EMT Exam Review Flashcards

Flashcards for reviewing EMT exam material.

Workforce safety & wellness: Enroute

Wear seat belts

Workforce safety & wellness: Scene

Appropriate PPE, Situational awareness (hazards, traffic, downed power lines, lightning, fire, active shooters)

Most effective way to control disease transmission

Handwashing

CO poisoning effect

CO binds stronger to Hb than O2, preventing O2 delivery to tissues

CO poisoning symptoms

Headache, dizziness, fatigue, nausea, dyspnea, chest pain, impaired judgement, confusion

Body fluid exposure actions

Turnover care, wash area, rinse eyes (20 min), get screened, notify supervisor

Immunity acquisition

Vaccinations, infection recovery

Career stress problems

Stress reactions, PTSD, burnout, compassion fatigue, suicide, irritability, insomnia, anxiety, substance abuse.

Cultural diversity benefit

enjoy benefits/skills of a broad range of people, be sensitive to cultural issues, communicate in a way that is sensitive to everyone’s needs

Sexual harassment types

Quid pro quo (favors for something) & hostile work environment (jokes, touching).

Substance abuse danger

Poor treatment decisions, bad work habits. Report immediately.

Importance of documentation

Safeguard against legal complications. If it isn’t recorded, it didn’t happen

EMT's legal duty to act

Once ambulance responds or treatment begins, legal duty exists

Forcible restraint protocols

Consult medical control/law enforcement. Only if serious medical condition or behavioral disorder poses risk.

Consent types

Expressed, Informed, Implied, Involuntary

Expressed consent

Pt specifically acknowledges that they want you to provide care/transport

Informed consent

Explain treatment nature, risks, benefits, alternatives, consequences of refusal

Implied consent

Unconscious/incapable person would consent to care/transport

Involuntary consent

Consent obtained from legal guardian for mentally incompetent adult

Duty to act defined

Responsibility to provide pt care, consistent with training & protocols

Breach of duty

EMT doesn’t act w/in expected and reasonable standard of care

Causation

Reasonable cause/effect between breach of duty and pt damages

HIPAA

Health Insurance Portability and Accountability Act: protects healthcare info privacy

PHI

Protected Health Information: medical info that can identify the pt

DNR honors

Clear statement of medical problem, pt/guardian signature, physician signature, expiration date < 12 months

Patient refusal treatment

Adults who are conscious, alert and appear to have decision-making have the right to refuse treatment or withdraw from treatment at any time

Glasgow Coma Scale

Provides numeric score associated w/ severity of brain dysfunction

Primary assessment goal

Identify and treat immediate life threats

Immediate transport conditions

Unresponsive, difficulty breathing, uncontrolled bleeding, altered LOC, severe chest pain, pale skin/poor perfusion, complicated childbirth, severe pain

Irregular heartbeat count

Full minute

Altered mental status causes

AEIOU TIPS (Alcohol, Epilepsy, Insulin, Opiates, Uremia, Trauma, Infection, Poisoning, Shock, Stroke, Seizure)

Pulse ox use

Monitors O2 saturation of Hb in capillary beds

Patient interview

Eye contact, repeat statements, don't interrupt, be empathetic

High BP symptoms

Severe headaches, chest pain, dizziness, dyspnea, nausea, blurred vision, anxiety, nosebleeds (often asymptomatic until severe)

Primary assessment redo

During reassessment or new symptoms

Pain types

radiating, referred, provoked

Focused history components

Chief complaint details, SAMPLE/OPQRST

Acute pancreatitis symptoms

Severe upper quadrant pain radiating to back, worsened by eating, nausea, vomiting, abdominal distention

Liver dysfunction symptoms

Jaundice, fatigue, abdominal pain, swelling, stool/urine changes, nausea, easy bruising

Gallbladder disease symptoms

UR quadrant pain radiating to back, shoulder, flank, nausea, vomiting, indigestion, bloating

LOC for medical/shock

Indicates neurological/physiological status, rapid decline signals decompensated shock

Oral airway indication

Unresponsive pt w/out a gag reflex, any apneic pt being ventilated w/ BVM

Oral airway contraindication

Conscious pts or any pt (conscious or unconscious) who has an intact gag reflex

Nasal indication

Semiconscious/unconscious pt w/ intact gag reflex or pts who otherwise will not tolerate an OPA

Nasal contraindication

Severe head injury w/ blood draining from nose/fx nasal bone

Positive pressure impact

Increase in airway wall pressure = increase in the overall intrathoracic pressure, reduced venous return, reduced cardiac output must regulate the rate & volume of artificial ventilations

Rapid shallow breathing problem

Poor perfusion to tissues

CPAP action

Increases pressure in lungs, opens collapsed alveoli, pushes O2 across membrane, forces fluid back into circulation

CPAP uses

asthma, COPD, pulmonary edema

Suctioning importance

Keeps airway clear. If you hear gurgling, suction!

Suctioning technique

Measure distance, apply suction in a circular motion as you withdraw the catheter. Suction 15 sec for adult, 10 sec for child, 5 sec for infant

Suctioning dangers

Too far = vomit, aggressive suctioning can = bradycardia

Nitro indication

S/S of atraumatic chest pain, med is prescribed to pt & med direction authorizes use

Nitro contraindications

BP < 10 or 39 mm drop from baseline, ED drugs in last 72 hrs, pt is under 18, suspected fall/head injury in last 24 hrs, pt has already taken 3 doses

Nitro side effects

CV collapse, bradycardia, hypotension, methemoglobinemia, flushing, headache, light headedness

Aspirin indications

S/S of atraumatic chest pain, 19+ years

Aspirin contraindications

Known allergy/sensitivity, bleeding or active bleeding disorder, 325 mg taken in last 24 hrs, suspected AAA, pregnant, expired

Aspirin side effects

Anaphylaxis, angioedema, bleeding, nausea/vomiting, stomach irritation

Epi indications

respiratory distress w/ multi systems, S/S of severe allergic rxn, med direction authorizes use

Epi contraindications

None when used in a life threatening situation or if med is discolored/expired

Epi side effects

Tachycardia, chest pain, excitability, headache, dizziness, nausea/vomiting

MDI technique

Shake, exhale, around MDI, depress/inhale deeply, hold breath, reassess

Narcan indication

respiratory distress secondary to opioid poisoning

Narcan contraindications

Hypersensitivity/allergy to Narcan, meds are discolored/precipitated/expired, cardiac disease, supraventricular arrhythmia, head trauma, brain tumor

Narcan side effects

increase BP, tachycardia, cardiac arrest, Vfib, pulmonary edema, diarrhea, dyspenia, diaphoresis, nausea/vomiting, abdominal cramps, agitation/combative, tremulousness, seizures

CPAP indications

Pt alert and able to follow commands, respiratory distress, rapid breathing, pulse ox < 90%

CPAP Contraindications

Pt in respiratory arrest/agonal respirations, hypoventilating, can’t speak, unresponsive, BP < 90, pneumothorax/chest trauma, tracheostomy, active GI bleed/nausea/vomiting, facial trauma, cardiogenic shock, can’t sit upright, xs facial hair, can’t tolerate mask

Hypoxic drive

Brain accommodates high CO2, uses low O2 as breathing trigger

Anaphylaxis symptoms

Airway swelling, vasodilation, hypotension, urticaria, itching, shock, asthma

Anaphylaxis treatment

Epi, O2, transport

Chronic lung disease O2

Low-flow O2 (2 L/min), adjust as needed

Hyperventilation causes

Diabetes w/ high blood glucose, panic attack

Respiratory distress tx Conscious

Pt in position of comfort O2 via NRB @ 10-15 L/min. Determine if airway is open, is breathing adequate, rate, rhythm, quality, effort of breathing, skin CTC, breath sounds, PASTE

Respiratory distress tx Unconscious

Airway, adjunct, monitor fluids, ventilate

ALS triggers after CPR/defib

Pt pulse returns, 6-9 shocks given, AED gives 3 consecutive no shock messages

Acute coronary syndrome

Symptoms from myocardial ischemia chest pain/reduced O2

Ischemic heart disease

Reduced heart blood supply due to plaque in coronary arteries (atherosclerosis)

Tachycardia bad?

Too fast reduces blood volume, reducing cardiac output. Not enough time fills completely

AMI

Death of heart muscle cells due to blocked blood flow, dead cells scar

AMI Risk Factors

smoking, high BP, cholesterol/glucose, lack of exercise, obesity, old age, family history of atherosclerosis, race, ethnicity, male, stress, alcohol and poor diet

CV system automaticity

Heart muscle contracts spontaneously w/out nerve stimulus , SA node starts

AED Types

Automatic implantable, external vest, AED manual defib

Cardiac patient rapid assessment

Essential, id/address life threats (ABC's)

LVAD

Left ventricular assist device: pump function of the LV in pts w/ severe heart failure or in pts who need a temp boost due to an MI and may not have palpable pulse

Neurologic assessment

Airway, breathing, circulation, LOC/deficits pre notify for strok, BEFAST, RACE

Neurologic emergency history

Unresponsive = family bystanders, responsive= SAMPLE, When was pt last healthy

Seizure type

generalized, focal, status epilepticus

Generalized seizure

Both hemispheres, twitching, all muscles

Focal seizure

One part of brain

Status epilepticus

Seizures w/ no consciousness 30+ minutes

Stroke

Ischemic or hemorrhagic

Ruptured cerebral S/S

worst headache, nausea, vomiting, stiff neck, light and vision sensitivity, weakness, seizures, loss of consciousness

GI/Urologic care

Shock tx, Vomiting = airway, Loosen cloth, comfort transport/ fast package pt w/ ABC issues

Kidney dialysis

Blood filter/cleans, waste removed

Dialysis types

PD = fluid circulates w/in the peritoneal cavity and Hemodialysis: Pt’s blood circulates thru a dialysis machine that functions in much the same way as normal kidneys.

Ab pain pt concern: child

exacerbation of a chronic problem, poisoning, infection, something they ate

Ab pain pt concern: elderly

S/S differ, decrease pain perception, temp may mean no fever, cardiac condition potential.

Ketone creation

Type 1 cells need glucose/ body burns fat/acids created/Kidneys can’t keep up/Kussmaul respirations

Hemophilia

Genetic, mostly males who can’t clot after injury

Thrombophilia

Clots easier than normal or spontaneously