Ch. 1-17 (Midterm)

OPQRST meaning

onset, palliation / provocation, quality, radiation, severity, time

What are contraindications for administering Nitroglycerin?

Systolic blood pressure <100 mm Hg, use of erectile dysfunction drugs within 24 hours, and maximum prescribed dose has been given.

There's a two car collision and you notice bystanders are gathering around, what is the first step taken when approaching the scene?

Scene safety

What's a sign of inadequate breathing?

Unequal chest rise

What are the components of scene safety?

Scene safety, BSI / PPE, MOI vs NOI, # of patients, additional resources, consider c-spine

Which method is used to open the airway of a suspected trauma patient?

Jaw thrust maneuver (JTM)

Which part of scene size up is the general impression conducted?

Primary assessment

What's the difference between "signs" and "symptoms"?

Signs = objective clinical findings by an EMT or paramedic that can be seen, felt, heard, or measured

Symptoms = subjective descriptions verbalized by the patient on how they're feeling

What does SAMPLE stand for?

Signs and symptoms

Allergies

Medications

Past medical history

Last oral intake

Events leading to current state

What is the meaning of AVPU?

Alert

Verbally responsive

Painfully responsive

Unresponsive

OPQRST questions you'll be asking the patient?

Onset

- When did the pain start?

- What was the patient doing when the pain began?

Palliation/Provocation

- Does anything increase or release the pain?

Quality

- How does the patient describe the pain: sharp, dull, aching, burning, tearing etc.

- Is the pain constant, intermittent or pulsating?

Radiation

- Does the pain radiate to other areas?

Severity

- Rate the intensity of pain on a scale from 0-10.

Time

- Is the pain the same intensity as when it started or has it decreased/increased?

What's the MAIN goal of the primary assessment?

Identify and treat any immediate life threats

Who has the highest authority during a medical call?

Medical director

What agency creates and enforces safety and performance standards for vehicles and related equipment?

NHTSA (National Highway Traffic Safety Administration)

What is a safety precaution for working with a suspected tuberculosis patient?

Wear an N95 respirator mask

What's the best method for infection prevention and blocking disease transmission?

Wash your hands

If a patient refuses consent to treatment what are your options?

- Explain the risks associated with non treatment

- Assess their mental capacity

What does providing medical treatment, clinical intervention, or physically handling without obtaining informed patient consent constitute?

Battery

What is the legal principle protecting providers who treat an unconscious or altered patient when explicit consent cannot be immediately gathered?

Implied consent

If an EMT forgets to secure the patient to the stretcher and the patient ends up breaking their arm, which of the following does not constitute negligence?

1. Duty to act

2. Breach of that duty

3. Caused injury

4. EMT intended to

4. EMT intended to

What constitutes an exception for refusing care?

Legally emancipated or explicitly pregnant

What does operating outside of your defined scope of practice constitute as?

Negligence

What does halting or terminating patient care without securing an official transfer of care to an EMS or hospital provider of equal or higher medical certification constitute as?

Abandonment

When dealing with a hearing impaired patient how can you ensure effective communication?

Speaking slowly, clearly, and facing the patient

How do you correct a documentation error on a physical chart?

Draw a single line through the error and initial next to it

What is the main purpose of HIPPA?

Patient confidentiality (protect a client's privacy related to health care issues)

Which chamber receives poorly oxygenated blood from the vena cava?

Right atrium

Which structure prevents food or liquids from entering the trachea during swallowing?

Epiglottis

What's the large anatomical opening at the base of the skull through which the brainstem transitions into the spinal cord?

Foramen magnum

At what age does the fontanelle fully develop?

9-18 months

What is the definition of a chief complaint?

Patient's report of symptoms and duration / why the patient called EMS

What takes priority over other assessments?

Life threats or uncontrolled external bleeding

What's the first step on a call where the patient is badly injured and quickly losing blood?

Control the bleeding

What's the physical gas exchange process occurring directly between the alveoli and pulmonary capillaries?

External respiration

What's the gas exchange process occurring at the microscopic cellular level between systemic capillaries and surrounding body tissue cells?

Internal respiration

What's the airway adjunct for patients who still maintain a fully intact gag reflex?

A measured NPA

What is used as a ventilation intervention when a respiratory rate is numerically regular but lacks adequate depth?

BVM with reservoir filled (highest concentration of oxygen)

What's it called when oxygen and carbon dioxide gases cross the thin alveolar-capillary membranes?

Diffusion

What should you do with a 40 year old that exhibits shallow breaths with 18 breaths per minute?

Ventilate

What's the maximum amount of nitroglycerin that can be administered?

1.2 mg (3 doses)

How is nitroglycerin administered?

Sublingual (SL) - under the tongue

What's used to increase blood sugar levels?

Oral glucose

What is epinephrine?

Vasoconstrictor that dilates the bronchioles to reverse anaphylactic shock

Where is epinephrine injected?

Anterolateral thigh (side of the thigh)

What are the side effects of epinephrine?

Tachycardia

What do you do before administering a second dose of epinephrine?

Contact medical control

What's the purpose of administering aspirin?

To stop platelets from clumping around blockages

What's a side effect of a MDI (meter dose inhaler)?

Tachycardia and tremors

What type of shock occurs when too much blood/fluid in the body is lost?

Hypovolemic shock

What type of shock occurs when there's a severe reaction to an allergen that's introduced to the bloodstream of an allergic individual?

Anaphylactic shock

Why type of shock is caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope)?

Psychogenic shock

Crackles / rales in the pulmonary structures is called which type of shock?

Cardiogenic shock

The late stage of shock when blood pressure is falling is referred to as?

Decompensated shock

Tracheal deviation and diminished or absent breath sounds suggest which emergency?

Pneumothorax

Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries is referred to as which type of shock?

Neurogenic shock

What is the preferred CPR technique for infants?

Two thumb encircling hand technique

Pneumothorax vs. Tension Pneumothorax

Pneumothorax - air in the pleural cavity caused by a puncture of the lung or chest wall

Tension pneumothorax - a type of pneumothorax in which air that enters the chest cavity is prevented from escaping (hypo)

A 25 year old male just returned from an overseas flight and experiences sudden, severe shortness of breath following prolonged immobility. What condition should you suspect?

Pulmonary embolism

What are three findings of bronchitis?

Productive cough, cyanotic, overweight

What is the sudden onset of a collapsed lung without any apparent cause typically in tall, thin individuals?

Spontaneous pneumothorax

A thin patient with a history of COPD is experiencing shortness of breath. What is the disease that destroys lung tissue and causes breathing difficulties?

Emphysema

Which conditions are pink frothy sputum associated with?

CHF (congestive heart failure) and APE (acute pulmonary embolism)

What are the shockable rhythms?

Ventricular fibrillation and pulseless ventricular tachycardia

A 54 year old diabetic female presents with fatigue and nausea, but no chest pain. What condition could be suspected?

AMI (acute myocardial infarction)

What is occurring when there's a structural failure of the aortic wall presenting as a sudden, sharp tearing pain going to the back or abdomen?

Dissecting aortic aneurysm

Pulmonary embolism lung sound signs

clear lung sounds is a sign

COPD lung sounds

rhonchi

CHF - congestive heart failure

crackles rales

• Peripheral edema in the lower extremities

• Jugular vein distention

• Dyspnea and pulmonary edema

Upper airway obstruction

stridor

Rhonchi lung sounds

patient with pneumonia