question

Sympathetic Nervous System

answer

Nor-epinephrine, controled from lower thoracic and lumbar Beta 1 is cardiac Beta 2 is respiratory ie; bronchodilation

question

Parasympathetic Nervous System

answer

Acetylcholine released by Vagus nerve Controls sludge Constricted pupils

question

Metabolic acidosis

answer

Cardiac or Respiratory arrest, aspirin overdose. Treatment: ventilate with oxygen and sodium bicarb

question

Metabolic Alkalosis

answer

too much bicarb, let it wear off

question

Respiratory Acidosis

answer

hypercarbia, respiratory distress. Treatment: Increase ventilation with a BVM. treat underlying causes. tube Patient if needed.

question

Respiratory Alkalosis

answer

Hyperventilation, some head injuries, response to DKA, Hyperglycemia, ventilating patient too fast. Blown off too much CO2

question

Inadequate perfusion

answer

Epinephrine release, restlessness, lowered LOC, Cold and clammy, dilated pupils, blood pressure will be hypotensive, HR is up, RR is up

question

Hypovolemia

answer

-Cause: Blood or Fluid loss -Sign:Tachycardia, Tachypnea, diaphoresis, restless, thirst, narrow pulse pressure, dilated pupils. -Treatment: stop bleeding, adequate ventilation and oxygenation, maintain temp, 1 liter or 20 mL/kg

question

Neurogenic shock

answer

-Cause: Spinal injury (vasodilation without catecholamine release) -Signs: Paralysis, hypo-tension, normal or bradycardia heart rate, possible diaphragm breathing -Management: stabilize, C-Spine, use Dopamine for vasoconstriction

question

Cardiogenic Shock

answer

-Cause: Decrease in force of cardiac constriction (inotropic) -Signs:Tachycardia, Tachypnea, Diaphoresis, narrow pulse pressure, possibly pulmonary edema -Treatment: stabilize, fluid generally restricted due to pulmonary edema, Dopamine to increase cardiac contraction (Force and Rate)

question

Anaphylactic Shock

answer

-Cause: Reaction -Signs: Tachycardia, Tachypnea, red flushed skin, hives, cool, clammy wheezing, hypo-tension -treatment: stabilize, administer vasso, Epinephrine SQ or IM for shock.

question

Obstructive shock

answer

tension Pneumo, cardiac tapanade, trauma

question

pounds to Kilograms

answer

1 pound equals 2.2 kilograms

question

Upper Airway

answer

ends at vocal cords

question

JVD

answer

Tension Pneumothorax, Cardiac Tamponade, Right Sided Heart failure, traumatic asphyxia.

question

Hypoxemia

answer

low oxygen in blood; hypercarbia - Increased CO in blood

question

Medulla

answer

Respiratory center of brain

question

Failed attempt of intubation

answer

Use LMA or Dual lumen

question

Cricothyrotomy

answer

Ineffective breathing with clenched teeth, laryngospasms, facial trauma, and inability to ventilate by other means

question

Oxygen devices

answer

-cannula less than 40% -simple mask 40 to 60% -NRM greater than 90% -BVM with oxygen 90 - 100%

question

CO2 levels

answer

-normal is 35 - 45 -if its high ventilate faster -cardiac arrest patients will be low because of inadequate profusion Acidosis is patients not breathing enough will be higher than 45mmHg Alkalosis is patient breathing too much will be below 35mmhg

question

wheezing

answer

narrowing of small airways due to edema continuous, coarse, whistling sound expiration

question

Rales or crackles

answer

fluid in small airways clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation

question

Rhonchi

answer

Mucus in the large airways

question

Kussmaul respiration's

answer

is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) or renal failure. It is hyperventilation, which reduces carbon dioxide in the blood due to increased rate or depth of respiration.

question

Cheyne-Stokes respiration's

answer

progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing. Increased Cranial Pressure

question

Biots respiration's

answer

quick, shallow inspirations followed by regular or irregular periods of apnea. Increase Cranial Pressure.

question

Pupils

answer

Dilated - Cerebral hypoxia, cocaine, epinephrine, amphetamines Small - Narcotics or Organophosphate unequal - brain injury

question

Cullen's signs

answer

ecchymosis around umbilicus, bleeding in abdominal cavity

question

Murphy's sign

answer

Right upper quadrant pain due to gallbladder

question

Kehr's sign

answer

shoulder pain due to blood under diaphragm

question

Grey Turner's sign

answer

ecchymosis in flank, bleeding from kidney

question

Decorticate

answer

Flexed arms and extended legs

question

Decerebrate (worse)

answer

extended legs and outstretched arms

question

Vitals

answer

Adult 60 to 100 Heart Rate 12 to 20 Respiration child 65 to 110 Heart Rate 18 to 30 Respiration newborn 140 to 160 Heart Rate 40 to 60 Respiration

question

Shock

answer

1st - 15%, BP is maintained by vaso-constriction, tachy 2nd - 15 to 25%, Cardiac output not maintained, tachycardia, increased respiration 3rd - 25 to 35%, classic signs, tachycardia, increased respiration, decreased BP altered mental status, cool and pale skin 4th - Hypotension, lethargic, irreversible.

question

Burns

answer

-first degree - Partial thickness, red, pain, no blisters -second degree - Partial thickness, pain, redness, blisters. -third degree - Full thickness, dry, white, yellow, black, painless

question

Carbon Monoxide

answer

Headache, Confusion, Cherry red lips, cyanotic with false Oxygen reading.

question

meninges order

answer

Dura mater , arachnoid , Pia Mater

question

Brain

answer

Cerebrum - Grey Matter, personality, judgement, sight cerebellum - Balance, coordination, and muscle tone Stem - Mid-brain, Pons, medulla, Blood pressure, Heart Rate, breathing, consciousness

question

Hypothalamus

answer

Temperature regulation, Hormones

question

Peripheral Nervous System

answer

Afferent - sensory nerves (ascending) Body to brain Efferent - Motor (descending) Brain to Body

question

Cerebral Injuries

answer

Sub-Dural Hematoma - below dura mater, but above pia mater (slower bleed) venous Epidural Hematoma or hemorrhage - Above dura -between dura and skull- arterial, middle meningeal artery, unconscious, then conscious, then unconscious (lucid interval)

question

Cushing's Response

answer

High Blood pressure, Low Heart Rate, Irregular Respiration, Cheyne-Stokes

question

Increased Cranial Pressure

answer

consider ventilating 20 to 24 times per minute, Mannitol (osmotic diuretic) ET tube may increase pressure

question

Alpha vs. Beta

answer

Alpha constricts Beta dilates

question

12 Lead ECG

answer

2, 3, AvF - Inferior Wall 1, AvL, V5, V6 - Lateral Wall V1, V2 - Septal V3, V4 - Anterior

question

the 6 P's or trauma

answer

Pulselessness, parethesia , paralysis, pallor, pain, and Pressure

question

Cardiac Tamponade

answer

Hypotension occurs because of decreased stroke volume, jugular-venous distension due to impaired venous return to the heart, and muffled heart sounds due to fluid inside the pericardium. These combination of symptoms are known as Beck's Triad

question

Pulse-less Paradox

answer

Narrowing pulse pressure

question

Chronic Obstructive Pulmonary Disease (COPD)

answer

Rely on hypoxic drive Bronchodilators

question

Emphysema

answer

Pink puffer, pursed lips, barrel chest, active expiration

question

Chronic Bronchitis

answer

Blue bloater, coughing, mucus, overweight, cyanotic, Rhonchi

question

Asthma

answer

Wheezing, silent chest Albuterol, Beta 2 antagonist , Epi

question

Rule of 9's

answer

Adult: Head and Neck 9%, Chest and Abdomen 18%, Butt and Back 18%, each Arm 9%, each Leg 18%, and Genitalia 1%. Pediatric: Head and Neck 18%, Front Trunk 18%, Back Trunk 18%,Chest, each Arm 9%, each Leg 14%.

question

Glasgow Coma Scale

answer

Eyes - 4 opens, 3 to voice, 2 to pain, 1 doesn't open verbal - 5 Oriented, 4 confused, 3 inappropriate, 2 incomplete, 1 none Motor - 6 obeys, 5 localizes pain, 4 withdraws, 3 flexion, 2 extension, 1 none

question

H's and T's

answer

Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyper or hypokalemia, Hypoglycemia, Hypothermia Toxins, Tamponade (cardiac),Tension pneumothorax, Thrombosis (coronary and pulmonary), and Trauma.

question

First-degree heart block

answer

PR interval is lengthened beyond 0.20 seconds

question

Second Degree Type One (Mobitz I or Wenckebach)

answer

progressive prolongation of the PR interval until the QRS drops off essentially restarting the rhythm

question

Second Degree Type Two (Mobitz II)

answer

Non-conducted P waves, P Waves not followed by a QRS complex

question

Third-degree (complete heart block)

answer

SA node in the atrium does not propagate to the ventricles No apparent relationship with P waves and QRS complex.

question

Epinephrine

answer

Asthma, Allergies, asystole, PEA, V-Fib, V-Tach Asthma and Allergic Reaction 1:1,000 SQ/IM .3 - .5 mg (or mL) Anaphylaxis (Hypo-tension) 1:10,000 IV .3 - .5 mg (or mL) Asystole 1:10,000 IV 1 mg 0.01 mg/kg pediatric dose Alpha and Beta stimulator; Bronchodilator Positive inotropic and chronotropic

question

Atropine

answer

Symptomatic bradycardia, organophosphate poisoning .5 mg IV push every 3 - 5 minutes, max 3 mg 2 - 5 mg for organophosphate .02 mg/kg Pediatric Dose Parasympathetic Blocker, PVC's, or hypo-tension with bradycardia

question

Amiodarone

answer

Antidysrhythmic 300 mg IV for V-Fib, 150 mg over 10 minutes for stable tachycardia contraindications - bradycardia, hypo-tension Blocks sodium and calcium channels

question

Adenosine

answer

SVT, Atrial Tachycardia, PSVT, slows conduction throught the SA and AV node 6 mg then 12 mg

question

Lidocaine

answer

PVC's, V-Tach, V-Fib, wide complex tachycardia 1 - 1.5 mg/kg IV bolus 1 mg/kg pediatric dose reduce by 50% when over 70 or liver disease

question

Cardizem

answer

A-Fib or A-Flutter Calcium Channel Blocker do not give if patient is on beta blockers

question

Calcium Chloride

answer

Calcium Channel overdose, hypocalcaemia, hyperkalemia, Mag sulfate overdose

question

Magnesium Sulfate

answer

Torsades de Pointes 1 - 2 grams for cardiac arrest 2 - 4 IV for Eclampsia

question

Sodium Bicarbonate

answer

Severe acidosis with respiratory problems 1 mEq/kg repeat in 10 minutes at .5 mEq/kg

question

Nitroglycerin

answer

Chest pain and Pulmonary Edema .4 mg sub-lingual vasodilator, decreases workload of heart, contraindication Hypotensio

question

Morphine Sulfate

answer

-Chest Pain during STEMI -not reduces by 3 doses of Nitro- -2 - 5 mg IV may be repeated -decreases pre-load and after-load, decreases venous return, CNS depression. -dont use with head injury, hypo-tension, and undiagnosed abdominal pain.

question

Lasix - Furosemide

answer

-Pulmonary Edema, CHF, Hypertension -20 to 40 mg IV slowly, up to 100 mg -Vasodilation within 5 minutes, Diuretic within 15 minutes

question

Digitalis

answer

-CHF or A-Fib -positive inotropic, negative chronotropic -electro-therapy can exacerbate

question

Aspirin

answer

-Anti-coagulant -160 - 325 mg -signs of overdose: Ringing in ears, tachycardia, metabolic acidosis, respiratory alkalosis

question

Dopamine

answer

-Cardiogenic and Neurogenic shock -IV drip usually 800 mg in a 500 mL in D5W - 1 to 2 units per kg dopamine effect, vasodilation - 2 to 10 units per kg beta effect increase rate & force - 10 to 20 units per kg alpha effect

question

Albuterol

answer

- asthma, COPD, Bronchospasm - 2.5 mg in 2 - 3mL saline - 1.5 pediatric dose - Beta 2 stimulator

question

Dextrose 50 %

answer

- hypoglycemia & Alcoholism with coma - 50 mL which is 25 grams slow IV - with Alcoholism also give Thiamine 100 mg IM or IV - check BGL - Dont give with brain bleeds

question

Benadryl / Diphenhydramine

answer

- allergic reaction & anaphylaxis - 25 to 50 mg IV or IM - antihistamine

question

Narcan / Naloxone

answer

- Narcotic overdose and coma of unknown origin - 0.4 to 2 mg IV or IM - used for Morphine, Methadone, Codeine

question

Umbilical Cord

answer

2 arteries / 1 vein

question

Stages of Labor

answer

- first stage - start of labor till the complete dilation - second stage - dilation until the delivery - third stage - delivery until delivery of placenta

question

Prolapsed Cord

answer

- Mother in knee to chest - prevent pressure on cord, don't push back on chord

question

Post par-tum hemorrhage

answer

- over 500 mL in 24 hours - massage fundus - tell mother to breast feed

question

First Trimester Complication

answer

- abortion - lower abdominal pain, cramps, bleeding - Ectopic - one sided lower abdominal pain, spotting, shock, possible syncope

question

Third Trimester Complication

answer

- Abruptio Placenta - tearing away of placenta, bright red blood associated with trauma with pain - Placenta Previa - completely or partially covering cervix, no pain - Toxemia

question

Sub-Arachnoid Bleed

answer

Sudden onset of severe, explosive headache, unconscious

question

Space Occupying lesion

answer

Tumor, blood Increased Cranial Pressure

question

AEIOU-TIPS

answer

Alcohol, Endocrine, Electrolytes, Encephalopathy,Insulin, Opiate, Uremia, Trauma, Intracranial, Poisoning, Seizure

question

Pituitary

answer

In the brain oxytocin

question

Adrenal

answer

Superior portion of kidney epinephrine and nor-epinephrine Disorders Addison's disease, adrenal gland failure Cushing's disease, over production of adrenal hormone

question

Thyroid Disorders

answer

Graves Disease- Hyperthyroidism, weight loss, heat intolerance, agitation, tachycardia

question

Upper GI hemorrhage

answer

Black tarry stools, vomiting blood or coffee ground colored. may be an ulcer

question

Lower GI Bleed

answer

bright red bloody stool

question

Appendicitis

answer

Right Lower Quadrant pain, no appetite, low fever unless ruptured, constipation

question

Kidney Stone

answer

severe flank pain, hemauria, sweating, pale

question

Renal Failure

answer

Fluid overload or Hypovolemia Before dialysis = hyperkalemia, Tall peaked T waves Post dialysis = hypo-everything, electrolyte imbalance complications of dialysis is air embolism, disequilibrium

question

Tricyclic Antidepressant

answer

Mellaril, Tofranil, Elavil, amytriptyline treat with sodium bicarb

question

Aspirin Overdose

answer

Hyperventilation, tachycardia, fever, sweating, ringing of the ears metabolic acidosis and respiratory alkalosis

question

Heat Emergencies

answer

Heat cramps = cramps, sodium and water loss Heat exhaustion = Tachycardia, dizzy, headache, weak, pale, hypo-tension Heat Stroke = temperature 105 to 106, unable to regulate heat, hot and dry, lowered level of consciousness

question

Hypothermia

answer

90 to 86 degrees = mild hypothermia = 1 round of meds 86 degrees or lower = No meds, only defib if V-Tach warmed IV fluid

question

Meningitis

answer

fever, stiff neck, headache, backache, bulging fontanels with infants.

question

Hepatitis

answer

Fever, right upper quadrant pain, no appetite, jaundice, dark urine, clay colored stool Hepatitis A is viral Hepatitis B is blood-borne

question

tuberculosis

answer

night sweats, cough, weight loss, hemoptysis or bloody sputum. Common in HIV patients

question

Infants

answer

Toe to Head

question

Triage Colors

answer

Red = Emergency Yellow = Delayed Green = Minimal Treatment Black = Dead or Mortal Injury

question

HAZ-MAT

answer

Red = Fire Hazard Blue = Health Hazard Yellow = Reactivity White = Special Instructions 0 to 4 scale with 4 being the highest risk

question

Ambulance Types

answer

Type 1 = Truck with Modular based with pass through Type 2 = Van Type 3 = Van chassis with modular back with pass through

question

FDA

answer

Controlled Substance Act of 1970 Schedule drugs are addictive Schedule 1 has no medical use Schedule 2 has medical use

question

Right Upper Quadrant

answer

Liver Gallbladder Stomach

question

Right Lower Quadrant

answer

Appendix Ovary and Tube Bladder / if distended

question

Left Upper Quadrant

answer

Spleen Liver Stomach Pancreas

question

Left Lower Quadrant

answer

Ovary and Tube

question

Micro-drip

answer

60 drops per Milliliter

question

Macro-drip

answer

10 drops per milliliter

question

Traumatic Asphyxia

answer

Caused by crushing injury to abdomen and lower chest signs are bulging eyes and tongue along with cyanoisis and JVD

question

Syphilis

answer

Chancre and tabes dorsalis

question

Gonorrhea

answer

women may be asymptomatic, men may have burning while urination

question

Spread by droplets

answer

Measles, mumps, rubella, and chicken pox

question

Psychiatric patients

answer

rule out metabolic causes such as drugs, alcohol, seizures, and hypoglycemia open ended questions keep eye contact

question

psychotic vs neurotic

answer

psychotic not in touch with reality

question

Length of Pregnancy

answer

40 weeks or 280 days

question

Stages of Development in Pregnancy

answer

Pre-embryonic 1 to 14 days Embryonic 15 days to 8 weeks Fetal 8 weeks to delivery

question

Hypertensive syndrome aka Preeclampsia

answer

Preeclampsia is before seizure, eclampsia is after seizure S & S Hypertension, Protein in urine, swelling, epigastric pain, and hyper reflexes Mag sulfate, is seizing continues give Valium

question

Febrile Seizures

answer

Under age of 6 cool but dont allow shivering meningitis

question

Pediatric Drug Doses

answer

Atropine .02 milligrams per kilogram Lidocaine 1 milligrams per kilogram Valium .2 milligrams per kilogram Charcoal 1 gram per kilogram Albuterol .15 milligrams per kilogram

question

Signs of Pediatric shock

answer

Compensated: mottled, pale, weak pulse, tachycardia, BP may be normal slow cap refill De-compensated: Hypotension, low urine output, low BP, lowered LOC

question

When the body's blood glucose level falls

answer

the pancreas secretes glucagon, which stimulates the liver to convert glycogen to glucose.

question

Highest tidal volume

answer

pocket mask

question

Curved Blade aka Macintosh

answer

goes in the vallecula

question

Position to check for JVD

answer

Semi-Folwlers

question

QRS

answer

Ventricular Polarization

question

Blood leaves the lung and goes to

answer

Left Atrium

question

Burns

answer

Plasma shifts to interstitial space

question

Elderly Patient

answer

output more than input aka electrolyte imbalance

question

Nasogastric tube

answer

gets in way of of seal or intubation

question

Left-sided failure

answer

Common signs are tachypnea and increased work of breathing. Rales or crackles, heard initially in the lung bases, and when severe, throughout the lung fields suggest pulmonary edema. Cyanosis which suggests hypoxemia is a sign of extremely severe pulmonary edema.

question

Right-sided failure

answer

Ascites, JVD, Swelling of feet and ankles, and Shortness of breath

question

Avulsions

answer

most blood loss

question

Inotrope

answer

is Contraction

question

Chronotrope

answer

is Rate

question

Dromotropic

answer

is Rhythm

question

C1 and C2

answer

No breathing

question

C4, C5, and C6

answer

intercostal muscles, difficulty breathing, uses diaphragm and accessory muscles. quadriplegic

question

T4

answer

nipple line, still breathing

question

T10

answer

umbilicus

question

pH 7.35 to 7.45

answer

amount of hydrogen ions in the blood Above 7.45 is Alkalosis, Below 7.35 is acidosis

question

PaCO2 35 to 45

answer

Respiratory components Partial Pressure of Carbon Dioxide

question

PaO2 or Blood Oxygen

answer

80 to 100 below 80% is hypoxia

question

Bicarb or HCO3, 22 - 26

answer

Metabolic Component low bicarb is metabolic acidosis

question

Arterial Blood Gases

answer

respiratory acidosis = increase ventilation respiratory alkalosis = decrease ventilation metabolic acidosis = Bicarb, check O2 and ventilation metabolic alkalosis = discontinue Bicarb

question

Beta

answer

Increase cardiac output, heart rate in the SA node via a chronotropic effect, atrial cardiac muscle contractility with inotropic effect, contractility and automaticity of ventricular cardiac muscle bronchodilation

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