EMT Exam 1 Diagram | Quizlet

Why is the year 1966 is important to EMS.

National Highway Safety Act charged the U.S. Department of Transportation (DOT) with developing EMS standards.

"White paper"

the document that lays the foundation for modern EMS

Emergency Medical Responder (EMR)

1st Responder; immediate care for life threatening injuries; controlling the scene

Emergency Medical Technician (EMT)

Basic; basic medical care, trauma interventions, and transport

Advance Emergency Medical Technician (AEMT)

Basic Life Support and Advance Life Support; i.e. advance airways, blood sugar, and intervenous medications

Paramedic

this healthcare provider possess the skill set of an EMT and AEMT in addition to other advance life support

Who is responsible for EMS at a federal level?

the Department of Transportation

Who is responsible for an EMS system as a whole?

National Highway Traffic Safety Administration

Who is responsible for the care of a patient?

Medical Director

Scene Size Up

(1) Is the scene safe?

(2) PPE/BSI

(3) MOI/NOI

(4) # of Patients

(5) Call for Additional Resources?

MOI

Mechanism of Injury [trauma]

NOI

Nature of Illness [medical]

BSI

Body Substance Isolation

Secondary Assessment

(1) Physical Exam: DCAP/P-BTLS

(2) Past Medical History(PMH): SAMPLE

(3) History of Present Illness (HPI): OPQRST

(4) Vital Signs

Vital Signs

~Level of Consciousness (LOC)

~Pulse (Carotid and Radial)

~Respirations & Lung Sounds

~Blood Pressure

~Skin (Temperature, Color, Condition)

-Pupils

-Capillary Refill (pt. under 6 y/o)

Primary Assessment

(1) General Impression

(2) C-Spine consideration

(3) Mental Status

(4) A.B.C.

(5) Identify Patient Priority

Reassessment process is

when you repeat BOTH the Primary and Secondary Assesment, including Vital Signs and Patient Priority

How often are Reassessments conducted for LOW Priority patients?

Every 15 minutes

How often are Reassessments conducted for HIGH Priority patients?

Every 5 minutes

When is a Detailed Assessment performed?

...when the patient is in transit to the hospital

Detailed Assessment

(1) Assess Mental Status

(2) Emphasis on C.C. and prior exam

(3) Reassess Vital Signs

(4) Perform Rapid Trauma DCAP/P-BTLS

DCAP/P-BTLS

Deformities

Contusions

Abrasions

Punctures

____

Penetrations

Burns

Tenderness

Lacreations

Swelling

AVPU

regarding patient's responsiveness:

Alert

Verbal response

Painful response

Unresponsive

What mnemonic do you use to assess mental status during the Primary Assesment?

AVPU

Upper Airway

Lower Airway

Rules of Suctioning

(1) Wear PPE

(2) Suction for no more than 10 seconds

(3) Suction on the way (OUT)

*If a patient is vomiting purfuselly, keep suctioning

What could happen if you suction a patient's airway for too long?

...the patient may become hypoxic

How do you OPEN an Airway?

~ Head tilt, Chin lift

~ Jaw Thrust

~ Airway Adjuncts

~Suctioning

How do you ASSESS an Airway?

Look, Listen, and Feel

Characteristics of a Poor Airway

~Abdominal breathing

~Diminished breath sounds

~Trouble speaking

~Retraction and Nasal Flaring (in Children)

Rapid Trauma Exam

When the patients is Unresponsive, has an Altered Mental Status OR a Severe M.O.I.

(1) C- Spine

(2) DCAP/P-BTLS: head to tow

(3) Immobilize the patient

(4) SAMPLE

(5) Vital Signs

Pulse Deficit

the conditionin which the central pulse is greater than the distal/periphial post

Pulsus Paradoxus

absent pulse during Inspiration

Anisocoria

the condition in which 1 pupil is always larger/smaller than the other

Pulse

characterized by Rhythm, Quality, & Rate

Hypoxia

low blood oxygen levels which leads to inadequate breathing

characterized by shallow breath, diminished/unusual sounds, cyanosis, a Blood oxygen saturation less than 95%

Airway Management

"Make it, Check it, Keep it"

When CO2 levels are HIGH and O2 levels are LOW

Patient will exhibit S.O.B., increased Respiration Rate and depth, & increase in Heart Rat

Tripod Position

What is the Intervention for Inadequate breathing?

Positive Pressure Ventilation

Hyperventilation leads to vasoconstriction -OR- vasodilation?

Vasoconstriction

BVM

Bag-Valve Mask

(i.e. Ambu Bag)

When artificially ventilating a patient with a stoma...

..Leave the Patient's head in a neutral position and clear mucus plugs

In which siutaitons do you ALWAYS provide supplemental Oxygenn?

~Cardiac Arrest

~Respiratory Arrest

~Repiratory Distress

~Other respiratory conditons

~Myocardial Infarction

~Stroke

~Shock

~Head injury

Non-Urgent Move

Patient is stable

Urgent Move

performed with precautions for spinal injury; rapid spinal immoblizaiton

Emergency Move

the scene is hazardous, move patient immediately:

Use dragging methods. (i.e. emergency clothes drag, blanket drag, arm drag, arm-to-arm drag)

How far is a severe fall?

Adult: 20ft

Child: 10ft OR twice their heigh

Non-Rebreather Mask

80-100% Oxygen

12 - 15 liters/minute

Nasal Cannula

24-44% Oxygen

4 - 6 liters/minute

Partial Rebreather/Simple Mask

40-60% Oxygen

9 - 10 liters/minute

Tracheotomy Mask

Placed over stoma

8 - 10 liters/minute

Up and Over Injury Pattern

i.e. head-on collision; starred windshield; C-Spine

Down and Under Injury Pattern

i.e. head-on collision; C-Spine; leg and hip injuries

Rear-End Collision

whip lash; C-Spine

Which type of motor vehicle collision is most likely to cause Ejection from the vehicle?

Rollover Collision

OPA

Used for:

~Unresponsive patients

~Patients with no gag reflex

NPA

Used for:

Patients with a gag reflex

Patients who will not tolerate the feeling of an OPA

SAMPLE

Sample

Allergies

Medications

Prior Medical History

Last Oral Intake

Events leading up to the incident

OPQRST

Onset

Palliation/Provocation

Quality

Radiation

Severity

Time

Trending

determined by Reassessment; indicates to the hospital/receiving providers if the patient is deteriorating or improving

CISD

Critical Incident Stress Debriefing

CISM

Critical Incident Stress Management system

Quality Assurance

= quality evaluation

Quality Improvement

= quality interventions

Oxygen Cylinders Rules

~Cylinders are always green

~ Keep containers filled to at least 200psi

~ Always store the cylinder laid down on its side

~No Smoking

Dead Airspace

150mL of air that rests in the lungs, but does not reach (the alveoli) for gas exchange

Chief Complaint (C.C.)

the reason why EMS was called; typically in the patient's own words

What mnemonic do you use to obtain a Past Medical History (PMH)

SAMPLE

What mnemonic do you use to obtain the History of Present Illness (HPI)?

OPQRST

Rules to Remember for Lifting and Moving

~Use your legs

~Keep the load close to your body

~Don't twist your torso

~Know your limits

~Feet shoulder width apart

Respiratory Distress

Adequate breathing with:

~unsual sounds

~normal or slighlty elevated breathing rate

~normal or pale skin

~Anxiety

Respiratory Failure

INadequate breathing with:

~unusual sounds

~too fast or too slow breaths

~Cyanosis

~Alerted Mental Status

Respiratory Arrest.

INadequate breathing with:

~NO breath sounds

~Cyanosis

~Unconsciousness

Emergency Response Guide

when determining whether or not the scene is safe; look for info about hazardous chemicals in this guide

Example of Supplemental Oxygen

Non Rebreather Mask, Nasal Cannula

Example of Artificial Ventilation

Pocket Face Mask, Bag Valve Mask (i.e. Ambu Bag)

How to calculate approximately normal BP for infants and children

Systolic= [80+ (2)(AGE)], Diastolic = [ (2/3) x (Systolic #)]

Shock

AKA Hypoperfusion: a life-threatening condition that occurs when the body is not getting enough blood flow.

Compensated Shock

When low blood flow (perfusion) is first detected by the body.A number of systems are activated in order to maintain/restore perfusion. The heart beats faster, the blood vessels become smaller in diameter, and the kidney works to retain fluid in the circulatory system to maximize blood flow to the most important organ systems of the body. The patient in this stage of shock has very few symptoms, and aggressive treatment may slow or stop progression to stage II shock

Decompensated Shock

When the methods of compensation begin to fail. The systems are unable to maintain perfusion any longer. Oxygen deprivation in the brain causes the patient to become confused and disoriented.

Irreversible Shock

The length of time that poor perfusion has existed begins to take a permanent toll on the body's organs and tissues. The heart's functioning continues to spiral downward, and the kidneys usually shut down completely. Cells in organs and tissues throughout the body are injured and dying. The endpoint is patient death.

Hospital Notification Script

(1) Address destination

(2) Identify self

(3) Relay: Age, Sex, C.C., Vitals, Status/Priorty, and ETA

Medical Command Script

(1) Address destination

(2) Identify self

(3) Why did I call?

(4) Relay: Age, Sex, C.C., Vitals, Status/Priorty, and ETA

(5) Assessment

(6) Response to treatment

(7) Vitals

(8) ETA

Crepitation

bone fragments rubbing together; identified during palpation

Acute Stress

fight or flight

Delayed Stress

i.e. PTSD

Cumulative Stress

Burnout

Stages of Stress

(1) ALARM---fight or flight

(2) RESISTANCE---coping

(3) EXHAUSTION

Components of Blood

Portable Radio

radio carried by an EMT

Mobile Radio

radio fixed to an ambulance

Base Radio

radio located at the hospital

What is the #1 Rule?

Safety!

Inspiration

an active process; negative (-) pressure

Expiration

a passive process; positive (+) pressure

Ventilation

the movement of air in/out of the lungs

Respiration

gas exchange

Anatomy of the Heart