EMT FINAL

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Herpes simplex

"cold sores"; clear vesicles with red base that evolve into pustules, usually at lip-skin junction

Arm

(1) Humerus is the supporting bone (2) Forearm consists of radius and ulna

Wrist and hand

(1) Modified ball-and-socket joint formed by the ends of the radius and ulna and wrist bones (2) 8 bones in the wrist (carpal bones) (3) 5 metacarpals extend from the carpal bones and make up the hand (4) Fingers are composed of phalanges

causes of dyspnea

(1) decreased compliance (2) increased airway resistance (3) chest bellows disease (4) interstitial inflammation/fluid accumulation

3 stages of labor

(1) dilation of the cervix, (2) delivery of the fetus, and (3) delivery of the placenta.

Falls

(>20 feet [adult]; >10 feet [pediatric])

FCC

(Federal Communications Commission) regulates the television and radio industry, grants licenses to television and radio stations, and blocks monopolies.

Foot

(a) Contains 7 tarsal bones (b) Talus and calcaneus are the largest bones (c) Talus joins with the distal tibia and fibula to form the ankle joint (d) Calcaneus forms prominence of heel (e) 5 metatarsal bones form the substance of the foot (f) Plantar surface: the bottom surface of the foot (g) Dorsum: the top of the foot (h) 5 toes formed by 14 phalanges (1) 2 phalanges in the great toe (2) 3 phalanges in each of the smaller toes

Ankle

(a) Hinge joint (b) Allows flexion and extension of the foot

skull/cranium

(a) Protects the brain (b) Connects to the spinal cord through a large opening at the base of the skull called the foramen magnum (c) Made up of 4 bones

Circulatory system

(aka cardiovascular system) This system works as the transportation highway for the body. It consists of the heart, blood, and blood vessels. It transports substances such as oxygen, carbon dioxide, and nutrients in the body. Arteries, arterioles, capillaries, venules, and veins

Bacteria

(microbiology) single-celled or noncellular spherical or spiral or rod-shaped organisms lacking chlorophyll that reproduce by fission

Signs/symptoms of hyperthermia

- Elevated body temperature - Warm or hot, flushed skin - Tachycardia - Tachypnea - Increased fluid requirements - Fatigue/malaise - Decreased appetite - Vomiting/diarrhea - Body aches

Frostnip vs Frostbite

- Nip: Affected skin is cold & painful - Bite: cold & numb - Tx: Warming of affected areas with warm water, Generalized warming (blankets)

Contraindication of epi pen

- None in true severe anaphylaxis - Caution in patients with heart disease

Side effects of epi pen

- Tachycardia, hypertension

When to not to use glucose for hypoglycemia

- Unconscious and unable to protect airway

Treating anaphylactic shock

-Administer epinephrine (intramuscularly) -Promptly transport the patient. -Provide high-flow oxygen and ventilatory assistance en route. -A mild reaction may worsen suddenly or over time. -Consider requesting ALS backup, if available.

Side effects of nitroglycerin

-Headache -flushing -dizziness -hypotension -tachycardia

Treating septic shock

-Hospital management is required. -Use standard precautions and transport. - high-flow oxygen. -Ventilatory support may be necessary. -blankets to conserve body heat. -Alert "sepsis team" if available.

•Organs that contain air are most susceptible to pressure changes.

-Middle ear -Lung -Gastrointestinal tract

Ask about these in vaginal bleeding:

-Onset -Duration -Quantity (number of sanitary pads soaked) -Associated symptoms such as syncope and light-headedness

Signs/Symptoms of depression

-Pupils -skin signs -breathing

Dispatcher

-Receives and determines the relative importance of the 911 call -Assigns appropriate EMS response unit(s) -Selects, dispatches, and directs the appropriate EMS response unit(s) -Coordinates with other public safety services -Provides emergency medical instructions to the telephone caller

Pertinent secondary assessment findings in vaginal bleeding

-Vital signs: blood pressure, pulse, skin color, orthostatic vital signs -Abdomen: distention and tenderness -Genitourinary: visible bleeding -Neurologic: mental status

traumatic brain injuries

-concussion -contusion -subdural or subarachnoid hemorrhage -cerebral edema

eviscerated bowel treatment

-four sided occlusive dressing -do not put bowels back in

What to do if pt seizes during assessment?

-if wearing restrictive clothing, remove -protect from injuring themselves more -room to breathe/move -prevent rolling/head injury

Skull fractures

-linear or depressed -simple, comminuted, or compound -closed or open

Signs/symptoms of heat exhaustion

-nausea -headache, dizziness -pale, cool, clammy, sweating skin -restlessness, weakness -fear, anxiety -confusion, disorientation -weak, rapid pulse -shallow, rapid respiration -cyanosis of the lips and fingernails

Carbon monoxide poisoning

-s/s include: nausea, vomiting, headache, weakness, and unconsciousness -death may occur with prolonged exposure -prevention by ensuring proper ventilation when using fuel-burning devices -gas-burning devices should be inspected annually -flues and chimneys should be unobstructed -carbon monoxide detectors should be installed and inspected regularly

Signs/symptoms of pulmonary edema

-severe hypoxia -symptoms usually occur at night lying down -sudden onset -breathlessness -restless/anxiety -productive cough **pink frothy sputum**

Open injuries

. A break in the protective skin layer or mucous membrane means that the wound is contaminated and may become infected. a. Contamination: the presence of infectious organisms or foreign bodies, such as dirt, gravel, or metal, in the wound b. Address both excessive bleeding and contamination in your treatment of open soft-tissue wounds. c. Four types of open soft-tissue wounds: i. Abrasions ii. Lacerations iii. Avulsions iv. Penetrating wounds

Open injuries (soft tissue)

Bleeding from nose/ears following head injury

. May indicate a skull fracture b. May be difficult to control c. Do not attempt to stop blood flow. i. Applying excessive pressure to the injury may force the blood leaking through the ear or nose to collect within the head. ii. This could increase the pressure on the brain and possibly cause permanent damage. d. If you suspect a skull fracture: i. Loosely cover the bleeding site with a sterile gauze pad to collect the blood and help keep contaminants away from the site. ii. Apply light compression by wrapping the dressing loosely around the head. e. A target or halo-shaped stain may occur on the dressing if blood or drainage contains cerebrospinal fluid.

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:

1 month

Infant

1 month to 1 year

infants

1 month to 1 year

Ventilations in CPR

1 second, or until chest rises

Eviscerated bowel resection interventions-

1) stay with the client and call for help 2) cover wound with saline-soaked gauze. 3) place in supine position with knees bent. 4) take client's vitals

Toddler

1-3 years

Toddlers

1-3 years a. Pulse rate is normally 90 to 150 beats/min. b. Respiratory rate is 20 to 30 breaths/min. c. Systolic blood pressure is 80 to 100 mm Hg. d. Average temperature is 96.8°F (36° C) to 99.6°F (38° C). e. A toddler's lungs continue to develop more terminal bronchioles and alveoli.

Stretcher on stairs

1. A backboard should be used for a patient: a. Who is unresponsive b. Who must be moved in supine position c. Who must be immobilized 2. Carry the patient on the backboard down the stairs to the prepared stretcher. a. Place the strongest EMTs at the head and foot ends of the board. b. The taller person should be at the foot end. 3. Once you reach the stretcher, place both the backboard and the patient on the stretcher; secure both to the stretcher with additional straps. 4. To carry a patient on stairs on a backboard, follow the steps in Skill Drill 8-5.

Hemothorax

1. A condition in which blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel 2. Common signs and symptoms: a. Signs and symptoms of shock without any obvious external bleeding or apparent reason for the shock state b. Decreased breath sounds on the affected side (lung is being compressed by the blood) 3. Prehospital treatment: a. Bleeding cannot be controlled in the prehospital setting. b. Provide rapid transport to the nearest facility capable of performing surgery. 4. Hemopneumothorax: the presence of air and blood in the pleural space

Neonatal isolette

1. A neonatal patient cannot be transported on a wheeled ambulance stretcher. 2. A neonatal isolette is sometimes referred to as an incubator. 3. Keeps the neonatal patient warm, with moistened air in a clean environment 4. Protects from noise, drafts, infection, and excess handling 5. The isolette can be: a. Placed directly on a wheeled ambulance stretcher and secured with seatbelts b. Freestanding and secured into the back of an ambulance in place of where the standard stretcher would be

Basket stretcher

1. A rigid stretcher also called a Stokes litter 2. Used to carry the patient across uneven terrain from a remote location that is inaccessible by ambulance or other vehicle 3. Used for technical rope rescues and some water rescues 4. If the patient has a suspected spinal injury, secure the patient to a backboard and place the backboard inside the basket stretcher. 5. When you return the ambulance, lift the backboard out of the basket stretcher and place it on the wheeled ambulance stretcher. 6. Basket stretchers are made of plastic with an aluminum frame or have a full steel frame that is connected by woven wire mesh. 7. Their design allows water to drain through the stretcher.

portable/folding stretcher

1. A stretcher with a strong rectangular tubular metal frame with rigid fabric stretched across it 2. Does not have a second frame or an adjustable undercarriage 3. Some models have two wheels that make it easier to move the loaded stretcher. 4. Some models can be folded in half for storage. 5. Used in areas that are difficult to reach or when a second patient must be transported on the squad bench 6. Weigh much less than wheeled stretchers 7. Because most models do not have wheels, your team must support all of the patient's weight, equipment, and the stretcher itself.

Steps of CPR

1. ABC's 2. 2 rescue breaths 3. 30 compressions 4. Repeat until the third cycle then recheck ABC's

Mandatory reporting requirements

1. Abuse a. Children b. Older people c. "At-risk" adults 2. Injury during commission of a felony 3. Drug-related injuries 4. Childbirth 5. Attempted suicides 6. Dog bites 7. Certain communicable diseases 8. Assaults 9. Domestic violence 10. Sexual assault or rape 11. Exposures to infectious disease 12. Transport of patients in restraints 13. Scene of a crime 14. The deceased

Adolescents psychosocial changes

1. Adolescents and their families often deal with conflict as adolescents try to gain control of their lives from their parents. a. Privacy becomes an issue. b. Self-consciousness increases. 2. Adolescents may struggle to create their own identity. 3. They often want to be treated like adults, yet cared for like younger children. 4. Antisocial behavior and peer pressure tend to peak at age 14 to 16 years. a. Smoking, illicit drug use, and unprotected sex are problems that may arise. b. Eating disorders can arise in adolescents from an attempt to gain self-control through what they eat. 5. Adolescents may show a greater interest in sexual relations. a. A code of personal ethics develops, based partly on parents' ethics and values and partly on the influence of the adolescent's environment. b. Many adolescents are fixated on their public image and are terrified of being embarrassed. c. Adolescents are at a higher risk than other populations for suicide and depression.

Vacuum mattress

1. Alternative to the backboard for immobilizing geriatric and pediatric patients 2. The patient is placed on the mattress and the air is removed from the device, allowing it to mold around the patient. 3. Provides a high degree of immobilization, comfort, and thermal insulation

Communicating with children

1. An emergency situation frightens anyone. 2. Fear is most obvious and severe in children. 3. Children may be frightened by: a. Your uniform b. The ambulance c. A crowd of people gathered around them 4. Let a child keep a favorite toy, doll, or security blanket. 5. If possible, have a family member or friend nearby. a. If practical, let the parent or guardian hold the child during evaluation and treatment. 6. Be honest. Children easily see through lies or deception. 7. Tell the child ahead of time if something will hurt. 8. Respect the child's modesty. 9. Speak in a professional, yet friendly way. 10. Use an appropriate tone and vocabulary. 11. Maintain eye contact. 12. Position yourself down at the child's level. a. Do not tower over a child.

Signs of developing shock

1. Anxiety or agitation 2. Changes in mental status 3. Increased heart rate 4. Increased respiratory rate 5. Diaphoresis 6. Cool or clammy skin 7. Decreased blood pressure

How to deal with an angry patient

1. Assess scene safety 2. Do not assume aggressive posture 3. Make good eye contact, but do not stare 4. Speak calmly, confidently, slowly 5. NEVER threaten a patient (verbally/physically)

Role as an EMT

1. Be prepared 2. Anticipate needed resources 3. Control the scene 4. Care for the patient

Neonates to infants psychosocial changes

1. Begin at birth and evolve as the infant interacts with, and reacts to, the environment 2. Crying is the main method of communicating distress. a. Parents can often tell what is wrong just by the tone of their infant's crying. 3. Infants develop relationships with their parents or caregivers at different rates. a. Bonding, or the formation of a close, personal relationship, is based on a secure attachment. i. A secure attachment occurs when an infant understands that parents or caregivers will be responsive to his or her needs. 4. Anxious-avoidant attachment is found in infants who are repeatedly rejected. a. Children show little emotional response to their parents or caregivers and treat them as they would strangers. 5. Separation anxiety is common in older infants. a. It involves clingy behavior and fear of unfamiliar places and people. 6. Trust and mistrust refers to a stage of development from birth to about 18 months, which involves an infant's needs being met by his or her parents or caregivers. a. If the environment is not perceived as secure by the infant, a sense of mistrust will develop.

scalp lacerations

1. Can be minor or serious 2. Even small lacerations can quickly lead to significant blood loss. 3. Occasionally, this blood loss may be severe enough to cause hypovolemic shock, particularly in children. 4. Because scalp lacerations are usually the result of direct blows to the head, they are often an indicator of deeper, more serious injuries.

Flexible stretcher

1. Can be rolled up across the stretcher's width or length so the stretcher becomes a smaller tubular package 2. Excellent for storage and carrying 3. Conform around a patient's sides and do not extend beyond them 4. When extended, useful when removing a patient from or through a confined space 5. Certain flexible stretchers can be belayed or rappelled by ropes. 6. The most uncomfortable stretcher but provides excellent support and immobilization

Cardiac tamponade

1. Cardiac tamponade (pericardial tamponade) occurs more commonly with penetrating chest trauma, although it may occur in blunt trauma. 2. The protective membrane around the heart (pericardium) fills with blood or fluid. 3. The heart then cannot pump an adequate amount of blood. 4. Signs and symptoms: a. Beck's triad: i. Distended or engorged jugular veins seen on both sides of the trachea ii. Narrowing pulse pressure iii. Muffled heart sounds b. Altered mental status due to decreased blood flow to the brain 5. Prehospital treatment: a. Support ventilations. i. Provide positive-pressure ventilation to any patient who is hypoventilating or apneic. b. Rapidly transport the patient to a facility capable of intervention.

Flail chest

1. Caused by compound rib fractures that detach a segment of the chest wall from the rest of the thoracic cage 2. The detached portion of the chest wall moves opposite of normal (paradoxical motion). a. In during exhalation b. Out during inhalation c. Paradoxical motion is a late sign of flail segment. 3. Prehospital treatment: a. Maintain the airway. b. Provide respiratory support, if needed. c. Give supplemental oxygen. d. Perform ongoing assessments for possible pneumothorax or other respiratory complications. e. Treatment may also include positive-pressure ventilation with a bag-valve mask. f. Restricting chest wall movement (splinting of the flail segment with bulky dressing) is no longer recommended. 4. Flail chest may indicate serious internal damage and possible spinal injury.

patient positioned based on chief complaint

1. Certain patient conditions, such as head injury, shock, spinal injury, pregnancy, and obese patients, call for special lifting and moving techniques. 2. A patient with no suspected injury reporting chest pain or respiratory distress should be placed in a position of comfort—typically a Fowler or semi-Fowler position. 3. Patients who are in shock should be packaged and placed in a supine position. 4. Patients in late stages of pregnancy should be positioned and transported on their left side if they are uncomfortable or hypotensive when supine. 5. An unresponsive patient with no suspected spinal, hip, or pelvic injury should be placed in the recovery position. 6. A patient who is nauseated or vomiting should be transported in a position of comfort. 7. Obese patients should be positioned the same as other patients with a similar condition a. Ensure their dignity is maintained.

School aged children psychosocial changes

1. Children learn various types of reasoning. a. Preconventional reasoning: children act almost purely to avoid punishment and get what they want. b. Conventional reasoning: children look for approval from their peers and society. c. Postconventional reasoning: children make decisions guided by their conscience. 2. Children begin to develop their self-concept and self-esteem. a. Self-concept is our perception of ourselves. b. Self-esteem is how we feel about ourselves and how we "fit in" with our peers.

Patients with special challenges

1. Children who were born prematurely and have associated respiratory problems 2. Infants or small children with congenital heart disease 3. Patients with neurologic disease 4. Patients with congenital or acquired diseases resulting in altered body function that requires medical assistance for breathing, eating, urination, or bowel function 5. Patients with sensory deficits such as hearing or visual impairments 6. Geriatric patients with chronic diseases requiring visitation from a home health care service

Neck

1. Contains many important structures 2. Supported by the cervical spine a. First seven vertebrae in the spinal column (C1 through C7) b. The spinal cord exits from the foramen magnum and lies within the spinal canal formed by the vertebrae. 3. The upper part of the esophagus and the trachea lie in the midline of the neck. a. The carotid arteries are found on either side of the trachea, along with the jugular veins and several nerves. 4. The larynx a. The Adam's apple is located in the center of the anterior of the neck. i. The Adam's apple is the upper part of the larynx. ii. It is formed by the thyroid cartilage. iii. More prominent in men than in women b. The other portion of the larynx is the cricoid cartilage, a firm ridge of cartilage below the thyroid cartilage. c. Cricothyroid membrane i. Lies between the thyroid cartilage and the cricoid cartilage ii. Soft depression in the midline of the neck iii. A thin sheet of connective tissue that joins the two cartilages 5. The trachea a. Below the larynx b. The trachea connects the oropharynx and the larynx with the main passages of the lungs (the bronchi). c. On either side of the lower larynx and the upper trachea lies the thyroid gland. 6. Sternocleidomastoid muscles a. Originate from the mastoid process of the cranium and insert into the medial border of each collarbone and the sternum at the base of the neck b. Allow movement of the head

Hypothermia

1. Core temperature of the body falls below 95°F (35°C) a. Temperature of the heart, lungs, and vital organs 2. The body loses the ability to regulate its temperature and generate body heat. 3. Physiology a. To protect against heat loss, the body constricts blood vessels in the skin, resulting in blue lips and/or fingertips. b. The body shivers to generate heat. c. As these mechanisms are overwhelmed, body functions begin to slow down and mental status deteriorates. d. Eventually, key organs such as the heart begin to slow down. e. This can lead to death. 4. Development of hypothermia a. Can develop quickly, as with cold water immersion b. Can develop gradually, as with exposure to the cold environment for several hours c. Air temperature does not have to be below freezing for hypothermia to occur. 5. People at risk a. Homeless people and those whose homes lack heating b. Swimmers, even in the summer c. Geriatric, pediatric, and ill individuals who are less able to adjust to temperature extremes d. Patients with injuries or illness, such as: i. Burns ii. Shock iii. Head injury iv. Stroke v. Generalized infection vi. Injuries to the spinal cord vii. Diabetes viii. Hypoglycemia e. Patients who have taken certain drugs or consumed alcohol

Head

1. Cranium a. Also referred to as the skull b. Contains the brain i. The brain connects to the spinal cord through the foramen magnum, a large opening at the base of the skull. c. The most posterior portion of the cranium is called the occiput. d. On each side of the cranium, the lateral portions are called the temples or temporal regions. i. Between the temporal regions and the occiput lie the parietal regions. e. The forehead is called the frontal region. f. Anterior to the ear, in the temporal region, you can feel the pulse of the superficial temporal artery. 2. Face a. Composed of: i. Eyes ii. Ears iii. Nose iv. Mouth v. Cheeks b. The six major bones of the face include: i. Nasal bone ii. Two zygomas iii. Two maxillae iv. Mandible c. The orbit of the eye is composed of: i. Lower edge of the frontal bone of the skull ii. Zygoma iii. Maxilla iv. Nasal bone d. The bony orbit protects the eye from injury. e. Only the proximal third of the nose is formed by bone. i. The remaining two thirds are composed of cartilage. f. The exposed portion of the ear is composed entirely of cartilage covered by skin. i. The external, visible part is called the pinna. ii. The tragus is a small, rounded, fleshy bulge immediately anterior to the ear canal. iii. The superficial temporal artery can be palpated just anterior to the tragus. g. About 1 inch posterior to the external opening of the ear is the mastoid process. i. Bony mass at the base of the skull h. The mandible forms the jaw and chin. i. The jaw is the lower border of the mouth, where the tongue and 32 teeth are located. ii. Motion of the mandible occurs at the temporomandibular joint, which lies just in front of the ear on either side of the face. iii. Below the ear and anterior to the mastoid process, the angle of the mandible is easily palpated.

History taking

1. Date of the incident 2. Patient's age 3. Patient's gender 4. Patient's race 5. Past medical history 6. Patient's current health status

The grieving process

1. Denial 2. Anger, hostility 3. Bargaining 4. Depression 5. Acceptance

The Star of Life

1. Detection 2. reporting 3. response 4. on-scene care 5. care in transit 6. transfer to definitive care

Moderate or severe hypothermia

1. Do not try to actively rewarm the patient—rewarming may cause a fatal cardiac dysrhythmia. 2. Local protocols may dictate the appropriate type of rewarming strategies based on the patient's body temperature. 3. The goal is to prevent further heat loss. 4. Remove the patient immediately from the cold environment. 5. Place the patient in the ambulance. 6. Remove wet clothing. 7. Cover the patient with a blanket and transport. 8. Handle the patient gently to decrease the risk of ventricular fibrillation. 9. If you cannot get the patient out of the cold immediately: a. Move the patient out of the wind and away from contact with any object that will conduct heat away from the body. b. Place blankets and a waterproof protective cover on the patient. c. Cover the head and neck with a towel. 10. Always remember that even an unresponsive patient may be able to hear you.

Drag guidelines

1. Drag the patient to within 15-20 inches. 2. Complete the drag while standing at the side of the bed. 3. Use the sheet or blanket under the patient rather than dragging the patient by his or her clothing.

Patient weight parameters

1. Estimate the patient's weight before lifting. a. Adults often weigh 120-220 lb. b. Two EMTs should be able to safely lift this weight. 2. Try to use four providers to lift when possible. a. More stability b. Requires less strength 3. Do not attempt to lift a patient who weighs more than 250 lb with fewer than four providers. 4. Know the weight limitations of the equipment and how to handle patients who exceed the weight limitations.

Cold exposure may cause injury to:

1. Feet 2. Hands 3. Ears 4. Nose 5. Whole body (hypothermia)

Middle adults psychosocial changes

1. Focus is on achieving life goals 2. Middle adults must readjust their lifestyle as children leave home. 3. Finances become a worrisome issue. 4. Generally, people of this age have the physical, emotional, and spiritual reserves to handle life's issues. 5. Middle adults may find themselves caring for children leaving for college and caring for their aging parents as well.

Musculoskeletal System provides

1. Form 2. Upright posture 3. Movement 4. Protection of vital internal organs

School-aged children physical changes

1. From ages 6 to 12 years, a school-age child's vital signs and body gradually approach those observed in adulthood. a. Pulse rate is approximately 70 to 120 beats/min. b. Respiratory rate is 15 to 20 breaths/min. c. Blood pressure is 80 to 110 mm Hg. 2. Obvious physical traits and body function changes become apparent. a. Growth of 4 lb (2 kg) and 2.5" (6 cm) each year 3. Permanent teeth come in. 4. Brain activity increases in both hemispheres. 5. Unintentional injuries are the leading cause of death in this age group.

Skeletal system functions

1. Gives the body its shape 2. Protects fragile organs 3. Allows for movement 4. Stores calcium 5. Helps create blood cells

Common geriatric conditions

1. Hypertension 2. Arthritis 3. Heart disease 4. Cancer 5. Diabetes mellitus 6. Asthma 7. Chronic bronchitis or emphysema 8. Stroke C. The leading causes of death in the geriatric population include: 1. Heart disease 2. Cancer 3. Chronic lower respiratory disease 4. Stroke 5. Alzheimer disease 5. Diabetes mellitus

Communicating with older patients

1. Identify yourself. 2. Present yourself as competent, confident, and caring. 3. Do not assume that an older patient is senile or confused. 4. You may encounter hostility, irritability, and some confusion. a. Do not assume this is normal behavior. 5. Approach an older patient slowly and calmly. 6. Allow plenty of time for the patient to respond to your questions. 7. Watch for signs of confusion, anxiety, or impaired hearing or vision. 8. The patient should feel confident that you are in charge and that everything possible is being done for him or her. 9. Be patient! 10. Older patients: a. Often do not feel much pain b. May not be fully aware of important changes in their body systems c. You must be especially vigilant for objective changes. 11. When possible, give the patient time to pack a few personal items before leaving for the hospital. 12. Locate any hearing aids, eyeglasses, and dentures before departure. 13. Older patients are often worried about the safety of their home, valuable items, and pets. a. Share these concerns with the person assuming care of the patient at the hospital.

treating respiratory insufficiency

1. Immediately secure and maintain the airway. 2. Clear the mouth and throat of any obstructions, including mucus, vomitus, and foreign material. 3. If necessary, provide ventilations with a BVM. 4. Administer supplemental oxygen, and transport the patient promptly.

Infection risk can be minimized by

1. Immunizations 2. Protective techniques 3. Handwashing

Adolescents physical changes

1. In adolescents (ages 12 to 18 years), vital signs begin to level off within the adult ranges. a. Pulse rate is 60 to 100 beats/min. b. Respiratory rate is 12 to 20 breaths/min. c. Systolic blood pressure is between 90 and 110 mm Hg. 2. Adolescents experience a 2- to 3-year growth spurt (an increase in muscle and bone growth) and body changes. a. Growth begins with hands and feet, then moves to the long bones of the extremities, and finishes with growth of the torso. b. Girls generally finish their growth spurt by 16 years and boys by 18 years. i. When this growth spurt finishes, boys are generally taller and stronger than girls. ii. Muscle mass and bone density are nearly at adult levels. 3. The reproductive system matures. a. Secondary sexual development takes place. i. The external sex organs enlarge. ii. Pubic hair and axillary hair begin to appear. iii. Voices start to change. iv. In girls, the breasts and thighs increase in size as fat tissue is deposited there. v. Menstruation begins. b. By the middle of adolescence, boys are able to produce sperm and eggs begin to develop in girls. i. Acne can also occur due to hormonal changes. 4. Unintentional injuries are the leading cause of death for adolescents.

Stress

1. Increased respirations and heart rate 2. Increased blood pressure 3. Dilated venous vessels near the skin surface (causes cool, clammy skin) 4. Dilated pupils 5. Tensed muscles 6. Increased blood glucose levels 7. Perspiration 8. Decreased blood flow to the gastrointestinal tract

Team leader

1. Indicates where each team member should be 2. Rapidly describes the sequence of steps to perform before lifting

Laryngospasm

1. Inhaling very small amounts of either fresh water or salt water can severely irritate the larynx. 2. The muscles of the larynx and the vocal cords spasm. 3. Prevents more water from entering the lungs 4. In severe cases, progressive hypoxia occurs until the patient becomes unconscious. a. The spasm relaxes. b. The patient may now inhale deeply. c. More water may enter the lungs.

Professional Attributes

1. Integrity: acting consistently; maintaining a firm adherence to a code of honest behavior 2. Empathy: being aware of and thoughtful toward the needs of others 3. Self-motivation: discovering problems and solving them without someone directing you 4. Appearance and hygiene: using your persona to project a sense of trust, professionalism, knowledge, and compassion 5. Self-confidence: knowing what you know and knowing what you do not know; being able to ask for help 6. Time management: performing or delegating multiple tasks while ensuring efficiency and safety 7. Communications: understanding others and making yourself understood to others 8. Teamwork and diplomacy: being able to work with others; knowing your place within a team; communicating while giving respect to the listener 9. Respect: holding others in high regard or importance; understanding that others are more important than you 10. Patient advocacy: constantly keeping the needs of the patient at the center of care 11. Careful delivery of care: paying attention to details; making sure that what is being done for the patient is done as safely as possible

Roles and Responsibilities of the EMT

1. Keep vehicles and equipment ready for an emergency. 2. Ensure the safety of yourself, your partner, the patient, and bystanders. 3. Be familiar with emergency vehicle operation. 4. Be an on-scene leader. 5. Perform an evaluation of the scene. 6. Call for additional resources as needed. 7. Gain patient access. 8. Perform a patient assessment. 9. Give emergency medical care to the patient while awaiting the arrival of additional medical resources. 10. Give emotional support to the patient, the patient's family, and other responders. 11. Maintain continuity of care by working with other medical professionals. 12. Resolve emergency incidents. 13. Uphold medical and legal standards. 14. Ensure and protect patient privacy. 15. Give administrative support. 16. Constantly continue your professional development. 17. Cultivate and sustain community relations. 18. Give back to the profession.

body drag

1. Keep your back locked in a slight curve created by tightening your abdominal muscles. 2. Kneel to minimize the distance you will have to lean over. 3. Extend arms no more than 15-20 inches in front of you. 4. When you can pull no farther because your hands have reached the front of your torso, stop and move back another 15-20 inches. 5. Alternate between pulling the patient by slowly flexing your arms and repositioning yourself.

Log roll

1. Kneel as close to the patient's side as possible. 2. When you lean forward, keep your back straight and lean solely from the hips. 3. Roll the patient without stopping until the patient is resting on his or her side and braced against your thighs. 4. Pulling toward you allows your legs to prevent the patient from rolling over completely and from rolling beyond the intended distance.

Head tilt chin lift

1. Kneel to side of victims head 2. Position and Seal Mask on victims face 3. Tilt victims head back and blow into mask

Inadequate breathing patterns

1. Labored breathing a. Requires effort and may involve accessory muscles b. Much slower or faster breathing than usual 2. Muscle retractions above the clavicles, between the ribs, and below the rib cage, especially in children 3. Pale or cyanotic (blue) skin 4. Cool, damp (clammy) skin 5. Patient in the tripod position (leaning forward on arms stretched forward) 6. Agonal gasps a. Gasping breaths after the heart has stopped (cardiac arrest)

Lifting technique

1. Legs should be spread about 15 inches apart (shoulder width). 2. Place feet so that your center of gravity is properly balanced. 3. With your back held upright, bring your upper body down by bending the legs. 4. Grasp the patient or stretcher and make any necessary adjustments in the location of your feet. 5. Lift the patient by raising your upper body and arms and straightening your legs until you are in a standing position, and then curling your arms up to waist height. 6. Lifting by extending the properly placed flexed legs is the safest and most powerful way to lift. a. This is called the power lift (Skill Drill 8-1). 7. Hold your arms so that your hands are almost adjacent to the plane described by your anterior torso, and keep the weight you are lifting as close to your body as possible. 8. Keep your arms the same distance apart as when hanging your arms at each side of your body.

Early adults psychosocial changes

1. Life centers on work, family, and stress. 2. During this period, adults strive to create a place for themselves in the world, and many do everything they can to "settle down." a. Along with this comes marriage and family. 3. Despite all of this stress and change, this is one of the more stable periods of life.

Older adults physical changes

1. Life expectancy is constantly changing. a. In the early 1900s, life expectancy was 47 years. b. It is now approximately 78 years. c. The age to which a person will live is based on many factors, including: i. Year of birth and country in which the person lives ii. Public heath advances, changes within diets, attitudes regarding exercise, advances in and access to medical care, and personal behaviors d. Cancer is the leading cause of death in ages 61 to 65 years; heart disease is the leading cause of death in ages 65 years and older. 2. Vital signs depend on the patient's: a. Overall health b. Medical conditions c. Medications taken 3. Older adults are often able to overcome numerous medical problems but may need multiple medications. 4. Cardiovascular system a. Cardiac function declines with age largely due to atherosclerosis. i. Cholesterol and calcium build up inside the walls of blood vessels, forming plaque. ii. Accumulation of plaque eventually leads to partial or complete blockage of blood flow. iii. More than 60% of people older than 65 years have atherosclerotic disease. b. Heart rate and cardiac output decrease. i. Cardiac output can no longer meet the demands of the body. c. The vascular system becomes stiff. i. Diastolic blood pressure increases with age. ii. The heart must work harder to move the blood effectively. d. The ability to produce replacement blood cells declines, as does the blood volume. 5. Respiratory system a. The size of the airway increases and the surface area of the alveoli decreases. b. The natural elasticity of the lungs also decreases. i. Intercostal muscles are used more to breathe. ii. Breathing becomes more labor intensive. c. The changes in the respiratory system are often gradual and go unnoticed until a severe, life-threatening condition occurs. d. Within the mouth and nose, there is a gradual loss of the mechanisms that protect the upper airway. i. This leads to a decreased ability to clear secretions as well as decreased cough and gag reflexes. ii. Aspiration and obstruction become more likely. e. As the smooth muscles of the lower airway weaken with age, strong inhalation can make the walls of the airway collapse inward and cause inspiratory wheezing. i. The cells of the immune system are less functional. f. By age 75 years, the vital capacity may amount to only 50% of the vital capacity of a young adult. Factors include: i. Loss of respiratory muscle mass ii. Increased stiffness of the thoracic cage iii. Decreased surface area available for the exchange of air g. Residual volume increases with age. i. A lifetime of breathing, especially breathing air with high levels of pollution, causes the accumulation of pollutants in the lungs. 6. Endocrine system a. Insulin production drops off and metabolism decreases. b. People tend to slow down their physical activity. i. But they tend not to decrease their food intake. ii. The pancreas may not be able to produce enough insulin for the person's body size, which can lead to diabetes mellitus. c. The reproductive system changes to some extent. i. Men are able to produce sperm long into their 80s, but the rigidity of the penis tends to decrease over time. ii. Women have a decrease in the size of their uterus and vagina. iii. Hormone production for both sexes gradually decreases as they age. iv. Sexual desire may diminish with age but does not cease. 7. Digestive system a. Changes in gastric and intestinal function may inhibit nutritional intake and utilization in older adults. i. Taste sensations decrease. b. Saliva secretion decreases, and this reduces the body's ability to process complex carbohydrates. c. The ability of the intestines to contract and move food diminishes. d. Gastric acid secretion diminishes. e. Gallstones become increasingly common. f. Anal sphincter changes can produce fecal incontinence. 8. Renal systems a. The filtration function declines by 50% from age 20 to 90 years. b. Kidney mass decreases 20% over the same span. i. Due in part to the decreased effectiveness of the blood vessels that supply blood to the nephrons c. There is a decreased ability to clear wastes from the body. d. There is a decreased ability to conserve fluids when needed. 9. Nervous system a. In the central nervous system, the brain weight may shrink 10% to 20% by age 80 years. i. Motor and sensory neural networks become slower. b. Neurons are lost. i. But there is not a loss of knowledge or skill. ii. Sleep patterns change. c. In younger adults, the brain, which is surrounded by the meninges, takes up almost all of the space in the skull. i. Age-related shrinkage creates a void between the brain and the outermost layer of the meninges, which provides room for the brain to move when stressed. d. Peripheral nerve sensation is diminished. i. Increased reaction times cause longer delays between stimulation and motion. ii. The resulting slowdown in reflexes and decreased kinesthetic sense may contribute to the incidence of falls and trauma. 10. Sensory changes a. Most older adults can see and hear well. i. They may need glasses or hearing aids. ii. It is wrong to assume that older patients are blind or deaf. iii. Visual distortions are common. b. Hearing loss is four times more common than vision loss.

Urinary bladder injuries

1. May result in rupture a. Urine spills into surrounding tissues. b. Blunt injuries to lower abdomen or pelvis can cause rupture to the urinary bladder, particularly when the bladder is full and distended. c. Penetrating wounds of the lower mid-abdomen or the perineum can directly involve the urinary bladder. 2. In males, sudden deceleration from a motor vehicle or motorcycle crash can shear the bladder from the urethra. 3. In later trimesters of pregnancy, bladder injuries increase from displacement of the uterus.

Lightning injuries

1. Mild a. Loss of consciousness b. Amnesia c. Confusion d. Tingling e. Other nonspecific signs and symptoms f. Burns, if present, are typically superficial. 2. Moderate a. Seizures b. Respiratory arrest c. Dysrhythmias that spontaneously resolve d. Superficial burns 3. Severe a. Cardiopulmonary arrest b. Many of these patients do not survive.

Lifting on backboard/stretcher

1. More of the patient's weight rests on the head half of the device than on the foot half. 2. The diamond carry uses one EMT at the head and one at the foot of the backboard, and one on each side of the torso (Skill Drill 8-2). 3. The one-handed carry includes four or more rescuers each using one hand to support the backboard so that they are able to face forward as they are walking (Skill Drill 8-3). 4. When the stretcher must be carried, it is best if four providers are available to carry it. One provider should be positioned at each corner of the stretcher to provide an even lift. 5. When you are rolling the wheeled ambulance stretcher, make sure that it is in the fully elevated position. a. Your partner should control the head end and assist you by pushing with his or her arms held with the elbows bent.

Removing unconscious patient from vehicle alone

1. Move the patient's legs clear of the pedals. 2. Rotate the patient so that his or her back is toward the open car door. 3. Place your arms under the patient's shoulders and through the patient's armpits, and support the patient's head against your body. 4. If the legs and feet clear the car, rapidly drag the patient from the seat to a safe location. a. If the legs and feet do not clear the car, lower the patient to the ground until the patient is on his or her back, clear the legs from the vehicle, and drag the patient to a safe location.

Heart (blood)

1. Needs a rich and well-distributed blood supply 2. Works as two paired pumps a. Upper chamber (atrium) b. Lower chamber (ventricle) 3. Blood leaves each chamber through a one-way valve, which keeps the blood moving in the proper direction.

Human life

1. Newborns and infants 2. Toddlers and preschoolers 3. School-age children 4. Adolescents 5. Three stages of adulthood: early, middle, and older

Normal breathing

1. Normal rate and depth (tidal volume) 2. Regular rhythm or pattern of inhalation and exhalation 3. Clear, audible breath sounds on both sides of chest 4. Regular rise and fall movement on both sides of the chest 5. Movement of the abdomen

Upper airway

1. Nose 2. Mouth (oral cavity) 3. Tongue 4. Jaw (mandible) 5. Larynx (voice box) 6. Pharynx 7. Trachea 8. Epiglottis 9. Esophagus

Kidney injuries

1. Not unusual and rarely occur in isolation a. A forceful blow or penetrating injury is often involved. b. Less significant injuries can result from an indirect blow or even a football tackle. 2. Suspect kidney damage if the patient has a history or physical evidence of any of the following: a. An abrasion, laceration, or contusion on the flank b. A penetrating wound in the region of the lower rib cage and above the hip (flank) or the upper abdomen c. Fractures on either side of the lower rib cage or of the lower thoracic or upper lumbar vertebrae d. A hematoma in the flank region

Definitive signs of death

1. Obvious mortal damage (decapitation) 2. Dependent lividity, which refers to blood settling to the lowest point of the body, causing discoloration of the skin 3. Rigor mortis, which is the stiffening of body muscles caused by chemical changes within muscle tissue a. Occurs between 2 and 12 hours after death 4. Putrefaction (or decomposition) of body tissues, which (depending on temperature conditions) occurs between 40 and 96 hours after death

Restraint requires minimum 5 responders

1. One for each extremity of the patient, and one for his or her head 2. One EMT should be the established team leader. 3. Develop a plan to restrain the patient together. 4. A patient who is caught off guard is less likely to cause injury to responders.

Signs/symptoms of internal bleeding

1. Pain (most common) 2. Swelling in the area of bleeding 3. Distention 4. Bleeding into the chest cavity or lung may cause dyspnea, tachycardia, and hypotension, and hemoptysis (bright red blood that is coughed up) 5. Hematoma—a mass of blood in the soft tissues beneath the skin 6. Bruising—a contusion or ecchymosis (may not be present initially) 7. Bleeding from any body opening a. Bright red bleeding from the mouth or rectum b. Hematuria—blood in the urine c. Nonmenstrual vaginal bleeding 8. Hematemesis—vomited blood a. Bright red or dark red b. Coffee-grounds appearance 9. Melena—black, foul-smelling, tarry stool with digested blood 10. Pain, tenderness, bruising, guarding, or swelling (possible closed fracture) 11. Broken ribs; bruises over the lower part of the chest; or a rigid, distended abdomen (indicate possible lacerated spleen or liver) 12. Hypoperfusion (hypovolemic shock)

Signs/symptoms of chest injury

1. Pain at the site of injury 2. Pain localized at the site of injury that is aggravated by or increased with breathing a. Irritation of or damage to the pleural surfaces causes sharp or sticking pain with each breath (pleuritic pain or pleurisy). 3. Bruising to the chest wall 4. Crepitus with palpation of the chest 5. Any penetrating injury to the chest 6. Dyspnea (difficult breathing, shortness of breath) a. Can be caused by airway obstruction, damage to the chest wall, improper chest expansion, or lung compression b. Prompt, vigorous support of oxygenation and ventilation with prompt transport are required. 7. Hemoptysis (spitting or coughing up blood) a. Indicates damage to the lung or air passage 8. Failure of one or both sides of the chest to expand normally with inspiration 9. Rapid, weak pulse and low blood pressure a. Principal signs of hypovolemic shock b. Can result from extensive bleeding of lacerated structures within the chest cavity 10. Cyanosis around the lips or fingernails a. Sign of inadequate respiration b. Immediate ventilation and oxygenation are required.

power grip

1. Palms up and thumbs extended upward 2. Hands about 10 inches apart 3. All fingers at same angle; fingers and thumb curled tightly over the top of the handle 4. Fully support the handle on your curved palm. 5. When directly lifting a patient, tightly grip the patient in a place and manner that will ensure that you will not lose your grasp on the patient.

Mild hypothermia

1. Patient is alert, shivering, and responds appropriately. a. Core body temperature between 90°F and 95°F 2. Treatment involves passive rewarming a. Place the patient in a warm environment. b. Remove wet clothing. c. Apply heat packs or hot water bottles to the groin, axillary, and cervical regions. d. Turn up the heat to high in the patient compartment of the ambulance. e. To avoid burns, do not place heat packs directly on skin. f. Give warm fluids by mouth (if the patient can swallow).

Open abdominal injuries

1. Patients with penetrating injuries a. Generally obvious wounds and external bleeding; however, significant external bleeding is not always present b. Maintain a high index of suspicion for serious, unseen blood loss. i. Only a surgeon can accurately assess the damage. ii. You should assume the object has penetrated the peritoneum and possibly injured organs. c. Follow the general procedures described previously for care of a blunt abdominal injury, as well as: i. Inspect the patient's back and sides for an exit wound. ii. Apply a dry, sterile dressing to all open wounds. iii. If the penetrating object is still in place, apply a stabilizing bandage around it to control external bleeding and to minimize movement of the object. d. Severe lacerations of the abdominal wall may result in evisceration. i. Internal organs or fat protrude through the wound ii. Never try to replace a protruding organ. (a) Keep the organs moist and warm. (b) Cover the wound with moistened, sterile dressings. (c) Secure the dressing with a bandage. (d) Secure the bandage with tape.

Functions of Circulatory System

1. Perfusion 2. Transporting oxygen 3. Transporting carbon dioxide 4. Transporting wastes and nutrients 5. Clotting (coagulation)

Priorities upon arrival

1. Personal safety 2. Scene safety 3. Patient care

Nine phases of ambulance call

1. Preparation 2. Dispatch 3. En route 4. Arrival at scene 5. Transfer of patient to ambulance 6. En route to receiving facility (transport) 7. At receiving facility (delivery) 8. En route to station 9. Postrun

functions of integumentary system

1. Protects the body in the environment a. Protects the body from infectious organisms 2. Regulates body temperature a. Sweat is secreted to the skin surface from the sweat glands. 3. Transmits information from the environment to the brain a. The skin reacts to pressure, pain, and pleasurable stimuli.

Components of the EMS System

1. Public access 2. Clinical care 3. Medical direction 4. Integration of health services 5. Information systems 6. Prevention 7. EMS research 8. Communication systems 9. Human resources 10. Legislation and regulation 11. Evaluation 12. System finance 13. Public education 14. Education systems

Groups that turn to terrorism

1. Religious extremist groups/doomsday cults a. Include groups such as Aum Shinrikyo b. Some of these groups may participate in apocalyptic violence. 2. Extremist political groups a. Include violent separatist groups and those who seek political, religious, economic, and social freedom 3. Cyber terrorists a. They attack a population's technological infrastructure as a means to draw attention to their cause. 4. Single-issue groups a. Include antiabortion groups, animal rights groups, anarchists, racists, and even ecoterrorists

Six Rights of Medication Administration

1. Right medication 2. Right dose 3. Right patient 4. Right route 5. Right time 6. Right documentation

Pulmonary contusion

1. Should always be suspected in a patient with a flail chest 2. The pulmonary alveoli become filled with blood, and fluid accumulates in the injured area, leaving the patient hypoxic. 3. Prehospital treatment: a. Provide supplemental oxygen and positive-pressure ventilation as needed to ensure adequate oxygenation and ventilation.

SAMPLE

1. Signs (see) and symptoms (complain of) -Chief complaint (c/c) 2. Allergies 3. Medications 4. Past Illnesses 5. Last oral intake 6. Events leading up to present

Lymphatic system consists of

1. Spleen 2. Lymph nodes 3. Lymph 4. Lymph vessels 5. Thymus gland 6. Other components

Possible causes of internal bleeding

1. Stomach ulcer 2. Lacerated liver 3. Ruptured spleen 4. Broken bones, especially ribs or femur 5. Pelvic fracture

Spinal injuries in submersion

1. Submersion incidents may be complicated by spinal fractures and spinal cord injuries. 2. Assume that spinal injury exists with the following conditions: a. The submersion has resulted from a diving mishap or significant fall. b. The patient is unconscious, and no information is available to rule out the possibility of a neck injury. c. The patient is conscious but complains of weakness, paralysis, or numbness in the arms or legs. d. You suspect the possibility of spinal injury despite what witnesses say. 3. Most spinal injuries in diving incidents affect the cervical spine. 4. Stabilize the suspected injury while the patient is still in the water.

How the body copes with heat

1. Sweating (and evaporation of the sweat) 2. Dilation of skin blood vessels 3. Removal of clothing and relocation to a cooler environment

The heart requires a constant supply of blood

1. The brain and spinal cord may last 4 to 6 minutes without perfusion. 2. The lungs can survive only 15-20 minutes without perfusion. 3. Kidneys may survive 45 minutes. 4. Skeletal muscles may last 2-3 hours. 5. The gastrointestinal tract can tolerate slightly longer periods. 6. Times are based on a normal body temperature (98.6°F [37.0°C]). a. Colder temperatures will lengthen survival times.

wheeled ambulance stretcher

1. The device most commonly used to move and transport patients 2. Weighs 40-145 lb (18-66 kg), depending on its design and features 3. Generally not taken up or down stairs or to other locations where the patient must be carried for any significant distance 4. Moving a patient by rolling, using a stretcher or other wheeled device, is preferred when the situation allows and helps prevent injuries from carrying. 5. Modern stretchers are available in a number of models. a. Before going on a call, familiarize yourself with the specific features of the stretcher that your ambulance carries. 6. General features of stretchers a. Specific head end and specific foot end b. Strong, rectangular, tubular metal main frame to which all other parts are attached c. Stretcher is pulled, pushed, or lifted by this main frame or its handles. d. Most models have a second tubular frame made up of three sections that is attached within or above the main frame. i. A metal plate is fastened to each of the three sections between its sides and serves as the platform on which the stretcher mattress and patient are supported. e. The head section of the stretcher runs from the head end to near the center, where the patient's hips will be. f. Hinges at the center allow the head end to be elevated and the patient's back to be positioned at any desired angle. g. Retractable guardrails are attached along the central portion of the main frame. i. Can be lowered when a patient is being loaded onto or out of a stretcher ii. Prevent the patient from rolling off of the stretcher h. The undercarriage frame allows the litter to be adjusted to any height and locked into place. i. From 12 inches above the ground for when the stretcher is secured within the ambulance to 32-36 inches above the ground for when the stretcher is being rolled i. The mattress on a stretcher must be fluid resistant so that it does not absorb any type of potentially infectious material, including water, blood, or other body fluid. j. Patients must always be secured with the straps on the stretcher. In the event of a crash while en route to the hospital, the straps help safeguard the patient from further injury.

Body mechanics/lifting position

1. The shoulder girdle should be aligned over the pelvis. 2. The hands should be held close to the legs. 3. Force then goes essentially straight down the spinal column. 4. Very little strain occurs.

Seizures

1. The sudden attack or recurrence of a disease 2. A single episode of epilepsy, often named for the type it represents

Early adults physical changes

1. Their vital signs do not vary greatly from those seen through adulthood. a. Pulse rate will average around 70 beats/min and range between 60 and 100 beats/min. b. Respiratory rate will stay in the range of 12 to 20 breaths/min. c. Systolic blood pressure will be between 90 and 140 mm Hg. 2. From age 19 years to shortly after 25 years, the body should be functioning at its optimal level. a. Lifelong habits are solidified. b. The body is working at peak efficiency, but, as early adulthood continues, subtle erosion begins. i. Disks in the spine begin to settle, and height sometimes "shrinks." ii. Fatty tissue and weight increase. iii. Muscle strength decreases, and reflexes slow.

History of EMS

1. There is a long tradition of people providing emergency medical care to their fellow human beings. 2. Origins of EMS include: a. Volunteer ambulances in World War I b. Field care in World War II c. Field medic and rapid helicopter evacuation in Korean conflict 3. As recently as the 1960s and early 1970s, emergency ambulance service and care varied widely in the United States. 4. EMS as we know it today originated in 1966 with the publication of Accidental Death and Disability: The Neglected Disease of Modern Society (more commonly known as "The White Paper"). 5. The DOT published the first EMT training curriculum in the early 1970s. 6. The American Academy of Orthopaedic Surgeons prepared and published the first EMT textbook in 1971.

Lower airway

1. Thyroid cartilage (Adam's apple) 2. Cricoid cartilage 3. Cricothyroid membrane 4. Trachea

Move pt out of cold

1. To prevent further damage to the feet, do not allow the patient to walk. 2. Remove any wet clothing. 3. Place dry blankets over and under the patient. 4. If available, give the patient warm, humidified oxygen. 5. Handle the patient gently. 6. Do not massage the extremities. 7. Do not allow the patient to eat or use any stimulants (eg, coffee, tea, soda, or tobacco)

When you move a patient, take care that injury does not occur:

1. To you 2. To your team 3. To the patient

Toddler to preschooler psychosocial changes

1. Toddlers or preschoolers learn to speak and express themselves. 2. At 36 months of age, basic language is mastered. 3. Interaction and playing games with other children begin. 4. By 18 to 24 months, cause and effect begin to become understood. 6. Children learn to recognize gender differences by observing role models.

Presumptive signs of death

1. Unresponsiveness to painful stimuli 2. Lack of a carotid pulse or heartbeat 3. Absence of chest rise and fall 4. No deep tendon or corneal reflexes 5. Absence of pupillary reactivity 6. No systolic blood pressure 7. Profound cyanosis 8. Lowered or decreased body temperature

Older Adults Psychosocial Changes

1. Until about 5 years before death, most people retain high brain function. a. In the 5 years preceding death, mental function is presumed to decline, a theory referred to as the terminal drop hypothesis. 2. As the elderly population continues to grow, we have the responsibility to accommodate their needs during their last 20 to 40 years of life. a. Statistics indicate that 95% of the elderly live at home. b. The increasing number of elderly in the United States as a result of the baby boom of the 1940s to 1960s has produced a need for additional assisted living facilities. 3. Financial limits may restrict access to health care or medications. a. Today, more than 50% of all single women in the United States who are 60 years of age or older are living at or below the poverty level. 4. One of the important issues that the elderly need to face is their own mortality. a. Isolation and depression can be challenges.

3 common signs of allergic reactions

1. Urticaria 2. Angiodema 3. Wheezing

Stair chair

1. Use a stair chair to carry a patient up or down a flight of stairs or other significant incline if: a. The patient is conscious. b. The patient's condition allows him or her to be placed in a sitting position. 2. A stair chair is a lightweight folding chair with a molded seat, adjustable safety straps, and fold-out handles at both the head and feet. 3. Most models have rubber wheels in the back with casters in front so that they can roll along the floor and make turns. 4. Some have a specially designed track to facilitate movement down steps with little lifting required.

Short backboards

1. Used to immobilize the head, torso, and neck of a seated patient with a suspected spinal injury until the patient can be moved to a long backboard a. 3-4 feet long b. Short wooden backboards have mostly been replaced with a vest-type device such as the KED, which is designed to immobilize that patient until he or she is moved from a sitting position to a supine position on a backboard.

Neonates to infants physical changes

1. Vital signs a. The younger the person, the faster the pulse rate and respirations. i. At birth, a pulse rate of 90 to 180 beats/min and a respiratory rate of 30 to 60 breaths/min are normal. ii. Shortly after birth, the pulse often drops to 120 beats/min and the respiratory rate falls to between 30 to 40 breaths/min. iii. By 1 year, the respiratory rate slows to 20 to 30 breaths/min. b. Blood pressure directly corresponds to the patient's weight, so it typically increases with age. i. The average systolic blood pressure is 50 to 70 mm Hg for a neonate, and 70 to 95 mm Hg for a 1-year-old. 2. Weight a. A neonate usually weighs 6 to 8 lb (3 to 3.5 kg) at birth. b. The head accounts for 25% of its body weight. c. After week 2, infants grow at a rate of about 1 oz (30 g) per day, doubling their weight by 4 to 6 months and tripling it by the end of the first year. 3. Cardiovascular system a. At birth, the neonate makes the transition from fetal to independent circulation. 4. Pulmonary system a. Infants younger than 6 months are particularly prone to nasal congestion. b. The rib cage is less rigid and the ribs sit horizontally. i. Explains diaphragmatic breathing in infants c. Infants have proportionately larger tongues and proportionally shorter, narrower airways. i. Airway obstruction is more common in infants than older children or adults. d. For bag-mask ventilation, remember that an infant's lungs are fragile. Too forceful ventilations can result in trauma from pressure, or barotrauma. e. Respiratory problems can quickly become life threatening. i. Infants who are struggling to breathe can quickly tire, become overheated, and even become dehydrated. 5. Nervous system a. The nervous system's evolution continues after birth. b. A neonate is born with certain reflexes. i. Moro reflex (startle reflex): when a neonate is caught off guard, it opens its arms wide, spreads its fingers, and seems to grab at things. ii. Palmar grasp: occurs when an object is placed into the neonate's palm iii. Rooting reflex: when something touches a neonate's cheek, it will turn its head toward the touch. iv. Sucking reflex: occurs when a neonate's lips are stroked c. A neonate's fontanelles allow the head to be molded. i. Spaces between the bones that eventually fuse to form the skull ii. The posterior fontanelle fuses by 3 months. iii. The anterior fontanelle fuses between 9 and 18 months of age. iv. If either of the fontanelles is depressed, the infant is most likely dehydrated. v. A bulging fontanelle is indicative of increased intracranial pressure. 6. Immune system a. Infants maintain some of the mother's immunities. b. Infants can also receive antibodies via breastfeeding, further bolstering their immune system.

Middle adults physical changes

1. Vital signs remain the same. a. Average pulse rate remains 70 beats/min, with a range between 60 and 100 beats/min. b. Respiratory rate continues at 12 to 20 breaths/min. c. Blood pressure remains between 90 and 140 mm Hg. 2. Middle adults are vulnerable to vision and hearing loss. 3. Cardiovascular health becomes an issue. 4. Cancer incidence increases. 5. Menopause takes place in the late 40s or early 50s. 6. Diabetes, hypertension, and weight problems are common. 7. Exercise and a healthy diet can diminish the effects of aging. 8. Unintentional injuries are the leading cause of death in ages 41 to 44 years; cancer is the leading cause of death in ages 45 to 60 years.

When to use urgent moves

1. With altered level of consciousness 2. With inadequate ventilation 3. In shock 4. In extreme weather conditions

A patient, parent, or caregiver's decision to accept or refuse treatment should be based on information that you provide:

1. Your assessment of what might be wrong 2. A description of the treatment you feel is necessary 3. Any possible risks of treatment 4. The availability of alternative treatments 5. The possible consequences of refusing treatment

Muscles of breathing

1. diaphragm 2. intercostal muscles 3. Neck (cervical muscles) 4. Abdominal muscles 5. Pectoral muscles

GCS (Glasgow Coma Scale)

1. predict severity + prognosis of coma during primary survey 2. 3 components i. ABILITY TO OPEN EYES ii. MOTOR RESPONSE iii. VERBAL RESPONSE

Orthostatic vitals

1. take vitals supine 2. sit or stand. wait 1-3m. take vitals +: SBP drop > 20 or DBP drop > 10 and 10% spike in HR

How to suction

1. turn it on to check 2. measure 3. open pts mouth and insert tip 4. suction to depth you can see 5. never suction for more than 15 secs on an adult

When to use NRB (symptoms)

10-15L hypoxia, but good chest signs respirations 8-28

When to use BVM (Symptoms)

10-15L pt requires manual ventilation respirations <8 or >28

How to treat carbon monoxide poisoning

100% humidified oxygen

While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age.

11, 50

normal infant HR

120-160bpm

When pulling a patient, you should extend your arm no more than ___ in front of your torso

15-20 inches

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately

16 hours

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.

18%

Early adults

19-40 years

ADA (Americans with Disabilities Act)

1990 Protects people who have a disability from being denied access to programs and services that are provided by state or local governments 2. Prohibits employers from failing to provide full and equal employment to the disabled 3. Title I: protects EMTs with disabilities who are seeking gainful employment under many circumstances a. Employers with a certain number of employees are required to adjust processes so that a candidate with a disability can be considered for a position and modify the work environment or how the job is normally performed.

Nature of illnesses for internal bleeding

2. Possible nontraumatic causes include: a. Bleeding ulcers b. Bleeding from the colon c. Ruptured ectopic pregnancy d. Aneurysms 3. These signs are frequent but not always present: a. Abdominal tenderness b. Guarding c. Rigidity d. Pain e. Distention 4. In older patients, signs include: a. Dizziness b. Faintness c. Weakness 5. Ulcers or other gastrointestinal problems may cause: a. Vomiting of blood b. Bloody diarrhea or urine

Facial fractures

2. You should assume that any patient who has sustained a direct blow to the mouth or nose has a facial fracture. 3. Other clues include: a. Bleeding in the mouth b. Inability to swallow or talk c. Absent or loose teeth d. Loose or movable bone fragments

Skeletal System consists of

206 bones, ligaments, tendons, cartilage

Normal Toddler Respiratory Rate

24-40/minute

preschool age

3-5 years

Preschoolers

3-6 years a. Pulse rate is 80 to 140 beats/min. b. Respiratory rate is 20 to 25 breaths/min. c. Systolic blood pressure is 80 to 100 mm Hg. d. Weight gain should level off. e. Although toddlers and preschoolers have more lung tissue, they do not have well-developed lung musculature. i. Prevents them from sustaining deep or rapid respirations for an extended period of time

Toddlers to preschoolers physical changes

3. The loss of passive immunity is possibly the most obvious development at this stage of human life. a. Colds often develop that may manifest as gastrointestinal distress or upper respiratory tract infections. b. Toddlers acquire immunity as their bodies are exposed to various viruses and germs. 4. Neuromuscular growth also makes considerable progress at this age. a. Toddlers and preschoolers spend time exploring by walking, running, jumping, and playing catch. b. Preschoolers will have a brain that weighs 90% of its final adult weight. c. Muscle mass and bone density increase. 5. Physiologically, toddlers have the neuromuscular control capable for bladder control by 12 to 15 months of age. a. However, the child may not be psychologically ready until 18 to 30 months of age. b. The average age for completion of toilet training is 28 months of age. 6. The leading cause of death for this age group is unintentional injuries (accidents).

Hydroplaning of the ambulance on wet roads would MOST likely occur at speeds of greater than _____ mph.

Single rescuer CPR

30 compressions; 2 breaths always for adults

Compressions in CPR

30 in adults

normal infant respiratory rate

30-60 breaths/min

Ventilation to compression ratio (adult)

30:2

Ventilation to compression ratio (child)

30:2 for 1 responder 15:2 for 2 responders

Ventilation to compression ratio (infant)

30:2 for 1 responder 15:2 for 2 responders

Dehydration

4. Signs of mild dehydration: a. Dry lips and gums b. Decreased saliva c. Few wet diapers 5. Signs of moderate dehydration: a. Sunken eyes b. Sleepiness c. Irritability d. Loose skin e. Sunken fontanelles 6. Signs of severe dehydration: a. Mottled, cool, clammy skin b. Delayed capillary response time c. Increased respirations

Middle adults

41-60 years

Sacrum

5 fused vertebrae

mouth to mask ventilations, its receive what percentage of O2?

55%

School-aged children

6-12 years

school-age child

6-12 years

The Microdrip administration delivers 1mL of fluid for every drops

Primary assessment should take no more than

60-90 seconds

normal infant blood pressure

60/40 mmHg

Older adults

61 years and older

older adults

65+

Average pulse 19-60 years

70bpm

In preparing for a disaster, EMS systems should have enough supplies for at least a period of self sufficiency

72 hour

Life expectancy

78 years old

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of:

Normal child pulse

80-100 bpm

Normal child blood pressure

80-100 systolic

Trunking

800MHz systems use the latest technology to allow greater traffic.

Normal toddler pulse

90-140

BVM Rules

>28 respirations or <8 respirations (inadequate, fast) 8-28 normal DO NOT USE

. When a team member speaks, you should repeat the message back to him or her. This is an example of: A.closed loop communication. B.a clear message. C.constructive intervention. D.courtesy.

1.A 41-year-old man presents with slow, irregular breathing; hypotension; and dilated pupils. These signs MOST likely indicate dysfunction of the: A.brain stem. B.hypothalamus. C.cerebrum. D.cerebellum.

1.All of the following are common signs and symptoms of cardiac ischemia, EXCEPT: A.headache. B.chest pressure. C.shortness of breath. D.anxiety or restlessness.

1.All of the following are examples of standard patient transfer equipment, EXCEPT: A.Stokes baskets. B.long backboards. C.wheeled stair chairs. D.wheeled ambulance stretchers.

1.The first stage of labor ends when: A.the presenting part of the baby is visible. B.contractions are less than 10 minutes apart. C.the mother experiences her first contraction. D.the amniotic sac ruptures and labor pains begin.

1.The process in which oxygen and carbon dioxide are exchanged in the lungs is called: A.respiration. B.ventilation. C.metabolism. D.inhalation.

1.The signs and symptoms of an allergic reaction are caused by the release of: A.histamine. B.epinephrine. C.leukotrienes. D.both histamine and leukotrienes.

1.What type of terrorist group would MOST likely bomb an abortion clinic? A.Single-issue group B.Technology terrorists C.Extremist political group D.Violent religious group

1.Which of the following statements regarding the "Adam's apple" is FALSE? A.It is inferior to the cricoid cartilage. B.It is formed by the thyroid cartilage. C.It is the uppermost part of the larynx. D.It is more prominent in men than in women.

10.A 40-year-old man, who was the unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. You should be MOST concerned that he: A.has injured his myocardium. B.has a collapsed lung and severe hypoxia. C.has extensive bleeding into the pericardial sac. D.is at extremely high risk for ventricular fibrillation.

10.All of the following are potential causes of impaired tissue perfusion EXCEPT: A.increased number of red blood cells. B.pump failure. C.low fluid volume. D.poor vessel function.

10.Nitroglycerin is contraindicated in patients: A.with a systolic blood pressure less than 100 mm Hg. B.with chest pain of greater than 30 minutes duration. C.who are currently taking antibiotics for an infection. D.who are younger than 40 years of age and have diabetes.

10.Patients with diabetic ketoacidosis experience polydipsia because: A.they are dehydrated secondary to excessive urination. B.the cells of the body are starved due to a lack of glucose. C.fatty acids are being metabolized at the cellular level. D.hyperglycemia usually causes severe internal water loss.

10.The five hazards most commonly associatedwith a structural fire are: A.smoke, oxygen deficiency, high ambient temperatures, toxic gases, and building collapse. B.smoke, oxygen deficiency, inhalation of tar particles, injury from breaking glass, and building collapse. C.smoke, high ambient temperatures, toxic gases, electric shock, and inhalation of tar particles. D.oxygen deficiency, high ambient temperatures, toxic gases, electric shock, and injury from breaking glass.

10.Upon arrival at a scene where hazardous materials are involved, you should park the ambulance: A.upwind from the scene. B.with the warning lights off. C.downhill from the scene. D.at least 50 feet from the scene.

10.When caring for a female with trauma to the external genitalia, the EMT should: A.use local pressure to control bleeding. B.carefully pack the vagina to reduce bleeding. C.remove any impaled objects from the vagina. D.cover any open wounds with moist, sterile dressings.

10.When requesting medical direction for a patient who was involved in a major car accident, the EMT should avoid: A.using radio codes to describe the situation. B.questioning an order that seems inappropriate. C.relaying vital signs unless they are abnormal. D.the use of medical terminology when speaking.

10.Which of the following mechanisms of injury would MOST likely cause a crushing injury of the larynx and/or trachea? A.Attempted suicide by hanging B.Gunshot wound to the lateral neck C.Car crash involving lateral impact D.Patient whose head hits the windshield

10.Your partner is working a 48-hour shift and has had little sleep. He disagrees with you over how to position the patient and how you should drive to the hospital. You should: A.follow your partner's orders and discuss the call after the patient has been dropped off at the hospital. B.confront your partner about his or her behavior in front of the patient. C.tell your partner he or she does not know that they are talking about. D.ask the patient who he or she thinks is correct.

14.Which one of the following is NOT an appropriate treatment for EMTs to provide to a patient who has a hematologic disorder? A.Analgesics for pain B.Support of symptoms C.High-flow oxygen therapy at 12 to 15 L/min D.Rapid transport

2. Prefixes can indicate: A.color. B.conditions. C.body parts. D.procedures.

2.A 30-year-old male, who ingested an unknown substance, begins to vomit. You should: A.collect the vomitus and bring it to the hospital. B.apply a bag-valve mask. C.analyze the vomitus and try to identify the poison. D.suction his oropharynx for no longer than 30 seconds.

2.A 45-year-old man with type 1 diabetes is found unresponsive. Which of the following questions is MOST important to ask his wife? A."Did he take his insulin today?" B."How long has he been a diabetic?" C."Has he seen his physician recently?" D."What kind of insulin does he take?"

2.Anaphylactic shock is typically associated with: A.urticaria. B.bradycardia. C.localized welts. D.a severe headache.

2.Depression and schizophrenia are examples of: A.functional disorders. B.altered mental status. C.behavioral emergencies. D.organic brain syndrome.

2.If an injury distracts an EMT from assessing a more serious underlying illness, the EMT has suffered from: A.tunnel vision. B.index of suspicion. C.virulence. D.a trauma emergency.

2.The EMT should assess a patient's tidal volume by: A.observing for adequate chest rise. B.assessing the facial area for cyanosis. C.counting the patient's respiratory rate. D.measuring the patient's oxygen saturation.

2.The MOST effective way of preventing the spread of disease is: A.handwashing. B.keeping your immunizations up-to-date. C.placing a HEPA respirator on the patient. D.wearing goggles, gloves, a gown, and a mask.

2.Upon arriving at a scene in which the incident command system has been activated, you should expect to: A.be passed from sector to sector, as needed, in between assignments. B.report directly to the incident commander in between assignments. C.be assigned a specific responsibility for the duration of the incident. D.be given general directions and allowed to function independently.

2.When a small child falls from a significant height, the ______ MOST often strikes the ground first. A.head B.back C.feet D.side

2.When communicating with an older patient, you should: A.approach the patient slowly and calmly. B.step back to avoid making the patient uncomfortable. C.raise your voice to ensure that the patient can hear you. D.obtain the majority of your information from family members.

2.Which of the following organs would be the MOST likely to bleed profusely if severely injured? A.Liver B.Kidney C.Stomach D.Gallbladder

3.A 34-year-old woman with a recent history of pelvic inflammatory disease presents with acute severe abdominal pain. Her abdomen is distended and diffusely tender to palpation. Based on these findings, you should suspect: A.peritonitis. B.pancreatitis. C.appendicitis. D.cholecystitis.

3.A 45-year-old convenience store clerk was shot in the right anterior chest during a robbery. Your assessment reveals that the wound has blood bubbling from it every time the patient breathes. Your MOST immediate action should be to: A.prevent air from entering the wound. B.cover the wound with a bulky dressing. C.assess the patient's back for an exit wound. D.transport the patient promptly to the closest trauma center.

3.A 56-year-old man experienced a sudden, severe headache and then became unresponsive. He has a history of high blood pressure. The MOST likely cause of his condition is a(n): A.hemorrhagic stroke. B.acute ischemic stroke. C.severe migraine headache. D.transient ischemic attack.

3.A condition that clouds the lens of the eye is called: A.cataract. B.nystagmus. C.astigmatism. D.glaucoma.

3.A diabetic patient presents with a blood glucose level of 310 mg/dL and severe dehydration. The patient's dehydration is the result of: A.excretion of glucose and water from the kidneys. B.a deficiency of insulin that causes internal fluid loss. C.an infection that often accompanies hyperglycemia. D.an inability to produce energy because of insulin depletion.

3.A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n): A.epidural hematoma. B.subdural hematoma. C.concussion. D.contusion.

3.As you approach an unconscious patient who is still in her wrecked vehicle, you note that there is a power line entangled in the wreckage of the vehicle. You should: A.retreat until the power line has been removed or the power is shut off. B.carefully gain access to the patient without touching any metal objects. C.don a pair of rubber gloves and carefully disentangle and remove the power line. D.call for a tow truck to lift the vehicle off of the power line and then access the patient.

3.Findings such as inadequate breathing or an altered level of consciousness should be identified in the: A.primary assessment. B.focused assessment. C.secondary assessment. D.reassessment.

3.It is impractical to apply a vest-type extrication device on a critically injured patient to remove him or her from a wrecked vehicle because it: A.takes too long to correctly apply. B.does not fully immobilize the spine. C.cannot be used on patients who are in their car. D.does not provide adequate stabilization.

3.Which of the following diseases is potentially drug resistant and is thought to be transmitted by coughing? A.Tuberculosis B.Croup C.Diphtheria D.Epiglottitis

4.The purpose of a shunt is to: A.minimize pressure within the skull. B.reroute blood away from the lungs. C.instill food directly into the stomach. D.drain excess fluid from the peritoneum.

4.What is a wheal? A.A raised, swollen, well-defined area on the skin B.An area of localized swelling involving the lips, tongue, and larynx C.Generalized itching or burning that appears as multiple, small, raised areas on the skin D.An exaggerated immune response to any substance

4.When caring for a chemical burn to the eye, the EMT should: A.prevent contamination of the opposite eye. B.immediately cover the injured eye with a sterile dressing. C.avoid irrigating the eye, as this may cause further injury. D.irrigate both eyes simultaneously, even if only one eye is injured.

4.Which of the following sets of vital signs is LEAST indicative of internal bleeding? A.BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min B.BP, 100/50 mm Hg; pulse rate, 120 beats/min; respirations, 24 breaths/min C.BP, 98/60 mm Hg; pulse rate, 110 beats/min; respirations, 28 breaths/min D.BP, 102/48 mm Hg; pulse rate, 100 beats/min; respirations, 22 breaths/min

5.A 30-year-old male, who has been playing softball all day in a hot environment, complains of weakness and nausea shortly after experiencing a syncopal episode. Appropriate treatment for this patient includes all of the following, EXCEPT: A.giving a salt-containing solution by mouth. B.moving him to a cooler environment at once. C.administering oxygen via nonrebreathing mask. D.placing him in a supine position and elevating his legs.

5.All of the following are responsibilities of the EMS medical director, EXCEPT: A.evaluating patient insurance information. B.serving as liaison with the medical community. C.ensuring that the appropriate standards are met by EMTs. D.ensuring appropriate EMT education and continuing training.

5.An 8-year-old boy was struck by a car, is unconscious, and is bleeding from the mouth. A police officer tells you that he is unable to contact the child's parents. You should: A.continue to treat the child and transport as soon as possible. B.cease all treatment until the child's parents can be contacted. C.continue with treatment only if authorized by medical control. D.provide only airway management until the parents are contacted.

5.An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: A.trauma to the pelvis. B.blunt abdominal trauma. C.a severe closed head injury. D.penetrating thoracic trauma.

5.Artificial ventilation may result in the stomach becoming filled with air, a condition called: A.gastric distention. B.vomitus. C.abdominal-thrust maneuver. D.acute abdomen.

5.Bronchospasm is MOST often associated with: 5.asthma. 6.bronchitis. 7.pneumonia. 8.pneumothorax.

5.During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. The first thing you should do is: A.turn the patient on her side. B.remove the airway at once. C.suction the patient's mouth. D.use a smaller-sized oral airway.

5.What does the DOPE mnemonic help you to recognize? A.Causes of airway obstruction B.Risk factors for patients using technology assistance C.Questions to ask patients with pacemakers D.A vagal nerve stimulator

5.Which of the following patients would have the HIGHEST treatment priority at the scene of a mass-casualty incident? A.24-year-old man who is unconscious, has snoring respirations, and severe burns B.32-year-old woman who is pulseless and apneic with an abdominal evisceration C.29-year-old woman who is in full cardiac arrest with massive open chest trauma D.32-year-old man with an open head injury, exposed brain matter, and no carotid pulse

5.While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find: A.a deformed steering wheel. B.that the airbags deployed. C.a crushed instrument panel. D.damage to the lower dashboard.

6.A 60-year-old woman presents with a BP of 80/60 mm Hg, a pulse rate of 110 beats/min, mottled skin, and a temperature of 103.9°F. She is MOST likely experiencing: A.septic shock. B.neurogenic shock. C.profound heart failure. D.a severe viral infection.

6.A 71-year-old man with a history of hypertension and vascular disease presents with tearing abdominal pain. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his respirations are 28 breaths/min. Your assessment reveals that his abdomen is rigid and distended. Considering his medical history and vital signs, you should be MOST suspicious for a(n): A.aortic aneurysm. B.hemorrhagic stroke. C.acute myocardial infarction. D.infarction of the large intestine.

6.A body part that lies closer to the midline when compared to another is considered to be: A.medial. B.distal. C.lateral. D.proximal.

6.To effectively immobilize a fractured clavicle, you should apply a(n): A.sling and swathe. B.air splint over the entire arm. C.rigid splint to the upper arm, then a sling. D.traction splint to the arm of the injured side.

6.When assessing a patient who was exposed to a vesicant agent, you should expect to encounter: A.skin blistering. B.loss of hearing. C.vomiting blood. D.profound bradycardia.

6.When assessing a patient with an infectious disease, what is the first action you should perform? A.Size up the scene and take standard precautions. B.Obtain a SAMPLE history. C.Hand the patient off to a paramedic. D.Cover your mouth and nose with your hand.

6.While the EMT is in a vehicle assessing the patient, the rescue team should be: A.assessing exactly how the patient is trapped and determining the safest way to extricate. B.awaiting further instructions from the EMT regarding how to proceed with the extrication. C.actively extricating the patient using whichever rescue method is deemed necessary by the rescue leader. D.preparing for a simple extrication process, as the EMT has obviously gained access to the patient.

6.Whiplash injuries are MOST common following _________ impacts. A.rear-end B.rollover C.frontal D.lateral

7.A 22-year-old male was attacked by a rival gang and has a large knife impaled in the center of his chest. Your assessment reveals that he is apneic and pulseless. You should: A.carefully remove the knife, control any bleeding, begin CPR, and transport. B.stabilize the knife in place, provide rescue breathing, and transport at once. C.remove the knife and control any bleeding, apply the AED, and analyze his rhythm. D.begin CPR, control any external bleeding, and transport rapidly to a trauma center.

7.Self-concept is: A.our perception of ourselves. B.how we feel about ourselves. C.how we fit in with peers. D.how we react to certain situations.

7.The MOST reliable indicator of upper airway swelling during a severe allergic reaction is: A.stridor. B.anxiety. C.cyanosis. D.wheezing.

7.The medical term for inflammation of the urinary bladder is: A.cystitis. B.nephritis. C.cholecystitis. D.diverticulitis.

8.A 70-year-old man is experiencing a severe nosebleed. When you arrive, you find him leaning over a basin, which contains an impressive amount of blood. He has a history of coronary artery disease, diabetes, and migraine headaches. His BP is 180/100 and his heart rate is 100 beats/min. Which of the following is the MOST likely contributing factor to his nosebleed? A.His blood pressure B.His history of diabetes C.The fact that he is elderly D.His heart rate of 100 beats/min

8.An important part of the assessment process for a patient with special needs is to: A.interact with the caregiver. B.interact with the patient. C.talk to the manufacturer of the equipment being used. D.transport immediately.

8.If the cells do not receive glucose, they will begin to metabolize: A.fat. B.acid. C.sugar. D.ketones.

8.To extract a patient from the basement of a building, you must transport the patient up a flight of stairs. In doing this, you must ensure that: A.the elevated head of the backboard goes first. B.the backboard with the elevated foot end goes first. C.the backboard is slightly tilted to the left to distribute weight. D.the patient's feet are higher than his or her head, whichever end is carried first.

8.When physically restraining a violent patient, the EMT should: A.continually talk to the patient as he or she is being restrained. B.check circulation in all extremities only if the patient is prone. C.remove the restraints if the patient appears to be calming down. D.use additional force if the restrained patient begins to yell at you.

8.When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the "D" stands for: A.delay in seeking care. B.divorced parents. C.dirty appearance. D.disorganized speech.

8.You are assisting the paramedic with vascular access. When you spike the IV bag, it is important for you to use __________ technique. A.sterile B.clean C.aseptic D.reduction

8.You are treating a patient with an apparent emotional crisis. After the patient refuses treatment, you tell him that you will call the police and have him restrained if he does not give you consent. Your actions in this case are an example of: A.assault. B.battery. C.negligence. D.abandonment.

9.A 33-year-old woman presents with a generalized rash, facial swelling, and hypotension approximately 10 minutes after being stung by a hornet. Her BP is 70/50 mm Hg and her heart rate is 120 beats/min. In addition to high-flow oxygen, this patient is in MOST immediate need of: A.epinephrine. B.rapid transport. C.an antihistamine. D.IV fluids.

9.A 70-year-old man presents with an acute onset of severe, tearing abdominal pain that radiates to his back. His BP is 88/66 mm Hg, pulse rate is 120 beats/min, and respirations are 26 breaths/min. Treatment for this patient should include: A.rapid transport to the hospital. B.firm palpation of the abdomen. C.placing him in a sitting position. D.oxygen at 4 L/min via nasal cannula.

9.A laceration located on the plantar surface is on the: A.sole of the foot. B.palm of the hand. C.back of the body. D.front of the body.

9.Instead of the abdominal-thrust maneuver, use ___________ for women in advanced stages of pregnancy and patients who are obese. A.chest thrusts B.Sellick maneuver C.basic life support D.DNR orders

9.Paradoxical chest movement is typically seen in patients with: A.a flail chest. B.a pneumothorax. C.isolated rib fractures. D.a ruptured diaphragm.

9.Placards are used on: A.buildings. B.individual packages. C.storage lockers. D.storage papers.

9.Polypharmacy is a term used to describe a patient who takes: A.multiple medications. B.other people's medications. C.a medication more than once a day. D.medication only when he or she feels the need to.

9.Shortly after ascending rapidly to the surface of the water while holding his breath, a 29-year-old diver begins coughing up pink, frothy sputum and complains of dyspnea and chest pain. You should suspect and treat this patient for: A.an air embolism. B.a pneumothorax. C.pneumomediastinum. D.decompression sickness.

9.The mnemonic DUMBELS can be used to recall the signs and symptoms of a cholinergic drug poisoning. The "E" in DUMBELS stands for: A.emesis. B.erythema. C.ecchymosis. D.elevated blood pressure.

9.Upon arrival at the residence of a young male with an apparent emotional crisis, a police officer tells you that the man is acting bizarrely. You find him sitting on his couch; he is conscious, but confused. He takes medications, but cannot remember why. His skin is pale and diaphoretic, and he has noticeable tremors to his hands. You should FIRST rule out: A.hypoglycemia. B.suicidal thoughts. C.severe depression. D.schizophrenia.

9.Which of the following drugs is commonly used to facilitate sexual assault? A.Rohypnol B.Heroin C.Cocaine D.Marijuana

9.Which of the following musculoskeletal injuries has the GREATEST risk for shock due to blood loss? A.Pelvic fracture B.Posterior hip dislocation C.Unilateral femur fracture D.Proximal humerus fracture

9.Which of the following statements about helicopters is true? A.It is possible that the main rotor blade will dip to within 4 feet of the ground. B.A helicopter is considered "hot" when it is on the ground and the rotors are still. C.If the helicopter must land on a grade, you should approach it from the uphill side. D.If you must go from one side of the helicopter to the other, the best way is to duck under the body.

9.While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. She tells you that she feels the urge to push. You should: A.cover the arm with a sterile towel and transport immediately. B.encourage her to keep pushing as you prepare for rapid transport. C.insert your gloved fingers into the vagina and try to turn the baby. D.instruct the mother to keep pushing and give her high-flow oxygen.

9.Why do finances become an issue during middle adulthood? A.Middle adults are often supporting both their children and their parents. B.Middle adults make less money than early adults. C.Their deteriorating health makes it difficult to get to work. D.Hearing loss prevents them from working.

9.Your patient opens his eyes when you say his name, is making incomprehensible sounds, and withdraws when you pinch his earlobe. What is his GCS score? A.9 B.8 C.11 D.12

Hypoxic drive

A "backup system" to control respiration; senses drops in the oxygen level in the blood.

Which in recovery position?

A 31 year old semiconscious male with hypoglycemia and adequate breathing

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?

A 49 year old female with diabetes and difficulty breathing

Pulmonary embolism

A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.

pulmonary embolism

A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.

Commotio cordis

A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat.

greater trochanter

A bony prominence on the proximal lateral side of the thigh, just below the hip joint.

coup-countercoup brain injury

A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact.

Pons

A brain structure that relays information from the cerebellum to the rest of the brain

Peptic ulcer disease

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

Rapid assessment

A brief, high-speed survey of an area's biological diversity. (no more than 60-90seconds)

subcutaneous emphysema

A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues.

Medication

A chemical substance that is used to treat or prevent disease or relieve pain.

Asthma

A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing.

load-distributing band (LDB)

A circumferential chest compression device composed of a constricting band and backboard that is either electrically or pneumatically driven to compress the heart by putting inward pressure on the thorax.

nerve agents

A class of chemical called organophosphates; they function by blocking an essential enzyme in the nervous system, which causes the body's organs to become overstimulated and burn out.

Embolus

A clot that breaks lose and travels through the bloodstream.

nonrebreathing mask

A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide).

head tilt-chin lift maneuver

A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.

Carbon dioxide retention

A condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high blood levels of carbon dioxide.

Gastric distention

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.

gastric distention

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.

Hypovolemic shock

A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion.

status epilepticus

A condition in which seizures recur every few minutes or last more than 30 minutes.

Diabetes

A condition in which the body is unable to produce enough insulin, the hormone required for the metabolism of sugar

Osteoporosis

A condition in which the body's bones become weak and break easily.

Shock

A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion.

Ventricular tachycardia (V-tach)

A condition in which the heartbeat is quite rapid; if rapid enough, ventricular tachycardia will not allow the heart's chambers to fill with enough blood between beats to produce blood flow sufficient to meet the body's needs. (150-200 bpm)

Acute abdomen

A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary.

acute abdomen

A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary.

Distributive shock

A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.

Nasal cannula

A device that delivers low concentrations of oxygen through two prongs that rest in the patient's nostrils.

mechanical piston device

A device that depresses the sternum via a compressed gas-powered plunger mounted on a backboard.

mucosal atomizer device (MAD)

A device that is used to change a liquid medication into a spray and push it into a nostril.

backboard

A device that is used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury. Also called a spine board, trauma board, and longboard.

GERD (gastroesophageal reflux disease)

A digestive disease in which stomach acid or bile irritates the food pipe lining.

Epiglottitis

A disease in which the epiglottis becomes inflamed and enlarged and may cause an upper airway obstruction.

infectious disease

A disease that is caused by a pathogen and that can be spread from one individual to another.

Epilepsy

A disorder of the central nervous system characterized by loss of consciousness and convulsions.

Ureter

A duct leading from the kidney to the urinary bladder.

Epiglottis

A flap of tissue that seals off the windpipe and prevents food from entering.

epiglottis

A flap of tissue that seals off the windpipe and prevents food from entering.

blowout fracture

A fracture of the orbit or of the bones that support the floor of the orbit.

cystic fibrosis

A genetic disorder that is present at birth and affects both the respiratory and digestive systems.

Prostate gland

A gland in males that contributes to the seminal fluid.

bag-valve mask (BVM)

A handheld device with a face mask and a self-refilling bag that can be squeezed to provide artificial ventilations to a patient. It can deliver air from the atmosphere or oxygen from a supplemental oxygen supply system.

Hemophilia

A hereditary disease where blood does not coagulate to stop bleeding

Stridor

A high pitched sound generated from partially obstructed air flow in the upper airway.

Heart

A hollow, muscular organ that pumps blood throughout the body.

Sickle cell disease

A human genetic disease caused by a recessive allele that results in the substitution of a single amino acid in the hemoglobin protein; characterized by deformed red blood cells that can lead to numerous symptoms.

Cerebellum

A large structure of the hindbrain that controls fine motor skills.

placenta abruptio

A life-threatening emergency condition in which the placenta peels away from the wall of the uterus, causing massive bleeding.

Cerebral palsy

A loss or deficiency of motor control with involuntary spasms caused by permanent brain damage present at birth

Cellular telephone

A low-power portable radio that communicates through an interconnected series of repeater stations called "cells".

MIH (Mobile Integrated Healthcare)

A method of delivering health care which involves providing health care within the community rather than at a physician's office or hospital.

Isolation Precautions

A method of infection control that assumed that all human blood and body fluids were potentially infectious.

continuous positive airway pressure (CPAP)

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.

metered-dose inhaler (MDI)

A miniature spray canister used to direct medications through the mouth and into the lungs.

EMS (Emergency Medical Services)

A multidisciplinary system that represents the combined efforts of several professionals and agencies to provide prehospital emergency care to the sick and injured.

Skeletal muscle

A muscle that is attached to the bones of the skeleton and provides the force that moves the bones.

Involuntary muscle

A muscle that is not under conscious control.

Voluntary muscle

A muscle that is under conscious control

vagina

A muscular, elastic passageway that extends from the uterus to the outside of the body

Ricin

A neurotoxin derived from mash that is left from the castor bean; causes pulmonary edema and respiratory and circulatory failure leading to death.

Norepinephrine

A neurotransmitter involved in arousal, as well as in learning and mood regulation

Which is true?

A patient can consent to transport but not treatment

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.

Which of the following is an example of a psychiatric emergency?

A person violently attacking family members

Marijuana

A plant whose leaves, buds, and flowers are usually smoked for their intoxicating effects

telemetry

A process in which electronic signals are converted into coded, audible signals; these signals can then be transmitted by radio or telephone to a receiver with a decoder at the hospital.

Fertilization in humans

A process that occurs when two haploid cells, a sperm and ovum (egg), combine to form a zygote; each parent donates 23 chromosomes and the resulting zygote has 46 chromosomes

barrier device

A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids.

Insulin

A protein hormone synthesized in the pancreas that regulates blood sugar levels by facilitating the uptake of glucose into tissues

In which of the following patients would you remove an impaled object?

A pulseless and apneic patient with a knife impaled in the back

Scanner

A radio receiver that searches or "scans" across several frequencies until the message is completed; the process is then repeated.

generalized tonic-clonic seizure

A seizure that features rhythmic back-and-forth motion of an extremity and body stiffness.

High Fowler's Position

A semi-sitting position; the head of the bed is raised 60 to 90 degrees

Excited delirium

A serious behavioral condition in which a person exhibits agitated behavior combined with disorientation, hallucinations, or delusions; also called agitated delirium or exhaustive mania.

Emphysema

A serious disease that destroys lung tissue and causes breathing difficulties.

dehydration

A serious reduction in the body's water content

2-3 word dyspnea

A severe breathing problem in which a patient can speak only two or three words at a time without pausing to take a breath.

Recovery position

A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.

recovery position (lateral recumbent)

A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.

Oral glucose

A simple sugar that is readily absorbed by the bloodstream; it is carried on the EMS unit.

Mobile data terminal (MDT)

A small computer terminal inside the ambulance that directly receives data from the dispatch center.

Midbrain

A small part of the brain above the pons that integrates sensory information and relays it upward.

JumpSTART triage

A sorting system for pediatric patients younger than 8 years or weighing less than 100 lb. There is a minor adaptation for infants since they cannot ambulate on their own.

Repeater

A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency.

Cardiogenic shock

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

Secondary assessment

A step within the patient assessment process in which a systematic physical examination of the patient is performed. The examination may be a systematic full-body scan or a systematic assessment that focuses on a certain area or region of the body, often determined through the chief complaint.

Scene size-up

A step within the patient assessment process that involves a quick assessment of the scene and the surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care.

Bile

A substance produced by the liver that breaks up fat particles.

Stroke

A sudden attack of weakness or paralysis that occurs when blood flow to an area of the brain is interrupted

Pin-indexing system

A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.

Incident command system

A system implemented to manage disasters and mass- and multiple-casualty incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander. Also referred to as the incident management system.

active compression-decompression CPR

A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression); may increase the amount of blood that returns to the heart, and thus, the amount of blood ejected from the heart during the compression phase.

Homeostasis

A tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as blood glucose, around a particular level

Thrombophilia

A tendency toward the development of blood clots as a result of an abnormality of the system of coagulation.

Capillary refill

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.

Symphysis

A type of joint that has grown together forming a very stable connection (slight, limited motion)

Preconventional reasoning

A type of reasoning in which a child acts almost purely to avoid punishment to get what he or she wants.

Postconventional reasoning

A type of reasoning in which a child bases decisions on his or her conscience.

Conventional reasoning

A type of reasoning in which a child looks for approval from peers and society.

CPR should be initiated when

A valid living will is unavailable

Epidemic

A widespread outbreak of an infectious disease.

Levels of PPE

A: Greatest level of eyes, skin, and mucus membranes Includes SCBA and fully encapsulating chemically protective suit FULLY ENCAPSULATED B: Greatest level of respiratory protection but lesser eye and skin Includes SCBA and chemical resistant clothing suit HOODED SUIT C: Known/quantified respiratory substance where skin and eye exposure unlikely Air purifying respirator and chemical resistant suit AIR PURIFYING RESPIRATOR D: Work uniform for nuisance contamination only CONTEXT SPECIFIC

How to treat allergic reaction

ABC, 02, monitor epi .3mg (im) 1:1000 Wheezing breathing Benadryle 25-50mg

What medications can an EMT administer?

ALL REQUIRE MEDICAL CONTROL -narcan (naxolene) -epipen (auto-injector) -activated charcoal -CAN ASSIST with prescribed drugs (nitro, etc.)

Decision-making capacity

Ability to understand and process information and make a choice regarding appropriate medical care.

Symptoms of seizures

Abnormal motor activity (convulsions) Abnormal sensory activity Abnormal autonomic activity Abnormal psychic activity

High Altitude Cerebral Edema

Above 12,000ft a. Severe, constant, throbbing headache b. Ataxia (lack of muscle coordination and balance) c. Extreme fatigue d. Vomiting e. Loss of consciousness

Cervical fractures and breathing

Above 5 suffocate (unable to breathe) 5 to stay alive (5 and below ok)

Acute mountain sickness

Above 5,000ft a. Headache b. Lightheadedness c. Fatigue d. Loss of appetite e. Nausea f. Difficulty sleeping g. Shortness of breath during physical exertion h. Swollen face

High Altitude Pulmonary Edema

Above 8,000 ft a. Shortness of breath b. Cough with pink sputum c. Cyanosis d. Rapid pulse

Intracranial pressure

Accumulations of blood within the skull or swelling of the brain can rapidly lead to an increase in intracranial pressure (ICP). a. Increased ICP squeezes the brain against bony prominences within the cranium. 2. Signs of increased intracranial pressure: a. Cheyne-Stokes respirations b. Ataxic (Biot) respirations c. Decreased pulse rate d. Headache e. Nausea f. Vomiting g. Decreased alertness h. Bradycardia i. Sluggish or nonreactive pupils j. Decerebrate posturing k. Increased or widened blood pressure

Frostbite

Actual freezing of tissue fluid resulting in damage to the skin and underlying tissue

Pertussis

Acute infectious disease characterized by a cough that has a "whoop" sound; also called whooping cough

Process of binding/sticking to a surface

Adsorption

ALS (Advanced Life Support)

Advanced procedures, such as drug administration

What occurs when a patient is breathing very rapidly and shallowly?

Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange

AEIOU TIPS

Alcohol, Epilepsy (seizures), Insulin, Overdose, Uremia, Trauma, Infection, Poisoning/psychiatric, Stroke.

AVPU

Alert, Verbal, Pain, Unresponsive

interoperable communications system

Allows all of the agencies involved to share valuable information with each other in real time

Cervical spine

Also known as the neck, is comprised of seven vertebral bodies (C1-C7) that make up the upper most part of the spine. These vertebrae connect the spine to the skull.

Which of the following is considered an organic brain syndrome?

Alzheimer dementia

Expiratory reserve volume

Amount of air that can be forcefully exhaled after a normal tidal volume exhalation

Tidal volume

Amount of air that moves in and out of the lungs during a normal breath

Cardiac Output (CO)

Amount of blood pumped in 1 minute (~5 L) CO = HR × SV

Dementia

An abnormal condition marked by multiple cognitive defects that include memory impairment.

Pulse oximetry

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.

Psychiatric emergency

An emergency in which abnormal behavior threatens a person's own health and safety or the health and safety of another person, for example when a person becomes suicidal, homicidal, or has a psychotic episode.

Hypertensive emergency

An emergency situation created by excessively high blood pressure, which can lead to serious complications such as stroke or aneurysm.

Paramedic

An individual who has extensive training in advanced life support, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills.

EMT (Emergency medical technician)

An individual who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications.

Palmar grasp

An infant reflex that occurs when something is placed in the infant's palm; the infant grasps the object.

Pneumonia

An inflammation of lung tissue, wherer the alveoli in the affected areas fill w/fluid

pneumonia

An inflammation of lung tissue, wherer the alveoli in the affected areas fill w/fluid

Meningococcal meningitis

An inflammation of the meningeal coverings of the brain and spinal cord; can be highly contagious.

Pancreas

An organs in the abdominal cavity with two roles. The first is an exocrine role: to produce digestive enzymes and bicarbonate, which are delivered to the small intestine via the pancreatic duct. The second is an endocrine role: to secrete insulin and glucagon into the bloodstream to help regulate blood glucose levels.

Tripod position

An upright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward.

Sniffing position

An upright position in which the patient's head and chin are thrust slightly forward to keep the airway open.

Medical Directives

Another form of a special power of attorney, a medical directive deals specifically with a person's medical care so that the person granted the special power of attorney can make decisions about the grantor's medical care in case the grantor becomes incompetent.

Altered mental status

Any deviation from alert and oriented to person, place, time, and event, or any deviation from a patient's normal baseline mental status.

Dysbarism injuries

Any signs and symptoms caused by the difference between the surrounding atmospheric pressure and the total gas pressure in various tissues, fluids, and cavities of the body.

Noise

Anything that dampens or obscures the true meaning of a message.

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?

Aortic rupture

APGAR

Appearance (all pink, pink and blue, blue (pale) Pulse (>100, <100, absent) Grimace (cough, grimace, no response) Activity (flexed, flaccid, limp) Respirations (strong cry, weak cry, absent)

How to protect yourself from TB/meningitis

Appropriate PPE

Cerebrum

Area of the brain responsible for all voluntary activities of the body

Fontanelles

Areas where the infant's skull has not fused together; usually disappear at approximately 18 months of age.

Joints

Areas where two or more bones join together

A 30 year old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30F. He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should

Assess for a carotid pulse for up to 60 seconds

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min?

Assess for bilateral radial pulses

How deep to perform chest compressions

At least 2 inches in adult and child 1.5 inches in infant

laryngopharynx

At the base of the laryngopharynx are the trachea and the esophagus posteriorly.

Index of suspicion

Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury.

1.A young male was struck in the forearm with a baseball and complains of pain to the area. Slight swelling and ecchymosis are present, but no external bleeding. Which type of injury does this describe? A.Abrasion B.Contusion C.Hematoma D.Avulsion

1.Breathing is controlled by an area in the: A.lungs. B.brain stem. C.spinal cord. D.diaphragm.

1.During the scene size-up, you should routinely determine all of the following, EXCEPT: A.the mechanism of injury or nature of illness. B.the ratio of pediatric patients to adult patients. C.whether or not additional resources are needed. D.if there are any hazards that will jeopardize safety.

1.The ___________ lies in the retroperitoneal space. A.liver B.pancreas C.stomach D.small intestine

1.The term "shock" is MOST accurately defined as: A.a decreased supply of oxygen to the brain. B.cardiovascular collapse leading to inadequate perfusion. C.decreased circulation of blood within the venous circulation. D.decreased function of the respiratory system leading to hypoxia.

1.Type 1 diabetes is a condition in which: A.too much insulin is produced. B.glucose utilization is impaired. C.too much glucose enters the cell. D.the body does not produce glucose.

1.What is the first rule of lifting? A.Twist slowly when you lift B.Keep your back in a straight position C.Bend at the waist to pick something up D.Use your arms to do most of the lifting

1.What is the narrowest portion of the uterus? A.Vagina B.Cervix C.Fallopian tubes D.Ovaries

1.When a person is exposed to cold temperatures and strong winds for an extended period of time, he or she will lose heat mostly by: A.radiation. B.convection. C.conduction. D.evaporation.

1.When providing bag-mask ventilations to an infant, what is most important to remember? A.Blood pressure typically increases with age. B.An infant's lungs are fragile. C.An infant grows at a rate of about 30 g per day. D.An infant has a proportionately larger tongue than an adult.

1.When the chest impacts the steering wheel during a motor vehicle crash with rapid deceleration, the resulting injury, which often kills patients, usually within seconds, is: A.a hemothorax. B.aortic shearing. C.a pneumothorax. D.a ruptured myocardium.

1.Which of the following is a characteristic of a regular team? A.They serve a specialized role within the larger emergency health care system. B.Members consistently interact with the same partner. C.The team performs special functions across geographic boundaries. D.Regular teams are more common in volunteer EMS systems.

1.Which of the following is a developmental disorder characterized by impairment of social interaction? A.Down syndrome B.Autism C.Cerebral palsy D.Spina bifida

1.Which of the following is an example of care that is provided using standing orders? A.Medical control is contacted by the EMT after a patient with chest pain refuses EMS care. B.The EMT defibrillates a cardiac arrest patient, begins CPR, and then contacts medical control. C.A physician gives the EMT an order via radio to administer oral glucose to a diabetic patient. D.Following an overdose, the EMT contacts the medical director for permission to give activated charcoal.

10.A newborn is considered to be "term" if it is born after ____ weeks and before ____ weeks. A.34, 37 B.37, 42 C.38, 44 D.39, 43

10.A patient injured her knee while riding a bicycle. She is lying on the ground, has her left leg flexed, is in severe pain, and cannot move her leg. Your assessment reveals obvious deformity to her left knee. Distal pulses are present and strong. The MOST appropriate treatment for her injury involves: A.wrapping her entire knee area with a pillow. B.splinting the leg in the position in which it was found. C.straightening her leg and applying two rigid board splints. D.straightening her leg and applying and inflating an air splint.

10.Controlling internal bleeding requires: A.applying a tourniquet. B.surgery in a hospital. C.positioning the patient in the sitting position. D.providing slow and considerate transport.

10.The EMTALA act states that: A.patients should only be treated if they can pay for care. B.all patients must be treated regardless of their ability to pay for care. C.only those with serious injuries can be treated without payment for care. D.only certain facilities can treat patients who cannot pay for care.

10.When administering epinephrine by auto-injector, the EMT should hold the injector in place for: A.5 seconds. B.10 seconds. C.20 seconds. D.30 seconds.

10.Which of the following patients is breathing adequately? A.36-year-old man with cyanosis around the lips and irregular respirations B.29-year old woman with respirations of 20 breaths/min, who is conscious and alert C.22-year-old man with labored respirations at a rate of 28 breaths/min and pale skin D.59-year-old woman with difficulty breathing, whose respirations are rapid and shallow

10.Which of the following signs is LEAST indicative of a patient's potential for violence? A.The patient appears tense and "edgy." B.The patient is 6'5" tall and weighs 230 lb. C.The patient is loud and shouting obscenities. D.The patient is facing you with clenched fists.

10.Which toxicity level would you assign a hazardous material spill that could cause a person temporary damage or residual injury unless prompt medical treatment is given? A.Level 1 B.Level 2 C.Level 3 D.Level 4

10.You and your partner are ventilating an apneic adult when you notice that his stomach is becoming distended. You should: A.suction his airway for up to 15 seconds. B.reposition his head. C.increase the rate and volume of your ventilations. D.decrease your ventilation rate but use more volume.

10.You are dispatched to the scene of a trench collapse. Upon arriving at the scene, your ambulance should be parked at least _____ feet from the incident. A.250 B.500 C.750 D.1000

12.What are the two main components of blood? A.Erythrocytes and hemoglobin B.Cells and plasma C.Leukocytes and white blood cells D.Platelets and neutrophils

2.A 23-year-old woman, who is 24 weeks pregnant with her first baby, complains of edema to her hands, a headache, and visual disturbances. When you assess her vital signs, you note that her blood pressure is 160/94 mm Hg. She is MOST likely experiencing: A.eclampsia. B.preeclampsia. C.a hypertensive crisis. D.chronic water retention.

2.According to the GEMS diamond, a person's activities of daily living are evaluated during the: A.SAMPLE history. B.social assessment. C.medical assessment. D.environmental assessment.

2.As you are assessing a 24-year-old man with a large laceration to the top of his head, you should recall that: A.the scalp, unlike other parts of the body, has relatively fewer blood vessels. B.blood loss from a scalp laceration may contribute to hypovolemic shock in adults. C.any avulsed portions of the scalp should be carefully cut away to facilitate bandaging. D.most scalp injuries are superficial and are rarely associated with more serious injuries.

2.Signs and symptoms of a chest injury include all of the following, EXCEPT: A.hemoptysis. B.hematemesis. C.asymmetrical chest movement. D.increased pain with breathing.

2.Which of the following respiratory diseases causes obstruction of the lower airway? A.Croup B.Asthma C.Epiglottitis D.Laryngitis

3.A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition? A.Coronary veins B.Coronary arteries C.Pulmonary veins D.Pulmonary arteries

3.All of the following are examples of passive rewarming techniques, EXCEPT: A.removing cold, wet clothing. B.administering warm fluids by mouth. C.turning up the heat inside the ambulance. D.covering the patient with warm blankets.

3.An infant who is repeatedly rejected experiences what type of attachment? A.Secure attachment B.Anxious-avoidant attachment C.Trust and mistrust D.Rejection attachment

3.The Department of Homeland Security posts a daily advisory system to keep the public aware of the current terrorist threat level. What does an orange level indicate? A.Low: Low risk of terrorist attacks B.High: High risk of terrorist attacks C.Severe: Severe risk of terrorist attacks D.Elevated: Significant risk of terrorist attacks

3.When EMS responds to a disaster, as part of their response within the ICS, EMS would start with a scene size-up. What is the next step for the first-responding units? A.Communicating with additional units B.Establishing command C.Caring for any injuries D.Stabilizing the incident

3.When a person is looking at an object up close, the pupils should: A.dilate. B.constrict. C.remain the same size. D.dilate, and then constrict.

3.When assessing a conscious and alert 9-year-old child, you should: A.isolate the child from his or her parent. B.allow the child to answer your questions. C.obtain all of your information from the parent. D.avoid placing yourself below the child's eye level.

3.When caring for a patient with a surface contact poisoning, it is important to remember to: A.prevent contamination of the patient. B.avoid contaminating yourself or others. C.let the hospital remove the surface poison. D.immediately flush dry chemicals with water.

3.While caring for a trauma patient, the EMT has blood splashed into her eyes. This is an example of: A.infection. B.exposure. C.indirect contact. D.transmission.

4.A 44-year-old man was struck in the back of the head and was reportedly unconscious for approximately 30 seconds. He complains of a severe headache and "seeing stars," and states that he regained his memory shortly before your arrival. His presentation is MOST consistent with a(n): A.contusion. B.concussion. C.subdural hematoma. D.intracerebral hemorrhage.

4.A two-door passenger car struck a tree while driving approximately 50 mph. The doors are badly damaged and jammed, and the driver appears to be unconscious inside the vehicle. Entering the vehicle by breaking the back window is an example of: A.simple access. B.complex access. C.technical rescue. D.disentanglement.

4.A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A.deployed airbags. B.steering wheel deformity. C.starring of the windshield. D.a crushed instrument panel.

4.All of the following are causes of acute dyspnea, EXCEPT: A.asthma. B.emphysema. C.pneumothorax. D.pulmonary embolism.

4.General guidelines to follow when caring for a patient with a behavioral crisis include all ofthe following, EXCEPT: A.being honest and reassuring. B.rapidly transporting the patient. C.having a definite plan of action. D.avoiding arguing with the patient.

4.Most poisonings occur via the _________ route. A.injection B.ingestion C.inhalation D.absorption

4.Protective measures that prevent health care workers from coming into contact with germs are referred to as: A.exposure. B.standard precautions. C.transmission. D.PPE.

4.Signs of adequate breathing in the adult include all of the following, EXCEPT: A.pink, warm, dry skin. B.shallow chest rise. C.symmetrical chest movement. D.a respiratory rate of 16 breaths/min.

4.The onset of menstruation is called: A.menopause. B.menarche. C.ovulation. D.bleeding.

4.The purpose of splinting a fracture is to: A.reduce the fracture if possible. B.prevent motion of bony fragments. C.reduce swelling in adjacent soft tissues. D.force the bony fragments back into anatomic alignment.

4.Unlike an ischemic stroke, a transient ischemic attack is characterized by all of the following, EXCEPT: A.symptoms that resolve within 24 hours. B.symptoms that persist for longer than 24 hours. C.weakness or paralysis to one side of the body. D.an acute onset of confusion and slurred speech.

4.Which combination of factors would MOST likely cause a hypoglycemic crisis in a diabetic patient? A.Eating a meal and taking insulin B.Skipping a meal and taking insulin C.Eating a meal and not taking insulin D.Skipping a meal and not taking insulin

4.Which of the following pieces of patient information is of LEAST pertinence when giving a verbal report to a nurse or physician at the hospital? A.The patient's name and age B.The patient's family medical history C.Vital signs that may have changed D.Medications that the patient is taking

4.You are dispatched to a bombing along with 15 other ambulances. Upon arriving at the scene, you should stage your ambulance: A.as close to the bombing site as possible. B.upwind and uphill from the bombing site. C.downwind and uphill from the bombing site. D.upwind and downhill from the bombing site.

5.A 19-year-old diabetic male was found unresponsive on the couch by his roommate. After confirming that the patient is unresponsive, you should: A.suction his oropharynx. B.manually open his airway. C.administer high-flow oxygen. D.begin assisting his ventilations.

5.An injured hang glider is trapped at the top of a large mountain and must be evacuated to the ground. The terrain is very rough and uneven. Which of the following devices would be the safest and most appropriate to use? A.Stair chair B.Stokes basket C.Scoop stretcher D.Long backboard

5.How much activated charcoal should you administer to a 55-pound child who swallowed a bottle of aspirin? A.12.5 g B.25 g C.2 g/kg D.50 g

5.The primary reason for applying a sterile dressing to an open injury is to: A.prevent contamination. B.control external bleeding. C.reduce the risk of infection. D.minimize any internal bleeding.

5.Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should: A.immediately clamp and cut the cord. B.make one attempt to slide the cord over the head. C.keep the cord moist and transport as soon as possible. D.give the mother high-flow oxygen and transport rapidly.

5.What purpose does a one-way "flutter valve" serve when used on a patient with an open pneumothorax? A.It prevents air escape from within the chest cavity. B.It allows a release of air trapped in the pleural space. C.It only prevents air from entering an open chest wound. D.It allows air to freely move in and out of the chest cavity.

5.Which of the following signs is least indicative of a head injury? A.Asymmetrical pupils B.Pupillary constriction to bright light C.Both eyes moving in opposite directions D.Inability to look upward when instructed to

5.Which of the following signs or symptoms would you be the LEAST likely to find in a patient with an acute abdomen? A.Rapid, shallow breathing B.Soft, nondistended abdomen C.Tachycardia and restlessness D.Constipation or diarrhea

5.You are managing a 62-year-old woman who complains of crushing chest pain. Her blood pressure is 84/64 mm Hg and her heart rate is 110 beats/min. Medical control advises you to assist her in taking her prescribed nitroglycerin. After receiving this order, you should: A.reassess the patient's heart rate and then assist with the nitroglycerin. B.repeat the patient's blood pressure to the physician and confirm the order. C.wait 10 minutes, reassess the blood pressure, and then give the nitroglycerin. D.administer the nitroglycerin to the patient and then reassess her blood pressure.

5.You are treating a woman who was stung numerous times by hornets. On assessment, you note that some of the stingers are still embedded in her skin. You should: A.leave the stingers in place. B.scrape the stingers from her skin. C.pull the stingers out with tweezers. D.cover the stings with tight dressings.

5.Your patient is having respiratory difficulty and is not responding to your treatment. What is the best method of transport? A.Without lights and sirens, to the closest hospital B.With lights and sirens, to the closest hospital C.Air transport, to a special facility located 30 miles away D.The patient does not need to be transported.

5.Your primary assessment of an elderly woman who fell reveals an altered level of consciousness and a large hematoma to her forehead. After protecting her spine and administering oxygen, you should: A.reassess your interventions. B.perform a rapid exam. C.transport the patient immediately. D.perform a focused assessment of her head.

6.A 59-year-old woman presents with chest pressure. She is conscious and alert, but her skin is cool, pale, and clammy. Your first step in providing care (treatment) should be: A.apply the AED. B.administer oxygen. C.ask her if she takes nitroglycerin. D.take a complete set of vital signs.

6.A school-age child looking for approval from his peers and society is demonstrating what kind of reasoning? A.Preconventional reasoning B.Conventional reasoning C.Postconventional reasoning D.Trust and mistrust

6.At what speed will the ambulance begin to hydroplane when there is water present on the roadway? A.25 mph B.30 mph C.40 mph D.50 mph

6.The ______________ is a circumferential chest compression device composed of a constricting band and backboard. A.mechanical piston device B.load-distributing band C.impedance threshold device D.cardiopulmonary resuscitation

6.The mnemonic BE MAGIC helps you remember the six typical steps of endotracheal intubation. Which of the following is not part of the mnemonic? A.Performing BVM preoxygenation B.Achieving venous access C.Manipulating the patient D.Evaluating for airway difficulties

6.The quickest and MOST effective way to control external bleeding from an extremity is: A.a pressure bandage. B.direct pressure. C.a splint. D.a tourniquet.

6.Which of the following situations would MOST likely disqualify a person for EMS certification? A.A misdemeanor at the age of 17 B.Driving under the influence of alcohol C.Possessing a valid driver's license from another state D.A mild hearing impairment that is corrected with hearing aids

7.A large tanker truck has overturned on a highway. When you arrive, you see a clear liquid leaking from the rear of the tanker. The driver, who appears to be unconscious, is still in the vehicle and is bleeding heavily from the face. You should: A.immediately notify law enforcement for traffic control. B.fully assess the situation and request the appropriate assistance. C.put on gloves, a gown, and a mask and quickly remove the driver. D.go to the rear of the tanker and determine what type of fluid is leaking.

7.A patient experienced a severe compression to the chest when trapped between a vehicle and a brick wall. You suspect traumatic asphyxia due to the hemorrhage into the sclera of his eyes and which other sign? A.Flat neck veins B.Cyanosis in the face and neck C.Asymmetrical chest movement D.Irregular heart rate

7.A patient tripped, fell, and landed on her elbow. She is in severe pain and has obvious deformity to her elbow. You should: A.assess distal pulses. B.manually stabilize her injury. C.assess her elbow for crepitus. D.apply rigid board splints to her arm.

7.Assessment of an unconscious patient's breathing begins by: A.inserting an oral airway. B.manually positioning the head. C.assessing respiratory rate and depth. D.clearing the mouth with suction as needed.

7.During immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until: A.an appropriate-size extrication collar has been placed. B.the patient is fully immobilized on a long backboard. C.a range of motion test of the neck has been completed. D.pulse, motor, and sensory functions are found to be intact.

7.The MOST important reason for promptly transporting a stroke patient to the hospital is because: A.a transient ischemic attack can be ruled out. B.medications may be given to reverse the stroke. C.the clot in the coronary artery may be dissolved. D.he or she needs close blood pressure monitoring.

7.The most common and often most serious ambulance crashes occur at/on: A.stop lights. B.intersections. C.highways. D.stop signs.

7.Treatment for a semiconscious child who swallowed an unknown quantity of pills includes: A.administering 1 g/kg of activated charcoal and rapidly transporting. B.monitoring the child for vomiting, administering oxygen, and transporting. C.positioning the child on his left side, elevating his legs 6 inches, and transporting. D.contacting medical control and requesting permission to induce vomiting.

7.When applying a tourniquet to an amputated arm, the EMT should: A.use the narrowest bandage possible. B.avoid applying the tourniquet over a joint. C.cover the tourniquet with a sterile bandage. D.use rope to ensure that the tourniquet is tight.

7.When caring for a patient with facial trauma, the EMT should be MOST concerned with: A.spinal trauma. B.airway compromise. C.associated eye injuries. D.severe external bleeding.

7.You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume? A.Sitting up B.Legs drawn up C.Legs outstretched D.On his right side

8.A 21-year-old male was found unconscious in an alley. Your initial assessment reveals that his respirations are slow and shallow, and his pulse is slow and weak. Further assessment reveals that his pupils are bilaterally constricted. His presentation is MOST consistent with an overdose of: A.cocaine. B.an opioid. C.a stimulant drug. D.methamphetamine.

8.Once you begin CPR in the field, you must continue until one of the following events occurs: A.The patient stops breathing and has no pulse B.The patient is transferred to another person who is trained in BLS, to ALS-trained personnel, or to another emergency medical responder C.You are out of gas in the ambulance D.A police officer assumes responsibility for the patient and gives direction to discontinue CPR

8.Pinpoint pupils, vomiting, bradycardia, and excessive salivation are signs of exposure to: A.lewisite. B.soman. C.cyanide. D.phosgene.

8.What is the EMT's FIRST priority when dealing with a patient experiencing excessive vaginal bleeding? A.Determine the cause of the bleeding. B.Treat the patient for shock and transport. C.Determine if the bleeding is a result of sexual assault. D.Keep the patient warm and apply oxygen.

8.When treating an open extremity fracture, you should: A.apply a splint and then dress the wound. B.dress the wound before applying a splint. C.irrigate the wound before applying a dressing. D.allow the material that secures the splint to serve as the dressing.

8.Which of the following conditions makes the elderly patient prone to fractures from even minor trauma? A.Hypertension B.Osteoporosis C.Arteriosclerosis D.Rheumatoid arthritis

8.Which of the following situations MOST likely involves a hazardous material? A.Milk truck that overturned and is leaking fluid B.Tractor trailer rig that is emitting a visible cloud C.Moving van that collided head-on with a small car D.Pickup truck from the gas company that struck a tree

8.Which stage of grieving commonly results in blame? A.Denial B.Anger, hostility C.Bargaining D.Depression

8.Your 12-year-old patient can speak only two or three words without pausing to take a breath. He has a serious breathing problem known as: A.nasal flaring. B.two- to three-word dyspnea. C.labored breathing. D.shallow respirations.

9.A 5-year-old boy was burned when he pulled a barbecue grill over on himself. He has partial- and full-thickness burns to his anterior chest and circumferentially on both arms. What percentage of his body surface area has been burned? A.18% B.27% C.36% D.45%

9.A 70-year-old man recently had a heart attack and now complains of severe difficulty breathing, especially when lying flat. He is coughing up pink, frothy secretions. This patient is MOST likely experiencing: A.acute right heart failure. B.severe left heart failure. C.an acute onset of bronchitis. D.an acute pulmonary embolism.

9.After administering a nitroglycerin tablet to a patient, the EMT should: A.check the expiration date of the nitroglycerin. B.reassess the patient's blood pressure within 5 minutes. C.instruct the patient to chew the tablet until it is dissolved. D.ensure that the nitroglycerin is prescribed to the patient.

9.Epinephrine is given to patients with anaphylactic shock because of its effects of: A.bronchodilation and vasodilation. B.bronchodilation and vasoconstriction. C.vasodilation and bronchoconstriction. D.bronchoconstriction and vasoconstriction.

9.If an injured patient needs to be moved but is not in immediate danger from fire or building collapse, you should first: A.order the equipment you need for extrication. B.check the patient's airway, breathing, and circulation. C.remove the patient with the rapid extrication technique. D.determine the number of people you will need to move the patient.

9.The EMT has a legal duty to act if he or she is: A.off duty and witnesses a major car accident. B.a volunteer, is on duty, and is dispatched on a call. C.paid for his or her services, but is not on duty. D.out of his or her jurisdiction and sees a man choking.

9.The adult EpiPen system delivers _____ mg of epinephrine, and the infant-child system delivers _____ mg. A.0.15, 0.3 B.0.3, 0.15 C.0.15, 0.5 D.0.5, 0.2

9.The term "hematuria" is defined as: A.blood in the stool. B.blood in the urine. C.vomiting up blood. D.urinary bladder rupture.

9.What should you do if you are exposed to a patient who is found to have pulmonary tuberculosis? A.Get the BCG vaccine. B.Get a tuberculin skin test. C.Undergo serious therapy. D.No precautions need to be taken.

9.When caring for a patient with severe epistaxis, the MOST effective way to prevent aspiration of blood is to: A.insert a nasopharyngeal airway and lean the patient back. B.tilt the patient's head forward while he or she is leaning forward. C.place the patient supine with his or her head in the flexed position. D.tilt the patient's head forward while he or she is leaning backward.

If the weight you are pushing is lower than your waist, you should push from: a. the waist b. a kneeling position c. the shoulder d. a squatting position

A 5 year old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the MOST indicative of decompensated shock?

BP of 70/40 mm Hg

Signs/symptoms of tuberculosis

Bad cough >2 wks., chest pain, blood tinged sputum/phlegm, weakness/fatigue, wt loss, loss of appetite, chills/fever, night sweats

Lymph nodes

Bean-shaped filters that cluster along the lymphatic vessels of the body. They function as a cleanser of lymph as wells as a site of T and B cell activation

When is an emergency move performed?

Before primary assessment and treatment

delerium tremens

Begin 48-72 hours after cessation of drinking; characterized by hallucinations, disorientation, and clouding of the sensorium; hyperventilation leading to respiratory alkalosis, hypovolemia, hypomagnesia, and hypophosphatemia

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

Pediatric patient

Between birth and 12 years of age - the primary fear of this patient is separation anxiety - that can cause a sense of abandonment - and a close second to that is anesthesia - this can lead to a fear of going to sleep forever

Postpartum bleeding

Bleeding that exceeds approximately 500 mL is considered excessive. 1. If bleeding continues after delivery of the placenta, you should continue to massage the uterus. 2. Check your technique and hand placement if bleeding continues. 3. Treat the woman if she appears to be in shock. 4. Excessive bleeding after birth is usually caused by the muscles of the uterus not fully contracting due to: a. Delivery of more than one infant b. A long labor process that causes the uterus to be too "tired" to contract c. Parts of the placenta still being inside the uterus 5. Cover the vagina with a sterile pad, changing the pad as often as possible. a. Do not discard any blood-soaked pads. b. Hospital personnel will use them to estimate the amount of blood loss. c. Save any tissues that may have passed from the vagina. 6. Administer oxygen if necessary, monitor vital signs frequently, and transport the patient immediately to the hospital. a. Never hold the woman's legs together or pack the vagina with gauze pads in an attempt to control bleeding.

Dependent lividity

Blood settling to the lowest point of the body, causing discoloration of the skin.

Veins

Blood vessels that carry blood back to the heart

Parietal bones

Bones that form the sides and top of the cranium.

Digestive System

Breaks down food into absorbable units that enter the blood for distribution to body cells.

Cheyenne-Stokes

Breathing pattern characterized by alternating periods of apnea and hyperventilation

Labored breathing

Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles.

Intrapulmonary shunting

Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.

1.A seizure patient is having what kind of medical emergency? A.Respiratory B.Cardiovascular C.Neurologic D.Immunologic

1.Proper protective equipment will vary depending on the hazards encountered. Which piece of equipment should be utilized during all patient contacts? A.Turnout gear B.Helmets C.Blood- and fluid-impermeable gloves D.Goggles

1.Which of the following components of a medical term conveys its essential meaning? A.Prefix B.Suffix C.Word root D.Combining vowels

1.You arrive at a scene where an older woman is complaining of chest pain. In assessing her, she holds her arm out for you to take her blood pressure. This is an example of: A.implied consent. B.informed consent. C.expressed consent. D.emergency consent.

10.A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury was MOST likely caused by ___________ blast injuries. A.primary B.secondary C.tertiary D.quaternary

10.Food poisoning is almost always caused by eating food that contains: A.fungi. B.viruses. C.bacteria. D.protozoa.

10.If a patient complains of a severe migraine, how should she be transported? A.In a brightly lit ambulance so she can see while her vision is impaired B.With loud sirens so she can get to the hospital as soon as possible C.Without lights and sirens D.This patient should not be transported.

10.In which position do most patients with acute abdominal pain prefer to be transported? A.Sitting, with their head elevated 45° B.Supine, with their legs elevated 12 inches C.On their side, with their knees flexed D.In Fowler's position, with their legs straight

10.The AVPU scale is used to monitor a patient's level of consciousness. What does the "P" stand for? A.Pallor B.Pediatric C.Painful D.Pale

10.The process by which medications travel through body tissues until they reach the bloodstream is called: A.adsorption. B.onset of action. C.absorption. D.transformation.

10.Three ambulances respond to a golf course where a group of six golfers were struck by lighting. Two of the golfers are conscious and alert with superficial skin burns (Group 1). The next two golfers have minor fractures and appear confused (Group 2). The last two golfers are in cardiac arrest (Group 3). According to reverse triage, which group of golfers should be treated FIRST? A.Group 1 B.Group 2 C.Group 3 D.Groups 1 and 2; Group 3 should be tagged as deceased

10.When assessing your patient's pain, he says it started in his chest but has spread to his legs. This is an example of what part of the OPQRST mnemonic? A.Onset B.Quality C.Region/radiation D.Severity

10.Which of the following statements regarding chemical burns is FALSE? A.Most chemical burns are caused by strong acids or alkalis. B.Fumes of strong chemicals can cause burns to the respiratory tract. C.Prior to removing a dry chemical, flush the area with sterile water. D.Do not attempt to neutralize an acid burn with an alkaline chemical.

2.A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A.Deployed airbag B.Bent steering wheel C.Non-intact windshield D.Crushed instrument panel

2.Essential elements of a group that people must share include: A.focusing on individual goals. B.placing emphasis on one way of accomplishing a task. C.working with a set of shared values. D.promoting a personal identity.

2.Known risk factors for Down syndrome include: A.smoking. B.traumatic brain injury at birth. C.increased maternal age. D.lack of vitamin B.

2.Quality control in an EMS system is the ultimate responsibility of the: A.paramedic. B.lead EMT. C.medical director. D.EMS administrator.

2.Shivering in the presence of hypothermia indicates that the: A.musculoskeletal system is damaged. B.nerve endings are damaged, causing loss of muscle control. C.body is trying to generate more heat through muscular activity. D.thermoregulatory system has failed and body temperature is falling.

2.The negative effects associated with anaphylactic shock are the result of: A.severe internal fluid loss. B.inadequate pumping of the heart. C.vasodilation and bronchoconstriction. D.the nervous system's release of adrenaline.

2.The term "weaponization" is defined as: A.the period of time that a chemical agent will remain on a given surface before it evaporates. B.the method or mechanism by which a terrorist or terrorist group delivers a chemical or biologic agent. C.the cultivation, synthesization, and/or mutation of an agent in order to maximize the target population's exposure. D.the detonation of an explosive device utilizing an item that is inconspicuous, such as a briefcase or suitcase.

2.What is the first phase of extrication? A.Arrival B.Preparation C.Scene size-up D.Gaining access

2.What is the outermost cavity of a woman's reproductive system? A.Cervix B.Ovaries C.Vagina D.Uterus

2.When lifting a stretcher using the power lift, you should: A.bend at the hips, knees, back, and arms. B.bend at the waist and keep your back straight. C.place your hands palms up on the litter handle. D.place your hands palms down on the litter's side bars.

2.Which of the following sequences of events describes the AHA's chain of survival? A.Early access, integrated post-arrest care, early advanced care, early CPR, early defibrillation B.Early advanced care, early defibrillation, integrated post-arrest care, early CPR, early access C.Early access, early CPR, early defibrillation, early advanced care, integrated post-arrest care D.Early access, early riser, early CPR, early advanced care

2.You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that: A.there is a disruption of the joint and the bone ends are no longer in contact. B.the patient has an incomplete fracture that passes only partway through the bone. C.stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred. D.the muscles of the ankle have been severely stretched, resulting in displacement of the bones from the joint.

2.You see an infant capable of reaching out to people and drooling. She is most likely: A.2 months of age. B.3 months of age. C.4 months of age. D.5 months of age.

3.For CPR to be effective, the patient must be on a firm surface, lying in the ______________ position. A.Fowler's B.prone C.supine D.recovery

3.If a "frequent flier" calls 9-1-1 because of a suspected head injury, you should NEVER: A.take the call seriously; don't waste your time or resources on such a caller. B.perform a primary assessment; he called for a head injury last week, and it wasn't serious. C.assume you know what the problem is; every case is different, and you don't want to miss a potentially serious problem. D.treat the patient with respect; he is probably lying.

3.In an otherwise healthy individual, the primary stimulus to breathe is a(n): A.increased level of oxygen in the blood. B.decreased level of oxygen in the blood. C.increased level of carbon dioxide in the blood. D.decreased level of carbon dioxide in the blood.

3.The unauthorized confinement of a person is called: A.assault. B.battery. C.false imprisonment. D.slander.

3.Upon arriving at the scene of a domestic dispute, you hear yelling and the sound of breaking glass from inside the residence. You should: A.immediately gain access to the patient. B.carefully enter the house and then call the police. C.retreat to a safe place until the police arrive. D.tell the patient to exit the residence so you can provide care.

3.Which of the following statements regarding intra-abdominal bleeding is FALSE? A.Intra-abdominal bleeding often causes abdominal distention. B.Intra-abdominal bleeding is common following blunt force trauma. C.The absence of pain and tenderness rules out intra-abdominal bleeding. D.Bruising may not occur immediately following blunt abdominal trauma.

3.You are called to a local baseball park for a 23-year-old man with difficulty breathing. He states that he ate a package of peanuts approximately 30 minutes ago and denies any allergies or past medical history. Your assessment reveals widespread urticaria, tachycardia, and a BP of 90/60 mm Hg. You can hear him wheezing, even without a stethoscope. You should be MOST suspicious of a(n): A.acute asthma attack. B.mild allergic reaction. C.anaphylactic reaction. D.moderate allergic reaction.

4.Even when seatbelts are worn properly and the airbags deploy, injury may occur to the: A.chest. B.extremities. C.iliac crests. D.lower ribcage.

4.Failure of the EMT to provide the same care as another EMT with the same training is called: A.libel. B.slander. C.negligence. D.abandonment.

4.Major controllable risk factors for an AMI include: A.older age. B.family history. C.cigarette smoking. D.male sex.

4.Most patients with this disease also have hydrocephalus. A.Paralysis B.Down syndrome C.Spina bifida D.Cerebral palsy

4.The statement "the lungs are superior to the bladder" indicates that the lungs are closer to the: A.feet. B.surface of the skin. C.head. D.trunk.

4.When caring for a patient with signs of a pneumothorax, your MOST immediate concern should be: A.hypovolemia. B.intrathoracic bleeding. C.ventilatory inadequacy. D.associated myocardial injury.

4.When treating a trauma patient who is in shock, LOWEST priority should be given to: A.spinal protection. B.thermal management. C.splinting fractures. D.notifying the hospital.

4.Which effects will the application of an ice pack have on a hematoma? A.Vasodilation and increased pain B.Vasodilation and decreased bleeding C.Vasoconstriction and increased swelling D.Vasoconstriction and decreased bleeding

4.Which of the following is NOT a component of continuous quality improvement (CQI)? A.Periodic review of run reports B.Discussion of needs for improvement C.Negative feedback to those who make mistakes while on a call D.Remedial training as deemed necessary by the medical director

5.A 30-year-old semiconscious man is pinned by the steering wheel of his badly wrecked vehicle. Once access has been gained to the patient, the EMT should: A.have the fire department disentangle the patient and quickly remove him from the vehicle. B.immediately apply high-flow oxygen to the patient and then allow extrication to begin. C.perform a primary assessment and provide any needed emergency care prior to extrication. D.ensure that the patient is not bleeding significantly before allowing the extrication process to commence.

5.A motorcyclist crashed his bike and has closed deformities to both of his midshaft femurs. He is conscious, but restless; his skin is cool and clammy; and his radial pulses are rapid and weak. The MOST appropriate splinting technique for this patient involves: A.applying rigid board splints. B.applying two traction splints. C.securing him to a long backboard. D.immobilizing his femurs with air splints.

5.A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if: A.CPR is initiated within 10 minutes. B.oxygen and rapid transport are provided. C.defibrillation is provided within 2 minutes. D.paramedics arrive at the scene within 5 minutes.

5.A young male was involved in a motor vehicle accident and experienced a closed head injury. He has no memory of the events leading up to the accident, but remembers that he was going to a birthday party. What is the correct term to use when documenting his memory loss? A.Concussion B.Cerebral contusion C.Retrograde amnesia D.Anterograde amnesia

5.Movement of the arm toward midline is referred to as: A.flexion. B.extension. C.adduction. D.abduction.

5.Potential causes of cardiogenic shock include all of the following, EXCEPT: A.inadequate heart function. B.disease of muscle tissue. C.severe bacterial infection. D.impaired electrical system.

5.The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is called: A.senility. B.delirium. C.dementia. D.delusion.

5.Which of the following is NOT a guideline for safe ambulance driving? A.Always use your siren if you have the emergency lights on. B.Always exercise due regard for person and property. C.Use one-way streets whenever possible. D.Go with the flow of the traffic.

5.Which of the following statements about the patient care report (PCR) is true? A.It is not a legal document in the eyes of the law. B.It cannot be used for patient billing information. C.It helps ensure efficient continuity of patient care. D.It is for use only by the prehospital care provider.

6.A device that receives a low-frequency signal and then transmits it at a relatively higher frequency is called a: A.duplex. B.scanner. C.repeater. D.receiver.

6.A semiconscious patient pushes your hand away when you pinch his earlobe. You should describe his level of consciousness as: A.alert. B.unresponsive. C.responsive to painful stimuli. D.responsive to verbal stimuli.

6.A sudden onset of difficulty breathing, sharp chest pain, and cyanosis that persists despite supplemental oxygen is MOST consistent with: A.severe pneumonia. B.myocardial infarction. C.a pulmonary embolism. D.a spontaneous pneumothorax.

6.A young male is experiencing signs and symptoms of anaphylactic shock after being stung by a scorpion. His level of consciousness is diminished, his breathing is severely labored, you can hear inspiratory stridor, and his face is cyanotic. The patient has a prescribed epinephrine auto-injector. What should you do first? A.Assist him in administering his epinephrine. B.Apply high-flow oxygen via nonrebreathing mask. C.Provide ventilatory assistance with a bag-valve mask. D.Elevate his legs and cover him with a warm blanket.

6.After taking Vicodin for 2 years for chronic pain, a 40-year-old woman finds that her usual dosage is no longer effective and goes to the doctor to request a higher dosage. This is an example of: A.addiction. B.dependence. C.tolerance. D.drug abuse.

6.An advance directive is: A.a set of specific guidelines that clearly defines the different types of consent. B.a formal list that defines by state law whether a patient has decision-making capacity. C.a written document that specifies the care you should provide if the patient is unable to make decisions. D.a verbal order given to you by a dying patient's family regarding whether treatment should be provided.

6.In which of the following patients would a nasopharyngeal airway be contraindicated? A.A semiconscious patient with a gag reflex B.An unconscious patient with an intact gag reflex C.A patient who fell 20 feet and landed on his or her head D.An unconscious patient who gags when you insert an oral airway

6.Signs of a cardiac tamponade include all ofthe following, EXCEPT: A.muffled heart tones. B.a weak, rapid pulse. C.collapsed jugular veins. D.narrowing pulse pressure.

6.The MOST appropriate way to dress and bandage an open abdominal wound with a loop of bowel protruding from it is to: A.cover the wound with a dry, sterile dressing and apply firm pressure. B.apply a moist, sterile dressing to the wound and apply firm pressure. C.apply a moist, sterile dressing to the wound and secure it with an occlusive dressing. D.carefully replace the protruding bowel into the abdomen and cover the wound.

6.The purpose of the eustachian tube is to: A.move in response to sound waves. B.transmit impulses from the brain to the ear. C.equalize pressure in the middle ear when external pressure changes. D.house fluid within the inner chamber of the ear and support balance.

6.What breathing pattern would you MOST likely encounter in a patient with diabetic ketoacidosis (DKA)? A.Slow and shallow B.Shallow and irregular C.Rapid and deep D.Slow and irregular

6.What device is placed directly into the stomach to feed patients? A.Colostomy B.Ileostomy C.Gastrostomy tube D.Central venous catheter

6.What is the most common presenting sign of PID? A.Vomiting B.Vaginal discharge C.Lower abdominal pain D.Fever

6.Which of the following patients is at HIGHEST risk for suicide? A.A 24-year-old woman who is successfully being treated for depression B.A 29-year-old man who was recently promoted with a large pay increase C.A 33-year-old man who regularly consumes alcohol and purchased a gun D.A 45-year-old woman who recently found out her cancer is in full remission

6.You are assessing a 27-year-old woman with a heat-related emergency. Her skin is flushed, hot, and moist; and her level of consciousness is decreased. After moving her to a cool environment, managing her airway, and administering oxygen, you should: A.give her ice water to drink. B.place her in the recovery position. C.cover her with wet sheets and fan her. D.take her temperature with an axillary probe.

6.You respond to a sick child late at night. The child appears very ill, has a high fever, and is drooling. He is sitting in a tripod position, struggling to breathe. You should suspect: A.croup. B.pneumonia. C.epiglottitis. D.severe asthma.

7.A patient with neurogenic shock would be LEAST likely to present with: A.tachypnea. B.hypotension. C.tachycardia. D.altered mentation.

7.If a patient with an implanted pacemaker is in cardiac arrest, the EMT should: A.avoid defibrillation with the AED and transport at once. B.not apply the AED until he or she contacts medical control. C.place the AED pads away from the pacemaker. D.apply the AED pads directly over the implanted pacemaker.

7.It is important to remove a drowning victim from the water before laryngospasm relaxes because: A.the patient will suffer less airway trauma. B.the risk of severe hypothermia is lessened. C.less water will have entered the patient's lungs. D.you can ventilate the patient with laryngospasm.

7.Proper removal of a critically injured patient from an automobile involves: A.moving the patient in one fast, continuous step. B.utilizing no more than two personnel to avoid crowding. C.moving the patient in smooth, slow, controlled steps. D.removing the patient by grasping the immobilization device.

7.The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min, a pink body but blue hands and feet, and rapid respirations. The baby cries when the soles of its feet are flicked and resists attempts to straighten its legs. You should assign an Apgar score of: A.4. B.6. C.8. D.9.

7.What does sulfur mustard do to the cells within the body? A.It makes the cells retain water until they explode. B.It causes the cells to release all their energy, which then causes cellular death. C.It makes the cells mutate, which damages and changes the cells and causes cellular death. D.It makes the cells release all their fluids and causes severe dehydration until cellular death occurs.

7.When caring for a patient with an emotional crisis who is calm and not in need of immediate emergency care, your BEST course of action is to: A.advise the patient that he or she cannot refuse treatment. B.leave the patient with a trusted friend or family member. C.attempt to obtain consent from the patient to transport. D.apply soft restraints in case the patient becomes violent.

7.When treating a potentially hostile patient, you should try to diffuse the situation by: A.assuming an aggressive posture. B.staring at the patient. C.speaking calmly, confidently, and slowly. D.verbally threatening the patient.

7.Which of the following is a physiologic change that occurs during the process of aging? A.Increased elasticity of the alveoli B.A gradual decrease in blood pressure C.A decline in kidney function D.10% to 15% increase in brain weight

7.Which of the following patients is competent and can legally refuse EMS care? A.A confused young female who states that she is the president B.A man who is staggering and states that he drank only three beers C.A conscious and alert woman who is in severe pain from a broken leg D.A diabetic patient who has slurred speech and is not aware of the date

7.Which of the following scenarios would warrant an interruption in CPR procedures? A.An hysterical family member trying to gain access to the unconscious patient B.A vehicle honking its horn anxious to pass by the scene on a blocked road C.A small set of steps leading to the exit of the building, on the way to the ambulance D.Being tired from trying to resuscitate a patient

7.Which of the following techniques is considered to be an emergency move? A.Extremity lift B.Supine transfer C.Firefighter's drag D.Direct ground lift

7.You are delivering oxygen to a patient with a nasal cannula at 4 L/min when he begins to complain of a burning sensation in his nose. You should: A. remove the nasal cannula. B. apply a nonrebreathing mask. C. attach an oxygen humidifier. D. increase the flow rate to 6 L/min.

7.Your patient believes he has hepatitis and is now exhibiting signs of cirrhosis of the liver. He most likely has: A.hepatitis A. B.hepatitis B. C.hepatitis C. D.hepatitis D.

7.______ is the fuel that makes the body run. A.Sleep B.Exercise C.Food D.Work/life balance

8.A 14-year-old baseball player was hit in the chest with a line drive. He is in cardiac arrest. Which of the following is the most likely explanation? A.Myocardial contusion B.Traumatic asphyxia C.Commotio cordis D.Hemothorax

8.A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his: A.liver. B.spleen. C.kidney. D.bladder.

8.A patient who requires cardiac monitoring in the field would require, at a minimum, which level of EMS provider? A.EMR B.EMT C.Paramedic D.AEMT

8.An acute bacterial infection that results in swelling of the flap that covers the larynx during swallowing is called: A.croup. B.laryngitis. C.epiglottitis. D.diphtheria.

8.If a hernia is incarcerated and the contents are so greatly compressed that circulation is compromised, the hernia is said to be: A.reducible. B.ruptured. C.strangulated. D.congenital.

8.Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? A.Head-on collision B.Angular collision C.Ejection D.Controlled crash

8.The MOST effective way to prevent cardiopulmonary arrest in a newborn is to: A.rapidly increase its body temperature. B.allow it to remain slightly hypothermic. C.ensure adequate oxygenation and ventilation. D.start CPR if the heart rate is less than 100 beats/min.

8.The presence of subcutaneous emphysema following trauma to the face and throat is MOST suggestive of: A.esophageal injury. B.cervical spine fracture. C.crushing tracheal injury. D.carotid artery laceration.

8.The recommended dimensions for a helicopter landing zone are: A.50 × 50 feet. B.75 × 75 feet. C.100 × 100 feet. D.150 × 150 feet.

8.Which of the following are components of the Cincinnati Prehospital Stroke Scale? A.Arm drift, blood pressure, speech B.Speech, pupil response, arm drift C.Facial symmetry, speech, arm drift D.Pupil response, facial droop, speech

8.Why should you be concerned about a 16-year-old patient who seems depressed? A.She could be exhibiting rebellious behavior. B.She has just finished her growth spurt and may be disappointed in the results. C.Adolescents are at a higher risk for suicide. D.She may be having unprotected sex.

8.You place a patient in the semi-Fowler'sposition for transport. This means the patient is: A.lying on his or her back. B.lying on his or her stomach. C.sitting at a 45-degree angle. D.sitting at a 90-degree angle.

8.Your patient is a 21-year-old male who has massive face and head trauma after being assaulted. He is lying supine, is semiconscious, and has blood in his mouth. You should: A.insert a nasal airway, assess his respirations, and give 100% oxygen. B.suction his airway and apply high-flow oxygen via a nonrebreathing mask. C.manually stabilize his head, log roll him onto his side, and suction his mouth. D.apply a cervical collar, suction his airway, and begin assisting his ventilations.

9.A 21-year-old male has a large laceration to his neck. When you assess him, you note that bright red blood is spurting from the left side of his neck. You should immediately: A.apply a pressure dressing to his neck. B.sit the patient up to slow the bleeding. C.place your gloved hand over the wound. D.apply 100% oxygen via nonrebreathing mask.

9.A 4-year-old girl fell from a second-story balcony and landed on her head. She is unresponsive; has slow, irregular breathing; has a large hematoma to the top of her head; and is bleeding from her nose. You should: A.immediately perform a full-body scan to detect other injuries, administer high-flow oxygen, and transport at once. B.apply a pediatric-sized cervical collar, administer high-flow oxygen via pediatric nonrebreathing mask, and prepare for immediate transport. C.manually stabilize her head, open her airway with the jaw-thrust maneuver, insert an airway adjunct, and begin assisting her ventilations with a bag-valve mask. D.suction her airway for up to 10 seconds, insert a nasopharyngeal airway, apply a pediatric-sized cervical collar, and administer oxygen via pediatric nonrebreathing mask.

9.What improves a patient's quality of life shortly before death? A.Home care B.Hospice care C.Comfort care D.Health care

9.When dealing with a hazardous materials incident, where should you set up your decontamination area? A.Inside the hazard zone B.Inside the treatment area C.Between the hazard zone and treatment area D.Between the treatment and transportation zone

9.When verbal transfer of care occurs, all team members should do their best to ensure that: A.the transfer of care occurs in a place where many staff members are present to hear. B.lifesaving care is not interrupted if it is being performed by the person giving report. C.everyone is respectful of each team member's role. D.patient care is centered around what you believe is the correct treatment.

9.Which of the following is a professional responsibility of the EMT? A.Telling the family of a dying patient that everythingwill be OK B.Maintaining only the skills that the EMT feels uncomfortable with C.Maintaining a professional demeanor even under the most stressful situations D.Advising an emergency department nurse that patient reports are given only to a physician

9.You respond to a plastic factory, where numerous people present with shortness of breath, flushed skin, and altered mental status. One of the patients tells you he smelled almonds before he started feeling sick. These people were MOST likely exposed to: A.sarin. B.bleach. C.cyanide. D.chlorine.

Check for when pt on gurney

CMS color, motor, sensory

When to use nasal cannula (symptoms)

COPD cough, sputum, wheezing, dyspnea 2-6 L mild hypoxia, but good ventilations

A man was found unresponsive, no evidence of injury, face cyanotic, pulse ox reads 98

Carbon monoxide poisoning

Diving/face down in bodies of water

Check C spine Usually we think PULSELESS, APNEIC

According to the E in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?

Check the mechanical ventilator for malfunction

How to know when an injury is related to Endocrine System?

Chemical imbalance (usually skin color or sugar levels)

When do you expect/assess JVD?

Chest pain/circulatory problem

Signs/Symptoms of bronchitis

Chronic cough (with sputum production) Wheezing Cyanosis Tachypnea (increased breathing rate)

Perfusion

Circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.

perfusion

Circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.

polydipsia, polyuria, polyphagia

Classic symptoms demonstrated by patients with Type I Diabetes

Rhonchi

Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways.

Past illnesses

Compare past to present -how does this feel different/similar -relate and help make a differential diagnosis

Which of the following statements regarding compartment syndrome is correct?

Compartment syndrome typically develops within 6 to 12 hours after an injury

The progression of shock

Compensated shock Decompensated shock Irreversible shock

strangulation

Complete obstruction of blood circulation in a given organ as a result of compression or entrapment; an emergency situation causing death of tissue.

Which of the following statements regarding crush syndrome is correct?

Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

Brain stem

Connects the brain and spinal cord

When do you position a pt in a position of comfort vs what they should be positioned in?

Consider: -respiratory problems -stroke -spinal immobilizations -pregnant WHICH POSITION WOULD CAUSE MORE HARM TO PT

Integumentary System

Consists of the skin, mucous membranes, hair, and nail (epidermis and dermis)

Treating hypovolemic shock

Control all obvious external bleeding. Splint any bone and joint injuries. Secure and maintain an airway, and provide respiratory support. Transport as rapidly as possible.

Genital system

Controls reproductive processes

Eviscerated bowels

Cover with moist sterile dressing

1.How does the pediatric anatomy differ from the adult anatomy? A.The trachea is more rigid. B.The tongue is proportionately smaller. C.The epiglottis is less floppy. D.The head is proportionately larger.

1.Peritonitis would MOST likely result following injury to the: A.liver. B.spleen. C.kidney. D.stomach.

1.The LEAST common cause of death in patients over 65 years of age is: A.stroke. B.diabetes. C.heart attack. D.drug overdose.

1.What is the purpose of the incident command system (ICS)? A.Ensuring responder and public safety B.Achieving incident management goals C.Ensuring the efficient use of resources D.All of the above.

1.When health care providers force their cultural values onto their patients because they believe their values are better, they are displaying: A.ethnocentrism. B.proxemics. C.nonverbal communication. D.cultural imposition.

1.Which of the following questions is of LEAST pertinence for the EMT to ask a patient who intentionally overdosed on a medication? A."How much do you weigh?" B."How much did you ingest?" C."What substance did you take?" D."Why did you take the medication?"

10. When using abbreviations, acronyms, or symbols, an EMT should: A.be familiar with those used in your agency. B.use only those that are medically accepted. C.use them to shorten documentation. D.All of the above.

10.All of the following are factors that increase the risk for developing MRSA, EXCEPT: A.antibiotic therapy. B.prolonged hospital stays. C.exposure to an infected patient. D.close contact with wild birds.

10.Emergency patient care occurs in progressive phases. What occurs first? A.Activation of EMS B.Initial prehospital care C.The patient receives definitive care D.Incident recognition

10.Factors that have the GREATEST impact on the severity of radiation exposure include: A.age and overall health. B.gender and wind speed. C.the method of dispersal. D.time, distance, and shielding.

10.In infants who have signs and symptoms of an airway infection, you should not waste time trying to dislodge a foreign body. You should intervene only if signs of ____________ develop, such as a weak, ineffective cough; cyanosis; stridor; absent air movement; or a decreasing level of consciousness. A.sudden infant death syndrome B.child abuse C.bronchitis severe airway obstruction

10.Inflicted bruises are commonly found in all ofthe following areas, EXCEPT: A.the buttocks. B.the lower back. C.the inner thighs. D.the forearms.

10.The rapid extrication technique is a: A.nonurgent technique to remove a patient from a vehicle. B.technique used to transfer a patient from a bed to a stretcher. C.technique used to lift a patient with no suspected spinal injury onto a stretcher. D.technique used to quickly remove a patient from a vehicle and onto a backboard.

10.Which of the following statements about records and reports is FALSE? A.Legally, if it was not documented, it was not performed. B.A complete, accurate report is an important safeguard against legal problems. C.An incomplete or untidy patient care report is evidence of incomplete or inexpert emergency medical care. D.Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital.

10.Why is breathing more labor intensive for the elderly? A.The size of the airway increases and the surface area of the alveoli decreases. B.The natural elasticity of the lungs decreases. C.The overall strength of the intercostal muscles and the diaphragm decreases. D.All of the above

10.You should NOT remove an injured football player's helmet if: A.a cervical spine injury is suspected, even if the helmet fits loosely. B.the patient has a patent airway, even if he has breathing difficulty. C.he has broken teeth, but only if the helmet does not fit snugly in place. D.the face guard can easily be removed and there is no airway compromise.

10.You should discourage a rape or sexual assault victim from doing which of the following? A.Urinating B.Cleaning herself C.Changing clothes D.All of the above

11.When dealing with hematologic disorders, the EMT must be familiar with the composition of blood. Which of the following is considered a hematologic disease? A.Sickle cell disease B.Hemophilia C.Lou Gehrig's disease D.Both A and B

13.The assessment of a patient with a hematologic disorder is the same as it is with all other patients an EMT will encounter. In addition to obtaining a SAMPLE history, EMTs should ask which of the following questions? A.Have you had a crisis before? B.When was the last time you had a crisis? C.How did your crisis resolve? D.All of the above.

2.A compression injury that is severe enough to cut off blood flow below the injury is called: A.a contusion. B.a hematoma. C.a local thrombus. D.compartment syndrome.

2.An acute ischemic stroke is caused by: A.a ruptured cerebral artery. B.increased intracranial pressure. C.an acute rise in a person's blood pressure. D.a blocked cerebral artery.

2.The globe of the eye is also called the: A.lens. B.orbit. C.retina. D.eyeball.

2.The primary purpose of a "jump kit" is to: A.ensure that you have immediate access to the AED. B.have available all of the equipment that you will use in the entire call. C.have easy access to manage patients with severe uncontrolled bleeding. D.have available all of the equipment that will be used in the first 5 minutes.

2.Which of the following is a hollow organ? A.Liver B.Kidney C.Spleen D.Gallbladder

2.Which of the following is an example of abandonment? A.An EMT leaves the scene after a competent adult has refused care. B.An EMT transfers care of a patient to an emergency department nurse. C.An AEMT transfers care of a patient to a paramedic. D.An AEMT transfers patient care to an EMT.

2.While palpating the radial pulse of a 56-year-old man with chest pain, you note that the pulse rate is 86 beats/min and irregular. This indicates: A.pain. B.fear. C.anxiety. D.dysrhythmia.

2.You arrive at the scene of an "injured person." As you exit the ambulance, you see a man lying on the front porch of his house. He appears to have been shot in the head and is lying in a pool of blood. You should: A.immediately assess the patient. B.proceed to the patient with caution. C.quickly assess the scene for a gun. D.retreat to a safe place and wait for law enforcement to arrive.

3.A man involved in a motorcycle crash has multiple abrasions and lacerations. Which of the following injuries has the HIGHEST treatment priority? A.Widespread abrasions to the back with pinkish ooze B.3" laceration to the forehead with dark red, flowing blood C.Laceration to the forearm with obvious debris in the wound D.1" laceration to the thigh with spurting, bright red blood

3.A young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess: A.false motion. B.distal pulses. C.capillary refill. D.sensory and motor functions.

3.During your assessment of a patient who was stabbed, you see an open wound to the left anterior chest. Your MOST immediate action should be to: A.position the patient on the affected side. B.transport immediately. C.assess the patient for a tension pneumothorax. D.cover the wound with an occlusive dressing.

3.If fertilization has not occurred within about ___ days following ovulation, the lining of the uterus begins to separate and menstruation occurs. A.8 B.10 C.12 D.14

3.Members of an interdependent group: A.focus on the goals of their own individual areas. B.rely on the group leader for task assignments. C.have limited ability to adapt and deliver critical care medical care in an uncontrolled field environment. D.work together with shared responsibilities, accountability, and a common goal.

3.Signs of compensated shock include all of the following, EXCEPT: A.restlessness or anxiety. B.pale, cool, clammy skin. C.a feeling of impending doom. D.weak or absent peripheral pulses.

3.The plural form of the word bronchus is: A.bronchae. B.bronches. C.bronchices. D.bronchi.

3.When assessing a patient with a behavioral crisis, your primary concern must be: A.allowing the patient to express himself or herself to you in his or her own words. B.setting your personal feelings aside and providing needed care. C.gathering the patient's belongings and taking them to the hospital. D.whether the patient will cause harm to you or your partner.

3.Which of the following may be difficult to perform on a patient with Down syndrome? A.CPR B.Pulse oximetry C.Splinting D.Intubation

3.Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash? A.Extensive damage to the automobile B.Flail chest and lower extremity fractures C.Massive external trauma with severe bleeding D.Aortic rupture or compression injury to the brain

3.While caring for a 5-year-old boy with respiratory distress, you should: A.avoid direct eye contact with the child, as this may frighten him. B.avoid letting the child hold any toys, as this may hinder your care. C.avoid alerting the child prior to a painful procedure. D.allow a parent or caregiver to hold the child if the situation allows.

3.You are transporting a woman who is 8 months pregnant. To prevent supine hypotensive syndrome, how should you position this patient? A.On her right side B.Supine C.Semi-Fowler's D.On her left side

3.You have been dispatched to a call for an unresponsive patient. What is the MOST important information that you should obtain from the dispatcher initially? A.The callback number of the caller B.The severity of the patient's problem C.Whether the patient is breathing D.The exact physical location of the patient

4.A woman has frostbite in both feet after walking several miles in a frozen field. Her feet are white, hard, and cold to the touch. Treatment at the scene should include: A.rubbing her feet gently with your own warm hands. B.trying to restore circulation by helping her to walk around. C.removing her wet clothing and rubbing her feet briskly with a warm, wet cloth. D.removing her wet clothing and covering her feet with dry, sterile dressings.

4.If your medical patient is not in critical condition, how long should you spend on scene? A.10 minutes or less B.30 minutes C.2 hours D.However long it takes to gather as much information as possible

4.Immediately after delivery of the infant's head, you should: A.suction the baby's mouth and then nose. B.suction the baby's nose and then mouth. C.assess the baby's breathing effort and skin color. D.check the position of the umbilical cord.

4.MOST patients with an acute abdomen present with: A.dyspnea. B.diarrhea. C.hypotension. D.tachycardia.

4.Proper guidelines for correct reaching include all of the following, EXCEPT: A.avoiding twisting your back. B.avoiding hyperextension of your back. C.keeping the back in a locked-in position. D.reaching no more than 30 inches in front of your body.

4.The pulse check should take: A.1 second. B.at least 1 second but no more than 5 seconds. C.at least 10 seconds. D.at least 5 seconds but no more than 10 seconds.

4.Which of the following statements BEST describes a mass-casualty incident? A.At least half of the patients are dead. B.Either a bus or an airplane has crashed. C.You have more than two critical patients. D.The patient count exhausts your resources.

4.Which of the following would you NOT detect while determining your initial general impression of a patient? A.Cyanosis B.Gurgling respirations C.Severe bleeding D.Rapid heart rate

4.While en route to a call for a major motor vehicle collision, the MOST important safety precaution(s) that you and your partner can take is/are: A.adhering to standard precautions. B.ensuring that the fire department arrives before you. C.using lights and siren and being aware of other drivers. D.wearing seat belts and shoulder harnesses at all times.

4.Why do colds develop so easily in toddlers and preschoolers? A.They experience a loss of passive immunity. B.They do not have well-developed lung musculature. C.They are spending a lot of time around playmates and classmates. D.All of the above

4.You are called to a neatly kept residence for an 80-year-old woman who lives by herself. She burned her hand on the stove and experienced a full-thickness burn. When treating this patient, it is important to note that: A.there is a high likelihood that she has been abused. B.isolated full-thickness burns to the hand are not critical burns. C.this patient should probably be placed in an assisted-living center. D.slowing of reflexes causes a delayed pain reaction in older people.

5.A patient with a suspected stroke presents with slurred speech that is difficult for you to understand. This is referred to as: A.aphasia. B.dysphasia. C.dysphagia. D.dysarthria.

5.A team leader: A.helps individual team members to work together. B.is often defined by policy, procedure, or statute. C.provides coordination, oversight, centralized decision making and support for the team. D.All of the above.

5.A terrorist would MOST likely use a secondary explosive device: A.to ensure that a structure is completely destroyed. B.in case the primary explosive device fails to detonate. C.as a means of dispersing a biologic or chemical agent. D.to injure rescuers and gain maximum public attention.

5.Reflective listening, an assessment technique used when caring for patients with an emotional crisis, involves: A.asking the patient to repeat his or her statements. B.simply listening to the patient, without speaking. C.asking the patient to repeat everything that you say. D.repeating, in question form, what the patient tells you.

5.The pulse rate of a toddler is: A.80 to 140 beats/min B.90 to 150 beats/min C.90 to 180 beats/min D.100 to 160 beats/min

5.What is the second stage of response in the stress response known as general adaptation syndrome? A.Recovery B.Exhaustion C.Alarm D.Reaction and resistance

5.When caring for a patient with internal bleeding, the EMT must first: A.ensure a patent airway. B.obtain baseline vital signs. C.control any external bleeding. D.take appropriate standard precautions.

5.Which of the following can cause vaginal bleeding? A.Ectopic pregnancy. B.Spontaneous abortion. C.Trauma. D.All of the above

5.Which of the following statements regarding febrile seizures is correct? A.Febrile seizures usually indicate a serious underlying condition, such as meningitis. B.Most febrile seizures occur between the ages of 2 months and 2 years of age. C.Febrile seizures are rarely associated with tonic-clonic activity, but last for more than 15 minutes. D.Febrile seizures usually last less than 15 minutes and often do not have a postictal phase.

6.A condition in which a person experiences a loss of appetite is called: A.ileus. B.colic. C.emesis. D.anorexia.

6.A distraction injury to the cervical spine would MOST likely occur following: A.a diving accident. B.blunt neck trauma. C.hyperextension of the neck. D.hanging-type mechanisms.

6.A type of seizure that is characterized by severe twitching of all the body's muscles and lasts for several minutes or longer is called a(n): A.partial seizure. B.absence seizure. C.tonic-clonic seizure. D.generalized seizure.

6.Activated charcoal is indicated for patients who have ingested certain drugs and toxins because it: A.acts as a direct reversal agent for most medications. B.induces vomiting before the chemical can be digested. C.detoxifies the drug before it can cause harm to the patient. D.binds to chemicals in the stomach and delays their absorption.

6.How does a disaster differ from a mass-casualty incident? A.Disasters may not involve personal injuries. B.In a disaster, EMS may be on the scene for days or weeks. C.Only an elected official can declare a disaster. D.All of the above.

6.Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include: A.placing dry towels over the open wound. B.cleaning the exposed bowel with sterile saline. C.applying the PASG to stop the associated bleeding. D.applying an occlusive dressing, secured by trauma dressings.

6.The condition characterized by reexperiencing an event and overresponding to stimuli that recall the event is called: A.acute stress reaction. B.delayed stress reaction. C.cumulative stress reaction. D.posttraumatic stress disorder (PTSD).

6.The need for and extent of newborn resuscitation is based on: A.the 1-minute Apgar score. B.the gestational age of the newborn. C.the newborn's response to oxygen. D.respiratory effort, heart rate, and color.

6.When two EMTs are lifting a patient on a long backboard, they should: A.lift the patient from the sides of the board. B.make every attempt to lift with their backs. C.position the strongest EMT at the foot of the board. D.position the strongest EMT at the head of the board.

7. As you ventilate an intubated patient, which of the following observations would cause you to immediately alert the team leader? A.Ventilation is creating equal chest rise. B.The patient's cyanosis is disappearing. C.The oxygen saturation level is now at 94%. D.The BVM is offering more resistance.

7.A woman called EMS because her 12-year-old son, who had been experiencing excessive urination, thirst, and hunger for the past 36 hours, has an altered mental status and is breathing fast. You should be MOST suspicious for: A.low blood sugar. B.hypoglycemia. C.hypoglycemic crisis. D.hyperglycemic crisis.

7.Albuterol, a beta-2 agonist, is the generic name for: A.Alupent. B.Metaprel. C.Brethine. D.Ventolin.

7.Death from a rollover motor vehicle crash is MOST often secondary to: A.crushing injuries. B.airbag-related trauma. C.multiple collisions to the interior of the car. D.ejection of the patient from the motor vehicle.

7.What do vagal nerve stimulators do? A.Keep seizures from occurring B.Keep the airway clear from secretions C.Act as an alternative treatment to seizure medicine D.Both A and C

7.When obtaining a SAMPLE history, which of the following pieces of information is important to obtain? A.Use of a birth control device or birth control pills B.The date of the patient's last menstrual period C.The possibility of pregnancy D.All of the above

7.Which of the following effects does drinking alcohol NOT produce? A.Induction of sleep B.Slowing of reflexes C.Inappropriate behavior D.Increased sense of awareness

7.Which of the following should be the EMT's highest priority? A.Controlling severe bleeding B.Maintaining a patient's airway C.Ensuring patient safety D.Ensuring personal safety

7.With regard to pharmacology, the term "action" refers to the: A.ability of a drug to cause harm. B.ability of a drug to produce side effects. C.amount of time it will take the drug to work. D.expected effect of a drug on the patient's body.

7.________ is used to identify a body part that is on the "belly side" or anterior surface of the body. A.Deep B.Superficial C.Dorsal D.Ventral

8.A 13-year-old girl is found floating face down in a swimming pool. Witnesses tell you that the girl had been practicing diving. After you and your partner safely enter the water, you should: A.turn her head to the side and give five back slaps. B.turn her head to the side and begin rescue breathing. C.rotate her entire body as a unit and carefully remove her from the pool. D.rotate the entire upper half of her body as a unit, supporting her head and neck.

8.A 20-year-old man was kicked numerous times in the abdomen during an assault. His abdomen is rigid and tender, his heart rate is 120 beats/min, and his respirations are 30 breaths/min. You should treat this patient for: A.a lacerated liver. B.a ruptured spleen. C.respiratory failure. D.hypovolemic shock.

8.A man has been sucked inside the bin of a grain silo and is trapped. Which of the following rescue teams is the MOST appropriate to request? A.Trench rescue B.High-angle rescue C.Local fire department D.Confined space rescue

8.A patient is found unconscious after falling from a third floor window. His respirations are slow and irregular. You should: A.place him in the recovery position. B.apply oxygen via a nonrebreathing mask. C.suction his airway for up to 15 seconds. D.assist his breathing with a bag-valve mask.

8.All of the following are functions of the emergency medical dispatcher, EXCEPT: A.alerting the appropriate EMS response unit. B.screening a call and assigning it a priority. C.providing emergency medical instructions to the caller. D.providing medical direction to the EMT in the field.

8.The main advantage(s) of the AED is: A.it provides quick delivery of a shock. B.it is easier than performing CPR. C.there is no need for ALS providers to be on scene. D.All of the above.

8.The most common trigger of anaphylaxis is: A.insect stings. B.chemicals. C.medications. D.food.

8.Which of the following is considered a severe burn? A.Any full-thickness burn B.20% partial-thickness burn C.10% full-thickness burn with abrasions D.5% full-thickness burn with a fracture

8.Your patient is complaining of fever, headache, stiffness of the neck, and red blotches on his skin. He most likely has: A.tuberculosis. B.hepatitis B. C.SARS. D.meningitis.

9.A man is found slumped over the steering wheel, unconscious and making snoring sounds, after an automobile accident. His head is turned to the side and his neck is flexed. You should: A.gently rotate his head to correct the deformity. B.carefully hyperextend his neck to open his airway. C.apply an extrication collar with his head in the position found. D.manually stabilize his head and move it to a neutral, in-line position.

9.After receiving an order from medical control over the radio, the EMT should: A.carry out the order immediately. B.disregard the order if it is not understood. C.obtain the necessary consent from the patient. D.repeat the order to the physician word for word.

9.How should you determine the pulse in an unresponsive 8-year-old patient? A.Palpate the radial pulse at the wrist. B.Palpate the brachial pulse inside the upper arm. C.Palpate the radial pulse with your thumb. D.Palpate the carotid pulse in the neck.

9.In contrast to a hyperglycemic crisis, a hypoglycemic crisis: A.rarely presents with seizures. B.presents over a period of hours to days. C.should not routinely be treated with glucose. D.usually responds immediately after treatment.

9.When assessing a stab wound, it is important for the EMT to remember that: A.stabbings to an extremity are rarely associated with an exit wound. B.the majority of the internal trauma will be near the path of the knife. C.most stabbings are unintentional and cause less severe internal injury. D.more internal damage may be present than the external wound suggests.

9.When ventilating an apneic adult with a bag-valve mask, you should squeeze the bag: A.until it is empty. B.over a period of 2 seconds. C.at a rate of 20 breaths/min. D.until visible chest rise is noted.

9.You respond to a wooded area to help search for a child who has been missing for approximately 24 hours. Which of the following equipment should you leave in the ambulance? A.Radio B.Flashlight C.Jump kit D.Backboard

What should you consider for immobilization of pregnant woman involved in MVC?

DO NOT LAY ON BACK if experiencing back/neck pain, backboard and transport on LEFT SIDE and put something UNDER RIGHT side

Kussmaul respirations

Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body.

DUMBELS

Defecation Urination Miosis (pupil constriction) Bronchorrhea Emesis Lacrimation (excessive tearing) Salivation

Pulmonary veins

Deliver oxygen rich blood from the lungs to the left atrium

DOT

Department of Transportation

Small intestine

Digestive organ where most chemical digestion and absorption of food takes place (duodenum, jejunum, ileum)

A 19 year old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations and has bilaterally closed femur deformities. You should

Direct your partner to begin ventilatory assistance.

Which of the following musculoskeletal injuries would MOST likely result in deformity?

Displaced fracture

Certification

Documentation of having met certain standards

The Centennial Park bombing during the 1996 Summer Olympics is an example of

Domestic terrorism

Why do you position someone in left lateral recumbent?

Don't want them to aspirate -typically abdominal pain -pt is more comfortable on side

Which of the following is an example of regional equipment or supplies?

DuoDote Auto Injector

NHTSA (National Highway Traffic Safety Administration)

EMS Education Standards

Which of the following areas of the body has the thinnest skin?

Ears

Urinary system

Eliminates nitrogenous wastes from the body. Regulates water, electrolyte and acid-base balance of the blood.

You and your partner arrive at the scene of a large office complex. Witnesses tell you that they heard a loud explosion shortly before the building caught fire. You should

Ensure that your ambulance is parked upwind and uphill from the building

Internal respiration

Exchange of gases between cells of the body and the blood

Which of the following duties or responsibilities does NOT fall within the realm of the medical branch of the incident command system?

Extrication

Distal

Farther from the trunk of the body

Tachycardia

Fast heart rate (HR>100bpm)

Ligaments

Fibrous tissues that connect bones to each other

Kidneys

Filter blood from the renal arteries and produce urine as waste

Plasma

Fluid portion of blood a. Water (primary component) b. Proteins (primary component) c. Oxygen d. Carbon dioxide e. Nitrogen f. Nutrients g. Cellular wastes

Temperature skin signs

Flushed, hot possible sepsis

MOI data

For people younger than age 44 years, traumatic injuries are the leading cause of death in the United States.

afterload

Force of resistance against heart, increases cardiac output

Communicable disease

From person to person OR From one species to another

Biceps

Front of upper arm

A 52 year old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, pulse 110bpm, respirations 22breaths/min with adequate tidal volume. You should:

Fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed and transport

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?

Gastrointestinal system

GEMS diamond

Geriatric - impaired Environment - hazardous Medical Assessment - prescriptions, OTC Social Assessment - help daily living

What can you do for a conscious semi-alert diabetic or hypoglycemic?

HAND JUICE/sugary drink instead of glucose

HAZWOPER

Hazardous Waste Operations and Emergency Response

A 30 year old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport?

He is currently not prescribed any medications

Dilated pupils

Head injury, shock, heat stroke, hemorrhage, and/or intake of a stimulant drug (cocaine)

Positions for head/neck

Head tilt chin lift Jaw thrust maneuver

Side effects of narcan/naxolene

Headache/withdrawal

HIPPAA

Health Insurance Portability and Accountability Act of 1996 1. HIPAA contains a section on patient privacy that strengthens privacy laws. 2. HIPAA safeguards patient confidentiality. 3. HIPAA provides guidance on: a. Which types of information are protected b. The responsibility of health care providers regarding that protection c. Penalties for breaching that protection 4. HIPAA considers all patient information you obtain in the course of providing medical treatment to a patient to be protected health information (PHI). a. PHI includes medical information. b. PHI includes any information that can be used to identify the patient.

Rigid splints

Helps stabilize fractures as well as refuse pain and prevent further damage to soft tissue injuries.

Vaginal Hemorrhaging

Hemorrhage from the vagina that occurs before labor begins may be very serious; call for ALS backup. a. In early pregnancy, it may be a sign of a spontaneous abortion, or miscarriage. b. In the later stages of pregnancy, vaginal hemorrhage may indicate a serious condition involving the placenta. i. In abruptio placenta, the placenta separates prematurely from the wall of the uterus, most commonly caused by hypertension or trauma. (a) Patient often reports severe pain but vaginal bleeding may not be heavy ii. In placenta previa, the placenta develops over and covers the cervix. (a) Patient may experience heavy vaginal bleeding without significant pain

How to tell if a patient is potentially violent

History Posture Scene Vocal Activity Physical Activity

Contraindications of albuterol

Hypersensitivty to this drug and peanuts, tachydysrhythmias.

Cushing reflex triad

Hypertension, bradycardia, and respiratory depression

Side effects of albuterol

Hypertension, tachycardia, anxiety, restlessness

Side effects of epinephrine

Hypertension, tachycardia, anxiety, restlessness

Contraindication of nitroglycerin

Hypotension, sildenafil (Viagra) within 24 hours, head injury, stroke

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

Hypovolemia

Hypoperfusion

Hypovolemic shock a. Change in mental status, such as anxiety, restlessness, or combativeness b. Weakness, faintness, or dizziness on standing c. Changes in skin color or pallor (pale skin) d. Later signs of hypoperfusion suggesting internal bleeding include: i. Tachycardia ii. Weakness, fainting, or dizziness at rest iii. Thirst iv. Nausea and vomiting v. Cold, moist (clammy) skin vi. Shallow, rapid breathing vii. Dull eyes viii. Slightly dilated pupils that are slow to respond to light ix. Capillary refill of more than 2 seconds in infants and children x. Weak, rapid (thready) pulse xi. Decreasing blood pressure xii. Altered level of consciousness

Which of the following statements regarding secondary brain injury is correct?

Hypoxia and hypotension are the two most common causes of secondary brain injury

A type ambulance features a conventional, truck cab-chassis with a modular ambulance body that can be transferred to a newer chassis as needed

Contraindication of glucose

INTRACRANIAL HEMORRHAGE & POSSIBLE CVA. CONSIDER D25

When to use occlusive dressing

In order to prevent a penetrating injury resulting in an air embolism.

ICS

Incident Command System

Hypercarbia

Increased carbon dioxide level in the bloodstream.

NOT a common factor that would affect 75 year olds vital signs

Increased weight

Moro reflex

Infant reflex where a baby will startle in response to a loud sound or sudden movement.

HIV infection

Infection with human immunodeficiency virus; caused by a retrovirus, which is attracted to CD4 T cells, lymphocytes, macrophages, and cells of the CNS; destruction of the CD4 T cells causes depletion in the number of CD4 T cells and a loss of the body's ability to fight infection

Bronchiolitis

Inflammation of the bronchioles that usually occurs in children younger than 2 years and is often caused by the respiratory syncytial virus.

Blast injuries

Injuries resulting from explosions; possible injuries include internal injuries resulting from the pressure wave, penetrating trauma from shrapnel or from being thrown, blunt trauma from being thrown, and burns.

Dermis

Inner layer of skin

Abdominal assessment

Inspect, Auscultate, Percuss, Palpate

Ingestion

Intake of food

ILCOR

International Liaison Committee on Resuscitation

After spiking a bag of IV fluid for the paramedic, the EMT notices that the drip chamber is too full. The EMT should:

Invert the IV bag and squeeze the drip chamber

guarding

Involuntary muscle contractions (spasms) of the abdominal wall in an effort to protect an inflamed abdomen; a sign of peritonitis.

Smooth muscle

Involuntary muscle found inside many internal organs of the body

Cardiac muscle

Involuntary muscle tissue found only in the heart.

Peristalsis

Involuntary waves of muscle contraction that keep food moving along in one direction through the digestive system.

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Ataxic respirations

Irregular, ineffective respirations that may or may not have an identifiable pattern.

Which of the following statements regarding the vitreous humor is correct?

It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost

Hinge joints

Joints that can bend and straighten but cannot rotate; they restrict motion to one plane (flexion and extension)

What is the first thing to check in an allergic reaction call?

LUNG SOUNDS

When do you expect/assess tracheal deviation?

Late sign of trauma

State level

Laws regulate EMS provider operations.

Which of the following destinations is the most appropriate for a 41 year old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive assuming that travel times to each is equal?

Level 1 or 2 trauma center

Medical emergencies

Life threats that require EMS attention because of illnesses or conditions not caused by an outside force.

Contusion causes

Like any other soft tissue in the body, the brain can sustain a contusion, or bruise, when the skull is struck. 2. A contusion is far more serious than a concussion. a. Involves physical injury to the brain tissue b. May produce long-lasting and even permanent damage 3. A patient who has sustained a brain contusion may exhibit any or all of the signs of brain injury.

conjunctiva

Lines the inside of the eyelids and covers the sclera

auscultation

Listen to the sounds a body makes by using a stethoscope

What organs are in RUQ?

Liver Gallbladder Duodenum Head of pancreas Right kidney and adrenal gland Hepatic flexure of colon Part of ascending and transverse colon

Which of the following is an early sign of pit viper envenomation?

Local swelling and ecchymosis

Inspection

Look at the patient for abnormalities

Topical medications

Lotions, creams, and ointments that are applied to the surface of the skin and affect only that area; a medication delivery route.

Lumbar spine

Low back; The part of the spine comprised of five vertebral bodies (L1-L5) that extend from the lower thoracic spine (chest) to the sacrum (bottom of the spine).

Hypoxia

Low oxygen saturation of the body, not enough oxygen in the blood

During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates:

Lower airway obstruction

What do you need to administer aspirin?

MED CONTROL Contraindications: - Known allergy or ASA-induced asthma - Hx of active bleeding disorder- Current ulcer or GI bleed- Receiving anticoagulation therapy

A 29 year old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardia. The EMT should suspect

Mallory-Weiss tear

What PPE is required for respiratory infectious disease?

Mask Gloves Possibly face shield

parenteral medications

Medications that enter the body by a route other than the digestive tract, skin, or mucous membranes.

Enteral medications

Medications that enter the body through the digestive system.

aerobic metabolism

Metabolism that can proceed only in the presence of oxygen.

Capillaries

Microscopic vessel through which exchanges take place between the blood and cells of the body

Treatment of Tuberculosis

Minimum of 6 months of drug therapy due to slow growth and dormancy First-line drugs: isoniazid, ethambutol, pyrazinamide, rifampin Second-line drugs: aminoglycosides, fluoroquinolones, para-aminoslicyclic acid (PAS) Multi-drug-resistant (MDR) strains: resistant to first-line drugs Extensively drug-resistant (XDR) strains: resistant to second-line drugs

Which of the following statements regarding autism is correct?

Most cases of autism are diagnosed by 3 years of age

Diffusion

Movement of molecules from an area of higher concentration to an area of lower concentration.

Retractions

Movements in which the skin pulls in around the ribs during inspiration.

Altered Mental Status (AMS)

Multiple causes: most common are hypoglycemia, infection, intoxication, and neurological

Altered mental status (AMS)

Multiple causes: most common are hypoglycemia, infection, intoxication, and neurological ABCs FIRST

Sphincters

Muscles arranged in circles that are able to decrease the diameter of tubes. Examples are found within the rectum, bladder, and blood vessels.

Heart attack pain quality

NOT sharp/stabbing or radiating usually MOST OFTEN PRESENT pressure/dull squeezing sensation -do you have any pain/discomfort?

Different ways to deliver oxygen

Nasal cannula NRB BVM

NIMS

National Incident Management System (NIMS) - a system that guides government agencies, the private sector, and nongovernmental organizations to work in an integrated and organized fashion to prepare for, prevent, respond to, recover from, and mitigate the effects of incidents.

Proximal

Nearer to the trunk of the body

Spinal cord

Nerves that run up and down the length of the back and transmit most messages between the body and brain

Epinephrine

Neurotransmitter secreted by the adrenal medulla in response to stress. Also known as adrenaline.

BLS (basic life support)

Noninvasive emergency lifesaving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest.

Excessive bleeding in childbirth

Normal

Airway adjuncts

OPA, NPA, king LT

OSHA

Occupational Safety and Health Administration, a government agency in the Department of Labor to maintain a safe and healthy work environment

Decompensated shock

Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.

Ulcers

Open sores in the lining of the digestive system

Spleen

Organ near the stomach that produces, stores, and eliminates blood cells

Internal Structures of Female Genitalia

Ovaries, fallopian tubes

Anticholinergic drugs

Oxybutynin (Ditropan, Gelnique), tolterodine (Detrol), Darifenacin (Enablex), Solifenacin (Vesicare), Trospium (Sanctura), Fesoterodine (Toviaz)

PEARRL

P Pupils E Equal A And R Round R Regular in size L React to light

Normal pupils

PERRL (2-6 mm, deep black)

Organs in LLQ

Part of descending colon Sigmoid colon Left ovary and tube Left ureter Left spermatic cord

What organs are in LLQ?

Part of descending colon Sigmoid colon Left ovary and tube Left ureter Left spermatic cord

Medulla oblongata

Part of the brainstem that controls vital life-sustaining functions such as heartbeat, breathing, blood pressure, and digestion.

Which of the following is a severe burn in a 65 year old patient?

Partial thickness burn to 20% of the BSA

Chyme

Partially digested, semiliquid food mixed with digestive enzymes and acids in the stomach.

PCR

Patient Care Report 1. Chief complaint 2. Level of consciousness or mental status 3. Vital signs 4. Initial assessment 5. Patient demographics (age, gender, ethnic background)

Which of the following statements regarding hemophilia is correct?

Patients with hemophilia may bleed spontaneously

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?

Pelvic fractures with hypotension

When to use OPA

Permanent help until pt does not have gag reflex intact

Consent

Permission to render care.

Adolescents

Persons who are 12 to 18 years of age.

adolescents

Persons who are 12 to 18 years of age.

early adults

Persons who are 19 to 40 years of age.

middle adults

Persons who are 41 to 60 years of age.

A 43 year old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 bpm and bounding. Preferred treatment includes:

Pinching the patient's nostrils and having him lean forward

Normal skin signs

Pink, war, dry

Blanket drag

Place the patient on a blanket, coat, or other item that can be pulled.

Arm-to-arm drag

Place your arms under the patient's shoulders and through the armpits, and, while grasping your opposite wrist, drag the patient backward.

Carina

Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi.

What are you expecting to find in an abdominal assessment?

Possibly rigid abdomen, problems in each quadrant

Which of the following would the EMT MOST likely be asked to do when assisting a paramedic with endotracheal intubation?

Preoxygenation with a BVM

Hydrostatic pressure

Pressure exerted by a volume of fluid against a wall, membrane, or some other structure that encloses the fluid.

When do you suction in childbirth?

Prevent neonate from aspirating

hernia

Protrusion of an organ through the wall of the cavity that normally contains it

NREMT

Provides national standard for EMS testing

PASTE

Provoking factors, Associated pain, Sputum (color) / Speech, Time of onset /Temperature, Exacerbation

Which of the following terms applies to a state of delusion in which the pt is out of touch w reality?

Psychosis

High flow O2 vs BVM

Pt chest rises adequately

Chronic overdose

Pt unresponsive, will experience withdrawal treat w narcan/naxolene

Clothes drag

Pull on the patient's clothing in the neck and shoulder area.

BLS Resuscitation Guidelines

Pulse, breathing CPR, AED Compression:Ventilation ratio

How to know when an injury is related to Circulatory/Cardiac System?

Pulses (distal absent or unequal)

Causes of shock

Pump Failure: -Cardiogenic shock -obstructive shock Poor Vessel function: -Distributive shock -Septic shock -neurogenic shock -Anaphalactic shock -Physiogenic shock Low Fluid Volume: -Hypovolemic shock -Hemorrhagic shock -Nonhemorrhagic shock

Closed-ended questions

Questions that can be answered in short or single word responses.

When can you not transport a pt?

REFUSAL -must be AnOx4 -no drugs/alcohol -no impeded judgement -not against will (no kidnapping)

Abdominal quadrants

RUQ, LUQ, RLQ, LLQ

UHF (ultra-high frequency)

Radio frequencies between 300 and 3,000 MHz.

Sucking reflex

Reflex that causes a newborn to make sucking motions when a finger or nipple if placed in the mouth

Extrication

Removal of a patient from entrapment or a dangerous situation or position, such as removal from a wrecked vehicle, industrial incident, or collapsed building.

Shallow respirations

Respirations characterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion.

RICES

Rest Ice Compression Elevation Splinting

Tendons

Ropelike structures that connect muscles to bones

Arm drag

Rotate the patient's arms so they are extended straight on the ground beyond his or her head, grasp the wrists, and drag the patient.

Which types of motor vehicle collisions present the greatest potential for multiple impacts?

Rotational and rollover

Tripod position (symptoms)

SOB, excessive use of accessory muscles

When to use albuterol

SOB, prescribed CALL MED CONTROL

SLUDGEM

Salavation, lacramation, Urination, Defication, GI, Emesis, Miosis=contraction of the eye.

febrile seizures

Seizures that result from sudden high fevers, particularly in children.

How to know when an injury is related to Nervous System?

Sensory, motor functions impaired

OB kit includes

Several pairs of sterile surgical gloves to protect from infection Towels or sheets to drape mother 1 dozen 2x2 (4x4) gauze pads 1 rubber bulb syringe to suction baby's mouth & nostrils Cord clamps or hemostats to clamp umbilical cord Umbilical cord tape to tie cord 1 pair of surgical scissors to cut cord 1 baby blanket to wrap baby Several individually wrapped sanitary napkins to absorb blood Plastic bag

Psychogenic shock

Shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope).

Obstructive shock

Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.

vasocclusive crisis

Sickle cell - fluids and pain management

Which of your senses can be safely used to identify a HazMat incident?

Sight and sound

Abdominal closed injuries

Signs and symptoms of a closed injury a. Pain can be deceiving. i. Often diffuse in nature ii. May be referred to another body location (a) Liver and spleen injuries refer pain to the shoulder. iii. Tearing pain from the abdomen posteriorly may be dissected aneurysm. iv. Pain following the angle from the lateral hip to the midline of the groin can be the result of damage to the kidneys or the ureters. v. Pain located in the RLQ can indicate an inflamed or ruptured appendix. vi. Pain under the margin of the ribs on the right side or between the shoulder blades can indicate an injury to the gallbladder. b. Blood or fluid in the peritoneal cavity produces acute pain in the entire abdomen. i. Pain spreads as the blood or contaminant seeks out the voids in the peritoneal cavity. ii. Often a jarring motion (rebound tenderness or Blumberg sign) will alert the patient to the peritonitis or inflammation of the peritoneum. c. Determining the location of the pain or referred pain can be difficult when the patient has voluntary or involuntary guarding. i. Conscious or unintentional stiffening of the muscles of the surface of the abdomen to avoid further pain ii. May be mistaken for abdominal rigidity d. Abdominal distention or swelling between the xiphoid process and the groin is often the result of free fluid, blood, or organ contents spilling into the peritoneal cavity. e. Additional signs of abdominal injury are bruising and discoloration. f. Closed abdominal injuries may initially appear as abrasions.

Bradycardia

Slow heart-rate (HR less than 60bpm)

Gallstones

Small crystals that form from bile in the gallbladder.

Cartilage

Smooth connective tissue that covers the ends of bones at mobile joints

kidney stones

Solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing in the urine; may become trapped anywhere along the urinary tract.

Which of the following statements regarding best injuries is correct?

Solid organs are relatively protected from shock wave injury but may be injured during the secondary or tertiary blast phase

Narcotics

Specific drugs that are obtainable only by prescription and are used to relieve pain

MSDS (Material Safety Data Sheet)

Standardized form that provides detailed information about potential environmental hazards and proper disposal methods associated with various computing components.

What organs are in LUQ?

Stomach Spleen Left lobe of liver Body of pancreas Left kidney and adrenal gland Splenic flexure of colon Part of transverse and descending colon

Extension

Straightening of a joint

Upper airway breathing problems

Stridor

metabolic agents

Substances that are intended to produce injury or death by disrupting chemical reactions at the cellular level

Signs/symptoms of anxiety attack

Sweating, shortness of breath, chest pain, nausea, dizziness, fear

Dependent edema

Swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure.

Jaw thrust maneuver

Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.

jaw-thrust maneuver

Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.

When to use NPA

Temporary help, pt has gag reflex

Organic brain syndrome

Temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiologic functioning of brain tissue.

Patient abandonment

Terminating the relationship with the patient without giving reasonable notice or providing a competent replacement, resulting in a lack of necessary medical care

Thoracic spine

The 12 vertebrae that lie between the cervical vertebrae and the lumbar vertebrae. One pair of ribs is attached to each of the thoracic vertebrae.

In which of the following situations would the EMTs MOST likely utilize a police escort?

The EMTs are unfamiliar with the location, but the police officer knows the area

Federal level

The National EMS Scope of Practice Model provides guidelines for EMS skills. This document provides overarching guidelines for the minimum skills each level of EMS provider should be able to perform.

Automaticity

The ability of the heart to generate and conduct electrical impulses on its own.

Passive ventilation

The act of air moving in and out of the lungs during chest compressions.

Gastric motility

The activity of muscles of the stomach wall that mixes and propels stomach contents.

Minute volume

The amount of air breathed in during each respiration multiplied by the number of breaths per minute. (respiratory rate x tidal volume)

Inspiratory reserve volume

The amount of air that can be inhaled after a normal inhalation; the amount of air that can be inhaled in addition to the normal tidal volume (deepest breath)

Stroke volume (SV)

The amount of blood pumped out of the heart with each contraction.

end-tidal CO2

The amount of carbon dioxide present in exhaled breath.

Dose

The amount of medication given on the basis of the patient's size and age.

Water rescue

The basic rule of water rescue is, "reach, throw, and row, and only then go." a. Reach for the person from the shore or wade into the water. b. If an object that floats is available, throw it to the person. c. Use a boat if available. d. If you must swim to the person, use a towel or board for her or him to hold onto. 3. Do not attempt a swimming rescue unless you are trained and experienced in the proper techniques. 4. If you work in an area near lakes, rivers, or the ocean, you should have prearranged plan for water rescue.

Spinal injuries

The cervical, thoracic, and lumbar portions of the spine can be injured in a variety of ways. 1. Compression injuries can result from a fall, regardless of whether the patient landed on his or her feet or experienced a direct blow to the crown of the skull, coccyx, or top of the head. a. Forces that compress the patient's vertebral body can cause herniation of disks, subsequent compression on the spinal cord and nerve roots, and fragmentation into the spinal canal. 2. Motor vehicle crashes or other types of trauma can overextend (hyperflex) the cervical spine and damage the ligaments and joints. 3. Rotation-flexion injuries of the spine result from rapid acceleration forces. a. More likely to happen at C1 and C2 b. Injuries to this area of the spine are considered unstable due to the location and lack of bony and soft-tissue support. 4. Any one of these unnatural motions, as well as excessive lateral bending, can result in fractures or neurologic deficit. 5. When the spine is pulled along its length (hyperextension), it can cause fractures in the spine as well as ligament and muscle injuries. 6. When bones of the spine are altered from traumatic forces, they can fracture or move out of place. a. When injuries pinch, pull, or penetrate the spinal cord, permanent damage may occur. b. Common findings include pain and tenderness on palpation. c. You may feel or observe a deformity of the spine ("step-off") where the spinous process may be palpable. d. If you suspect these types of injuries, take extra precautions when stabilizing the spine.

Germinal layer

The deepest layer of the epidermis where new skin cells are formed.

Compensated shock

The early stage of shock, in which the body can still compensate for blood loss.

Joint capsule

The fibrous sac that encloses a joint.

EMR (Emergency Medical Responder)

The first trained professional, such as a police officer, firefighters, lifeguard, or other rescuer, to arrive at the scene of an emergency to provide initial medical assistance.

Sweat glands

The glands that secrete sweat, located in the dermal layer of the skin.

perfusion triangle

The heart (the pump) The pipes (blood vessels or arteries) The contents of container (blood) When a person is in shock one or more of these will not work properly

Triage supervisor

The individual in charge of the incident command triage sector who directs the sorting of patients into triage categories in a mass-casualty incident.

Treatment supervisor

The individual, usually a physician, who is in charge of and directs EMS personnel at the treatment area in a mass-casualty incident.

Normal skin signs for childbirth

The infant is now free from the mother. If available, use a bulb syringe to suction the child's mouth then nares, and with a clean towel dry and stimulate the infant. As it is unlikely that an ambient warmer will be available in the prehospital setting, skin to skin contact between child and mother is strongly encouraged. This promotes bonding and helps keep the child warm.

Acromioclavicular joint

The joint between the outer end of the clavicle and the acromion process of the scapula

External female genitalia

The labia, perineum, and vagina

Aorta

The large arterial trunk that carries blood from the heart to be distributed by branch arteries through the body.

Large intestine

The last section of the digestive system, where water is absorbed from food and the remaining material is eliminated from the body

Temporal bones

The lateral bones on each side of the cranium; the temples.

What is an EMT's primary service area?

The main area in which the EMS agency operates

Brain

The mass of nerve tissue that is the main control center of the nervous system

Local level

The medical director provides daily oversight and support to EMS personnel. Examples include the medications that will be carried on an ambulance or where patients are transported.

anaerobic metabolism

The metabolism that takes place in the absence of oxygen; the principle product is lactic acid.

Tunica media

The middle and thickest layer of tissue of a arterial wall, composed of elastic tissue and smooth muscle cells that allow the vessel to expand or contract in response to changes in blood pressure and tissue demand.

occiput

The most posterior portion of the cranium.

Oncotic pressure

The osmotic pressure in the blood vessels due only to plasma proteins (primarily albumin) --> causes water to rush back into capillaries at end.

Stratum corneal layer

The outermost or dead layer of the skin.

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?

The patient takes rivaroxaban (Xarelto)

Which of the following observations or statements represents the E in the GEMS diamond?

The patient's residence is cold due to a malfunctioning heater

Behavioral crisis

The point at which a person's reactions to events interfere with activities of daily living; this becomes a psychiatric emergency when it causes a major life interruption, such as attempted suicide.

Dead space

The portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange.

Pleural space

The potential space between the parietal pleura and the visceral pleura. It is described as "potential" because under normal conditions, the space does not exist.

Preload

The precontraction pressure in the heart as the volume of blood builds up.

blood pressure (BP)

The pressure that the blood exerts against the walls of the arteries as it passes through them.

Pharmacodynamics

The process by which a medication works on the body.

Absorption

The process by which nutrient molecules pass through the wall of the digestive system into the blood

Licensure

The process whereby a competent authority, usually the state, allows people to perform a regulated act.

Wheezing

The production of whistling sounds during expiration such as occurs in asthma and bronchiolitis.

lesser trochanter

The projection on the medial/superior portion of the femur.

Femoral head

The proximal end of the femur, articulating with the acetabulum to form the hip joint.

Shoulder girdle

The proximal portion of the upper extremity, made up of the clavicle, the scapula, and the humerus.

Heart Rate (HR)

The rate at which the heart pumps (normal 50-60bpm)

Documentation

The recorded portion of the EMT's patient interaction, either written or electronic. This becomes part of the patient's permanent medical record.

return of spontaneous circulation (ROSC)

The return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest.

patient autonomy

The right of a patient to make informed choices regarding his or her health care.

Accessory muscles

The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.

Hair follicles

The small organs that produce hair.

Vas deferentia

The spermatic duct of the testicles; also called vas deferens.

Topographic anatomy

The superficial landmarks of the body that serve as guides to the structures that lie beneath them.

Capillary vessels

The tiny blood vessels between the arterioles and venules that permit transfer of oxygen, carbon dioxide, nutrients, and waste between body tissues and the blood.

chest compression fraction

The total percentage of time during a resuscitation attempt in which active chest compressions are being performed.

Airway

The upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat.

Capnometry

The use of a capnometer, a device that measures the amount of expired carbon dioxide.

Residual volume

The volume of air remaining in lungs after maximum exhalation.

Stroke Volume (SV)

The volume of blood pumped forward with each ventricular contraction.

MOI (mechanism of injury)

The way in which traumatic injuries occur; the forces that act on the body to cause damage.

Which of the following statements regarding anterior nosebleeds is correct?

They usually originate from the septum area and bleed slowly.

TACOs

Tobacco Alcohol Caffeine Over the counter meds/herbs Sexual and street drugs

TICLS

Tone Interactiveness Consolability (Agitable) Look (Gaze) Speech (Cry)

Negative effects of using BVM

Too much air -gastric distention -diminished blood flow to heart -pressure in thorax

Dorsal (posterior)

Toward or at the back of the body Spinal side

A 70 year old male complains of shortness of breath. During your assessment you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should

Try repositioning the hearing aid or remove it and turn down the volume

Abandonment

Unilateral termination of care by the EMT without the patient's consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient.

Battery

Unlawfully touching a patient or providing emergency care without consent.

Signs/symptoms of allergic reaction

Urticaria Rhinorrhea Bronchospasm Compromised respiratory status Circulatory collapse & Death

Suctioning

Use of a vacuum device to remove blood, vomitus, and other secretions or foreign materials from the airway.

Pelvic binders

Used to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.

Therapeutic communication

Uses various communication techniques and strategies, both verbal and nonverbal, to encourage patients to express how they are feeling and to achieve a positive relationship with the patient.

MED channels

VHF and UHF channels that the FCC has designated exclusively for EMS use

How to treat hemorrhaging in childbirth

Vigorous massage of the uterine fundus can be implemented to help initiate uterine contraction. If this is insufficient, bimanual uterine massage can be done by placing one hand in the vagina and the other on the abdomen over the fundus and compressing the uterus between the hands

You are attending to a 32 year old male patient. The pt's wife tells you that he returned from Afghanistan last year. While he initially seemed fine, lately he has become withdrawn and distanced himself from his family and friends. He does not talk about it, but she knows that he has been having terrible nightmares that wake him up. The most appropriate question to ask regarding his experience is:

Were you shot at or under fire?

Lower airway problems

Wheezing, crackles (rales), rhonchi

Cultural imposition

When one person imposes his or her beliefs, values, and practices on another because he or she believe his or her ideals are superior

Peer assisted medication

When the EMT administers medication to him or herself or to a partner.

Patient assisted medication

When the EMT assists the patient with the administration of his or her own medication.

EMT-administered medication

When the EMT directly administers the medication to the patient.

When to call dispatch

When you need more units -helicopter Tell them what code you're running what hospital you're going to request any additional info you cannot find from pt/scene

CHEMTREC

Who can you call to obtain information about a specific hazmat incident when on scene?

Direct carry

With two or more rescuers, move the supine patient from the bed to stretcher using a direct carry method

Good skin signs for neonate

Wrinkles, redness, dryness, and fuzz. Newborn skin is far from flawless but it usually doesn't mean something is wrong. Baby's skin is adjusting to life outside the womb. Most skin imperfections disappear over time. For example, premature babies sometimes have soft hair on their face and back. Late babies often have dry, peeling skin. Both should go away within a few weeks.

standard of care

Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.

Medical Control

You may need to call medical control for permission to: -Administer certain treatments -Determine the transport destination of patients -Stop treatment and/or not transport a patient

Rooting reflex

a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:

a blowout fracture

Heart failure

a chronic condition in which the heart is unable to pump out all of the blood that it receives

CSF (cerebrospinal fluid)

a clear fluid (similar to plasma) found in the brain and spinal cord.

pericardial effusion

a collection of fluid between the pericardial sac and the myocardium

Trade name

a commercial, legal name under which a company does business

Down syndrome

a condition of intellectual disability and associated physical disorders caused by an extra copy of chromosome 21.

sudden infant death syndrome (SIDS)

a condition that occurs when an infant stops breathing, usually during the night, and suddenly dies without an apparent cause

Spina bifida

a congenital defect that occurs during early pregnancy when the spinal canal fails to close completely around the spinal cord to protect it

Hyperthermia

a core temperature of 101°F (38.3°C) or higher. 1. When heat gain exceeds heat loss, hyperthermia results. C. Risk factors of heat illness 1. High air temperature (reduces radiation) 2. High humidity (reduces evaporation) 3. Lack of acclimation to the heat 4. Vigorous exercise (loss of fluid and electrolytes)

oropharyngeal airway (OPA)

a curved device inserted through the patient's mouth into the pharynx to help maintain an open airway

Heat stroke

a dangerous condition in which the body loses its ability to cool itself through perspiration

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:

a decreased ability to cough

Autism Spectrum Disorder (ASD)

a disorder that appears in childhood and is marked by significant deficiencies in communication and social interaction, and by rigidly fixated interests and repetitive behaviors

Negligence

a failure to provide the expected standard of care

nasopharyngeal airway (NPA)

a flexible breathing tube inserted through the patient's nostril into the pharynx to help maintain an open airway

incident command system

a flexible system implemented to manage a variety of emergency scenes.

diabetes mellitus

a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both

Schizophrenia

a group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions

rapid secondary assessment

a head-to-toe physical exam that is swiftly conducted on a trauma patient who is unresponsive or who has a significant mechanism of injury, has altered mental status, responds to verbal or painful stimuli, or is unresponsive; or on a medical patient who is not alert, is disoriented, does not respond to verbal or painful stimuli, or is unresponsive

A 75 year old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing

a heart attack

Laceration

a jagged cut caused by a sharp object or a blunt force that tears the tissue. a. An incision is a sharp, smooth cut. b. The depth of the injury can vary. c. Lacerations and incisions may appear linear (regular) or stellate (irregular). d. Lacerations or incisions that involve arteries or large veins may result in severe bleeding.

Laceration (soft tissue)

An infectious disease is MOST accurately defined as:

a medical condition caused by the growth and spread of small, harmful organisms within the body

The EMT should suspect that a patient who was exposed to cyanide will have

a normal pulse ox reading

NOI (nature of illness)

a patient's general medical condition or complaint.

Modified secondary assessment

a physical exam that is focused on a specific injury site, performed on a responsive patient with no significant mechanism of injury or critical injuries; or on a medical patient who is alert, oriented, and stable

Modified secondary assessment (definition)

Reassessment

a procedure for detecting changes in a patient's condition. It involves four steps: repeating the primary assessment, repeating and recording vital signs, repeating the physical exam, and checking interventions.

dialysis

a procedure to remove waste products from the blood of patients whose kidneys no longer function

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

a rapid heart rate

Fowler's position

a semi-sitting position; the head of the bed is raised between 45 and 60 degrees

Septic shock

a serious condition that occurs when an overwhelming bacterial infection affects the body

Tracheal deviation

a shifting of the trachea to either side of the midline of the neck caused by the buildup of pressure inside the chest

Injection

a shot; the "throwing" of medicine into the body by a needle

Wellness

a state of complete mental, physical, and social well-being.

Neurogenic shock

a state of shock (hypoperfusion) caused by nerve paralysis that sometimes develops from spinal cord injuries

Methicillin-resistant Staphylococcus aureus (MRSA)

a strain of the bacterium Staphylococcus aureus that has become resistant to the antibacterial action of the antibiotic methicillin, a form of penicillin

Activated charcoal

a substance that absorbs many poisons and prevents them from being absorbed by the body

Poison

a substance that causes illness, injury or death if taken into the body or produced within the body.

Seizure

a sudden surge of electrical activity in the brain that affects how a person feels or acts for a short time

Anxiety attack

a sudden, unexpected episode of severe anxiety with symptoms such as rapid heartbeat, sweating, dizziness, and nausea

Prefix

a syllable or word that comes before a root word to change its meaning

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect:

a systematic infection

Mobile radio

a two-way radio that is used or affixed in a vehicle

tension pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping

WMD

a weapon that kills or injures civilian as well as military personnel (nuclear and chemical and biological weapons)

Abrasion

a wound of the superficial layer of the skin, caused by friction when a body part rubs or scrapes across a rough or hard surface. a. An abrasion usually does not penetrate completely through the dermis, but blood may ooze from the injured capillaries in the dermis. i. Examples: road rash, road burn, strawberry, rug burn b. Abrasions can be extremely painful because the nerve endings are located in this area.

Abrasion (soft tissue)

Appendix

a. A 3- to 4-inch-long tube that opens into the cecum (first part of large intestine) in the RLQ of the abdomen b. It may easily become obstructed, inflamed, or infected (appendicitis). c. Appendicitis is one of the major causes of severe abdominal distress.

Five essential elements of a group

a. A common goal b. An image of themselves as a "group" c. A sense of continuity of the group d. A set of shared values e. Different roles within the group

Gowns

a. A gown provides protection from extensive blood splatter. b. A gown may not be practical in many situations. i. May even pose a risk for injury

Medical examiner cases

a. A patient who is dead on arrival (DOA) (sometimes called dead on scene [DOS]) b. Death without previous medical care, or when the physician is unable to state the cause of death. c. Suicide (self-destruction) d. Violent death e. Poisoning, known or suspected f. Death from accidents g. Suspicion of a criminal act h. Infant and child deaths

Breath holding syncope

a. A person swimming in shallow water may experience a loss of consciousness caused by a decreased stimulus for breathing. b. Happens to swimmers who breathe in and out rapidly and deeply before entering the water in an effort to expand their capacity to stay underwater c. Hyperventilation lowers the carbon dioxide level. d. The swimmer may not feel the need to breathe even after using up all the oxygen in his or her lungs. d. Treatment is the same as that for a drowning patient.

Subdural hematoma

a. Accumulation of blood beneath the dura mater but outside the brain b. Usually occurs after falls or injuries involving strong deceleration forces c. More common than epidural hematomas and may or may not be associated with a skull fracture d. A subdural hematoma is associated with venous bleeding, so the signs typically develop more gradually than with an epidural hematoma. e. The patient often experiences a fluctuating level of consciousness or slurred speech. f. Any patient with a suspected subdural hematoma needs to be evaluated by a physician.

Epidural hematoma

a. Accumulation of blood between the skull and dura mater b. Nearly always the result of a blow to the head that produces a linear fracture of the thin temporal bone c. Arterial bleeding into the epidural space will result in rapidly progressing symptoms. d. Often, the patient loses consciousness immediately following the injury. i. This is often followed by a brief period of consciousness (lucid interval), after which the patient lapses back into unconsciousness. ii. Death will follow very rapidly without surgery to evacuate the hematoma.

Causes of poisoning in children

a. Alcohol b. Aspirin and acetaminophen c. Cosmetics d. Household cleaning products such as bleach and furniture polish e. Houseplants f. Iron g. Prescription medications h. Illicit (street) drugs i. Vitamins

FCC regulations

a. Allocating specific radio frequencies for use by EMS providers b. Licensing base stations and assigning appropriate radio call signs for those stations c. Establishing licensing standards and operating specifications for radio equipment used by EMS providers d. Establishing limitations for transmitter power output e. Monitoring radio operations

How to treat nuchal chord

a. As soon as the head is delivered, use one finger to feel whether the umbilical cord is wrapped around the neck. b. This commonly is called a nuchal cord. c. A nuchal cord that is wound tightly around the neck could strangle the fetus. d. Usually, you can slip the cord gently over the delivered head. e If not, you must cut it. f. Once the cord is cut, you must attempt to speed the delivery by encouraging the woman to push harder and possibly more often because the fetus will now have no oxygen supply until it is delivered and breathing spontaneously.

Basilar skull fractures

a. Associated with high-energy trauma, but usually occur following diffuse impact to the head (falls, motor vehicle crashes) b. These injuries generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose without radiography. c. Signs of a basilar skull fracture include CSF drainage from the ears, raccoon eyes, and Battle's sign.

Standard PPE

a. At a minimum, gloves must be in place before any patient contact. b. Also consider glasses and a mask. 5. If the patient's condition warrants a higher level of PPE, providers should regroup and upgrade the protection.

Signs/Symptoms of hypothermia

a. Become more severe as the body's core temperature falls b. Hypothermia generally progresses through four stages (see Table 32-1). i. No clear distinction between the stages ii. The different signs and symptoms will help to estimate the severity of the problem c. Assess general temperature. i. Pull back your glove and place the back of your hand on the patient's abdomen. ii. If the abdomen feels cool, the patient is likely experiencing a generalized cold emergency. iii. You may carry a hypothermia thermometer, which registers lower body temperatures. d. Mild hypothermia occurs when the core temperature is between 90°F and 95°F (32°C and 35°C). i. The patient is usually alert and shivering. ii. Pulse rate and respirations are usually rapid. iii. Skin may appear red, pale, or cyanotic. e. More severe hypothermia occurs when the core temperature is less than 90°F (32°C). i. Shivering stops. ii. Muscular activity decreases. iii. Eventually, all muscle activity stops and mental status deteriorates. f. As the core drops toward 85°F (29°C): i. The patient becomes lethargic and stops fighting the cold. ii. The level of consciousness decreases. iii. The patient may try to undress. iv. Poor coordination and memory loss follow, along with reduced or complete loss of sensation to touch. v. Mood changes occur. vi. The patient shows impaired judgment. vii. The patient becomes less communicative. viii. The patient experiences joint or muscle stiffness. ix. The patient has trouble speaking. x. The patient appears stiff or rigid. g. If the body temperature continues to fall to 80°F (27°C): i. Vital signs slow. ii. Pulse becomes slower and weaker. iii. Respirations slow to shallow or become absent. iv. Cardiac dysrhythmias may occur as the blood pressure decreases or disappears. h. At a core temperature of less than 80°F (27°C): i. All cardiorespiratory activity may cease. ii. Pupillary reaction is slow. iii. Patient may appear dead (or be in a coma). i. Never assume that a cold, pulseless patient is dead.

B-NICE

a. Biologic b. Nuclear c. Incendiary d. Chemical e. Explosive

Capillary bleeding

a. Bleeding from damaged capillary vessels b. Dark red c. Oozes from a wound steadily but slowly d. More likely to clot spontaneously than arterial blood

Intracranial hemorrhage

a. Bleeding inside the skull also increases the ICP. b. Bleeding can occur between the skull and dura mater, beneath the dura mater but outside the brain, or within the tissue of the brain itself.

Subarachnoid hemorrhage

a. Bleeding occurs into the subarachnoid space, where the CSF circulates b. Results in bloody CSF and signs of meningeal irritation c. Common causes include trauma or rupture of an aneurysm. d. Patient reports a sudden, severe headache. e. A sudden, severe subarachnoid hematoma usually results in death; survivors often have permanent neurologic impairment.

Blood clot formation depends on several factors:

a. Blood stasis b. Changes in the blood vessel walls (such as a wound) c. Blood's ability to clot (affected by disease or medication)

Gonorrhea

a. Caused by bacteria that grow and multiply rapidly in warm, moist areas of reproductive tract i. Cervix, uterus, fallopian tubes in women ii. Urethra in men and women b. Bacteria can also grow in the mouth, throat, eyes, and anus. c. Symptoms are more severe in men than women. d. Women may present with painful urination, burning or itching, yellowish or bloody vaginal discharge, and blood associated with sexual intercourse. e. Severe infections present with cramping and abdominal pain, nausea, vomiting, and bleeding between periods. i. These symptoms indicate it has progressed to PID. f. Untreated, it can enter the bloodstream and spread to other parts of the body, including the brain.

Signs/symptoms of asthma

a. Characteristic wheezing as patients attempt to exhale through partially obstructed lower air passages b. In other cases, the airways are completely blocked and no air movement is heard. c. Cyanosis and respiratory arrest may quickly develop. d. Tripod position allows for easier breathing.

CBRNE

a. Chemical b. Biologic c. Radiologic d. Nuclear e. Explosive

Epistaxis (nose bleed)

a. Common emergency b. Occasionally can cause enough blood loss to lead to shock c. The blood you see may be only a small part of the total blood loss. i. Much of the blood may pass down the throat into the stomach as the patient swallows. ii. A person who swallows a large amount of blood may become nauseated and start vomiting (may be confused with internal bleeding). d. Most nontraumatic nosebleeds occur from sites in the septum, the tissue dividing the nostrils. e. You can usually handle this type of bleeding effectively by pinching the nostrils together.

Hazards of improper splinting

a. Compression of nerves, tissues, and blood vessels b. Delay in transport of a patient with a life-threatening injury c. Reduction of distal circulation d. Aggravation of the injury e. Injury to tissue, nerves, blood vessels, or muscles as a result of excessive movement of the bone or joint

PCR functions

a. Continuity of care b. Legal documentation c. Education d. Administrative information e. Essential research record f. Evaluation and continuous quality improvement

Evaporation

a. Conversion of any liquid to a gas b. Natural mechanism by which sweating cools the body

Veinous bleeding

a. Dark red (low in oxygen) b. Flows slowly or rapidly, depending on the size of the vein c. Does not spurt and is easier to manage d. Can be profuse and life threatening e. More likely to clot spontaneously than arterial blood

Infection Control Plan

a. Determination of exposure risk b. Education and training c. Hepatitis B vaccine program d. Personal protective equipment (PPE) e. Cleaning and disinfection practices f. Tuberculin skin testing/fit testing g. Postexposure management h. Compliance monitoring i. Record keeping

Routes of transmission

a. Direct contact (eg, blood-borne pathogens) b. Indirect contact (eg, needle sticks) c. Airborne transmission (eg, sneezing) d. Foodborne transmission (eg, contaminated food) e. Vector-borne transmission (eg, fleas)

Conduction

a. Direct transfer of heat from a part of the body to a colder object by direct contact b. Heat can also be gained if the substance being touched is warm.

When to use a tourniquet

a. Do not apply a tourniquet directly over any joint. b. Always place the tourniquet proximal to the injury. c. Make sure the tourniquet is tightened securely. d. Never use wire, rope, a belt, or any other narrow material because it could cut into the skin. e. Place padding under the tourniquet if possible to protect the tissues and help with arterial compression. f. Never cover a tourniquet with a bandage. g. Do not loosen the tourniquet after you have applied it.

Simple pneumothorax

a. Does not result in major changes in a patient's cardiac physiology b. Commonly the result of blunt trauma that results in fractured ribs i. Decreased breath sounds associated with significant lung collapse c. Signs and symptoms: i. Dyspnea, increased work of breathing, and increased respiratory rate ii. Tachypnea and accessory muscle use iii. Decreased oxygen saturation iv. A crackling sensation felt on palpation of the skin (subcutaneous emphysema) d. Late findings: i. Decreased breath sounds on the injured side ii. Lethargy iii. Cyanosis e. Be vigilant, because the simple pneumothorax can often worsen or deteriorate into a tension pneumothorax or develop complications like bleeding or hemothorax. f. Prehospital treatment: i. Provide high-flow oxygen. ii. Monitor oximeter readings and breath sounds. iii. Treat underlying causes of the injury. iv. Do not withhold positive-pressure ventilation if the patient needs support. (a) May cause tension pneumothorax (b) Have a plan to resolve complications.

Optional hold

a. Extend one arm across and in front of your chest, and grasp the patient's armpit. b. Extend your other arm in front and to the side of the patient's torso, and grasp the patient's belt. c. Raise your elbows and flex your arms to pull the patient.

Eye protection and face shields

a. Eye protection protects from blood splatters. b. Prescription glasses are not adequate. c. Goggles or face shields are best.

Motor vehicle crashes are classified as:

a. Frontal (head-on) b. Rear-end c. Lateral (T-bone) d. Rollovers e. Rotational (spins)

Hollow organs

a. Gallbladder b. Stomach c. Small intestine d. Large intestine e. Urinary bladder

Closed soft tissue injuries

a. History of blunt trauma b. Pain at the site of injury c. Swelling beneath the skin d. Discoloration

Treatment of impaled object in cheek

a. If you are unable to control the bleeding and it compromises the airway, consider removing the object. b. Then provide direct pressure both on the inside and outside of the cheek. c. The amount of bandaging should not be so overwhelming that it occludes the mouth and makes it difficult to breathe.

Esophagus

a. Immediately posterior to the trachea b. Food and liquids enter the pharynx and pass into the esophagus, which carries them to the stomach.

Cushing triad

a. Increased blood pressure (hypertension), decreased heart rate (bradycardia), and irregular respirations (Cheyne-Stokes or Biot) b. If this process is allowed to continue, it is a fatal injury. c. Perform controlled hyperventilation of your patient via positive-pressure ventilations at a rate of 20 breaths/min. d. Follow local protocols and your medical direction in regard to hyperventilation in the presence of herniation.

Common causes of fever in peds

a. Infection b. Status epilepticus c. Cancer d. Drug ingestion (aspirin) e. Arthritis f. Systemic lupus erythematosus (rash across nose) g. High environmental temperature

Nonsignificant MOIs

a. Injury to an isolated body part b. A fall without the loss of consciousness

Significant MOIs

a. Injury to more than one body system (multisystem trauma) b. Falls from heights c. Motor vehicle and motorcycle crashes d. Car versus pedestrian (or bicycle or motorcycle) e. Gunshot wounds f. Stabbings

Scoop stretcher

a. Insert the halves of the scoop stretcher under each side of the patient. b. Fasten the sides together. c. With two or more rescuers, move the patient to a nearby stretcher. 1. Also called an orthopaedic stretcher 2. Designed to be split into two or four pieces 3. Pieces are fitted around the patient who is lying on the ground or on a flat surface 4. The parts are then reconnected and the patient is lifted and put onto a backboard. 5. Both sides of the patient must be accessible to use a scoop stretcher. 6. You must fully immobilize and secure the patient on the scoop stretcher.

Intracerebral hemorrhage

a. Involves bleeding within the brain tissue itself b. Can occur following a penetrating injury to the head or because of rapid deceleration forces c. Many small, deep intracerebral hemorrhages are associated with other brain injuries. d. Intracerebral hematomas have a high mortality rate, even if the hematoma is surgically evacuated.

Terrorism

a. Involves violent acts or acts dangerous to human life that violate federal or state law b. Appears to be intended (i) to intimidate or coerce a civilian population; (ii) to influence the policy of a government by intimidation or coercion; or (iii) to affect the conduct of a government by mass destruction, assassination, or kidnapping

Solid organs

a. Liver b. Spleen c. Pancreas d. Kidneys e. Ovaries in women

Respiration (way to lose heat)

a. Loss of body heat during normal breathing b. Warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled. c. If the air temperature is above body temperature, an individual can gain heat with each breath.

Transport of pregnant trauma pt

a. Maintain an open airway. i. Be prepared for and anticipate vomiting. ii. Keep your suction unit readily available. b. Administer high-flow oxygen. i. Keep the oxygen saturation level high. ii. Administer high-flow, 100% oxygen by nonrebreathing mask. c. Ensure adequate ventilation. i. Listen to breath sounds and confirm that bilateral breath sounds are present. ii. If the patient's ventilations are inadequate, provide or assist ventilation with a bag-valve mask and 100% oxygen. d. Assess circulation. i. Control external bleeding. ii. Maintain a high index of suspicion for internal bleeding and shock based on the MOI. iii. Keep the patient warm. e. Transport considerations i. Transport the patient on her left side. ii. If spinal injury is suspected, tilt the backboard 30° to the left. iii. Transport the patient to a trauma center if one is available in your area.

10 golden rules to calm patient

a. Make and keep eye contact at all times. b. Provide your name, and use the patient's proper name. c. Tell the patient the truth. d. Use language the patient can understand. e. Be careful what you say about the patient to others. f. Be aware of your body language. g. Speak slowly, clearly, distinctly. h. If the patient is hard of hearing, face the patient so he or she can read your lips. i. Allow the patient time to answer or respond. j. Act and speak in a calm, confident manner.

Signs/symptoms of dislocations

a. Marked deformity b. Swelling c. Pain that is aggravated by any attempt at movement d. Tenderness on palpation e. Virtually complete loss of normal joint motion (locked joint) f. Numbness or impaired circulation to the limb or digit

Sexual Assault Focus On:

a. Medical treatment of patient i. Is she physically injured? ii. Are any life-threatening injuries present? iii. Does the patient complain of any pain? b. Psychologic care of patient i. Do not pass judgment on the patient. ii. Protect her from judgment of others on scene. c. Preserve evidence i. Do not cut through any clothing. ii. Do not throw away anything from the scene. iii. Place bloodstained clothing and anything else that could be evidence in separate paper bags.

Strategies to manage stress

a. Minimize or eliminate stressors as much as possible. b. Change partners to avoid a negative or hostile personality. c. Change work hours. d. Change the work environment. e. Cut back on overtime. f. Change your attitude about the stressor. g. Talk about your feelings with people you trust. h. Seek professional counseling if needed. i. Do not obsess over frustrating situations that you are unable to change, such as relapsing alcoholics and nursing home transfers; focus on delivering high-quality care. j. Try to adopt a relaxed, philosophical outlook. k. Expand your social support system beyond your coworkers. l. Develop friends and interests outside emergency services. m. Minimize the physical response to stress by using various techniques: i. Periodic stretching or yoga ii. Slow, deep breathing iii. Regular physical exercise (150 minutes per week, including cardiovascular effort) iv. Progressive muscle relaxation v. Meditation vi. Limiting intake of caffeine, alcohol, and tobacco use

Chlamydia

a. Most common STD in the United States b. Caused by bacteria c. Usually mild or absent symptoms d. Some women may report lower abdominal pain, low back pain, nausea, fever, pain during sexual intercourse, or bleeding between menstrual periods. e. Infection of the cervix can spread to the rectum and can progress to PID.

Speed of blood flow

a. Must be fast enough to maintain adequate circulation throughout the body and to avoid clotting b. Must be slow enough to allow cells time to exchange oxygen and nutrients for carbon dioxide and other waste products

Linear skull fractures

a. Nondisplaced skull fractures b. Account for approximately 80% of all fractures to the skull c. Radiographs are required to diagnose a linear skull fracture because there are often no physical signs such as deformity. d. If the brain is uninjured and there are no scalp lacerations, then linear fractures are not life threatening.

Open skull fractures

a. Open fractures of the cranial vault result when severe forces are applied to the head and are often associated with trauma to multiple body systems. b. Brain tissue may be exposed to the environment, which significantly increases the risk of a bacterial infection. c. High mortality rate

Oral report components

a. Opening information i. Name, chief complaint, nature of the illness, or mechanism of injury b. Detailed information i. Not provided during radio report c. Any important history i. Not already provided d. Patient's response to treatment given en route e. Vital signs f. Any other information, such as details gathered during transport, known allergies, and patient medications you brought with you

Signs/symptoms of skull fractures

a. Patient's head appears deformed b. Visible cracks in the skull c. Ecchymosis (bruising) that develops under the eyes (raccoon eyes) d. Ecchymosis that develops behind one ear over the mastoid process (Battle's sign)

Signs/Symptoms of severe bleeding

a. Poor general appearance and no response to external stimuli b. Signs and symptoms of shock (hypoperfusion) c. Significant blood loss d. Rapid blood loss e. Uncontrolled bleeding f. Significant MOI

Arterial bleeding

a. Pressure causes blood to spurt and makes bleeding difficult to control. b. Typically brighter red (rich in oxygen) and spurts in time with the pulse c. Decreases as the amount of blood circulating in the body drops and blood pressure drops

Principles of Splinting

a. Remove clothing from the area of any suspected fracture or dislocation so that you can inspect the extremity for DCAP-BTLS. b. Note and record the patient's neurovascular status distal to the site of the injury, including pulse, sensation, and movement. c. Cover open wounds with a dry, sterile dressing before splinting. d. Do not move the patient before splinting an extremity unless there is an immediate danger to the patient or you. e. In a suspected fracture of the shaft of any bone, be sure to stabilize the joints above and below the fracture. f. With injuries in and around the joint, be sure to stabilize the bones above and below the injured joint. g. Pad all rigid splints to prevent local pressure and discomfort to the patient. h. While applying the splint, maintain manual stabilization to minimize movement of the limb and to support the injury site. i. If fracture of a long-bone shaft has resulted in severe deformity, use constant, gentle manual traction to align the limb so that it can be splinted. j. If you encounter resistance to limb alignment, splint the limb in its deformed position. k. Immobilize all suspected spinal injuries in a neutral in-line position on a backboard. l. If the patient has signs of shock, align the limb in the normal anatomic position, and provide transport. m. When in doubt, splint.

Depressed skull fractures

a. Result from high-energy direct trauma to the head with a blunt object b. The frontal and parietal bones of the skull are most susceptible. c. Bony fragments may be driven into the brain, resulting in injury. d. Patients often present with neurologic signs (such as loss of consciousness).

Tension pneumothorax

a. Results from ongoing air accumulation in the pleural space b. This air gradually increases the pressure in the chest. i. Causes complete collapse of the unaffected lung ii. Mediastinum is pushed into the opposite pleural cavity (a) Blood cannot return through the venae cavae to the heart. (b) Decreases cardiac output (c) Leads to shock (d) Ultimately, results in death c. Tension pneumothorax is commonly caused by blunt injury in which a fractured rib lacerates a lung or bronchus. d. Common signs and symptoms: i. Chest pain ii. Tachycardia iii. Marked respiratory distress iv. Absent or severely decreased lung sounds on the affected side v. Hypotension vi. Altered mental status vii. Jugular vein distension (JVD) viii. Cyanosis ix. Tracheal deviation e. Prehospital treatment: i. Support ventilation with high-flow oxygen. ii. Request ALS support or transport immediately. iii. Needle decompression may be performed by ALS personnel or emergency department staff depending on local protocols.

Blunt abdominal wounds

a. Severe bruising of abdominal wall b. Liver and spleen laceration c. Rupture of intestine d. Tears in mesentery e. Rupture of kidneys or avulsion of kidneys from their arteries and veins f. Rupture of urinary bladder g. Severe intra-abdominal hemorrhage h. Peritoneal irritation and inflammation

Tympanic membrane rupture

a. Sudden changes in pressure created by a blast wave may cause rupture. b. Patients will report severe pain, difficulty hearing, or ringing in the affected ear. c. May be caused by insertion of objects too far into the ear d. Patients with a suspected tympanic membrane injury should be transported to the hospital for evaluation.

Bacterial vaginosis

a. The most common vaginal infection to afflict women ages 15-44 years b. Normal bacteria in the vagina are replaced by an overgrowth of other bacteria. c. Symptoms include itching; burning; pain; and a fishy, foul-smelling discharge. d. Untreated, it can lead to premature birth or low birth weight in case of pregnancy, make the patient more susceptible to other serious infections, and cause PID.

Formable splint

a. The most commonly used formable or soft splint is the precontoured, inflatable, clear plastic air splint. b. Always inflate the splint after applying it. c. The air splint is comfortable, provides uniform contact, and has the added advantage of applying firm pressure to a bleeding wound. d. Air splints are used to stabilize injuries below the elbow or below the knee. e. Air splints have some drawbacks, particularly in cold weather areas. i. The zipper can stick, clog with dirt, or freeze. ii. Significant changes in the weather or altitude affect the pressure of the air in the splint. f. You must first cover all wounds with a dry, sterile dressing, making sure that you use standard precautions.

When to remove an impaled object

a. The object is in the cheek or mouth and obstructs the airway. b. The object is in the chest and directly interferes with CPR.

Radiation

a. Transfer of heat by radiant energy b. Heat loss caused when a person stands in a cold room c. Heat can also be gained by radiation.

Convection

a. Transfer of heat to circulating air, as when cool air moves across the body b. Heat can be gained if the air moving across the body is hotter than the temperature of the environment.

Blood loss

a. Typical adult male has approximately 70 mL of blood per kilogram of body weight b. Typical adult female has approximately 65 mL of blood per kilogram of body weight c. Adverse changes in vital signs may occur with significant blood loss i. Increase in heart rate ii. Increase in respiratory rate iii. Decrease in blood pressure

High priority patients

a. Unresponsive b. Poor general impression c. Difficulty breathing d. Uncontrolled bleeding e. Responsive but unable to follow commands f. Severe chest pain g. Pale skin or other signs of poor perfusion h. Complicated childbirth i. Severe pain in any area of the body

Structures vulnerable in Neck injuries

a. Upper airway b. Esophagus c. Carotid arteries and jugular veins d. Thyroid cartilage (Adam's apple) e. Cricoid cartilage f. Upper part of the trachea

Extremity lift

a. Used for patients with no suspected extremity or spinal injury who are supine or in a sitting position b. May be helpful when the patient is in a small space because it does not require EMTs to stand side by side c. One EMT is positioned at the patient's head and the other EMT is positioned at the patient's feet. d. Coordinate your movements using direct verbal commands.

Direct ground lift

a. Used for patients with no suspected spinal injury who are found supine on the ground b. Use the direct ground lift when the patient will need to be carried a distance to the stretcher. c. EMTs stand side by side to lift and carry the patient. d. Ideally it should be performed by three EMTs, but it can be done with two.

Masks, respirators, and barrier devices

a. Wear a standard surgical mask for fluid spatter. b. Place a surgical mask on the patient with a communicable disease. c. Use a mask with a particulate air respirator on yourself if the disease is tuberculosis. d. When performing artificial resuscitation, use a pocket mask or a bag-valve mask. e. With an infected patient, use: i. Pocket mask ii. Bag-valve mask f. Dispose of these devices according to local guidelines.

Gloves

a. Wear gloves if there is any possibility for exposure to blood or body fluids. b. Vinyl, nitrile, and latex gloves are effective protection. Wear heavy-duty gloves when cleaning the ambulance. c. Change gloves between patients. d. Removing gloves requires a special technique to avoid contaminating yourself with the materials on the outside of the gloves (see Skill Drill 2-1).

draw-sheet method

a. With two or more rescuers, move the patient from the bed to the stretcher using a sheet or blanket. b. Place the stretcher next to the bed, making sure it is at the same height or slightly lower, the rails are lowered, and straps are unbuckled. Hold or secure the stretcher to keep it from moving. Loosen the bottom sheet underneath the patient, or log roll the patient onto a blanket. Reach across the stretcher, and grasp the sheet or blanket firmly at the patient's head, chest, hips, and knees. Gently slide the patient onto the stretcher. c. Center the patient on the sheet and tightly roll up the excess fabric on each side. This produces a cylindrical handle that provides a strong, secure way to grasp the fabric.

Signs/Symptoms of Spinal injuries

a. constant or intermittent pain or tenderness in the spinal column b. weakness in the legs with or without movement c. respiratory distress d. injury to the head, neck, shoulders, back, and abdomen e. tingling, numbness, loss of sensation in upper or lower extremities f. obvious deformity of the spine (rarely seen) g. loss of bladder or bowel control h. persistent erection in males (lower back injury)

cerebrovascular accident (CVA)

a.k.a. "Stroke". Lack of blood supply to the brain causing brain damage

AAA

abdominal aortic aneurysm

The MOST prominent symptoms of decompression sickness is

abdominal or joint pain

self-motivation

ability to begin or to follow through with a task without the assistance of others

When minor requires parental consent

able to respond/ minor

dysrhythmia

abnormal rhythm

Normal toddler blood pressure

about 80 to 90 systolic

Apnea

absence of breathing

Equipment and supplies that are carried on an ambulance should be stored:

according to the urgency and frequency of their use

Pulmonary edema

accumulation of fluid in the lungs

Aspirin

acetylsalicylic acid

cardiac tamponade

acute compression of the heart caused by fluid accumulation in the pericardial cavity

A 66 year old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100bpm and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92. The patient does not have prescribed nitro, but her husband does. You should:

administer O2, give her 324 mg of aspirin, and assess her further

Allergic reaction, no cell signal, has epi injector

administer epi, begin transport, attempt to contact en route

A 39 year old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should

administer high flow oxygen

A team of EMTs is caring for a critically injured patient. The team leader advises the EMT that transport will not begin until the patient's closed forearm fracture is splinted. Utilizing the crew resource management model, the EMT should

advise the team leader that immediate transport is more important than splinting

Partial (focal) seizures

affect single area of brain most commonly originate in temporal lobe often preceded by seizure aura can generalize 2 types: simple, complex

post

after

When functioning at the scene of a motor vehicle crash in which a patient will require complex extrication, you should enter the vehicle and provide care to the patient:

after receiving approval from the incident commander

When a child is struck by a car, the area of greatest injury depends MOSTLY on the:

age of the child and the size of the car that struck him or her

sympathomimetic

agent that mimics the effects of the sympathetic nervous system

An open pneumothorax occurs when: A. a fractured rib perforates the tissue of the lung. B. air enters the pleural space from outside the body. C. extreme pleural pressure causes the lung to rupture. D. air enters the pleural space from a perforated lung.

air enters the pleural space from outside the body

Pneumothorax

air in the pleural cavity caused by a puncture of the lung or chest wall

Crackles (rales) are caused by _________.

air passing through fluid

Oral glucose counterindications

airway compromise unconscious

ABCs

airway, breathing, circulation

A&O

alert and oriented (the patient can answer questions and is aware of what's going on)

A&Ox2

alert and oriented to person, place

A&Ox3

alert and oriented to person, place, and time

A&Ox4

alert and oriented to person, place, time, situation

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after:

all patients have been triaged

hay fever (allergic rhinitis)

allergic disease of the mucous membranes in the nose and the upper respiratory passages; caused by exposure to pollen from grass, weeds, flowers, and other allergenic substances

When to use epi pen

allergic run - anaphylaxis CALL MED CONTROL

The purpose of the pediatric assessment triangle (PAT) is to

allow you to rapidly and visually form a general impression of the child

Compliance

alveoli expand during inhale

When to remove Impaled objects in cheek

always

How to treat impaled objects in cheek

always remove

Common causes of depression in the elderly include all of the following, EXCEPT:

an acute onset of dementia

Croup

an acute respiratory syndrome in children and infants characterized by obstruction of the larynx, hoarseness, and a barking cough

croup

an acute respiratory syndrome in children and infants characterized by obstruction of the larynx, hoarseness, and a barking cough

Delirium

an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:

an air embolism

Type I Diabetes

an autoimmune disorder characterized by lack of insulin production by the beta cells of the pancreas

informed consent

an ethical principle that research participants be told enough to enable them to choose whether they wish to participate

aneurysm

an excessive localized enlargement of an artery caused by a weakening of the artery wall.

Contusion

an injury that causes bleeding beneath the skin but does not break the skin. a. Contusions result from blunt forces striking the body. b. The epidermis remains intact, but cells within the dermis are damaged, and small blood vessels are usually torn. c. The buildup of blood produces a characteristic blue or black discoloration called ecchymosis.

duty to act

an obligation to provide care to a patient

open head injury

an opening from the brain to the outside world exists.

Diarrhea treatment

antibiotics, IV fluid replacement, electrolyte readjustment, treat underlying conditions

Points of distribution (PODs) are strategically placed facilities where:

antidotes, antibiotics, and vaccines are distributed

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?

any behaviors that are a violent threat to the pt, EMTs, or others

Base station

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

When to call medical control

anything outside scope of practice/struggling with decision

During your assessment of a 29 year old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should

apply gentle manual traction in line with the limb and reassess for a pulse

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

apply high flow O2 therapy, place the pt in a shock position, and help maintain the pt's body temp

A 54 tear old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for the patient includes

applying direct pressure with a dry, sterile dressing

Injuries to the external male genitalia _______.

are rarely life-threatening

Types of blood vessels

arteries, arterioles, capillaries, venules, veins

Under what circumstances is a left ventricular assist device used?

as a bridge to heart transplantation while a donor heart is being located

Skin signs - circulatory

ashen/gray/pale hypo perfusion

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should:

ask the patient if he can unlock the door

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

ask the patient if she has developed a suicidal plan

You are called to the scene of a 56 year old female patient who was the driver of a car that struck a telephone pole. The patient is sitting in her vehicle with her seat belt on and the air bag has deployed. A bystander approaches as you arrive and informs you that he is an off duty firefighter and was first on the scene. The bystander wished to provide you with a patient care report. You should

ask your partner to perform the primary survey while you listen to the report

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

aspiration pneumonia

A 49 year old male presents with an acute onset of crushing chest pain and diaphoresis. you should

assess the adequacy of his respirations

Focused assessment

assessment conducted to assess a specific problem/AREA; focuses on pertinent history and body regions

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has a severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should:

assign him a delayed (yellow) category and continue triaging the other patients

After eating at a local restaurant, a 20-year-old male complains of blurred vision, difficulty speaking, and difficulty breathing. He is conscious; however, his respirations are profoundly labored and producing minimal tidal volume. You should:

assist his ventilations with high flow oxygen

A young male who was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should

assist the patient's ventilations

62 year old with crushing chest pain, history of MI, prescribed nitro, after administering O2 and contacting medical control

assist with nitro unless systolic BP less than 100mm Hg

What are the appropriate times to contact medical control?

assist with prescriptions -verify its ok -typically for: anaphylaxis, hypoglycemia, chest pain

Normal child respiratory rate

at rest, 15-30 breaths per minute

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:

at the feet

atlas

positive bruit

auscultation blood turbulence in AV fistula

Lateral

away from the midline

Deep

away from the surface

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of

axial loading

axis

Placenta priva

baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery

Vertebrae

backbones

A 47 year old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to

be alert for signs and symptoms of shock

When you shine a light into one pupil, the normal reaction of the other pupil should be to:

become smaller

pre

before

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:

begin high-quality CPR and apply the AED asap

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:

begin some form of positive pressure ventilation

Trachea (lower)

below the cricoid cartilage a. The trachea ends at the carina. b. It divides into two tubes, the right and left main stem bronchi, which enter the lungs and branch into smaller airways.

Flexion

bending a joint

cricothyroid membrane

between the thyroid and cricoid cartilage

neonates

birth to 1 month

Gastrointestinal hemorrhage

bleeding within the digestive tract, symptom of another disease

Which of the following conditions is the diabetic patient at an increased risk of developing?

blindness

Atherosclerosis

blockage of coronary artery

platelets

blood clotting, thrombocytes

Hematoma (soft tissue)

blood that is collected within damaged tissue or in a body cavity. a. It occurs whenever a large blood vessel is damaged and bleeds rapidly. b. It is usually associated with extensive tissue damage.

Pale skin in a child indicates that the:

blood vessels near the skin are constricted.

Coronary arteries

blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle

BSI

body substance isolation

Sensory nerves

body to brain

Frontal bone

bone that forms the forehead

Facial bones

bones of the face: lacrimal, mandibular, maxillary, nasal, vomer, and zygomatic

appendicular skeleton

bones of the shoulder, pelvis, and upper and lower extremities

Bilateral

both sides of midline

CNS (central nervous system)

brain and spinal cord

If the brain is deprived of oxygen for 0 to 4 minutes:

brain damage not likely

If the brain is deprived from oxygen for 4 to 6 minutes

brain damage possible

If the brain is deprived from oxygen for 6-10 minutes

brain damage very likely

motor nerves

brain to body

Signs/Symptoms of CNS injuries

brain/spinal cord -possibly pupils, priapism in males -decerebrate, inter cranial pressure

geriatrics

branch of medicine dealing with older individuals and their medical problems

Inhalation

breathing in

Exhalation

breathing out

Transient Ischemic Attack (TIA)

brief episode of loss of blood flow to the brain, usually caused by a partial occlusion that results in temporary neurologic deficit (impairment); often precedes a CVA

In contrast to Lyme disease, Rocky Mountain spotted fever:

can cause paralysis and cardiopulmonary collapse

Air splints

can control internal and external bleeding. also stabilize the fracture its self. also most commonly covers the entire extremity.

The nasopharyngeal airway is most beneficial because it

can maintain a patent airway in a semiconscious patient with a gag reflex

If the heart is deprived from oxygen from 0-1 minutes

cardiac irritability

Several attempts to adequately open a trauma patient's airway with the jaw-thrust maneuver have been unsuccessful. you should

carefully perform the head-chin lift maneuver

Arteries

carry blood away from the heart

Pulmonary arteries

carry deoxygenated blood out of the right ventricle and into the lungs

Hydrogen sulfide

category of drugs

Cholinergenic drugs

category of drugs abused

Infectious disease

caused by harmful organisms within the body

Penetrating trauma

causes injury by objects that primarily pierce and penetrate the surface of the body and cause damage to soft tissues, internal organs, and body cavities.

Organs in RLQ

cecum, appendix, right ovary and tube, right ureter, right spermatic cord

What organs are in RLQ?

cecum, appendix, right ovary and tube, right ureter, right spermatic cord

Treatment of meningitis

ceftriaxone + vanc for MRSA + ampicillin for listeria coverage dexamethasone to prevent blindness

When treating an 80-year-old patient who is in shock, it is important to remember that:

changes in gastric motility may delay gastric emptying, which increases the risk for vomiting

Toxin

changes metabolism

If a technical rescue team is required at the scene, but is not present when you arrive, you should:

check with the incident commander to ensure that the team is en route

Zygomas

cheek bones

Hormones

chemical messengers that are manufactured by the endocrine glands, travel through the bloodstream, and affect other tissues

Surfactant

chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing

Chemoreceptors

chemical sensors in the brain and blood vessels that identify changing levels of oxygen and carbon dioxide

Pulmonary agents

chemicals that primarily cause injury to the lungs; commonly referred to as choking agents.

Thorax

chest

thorac

chest

acute coronary syndrome (ACS)

chest pain and other signs and symptoms associated with cardiac ischemia

When to use nitroglycerin

chest pain, prescribed CALL MED CONTROL

angina pectoris

chest pain, which may radiate to the left arm and jaw, that occurs when there is an insufficient supply of blood to the heart muscle

Gallbladder disease

cholelithiasis-gallstones S&S- abdominal pain, jaundice, heart burn, food intolerance

Signs/symptoms of COPD

chronic cough, excessive sputum production, wheezing, dyspnea, poor exercise tolerance

When to use narcan/naxolene

chronic overdose CALL MED CONTROL

Cardiovascular system

circulates blood to all of the body's cells and tissues. 1. Delivers oxygen and nutrients 2. Carries away metabolic waste products 3. Responsible for supplying and maintaining adequate blood flow 1. Pump (heart) 2. Container (blood vessels) 3. Fluid (blood and bodily fluids)

Systemic circulation

circulation that supplies blood to all the body except to the lungs

The process of removing dirt, dust, blood, or other visible contaminants from a surface or equipment is called

cleaning

You are attending to a 46 year old male patient complaining of chest pain. Shortly after you begin to render care an ALS unit arrives and the transfer of care is made. The decision is made to start an intravenous line and administer medication you should

clear space and if necessary explain the procedure to the patient

Addiction

compulsive drug craving and use, despite adverse consequences

CHF (congestive heart failure)

condition in which the heart cannot pump enough blood to the rest of the body

Heat exhaustion

condition resulting from exposure to heat and excessive loss of fluid through sweating

Gross negligence

conduct that constitutes a willful or reckless disregard for a duty or standard of care

Involuntary consent

consent that is assumed when the patient is either mentally incompetent or legally not permitted to make his own medical decisions

Two-way radio

consists of a transmitter and a receiver

Respiratory system

consists of structures of the body that contribute to the process of breathing (respiration).

Amputations

control bleeding & treat for shock; if amputated body part is found - save it wrapped in clean material and placed in plastic bag, keep cool, but NOT directly on ice, keep it with the victim

Skin signs - respiratory

cool and diaphoretic -> stat pt (unstable) cyanotic = hypoxia additional symptoms: tachycardia, high respirations rate

Why are we careful not to move pt too quickly?

could send pt into cardiac arrhythmia

When do we call ALS for allergic reaction?

could worsen beyond our control

Visceral pleura

covers the lungs

A viral infection that may cause obstruction of the upper airway in a child is called

croup

Putrefaction

decomposition of proteins by the action of enzymes from anaerobic bacteria

DCAP-BTLS

deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling

The MOST significant hazard associated with splinting is

delaying transport of a critically injured patient

Compartment syndrome

develops when edema and swelling result in increased pressure within a closed soft-tissue compartment. a. Pressure increases within the compartment, which interferes with circulation. b. Delivery of nutrients and oxygen is impaired and by-products of normal metabolism accumulate. c. There is pain, especially on passive movement. d. The longer this situation persists, the greater the chance for tissue death. e. EMTs must continually reassess skin color, temperature, and pulses distal to the injury site if crush injury is suspected.

Compartment syndrome (shock)

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm

Pulse pressure

difference between systolic and diastolic pressure

Dyspnea

difficulty breathing

motor vehicle crash, find pt seated, semiconscious, with large laceration on forehead positioning?

direct your partner to apply manually in-line support of patient's head

-pathy

disease

Neuropathy

disease of the nerves

COPD (chronic obstructive pulmonary disease)

disease with enlarged lung spaces, usually from smoking can cause shortness of breath

The means by which a terrorist will spread a particular agent is called

dissemination

A supracondylar or intercondylar fracture is also known as a fracture of the

distal humerus

Treatment of anxiety attack

distraction

Seizure treatment

do not restrain, stay calm and time the duration of seizure. protect the patient from contact with hard, sharp or hot objects, loosen ties or anything around the neck, temporary non breathing is norm. after seizure turn on back and make sure breathing isnt obstructed, if patient doesnt begin breathing after seizure, begin rescue breathing

DNR

do not resuscitate order To be valid, DNR orders must meet the following requirements: 1. Clear statement of the patient's medical problem(s) 2. Signature of the patient or legal guardian 3. Signature of one or more physicians or other licensed health care providers 4. DNR orders with expiration dates must be dated in the preceding 12 months to be valid.

Pleura

double-layered membrane surrounding each lung

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

drooling or congestion

Hypnotic

drug that exerts a sleep-inducing effect

Antagonists

drugs that block the function of a neurotransmitter

Agonists

drugs that increase the action of a neurotransmitter

when to use albuterol

dry, hacking cough

Prove negligence

duty, breach of duty, causation, damages

A patient whose speech is slurred and difficult to understand is experiencing

dysarthria

Independent groups

each individual is responsible for his or her own area (either a physical space or set of tasks).

Dependent groups

each individual is told what to do, and often how to do it, by his or her supervisor or group leader.

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for

ectopic pregnancy

Your conscious patient has a mild partial airway obstruction. You should:

encourage the patient to cough

-megaly

enlargement

The rescue team is in the process of extracting a 40 year old male from his truck. The patient's wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be alright you should

ensure that she is in a safe area, away from the scene

Burns in children are commonly caused by all of the following, EXCEPT:

entrapment in a structural fire

A 30 year old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history, no meds. During your assessment, you hear wheezing over all the lung fields. His BP 90/50 mm Hg and his heart rate is 110bpm. In addition to giving him HF O2, most important treatment is

epinephrine

The two main types of cells contained in the blood are called

erythrocytes and leukocytes

Polyphagia

excessive hunger

Polydipsia

excessive thirst

Polyuria

excessive urination

Signs/symptoms of pneumonia

exertional dyspnea, a productive cough, chest discomfort and pain, wheezing, headache, nausea and vomiting, musculoskeletal pain, weight loss, and confusion

early adults typically

experience increase in fatty tissue, therefore weight gain

To date, the preferred weapons of mass destruction for terrorists have been:

explosive weapons

Decerebrate

extension away from body, pronation of arms/legs

Symptoms of hyperglycemia

extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, nausea

Factors/Strategies to Consider during Communication

eye contact age education posture body position/language clothing environment voice tempo facial expression culture gender volume

Orbit

eye socket

Prone

face down

Supine

face up

Signs/Symptoms of stroke

facial drooping sudden weakness or numbness in the face, arm, leg or one side of the body loss of movement and sensation on one side of the body speech disorders aphasia sudden and severe headache trouble walking confusion, combativeness tongue deviation

Therapeutic Communication Techniques

facilitation, silence, reflection, empathy, clarification, confrontation, interpretation, explanation, summary

syncope

fainting

tachy

fast

What is the most common misconception surrounding mental illness?

feeling "bad" or "depressed" means that you must be "sick"

Referred pain

feeling of pain when sensory information from internal and external areas converges on the same nerve cells in the spinal cord

ovaries

female gonads

white blood cells (leukocytes)

fight infection

Crackles

fine crackling or bubbling sounds, commonly heard during inspiration when there is fluid in the alveoli; also called rales

Pulmonary circulation

flow of blood from the heart to the lungs and back to the heart

Influenza

flu virus

Peritonitis may result in shock because:

fluid shifts from the bloodstream into body tissues.

postdictal state

following seizure

work

force acting over a distance.

deep vein thrombosis (DVT)

formation of a clot in a deep vein of the body, occurring most often in the femoral and iliac veins

Joint

formed wherever two bones come into contact. a. Joints are held together in a tough fibrous structure known as a capsule, which is supported and strengthened in certain key areas by bands of fibrous tissue called ligaments. b. In moving joints, the ends of bones are covered with a thin layer of cartilage known as articular cartilage. c. Joints are bathed and lubricated by synovial (joint) fluid. d. Joints allow circular motion (shoulder), hinge motion (knee and elbow), minimum motion (sacroiliac and sternoclavicular joints), or no motion (sutures in the skull).

Thyroid cartilage (Adam's apple)

forms the anterior part of the larynx a. Tiny muscles open and close the vocal cords and control tension. b. Sounds are created as air is forced past the vocal cords, making them vibrate.

Word root

foundation of the word

Coccyx

four vertebrae fused together to form the tailbone

The term used when individual units or different organizations make independent and often insufficient decisions regarding an incident is called

freelancing

What do you use to clear stomas?

french catheter (thin) to suction for NO MORE THAN 15 SECONDS possible use PDA mask

Flow of blood through the heart

from the body superior and inferior vena cavas right atrium tricuspid valve right ventricle semilunar valve pulmonary artery lungs pulmonary veins left atrium bicuspid valve left ventricle semilunar valve aorta to the body

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

frostbite

Complications associated with chest compressions include all of the following except

gastric distention

A 67 year old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120bpm and thready. You should be MOST suspicious that the patient is experiencing

gastrointestinal bleeding

Placards and labels on a storage container are intended to:

give a general idea of the hazard inside that particular container

Standard PPE on any call

gloves and goggles (base layer)

When to use glucose for hypoglycemia

glucometer under 80

Brain requires

glucose and O2

Extraneous PPE

gown - blood face shield - childbirth mask - coughing

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should:

grab him by the clothes and immediately move him to safety

Hyperextension injuries of the spine are MOST commonly the result of

hangings

According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she:

has a GCS score of less than or equal to 13 with a mechanism attributed to trauma

Hep B is more virulent than Hep C. Therefore B

has a greater ability to produce disease

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:

has a history of eye surgeries

A supervisor who has more than seven people reporting to him or her:

has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person

Signs/symptoms of head injuries

head pain, bleeding, swelling, nausea, vomiting, unequal or dilated pupils, blood or clear fluids

cardi

heart

Myocardium

heart muscle

Association of Air Medical Services (AAMS) and MedEvac Foundation International

helicopter b. The distance to the trauma center is more than 20 to 25 miles.

EMS as a career

help people

You are attending to a 68 year old female patient in cardiac arrest. An ALS provider arrives shortly after you do and the transfer of care is made. The ALS provider asks that you assist in the endotracheal intubation. As part of the process, you may be required to

help position the patient for a better view of the airway during the procedure

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

hemophilia A

Opiates/Opioids

heroin, morphine, opium, pain pills decreased reaction to pain, euphoria

Hypertension

high blood pressure

Hyperglycemia

high blood sugar

treating obstructive shock

high flow O2 nonrebreather

When to use nonrebreather

high flow O2 steady stream DO NOT require physical help ventilation

EMT licensure criteria

high school diploma, immunization against certain communicable diseases, completion of background check/drug screening, valid driver's license, BLS/CPR course, EMT course, state written/practical exam, mental/physical ability, compliance with state provisions

RSV (respiratory syncytial virus)

highly contagious viral respiratory infection, major cause of respiratory illness in young children

urticaria

hives

Urticaria

hives; an eruption of wheals on the skin accompanied by itching

transverse (axial) plane

horizontal (cross-sectional) plane dividing the body into upper and lower portions

Common signs and symptoms of heat exhaustion include all of the following except

hot, dry skin

Articular cartilage

hyaline cartilage that covers ends of bones in synovial joints

Signs/symptoms of diabetes

hyperglycemia, acetone breath, ketonemia, ketonuria, polydipsia, polyuria, polyphagia

You are assessing a 70 year old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads high. She is conscious, but confused. Her blood pressure is 92/52 mm Hg. Her pulse rate is 130 bpm and weak and her respirations are 22 and shallow. The patient's clinical presentation is MOST consistent with

hyperosmolar hyperglycemic nonketonic syndrome

When to use glucose

hypoglycemia CALL MED CONTROL

In an acute injury setting, neurogenic shock is commonly accompanied by:

hypothermia

Internal bleeding can cause

hypovolemic shock

Quaternary blast injuries

i. Burns from hot gases or fires started by the blast ii. Respiratory injury from inhaling toxic gases iii. Crush injury from the collapse of buildings iv. Suffocation, poisoning, other medical emergencies v. Contamination of wounds from environmental, chemical, or toxic substances

BE MAGIC

i. B—Perform BVM preoxygenation. ii. E—Evaluate for airway difficulties iii. M—Manipulate the patient iv. A—Attempt first-pass intubation v. GI—Use a supraGlottic or Intermediate airway if unable to intubate vi. C—Confirm successful intubation

Capillary refill assessment

i. Capillary refill is often evaluated in pediatric patients to assess the ability of the circulatory system to perfuse the capillary system in the fingers and toes. ii. Capillary refill time can be affected by the patient's age, history, medications, and the environment. ii. To test capillary refill: (a) Place your thumb on the patient's fingernail with your fingers on the underside of the patient's finger and gently compress. (b). Remove the pressure. (c). As the underlying capillaries refill with blood, the nail bed return to its normal pink color. (d). With adequate perfusion, the color in the infant or child's nail bed should be restored to its normal pink color within 2 seconds.

Spinal column

i. Central supporting structure of the body ii. Composed of 33 bones, called vertebrae iii. Vertebrae are named according to section of spine in which they lie and numbered from top to bottom. iv. The spine is divided into five sections (top to bottom):

Common causes of seizures

i. Child abuse ii. Electrolyte imbalance iii. Fever iv. Hypoglycemia v. Infection vi. Ingestion vii. Lack of oxygen viii. Medications ix. Poisoning x. Seizure disorder xi. Recreational drug use xii. Head trauma xiii. No cause can be found

Pelvis

i. Closed bony ring consisting of three bones: (a) Sacrum (b) Two pelvic bones ii. Each pelvic bone is formed by fusion of the ilium, ischium, and pubis. (a) These three bones are joined posteriorly by the sacrum. (b) Anteriorly, the right pubis and left pubis are joined by the pubic symphysis—a hard bony and cartilaginous joint with minimal motion. (c) The leg connects to the hip joint at the acetabulum—the part of the pelvis where the ilium, ischium, and pubic bones meet.

Secondary blast injuries

i. Damage to the body results from being struck by flying debris.

Concussion signs/symptoms

i. Dizziness ii. Weakness iii. Visual changes iv. Nausea v. Vomiting vi. Ringing in the ears vii. Slurred speech viii. Inability to focus ix. Lack of coordination x. Delay of motor functions xi. Inappropriate emotional responses xii. Temporary headache xiii. Disorientation

Full thickness (third degree burns)

i. Extend through all skin layers and may involve subcutaneous layers, muscle, bone, or internal organs ii. The burned area is dry and leathery and may appear white, dark brown, or even charred. iii. If the nerve endings have been destroyed, a severely burned area may have no feeling. iv. The surrounding, less severely burned areas may be extremely painful.

Functions of liver

i. Filtering harmful substances ii. Forming the factors needed for blood clotting and normal plasma production iii. Principal organ for storing sugar or starch for immediate use by the body for energy

Level I Trauma Center

i. Generally serves large cities or heavily populated areas ii. Provides every aspect of trauma care iii. Most Level I facilities are university-based teaching hospitals.

Possible causes of intellectual disability

i. Genetic factors ii. Congenital infections iii. Complications at birth iv. Malnutrition v. Environmental factors vi. Prenatal drug or alcohol use vii. Traumatic brain injury viii. Poisoning (eg, with lead or other toxins)

Signs/symptoms of airway obstruction

i. Ineffective cough (no sound) ii. Inability to speak or cry iii. Increasing respiratory difficulty, with stridor iv. Cyanosis v. Loss of consciousness

Superficial (first degree burns)

i. Involve only the top layer of skin, the epidermis ii. The skin turns red but does not blister or burn through this top layer. iii. The burn site is often painful. iv. Example: sunburn

Partial thickness (second degree burns)

i. Involve the epidermis and some portion of the dermis ii. These burns do not destroy the entire thickness of the skin, nor is the subcutaneous tissue injured. iii. Typically, the skin is moist, mottled, and white to red. iv. Blisters are present. v. Can cause intense pain

Level II Trauma Center

i. Located in less population-dense areas ii. Provides initial definitive care

Airway burns

i. May be associated with singed hair within the nostrils, soot around the nose and mouth, hoarseness, and hypoxia ii. These patients should be rapidly transported to an ED or facility capable of advanced airway management.

Eye injuries following head injury

i. One pupil larger than the other ii. Eyes not moving together or pointing in different directions iii. Failure of the eyes to follow movement of your finger as instructed iv. Bleeding under the conjunctiva v. Protrusion or bulging of one eye b. For an unconscious patient, keep the eyelids closed. i. Cover the lids with moist gauze, or hold them closed with clear tape. ii. Normal tears will then keep the tissues moist.

Level III Trauma Center

i. Provides assessment, resuscitation, emergency care, and stabilization ii. Transfers patients to Level I or Level II facility when necessary

Larynx injuries

i. Respiratory distress ii. Hoarseness iii. Pain iv. Difficulty swallowing (dysphagia) v. Cyanosis vi. Pale skin vii. Sputum in the wound viii. Subcutaneous emphysema ix. Bruising on the neck x. Hematoma xi. Bleeding b. To manage a laryngeal injury: i. Provide oxygen and ventilation. ii. Apply cervical immobilization, but avoid the use of rigid collars.

Skin signs

i. The skin's color is determined by the blood circulating through vessels and the amount and type of pigment that is present in the skin. ii. Poor peripheral circulation will cause the skin to appear pale, white, ashen, or gray. iii. When the blood is not properly saturated with oxygen, it appears blue. iv. High blood pressure may cause the skin to be abnormally flushed and red. v. Changes in skin color may also result from chronic illness.

Tertiary blast injuries

i. The victim is hurled by the force of the explosion against a stationary object.

Primary blast injuries

i. These are due entirely to the blast itself. ii. Damage to the body is caused by the pressure wave generated by the explosion.

Level IV Trauma Center

i. Typically found in remote outlying areas where no higher level of care is available ii. Provides advanced trauma life support iii. Transfers to a higher-level trauma center

Advil, Nuprin, and Motrin are brand (trade) names for the generic medication:

ibuprofen

For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________.

identify whether the patient requires rapid transport

If family shows a valid DNR, stop resuscitative efforts

if pt has regained pulse, but not breathing you HAVE TO TAKE TO HOSPITAL -communicate to family -legally operated under implied consent

If family member wants to watch pt in cardiac arrest, LET THEM

if they do, DO NOT IGNORE THEM give updates ease them into death be mindful when using AED

Triage categories

immediate (red) delayed (yellow) minor or minimal (green, hold) expectant (black, likely to die or dead)

cricoid cartilage

immediately below the thyroid cartilage

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from the vehicle. you should

immediately request additional resources

After the AED has delivered a shock, the EMT should:

immediately resume CPR

Asthma is caused by a response of the:

immune system

Primary brain injury

impact to the head.

Aphasia

impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

When to transport minors without parental consent

implied consent unable to respond

Respiratory compromise

inability to move gas efficiently

Precontraction

increase in pressure before heart muscle stretches

You are attending to a 34 year old male patient with chronic back pain, weighs over 750lbs, bariatric stretcher had wider surface area to allow?

increased patient comfort and dignity

postpartum pts

increased risk of an embolism—most commonly a pulmonary embolism.

Hypovolemia

increased temp, rapid/weak pulse, increase respiration, hypotension, anxiety. Urine specific gravity >1.030

Secondary brain injury

increases the severity of the primary injury, and may be caused by: i. Cerebral edema ii. Intracranial hemorrhage iii. Increased intracranial pressure iv. Cerebral ischemia v. Infection

Tracheostomy tube

indwelling tube inserted directly into the trachea to assist with ventilation

Tuberculosis (TB)

infectious disease caused by Mycobacterium tuberculosis; lungs usually are involved, but any organ in the body may be affected

-itis

inflammation

Chronic bronchitis

inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD)

Pelvic inflammatory disease (PID)

inflammation of organs in the pelvic cavity; usually includes the fallopian tubes, ovaries, and endometrium; most often caused by bacteria 2. Most common presenting sign of PID is generalized lower abdominal pain. a. Other signs include abnormal or foul-smelling vaginal discharge, increased pain with intercourse, fever, general malaise, and nausea and vomiting.

Appendicitis

inflammation of the appendix

Cystitis

inflammation of the bladder

Bronchitis

inflammation of the bronchi

Diverticulitis

inflammation of the diverticula

Esophagitis

inflammation of the esophagus caused by acid reflux

Cholecystitis

inflammation of the gallbladder; usually associated with gallstones

Hepatitis

inflammation of the liver

Meningitis

inflammation of the meninges

gastroenteritis

inflammation of the mucous membrane lining the stomach and intestines

Pancreatitis

inflammation of the pancreas

Peritonitis

inflammation of the peritoneum (membrane lining the abdominal cavity and surrounding the organs within it)

Different types of consent

informed Implied Minor

How poisons enter the body

inhalation, ingestion, absorption, injection

Childbirth process

initiated by a series of hormonal changes at about 9 months, stage one is dilation and effacement of cervix and transition, stage two is pushing and birth, stage three deliver placenta

What happens when spinal injuries get worse?

injuries pinch, pull, or penetrate spinal cord -possible paralysis

Trauma emergencies

injuries that are the result of physical forces applied to the body

Barotrauma

injuries that result from sudden or extreme changes in air pressure.

Subcutaneous layer

innermost layer of the skin, containing fat tissue

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:

instruct him to hold his breath for as long as he comfortably can

sphygmomanometer

instrument to measure blood pressure

You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes:

insulin

Action

intended therapeutic effect

Guidelines for personal space

intimate : <18in personal : 18in-4ft social : 4ft-10ft public : 10ft-25ft

autonomic

involuntary

In cIn contrast to a cerebral concussion, a cerebral contusion

involves physical injury to the brain tissue

A 37 year old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop

irreversible renal failure

A simple pneumothorax: Select one: A. often has a nontraumatic cause. B. is caused by penetrating chest trauma. C. heals on its own without any treatment. D. is commonly caused by blunt chest trauma.

is commonly caused by blunt chest trauma

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?

it forces the alveoli open and pushes oxygen across the alveolar membrane

Which is true about secondary assessment?

it should focus on a certain area or region of the body as determined by the chief complaint

Synovial fluid

joint-lubricating fluid secreted by the synovial membrane

The superficial temporal artery can be palpated

just anterior to the tragus.

A 17 year old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should

keep her knee flexed and secure it with padded board splints

Maintaining a cushion of safety when operating an ambulance means:

keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirrors' blind spots

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?

kidney

nephr

kidney

Retroperitoneal organs

kidneys and pancreas

Patella

kneecap

Stomach

large muscular sac that continues the mechanical and chemical digestion of food

Acetabulum

large socket in the pelvic bone for the head of the femur

In pediatric patients, the liver and spleen are

larger in proportion to the abdomen

Radius

lateral bone of the forearm

midsagittal (midline) plane

left and right equal halves

LLQ

left lower quadrant contains the descending and sigmoid portions of the colon

LUQ

left upper quadrant contains the stomach, spleen, and a portion of the colon

Generic name

legal noncommercial name for a drug

sagittal (lateral) plane

lengthwise, vertical plane dividing the body or structure into right and left sides

LOC

level of consciousness

Most patients with abdominal pain prefer to:

lie on their side with their knees drawn into the abdomen.

The impedance threshold device (ITD) may improve circulation during active compression-decompression CPR by

limiting the amount of air that enters the lungs during the recoil phase between chest compression, which results in negative intrathoracic pressure and improved cardiac filling

hepat

liver

Organs in RUQ

liver, gallbladder, duodenum, hepatic flexure of colon, part of ascending and transverse colon

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53 year old diabetic man, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg, you should:

load him into the ambulance and begin rapid cooling interventions

Signs/symptoms of edema

localized swelling, pale (severe) or red skin, slow bounding pulse, high bp, lethary, pulmonary congestion, ascites (abd fluid), anasarca (severe generalized edema)

As an EMT, the standards of emergency care are often partially based on:

locally accepted protocols

Most appropriate device for immobilizing pt with suspected spinal injury

long backboard

When to extricate in full spinal precautions?

lot of time

Hypotension

low blood pressure

Hypoglycemia

low blood sugar

When to use nasal cannula

low flow O2 steady stream DO NOT require physical help ventilation

Ventricle

lower chamber of the heart

Mandible

lower jaw bone, moveable

ATP (adenosine triphosphate)

main energy source that cells use for most of their work

The main function of the endocrine system is to

maintain homeostasis

Treating neurogenic shock

maintain proper airway supplemental O2

Abdomen

major body cavity

Testes

male gonads

MCI

mass casualty incidents, or any incident where casualties are greater than the resources

Vaginal bleeding

may be considered menstrual bleeding and overlooked. 2. Possible causes include: a. Abnormal menstruation b. Vaginal trauma c. Ectopic pregnancy d. Spontaneous abortion e. Cervical polyps f. Cancer

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

may decrease the amount of blood that returns to the heart

When a person is lying supine at the end of exhaustion, the diaphragm

may rise as high as the nipple line

Life threatening to hollow organs

may rupture and leak toxic digestive chemicals. i. The patient may eventually develop a life-threatening infection.

Life threatening to solid organs

may tear, lacerate, or fracture, which can cause serious bleeding into the abdomen.

-meter

measure

Systolic

measurement of blood pressure taken when the heart is contracting and forcing blood into the arteries (normal 120)

Ulna

medial bone of the forearm

Required for EMT to administer drug to patient

medical direction approval

When assessing a patient with a medical complaint, which of the following is most likely to reveal the cause of the problem?

medical history

Sedative

medicine used to help a person settle into a state of calmness

Synovial membrane

membrane lining the capsule of a joint

Peritoneum

membrane that lines the abdominal cavity

Traction splints

metal devices that immobilize and pull on muscles that are in a state of contraction

Rule of nines

method used to calculate the amount of fluid lost as the result of a burn; divides the body into 11 areas, each accounting for 9% of the total body area

psych

mind

VHF (very high frequency)

mobile radios operate between 30 and 300 MHz

Abrasions

most common type of open wound which is characterized by skin that has been rubbed or scraped away

The FIRST step in the START triage system is to

move all walking patients to a designated area.

Abduction

movement away from the midline

Ventilation

movement of air in and out of the lungs

Adduction

movement toward the midline

Heat cramps

muscle spasms that result from a loss of large amounts of salt and water through perspiration

As a triage supervisor, you:

must not begin treatment until all patients have been triaged

adequate blood

must preload heart muscle, myocardial contractility increases

Angina pectoris occurs when:

myocardial oxygen demand exceeds the supply

Side effects of glucose

nausea and vomiting

Signs/symptoms of heat stroke

nausea and vomiting, dizziness, muscle cramps, tachycardia, tachypnea, dyspnea, warm, dry skin (absence of perspiration), seizures in children -> can lead to CV and/or pulmonary failure, myonecrosis (myoglobinuria), DIC, death

Superficial

near the surface

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:

neck and facial injuries

The first month of life after birth is referred to as the:

neonatal period

neur

nerves

The venom of a black widow spider is toxic to the

nervous system

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem.

neurologic

When approaching a helicopter whether the rotor blades are moving or not you should

never duck under the body or the tail boom because the pilot cannot see you in these areas

Neonate

newborn baby

nitroglycerin

nitrate drug used in the treatment of angina

When to extricate emergency?

no time

Small infants

nose breathers, require nasal passages at all times

Contraindication of narcan/naxolene

nose is dry, but still administer

Rules based medication error

not approved by medical direction

Sign

objective condition you can observe or measure about the patient

Patient Assessment

objective evaluation and determination of the status of a patient

Agonal gasps

occasional, gasping breaths that occur after the heart has stopped

Acute psychosis

occurred when the patient develops one ore more of the following symptoms: hallucinations, delusions, catatonia, or a thought disorder

hemorrhagic stroke

occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed

Diastolic

occurs when the ventricles are relaxed; the lowest pressure against the walls of an artery (normal 80)

When preparing a pregnant for delivery you should position her

on a firm surface with her legs elevated 2 to 4 inches

You are attending to a 26 year old female pregnant, experiencing lower abdominal pain and cramping placement?

on left side

When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed

on the thighs or ankles

To protect a restrained patient and prevent him from using leverage to break free, the EMT should secure __________.

one arm above the head

When to extricate on a short board?

only spinal injuries/c spine

OPQRST

onset, provocation, quality, radiation, severity, time

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should:

open and maintain her airway and assess breathing

pt scored 9 on GCS 2 eye opening 3 verbal response 4 motor response

opens eyes in response to pain uses inappropriate words withdraws from pain

What meds can an EMT give?

oral glucose, activated charcoal, prescribed medications, auto-injectors

A&Ox1

oriented to person

Parietal pleura

outer layer of pleura lying closer to the ribs and chest wall

Epidermis

outermost layer of skin

hyper

over

-algia

pain

Signs/symptoms of meningitis

pain in the back, muscles, stiff neck, headache , fever , nausea or vomiting; blotchy or red rashes, AMS, tachypnea, tachycardia

Palmar

palm of hand

When assessing a patient with abdominal pain, you should:

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful

A spinal cord injury at the level of C7 would MOST likely result in

paralysis of the intercostal muscles

Which of the following is a specific example of the Mobile Integrated Healthcare (MIH) model?

paramedic administering flu vaccination

Upon arrival at a trench rescue operation, you should _________.

park at least 500 ft from the incident

You have sealed the open chest wound of a 40 year old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should

partially remove the dressing

Why use a tourniquet

patient has substantial bleeding from an extremity injury.

Open-ended questions

patient provides detail

For every emergency request, the dispatcher should routinely gather and record all of the following information, EXCEPT the:

patient's medical history

Which of the following is true about dialysis?

patients who miss a dialysis treatment often present with weakness

-al

pertaining to

-ic

pertaining to

Whooping cough

pertussis

The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________.

physical and psychological

When moving a conscious, weak patient down a flight of stairs, you should:

place the wheeled stretcher at the bottom of the stairs, carry down stairs in stair chair

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes

placing the mother supine with her head down and pelvis elevated

The development of an incident action plan is the responsibility of the

planning section

Blood composition

plasma, red blood cells, white blood cells, platelets

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:

pneumonia

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

pneumothorax

Pinpoint pupils

pons damage or drugs (opiates)

What position for pt with SOB?

position of comfort

What position for pt with pain/angina?

position of comfort

When arriving at the scene of an overturned tractor-trailer rig, you note that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but bleeding profusely from the head. After notifying the hazardous materials team, you should:

position the ambulance upwind

Crepitus and false motion are:

positive indicators of a fracture.

What to do after patient seizes?

postdictal phase, do not question, ice pack possibly

Obstetrics

pregnancy and childbirth

Upon arrival at a search-and-rescue incident, the EMS crew should _________.

prepare the equipment to carry the patient

Mean Arterial Pressure (MAP)

pressure forcing blood into tissues, averaged over cardiac cycle MAP = (HR x SV) x SVR MAP = CO x SVR

palpable pulse is created by

pressure waves through the arteries caused by cardiac contraction.

The purpose of a ventricular peritoneum shunt is to

prevent excess CSF from accumulating in the brain

When assessing a patient who experienced a blast injury, it is important to remember that:

primary blast injuries are the most easily overlooked

EMS requires

privacy officer

Capnography

procedure to record carbon dioxide levels

Functional disorder

produces symptoms for which no physiological or anatomical cause can be identified

Signs/symptoms of brain bleeds

progression BP pupils pulse

Pt positions upon arrival

prone, supine, fowlers

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury

Law enforcement personnel request your assistance to assess a 31 year old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:

provide emotional support and visually assess her for obvious trauma

An important aspect in the treatment of a patient with severe abdominal pain is to:

provide emotional support en route to the hospital

AEMT (Advanced Emergency Medical Technician)

provides both basic and advanced emergency medical care and transportation to patients in the prehospital environment. IV and certain emergency medications

Interview techniques to avoid

providing false assurance, giving unsolicited advice, asking leading questions, talking too much, interrupting, using "why" questions, using authoritative language, speaking in professional jargon

A "hip" fracture is actually a fracture of the

proximal femur

Hallucinogens

psychedelic ("mind-manifesting") drugs, such as LSD, that distort perceptions and evoke sensory images in the absence of sensory input

When to use BVM

pt needs assistance w VENTILATION (physical action of breathing - you need to push air in and our for them)

edema

puffy swelling of tissue from the accumulation of fluid

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:

pulmonary contusion

Pulmonary blast injuries

pulmonary trauma that results from short-range exposure to the detonation of explosives. a. Primary blast injury is often characterized by a lack of external visible injuries. b. Pneumothorax is a common injury and may require emergency decompression in the field. c. Pulmonary edema may ensue rapidly.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

pupillary constriction

Eye

pupils, cornea, retina, lens

Simplex

push to talk, release to listen

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________.

quickly, within 30 minutes

RDD

radiation dispersal device

A 6 year old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is

rapidly transporting her to the hospital

acute asthma attack, alert, respiratory distress, assist MDI then

reassess patient and document her response to medication

You are caring for a 68 year old man with sudden onset of left-sided paralysis and slurred speech. His airway is present, his respirations are 14 breaths/min with adequate depth, and his O2 sat 98. Treatment should include:

recovery position and transport

Blood contains

red blood cells, white blood cells, platelets, plasma

CPR (cardiopulmonary resuscitation)

refers to medical procedures used when a person's heart and lungs have stopped working

Nasopharynx

region of the pharynx at the back of the nose and above the soft palate

Pulses

regular, measured beats

General guidelines for safe ambulance driving include all of the following, EXCEPT:

regularly using the siren as much as possible

Testes hormone

regulate sexual function, characteristics, and reproduction in men

Pituitary hormone

regulates all other endocrine glands

Pancreas hormone

regulates glucose metabolism and other functions

Thyroid hormone

regulates metabolism

Parathyroid hormone

regulates serum calcium

Ovary hormone

regulates sexual function, characteristics, and reproduction in women

Adrenal hormone

regulates stress response, fight-or-flight response

Nervous stimulation

release of epinephrine and norepinephrine by adrenal medulla in response to sympathetic nervous stimulation

-ectomy

removal

What to do if patient is seizing?

remove restrictive clothing, give space and prevent them from seizing

2 person CPR

rescuer 1 gives 2 rescue breaths, rescuer 2 gives 30 compressions for adult, 15 for child&infant

Most AEDs are set up to adjust the voltage based on the impedance, which is the:

resistance of the body to the flow of electricity

In most cases, cardiopulmonary arrest in infants and children is caused by

respiratory arrest

White blood cells

responsible for fighting infection

Platelets

responsible for forming blood clots

Red blood cells

responsible for the transportation of oxygen to the cells and for transporting carbon dioxide away from the cells to the lungs

RLQ

right lower quadrant contains two portions of the large intestine (cecum and ascending colon) (a) The appendix is attached to the lower cecum.

5 patient rights

right patient, right drug, right dose, right route, right time

RUQ

right upper quadrant contains the liver, gallbladder, and a portion of the colon

When moving a patient to a long spine board, you should consider

rolling the pt towards you

Ball and socket joint

rotation and bending

Urinary bladder

saclike organ in which urine is stored before being excreted

How to minimize stoma complications

seal nose/mouth prevent leaks in O2 between stoma and BVM (only if they have special tracheal appendage) or PDA mask (USUALLY USED)

sebaceous glands

secrete sebum (oil) into the hair follicles where the hair shafts pass through the dermis

How to treat paradoxical movements/flail segments

secure pt using bandages

You are attending to a 22 year old woman overdosed, unresponsive upstairs, appropriate way to bring downstairs

secured to fracture board with strongest provider at head end

Kidnapping

seizing, confining, abducting, or carrying away by force

Gels

semisolid systems consisting of either suspensions of small inorganic particles or large organic molecules interpenetrated by a liquid

Avulsion

separates various layers of soft tissue (usually between the subcutaneous layer and fascia) so that they become either completely detached or hang as a flap. a. Often there is significant bleeding. b. Never remove an avulsion skin flap, regardless of its size. c. An amputation is an injury in which part of the body is completely severed. i. You can easily control the bleeding from some amputations, such as the fingers, with direct pressure and pressure dressings. ii. If there is massive bleeding, you should stop the bleeding, which often requires a tourniquet, and treat the patient for hypovolemic shock.

anaphalactic shock

severe allergic reaction system release of histamines massive vasodilation decreases BP

tibia

shin bone

Signs/symptoms of hypothermia

shivering, in early stages numbness stiff or rigid posture drowsiness rapid breathing and pulse loss of motor coordination joint/muscle stiffness unconsciousness cool abdominal skin temperature (red skin in early stages, becomes pale or cyanotic in prolonged stages)

When to use PASTE

shortness of breath (ONLY RESPIRATORY)

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

shortness of breath and a blood pressure of 76/56 mm Hg

During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. The wound pattern is MOST consistent with a:

shotgun

The risk of bleeding in the skull, which increases with age, is MOST directly related to:

shrinkage of the brain

The use of lights and siren on an ambulance:

signifies a request for other drivers to yield the right of way.

Duplex

simultaneous talk-listen

The electrical impulse generated by the heart originates in the:

sinoatrial node

Alveoli

site of gas exchange, CO2 and O2

3 types of muscle

skeletal, cardiac, smooth

hemiparesis

slight paralysis or weakness affecting one side of the body

Mucus

slimy fluid secreted by the mucous membranes

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is

slow

brady

slow

Clinical signs to administer naxolene (narcan)

slow respirations

Organs that lie in more than one abdominal quadrant

small intestine, pancreas, large intestine, and urinary bladder

Arterioles

small vessels that receive blood from the arteries

Wheal

small, round, raised area on the skin that may be accompanied by itching; usually seen in allergic reactions

Bronchioles

smallest branches of the bronchi

Plantar

sole of foot

Interstitial space

space between cells

Glottis

space between the vocal folds

-logist

specialist

Indications

specific signs or circumstances under which it is appropriate to administer a drug to a patient

Contraindications

specific signs or circumstances under which it is not appropriate and may be harmful to administer a drug to a patient

Diarrhea causes

spicy or spoiled foods bacteria (E. coli), virus, toxins drug reactions fecal impaction, laxative abuse malabsorption disorders, bowel tumor, inflammatory bowel disease Stress, anxiety

Significant trauma to the face should increase the EMT's index of suspicion for a(n):

spinal column injury

Internal bleeding into a fractured extremity is MOST often controlled by:

splinting the extremity

Slander

spoken

A 59 year old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the most likely cause?

spontaneous pneumothorax

A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:

stabilize her entire spine

A 22 year old female was ejected from her car after striking a tree head on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should

stabilize her head and perform a primary assessment

When determining the frequency of contractions, you should time the contractions from the:

start of one to the start of the next

Define shock

state in which blood flow to and perfusion of peripheral tissues is inadequate to sustain life commonly p/w hypotension, oliguria, anuria, tachycardia

Expressed (actual) consent

stated explicitly

You are attending to a 27 year old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some meds. The pt did not take the meds and is alert and oriented. Despite all of your best efforts to convince her, the pt refuses to go to hospital for treatment. Based on this, you should:

stay with the pt while you arrange for other transport options as a potentially life-threatening emergency exists

Rigor mortis

stiffness of the body that sets in several hours after death

Organs in LUQ

stomach, spleen, left lobe of liver, splenic flexure of colon, part of transverse and descending colon

potential energy

stored energy (product of mass (weight), force of gravity, and height)

Strain

stretching or tearing of the muscle, causing pain, swelling, and bruising of the soft tissues in the area.

Uneven pupils

stroke

-logy

study of

Toxicology

study of poisonous substances and their effects upon body parts

Immunology

study of the body's resistance to infectious disease

Symptom

subjective condition the patient feels and tells you about

Allergens

substances that activate the immune system -food -medication -plants -chemicals -insect bites and stings

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

suction his mouth and nose, apply high flow oxygen, monitor the patient's breath sounds of pneumothorax, and contact medical control regarding transport to a recompression facility

When caring for a patient experiencing excited delirium, the EMT should remember that

sudden death can occur if the pt's violence is not controlled

Signs and symptoms of meningitis in the infant or child include all of the following EXCEPT

sunken fontanelles

Burns associated with lightning strikes are typically:

superficial

A 31 year old male was bitten on the leg by an unidentified snake. The patient is conscious and alert with no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for the patient should include

supine positioning, splinting the leg, and transporting

What position for pt in chest pain?

supine, fowlers, or position of comfort

Cerebral edema

swelling from the inflammatory response, may compress and kill brain tissue

Angiodema

swelling of the blood vessels

esophageal varices

swollen, twisted veins in the esophagus that are especially susceptible to ulceration and hemorrhage

hemorrhoids

swollen, twisted, varicose veins in the rectal region

Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm.

sympathetic

The severity of bleeding should be based on all of the following findings, EXCEPT:

systolic blood pressure

Symptoms of hypoglycemia

tachycardia, excessive sweating (diaphoresis), light-headedness, visual disturbances

Patients with chest injuries will often present with

tachypnea

The EMT should suspect life sided heart failure in the geriatric patient who presents with

tachypnea and paroxysmal nocturnal dyspnea

older adults frequently

take multiple medications

Symptomatic hypoglycemia will MOST likely develop if a patient:

takes too much of his/her prescribed insulin

Mallory-Weiss tear

tear that occurs in the esophageal mucosa at the junction of the esophagus and stomach caused by severe retching and vomiting and results in severe bleeding.

Skeletal muscle is attached to the bone by tough, roselike, fibrous structures called

tendons

Returning the emergency unit to service is part of the _________.

termination phase

At present, the likelihood of a nuclear attack against the United States is very low because:

terrorist nations do not have the ability to deliver a nuclear weapon via missile or bomb

Orientation

tests memory and thinking (person, time, place, event)

myocardial contractility

the ability of the heart to squeeze blood from the ventricles and prepare for the next contraction

Seizing

the act of gripping something firmly with the hands

Partial pressure

the amount of gas in the air or dissolved in fluid, such as blood

Hypovolemic shock occurs when

the body cannot compensate for rapid blood loss.

Endocrine system

the body's "slow" chemical communication system; a set of glands that secrete hormones into the bloodstream

endocrine system

the body's "slow" chemical communication system; a set of glands that secrete hormones into the bloodstream

Nervous system

the body's speedy, electrochemical communication network, consisting of all the nerve cells of the peripheral and central nervous systems

Closed head injuries

the brain has been injured but there is no opening into the brain.

Sternum

the breastbone, forms the middle of the front of the rib cage and is divided into three parts: (1) Manubrium (upper section) (2) Body (3) Xiphoid process (narrow, cartilaginous tip)

Breech delivery

the buttocks are the first part of the body to be delivered

pubic symphysis

the cartilaginous joint known that allows some movement to facilitate childbirth

Histamines

the chemicals that the immune cells release to draw more blood and lymph to the area affected by the allergen

Metabolism

the combination of chemical reactions through which an organism builds up or breaks down materials

Semen

the combination of sperm and seminal fluid

Defamation

the communication of false information that damages a person's reputation

Implied consent

the consent it is presumed a patient or patient's parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed

Tolerance

the diminishing effect with regular use of the same dose of a drug, requiring the user to take larger and larger doses before experiencing the drug's effect

sympathetic nervous system

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations

parasympathetic nervous system

the division of the autonomic nervous system that calms the body, conserving its energy

kinetic energy

the energy an object has due to its motion KE = ½ mass x velocity2

External respiration

the exchange of gases between the atmosphere and the blood

Respiration

the exchange of oxygen and carbon dioxide in the alveoli and in tissues of the body

congestive heart failure (CHF)

the failure of the heart to pump efficiently, leading to excessive blood or fluids in the lungs, the body, or both

Rectum

the final section of the large intestine, terminating at the anus.

Larynx

the hollow muscular organ forming an air passage to the lungs and holding the vocal cords in humans and other mammals; the voice box.

Which of the following statements regarding the acute abdomen is correct?

the initial pain associated with an acute abdomen tends to be vague and poorly localized

sacroiliac joint

the joint between the sacrum and the ilium, surrounded by tough, thick ligaments

Superior Vena Cava (SVC)

the large vein that returns deoxygenated blood to the right atrium from the head, neck and upper chest and arms.

Inferior Vena Cava (IVC)

the largest vein in the human body; returns de-oxygenated blood to the heart

Chief complaint

the main reason for the patient's visit

bariatrics

the management (prevention or control) of obesity and allied diseases.

Triage

the medical screening of patients to determine their relative priority of need and the proper place of treatment

Uncontrollable bleeding

the most common cause of shock following a traumatic injury.

Nervous System

the network of nerve cells and fibers that transmits nerve impulses between parts of the body.

An open fracture is MOST accurately defined as a fracture in which:

the overlying skin is no longer intact

Reticular activating system

the part of the brain that is involved in attention, sleep, and arousal

Axial skeleton

the part of the skeleton that includes the skull and spinal column and sternum and ribs

Ileus

the partial or complete blockage of the small and/or large intestine

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard

In general, musculoskeletal injuries should be splinted before moving the patient unless:

the patient is clinically unstable

A 77 year old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that

the patient is experiencing delirious behavior, which suggests a new health problem

Primary assessment

the portion of patient assessment that focuses only on life threats, specifically ABCs

Systemic Vascular Resistance (SVR)

the pressure in the peripheral blood vessels that the heart must overcome to pump blood into the system

ventricular fibrillation

the rapid, irregular, and useless contractions of the ventricles

ventilation-perfusion ratio

the ratio between ventilation and perfusion in the lung; matching of ventilation to perfusion optimizes gas exchange

After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, EXCEPT:

the recommended transport destination for each patient

Blunt trauma

the result of force to the body that causes injury without penetrating the soft tissues or internal organs and cavities.

PNS (peripheral nervous system)

the sensory and motor neurons that connect the CNS to the rest of the body

Pharmacology

the study of drugs and their interactions with living systems

pathophysiology

the study of how disease processes affect the function of the body

Frostnip

the superficial local tissue destruction caused by freezing; it is limited in scope and does not destroy the full thickness of skin

Golden Hour/period

the time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best.

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:

the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released

Communication

the transfer of information and understanding from one person to another

Maxillae

the two fused bones forming the upper jaw, non-moveable

The Adam's apple is

the upper part of the larynx that is formed by the thyroid cartilage.

Treatment

therapy

Femur

thigh bone of the leg; the longest and strongest bone in the body

Chordae tendineae

thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting

Mucous membranes

thin sheets of tissue that line respiratory passages and secrete mucus, a viscid (sticky) fluid

JVD (jugular vein distention)

this is bulging of the external jugular vein which indicates increased blood volume and usually congestive heart failure (CHF)

Triceps

three bundles of muscles which join at elbow

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

tightness in the chest/throat

Apex

tip

Palpate

to feel

Ventral (anterior)

toward or at the front of the body belly side

Inferior

toward the feet

Superior

toward the head

Medial

toward the midline

Neurotoxins

toxic substances, such as lead or mercury, that specifically poison nerve cells

Stoma

tracheal hold for breathing

Packaging

transport

red blood cells (erythrocytes)

transport oxygen

limb presentation management

transport rapidly with mother in head down/pelvis elevated position

Urethra

tube leading from the urinary bladder to the outside of the body

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:

tuberculosis

-oma

tumor

AED Steps

turn it on; remove clothing and other obstructions; place pads; let it analyze, deliver shock

Multiplex

two or more frequencies

Bronchi

two short branches located at the lower end of the trachea that carry air into the lungs.

Seminal vesicles

two small glands that secrete a fluid rich in sugar that nourishes and helps sperm move

Lungs

two spongy organs, located in the thoracic cavity enclosed by the diaphragm and rib cage, responsible for respiration 1. The two lungs are held in place by: a. Trachea b. Arteries and veins c. Pulmonary ligaments 2. Each lung is divided into lobes. a. The right lung has upper, middle, and lower lobes. b. The left lung has upper and lower lobes.

Type II Diabetes

type of diabetes in which the body produces insulin but the insulin cannot be used by body cells

hypo

under

Assault

unlawfully placing a person in fear of immediate bodily harm

Atrium

upper chamber of the heart

UTI

urinary tract infection

Uremia

urine in the blood

You may injure your back if you lift

using a powerlifting technique

From what internal female organ is the fetus expelled during delivery?

uterus

Impedence threshold device

valve placed between ET tube and BVM limits air entering lungs during recoil phase

Veinous vs arterial bleeds

veinous no pressure arterial extreme pressure

The physical act of moving air into and out of the lungs

ventilation

Hyperventilation

ventilation of the lungs beyond normal body needs

frontal (coronal) plane

vertical plane dividing the body or structure into anterior and posterior portions

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:

viral infection of the upper respiratory tract

treating psychogenic shock

vital signs level of consciousness

Somatic

voluntary movements

What are you worried about happening if placing pt supine instead of on side? What could be avoided?

vomiting could avoid aspiration

Combining vowels

vowels that join one or more word roots to other components of a term

The EMT's responsibility during search and rescue operations is to

wait at the staging area until the patient is located

Lymph

watery fluid, carries O2, nutrients, etc. to excretion

When caring for a patient with an open facial injury, the EMT's immediate priority should be to

wear gloves and facial protection

Lung sounds in allergic reaction

wheezing

Sprain

when a joint is twisted or stretched beyond its normal range of motion.

Limb presentation

when an infant's limb protrudes from the vagina before the appearance of any other body part

Nuchal chord

when the embilical chord is wrapped around a baby's neck

fallopian tubes

where fertilization takes place

Air embolism

which occurs on alveolar disruption with subsequent air embolization into the pulmonary vasculature.

Nitroglycerin is contraindicated in patients:

who have experienced a head injury.

Common signs and symptoms of a serious head injury include

widening pulse pressure decerebrate posturing CSF leakage from the ears

Trachea (upper)

windpipe a. Located at the bottom of the pharynx b. Semi-rigid, enclosed air tube made up of rings of cartilage

When performing CPR on a child, you should compress the chest

with one or two hands

Suffix

word ending

Pandemic

worldwide epidemic

Libel

written

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:

you were exposed to another infected person prior to treating the 34yo patient

Revised Trauma Score (RTS)

~Components: Glasgow Coma Scale (GCS), Systolic blood pressure, Respiratory rate ~Follow local protocol for use of the trauma scoring system ~Do not let it interfere with patient care

Signs/symptoms of CHF

• Tachycardia • Dyspnea and cyanosis • Normal or elevated blood pressure • Diaphoresis • Pulmonary edema • Anxiety or confusion due to hypoxia • Pedal edema • Engorged, pulsating neck veins (late sign) • Enlarged liver and spleen

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