First Responder

What is a First Responder?

The first medically trained person to arrive at an emergency scene.

What are the basic goals of first responder training?

Evaluate, stabilize, and treat patients with minimal equipment, improvise, and assist EMTs/Paramedics.

What are the responsibilities of a First Responder?

Respond safely, ensure scene safety, protect yourself, summon help, gain access to patients, assess patients, provide care, and document care.

What is Duty to Act?

The obligation to respond and provide care when dispatched within your training and equipment limits.

What is Standard of Care?

Care a reasonable, prudent person with similar training would provide under similar circumstances.

What is Negligence?

Failure to provide the standard of care resulting in injury.

Four elements of negligence?

Duty to Act, Breach of Duty, Resulting Injury, Proximate Cause.

What is abandonment?

Leaving a patient after care has begun before equal or higher-trained personnel take over.

What is Expressed Consent?

Patient verbally or nonverbally agrees to treatment.

What is Informed Consent?

Patient understands who you are, what happened, and what treatment is proposed.

What is Implied Consent?

Assumes an unconscious person would consent to emergency care.

If a valid DNR is present and the patient is in cardiac arrest, what do you do?

Do not resuscitate.

If a DNR or MOLST is invalid or expired, what should you do?

Begin resuscitation.

Four obvious signs of death?

Decapitation, rigor mortis, tissue decomposition, dependent lividity.

What are Standard Precautions?

Treat all blood and bodily fluids as potentially infectious.

Four means of disease transmission?

Direct contact, indirect contact, airborne, vector-borne.

What gloves are approved for standard precautions?

Nitrile gloves.

When should a patient be placed in the recovery position?

Unconscious patients who have not suffered trauma.

Why use the recovery position?

Keeps the airway open and allows drainage of secretions.

Two methods to open an airway?

Head Tilt-Chin Lift and Jaw Thrust.

When is the Jaw Thrust maneuver used?

When a neck injury is suspected.

When is an Oral Airway used?

Unconscious patients without a gag reflex.

When should a Nasal Airway NOT be used?

Patients with head trauma.

Normal adult respiratory rate?

12–20 breaths per minute.

Three signs of inadequate breathing?

Noisy respirations, rapid/gasping respirations, pale/blue skin.

Nasal cannula oxygen flow rate?

2–6 L/min.

Nonrebreather mask oxygen flow rate?

8–15 L/min.

Normal oxygen saturation?

95–100%.

What does AVPU stand for?

Alert, Verbal, Painful, Unresponsive.

What does SAMPLE stand for?

Signs/Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events Leading Up.

What does DOTS stand for?

Deformities, Open injuries, Tenderness, Swelling.

Difference between a sign and a symptom?

Sign = what you observe; Symptom = what the patient tells you.

Normal adult pulse?

60–100 beats per minute.

Conscious patient pulse location?

Radial pulse.

Unconscious patient pulse location?

Carotid pulse.

Normal capillary refill time?

Less than 2 seconds.

Hypertension is defined as what BP?

Greater than 140/90 mmHg

What causes seizures?

Sudden uncontrolled electrical impulses in the brain.

How long do generalized seizures usually last?

1–2 minutes.

What should NEVER be placed in a seizure patient's mouth?

Anything.

What should be done after a seizure ends?

Ensure airway is open and place patient in recovery position.

What is angina?

Chest pain caused by inadequate blood flow and oxygen to the heart.

What causes a heart attack?

Complete blockage of a coronary artery.

Common symptoms of a heart attack?

Chest pain, pain radiating to arms/jaw, sweating, nausea, shortness of breath.

What should you do if the patient has prescribed nitroglycerin?

Assist them with one dose according to prescription directions

What is cardiac arrest?

Complete cessation of the heartbeat.

What does CAB stand for?

Circulation, Airway, Breathing.

Reassess stable patients every?

15 minutes.

Reassess unstable patients every?

5 minutes.

When should emergency movement of a patient occur?

Fire, explosion, hazardous materials, unsafe scene, inaccessible patients, or cardiac arrest.

What does MOI stand for?

Mechanism of Injury.

What causes most strokes?

A blood clot blocking blood flow to part of the brain.

Common signs and symptoms of stroke?

Dizziness, confusion, facial droop, inability to speak, numbness/paralysis on one side of the body.

What is the most important piece of information to determine during a stroke assessment?

Time symptoms began or the last time the patient was seen normal.

What does FAST-ED assess?

Facial droop, Arm drift, Speech, Eye deviation, Denial/Neglect.

What phrase is used to test speech during the Massachusetts Stroke Scale?

"The sky is blue in Boston."

What is the first treatment priority for a stroke patient?

Maintain an open airway.

When should oxygen be withheld in a suspected stroke?

When SpO₂ is above 94%.

What causes diabetes?

The body's inability to process and use glucose properly.

What is hypoglycemia (insulin shock)?

Enough insulin is present, but not enough blood glucose

Signs of insulin shock?

Pale, cool, moist skin; rapid weak pulse; dizziness; confusion; sweating; hunger.

What may a patient in insulin shock appear to be?

Intoxicated/drunk.

What should you give a conscious diabetic patient?

Sugar by mouth.

Should you give oral fluids to an unconscious diabetic?

No. Place them in the recovery position and maintain airway.

What causes CHF?

Failure of the heart to pump adequately.

Major symptom of CHF?

Difficulty breathing.

Other signs of CHF?

Rapid shallow breathing, gurgling respirations, sweating, enlarged neck veins, swollen ankles, anxiety.

Best position for a CHF patient?

Sitting upright with legs down.

What causes asthma?

Narrowing of air passages with excess mucus and swelling.

Common causes of asthma attacks?

Allergic reactions, stress, exercise, respiratory infections.

What lung sound is common with asthma?

Wheezing.

What breathing technique helps asthma patients?

Pursed-lip breathing.

Four routes’ poisons enter the body?

Ingestion, inhalation, injection, absorption.

What percentage of poisonings are caused by ingestion?

More than 80%.

Signs of ingested poison?

Nausea, vomiting, diarrhea, abdominal pain, decreased respirations, unconsciousness, seizures.

What should be your first step with a poisoning?

Identify the poison.

How should an unconscious poisoning victim be positioned?

Recovery position.

Common sources of carbon monoxide?

Improperly vented heaters, fires, vehicles with blocked exhaust.

Symptoms of CO poisoning?

Headache, nausea, flu-like symptoms, disorientation, unconsciousness.

What should you suspect if multiple people have flu-like symptoms in the same location?

Carbon monoxide poisoning.

What are signs of amphetamine use?

Restlessness, irritability, talkativeness.

What drugs depress the central nervous system?

Barbiturates, tranquilizers, opiates.

What can an opiate overdose cause?

Respiratory depression or arrest.

Signs of PCP overdose?

Convulsions, coma, heart/lung failure, stroke.

Signs of methamphetamine overdose?

Agitation, rapid heart rate, high BP, paranoia, increased respirations.

What are the three heat emergencies?

Heat cramps, heat exhaustion, heat stroke.

Treatment for heat cramps?

Move patient to a cool place and allow rest.

Signs of heat exhaustion?

Sweating, dizziness, nausea, weak pulse, low blood pressure.

Treatment for heat exhaustion?

Cool environment, oral fluids if conscious, monitor CABs.

Signs of heat stroke?

Hot dry skin, altered mental status, temperature up to 106°F.

Signs of hypothermia?

Shivering, confusion, poor coordination, sleepiness, unconsciousness.

As hypothermia worsens, what happens to shivering?

It stops.

Treatment for hypothermia?

Warm location, remove wet clothing, blankets, heated vehicle.

What academy phrase should you remember about hypothermia?

"They're not dead until they're warm and dead."

Definition of drowning?

Suffocation because of submersion in water or fluid.

Signs of drowning/submersion injury?

Coughing, vomiting, breathing difficulty, respiratory arrest, cardiac arrest, hypothermia.

If a drowning victim is not showing definitive signs of death, what should you do?

Begin CPR

What is shock?

Failure of the cardiovascular system to adequately deliver blood to organs.

What kills more trauma patients than any other condition?

Shock

Signs of a respiratory burn?

Singed nose hairs, soot around mouth/nose, breathing difficulty, pain while breathing.