EXS 295 Flashcards
(92 cards)
0
Q
Survival and recovery depends on
A
- early recognition and response
- early activation of the EMS system (call 911)
- care being provided until more advanced medical personnel take over
Everyone must b performing their roles promptly and correctly
1
Q
EMS
A
Emergency Medical Service
- network of community resources and medical personnel
- provide emergency care to victims of injury or sudden illness
2
Q
Professional rescuers must
A
- keep training current
- stay on top of new issues and developments in emergency care
3
Q
Legal considerations
A
- individuals have a basic right to accept or refuse care
- consent is obtained verbally or through a gesture
- if victim is a minor consent must b given from a parent or guardian if available
4
Q
Implied consent
A
If someone is unconscious, confused, seriously injured, drunk, high, or mentally impaired it is implied you can help
-have implied consent from a minor unless parent or guardian is there and says otherwise
5
Q
Abandonment
A
Start giving care, but then you leave. Can leave if situation becomes unsafe, but must stay until medical professionals arrive
6
Q
Obtaining consent (steps)
A
- Identify yourself to the victim
- State your level of training
- Ask the victim if you may help
- Explain what you observe
- Explain what you plan to do
7
Q
Confidentiality
A
- private and confidential information may be learned while providing care (share this information with only EMS personnel directly associated with the victims medical care)
- always document care so have a written record (events tht took place, care provided, facts discovered after incident occured)
8
Q
DNR order
A
Do not recessitate
9
Q
Standard precautions
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Always use personal protective equipment (PPE) to prevent the spread of bloodborne pathogens
(Gloves, masks, gowns etc)
10
Q
In any emergency
A
- size up the scene
- gain consent
- PPE
- perform a primary assessment
- summon more advanced medical personnel if needed
11
Q
Scene size up
A
- careful and systematic approach of a scene to get a complete view of the emergency situation
- use all senses
- important bcuz
12
Q
Primary assessment
A
Identify any life threatening conditions
1. Check consciousness. If unconscious call 911.
Tap and shout for child and adult. Flick infants foot
2. Open airway (head tilt chin lift or If head/neck injury use jaw thrust w/o neck extension). check for breathing. (Look, listen and feel) 10 s
3. check pulse. Adult and child carotid artery two fingers. Infant brachial (arm). 10s
4. Check for severe bleeding
13
Q
Life threatening conditions
A
- Unconscious
- Absence of breathing
- absence of pulse
- Severe bleeding
14
Q
When checking for consciousness can also use
A
AVPU alertness scale
- alert
- verbal (Respond to verbal commands)
- painful (respond to verbal commands)
- unresponsive
15
Q
OSHA Bloodborne Pathogens Standard
A
- applies to employees who may be exposed to blood or other body substances
- requires that employers reduce or remove hazards from the workplace that may place employees in contact with infectious material
- revised in 2001 in response to passage of the federal needlestick safety and prevention act
16
Q
Bloodborne pathogens
A
- pathogens are small disease causing agents
- present in blood and body fluids and can cause disease
17
Q
Major bloodborne pathogens
A
- hepatitis B virus: affects liver, can cause jaundice
- hepatitis C virus: liver disease, most common
- HIV: causes aids
18
Q
Two most common types of pathogens
A
- bacteria: treated with antibiotics
- viruses: there are preventative measures (shots), antivirals, some you have to let run their course, others are with you for the rest of your life
19
Q
How do infections occur
A
- present: pathogen must be present
- quantity: must b in sufficient quantity (mult. Pathogens)
- entry site: must enter through correct entry site. (Skin and mucous membrane usually good at keeping out stuff)
- susceptible: have to be susceptible to the disease
20
Q
Types of transmission
A
- direct contact
- indirect contact
- airborne or droplets transmission
- vector transmission
21
Q
Direct contact
A
Blood of one person goes into correct entry site of another
22
Q
Indirect contact
A
Blood of one person is on an object. Another person picks up object and blood goes into correct entry site of that person
23
Q
Airborne or droplet transmission
A
Sneeze or cough travels (tuberculosis)
24
Vector
-from one animal/insect to you (dog bite, mosquitoes)
25
Exposure control plan
Plan that is put into place to decrease your chance of infection or exposure to bloodborne pathogen
OSHA requires tthat the Hep B vaccine b offered free of charge to employees who may be exposed
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Two ways to prevent exposure
1. behaviors: behaviors we employ to prevent exposure. Work practice controls. I shouldn't eat a sandwich where there is blood being stored. When changing people's bandages, after don't handle a pen or other object
2. Equipment: stuff designed to prevent exposure when dealing with blood/ body fluids. Engineering controls. Ex, sharps disposable containers, self sheathing needles
27
PPE
- gloves
- mask
- gown
28
Hand hygiene
- hand washing: most effective measure to prevent spread of infection
- hand sanitizer: if hand washing not available, wash hands ASAP after
29
Managing spills
- containment
- clean spills ASAP
- use protective wear
- if sharp objects in spill, pick up with tongs
- use absorbent materials (towels)
- disinfectant solution
30
Infant
Under 1 year
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Child
1-12
| 1-8 for AED
32
Adult
12 and up
| 8 and up for AED
33
Some causes of breathing emergencies
- choking
- drowning
- anaphylactic shock (allergic reaction)
- being strangled
- illness
- asthma, emphysema
- electrocution
- poisoning
- emotional stress
- drugs
- injury to the head, chest, lungs, or abdomen
- heart attack
34
Two types of respiratory emergency
- respiratory distress: having trouble/problems breathing
| - respiratory arrest: stopped breathing
35
Signs and symptoms of respiratory distress
- shallow breathing
- wheezing
- changes in level of consciousness
- skin color changes
- tingling in the hands feet or lips
- dizziness
- slow/rapid breathing
- gasping
- increased heart rate
36
BVM
Bag valve mask
37
How to respond to respiratory distress
- calm them down, call 911
- make sure airway is clear
- help them if they have an inhaler
- put them in position of comfort
- administer emergency oxygen
38
Response to respiratory arrest
- can result from respiratory distress or occur suddenly from another problem
- If unconscious but have a pulse, do rescue breathing
39
Rescue breathing
-give ventilations rhythmically for about 2 mins
Adult: 1 ventilation every 5secs
Child and infant: 1 ventilation every 3 secs
Need to periodically stop and check pulse to see if heart is still beating
If breaths don't go in, open airway again (if during first attempt). Afterwards, assume they are choking
40
Steps for putting mask on
- place btwn lower lip and chin, then place over mouth and nose
- if on the side, place thumb over bottom, use fingers to lift chin and open airway. Second hand forms a C with thumb and forefinger around top, press firmly
- if behind the head, place your hand on either side of mask in a C (thumb and forefinger) use your other fingers to do the head tilt-chin lift technique
41
Airway obstruction
- Most common cause of respiratory emergencies
| - mechanical and anatomical
42
Mechanical
Foreign body obstruction
Adults: most common is food in combination with alcohol
Children under 4: food and small objects (most common being a hot dog)
Other commonalities
-chewing food poorly
-eating to fast or while talking or laughing
-walking, playing, or running with food or objects in the mouth
-wearing dentures
43
Universal sign for choking
-clutching the throat
44
Responding to choking
- encourage coughing
| - if the person cannot cough, speak, breathe, or cry take immediate action. Also call 911
45
Conscious choking
- use back blows and abdominal thrusts or chest thrusts if pregnant or too wide to get your arms around.
- 5 back blows then 5 abdominal
- when administering back blows bend victim over so parallel to the ground
46
Unconscious choking
- lower the victim to the ground, by leaning them towards you and sliding them down your leg
- open the mouth and look for an object, use finger sweep to remove an object
- don't see object, reopen the airway and do 2 ventilations
47
symptoms/ signs of a possible head/ neck spine injury
- injured as a result of a fall from a great height
- involved in a motorcycle, motor-vehicle crash
- appears frail (older than 65, younger than 3)
- loss of balance, severe pain or pressure in the head neck or spine
- partial or complete loss of movement of any body part
- bruising of head around eyes and behind ears
- seizures
- persistent headache
47
symptoms/ signs of a possible head/ neck spine injury
- injured as a result of a fall from a great height
- involved in a motorcycle, motor-vehicle crash
- appears frail (older than 65, younger than 3)
- loss of balance, severe pain or pressure in the head neck or spine
- partial or complete loss of movement of any body part
- bruising of head around eyes and behind ears
- seizures
- persistent headache
48
Clearing vomit frm airway
Turn victim onto side
Wipe mouth out using a finger sweep
Suction if necessary
48
Clearing vomit frm airway
Turn victim onto side
Wipe mouth out using a finger sweep
Suction if necessary
49
Why would we place a victim in a recovery position?
- If you are alone and have to leave the victim (perhaps to call for help)
- if you cannot maintain an open airway bcuz of fluids or vomit
49
Why would we place a victim in a recovery position?
- If you are alone and have to leave the victim (perhaps to call for help)
- if you cannot maintain an open airway bcuz of fluids or vomit
50
Why summon more advanced personnel?
- any of the life threatening conditions
- vomiting blood
- severe burns
- suspected poisoning
- seizures
- stroke
50
Why summon more advanced personnel?
- any of the life threatening conditions
- vomiting blood
- severe burns
- suspected poisoning
- seizures
- stroke
51
Reasons you would move a victim
- scene becomes unsafe
- they are on top of another victim
- necessary to provide proper care
51
Reasons you would move a victim
- scene becomes unsafe
- they are on top of another victim
- necessary to provide proper care
52
Hypoxia
Condition in which insufficient oxygen reaches the cells
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Hypoxia
Condition in which insufficient oxygen reaches the cells
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Causes of hypoxia
- obstructed airway
- shock
- strangulation
- drowning
- head trauma
- cardiac arrest
53
Causes of hypoxia
- obstructed airway
- shock
- strangulation
- drowning
- head trauma
- cardiac arrest
54
Signs and symptoms of hypoxia
- increased breathing, heart rate
- restlessness
- chest pain
- changes in level of consciousness (loc)
- cyanosis (blue around lips and nail beds)
54
Signs and symptoms of hypoxia
- increased breathing, heart rate
- restlessness
- chest pain
- changes in level of consciousness (loc)
- cyanosis (blue around lips and nail beds)
63
Unconscious choking
- retilt the head and give another ventilation
- if chest does not rise, give 30 chest compressions
- look in the mouth, sweep of you see something, little finger for infant (grasp tongue and jaw btwn thumb and fingers and lift jaw
- give two ventilations
- if doesn't work, repeat
- if does work, recheck for breathing and pulse, monitor victim until help arrives
64
Heart attack
- occurs when the heart muscles experience a loss of oxygenated blood, also known as myocardial infraction (MI)
- the sooner the signs and symptoms are recognized, the better the victims chances are for survival.
- signs may differ
65
Signs
- Severe chest discomfort or pain, lasts a long time, goes away and comes back
- difficulty breathing
- pale/ashen face
- angina -tight pressure on chest
- dizziness or light-headedness
- nausea or vomiting
- loss of consciousness
- sweating
- pain or pressure tht spreads to shoulder, arm, neck, jaw, stomach, or back
66
Women may experience diff signs
```
-chest pain or discomfort experienced by women may be sudden, sharp, but short lived pain outside the breastbone
More likely to experience
-shortness of breath
-nausea or vomiting
-back or jaw pain
-unexplained fatigue or malaise
```
67
Caring for a heart attack
- take immediate action, call 911
- have victim rest
- loosen tight clothing
- monitor victim and note changes
- comfort them
- assist them with medication, such as nitroglycerine or aspirin, administer emergency oxygen if available and trained to do so
- b prepared to perform CPR and use an AED
68
4steps for cardiac chain of survival
- call 911
- early CPR
- early defibrillation
- early more advanced medical care
69
Cardiac arrest
Life threatening situation in which the heart stops beating or beats too irregularly or too weakly to circulate blood efficiently
70
Cardiac distress
Heart attack
71
Causes of cardiac arrest
- heart attack
- electrocution
- respiratory arrest
- drowning
- in infants and children also
- airway and breathing problems
- traumatic injuries or accidents
- hard blows to the chest
- congenital heart disease
- sudden infant death syndrome
72
Signs of cardiac arrest
- unconsciousness
- lack of breathing
- lack of pulse
73
CPR
- combination of chest compressions and ventilations tht circulate blood containing oxygen to the vital organs
- should b used in combination with an AED
74
Why are chest compressions needed?
- To ensure tht blood circulates to the brain and other vital organs
- increases the likelihood that a successful shock can b delivered
75
How much oxygen is in the air
20-21%
76
How much oxygen does a person breathe out
16-17%
77
Effective compressions
- victim on a firm, flat surface
- compressions are the proper depth
- keep arms straight as possible
- chest fully recoils after each compression
- compression rate is 100 per minute
- CPR performed without interruption
78
Compression depth
At least 2 inches for an adult
About 2 inches for a child
About 1 1/2 for an infant
79
CPR cycles
30 chest compressions and 2 ventilations
80
Reasons to stop CPR
- obvious signs of life
- an AED is available and ready to use
- another trained rescuer takes over
- more advanced medical personnel take over
- you are presented with a valid DNR order
- you are too exhausted to continue
- scene becomes unsafe
81
Agonal breathing
Death breaths, not normal breathing, continue with CPR
82
Complications when performing CPR
- broken ribs
- separation of cartilage
- vomiting
- frothing from the mouth and nose
- chaos at the scene
83
Irregular heart beats common in cardiac arrest
ventricular tachycardia: rapid heart beat
Ventricular fibrillation: irregular contractions, uncontrolled twitching or quivering
Flatline: also called asystole
84
Two person CPR
-used when two rescuers arrive on the scene at the same time and begin CPR together or when one rescuer is performing CPR and a second rescuer becomes available
85
Using 2 person CPR
- one gives ventilations, other gives chest compressions
- switch every two minutes
- while CPR is in progress, 2nd rescuer should make sure 911 has been called and get an AED or assist with care
86
2person CPR infant
Compressions are given with two thumbs just below the nipple line
15 chest compressions and two ventilations
87
When the heart stops
- damage to the heart muscle from disease or injury can disrupt the hearts electrical system
- most common treatable heart problems: ventricular tachycardia and ventricular fibrillation
88
AED
- automated external defibrillation
- portable electronic devices that analyze the hearts rhythm and provide an electrical shock that may help reestablishment an effective rhythm
89
Early defibrillation
- can correct v-fib and v-tach
- cannot correct asystole
- each minute CPR and defibrillation are delayed = 10% reduction in victims chance for survival
90
Using an AED
- when cardiac arrest occurs, use AED ASAP
- provide shock followed by about 2 minutes of CPR (5 cycles)
- if CPR is in progress do not interrupt until the AED is turned on, pads are applied, and it is ready to analyze heart rhythm
91
Child and infant AED
- pediatric pads are appropriate for use on infants and children up to 8yrs of age or weighing less than 55 lbs
- if pediatric specific equipment is unavailable, use adult equipment
