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emt chapter 11-14 Flashcards

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1
Q

which of the following is not determined in a scene size up
A. Chief complaint
B. Mechanism of injury
C. Potential hazards to the EMS crew
D. Need for additional resources

A

A. Chief complaint

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2
Q

At what point is the scene size up complete

A

at the end of the call

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3
Q

at which point do you begin your scene size up

A

As you approach the scene in the ambulance

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4
Q

Which of the following situations requires additional action by the emt during scene size up
A. a vehicle collision involving a tractor trailer that appears to be empty
B. the sound of a barking and growling dog upon approaching the door to a residence
C. a bystander who is smoking a cigaretteat the scene of an assault at the park
D. a news media helicopter hovering overhead at the scene of a vehicle collision

A

B.

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5
Q

you are called to a motor vehicle collision where the car is on fire. You should ensure safety by

A

Remaining a safe distance from the car until the fire is out

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6
Q

As you arrive at the scene of a house fire a very upset man screams at you to help his young son who is trapped under a piece of burning wood on the ground. What should you do first

A

size up the scene before acting

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7
Q

what are the guidelines should be followed to establish a danger zone

A

dangerzone should be 50 feet in all directions

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8
Q

which of the following is not a consideration that should be used by emt in establishing the size of the danger zone
A. presence of hazardous materials
B. wind direction
C. amount of equipment needed
D. fire

A

C.

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9
Q

what should be used to alert oncoming traffic to a situation

A

reflective triangles

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10
Q

arrive to a group of 30 adults surrounding a middle aged man who is unconscious. What should you do

A

wait for the police to assess the safety of the scene

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11
Q

which of the following is true concerning the potential for violence at the scene of an EMS call
A. an unusual lack of activity at the scene may signal impending violence against an emt
B. the chance for violence is very low at emergency scenes
C. you do not need to worry about violence at an emergency scene once the police have secured it
D. signs of impending violence are obvious if you know what to look for

A

A

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12
Q

You are at on the scene of an explosion at a suspected meth manufacturing operation. You and your partener are the first to arrive and note two middle aged men and a woman on the front lawn with burns and cuts on their faces and arms. The fire department is en route. Which of the following resources would be the least important to request during the scene size up
A. gas company
B. law enforcement
C. one or two additional ambulances
D. hazardous material clean up crew

A

D.

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13
Q

as you are assessing a 32 year old asthmatic woman who has called EMS due to difficulty breathing, her husband enters the home through a back door and shouts “get your hands off her; she doesn’t need your help. She needs to be taught a lesson about her smart mouth” which of the following is the best course of action
A. attempt to remove the patient from the home and continue treatment en route to the hospital
B. continue assessment and respond that the patient is sick and needs medical attention
C. leave the scene and the patient, and then notify the police
D. let the husband know that his behavior is inappropiate and if it continues you will call the police

A

C

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14
Q

You are dispatched to a local bar for the report of an unresponsive female patient found in the bathroom. As you approach the scene you notice a large crowd outside the front door holding beer bottles. The group has pulled the patient outside. as you approach the scene, people from the group start yelling do something, she’s not breathing. What concerns you the most
A. large crowd that has been drinking and is now yelling at you
B. the fact that the patient has been moved from where she was found
C. the crowd stating the patient is not breathing
D. all of the above

A

A

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15
Q

As you approach the scene of a motorcycle accident you see an emr trying to stop the bleeding on the patient’s left arm. You notice that the EMR has blood covering the front of his shirt and running down his arms. WHat standard precautions are needed.
A. there is no need for standard precautions because you have no open injuries
B. gloves, gown, and face mask with eye shield are needed
C. gloves, gown, eye protection, and N-95 mask
D. gloves and gown are only needed

A

B

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16
Q

what will deliver a medium velocity impact

A

bullet from hand gun

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17
Q

which law of physics explains why a patient’s liver can be injured from the impact of his car with a tree

A

law of inertia

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18
Q

Injury caused by an object that passes through the skin or other tissues is known as

A

penetrating trauma

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19
Q

a fall is considered severe anytime from how high

A

20 feet

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20
Q

what is blunt force trauma

A

an object strikes the body but does not penetrate the body tissue

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21
Q

In which of the following situations should the EMT consult the Emergency Response Guidebook
A. chlorine gas leak at a public swimming pool
B. domestic disturbance with the potential for violence
C. patient with a suspected infectious disease
D. down power lines at the scene of a vehicle collision

A

A

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22
Q

when should the emt evaluate the need for standard precautions

A

An evaluation should be made throughout the call

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23
Q

keen awareness that there may be injuries based on your scene size up

A

index of suspicion

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24
Q

which of the following is true concerning scene size up
A. the need for additional resources must be determined on both medical and trauma calls
B. scene size up does not playa role in determining the nature of illness
C. determining the number of patients is not important on a medical call
D. inormation from a bystander is not important on trauma calls

A

A.

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25
what are the elements to scene size up
1. checking scene safety 2. take standard precautions 3. noting the mechanisms of injury or nature of patient's illness 4. number of patients 5. deciding what additional resources may be necessary
26
what is the only predictable thing about emergencies
their unpredictable
27
what distance to establish a danger zone around a wreck with no hazard and fuel being spilled. What is the difference if there is no hazard
50 feet no hazard 100 feet with wreckage and fuel
28
how far back when electric wires are down20 feet
one full span of wires away from ther pole to which broken wires are attached
29
what is considered a severe fall for adults and children
20 feet for adults children under 15 years old more than 10 feet or two or three times the child height
30
What is the first step in the primary assessment?
Check for LOC and ask: Can you hear me? ## Footnote Use AVPU scale.
31
What should you assess in the primary survey?
Inspect, palpate, and auscultate all areas, including lung sounds.
32
What is the chief complaint?
the main issue or the reason that EMT was summoned
33
What should you ask yourself when your coming up to a patient
Ask: Are there obvious Life Threats? Treat immediately.
34
What should you assess in the chest?
Auscultate lung sounds.
35
What is the protocol for assessing vital signs?
Obtain a baseline set of vital signs.
36
How often should you reassess during ongoing assessment for stable and unstable patients
Reassess every 5 minutes for unstable patients, every 15 minutes for stable
37
What is the GCS score in trauma assessment?
measures the persons level of consciousness and neurological function
38
which term refers to the emt initial sense of the patients condition based on emmediate assessment of the patient's enviorment, appearence, and chief complaint
general impression
39
which of the following is not part of the general impression A. patients facial impression B. patients age and sex C. position in which the patient is found D. patients past medical history
D
40
what does mental status refer to
the patients level of awareness of his surroundings
41
what best describes the word intervention
taking steps to correct the problem
42
what is chief complaint
reason why the patient summoned ems
43
what is the correct order of assessment
1. general impression 2. mental status 3. airway 4. breathing 5. circulation 6. patient priority
44
what is the first thing the emt does during the primary assessment
forms a general impression
45
what describes the ems provider's "sixth sense"
clinical judgment
46
what is the purpose of the primary assessment
to detect and treat immediately life threatening problems
47
which of the following is true concerning the primary assessment A. manual airway maneuvers must be performed on all patients B. the emt should perform a sternal rub on all patients to test for response to painful stimuli C. external bleeding will be obvious as you enter the room and initially see the patient D. the primary assessment begins by just observing the patient as you enter the room
D.
48
what techniques is used when formulating the general impression
1. Detecting odors 2. listening for unusual sounds 3. looking for visual clues
49
A patient whose mental status can be described as verbal is
respond to speaking or shouting by opening the eyes
50
the mnemonic AVPU is used to evaluate what
patients level of responsivness
51
which of the following is not performed during the airway phase of the primary assessment A. head tilt, chin lift maneuver B. obtaining the respitory rate C. suctioning D. insertion of an oropharyngeal airway
B
52
what is assessed during breathin phase of primary assessment
1. depth of respiration 2. respitory rate 3. presence of respirations
53
which of the following presentations would be considered normal during th ebreathing phase of the primary assessment. A. rr of 6 with shallow depth B. rr of 28 with adequate depth C. RR of 12 with adequate depth D. rr of 16 with altered mental status
C
54
what are acceptable methods of assessing the patient's circulatory status
1. assessing the patient's skin color 2. checking a radial pulse 3. looking for serious breathing
55
during primary assessment of a responsive adult patient where should the pulse be checked
radial pulse
56
what is the most reliable means of determining whether a patient has any immediately life threatening injuries
systematic approach to assessment
57
what is a good indication of a partially occluded airway
patient has snoring respirations
58
Patient is 33 yr old man whos has been ejected from his vehicle during a high speed collision. During your primary assessmen it is discovered that he is not moving, does not appear to have adequate respirations, and has suffered moderate external bleeding A. control the bleeding with direct pressure B. open the airway C. begin bag valve mask ventilation D. check the patients carotid pulse
B
59
what are indications of possible circulatory problems
1. weak thready pulse that is normal in rate 2. slow pulse 3. rapid pulse
60
how do you check responsiveness in infants
flicking the soles of their feet
61
what is a normal capillary refill time in a pediatric patient
less than 2 seconds
62
what is the proper position for maintaining airway in a child with a decreased level of consciousness
placing head and neck in a neutral position; using a folded towel under the shoulders if necessary
63
what is one thing you should expect to see different in children and adults when assessing
Childs respitory rate will be faster
64
during primary assessment of an unresponsive two month old infant which pulse should be palpated
Brachial
65
what is not used to assess an adults circulation and why
patients capillary refill time and because it is unreliable in adult patients
66
how long do you check a pulse for
no longer than 10 seconds
67
The Glascow Coma scale goes between what score
3-15
68
what are the ABCs
Airway Breathing Circulation
69
When do you use ABC or CAB
CAB is used for lifeless patients , no pulse. ABC is used on all other patients
70
what is SMR
spinal motion restriction- can be manually or with c-collar
71
what is the look test
getting a feeling about patient's condition from enviormental observations also first look at the patient
72
what is LOC
level of consciousness
73
what is AVPU when assessing mental status
1. Alert [awake, confused] 2. Verbal response {unconscious but responds to sound} 3. Painful response {unconscious but responds to pain} 4. Unresponsive {unconscious and unresponsive}
74
if airway i not open or endangered what measures are to be taken
1. Make it > either head tilt chin lift or jaw thrust 2. Assess it > Gurgling, snoring? 3. Treat it > suction, open airway again if needed 4. keep it
75
what are the three things assessed in circulation assessment
1. Pulse 2. skin (color, temperature, condition) 3. Shock (pale, clammy skin)
76
age 1 and below where do you check their pulse
brachial pulse
77
above 1 year old wher do you check their pulse
radial pulse
78
what artery is used to check pulse when patient is unconscious
carotid pulse
79
what does the glasgow coma scale give scores for
1. best eye response (E) a 1 to 4 score 2. best verbal response (V) a 1-5 score 3. Best motor response (M) a 1-6 score
80
How to locate the radial pulse?
2-3 finger tips with mild pressure.
81
How to locate the carotid pulse?
2-3 finger tips with mild pressure.
82
How to calculate pulse rate?
Count for 30 seconds and multiply by 2.
83
What does rhythm refer to in pulse assessment?
If there is a regular pattern without changes. ## Footnote If irregular, count the full 60 seconds.
84
What does quality refer to in pulse assessment?
How it feels: strong, weak, bounding.
85
How to record an irregular pulse?
Write the number followed by 'irr'. ## Footnote Example: 88 irr
86
How to record an irregular and weak pulse?
Write the number followed by 'irr / weak'. ## Footnote Example: 88 irr / weak
87
What is the normal adult pulse range?
60-100 beats per minute.
88
How to count respiration?
Count for 30 seconds and multiply by 2.
89
How to assess respiration rate?
Number of breaths per minute.
90
How to assess rhythm in breathing?
Pattern of breathing, not while talking.
91
How to assess quality in breathing?
Deep, shallow, regular.
92
What is the normal adult respiration range?
12-20 breaths per minute.
93
How to check pupils?
Ask if sensitive to bright lights and shine light into each eye.
94
What to do if you don't have a light to check pupils?
Check for size and reactivity.
95
What aspects should be assessed for skin?
Color, temperature, and condition.
96
What colors should be assessed in skin color?
Pink, pale, cyanotic, flushed, gray, jaundice.
97
What temperature states should be assessed?
Warm, hot, cool, cold.
98
What is capillary refill?
Looking for the return of capillary blood to an area that was blanched.
99
Where can capillary refill be assessed?
Finger nail bed, palm of hand, forehead, etc.
100
What condition states should be assessed?
Wet, dry, clammy, extremely dry (dehydrated).
101
What indicates a delayed capillary refill?
An early indication of hypoperfusion/shock in children.
102
At what age should capillary refill be taken on children?
Less than 5/6 years old.
103
What should you do regarding capillary refill for all patients?
Take it on everyone to avoid forgetting.
104
Where should breath/lung sounds be assessed?
Four places on the back, under the shirt.
105
What should the patient do while assessing lung sounds?
Take a deep breath (if possible).
106
What should be listened to during lung sound assessment?
Full inhalation and exhalation, then move the scope.
107
What can lung sounds indicate?
Can be noisy only on one side/one lobe area.
108
What is important to know about the pulse oximeter?
How it goes on and what to do if it does not read.
109
What is the first step in blood pressure auscultation?
Explain procedure to patient; 'you'll feel a tight squeeze, please hold real still.'
110
How should the patient position their arm during blood pressure auscultation?
Ask patient to hold their arm out with palm up.
111
What is the first action after applying the cuff?
Palpate for the Brachial pulse.
112
Where should the stethoscope be placed during auscultation?
Place stethoscope in the elbow bend of the arm.
113
What is the target inflation pressure for the cuff?
Close valve / inflate cuff to ~ 160 mmHg.
114
What should you do after inflating the cuff?
Open valve slowly.
115
What do you listen for while releasing pressure from the cuff?
Watch and listen for the first beat and the last beat as pressure is released.
116
How is blood pressure recorded?
Write Systolic over Diastolic.
117
What is the normal range for Systolic Pressure?
100-140 mmHg ## Footnote {1st beat you hear}
118
What is the normal range for Diastolic Pressure?
60-90 mmHg ## Footnote {last beat you hear}
119
What is the first step in blood pressure palpation?
Explain procedure to patient; 'you'll feel a tight squeeze, please hold real still.'
120
What should you do after applying the cuff for palpation?
Palpate radial pulse / keep 2 fingers on radial pulse.
121
What is the inflation method for palpation?
Close valve / inflate cuff until radial pulse is lost, continuing inflating for another 20 mmHg.
122
What should you do after inflating the cuff for palpation?
Release valve slowly.
123
What do you feel for during blood pressure palpation?
Feel for the first beat to return to your fingertips at the radial.
124
How is Systolic Pressure recorded in palpation?
Write Systolic: #P ## Footnote Systolic Pressure: 100-140 mmHg {1st beat you feel}
125
How does palpated Systolic Pressure compare to auscultated?
Will be around 10 lower than auscultated.
126
heart contracts and forces blood into the arteries, the pressure created is known as what
systolic blood pressure
127
what is the pressure remaining in the arteries after the pulse wave has passed through
Diastolic blood pressure
128
patient with a pulse of 120 bpm is what
tachycardic
129
method of taking blood pressure by using a stethoscope to listen to the characteristic sound produced is called
auscultation
130
upon assessment of your patient, you notice that he has cool, sweaty skin. This finding is best described as which of the following A. Diagnosis B. Vital sign C. Complaint D. Sympton
B
131
The first set of vital sign measurements obtained are often referred to as what
Baseline vital sign
132
what vital signs that need to be recorded for virtually every EMS patient is what
1. pulse 2. respiration 3. skin color 4. temperature and condition 5. pupils 6. bowel sounds
133
what breathing sounds should concern EMTs
1. snoring 2. gurgling 3. wheezing 4. crowing
134
you are assessing a 48 year old who is unconscious. The scene is safe and you hear the patient gurgling. what is your next action A. suction the airway B. insert an airway C. open the airway with a head tilt D. quickly check the pulse
A
135
If you can't find the radial pulse where do you check next
cartotid pulse
136
when would you determine the blood pressure by palpation rather than ascultation
when there are to much noise
137
how often should you reassess patients during transport that are considered critical and non critical
every 5 minutes for critical and 15 minutes for normal patients
138
where do baseline vital signs fit into the sequence of patient assessment
secondary assessment
139
Vital signs should be reassessed every
15 minutes
140
increase in the work of breathing is reported as what
labored breathing
141
pale skin with dark spots of cyanosis is
mottling
142
what color of the skin if it is described as cyanotic
blue-gray
143
best way to assess a patient's skin temp
place the back of your hand against the patient's forehead
144
when EMT checks for pupils, he or she is checking for what three things
1. size 2. quality 3. reactivity
145
what can cause unequal pupils
1. artificial eye 2. stroke 3. eye injury 4. brain damage
146
what are the three ways to take blood pressure
1. palpation 2. auscultation 3. blood pressure monitor
147
when taking blood pressure manually, the cuff should be inflated to what point
30 mmHg beyond the point where the pulse disappears
148
device that uses wavelengths of light to measure oxygen saturation (SpO2)
pulse oximeter
149
what is the normal range of blood glucose
70-100 mg/dL
150
what is the normal respitory rate for an adult
12-20 breaths per minute
151
what are some things that can give a false SpO2 reading
1. carbon monoxide inhalation 2. chronic cigarette smoking 3. wearing fingernail polish
152
an approximate normal systolic blood pressure can be calculated for infants and children by using what formula
90 plus 2 times the age in years
153
how long should it take the normal pink color to return to nail bed when capillary refill is assessed
2 seconds
154
best places to assess skin color on adults
1. nail beds 2. inside of cheeks 3. inside of lower eye lids
155
best places to assess skin color on infants and children
1. palms of hands 2. soles of the feet
156
best places to assess skin color on patients with dark skin
lips and nail beds
157
what is the normal levels of Capnography
35-45 mmHg
158
what is the feeling of bone ends rubbing together called
crepitation
159
what techniques of a physical exam must an EMT master
1. observation 2. palptatation 3. auscultation
160
what metho should be used to have a patient rate their amount of pain
pain scale 0-10
161
what should you do if someone keeps answering for a patient
have your partener interview them away from you and the patient
162
the process by which emt forms a field diagnosis is known as what
critical thinking
163
while an EMT forms a field diagnosis on the scene of an emergency how do the steps differ from the traditional approach to diagnosis
the EMT must rule in or out the most serious conditions asscociated with the patients presentation
164
_______ are signs or symptoms that suggest the possibility of a particular problem that is very serious
red-flags
165
what is one advantage of using heuristics
it speeds up the process of diagnosis
166
expert clinicians may use different approaches of thinking throug problems, but which of the following will they have in common
strong foundation of knowledge
167
a description of a patient's condition that assists a clinician in further evaluation and treatment is known as what
diagnosis
168
a list of potential diagnosis compiled early in the patients assessment is known ass which of the following
differential diagnosis
169
once you reached a possible diagnosis for a patient you should do what
continue to look for data that will help you rule in or out other conditions
170
is there odd numbers on blood pressure
no
171
when is the only time to used closed end questions
when you need an immediate answer. Other than that ask open ended questions
172
what does OPQRST stand for and meaning
Onset- what were you doing when it started Provocation- did anything trigger it? Does anything make it better or worse Quality- can you describe the pain Region; radiation- where did the pain begin? Does it spread anywher? Severity- On a scale from 1-10 with 10 being the worse 1 being the least where would you rate the pain Time- what time did the pain, problem begin
173
what are the extra Rs in OPQRST
Recurrence- have you had anything like this happen before; did you go to the hospital, what did you do for pain Relief- did you take anything for the pain if yes what when and how much and did it help
174
what does sample stand for in patients past medical history
Signs and symptoms Allergies- are you allergic to anything Medications- what current medications do you take Pertinent past history- do you have a history of? Last oral intake- when was the last time you ate something Events leading to the injury illness- so you were ____ when the pain/problem began
175
what are the three primary techniques for physical examination
1. Observe- look at patient for an overall sense of patient condition 2. Auscultate- listen for sounds of an abnormal condition 3. Palpate- feel an area for deformities or other abnormal findings
176
how do you approach a pediatric physical exam
approach slowly starting at the least invasive (toes to trunk than towards the head, explain all equipment before use, never lie to a child about something that hurts, provide patient privacy
177
how do you get the pulse pressure
systolic-diastolic

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