NCEMT state exam

Perfusion Triangle

heart, blood vessels, blood

systolic pressure

Blood pressure in the arteries during contraction of the ventricles.

diastolic pressure

Blood pressure that remains between heart contractions.

cardiogenic shock

Shock caused by inadequate function of the heart, or pump failure.

pulmonary edema

fluid in the air sacs and bronchioles
- pink frothy sputtum

cardiac tamponade

acute compression of the heart caused by fluid accumulation in the pericardial cavity

psychogenic shock

Shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope). blood pressure falls, the skin becomes cold and sweaty, and the pulse rate increases.

septic shock

Shock caused by severe infection, usually a bacterial infection.

neurogenic shock

hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dilation of blood vessels that increases the volume of the circulatory system beyond the point where it can be filled.

upper airway obstruction

stridor, hoarse

Lower airway obstruction

wheezing, rhonchii, pulmonary edema

contraindications for nitro

Hypotension (generally systolic < 100); recent use of erectile dysfunction medications [e.g. Viagra (sildenafil citrate) and Lavitra (vardenafil) within last 24 hrs; Cialis (tadalafil) within last 48 hr]; Right sided MI may be contraindication in some protocols.

Nitro dose

0.3 to 0.4 mg/0.4mg (spray)

Epi dose

adult .3mg auto injector, pediatric .15mg auto injector for 66 lbs or less

tension pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping

4.The statement "the lungs are superior to the bladder" indicates that the lungs are closer to the:
A.feet.
B.surface of the skin.
C.head.
D.trunk.

head

5.Movement of the arm toward midline is referred to as:
A.flexion.
B.extension.
C.adduction.
D.abduction.

adduction

A body part that lies closer to the midline when compared to another is considered to be:
A.medial.
B.distal.
C.lateral.
D.proximal.

medial

________ is used to identify a body part that is on the "belly side" or anterior surface of the body.
A.Deep
B.Superficial
C.Dorsal
D.Ventral

ventral

You place a patient in the semi-Fowler's position for transport. This means the patient is:
A.lying on his or her back.
B.lying on his or her stomach.
C.sitting at a 45-degree angle.
sitting at a 90-degree an

A patient that is sitting at a 45-degree angle

9.A laceration located on the plantar surface is on the:
A.sole of the foot.
B.palm of the hand.
C.back of the body.
front of the body

sole of the foot

neonates

birth to one month

infants

1 month to one year

-Crying is the main method of communicating.
-Bonding is based on a secure attachment.
-Separation anxiety is common in older infants.
-Trust and mistrust involves needs being met.

toddlers

1-3 years

toddlers pulse, respiratory and BP

pulse 90 to 150
respiratory 20-30 breaths per min
BP 80-100

preschoolers pulse, respiratory, BP

pulse 80 to 140
respiratory 20-25
BP 80-100

preschoolers age

3-6

school age children

6 to 12 years

school age children pulse, respiratory, BP

pulse 70-120
respiratory 15-20
BP 80-110

Adolescent age

12-18

adolescent vitals pulse, respiratory, BP

pulse 60-100, resp 12-20, BP 90-110

growth spirts in girls and boys

girls end at 16
boys end at 18

early adult age

19-40

middle adult age

41-60

older adult age

61+

1.When providing bag-mask ventilations to an infant, what is most important to remember?
A.Blood pressure typically increases with age.
B.An infant's lungs are fragile.
C.An infant grows at a rate of about 30 g per day.
D.An infant has a proportionately larger tongue than an adult.

B.An infant's lungs are fragile.

2.You see an infant capable of reaching out to people and drooling. She is most likely:
A.2 months of age.
B.3 months of age.
C.4 months of age.
D.5 months of age.

4 months of age.

2 months

knows faces and can track objects with eyed

3 months

smile and frown

4 months

reaches out to people; drools

5 months

sleeps thought night; can tell family from strangers

7 months

afraid of strangers; mood swings

8 months

responds to "no" can sit alone, plays peek a boo

9 months

pulls self up, places objects in mouth to explore them

10 months

responds to name, crawls

11 months

stands alone

12 months

knows name, can walk

3.An infant who is repeatedly rejected experiences what type of attachment?
A.Secure attachment
B.Anxious-avoidant attachment
C.Trust and mistrust
Rejection attachment

Anxious-avoidant attachment

4.Why do colds develop so easily in toddlers and preschoolers?
A.They experience a loss of passive immunity.
B.They do not have well-developed lung musculature.
C.They are spending a lot of time around playmates and classmates.
D.All of the above

D.All of the above

5.The pulse rate of a toddler is:
A.80 to 140 beats/min
B.90 to 150 beats/min
C.90 to 180 beats/min
D.100 to 160 beats/min

90 to 150 beats/min

6.A school-age child looking for approval from his peers and society is demonstrating what kind of reasoning?
A.Preconventional reasoning
B.Conventional reasoning
C.Postconventional reasoning
D. Trust and mistrust

B.Conventional reasoning

7.Self-concept is:
A.our perception of ourselves.
B.how we feel about ourselves.
C.how we fit in with peers.
D.how we react to certain situations.

A. our perception of ourselves.

8.Why should you be concerned about a 16-year-old patient who seems depressed?
A.She could be exhibiting rebellious behavior.
B.She has just finished her growth spurt and may be disappointed in the results.
C.Adolescents are at a higher risk for suicide.
D.She may be having unprotected sex.

C.Adolescents are at a higher risk for suicide.

9.Why do finances become an issue during middle adulthood?
A.Middle adults are often supporting both their children and their parents.
B.Middle adults make less money than early adults.
C.Their deteriorating health makes it difficult to get to work.
D.Hearing loss prevents them from working.

A.Middle adults are often supporting

10.Why is breathing more labor intensive for the elderly?
A.The size of the airway increases and the surface area of the alveoli decreases.
B.The natural elasticity of the lungs decreases.
C.The overall strength of the intercostal muscles and the diaphragm decreases.
D.All of the above

A.All of the above

position for chest pain

position of comfort

position for patient in shock

supine

position for late stage of pregnancy

left side

position for unresponsive pt w no spine injury

recovery position

position fot nauseated pt

position of comfort

1.What is the first rule of lifting?
A.Twist slowly when you lift
B.Keep your back in a straight position
C.Bend at the waist to pick something up
D.Use your arms to do most of the lifting

.Keep your back in a straight position

3.It is impractical to apply a vest-type extrication device on a critically injured patient to remove him or her from a wrecked vehicle because it:
A.takes too long to correctly apply.
B.does not fully immobilize the spine.
C.cannot be used on patients who are in their car.
D.does not provide adequate stabilization.

takes too long to correctly apply.

Responsiveness acronym

APVU

use ____ when Respirations exceed 28 breaths/min
-Respirations are fewer than 8 breaths/min

positive pressure airway

capillary refill

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.
peripheral tissues
2 seconds

Rapid scan

60 to 90 seconds to identify injuries that must be managed immediately
assess head, neck, chest, abdomen, pelvis, extremities, back and buttocks

-Signs and symptoms
-Allergies
-Medications
-Pertinent past medical history
-Last oral intake
-Events leading up to the injury/illness

resp rate

12-20 breaths/min

pulse

60-100 bpm

BP

90-130
children 90-110

pulse oximetry measures

arterial oxygen saturation of hemoglobin in capillary beds

reassess stable and unstable patients every

stable - 15
unstable - 5

5.Your primary assessment of an elderly woman who fell reveals an altered level of consciousness and a large hematoma to her forehead. After protecting her spine and administering oxygen, you should:
A.reassess your interventions.
B.perform a rapid exam.
C.transport the patient immediately.
D.perform a focused assessment of her head.

.perform a rapid exam.

Ventillation

movement of air into and out of the lungs

Oxygenation

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.

Respiration

exchange of oxygen and carbon dioxide in the alveoli

agonal gasps

occasional, gasping breaths that occur after the heart has stopped

Cheyne-Stokes

abnormal breathing pattern; periods of dyspnea and apnea

ataxic respirations

Irregular, ineffective respirations that may or may not have an identifiable pattern.

Kussmaul respirations

Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body.

suction time

adult 15
children 10
infant 5

NRB

10-15L up to 100%. Fill reservoir first and must remain ⅔ full during inspiration

nasal cannula

•Delivers 24% to 44% inspired oxygen with flowmeter set at 1-6 L/min
•Consider humidification for long transports.

BVM

With an oxygen flow rate of 15 L/min, a BVM can deliver nearly 100% oxygen.

CPAP

opens collapsed alveoli
caution with patients with potentially low blood pressure, because CPAP causes a drop in cardiac output.
pulse ox less than 90

breathing is controlled by

medulla oblongata and pons

3.In an otherwise healthy individual, the primary stimulus to breathe is a(n):
A.increased level of oxygen in the blood.
B.decreased level of oxygen in the blood.
C.increased level of carbon dioxide in the blood.
decreased level of carbon dioxide in the blood

increased level of carbon dioxide in the blood.

systolic pressure

Blood pressure in the arteries during contraction of the ventricles.

diastolic pressure

Blood pressure that remains between heart contractions. in arteries

pulse

•the difference between the systolic and diastolic pressures.

cardiogenic shock

Shock caused by inadequate function of the heart, or pump failure.

obstructive shock

Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.
-Cardiac tamponade
-Tension pneumothorax
-Pulmonary embolism

distributed shock

•Results from widespread dilation of small arterioles, small venules, or both
•The circulating blood volume pools in the expanded vascular beds.
•Septic shock
•Neurogenic shock
•Anaphylactic shock
•Psychogenic shock

function of the lungs

gas exchange w/ blood
simple diffusion across concentration gradients
exchange of oxygen and carbon dioxide

croup

an acute respiratory syndrome in children and infants characterized by obstruction of the larynx, hoarseness, and a barking cough

Epiglottitis

inflammation of the epiglottis
children in tripod position and drooling

pertussis

whooping cough; highly contagious bacterial infection
6 years old and under