EMT HCC UNIT 3 EXAM!

Three types of radio

Portable (handheld), mobile (in vehicle), and base station (fixed spot)

When to use cell phone vs radio to call

Use your radio first for all formal communication (Communicating with dispatch, medical direction, hospital, EMTS, and multiple agencies.

Use your cell phone only when the radio:

• Doesn't work

• Is out of range

• Would violate patient confidentiality

FCC (Federal Communications Commission)

The FCC has jurisdiction over all radio operations in the United States, including EMS. It regulates radio traffic, assigns frequencies, issues licenses, and ensures that communication is clear, safe, and legal.

- FCC makes sure EMTs, dispatchers, and hospitals use radios correctly, don't interfere with each other, and follow legal standards.

Repeat back medication orders

- After receiving the order, repeat the order word by word. Repeat it even if denied, do the procedure, or give medication.

- If order appears to be inappropriate, question the physician.

Medical Radio Report

units identification and level of providers, estimated time of arrival, patient's age and sex, chief complaint, brief, pertinent history of the present illness, major past illnesses, mental status, baseline vital signs, pertinent findings of the physical exam, emergency medical care given, response to emergency medical care, contact medical direction if required

Therapeutic Communication

Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.

• Use eye contact

• Be aware of your position and language

• Use language only they can understand

• Be honest

• Use the patient’s proper name

• Listen

Children:

• Always come to the child’s eye level

• Tell truth to children

Objective vs. Subjective

Objective is observable, measurable, and verifiable

Subjective is from an individual point of view

How to correct a PCR error

Electronic PCR:

Correct data and add an addendum that explains changes you made and why

Paper PCR:

Draw single horizontal line through error, initial, and then write correct info beside it; no erasing

Discovered at a later date:

single line through error, mark with initials and the date, and add correct info to the end of report or in sperate note

Oral Glucose

a form of glucose (a kind of sugar) that can be taken by mouth as a treatment for a conscious patient (who can swallow) with an altered mental status and a history of diabetes.

- Tube of gel

- Apply to a tongue depressor and place between the patient’s cheek and gum or under the tongue

- Patient swallows glucose so it can be easily absorbed into the digestive tract and bloodstream, which carries it to the brain

Hypoxia

Low oxygen saturation of the body, not enough oxygen in the blood

Signs = altered mental status, cyanosis, increased work of breathing

Medications EMT's can administer

Aspirin, oral glucose, oxygen, prescribed bronchodilator inhalers, nitroglycerin, activated charcoal, naloxone, and epinephrine (auto-injectors)

Epinephrine

Patient that is highly allergic to something causes life-threatening changes in the airway and circulation (anaphylaxis)

Reverses: Medication that will help constrict blood vessels and relax airway passages

- Epinephrine Auto-injector is a syringe with a spring-loaded needle that will release and inject epinephrine into the muscle

5 Rights

right patient, right drug, right dose, right route, right time

Routes of Administration

Oral, Sublingual (placed under tongue and dissolves), Inhalation, Intranasal (sprayed in nostrils), Intravenous (Injected into a vein), Intramuscular (Injected into a muscle), Subcutaneous (Injected under skin), Intraosseous (Injected into bone marrow cavity), and Endotracheal (Sprayed directly into a tube inserted into the trachea.)

Reassess pt. after meds

• After admistration, you must reassess

• Look for any changes - Improvements, deteriorations, or unintended effects

• Clearly document medications given -5 Rs and any effects should be documented

What's normal/abnormal signs for children

Signs of inadequate breathing/airway

Mental status changes, cyanosis, rapid heart rate, rapid breathing, sweaty skin, fats respiratory rate, slowing or irregular respirations, inability to speak, no lung sounds, low oxygen saturation, dying respirations, irregular rate, breath sounds may be diminished or absent, tidal volume will be inadequate or shallow, chest expansion may be inadequate or unequal, and respiratory effort is increased

BVM

Positive pressure ventilation

Positive pressure: air is pushed into lungs, increases pressure inside airway, and used when patient can’t breathe well on their own

EX. BVM, ventilator, CPAP

Negative Pressure: air is pulled into lungs, lowers pressure inside chest, used when normal healthy breathing

EX. Normal breathing

CPAP

COPD (Chronic Obstructive Pulmonary Disease)

• Most common problem of middle age or older patients

• Smoking ciagarette causes most of cases

MDI and Nebulizer

pulmonary edema

fluid in the air sacs and bronchioles (lungs)

COPD (chronic obstructive pulmonary disease)

A group of lung diseases that block airflow and make it difficult to breathe.

2 types of COPD

emphysema (damage to lungs overtime) and chronic bronchitis (long term couch with mucus)

pneumonia

Bacterial infection of the lungs

Epiglottis

A flap of tissue that seals off the windpipe and prevents food from entering.

pneumothorax

air in the pleural cavity caused by a puncture of the lung or chest wall

coronary arteries

blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle

ACS (acute coronary syndrome)

group of conditions caused by decreased blood flow through the coronary arteries (STEMI, NSTEMI, unstable angina)

Palpations

left ventricle

Pumps oxygenated blood into the aorta

croup

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

Nitroglycerin

nitrate drug used in the treatment of angina, vasodilator

Aspirin

coronary artery disease CAD

a condition affecting arteries of the heart that reduces the flow of blood and the delivery of oxygen and nutrients to the myocardium; most often caused by atherosclerosis

aneurysm

a localized weak spot or balloon-like enlargement of the wall of an artery

Angina vs MI

angina (low oxygen to heart tissues) = no dead heart tissues. MI=

dead heart tissue present.

CHF (congestive heart failure)

condition in which the heart cannot pump enough blood to the rest of the body

Chain of survival

Most important actions needed to treat life threatening emergencies

- Early Access, Early CPR, Early Defibrillation, Early Advanced Care

V-fib

ventricular fibrillation

When to transport to cardiac center

Child vs. adult cardiac arrest

High performance CPR

Providing high-quality chest compressions as part of a well-organized team response to a cardiac arrest.

When to stop CPR

S- patient starts breathing and has a pulse

T- patient transferred to another person trained in BLS

O- out of strength to continue

P- a physician is present or providing online direction and assumes responsibility of the patient, gives direction to stop

When to switch roles in CPR

Every five cycles or 2 minutes

Communication with family during cardiac arrest

AED Operation

1. Turn on AED

2. Follow voice command

3. Remove Pads from pad pack

4. Place Pads

5. Let AED analyze

6. Shock if necessary (not follow AED's command)

7. Do not Turn OFF AED until PAX is removed from A/C

No Shock Advised what you should do

Pad placement and pace makers

Dyspnea

difficult or labored breathing

Bradycardia

slow heart rate (less than 60 bpm)

Tachycardia

A rapid heart rate, more than 100 beats/min.

Insulin

A hormone produced by the pancreas or taken as a medication by many diabetics

apnea

absence of breathing

aura

a sensation experienced by a seizure patient right before the seizure, which might be a smell, sound, or general feeling

3 phases of a seizure

Tonic (tensing), clonic (jerks violently), and postictal (recovery)

Hypoglycemia

hyperglycemia

3 P's

polyuria, polydipsia, polyphagia

stroke

A sudden attack of weakness or paralysis that occurs when blood flow to an area of the brain is interrupted

Thrombolyotic drug

Lyme disease

Tick-borne disease caused by the spirochete Borrelia burgdorferi.

Syncope/dizziness

"Passing out", loss of consciousness or fainting

allergic rxn vs anaphylaxis

febrile seizures

Seizures that result from sudden high fevers, particularly in children.

Histamine

Chemical stored in mast cells that triggers dilation and increased permeability of capillaries.

Allergies and antibodies

How and when to give epi pen

Lyme disease

Sepsis

infection (local), sepsis (systematic), and septic shock (systematic with hypotension)

Meningitis

inflammation of the meninges of the brain and spinal cord

EMS role in new diseases

carbon monoxide

a colorless, odorless, and poisonous gas

Poison

When to not enter with poison

Activated Charcoal

a substance that absorbs many poisons and prevents them from being absorbed by the body

Alcohol use

Opioid triad

coma, depressed respiration, pinpoint pupils

uppers

stimulants such as amphetamines that affect the central nervous system to excite the user

Downers

depressants, such as barbiturates, that depress the central nervous system, which are often used to bring on a more relaxed state of mind

referred pain

pain that is felt in a location other than where the pain originates

radiating pain

pain felt at the site of tissue damage and in nearby areas

(Spread)

Cholecystitis

Abdominal pain, portion of comfort, guarding,

Major abdominal cpmplaints based on quadrants

Behavioral emergency

when a patient's behavior is not typical for the situation; when the patient's behavior is unacceptable or intolerable to the patient, his family, or the community; or when the patient may harm himself or others

Safety on behavioral emergency

Same sex standard for treating behavioral pt.

Signs of violence on scene/ when to never leave

Anemia

A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.

hemodialysis

the process by which waste products are filtered directly from the patient's blood

spleen

Organ near the stomach that produces, stores, and eliminates blood cells

liver

produces bile

Pancreas

Regulates the level of sugar in the blood

kidneys

Filter blood from the renal arteries and produce urine as waste

Gallbladder

A muscular sac attached to the liver that secretes bile and stores it until needed for digestion

stomach

large muscular sac that continues the mechanical and chemical digestion of food

excited delirium

A serious behavioral condition in which a person exhibits agitated behavior combined with disorientation, hallucinations, or delusions; also called agitated delirium or exhaustive mania.

Perineum dialysis

Role of potassium in dialysis