EMR Final

"ectomy"

removal of body part, object, or organ

pulmonary embolism

causes an obstruction (clot) in the circulatory vessels of the lungs. This decreases the ability of oxygen to transfer from the alveoli to the pulmonary circulation. This is also known as a ventilation-perfusion mismatch. It is a circulation problem not a ventilation problem.

Pancreas

in the endocrine system, secretes insulin

Superior

Higher on the body, nearer to the head

Inferior

Lower on the body, farther from the head

Lateral

Away from the midline of the body

Medial

Toward the midline of the body

Dorsal

toward the back of the body

Ventral

toward the front of the body

Ligaments

Connect bone to bone

Tendons

Connect muscle to bone

pulmonary edema

oxygen and cardon dioxide molecules cannot swim. Therefore, they cannot diffuse through fluid to get to where they need to be and gas exchange cannot occur.

lateral recombant position (recovery)

lying on the side

prone

lying face down

supine

lying on the back

6 R's

Right patient, right drug, right dose, right route, right time, right documentation

OPQRST

Onset, Provocation, Quality, Region/Radiation, Severity, Timing.

SAMPLE

Signs/Symptoms, Allergies, Medications, Pertinent Past History, Last Oral Intake, Events Leading To Injury Or Illness.

Narcan (naloxone)

1. Opioid antagonist that reverses the effects of opioid drugs

2. Used to treat opioid overdose (heroin)

IN dose: 1mg (.5 per nostril)

Epinephrine

adrenaline; used for allergic reaction. IM via autoinjector dosage: 3mg adult .15mg peds

Activated Charcoal

a substance that absorbs many poisons and prevents them from being absorbed by the body- given orally at 25g to 50g

Glucose

for low blood sugar, done buccally at 15g

Asprin

dose 324 mg- chewed.

Nitroglycerine (Nitrostat)

.4 mg per tablet, can give up to 3 times

Albutoral

dose 2.5 mg in 3L

normal skin parameters:

pink, warm, dry

What is checking any treatments or interventions and repeating vitals a part of:

Ongoing assessment

Regular respiration rate of an adult:

12-20 bpm

Regular respiration rate of school aged children:

18-25 bpm

Regular respiration rate of preschool aged children:

20-28 bpm

Regular respiration rate of toddlers:

22-37 bpm

Regular respiration rate of infant

30-53 bpm

Regular respiration rate of neonate:

40-60 bpm

Pulse neonate

100- 205 bpm

Pulse Infant

100-180 bpm

Pulse Toddler

98-140 bpm

Pulse Preschooler

80-120 bpm

Pulse school aged child

75-117 bpm

pulse adult

60-100 bpm

Adult BP

120/80 mmHg

Adolescent BP

110-131/64-83

Preadolescence BP

102-120/61-80

School aged child BP

97-115/57-86

Preschooler BP

97-115/57-86

Infant BP

72-104/37-56

Neonate BP

67-84/35-53

Main priority for trauma pt:

rapid trauma assessment

How long will a oxygen D-tank with 1200 psi at 15 lpm last for?

10.6 minutes

How long will a oxygen E-tank with 600 psi at 15 lpm last?

7.5 minutes

nasal canula flow rate and oxygen concentration

1-6 L

Liter flow for non-rebreather mask

10-15 L

Hemophilia

A hereditary disease where blood does not coagulate to stop bleeding

when and how should dressings be applied?

Apply DRY, sterile dressings to burns greater than 10% body surface area (BSA). Avoid using water, soapy water, or wet dressings to avoid heat loss.

Things to remember for burn pts:

keep them warm, and watch carefully for signs of shock.

How should you auscultaste lungs?

Bilaterally, anteriorly, and posteriorly

Lacerations, abrasions and punctures are considered:

"Open" soft tissue injuries

What do you do if an unconscious patient has vomit in their mouth?

Log roll that patient to clear airway, suction if needed.

With AMS you should check:

blood sugar!!

when do you look for significant external bleeding?

In the primary/initial assessment

What is a common complication of applying bandages?

Cutting off circulation distal to the injury site. Always assess for pulses distal to pressure bandages after placing them.

What kind of bleed is the highest priority for treatment and transport?

Arterial bleeding

What do you do with trauma patients exposed to the cold?

Actively warm them with heat packs and blankets.

Do you give cold patients warm fluids or warm their extremities?

No

second degree burn

A partial-thickness burn involving the epidermis and the dermis.painful, swollen and mottled with blisters. The nerve endings are still intact.

first degree burn

Superficial burns through only the epidermis, red and painful with no blistering.

What should you consider in swimming injuries?

stabilize head and neck

Third Degree Burn

A full-thickness burns that involve the epidermis, dermis, and varying levels of the subcutaneous and underlying structures.

Arterial bleed

Bright red blood that is spurting

Superficial frostbite (frost nip)

Involves some freezing of the epidermal tissue, with no tissue destruction.

Avulsion

Open wound to the skin with a partially attached flap of tissue

Primary goal of triage

Determine which patients will receive treatment resources first

Hot, dry skin indicates:

patient is unable to regulate his own body temperature. He is beginning to decompensate. This indicates that the patient is suffering from heat stroke.

What should you suspect In any patient that has been removed from a burning building?

Carbon monoxide poisoning

Any "cardiac involvement" secondary to a lightning strike should be:

closely monitored and treated asap

A trauma patient that has been allowed to bleed for 20 minutes is most likely

In the end stages of shock

What is typically worse than a venous bleed?

An arterial bleed

When do you apply a tourniquet?

After direct pressure has failed to control bleeding

Treatment for shock from severe bleeding includes:

controlling external bleeding, providing supplemental oxygen, and preventing heat loss. Do not delay transport, do not elevate the legs.

Sudden improvement from depression is:

risk factor for suicide

A person who is at risk of harming himself or others is deemed:

unable to make rational decisions and can and should be transported to the ER for the protection of all

A patient who has received a direct lightning strike will most likely have

burn injuries and potential cardiac problems.

The visible indication of a patient's mood is termed:

Affect

How many rescuers is preferred to take down a combative patient?

5

What is always a priority throughout the trauma patient assessment?

Protect the rescuers from harm

What do you assume if a patient has been involved in a head on collision where they were not wearing a seatbelt, had no airbags and is unresponsive?

Head injury

What do you do when you have a patient that you are going to backboard and you have decided to leave the helmet in place?

you will need to pad under the shoulders.

What do you need to do with smaller children when putting them on a backboard?

You will need to pad under the shoulders when immobilizing onto a long board in order to maintain neutral alignment.

What do you do if while applying a splint or sling and swath the patient states that you are causing them pain?

Wait a minute before reattempting to apply the splint, and/or ask the patient for suggestions. We do not want to cause further pain if at all possible.

When do we immobilize the entire spine?

When an isolated cervical spine injury is suspected because the cervical spine injury could mask other spinal injuries.

What is a life threatening nervous system related injury?

One to the brainstem

What do you TYPICALLY do with helmets?

Leave them in place, removing a snug-fittting helmet can make the situation worse.

Does the cervical collar fully immobilize the cervical spine?

No, it is there to reduce movement and to remind the patient not to move the head and neck.

What will a patient with a spinal cord injury display?

Neurological dysfunction (Numbness, tingling, burning, paralysis) An absence of neurological deficit would indicate the absence of injury to the spinal cord.

What should every patient receive?

SAMPLE and OPQRST

What do you do if a patient had a pulse in the injured extremity before placing a splint but they don't have one after?

Loosen the splint

Spinal cord injuries shows when?

Initial spinal cord injury may be minimal and not show a neurological deficit until bleeding or swelling occur. As swelling occurs with an injury, a neurological deficit can appear.

What provides the greatest relief and immobilization for a mid-shaft femur fracture?

A traction splint

What is a significant concern associated with a lumbar fracture?

Paralysis of the lower half of the body