EMT Study Guide Notes

based on the study guide

What is the normal systolic blood pressure range?

The normal systolic range for blood pressure is between $100-139\,\text{mmHg}$.

What blood pressure readings indicate hypertension?

A systolic blood pressure greater than $139\,\text{mmHg}$ or a diastolic blood pressure greater than $89\,\text{mmHg}$.

What blood pressure readings indicate hypotension?

A systolic blood pressure less than $100\,\text{mmHg}$ or symptomatic (dizziness, syncope).

What is the normal heart rate range?

The normal heart rate range is $60-99\,\text{bpm}$.

What is tachycardia?

A heart rate greater than $100\,\text{bpm}$.

What is bradycardia?

A heart rate less than $60\,\text{bpm}$.

What is the normal SpO$_2$ range?

The normal SpO$_2$ (oxygen saturation) range is $94-100\%$\text on room air.

What is the normal respiratory rate range?

The normal respiratory rate range is $12-20\,\text{breaths/min}$.

What is Bradypnea?

A respiratory rate less than $12\,\text{breaths/min}$, potentially indicating opioid overdose, head injury, or agonal breathing.

What is Tachypnea?

A respiratory rate greater than $20\,\text{breaths/min}$, often seen in hyperventilation, anxiety, hypoxia, or DKA.

What is the normal oral temperature range?

The normal oral temperature range is $96.8-98.9^{\circ}\text{F}$ ($36-37.2^{\circ}\text{C}$).

What is hypothermia?

A core body temperature less than or equal to $95^{\circ}\text{F}$ ($35^{\circ}\text{C}$).

What is the normal FSBG range?

The normal fasting Finger-Stick Blood Glucose (FSBG) range is $70-120\,\text{mg/dL}$.

What is critical hypoglycemia?

A critical blood glucose level less than $70\,\text{mg/dL}$.

What is concerning hyperglycemia?

A concerning blood glucose level greater than $350-400\,\text{mg/dL}$.

What is Aspirin used for and what are its contraindications?

An antiplatelet medication given for chest pain, typically up to $324\,\text{mg}$. Contraindicated for salicylate allergy or active GI bleed.

How is Nitroglycerin administered and what are its contraindications?

A medication for chest pain, $0.4\,\text{mg}$ sublingually, often repeated. Contraindicated if systolic BP <$100\,\text{mmHg}$ or recent ED (erectile dysfunction) medication use.

What is Albuterol and how is it administered?

A beta-2 agonist bronchodilator ($2.5\,\text{mg}/3\,\text{mL}$) delivered via nebulizer @ $6-8\,\text{L/min}$ O$_2$.

What is Atrovent (ipratropium) and what should be monitored?

An anticholinergic bronchodilator ($0.5\,\text{mg}/3\,\text{mL}$) often co-administered with Albuterol; watch for peanut/soy allergy.

What is anaphylaxis and how is it treated?

A severe systemic allergic reaction requiring Epinephrine auto-injector (Adult $0.3\,\text{mg}$, Child $0.15\,\text{mg}$ IM).

What is Naloxone (Narcan) used for and what are its indicators?

Medication ($2\,\text{mg}$ IN via MAD) used to reverse opioid overdose, indicated by respiratory depression and pinpoint pupils.

When can oral glucose be administered?

$15\,\text{g}$ via oral tube, given ONLY if the patient is A&O x4 and can protect their airway.

What is Activated Charcoal used for?

Substance ($1\,\text{g/kg}$ orally) that absorbs toxins in the GI tract for ingested poisons; requires Poison Control confirmation.

What medication is given for fever?

Medication (e.g., Tylenol) given for fever typically $101-102^{\circ}\text{F}$ causing discomfort.

What is a Nasal Cannula used for and at what flow rate?

Oxygen delivery device operating at $2-6\,\text{L/min}$ for conscious, stable patients with mild hypoxia (SpO$_2$ $$88-93\%$).

What is a Non-Rebreather Mask (NRB) used for and at what flow rate?

Oxygen delivery device operating at $10-15\,\text{L/min}$ for A&O patients with moderate to severe hypoxia (SpO$_2$ $$70-87\%$).

What is a Nebulizer used for?

Oxygen delivery device operating at $6-8\,\text{L/min}$ primarily for delivering aerosolized medications.

What is a Bag-Valve Mask (BVM) used for and at what flow rate?

Oxygen delivery device operating at $15\,\text{L/min}$ for patients with inadequate breathing (RR <$12$ or failing airway), typically unconscious.

When is the Head-Tilt/Chin-Lift maneuver used?

Airway maneuver used for medical patients with no suspected trauma, opens airway by lifting the tongue.

When is the Jaw-Thrust maneuver used?

Airway maneuver used for patients with suspected C-spine injury/trauma to minimize spinal movement.

What are the recommended suction timings for adults, children, and infants?

Maximum suction duration: Adults \u2264$15$\text{ seconds}, Children \u2264$10$\text{ seconds}, Infants \u2264$5$\text{ seconds}.

When is a Nasopharyngeal Airway (NPA) contraindicated?

Airway adjunct contraindicated in facial/basilar skull fracture or severe nasal trauma.

What do snoring respirations indicate?

Indicates tongue obstruction and requires manual maneuvers or OPA insertion.

What do gurgling respirations indicate?

Indicates fluid in the airway (blood, vomitus, secretions) and requires immediate suctioning.

What is stridor?

High-pitched inspiratory sound indicating upper airway obstruction.

What is paradoxical chest motion (flail segment)?

Movement of a section of ribs independently from the chest wall during breathing due to multiple fractures.

What do one-sided breath sounds indicate?

Suggests pneumothorax or hemothorax post-trauma; requires ALS.

What does a capillary refill time of <$2$\text{ seconds indicate?

Reflects good peripheral perfusion when <$2$\text{ seconds}.

What are the signs and treatment for Carbon Monoxide Poisoning?

Classic signs include cherry-red skin (late sign), headache, flu-like symptoms. SpO$<em>2$ readings are falsely high. Treat with high-flow O$</em>2$.

What are the characteristics of Croup?

Viral infection causing a "seal-bark" cough and inspiratory stridor.

What are the signs of Epiglottitis and how should it be managed?

Bacterial infection causing rapid, life-threatening upper airway obstruction with high fever, drooling, and tripod position; minimize agitation.

What are Kussmaul Respirations?

Deep, rapid, labored breathing, the body's attempt to compensate for metabolic acidosis, typically seen in DKA.

Describe the blood flow path through the heart and body.

Deoxygenated blood enters rt atrium \u2192 tricuspid \u2192 rt ventricle \u2192 pulmonary artery \u2192 lungs \u2192 pulmonary vein \u2192 lt atrium \u2192 bicuspid/mitral \u2192 lt ventricle \u2192 aorta \u2192 body \u2192 veins \u2192 S/IVC \u2192 rt atrium.

What is the procedure for CPR after a shock from an AED?

CPR should be resumed immediately after shock, without a pulse check.

What are the recommended CPR compression depths for adults, children, and infants?

CPR compression depth: Adults $2-3\text{''}$, Child/Infant $\tfrac13$\text{ chest depth}.

What is the recommended CPR compression rate?

CPR compression rate: $100-120$\text{ compressions per minute}.

What are the CPR compression to ventilation ratios?

CPR compression to ventilation ratio: Single-rescuer any age $30:2$; Two-rescuer infant/child $15:2$.

What does ROSC stand for?

Return Of Spontaneous Circulation.

What are the differences in symptoms between left-sided and right-sided Congestive Heart Failure (CHF)?

Left-sided heart failure causes pulmonary edema; Right-sided heart failure causes pedal edema.

What causes the S1 heart sound?

First heart sound ("lub") caused by the closure of the AV valves (tricuspid and mitral).

What causes the S2 heart sound?

Second heart sound ("dub") caused by the closure of the semilunar valves (aortic and pulmonic).

What is an Ischemic Stroke?

Stroke caused by a blood clot blocking blood flow to the brain.

What is a Transient Ischemic Attack (TIA)?

Stroke symptoms resolve spontaneously within <$24\,\text{hours}$, often a warning sign for a full stroke.

What is a Hemorrhagic Stroke?

Stroke caused by a blood vessel rupturing in the brain; often associated with severe headache and hypertension.

What are common signs of a stroke?

One-sided weakness or paralysis, facial droop, and speech issues are common signs.

Name some prehospital stroke scales.

Prehospital stroke assessment scales including Cincinnati, FAST, and VAN.

What is the time-critical period for stroke treatment?

Time window (<$3-4.5\,\text{hours}$) for thrombolytic medications for ischemic stroke after ruling out hemorrhage.

What are the key principles of seizure management?

Protect the patient from injury, NEVER place objects in their mouth, and request ALS for prolonged or repetitive seizures.

What is hypoglycemia?

A blood glucose level <$70\,\text{mg/dL}$, which is immediately life-threatening.

What is Diabetic Ketoacidosis (DKA)?

A condition caused by severe hyperglycemia, leading to Kussmaul respirations and fruity breath odor.

What abdominal quadrant pain indicates appendicitis?

Quadrant pain signifying appendicitis; palpate LUQ first, then LLQ, RLQ last.

What abdominal quadrant pain with shoulder referral suggests spleen injury?

Quadrant pain + shoulder referral (Kehr's sign) suggesting spleen injury.

What type of abdominal pain might indicate an Abdominal Aortic Aneurysm (AAA)?

Sudden tearing abdominal pain radiating to the back, indicating a ruptured or dissecting Abdominal Aortic Aneurysm (AAA).

What symptoms might indicate meningitis?

Stiff neck + fever + headache (especially in a child) indicating potential meningitis.

What does jaundice indicate?

Yellow skin/sclera, indicative of liver failure or hepatitis.

What does pink/frothy sputum suggest?

Pink/frothy sputum often associated with pulmonary edema (Left-sided CHF); if suspected TB, use N95 respirator.

What does Gravida mean in obstetrics?

Terminology for total number of confirmed pregnancies.

What does Para mean in obstetrics?

Terminology for total number of births after 20 weeks gestation.

What is Placenta Previa and its key sign?

Painless bright-red vaginal bleeding after 20 weeks gestation due to placenta covering the cervical opening; do not perform vaginal exams.

What is Abruptio Placenta and its key signs?

Painful abdominal tenderness (rigid abdomen) with vaginal bleeding due to premature separation of the placenta; often associated with trauma.

What is an Ectopic Pregnancy?

Implantation of the fertilized egg outside the uterus (most commonly fallopian tube), presenting with severe unilateral abdominal pain; life-threatening if ruptured.

What is Pre-eclampsia?

Hypertension + edema/headache during pregnancy, risking seizures; requires ALS.

What is Eclampsia?

Pre-eclampsia with associated seizures.

What signs indicate an imminent delivery?

Stop transport and prepare for delivery if contractions are <$2$\text{ minutes apart, strong urge to push, or crowning.

What is a nuchal cord and how is it managed?

Umbilical cord wrapped around the baby's neck; attempt to unwrap, or clamp/cut if no slack.

What is a prolapsed cord and how is it managed?

Umbilical cord presents first before the baby; requires manual lifting of baby's head off the cord and rapid transport with hips elevated.

What is a breech presentation?

Legs or buttocks are presenting first; may deliver but single-limb cannot; requires rapid transport.

What is the APGAR Score?

A scoring system for newborns at 1 and 5 minutes after birth (Activity, Pulse, Grimace, Appearance, Respiration).

What does XABC stand for in trauma assessment?

The immediate priority in trauma, focusing on stopping massive hemorrhage (Exsanguination), Airway, Breathing, and Circulation.

What is the rule for managing impaled objects?

Always stabilize impaled objects in place; never remove them unless they obstruct the airway or interfere with CPR.

How do you manage an eye impalement?

Cover BOTH eyes with a cup/cone over injured eye and bandage both gently to prevent sympathetic movement.

What is a Coup-Contrecoup Injury?

Type of brain injury where the brain impacts the front of the skull then rebounds to impact the back.

What is a Greenstick Fracture?

Fracture type common in children where the bone bends but does not break all the way through.

When is a traction splint applied?

Applied ONLY for suspected closed mid-shaft femur fractures to reduce pain and bleeding.

How do you control an arterial bleed?

Bright red, spurting bleed requiring direct pressure first, then a tourniquet if ineffective.

How is a tourniquet applied?

Applied proximal to the wound, at least $2\text{''}$ above (not over a joint), tightened until bleeding stops; note time of application.

What is Cardiac Tamponade?

Fluid accumulation around the heart compressing it and preventing effective filling; presents with Beck's Triad (JVD, muffled heart sounds, hypotension).

Describe First-Degree Burns (1\text{\textdegree}).

Burns characterized by redness and pain, involving only the epidermis.

Describe Second-Degree Burns (2\text{\textdegree}).

Burns characterized by blisters, pain, and moist appearance, involving epidermis and dermis.

Describe Third-Degree Burns (3\text{\textdegree}).

Burns characterized by white/leathery/charred appearance and no local pain, involving all skin layers and potentially underlying tissue.

Explain the Adult Rule of Nines.

Method for estimating Adult TBSA burns: Head 9%, Arm 9% each, Leg 18% each, Anterior 18%, Posterior 18%, Perineum 1%.

Explain the Pediatric Rule of Nines.

Method for estimating Pediatric TBSA burns: Head 18%, Arm 9% each, Leg 13.5% each, Anterior 18%, Posterior 18%, Perineum 1%.

Explain the Rule of Palm for burns.

Method for estimating TBSA burns where the patient's palm (excluding fingers) equals ~$1\%$ TBSA.

What is Cushing's Triad?

Triad of symptoms indicating increased intracranial pressure (ICP): Hypertension, Bradycardia (<$60$\text{), and Irregular respirations.

Describe Heat Exhaustion.

Condition with sweating, cool/clammy skin, weakness, normal/slightly elevated temp; due to dehydration and heat exposure.

Describe Heat Stroke.

Life-threatening condition with hot/dry or moist skin, AMS, seizures, core temp >$104^{\circ}\text{F}$; body's cooling mechanisms fail.

What is near-drowning and why is hospital evaluation important?

Survivable immersion in liquid that results in respiratory impairment; encourage hospital evaluation due to risk of secondary complications.

How should a snakebite be managed?

Snakebite management involves keeping the limb below heart level, circling swelling, and NO ice/tourniquet.

What is Lyme Disease?

Tick-borne illness characterized by flu-like symptoms and a "bullseye" rash.

What is Excited Delirium and how is it managed?

State of extreme mental and physiological excitement with violent behavior, profuse sweating, and hyperthermia; requires ALS for sedation.