EMT 106 Mid-Term Review

Anticipated EMT Levels
EMR Emergency Medical Responder
EMT Emergency Medical Technician
AEMT Advanced Emergency Medical Technician
Paramedic

Engineering Control
precautionary measures that isolate or remove the bloodborne pathogens hazard from the work place.

Agency affiliation

Good samaritan law
A series of laws, varying in each state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care.

BVM difficulties
Decreasing cardiac output
Gastric distension
Hyperventilation

Palpation of abdominal quadrants
Asses the four quadrants of the abdomen, palpate and asses DCAPBTLS

Exam of responsive/nonresponsive

Rectal/vaginal bleeding

Documentation
confidentiality, patient refusals, falsification, and error correction.

Nitro indications/contraindications
indications-chest pain, heart attack
contraindications-ED drugs, low blood pressure

administer 0.4 mg only 3 times or less

Tall/thin spontaneous pneumothorax
More likely to have a weak spot that can rupture with a caugh

Small volume nebulizer
a respiratory device that holds liquid medicine that is turned into a fine mist. The patient inhales the medicine into the airways and lungs as a treatment for conditions like asthma. The patient inhales the medicine into the airways and lungs as a treatment for conditions like asthma.

Actions of beta-blocker drugs
Reduces cardiac contractility (BP), decreases pulse.

Congestive heart-failure
syndrome where the heart is unable to pump enough blood to meet the body’s needs for oxygen and nutrients; as a result, fluid is retained and accumulates in the ankles and legs

Result of a R/L failure
Pulmonary Edema

Pulmonary edema
fluid filling of the spaces around the alveoli, eventually flooding into the alveoli

Glucose accuracy
insure proper training with agencies blood glucose meter, and check meters for malfunctions

Hyper/Hypoglycemia
(hyperglycemia) a condition in which the level of sugar (glucose) in the blood is high, as in diabetes mellitus; (hypoglycemia) condition in which the level of sugar (glucose) in the blood is low

Actions of glucose
Increases blood sugar
High glucose leads to increased ATP production, K+ channels close (more K+ inside the cell), depolarization of the cell will then open Ca2+ channels, Ca2+ enters the cell and insulin is secreted.

Postictal phase of seizure
pertaining to the period following a seizure or convulsion

Cincinnati stroke scale
Facial Droop, Arm Drift, Abnormal Speech

Aphasia stroke
partial or total loss of the ability to articulate ideas or comprehend spoken or written language, resulting from damage to the brain caused by injury or disease

Insulin
Hormone produced by the pancreas that is released when stimulated by elevated glucose levels. This hormone decreases blood sugar levels by accelerating the transport of glucose into the body cells where it is oxidized for energy or converted to glycogen or fat for storage.

Seizure
neuromuscular reaction to abnormal electrical activity within the brain

Vagal maneuver
method used to stimulate the vagus nerve in an attempt to slow conduction thru the AV node, resulting in slowing of the heart rate

When to administer epi-pen
As soon as the allergic reaction become anaphylaxis and life threats are present.

Epi dose
One adult dose is 0.3mg
one infant or child dose is 0.15mg

Epi actions/side effects
Actions-dilates bronchioles, constricts blood vessels, makes the capillaries less permeable.

Side effects-increased heart rate, pallor, dizziness, chest pain, anxiety

Epi site time
inject into thigh and hold in place for 10 seconds to ensure the full dosage has been administered.

Alcohol withdrawl
begins 6-8 hours after last drink
s/s: irritability, anxiety, insomnia, tremors, sweating, mild tachycardia

Activated charcoal dosage
1. Adults and children: 1 gram of activated charcoal/kg of body weight.
2. Usual adult dose: 25 – 50 grams.
3. Usual pediatric dose: 12.5 – 25 grams.
Mix with soda for easier consumption

Time of drug ingestion
Know when to administer drugs

Recreational drug routes
Intravenous, inhalation, sublingual

Pt. refusal /contact med control
Contact medical direction when you receive a patient refusal

S/S Appendicitis
lower R quadrant pain, fever, N/V, positive rebound tenderness (blumberg’s sign), positive obturator test

S/S Cholecystitis
indigestion, moderate to sever pain, fever, jaundice, tenderness RUQ possible referred to R shoulder/ scapula. Possible N&V, restlessness, diaphoresis, leukocytosis, fever.

S/S Pancreatitis
Symptoms–
Severe abdominal pain, poorly localized, frequently radiates to back

S/S Aortic aneurysm
anterior chest pain, may radiate to back
excruciating, tearing pain sudden onset, last hours to days
pain unrelated to anything
BP Lower in left arm

parietal pain/visceral pain
Visceral pain-A poorly localized, dull or diffuse pain that arises from the abdominal organs, or viscera.
Parietal pain A localized, intense pain that arises from the parietal peritoneum, the lining of the abdominal cavity.

Hypothermia effects
– slows chemical reactions
– increases blood viscosity
– encourages blood coagulation
– stimulates vasoconstriction
– to overcome, the hypothalamic center stimulates shivering to increase heat production
– muscular processes become sluggish

Head trauma
Injury to the head and, therefore, to the brain, typically caused by accidents; can lead to cognitive impairments, including memory loss.

Mind altering substance effects

Behavioral emergencies: how to act
careful scene size-up
Identify yourself and your role
Complete primary assessment
Perform as much of a detailed examination as possible
Gather a thorough patient history

Spitting patients
BSI

Pt. priorities
Know when to transport and who to transport

Reasonable force
The force necessary to keep a patient from hurting themselves

Suicidal pts
Be nice, talk to them and gain trust. then slap them for being selfish!

End stage renal disease
refers to the late stages of chronic renal failure in which there is irreversible loss of the function of both kidneys

Hemodialysis
dialysis of the blood to remove toxic substances or metabolic wastes from the bloodstream

AV fistula
Surgically connects an artery to a vein

Sickle cell anemia
A genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape

Renal system anatomy
two kidneys, two ureters (to carry urine from each kidney to the bladder) and a single urethra (to carry urine from the bladder to the outside of the body)

Types of shock
Hypovolemic: due to external hemorrhage, lacerations, or plasma loss due to burns
Septic: due to massive infection
Vasogenic, Neurogenic: patients that suffer head or spinal trauma resulting in a failure of arterial resistance
Cardiogenic: resulting from cardiac failure
Allergic or anaphylaxis: results from being injected with a foreign protein, bee stings, iodinated contrast media

Bleeding characteristics
Arterial-spurting blood, pulsating flow, bright red color
Venous-steady; slow flow dark red
Capillary-slow even flow

Use of tourniquet
2 inches proximal of wound, in distal of joint if joint can be saved.

Body response to blood loss
Altered mental status
pale, cool and clammy skin
Nausea and vomiting
Vital sign change

Stages of shock
Compensatory – body can maintain nearly normal levels.
Decompensatory – failing blood pressure & perfusion.
Irreversible – Death from organ, tissue & cell failure.

Leading cause of internal bleeding
Blunt Trauma
* Falls
* Motor-vehicle or motorcycle crashes
* Auto Pedestrian collisions
* Blast Injuries

Time on scene
the faster the better

Skin anatomy
Heat loss-
Shock absorption-

Avulsions
open injury, flap created by damage to skin and tissues

Impaled objects
Leave them, unless they jeopardize a patent airway

Eviscerations
opening in abdominal wall with loops of intestines protruding, DO NOT PUSH IN, sterile dressing, may be moistened with sterile saline, occlusive dressing to prevent drying

sprains/strains
Sprains-excessive stretching of a ligament
Strains-Tearing or overstretching of a muscle. Tendons attach muscles to bone.

Burns-rule of 9s
face-9 (total f&b)
each arm-9 (total f&b)
each leg-18 (total f&b)
chest-36 (total f&b)
genital-1

Chest injuries
Blunt trauma
penetrating objects
compression

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

Tendons/ligaments
tendons-Connect muscle to bone
Ligaments-connect bone to bone

Direct/indirect force
Direct force-Force caused by a direct blow to an area of the body
Indirect force-a force that causes injury some distance away from the point of impact

Compartment syndrome
involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles

Blood loss from fractures
Femur-2 pints
Pelvic fracture-3-4 pints

Types of fractures
Greenstick;children-incomplete fracture.
Epiphyseal; children-growth section, growth abnormalities. Comminuted;broken in more than 2 fragments.
Pathological; weakened or diseased bone.
Oblique; across the bone, angled.
Transverse; across bone from direct blow or running.
Spiral; twisting force.
Incomplete; partial crack.

Open/closed head injuries

Cushing’s triad
widening of pulse pressure, irregular respirations, and bradycardia; is a sign of increased ICP

Penetrating injuries
Exit wounds

Jaw injuries

Glasgow coma scale
It is a widely accepted measure of level of consciouness and responsiveness. It relates consciousness to three elements or response. Eye opening (E) with a max possible score = 4, Motor response (M) with a max possible score = 6, and verbal response (V) with a max possible score = 5.
Score = (E+M+V)
Max score = 15 and lowest score = 3.
A score of ≤ 8 signifies coma or severe brain injury

Result of severed jugular vein

Air embolism
obstruction of the circulatory system caused by an air bubble as, e.g., accidentally during surgery or hypodermic injection or as a complication from scuba diving

Result of levels of spinal cord injuries

Helmets remove/do not remove
remove-interferes with the EMT’s ability to assess and manage airway and breathing
Helmet is improperly fitted
interferes with immobilization
cardiac arrest patient

Do not remove-fits snugly, allowing little to no movement
nothing blocking airway, airway patent
removal would cause further damage

Vehicle extrication

Result of intercranial pressure
the brain is forced into the opening base of skull called the Foramen magnum

Actions/side effects of aspirin
actions: prevents blood from clotting as quickly
side effects: nausea, vomiting, heartburn, bleeding, if allergic wheezing and bronchospams

dosage-320 mg

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