EMT Unit 1

systolic blood pressure

the pressure the blood exerts on the arterial wall when the ventricles contract

freedom house

the first non-law enforcement emergency service created by unemployed members of Hill District in Pittsburgh PA

National highway traffic safety administration

the organization to create the first standards for EMS

What is the most frustrating part of research?

methods must be tested through the Institutional Review Board (IRB)

pathogens

organisms that can cause infection

occupational safety and health administration (OSHA)

a federal agency that sets and enforces workplace safety and health standards It provides training, outreach, education, and assistance and conducts inspections to address imminent danger, catastrophes, worker complaints, and more

order of donning PPE

1. gown

2. mask

3. eye protection

4. gloves

order of doffing ppe?

1. gloves

2. gown

3. hand hygiene

4. eye protections

5. mask

diastolic blood pressure

the pressure the blood exerts on the arterial walls when the ventricles refill

hepatitis

an infection that causes severe inflammation of the liver

how is hepatitis A spread?

through the oral-fecal route

how is hepatitis B and C spread?

through bodily fluids

tuberculosis

a bacterial infection that usually affects the lungs, but can also affect other parts of the body; it is an airborne infection and spread when someone coughs, sneezes, or spits

what to do if someone is choking and conscious?

start 5 abdominal thrusts and then 5 back thrusts

what to do if someone is choking but unconscious?

start chest compressions; and after 30 compressions turn them over to their side and finger swipe trying to dislodge the object

Narcan

a drug administered when someone is experiencing a drug overdose and rapidly reverses opioid overdoses

sympathetic division

fight or flight response where blood vessels constrict, breathing rate increases, blood pressure increases, heart rate increases, and pupils dilate

parasympathetic division

rest and digest response where blood vessels dilate, breathing rate decreases, blood pressure decreases, heart rate decreases, and pupils normalize

Type I diabetes

an autoimmune disorder in which the body attacks the cells in the pancreas that secretes insulin

what are the layers of the integumentary system

1. epidermis

2. dermis

3. subcutaneous

alpha cells

these cells of the pancreas secrete glucagon

beta cells

these cells of the pancreas secrete insulin

delta cells

these cells of the pancreas secrete somatostatin

perfusion

adequate supply of oxygen and nutrients to the cells of the body, with the removal of waste products

hypofusion

also known as shock; when perfusion becomes inadequate and there is too much carbon dioxide in the blood and blood becomes acidic

atelectasis

the loss of elasticity in the alveoli usually as a result of emphysema making it more difficult to exhale

stridor

high pitched whistling sounds; indicative of a severely narrowed air passage

hoarseness

raspy change in voice; indicative of swelling around the vocal chords

snoring

similar to a snore during sleep; indicative of diminished muscle tone

gurgling

bubbling sound; indicative of vomit, blood, or secretions in the airway

Questions that must be asked concerning the airway?

Is the airway open?

Is it patent?

Is the open airway maintainable?

what is optimal position when opening an airway?

the ear should be in line with the jugular notch

What is the proper way to measure the right size of an oropharyngeal airway?

measure from the corner of the mouth to the corner of the jaw

What is the proper way to measure the size of a nasopharyngeal airway (NPA)

measure from the tip of the nose to the ear and the bevel should be toward the septum

trismus

a condition that makes it difficult or impossible to open your mouth — an example of a time you would use an NPA

supraglottic airway

a device that is used when all other, basic methods of failed; it isolates the glottic opening by occupying space in the larynx and hypo pharynx

How long should you be suctioning for?

from anywhere between 10-15 seconds

What should you do if OPA/NPA and suctioning does not work?

call dispatch for Advanced Life Support

FIO2

the fraction of inspired oxygen

EcMo

a device that bypasses the lungs, and oxygenates the blood while circulating it

What is altitude sickness comprised of?

High Altitude Flatulence Sickness (HAFS), High Altitude Cerebral Edema (HACE), and High Altitude Pulmonary Edema (HAPE)

tidal volume

the amount of air that moves in and out of the lungs in a normal breath

anatomic dead space

the air that remains in the trachea and lungs that does not get used for respiration

minute volume

the amount of air inhaled per minute
(tidal volume) * (number of breaths per minute)

scope of practice

what the state medical director says EMTs are allowed to do

standard of care

care that would be expected from an EMT with similar training when caring for a patient in a similar situation

expressed consent

consent given by someone 18 or older who must be in aware and informed of what will be done to them

implied consent

assumed consent that is how we operate when we find someone unconscious

What happens if a patient is considered a threat to themselves or others and refuses transportation?

under section 12, this allows for involuntary transportation for the court-ordered admission of a person to a hospital for a psychiatric evaluation or treatment

If a patient is refusing care, what should you do?

spend time with your patient, listen carefully to try and determine why the patient is refusing care, inform the consequences of your patient not going to the hospital, ask the patient if it is all right if you call a family member or advise the patient that you would like to call a family member

POLST

physician order for life-sustaining treatment

MOLST

medical order for life-sustaining treatment

living will

a legal document that states a patient’s preferred form of end of life care

What is the order when you size-up a scene

1. Scene safety/BSI

2. MOI/NOI

3. Number of patients

4. Additional resources

5. Consider injury to the C-spine

AVPU

1. alert

2. voice

3. pain

4. unresponsive

What are some triage tests to determine wellness?

30 - 2 - can do: can they follow commands? How are the rate, rhythm, and quality of their respirations? Capillary refills?

capillary refills

an important triage test that should be done for every child under the age of 6 and it should take no more than 2 seconds to refill

what is the danger zone when a vehicle is on fire?

at least 100 feet in all directions from the crash

what is the danger zone when wires are down?

one full span of wires away from the poles to which broken wires are attached

what is the danger zone when hazardous materials are involved?

the danger zone is established in the Emergency Response Guidebook

what is considered a dangerous fall for an adult? for a child?

a dangerous fall for an adult is more than 20 feet. a dangerous fall for a child is more than 10 feet (or two to three times a child’s height)

How is penetrating trauma classified?

penetrating trauma is classified by the velocity of the item that caused the injury

cavitation

the process by which a bullet creates pressure waves that damage tissue beyond the bullet’s path

blunt force trauma

injury caused by a blow that strikes the body but does not penetrate the skin or other body tissues

index of suspicion

a level of concern and awareness for a possible serious injury or illness that is not yet apparent

what is the purpose of a primary assessment?

to assess for life-threatening injuries and treat them as you find them

Inspiration

an active process that requires the contraction of accessory muscles

expiration

a passive process (normally) where accessory muscles relax

what oxygen saturation percentage is considered normal?

94-98%

Cheyne stokes

an abnormal breathing pattern characterized by gradual increase and then decrease in the depth of each breath followed by shallow or absent breathing

Biots

an abnormal breathing pattern that randomly alternates between rapid and slow breathing and apnea

Kussmauls

A deep, labored breathing pattern characterized by rapid, gasping breaths, and fruity odor

eupnea

normal breathing

what is considered a normal tidal volume?

500 mL

OPQRST

1. Onset - did it happen suddenly or gradually?

2. Provocation/Palliation - what makes it worse/better?

3. Quality

4. Region/Radiation

5. Severity

6. Time - when did it start?

SAMPLE(T)

1. Signs/Symptoms - what is bothering you

2. Allergies

3. Medications

4. Past Medical History

5. Last Oral Ingestion

6. Events leading up to the incident

7. (Travel)

free floating radicals

oxygen molecules floating in the blood not bound to hemoglobin on red blood cells as a result of over oxygenation

agonal respirations

fake out breaths

what is the range for a normal number of breaths?

12-20 breaths

respiratory distress

having difficulty breathing but still able to ventilate

respiratory failure

a severe impairment in breathing where the body cannot maintain adequate oxygenation or ventilation.

respiratory arrest

complete cessation of breathing

what would you observe is someone was in respiratory distress?

altered mental status, unusual anatomy (barrel chested), pale, cyanotic skin, and pedel edema

what lung sounds would you hear is you have edema in the lungs?

crackling sounds

ascites

a condition where excess fluid accumulates in the abdominal cavity

ascultation

the act of listening to internal body sounds, typically using a stethoscope, to assess the condition of the lungs, heart, and other organs.

wheezes

high pitched sounds created by air moving through narrowed passages

crackles

fine crackling or bubbling sounds heard on inspiration and are caused by fluid in alveoli or by an opening of closed alveoli

rhonchi

low-pitched sounds resembling snoring or rattling caused by secretions in larger airways

Pin Index Safety System (PISS)

a system that prevents the wrong gas from being used in the medical equipment

Continuous positive airway pressure (CPAP)

a form of noninvasive positive pressure ventilation consisting of a mask and a means of blowing oxygen or air into the mask — blowing oxygen or air continuously at low pressure into the airway prevents alveoli from collapsing and can prevent fluid from entering the alveoli in pulmonary edema

what are the side effects of using a CPAP machine?

hypotension, risk of pneumothorax, aspiration, drying of corneas

Chronic Obstructive Pulmonary Disease (COPD)

a group of lung diseases that cause breathing problems including: emphysema, chronic bronchitis, and many other undetermined respiratory illnesses. An overwhelming majority of cases are due to cigarette smoking

chronic bronchitis

a condition in which cells in bronchioles that normally clear away mucus accumulations are not able to do so

emphysema

a condition in which the alveolar walls break down and the surface area for respiratory exchange is greatly reduced; the lungs lose elasticity, results in air laden with CO2 being trapped in the lungs, reducing the effectiveness of normal breathing

asthma

a chronic disease in which small bronchioles narrow (bronchoconstriction) and mucus is overproduced severely restricting air flow

pulmonary edema

Presentation: abnormal accumulation of fluid in the alveoli likely caused by congestive heart failure and can lead to pedal edema
Signs and Symptoms: dyspnea, anxiety, pale and sweaty skin, tachycardia, hypertension, low oxygen saturation, crackling lung sounds, and sometimes coughing frothy white or pink suptum
Treatment: assess for and treat inadequate breathing with high concentration oxygen, keep patients legs in a dependent position, and CPAP may be used to push fluid out of the lungs and into the capillaries

Pneumonia

Presentation: an infection of one or both lungs resulting from the inhalation of bacteria, viruses, and fungi

Signs and Symptoms: shortness of breath, coughing, fever and chills, chest pain (often sharp and pleuritic) worsening on inhalation, headache, pale and sweaty skin, fatigue, confusion

Treatment: Assess for and treat inadequate breathing, high concentration oxygen, apply CPAP if necessary

Spontaneous pneumothorax

Presentation: lung collapses without injury or other obvious cause

Signs and Symptoms: sharp, pleuritic chest pain, shortness of breath, easily tired, low oxygen saturation, cyanosis, tachycardia, tachypnea, decreased or absent lung sounds, jugular vein distention

Treatment: contact ALS immediately, administer oxygen, CPAP contraindicated, transport for definitive care

Pulmonary embolism

Presentation: a blockage in blood supply to the lungs commonly caused by DVT

Signs and symptoms: sharp, pleuritic chest pain, shortness of breath, anxiety, coughing, tachycardia, tachypnea, lightheadedness, pain and swelling in one or both legs, hypotension, and cardiac arrest

Treatments: administer oxygen and if they remain hypoxic, administer CPAP machine, administer anticoagulants