EMT Cognitive Exam

Acute Myocardial Infarction

Death of heart muscle by blockage or coronary artery

* Hypotension
* tachycardia and brachycardia

Aneurysm

Artery that can burst in brain or aorta

Angina

Chest pain due to inadequate blood supply to heart

Asystole

No electrical activity in heart

Atherosclerosis

Thickening and destruction of arterial walls, caused by fat deposits; arteries can’t carry blood

Cardiogenic shock

shock from inadequate function of heart

CHF

shortness of breath, fluid in lungs and swelling of lower extremities. Heart can’t contract well

* left ventricle gets damaged

Diaphoresis

sweating

dyspnea

deep, labored breathing

Dysrythmia

abnormal heart rhythm

Pedal edema

fluid collecting in feet from CHF

Acute Coronary syndrome (ACS)

range of symptoms from angina to AMI

Aortic Dissection

Tear in lining of aorta. It can obstruct arterial blood supply to vital organs

Infarction

Death of tissue due to loss of blood flow

Ischemia

Poor O2 blood

Necrosis

tissue death

pulmonary edema

fluid in lungs due to ami and chf

Thrombus

clot formed in blood vessel or chamber of heart

vasospasm

sudden constriction of blood vessel

Thoracic Cavity

Mediastinum: area that lies in center of chest that contains many functional parts

Pleural cavity: each contains one lung

Visceral pleura: lines outside of lung

12 pair of ribs that connect sternum through a cartilage bridge

arteries and veins

* arteries are thicker than veins
* arterioles are small branches of arteries that connect with capillaries (which exchange H2O, O2, etc)
* Venules (small veins) connect capillaries to larger veins

Coronary thrombosis

* arterial plaque ruptures and platelets adhere
* fibrinolytic enzymes try and block clot

12- lead EKG

* consider shaving skin
* patient supine
* stop ambulance

AED on pacemaker patient

inch away

Change in breath sounds

* pleural effusion - fluid building up
* tension pneumothorax - absent breath sounds
* hemothorax - accumulation of blood in pleural space

O2/CO2 exchange

Trachea > divides at carina > 2 bronchi > 23 bifurcations of bronchioles > alveoli

Opiod medications

fentanyl, morphine, oxycodone

Respiration

* 0-1 (30-60)
* 1-3 (24-40)
* 4-5 (22-34)
* 6-12 (18-30)
* 13+ (12-20)

Cliff Side and uneven train

use basket stretcher

* use flexible stretcher for narrow or steep stairs
* scoop stretchers fit around patient in supine

Cervical spine pain

unequal pupils will occur, NOT dyspnea, capillary refill time or urticaria

Heat exhaustion

* dizzy, weak, headache
* can lead to heat stroke if there is loss of consciousness

Hemodynamic instability and bones

* rib fracture = 100-200 mL
* tibia = 300-500 mL
* femur = 800-1000 mL
* pelvic = 2000

Aortic aneurysm

* pulmonary embolism is most likely
* deep vein thrombosis = blood clot in deep veins
* atherosclerosis = buildup of cholesterol

Significant mechanisms of injury

* Falls
* Adults > 20 ft
* Kids > 10ft
* Crashes
* ejection
* death of passenger
* vehicle date w/ high risk

long spine board

* no intoxication
* no neurological findings and complaints
* normal consciousness

ectopic pregnancy

* outside uterus, usually in Fallopian tube
* sudden and severe ab pain
* bleeding

placenta pervia

* no ab pain, heavy bleeding

preeclampsia

severe hypertension, headache and confusion, NO bleeding

when to check AED

every shift

layers of heart

* epi (outer)
* myo (middle)
* endo (inner)

Larnyx and OPA

if opa is too big it could obstruct larnyx

hazardous materials

stay uphill and up wind

tension pneumothorax

trauma to chest (closed)

flail chest

3+ broken ribs, possible flail chest

traumatic asphyxiation

distended neck veins, severe pressure in chest

hypothermia

cyanosis w/ rapid breathing

Mask and O2 delivery

BVM = 100%

Non-rebreather = 90-95%

simple = 40-60%

nasal canula = 24-44%

Max. suction time for all ages

10 seconds

Joints EMT’s can stabilize

knee, wrist and shoulder

what do AED’s shock for

VTech and VFib

Carotid arter

used for all ages 1+ on neck

brachial artery

use for infants

CPR and AED

every 2 minutes, 5 cycles

hypovolemic shock

profuse bleeding, diarrhea, no fluid intake

Children airway obstruction

smaller mandible and larger tongue, have larger occiput

rights to confidential billing info.

3rd party insurance and billing rep.

pediatric triage

* skin circulation
* work of breathing
* appearance

CPAP (respiratory distress)

* pulmonary edema
* COPD, asthma
* pneumonia

\*not apnea

Occupational safety and health admin.

reduce hazards in work place like blood borne pathogens

\
CDC is healthcare worker w/ patients

Heart \*

* R. ventricle pumps dO2 to lungs for oxygenation
* O2 blood > L. atrium via pulmonary vein
* L. atrium > L. ventricle via mitral valve
* L. ventricle to body via aorta
* dO2 blood returns to R. atrium via vena cava
* dO2 from R.atrium > R.ventricle via tricuspid valve

maternal physiological changes

* 30-50% increase in blood volume
* increased HR by 20%
* faster clotting time

GCS

level of consciousness

\
revised trauma score = survivability

SOAP

subjective (symptom by person experiencing it), objective (physical findings), assessment, and patient care

Benzodiazepine (depressant)

hypersomnolence

APGAR

for babies, lots of crying is good

upper longboard what is secured first

upper torso

Nitro CANT’S

* SPB

suctioning

max 10 sec. at 300 mmHg

Hypovolemic shock

rapid and weak pulse, hypotension, tachypnea, tachycardia/brachycardia, long cap. refill time

Antidote kits for nerve agents

Duodate and AtNAA

Cushing’s Triad Head Injury

widening pulse pressure, change in respiration, and bradycardia

Trauma lethal triad

acidosis, hypothermia, and coagulopathy

Venous bleeding

dark red and flows steadily

arterial bleeding

bright red and spurts all over

capillary

dark and oozes steady and slow

appendicitis

lower right quad pain

renal calculi

kidney stones can have groin pain and hematuria

when to get BP from thigh

when you can’t use arm

meds for seizures

tagretal and klonopin

Ishemic stroke

* onset of symptoms = critical point
* EMS needs to notify hospital ASAP
* interventions between 3-6 hours

Assault

fear of bodily harm

battery

unlawful touching

NFPA 704

* flame hazard
* health hazard
* special info.

SALT

* sort
* assess
* life saving
* treatment and transport

START

simple, triage, and rapid, transport

blind finger sweep

ONLY if you can physically see object

Nerve Agents

Tabun, sarin, and VX

Characteristics of a pulse

bounding, thready and regular

NOT full

Landing zone - Air EMT

* Ensure all equipment is secure
* no flames or smoking 50ft of craft

Red alert in START

* RR

End of upper respiratory tract

larnyx

lower respiratory

trachea, bronchi, bronchioles and alveoli

epiglottis

closes trachea during swallowing

Trending

comparison of previous and current vital signs

Cardiac tamponade

* bilateral jugular vein distension
* not a big difference btw systole and diastole
* Becks triad, heart muffles

cerebrovascular accident

stroke

lower airway problems

wheezing, rales and rhonchi

stridor

upper airway problem

intracranial pressure elevation

* decreased pulse rate
* unilateral fixed and dilated pupils
* abnormal respirations
* ataxic respirations

first stage of birth

12-18 hours