CCMA Certification study guide

Chief complaint CC

The reason a patient called for help. Also, the patient's response to questions such as "What's wrong?" or "What happened?"

History of present illness HPI

Explains the chief complaint. A chronological description of the development of the patient's present illness from the first sign or symptom or from the previous encounter to the present.

Vital Signs

Temperature, pulse, respiration, and Blood pressure are all ___________ ___________.

Normal oral temperature

97.6F - 99.6F

intermittent fever

Fever that alternates between elevated and normal or subnormal body temperatures.

Remittent fever

fever in which temperature fluctuates greatly but never falls to the normal level.

Continuous fever

A fever that remains constant above the baseline, does not fluctuate.

60-100 BPM

Normal pulse rate

Respirations

Rate, rhythm, and depth are taken into account when measuring what?

Systole

contraction of the heart

Diastole

relaxation of the heart

Anthropometric measurements

Measurement of height, (length rather than height is used in infants because they cannot stand.), weight, BMI, head circumference in infants, waist to hip, % of body fat.

Inspection

General appearance, state of nutrition, body habits, symmetry, pasture and gait, speech.

palpation

to examine by touch

Percussion

physical examination method of tapping over the body to elicit vibrations and sounds to estimate the size, border, or fluid content of a cavity such as the chest.

Ausculation

the act of listening to sounds arising within organs (as the lungs or heart) as an aid to diagnosis and treatment.

OSHA

a government agency in the Department of Labor to maintain a safe and healthy work environment

cardiopulmonary resuscitation

an emergency procedure for life support consisting of artificial respiration and manual external cardiac compression

SHOCK

This is caused by inadequate blood flow to the heart and in turn to the rest of the body.

Symptoms of shock

Pale, cold, clammy skin

rapid, weak pulse

increased shallow breathing

expressionless face or staring eyes are all ____________ ___ _________.

First aid for Shock

maintain open airway for the victim, call for assistance, keep victim lying down w/ head lower than rest of body; attempt to control bleeding or other cause of shock if known; keep victim warm until help arrives

Portal of exit

Method in which a infectious agent leaves the reservoir. Ex: contact with body fluids such as blood or saliva.

mode of transmission

contact, droplet, air, vehicles, or vectorborne

Portal of entry

A pathway by which the causative agent enters the host. The area in which a microorganism enters the body. They may be cuts, lesions, injection sites, or natural body orifices.

Susceptible host

An individual who has little resistance to an infectious agent.

Disinfection

Process used to destroy microorganisms; destroys all pathogenic organisms except spores, can only be used on inanimate objects. Will not be used for invasive procedures, and will not be inserted into body orifices nor be used in sterile procedure.

Chemical sterilization

Uses the same chemical used for disinfection, but exposure time is longer.

Steam sterilization (Autoclave)

uses steam under pressure to obtain higher temperature (250-254F) with exposure time of 20-40 minutes depending on item being sterilized.

hand washing

What is the most important means of preventing the spread of infection?

hand antisepsis

the removal & destruction of transient microorganisms using antimicrobial soaps.

PPE Personal protective equipment

mask, goggle, face shield, respirator

Intradermal Injection

ID; 15 degrees no aspiration; used for TB test, allergy test, and local anesthetic

Intramuscular Injection

IM; 90 degress with aspiration

Subcutaneous Injection

SQ; 45 degress

pericardium

protective sac enclosing the heart composed of two layers with fluid between

Right atrium

The upper right chamber of the heart, where deoxygenated blood is received from the vena cava and then sent to the right ventricle.

Right ventricle

the chamber on the right side of the heart that receives deoxygenated blood from the right atrium and pumps it into the pulmonary trunk

Left atrium

the left upper chamber of the heart that receives oxygenated blood returning from the lungs via the right and left pulmonary veins.

Left ventricle

the chamber on the left side of the heart that receives oxygenated blood from the left atrium and pumps it into the aorta

Aorta

The largest artery of the body

Pulmonary arteries

The only arteries in the body that carry deoxygenated blood.

pulmonary veins

the only veins in the body that carry oxygenated blood.

atrioventricular valves

Separate the atria and the ventricles. Right sided tricuspid, left sided mitral

tricuspid valve

between right atrium and right ventricle

mitral valve

between left atrium and left ventricle.

Pulmonary valve

between right ventricle and pulmonary trunk.

Aortic Valve

Between left ventricle and aorta

depolarization

sodium rushes into neuron through membrane, potassium ruses out; results in a positive charge

repolarization

when the K+ ions leave the inside of the axon, making the inside charge negative. Myocardial relaxation.

SA NODE

the pace-maker of the heart; where the impulse conduction of the heart usually starts; located in the top of the right atrium just below superior vena cava

AV node

Located at the posterior septal wall at the right atrium just above the tricuspid valve. There is a 1/10 second delay of electrical activity at this level to allow blood to flow from the atria to the ventricles.

Lead I

Left arm is positive and right arm is negative (LA-RA)

Lead II

Left leg is positive and right arm is negative (LL-RA)

Lead III

Left leg is positive and left arm is negative (LL-LA)

aVR

The right arm is positive and the other limbs are negative

aVL

The left arm is positive and the other limbs are negative

aVF

The left leg (or foot) is positive and the other limbs are negative

V1

4th intercostal space, right sternal border

V2

4th intercostal space, left sternal border

V3

equidistant between v2 and v4

V4

5th intercostal space, on the left midclavicular line

V5

5th intercostal space at the anterior axillary line

V6

5th intercostal space, midaxillary line

1mm

1 small square on eKG grid is equal to

5mm

1 large square on EKG grid is equal to

1mv

2 large squares on EKG grid is equal to

.04 seconds or 40m seconds

1 small square on eKG grid is equal to how much time?

.2 seconds or 200m seconds

1 large square on eKG grid is equal to how much time?

1 second or 1000 m seconds

5 large squares on eKG grid is equal to how much time?

25mm per second

The running speed of an EKG is?

Horizontal axis

What represents time on an EKG?

Vertical axis

What represents amplitude on an EKG?

P Wave

Deflection produced by Atrial depolarization. Normal range does not exceed 0.11s in duration or 2.55mm in height.

T wave

Deflection produced by ventricular repolarization

QRS complex

Ventricular depolarization

Somatic tremors

Patients tremors or shaking the wires can produce jittery patterns on the EKG tracing.

Wandering baseline

sweat or lotion on the patients skin or tension on the electrode wires can interfere with the signal going to the EKG apparatus causing the baseline of the tracing to move up and down on the EKG paper.

60-cycle interference

can produce deflections occurring at rapid rate that may mimic atrial flutter. this is caused by electrical appliances or apparatus being used nearby while the tracing is taken.

broken recording

the stylus goes up and down trying to find the signal. tis can be caused by loose electrode or cables, or by frayed or broken wires

arrhythmia

abnormal heart rhythms

Ischemia

decreased blood flow to tissue caused by constriction or occlusion of a blood vessel can cause chest pain or angina

Myocardial infarction

Death of myocardial cells

PR segment

.16 mm/s; line from the end of the P wave to the onset of the QRS complex

ST segment

From J point to the onset of the T wave; if elevated above base line could indicate myocardial infarction (STEMI)

Beta Blockers

Reduce heart rate, blood pressure, myocardial oxygen consumption, effectively treat angina pectoris and hypertension. Contraindicated for cardiac stress test.

5-6 liters

The average adult has __ - ___ _______ of blood.

55%

How much of our blood is plasma?

45%

How much of our blood is made up of formed elements? RBC, WBC, Platelets

99%

____ Of formed elements are Red Blood cells

Erythrocytes

Oxygen carrying protein RBC's

120 days

What is the normal lifespan of an RBC?

4.2-6.2 Million

How many RBC's are the per microliter of blood?

Thrombocytes

Platelets are irregularly shaped packets of cytoplasm formed in the bone marrow from megakaryocytes. Promote blood coagulation.

140,000-440,000

What is the average number of platelets per microliter of blood?

Leukocytes

WBC that proves the body protection again infection.

5,000-10,000

What is the normail amount of Leukocytes for an adult per microliter?

Leukocytosis

Increased WBC's

Leukopenia

Decreased WBC's

Neutrophils

These WBC's are the most numerous and they comprise between 40-60%. of the WBC's

Lymphocytes

THe second most numerous WBC, comprise between 20-40% of the WBC's