Final Exam (Code Red Cardiac Arrest)

What are nasopharyngeal airways and when should they be used?

They are an airway device that are used IN when the airway is compromised, used for conscious, have a gag reflex, seizure.

scope of practice

a set of regulations and ethical considerations that define the scope, or extent and limits, of the EMT's job

What is an example of an assault?

a threat

What is an antigen?

a toxin or other foreign substance that induces an immune response in the body, especially the production of antibodies.

Whats is tension pneumothorax?

air gets into chest cavity then moves to the other side

What is automaticity?

allows a cardiac muscle cell to contract spontaneously without a stimulus from a nerve source

What is a weapon of mass destruction?

any particularly dangerous hazardous material such as certain chemical, biological, radiological, nuclear, or explosive materials being used as weapons

Know when to use the head-tilt-chin lift maneuver versus the jaw-thrust maneuver.

anytime there is no suspected spinal injury

What is APGAR?

appearance, pulse, grimace, activity, respiration - a score doctors use to evaluate a newborn baby

What is driving with due regard?

asking for the right away

What key term is the most common cause of widespread obstruction to airflow in the lower airway?

bronchiolconstriction

what is Cullens sign

bruising around umbilicus

Describe inhalation injuries

burned airways damaged airways Compromised airway (swelling)

Explain shivering and its effects on body?

burns energy, maintains body heat internally

At what heart rate should you begin compressions of a neonate?

60

How many beats per minute is the intrinsic rate of self-excitation for the AV node?

60

What is a coup-contrecoup injury?

Dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds.

What could cause gurgling respirations?

Excess fluid in airway; being drunk

What is proper suctioning?

on the way out, no more than 15 seconds, 300 mmHg, air flow 30 L/minute.

What occurs with insulin in type 2 diabetes?

produced but not used, cells do not react correctly to insulin.

Which artery carries deoxygenated blood away from the heart?

pulmonary artery

what breath sounds would you hear with a patient who is experiencing shortness of breath, has congestive heart failure, and acute pulmonary disease?

rails, crackles

What is an abdominal aortic aneurysm?

rapidly fatal condition in which the walls of the aorta in the abdomen weaken and blood leaks into the layers of the vessel, causing It to bulge.

Know when to use and how to use proper chest compressions.

recoil, at least 2 inches of depth, 30-2 for adult.

What is a transient ischemic attack?

reduction of blood flow with stroke like symptoms - symptoms resolve themselves

When should you use aspirin therapy?

relief of mild pain, headache, muscle aches, fever; chest pain of cardiac origin.

What is Cheyenne-Stokes respiration?

respiratory rate and depth are irregular, characterized by alternating periods of apnea and hyperventilation

what is decompression thickness

seen in divers who ascend too quickly; in which gas, especially nitrogen, forms bubbles in blood vessels and other tissues; see bends.

Difference between stable and unstable angina?

stable - occurs with exertion or excercise and is relieved by rest or meds, predicable, occurring for more than 4 weeks. unstable - new angina or change in angina, occurs with or without exertion, unrelieved by rest or meds, occuring less than 4 weeks.

What is deep vein thrombosis?

the formation of blood clot within the larger veins of an extremity, typically following a period of prolonged immobilization.

What is inadequate perfusion?

tissues don't get enough oxygen and nutrients.

why would a person need an implanted pacemaker?

to stimulate a faster heart rate when the heart Is beating too slowly

What is the proper defibrillator pad placement?

upper right chest, lower left

What is the main muscular organ that develops a baby during pregnancy?

uterus

Hemorrhagic shock involves what organ?

vasculature, blood cells

When utility poles are involved in motor vehicle accidents, what is proper procedure when dealing with patients?

wait till the power shuts off

What causes the braking and stopping distance of an ambulance to b 3 times greater than cars?

weight

When do patients represent no contamination threat to you?

when they have been decontaminated, or if they got exposed to radiation

When a car is on its side and patients are trapped inside which is the easiest access point?

windshield

What is placenta previa?

It is a condition in which the placenta develops over and covers the cervix.

What does the tricuspid valve do?

It prevents back flow from the right ventricle into the right atrium

What technique is most commonly used to open the airway for patients who may have a cervical spine injury?

Jaw-Thrust

Understand how the physiological goal of providing oxygen to the cells and eliminating carbon dioxide can be disrupted.

Loss of blood, interruption of the circulatory system, shock

what steps would you take with a patient who overdosed on an unknown drug who has snoring respirations and an intact gag reflex, but is slightly cyanotic?

NPA, bag the patient, log roll if needed, suction if needed

What should you use to determine specifics about chest pain?

OPQRST SAMPLE; History Taking

What can cause hypoventilation?

Opoids. Anything that causes CNS depression. Impairment of the respiratory drive, impairment of muscle work, damage to chest wall, high resistance to breathing.

How should you care for a patient with non-traumatic back pain?

Position of comfort, transport.

What symptoms would you most likely see with a patient with an infectious disease?

fever, vomit, sneezing, etc...

What is pericardial tamponade?

fluid builds up in the space between heart and pericardium

What is the sinoatrial node?

generates electrical signal that causes the upper heart chambers to contract.

How do you perform head-Tilt Chin lift?

hand on forehead, lift chin

What symptoms might occur after administering a nitroglycerin tablet?

headache, burning under the tongue, hypotension, nausea

Explain the conduction system

heat energy is transmitted through collisions between neighboring atoms or molecules.

Explain convection system

heat is transferred by movement of a heated fluid such as air or water

What molecule carries the vast majority of oxygen in the blood?

hemoglobin

Why are biological weapons hard to identify?

incubation period, long period before showing symptoms, flu like symptoms

What is endometritis?

infection of the uterine lining, grows outside uterus

What are bloodborne pathogens?

infectious microorganisms in human blood that can cause disease in humans

What is epiglottitis?

inflammation of the epiglottis, which could block air to the lungs, DRZOOLING

What are oxygen cylinders typically filled to?

2,000 PSI

What is a myocardial infarction?

death of cells in the area of the heart muscle where blood flow is obstructed.

What does a pulse oximeter measure?

measures percent of oxygen bound to hemoglobin

How does aspirin treat myocardial ischemia?

prevents more clots from getting bigger, reduces more clots.

What is the coronary arteries main purpose?

delivers oxygenated blood to the myocardium

What are symptoms of a pulmonary embolism in a woman who just gave birth?

- difficulty breathing - shortness of breath

What information does the Emergency response guidebook provide?

- hazmat emergencies, tells you about chemicals and where to stage.

Describe upper airway obstruction.

- hearing stridor - narrowing of the airways leading to compromise in ventilation.

What should you expect to treat when arriving on scene of an MCI involving an incendiary device?

expect to treat burns

What is a tonsil-tip suctional catheter best used for?

- Infants and Children - removes blood, emesis, and secretions

What happens when a patient is sent to the cardiac cauterization lab?

- They look for coronary artery blockage (puts in stint)

What is the best way to get other drivers' attention when driving lights and sirens?

- air horn - wail

What is an AED and know how to use it for adults and children.

- automated external defibrillator - children - apply AED after first 5 cycles of CPR

What types of weapons are considered weapons of mass destruction?

- biologic weapons - nuclear weapons - incendiary - chemical - explosive weapons

What is the major cause of pain for sickle cell patients?

- cells stick in capillaries, clumping together, reducing blood flow producing pain.

What should you do when an infant is about to be delivered and you are presented with feet-first presentation.

- cover with sterile towel - place patient on back with head down and pelvis elevated - high flow oxygen

What is the main purpose of valves in the circulatory system?

- keeps blood flowing the proper direction.

Know the structure of the 4 chambers of the heart.

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

What do you do when a spine injury is suspected?

- manual immobilization, backboard, C-spine

What is parietal pain?

- point to pain - a localized, intense pain that arises from the parietal peritoneum, the lining of the abdominal cavity

What is included in accurate assessment of a patients respirations.

- rate and quality, depth, noises - tidal volume 6,000 ml

What is the most important thing in treating a behavior problem?

- scene safety - spend time with patient - try to understand with the patient

What are the initial signs of Cushings triad?

- slow heart - irregular breathing - widening blood pressure

When should you collaborate with an extrication team?

- someone trapped - MVCs

What is the cold zone and what are your responsibilities in this zone?

- staging area - treat patients in this area

Why would you use CPAP?

- to push fluid out of the lungs - provides ventilatory support for patients with respiratory distress - may wear it if you have sleep apenea - maintain airway while sleeping - use it for COPD, acute pulmonary edema, and acute bronchospasm.

When responding to an emergency, what do you do when traffic is at a standstill?

- turn lights and sirens off and wait for traffic to move

What is the most important info to give to family members in regards to transporting the patient to the hospital?

- what hospital - location - phone number

When is a newborn most in need of neonatal resuscitation?

- when not breathing within 30 seconds - pulse is under 60

Describe superficial burns

-1st degree involves superficial epidermis - sunburn

When performing CPR, an infant is how old? Know how to properly perform CPR on an infant.

1 year. 2 rescuer is 2 thumb, 1 rescuer 2 finger.

What are the signs of a basal skull fracture?

1. Battle's signs. 2. Raccoon eyes. 3. leakage from ears 4. Retroauricular ecchymosis = fractured ear canals. 5. Bilateral periorbital ecchymosis = fractured orbitals.

how many breaths per minute when ventilating?

10-12

What is ectopic pregnancy?

A pregnancy in which the fertilized egg implants outside the uterus, in Fallopian tubes, then ruptures.

What is a febrile seizure?

A seizure brought on in infants and young children caused by high fever.

Rule of nines

A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burn area.

What would you use epinephrine for?

Anaphylaxis

Know when not to use resuscitation attempts.

Dependent lividity, rigor mortis, putrefaction, decapitation, mummification.

What key term is described with deep, rapid breathing and creates certain acids when insulin is not available in the body?

Diabetic Ketoacidosis

What steps would you take when arriving to a scene of a patient who overdosed on drugs and alcohol, is responsive to painful stimuli, and is experiencing shallow breathing?

Bag the patient, NPA, check blood glucose

When does preterm delivery occur?

Before 37 weeks

how would you treat a patient who has a history of COPD and is complaining of shortness of breath? Patients O2 is sating at 74 percent room air and you hear very little air movement upon auscultation.

CPAP

What is CPR and when should it be used?

CPR is a life-saving first-aid procedure that should be done when a person's breathing and heartbeat have stopped.

what are shipping papers and where do you locate them on trucks?

Cab of truck, tells what chemicals are in the truck.

what is the most commonly injured area of the spinal cord?

Cervical region C1-C7

Describe Venous bleeding

Comes from a vein, dark red, steady flow

What is the root cause of heart failure?

Coronary artery disease

Know and understand procedures to take when exposed to hazardous materials.

Follow protocols, decontamination.

how would you treat a patient with a history of acute heart failure who presents with respiratory distress, pulmonary edema, respiratory rate of 32 and spo2 of 88%.

Fowler position, CPAP

What is different about a fully automated AED?

Fully does not have a button for shock and it shocks on its own.

When is it prohibited to administer aspirin to a cardiac patient?

GI bleeding hypersensitivity; recent bleeding

What should you do when a patient in labor gets the urge to push?

Get ready to deliver the baby.

When would you inquire about the patients history of heart problems?

History taking assessment

What is cariogenic shock?

Inadequate pumping of blood by the heart

What are some signs of airway obstruction?

Increased inspiratory effort with retractions Abnormal inspiratory sounds Absence of breath sounds

How does ventilation occur?

Inhalation - diaphragm constricts (negative pressure) Exhalation - diaphragm relaxes (positive pressure)

What is the main function of an epiglottis?

Prevents food and drink from entering windpipe. Keeps air out of stomach and food out of lungs.

Good Samaritan Law

Provides limited protection to someone who voluntarily chooses to provide first aid, specifically EMTs

how does a head-tilt/chin-lift maneuver open an airway?

Pulls tongue forward. Lifts tongue and epiglottis away from the glottic opening.

What are you qualified for if you have been trained to the level of OSHA "First Responder Awareness"?

Qualified for to respond to hazardous materials emergencies in a defensive fashion.

What is proper procedure when you arrive on scene to a patient In calm water?

Reach, row, throw, go - call rescue squad, dive team

When should you use nasal cannula?

Sats are a little low, breathing adequately, throw them on NC to get their sats up.

what are your main priorities, as an EMT, when arriving to a scene involving a weapon of mass destruction.

Scene safety

What is partial avulsion?

Skin that is hanging that is still attached to the body

what steps would you take with a patient who is unresponsive with. head trauma and is vomiting?

Suction, manual stabilization, log roll, put c color on then.

What is an appropriate intervention for aortic dissection?

TRANSPORT, needs surgery, prompt transport.

What should you do after evaluating a pregnant patient who is supine on the coach and has a low Blood pressure?

Transport her in a lateral recumbent position

What occurs in the fallopian tubes?

Transports the egg to the uterus.

What are signs of inadequate breathing?

Use of accessory muscles, cyanosis, shallow breathing, tripod position, out of breath when talking, AMS, restless, unilateral movement.

What cardiac arrest rhythms is an AED designed to shock?

V-Fib

What is the greatest concern regarding potential airway occlusion with a patient who overdosed on a medication and is unresponsive?

Vomit, emesis, tongue in the back of the airway

What happens when a patients heart is in ventricular fibrillation?

Whole heart is quivering

What is subcutaneous emphysema?

a characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in the soft tissue

What is implied consent?

consent to treat when patient is unconscious

What is primary contamination?

contaminated from the exact source itself

What key term is described with a rattling breath sound signaling fluid in the air spaces of the lungs?

crackles

What is grey turners sign

ecchymosis at the flank due to retroperitoneal bleed

What is type 1 diabetes mellitus?

insulin dependent Diabetes Mellitus where the beta cells are not producing any or very little insulin

Where do most ambulance crashes occur?

intersections

Define abandonment

leaving someone with a person with less qualifications

What is the main purpose of the left ventricle of the heart? Right ventricle?

left ventricle pumps blood to body, right ventricle pumps blood to lungs

What is the upper most part of the pharynx?

nasopharynx

What is epistaxis?

nose bleed

When arriving to a motor vehicle collision, you see exposed wires. Which color wires do you want to avoid?

orange

describe the chest wall movement in a patient with flail segment.

paridoxal motion

Describe partial airway obstruction with poor air exchange.

patient will be able to breath and cough, may hear stridor.

What temporary organ of pregnancy supplies oxygen and nutrients to the developing fetus?

placenta