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lists of steps, such as assessments and interventions, to be taken in different situations. Protocols are developed by the Medical Director of an EMS system
consists of standing orders issued by the medical director that allows EMTs to give certain medications or perform certain procedures without speaking to the medical director or another physician.
consists of orders from the on-duty physician given directly to an EMT-B in the field by radio or telephone.
A policy or protocol issued by a Medical Director that authorizes EMT-Bs and others to perform particular skills in certain situations.
High Efficiency Particulate Air respirator; used for patients with suspected TB; worn by the EMT provider to prevent airborne transmission
infectious inflammation of the liver caused by the hepatitis B virus (HBV) that is transmitted sexually or by exposure to contaminated blood or body fluid
inflammation of the liver caused by the hepatitis C virus, transmitted by exposure to infected blood (rarely contracted sexually)
Infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Most commonly affects the respiratory system and causes inflammation and calcification of the system.
the degree of care that a reasonably prudent person should exercise under the same or similar circumstances
Permission that must be obtained from every conscious, mentally competent adult before emergency treatment may be provided
The consent it is presumed a patient or patient's parent or gaurdian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed.
a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care; may also be called a living will or durable power of attorney for health care
Move used if a scne factor causes a decline in patient's condition, or if the treatment of a patient requires a move.
Non urgent move
No immediate threat to life, are carried out in such a way as to prevent injury and to avoid discomfort and pain.
this cot splits in tow or four sections, so it can be used where larger stretchers cannot fit.
designed to surround and protect the patient, this stretcher is used to move a patient from one level to another to over rough terrain.
made of canvas or rubberized or other flexible material, often with wooden slats sewn into pockets and three carrying handles on each side. can be useful in restricted areas or narrow hallways
1. coronal (vertical cut into front and back halves) 2. transverse (horizontal cut into upper and lower) 3. sagittal (vertical cut into left and right halves)
semi fowler position
the head of the bed is raised 30 degrees; or the head of the bed is raised 30 degrees and the knee portion is raised 15 degrees
quadrants of the abdomen
Describing where an abdominal organ or pain is located is made easier by dividing the abdomen into four imaginary quadrants.
*Right upper quadrant (RUQ)
*Left upper quadrant (LUQ)
*Right lower quadrant (RLQ)
*Left lower quadrant (LLQ)
Vertebrosternal = 'True ribs" -ribs 1-7 attach directly to the sternum through their costal cartilage. Vertebrochondral = "False ribs" =ribs 8-10 costal cartilage articulate indirectly with the sternumb by joing the costal cartilages of ribs above. Vertebral Ribs = "Floating ribs" ribs 11 and 12 no anterior attachment.
(Nose, mouth, pharynx, larynx)FUNCTION:Conducts air to lower airway Protects lower airways *Warms, filters & humidifies air
trachea, bronchi, bronchioles, and aveoli (gasses travel through the structers to and from the blood)
muscular partition that separates the thoracic cavity from the abdominal cavity and aids in respiration by moving up and down
The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries.
Also known as shock (decreased blood flow through an organ, as in hypovolemic shock; if prolonged, it may result in permanent cellular dysfunction and death.)
the "little brain" attached to the rear of the brainstem; its functions include processing sensory input and coordinating movement output and balance
the part of the brain continuous with the spinal cord and comprising the medulla oblongata and pons and midbrain and parts of the hypothalamus
adrenaline; activates a sympathetic nervous system by making the heart beat faster, stopping digestion, enlarging pupils, sending sugar into the bloodstream, preparing a blood clot faster
A neurotransmitter from nerve endings and a hormone from the adrenal gland. It is release in times of stress and is involved in hunger regulation, blood glucose regulation and other body processes.
..., process that releases energy by breaking down glucose and other food molecules in the presence of oxygen
signs of mild hypoxia
Pale cool clammy skin ( early)
Elevation of blood pressure
Disorientation and confusion ( from high carbon dioxide levels)
signs of severe hypoxia
Tachycardia may lead to dysrhythmias and eventually bradycardia
Loss of coordination
Slow reaction time
Altered mental status
..., A breathing sound similarto the cawing of a crow; may indicate that muscles around the larynx are in spasm.
..., -curved plastic device used to establish an airway in a patient by displacing the tongue from the posterior wall of the oropharynx
-used in unconscious patients who do not have a gag reflex
..., a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high
..., fast breathing, an abnormally rapid rate of respiration, usually >20 breaths per minute
..., Pressure on the trachea, prevents air from entering the esophagus/stomach and vomiting
..., flow-restricted, oxygen-powered ventilation device: a device that uses oxygen under pressure to deliver artifical ventilations. Its trigger is placed so that the rescuer can operate it while still using both hands to maintain a seal on the face mask. Has automatic flow restriction to prevent overdelivery of oxygen to the patient.
..., lower-pitched sounds like snoring or rattling, secretions in larger airways (pneumonia, bronchitis, aspiration)
..., tested by pressing the nail tip briefly and watching for color change. A normal finding is the pink tone returns immediately when pressure is released. An abnormal finding is slow (greater than 2 seconds) return of pink tonewith respiratory or cardiovascular diseases that cause hypoxia.
(Formerly known as decorticate posturing). Client flexes one or both arms on the chest and may extend the legs stiffly. Indicates nonfunctioning cortex. Lesions of cerebral hemispheres or internal structures of brain cause this posturing.
A posture in which the pt arches the back and extends the arms straight out parallel to the body. A sign of serious head injury
after immediate life- or limb-threatening injuries/illnesses have been identified, this more thorough evaluation is performed to identify more subtle, yet still important, injuries
Jugular vein distention
the visible bulging of the jugular vein when the Pt is in semi-fowlers position or full fowlers position. this is indicative of inadaquate blood movement through the heart and/or lungs
a pneumothorax with rapid accumulation of air in the pleural space causing severely high intrapleural pressures with resultant tension on the heart and great vessels
filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.
Glasgow coma scale
Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.
Increasing intracranial pressure related to the presence of lg pocket of blood (hematoma)
contains majority of liver, gallbladder, small portion of pancreas, right kidney, small intestines, and colon.
contains parts of the small and large intestines, right ovary, right fallopian tube, appendix, right ureter
less distribution of blood to areas = venous pooling, most common in general anesthesia and spinal cord injuries and septic shock (bacterial infection where toxins in blood). cause: general anesthesia and spinal cord injuries and septic shock
A type of pneumothorax in which air can enter the pleural space but cannot escape via the route of entry. This leads to increased pressure in the pleural space, resulting in lung collapse. The increase in pressure also compresses the heart and vena cavae, which impairs circulation.
filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.
If patient been in cardiac arrest for more than 5 min and no CPR has been done what do you do
Provide 2 min of CPR before ard
Indicates that a patient is breathing but is having trouble doing so. May lead to respiratory arrest.
The reduction of breathing to the point where oxygen intake is not sufficient to support life
chronic obstructive pulmonary disease; chronic bronchitis - bronchiole lining inflamed, excess mucus formed; emphysema - walls of alveoli break down; HYPOXIC DRIVE (not in asthma)
obstructive pulmonary disease characterized by overexpansion of the alveoli with air, with destructive changes in their walls resulting in loss of lung elasticity and gas exchange
obstructive pulmonary disease characterized by excessive production of mucus and chronic inflammatory changes in the bronchi, resulting in a cough with expectoration for at least 3 months of the year for more than 2 consecutive years.
acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction
Acute pulmonary edema
occurs when an excessive amount of fluid collects in the spaces between the alveoli and capillaries, disturbs normal gas exchange
Acute infectious disease characterized by a cough that has a "whoop" sound; also called whooping cough
located in the upper portion of the "R" atrium. Has its own rhythm. Sets the basic pace for the cardiac rate.
located in the lower wall of the right atrium; delays impulses from the SA node to allow the atria to completely empty before the ventricles contract
the most common form of CVD; a disease characterized by plaques along the inner walls of the arteries.
Acute coronary syndrome
sudden symptoms of insufficient blood supply to the heart, sudden symptoms of insufficient blood supply to the heart indicating unstable angina or myocardial infarction
chest pain caused by a temporary loss of oxygenated blood to heart muscle often caused by narrowing of the coronary arteries
congenital or developed weakness in wall of lower lumbar region (aorta), balloons out, anterior abdominal wall pulses, untreatable if ruptures
damage may result in fatal bleeding, dissection is a condition where the inner layer of the wall of the aorta begins to tear; patient may complain of pain in the chest, abdomen or back will exhibit signs of shock
Congestive Heart Failure failure of the heart to pump blood away from the heart causing accumulation of fluid in the tissues and lungs
any deficiency in the nervous system's functioning, typically exhibited as a motor, sensory, or cognitive deficit
a type of ischemic stroke that causes a clot to travel to the brain, mostly from the left side of the heart
sudden, transient disturbances in brain function resulting from abnormal firing of nerve impulses (may or may not be associated with convulsion)
a condition in which there are continuing attacks of epilepsy without intervals of consciousness
generalized tonic-clonic (it is sudden cry, fall, rigidity, followed by muscle jerking; shallow, irregular breathing; possible loss of bladder or bowel control; usually lasts seconds to minutes, followed by some confusion, a period of sleep (postical lethargy), and then return to full consciousness.
Simple partial seizures
begins in one area can move, patient aware and conscious, expreience change in taste/smell cause nausea
Complex partial seizure
impairment of consciousness for a few min or less; usually has rhythmic movements of face or extremities
milder form with loss of consciousness for a few seconds. Common in children. May disappear by late adolescence
convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body.
a sudden, and generally temporary, loss of consciousness and postural tone, due to inadequate flow of oxygenated blood to the brain (fainting)
hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin
this type of diabetes mellitus is an autoimmune situation. The pancreas produces and releases NO insulin, so no glucose transport.
Diabetes mellitus initially begins with INSULIN RESISTANCE, where the cells are not able to use the insulin properly and pancreas loses its ability to produce adequate quantities of insulin.
Pain is less severe and poorly localized because of lack of pain receptors on the organ pain is generalized
a neural structure lying below the thalamus; directs eating, drinking, body temperature; helps govern the endocrine system via the pituitary gland, and is linked to emotion
Body heat lost to surrounding air, which becomes warmer then rises and is then replaced by cool air and then repeat the cycle
5 Stages of hypothermia
Apathy and decreased muscle function
Decreased level of responsiveness
Decreased vital signs
muscle pain or spasm due largely to the loss of salt from the body from sweating, or inadequate intake of salt
Occurs when the body's cooling mechanism have been expended
Skin is normal to cool in temp
Pale or Gregory in color
The failure of the heat-regulating ability of an individual under heat stress.
Skin will be hot and red possibly not sweating
Low velocity injuries
A knife or other impailed object in the body exerts damage to the immediate area of impact and it's underlying structures. The length of the object used is important
Medium and high velocity injuries
Med/High velocity projectiles are from pellets or bullets. The damage caused, depends on the Trajectory and the dissipation of energy. Dissipation of energy is affected by Drag,Profile,Cavitation, & Fragmentation.
Primary phase injuries
Are due to the pressure wave of the blast. Injuries primarly effect the gas-containing organs, such as the lungs, stomach, intestines, inner ears and sinuses. Death may occur from this stage w/o any sign of external injury
Secondary phase injuires
Are due to flying debris propelled by the blast
They are usually lacerations fracture burns
Tertiary phase injuries
Are due to being throw and then landing on the ground similar to being ejected out of a car
When can I apply a splint on scene
To extremity fractures only if the patient is stable and there is no life threat
Good indicator of internal blood loss
Weak pulse the into fast pulse
Also no radial pulse body brings blood to core
Factors that may increase bleeding
Low body temp clotting less effective
Medication anticlotting like aspirin
Removal of bandages
tissue layer beneath the dermis; contains adipose tissue, a connective tissue that includes fat-storing cells and blood vessels
a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn. Also called a first-degree burn.
Partial thickness burn
a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence. (Also called second-degree burn).
Full thickness burn
a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third-degree burn.
Rule of nines
A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burn are, a method of estimating the extent of a burn. For an adult, each of the following surfaces represents 9% of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region. For an infant or child the percentages are modified so that 18% is assigned to the head, 14% to each lower extremity.
the cup-shaped hollow in the hipbone into which the head of the femur fits to form a ball-and-socket joint
Secondary assessment for trauma minor injury
Focused on injury
Then detailed exam in the back of truck
This is an assessment tool used to determine consciousness in clients. The Score of 15 reveals a fully oriented person. 3 is deep coma., Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.
Hollow organ in abdominal
a transparent membrane that lines the abdominal cavity in mammals and covers most of the viscera
a disorder of pregnancy in which the placenta prematurely separates from the wall of the uterus
Examples if distributive shock
Infection that causes the vessels to dilate
Spinal cord injury cause vessels to dilate
Body wide vessel dilation
Example of obstructive shock
Blood can't move forward
Both put pressure on Herat and can't fill appropriately
the pink-tinged secretions that follow the loss of the mucous plug b/c of exposed cervical capillaries. this is a sign that labor will begin within 24-48 hours.
Umbilical cord blood vessels
Unique cause they do opposite
Veins bring oxygen blood
Arteries bring deoxygenated blood
White blood cell
blood cell that functions in defending the body against infections and cancer cells; also called a leukocyte
What should I do with someone had a spontaneous abortio.
Transport because there is lots of blood that may be lost
pregnancy in which the placenta is implanted in the lower part of the uterus (instead of the upper part)
a toxic condition characterized by convulsions and possibly coma during or immediately after pregnancy
abnormal state of pregnancy characterized by hypertension and fluid retention and albuminuria
first stage of labor; the uterine muscle contracts strongly to expel the fetus; the fetus presses on the cervix and causes it to dilate or expand
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