NREMT AEMT

You are on scene at the local health club with a 42-year-old accountant who was working out after work. Bystanders report that the patient had been running on the treadmill for an hour when he "passed out," hitting his head on the floor as he fell. The patient has a weak, rapid pulse, and hot, dry skin. A manual blood pressure reads 70/P. What component of stroke volume is most likely the cause of the patient's condition?

Decreased preload *Factors affecting preload include blood volume, volume of blood returned to the heart, and strength of atrial contraction. A dehydrated and hypotensive patient with have problems with blood volume.

In the human heart, the right ventricle pumps what?

Deoxygenated blood to pulmonary circulation

You have been dispatched to a 72-year-old male with chest pain and you arrive on scene to find him supine on the floor. It is unknown how long he has been down, and your initial assessment reveals that he is pulseless and apneic. You should immediately?

Do 5 rounds of CPR before attaching the AED *If you don't see the patient go down, start with 5 cycles of CPR.

You are conducting a physical exam on a 76-year-old female patient. During your assessment, you conclude that the patient may be experiencing serious heart problems. Which of the following is the best indicator of this?

Irregular pulse

Someone who is in decompensated shock can no longer do which of the following?

Maintain preload *

Which drug should be withheld from a patient with a right-sided MI?

Nitroglycerin *Nitro reduces preload and patient with a r. sided MI is already experiencing this so Nitro will exacerbate the situation.

You are called to a private home where a 4-year-old female is experiencing cardiac problems. Which of the following is NOT a useful indicator of hypoperfusion in this case?

Oxygen saturation *Too unreliable

When performing chest compressions, what should you allow time for between each compression?

Recoil

You are on the scene w/ a 28-year-old female patient complaining of chest pain. A 12-lead shows normal sinus rhythm with a pulse of 88 bpm. What structure of the cardiac conduction system is responsible for this rhythm and rate?

SA Node *"Primary pacemaker"- intrinsic rate of 60-100bpm.

The left coronary artery supplies blood to all of the following areas of the heart except which?

The inferior wall of the left ventricle *R. coronary artery supplies blood here

What heart rhythm often leads to ventricular fibrillation?

Ventricular tachycardia

You are called to an unknown "patient down" at a private residence. As you get inside and into the back bedroom, you can see that there is a woman face down and motionless. She does not appear to be conscious and there is a pool of saliva next to her head. You and your partner maintain spinal precautions as you get her onto her back. The husband states that she has a history of heart problems, takes a lot of medications, and has no allergies. What would you do next?

Verify the absence of a carotid pulse and begin CPR. *C-A-B. Pulse, then CPR.

An action potential begins in a myocardial cell when __ enters the cell, giving it a __ charge.

sodium, positive

Why must you question a patient about ED drug use prior to administration of nitroglycerin?

Administration of nitroglycerin can cause dangerous hypotension if there has been recent ED drug use. *Both drugs are vasodilators.

When you enter the home, you find a 56-year-old male sitting on a chair, leaning forward. He is holding his chest and breathing rapidly. He says that he feels like an elephant is sitting on his chest. He is also feeling dizzy and nauseated. The pain has occurred suddenly, within the last 30 minutes. His symptoms suggest that he is experiencing which of the following?

Angina pectoris *It is slowing leading to an MI.

Which of the following is not an intrinsic cause of cardiogenic shock?

Cardiac tamponade *Extrinsic, not intrinsic

You are responding to an unresponsive child at a school playground. You arrive to find a 10-year-old male unresponsive, pulseless, and apneic. Teachers on scene say the child was hit with a softball in his chest and fell to the ground. What is the most likely cause for the patient's sudden cardiac arrest?

Commotio Cordis *Direct blow to the chest during the heart's repolarization period causes the patient to go into v-fib. Early defibrillation is best treatment.