Study Guide For NREMT-B

Normal adult respiratory rate?

12-20 breaths/min

Normal SpO2 range?

94-100%

Normal heart rate?

60-99 bpm

Tachycardia begins at what heart rate?

100 bpm

Normal capillary refill time?

Less than 2 seconds

Capillary refill greater than 2 seconds indicates what?

Inadequate perfusion

Air contains approximately what percentage of oxygen?

21%

What airway maneuver is used when trauma is NOT suspected?

Head tilt-chin lift

What airway maneuver is used when trauma IS suspected?

Jaw-thrust maneuver

If an unconscious patient is found on the ground, what should you assume?

Trauma until proven otherwise

What airway adjunct is contraindicated with a suspected basilar skull fracture?

NPA

Maximum suctioning time for adults?

15 seconds

Maximum suctioning time for pediatric patients?

10 seconds

Snoring respirations usually indicate obstruction by what?

The tongue

What does paradoxical chest movement indicate?

Flail chest

One-sided diminished lung sounds after trauma suggest what?

Pneumothorax

Cherry-red skin suggests what poisoning?

Carbon monoxide poisoning

Why can carbon monoxide poisoning show a normal SpO2?

Pulse oximeters cannot distinguish CO from oxygen on hemoglobin

What type of infection causes croup?

Viral

Classic croup cough?

Barking or seal-like cough

What type of infection causes epiglottitis?

Bacterial

Classic sign of epiglottitis?

Drooling

What position is commonly seen in respiratory distress?

Tripod position

What are Kussmaul respirations?

Deep rapid respirations

Kussmaul respirations are associated with what condition?

Diabetic ketoacidosis

Patients with Kussmaul respirations are usually what?

Hyperglycemic

Nasal cannula oxygen flow rate?

2-6 LPM

Nasal cannula is generally used for what SpO2 range?

88-93%

Nonrebreather oxygen flow rate?

10-15 LPM

Nonrebreather is generally used for what SpO2 range?

70-87%

Nebulizer oxygen flow rate?

6-8 LPM

What medications are commonly delivered via nebulizer?

Albuterol and Atrovent

What respiratory finding indicates albuterol may be helpful?

Wheezing

What respiratory finding indicates bronchoconstriction?

Wheezing

BVM oxygen flow rate?

15 LPM

When should a BVM be used?

Inadequate respirations or unconscious patient

What respiratory rate is commonly associated with ventilatory failure on NREMT questions?

8 breaths/minute

What is the upper airway?

Nose, mouth, pharynx, epiglottis, larynx

What is the lower airway?

Trachea, bronchi, bronchioles, alveoli

What is minute volume?

Tidal volume × respiratory rate

What is the formula for minute volume?

MV = TV × RR

A patient with asthma and wheezing should receive what medication?

Albuterol

What medication may be given alongside albuterol?

Atrovent

Signs of anaphylaxis include what skin finding?

Urticaria (hives)

What medication is used for severe anaphylaxis?

Epinephrine

Adult EpiPen dose?

0.3 mg

Pediatric EpiPen dose?

0.15 mg

What concentration of epinephrine is used for anaphylaxis?

1:1000

What respiratory emergency is associated with drooling and fever?

Epiglottitis

How should epiglottitis patients be transported?

In position of comfort with minimal agitation

What is the primary concern with epiglottitis?

Sudden airway obstruction

A patient with wheezing and respiratory distress likely has what airway issue?

Bronchoconstriction

What respiratory pattern is seen in DKA?

Kussmaul respirations

What respiratory finding suggests airway obstruction by the tongue?

Snoring respirations

What should be suspected when breath sounds are absent on one side after trauma?

Pneumothorax

When should ALS be requested for respiratory trauma?

Suspected pneumothorax

What poison binds hemoglobin approximately 200 times more strongly than oxygen?

Carbon monoxide

What is the first step in carbon monoxide poisoning?

Remove patient from exposure

Normal adult pulse rate

60-100 bpm

Normal pediatric pulse rate

80-150 bpm

Normal infant pulse rate

100-160 bpm

Bradycardia in adults

Pulse less than 60 bpm

Tachycardia in adults

Pulse greater than 100 bpm

Pulse pressure

Difference between systolic and diastolic blood pressure

Systolic blood pressure

Pressure during ventricular contraction

Diastolic blood pressure

Pressure during ventricular relaxation

Normal adult blood pressure

Approximately 120/80 mmHg

Hypertension

Blood pressure consistently above normal range

Hypotension

Systolic blood pressure less than 90 mmHg

Perfusion

Circulation of blood through capillaries to tissues

Signs of poor perfusion

Altered mental status, cool skin, weak pulses

Shock state

Inadequate tissue perfusion

Cardiogenic shock

Shock caused by pump failure of the heart

Hypovolemic shock

Shock caused by loss of blood or fluids

Distributive shock

Shock caused by widespread vasodilation

Obstructive shock

Shock caused by physical obstruction of circulation

Compensated shock

Body maintains blood pressure despite poor perfusion

Decompensated shock

Body can no longer maintain adequate perfusion

Coronary arteries

Vessels supplying blood to the heart muscle

Myocardial infarction

Death of heart muscle due to lack of blood flow

Acute coronary syndrome

Spectrum of conditions caused by myocardial ischemia

Angina pectoris

Chest pain due to temporary myocardial ischemia

Stable angina

Predictable chest pain relieved by rest or nitroglycerin

Unstable angina

Chest pain occurring at rest or worsening pattern

Common heart attack symptom

Chest pressure or discomfort

Heart attack pain radiation

Jaw, neck, shoulder, arm, or back

Diaphoresis

Excessive sweating

Nitroglycerin indication

Suspected cardiac chest pain

Nitroglycerin dose

0.4 mg tablet or spray

Maximum nitroglycerin doses

Three doses if indicated and permitted

Nitroglycerin contraindication

Systolic BP less than 100 mmHg

Nitroglycerin contraindication

PDE-5 medication use within previous 24-48 hours

PDE-5 medications

Sildenafil, tadalafil, vardenafil

Aspirin action

Reduces platelet aggregation

Aspirin dose for ACS

324 mg chewable

Aspirin contraindication

Allergy or active GI bleeding

Myocardial ischemia

Inadequate oxygen supply to heart muscle

Myocardial infarction

Complete blockage causing heart muscle death

Congestive heart failure

Inability of heart to pump effectively

Left-sided heart failure

Commonly causes pulmonary edema