NREMT Cheat Sheet Study Notes

NREMT Cheat Sheet Study Notes

Introduction

• Purpose: Designed to support learning throughout EMT school and preparation for the National Registry exam.
• Approach: Simplifies complex EMS topics into clear, organized summaries for efficient learning.
• Key Components:
  • Understanding protocols contextually ("how" and "why")
  • Decision-making confidence
  • Quick recall of critical information
• Structure: Breaks down essential topics (airway management, trauma, patient assessment, pharmacology) into digestible sections.
• Formats: Available digitally and physically for flexible study options.
• Study Routine: Recommended use alongside practice questions, flashcards, and group discussions to improve retention.
• Mindset: Emphasize motivation to help others during emergencies.

Why This Cheat Sheet Is Essential

• Value: Highlights critical concepts needed for EMT training, reducing overwhelm from content volume.
• Study Strategy: Prioritizes key points for focused study; supports reinforcement of knowledge and identification of knowledge gaps.
• Confidence Booster: Aims to ensure preparedness for the NREMT exam through organized and clear explanations.

Table of Contents

1. Patient Assessment
2. Airway Management
3. Breathing Interventions
4. Circulation Management
5. Cardiac Emergencies
6. CPR Quick Reference Chart
7. Trauma Management
8. Medical Emergencies
9. Obstetric and Pediatric Emergencies
10. Environmental Emergencies
11. Documentation and Communication
12. Legal and Ethical Considerations
13. EMS Operations
14. Pharmacology
15. Common EMT Medications: Dosages & Routes PT.1
16. Common EMT Medications: Dosages & Routes PT.2
17. Special Patient Populations
18. Infectious Diseases Control
19. Conclusion

Patient Assessment

Scene Safety: Assess the Environment

• Importance: First priority upon arrival, ensuring safety before patient care.
• Common Hazards:
  • Traffic Hazards: Risks from moving vehicles during roadside incidents.
  • Hazardous Materials: Potential toxic exposures from chemicals or fuel spills.
  • Structural Instability: Risk of collapse—avoiding entry or asking for specialist stabilization.
• Goal: Minimize injury risk to self, team, and patient.

Primary Survey (ABCs)

• Focus: Quick identification and management of life-threatening conditions.
  1. Airway: Check for openness; clear if obstructed.
  2. Breathing: Ensure effective respiration; identify irregularities.
  3. Circulation: Assess pulse; if absent, initiate CPR.
• Purpose: Guides immediate intervention and subsequent treatment steps.

Secondary Survey (SAMPLE)

• Acronym: Structure for thorough history-taking.
  • Signs & Symptoms: Evaluate patient complaints and observable signs.
  • Allergies: Inquire about known allergies (medications, foods).
  • Medications: Document current medications affecting treatment.
  • Past Medical History: Identify chronic conditions.
  • Last Meal: Ask about the recent meal for surgical or sedative considerations.
  • Events Leading to Injury/Illness: Gather context about the incident.

Vital Signs

• Definition: Indicators of physiological status guiding interventions.
• Core Vital Signs:
  • Heart Rate (HR): Normal values indicate general health; abnormalities suggest issues (e.g., shock).
  • Respiratory Rate (RR): Abnormal patterns indicate respiratory distress or other conditions.
  • Blood Pressure (BP): Monitor for variations that may indicate serious health issues.
  • Temperature: Changes can indicate infections or other medical concerns.

OPQRST Pain Assessment

• Purpose: Structured approach to assess patient pain.
  1. Onset: When pain started.
  2. Provocation/Palliation: Factors affecting pain severity.
  3. Quality: Patient description of pain nature (sharp, dull).
  4. Radiation: Determine if pain spreads.
  5. Severity: Pain intensity on a scale of 1 to 10.
  6. Time: Duration of pain.

Vital Signs - Normal Ranges

Airway Management

• Importance: Ensures oxygen delivery, especially in respiratory distress.

Techniques

1. Head Tilt-Chin Lift Maneuver:

   • Use: For patients without spinal injuries.
   • Effect: Opens airway by tilting head back and lifting chin.

2. Jaw Thrust Maneuver:

   • Use: For suspected cervical spine injuries.
   • Effect: Preserves spinal integrity while opening airway.

3. Oropharyngeal Airway (OPA) Insertion:

   • Patient Condition: Unconscious with no gag reflex.
   • Effect: Prevents tongue obstruction; inserted with rotation.

4. Nasopharyngeal Airway (NPA) Insertion:

   • Patient Condition: Conscious or semi-conscious.
   • Effect: Flexible tube that bypasses the tongue; suitable for oral trauma.

5. Bag-Valve-Mask (BVM) Ventilation:

   • Use: For inadequate or absent respirations.
   • Effect: Provides positive pressure ventilation; requires mask seal.

6. Endotracheal Intubation:

   • Use: For prolonged airway support.
   • Effect: Tube insert into trachea; advanced skill generally by ALS providers.

Breathing Interventions

• Goal: Support and improve patient oxygenation/breathing capacity.

Assessment of Breath Sounds

• Procedure: Auscultation with a stethoscope to identify respiratory issues.
• Types of Breath Sounds:
  • Normal: Clear and even.
  • Wheezing: Suggests asthma/obstruction.
  • Crackles: Indicate fluid presence (pneumonia/pulmonary edema).
  • Absent: Potential severe obstruction or lung collapse.

Oxygen Administration

• Oxygen Devices:
  • Nasal Cannula: Delivers 24-44% oxygen; mild distress.
  • Non-Rebreather Mask: Delivers up to 90% oxygen; moderate distress.
  • BVM: For non-breathing patients.

Chest Seal Application

• Use: To prevent air entry in open chest wounds; allows exiting airflow.

Needle Decompression

• Purpose: For suspected tension pneumothorax; relieves pressure on lungs.

Circulation Management

• Focus: Essential for nutrient delivery and shock recognition.

Circulation Assessment

1. Peripheral Pulses: Check radial, brachial, and femoral pulses.
2. Bleeding Control:
   • External: Apply direct pressure; tourniquet for severe cases.
   • Internal: Monitor for shock; initiate fluid resuscitation.
3. Intravenous (IV) Access: Enables fluid, medication, and blood administration.
4. Fluid Resuscitation: Critical for hypovolemic shock; use normal saline or lactated Ringer’s to restore volume.

Cardiac Emergencies

Cardiopulmonary Resuscitation (CPR)

• Purpose: Maintains oxygenation during cardiac arrest.
• Components:
  • Chest Compressions: At least 2 inches deep, 100-120/min.
  • Rescue Breaths: 30 compressions to 2 breaths ratio.

Automated External Defibrillator (AED)

• Use: To restore normal rhythm during cardiac events.
• Function: Analyzes rhythm and prompts for shock if indicated.

Recognition of Cardiac Arrest

• Signs:
  • Unresponsiveness, no pulse, absence of breathing.
• Actions: Start CPR, seek advanced help, use AED.
• Time Importance: Survival decreases ~10% per minute without defibrillation.

Chest Pain Assessment (Acute Coronary Syndrome - ACS)

• Signs: Pressure, tightness, radiating pain, sweating, nausea.
• Treatment: Aspirin, nitroglycerin, rapid transport.

CPR Quick Reference Chart

Trauma Management

• Key Steps: Scene safety, primary survey, control bleeding, stabilize spine.

Mechanism of Injury Assessment (MOI)

• Definition: Understanding how injuries occurred to anticipate potential health issues.
  • High-impact collisions, falls, penetrating trauma.

Spinal Motion Restriction (SMR)

• Purpose: Prevent spinal cord damage in suspected spinal injuries.
  • Use cervical collars and spinal boards to immobilize.

Management of Head Injuries

• Assessment: Use Glasgow Coma Scale (GCS); look for signs of increased intracranial pressure (ICP).

Management of Fractures and Dislocations

• Steps:
  • Splinting: Immobilization to reduce pain.
  • Realignment: Gentle adjustments if necessary (to restore function).
  • Pain Management: Provide analgesics as needed.

Medical Emergencies

Stroke Assessment (FAST)

• Acronym:
  • Face: Face drooping?
  • Arms: One arm weaker?
  • Speech: Slurred speech?
  • Time: Call for help if any signs present.

Seizure Management

• Actions: Protect from injury, monitor airway post-seizure.

Diabetic Emergencies

• Hypoglycemia: Administer glucose if conscious; IV glucose if unconscious.
• Hyperglycemia: Transport for high blood sugar management.

Allergic Reactions (Anaphylaxis)

• Symptoms: Swelling, breathing difficulties, rash.
• Interventions: Administer epinephrine, provide oxygen, transport quickly.

Obstetric and Pediatric Emergencies

Labor and Delivery Management

• Role: Monitor status, prepare for delivery as needed.

Neonatal Resuscitation

• Components: Airway management, temperature control, positive pressure ventilation.

Pediatric Patient Assessment

• Considerations: High heart rate, unique assessment techniques, age-appropriate pain assessments.

Environmental Emergencies

Heat-Related Illnesses

1. Heat Exhaustion: Symptoms include weakness, dizziness, nausea. Treatment involves hydration and cooling.
2. Heat Stroke: Body temperature > 104°F (40°C). Symptoms include altered mental state; requires rapid cooling.

Cold-Related Emergencies

1. Hypothermia: Body temperature < 95°F (35°C). Symptoms include confusion, slow breathing; warm gradually, avoid direct heat.
2. Frostbite: Symptoms include numbness; rewarm gently, transport for care.
3. Carbon Monoxide Poisoning: Remove from source, administer 100% oxygen, monitor closely.

Documentation and Communication

Patient Care Report (PCR)

• Purpose: Detailed records for continuity of care, legal protection.
  • Components: Patient info, assessment findings, interventions, transport details.

Handoff Communication

• Elements:
  • Situation: Current patient assessment.
  • Background: Relevant history.
  • Assessment: Key findings.
  • Recommendation: Next steps in care.

HIPAA Compliance

• Practices: Ensure patient confidentiality during documentation and communication; secure transmission of information.

Legal and Ethical Considerations

Duty to Act

• Definition: Obligation to provide care regardless of on-duty status; breach can lead to legal consequences.

Good Samaritan Laws

• Protection: Encourages aid provision without fear of legal repercussions.

Informed Consent

• Process: Explain treatment and acquire patient agreement; document refusals clearly.

Advanced Directives

• Types: DNRs and living wills provide care guidelines for incapacitated patients.

Ethical Responsibilities

• Principles: Respect, compassion, confidentiality, and informed decisions guide patient care.

EMS Operations

Incident Command System (ICS)

• Structure: Hierarchical organization for efficient emergency management.

Radio Communication

• Strategies: Use standardized terminology; focus on key patient details.

Vehicle Operations Safety

• Practices: Adhere to traffic laws; ensure vehicle maintenance for response readiness.

Pharmacology

Medication Administration Routes

• Common Routes: Oral, IV, IM, sublingual, inhalation.

Commonly Administered Medications

1. Oxygen (O₂): For hypoxia; dose varies with device.
2. Albuterol: Asthma treatment.
3. Epinephrine: For anaphylaxis.
4. Aspirin: Cardiac-related chest pain.
5. Nitroglycerin: For angina pain management.

Common EMT Medications: Dosages & Routes

Part 1

• Oxygen: 1-15 L/min
• Albuterol: 2.5 mg via nebulizer
• Epinephrine: 0.3 mg for adults, 0.15 mg for pediatrics.

Part 2

• Aspirin: 324 mg oral
• Nitroglycerin: 0.3-0.6 mg sublingual
• Oral Glucose: 15-25 grams buccal.

Special Patient Populations

Unique Care Considerations

• Geriatric Patients: Adapt assessment for chronic conditions, frailty.
• Patients with Disabilities: Communicate effectively and compassionately.
• Behavioral Emergencies: Use de-escalation techniques, ensure safety during transport.

Infectious Diseases Control

Standard Precautions

1. Hand Hygiene: Crucial for infection prevention.
2. PPE Use: Essential when interacting with patients.
3. Environmental Cleaning: Disinfect regularly.

Isolation Precautions

• Must use appropriate precautions based on disease type (airborne, droplet, contact).

Conclusion

• Encouragement: Persist through EMT training, knowing it directly impacts lives.
• Study Strategy: Combine knowledge with hands-on experience; use varied study methods for retention.
• Outlook: Your journey is just beginning; continue learning to provide compassionate care.