Emergency medicine

As you reach scene

- follow instructions of incident commander - don appropriate personal protective equipment

Windshield report

Brief description of scene given to communications. Done before responder leaves the vehicle

What is the sequence if the patient appears lifeless, no pulse (immediate interventions may be needed)

C-A-B

Lymphatic system function

Capture fluid and maintain balance of fluid

Automaticity

Cardiac

Epiglottis

Closes over glottis

Three situations may require the use of an emergency move

Hazardous scene care of life-threatening conditions that require repositioning the necessity to reach other patients

Cardiogenic

Heart fails to pump

Platelets

Help with clotting

Renal system function

Helps the body regulate fluid levels, filter chemicals, and adjust body pH

Hypertension

High blood pressure

Hypercapnea

High carbon dioxide level

Unstable

Threat to ABC

Tachycardia

Too fast

Bradycardia

Too slow

Ureters

Transport urine to bladder from kidneys

What should you do if the emergency move is required

Try to move the patient in line with the long axis of the spine

Four chambers

Two atria two ventricles

Power grip

Use as much hand surface as possible hands ten inches apart

Larynx

Voice box

Hydrostatic pressure

Water pushed back out of blood vessels toward cells

White blood cells

White blood cells, leukocytes, white corpuscles

Blood dysfunction

Without enough blood, oxygen and carbon cannot be properly moved around - bleeding -dehydration -anemia - liver failure

Gliding

Wrist

Prehospital care report (PCR)

Written documentation of everything that happened during call there are several forms - handwritten -laptop -electronic tablet - web based

Exhalation

Passive process

spinal column

- 33 - movement, sensation, and vital functions

Focus on life threats

- Airway (A) - breathing (B) - Circulation (C)

Verbal report

- Also referred to a the bedside report - given upon arrival at destination - introduce patient by name - give complete and detailed report - written notes are a bonus

General impression

- Assesses environment, patient's chief complaint, and appearance - helps determine patient severity - helps set priorities for care and transport

OPQRST- (AS/PN)

- Associated signs - pertinent negatives

Lungs

- Bronchi - Alveoli

What do prove with negligence claim

- EMT had duty to act - breach of duty - proximate causation

The rapid medical exam

- In-responsive or AMS - unknown issues

General impression: look test

- feeling from environmental observations as well as first look at patient

Blood pressure

- The force against the walls of the blood vessels

Verbal

- a patient that is only responsive to verbal stimuli may appear lethargic when you approach the scene - as you speak loudly to the patient, they are able to respond

Physcial examination: look for

- abnormalities in symmetry - color - shape - movement

Perfusion

- adequate circulation of blood and exchange of oxygen and waste products

Consent for mentally incompetent adults

- adult patients incapable of informed decisions about care - state and local laws and protocols permit transport of such patients under implied consent

AVPU

- alert - verbal - painful (tactile) - unresponsive

Hypersensitivity

- allergic reaction to certain food, drugs, other substances - result of exaggerated immune response

Safe haven laws.

- allow person to drop an infant or child at any fire, police, or EMS station -states have different guidelines for ages of children included - protect children who may otherwise be abandoned or harmed by parents unwilling or unable to care for them

Findings that may indicate critical patient

- altered mental status - anxiety - pale, sweaty skin - obvious trauma to head, chest, abdomen, pelvis - specific positions indicating distress

Pediatric physcial exam

- apprach frightened children slowly - start from the least invasive parts to the most invasive -start with the toes or trunk and work your way toward the head - explain all equipment to the child before use - never lie to a child about something that hurts - provide for the patient's privacy

Physical examination

- areas assessed depend on injuries and chief complaint - mechanism of injury may point to potential injuries

Genitals

- as needed based on situation and injury - also check for priapism

Circulation

- assess pulse - assess skin - assess bleeding - signs/symptom of shock

Patient care report

- assessment and treatment - conveys picture of scene -entered into patients permanent medical record

What does it mean to be alert

- awake, answering questions

Radio systems- EMS radio systems consist of

- base station - mobile radios - portable radios - repeaters

Diagnosis is label for condition

- based on history, physical examination, vital signs - involves both physical and intellectual activity

Fluid balance

- brain and kidneys regulate thirst and elimination of excess fluid - blood plasma proteins pull fluid into bloodstream - cell member and and capillary permeability regulate flow in and out

Legal document

- can be subpoenaed and used as evidence -may help patient win a case -may be used against you in case of negligence

Pediatric trauma exam: extremities

- capillary refill and distal pulse - check for painful, swollen, and deformed injury sites

Pediatric trauma: chest

- check for even breath sounds - check for symmetry, bruising, paradoxical movement, and retraction

Circulation bleeding

- check for signs of major bleeding - gross blood sweep

Head

- check head - check face - check neck (step off, JVD, tracheal deviation

Pediatric trauma exam: pelvis

- check stability of pelvic girdle

Detailed verbal report: elements of report

- chief complaint - history or present illness/injury -assessment findings, including pertinent negatives -treatment given and response -complete viral signs

Alert and oriented, specific complaint

- chief complaint - physcial exam

Repeat assessments

- chief complaint may change, especially with regard to severity - ask about changed in symptoms, especially ones anticipated because of treatments administered - repeat physical exam to identify changes from baseline - check any interventions

Mandatory reporting guidelines

- child, elderly, or domestic abuse - sexual assault - stab/gunshot wounds -animal attacks - check local laws and protocols

Steps for when you reach the distal portion of each extremity

- circulation - sensation - motor function

Reaching a diagnosis

- clinicians have different levels of training, experience, time, technology, and other resources - techniques vary amount types of clinicians

Pelvis

- compression - flexion

What are examples of evidence

- condition of scene - patient - fingerprints and footprints - microscopic evidence

Thorax

- contains the heart, lungs, and major blood vessels

Negative side effects of positive pressure ventilation

- decreasing cardiac output/dropping blood pressure - gastric distinction - hyperventilation

DCAP-BTLS

- deformities - contusions - abrasions -punctures/ penetrations - burns - tenderness - lacerations - swelling

Administrative

- demographic information -insurance information -billing address

Nervous system history

- determine patients mental status - determine patients normal state of mental functioning - obtain history of neurological conditions - note patients speech

Endocrine system history

- diabetes mellitus or thyroid disease history - current medications and whether being taken properly - whether patient has eaten or exerted energy at an unusual level - whether patient is sick - whether patient has taken blood glucose or uses insulin pump

If in doubt about refusal

- discuss decision with patient - ensure patient understands risks -consult medical direction -ask to contact family member -contact law enforcement -listen to patient to determine why refusing care

Pediatric trauma exam: head

- do not apply pressure to fontanelles - collisions can produce head injuries

Legal document expressing patients wishes if patient unable to speak for self

- do not resuscitate order (DNR) - living will - health care proxy (power of attorney POA)

Check interventions

- ensure adequacy of oxygen delivery and artificial ventilation - ensure management of bleeding - ensure adequacy of other interventions

Establish danger zone

- evaluate hazard and restrict area based on threat level - different hazards require different-sized danger zones - when a hazmat material is involved, where do we find this information?

Endocrine system physical exam

- evaluate patients mental status - observe the patient skin - obtain a blood glucose level - look for an insulin pump - look for medical jewelry

when to reassess

- every 15 minutes for stable patient - every 5 minutes for unstable or potentially unstable patient

Cardiovascular system history

- existing cardiac conditions and medications - signs and symptoms of episode - description of chest pain using OPQRST - determine specific characteristics of discomfort

Communicate with patient

- explain process - consider patients feelings, such as anxiety or embarrassment - prepare patient for transfer of care

Ventilation

Both inhaling and exhaling

Mechanism of injury

- forces that caused the injury - understanding forces can predict injury patterns - can be very useful in predicting injuries associated with certain types of motor vehicle crashes

Steps for primary assessment

- general impression (c-spine decision) - mental status - ABCs - priority for transport

What the three main functions of the Musculoskeletal system

- gives the body shape - protects vital internal organs - provides for body movement

Good Samaritan laws

- grant immunity from liability if person acts in good faith within level of training .- rarely applies to on-duty personnel - may not cover EMTs in some situations -does not protect persons from gross negligence or violations of law

Things to consider during refusal

- have witnesses to refusal - inform patient that if changes mind, can call back - if possible, have friend or relative remain with patient - DOCUMENT

Up and over injury pattern

- head on collision - head hits windshield - starring/spidering - chest/abdomen strike steering wheel

Down and under injury pattern

- head on collision - knees strike dashboard - concern for major bleeding

Cardiovascular system

- heart - blood - blood vessels

Severe fall

- height from which patient falls - surface patient fell onto - part of patient that hit ground - anything that interrupted fall

history taking techniques

- history is obtained by talking to the patient - if the patient is unable to respond, gather information From family members, bystanders, medications present, other things you observe at the scene - develop a rapport with the patient - ask open-ended questions - only use close-ended questions if you need an immediate answer

Immune system history

- history of allergies ( exposure to known allergens) and ( what are typical reactions like) - history of asthma - symptoms of tightness in chest or throat - GI distress, itchiness, or rash - medications for allergic reaction

What are the two types of radio reports

- hospital notification - medical command consult

Standard of care

- how you should do it - care expected from EMT with similar training for patient in similar situation - meeting standard of care reduced risk of legal action

While speaking on the radio DOS:

- if number might be unclear, say number and repeat individual digits - use objective, impartial statements - use "we" instead of "I" - "affirmative" and "negative" preferred over "yes" and "no"

Other radio procedures

- if two units transmit simultaneously, only one will be heard - dispatch often confirms receipt of transmission by repeating part of it back - dispatch will end transmission with time for documentation - carry portable radio whenever you leave unit - radios need proper care and maintenance

Pertinent negatives

- important negative findings

Consent for children possible exceptions

- in loco parentis - emancipated minors - life threatening illness or injury

Past medical history (PMH)

- information gathered regarding the patients health problems in the past - obtained using sample

History of the present illness (HPI)

- information gathered regarding the symptoms and nature of the patient's current concern - obtained using OPQRST

Blunt-froce trauma

- injury caused by a blow that strikes body but does not penetrate skin or other body tissues - signs are often subtle and easily overlooked - maintain index of suspicion based on mechanism of injury

Muculoskeletal system physcial exam

- inspect for signs of injury, such as deformity - palpate areas with suspected injury - compare sides for symmetry - be alert for crepitiation - assess patient head- to -toe of there are multiple injuries or if the patient is unresponsive

Immune system physcial exam

- inspect point of contact with allergen - inspect patients skin for rash or hives - inspect he face, lips, and mouth for swelling - listen to the patient speak - listen to lungs to ensure adequate breathing

Three techniques for physical examination

- inspection - palpate on - auscultation

Pediatric trauma: airway

- keep infants head in neutral position - keep child's head in neutral plus of sniffing position

Refusal of care means that the person

- legally able to consent - mentally competent and oriented -fully informed of risks - sign release form

Physical examination: auscultation

- listen for: decreased or absent breath sounds

Crime scenes

- location where crime was committed or anywhere evidence may be found - once police have made scene safe, EMT's priory is patient care - know what evidence is - take steps to preserve evidence

Upon approaching scene

- look and listen for other emergency units approaching - look for signs of a collision-related power outage - observe traffic flow - look for smoke in the direction of the collision scene

Pediatric trauma exam: Nose and ears

- look for blood and cleat fluids - mucus or blood obstructions can disrupt breathing

When within sight of scene

- look for clues to escaped hazardous materials - look for collision victims on or near the road - look for smoke not seen at a distance - look for broken utility poles and downed wires - be alert for persons walking along side of road toward collision scene - watch for signals of police officers and other emergency service personal

Cardiovascular system physcial exam

- look for signs condition may be servere - obtain pulse - obtain blood pressure - note pulse pressure - look for jugular vein distinction - palpate the chest - observe posture and breathing

Penetrating trauma

- low velocity (knife) injuries - damage limited to area penetrated - may be multiple wounds

Possible reasons for medical command consult

- medication administration - destination assistance - patient refusal

Respiratory system physcial exam

- mental status - level of respiratory distress -chest wall motion - Auscultate lung sounds - use pulse oximetry - observe edema - fever

Consent for children

- minors not permitted to provide consent for treatment - obtain from parent or legal guardian

Ethics

- morals or standards governing actions - not always required by law - golden rule standard - very important in EMS - good ethical behavior- what you do when no one is looking

Nature of the illness

- more commonly used for medical calls - reason patient called EMS - essentially evaluates the chief complaint

Elements of PCR: patient information

- name, address, phone number - genera, age, date of birth - weight - race and/or ethnicity - billing and insurance information

Circulation shock steps

- shock position - keep the patient warm - deliver oxygen

Central nervous system

Brain and spinal cord

The blood vessels

- need adequate pressure to make cycle work - pressure controlled by changing diameter of blood vessels - stretch receptors monitor pressure pressure can be increased or decreased depending on situation

Focused exam

- no significant distress - responsive - alert and oriented

Stable

- no threats to ABCs found - general impression not concerning

Circulation skin

- normal circulation: warm, pink, dry skin - shock: pale, clammy (cool and moist) skin

Pediatric trauma: Abdomen

- note rigid or tender areas and distention - injury that impedes movement of diaphragm can compromise breathing

Duty to act

- obligation to provide care - while on duty, EMT obligate to provide care if no threat to safety - follow local laws and protocols - follow own conscience

Objective information

- observable - measurable - verifiable

Gastrointestinal system physcial exam

- observe patients position - assess the abdomen - inspect other parts of the gastrointestinal system - inspect vomitus of feces if available

Respiratory system history

- obtain history of existing respiratory conditions and medications taken for each - determine if medications have been taken as prescribed - determine if signs and symptoms of this episode match previous episodes

Acute stress reaction

- often linked to catastrophe, signs and symptoms develop quickly - occurs in EMTs and patients - normal reactions to extraordinary situation - may require immediate intervention from physician or mental

Medical command consult

- on line medical direction - give information clearly and accurately - after receiving order or denial for medication or procedure, repeat back word for word - of order unclear, ask physician to repeat - if order seems inappropriate, question physician

Abandonment

- once care initiated, may not be discontinued until transferred to medical personnel of equal or greater training - if there is failure to do this then it may constitute abandonment

C-spine decision

- once you've formed your general impression you should make c-spine decision - if there is any possibility of a cervical spine injury direct another provider or hold manual c-spine

Respiratory anatomy steps

- oropharynx - nasopharynx - pharynx

What are the importance of vital signs

- outward signs of what is going on inside the body -identify important conditions or trends in patient conditions - gathered on virtually every EMS patient

Gastrointestinal system history

- pain or discomfort - oral intake - history of gastrointestinal issues - vomiting - bowel movements

Assessing the abdomen

- palpate all four quadrants - distention - rigidity - tenderness

Staging

- parking away from scene, until it is secure - certain calls you will be advised to stage - you can always make the decision for yourself/ your crew

Patient history

- past medical history (PMH) - history of present illness (HPI)

Nature of the illness- how will the information be obtained

- patient - family and bystanders - scene

Involuntary transportation

- patient considered threat to self or others - court order - usually requires decision by mental health professional or police officer - if patient restrained, must not risk legal liability

Components of secondary assessment

- patient history - physcial exam - vital sign

Nervous system physical exam

- perform a stroke scale - check peripheral sensation and movement - gently palpate the spine - check extremity strength - check patients pupils for equality and reactivity - examine the patients gait

Patient consent

- permission from patient to assess, treat, and transport - expressed consent (must be informed) - implied consent (assumed consent)

What questions to ask to determine orientation

- person - place - time - event

Organ donor

- person with completed legal document allowing donation of organs and tissues in event of death - may be identified by family members, donor card, drivers license - receiving hospital and/or medical direction should be advised per protocol

Delayed stress reaction

- post traumatic stress disorder - signs and symptoms not evident until long after incident - delay make dealing with reaction much harder- patient may not recognize what is causing problems - requires intervention by mental health professional

Assessing children

- preschoolers can be interviewed with simple language - school-age children will be able to describe what they feel and what happened - include parents, teachers, and/or care providers in you interview

Chief complaint

- primary complaint, as stated by patient - best recorded as a direct quote

Musculoskeletal system history

- prior injuries - whether patient takes blood thinning medication - underlying diseases or conditions that make fractures more common - history to determine if a medical problem caused the traumatic injury

Confidentiality

- privacy rule of the health insurance portability and accountability act (HIPPA) - information on patients history, condition, treatment considered confidential - can be shared with other health care personnel as part of patients continuing care - otherwise must be obtained through subpoena

Pediatric trauma: neck

- proportionately larger heads increase chance of spinal cord injury - can have spinal cord injury without spinal bone fractures

Principles of radio communication: before you speak on the radio

- radio on and volume adjusted properly - reduce background noise - ensure frequency is cleat before starting - lips about 2-3 inches from microphone - press PTT button on radio; wait 1 second before speaking

EMS uses various communication systems

- radios - on-way pagers - cell phones - traditional telephones (landlines)

AMS/unresponsive

- rapid medical exam - patient environment

Radio communication

- regulated by the Federal Communications Commission (FCC) - assigns and licenses designated radio frequencies - prevents interference with emergency radio traffic - prohibits profanities and offensive language

Homeostasis

- regulated in the brain - maintained through nervous system feedback and messaging - key structures are the hypothalamus and medulla oblongata

Evidence preservation

- remember what you touch - minimize impact on scene - work with police - if patient transported on your stretcher, stretcher sheet may be valuable source of evidence - document thoroughly

What needs to be repeated with reassessment

- repeat primary assessment - reassess viral signs

Hospital notification

- report given to the designation hospital so it can prepare for arrival - structured to present only the most important information

Cumulative stress reaction

- results from years of sustained low-level stressors - early signs: vague anxiety, emotional exhaustion - progresses to physical complaints, loss of emotional control, depression - may present as severe withdrawal or suicidal thoughts requiring long-term psychological intervention

What to do if the patient appears lifeless

- resuscitate by beginning CPR compressions - prepare AED as soon as possible

Pathway of blood through heart

- right atrium - right ventricle - left atrium - left ventricle

Quality improvement

- routine call review -ensures compliance to standards -can reveal providers deserving special recognition -can reveal opportunities for improvement

Elements of PCR

- run data - agency name, date, times, call number, unit personnel, certification levels, other information mandated by service - use official time given by dispatch so all times in report match - information gathered during call - general impression of patient - narrative summary of call - patient history and treatment as required by service - transport information

Aerobic metabolism

Oxygen

Negligence

- something was not done, or was done incorrectly

Chest (upper torso)

- start at clavicle - check sternum - apply C-collar - complete sternum - check high and wet - check for paradoxical motion - crepitation

Subjective information

- subject to interpretation or opinion

Skull

- the head -the function is to protect brain - cranium - face

Unresponsive

- the the patient does not respond to any of the previous stimuli, they are unresponsive

Alveoli

- tiny sacs in grape-like bunches at the end of the airway -surrounded by pulmonary capillaries -oxygen and carbon dioxide diffuse through pulmonary capillary membranes

Detailed physical exam

- typically completed en route to hospital - gathers additional information - complements primary and secondary assessments - performed after all critical interventions completed - primary assessment re-evaluated again before initiating - expose patient - work around immobilization equipment - components similar to rapid trauma exam - more detail and focus

Hospital notification components

- unit identification and level of provider - estimated time of arrival (ETA) - patients age and sex - chief complaint - brief, pertinent history of present illness/injury - major past illnesses - mental status - baseline vital signs - pertinent findings of physical exam - emergency care given - response to medical care - medical direction if required, or if questions

While speaking on the radio DON'T

- use patients name - use profanities or slander - give assessment information about patient; avoid offering diagnosis - use EMS frequencies for unauthorized communication - use slang or unauthorized abbreviations (10 codes)

Rules to follow while speaking on the radio

- use unit names or numbers - call units attention first; wait for "go ahead" - unit may say "stand by" until ready - speak slowly and clearly - keep it brief - use plain English, avoid codes - avoid unnecessary words

Painful

- uses tactile stimuli - this patient may have a responsive such as withdrawing or localizing the pain

Scope of practice

- what you can do - Regulations and ethical considerations that define extent or limits of job duties - may include skills and procedures - determined by national, state, local laws, statues, and protocols

Circulation pulse

- within normal limits - unusually slow - unusually fast - or not at all

Pupils

-Assess size, equality, and reactivity -cover one eye and shine a light into other eye, repeat with other eye

Education and research

-clinical research - statistics -continuing education -treating EMT's personal experience

Pulse rate

-normal of beats of heart per minute -adults 60-100 beats per minute

Pulse

-palpable pressure of heart beating, causing blood to move through arteries in waves -can be felt by placing fingertip over artery where it lies close to body's surface and crosses over bone

What are the vital signs?

-pulse -respiration -skin color -temperature -condition -pupils -blood pressure -oxygen saturation

Penlight

-the tool used to asses a patients pupils -push down on the metal bar to turn the light on, when released, the light will tun off -the pupil gauge can assist in determining pupil size

Safety is the #1 rule

1- keep your self safe 2- keep your partner/rescuers safe 3- keep bystanders safe 4- keep patient safe

NHTSA Standards for EMS Systems

1. Regulation and policy 2. Resource management 3. Human resources and training 4. Transportation 5. Facilities 6. Communications 7. Public information and education 8. Medical direction 9. Trauma systems 10. Evaluation

What is the sequence if the patient has vital signs

A-B-C

Inhalation

Active process

Dead space air

Air moved in ventilation nor reaching alveoli

Stretcher rules

Always have two providers holding the stretcher do not move around at "load" height the person in the front steers the person in the read pushes

Tidal volume

Amount of air moved in one breath

When apply cervical collar

Assume spinal injury on all trauma patients

Upper Airway

Begin at mouth and nose and ends at glottic opening

Lower airway

Begins at glottic opening

Obstructive

Blood cannot flow

Immovable

Cranium

External respiration

Diffusion of oxygen and carbon dioxide between alveoli and circulating blood

bronchoconstriction

Disorder of lower airway - smooth muscle constricts internal diameter of airway

Respiratory dysfunction

Disruption of respiratory control

Breach of duty

EMT failed to provide standard of care expected or failed to act

Internal respiration

Exchange of gases between blood and cells

Respiration

Exchange of gases between cells and bloodstream

Urethra

Excretes urine from the bladder to external environment

Palpate

Feel an area for deformities or other abnormal findings

Physical examination: palpation

Feel for - abnormalities in shape - temperature - texture - sensation

Sympthetic Nervous System

Fight or flight

Baseline vital signs

First vital signs obtained

Joints

Formed when bones connect to other bones

Repeat vital signs

Gain further information by establishing trends

What are the risk types

Inhalation, ingestion, absorption, injection

Autonomic nervous system

Involuntary functions

Reaching

Keep back in Locked-in position avoid twisting while reaching avoid reaching more than 15-20 inches in front of body avoid prolonged reaching when strenuous effort is required

Hinge

Knee

Diaphragm

Large, flat muscle at the bottom of the chest cavity that helps with breathing

The thing speaks for itself

Legal concept important in negligence cases - the occurrence of an accident implies negligence

Power lift

Lift from a squatted position feet flat and shoulder width back straight and locked keep weight as close to your body as possible

Auscultate

Listen for sounds of an abnormal condition

Observe

Look at the patient for an overall sense of patient condition

Steps for forming a general impression

Look: patients age, sex, and position listen: moaning, snoring, or gurgling respirations smell: fumes, urine, feces, vomitus, or decay

Distributive

Low blood vessel tone

Hypocapne

Low carbon dioxide

Hypoxia

Low oxygen level in cells

Penetrating trauma part 2

Medium velocity (handgun/shotgun) and high velocity rifle - damage from the billet itself - damage from cavitation

Plasma

More than half the volume of the bloods

Diffusion

Movement of gases from high concentration to low concentration

Ventilation

Movement of gases to and from alveoli

Best places to assess skin color

Nail beds, Inside of cheek & Inside of lower eyelids

Pivot

Neck

Important physical findings

Neck: JVD, medical identification devices Chest: breath sounds abdomen: distention, firmness or rigidity pelvis: incontinence if urine or feces extremities: pulse, motor function, sensation, oxygen saturation, medical identification devices

parasympathetic nervous system

Neurotransmitters regulate digestion and reproduction

Respiratory rate for adults

Normal 12-20

Anaerobic metabolism

Not using oxygen

Respiratory rate

Number of breaths the patient takes in 1 minute

Obstructions

Objects may have to be removed with manual techniques: abdominal thrusts, chest trusts, finger sweeps

OPQRST

Onset provocation quality region; radiation severity time

Proximate causation

Patient suffered harm because of EMT action or inaction

Potentially unstable

Potential for deterioration can indicate potentially unstable category

Capillary refill

Press on nail bed and observe how long it takes normal pink color to return

Pulse

Pressure wave of blood flowing down an artery when the left ventricle contracts

Ventilation

Process of moving air into and out of chest

Endocrine system

Produces hormones

Gowns

Protect clothings and care skin from spilled or splashed fluid

Integumentary system functions

Protection, water balance, temperature regulation, excretion, shock absorption

plasma oncotic pressure

Proteins in plasma attract water away from are around cells and pulls it into bloodstream

Digestive system

Provides the mechanisms by which food travels through the body and is digested

Pushing or pulling

Push, don't pull back locked in line of pull through center of body Weight close to body when weight is below waist, use kneeling position avoid pushing or pulling overhead elbows bent, arms close to sides

The measurement of respirations include

Rate, rhythm, and quality

Red blood cells

Red blood cells, erythrocytes, red corpuscles

sample(R)

Risk factors

Peripheral nervous system

Sensory nerves and motor nerves

Hypoperfusion

Shock: when flow becomes inadequate

Emergency move

Should only be used only when absolutely necessary

Ball and socket

Shoulder

Sample

Signs/symptoms allergies medications pertinent past history last oral intake events leading to the injury or illness

Voluntary

Skeletal

Respirations

The act of breathing in and out

Involuntary

Smooth

Pathophysiology

Study if how disease produces affect function of body

What might be required of the EMT because of negligence

The negligent EMT may be required to pay damages

Systolic

The pressure when the heart is contracting

Diastolic

The pressure when the heart is relaxed

Alveolar ventilation

air actually reaching alveoli

BSI

body substance isolation

CAOx4

conscious, alert and oriented to person, place, time and event

Shock position

elevation of the feet of a supine patient 6 to 12 inches; recommended for shock that is not caused by injury

EMS

emergency medical services

Layers of skin

epidermis, dermis, hypodermis

PPE

gloves, gowns, masks, protective eyewear, food protection

Pelvis

ilium, ischium, pubis - hip joint

Hypotension

low blood pressure

Hypovolemic

low blood volume

Prone

lying face down

Supine

lying on the back

Recovery position

lying on the side

Roles and Responsibilities of the EMT

personal safety; safety of the crew, patient, and bystanders; patient assessment; patient care; lifting and moving; transport; transfer of care; patient advocacy

Pearl

pupils equal and reactive to light

Pulse reporting

rate, quality, regularity, equality

The cardiopulmonary system

respiratory and cardiovascular system

Fowler

semi-sitting position with slight elevation of the knees

Trachea

windpipe