emt final take 2
What is a CABC?:: Commission for the Accreditation of Birth Centers
What does Carbon Monoxide do to your body?:: Combines with hemoglobin in red blood cells 200 times more readily than oxygen Blocks the ability of hemoglobin to transport oxygen to the body's tissues.
What is the first thing you should do if you are exposed to another person’s body fluids?:: Turn over patient care to another EMS provider Clean the exposed area with soap and water. If eyes are exposed, rinse them with water for at least 20 minutes as soon as possible.
Why is it so important to document EVERYTHING?:: It demonstrates that care was delivered appropriately and within the scope of practice of the providers Serves as an opportunity to communicate the patient’s story to others as adequate reporting and accurate records ensure continuity of patient care; facilitating transfer of care and responsibility.
When do you have a duty to act?:: As an EMT, when you are charged with an emergency or medical response; your service or department states you must assist in an emergency. When you’ve already begun treatment on a patient.
When are restraints allowed?:: If the patient has a medical condition that appears serious or if they suffer from an apparent behavior disorder that poses a risk to the patient or others.
Expressed Consent (or actual consent):: Type of consent which patient specifically acknowledges that he or she wants you to provide care or transport (this can be verbal or nonverbal).
Implied Consent:: Type of consent in which a patient who is unable to give consent is given treatment under legal assumption that he or she would want treatment (e.g if patient is unconscious).
Involuntary consent:: Type of consent that is given through legal obligations; E.g. treating a minor but parent/guardian is not present to provide informed/expressed consent).
What are the early signs of respiratory distress in a pediatric patient?:: Increased breathing rate (tachypnea),Nostril flaring, Increase in work of breathing, Abnormal airway noise (grunting or wheezing), Use of accessory muscles, Retractions: drawing in of the muscle between ribs or sternum during inspiration, Head bobbing (back during inspiration and forward during expiration), Tripod position.
What are indicators of a pulmonary embolism?:: Chest pain, Lightheadedness, Rapid breathing or shortness of breath, Tachycardia, Varying degrees of hypoxia, Hemoptysis, Cyanosis.
What should you do if a patient on a medical device is not having respiratory distress?:: Check oxygen levels and rapid transport; Check for any other life threats.
What information does a dispatcher get from a 911 call?:: Address, Chief complaint, Name, Type of call, Call back number,
Understand traffic laws when responding?:: Stop for school busses when children crossing or stop sign is up; Come to a complete stop at red lights and stop signs before proceeding with caution; When on a highway- turn off lights and sirens until you are in the left hand lane; Do not exceed speed limits in school zones; AMBULANCES CAN: Park or stand in otherwise illegal locations; Drive above the posted speed limit; Drive against flow of traffic on a one-way street or make a turn that would normally be illegal; Travel left of center to make an otherwise illegal pass.
How do you evaluate hazards at a scene including the number of patients?:: Scene Size Up.
What are the risk factors of AMI?:: Lack of physical activity; Substance abuse; Smoking; Hypertension; Diabetes mellitus; Obesity; Stress; Older age (especially if above 65); Gender- male are more likely to get an AMI.
Where does the myocardium receive oxygenated blood from?:: Pulmonary vein.
Braxton-Hicks contractions:: Definition- false labor ; Signs and Symptoms- Not regular contractions and don’t increase in intensity or frequency; come and go; Pain and contractions start and stay in lower abdomen; Physical activity or change in position may alleviate pain and contractions; Bloody show if present is brown-ish; If fluid leakage occurs, it’s usually urine, It will be small and smell of ammonia.
Meconium:: Definition-fetal stool; Signs and symptoms- When appearing as a dark green material in amniotic fluid, it can indicate distress or disease in newborn; This can be aspirated into the fetus’ lungs during delivery.
Uterus:: Definition- the muscular organ where the fetus grows; also called the womb; responsible for contractions during labor.
Stages of labor:: 1- Dilation of cervix; 2- Delivery of fetus; 3- Delivery of placenta.
Types/stages of dehydration:: Mild dehydration; moderate dehydration; severe dehydration.
Stridor:: Harsh, high-pitched respiratory sound, generally heard during inspiration; caused by partial blockage or narrowing of upper airway; may be audible without stethoscope.
Rhonchi:: Coarse, low pitched breath sounds heard in patients with chronic mucous in upper airways.
Wheezing:: High-pitched whistling breath sound that is most prominent on expiration; suggests obstruction or narrowing of lower airways.
PAT (Pediatric Assessment Triangle):: Structured assessment tool used to rapidly form a general impression of infant or child without touching him or her; Consists of assessing appearance, work of breathing, and circulation to skin.
Retracting (during breathing):: Physical act of chest wall expanding and retracting during breathing helps circularory system return blood to heart; Drawing in of the muscle between ribs or sternum during inspiration .
Cataracts:: Clouding of the lens of the eye or its surrounding transparent membranes; Makes it difficult to distinguish between colors and see clearly.
Glaucoma:: Condition of increased pressure within the eye; Contraindications for a lot of drugs (like epinephrine!)
Emergency Medical Treatment and active labor act:: All hospital emergency departments MUST provide a medical assessment and required treatment, regardless of the patient’s ability to pay.
Cerebral palsy:: Group of disorders characterized by poorly controlled body movement; Difficult muscle coordination; Development delays; Speech disorders.
Down Syndrome, what is it and in regard to airway management:: Characterized by genetic chromosomal defect in mild to severe intellectual and physical characteristics, such as a round head with flat occiput and slanted wide-set eyes; Airway- Small facial features like mouth and nose cavities, Large tongues.
How to set up a LZ (Landing Zone):: Ensure area is 100ft x 100 ft (30m x 30m) and no less than 60ft x 60ft (18m x 18m); Make sure land is hard or grassy; Notify flight of steepness and slope direction (should not exceed 5 to 7 degrees); Clear loose debris; Examine immediate area for overhead or tall hazards, such as power lines, telephone cables or tall or leaning trees; Use weighted cones or position vehicles at corners of landing zone, headlights facing inwards to form an ‘X’; Move nonessential people and vehicles to a safe distance outside of the landing zone; Communicate strong winds and wind direction to flight team.
Disinfection:: Killing of pathogenic agents by direct application of chemicals.
Compartment Syndrome:: Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue; Pain in injury worsens; Signs of impaired circulation may be present.
Herniation of the brain stem:: Protrusion of an organ or tissue through an abnormal opening in the brain; Signs and symptoms- Dilated pupils, Headache, Drowsiness, Difficulty concentrating, Hypertension, Seizure, Shortness of breath or rapid breaths, loss of consciousness, Coma, Cardiac arrest, Abnormal posturing, Altered reflexes.
Sympathetic nervous system:: Part of the autonomic nervous system that controls active functions such as responding to feat (fight or flight system).
Parasympathetic nervous system:: Part of autonomic nervous system that controls vegetative functions such as digestion of food and relaxation.
Laceration of the aorta:: Aka aortic dissection; Signs and symptoms- Sudden severe chest pain or upper back pain; Tearing or ripping sensation spreads to neck or down back; Sudden severe stomach pain; Loss of consciousness; Shortness of breath; Sudden vision problems, difficulty speaking, weakness or paralysis of one side of body; Weak pulse in one arm or thigh when compared to other; Leg pain; Difficulty walking.
Pericardial tamponade:: define- compression of heart as a result of buildup of blood or other fluid in the pericadial sac, leading to decreased cardiac output; signs & symptoms- Beck’s triad- Jugular vein distension, Muffled heart sounds, Narrowing pulse pressure.
Heat Stroke:: define- life threatening condition of severe hyperthermia caused by exposure to excessive natural or artificial heat. signs & symptoms- Warm, red, dry skin; Severely altered mental status; Irreversible coma; Headache; Confusion or delirium; Possible loss of consciousness; Absence of sweating; Nausea or vomiting; Tachycardia; body temperature above 104 F (40 C).
Hypoxic drive:: a condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases.
Acute pulmonary embolism:: define- a blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow; signs & symptoms- dyspnea, sharp chest pain, sudden onset, tachycardia, clear breath sounds, hemoptysis, cyanosis, hypoxia, tachypnea.
Aspiration Pneumonia:: define- when food or liquid is breathed into the airways of lungs, instead of being swallowed; signs & symptoms- chest pain, coughing, fatigue, fever, shortness of breath, wheezing, breath odor.
Spontaneous pneumothorax:: define- occurs when weak area on lung ruptures in the absence of major injury, allowing air to leak into the pleural space; signs & symptoms- pleuritic chest pain, sharp, stabbing pain on one side that is worse during inspiration and expiration or with certain movement of the chest wall, absent or decreased breath sounds on affected side.
Acute coronary syndrome:: define- a group of symptoms caused by myocardial ischemia; signs & symptoms- acute chest pain.
Focal-onset aware seizure:: define- affecting a limited portion of the brain; signs & symptoms- no change in level of consciousness, numbness, weakness, dizziness, visual changes, unusual smells or tastes, muscle twitches and extremity twitches, brief paralysis.
Complex partial seizure:: define- begins in one part of the brain; abnormal discharges from the temporal lobe of the brain; signs & symptoms- altered mental status, lip smacking, eye blinking, isolated convulsions or jerking of the body or one part of the body such as an arm, visual hallucinations, unpleasant smells, fear, repetitive movements, does not remember events during seizure.
Ruptured Cerebral artery (aneurysm):: define- a swelling or enlargement of the wall of the blood vessel that results from weakening of the vessel wall. once ruptured, it can hemorrhage, causing stroke, brain damage, coma, death; signs & symptoms- sudden onset, severe headache.
Ketone production:: define- chemical that liver produces when breaking down fats → body uses ketones for energy during fasting, long periods of exercise, or when you don't have as many carbohydrates.
How to treat prolapsed cord:: DO NOT PUSH CORD INTO THE VAGINA (OR ELSE); place woman supine with foot end of the stretcher raised 6-12 inches higher than the head; elevate hips; insert sterile gloved hand into vagina and gently push fetus’s head away from the umbilical cord; maintain the position throughout transport to the hospital; wrap a sterile towel moistened with saline around exposed cord, administer high flow oxygen and rapid transport.
How to treat Breech presentation:: call for ALS; if no delivery within 10 minutes of buttocks presentation, provide prompt transport; position pregnant woman, prepare OB kit, and prepare like normal delivery; allow buttocks and legs to deliver spontaneously + support them with hand to prevent rapid expulsion- allow legs to dangle off arm in order to support infant’s trunk; allow head to deliver + make a V with gloved fingers, positioning them in the vagina to keep the walls from compressing the airway.
How to treat Neck pain in a vehicle:: manage airway; apply cervical collar if indicated; call als.
How to treat Snake bite:: Rapid transport and call hospital to ensure resources are readily available at hospital; If bit by a pit viper or coral snake, let hospital know to provide antivenom.
How to treat heat cramps:: remove the patient from the hot environment, including direct sunlight and loosen any tight clothing; administer high flow oxygen if shows signs of hypoxia; rest the cramping muscles (have the patient lie down); replace fluids by mouth. Give water or diluted balanced electrolyte solution; cool the patient with cool water spray or mist and add convection to the cooling method by manually or mechanically fanning the patient.
How to treat heat exhaustion:: remove the patient from the hot environment and excess layers of clothing (esp around head and neck); administer high flow oxygen if indicated; if patient has altered mental status, check blood glucose level; cool the patient with misting and ice packs to the trunk of the body- ice bath the patient if 104 degrees or altered mental status; encourage patient to lie down; if fully alert, encourage them to sit up and slowly drink up to a liter of water; transport patient on his or her left side if you think the patient may be nauseated but make certain that the patient is secured.
how to treat heatstroke:: move the patient out of the hot environment and into the ambulance; set air conditioning to maximum cooling; remove the patient’s clothing; administer high flow oxygen if indicated or bvm- if unresponsive, rapid transport and cooling en route; provide cold water immersion in an ice bath if possible- if available at scene, allow for immersion until cbt is 101-102 degrees; spray skin with cool water and fan to quickly evaporate the moisture on the skin; aggressively and repeatedly fan the patient; exclude other causes of altered mental status and check blood glucose level if possible; rapid transport ; notify hospital asap; do not overcool the patient; call als assistance if patient begins to shiver.
How to treat Anaphylactic reaction:: apply high flow oxygen, treat for shock after administration of epinephrine.
How to treat Hypoxemic patient with chronic lung disease:: apply high flow oxygen to the patient and rapid transport; don't deny it when in need but be cautious.
How to treat Scorpion bite:: notify receiving hospital of suspected C sculpturatus for antivenin (can only be administered by physicians); Administer bls care (treat other symptoms); Rapid transport to ed.
Staging:: area to keep EMS providers safe until police secure a violent or potentially violent scene.
Incident commander:: individual who has overall command of the incident in the field.
Safety officer:: the person who monitors the scene for conditions or operations that may present a hazard to responders and patients; may stop an operation when responder safety is an issue.
What is the first step of arriving at an MCI?:: primary triage done in the field, allowing you to quickly categorize the patient’s condition and transport needs.
What are the placards on trucks and storage containers used for?:: Indicates the hazards of chemicals that are being carried inside.
How is Smallpox transmitted:: route- inhalation of coughed droplets or direct skin contact with blisters; signs + symptoms-severe fever, malaise, body aches, headaches, small blisters, bleeding of the skin and mucous membranes.
How is Ricin transmitted:: exposure- inhalation, ingestion, injection; signs + symptoms- inhaled = cough, difficulty breathing, tightness in chest, nausea, muscle aches, pulmonary edema, and hypoxia; ingested = nausea + vomiting, internal bleeding, and death; injected = no signs except swelling at injection site and death.
How is Pneumonic plague transmitted:: route- infected by rodents and fleas; signs + symptoms- fever, headache, muscle pain, shortness of breath, tenderness, pneumonia, extreme lymph node pain and enlargement.
What does a pulse oximeter do?:: The pulse oximeter identifies the oxygen saturation present in the blood. The normal range is from 94-99%.
What should you do when you are interviewing a pt to show that you understand them?:: use eye contact to encourage the patient to continue speaking; repeat statements back to the patient to show that you understand; do not interrupt and be empathetic.
How does positive pressure ventilation affect cardiac output?:: When positive pressure ventilation is initiated, more air is needed to achieve the same oxygenation and ventilatory effects of normal breathing. This increase in airway wall pressure causes the walls of the chest cavity to push out of their normal anatomic shape. There is an increase in intrathoracic pressure which affects the return of venous blood to the heart. Reduced venous blood = reduced cardiac output (pg 461).
Why is rapid and shallow breathing a problem?:: Rapid and shallow breathing, hyperventilation, decreases the tidal volume and does not allow for optimal oxygenation and the emission of carbon dioxide; Feeling lightheaded, dizzy, weak, or not able to think straight, increased blood pressure and heart rate as well.
What should be done after administering a MDI?:: apply supplemental oxygen via nonrebreather; reassess the patient and document pt’s response.
What are the possible side effects of Naloxone?:: Agitation/Combative; Nausea; Vomiting; Diarrhea; Tremulousness; Diaphoresis; Tachycardia; Seizures; Dyspnea; Abdominal cramps; Increased Blood Pressure; Cardiac Arrest/Ventricular Fibrillation; Pulmonary Edema.
When would you use CPAP?:: When a patient has obstructive respiratory distress (emphysema) and acute pulmonary edema; Copd, chf.
Why does cardiac output decrease if the pt is tachycardic?:: The increase in heart rate decreases the amount of blood being ejected from the left ventricle, therefore decreasing cardiac output; decreased ventricular filling (preload) at high rates of contraction (not enough blood fills the ventricles during contractions).
What type of injuries occur from primary blast injuries:: disruption of major blood vessels and rupture of eardrums and major organs; hollow organs are most susceptible to the pressure wave; can amputate limbs as well.
What type of injuries occur from secondary blast injuries: penetrating/blunt trauma from debris.
What type of injuries occur from tertiary blast injuries:: body is hurled or thrown = blunt trauma.
What type of injuries occur from quaternary blast injuries:: burns, suffocation, poisoning, respiratory injury, crush injuries, contamination of wounds.
What type of injuries occur from MVA rollovers:: spinal injury; otherwise unpredictable based on whether the patient was restrained or not.
What kind of injuries occur from Blunt trauma injuries in a MVA:: significant internal bleeding and bruising to the brain/bleeding in and around the brain tissue; causes for an increase in pressure in the skull around the brain.
What kind of injuries occur from Electrical injuries:: electrical burns; severe burns and cardiac dysrhythmias; burn injury has entrance and exit wound.