EMT Basic - AAOS - Exam 2 (Combined Chapters 8,9,40)

196 terms by MarquisG

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aerobic metabolism

Metabolism that can proceed only in the presence of oxygen.

agonal respirations

Slow, shallow, irregular respirations or occasional gasping breaths; sometimes seen in dying patients.

airway

The upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat.

alveolar ventilation

The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume.

American Standard System

A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas.

anaerobic metabolism

The metabolism that takes place in the absence of oxygen; the principle product is lactic acid.

apnea

Absence of spontaneous breathing.

aspiration

In the context of airway, the introduction of vomitus or other foreign material into the lungs.

ataxic respirations

Irregular, ineffective respirations that may or may not have an identifiable pattern.

automatic transport ventilator (ATV)

A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated.

bag-mask device

A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.

barrier device

A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids.

bilateral

A body part or condition that appears on both sides of the midline.

bronchioles

Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli.

carina

Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi.

chemoreceptors

Monitor the levels of O2, CO, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time.

compliance

The ability of the alveoli to expand when air is drawn in during inhalation.

continuous positive airway pressure (CPAP)

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.

cricoid pressure

Pressure on the cricoid cartilage; applied to occlude the esophagus to inhibit gastric distention and regurgitation of vomitus in the unconscious patient.

dead space

The portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange.

diffusion

A process in which molecules move from an area of higher concentration to an area of lower concentration.

dyspnea

Shortness of breath or difficulty breathing.

exhalation

The passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs.

external respiration

The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration.

gag reflex

A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.

gastric distention

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.

glottis

The space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening.

good air exchange

A term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.

head tilt-chin lift maneuver

A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.

hypercarbia

Increased carbon dioxide level in the bloodstream.

hypoxia

A dangerous condition in which the body tissues and cells do not have enough oxygen.

hypoxic drive

A "backup system" to control respiration; senses drops in the oxygen level in the blood.

inhalation

Breathing into the lungs; a medication delivery route.

internal respiration

The exchange of gases between the blood cells and the tissues.

intrapulmonary shunting

Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.

jaw-thrust maneuver

Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.

labored breathing

Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles.

larynx

A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box.

manually triggered ventilation device

A fixed flow/rate ventilation device that delivers a breath every time its button is pushed; also referred to as a flow-restricted, oxygen-powered ventilation device.

mediastinum

Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs.

metabolism (cellular respiration)

The biochemical processes that result in production of energy from nutrients within the cells.

mild airway obstruction

Occurs when a foreign body partially obstructs the patient's airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress.

minute ventilation

The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate; also referred to as minute volume.

nasal cannula

An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate.

nasopharyngeal (nasal) airway

Airway adjunct inserted into the nostril of an unresponsive patient, or a patient with an altered level of consciousness who is unable to maintain airway patency independently.

nasopharynx

The nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants.

nonrebreathing mask

A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide).

oropharyngeal (oral) airway

Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary.

oropharynx

Forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue.

oxygenation

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.

parietal pleura

Thin membrane that lines the chest cavity.

partial pressure

The term used to describe the amount of gas in air or dissolved in fluid, such as blood.

patent

Open, clear of obstruction.

phrenic nerve

Nerve that innervates the diaphragm; necessary for adequate breathing to occur.

pin-indexing system

A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.

pneumothorax

A partial or complete accumulation of air in the pleural space.

poor air exchange

A term used to describe the degree of distress in a patient with a mild airway obstruction. With poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor).

positive end-expiratory pressure (PEEP)

Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs.

pulse oximetry

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.

recovery position

A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.

residual volume

The air that remains in the lungs after maximal expiration.

respiration

The process of exchanging oxygen and carbon dioxide.

retractions

Movements in which the skin pulls in around the ribs during inspiration.

Sellick maneuver

A technique that is used with intubation in which pressure is applied on either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure.

severe airway obstruction

Occurs when a foreign body completely obstructs the patient's airway. Patients cannot breathe, talk, or cough.

stoma

An opening through the skin and into an organ or other structure; a stoma in the neck connects the trachea directly to the skin.

stridor

A high-pitched noise heard primarily on inspiration.

suction catheter

A hollow, cylindrical device used to remove fluid from the patient's airway.

surfactant

A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome.

tension pneumothorax

A life-threatening collection of air within the pleural space; the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side.

tidal volume

The amount of air (in milliliters) that is moved in or out of the lungs during one breath.

tonsil tips

Large, semirigid suction tips recommended for suctioning the pharynx; also called Yankauer tips.

tracheostomy

Surgical opening into the trachea.

ventilation

Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT.

visceral pleura

Thin membrane that covers the lungs.

vital capacity

The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible.

vocal cords

Thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production.

wheezing

The production of whistling sounds during expiration such as occurs in asthma and bronchiolitis.

12-lead ECG

An ECG that uses 12 leads attached to the patient's skin; these include the limb leads and chest leads

4-lead ECG

An ECG that uses 4 leads attached to the patient's skin; these include the limb leads

access port

A sealed hub on an administration set designed for sterile access to the intravenous fluid

arrhythmia

An irregular or abnormal heart rhythm

asystole

The complete absence of any electrical cardiac activity, appearing as a straight or almost straight line on an ECG strip

cardiac monitoring

The act of viewing the electrical activity of the heart through the use of an ECG machine or cardiac monitor

catheter

A flexible, hollow structure that drains or delivers fluids

catheter shear

The cutting of the catheter by the needle during improper rethreading of the catheter with the needle; the severed piece can then enter the circulatory system

chest leads

The leads that are used only with a 12-lead ECG and must be placed exactly; includes leads V1, V2, V3, V4, V5, and V6

Combitube

A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative airway device if endotracheal intubation is not possible or has failed

drip chamber

The area of the administration set where fluid accumulates so that the tubing remains filled with fluid

drip sets

Another name for administration sets

Electrocardiogram (ECG)

an electronic tracing of the heart's electrical activity through leads, which originate in the electrocardiograph machine and contain electrodes that attach to the patient's chest and/or limbs

electrical conduction system

A network of special cells in the heart through which an electrical current flows, causing contractions of the heart that produce pumping of blood

end-tidal carbon dioxide detectors

Plastic, disposable indicators that signal by color change when an endotracheal tube is in the proper place

endotracheal intubation

Insertion of an endotracheal tube directly through the larynx between the vocal cords and into the trachea to maintain and protect an airway

external jugular IV

IV access established in the external jugular vein of the neck

extubation

Removal of a tube after it has been placed

gastric tube

An advanced airway adjunct that provides a channel directly into a patient's stomach, allowing for removal of gas, blood, and toxins and for instilling medications and nutrition

gauge

A measure of the interior diameter of the catheter, It is inversely proportional to the true diameter of the catheter

infiltration

The escape of fluid into the surrounding tissue when the IV catheter is not in the vein

intraosseous (IO) needles

Rigid, boring catheters placed into a bone to provide intravenous fluids

isotonic crystalloids

Intravenous solutions that do not cause a fluid shift into or out of the cell; examples include normal saline and lactated Ringer's solutions

King LT

A disposal supraglottic airway used as an alternative to tracheal or mask ventilation

laryngeal mask airway

An advanced airway device that is blindly inserted into the mouth to isolate the larynx for direct ventilation; consists of a tube and a mask or cuff that inflates to seal around the laryngeal opening

laryngoscope

An instrument used to give a direct view of the patient's vocal cords during endotracheal intubation

limb leads

The four leads used with a 4-lead ECG; placed on or close to the right arm, left arm, right leg, and left leg

macrodrip set

An administration set named for the large orifice between the piercing spike and the drip chamber; allows for rapid fluid flow into the vascular system

microdrip set

An administration set named for the small orifice between the piercing spike and the drip chamber; allows for carefully controlled fluid flow and is ideally suited for medication administration

multilumen airways

Advanced airway devices, such as the esophageal tracheal Combitube and the pharyngeotracheal lumen airway, that have multiple tubes to aid in ventilation and will work whether placed in the trachea or esophagus

normal sinus rhythm

A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate of between 60 and 100 beats/min

occlusion

A blockage, usually of a tubular structure such as a blood vessel

orotracheal intubation

Endotracheal intubation through the mouth

pharyngeotracheal lumen airway

A multilumen airway that consists of two tubes, two masks, and a bite block

phlebitis

Inflammation of a vein; often associated with a clot in the vein

piercing spike

The hard, sharpened plastic spike on the end of the administration set designed to pierce the sterile membrane of the intravenous bag

proximal tibia

Anatomic location for intraosseous catheter insertion; the wide portion of the tibia located directly below the knee

saline locks (buff caps)

Special types of intravenous apparatus, also called heparin caps and heparin locks

Sellick maneuver

A technique that is used with intubation in which pressure is applied on either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure

sinus bradycardia

A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate that is less than 60 beats/min

sinus rhythm

A rhythm in which the sinoatrial node acts as the pacemaker

sinus tachycardia

A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate that is more than 100 beats/min

STEMI (ST-segment elevation myocardial infarction)

Elevation of the ST segment of the 12-lead ECG that is likely evidence that the patient is having a heart attack

stylet

A plastic-coated wire that gives added rigidity and shape to the endotracheal tube

systemic complication

A moderate to severe complication affecting the systems of the body; after administration of medications, the reaction might be systemic

ventricular fibrillation

Disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest

ventricular tachycardia

A rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest

accessory muscles

The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.

auscultate

To listen to sounds within an organ with a stethoscope.

AVPU scale

A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.

blood pressure

The pressure of circulating blood against the walls of the arteries.

bradycardia

A slow heart rate, less than 60 beats/min.

breath sounds

An indication of air movement in the lungs, usually assessed with a stethoscope.

capillary refill

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.

capnography

A noninvasive method that can quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism.

capnometry

The use of a capnometer, a device that measures the amount of expired carbon dixoide.

carbon dioxide

A component of air that typically makes up 0.3% of air at sea level; also a waste product exhaled during expiration by the respiratory system.

chief complaint

The reason a patient called for help; also, the patient's response to questions such as "What's wrong?" or "What happened?"

coagulate

To form a clot to plug an opening in an injured blood vessel and stop bleeding.

colorimetric devices

Capnometer or end-tidal carbon dioxide detectors are devices that use a chemical reaction to detect the amount of carbon dioxide present in expired gases by changing colors (qualitative measurement rather than quantitative).

conjunctiva

The delicate membrane that lines the eyelids and covers the exposed surface of the eye.

crepitus

A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.

cyanosis

A bluish gray skin color that is caused by a reduced level of oxygen in the blood.

DCAP-BTLS

A mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, and Swelling.

diaphoretic

Characterized by profuse sweating.

diastolic pressure

The pressure that remains in the arteries during the relaxing phase of the heart's cycle (diastole) when the left ventricle is at rest.

end-tidal CO2

The amount of carbon dioxide present in exhaled breath.

focused assessment

A type of physical assessment that is typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part

frostbite

Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts are frostbitten

full-body scan

A systematic head-to-toe examination that is performed during the secondary assessment on a patient who has sustained a significant mechanism of injury, is unconscious, or is in critical condition (Pg 291 - 295)

general impression

The overall initial impression that determines the priority for patient care; based on the patient's surroundings, the mechanism of injury, signs and symptoms, and the chief complaint

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