EMT Academy Exam 3 Shared Class Notes

Comprehensive vocabulary flashcards covering shock, trauma, patient assessment, chest emergencies, and medical topics from the EMT Academy Exam 3 review notes.

Shock

A state of inadequate cellular perfusion, fundamentally involving issues with the pump (heart), container/pipes (vessels), or circulating volume.

Compensated shock

The early stage of shock where the body maintains blood pressure; characterized by anxiety or agitation, tachycardia, tachypnea, weak pulse, cool clammy skin, delayed capillary refill, thirst, and narrowing pulse pressure.

Decompensated shock

The advanced stage of shock where compensatory mechanisms fail; characterized by falling blood pressure, worsening mental status, irregular or labored respirations, weakening or absent distal pulses, ashen or cyanotic skin, and reduced urine output.

Hypovolemic shock

Shock resulting from blood or fluid loss; features tachycardia, a weak rapid pulse, cool pale clammy skin, narrowing pulse pressure, and late hypotension.

Cardiogenic shock

Shock caused by pump failure of the heart, characterized by hypotension, a weak or irregular pulse, and possible pulmonary edema or crackles.

Obstructive shock

Shock caused by a mechanical block to cardiac filling or outflow, with classic examples including tension pneumothorax, cardiac tamponade, and pulmonary embolism.

Septic shock

Shock resulting from severe infection accompanied by vasodilation and capillary leak; skin may initially appear warm and flushed before turning cool and mottled.

Neurogenic shock

Shock caused by the loss of sympathetic tone after a high spinal cord injury, classically presenting with hypotension, relative bradycardia or normal heart rate, and warm, dry skin.

Anaphylactic shock

Severe distributive shock characterized by systemic vasodilation and increased capillary permeability combined with bronchoconstriction, hives, edema, stridor, wheezing, and hypotension.

Pediatric hypotension threshold

A systolic blood pressure less than $70 + (2 \times \text{age})$ in children aged $1-10$.

AVPU

Rapid mental status assessment tool categorizing patient responsiveness as Alert, Verbal, Pain, or Unresponsive.

Glasgow Coma Scale (GCS)

Standardized evaluation tool scoring Eye ($4-1$), Verbal ($5-1$), and Motor ($6-1$) responses, totaling a maximum score of $15$.

SAMPLE

History-taking mnemonic representing Signs/symptoms, Allergies, Medications, Pertinent history, Last oral intake, and Events.

OPQRST

Symptom evaluation mnemonic standing for Onset, Provocation/palliation, Quality, Region/radiation, Severity, and Time.

DCAP-BTLS

Physical examination mnemonic for identifying Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, and Swelling.

Pediatric Assessment Triangle (PAT)

Rapid visual assessment framework evaluating Appearance, Work of breathing, and Circulation to skin.

GEMS diamond

Assessment framework for older adults addressing Geriatric patient characteristics, Environmental factors, Medical problems, and Social issues.

Pulse oximetry

Assessment tool that estimates hemoglobin oxygen saturation in the blood without measuring ventilatory adequacy.

Capnography

Assessment modality that displays exhaled $CO_2$ levels over time to provide direct information regarding patient ventilation.

Aphasia

An impairment in language production or comprehension resulting from brain injury, distinct from simple slurred speech.

Status epilepticus

A continuous seizure lasting longer than $5\text{ minutes}$ or recurring seizures occurring without the patient regaining consciousness between episodes.

Syncope

A brief loss of consciousness resulting from transiently reduced cerebral perfusion followed by rapid recovery.

Cushing triad

A late sign of dangerously elevated intracranial pressure characterized by increased systolic blood pressure with a widened pulse pressure, bradycardia, and irregular respirations.

Retrograde amnesia

The loss of memory for events occurring before an injury.

Anterograde amnesia

The inability to form or retain new memories for events occurring after an injury.

Epidural hematoma

An intracranial bleed, often arterial, classically presenting with a transient lucid interval followed by rapid neurologic deterioration.

Subdural hematoma

An intracranial bleed that is typically venous and slower to develop, occurring at higher frequency in older adults and patients taking anticoagulants.

Insulin

A pancreatic hormone that lowers blood glucose by moving glucose into cellular spaces and promoting storage.

Glucagon

A pancreatic hormone that elevates blood glucose by mobilizing stored glycogen, primarily from the liver.

Diabetic Ketoacidosis (DKA)

An endocrine emergency characterized by hyperglycemia, dehydration, polyuria, polydipsia, abdominal pain, Kussmaul respirations, fruity or acetone breath odor, and altered mental status.

Hyperosmolar Hyperglycemic State (HHS)

A metabolic complication typically seen in older adults with type 2 diabetes, presenting with markedly high blood glucose, severe dehydration, dry skin, and altered mental status without predominant ketosis.

Sickle cell disease

A genetic hemoglobin disorder featuring sickled erythrocytes and impaired microvascular flow, where hypoxia and dehydration trigger painful vaso-occlusive crises.

Hemophilia A

An inherited clotting-factor deficiency classically affecting males, in which minor trauma can cause severe, prolonged internal or joint bleeding.

Thrombophilia

A medical condition characterized by an increased tendency to form blood clots, elevating the risk of deep vein thrombosis, pulmonary embolism, myocardial infarction, and stroke.

Deep vein thrombosis (DVT)

A thrombus within a deep vein (commonly of the calf) causing swelling, pain, warmth, and erythema, carrying the risk of embolization to the pulmonary arteries.

Visceral pain

Vague, dull, poorly localized, and pressure-like abdominal pain originating from the hollow or solid organs.

Somatic pain

Sharp and well-localized abdominal pain associated with irritation or inflammation of the parietal peritoneum.

Hematemesis

The vomiting of blood; appearance is bright red in fresh bleeding or dark 'coffee-ground' when blood is partially digested.

Melena

Dark, tarry stool resulting from digested blood transiting the gastrointestinal tract.

Esophageal varices

Abnormally enlarged veins around the esophagus secondary to portal hypertension from liver disease; rupture can cause catastrophic, bright-red hematemesis.

Mallory-Weiss tear

A laceration at or near the junction of the esophagus and stomach, classically caused by violent retching or vomiting, resulting in upper gastrointestinal hemorrhage.

Appendicitis

Inflammation of the appendix, classically presenting with vague periumbilical pain migrating to the right lower quadrant, accompanied by fever, guarding, and rebound tenderness.

Renal calculi

Kidney stones that typically cause sharp or tearing flank pain radiating toward the groin, severe patient restlessness, nausea, vomiting, and hematuria.

End-stage renal disease (ESRD)

A severe stage of kidney failure where kidney function has deteriorated to the point of requiring peritoneal dialysis, hemodialysis, or organ transplantation to sustain life.

Peritoneal dialysis

A form of renal replacement therapy in which dialysis solution is introduced into the peritoneal cavity to allow waste removal via diffusion across the peritoneal membrane.

Hemodialysis

A procedure where blood is removed, filtered externally, and returned via vascular access (fistula or graft), typically performed $3\text{ days per week}$ for $3-4\text{ hours}$ per session.

Pneumothorax

An accumulation of air within the pleural space, presenting with unilateral diminished or absent breath sounds and hyperresonant percussion.

Tension pneumothorax

A life-threatening complication of pneumothorax involving air trapping, unilateral absent breath sounds, hyperresonance, severe respiratory distress, hypotension, jugular venous distention, and late tracheal deviation.

Hemothorax

An accumulation of blood within the pleural space, presenting with unilateral diminished or absent breath sounds, dull or hyporesonant percussion, and signs of hemorrhagic shock.

Cardiac tamponade

Mechanical compression of the heart by pericardial fluid causing obstructive shock, clinically identified by jugular venous distention, muffled heart sounds, hypotension/narrowing pulse pressure, and clear lung sounds.

Hyperresonant percussion note

A physical exam finding elicited over the thorax indicating an abnormal accumulation of excess air.

Dull or hyporesonant percussion note

A physical exam finding elicited over the thorax indicating an abnormal accumulation of fluid or blood.

Flail chest

A thoracic injury where multiple adjacent rib fractures detach a free-floating chest wall segment, resulting in paradoxical chest wall motion during breathing.

Pulmonary contusion

Bruising of the lung parenchyma following blunt chest trauma, often resulting in hypoxemia that progressively worsens over several hours.

Commotio cordis

Sudden cardiac arrest triggered by a direct, blunt impact to the chest occurring at a critical phase of the cardiac cycle, in the absence of underlying structural heart injury.

Traumatic asphyxia

A condition caused by severe, prolonged crushing chest compression, characterized by marked upper-body and facial cyanosis, jugular venous distention, and conjunctival hemorrhage.

Conduction

Mechanism of direct heat transfer occurring via physical contact between the body and another surface.

Convection

Mechanism of heat loss or gain mediated by the circulation of moving air or water across the body surface.

Heatstroke

A life-threatening heat emergency defined by hyperthermia accompanied by altered mental status, in which the skin may present as either dry or diaphoretic.

Decompression sickness

A dive-related emergency caused by nitrogen bubble formation in the blood and tissues following rapid pressure changes, presenting with joint pain, neurologic deficits, dyspnea, or extreme fatigue.