of the lungs is known as the pulmonary vascular resistance (PVR).
The thorax (aka the chest) is composed of what?
The ribs, sternum and thoracic spine.
What is the acetabulum?
The rounded cavity or socket on the external surface of the pelvis that receives the head of the femur.
"Ipsilateral" refers to _______ ?
The same side.
Treat stroke and AMS in children how?
The same way you would for an adult.
Plantar & palmar refer to _______ ?
The sole of the foot and the palm of the hand.
The specialized subdivision of the peripheral nervous system is known as the _________ subdivision. It is further broken down into sympathetic and parasympathetic.
The specialized subdivision of the peripheral nervous system is known as the autonomic subdivision. It is further broken down into sympathetic and parasympathetic.
Name the components (inferior & superior) of the sternum.
The superior manubrium and the inferior xiphoid process.
Which bone is the "shin bone" ?
The tibia (the medial larger bone of the lower leg).
What is a common airway obstruction in ALOC patients?
The tongue which falls back and occludes airway.
What is the complication with administering oxygen therapy to COPD patients?
Their chemoreceptors sense excessive levels of oxygen in the body and send signals to slow or even stop respirations (respiratory arrest or failure could occur).
Describe 3rd degree burns.
Third degree burns or full thickness burns involve all of the tissue layers and will include bone or organ damage as well. Pain in the area of a third degree burn is nonexistent because of destroyed nerves. The area immediately surrounding the full thickness burn can be incredibly painful though, as nerves are likely still intact.
Your patient is a 19 year old female who is G4/P2/A1. Her boyfriend called 911 stating that the woman is a diabetic and pregnant in her third trimester. She is complaining of a headache, abdominal pain, and blurred vision. Upon arrival at the residence, you notice the woman's feet and fingers are swollen. Her pulse is 116 and her respirations are about 16 breaths per minute. The patient's blood pressure is 145/92 and auscultation of the lungs reveals rales. How many live births has this woman had? What is most likely wrong with her and how should she be treated?
This woman has had 4 pregnancies, 2 live births and 1 abortions. She has preeclampsia and should be transported to the hospital in a left lateral position while on high flow O2. Initiate an IV line TKO if protocols and scope of practice allow.
IV fluids administered over long periods of time can cause an irritation in the vein called?
Thrombophlebitis
What is the "crossed finger" technique used for?
To open mouth of an ALOC or unresponsive patient.
Sucking chest wound, your first priority is what?
To prevent air from entering the wound. Use an occlusive dressing taped on 3 sides, NOT trauma dressing.
The body's first physiological response to a deep laceration is _______?
To stop it by chemical means and vasoconstriction (hemostasis).
Everything above the _____ is considered the upper airway.
Trachea
The larynx is above the _____.
Trachea
Which plane divides the body into the upper & lower planes?
Transverse
A spontaneous pneumothorax is more common in men than women, true or false?
True
What is a significant finding for a patient complaining of a severe headache?
Unilateral weakness (could indicate a stroke).
Unlike ______ the _____ have valves to keep blood from backflowing.
Unlike the arteries, the veins have valves to help prevent the backflow of blood.
Drugs such as ____ and _____ are benzodiazepines.
Valium & Xanex
Epinephrine is a ________ ?
Vasoconstrictor, bronchodilator, and decreases capillary permeability (to reduce fluid leakage).
Nitroglycerin is a __________ ?
Vasodilator. (Main side effect: hypotension, causes headache)
What would you do if a newborn infant has a heart rate lower than 100 beats per minute?
Ventilate at 40-60 breaths a minute.
The membrane closest to the lungs is called the?
Visceral pleura
When is the AED not reccommended for a patient in cardiac arrest?
When the arrest is due to a traumatic injury.
he windshield in the ambulance is made of what material?
Windshields are made of safety glass that does not shatter when broken, but bullets will penetrate.
You and your partner Monroe arrive on scene to a house fire that has just been put out. You are treating a female patient with a full thickness burn to her leg. Which of the burn zones is the one most likely to recover?
Zone of hyperemia
Which laryngoscope blade would you choose when intubating a child?
he Miller blade is preferred in intubation of a child as the curve of the McIntosh blade takes up more of the airway and can interfere with visualization.
he National Institute of Neurological Disorders and Stroke state that a TIA is a transient stroke that lasts ________, but symptoms can persist for __________.
he National Institute of Neurological Disorders and Stroke state that a TIA is a transient stroke that lasts only a few minutes, but symptoms can persist for up to 24 hours.
