When a patient is placed on a long backboard, which of the following areas is secured first?

Post-partum hemmorage

Excessive bleeding following childbirth

Polydipsia

excessive thirst

Polyphagia

excessive hunger

Polyuria

excessive urination

ICS roles:

• Incident Commander

• Triage Officer

• Staging Officer

• Incident Commander = command role

• Triage Officer = patient care role

• Staging Officer = support/logistics role

Common LOWER airway pediatric infections

• Pneumonia

• Bronchiolitis

• RSV

RSV (Respiratory Syncytial Virus)

A) is a common viral infection in infants and young children that can cause respiratory illnesses such as bronchiolitis and pneumonia

Common causes of abdominal pain

• appendicitis

• pancreatitis

• renal calculi

• bowel obstruction

Renal calculi signs

• severe flank pain

• radiates to groin

• restless patient

• hematuria possible

Pancreatitis signs

• epigastric pain radiating to back

• nausea/vomiting

• worse after eating/alcohol

CPAP indications

• COPD exacerbation

• pulmonary edema/CHF

• pneumonia with respiratory distress

compartment syndrome symptoms

• tenderness

• pain

• numbness

Common AED error cause?

Using AED in moving vehicle

Spleen referred pain location?

Left shoulder (Kehr’s sign)

Liver/gallbladder referred pain location?

Right shoulder

Diaphragm irritation can cause pain where?

Shoulders (referred pain)

Treatments for a patient with pulmonary edema from Congestive Heart Failure (CHF)?

• nitro

• CPAP

• supplemental oxygen

central pulses

Carotid and femoral arteries.

For most adults, at what level must a patient's systolic blood pressure be in order to demonstrate a palpable radial pulse?

90 mm Hg

Liver vs spleen referred pain

Liver → right shoulder
Spleen → left shoulder

Jaw-thrust/chin-lift opens airway, then what?

Insert airway adjunct (OPA/NPA)

Stable seated MVC patient needing SMR (Spinal Motion Restriction) extrication?

Short backboard/KED for vehicle extrication

Purpose of short backboard/KED?

Spinal motion restriction during seated vehicle extrication

Unresponsive patient with severe foreign body airway obstruction → treatment?

Start CPR/compressions

Epistaxis

Nosebleed caused by broken blood vessels

How to prevent gastric distention during bag-valve mask ventilation?

Deliver each breath slowly over 1 second with only enough volume for visible chest rise

When a patient is placed on a long backboard, which of the following areas is secured first?

Upper torso

Chemical suicide commonly releases what gases?

• Hydrogen sulfide

• Hydrogen cyanide

Acute myocardial infarction vs pulmonary embolism

Acute myocardial infarction:

• crushing/radiating pain

• diaphoresis

• nausea

Pulmonary embolism:

• pleuritic pain

• clear lungs

• hemoptysis

• sudden dyspnea

Systemic vascular resistance

vasoconstriction

organophosphate poisoning

Chemicals found in:

pesticides/insecticides

some nerve agents

organophosphate poisoning signs

• Vomiting

• Diaphoresis

• Excessive urination

Both arms injured → where take blood pressure?

Thigh/leg blood pressure

Addison's disease

Endocrine disorder in which the adrenal glands do not produce enough hormones: weakness, weight loss, low blood pressure

Thyroid storm

Endocrine emergency—extreme overactivity of the thyroid gland

fever

rapid heart rate

hypertension,

agitation

Cholelithiasis

Gallstones, which are hardened deposits that form in the gallbladder or bile ducts

No crowning but urge to push → EMT action?

Instruct patient not to push and transport

Nerve agent antidote kits

• Mark 1

• DuoDote

Posterior vs anterior hip dislocation

Posterior hip dislocation:

• MOST common

• shortened leg

• internally rotated

Anterior hip dislocation:

• externally rotated

• lengthened appearance possible

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EMS provider levels in order

First Responder/EMR → EMT → Advanced EMT → Paramedic

Upper gastrointestinal bleed causes

• Mallory-Weiss tear/syndrome

• Esophageal varices

• Peptic ulcers

Lower gastrointestinal bleed causes

• hemorrhoids

• ulcerative colitis

• diverticulosis

APGAR — Appearance scoring

0 = blue/pale all over
1 = body pink, hands/feet blue
2 = completely pink

APGAR — Pulse scoring

0 = absent pulse
1 = under 100 bpm
2 = over 100 bpm

APGAR — Grimace scoring

0 = no response
1 = grimace/weak response
2 = coughs, cries, pulls away

APGAR — Activity scoring

0 = limp/floppy
1 = some flexion
2 = active movement

APGAR — Respirations scoring

0 = absent breathing
1 = weak/slow breathing
2 = strong cry/good respirations

Excited delirium vs acute manic episode

Excited delirium:

• tachycardia

• hypertension

• tachypnea

• diaphoresis

• medical emergency

Acute manic episode:

• impulsivity

• anxiety

• manic behavior

By which route is an auto-injectable syringe of epinephrine administered?

Parental

Amphetamine/stimulant overdose signs

• hypertension

• tachycardia

• agitation

• dilated pupils

Patient opens eyes but does not answer questions → likely AVPU?

Responds to painful stimuli unless stated otherwise

Supine position is preferred for?

Shock/hypoperfusion patients

Fowler position is usually used for?

Breathing difficulty/respiratory distress

Semi-Fowler position is used for?

Breathing difficulty/respiratory distress

Heat exhaustion vs heat stroke

Heat exhaustion = cool clammy skin, sweating, weakness, normal mental status

Heat stroke = hot skin, altered mental status, medical emergency

Pneumonia patient becomes suddenly agitated and removes oxygen mask → likely cause?

Worsening hypoxia

Why might a hypoxic patient remove their oxygen mask?

Hypoxia can cause confusion, agitation, and irrational behavior

Distributive shock types

Septic, neurogenic, anaphylactic

Effects of positive pressure ventilation

Increases intrathoracic pressure and decreases blood return to the heart (preload)

When is it acceptable to disturb a crime scene?

Only when absolutely necessary to care for the patient

Lower airway lung sounds

Crackles (rales), wheezing, rhonchi

Upper airway sounds

Snoring respirations and stridor

Order to remove personal protective equipment

Gloves → eye protection → gown → mask

Abruptio placentae vs uterine rupture

Abruptio placentae = painful bleeding/rigid abdomen
Uterine rupture = tearing pain and contractions suddenly stop

The Warm Zone is primarily established for what purpose?

Contamination reduction

Oxygen cylinder factors D & E

D cylinder = 0.16
E cylinder = 0.28

Dirty bomb vs biological agent

Dirty bomb = radiation exposure
Biological agent = infectious disease exposure

How should an ambulance be parked at a motor vehicle crash?

Park at an angle in the fend-off position with wheels turned away from the scene

3 Ps of diabetes

Polyuria = excessive urination
Polydipsia = excessive thirst
Polyphagia = excessive hunger

Activated charcoal is NOT used for?

Acids, alkalis/corrosives, inhaled poisons

SLUDGEM

Salivation
Lacrimation
Urination
Defecation
Gastric upset
Emesis
Miosis (pinpoint pupils)

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Grey-Turner sign

Bruising/flank discoloration from internal abdominal bleeding or pancreatitis

Cullen’s sign

Bruising around the umbilicus from internal bleeding/pancreatitis

Murphy’s sign

Pain when breathing in during RUQ palpation → gallbladder inflammation (cholecystitis)

Neurogenic shock signs

Warm flushed skin, bradycardia, hypotension

cholecystitis

Inflammation of the gallbladder, usually associated with gallstones, causing abdominal pain and potential infection.

Cholecystitis signs

Right upper quadrant pain, right shoulder pain, bloating/indigestion, pain after fatty foods

Hepatitis signs

Right upper quadrant pain, jaundice/yellow skin, fatigue, nausea, decreased appetite

Pediatric Total Burn Surface Area methods

Rule of nines and rule of palms

Signs of increased work of breathing in pediatrics

Head bobbing, tachypnea, nasal flaring

Hypovolemic shock positioning

Supine position