EMT-105 Comprehensive Study Guide Flashcards

EMT-105 Comprehensive Study Guide Notes

Chapter 9: Airway Management

  • Upper Airway: Nose, mouth, pharynx, epiglottis.

  • Lower Airway: Larynx, trachea, bronchi, alveoli.

  • Pediatric Airway Considerations:

    • Larger tongue.

    • Smaller airway.

    • Neutral sniffing position often preferred for airway opening.

  • Airway Obstruction:

    • Causes: Tongue, swelling, vomit, blood.

    • Signs: Gurgling, snoring, stridor, wheezing.

  • Opening the Airway Techniques:

    • Head-tilt chin-lift: Used when no trauma is suspected.

    • Jaw-thrust: Used when trauma is suspected to protect the cervical spine.

  • Airway Adjuncts:

    • OPA (Oropharyngeal Airway): Used for unresponsive patients with no gag reflex.

    • NPA (Nasopharyngeal Airway): Used for patients with an intact gag reflex.

Chapter 10: Respiration & Ventilation

  • Key Distinctions:

    • Ventilation: The mechanical process of moving air in and out of the lungs.

    • Respiration: The physiological process of gas exchange (oxygen and carbon dioxide) at the alveolar and cellular levels.

    • Oxygenation: The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

  • Signs of Inadequate Breathing:

    • Cyanosis (bluish discoloration of the skin).

    • Altered Mental Status (AMS).

    • Accessory muscle use for breathing.

  • Artificial Ventilation (Bag-Valve Mask - BVM):

    • Flow rate: 15 LPM.

    • Ventilation rate for adults: 10-12 breaths per minute.

    • Ventilation rate for children: 12-20 breaths per minute.

  • Oxygen Delivery Devices:

    • Nasal Cannula:

      • Flow rate: 1-6 LPM.

      • Oxygen concentration: 24-44\%

    • Non-rebreather Mask (NRB):

      • Flow rate: 10-15 LPM.

      • Oxygen concentration: Approximately 90\%

    • Bag-Valve Mask (BVM):

      • Flow rate: 15 LPM.

      • Oxygen concentration: Approximately 100\%

Chapter 11: Scene Size-Up

  • Steps of Scene Size-Up:

    1. Body Substance Isolation (BSI) precautions.

    2. Ensure Scene Safety.

    3. Determine Mechanism of Injury (MOI) or Nature of Illness (NOI).

    4. Determine Patient Count.

    5. Request additional Resources if needed.

    6. Consider Spinal Precautions.

  • Mechanisms of Injury in Motor Vehicle Collisions (MVCs):

    • Up & Over.

    • Down & Under.

    • T-bone (side impact).

    • Rollover.

    • Ejection from vehicle.

  • Significant Fall Heights:

    • Adult: Greater than 20 feet (6 meters).

    • Child: Greater than 10 feet (3 meters) or 2-3\times their height.

Chapter 12: Primary Assessment

  • Primary Goal: Identify and correct immediate life threats.

  • Steps of Primary Assessment:

    1. Formulate a General Impression of the patient.

    2. Assess Mental Status using AVPU (Alert, Verbal, Pain, Unresponsive).

    3. Identify Chief Complaint (CC).

    4. Assess ABCs (Airway, Breathing, Circulation) or CAB (Circulation, Airway, Breathing) if severe bleeding is present.

    5. Determine Transport Priority.

  • Immediate Life Threats:

    • Exsanguination (severe blood loss).

    • Airway compromise.

    • Respiratory failure.

    • Shock.

Chapter 13: Vital Signs

  • Adult Normal Ranges:

    • Pulse: 60-100 beats per minute (bpm).

    • Respiratory Rate (RR): 12-20 breaths per minute.

    • Blood Pressure (BP): 90-140 mmHg systolic.

    • Oxygen Saturation (SpO2): 95-100\%.

  • Skin Assessment: Pink, warm, dry.

  • Pupil Assessment: PEARL (Pupils Equal And Reactive to Light).

  • Pulse Locations:

    • Radial pulse: Assessed in conscious patients.

    • Carotid pulse: Assessed in unconscious patients.

  • Glasgow Coma Scale (GCS): Used for neurological assessment.

Chapter 14: Secondary Assessment

  • Approach to Patient Assessment:

    • Stable Patient: Conduct a Focused Exam, gather SAMPLE history, and obtain OPQRST for pain assessment.

    • Unstable Patient: Perform a Rapid Trauma Exam (head-to-toe assessment), and repeat vitals every 5 minutes.

  • DCAP-BTLS (Trauma Checklist): An acronym used to remember what to look for during a physical assessment:

    • Deformities

    • Contusions

    • Abrasions

    • Punctures

    • Burns

    • Tenderness

    • Lacerations

    • Swelling

Chapter 15: Communication & Documentation

  • Radio Reports: Should include patient's Age, Sex, Chief Complaint, Vitals, and Interventions performed.

  • Patient Care Report (PCR): Serves as a crucial legal record and includes:

    • Objective information: Vitals, physical findings, and treatments administered.

    • Subjective information: Patient's chief complaints and symptoms.

Chapter 16: General Pharmacology

  • Routes of Administration:

    • Oral (by mouth).

    • Sublingual (under the tongue).

    • Intramuscular (IM - into the muscle).

    • Intranasal (IN - into the nose).

    • Inhaled (breathed in).

  • EMT-Administered/Assisted Medications:

    • Aspirin: 324 mg (for chest pain, typically non-enteric coated chewable).

    • Nitroglycerin (Nitro): 0.4 mg Sublingual (SL) (for angina/CHF, EMTs typically assist with patient's prescribed medication).

    • Oral Glucose: 15-25 g (for hypoglycemia).

    • Epinephrine (Epi): 0.3 mg adult auto-injector (for anaphylaxis).

    • Albuterol: 2.5 mg (for asthma, administered via nebulizer).

    • Activated Charcoal: 1 g/kg (for poisoning).

    • Naloxone: 0.4-4 mg Intranasal (IN) (for opioid overdose).

Medical Assessment Protocol

  1. BSI, Scene Safety, NOI: Begin with Body Substance Isolation, ensuring scene safety, and determining the Nature of Illness.

  2. Primary Assessment: Identify and address immediate life threats.

  3. ABC + CC: Assess Airway, Breathing, and Circulation, and identify the Chief Complaint.

  4. SAMPLE History: Gather information using the SAMPLE mnemonic.

  5. OPQRST: For pain assessment, use the OPQRST mnemonic.

  6. Focused or Full Exam: Perform a focused physical exam based on the chief complaint or a full body exam if indicated.

  7. Vitals: Obtain Blood Pressure, Pulse, Respiratory Rate, SpO2, Glucose level, and Temperature.

  8. Transport Decision: Make a decision regarding transport to a medical facility.

  9. Reassessment: Reassess the patient every 5 minutes for unstable patients and every 15 minutes for stable patients.

Trauma Assessment Protocol

  1. BSI, Scene Safety, MOI: Begin with Body Substance Isolation, ensuring scene safety, and determining the Mechanism of Injury.

  2. General Impression: Form a general impression of the patient's condition.

  3. Primary Assessment (XABC): Assess and manage in this order:

    • Xsanguination (Exsanguination - control severe bleeding immediately).

    • Airway.

    • Breathing.

    • Circulation.

  4. Rapid Trauma Exam: Conduct a rapid head-to-toe examination using DCAP-BTLS.

  5. Vitals + SAMPLE: Obtain vital signs and gather a SAMPLE history.

  6. C-spine Precautions: Initiate and maintain cervical spine immobilization precautions as needed.

  7. Transport & Reassessment: Transport the patient and continue reassessment en route.

High-Yield Mnemonics

  • SAMPLE History:

    • Signs/Symptoms

    • Allergies

    • Medications

    • Past medical history

    • Last oral intake

    • Events leading to present illness/injury

  • OPQRST (Pain Assessment):

    • Onset (When did it start?)

    • Provocation/Palliation (What makes it better or worse?)

    • Quality (What does it feel like?)

    • Radiation (Does it move anywhere?)

    • Severity (On a scale of 1-10?)

    • Time (How long has it been happening?)

  • AVPU (Level of Consciousness):

    • Alert

    • Verbal (responsive to verbal stimuli)
      Pain (responsive to painful stimuli)

    • Unresponsive

  • DCAP-BTLS (Trauma Checklist):

    • Deformities

    • Contusions

    • Abrasions
      Punctures
      Burns

    • Tenderness

    • Lacerations

    • Swelling

  • PEARL (Pupil Assessment):

    • Pupils

    • Equal

    • And

    • Reactive to

    • Light