MOD 3 Study Guide (plus Qz Questions)

What would these cause - pnuemothorax

resp acid

What would these cause - alka selter/antiacid

met alk

What would these cause - panick attack

resp alk

What would these cause - NG to suction

met alk

What would these cause - contusion to lung

resp acid

What would these cause - pt getting excessive bicarb

met alk

What would these cause - diarrhea

met alk

What would these cause - renal insufficiency

met acid

What would these cause - pneumonia

resp acid

What would these cause - anemia

met acid

What would these cause - cushing's syndrome [too many steroids, retain Na/N2O, excrete potassium (acid)]

met alk

What would these cause - broken ribs

resp acid

What would these cause - acute aspirin overdose (hyperventilation)

acute resp alk and late met acid

What would these cause - hyperglycemia (DKA)

met acid

5 Types of Shock

obstructive (pnuemo/cardiac tamp/pulm emb), cardiogenic, neurogenic, hypovolemic (dehydration/GI bleed), septic

Cardiac tamponade

JVD, muffled heart sounds, narrowing pulse pressure (shock by reason of exclusion)

ET tube sizing, how to know teeth mark

if 7.0 tube, multiply by 3 and get 21

Lasix is a ______ diauretic

loop (for CHF/ HTN)

What is morphine?

for pain, slows HR and RR, agonist *opiod receptor site blocked

Nitro is a

vasodialtor, target the coronary vessels of the heart, lowers BP and preload, and doesnt increase work of the heart

Stage 3 of shock is decompensating, loosing how much blood

30% (25-35)

If patient is thrown from being hit by a car, what type of shock

neurogenic

If patient stands up and faints, what is that called

positive orthostatic hypotension

What cell holds the most water?

intracellular

What cell holds the primary solvent of water inside our blood vessels?

intravascular

Pediatrics relationship to epi

smaller reserve of epi than adult, constrict quicker and not as long as an adult, which can cause them to decomp faster

Bi Carb Buffer System is most important to what of the cell?

extracellular

What is a prevalent cation of intracellular

sodium

What is a prevalent cation of extracellular

potassium

What is a prevalent anion

BiCarb

Electrolytes mainly control

Homeostasis

If there is blood loss

volume drops and there is vaso constriction

Receptors that lower pressure called

baroreceptors, in aortic arch

When don't you inflate trousers

edema/chest/shock

When do you inflate trousers

pelvic and femur fractures

What causes AMS to decline

lack of cerebral perfusion

What is called for peds?

20 cc/K

Cell death is called

infarction

Cell injury is called

iscemia

AB blood

universal receivers

O blood

universal donors

Kidneys during emt acid with

retain BiCarb

Polarized cells and equal

• and - charges

Tunica intima (or tunica interna)

The innermost layer lined with endothelium, touching the blood flow

Tunica media

The middle layer made of smooth muscle and elastic fibers that controls vessel width and blood pressure.

Tunica externa (or tunica adventitia)

The outermost layer of connective tissue that anchors and protects the vessel.

Iv's are mainly used to do what?

deliver fluids and MEDS

During cardiogenic shock

contractility decreases, preload and afterload increases

What is the circular motion of cleaning a IV site called

aseptic/ called "friction"

1. On the average-sized adult, which of the following IV catheters would be used in the prehospital environment for medication administration?

C. 20 ga, 1.5 inches

3. The external jugular access for IV therapy is known as a

b. Peripheral line

4. When initiating external jugular IV access, the patient should be positioned

b. Supine and Trendelenburg

5. Which of the following should be checked if IV therapy has been initiated and the IV is not flowing properly?

The tourniquet has not been removed/ The cannula is blocked by a venous valve/ The IV bag is not placed at the appropriate height(all of the above)

6. Which of the following is a complication of IV therapy?

Pyrogenic reaction/ Infiltration/ Air embolus (All of the above)

7. A surgically implanted device that allows repeated access to central venous circulation is known as

Venous access device

8. The most common site for pediatric and adult intraosseous IV access is the

Proximal tibia

9. When using the EZIO tool for an intraosseous infusion, which location is the most common?

Proximal tibia

10. If bone, fat, or marrow enters the circulatory system, what may result?

pulmonary embolism

Lung chemical

CO2

Kidney chemicals

Bicarb and Hydrogen (B&H)

There's only one way to get rid of CO2. What is it?

Exhale

In respiratory acidosis/alkalosis, which organs are sick?

Lungs

Who's going to fix everything (compensate)?

Kidneys (because the lungs are sick)

What are the chemicals the kidneys use to compensate with?

HCO3, H+

In metabolic acidosis/alkalosis, which organs are sick?

Kidneys

If they are sick, who is going to fix things (compensate)?

Lungs

What is the only chemical the lungs have to compensate with?

CO2

Do the lungs compensate slowly or quickly?

quickly

Do the kidneys compensate slowly or quickly?

Slowly

Compensation goal is to

pH in normal range

Metabolic Acidosis

Lungs compensate/ RR raise to blow off CO2/ PCO2 decrease (*CO2 in arterial blood)

Normal Lab Values

HCO3, Bicarbonate, 22-26 mEq/L

Respiratory Acidosis

Kidneys Compensate/ Retain HCO3/ Excrete H in the Urine/ HCO3 on ABGs raise because it holds onto it

Metabolic Alkalosis

Lungs compensate/ Respiratory Rate drops to save CO2/ PCO2 increase (*CO2 in arterial blood)

Respiratory Alkalosis

Kidneys compensate/ Excrete HCO3/ Retain H/ HCO3 on ABGs drop, excreted through the kidneys

Respiratory Acidosis

hypoventilating, drop RR, raise CO2, drop pH (retention)

Is Respiratory Acidosis a lung problem or a kidney problem?

lung Problem

What's the problem Respiratory Acidosis chemical?

CO2

Do we have too much or too little of this chemical in the Respiratory Acidosis body?

too much

Respiratory Acidosis, Who's going to compensate?

Kidneys

Hypoxia may be one of the first signs of

Respiratory Acidosis

How did Respiratory Acidosis happen?

Pain, Narcotics

Respiratory Acidosis symptoms

Increased CO2 -> Decreased LOC -> Increased CO2 -> Decreased O2 -> Early hypoxia = Tachycardia & Restlessness / Late Hypoxia = Cyanosis & Brady Cardia

Respiratory Acidosis Treatment

Fix the problem! (It's a breathing problem, so we need to ventilate the patient)

Be aware of drugs that decrease respiratory rate, Respiratory Acidosis

Analgesics, Narcotics, Benzodiazepines

Respiratory Acidosis - Restlessness think

Hypoxia FIRST! You need to check the SaO2 level and administer O2 as needed.

Respiratory Alkalosis has what major reasoning

hyperventilating

Respiratory Alkalosis, Who's sick?

Lungs

Respiratory Alkalosis, Who's going to compensate?

Kidneys

Situation - Hysterical patient - (1) Are we going to wait until the kidneys kick in?/Need to rebreathe/Treatment?

No; NRM; May sedate the patient; treat the problem

Metabolic Acidosis, Who's sick?

Kidneys

Metabolic Acidosis, Who's going to compensate?

Lungs

Metabolic Acidosis, scenario - DKA - Starvation/Treatment

When you're starving, you break down fats, producing ketones; treat the problem

Ketones are

acids

Drug to help Metabolic Acidosis?

Sodium bicarbonate

Metabolic Alkalosis, Who's sick?

Kidneys

Metabolic Acidosis, scenario - Vomiting/treatment

Lose lots of acid from the gastrointestinal tract; Treat the problem.

Acidosis =

Hyperkalemia - In a state of acidosis, the body will attempt to "fix the problem" by moving hydrogen into the cell. In exchange for hydrogen moving into the cell, potassium moves out, resulting in a higher amount of potassium in the blood (Bodies attempt to compensate)

Alkalosis =

Hypokalemia - In a state of alkalosis, the body will attempt to "fix the problem" by pulling hydrogen out of the cell. In exchange for hydrogen moving out of the cell, potassium moves into the cell, resulting in a lower amount of potassium in the blood (Bodies attempt to compensate)

Frequent occuring cations

sodium (Na+), potassium (k_), calcium (Ca++), magnesium (Mg++)