EMT- Finale Test Review
Final Exam Study Guide EB 2024 – 120 questions in two hours
Know which splints are appropriate for clavicles, closed shaft femur fractures, ulna / radius
Clavicles: Sling and Swathe
Closed shaft femur fractures: Hare and Sager traction splints
Ulna Radius: Sam splint
Know how to position and transport abdominal pain patients
Left lateral recumbent with the knees flexed
Know how to call a hospital on the radio and give report
identify yourself and wait for dispatch to respond
Provide Basic Information (Unit and ETA, Patient Age and Gender, Chief complaint or reason for transport)
Detailed Report (MOI/NOI, signs/symptoms, interventions)
Be sure to be concise
repeat
update if needed
Know what patients need to be reported to law enforcement
Children/Elders who are facing abuse & neglect
Domestic Violence
Death
Know the positions and job responsibilities of MCI personnel
Incident Commander-
Establish overall command and control of the scene.
Develop and implement the Incident Action Plan (IAP).
Coordinate with all sectors, including fire, EMS, police, and other responding agencies.
Communicate with emergency operations centers (EOCs) or hospitals.
Triage officer-
Public Information Office- Talk to general public/News
Safety Officer- Can override the IC. On Scene, In charge of general safety
Liaison Officer - Representative that serves as a communication channel between agencies
Transport Officer -
Know when to remove helmets
When it is blocking access to the airway
Know who gets DCAP-BTLS & OPQRST assessments
An unreliable trauma patient
Define unified command
multiple agencies working under the same command: One representative from each agency.
Know: Expressed, informed, implied, and parental consent
Expressed Consent: Verbally informed
Informed Consent: An Emt informs the patients of the risks and benefits of a treatment
Implied Consent:A patient, who is in a critical condition, it is implied that they would want the treatment (AMS or unconscious)
Parental Consent: parent must approve of a treatment for minors
Know how to make corrections to mistakes on a written PCR
Put a line through the wrong statement, And initial it
Know the stages of labor and what occurs in the first, second, and third trimesters
First Trimester (0-13 weeks)
Early development: The fertilized egg implants in the uterus, forming the placenta.
Organ formation: The baby’s heart, brain, spinal cord, and organs start to form.
Early symptoms: Nausea, fatigue, and hormonal changes in the mother.
Possible spontaneous abortions
Second Trimester (14-26 weeks)
Growth and movement: The baby grows rapidly, and the mother may feel the baby move.
Organ maturation: Organs continue to develop, and the baby’s skeleton hardens.
Visible changes: The belly grows, and the mother’s symptoms often improve.
Complications such as placenta previa and abruptio
Third Trimester (27-40 weeks)
Final development: The baby gains weight, organs mature, and it prepares for birth.
Positioning: The baby moves into a head-down position.
Preparation for birth: The mother may feel contractions as the body prepares for labor
Stages of Labor
1. Dilation of cervix
about 16 hrs
2. Expulsion
1-2 min contraction cycles, contraction lasts 30s-1min
Crowning = imminent delivery
3. Placental delivery
Know the complications of applying splints
Extreme Pain, Loss of PMS
A complication of applying tourniquet is not having a pulse
Define child abuse and child neglect
(intentional or unintentional harm) Neglect: the failure of someone to provide necessities for a person under their care
(intentional harm only) Abuse: the physical act of hurting a person
Know that all patients with respiratory distress get oxygen in the primary assessment.
What medicine is in an inhaler, and what are its actions?
Albuterol. Bronchodilator
Know the size of the tank in your first-in bag.
Class D, 2,000 psi
Know what OB emergencies allow you to place your fingers in the patient’s vagina
Prolapsed cord (cord out first) + breech presentation with entrapped head (buttocks/legs)
Know BEFAST
Balance, Eyes, Facial Droop, Arm Drift, Slurred Speech, Last time seen normal
What could cause a patient to vomit blood
GI bleed (add on?)
What is the function of the small intestine?
Absorption/Keep toxins away
Site of digestion via its own hydrolytic enzymes, some from pancreas, and bile. First site of absorption of nutrients.
Why is the brain stem so important? What is its function?
The brain stem consists of the midbrain, pons and medulla oblongata. Midbrain controls some motor control and sensory functions, the pons coordinates eye and face movements/facial sensation/hearing and balance, but most importantly is the medulla oblongata which controls breathing, heartbeat, blood pressure, and swallowing. Any severe damage to the medulla will kill you.
Know what patients get a short backboard / KED
Stable Patient who is sitting and has a suspected spinal injury
Signs, symptoms, and treatment of carbon monoxide poisoning
Signs/symptoms- Weakness, dizziness, altered level of consciousness, nausea/headache
Essentially the carbon monoxide is provided to cells instead of oxygen, which poisons the cells
Treat by moving away from area of suspected carbon monoxide presence followed by high flow oxygen
What infectious disease could cause a person to cough up blood? What PPE would you use?
Tuberculosis, Eye wear, mask, gloves.
Know your terms: lateral, medial, proximal, distal, superior, inferior
Superior and Inferior:
Superior:
Nearer to the head
Inferior:
Nearer to the feet
Terms describe the relationship of one structure to another:
Example: The knee is superior to the foot and inferior to the pelvis
Knee is above the foot and below the pelvis
Lateral and Medial:
Lateral (outer):
Body that lie farther from the midline
Medial (inner):
Body parts that lie closer to the midline
Proximal and Distal: The relationship between any two structures on an extremity (arms and legs)
Proximal: Closer to a joint
Distal: farther from the joint
Posterior and Anterior:
Anterior: front
Posterior: back
Capillary, venous, and arterial bleeding severity and treatments
ARTERIAL- Spurting Bright red Blood, Higher pressure more difficult to control. Oxygen Rich blood
VENOUS- Flow normally or slowly. Oxygen poor Blood. Darker Colored.
CAPILLARY-Usually minor. Dark red. Oozing. Will most of the time clot on its own.
Know how to do a head-tilt chin-lift and jaw thrust
If you don’t know “shame” (YUSEF)
Delirium vs hallucination
Delirium : altered state of mind (Cannot hold a conversation with)
Hallucination: altered sensory perceptions(Can hold a conversation)
Delirium can lead to hallucinations
Who declares an MCI
First on scene/Incident Commander
What is ominous about a decreased level of consciousness in pediatrics?
The child is on the verge of death
What do you do before cutting off the roof of a car for patient access?
Try the car doors
Know eclampsia and how to treat / transport. You do NOT need ALS TRANSPORT
High BP for pregnant patients in 2nd semester
Left lateral recumbent, patent airway, O2
seizures
Know the potential causes for barotrauma due to changes in pressure.
Scuba diving
Define inadequate breathing
Breathing that is insufficient to support bodily functions
Shortness of breath, difficulty breathing, or visible signs of labored breathing like chest movement that is not sufficient
Know how to treat chemical burns
Call hazmat
Define laceration, avulsion, hematoma, contusion
Laceration: a jagged cut
Avulsion: A detachment of the skin (flap)
Hematoma: The pooling of blood outside a blood vessel (swollen bruise essentially)
Contusion: Bruising (ecchymosis present)
What is going on during a D&C (OB)?
Dilation & curettage : expands the cervix to remove the uterine lining (endometrium) of abnormal tissues.
After abortion sometimes
How might a hypertensive patient present and complain about?
Headache, nausea/vomiting, chest pain, nosebleed, blurred vision, dizziness, AMS, numbness/weakness
Know organophosphate poisoning (insecticide) and how it relates to SLUDGEM / DUMBELS
Anticholinergics
Salivation, Lacrimation, Urination, Defecation, Gastrointestinal issues, Emesis, Miosis
DNR for financial reasons is stupid
How would a woman with a UTI present?
Frequent urination, burning sensation during urination
Cloudy or foul-smelling urine, blood in urine
Lower abdominal pain or pressure, back pain
Fever, nausea, vomiting
Know prolapse & nuchal cord emergencies
Nuchal cord (cord over baby’s neck): gently try removing the umbilical cord from the baby’s neck
Prolapse cord (cord delivers first): stick your hand in the vagina, keep the baby breathing
Identify patients with croup
Upper respiratory disease, usually in children
Narrowing → causes a seal like bark
give high flow
Know how to deliver a baby, cut the cord and deliver the placenta
Know how to care for a newborn, know APGAR and how to resuscitate
APGAR: do at 1 minute and 5 minutes after birth
A: Appearance
P: Pulse
G: Grimace
A: Activity
R: Respiration
Tap the baby’s foot for stimulation
Suction the baby and give baby breaths with bvm
REMEMBER 5!!!!!
If you want to know if the patient is bleeding or determine the amount of blood loss, the heart rate tells you that. The faster the heart rate, the more blood loss is/has occurred.
Heat exhaustion vs heat stroke
During heat exhaustion, your body actively compensates for the excessive heat so although your body will be hot, because your sweat elicits evaporative cooling it won't be too extreme. During heat stroke, your body has lost this ability to compensate via sweating, so patient will have even higher body temperatures (symptoms like dry/maybe damp skin, LOC/AMS, weak pulse)
Respiratory distress vs failure vs arrest
Distress: The person is struggling to breathe
Failure: The lungs cannot compensate for the amount of oxygen the body needs
Define peritonitis. What can cause it?
Inflammation of peritoneal cavity
Know how to stop bleeding and what PPE to use for the various types of bleeding
What is the concern with patients that have a sudden improvement from depression?
Planned Suicide that they are happy about
What does a window punch do regarding extrication?
Breaks a car window on the vehicle
Assessments go A, then B, and then C, which are the highest priority. Vitals are the very last thing you do
What training does and EMR receive?
Eviscerations, define and treat
Guts are out
Keep them warm & moist
Supine with knees flexed
Know the stages of shock and what defines the stages
Compensated shock: the body is able to provide blood to the organs that need it.
Decompensated shock: the body cannot provide blood flow anymore to the organs
Irreversible:no point of return
Define partial thickness burn
Burn that goes through the epidermis and part of the dermis, aka second degree
Know how to manage a multi-system trauma patient.
Pocket mask vs one person BVM. Which is better and why?
Define APHASIA and APHAGIA
Aphasia is the loss of the ability to communicate properly, involving both interpretation or expression of language.
Aphagia is the inability to swallow
Know how to clear a partially obstructed airway
Sometimes, 4 LPM nasal is all you need for cardiac patients
Know everything about anaphylaxis and epinephrine auto injector
Visceral vs somatic – define them
Visceral: Inside organs
Somatic: Muscles, skin, and bones
What does and does not go into a PCR
5 →this is the apgar score
What is unified command?
Know how to treat a patient with a terminal disease and how to interact with the family
do not say “i understand”
Never lie
Adsorption & absorption: what is the difference
adsorption is like binding of charcoal to GI tract
Kyphosis, what is it and how do we use longboards if this is present?
Kyphosis is being hunchback, rounding off the back. You place blankets behind the patient's head when placing them on a longboard.
What is an absent seizure and what is it also known as?
Daydreaming. staring off into space.
Petit mal seizure
Normal respiratory rate and tidal volume for an adult is…
12-20 respirations, 500mL tidal volume
Who typically gets a nasal cannula
need oxygen, cannot tolerate high flow mask
can help calm the patient
The target compression fraction during CPR is?
80%