what do you do for labored, contstriction, or lack of tidal volume
assist ventilations with BVM
What do you do for acid in eyes
irrigate, if contacts take them out
Signs and Symptoms of tension pneumothorax
progressive shortness of breath
increased altered level of consciousness
neck vein distention
tracheal deviation
What organ could be affected by trauma to the upper right quadrant
liver
flail chest is charcterized and defined by
paradoxical motion
2 or more ribs broken in two or more places
subcutaneous emphysema what is it and how to treat
A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues. treat by positive pressure ventilations
Daughter is power of attourney and wants father to recieve care, father is AxO x4 and does not want care
Respect patient wishes because he is concious without altered mental status
Open fracture and bleeding PPE
gloves, mask, goggles
What EMS statistic is needed to reduce speed limit in given area
Fatalities and injuries that have happened on that stretch of road
Triage color green
ambulatory,
yellow
delayed
red
immediate
black
dead/ expectant
you are treating a 300 pound male who cannot walk what should you do
call for assistance
triage in the
cold zone
Pedatric/ infant breath rate
18-30
Cardiac arrest in children is caused most likely by
hypoxia, resp distress or failure
Croup is characterized by
hoarseness, “barking” cough, inspiratory stridor and varying degrees of respiratory distress resulting from swelling in or obstruction in the region near the larynx.
Steps to treating bleeding
first direct pressure then tourniquet is direct pressure does not stop the bleeding
Signs and symptoms of meningitis
fever, rash, stiff neck, altered mental status
specifcally in infants: Swelling of fontanelles
Apgar scale
appearance, pulse, grimace, activity, respiration
when treating allergy primary concern is
AIRWAY
when to start chest compression on newborn
pluse under 60
ruptured spleen in child
bleeding and pain
right upper quadrant
Liver, Right Kidney, Colon, Pancreas, Gallbladder
left upper quadrant
liver, spleen, left kidney, stomach, colon, pancreas
left lower quadrant
Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord
right lower quadrant
cecum, appendix, right ovary and tube, right ureter, right spermatic cord
Signs and symptoms of epiglottitis
Sudden onset, high fever
“Hot-potato” voice
Dysphagia, drooling
No cough
Prefers to sit upright, lean forward (tripod position)
Appears toxic and stridulous
when babies head appears out of vaginal canal check for
nuhical cord
place baby where until umbillical cord is done pulsating
at the height of the vaginal canal
transport pregnant women in what position and why
left lateral recumbant to take pressure of the heart and vena cava
questions for pregnant mom
how many weeks along are you
how far apart are contractions
Signs of imminent delivery
Crowning, Urge to bear down or go to the bathroom, “It’s Coming”, and Contractions of increased frequency & intensity.
preclampsia
abnormal condition associated with pregnancy marked by high blood pressure proteinuria, and edema.
eclampsia
true toxemia of pregnancy characterized by high blood pressure, albuminuria, edema of the legs and feet, severe headaches, dizziness, convulsions, and coma
ovarian cyst signs and symptoms
lower pain on either side, nausea, bleeding, ask when last menstrutal cycle was
PID signs and symptoms
-onset is usually after menses
-sudden pelvic pain, profuse vaginal exudate, fever, metrorrhagia, discharge
When to massage fundus
stops bleeding and cramping after delivery
woman is bleeding after sexual assualt
use pad or sterile gauze and put under her to collect the blood
breech birth
Baby is delivered feet or buttocks first
when can you insert a gloved finger into the vaginal canal
if umbillical cord is around the babies neck
perineum tearing
tearing from vagina to anus after delivery
preciptitous delivery
perineum tearing and emergency delivery
bleeding from shunt
don’t let this question confuse you
hold pressure at place of bleeding
Pancreatitis symptoms
upper abdominal pain, swollen and tender abdomen, nausea, vomiting, fever, increased heart rate, weight loss, and diabetes.
important to note if they are chronic drinkers
petite mal seizure
blank out for 3-5 seconds, still conscious, eyes may flutter
zone out
Focal Motor Seizure
Starts in a group of muscles a “focus”
May progress to include the whole entire arm
May progress to a Grand Mal Seizure
grand mal seizure
They may have an “aura”
Tonic-Clonic phase
Loss of consciousness
clenched teeth, biting the cheek or tongue, incontinence
post-itcal phase
status epilepticus
A condition in which seizures recur every few minutes or last more than 5 minutes.
example question: Patient is zoned out, could be poison, OD or low blood sugar or seizure, question gives you the age of the patient and no other signs or symptoms, because of the lack of signs of poison or pills or history of diabetes it is most likely
seizures
Appendicitis signs and symptoms
rebound tenderness, young, pain near umbilical region, right lower quad
eptopic pregnancy
implantation of the fertilized egg in any site other than the normal uterine location happens in first trimester
abruptio placentae
premature separation of the placenta from the uterine wall, third trimester
placenta previa
implantation of the placenta over the cervical opening or in the lower region of the uterus, third trimester
spontaneous abortion
when the fetus and placenta deliver before the 20th week of pregnancy; commonly called a miscarriage
subarachnoid hemorrhage
worst headache, assess bp will be low, cushing triaid, slow pulse, unbalanced respirations
Left sided heart failure
shortness of breath
right sided heart failure
- Jungular Vein Distention
- Ascending Dependent Edema
- Weight Gain
- Hepatomegaly (Liver Enlargement)
steps when assessing unconc patient
check for responsiveness, check for pulse, check for chest rise and fall
communicable disease PPE and decom
mask, gloves, goggles, disinfect with approved germicidal agent
Oral Glucose Indications
hypoglycemia, able to swallow
when to extricate before giving care
direct life threat/ scene saftey threat ex: fire in car
OPIOD indications
pinpoint pupils, respiratory arrest, cyanosis, track marks
Cholecystitis
inflammation of the gallbladder
Cholecystitis S/S
severe midepigastric or right upper quadrant pain radiating to back and referred to right scapula usually after meals
fat intolerance
flatulence
indigestion
diaphoresis
n/v
chills
low grade fever
possible jaundice
clay-colored stools with common bile duct obstruction
when approaching a psych patient
calm them down, be reassuring, deescalate the situation
carbon monoxide poisoning
-carbon monoxide binds with hemoglobin and reduces oxygen supply to tissues
-cannot be seen. smelled, or tasted
-s/s include: nausea, vomiting, headache, weakness, and unconsciousness, Altered LOC, high SPO2
-death may occur with prolonged exposure
-prevention by ensuring proper ventilation when using fuel-burning devices
-gas-burning devices should be inspected annually
-flues and chimneys should be unobstructed
-carbon monoxide detectors should be installed and inspected regularly
NPA indications
concious with gag reflex
Suction Catheter for oropharynx
yonker tip/ ridgid tip
spontaneous pneumothorax
increaed heart rate, hypoxia, chest pain
Tension pneumothorax
S/S
JVD, diminished/absent lung sounds, tracheal deviation towards unaffected side, poor BVM compliance
pneumonia
swollen avoli, crackles, fever, warm dry and flushed, transport and give oxygen
chronic bronchitis
lungs constantly inflamed, barrel chest
systolic pressure
Blood pressure in the arteries during contraction of the ventricles.
diastolic pressure
Blood pressure that remains between heart contractions.
Contraindications of nitroglycerin
(Contraindications:) Cerebral hemorrhage, sexual enhancement drugs, hypotension-systolic blood pressure < 100.
important stroke question to ask
when was the last time they were seen normal
pulmonary edema s/s
Severe dyspnea and air hunger
Cough productive of frothy, blood tinged sputum
Tachypnea and tachycardia
Cold, clammy skin
Cyanosis
Extreme apprehension
Confusion, stupor
caused by left sided heart failure
transport shock patient in
supine
agonal respirations treatment
BVM
Heart Failure S/S
Shortness of breath, fatigue, and weakness, weilling in the legs, feet abdomen. Reapid or irregular heartbeat with S3 or S4 heart sounds, persistent cough or wheezing, and weight gain from fluid etention. Treatment: balance of medication, devices, and lifestule changes to heald the heart contract normally.
TIA
mimic stroke, symptoms go away in 24 hours
CVA
ruptured artery in brain hemmorragic shock
Ischemic stroke symptoms
facial droop, weak, slurred speech, time
cardiogenic shock
post MI, irregular pulse, low BP, thready pulse rate fast, pale, cool, clammy
BVM if respirations are
under 12 or over 20 (not exact) and do not have good lung sounds, under 8 ventilate
wheezing
High pitched sound heard in the lungs with asthmatics or lung disease lower airway
Rhonchi
Rattling noise of mucous in the lungs, upper airway
crackles
(rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration lower airway
stridor
upper airway, indicated foreign object
if ventilations are not going in what should you do
resposition
Nasal Canula flow rate
1-6
BVM flow rate
15-25
NRB flow rate
10-15 LPM
Nebulizer flow rate
6-8 lpm
if patient collaspes with airway obstruction
check for pulse, start w chest compressions
what to ask when approaching chocking vicitm
Are you chocking? Tell them to cough, when no air is entering the lungs start back blows and chest thrust
threat patient w humidified oxygen if
swollen throat, croupy cough, assessory muscle use, or stridor, not if anaphylatic
when patient is having trouble breathing, to get their history ask
yes or no questions
landing zone
100 by 100 ft
when to request additional assitance
too many for your team to handle, requested before even exiting ambulance
Quaility improvement for EMS
critiquing what went well and what could be improved upon, internal and external review
Rapid extraction
can be necessary even if CSPine is indicated
BSi PPE for profuse bleeding
Gloves, eye protection, mask
Notify law enforcement when hospice death
doesn’t add up to natural causes
USing TC
extracation when needing to remove piece of car from patient
Minor on scene transporting parent
take them in ambulance with you or call law enforcement to transport them
Using power grip hand go
10 inches apart
When driving proceed through intersections
like no one can hear the sirens
when correcting an error on document
line through it and initial
triage where
in cold zone
community relations example
offer BP check to whole community
WHn patient is unoconcious and unrepsonsive first always
check pulse and start CPR
black and tarry stool
upper GI bleed
Lower GI bleed
bright red stool
When to remove a penetrating object?
- Obstructs airway
- Impedes CPR
usually just stablilize
3 year old is drooling and oesn’t want to eat? what does he most liekly have?
epiglottitis
Signs of respiratory distress in children
grunting, intercostal retractions, nasal flaring
You arrive on scene and CPR is in progress what shuld you do
apply AED
AED Shockable Rhythms
V-tach and V-fib
what to do for gurgling respirtations
suction
pumonary edema
Abnormal accumulation of fluid in the interstitial spaces of the lungs. Blood backs up into pulmonary circulation because left ventricle can’t pump it forward (Can occur acutely, such as with MI Or can occur as an exacerbation of chronic HF)
Emphysema
A serious disease that destroys lung tissue and causes breathing difficulties.
pink and skinny
check pulse of hypothemic oatient for at least
30 seconds
signs and symptoms of congestive heart failure
-Cough (frequent, productive, hemoptysis)
-Progressive dyspnea with exertion
-Orthopnea
-Pitting edema of legs and feet or generalized edema of face, hands, or sacral area
-Heart palpitations
-Progressive fatigue or syncope with exertion
-Moist rales in lower lobes, indicating pulmonary edema
What does nitroglycerin do
- Vasodilator, opening up vessels to increase blood supply to the heart
- Smooth muscle relaxant
what position to place nitro patient in
supine
responding to cardiac arrest
start w compressions then go to AED
after delivery of baby
dry and warm keep at vaginal opening level
hypothermia treatment
remove from cold, take off wet clothing, wrap in blankets, severe cases EMS ASAP
gunshot wound, shortness of breath how to treat
ventilate, immoblize, take vitals and apply occlusive dressing
puncture wound apply what
3 sided occlusive dressing
head inury and blood thinner causes
hemorrraging
bubbling/ bleding from chest apply
fully occulsive dressing
femur fracture
lower than hip, deformities, less angulation that hip dislocations
hip discolation
rotates whole leg
knife is implaed
stablilize with bulky dressings
pulmonary contustion
trauma to the chest
aorta dissection
tearing pain to the back
Annurism
when a vessel wall weakens and balloons
aorta rupture
dead
Nose bleed
lean forward and pinch nose
Rule of (s
arm – 9, 1/2 arm 4.5, head 9, palm 1
neck puncture wound
occlusive dressing
spleen
-Upper left of the abdomen, behind the stomach and below diaphragm.
-Lymphoid tissue
-Blood vessels are connected to the spleen by splenic sinuses.
-Function: Filter unwanted materials from the blood (including old RBC) and to help fight infections.
-Up to 10% of the population has one or more accessory spleens that tend to form at the hilum of the original spleen.
eccomosis
bruising, often caused by internal bleeding
solid organ rupture
results in internal bleeding, abdominal distention, eccomosis
any kind of abdominal pain first thing you do
two Es: expose and examine region
pulmonary embolism
A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.
A critical incident stress debriefing should be conducted no longer than __ hours following the incident.
72
Which of the following skills or interventions is included at every level of prehospital emergency training?
AED
As an EMT, it is important to remember that the signs and symptoms of cumulative stress:
may not be present or obvious at all times
The patient care report (PCR) ensures:
continuity of care
Which of the following scenarios does NOT involve the administration of ALS?
A. a 53-year-old patient who is given glucagon for significant hypoglycemia Incorrect
B. a 64-year-old cardiac arrest patient who is defibrillated with an automated external defibrillator (AED) Correct
C. a 48-year-old patient whose airway is secured with a multilumen device Incorrect
D. a 61-year-old trauma patient whose chest is decompressed with a needle Incorrect
B. a 64-year-old cardiac arrest patient who is defibrillated with an automated external defibrillator (AED)
A patient’s refusal for EMS treatment and/or transport must be:
an informed refusal
Which of the following MOST accurately defines negligence?
deviation from the standard of care that may result in further injury
Which of the following scenarios MOST accurately depicts abandonment?
A paramedic transfers patient care to an EMT
While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should:
report the incident to your supervisor after the call
A positive TB skin test indicates that:
. you have been exposed to the disease.
Communicating with hearing-impaired patients can be facilitated by doing all of the following, EXCEPT:
. elevating the tone of your voice and exaggerating word pronunciation.
When relaying patient information via radio, communications should be:
. brief and easily understood.
f an action or procedure that was performed on a patient is not recorded on the written report:
it was not performed in the eyes of the law.
Maintaining the chain of evidence at the scene of a crime should include:
not cutting through holes in clothing that were caused by weapons
When you begin an oral report, you should state the patient’s age, sex, and:
chief complaint.
The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the:
medical director.
Two-way communication that requires the EMT to “push to talk” and “release to listen” describes what mode of communication?
. simplex
According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:
offer a workplace environment that reduces the risk for exposure.
which of the following errors is an example of a knowledge-based failure?
An EMT gives the correct drug to a patient, although his protocols clearly state that he is not authorized to do so.
B. Due to an improperly applied cervical collar, a patient’s spinal injury is aggravated and he is permanently disabled.
C. An EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug.
D. A patient is given nitroglycerin by an EMT who did not obtain proper authorization from medical control first.
An EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug. Correct
Which of the following statements regarding the Good Samaritan law is correct?
It provides the EMT immunity from a lawsuit.
B. The law does not protect EMTs who are off duty.
C. It will not protect the EMT in cases of gross negligence.
D. It guarantees that the EMT will not be held liable if he or she is sued.
it will not protect the EMT in cases of gross negligence.
In which of the following situations does the EMT NOT have a legal duty to act?
Choose one answer.
A. a response to an injured patient while off duty
B. a response to a motor vehicle crash while off duty
C. Local policy requires you to assist in any emergency.
D. a response to the residence of a patient who fell
a response to a motor vehicle crash while off duty
The official transfer of patient care does not occur until the EMT:
gives an oral report to the emergency room physician or nurse
The spread of HIV and hepatitis in the health care setting can usually be traced to:
careless handling of sharps.
When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located, you should:
begin resuscitation at once.
After delivering your patient to the hospital, you sit down to complete the PCR. When documenting the patient’s last blood pressure reading, you inadvertently write 120/60 instead of 130/70. To correct this mistake, you should:
draw a single horizontal line through the error, initial it, and write the correct data next to it.
What section of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel?
protecting patient privacy
Typical components of an oral patient report include all of the following, EXCEPT:
important medical history not previously given.
B. the set of baseline vital signs taken at the scene.
C. the chief complaint or mechanism of injury.
D. the patient’s response to treatment you provided.
the set of baseline vital signs taken at the scene.
Calming and reassuring an anxious patient can be facilitated by:
A. maintaining eye contact with the patient whenever possible.
B. using medical terminology to ensure the patient understands.
C. positioning yourself at a level that is higher than the patient.
D. withholding unpleasant information until arrival at the hospital.
maintaining eye contact with the patient whenever possible.
General guidelines for effective radio communications include all of the following, EXCEPT:
Choose one answer.
A. acknowledging a transmission as soon as possible.
B. holding the microphone about 2″ to 3″ from your mouth.
C. using 10 codes to ensure radio traffic confidentiality.
D. speaking in a clear, calm, monotone voice.
C. using 10 codes to ensure radio traffic confidentiality.
Why are prehospital emergency care guidelines updated on a regular basis?
Choose one answer.
A. Statistical data indicate that an increasing number of people are being diagnosed with a particular illness.
B. The federal government requires that changes be made to existing emergency care protocols at least every 5 years.
C. EMS providers should be encouraged to actively participate in research and become familiar with data analysis.
D. Additional information and evidence indicate that the effectiveness of certain interventions has changed.
D. Additional information and evidence indicate that the effectiveness of certain interventions has changed.
While trying to make a family member feel better after a loved one has died, your partner uses trite statements. The family members may view this as:
Choose one answer.
A. your partner’s attempt to diminish their grief.
B. a show of respect for the person who has died.
C. your partner’s caring and supportive attitude.
D. coaching them through the grieving process.
A. your partner’s attempt to diminish their grief.
Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction?
Choose one answer.
A. An EMT is emotionally exhausted and depressed after a school bus crash involving critical injuries and the death of several children.
B. An EMT with many years of field experience becomes irritable with her coworkers and experiences headaches and insomnia.
C. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.
D. A newly certified EMT becomes extremely nauseated and diaphoretic at the scene of an incident involving grotesque injuries.
C. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed. Correct
CPAP is indicated for patients who:
have pulmonary edema and can follow verbal commands.
When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
tachycardia
Which of the following is MOST characteristic of adequate breathing?
Choose one answer.
A. 24 breaths/min with bilaterally equal breath sounds and pink skin
B. 30 breaths/min with supraclavicular retractions and clammy skin
C. 20 breaths/min with shallow movement of the chest wall and pallor
D. 22 breaths/min with an irregular pattern of breathing and cyanosis
24 breaths/min with bilaterally equal breath sounds and pink skin Correct
Which of the following will MOST reliably allow you to determine the nature of a patient’s illness?
Choose one answer.
A. asking questions related to the chief complaint
B. trending of the patient’s vital signs over time
C. focusing solely on how the call is dispatched
D. refraining from asking open-ended questions
A. asking questions related to the chief complaint
The diaphragm functions as an involuntary muscle when a person:
sleeps
the leaf-shaped structure located superior to the larynx is called the:
epiglottis.
The primary prehospital treatment for most medical emergencies:
addresses the patient’s symptoms more than the actual disease process.
An index of suspicion is MOST accurately defined as:
your awareness and concern for potentially serious underlying and unseen injuries or illness.
Structures of the lower airway include all of the following, EXCEPT the:
Choose one answer.
A. trachea.
B. alveoli.
C. epiglottis.
D. bronchioles.
C. epiglottis.
The jaw-thrust maneuver is used to open the airway of patients with suspected:
cervical spine injuries
Without adequate oxygen, the body’s cells:
incompletely convert glucose into energy, and lactic acid accumulates in the blood.
19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should:
remove the airway and be prepared to suction her oropharynx.
Inhalation occurs when the
diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
Dyspnea is MOST accurately defined as:
shortness of breath or difficulty breathing.
Hyperventilation could be associated with all of the following, EXCEPT:
Choose one answer.
A. a respiratory infection.
B. an overdose of aspirin.
C. high blood glucose levels.
D. a narcotic overdose.
a narcotic overdose
You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to:
log roll him as a unit to a supine position.
In what area of the lungs does respiration occur?
alveoli
Harsh, high-pitched inspiratory sounds are characteristic of:
stridor
Which of the following structures is NOT found in the upper airway?
A. larynx
B. pharynx
C. bronchus
D. oropharynx
C. bronchus
In infants and children, a capillary refill time (CRT) that is greater than __ second(s) is a sign of poor peripheral perfusion.
2
Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:
you were exposed to another infected person prior to treating the 34-year-old patient.
Distributive shock occurs when:
widespread dilation of the blood vessels causes blood to pool in the vascular beds.
The two processes that occur during respiration are
inspiration and expiration.
Which of the following statements regarding the hypoxic drive is MOST correct?
Choose one answer.
A. Chronic carbon dioxide elimination often results in activation of the hypoxic drive.
B. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.
C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.
D. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
In order for efficient pulmonary gas exchange to occur:
. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct?
Choose one answer.
A. MRSA is a bacterium that causes infections and is resistant to most antibiotics.
B. The communicable period for MRSA is 10 days to 2 weeks after being infected.
C. Studies have shown that less than 1% of health care providers are MRSA carriers.
D. Most cases of MRSA transmission occur following an accidental needlestick.
MRSA is a bacterium that causes infections and is resistant to most antibiotics.
Hypoxia is MOST accurately defined as:
inadequate oxygen to the tissues and cells.
Upon initial contact with a patient who appears to be unconscious, you should
attempt to elicit a verbal response by talking to the patient
Which of the following conditions would LEAST likely result in hypoxia?
A. pleural effusion
B. pulmonary edema
C. prolonged seizures
D. severe anxiety
D. severe anxiety
Syphilis is a:
bloodborne disease that can successfully be treated with penicillin
Which of the following clinical signs is unique to anaphylactic shock?
Choose one answer.
A. hypotension
B. wheezing
C. pallor
D. dizziness
wheezing
Which of the following conditions is NOT categorized as a psychiatric condition?
Choose one answer.
A. substance abuse
B. schizophrenia
C. depression
D. Alzheimer’s disease
A. substance abuse
Which of the following would MOST likely result in hemorrhagic shock?
Choose one answer.
A. liver laceration
B. repeated diarrhea
C. severe vomiting
D. excessive sweating
liver laceration
Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:
psychogenic shock.
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
Which of the following statements regarding the human immunodeficiency virus (HIV) is correct?
Choose one answer.
A. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
B. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting.
C. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.
D. The risk of HIV infection is high, even if an infected person’s blood comes in contact with your intact skin.
The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.
Gas exchange in the lungs is facilitated by:
adequate amounts of surfactant.
Which of the following is a late sign of hypoxia?
Choose one answer.
A. tachycardia Incorrect
B. anxiety Incorrect
C. restlessness
D. cyanosis
cyanosis
An infectious disease is MOST accurately defined as:
Choose one answer.
A. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs.
B. a disease that can be spread from one person or species to another through a number of mechanisms.
C. a medical condition caused by the growth and spread of small harmful organisms within the body.
D. any disease that enters the body via the bloodstream and renders the immune system nonfunctional.
C. a medical condition caused by the growth and spread of small harmful organisms within the body. Correct
Pulmonary edema and impaired ventilation occur during:
cardiogenic shock
Reassessment of a patient with a medical complaint should begin by
repeating the primary assessment
an organ or tissue may be better to resis damage from hypperfusion if the
body temperature is consistently less than 98.6F (37.0)
the electrical impulse by the heart originates in the
sinoatrial node(sa)
what is true about blood clotting?
a person taking aspirin will expierence slower blood clotting
classic symptoms and signs of hypoglycemia include
cool, clammy, weak, tachycardia, rapid respirations
glucose is a trade name for
oral glucose
What organs lie in the retroperitoneal space?
gallbladder
common causes of psychotic behavior include the following, except
Alzheimers dieses
significant vital signs changes will occur if the typical adult acutely loses more than___of his or her blood
20%
What is a fact of hemophilia’s?
may bleed spontaneously
as red blood cells begin to clumb together to form a clot,____reinforces the clumped red blood cells
fibrinogen
when assessing arm movement of a suspected stroke, you should
expect to see one arm slowly drift down to the patients side
hypoperfusion is another name for
shock
activated charcoal administration is contraindicated in patients who have ingested
acids or alkalies
anaphylaxis is mod accurately defines as an
extreme allergic reaction that may affect multiple body systems
what is not an assessment parameter included in the cincinati prehospital stroke scale
memory
what is not a function of the sympathetic nervous system?
constriction of blood vessels in the digestive system,
an absence seizure is also referred to as
petit mal seizure
which of the following is a metabolic cause of a seizure
poisoning
a raised swollen well defined area on the skin that is the result of an insect bit or sting
wheal
status epileptics is characterized by
prolonged seizures without return of consciousness
a transient ischemic attack (TIA) occurs when
the normal body process destroy a clot in a cerebral artery
as woman approaches menopause
her menstrul periods may become irregular and vary in severity
a young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. as your partner is assessing and managing his airway, you should control obvious bleeding then
assess for an exit wound
the most significant risk factor for a hemorragic stroke is
hypertension
cardiac output may decrease if the heart beats too rapidly because
there is not enough time between contractions for the heart to refill
because the stinger of a honeybee remains in the wound following sting
it can continue to inject venom up to 20 mins
your unit is dispatched to the county jail for an inmate. on arrival, you find the patient a 33 year old male lying supine in a jail cell. He is responsive to painful stimuli only has a slow, shallow respirations. you should be most concerned that this patient
may vomit and aspirate
air bags are designed to
decrease the severity of deceleration injuries
functions of the liver include
production of substances necessary for blood clotting
the normal blood glucose level as measured by a glucometer is between
80 and 120 mg/dl
epinephrine is indicated for patients with an allergic reaction when
wheezing and hypotension are present
sudden death following AMI is most often caused by
ventricular fibirillation
the head and brain receive their supply of oxygenated blood from the
carotid arteries
the purpose of defibrillation
stop the chaotic,disorganized contraction of the cardiac cells
your paramedic partne administers atropine to a 49 year old male with bradycardia. which of the following side effects would you expect the patient to have
dry mucus membrane
what organ would most likely bleed profusely if injured?
liver
in contrast to level 3 trauma center, a level 1 trauma center
must have general surgeons on call 24/7
you respond to a 55 year old residence, female with a possible allergic reaction to peanuts that she ate approx 30 mins ago. the patient is conscious and alert but has diffuse uticaria and the feeling that she has a lump in her throat. as your partner applied oxygen. you should
ask her if she has prescribed epi
esophageal varicose most commonly occur in patients
drink a lot of alcohol
urticaria is the medical term for
hives
a patient with an altered mental status
is not thinking clearly or is incapable of being aroused
hypoglycemic crisis tends to develop more often and severely in children
they do not always eat correctly and on schedule
you arrive at the scene of a 33 year old woman who i experiencing a generalized seizure. she has a small amount of vomiyus draining from the side of her mouth. after protecting her from further injury. you should
maintain her airway, suction her airway, insert nasopharyngerl airway. admin high flow o2
an important aspect in the treatment of a patient with severe abdominal pain is to
provide emotional support to the hospital
pain that is localized to the lower back and/or lower abdominal quadrants is most suggestive of
aortic aneurysm
gastrointestinal bleeding should be suspected if a patient presents with
hematemsis
the inferior vena cava returns deoxygenated blood to the right side of the heart from all the following areas(kidney abdomen legs) except the
brain
approx 25% of severe injuries to the aorta occurring during
lateral collisions
in non trauma patients, an early indictor of internal bleeding is
dizziness upon standing
the systemic veins function by
returning deoxygenated blood back to the heart
injury to a hollow abdominal organ would most likely result in
a leakage of contents into the abdominal cavity
nitroglycerin is contraindicated in patients
who have experienced a head injury
the single most significant factor that contributes to suicide is
depression
which of the following met accurately describes the cause of an ischemic stroke
blockage of a cerebral artery
AED is the most advantageous to an EMT because
it delivers prompt defillbilartion to patients in V-Fib
you arrive at the home of a 50 year old female with severe epitaxis, as you treat her it is most important to recall
the patient is at risk for vomitting and aspiration
two of the most common mechanisms of injury for blunt trauma are
falls and motor vehicle collisions
acute coronary syndrome is a term to describe
a group of symptoms that are cause myocardial ischemia
deoxygenated blood from the body returns to
the right atrium
what organ can tolerate inadequate profusion for up to 2 hours
skeletal muscle
if direct pressure with a sterile fails immediately to stop severe bleeding you should apply
a tourniquet proximal to injury
when assessing a patient who is displaying bizarre behavoir an emt should
consider acute medical illness may be causing the patients behavior
what is the major difference between AMI and angina pectoris
anginal pain typically subsides with rest
patients with acute abdominal pain should not be given anything to drink because
substances in the stomach increase risk for aspiration
most patients with the abdominal pain prefer to
lie on side with knees drawn in
after applying pressure dressing to a laceration on a patients arm, you notice the blood is beginning to saturate, you should
place additional dressings
prior to assisting a patient with his or her prescribed nitrogen, the emt must
obtain authorization by medical control
assessment of a patient with hypoglycemia will most likely reveal
combativeness
when assessing a patient with a behavioral crisis, you should
be direct and clearly state your intentions
what sound indicated swelling of the upper airway
stridor
diabetes is most accurately defined as a
disorder of carbohydrate metabolism
hypovolemic shock occurs when
the body can’t compensate for rapid blood loss
the effects of epinheprine are typically within___following administration
1 minute
what finding is the least suggestive of the presence of high energy trauma
deployment of airbag
chronic renal failure is a condition that
often caused by hypertension or diabetes
a generalized seizure is characterized by
severe twitching of all body muscles
PID typically does not affect the
urinary bladder
DTs is a syndrome associated with a withdraw from
alchol
common signs and symptoms of an allergic reaction include: dry cough, flushing of the skin and abdominal cramps but not__
drying of the eyes
a fractured femur can result in the loss of__or more of blood
1 L
an overdose on acetaminophen, the active ingredient tylenol,will most likely cause
liver failure
the ability of cardiac muscle to contract spontaneously without a stimulus from a nerve source is called
automaticity
heroin id an example of
opiod
common side effects of nitro include headache, bradycardia, hypotension except
hypertension
what is the function of the left atrium
receives oxygenated blood from the lungs
perfusion is most accurately defined as
circulation of blood within an organ in adequate amounts to meet the bodes metabolic needs
ventricular tachycardia causes hypotension because
the left ventricle does not adequately fill with blood
you and your partner arrive at the scene of a middle aged man who collapsed 5 mins ago. he is unresponsive, apenic, and pulseless. Bystanders are present but have not provided any care. you should
perform 5 cycles of cpm and apply the aed
early signs and symptoms of intra-abdominal bleeding include
pain and distention
which of the following medication blocks the release of histamines
a. albuterol(ventolin)
b. diphenhydramine(benadryl)
c. acetametaphen(tylenol)
d. epi
B
a poison that enters the body by__is the most difficult to treat
injection
when caring for a woman who is experiencing a gynecolgic emergency the emts main focus should be
maintain abcs and transport without delay
you respond to movie theater for a 70 year old male who is confused. he has type 2 diabetes and refuses to take his pills. he is diaphoretic tacky and tachypenic. initial management should include
applying a nonrebreather mask at 15 L/m
what vein is located inferior to the trunk
saphenous
the first indicator of non traumatic internal bleeding may be
weakness or dizziness
when evaluating the mechanism of injury of a car vs pedestrian you should first
approximate the speed of the vehicle that souk the patient
when using an auto inject, the primary inject site is the
lateral portion of the thigh muscle control nd coordination are controlled by the cerebellum
a dissecting aortic anerysm occurs when
the inner layer of th aorta become separated
when assessing an elderly patient who fell it is important to remember
osteoporosis van cause a fracture that may have resulted from the fall
the physical exam of sexual assault should
limited to brief survey for life threatening events
what about gonorrehea is correct
painful urination is seen in both men and women
you are dispatched to a 56 year old with ams, the patients wife tells you that he complained of chest pain the day before. he is semiconscious rapid and shallow respirations and therapy pulse you should
begin ventilary assistance
type 1 diabetes is
a condition where the body makes no insulin
the onset of menstruation(menarche) usually occurs when women are
11-16
what had the greatest impact on producing injury for a gunshot wound
the speed of the bullet
a 40 year old ale with 300 mg blood sugar. is semi conscious and breathing slowly and is receiving assisted ventilation from your partner. you should recognize the definitive treatment as
insulin
force acting over a distance defines the concept of
work
commons sign and symptoms of AMI include: irreg heartbeat unexplained sweating and dypsnea but NOT
pain exacerbated by breathing
how do fire ants bite?
repeatedily
the ability for a person’s cardiovascular system to compensate for blood loss most related to
how fast they bleed
if a person stands near a building when it explodes, the will pst likely expiernce
stomach rupture
if one or more occupants in the same car are killed the emt should
suspect that all living occupants have the same trauma
signs of agitated delirium include
diaphoresis tacky and hallucinations w
whenever possible a female sexuale assault victim should be
given the option of being treated by a female emt
bleeding from the nose following head trauma is a sign
of skull fracture and should not be stopped
common side effects of epi does not include
drowsiness
diabetic coma is a life-threatening condition tha results from
hyperglycemia ketoacidosis and dehydration
kussmaul respirations indicate the body is
attempting to eliminate acids from the body
angina pectoris occurs when
myocardial o2 demand exceeds supply
the left ventricle has the thickest walls because it
pumps blood into the aorta and systemic circulation
the two most common signs of anaphylaxis
wheezing and widespread uticaria
what is NOT a major risk factor of AMI
hypoglycemia
the term “behavioral crisis” is most accurately defined as
any reaction that interferes with the activities of daily living or is deemed unacceptable by others
a stinger from a honey bee should be
scraped off
the mental status of a patient who has experienced a typical seizure
is likely to improve over a period of 5 to 30 mins
most cases of external bleeding from the extremity can be controlled by
applying local and direct pressure
the right coronary artery supplies blood to
the right ventricle and inferior wall of the left ventricle
the mucosal atomizer device(MAD) is used to deliver certain meds via the
intranasal route
the left side of the heart that receives oxygenated blood from the lungs through the
pulmonary veins
Order of the spinal column
cervical thoracic lumbar sacral cocyx
anterior to the knee is a specialized bone called the
patella
which of the arteries does not carry highly oxygenated blood
pulmonary
the elbow is a __ joint
ball and socket
what happens when blood volume is lost from the body
arteries contract to increase the bp
the anterior fontanelle fuses together between the ages of
9 and 18 months
what is a physical change that typically occurs in the adolescent age
secondary sexual development
abnormalities in metabolism are most likely due to the disfunction of the
pancreas
a bp cuff that is too small for a patients arm will give a
falsely high systolic and diastolic reading
which of the following statements regarding middle adults is correct
cardiovascular health becomes an issue and increased risk of cancer
in relation to the wrist the elbow is
proximal
a decrease in bp may indicate
loss of vascular tone
medication that has the slowest rate of absorption
oral
the primary function of the right atrium is to
receive blood from the vena cava
the vocal cords are located in
the larynx
the human body is at the optimal level at ages
19-25
LUQ
Spleen stomach and a portion of the colon
RUQ
Liver gallbladder and portion of the colon
RLQ
Two portions of the large and small intestine, appendix
LLQ
The descending and sigmoid portions of the colon
what do you do for labored, contstriction, or lack of tidal volume
assist ventilations with BVM
What do you do for acid in eyes
irrigate, if contacts take them out
Signs and Symptoms of tension pneumothorax
progressive shortness of breath
increased altered level of consciousness
neck vein distention
tracheal deviation
What organ could be affected by trauma to the upper right quadrant
liver
flail chest is charcterized and defined by
paradoxical motion
2 or more ribs broken in two or more places
subcutaneous emphysema what is it and how to treat
A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues. treat by positive pressure ventilations
Daughter is power of attourney and wants father to recieve care, father is AxO x4 and does not want care
Respect patient wishes because he is concious without altered mental status
Open fracture and bleeding PPE
gloves, mask, goggles
What EMS statistic is needed to reduce speed limit in given area
Fatalities and injuries that have happened on that stretch of road
Triage color green
ambulatory,
yellow
delayed
red
immediate
black
dead/ expectant
you are treating a 300 pound male who cannot walk what should you do
call for assistance
triage in the
cold zone
Pedatric/ infant breath rate
18-30
Cardiac arrest in children is caused most likely by
hypoxia, resp distress or failure
Croup is characterized by
hoarseness, “barking” cough, inspiratory stridor and varying degrees of respiratory distress resulting from swelling in or obstruction in the region near the larynx.
Steps to treating bleeding
first direct pressure then tourniquet is direct pressure does not stop the bleeding
Signs and symptoms of meningitis
fever, rash, stiff neck, altered mental status
specifcally in infants: Swelling of fontanelles
Apgar scale
appearance, pulse, grimace, activity, respiration
when treating allergy primary concern is
AIRWAY
when to start chest compression on newborn
pluse under 60
ruptured spleen in child
bleeding and pain
right upper quadrant
Liver, Right Kidney, Colon, Pancreas, Gallbladder
left upper quadrant
spleen, left kidney, stomach, colon,
left lower quadrant
Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord
right lower quadrant
cecum, appendix, right ovary and tube, right ureter, right spermatic cord
Signs and symptoms of epiglottitis
Sudden onset, high fever
“Hot-potato” voice
Dysphagia, drooling
No cough
Prefers to sit upright, lean forward (tripod position)
Appears toxic and stridulous
when babies head appears out of vaginal canal check for
nuhical cord
place baby where until umbillical cord is done pulsating
at the height of the vaginal canal
transport pregnant women in what position and why
left lateral recumbant to take pressure of the heart and vena cava
questions for pregnant mom
how many weeks along are you
how far apart are contractions
Signs of imminent delivery
Crowning, Urge to bear down or go to the bathroom, “It’s Coming”, and Contractions of increased frequency & intensity.
preclampsia
abnormal condition associated with pregnancy marked by high blood pressure proteinuria, and edema.
eclampsia
true toxemia of pregnancy characterized by high blood pressure, albuminuria, edema of the legs and feet, severe headaches, dizziness, convulsions, and coma
ovarian cyst signs and symptoms
lower pain on either side, nausea, bleeding, ask when last menstrutal cycle was
PID signs and symptoms
-onset is usually after menses
-sudden pelvic pain, profuse vaginal exudate, fever, metrorrhagia, discharge
When to massage fundus
stops bleeding and cramping after delivery
woman is bleeding after sexual assualt
use pad or sterile gauze and put under her to collect the blood
breech birth
Baby is delivered feet or buttocks first
when can you insert a gloved finger into the vaginal canal
if umbillical cord is around the babies neck
perineum tearing
tearing from vagina to anus after delivery
preciptitous delivery
perineum tearing and emergency delivery
bleeding from shunt
don’t let this question confuse you
hold pressure at place of bleeding
Pancreatitis symptoms
upper abdominal pain, swollen and tender abdomen, nausea, vomiting, fever, increased heart rate, weight loss, and diabetes.
important to note if they are chronic drinkers
petite mal seizure
blank out for 3-5 seconds, still conscious, eyes may flutter
zone out
Focal Motor Seizure
Starts in a group of muscles a “focus”
May progress to include the whole entire arm
May progress to a Grand Mal Seizure
grand mal seizure
They may have an “aura”
Tonic-Clonic phase
Loss of consciousness
clenched teeth, biting the cheek or tongue, incontinence
post-itcal phase
status epilepticus
A condition in which seizures recur every few minutes or last more than 5 minutes.
example question: Patient is zoned out, could be poison, OD or low blood sugar or seizure, question gives you the age of the patient and no other signs or symptoms, because of the lack of signs of poison or pills or history of diabetes it is most likely
seizures
Appendicitis signs and symptoms
rebound tenderness, young, pain near umbilical region, right lower quad
eptopic pregnancy
implantation of the fertilized egg in any site other than the normal uterine location happens in first trimester
abruptio placentae
premature separation of the placenta from the uterine wall, third trimester
placenta previa
implantation of the placenta over the cervical opening or in the lower region of the uterus, third trimester
spontaneous abortion
when the fetus and placenta deliver before the 20th week of pregnancy; commonly called a miscarriage
subarachnoid hemorrhage
worst headache, assess bp will be low, cushing triaid, slow pulse, unbalanced respirations
Left sided heart failure
shortness of breath
right sided heart failure
- Jungular Vein Distention
- Ascending Dependent Edema
- Weight Gain
- Hepatomegaly (Liver Enlargement)
steps when assessing unconc patient
check for responsiveness, check for pulse, check for chest rise and fall
communicable disease PPE and decom
mask, gloves, goggles, disinfect with approved germicidal agent
Oral Glucose Indications
hypoglycemia, able to swallow
when to extricate before giving care
direct life threat/ scene saftey threat ex: fire in car
OPIOD indications
pinpoint pupils, respiratory arrest, cyanosis, track marks
Cholecystitis
inflammation of the gallbladder
Cholecystitis S/S
severe midepigastric or right upper quadrant pain radiating to back and referred to right scapula usually after meals
fat intolerance
flatulence
indigestion
diaphoresis
n/v
chills
low grade fever
possible jaundice
clay-colored stools with common bile duct obstruction
when approaching a psych patient
calm them down, be reassuring, deescalate the situation
carbon monoxide poisoning
-carbon monoxide binds with hemoglobin and reduces oxygen supply to tissues
-cannot be seen. smelled, or tasted
-s/s include: nausea, vomiting, headache, weakness, and unconsciousness, Altered LOC, high SPO2
-death may occur with prolonged exposure
-prevention by ensuring proper ventilation when using fuel-burning devices
-gas-burning devices should be inspected annually
-flues and chimneys should be unobstructed
-carbon monoxide detectors should be installed and inspected regularly
NPA indications
concious with gag reflex
Suction Catheter for oropharynx
yonker tip/ ridgid tip
spontaneous pneumothorax
increaed heart rate, hypoxia, chest pain
Tension pneumothorax
S/S
JVD, diminished/absent lung sounds, tracheal deviation towards unaffected side, poor BVM compliance
pneumonia
swollen avoli, crackles, fever, warm dry and flushed, transport and give oxygen
chronic bronchitis
lungs constantly inflamed, barrel chest
systolic pressure
Blood pressure in the arteries during contraction of the ventricles.
diastolic pressure
Blood pressure that remains between heart contractions.
Contraindications of nitroglycerin
(Contraindications:) Cerebral hemorrhage, sexual enhancement drugs, hypotension-systolic blood pressure < 100.
important stroke question to ask
when was the last time they were seen normal
pulmonary edema s/s
Severe dyspnea and air hunger
Cough productive of frothy, blood tinged sputum
Tachypnea and tachycardia
Cold, clammy skin
Cyanosis
Extreme apprehension
Confusion, stupor
caused by left sided heart failure
transport shock patient in
supine
agonal respirations treatment
BVM
Heart Failure S/S
Shortness of breath, fatigue, and weakness, weilling in the legs, feet abdomen. Reapid or irregular heartbeat with S3 or S4 heart sounds, persistent cough or wheezing, and weight gain from fluid etention. Treatment: balance of medication, devices, and lifestule changes to heald the heart contract normally.
TIA
mimic stroke, symptoms go away in 24 hours
CVA
ruptured artery in brain hemmorragic shock
Ischemic stroke symptoms
facial droop, weak, slurred speech, time
cardiogenic shock
post MI, irregular pulse, low BP, thready pulse rate fast, pale, cool, clammy
BVM if respirations are
under 12 or over 20 (not exact) and do not have good lung sounds, under 8 ventilate
wheezing
High pitched sound heard in the lungs with asthmatics or lung disease lower airway
Rhonchi
Rattling noise of mucous in the lungs, upper airway
crackles
(rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration lower airway
stridor
upper airway, indicated foreign object
if ventilations are not going in what should you do
resposition
Nasal Canula flow rate
1-6
BVM flow rate
15-25
NRB flow rate
10-15 LPM
Nebulizer flow rate
6-8 lpm
if patient collaspes with airway obstruction
check for pulse, start w chest compressions
what to ask when approaching chocking vicitm
Are you chocking? Tell them to cough, when no air is entering the lungs start back blows and chest thrust
threat patient w humidified oxygen if
swollen throat, croupy cough, assessory muscle use, or stridor, not if anaphylatic
when patient is having trouble breathing, to get their history ask
yes or no questions
landing zone
100 by 100 ft
when to request additional assitance
too many for your team to handle, requested before even exiting ambulance
Quaility improvement for EMS
critiquing what went well and what could be improved upon, internal and external review
Rapid extraction
can be necessary even if CSPine is indicated
BSi PPE for profuse bleeding
Gloves, eye protection, mask
Notify law enforcement when hospice death
doesn’t add up to natural causes
USing TC
extracation when needing to remove piece of car from patient
Minor on scene transporting parent
take them in ambulance with you or call law enforcement to transport them
Using power grip hand go
10 inches apart
When driving proceed through intersections
like no one can hear the sirens
when correcting an error on document
line through it and initial
triage where
in cold zone
community relations example
offer BP check to whole community
WHn patient is unoconcious and unrepsonsive first always
check pulse and start CPR
black and tarry stool
upper GI bleed
Lower GI bleed
bright red stool
When to remove a penetrating object?
- Obstructs airway
- Impedes CPR
usually just stablilize
3 year old is drooling and oesn’t want to eat? what does he most liekly have?
epiglottitis
Signs of respiratory distress in children
grunting, intercostal retractions, nasal flaring
You arrive on scene and CPR is in progress what shuld you do
apply AED
AED Shockable Rhythms
V-tach and V-fib
what to do for gurgling respirtations
suction
pumonary edema
Abnormal accumulation of fluid in the interstitial spaces of the lungs. Blood backs up into pulmonary circulation because left ventricle can’t pump it forward (Can occur acutely, such as with MI Or can occur as an exacerbation of chronic HF)
Emphysema
A serious disease that destroys lung tissue and causes breathing difficulties.
pink and skinny
check pulse of hypothemic oatient for at least
30 seconds
signs and symptoms of congestive heart failure
-Cough (frequent, productive, hemoptysis)
-Progressive dyspnea with exertion
-Orthopnea
-Pitting edema of legs and feet or generalized edema of face, hands, or sacral area
-Heart palpitations
-Progressive fatigue or syncope with exertion
-Moist rales in lower lobes, indicating pulmonary edema
What does nitroglycerin do
- Vasodilator, opening up vessels to increase blood supply to the heart
- Smooth muscle relaxant
what position to place nitro patient in
supine
responding to cardiac arrest
start w compressions then go to AED
after delivery of baby
dry and warm keep at vaginal opening level
hypothermia treatment
remove from cold, take off wet clothing, wrap in blankets, severe cases EMS ASAP
gunshot wound, shortness of breath how to treat
ventilate, immoblize, take vitals and apply occlusive dressing
puncture wound apply what
3 sided occlusive dressing
head inury and blood thinner causes
hemorrraging
bubbling/ bleding from chest apply
fully occulsive dressing
femur fracture
lower than hip, deformities, less angulation that hip dislocations
hip discolation
rotates whole leg
knife is implaed
stablilize with bulky dressings
pulmonary contustion
trauma to the chest
aorta dissection
tearing pain to the back
Annurism
when a vessel wall weakens and balloons
aorta rupture
dead
Nose bleed
lean forward and pinch nose
Rule of (s
arm – 9, 1/2 arm 4.5, head 9, palm 1
neck puncture wound
occlusive dressing
spleen
-Upper left of the abdomen, behind the stomach and below diaphragm.
-Lymphoid tissue
-Blood vessels are connected to the spleen by splenic sinuses.
-Function: Filter unwanted materials from the blood (including old RBC) and to help fight infections.
-Up to 10% of the population has one or more accessory spleens that tend to form at the hilum of the original spleen.
eccomosis
bruising, often caused by internal bleeding
solid organ rupture
results in internal bleeding, abdominal distention, eccomosis
any kind of abdominal pain first thing you do
two Es: expose and examine region
pulmonary embolism
A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.
- Which statement strongly indicates syncope?
I blacked out for a few seconds - When assessing the patient for arm drift, you should ask the patient to
hold their arms out palms up, eyes closed - 68 yo patient reports abdominal pain, vomiting, and a loss of appetite, as well as black, tarry stools. you should suspect
upper gi bleed - You are called to an outdoor garden center on a hot, humid day. Your patient is pale, wheezing, and has hives. you should suspect
bee sting - you have been dispatched to a behavioral emergency. The police are on the scene and have asked you to evaluate the patient. you should
restrain the pt. to your cot and transport to the nearest hospital - a pt. was cleaning a bathroom when he came out gagging and coughing. his eyes are red and watering and he is complaining of dyspnea. you should
move the pt to a well ventilated area - 38 yo pt. has a history of hypothyroidism. she is hypertensive, tachycardic, and hyperthermic. you find an empty bottle of Synthroid nearby. You should
contact the poison center or medical command. - a pt’s family member reports a glucometer reading of 57 mg/dL. how should you interpret this reading?
low - a worker at a fertilizer plant has spilled lye all over his upper body. you should
brush the powder off the pt. - to assess a possible stroke pt for abnormal speech, you should
ask the pt to repeat a common phrase - a pt was stung by a bee. you should
apply ice cold compress to the affected area - 72 yo male has weak hand grips, blurred vision, and is unable to tell you the day of the week. he is a type 2 diabetic. what should you do
evaluate for facial droop - which of the following meds helps the body transport sugar into the cells
insulin - an unconscious patient has one pupil that is significantly larger than the other and not reactive to light. the most likely cause is
stroke - where would you expect to find pain in a pt with suspected appendicitis
right lower quadrant - when assessing a pt for facial droop, you should
ask pt to smile or show his teeth - which of the following assessment findings suggests a gi bleed
bright red blood from the rectal area - you are assessing an unresponsive medical patient. what should be your primary focus
chief complaint - a patient has a headache. how should you position him on the cot
90 degree fowler - 50 yo male who recently completed renal dialysis is bleeding profusely from his shunt. how should you classify this bleeding
a life-threatening problem that requires immediate surgical intervention - a 28 yo pt is outside at a concert and appears confused. he is unable to answer your questions. you should
look for a medical identification necklace or bracelet - a car battery exploded in your pt’s face. he denies any breathing difficulty. you should
irrigate eyes with water - a patient is having a tonic-clonic seizure. he is not breathing. you should
prevent the pt from further injury - your first priority whe. dealing with a pt who is exhibiting behavior issues is to
ensure the safety of yourself and your partner - 78 yo M alzheimers pt has bruising on his back, neck, and stomach. when you ask the pt what happened, his caregiver insists “he fell getting out of bed” what should you do
a. ask on of the family members to ride in the back with him
b. ask the caregiver why the pt required restraint
c. immediately notify law enforcement to take a report
d. move him into the ambulance so you can talk to him alone
c. notify law enforcement to take a report - according to the Cincinnati prehospital stroke scale, which of the following should be assessed
facial droop - A 32-year-old patient is found unconscious in the snow. You cannot detect a pulse or respiration rate within 10 seconds. What should you do?
assess her pulse for 30-45 seconds - An 80 y/o male complains of a headache and nausea. He is confused with hot, dry skin. His house is hot and humid. VS are BP 90/55, P 96, R 18, SpO2 88% and BGA 88 mg/dL. What should you do?
Begin active cooling measures (signs of heat stroke, also think of fluid replacement due to dehydration) - A 28 y/o female complains of sudden onset of dyspnea while eating in a restaurant. Her tongue is swelling and she has urticaria on her neck. VS are BP 86/44, P 116, R 18 with wheezing. What should you administer?
Epinephrine .3 to .5 IM 1:1000 (should suspect anaphylactic shock) - While spraying pesticide on his crops, a 51 y/o male started to feel lightheaded and had trouble breathing with excessive saliva production. What should you administer?
Atropine (cholinergic response with the signs of SLUDGE, need to use a anticholinergic drug which is atropine, which blocks the effects of the accumulating acetylcholine) - An adult male is sitting alone in a dark room, rocking back and forth. he mutters to his sock puppet “are you feeling sad?” what should you do?
introduce yourself and start an assessment - A mother of a 17 y/o male called EMS because her son has a depressed affect. While assessing him, he states “I’m not sure if I can take this anymore.” What should you do?
Inquire about his suicidal ideations (his statement is a warning sign that he may be thinking of suicide) - A febrile 54 y/o female complains of nausea and vomiting with pain around her umbilicus. Her abdominal tenderness increases on palpation. VS are BP 80/40 and P 130. What should you suspect?
Ruptured appendix (rebound tenderness and febrile) - a 42-year-old man complains of difficulty breathing and pain in his chest and shoulders. he recalls feeling a sharp pinprick on his arm while cleaning out his basement. what type of spider bite is this man most likely suffering from?
black widow - a car battery exploded in your patient’s face. he denies breathing difficulty. you should?
begin irrigating eyes with clean water - a 19-year-old female is unresponsive after taking a whole bottle of her sleeping medicine about 4 hours ago. you should?
apply high-flow oxygen - a 32-year-old male complains of photophobia (sensitivity to light) and vomiting. the most likely cause is?
migraine - a patient tells you he had anemia, you should expect him to present with?
pallor - your epileptic patient complains of a persistent metallic taste in her mouth. you should suspect:
a seizure may occur - A patient is having a tonic-clonic seizure and is not breathing. you should:
prevent patient from further injury - a patient has severe groin pain radiating to the flank area and can’t sit still
kidney stones (renal calculi) - A nursing home patient, an older lady has various colors of bruising on her cheek and wrist. what should you suspect?
abuse - a patient has flank pain, pain on urination, and diaphoretic with no fever. what do you suspect?
kidney stones - unresponsive patient naked guy in the front yard with pinpoint pupils. what should you suspect?
opioid overdose - how to treat a postictal patient?
high flow oxygen - female patient with abdominal pain vomits bright red blood. what should you do?
manage the airway - A 40-year-old female with abdominal pain in mid epigastric region is nauseous and subsides with eating. you should suspect?
peptic ulcers - severe abdominal pain radiating to the back. what should you suspect?
triple a - working in shed complains of abdominal pain. red small mark that starts to swell. what type of spider bite is it?
black widow - A 32-year-old patient is found unconscious in the snow. You cannot detect a pulse or respiration rate within 10 seconds. What should you do?
assess her pulse for 30-45 seconds
51 a 42-year-old man complains of difficulty breathing and pain in his chest and shoulders. he recalls feeling a sharp pinprick on his arm while cleaning out his basement. what type of spider bite is this man most likely suffering from?
black widow
52 19 year old female is unresponsive after taking a whole bottle of her sleeping medicine about 4 hours ago. you should?
apply high-flow oxygen
53 an 18 year old male states “the CIA is after me” you notice he has covered his head and windows with aluminum foil. when you ask why he says “in order to block out the government radio waves” vitals are BP138/34, P122, R24. you should suspect?
paranoid schizophrenia
54 a patient is running a high fever, vomiting and reporting pain that has shifted from around her belly button to the lower right area of her abdomen you should suspect?
appendicitis
55 a 20 year old male in a college dorm room complains of fever, headache, and a stiff neck. he has an altered mental status, and you notice red blotches on his skin. which of the following are the most appropriate BSI precautions
gloves and HEPA mask
56 an unconscious patient has one pupil that is significantly larger than the other and not reactive to light. the most likely cause is:
stroke
57 what is hyperglycemia
high blood sugar
58 when assessing a patient for facial droop you should?
ask the patient to smile or show his teeth
59 an alert patient has a severe headache/weakness of the left arm you should suspect?
stroke
60 which of the following most accurately describes insulin?
it helps glucose move into the cells
61 a patient with a headache. how should you position him on the cot?
62 You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this scenario, what should you do immediately?
check the patients BGL
63 Which of these statements made by your new EMT partner demonstrates an understanding of assessment findings related to stroke?
“If one arm is weak, a stroke should be suspected.”
64 A 41-year-old female patient has called 911 for a headache. Which of these assessment findings should make the EMT suspicious that the patient has a migraine headache?
The pain was preceded by an aura
65 An elderly male patient with a history of COPD, hypertension, and diabetes presents as lethargic and confused. His airway is patent, and breathing is adequate. His skin is hot and his radial pulse is strong, regular, and bounding. Vital signs are pulse, 112; respirations, 20 breaths/min; blood pressure, 108/64 mmHg; SpO2, 94%; andtemperature, 102.8°F. Also noted is swelling to his right lower leg. Given these assessment findings, the EMT should suspect which condition is responsible for thepatient’s altered presentation?
infection
66 Assessment reveals a drooling 48-year-old male patient to have gurgling speech and left-arm paralysis. The EMT’s immediate priority treatment is to:
Suction the airway
67 a patient with a headache. how should you position him on the cot?
Semi Folwer
68 an unconscious 33 year old patient was found lying prone in a local park. he was apneic. you should:
put in supine, check airway
69 you have been dispatched to a behavioral emergency. the police are on scene and have asked you to evaluate the patient. you should
ask police to help secure the scene
70 an 18 year old female has progressively became lethargic at a party. vitals are BP90/60, P48, R4, you should suspect:
narcotic overdose
71 a 20 year old female is resting after running for 30 minutes. she normally runs 5 miles every day but today she “can’t catch her breath”. flushed skin, fast and weak pulse, fast respirations with wheezing, complains of itching arms and chest
anaphylaxis
72 An unresponsive patient with arms and legs violently jerking. what phase of generalized seizure is this?
clonic
73 An elderly patient complains of abdominal pain and back pain. has tarry stools for three days. what should you suspect?
GI bleeding
74 A 82-year-old female complains of nausea and vomiting for two days. she ran out of her prescription heart medication last week. BP158/92, P92 irregular, R18
administer oxygen and monitor vitals
75 a 16 year old female with severe abdominal pain “hasn’t had a period in two months and the pain started this morning” BP90/70, P130, R28. skin is pale and cool. what should you suspect?
hypovolemic
epinephrine side effects on the cardiovascular system
constricts blood vessels
a hiker is found in the mountains. patient is flushed and their mucous membrane is slightly blue
low oxygen level
a 23 year old male with bipolar disorder. depressed and locked himself inside the bathroom
call law enforcement to secure the scene
patient has irregular respirations and is agitated. is pacing back and forth. skin is cool and clammy
hypoglycemia
a 71 year old male is unconscious and cold to the touch at a park. he is a resident of the Alzheimer’s center. outside temperature is in the low teens. what do you keep in mind when trying to obtain a pulse
pulse should be palpated in two places
a 31 year old male is vomiting and has diarrhea for 10 hours. complains of weakness and light headedness upon standing. pale and diaphoretic. vitals should be:
BP90/60, P124, R20
72 year old female has slurred speech and left arm weakness prior to EMS arriving. what do you think happened
transient ishemic attack
a 20 year old female is unconscious after being submerged in a lake for three minutes. she has a pulse and agonal breathing.
ventilate using a BVM
middle aged patient outside a homeless shelter. coughs up pink sputum and passes out
don a N95 respirator prior to continuing assessment
a 42 year old female states she is “having the worst headache of my life”. vomiting. BP180/90, P68, R14 what should you suspect?
Migraine
5 employees feel “light-headed”. they have respiratory problems after working in a packing company.
toxic substance exposure
characteristics of transient ischemic attack
it resolves within 24 hours
patient has DKA and is now unconscious and breathing deeply. what should you suspect?
hyperglycemia
when treating a patient with altered behavior
consider any possible medical causes
elderly patient has been drinking all afternoon. en route to the hospital he has become confused and slow to respond to questions
check blood glucose levels
a 15 year old soccer player is hot, pale and semiconscious. what should you do?
remove patient from hot environment
there is an unresponsive medical patient. what is the primary focus?
*chief complaint
a 23 year old female complains of fever, muscle aches, and congestion, is pale; BP94/60, P120, R24. roommate feels the same
influenza
a 40 year old unconscious patient was working in 90F weather for the last 5 hours
move patient to a cool environment, remove clothing give a cold pack, and give oxygen
elderly patient is malnourished and wearing inadequate clothes for the current temperature. they are lying on soiled bedding and has a strong smell of urine all over the house. caregiver daughters says mother refused to get out of bed most days. won’t do housekeeping, and not taking medication
report suspicion of neglect to medical director and local abuse agency
virus and bacteria can be classified as
pathogens
seeing and hearing things not present. which type of drug?
hallucinogen
signs of hypoglycemia
cold, clammy skin
contraindication of administration of oral glucose
unconsciousness
a 87 year old has a productive cough over the past three days and confusion over the past day. there is rhonci and wheezing in the right lung. BP116/92, P92, R24 and temperature is 101F. what should you suspect?
pneumonia
an alert 56 year old female has severe headache and weakness in the left arm. BP188/92, P106, R14
stroke
a 72 year old male has weak hand grips, blurred vision, and unable to tell what day it is he has type II diabetes
evaluate facial droop
patient has a bee allergy, was stung and says their throat is itchy. lips are swelling, patient has a EpiPen. what should you do?
Assist with EpiPen
assessment findings that suggest a gastrointestinal GI bleed would be
bright red blood from the rectal area
RUQ organs
liver, gallbladder
RLQ organs
appendix
Pt. who has excessive thirst & urination, they are acting strange, there’s a fruity odor on their breath, what should your treatment be?
250 – 500 mL of fluid.
Uticaria is another word to describe:
Hives
A paralysis that may resemble a stroke and presents with sudden weakness in the muscles on one half of the face.
Bell’s palsy
The purpose of the _ is to filter blood, which then creates urine.
Kidney
The purpose of the __ is to store bile produced by the liver, which aids in the digestion and absorption of fats.
Gallbladder
Strongly indicates syncope
Strongly indicates syncope
Which of these conditions places the patient at the greatest risk for an acute neurologic deficit?
Transient ischemic attack
When using a stroke scale to assess a patient for abnormal speech, the EMT should…
Ask the patient to repeat a specific but common phrase
When assessing a patient for a facial droop, the EMT should…
Ask the patient to show you his teeth or smile
Which one of these instructions to a patient with possible stroke indicates proper assessment for an arm drift?
“Close your eyes and hold your arms straight out for 10 seconds.”
Which question would it be critical that the EMT ask the family of a patient who cannot speak and is suspected of having a stroke?
“What time did the weakness and dizziness start?”
You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this scenario, what should you do immediately?
Check the patient’s blood glucose level
With the Cincinnati Prehospital Stroke Scale, which of these patient parameters is assessed?
Facial droop
A patient has an altered mental status accompanied by loss of motor function on one side of the body. The EMT must suspect which condition as the cause of this presentation?
Stroke
When assessing a patient with stroke like signs and symptoms, it is critical that the EMT also suspect and rule out which condition?
Hypoglycemia
A male patient is confused and combative for no apparent reason. There are no life threats to his airway, breathing, or circulation, and his vital signs are pulse, 88; respirations, 16 breaths/min and adequate; blood pressure, 144/68 mmHg; and SpO2, 93% on room air. When addressing the patient’s oxygenation status, which of these treatments would be appropriate?
Oxygen at 2 lpm via nasal cannula