NJ EMT

Describe the anatomy and function of the following major body systems: Respiratory, Circulatory, Musculoskeletal, Nervous, and Endocrine.

  • Respiratory System:

    • Anatomy: Consists of the airways (nose, mouth, pharynx, larynx, trachea, bronchi, and bronchioles), lungs, and the muscles of respiration (diaphragm and intercostal muscles).

    • Function: Facilitates gas exchange, allowing oxygen to enter the bloodstream and carbon dioxide to be expelled. It maintains the body's pH balance and supplies oxygen to tissues for metabolism.

  • Circulatory System:

    • Anatomy: Includes the heart, blood vessels (arteries, veins, capillaries), and blood.

    • Function: Transports oxygen, nutrients, hormones, and waste products throughout the body. The heart pumps oxygenated blood from the lungs to the body and returns deoxygenated blood back to the lungs.

  • Musculoskeletal System:

    • Anatomy: Comprises bones, muscles, tendons, ligaments, and connective tissues.

    • Function: Provides structure, support, and protection to the body. It facilitates movement through muscle contraction and joint articulation. It also stores minerals and produces blood cells in the bone marrow.

  • Nervous System:

    • Anatomy: Divided into the central nervous system (brain and spinal cord) and peripheral nervous system (nerves branching out from the spinal cord).

    • Function: Controls and coordinates body activities by transmitting signals between different body parts. It processes sensory information and initiates responses, including voluntary movements and involuntary actions like reflexes.

  • Endocrine System:

    • Anatomy: Consists of glands such as the pituitary, thyroid, adrenal, pancreas, and gonads.

    • Function: Regulates body functions through the secretion of hormones into the bloodstream. Hormones control growth, metabolism, reproduction, and stress responses.

2. List the signs of inadequate breathing.

  • Increased or decreased respiratory rate (tachypnea or bradypnea)

  • Irregular breathing patterns

  • Use of accessory muscles (neck, chest, abdomen)

  • Nasal flaring (especially in children)

  • Retractions (skin pulling in around ribs or above the clavicles)

  • Cyanosis (bluish discoloration of the skin, lips, or nail beds)

  • Shallow or labored breathing

  • Decreased or absent breath sounds upon auscultation

  • Altered mental status due to hypoxia

  • Tripod positioning (leaning forward to breathe easier)

3. Discuss the reason for performing a focused history and physical exam.

Performing a focused history and physical exam allows EMTs to:

  • Identify life-threatening conditions quickly.

  • Gather specific information related to the patient's chief complaint.

  • Tailor assessment and interventions to the patient's immediate needs.

  • Detect signs and symptoms that may not be immediately apparent.

  • Make informed decisions about patient care and prioritize treatment.

  • Provide accurate information to receiving healthcare facilities.

4. Identify the medications with which the EMT-Basic may assist the patient with administering.

EMT-Basics may assist patients with the following prescribed medications:

  • Epinephrine Auto-Injectors (e.g., EpiPen) for anaphylaxis

  • Metered-Dose Inhalers (MDIs) containing bronchodilators (e.g., albuterol)

  • Nitroglycerin tablets or sprays for chest pain (angina)

  • Oral Glucose for hypoglycemia

  • Aspirin for chest pain suspected to be cardiac in origin

  • Activated Charcoal for certain poisonings (as directed by medical control)

5. Explain the rationale for the administration of medications.

Administering medications in the prehospital setting aims to:

  • Provide immediate relief of symptoms.

  • Stabilize the patient's condition before reaching the hospital.

  • Prevent deterioration of the patient's condition.

  • Address life-threatening emergencies (e.g., anaphylaxis, asthma attacks, cardiac chest pain).

  • Ensure timely intervention, which can be critical for patient outcomes.

6. List the structure and function of the respiratory system.

  • Structures:

    • Upper Airway: Nose, mouth, pharynx (nasopharynx, oropharynx, laryngopharynx), larynx.

    • Lower Airway: Trachea, bronchi, bronchioles, alveoli.

    • Supporting Structures: Diaphragm, intercostal muscles, pleura.

  • Functions:

    • Air Conduction: Transporting air to and from the lungs.

    • Gas Exchange: Occurs in the alveoli where oxygen enters the blood, and carbon dioxide is removed.

    • Protection: Mucus and cilia trap and expel foreign particles.

    • Phonation: Vocal cords in the larynx allow for speech.

    • Olfaction: Sense of smell through receptors in the nasal cavity.

7. Defend EMT-Basic treatment regimens for various respiratory emergencies.

EMT-Basic treatments are designed to:

  • Ensure Airway Patency: By positioning, suctioning, or using airway adjuncts.

  • Provide Adequate Ventilation: Through assisted ventilations with bag-valve masks when necessary.

  • Administer Oxygen Therapy: To improve oxygenation in hypoxic patients.

  • Assist with Prescribed Medications: Such as bronchodilators for asthma or COPD exacerbations.

  • Monitor Vital Signs: To detect changes in the patient's condition.

  • Rapid Transport: To ensure the patient receives advanced care promptly.

These interventions are crucial for preventing respiratory failure and ensuring the patient's survival until they reach definitive care.

8. List signs of adequate air exchange.

  • Normal respiratory rate (12-20 breaths per minute for adults)

  • Regular and unlabored breathing pattern

  • Equal chest rise and fall

  • Clear and equal breath sounds bilaterally

  • Normal skin color (pink, warm, and dry)

  • Alert mental status

  • Normal oxygen saturation levels (95-100% on pulse oximetry)

  • Ability to speak in full sentences without distress

9. State the generic name, medication forms, dose, administration, action, indications, and contraindications for the prescribed inhaler.

  • Generic Name: Albuterol (common bronchodilator)

  • Medication Forms: Metered-dose inhaler (MDI), nebulizer solution

  • Dose: Typically 1-2 inhalations (as prescribed)

  • Administration: Patient inhales medication through the inhaler device

  • Action: Relaxes bronchial smooth muscle, leading to bronchodilation

  • Indications: Asthma exacerbation, bronchospasm due to COPD

  • Contraindications:

    • Hypersensitivity to the medication

    • Maximum prescribed dose already taken

    • Lack of prescription for the patient

10. Describe the structure and function of the cardiovascular system.

  • Structure:

    • Heart: Four-chambered muscular organ (two atria, two ventricles)

    • Blood Vessels: Arteries, veins, capillaries

    • Blood: Plasma, red blood cells, white blood cells, platelets

  • Function:

    • Circulation of Blood: Delivers oxygen and nutrients to tissues

    • Removal of Waste Products: Transports carbon dioxide and other wastes to excretory organs

    • Regulation of Body Temperature: Through vasodilation and vasoconstriction

    • Protection: White blood cells fight infection; platelets aid in clotting

11. Explain the importance of prehospital Advanced Cardiac Life Support (ACLS) intervention if it is available.

Prehospital ACLS interventions are vital because they:

  • Provide advanced airway management and ventilation

  • Allow for the administration of cardiac medications

  • Enable early defibrillation for arrhythmias like ventricular fibrillation

  • Improve patient survival rates during cardiac emergencies

  • Bridge the gap between basic life support and hospital care

12. Differentiate between the fully automated and the semi-automated defibrillator.

  • Fully Automated Defibrillator:

    • Analyzes the patient's heart rhythm automatically

    • Delivers a shock without operator input if a shockable rhythm is detected

    • Minimizes the need for user decision-making

  • Semi-Automated Defibrillator:

    • Analyzes the heart rhythm automatically

    • Requires the operator to press a button to deliver the shock

    • Allows the user to confirm safety before shock delivery

13. State the reasons for assuring that the patient is pulseless and apneic when using the automated external defibrillator (AED).

  • Safety: Avoids unnecessary shocks to patients who do not need defibrillation

  • Efficacy: AEDs are designed to treat ventricular fibrillation or pulseless ventricular tachycardia

  • Prevent Harm: Shocking a patient with a pulse can cause arrhythmias

  • Resource Management: Ensures appropriate use of the AED

14. Explain the considerations for interruption of CPR when using the AED.

  • Minimize Interruptions: To maintain blood flow to vital organs

  • Timing: Pause CPR only when necessary for rhythm analysis and shock delivery

  • Duration: Keep pauses under 10 seconds if possible

  • Coordination: Team members should be prepared to resume CPR immediately after shock

15. Discuss the use of remote defibrillation through adhesive pads.

  • Adhesive Pads:

    • Allow for hands-free defibrillation

    • Reduce the risk of accidental shock to rescuers

    • Provide better skin contact and reduce impedance

  • Placement:

    • Pads are placed in the anterior-lateral or anterior-posterior positions

  • Benefits:

    • Quicker application

    • Continuous monitoring without interruption

16. List the indications for automated external defibrillation (AED).

  • Unresponsive patient

  • Absence of normal breathing (apnea)

  • Absence of a palpable pulse (pulselessness)

  • Suspected sudden cardiac arrest

  • Patient aged typically over 1 year (depending on protocols)

17. List the components of post-resuscitation care.

  • Continuous monitoring of vital signs

  • Maintenance of airway and breathing support

  • Reassessment of the patient's condition

  • Management of underlying causes

  • Preparation for transport to an appropriate medical facility

  • Documentation of interventions and patient response

18. Explain the importance of frequent practice with the AED.

  • Skill Retention: Ensures proficiency in AED operation

  • Confidence: Builds confidence in using the device during emergencies

  • Efficiency: Reduces response time and errors

  • Updates: Keeps up with changes in protocols and device functions

19. Discuss the role of the American Heart Association (AHA) in the use of AEDs.

  • Guidelines Development: Provides evidence-based recommendations for resuscitation

  • Training Programs: Offers courses like BLS and ACLS that include AED use

  • Public Awareness: Promotes AED availability and use in the community

  • Research Support: Funds studies to improve cardiac arrest outcomes

20. List the indications for the use of nitroglycerin.

  • Chest pain suspected to be of cardiac origin (angina)

  • Patient has a prescription for nitroglycerin

  • Systolic blood pressure typically above 100 mmHg (per protocols)

  • Medical control authorization

21. State the contraindications and side effects for the use of nitroglycerin.

  • Contraindications:

    • Hypotension (systolic BP below protocol threshold)

    • Recent use of erectile dysfunction medications (e.g., sildenafil) within 24-48 hours

    • Known hypersensitivity to nitroglycerin

    • Severe anemia or increased intracranial pressure/TBI

  • Side Effects:

    • Headache

    • Dizziness or lightheadedness

    • Hypotension

    • Reflex tachycardia

    • Flushing of the skin

22. Define the function of all controls on an AED, and describe event documentation and battery defibrillator maintenance.

  • AED Controls:

    • Power Button: Turns the device on/off

    • Shock Button: Delivers defibrillation when prompted

    • Analysis Button: Initiates heart rhythm analysis (if not automatic)

    • Pads Connector: Connects the electrode pads to the AED

    • Indicator Lights/Display: Provides prompts and status information

  • Event Documentation:

    • Record time of collapse, CPR initiation, and AED application

    • Document number of shocks delivered and patient response

    • Note any changes in rhythm or vital signs

  • Battery and Defibrillator Maintenance:

    • Regularly check battery levels and replace as needed

    • Perform routine device checks according to manufacturer guidelines

    • Ensure pads are within expiration dates

    • Keep the device clean and in good working condition

23. Defend the reasons for obtaining initial training in AED use and the importance of continuing education.

  • Initial Training:

    • Provides foundational knowledge and skills for AED operation

    • Ensures understanding of protocols and safety measures

    • Prepares responders for real-life emergencies

  • Continuing Education:

    • Updates on new guidelines and technological advancements

    • Reinforces skills to prevent degradation over time

    • Encourages best practices and improves patient outcomes

24. Defend the reason for maintenance of AEDs.

  • Reliability: Ensures the device functions correctly during emergencies

  • Safety: Prevents malfunctions that could harm patients or rescuers

  • Compliance: Meets legal and regulatory requirements

  • Longevity: Extends the lifespan of the equipment

  • Readiness: Guarantees the AED is ready for immediate use

25. Explain the impact of age and weight on defibrillation.

  • Age Considerations:

    • Pediatric patients require adjusted energy doses

    • Special pediatric pads or settings are used for children under 8 years or under 55 lbs (25 kg)

  • Weight Considerations:

    • Obese patients may need higher energy settings (handled by device algorithms)

    • Adequate pad placement is crucial for effective defibrillation regardless of body size

26. Discuss the position of comfort for patients with various cardiac emergencies.

  • Positions:

    • Semi-Fowler's Position: Sitting up at a 45-degree angle, beneficial for chest pain or difficulty breathing

    • Supine Position: Lying flat, used if the patient is hypotensive

    • Recovery Position: On the side, if the patient is unresponsive but breathing adequately

  • Rationale:

    • Positions that reduce workload on the heart and ease breathing

    • Improves venous return and oxygenation

    • Enhances patient comfort and reduces anxiety

27. Predict the relationship between the patient experiencing cardiovascular compromise and basic life support.

  • Cardiovascular compromise can lead to decreased perfusion and oxygenation

  • Early recognition and initiation of BLS (CPR and AED use) are critical

  • BLS maintains circulation and ventilation until advanced care is available

  • Rapid BLS interventions improve survival rates in cardiac emergencies

28. Identify the patient taking diabetic medications with altered mental status and the implications of a diabetes history.

  • Identification:

    • Medical alert bracelets or information from bystanders

    • Presence of insulin or oral hypoglycemic agents

    • Signs of hypoglycemia (sweating, tremors, confusion)

  • Implications:

    • Altered mental status may be due to hypoglycemia or hyperglycemia

    • Immediate glucose administration may be required

    • History guides treatment decisions and transport priority

29. Establish the relationship between airway management and the patient with altered mental status.

  • Altered mental status can lead to loss of airway protective reflexes

  • Risk of airway obstruction due to the tongue or aspiration

  • Requires vigilant monitoring and possible airway adjuncts

  • Ensures adequate oxygenation and ventilation to prevent further deterioration

30. Explain the rationale for administering oral glucose.

  • Purpose: To raise blood glucose levels in hypoglycemic patients

  • Indications: Known diabetes with signs of hypoglycemia and ability to swallow

  • Mechanism: Provides a rapid source of glucose absorbed through the oral mucosa and GI tract

  • Outcome: Improves mental status and prevents progression to unconsciousness

31. Describe the emergency medical care of the patient with an allergic reaction.

  • Assessment:

    • Identify signs of an allergic reaction (hives, itching, swelling)

    • Monitor airway for signs of compromise (stridor, wheezing)

  • Interventions:

    • Maintain airway and assist ventilations if needed

    • Administer oxygen

    • Assist with patient's prescribed epinephrine auto-injector if indicated

    • Monitor vital signs and prepare for rapid transport

32. Describe the mechanisms of allergic response and the implications for airway management.

  • Mechanisms:

    • Exposure to allergen triggers immune response

    • Release of histamines and other mediators

    • Causes vasodilation, increased permeability, bronchoconstriction

  • Implications:

    • Swelling of airway structures (tongue, pharynx, larynx)

    • Bronchospasm leading to difficulty breathing

    • Requires prompt airway management to prevent asphyxiation

33. State the generic and trade names, medication forms, dose, administration, action, and contraindications for the epinephrine auto-injector.

  • Generic Name: Epinephrine

  • Trade Names: EpiPen, Adrenaclick

  • Medication Form: Auto-injector device

  • Dose: Typically 0.3 mg for adults, 0.15 mg for children

  • Administration: Intramuscular injection into the lateral thigh

  • Action: Vasoconstriction, bronchodilation, reduces swelling

  • Contraindications: None in life-threatening anaphylaxis

34. Differentiate between patients having an allergic reaction and those requiring immediate use of an epinephrine auto-injector.

  • Mild Allergic Reaction:

    • Localized hives or itching

    • No respiratory distress or hypotension

  • Severe Allergic Reaction (Anaphylaxis):

    • Signs of airway swelling or respiratory compromise

    • Hypotension or signs of shock

    • Multiple body systems involved

    • Requires immediate administration of epinephrine

35. List various ways that poisons enter the body.

  • Ingestion: Swallowing substances (drugs, chemicals)

  • Inhalation: Breathing in gases, fumes, or airborne particles

  • Injection: Through needles, bites, or stings

  • Absorption: Through skin or mucous membranes

  • Transplacental: From mother to fetus

36. State the generic and trade names, indications, contraindications, medication form, dose, administration, actions, side effects, and reassessment strategies for activated charcoal.

  • Generic Name: Activated Charcoal

  • Trade Names: Actidose, Liqui-Char

  • Indications: Certain poisonings and overdoses ingested orally

  • Contraindications:

    • Altered mental status

    • Ingestion of acids, alkalis, or petroleum products

    • Inability to swallow

  • Medication Form: Suspension (slurry)

  • Dose: Typically 1 gram/kg body weight

  • Administration: Orally

  • Actions: Adsorbs toxins in the gastrointestinal tract

  • Side Effects: Nausea, vomiting, black stools, potential aspiration

  • Reassessment: Monitor for vomiting and airway compromise

37. List the signs and symptoms of exposure to heat.

  • Heat Cramps:

    • Muscle spasms

    • Sweating

  • Heat Exhaustion:

    • Cool, pale, clammy skin

    • Weakness, dizziness

    • Rapid pulse and breathing

    • Nausea or vomiting

  • Heat Stroke:

    • Hot, flushed, dry skin

    • Altered mental status

    • Rapid, strong pulse initially, becoming weak

    • Potential seizures or unconsciousness

38. State the various reasons for psychological crises.

  • Mental health disorders (depression, anxiety, schizophrenia)

  • Acute stress reactions

  • Substance abuse

  • Traumatic events or loss

  • Medical conditions affecting the brain

  • Medication reactions or non-compliance

39. Discuss the characteristics of an individual's behavior which suggests that the patient is at risk for suicide.

  • Expressing feelings of hopelessness or worthlessness

  • Talking about wanting to die or kill oneself

  • Withdrawal from friends and activities

  • Sudden mood changes

  • Giving away possessions

  • Previous suicide attempts

  • Self-harm behaviors

  • Substance abuse increase

40. Discuss special medical/legal considerations for managing behavioral emergencies.

  • Consent: Patients may refuse care; assess decision-making capacity

  • Confidentiality: Maintain privacy but report if necessary (e.g., mandatory reporting laws)

  • Use of Restraints: Follow protocols and laws; use minimum force necessary

  • Documentation: Thoroughly record observations, actions, and statements

  • Duty to Warn: May be required to notify authorities if the patient poses a threat to themselves or others

41. Discuss the special considerations for assessing a patient with behavioral problems.

  • Ensure scene safety

  • Approach calmly and non-threateningly

  • Use active listening and empathy

  • Avoid sudden movements

  • Be aware of potential for violence

  • Involve family or friends if appropriate

  • Assess for medical causes of behavior changes

42. Describe how and when to cut the umbilical cord.

  • When:

    • After the cord stops pulsating (usually within 1-3 minutes)

    • If the cord is wrapped tightly around the neck and cannot be slipped over the head

  • How:

    • Use sterile clamps or ties

    • Place first clamp 6 inches from the baby

    • Place second clamp 2-3 inches from the first

    • Cut between the clamps using sterile scissors

    • Ensure minimal handling to prevent infection

43. List the steps in the emergency medical care of the mother post-delivery.

  • Monitor vital signs

  • Control vaginal bleeding by massaging the uterus

  • Encourage breastfeeding to stimulate uterine contractions

  • Provide emotional support

  • Clean perineal area

  • Transport to the hospital for further evaluation

44. Summarize neonatal resuscitation procedures.

  • Dry and warm the newborn

  • Clear airway if necessary (bulb syringe suction of mouth then nose)

  • Stimulate breathing if not initiated

  • Assess breathing and heart rate

  • If heart rate <100 bpm, begin ventilations at 40-60 breaths per minute

  • If heart rate <60 bpm after 30 seconds of ventilation, begin chest compressions

  • Reassess every 30 seconds and adjust interventions accordingly

45. Discuss the emergency medical care of a patient with a gynecological emergency.

  • Ensure privacy and modesty

  • Assess for signs of shock

  • Control external bleeding with sterile dressings

  • Do not pack or place anything inside the vagina

  • Provide emotional support

  • Gather history related to menstrual cycle, pregnancy, and symptoms

  • Transport promptly for further evaluation

46. Explain the rationale for understanding the implications of treating two patients (mother and baby).

  • Interventions may affect both patients

  • Prioritize care based on life threats to either patient

  • Be prepared for complications affecting one or both

  • Coordinate care to optimize outcomes for mother and child

  • Legal and ethical considerations in decision-making

47. Identify and explain the use of the contents of an obstetrics kit.

  • Sterile Gloves: For infection control

  • Bulb Syringe: To clear newborn's airway

  • Sterile Towels: To dry and wrap the baby

  • Umbilical Cord Clamps/Ties: To clamp the cord before cutting

  • Scissors/Scalpel: For cutting the umbilical cord

  • Sterile Pads: For absorbing blood and amniotic fluid

  • Plastic Bag: For placenta

  • Baby Cap: To keep the newborn warm

  • Emergency Blanket: To maintain body temperature

48. Identify predelivery emergencies.

  • Eclampsia/Pre-eclampsia: High blood pressure with seizures

  • Placenta Previa: Placenta covers cervix causing bleeding

  • Abruptio Placentae: Premature separation of placenta causing pain and bleeding

  • Prolapsed Umbilical Cord: Cord presents before the baby

  • Breech Presentation: Baby's buttocks or feet present first

  • Limb Presentation: An arm or leg presents first

49. State indications of an imminent delivery.

  • Strong, frequent contractions (less than 2 minutes apart)

  • Urge to push or have a bowel movement

  • Crowning (baby's head visible at vaginal opening)

  • Mother feels the baby is coming immediately

  • Rupture of membranes (water breaking) with signs of delivery

50. Differentiate the emergency medical care provided to a patient with predelivery emergencies from a normal delivery.

  • Predelivery Emergencies:

    • Do not attempt delivery in the field

    • Position the mother appropriately (e.g., knee-chest for prolapsed cord)

    • Provide high-flow oxygen

    • Rapid transport to a facility with obstetric capabilities

    • Monitor vital signs and fetal heart tones if possible

  • Normal Delivery:

    • Prepare for delivery on scene

    • Support the baby's head and body as it delivers

    • Follow standard childbirth procedures

51. State the steps in the predelivery preparation of the mother.

  • Ensure scene safety and privacy

  • Position the mother comfortably (usually semi-reclined)

  • Don appropriate PPE

  • Prepare the obstetrics kit

  • Explain procedures to the mother

  • Assess for signs of imminent delivery

  • Time contractions and monitor vital signs

52. Establish the relationship between body substance isolation and childbirth.

  • Childbirth involves exposure to blood and bodily fluids

  • Use of PPE (gloves, gown, eye protection, mask) prevents transmission of infectious diseases

  • Protects both the provider and the patient

  • Proper disposal of contaminated materials is essential

53. State the steps to assist in the delivery.

  • Encourage the mother to push during contractions

  • Support the perineum to prevent tearing

  • Guide the baby's head gently as it emerges

  • Check for nuchal cord and manage if present

  • Assist the shoulders and body as they deliver

  • Keep the baby at the level of the mother's vagina

  • Dry and stimulate the newborn

54. Describe care of the baby as the head appears.

  • Support the head with gentle pressure

  • Suction the mouth then nose if necessary

  • Check for umbilical cord around the neck

  • Gently guide the head downward to deliver the upper shoulder

  • Then guide upward to deliver the lower shoulder

55. Identify the developmental considerations for the following age groups: infants, toddlers, pre-school, school age, adolescent.

  • Infants (0-1 year):

    • Limited communication; nonverbal cues

    • Separation anxiety from caregivers

  • Toddlers (1-3 years):

    • Fear of strangers

    • Limited understanding; use simple language

  • Pre-School (3-5 years):

    • Imaginative; may view procedures as punishment

    • Explain procedures in simple terms

  • School Age (6-12 years):

    • More understanding; can follow instructions

    • May fear pain or bodily injury

  • Adolescent (13-18 years):

    • Concerned about body image and privacy

    • May be reluctant to share information

56. State the usual cause of cardiac arrest in infants and children versus adults.

  • Infants and Children:

    • Respiratory failure or airway obstruction leading to hypoxia

    • Trauma, congenital heart defects, or severe infections

  • Adults:

    • Cardiac arrhythmias due to coronary artery disease

    • Myocardial infarction (heart attack)

57. Describe the management of seizures in the infant and child patient.

  • Protect the child from injury

  • Do not restrain movements

  • Position on side to maintain airway

  • Ensure open airway; suction if necessary

  • Provide oxygen as needed

  • Monitor vital signs and level of consciousness

  • Transport for further evaluation

58. Summarize the indicators of possible child abuse and neglect.

  • Unexplained injuries or inconsistent explanations

  • Multiple bruises or fractures in various healing stages

  • Burns in patterns or shapes

  • Fearful behavior around caregivers

  • Poor hygiene, malnutrition, or lack of medical care

  • Delay in seeking treatment

59. Describe the medical legal responsibilities in suspected child abuse.

  • Mandatory reporting to appropriate authorities

  • Documentation of observations and statements

  • Provide necessary medical care

  • Maintain patient confidentiality within legal requirements

  • Avoid confrontation with caregivers on scene

60. Explain the rationale for having knowledge and skills appropriate for dealing with the infant and child patient.

  • Children have unique anatomical and physiological differences

  • Requires specialized assessment and management techniques

  • Early interventions can prevent deterioration

  • Builds trust with the child and family

  • Enhances patient outcomes and satisfaction

61. Describe differences in anatomy and physiology of the infant, child, and adult patient.

  • Airway: Smaller, more flexible in children; tongue proportionally larger

  • Respiratory Rate: Higher in infants and children

  • Heart Rate: Faster in younger patients

  • Blood Volume: Smaller total volume; blood loss is more significant

  • Body Surface Area: Larger surface area to volume ratio; more heat loss

  • Bones: More flexible; growth plates present

62. Understand the provider's own response (emotional) to caring for infants or children.

  • May experience increased stress or anxiety

  • Personal feelings may affect performance

  • Importance of maintaining professionalism

  • Need for debriefing and support after difficult calls

63. Differentiate the response of the ill or injured infant or child (age-specific) from that of an adult.

  • Infants: Crying, irritability, or lethargy

  • Toddlers/Pre-School: Fearful, may hide or resist examination

  • School Age: May cooperate but fear pain

  • Adolescents: May be stoic or minimize symptoms due to embarrassment

64. Differentiate between respiratory distress and respiratory failure.

  • Respiratory Distress:

    • Increased work of breathing

    • Adequate gas exchange maintained

    • Signs: Tachypnea, retractions, nasal flaring

  • Respiratory Failure:

    • Inadequate oxygenation and ventilation

    • Fatigue of respiratory muscles

    • Signs: Bradypnea, altered mental status, cyanosis

65. List the steps in the management of foreign body airway obstruction.

  • Conscious Infant (<1 year):

    • 5 back blows followed by 5 chest thrusts

  • Conscious Child (>1 year):

    • Abdominal thrusts (Heimlich maneuver)

  • Unconscious Patient:

    • Begin CPR starting with chest compressions

    • Check for object during airway assessment

    • Remove object if visible, do not perform blind sweeps

66. Summarize emergency medical care strategies for respiratory distress and respiratory failure.

  • Respiratory Distress:

    • Provide oxygen via appropriate device

    • Position of comfort

    • Calm and reassure the patient

    • Monitor for deterioration

  • Respiratory Failure:

    • Assist ventilations with bag-valve mask

    • Ensure airway patency

    • Rapid transport

    • Monitor vital signs closely

67. Identify the signs and symptoms of shock (hypoperfusion) in the infant and child patient.

  • Tachycardia

  • Pale, cool, clammy skin

  • Delayed capillary refill (>2 seconds)

  • Altered mental status

  • Decreased urine output

  • Hypotension (late sign)

68. Describe the methods of determining end organ perfusion in the infant and child patient.

  • Assess mental status (alertness)

  • Check skin color, temperature, and moisture

  • Capillary refill time

  • Monitor urine output if possible

  • Observe for signs of respiratory distress

69. Distinguish among the terms cleaning, disinfection, high-level disinfection, and sterilization.

  • Cleaning: Removal of visible soil from surfaces

  • Disinfection: Elimination of many or all pathogenic microorganisms except spores

  • High-Level Disinfection: Kills all microorganisms except high levels of bacterial spores

  • Sterilization: Complete elimination of all forms of microbial life, including spores

70. Discuss "Due Regard For Safety of All Others" while operating an emergency vehicle.

  • Definition: Operating with consideration for the safety of others on the road

  • Legal Responsibility: Emergency vehicle drivers must follow laws and drive safely

  • Practices:

    • Obey traffic signals when possible

    • Use warning devices appropriately

    • Anticipate other drivers' actions

    • Maintain control of the vehicle at all times