Module 3 EMS Exam
Signs and symptoms of a GI bleed
black or tarry stool bright red blood in vomit cramps in the abdomen dark or bright red blood mixed with stool dizziness or faintness feeling tired paleness shortness of breath vomit that looks like coffee grounds weakness
Signs and symptoms of hypoglycemia.
If blood sugar levels become too low, signs and symptoms can include: An irregular or fast heartbeat Fatigue Pale skin Shakiness Anxiety Sweating Hunger Irritability Tingling or numbness of the lips, tongue or cheek As hypoglycemia worsens, signs and symptoms can include: Confusion, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as blurred vision Seizures Loss of consciousness
Cardiac arrest in children is usually caused by what?
Infant and newly born cardiac arrest is almost always a result of respiratory failure or airway obstruction, with SIDS being the most common cause of death in children under 6 months of age.
What are the routes of absorption of a poison?
Inhalation of toxic vapors, mists, gases, or dusts can produce poisoning by absorption through the mucous membrane of the mouth, throat, and lungs and can seriously damage these tissues by local action.
Where is insulin secreted from?
Insulin is a hormone made by an organ located behind the stomach called the pancreas.
Know the functions of the components of blood.
It has four main components: plasma, red blood cells, white blood cells, and platelets. Blood has many different functions, including: transporting oxygen and nutrients to the lungs and tissues. bringing waste products to the kidneys and liver, which filter and clean the blood.
What is the window of treatment for clot-busting drugs for a stroke patient?
Long-time guidelines stated that the drug should be infused within three hours of the first stroke symptoms -- or, for certain patients, within 4.5 hours. That has limited its use.
What are other medical or traumatic conditions that could mimic a behavioral emergency?
Medical conditions that can cause the type of mental changes required for a behavioral emergency include low blood sugar related to diabetes or hypoglycemia, hypoxia, a traumatic brain injury or reduced blood flow to the brain and central nervous system infections such as meningitis.
The medications a transplant patient takes to prevent rejection can also make them susceptible to what?
Medications After a Transplant. After an organ transplant, you will need to take immunosuppressant (anti-rejection) drugs. These drugs help prevent your immune system from attacking ("rejecting") the donor organ. Typically, they must be taken for the lifetime of your transplanted organ.
What is the definition of a behavioral emergency?
A behavioral emergency is defined as a situation in which a client presents as being at imminent risk of behaving in a way that could result in serious harm or death to self or others.
What is nitroglycerin and what are the contraindications for it?
Nitroglycerin (NTG), also known as glycerine trinitrate (GTN) is a nitrate medication typically administered to relieve anginal chest pain and manage blood pressure through vasodilation. Nitroglycerin is contraindicated in patients who are allergic to it. Sublingual nitroglycerin therapy is contraindicated in patients with early myocardial infarction, severe anemia, increased intracranial pressure, and those with a known hypersensitivity to nitroglycerin.
Pain in the epigastric region could be a sign of what cardiac condition?
Other symptoms that may accompany epigastric pain include abdominal bloating, constipation, diarrhea, and vomiting, depending on the underlying cause. In rare cases, epigastric pain is due to heart conditions such as heart attack and angina (chest pain due to the heart not getting enough oxygen).
What would most affect the extent of damage a poison does to the body?
Patient's age, weight, and general health
What is positional asphyxia?
Positional asphyxia happens when a person can't get enough air to breathe due to the positioning of his/her body. This happens most often in infants, when an infant dies and is found in a position where his/her mouth and nose is blocked, or where his/her chest may be unable to fully expand.
Know the different types of seizures.
A partial (focal) seizure happens when unusual electrical activity affects a small area of the brain. When the seizure does not affect awareness, it is known as a simple partial seizure. Simple partial seizures can be: Motor - affecting the muscles of the body. Generalized seizures the whole brain is affected by the abnormal electrical disturbance and the person becomes unconscious. In some cases, the period when the person is unconscious can be very brief and may be missed. Tonic-Clonic Seizure: A tonic-clonic seizure usually begins on both sides of the brain, but can start in one side and spread to the whole brain. A person loses consciousness, muscles stiffen, and jerking movements are seen. These types of seizures usually last 1 to 3 minutes and take longer for a person to recover.
Difference between an adult and pediatric airway.
The pediatric airway is smaller in diameter and shorter in length than the adult's. The young child's tongue is relatively larger in the oropharynx than the adult's. The larynx in infants and young children is located more anteriorly compared with the adult's.
Status Epilepticus
A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes is called status epilepticus. This is a medical emergency that may lead to permanent brain damage or death.
What is a palpitation?
A sensation that the heart is racing, pounding, fluttering, or skipping a beat, often bothersome, but hardly ever a sign of heart disease.
What is occurring in the body during anaphylaxis?
The symptoms are caused by the sudden release of chemical substances, including histamine, from cells in the blood and tissues where they are stored. The release is triggered by the interaction between an allergic antibody called Immunoglobulin E (IgE) and the substance (allergen) causing the anaphylactic reaction. Histamines, the substances released by the body during an allergic reaction, cause the blood vessels to expand, which in turn causes a dangerous drop in blood pressure. Fluid can leak into the lungs, causing swelling (pulmonary edema). Anaphylaxis can also cause heart rhythm disturbances.
What are the functions of the kidneys?
Their main job is to cleanse the blood of toxins and transform the waste into urine. Each kidney weighs about 160 grams and gets rid of between one and one-and-a-half litres of urine per day. The two kidneys together filter 200 litres of fluid every 24 hours.
What position would you place a patient with abdominal pain?
To perform an abdominal exam, you will need to palpate the abdomen after asking the patient the location of the pain. Place the patient in a supine position.
When should you apply an AED?
AEDs (Automatic External Defibrillators), when used swiftly-in the first 3-5 minutes of a person collapsing-have been shown to dramatically increase the survival rate of people suffering from cardiac arrest.
What is pedal edema?
Accumulation of fluid in the feet and lower legs
Treatments for poison.
Activated charcoal - sometimes used to treat someone who's been poisoned; the charcoal binds to the poison and stops it being further absorbed into the blood. antidotes - these are substances that either prevent the poison from working or reverse its effects. sedatives - may be given if the person is agitated.
When would we use activated charcoal and how does it work?
Activated charcoal is commonly taken by mouth to treat poisonings. It is also used for intestinal gas (flatulence), high cholesterol, hangovers, upset stomach, and bile flow problems (cholestasis) during pregnancy. Activated charcoal is applied to the skin as part of bandages for helping heal wounds. Activated charcoal works by trapping toxins and chemicals in the gut, preventing their absorption ( 2 ). The charcoal's porous texture has a negative electrical charge, which causes it to attract positively charged molecules, such as toxins and gases. This helps it trap toxins and chemicals in the gut ( 2 , 3).
Max number of tablets of nitro you could give in the field.
Adults—1 tablet placed under the tongue or between the cheek and gum at the first sign of an angina attack. 1 tablet may be used every 5 minutes as needed, for up to 15 minutes. Do not take more than 3 tablets in 15 minutes.
What are agonal respirations?
Agonal breathing is when someone who is not getting enough oxygen is gasping for air. It is usually due to cardiac arrest or stroke. It's not true breathing. It's a natural reflex that happens when your brain is not getting the oxygen it needs to survive. Agonal breathing is a sign that a person is near death.
What is an aneurysm?
An excessive localized enlargement of an artery caused by a weakening of the artery wall.
What is anaphylaxis and what are the signs and symptoms?
Anaphylaxis causes your immune system to release a flood of chemicals that can cause you to go into shock — your blood pressure drops suddenly and your airways narrow, blocking breathing. Signs and symptoms include a rapid, weak pulse; a skin rash; and nausea and vomiting.
What is angina pectoris and how does it differ from a MI?
Angina Pectoris: a condition marked by severe pain in the chest, often also spreading to the shoulders, arms, and neck, caused by an inadequate blood supply to the heart. The key difference between angina and a heart attack is that angina is the result of narrowed (rather than blocked) coronary arteries. This is why, unlike a heart attack, angina does not cause permanent heart damage.
Why would we give aspirin to a patient having chest pain? What would be the contraindications?
As the clot grows, it blocks the artery. If the blockage is complete, it deprives a portion of the heart muscle of oxygen. As a result, muscle cells die — and it's a heart attack. Aspirin helps by inhibiting platelets. Contraindications: Aspirin is contraindicated in patients with known allergy to NSAIDs and in patients with asthma, rhinitis, and nasal polyps. It may cause anaphylaxis, laryngeal edema, severe urticaria, angioedema, or bronchospasm (asthma).
What is ventricular fibrillation?
Ventricular fibrillation (VF) is a rapid, life-threatening heart rhythm starting in the bottom chambers of the heart. It can be triggered by a heart attack. Because the heart doesn't pump adequately during ventricular fibrillation, sustained VF can cause low blood pressure, loss of consciousness, or death. Emergency treatment includes immediate defibrillation with an automated external defibrillator (AED) and cardiopulmonary resuscitation (CPR). Long-term therapy includes implantable defibrillators and medications to prevent recurrence.
What three functions should be tested during assessment of a possible stroke patient?
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
Know when and how to inject and epi pen and how many doses are contained in one.
EpiPen is injected into the skin or muscle of your outer thigh. In an emergency, this injection can be given through your clothing Form a fist around the auto-injector with the tip pointing down. Place the tip against the fleshy portion of the outer thigh. Push the auto-injector firmly against the thigh to release the needle that injects the dose of epinephrine. Each carton contains 1 multiple dose vial containing 30 mg/30 mL (1 mg/mL) Adrenalin (epinephrine injection, USP) solution in a 36 mL amber glass vial. Vial and contents must be discarded 30 days after initial use.
How does epinephrine help during anaphylaxis?
Epinephrine is the medication of choice for the first-aid treatment of anaphylaxis. Through vasoconstrictor effects, it prevents or decreases upper airway mucosal edema (laryngeal edema), hypotension, and shock. In addition, it has important bronchodilator effects and cardiac inotropic and chronotropic effects.
What are the side effects of a bronchodilator inhaler?
General side effects of bronchodilators include: trembling, particularly in the hands. headaches. a dry mouth. suddenly noticeable heartbeats (palpitations) muscle cramps. a cough. nausea and vomiting. diarrhoea.
Know when to give oral glucose and what the contraindications are
Give oral glucose when the patient is awake and can't swallow. The contraindications is when the patient is unresponsive.
Signs and symptoms of epiglottis.
a severe sore throat. difficulty and pain when swallowing. difficulty breathing, which may improve when leaning forwards. breathing that sounds abnormal and high-pitched (stridor) a high temperature. irritability and restlessness. muffled or hoarse voice. drooling.
What is a poison?
a substance that is capable of causing the illness or death of a living organism when introduced or absorbed.
Syncope
fainting or sudden loss of consciousness caused by lack of blood supply to the cerebrum
Treatment for vaginal bleeding
medication. birth control pills or hormone-releasing intrauterine devices. Uterine fibroid embolization (UFE). ... Endometrial ablation. ... Myomectomy, the surgical removal of fibroids. Dilation and curettage (D&C). ... Hysterectomy.
Treatment for stroke
monitor airway, high concentration oxygen - transport either semi-sitting or for unconscious patient - lying on the affected side, onset of stroke symptoms less than 3 hours prior to administration of thrombolytic drug
Signs and symptoms of renal colic, appendicitis, ectopic pregnancy.
pain or difficulty urinating. blood in the urine, which may make it appear pink, red, or brown. urine that smells unusual. nausea. vomiting. small particles in the urine. feeling a constant urgent need to urinate. cloudy urine. Sudden pain that begins on the right side of the lower abdomen. Sudden pain that begins around your navel and often shifts to your lower right abdomen. Pain that worsens if you cough, walk or make other jarring movements. Nausea and vomiting. Loss of appetite. Light vaginal bleeding and pelvic pain. Upset stomach and vomiting. Sharp abdominal cramps. Pain on one side of your body. Dizziness or weakness. Pain in your shoulder, neck, or rectum.
Signs and symptoms of MI.
pressure or tightness in the chest. pain in the chest, back, jaw, and other areas of the upper body that lasts more than a few minutes or that goes away and comes back. shortness of breath. sweating. nausea. vomiting. anxiety. a cough.
Know the types of dialysis, how many times a week a pt would need dialysis, and what are the possible complications.
Hemodialysis. Hemodialysis is the most common type of dialysis. Peritoneal dialysis. Peritoneal dialysis involves surgery to implant a peritoneal dialysis (PD) catheter into your abdomen. Continuous renal replacement therapy (CRRT) Usually, each hemodialysis treatment lasts about four hours and is done three times per week. A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you. Low blood pressure (hypotension). A drop in blood pressure is a common side effect of hemodialysis, particularly if you have diabetes. Muscle cramps. Itching. Sleep problems. Anemia. Bone diseases. High blood pressure (hypertension). Fluid overload.
What are the five rights of medicine administration?
"Five Rights of Medication Administration." Also known as the "5Rs", these principles help to ensure the right drug, right dose, right route, and right patient, at the right time.
Signs and symptoms of COPD.
Chronic Obstructive Pulmonary Disease: Chronic cough. Shortness of breath while doing everyday activities (dyspnea) Frequent respiratory infections. Blueness of the lips or fingernail beds (cyanosis) Fatigue. Producing a lot of mucus (also called phlegm or sputum) Wheezing.
How would we give a medication sublingual?
Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there.
Signs and symptoms of a stroke
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination. Sudden severe headache with no known cause.
Signs and symptoms of congested heart failure.
Symptoms: Shortness of breath (dyspnea) when you exert yourself or when you lie down. Fatigue and weakness. Swelling (edema) in your legs, ankles and feet. Rapid or irregular heartbeat. Reduced ability to exercise. Persistent cough or wheezing with white or pink blood-tinged phlegm. Increased need to urinate at night.
The difference between a TIA and a stroke
TIA (transient ischemic attack, also sometimes called a "mini-stroke") begins just like an ischemic stroke; the difference is that in a TIA, the blockage is temporary and blood flow returns on its own. Since blood flow is interrupted only for a short time, the symptoms of a TIA don't last long - usually less than hour. A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.
How would you treat a patient having a behavioral emergency?
Techniques to Handle a Behavioral Emergency: It is important to speak directly to the patient, establish and maintain eye contact and speak reassuringly. Do not make any sudden movements that can be misinterpreted by the patient and keep some distance between the two of you. Remain with the patient at all times.
What is end stage renal disease?
The complete or nearly complete irreversible loss of renal function
Signs and symptoms of an AAA.
The most common sign of an abdominal aortic aneurysm is pain, either sharp or dull, in the abdomen, groin, lower back, or chest. Abdominal aortic aneurysms may also cause a pulsing or throbbing feeling, similar to a heartbeat, in the abdomen.
What is an EMT's best defense against allegations of misconduct when treating a mentally ill patient?
Providing accurate and complete documentation, supported by a third-party witness
Know the different phases of a seizure and what is occurring during these stages: aura, tonic, clonic, postictal
Aura: An 'aura' is the term that some people use to describe the warning they feel before they have a tonic clonic seizure. An epilepsy 'aura' is in fact a focal aware seizure. Focal aware seizures (FAS) are sometimes called 'warnings' or 'auras' because, for some people, a FAS develops into another type of seizure. Tonic: A tonic seizure causes a sudden stiffness or tension in the muscles of the arms, legs or trunk. The stiffness lasts about 20 seconds and is most likely to happen during sleep. Tonic seizures that occur while the person is standing may cause them to fall. After the seizure, the person may feel tired or confused. Clonic: Clonic means sustained rhythmical jerking. During a clonic seizure, jerking of the body or parts of the body are the main symptom. They can begin in one area (called focal motor) or affect both sides of the brain (called generalized clonic). Clonic seizure movements cannot be stopped by restraining the person. Postictal: The postictal state is a period that begins when a seizure subsides and ends when the patient returns to baseline. It typically lasts between 5 and 30 minutes and is characterized by disorienting symptoms such as confusion, drowsiness, hypertension, headache, nausea, etc.
Know what barbiturates and narcotics are and the signs and symptoms of their use.
Barbiturates are a group of drugs in the class of drugs known as sedative-hypnotics, which generally describes their sleep-inducing and anxiety-decreasing effects. Barbiturates can be extremely dangerous because the correct dose is difficult to predict. amobarbital (Amytal) butabarbital (Butisol) pentobarbital (Nembutal) secobarbital (Seconal) belladonna and phenobarbital (Donnatal) butalbital/acetaminophen/caffeine (Esgic, Fioricet) butalbital/aspirin/caffeine (Fiorinal Ascomp, Fortabs) Drowsiness. Headache. Low blood pressure (hypotension) Nausea. Sedation. Skin rash.
What is CPAP, when would you use it and what would be the contraindications?
CPAP: Continuous positive airway pressure is a form of positive airway pressure ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person. It should be used on patients who are alert and able to follow commands, show signs of respiratory distress, have rapid breathing, and a pulse oximetry of less than 90% Indications and contraindications for CPAP: Contraindications Uncooperative or extremely anxious patient. Reduced consciousness and inability to protect their airway. Unstable cardiorespiratory status or respiratory arrest. Trauma or burns involving the face. Facial, esophageal, or gastric surgery. Air leak syndrome (pneumothorax with bronchopleural fistula)
Know what carbon monoxide is and the effects it has on the body.
Carbon Monoxide: Carbon monoxide (CO) is an odorless, colorless gas formed by the incomplete combustion of fuels. When people are exposed to CO gas, the CO molecules will displace the oxygen in their bodies and lead to poisoning. Carbon monoxide is harmful when breathed because it displaces oxygen in the blood and deprives the heart, brain and other vital organs of oxygen. Large amounts of CO can overcome you in minutes without warning — causing you to lose consciousness and suffocate.
What is cardiac compromise?
Cardiac compromise refers to any kind of heart problem. Acute Coronary Syndrome or ACS is a blanket term that refers to any time the heart may not be getting enough oxygen. Patients may complain of chest pain, flu-like symptoms, or dyspnea(difficulty breathing). The most common complaint is chest pain.
What is pulmonary edema?
Pulmonary edema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.
What would we do after administering a medication?
Reassess your patient, document the medications you have given them, and the time of administration.
Know the four abdominal quadrants and what organs are in each one.
Right Upper Quadrant: Liver, stomach, gallbladder, duodenum, right kidney, pancreas, and the right adrenal gland. Left Upper Quadrant: Liver, stomach, pancreas, left kidney, spleen, and the left adrenal gland. Right Lower Quadrant: appendix, reproductive organs, right ureter
Know what sludging is
SLUDGE stands for Salivation, Lacrimation, Urination, Defecation, Gastrointestinal Distress and Emesis (medical term; response to organophosphate poisoning)
What is a side effect of a medication? What is a contraindication?
Side effects, also known as adverse events, are unwanted or unexpected events or reactions to a drug. Side effects can vary from minor problems like a runny nose to life-threatening events, such as an increased risk of a heart attack. A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. ... Relative contraindication means that caution should be used when two drugs or procedures are used together. (It is acceptable to do so if the benefits outweigh the risk.)
Signs and symptoms of hyperglycemia
Signs and symptoms include: Fruity-smelling breath. Nausea and vomiting. Shortness of breath. Dry mouth. Weakness. Confusion. Coma. Abdominal pain.
