1
Q
What to consider before lifting any patient?
A
The object
Your limitations
Communication
2
Q
During an emergency move, how should you move the patient?
A
Move the patient in the direction of the long axis of the body
3
Q
Rules to follow to prevent injury when lifting
A
Positioning your feet properly
Use your legs
Never return or twist
Do not compensate when lifting with one hand
Keep the weight as close as possible to your body
Use a stair chair when carrying a patient on stairs whenever possible
3
Q
What is consent?
A
Permission from the patient for care or other action by the EMT
4
Q
What is expressed consent?
A
Consent given by adult tour of legal age in our mental mentally competent to make rational decision with regard to their medical well-being
5
Q
What is informed consent?
A
Patient must understand the risk associated with the care they will receive
6
Q
In loco parentis
A
In place of a parent
7
Q
What is implied consent?
A
Rational patients would consent to treatment if they were conscious
8
Q
What is proximate causation?
A
The concept that the damages to the patient or the result of action or in action by the EMT
9
Q
What is “duty to act”?
A
An obligation to provide care to a patient
10
Q
What is abandonment?
A
Leaving a patient aftercare has been initiated and before the patient has been transferred to someone with equal or greater medical training
11
Q
What is negligence?
A
A finding that there was a failure to act properly in a situation in which there was a duty to act that needed care as would reasonably be expected at the EMT was not provided, and that harm was caused to the patient as a result
12
Q
What is standard of care?
A
The care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation
13
Q
Dys-
A
Difficult or painful
14
Q
Ab-
A
Away from
15
Q
-ac
A
Pertaining to
16
Q
-algia
A
Pain
17
Q
Ad-
A
Toward or near
17
Q
-emesis
A
Vomiting
18
Q
-itis
A
Inflammation
19
Q
Where is the anterior part of the body?
A
At the front
20
Q
Medial
A
Toward the midline of the body
21
Q
Where is the midaxillary line?
A
A line drawn vertically from the middle of the armpit to the ankle
22
Q
Superior
A
Towards the head
23
Lateral
To the side, away from the midline of the body
24
Inferior
Away from the head
25
Bilateral
On both sides
26
What is aerobic metabolism?
The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal waist products, such as carbon dioxide and water.
27
What is an anaerobic metabolism?
The process in which glucose is metabolized into energy without oxygen. Energy is produced in an inefficient manner with many ways products such as lactic acid.
28
What is metabolism?
The cellular function of converting nutrients into energy
29
What is homeostasis?
Steady state environment that allows the body to grow heal and carry out normal functions
30
What part of the central nervous system controls “feed or breed” functions in the body
The parasympathetic nervous system
31
What part of the central nervous system controls the “fight or flight”?
The sympathetic nervous system
32
Moro reflex
Response to being startled in which the infant throws out both arms and spreads fingers, then grabs with fingers and arms
33
Palmer reflex
A grasp being reflex in which an infant grabs onto a finger placed in the infant palm
34
Rooting reflex
A reflex response in which a hungry invent automatically turns towards a stimulus when the cheek or one side of the mouth is touched
35
Sucking reflex
A reflex in which stroking a hungry infant lips causes the infant to start sucking
35
Infant heart rate
90 to 160
36
Infant respiratory rate
24 to 30 breaths per minute
37
An infant at two months can
Track objects with eyes
Recognize familiar faces
38
An infant at three months can
Move object objects to mouth with hands
Distinct facial expressions
39
An infant four months can
Drool without swallow
Reach out to people
40
An infant at six months can
Sit up in a highchair
Make one syllable sounds
41
An infant at eight months can
Sit alone
Play peekaboo
Respond to the word no
42
Toddler heart rate
80 to 140
43
Toddler respiratory rate
24 to 40
44
Types of stress
Acute stress reaction
Delayed stress reaction
Cumulative stress reaction
45
What is the earliest documented emergency medical service?
The French in the 1790s transporting wounded soldiers away from the scene of battle
45
When did non-military ambulance services begin in a major American cities
In the 1900s, but as transport services only
46
In the 1966 the national Highway safety act charged who with the development of EMS standards
The US Department of transportation (DOT)
47
Stages of stress
Alarm reaction
Resistance
Exhaustion
48
How can emt maintain their well-being?
Maintaining solid, personal relationship relationships
Exercise
Sleep
Eating right
Limiting alcohol and caffeine
Seeing a physician regularly, you smell
49
Preschool age, heart rate
70 to 120
50
School age, heart rate
65 to 20
51
School age, respiratory rate
18 to 30
52
In what age group does self-esteem develop
School age
53
What is a patent airway?
An airway that is open and clear and will remain open and clear without interference to the passage of air into and out of the body
54
Parts of the upper airway
Nose, mouth, nasopharynx, oropharynx, larngopharynx
55
Parts of the lower airway
Trachea, bronchus, bronchioles,aveoli
56
Stridor
Caused by severely restricted air movement in the upper airway
High-pitched, almost whistling sound can be heard
57
Hoarseness
Voice changes reflect a narrowing of upper airway passages, often an ominous sign
58
Snoring
Sound of the soft tissue of the upper airway creating impedance to the flow of air. Can indicate a decrease in mental status such that the airway muscle tone is diminished.
59
Gurgling
Sound of fluid obstructing the airway
60
How to determine a patent airway
Look
Listen
Feel
61
Signs of an inadequate airway
No breathing or air movement
Foreign bodies in the airway
Patient unable to speak or has difficulty speaking
Unusual horse or a raspy voice
Absent or minimal chest movements
Breath sounds diminished or absent
Noisy breathing
Retractions
Nasal flaring
62
What is inhalation?
An active process. The muscles of the chest, including intercostal muscle muscles are engaged at the same time, the diaphragm contracts in a downward motion. These movements create a negative pressure pulling air into the lungs.
62
Preschool age, respiratory rate
22 to 34
63
What is hypoxia?
Low levels of oxygen
64
Respiratory distress
Increased work of breathing, a sensation of shortness of breath
65
Respiratory failure
An adequacy of breathing to the point where oxygen intake or the ventilation removal of carbon dioxide is not sufficient to support Life
66
Respiratory arrest
When breathing completely stops
67
How to provide assisted ventilations
10 to 12 per minute for an adult or 20 per minute for a child or infant
68
When to use a BVM
To ventilate a non-breathing patient and to assist ventilations in a patient whose own respiratory attempts are not enough to support life
69
When to use a non-rebreather mask
For patients with signs of severe hypoxia in those short of breath, suffer suffering, severe injuries, or displaying an altered mental status
70
When to use a nasal cannula
For patients with signs of hypoxia in those short of breath, who need a small amount of supplemental oxygen or cannot tolerate a mask
71
Components of the scene size up
BSI scene safe
Mechanism of injury or nature of illness
Number of patients
Additional resources
72
What are signs of violence when approaching a scene
Fighting or loud noise noises
Weapons visible, or in use
Signs of alcohol or drug
Unusual silence
Knowledge of prior violence
73
What are six parts of the primary assessment?
General impression
Mental status
Airway
Breathing
Circulation
Transport decision
74
What is the primary goal of the primary assessment?
Identifying in treating life threats
75
What is a general impression?
Impression of the patient’s condition that is formed on first approaching the patient, their environment, chief complaint, and appearance
76
Where should you palpate a pulse on an unconscious patient?
Carotid artery
77
Where should you palpate a pulse on a conscious patient?
Radial artery
78
How frequently should you reassess vital signs on a stable patient?
Every 15 minutes
79
How often should you reassess vital signs on unstable patient?
Every five minutes
80
What is normal blood glucose?
70 to 100 mg/dL
81
Normal end tidal
35 to 45 mmHg
82
Three techniques to use in your physical examination
Observe
Auscultate
Palpate
83
Order of assessment of a responsive medical patient
Chief complaint, and History of Present illness - OPQRST
PAST MEDICAL HISTORY- SAMPLE
Physical exam
Vital signs
84
Order of assessment in an unresponsive medical patient
Rapid physical exam
Baseline vital signs
History of present illness (OPQRST)
Past medical history (SAMPLE)
85
Most important thing to look for in an unresponsive patient
MOI, signs of spine injury
86
Order of assessment for a not seriously injured trauma patient
Chief complaint
History of present illness
Physical exam based on chief complaint and MOI
Baseline vital signs
Past medical history
87
Order of assessment for a seriously injured trauma patient
Rapidly Determine chief complaint and history of present illness
Spinal precautions if indicated
Consider ALS
Rapid trauma assessment
Vital signs
Past medical history
88
What is an indication?
Specific signs or circumstances under which it is appropriate to administer a drug to a patient
89
What is a contraindication?
Specific signs or circumstances under which it is not appropriate and may be harmful to administer a drug to a patient
90
Sublingual route
Dissolved under the tongue
90
Inhaled route of administration
Breathed into the lungs usually as tiny aerosol particles, such as from an inhaler, or as a guess, such as oxygen. Medication is absorbed into the bloodstream through the alveoli.
91
Intranasal route
Sprayed into the nostrils.
92
Intravenous route
Accessing the bloodstream through a vein
93
Intramuscular
Injected into a muscle. Typically uses a needle as in an auto injector to deliver medication.
94
Subcutaneous
Injected under the skin
95
Intraosseous
Injected into the bone marrow cavity
96
Endotracheal
Spray directly into a tube, inserted it into the trachea
97
Information included in the pre-hospital care report
General impression
Narrative of events throughout the call
Chief complaint, history of present illness, past medical history, physical exam, interventions
Vital signs
Transport information
98
objective information
Observable, measurable, verifiable
99
Subjective information
Patients point of view
100
Signs of inadequate breathing
Altered mental status
Abnormal breathing: rate, rhythm, quality
Diminished/ absent breath sounds
Noisy breathing
Decreased minute volume
Low pulse oximetry
Cyanosis
101
Rhonchi
Lower-pitched sounds that resemble snoring or rattling
Pneumonia or bronchitis i
102
Crackles
Fine crackling or bubbling heard on inspiration in the lower airway
103
CPAP
Noninvasive positive pressure ventilation.
Blows oxygen into the mask to prevent airway collapse or to help alleviate difficulty breathing
104
Order of blood flow
Body → RA → RV → Lungs → LA → LV → Body
105
The coronary syndrome
Any symptoms related to a lack of oxygen in the heart muscle
106
Indications for administering aspirin
Chest pain in an area commonly associated with ACS
Not allergic to aspirin
Not already taking medication’s to prevent clotting
Patient is able to swallow
Medical direction authorizes administration
107
Contraindications for administering aspirin
Patient unable to swallow
Patient allergic or sensitive to aspirin
Patient has gastrointestinal ulcer or recent bleeding
Known bleeding disorder
108
Aspirin dosage
162 - 325mg ( 2-4, 81 mg tablets)
108
Indications for the administration of nitroglycerin
Chest pain associated with ACS
History of cardiac problems
Prescribed nitroglycerin
Systolic blood pressure greater than 90 systolic
Medical direction, authorizes administration
109
Contraindications of nitroglycerin
Patient has hypertension or blood pressure below 90
Patient has a head injury
Patient has taken back prescribed dose
Patient has recently taken Viagra or other drug for erectile dysfunction
110
Nitroglycerin dosage
Windows every five minutes if less than completely relief as long as blood pressure remains above 90 systolic
111
Side effects of nitroglycerin
Hypotension
Headache
Pulse rate changes
112
Coronary artery disease
Result of buildup of fatty deposits on the inner and middle walls of arteries, causing a narrowing of the inner vessel diameter restricting the flow blood
113
Angina pectoris
Pain in the chest, during times of exertion or stress
114
Congestive heart failure
The failure of the heart to pump blood with normal efficiency 
115
Mechanical failure of the heart
Pump failure. Loss of normal heart muscle structure.
116
Electrical dysfunction of the heart
The heart cannot generate an organized rhythm, dysrhythmias. Ventricular fibrillation, ventricular tachycardia. Asystole
117
Agonal breathing
Irregular, gasping breaths that proceed at the end death
118
Chain of survival of cardiac arrest patients
Recognition and activation
High-quality CPR
Rapid defibrillation
Basic in advance emergency medical services
Advanced life support and post arrest care
119
Indications for oral glucose
Patient with altered mental status
History of diabetes
120
Hypoglycemic blood glucose
Lower than 60 mg/dL and symptomatic diabetic
121
Blood glucose reading, indicating hyperglycemia
Greater than 140 mg/dL
122
Two types of seizures
Partial and generalized
123
Anaphylaxis
Severe or life-threatening allergic reaction in which blood vessels, dilate, causing a drop in blood pressure and the tissues lining their respiratory system swell interfering with airway
124
Allergic reaction
An exaggerated immune response
125
Indications to use an epinephrine auto injector
Patient exhibits signs of severe allergic reaction, including either respiratory distress or shock
Medication is prescribed for this patient
Medical direction authorize is used for a patient
126
Adult dosage for epinephrine
.3 mg
127
Child dosage for epinephrine
.15mg
128
Actions of epinephrine
Dilate the bronchioles
Constricts blood vessels
Makes the capillaries less permeable
129
Poison
Any substance that can harm the body by altering cell structure or functions
130
Poisons that are swallow
Ingested poisons
131
Poisons that are breathed in, gases, papers, and sprays
Inhaled poisons
132
Poisons that are taken into the body through unbroken skin
Absorbed poisons
133
Poisons that are inserted through the skin by needle, snake fans or insect stinger
Injected poison
134
Indications were activated charcoal
Poisoning by the mouth
135
Contraindications of activated charcoal
Altered mental status
Ingestion of acids, alkalis, or petroleum products
Active vomiting
Inability to swallow
136
Dosage of activated charcoal
Adult: 25 to 50 g
Pediatric: 12.5-25 g
137
Opioids
Class of drugs that affects the nervous system and changes normal body activities.
Legal use: relief of pain
Illicit use: produce an intense state of relaxation
138
Examples of opioids
Cocaine, OxyContin, Percocet, heroin
139
Opioid triad
Coma
Pinpoint pupils
Respiratory depression
140
Uppers
Stimulant such as cocaine and methamphetamine that affect the central nervous system and excite the user
141
Downers
Depressants that depressed central nervous system, and are often used to bring on a more relaxed state of mind
142
Hallucinogens
Mind altering drugs that affect the central nervous system to produce excitement and distortion of perceptions
143
Volatile chemicals
Vapors that can be inhaled. They give an initial rush, then act as a depressant on the central nervous system.
144
Hernia
A hole in the muscle layers of the abdominal wall, allowing tissue to protrude up against a skin
145
Perfusion
Supply of oxygen to and removal wastes from the body's cells and tissues as a result of the flow of blood through the capillaries
146
Hypoperfusion
Body's inability to adequately circulate blood to the body's cells to supply them with oxygen and nutrients
147
Inside signs symptoms of shock
Increased heart rate
Increased respiratory rate
Vasoconstriction
Regulation of volume
Hypoperfusion
148
Outside signs +symptoms of shock
AMS
Pale skin
Narrowing pulse pressure
Decreased urinary output
Delayed capillary refill
149
Compensated shock
Increased heart rate
Increased respiratory rate
Normal blood pressure
150
Decompensated shock
Decreased heart rate
Decreased respiratory rate
Decreased blood pressure
151
Deadly triad of trauma
Acidosis
Hypothermia
Coagulopathy
152
Epidermis
Outer most layer of the skin
153
Dermis
Layer of the skin rich with blood vessels, nerves and specialized structures, such as sweat glands. It registers cold heat in pain.
154
Subcutaneous layer
Layers of fat and soft tissue below the dermis. Major function: shock, absorption, and insulation.
155
Contusion
A bruise. Cells in blood vessels in the dermis are damaged.
155
Hematoma
Swelling caused by the collection of blood under the skin or damaged tissues as a result of an injured or broken blood vessel
156
Superficial burn
A burn that involves only the epidermis. Characterized by reddening of the skin and perhaps I’m swelling.
157
Partial thickness burn
Burn in which the epidermis is burned through in the dermis is damaged. Reddening, blisters and mottled appearance.
158
Full thickness burn
Burn in which all layers of the skin or damaged
159
Type of dressing used on a penetrating chest wound
Occlusive dressing at least 2 inches wider than the wound
160
Indirect brain injuries
The shock of impact on the school is transferred to the brain, including concussions and contusions
161
Cushing reflex
Decreased heart rate and increased blood pressure
162
Revised trauma score characteristics
Glasgow coma scale
Systolic blood pressure
Respiratory rate
163
Conduction
Transfer of heat from one material to another through direct contact
164
Convection
Carrying away of heat by currents of air, water, or other gases or liquids
165
Radiation
Sending out energy, such as heat, in waves - into space
166
Evaporation
The change from liquid togas. When the body perspires or gets wet
167
Respiration
Causes loss of body heat when warm air is exhaled from the body
168
Passive rewarming
Covering a hypothermic patient and taking other steps to prevent further heat loss and help the body reward itself
169
Active rewarming
Application of an external heat source to rewarm the body
170
Central rewarming
Application of heat to the lateral chest, neck, armpits, and groin, of hypothermic patient
171
Local cooling injury classifications
Early or superficial
late or deep
172
Frostbite
Skin and subcutaneous layers are affected.
Skin appears white and waxy turning mottled or blotchy
White to grayish yellow to grayish blue
173
Heat exhaustion
Patient with moist, pale, and normal or cold skin.
Heavy perspiration causing loss of body salts bringing on muscle cramps
174
Heat stroke
Patient with hot, dry or moist skin. Dilated pupils
Patient stops sweating, preventing heat loss through evaporation.
175
Body systems most affected by hypothermia
Cardiovascular and central nervous system
176
First stage of labor
Start: Regular contractions, thinning, gradual dilation of cervix
Ends: cervix is fully dilated
177
Second Stage of Labor
Starts: baby enters birth canal
Ends: when baby is born
178
Third Stage of labor
Starts: after baby is born
Ends: afterbirth is delivered (placenta, umbilical cord, amniotic sac and the lining of the uterus)
179
Characteristics of labor pains
Contraction time, or durations
Contraction interval, or frequency
180
Patient assessment for women in labor
Due date
First pregnancy?
Prenatal care
When labor pains start
Has water broken? Bloody show?
Feel the urge to push
181
APGAR score
Appearance
Pulse rate
Grimace
Activity
Respiratory effort
182
Contractions demonstrating labor has progressed
Contractions lasting between 30 seconds and 1 minute
Contractions that are 2-3 minutes apart
183
Neonatal resusication interventions
Drying, warming, stimulation
Positive pressure ventilations
Advanced airway
Medications
184
How do you ventilate a neonate
40-60 breaths per minute
“Breath - two - three - breath - two - three”
185
When to begin chest compressions on a neonate
If heart rate is less than 60 bpm, use two-thumb encircling technique delivered at 90 compressions per minute
186
Premature infant
Weighs less than 5 1/2 points or born before 37 weeks
187
DOPE
Displacement
Obstruction
Pneumothorax or pneumonia
Equipment
188
Automatic implanted cardiac defibrillator (AICD) location
Implanted into the upper left chest, occasionally upper left quadrant of the abdomen. Palpable through the skin
189
Signs of abuse in adults
Unexplained absence of caregiver/ harmful periods of abandonment
Signs of hunger, malnourishment, improper toilet routine
Unusual interactions with caregivers
Caregiver interference with assessment, treatment or transport
190
Autism spectrum disorders
Developmental disorders that affect the ability to communicate, report medical conditions, self-regulating behaviors and interact with others
191
Why can active rewarming cause cardiac arrest
Rapid rewarming may circulate stagnant blood too quickly
FWFD Class 100/1 - EMT
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