EMT Midterm Study Guide

OPQRST

A memory aid for assessing symptoms: Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, and Time.

SAMPLE

A memory aid for gathering medical history: Signs/Symptoms, Allergies, Medications, Pertinent past history, Last oral intake, and Events leading up to the illness or injury.

Differential Diagnosis

A working list of potential diagnoses compiled early in the patient assessment that could explain the presentation.

Diagnosis

A description or identification of a patient's condition that guides further evaluation and clinical management.

Observation, Palpation, and Auscultation

The three standard hands-on physical examination techniques that an EMT must master.

Critical Thinking

The clinical reasoning process by which an EMT evaluates assessment findings, considers alternatives, and reaches a reasoned field impression.

Illusory Correlation

The perception of a causal relationship between two events or variables when no true relationship actually exists.

Crepitation

A grating or crackling sensation felt on palpation when fractured bone ends rub together.

Red Flags

Assessment findings or symptoms that suggest the possibility of a particularly serious or life-threatening problem.

Heuristics

Mental shortcuts or rules of thumb used to speed up the process of clinical decision-making.

Representativeness

A decision-making strategy where a situation is judged based on how closely it matches a familiar clinical pattern or prototype.

Sign

An objective physical finding observed, felt, or measured by the EMT, such as bleeding or vital signs.

Symptom

A subjective sensation or condition described by the patient, such as pain, nausea, or dizziness.

Priapism

A persistent penile erection that may indicate spinal cord injury.

Subcutaneous Emphysema

A crackling or crunching sensation felt under the skin when air escapes from normal passageways and becomes trapped in tissue.

Paradoxical Motion

The movement of an injured chest wall segment in the opposite direction from the rest of the chest during respiration, indicative of flail chest.

Tracheostomy

A surgical incision in the neck held open by a tube through which a patient can breathe.

Colostomy

A surgical opening in the abdominal wall diverting the colon into a collection bag for digestive waste.

Distention

Abnormal enlargement or swelling of the abdomen beyond its normal size.

Contusion

A bruise caused by tissue damage and internal bleeding beneath skin that remains intact.

Reassessment

The ongoing process of repeating the primary assessment, vital signs, physical exam, and evaluating treatment effectiveness during transport.

Trending

The continuous comparison of serial assessment findings and vital signs over time to detect changes in patient status.

Reassessment Interval for Stable Patients

Reassessing and documenting vital signs and status approximately every 15 minutes.

Reassessment Interval for Unstable Patients

Reassessing and documenting vital signs and status approximately every 5 minutes.

Base Station

A two-way radio situated at a fixed site, such as a hospital or dispatch center.

Mobile Radio

A two-way radio mounted or affixed in an emergency vehicle.

Portable Radio

A handheld two-way radio that can be carried on an EMT's belt or person.

Repeater

A device that receives low-power radio signals and retransmits them at higher power over long distances.

Federal Communications Commission (FCC)

The federal agency responsible for assigning and licensing radio frequencies to maintain orderly communications.

PCR Narrative

The written narrative section of the Patient Care Report detailing the patient presentation, assessment findings, interventions, and response.

Chief Complaint

The patient's primary reason for calling EMS, ideally recorded in the PCR using the patient's exact words in quotes.

NHTSA Minimum Data Set

A standardized set of operational and clinical data elements, including time of arrival at patient location, developed for EMS research.

Subjective Information

Data based on an individual's personal perception, opinion, or report, such as a symptom or complaint.

Objective Information

Data that is measurable, observable, verifiable, and free of bias.

Indication

A specific sign, symptom, or circumstance under which it is appropriate and recommended to administer a medication.

Contraindication

A sign, symptom, or condition that makes medication administration inappropriate or potentially harmful.

Pharmacodynamics

The study of how a medication affects the body, accounting for patient-specific factors like age and weight.

Five Rights of Medication Administration

The safety verification standard: right patient, right medication, right time, right dose, and right route.

Sublingual Route

Medication administration placed and absorbed directly beneath the tongue.

Parenteral Route

A route of medication administration that bypasses the gastrointestinal tract, such as an intramuscular injection.

Aspirin

A medication given for suspected cardiac chest pain that reduces platelet aggregation and helps prevent further clotting.

Nitroglycerin

A sublingual vasodilator that increases blood supply to ischemic heart tissue and relaxes coronary vessels; can cause hypotension and headache.

Epinephrine

A hormone and medication that reverses severe anaphylaxis by dilating bronchioles and constricting blood vessels.

Activated Charcoal

A powdered medication mixed with water that binds ingested poisons to inhibit absorption in the gastrointestinal tract.

Oral Glucose

An oral gel given to conscious diabetic patients with altered mental status who can swallow to elevate blood sugar levels.

Off-Line Medical Direction

EMS protocols and standing orders written in advance by the Medical Director that do not require direct verbal radio contact.

Carina

The point where the trachea divides into the right and left mainstem bronchi.

Large-Bore Suction Tubing

Suction tubing used without a tip or catheter attached, which is most effective for clearing copious amounts of thick material or large food particles from the airway.

Nasopharyngeal Airway (NPA)

An airway adjunct inserted with the bevel turned toward the nasal septum or base of the nostril; it is often tolerated by patients who still have an intact gag reflex.

Portable Suction Unit Requirements

A suction unit that must be able to generate an air flow of at least $30\,\text{L/min}$ and create a vacuum of no less than $300\,\text{mmHg}$ when the tubing is clamped.

Snoring

The sound produced when relaxed upper-airway soft tissues create impedance or partial obstruction to the flow of air.

Stridor

A high-pitched sound caused by turbulent airflow through a narrowed upper airway or upper airway obstruction.

Oropharyngeal Airway (OPA)

An airway adjunct used for unresponsive patients without an intact gag reflex, inserted upside down and rotated $180$ degrees into the pharynx.

Jaw-Thrust Maneuver

The recommended manual airway procedure for an unconscious patient with a suspected head, neck, or spine injury, or an unknown mechanism of injury.

Nasal Flaring

Flaring of the nostrils during inhalation, serving as a sign of increased work of breathing and potential respiratory compromise.

Nasal Cannula

A low-flow oxygen delivery device whose flow rate should generally not exceed $6\,\text{L/min}$.

Inadequate Breathing

A condition in which minute volume is less than normal, resulting in insufficient air movement to meet the body's needs.

Nonrebreather Mask

A high-concentration oxygen delivery device providing approximately $80\%$ to $90\%$ oxygen at $12$ to $15\,\text{L/min}$, requiring the reservoir bag to be preinflated before application.

Pressure-Compensated Flowmeter

An oxygen flowmeter with a floating indicator that is gravity dependent and must remain upright to deliver an accurate flow reading.

Pulmonary Respiration

The process of gas exchange (movement of oxygen and carbon dioxide) between the alveoli and circulating pulmonary capillary blood.

BURP Maneuver

An intubation assistance technique involving Backward, Upward, Rightward Pressure applied over the Adam's apple to push the vocal cords into view.

Safe Residual Pressure

The threshold pressure of $200\,\text{psi}$ below which an oxygen cylinder should not be allowed to fall before being changed.

Internal Respiration

The movement and exchange of oxygen and carbon dioxide across cell membranes between systemic capillaries and body cells.

Minute Volume

The total volume of air moved into and out of the lungs in one minute, calculated as $\text{Minute Volume} = \text{Tidal Volume} \times \text{Respiratory Rate}$.

Oxygen Regulator

A device connected to an oxygen cylinder that reduces high tank pressure down to a safe working pressure for patient delivery.

Index of Suspicion

A keen awareness formed during scene size-up that specific unseen injuries may be present based on the mechanism of injury.

Emergency Response Guidebook (ERG)

A reference book used by emergency responders during scene size-up to identify hazardous materials and establish safe response parameters.

Blunt-Force Trauma

An injury caused by a blow that strikes the body without penetrating the skin or underlying body tissues.

Penetrating Trauma

A mechanism of injury in which an object pierces into the body.

Law of Inertia

A physics principle explaining the three distinct collisions in a motor-vehicle crash: vehicle collision, body collision, and organ collision.

Danger Zone

The safety perimeter established around an incident scene; extends at least $50\,\text{ft}$ in all directions when no apparent hazards are present.

Primary Assessment

The initial systematic evaluation conducted to detect and treat immediate life-threatening conditions in the order: general impression, mental status, airway, breathing, circulation, and transport priority.

AVPU Mnemonic

A scale used during primary assessment to classify a patient's level of responsiveness: Alert, Verbal, Pain, or Unresponsive.

General Impression

The EMT's initial sense of the patient's condition formed upon first sight, based on the environment, patient appearance, and chief complaint.

Chief Complaint

The primary reason why the patient summoned EMS, ideally documented in the patient's own words.

Tripod Position

A posture where a patient sits upright, leaning forward with arms supporting the upper body, indicative of severe respiratory distress.

Auscultation

The method of measuring blood pressure using a stethoscope to listen for Korotkoff sounds over the brachial artery as the cuff is deflated.

Prehypertension

A blood pressure classification defined as a systolic pressure of $121\,\text{mmHg}$ to $139\,\text{mmHg}$ or a diastolic pressure of $81\,\text{mmHg}$ to $89\,\text{mmHg}$.

Mottling

A blotchy, uneven discoloration of the skin associated with poor peripheral perfusion or shock.

Systolic Blood Pressure

The pressure created in the arterial walls when the left ventricle contracts and forces blood into the systemic circulation.

Diastolic Blood Pressure

The pressure remaining in the arterial system when the left ventricle relaxes between contractions.

Pulse Oximeter

A noninvasive monitoring device that uses wavelengths of light to estimate arterial blood oxygen saturation ($\text{SpO}_2$).

Jaundice

A yellow discoloration of the skin and mucous membranes commonly associated with liver failure or dysfunction.

Baseline Vital Signs

The initial set of vital sign measurements obtained during the secondary assessment, serving as a reference point for comparing subsequent reassessments.

Approximate Pediatric Systolic BP Formula

The course formula used to calculate an approximate normal pediatric systolic blood pressure: $\text{Systolic BP} = 90 + (2 \times \text{age in years})$.

Body Mechanics

Proper use of the body to facilitate lifting and moving objects safely, efficiently, and without injury.

Emergency Move

A patient move carried out immediately when there is an environmental threat to life, or when movement is required to perform lifesaving care or access another critical patient.

Urgent Move

A rapid patient move performed when life threats exist but there is still time to take quick precautions for potential spinal injuries.

Bariatric Stretcher

A specialized stretcher built to carry heavier or obese patients, typically rated to support 800 pounds or more.

Power Grip

A lifting technique using maximum hand contact, where all fingers and the palm contact the object, with hands positioned at least 10 inches apart.

Power Lift

A lifting technique, also known as the squat-lift position, where the lifter uses strong leg muscles while keeping the back straight.

Standard of Care

The degree of care expected to be provided by an EMT with similar training when caring for a patient in a similar emergency situation.

Scope of Practice

The set of regulations and legal boundaries defining the emergency actions expected of and limitations placed upon an EMT.

In Loco Parentis

A legal concept allowing an authorized caregiver, school authority, or administrator to act in place of a parent when giving consent for a minor.

Duty to Act

An EMT's formal legal or ethical obligation to provide emergency medical care in certain situation contexts.

Expressed Consent

Permission granted for care by a mentally competent adult who is fully informed and capable of making a rational decision.

Implied Consent

A legal presumption of consent that applies when a patient is unconscious or unable to make informed decisions during a medical emergency.

Anatomy

The scientific study of physical body structures and their physical relationships.

Physiology

The scientific study of body function and how physical structures operate.

Prone

An anatomical position in which a patient lies face down on their stomach.