EMT-B ALL CHAPTERS Flashcards

Emergency Medical Care
Terms Definitions
Advanced Life Support (ALS)
Advanced Lifesaving procedures, some of which are now being provided by the EMT-B
Americans with Disabilities Act (ADA)
Comprehensive legislation that is designed to protect individuals with disabilities against discrimination
Automated External Defibrillator (AED)
A device that detects treatable life-threatening cardiac arrhythmias (ventricular fibrillation and ventricular tachycardia) and delivers the appropriate electrical shock to the patient.
continuous quality improvement (CQI)
a system of internal and external reviews and audits on all aspects of the EMS system
Emergency Medical Dispatch (EMD)
a system that assists dispatchers in selecting appropriate units to respond to a particular call for assistance and in providing callers with vital instructions until the arrival of EMS crews.
Emergency Medical Service (EMS)
a multidisciplinary system that represents the combined efforts of several professionals and agencies to provide prehospital emergency care to the sick and injured
Emergency Medical technician (EMT)
A medical professional who is trained and certified/licensed by his or her state to provide emergency life support prior to or with more advanced medical procedures.
EMT-Basic (EMT-B)
an EMT who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications.
EMT-Intermediate (EMT-I)
an EMT who has training in specific aspects of advanced life support, such as IV (intravenous) therapy, interpretation of cardiac rhythms and defibrillation, and orotracheal intubation.
EMT-Paramedic (EMT-P)
an EMT who has extensive training in specific aspects of advanced life support, including IV (intravenous) therapy, pharmacology, cardiac monitoring, and other advanced assessment and treatment skills.
first responder
The first trained individual, such as a police officer, fire fighter, lifeguard, or other rescuer, to arrive at the scene of an emergency to provide initial medical assistance.
Health Insurance portability and Accountability Act (HIPAA)
Federal legislation passed in 1996. Its main effect in EMS is limiting the availability of patients health care information and penalizing violations of patient privacy
intravenous (IV) therapy
the delivery of medication directly into a vein
medical control
Physician instructions that are given directly by radio or cell phone (online/direct) or indirectly by protocol/guidelines (offline/indirect), as authorized by the medical director of the service program.
Medical director
The physician who authorizes or delegates to the EMT the authority to provide medical care in the field.
primary service area (PSA)
The designated area in which the EMS service is responsible for the provision of prehospital emergency care and transportation to the hospital.
quality control
The responsibility of the medical director to ensure that the appropriate medical care standards are met by the EMT-B's on each call.
US DOT
United States Department of Transportation: sets guidelines for training required to be a certified EMS worker. Usually exceeded on the state level
BLS
Basic Life Support
CPR
Cardio-Pulmonary Resuscitation
NHTSA
National Highway Traffic Safety Administration
Dispatchers Responsibilities
1. Provide callers with vital instructions to deal with the emergency until EMT's arrive 2. Select appropriately resourced units to respond 3. Relay all relevant and available information to the responding crews in a timely manner.
Online Medical Control
Consists of directions given over the phone or radio directly from the medical director or designated physician.
Offline Medical Direction
Standing orders, training, and supervision authorized by the medical director
Phases of Emergency Patient Care
1. Patient or bystanders recognize emergency and call 911. Initial care offered by dispatch. 2. EMT patient assessment, prehospital care, proper packaging, safe transport to hospital. 3. Continued assessment and stabilization in the hospital emergency department. 4. The patient receives the needed definitive specialized care.
Body Substance Isolation (BSI)
An infection control concept and practice that assumes that all bodily fluids are potentially infectious.
Burnout
a condition of chronic fatigue and frustration that results from mounting stress over time
carrier
an animal or person who is infected with and may transmit an infectious disease but may not display any symptoms of it; also known as a vector
communicable disease
Any disease that can be spread from person to person or from animal to person.
contagious disease
an infectious disease that is capable of being spread from one person to another
contamination
The presence of infectious organisms on or in objects such as dressings, water, food, needles, wounds, or a patient’s body.
cover and concealment
The tactical use of an impenetrable barrier to conceal EMS personnel and protect them from projectiles.
Critical incident stress debriefing (CSID)
A confidential peer group discussion of a severely stressful incident that usually occurs within 24-72 hours of the incident.
Critical incident stress management
a process that confronts the responses to critical incidents and defuses them, directing emergency services personnel toward physical and emotional equilibrium
designated officer
The individual in the department who is charged with the responsibility of managing exposures and infection control issues.
direct contact
exposures or transmission of a communicable disease from one person to another by physical contact
exposure
a situation in which a person has had contact with blood, body fluids, tissues, or airborne particles in a manner that suggest that disease transmission may occur
exposure control plan
a comprehensive plan that helps employees to reduce their risk of exposure to or acquisition of communicable diseases
general adaption syndrome
The body's 3-stage response to stress. 1. Stress causes the body to trigger an alarm response. 2. Reaction and resistance. 3. Recovery (or if stress is prolonged, exhaustion.)
hepatitis
Inflammation of the liver usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function.
herpes simplex
Infections caused by human herpes viruses 1 and 2, characterized by small blisters whose locations depend on the type of virus. Type 2 results in blisters on the genital area. While type 1 blisters are non-genital.
HIV infection
Human immunodeficiency virus. The virus can cause acquired immunodeficiency syndrome (AIDS)
indirect contact
Exposure or transmission of disease from one person to another by contact with a contaminated object (vehicle)
infection
The abnormal invasion of a host or host tissues by organisms such as bacteria, viruses, or parasites, with or without signs or symptoms of disease.
infection control
procedures to reduce transmission of infection among patients and health care personnel
infectious disease
A disease that is caused by infection, in contrast to one caused by faulty genes, metabolic or hormonal disturbances, trauma, or something else.
meningitis
an inflammation of the meningeal coverings of the brain and spinal cord; it is usually caused by a virus or bacterium
Occupational Safety and Health Administration (OSHA)
The federal regulatory compliance agency that develops. Publishes, and enforces guidelines concerning safety in the workplace.
pathogen
A microorganism that is capable of causing disease in a susceptible host.
personal protective equipment (PPE)
Protective equipment that OSHA requires to be made available to the EMT. In the case of infection risk, PPE blocks entry of an organism into the body.
posttraumatic stress disorder (PTSD)
A delayed stress reaction to a prior incident. This delayed reaction is often the result of one or more unresolved issues concerning the incident.
SARS (severe acute respiratory syndrome)
Potentially life-threatening viral infection that usually starts with flu-like symptoms.
transmission
the way in which an infectious agent is spread: contact, airborne, by vehicles, or by vectors
tuberculosis
A chronic bacterial disease, caused by Mycobacterium tuberculosis that usually affects the lungs but can also affect other organs such as the brain or kidneys.
universal precautions
protective measures that have traditionally been developed by the Centers for Disease Control and Prevention (CDC) for use in dealing with objects, blood, body fluids, or other potential exposure risks of communicable disease.
virulence
The strength or ability of a pathogen to produce a disease.
MCI
mass casualty incident
Ways self control is developed
Proper training, ongoing experience dealing with various types of stress, healthy stress coping strategies, dedication to serve
5 stages of grief
Denial, anger, bargaining, depression, acceptance.
factors that can influence reactions to stress
Action to medication; age; nutrition; guilt; past experience.
options for stress management
lifestyle changes; nutritional changes; exercise; balance of work and family;
2 types of sexual harassment
1. Quid pro quo harassment. 2. Hostile work environment.
steps for removing gloves
1. Pull first glove about half off. 2 using still covered fingers, pull second glove completely off. 3. grasp the inside of remaining glove and remove
levels of toxicity
0. Little to no hazard - No Protection Needed. 1. Slightly hazardous - SCBA (level c). 2. Slightly hazardous - SCBA (level c). 3. Extremely hazardous - full protection, with no exposed skin (level a or b). 4-minimal exposure causes death=special hazmat gear (lvl a)
abandonment
unilateral termination of care by the EMT-B without the patients consent and without making provisions for transferring care to another medical professional with skills at the same level or higher
advance directive
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will.
assault
unlawfully placing a patient in fear of bodily harm
battery
touching a patient or providing emergency care without consent
certification
a process in which a person, an institution or a program is evaluated and recognized as meeting certain predetermined standards to provide safe a and ethical care.
competent
able to make rational decisions about personal well-being
consent
permission to render care
dependent lividity
blood settling to the lowest point of the body, causing discoloration of the skin,
DNR Orders
"Do not resuscitate" written documentation by a physician giving permission to medical personnel not to attempt resuscitation in the event of cardiac arrest.
duty to act
A mediocolegal term relating to certain personnel who either by stature or by function have a responsibility to provide care.
emergency
A serious situation, such as injury or illness, which threatens the life or welfare of a person or group of people and requires immediate intervention.
emergency medical care
immediate care or treatment
expressed consent
a type of consent in which a patient gives express authorization for provision of care or transport
forcible restraint
the act of physically preventing an individual from any physical action
Good Samaritan Laws
statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is wanton, gross or willful negligence.
Implied consent
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.
informed consent
Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained.
mediocolegal
a term relating to medical jurisprudence or forensic medicine,
negligence
Failure to provide the same care that a person with similar training would provide.
precedence
Basing current action on lessons, rules, or guidelines derived from previous similar experiences.
putrefecation
decomposition of body tissue
rigor mortis
stiffening of the body; a definitive sigh of death
standard of care
Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.
Scope of Practice
Most commonly defined by state law, outlines the care that an EMT is able to provide the patient.
Proving Negligence
1. Duty to act. 2. Breach of Duty. 3. Damages. 4. Cause
How to protect yourself if the patient refuses treatment:
Document everything and inform Medical Control right away.
in order to be valid, DNR orders must:
1. Clearly state the patient’s medical problems. 2. Be signed by the patient or legal guardian. 3. Be signed by one or more physicians. 4. In some states, DNR have expirations. Must be date within the last 12 months to be valid.
When in doubt of DNR or they are not present:
resuscitate
Courts assumptions regarding rules and reports:
1. If it wasn't written down on the report, it was not performed. 2. An incomplete or untidy report is evidence of incomplete or inexpert emergency medical care.
Exceptions of Confidentiality
1. Abuse of Children or Elderly (or others) 2. Injury during commission of a felony. 3. Drug-related injuries (criminal). 4. Childbirth 5. Scene of a Crime. 6. Deceased
Presumptive Signs of Death:
1. Obvious mortal damage (decapitation). 2. Dependent Lividity. 3. Rigor Mortis. 4. Putrefecation
Considered Medical examiner cases (Coroner):
1. When person is DOS. 2. When physician is unable to state the cause of death. 3. Suicide 4. Violent Death 5. Poisoning, known or suspected 6. Death from accidents 7. Suspicion of a criminal act
abdomen
Body cavity that contains the major organs of digestion and excretion. Located below the diaphragm and above the pelvis.
abduction
motion of a limb away from the midline
acetabulum
the depression on the lateral pelvis where its three component bones join in, in which the femoral head fits snugly
Adam's apple
The firm prominence in the upper part of the larynx formed by the thyroid cartilage. It is more prominent in men than women.
adduction
motion of a limb toward the midline
agonal respirations
slow, gasping respirations, sometimes seen in dying patients
alveoli
The air sacs of the lungs in which the exchange of oxygen and carbon dioxide takes place.
anatomic position
the position of reference in which the patient stands facing you, arms at the side, with the palms of the hands forward
angle of Louis
A ridge on the sternum that lies at the level where the second rib is attached to the sternum; provides a constant and reliable bony landmark on the anterior chest wall.
anterior
The front surface of the body.
anterior superior iliac spines
the bony prominence of the pelvis (ileum) at the front of each side of the lower abdomen just below the plane of the umbilicus
aorta
The principle artery leaving the left side of the heart and carrying freshly oxygenated blood to the body.
apex (apices)
the pointed extremity of a conical structure
appendix
A small tubular structure that is attached to the lower border of the cecum in the lower right quadrant of the abdomen.
arteriole
the smallest branch of an artery leading to the vast network of capillaries
atrium
upper chamber of the heart
autonomic nervous system
the part of the nervous system that regulates functions, such as digestion and sweating, that are not controlled voluntarily
ball-and-socket joint
a joint that allows internal and external rotation as well as bending
biceps
the large muscle that covers the front of the humerus
bilateral
A body part that appears on both sides of the midline.
bile ducts
ducts that convey bile between the liver and the intestine
blood pressure
The pressure that the blood exerts against the wall of the arteries as it passes through them.
brachial artery
the major vessel in the upper extremity that supplies blood to the arm
brain
The controlling organ of the body and center of consciousness; functions include perception, control of reactions to the environment, emotional responses, and judgment.
brain stem
The area of the brain between the spinal cord and cerebrum, surrounded by the cerebellum; controls functions that are necessary for life, such as respiration.
capillary vessels
The fine end-divisions of the arterial systems that allows contact between cells of the body tissues and the plasma and red blood cells.
carotid artery
The major artery that supplies blood to the head and brain.
carpometacarpal joint
the joint between the wrist and the metacarpal bones; the thumb joint
cecum
The first part of the large intestine, into which the ileum opens.
central nervous system (CNS)
the brain and spinal cord
cerebellum
One of the three major subdivisions of the brain, sometimes called the "little brain"; coordinates the various activities of the brain, particularly fine body movements.
cerebrum
the largest part of the three subdivisions of the brain, sometimes called the "gray matter"; made up of several lobes that control movement, hearing, balance, speech, visual perception, emotions, and personality
cervical spine
the portion of the spinal column consisting of the first seven vertebrae that lie in the neck
circulatory system
the complex arrangement of connected tubes, including the arteries, arterioles, capillaries, venules, and veins, that moves blood, oxygen, nutrients, carbon dioxide, and cellular waste throughout the body.
clavicle
the collarbone; it is lateral to the sternum and medial to the scapula
coccyx
the last three or four vertebrae of the spine; the tailbone
connecting nerves
nerves that connect the sensory and motor nerves I the spinal cord
costal arch
A bridge of cartilage that connects the ends of the sixth through tenth ribs with the lower portion of the sternum.
costovertebral angle
an angle that is formed by the junction of the spine and the tenth rib
cranium
The area of the head above the ears and eyes; the skull. The cranium contains the brain.
cricoid cartilage
a firm ridge of cartilage that forms the lower part of the larynx
cricothyroid membrane
A thin sheet of fascia that connects the thyroid and cricoid cartilages that makes up the larynx.
deep
further inside the body and away from the skin
dermis
The inner layer of the skin, containing hair follicles, sweat glands, nerve endings, and blood vessels.
diaphragm
A muscular dome that forms the under surface of the thorax, separating the chest from the abdominal cavity. Contraction of the diaphragm (and the chest wall muscles) brings air into the lungs. Relaxation allows air to be expelled from the lungs
diastole
The relaxation or period of relaxation, of the heart, especially on the ventricles.
digestion
the processing of food that nourishes the individual cells of the body
distal
structures that are farther from the trunk or nearer to the free end of the extremity
dorsal
the posterior surface of the body, including the back of the hand
dorsalis pedis artery
the artery on the anterior surface of the foot between the first and second metatarsals
endocrine system
The complex message and control system that integrates many body functions, including the release of hormones.
enzymes
Protein catalysts designed to speed up the rate of specific biochemical reactions.
epidermis
The outer layer of skin, which is made up of cells that are sealed together to form a watertight protective covering for the body.
epiglottis
A thin, leaf-shaped valve that allows air to pass into the trachea by prevents food or liquid from entering.
esophagus
A collapsible tube that extends from the pharynx to the stomach; contractions of the muscle wall of the esophagus propel food and liquids through it to the stomach.
extend
to straighten
extension
the straightening of a joint
fallopian tubes
long, slender tube that extends from the uterus to the region of the ovary on the same side, and through which the ovum passes from ovary to uterus
fascia
a sheet or band of tough fibrous connective tissue lies deep under the skin and forms an outer layer for the muscles
femoral artery
The principal artery of the thigh, a continuation of the external iliac artery. It supplies blood to the lower abdominal wall, external genitalia, and legs. It can be palpated in the groin area.
femoral head
The proximal end of the femur, articulating the acetabulum to form the hip joint.
femur
the thighbone; the longest and one of the strongest bones in the body
flex
to bend
flexion
the bending of a joint
floating ribs
the eleventh and twelfth ribs, which do not attach to the sternum through the coastal arch
foramen magnum
a large opening at the base of the skill through which the brain connects to the spinal cord
Fowler's position
the position in which the patient is sitting up with the knees bent
gallbladder
A sac on the undersurface of the liver that collects bile from the liver and discharges it into the duodenum through the common bile duct.
genital system
the male and female reproductive organs
greater trochanter
a bony prominence on the proximal lateral side of the thigh, just below the hip joint
hair follicles
the small organs in the skin that produce hair
heart
a hollow muscular organ that receives blood from the veins and propels it into the arteries
heart rate (Pulse)
The wave of pressure that is created by the heart's contracting and forcing blood out the left ventricle and into the major arteries.
hinge joints
joints that can bend and straighten but cannot rotate; the restrict movement to one plane
humerus
the supporting bone of the upper arm
hypoxic drive
the "backup system" to control respiration, senses drops in oxygen level in the blood
iliac crest
the rim, or wing, of the pelvic bone
ileum
one of 3 bones that fuse to for the pelvic ring
interior
The part of the body, or any body part, nearer to the feet.
inferior vena cava
one of the 2 largest veins in the body; carries blood from the lower extremities and the pelvic and abdominal organs into the heart
inguinal ligament
the tough, fibrous ligament that stretches between the lateral edge of the pubic symphysis and the anterior superior iliac spine
involuntary muscle
Muscle over which a person as no conscious control. It is found in many automatic regulating systems of the body.
ischium
one of 3 bones that fuse to for the pelvic ring
joint (articulation)
The place where 2 bones come into contact.
joint capsule
the fibrous sac that encloses a joint
kidneys
2 retroperitoneal organs that excrete the end products of metabolism as urine and regulate the body's salt and water content.
large intestine
The portion of the digestive tube that encircles the abdomen around the small bowel, consisting of the cecum, the colon, and the rectum. It helps regulate water and eliminate solid waste.
lateral
Parts of the body that lie farther from the midline. Also called out structures
ligament
A band of the fibrous tissue that connects bones to bones. It supports and strengthens a joint.
liver
A large solid organ that lies in the RUQ immediately below the diaphragm it produces bile, stores sugar for immediate use by the body, and produces many substance that help regulate immune responses.
lumbar spine
The lower part of the back, formed by the lower five nonfused vertebrae also called the dorsal spine.
lumbar vertebrae
vertebrae of the lumbar spine
mandible
the bone of the lower jaw
manubrium
the upper quarter of the sternum
mastoid process
a prominent bony mass at the bass of the skull behind the ear
maxillae
the upper jawbones that assist in the formation of the orbit, the nasal cavity, and the palate, and lodge the upper teeth,
medial
parts of the body that lie closer to the midline; also called inner structures
metabolism
The sum of all physical and chemical processes of living organisms; the process by which energy is made available for the use of the organism.
midaxillary line
An imaginary vertical line drawn through the middle of the axila (armpit), parallel to the midline.
midclavicular line
an imaginary vertical line drawn through the middle portion of the clavicle and parallel to the midline
midline
an imaginary vertical line drawn from the middle of the forehead through the nose and the umbilicus (naval) to the floor
motor nerves
Nerves that carry information from the central nervous system to the muscles of the body
mucous membranes
the lining of body cavities and passages that communicate directly or indirectly with the environment outside the body
mucus
the opaque, sticky secretion of the mucous membranes that lubricates the body openings
musculoskeletal system
the banes and voluntary muscles of the body
myocardium
the heart muscle
nasopharynx
The part of the pharynx that lies above the level of the roof of the mouth, or the soft palate.
nervous system
The system that controls virtually all activities of the body, both voluntary and involuntary.
occiput
The most posterior portion of the cranium.
orbit
the eye socket, made up of the maxilla and zygoma
oropharynx
A tubular structure that extends vertically from the back of the mouth to the esophagus and trachea.
ovary
a female gland that produces sex hormones and ova (eggs)
palmar
the front region of the hand
pancreas
A flat, solid organ that lies below the liver and the stomach; it is the major source of digestive enzymes and produces the hormone insulin.
parietal region
the areas between the temporal and occiput regions of the cranium
patella
The kneecap; a specialized bone that lies within the tendon of the quadriceps muscle.
perfusion
The circulation of oxygenated blood within an organ or tissue in adequate amounts to meet the cells current needs.
peripheral nervous system
The part of the nervous system that consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. These peripheral nerves may be sensory nerves, motor nerves, or connecting nerves.
peristalsis
The wave-like contraction of smooth muscle by which the ureters or other tubular organs propel their contents.
pinna
The external, visible part of the ear.
plantar
the bottom of the foot
plasma
A sticky, yellow fluid that carries the blood cells and nutrients and transports cellular waste material to the organs of excretion.
platelets
Tiny, disk-shaped elements that are much smaller than the cells; they are essential in the initial formation of a blood clot, the mechanism that stops bleeding.
pleura
The serous membrane covering the lungs and lining the thoracic cavity, completely enclosing a potential space known as the pleural space.
pleural space
The potential space between the parietal pleura and the visceral pleura. It is described as "potential" because under normal conditions, the lungs fill this space.
posterior
The back surface of the body; the side away from you in standard anatomic position.
posterior tibial artery
the artery just posterior to the medial malleolus; supplies blood to the foot
priaprism
A continuous and painful erection of the penis caused by certain spinal injuries and some diseases.
prone position
The position in which the body is lying face down.
prostate gland
A small gland that surrounds the male urethra where it emerges from the urinary bladder; it secretes a fluid that is part of the ejaculatory system.
proximal
structures that are closer to the trunk
pubic symphysis
a hard bony prominence that is found in the midline in the lowermost portion of the abdomen
pubis
one of three bones that fuse to form the pelvic ring
pulmonary artery
The major artery leading from the right ventricle of the heart to the lungs; it carries oxygen-poor blood.
pulmonary veins
The four veins that return oxygenated blood from the lungs to the left atrium of the heart.
pulse
The wave of pressure created as the heart contracts and forces blood out the left ventricle and into the major arteries.
quadrants
The way to describe the sections of the abdominal cavity.
radial artery
The major artery of the forearm; it is palpable at the wrist on the thumb side.
radius
the bone of the thumb side of the forearm
rectum
the lowermost part of the colon
red blood cells
Cells that carry oxygen to the body's tissues. Also called erythrocytes.
renal pelvis
A cone-shaped collecting area that connects the ureter and the kidney.
respiratory system
All the structures of the body that contribute to the process of breathing, consisting of the upper and lower airways and their component parts.
retroperitoneal
behind the abdominal cavity
sacrum
one of the three bones (sacrum and 2 pelvic bones) that make up the pelvic ring; consists of 5 fused vertebrae
salivary glands
The glands that produce saliva to keep the mouth and pharynx moist.
scalp
The thick skin covering the cranium, which usually bears hair.
scapula
the shoulder blade
sebaceous glands
Glands that produce an oily substance called sebum, which discharges along the shafts of the hairs.
semen
seminal fluid ejaculated from the penis and containing sperm
seminal vesicles
Storage sacs for sperm and seminal fluid, which empty into the urethra at the prostate.
sensory nerves
the nerves that carry sensations of touch, taste, hear, cold, pain, or other modalities from the body to the central nervous system
shock position
The position that has the head and torso (trunk) supine and the lower extremities elevated 6" to 12". This helps to increase blood flow to the brain; also referred to as the modified trendelenburg's position.
shoulder girdle
The proximal portion of the upper extremity, made up of the clavicle, scapula, and the humerus.
skeletal muscle
Muscle that is attached to bones and usually crosses at least one joint; striated, or voluntary, muscle.
skeleton
the framework that gives us our recognizable form; also designed to allow motion of the body and protection of vital organs
small intestine
The portion of the digestive tube between the stomach and the cecum, consisting of the duodenum, jejunum, and ileum.
smooth muscle
nonstriated, involuntary muscle; it constitutes the bulk of the gastrointestinal tract and s present in nearly every organ to regulate automatic activity
somatic nervous system
The part of the nervous system that regulates activities over which there is voluntary control.
spinal cord
An extension of the brain composed of virtually all the nerves carrying messages between the brain and the rest of the body. It lies inside of, and is protected by, the spinal canal.
sternocleidomastoid muscles
The muscles on either side of the neck that allow movement of the head.
sternum
the breastbone
striated muscle
Muscle that has characteristic stripes, or striations, under the microscope; voluntary or skeletal, muscle.
subcutaneous tissue
Tissue, largely fat, that lies directly under the dermis and serves as an insulator of the body.
superficial
Closer to or on the skin.
superior
The part of the body, or any body part, nearer to the head.
superior vena cava
one of the two largest veins in the body; carries blood from the upper extremities, head, neck, and chest to the heart
supine position
the position of the body when lying face up
sweat glands
the glands that secrete sweat, located in the dermal layer of the skin
systole
the contraction, or period of contraction, of the heart, especially of the ventricles
temporal regions
the lateral portions on each side of the cranium
temporomandibular joint
the joint where the mandible meets with the temporal bone of the cranium just in front of each ear
testicle
a male genital gland that contains specialized cells that produce hormones and sperm
thoracic cavity
the chest or rib cage
thoracic spine
The 12 vertebrae that lie between the cervical vertebrae and the lumbar vertebrae. One pair of ribs is attached to each of the thoracic vertebrae
thorax
the chest cavity that contains the heart, lungs, esophagus, and great vessels (the aorta and the 2 vena cava)
thyroid cartilage
a firm prominence of cartilage that forms the upper part of the larynx; the Adam's apple
tibia
The shinbone, the larger of the 2 bones of the lower leg.
topographic anatomy
The superficial landmarks of the body that serve as guides to the structures that lie beneath them.
torso
the trunk without the head or limbs
trachea
the windpipe; the main trunk for air passing to and from the lungs
trendelenburg's position
the position in which the body is supine with the head lower than the feet
triceps
the muscle in the back of the upper arm
ulna
the inner bone of the forearm, on the side opposite the thumb
ulnar artery
one of the major arteries of the forearm; it can be palpated at the wrist on the ulnar side(at the base of the 5th finger)
ureter
a small, hallow tube that carries urine from the kidneys to the bladder
urethra
the canal that conveys urine from the bladder to outside the body
urinary bladder
A sac behind the pubic symphysis made of smooth muscle that collects and stores urine.
urinary system
The organs that control the discharge of certain waste materials filtered from the blood and excreted as urine.
vagina
The muscular distensible tube that connects the uterus with the vulva (the external female genitalia); also called the birth canal.
vasa deferentia
the spermatic duct of the testicles; also called the vas deferens
ventral
the anterior surface of the body
ventricle
the lower chamber of the heart
vertebrae
the 33 bones that make up the spinal column
voluntary muscle
muscle that is under the direct control of the brain and can be constricted and relaxes at will; skeletal, striated muscle
White blood cells
blood cells that play a role in the body's immune defense mechanisms against infection; also called leukocytes
xiphoid process
the narrow, cartilaginous lower tip of the sternum
zygomas
The quadrangular bones of the cheek, articulating with the frontal lobe, the maxillae, the zygomatic processes of the temporal bone, and the great wings of the sphenoid bone.
RUQ
most of the liver, the gallbladder, a bit of the stomach, large and small intestine
LUQ
Most of the stomach, the spleen, about a third of the liver. Some of the large and small intestine
RLQ
the appendix, the cecum, half the rectum, some of the large and small intestine
LLQ
the colon, half the rectum, some of the large and small intestine
Bones of the Skull
Parietal, frontal, sphenoid, nasal, ethmoid, maxillae, mandible, Vomer, middle and inferior nasal concha, zygomatic, lacrimal, temporal, palatine, occipital
jugular notch
Superior border of the sternum. Easily palpable
scapulae
Posterior section of shoulder girdle. Overlie the thoracic wall.
fibula
Small bone of the lower leg. Lies on the lateral side of the calf.
Achilles tendon
attaches to the calcaneus of the foot
calcaneus
heel bone
medial malleous
the end of the tibia where it meets the foot structure
talus
the first bone of the foot structure; meets with the medial malleolus of the tibia, the calcaneus, and the navicular
navicular
The first bone toward the toes of the foot after the talus.
medial cuneiform
after the navicular, the last full foot bone before the metatarsals
metatarsals
First joint bones of the foot. Connect the main foot to the phalanges
phalanges
The 2 bones of each toe.
sternoclavicular joint
The joint between the clavicle and the top of the sternum. Little motion happens here
acromioclavicular (A/C) joint
The joint between the clavicle and the acromion process. Little motion happens here
glenohumeral joint
Shoulder joint. The joint between the humerus and the glenoid fossa. Ball and socket joint
glenoid fossa
The small bowl of the scapula that meets with the humerus to form the shoulder joint.
acromion process
the outcropping of the scapula that meets with the clavicle in the A/C joint
lateral condyle
the outer distal nub of the Humerus, meets with radius and ulna
auscultation
a method of listening to sounds within an organ with a stethoscope
AVPU scale
a method of assessing level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli, or pain, or unresponsive; used early in the assessment.
radial styloid
the distal end of the radius that meets with the hand bones
ulnar styloid
the distal end of the ulna that meets with the arm bones
bradycardia
slow heart rate, less than 60 bpm
capillary refill
The ability of the circulatory system to restore blood to the capillary system.
medial condial
the inner distal nub of the humerus
olecranon process
the proximal end of the ulna, meets with the humerus
chief complaint
The reason a patient called for help. Also, the patient's response to "what's wrong?"
conjunctiva
The delicate membrane lining the eyelids and covering the exposed surface of the eye.
cyanosis
A bluish-grey skin color that is caused by reduced levels of oxygen in the blood.
meniscus
the cartilage buffer between the femur and the tibia
diaphoretic
characterized by profuse sweating
synovium
diastolic pressure
The pressure that remains in the arteries during the relaxing phase of the heart's cycle (diastole) when the ventricles are at rest.
articulate cartilage
Cartilage that covers the end of bones at joints, protecting them but allowing them to bend.
hypertension
blood pressure that is higher than the normal range
pharynx
the joint passage created by the meeting of nasopharynx and the oropharynx
hypotension
blood pressure that is lower than the normal range
larynx
Complex arrangement of tiny bones, cartilage, muscles, and 2 vocal cords. Cannot tolerate solid material.
jaundice
a yellow skin or sclera color that is caused by liver disease or dysfunction
bronchioles
smaller shoots off the main bronchi
labored breathing
Breathing that requires visibly increased effort; characterized by grunting, stridor, and use of accessory muscles.
main bronchi
tubes off the carina that go directly into the lungs
OPQRST
Acronym for key terms used to assess patients symptoms: onset, provocation/pallation, quality, region/radiation, severity, and timing of pain.
carina
Ending of the trachea, beginning of the divide that leads into the lungs.
pulse oximetry
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
How many lung lobes are there and on which sides?
Right - 3; Left - 2
Content of exhaled air
16% oxygen, 3-5% CO2, the rest is nitrogen.
SAMPLE history
A brief history of the patient’s condition: Signs/symptoms, Allergies, medications, Pertinent past history, Last oral intake/Last menstruation, Events leading up to incident or illness.
cyanotic
blue skin caused by lack of proper blood circulation
sclera
the white portion of the eye
Normal respiration rates
12-20 Adults; 15-30 Children; 25-50 infants
signs
objective findings that can be seen, heard, felt, smelled, or measured
Sinoatrial (SA) Node
pacemaker of the heart, begins the electric pulse
sniffing position
An unusually upright position in which the patients head and chin are thrust slightly forward.
Atriventricular (AV) node
Second stop of the properly working electrical pulse of the heart.
spontaneous respiration
breathing in a patient that occurs with no assistance
Purkinje Fibers
The electrical impulse of the hear travels from the AV Node to these.
stridor
A harsh, high-pitched, crowing inspiratory sound, such as often heard in acute laryngeal (upper airway) obstruction.
Spleen
Solid organ, in the ULQ. Susceptible to blunt force trauma, can lead to severe internal bleeding.
symptoms
Subjective findings that the patient feels but that can only be identified by the patient
How much blood is in the vascular system of an adult? A child? An infant?
~6L, ~3L, ~300mL
systolic pressure
The increase pressure along an artery with each contraction (systole) of the ventricle.
Cerebrospinal Fluid (CSF)
Bathes the brain and spinal cord and cushions them, filtering out impurities and toxins. Leaks from ear during severe skull fracture.
tachycardia
rapid heart rhythm, more than 100 bpm
Adrenal Gland
Location: Kidneys. Regulates Salt, sugar, and sexual function. Produces Adrenaline (epinephrine, etc.)
tidal volume
the amount of air that is exchanged with each breath
Ovary
In Female pelvis; regulates sexual function, characteristics, and reproduction. Produces Estrogen and others
tripod position
an upright position in which the patient leans forward onto two arms stretched forward and thrusts head and chin forward,
Parathyroid
in Neck; regulates serum calcium
vasoconstriction
narrowing of blood vessels
Pituitary
Base of skull; regulates all other endocrine glands.
vital signs
The key signs used to evaluate the patient's overall condition: respirations, pulse, blood pressure, level of consciousness, skin characteristics.
Thyroid
Neck, over larynx; regulates metabolism.
Normal Heart Rates
Adult: 60-100 bpm; Child: 70-150 bpm; infant: 100-160 Bpm
PEARRL
Pupils Equal And Round, Regular in size, responsive to Light
Opiates effect on pupils
Constriction
Blown pupil
The eye can no longer receive commands from the brain due to pressure on the occulomotor nerve, perhaps from the pressure of intracranial bleeding. They become fully dilated and fixed.
Things the eyes will do if the patient has depressed brain function
Fixed with no reaction to light; reversed light reactions; react sluggishly; unequal in size; unequal in size with the addition of removal of light.
Systolic BP ranges
Adults: 90-140; Children: 80-110; infants: 50-95
palpation
feeling parts of the body with the fingers
BP palpation method
Using the radial pulse and a BP cuff to get the systolic pressure. Diastolic pressure cannot be ascertained.
potential reasons for a decrease in BP
lose of blood or its fluid component; loss of vascular tone and sufficient arterial constriction to maintain the needed pressure even without actual fluid or blood loss; cardiac pumping issue
Healthy person skin is:
Warm, dry, and pink.
How long for Capillary Refill?
<2 sec
What are you checking with pulse
Rate, Strength, and Regularity
What are you checking with respiration?
Rate, Quality(rhythm, Effort, sound), Depth
Describe Shallow breathing?
decrease chest or abdominal wall motion
Describe labored breathing
increased breathing effort; use of accessory muscles; possible gasping; nasal flaring, supraclavicular and intercostal retractions in infants and children
describe noisy breathing
Increase in breathing sound, including snoring, wheezing, gurgling, crowing, grunting, and stridor.
backboard
a device that is used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury. Also called a spine board, trauma board, or longboard.
basket stretcher
A rigid stretched commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom. Also call a Stokes littler.
diamond carry
a carrying technique in which one EMT-B is located at the head end, one at the foot end, and one at each side of the patient; each of the two EMT-B's at the sides uses one hand to support the stretcher so that they are all able to face forward as they walk.
direct ground lift
A Lifting technique that is used for patients who are found lying supine on the ground with no suspected spinal injury.
emergency move
A move in which the patient is dragged or pulled from a dangerous scene before initial assessment and care are provided.
extremity lift
A lifting technique that is used for patients who are supine or in a sitting position with no suspected extremity or spinal injuries.
flexible stretcher
A stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.
portable stretcher
A stretcher with a strong rectangular tubular metal from and rigid fabric stretched across it.
power grip
A technique in which the litter or backboard is gripped by inserting each hand under the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb.
power lift
A lifting technique in which the EMT-B's back is held upright, with legs bent, and the patient is lifted when the EMT-B straightens the legs to raise the upper body and arms.
rapid extrication technique
A technique to move a patient from a sitting position inside a vehicle to a supine on a backboard in less than 1 minute when the conditions do not allow for standard immobilization.
scoop stretcher
a stretcher that is designed to be split into two or four sections that can be fitted around a patient who is lying on the ground or other relatively flat surface; also called a split litter.
stair chair
A lightweight folding device that is used to carry a conscious, seated patient up or down stairs.
wheeled ambulance stretcher
A specially designed stretcher that can be rolled along the ground. A collapsible undercarriage allows it to be loaded into the ambulance. Also called the cot or an ambulance stretcher.
kyphosis
A spinal malady that causes the back to bow out at the top.
spondylosis
A spinal malady that causes the top of the spine to cave in, giving a hunched over appearance.
Bariatrics
The branch of medicine that is concerned with the management (prevention and control) of obesity and its allied diseases.
osteoporosis
brittle bones
draw sheet carry
Place the cot next to the bed at the same height. With the patient on the blanket, grasp the blanket at the patients head, chest, hips and knees. Slide the patient onto the cot
front cradle
one rescuer move, EMT carries patient in front of him while supine, with his arms under the patients knees and shoulders
fire fighter's drag
The met ties the patients hands together and loops them around his neck. He then crawls with the patient under him
One-person walking assists.
fire fighters carry
The EMT puts the patient over his own shoulder, with the split of the legs on one shoulder. The EMT the grasps the patient by the knee and wrist.
Pack strap
The patient is behind the EMT facing his back. The patient has her arms over the EMT's shoulders and he is grasping her arms to lift her off her feet.
Emergency dragging methods
Emergency clothes drag; blanket drag; arm drag; arm to arm drag.
Safe Reaching and pulling
1. Put yourself on the same plane as the patient you are dragging. 2. Never extend your arms past 15" to 20". 3. Pull the patient by flexing your arms. 4. Reposition yourself 15" or so away and repeat.
Feet position when lifting
approx. 15" apart
agonal respirations
occasional gasping breaths that have occurred after the heart has stopped
airway
the upper airway tract or the passage above the larynx, which includes the nose, mouth and throat
American Standard System
a safety system for oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas
apnea
a period of not breathing
aspiration
the introduction of vomitus or other foreign material into the lungs
ataxic respirations
irregular, ineffective respirations that may or may not have an identifiable pattern
bag-valve-mask (BVM) device
a device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, delivers more the 90% supplemental oxygen
barrier device
a protective item, such as a pocket mask with a valve, that limits exposure to a patient’s body fluids
bilateral
a body part or condition that appears on both sides of the midline
compliance
the ability of the alveoli to expand when air is drawn in during inhalation
cricoid pressure
pressure on the cricoid cartilage; applied to occlude the esophagus in order to inhibit gastric distention and regulation of vomitus in the unconscious patient
diffusion
a process in which molecules move from one area of higher concentration to an area of lower concentration
dyspnea
difficulty breathing
exhalation
the passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs
gag reflex
a normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat
gastric distention
a condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation
head tilt-chin lift maneuver
a combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients
hypoxia
a dangerous condition in which the body tissues and cells do not have enough oxygen
hypoxic drive
Conditions in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung disease.
inhalation
the active, muscular part of breathing that draws air into the airway and lungs
ischemia
a lack of oxygen that deprives tissues of necessary nutrients
jaw-thrust maneuver
technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury
labored breathing
breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles,
metabolism
The biochemical process that results in the production of energy from nutrients within the cells.
mild airway obstruction
Occurs when a foreign body partially obstructs the patient’s airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress
minute volume
the volume of air moved through the lungs in 1 minute; calculated by multiplying tidal volume and respiratory rate
nasal cannula
an oxygen-delivery device in which oxygen flows through 2 small, tube-like prongs that fit into the patient's nostrils; delivers 24%-44$ supplemental oxygen, depending on the flow rate.
nasopharyngeal (nasal) airway
airway adjunct inserted into the nostril of a conscious patient who is unable to maintain airway patency independently
nonrebreathing mask
a combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide)
oropharyngeal (oral) airway
Airway adjunct inserted into the mouth to keep the tongue from blocking the upper airway and to facilitate suctioning the airway.
patent
open, clear of obstruction
pin-indexing system
a system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas
pneumothorax
a partial or complete accumulation of air in the pleural space
recovery position
A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.
retractions
movements in which the skin pulls in around the ribs during inspiration
Sellick maneuver
a technique that is used to prevent gastric distention in which pressure is applied to the cricoid cartilage; also referred to as cricoid pressure
sever airway obstruction
Occurs when a foreign body completely obstructs the patient’s airway. Patients cannot breath, talk, or cough.
stoma
an opening through the skin and into an organ or other structure; a stoma in the neck connects the trachea directly to the skin
suction catheter
a hollow, cylindrical device used to remove fluid from the patient's airway
tidal volume
the amount of air moved in or out of the lungs during one breath
tonsil tips
Large, semi-rigid suction tips recommended for suctioning the pharynx; also called Yankauer tips.
ventilation
Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT-B.
The Upper airway
Nasal air passage, nasopharynx; mouth, oropharynx; pharynx; epiglottis
The Lower Airway
Larynx, trachea, main bronchi, bronchioles, alveoli
Avg. Tidal Volume for a man
500 mL
0-1 min without air
cardiac irritability
0-4 min without air
brain damage not likely
4-6 min without air
brain damage possible
6-10 min without air
brain damage very likely
>10 min without air
irreversible brain damage
surfactant
a chemical produced by the alveoli that help to keep the alveoli open to make diffusion more efficient,
Early signs of hypoxia
restlessness, irritability, apprehension, tachycardia, and anxiety
Late signs of hypoxia
Mental status change, weak pulse, cyanosis.
Conditions associated with Hypoxia
Heart attack; pulmonary edema; acute narcotic or sedative overdose; inhalation of smoke/toxic fumes; Stroke; Shock; COPD; Asthma; premature birth
Myocardial Infarction
Heart attack; occurs when there is inadequate circulation of oxygen-carrying blood to the tissues of the heart.
Pulmonary edema
Fluid accumulates in the lungs
hypoperfusion
Shock
COPD
Chronic Obstructive Pulmonary Disease
Cerebrovascular Accident
Stroke
Adequate Breathing signs
Normal rate; regular pattern; bilateral clear and equal lung sounds; regular and equal chest rise; adequate tidal volume
Inadequate Breathing Signs
respiratory rate less than 12 or more than 20; irregular rhythm; auscultated breath sounds absent, diminished, or noisy; reduced flow of air at the nose and mouth; unequal or inadequate chest expansion; increased effort; shallow; pale; cyanotic, cool, moist, clammy skin; skin pulling in around the ribs or above the clavicles
Cheyne-Stokes respirations
Seen in patients with strokes or serious head injuries; irregular patterns of breathes with increasing rate and depth followed by a period of apnea, then repeated.
Indications for an oropharyngeal airway
unconscious patient without a gag reflex; any apneic patient being ventilated with a BVM
reasons to use a oropharyngeal
keep the tongue from blocking the airway; make it easier to suction
Contraindications for oropharyngeal airway use
conscious patient; any patient with an intact gag reflex
How to you choose the correct size of Oropharyngeal
measure from patients earlobe to the corner of their mouth on the same side of the face
Nasopharyngeal airway use
Use on a patient with an intact gag reflex, altered mental status, or seizure.
contraindications for nasopharyngeal
head or face trauma
how to measure a nasopharyngeal
tip of the patients nose to the earlobe
Suction for a fixed suctioning unit
300 mm HG
How long can you suction?
Never more than 15 sec; then follow with 2 minutes of ventilation
Suctioning times:
adult: 15sec; Child: 10 sec; Infant: 5 sec
Volume of a D cylinder
350 mL
Volume of a Super D cylinder
500mL
Volume of an M cylinder
3000 mL
formula for duration of flow on a tank:
(gauge pressure in psi-the safe residual pressure)xConstant/flow rate in L/min = duration of flow in minutes
Pressure of gas in a full oxygen tank
~2000 psi
How low to change out an oxygen tank
~500 psi
pressure -compensated flowmeter
Used on bigger, fixed tanks; has a float ball within a tapered calibration tube.
Bourdon-gauge flowmeter
Not affected by gravity; used on portable units but susceptible to cold.
Rates on Nasal Cannula
Flow: 1-6 L/min; O2 Delivered: 24-44%
Rates on Nonrebreathing mask
Flow: 10-15 L/Min; O2 delivery: up to 90%
Rates on BVM device with respirator
15 L/min-flush; O2 delivery: nearly 100%
Ventilation rates
Adult: 1 breath every 5 sec; child/infant: 1 breath every 3-5 sec
What is the most common airway obstruction?
the tongue
Sure sign of airway obstruction
inability to speak or cough
Accessory muscles
The secondary muscles of respiration
avpu
a method of assessing a patient's level of consciousness by determining whether a patient is awake and alert, responsive to verbal stimulus or pain, or unresponsive; used principally in the initial assessment.
Body Substance Isolation (BSI)
And infection control concept and practice that assumes that all bodily fluids are potentially infectious
Breath sounds
An indication of air movement in the lungs, usually assessed with assessed with a stethoscope
Capillary refill
A test that evaluates distal circulatory system functioned by squeezing (blanching) the blood from an area such as a nail bed and watching the speed of its return after releasing the pressure
Chief complaint
The reason the patient called for help; also, the patient's response to general questions such as "what's wrong?" Or "what happened?"
coagulate
to form a clot to plug an opening in an injured blood vessel and stop the bleeding
conjunctiva
The delicate membrane that lines the eye lids and covers the exposed surface of the eye
crepitus
a greeting or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin to produce a crackling sound or crinkly feeling
cyanosis
bluish gray skin color that is caused by reduced oxygen levels in the blood
DCAP-BTLS
A mnemonic for assessment in which each area of the body is evaluated for deformities, contusions, operations, punctures/penetrations, Burns, tenderness, lacerations, and swelling.
Detailed physical exam
The part of the assessment process in which a detailed area-by-area exam is performed on patients whose problems cannot be readily identified or when more specific information is needed about problems identified in the focused history and physical exam
Focused history and physical exam
The part of the assessment process in which the patient's major complaints or any problems that are immediately evident are further and more specifically evaluated.
Frostbite
Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts.
General impression
the overall initial impression that determines the priority for patient care; based on the patient's surroundings, the mechanism of injury, signs and symptoms, and the chief complaint.
Golden hour
The time from injury to definitive care, during which treatment of shock or dramatic injuries should occur. Because survival potential is best.
Guarding
Involuntary muscle contractions (spasm) of the abdominal wall in an effort to protect me inflamed abdomen; a sign of peritonitis.
Hypothermia
A condition in which the internal body temperature falls below 95°F (35°C) after exposure to a cold environment.
Initial assessment
The part of the assessment process that helps you to identify any immediately or potentially life-threatening conditions so that you can initiate lifesaving care.
Jaundice
A yellow skin color that is seen in patients with liver disease or dysfunction.
mechanism of injury (MOI )
The way in which dramatic injuries occur; the forces that acts on the body to cause damage.
Nasal flaring
Flaring out of the nostrils, indicating that there is an airway obstruction.
Nature of illness (NOI )
The general type of illness of patients experiencing.
Ongoing assessment
The part of the assessment process in which problems are reevaluated and responses to treatment are assessed.
Orientation
The mental status of a patient as measured by memory of person (name), place (see current location), time (see), and event (what happened).
OPQRST
The 16 questions: Onset, Provoking factors, Quality, Or radiation, Severity, Time.
Palpate
Examined by touch.
Paradoxical motion
To have the motion of the chest wall section that is detached in a flail chest; the motion is exactly the opposite of normal motion during breathing (i.e., in during inhalation, out during exhalation).
rales
Crackling, rattling, breath sound signals fluid in the air spaces of lungs; also called crackles.
Responsiveness
the way in which a patient response to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli
Retractions
Movement in which the skin pulled in around the ribs during inspiration.
rhonchi
Course, low-pitched sounds heard in patients with chronic mucus in the airways.
SAMPLE history
A key brief history of a patient's condition to determine signs/symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the illness/injury.
Scene size-up
A quick assessment of the scene and the surroundings made to provide information about its safety and the mechanism of injury or nature of illness, before you enter and begin patient care.
Sclera
The white portion of the eye; the tough outer coat that gives protection to the delicate, alike-sensitive, inner layer.
Stridor
A harsh, high-pitched inspiratory sound that is often heard in cute laryngeal (see upper airway) the obstruction; it may sound like Crow Wing and be audible without a stethoscope.
Subcutaneous emphysema
The presence of air in soft tissues causing a characteristic crackling sensation on palpation.
Triage
The process of establishing treatment and transportation priorities according to severity of injury and medical need.
Two- to three-word dyspnea
A severe breathing problem in which a patient can speak only 2 to 3 words at a time without pausing to take a breath.
Possible dangers at scene
Ongoing traffic; unstable surfaces; leaking fluids and fumes; broken utility poles and downed electrical wires; aggravated or hostile bystanders; smoke or fire; possible hazardous and toxic chemicals; crash or rescue scenes with unstable elements; such as unsecured vehicle; the violence and crime scenes
the three factors that you evaluate to predict potential for serious injury when using the mechanism of injury
The amount of force applied to the body; the length of time the force was applied; in the areas of the body that are involved
Most common orientation tests
Person, place, time, event
High priority patients that should be transported immediately
Difficulty breathing; poor general impression; unresponsive with no gag or cough reflexes; severe chest pain, especially when the systolic blood pressure is less than 100 mg of mercury; pale skin, or other signs of poor perfusion complicated childbirth; uncontrolled bleeding; responsive but unable to follow commands; severe pain in any area of the body are going inability to move any part of the body
Breakdown of the golden hour
First 20 minutes: discovery of incident and activation of EMS; "The Platinum 10 Minutes": initial assessment and intervention; minutes 31 through 40: EMS packaging and transport; last 20 minutes: initial Hospital stabilization
decapitated Beatles
By mnemonic for remembering DCAP-BTLS
Order of the focused physical exam
Head and neck and cervical spine; chest and breath sounds; abdomen; Pelvis; extremities; posterior body
The three types of physical exam techniques
Inspection/look, palpation/feel, auscultation/listen
What are the things that you check for on the extremities
Pulse, motor function, sensory function
PMS
Polls, motor fortune, sensory function
The focused history and physical exam on a responsive patient
History of illness, sample history, focused medical assessment based on chief complaint, they find vital signs, reevaluate transport decision
The focused history and physical exam on an unresponsive patient
Rapid medical assessment, baseline vital signs, sample history, reevaluate transport decision
Steps of a detailed physical exam
Perform detailed physical exam; reassess vital signs
What are the three questions you ask during the ongoing assessment
Has treatment improved the patient's condition? Has the already identified problem gotten better? Worse? What is the nature of any newly identify problems?
What are the steps of the ongoing assessment
Repeat the initial assessment; reassessing record vital signs: repeat your focus assessment regarding patient complaint or injuries, including questions about the patient's history; check interventions
Where the individual steps of repeating the initial assessment during ongoing assessment
Reassessment of status; making an open airway; monitor the patient's breathing; reassess pulse rate and quality; monitors skin color and temperature; reestablished patient priorities
What are the individual steps of checking the interventions during ongoing assessment
Ensure adequacy of oxygen delivery/artificial ventilation; ensure management bleeding; ensure adequacy of other interventions
Parts of the scene size-up
Body substance isolation; seen safety; mechanism of injury/nature of illness; number of patients; additional resources; C-Spine immobilization
Parts of the initial assessment
General impression; mental status; airway; breathing; circulation; priority patients and transport decisions
Parts of the focused history and physical exam for responsive patient
History of illness; sample history; focused medical assessment based on chief complaint; baseline vitals; reevaluate transport
Participant focused history and physical exam for an unresponsive patient
Rapid medical assessment; baseline vitals; sample history; reevaluate transport
Focused history and physical exam for a significant mechanism of injury
Rapid trauma assessment; baseline vitals; sample history; reevaluate transport
Focus history and physical exam for no significant mechanism of injury
Focus, assessment based on chief complaint; baseline vitals; sample history; reevaluate transportation
Parts of the detailed physical exam
Perform the detailed physical exam; reassess vital signs
Parts of the ongoing assessment
Repeat initial assessment; reassessed and record vital signs; repeat focused assessment; check interventions
Base station
Any radio hardware containing a transmitter and receiver that is located in a fixed place
Cellular telephone
A low-power portable radio that communicates through an interconnected series of repeater stations called cells
Channel
an assigned frequency or frequencies that are used to carry voice and/or data communications
Dedicated line
A special telephone line that is used for specific point-to-point communications; also known as a hot lime
Duplex
The ability to transmit and receive simultaneously
Federal Communications Commission (FCC )
The federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite mutations, all of which may involve EMS activity
MED channels
VHF and UHF channels that the FCC has designated exclusively for EMS use
Paging
the use of radio signal and a voice or digital message that is transmitted to pagers or desktop monitor radios
Rapport
A trusting relationship that you build with your patient
Repeater
A special base station radio that receives messages and signals on one frequency, and then automatically retransmits them a second frequency
Scanner
A radio receiver that searches or scans across several frequencies and until the message is completed; the process is then repeated
Simplex
Single frequency radio; transmission can occur in either direction but not simultaneously both Emma: when one party transmits, the other can only receive, and the part it is transmitting is unable to receive
Standing orders
Written documents, signed by the EM ASP system's medical director, that outlined specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols
Telemetry
A process in which electronic signals are converted into coded, audible signals by; the signals can then be transmitted by radio or telephone to a receiver at the hospital with a decoder
UHF (ultrahigh frequency)
Radio frequencies between 303,000 MHz
VHF (very high frequency)
Radio frequencies between 30 space and 300 MHz; the VHF spectrum is further divided into high and low ends
How much power the PlayStation have
Often 100 W or more
What are the five principal EMS related responsibilities of the FCC
1. Allocating specific radiofrequency for use by EMS providers; 2. Licensing base station and assigning appropriate radio call signs for the station; 3. Establishing licensing standards and offerings vacations for radio used by EMS providers; 4. Establishing limitations for transmitter power output; 5. Monitoring radio operations
What are things the dispatcher must do during a call
Properly screened and assigned prior to each call; selectable or the appropriate EMS response unit; dispatching direct EMS response units to the correct location; coordinate EMS response units with other public safety services until the incident is over; provide emergency medical structures that telephone call or so that essential care may begin before the EMTs arrive.
What are the things that dispatcher uses to assign the appropriate EMS response unit
The nature and severity of the problem; the anticipated response onto the scene; the level of training; the need for additional EMS units, fire suppression, rescue, a hazmat team, air medical support, or log force
What information did the dispatcher give the responding unit?
The nature and severity of the injury, illness, or incident; the exact location of the incident; the number of pages; responses by other public safety agencies; special directions or advisories, such as adverse road or traffic conditions, severe weather reports, or potential seen hazards; the time at which the unit or units are dispatched
Things that the EMS unit should tell the dispatcher
Any problems during the response; when you arrive at the scene; any obvious details that you see during scenes as a
Elements of the patient report (7)
1. Your unit identification level of services; 2. The receiving hospital and your estimated time of arrival 3. The patient's age and gender; 4. The patient's chief complaint or your perception of the problem and its severity; number five. A brief history of the patient's current problem; 6. A brief report of the findings; 7. A brief summary of the caregiving in any patient response
CMED
Centralized medical emergency dispatch
How should you deal with special situations
the earlier the notification of the better; asked to speak to the charge nurse or physician in charge; provide an estimate of the number of individuals who may be transported to the facility; be sure to identify any conditions the patient might have that require special meanings.
What are you reporting requirements
1. To ignore the dispatch information; 2. For that arrival at the scene; 3. Announce that you are leaving; 4. Announce your arrival at the hospital; 5. To announce that you are clear of the incident; 6. Announce your arrival back at headquarters
What are some guidelines for effective radio communication?
1. Monitor the channel before transmitting; 2. Plan your message before pushing the transmit switch; 3. Press the push to talk button on the radio; 4. Hold the microphone to 3 inches from your mouth; 5. Another person or unit you are calling; 6. Acknowledged transmission as soon as you can; 7. Use plain English; 8. Keep your message brief; 9. Avoid voicing negative emotions; 10. When transmitting a number with two or more digits say the entire number first and then each digit separately; 11. Do not use profanity on the radio; 12. Use EMS frequencies for EM excommunications; 13. Reduce background noise as much as possible; 14. Be sure other radios in the same frequency are turned off or down
What are the six components of an oral report?
1. The patient's name and chief complaint nature of illness or mechanism of injury; 2. More detailed information of what you gave me a radio report; 3. Any important history that has not been given already; 4. The patient's response to treatment given and route; 5. The biosynthesis during transport and after the radio report; 6. Any other information that you may have gathered that was not important to report sooner
Things to consider when communicating with a patient whose hearing-impaired
Have different and available; patient can read lips, you should face the patient speak slowly and distinctly; never shop; be sure to listen carefully asked for questions and give short answers; licensable phrases in sign language
What is the information collected on the prehospital care report?
Chief complaint; level of consciousness or mental status; systolic blood pressure for patients older than three years; A. refill for patient demand and Sixers; skin color and temperature; pulse; respirations and effort; the time that the incident was reported; the time that the EMS unit was notified; a time that the EMS unit arrived at the scene; the kind of the EMS unit left the scene; time that the EMS unit arrived at the receiving facility; the time the patient was transferred
One of the six functions for prehospital report serves?
1. Continuity of care; and 2. Legal documentation; 3. Education; 4. Administrative; 5. Essential research record; 6. Evaluation and continuous quality improvement
What do you do the discover errors in your report question?
Dry single horizontal line through the air, initial it, and write the correct information act to it. Do not try to erase or cover the error with correction fluid.
What he discovered here after you submit your report?
Try single entity error, preferably in a different color ink, initially, and they.
What are some considerations when documenting refusal of care?
She should have a family member, police officer, or bystander sign the form as a witness. If the patient refuses to sign the refusal form, have a family member, police officer, or bystander signed up for verifying that the patient refused to sign.
What are some special reporting situations?
Gunshot wounds, dog bites, certain infectious diseases, or suspected physical, sexual, or substance abuse. Also, mass casualty incidents
Absorption
The process by which medications travel through body tissues until they reach the blood stream
Action
The therapeutic effect of medication on the body
Activated charcoal
An oral medication that binds to and adsorbs ingested toxins in the gastrointestinal tract for treatment of some poisonings and medication overdoses. Charcoal is ground into a very fine powder that provide the greatest possible surface area for binding medications been taken by mouth; it is carried on the EMS unit
Absorption
The process of binding or sticking to the surface
Aspirin (acetylsalicylic acid, or ASA)
Medication is an antipyretic (reduces fever), analgesic (reduces pain), anti-inflammatory, and potent inhibitor of platelet aggregation (clumping)
Contraindications
Conditions that make a particular medication or treatment inappropriate. For example, a condition in which a medication should not be given because it would not help me to harm a patient
Dose
The amount of medication given on the basis of patient size and age
Epinephrine
The medication increases heart rate and blood pressure but also ease his breathing problems by decreasing muscle tone of the bronchial tree; you may be allowed to help the patient self administer the medication
gel
A semi liquid substance that administered orally in capsule form or through plastic tubes
Generic name
The original chemical name of the medication (in contrast with one of its trade names.); The name is not capitalized
Hypoglycemia
An abnormally low blood glucose level
Indications
Therapeutic uses for specific medication
Inhalation
Reading into the world; and medication delivery route
Intramuscular injection
Injection into a muscle; the medication delivered a
Intra-osseous
Into the bone; and medication delivery route
Intravenous injection
Injection directly into a vein; and medication delivery route
Metered dose inhaler
Miniature spray canisters through which droplets or particles of medication may be inhaled
Natural glycerin
Medication increases cardiac perfusion by causing arteries dilate; maybe love to help patients of administer the medication
Oral
By mouth; a medication delivery route
Oral glucose
A simple sugar that is readily absorbed by the bloodstream; it is carried on the EMS unit
Over-the-counter medications
Medication that may be purchased directly by a patient without prescription
Oxygen
A gas that all cells need for metabolism; the heart and brain, especially, cannot function without oxygen
Per os
Through the mouth; and medication delivery route; same as oral
Per rectum
Through the rectum; the medication delivery route
Pharmacology
The study of the properties and effects of medications
Polypharmacy
Use of multiple medications on a regular basis
Prescription medications
Vacations are treated patients only by pharmacists according to physicians orders
Side effects
Any effects of the medication other than the desired ones
Solution
A liquid mixture that cannot be separated by filtering or allowing the mixture to stand
Subcutaneous injection
Injection into the tissue between the skin and muscles; a medication delivery route
Sublingual
Under the tongue; a medication delivery route
Suspension
A mixture of ground particles are distributed evenly throughout a liquid but do not dissolve
Topical medications
Lotions, creams, and ointment that are applied to the surface of the skin and affect only that area; medication delivery route
Trade name
The brand name the manufacturer gives medication; the name is capitalized
Transcutaneous
Through the skin; the medication delivery route
Transdermal medications.
Medications are designed to be sort of the skin (transcutaneously)
Characteristics of epinephrine
Secreted naturally by the adrenal glands; LH passages of loans; contracts blood vessels, causing increased blood pressure; increases heart rate and blood pressure
Effects of nitroglycerin
Relaxes the muscular walls of coronary arteries and veins; results in less blood returning to the heart; decreases blood pressure; relaxes veins throughout the body; often causes a mild headache after administration
General steps in administering medication
1. Obtain an order for medical control; 2. Verify the proper medication prescription; 3. Verify the form, dose, and route of the medication; 4. Check the expiration date and condition of the medication; 5. Reassess the vital signs; 6. Document
Allergen
A substance that causes allergic reaction
Asthma
A disease of the lungs in which muscle spasm in the small air passageways in the production of large amounts of mucus. With one of the mucus linings of the roster -- it does result in the airwave structured
Carbon dioxide retention
A condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center and a longer response to high blood levels of carbon dioxide
Chronic bronchitis
The rotation of the major long passages, from either infectious disease or irritants such as smoke
Chronic obstructive pulmonary disease (COPD
The slow process of dilation and description of the airways and alveoli , caused by chronic bronchial obstruction
Common cold
A girl infection usually associated with swollen nasal mucous membranes and the production of food from the sinuses and those
Crackles
Crackling, rattling breath sound signaling fluid in the airspace belongs
croup
Infectious disease of the upper respiratory system that may cause partial airway structures and is characterized a barking cough; usually seen in children
Diphtheria
An infectious disease in which a member informs, lining the pharynx; this lining can severely obstruct the passage of air into the larynx
dyspnea
A shortness of breath or difficult breathing
Embolus
A blood clot or other substance and circulatory system to travel to blood vessel where it causes blockage
Emphysema
These are the ones in which there is extreme dilation and eventual distraction of pulmonary. alveoli with poor exchange of oxygen and carbon dioxide; it is one form of chronic obstructive pulmonary disease
Epiglottitis
An infectious disease in which the epiglottis becomes inflamed and enlarged and may cause upper airway obstruction
Hyperventilation
Rapid or deep breathing that lowers blood carbon dioxide levels below normal
Hypoxia
A condition in which the body cells and tissues do not have enough oxygen
Hypoxic drive
Backup system to control respirations with oxygen levels all
Pleural effusion
A collection of fluid between the lung and chest walls that may compress the one
pleuritic chest pain
Sharp, stabbing pain in the chest that is worsened by deep breath or other chest wall movement; often caused by inflammation or irritation of the pleura
Pneumonia
Infectious disease of the lungs that damages lung tissue
Pneumothorax
Partial or complete accumulation of air in the plural space
Pulmonary edema
A buildup of fluid in the lungs usually as a result of congestive heart failure
Pulmonary embolism
A blood clot breaks off from a large vein and travels the blood vessels of the long, causing instruction of blood flow
rhonchi
Coarse brass have heard in patients with chronic mucus in the airways
Severe acute respiratory syndrome
Potentially like the invalid infection that usually starts with flulike symptoms
stridor
A harsh, high-pitched, barking inspiration sound often heard acute laryngeal obstruction
wheezing
A high-pitched, whistling breaths out, characteristically heard on expiration in patients with asthma or COPD
Characteristics of adequate breathing
A normal rate and depth; irregular pattern of inhalation and exclamation; good audible breath sounds on both sides of the test; irregular rise and fall movement on both sides of the chest; pink, warm, dry skin
Signs of inadequate breathing
Errata breathing that is slower than 12 breasts per minute or faster than 20 breaths per minute; unequal chest expansion; decreased breath sounds on one or both sides of the chest; Russell retractions about the clavicles, between the ribs, and below the rib cage, especially in children; pale or cyanotic skin; cool, damp skin; shallow or irregular respiration; pursed lips; nasal flaring
Acute myocardial infarction
Heart attack; death of heart muscle following obstruction of blood flow to it. Acute in this context means "new" or "happening right now."
Angina pectoris
Transient (short-lived), chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle
Anterior
Structure of the body; the side facing you in the standard anatomic position
Aorta
The main artery, and it receives blood from the left ventricle and delivers it to all the other arteries that carry blood to tissues of the body
Aortic valve
The one-way valve that lies between the left ventricle, and the aorta. He keeps blood from flowing back into the left ventricle after the left ventricle ejects its blood into the aorta. One of the four heart valves
Arrhythmia
An irregular or abnormal heart rhythm
Atherosclerosis
A disorder in which cholesterol and calcium builds up inside the walls of blood vessels, eventually leading to partial or complete blockage of blood flow
asystole
Complete absence of heart electrical activity
Atrium
One of two upper chambers of the heart. The right atrium receives blood from the vena cava and delivers it to the right ventricle. The left atrium receives blood from pulmonary veins and delivers it to the left ventricle
Bradycardia
Slow heart rate, less than 60 beats per minute
Cardiac arrest
A state in which the heart fails to generate an effective and detectable bloodflow; pulses are not palpable in cardiac arrest, even if muscular electrical activity continues in the heart
Cardiogenic shock
A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be severe be severe, be a severe complication of the large acute myocardial infarction, as well as other conditions
Congestive heart failure
A disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs
Coronary artery
A blood vessel that carries blood and nutrients to the heart muscle
Defibrillate
To shock a fibrillating heart with specialized electrical current in an attempt to restore a normal rhythmic beat
Dependent edema
Swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure
Dilation
Widening of a tubular structure such as a coronary artery
Infarction
Death of a body tissue usually caused by interruption of blood supply
Inferior
The part of the body, or any body part, nearer to the feet
ischemia
A lack of oxygen at the price tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred
Lumen
The inside diameter of an artery or other hollow structure
Myocardium
Heart muscle
occlusion
Blockage, usually of a tubular structure such as a blood vessel
Perfusion
The flow of blood through the body tissue and vessels
Posterior
The back surface of the body; the site away from you in the standard anatomical position
Superior
Part of the body, or anybody parked near to the head
Syncope
Fainting spell or transient loss of consciousness
Tachycardia
Rapid heart rhythm, more than 100 beats per minute
Ventricle
One of two lower chambers of the heart. The left-center code receives blood from the left atrium and delivers blood to the aorta. The right ventricle receives blood from the right atrium and pumps it to the pulmonary artery
Ventricular fibrillation
Disorganized, ineffective twitching of the ventricles, resulting in no blood flow at the state of cardiac arrest
Ventricular tachycardia
Rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest
Describe blood flow through the heart
Oxygen poor blood comes in to the right atrium from the inferior and superior vena cava; the right atrium pumps oxygen poor blood through the tricuspid valve into the right ventricle. The right ventricle pumps oxygen poor blood out the pulmonary arteries into the lungs; blood comes back from the pulmonary vein into the left atrium; the left atrium pumps blood through the mitral belt into the left ventricle; the left ventricle pumps blood out to the body through the aorta.
Describe the electricity flow through the heart
The Sino atrial node begins the electric impulse. The impulse travels across the issue causing the contract. The impulses then cross over a bridge called the atrioventricular node. After a short cause electric impulse travels to both ventricles causing ventricular muscles to contract. After that atrioventricular node travels through the bundle of His through the Purkinje network.
Carotid arteries
Supply blood to the head and brain
Subclavian arteries
Supply blood to the upper extremities
Iliac arteries
Supply blood to the grand Palace and legs
Cholesterol
Having material form plaque inside the walls of blood vessels, attracting flow interfering with their ability to dilate or contract
Name the pulse point
Carotid; femoral; brachial; radial; posterior tibial; dorsalis pedis
What age does the peak incidence of heart disease occur?
40 to 70
What are the major controllable risk factors for myocardial infarction
Cigarette smoking, high blood pressure, elevated cholesterol levels, elevated blood glucose levels, lack of exercise, stress
what are the nature of uncontrollable risk factors for myocardial infarction
Older age, family history of coronary disease, being male
How is the pain of angina pectoris usually described?
Like somebody standing on my chest; crushing or squeezing.
Where is the pain of angina pectoris usually felt?
Mid chest, under the stern. It can radiate to the job and arms on the back or the epic gastronome
How long does angina pectoris usually last?
3 to 8 minutes
Characterize unstable angina
Pain in the chest of a coronary origin that occurs in response to progressively less exercise or fewer other stimuli other than those ordinarily required to produce angina. If untreated it can often lead to myocardial infarction
Character a stable angina
Pain in the chest of a coronary organ that is relieved by things that normally relieve it in a given patient, such as resting or taking nitroglycerin
How long after oxygen was cut off of heart muscles begin to die
30 minutes
Define thrombolytic
Clotbusting
Angioplasty
Mechanical cleaning of the artery
Signs and symptoms of a heart attack
Sudden onset of weakness, nausea, and sweating without obvious cause; chest pain/discomfort/pressure is often? Squeezing and that does not change with each breath; pain/discomfort/pressure in the lower jaw, arms, back, abdomen, or neck; sudden arrhythmia, with syncope; shortness of breath, or dyspnea; pulmonary edema; sudden death
How does the pain of heart attack differ from the pain of angina?
It may or may not because the exertion that may occur anytime; it does not result in a few minutes; it may not be relieved by rest or nitroglycerin
Physical findings of AMI and cardiac compromise
Pulse rate increases is a normal response to pain stress or fear may be some irregularity; blood pressure may fall as a result of this cardiac output, although it may be normal or slightly elevated; respiration to normal, unless the patient has congestive heart failure, which will cause aspirations to become rapid and labored; patient often appears frightened. There may be not a vomiting or cold sweat. The skin is often action grade because of poor cardiac output, although it may be foolish to.
Percentage of patients with AMI that never reached the hospital?
40%
Percent that survival diminishes per minute defibrillation?
10%
Changes in heart during congestive heart failure?
Heart rate increases; left ventricle enlarges
Why is it called congestive heart failure?
The lungs become congested with fluid. Once the heart fails to pump blood effectively
During congestive heart failure, the left ventricle fails:
Patient suffers pulmonary edema; and may have pink frothy sputum.
During congestive heart failure, with the right ventricle fails:
Fluid collects in the feet and legs causing them to swell
Coronary artery bypass graft (CABG)
A blood vessel from the chest or leg is so directly from the aorta to a coronary artery beyond the point of the attraction.
Percutaneous transluminal coronary angioplasty
A tiny balloon is attached to a long thin tube and used to clear extraction
stent
A metal mesh place inside the artery to keep Kerry from narrowing again.
Three common errors, with an AED
Not having the battery charged; apply to the patient was moving or being moved; apply to respond to patient with a rapid heart rate.
The four links in the chain of survival
Recognition of early warning signs in the activation of EMS; immediate bystander CPR; early defibrillation; early advanced cardiac life support
Medication for congestive heart failure
furosemide (Lasix),digoxin ,amiodarone
What dosage of aspirin you give during heart issues?
Between 162 and 324 mg
beats per minute on the AV node
40 -- 60
beats per minute on the Perkinje fibers
20-40
Another name for the brainstem
The reptilian brain
The three meninges
Pia, dura, arachnid
Mnemonic for remembering the Cincinnati stroke scale
FAST = face; arms; speech; time
Mnemonic for remembering the Glasgow scale
EVM = extra value meal = eyes; voice; motor
Absence seizure
Seizure that may be characterized by a brief lapse of attention in which the patient may stare and does not respond. Also known as petite mall seizure
Aphasia
The inability to understand or produce speech
Arterial rupture
Rupture of a cerebral artery that may contribute to interruption of cerebral blood flow
Atherosclerosis
A disorder in which cholesterol and calcium buildup inside the walls of blood vessels, forming plaque, which eventually leads to partial or complete blockage of blood flow; lack of this type can also become a state where blood clots can form, break up, and am glad elsewhere in the circulation.
Aura
A sensation experienced heart procedure; serves as a warning sign that a seizure is about to occur
Cerebral embolism
Extraction of a cerebral artery caused by clots that was formed elsewhere in the body and travel to the brain.
Cerebral vascular accident
An interruption of blood flow to the brain that results in the loss of brain function
Coma
A state of unconsciousness from which one cannot be roused
Coup-countercoup brain injury
A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of the original impact
dysarthira
The inability to pronounce speech clearly, often due to loss of the nerves or brain cells that control the small muscles larynx.
Expressive aphasia
A speech disorder in which a person can understand what is being said, but cannot produce the right sounds in order to speak properly
febrile seizures
Convulsions that result from sudden high fevers, particularly in children
Generalized seizure
Future characterized by severe twitching of all the body's muscles that may last several minutes or more; also known as a grand mal seizure
hemiparesis
Weakness on one side of the body
Hemorrhagic stroke
One of the two main types of stroke; occurs as a result of bleeding inside the brain
Hypoglycemia
A condition characterized by low blood glucose levels
Incontinence
Loss of balance blood control due to a generalized seizure
Infarcted cells
Cells in the brain that dives result of loss of blood flow to the brain
Ischemia
A lack of oxygen in the cells of the brain that cause them not to function properly
ischemic stroke
One of the two main types of stroke; occurs when blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel.
postictal state
period Following a seizure that last between five and 30 minutes, characterized by labored respiration and some degree of altered mental status
Receptive aphasia
A speech disorder which a person has trouble understanding speech was able to speak clearly
Seizure
Generalized uncoordinated muscular activity associated with loss of consciousness; a convulsion
Status epilepticus
A condition in which seizures recur every few minutes, or last more than 30 minutes.
Stroke
A loss of brain function in certain brain cells that do not get enough oxygen during the CVA. Usually caused by the structure of the blood vessels in the brain that the oxygen to those brain cells
Thrombosis
Clotting of the cerebral arteries that may result in interruption of cerebral blood flow and subsequent stroke
tonic-clonic
A type of seizure that features rhythmic back-and-forth motion of an extremity and body stiffness
Transient ischemic attack
A disorder of the brain in which brain cells temporarily stop working because of insufficient oxygen, causing stroke-like symptoms that resolve completely within 24 hours of onset
What are the top three leading causes of death in the United States in order?
Heart disease, cancer, stroke
What does AMS stand for
Altered mental status
Define the mnemonic "tips on the vowels"
TIPS AEIOU= trauma; infection; psychogenic causes; the seizure, syncope; alcohol; electrolytes; insulin; opiates; uremia
Frontal lobe
From part of the brain, controls emotion and thought
Patients who are at high risk for hemorrhagic stroke
Very high blood pressure or long-term elevated blood pressure that is not treated
Aneurysms
Swelling or enlargement of part of an artery, resulting from weakness of the arterial wall.
A berry aneurysm
Tiny balloon that jut out from the artery
The three conditions that may mimic a stroke
Hypoglycemia; a postictal state; subdural or epidural bleeding
Dura
A leathery covering over the brink, next to the skull.
On which side should you place a stroke patient with paralyzation
On the paralyzed side
When alterations should be made to the recovery position for stroke patient
The patient's head should be elevated about 6 inches to maximize drainage of secretions
What are the three things that you look for on the Cincinnati stroke scale
Facial droop; arm drift; speech
Computed tomography
A type of scan/x-ray on which blood can be seen
Characteristics of an absence seizure
Lip smacking, I blinking, or isolated convulsions or jerking of the body.
Medications that control seizures
phenytoin, phenobarbital, or carbamazepine
Define seizures with a structural cause
Seizures that are caused by an area of abnormality in the brain, such as a benign or cancerous tumor, an infection, or scar tissue.
Define seizures, metabolic cause
Abnormal levels of certain blood chemicals, hypoglycemia, poisons, drug overdoses, or sudden withdrawal from routine heavy alcohol or sedative drug usage, or even prescribed medications.
Some things you should consider if a patient in a postictal state refuses transport?
1. Is the patient awake and completely oriented after a seizure? 2. Does your assessment revealed no indication of trauma or publications from the seizure. 3. If the patient never had a seizure before. 4. With this feature the usual seizure in every way. Number five. Patient currently being treated with medications and receiving regular evaluations by physician
Special questions it to include documentation for seizure
The description of the episode with bikes in the comments especially if they witnessed the patient seizing. Document the onset and duration of theater. The patient knows her express noticing an aura?
Various causes of altered mental status
Hypoglycemia; hypoxemia; intoxication; drug overdose; unrecognized head injury; brain infection; body temperature abnormalities; brain tumors; glandular abnormalities; overdoses/poisonings
Acute abdomen
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary.
Aneurysm
A swelling or enlargement of part of an artery, resulting from weakening of the arterial wall
Anorexia
Lack of appetite for food
Appendicitis
Inflammation of the appendix
cholecystitis
Inflammation of the gallbladder
colic
Acute, intermittent cramping abdominal pain
Cystitis
Inflammation of the bladder
diverticulitis
Bulging out the intestinal rings in small pockets of weak areas in the muscle walls, creating abdominal discomfort.
emesis
Vomiting
Guarding
Involuntary muscle contraction of the double wall, an effort to protect the inflamed abdomen
Hernia
The protrusion of a loop of an organ or tissue through abnormal body opening
ileus
Paralysis of the bowel, arising from any one of several causes; stop contractions that move material through the intestine
Pancreatitis
Inflammation of the pancreas
Peritoneum
The membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs (visceral peritoneum)
Referred pain
Painful in an area of the body other than the area where the cause of pain is located
Strangulation
Complete obstruction of blood circulation in a given organ as a result of compression or entrapment; an emergency situation causing death of tissue
ulcer
Erosion of the stomach or intestinal lining
Peritoneal fluid
Included in the abdominal space that is there to bathe and lubricate the organs
Visceral peritoneum
A membrane that covers the abdominal cavity organs
Parietal peritoneum
A membrane that covers the abdominal cavity
Retroperitoneal
Organs that live behind the peritoneum; include kidneys, ovaries and the pancreas
Where is insulin formed
Pancreas
Renal colic
Pain caused by stone passes of the kidney
Localization of paying for appendicitis
Right lower quadrant-direct; around Naval-referred; rebounding pain-pain felt on the rebound of palpation
Localization of pain for cholecystitis
Right upper quadrant-direct; right shoulder-referred
Localization of paint for ulcer
Upper mid abdomen or upper back
Localization of pain for diverticulitis
left lower quadrant
localization of pain for Aortic aneurysms
Low back and lower quadrants
localization of pain-Cystitis
Lower mid abdomen-retro pubic
localization of pain-Kidney infection
costovertebral angle
localization of pain-Kidney stone
Right or left flanks, radiating to genitalia-referred
localization of pain-pubic inflammation
Both lower quadrants
Localization of pain-pancreatitis
Upper abdomen; back
mittelschmerz
A common lower abdominal pain often confused with appendicitis. Associated with the release of an egg from the ovary. Characteristically occurs in the middle of the menstrual cycle.
Pelvic inflammatory disease
An infection of the fallopian tubes and the shredding tissues of the pelvis. Acute pain and tenderness in the lower abdomen may be intense and accompanied by a high fever. Public transport
Ectopic pregnancy
Means that the fertilized egg has come to light in an area outside the uterus, usually the fallopian tube. 1 to 2% of pregnancies
Things that can cause hernia
A congenital defect, as around in the umbilicus; a surgical wound is still the heal properly; some natural weakness in areas such as the groin
A reducible hernia
A hernia mess that will disappear back into the body cavity in which it belongs
An incarcerated hernia
A hernia that cannot be pushed back within the body.
Signs and symptoms of a serious hernia problem
A clear statement of a mass that was reducible can no longer be pushed back inside the body; pain at the hernia site; tenderness from the hernias palpated; red or blue, skin discoloration over the hernia
How can the general impression of the way the patient is laying be helpful?
In some situations, patients are comfortable only when lying in one particular position, which tends to relax muscles adjacent to the inflamed organ and thus lessen the pain. Therefore, the position of the patient may provide an important clue
symptoms that can help you determine whether the patient has acute abdomen
Local or diffuse abdominal pain, and/or tenderness; a quiet patient who's guarding the abdomen (in shock); rapid and shallow breathing; referred pain; anorexia, nausea, vomiting; tents, and often distended, abdomen; constipation or bloody diarrhea; tachycardia; hypotension; fever; rebound tenderness
Acidosis
A pathologic condition resulting from the accumulation of acid in the body
Diabetes mellitus
A metabolic disorder in which the ability to metabolize carbohydrates is impaired, usually because of lack of insulin
Diabetic coma
Unconsciousness caused by dehydration, very high blood glucose levels, and acidosis in diabetes
Diabetic ketoacidosis
A form of acidosis in uncontrolled diabetes in which certain acids accumulate with insulin is not available
Glucose
One of the basic sugars; it is the primary fuel, along with auction, for cellular metabolism
Hormone
A chemical substance that regulates the activity of body organs and tissues; produced by a gland
Hyperglycemia
Abnormally high glucose level in the blood
Hypoglycemia
Abnormally low glucose level in the blood
Insulin
A hormone produced by the islets of langerhans(an exocrine gland on the pancreas) that enables glucose in the blood to enter the cells of the body; used in synthetic form to treat and control diabetes mellitus
Insulin shock
Unconsciousness or altered mental status in a patient with diabetes, caused by significant hypoglycemia; usually the result of excessive exercise and activity or failure to eat after a routine dose of insulin.
Kussmaul respirations
Deep, rapid breathing; usually the result of an accumulation of certain assets when insulin is not available in the body
polydipsia
Excessive thirst persisting for long periods of time despite reasonable fluid intake; often the result of excessive urination
Polyphagia
Excessive eating; and diabetes, the inability to use glucose properly can cause a sense of hunger
Polyuria
The passage of an unusually large volume of urine in a given period; and diabetes, this can result from wasting of glucose in the urine
Type I diabetes
The type of diabetic disease that usually starts in childhood and requires insulin for proper treatment and control
Type II diabetes
The type of diabetic disease usually starts in later life and often can be told through diet and oral medications
What percentage of the population is affected by diabetes
6%
What does the word diabetes mean
A passer through; a siphon
Diabetes insipidus
A rare condition, also involves excessive urination, but here the missing hormone is one regulates urinary fluid reabsorption
Cellular key
Insulin: you need to allow glucose into individual body cells
Blood glucose levels in hyperglycemia
200 mg
Normal amount of glucose in the blood
80 to 120 mg
Signs and symptoms of diabetic ketoacidosis
Vomiting, abdominal pain, and kussmaul respirations
Blood glucose level at which diabetic coma occurs
800 mg or greater
Click the close level at which DKA occurs
400 800 mg
Blood glucose level at which hypoglycemia occurs
80 to 40 mg
Blood glucose levels at which insulin shock occurs
Less than 40 mg
Things that can cause diabetic coma
Patient who is not under medical treatment, takes insufficient insulin, remarkably overeat, or who is undergoing some sort of stress that may involve an infection, illness, or over exertion, fatigue, or drinking alcohol
Symptoms of diabetic coma
Kussmaul respirations, dehydration, as indicated by dry, warm skin and sunken eyes; a suite or fruity order on the breath; a rapid pulse; a normal slightly low blood pressure; varying degrees of unresponsiveness
Things that cause insulin shock
Taking too much insulin; taking a regular dose of insulin but have not eaten enough food; had an unusual amount of activity or vigorous exercise and use up all available glucose
Symptoms of hypoglycemia
Normal or rapid respiration; pale, moist skin; excessive sweating; dizziness, headache; rapid pulse; normal to low blood pressure; altered mental status; anxious or combative behavior; hunger; seizure, fainting, or coma; weakness on one side of the body
Idiopathic
Of unknown cause
Allergen
A substance that causes an allergic reaction
Allergic reaction
The bodies exaggerated immune response to an internal or service agent
Anaphylaxis
Extreme, possibly life -- threatening systemic allergic reaction that may cause shock and respiratory failure
envenomation
The act of injecting venom
Epinephrine
A substance produced by the body, and a drug produced by pharmaceutical companies that increased pulse rate and blood pressure; the drug of choice for an anaphylactic reaction
Histamines
Substances released by the immune system and allergic reactions that are responsible for many of the symptoms of anaphylaxis
leukotrienes
Chemical substances that contribute to anaphylaxis; released by the immune system and allergic reactions
stridor
A harsh, high-pitched Reisterstown, generally heard during inspiration, is caused by partial blockage or nearing of the upper airway
Toxins
A poison or harmful substance
urticaria
Small spots of generalized itching and/or burning that appear as multiple raised areas of skin; hives
wheal
A raise, swollen, well-defined area on the skin resulting from an insect bite or allergic reaction
Wheezing
A high-pitched, whistling breasts sound, usually caused by a projection of the smaller tubes of the lungs and typically heard on expiration
The five categories of general allergens
Insect bites and stings; medications; plants; food; chemicals
Signs and symptoms of insect bites or stings
Sudden pain, swelling, local IT, and redness in light-skinned individuals usually at the site of injury
How long can a honey bee sting or inject venom
20 minutes after the bee has flown away
How do you remove the stinger
Scraping the skin with an edge of a sharp stiff object such as a credit card
What percentage of people are allergic to the venom of bee, hornet, yellowjacket, or wasps
I present
What are some medications that people with severe allergic actions may carry
chlorophenarimine ;dithenhytramine (Benadryl)
Common signs and symptoms of an allergic reaction -- respiratory system
Sneezing or an itchy, runny nose; tightness in the chest or throat; irritating, persistent drug costs; hoarseness; respirations that become rapid, labored, or noisy; wheezing and or stridor
Common signs and symptoms of an allergic reaction -- circulatory system
Decrease in blood pressure as the blood vessels dilate; increasing pulse rate; no skin in business as the vascular system fails; loss of consciousness and coma
Common signs and symptoms of an allergic reaction -- skin
Flushing, itching, or burning skin; especially common over the face and upper part of the chest; urticaria over large areas of the body, both internally and externally; swelling, especially the face, neck, hands, feet, and/or tongue; swelling and sinuses or pallor Aronowitz; warm, tingling feeling in the face, mouth, chest, feet, and hands
Common signs and symptoms of allergic reaction -- other findings
Anxiety, a sense of impending doom; abdominal cramps; headache; itchy, watery eyes; decreased mental status
Addiction
A state of overwhelming obsession or physical need to continue use of the drug or agent
Antidote
A substance that is used to neutralize or counteract a poison
delirium tremens
A severe withdrawal syndrome seen in alcoholics who are deprived of ethyl alcohol; characterized by restlessness, fever, sweating, disorientation, agitation, and seizures; can be fatal if untreated.
Emesis
Vomiting
Hallucinogens
Agents that produce false perceptions in any one of the five senses
hematemesis
Vomiting blood
hypnotic
A sleep-inducing effect or agent
Ingestion
Swallowing; taking a substance by mouth
Opioids
Any drug or agent with actions similar to morphine
Poison
A substance whose chemical action could damage structures or impair function when introduced into the body
Sedative
A substance that decreases activity and excitement
Stimulant
An agent that produces an excited state
Substance abuse
The misuse of any substance to produce some desired effect
Tolerance
The need for increasing amounts of the drug to obtain the same effect
Toxin
A poison or harmful substance produced by bacteria, animals, or plant.
Vomitus
Vomited material
Acute poisoning affects...
5 million children and adults each year
An EMT's primary responsibility to a patient who had been poisoned
To recognize that poisoning has occurred
The questions that you ask a patient that has been poisoned
1. What substance did you take? 2. When did you take it (or become exposed to it)? 3. How much did you ingest? 4 What actions have been taken? 5. How much do you weigh?
Signs and symptoms for drug overdose with opioid
Hypo ventilation or respiratory arrest; pinpoint pupils; sedation or,; hypotension
Signs and symptoms of drug overdose sympathomimetic
Hypertension; tachycardia; dilated pupils; agitation or seizures; hyperthermia
Signs and symptoms of a drug overdose sedative-.hypnotics.
Slurred speech; sedation or coma; hypoventilation; hypotension
Signs and symptoms for a drug overdose anticholinergics
Tachycardia; hyperthermia; hypertension; dilated pupils; dry skin and mucous membrane; sedation, agitation, seizures, coma, or delirium; decreased bowel sounds
Signs and symptoms for drug overdose cholinergic
Excessive defecation or urination; muscle fasticulations; pinpoint pupils; excessive lacrimation or salivation; airway compromise; nausea or vomiting
The four avenues for poison to get into the patient's body
Inhalation; absorption; indigestion; injection
What two substances ignite when coming to contact with water
Phosphorus; elemental sodium
What percentage of poisonings are by mouth
80%
Where the fatality numbers associated with alcohol
200,000 people die each year. 40% of all traffic fatalities or injuries. 67% of all murders. At 33% of all suicides.
Acronym for central nervous system
CNS
Why should internal bleeding be considered a patient who seems to be in shock Due to alcohol consumption?
Blood might not clot effectively in a patient who has prolonged history of alcohol abuse
What are some of the symptoms of delirium tremens
Agitation and restlessness; fever; sweating; confusion and/or disorientation; delusions and/or hallucinations; seizures
What are opioids made from
Opium and poppy seeds
What are some common opioids
Codeine; morphine; and heroine. Methadone
Worsen trade names for opioids that can be prescribed
Demerol; Percocet; OxyContin; Vicodin
What is the effective antidote to reverse the symptoms and signs of opioid overdose
naloxone (Narcan)
What are some common sedative-hypnotic drugs
Phenobarbital; diazepam; cyclobenzaprine; ethyl alcohol; isopropyl alcohol; Xanax; Valium; Rohypnol
What is the antidote for acute benzodiazepine overdose
flumazenil; given intravenously
What are some common abused inhalants
Acetone; gasoline halogenated hydrocarbons.
What are some well known sympathomimetics
Amphetamine; methamphetamine; caffeine by: ecstasy; Eve; cocaine
Order some reasons to take sympathomimetic's
Improve task performance; suppress appetite; prevent sleepiness; and just a feel-good.
What the temperature at which crack melts
93°F
One of the actual name for the marijuana plant
Cannabis sativa
What are some common hallucinogens
Lysergic acid diethalamide (LSD); PCP; Angel dust
What is the classic picture of a person who is taking too much of an anticholinergic medication
Hot as a hare, blind as a bat, dry as a bone, red as a beat, and mad as a hatter
How do anti-cholinergic agents work
They block the parasympathetic nerves.
What are some common anticholinergics
Atropine; Benadryl; Jim some weed
What is the other type of drug that may be hard to distinguish from an anti-cholinergic overdose
Sympathomimetic overdose
What can an anticholinergic poisoning be treated with
physostigmine intravenously
What are cholinergic usually known as
Nerve gases
Mnemonic DUMBELS
Defecation; urination; Miosis; Broncherra; emesis; lacrimation; salvation
Mnemonic SLUDGE
Salvation; lacrimation; urination; defecation; G.I. irritation; EYE construction/emesis
Aspirin poisoning symptoms
Nausea, vomiting, hyperventilation, and ringing ears. Patients may feel anxious, confused, tachypneic hyperthermia, and in danger of having seizures
What is the good news about acetaminophen regarding overdose
Acetaminophen is not generally very toxic. A healthy patient could ingest hundred 140 mg of acetaminophen for every kilogram of body weight without serious adverse effects
What is the bad news about acetaminophen regarding overdose
Symptoms of an overdose generally do not appear until it is too late
Where is methyl alcohol found
In dry gas products and sterno
Where is ethylene glycol found
Anti-freeze
What is the term coined in 1870, to indicate poisoning by a class of chemicals found in rotting food
ptomaine poisoning
What are the two main types of food poisoning
The organism itself causes the disease; the organism produces toxins that cause the disease
What are the characteristics of salmonella poisoning
Severe gastrointestinal symptoms within 72 hours of ingestion, including non-Zia, vomiting, abdominal pain, and diarrhea. Possibly ill with fever and generalized weakness.
Were some of the symptoms of a staphylococcus infection
Gastrointestinal symptoms, including nausea, vomiting, and diarrhea.
Describe botulism
An often fatal disease usually results from eating improperly canned food. Symptoms of Bob chose him our neural logic: blurring of vision, weakness, difficulty in speaking and breathing.
One of the bacteria that causes botulism
Clostridium
How long could it take for symptoms of botulism to present
May develop as long as four days after ingestion, or as early as the first 24 hours
What are some plants that can cause poisoning
Mistletoe; Castor Bean; nightshade by: foxglove; Rhododendron by: poke weed; poison ivy; poison oak; poison sumac
Air embolism
Air bubbles in the blood vessels
Ambient temperature
The temperature of the surrounding environment
antivenin
A serum to counteract the effects of venom from an animal or insect
bends
The common name for decompression sickness
Bradycardia
Slow heart rate, less than 60 beats a minute
Breath-holding syncope
Loss of consciousness caused by decreased breathing stimulus
Conduction
The loss of heat by direct contact (e.g. When a body part comes into contact with a colder object)
Convection
The loss of body heat caused by air movement (e.g. Breeze blowing across the body)
Core temperature
The temperature of the central part of the body (the heart, lungs, and vital organs)
Decompression sickness
A painful condition seen in divers who ascend too quickly, in which gas, especially nitrogen, forms bubbles in blood vessels and other tissues; also called the bends
Diving reflex
Slowing of the heart rate caused by his immersion in cold water
Drowning
Death from suffocation by submersion in water
Electrolytes
Certain salts and other chemicals that are dissolved in body fluids and cells
Evaporation
Conversion of water or another fluid from a liquid to a gas
Frostbite
Damage to tissues as the result of exposure to cold; frozen body parts
Heat cramps
Painful muscle spasms usually associated with vigorous activity in a hot environment
Heat exhaustion
A form of heat injury in which the body loses significant amounts of fluid and electrolytes, because of heavy sweating; also called heat prostration or heat collapse
Heatstroke
A life-threatening condition of severe hyperthermia caused by exposure to excessive natural or artificial heat, marked by warm, dry skin; severely altered mental status; and often irreversible coma
Hyperbaric chamber
A chamber, usually a small room, pressurized more than atmospheric pressure
Hyperthermia
A condition in which core temperature rises to 101°F (38.3°C) or more
Hypothermia
A condition in which core temperature falls below 95°F (35°C) after exposure to cold environment
laryngospasm
A severe constriction of the larynx and vocal cords
Near drowning
Survival, at least temporarily, after suffocation in water
Radiation
The transfer of heat to colder objects in the environment by radiant energy, for example, heat gained from a fire
Respiration
A loss of body heat as warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled
Reverse triage
A triage process in which efforts are focused on those who are in respiratory and cardiac arrest, and different from conventional triage were such patients would be classified as deceased. Used in triaging multiple victims of a lightning strike
SCUBA
A system that delivers air to the mouth and lungs at the various atmospheric pressures, increasing the depth of the dive; stands for self-contained underwater breathing apparatus
turgor
The ability of the skin to resist the deformation; tested by gently pinching skin on the four head or back of the hand
What are the four factors affecting exposure?
Physical condition; age; nutrition and hydration; environmental conditions
What are the five ways a body can lose heat?
Conduction; convection; evaporation; radiation; respiration
How can the rate and amount of heat loss or gain by the body be modified?
Increase or decrease heat production; move to an area where heat loss is decreased or increased; where insulated clothing, which helps to decrease heat loss in several ways.
What sorts of patients are prone to hypothermia?
Patients with injuries or illness, such as burns, shock, head injury, stroke, generalized infection, injuries to the spinal cord, diabetes, and hypoglycemia
Core temperature 90 to 95°F
Shivering, foot stamping; constricted blood vessels, rapid breathing; withdrawing level of consciousness
Core temperature 89° to 92°F
Lots of ordination, muscle stiffness; slowing respirations, slow pulse; confused, lethargic, sleepy level of consciousness
Core temperature 80° to 88°F
Coma; weak pulse, arrhythmias, very slow respiration; unresponsive level of consciousness
Core temperature less than 80°F
Apparent death; cardiac arrest; unresponsive level of consciousness
Management of cold exposure
Remove wet clothing and keep patient derived; prevent conduction heat loss; insulate all exposed body parts; prevent convection heat loss; remove the patient from the environment
Factors that can contribute to local cold injuries
Restricted circulation from tight clothing; circulatory disease; fatigue; port attrition; alcohol or drug abuse; hypothermia; diabetes; older age
Frost nip
The skin freezes while the deeper tissues are unaffected
Immersion foot
Also called trench foot; occurs after prolonged exposure to cold water.
What are the two most efficient way the body tries to cool itself
Sweating; and dilation of skin blood vessels, which brings blood to the skin surface to increase the rate of heat radiation
Gangrene
Permanent damage or cell death
Patients at the greatest risk for heat illness
Children; geriatric patients; patients with heart disease, COPD, diabetes, dehydration, and obesity; and those with limited mobility
What is the progression of drowning
Something goes wrong; panic; inefficient breathing; decreased buoyancy; exhaustion; cardiac or respiratory arrest
What are the steps of rescuing someone from the water, taking into account potential spinal injuries
Turn the patient supine; restore the airway begin ventilation; float a buoyant backboard under the patient; secure the truck and head of the backboard; remove the patient from the water on the backboard; cover the patient with a blanket
Define mild lightning injury
Loss of consciousness, amnesia, confusion, tingling, and other nonspecific signs and symptoms. Burns are usually superficial
Define moderate lightning injury
Seizures, restaurants, cardiac standstill that spontaneously resolves, and superficial burns
Define severe lightning injury
Cardiopulmonary arrest.
What are the two most common, poisonous spider bites in the states
Female black widow; brown recluse
What type of venom is used by the black widow spider
A neurotoxin
What sort of venom is used by the Brown recluse
Cytotoxic
The most common types of poisonous snake
Rattlesnake, the copperhead, the cottonmouth or water moccasin , and the coral snake
Which three poisonous snakes are pit viper's
Rattlesnakes, copperheads, and cottonmouths
What is the mnemonic poem for remembering coral snake poison is
Red on yellow will kill a fellow; red on black, venom will lack
How does the coral snake poison its victims
It has tiny things and injects the venom with its keep by chewing motion, leaving behind one or more puncture or scratch like wounds. It is a powerful toxin that causes paralysis of the nervous system
What is the one American scorpion that has significant poison
centruroides sculpturatus
What two diseases do ticks carry
Rocky Mountain spotted fever; Lyme disease
How do you take a tick out
With tweezers by the head
What type of marine animal is responsible for more envenomations than any other
coelenterates: fire coral, Portuguese man-of-war, see wasp, sea nettles, true jellyfish, sea anemones, true coral, and soft coral
How do you treat stains from marine animals
Pour vinegar on it
Activities of daily living
The basic activities a person usually accomplishes during a normal day, such as eating, dressing, and bathing
Altered mental status
A change in the way a person thinks and behaves that may signal disease in the central nervous system or elsewhere in the body
Behavior
How a person functions or acts in response to his or her environment
Behavioral crisis
The point at which a person's reactions to events interfere with activities of daily living; it becomes a psychiatric emergency when it causes a major life interruption, such as an attempted suicide
Depression
A persistent mood of sadness, despair, and discouragement; may be a symptom of many different mental and physical disorders, or it may be a disorder on its own
Functional disorder
A disorder in which there is no known physiological reason for the abnormal functioning of an organ or organs system
Mental disorder
An illness with psychological or behavioral symptoms and/or impairment in functioning caused a social, psychological, genetic, physical, chemical, or biological disturbance
Organic brain syndrome
Temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiological functioning of brain tissue
Psychogenic
A symptom or illnesses caused by mental factors as opposed to the ones
Reflective listening
A technique used to gain insight into the patient's thinking, involving repeating, in the form of a question, what the patient has said
Adjustment
When individuals respond to a variety of situations in daily life, including stresses and strains in reasonable ways
How many Americans have some sort of mental disorder
One in five
What are some examples of organic brain syndrome
Sudden illness, recent trauma, drug or alcohol intoxication, and diseases of the brain
What are some examples of functional disorder
Schizophrenia and depression
The mnemonic to remember safety guidelines for behavioral emergency
MJ has sad fits
Safety guidelines for behavioral emergencies in mnemonic order
encourage purposeful Movement; do not Judge; be Honest and reassuring; have a definite plan of Action; assess the Scene; Stay with the patient; stay a respectable distance Away from the patient; E. Direct; avoid Fighting with the patient; Identify yourself calmly; be prepared to spend extra Time; express interest in the patient's Story
What are some risk factors for suicide?
Depression; previous suicide attempt; expressions of wanting to commit suicide or sense of hopelessness; family history of suicide; although in 40 years, quickly for singles; recent loss of a spouse or significant other family member; chronic debilitating illness or recent diagnosis with a serious disease; holidays; financial or job setback; substance abuse; token of an alcoholic parent; severe mental illness; anniversary of tragedies;
What are some warning signs of suicide?
Does the patient have an air of hopelessness and despair? Does the patient avoid eye contact or speak slowly and haltingly, which were with the patient project isn't a vacancy? Does the patient seem unable to talk about the future? Is there any suggestion of suicide? Does the patient have any specific plans relating to death?
You people should always be used to restrain a patient
4
What are the five main risk factors to assess level of danger/patient violence
History; posture; the scene; local activity; physical activity
What sort of abdominal organ is involved with the pain comes and goes?
Hollow
What sort of abdominal organ is involved if the pain is constant
Solid
One patient complained of abdominal pain which section do you palpate first and last
First: the section furthest from the complaint area. Last, the complaint area
What are histamines and leukotrienes
Chemicals released by the immune system
What are the things you need to know in order to tell poison control about the nature of poisoning
The name of the substance; its concentration; if ingredient; the number of pills in a jar and ingested; the name of the manufacturer; the dose prescribed
The formula for conversion from pounds to kilograms
(Pounds/2) -10%
How far away is a professional distance
4 to 6 feet
Abortion
The delivery of the fetus and placenta before 20 weeks; miscarriage
Amniotic sac
The fluid-filled, bag like membrane in which the fetus develops
Apgar score
A scoring system for assessing the status of a newborn that assigned a number value to each of five areas of assessment
Birth canal
The vagina and cervix
Bloody show
A small amount of blood at the vagina that appears at the beginning of labor and may include a plug of pink-tinged mucus that is discharged when the cervix begins to dilate
Breech presentation
A delivery in which the buttocks comes out first
Cervix
The lower third, or neck, of the uterus
Crowning
The appearance of the infant head at the vagina opening during labor
Eclampsia
Seizures resulting from severe hypertension in pregnant women
Ectopic pregnancy
A pregnancy that develops outside the uterus, typically in a fallopian tube
Fetal alcohol syndrome
A condition of infants who are born to alcoholic mothers; characterized by physical and mental retardation and a variety of congenital abnormalities
Fetus
The developing, unborn infant inside the uterus
Gestational diabetes
Diabetes that develops during pregnancy in women who did not have diabetes before pregnancy
Limb presentation
A delivery in which the presenting part is a single arm, leg, or foot
Meconium
A dark green material in the amniotic fluid that can indicate disease in the newborn; the meconium can be aspirated into the infant 's lungs during delivery; the baby's first bowel movement
Miscarriage
The delivery of the fetus and placenta before 20 weeks; spontaneous abortion
Multi-gravida
A woman who has had previous pregnancies
Multi-para
A woman who has had more than one live birth
Nuchal cord
An umbilical cord that is wrapped around the infant neck
Pelvic inflammatory disease
Infection of the fallopian tubes and the surrounding tissues of the pelvis
perineum
The area of the skin between the vagina and anus
Placenta
The tissue attached to the uterine wall that nourishes the fetus through the umbilical cord
Placenta abruptio
A premature separation of the placenta from the wall of the uterus
Placenta previa
A condition in which the placenta develops over and covers the cervix
Preeclampsia
A condition of late pregnancy that involves headache, visual changes, and swelling of the hands and feet; also called pregnancy-induced hypertension
Presentation
The position in which an infant is born; the part of the infant that appears first
primigravida
A woman who is experiencing her first pregnancy
primipara
A woman who has had one live birth
Prolapse of the umbilical cord
A situation in which the umbilical cord comes out the vagina before the infant
Spina bifida
A developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly even outside of the body, usually at the lower third of the spine in the lumbar area
Supine hypotensive syndrome
Low blood pressure resulting from compression of the inferior vena cava by the weight of the pregnant uterus when the mother is supine
Umbilical cord
The conduit connecting mother to infant via the placenta; contains two arteries and one vein
Uterus
The muscular organ where the fetus grows, also called the womb; responsible for contractions during labor
Vagina
The outermost cavity of the woman's reproductive system; the lower part of the birth canal
What are the only two situations in which an EMT can insert their hands into the vagina
Breech presentation; prolapse of the umbilical cord
What are the three stages of labor
Dilation (begins with the onset of contractions and ends when the cervix is fully dilated); expulsion of the baby (begins when the cervix is fully dilated and ends when the infant is born); delivery of the placenta (begins with the birth of the infant and ends with the delivery of the placenta)
After which point is it too late to transport
Crowning
How often do twins occur
Once in every 80 births
What is the difference between identical and fraternal twins in regards to the placenta
Identical twins will have their umbilical cords coming from the same placenta; fraternal twins will have their own placentas
What constitutes a premature infant
Any infant that delivers before eight months (36 weeks) or weighs less than 5 pounds
When should you check Apgar scores
One minute and five minutes after birth
What does Apgar stand for
Appearance; pulse; grimace; activity; respirations
How long after birth should a newborn infant spontaneously begin breathing
Within 15 to 20 seconds
What is considered an average blood loss during delivery
500 to 700 cc
How can you help to slow postdelivery bleeding
Massaging the mother's abdomen with a firm, circular motion (the fundus); encouraging the infant to breast-feed
What should you do with an unwrapped her amniotic sac
Puncture the sac with a clamp, away from the baby's face, only as the head is crowning, not before. Push the ruptured sac away from the baby's face as the head is delivered.
In what order should you siphon the baby's airway and why
Mouth first, then nose; because siphoning the nose may cause the baby to inhale through the mouth, accidentally inhaling fluid
How should you deal with the nuchal cord
Attempt to slip the court over the baby's head. If that does not work, quickly clamp cord and cut it before the baby is fully delivered
Why should you place the baby at or below the level of the vagina after birth
To allow blood to drain through the umbilical cord into the infant
What questions should you ask a pregnant woman who has called for emergency care
How long have you been pregnant; when are you two; is this your first baby; are you having contractions and how far apart are they and how long do they last; if you feel as though you have to strain or move your bowels; have you had any spotting or bleeding; is your water broken; for any of your previous children delivered by cesarean; have you had a complicated pregnancy in the past; do you use drugs, drink alcohol, or take any medications; is there any possibility that this is a multiple birth; does your doctor expect any complications
How do you time contractions
From the start of one contraction to the start of the next
When is preeclampsia usually begin
After the 20th week of gestation
What is the average blood pressure for preeclampsia
140 through 150
What is the blood pressure usually for eclampsia
150
What are some signs of pelvic inflammatory disease
Yellow, greenish pus; a discharge; smelly
How much fluid as the amniotic sac containing
500/1000 mL
Why can pregnant women compensate better for blood loss
During pregnancy blood volume doubles
Blunt trauma
An impact on the body by objects that cause injury without penetrating soft tissues or internal organs and cavities
Cavitation
A phenomenon in which speed causes a bullet to generate pressure waves, which caused damage distant from the bullet's path
Coup-countercoup brain injury
A brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of the original impact
Deceleration
The slowing of an object
Index of suspicion
Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury
Kinetic energy
The energy of a moving object
Mechanism of injury
The forces or energy transmission plights the body that cause injury
Multi-system trauma patient
A patient who experienced trauma that affects more than one body system
Penetrating trauma
Injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs
Potential energy
The product of mass, gravity, and height, which is converted into kinetic energy and results in injury, such as from a fall
what are the three collisions that occur in every crash
The collision of the car against some type of object; the collision of the passenger against the interior of the car; the collision of the passenger's internal organs against the solid structures of the body
When considering the severity of a fall, what should you take into account
The height of the fall; the surface struck; the part of the body that hit first, followed by the path of energy displacement
What is the relation of speed and mass when considering the damage done by a moving object
If the mass of the bullet is doubled, the energy that is available to cause injury is doubled. If the speed (velocity) of the bullet is doubled, the energy that is available to cause injury is quadrupled
How high is a fall need to be to be considered significant
A height greater than 15 feet or three times the patient's height
What are the considerations for car versus pedestrian accident
Estimate the speed of the vehicle; determine whether the patient was thrown and what distance or whether the patient was struck and pulled under the car; evaluate the car for structural damage that might indicate contact points
What are common injuries in rear-end collisions
Whiplash type injuries
What is another name for lateral collisions
T-bone collisions
What is submarining the seatbelt
When the person's body goes under the shoulder restraint when the lap portion is not attached
What are Newton's three laws of motion
First: an object at rest tends to stay at rest objects in motion tend to stay in motion unless acted upon by some force. Second: force equals mass times acceleration; in which acceleration is the change in velocity that occurs over time. Third: for every action, there is an equal and opposite reaction
Define work
Force acting over a distance
How do you calculate kinetic energy
One half mass times velocity squared
What is potential energy product of
Mass, force of gravity, and height
Aorta
The main artery, which receives blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body
Arterioles
The smallest branches of arteries leading to the vast network of capillaries
Artery
A blood vessel, consisting of three layers of tissue in smooth muscle that carries blood away from the heart
Capillaries
The small blood vessels that connect arterioles and venules; various substances passed through capillary walls, into and out of the interstitial fluid, and then onto the cells
coagulation
The formation of clots to plug openings and injured blood vessels and stop blood flow
Contusion
A bruise, or eccymosis
Eccymosis
Discoloration of the skin associated with a closed wound; bruising
Epistaxis
A nosebleed
Hematoma
A mass of blood in the soft tissues beneath the skin
Hemophilia
A congenital condition in which the patient lacks one or more of the blood's normal clotting factors
Hemorrhage
Bleeding
Hypovolemic shock
A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, result in inadequate perfusion
Perfusion
Circulation of blood within an organ or tissue in adequate amounts to meet the current needs of the cells
Pneumatic antishock garment
Inflatable device that covers the legs and abdomen; used to splint the lower extremities or pelvis or to control bleeding in the lower extremities, pelvis, or abdominal cavity
Pressure point
A point where blood vessel lies near a bone; useful when direct pressure and elevation do not control bleeding
Shock
A condition in which the circulatory system fails to provide sufficient circulation so that every body part can perform its function; also called hypoperfusion
Tourniquet
The bleeding control method of last resort that includes arterial flow; used only when all other methods have failed in the patient's life is in danger
The veins
The blood vessels that carry blood from the tissues to the heart
What are the seven methods to control bleeding, in order
Direct local pressure; elevation; pressure dressing; pressure points; splinting device; pneumatic antishock garment; tourniquets
How do you treat a nosebleed if skull fracture is not suspected
Pinch post nuptials together for 15 minutes while leaning forward. If the patient is awake and has a patent airway, place gauze pad inside the upper lip against the gum
How do you treat a nosebleed if skull fracture is suspected
Place a gauze pad loosely under the nose
What is hematemesis
Vomiting blood
Melena
Black tarry stools (contain blood)
Hemoptysis
Coughing up blood
What is the most common symptom of internal bleeding
Pain
What are contraindications for using a PASG
Pregnancy; pulmonary edema; acute heart failure; penetrating chest injuries; groin injuries; major head injuries; a transport time of less than 30 minutes
A systolic blood pressure less than BLANK with a week, rapid pulse should suggest to you the presence of hypoperfusion
100 mm of mercury
Bleeding from capillary vessels
Dark red and oozes from the wound slowly but steadily
Bleeding from vein
Darker than arterial bleeding and flows steadily
Bleeding from an artery
Characteristically brighter red and spurts in time with the pulse
What is one unit of blood
500 mL
The body will not tolerate an acute blood loss of greater than...
20% of blood volume
How much blood volume does the typical adult to have
70 mL of blood per kilogram of body weight, or 6 L (10 to 12 pints) in a body weighing 80 kg (hundred and 75 pounds)
How long can the brain and spinal cord last without perfusion
4 to 6 minutes
How long will it take kidneys to be damaged with inadequate perfusion
45 minutes
How long before skeletal muscle demonstrates injury after inadequate perfusion
Two hours
fibrinogen
Reinforces the red blood cells.
What is the flow of blood in the body starting with deoxygenated blood entering the heart
Deoxygenated blood travels back to the heart through the superior and inferior vena cava and enters the heart of the right atrium; the right atrium pumps blood through the tricuspid valve into the right ventricle; the right ventricle pumps blood to the lungs through the right and the left pulmonary artery; the lungs oxygenate the blood; blood returns to the left atrium through the pulmonary veins; the left atrium pumps blood into the left ventricle through the mitral valve; the left ventricle pumps blood out to the body through the aortic valve; the aorta delivers blood to the lesser arteries; arteries move blood through arterioles, which move blood into capillaries, which drop off oxygen and nutrients to the cells while removing waste; blood then travels into the venules, and then in the veins to return to the heart through the vena cava
Pulse points in the body
Dorsal pedis; posterior tibial; popiteal; femoral ; radial; ulnar; brachial; carotid; external maxillary; superficial temporal
Anaphylactic shock
Severe shock caused by an allergic reaction
Anaphylaxis
An unusual or exaggerated allergic reaction to foreign proteins or other substances
Aneurysm
A swelling or enlargement of part of an artery resulting from weakening of the arterial wall
Autonomic nervous system
Part of the nervous system that regulates involuntary functions such as heart rate and blood pressure, digestion and sweating
Cardiogenic shock
Shock caused by inadequate function of the heart, or pump failure
Compensated shock
The early stage of shock, in which the body can still compensate for blood loss
Cyanosis
Bluish color of the skin resulting from poor oxygenation of the circulating blood
Decompensated shock
The late stage of shock when blood pressure is falling
Dehydration
Loss of water from tissues of the body
Edema
The present of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area
Homeostasis
A balance of all systems of the body
Hypothermia
A condition in which the internal body temperature falls below 95°F (35°C), usually as a result of prolonged exposure to cool or freezing temperatures
Hypovolemic shock
Shock caused by fluid or blood loss
Irreversible shock
The final stage of shock, resulting in death
Neurogenic shock
Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in spinal cord injuries
Perfusion
Circulation of blood within an organ or tissue in adequate amounts to meet the cell's current needs
Psychogenic shock
Shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting
Sensitization
Developing a sensitivity to a substance that initially caused no allergic reaction
Septic shock
Shock caused by severe infection, usually a bacterial infection
Shock
A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion
sphincters
Circular muscles that encircle and, by contracting, constrict a duct, to, or opening
Syncope
Fainting
What is the perfusion triangle
The pump (the heart); the pipes, or container (blood vessels); content, or volume (blood)
What are some signs of compensated shock
Pale, cool, moist skin; increased respiratory rate; nausea and vomiting; increased thirst.
What are some signs of decompensated shock
Labored or irregular respirations, ashen gray cyanotic skin, weak or absent distal pulses, dilated pupils, and profound hypotension
What are some issues with septic shock
The toxins damage the vessel walls, causing them to become leaky and unable to contract well. Widespread violation of vessels, in combination with plasma lost through the injected vessel walls, results in shock.
What is another name for hypovolemic shock caused by bleeding
Hemorrhagic shock
What are the eight types of shock
Cardiogenic shock; neurogenic shock; hypovolemic shock; septic shock; anaphylactic shock; psychogenic shock; metabolic shock; respiratory insufficiency
Abrasion
Loss or damage of the superficial layer of skin as a result of a body part rubbing or scraping across a rough or hard surface
avulsion
An injury in which soft tissue either is torn completely loose or is hanging as a flat
Burn
An injury in which the soft tissue receives more energy than it can absorb without injury from thermal heat, frictional heat, toxic chemicals, electricity, or nuclear radiation
Closed injury
Injury in which damage occurs beneath the skin or mucous membrane but the surface remains intact
Compartment syndrome
Swelling in a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue
Contusion
A bruise without a break in the skin
Contamination
The presence of infected organisms or foreign bodies such as dirt, gravel, or metal
Dermis
The inner layer of the skin, containing hair follicles, sweat glands, nerve endings, and blood vessels
eccymosis
Discoloration associated with a closed wound; signifies bleeding
Epidermis
The outer layer of skin that acts as a watertight protective covering
evisceration
The displacement of organs outside the body
Full-thickness burn
A burn that affects all layers of skin and may affect the subcutaneous layers, muscle, bone, and internal organs, leaving the area dry, leathery, and white, dark brown, or charred; traditionally called a third-degree burn
Hematoma
Blood collected within the body's tissue or any body cavity
Incision
A sharp or smooth cut
Laceration
A jagged open wound
Mucous membrane
The lining of body cavities and passages that are in direct contact with the outside environment
Occlusive dressing
Dressing made of Vaseline gauze, aluminum foil, plastic that prevents air and liquids from entering or exiting a wound
Open injury
An injury in which there is a break in the surface of the skin or the mucous membrane, exposing deeper tissue to potential contamination
Partial-thickness burn
A burn affecting the epidermis and some portion of the dermis but not the subcutaneous tissue, characterized by blisters and skin that is white to red, moist, and mottled; traditionally called a second-degree burn
Penetrating wound
An injury resulting from a sharp, pointed object
Rabid
Describes an animal that is infected with rabies
Rule of Nines
A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burned area
Superficial burn
A burn affecting only the epidermis, characterized by skin that is red but not blistered or actually burned through; traditionally called a first-degree burn
What are the main functions of the skin
Keeping pathogens out, fluids in, maintain body temperature, and provide environmental information to the brain
What are the three classifications of soft tissue injuries
Closed injuries, open injuries, burns
Define RICES
Rest, ice, compression, elevation, splinting
What are the two types of closed injuries
Hematomas, crushing injuries
What are the five types of open injuries
Abrasions, lacerations, incisions, avulsions, penetrating injuries
What are the three primary functions of dressings and bandages
To control bleeding; to protect the wound from further damage; to prevent further contamination and infection
What are the two dangers specifically associated with electrical burns
There may be a large amount of deep tissue injury. Electrical burns are always more severe than the external signs indicate. Also, the patient may go into cardiac or respiratory arrest from the electric shock
What is a conductor
Any substance that allows an electric current to flow through
What is an insulator
Any substance that prevents an electric circuit from being completed
Give the basic steps for treating a chemical burn
BSI; scrape off any dry chemicals before adding water (check to make sure the chemical is not water reactive); immediately begin to flush the burned area with large amounts of water, taking care not to contaminate an injured areas or make the patient hypothermic. Continue flooding the area with gallons of water for 15 to 20 minutes after the patient says the burning pain has stopped.
What are the basic steps for emergency medical care of a burn
BSI; move the patient away from the burning area/remove any clothing that is on fire; immerse the area in cool, sterile water or saline solution; provide high flow oxygen; rapidly estimate the burn severity; check for traumatic injuries or other medical conditions; treat the patient for shock; prevent further heat loss; provide prompt transport
What are some signs of potential airway burn
Singed facial hair or sit present in or around the airway. Copious secretions and frequent coughing may also indicate a respiratory burn
What is the Palmer Method
A way of estimating a Burns surface area is to compare it to the size of the patient's palm, which is roughly equal to 1% of the patients total body surface area
What are the five factors that will help you determine the severity of a burn
What is the depth of the burn; what is the extent of the burn; are any critical areas (face, upper airway, hands, feet, genitalia) involved; are there any pre-existing medical conditions or other injuries; if the patient younger than five years or older than 55 years
What is the exception to the rule of not removing an impaled object
When the object obstructs breathing or an object in the chest that interferes with CPR
What is anemia
Low quantity of hemoglobin in the blood
What is hemophilia
A disorder in which the blood is diminished ability to clot
What are some things to find out when treating a gunshot wound
The speed of the bullet; the location of the entrance and exit wounds
What is a stellate incision
An irregular incision
How much blood me a hematoma contain
More than a leader
What are sebaceous glands
Glands in the dermis that produce sebum; the oily material that waterproofs the skin and keeps it simple
What is the germinal layer
A lower layer of the epidermis that contains pigment granules
Rule of nine: common numbers
Chest & back: 18 each; arms: nine each; genitals: one each
Rule of nine: adult differences
Head: 9; legs: 18 each
Rule of nine: child differences
Head: 12; legs: 16.5
Rule of nine: infant differences
Head: 18; legs: 13.5
Blowout fracture
A fracture of the orbit or of the bones that support the floor of the orbit
Conjunctiva
The delicate membrane that lines the eye lids and covers the exposed surface of the eye
Conjunctivitis
Inflammation of the conjunctiva
Cornea
The transparent tissue layer in front of the pupil and iris of the eye
Globe
The eyeball
hyphema
Bleeding into the anterior chamber of the eye, obscuring the iris
Iris
The muscles and surrounding tissue behind the cornea to dilate and constrict the people, regulating the amount of light that enters the eye; pigment in this tissue gives the eye its color
Lacrimal glands
The glands that produce fluids to keep the eyes moist; also called tear glands
Lens
The transparent part of the eye through which the images are focused on the retina
Optic nerve
A cranial nerves that transmit visual information to the brain
Orbit
The bony eyesocket
Pupil
The circular opening in the middle of the iris that admits light to the back of the eye
Retina
The light-sensitive area of the eye where images are projected; a layer of cells at the back of the eye that changes the light image into electrical impulses, which are carried by the optic nerve to the brain
Retinal detachment
Separation of the retina from its attachment at the back of the eye
Sclera
The tough, fibrous, white portion of the eye that protects the more delicate inner structures
Vitreous humor
The fluid in the back chamber of the eye; it cannot be replaced
aqueous humor
The fluid in the front chamber of the eye; it can be replaced
When is the only time that you should remove contact lenses from the eye
If there is a chemical burn
What does an equal pupils suggest
An illness or injury to the brain
What are some findings of the eye that should alert you to the possibility of head injury
One pupil larger than the other; the eyes not moving together are pointing in different directions; failure of the eyes to follow movement; bleeding under the conjunctiva which obscures the sclera; protrusion or bulging of one I
What are three important guidelines in treating penetrating injuries of the eye
Never exert pressure on or manipulate the injured eye in any way; if part of the eye is exposed, gently apply a moist, sterile dressing; cover the injured eye with a protective metal eye shield, cup, or sterile dressing.
Why should you always cover both eyes
To prevent sympathetic movement from causing more damage to the injured eye
How should you treat chemical burns to the eye
Irrigate the eye for at least five minutes. If the burn was caused by an alkali or a strong acid, each year gave the eye continuously for 20 minutes.
How should you always flush eyes
From the nose side of the eye toward the outside to avoid flushing material into the other I
What does a teardrop-shaped pupil suggest
A laceration to the eye itself
What should you consider when deciding on transport decisions for eye injuries
In some situations surgery or restoration of circulation to the eye would need to be accomplished in 30 minutes or permanent blindness may result
What is the choroid
A layer of blood vessels between the retina and the sclera at the back of the globe which nourishes the retina
How much of the eyeball is protected by the orbit
80%
Adam's apple
The firm prominence in the upper part of the larynx formed by the thyroid cartilage
Air embolism
The presence of air in the veins, which can lead to cardiac arrest if it enters the heart
avulsed
Pulled or torn away
Cranium
the skull
Eustachian tube
A branch of the internal auditory canal that connects the middle ear to the oropharynx
External auditory canal
The ear canal; leads to the tympanic membrane
foramen Magnum
The large opening at the base of the skull through which the brain connects to the spinal cord
Hematoma
The collection of blood in a space, tissue, or organ due to a break in the wall of a blood vessel
Mandible
The bone of the lower jaw
Mastoid process
A prominent bony mass at the base of the skull about 1 inch posterior to the external opening of the ear
maxillae
The bones that form the upper jaw on either side of the face; they contain in the upper teeth and form part of the orbit of the eye, the nasal cavity, and the palate
Occiput
The most posterior portion of the skull
pinna
The external, visible part of the ear
sternocleidomastoid muscles
The muscles on either side of the neck that allow movement of the head
Subcutaneous emphysema
A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues
temporomandibular joint
The joint form where the mandible and the cranium meet, just in front of the ear
Tragus
The small, rounded, fleshy bulge that lies immediately anterior to the ear canal
turbinates
Layers of bone within the nasal cavity
Tympanic membrane
The eardrum, which lies between the external and middle ear
Why should you always check for bleeding inside the mouth
Blood inside the mouth may produce airway instruction
What sort of injury in a fluid draining from the ears or nose suggest
Basal skull fracture
What is the Halo test
Checking gauze to see if there is a lighter ring of fluid around the blood
Name the parts of the external ear
pinna, the external auditory canal
Name the parts of the middle ear
The tympanic membrane, the hammer, the anvil, and the stirrup
Name the parts of the inner ear
The cochlea
How many days after a facial fracture is it possible for plastic surgeons to repair damage
7 to 10
What is epistaxis
Nosebleeds
Where do anterior epistaxis usually derived from
They originate from the area of the septum and bleed slowly. They are usually self-limiting and resolve quickly
Where does posterior epistaxis originate from?
, To the face and skull that results in a basil skull fracture often will cause the posterior wall of the nasal cavity to become unstable. Posterior nosebleeds are usually more severe and often cause blood to drain into the patient's throat.
What are the three turbinates
Superior turbinates, middle turbinates, and inferior turbinates
How much of the nose is formed of bone?
The proximal third
Name the bones of the face
The nasal bone; zygoma, maxilla, mandible
Name the bones of the cranium
Frontal bone, parietal bone, temporal bone, occipital bone
What is the only joint in the head
Temporomandibular joint
Closed chest injury
An injury to the chest in which the skin is not broken, usually due to blunt trauma
Dyspnea
Difficulty breathing
Flail chest
A condition in which two or more ribs and fractured in two or more places or in association with a fractured sternum so that a segment of the chest wall is effectively detached from the rest of the thoracic cage
Flutter valve
A one-way valve that allows air to leave the chest cavity did not return; formed by taping three size of an occlusive dressing to the chest wall, leaving the fourth side open as a valve
Hemoptysis
The spitting or coughing up blood
Hemothorax
A collection of blood in the plural cavity
Myocardial contusion
A bruise of the heart muscle
Occlusive dressing
A dressing made of Vaseline gauze, aluminum foil, plastic that prevents air and liquid from entering or exiting the wound
Open chest injury
An injury to the chest in which the chest wall itself is penetrated, a fractured rib or, more frequently, by an external object such as a bullet or knife
Paradoxical motion
The motion of the portion of the chest wall that is detached in a flail chest; the motion --- in during inhalation, out during excavation --- is exactly the opposite of normal chest wall motion during breathing
Pericardial tamponade
Compression of the heart due to a buildup of blood or other fluids in the pericardial sac
Pericardium
The fibrous sac that surrounds the heart
Pneumothorax
An accumulation of air or gas in the plural cavity
Pulmonary contusion
A bruise of the lung
Spontaneous pneumothorax
A pneumothorax occurs when a weak area on the lung ruptures in the absence of major injury, allowing air to leak into the pleural space
Sucking chest wound
and open penetrating chest wall wound through which air passes during inspiration and expiration, creating a sucking sound
Tachypnea
Rapid respiration
Tension pneumothorax
An accumulation of air or gas in the plural cavity that progressively increases the pressure in the chest with potentially fatal results
hemopneumothorax
The accumulation of blood and air in the pleural space of just
Where are the great vessels of the bodies located
The mediastinum
Traumatic asphyxia
A sudden increase in interthoracic pressure (often caused by a sudden, severe compression of the chest) results in a characteristic appearance, including distended nicknames, cyanosis in the face and neck, and hemorrhage into the sclera of the eye, signaling the bursting of small blood vessels. These findings suggest an underlying injury to the heart and possibly a pulmonary contusion
bleb
A weak area On the surface of the lung
Pleuritic pain
A sharp or sticking pain with each breath
Thoracic cage
Another name for the chest where it extends from the lower end of the neck to the diaphragm
Phrenic nerves
The nerves that supply the diaphragm and exit the spinal cord C-3, C-4, and C5
Closed abdominal injury
Any injury of the abdomen caused by a non-penetrating instrument or force, in which the skin remains intact; also called Blunt abdominal injury
Evisceration
The displacement of organs outside the body
Flank
The region of the lower rib cage
Guarding
Contracting the stomach muscles to minimize the pain of abdominal movement; a sign of peritonitis
Hematuria
The presence of blood in the urine
Hollow organs
Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and bladder
Open abdominal injury
An injury of the abdomen caused by penetrating piercing instrument or force, in which the skin is lacerated or perforated in the cavity is opened to the atmosphere; also called penetrating injury
Peritoneal cavity
The abdominal cavity
Peritonitis
Inflammation of the peritoneum
Solid organs
Solid masses of tissue where much of the chemical work of the body takes place
Supine hypotensive syndrome
A drop in blood pressure caused when the heavy uterus of a supine patient in the third trimester of pregnancy obstructs the vena cava, decreasing blood returned to the heart
Name the solid organs of the body
Liver; spleen; adrenal glands; pancreas; kidneys; ovaries; testes
Name the hollow organs of the body
Stomach; gallbladder; bile duct; large intestine; small intestine; rectum; uterus; appendix; urinary bladder; fallopian tubes; ureter
acromioclavicular joint
A simple joint where the bony projections of the scapula and clavicle meet at the top of the shoulder
articular cartilage
A pearly layer of specialized cartilage covering the articular surfaces (contact surfaces on the ends) of bones & synovial joints
calcaneus
The heel bone
Clavicle
Collarbone
Closed fracture
A fracture in which the skin is not broken
Compartment syndrome
An elevation of pressure within a closed fascial compartment, characterized by extreme pain, decreased pain sensation, paying on stretching affected muscles, and decreased power; frequently seen in fractures below the elbow or knee and children
crepitus
A grating or grinding sensation of sound caused by fractured bones or joints rubbing together
dislocation
Disruption of a joint in which ligaments are damaged and the bone ends are completely displaced
Displaced fracture
A fracture in which bone fragments are separated from one another and not in an anatomical alignment
ecchymosis
Bruising or discoloration associated with bleeding within or under the skin
femur
The thighbone, which extends from the pelvis to the knee and is responsible for formation of the hip and knee; the longest and largest bone in the body
The fibula
The outer and smaller bone of the two bones of the lower leg
Glenoid fossa
The part of the scapula that joins with the humeral head to form the glenohumeral joint
hematuria
Blood in the urine
humerus
The supporting bone of the upper arm joints with the scapula to form the shoulder joint and with the ulnar and radius to form the elbow joint
Joint
The place where two bones come into contact
Ligament
A band of fibrous tissue that connects bones to bones, and supports and strengthens a joint
Non-displaced fracture
A simple crack in the bone that has not caused the bone to move from its normal anatomic position; also called a hairline fracture
Open fracture
Any break a bone in which the overlaying skin has been damaged
Patella
Kneecap
Point tenderness
Tenderness that is sharply located at the site of the injury, found by gently palpitating along the bone with the tip of one finger
Position of function
A hand position in which the wrist is slightly Dorsey flexed and all finger joints are moderately flexed
Pubic symphysis
The firm cartilaginous joints between the two pubic bones
The radius
The bone on the thumb side of the forearm; important in both wrists and hand function
Reduce
Return to a dislocated joint or fractured bone to its normal position; otherwise known as setting
Retroperitoneal space
The space between the abdominal cavity and the posterior abdominal wall, containing the kidneys, certain large vessels, and parts of the gastrointestinal tract
Scapula
Shoulder blade
sciatic nerve
The major nerve of the lower extremity controlled much of muscle function in the leg, and sensation in most of the leg and foot
Skeletal muscle
A voluntary, striated muscle that attaches to bone and usually cross at least one joint
Sling
A bandage of material that helps to support the weight of an injured upper extremity
Splint
A flexible or rigid appliance used to protect and maintain the position of an injured extremity
Sprain
A joint injury involving damage to supporting ligaments, and sometimes partial or temporary dislocation of bone ends
Strain
Stretching or tearing of the muscle; also called a muscle pull
swathe
A bandage that passes around the chest to secure an injured arm to the chest
Tendon
A tough, rope like chord of fibrous tissue that attaches a skeletal muscle to a bone
Tibia
The larger of the two lower leg bones responsible for supporting the major weight-bearing surface of the knee and ankle; the shin bone
Traction
Longitudinal force applied to a structure
ulna
The bone on the small finger side of the form; most important for LBO function
Zone of injury
The area of potentially damaged soft tissue, adjacent nerves, and blood vessels surrounding an injury to a bone or joint
How many bones are there in the human body
206
How much blood can be lost from femoral shaft fracture
500 to 1000 mL
How long can a PAS G. stay on
Within 24 hours it must be removed
What are the two situations in which you must Splint a limb in the position of deformity
When the deformity is severe or when you encounter resistance or extreme pain when applying gentle traction to the fracture of a shaft of a long bone
How long does it take for compartment syndrome to develop
6 to 12 hours after the injury
What is free movement
Motion at a point in the Limb where there is no joint. It is a positive indication of fracture
Green stick fracture
An incomplete fracture that passes only partway through the shaft of the bone but may still cause substantial angulation; occurs in children
comminuted fracture
A fracture in which the bone is broken into more than two fragments
Pathologic fracture
A fracture of weakened or diseased bone seen in patients with osteoporosis or cancer, generally produced by minimal force
Epiphyseal fracture
A fracture that occurs in growth section of the child's bone and may lead to growth abnormalities
Synovial fluid
The fluid that bathes and lubricates joints
Subluxation
Similar to a dislocation except the disruption of the joint is not complete
anterograde amnesia
Inability to remember events after an injury
Autonomic nervous system
The part of the nervous system regulates functions that are not controlled by the conscious will, such as digestion and sweating
Battle's sign
Bruising behind the ear over the mastoid process that may indicate skull fracture
Brainstem
The part of the central nervous system that controls virtually all functions that are necessary for life, including the cardiac and respiratory systems
Central nervous system
The brain and spinal cord
Cerebellum
Part of the brain coordinates body movements
Cerebrum
Largest part of the brain, containing about 75% of the brain's total volume
Closed head injury
Injury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding
Concussion
A temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain
Connecting nerves
Nerves in the spinal cord to connect the motor and sensory nerves
Distraction
The action of pulling the spine along its length
Eyes-forward position
A head position in which the patient's eyes are looking straight ahead and head and torso are in line
Four-person log roll
The recommended procedure for moving a patient with suspected spinal injury from the ground into a long backboard
Glasgow Coma Scale
A method of evaluating level of consciousness that uses a scoring system for neurologic responses to specific stimuli.
intervertebral disk
the cushion that lies between two vertebrae
involuntary activities
the actions that we do not consciously control
meninges
Three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal.
Motor nerves
Nerves that carry information from the central nervous system to the muscles of the body
open head injury
injury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue
peripheral nervous system
the 31 pairs of spinal nerves and 12 pairs of cranial nerves that link the body to the CNS
raccoon eyes
bruising under the eyes that may indicate skull fractures
retrograde amnesia
the inability to remember events leading up to a head injury
sensory nerves
Nerves that transmit sensory inputs such as touch, taste, heat, cold, and pain, from the periphery to the central nervous system.
somatic nervous system
The part of the nervous system that regulates our voluntary activities, such as walking, talking, and writing.
voluntary activities
Actions we consciously perform, in which sensory input or conscious thought determine a specific muscular activity.
cerebral edema
brain swelling
What are the three layers of meninges?
The dura matur, the arachnoid, and Pia matur
What pressures are considered hypertensive emergency
Over 150 systolic
Damage to what vertebrae will cause quadraparalysis?
C 5-6
Damage to what vertebrae will cause paraparalysis?
L1
Above what value should pulse oximeter values be maintained
95%
What are the parts of Cushing's triad
Blood pressure up, pulse down, irregular respirations
What type of intracranial hematoma is beneath the dura but outside the brain
A subdural hematoma
What type of intracranial hematoma is within the substance of the brain tissue itself
An inter-cerebral hemorrhage
What type of intracranial hematoma is outside the dura and under the skull
An epidural hematoma
Above which vertebra will spinal damage caused diaphragm to stop contracting
C3
How many bones in the spinal column
33
What is the name of the only joint in the skull
Temporomandibular joint
Name the six bones of the face
Mandible; the two maxilla; the two zygoma; and the nasal bone
Name the bones of the cranium
Frontal bone; parietal bone; temporal bone; occipital bone
What is the bone that juts out just behind the ear canal
The mastoid process
What is the sympathetic nervous system
It reacts to the stress would fight-or-flight response. This response causes the pupils to dilate smooth muscles in the lungs to dilate, heart rate to increase, blood pressure to rise, and also causes the body to shunt blood to vital organs into skeletal muscle
What is the parasympathetic nervous system
Has the opposite effect of the sympathetic nervous system; causing blood vessels to dilate, slowing the heart rate, relaxing the muscle sphincters. The body also shunts blood to the organs of digestion.
What makes up the inside of the cranium
80% brain; 10% blood supply; and 10% cerebrospinal fluid
What's at the bottom of the skull that allows the spinal column to pass through it
foramen magnum
Adolescents
Children between 12 to 18 years of age
Apparent life-threatening event (ALTE)
An event that causes unresponsiveness, cyanosis, and at the end in an instant, then resumes breathing with stimulation
Child abuse
Any improper or excessive action that injures or otherwise harms a child or infant; includes neglect and physical, sexual, and emotional abuse
Dehydration
A state in which fluid losses are greater than food intake into the body, leading to shock and death if untreated
Dependent lividity
Pooling of blood in the lower parts of the body after death
Febrile seizure
Seizure relating to a fever
Gastronomy tube
A feeding tube placed directly through the wall of the abdomen; used in patients who cannot digest liquids or solids
Generalized tonic-clonic seizure
A seizure that features rhythmic back-and-forth motion of an extremity and body stiffness
Hypoventilation
Reduced Minute volume, either from reduced rate and/or depth of breathing
Infancy
The first year of life
Meningitis
Inflammation of the meninges that cover the spinal cord and brain
Neisseria meningitidis
A form of bacterial meningitis characterized by rapid onset of symptoms, often leading to shock and death.
Neonatal
The first month after birth
occiput
The back of the head
Pediatrics
A specialized medical practice devoted to the care of the young
Pneumatic anti-shock garment
Inflatable device that covers the legs and abdomen; used to splint the lower extremities or pelvis, or to control bleeding in the lower extremities, pelvis, or, abdominal cavity
Preschool-age
Children between 3 to 6 years of age
Rigor mortis
Stiffening of the body after death
School-age
Children between 6 to 12 years of age
Shaken baby syndrome
Bleeding within the head and damaged cervical spine of an infant who has been intentionally and forcibly shaken; a form of child abuse
Shunt
A tube that diverts Excess cerebrospinal fluid from the brain to the abdomen
Sudden infant death syndrome
Death of an infant or young child that remains unexplained after a complete autopsy
Toddler
The period Following infancy until three years of age
Tracheostomy tube
A tube inserted into the trachea in children who cannot breathe on their own; passes through connect directly to the major airway
Why is the tongue in children at higher risk of airway obstruction than an adult
The tongue is large relative to other structures
What should you do if you encounter a child with a central IV line
BLS cannot transport. You must call and ALS rig
What ages is it SIDs prevalent in
It is the leading cause of death in infants younger than one year; most cases occur in infants younger than six months
What is the second most common cause of unintentional deaths among children in the United States
Drowning
What is the number one killer of children in the United States
Injuries
How does a rabbit or focused physical assessment differ on children and adults?
You start from the feet and work towards the head
What age does adulthood officially begin a
21
Anemia
A deficiency of red blood cells or hemoglobin
apnea
Absence of breathing
AVPU scale
Used to assess level of consciousness; recorded as being alert, verbally responsive, responsive pain, or unresponsive.
Blanching
Turning white
bradycardia
A heart rate of less than 80 beats per minute and children in less than 100 beats per minute
Capillary refill time
The amount of time that it takes for blood to return to the capillary bed after applying pressure to the skin or nail bed; indicates the status of end-organ perfusion; reliable and children younger than six years
Central pulses
Pulses that are closest to the core (Central) part of the body where the vital organs are located; including the carotid, femoral, and apical pulses
Crackles
A crackling sound caused by the flow of air through liquid in the lungs; he cited lower airway obstruction
Croup
Infection of the airway below the level of the vocal cords, usually caused by a virus
Cyanosis
A blue discoloration of the skin and mucous membranes; indicates decreased levels of oxygen in the blood
End-organ perfusion
The status of perfusion to the vital organs of the body; determined by assessing capillary refill time
epiglottitis
An infection of the soft tissue in the area of the vocal cords
Grunting
And "uh" sound heard during excavation; reflects the child's attempt to keep the alveoli opened; a sign of increased work of breathing
Head bobbing
The headless and tilts back during inspiration, and moves forward during expiration; a sign of increased work of breathing
Meconium
Dark green material in the amniotic fluid can cause lung disease in the newborn
nares
External openings of the nostrils. A single nostril openings called a naris
Nasal flaring
Widening of the Nares during inspiration; commonly seen in infants; indicates increased work of breathing
Pediatric assessment triangle
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
Pediatric resuscitation tape measure
Tape used to estimate an infant or child weight on the basis of length; appropriate drug doses and equipment sizes are listed on the tape
Retractions
Drawing in the intercostal muscles and sternum during inspiration; a sign of increased work of breathing
Septum
The center divider in the nose
Sniffing position
Optimal neutral head position for the uninjured child who requires airway management
Stridor
A high-pitched breath sound heard mainly on inspiration that is a sign upper airway obstruction
Tachypnea
Increased respiratory rate
Tenting
A condition in which the skin does not quickly returned to its original shape after being pinched; indicates dehydration
Tidal volume
The amount of air that is delivered to the lungs and airways in one inhalation
tragus
Small cartilaginous projection in front of the opening of the year
Transition phase
A time. It allows the infant or child to become familiar with you and your equipment; only appropriate if the child's condition is stable
Tripod position
An abnormal position to keep the airway open; it involves leaning forward onto two arms stretched forward
Wheezing
A whistling breath sound caused by air traveling through narrowed air passages within the bronchioles; a sign of lower airway obstruction
Work of breathing
An indicator of oxygenation and ventilation. Work of breathing reflects the child's attempts to compensate for hypoxia
xiphoid process
The lower tip of the sternum
What are appropriate oxygen delivery devices for a child
The blow by technique at 6 L per minute; a nasal cannula at 1 to 6 L per minute; a non-rebreathing mask at 10 to 15 L per minute; a BVM device with supplemental oxygen attached in a flow rates at 10 to 15 L per minute
At what age are febrile seizures, and children
Between six months and six years of age
Are the most common causes of dehydration in children
Vomiting and diarrhea
What is the rate for rescue breaths and infant or child
12 to 20 breaths a minute (one breath for 3 to 5 seconds)
What is the compression rate to ventilation ratio to provide CPR infant
If you are alone 30:2; if two rescuers are present 15:2.
To what depths should the sternum decompressed on infant during CPR
1/3 to 1/2 the depth of the chest
At what rate per minute should chest compression be done on an infant
100 compressions per minute
Respirations exceeding BLANK are a sign of a problem in infants and children
60 breaths per minute
At what age children be placed in a car seat rear facing
Less than one year
At what age should pediatric pads be used on an AED
1 to 8 years of age
Why should the five cycles (about two minutes) of CPR be done on children before activating the EMS system
Because cardiopulmonary arrest in children is most often the result of respiratory failure, not a primary cardiac event
What percentage of deliveries are complicated by the presence of meconium
12%
What are some problems that can be encountered with a nasopharyngeal airway and children?
If the area is too long, it may stimulate the vagus nerve and slow heart rate, or enter the esophagus, causing gastric distention
At what age is blood pressure usually assessed?
Three and up
What is the best method for determining breathing child?
In infants test or belly breathing is considered adequate. In older children, chest rise and fall
What causes mottling?
Constriction of peripheral blood vessels and is another sign of poor perfusion
acetabulum
The depression on the lateral pelvis where its three component bones join, in which the femoral head fits so snugly
Bacteremia
The presence of bacteria in the blood, whether or not a disease process is present
Burst fractures
Compression fractures of the vertebrae that typically result from a higher energy mechanism such as a motor vehicle crash or fall from a substantial height
Central cord syndrome
A form of incomplete spinal cord injury in which some of the signals from the brain to the body are not receive; results in weak or absent motor functions, which is more pronounced in the upper extremities and the lower extremities
Compression fractures
Stable spinal cord injuries in which often only the anterior third of the vertebra is collapsed. This type of fracture often results from minimal trauma, simply bending over, rising from a chair, or sitting down forcefully
Polypharmacy
Simultaneous use of many medications
Seat belts-type fractures
Fractures that involved flexion, with the distraction component (energy being disbursed in two opposite directions) that causes a fracture through the entire vertebral body and bony arch; typically results from ejection or occurs in those wearing only a lap belt without a shoulder harness
Septicemia
The disease state that results from the presence of microorganisms or the toxic products in the blood stream
Stable spinal injury
A spinal injury that has a low risk of leading to permanent neurological deficit or structural deformity
Unstable spinal injury
A spinal injury that has a high risk of permanent neurological deficit or structural deformity
What are some things to take into account when treating a geriatric patient as opposed to a younger patient?
The condition of older patients is more unstable than that of younger patients, and there is an increased possibility for sudden, rapid deterioration
What term is used interchangeably with septicemia bacteremia?
Sepsis
What is the time and death rate for geriatric patients with hip fractures?
20% will die within the first 12 months
Where the different places a hip fracture can occur?
The head, neck, proximal portion of the femur
How much more likely is a geriatric patient to be severely injured or fatally injured in a car crash and a younger patient?
Five times
After 65 was the increase in systolic pressure per year?
1 mg of mercury
What is the average amount of dedication to patient over 65 will be taking?
Four
Abdominal aortic aneurysm
A condition in which the walls of the aorta in the abdomen weekend and blood leaks into the layers of the vessel, causing it to bulge
Advance directives
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called living wills
Aneurysm
A swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall.
Arteriosclerosis
A disease that is characterized by hardening, thickening, and calcification of the arterial walls.
Atherosclerosis
A disorder in which cholesterol and calcium builds up inside the walls of blood vessels, forming plaque, which eventually leads to partial or complete blockage of blood flow and the formation of clots that can break off embolize
Cataracts
Clouding of the lens of the eye or its surrounding transparent membranes
Collagen
A protein that is the chief component of connective tissues and bones
Compensated shock
The early stage of shock, in which the body can still compensate for blood loss
Decompensated shock
The late stage of shock, when blood pressure is falling
Delirium
Changes in mental status marked by the inability to focus, think logically, and maintain attention.
Dementia
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function
Dyspnea
Shortness of breath or difficulty breathing
elastin
A protein found in elastic tissues such as skin and artery walls
Elder abuse
Any action on the part of an older person's family member, caregiver, or other associated person that takes advantage of the older individual's person, property, or emotional state; also called granny beating and parent battering
Hypoxia
A condition in which the body's cells and tissues do not have enough oxygen
Kyphosis
A forward curling at the back caused by an abnormal increase in the curvature of the spine
Osteoporosis
A generalized bone disease, commonly associated with postmenopausal women, in which there is a reduction in the amount of bone mass leading to fractures after minimal trauma in either sex
Syncope
A fainting spell or transient loss of consciousness, often caused by an interruption of blood flow to the brain
Vasoconstriction
A narrowing of the blood vessel
Vasodilation
The widening of the blood vessel
Define the GEMS of diamond
G.-geriatric (older patients present atypically). E-environment (be aware of the patients living environment). M-medical problems. S-social (social aspect of the patient's life and the importance of the patient's social network)
Leading causes of death in geriatrics
Heart disease, cancer, stroke, cardiopulmonary disease, respiratory illness, diabetes, trauma
Why isn't the exact extent of elder abuse known?
Many patients do not report it; users are often family members who must care for older persons in addition for caring for their own spouses and children.
Work with his elder abuse most often seen in?
Women older than 75 years
What group of geriatrics has the highest suicide rate?
Older men
What is the most common complaint of a patient is having an abdominal aortic aneurysm
Abdominal pain radiating through to the back with occasional flank pain
The vagus nerve
What is a silent heart attack?
A heart attack in which the usual chest pain is not present
What percentage of geriatric patients have a silent heart attack
As many as a third
What are other names for kyphosis?
Humpback, hunchback, or pott curvature
By what percentage does renal and kidney function decline in older people
20 to 50%
What percentage per year does the body deteriorate after 30
1%
What is the age that after which somebody is considered geriatric?
65
What is the age for the so-called "super geriatric"
85
What are the 10 phases of extrication?
Preparation; in route to the scene; a rival team is up; another control; support operations; gaining access; emergency care; and disentanglement; removal and transfer; termination
Air ambulances
Fixed-wing aircraft and helicopters that have been modified for medical care; used to evacuate and transport patients with life-threatening injuries to treatment facilities
Ambulance
A specialized vehicle for treating and transporting sick and injured patients
Blind spots
Areas of the roads are blocked from the driver site with their own vehicle or mirrors
Cleaning
The process of removing dirt, dust, blood, or other visible contaminants from the surface
CPR board
A device that provides a firm surface under the patient's torso
Cushion of safety
Keeping a safe distance between your vehicle and other vehicles to any side of you
Decontaminate
Removed or neutralize radiation, chemical, or other hazardous material from clothing, equipment, vehicles, and personnel
Disinfection
The killing of pathogenic agents by direct application of chemicals
Emergency mode
The use of lights and sirens
First-responder vehicle
A special vehicle used to transport EMS equipment and personnel to the scenes of medical emergencies
High-level disinfection
The killing of pathogenic agents are using potent means of disinfection
Hydroplaning
A condition in which the tires of a vehicle could lift it off the road surface as water "piles up" under them, making the vehicle feel as though it is floating
Jump kit
A portable kit containing items that are used in the initial care of the patient
Medivac
Medical evacuation of the patient by helicopter
Spotter
A person who assists the driver in backing up an ambulance in order to compensate for blind spot at the back of the vehicle
Star of life
The six-pointed Star that identifies vehicles that meet federal specifications as licensed or certified ambulances
Sterilization
A process, such as heating, that removes microbial contamination
How should you approach a helicopter parked on a slope?
From the downhill side, or by traveling towards an uphill
How big should a landing zone be for a helicopter?
No less than 60' x 60'; preferably more like 100' x 100'
One can use lights and sirens?
The unit must be on a true emergency call to the best of your knowledge; both audible and visual warning devices must be used simultaneously; the unit must be operated with due regard for the safety of all others, on and off the road way
When are fixed-wing aircraft used?
For transports greater than 100 to 150 miles
What sort of things can and don't do during an emergency?
Park or stand in an otherwise illegal location; proceed through a red traffic light or stop sign; drive faster than the posted speed limit; driving against the flow of traffic on a one-way street, or make a turn that is normally illegal; travel left of center to make an otherwise illegal pass
At what speeds are you in danger of hydroplaning?
Speeds greater than 30 mph
What is the first rule of safe driving in an emergency?
Speed does not save lives; good care does
What is the second rule of safe driving in an emergency?
The driver and all passengers must wear seat belts and shoulder restraint at all times
How fast can ambulance travel above the speed limit?
Only 10 miles an hour over the speed limit
Where should you park in relation to the scene of a crash or hazard?
Park at 100 feet past the scene on the same side of the road. It is best to park uphill and or upwind of the scene
What are the phases of an ambulance call?
Preparation for the call; dispatch; en route; arrival at the scene; Transfer of the patient to the ambulance; en route to the receiving facility; a the receiving facility; en route to the station; Postrun
What is the mnemonic for remembering the phases of an ambulance call?
Please don't ever ask to entertain an effeminate pachyderm
What is a type I basic ambulance design
Conventional, truck cab-chassis with a modular in the body that can be transferred to a newer chassis is needed
What is a type II basic ambulance design
Standard van, forward-control integral cab-body ambulance
What is a type III basic ambulance design
Specialty van, forward-control integral cab-body ambulance
Access
The ability to gain entry to an enclosed area and reach the patient
Command Post
The location of the incident commander at the scene of an emergency and where command, coordination, control, and communication are centralized.
Complex access
Located entry that requires special tools and training and includes breaking windows or using other force
Danger zone (hot zone)
An area where individuals can be exposed sharp metal edges, broken glass, toxic substances, lethal rays, or an ignition or explosion of hazardous materials.
Disentanglement
The removal of a motor vehicle from around the patient
Entrapment
To be caught within a vehicle, room, or container with no way out or to have a limb or other body part trapped
Extrication
Removal of a patient from entrapment or dangerous situation or positions, such as removal from a wrecked vehicle, industrial accident, or building collapse.
Hazardous material
Any substance that is toxic, poisonous, radioactive, flammable, or explosives and causes injury or death with exposure
Incident commander
The individual who has overall command of the scene in the field
Self-contained breathing apparatus (S C B A)
Respirator with independent air supply used by firefighters to enter toxic and otherwise dangerous atmosphere
Simple access
Access is easily achieved without the use of tools of force
Special weapons and tactics team (SWAT)
A specialized law enforcement tactical unit
Structure fire
Define a house, apartment building, office, school, plant, warehouse or other building
Tactical situation
A hostage, robbery, or other situation in which armed conflict threatened or shots fired and the threat of violence remains
Technical rescue group
A team of individuals from one of more departments in the region who are trained and on-call for certain types of technical rescue
Technical risky situation
He rescued that require specialized technical skills and equipment in one of many specialist rescue areas, such as technical rope rescue, Cave rescue, and dive rescue.
When can you leave the scene of the fire?
Do not leave the scene even after the fire is out, in case a firefighter is injured during salvage an overhaul. The ambulance should leave the scene only if transporting a patient or if the incident commander has released it
How far away should response vehicles the park at the scene of a cave in or trench collapse?
At least 500 feet from the scene
How deep can you trench be before you need proper shoring
4 feet
Where does the EMT stay during lost person search and rescue
You will stay at the location to which the group will bring the patient; unless the patient cannot be moved, then the group will take you to the patient
What should you do if you have a patient who is suffering from compartment syndrome?
Do not move that patient or release them from their entrapment. Call and AL S unit
How should you protect yourself and the patient if it car needs to be disentangled
Both you and the patient should be covered by a thick, fire resistant canvas or blanket for protection from broken glass, fine particles, tools, or other hazards during any cutting or forceful extrication maneuvers
With services does an EMT serve during disentanglement
Your input is essential so that the patient's injuries are considered as the rescue team plans a move that protect the patient from further harm
Law enforcement responsibilities during hazard control
Traffic control and direction, maintaining order at the scene, investigating the crash of a crime scene, and establishing and maintaining lines of that bystanders are kept at a safe distance and out of the way of rescuers
Firefighters responsibility at hazard control
Extinguishing any fire, preventing additional ignition, and ensuring that the scene is safe, and removing any spilled fuel
Rescue team responsibilities at a hazardous scene
Securing and stabilizing the vehicle, providing safe interests and access to patients, extricating any patients, ensuring that patients are properly protected during excavation or other rescue activities, and providing adequate room so that patients can be removed promptly
EMS personnel responsibility at a hazard scene
Assessing and providing immediate medical care, triage and assigning priority to patients, packaging patients, providing additional assessment and care as needed once patients are removed, and providing transport to the emergency department
10 phases of extrication
preparation, en route to scene, arrival and scene size-up, hazard control, support ops, gaining access, emergency care, disentanglement, removal and transfer, termination
Casualty collection area
An area set up by physicians, nurses, and other hospital staff near a major disaster s