EMR: Test 3 (Chapter(s): 11, 16-23, 33) Study Guide

This is the information from guided notes and answer keys. Grade on Test (*weird test score): 96/97

Ventilation

includes inhalation and exhalation- one full breath

What has to happen for a person to inhale?

diaphragm goes down and ribs go out, the air diffuses from high to low concentration into the lungs until pressure is equal

What has to happen for a person to exhale?

diaphragm comes back up and ribs back in and air rushes out by diffusion

External respiration

in the alveoli diffusion of oxygen in the lungs to bloodstream

Internal respiration

diffusion of oxygen, water, and glucose from the capillaries into cells

Cellular respiration

process of making ATP from oxygen, water and glucose

Hypoxia

low oxygen in body

Stridor

whistling blockage in upper airway

Mottled

patchy skin red/blue skin color

Flushed

red skin color

Jaundice

yellow skin and possible eye color

Cyanotic

blue skin

Wheezing

gasping, labored breathing in the lower airway

Apnea

not breathing

Crepitus

bones grinding against each other, OR popping and cracking under the skin and joints

Dyspnea

difficulty breathing

What is the air pillow-like structure that is wrapped in capillaries?

alveoli

Hypercapnia

a high level of CO2 in the bloodstream

What are some causes for hypoxia?

Smoke, fire with smoke, trauma, diseases such as emphysema, lung cancer, heart attack, COPD, drowning, high fever, pressure on the chest, congestive heart failure, asthma, chronic bronchitis, and many others

List the signs of inadequate breathing

pale, cool, clammy skin, lung sounds like stridor and wheezing, cyanotic, breathing rate very high, percent oxygen low, altered mental status, possibly unconscious

Pulse oximeter reading (What exactly does the percentage mean?)

It looks at the hemoglobin of the red blood cells and shows the percent of hemoglobin that is covered by another molecule. An advanced oximeter will tell whether the molecules are O2 which people can use for cellular respiration or CO (carbon monoxide) which can not be used for cellular respiration.

What can give incorrect readings on a pulse oximeter?

nail polish, smoker, lotion, cold fingers

Tachypnea

breathing at a fast rate

Nasal flaring

a sign in children that they are having trouble breathing and moving to hypoxia

Capillary refill

a sign in children they have hypoxia, press the nail bed, the skin under turns white, and then measures the time it takes to turn back to the normal skin color.

* It should be less than 2 seconds in children.

The ___ is easily obstructed in children:

trachea (upper airway)

Compare the following between children and adults (head size, airway size, breathing rate, and heart rate)

a. Head size- children have a head bigger in comparison to their body

b. Airway size- smaller in children

c. Breathing rate- faster in children

d. Heart rate- faster in children

How do you decide which way to open the airway (head/tilt/chin lift or jaw thrust)?

* head tilt/chin lift (usually)
* jaw thrust (trauma to head or back)

How do you decide whether you choose a non-rebreather or a BVM?

BVM: the highest level

* not breathing
* breathing less than 8 or more than 24
* pulse ox less than 86%
* could be unconscious
* usually trauma situations

\
Nonrebreather: the medium level

* complain of trouble breathing
* signs of hypoxia
* pulse ox 86-95%
* must look at the entire patient to decide.

Air that is coming out of an oxygen tank used for breathing treatment is ___ oxygen coming out of the tank.

100%

What is a CPAP machine and when is it used?

* Continuous positive airway pressure (better known as CPAP)
* For respiratory distress patients, like those with pulmonary edema from congestive heart failure, bronchitis, emphysema, asthma

What color is an oxygen canister?

Green

What is the procedure to giving oxygen to a patient with a stoma?

Use a tracheostomy mask, mask over the stoma, cover the mouth

What circumstances could continued oxygen therapy cause a hazard to a patient?

Patients with COPD like emphysema could have decreased breathing rates, decreased cardiac output, gastric distention, and dangerous changes in blood pressure

Why is it so important to get the right size C collar on a patient?

* Too loose: neck not stabilized, the spine can be injured


* Too tight: cause breathing difficulty

What is the whole purpose of the Primary Assessment?

Find and treat any life threats

What is an intervention?

The procedures and/or medicine you would do to help the patient

What is a contraindication?

Conditions where medication should not be used

What does trending mean?

Compare the baseline vital signs to the recent vital signs

* Are they stable?
* Getting worse?
* Condition getting better?

What is the difference between a sign and a symptom?

* Signs are something you can see and measure
* Symptoms are what the person tells you and is subjective

What three things are you looking for when checking a victim's eyes?

PERRL: pupils equal, round, reactive to light

A fall that is __*___*__ times the height of the person is considered trauma.

3

* A medical assessment patient is checked ___ minutes


* A patient in trauma should be rechecked every *__* minutes

* 5-10 minutes
* 5 minutes

Define anaphylactic shock

allergic reaction, blood pressure drops, bronchioles constrict, hard to breath

What is the normal range for blood sugar?

70-120

When checking a patient during a trauma check. What are the three things that are checked in the
chest?

a. Auscultate: lung sounds

b. Palpate: tenderness

c. Inspect: deformities

Define shock

(aka hypoperfusion) is the lack of oxygen in all the cells of your body.

Nasal Cannula

* Pulse Oxygen %
* L/min
* Gurgling

* Pulse Oxygen is 90-95% (+)
* 4-6 L/min of 100% O2
* suction

Nonrebreather

* Pulse Oxygen %
* L/min
* Gurgling

* Pulse Oxygen is 86-90%
* Patent airway (12-20 min, struggling to breathe, 10-15 L/min of 100% O2
* Suction

BVM

* Pulse Oxygen %
* L/min
* Gurgling

* Pulse Oxygen of 86% (-)
* Patent (head tilt, chin lift/jaw thrust)
* Less than 8 or more than 24 breaths/minute
* 10-15 L/min of 100% O2
* Suction

What structures are in the upper airway?

1. Nasopharynx, Oropharynx, and Laryngopharynx

* nose, mouth, sinuses, pharynx, larynx, ends at the epiglottis

What structures are in the lower airway?

1.  Below the epiglottis

* the windpipe (trachea) and within the lungs, the bronchi, bronchioles, and alveoli

List five causes of dyspnea.

1. Lung and airway conditions
2. Heart and blood conditions
3. Asthma
4. Allergies
5. Anxiety

Respiratory Diseases:

* Croup
* Epiglottitis
* RSV
* Pneumonia
* Pertussis
* Influenza A
* COVID
* TB
* Pulmonary Edema
* COPD
* Asthma
* Spontaneous pneumothorax
* Pulmonary embolism

Cardiac arrest

loss of heart function from an electrical malfunction

* Electrical Problem

Heart Attack

Myocardial Infarction- blood flow to the heart is blocked, tissues dies

* Circulation Problem

CPR and its purpose

actions are taken to revive a person by getting blood with oxygen to the brain tissue with cells

* These cells can possibly then still make ATP and will not die or kill the person.

Defibrillation and its purpose

delivery of an electrical shock with an AED to stop the fibrillation of heart muscles

* Heart tissue (SA and AV nodes) will then start the electricity again (automaticity) and restore a normal heart rhythm

Name the four chambers of the heart

1. right atrium
2. right ventricle
3. left atrium
4. left ventricle

Name two arteries on the outside of the heart (coronary arteries) that keep the heart alive

left and marginal artery

What does the heart have to have to keep the heart tissue alive?

Oxygen, glucose and water from the blood

What are the two large veins going into the heart?

1. Pulmonary vein
2. Inferior and superior vena cava

The right side of the heart has (oxygenated, deoxygenated) blood.

deoxygenated

Where does the pulmonary artery go to?

the lungs

True or false. Both atria fill with blood and then contract and then both ventricles fill with blood and contract.

True

What causes the lub, dub sound of the heart?

* Bi and tricuspid valves closing for the lub
* Pulmonary semilunar valve and aortic semilunar valves closing for the dub

Why does the cell need these things (oxygen, water, glucose)? What happens if these are not present?

For ATP; Your cells would die and thus you would die

The heart makes its own electricity. What is this ability called?

Automaticity

The electricity goes from the SA node and causes these to contract (atria) and then goes to the __ node which causes these to contract. (ventricles)

AV

Nitroglycerin

one dose every 5 minutes up to 3 doses. .4 mg each tablet

* relaxes blood vessels in coronary arteries and decreases the workload of heart; dilates coronary arteries

Aspirin

Four, 81 mg baby aspirin OR 1, 324 mg adult aspirin

* Prevents blood from clotting as quickly (anticoagulant), leading to increased survival after myocardial infarction; when administered to cardiac patients, aspirin is not being used to relieve pain

CAD (Coronary Artery Diseases)

diseases that affect the arteries of the heart; fatty buildup in the artery

Thrombus

a clot formed of blood and plaque attached to the inner wall of an artery or vein and embolism: blockage of a vessel by a clot or foreign material brought to the site by the blood current

Aneurysm

the dilation, or ballooning, of a weakened section of the wall of an artery

Bradycardia and Tachycardia

* Brady: when the heart rate is slow, usually less than 60 beats per minute
* Tachy: when the heart rate is fast, more than 100 beats per minute

Ischemia

lack of blood to a certain place; narrowing of the vessels; angina: chest pain caused by this

CHF: congestive heart failure

the failure of the heart to pump efficiently (heart tissue weakness) leading to excessive blood or fluids in the lungs, the body, or both (this is also called an enlarged heart)

Pedal edema

Accumulation of fluid in the feet or ankles

Cardiac arrest

loss of heart function

What artery takes deoxygenated blood to the lungs?

Pulmonary artery

Why do coronary arteries on the heart need oxygen?

To make ATP for the heart muscles to pump blood

What are the two best arteries for checking for a pulse in an adult?

a. Carotid artery
b. Radial artery

What is cardiac output?

The amount of blood ejected from the heart in one minute (heart rate x stroke volume)

What is the whole purpose of CPR? (please don’t write to keep you alive). How does it keep you alive?

Keep oxygen flowing to the brain so the brain can make ATP to keep the brain cells alive

Angina

chest pain from a narrowed coronary artery. (nitro will dilate these narrowed arteries to bring more oxygen to the heart which decreases chest pain)

* THIS CAN COME ON QUICKLY WHEN EXERCISING AND GO AWAY QUICKLY ALSO

Cerebrovascular Accident (CVA)

* artery in the brain is ruptured, disrupting the supply of oxygenated blood or causing bleeding into the brain (hemorrhagic)


* blood vessel in the brain is blocked with a clot or fat plaque (ischemic stroke)

Transient ischemic attack (TIA)

small clots may be temporarily blocking circulation to part of the brain (like mini-strokes)

How often should the batteries be checked on an AED?

They should be checked once a week.

EMTs believe their patient needs to have their heart rhythm analyzed. Do you stop the ambulance to do this or keep going?

Yes; you stop.

What are the two physiological effects of taking aspirin?

Reduces clotting time, and stops headache, and joint pain

* Prevents blood from clotting as quickly, leading to increased survival after myocardial infarction

Congestive heart failure

Weak heart, fluid builds up back to the lungs

Cardiac arrest

Heart stops beating

Pedal edema

Fluid builds up in the feet

Angina

Chest, heart pain

Aneurysm

Thin area in an artery could burst

Angioplasty

Balloon procedure to open the blood vessel

Transient Ischemic Attack (TIA)

Small clot blockages in the brain that then let loose

Apnea

Not breathing

Cardiac compromise

Any condition that stops the heart from operating correctly

Coronary heart disease

Build up of fat inside the coronary arteries