EMT Basic Review Questions
DIABETIC COMA
"HYPERGLYCEMIA" COOL, CLAMMY SKIN
a sign of inadequate breathing
"Seesaw" breathing is:
A 39-year-old male with a history of type 1 diabetes is found unresponsive by his wife. When obtaining initial information from the wife, which of the following questions would be LEAST pertinent?
"Was your husband hospitalized for this problem in the past?"
With regard to potential treatment in the hospital, which of the following questions is MOST important to ask the spouse of a 66-year-old female who presents with signs and symptoms of an acute ischemic stroke?
"When did you first notice the symptoms?"
trachea
"windpipe", structure that connects the pharynx to lungs
What is GOPD
(Chronic Obstructive Pulmonary Disease)
CHF
(Congestive Heart Failure/Pulmonary Edema)- (left-sided heart failure) from chronic heart disease or M.!. SOB, Pale, cool, diaphoretic, Hypertension, Neck vein distention, Jugular Vein Distention, Pedal edema,Productive sputum (foaming from mouth) Transport in Fowler's with legs down, over edge of gurney, dependent and high oxygen
PID
(Pelvic lnflammatorv Disease) right or left lower quadrant pain, abnormal vaginal discharge, fever, N&V.
TIA
(Transient ischemic Attack)- temporary inadequate perfusion to brain resulting in neurological deficit(Weakness, paralysis, speech disorder, etc.) minutes or hours. Has S&S of stroke.
What is a Stoma?
(laryngectomies) - surgical hole in anterior neck, in trachea. Must ventilate/_suction through stoma using small mask, BVM, if soB.
what is Hyperventilation syndrome and what dos it do?
(too much tidal volume) causes changes in blood chemistry causing chest pain, dizziness, carpal (hand) spasms, or pedal (foot) spasm / cramps. Pt. has sufficient 02 but is blowing off excessive C02. EMT cannot 'diagnose' hyperventilation. Treat like SOB, give 02, and transport. (Never allow re breathing into bag)
Ectopic Pregnancy
(tubal pregnancy) right or left lower abdominal pain, shock, vaginal bleeding (code 3 transport!) Egg growing in fallopian tube will rupture and cause bleeding
Critical burns
* with injuries to respitory tract, soft tissue, bones * Full thickness burns > 10% * partial thickness burns > 30% * burns with painful, swollen, or deformed extremity * moderate burns in young or elderly * burns to face, hands, feet, or genitalia * burns encircling any body part
AREAS OF THE SPINE IN DESCENDING ORDER
-CERVICAL -THORACIC -LUMBAR -SACRAL -COCCYX
WHICH COMPONENTS ARE NEEDED TO PROVE NEGLIGENCE?
-DUTY TO ACT -BREACH OF DUTY -INJURY/DAMAGES -CAUSATION
CONTRAINDICATIONS FOR ADMINISTERING ACTIVATED CHARCOAL
-INABILITY TO SWALLOW -UNCONSCIOUS -INGESTION OF ALKALI OR CAUSTIC MATERIAL
MI Parameters: Assessment S/S Teatment
-In an MI, mycardial infarction, portion of the heart muscle dies because of the lack of adequate supply of oxgenated blood. Patients suffering from MI need clot busters.
THE AXIAL SKELETON IS COMPOSED OF THE...
-SKULL -FACE -THORAX -VERTEBRAL COLUMN
protocols
-lists of steps ( assessments and interventions) to be taken in different situations -developed by medical director of EMS system
standing orders
-policy or protocol issued by medical director that authorizes EMT's and others to perform particular skills in certain situations
quality improvement
-process of continuous self review with the purpose of identifying and correcting aspects of the system that require improvement
911 system
-system for telephone access to report emergencies -dispatcher takes info and alert EMS or fire or police -"enhanced 911" has capability of automatically identify caller's number and location
Patient with with a history of epilepsy who is at the very
...
What organs are in the Lower Left Quadrant
...
Spinal column and its parts
...Principal support system of the body (p 156). Cervical Spine: C1-C7 (most prone to injury) Thoracic spine T1-T12 (ribs attach to these) Lumbar L1-L5 Least mobile, lower back Sacral S1-S5 (back wall of pelvis) Coccyx 4 (tail bone)
PEDIATRIC DOSE OF EPINEPHRINE
.15 MG
CORRECT DOSE OF EPINEPHRINE IN AN ADULR AUTO-INJECTOR
.3 MG
DOSE OF ACTIVATED CHARCOAL
1 GRAM FOR 1 KG OF BODYWEIGHT
1-5
1. B 2. D 3. B 4. B 5. D
What are the two catagories of stroke?
1. Ishemic stroke- occur when a cerebral artery is blocked by a clot or foreign matter 2. Hemorrhagic stroke- results from a rupture of an artery that causes bleeding in the brain
When Triage in a multiple patient disaster you should only
1. stop bleeding. 2. if Pt. in full arrest, open airway only, (no CPR if resources limited)
Mobile radio
10-15 mile range, used to communicate w/in EMS system
What are the normal pulse for a neonate?
100-160 beats per minute
102-106
102. C 103. C 104. A 105. C 106. C
107-111
107. C 108. A 109. A 110. D 111. A
11-14
11. D 12. D 13. A 14. D
112-115
112. D 113. C 114. D 115. A
116-119
116. A 117. D 118. D 119. C
NORMAL RESPIRATORY RATE FOR AN ADULT
12 TO 20 BREATHS PER MINUTE
120-123
120. B 121. D 122. A 123. D
Pre-Hypertension
120/80 BP
124-127
124. D 125. B 126. A 127. B
128-132
128. B 129. C 130. C 131. C 132. C
133-137
133. D 134. A 135. A 136. A 137. B
138-142
138. A 139. A 140. D 141. C 142. D
143-146
143. C 144. C 145. B 146. A
147-150
147. D 148. B 149. C 150. B
15-19
15. B 16. C 17. B 18. D 19. B
DOSE OF ASPIRIN FOR CHEST PAIN
162-324 MG
A 6 year old male, who weighs 40 pounds, ingested a bottle of aspirin approximately 20 minutes ago. Medical control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal will you administer? A. 12 g B. 14 g C. 18 g D. 24 g
18 g
Man burns the Anterior of both his arm as well as the anterior of his chest. What percent of his body is burned? (rule of nine)
18% (anterior chest = 9, anterior of arm = 4.5 (2) = 9
HIPAA
1996 Health Insurance Portability and Accountability Act : Protects the privacy of, and gives the patient control over, patient health care information. (PG. 62)
CAPILLARY REFILL TIME IN AN INFANT
2 SECONDS
How long is national registry good for? state registry?
2 years; 3 years
20-24
20. D 21. D 22. C 23. D 24. B
25-29
25. A 26. B 27. D 28. D 29. A
A 40-year old patient sustained full=thickness burns to the entire head, anterior chest, and both anterior upper extremities. Using the adult Rule of Nines, what percentage of the patient's body surface area has been burned? A. 18% B. 27% C. 36% D. 45%
27%
Where is the Location of heart?
2nd intercostal space at right sternal border to 5th intercostal space at Ieft midclavicular line
MAXIMUM DOSES FOR NITRO
3 DOSES
What are the normal respirations for a neonate?
30-40 breathes per minure
30-34
30. B 31. D 32. B 33.C 34. B
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. As you are performing one-rescuer CPR, your partner prepares the AED. The appropriate compression to ventilation ratio for this child is A. 3:1 B. 5:1 C. 15:2 D. 30:2
30:2
vertebrae
33 bones of spinal column
35- 38
35. B 36. C 37. B 38. C
A 60-year-old male has sustained partial- and full-thickness burns to his anterior chest, head, and both anterior arms. On the basis of the "Rule of Nines," what percentage of his body surface area (BSA) has been burned?
36%
39-42
39. A 40. A 41. A 42. A
abdominal quadrants
4 divisions of the abdomen used to pinpoint the location of a pain or injury RUQ,LUQ,RLQ,LLQ
immobilizing the injury site and the joints above and below it
4. General rules of immobilization of extremity injuries include:
43-46
43. C 44. C 45. A 46. A
47-51
47. B 48. C 49. A 50. A 51. D
52-56
52. D 53. B 54. D 55. D 56. D
in which of the following patients would nitroglycerin be contraindicated? A. 41-year-old male with crushing chest pressure, a blood pressure of 160/90 mm Hg, and sever nausea B. 53-year old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Cialis C. 58-year old male with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol D. 66-year-old female with chest pressure of 6 hours' durationi, lightheadedness, and a blood pressure of 110/58 mm Hg
53-year old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Cialis
57-61
57. B 58. B 59. D 60. C 61. A
6-10
6. B 7. D 8. D 9. D 10. B
62-65
62. B 63. C 64. D 65. D
66-69
66. A 67. B 68. A 69. A
What are the normal blood pressure for a neonate?
70-90 systolic
70-74
70. D 71. B 72. A 73. B 74. A
Which of the following patients would MOST likely present with atypical signs and symptoms of acute myocardial infarction? A. 72-year old female with diabetes and hypertension B. 64-year old male with renal disease and depression C. 59 year old male with alcoholism and angina pectoris D. 55-year old female with COPD and frequent infections
72-year old female with diabetes and hypertension
75-79
75. B 76. C 77. B 78. B 79. C
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. A paramedic unit arrives at the scene to provide assistance. After one of the paramedics intubates the child, you should deliver ventilations at a rate of A. 6 to 8 breaths/min B. 8 to 10 breaths/min C. 10 to 12 breaths/min D. 12 to 20 breaths/min.
8 to 10 breaths/min
What is a normal blood glucose level?
80-120 mg/dL
80-84
80. D 81. B 82. C 83. B 84. C
85-89
85. A 86. D 87. D 88. D 89. A
90-93
90. D 91. B 92. A 93. C
94-97
94. A 95. D 96. B 97. C
HYPOTHERMIA OCCURS WHEN THE CORE BODY TEMP FALLS BELOW
95 F, 35 C
What is normal temperature for a neonate?
98-100
98-101
98. A 99. B 100. A 101. C
S/S of qastrointestinal bleeding
:Epigastric or lower abdominal pain, "Heartburn", Nausea/vomiting blood, or bloody diarrhea, Signs of shock, Melena, = possible internal bleeding. Treat by Left lateral or shock position. No oral fluids, oxygen, Transport Code 3 continue assessment in route
pulmonary embolism
A 32-year-old female has a complaint of sudden onset of dyspnea with no history of any respiratory problems. She is a one-pack-a-day smoker, takes an oral contraceptive but no other meds and has no allergies. Which of the following conditions should be highly considered as the cause of the acute dyspnea?
Which of the following situations would necessitate treatment using implied consent? A. A 16 year old pregnant girl with an isolated extremity injury B. An 18-year old man who is now alert after receiving oral glucose C. A 25 year old man who is restless and has severe chest pain and diaphoresis D. A 65-eyar old man who is semiconscious and suspected of having a severe stroke
A 65-eyar old man who is semiconscious and suspected of having a severe stroke
IN AN ADULT, TACHYCARDIA IS DEFINED AS
A HEART RATE GREATER THAN 100 BEATS/MIN
IN AN ADULT, BRADYCARDIA IS DEFINED AS
A PULSE RATE LESS THAN 60 BEATS/MIN
15
A bag mask should be connected to an oxygen inlet flow of _____ liters per minute
What is a pulmonary embolism?
A blockage of the pulmonary artery that prevents blood flow to the lung
Cardiac arrest in adult most often happens due to
A cardiac arrhythmia
What is a central intravenous catheter and why are they used?
A catheter that is designed to deliver medication into the central circulation of the body It is used to administer medications and nutrients
Acute Abdomen def
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; demands immediate medical or surgical attention. ○ A sharp, severe abdominal pain with rapid onset.Meaning- many possible causes; some obvious some not. Ie. Cardiac, pulmonary, GI, genital, urinary, reproductive, or other body systems
Burnout
A condition resulting from chronic job stress, characterized by a state of irritability and fatigue that can markedly decrease effectiveness. (PG. 27)
Which of the following patients with diabetes should receive oral glucose? A. A confused patient who has cool, clammy skin B. A confused patient who has suspected C. A semiconscious patient with pale skin D. An unconscious patient who took too much insulin
A confused patient who has cool, clammy skin
hypertension
A diastolic blood pressure greater than 90 mmHg is considered:
Americans with Disabilities Act (ADA)
A federal law passed in 1990 that protects people with a documented disability from being denied initial or continued employment based on their disability. (PG. 12)
Which of the following situations is an example of abandonment? A. An EMT--Paramedic givers a verbal report to any emergency nurse. B. An EMT--Intermediate assumes patient care from an EMT-Basic C. An EMT--Basic transfers care of a patient to patient to an EMT-Paramedic D. A first responder assumes patient care from an EMT-Intermediate
A first responder assumes patient care from an EMT-Intermediate
abdominal thrusts
A four-year-old male patient has just swallowed a marble in front of you, which has caused a complete (severe) airway obstruction. Your immediate care should include:
Which of the following patients would be at most risk for suicide? A. A woman who quit her job for one that pays more B. A man who is in the midst of losing a significant relationship C. A man who is planning a family trip, but gets called away to work D. An EMT who saved a drowning child and receives a lot of media attention
A man who is in the midst of losing a significant relationship
during bleeding control
A mask should be worn by the EMT-Basic to prevent the spread of disease:
4
A medication, or drug, can have up to _____ different names.
Standards Precautions
A method of preventing infection based on the concept that all blood and body fluids are infectious. (PG. 32)
side effect
A non-desired medication reaction that occurs, in addition to the desired reaction, is known as a:
22.5
A patient has sustained a third-degree burn on the back of her torso and the back of her left arm. What percentage of her body surface area is burned?
START Triage
A patient sorting process that stands for simple triage and rapid treatment and uses a limited assessment of the patient's ability to walk, respiratory status, hemodynamic status, and neurologic status
What is status epilepticus?
A patient who has a seizure that lasts more than 5 minutes or seizures that occur consecutively without responsiveness between them
no breathing but may still have a pulse
A patient who is said to be in respiratory arrest has:
95F or less (35C or less)
A patient with a core body temperature of ______ is considered to be hypothermic.
no history of cardiac problems
A patient with cardiac compromise should be transported immediately if he has:
inserting several fingers into the mother's vagina and gently pushing the presenting part off the cord.
A prolapsed umbilical cord, when the cord is pinched between the vaginal wall and presenting part of the baby, is handled by:
Cushing's reflex
A sign of severe head injury in which the systolic blood pressure increases, the heart rate decreases, and the respiratory pattern changes, is known as:
from more than 10 feet
A significant mechanism of injury for a child is a fall:
morality def
A system of learned attitudes about social practices, instituations, and individual behavior used to evaluate situations and behavior as right or wrong, good or bad
Assault
A threat to inflict harm on a person. (PG. 61)
the Glasgow Coma Scale
A tool for assessing a patient's level of responsiveness that uses numerical values to score responses is:
civil wrong
A tort is a:
a bronchodilator
A type of medication designed to relax and open the smaller airways, helping to improve breathing, is called a(n):
What are the signs and symptoms of cardiogenic shock?
A type of shock that is due to myocardial infarction (heart attack), congestive heart failure, abnormal cardiac rhythm, and drugs
Tort
A wrongful act, injury, or damage. (PG. 59)
suspension
A(n) _____ is a form of medication with drug particles that are mixed in a suitable liquid.
creasing mental status
A(n) ______ is the most important sign in cases of suspected head injury.
increased stress level
A(n) ______ will increase the work of breathing and the body's oxygen demand, especially in children.
The path air takes during exhalation goes through the following route: A: Alveoli, bronchioles, bronchi, trachea, epiglottis, oropharynx B: Oropharynx, larynx, trachea, carina, bronchi, alveoli C: Bronchioles, carina, larynx, oropharynx, epiglottis D: Alveoli, trachea, carina, epiglottis, pharynx, mouth
A: Alveoli, bronchioles, bronchi, trachea, epiglottis, oropharynx This sequence accurately describes the structures air passes through during exhalation.
AIRWAY MANAGEMENT: 41-50 What is meant by respiratory distress? A: An increase in breathing effort, accompanying a feeling of being short of breath. B: When breathing, for whatever reason, decreases to a point of where the body can not get enough oxygen. C: When breathing completely stops. D: When the body gets too much oxygen, which creates a hypoxic drive.
A: An increase in breathing effort, accompanying a feeling of being short of breath. Answer B describes respiratory failure. Answer C describes respiratory arrest. Answer C relates more to COPD (chronic obstructive pulmonary disease)
INTRO TO EMERGENCY MED CARE: 1-10 The organization in the United States government that is responsible for establishing the National Standard Curriculum for each EMT level is the: A: Department of Transportation. B: Department of Health and Human Services. C: Department of Homeland Security. D: Department of Defense.
A: Department of Transportation. The Department of Transportation establishes the National Standard Curriculum. The DOT relationship to EMS standards goes back nearly 40 years to the publication Accidental Death and Disability. The curricula for different levels are published on the National Highway Traffic Safety Administration website
Fever in children is a common reason for parents to call for an ambulance. A fever can result from: A: infection. B: lack of oxygen. C: blood loss. D: cold environments.
A: Infection. Body temperature of 100.4 degrees F (38 degrees C) or higher are considered abnormal and may be caused by infection, cancer, drug ingestion, arthritis, lupus, or a high environmental temperature
A patient who to takes an occasional gasping breath after their heart has stopped has: A: agonal respirations. B: ataxic respirations. C: apneic respirations. D: hypoxic respirations.
A: agonal respirations. Agonal respirations are shallow, inadequate respirations that occur after the heart has stopped.
An oropharyngeal airway or OPA is used: A: as a convenient way to maintain an open airway in an unconscious patient. B: as a one size fits all piece of curved plastic inserted into the throat and designed to maintain an open airway. C: as a small rubber device inserted into a patients nose and down into the throat in order to maintain an open airway. D: as a simple way to provide oxygen to the body via oxygen tubing and a non rebreather mask.
A: as a convenient way to maintain an open airway in an unconscious patient. OPAs come in different sizes and must be fit to the patient. Answer C describes a nasopharyngeal airway. Answer D does not describe what an OPA does.
At the scene of an unexplained infant death, or SIDS call, the EMT-B should: A: carefully inspect the scene for signs of illness, the general condition of the house, and family interaction. B: attempt to calm the parents by telling them, "I know exactly how you must feel." C: treat the house as a crime scene because SIDS results from child abuse or neglect. D: withhold attempting CPR as SIDS is not reversible.
A: carefully inspect the scene for signs of illness, the general condition of the house, and family interaction. Careful inspection of the house and infant is essential to provide important diagnostic information, including toys and other items in the infant's crib. The EMT-B should never say that he or she knows how the patient or family feels. SIDS is more likely a result of a medical condition than abuse. Some SIDS cases may revive with stimulation and are then known as "apparent life-threatening events" or "near-miss SIDS."
Abnormal skin characteristics such as paleness, coolness, or moistness may indicate: A: hypoperfusion. B: hypertension. C: jaundice. D: coagulation
A: hypoperfusion Hypoperfusion or shock can often be detected in the skin because the body shunts blood to more important body tissues. This finding during the initial assessment is important because treatment for shock needs to begin quickly
To relieve choking in a conscious child, the EMT-B should: A: kneel behind the child, encircle the child with both arms, and apply five rapid abdominal thrusts. B: place the child on a chair, table, or countertop and apply six to ten abdominal thrusts. C: lie the child on his or her back, straddle the child, and deliver five abdominal thrusts. D: deliver five deliberate back blows and encouraged the child to cough.
A: kneel behind the child, encircle the child with both arms, and apply five rapid abdominal thrusts. To relieve a foreign obstruction from the airway of a standing or sitting child, kneel behind the child and encircle the body with both arms to deliver five rapid, distinct abdominal thrusts, repeating until the object is cleared or the child becomes unconscious. The child should not be placed on a chair, table, or counter to reduce risk of injury if they become unconscious. Lying the child down and delivery of abdominal thrusts is done once the patient becomes unconscious. Back blows alternating with chest thrusts are recommended only for infants less than 1 year old.
A significant difference between adults and children in shock is: A: loss of even a small volume of blood can lead to shock in the child. B: children require greater amounts of blood loss to develop shock. C: capillary refill is the most reliable indicator of shock in adults. D: adults can compensate for blood loss better than children.
A: loss of even a small volume of blood can lead to shock in the child. Infants and children have less circulating blood than adults, so small losses can result in shock developing. Blood volume loss of 25% or more significantly increases childhood risk of shock, compared with 30% to 40% in the adult. Capillary refill is more reliable in children than adults. Hypotension in adults, although a late sign, is a more reliable indicator of shock than capillary refill. Children are able to compensate longer for shock than adults.
The carrier of an infectious organism: A: may never know that they have the disease. B: will always tell an EMT-B that they are contagious. C: can only transmit the disease by exposure to blood. D: can be traced through an investigation.
A: may never know that they have the disease. Carriers of an infectious organism may never know that they are contagious and may have no symptoms of the disease.
Signs of respiratory distress in children include: A: nasal flaring, grunting, wheezing or stridor, retractions, and tripod positioning. B: loud crying, effective coughing, ability to speak, and flushed color. C: cyanosis in the beds of the fingernails with shivering. D: respiration rates between 20 to 30 breaths/min.
A: nasal flaring, grunting, wheezing or stridor, retractions, and tripod positioning. As the body attempts to maximize air exchange, the work of breathing increases, resulting in retractions, nasal flaring, accessory muscle usage, and decrease in chest rise and fall. The ability to speak, cough, or cry indicates freely moving air. Shivering and bluish nails is associated with local cold exposure. Respiration rates of 12 to 50 breaths/min are normal depending on the child's age.
The roles and responsibilities of the EMT-B do not include: A: placing yourself or your partner at risk to save a patient's life. B: providing essential immediate intervention. C: advising the patient of any procedures you will perform. D: documenting all findings and care on the patient care report.
A: placing yourself or your partner at risk to save a patient's life. Ensuring safety of yourself and your crew are more important than any risk for a patient. Most EMT-Bs lack the special training and equipment for rescue situations.
Suctioning is used to: A: remove small debris and liquid from a patient's airway. B: provide the negative pressure necessary to deflate the lungs after ventilation. C: to vacuum the periphery of the airway in order to eliminate possible future lung infections. D: remove any debris that may have gotten into the patient's lungs and which may interfere with artificial ventilation.
A: remove small debris and liquid from a patient's airway.
Head injuries are common in children because: A: the size of the head is larger in relation to the body than an adult. B: helmets designed for children offer less protection than expected. C: they are more likely to suffer whiplash in auto accidents. D: infants haven't fully developed balance for walking.
A: the size of the head is larger in relation to the body than an adult. In proportion to the body, a child's head is larger than an adult. Helmets for children have been designed to offer maximum protection, whiplash is more likely to occur in the adult, and infants have not yet begun to walk.
OCCURS WHEN ORGANS PROTRUDE THROUGH AN OPEN WOUND
ABDOMINAL EVISCERATION
AED Weight Limit
AED minimum weight for children, must be 80 lbs. (55k9) Although new AED's may' be used for children if allowed for that particular model of AED.
OPEN PNEUMOTHORAX OCCURS WHEN
AIR ENTERS THE PLEURAL SPACE FROM OUTSIDE THE BODY
PLACENTA
ALLOWS 02, CO2, AND OTHER PRODUCTS TO TRANSFER BETWEEN MOTHER AND FETUS BUT DOES NOT ALLOW THEIR BLOOD TO MIX
THE ACTUAL EXCHANGE OF 02 AND C02 OCCURS IN THE
ALVEOLAR SACS
AVULSION
AN INJURY THAT SEPARATES VARIOUS LAYERS OF SOFT TISSUE, RESULTING IN COMPLETE DETACHMENT OR A FLAP OF SKIN
SPLEEN
ASSISTS IN BLOOD FILTRATION, SERVES AS A BLOOD RESERVOIR, AND PRODUCES ANTIBODIES
KUSSMAUL RESPIRATIONS ARE AN INDICATION THAT THE BODY IS...
ATTEMPTING TO ELIMINATE ACIDS FROM THE BODY
NARCAN IS ADMINISTERED BY THE EMT-B VIA:
AUTOMIZER
S/S for non-traumatic abdominal emergency and treatment
Abdominal pain, Nausea/vomiting (N&V), Signs/symptoms of shock. No oral fluids, Position of comfort (knees drawn up to chest), Monitor vitals, and Treat for shock, 'p r n' as needed. Code 3 if vitals are odd or vomiting blood.
What do we assess when we use the START triage system?
Ability to walk Respirations Perfusion Mental status
A man is experiencing significant anxiety and depression regarding the impending death of his wife. However, the wife is trying to comfort her husband by telling him that she loves him and is prepared to die. What stage of the grieving process is the patient experiencing?
Acceptance
Scope of practice
Actions or care that an EMT can provide
What is Homeosatasis
Activity in the body to needed to maintain balance between all body systems.
You are assessing a 45-year-old male who experienced a syncopal episode. He is conscious and alert, and complains only of slight weakness. He denies any medical problems or drug allergies. His blood pressure is 140/90 mm Hg, pulse is 40 beats/min, and respirations are 22 breaths/min. What is the MOST likely cause of this patient's syncopal episode?
Acute bradycardia
What are the depth sizes of chest compression for an adult, child and infant?
Adult - 2' inches minimum child - 2' inches max Infant -1 1/2' inches, or 1/3rd
What are the two types of celluar metabolism?
Aerobic metabolism- a breakdown of molecules such as glucose through a series of reactions that produce energy within the cells in the presence of oxygen Anaerobic metabolism- the breakdown of molescules in the cells without the presence of oxygen
Refusal forms
Against Medical Advice in this case bud ● Patient must sign. If not Doctor or Nurse may sign if at all possible
shallow and gasping.
Agonal respirations are:
Metered dose inhalers
Albuterol - Adult and child over 12yo: INH (metered dose inhaler) 2 puffs q4h; PO 2-4mg tid-qid not to exceed 8mg; NEB/IPPB 2.5mg tid-qid//Elderly: PO mg tid-qid, may increase gradually to 8mg tid-qid//Child 2-12yo: INH 0.1mg.kg tid (max 2.5mg tid-qid); NEB/IPPB 0.1-0.15mg/kg/dose tid-qid or 1.25mg tid-qid for child 10-15kg or 2.5mg tid-qid more than 15kg///Adult and child over 4yo: INH cap (rotahaler inhalation) 200 mcg cap inhaled q4-6h
INITIAL ASSESSMENT: 151-160 The 'A' in AVPU stands for:
Alert
You are a member of the time travelling EMT force, enabling you to meet yourself in the past and correct your mistakes. What would you correct?
All of the above: Visualizing the cherry red epiglottis during assessment of a child with epiglottitis. Using the rule of eights to assess a burn patient. Not studying enough to pass the NREMT the first time.
An 8 child has been struck by a bull. Witnesses say he was thrown into the air, over a fence and onto pavement. When you arrive on scene, the child has no obvious signs of trauma and is sitting on the ground with multiple bystanders comforting him. What should you suspect before you even begin your assessment.
All of the above: internal injuries. head injury. limb fractures.
reduction of pain
All of the following are potential hazards of improper splinting, except:
After giving birth and having with excessive bleeding what should you do?
Also know as postpartum hemorrhage = greater than 5OOcc. Only after delivery of placenta externally massage of funda and allow breast feeding. If the bleeding continues transport code 3.
Sovereign Immunity
Also known as Governmental Immunity, prevents persons treated by governmentally operated EMS systems from suing the government for civil liability. (PG. 53)
Durable Power of Attorney
Also known as Health care proxy, Empowers someone to make health care decision's for the signer. (PG. 55)
Patient that is acting confused and laking incoherently, nature of the illness is most consistent with
Altered mental Status
Which of the following natures of illness is most consistent with a patient with low blood glucose level who is acting bizarre and breathing shallowly? A. Cardiac compromise B. Altered mental status C. Behavioral emergency D. respiratory emergency
Altered mental status
Patient with severe facial injuries, inadequate breathing, and bleed from mouth. What should you do?
Alternate suctioning (10 sec), on side, ventilate with high flow oxygen
What is the basic care an EMT should provide to a pregnant woman with a chief complaint?
Always administer oxygen no matter what their SpO2 reading is
When transporting a patient with a colostomy bag
Always keep bad below waist level.
What are the S/S of Pesticides
An Organophosphate poisoning that results in Bradycardia, Hypotension, flushed skin, muscle weakness, constricted pupils, drooling or increased salivation, abdominal cramping/diarrhea.
What are the signs and symptoms of distributive shock?
An abnormal distribution of blood flow in the blood vessels and results in inadequate supply of blood to the bodies tissues and organs 3 types: Anaphylactic shock- allergic reaction Septic shock- an infection that releases bacteria into the blood causing the blood vessels to dialate Neurogenic shock- spinal cord injury
lower airway disease
An infant or child patient who exhibits wheezing, increases breathing effort on exhalation, or rapid breathing without stridor, probably has a(n):
Ataxic
An irregular , unpredictable respiratory rate and tidal volume.
sucking chest wound
An open wound to the chest that allows air to pass through it, causing shortness of breath and bubbling of blood around the wound, is called a:
Defusing
An opportunity to vent emotions and get information before the CISD. (PG. 30)
In which of the following patients would an oropharyngeal airway be indicated? A. Any patient suspected of having hypoxia B. A semiconscious patient with an intact gag reflex C. A semiconscious patient who took an overdose of propoxyphene D. An unconscious patient with fluid drainage from the ears
An unconscious patient with fluid drainage from the ears
Epinepherine
Anaphylactic reaction/asthma Adult: SUBCUT/IM 0.1-0.5mg, repeat q10-15min, not to exceed 1mg/dose; epinephrine susp 0.5 mg SUBCUT, may repeat 0.5-1.5mg q6h///Anaphylactic reaction/asthma Child: SUBCUT 0.01mg/kg, repeat q15min X 2 doses, then q4h as needed, up to 0.5mg/dose; epinephrine susp 0.025mg/kg SUBCUT, may repeat q6h, max 0.75 mg in child less than or equal to 30kg
the infant's head is proportionately larger than the adult's.
Anatomical differences between adults and children include:
In most states; the EMT-Basic is required to report which of the following occurrences? A. Animal bite B. drug overdose C. Injury to a minor D. Motor vehicle crash
Animal bite
Describe the most serious types of burns
Any burn injury involving the respiratory tract or other major traumatic injury Full or partial thickness burns involving the face, eyes, ears, hands, feet, genetalia, major joints Any full thickness burn injury covering 10% or more Any partial thickness burn covering 25% or more in adults younger than 50 or 20% in adults over 50 Any burn that encircles a body part (arm,leg,chest)
Critical Incident
Any situations that causes unusually strong emotions that interfere with the ability to function. (PG. 29)
What is Serious blood loss in child?
Anything greater than 250 milliliters/cc
Coronary arteries branch from the
Aorta
What organs are in the Lower Right Quadrant
Appendix
Head trauma patient has fluid mixed with blood draining from his ears and has bruising behind the ears. What do you do first?
Apply Spinal Immobilization and give high flow oxygen.
A large laceration to the abdomen with protruding bowls should be managed how?
Apply moist, sterile dressing covered by a dry sterile dressing
You respond to a call for a shooting at a local bar. You arrive at the scene and find a young man sitting against the wall, screaming in pain, with bright red blood spurting from a wound near his groin. What should you do first? A. Ensure an open airway B. administer 100% oxygen C. Apply pressure to the wound D. Transport the patient at once.
Apply pressure to the wound
A 55-year-old male with poorly controlled hypertension presents with respiratory distress and difficulty speaking in complete sentences. He is conscious and alert with a blood pressure of 150/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 28 breaths/min and labored. Auscultation of his lungs reveals diffuse coarse crackles. After placing the position in a comfortable position, you should:
Apply the CPAP device
Basic Shock Management consists of
Applying oxygen, elevating lower extremities, and providing warmth
Emergency moves
Armpit-forearm drag, shirt drag, blanket drag
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. Epinephrine possesses which of the following effects when it is used to treat anaphylaxis? A. As a vasodilator, it increases the blood pressure. B. As a vasoconstrictor, it lowers the blood pressure C. As a bronchodilator, it facilitates adequate breathing D. As a bronchoconstrictor, it inhibits the release of chemicals that cause the reaction.
As a bronchodilator, it facilitates adequate breathing
When is it most appropriate to clamp and cut the umbilical cord? A. As soon as the cord stops pulsating B. After the placenta has completely delivered C. Before the newborn has taken its first breath D. Immediately following delivery of the newborn
As soon as the cord stops pulsating
How to assess severe lower abdominal pain?
Ask where the pain is and palpate that area last. This is to help verify the actual vicinity of the pain.
A middle-aged woman has acute shortness of breath and respirations of 30 breath/min. How should you first manage this patient? A. Assess respiratory quality B. Begin assisting ventilations. C. Apply supplemental oxygen D. Perform a detailed examination
Assess respiratory quality
The first action for treating a 40 year old with rapid respiration's.
Assess the regularity and quality of breathing (Rate, Rhythm, and Quality)
Which of the following actions should be carried out during the initial assessment of an unconscious patient? A. Assessing the skin B. Palpating the cranium C. Auscultating the lungs D. Obtaining a blood pressure
Assessing the skin
proximal pulse, motor function, and sensation
Assessment of ________ should be done before and after immobilization of any extremity
Assessment, parts of: OPQRSTI and its components
Assessment, parts of: OPQRSTI and its components
Assessment, parts of: SAMPLE and its components
Assessment, parts of: SAMPLE and its components
Assessment, parts of: and its components
Assessment, parts of: and its components
Assessment, parts of: primary assessment and its components
Assessment, parts of: primary assessment and its components
Assessment, parts of: scene size up and its components
Assessment, parts of: scene size up and its components
When treating an anxious and uncooperative patient with chest pain, you state, "If you don't settle down, I am going to put a large IV in your arm." What is this an example of?
Assualt
Adult patient compaining of chest pain suddenly loses consciousness. What should you do first?
Attach AED
ALI
Auto location identification
ANI
Automatic number identification
The party responsible for ensuring that an EMT-B maintains his or her ability to provide high-quality EMS care and updates his or her knowledge of EMS care is the: A: state regulatory authority. B: EMT-B. C: medical director. D: EMS agency chief.
B. EMT- Bs After EMT-Bs become certified; they become responsible for continuing their education. The state regulatory authority or EMS agency chief may require certain hours or types of training, and the medical director may identify areas that need training, but it is up to the EMT-B to remain committed to learning new things and remaining comfortable with the core knowledge of an EMT-B.
What is the rate of breaths per minute for an adult? A: 10-18 B: 12-20 C: 15-25 D: 8-16
B: 12-20
If a D-sized oxygen cylinder contains 300 L of oxygen and is at 2,000 PSI at the start of call, the best estimate for the amount of time a patient can receive 15 L/min with a nonrebreathing mask is: A: 10 minutes. B: 20 minutes. C: 30 minutes. D: 40 minutes.
B: 20 minutes. 20 minutes. This can be calculated either by dividing 15 L/min into 300 L, for a result of 20 minutes, or by using the psi constant for a D cylinder, which is 0.16. The calculation would then be (2,000 -200) x 0.16 /15 L/min = 19.2, which is approximately 20 minutes.
Your decision regarding whether the patient is high priority should be made at which step in the assessment? A: When receiving dispatch information B: After the initial assessment is performed C: After vital signs are taken D: After the focused physical exam is performed
B: After the initial assessment is performed Although a patient can be upgraded to priority at anytime based on additional information, the first point where you should make that decision is after the initial assessment.
To which of the following patients is appropriate to administer the head tilt chin lift maneuver? A: An unconscious teenage male who fell off his skateboard. B: An unresponsive 70 year old male who has is in cardiac arrest at a restaurant. C: A 25 year old female complaining of difficulty breathing after falling an hitting her head. D: A 35 year old man who loses consciousness in you presence after being extricated from a car accident.
B: An unresponsive 70 year old male who has is in cardiac arrest at a restaurant. The head tilt chin lift maneuver is contraindicated for suspected c-spine and head trauma.
PATIENT ASSESSMENT: 161-170 You are working on a night shift on an ambulance and arrive on the scene of an assault at a residence. The house is dark and the front screen door has been knocked off its hinges. No law enforcement is on scene yet and the street is quiet. Which of the following is your best course of action? A: Get out of the ambulance and approach the house, calling out, "EMS—we're here to help." B: Park your ambulance several houses away and wait for the police. C: Take your equipment and quietly head up to the house. D: Pull the ambulance onto the front lawn to get it as close as possible to use for shelter.
B: Park your ambulance several houses away and wait for the police. The safest course of action in approaching an unknown dark scene is to wait for law enforcement to arrive to make certain that the scene is safe. Regardless of how badly injured a patient may be, your safety comes first.
A common source of confusion, vomiting, or even unconsciousness, especially in toddlers, is: A: infection. B: poisoning. C: near drowning. D: sport injury.
B: Poisoning Toddlers frequently ingest improperly stored household chemicals as they explore their surroundings. Infections, near drowning, and sport injury are infrequent among toddlers by comparison.
What is the difference between the head-tilt-chin-lift maneuver and the jaw thrust maneuver? A: The head tilt is for trauma patients and the jaw thrust is for medical patients. B: The mechanism of injury or nature of illness determines which technique is used in opening the airway. C: The jaw thrust requires two EMTs, whereas the head tilt requires only one. D: The head tilt opens the airway more than the jaw thrust, allowing for more effective artificial respirations.
B: The mechanism of injury or nature of illness determines which technique is used in opening the airway. The head tilt chin lift is contraindicated for a suspected head, neck or spine injury patient. In these cases the jaw thrust must be used. This is determined by the mechanism of injury.
Children between the age of one and three years of age are considered to be: A: infants. B: todlers. C: preschoolers. D: adolescents.
B: Toddlers Infants are children up to age 1, toddlers are age 1 to 3, preschoolers are age 3 to 6, school-age children are age 6 to 12, and adolescents are between age 12 and 18
The three stages of the body's reaction to stress (general adaptation syndrome) do not include: A: the alarm response. B: burnout. C: reaction and resistance. D: recovery or exhaustion.
B: burnout. Burnout can be a result of poorly managed stress, but it is not a part of the body's physiological reaction to stress.
The second most common cause of death in children is: A: child abuse. B: drowning. C: sport injuries. D: poisoning. what is the first cause?
B: drowning Children under 5 years of age are particularly at risk for submersion injury. After toddlers, adolescents account for the most drownings. trauma is the number one cause
PEDIATRIC ASSESSMENT AND MANAGEMENT: 191-200 Problems leading to cardiopulmonary arrest in children include: A: coronary artery disease, heart attack, and elevated cholesterol. B: foreign body obstruction, respiratory infection, and electrocution. C: congestive heart failure, diseased heart valves, and dysrhythmia. D: acute myocardial infarction, stroke, and kidney failure.
B: foreign body obstruction, respiratory infection, and electrocution. Because most children have healthy hearts, cardiopulmonary arrest is more commonly a result of infections of the respiratory tract, foreign body obstruction, electrocution, drowning, poisoning, and drug overdose, injury, and SIDS. In adults, cardiac arrest is usually the result of an underlying heart disease or ailment.
AIRWAY: 21-40 The aspect of natural ventilation that involves the diaphragm contracting and the chest wall expanding is: A: metabolism. B: inhalation. C: exhalation. D: airway expansion.
B: inhalation. Inhalation is the active phase of breathing or ventilation. The body must work to bring air in.
Hypoxia is best defined as: A: cyanosis, altered mental status, shortness of breath, grayish skin tone B: insufficient oxygen supply to the tissues of the body. C: respiratory arrest D: Chronic Obstructive Pulmonary Disease
B: insufficient oxygen supply to the tissues of the body. This one was a little tricky. Answer A describes the symptoms of hypoxia, not what it is. Prolonged hypoxia can turn into respiratory arrest. COPD can cause hypoxia.
If you arrive at the scene of a motor vehicle crash involving a truck with a black and white diamond-shaped label stating "corrosive" that is leaking a fluid, you should: A: slowly walk around the vehicles, looking for more leaks. B: keep a safe distance from the scene and notify dispatch of a hazardous material. C: quickly but carefully run to the cab of the truck to check for patients. D: begin treating any patients.
B: keep a safe distance from the scene and notify dispatch of a hazardous material. Never go into a known hazardous material scene unless you are properly trained and protected. Notify dispatch with as much information as possible to update incoming units.
Emergency management of the child in seizure includes: A: physically restraining the arms and legs until the seizure ends. B: preventing injury by clearing away close objects and focusing on the ABC's. C: placing several taped tongue blades between the teeth to prevent biting. D: placing ice packs at the nape of the neck and armpits to rapidly cool the patient.
B: preventing injury by clearing away close objects and focusing on the ABC's. Initial assessment begins with scene safety, protecting the seizure patient from further harm, and ensuring an open airway, breathing, and circulation. In addition, the EMT-B should be prepared to suction and apply oxygen as necessary. Physical restraint of the arms and legs may cause further harm and should not be done. Bite blocks of any kind, including your fingers, should never be placed in the mouth as they may break teeth or force the tongue into the airway. Although children between 6 months and 6 years of age commonly experience seizure caused by fever, you should never use ice packs to cool the seizure patient.
A patient who is developing early stages of hypoxia may exhibit: A: cyanosis. B: restlessness. C: a weak pulse. D: a pulse oximetry reading below 80%.
B: restlessness Restlessness is an early sign of hypoxia and should lead to immediate oxygen therapy. The others are all late signs of hypoxia.
The T in "DCAP-BTLS" stands for: A: tingling. B: tenderness. C: tightness. D: turgor.
B: tenderness Tenderness is associated with musculoskelatal injuries and is an important finding during the rapid physical exam.
What is meant by artificial ventilation? A: the insertion of an oropharyngeal bag valve mask to provide negative air flow and proper suction. B: the forcing of air or oxygen into the lungs when a patient cannot breathe for themselves at all. C: when a machine does the breathing for a patient that can still breathe on normally their own. D: breathing assistance for a patient that has a slow heart rate.
B: the forcing of air or oxygen into the lungs when a patient cannot breathe for themselves at all.
What is respiration? A: the way the body uses carbon dioxide to maintain metabolism. B: the process by which the body uses oxygen and expels carbon dioxide. C: when oxygen is perfused with the blood and carbon monoxide is removed. D: the process by which the body removes excess moisture and cools the body through evaporation.
B: the process by which the body uses oxygen and expels carbon dioxide.
Properly performed suctioning of a patient may still cause: A: hypoxia. B: vomiting. C: gastric distention. D: aspiration.
B: vomiting. Vomiting maybe caused even when the skill is performed correctly. Hypoxia can be prevented if the EMT-B only uses the machine for 15 seconds or less on adult patients. Aspiration and gastric distention are not caused by suctioning.
DURING TRUE LABOE, UTERINE CONTRACTIONS....
BECOME MORE REGULAR
NORMAL BLOOD GLUCOSE LEVEL
BETWEEN 80 AND 120 MG/DL.
_____MY BE THE LAST MEASURABLE FACTOR TO CHANGE IN SHOCK
BLOOD PRESSURE
THE MUSCULOSKELETAL SYSTEM
BONES AND VOLUNTARY MUSCLES
What are the S/S of stroke?
BP above 140/90, altered LOC, hemiparesis - one-sided tingling, hemiparalysis or numbness/one-side paralysis, headache, blurred vision, incontinence, aphasia - inability to speak. Transport in Flowers or Reverse Trendelenburg.
general impression
Based on your immediate assessment of the environment and the patient's chief complaint and appearance, you form a(n):
BLS HCP
Basic Life Support Health Care Provider
rollover
Because of multiple impacts, the type of collision that is potentially the most serious is the:
You respond to the home of a 75-year-old man who is in cardiac arrest. The family states that the patient is terminally ill and has an advance directive; however, they are unable to locate it. How should you manage this situation?
Begin CPR and contact medical control
You encounter a baby in it's crib who is not breathing, has no pulse and is cool to the touch. The parents are very distraught and are looking to you for help. What would you do next?
Begin CPR and initiate rapid transport to hospital.
You assess a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do next? A. Resuction the mouth. B. Briskly dry off the infant. C. Begin chest compressions D. Begin artificial ventilations
Begin artificial ventilations
Why are penetrating injuries to the neck so dangerous and how do EMTs treat these injuries?
Bleeding from a major artery can occur or air may enter a lacerated vein Place a gloved hand over the wound to control bleeding Apply an occlusive dressing and tape all 4 sides Cover the occlusive dressing with regular dressing Apply enough pressure to control bleeding Once bleeding is controlled apply a pressure dressing If there is a suspected spinal injury provide appropriate immoblization
A 67-year-old male complains of burning sensation in his abdomen and hematemesis. During your assessment, you note pain to palpation of his left upper quadrant; his vital signs are suggestive of shock. Which of the following conditions should you suspect?
Bleeding peptic ulcer
Which of the following injuries or conditions should be managed first? A. Fluid drainage from both ears B. Bleeding within the oral cavity C. A large open abdominal wound D. Bilateral fractures of the femurs
Bleeding within the oral cavity
a one-way valve between the atrium and the ventricle.
Blood in the ventricle is prevented from being forced back up into the atrium when the ventricle contracts by:
Which artery should you palpate when assessing for a pulse in an unresponsive 6-month old patient? A. Radial B. Carotid C. Femoral D. Brachial
Brachial
Which of the following signs would LEAST suggest a diabetic emergency? A. Bradycardia B. Tachycardia C. Combativeness D. Fruity breath odor
Bradycardia
Encoder
Breaks down sounds waves into unique code
Which of the following mechanisms cause respiratory and circulatory collapse during anaphylactic shock? A. Bronchodilation and vasodilation B. Bronchodilation and vasoconstriction C. Bronchoconstriction and vasodilation D. Bronchoconstriction and vasoconstriction
Bronchoconstriction and vasodilation
What are the signs and symptoms of child abuse?
Bruises that have multiple stages of healing A fearful child Unusual wounds Injuries do not match the MOI described by parents Malnourishment Implausible explanations based on childs age level, 6 month old spilled boiling water on himself
What is meant by BVM. A: A device for measuring minute volume. B: Bilateral (lungs) Ventilation Machine C: Bag Valve Mask D: Breathing and Ventilation Maneuvers
C: Bag Valve Mask
When inserting a nasopharyngeal airway, it is important to do all the following except: A: Measure the size from the tip of the nose to the earlobe. B: Ensure that the bevel faces the septum when inserting into the right nare. C: Insert with a constant rotating motion. D: Lubricate the airway with a water-based lubricant.
C: Insert with a constant rotating motion. The device should be rotated 180 degrees if placed in the left nare, and not at all in the right nare.
An inflammation of the layers of tissue around the brain and spinal cord is known as: A: neoplasm. B: infarction. C: meningitis. D: epilepsy.
C: Meningitis Meningitis can lead to permanent brain damage or death, making recognition by the EMT very important. Neoplasm is an abnormal growth (cancer), infarction is the hypoxic injury to tissue, and epilepsy is an illness that manifests in seizures.
Why is the year 1966 usually referred to as the beginning of the modern era of EMS? A: It was the year the first EMT textbook was published. B: It was the year the term "paramedic" was first used. C: The report "Accidental Death and Disability: The Neglected Disease of Modern Society" was published. D: The first "van ambulance" was manufactured.
C: The report "Accidental Death and Disability: The Neglected Disease of Modern Society" was published. The paper "Accidental Death and Disability" highlighted the serious inadequacy of prehospital care and transportation in many areas. The other events all occurred later in the 1960s or in the early 1970s.
When would an EMT use the jaw thrust maneuver to open an airway? A: When the patient has no suspected cervical injury. B: When the patient is bleeding profusely, necessitating a more rapid way to open the airway. C: When the patient has a suspected neck injury. D: When there is a high suspicion of an airway obstruction.
C: When the patient has a suspected neck injury. When there is a suspected c-spine injury the jaw thrust maneuver is used in order to minimize damage that could be caused by opening the airway.
Respiratory failure is distinguished from respiratory distress by: A: the patient refusing to sit upright, preferring to lie flat. B: the heart rate returning to normal and skin color improving. C: a decreased level of consciousness and developing cyanosis. D: respiration rates between 20 to 30 breaths/min indicating an increase in hypoxia.
C: a decreased level of consciousness and developing cyanosis. Although a definitive diagnosis of respiratory failure is made in the hospital, progression to failure includes decreased effort to breathe, less chest rise with inspiration, changes in behavior, developing cyanosis, and apnea. Patients experiencing respiratory distress prefer to sit upright, or in a tripod position. In respiratory distress the heart rate returns to normal when the condition is reversed. Abnormal respiratory rates in the child are above 60 breaths/min.
When dealing with the death of a child, the EMT-B should: A: attempt to joke with the family regarding the circumstances. B: tell the family that child is going to "make it." C: acknowledge to the family that the child is dead. D: not tell the family anything until a clergy member is present.
C: acknowledge to the family that the child is dead. Acknowledging the death to the family can help them begin the grieving process. It is not appropriate to joke, deceive, or unnecessarily delay the notification to the family.
Emergency Medical Dispatch has been developed to: A: provide an exact location of the caller using GPS. B: see what is going on at the scene. C: allow dispatchers to provide instructions to the caller until EMS arrives. D: all of the above.
C: allow dispatchers to provide instructions to the caller until EMS arrives. EMD allows a dispatcher to provide instructions for a caller using a script and to categorize a call so appropriate assistance can be sent to the scene. Enhanced 9-1-1 for certain cellular phones can provide the exact location. Technology doesn't yet exist to allow us to see the scene.
During your assessment of the patient's breath sounds, you should: A: tap the chest wall to hear an echo. B: auscultate the chest the ventral wall. C: auscultate the chest from the dorsal wall. D: ask them to exhale forcefully so you can listen.
C: auscultate the chest from the dorsal wall. The preferred place to listen is the dorsal (back) wall of the chest because there is usually less tissue.
Considerations in immobilization of a small child with a suspected head and neck injury include: A: children are less likely to experience cervical trauma than adults. B: children should always be removed from child restraint seats for transport. C: children should be secured to a backboard with padding under the shoulders. D: children should be secured to a backboard, head before torso, to minimize panic.
C: children should be secured to a backboard with padding under the shoulders. Childrens' heads are proportionately larger than adults'. To maintain a neutral airway position, padding is necessary under the child's shoulders. Because children have weaker muscles in the neck, they are more prone than adults to experience neck injury. If the child is unstable or the seat is visibly damaged, the child must be removed to another spinal restraint device. When securing a patient of any age to a backboard, the torso must always be secured before the head to prevent accidental neck injury.
Common signs and symptoms of patients suffering from cardiac compromise include: A: crushing pain, tremulousness, lacrimation, dyspnea and alopecia B: dyspnea, complaints of dull chest pain, diarrhea, diaphoresis, cardiomyopathy C: dyspnea, chest pain that is described a squeezing dull or crushing, mild chest discomfort, sweating, nausea and vomiting D: dull aching chest pain, numbness in the extremities, cyanosis, decreased blood pressure, diminished bowel sounds
C: dyspnea, chest pain that is described a squeezing dull or crushing, mild chest discomfort, sweating, nausea and vomiting
Of the following, what is the most likely place an EMT would look for cyanosis in her patient? A: the superior aspect of the scalp. B: the palms. C: earlobes D: both the palms and the superior aspect of the scalp.
C: earlobes.
When using a bag-valve-mask device, the key finding to observe to assure adequate ventilation is: A: three seconds between squeezing the bag and lifting the mask off the face. B: the patient's weight in kilograms. C: good chest rise and fall. D: the location of the patient's cricoid cartilage.
C: good chest rise and fall. Good chest rise and fall is the most important method to measure the patient's ventilations.
Oxygen cylinders are what color? A: red B: blue C: green D: magenta
C: green
The goal of universal precautions is to: A: protect you from all infectious diseases. B: protect you from all hazardous materials. C: interrupt the transmission of germs. D: prevent exposure to stressful situations.
C: interrupt the transmission of germs. The goal is to interrupt the transmission of germs by decreasing the chance that you will come in contact with them.
As you approach the scene of a motor vehicle crash, you observe that the vehicle appears to have struck a telephone pole on a rural road at high speed. The windshield is cracked near the driver's seat and the hood has been bent up significantly. You have observed the: A: nature of illness. B: scene safety. C: mechanism of injury. D: history of the accident.
C: mechanism of injury. The mechanism of injury is observed by looking at the patient and his or her surroundings to determine how much force they might have received.
The type of medical control where a physician may either confirm or modify a proposed treatment plan over the radio or telephone is referred to as: A: offline or indirect medical control. B: retrospective Medical control. C: online or direct medical control. D: implied medical control.
C: online or direct medical control. Online medical control involves direct communication between an EMS provider and medical control physician. Offline medical control are usually found in protocols and quality assurance activities.
When encountering a patient who is not breathing the first thing you should do is: A: stabilize C-spine in case the patient is suffering from syncope. B: administer high flow oxygen at 15 lpm via non-rebreather mask. C: open the airway. D: check the patient's pulse.
C: open the airway
If you suspect that a patient has a communicable disease, you may: A: refuse to treat them. B: delay treating them while you wait to learn the seriousness of the condition. C: pause to don appropriate personal protective equipment. D: none of the above.
C: pause to don appropriate personal protective equipment. The only acceptable delay in care for a person with a communicable disease is to reduce your risk by donning PPE. Refusal to care for them or a lengthy delay may be considered a breach of duty.
Dehydration can present a serious problem to the infant or small child and should be suspected if: A: the child has produced frequent wet diapers. B: the child has unexplained, tearful crying. C: the skin is loose and has no elasticity. D: the child has excessive saliva or drooling.
C: the skin is loose and has no elasticity. Signs of dehydration include dry lips and gums, decreased saliva, fewer or dryer diapers, sunken dry eyes, crying without producing tears, poor skin turgor or elasticity, and infants may also have a sunken anterior fontanel. Unexplained, tearful crying may be an indication of abuse. Excessive drooling may indicate epiglottitis.
One of the simplest and most effective ways to control disease transmission is to: A: wear latex gloves on all EMS calls. B: wear a HEPA mask during long transports. C: wash your hands after every call. D: recap a dirty needle after it is used.
C: wash your hands after every call. Washing hands properly is the best answer. Gloves should be used anytime there is possibility of blood or body fluid exposure. HEPA masks should be worn when transporting a patient requiring airborne precautions. Needles should never be recapped
The general impression of the patient should be formed: A: after the vital signs are taken. B: during the SAMPLE history. C: while observing the patient during your approach and initial conversation. D: based on the dispatch information.
C: while observing the patient during your approach and initial conversation. The general impression is formed as soon as you reach the patient and begin speaking with them.
THE EXCHANGE OF O2 AND NUTRIENTS FOR WASTE PRODUCTS OF METABOLISM OCCURS AT THE CELLULAR LEVEL IN THE....
CAPILLARIES
CIRCULAR MUSCULAR WALLS THAT REGULATE BLOOD FLOW THROUGH THE CAPILLARIES
CAPILLARY SPHINCTERS
PULMONARY EDEMA AND IMPAIRED VENTILATION OCCUR DURING WHICH TYPE OF SHOCK?
CARDIOGENIC SHOCK
THREE MAJOR PARTS OF THE BRAIN
CEREBRUM CEREBELLUM BRAIN STEM
PERFUSTION
CIRCULATION OF BLOOD WITHIN AN ORGAN IN ADEQUATE AMOUNTS TO MEET THE BODY'S METABOLIC NEEDS
TYPE 1 DIABETES
CONDITION IN WHICH NO INSULIN IS PRODUCED BY THE BODY
CLASSIC SIGNS OF HYPOGLYCEMIA
COOL, CLAMMY SKIN WEAKNESS TACHYCARDIA RAPID RESPIRATIONS
POSITIVE INDICATORS OF A FRACTURE
CREPITUS AND FALSE MOTION
Upon arriving at the scene of a multiple vehicle crash, you can see that at least two patients have been ejected from their vehicles. What should you do next? A. Begin triage B. Treat the most critical patient first C. Gather all of the patients together D. Call for at least one more ambulance
Call for at least one more ambulance
Long term complications of Diabetes?
Can contribute to leg ulcers, vision problems, damage to organs, and amputations.
About the head tilt chin lift maneuver
Can only be used temporarily and must be replaced by an airway adjunct.
What occurs during cellular/capillary gas exchange?
Capillaries give up oxygen to cells.
at room temperature
Capillary refill is most reliable when assessed:
Standard of Care
Care expected from any trained EMT under similar circumstances. (PG. 53)
pulling the object out in the direction it entered the cheek
Care for the patient with an impaled object in the cheek includes:
What are the common signs and symptoms of a brain injury?
Cerebral spinal fluid from nose and ears Systolic blood pressure increase Heart rate decrease Unequal pupils Decreasing mental status
When should you do before and after splinting a fracture?
Check for PMS
An AED gives a "No shock advised" for a patient. what should you do first?
Check pulse
When using a BVM to ventilating a patent with Apnea you see very little rise in the chest. What actions should you take first?
Check the mask seal, and preposition head
Use position of comfort with...
Chest pain/breathing difficulties
CHEATED acronym
Chief complaint, History, Exam, Assessment, Treatment, Evaluation, Disposition
Activated Charcoal
Children should not get more than one dose of products with sorbitol.//Adult/child: PO 30-100g or 1g/kg, minimum dosage 30g/250ml of water; may give 20-40g q6h for 1-2 days in severe poisoning
When transporting a patient with a feeding tube you may
Clamp the tube to prevent vomiting.
A semicoscious young man with shallow, gurgling respirations at a rate of 10 breaths/min. What action should you make first?
Clear the airway by suctioning,
You are dispatched to the home of a 64-year-old male patient with lung cancer. The patient complains of acute dyspnea; however, as long as he is sitting upright, his breathing is easier. He denies fever and his breath sounds are decreased over the base of the left lung. What is the MOST likely cause of this patient's symptoms?
Collection of fluid outside of the lung
difficulty breathing
Common symptoms of a patient in cardiac compromise include:
What are the steps that an EMT must take for a patient refusing treatment and transport?
Complete a refusal of care form then have it signed and witnessed
Which of the following describe the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest? A. Compress the chest to a depth of 1 1/2" to 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions. B. Allow full recoil of the chest after each compression, compress the chest to a depth of 2", deliver compressions at a rate of at least 80/min C. Do not interrupt chest compressions for any reason, compress the chest to a depth of 1 1/2" to 2", allow partial recoil of the chest after each compression D. Minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min
Compress the chest to a depth of 1 1/2" to 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions
Implied Consent
Consent also known as Emergency Doctrine. Consent assumed when a patient who is unresponsive or who is not competent or who is unable to make a rational decision would if they could. (PG. 55)
Involuntary Consent
Consent that can be applied when you are dealing with a mentally incompetent adult or with an individual who is in custody of law enforcement or is incarcerated. (PG. 55)
Consent to Treat a Minor
Consent that must be obtained from a parent, legal guardian, or other person who has been grated limited rights of decision making by the parent or guardian, such a a teacher, stepparent, etc. (PG. 55)
Expressed Consent
Consent that must be obtained from every conscious, competent, adult before treatment, must be of legal age, competent, rational, and informed of the assessment and procedures. (PG. 55)
COBRA
Consolidated Omnibus Budget Reconciliation Act: Regulations that ensure public access to emergency health care regardless of ability to pay. (PG. 62)
when performing CPR and presented with a document of DNR for the patient you should
Continue until you have contacted and confirmed with medical control that you can stop.
You respond to a call for an 16-year-old boy who injured his arm. As you are assessing the child, he tells you that he does not want you to touch him. His mother tells you to begin treatment and transport the child to the hospital if necessary. What should you do?
Continue your assessment and transport if necessary
CQI
Continuous Quality Improvement: A system of internal and external reviews and audits of an EMS system to ensure a high quality of care. (PG. 16)
FIrst respons to treat a large avulsion
Control any bleeding and bandage.
The Myocardium receives blood from the
Coronary arteries
hemoptysis
Coughing up blood
patient who was just removed from a house fire sustaining full thick burns to 50% of her body. What do you do?
Cover burns with dry sterile dressing and prevent hypothermia (less blood/fluid = less warmth)
What should you do when you discover a patient with an open chest wound?
Cover the would (sucking chest would = Valvoline patch with tape, moist dressing = everything else)
CISD
Critical Incident Stress Debrief: A session where counselors help emergency personnel process emotions from a critical incident. (PG. 29)
The process of counseling after critical incident
Critical incidence stress debriefing (CISD)-held 24-72 hours after a critical incident and is a team of peer counselors and mental health professionals to help EMS work through the seven phases. It is NOT meant to assign blame and it is NOT professional counseling. It is a means to relieve stress.(p 29-30) 1-4 hours after incident with those directly involved) i. review facts ii. share feelings iii. identify signs & symptoms iv. sort feelings w/ professional v. suggestions for overcoming stress vi. plan for return to job vii. follow-up assistance
what is D5w?
D5W- 5% dextrose (sugar) in water. TKO IV, with a minidrip tubing
A nasal canula is meant to deliver oxygen concentrations of: A: 2-6% B: 4-8% C: 8-15% D: 24-44%
D: 24-44%
EMS providers who can perform advanced cardiac life support skills, may use a manual defibrillator, and are trained for 800 to 1,500 hours are called: A: first responders. B: EMT-Basics. C: EMT-Intermediates. D: EMT-Paramedics.
D: EMT-Paramedics. EMT Paramedics are recognized as the highest level of pre-hospital care in the national curriculum. They can perform a wide range of advanced life support skills.
Differences in anatomy between adults and children that influence treatment decisions, include: A: The proportionately larger diameter airway of the child is less easily obstructed by secretions. B: The proportionately larger tongue of the child is less likely to cause obstruction. C: The epiglottis is larger in the child than adult and is more likely to prevent aspiration. D: The child's occiput is larger and rounder than an adult, requiring careful positioning.
D: The child's occiput is larger and rounder than an adult, requiring careful positioning. The proportionately larger head makes it easier to close the child's airway if it is not carefully positioned to maintain a neutral position, a larger tongue can easily block the airway, a floppy epiglottis is less likely to prevent aspiration, less well-developed rings of cartilage may easily collapse if the neck is flexed or hyperextended, and the lower airway is much narrower, allowing for more problems.
Describe a patent airway. A: an airway that is blocked and must be cleared with a series of abdominal thrusts. B: an airway that is mostly clear, but contains a small yet irremovable obstruction that does not interfere with ventilation. C: an airway that requires either the jaw thrust or the head tilt chin lift maneuver. D: an airway that is open and clear, and that will remain so, so that air may freely pass in and out of the lungs.
D: an airway that is open and clear, and that will remain so, so that air may freely pass in and out of the lungs.
The PAT or pediatric assessment triangle is a structured assessment tool to rapidly determine the child's condition using: A: muscle tone, facial grimace, and activity. B: respiratory rate, pulse, and capillary refill. C: patient weight, height or body length, and age. D: appearance, work of breathing, and circulation to the skin.
D: appearance, work of breathing, and circulation to the skin. The three components of the Pediatric Assessment Triangle include the appearance, work of breathing, and circulation to the skin. Muscle tone, facial grimace, and activity are components to the APGAR newborn assessment. Respiratory rate, pulse, and capillary refill are among the vital signs assessed during the physical exam. Patient weight, height, and age are helpful to determine proper medication and other devices.
Inadequate breathing is best described as: A: no chest rise, no air moving in and out of lungs, no sounds B: the patient complains of shortness of breath and is cyanotic around the lips. C: the rate of breaths per minute is 16, with cold clammy skin. D: shallow breathing that is too slow or too fast, diminished breath sounds, abnormal noises, cyanosis, inadequate minute volume.
D: breath sounds, abnormal noises, cyanosis, inadequate minute volume. Answer A describes a patient who is not breathing. Answer B describes some possible symptoms of inadequate breathing. Answer C does not contain enough information.
THE WELL BEING OF THE EMT: 11-20 According to Dr. Kubler-Ross, the stage of the grieving process identified by the open expression of grief, hopelessness, and the desire to die is: A: denial. B: acceptance. C: bargaining. D: depression.
D: depression. Depression is the open expression of grief, internalized anger, hopelessness, the desire to die
The process by which carbon dioxide moves from a high concentration in the capillaries to the lower concentration in alveoli is: A: ventilation. B: hypoxia. C: wicking. D: diffusion.
D: diffusion Diffusion is the process where the gases are exchanged from a high concentration to a low concentration. Diffusion is aided by the round shape of the alveoli.
During your focused physical exam, you find that the patient has good pulse in his feet, but has trouble moving them or feeling your touch. You should: A: ask the patient if he can take a few steps, while you hold his arm. B: bend his knees to see if the sensation improves. C: place the patient on oxygen. D: ensure that proper spinal immobilization steps have been taken.
D: ensure that proper spinal immobilization steps have been taken. This patient may have a spinal injury and should be treated for that condition until proven otherwise at the hospital.
At violent situations, EMS personnel should: A: assume that parties will not try to harm EMS providers. B: enter the scene as soon as law enforcement arrives. C: trust that bystanders will protect them from possible harm. D: enter the scene only when law enforcement indicates it is safe.
D: enter the scene only when law enforcement indicates it is safe. You should always ask for law enforcement to indicate that the scene is safe if the scene is potentially violent. EMS providers should not trust that bystanders to leave them alone or protect them.
You should NOT be concerned about the following symptoms when you suspect breathing problems in a pediatric patient? A: grunting at the end of respirations. B: the patient is breathing at 65 breaths per minute. C: nasal flaring. D: equal expansion of the lungs.
D: equal expansion of the lungs. Grunting and nasal flaring are both signs of respiratory distress in children. The range of breathing in children is: Infant (birth-1 year) 30-60, Toddlers (1-3 years) 24-40, Preschoolers (3-6 years) 22-34, School-age (6-12 years) 18-30, Adolescents (12-18 years) 12-16. Equal expansion of the lungs is one sign of adequate breathing.
The most common complication of the flow-restricted, oxygen-powered ventilation device is: A: pneumothorax. B: hypoventilation. C: cricoid pressure. D: gastric distention.
D: gastric distention. Medical literature indicates that gastric distention is the most common complication, however, patients with COPD maybe at greater risk for a pneumothorax.
During your initial assessment, you observe that the patient can only answer questions in two- to three-word sentences. Based on this finding, you should: A: apply a pulse oximeter to see if he is having trouble breathing. B: place him in a supine position and begin to give them artificial respirations. C: give him oxygen at 6 L/min by nasal cannula. D: give him oxygen at 15 L/min by nonrebreathing mask.
D: give him oxygen at 15 L/min by nonrebreathing mask. Oxygen should be given as soon as you identify trouble breathing during your initial assessment.
A Continuous Quality Improvement (CQI) system is designed to: A: identify medical mistakes and punish those who commit them. B: identify new trends in medical care and implement them. C: identify EMS providers who have to recertify. D: identify areas of improvement and appropriate education to help fix them.
D: identify areas of improvement and appropriate education to help fix them. CQI works to identify and improve areas of medical care. The CQI process should not punish the provider and should focus their education only on the skills needing assistance, not require unnecessary training. Advances in medical care are constant, and providers must work to stay up to date, but this is not the primary reason for CQI.
Strategies that EMT-Bs may use to positively manage the stress of the job include the following except: A: sustaining friends and interests outside of EMS. B: regular physical activity. C: eating a balanced diet of carbohydrates, protein, and limited fats. D: learning how to hold your stress reaction inside.
D: learning how to hold your stress reaction inside. The other three choices are among the many that are strategies recognized to help EMT-Bs manage stress.
Following your detailed physical exam for an unstable medical patient, you should begin transport, then: A: repeat the initial assessment and vital signs every 15 minutes. B: remove the oxygen to get an accurate reading for pulse oximetry. C: wait until you are arriving at the hospital to reassess. D: repeat the initial assessment and vital signs at least every 5 minutes.
D: repeat the initial assessment and vital signs at least every 5 minutes. Vital signs, initial assessment, and interventions should be checked every 5 minutes in an unstable patient or more frequently if needed.
The EMT-B is likely to encounter children with tracheostomy tubes, artificial ventilators, central IV lines, gastrostomy tubes, or shunts in the home environment because: A: these children have poor prognosis for survival and are sent home to die. B: home health care services and visiting nurses are often incapable of providing proper care. C: parents of these children are more likely to become panicked easily and call 9-1-1. D: technology continues to improve and health care continues to focus on decreasing hospitalizations.
D: technology continues to improve and health care continues to focus on decreasing hospitalizations. The number of children with chronic illness who are living at home or in other environments outside the hospital continues to grow as their prognosis for survival is improved from the past, making it likely that the EMT-B will be called to assist these patients. These parents often know the child's history and condition better than some skilled health care workers and are rarely panicked.
What is meant by minute volume?. A: the amount of air taken in by the lungs over a two minute period. B: the amount of air that can be taken into the lungs in one breath, otherwise known as lung capacity. C: the amount of breaths per minute, minus the dead space in the lungs. D: the amount of air inhaled in one breath times the breaths per minute.
D: the amount of air inhaled in one breath times the breaths per minute. Example. A patient may inhale 14 times per minute, taking in a full breath of 500 mL. 14bpm X 500 mL = 7000 mL per minute.
The second phase of a coordinated continuum of care is: A: the patient receives assessment and stabilization in the hospital emergency department. B: the patient receives the necessary definitive specialized care. C: the patient recognizes an emergency and initiates the EMS system. D: the patient is assessed, treated, packaged, and transported to the hospital.
D: the patient is assessed, treated, packaged, and transported to the hospital. The second phase of the Coordinated Continuum of Care is assessment, treatment, packaging, and transport, and is usually provided by EMTs on an ambulance.
Children may have experienced a serious injury even though there may be little or no outward signs such as fractured ribs, bleeding, or contusions, because: A: their bodies can absorb energy better than an adult's. B: their organs are closer to the surface than an adult's. C: their organs contain more blood vessels than an adult's. D: their bodies can compensate better for significant blood loss.
D: their bodies can compensate better for significant blood loss. Children can compensate for significant blood loss, resulting in delayed external indication of serious injury. Their flexible ribs allow energy of blunt trauma to penetrate deeply into underlying organs, their organs are no more superficial than an adult's, nor do they have more blood vessels.
When you are called to assist a patient who is uncooperative and verbally abusive, you should: A: treat the patient in a similar manner to gain control of the situation. B: leave the scene and go back in service. C: threaten the patient with force if they don't calm down D: treat the patient with respect and call for law enforcement assistance.
D: treat the patient with respect and call for law enforcement assistance. Patients may not be able to effectively communicate when they are experiencing a medical crisis and must always be treated with respect. If you feel threatened, you should contact law enforcement and retreat to safety until they arrive.
The difference in attempting to clear a foreign body from the airway in the adult, child, and infant is: A: you perform blind finger sweeps in the infant, but not in the adult. B: you perform back blows in children and infants, but not in the adult. C: you perform two initial breaths in the adult, but only one in children and infants. D: you perform abdominal thrusts in adults and children, but back slaps and chest thrusts in infants.
D: you perform abdominal thrusts in adults and children, but back slaps and chest thrusts in infants. Back slaps and chest thrusts are performed on infants only. Two initial breaths are delivered in all age groups.
WHAT ACTIVITIES OCCUR IN THE "WARM ZONE"?
DECONTAMINATION
OSTEOPOROSIS
DECREASE IN BONE MASS AND DENSITY
ISCHEMIC HEART DISEASE
DECREASED BLOOD FLOW TO ONE OR MORE PORTIONS OF THE MYOCARDIUM
A PATIENT WHO IS SWEATING PROFUSELY IS REFERRED TO AS BEING:
DIAPHORETIC
NITROGLYCERIN RELIEVES CARDIAC-RELATED CHEST PAIN BY
DILATING CORONARY ARTERIES AND IMPROVING CARDIAC BLOOD FLOW
BLEEDING FROM SOFT-TISSUE INJURIES TO THE FACE IS MOST EFFECTIVELY CONTROLLED WITH
DIRECT PRESSURE USING DRY, STERILE DRESSINGS
DISLOCATION
DISRUPTION OF A JOING IN WHICH THE BONE ENDS ARE NO LONGER IN CONTACT
advance directive
DNR order
Obvious signs of death
Decapitation, Evisceration of heart, lung, brain, incineration, Decomposition, Levidity and rigor mortis
What is Anqina' pectoris and what are the S/S
Decreased blood supply to heart muscle causing temporary ischemia and is easy to provoke. Pain generally lasts up to 30 min. Same s/s as M.l
Slander
Defaming through spoken statements with malicious intent or reckless disregard. (PG. 61)
Libel
Defaming through writing or mass media with malicious intent or reckless disregard. (PG. 61)
You encounter an 1 ½ year old who is crying, but has no tears. You notice the diaper is dry. What do you suspect?
Dehydration
Living Will
Delineates the signer's wishes about general health care issues. (PG. 55)
What are DT's?
Delirium Tremors - potentially life threatening reaction to alcohol withdrawal
The goal of EMS Quality improvement program is to
Deliver a consistently high standered of care to all patients who are encountered
last 30 seconds to 1 minute, and are 2 to 3 minutes apart
Delivery of the baby may be imminent when the mother's contractions:
5 Emotional Stages of Death and Dying
Denial, Anger, Bargaining, Depression, and Acceptance. (PG. 24)
False Imprisonment
Detention of a person without his consent or other legal authority. (PG. 61)
What is triage?
Determines which persons need immediate emergency care in order to survive their injuries which patients will live with a delay in emergency medical care and which patients will die regardless of the emergency care provided
Negligence
Deviating from an accepted standard of care through carelessness, inattention, disregard, inadvertence, or oversight. (PG. 59)
Nonurgent moves
Direct ground lift, extremity lift, direct carry, drawsheet
Abandonment
Discontinuing care without transferring care to a health care professional with equivalent or better training. (PG. 60)
When cleaning around her empty swimming pool, a 30-year-old female fell into the deep end of the pool. She presents with decreased sensation and movement in her lower extremities, a blood pressure of 80/50 mm Hg, and a heart rate of 50 beats/min. What is the MOST likely etiology of this patient's condition?
Disruption of the nervous system and relative hypovolemia
When dealing with Suicide patient how do you restrain them?
Do Not initially restrain them to prevent violence, this may only cause violence. If restrained do not use any material that can harm their wrists or have them in the prone position.
Quality Improvement Roles
Document carefully, Perform reviews/audits, Obtain feedback, Maintain equipment, participate in continuing education, and maintain skills. (PG.17)
improvements in a patient's condition, route and time of administration, deterioration of a patient's condition.
Documentation of medication the EMT-Basic administers should include:
Significance of bruising in several stages of healing
Domestic/child/elder abuse
location to palpate pedal pulse
Dorsalis pedis artery; person with poor arterical circulation to feet, occurs with many diabetic persons - may be undetectable.
Tx of submersion pts
Drowning pg 845 1. Remove pt from water/If c-spine is suspected, do it in water and then get them out 2. If no c-spine needed, get pt out&place L lateral recumbent for proper draining of fluids from airway 3. Be ready to suction 4. If depressed/no breathing, do + pressure ventilations w/ O2 5. CPR/AED if pulseless/apneic and over 1yo 6. If gastric distension, place pt on side and himlenic maneuver to remove air/water content from stomach 7. Manage other trauma/med situation ie. Soft tissue inj, seizure, diabetic, etc 8. Transport w/O2 stat Pg 854 Air embolism/decompression sickness/brain trauma: 1. C-spine if needed, keep pt supine/pt alert. If pt does not need c-spine, is not alert, or has altered mental status, L lateral recumbent. **NO trelenberg or head-down position 2. Open airway and assess breathing and do non-rebreather at 15L/min even if resp's are good because it decreases the nitrogen bubbles and improves circulation. Document the exact time of O2 delivery. If inadequate breathing, do + pressure vent's 3. AED/CPR if needed 4. Transport, get diving log: get med direction regarding re-compression chaimer
At what point in an assessment would you check the back of the patient?
During the rapid trauma assessment
supine hypotension syndrome
During the transportation of a woman in her third trimester, the EMT-Basic should place the patient in a sitting position to avoid
4 Elements to prove negligence
Duty to act or standard of care, breach of duty, damage done to patient, proximate cause (connection between breach of duty and damage) (PG. 60)
what are the Four elements of 'Negligence'?
Duty to act, failed to act or acted improperly, resulted in 'damage', EMT was the cause of the damage.
S/S for Smoke inhalation:
Dyspnea, tachypnea, cough, stridor, wheeze or rales, watery eyes, singed nasal hairs, strider.
Emergency Medical Responder (EMR)
EMS Practitioner likely to be the first person on scene with emergency care training use basic airway, ventilation, oxygen, vitals, c-spine, stabilizing injuries, CPR, defib., and birth care. (PG. 9)
Emergency Medical Technician (EMT)
EMS Practitioner who provides basic emergency medical care. Uses advanced oxygen, ventilation, pulse oximetry, auto-blood pressure, and limited medication and everything an EMR can do. (PG. 9)
designated agent
EMT or other person authorized by a medical director to give medication or give emergency care, extension of medical director's license to practice
Advanced Emergency Medical Technician (AEMT)
EMT that does what an EMR and EMT can do but can also do advanced airway, blood glucose, intravenous/intraosseous infusions, and administration of a select number of medications. (PG. 10)
Paramedic
EMT that does what an EMR, EMT, and AEMT do but also can do advanced assessments, field impressions, and invasive and drug interventions. It is to reduce disability and death. (PG. 10)
LEAF-SHAPED STRUCTURE LOCATED SUPERIOR TO THE LARYNX
EPIGLOTTIS
AT THE ONSET OF AN ACUTE ASTHMA ATTACK, PATIENTS COMMONLY EXPERIENCE DIFFICULTY BREATHING AND
EXPIRATORY WHEEZING
WHAT RESPONSIBILITY/DUTY DOES NOT FALL WITHIN THE REALM OF THE MEDICAL BRANCH OF THE ICS?
EXTRICATION
Lowest level of training of the 4 trainings
Emergency Medical Responder. Provides immediate life saving care to patients who have accessed EMS while waiting for higher-level EMS practitioner. (pg. 9)
EMTALA
Emergency Medical Treatment and Active Labor Act: Regulations that ensure pubic access to emergency health care regardless of ability to pay. (PG. 62)
Prehospital Care
Emergency medical treatment given to patients before they are transported to a hospital or other facility. Includes treatment during transport. (PG. 10)
You respond to a call for an older woman who has fallen. Upon arrival at the scene, you assess the patient, who is responsive and alert to person, place, time, and event. She states that she does not want to go to the hospital; however, her son requests that you take her. What should you do?
Ensure the patient is fully aware of the consequences of refusing treatment
Which of the following conditions would most likely cause flushed skin? A. Shock B. Hypoxia C. Exposure to heat D. Low blood pressure
Exposure to heat
How do you open the airway on a young child?
Extend the head only enough to ensure a patent airway because a childs airway is smaller and more flexible, hyperextension of the head can result in the airway kinking (like a garden hose) occluding the airway
NEUROGENIC SHOCK OCCURS WHEN"
FAILURE OF THE NERVOUS SYSTEM CAUSES WIDESPREAD VASODILATION
THE SPINAL CORD EXITS THE CRANIUM THROUGH THE
FORAMEN MAGNUM
FUNCTION OF PLATELETS
FORMATION OF BLOOD CLOTS
s/s of a patient in decompensated shock?
Falling blood pressure
Defamation
False communication that injures another person's reputation. (PG. 61)
What is the biggest risk to a patient with an abdominal aortic aneurysm?
Fatal internal bleeding
Who controls radio systems?
Federal Communication Commission
as soon as the baby is delivered.
Fluids should be removed from the newborn infant's airway:
For what conditions should up place a patient in Supine?
For C-spine trauma without shock, pelvic fracture, flail chest
For what conditions should up place a patient in Left lateral Trendelenburg?
For Pregnency complications or diving emergenices
For what condition should you put a patient in Fowlers?
For dyspnea, chest pain, CVA with hemiplegia (one-sided paralysis) or any suspected CVA
For what conditions should up place a patient in shock position?
For patient in shock'without' spinal trauma
Long spine board immobilization device
For patient with multiple injuries and unstable vital signs
When dealing with major burn victims what should you do to treat them?
For significant burns: 70% or so don't use wet dressings (too much moisture can lead to hypothermia) Cool burn with water, then apply a DRY dressing. Expect respiratory problems.
For what conditions should up place a patient in Trendelenburg?
For spinal trauma 'with' shock
For what conditions should up place a patient in Left lateral ?
For unconscious (non-traumatic), altered level of consciousness
assault and battery
Forcing a competent patient to go to the hospital against his will may result in being charged with:
THE EYEBALL ITSELF IS REFERRED TO AS
GLOBE
Which of the following organs is not part of the endocrine system? A. Thyroid B. Pituitary C. Pancreas D. Gallbladder
Gallbladder
What organs are Hollow?
Gallbladder, Intestine, Appendix, Stumach
When first approaching a patient on scene the EMT will form a ______ based on environment, appearance and chief complaint.
General Impression
What are the parts of the primary assessment?
General impression of the patient Determine the patients level of responsiveness (AVPU) Determine the patients chief complaint/Life threats Airway-open and assess airway Breathing Assures adequate ventilation Initiates appropriate oxygen therapy Circulation Checks pulse Assess skin Assess/control bleeding at appropriate time
And adult patient has "crushing" chest pain lasting longer then 30 minutes. Skin signs are pale and clammy. What should you do first?
Give High flow oxygen (Initiate oxygen therapy)
Elderly patient complaining of chest pain tells you she had taken two of her husbands Nitro. pills before you arrived and has not relived the pain. What should you do?
Give oxygen therapy and transport ASAP in position of comfort
Squat lifts
Good for one weak leg, both legs strong
hop to a safe place on one foot.
Ground gradient is electricity spreading out from a power line touching the ground. If you feel a tingling sensation in your legs you should:
the scope of practice
Guidelines that define the extent and limits of the job the EMT-Basic does are referred to as:
STRIDOR
HARSH, HIGH-PITCHED INSPIRATORY SOUNDS IN THE UPPER AIRWAY
While caring for a 40-year-old male with shortness of breath and a history of tuberculosis, the AEMT should place a:
HEPA respirator on himself and a nonrebreathing mask on the patient
AS A WOMAN APPROACHES MENOPAUSE
HER MENSTRUAL PERIODS BECOME IRREGULAR AND VARY IN SEVERITY
PERITONITIS USUALLY OCCURS WHEN
HOLLOW ABDOMINAL ORGANS SPILL THEIR CONTENTS
SHOCK IS THE RESULT OF
HYPOPERFUSION TO THE CELLS OF THE BODY
THE MOST SIGNIFICANT COMPLICATION ASSOCIATED WITH OROPHARYNGEAL SUCTIONING IS
HYPOXIA DUE TO PROLONGED SUCTION ATTEMPTS
What is the number one way to reduce the spread of disease?
Hand washing
S/S and treatment for Carbon Monoxide (GO) inhalation
Headache, confusion, N&V, dyspnea, tachypnea, tachycardia, flushed skin, unconsciousness. -Remove Pt. from exposure if possible, oxygen
S/S of a Cardiac tamponade
Hear only muffled heart sounds, with a 'narrowing' pulse pressures
S/S and treatment for Heat exhaustion
Heat exhaustion - dehydration with loss of salts. They will be warm, moist, flushed skin. Headache, nausea, weakness, dizziness, syncope. Treat by giving oral fluids, and remove from heat, loosen clothes
What is the difference between heat stroke and heat exhaustion?
Heat exhaustion- occurs when the body has maximized the heat dissipating mechanisms to a point where other body systems are starting to dysfunction Heat stroke- occurs when the bodies cooling system breaks down and can no longer cool the body
Rattle snake bite treatment
High flow oxygen, lower the effected part, and immobilize the it.
Every 5 minutes
How often should you reassess an unconscious medical patient who has a nasal airway and nonrebreathing mask in place?
Parameters for human resources
Human resources and training: All personnel who staff ambulances and transport patients must be trained to at least the EMT level (pg 8)
Hvpothermia
Hvpothermia - general lowering of body temperature. Apathv, shivering, delayed capillary refill, altered LOC, Bradycardia, Hypotension, dilated pupils. Remove wet clothing, cover patient with blankets, Warm ambulance, Handle patient gently, oxygen.
What are the common causes of the categories of shock?
Hypovolemia- trauma, hemorrhage, burns, dehydration, diarrhea Cardiogenic- myocardial infarction, dysrhythmia Obstructive- tension pneumothorax, cardiac tamponade, pulmonary embolus, dissecting aortic aneurysm Distributive- spinal cord trauma, sepsis = widespread infection, anaphylaxis, drugs/overdose (especially barbiturates)
What are the Categories of shock, and what do they do?
Hypovolemic - inadequate blood volume ' . Cardiogenic - pump failure . Obstructive - physical obstruction to blood flow . Distributive - widespread reduction in vessel tone (PVR)
GOAL OF THE PRIMARY ASSESSMENT
IDENTIFY AND RAPIDLY TREAT ALL LIFE-THREATENING CONDITIONS
THE LEAST PRACTICAL PLACE TO STORE A PORTABLE OXYGEN CYLINDER IS:
IN THE DRIVER'S COMPARTMENT
AMNIOTIC FLUID SERVES TO
INSULATE AND PROTECT THE FETUS
COMPARED TO AN ADULT, THE DIAPHRAM DICTATES THE AMOUNT OF AIR A CHILD INSPIRES BECAUSE
INTERCOSTAL MUSCLES ARE NOT WELL DEVELOPED
SYNCOPE IN OLDER PATIENTS IS CAUSED BY
INTERRUPTION OF BLOOD FLOW TO THE BRAIN
COMMON SIGN OF AMI
IRREGULAR HEARTBEAT SUDDEN UNEXPLAINED SWEATING SHORTNESS OF BREATH / DYSPNEA
CHEYNE-STOKES RESPIRATIONS
IRREGULAR RESPIRATIONS CHARACTERIZED BY AN INCREASING RATE AND DEPTH OF BREATHING FOLLOWED BY PERIODS OF APNEA
TREATMENT FOR JELLYFISH STING
IRRIGATING WOUND WITH VINEGAR AND IMMERSING HIS LEG IN HOT WATER
You are dispatched to a residence for a 69-year-old female with "breathing problems." When you arrive, the patient's husband directs you to his wife, who is sitting on the couch in obvious respiratory distress. She is semiconscious and has labored, shallow respirations. You auscultate her lungs and hear diffuse rhonchi in all lung fields. Which of the following interventions would be of LEAST benefit to her?
IV therapy with up to a 500 mL normal saline bolus
Physician Orders For Life-Sustaining Treatment (POLST)
Identify desired level of life-sustaining treatment in patients with terminal or life-threatening illness. (PG. 55)
A 30-year-old male presents with a partial seizure to his left arm. His wife denies that he has ever had seizures in the past. Which of the following conditions would be the LEAST likely cause of this patient's seizure?
Idiopathic epilepsy
When to preform Newborn CPR
If not breathing or with a pulse less than 80/mm.
oral glucose
If your patient has an altered mental status and a history of diabetes, you may give him:
dilate
In a dark room, the normal pupil should:
skin color, temperature, and condition
In children _____ provide more valuable information about the perfusion and shock status than the blood pressure.
respiratory failure
In infants and children, the primary cause of nontraumatic cardiac arrest is:
right ventricle
In some pulmonary diseases, such as emphysema, the pulmonary vessels are compressed, making it much more difficult for the _____ to pump the blood out.
Length of illness
In the term SAMPLE history, each letter stands for an element of the history. Which of the following is NOT one of those elements?
the patient
In unresponsive patients the chief complaint may be determined by all of the following except:
Worst effect of tachycardia for a patient?
Increase oxygen demand (Need for oxygen)
When transporting from a multi-casualty scene
Inform dispatch of your status
the destination hospital of all patients
Information you should report back to dispatch about the scene size-up of an MCI includes all of the following, except:
How do inhalers improve breathing?
Inhalers cause the bronchioles to dialate
Which of the following describes the most correct method for inserting a nasopharyngeal airway A. Insert the device with the bevel facing the septum B. Insert the device with the bevel facing the lateral aspect of the nose. C. Rotate the device as you insert it into the right nostril D. Apply firm, gentle pressure if you meet resistance during insertion.
Insert the device with the bevel facing the septum
Advance Directive
Instructions written in advance of care. EX) DNR (PG. 55)
What assessment findings would likely indicate cardiac problem? (such as CAD, Pulmonary Edema, excreta)
Irregular Pulse
stress
Irritability with co-workers, inability to concentrate, indecisiveness, loss of appetite, or isolation, are all warning signs of:
Common signs and symptoms of stress reactions
Irritability with coworkers, family, and friends, Inability to concentrate, insomnia, nightmares, anxiety, indecisiveness, guilty, and loss of appetite. (PG. 27)
What is negligence and what is required to prove negligence?
Is a tort in which there is not intent to do any harm to the patient but in which a breach in the duty to act occured The EMT had a duty to act The EMT breached that duty to act The patient suffered an injury The injuries were a result of the breach of duty
When assessing a patient with a complaint of chest pain, which of the following questions would you ask to assess the R in OPQRST? A. Did the pain begin suddenly or gradually B. What were you doing when the began? C. Is there anything that makes the pain worse? D. Is the pain in one place or does it move around?
Is the pain in one place or does it move around?
What is the general impression of a patient and when does it start?
It begins as soon you approach the patient Observation of the patients condition, age, sex
Pulmonary surfactant serves which of the following functions? A. It carries fresh oxygen from the lungs to the left side of the heart B. it dilates the bronchioles in the lungs and enhances the flow of air C. It lubricates the alveolar walls and allows them to expand and recoil D. It facilitates the transport of oxygen-poor blood from the right ventricle to the lungs.
It facilitates the transport of oxygen-poor blood from the right ventricle to the lungs.
Which of the following statements regarding the function of insulin is most correct? A. it stimulates the liver to produce glycogen B. it promotes the entry of glucose from the cell into the bloodstream C. It facilitates the uptake of glucose from the bloodstream into the cell. D. it causes the pancreas to produce glucose based on the body's demand
It facilitates the uptake of glucose from the bloodstream into the cell.
What is the importance of mechanism of injury?
It will give clues to how the patient could be hurt
What is the most serious sign in Shock?
Its is NOT tachycardia (that is the 'first' sign) most serious is low BP
DISINFECTION IS MOST ACCURATELY DEFINED AS
KILLING PATHOGENIC AGENTS WITH A CHEMICAL MADE FOR THAT PURPOSE
other then giving oxygen, what is the best way to reduce the effects of cardiac related problems?
Keep them calm and get them to a hospital
4 principles of moving
Keep weight close to body, use leg/hip/butt muscles to move, stack levels of body, reduce heigh/distance for move
Intentional Tort
Knowingly committing a wrongful act, injury, or damage. (PG. 60)
BLACK WIDOW SPIDER
LARGE SPIDER WITH RED-ORANGE "HOURGLASS" MARK ON ITS ABDOMEN
THE VOCAL CORDS ARE LOCATED IN THE
LARYNX
INJURY TO A HOLLOW ORGAN WOULD MOST LIKELY RESULT IN
LEAKAGE OF CONTENTS INTO THE ABDOMINAL CAVITY
AN OXYGEN TANK SHOULD BE TAKEN OUT OF SERVICE AND REFILLED WHEN THE PRESSURE INSIDE IS LESS THAN
LESS THAN 500 PSI
What is a sign that indicate ALOC in a small child?
Lack of attention to the EMT presence.
Patient with pain in the upper quadrent of her abdomen and a yellowish tinge to her skin. This is caused by which organ?
Liver
What organs are in the Upper Right Quadrant
Liver, Gallbladder
What organs are Solid?
Liver, Spleen, Pancreas, Kidneys
location to palpate brachial pulse
Located in the antecubital space of the elbow. This is the most common site used to check blood pressure.
When assessing a patent with a gun shot wound you should
Look for an exit wound
Asprin (national only)
MI, stroke prophylaxis: PO 81-650/day Acute rheumatic fever: adult-PO 5-6g/daily initially//child-PO 100mg/kg/day X 2 wks, then 75mg/kg/day X4-6wks Thromboembolic disorders adult:PO 325-650 mg/day or bid ○ Transient ischemic attack adult: PO 650 mg bid or 350 mg qid
AS A TRIAGE SUPERVISOR, YOU:
MUST NOT BEGIN TREATMENT UNTIL ALL PATIENTS HAVE BEEN TRIAGED
AMI OCCURS WHEN
MYOCARDIAL TISSUE DIES SECONDARY TO AN ABSENCE OF OXYGEN
Appropriate ways of dealing with stress
Maintain good physical, emotional, behavioral, and psychological health. Keep a good diet, excersise often, learn to relax, and avoid self medication.
What is Status Epilepticus
May be life threatening) Seizure more then 10 minutes long, repetitive without periods of consciousness, more then 3 per hour. This may lead to - Hypoxia, trauma, hyperthermia, hypoglycemia, aspiration, dehydration.
What Types of SEIZURES(Epilepsy) are there and what do they do?
May experience an "aura" before seizure. Grand-mal - full body generalized tonic-clonic muscle contractions with loss of consciousness. Post-ictal - period of ALOC following seizure Febrile seizure - only happens to kids and by fever Hypoxic seizure - lack of oxygen to the brain (loss of consciousness)
excessive cold, hypoxia, infections
Medical factors that could mimic a behavioral emergency include:
What factor provide the most information about the condition of a patient with a head injury?
Mental Status
Methods of improving quality care
Methods of quality improvement: documentation, reviews&audits, MD/RN/pt feedback, continued edu, preventative maintenance, and regular skill maintenance (pg 17)
Pathogens
Microorganisms such as bacteria and viruses that cause disease. (PG. 30)
Bacteria
Microscopic single-celled organisms that have the capability of reproducing on their own within a host that can provide a favorable environment and food supply. (PG. 30)
administration of an antidote
Modern treatment of poisonings and overdoses consists primarily of all the following, except
paranoid
Most ____ patients have elaborate delusions, mostly of persecution.
can exceed the posted speed limit as long as life or property is not endangered.
Most states allow ambulances responding to emergencies with lights and sirens to disregard certain traffic laws. The emergency vehicle operator:
When Realigning fractures
Must be pulseless, transport time over one hour, or if it is necessary to apply splint
What to report
Must' report all suspected gun shot wounds to police. Not required by law to report stab wound or drug use (but may do so if part of your protocol to notify police)
What can cause chest pain?
Mvocardial - angina, Ml, pericarditis (CAD = coronary artery disease, plaque build-up, hardening of arteries) Vascular - dissecting aneurysm Pulmonary - pulmonary embolus, pneumonia pneumothorax, pleurisy (pain with breaths) Gastro- intestinal - gastritis, esophagitis
_______OVERDOSE IS NOT ASSOCIATED WITH HYPERVENTILATION
NARCOTIC OD
ATHEROSCLEROSIS
NARROWING OF THE CORONARY ARTERIES DUE TO A BUILDUP OF FATTY DEPOSITS
GIVEN FOR CARDIAC-RELATED CHEST PAIN, __________ RELAXES THE WALLS OF THE CORONARY ARTERIES
NITROGLYCERIN
Unconsciousness, shallow breathing, and constricted pupils are most indicative of what type of drug overdose? A. Narcotic B. Marijuana C. Barbiturate D. Amphetamine
Narcotic
What is the maximum amount of time CPR should be interupted?
No more then 10 seconds, except for intubation (30 sec.) or transportation problems.
Dos a AED recognize and defibrillate patients not in Asystole?
No, but can still send a deadly shock to anyone in contact to a Asystole patient being defibilllated.
the patient is not using accessory muscles to breathe
Normal breathing means:
HEROIN IS AN EXAMPLE OF AN
OPIOID
WHICH OF THE FOLLOWING MEDICATION ROUTES HAS THE SLOWEST RATE OF ABSORPTION?
ORAL
WHAT CAN CAUSE THE PUPILS TO REMAIN SIGNIFICANTLY CONSTRICTED?
OVERDOSE OF AN OPIATE DRUG
Duty to Act
Obligation to provide service, whether you think the patient needs an ambulance or not. (PG. 52)
What is decompression sickness and what is the EMT treatment for this condition?
Occurs as the result of bubbles formed from the expansion of nitrogen in the blood and tissues. The bubbles can obstruct circulation and they compress or stretch the blood vessels and nerves Consider C spine. If no spinal injury is suspected place the patient in the lateral recumbent position. Never place the patient in trendelenburg position (feet up) Open the airway and assess breathing. Admisinster oxygen regardless of SpO2 reading. If breathing is inadequate begin positive pressure ventilation Initiate CPR and apply an AED if needed Transport the patient to a facility with a recompression chamber
direct pressure
Of each of the following methods of bleeding control, which should be used first?
arteries
Of the three major types of blood vessels, the vessels that carry blood away from the heart are called:
listen
One of the best techniques to use when working with death and dying is to just:
capillary refill
One of the most reliable signs of decreased perfusion in the pediatric patient is:
When should you remove an Impaled objects?
Only removed if you have to for CPR / Airway management (Knife in back MUST be removed to do CPR, can,t just turn on their side for CPR)
A confirmed cardiac arrest patient is receiving one person CPR from your partner. What should you do first?
Open airway
Elderly man found lying unresponsive, no witness of event. What should you do first?
Open the air way by Grasp the angle of the lower jaw and lift (only if needed)
first step for managing an unconscious adult for fell 15 ft
Open the airway by using the Jaw thrust Maneuver.
Oral glucose
Oral gel 40%; 5g chewable tablets to be used in conscious patients only. If glucose has not increased by 20mg/100ml in 20-30 min, dose should be repeated and serum glucose checked again
What medications can an EMT administer to a patient?
Oxygen Oral glucose Activated charcoal Aspirin Metered dose inhaler Nitroglycerin Epinephrine
You arrive at the scene shortly after a 3-year old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5 degrees F. What is the MOST appropriate treatment for this child? A. Oxygen via pediatric nonrebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport B. Oxygen via the blow-by technique, remove clothing and cool the child with towels soaked in tepid water, and transport. C. Oxygen via pediatric nonrebreathing mask, avoid any measures to lower the child's body temperature, and transport at once. D. Oxygen via the blow-by technique, transport at once and request a paramedic rendezvous so that an anticonvulsant drug can be given
Oxygen via the blow-by technique, remove clothing and cool the child with towels soaked in tepid water, and transport.
INSULIN SHOCK OCCURS IF
PATIENT TAKES TOO MUCH OF HIS PRESCRIBED INSULIN
USUAL DOSE OF ACTIVATED CHARCOAL MAXIMUM ADULTS AND PEDIATRIC
PEDIATRIC- UP TO 25 GRAMS ADULT- UP TO 50 GRAMS
NORMAL SKIN COLOR, TEMP AND CONDITION
PINK, WARM AND DRY
IN INFANTS AND CHILDREN, CAP REFILL GREATER THAN 2 SECS IS A SIGN OF
POOR PERIPHERAL PERFUSION
Lifting techniques Power lift and Squat lift
POWER LIFT: 1-Feet shoulder width apart w/ feet turned out slightly. 2- Bend knees as if sitting down, get center of gravity closer to object being lifted. 3-Tighten core muscles, keep back straight w/ head facing fwd. 4. Stradle object w/ feet flat on ground, place hands about 10 in apart, grip object firmly and lift keeping back staright. upper body comes up before hips SQUAT LIFT: 1-Weaker leg slightly fwd, Squat down and use power grip. 2. Push self up with stonger leg, upper body comes up before hips. Lead with head
Which of the following assessment findings would LEAST suggest cardiac compromise? A. Tachycardia B. An irregular pulse C. Palpable pain to the chest D. nausea and epigastric pain
Palpable pain to the chest
How do the symptoms of a stroke differ from a spinal cord injury?
Paralysis from stroke occurs on one side of the body Paralysis from spinal cord injuries occur in both legs or all 4 extremities
cervical
Paralysis of the respiratory muscles may occur with injury to the _______ spine.
Helminths
Parasitic worms, such as roundworms, flukes, and tapeworms, that cause infection. (PG. 31)
How should you park at a scene?
Park ahead of accident, same side of road, when possible
Parts of the pre hospital care report
Parts of the pre hospital care report
Organisms that cause disease
Pathogens
PCR
Patient Care Report; continuity of care, legal document, QI, education, billing, stats, research
Use supine with...
Patient in shock
can often read your lips.
Patients who are hearing impaired or deaf:
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. You have given high concentration oxygen to the man and completed the remainder of your initial assessment. What should you do next? A. Obtain baseline vital signs B. Perform a rapid trauma assessment C. Conduct a detailed physical examination D. Immobilize the patient with a vest-style device
Perform a rapid trauma assessment
What is the sac around the heart?
Pericardium, protects and pressurizes the heart.
Consent
Permission that must be obtained before care is rendered; types include informed, expressed, implied, minor, and involuntary consent. (PG. 54)
EMS System
Permits Patient care at the scene of injury or illness and continues through till discharge at the hospital. (PG. 7)
PPE
Personal Protective Equipment: Equipment worn to protect against injury and against spreading infectious disease. (PG. 32)
What is in the lower airway?
Pharynx-- contains vocal cords, location of gag reflex Larynx - voice box
Medical Director
Physician who os legally responsible for the medical oversight of an EMS System. (PG. 16)
When transporting a pregnant woman c-spine on backboard
Place in Trendelenburg position. If in discomfort place towels under the left side of the backboard to help relieve pressure.(Supine hypotensive syndrome)
when managing a patient with chest pain
Place in position of comfort, give oxygen, and ask what the pain feels like
Fungi
Plantlike microorganisms that typically do not cause infection in a person with normally functioning immune system. (PG. 31)
the elderly
Pneumonia is primarily an acute infectious disease and usually presents with a fever in patients, except:
Medical Direction
Policies, procedures, and practices available either off-line or on-line. (PG. 16)
During the initial assessment of a trauma patient, you note massive facial injuries, weak radial pulses, and clammy skin. What should be your most immediate concern? A. Potential obstruction of the airway B. Internal bleeding and severe shock C. Applying 100% supplemental oxygen D. Providing rapid transport to a trauma center
Potential obstruction of the airway
Evidence-Based Medicine
Practice based on evidence that procedures, medications, and equipment improve patient outcome. If evidence exists, may make change (PG. 18)
Comprehensive critical incident stress management should include:
Pre-incident stress education, on-line peer support, one-one one support, disaster support services, defusing, CISD, follow-up services, spouse and family support, community outreach, and other health and welfare.
Standing orders
Preauthorized treatment orders; A type of treatment protocol. (PG. 16)
Prefered method of ensuring patent airway in various patients
Prefered method of ensuring patent airway in various patients
Use left side position with...
Pregnant woman in third trimester
Chest pain associated with cardiac compromise often is described as
Pressure
During the rapid trauma assessment of a patient with multiple injuries, you expose the chest and find an open wound with blood bubbling from it. What should you do next? A. Apply 100% supplemental oxygen. B. Provide rapid transport to the hospital C. Prevent air from entering the wound. D. Place a porous dressing over the wound.
Prevent air from entering the wound.
Good Samaritan Law
Protects a person who is not being paid for his services from liability for acts performed in good faith unless those acts constitute gross negligence. (PG. 53)
Off-Line Medical Direction
Provided through a set of predetermined, written guidelines that allow EMT's to use their judgement to administer emergency medical care without having to contact a physician. (PG. 16)
Pulmonary Embolus
Pulmonarv Embolus- (P.E.), pleuritic chest pain, hemoptysis, rales, prolonged bed rest, recent fractures, surgery, pregnancy.
What blood vessels take freshly oxygenated blood to the heart.
Pulmonary vein.
Which vital sign is the best indicator of cardiac output during the initial assessment? A. Pulse rate and quality B. Systolic blood pressure C. Quality of the respirations D. Condition and color of the skin
Pulse rate and quality
PPD
Purified Protein Derivative Tuberculin Test: A test to determine the presene of a tuberculosis infection based on a person's positive reaction to tuberculin, a substance prepared from the tubercle bacillus. (PG. 36)
What are the S/S of Emphysema
Pursed lip breathing, prolonged expiratory phase, barrel chest, sitting in 'tripod' position. Patients are often thin and Smokes,
If Delivery complications occure
Put the mother in left lateral trendelenburg position or supine with hips raised and transport code 3.
IN RESPONSIVE PATIENTS THAT ARE OLDER THAN 1, PALPATE THE PULSE AT THE _____ARTERY
RADIAL
PATIENTS WITH RIB FRACTURES WILL COMMONLY (BREATHE)
RAPIDLY AND SHALLOWLY
AFTER ASSISTING WITH NITRO...
REASSESS BP WITHIN 5 MINS TO DETECT HYPOTENSION
THE PRIMARY FUNCTION OF THE RIGHT ATRIUM IS TO...
RECEIVE BLOOD FROM THE VENA CAVA
CARDIAC ARREST IN PEDIATRIC PATIENTS IS MOST COMMONLY THE RESULT OF
RESPIRATORY OR CIRCULATORY FAILURE
DEOXYGENATED BLOOD FROM THE BODY RETURNS TO THE
RIGHT ATRIUM
Which of the following bones is affected with a swollen, painful deformity to the lateral bone of the left forearm? A. Ulna B. Radius C. Clavicle D. Humerus
Radius
Urgent moves
Rapid extrication (if patient has abnormality breathing/with airway)
Repeaters
Receive low-power radio transmissions making it easier for areas affected by terrain
Decoder
Recognizes code from encoder and transmits to only those codes
When dealing with a bee stings what is top priority?
Removal of stinger is NOT first priority in bee sting if not breathing, BVM /Oxygen FIRST, finding out and dealing with what caused problem NOT first priority.
A patient who OD on a narcotic is unconscious with slow, shallow breathing. When inserting an oropharyngeal airway, the patient gag's. What should you do first?
Remove Oropharyngeal airway and be ready to suction the mouth
What should you do with a man who has an impaled object in chest is pulseless and apneic?
Removed impaled object, control bleeding and start CPR
Special Reporting Situations
Reports that include: MCI, Abuse, Crime, infectious disease exposure, and Drug-related injuries. (PG. 65)
When dealing with a sexual assault victim who will not allow you to examine her what should your first action be?
Request a female EMT to preform the assessment (if one is not on hand you can request one)
What do you do when a large patient cannot be moved by only two EMTs?
Request for additional resources
On-Line Medical Direction
Requires that the EMT acquire permission from a physician via phone or radio before doing certain things such as administering certain medications. (PG. 16)
Minute Volume=
Respiratory Rate x Tidal Volume
A 43-year-old female is unconscious following an overdose of heroin. Her respirations are slow and shallow. Which of the following conditions will she initially develop if not treated?
Respiratory acidosis
Early signs of shock?
Restlessness
Cumulative Stress Reactions
Result of constant exposure to stressful situations that build over time. (PG. 27)
Acute Stress Reactions
Results from exposure to a high-stress situation. (PG. 26)
Non-medical supplies found in the ambulance
Road map ● Comm. system
ECLAMPSIA
SEIZURES THAT RESULT FROM SEVERE HYPERTENSION
THE CERVICAL SPINE IS COMPOSED OF ___ VERTEBRAE
SEVEN (7)
A TUBE FROM THE BRAIN TO THE ABDOMEN THAT DRAINS EXCESSIVE CS FLUID
SHUNT
Nitroglycerin
SL dissolve tab under tongue when pain begins, may repeat q5min until relief occurs; take no more than 3 tab/15 min
ARTERIOLES
SMALLER VESSELS THAT CARRY BLOOD AWAY FROM THE HEART AND CONNECT THE ARTERIES TO THE CAPILLARIES
THE ____OF A BULLET HAS THE GREATEST IMPACT ON PRODUCING INJURY
SPEED
SOLID ABDOMINAL ORGANS INCLUDE THE
SPLEEN KIDNEYS PANCREAS
THE MANNER IN WHICH THE EMT MUST ACT OR BEHAVE WHEN CARING FOR A PATIENT
STANDARD OF CARE
DETERMINING FREQUENCY OF LABOR CONTRACTIONS- TIME THE CONTRACTIONS FROM THE:
START OF ONE TO THE START OF THE NEXT
TWO WAYS OUR BODY ELIMINATES HEAT
SWEATING DILATION OF SKIN BLOOD VESSELS
ANAPHYLAXIS IS CHARACTERIZED BY AIRWAY______ AND ____TENSION
SWELLING HYPO
CONTRAINDICATION OF ADMINISTERING NITROGLYCERIN
SYSTOLIC BP IS LESS THAN 100MM HG
Most important priority of EMT at a crime scene
Safety of self, then partner, then EMS, and then public
A 50-year-old female with nausea, vomiting, and diarrhea complains of intense thirst and generalized weakness. Her blood pressure is 86/50 mm Hg and her pulse rate is 130 beats/min and thready. Which of the following interventions would NOT be appropriate for her?
Salt-containing solutions by mouth
Describe the most serious types of burns in children under 5
Same as adults Any full or partial thickness burn greater than 20%
extreme inspiratory efforts in children
Seesaw or rocky breathing, exhibited by the chest drawn inward and the abdomen moving outward, is a sign of:
Which of the following actions is most important when immobilizing a patient with a suspected spinal injury? A. Immobilize the patient using a vest-style device B. Secure the patient's head prior to immobilizing the torso. C. Select and apply the appropriate size of extrication collar. D. Assess for range of motion by asking the patient to move the head
Select and apply the appropriate size of extrication collar.
What are the signs and symptoms of hypovolemic shock?
Shock that is caused by low blood volume 3 types: Hemorrhagic shock- loss of blood from severe bleeding Nonhemorrhagic shock- loss of fluid from severe diarrhea, vomiting, excessive sweating, and excessive urination Burn shock- results from a burn injury
crowning
Signs and symptoms of a possible spontaneous abortion include all of the following, except:
increased urine output
Signs and symptoms of shock (hypoperfusion), which are actually the body's compensating mechanisms, include all of the following except:
Signs of death in the Field
Signs include: No pulse, no breathing, no breath sounds, complete unresponsiveness to any stimuli, no eye movement, no pupil response, no blood pressure, and no reflexes. (PG. 64)
deep, sharp cuts
Signs of blunt trauma include all of the following, except:
Protozoa
Single-celled organisms that are typically found in the soil and are able to move. (PG. 31)
Which of the following structures is the primary pacemaker, which sets the normal rate for the heart? A. Bundle of His B. Purkinje fibers C. Sinoatrial node D. Atrioventricular node
Sinoatrial node
Kyphosis
Slouch, poor posture
What are the signs and symptoms of stroke?
Slurred speech Paralysis on one side of the body Facial droop Severe head ache
Area of the GI tract that does most of the absorption
Small intestine
Viruses
Smaller than bacteria and cannot grow on their own but require a host cell to reproduce. (PG. 30)
Why do we give a verbal report to the staff in the ER when we turn out patient over to them?
So the staff is aware of what is happening to the patient
palpitations
Some patients complain of irregular or rapid heartbeats that they can feel as a fluttering sensation in the chest. This is called:
Use backboard with...
Spinal injury
A 9-year-old girl was struck by a car while she was crossing the street and is displaying signs of shock. During your assessment, you note a large contusion over the left upper quadrant of her abdomen. Which of the following organs has most likely been injured? A. Liver B. Kidney C. Spleen D. Pancreas
Spleen
Do Not Resuscitate Order (DNR)
State which, if any, life-sustaining measures to take when vital functions cease. (PG. 55)
Base station
Stays in one location, take information, lots of output power
Delayed Stress Reaction
Stress reaction occurs from exposure to a high-stress situations but the signs and symptoms are not immediate. (PG. 26)
high-pitched sound resulting from partial airway obstruction.
Stridor is a:
Haptics
Study of touching, could be powerful tool for working with patients
What organs are in the Upper Left Quadrant
Stumach, Spleen
Sterilization
Subjecting an object to chemical or physical substances (typically, superheated steam in an autoclave) that kill all microorganisms. (PG. 35)
SOAP
Subjective Objective Assessment Plan
You are caring for an infant who is having mild respiratory distress. You notice that he is having difficulty breathing through his nose. What is the most appropriate step to take next.
Suction the nose with a bulb syringe.
Which position is most appropriate for a mother in labor with a prolapsed umbilical cord? A. Left lateral recumbent B. Left side with legs elevated C. Supine with hips elevated D. Supine with legs elevated
Supine with hips elevated
Oxygen
Supplemental oxygen min via nasal cannula, mask, venturi, full face depends on oxygen (content )saturation levels
40 year old patient with respiratory distress and a rate of 26 breaths/min and no other issues found. What is the best method to manage this airway?
Supply high flow oxygen with oxygen mask,(No need for BVM),
Lodosis
Swayback, poor posture
Why are facial burns so dangerous?
Swelling of the face or throat may cause airway closure
Hepatitis B
Symptoms Include: Fatigue, Nausea, Loss of appetite, abdominal pain, headache, fever, jaundice, and dark urine. (PG. 36)
Tuberculosis
Symptoms Include: Fever, cough, coughing up blood, night sweats, and weight loss.
Hepatitis C
Symptoms Include: Jaundice, fatigue, abdominal pain, nausea, dark urine, and loss of appetite. (PG. 37)
Acquired Immune Deficiency Syndrome (AIDS)
Symptoms Include: Persistent low grade fever, night sweats, swollen lymph glands, loss of appetite, nausea, persistent diarrhea, headache, sore throat, fatigue, weight loss, shortness of breath, mental status changes, muscle/joint aches, rash, and opportunistic infections. (PG. 37-38)
Severe Acute Respiratory Syndrome (SARS)
Symptoms include: High fever greater than 100 Degrees, headache/body ache, general discomfort, respiratory symptoms, diarrhea, and dry cough. (PG. 38)
West Nile Virus (WNV)
Symptoms include: Severe case: High fever, headache, stiff neck, confusion, disorientation to coma, seizures, muscle weakness, numbness, paralysis, and vision loss. Mild case: Fever, headache, body ache, nausea, vomiting, rash, and swollen lymph glands. (PG. 38)
What are the signs of increased intracranial pressure?
Systolic blood pressure increases and heart rate (pulse) decreases
HEATSTROKE OCCURS WHEN
THE BODY'S HEAT-ELIMINATING MECHANISMS ARE OVERWHELMED AND CAN NO LONGER SWEAT
BRUISING TO THE RIGHT UPPER QUADRANT OF THE ABDOMEN FOLLOWING BLUNT TRAUMA IS MOST SUGGESTIVE OF INJURY TO
THE LIVER
HYPOTENSION IN A CHILD WITH BLUNT OR PENETRATING TRAUME OFTEN INDICATES:
THE LOSS OF HALF OF HIS/HER BLOOD VOLUME (THIS IS A LATE STAGE OF SHOCK)
SUPINE HYPOTENSIVE SYNDROME
THE PREGNANT UTERUS COMPRESSES THE INFERIOR VENA CAVA
SYSTOLIC PRESSURE
THE PRESSURE EXERTED AGAINST THE WALLS OF THE ARTERY WHEN THE LEFT VENTRICLE CONTRACTS
ADSORPTION
THE PROCESS OF BINDING OR STICKING TO A SURGACE (ACTIVATED CHARCOAL)
WHAT IS THE TYPICAL FUNCTION OF THE RESCUE TEAM?
TO PROVIDE SAFE ENTRY AND ACCESS TO PATIENTS
THE MAJORITY OF A HORIZONTAL PATIENT'S WEIGHT IS IN THE
TORSO
QUID PRO QUO
TYPE OF SEXUAL HARASSMENT, WHEN HARASSER REQUEST SEXUAL FAVORS IN EXCHANGE FOR SOMETHING ELSE
Which of the following assessment findings would most suggest a systemic reaction following ingestion of a poison? A. Nausea and vomiting B. Burns around the mouth C. Tachycardia and hypotension D. Difficulty swallowing and burning in the mouth
Tachycardia and hypotension
When arriving to a call involving violence (any danger)
Take your time, consider s-econdary danger, exprosion/shooting Prejudge for danger, gang cross outs, Assess police presence (If police are present always talk to them first when arriving on scene)
Which of the following actions would most likely cause a sudden drop in a patient's blood glucose level? A. Mild exertion after eating a meal B. Eating a meal after taking insulin C. Taking too much prescribed insulin D. Forgetting to take prescribed insulin
Taking too much prescribed insulin
keeping the patient's hair out of the way.
Techniques for applying a cervical collar include:
If a patent goes in to cardiac arrest while in rout to the hospital what should you do?
Tell your partner to stop the ambulance.
all cardiac arrest patients with shockable rhythms, except infants.
The AED is intended for use with:
some type of hazardous gas or poison
The EMT-Basic arrives at an office to find multiple patients with altered mental status. The EMT-Basic should suspect _____ is causing the illness.
bag-valve mask
The EMT-Basic can provide positive pressure ventilation to a patient using a(n):
by auto-injector
The EMT-Basic may assist a patient in using epinephrine when administered:
when to access the public service answering point (PSAP).
The EMT-Basic may be required to make a decision about any of the following aspects of care, except:
no known drug allergies
The abbreviation NKDA means:
immediately
The abbreviation STAT means:
Scope of Practice
The actions and care an EMT is legally allowed to perform. (PG. 52)
Federal Communications Commission.
The agency that assigns and licenses radio frequencies is the:
the level of coolant/antifreeze and the pressure cap indicator
The ambulance vehicle should be regularly inspected. Inspections done while the ambulance engine is turned off include:
thoracic
The area of the spine that is the least susceptible to injury would be the _________ spine
a rapid rise in temperature
The cause of febrile seizures in children is:
distal
The elbow is____to the shoulder since it is farther from the torso than the shoulder.
Ulcer
The erosion of stomach or intestinal lining causing pain and/or bleeding
placenta
The exchange area where oxygen and nutrients from the mother's bloodstream are carried across to the fetus is called the:
move the patient to a cool environment as quickly as possible.
The first step in the care of a patient presenting with confusion, who is found in a hot environment, is to:
What might lead you most to suspect a that baby may be dehydrated.
The fontanelle appears sunken and there is a recent history of diarrhea.
inhaled
The four types of poison classifications include ____ poisons
temperature
The functions of the integumentary system are: protection, sensation, excretion, vitamin D synthesis, and:
chest discomfort
The heart's typical response to ischemia is:
support, protection, movement
The key functions of the musculoskeletal system include:
pulse
The main components of an adult's vital signs include assessment of breathing, skin, pupils, blood pressure, and:
Medical Oversight
The medical director's broad responsibilities, including all clinical and administrative functions and activities necessary to exercise ultimate responsibility for the emergency care provided by individual personnel and the entire emergency medical services (EMS) system. (PG. 16)
Abrasions
The memory aid DCAP-BTLS includes which of the following?
"severity" or how bad is the pain?
The memory aid OPQRST includes letters standing for:
radiation
The most significant mechanism of heat loss is
autonomic
The nerves that control the involuntary functions of digestion, the bowels, and the bladder are part of the _____________ nervous system
Which of the following statements best describes a mass-casualaty incident? A. More than 5 patients are involved B. At least half of the patients C. The number of patients overwhelms your resources D. More than three vehicles are involved
The number of patients overwhelms your resources
all patients who are transported
The ongoing assessment is performed on:
KED
The patient carrying device most commonly used for removing patients from vehicles is the:
A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty, but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?
The patient may die several hours later due to pulmonary complications
When do we administer oral glucose?
The patient must meet the following 3 things 1. Has an altered mental status 2. Has a history of diabetes controlled by medication or a blood glucose reading less than 60mg/dL 3. Has the ability to swallow
Protocols
The policies and procedures for all components of an EMS system. Also called standing orders. (PG. 16)
using a tongue depressor to press the tongue down while inserting the airway.
The preferred method of inserting an oropharyngeal airway in a child is:
Cleaning
The process of washing a soiled object with soap and water. (PG. 35)
chief complaint
The reason a patient calls EMS is referred to as the:
You encounter a child after a bicycle accident. You note an open fracture of the forearm with copious blood loss. The child is alert and oriented and all vitals are normal. You have successfully controlled the bleeding using pressure points, splinted the arm and packaged the child for transport. Which of the following statements best reflects the situation:
The risk of rapid decompensation into hypovolemic shock is something to be considered.
color, temperature, and condition.
The skin should be assessed for:
pharmacology
The study of drugs, their sources, characteristics, and effects, is called:
gently pushing tip of the nose upward
The technique for inserting a nasopharyngeal airway includes:
insulin:glucagon
The two primary hormones that are responsible for controlling the blood sugar level are ____ and ____, both of which are secreted by the pancreas.
larynx
The vocal cords are found in the:
the pin-index safety system
The yoke of a portable oxygen pressure regulator is designed so it will fit an oxygen tank and not on a tank containing another type of gas. The system used to assure this is called:
puncture
There is a potential for internal bleeding or life-threatening injuries to internal organs from a(n):
What are the S/S of Ingested Caustic Substances?
They are Caustic: substance that burns tissue, may be acid or base. Give sips of water or milk, maintain airway, fowler's position, rapid transport (We dont administer lpecac, or activated charcoal)
What are Aerobic metabilism
They are carbonic acid, weak, easily broken down to COz and HzO
What are the standard precautions and why do we use them?
They are used to protect yourself from disease transmission through exposure to blood and other body fluids Handwashing Personal protective equipment
What is the difference between a stroke and TIA?
They key difference is that the signs and symptoms of TIA disappear
What are the signs and symptoms of an allergic reaction and why they occur?
They occur because of a release of chemical substances by the immune system Signs and symptoms: Hives Swelling of the tongue and lips Itching Runny nose Tachycardia
What happens to a patient that has an injury occur below their cervical spine?
They will be paralyzed in the lower half of their body
What happens to a patient that damages their cervical spine?
They will lose the ability to breath on their own and will be unable to move all 4 extremities
What is Key for cardiac Arrest Patients?
Timely defibillation is the key factor in the their servival
make a priority transportation decision.
To complete the initial assessment the EMT-Basic should:
corner of the mouth to the tip of the earlobe
To select the proper size oropharyngeal airway, you should measure from the patient's:
illegal or abused substances
To the general public, the word "drugs" generally refers to:
PEDIATRIC EMERGENCIES: 171-190 This age group does not like to be separated from parents, and can often frighten easily. They often need simple explanations and need to establish some sense of trust before assessment can begin.
Toddler - 1 to 3 years old.
Battery
Touching a person without consent. (PG. 61)
You find a diabetic patient that unconscious and the last time she took her insulin shot is unknow
Transport and give high flow oxygen by BVM
ongoing assessment
Trending a patient's condition is something that is done in the
You are called to treat a male patient who overdosed on heroin and is unconscious with shallow breathing and cyanosis to the face. The patient suddenly begins to vomit. What should you do first? A. Suction the oropharynx B. Turn the patient onto his side. C. Insert an oropharyngeal airway. D. Assist ventilations with 100% oxygen.
Turn the patient onto his side.
A PT WITH GALLSTONES WOULD COMPLAIN OF PAIN IN:
UPPER RIGHT QUADRANT WITH REFERRED PAIN TO THE RIGHT SHOULDER
THE MOST APPROPRIATE LOCATION TO PARK YOUR AMBULANCE AT A HAZMAT INCIDENT IS:
UPWIND AT LEAST 100' AND UPHILL AT LEAST 25' FROM THE INCIDENT SITE
PID DOES NOT TYPICALLY AFFECT THE
URINARY BLADDER
Reduced tidal volume would most likely occur from
Unequal chest expansion
Use left lateral recumbent position with...
Unresponsive patient w/o head or spine injury
sublingually
Upon arrival at the scene of a 68-year-old man who was having chest pain, the patient's wife tells you he just took a nitro tablet and has experienced some relief. Nitroglycerin tablets are administered:
SBAR method
Useful for medical direction: Situation, Background, Assessment, Recommendation
Disinfecting
Using a disinfectant such as alcohol or bleach to kill microorganisms. (PG. 35)
How do you sssess the abdomen?
Using all fingers of one hand to palpate gentily, then harder
The patient is no longer in V-fib
Using the AED, the EMT-Basic delivers one shock to an apneic and pulseless patient. The AED now states, "no shock advised." What most likely is the reason for this alert from the AED?
WHAT PHYSIOLOGIC ACTIONS DOES EPINEPHRINE PRODUCE WHEN GIVEN FOR AN ALLERGIC REACTION?
VASOCONSTRICTION BRONCHODILATION
EXTERNAL BLEEDING FROM A VEIN IS RELATIVELY EASY TO CONTROL BECAUSE
VEINS ARE UNDER A LOWER PRESSURE
AN AED DELIVERS PROMPT DEFIBRILLATION TO PATIENTS WITH
VENTRICULAR FIBRILLATION
SKELETAL MUSCLE IS ALSO CALLED
VOLUNTARY MUSCLE
Health Achievements in the USA in the 20th century
Vaccinations, Motor-Vehicle safety, Workplace safety, Control of infectious disease, reduction in deaths from coronary heart disease, safer and more healthful foods, decline in material and infant mortality, use of barrier devices during sexual contacts, flouridation of drinking water, and reduction in the use of tobacco products. (PG. 19)
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. After you attach the AED and analyze this patient's heart rhythm, the machine states, "shock advised." What cardiac rhythm is the patient most likely in? A. Asystole B. Ventricular fibrillation C. Ventricular tachycardia D. Pulseless electrical activity
Ventricular fibrillation
Three types of communication?
Verba, radio, interpersonal
What is Tidal Volume?
Volume of air inhaled in a single breath
TWO MOST COMMON SIGNS OF ANAPHYLAXIS
WHEEZING URTICARIA (HIVES)
EPINEPHRINE IS INDICATED FOR PATIENTS WITH AN ALLERGIC REACTION WHEN _____ AND _____ ARE PRESENT
WHEEZING AND HYPOTENSION
SUCCESSFUL TREATMENT OF A STROKE DEPENDS ON:
WHETHER THROMBOLYTIC THERAPY IS GIVEN WITHIN 3 HOURS AFTER SYMPTOM ONSET
DISTRIBUTIVE SHOCK OCCURS WHEN:
WIDESPREAD DILATION OF THE BLOOD VESSELS CAUSES BLOOD TO POOL IN THE VASCULAR BEDS
What should you do when you have eletrical wires down on the street at the scene of an accident?
Wait until a power company representative tells you that the power lines are off
Disposable vs non-disposable
We should avoid using non-disposable equipment and supplies whenever possible
What should you ask first for a patient with chest pain?
What dos the pain feel like?
Assesing a patient suffering from an OD, what should you ascertain (find out) first?
What drug was it?
Methods developed for the proper positioning of the patient during lifting and moving operations
What is body mechanics?
What sound indicates a likely lower airway obstruction?
Wheezing (Anatomical obstruction of birinci)
rapid extrication
When a patient with a suspected spine injury must be moved before being immobilized, this is called:
stale air becomes trapped in the lungs
When an asthma attack occurs:
What is CPR with 'Signs of recovery"?
When checking pulse and breathing, Signs of recovery means they are not in cardiac arrest
take a deep breath and slowly ventilate over 1 1/2 to 2 seconds
When delivering artificial ventilations to an adult patient using a pocket mask, it is important to
Proximate Cause
When deviation from an accepted standard of care results in further injury to the patient. (PG. 60)
the mouth and nose are more easily obstructed than in adults.
When managing the airway of a pediatric patient, the EMT-Basic should consider:
during heavy fog
When responding to a call, minimal lighting should be used:
produce antibodies
When the body's immune system detects an antigen, the response is to:
When should you used the Jaw-thrust maneuver?
When the mechanism of injury is unclear (Possible spinal, or head trauma)
never lose sight of the tip
When your unconscious patient needs to be suctioned, due to a collection of secretions that are accumulating in his mouth, you should utilize a rigid tip (Yankauer) whenever possible. If you only have a flexible catheter to suction with remember to:
Brachial
Which artery should be checked first by a healthcare provider for a pulse in the unresponsive infant?
decreasing the likelihood of internal organ damage with blunt chest trauma.
Which of the following is least accurate about the chest of a child? The rib cage is more flexible:
The miscarriage is commonly considered spontaneous, and the abortion induced
Which of the following is true regarding miscarriages and abortions?
It becomes part of the patient's permanent hospital record.
Which of the following is true regarding the prehospital care report?
rapid extrication
Which of the following moves is not considered an emergency move?
bag mask devices
Which of the following patient care equipment should be carried in various sizes (such as pediatric, adult, etc.)?
Not all behaviorally disturbed patients will become violent.
Which of the following statements about behavioral emergencies is most accurate?
The deformity itself does not cause disability or death.
Which of the following statements about skull injuries is most accurate?
When is the best time to perform a detailed physical examination? A. While enroute to the hospital B. After all life threats have been ruled out C. Immediately after taking baseline vital signs D. Following the initial assessment of a trauma patient.
While enroute to the hospital
A 21-year-old male has lost approximately 35% of his blood volume following a penetrating injury to the chest. Which of the following signs or symptoms would you NOT expect to see?
Widened pulse pressure
S/S of a diabetic coma?
Worm,dry skin and slow onset. Hyperglycemia
What should you do with an amputed body part?
Wrapping it in moist dressing and place it on ice
Dos a AED recognize and defibrillate patients in Asystole?
Yes
While managing a patient in cardiac arrest, you turn the AED on and attach the pads to the patient. When you push the analyze button, the machine signals "low battery" and then ceases to function. The patient subsequently dies. Which of the following statements regarding this case is most correct? A. You and your partner may be held liable for negligence. B. The crew that preceded you may be held liable for negligence. C. The manufacturer of the AED may be held liable for negligence. D. Most errors associated with the AED involve equipment failure.
You and your partner may be held liable for negligence.
painful
You are on the scene of a 29-year-old female who was painting and fell off a ladder onto her head. During your initial assessment she responds only when you pinch her toe or rub her sternum briskly. This level of responsiveness would be:
perform two minutes of CPR and reassess
You are on the scene of a 58-year-old male patient who collapsed in the bathroom at a local resturant. Bystanders determined he had no signs of circulation so they started CPR. After delivering your first shock with an AED, if the patient is still pulseless, you should next:
gloves, mask, and eye protection
You are treating a 39-year-old female who had an apparent seizure. She has a lot of secretions and foam around her mouth and nose, so you decide to suction her. What body substance isolation precautions should be used during suctioning?
shaking baby syndrome
You are treating a 9-month-old who "fell out of the crib while sleeping." You note the child is only responsive to painful stimuli, and note the soft spots on the skull (fontanelles) look swollen. What should you suspect?
face down / sideways
You have just arrived on the scene of a woman who is in active labor. Her water broke already and it appears from your inspection for crowning that birth is imminent. In a normal delivery the head will deliver in a ____ position and turn:
stimulating contractions, which decreases the uterine size
You have just assisted a mother with the delivery of a healthy full-term baby girl. The apgar is a 10 and the child is resting. You notice that the mother continues to bleed at a rapid pace, so you attempt uterine massage. Uterine massage helps to stop vaginal bleeding after childbirth by:
perform the rapid trauma exam
You have just completed the initial assessment of a 30-year-old victim of a fall. According to the patient he is not sure if he lost consciousness. The first step in the focused history and physical exam of the trauma patient is to:
family,friends,co-workers
You obviously will not be able to obtain a SAMPLE history from the patient if he is unresponsive. However, you may be able to obtain one from:
When caring for a patient with an emotional/behavioral crisis, your first concern is
Your partners and your own safety
assisted ventilations, using a bag-valve mask and oxygen
Your treatment for a 3-year-old male in severe respiratory distress should include:
epinephrine
Your unit has arrived on the scene of a 19-year-old female who was painting the deck when she was stung by a group of bees. She states she is highly allergic to bee stings. The medication used to reverse a life-threatening allergic reaction by constricting blood vessels and relaxing airway passages is:
activated charcoal
Your unit has arrived on the scene of a private residence where the scene is determined to be safe. According to the parent who meets you at the door her six-year-old son may have taken a handful of pills, thinking they were candy. To treat the child who has ingested a dangerous amount of medication, the EMT-Basic should contact medical direction or the poison control center to consider administering
implied
Your unit has just arrived on the scene of a 34-year-old male patient who was found by a co-worker at the base of the stairwell. He states the patient has not been responding for the past 20 minutes. You assume that an unconscious medical patient would give you permission to treat him. This is known as________consent.
break the window furthest from the patient.
Your unit has just arrived on the scene of a two-vehicle head-on collision. One patient is dead at the scene and the other driver is entrapped in his vehicle. To gain access to a patient trapped in a vehicle the EMT-Basic should:
cold
Your unit is arriving at the scene of an overturned tanker truck. After calling for additional help and identifying the substance from the placard on the truck, you establish a location to treat the exposed patients. The _____ zone at the site of a HAZ-MAT emergency is where normal triage, stabilization and treatment are performed.
patient transport priority decision
Your unit is dispatched to a call for a victim of an assault in a local bar. As you call for the police to respond, you review in your mind the steps of the scene size-up. All the following are elements of a scene size-up, except:
in a knee-chest (hip elevated) position
Your unit is on the scene of a 18-year-old woman in active labor. She states that her water broke, and lets you check for crowning. You note that the umbilical cord is sticking out of her vagina. How should the EMT-Basic transport a patient who presents with a prolapsed cord?
head tilt/chin lift
Your unit is on the scene of a 28-year-old male who was found by a coworker unconscious at his desk. Once you assure the scene is safe you begin your initial assessment. Which airway maneuver should be used to open the airway of an adult without suspected spinal injury?
severe respiratory distress
Your unit is on the scene of a 38-year-old female who may be having an asthma attack. As you enter the room you notice audible wheezing and the patient is sitting with her elbows out. This tripod position is associated with a patient having:
not take the time to diagnose what type of cardiac emergency is occurring.
Your unit is on the scene of a 58-year-old male patient who has had crushing substernal chest pain for the past 30 minutes. You have taken a set of vitals and are administering oxygen. When assessing and treating a patient with chest pain or discomfort, the EMT-Basic should:
aneurysm
Your unit is on the scene of a 68-year-old male patient who is complaining of a tearing sensation in his abdomen. He has a history of hypertension and you find there is a mass in his abdomen, which has a pulse. A weakened section of an arterial wall that begins to dilate is known as a(n):
generalized weakness
Your unit is on the scene of a 69-year-old male whose wife called the ambulance because she was concerned that his color was not good and he has a cardiac history. His vitals are respirations of 20, pulse of 88 and BP of 138/82. Which of the following is an atypical presentation of an acute coronary syndrome?
medications that are taken orally or by injection
Your unit is on the scene with a 18-year-old patient who suddenly became ill after eating in a seafood restaurant. His color is pale and his vital signs are: respirations of 28, pulse of 120 and BP of 110/60. You suspect an allergic reaction is the problem. The most common cause of allergic reactions and anaphylaxis is:
the type of object that was burning
Your unit is standing by at the scene of a residential fire. Suddenly a firefighter comes out carrying a 48-year-old female who is severely burned on the upper half of her body. Burn severity depends on each of the following factors, except:
A patient breathing in room air should be receiving ____ percent oxygen. a) 21 b) 5 c) 16 d) 100
a
What do chemoreceptors found in the body and vascular system measure? a) low oxygen and high carbon dioxide b) high oxygen and low carbon dioxide c) low oxygen and low carbon dioxide d) high oxygen and high carbon dioxide
a
What is the name of the heart dysfunction caused by an electrical source that causes the heart to beat too fast? a) tachycardia b) trauma c) heart attack d) bradycardia
a
When a person has an exaggerated response to a body invader, the person is said to have a) hypersensitivity b) antibody reaction c) histamine dump d) hyposensitivity
a
When the body's water moves from the bloodstream into the interstitial space, it is called: a) edema b) hydrostatic c) dehydration d) hypovolemia
a
Which of the following is NOT a common psychosocial challenge of late adulthood? a) self-destructive behaviors b) concern about death and dying c) financial burdens d) issues of self-worth
a
Which three "Rs" are essential for the EMT to practice when reacting to danger? a) retreat, radio, reevaluate b) remember, respect, respond c) ricochet, recover, re-entry d) ralize, react reassess
a
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. Skin will become cyanotic with A. an increase in the amount of venous oxygen B. an increase in the amount of arterial oxygen C. a decrease in the amount of arterial oxygen D. a decrease in circulating red blood cells
a decrease in the amount of arterial oxygen
Initial attempts at providing artificial ventilation should be accomplished using A. the one-person bag valve mask technique B. the two-person bag valve mask technique C. a pocket mask with supplemental oxygen D. a flow-restricted oxygen-powered ventilation device
a pocket mask with supplemental oxygen
Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be MOST suspicious of:
a pulmonary embolism
Signs of inadequate breathing in an unconscious patient include A. a fast heart rate B. warm, moist skin C. equal breath sounds D. a rapid respiratory rate
a rapid respiratory rate
A 19-year-old female presents with severe pain to the left lower quadrant of her abdomen. She is restless, tachypneic, and tachycardic. When you inquire about her last menstrual period, she tells you that it was approximately 2 months ago. You should suspect:
a ruptured ectopic pregnancy
A 20-year-old female with a history of chronic epilepsy, who is compliant with her anticonvulsant medication, experiences a "breakthrough" seizure. This usually happens when:
a seizure occurs despite a therapeutic medication blood level
atherosclerosis def
a stage of arteriosclerosis involving fatty deposits (atheromas) inside the arterial walls
Complete the next sentence so that it makes the most clinical sense. Your patient has been thrown form an automobile and is unresponsive to your voice, but responds to ______, leading you to assess this patient as ______.
a sternal rub, responsive to painful stimuli
What is a weapon of mass destruction?
a weapon with the intent to cause widespread and indiscriminate death and destruction
A 22-year-old female was involved in a traumatic incident. She is exhibiting signs of shock, but there are no obvious external signs of trauma. You should suspect bleeding within the:
abdominal cavity
automaticity
ability of the heart to generate and conduct electrical impulses on its own
tachycardia
abnormal heart rate, usually 120+ beats per minute
bradycardia
abnormal heart rate, usually 50 or fewer beats per minute
While assessing a patient with chest pain, you note that the patient's pulse is irregular. This most likely indicates A. acute myocardial infarction or angina pectoris B. a dysfunction in the left side of the patient's heart C. high blood pressure that is increasing cardiac workload D. abnormalities in the heart's electrical conduction system
abnormalities in the heart's electrical conduction system
asystole
absence of ventricular contractions
S/S of a Tension pneumothorax
absent lung/breath sounds on affected side, tracheal deviation, JVD, increasing respiratory difficulty.
inhalation
active process in which intercostal muscles(ribs) and diaphragm contract, expanding the size of the chest cavity and causing air to flow into lungs
A 77-year-old man presents with hypertension, anuria, generalized edema, and tachypnea. This clinical presentation is MOST consistent with:
acute renal failure. anuria- failure to produce urine
A 22-year-old female with type 1 diabetes is unresponsive and has a blood glucose level of 29 mg/dL. She is receiving high-flow oxygen and several attempts to establish IV access have failed. You should:
administer 0.5 to 1 mg of glucagon via the intramuscular route
Your COPD patient is alert, but is breathing at 26 breaths per minute. Your next best course of action is to:
administer high flow oxygen via non-rebreathr mask
When treating a 56-year-old female with chest pain, you have placed on her oxygen, established IV access, and administered two doses of sublingual nitroglycerin. However, the patient's pain has not improved. You reassess her blood pressure and note that it is 106/66 mm Hg. You should:
administer one more dose of nitroglycerin
Management of a patient with severe abdominal pain includes A. administering 100% oxygen B. auscultating for bowel sounds C. giving the patient sips of water D. placing the patient in a supine position
administering 100% oxygen
Following delivery of a newborn, you note that the mother has a moderate amount of vaginal bleeding. The mother is conscious and alert and her vital signs are stable. The most appropriate management of the mother includes A. massaging the uterus if signs of shock develop B. administering oxygen and massaging the uterus C. placing a sanitary pad in the vagina and administering oxygen D. treating her for shock and providing immediate transport
administering oxygen and massaging the uterus
ALS
advanced life support
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. As you are loading the man into the ambulance, the police officer advises you that the woman is refusing EMS treatment and transport. You should next A. ask the police officer to obtain a signed refusal from the patient as you proceed to the hospital B. ask the police officer to administer a breathalyzer test to determine if the patient has been drinking alcohol C. advise the patient that she should be transported to the hospital because of the seriousness of the crash D. obtain a signed refusal from the patient and ask the police officer to transport her to the hospital
advise the patient that she should be transported to the hospital because of the seriousness of the crash
An awake and alert 92-year-old woman with chest pain is refusing EMS treatment and transport to the hospital. Her family insists that you transport her. This situation is most appropriately managed by A. transporting the patient as the family wishes. B. advising the patient of the risks of refusing care C. obtaining a signed refusal from a family member D. transporting the patient as you explain your actions.
advising the patient of the risks of refusing care
placenta
afterbirth
ABC
airway, breathing, circulation
AVPU
alert, responds to verbal stimulus, responds to pain stimulus, unresponsive
You are called to a local park for a 7-year old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has wide-spread hives and facial edema. What should you suspect has occurred? A. Heat emergency B. allergic reaction C. Acute asthma attack D. Exposure to a poisonous plant
allergic reaction
When with a Partner suffering from stress due to the death of a child
allow them to open up to you and express how they feel
After removing a patient from the water, your assessment reveals that the patient is breathing inadequately and is continuously regurgitating large quantities of water. You should manage this patient by A. alternating suctioining with artificial ventilations B. performing abdominal thrusts to remove the water. C. placing the patient on the side and press in on the abdomen. D. initiating artificial ventilations after the patient stops regurgitating
alternating suctioining with artificial ventilations
In any incident involving excessive bleeding
always control bleeding
Common source of injury from an agricultural combine
amputations and avulsions
A 20-year-old female presents with acute respiratory distress. Auscultation of her lungs reveals diffuse expiratory wheezing. She is in moderate distress and tells you that she has a prescribed inhaler that she uses when this happens. You should suspect:
an acute asthma attack
A 72-year-old male with type 2 diabetes complains of "not feeling well." He is diaphoretic and his blood sugar reading is 110 mg/dL. You should be MOST suspicious for:
an acute myocardial infarction
A soft-tissue injury that results in a flap of torn skin is referred to as A. an incision B. an avulsion C. an abrasion D. a laceration
an avulsion
Which of the following patients would be most in need of a rapid trauma assessment? A. an awake and alert 19-year-old man with a small caliber gunshot wound to the abdomen B. A conscious 25-year-old woman who fell 12' from a roof and landed on her side C. A 43-year-old woman with a unilaterally swollen, painful deformity of the femur D. a 60-year old man who fell from a standing position and has an abrasion on his check
an awake and alert 19-year-old man with a small caliber gunshot wound to the abdomen
A 30 year old woman has sever lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect A. a normal pregnancy B. an ectopic pregnancy C. a spontaneous abortion D. a ruptured ovarian cyst
an ectopic pregnancy
Out of the following, which would be considered a the highest priority patient:
an unresponsive patient with normal vital signs and no signs of trauma or illness
Management of an unconscious, breathing patient with a significant cardiac history would include all of the following, EXCEPT A. analyzing the rhythm with an AED B. providing ventilatory support as needed C. requesting the presence of an ALS ambulance D. obtaining a SAMPLE history from the patient's spouse
analyzing the rhythm with an AED
Angina Parameters: Assessment S/S Teatment
angina symptoms go away with nitro and rest
What is the Malleolus
ankle bone (posterior to medial malleolus is site of posterior tibial pedal pulse)
tarsals
ankle bones
Hypertension
any blood pressure greater than 140/90
artery
any blood vessel carrying blood away from heart
A 27-year-old male complains of an acute onset of abdominal pain. He is found curled in a fetal position with his right knee drawn up into his abdomen. This position is MOST commonly seen in patients with acute:
appendicitis
You are dispatched to a local nightclub for a patient who has been stabbed. After arriving at the scene and ensuring you and your partner's safety, you find the patient sitting on the ground. He is conscious, screaming in pain, and attempting to control bright red blood that is spurting from his groin area. After taking standard precautions, you should:
apply direct pressure to control the bleeding
Rapid extraction of a patient from an automobile accident is done by.
apply neck brace, slide a long backboard undre the patients butt, and removing them from the car.
You arrive at the scene of a residential fire where the occupant, a 48-year-old male, has sustained partial- and full-thickness burns to his lower extremities and lower torso. Firefighters removed the patient's smoldering clothing and stopped the burning process prior to your arrival. The patient is conscious, but restless, and complains of intense pain to the burned areas. After taking the standard precautions, you should:
apply supplemental oxygen and monitor his airway.
You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that he is diaphoretic, tachycardic, and tachypneic. Initial treatment for this patient should include:
applying a nonrebreathing mask at 15 L/min
A 29-year-old male experienced multiple fire-ant bites to his lower extremities. He is conscious and alert, and denies respiratory distress. His skin is warm, dry, and without urticaria and his breath sounds are clear and equal bilaterally. Appropriate management for this patient includes:
applying ice to the bites and observing for signs of an allergic reaction
The scene size up includes all of the following components, EXCEPT A. determining scene safety B. applying personal protective gear C. assessing the need for assistance D. evaluating the mechanism of injury
applying personal protective gear
What to wear in hot zone
appropriate protective gear
In addition to ensuring your own safety, your primary responsibility when functioning at the scene of a violent crime is to A. preserve any potential evidence B. appropriately manage the patient C. notify medical control prior to initiating care D. obtain police permission before providing patient care
appropriately manage the patient
The automated external defibrillator (AED) should NOT be used in patients who A. are between 1 and 8 years of age B. experienced a witnessed cardiac arrest C. are apneic and have a weak carotid pulse D. have a nitroglycerin patch applied to the skin
are apneic and have a weak carotid pulse
oropharynx
area directly posterior to mouth
pharynx
area directly posterior to mouth and nose, made up of oropharynx and nasopharynx
nasopharynx
area directly posterior to nose
A 57-year-old female with a history of peripheral vascular disease presents with an acute onset of confusion, aphasia, left-sided hemiparesis, and loss of muscle control to the right side of her face. You should suspect an:
arterial blockage in the right cerebral hemisphere
radial artery
artery of lower arm
brachial artery
artery of upper arm, site of pulse checked during infant CPR
posterior tibial artery
artery supplying the foot behind the medial ankle
dorsal pedis artery
artery supplying the foot, lateral to the large tendon of the big toe
A 29-year-old confused female has a blood glucose reading of 50 mg/dL. After administering one tube of oral glucose, you note marked improvement in her mental status. As you are taking her vital signs, her level of consciousness suddenly decreases. You should:
assess her airway and treat accordingly
You are transporting a 55-year-old female with chest pain, who has not responded to 3 doses of nitroglycerin. As you are talking to her, she becomes unresponsive and apneic. You should:
assess her pulse, tell your partner to stop the vehicle, begin CPR, and analyze her cardiac rhythm with an AED
A 49-year-old male complains of acute chest discomfort. He is conscious but restless, and he is noticeably diaphoretic. As your partner is applying 100% oxygen, the patient hands you a bottle of nitroglycerin that was prescribed to him by his family physician. Prior to assisting the patient with his medication, you should:
assess his systolic BP to ensure that it is at least 100 mm Hg
When ensuring a patients airway is clear what should you do next?
assess respiratory quality
After the delivery of the defibrillation with the AED, the patient has a return of a pulse. You should next A. provide rapid transport to the hospital B. reanalyze the rhythm for confirmation C. assess the airway and ventilatory status D. remove the AED and apply 100% oxygen
assess the airway and ventilatory status
You are called to the county jail for a 50-year-old male who is "drunk." When you assess him, you note the smell of alcohol on his breath and a markedly decreased level of consciousness. The sheriff's deputy tells you that this patient is a "regular." On the basis of the information that you have obtained, you should:
assess the patient's blood glucose and suspect intracranial bleeding
While assessing a semiconscious 22-year-old female's respirations, you note that they are 16 breaths/min. You should:
assess the regularity and depth of the patient's breathing
En route to the hospital, a diabetic patient regains partial consciousness. He tells you that he feels fine and that he does not want to go to the hospital. Under these circumstances, you should:
assess whether the patient's mental condition is impaired
The most effective method for determining whether you are providing adequate artificial ventilation is A. assessing the chest for adequate rise B. assessing the pulse for a improving heart rate C. checking the pupils for increased reactivity D. checking the skin for improvement of cyanosis
assessing the chest for adequate rise
While triaging patients at a multiple-casualty incident, you encounter a 40-year-old female with an obvious fracture of her right forearm and multiple abrasions to her face and arms. She is responsive and alert and does not appear to have any airway or breathing problems. You note that she is wearing an organ donor bracelet. You should:
assign her an appropriate triage category and move to the next patient
At the scene of a mass-casualty incident, you notice a bystander who is clearly emotionally upset. An appropriate action to take would be to A. tell the bystander to leave the scene at once. B. have the bystander assist you with patient care C. notify the police and have the bystander removed D. assign the bystander a simple, non-patient-care task
assign the bystander a simple, non-patient-care task
A young female with severe lower abdominal pain presents with a decreased level of consciousness, tachypnea, and shallow breathing. Her blood pressure is 88/48 mm Hg and her pulse is 130 beats/min and weak. You should:
assist her ventilations with a bag-mask device
Your patient is unresponsive, has pulse of 110 and is breathing at 8 breaths per minute. What's the next best treatment.
assist respirations with BVM and 100% oxygen
Your unconscious patient is breathing at 24 breaths per minute. What's the next best course of action?
assist ventilations with BVM and 100% oxygen
A 60-year-old female is in possible cardiogenic shock. She is semiconscious with shallow respirations, an irregular pulse, and hypotension. Appropriate treatment for this patient should include:
assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport
A 56-year-old male is found unresponsive by a neighbor. Your assessment reveals that he is diaphoretic, pale, and is breathing rapidly and shallowly. His blood glucose reading is 49 mg/dL. The MOST appropriate management for this patient includes:
assisted ventilation, 50 mL of D50 IV, and oropharyngeal suctioning as needed
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. The patient's respirations are at a rate of 26 breaths/min and shallow. The most appropriate management includes A. a nasal cannula set at 1 to 6 L/min B. assisted ventilations with 100% oxygen C. a simple face mask set at 10 to 12 L/min D. A nonrebreathing mask set at 15 L/min
assisted ventilations with 100% oxygen
Indications that artificial ventilations in an apneic adult are ineffective include A. a normal heart rate B. improvement of skin color C. asymmetrical rise of the chest D. ventilations given at 12 breaths/min
asymmetrical rise of the chest
lateral malleolus
at lower end of fibula, seen on outer ankle
You have completed your prehospital care report and left a copy at the hospital when you realize that you forgot to document a pertinent finding on the front of the report. Your most appropriate action would be to A. attach an addendum to the original run report. B. write the information on the original run report. C. complete a new run report and add the information. D. take no action and report the event to your supervisor
attach an addendum to the original run report
You are assessing a 59-year-old male with an altered mental status. You should suspect an acute ischemic stroke versus hypoglycemia if the patient:
attempts to communicate with you
AED
automated external defribrilator
inferior
away from the head
An artery is a blood vessel that only: a) returns blood to the heart b) carries blood away from the heart c) carries deoxygenated blood d) none of the above
b
The Trendelenburg position would be used to transport which of the following patients? a) a patient having difficulty breathing b) a patient in shock c) a patient with a head injury d) a patient having difficulty maintaining his airway
b
What reference provides important information regarding hazardous materials,, emergency care, and procedures in case of accidental fire or release; supplies definitions of placard colors and identification numbers; and should be standard issue on-board all ambulances and rescue units? a) Accidental Exposure and Contamination Guide b) Emergency Response Guidebook c) Emergency Preparedness and Response Plan d) Material Safety Data Sheets
b
Which of the following statements regarding body mechanics is true? a) use your back to lift b) use your legs to lift c) twist your torso while lifting d) position your feet close together
b
Which of the following structures closes over the trachea to protect it during swallowing? a) Pharynx b) Epiglottis c) Cricoid Cartilage d) Diaphragm
b
posterior
back of body
BVM
bag valve mask
Medical supplies found in the ambulance
bandages, etc, and O2, glucose,and charcoal
An EMT-B's failure to obtain consent to treat a patient could result in allegations of A. battery B. negligence C. abandonment D. breach of duty
battery
You are dispatched to a residence for a 4-year-old male who is not breathing. When you and your partner arrive at the scene, you find the child's father is performing mouth-to-mouth rescue breathing on him. The father tells you that his son stuck a pin in an electrical socket. After assessing the child and determining that he is pulseless and apneic, you should:
begin CPR and apply the AED as soon as possible
You are transporting a 60-year-old male to the hospital for suspected COPD exacerbation. He is receiving 100% oxygen via a nonrebreathing mask. As you reassess him, you note that his respirations have decreased and have become shallow. You should:
begin assisting his ventilations
You are dispatched to an assisted-living center for a 67-year-old male with "mental status changes." You arrive at the scene and begin to assess the patient. He is responsive to painful stimuli only, has rapid and shallow breathing, and a slow radial pulse. You should:
begin assisting the patient's ventilations
When talking about respirations, the word "normal" refers to
bilateral rise and fall with adequate rate, depth, and tidal volume
B-NICE
biological, nuclear, incendiary, chemical, explosives
Melena
black, tarry stool. lndicates gastro-intestinal bleeding.
Triaqe tag colors
black= dead/morgue red= immediate yellow=delayed green= minor
Following blunt injury to the anterior trunk, a patient is coughing up bright red blood. You should be most suspicious of A. intra-abdominal bleeding B. gastrointestinal bleeding C. bleeding within the lungs D. severe myocardial damage
bleeding within the lungs
Hemopneumothorax
blood and air in thoracic cavity
hypertension
blood pressure above normal range
hypotension
blood pressure below that considered normal
coronary arteries
blood vessels that supply the muscle of the heart(myocardium)
BSI
body substance isolation
S/S and treatment for Frostbite
body tissue injury due to cold. Appear white, may or have no pain. Remove from cold, do not massage or allow patient to use the part.
humerus
bone of upper arm, between shoulder and elbow
bones of the body
bones of the body
bones of the lower extremity
bones of the legs from hip to toes, starting with the femur head (p 157) i. phalanges ii. metatarsals iii. tarsals iv. tibia v. fibula vi. femur calcaneous medial/lateral maleolis
central nervous system(CNS)
brain and spinal cord
sternum
breastbone
A 60-year-old male presents with shortness of breath and a productive cough of two days' duration. He denies chest pain or any other associated symptoms. Auscultation of his lungs reveals scattered bilateral rhonchi in all fields. His skin is pink, warm, and dry and the pulse oximeter reads 94% on room air. This patient is MOST likely experiencing:
bronchitis
If a hole is created in the chest wall, air could escape or be drawn in, or if bleeding develops within the chest, air and blood can accumulate in the pleural space. This would force the lung to: a) increase respirations b) increase the minute volume c) collapse d) work harder with minimal problems
c
The process by which glucose and other nutrients are converted into energy is called: a) catabolism b) respiration c) metabolism d) depolarization
c
The pulse palpated on the top of the foot is called the ____ pulse. a) phalanx proximalis b) tibialis posterior c) dorsalis pedis d) suprametatarsal
c
What are the two most easily injured portions of the spine? a) sacral and coccygeal b) cervical and thoracic c) cervical and lumbar d) lumbar and sacral
c
What condition of immediate concern results from a loss of red blood cells due to hemorrhage? a) decreased ability to fight infection b) decrease in pulse rate c) decreased oxygen delivery to the tissues d) decreased production of carbon dioxide
c
What is the bone on the thumb side of the forearm? a) fibula b) acromion c) radius d) ulna
c
Which of the following BEST describes a person who speaks up on behalf of the patient and supports his cause? a) Guardian b) Assistant c) Advocate d) Representative
c
You are approaching the scene of a motor vehicle crash. Which of the following would be the first way to safeguard your well-being as an EMT? a) take personal protective equipment (PPE) precautions b) request additional resources c) ensure scene safety d) utilize DOT-approved reflective safety clothing
c
Your patient is a 10-year-old boy who suffered a possible fractured arm while rollerblading at a friend's house. Which of the following is the BEST way to obtain consent for treatment? a) Act on implied consent b) Get consent from the patient's 15-year-old sister, who is at the scene c) Call the patient's mother at work d) Allow the patient to consent as an emancipated minor
c
Minimum data set
c/c, mental status, BP, skin perfusion/color/temp, pulse, resp rate, demographics; time of incident reported, unit notified, arrival, left scene, arrived at destination, transfer of care
Which of the following parameters would be most reliable as an indicator of perfusion in a 1 year old child? A. Heart rate B. capillary refill C. Blood pressure D. Respiratory rae
capillary refill
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. Cardiac arrest in the adult population is most often the result of A. an acute stroke B. respiratory failure C. cardiac arrhythmias D. myocardial infarction
cardiac arrhythmias
CPR
cardio pulmonary resuscitation
central pulses
carotid and femoral pulses, which can be felt in central part of body
What is the NERVOUS SYSTEM?
cerebrum - center of intellect, learning, personality cerebellum - balance, equilibrium, coordination Brainstem - controls vital functions Autonomic nerves - control involuntary (automatic) functions
thorax
chest
angina pectoris
chest pain caused by stress or exertion
COPD
chronic obstruction pulmonary disease
asthma
chronic obstructive lung disease triggered by allergy condition
In the patient with diabetes, hypoglycemia typically presents with A. dry skin and a slow onset B. dry skin and a rapid onset C. clammy skin and a slow onset D. clammy skin and a rapid onset
clammy skin and a rapid onset
the most important initial steps of assessing and managing a newborn include A. suctioning the airway and obtaining a heart rate B. clearing the airway and keeping the infant warm C. keeping the infant warm and counting respirations D. drying and warming the infant and obtaining an APGAR score
clearing the airway and keeping the infant warm
proximal
closer to torse
Firefighters have rescued a man from his burning house. he is conscious and in considerable respiratory distress. He has a brassy cough and singed nasal hairs. The most immediate threat to this patient's life is A. hypothermia B. severe burns C. sever infection D. closure of the airway
closure of the airway
You are assessing a young male with an acute onset of tachypnea. He is conscious and alert with shallow respirations of 40 breaths/min, and complains of numbness and tingling to his face and hands. The patient's girlfriend tells you that he has been very worried about his mother, who was recently diagnosed with cancer. Appropriate treatment for this patient includes:
coached breathing and oxygen as needed
You are caring for a 59-year-old male involved in a motor-vehicle crash. During your assessment, you note that his pelvis is unstable, he is pale and diaphoretic, and his blood pressure is 80/50 mm Hg. Use of the pneumatic antishock garment (PASG) would be absolutely contraindicated if further assessment of this patient revealed:
coarse crackles in the lungs, pregnancy, pulmonary edema, acute heart failure, penetrating chest injuries, groin injuries, major head injuries, a transport time of less than 30 minues.
clavicle
collarbone
A 75 year old man has generalized weakness and chest pain. He has a bottle of prescribed nitroglycerin and he states that he has not taken any of his medication. After initiating oxygen therapy, you should next A. apply the AED and prepare the patient for immediate transport B. perform a detailed physical examination to located any other problems. C. contact medical control for permission to assist the patient with his nitroglycerin. D. complete a focused physical examination, including obtaining baseline vital signs.
complete a focused physical examination, including obtaining baseline vital signs.
red blood cells
components of blood, carry oxygen to and carbon dioxide away from cells
white blood cells
components of blood, produce substances that help body fight infection
platelets
components of the blood, membrane-enclosed fragments of specialized cells
CISM critical incident stress management
comprehensive system that includes education and resources to both prevent stress and to deal with stress appropriately when it occurs
hypoglycemia
condition of low blood pressure
insulin shock
condition of low blood pressure
apnea
condition of not breathing
You receive a call to a local grocery store for a possible heart attack. Upon arrival at the scene, you find two bystanders performing CPR on the patient, a 49-year-old male. You should:
confirm that the patient is in cardiac arrest
Immediately following a generalized motor seizure, most patients are A. apneic B. confused C. hyperactive D. awake and alert
confused
expressed consent
consent given by adults of legal age and mentally competent to make a rational decision in regard to their medical well-being
implied consent
consent presumed by patient or patient's parent would give if they could such as for an unconscious patient or small child at school
First actions taken for a Drowning victim?
consider C-spine first, 'then' airway, CPR, etc.
A child with respiratory distress is:
considered to be a medical emergency.
What is Botulism?
constipation, dysphagia (difficulty swallowing), loss of head control
Bowel obstruction
constipation, history of recent abd. surgery,cramp pain, or abd. distention.
Prior to administering nitroglycerin to a patient with chest pain, you must A. complete a detailed physical examination of the patient B. contact medical control and obtain proper authorization C. make sure that the systolic blood pressure is at least 120 mm Hg D. make sure that the nitroglycerin is prescribed to the patient or a family member
contact medical control and obtain proper authorization
You are administering oxygen to a woman with asthma who took two puffs of her prescribed inhaler without relief prior to your arrival. Your next action should be to A. contact medical control for further advice B. administer one more puff from the inhaler C. provide immediate transport to the hospital D. confirm that her inhaler is prescribed to her
contact medical control for further advice
As you are performing CPR on an elderly man, his wife presents you with a "do not resuscitate" order. Your most appropriate course of action is to A. ignore the document and continue the CPR B. comply with the document and stop CPR C. continue CPR until medical control is notified D. withhold CPR until medical control validates the order
continue CPR until medical control is notified
A 61-year-old female called EMS after suddenly being awakened in the middle of the night with a feeling that she was "smothering." You arrive to find the patient, very apprehensive and restless, sitting on the living room couch in obvious respiratory distress. Her BP is 160/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. Auscultation of her lungs reveals diffuse rhonchi in all fields. Treatment for this patient should include:
continuous positive airway pressure and an IV line set to keep the vein open
While a man was using a chainsaw to trim branches from a tree, it slipped and caused a large laceration to his left forearm. Bright red blood is spurting from the wound. The patient is conscious, alert, and talking. You should first A. copen the patient's airway B. control the active bleeding C. apply supplemental oxygen D. thoroughly cleanse the wound
control the active bleeding
eclampsia
convulsions resulting from severe hypertension
Snoring respirations are most rapidly managed by A. suctioning the oropharynx B. initiating assisted ventilations C. correctly positioning the head D. inserting an oropharnygeal airway
correctly positioning the head
Eye injuries
cover both eyes Emergency care for all types of eye injuries are on page 1099 pg 1094/5
A 62-year-old female with a history of type 2 diabetes has sustained partial-thickness burns to 27% of her body surface area (BSA). This burn should be classified as a:
critical burn
The potential space between the lung and chest wall is called the: a) carina space b) lung space c) dead space d) pleural space
d
What action does an organ undergo to best describe the term hypertrophy? a) absence b) wasting c) changing d) enlargement
d
What is another term for the frontal aspect of the body? a) caudal b) dorsal c) posterior d) anterior
d
What is the contraindication for the use of a scoop or orthopedic stretcher? a) internal injuries b) hip fractures c) pelvic injury d) spinal injury
d
What is the name of the federal act that mandates a procedure by which emergency healthcare providers can find out if they have been exposed to potentially life-threatening diseases while on the job? a) The Communicable Disease Notification Act b) The EMS Personnel Health Protection Act of 1991 c) The Occupational Exposure to Bloodborne Pathogens Act d) The Ryan White Comprehensive AIDS Resource Emergency Act
d
What is the preferred number of rescuers when using a stair chair? a) two: one in front and one in back b) only one with the trac-like chair c) four: one for each corner of the device d) three: two lifting and one spotting
d
When covering a patient's mouth and nose with a mask of any kind, which of the following is the primary risk? a) causing or exasperating respiratory illnesses b) interfering with patient communication c) upsetting the patient because of the social stigma d) obstructing the ability to visualize and protect the airway
d
Which of the following actions is NOT permitted by an advance directive? a) providing only comfort measures, such as pain medication b) withholding CPR if cardiac arrest is not witnessed c) refusing to allow long-term life support measures, such as a ventilator or feeding tube d) assisted suicide via medication overdose
d
Which of the following descriptions BEST defines the term pathogen? a) an immunity developed after an exposure b) a study of the origins of infection and disease c) a medication with a harmful effect d) an organism that causes infection and disease
d
Which of the following factors should be considered before lifting any patient? a) the weight of the patient b) your physical limitations c) communications d) all of the above
d
Which of the following groups is credited with developing the earliest documented emergency medical service? a) the Spanish b) the Egyptians c) the Mayans d) the French
d
Which of the following information may be important to law enforcement officers investigating a crime scene? a) What route you took when responding to the scene b) How you gained access to the scene c) Your opinion of what happened before you arrived on-scene d) All of the above
d
Which of the following is NOT correct when performing a log-roll? a) keep your back straight b) lean forward from the hips c) use your shoulder muscles d) roll the patient away from you
d
Which of the following is a function of the skin? a) regulation of body temperature b) regulation of salt and water balance c) protection from the environment d) all of the above
d
Which of the following should you do when reaching for something? a) keep your back in a locked-in position b) avoid twisting c) avoid reaching more than 15 to 20 inches in front of your body d) all of the above
d
Which of the following situations would require the use of an emergency move? a) your patient has a life-threatening condition that requires repositioning b) you must reach other, more critically injured patients c) the scene is hazardous d) all of the above
d
You are treating a patient who has a productive cough and who reports weight loss, loss of appetite, weakness, night sweats, and fever. Which of the following diseases is most likely the cause of these signs and symptoms? a) Hepatitis B b) Pneumonia c) AIDS d) Tuberculosis
d
You respond to a large concert venue where a number of spectators are reported to be severely intoxicated. You are directed to an area where several patients appear to be unconscious, lying face down on the ground. The position of these patients is described as: a) posterior b) supine c) anterior d) prone
d
When attempting to ventilate an unconscious patient, you note decreased lung compliance. This indicates:
decreased alveolar expansion
During your assessment of a 34-year old man with a gunshot wound to the chest, you note that his skin is pale. This finding is most likely caused by A. a critically low blood pressure B. increased blood flow to the skin C. decreased blood flow to the skin D. peripheral dilation of the vasculature
decreased blood flow to the skin
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. Shallow respirations will result in A. decreased tidal volume B. increased tidal volume C. increased oxygen intake D. increased carbon dioxide removal
decreased tidal volume
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. In infants and children, the most detrimental effect of gastric distention is A. increased ease of ventilations B. decreased ventilatory volume C. acute rupture of the diaphragm D. less effective chest compressions
decreased ventilatory volume
DCAPBTLS
deformities, contusions, abrasion, punctures, burns, tenderness, lacerations, swelling
emphysema
degeneration of alveolar structure
During your initial assessment of an unconscious adult patient, you find the patient is apneic. You should next A. assess for a carotid pulse B. begin chest compressions C. deliver two rescue breaths d. place an oropharyngeal airway
deliver two rescue breaths
The main purpose for checking circulation during the initial assessment is to:
determine if the patient has a pulse
fetus
developing baby
ectopic pregnancy
development of the fetus outside the uterus
placenta previa
development of the fetus over the mouth of the uterus
dyspnea
difficulty in breathing
What are the Three stages of labor?
dilation, expulsion, placental
autonomic nervous system
division of peripheral nervous system that controls involuntary motor functions
If there is a Police presence at the scene
do not follow police into dangerous , you can wait until they secure area and call you in.(always wait till they say its clear)
DNR order
don not resuscitate order, legal document signed by patient and physician and states patient has terminal illness and does not wish to prolong life
The most effective means of preventing the spread of disease is A. effective handwashing B. up-to-date immunizations C. wearing gloves with all patients D. wearing a mask with all patients
effective handwashing
multiple casualty incident MCI
emergency involving multiple patients
Esophageal Vaices
enlarged vessels in the esophagus, may rupture and cause serious bleeding. (caused by liver disease,in alcoholics).
The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is indicated. You should A. deliver the shock and resume CPR B. ensure that nobody is touching the patient C. perform CPR for 2 minutes and then deliver the shock D. push the analyze button to confirm that the shock is indicated
ensure that nobody is touching the patient
Prior to administering IV dextrose to an unresponsive 43-year-old male with a blood glucose reading of 35 mg/dL, you should:
ensure that the IV line is patent and running effectively
Skin layers
epidermis, dermis, subcutaneous
A 56-year-old man with a history of cardiac problems reports pain in the upper midabdominal area. This region of the abdomen is called the A. peritoneum B. epigastrium C. mediastinum D. retroperitoneum
epigastrium
PPE personal protective
equipment that protects the EMS worker from infection or exposure to danger of rescue operations
What is Supine hypotensive syndrome?
especially in pregnancy; pressure on vessels (vena cava) causing low BP, shock. Put patient in left lateral position.
S/S and treatment for Heat stroke
failure of body's cooling mechanisms. Will be hot dry flushed, ALOC, Hypotension, tachycardia, seizure . Do not give oral fluids. immediate cooling, Oxygen, shock, position, rapid transpoi rt.
Syncope
fainting due to lack of brain perfusion
distal
farther away from torso
Under what organization's law is it to wear high-visible vests?
federal law under ANSI/ISEA
Appendicitis
fever, anorexia (loss of appetite), right lower quadrant pain
plane
flat surface formed when slicing through a solid object
pulmonary edema
fluid in lungs
plasma
fluid portion of blood
amniotic fluid
fluid-filled membrane where fetus develops
metatarsals
foot bones
Hip dislocation
foot facing out, knee bent inward, no movement, and longer then the other.
FBAO
foreign body airway obstruction
zygomatic arches
form the structure of cheeks
anterior
front of body or body part
Cholecystitis
gallbladder disease. RUQ pain with 'referred' pain to right shoulder
Cholecystitis
gallbladder drsease/fatty food,riqht upper quadrant pain. (fat, forty, farty, female)
pancreas
gland located behind stomach that produces insulin and juices that assist in digestion of food in duodenum of small intestine
What is the Responsibility for patient care?
goes to highest medical authority on scene (Doctors/nurses must have proper l.D.) (contact base hospital doctor if a dispute happens) Always be there until all the paperwork is done and the patient has been transfer to the care of the hospital (otherwise that abandonment)
A 42- year old man was ejected from his car after it struck a bridge pillar at a high rate of speed. You find him lying approximately 50' from the car. After manually stabilizing his head, your next action should be to A. assess the quality of his breathing B. grasp the angles of the jaw and lift C. administer high-concentration oxygen D. determine the patient's level of consciousness
grasp the angles of the jaw and lift
metacarpals
hand bones
you receive a call for a 3 year old girl with respiratory distress. When you enter her residence, you see the mother holding the little girl, who does not acknowledge your presence. This finding indicates that the child a. has hypoxia B. probably is sleeping C. is afraid of your presence d. is reacting normally for her age.
has hypoxia
You arrive at a residence where you find a man lying unconscious in his front yard. There were no witnesses to the event that caused the unconsciousness. In assessing this man, you must assume that he A. has sustained an injury B. is having a heart attack C. is having a diabetic reaction D. is having a heat-related emergency
has sustained an injury
You are responding to a call for a 2 year old child who fell from a second story window. With the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's A. head B. chest C. abdomen D. lower extremities
head
rule of 9
head and each arm are 9, chest and ea. Leg is 18
A common side effect of nitroglycerin is A. nausea B. headache C. hypertension D. chest discomfort
headache
In a patient with cardiac compromise, you would be LEAST likely to encounter A. anxiety B. dyspnea C. headache D. chest pain
headache
HIPAA
health insurance portability and accountability act, federal law protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed
acute myocardial infarction
heart attack
Tachycardia
heart rate greater than 100/min
Bradycardia
heart rate less than 60/min.
calcaneus
heel bone
acromion process
highest portion of the shoulder
epinephrine
hormone produced by body, as medication it dilates respiratory passages and is used to relieve severe allergic reactions
insulin
hormone produced by pancreas or taken as medication by many diabetics
You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:
humidified oxygen
Patients with closed head injuries often have pupillary changes and A. paralysis B. paresthesia C. hypertension D. tachycardia
hypertension
An elderly man is found unconscious in his kitchen. The patient's wife tells you that her husband has diabetes and that he took his insulin, but did not eat anything. You should suspect A. ketoacidosis B. diabetic coma C. hypoglycemia D. hyperglycemia
hypoglycemia
What are shipping papers where would they be located?
identify the exact substance, quantity, origin and desitination for hazardous materials They can be found in the cab of a motor vehicle
Patent with an imapaled object in the back
if CPR is needed remove. lf patient is breathing, left lateral position and rapid transport, 'don't' remove
midline
imaginary line drawn down the center of the body, dividing it into right and left
empathy def
imaginative projection of one's own consciousness into another being
You receive a call to a local daycare center for a 3-year old boy who is not breathing. When you arrive and assess the child, you find him to be in cardiopulmonary arrest. You initiate CPR and request a back-up ambulance. After attaching the AED, you push the analyze button and receive a "shock advised" message. After delivering the shock, you should A. assess for a carotid pulse B. immediately perform CPR C. reanalyze the cardiac rhythm D. open the airway and ventilate
immediately perform CPR
What is the important factor for EMT safety regarding communicable diseases
immunizations are VERY important factor for EMT safety regarding communicable diseases, (gloves are NOT the 'most' important factor.)
Epiglotitis
in child, drooling, fever, stridor, tripod position, inability to swallow, history of recent illness, (put nothing in mouth, transport immediately and quietly, 02 it tolerated, do not intervene if not necessary- crying may cause further obstruction of airway)
location to palpate carotid pulse
in the neck, easily accessible site to assess character of peripheral pulse, used during phsyiological shock or cardiac arrest when other sites are not palpable
Your patient has cool, pale and moist skin. These signs may indicate:
inadequate perfusion
hypoperfusion
inadequate perfusion of the cells and tissues of body caused by insufficient flow of blood through capillaries
As you are providing initial ventilations to a patient with apnea using a bag-valve-mask device, you note minimal rise of the chest. You should next A. initiate the mouth-to mask technique B. increase the volume of the ventilations C. switch to a smaller mask for the BVM device D. ensure that a reservoir is attached to the BVM device
increase the volume of the ventilations
Chevne-Stok
increasing and decreasing respiratory rate and tidal volume with periods of apnea. sign of injury to head/brain
What dos Bright red Emesis mean?
indicated recent upper gastrointestinal bleeding, often acute ulcer or rupture of esophageal varices.
xiphoid process
inferior portion of sternum
epiglottis
inflammation appearing similar in clinical picture to croup, oxygen therapy contraindicated
After an initial attempt to ventilate a patient fails, you reposition the patient's head and reattempt ventilation without success. You should next A. assess for a carotid pulse and initiate CPR if necessary B. use a flow-restricted oxygen-powered ventilation device C. initiate airway obstruction removal techniques and provide transport D. continue to reposition the patient's head at the scene until you are able to secure a patent airway
initiate airway obstruction removal techniques and provide transport
Common finding to differentiate between stroke and spinal injury
injury Double check this please ● For a stroke, it only causes paralysis to one side or one extremity (hemiparalysis) ● For Spinal Injury, you may be paralyzed from the injury down, or to both sides
Sprain
injury to tendon, muscle, or ligaments
location to palpate radial pulse
inner surface of wrist near thumb, most common
dermis
inner(second) layer of skin, rich in blood vessels and nerves, found beneath epidermis
You arrive at the scene where a 49 year old woman is found semiconscious on the floor of her living room. The patient's husband tells you that they were watching TV when this condition suddenly developed. No trauma was involved. The patient moans occasionally and has slight cyanosis to her lips. After performing a head tilt-chin lift maneuver on this patient, you should next A. assess her respirations B. determine the need for oxygen C. insert an oropharyngeal airway D. insert a nasopharyngeal airway
insert a nasopharyngeal airway
You are assessing a 32-year-old female who was stung by a scorpion. She is unresponsive and has stridorous, severely labored respirations. Your partner, who is assisting the patient's ventilations with a bag-mask device, tells you that he is meeting significant resistance with each ventilation. You should:
insert an advanced airway device to protect her airway
A 70-year-old male with a history of esophageal cancer is unresponsive with slow, shallow respirations. Appropriate airway management for this patient includes:
inserting an oral airway and ventilating with a bag-mask device
sphygmomanometer
instrument used to determine arterial pressure with non-invasive technique
Your patient is a 29-year-old male who presents with signs and symptoms of shock. However, your assessment reveals no obvious external signs of injury. You should suspect:
intraabdominal bleeding
contamination
introduction of dangerous chemicals, disease, or infectious materials
Breathing in children:
is assessed using a stethoscope.
How long should a 2 person CPR Switch take?
it should take 5 seconds or less to switch
acromioclavicular join
joint where the acromion and clavicle meet
diabetic coma
ketcacidosis and hyperglycemia
Anaerobic metabolism
lactic acid, strong, difficult for body to excrete
femur
large bone of thigh
carotid arteries
large neck arteries, one on each side of neck, that carry blood from the heart to head
aorta
largest artery in body, transports blood from left ventricle to being systemic circulation
liver
largest organ, produces bile to assist in breakdown of fats and assists in the metabolism of various substances in body
fibula
lateral and smaller bone of lower leg
subcutaneous layers
layers of fat and soft tissues found below the dermis
prone
laying face down
supine
laying on back
epiglottis
leaf-shaped structure that prevents food and foreign matter from entering trachea
abandonment
leaving a patient after care has been initiated and before patient has been transferred to someone with equal or greater medical training
Common organ trauma problems
left upper quadrant (contains stomach and spleen) Spleen often damaged in trauma causing internal bleeding/shock.
Hip fracture
leg shortened, externally rotated, swelling,
An AEMT witnessed a call in which his partner gave adequate physical care; however, he was deliberately rude because the patient was thought to be infected with HIV. The AEMT ignored his partner's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the AEMT is considered:
legal but unethical
When monitoring a patient with a head injury, the most reliable indicator of his or her condition is the A. pupillary reaction B. level of consciousness C. systolic blood pressure D. rate and depth of breathing
level of consciousness
What is PIH?
lfgg_nrrcy.lnduced Hypertension same as toxemia, eclampsia. Results in edema, weight gain, may result in life threatening seizures.
Where are the Kidneys?
lie in the 'retroperitoneal' space, between peritoneum and the back muscles
mid-axillary line
line drawn vertically from middle of armpit to ankle
mid-clavicular line
line through center of each clavicle
LPM
liters per minute
A patient was struck in the right lower anterior chest with a baseball bat. In addition to fractured ribs, you should be suspicious of injury to the:
liver
An 80-year old woman has pain in the right upper quadrant of her abdomen and a yellowish tinge to her skin. You should suspect dysfunction of the A. liver B. spleen C. pancreas D. gallbladder
liver
To obtain the most reliable assessment of a patient's tidal volume, you should A. assess for retractions B. listen for airway noises C. count the respiratory rate D. look at the rise of the chest
look at the rise of the chest
Signs and treatment of a Flailed Chest
loose chest segment, 'paradoxical,chest movement stabilize segment with dressing, hand.
medial malleolus
lower end of tibia, seen on inner ankle
mandible
lower jaw bone
ischium
lower, posterior portions of pelvis
recovery position
lying on side, also called "lateral recumbent position"
femoral artery
major artery supplying leg
Your first action in managing a patient with an altered mental status should be to A. give the patient oral glucose B. administer 100% supplemental oxygen C. make sure that the patient is breathing adequately D. try to determine the cause of the altered mental status
make sure that the patient is breathing adequately
To ensure delivery of the highest concentration of oxygen to your patient using a nonrebreathing mask, you should A. set the flow rate to at least 12 L/min B. securely fasten the mask to the patient's face C. make sure that the reservoir bag is pre inflated D. cover the one-way valves on the oxygen mask
make sure that the reservoir bag is pre inflated
During a soccer game, an 18 year old woman injured her knee. You note that the knee is in the flexed position and is obviously deformed. Your first action should be to A. assess her distal circulation B. straighten the knee to facilitate immobilization C. manually stabilize the leg above and below the knee D. immobilize the knee in the position in which it was found
manually stabilize the leg above and below the knee
As you begin your assessment of an unresponsive man who fell approximately 20' from a roof, you should first A. gently shake the patient to confirm unresponsiveness B. gently tilt the patient's head back to assess for breathing C. assess the rate, depth, and regularity of the patient's breathing D. manually stabilize the patient's head and perform a jaw-thrust maneuver
manually stabilize the patient's head and perform a jaw-thrust maneuver
A 59-year-old female with a history of poorly controlled hypertension becomes acutely dyspneic, develops profound cyanosis to the upper chest, and becomes unresponsive. She is pulseless and apneic upon your arrival. As you and your partner are performing the appropriate treatment interventions, you discuss the possible cause of her condition, which is MOST likely a(n):
massive pulmonary embolism
ulna
medial bone of forearm
nitroglycerine
medication used for chest pain
alveoli
microscopic sacs of lungs where gas exchange with bloodstream takes place
At the peak of the inspiratory phase, the alveoli in the lungs contain A. high quantities of carbon dioxide B. minimal levels of oxygen and carbon dioxide C. equal levels of oxygen and carbon dioxide D. more oxygen than carbon dioxide
more oxygen than carbon dioxide
Mobile data terminal
mounted on cab in ambulance for digital communication
cervix
mouth of uterus
voluntary muscle
muscle that can be consciously controlled
involuntary muscle
muscle that responds automatically to brain signals but cannot be consciously controlled
stomach
muscular sac between esophagus and the small intestine where digestion begins
diaphragm
muscular structure that divides chest cavity from abdominal cavity, major muscle of respiration
small intestine
muscular tube between stomach and large intestine, divided into duodenum, jejunum, and ileum which receives partially digested food from stomach and continues digestion, nutrients are absorbed by body through its walls
large intestine
muscular tube that removes water from waste products received from small intestine and removes anything not absorbed by the body toward excretion from the body
What to wear in cold zone
must shed contaminated gear
MI
myocardial infarction
The middle, muscular layer of the heart is called the A. epicardium B. pericardium C. myocardium D. endocardium
myocardium
PNS peripheral nervous system
nerves that enter and leave the spinal cord and travel between brain and organs without passing through spinal cord
NRB
non rebreather mask
When exposed to anything lnfectious
notify receiving hospital, notify your supervisor, determine if followup care is needed, fully document the exposure and the steps taken
confidentiality
obligation not to reveal information obtained about a patient except to other health care professionals involved in patient's care
duty to act
obligation to provide care to patient
A sudden onset of respiratory distress in a 5 year old child with no fever most likely is the result of A. infection of the lower airways B. inflammation of the upper airway C. a progressive upper airway infection D. obstruction of the airway by a foreign body
obstruction of the airway by a foreign body
obstructed airway
occurs when food bolus or other object prevents inspiratory/expiratory process
Following an apparent febrile seizure, a 4 year old boy is alert and crying. His skin is warm and moist. The most appropriate management of this child includes A. rapidly cooling the child in cold water B. allowing the parents to transport the child C. offering oxygen and providing transport D. keeping the child warm and providing transport
offering oxygen and providing transport
bilateral
on both sides
As you step out of the ambulance at the scene of a nighttime motor vehicle crash on the highway, your immediate concern should be A. oncoming traffic B. whether the car will catch on fire C. placing safety flares by the ambulance D. quick assessment of the patients in the car
oncoming traffic
Hemiplegia
one-sided paralysis
When should you hyperventilate a patient with a head injury
only if signs of cerebral herniation are present; BP rises, pulse slows, Cheney-stokes breathing, posturing, blown pupil
When should you remove a helmet from a patient?
only remove if necessary (if loose or unstable) or for airway control.
When should you restrain a patient and how?
only used if patient is violent or a danger to themselves or others. lf police use their restraints, they must remain available to remove them immediately if needed. EMS should use soft and/or padded restraints, not plastic hand ties,Never restrain hands and feet behind the back. Check restrained patients every 15 minutes for pulse, capillary refill, PMS. Never use the 'sandwich' technique to restrain. Can attach restraints to gurney but must use frame, not movable side rails.
OPQRST
onset, provocation, quality, radiation, severity, time
You are dispatched to a football game, where a spectator fell approximately 20 from the stands. As you approach the patient, you can see that he has obvious bilateral femur fractures and is not moving. Your initial action should be to:
open his airway and assess his breathing
on-line medical direction
orders from an on-duty physician given directly to EMT through radio or phone
off-line medical direction
orders from medical director to EMT to give certain medications or do certain procedures without speaking to medical director or physician
spleen
organ located in left upper quadrant of abdomen that acts as a blood filtration system and reservoir for reserves of blood
pathogens
organisms that cause infection such as viruses and bacteria
lungs
organs where exchange of atmospheric oxygen and waste carbon dioxide take place
OPA
oropharyngeal airway
epidermis
outer layer of skin
medical direction
oversight of patient-care of ems system
02
oxygen
A 33-year-old male complains of generalized weakness and chest discomfort that began following his morning workout at the gym. He is conscious and alert, but restless. Your assessment reveals a BP of 130/64 mm Hg, pulse of 78 beats/min and occasionally irregular, respirations of 16 breaths/min and unlabored, and an SpO2 of 98% on room air. He has prescribed nitroglycerin tablets and states that he took one without relief. Appropriate treatment for this patient includes:
oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport
The most appropriate management of a patient who has sustained widespread full-thickness burns following an explosion should consist of applying A. oxygen; dry, sterile dressings; warmth; and providing rapid transport B. oxygen; dry; sterile dressings; burn ointment; and providing rapid transport C. oxygen; moist; sterile dressings; warmth; and providing rapid transport D. oxygen; moist; sterile dressings; burn ointment; and providing rapid transport
oxygen; dry, sterile dressings; warmth; and providing rapid transport
Guidelines for moving
p 115 1. keep weight as colse to body as possible 2. Keep back locked; don't hyperexctend/lean from waist 3. never twist. first lift, then turn.
Guidelines for log-roll
p117 lean from the hips, keep back straight. Use shoulder muscles to assist
power grip
page 115-116 ■ Your palm and fingers should come in complete contact with the object and all fingers must be bent at the same angle
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. the most reliable indicator of injury to the spinal vertebrae is A. lack of pain at the site of the injury. B. palpable pain at the site of the injury. C. decreased movement on one side of the body D. decreased grip strength in the upper extremities
palpable pain at the site of the injury.
The effectiveness of chest compressions are most effectively assessed by A. listening for a heartbeat with each compression B. carefully measuring the depth of each compression C. palpating for a carotid pulse with each compression D. measuring the systolic blood pressure during compressions
palpating for a carotid pulse with each compression
A 5 year old boy complains of pain to the right lower quadrant of his abdomen. Correct assessment of this child's abdomen includes A. avoiding palpation of the abdomen B. palpating the left upper quadrant first C. auscultating bowel sounds for 2 minutes D. palpating the right lower quadrant first
palpating the left upper quadrant first
Cyanide poisoning parameters: Assessment S/S Teatment
parameterspg. 731 ○ Cyanide poison is a poison that operates by disrupting the cell's energy cycle by preventing electron transfer to oxygen so the cell can no longer produce energy with aerobic respiration, essentially suffocating the cell. ○ In other words, it intereferes with respiration at the cellular level ○ can enter body thru inhalation/ absorption/ injection, AND ingestion ○ in large doses, will kill within minutes ○ Smells like bitter almonds
systole
part of cardiac cycle during which myocardial fibers contract and cardiac chambers empty
exhalation
passive process in which intercostal muscles(ribs) and diaphragm relax, causing chest cavity to decrease in size and air to flow out lungs
laryngectomee
patient who breathes through incision (partial or total removal of larynx) made in throat
acetabulum
pelvic socket into which the ball at the proximal end of femur fits to form the hip joint
You and your partner arrive at the side of a 60-year-old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. how long should you preform CPR for before applying the AED?
perform CPR for about 2 minutes and then apply the AED
As you assess a 56-year old man, you note that he is pulseless and apneic. As your partner gets the AED from the ambulance, you should A. obtain a medical history from the wife. B. place the patient in the recovery position C. perform CPR until the AED is ready to use D. conduct a detailed examination of the patient.
perform CPR until the AED is ready to use
You respond to a call for a 39-year-old female with an altered mental status. Your primary assessment reveals that she is conscious but confused, has a heart rate of 88 beats/min, and has respirations of 22 breaths/min with adequate tidal volume. After administering supplemental oxygen, you should:
perform a focused history and physical exam
diastole
period of myocardial relaxation during which cardiac chambers fill
consent
permission from patient for care or other action by EMT
Guidelines for lifting
pg 115 1. know own limitations, pt weight, & those of equipment. 2. get help if needed 3. Use even number of resuers
MCI parameters: Assessment S/S Teatment
pg 1420 Not too sure on this answer ○ Make sure to call for more than enough help, positioning vehicles properly, giving appropriate emergency medical care, transporting patients efficiently, and providing follow up care. ○ MCIs include motor vehicle crashes, gang-related violence, apartment fires, food poisoning, toxic gas inhalation, and even refugee influx
Behavioral emergency pts
pg 863 -> keep in mind the following principles: every person has limitations, a right to their own feelings; more ability to cope with own crisis than own perception (pt's, not mine);
Spontaneous abortion parameters: Assessment S/S Teatment
pg#-1176 ○ [This is God's way of rejecting an unfit fetus...trish's words-probably not on the test ], usually due to genetic insufficiencies but other times due to immunological or hormonal issues.
Stroke Parameters: Assessment S/S Teatment
pg. 630 ○ TIA s/s are similar to stroke, but typically disappear w/i 10-15 minutes, almost always w/i an hour
TIA parameters: Assessment S/S Teatment
pg. 630 ○ TIA s/s are similar to stroke, but typically disappear w/i 10-15 minutes, almost always w/i an hour
Diabetes parameters: Assessment S/S Teatment
pg. 668 and on ○ altered relationship between glucose/insulin, glucose is body's main energy source ○ HYPOGLYCEMIA blood glucose level of <=60mg/dl, AND showing signs, or anything less than 50mg/dl ○ HYPERglycemia is [book says] consistently over 120mg/dl ○ NORMAL is 80-120mg/dl ○ TYPE 1 diabetes is a condition inwhich the pancreas does not secrete insulin pg. 670 ○ TYPE 2 is non-insulin dependent and can be regulated with diet and exercise,etc
Pediatric meningitis
photophobia (light sensitivity) nucchal rigidity (stiff neck)
medical director
physician who assumes ultimate responsibility for the patient care aspects of EMS system
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. Suspecting an allergic reaction, your first action should be to A. ask the patient if he has an epinephrine auto-injector B. remove the patient's shirt to inspect his chest for urticaria C. obtain a set of baseline vital signs and a SAMPLE history D. place a nonrebreathing mask set at 15 L/min on the patient.
place a nonrebreathing mask set at 15 L/min on the patient.
Shortly after administering a second nitroglycerin dose to a 44-year-old male with chest pain, he becomes lightheaded. You take his blood pressure and is reads 80/50 mm Hg. You have already established IV access and are administering oxygen. You should:
place him supine and elevate his legs
You are dispatched to an office complex for a middle-aged male with acute abdominal pain. Your assessment reveals that he is conscious, restless, and in severe pain. His airway is patent, his breathing is adequate, and his vital signs are stable. Treatment for this patient should include all of the following, EXCEPT:
placing him supine and elevating his legs
Management of an 18-year old woman with severe vaginal bleeding includes all of the following, EXCEPT A. high concentrations of oxygen B. elevation of the lower extremities C. placing sterile dressings into the vagina D. covering the vagina with a trauma dressing
placing sterile dressings into the vagina
After assisting a patient with her epinephrine auto-injector, you should dispose of the device by A. giving it to the patient to have it refilled B. placing the device in a red biohazard bag. C. placing the device in a puncture proof container D. replacing the cover and putting it in a trash can
placing the device in a puncture proof container
A 67-year-old male who smokes three packs of cigarettes per day complains of a productive cough, chills, and generalized weakness. He is in mild respiratory distress; auscultation of his lungs reveals rhonchi to the lower left lobe. This patient's clinical presentation is MOST consistent with:
pneumonia
joint
point where two bones come together
trendelenburg position
position which the patient's feet and legs are higher than head
A 56-year old man has labored, shallow breathing at a rate of 28 breaths/min. He is conscious, but extremely restless. Airway management should consist of a. a nasal cannula b. a simple face mask c. a nonrebreathing mask d. positive pressure ventilation
positive pressure ventilation
PSI
pounds per square inch
Prior to applying a nonrebreathing mask on a patient with difficult breathing you should A. set the flow rate to no more than 10 L/min. B. prefill the reservoir bag to ensure delivery of 100% oxygen C. insert a nasopharyngeal airway to maintain airway patency. D. perform a complete physical examination to determine the degree of hypoxia.
prefill the reservoir bag to ensure delivery of 100% oxygen
placenta abruption
premature separation of the placenta from the wall of the uterus
A 66-year-old female is in cardiac arrest and requires advanced airway management. Prior to inserting a Combitube, you should take standard precautions and then:
preoxygenate the patient with a bag-mask device and 100% oxygen
blood pressure
pressure caused by blood exerting force against the walls of blood vessels, usually arterial blood pressure is measured, diastolic/systolic
systolic blood pressure
pressure created in arteries when left ventricle contracts and forces blood out into circulation
diastolic pressure
pressure in arteries when the left ventricle refilling
Power lifts
prevent injury, good for those w/ weal knees/thighs
the initial treatment of choice for ventricular fibrillation of short duration, such as a witnessed cardiac arrest is A. 100% oxygen delivery B. prompt defibrillation C. CPR for 2 minutes D. cardiac drug therapy
prompt defibrillation
Your general impression of a 50-year-old man with acute abdominal pain reveals that he is confused and has pale, diaphoretic skin. After correcting any problems with airway, breathing, and circulation, your main focus should be on:
prompt transport to the hospital
Body Substance Isolation
protecting yourself from disease exposure
malleolus
protrusion on the side of ankle
You and your partner are the first to arrive at a potential crime scene involving a critically injured patient. The scene is safe. Your FIRST priority is to:
provide emergency care to the patient
While treating a man with severe chest pain and difficulty breathing, you are presented with a valid do not resuscitate (DNR) order by the patient's wife. She tells you that her husband does not want any "heroics." How should you manage this situation?
provide supportive care and transport the patient.
You receive a call to a restaurant where a 34 year old man is experiencing shortness of breath. When you arrive you immediately note that the man has urticaria on his face and arms. He is in obvious respiratory distress, but is awake and alert. the patient tells you that he does not have his own epinephrine; however, his wife is allergic to bees and has a prescribed epinephrine auto-injector. you should next. A. provide transport and consider an ALS rendezvous B. assist the patient with the wires prescribed epinephrine C. obtain consent from medical control to give the wife's epinephrine to the patient D. assist the patient with one half the usual dose of the wife's epinephrine.
provide transport and consider an ALS rendezvous
Prevention of cardiac arrest in infants and small children should focus primarily on A. keeping the child warm B. avoiding upsetting the child C. providing immediate transport D. providing airway management
providing airway management
A 60-year-old woman is experiencing severe respiratory distress. When you ask her a question, she can only say two words at a time. You should manage this patient by A. inserting a nasopharyngeal airway B. providing positive pressure ventilations. C. applying a nasal cannula set at 2 to 6 L/min. D. applying a nonrebreathing mask set at 15 L/min.
providing positive pressure ventilations.
You are managing a conscious patient who you believe is having an acute ischemic stroke. After administering oxygen, your next priority should include: A. providing prompt transport for possible fibrinolytic therapy. B. determining whether the patient has prescribed nitroglycerin C. closely monitoring the blood pressure D. completing a detailed physical examination before providing transport.
providing prompt transport for possible fibrinolytic therapy.
brachial pulse
pulse produced by compressing major artery of the upper arm
you should suspect potential abuse of a 4 year old child when you encounter A. bruises to the anterior tibial area B. curious siblings who are watching you C. purple and yellow bruises to the thighs D. clinging to the parent during your assessment
purple and yellow bruises to the thighs
peripheral pulses
radial, brachial, posterior tibial, dorsalis pedis pulses, which can be felt at peripheral (outlying) points of the body
Three types of communication
radio, verbal, interpersonal
While managing a patient with acute shortness of breath, you prepare and apply a nonrebreathing mask set at 12 L/min. The patient pulls the mask away from his face, stating that it is smothering him. You should next A. increase the oxygen flow and reapply the mask B. securely tape the oxygen mask to the patient's face C. reassure the patient and apply a nasal cannula instead D. inform the patient that refusing oxygen might result in his death
reassure the patient and apply a nasal cannula instead
left atrium
receives oxygenated blood returning from the lungs
right atrium
receives unoxygenated blood returning from the body
While ventilating an apneic 33-year-old man, you note that his stomach is becoming slightly distended. You should:
recheck and reposition his airway
After inserting the CobraPLA into your patient, you note that her tongue is protruding from her mouth. You should:
recognize that the device is not inserted far enough
An apneic 2-year-old child with a heart rate of 110 beats/min is being ventilated with a bag-mask device at a rate of 20 breaths/min. After 2 minutes of ventilations, you note that the child's heart rate is 80 beats/min. You should:
recognize that your ventilations are not adequate
A 56-year-old male complains of pain to the right upper quadrant of his abdomen and pain to his right shoulder; however, he denies pain in between his abdomen and shoulder. This is characteristic of:
referred pain
dorsal
referring to back of body
ventral
referring to front of body
primary function of autonomic nervous system
regulate unconscious or involuntary body functions
Prescribed inhalers, such as albuterol (Ventolin), relieve respiratory distress by A. constricting the bronchioles in the lungs. B. contracting the smaller airways in the lungs. C. relaxing the smooth muscle of the bronchioles. D. dilating the large mainstem bronchi of the airway.
relaxing the smooth muscle of the bronchioles.
hazardous-material incident
release of a harmful substance into the environment
decontamination
removal or cleansing of dangerous chemicals and other dangerous or infectious materials
You have applied a pressure bandage and additional dressings to a large laceration with severe arterial bleeding. The bandages are quickly blood-soaked. You should next A. elevate the extremity and apply a proximal arterial tourniquet B. apply pressure to the pulse point that is most distal to the injury C. place additional dressings on the wound until the bleeding stops D. remove the bandages and apply pressure at the site of the bleeding
remove the bandages and apply pressure at the site of the bleeding
During a bar fight, a 22-year old man was stabbed in the chest with a large knife. The patient is pulseless and apneic, and the knife is impaled in the center of his chest. management should include A. stabilizing the knife, starting CPR, and providing rapid transport B. stabilizing the knife, applying an occlusive dressing and providing rapid transport C. removing the knife, starting CPR, and providing rapid transport D. removing the knife, applying an occlusive dressing, and providing rapid transport.
removing the knife, starting CPR, and providing rapid transport
A 29-year-old male with a history of type 1 diabetes presents with excessive urination and marked thirst. These signs indicate that the:
renal system is excreting excess glucose
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. While en route to the hospital with the male patient, you begin a detailed physical exam. During the exam, you note that the patient's respiratory rate has increased. You should A. immediately notify the receiving facility B. count the number of respirations per minute C. assess his oxygen saturation with a pulse oximeter D. repeat the initial assessment and treat as needed
repeat the initial assessment and treat as needed
You have just established an IV on a critically injured patient. As you prepare to dispose of the needle in the appropriate container, you get stuck with the needle. You should:
report the incident to your supervisor as soon as possible
When arriving at a multi casualty scene which other ambulance have arrived you should
report to the incident commander
You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
retreat at once and call law enforcement
You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement "He has a gun!" At this point, you should:
retreat immediately and call law enforcement.
pulse
rhythmic beats caused as waves of blood move through and expand arteries
cricoid cartilage
ring-shaped structure that forms the lower portion of larynx
A 69-year-old male with a history of hypertension and insulin-dependent diabetes complains of an acute onset of tearing pain in the lower quadrants of his abdomen that radiates to the back. His blood pressure is 90/50 mm Hg, pulse is 110 beats/min and thready, and respirations are 24 breaths/min and shallow. This clinical presentation is MOST consistent with:
ruptured or dissecting aortic aneurysm
gallbladder
sac on underside of liver that stores bile produced by the liver
A set of regulations and ethical considerations that define the extent or limits of an EMT-Basic's job is called A. a duty to act B. confidentiality C. scope of practice D. the Medical Practices Act (??? can't read this for sure)
scope of practice
When preforming Spinal immobilization which section do you secure to the backboard first?
secure torso on backboard before securing, the head to the backboard
SAED
semi automatic external defribrillator
The position of comfort for a patient with nontraumatic chest pain most commonly is A. semisitting B. lateral recumbent C. on the side with the head elevated D. supine with the legs elevate slightly
semisitting
The wall that separates the left and right sides of the heart is the A. carina B. septum C. pericardium D. mediastinum
septum
good samaritan laws
series of laws varying in each state designed to provide limited legal protection for citizens and some health care personnel when they are administered care
Function of the pre-hospital care report
serves as a baseline to gauge improvement/deterioration in continued care (TRENDING)
scope of practice
set of regulations and ethical considerations that define the scope, or extent and limits of the EMT's job
Kidney stones
severe cramp pain radiating to groin, with restlessness, N&V
A 50-year-old male with a blood sugar level of 38 mg/dL would be expected to present with all of the following, EXCEPT:
severe dehydration
Dissecting Aortic Aneurysm
severe tearing knifelike pain, radiatinq from chest throuah to back, unequal pulses/BP (putsating abdominal mass)
When assessing a patient with a reduction in tidal volume, you would expect the respirations to be A. deep B. labored C. shallow D. dyspneic
shallow
S/S of hypothermia
shivering stops and muscular activity decreases/stiffness; no muscle coordination; lethargic; confused; sleepy; altered mental status; may try to remove clothing; decreased LOC; weak pulse and slow respirations; low BP or none; loss of sensation to touch; mood changes; impaired judgement ○ Hypothermia ● Shivering ● Clumsiness or lack of coordination ● Slurred speech or mumbling ● Stumbling ● Confusion or difficulty thinking ● Poor decision making, such as trying to remove warm clothes ● Drowsiness or very low energy ● Apathy, or lack of concern about one's condition ● Progressive loss of consciousness ● Weak pulse ● Shallow breathing ● when you stop shivering is when your about to die
When should the Trauma assessment be done?
should be done before and after any treatment, not wait until transport.
bones of the upper extremity
shoulders, arms, forearms, wrists, hands (p 157) i. phalanges ii. metacarpals iii. carpals iv. radius v. ulna vi. humerus
When a patent is "Posturing"
sign of intracranial pressure:
cyanosis
sign that adequate perfusion is not accomplished
SAMPLE
signs & symptoms, allergies, medical history, past medications, last oral intake, event that led to injury/illness
fowler's position
sitting position
appendix
small tube located near the junction of the small and large intestines in right lower quadrant of abdomen
arteriole
smallest kind of artery
venule
smallest kind of vein
Muscles found in walls of organs
smooth
cardiac muscle
specialized involuntary muscle found only in the heart
Prior to your arrival at the scene, a near-drowning victim was removed from the water. You should manage the patient's airway appropriately while considering the possibility of A. spinal injury B. hyperthermia C. internal bleeding D. airway obstruction
spinal injury
miscarriage
spontaneous abortion
A 77-year-old male with a history of emphysema complains of an acute worsening of his shortness of breath and pleuritic chest pain that occurred after a forceful cough. Auscultation of his lungs reveals scattered wheezing on the left side and diminished breath sounds on the right. This patient's clinical presentation is MOST consistent with:
spontaneous pneumothorax
You are dispatched to the scene of a motorcycle crash in which two patients were injured. Upon arrival, you find that one patient, a 19-year-old woman, is conscious and alert and is being tended to by a police officer for minor scrapes and cuts. The second patient is a 20-year-old man who is found facedown approximately 25' from the motorcycle. he states that he cannot feel or move his legs. Neither patient was wearing a helmet. After taking body substance isolation precautions, you begin your initial assessment of the man. Your first action should be to A. apply an extrication collar B. stabilize his head manually C. evaluate the patency of his airway D. roll him to a supine position
stabilize his head manually
A 56-year-old male with a history of coronary artery disease complains of an acute onset of substernal chest discomfort and diaphoresis while moving a heavy box. After sitting down and taking one nitroglycerin tablet, the discomfort promptly subsides. This episode is MOST consistent with:
stable angina pectoris
anatomical position
standard reference position for the body, body stands erect facing the observer with arms down at sides and palms of hands forward
While attempting resuscitation of a patient in cardiac arrest, you initiate CPR, defibrillate the patient with an AED, and insert a multilumen airway prior to contacting medical control. What does this scenario most accurately describe?
standing orders
You are dispatched to a residence for a 60-year-old diabetic male who is unresponsive. As you are assessing the patient, your partner attempts to obtain a blood glucose reading; however, the glucometer reads "error" after two attempts. You should manage this patient's airway appropriately and then:
start an IV and administer 50 mL of 50% dextrose
stress
state of physical and or psychological arousal to a stimulus
A 55-year-old male sustained partial-thickness burns to his face and neck when he opened the hot radiator cap on his car. He is conscious and alert, but complains of dyspnea and difficulty swallowing. His oxygen saturation is 96% on room air. You should be MOST concerned about the:
status of his airway
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. The man's wife states that he had cardiac by-pass surgery approximately 6 months earlier. There are no signs of trauma. Your first action in the management of this patient should be to A. attach an AED and analyze the cardiac rhythm. B. check the effectiveness of the CPR in progress. C. insert an oropharyngeal airway and continue CPR D. stop CPR so you can assess pulse and breathing
stop CPR so you can assess pulse and breathing
A 38-year-old male with an inguinal hernia complains of increased pain and nausea. He tells you that he has been able to reduce the hernia himself in the past, but it will not reduce today. This patient is at GREATEST risk for:
strangulation of the bowel
standard precautions
strict form of infection control that is based on assumption that all blood and other body fluids are infectious
C.V.A.
stroke
valve
structure that opens and closes to permit the flow of a fluid in only one direction
anatomy
study of body structure
You respond to a residence for a 27-year-old male with an altered mental status. As you are assessing him, his girlfriend tells you that he does not have any medical problems that she is aware of; however, he did fall two days ago and struck his head. These clinical and historical findings should make you MOST suspicious for:
subdural hemorrhaging
Exceptions to confidentiality
subpoena, other healthcare people treating, mandatory reporting, insurance
Immediately upon delivery of a newborn's head, you should first A. dry the face B. cover the eyes C. suction the nose D. suction the mouth
suction the mouth
You are dispatched to the scene of a shooting. Upon arrival, you are directed by law enforcement to the patient, a 44-year-old male, who is unconscious. He is lying in an impressive pool of blood and you can hear gurgling from his mouth when he breathes. After your partner assumes C-spine control and opens the patient's airway, you should:
suction the patient's oropharynx
A 72-year-old male with a tracheal stoma requires ventilatory assistance. However, when you attempt to ventilate, you meet resistance. You should:
suction the stoma and mouth
40-year-old male is unconscious, has inadequate breathing, and is producing copious, continuous secretions from his mouth. This situation is MOST effectively managed by:
suctioning for 15 seconds and ventilating for 2 minutes
Least likely pt to commit suicide
suicide pg 862 ○ Males are four times more likely to commit suicide, yet women make three times as many attempts
Most likely pt to commit suicide
suicide pg 862 ○ Males are four times more likely to commit suicide, yet women make three times as many attempts
ilium
superior and widest portion of pelvis
manubrium
superior portion of sternum
venae cavae
superior vena cava and inferior vena cava, these two major veins return blood from body to right atrium
perfusion
supply of oxygen to and removal of wastes from the cells and tissues of body as a result of the flow of blood through capillaries
Shunt
surgical procedure for dialysis patients (patients with kidney failure), brings an artery closer for access during dialysis. Do not take blood pressure on the arm with a shunt. (also known as a 'fistula')
Dependent edema
swelling of 'dependent' parts: parts lower than rest of body; feet, hands if hanging down, the back if bedridden (sacral edema)
digestive system
system by which food travels through body and digested, or broken down into absorbable forms
cardiovascular system
system made up of heart( cardio) and blood vessels (vascular), circulatory system
musculoskeletal system
system of bones and skeletal muscles that support and protect the body and permit movement
nervous system
system of brain, spinal cord, and nerves that govern sensation, movement, and thought
endocrine system
system of glands that produce chemicals called hormones that help to regulate many body activities and functions
respiratory system
system of nose, mouth, throat, lungs, and muscles that brings oxygen into body and expels carbon dioxide
cardiac conduction system
system of specialized muscle tissues which conduct electrical impulses that stimulate the heart to beat
S/S of hyperthermia
tachycardia, hyperthermia, rigidity, temp 105-106 Tx: Cool pt down i. Elevated core temperature ii. Muscle cramps iii. Weakness or exhaustion iv. Dizziness or faintness v. A rapid pulse that is usually strong at first, but becomes weak vi. Initial deep, rapid breathing that becomes shallow and weak as damage progresses vii. Headache viii. Seizures ix. Loss of appetite, nausea, or vomiting x. Altered mental status, possibly unresponsiveness xi. Skin is either moist and pale with normal to cool temperature, or hot and either dry or moist ( hot skin that is dry or moist = dire medical emergency)
advocacy def
taking action to influence others to address a health-related concern or to support a health-related belief
You are dispatched for a young male who, according to witnesses, is "not acting right." The patient is found sitting on the ground outside of a grocery store, rocking back and forth. He has blood on his arm from an apparent wound to his wrist. You should:
talk to him as you approach him, but be prepared for him to turn violent
Abdominal Aneurvsm
tear between layers of the aorta creating a balloon effect, often fatal, bleeding (may feel pulsating mass in abdomen)
T.I.A
temporary signs of a stroke
compassion def
the humane quality of understanding the suffering of others and wanting to do something about it
tibia
the medial and larger bone of lower leg
What to worry about Electrical injury
the most serious injury may be expected at the 'exit' wound site. Also suspect internal damage, irregular pulse. (use moist dressing)
In dark skinned patients the EMT can check the following areas:
the nailbeds and around the lips
Most useful information received from dispatch
the nature of the call and location"-Q49
When Driving on bridges/overpasses
they tend to freeze sooner in cold weather so use caution, and slow down
arteriosclerosis def
thickening and hardening of the walls of the arteries, can also decrease the blood supply to the brain and cause a decrease in mental abilities
capillary
thin-walled, microscopic blood vessel where the oxygen/carbon dioxide and nutrient/waste exchange with body' cells takes place
You are at the scene where a man panicked while swimming in a small lake. As you attempt to rescue this patient, you should first A. throw a rope to the patient B. row a small raft to the patient C. swim to the patient to rescue him D. attempt to grab the patient with a stick
throw a rope to the patient
muscle
tissue that can contract to allow movement of a body part
ligament
tissue that connects bone to bone
tendon
tissue that connects muscle to bone
lateral
to the side, away from midline
Hypotension
too low for needs of body
cranium
top, back, sides of skull
medial
toward midline
superior
toward the head
High risk activities?
transfer of care, medical errors, carrying patients, ambulance crashes, lack of spine immobilization
SCENARIOS: 51-150 You respond to a nursing home's call regarding an older patient who fell. During your assessment, you note injuries that are not consistent with the mechanism described. You should:
transport the patient and report your suspicions
torso
trunk of body, body without the head and extremities
Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. You should manage this situation initially by A. clamping and cutting the umbilical cord B. gently pulling on the cord to facilitate removal C. trying to remove the cord from around the neck. D. keeping the cord moist and providing rapid transport
trying to remove the cord from around the neck.
maxillae
two fused bones forming the upper jaw
bronchi
two large sets of branches that come off trachea and enter lungs, right and left bronchi
ventricles
two lower chambers of heart, right ventricle sends oxygen -poor blood to lungs and left ventricle sends oxygen-rich blood to body
artria
two upper chambers of heart
You arrive at the scene of an overturned semi-trailer truck. There is an odd odor in the air and you can see material leaking from the truck. After ensuring that fire department and law enforcement personnel are notified, you should:
use binoculars to try to read the placard
The 'V' in AVPU stands for:
verbal
Lumbar spine
vertebrae that make up the lower back
Cervical spine
vertebrae that make up the neck
Thoracic spine
vertebrae that make up the upper back
pulmonary arteries
vessels that carry blood from the right ventricle of heart to lungs
pulmonary veins
vessels that carry oxygenated blood from lungs to left atrium of heart
Sacral spine
vetebrae that make up the pelvis
larynx
voice box
Hematemesis
vomiting bright red blood
When you happen uppon Evidence at a crime scene
whenever possible don't disturb evidence, report any changes made to scene. Unless you like going to court then you can touch whatever you like.
When dealing with an emotionally disturbed patient, you should be concerned with A. providing safe transport B. whether the patient could harm you C. obtaining a complete medical history D. gathering all of the patient's medications
whether the patient could harm you
uterus
womb
carpals
wrist bones
Treatment of drug overdose
■ Activated Charcoal ■ ALS: Narcan or other agonist
Components of CNS and what they are responsible for
■ Brain - the control center of the nervous system ■ Spinal cord - Conduction of nerve impulses
BLS HCP AED
■ CPR old ■ Airway, Breathing, Chest compressions ■ (A-B-C) ■ Previously, after responsiveness was assessed, a call for help was made, the airway was opened, the patient was checked for breathing, and 2 breaths were given, followed by a pulse check and compressions. ■ Compressions were to be given at a rate of about 100/min. Each cycle of 30 compressions was to be completed in 23 seconds or less. ■ ■ Compression depths were as follows: ■ Adults: 1½ to 2 inches ■ Children: one third to one half the diameter of the chest ■ Infants: one third to one half the diameter of the chest ■ ■ CPR NEW ■ Chest compressions, Airway, Breathing (C-A-B) ■ New science indicates the following order: ■ 1. Check the patient for responsiveness and no breathing. ■ 2. Call for help and get the AED ■ 3. Check the pulse. ■ 4. Give 30 compressions. ■ 5. Open the airway and give 2 breaths. ■ 6. Resume compressions. ■ Compressions should be given at a rate of at least 100/min. Each set of 30 compressions should take approximately 18 seconds or less. ■ ■ Compression depths are as follows: ■ Adults: at least 2 inches (5 cm) ■ Children: at least one third the depth of the chest, approximately 2 inches (5 cm) ■ Infants: at least one third the depth of the chest, approximately 1½ inches (4 cm) ■ ■ AED USE IS UNCHANGED ■ For children from 1 to 8 years of age, an AED with a pediatric dose-attenuator system should be used if available. If an AED with a dose attenuator is not available, a standard AED may be used. For infants (<1 year of age), a manual defibrillator is preferred. If a manual defibrillator is not available, an AED with a pediatric dose attenuator is desirable. If neither is available, an AED without a dose attenuator may be used.
Stages of delivery
■ Cervix Dilation phase ■ Expulsion phase ■ Placental phase
Def and description of each: DCAP-BTLS
■ Deformities ■ Contusions ■ Abrasions ■ Punctures/PENETRATION ■ Burns/Bleeding ■ Tenderness ■ Lacerations ■ Swellings
Type of injury caused by hanging
■ Distraction
Types of muscle and their location
■ Involuntary/smooth- Found in the walls of organs ■ Cardiac- Found only in the walls of the heart ■ Voluntary- Most voluntary muscles are attached at one or both ends to the skeleton
What to do if female pt put a bean in her ear
■ lol wtf -- hahaha ask how old she is then rinse with saline! really. and i don't know why! ■ If it's visible, get foreceps/tweezers and remove. If not visible, load and go
assault: def and parameters
○ A willful threat to inflict harm on a patient
Inadequate breathing S/S
○ Abnormal work of breathing ○ Abnormal breath sounds ○ Reduced minute ventilation ○ Inadequate chest wall movement or chest wall injury ○ Irregular respiratory pattern (head injury, stroke, metabolic derangement, toxic inhalation) ○ Rapid respiratory rate w/o clinical improvement in the pt's. condition
Resp rates for infants, peds, adults, and seniors
○ Adult = 8-24 per minute (i think its 8-20) (elderly often have resting resp. rates of 20) ○ I believe that 8-24 is the proper range for adults, but a more precise range is 12-20 ○ Peds = 15-30 per minute ○ Infants = 25-50 per minute
The most radiant heat loss occurs from what
○ Body heat is lost to the atmosphere or nearby objects without physically touching them.
COPD parameters: Assessment S/S Teatment
○ COPD is Chronic Obstructive Pulmonary Disorder. It is a generic term used to describe a variety of conditions with similar pathologies, namely a decreased ability to inhale. Think of the lung as being
Silent MI in elderly: least common complaint
○ Chest Pain, believe it or not pg. 1288
negligence
○ Deviating from an accepted standard of care through carelessness, inattention, disregard, inadvertence, or oversight
Signs/Symptoms of shock
○ Early signs i. restlessness, anxiety, irritability ii. increased heart rate iii. pale, cool skin iv. slightly increased resp. rate v. slightly decreased body temp Late signs - apathy, confusion, slowed speech - tachycardia - slowed, irregular, weak, thready pulse - decreased BP - cold, clammy, pale skin - rapid breathing - severly decreased body temp. check protocall book for s/s of shock as well.
Crime scenes
○ Enter only when safe to do so. ○ Preserve all evidence ○ Ensure victims do not unintentionally destroy evidence. ○ Protect patient's dignity/be an advocate
O2 flow for nasal canula, non-rebreather, and BVM
○ For adequate breathing... i. Non-rebreather mask = 12-15 lpm ii. Nasal cannula = 6 lpm iii. simple face mask=up to 60% O2*6-10 lpm iv. partial rebreather mask*6-10 lpm v. venturi mask*low flow no more than*6lpm? vi. tracheostomy mask=used for medications, only delivers 50% O2? ○ For inadequate breathing... i. BVM w/ 12-15 lpm O2
What protects EMT from sharp objects in extrication
○ Gloves, clothing, etc. turn-outs? ○ Protective eyewear
Indication of HOT DRY skin
○ Hot- either from environment or elevated core temperature ○ Dry- dehydrated, or severe heat exposure (heat stroke); or certain medical emergencies
abandonment: def and parameters
○ If an EMT stops treatment of a patient w/o transferring the care to another profession of an equal or higher level of training, cert., or license. Also to an inappropriate medical professional. ○ The EMT must give an oral report to a physician, nurse or other healthcare worker who is qualified to care for the patient and injuries
Parameters of siren operation
○ Only when authorized by dispatch or a true emergency
How to communicate with a deaf person
○ Paper and pen/sign language
EMT's role in a WMD situation
○ START triage
EMT's role in a disaster
○ START triage
What should a pt's tounge do whena laryngoscope is inserted
○ Should go down and not block their airway
Restraint parameters: Assessment S/S Teatment
○ Soft restraints for "diggy butts"-lol ○ Other restraints "HARD restraints"for violent or potentially violent patients ○ Medical direction should be consulted prior to application ○ Once you restrain an individual, the restraints cannot be removed.
Parameters of suction
○ Suction on way out only i. Adults = ≤15 seconds ii. Peds/Infants = ≤5 seconds
Worse complication of anaphylacsis
○ The complication (airway obstruction) is that the allergic reaction is so bad that the airway becomes constricted therefore the patient cant breath then leading to death
CHF parameters: Assessment S/S Teatment
○ This is when there is an imbalance of load volumes between the systemic and pulmonary circuits of the heart. A backup of blood in the left (systemic) side causes pulmonary edema (interstitial fluid pooled in the lungs) whereas a backup of blood in the right (pulmonary) side of the heart causes pedal edema (interstitial tissue pooled in the extremities, particularly the feet) ○ This is a function of VENTRICULAR failure, NOT ATRIAL failure.
Prehospital: what is it used for and what is it not used for
○ To make sure one stays alive long enough to get into a hospital. ○ Maximize the platinum ten and golden hour.
When is an EMS provider most likely to be injured
○ Trying to lift Rosie O' Donnell? Yeah it'll hurt your back and then she'll sock you in the face for trying to help her! That is a scary woman! And then eat you. ○ OM-NOM-NOM!!!!
breach of duty: def and parameters
○ When the EMT deviates from the standard of care
when not to use the jaw-thrust
○ When there is a suspected spinal injury or if you suck at head-tilt chin-lift
Allergic reaction parameters: Assessment S/S Teatment
○ allergic refers to your basic hives, itchy, red, tender deal. ○ Anaphylaxis refers to when the allergic rxn interferes in any way with the respiratory system
Anaphylactic reaction parameters: Assessment S/S Teatment
○ allergic refers to your basic hives, itchy, red, tender deal. ○ Anaphylaxis refers to when the allergic rxn interferes in any way with the respiratory system
When a child is placed in supine position, what the head may tend to do
○ block the upper airway? correct me if i'm wrong.
Bleeding control and soft tissue injuries: -Tx for -physiology of
○ direct pressure, and if that doesn't work, tourniquet ○ direct pressure, elevate, and if blood loss is still significant, tourniquet
Airway management in different scenarios (C-spine, stoma, infant, )
○ keep it open. :) ○ reassess, reassess, reassess!!!
Indication of high-pitched sounds from pt's airway
○ possible obstruction in the upper airway and/or bronchoconstriction
What abdominal organs store and secrete
○ the pancreas is the only organ i remember that "secretes" anything- pancreatic juices aid in digestion, and insulin regulates sugars in blood ○ The Liver is a organ and also considered a gland because, among its various functions, it makes and secretes bile.
Def of trends and when they should be documented
○ vital signs- after taking a set of baseline vitals, reassess every 5 minutes in the unstable pt. and every 15 in the stable pt.
Reassessment times
● 15 mins for stable patient ● 5 mins for unstable patient ● 2min for an intervention ● 30sec post-resuscitation
Stages of seizures
● aura, Loss of consciousness, tonic, hypertonic, clonic, postictal state.
Causes of injury in adults/peds
● brain injury/stroke for adults ○ high fever for peds
Arteries to place direct pressure for various injuries
● for severe bleed= brachial and femoral
Descriptions of different types of impact
● frontal ● rear ● lateral ● rotational/rollover,
Best carrying device for spinal injury
● long back board
Simple vs complex extrication
● simple=window or door ○ complex=tearing the roof off
S/S of stimulant overdose
● tachycardia/apnea ● dilated pupil size ● dry mouth ○ increased blood pressure ○ excitability, elevated mood, agitation, apprehension
Hazards that make every scene potentially dangerous
● why do we have to wear bsi? blood borne pathogens