EMRG1242 final- theory Flashcards
(124 cards)
1
Q
Routine practice
A
Infection prevention and control that is used with every patient prevent transmission of micro-organisms
Risk assessment, hand hygiene, appropriate cleaning
2
Q
Contact precaution (direct contact)
A
Used in addition to routine practices
gloves and surgical mask
3
Q
Droplet precaution
A
In addition to routine precaution for patients with infections that are transmitted through respiratory droplets
Gloves, surgical mask, eye wear, gown
4
Q
Airborne precautions
A
In addition to routine precautions for patients with illnesses transmitted through air
N95, gloves, gown, eye protection
5
Q
Good Samaritan law
A
legal protection against individuals who provide care to injured people from being liable for any harm caused while attempting help
6
Q
Speed splint
A
Fast immobilization
Used for hands, wrists, arm, foot, ankle, lower leg, knee
X-ray safe
Needs to be padded
7
Q
Malleable splint
A
Strong enough for pre/post cast care while being light/ portable
Can bend back to previous form or remolded
8
Q
Buddy Splint
A
Quick splinting when no times available
Femurs, fingers, toes
9
Q
AVPU
A
Alert Verbal Pain Unresponsive
10
Q
Triangular splint
A
Collar bone, shoulder dislocation
Used to sport in place to remove tension
11
Q
Pillow splint
A
Limits movement of injured area
Ankles, knees, wrist, lower legs, arms, elbows
Needs to be secured around the injury
12
Q
Penetrating object
A
Build a log cabin around it
Don’t remove unless compromises breathing
can cut object if stuck but stabilize remaining piece
13
Q
EMCA
A
Environment, Mechanism, casualties, Additional resources
14
Q
Compression ratio for a neonate
A
3 compression 1 breath
15
Q
How deep do you go during CPR for a neonate
A
1/3 diameter of the chest
16
Q
Compression ratio for an infant
A
30:2 or 15:2
17
Q
Compression ratio for a paediatric aged child
A
30:2 or 15:2
18
Q
Compression rate for an adult
A
30:2 or 15:2
19
Q
What is the age for a neonate
A
<30 days
20
Q
What is the age group for an infant
A
> 30 days to <1 year
21
Q
What is the age group for paediatric
A
1 year until puberty
22
Q
What is the age group for an adult
A
Puberty and older
23
Q
How many compressions per minute for an adult
A
100-120 compressions per minute
24
Q
Obvious signs of death
A
Rigor mortis, dependent lividity, transection, decomposition, DNR
25
What is the sizing for adult pads and paediatric pads
adult: >8 years
pediatric: <8
26
What are body mechanics
The way the body moves during daily activities
Can help to avoid injuries and muscle fatigue and increase amount of weight lifted
27
What are the principles of body mechanics
Assess environment, plan the move, avoid stretching/ twisting, ensure proper body stance, stand close to object being moved, face direction of movement, avoid lifting, reduce friction b/w surfaces, bend knees, push objects rather than pull, use assistive devices, work with others
28
Portable stretcher
Not on land ambulances, easy to clean, portable, max weight of 350lbs, back rest has 8 positions
29
Scoop stretcher
Can hold 500lbs, wipeable, 4 required straps with 4 adjustable positions, easy storage, good for SMR and pelvic injuries, MOH mandated
30
Manta mat
No SMR, can hold 800lbs, fire retardant, wipeable, minimum 4 carriers but up to 6-8, good for confined spaces and bariatric patients
31
Canvas stretcher
max weight 350lbs, needs to be laundered, No SMR, hard to maneuver in tight spaces
32
Stair chair
Can hold 500lbs, wipeable, 5 adjustable bars, straps to restrain patients
33
Proflexx stretcher
Can hold 700lbs- bariatric 1100lbs, 9 adjustable heights w/ adjustable head b/w 0-65 degrees, wipeable, 5 point harness and two leg straps
34
fore and aft
one medic behind patient grabbing opposite wrists while other grabs below knees and lifts
35
Stand and pivot
patient must be able to stand (no stroke/fractures) and doesn't violate BLS
36
Sheet pull
transfers pt from stretcher to bed.
High injury rate due to the unnatural leaning when pulling
37
Transfer/slider board
thin flexible board good for heavier pts that's found in all ERs- use like a sheet pull just slide board underneath sheet
38
Helmet removal
take it off for head assessments (are they alert, talking, breathing?), airway management, secure c-spine, and apply collar
39
Log roll
To check the back and then move to spinal board
Stabilize c-spine then roll pt to the side and check back and then slide a board on an angle under back and put pt back on the ground and strap pt in
40
Wheel chair transfer
like a stand and pivot but from a wheelchair
41
why must medics be careful with the elderly
if they are handled rough they can get skin tears, fractures (severe arthritis), and dislocations (shoulders most common)
42
Stryker power stretcher
Complies with MOH equipment
Max weight of 700lbs
Siderails have 7 locking positions
43
Rescue seat
In place of fore and aft
Easy to clean and resists blood/bodily fluids
Can remain under patient to avoid additional transfer
Not MOH mandated
44
PediMate
Used for patients 10-40lbs
5 point harness that attaches to the stretcher
Wipeable
45
Cervical Collar
Keeps neck/head/spine in neutral alignment for suspected c-spine injuries
46
Sizing a collar
Put your hand in a salute motion and place hand on the base of the patient's shoulder- pinky down) and count amount of fingers, measure against the collar for sizing
47
KED
Great for tough extrications
Color coded straps
Wipeable
Radiolucent
good choice for patients who can't lie flat (asthma/dyspnea/kyphosis (curvature of the spine in the neck))
48
When can you not use a KED
on an unstable patient
49
How to decide to use a KED, Scoop, Spinal board
KED: SMR, can't lie flat, conscious/stable, tough extrication, confined space
Scoop: SMR, pelvic fracture, multi system trauma, no roll req'd
Spinal board: roll req'd, visualizes back, basic SMR
50
What is a rapid Ex
Technique used to move a patient from sitting in a car to lying supine on a backboard in approx. 2 minutes
51
When would you use a Rapid Ex
Load and go: critical pts requiring immediate intervention in supine and transportation
Scene safety: scene is unsafe and you can get pt out without risking medics
Multiple patients: limited resources, pt. condition, pt blocks access to another seriously injured pt.
52
Common pelvic fractures
Lateral compression: most common and occurs when lateral forces are applied to the pelvis
AP compression: disrupts symphis pubis and dangerous as pelvic volume increases- stores more blood
Vertical shear: most unstable and often associated with axial loading injuries
53
Symptoms of pelvic fractures
Pain, swelling/ bruising, broken skin, instability with palpation, blood in urine, difficulty urinating, incontinence, bleeding from rectum or vagina
54
what is hemodynamically unstable
hypotension, altered LOC, increased heart rate
55
in how many pelvic fractures does hemodynamic instability occur
10%
56
what other injuries can occur from a pelvic fracture
neurological and urologic
57
58
what urologic injuries happen from pelvic injuries
Approx 5% of pelvic fractures
Assess for blood
59
What amount blood loss occurs
500-1500ml
60
symptoms of a femur fracture
pain, limb shortening, potential open skin, edema, bruising, crepitus, muscle spasm
61
Hip fractures
Involves femoral head, femoral neck, inter trochanter area or femoral shaft
Fall is leading MOI
62
Symptoms of hip fractures
pain, inability to bear weight, heard/felt snap, external rotation/ shortening to leg, tenderness on palpation, swelling, deformity
63
treatment for hip fractures
support injured extremity in position found, minimize movement, assess for analgesia, no sager
64
posterior hip dislocation
hip rotates inwards
65
anterior hip dislocation
hip rotates outwards
66
external bleeding
occurs due to break in the skin, extent and severity is often a function of the type of wound/ types of blood vessels, managed with direct pressure, arterial bleeding can take more than >5 minutes to form a clot
67
signs and symptoms of internal bleeding
pain, tenderness, tachycardia, pallor, hypotension
68
how much acute blood loss can the body not handle
body cannot tolerate an acute loss of more than 20% of total blood volume
69
what are the load and go findings in advanced wounds
airway obstruction, cardiac arrest/respiratory arrest, de creased LOA with inadequate respirations, sucking chest wounds, impaled objects, external hemorrhage, unstable pelvis
70
types of wounds
amputations, penetrations, eviscerations, burns, avulsion, flail chest
71
amputations/avulsions
assess site for distal pulses, circulation, sensation, movement
72
how long do you hold the hemostatic dressing on to see If bleeding stops
3 minutes
73
signs and symptoms of a sucking chest wound
hemoptysis, decreased/absent breath sounds, SOB, anxiety, bubbling at the site, unequal chest movement, cyanosis, tachycardia, tachypnea
74
types of pneumothorax's
closed pneumothorax, open pneumothorax, tension pneumothorax
75
flail chest
3 or more ribs broken in 2 or more places that creates a free floating sections of ribs
Paradoxical bleeding is the common sign
Treat with an internal splint via BVM
76
how to cover an evisceration
cover with moist, sterile, bulky dressings or plastic wrap
77
burns
dress digits individually, remove jewelry, leave finger/toe tips exposed, elevate
78
how to transport a pt with an eye injury
semi sitting (head elevated to 30 degrees)
79
required vital signs
heart rate, respiratory rate, blood pressure, GCS, skin, pupils, SPO2, temperature
80
normal heart rate for adults
60-100
81
respiratory rate can be altered by:
fever, illness, chronic conditions, drugs/alcohol
82
bradypnea
slow RR
83
tachypnea
fast RR (>28)
84
blood pressure
the force of blood against he artery walls during contraction/relaxation of the heart
85
systolic
pressure in he heart when the artery contracts and pumps blood
86
diastolic
pressure inside the artery when the heart relaxes and fills with blood
87
Adult BP ranges
Hypotension: <90mmHg
Normotension: >100mmHg
88
pediatric BP ranges
Hypotension: SBP <70mmHG + (2 x age)
Normotension: SBP > 90mmHG = (2 years)
89
what causes an abnormal pupillary response
drugs, trauma, stroke, brain/ brain stem injury, inadequate perfusion/ oxygenation
90
temperature
36.1-37.2 degrees C
fever is >38 degrees celsius (>38.5 for medics)
91
what can alter an SPO2 reading
nail polish, hypovolemia, CNS depression, respiratory distress, respiratory disease
92
lung sounds are assessed in 4 fields:
upper (apices) left, upper (apices) right, lower (base) left, lower (base) right
93
abnormal lung sounds
Rhonchi, wheezing, stridor,, crackles, pleural rub
94
Rhonchi
continuous low pitched sounds w/ expiration that's associated w/ presence of mucus
95
wheezing
continuous high pitched hissing sounds as air passes through a narrow space
can be inspiratory or expiratory
96
97
stridor
continuous high pitched whistle or squeaking sound usually with inspiration
98
pleural rub
rough grating sounds of lungs on the lining, heard w/ inspiration or expiration
99
crackles
generally discontinuous rattling, bubbling, or clicking sounds that can be fine or coarse. associated with fluid
100
what does the cardiac monitor monitor?
cardiac rhythm, BP, ETCO2, SPO2, defibrillator
101
NIBP
MOH states must need adult and paediatric
102
SPO2
indication of oxygenation (measures % of O2 bound to hemoglobin) and is found as a finger probe or tape/sticker
103
ETCO2
measures amount of CO2 in expired air in real time
measured by nasal prongs or inline with BVM
104
4 lead
limb leads: white right arm, black left arm, green right leg, red left leg
ensure not to place on bone, dry skin, no excessive hair, and good contact with skin
lead 11 for rhythm interpretation
105
12 lead
must have 4 lead + additional 6 wires
used on calls for chest pain, SOB, weakness/dizziness, syncope, any call ,edits think hearts involved
106
placement of the 12 lead wires
RA- right forearm/wrist
LA- left forearm/wrist
LL- left lower leg
RL- right lower leg
V1- 4th intercostal right of sternum
V2- 4th intercostal left of sternum
V3- midway b/w V2 and V4
V4- 5th intercostal mid clavicular line
V5- anterior axillary line straight w/ v4
V6- mid axillary line in straight w/ v4/v5
107
D tank
425L of air
2000-2200 PSI
needs regulator
108
M tank
3450 L compressed air
2000-2200 PSI
secured in ambulance- not portable
109
PISS
pressure index safety system
110
portable flow meter
allows adjustments from 0.5 LPM to 25LPM
connected to regulator
111
safe residual pressure
MOH states 500 PSI
common practice:
M tank: 200 PSI
D tank: 500 PSI
112
standard tank conversion factors
D tank: 0.16
M tank: 1.56
113
formula for oxygen tank life
tank PSI- safe residual pressure X factor/ litre flow = tank duration in min
114
oxygen concentrations formula
FiO2=(l/min x4%) + 21%
115
low flow oxygen devices
21-50% oxygen
nasal cannula- 1-6 lpm, don't use on pts w/ apnea or severe dyspnea
simple face mask- 6-10 lpm,
nebulizer- 4-6 lpm, exception of croup
116
high flow oxygen devices
50-100% O2
NRB- 12-15 LPM 90-100% O2
filtered O2 mask- low flow high concentration mask that delivers 30-99% O2
117
OPA
Holds tongue of posterior wall of the pharynx
Used on patients with no gag reflex needing airway ventilatory support
118
BVM air volumes
Adult: 1600 ml
Child: 500 ml
Infant: 300 ml
119
Tidal volumes
Adult: 500 cc/breath
Child: 8 ml/kg
Infant: 4-6 ml/kg
120
Ventilation rates
Adult: 1 every 6 seconds
Child: 1 every 3 seconds
Infant: 1 every 3 seconds
121
Oral suctioning pressures
Adult: 500-550 mmHg
Child: 200-220 mmHg
Infant: 80-100 mmHg
122
Deep suctioning pressures
Adult: 100-150 mmHg
Child: 100-120 mmHg
Infant: 60-100 mmHg
123
definition of a tracheostomy reinsertion
insertion of the cannula into the tracheostomy
124
what degree is the patient sitting in for a trach reinsertion
30-90 degrees
