Comprehensive EMT Study Guide on Medical Emergencies

Upper Airway

Nose, Mouth, Pharynx (nasopharynx, oropharynx, laryngopharynx), Larynx (Voice box).

Lower Airway

Trachea, Bronchi & Bronchioles, alveoli, lungs.

Inhalation

Active process where diaphragm & intercostals contract, chest cavity expands, negative pressure draws air into the lungs.

Exhalation

Passive process where diaphragm relaxes, chest cavity decreases, air is pushed out due to positive pressure.

Signs of adequate breathing

Normal rate (12 - 20), equal chest rise, regular rhythm, mental status and skin color.

Signs of inadequate breathing

Too fast/too slow or irregular, shallow chest rise, nasal flare, accessory muscle use, cyanosis, altered LOC, diminished/absent breath sounds.

Assessment of dyspnea and apnea

OPQRST/SAMPLE, RRQ, Lung Sounds, SPO2, retraction etc.

Care for dyspnea and apnea

Ensure an open airway, administer oxygen (if needed), suction (if needed), and use a BVM if breathing is inadequate or absent; rapid transport is also necessary.

Importance of suction techniques

Prevents aspirations and airway blockage; no more than 15 sec (adults) and 10 sec (children).

Signs of adequate Positive Pressure Ventilation

Chest rises, improved skin color/mental status, heart rate normalizes.

Signs of inadequate Positive Pressure Ventilation

No chest rise, gastric distention, worsening mental status, no improving vitals.

Respiratory Distress

Increased work of breathing; still compensating.

Respiratory Failure

Inadequate oxygenation/ventilation; impending arrest.

Respiratory Arrest

No breathing; requires BVM/CPR.

COPD

Chronic bronchitis or Emphysema.

Triggers of COPD

Smoking, infection, pollution.

Signs of COPD

Wheezing, productive cough, barrel chest, pursed lips.

Treatment for COPD

Oxygen (beware of hypoxic drive), assist inhaler, transport.

Brain Function

Controls thoughts, motor/sensory function, and autonomic function.

Spinal Cord Function

Relays signals between the brain and the body.

Ischemic Stroke

Blockage of the artery.

Hemorrhagic Stroke

Ruptured vessel/bleeding in the brain.

TIA

Temporary blockage; resolves within 24 hours.

Signs of Neurologic Emergencies

Sudden numbness/weakness (often one side), facial droop, slurred speech, confusion, vision problems, balance/coordination issues.

Generalized Seizures

Full body convulsions; LOC.

Focal-Onset Seizures

Localized to part of the body; may or may not lose consciousness.

Status Epilepticus

Seizures >5 min or multiple without regaining consciousness.

Stages of Seizures

Aura (warning sensation), Tonic (muscle stiffness), Clonic (jerking movements), Postical (confused, sleepy recovery phase).

Postical State

Immediately following a seizure, during which the brain is recovering.

Postical Care

Open the airway and monitor for adequate breathing, suction if the patient vomits or has excessive salivation, protect the patient in the LLR to prevent aspiration, and provide oxygen if the patient is cyanotic.

Altered Mental Status

Any change in LOC, awareness, or behavior

AEIOU-TIPS

A mnemonic for possible causes of altered mental status: Alcohol, Epilepsy, Insulin, Overdose, Uremia, Trauma, Infection, Psych, stroke

Acute Abdomen

Sudden, severe abdominal pain

Referred Pain

Pain felt elsewhere

Gastrointestinal Hemorrhage

Vomiting blood, bloody stool

Peritonitis

Inflammation of the abdominal lining

Ulcerative Disease

Sores in the stomach or intestines

Kidney Disorders

Conditions such as stones, infection, renal failure

Endocrine System

Glands that secrete hormones (pancreas, thyroid, adrenal glands)

Diabetes Mellitus

A group of diseases that result in high blood sugar (hyperglycemia)

Hyperglycemia

High blood sugar (slow onset; dry skin, fruity breath)

Hypoglycemia

Low blood sugar (rapid onset; sweating, confusion, seizure)

Blood Function

Transport O2, nutrients, hormones, clotting, and Immune response

Allergic Reaction

Localized; mild symptoms like rash, itching, or hives

Anaphylaxis

Life-threatening systemic reaction involving 2+ body systems (e.g., respiratory and cardiovascular)

Local Response to Allergens

Swelling, itching, redness at the contact site

Systemic Response to Allergens

Airway swelling, bronchoconstriction, hypotension, widespread rash

Types of Allergens

Insect stings, Food, Medication, Latex, Environmental

Primary Assessment in Anaphylaxis

Importance of managing the ABCs for a patient experiencing an anaphylaxis reaction

Airway Swelling

Can lead to obstruction; signs include stridor, wheezing, or absent breath sounds

Hypotension

Signs or shock indicating low blood pressure.

ABC's

Immediate focus on Airway, Breathing, and Circulation.

Transport decision factors for allergic reaction

Early transport is critical even if the symptoms improve.

ALS backup

Advanced Life Support backup for airway management or IV epinephrine.

Epinephrine administration

If epinephrine is administered, patients must go to the ER.

Signs of respiratory distress

Signs or symptoms indicating difficulty in breathing or shock.

Known allergen exposure

Exposure to a known allergen with involvement of multiple systems.

Contraindications in emergency settings

No contraindications for administering epinephrine in emergencies.

Toxicology

Study of poisons.

Poison

Harmful substance when ingested, inhaled, injected, or absorbed.

Toxin

Poison from plants, animals, or bacteria.

Overdose

Excessive dose of substance, often drugs.

Signs and symptoms of poisoning

Nausea, vomiting, altered mental status, respiratory distress, burns around mouth, seizures, pupillary changes.

Methods of poison entry

Ingestion, inhalation, injection, absorption.

Airway management in poisoning

Maintain airway, suction as needed, administer oxygen, be prepared for assisted ventilation.

Assessment and treatment of overdose

Signs/symptoms, ABCs + Vitals, SAMPLE history, look for pill bottles, needles, substances, Naloxone, rapid transport.

Scene safety concerns

Don't enter hazardous material scenes unless safe; call for law enforcement for violent patients.

Opioid overdose management

Begin CPR if pulseless, ventilate with BVM, administer Naloxone, use AED.

Food poisoning assessment

Nausea, vomiting, diarrhea, may involve fever; treatment includes fluids and monitoring for dehydration.

Behavioral crisis

Situation where behavior is unacceptable or dangerous.

Acute Psychosis

Severe break with reality, including hallucinations and delusions.

Schizophrenia

Chronic disorder characterized by hallucinations, delusions, and disorganized speech.

Emergency care for psychiatric patients

Signs/symptoms, calm and non-threatening approach, do not play into delusions, restraints only if necessary.

Excited delirium

Agitation, aggression, hyperthermia, and possible sudden death.

Restraint methods

Use the least restrictive means, document time, reason, method, monitor airway and circulation continuously.

Suicide risk behaviors

Direct threats or talking of dying, depression, hopelessness, sudden calmness after distress; ask directly about suicide.

PTSD issues in veterans

May react violently to loud noises or physical touch, respect personal space, calm environment, flashbacks are common.

Behavioral health emergency legal issues

Informed consent may not be possible, implied consent applies if threat to self/others, document thoroughly, involve law enforcement if needed.

Thromboembolism

Blood clot blocks blood flow, can lead to MI, PE, or stroke.

Angina Pectoris

Chest pain due to poor oxygen supply to heart, lasts <10 min, relieved by rest or nitro.

Myocardial Infarction

Blockage of coronary artery causes tissue death, signs include crushing chest pain, radiating pain, nausea, sweating, dyspnea.

Hypertension

High blood pressure, often asymptomatic, can lead to stroke or heart failure.

Shock (Hypoperfusion)

Inadequate tissue perfusion leads to organ failure.

CPR Guidelines for Adults

Compression:Ventilation ratio of 30:2, rate of 100-120/min, depth ≥2 in.

CPR Guidelines for Children

Compression:Ventilation ratio of 30:2 (1 rescuer), 15:2 (2 rescuers), same rate and depth as adults.

CPR Guidelines for Infants

Compression:Ventilation ratio of 30:2 (1 rescuer), 15:2 (2 rescuers), depth of 1.5 in.

Advanced airway management

Continuous compressions with 1 breath every 6 seconds.

Pacemakers

Small lump near clavicle; avoid during AED pad placement.

AICD

Automatic Implanted Cardiac Defibrillator; may shock patient unexpectedly.

LVAD

Left Ventricular Assist Device; mechanical pump; patient may not have pulse or normal BP.

Heart

Four chambers (two atria, two ventricles) pump blood; right side takes in deoxygenated blood, left side pumps oxygenated blood.

Arteries

Carry oxygen-rich blood from heart under high pressure; thick muscular walls.

Veins

Carry deoxygenated blood to heart; thinner walls, have valves to prevent backflow.

Capillaries

Tiny vessels between arteries and veins where gas/nutrient exchange occurs.

Blunt trauma

Doesn't break skin but can damage vessels/organs internally.

Perfusion

Flow of oxygen-rich blood to tissues; internal bleeding reduces perfusion → hypoxia, shock.

Rapid internal blood loss

Dangerous because signs may be delayed (e.g., tachycardia, hypotension).

BSI (Body Substance Isolation)

Use gloves + eye/face shields.

Bloodborne pathogens

Remain a real hazard.

Conditions of Internal Bleeding

Injuries to spleen, liver, kidneys, pelvic fractures, long bone fractures.