Emergency Medical Care Lecture Notes

Flashcards on Emergency Medical Care and Related Topics

What is an Emergency?

A combination of unforeseen circumstances that calls for immediate action.

Emergency Medical Responders

Initiates immediate lifesaving care, basic knowledge and skills for airway/breathing, AED, stabilization of extremities, bleeding control, and emergency moves.

Emergency Medical Technicians

Same skills as EMRs, final say in patient transport.

Advanced EMT

Basic and limited advanced emergency care; airways, suctioning, vitals, lung sounds, glucometry, IVs, IOs, non-medicated IV fluids, nitroglycerine, IM epinephrine, oral glucose, IV dextrose, MDI's, narcotic antagonists, nitrous oxide.

Paramedics

Advanced emergency medical care for critical patients.

Level V Trauma Center

Provides initial evaluation, stabilization; may transfer to higher-level centers.

Level IV Trauma Center

Provides initial stabilization, advanced trauma life support before transfer.

Level III Trauma Center

Same as Level IV, may perform emergency surgery.

Level II Trauma Center

Initial definitive care for most injuries, 24/7 coverage by general surgeons/specialists; may transfer complex patients.

Level I Trauma Center

Comprehensive trauma care, 24/7 in-house surgeons/specialists, research, education, full services.

SBAR (Transfer of Care Communication)

Situation, Background, Assessment, Recommendation.

What information is included in the SBAR communication tool?

The patient's age and sex, chief complaint/current condition, history of present illness, past medical history, mental status, baseline vital signs, physical exam findings, emergency care provided, patient's response to care, patient's current condition.

The Three C's

Confidence, Compassion, and Cooperation

Introduction Steps

Wash Hands, Introduce Team, Ask Patient's Name, Permission to Treat, Use Patient's Name, Be Aware of Body Language

Stress

State of physical arousal to respond to threatening/demanding situations.

Stressor

Event that brings about the stress response

Post-Traumatic Stress Disorder (PTSD)

Affects social or occupational lives for more than one month after the event; nightmares, flashbacks, concentration problems, irritability, emotional fluctuations, insomnia, avoiding reminders.

Acute Stress Disorder (ASD)

Extreme stress reactions in the first month after trauma; dissociation, emotional numbness, memory loss.

Personnel Duties in EAP

Patient care, assist in patient care, activate EMS, equipment/crowd control.

Epidemiology

Study of patterns, causes, and effects of death/disability in sports.

Incidence

Occurrence, rate, or frequency of a disease.

Prevalence

Proportion of population with a condition.

Relative Risk

Probability of developing a disorder when exposed to a risk factor.

Odds Ratio (OR)

Association between exposure and outcome.

Vitals Reassessment

Reassess every 15 minutes if stable, every 5 minutes if unstable.

Respiration Assessment

Rate, quality, and rhythm.

Apnea

Stoppage of breathing.

Bradypnea

<12 bpm

Tachypnea

20 bpm

Dyspnea

Painful breathing

Cheyne-Stokes

Changing tidal volume and breath gets faster

Biot

Same as Cheyne-Stokes but tidal volume stays the same

Apneustic

Periods of long inhalation

Ataxic

Irregular breathing rates

Agonal

Gasping breath then apnea

Kussmaul

Very rapid rate and very deep breaths

Central neurogenic hyperventilation

Sustained rapid rate

Snoring

Tongue blocking airway

Gurgling

Fluid in airway

Stridor/Crowing

Obstruction of larynx

Wheezing

Constriction and inflammation of bronchioles

Crackles (Rales)

Fluid in alveoli

Rhonchi

Mucus blocking bronchioles

Pulse Locations

Carotid, femoral, brachial, radial, popliteal, posterior tibial, dorsalis pedis.

Rapid, Regular, and Full Pulse

Exertion, fright, fever, high blood pressure, early blood loss.

Rapid, Regular, and Thready Pulse

Shock, early blood loss.

Slow Pulse

Head injury, drugs, poisons, cardiac problem, hypothyroidism.

No Pulse

Cardiac arrest, hypotension.

Pallor (White Skin)

Vasoconstriction, blood loss, shock, heart attack, fright, anemia, fainting, emotional distress.

Cyanosis (Blue-Gray Skin)

Inadequate oxygenation/perfusion, respiratory issues, heart attack.

Flushing (Red Skin)

Heat exposure, carbon monoxide poisoning.

Jaundice (Yellow Skin)

Liver disease.

Mottling (Gray-Blue Skin)

Blotchy pattern; Poor perfusion or cold exposure

Hot Skin

Fever, heat exposure.

Cool Skin

Shock, cold exposure.

Cold Skin

Extreme cold exposure.

Wet/Moist Skin

Shock, heat emergency, diabetic emergency.

Abnormally Dry Skin

Spinal injury, dehydration, heat stroke, poisoning, hypothyroidism.

Dilated Pupils

Cardiac arrest, drug use.

Constricted Pupils

CNS disorder, narcotics.

Unequal Pupils

Stroke, head injury, artificial eye, eye drops.

Nonreactive Pupils

Cardiac arrest, brain injury, eye drops, drug intoxication.

Blood Pressure

Force of blood against arterial walls

Systolic BP

BP during left ventricle contraction.

Diastolic BP

Pressure during left ventricle relaxation.

Pulse Pressure

Difference between systolic and diastolic BP.

Pulse Oximetry

Measures oxygen saturation in blood.

Capnometry

Non-invasive CO2 level measurement

Scope of Practice

Actions/skills allowed to be performed.

Standard of Care

Expected care to be provided.

Duty to Act

Legal obligation to provide service if on-duty/contracted.

Good Samaritan Laws

Protect those who render emergency care in good faith, without pay, and with no duty to act.

Sovereign Immunity

Government not liable for negligence.

Statutes of Limitation

Time limit to sue for damages.

Liability

Legally responsible for harm.

Contract Law

Waivers, consent forms, etc.

Tort

Legal wrong with remedy.

Negligence

Failure to act reasonably causing harm.

Nonfeasance

Act of omission (failure to act).

Malfeasance

Act of commission (illegal act).

Misfeasance

Improperly doing something.

Informed consent

Agreement to treat for athlete

Expressed consent

Research study, verbal consent

Implied consent

Head nod, rolling up sleeve for BP

Decerebrate Posturing

Arms extended, head arched back, legs extended.

Decorticate Posturing

Arms flexed, hands clenched, legs extended.

Triage

Method to sort patients based on severity.

START Triage

Simple Triage and Rapid Treatment.

Black Triage Category

Injuries incompatible with life.

Red Triage Category

Severe injuries, high survival potential.

Yellow Triage Category

Serious injuries, not life-threatening.

Green Triage Category

Minor injuries, walking wounded.

SALT Triage

Sort, Assess, Life-saving interventions, Treatment/Transport.

SAMPLE History Taking

Signs and symptoms, allergies, medications, pertinent past history, last oral intake, events leading up to.

Athletic Training Evaluation, low complexity (97169)

15 minutes face to face, no comorbidities, 1-2 body structure elements affected.

Athletic Training Evaluation, moderate complexity (97170)

30 minutes face to face, 1-2 comorbidities, 3+ body structure elements affected.

Athletic Training Evaluation, high complexity (97171)

45 minutes face to face, 3+ comorbidities, 4+ body structure elements affected.

Rule of 100 - Not likely a serious injury/illness

Systolic BP > 100, pulse and temp < 100

Rule of 100 - May indicate a serious injury

Systolic BP < 100 and or pulse and temperature > 100

Oppenheim Reflex

Drawn along anteromedial tibia, (+) great toe extension and splaying; indicates upper motor neuron lesion.