Final Exam West Coast EMT

What is croup? What are the S/S? - upper airway viral infection that blocks the breathing s/s: barking cough, hoarse voice, fever, labored or noisy breathing What is Epiglottis? What the S/S? - The tissue protecting the windpipe is inflamed causing swelling, which blocks the lungs from a bacterial infection S/S: SOB, difficulty swallowing, sore throat, fever from infection What is a vesicant agent (Terrorism) - man-made chemical warfare agent (mustard gas, phosgene) What is compensated shock? What are the S/S? How does the body react? - Is a stage of shock refers to the initial stage the the body is still able to compensate for the tissue perfusion decrease, including tachycardia, peripheral vasoconstriction S/S: cool extremities, weak pulse, delayed cap refill, tachycardia, narrowing pulse pressure What is decompensated shock? - when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident S/S: cold, clammy extremities, feeble or absent peripheral pulse, bradycardia, low systolic blood pressure What is the axial skeleton? - the part of the skeleton that consists of the bones of the head and trunk of a vertebrate, the framework supports and protect the organs Blunt trauma to the right upper or left lower abdomen - Right upper: Liver, Gallbladder, R kidney Left Lower: Colon, Left Kidney compression to breath ratio 1 to 2 person rescue for adult and infants - Adult/Infant 1 person rescuer 30:2 Adult/Infant 2 person rescuer 15:2 What is APGAR? - A quick test performed on a baby 1-5 minutes after birth Appearance, Pulse, Grimace, activity, and Respiration Where do you start assessment on adults vs children - Begin at the toes for a child Begin at the head for an adult When someone gets hit by car, where would you see injuries in and adult vs a kid ( likelihood) - Adult: front bumper strikes the lower leg region or pelvic region Child: small child head and neck, bigger child would be chest or torso pediatric non rebreather and nasal cannula - Non rebreather: 10-15 LPM flow rate Nasal Cannula: 2-6 LMP flow rate why do elderly have brittle bones (osteoporosis) - The holes in the bones get bigger and the outer layer becomes thinner, The bones get less dense What is evaporation? - The body's Natural cooling mechanism, in which sweat is converted to a gas. What is conduction? - Heat from the body being transferred to an cooler surface What is convection? - Loss of heat through thorough contact with a cooler gas or fluid. What is Radiation? - The transfer of heat by radiant energy. radiant energy is a type of invisible light that transfers heat. radiation can also transfer the cold like standing in a cold room or heat by standing next to a fire What is a tension pneumothorax? - occurs when air accumulates between the chest wall and the lung and increases pressure in the chest, reducing the amount blood returned to the heart s/s: chest pain, SOB, rapid breathing, racing heart, followed by shock What is a pneumothorax? - a collapsed lung that cause air to enter the space between your lung and chest wall S/S: Sudden chest pain, SOB, shallow breathing, sometimes a cough Whats the difference between hyper and hypo glycemia? What do you do for each?/what could a hospital do for each? - Hyper- high blood sugar - Continuous IV infusion of regular insulin is the treatment of choice beware for vomiting, monitor cardiac rhythm - hospitals will administer insulin Hypo- low blood sugar - We can help by monitoring blood glucose and administering oral glucose - Hospitals can rapid-acting glucose Newborn infant - How do they act? - what do they do? - what are seeing when first born? - .... what is the electrical conduction system? - The electrical signals that travel through your heart conduction system cause your heart to expand and contract, These contractions controls how blood flows through your heart keeping a steady, even heart rate. How does the electrical function go to the heart? (name of steps assuming no issues) - The SA node starts the sequence by causing the atrial muscles to contract. Next, the signal travels to the AV node, through the bundle of HIS, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract what is the peripheral nervous system composed of? - The peripheral nervous system consists of the nerves that branch out from the brain and spinal cord. These nerves form the communication network between the CNS and the body parts. The peripheral nervous system is further subdivided into the somatic nervous system and the autonomic nervous system. What is the central nervous system composed of? - The central nervous system consists of the brain and spinal cord. The central nervous system controls thought, movement, and emotion, as well as breathing, heart rate, hormones, and body temperature. What does blunt force trauma do to hallow vs solid organs? - Solid organs include the spleen, liver and pancreas, and generally bleed when injured. Hollow organs, including the stomach, intestines, bladder and gallbladder, spill their contents into the abdominal cavity (also called peritoneal cavity) when injured. What are the s/s of placenta previa? - Bright red bleeding from your vagina. The bleeding often starts near the second half of pregnancy. It can also start, stop, then start again a few days later. Mild cramping or contractions in your abdomen, belly or back. What are the s/s of abruptio placenta? - Vaginal bleeding, although there might not be any. Abdominal pain. Back pain. Uterine tenderness or rigidity. Uterine contractions, often coming one right after another. what is the difference between abruptio placenta and placenta previa? - Placenta previa : placenta is near or covers the cervical opening Placental abruption: placenta detaches prematurely from the uterus What are the s/s of pelvic inflammatory disease? - pain around the pelvis or lower tummy. discomfort or pain during sex that's felt deep inside the pelvis. pain when peeing. bleeding between periods and after sex. heavy periods. painful periods. unusual vaginal discharge, especially if it's yellow, green or smelly. What is pelvic inflammatory disease? - Pelvic inflammatory disease (PID) is an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries. Untreated can cause scar tissue and pockets of infected fluid (abscesses) to develop in the reproductive tract, which can cause permanent damage. What are the s/s for septic shock? - Fast heart rate. Fever or hypothermia (low body temperature). Shaking or chills. Warm, clammy or sweaty skin. Confusion or disorientation. Hyperventilation (rapid breathing). Shortness of breath. What are the s/s for anaphylactic shock? - tchy skin or a raised, red skin rash. swollen eyes, lips, hands and feet. feeling lightheaded or faint. swelling of the mouth, throat or tongue, which can cause breathing and swallowing difficulties. What are the steps for ABC? - check airway (open, clear, and maintainable) check breathing ( rate, depth, and quality) check circulation ( cap refill, obvious bleeding, pulse, skin signs) What items would you take into a call? - .... What are s/s in cardiac arrest for children/peds? - Some common warning signs include: Chest pain or discomfort during exercise. Fainting or extreme dizziness during or just after an athletic activity. Racing heart or palpitations. What steps come after baby is born? What do you need to do? - The umbilical cord must be cut and the placenta delivered. The role of the EMS provider must prevent rapid delivery. What is subcutaneous emphysema? - Subcutaneous emphysema is a condition in which air becomes trapped under the subcutaneous layer of the skin. The main symptoms are edema and crepitus. There are many possible causes, including accidental injuries during surgery, injury during the placement of a breathing tube, and certain infections "Rule of palm" method of burns - The "rule of palm" is another way to estimate the size of a burn. The palm of the person who is burned (not fingers or wrist area) is about 1% of the body. Use the person's palm to measure the body surface area burned. It can be hard to estimate the size of a burn. What is a common airway obstruction in an unconscious patient? - The tongue What is the difference between respirations and ventilations? - Ventilation: The ability of the body to move air into and out of the lungs in sufficient volumes. Respiration: The exchange of gases between the air in the alveoli and the lungs capillaries. motor nerve neuropathy - loss of balance, muscle weakness, and spasms. expiratory reserve volume - the volume of air that can be maximally exhaled at the end of a tidal expiration inspiratory reserve volume - the additional amount of air that can be inhaled after a normal inhalation. tidal and residual volume - Tidal volume is the volume of air inhaled in a single, normal breath. Residual volume is the amount of air left in the lungs after forceful respiration. Aortic aneurysm - a balloon-like bulge in the aorta. Aortic aneurysms can dissect or rupture: The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. cardiogenic shock - A life-threatening condition in which your heart suddenly can't pump enough blood to meet your body's needs. Shock caused by inadequate function of the heart, or pump failure. Asthma - disease that has attacks involving bronchoconstriction and mucous production with significant difficulty breathing Acetabular seperation - .... psychosis - a psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions Neurosis - a mental condition that is not caused by organic disease, involving symptoms of stress (depression, anxiety, obsessive behavior, hypochondria) but not a radical loss of touch with reality. Behavior - The manner in which one acts; the actions or reactions of individuals under specific circumstances. Affect - the patient's immediate expression of emotion psychotic emergency - a disturbance in thought, mood and/or action which causes sudden distress to the individual/others and sudden disability or death, thus requiring immediate management behavioral crisis - occurs when someone's behavior is so out of control that the person becomes a danger to everyone recumbent position - the person is lying on their left side with the left arm extended, and the left leg bent at a right angle to provide stability Hemothorax - a collection of blood in the pleural cavity (visceral and parietal pleura) Hemopneumothorax - The accumulation of blood and air in the pleural space of the chest. MCI - Mild cognitive impairment (MCI) is an early stage of memory loss or other cognitive ability loss ( language or visual ) hydrocephalus - accumulation of fluid in the spaces of the brain hepatomegaly - enlargement of the liver nephritis - inflammation of the kidney CISM - Critical Incident Stress Management - is an intervention protocol developed specifically for dealing with traumatic events Dextrose - another form of glucose definitive treatment - comprehensive care for the full spectrum of injuries beyond the initial assessment and resuscitation phase. Insulin - A hormone produced by the pancreas or taken as a medication by many diabetics Glucagon - a hormone that raises blood glucose levels, is used to treat severe hypoglycemia. Glucagon is taken as a spray into the nose or an injection administered under the skin. Pediatric Assessment Triangle (PAT) - A structured assessment tool that allows you to rapidly form a general impression of the infant or child without touching him or her; consists of assessing appearance, work of breathing, and circulation to the skin. Cardio Pulmonary Resuscitation - combines rescue breathing and chest compressions to temporarily pump enough blood to the brain until specialised treatment is available. CNS - central nervous system- the brain and spinal cord PNS - Peripheral nervous system- part of your nervous system that lies outside your brain and spinal cord. Meninges - three protective membranes that surround the brain and spinal cord Cerebrum - Area of the brain responsible for all voluntary activities of the body L and R bundle branches - Split off from AV bundle, conduct impulses to Purkinje fibers on both sides of heart Purkinje system (fibers) - transmit electrical impulses six times faster than normal ventricular muscle fibers internodal pathways - Interconnect the SA Node with the AV Node, conducts impulses throught to the atrial working cells. SA node and AV node - SA Node -intrinsically rhythmic -120 impulse/min (vagus nerve slows SA node to 50-75) -heart's natural pacemaker AV Node -conducts SA signal -located near intersection of 4 heart chambers *signal travels from SA- AV - bundle of His - purkinje fibers Incident Commander - The person responsible for all aspects of an emergency response Venules - small vessels that gather blood from the capillaries into the veins Arterioles - small vessels that receive blood from the arteries Veins - Blood vessels that carry blood back to the heart Arteries - carry blood away from the heart Capillaries - The tiny blood vessels throughout the body that connect arteries and veins. Capillaries form an intricate network around body tissues in order to distribute oxygen and nutrients to the cells and remove waste substances. Platlets - cell fragments that cause clotting and produce growth factors involved in tissue repair Macrodrip and microdrip - Macrodrip tubing is wider and produces larger drops. Microdrip tubing used to carry fluids at a slow, controlled rate from a reservoir to a patient and containing a buret that divides each milliliter (ml) of fluid into 60 drops. CPAP - continuous positive airway pressure- a machine that uses mild air pressure to keep breathing airways open while you sleep tachycardia and bradycardia - fast heart rate, slow heart rate polyphagia - excessive hunger polydipsia - excessive thirst polyuria - excessive urination Hypertension/Hypotension - high blood pressure/low blood pressure Ovarian abscess - An ovarian abscess is a pus-filled pocket in an ovary. An ovarian abscess is usually caused by bacteria that travel from another part of your body. Can develop in women who have PID. ectopic pregnancy - A pregnancy outside of the womb, usually in a fallopian tube uterine rupture - a tear in the wall of the uterus ovarian cysts - collections of fluid within a sacs (cysts) in or on the ovary Pulseless ventricular tachycardia - When the lower chambers of the heart (ventricles) begin contracting at a very fast pace, leading to insufficient organ perfusion and heart failure ventricular fibrillation - type of arrhythmia, or rapid irregular heartbeat, that affects your heart's ventricles Sepsis - Dangerous infection of the blood cardiac output - the quantity of blood pumped by the heart in a given period of time, typically measured in liters per minute. non-flammable gasses - neither flammable or toxic, some examples include nitrogen, carbon dioxide, compressed air and helium. water reactive solids - A material that explodes, violently reacts, produces flammable, toxic or other hazardous gases, and/or generates enough heat to cause autoignition or ignition of combustible materials upon exposure to water or moisture. Flammable liquid - A flammable liquid is a liquid which can be easily ignited in air at ambient temperatures Air-reactive solids - Reactive solids are more likely than other solids to be dispersed into the air due to the energy or heat created from their reactivity with water or air. Medical Director - The physician who authorizes or delegates to the EMT the authority to provide medical care in the field. Defiberillation - the stopping of fibrillation of the heart by administering a controlled electric shock in order to allow restoration of the normal rhythm. recovery position - lying on the side. also called the semi prone position, one knee up and an arm extended out hematemesis - vomiting blood hemoptysis - coughing up blood Ecchymosis - bruises BSA - body surface area (burn assessment) contusion - a bruise that results from a blunt force applied to the soft tissues of the body organic brain disorder - disturbances in cognitive functions (memory, thinking, perception, and attention). The expression of emotions is altered, and alertness and vigilance are disturbed functional behavior disorder - .... Atherosclerosis - condition in which fatty deposits called plaque build up on the inner walls of the arteries embolism - obstruction of an artery, typically by a clot of blood or an air bubble. aneurysm - a localized weak spot or balloon-like enlargement of the wall of an artery thrombus - blood clot apnea - absence of breathing ICP - intracranial pressure-A brain injury or another medical condition can cause growing pressure inside your skull aspiration - Removal by suction of fluid and cells through a needle. Aspiration also refers to the accidental sucking in of food particles or fluids into the lungs. Perfusion - 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. Supraventricular tachycardia - an irregularly fast heartbeat. It occurs when faulty electrical connections in the heart set off a series of early beats in the upper chambers of the heart (atria) Respiration - The transfer of oxygen from the outside environment to cells within tissues, as well as the removal of carbon dioxide in the opposite way Oxygenation - The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs. AMI (heart attack) - acute myocardial infarction- occurs when there is a sudden blockage of blood flow to a portion of the heart muscle. HIPPA - Health Insurance Portability and Accountability Act (HIPAA) that MOST affects EMS personnel is protecting patient privacy. HIPAA requires businesses that use health information, such as insurance companies and healthcare providers, to maintain strict confidentiality of patient records. Expressive consent - consent is made by conscious, mentally competent adults. Implied consent - is automatically assumed if a patient is unresponsive or unable to make a rational decision (e.g. altered mental status). Informed consent - is the voluntary agreement of an individual, or his or her authorized representative ( parent or guardian ), who has the legal capacity to give consent, and who exercises free power of choice, without undue inducement or any other form of constraint or coercion to participate in research. Involuntary consent - applied to patients who may be: mentally ill, behavioral crisis, developmentally delayed, Try to obtain consent from parent or guardian What's occurring during Bradycardia? - Bradycardia is a type of abnormal heart rhythm, or arrhythmia. It occurs when the heart beats very slowly — less than 60 beats per minute. What's occurring during tachycardia? - an irregular electrical signal, called an impulse, starts in the upper or lower chambers of the heart. This causes the heart to beat faster. Tachycardia is the medical term for a heart rate over 100 beats a minute What's occurring during Supra-ventricular tachycardia (SVT) - the signal to start your heartbeat doesn't come from the SA node. Instead, it comes from another part of the left or right atrium, or from the AV node. An area outside the SA node begins to fire quickly, causing a rapid heartbeat of over 100 beats per minute. PCR and the proper documentation - Each PCR should include all pertinent times associated with the EMS call. As well as the times of the assessments and treatments provided, the PCR should include detailed signs and symptoms and other assessment findings such as vital signs, and all the specific emergency care provided. What is Ventilation-perfusion (V/Q) ratio - is a measure of the relationship between the amount of air entering the alveoli (V) and the amount of blood flowing through the capillaries surrounding the alveoli in the lungs (Q). When do you use a nasal cannula? - Nasal cannulas are used to administer supplemental oxygen to a responsive patient when they could benefit from oxygen administration but may not be able to tolerate a non-rebreather (NRB) mask or do not need a large amount of oxygen it would provide. When do you use a non-rebreather? - Non-rebreathing masks are used to deliver high concentrations of oxygen in emergency situations to a responsive patient. These masks may be used for traumatic injuries, after smoke inhalation, and in cases of carbon monoxide poisoning. When do you use a BVM? - This basic airway management technique allows for oxygenation and ventilation of patients until a more definitive airway can be established, like hypoxic respiratory failure, apnea, or altered mental status with the inability to protect the airway. It's usage is advocated while delivering breaths during cardiopulmonary resuscitation. When do you use the CPAP? - for people with fluid in their lungs (pulmonary edema), Chronic Obstructive Pulmonary Disease (COPD), and acute bronchospasms, such as asthma. Other reasons people may need CPAP include toxic inhalation, drowning, flail chest and various lung infections such as pneumonia What is the respiratory cycle including negative pressure breathing? - Negativepressure breathing involves: a drop in pressure within the chest cavity. Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called: increase in carbon dioxide, which decreases the pH of the cerebrospinal fluid. Hydrostatic pressure vs. Oncotic pressure in Capillaries - The force of hydrostatic pressure means that as blood moves along the capillary, fluid moves out through its pores and into the interstitial space. Oncotic pressure is the pressure that moves water into the capillaries due to the "high solute concentration" in the capillaries. It is greater at the vein side of the capillary Adult and Pediatric Compression depth - at least 2 inches (5cm) no more than 2.4 for adults, approximately 2 inches (5cm) for children, and approximately 1 ½ or 1.5 inches (4cm) for infants. Adequate breathing - Great depth, quality, rate , Rhythm (adult 12-20) Inadequate breathing - breathing that is insufficient to support life or normal, healthy function of the body (adult less than 10 times per minute and over 30 times per min) What are the signs of respiratory distress? - Shortness of breath. Fast breathing, or taking lots of rapid, shallow breaths. Fast heart rate. Coughing that produces phlegm. Blue fingernails or blue tone to the skin or lips. Extreme tiredness. Fever. Crackling sound in the lungs. Signs and symptoms of COPD/emphysema - Shortness of breath, especially during physical activities Wheezing Chest tightness A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish Frequent respiratory infections Lack of energy Unintended weight loss (in later stages) Swelling in ankles, feet or legs what is flail chest - occurs when adjacent ribs have two or more fractures, creating a portion of the rib cage that detaches from the rest of the chest wall. This detached segment depresses inward on inspiration (due to negative intrathoracic pressure) and is pushed outward on expiration (due to positive intrathoracic pressure). what is paradoxical movement - When multiple adjoining ribs fracture, the chest wall can fully lose rigidity. This results in a larger flail segment that moves with the lungs as opposed to staying stationary and allowing proper lung expansion/contraction What are the structures lined with mucous membranes in the body - Mucous membranes line many tracts and structures of the body, including the mouth, nose, eyelids, trachea (windpipe) and lungs, stomach and intestines, and the ureters, urethra, and urinary bladder. What is AMI? - Acute myocardial infarction (AMI) occurs when oxygenated blood cannot reach the myocardium and muscle tissue dies. It is caused when a coronary artery is completely blocked or occluded. AMI is caused by the same mechanism as angina except that AMI results in tissue death and is not reversible. What is Angina? - angina refers to the chest pain felt with cardiac tissue ischemia. The pain is caused by a narrowing of the coronary arteries either through atherosclerosis or Prinzmetal angina, a type of angina caused by vasospasms. In Stable Angina: The pain is predictable typically occurring with exertion What is cardiogenic hypoperfusion? (cardiogenic shock) - Cardiogenic shock happens when your heart cannot pump enough blood and oxygen to the brain and other vital organs. This is a life-threatening emergency. It is treatable if diagnosed right away, so it's important to know the warning signs. What is ischemic heart disease? - It's heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reach the heart muscle. This is also called coronary artery disease and coronary heart disease. This can lead to heart attack What is the Appendicular skeleton? - appendicular skeleton includes the bones in your shoulders, pelvis and limbs, including your arms, hands, legs and feet. What is ICS organization, roles and responsibilities? - The ICS provides for responder accountability. Personnel will know how the system will evolve to fit the emergency, who they will be working for, who will be working for them, how to communicate decisionmaking information, and how to request the resources needed for their area of responsibility. command, operations, planning, logistics, and finance/administration. what is the span of control? - the number of subordinates who report directly to a manager or leader. The more employees assigned to a manager, the wider their span of control. What is START? - Simple Triage and Rapid Treatment was developed to allow first responders to triage multiple victims in 30 seconds or less, based on three primary observations: Respiration, Perfusion, and Mental Status (RPM). What is Jump START? - JumpSTART is a modification to the START system and takes into account the difference in "normal" respiratory rates for children that are 8 years old or younger and 100 lbs or less. This tool acts to assess pediatric patients better. The differences in this algorithm include: Five rescue breaths are to be given to apneic children with a pulse; then, they are given a black tag. Normal RR are more than 15 or less than 45 Neurological assessment is done using the mnemonic AVPU (alert, responds to verbal stimuli, responds to painful stimuli, and unresponsive). Any patient who has abnormal posturing to painful stimuli or is unresponsive gets a red tag designation. Is croup viral or bacterial? - Croup is most often viral but occasionally bacterial infections can also cause it What is epiglottis? - The epiglottis is a flap of tissue that sits beneath the tongue at the back of the throat. Its main function is to close over the windpipe (trachea) while you're eating to prevent food entering your airway. Types of O2 cylinders, and minimum operating PSI before you should go out of service (M and D tank) - 500 psi