Last-minute preparation for your NREMT exam with this crash course review. This guide covers high-yield topics, critical concepts, and essential test-taking strategies for EMT certification.
Q: White Paper
Answer: In 1966, a paper titled “Accidental Death and Disability: The Neglected Disease of Modern Society” is published by the National Academy of Sciences. This paper, commonly referred to as ________ __________ is considered the birth of modern EMS
Q: American Heart Association
Answer: In the 1980s, the ______ ______ ________ increases the emphasis on cardiovascular disease prevention, science, and education. Additional levels of training are added to the existing curriculum and despite advances, the scope of practice for various levels lacks unity.
Q: U.S. Department of Transportation
Answer: In the 70s, this federal agency developed the first EMT National Standard Curriculum including textbooks and paramedic NSC
Q: National Registry of Emergency Medical Technicians; National Highway Transportation Safety Administration
Answer: In the 1990s, the _____ ____ ___ ___ ___ ___ advocates for the creation of a national training curriculum and the _______ ___ ____ ___ ___ begins work on the EMS Agenda for the Future
Q: National EMS Education Standards (NEMSES)
Answer: In the 2000s, the NHTSA identifies universal knowledge and skills for EMS professionals through the new _________ ________ ______ __________. This new curriculum replaces the National Standard Curricula created by USDOT.
Q: EMR
Answer: CPR, AED, Oral airways, airway obstruction, manual airway techniques, BVM ventilation, oxygen therapy, airway suctioning, manual BP, auto injector, bleeding control, assisted childbirth
Q: EMT
Answer: EMR skills + humidified oxygen, venturi mask, automated transport ventilators, nasal airways, pulse oximetry, auto BP, assisted medications, spinal immobilization, splinting, tourniquet, MAST/PASG, mechanical CPR, assisted complicated childbirth
Q: AEMT
Answer: EMT skills + multilumen airways, blood glucose monitoring, IV/IO insertion, medication administration
Q: Paramedic
Answer: AEMT skills + BiPap/CPAP, needle decompression, percutaneous cricothyrotomy, ETCO2/capnography, NG/OG tube, intubation, direct laryngoscopy, PEEP, ECG interpretation, manual defibrillation/cardioversion, transcutaneous external pacing, extensive medication administration, thrombolytic therapy
Q: Scene safety
Answer: What is an EMT’s first priority ALWAYS?
Q: Acute stress
Answer: an immediate physiological and psychological reaction to a specific event. The event triggers the body’s fight or flight response
Q: Delayed stress
Answer: a stress reaction that develops after the stressful event. It does not interfere with the EMT’s ability to perform during the stressful event. Posttraumatic stress disorder (PTSD) is an example of ________ _______
Q: Cumulative stress
Answer: the result of exposure to stressful situations over a prolonged period of time. This leads to burnout for many EMTs.
Q: Critical Incident Stress Management (CISM)
Answer: is a formalized process to help emergency workers deal with stress- diffusing sessions are held within 4 hours of the incident- debriefing sessions are held 24 to 72 hours after the incident
Q: Occupational Safety and Health Administration
Answer: oversees regulations concerning workplace safety, including infectious disease precautions
Q: Minimum PPE
Answer: Gloves and eye protection should be used during any patient contact situation and are examples of…
Q: Expanded PPE
Answer: The use of disposable gown and mask for significant contact with body fluids. Use a high-efficiency particulate air (HEPA) mask or a N-95 respirator for suspected airborne disease exposure, such as tuberculosis
Q: not enter; emergency care
Answer: Unless cleared by a hazmat specialist, an EMT is expected to _____ ______ and not begin _______ ______ until patients have been decontaminated or otherwise cleared by hazmat crews
Q: not enter; safe distance
Answer: When it comes to crime scenes, EMS providers should ____ ______ a crime scene unless law enforcement has determined it is safe. EMS providers may be advised to respond to the call but maintain a _____ _______ away until cleared by law enforcement. This is sometimes called “staging for PD”
Q: highly reflective traffic safety vest
Answer: In extrication situations, federal law requires EMS workers wear approved _______ ______ ____ ____ ______ when working on roadways, around traffic, or at an accident scene
Q: Power lift
Answer: A method of lifting where one keeps the object close to the body, using the legs to lift and not the back (legs bent, back straight). Use a power grip with palms UP and all fingers wrapped around the object.
Q: Urgent move
Answer: the patient has a potentially life-threatening injury or illness and must be moved quickly for evaluation and transportincludes rapid extrication
Q: Rapid extrication
Answer: an urgent move used for patients in a motor vehicle; it requires multiple rescuers and a long backboard. The patient is rotated onto a backboard with manual cervical spine precautions and removed from the vehicle
Q: Non-urgent moves
Answer: used when there are no hazards and no life-threatening conditions apparent.includes direct ground lift, extremity lift, direct carry method, and draw sheet method
Q: Log roll technique
Answer: commonly used to place a patient on a backboard or assess the posterior, can be done while maintaining manual cervical spine precautionsshould have at least 3 trained personnel
Q: Stair-chair
Answer: excellent for staircases, small elevators, etc. Does not allow for manual cervical spine protection, CPR, or artificial ventilation
Q: Backboard
Answer: used primarily for cervical spine immobilization, allows for CPR and artificial ventilation.requires 4 people
Q: scoop stretcher
Answer: allows for easy positioning with minimal patient movement. good for reducing patient discomfort during movement
Q: rear
Answer: when approaching a helicopter, never approach from the
Q: left
Answer: if the patient is pregnant and needs to be on a backboard, they should be placed on the ___ side
Q: advance directives
Answer: written instructions, signed by the patient, specifying the patient’s wishes regarding treatment and resuscitative effortsincludes DNRs and living wills
Q: assault
Answer: a person can be guilty of ______ even if another person only perceived that they intended to inflict harm. Physical contact is not required to be guilty of assault.
Q: battery
Answer: physically touching another person without their consent
Q: negligence
Answer: the most common reason EMS providers are sued civillyincludes a breech of four core values:- duty to act: the EMT had an obligation to respond and provide care- breech of duty: the EMT failed to assess, treat, or transport patient according to the standard of care.- damage: the plaintiff experienced damage or injury recognized by the legal system as worthy of compensation- causation (proximate cause): the injury to the plaintiff was, at least in part, directly due to the EMT’s breech of duty
Q: gross negligence
Answer: exceeds simple negligence. It involves an indifference to, and violation of, a legal responsibility.- reckless patient care- can result in civil or criminal charges
Q: abandonment
Answer: once care is initiated, EMS providers cannot terminate care without the patient’s consent. This is the termination of care without transferring the patient to an equal or higher medical authority
Q: continuity of care; billing; subpoena; crimes
Answer: EMTs can release patient information without consent when:1) the information is necessary for ________ ___ ______2) the information is necessary to facilitate ______ for services3) the EMT has received a valid __________4) reporting possible ________, abuse, assault, neglect, certain injuries, or communicable diseases
Q: obvious signs of death
Answer: decomposition, rigor mortis, dependent lividity, and decapitation are all _________ _______ ____ __________ and mean that resuscitation is not necessary
Q: dead on arrival; suicide; assault; abuse; crime
Answer: Law enforcement or the medical examiner must be notified for situations including:1) any scene where the patient is ______ ____ _______2) _______ attempts3) _________ or sexual __________4) child _______ or elder _________5) suspected ________ scene6) childbirth
Q: repeater
Answer: a type of base station that receives low-power transmissions from portable or mobile radios and rebroadcasts at higher power to improve range
Q: mobile data computers
Answer: relay digital information instead of voice transmissionscan display the address of the call and routing informationallow digital communication with dispatch and other responding unitsreduce the volume of routine radio traffic
Q: federal communications commission
Answer: the FCC regulates all radio operations in the United States and has allocated specific frequencies for EMS use only
Q: F.A.C.T documentation
Answer: F- factual: the PCR should be fact-based, not opinion basedA – accurate: the PCR should be as accurate as possibleC – complete: the PCR should be complete unless circumstances dictate it appropriateT – timely: the PCR should be completed as soon as possible after transfer of care
Q: objective documentation
Answer: based on facts, findings, or observations that are highly difficult to dispute. Objective documentation is not about being “right”
Q: subjective documentation
Answer: based on opinions or perceptions and can be easily disputed. Subjective documentation is about being “right” about your opinion. Subjective information from the patient, however is acceptable and should generally be documented in quotations
Q: associated symptoms
Answer: patient complaints in addition to the chief complaint
Q: pertinent negatives
Answer: signs or symptoms you have reason to suspect but the patient denies having
Q: abduction
Answer: movement away from midline
Q: adduction
Answer: movement toward the midline
Q: Shock or Trendelenburg Position
Answer: supine with legs elevated
Q: Fowler’s position
Answer: seated with head elevated and knees bent
Q: ligaments
Answer: connect bone to bone
Q: tendons
Answer: connect muscle to bone
Q: axial skeleton
Answer: consists primarily of the skull, spinal column, and rib cage
Q: 7
Answer: how many cervical vertebrae are there?
Q: 12
Answer: how many thoracic vertebrae are there?
Q: 5
Answer: how many lumbar vertebrae are there?
Q: 5 fused vertebrae
Answer: how many vertebrae are in the sacrum?
Q: 4 fused vertebrae
Answer: how many vertebrae are in the coccyx?
Q: appendicular skeleton
Answer: consists of the bones of the arms, legs, and pelvis
Q: illium
Answer: upper portion of the pelvis
Q: ischium
Answer: lower portion of the pelvis
Q: pubis
Answer: anterior portion of the pelvis
Q: tibia
Answer: medial bone of the lower leg
Q: fibula
Answer: lateral bone of the lower leg
Q: symphysis
Answer: a joint with limited motion
Q: ball-and-socket joint
Answer: a joint where the distal end is capable of free motion, such as the shoulder
Q: hinge joint
Answer: a joint where the bones can only move uniaxially such as the knee
Q: alveoli
Answer: the only place in the respiratory system where oxygen and carbon dioxide are exchanged
Q: visceral pleura
Answer: lines the outer surface of the lungs
Q: parietal pleura
Answer: lines the inside of the chest cavityduring inhalation, this pulls the visceral pleura which pull the lungs
Q: diaphragm
Answer: the primary muscle of respiration, typically under involuntary control.During inhalation, it moves down and expands the size of the thoracic cavity
Q: inhalation
Answer: the diaphragm and intercostal muscles contract, the thoracic cage expands, pressure in the chest cavity decreases, and air rushes inthe active part of ventilation, energy is required
Q: 21%
Answer: atmospheric air contains _____ % of oxygen?
Q: exhalation
Answer: the diaphragm and intercostal muscles relax, the thoracic cage contracts, pressure in the chest cavity rises, and air is expelledpassive part of ventilation
Q: 16%
Answer: exhaled air contains _____% oxygen?
Q: external respiration
Answer: the exchange of oxygen and carbon dioxide between the alveoli and pulmonary capillaries
Q: internal respiration
Answer: gas exchanged between the body’s cells and the systemic capillaries
Q: cellular respiration
Answer: aerobic metabolism, uses oxygen to break down glucose to create energy
Q: carbon dioxide drive
Answer: the primary mechanism of breathing control for most people where the brain stem monitors carbon dioxide levels in the blood and cerebrospinal fluidhigh levels of CO2 stimulate an increase in respiratory rate and tidal volume
Q: hypoxic drive
Answer: a backup system to the CO2 drive which involves specialized sensors in the brain, aorta, and carotid arteries that monitor oxygen levelslow levels of oxygen stimulate breathing… less effective than CO2 breathing
Q: tidal volume
Answer: the amount of air inhaled or exhaled in one breath
Q: residual volume
Answer: amount of air in the lungs after completely exhaling. The residual volume keeps the lungs open.
Q: inspiratory and expiratory reserve volume
Answer: the amount of air you can still inhale or exhale after a normal breath
Q: dead space
Answer: the amount of air in the respiratory system not including the alveoli
Q: minute volume
Answer: respiratory rate x tidal volume
Q: normal adult respiratory rate
Answer: 12 to 20 breaths per minute
Q: normal pediatric rate
Answer: 15 to 30 breaths per minute
Q: normal infant rate
Answer: 25 to 50 breaths per minute
Q: agonal breaths
Answer: dying gasps; slow and shallow; will not move air into alveoli
Q: left; oxygenated blood; lungs; body
Answer: the ______ pump receives ________ ________ from the ________ and sends it to the ________. It is the stronger of the two pumps, with a greater workload than the right pump
Q: right; deoxygenated blood; body; lungs
Answer: the ______ pump receives ________ _______ from the ____ and sends it to the ________ to drop off carbon dioxide and pick up oxygen on its way to the left heart
Q: atria
Answer: the two upper chambers of the heart. Blood returning to the heart on both sides enters and then is pumped into the ventricles just before the ventricles contract
Q: ventricle
Answer: the lower and larger chambers of the heart.the left sends oxygen-rich blood throughout the body under high pressurethe right sends oxygen-depleted blood to the lungs under low pressure
Q: sinoatrial node
Answer: the primary electrical impulse within the heart, about 60 to 100 pulses per minute in the adult
Q: atrioventricular junction
Answer: the backup pacemaker and generates electrical impulses at 40 to 60 per minute
Q: pulmonary artery
Answer: the only artery in the body that carries deoxygenated blood
Q: pulmonary vein
Answer: the only vein in the body that carries oxygen-rich blood
Q: systolic pressure
Answer: the blood pressure exerted during contraction of the left ventricle (high number)
Q: diastolic pressure
Answer: the blood pressure in between contractions
Q: central nervous system
Answer: consists of the brain and spinal cord, the command and control portion of the nervous system
Q: cerebrum
Answer: largest part of the brain; controls though, memory, and the senses
Q: cerebellum
Answer: coordinates voluntary movement, fine motor function, and balance
Q: brain stem
Answer: includes midbrain, pons, and medulla; controls essential body functions, such as breathing and consciousness
Q: peripheral nervous system
Answer: includes all other nervous system structures outside of the CNS, including cranial and peripheral nerves
Q: sensory division and motor division
Answer: two divisions of the PNS
Q: sensory division
Answer: sends sensory information to the CNS
Q: motor division
Answer: receives motor commands from the CNS. There are two divisions of the _______ portion of the PNS
Q: somatic and autonomic nervous system
Answer: two portions of the motor division of the PNS
Q: somatic nervous system
Answer: voluntary portion of the PNS
Q: autonomic nervous system
Answer: involuntary portion of the PNS with two portions- sympathetic- parasympathetic
Q: sympathetic
Answer: “fight or flight” portion of autonomic nervous system; exerts greater control in times of stress or danger
Q: parasympathetic
Answer: “feed and breed” portion of nervous system; exerts greater control in times of rest, digestion, or reproduction
Q: stomach
Answer: hollow digestive organ in LUQ which receives food, begins breaking it down, and sends it to small intestine
Q: pancreas
Answer: solid organ; aids in digestion, produces insulin, and helps regulate blood glucose levels
Q: liver
Answer: solid organ; occupies most of the RUQ which helps to break down fats, filters toxins, and produces cholesterol
Q: gall bladder
Answer: a hollow organ positioned beneath the liver which collects and stores bile from the liver, it releases bile into the intestine to aid in digestion
Q: small intestine
Answer: hollow organ; occupies both lower abdominal quadrants, digestion of fats via enzymes as well as the absorption of contents
Q: large intestine
Answer: hollow organ; includes the colon and rectum which occupies the outer border of the abdomen
Q: appendix
Answer: a hollow organ in the RLQ which can be easily obstructed, causing inflammation, rupture, etc
Q: spleen
Answer: solid organ; little protection in the LUQ which filters blood
Q: kidneys
Answer: solid organ; part of the urinary system which controls fluid balance, filters waste, and controls pH
Q: larger; obstructed; larger
Answer: Anatomical differences between children and adults:- the pediatric tongue is ______ in proportion to the airway- the pediatric airway is more easily __________- the pediatric head is _______ in proportion to the body
Q: neonate
Answer: a newborn from birth to one month of age
Q: infant
Answer: up to one year of age
Q: normal neonate respiratory rate
Answer: 30 to 60 breaths per minute
Q: normal neonate pulse rate
Answer: 140 to 160 beats per minute
Q: normal infant pulse rate
Answer: 100 to 140 beats per minute
Q: normal neonate blood pressure
Answer: 70 systolic
Q: normal infant blood pressure
Answer: 90 systolic
Q: 6; 8
Answer: The typical newborn weight is about ___ to ___ pounds. The newborn’s weight will typically double by six months and triple by about one year.
Q: 25%
Answer: the newborn’s head makes up about ______ % of the body and is a significant source of heat loss
Q: startle reflex
Answer: opens arms wide, spreading fingers
Q: grip reflex
Answer: grips when something placed in palm
Q: rooting reflex
Answer: turns towards a touch to the cheek
Q: sucking reflex
Answer: stimulated by touching the lips
Q: 6 months old
Answer: at what age can an infant begin teething, sit upright, and track objects visually?
Q: 12 months old
Answer: at what age do infants know their name, recognize parents, walk with assistance, and communicate through crying?
Q: toddlers
Answer: kiddos aged one to three years old
Q: preschoolers
Answer: kiddos ages three to six years old
Q: normal toddler respiratory rate
Answer: about 20 to 30 breaths per minute
Q: normal preschooler respiratory rate
Answer: about 20 to 25 breaths per minute
Q: normal toddler pulse rate
Answer: about 90 to 140 beats per minute
Q: normal preschooler pulse rate
Answer: 80 to 130 beats per minute
Q: normal toddler blood pressure
Answer: about 80 to 90 systolic
Q: normal preschooler blood pressure
Answer: about 90 to 110 systolic
Q: normal school-age respiratory rate
Answer: about 15 to 20 bpm
Q: normal school-age pulse rate
Answer: 70 to 110 beats per minute
Q: normal school-age blood pressure
Answer: about 90 to 120 systolic
Q: normal adolescent respiratory rate
Answer: 12 to 20 bpm (first to reach this stage)
Q: normal adolescent pulse rate
Answer: 60 to 100 beats per minute (first to reach this stage)
Q: normal adolescent blood pressure
Answer: about 100 to 120 systolic
Q: adolescents
Answer: age group 12-18 years of age
Q: normal adult pulse rate
Answer: 60 to 100 beats per minute
Q: normal adult blood pressure
Answer: about 110/70 to 130/90
Q: ventilation
Answer: the moving of air in and out of the lungs, required for effective oxygenation and respirationincludes inhalation and exhalation
Q: hypoxia
Answer: inadequate delivery of oxygen to the cells
Q: early hypoxia
Answer: restlessness, anxiety, irritability, dyspnea, tachycardia are all signs of….
Q: late hypoxia
Answer: altered or decreased level of consciousness, severe dyspnea, cyanosis, and bradycardia (especially in peds) are all signs of…
Q: oxygenation
Answer: delivery of oxygen to the blood, required for respiration but does not ensure respiration
Q: 4 minutes
Answer: Without oxygen, brain damage begins within about…
Q: 6 minutes
Answer: Without oxygen, permanent brain damage is likely within…
Q: 10 minutes
Answer: irrecoverable injury to the brain is likely within…
Q: wheezing
Answer: high-pitched sounds usually heard during exhalation
Q: rales
Answer: “wet” or “crackling” sounds
Q: stridor
Answer: a high-pitched sound indicating partial upper airway obstruction. Stridor is auscultated in the upper airway, not the lower lung fields
Q: head tilt-chin lift
Answer: the preferred manual method of opening the airwaygood for… patients with altered or decreased level of consciousness, patients with suspected airway obstruction, patients requiring suctioningNOT for suspected cervical spine injury
Q: jaw-thrust maneuver
Answer: good for… patients with altered or decreased level of consciousness and suspected c-spine injurycontraindication… conscious patients
Q: oropharyngeal airway
Answer: used to prevent the tongue from obstructing the airway. Failure to size or insert OPA correctly can cause the tongue to block the airwaygood for… unresponsive patients without a gag reflexNOT for… conscious patients or any patient with an intact gag reflex(measured mouth to earlobe)
Q: nasopharyngeal airway
Answer: used to prevent the tongue from obstructing the airway in patients who may not be able to protect their own airwaygood for… unresponsive patients without a gag reflex and patients with a decreased level of consciousness but an intact gag reflexNOT for… conscious patients with an intact gag reflex capable of protecting their own airway, severe head injury or facial trauma, resistance to insertion in nostrils, not used for patients under one year of age(tip of nose to earlobe)
Q: rigid suction catheter
Answer: also known as a “tonsil tip” or Yankauer, best suited for suctioning the oral airway
Q: French catheter
Answer: also known as whistle-tip, a flexible catheter that comes in several sizes that is best suited for suctioning the nose, stoma, or inside of an advanced airway device
Q: suctioning
Answer: increases risk of hypoxia and should not exceed- 15 seconds for adults- 10 seconds for pediatrics- 5 seconds for infants
Q: recovery position
Answer: patient positioned on his side, reduces the risk of aspirationunresponsive patients with adequate breathing and no c-spine injury should be placed in the recovery position
Q: 94%
Answer: supplemental oxygen is not needed if there are no signs or symptoms of respiratory distress and the pulse oximetry is at least ______%
Q: D cylinder
Answer: about 350 L capacity
Q: E cylinder
Answer: about 625 L capacity
Q: M cylinder
Answer: about 3,000 L capacity
Q: G cylinder
Answer: about 5,000 L capacity
Q: H cylinder
Answer: about 7,000 L capacity
Q: nonrebreather masks
Answer: usually the preferred method of oxygen administration in prehospital, referred to as “high-flow” oxygen10 to 15 lpmup to 90% O2 delivered
Q: nasal cannula
Answer: referred to as “low-flow” oxygen1 to 6 lpmup to 24%-44% O2 delivered
Q: assisted ventilation
Answer: also called artificial ventilation or positive pressure ventilation- mouth to mask- flow-restricted device- bag valve mask- mouth to mouthCNS injury, foreign-body airway obstruction, chest trauma, bronchoconstriction, pulmonary edemaanyone breathing less than 8 breaths per minute or more than 24
Q: 5; 6
Answer: the correct rate of artificial ventilation for apneic adults is one breath every ___ to ___ seconds (10 to 12 times per minute)
Q: 3; 5
Answer: the correct rate of artificial ventilation for infants and children is one breath every ___ to ____ seconds (12 to 20 times per minute)
Q: 1; 1.5
Answer: the correct rate of artificial ventilation for neonates is one breath every ___ to ____ seconds (40 to 60 times per minute)
Q: single rescuer CPR
Answer: 30 compressions; 2 breathsalways for adults
Q: two rescuer CPR
Answer: 15 compressions; 2 breathschildren and infants
Q: bag valve mask
Answer: the most frequently used method of artificial ventilations in the prehospital setting- about 15 lpm of almost 100% oxygen- reduces biohazard risk- extremely difficult for single rescuer to get effective useAdult – 1,200 to 1,600 mlChild – 500 to 700 mlInfant – 150 to 240 ml
Q: continuous positive airway pressure
Answer: used to improve ventilatory efficiency in spontaneously breathing patients in respiratory distressused for patients with sleep apnea, very effective for patients with COPD or pulmonary edemaindications : conscious patients in moderate to severe respiratory distress, tachypnic patients, pulse ox below 90%contraindications : apneic patients, chest trauma, vomiting, hypotension
Q: respiratory failure
Answer: these are all signs of what in pediatric patients?-bradycardia and poor muscle tone-altered level of consciousness-headbobbing, and grunting on exhalation-seesaw breathing
Q: foreign-body airway obstruction
Answer: the tongue is the number one cause of airway obstruction; however, foreign bodies such as vomit, food, latex balloons, and toys can also obstruct the airwayinability to cough, speak, or breathe, or clutching the throatinability to artificially ventilate the patient despite repositioning airway and managing the tongue
Q: abdominal thrusts
Answer: with a conscious adult who has a foreign-body airway obstruction, what do you need to do/administer?
Q: five back blows/five chest thrusts
Answer: with a conscious infant with a foreign-body airway obstruction, what do you need to do/administer?
Q: CPR, inspect airway
Answer: with an unconscious patient with a foreign-body airway obstruction, what do you need to do/administer?
Q: chief complaint
Answer: the patient’s primary reason for calling EMS
Q: sign
Answer: findings you can objectively see, feel, hear, or smellex. vomiting, deformity, wheezing
Q: symptom
Answer: the patient must tell you about these thingsex. nausea, pain, dyspnea
Q: carotid pulse
Answer: where do you check pulse in adults and children who are suspected to have gone through cardiac arrest?
Q: brachial pulse
Answer: where do you check pulse in infants who are suspected to have gone through cardiac arrest?
Q: blood pressure
Answer: measures the pressure exerted against the walls of the arteries during contraction of the left ventricle and in between contractions
Q: systole
Answer: the pressure exerted against the walls of the arteries during contraction
Q: diastole
Answer: is the pressure exerted against the walls of the arteries while the left ventricle is at rest
Q: pulse pressure
Answer: the difference between the systolic and diastolic pressuresnormal: greater than 25% but less than 50% of systolic pressure
Q: widened pulse pressure
Answer: pulse pressures above 50% of systolic- indicates possible head injury- ex. 210/100
Q: narrow pulse pressure
Answer: pulse pressures below 25% of systolic- indicates possible hypoperfusion, tension pneumothorax, pericardial tamponadeex. 80/62
Q: 98.6 degrees
Answer: normal body temperature
Q: capillary refill
Answer: a more accurate determination in children and infants which measures the time it takes for capillaries to refill with blood after being squeezed
Q: glucometer
Answer: identifies the amount of glucose in the bloodnormal: 80 to 120 mg/dLhypoglycemia: 60mg/dL or belowhyperglycemia: over about 140mg/dLany patient with altered or decreased level of consciousnessany patient with a known or suspected diabetic history
Q: pharmacokinetics
Answer: the study of how drugs enter the body, and are metabolized and eliminated
Q: pharmacodynamics
Answer: the study of a drug’s effects on the body
Q: trade name
Answer: a brand name for a drug that has typically been trademarked by the manufacturerex. Nitro-Bid
Q: generic name
Answer: a name that is not trademarked and can be used by any manufacturerex. nitroglycerin
Q: agonists
Answer: medications that stimulate an effectex. an asthmatic using an inhaler to increase bronchodilation
Q: antagonists
Answer: medications that inhibit an effectex. taking aspirin to reduce pain
Q: enteral medications
Answer: enter the body through the digestive systemex. oral medications
Q: parenteral medications
Answer: enter the body through any means other than enteralex. intramuscular and intravenous medications
Q: Oral (PO)
Answer: slow onset of action, safe but unpredictable absorptionex. aspirin, activated charcoal, oral glucose
Q: Intramuscular (IM)
Answer: directly into the musclerapid absorption, not quite as fast as intravenous or intraosseous; faster than oralless reliable absorption than IV or IOex. epi-pen
Q: right patient, right drug, right route, right amount, right time, right documentation
Answer: what are the 6 rights of medication administration?
Q: activated charcoal
Answer: names: activated charcoal, actidose, super-char, liqui-charclass: adsorbentmechanism of action: adheres many drugs and chemicals preventing their absorption from the gastrointestinal tractindication: recently ingested poisonscontraindications: decreased level of consciousness, inability to swallow, ingestion of acids, alkalis, or hydrocarbons, expired medications, lack of medical directionadult dose: 1 gram per kilogram of body weightpeds: 25 to 50 gramsside effects: nausea and vomiting, dark and tarry stool
Q: aspirin
Answer: names: acetylsaliclic acid, aspirin, Anacin, Bayerclass: anti-inflammatory, anti-platelet aggregate, antipyreticmechanism of action: reduces inflammation, decreases platelet aggregation, reduces feverindication: chest paincontraindications: allergy to medication, lowered LOC, inability to swallow, recent bleeding, pediatric patient, expired meds, lack of medical directiondose: 160 to 325 mg (2-4 peds chewables)side effects: nausea and vomiting, stomach pain, bleeding, allergic reaction
Q: MDI and SVN Medications
Answer: names: albuteral, atrovent, bronkosolclass: bronchodilatormechanism of action: relaxes bronchial smooth muscle, improving air exchangeindications: dyspnea, asthma, reactive airway diseasecontraindications: allergy to medication, patient unable to follow commands, expired meds, not prescribed to patient, lack of medical directiondose: one to two inhalationsside effects: tachycardia, hypertension, increased myocardial oxygen demand, restlessness, anxiousness
Q: Epi Auto-Injector
Answer: names: epinephrine, Epi-Pen, Epi auto-injectorclass: sympathomimetic, bronchodilatormechanism of action: peripheral vasoconstriction, increased heart rate, bronchodilationindication: anaphylaxiscontraindications: expired meds, lack of medical directiondose: one auto injector, administered IM, usually lateral mid-thighside-effects: tachycardia, hypertension, increased myocardial oxygen demand, restlessness, anxiousness
Q: nitroglycerin
Answer: names: nitroglycerin, Nitrostat, Nitrobid, Nitrolingualclass: antianginal, vasodilatormechanism of action: vasodilation, decreased myocardial oxygen demand, increased myocardial oxygen supplyindications: chest pain, suspected angina or myocardial infarctioncontraindications: expired medications, not prescribed, hypotension, recent use of viagra (cialis, levitra, or other ED med), head injury, lack of medical directiondose: 0.4 mg and sublingualside effects: reflex tachycardia, hypotension, headache, burning under the tongue, nausea, vomiting
Q: oral glucose
Answer: names: oral glucose, Glutose, Insta-Glucoseclass: oral hyperglycemicmechanism of action: increases blood glucose levelindication: hypoglycemiacontraindications: decreased level of consciousness, inability to swallow, expired medication, lack of medical directiondose: half a tube to one tubeside effects: nausea and vomiting
Q: oxygen
Answer: names: oxygenclass: inhaled gasmechanism of action: increases oxygen concentrationindication: suspected hypoxiacontraindication: unsafe environmentdose: 15lpm via nonrebreather maskside effects: rare respiratory depression in COPD patients
Q: Scene size-up, primary assessment, patient history, secondary assessment, reassessment
Answer: What are the five components of a patient assessment?
Q: primary and secondary assessment
Answer: Trauma patients typically tend to demand a more intensive _______ and ________ ________ than conscious medical patients
Q: patient history
Answer: medical patients often demand a more thorough __________ __________ than trauma patients
Q: staging
Answer: when EMS systems are dispatched to a scene that has not been secured by law enforcement but will be told to remain a safe distance until it is cleared
Q: scene size-up
Answer: when do you determine the number of patients as well as the need for additional resources in your patient assessment?
Q: mechanism of injury (trauma patients)
Answer: determine how the injury occurred.ex. fall injury, motor vehicle accident, assault- blunt trauma- penetrating traumacan help predict injuries and make treatment decisions, and select appropriate hospital destinations
Q: nature of illness (medical patients)
Answer: determine the nature of the patient’s medical complaint; related to the chief complaint but is not the same thing.
Q: primary assessment
Answer: begins once you arrive at the patient and is used to identify and treat any life-threatening conditions (c-spine)
Q: Circulation, airway, breathing
Answer: for unresponsive patients, in the primary assessment, what is the proper order of checking airway, circulation, and breathing?
Q: Golden Period
Answer: this period starts when the injury occurs and does not end until the patient receives definitive care- survival rates from shock and trauma plummet in 1 hour- 10 minutes to assess the patient, manage life-threatening conditions, package the patient for transport, and begin transport within 10 minutes
Q: Deformities, contusions, abrasions, penetrating injuries, burns, tenderness, lacerations, swelling
Answer: What does DCAP-BTLS stand for?
Q: Reassess LOC, ABCs, chief complaint, interventions, and vitals
Answer: What are the components in reassessment?
Q: perfusion
Answer: the adequate circulation of oxygenated blood throughout the body, necessary to maintain homeostasis
Q: shock (hypoperfusion)
Answer: inadequate tissue perfusion, the cells of the body do not get the oxygen and nutrients they need from the circulatory system- compensated shock- decompensated shock- irreversible shock
Q: compensated shock
Answer: the early stage of shock. the body is still able to compensate for the hypovolemic state through defense mechanisms, such as increased heart rate and peripheral vasoconstriction
Q: decompensated shock
Answer: late or “progressive” shock. The body can no longer compensate for the hypovolemic state, and blood pressure starts to fall
Q: irreversible shock
Answer: final stage of shock. The patient will not survive once entering irreversible shock
Q: pump problems, pipe problems, fluid problems
Answer: What are the three primary causes of shock?
Q: tachycardia, peripheral vasoconstriction, increased respiratory rate, (late) failing blood pressure
Answer: What are the compensation mechanisms of the body once the body is in shock?
Q: cardiogenic shock
Answer: (pump problem)the heart muscle cannot pump effectively, causing a backup of fluid, pulmonary edema, and hypotensioncaused by low cardiac output due to reduced preload, high afterload, or poor myocardial contractility
Q: pulmonary edema
Answer: accumulation of fluid in the lungscauses: CHF, toxic inhalation, disease, and traumaS/S:- possible cardiac history- rales- swollen feet- difficulty breathing lying down
Q: obstructive shock
Answer: this type of shock is a pump problem caused by mechanical obstruction of the heart muscle- cardiac tamponade- tension pneumothorax
Q: cardiac tamponade
Answer: fluid accumulates within the pericardial sac and compresses the heart. also called pericardial tamponade.S/S: JVD, narrowing pulse pressures, hypotension
Q: tension pneumothorax
Answer: air enters the chest cavity due to lung injury or sucking chest wound. Accumulating pressure compresses the lungs and great vesselsS/S: JVD, respiratory distress, lack of or diminished breath sounds, poor compliance with artificial ventilation via BVM, (late) tracheal deviation
Q: distributive shock
Answer: (pipe problem)occurs due to widespread vasodilation, which causes blood pooling and relative hypovolemia- anaphylaxis- neurogenic shock- septic shock- psychogenic shock
Q: relative hypovolemia
Answer: low volume of blood relative to the size of the space
Q: anaphylactic shock
Answer: a life-threatening form of severe allergic reaction due to three factorso massive vasodilationo widespread vessel permeability (fluid leakage)o bronchoconstrictioncauses: medications, foods, bites, stings, environmental allergensS/S:- skin: hives, swelling, itching, flushed or cyanotic color- cardiovascular: weak pulses, hypotension- respiratory: severe dyspnea, wheezing, respiratory failureusually occurs within 30 minutes of exposure to allergen
Q: neurogenic shock
Answer: caused by spinal cord damage, typically in the cervical region -> leads to massive, systemic vasodilation below the level of injuryS/S:-MOI c-spine injury- hypotension- warm skin, normal color (due to inability to vasoconstrict)- heart rate that is NOT tachycardic- paralysis- respiratory paralysis
Q: septic shock
Answer: caused by severe infection, which damages blood vessels and increases plasma loss out of the vascular space.vessels do not constrict well, cannot compensateS/S:- fever, chills, weakness- recent illness, infection, or surgery- altered level of consciousness, increased respiratory rate- tachycardia, hypotension, pale, cool skin- weak peripheral pulses and loss of appetite
Q: psychogenic shock
Answer: pseudo-shock caused by sudden, temporary vasodilation that leads to syncope (fainting). does not inerently present a sustained problem due to inadequate tissue perfusionsudden vasodilation interrupts blood flow to the brain, leading to a syncopal episode
Q: hypovolemic shock
Answer: (fluid problem)causes: loss of whole blood, dehydrationS/S:- trauma, blunt or penetrating- bleeding, altered LOC, nausea, vomiting, diarrhea- tachycardia, pale, cool skin- weak peripheral pulses, hypotension
Q: Altered LOC, tachycardia, pale and cool skin, weak peripheral pulses, increased respiratory rate, thirst, delayed capillary refill
Answer: What are the 7 main early signs of shock?
Q: falling blood pressure, irregular breathing, mottling or cyanosis, absent peripheral pulses
Answer: What are the 4 major signs of late shock?
Q: warm skin, normal heart rate, paralysis
Answer: What three signs make the presentation of neurogenic shock unique?
Q: control bleeding, place in shock position, prevent loss of heat, rapid transport
Answer: How do you manage for shock? 4 Steps
Q: cardiogenic and obstructive
Answer: Those with ________ and ___________ shock should not be placed supine
Q: asthma
Answer: an acute condition caused by bronchoconstriction and excess mucus production (exercise, allergic response, illness)S/S: wheezing upon exhalation, absent lung sounds, coughing
Q: chronic obstructive pulmonary disorder
Answer: a slow, chronic disease process that obstructs and damages the lower airways and alveoli. COPD disorders include chronic bronchitis and emphysemacauses: cigarette smokingS/S:- history of smoking- chronic productive cough- prolonged expiratory phase- abnormal lung sounds
Q: congestive heart failure
Answer: a cardiac emergency in which the heart does not pump effectively, leading to a backup of fluid and pulmonary edemaS/S:- dyspnea, chest pain, pulmonary edema, JVD, pedal edema- orthopnea
Q: croup
Answer: inflammation of the pharynx, larynx, and trachea. Highly infectious and usually occurs in children up to 3 years oldS/S:- colds, usually in winter- “barking” cough- stridor (upper airway high pitched sound)
Q: cystic fibrosis
Answer: genetic disorder leading to thick mucus production and chronic lung infections which often causes death before adulthoodS/S:- asthmalike symptoms- gastrointestinal problems
Q: Pneumonia
Answer: infection of the lungs, typically a secondary infection. #1 cause of pediatric deathsS/S:- Chronic or terminal illness- productive cough- weakness- chest pain- fever- low pulse ox reading
Q: pneumothorax
Answer: accumulation of air in the pleural space which can occur spontaneously or as a result of trauma (asthma patients)S/S:- history of respiratory problems- thoracic trauma- diminished or absent lung sounds
Q: pulmonary embolism
Answer: the blockage of a pulmonary artery due to a blood clot or other obstructionS/S:- history of recent surgery- long bone fracture- chest pain- tachypnea- chest pain- hemoptysis- sudden cardiac arrest
Q: respiratory syncytial virus
Answer: a very common infection in infants and children which is extremely contagious. The virus can survive on surfaces, clothing, etc.S/S:- coldlike symptoms- poor fluid intake- dehydration
Q: acute coronary syndrome
Answer: caused by myocardial ischemia (poor blood supply)- angina pectoris- acute myocardial infarction
Q: angina pectoris
Answer: transcient chest pain caused by a lack of oxygen to the heart muscle. The heart’s oxygen demand temporarily exceeds its supply.caused by atherosclerosisusually does not last longer than 10 minutes and does not cause permanent heart damageS/S: very similar to acute myocardial infarction
Q: atherosclerosis
Answer: the buildup of plaque in a blood vessel, which can restrict or obstruct blood flow
Q: acute myocardial infarction
Answer: death to an area of the heart muscle due to a lack of oxygenated blood flow through the coronary arteriesS/S:- chest pain or pressure, nausea- weakness, fatigue- dyspnea, diaphoresis- abnormal vital signs, sudden cardiac arrest- patient’s denial or sudden doomUsually does not go away in a few minutes and can occur at any time, not only in exertioncommon in geriatrics, women, diabeticscan lead to -> cardiac dysrhythmias, sudden cardiac arrest, congestive heart failure, cardiogenic shock
Q: right-sided congestive heart failure
Answer: if the right ventricle pumps inefficiently, blood backs up in the venous system that feeds into the heartS/S: JVD, swollen feet
Q: left-sided congestive heart failure
Answer: if the left ventricle pumps inefficiently, blood backs into the lungsS/S: pulmonary edemausually leads to right sided failure
Q: hypertension
Answer: a systolic pressure above 140mmHg or a diastolic pressure above 90Crises -> +164/+94S/S:- may be asymptomatic- headache, often severe- tinnitus: ringing in the ears- nausea and vomiting, dizziness, nosebleed
Q: automatic implanted cardiac defibrillators (AICD)
Answer: similar to an automated external defibrillator, but is placed under the skin and connected directly to the heartenergy output of an AICD is much lower than that of an AEDmove pads for AED use
Q: Pacemaker
Answer: an implanted device that helps regulate a patient’s cardiac rate and rhythm by serving as an artificial source of electrical impulses to stimulate the heatavoid placing pads directly over it
Q: Race, age, sex, heredity; smoking, hypertension, exercise, diet, stress
Answer: What are the risk factors for heart disease? (RASH + SHEDS)
Q: Stroke
Answer: death to brain tissue due to an interruption of blood flowalso called cerebrovascular accident
Q: ischemic stroke
Answer: blood flow to the brain is compromised due to a blockageischemic strokes are often due to atherosclerosisoverwhelming majority of strokes are ischemic in nature
Q: hemorrhagic strokes
Answer: caused by bleeding within the brainthe bleeding robs the brain of oxygen delivery and can apply pressure to surrounding brain tissue, further compromising oxygenationoften fatalprevention through modifications of risk factors is key
Q: Severe headache, slurred speech, facial droop, drooling, unilateral numbness, altered LOC, vision problems
Answer: signs and symptoms of a stroke include…? (7)
Q: Cincinnati Prehospital Stroke Scale
Answer: Facial Droop- ask the patient to smile- abnormal: facial droop is presentArm drift- ask the patient to close eyes while holding arms out front, palms up- abnormal: one arm drifts unintentionallySpeech- ask the patient to repeat a given sentence- abnormal: speech is slurred, word choice is incorrect, or patient is unable to speak(FAST)
Q: Transient Ischemic Attack
Answer: TIAs have the same presentations as a CVA. However, the signs and symptoms self-correct within about 24 hours with no permanent brain damageWarning of impending strokes
Q: Seizures
Answer: caused by disorganized electrical activity within the brain- generalized- absence- partial- status epilepticus
Q: Generalized Seizures or Grand Mal seizures
Answer: patient is unresponsive and experiences full-body convulsions
Q: Absence seizures or Petit Mal Seizures
Answer: patient does not interact with environment, but there is no convulsive activity
Q: Simple partial seizure
Answer: no change in level of consciousness, possible twitching or sensory changes, but no full-body convulsions
Q: complex partial seizures
Answer: altered LOC; isolated twitching and sensory changes possible
Q: status epilepticus
Answer: prolonged seizure (about 30 minutes long) or recurring seizures without patient regaining consciousness in betweenhighly dangerous, possibly leading to permanent brain damage or death
Q: Aura, tonic, tonic-clonic, postictal
Answer: What are the phases of a seizure?1)2)3)4)
Q: aura phase
Answer: the phase of a seizure that serves as a warning, the patient may sense an onset of a seizure
Q: tonic phase
Answer: the phase of a seizure where muscle rigidity is present and possible incontinence
Q: tonic-clonic phase
Answer: patient experiences uncontrolled muscle contraction and relaxation in this phase of the seizurepossibly apneic
Q: postictal phase
Answer: this is the recovery phase of the seizure where the patient’s LOC progressively improves over about 30 minutes
Q: febrile seizures
Answer: common cause of seizures in pediatric patients which are caused by rapidly developed high fevers
Q: syncope
Answer: faintingtypically caused by a temporary loss of blood flow to the braincauses: cardiac emergencies, hypotension, neurological problems, stress, diabetes, pregnancy, anemia, medications and toxic exposure
Q: headache
Answer: have many causes, some of them neuorlogicalcauses: stroke, aneurysm, tumor, hypertension, migraines, trauma, and meningitisS/S:- severe headache- hypertension- fever- stiff neck- neurological impairment- recent trauma
Q: glucose
Answer: the body’s primary fuel source, only fuel source used by the brainuses aerobic respiration
Q: fats and proteins
Answer: the brain cannot use these alternate fuel sources, but the rest of the body cananaerobic environmentfar less efficient (by 19 times)the byproducts (ketones) are dangerous
Q: insulin
Answer: needed to move glucose out of bloodstream and into the cells to provide energy, causing blood glucose levels to drop as glucose leaves the blood stream and enters cells
Q: glucagon
Answer: serves to increase blood glucose levels
Q: hyperglycemia
Answer: a sustained blood glucose greater than about 120mg/dLdevelops slowly and requires a slower recovery processS/S:- seizures- coma- permanent injury
Q: hypoglycemia
Answer: a blood glucose of 60mg/dL or lessoccurs more often in type 1can lead to altered LOC, seizures, coma, and brain death
Q: normal blood glucose
Answer: 80 to 120mg/dL, however 120 to 140mg/dL is not uncommon after eating
Q: diabetes
Answer: a disease caused by an inability to metabolize glucose normally. This is frequently due to a problem with insulin production. Untreated diabetics typically have elevated blood glucose levels due to a lack of insulin or ineffective insulin.
Q: Type 1 Diabetes
Answer: insulin-dependent diabetes mellitususually inject supplemental insulin, usually pedsS/S:- polyuria- polydipsia- polyphagia- very high blood glucose levelshigh risk for insulin shock
Q: Type 2 Diabetes
Answer: non-insulin-dependent diabetes mellituscaused by a combination of lifestyle and geneticsmore common
Q: insulin shock
Answer: severe hypoglycemiaS/S:- confused- violent- unresponsive- low blood glucose level- altered LOC- seizures or coma- diaphoresis, tachycardia- pale, cool skin, tremorscauses: unexpected drop in blood glucose due to taking insulin but not eating, extreme physical activity, insulin overdose
Q: diabetic ketoacidosis
Answer: occurs more frequently with type 1blood glucose over 350mg/dLBrain cells are able to utilize glucose, but the rest of the body’s cells are starving and begin using alternate fuel sourcesLeads to dehydrationS/S:- high blood glucose over 350mg/dL- deep rapid breaths- polydipsia- polyphagia-polyuria-fruity odor on breath- incontinence- tachycardia- coma
Q: sedatives, narcotics, and barbiturates
Answer: commonly abused drugsall three can cause a decreased LOC and respiratory depression
Q: alcohol
Answer: the most widely abused drug in the United Statesis a CNS depressant and a sedative hypnoticincreases chances of vomitingwithdrawal may cause delirium tremens – restless, irritable, agitated, hallucinations, tremors, seizures
Q: narcotics
Answer: or opioids, include morphine, codeine, heroin, oxycodone, and many more.CNS depressants that can cause coma and severe respiratory depression
Q: sedative hypnotic drugs
Answer: CNS depressantscalming effect, and can induce sleepusually taken orally, but can be injectedBarbiturates such as Amytal, Seconal, and Luminal are sedative hypnoticsBenzodiazepines such as Valium, Xanax, and Rohypnol are sedative hypnotics
Q: Inhalants
Answer: acetones, glues, cleaning chemicals, paints, hydrocarbons, aerosols, and propellantsbrain damage and or cardiac arrest due to abuse is commonprescription and over-the-counter bronchodilators are also abused. They are taken for stimulant effects or perceived advantage in competitive sports
Q: stimulants
Answer: caffeine, cocaine, amphetamines, methamphetamines, among othersstimulant and euphoric effects
Q: acids
Answer: have a very low pH and burn on contact. Pain is usually immediate
Q: alkalis
Answer: have a very high pH and tend to burn deeper than acids. Pain may be delayed
Q: hydrocarbons
Answer: petroleum-basedfound in gasoline, paints, solvents, sunscreen, baby oil, makeup remover, kerosene, lighter fluid and more
Q: visceral pain
Answer: what type of abdominal pain is this?dull, diffuse pain that is difficult to locatefrequently associated with nausea and vomitingoften not severe, but may indicate actual organ injuries
Q: parietal pain
Answer: what type of abdominal pain is this?severe, localized pain. Usually sharp and constant.the pain will often cause the patient to curl up with knees to chest. The patient is often very still and breathing shallowly to diminish pain.
Q: referred pain
Answer: what type of abdominal pain is this?causes pain in an area of the body other than the source
Q: appendicitis
Answer: caused by inflammation of the appendixcan lead to life-threatening infection and septic shockS/S:- nausea, vomiting, diarrhea, loss of appetite, fever- pain may begin as diffuse, but usually localizes to right lower quadrant
Q: peritonitis
Answer: caused by inflammation of the peritoneumS/S:- nausea- vomiting- loss of appetite- diarrhea- fever
Q: Cholecystitis
Answer: inflammation of the gall bladder, often due to gallstonesmost often in females 30-50 years of ageS/S:- right upper quadrant pain- increased pain at night- increased pain after eating fatty foods- referred pain to the shoulder is common- nausea and vomiting
Q: Diverticulitis
Answer: develops when small pouches along the wall of the intestine fill with feces and become inflamed and infectedtypically +40 and a low fiber dietS/S:- usually abdominal pain in the lower left quadrant- fever- weakness- nausea and vomiting- bleeding not common
Q: Gastrointestinal bleed
Answer: most often in middle-aged patients, fatal in geriatric patientsUpper GI bleeds – ulcersLower GI bleeds – diverticulitisS/S:- hematemesis- hematochezia (bloody stool)- dark, tarry stool- hypovolemic shock
Q: gastroenteritis
Answer: infection with associated diarrhea, nausea, and vomitingcontaminated food or water and is not contagiousprolonged vomiting and diarrhea can lead to hypovolemic shockcommon cause of shock in children
Q: esophageal varices
Answer: weakening of the blood vessels lining the esophagusassociated with alcoholismS/S:- vomiting large amounts of bright red blood- history of alcohol abuse or liver disease- signs and symptoms of hypovolemic shock
Q: ulcers
Answer: open wounds along the digestive tract, often the stomachS/S:- history of ulcers- abdominal pain in the left upper quadrant- nausea and vomiting- increase in pain before meals and during stress
Q: Abdominal aortic aneurysm
Answer: a weakening of the wall of the aorta in the abdominal region, prone to rupture which causes rapid, fatal bleeding.S/S:- most common in geriatric males- tearing back pain- signs and symptoms of hypovolemic shock- pulsating abdominal mass
Q: pelvic inflammatory disease
Answer: painful and requires treatment. Nonemergency transport is recommended.S/S:- abdominal pain- fever- pain during urination- pain while walking
Q: Urinary Tract infection
Answer: S/S:- abdominal pain- hematuria- painful or frequent urination- fever, nausea, vomiting
Q: Kidney stones
Answer: crystals formed in the kidneys that cause an obstruction in the urinary tractmore likely in malesS/S:- severe abdominal pain, groin pain- painful urination, fever, nausea, and vomiting
Q: Kidney failure
Answer: kidneys are no longer able to function sufficiently. Water and toxins accumulate and dialysis may be needed.Dialysis artificially removes excess fluid and waste products from the blood
Q: air med transport
Answer: extended extrication time, no other ALS providers available, closest trauma centers unavailable, multiple patients requiring transport, traffic conditions delay ground transport, and distance to trauma center greater than 20 miles
Q: level one trauma center
Answer: capable of handling all types of trauma 24/7. This includes on-site trauma teams, surgical capabilities, trauma intensive care unites, and rehabilitation services
Q: level two trauma center
Answer: capable of stabilizing trauma patients and transferring to a Level 1 trauma center
Q: level three and four trauma centers
Answer: limit services and ability to stabilize trauma patients
Q: arterial bleed
Answer: spurting, bright red blood
Q: venous bleed
Answer: steady flow of dark red blood
Q: capillary bleed
Answer: slow oozing of dark red blood. May be mixed with clearish fluid
Q: abrasion
Answer: a scape to the skin due to surface friction
Q: laceration
Answer: a jagged cut
Q: penetrating wound
Answer: puncture wound
Q: incision
Answer: a sharp, clean cut
Q: avulsion
Answer: injury caused by a flap of skin being torn partially or completely loose
Q: crush injury
Answer: may be open or closed
Q: compartment syndrome
Answer: caused by compression of nerves, blood vessels, and muscle in a closed space within the bodytissue cannot receive adequate blood supply and may diecrush injuries can lead to this
Q: evisceration
Answer: open abdominal injury with external organs protruding- cover with moist sterile dressing- cover moist dressing with an occlusive dressing- flex legs to reduce abdominal contraction- treat for shock- high priority transport
Q: impaled objects
Answer: should be stabilized in place UNLESS it creates an airway obstruction or is in the chest and prevents CPR
Q: open neck injury
Answer: cover open neck wounds with an occlusive dressing to prevent air embolism
Q: partial thickness burn
Answer: (second degree) burnepidermal and partial dermal injurypainful, blisters present
Q: superficial burn
Answer: (first degree) burnepidermal damage onlypainful, red, no blisters
Q: full thickness
Answer: (third degree) burninjury completely through dermal layerdry, leathery skin; no pain
Q: Rule of nines
Answer: – burns with respiratory compromise- full-thickness circumferential burns- partial thickness burns covering more than 30% of TBSA- burns with associated trauma, such as fractures- full-thickness burns to the airway, hands, face, feet, or genitalia- full thickness burns covering more than 10% of the TBSA- all moderate burn criteria for patients under 5 or over 55 years of age
Q: severe burn injuries
Answer: -full thickness burns covering 2-10% of the TBSA- partial-thickness burns covering 15-30% of TBSA- superficial burns covering more than 50% TBSA
Q: moderate burn injuries
Answer: – full thickness burns covering less than 2% of TBSA- partial-thickness burns covering less than 15% of TBSA- superficial burns covering less than 50% TBSA
Q: minor burn injuries
Answer: can be open or closed injuriesthe scale is highly vascular and bleeds heavily when lacerated
Q: scalp injuries
Answer: indicate potential injury to the braininclude:- linear- basal- depressed
Q: skull fractures
Answer: most skull fractures are __________ fractures and do not present with deformity or depression
Q: linear fracture
Answer: ___________ skull fractures may be noticeable upon palpation; increased risk of brain injury due to bone being displaced into brain tissue
Q: depressed fracture
Answer: these fractures occur at the base of the skull; cerebrospinal fluid may leak from nose or earsS: Battle’s sign, raccoon eyes
Q: basal skull fracture
Answer: bruising behind the ears
Q: Battle’s sign
Answer: What is this condition
Q: raccoon eyes
Answer: causes brain function to be disrupted in some mannerS/S: (typically occur rapidly and gradually improve)- altered LOC- brief loss of consciousness- nausea- vomiting- irritability- repetitive questioning- vision problems- amnesia
Q: concussion
Answer: can’t remember what happened after the injury
Q: anterograde amnesia
Answer: can’t remember events before the injury
Q: retrograde amnesia
Answer: often accompanied by edema and concussion injuriesS/S:- signs of concussion and at least one of the following–decreasing mental status–unresponsive–pupillary changes–changes in vital signs–obvious behavioral abnormalities
Q: cerebral contusion
Answer: bleeding beneath the skull but above the dura mattertypically significant arterial bleedingextremely dangerous due to increase in intracranial pressureoften accompanied by temporal skull fractureS/S:- brief loss of consciousness- LOC deteriorates- worsening LOC- headache- seizures- vomiting- posturing- hypertension- bradycardia- changes in respirations- pupillary changes
Q: epidural hematoma
Answer: bleeding above the brain (beneath the dura mater and above the arachnoid meningeal layer)often caused by venous bleeding following a cerebral contusionS/S:- vomiting- decreasing LOC- pupillary changes- unilateral weakness or paralysis- hypertension- changes in respirations- headaches- seizures
Q: subdural hematoma
Answer: bleeding within the subarachnoid spaceallows blood to enter the cerebrospinal fluiddue to trauma or a ruptured aneurysmS/S:- headache- stiff neck- neurological impairment- decreased LOC- seizures
Q: subarachnoid hemorrhage
Answer: bleeding within the brain tissuepatients can deteriorate rapidlyhigh mortality rate
Q: intracerebral hemorrhage
Answer: when the brain is compressed due to excessive ICPS/S:- Cushing’s reflex
Q: herniation syndrome
Answer: a response with these symptoms- hypertension- bradycardia- altered respiratory pattern
Q: Cushing’s reflex
Answer: What is the severity of a head injury with a GCS between 13-15?
Q: Mild
Answer: What is the severity of a head injury with a GCS between 9-12?
Q: Moderate
Answer: What is the severity of a head injury below 8?
Q: Severe
Answer: accumulation of air in the pleural space which can compress lung space, preventing gas exchangecan be due to trauma or nontraumatic injury to lung tissuelung sounds may be diminished or absent over injured area
Q: Pneumothorax
Answer: an open chest injury that penetrates the pleural space which draws air during inhalationshould be covered with a three-sided occlusive dressing to prevent air from entering the chest cavity
Q: sucking chest wound or open pneumothorax
Answer: bleeding into the pleural space
Q: hemothorax
Answer: All of these signs are a part of what?- JVD- muffled heart sounds- narrowing pulse pressure
Q: beck’s triad
Answer: a portion of the thorax becomes separated from the rest, caused by fracture of at least two consecutive ribs in two or more placesS/S:- paradoxical motion of the chest
Q: flail chest
Answer: _____ organs bleed when injured. Include spleen, liver, kidneys, and pancreas
Q: solid
Answer: What are the solid organs of the body?
Q: spleen, liver, kidneys, and pancreas
Answer: _______ organs can spill their contents when injured. primary risk is infection. Include stomach, intestines, and urinary bladder
Q: hollow
Answer: What are the hollow organs of the body?
Q: stomach, intestines, urinary bladder
Answer: What is the referred pain in the shoulder caused by blood in the peritoneal cavity?
Q: Kehr’s sign
Answer: What are the patient factors that influence heat and cold emergencies? (4)
Q: Age, general health and nutrition, environmental conditions, medications and alcohol
Answer: What are the main two systemic effects of cold on the body?
Q: Vasoconstriction and slowing of metabolic rate
Answer: direct transfer of heat through contact with a colder structure. ex: bare feet on a cold floor
Q: Conduction
Answer: loss of heat to passing air. ex: standing in a cold breeze
Q: Convection
Answer: loss of heat through _______ of water from the skinex: getting out of the pool or shower
Q: Evaporation
Answer: in a cold environment, exhaled air has been warmed within the body, heat is lost on exhalation
Q: Respiration
Answer: transfer of radiant heat ex: entering a walk-in freezer
Q: Radiation
Answer: a systemic cold emergency, affects the entire bodyS/S:- skin: cold, pale, cyanotic- shivering: ceases with extreme hypothermia- loss of coordination: muscles begin to stiffen, difficulty speaking- altered LOC: confused to comatose- vitals: bradycardia, bradypnea, hypotension
Q: hypothermia
Answer: develops when body parts get very cold but are not yet frozenS/S: pale, cold skin, loss of sensation in affected areas
Q: frostnip
Answer: immersion foot, prolonged exposure to cold and water
Q: trenchfoot
Answer: most dangerous local cold emergencytissue is frozen, which frequently leads to permanent damageS/S:- hard, frozen tissue- possible blistering- possible mottling
Q: frostbite
Answer: What are two systemic effects of heat on the body?
Q: Vasodilation and an increase in metabolic rate
Answer: local heat emergencyelectrolyte imbalance and dehydrationmanagement: rest, rehydration, restoration of electrolytes
Q: heat cramps
Answer: systemic heat emergency, occurs frequentlyheat exposure and hypovolemiaS/S:- exertion in warm environment- dizziness, weakness- nausea, vomiting- headache- muscle and abdominal cramps- thirst- tachycardia
Q: heat exhaustion
Answer: uncommon, extremely dangerous systemic emergencybody loses its ability to regulate body heat, can develop due to exertion, passive exposureS/S:- similar to heat exhaustion- altered or decreased LOC- hot and dry skin- seizures
Q: heatstroke
Answer: common cause of bleeding in the third trimester, occurs when the placenta attaches to the uterus over the cervical openingS/S:- painless vaginal bleeding in the third trimester
Q: placenta previa
Answer: premature separation of the placenta from the uterine wall leading to bleedingoxygen and nutrient delivery to fetus is compromisedmaternal blood loss can be severe
Q: abruptio placenta
Answer: when the egg is implanted outside of the uterus, usually in the fallopian tubecan lead to rupture and severe bleedingS/S: severe abdominal pain without bleeding
Q: ectopic pregnancy
Answer: the uterus thins as it grows, increasing risk of rupturedanger to mother and fetus is highS/S: abdominal pain, vaginal bleeding
Q: uterine rupture
Answer: (miscarriage) delivery of the fetus before it is capable of surviving. This is prior to about the 20th-22nd week of pregnancyS/S: cramping, lower abdominal pain, vaginal bleeding, passage of tissue or clots
Q: spontaneous abortion
Answer: typically occurs in the third semesterS/S: include sudden weight gain, visual disturbances, sudden swelling of the face, hands or feet; headache, hypertension
Q: preeclampsia
Answer: occurs when the mother seizes following preeclampsialife threatening condition for mother and fetus
Q: eclampsia
Answer: blood pressure in a pregnant patient above 140/90 at least twice at six hours apartS/S:- same as preeclampsia
Q: Pregnancy induced hypertension
Answer: occurs when the fetus compresses the inferior vena cava, can lead to a severe drop in blood pressureusually in later stages of pregnancy, mother is supineS/S:- dizziness- hypotension- pale skin- altered LOC
Q: supine hypotensive syndrome
Answer: What stage of labor is this?begins with the onset of contractions and ends with full cervical dilation to 10cmmucus plug leavesamniotic sac may rupture spontaneously
Q: First stage
Answer: begins with full cervical dilation and ends with delivery of the babycontractions are close together
Q: Second stage
Answer: begins once baby is delivered and ends with delivery of the placentaplacenta delivers within 30 minutes after delivery of baby
Q: third stage
Answer: AppearanceWork of BreathingCirculation to Skin
Q: pediatric assessment triangle
Answer: a blood clot in a large vein, usually in the lega loose clot can cause a pulmonary embolism
Q: deep vein thrombosis
Answer: increased risk in geriatric patientsS/S:- vomiting blood- coffee-ground emesis- bloody stool- dark, tarry stool- severe back or flank pain- pulsating abdominal mass
Q: GI Disorders
Answer: truck chassis with modular ambulance body
Q: Type 1 Ambulance
Answer: standard van design
Q: Type 2 Ambulance
Answer: specialty van design with a square patient compartment mounted on the chassis
Q: Type 3 Ambulance
Answer: contaminated areaappropriate PPE is requiredRegardless of paitent condition, those without proper training and PPE are NOT permitted in the hot zonePatient Care NOT in hot zone
Q: hot zone
Answer: area between hot and cold zonesonly life-threatening conditions are treated in the warm zoneeveryone must be decontaminated in the warm zone before
Q: Warm zone
Answer: most treatment is performed in this zoneTypically, EMS providers stay in this zone
Q: cold zone
Answer: NIMS provides an adaptive, standardized approach to any domestic incident which standardizes the command structure, terminology, training, etc.- Preparedness- Communications and Information- Command and Management- Resource Management- Ongoing Management
Q: National Incident Management System
Answer: done quickly to determine the patient’s basic condition and needsdone wherever the patient is locatedpatient’s condition is identified through the use of a triage tag
Q: Primary Triage
Answer: assessment done once the patient arrives in the appropriate treatment area
Q: Secondary triage
Answer: Highest patient priorityPrimary assessment problems, exhibit signs of shock or head injuryRED
Q: Immediate
Answer: Second patient priorityRequire treatment and transport but not immediatelyYELLOW
Q: Delayed
Answer: Third patient priorityLittle or no treatment by EMS”walking wounded”GREEN
Q: Minor
Answer: Last patient priority”expectant” patientsCardiac arrest, respiratory arrest, severe head injuriesTreated only after all other patients have been cared forBLACK
Q: Dead or Dying
Answer: injuries caused directly by the blast
Q: Primary blast injuries
Answer: injuries caused by the flying debris and shrapnel
Q: Secondary blast injuries
Answer: injuries caused by striking the ground or other objects
Q: Tertiary blast injuries
Answer: cause excess parasympathetic nervous system stimulationinclude: Tabun, Sarin, Soman, VX
Q: Nerve agents
Answer: cause pain, burns, and blisters to exposed skin, eyes, and respiratory tract”blistering agents”affected areas should be irrigated with copious amounts of water
Q: Vesicants
Answer: interferes with the body’s ability to deliver oxygen to the cells leading to severe hypoxia and death”blood agent”S/S:- dizziness- weakness- anxiety- nausea- tachypnea- seizures- respiratory arrest
Q: Cyanide
Answer: cause lung injury and are also known as “choking agents”S/S:- dyspnea- cough- wheezing- runny nose- sore throat
Q: Pulmonary agents
Answer: used to cause diseaseS/S:- fever- weakness- respiratory distress- flulike symptoms