EMT Review Sessions Flashcards
(318 cards)
1
Q
Standard of Care may change based upon:
A
The situation (MCI for example) What the medical director dictates
2
Q
Conditions under which a patient may refuse treatment:
A
Alert and oriented x4 (person, place, time, event)
Adult (or emancipated minor)
Do they understand the nature of their condition and the consequences of refusal
Unimpaired (i.e. no alcohol)
3
Q
The MOLST has two sides that includes:
A
CPR
Life Sustaining Treatments
4
Q
Four aspects of Negligence
A
Duty to Act
Breach of Duty
Injury
Causation
5
Q
Ways duty can be breached (under negligence) which results in a violation of the standard of care
A
Omission
Commission
6
Q
Breach of duty where you did something poorly
A
Commission
7
Q
Breach of duty where you did not do something
A
Omission
8
Q
Abandonment
A
Termination of Care without the patient’s consent
Failure to transfer care to someone of equal or higher standard (exception ALS back to BLS)
9
Q
Infection
A
A host is invaded by a pathogen
10
Q
Pathogens
A
Virus, bacterial, fungus, parasite
11
Q
Routes of transmission
A
Airborne, direct, vector, indirect (vehicle transmission)
12
Q
Factors contributing to infection:
A
Virulence
Dose
Immunity
Portal of Entry
13
Q
Normal blood pressure ranges, systolic:
A
Adult male 100+age (max 140)
Adult female 90+age (max 130)
Child (under 10) 80 + (2x age)
14
Q
Normal blood pressure ranges, diastolic
A
Adult male 60-90 (<100)
Adult female 50-80 (<90)
Child (under 10) 2/3 SBP
15
Q
BP for children is (higher/lower) for children than adults
A
Lower
16
Q
BP is (higher/lower) for pregnant women. How much higher or lower?
A
10-15 mmHg lower
17
Q
Widening pulse pressure is indicative of?
A
Increasing ICP
18
Q
Narrowing pulse pressure in indicative of?
A
Chest injury (tension pneuothorax, pericardial tamponade) or early shock
19
Q
Pulse pressure is
A
Systolic blood pressure-diastolic blood pressure
20
Q
Narrowing pulse pressure is when the DBP is within ___of the SBP
A
25%
21
Q
Widening pulse pressure is when DBP is great than ___of SBP
A
50%
22
Q
Pulses paradoxes is indicative of
A
Cardiac or respiratory injury
23
Q
Pulses paradoxes-
A
BP changes during respiration
24
Q
Pulse is (faster/slower) during pregnancy. By how much?
A
Faster, 10-15 beats faster
25
Pulse rates
Adult: 60-100
Children: 80-100
Newborn: 140-160
26
An irregularly irregular pulse is indicative of
atrial fibrillation
27
An irregular pulse is indicative of
ischemia
28
When the pulse is weak or thready that means the body is ?
Compensating
29
Breathing rates
Adults: 12-20
Children: 15-30
Infants: 25-50
30
The inspiratory and expiatory ratio is
2/3
31
Prolonged expiatory period is indicative of
bronchoconstriction
32
Ineffective gasping
Agonal respirations
33
Mottled skin is indicative of____, especially in____
Poor perfusion, children
34
One can assess level of consciousness using the ____and ____
Glasgow coma scale
| Pupils
35
Unequal pupils indicate
ICP
36
Glasgow coma scale: Eye opening response
4-spontaneously
3-to speech
2-to pain
1-no response
37
Glasgow coma scale: verbal response
```
5-Oriented x 4 (person, place, time, event
4-Confused
3-Inappriopate words
2-Incomprehensible sounds
1-No response
```
38
Glasgow coma scale: Motor response
```
6-Obeys commands
5-Moves to localized pain
4-Flexion withdrawal to pain
3- Abnormal flexion (decorticate)
2- Extension withdrawal to pain (decerebrate)
1-No response
```
39
What is the landmark between the upper and lower airway?
Vocal cords
40
Pharynx contains:
Nasopharynx, oropharynx, hypopharynx (larynopharynx)
41
What is the largest, most palpable part of the layrnx?
Thyroid cartilage
42
What is the lowest part of the larynx?
Cricoid cartilage
43
The vocal cords are embedded in the ?
Thyroid cartilage
44
The trachea is made of ____ and protected by____
Smooth muscles
| C shaped cartilaginous rings
45
The trachea is located in the ____
mediastinum (along with the heart and great vessels)
46
Which lung is aspiration more likely to happen? Why?
The right lung because it is larger and less angled
47
Gas exchange happens at the aveoli via ___
Diffusion
48
Diffusion is a ______
Concentration gradient
49
The _____ pleura covers the lung
Visceral
50
The ____pleura covers the chest wall
Parietal
51
Nerves that control the diaphragm are the
Phrenic nerves
52
Nerves that control the intercostal muscles
Intercostal nerves
53
Part of the brainstem that is responsible for breathing
Pons and medulla
54
Signs of a foreign body airway obstruction
stridor, cyanotic, sudden onset, pale, cool
55
Signs of an anatomic obstruction
```
infection or inflammation (edema)
gradual/rapid onset-not sudden
febrile, urticaria
tongue swelling (anaphylaxes)
Epiglottitis
```
56
Treatment for a FBAO
Conscious adult: abdominal thrusts
Unconscious adult/infant: CPR
Infant: back blows, chest thrust
57
Treatment for an anatomic obstruction
Humidified O2, epi pen
58
Signs of a respiratory infection
Rhonchi, febrile, gradual onset, cough, productive cough
59
Bronchitis leads to damaged type __ cells
Type I (where gas exchange occurs)
60
Bronchitis is:
Inflammation of the bronchi which leads to hyper-secretion of mucus. This blocks the airways, leasing to a decrease of gas exchange
61
Emphysema cause
Inhaled toxins leasing to scar tissue. Leads to damaged Type I and II cells. Loss of elasticity. Air is trapped
62
Signs of COPD
Rhonchi and wheezing
63
Arteriosclerosis
Stiffening of atrial wall as age results in calcium deposits
64
Atherosclerosis
Cholesterol getting stuck in arteries
65
Ischemia and infarction lead to:
Acute coronary disease
66
Two types of acute coronary disease:
Angina, myocardial infarction
67
What types of cardiogenic shock is more concerning? Left Ventricular MI or conductivity issue?
Left ventricular
68
S/S Left Ventricular Event
```
Pulmonary Edema
Rales
Increase HR
Decrease BP
Pale, cool, diaphoretic (due to adrenaline dump)
```
69
S/S Conductivity Issue
Decreased HR
Normotensive
No pulmonary edema (clear and equal)
Pale, cool, diaphoretic (due to adrenaline dump)
70
When would you apply 02 for an MI?
02 sat <94%
Respiratory distress
Poor perfusion
71
CHF is usually due to left or right sided failure?
Left sided failure
72
S/S of CHF (left side)
```
BP way up
HR increase
pulmonary edema (rales)
JVD
Pale, cool, diaphoretic
DOB
```
73
Right side CHF and how it differs from Left side CHF
No pulmonary edema
| Peripheral edema
74
What is the #1 case of right sided CHF?
Left sided CHF
75
Syncope in the elderly should be considered a sign of ____ until proven otherwise
Cardiac
76
Hemiplegia
Inability to move half of the body
77
Monoplegia
Inability to move one limb
78
Paresis
Weakness
79
Types of occlusive events?
Types of strokes: embolus and thombosis
80
Embolus
Clot
81
Thrombosis
Gradual narrowing of cerebral arteries. No seizure/no pain
82
What may lead to a hemorrhagic stroke?
Aneurysm
83
Aneurysm
Weakened cerebral vessel
84
S/S Hemorrhagic stroke
```
Rapid onset
Headache
Increase ICP (unequal pupils)
Posturing (flexion/extension)
Cushing's response (increase BP, decreased, irregular breathing)
```
85
FAST ED
```
Facial droop (0-1)
Arm Drift (0-2)
Speech (0-2)
Time (0-2)
Eye Deviation (0-2)
Denial/Neglect (0-2)
```
86
Should be concerned about an emergent large vessel occlusions with a FAST ED score equal or larger than ___
4
87
Seizure
Chaotic discharge of electricity in the brain
88
The types of seizure is dependent upon?
The location
89
Transient Ischemic Attacks are similar to CVA's but resolve within ___
24 hours
90
How long does a seizure last?
Typically 1-2 minutes, less than 5
91
Jacksonian march is associated with what type of seizure?
Simple partial
92
Automatism is associated with what time of seizure?
Complex partial
93
Complex partial are what type of seizures?
Psychomotor
94
Treatment of Generalized grand mal seizure
Positioning (lateral recumbent), airway (OPA/NPA), 02, transport (do not wait until the seizure is over), prevent injury
95
Treatment for status epilepticus
Aggressive airway management
Ventilation
ALS
96
When would you involve ALS for a seizure?
Status epilepticus and first time adult seizure
97
Insulin
Hormone that triggers cell membrane to allow glucose
98
What part of the body does not require insulin and why?
The brain because glucose can flow across the blood brain barrier
99
Short and long term stores of glucose are called?
Glycogen
100
Short term stores of glycogen are where?
Muscles, Liver
101
Long term stores of glycogen are where?
Liver, fatty tissue
102
What turns glycogen into glucose?
Glucagon
103
Types of diabetes where the individual produces no insulin?
Type I
104
Type of diabetes where the individual produces insufficient insulin?
Type II
105
Frequent urination
Polyuria
106
Frequent thirst
Polydipsia
107
Frequent hunger
Polyphagia
108
Normal blood sugar range
70-120 (fasting)
| 80-140 (after eating)
109
Rapid, deep, sighing respirations
Kussmaul respirations
110
Do you need to be diabetic to be in insulin shock?
No, it is anyone who is hypoglycemic
111
Insulin shock-onset?
Rapid
112
Is DKA-onset rapid or gradual?
Gradual
113
Parts to maintain adequate perfusion?
1) Adequate pump
2) Adequate blood volume
3) Adequate vessels
4) Adequate gas exchange
114
Pump issue is a type of ___shock
Mechanical
115
Types of pump (mechanical) shock issues?
1) Cardiogenic issues (MI)
| 2) Obstructive shock (tension pneumothorax, pericardial tamponade)
116
Blood volume issues
Low space or absolute hypovolemia
117
Vessel issue
Distributive shock (high space or relative hypovolemia)
118
Metabolic shock
Gas exchange issue-hypoxia, hypoglycemia
119
Early Shock=
Compensatory Shock (1st stage)
120
S/S of compensatory shock
```
Tachycardia
Tachypnea
Vasoconstriction
BP may stay or increase (if neurogenic BP decreases)
Altered mental status (anxiety)
Adrenaline dump-sympathetic response
```
121
2nd stage of shock
Progressive shock
122
S/S of progressive shock
Changes in mental status (irritability, confusion, anxiety)
Tachypnea
Tachycardia with weakened pulses
Vasoconstriction increases
123
3rd/last stage of shock
De-compensated shock
124
S/S of de-compensated shock
```
Tachycardia with thready pulses
Worsening mental status
Rapid, shallow respirations
Hypotension
Mottling
```
125
Location of tourniquet
3-6" proximal to injury
| Never over joint
126
when is the tourniquet tight enough?
No distal pulse and bleeding stops
127
Closed injuries
Contusions, hematoma (maybe crush injury)
128
Treatment for close injuries
Ice, compression, elevation
129
Open injuries
Abrasions, lacerations, avulsion, amputation, punctures
130
What is the flap of an avulsion?
Pedicle
131
What do you do with pedicles (complete avulsions) and amputated parts?
Dry dressing, waterproof bag, and keep part cool
132
5 P's of compartment syndrome
```
Pain out of proportion
Pallor
Pulselessness
Parathesia
Paralysis
```
133
Crush injuries lead to ___ metabolism
Anaerobic
134
ICES (immobilizing injuries)
Ice
Compression
Elevation
Splint
135
Severely angulated longbone fracture-how do you splint?
You apply gentle traction to attempt to bring into place (once), then you split
136
How do you splint a joint?
You should not attempt to put a joint back into place (unlike a longbone fracture). Splint in place
137
Sprain is associated with the
Soft tissue that surrounds the joint capsule, usually a ligament
138
Strain is associated with
muscle (due to stretching/tearing)
139
Muscle to bone
Tendons
140
Fascia
Connective tissue that surrounds muscle fibers
141
Compartment syndrome
Edema and hemorrhage increase pressure in fasical compartments
142
What fractures are young individuals prone to?
Greenstick fractures/epiphyseal fracture
143
Greenstick fracture
Partial break of the bone. Usually because the bones of the individual are not calcified
144
Epiphyseal fracture
Growth plates-proximal and distal end of long bones
145
What fractures are old people prone to?
Pathological fractures, because of brittle bones and osteoporosis
146
Pathological fractures
Underlying medical issue
147
Fracture
Loss of continuity in the bone
148
Dislocation
A joint is forced out of its normal position
149
Type of fracture where the break is at a right angle to the long plane of the bone.
Transverse
150
Fracture where the break is on an angle through the bone
Oblique
151
Fracture that occurs occurs due to a rotational, twisting, force
Spiral fracture
152
Fracture in which one of the fragments is driven into another fragment
Impacted fracture
153
Fracture in which the broken ends of the bone are shattered into many pieces
Comminuted
154
Fracture of the distal forearm in which the broken end of the radius is bent backwards
Colles'
155
In splinting an injury when are CSM's assessed?
Before and after splinting
156
What is in the arachnoid layer?
CSF and small vessels
157
What is in the dura mater?
Large arteries
158
What is the most sensitive indicator of a head injury?
Altered mental status
159
Retrograde
Do not remember what happened
160
Anterograde
Ability to form new memory is impacted (repetition is a good indicator)
161
S/S of a head injury
Altered mental status
Nausa/Vomiting
Seizure
Dizziness
Unequal pupils (increasing ICP)
Cushing's Response (bradycardia, hypertension, abnormal respiratory pattern)
Posturing (decorate-flexion-, decerebrate-extension-)
Numbness, tingling
Diplopia (seeing double)
Hearing, taste, smell
Visual complaints (occipital lobe is the visual center of the brain)
162
Concussion presentation
LOC at time of event but rapid recovery
| S/S Nausea/vomiting, decreased ability to concentrate, headaches, blurred vision, confusion, irritable
163
Intracerebral bleeding-contusion presentation
Similar to concussion but without improvement. Additional signs- mentation down, ICP up, personality change
Mimic stroke and are difficult to manage
164
Diffuse axonal injury
Injury due to forces on brain shearing, stretching, compression of tissue
Injury to nerves that make up brain due to energy involved in mechanism
165
In diffuse axonal injury you will probably see:
Cerebral edema
166
Epidural hematoma presentation
Very serious (this is where your large arteries are)
Rapid onset
LOC resolves then there is a lucid period after which a rapid decrease in LOC
Mental status declines with increasing ICP
167
What is the most common type of hematoma?
Subdural hematoma
168
Subdural hematoma presentation
Slowly evolves into declining stage. Due to small vessels therefore, slower to evolve
169
Subarachnoid bleeding presentation
Headache and nuchal rigidity (stiff neck)
| Bleeding vessels in tissue of arachnoid layer
170
Temporal impact is where?
Underneath the middle meningeal artery
171
Treatment for head injury
Patient needs 02 >95
May want to consider ventillation
Spinal motion restriction-SMR
Assist if hypotensive (patient may be a multi-trauma patient)-may be an injury that can be addressed
172
SMR
Spinal motion restriction
173
C
T
L
S
Cervical 7
Thoracic 12
Lumbar 5
Sacral 5
174
What acts as a cushion between discs?
intraertebral disc
175
Type of breathing associated with spinal injuries:
C1-C2
C3-C5
C6-C7
Respiratory arrest
Impaired use of diaphragm
Diaphragmatic breathing (phrenic nerve is spared)
176
Neurogenic shock presentation
```
Priapism
Bradycardia
skin warm, dry and flushed
hypotension
Possible Posterior midline pain/tenderness
Possible Neck pain
```
177
For which of the below is recovery possible?
Severed spinal cord
Cord impingement
Cord inflammation
Severed spinal cord-not possible
Cord impingement -possible
Cord inflammation-possible
178
When considering a spinal cord injury, what may make someone an unreliable witness which would cause concern?
Altered mental status, because may not remember or feel injury
alcohol
179
Who is an age group of concern for a spinal injury?
Old people, brittle bones
180
S/S Chest injury
```
Paradoxical movement
Pleuritic chest pain
JVD
Tracheal deviation
Hypotension
Breath sounds-unequal
Narrowing pulse pressue
```
181
Hemoptysis
Blood in spit
182
Air in the pleural space
Pneumothorax
183
Closed versus open pneumothorax
Closed-air coming from lung
| Open-sucking chest wound
184
A pneumothorax can evolve into a____
Tension pneumothorax
185
Type of breath sounds associated with a tension pneumothorax
hyperresonance (hollow breath sounds)
186
Tension pneumothorax presentation
```
Tracheal deviation
JVD
Narrowing pulse pressuer
hyperresonance
Unilateral breath sounds
Bulging intercostals
Subcutaneous air
```
187
What type of shock does tension pneumothorax lead to?
Mechanical shock (obstructive shock)
188
What type of shock does pericardial tamponade lead t?
Mechanical shock (obstructive shock)
189
Blood in pleural cavity
Hemothorax
190
Hemothorax presentation
Unilateral breath sounds
Hyporesonance
NO JVD (because so much blood loss, cannot fill veisn)
191
What type of shock does a hemothorax cause?
Hypovolemic
192
Blood in pericardial sack
Pericardial tamponade
193
Pericardial tamponade presentation
Beck's Triad: JVD, narrowing pulse pressure, muffled heart sounds
194
Injury due to a circumferential injury to the chest
Traumatic asphyxia
195
Traumatic asphyxia presentation
JVD, cyanosis of the head and neck, scleral hemorrhage
196
Bruise to the lung tissue
Pulmonary contusion
197
Myocardial contusions present as
Heart attack
| Leads to an irregular pulse
198
Cordis commotio
Sudden cardiac arrest due to low force impact to chest at the perfect time. Puts you into V-Fib. Treated as an electrical event
199
Puts you into V-Fib. Treated as an electrical event
Cordis Commotio
200
Solid organs
Liver, spleen, kidney, pancreas, ovaries
201
Hollow organs
Stomach, intestines, uterus, gallbladder
202
Solid organs, you are concerned about
Hemorrhage
203
Hollow organs, you are concerned about
Hemorrhage and leakage
204
Stomach location
Upper left quadrant (some in right)
205
Spleen location
Upper left (retropetineal)
206
Pancreas location
Upper left (some in right)
207
Liver location
Upper right (some in left)
208
Gallbladder location
Upper right
209
Intestines location
All four quadrants
210
Kidney location
Flank-retropetineal space
211
Inflammation of the Periteneum is a concern, why
Life threatening event
| Leakage, bleeding, infectious
212
Ways to test for rebound tenderness
Heel jar test, markle signs
213
Contradictions for MDI
Exceeds dosing
214
Indications for MDI
Presence of bronchoconstriction, history of bronchoconstrictive disease, prescribed emergent inhalter
215
Dose for MDI
As prescribed
216
Albuterol contraindications
Ischemic cardiac disease
217
Alburterol indications
Presence of bronchoconstrictive diseas
218
Albuterol indications
Presence of bronchoconstrictive disease
History of bronchoconstrictive disease
Perscribed emergent inhaler
219
Nitroglycerin contraindications
SBP<120
Recent head trauma
Children
220
Albuterol dose
2. 5 mg in 3 cc saline (Adult >2 years old)
| 2. 5 mg in 6 cc saline/1.25 mg in 3 cc saline (Pedi 6 months-2 years)
221
Baby aspirin contraindications
```
ASA allergy
Anticoagulation therapy
Recent GI bleed
Recent surgery/trauma
pregnancy
```
222
Baby aspirin dose
162-325 mg
223
Medical direction for MDI
Standing order
224
Medical direction for Alburterol
1st dose: Standing order
| 2nd dose: Medical control
225
Nitroglycerin medical direction
Standing order
| Medical direction: erectile dysfunction meds in the last 48 hours
226
Medical direction baby aspirin
Standing order
227
Epinephrine medical direction
Standing order: 6 months-65 years
| Medical control: <6 months; >65 years, 2nd dose to pedi
228
Narcan contraindication
Considerations:
HR>100, abnormal breath sounds, nasal obstructions, seizures or history of recent seizure, trauma, cardiac arrest, chronic opiates for pain control
229
Epinephrine dose
.3 mg (Adults >25 kg; 55 lbs)
| .15 mg (Pedi <25 kg; 55 lbs)
230
Narcan dose
1 mg/ml per nostril
| 2-4 mg, repeat once
231
Narcan indication
Suspected opiate OD
| RR<8
232
Glucose contraindications
No gag reflex
233
Glucose medical direction
Standing order
234
Glucose indication
Altered mental status
| Documented blood glucose <70mg/dl
235
What is administered in lieu of glucose if patient is unconscious or does not have a gag reflex
Glucagon
236
How is glucagon administered?
1 mg IM
237
What is administered in conjunction with albuteral?
Ipratriopium
| Atrovent
238
Ipratriopium/Atrovent is a____
Anticholinergics
239
What do anticholinergics do?
Block the action of acetylcholine
240
Repository of eggs, contained in sacs called follicles
Ovaries
241
Where does fertilization occur?
Fallopian tubes
242
Where does implantation occur?
Uterus
243
Area between the urethra and anus
Cervix, vagina, perineum
244
What is the purpose of the placenta?
Oxygen (exchange happens between placenta and endometrium) and nutrients from mother to fetus
245
Purpose of the umbilical cord?
Connect placenta to the fetus
246
The primary drive to breathe is?
CO2 drive-the more CO2 the higher the RR
247
The secondary drive to breathe is?
Hypoxic drive (02)
248
Why should you be careful when giving oxygen to COPD patients?
If there is poor gas exchange because C02 is building up, eventually the brain only listen to the 02 drive because C02 is too high. If give 02, must be careful because you may knock out 02 drive if give too much 02
249
Three components of asthema?
1) Bronchospasm
2) Hypersecretion of mucus
3) Inflammatory response-airway swells
250
Wheezing trend in asthma patients
End expiratory-expiratory-inspiratory/expiratory-silent chest
251
Treatment of asthma
High flow 02
Bronchodilator
pedi with arrest-epi
252
Common causes of pulmonary edema
Cardiogenic-heart failure, massive MI, CHF (#1 cause)
If not cardiogenic-renal failure, inhalation injury, salt water drowning (secondary drowning), HAPE (high altitude pulmonary edema), hypotherma
253
Breath sounds associated with pulmonary edema
Rales
254
Risk factors for pulmonary embolus
Sedentary, history of deep vein thrombosis, history of a-fib, smoker, birth control, pregnancy, long bone fracture
255
Treatment for pulmonary embolus
High flow 02
| Positioning
256
S/S spontaneous pneumothorax
Unequal breath sounds
| Pleuritic chest plain
257
S/S pulmonary embolus
```
Sudden onset pleuritic chest pain
Hemoplysis (blood in sputum when cough)
Equal, clear breath sounds
Syncope
Agitation
```
258
Allergy versus anaphylaxis
Allergy is local
| Anaphylaxis is a systemic reaction
259
Antigen
Foreign substance
260
When the antigen enters the body , the ___ releases ___. The ____ binds to the antigen and makes a ____.
White blood cells (lymphocytes)
Antibodies
Antibody
Ag-Ab complex
261
What eats the Ag-AB complex?
Macrophage (phagocyte)
262
What allows the body to respond faster the next time an antigen enters the body?
Memory cell
263
What causes antibody production and then causes the body to go wild with antibody production?
Sensitizing exposure
264
How does anaphylaxis arise after sensitizing exposure
Sometimes Ab circulates in bloodstream or they bind to mast cells/basophils. They can stick to mast cells/basophils permanently. Issue occur when body encounters antigen again. This next time antigen binds to the antibody, making the ag-ab complex, the mast cells/basophils explode (b/c too much stuff in them). Release histamines.
265
S/S of anaphylactic reaction
```
Stridor
Wheezing
Facial edema
Abdominal cramps
Urticara
Tachydysrhymthias
Hypotension (due to vasodilation-leaky blood vessels)
```
266
Epinephrine counters the most dangerous parts of anaphylaxis which are:
Bronchoconstruction and vasodilation
267
Epinephrine is a -
Sympathomemtic
268
Reaction due to the antigen, not antibody
Anaphylactoid reaction
269
V minute
Vtidal x RR
270
Layer that surrounds the heart
Fibrous pericardium
271
Double self reflecting layer surrounding the heart
Serous pericardium
272
Part of the serous pericardium that covers the heart
Visceral
273
Part of the serous pericardium that covers the inside of the fibrous pericardium
Parietal
274
P wave
```
Atrial depolarization
atrial contraction (mechanical)
```
275
QRS complex
Ventrical depolarization
Ventricle contraction
Systole
276
T wave
Ventricle repolarization
| Ventricle relaxation
277
QRS=
Systole
278
S-T-P-Q (everything but QRS)
Diastole
279
Coronary arteries are at base of the aorta, perfuse the heart during diastole ____ allows coronary arteries to be filled
Backflow
280
Cardiac Output
CO=stroke volume x HR
281
Stroke volume
Amount of blood pushed out per beat
282
Critical areas for burns
```
Face
Airway
Hands
Feet
Gonads
Circumferential burns
```
283
Factors determining burn severity
```
Involving critical areas
Pre-existing medical problems/associated trauma
Age (<5, >55)
Depth of burn
Body surface area
```
284
Considerations for burns
Inhalation injury-first 1/2 hour
Hypothermia (cannot vasoconstrict)-first 1/2 hour
Hypovolemia (third spacing may cause edema and shock-fluid in institual space)
Infection
285
Body surface area measurements for burns-adults
```
Adults-multiples of 9
head:9
arm:9
Back of torso:18
torso:18
leg:18
```
286
Body surface area measurements for burns-children
```
Head:18
arm:9
torso:18
back of torso:18
leg: 13 1/2
```
287
Chemical burns decontamination protocol
Disrobe
Dust
Dilute (20 minutes)
288
What type of dressing is used for burns?
Dry sterile dressing because concerned about hypothermia
289
Minor burn determination-adult
3rd degree <2% BSA
2nd degree <15% BSA
1st degree <50% BSA
290
Moderate burn determination-adult
3rd degree 2 to 10% BSA (excluding critical areas)
2nd degree 15 to 25% BSA
1st degree >50% BSA
291
Critical burn determination-adult
```
Respiratory injury
Critical area (2nd or 3rd degree)
3rd degree >10% BSA
2nd degree > 25% BSA
Circumferential burn
Trauma
Pre-existing illness
Moderate burns on patients < or >55
```
292
Minor burns-children
2nd degree <10% BSA
293
Moderate burns-children
2nd degree 10 to 20% BSA
294
Critical burns-children
Critical areas (1st, 2nd, 3rd degree)
2nd or 3rd degree >20% BSA
Moderate burns for adults
295
Eschar is associated with
3rd degree burns
296
Blisters, painful, involves epidermis and the dermis
Partial thickness/2nd degree burn
297
Painless and eschar
Full thickness burn/3rd degree
298
A colorless, odorless and tasteless flammable gas that is slightly less dense than air
Carbon monoxide CO
299
S/S of CO poisoning
```
Multiple people are affected (pets and children are usually first)
Headache
Nausea/vomiting
Altered mental status
Cherry red skin
```
300
Treatment for CO poisoning
Get out of the location
Non-rebreather mask
High flow O2
Hyperbaric chamber (also used for the bends)
301
Headache, dizziness, tachycardia, SOB, vomiting followed by seizures, bradycardia, hypotension, LOC and cardiac arrest. Common in fires as it is used for pressure treated wood
Cyanide
302
Antidote for cyanide
Amyl nitrate (poppers)
303
```
Difficulty swallowing or breathing
Drooling
Cramps
Severe vomiting
Chemical burns to skin and throat
```
Caustic toxin
304
What causes delirium tremens and timeline
```
Alcohol withdrawel
Stages
1-8 hours from last intake
2-8-72 hours-seizure, vomiting, visual hallucinations, auditory hallucinations
3-status seizures
4-delrium tremens
```
305
Amphetamine, methamphetamine and cocaine are examples of
Sympathomimetics
306
The main psychoative part of ___ is tetrahydrocannabinol (THC)
Cannabis
307
What nerve agent affects the neurotransmitter acetylcholine? How?
Sarin
| Inhibitor of acetylcholinesterase (which degrades acetylicholine after it is released into the synaptic cleft)
308
What is a treatment for sarin?
Atropine
309
What does atropine do?
Blocks the parasympathetic nervous system
310
Ipatropium (Atrovent) blocks the action of
Acetylcholine
311
Imminent Delivery
Contractions are 2 minutes apart
| 30-60 minutes in duration
312
What is the difference between placenta abruptio and a uterine rupture? s/s of both
Fetal parts are palpable in a uterine rupture
| Tearing pain, vaginal bleeding
313
Ways to help the placenta come out
Fundal message
| Breat feeing
314
Three stages of delivery
Dilation
Expulsion
Placental (uterine contractions continue, within 30 minutes placenta will expel)
315
What position should the mother be in a for a prolapsed cord?
Knees to chest
| Gloved hand to push baby off of cord
316
What should do with mother for a limb presentation
knees to chest
breath through contractions
may need to used a gloved hand to physically prevent birth
317
In which delivery complications would you attempt to deliver?
Breech presentation
318
What delivery complications are undeliverable?
Limb presentation
Prolapsed cord
Placenta previa
(probably placenta abruptio/uterine rupture)
