Florida State Paramedic Exam

. A dose of Atropine of less than 0.5 mg in an adult patient will result in?
bradycardia
Patient drinks pesticide, what would be your drug of choice?
atropine, organophosphate poisoning
Patient complaining of severe abd pain, excessive drooling, ect., what would you suspect?
organophosphate poisoning, SLUDGE
How do you treat a 3rd degree block?
TCP(Transcutaneous Pacing)
Know what patients not to pace
HR-55, R-20, BP-110/65-asymptomatic bradycardia
What are the side effects of lidocaine?
siezures
Pt has reaction to blood while enroute with a interfacility transfer, How to treat?
Discontinue blood products
What are side effects of diuretics?
Hypokalemia
What does the cerebellum control?
Fine motor skills
What is referred to as the master gland, “pea sized” or size of a grape
pituitary gland, its secretions control or regulate the secretions of the endocrine glands
R on T causes?
V-Fib
Pt has sinus brady with unifocal PVC`s, how do we treat this pt?
0.5mg atropine, treat the bradycardia not the PVC`s
What is a contraindication of Lidocaine?
sinus brady
Fluid resuscitation for a neonate?
10ml/kg
What is the wrongful act that gives rise to a civil suit called?
Tort
Patient is unconscious and ill, it is alright to treat this pt based on what?
Implied consent
A pt left in an ER for 20 mins before returning in order to run another call is an example of what?
negligence or abandonment..if answer key includes abandonment pick abandonment
When you inform a pt of the risks involved with refusing treatment and they agree to treat them they give you what?
informed consent
What offers you protection while off duty?
The good samaritan law
Anytime you are dispatched to a call you have a duty to what?
Duty to Act, it is prescribed by law as what we must do an how we must do it.
Anytime we leave a pt before official transfer we may be sued for what?
abandonment
What did the food, drug and cosmetic act do?
created FDA, required drug makers to label products and admit if they are habit forming, mandated dangerous drugs could only be dispensed with a prescription
What is the FDA charged with doing?
determining the safety and efficacy of drugs before they enter the market
Remember before allowing a pt to refuse treatment?
Must explain to the patient the severity of their condition and risks of refusing.
Can intoxicated pt`s sign refusals?
pt must have decision making capacity in order to refuse care
What causes negligence?
There was a duty to act, breech of duty, which was the proximate cause of harm, INTENT IS NOT NEEDED
What is a legal document indicating end of life request regarding resuscitation?
DNR-yellow in color
Emergency with a minor, no parents, what should the medic do?
treat the pt, assume implied consent
what is one of the first signs of hypovolemic shock?
Tachycardia
What is an early sign of any shock?
Altered mental status
How do we open a trauma pt`s airway?
Jaw thrust or modified jaw thrust
What is taking place in all forms of shock?
inadequate tissue perfussion
What is the most reliable indicator of how severe an injury is in trauma?
The mechanism of injury
Damage to tissues due to a high speed bullet is known as what?
cavitation
What is a physical finding of traumatic asphyxia?
cyanosis of the head, the upper extremities, and the torso above the level of the compression. SWELLING OF THE TONGUE AND LIPS!!!!
Fluid replacement for a trauma pt?
3x the estimated blood loss
Fluid of choice in trauma?
Lactated Ringers
How is traumatic asphyxia most commonly caused?
Crush injury, forceful compression of the thoracic cavity
What specifically can a crushing injury cause?
Compartment syndrome increased pressure within soft tissues
How do we treat someone with an abdominal evisceration?
Treat for shock, oxygen, cover organs, w/ moist saline soaked dressings, lactated ringers..DO NOT PUSH ORGONS BACK INTO ABDOMEN
Pt with JVD, mediastinal shift away from effected area and dypsnea,,what is it?
Tension Pneumothorax
how do we deal with explosive injuries?
Treat Airway, ventilate and oxygenate, stop arterial bleeding and treat closed femur fractures.
What is commonly injured in blast injuries?
Large intestines, hollow organs
What is the pathophysiology of neurogenic shock?
Spinal cord injury occurs resulting in complete dilation of all vessels below the injury, hence the fluid container of the body just got alot bigger an the normal 5L of blood is no longer sufficient so shock ensues.
Wht are S/S of neurogenic shock?
hypotension, bradycardia, lack of sweating below injury.
What is an early sign of ICP?
vomiting(without nausea), headache and altered LOC
What is cushings Triad?
Alater and ominous sign of ICP, Hypertension,. Bradycardia, and irregular respirations. HYPER BRADY!!!!
What will a pt`s pupils look like in Cushings Triad and what causes it?
unilaterally unequal and non-reactive pupil, pressure on the oculomotor nerve. Also posturing(decorticate and Decerebrate)
bleeding from nose and ear, what do you do?
allow to drain, it allows decrease of ICP!
What are the 2 most common forms of death from electrical burn injuries?
asphyxia and cardiac arrest
Rule of nines, head-adult?
9
Rule of nines, head-child?
12
Rule of nines, head infant?
18
Rule of nines chest/abdomen, adult, child and infant?
18
Rule of nines, arms, adult, child and infant?
9 a piece
Rule of nines, legs adult?
18 a piece
Rule of nines, legs child?
16.5 a piece
Rule of nines, legs infant?
13.5 a piece
In an electrical burn injury where will the current be most intense?
at the entrance and exit, causes a bulls eye lesion.
What is the maximum amount of fluid given to a trauma victim?
2000-3000 ml
Unconscious, no response to verbal or painful stimuli, what is this pt`s GCS?
3
What is significant about the pathway of an electrical burn and what can it cause?
It follows the nerve pathways, which can cause V-Fib and more internal then external damage
What is a AAA?
Abdominal Aortic Aneurism
What does a pt with a AAA when symptomatic look like?
Sudden onset of abdominal or back pain, pain centers on the umbilicus, can radiate to thigh or groin, PT MAY COMPLAIN OF AN URGE TO DEFECATE DUE TO THE LEAKING BLOOD IN THE RETROPERITONEAL SPACE, Look for a pulsatile mass in the abdomen
How do u treat AAA?
Get to the hospital!!!!
Place for needle decompression of Tension Pneumo-thorax?
14g needle.Mid clavicular between the 2nd and 3rd intercostal space or 4th and 5th of mid axillary
MVA, HR-120, BP-40 palp, whats happening?
De-compensating Hypovolemic Shock
Severe Angulated Leg, HR110, BP80/60?
Hypovolemic shock
What is Becks Triad?
It is a sign of Cardiac Tampenade, usually secondary to penetrating chest trauma
What are the tell tale signs of Becks Triad?
narrowed Pulse pressure, JVD, Muffled heart Tones, clear lungs
Flat neck veins, mid-line trachea,DEHYDRATION, HYPOVOLEMIA, dullness on percussion of chest?
Hemothorax
With abdominal injuries why palpate the painful quadrant last?
Once palpated the entire abdomen will hurt
What does the visceral Pleura cover?
thin slippery outer lining covers the lungs
What is the Parietal Pleura?
Lines the inside of the thoracic cavity, small amount of fluid is between the pleurae, reduces friction during breathing
What is effusion?
The escape of fluid into a cavity
#1 vertebrae, C1-C2, what is it referred to as?
Atlas or the joint of atlas
Collapsed steering wheel, what do we look for?
Flail Chest
What kind of nerve pathways send signals to the brain?
Affective Nerve Pathways, Affective=Ascending
What is the most common organ injured from blunt trauma?
Liver, RUQ
Motorcycle crash, 3″lac on head, tachy, Low BP, What is the fluid of choice?
Normal Saline KVO, do not want to fluid overload should ICP develop.
What do you not want to give a pt with a closed head injury?
SUGAR, no D5W, Normal Saline or Lac Rings only.
Fluid replacement for an adult trauma pt?
20ml/kg or 3x estimated blood loss
Whats the universal blood donor?
O negative, has AB antigens
Universal Blood recipient?
AB
What is the antidote for triciclate antidepressant overdose?
Sodium Bicarb
Asthma meds?
albuterol 2.5 mg, epi 3-5mg SQ1:1,000
Collapsed Alveoli with decreased ventilation?
Atelactasis
Lack of surfactant?
Atelactasis
What are signs and symptoms of respiratory distress?
Nasal Flaring, tracheal Tugging, Sternomastoid Muscle Use, Intercostal retractions
When will you see JVD?
tension pneumo, Rt sided heart failure, tampenade, traumatic asphyxia..increase in portal htn.
How do we manage a postpartum hemorrhage?
Pitocin, massage fundus, IV fluids, put baby to breast
What does pitocin do?
Increases uterine contractions
How much does pregnancy increase a womans blood volume?
40%
What happens to a womans vitals during pregnancy?
BP, Cardiac output>, Resp rate>, stroke volume stays the same
What is released by the pituitary gland?
oxytocin and ACH
If bleeding persists from a clamped cord what do we do?
Clamp again
Gravida?
number of pregnancies
Para?
number of deliveries
Prima Gravida?
first pregnancy
Prima Para?
Delivery of first child
What is the normal pregnancy length?
9 months, 280 days, 40 weeks
Ectopic pregnancy?
fertilization of egg outside uterus, usually in fallopian tubes
Umbilical cord?
2 arteries 1 vein, larger opening
Mother gives birth 24 hours ago, now sudden onset of SOB, Dypsnea, chest pain, Whats happening?
Pulmonary Embolism
26 y/o multi gravida w/ prior c sections, tearing pain!!!,Tender rigid uterus, bright red bleeding?
abrupto placenta
What is abrupto placenta?
premature seperation of a normally implanted placenta from the wall of the uterus, ocurs during last trimester
What is Placenta Previa?
The placenta is implanted to low in the uterus as it grows it blocks the cervical canal. Prevalent in woman over 30.
S/S of placenta previa?
Painless vaginal bleeding, bright red, soft and non tender uterus.
Prolapsed cord?
Gently insert gloved hand in vagina and relieve pressure on the cord, DO NOT PUSH CORD BACK IN CANAL.
When is intervention required regarding APGAR score?
If the score is under 6
What are the 5 parameters of the APGAR and what is a healthy score?
Heart rate, resp efort, muscle tone, reflex irratability, color, between 7-10
Where do you tie clamps to cut the cord?
8″from infants navel with 2 ties, placed 2″ apart.
What is a breech presentation?
another part of the body leads the way, usually the buttocks, Transport fast!
When do we do an APGAR?
1 and 5 mins
How do we transport and OB pt over 3 months gestation?
Left Lateral recumbant, take pressure off inferior vena cava.
22y/o female, severe LRQ, no appetite, with constipation?
Appendicitus
9 months, seizures from Eclampsia, what is our frontline drug of choice?
Mag Sulfate
How will Preeclampsia present?
HTN, Edema, proteinuria, NOT SEIZING
Eclampsia, whats happening?
Seizing
32 y/o woman, excruciating headache while working out and loss consciousness, unresponsive with bilateral dilated pupils?
Cerebral aneurism
What is a common cause of uterine bleeding in the first trimester?
Threatening abortion, incomplete abortion, ruptured ectopic pregnancy
22yo female, RLQ pain, radiating to right shoulder!!!, no menses with spotting?
Ectopic Pregnancy
When does BP begin to decrease?
during third trimester
What is the timeframe for a neonate?
birth-1 month
What is a serous membrane covering abdominal organs?
Visceral
What is the most common cause of PID?
Gonorrhea
Where does decontamination take place in a hazmat situation?
in the yellow or warm zone
Whats the time frame for CISD?
72 hours
What is the highest level of driving referred to as?
due regard for others
4 man log roll when stabalizing a pt, whats the medics first step?
Stabalize C-spine
EKG, No P-waves, what rhythm?
assume A-fib, SA Node is not the pacemaker
What is tracheal deviation considered when it comes to tension pneumothorax?
a late sign
When do we stop giving the pt procainamide?
arrhythmia resolved, QRS widens by 50%, P-R interval is prolonged, BP drops greater than 15mm/hg
P for every QRSm P-R interval is .16s, Pt is cold and clammy w/ BP-70/50, HR-50, Rhythm and treatment?
Sinus Brady, Pt is having symptomatic bradycardia, increase HR and increase BP. Atropine 0.5mg!
What does atropine treat?
bradycardia, asystole, 2nd degree heart block
V-tach, unconscious, no vitals, what do u do?
defibrilate 200j, 300j, 360j
Whats an early sign and symptom of lidocaine toxicity?
muscle twitching, tremors, numbness or tingling
Major side effect of lidocaine?
Hypotension and Bradycardia
What part of the brain regulates BP, Resp, and Pulse?
Medulla Oblangata
What does a calcium channel blocker do?
decreases HR
Double sided heart failure will cause what?
Pulmonary edema
85y/o woman, headache, dizziness, BP-210/120?
Hypertensive crisis
What does Epinephrine cause?
increased HR, BP, Myocardial oxygen demand, automaticity. NOT DECREASED SYSTEMIC RESISTANCE.
What is the definition of automaticity?
the ability of the heart to generate its own electrical impulses
Adult female, tachycardic, vitals are within normal limits, how do we treat?
o2 and vagal maneuvers
When should we intubate a cardiac arrest pt?
Immediately
Where does synchronized cardioversion occur on the QRS complex?
occurs on the R wave
What is a major side effect of Lasix?
Hypokalemia
What is ascites?
Fluid in the abdomen, usually cause of CHF or liver disfunction
Verapamil Side effects?(Think about what it treats!)
hypotension, coronary artery dilation, bradycardia
Pulmonary edema treatment?
Lasix, morphine, Nitro, O2
What causes CHF?
Left ventricular failure, inability of the blood to be pumped to the body, backs up in the lungs
WPW with no S/S?
O2
WPW hemodynamically unstable in PSVT?
adenosine, 6mg, if no change 12mg
What does adenosine do?
slows conduction through the AV node, slows all cations
How do you defibrilate pulseless v-tach?
200j, 300j, 360j
Hyperkalemia, how do we know?
Peaked T waves
How does lasix work?
Works in loop of henle, loop diuretic, decreases preload, prevents reabsorbtion of sodium. REDUCE PRELOAD!!
Acute Myocardial Infarction, whats the treatment?
ASA, Nitro, Morphine
Beta Stimulation?
Vasodilation, broncho dilation,
Where do most unstable or lethal ectopic beats originate?
ventricles
Pt presents with pain in chest, SHEARING OR TEARING IN NATURE, radiates to neck and no pedal pulse.
Aortic Aneurysm
Pink frothy sputum, cyanosis, rhales, tachycardic?
Pulmonary Edema
What do adrenal glands secrete?
Epinephrine
If stroke volume doesnt change but HR decreases?
Then cardiac output decreases as well
EKG paper, large block?
.20s
EKG paper, small block?
.04s
P-R interval greater than .20 s?
first degree heart block
Normal PR interval for QRS?
.12-.20seconds
Hypovolemic mom due to blood loss and newborn is delivered, what is the newborn fluid replacement rate?
10cc/kg(newborn and infant up til 1 year)
Seal bark, stridor, occurs at night?
Croup, do not lay flat, keep calm,humidified O2
Life threatening infection, drooling, can not swallow due to pain, HIGH FEVER, can cause upper airway infection in a child
Epiglotitis
What is important to remember about opening an infants airway?
do not exaggerate head tilt chin lift, could obstruct breathing passages
Remember kids are avid nose breathers, this is important with newborns why?
because when suctioning Mouth first, then nose
SIDS, when does it happen?
occurs at night, 4-6 months of age
PH below 7.35?
acidosis
What will the pt`s PCO2 be in respiratory acidosis?
greater than 40
What will the pt`s PCO2 be in respiratory alkalosis?
PH greater than 7.45, PCO2 will be less than 40
What are your primary concerns when treating a near drowning victim?
Manage Hypoxia and Acidosis
What is the benefit of an NPO?
can be used on pt`s with a gag reflex and its rapidly inserted
What is a contraindication of an NPO?
Basilar Skull fracture, Look for battle signs or raccoon eyes
Intubated pt, sounds heard only on the right, what do you do?
Pull back on the tube slightly, and listen again, could have been right mainstem.
Curved mac blade placement?
Between epiglotis and base of tongue
Miller straight blade Placement?
Lifts epiglotis
Thin shaped valve, covers trachea?
epiglotis
Cricoid stick, what is the landmark?
cricoid cartilage or depression inferior to adams apple
What is a term we use to describe stiffness of airflow with minimal resistance?
Compliance, bag compliance
In what pt`s do we see Kussmaul resps?
Rapid breathing associated with DKA
What is a complication of BVM?
Abdominal Distention, pushes diaphragm down, leads to vomiting
Define Libel
malicious writing
Define slander
malicious spoken
Whats a good way to avoid anaphylactic reaction when interviewing a pt?
Ask what are you allergic to
What are the established policies and procedures of an EMS system?
protocols
What are written medical orders via an EMS physician referred to as?
standing orders
proper distance for an LZ?
100×100
When driving lights and sirens on a four lane highway, which lane do you use and why?
left lane so traffic can move to the right
Define frequency
How frequently a wave recurs in a given time(usually 1 second)
What is VHF?
Very High frequency band-30-175MHZ
What is UHF?
Ultra High frequency band-300-3,000MHZ
What is meant by the term Trunking?
It means that multiple agencies or systems can share frequencies
Name a controlled substance that does not produce constricted pupils?
Valium
What does produce constricted pupils?
heroin, demerol, organophosphates
Whats a major problem with catherters thru the needle system?
Catheter embolus
What is our first compensatory mechanism to maintain Homeostasis?
Bicarbonate buffer, then resp and renal
What is the movement of gas from a higher concentration to lower concentration?
Diffusion
movement of water across a membrane?
Osmosis
Decreased 02 in blood?
hypoxemia
Decreased 02 in lungs?
hypoxia
How do you correct resp acidosis?
Hyperventilation of a patient
Major extracellular cation
sodium(sweat tastes salty on the skin)
Major intracellular cation
potassium
Normal stimulus to breathe
increased PACO2, arterial
PH above 7.45?
alkalosis
Whats the normal cardiac output per 1 heartbeat?
500ml
Adult pulse rate?
60-100
What is intrinsic ventricular firing rate?
20-40
What is significant about heat stroke as opposed to heat exhaustion and how do we treat?
In heat stroke there will be NO SWEATING. aggressive cooling methods and 2 IV`s wide open.
TB s/s?
weakness, weight loss, night sweats, fever, SOB, heoptsis
What deficiencies will a pt have from a fresh water drowning?
electrolyte imbalance, hypoxia w/ resp acidosis
What is the term used to describe divers who make fast ascents and what symptoms do they have?
decompression sickness, joint pain, tingling in legs and abdominal pain
Hot, dry skin, NO SWEATING, pt is 106 degrees and unconscious?
heat stroke
same pt, awake and profuse sweating?
heat exhaustion
Leg cramps from lactic acid accumulation in heat?
heat cramps
What organ of the lymphatic system resides in the LUQ of the abdomen?
spleen
pt vomiting green/yellow bile from eating an excessively fatty meal?
Choleosystitis
Where is bile produced and stored?
produced in liver and stored in gall bladder
What does the occipital lobe produce?
vision
What does the optic nerve do?
transmits sight from back of eye to the brain
What is referred to as the master gland and what does it do?
Pituitary Gland, secretes oxytocin and ACH
Ductless hormones release directly into the bloodstream
endocrine
duct glands, excrete directly through epithelial cells(sweat and salivary)
exocrine
How long after an alcoholic stops drinking do DT`s usually take place?
48-72hrs, chronic ETOH abuse
How do we transport a scuba diver?
Left Lateral recumbent
What is the most common route of poisoning?
ingestion
TCI overdose?
Sodium Bicarb
Benzodiazepine overdose?
flumazenil
Weak rapid pulse, bizarre behavior, cool, clammy, slurred speech? and how do we treat?
hypoglycemia, not polyuria, 25 grams dextrose in 50-ml of saline, 12.5g for a child
When do you see kussmauls respirations?
DKA, deep and gasping
A patient has all the signs and symptoms of DKA except kussmaul resps and no fruity odor, what is it?
HHNK, osmotic diuresis with no keytones being burned for energy
How is JVD best evaluated?
45 degree angle, semi fowlers
A thrombus that forms in the deep veins of the legs that travels to the pulmonary artery?
pulmonary embolis
One of the most common kinds of maternal death
Pulmonary embolism, think recent delivery of a child, sharp chest pain, PE.
When you radio a physician what is one thing you are not permitted to say over the radio?
The patients name
What are the standards governing a group of people or a profession?
ethics
An example of indirect medical control is?
standing orders
In an ambulance crash what will the court try to prove?
lack of due regard
In patients with hypoxic drive, COPD what is there stimulus to breathe?
decreased O2 levels
Skin Pallor, vasoconstriction or vasodilation??
vasoconstriction causes this condition
upper airway sound with inspiratory difficulty?
stridor
Lower airway sound with whistle on inspiration
wheezing
Fluid or mucous in large airway?
rhonchi
seal bark
croup, stridor
fluid heard popping in lower airway
rhales
Poor bag compliance seen in what pts?
sucking chest wounds, tension pneumo thorax
what is a classic sign of anaphylaxis besides facial swelling?
HYPOTENSION
fever, rhonchi, hot dry skin, NO PEDAL EDEMA
pneumonia
SOB, Barrel chest, thin pursed lip breathing indicating there having a difficult time expelling breathes.
emphysema
Coughing up pink tinged sputum, sign of what?
left sided heart failure, CHF
patients with emphysema, what kind of O2 treatment should they receive?
Nasal cannula or venturri mask
What is hemoglobin responsible for?
transport and delivery of O2
Define Cor Pulmonale?
Right sided heart failure secondary to chronic lung disease
21 yo,chest pain after coughing
spontaneous pneumo
What is difficulty breathing while laying down referred to as?
orthopnea, sit them up
How do we check neurological function of a pt?
does he or she follow commands, PUPIL RESPONSE, grip strength
What would a severed C4 cause?
total paralysis of motor and resp
pt`s with suspected ICP, how dow we treat?
hyperventilate and mannitol
What is the cerebellum responsible for?
balance, coordination and motor thought
What does the cerebrum control?
thought, intelligence and higher thought
Seizures without regaining consciousness and 2 additional seizures?
status epilepticus
What is the best place for IV canalization to avoid joints
forearm
What is involved in a central line and what should be cannulated instead?
Internal jugular, femoral and subclavian,, attempt external jugular first
60 mg equals how many grains?
1
child whom feels like bells are ringing in his head, and he is hyperventilating?
aspirin overdose
What is the single indicator of neonatal distress?
bradycardia
How do you treat a child playing with dry ice?
immerse in warm water
What is the first line drug for pediatric bradycardia?
O2
#1 cause for pediatric arrest
resp arrest
What is the proper location for IO placement?
proximal tibia, below tibial tuberosity
Hr less than 60 in an infant?
compressions
When are PPV given to an infant?
HR less than 100
Define battery?
when the ems provider touches another person(pt) without his or her consent.(kicking the persons teeth in)
Define assualt?
when the ems provider instills the fear of bodily harm upon the pt. (Im going to kick your teeth in)
Bright red bleeding, cramping in 1st trimester?
spontaneous abortion
Define antepartum hemorrhage?
hemorrhage before delivery
Signs and symptoms of heart failure?
enlarged liver, JVD, Edema
define a simplex system?
portable units can only transmit in one mode(voice or telemetry) or receive voice at any given time.
define duplex system?
a network that uses 2 different frequencies at the same time. Simultaneous transmission or reception.
define multiplex system?
combine 2 or more signals such as the paramedics voice and telemetry.
what rhythms need to be defibrillated as soon as possible
V-fib, pulseless V-tach
What if cardiac arrest is unwitnessed and CPR is not in progress?
CPR for at least 2mins, before delivering first shock
you start an IV and notice catheter shear, what do you do?
lift arm, aspirate, remove and start over
Intrinsic rate of the sino-atrial?
60-100
Which is an isotonic solution, 0.9%NS or 0.45%NS?
0.9% Normal Saline not plasma or D5W
What will a positive inotropic medication do?
increase contractility
What will a positive chronotropic drug do?
increase Heart Rate
What kind of effect will a dromotropic drug have?
a drug that alters velocity of conduction
Which snakes venom is mostly neurotoxins?
coral snake
Mental pt, with a history of mental illness is saying strange things that are not normal, what should you do?
encourage her to share her feelings
Woman with a history of asthma, what should your first drug be?
Oxygen
What kind of angina would a man have after playing basketball and vigorous exercise?
stable angina, predictable chest pain following exercise that will right itself
after 3 stacked shocks and no pulse on apt in Vfib, what is the next process?
CPR, Epi, shock, Lidocaine(or amioderone)
What does a pt lose when they experience a burn?
Plasma
Most common time of death during sudden onset MI?
2-3 hours after onset of symptoms(1-2 if on answer key)
What do we not want to give a stroke pt?
fluid bolus
20 y/o male sitting watching a football game becomes unconscious, awakes with a stiff neck, hot skin, and a rash?
meningitis, stiff neck dead give away
What does glucagon do?
it is a hormone secreted by islets of langerhans, its a starch form of sugar to raise blood glucose levels when they fall. STIMULATES LIVER TO CHANGE GLYCOGEN INTO SUGAR AND SECRETE IT INTO THE BLOOD STREAM FOR ENERGY.
What are the medication routes from slowest to fastest?
PO, SQ, IM, IV/IO
How many ml are delivered from a 60gtts/ml set at 20gtts/min after 30 min?
20×30=600, 600/60=10
10
Which is not a vector of hepatitis, blood, semen, saliva or feces??
SALIVA?
What is a major neuro change chategorized by?
change in mental status
How does an elderly Pt mask an MI?
They have a decreased sensation to pain
How do we adjust an unconscious pt`s airway that we removed from a pool and put in a C-Collar?
Modified Jaw Thrust, considered a trauma pt
Pt with burn injury, why are they hypovolemic?
Fluid moves from into interstitial tissue
Proper meds for CHF?
02, Morphine sulfate, lasix and Nitro
Why would you administer morphine to a pt with a PE?
Vasodilation
You start an IV, attach cardiac monitor, admin 02, and contact med control, what are you doing?
Following protocol
What would we consider a central line?
Internal Jugular
What does HR do late in de-compensating shock?
less then normal, there will be a narrowing of the pulse pressures
how do we treat a pt with frostbite?
re-warm the injured part with body heat, do not massage, keep away from a heater, do not use radiant or dry heat
What is twitching of the eyes?
nystag-mus
Wht type of seizure involves muscle contraction and relaxation?
Grand Mal
What is the normal width of the QRS?
.12s
Where does the curved blade go when using a macintosh tipped laryngoscope blade?
The tip of the curved blade is placed in the vallecula(the space between the epiglottis and base of the tongue)
Low BP, Tachy, pale cool moist skin, crackles heard in the lungs, what kind of shock?
cardiogenic
Low bp, tachy, pale cool moist skin, lungs are CLEAR, what kind of shock?
hypovolemic
Low BP, Bradycardic, flushed dry warm skin, clear lung sounds, what kind of shock?
neurogenic
Low BP, Tachy, flushed warm moist skin, wheezing to no lung sounds heard, what kind of shock?
anaphylactic
Low BP, Tachy, pale, Hot moist skin, possible crackles heard, what kinf of shock?
Septic
What is the most common cause of cardiogenic shock?
extensive infarction of the left ventricle, diffuse ischemia, decompensated heart failure.
What type of shock can long bone or pelvic fractures cause?
exogenous hypovolemic shock
dehydration, burn injury, crush injury, what type of shock?
endogenous hypovolemic shock, the fluid loss is contained within the body
Where do we listen to lung sounds?
we listen anterior and posterior
Pd has secured the scene, and advised you that you have 6 injuries, what do you do upon arriving at the scene?
Start Triage
How does gas exchange in the body take place?
diffusion
What is it when water moves from an area of low solute concentration to an area of high concentration through a permeable membrane?
Osmosis
What is the movement of water and a dissolved substance from an area of high pressure to low pressure?
Filtration
What is a good indication for a nasal intubation?
Gag reflex intact
How do we measure size of a pediatric ETT tube?
size of the pt little finger
Severe abdominal pain, bleeding, 3rd trimester?
Abrupto placenta
no pain, bleeding, 3rd trimester?
Placenta previa
Pt found with an angulated right leg, AMS, BP-80/50, HR-130, what kind of shock?
Hypovolemic, femur fracture, internal bleeding, low BP, Tachy
23y/o male, asymptomatic pneumo, no BS on left side, all vitals within normal, how do we treat?
Just transport, NO DECOMPRESSION