Paramedic NREMT Comprehensive Study Guide

Comprehensive vocabulary flashcards covering the Paramedic NREMT curriculum including exam specifications, medical terminology, respiratory management, cardiology and ACLS protocols, neurology, pharmacology, trauma, obstetrics, and EMS operations.

Computer Adaptive Test (Cognitive Exam)

A computer-based examination that tailors questions based on candidate performance and question difficulty, stopping once it is $95\%$ confident competency has or cannot be achieved after answering at least $80$ questions (within $2\text{ hours and } 30\text{ minutes}$).

Pilot Questions

$20$ questions on the NREMT cognitive exam that are not factored into the candidate's scored performance.

Aniscoria

A condition characterized by unequal pupil size.

Blebs

A collection of air between the lung and visceral pleura that can result in a spontaneous pneumothorax.

Bruit

An abnormal sound or murmur due to a narrowing of a blood vessel.

Crepitus

A grating sound or sensation often caused by bone rubbing on bone, or by inflammation in the joints.

Dermatomes

Specific areas of the body supplied by a single spinal nerve.

Dysarthria

Poor articulation of speech, often due to impairment of muscles used in speaking.

Polycythemia

An unusually large number of red blood cells in the blood as a result of increased production by the bone marrow, often caused by COPD and/or right ventricular failure/enlargement.

Pulsus Paradoxus

An abnormal decrease in systolic blood pressure of $10-15\,\text{mmHg}$ during inspiration.

Trismus

Limited jaw range of motion commonly caused by muscle spasms of the jaw, which can be a primary symptom in tetanus.

Volvulus

A twisting or knotting of the intestines causing a bowel obstruction.

Zone of Coagulation

The central area of a burn wound that has sustained the most intense contact with the thermal source.

Zone of Stasis

The area of burn tissue surrounding the critically injured central zone of a burn.

Tidal Volume

The volume of air inspired or expired in a single breath, averaging $500\,\text{mL}$ ($5-7\,\text{mL/kg}$ of ideal body weight) in an adult and $8\,\text{mL/kg}$ in pediatrics.

Dead Space

The portion of the tidal volume that does not participate in gas exchange, averaging $150\,\text{mL}$ in an adult ($2.3\,\text{mL/kg}$ in infants and $0.8\,\text{mL/kg}$ in school-age children).

Cheyne-Stokes Respirations

Abnormal breathing characterized by regular, periodic breathing with intervals of apnea and a crescendo-decrescendo pattern of respirations.

Kussmaul's Respirations

Rapid and deep respirations, most often associated with diabetic ketoacidosis (DKA) as a compensatory mechanism to correct metabolic acidosis.

DOPE Mnemonic

An assessment tool for troubleshooting endotracheal tube complications: Displacement or dislodgement, Obstruction, Pneumothorax, and Equipment failure.

ROME Mnemonic

An arterial blood gas interpretation rule meaning 'Respiratory Opposite, Metabolic Equal', describing the directional relationship between $\text{pH}$ and $\text{CO}_2$ or $\text{HCO}_3$.

Curare Cleft

A capnogram dip in the plateau phase occurring when neuromuscular blockade begins wearing off and the patient takes a small spontaneous breath.

Status Asthmaticus

A severe, prolonged asthma attack that has not been terminated by repeated doses of bronchodilators, often leading to dehydration and requiring advanced airway management.

High Altitude Pulmonary Edema (HAPE)

The most lethal high-altitude illness caused by increased pulmonary artery pressure, with symptoms developing $24-72\text{ hours}$ after exposure requiring descent to $< 500\,\text{feet}$.

Variant Angina (Prinzmetal Angina)

Chest pain caused by coronary vessel vasospasm that can occur at rest and may resolve spontaneously or with medication administration.

Beck's Triad

A collection of three clinical signs indicative of cardiac tamponade: jugular vein distention (JVD), muffled heart sounds, and hypotension.

Right Ventricular Infarction (RVI)

Infarction of the right ventricle identified by ST elevation $> 1\,\text{mm}$ in lead $\text{V}_4\text{R}$, indicating caution with nitroglycerin administration and necessity of fluid boluses to maintain preload.

Turn Signal Method

A diagnostic method for bundle branch blocks in lead $\text{V}_1$: a wide $\text{QRS} > 0.12\,\text{s}$ deflected upward indicates a Right Bundle Branch Block (RBBB), while deflection downward indicates a Left Bundle Branch Block (LBBB).

Adenosine (Adenocard)

An antidysrhythmic agent that delays conduction through the AV node, given as a rapid $6\,\text{mg}$ IV push followed by a $12\,\text{mg}$ dose with a $10-20\,\text{mL}$ saline flush for stable SVT.

Amiodarone (Cordarone)

A Class III antidysrhythmic that blocks potassium channels, administered at $300\,\text{mg}$ IVP then $150\,\text{mg}$ IVP for refractory VF/pVT, or $150\,\text{mg}$ over $10\text{ minutes}$ for stable VT.

Reticular Activating System (RAS)

A network in the brain responsible for maintaining consciousness and the ability to respond to stimuli.

Babinski Reflex

Dorsiflexion of the great toe and fanning of the other toes in response to plantar stimulation, indicating dysfunction of the central nervous system.

Transient Ischemic Attack (TIA)

A temporary interference with the brain's blood supply with neurological symptoms that completely resolve within $24\text{ hours}$ without residual damage.

Status Epilepticus

Two or more generalized motor seizures occurring without an intervening return of consciousness.

Trigeminal Neuralgia (Tic Douloureux)

An extremely painful condition affecting the fifth cranial nerve ($\text{CN V}$), characterized by chronic, electric-shock-type spasms and pain.

Bell's Palsy

Sudden, unilateral weakness or paralysis of the facial muscles caused by dysfunction of the seventh cranial nerve ($\text{CN VII}$, Facial Nerve).

SLUDGE Mnemonic

A syndrome of cholinergic toxidrome symptoms caused by organophosphates or nerve agents: Salivation, Lacrimation, Urination, Defecation, GI Upset, and Emesis.

Wernicke Encephalopathy

An acute neurological disorder in alcohol abuse caused by thiamine deficiency, presenting with ataxia, nystagmus, speech disturbances, neuropathy, stupor, and coma.

Therapeutic Index

A measurement of relative drug safety calculated as $\frac{\text{TD}_{50}}{\text{ED}_{50}}$, where values closer to $1$ indicate greater toxicity.

Colloid

An intravenous fluid containing large molecules (typically proteins like albumin) that are too large to pass through the capillary membrane.

Cushing's Triad

A sign of increased intracranial pressure and impending brain herniation consisting of bradycardia, irregular respirations, and an increased blood pressure (widening pulse pressure).

Epidural Hematoma

An arterial bleed (most commonly the middle meningeal artery) between the cranium and dura, often presenting with loss of consciousness, a lucid interval, and subsequent neurologic deterioration.

Brown-Sequard Syndrome

A hemitransection of the spinal cord resulting in ipsilateral motor weakness/paralysis and contralateral loss of pain and temperature sensation.

Commotio Cordis

Blunt trauma to the chest during the vulnerable upstroke of the T-wave (R-on-T phenomenon) inducing ventricular fibrillation.

Kehr's Sign

Referred pain to the left shoulder indicative of splenic injury or rupture.

Decompression Sickness

A multisystem condition occurring during ascent when dissolved nitrogen forms bubbles in blood and tissues (governed by Henry's Law), causing joint pain, rashes, and subcutaneous bubbles.

Nitrogen Narcosis

A state of central nervous system depression ('rapture of the deep') caused by dissolved nitrogen crossing the blood-brain barrier at diving depths of $75-100\,\text{ft}$.

Osborn Wave (J Wave)

An abnormal positive deflection located at the junction of the QRS complex and the ST segment characteristically seen on EKGs in hypothermic patients.

Placenta Previa

Placental implantation over or near the cervical opening, characteristically presenting as painless, bright red third-trimester vaginal bleeding.

Abruptio Placentae

Premature separation of a normally implanted placenta after $20\text{ weeks}$ of gestation, characterized by stabbing abdominal pain, dark red bleeding, and uterine tenderness.

Eclampsia

The development of grand mal (tonic-clonic) seizures in a preeclamptic pregnancy patient, treated with $4\,\text{g}$ of magnesium sulfate over $10-20\text{ minutes}$.

McRobert's Maneuver

A maternal positioning technique involving hyperflexion of the mother's legs to the abdomen accompanied by suprapubic pressure to resolve shoulder dystocia.

Croup (Laryngotracheobronchitis)

A viral upper airway infection typically occurring in children $6\text{ months to } 4\text{ years}$ old, characterized by hoarseness, inspiratory stridor, low fever ($< 104^\circ\text{F}$), and a barking cough.

Epiglottitis

A severe bacterial infection of the epiglottis presenting with high fever ($> 104^\circ\text{F}$), muffled voice, drooling, painful swallowing, and tripod positioning.

Mallory-Weiss Tear

A partial-thickness laceration of the lower esophagus caused by excessive retching and vomiting (frequently linked with bulimia) leading to upper GI bleeding.

Boerhaave Syndrome

A full-thickness rupture of the esophagus resulting from prolonged violent retching that allows blood, air, and food into the mediastinum, carrying a $90\%$ untreated mortality rate.

Simplex Transmission

Radio communications that transmit and receive on the same frequency and cannot occur simultaneously, commonly used for dispatch and on-scene communications.

Duplex Transmission

Simultaneous two-way radio communication utilizing two distinct frequencies for each channel, functioning similarly to a telephone.

HOTSAW Mnemonic

A checklist for helicopter landing zone site preparation: Hazards, Obstructions, Terrain, Surface, Animals, and Wind/weather.

Span of Control

The number of individuals or organizational tasks an incident commander can effectively manage, ranging between $3\text{ and } 7$, with $5$ considered optimal.