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- Glasgow Coma scale
o Eye opening: spontaneous (4), to speech (3), to pain (2), none(1).
o Verbal response: orientated conversation(5), confused conversation(4), inappropriate words (3), incomprehensible sounds (2), none(1)
o Moto Response: obeys commands (6), localizes pain (5), withdraws from pain (4), abnormal flexion (3), abnormal flexion (2), None
- What is the altered mental status acroynym?
o AEIOU TIPS: Alcohol, Epiliepsy, insulin, opiates/ other drugs, Uremia (kidney failure), Trauma, Infection, Poisoning/psychogenic causes, Shock/stroke/seizures/syncope/subarachnoid hemorrhage
- What are the meds that are on standing order to give?
O2, oral glucose
- How much of an inhaler can you administer?
o To the max dose if a max is given, if "as needed" then one extra dose
- How much Nitro can be administered
o Up to 3 doses total with med control signing off each dose, as long as systemic BP is above 100. ( 1 dose is .4mg)
- How much aspirin can be administered? What are the contraindications
o 324mg then immediate transport. No NSTEADS/ Blood thinners
- When to administer Epi? Age, Route, dose?
o Under 11 or below 55lbs give .15 mg epi... for adult it's the opposite for .30 epi
- When to give oral glucose?
o History of diabetes and hypoglycemic/ any reading below 70 mg/dl
- What does insulin do within the body?
o Opens the cells wall to allow glucose to enter
- When to give charcoal? Contraindications? Dosages?
o Ingested poison. Doesn't work for acids, alkalis, or petroleum products. Dosage: A= 25-50 g, C= 12.5-25 or 1 g per kilogram
- What are the 5 rights for medications
o Right: dose, patient, route, expiration, medication
- What is a agonist
o Medication that causes receptor to stimulate
- What is an antagonist
o Blocks medication receptor
- What is an "action" pertaining to mediation?
o The intended effect of the medication
- What is an unintended side effect?
o A side effect which causes little or no harm
- What is an untoward side effect?
o Harmful side effect
- When delivering a medication, what routes are PO and PR
o Per oral, Per rectum
- What is a eternal medication
o Medication the enters the body through digestive track
- What is a parental med?
o Meds enter body through outside digestion ( like sub muscular)
- What is the subcutaneous administration of medication
o Needle
- What is the Transcutaneous administration of medication?
skin
- Define adsorption
to bind
- What is the trade name of a medication?
brand name of med
- How much O2 to give a patient
o Raise the patients blood ox to 94% and attempt to stay there, not raise beyond that
- When to administer Albuterol?
o Breath sounds pertaining to wheezes, no rhales or crackles
- What is respiratory syncytial virus?
o Normally called RSV, is highly contagious respiratory infection in children, is a gateway into other infections such as bronchiolitis
- What is pulmonary edema?
o Blood in the lungs
- What is pleural effusion?
o Collection of fluid in pleural space of lungs.
- What is automaticity?
o Cardiac muscle that can contract spontaneously without stimulation from nerves
- What are the Right and left subclavin?
o Arteries that supply blood to the upper extremities
- What is the function of the superior vena cava?
o Provide blood from the head and arms back to the atrium
- What is the function of the Inferior Vena Cava?
o Bring blood from the abdomen, kidneys, and legs up to the superior vena cava
- What is Ischemia?
chest pain from decreased blood flow
- What is Atherosclerosis?
o Calcium/ fatty materials ( cholesterol) block pathway
what is occulsion
blockage
- What is a Thromboembolism?
o Blood clot floating through blood vessel.
- What is an Acute Myocardial infarction? Signs and symptoms? Treatment?
o Blockage in the coronary artery, sudden onset, fainting, irregular pulse, over 30 minutes of pain, shunting symptoms found. Can be given Aspirin (324mg is platelet aggregator) or nitro if prescribed (.4 mg is vasodilator)
- What is ventricle fibrillation
o Heart is using energy but not pumping
- What systolic BP is it considered hypovolemic?
under 90 systolic
- In the EKG what is the P, QRS, and T wave designating
o P= atria contracting, QRS= ventricles, T heart filling with blood
- Signs and symptoms of Aortic Dissection?
o Unequal BP found from one arm to another
- What is the amount of shocks to be delivered on scene and en route
o 3 on scene then 3 in route
- what is needed prior to shocking an infant?
o Intinuator
- What are the 5 links in survival ?
o Early recognition/ activation of Emergency response
o High quality CPR
o Rapid defib
o Basic/advance emergency medical service
o ALS support
- How is the brain separated and what is their functions?
o Brain Stem: controls all basic human functions
o Cerebellum: controls muscles and body coordination
o Cerebrum: controls the opposite side of the body's motor functions
- What is the brain most sensitive to?
o O2, Glucose, Temperature
- What are the headache red flags?
o Sudden onset, explosive pain, altered mental status, over 50 years old, high fever
- What is the time window to get a patient to the hospital suspected of stroke?
o 3 hours of TLKW
- for a right sided stroke, what are the Signs and Symptoms?
o Person will sound as if they are drunk
- For a left sided stroke, what are the signs and symptoms?
o Patient will understand but use wrong words in responding
- A stroke is considered what
o A brain attack, also referred to an cerebrovascular accident (CVA)
- What is a thrombus
o Where a blood clot occurs
- Signs and symptoms of Hemorrhagic stroke?
o History of hypervolemia, sudden onset, called a aneurysm in younger person.
- What is the Cincinnati stroke scale?
o FAST: Facial droop, Arm drift, Symmetrical, TLKW
o Any signs of the FST then immediately transport and call in stroke protocol.
- What is Hemiparesis?
o Weakness on one side of the body
- What is dysphasia?
o Speech disorder
- What is dysarthria?
o Slurred speech
- What is aphasia?
o Inability to speak
- What is a generalized seizure?
o Whole body involved
- What are the steps of the seizure?
o Aura
o Tonic: stiffening, biting, no breathing
o Clonic: convulsions
o Postictal: after effects, still out of it
- What is a simple partial seizure
o No change in the LOC (level of consciousness)
- What is a complex partial seizure
o Starts small and progresses throughout the brain
- What is tonic clonic?
o Bilateral rigidity of muscle, 1-3 min active, with 5-20 post.
- What is status epilepticus?
o Over 5 min seizure, 2 or more convulsive seizures without regaining consciousness, can transport patient using flexible reaves
- What is febrile seizure?
o Leading seizure in infants, they cant regulate their temp until 18 months
- What is type 1 diabetes
o Body cells fight insulin person needs insulin
- What is type 2 diabetes?
o Body cant use insulin properly
- What are the ranges of blood sugar?
o 80-120 normal, 60-80 is low, below 60 is severe, above 120 is high severe
- What is diabetic Ketoacidosis?
o 400-600 blood glucose level, shits bad then
- define acute
sudden
- for patient given oral glucose, when should you reevaluate
o After 10 min
- Define: Polyuria, Polydipsia, Polyphagia
o Increased Urine, thirst, Hunger
- What is Kussmul Breathing?
o High BP and patient is doing long breaths out and short in
- What is Urticarial? What is Pruritus?
o Hives.... Itchiness
- How long to wait before reevaluation after giving epi
5 min
- What protection do EMT's have as a last resort to nerve agents
o Dudou kits or Mark 1 kits
- Signs and symptoms of poisoning by chlorine?
o D: Diarrhea, Urination, Miosis (pupil constriction, Bradycardia, emesis, Lacrimation (excessive watery eyes), Seizers/ salivation, sweating .
- What is hypothermia temp and how long should a pulse be assessed for?
o Below 95F and minimum 30-45 seconds
- How much faster is body heat lost in water compared to dry land?
25% faster
- what type of heat loss is the wind?
convection
- What type of heat loss is from wet clothes
conduction
heat loss methods
conduction, convection, radiation, respiration
- What is necrosis?
o Changing of color of skin due to tissue death
- What is Angioedema?
o Swelling of certain areas pertaining to anaphylaxis
- What are the signs and symptoms of overdose of opiates
o Pinpoint pupils, respiratory arrest, hypotension
- What are the signs and symptoms of an overdose of sympathomimetic
o Hypertension tachycardia, dilated pupils, seizers hyperthermia
o Epi, albuterol coke, meth
- What are S+S of sedative hypnotics
o Slurred speech, hypoventilation, hypotension
o Diazepam, (relaxers) technically alcohol
hat is the most common route of contamination of poisoning?
o Ingestion
- S+S of 93-95F body tmep
shivering
- S+s of 89-92 body tempt
loss of coordination and muscle stiffness
- What are the S+S of High altitude pulmonary edma?
o Above 8000 feet sickness, can have pink sputum, cyanosis
- What are the S+S of High altitude cerebral edema (HACE)
o Sickness above 5000 ft
- What is the treatment procedure of multiple lightning casualties
o Reverse triage. AED to bring back each patient
- What temp range to rewarm limbs effected by frostbite?
o 100-112F under med control
- What is the stages of an infant in pregnancy?
o 0-10 weeks is embryo, 10 weeks on is fetus
- Define Hymenoptera
o Sting from bees and shit
- how much amniotic fluid is in the amniotic sac?
o 500-1000 mL
- S+S of Preeclampsia
o After 20th week, severe hypertension, persistent headache, seeing spots/bad vision, edema of hands/ feet
- S+S of Eclampsia
o Seizure as result of hypertension
- Define Ectopic pregnancy?
o Embryo develops outside uterus, S+S is eternal bleeding within first trimester of pregnancy.
- Define Placenta Previa
o Placenta develops over the cervix, heavy bleeding will commence and is life threatening condition of early labor.
- What is Meconium?
o Fetal stool which shows when the water breaks, shows infant in distress
- What is Nuchal Cord?
o Umbilical cord wrapped around newborn neck,
- When is it considered premature
o 38 weeks
- What is the trimester break up
o 1-12, 13-27-28 birth
- what to do for prolapsed cord
o With glove hand, move cord back in until pulse resumes, keep hand in for transport
- What are the rates for neonates? HR, Breaths per min, Skin color,
o 120hr, 50bpm, jaundice is normal, pink normal, cap refill 2 seconds for BP.
- Pertaining to pregnancy what does Para and gravity mean?
o Para is number of birthed children, gravity is number of pregnancies.
APGAR SCORING
Appearance: Newborn is pink (2), Body is pink but hands and feet blue (1), baby blue (0)
Pulse: more than 100 BPM(2), fewer than 100 (2), No pulse (0)
Grimace or irritability: cries and tries to move foot when flicked (2), weak cry in response to stimulus(1). No reaction (0)
Activity or muscle tone: attempts to straighten body (2), weak attempts, resists straightening(1), muscle limp(0)
Respiration: rapid (2), slow(1), none(0)
Blood flow from Superior Vena Cava
from head and arms back to right atrium
blood flow from inferior vena cava
from abdomen, kidneys, legs back to superior vena cava
what is ischema
chest pain from decreased blood flow
what is an thromboembolism
blood clot floating through the blood vessels
what is an AMI? S+S
acute myocardial infarction, blockage in the coronary artery. sudden onset. irregular heart beat, fainting. over 30 min. shunting symptoms occur
what is an infarction
death of tissue
what is ACS
acute coronary syndrome. group of symptoms caused by myocardial ischemia
what is angina pectoris S+S
pain from hart tissue being malnourished with O2. crushing pain, 3-8 min no more than 15 min
Ventricle Fibrillation
heart using energy without actually pumping
Vtach speeds
150bpm
what BP is considered to be cardiogenic shock?
under 90 systolic
what does the P-QRS-T wave each designate?
p is the atria- qrs are the ventricles going off and T is the heart refilling with blood
S+S to administer nitro.. what are the contraindications
chest pain, prescribed nitro, Systolic above 100. No ED medications
S+S of Aortic Disection
Unequal BP in both arms
S+S to indicate to give Aspirin and dosage
chest pain, not on blood thinners or NSteads (anti-inflammatory)
what are the types of car accidents? (5)
head on, lateral, rotational, rear end, t bone
What is coup/ countercoup?
coup is the reaction of blunt force trauma, countercoup is the opposite side of that injury
what crash is most likely to cause whip lash
rear end
what are the 4 type of motorcycle crashes
head on, angular, ejection, controlled
what are the questions to ask fall victim
how high the fall was, surface landed on, part of the body that hit first
what is a cavitation
rapid changes in tissues and fluids in the body from a projectile
what are the blast types?
primary, secondary, tiritere, quaternary
what are the bodies reactions to bomb explosions
tympanic membrane in ear will rupture at 5-7lbs atmospheric pressure change . lungs can deflate causing arterial air embolism
3 concepts of energy
potential, kinetic, work
define ecchymosis
bruising
what are the types of shock?
hypovolumic, cardiogenic, obstructive, neurogenic, septic, anaphylactic, psychogenic
what is hypovolumic shock
low volume, rapid weak pulse found, low BP, altered mental status, cyanosis, shunting, higher breaths, burns can be a cause as a "non hemorragic" hypovolumic shock due to the loss of water in the body.
what is psychogenic shock
mental reaction, can be created by anxiety findings are rapid pulse, normal/low BP
anaphylaxis what is it
allergies; hives (Urticaria)found, burning/ mottling skin,vascular dilation, coma, edema found
what is neurogenic shock
damaged spinal column. bradycardia found, BP low, signs of neck injury
what is septic shock
severe infection; fever over 101. low BP, tacky cardia, recent past surgeries is the thing to pay attention to.
what is obstructive shock
mechanical obstruction. tension pneumothorax, cardiac tamponade, pulmonary embolism. dyspnea found, rapid weak pulse, decreased lung compliance. low BP. JVD. trachea deviation. narrowing pulse pressure.muffled heart sounds
what is cardiogenic shock
inadequate heart function; diseased muscle tissue, chest pain is S+S, irregular pulse, weak pulse, low BP, cyanosis, shunting, anxiety, rhales, pulmonary edema
what are the three things a body needs to maintain?
adequate pump. adequate vaisselles, adequate fluid
what type of shocks will shunting not occur in?
distributive shock due to it being a vasodilatation reaction so anaphylaxis, nuerogenic, septic
what is an oncotic medication
medication the medics give to assist hydrostatic pressure
what is a pericardial tamponade
fluid in the heart space refereed to as the myocardium
what is a tension pneumothorax
air in the lung leaves and collapses, air will deviate the trachea
what is preload pertaining to the heart
amount of blood in the heart (after load is the blood afterwards
what is the difference between a dressing and a bandage
dressing goes directly on wound, bandage goes over dressing
how far above the site of injury does a tourniquet go?
3"
what is epistaxis?
a nose bleed
what are the injuries that consist with internal bleeding
DCAP-BTLS--> DCTS
when to use PASG pants
BP lower than 90. pump from the feet up
what are kidneys critical function
bleeding control and filtration of blood
what is hemoptysis
coughing up blood
what is hematuria
bleeding from an orifice
what is hematemesis
vomiting blood
how much blood is lost in a femur fracture
1500ml
what is malena
bloody stool
what is a linear cut
smooth like a knife
stellate cut? what is it
jagged edge from blunt object
what to do with a amputated portion
dry wrapping, plastic wrap, then ice
what to do with an impaled object
only remove when it compromises airway, breathing, or compromises chest compressions
what to do with a pneumothorax
3 sided occlusive bandage
what bandage to do for evisceration
4 side occlusive
method to use for air bubles present upon initial investigation
use a gloved hand to seal until bandage is available
what are lymphocytes
white blood cells: kill bacteria
how to tell if a burn has effected the airway?
auscultate for wheezes/ stridor
what are the critical burn considered? locations, child %/ Adult, age, type of burn
hands, face, eyes, lungs, chest, full thickness over 10% , partial over 25%(A) (20%C)... electrical/ chemical, under 5, over 55 old
what are the burn types
superficial, partial thickness, full thickness
what is a flash burn
type of burn found in welders with no face shield on eyes and shit
at what percentage do you not put burns into water?
10%
what is a scald burn?
burn from boiling water
what is flash burn
explosion burn
what is excited delirium
extreme agitation, bath salt reaction you see
what is the aqueous humor?
fluid behind the eye
if your given the height of a patient over 6'2" expect the question to be asking about a spontaneous pnuemothorax
thats it bruh, continue on
what is a flail segment
3 or more ribs in a row broken, paradoxical movement. use 5lb of pressure with bulky roll
what is a pulmonary embolism S+S
hard to breath in, blood in lungs by blood clot
what is pulmonary contusion S+S
blunt force, hurts to breath in, feels better to breath out. quiet crackles can be present
what is a hemothorax
blood in the lungs
what is traumatic asphyxia
sudden compression of vessels. squeezes the blood into the face, JVD is present
what is cardiac tamponade
blood in heart pleural space known as pericardium
what position is easiest to locate JVD
45 degree in semi fowler
what is commotio cardis
cardiac arrest caused by blunt force
what is a subdural hematoma
slow onset bleeding, can take hours and kill, bleeding , justin's nightclub story. the fast reaction is called an epidural hematoma
what is cerebral spinal fluid
produced in "third ventricle" acts as a shock absorber, body has 125-150 ml
what makes up the cranium
dura mater, meniges, arachnoid, pia mater
head injuries types
linear: crack in the skull
depressed: caved in
basillar: occipital lobe fainting can occur here
S+S of inter cranial pressure
high systolic low diastolic
what is chain stokes breathing
rapid breaths, period of no breathing, need BVM
what is anterograde amnesia
can't remember events after injury, retrograde is events before
what are motor tracks
path of pain from location to brain nerves
what are the type of spinal injuries
flexing: falling down stairs, compression: diving into a pool, hyperextension: whip lash, distraction: hanging, flexion: spinning, penetration:bullet
what is a transection of vertebrae
severed vertebrae
what is central cord syndrome
arms are effected and unable to move
what is anterior cord syndrome
all distal of site on injury won't work
what is brown-sequard syndrome
one side of the body won't work
what does HIPAA stand for
health insurance portability accountability act
what is a breach of confidentiality
disclosure of information without proper authorization
what is defamation
communication of false info about a person that is damaging to their reputation
what is Libel
false/damaging information about a person in writing
what is proximate causation
somehow has a duty and abuses it
what are the 3 R's for reacting to hazardous incident
retreat, react re-evaluate
what are the body planes
midline, medial, lateral, distal, proximal, midaxillary,
what is found in the RUQ
gallbladder, liver
what is found in the LUQ
spleen, stomach diaphragm
what is found in the RLQ
appendix intestines
what is the purpose of the muscular skeletal system
give shape, protection, and movement
what part of the vertebrae control the diaphragm
c3-c5
what does the thorax contain?
heart, lungs, vena cava's, is protected by t1-t12
what is the respiratory rate for an adult, child and infant
A= 12-20; C= 12-40; I= 30-60
what does Fi02 mean
atmospheric air
what makes up the autonomic nervous systems and their functions
sympathetic -> fight or flight; parasympathetic -> more rational thought through
what is the integumentary system and its function?
skin; protection, temp regulation, sensation. layers of skin are the epidermis, dermis, subcutaneous
what is the pulse rate range for an Adult, child, and infant
A=60-100, C=60-140, 85-205
what is the bp range for an adult, child, infant
A=90-140; 60-90 C= 80-130; 68-76, I= 78-116;64 (for children under 3, do capillary refill to assess BP)
what is the ventilation rate for an Adult, child,infant
A= 1 breath every 5-6 seconds. C+I= 1 breath every 3-5
what are the causes of breathing disruptions
mechanical, disease, obstructions
what is respiratory arrest
no breathing
what is respiratory failure
failing at breathing, need BVM
what does trending standing for
the assessment of vitals over time
if no immediate life threat, how long to assess pulse
30 seconds
trauma levels and objects that can cause them
low velocity= knife, medium velocity= shotgun, high is rifle
follow a drop of blood through the heart (14)
right atrium- right ventricle- pulmonary arteries- lungs to get o2- pulmonary veins- left atrium- left ventricle- aorta- arteries- arterioles- capillary bed- venules- veins, inferior/superior vena cava
vertebre in the spine named
cervical 1-7, thoracic 1-12, lumbar 1-5, secrum 1-5, coccyx 1-4
anatomy of the respiratory system
nose/mouth, orpho/naso pharynx, larynx, teaches, carina, r+l main stream bronchi, bronchioles, alveolus, capillary bed
what are the upper airway sounds
crowing, strider, gurgling
how far insert soft tip catheter into stoma
3-5"
how long to suction for an adult/ child
A=no more than 15, child is no more than 10
how long to suction for
2 minute cycles then ventilate if needed... suction 15 sec on adult and 10 for child in cycles
child development steps
0-2months; sleep 16 hours, sucking reflex
2-6months; can recognize parents, active extremities
6-12 months; babble talk, can sit, crawl, walk, cry if irritated
12-18 months; explores, imitates others, can speak 4-6 words, can't chew before swallowing because lack of molars
18-24 months: speak roughly 100 words, understands cause and effect, have special item like blanket or teddy
3-6 years; can run, fear pain, (preschool)
6-12 years; act like adults, concern about popularity, understands death is an end(school age)
12-18; personal morals, understand right versus wrong, puberty (adolescence )
what does the pediatric assessment triangle overview
use without touching baby, assesses; appearance, work of breathing, circulation to skin
what are the S+S of croup
children 6m-3 years: fever 2 days, seal bark cough of stridor
what is pertussis
whooping cough
what are the S+S of dehydration in infant
sunken eyes, depressed fontanels
what are febrile seizures
found in children 6m-6Years, seizure less than 15 min, fast postictal phase
when is it considered a fever in an infant
past 100.4 F
how long will a seizure need to occur for it to be status epilepticus
over 30 min
what is Ascites
fluid in the lungs
S+S of deep venous thrombosis
swelling in feet and legs, tired limbs upon standing, red brown discoloration
S+S of MI in woman, elderly, and diabetics
silent heart attacks can occur where no chest pain, abdominal pain, dyspnea, bowl loss, vomiting, mottled skin,
what are the S+S of right side heart failure
JVD, liver fills with blood which can be palpated, respiratory distress can occur especially during sleep, feel suffocated
what is presbycusis
age related hearing loss
neuropathy reactions as an result of aging
motor nerves diminish; muscle weakness and cramps, loss of balance, loss of coordination

sensory nerves; tingling, numbness, itchy, burning/freezing feeling

automic nerves; bp+ heart are less effective, bladder and constipation effected,
S+S of pelvic ulcer disease
NSAIDS trigger, gnawing pain, burning pain upper abdomen
S+S of gallbladder issue
upper quadrant, jaundice, radiates to the shoulder
S+S of gastrointestinal bleeding
hematemesis( vomits blood) coffee ground vomit
S+S of diverticulosis
lower left quadrant pain + fever, pouches from the colon distrust normality
S+S of abdominal aortic aneurism
history of hypertension, and antherosclerosis, abdominal pain that radiates to the back, pulsating mass slightly left of naval,
what is a decubitus ulcer
bed sores
what is the GEMS acronym
geriatric patient, environment (how are they living),Medications, social ( are the ambulatory? what do they do daily)
what is orthostatic hypotension
syncope from standing too fast
how long to take for triage of each patient
30 seconds