Portage College Advanced Care Paramedic Lab Skills Manual

Vocabulary practice flashcards covering terminology, principles, formulas, diagnostic procedures, critical actions, and clinical management criteria from the Portage College Advanced Care Paramedic Lab Skills Manual.

NOCP (National Occupational Competency Profile)

The standard competency framework defined by the Paramedic Association of Canada that outlines proficiency expectations, skill guidelines, and clinical performance criteria for paramedics.

Consistency (NOCP Proficiency Principle)

The ability to repeat practice techniques and outcomes, requiring performance more than once in the appropriate performance environment.

Independence (NOCP Proficiency Principle)

The ability of a student or practitioner to practice without assistance from others.

Timeliness (NOCP Proficiency Principle)

The ability to practice within a designated time frame that enhances patient safety.

Accuracy (NOCP Proficiency Principle)

The ability to practice utilizing correct techniques and to achieve the intended clinical outcomes.

Appropriateness (NOCP Proficiency Principle)

The ability to practice in accordance with established clinical standards and protocols outlined within the specific practice jurisdiction.

CompTracker

The digital documentation platform used by students and instructors to record, track, sync, and sign off competency evaluations during lab skills and scenario assessments.

Section 4(1) Child, Youth and Family Enhancement Act

Legislation governing mandatory reporting requirements when a child is subjected to abuse or neglect caused or allowed by a parent or guardian.

START Triage Principles

A 30-second rapid primary triage assessment system evaluating four objective criteria: ability to walk, respiratory effort, pulses/perfusion, and neurological status.

Pediatric Patient (NOCP Definition)

An infant or child aged 29 days up to the onset of puberty.

Neonate (NOCP Definition)

An infant who is 28 days of age or younger.

Pulse Assessment Technique

Palpating flat across a pulse point, counting beats over $15\,\text{seconds}$, and multiplying that number by $4$ to obtain the minute rate while assessing rhythm and central-versus-peripheral quality.

Respiration Assessment Technique

Looking, listening, and feeling to count inspirations and expirations over $30\,\text{seconds}$, multiplying by $2$ to calculate the minute rate, and assessing depth and ventilatory effort.

Blood Pressure by Auscultation Protocol

Inflating the cuff rapidly while auscultating the brachial artery until circulation ceases, inflating an additional $30\,\text{mmHg}$, then deflating slowly to note the first sound (systolic) and disappearance of sound (diastolic).

Blood Pressure by Palpation Protocol

Inflating the cuff rapidly while palpating the radial pulse until $30\,\text{mmHg}$ above the loss of the radial pulse, then deflating slowly to record the exact pressure at which the radial pulse returns (e.g., $120/\text{P}$).

Allen Test

A vascular assessment performed prior to radial artery puncture to verify adequate collateral circulation through the ulnar artery.

Radial Artery Puncture Technique

Inserting a needle and syringe at a $45^\circ$ angle to the patient's arm distal to the palpated radial pulse, obtaining $1\text{--}2\,\text{ml}$ of blood, gently inverting the syringe $3$ times, and holding direct pressure for $5\,\text{minutes}$.

Macroscopic Urinalysis Microscopic Criteria

Reagent strip findings of $1+$ or greater protein, any presence of blood, nitrites, or leukocytes, or a $\text{pH} > 8.0$, indicating that the urine specimen requires formal microscopic evaluation.

3-Lead ECG Limb Electrode Configuration

Placement of the white lead wire on the right arm (RA), the green lead wire on the right leg (RL), the red lead wire on the left leg (LL), and the black lead wire on the left arm (LA).

Precordial Leads V1 and V2 Placement

Electrode positions placed respectively at the fourth intercostal space at the right sternal border ($V_1$) and the fourth intercostal space at the left sternal border ($V_2$).

Right-Sided Chest Leads (V4R–V6R)

Unipolar chest leads placed on the right anterior thorax (with $V_{4R}$ at the fifth intercostal space, midclavicular line) indicated to evaluate right ventricular infarction when ST elevation is present in inferior leads.

Suction Pressure Settings

Negative vacuum pressure limits configured to an adult target of $120\,\text{mmHg}$, a pediatric target of $80\text{--}120\,\text{mmHg}$, and a neonatal target of $80\text{--}100\,\text{mmHg}$, with the unit capable of generating at least $300\,\text{mmHg}$ when occluded.

Deep Tracheal Suctioning Duration Limits

A procedure requiring intermittent suction while rotating the catheter during withdrawal, limited to a maximum duration of $15\,\text{seconds}$ in adults, $10\,\text{seconds}$ in pediatrics, and $5\,\text{seconds}$ in infants.

Oropharyngeal Airway (OPA) Sizing

Measuring the distance from the corner of the patient's mouth to the earlobe.

Nasopharyngeal Airway (NPA) Sizing

Measuring the distance from the tip of the patient's nostril to the earlobe, with a tube diameter roughly equal to the patient's little finger.

Bougie (Tracheal Tube Introducer)

An intubation adjunct advanced through the vocal cords until clicks are felt as the angled tip passes over the tracheal rings, serving as a guide over which an endotracheal tube is threaded.

Absolute Confirmation of Endotracheal Intubation

Direct visual observation of the distal cuff of the endotracheal tube passing completely through the vocal cords past the glottic opening.

Infant Foreign Body Airway Obstruction Technique (<1 Year)

Delivering up to $5$ forceful back slaps between the shoulder blades followed by up to $5$ downward chest thrusts at a rate of $1\,\text{per second}$ until the object is expelled or the infant becomes unresponsive.

Percutaneous Cricothyrotomy

Emergency airway puncture inserting a $14\text{--}16\,\text{gauge}$ plastic catheter at a $45^\circ$ angle directed caudally through the cricothyroid membrane, connecting an oxygen flow modulator at $15\,\text{L/min}$ or a modified $3\,\text{ml}$ syringe-BVM assembly.

Surgical Cricothyrotomy Incision Technique

Making a $1\text{--}2\,\text{cm}$ vertical incision over the cricothyroid membrane, followed by a horizontal puncture cut of $1\,\text{cm}$ in each direction from the midline using a finger as a guide.

Portable Oxygen Tank Safety Threshold

The operational cylinder pressure below which a portable tank must not be placed into service, specifically when the pressure reading is less than $500\,\text{psi}$.

High Concentration Mask (Non-Rebreather)

An oxygen delivery device with a reservoir bag that delivers $90\text{--}100\%$ concentration at a flow rate of $12\text{--}15\,\text{L/min}$, requiring pre-inflation of the bag prior to placement.

Ideal Body Weight (IBW) Calculation

The standardized formulas used for tidal volume settings: Male = $50 + [(\text{Height in inches} - 60) \times 2.3]$; Female = $45.5 + [(\text{Height in inches} - 60) \times 2.3]$.

Assist/Control Mandatory Ventilation (A/CMV)

A mechanical ventilation mode configured with mandatory tidal volumes of $6\text{--}8\,\text{ml/kg}$, sensitivity of $-1\,\text{cmH}_2\text{O}$, minimum PEEP of $5\,\text{cmH}_2\text{O}$, and high peak airway pressure alarm limits set $10\,\text{cmH}_2\text{O}$ above peak inspiratory pressure.

CPR Compression Depth and Recoil

Compressing at least $5\,\text{cm}$ ($2\,\text{inches}$) in adults and children, and at least $1/3$ of the anterior-posterior diameter (approximately $4\,\text{cm}$ or $1.5\,\text{inches}$) in infants at a rate of $100\text{--}120\,\text{beats/min}$ with complete chest recoil.

Hemostatic Agent Application Protocol

Direct wound packing and application of a topical clotting agent with fingertip compression over a $4 \times 4$ dressing for at least $2\,\text{minutes}$ when conventional pressure or tourniquets are ineffective or anatomically infeasible.

Proximal Tibia Intraosseous (IO) Landmark

The landmark located two to three finger breadths below the tibial tuberosity and along the flat medial surface of the tibia.

EZ-IO Needle Depth Indicator Line

The black laser mark on an intraosseous needle that must remain visible (at least $5\,\text{mm}$ above the skin) prior to powering the driver to ensure adequate bone penetration depth.

Pressure Infuser Device Pressure Setting

Pumping the pressure infuser bladder to an internal pressure of $300\,\text{mmHg}$ using the hand bulb to facilitate rapid crystalloid or colloid delivery.

Transfusion Service Identification Number (TSIN)

The unique identifying transfusion number matched directly from the recipient's wristband to the crossmatched blood unit prior to initiation of a transfusion.

Blood Product Initial Infusion Rate

Administering blood products at a low rate not exceeding $2\,\text{ml/min}$ for the initial $15\,\text{minutes}$ while monitoring for adverse hemolytic or non-hemolytic reactions.

Manual Defibrillation Energy Dosing

Standard electrical shock delivery defined as $360\,\text{J}$ for monophasic devices, or $120\text{--}200\,\text{J}$ for biphasic devices, for ventricular fibrillation or pulseless ventricular tachycardia.

Synchronized Cardioversion Energy Selection

Delivering synchronized shocks at $100\,\text{J}$ for wide regular tachycardias, $50\text{--}100\,\text{J}$ for narrow regular tachycardias, and $120\text{--}200\,\text{J}$ biphasic ($200\,\text{J}$ monophasic) for narrow irregular tachycardias.

Transcutaneous Pacing Mechanical Capture Threshold

Confirming pulse response at the right femoral artery, after which current is set $2\,\text{mA}$ above the threshold dose at an initial rate of $60\,\text{beats/min}$.

Water Seal Chamber Air Leak Test (Chest Tube)

Clamping the chest tube close to the insertion site with padded clamps for $1\text{--}2\,\text{seconds}$: if persistent bubbling ceases, the leak is located on the patient side; if bubbling continues, the leak is on the drainage system side.

Needle Thoracostomy Landmark

The second intercostal space on the anterior chest along the midclavicular line, inserting the catheter perpendicular at a $90^\circ$ angle to the superior border of the third rib.

Parkland Burn Resuscitation Formula

$4\,\text{ml} \times \text{Patient Weight (kg)} \times \text{TBSA burned (\%上来)}$, with one half of the calculated crystalloid volume infused over the first $8\,\text{hours}$ and the remainder over the next $16\,\text{hours}$.

Zone of Stasis

The surrounding zone of a thermal burn where microcirculation is compromised but tissue remains potentially salvageable with appropriate fluid resuscitation.

Hydroxocobalamin Mechanism of Action

An intravenous cyanide antidote that chemically binds with systemic cyanide molecules to form harmless, excretable cyanocobalamin (vitamin $B_{12}$).

Flashover Phenomenon

A condition occurring in high-voltage lightning strikes where direct current (DC) flows rapidly along the exterior surface of the victim's body without direct internal path traversal.

Electrical Burn Urine Output Goal

Maintaining aggressive fluid resuscitation to establish a target renal output of $0.5\text{--}1\,\text{ml/kg/hr}$ to prevent tubular obstruction from myoglobin release during rhabdomyolysis.

NAVEL Mnemonic

The five emergency medications approved for endotracheal tube administration when IV/IO access cannot be established: Narcan, Atropine, Ventolin, Epinephrine, and Lidocaine.

Subcutaneous Injection Specifications

Administering medication into the hypodermis using a $24\text{--}26\,\text{gauge}$ needle inserted at a $45^\circ$ angle, restricted to a maximum volume of $1\,\text{ml}$.

Intramuscular Maximum Volume Limits

A $90^\circ$ injection restricted to $2\,\text{ml}$ in the deltoid, and up to $5\,\text{ml}$ in the dorsal gluteal, vastus lateralis, rectus femoris, and ventrogluteal muscles.

Intravenous Bolus Delivery Rates (IVP vs SIVP vs RIVP)

IV Push (IVP) is administered over $30\text{--}60\,\text{seconds}$, Slow IV Push (SIVP) requires a minimum of $2\,\text{minutes}$, and Rapid/Fast IV Push (RIVP/FIVP) is given as fast as the plunger can be fully depressed.

Prolapsed Umbilical Cord Management

Positioning the mother in left lateral recumbent with hips elevated, knee-chest, or Trendelenburg, inserting two gloved fingers to gently lift the fetus off the cord, covering exposed cord in moist sterile dressings, and maintaining finger placement without removal.

MR SOPA Mnemonic

The sequential corrective ventilation steps utilized when neonatal heart rate fails to improve with PPV: Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase, and Alternative airway.

Neonatal Resuscitation Epinephrine Dosing

Administering $0.1\,\text{mg/ml}$ ($1:10\,000$) Epinephrine at $0.01\,\text{mg/kg}$ IV/IO/UVC followed by a $0.5\text{--}1\,\text{ml}$ normal saline flush, or $0.1\,\text{mg/kg}$ via endotracheal tube (maximum $0.3\,\text{mg}$) if vascular access is absent.

Competency Evaluation Requirement (S, C, and P)

Students must achieve evaluated proficiency a minimum of two times in each skill competency ('S'), and a minimum of one time in the skill environment plus two times in clinical ('C') and preceptorship ('P') environments to satisfy course completion standards.