JB Learning EMT Chapter 10

What is the purpose of the scene size-up?

To ensure safety, determine the mechanism of injury or nature of illness, and identify the number of patients before beginning care.

What does the term "BSI" mean?

Body Substance Isolation; it reminds EMTs to use protective gear to prevent exposure to bodily fluids.

What is PPE used for?

Personal Protective Equipment protects EMTs from pathogens and hazardous substances during care.

What should you do if a scene appears unsafe?

Do not enter until it's secured; call for additional resources to ensure provider safety.

What does "MOI" stand for and what does it tell you?

Mechanism of Injury; it helps predict possible trauma based on how the injury occurred.

What does "NOI" stand for and what does it tell you?

Nature of Illness; it helps identify medical causes of a patient's symptoms.

What is the first priority upon arrival?

Ensure your safety and the safety of your crew and bystanders.

What is the purpose of determining the number of patients?

To decide if additional resources or units are needed for multiple casualties.

What does "general impression" refer to?

Your initial view of the patient's condition and environment, guiding urgency of care.

What are the components of the primary assessment?

General impression, responsiveness, airway, breathing, circulation, and transport decision.

What is the AVPU scale used for?

It assesses responsiveness: Alert, Verbal, Pain, or Unresponsive.

What should you do if a patient is unresponsive?

Check for breathing and a pulse immediately to identify life threats.

What is the difference between a sign and a symptom?

A sign is observable (e.g., pale skin), while a symptom is reported by the patient (e.g., pain).

What does assessing airway involve?

Checking if the airway is open, clear, and maintained.

What maneuver opens the airway in trauma patients?

The jaw-thrust maneuver, which prevents spinal movement.

When should you use the head tilt-chin lift?

On medical patients without suspected spinal trauma to open the airway.

What is the next step if the airway is obstructed?

Clear it using suction or manual techniques before proceeding.

How do you assess breathing?

Observe chest rise, listen for breath sounds, and feel for air movement.

What indicates inadequate breathing?

Shallow respirations, accessory muscle use, or abnormal breath sounds.

What does "tidal volume" mean?

The amount of air moved in and out of the lungs during one breath.

What does "labored breathing" indicate?

Increased effort due to airway obstruction or respiratory distress.

What is wheezing?

A high-pitched whistling sound suggesting narrowing of the lower airways, common in asthma.

What is stridor?

A harsh inspiratory sound signaling upper airway obstruction.

What does cyanosis mean?

Bluish discoloration of skin indicating poor oxygenation.

What is the normal respiratory rate for adults?

12-20 breaths per minute.

What is the normal pulse rate for adults?

60-100 beats per minute.

What are pulse oximeters used for?

They measure oxygen saturation of hemoglobin to evaluate perfusion.

What does capillary refill assess?

The return of blood flow, reflecting peripheral circulation and perfusion.

What is systolic blood pressure?

The pressure during heart contraction, indicating arterial force.

What is diastolic blood pressure?

The pressure during heart relaxation, showing vascular tone.

What is considered hypotension in adults?

A systolic pressure below 90 mm Hg, which may mean poor perfusion.

What is tachycardia?

A heart rate above 100 bpm, often due to stress, shock, or illness.

What is bradycardia?

A heart rate below 60 bpm, possibly from hypoxia or medication.

What does skin color tell you about perfusion?

Pale, cool, or cyanotic skin suggests poor circulation or shock.

What is jaundice a sign of?

Yellow skin or sclera indicating liver disease or dysfunction.

What is the Golden Hour?

The period after trauma where rapid treatment gives the best survival chance.

What does SAMPLE history stand for?

Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading up.

What does OPQRST stand for?

Onset, Provocation, Quality, Region/Radiation, Severity, Timing—used to assess pain.

What is the purpose of the secondary assessment?

To perform a focused or head-to-toe exam to find other injuries.

What is DCAP-BTLS used for?

It guides physical assessment for Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, and Swelling.

When is a rapid full-body scan performed?

For trauma patients with significant MOI or altered mental status.

What does crepitus indicate?

Grinding between bone ends suggesting a fracture.

What should you look for in the neck during assessment?

Jugular vein distention (JVD) or tracheal deviation, signs of serious chest injury.

What is guarding?

Involuntary tightening of abdominal muscles indicating internal pain or peritonitis.

What is subcutaneous emphysema?

Air trapped under skin, often from chest trauma or lung injury.

What are pertinent negatives?

Symptoms that are notably absent but clinically important (e.g., "no shortness of breath").

What are baseline vital signs?

Initial vitals used for comparison throughout care.

What is the purpose of reassessment?

To identify any changes in condition or effectiveness of treatment.

How often should unstable patients be reassessed?

Every 5 minutes.

How often should stable patients be reassessed?

Every 15 minutes.

What does triage mean?

Prioritizing patients based on the severity of their condition.

What is the purpose of situational awareness?

To anticipate hazards and make informed, safe decisions during care.

What is the sniffing position used for?

To open the airway by aligning airway structures during ventilation.

What does the tripod position indicate?

The patient is struggling to breathe and bracing themselves for easier airflow.

What is paradoxical motion?

When a flail chest segment moves opposite to normal chest motion, showing serious chest injury.

What is the AVPU scale?

A quick tool to assess alertness and responsiveness to stimuli.

What is a focused assessment used for?

Evaluating one body system based on the patient's chief complaint.

What is the field impression?

The EMT's working conclusion based on assessment findings.

What should you do if the patient refuses treatment but is confused?

Consider altered mental status—may lack decision-making capacity, requiring further evaluation.

What is diaphoretic skin?

Sweaty skin indicating shock, fever, or exertion.

What is two- to three-word dyspnea?

When a patient can only speak a few words at a time, showing severe respiratory distress.

What are crackles?

Popping sounds during inhalation, suggesting fluid in alveoli as in CHF or pneumonia.

What are rhonchi?

Low-pitched rattles from mucus in larger airways.

What are accessory muscles?

Muscles used to aid breathing when primary muscles can't maintain adequate ventilation.

What does nasal flaring indicate?

Airway obstruction or labored breathing.

What is shallow respiration?

Minimal chest movement indicating poor air exchange.

What is hypertension?

Consistently elevated blood pressure that increases risk of cardiac events.

What does hypotension indicate?

Low blood pressure, suggesting poor perfusion or shock.

What is perfusion?

Delivery of oxygenated blood to tissues.

What is vasoconstriction?

Narrowing of blood vessels, often to maintain blood pressure during shock.

What is metabolism in the cellular context?

The process of converting nutrients into energy for body functions.

What is frostbite?

Tissue damage from freezing temperatures that can lead to necrosis.

What is hypothermia?

Core body temperature below 95°F, leading to slowed metabolism and poor perfusion.

What does the incident command system (ICS) do?

Organizes emergency response teams under one coordinated structure.

What does standard precautions mean?

Universal infection-control steps applied to all patients to prevent disease spread.

What is the purpose of a field triage?

To sort and prioritize patients based on injury severity in mass-casualty events.

During the primary assessment, what are the ABCs?

Airway, Breathing, Circulation—the first critical priorities.

What is the normal range for oxygen saturation (SpO₂)?

95-100%; lower suggests hypoxia or poor perfusion.

How do you assess circulation in an unresponsive adult?

Check the carotid pulse for 5-10 seconds.

When is a radial pulse checked?

In responsive adults to assess circulation.

What does unequal chest rise indicate?

Possible pneumothorax or chest injury.

What does the term "retractions" describe?

Skin pulling in around ribs during inspiration due to labored breathing.

What does guarding indicate in the abdomen?

Peritoneal irritation or internal injury.

What is crepitus a sign of in chest trauma?

Air under the skin or rib fractures causing crackling sensation.

What is subcutaneous emphysema a sign of?

Air leakage from lungs or airway into tissue.

What does scene size-up include besides safety?

Determining mechanism, number of patients, and need for resources.

What are the five vital signs?

Respirations, pulse, blood pressure, skin condition, and level of consciousness.

What should you do if pulse oximetry reads 85%?

Provide oxygen and reassess; may indicate hypoxia.

Why is the secondary assessment delayed in unstable patients?

Life threats must be corrected before detailed exams.

Why is reassessment important after interventions?

To verify that treatments are working and patient condition isn't worsening.

What are distracting injuries?

Painful injuries masking others, requiring full assessment.

What does the sclera show clinically?

Jaundice or pallor indicating systemic conditions.

What does conjunctiva color indicate?

Pink and moist is normal; pale or dry suggests poor perfusion.

What is the most reliable indicator of perfusion?

Mental status—brain receives blood last in shock.

What is the first step after controlling massive bleeding?

Reassess airway and breathing as next priorities.

What does DCAP-BTLS help identify?

Hidden injuries through systematic inspection and palpation.

What is the difference between primary and secondary assessment?

Primary finds immediate life threats; secondary locates additional issues.

What is a sign of inadequate circulation?

Weak pulse and cool, clammy skin.

What are the main components of reassessment?

Rechecking vitals, interventions, mental status, and ABCs.

What is a "field impression"?

EMT's initial diagnosis guiding treatment decisions.