NREMT - Everything you need to know.

Standing Orders

A policy or protocol that define certain treatment interventions that the EMT is authorized to perform prior to contacting medical control

HEPA Mask

Used for patients with suspected TB; worn by the EMT provider to prevent airborne transmission

Hepatitis B

infectious inflammation of the liver caused by the hepatitis B virus (HBV) that is transmitted sexually or by exposure to contaminated blood or body fluid

Hepatitis C

inflammation of the liver caused by the hepatitis C virus, transmitted by exposure to infected blood (rarely contracted sexually)

Tuberculosis

Infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Most commonly affects the respiratory system and causes inflammation and calcification of the system.

Expressed Consent

Permission that must be obtained from every conscious, mentally competent adult before emergency treatment may be provided

Implied Consent

The consent it is presumed a patient or patient's parent or gaurdian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed.

Advanced Directive

a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care; may also be called a living will or durable power of attorney for health care

Polst

Physicians orders for life sustaining treatment. May include order for DO NOT RESUSCITATE

Emergency Move

a move made when there is an immediate danger to the patient.

Urgent Move

Move used if a scne factor causes a decline in patient's condition, or if the treatment of a patient requires a move.

Non urgent move

No immediate threat to life, are carried out in such a way as to prevent injury and to avoid discomfort and pain.

scoop stretcher

For patients with a suspected pelvic fracture (use with pelvis binder)

anatomical planes

1. coronal (vertical cut into front and back halves) 2. transverse (horizontal cut into upper and lower) 3. sagittal (vertical cut into left and right halves)

fowler position

a bed sitting position with the head of the bed raised to 45 degrees

semi fowler position

the head of the bed is raised 30 degrees; or the head of the bed is raised 30 degrees and the knee portion is raised 15 degrees

shock position

supine feet elevated 12 inches higher than head

anterior

Toward the Front

posterior

Toward the back

superior

toward the head or above point of reference

inferior

away from the head or below point of reference

dorsal

Toward the back/spine

ventral

Toward the front/ belly

medial

Toward center of body

lateral

Away from center of body

proximal

Near the point of reference

distal

Far from point of reference

mid clavicular

the line through the center of the clavical

mid axillary

line drawn veritcally from the middle of the armpit to the ankle

vertebrae

the 33 bones of the spinal column

upper airway

(Nose, mouth, pharynx, larynx)

Conducts air to lower airway

Protects lower airways

Warms, filters & humidifies air

lower airway

trachea, bronchi, bronchioles, and alveoli (gasses travel through the structers to and from the blood)

cricoid cartilage

the ring-shaped structure that forms the lower portion of the larynx

diaphragm

muscular partition that separates the thoracic cavity from the abdominal cavity and aids in respiration by moving up and down

phrenic nerve

stimulates the diaphragm

edema

swelling

perfusion

Circulation of blood in organ or tissue in adequate amounts to meet cell needs

hypo perfusion

Also known as shock (decreased blood flow through an organ, as in hypovolemic shock; if prolonged, it may result in permanent cellular dysfunction and death.)

cerebrum

large part of the brain that controls the senses and thinking

cerebellum

Controls muscle and body coordination.

brain stem

the part of the brain continuous with the spinal cord and comprising the medulla oblongata and pons and midbrain and parts of the hypothalamus

epinephrine

adrenaline; activates a sympathetic nervous system

pulse pressure

difference between systolic and diastolic pressure no more than 25%

carina

..., the fork at the lower end of the trachea where the two mainstem bronchi branch.

pleura

Membrane surrounding the lungs

visceral pleura

Inside pleural membrane (surrounds the lungs)

parietal pleura

Outside pleural membrane

pleural space

The small potential space between the parietal and visceral layers of the pleura

intercostal muscles

..., Muscles which move the rib cage during breathing

signs of mild hypoxia

Tachypnea

Dyspnea

Pale cool clammy skin ( early)

Elevation of blood pressure

Agitation

Disorientation and confusion ( from high carbon dioxide levels)

Headache

signs of severe hypoxia

Tachypnea

Dyspnea

Cyanosis

Tachycardia may lead to dysrhythmias and eventually bradycardia

Confusion

Loss of coordination

sleepy appearance

Head bobbing

Slow reaction time

Altered mental status

dyspnea

..., difficult or labored respiration

snoring sounds

..., airway blocked, open patients airway promt transport

Stridor

High-pitch harsh whistling, sign of upper airway obstruction

stridor

..., a whistling sound when breathing (usually heard on inspiration) upper airway

n-95

Mask used for a patient with TB

tonsil tip

... Rigid suction

retractions

..., Movements in which the skin pulls in around the ribs during inspiration.

respiratory failure

..., a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high

respiratory arrest

..., When breathing completely stops.

tachypnea

..., fast breathing, an abnormally rapid rate of respiration, usually >20 breaths per minute

bradypnea

..., slow respiratory rate, usually below 10 respirations per minute

cricoid pressure

..., Pressure on the trachea, prevents air from entering the esophagus/stomach and vomiting

FROPVD

Flow-restricted, oxygen-powered ventilation device: a device that uses oxygen under pressure to deliver artifical ventilations

Rales/crackles

"Slurp in straw"
Fluid in lungs, obstructing alveoli (lower airway)

rhonchi

Harsh/rattling
Large lower airway obstruction due to mucus, secretions, or other fluids

paradoxus pulsus

blood pressure declines as one inhales and increases as one exhales

capillary refill

Tested by pressing the nail tip briefly and watching for color change. An abnormal finding is slow (greater than 2 seconds) return of pink tone with respiratory or cardiovascular diseases that cause hypoxia.

Penetrating truma

Made a cut through

Blunt force trauma

No cut but internal problem

Hypercapnia

Too much carbon dioxide

Occluded

closed off

Dyspnea

difficult or labored respiration

Hypoperfusion

inadequate perfusion also known as shock

Cerebrospinal fluid

clear liquid produced in the ventricles of the brain

Jugular vein distention

the visible bulging of the jugular vein when the Pt is in semi-fowlers position or full fowlers position. this is indicative of inadaquate blood movement through the heart and/or lungs

Cardiac tamponade

filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.

Sputum

material expelled from the lungs by coughing

What is PMS

Pulses

motor function

Sensation

MOI falls

Adults 20 feet

children/infants more than 10 feet or 2or3 times their height

Glasgow coma scale

Used for levels of consciouness after a brain injury - Score 3-15, based on Eye opening, Verbal response and Motor response.

What number on the GCS should you do rapid transport?

Less than 13

Brain herniation

Increasing intracranial pressure that moves brain tissues

RUQ

Liver, gallbladder

LUQ

stomach

spleen

pancreas

RLQ

Appendix

Sublingual

beneath the tongue

Intramuscular

into the muscle

Shock

Inadequate tissue perfusion

Also know as hypoperfusion

Types of shock

Hypovolemic

Distributive

Cardiogenic

Obstructive

Hypovolemic shock

shock caused by severe blood or fluid loss

Distributive shock

Widespread vasodilation

Cardiogenic shock

shock that results from failure of the heart in its pumping action.

Obstructive shock

mechanical obstruction or compressing that prevents blood from reaching the heart

Tension pneumonthorax

A type of pneumothorax in which air can enter the pleural space but cannot escape via the route of entry. This leads to increased pressure in the pleural space, compressing the great vessels, resulting in lung collapse.

Stages of shock

1. Compensatory Shock 2. Decompensatory Shock 3. Irreversible Stage

If patient been in cardiac arrest for more than 5 min and no CPR has been done what do you do

Provide 2 min of CPR before ard

V-fib

completely erratic rhythm with no identifiable waves; fatal

V-tach

Ventricular tachycardia (an increased ventricular heart rate).

Asystole

the absence of a heartbeat