Exam 2 JCCC EMS 129 (EMR)

Name some signs and symptoms of hypoglycemia

Bizarre behavior (AMS), possibly difficulty swallowing, may appear drunk, dizziness, etc……

Name some of the techniques to check for breathing on a conscious patient

You can put your hand on a patient’s chest or abdomen to use as a distraction when checking for breathing on a conscious patient.

Name some signs and symptoms of hypoglycemia

Bizarre behavior (AMS), possibly difficulty swallowing, may appear drunk, dizziness, etc……

Name some of the techniques to check for breathing on a conscious patient

You can put your hand on a patient’s chest or abdomen to use as a distraction when checking for breathing on a conscious patient.

Name an endocrine disorder

Most common is diabetes. Others include pituitary disorders and thyroid disorders.

If you have someone with extreme difficulty breathing…how do you treat?

Needs an assisted breathing device - BVM would be appropriate.

What would be the signs and symptoms of respiratory distress

People who can’t breathe are often anxious and will often show a decrease in LOC. You will also see skin becoming cyanotic, but that takes time…Physically, they can use the tripod position to help their breathing and if long term, may also have accessory muscle use.

What is arteriosclerosis

A blockage or narrowing of arteries. It can interrupt the blood flow to the heart and cause them not to constrict and dilate properly.

You have a combative patient, how many rescuers would be the most you would want to help with the patient?

It can be four or five but be careful of too many because that can cause confusion.

What is epistaxis

Common name is a nosebleed.

When treating patients, what is often your most immediate concern

Ensuring your patients can maintain an airway.

Define the difference between heat exhaustion and heat stroke

In heat exhaustion, the skin is still moist and trying to cool… in heat stroke, the skin is hot and dry (the body is no longer able to cool).

What do we do to protect a patient who is having a seizure

Don’t restrain/make sure they are in a safe environment and protect them as best you can/be sure they can maintain an airway and give oxygen as soon as you can.

Does technique matter when a poisoning occurred?

It could matter on the effectiveness of the antidote.

Name one predelivery emergency involving the placenta

Placenta previa and placental abruption are both emergencies.

Describe what the condition of the cord should be before you cut

The cord should be clamped and no longer pulsating.

Name the stages when a baby is delivered

• Dilation stage: Occurs before delivery • Expulsion stage: Baby is delivered • Placental stage: Placenta is delivered

What is the Cincinnati Stroke Scale

Facial droop, arm drift, speech.

If you have a pregnant patient that has a decreased LOC (verbal) and her blood pressure is low, what would be a good treatment?

Turn the patient on their left side. This allows more blood to return to the right side of their heart.

What is this condition called? Supine hypotensive syndrome

Explain a breech presentation

The infant’s legs and buttocks are delivering first.

A pregnant female has excessive bleeding or no uterine contraction has started, how do you help your patient?

Massage the uterus until you feel it contract and the bleeding has slowed (fundal rub). Extra: Breastfeeding can help the uterus contract, reducing postpartum bleeding and aiding recovery.

What patient has ‘bloody show’

A pregnant female whose body is getting ready to give birth. It is a small amount of blood and mucous that precedes delivery.

What is a seizure in medical terms

The brain’s electrical activity is altered, often due to a massive electrical discharge in the brain. Extra: What is the stage called right after a seizure is over? POST-ICTAL stage (there will still be confusion but often resolves).

What is required if an adolescent tells you they have been sexually assaulted?

Be sure to fill out the proper paperwork and tell the emergency room staff.

Describe APGAR. What does it stand for and when is it used?

It is an assessment tool for a newborn. Scoring is 0-2 for each category: • A - Appearance • P - Pulse • G - Grimace • A - Activity • R - Respiration

What are atropine and pralidoxime used for?

As an antidote for nerve agents.

What is an indication that birth is imminent?

Crowning and often the mom indicates she wants to move her bowels.

If you have a patient with difficulty breathing, what are some of the earliest signs?

Patients often become anxious and can have a decreased LOC. Remember, it’s not only the rate but the depth of breathing that’s important.

When working on an infant or toddler, where should you start your assessment?

Assess from Toe to Head.

What type of patient would get a head tilt chin lift?

We would prefer a head tilt chin lift if there is no suspected spinal injury. Doing the head tilt chin lift will lift the tongue out of the way to help clear the airway.

If a patient is going to be considered for receiving nitro, what vital sign is very important?

Blood pressure.

What is dyspnea?

Difficulty breathing.

Hypoglycemia is critical when

Patient is unable to swallow.

If a child is in anaphylactic shock, what reaction is the biggest concern?

Loss of the airway.

Describe techniques to open the airway with a spinal injury

From the top of the head, move the tongue with your thumb. It helps open the airway with patients of suspected spinal injury. It should minimize the head from moving or being flexed or… thumbs on cheeks pushing downwards with the fingers on the jawline lifting straight up. Extra: Called Jaw thrust / trauma maneuver.

How do you transport an amputated body part?

Keep it cool in a plastic bag—not directly on ice.

What is angina?

A heart condition caused by spasms or brief blockage of the arteries, causing pain due to lack of oxygen. Can usually be relieved by rest.

In an ongoing exam, what vital sign would be the most serious sign?

Decreased BP.

If an infant’s legs and buttocks have already been delivered, what is this presentation called?

Breech.

If you think a patient has had a stroke, how should they be positioned if the paralysis is on the left side?

Left lateral recumbent.

After delivering a baby, you find the infant is limp. What do you do to assist?

With a clean towel, dry and rub to help stimulate the infant.

Cincinnati Stroke Scale

Facial droop, arm drift, and speech quality. Extra credit: It is also important to know, if possible, the time the symptoms have been going on.

If a patient has a head injury, what must be a primary concern for the first responder?

Can they maintain their airway.

What is a quick and easy method to check for adequate circulation in a child?

Capillary refill.

If you are doing compressions and have an advanced airway in place, how do you give breaths?

Breathe once every 6 seconds without stopping to give breaths during continuous compressions.

If you have a young patient, what options are available to insert an oral airway?

Flatten out the tongue with a bite stick and insert the OA directly. Or: Use scissors or tongue-jaw lift.

Manual stabilization of the c-spine occurs when you hold…

Head and face (no c-collar).

What medical condition often causes a child to have seizures?

High fever can cause febrile seizures.

What is the age range of a child most likely to have an accidental poisoning?

Under the age of six.

What is the technique called to open a blocked airway for a conscious choking infant?

Five back slaps / five chest thrusts. What if they become unresponsive? CPR when they become unresponsive.

You have an adult patient with inadequate breathing. What would be the preferred method to assist if two responders are available?

Two-person BVM—one person using BVM to ventilate and the second rescuer holding the mask using a two-handed C3 seal.

How is a behavioral emergency defined?

An abnormal behavior that is considered unacceptable.

A patient has a medical condition that requires oxygen, but SpO2 is average (93-94). What should you do?

Start with appropriate O₂, but if the patient is not having trouble breathing and stats are good, consider starting on the low side of the adjunct range and titrate up from there.

Patient has SOA and is drooling. No other signs of weakness. What could that be?

With no other signs of weakness, it is unlikely that it is a stroke but do not rule out completely… Could also be swelling in the airway, which would make swallowing difficult (anaphylaxis, etc.). Watch symptoms and treat appropriately.

After delivering a baby, the baby seems weak and listless… what is the next step?

Stimulate the newborn with a clean towel, rubbing vigorously on their back.

What age is a neonate?

0 to 1 month.

You have a neonate that is pulseless. What should be your rate of compressions?

120 a minute (use the fastest number in the range since neonates’ pulse is usually faster).

A patient is acting like they could be intoxicated. Police are unable to do a sobriety test… what do you do for the patient?

Do a glucose test or provide sugar and watch for a reaction.

After treating life-threatening issues, you triage red. As the patient is getting prepared for transport, what do you do?

A rapid secondary assessment.

A 1-year-old has snoring respirations and decreased breathing. How do you help?

Reposition the head—it should help with snoring. Consider a BVM if unable to control airway/breathing.

What is the most common food allergy in adults?

Seafood.

What do you do if treating a child with a high fever and possible seizure?

Maintain the airway by putting them on their side to prevent aspiration and provide some type of oxygen.

You have a patient that you believe is having a heart attack… what is your first step?

Be sure ALS is on the way. We will always treat accordingly (O₂, etc.), but if you have reason to honestly believe it is a heart attack, be sure ALS is on the way.

You encounter a case of inhaled poisons. What do you do?

Make sure everyone is safe. (Leave finding the source and treatments until after everyone is safe.)

What should we remember when waiting for a placenta to be delivered?

It will normally take 20 minutes. Other steps can help facilitate the delivery, but remember to be patient…

What is a person called if they must report certain activities to the proper authorities?

Mandated reporters.

What is one of the most important things to do when treating a child with an apparent head injury?

Keep them still and as immobilized as possible.

10-year-old patient injured in a bicycle accident. Has some cuts/abrasions and a stomach ache. What question would they be likely to ask?

Could the injury and resulting healing become permanent (as in scarring)?

Patient is having symptoms of a heart attack… name a couple

Chest pain, difficulty breathing, dizziness, radiating pain in upper extremities.

What is the correct compression-to-ventilation ratio for a newborn?

3:1.

What do we put clothes in from a patient being treated for sexual assault?

Paper bag.

What is one of the most important things we must do to treat a newborn of a multiple birth?

Like all newborns, keep them warm.

A teenager has shared they are bleeding and further indicates it could be from an abortion. What do you do?

Make them comfortable, finish assessment, and be sure to apply oxygen. Pads can be used to absorb blood, but the main focus needs to be the overall care of the patient.

You are called to a residence where some residents have been complaining of not feeling well and headaches. Some residents are becoming unconscious. What could be the cause?

Carbon monoxide could be the culprit, so get everyone away from the area and give oxygen ASAP.

A patient is having an allergic reaction. What do you do?

Initially, put the patient on oxygen to help with breathing. Consider EPI if the allergy becomes life-threatening. Remember: Not all allergic reactions require EPI.

What is the space called between the cheek and gum where we place glucose when appropriate?

Buccal space.

Terms used in obstetrics to describe a woman’s pregnancy history

• Gravida: Total number of pregnancies. • Para: Number of viable births (after 20 weeks). • Extra: Example: “G3P2” means 3 pregnancies, 2 live births