EMT Chp. 10 Flashcards
(199 cards)
1
Q
Symptom
A
Subjective condition that the patient feels and tells you about
2
Q
Sign:
A
:Objective condition that you can observe or measure
3
Q
Define scene size-up:
A
An evaluation of the conditions in which you will be operating
4
Q
Explain situational awareness:
A
Paying attention to the conditions and people around you at all times and the potential risks those conditions or people pose.
5
Q
If a scene is not safe what should you do?
A
Ask yourself what can you do to make it safe or call for additional resources.
6
Q
What should you do if you are on a scene and notice a weapon such as a handgun or knife?
A
If not secured make sure you place yourself between the patient and the potential danger
7
Q
What is the best way to determine if a patient has a medical problem or a trauma MOI?
A
The Chief Complaint
8
Q
When should you take standard precautions during a call?
A
Before actual patient contact often before you step out of your response vehicle
9
Q
What questions should be asked to determine if you require additional resources?
A
10
Q
Does the scene pose a threat to you
A
your patient or others?
11
Q
How many patients are there?
A
12
Q
Do we have the resources to respond to their conditions?
A
13
Q
What is the goal of the primary assessment? To identify and begin treatment of immediate or imminent life threats.
A
14
Q
When approaching a patient with injuries to form a general impression
A
why is it important to make sure the patient sees you coming? (page 351) To avoid surprising the patient or causing the patient to turn to see you
15
Q
What is the AVPU scale used for?
A
16
Q
It tests a patient’s responsiveness and LOC.
A
17
Q
Explain each component:
A
18
Q
A Awake and Alert (eyes open as your approach
A
follows commands
19
Q
V Responsive to verbal stimuli (Not alert and awake
A
eyes do not open
20
Q
P Responsive to pain (Doesn’t respond to questions but moves or cries out of response to painful stimuli.)
A
21
Q
U Unresponsive (Patient doesn’t respond to verbal or painful stimuli)
A
22
Q
What are some causes of altered mental status? (page 353) Ongoing illness
A
history of stroke
23
Q
Define altered mental status: Any deviation from alert and oriented to person
A
place
24
Q
After determining the level of consciousness in a patient
A
the priorities of care should then focus on (page 354). Identify and correct life threatening issues with ABC
25
What are the exceptions to the order of treating airway
breathing
26
When the patient has a life threatening bleeding.
27
Be familiar with the information in Table 10-1 on page 354.
28
Indications for Spinal Immobilization
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Either blunt or penetrating trauma with any of the following:
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Pain or tenderness on palpation of the neck or spine
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Patient report of pain in neck or back
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Paralysis or neurologic complaint (numbness
tingling
33
Blunt trauma with any of the following:
34
Altered mental status
35
Intoxication (alcohol or drugs)
36
Difficulty or inability to communicate
37
What is a sign of an airway obstruction in a conscious patient? A patient who cannot speak or cry.
38
When a patient has secretions
vomitus
39
What are the signs of airway obstruction in an unconscious patient?
40
Obvious trauma
blood
41
Noisy breathing
such as snoring
42
Extremely shallow or absent breathing
43
What is the goal for oxygen saturation for most patients? ____94___%
44
When should positive-pressure ventilations be used on a patient?
45
When a patient who is not breathing or whose breathing is too slow or too shallow.
46
What are signs of breathing difficulty in patients? (page 356)
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Shallow Respirations
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The presence of retractions
49
Use of Accessory Muscles
50
Nasal Flaring and seesaw breathing
51
Two to three dyspnea
52
Labored breathing
53
Tripod Position
54
Explain tripod position: A patient is sitting and leaning forward on outstretched arms with the head and chin thrust slightly forward.
55
What are some signs of labored breathing in infants and small children?
56
Nasal flaring and seesaw breathing in pediatric patients indicate inadequate breathing
57
Tripod position
58
Know the signs of respiratory distress and failure in Table 10-2 on page 357.
59
Signs of Respiratory Distress and Failure
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Respiratory Distress
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Respiratory Failure
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Agitation
Anxiety
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Lethargy
difficult to rouse
64
Stridor
Wheezing
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Tachypnea with periods of bradypnea or agonal respirations
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Accessory muscle use;intercostal retractions
neck muscles use (Sternomastoid)
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Inadequate chest rise/poor excursion
68
Tachypnea
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Inadequate respiratory rate or effort
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Mild Tachycardia
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Bradycardia
72
Nasal flaring
seesaw breathing
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Diminished muscle tone
74
The first step in evaluating any patient is to rapidly scan for
identify
75
Define pulse: The pressure wave that occurs as ach heartbeats causes a surge in the blood circulating through the arteries
76
Define palpate: Feel the pulse. Hold together your fingertips over a pulse point. Press gently against the artery until you feel intermittent pulsations.
77
What should you do if you cannot palpate a carotid pulse in an unconscious patient? Begin CPR and an AED.
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What should you do if a patient has a pulse but is not breathing? Provide ventilations at a rate of 10 to 12 breaths a minute for adults and 12 to 20 breaths a minute for an infant or child.
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What should you do if the patient becomes pulseless? Start CPR and apply an AED.
80
Circulation is evaluated by assessing:
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1.Skin Condition
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2. Skin Color
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3. Skin Temperature
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4.Skin Moisture
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Where should changes in skin color be apparent in patients with deeply pigmented skin? Fingernail beds
the mucous membranes in the mouth
86
Define cyanosis: Insufficient air exchange and low levels of oxygen in the blood
the blood vessels appear blue.
87
Define diaphoretic: When the skin is bathed in sweat
such as after strenuous exercise or when the patient is in shock.
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How can the condition/moisture of the skin be described? (page 360)
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First describe the color
then the temperature
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Normal skin condition should be described as: Pink
Warm
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How fast should capillary refill be restored to normal pink color in the fingernail beds be restored in infants and children?
92
2 seconds
93
How should CRT be documented?
94
CRT >2 (Delayed)
95
What is the simplest way of controlling external bleeding?
96
Direct pressure with your gloved hand and soon thereafter a sterile bandage over the wound will control bleeding in most cases.
97
What is the purpose of the rapid head-to-toe exam following the primary assessment?
98
Be familiar with the steps in Skill Drill 10-1 on page 362-363.
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Head
100
Neck
101
Chest
102
Abdomen
103
Pelvis
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All four extremities
105
Back and Buttocks
106
What conditions are considered examples of high-priority patients requiring immediate transport?
107
Unresponsive
108
Difficulty breathing
109
Uncontrolled bleeding
110
Altered LOC
111
Severe Chest Pain
112
Pale skin or other signs of poor perfusion
113
Complicated childbirth
114
Severe pain in any area of the body.
115
When does the Golden Hour begin and end?
116
Time the injury to definitive care
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How often should unstable patients be reassessed?Every 5 minutes
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How often should stable patients be reassessed?
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Every 15 minutes
120
Explain history taking: Provides details about the patient's chief complaint and an account of the patient's signs and symptoms.
121
Date of incident
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Patient’s age
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Patient’s sex
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Patient’s race
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Past medical history any pertinent information.
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Patient’s current health status
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When investigating the chief complaint
begin by: making introductions (make patient feel comfortable)
128
How can you gain information about an unconscious patient’s medical history?
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Observable signs
and original dispatch. Family members that are present
130
What questions should you ask for each component of SAMPLE history?
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S: Signs and Symptoms (What signs and symptoms happened at onset of incident?)
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A: Allergies (Any food or medications?)
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M: Medications (Prescribed? OTC? Taken the last 12 hours?)
134
P: Pertinent past medical history (History of medical
surgical
135
L: Last oral intake (What did you last eat
and when?)
136
E: Events leading up to the injury or illness (What was the patient doing when the illness started?)
137
Explain what each component of OPQRST means:
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O: Onset - what were you doing when symptoms began?
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P: Provocation/Palliation- What makes symptoms better or worse?
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Q: Quality- What does it feel like? Crushing
dull
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R: Region/Radiation- Does it move anywhere?
142
S: Severity- On a scale from 1-10
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T: Timing- When did it start?
144
Explain what a pertinent negative is:
145
Signs and symptoms the patient does not have
are important negatives.
146
How do you prioritize a patient’s complaints when they present with multiple symptoms?
147
Prioritize the patient’s complaint as you would with triage; start with the most serious and end with the least serious.
148
Give an example of a situation where you may not have time to perform a secondary assessment:
149
If you have to continually mage life threats that were identified during the primary assessment. Ex: CPR
150
What is the purpose of the secondary assessment?
151
Perform a systematic physical examination of the patient.
152
Explain auscultation (page 378) The sound to the flow of blood against the brachial artery as you release the pressure in the blood pressure cuff.
153
What types of patients should a systematic head-to-toe assessment be performed on? (page 378)
154
Significant MOI
is unconscious
155
What are the ears assessed for in the secondary assessment? Bruising behind the ears (Battle Sign
156
Define stridor and what it indicates:
157
A brassy crowing sound prominent on inspiration
suggests a partially occluded upper airway caused by swelling.
158
High pitched crowing indicates an upper airway obstruction from a foreign body.
159
What is the normal resting pulse rate for an adult?
160
60-100 beats/minute
161
What is the best way to assess the quality of air movement in the lungs? Listen to breath sounds on each side of your patient's chest.
162
Blood pressure by palpation measures the ______systolic______ blood pressure.
163
Explain how to accurately measure blood pressure by palpation:
164
Inflate the cuff rapidly to 70 mmHg
and increase by 10 mm Hg increments while palpating the radial pulse.
165
Be familiar with the Characteristics of Respirations in Table 10-5 on page 387.
166
Normal: Breathing is neither shallow nor deep; it appears effortless. Equal chest rise and fall. No use of accessory muscles.
167
Shallow: Decreased chest or abdominal wall motion
168
Labored:Increased breathing effort. Use of accessory muscles. Possible gasping. Nasal flaring
supraclavicular and intercostal retractions in infants and children
169
Noisy: Increase in sound of breathing
including snoring
170
What does systolic blood pressure measure?
171
The increased pressure that is caused along the artery with each contraction (systole) of the ventricles and the pulse wave that it produces.
172
What does diastolic blood pressure measure?
173
The residual pressure that remains in the arteries during the relaxing phase of the heart’s cycle. When the left ventricle is at rest.
174
Evaluate if the pupils reach in any of the following ways:
175
Become fixed (either dilated or constricted)
176
Dilate with introduction of bright light and constrict when the light is removed
177
React sluggishly instead of briskly
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Become unequal in size
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Become unequal in size when a bright light is introduced into or removed from one eye.
180
What are some of the causes of depressed brain function?
181
Injury of the brain or brainstem
182
Trauma or stroke
183
Brain tumor
184
Inadequate oxygenation or perfusion
185
Drugs or toxins (CNS or depressants)
186
What does jugular vein distention indicate? A problem with blood returning to the heart.
187
At what angle should the patient be sitting to evaluate the jugular veins? Sitting up
188
What does pulse oximetry evaluate? The effectiveness of oxygenation
189
What does capnography measure? A patient’s ventilation
circulation
190
The effectiveness of breathing treatments.
191
What is a way of gaining valuable information in a patient with an altered mental status? (page 402)
192
Measuring blood glucose level of a patient.
193
What are the steps of patient reassessment?
194
Reassess Vital Signs
195
Reassess the Chief Complaint
196
Recheck Interventions
197
Identify and Treat Changes in the Patient’s Condition
198
Reassess Patient
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