EMT CRASH COURSE

CH.2
1. Which of the following is widely considered to mark the beginning of the modern EMS system?
A. A paper titled Accidental Death and Disability: The Neglected Disease of Modern Society.
B. The current National EMS Education Standards.
C. The creation of the American Heart Association.
D. A paper called the EMS Agenda for the Future.
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CH.2
1. Which of the following is widely considered to mark the beginning of the modern EMS system?
A. A paper titled Accidental Death and Disability: The Neglected Disease of Modern Society.
B. The current National EMS Education Standards.
C. The creation of the American Heart Association.
D. A paper called the EMS Agenda for the Future.
A.
CH.2
2. EMS care today is based on
A. what has been done in the past.
B. whatever physicians recommend.
C. evidence-based medicine.
D. the original National Standard Curriculum .
C.
Ch.2
3. Which of the following describes the EMT level of training?
A. provides basic, immediate care including bleeding control, CPR, AED, and emergency childbirth.
B. includes oxygen and ventilation skills, pulse oximetry, and administration of certain medications.
C. includes advanced assessment and management skills, various invasive skills, and extensive pharmacology interventions.
D. includes advanced airway devices, intravenous and intraosseous access, and blood glucose monitoring.
B.
CH.2
4. EMT roles and responsibilities include
A. strong written and verbal communication skills.
B. the ability to establish intraosseous access.
C. initial investigation at a crime scene.
D. swift water rescue operations.
A.
Ch.2
5. Which of the following EMT activities is considered high risk for the patient?
A. assessment of vital signs
B. obtaining a blood glucose test
C. requesting permission to treat
D. transferring patient care
D.
Fowler's position
a semi-sitting position; the head of the bed is raised / declined between 45 and 60 degrees
Semi-Fowler's Position
Seated with back reclines 30-45 degrees
Trendelenburg position
lying on back with body tilted so that the head is lower than the feet
shock position
Lying supine with feet elevated approximately 12 inches
Ipsilateral
on the same side of the body
The airway structure immediately inferior to the larynx is theTracheaThe heart is ___ to the left lungmedialcardiac outputThe volume of blood ejected from the left side of the heart in one minute.Stroke Volume (SV)The amount of blood pumped out of the heart with each contraction (beat)PharynxPassageway for air, assists in voice function; balances air pressures between the ears and throatLarynxvoice box; passageway for air moving from laryngpharynx to trachea; contains vocal cordsValleculadepression between the epiglottis and the base of the tongue.AlveoliStructures shaped like grapes; capillary membrane surrounds each alveolus where the exchange of air and waste products takes place; the only place in the entire airway that air exchange can occur, alveoli collapse is called atelectasisparotid glandsalivary gland within the cheek, just anterior to the earsmall intestine functionAbsorbs most nutrients; Main absorption organ of the digestive tract. Responsible for most digestionpancreas functionsecretes digestive enzymes and hormones that regulate blood glucoselarge intestine functionConcentrates, mixes, and stores waste material; Absorbs water, ions, and vitamins; Produces some B vitamins and vitamin K.PAIN IN RIGHT UPPER QUADRANTCirrhosis, cholecystitis, pancreatitis, kidney stone, GERD gastroesophageal reflux painPAIN IN RIGHT LOWER QUADRANTappendicitis, ovarian cyst, inguinal herniaPAIN IN LEFT UPPER QUADRANTKidney stone, gastric ulcer, pancreatitis, GERDPAIN IN LEFT LOWER QUADRANTOvarian cysts, diverticulitis, cancer, inguinal herniaHeart rate (beats/min.) and Respiratory rate (breaths/min.) age expected vitals:Infant: HR: 100-140 RR: 30-60 1-8yrs: HR: 80-140 RR: 24-40 8-17rs: HR: 60-100 RR: 12-16 Adult: HR: 60-100 RR: 12-20Respiratory distress symptoms-nasal flaring -use of accessory muscles -tripod position -audible sounds like stridor, grunting, wheezing -increased respiratory rate3 types of shock are:Hypovolemic/ hemorrhagic shock: loss of blood or body fluids -Distributive shock: lack of blood flow to tissues or organs; includes septic, anaphylactic, and neurogenic shock - Cardiogenic shock: inadequate blood flow due to dysfunction of the hearts ventricles *HYPOVOLEMIC, SEPTIC, AND ANAPHYLACTIC are the most common forms of shock seen in children2 STAGES OF SHOCK-Compensated shock : patient experiences low blood volume but does not have hypotension. A patient in this state can maintain a BP until about 40% blood loss. - Decompensated Shock: the patient is failing. Hypotension indicates loss of sympathetic flight or flight mechanism and the ability to vasoconstrict and preserve fluids is gone. In children this is a very late sign3 Types of Hypovolemic/hemorrhagic shocks:-Relative Hypovolemia: fluid volumes are lower, but blood / fluids are not necessarily leaving the body. Blood volume may decrease due to vasodilation. Fluid is in the extremities and the brain registers their low return. - Absolute hypovolemia : fluids have left the body, as with a hemorrhage of trauma; vomiting increases the loss of fluids - orthostatic hypoTENSION: when the patient moves suddenly from lying down to sitting, or from sitting to standing l, he/she might experience a fainting sensation known as orthostatic hypotension. Defines as a systolic BP drop of 20mmHg or a diastolic drop of 10mmHG.Signs / symptoms of shock:Increase in HR and respiratory rate Lightheadedness, feeling of faintness Decreases level of consciousness (LOC) Pale or mottled appearance Poor skin turgor Obvious bleeding History of vomiting and/or diarrhea Decreases in BP- late signCapillary refill testQuick way to assess perfusion by squeezing a fingernail and counting the seconds elapsed before blood returns to the nail bed. A refill taking more than 2 seconds indicates poor perfusion. Capillary refill works most accurate children3 types of distributive shockDistribution shock is characterized by a lack of blood flow to tissues or organs. - SEPTIC SHOCK : caused by infections such as cystitis (UTI with painful urination and bleeding -common in children and geriatrics) or pneumonia (lung infection with a heavy cough producing thick yellow-green mucus- common in geriatrics). -occurs in 2 stages: * warm shock : is the first stage. Symptoms include fever , chills, warm to touch, flushed, sweaty, HR up slightly, BP normal to high, and the patients LOC may or may not be altered. Blood vessels are dilated so fluid goes into tissue *cold shock : looks like hypovolemic shock. Symptoms include no fever, cool clammy skin, pale or cyanotic skin, and changing vitals - ANAPHYLACTIC SHOCK: allergic reaction that involves the cardiopulmonary system. like septic shock, the initial stage involves vasodilation and loss of fluids in the tissues. The patient is flushed, warm, May or May not have visible hives, BP normal to high, HR slightly increased, wheezing, and May have sweeping off the face that affects airway. -NEUROGENIC SHOCK: caused by injury to or severing of the spinal cord. As with anaphylaxis and septic shock, the initial phase is warm with flushed skin, vasodilation, BP is normal to LOW, and HR normal to low. Patient cannot experience rapid HR or vasoconstriction. The mechanism of fight or fright response will not occur because the sympathetic nerves traveling down the spinal cord are injured or severed.cardiogenic shockCaused by an inadequate blood flow due to a dysfunction of the ventricles. The pumping failure is usually caused by a heart attack but could also be from trauma. *symptoms may include chest pain, fatigue, and SOB. Patient May have a normal sinus heart rhythm or could have an arrhythmia.Compression to Ventilation ratio for Adults, Children, and InfantsAdult- 30:2 , 1 or 2 rescuers, 2 hands Children (1 yr- puberty): 30:2 for 1 rescuer 1-2hands, 15:2 for 2 rescuers / 1-2 hands Infants- 30:2 single rescuer / 2 fingers on sternum; 15:2 2 rescuers / 2 thumbs encircling the chestRescue breathing for adults, children and infantsInfant: 1 breath every 3-5 seconds. 12-20/min. Children: 1 breath every 3-5 seconds. 12-20/min. Adult : 1 breath every 5-6 seconds. 10-12/ min.Rule of Nines for adult and childrenAdult : Head- 9% (4.5 face, 4.5 back) Trunk- 18% (9 chest, 9 abdomen) Back- 18% (9 back, 9 buttocks) Arms- 9% (4.5 upper and 4.5 lower) Legs- 18% (9 upper, 9 lower) Child: Head- 18% Trunk- 18% Back- 18% Arms- 9% Legs- 14% Genitalia 1% for any agetype 1 diabetes mellitus(Typically birth- 40years).diabetes in which no beta-cell production of insulin occurs and the patient is dependent on insulin for survival. I skiing is needed to transport glucose into the cells. Unused glucose remains in the bloodstream, raising glucose levels (hyperglycemia). Patients must take insulin injections in order to move their blood glucose into the cells.type 2 diabetesTypically presents in patients over 40. This type of diabetes is relates to diet, exercise, and aging, causing the pancreas to produce less insulin. Most adult patients take oral hypoglycemic medication to manage their glucose levels.blood glucose levelsNormal- 80-110mg/dL Hypoglycemia- low blood sugar- less than 60mg/dL for adults, infants less than 40mg/dLsigns and symptoms for hyperglycemiaExcessive hunger/eating (polyphagia) Excessive thirst/drinking (polydipsia) Excessive urination (polyuria) Blood glucose greater than 130mg/dLSigns and symptoms for hypoglycemiaResembles hypovolemic shock Altered LOC Rapid HR Pale, cool, clammy Requires oral glucose if consciousSigns and symptoms for Diabetic Ketoacidosis (DKA)Altered LOC Nausea, vomiting, abdominal pain May have deep rapid respirations Flue like symptoms for several hours or days Blood glucose usually greater than 250mg/dLHepatitis Ainflammation of the liver caused by the hepatitis A virus (HAV), usually transmitted orally through fecal contamination of food or water. Common among childrenHepatitis B Virus (HBV)virus that causes inflammation of the liver; transmitted through any body fluid, including vaginal secretions, semen, and bloodHepatitis C and DMay he caused by bodily fluid exposure but the mechanism is not fully clearHepatitis signs and symptomsFatigue, RUQ abdominal pain, dark urine, light colored stool, vomiting, jaundice, and possibly feverTuberculosis (TB)infectious bacterial disease, most commonly spread by inhalation of small particles and usually affecting the lungs; may spread to other organsectopic pregnancyA pregnancy outside of the womb, usually in a Fallopian tube, in which a ruptured tube causes sudden severe abdominal pain and possible referees shoulder pain as abdomen fills with bloodplacenta previaimplantation of the placenta over the cervical opening or in the lower region of the uterusabruptio placentaepremature separation of the placenta from the uterine wallsupine hypotensive syndromeDizziness and a drop in blood pressure caused when the mother is in a supine position and the weight of the uterus, infant, placenta, and amniotic fluid compress the inferior vena cava, reducing return of blood to the heart and cardiac output.preeclampsiaabnormal condition associated with pregnancy, marked by high blood pressure, proteinuria, edema, and headachegestational diabetesdiabetes during pregnancyAssessment of labor4 signs of imminent delivery - crowning - contractions less than 2 min apart - dilation if the recital sphincter -urge to pushAssessment for pregnant patient-full name and age -expected due date - ask if first pregnancy - how long since labor pains began - whether or not the patients water has broken or if any blood showed - if patient feels urge to push or bowel movementThe exchange of oxygen and carbon dioxide that occurs between a capillary and a skeletal muscle cell in the bicep is known as: A.external respiration B. Internal respiration C. Ventilation D. AbsorptionB. Internal respirationWhen blood leaves the right ventricle, it enters the A. Left atrium B. Aorta C. Pulmonary circulation D. Systemic circulationC. Pulmonary circulation - when blood leaves the right ventricle, it enters the pulmonary circulation, first going to the pulmonary trunk, then to the pulmonary arteries, then to the lungs where it's oxygenatedAfter a motor vehicle accident , a patient who sustained closed trauma to the head complains that he cannot see. You suspect damage to cranial nerve: A. I (olfactory) B. II (optic) C. III (oculomotor) D. IV (trochlear)B. Cranial nerve II , optic nerveYou respond to a call involving a 35 year old woman complaining of intense abdominal pain. She is awake and alert, oriented, breathing normally, and appears to be well perfumed. Her heart rate is elevated but regular. Your priority at this point should be to: A. Transport the patient as gently and smoothly as possible B. Palpate the abdomen to rule out appendicitis C. Obtain a full set of vitals D. Administer aspirin to the patient for painA. Transport the patientThe primary concern with a patient with hypoperfusion of the kidneys is A. Hyperglycemia B. Respiratory distress C. Cardiac arrest D. A buildup of toxins in the bloodD. A buildup of toxins in the blood led by azure kidney failureCh. 3 1. You are called to a business for a patient with dizziness, headache, and nausea. As you enter the business, you detect a strong odor and your eyes begin to water. You should immediately: A. Leave the area and call for additional resources. B. attempt to locate the caller and remove him. C. apply a mask and safety goggles before continuing. D. determine the cause of the odor and notify your dispatcher.A. Leave the area and call for additional resources.Ch. 3 2. Which of the following statements regarding stress is correct? A. EMTs can avoid stress by eating healthy and exercising. B. stress will eventually cause most EMTs to leave the profession. C. Stress is an evitable consequence of the profession. D. Acute stress develops slowly due to repeat exposure to certain events.C. Stress is an evitable consequence of the profession.Ch.3 3. Which of the following is a formalized process to help emergency workers deal with stress? A. paid time off B. modified duty assignment C. critical incident stress management D. EMS stress management exercisesC. critical incident stress managementCh.3 4. Which of the following provides the best protection from exposure to an airborne disease? A. HEPA mask B. simple mask C. long-sleeve gown D. mask with splash guardA. HEPA maskCh.3 5. Which of the following moves is used when the scene is dangerous and the patient must be moved before providing care? A. urgent move B. emergency move C. non-urgent move D. critical moveB. emergency moveCh.4 1. Which of the following terms refers to the actions an EMS provider is legally allowed to perform based on his or her license or certification level? A. duty to act B. standard of care C. scope of practice D. doctrine of certificationC. scope of practiceCh.4 2. Which of the following terms refers to the degree of care a reasonable person with similar training should provide in a similar situation? A. standard of care B. scope of practice C. Standardized curriculum D. EMS expectation clauseA. standard of careCh.4 3. Which of the following are specific to resuscitation efforts and do not affect treatment prior to the patient entering cardiac arrest? A. living will B. advance directive C.DNR order D. medical power of attorneyC.DNR orderCh. 4 4. During a negligence lawsuit, it is shown that the injury to the plaintiff was, at least in part, directly due to the EMT's action or inaction. Which component of negligence is the EMT guilty of? A. proximate cause B. duty to act C. breech of duty D. gross incompetenceA. proximate causeCh.4 5. Which of the following is a definitive sign of death? A. decapitation B. pulselessness C. apnea D. unresponsivenessA. decapitationCh.5 1. What federal agency regulates all radio operations in the United States ? A. Federal Trade Commission B. Department of Transportation C. National Registry of EMTs D. Federal Communications CommissionD. Federal Communications CommissionCh.5 2. Which of the following statements regarding EMS radio communications is correct? A. Begin and end radio transmissions with "please" and "thank you." B. Use the 10 codes approved by the NREMT. C. Use clear text, not radio codes, for EMS communications. D. State "over and out" and the end of each radio transmission.C. Use clear text, not radio codes, for EMS communications.Ch.5 3. Which of the following is an example of an objective observation? A. "The paDifference between bvm and non-rebreather:BVM: assists with breathing, connected to o2. Allows you to increase the number of breaths or depth of breathing. If breathing spontaneously with good tidal volume and don't seem to have labored breathing , then use NRB NONREBREATHER: Straps go around head, constant o2 flowing 10-15L/min.CH.5 1. What federal agency regulates all radio operations in the United States? A. Federal Trade Commission B. Department of Transportation C. National Registry of EMTs D. Federal Communications CommissionD. The FCC regulates all radio communications in the U.S. The NREMT is not a federal agency.Ch.5 2. Which if the following statements regarding EMS radio communications is correct? A. Begin and end radio transmissions with "please" and "thank you" B. Use the 19 codes approved by the NREMT C. Use clear text, not radio codes, for EMS communications D. State "over and out" at the end of each radio transmissionC. Use clear text, not radio codes, unless approached locally.Ch. 5 3. Which of the following is an example of an objective observation? A. " the patient has slurred speech and an uneasy gait. B. "The patient is high on something." C. " the patient is obviously intoxicated." D. " the patient is under the influence of alcohol or drugs."A. The correct answer demonstrates an objective observation. The other answer choices are subjective opinions.Ch. 5 4. Your medical direction has just ordered administration of a medication for your patient. You should immediately: A. Administer the medication as directed. B. Check with one additional physician to confirm the order is correct. C. Repeat the order back to ensure you have understood it correctly. D. Ask the physician to verbally acknowledge that you are allowed to give the medication.C. Always repeat the order back (known as echoing) to ensure you hears it correctly. This should be done before the medication is administered.Ch. 5 5. Which of the following statements regarding the transfer of care report is correct? A. Transfer of care must always be to the accepting physician. B. Transfer of care must include a verbal report to an equal or higher medical authority. C. Transfer of care is not allowed until you have complete your documentation form. D. Transfer of care can be made to anyone as long as the patient agrees.B. Transfer of care must be made to an equal ke higher medical authority. A copy of the PCR must be provided, but it does NOT delay transfer of care.Ch.6 1. Which of the following suggestions should you follow regarding patient care reports? A. Always keep a copy of the PCR for your own records. B. If you didn't do it, don't write that you did. C. Have the patient review the PCR once it is complete. D. Leave your name off the PCR if you have concerns about the call.B. If you didn't do it, don't write that you did.Ch.6 2. The minimum data set on a PCR includes A. dispatch times. B. patient diagnosis. C. insurance information. D. the medical director's name.A. dispatch times.Ch.6 3. Your PCR has a section that allows you to free text a description of the call. This is known as the A. dispatch section. B. treatment section. C. physical exam section. D. narrative section.D. narrative section.Ch. 6 4. Your patient is complaining of knee pain following a fall from a bicycle. You ask the patient if he has any neck pain and he states he does not. In this case, neck pain would be considered: A. a pertinent negative. B. an associated symptom. C. multi-system trauma. D. an irrelevant question.A. The question is relevant and important to ask. Since it's not present, it would be considered a pertinent negative. If the patient answered "yes," then neck pain would be considered an associated symptom.Ch.6 5. What abbreviations should you use on your PCR? A. any abbreviation you like, as long as you are consistent. B. any abbreviation a senior EMT or paramedic uses. C. only abbreviations approved by your agency and medical director. D. only abbreviations approved by the NREMT.C. only abbreviations approved by your agency and medical director.Ch.7 1. Which of the following regarding homeostasis is correct? A. Homeostasis is a state of balance or equilibrium within the body. B. Homeostasis is assured if all vital signs are within normal limits. C. The body works to avoid homeostasis over prolonged periods. D. Patients who are alert and without pain are demonstrating homeostasis.A. Homeostasis is a state of balance or equilibrium within the body.Ch. 7 2. The frontal plane divides the body into A. left and right sides. B. top and bottoms halves. C. anterior and posterior. D. proximal and distal.C. anterior and posterior. The transverse plane divides the body into superior and inferior. The midline divides the body into left and right.Ch.7 3. From anatomical position, which of the following is the lateral bone in the forearm? A. the ulna B. the radius C. the humerus D. the tibiaB. the radiusCh. 7 4. Ventral refers to the A. anterior surface. B. posterior surface. C. medial aspect. D. lateral aspect.A. anterior surface. Dorsal refers to the posterior surface.Ch.7 5. Your adult patient is unconscious, breathing adequately, and has a pulse. There is no indication of trauma. The patient should be positioned A. in the shock position. B. supine. C. prone. D. recovery position.D. recovery position. The patient should be places in the recovery position to help the airway. The shock position (Trendelenburg) is no longer recomended/5 ARTERIAL PULSES-Central pulses: carotid & femoral -Peripheral pulses: Radial (thumb side), Brachial (palpated on medial portion of upper arm beneath biceps/ can also be felt on anterior medial arm where the humerus meets elbow; Doraalis pedis- palpated on top of the foot.4 components of bloodplasma, red blood cells, white blood cells, platelets. -plasma: liquid component of blood, made mostly of water -RBC (erythrocytes): the oxygen-carrying component of blood -WBC (leukocytes): fight infection by defending against invading organisms -Platelets: essential for clot formation to stop bleedingBlood pressure - what is it and 2 types of pressureBP is a measurement of the pressure exerted against the walls of the arteries. 1. Systolic pressure : the BP exerted during contraction of the left ventricle. 2. Diastolic pressure: the BP in between contractionsPerfusion / adequate vs inadequate (hypo-perfusion or shock)- is the flow of blood throughout the body. -Adequate perfusion means blood flow is adequate to all the tissues and organs in the body -Inadequate perfusion means blood flow has been compromised to the point the entire body is at risk.CNS (central nervous system)brain and spinal cord - is the command and control portion of the nervous systemPNS (peripheral nervous system)Includes all other nervous system structures outside of the CNS, including cranial and peripheral. The sensory and motor neurons that connect the CNS to the rest of the body. The brain receives information from the PNS, makes decisions, and sends orders to the PNS2 Divisions of PNS (Peripheral nervous system)-sensory division: sends sensory information to the CNS -motor division : receives motor command from the CNS. There are 2 divisions of the motor portion of PNS: 1. Somatic : voluntary portion of the PNS 2. Autonomic nervous system: involuntary portion of PNSsympathetic nervous system"Fight or flight" portion of ANS (autonomic nervous system), exerts greater control in times of stress or dangerparasympathetic nervous systemthe division of the autonomic nervous system that calms the body, conserving its energy, bringing it back to its rest state. - "feed and breed" portion of nervous system; exerts greater control in times of rest, digestion, or reproduction3 Parts of the brain and their functionscerebrum, cerebellum, brain stem -Cerebrum: largest part of the brain; controls thought, memory, and the senses - cerebellum: coordinates voluntary movement, find motor function, and balance - brain stem: includes midbrain, pons, and medulla; controls essential body functions, such as breathing and consciousnesscerebrospinal fluid (CSF)plasma-like clear fluid circulating in and around the brain and spinal cord; cushions the CNS and filters contaminantsEpidermisoutermost layer of skin. 2 epidermal layers: -the germinal layer produces new cells and pushes then to the surface. The cells die en route to the surface. - the stratum corneal layer is the top epidermal layer and consists of dead skin cellsDermismiddle layer of skin. Contains blood vessels, nerve endings, sweat glands, and hair folliclesSubcutaneous tissueTissue, largely fat, that lies directly under the dermis and serves as an insulator of the body. Deepest layer, above the muscle layerAbdominal cavityContains stomach, intestines, spleen, and liver, and other organs of digestion and excretion - separated from the thoracic cavity by the diaphragm - it continues inferiorly into the pelvic cavity. The 2 continuous cavities are sometimes referred to as the abdominopelvic cavity - the abdominal cavity is divided into 4 quadrants by the transverse line and midline.EsophagusA muscular tube that connects the mouth to the stomach. (A collapsible digestive structure) resides posterior to the tracheaStomachHollow digestive organ in LUQ. It receives food, begins breaking it down , and sends it to the small intestine.PancreasSolid organ Aids in digestion, produces insulin, and helps regulate blood glucose levels. The first is an exocrine role: to produce digestive enzymes and bicarbonate, which are delivered to the small intestine via the pancreatic duct. The second is an endocrine role: to secrete insulin and glucagon into the bloodstream to help regulate blood glucose levels.LiverSolid organ; occupies most of RUQ. The lover helps break down fats, filters toxins, and produces cholesterolGallbladderHollow organ positioned beneath the liver. The gall bladder collects and stores bile from the liver. It releases bile into the intestine to aid in digestion.Small intestineHollow organ; occupies both lower abdominal quadrants. Food from stomach is mixed with digestive enzymes to digest fat. Most of the contents are absorbed out of the small intestine and used or stored by the body.