Final Paramedic Fisdap Study Guide 2023 | Score 100%

Final Paramedic Fisdap Study Guide 2023 | Score 100%. Treating a Violent Patient (99/100) • May restrain a violent patient to protect you/crew and as well as the patient • Under the law, you are only able to use force if the patient attacks you. You may defend yourself. • Contact Law Enforcement if patient becomes uncooperative and or has weapons. • Violence can be the result of hypoxia, hypoglycemia, mental illness, brain injury, drug abuse/ OD, or alcohol use, and psych problems. • Protocol dependent - however, some agencies let EMS personal use “Chemical Restraints” such a benzodiazepines or antipsychotics to calm patients who are violent and need transportation to hospital. • If scene is not safe - contact Law enforcement and go back to ambulance like a lil bitch boy you are • Bullet proof vests? • Always be aware of your surrounding • Soft restraints while transporting if needed • OB/GYNECOLOGY 1. Complications Associated with Pregnancy Induced Hypotension (1931) • When a Pregnant females uterus compresses the Inferior Vena Cava, venous blood return to the heart is diminished or occluded. • Occurs when the women is Supine, or sometimes when she is sitting • Usually in the 3rd Trimester • Can lead to fetal distress • Generally takes 3-7 minutes of Compression before S/S occur • Early S/S - Nausea, Dizziness, Tachycardia, Claustrophobia • Late S/S - Diff Breathing, Syncopal Episodes, Hypovolemia from either blood loss or dehydration. • Treatment - Placing patient in the left lateral recumbent position - tilting backboard and treating underlying causes (Fluids if hypovolemic) and monitoring VS such as BP/EKG 2. Complications associated with pregnancy induced hypertension (PIH): (1931) Chronic HTN: BP that is equal to or Greater than 140/90mm Hg prior to 20th week. (Diastolic 110mmHg = increased risk for stroke or Cardiovascular disorders) Pregnancy Induced Hypertension: Develops after the 20th week and resolves postpartum. (Early sign of Preeclampsia) 2. Identifying a Patient with Braxton Hicks Contractions (1930) • Known as “False Labor” • Intermittent Uterine Contractions that may occur every 10-20 mins • Usually seen in the 3rd Trimester • No way to actually tell if it is a miscarriage or another complication of pregnancy, the patient needs to be transported. 3. Identifying and Treating a Nuchal Cord Nuchal Cord: Umbilical cord becomes wrapped around the newborn’s neck. Tx: 1. Slip cord over head with one gloved finger. 2. If unsuccessful or cored is wrapped multiple times - clamp and cut cord 4. Identifying and Treating a Patient with Eclampsia (1931/1932) • Exist when patient experiences a seizure seizure as a result of the severe hypertension. A systolic pressure exceeding 160 to 180mm Hg and diastolic pressure exceeding 105mm Hg, in the presence of these other risk factors, may require administration of hypertensive meds. • Risk Factors - Liver or renal failure, Cerebral Hemorrhage, Placenta Abruption, Younger than 20 or older than 35, Poor Diet, First time Pregnancy, HELLP Syndrome - • S/S - Seizures, Loss of consciousness, Agitation, Headaches or muscles pain, RUQ pain, Visual disturbances. • Causes - Develops from preeclampsia, Develops after 20th week, Proteinuria, Hypertension • TX - Anticonvulsant med - Mag Sulfate 1-4g in 50-100mL NS IVP/IVPB over 5 mins. Transport to Hospital 5. Identifying and Treating a Patient with Postpartum Bleeding • Early postpartum hemorrhage is bleeding within 24 hours of delivery and is the most common. • Late postpartum hemorrhaging: 24 hr to 6 weeks after delivery • Average Blood Loss is 150mL ! 500mL during first 24hrs considered postpartum hemorrhaging. ! Causes:! 1. Lacerations or tears around vagina or perineum ! ! 2. Prolong labor or multiple deliveries ! ! 3. Retained products of conception ! ! 4. Uterus loses ability to contract ! ! 5. Placenta Previa ! ! 6. Full Bladder-may prevent placenta separation Tx:! ! 1. Continue Fundal massage ! ! 2. Encourage Breast Feeding ! ! 3. Oxytocin (Pitocin): 10 Units in 1000mL NS @ rate 20-30 mL/min ! ! 4. Advise Receiving Hospital ! ! 5. Establish 2nd IV ! ! 6. Manage bleeding from external only 6. Postpartum Complications () • Postpartum Hemorrhage (See above) • Postpartum Depression - Also called the “Baby Blues” Is the most common pregnancy complication. S/S of this disorder can appear any time during pregnancy and up to 1 year after birth. • Risk Factors - Adolescent mothers and those in lower income levels have an increased chance of this condition, Previous history of depression or family history; financial or marital/ relationship issues; diabetes; a complicated pregnancy or delivery, major life-changing events, • S/S - Depression, lack of interest to care for themselves, insomnia to sleeping all the time, sadness and crying, lack of apatite. Sometimes strong anger to themselves and infants. 7. S/S of a Patient with a Spontaneous Abortion (1936) • Abortion is defined as “Expulsion of the fetus from any cause before the 20th week of gestation • Most abortions occur during the 1st trimester, before the placenta is fully mature • Also known as “Miscarriage” • Abdominal cramping with vaginal bleeding 8 weeks pregnant • Bleeding usually before pain • Causes: - Acute or chronic illness in the pregnant women - Maternal exposure to toxic substances (Drugs) - Abnormalities in the fetus - Abnormal attachment of the placenta Elective Abortion • Brought on intentionally • Women may try to export the fetus by traumatic ways or “Self-Medicate” - Making it too toxic for the fetus Habitual Abortion • Defined as 3 or more consecutive pregnancies that end in abortion • Causes: Chromosomal and Endocrine disorders, Ovarian Issues, Uterine malformations, Cervical conditions (Incompetence), Infections, and lifestyle factors. Threatened Abortion • Is an abortion that is attempting to take place • Characterized by - Vaginal Bleeding during the first half of pregnancy - usually in the 1st Trimester • S/S: Abdominal discomfort, or menstrual cramps • Severe pain is rarely a presenting complaint because uterine contractions are not rhythmic. • Threatened Abortion can progress to an Incomplete Abortion, or it may subside, allowing the pregnancy go to term.