High Yield NREMT Flashcards
1
Q
Appendix is in the
A
Right Lower Quadrant
2
Q
Transverse/horizontal
A
top/bottom
3
Q
Relationship b/t SVR and BP and constriction
A
constriction ↑ SVR ↑ BP
4
Q
Pulsus paradoxus
A
A drop in systolic BP of 10 mmHg or more on inhaling
5
Q
Kussmaul Respirations
A
deep and labored breathing pattern often associated with severe metabolic acidosis, DKA and kidney failure
6
Q
most common cause of cardiogenic shock
A
AMI
7
Q
Differentiate sprain and strain
A
A sprain is the stretching or tearing of ligaments.
A strain is a stretching or tearing of muscles or tendons
8
Q
Preload
A
Preload = The force exerted on the ventricle walls at the end of diastole
9
Q
Right ventricular failure
what happens
S/S
A
Right ventricular failure
• Blood backs up into the venous system that feeds into the right heart
• S/s: JVD, pedal edema
10
Q
Types of bleeding:
Capillary
A
oozing, dark red
11
Q
Normal HR for toddler (1-3 yo)
A
Toddler HR
80-130 bpm
12
Q
Infants BVM volume
A
150-240 mL
13
Q
Nuchal cord vs prolapsed cord
A
in the nuchal cord, the umbilical cord has wrapped itself around the newborn’s head and in prolapsed cord, the umbilical cord precedes the baby in the birth canal
14
Q
Type of shock with:
- hypotension
- cool, clammy skin
- rapid, weak pulse
- tachypnea
A
hypovolemic
15
Q
Simple face mask
Flow rate
FdO2
best used when x
A
Simple face mask (NRB without O₂ reservoir)
Flow rate: 6-10 LPM
FdO2: 40-60 %
16
Q
Implied consent vs expressed consent
A
Implied = assumption of care; unresponsive or incompetent patient
Expressed = if you say yes to A it means you’re saying yes to B and C and D within reason
17
Q
Differentiate between DKA and HHS
A
DKA is absolute insulin deficiency and is usually seen in type I diabetics and develops over hours to 1-2 days.
HHS is relative insulin deficiency and is usually seen in type II diabetics and develops over days to weeks.
18
Q
How to measure an NPA?
A
tip of the nose to the earlobe
19
Q
differentiate between placenta previa and abrupto placenta
A
placenta previa occurs when the placenta attaches to the uterus over the cervical opening and results in painless vaginal bleeding.
Abrupto placenta occurs when the placenta prematurely separates from the uterine wall and results in painful vaginal bleeding.
20
Q
Pink puffers
smoking
lower airway disease
wheezing
A
Emphysema
21
Q
Normal RR for infancy (birth to 1 year)
first born
first few minutes
by one year
A
Infant RR
40-60 at first
30-40 after first few minutes
20-30 by 1 year
22
Q
Orthopnea
A
inability to breathe unless in an upright position
23
Q
Normal RR for toddler (1-3 yo)
A
Toddler RR
20-30
24
Q
Burn type for blisters and wet
A
2ⁿᵈ degree
25
Types of bleeding:
| Venous
Steady flow, dark red
26
How to measure an OPA?
corner of the mouth to the earlobe
| corner of the mouth to angle of jaw
27
Dehydration and burns are examples of ____ ____ shock
Dehydration and burns = non-hemorrhagic hypovolemic shock
28
ADULT BVM volume
1200-1600 mL
29
Hot zone
contamination zone; limited # of rescuers; PPE; bystanders never allowed
30
Normal RR for adulthood
Adulthood RR
| 16-20 (12-20 normal)
31
BP and CO equations
```
BP = SVR x CO
CO = HR X SV
```
32
Cardiac Tamponade s/s
JVD, narrow pulse pressure, hypotension
| Becks Triad
33
Tension pneumothorax—tracheal deviation towards
Tension pneumothorax—tracheal deviation towards unaffected side
34
blue bloaters
Chronic bronchitis
35
Respiratory distress vs. respiratory failure
respiratory distress = abnormal respiratory rate/effort
respiratory failure = clinical state of inadequate oxygenation, ventilation, or both
36
Carina
where the trachea branches into left and right mainstem bronchi
37
NRB
Flow rate
FdO2
best used when
NRB
Flow rate : 10-15% (high flow)
FdO2 can be 100%
best used when: breathing w/o aid but hypoxic
38
Use this type of move when the Scene is dangerous and pt needs to be moved in order to provide care
Give examples if applicable
```
Emergency moves
includes:
armpit-forearm drag
shirt drag
blanket drag
```
39
Hypotension calculation
systolic BP <70+2(age)
40
Liver quadrant
RUQ
41
Common injuries for the Down-and-under pathway
injuries to knees, femurs, hips, acetabulum, and spine
42
Left ventricular failure
what happens
S/S
Left ventricular failure:
• Blood backs into the heart
• S/s: pulmonary edema, pulmonary veins fill due to back pressure, pressure ↑ in the pulmonary capillaries, water leaks from pulmonary capillaries into the alveoli
• Left HF frequently leads to Right HF
43
Normal BP for preschool age (3-5 yo)
Preschool BP
| 80-110 mmHg
44
Normal RR for Adolescence (13-18 yo)
Adolescence (13-18) RR
| 12-20
45
Gallbladder quadrant
RUQ
46
SV vs. SVR
```
SVR = total resistance of arterioles to flow of blood
SV = amount of blood pumped by the heart each cycle
```
47
Normal RR for preschool age (3-5 yo)
Preschool RR
| 20-30
48
Subcutaneous emphysema
air flowing upward and being trapped under the skin; cracking sensation upon palpation of the patient's neck
49
Normal BP for toddler (1-3 yo)
Toddler BP
| 70-110 mmHg
50
Normal BP for school age (6-12 yo)
School age 6-12 BP
| 80-120 mmHg
51
Normal HR for Adolescence (13-18 yo)
Adolescence (13-18) HR
| 55-105 bpm
52
Common injuries for the Up-and-over pathway
injuries to abdomen, chest, face, head, and neck
53
Steps of secondary assessment for a:
| Responsive medical pt, no AMS
Responsive medical pt, no AMS
| (1) history, (2) modified secondary, (3) baseline vitals
54
differentiate between frank and complete/incomplete breech presentations
```
frank = legs extended
incomplete/complete = legs are flexed
```
55
Right-sided heart failure causes blood to back up into the body, causing pitting edema throughout the body
Cor Pulmonale
56
Atelectasis
condition in which the lungs have collapsed or are airless
57
Residual tank pressure
200-300 psi
58
Types of bleeding:
| Arterial
spurting, bright red
59
Type of shock that is hypotension, bradycardia, warm dry skin
neurogenic
60
```
Rule of nines- peds
head
chest front
chest back
arm
leg
genital
```
```
Rule of nines- peds
head = 18
chest front = 18
chest back = 18
arm = 9
leg=14
genital=1
```
61
BVM
Flow rate
FdO2
best used when
```
BVM
Flow rate: 15 LPM
FdO2: 21% w/o O₂ attached; 90-95% with O₂
best used when: pt need help ventilating
600 mL delivery for 1 sec ventilation
```
62
PE, tension pneumo, or cardiac tamponade = ____ shock
obstructive
63
Normal HR for infancy (birth to 1 year)
first born
settling
Infant HR
HR = 100-160 (first 30 mins)
After = 120 bpm
64
Normal BP for Adolescence (13-18 yo)
Adolescence (13-18) BP
| 100-120 mmHg
65
Venturi mask
Flow rate
FdO2
best used when
Venturi mask
Flow rate: ≤15 LPM
FdO2: 24-60%
Venturi masks are especially helpful for COPD patients
66
At what age group does temp usually stay 98.6
school age children (6-12) and on
67
```
Explain the process of inhalation
active or passive process
what happens to the diaphragm
intercostal muscles
thoracic cavity (contracts/expands)
pressure in chest cavity
```
```
Inhalation
Active process
Diaphragm contracts
intercostal muscles contract
thoracic cavity expands
negative pressure
```
68
Normal Temp for toddler (1-3 yo)
Toddler Temp
| 96.8-99.6
69
```
hypovolemic shock
BP
Skin
Pulse quality
Breathing rate
LOC
```
```
hypovolemic shock
BP: hypotension
Skin: cool, clammy
Pulse quality: rapid, weak
Breathing rate: tachypnea
LOC: AMS
```
70
Beck's Triad consists of what 3 signs?
Muffled heart tones, hypotension and jugular vein distension
71
PEDS BVM volume
500-700 mL
72
Hollow organs do what when injured and they include what? (6)
Hollow organs:
Leak
Include:
Stomach, intestines, gallbladder, urinary bladder, ureters, uterus
73
```
Rule of nines- adult
head
chest front
chest back
arm
leg
genital
```
```
adult
head = 9
chest front = 18
chest back = 18
arm = 9
leg = 9
genital = 1
```
74
Steps of secondary assessment for a:
| Trauma pt no sig MOI no AMS
Trauma pt no sig MOI no AMS
| (1) modified secondary, (2) baseline vitals, (3) history
75
Normal temp for infancy (birth to 1 year)
Infant Temp
| 98-100
76
Distributive shock includes 3 types of shock:
distributive shock: neurogenic, septic, anaphylactic
77
deficiency in insulin; urine contains glucose
diabetes mellitus
78
```
Explain the process of exhalation
active or passive process
what happens to the diaphragm
intercostal muscles
thoracic cavity (contracts/expands)
pressure in chest cavity
```
Exhalation
passive process
Diaphragm and intercostal muscles relax
Creates a positive pressure in the thoracic cavity
air flows out until pressure is equalized
79
Deficiency in vasopressin; excessive thirst, large amounts of extremely dilute urine
diabetes insipidus
80
Type of diabetes where the body cells are resistant to insulin
type ii diabetes
81
Cold zone
Safe zone Normal triage, stabilization, and treatment performed; SHED PPE before entering
82
Normal HR for school age (6-12 yo)
School age 6-12 HR
| 70-110 bpm
83
Normal HR for preschool age (3-5 yo)
Preschool HR
| 80-120 bpm
84
Warm zone
control zone = prevents spread of contamination; PPE; lifesaving emergency care is performed
85
type of diabetes where the body lacks insulin
type 1 diabetes
86
Nasal cannula
Flow rate
FdO2
best used when
Nasal cannula
Flow rate-: 6 LPM
FdO2: 20-40%
best used when: pt not able to tolerate face mask
87
Commotio cordis
an often lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart (
88
Frontal/coronal plane
anterior/posterior
89
Normal BP for adulthood
Adulthood BP
| 120/80 mmHg
90
Solid organs do what when injured and they include what? (4)
```
Solid organs BLEED when injured
Include: KLOPS
Kidneys
liver
(ovaries)
pancreas
Spleen
```
91
Steps of secondary assessment for a:
| Trauma pt / Medical pt + AMS
Trauma pt / Medical pt + AMS
| (1) rapid secondary, (2) baseline vitals, (3) history
92
Estimating BP: Normal systolic
Adult male:
Adult female:
Child
Estimating BP: Normal systolic
Adult male:100+age (≤140)
Adult female: 90+age (≤130)
Child: 80+2 (age) [only for children 1-10]
93
Midline/medial/sagittal
left/right
94
Cheyne-Stokes
progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in apnea
95
Stomach quadrant
LUQ
96
Spleen
LUQ
97
shock that is from widespread vasodilation
distributive shock
98
type of shock that is hypotension, tachycardia, weak thready pulse, cool, moist, pale skin
cardiogenic
99
```
Cardiogenic shock
BP
Skin
Pulse quality
Breathing rate
LOC
```
Cardiogenic shock
BP: hypotension
Skin: cool/clammy
Pulse quality: weak, irregular, tachycardia
Breathing rate: tachypnea, shallow, dyspnea
LOC: restless and anxiety
100
Afterload
Afterload is the resistance the heart must overcome during ventricular contraction.
101
Use this type of move when the PT has potentially life-threat injuries/illness and must be moved quickly for evaluation and transport
Give examples if applicable
Urgent moves
102
Cushing reflex
BP
HR
Breathing
↑Systolic BP↓HR, irregular breathing
103
Right-sided vs. left-sided Heart failure
Right sided = dependent edema, JVD, enlarged liver; COR PULMONALE
Left side = crackles, dyspnea, hypoxia, fluid in lungs (pulmonary edema)
104
Estimating normal diastolic pressure:
Adult
Children
Estimating normal diastolic pressure:
Adult: 60-85 mmHg
Children: 1-10 yrs
80 + 2(age) /0.66 systolic
105
Recovery position is recommended for patients who are (conscious/unconscious) and (breathing spontaneously / not breathing spontaneously)
Recovery position = unconscious + breathing spontaneously
106
Normal RR for school age (6-12 yo)
School age 6-12 RR
| 20-30
107
Differentiate between the different types of blast injuries
primary blast injury is due from the sudden change in environmental pressure
secondary blast injury is from being struck by a flying object
in the tertiary blast injury, it results from the victim being thrown through the air and striking the ground or other objects
108
fluid accumulates w/in the pericardial sac, compressing the heart
Cardiac Tamponade
109
Normal BP for infancy (birth to 1 year)
at birth
at 1 year
Infant BP systolic
70 @ birth
90 @ 1 yr
110
type of shock that is hypotension, tachycardia, tachypnea, pink, warm flushed skin
septic shock
111
Normal HR for adulthood
Adulthood HR
| 60-100 (NEMSES says 70)
112
Type of shock Due to inadequate amount of fluid or volume in the circulatory system
Hypovolemic shock
113
Type of shock where the Heart lacks enough power to maintain an adequate cardiac output
cardiogenic shock
114
Cor Pulmonale
Right-sided heart failure causes blood to back up into the body, causing pitting edema throughout the body
115
Hypoglycemia HR and BP
Hypoglycemia
HR = tachycardic
BP = hypertensive
116
Hyperglycemia HR and BP
Hyperglycemia
HR = tachycardic
BP = hypotensive
117
How long will a patient go without breathing before it is likely that irreversible brain damage has set in?
6-10 minutes
118
Appendix
RLQ
119
Anterior circulation stroke
blockage of cerebral artery that perfuses the cerebrum and cerebral cortex
120
posterior circulation stroke
blockage of cerebral artery that perfuses the brainstem and cerebellum
121
RUQ pain and jaundice
hepatitis
122
LUQ pain, N/V, abdominal distention
pancreatitis
123
cholecystitis
inflammation of the gallbladder
124
RUQ pain which increases at night, referred shoulder pain
cholecystitis
125
RLQ pain, N/V, decreased appetite
appendicitis
126
calculate cardiac output
stroke volume x heart rate
127
normal stroke volume =
SV = 70 mL
128
Calculate BP
BP = CO x SVR
129
SV vs. SVR
SV = stroke volume and is the volume of blood ejected with each ventricular contraction (normal = 70)
SVR = systemic vascular resistance and is the resistance of blood to flow throughout the body (increases with constriction)
130
Pulmonary artery
The artery carrying blood from the right ventricle of the heart to the lungs for oxygenation. Note: This is the only artery in the body that carries deoxygenated blood.
131
Pulmonary vein
A vein carrying oxygenated blood from the lungs to the left atrium of the heart. Note: This is the only vein in the body that carries oxygenated blood.
132
Vasoconstriction effect on SVR and BP
Vasoconstriction ↑ SVR and ↑ BP
133
Pharmacodynamics
biological effects (therapeutic or adverse) of drug administration
134
parenteral drugs are those that are
injected or inhaled
135
enteral drugs are those that are
ingested
136
tidal volume
normal volume of gas inhaled during one respiration cycle (~500 mL)
137
inspiratory reserve volume
volume of air inhaled greater than the tidal volume during forced deep inhalation (<3000 mL)
138
Vital capacity
the maximum volume of air exhaled during forceful exhalation
139
Minute volume define and equation
Minute volume = volume of gas expelled from the lungs in one minute
= respiratory rate x tidal volume
140
normal tidal volume
500 mL
141
Total lung capacity define and equation
| normal amount
the total volume that the lungs can contain
Total lung capacity: vital capacity + residual volume
Usually ∼ 6000 mL for adults
142
what 2 oxygen tanks do emts use the most? and what are their volumes?
D tank @ 350 (M15) factor 0.16
| E tank @ 650 (M24) factor 0.28
143
which node is the heart's natural pacemaker
SA node
144
Cystitis vs cholecystitis
cystitis is inflammation of the bladder whereas cholecystitis is inflammation of the gallbladder
145
Chemoreceptors vs. baroreceptors
chemoreceptors respond to pH ∆ and monitor levels of CO₂ in the blood whereas baroreceptors respond to pressure changes (blood pressure)
146
Hypothermia levels
```
mild = >93.2
moderate = 86-93.2
sever = <86
```
147
temp cut off for heat stroke
>104F + AMS
148
Differentiate the different types of headaches in the 3 types of brain bleeds
epidural headache = sudden, severe, intense
Subdural = progressive and worsening over time
Subarachnoid = thunderclap severe headache, abrupt onset, may be worse @ the back of the head
149
subdural hematoms occur between
subdural = dura mater and arachnoid layer
150
epidural hematomas occur between
skull and dura mater
151
RUQ main organs (2) and diseases (3)
RUQ
liver, gallbladder
hepatitis, cholecystitis, peptic ulcer
152
RLQ main organs (2) and diseases (1)
RLQ
appendix, ascending colon
appendicitis
153
LUQ main organs (3) and diseases (1)
LUQ
stomach, spleen, pancreas
intestinal malrotation
154
LLQ main organs (3) and diseases (5)
LLQ
descending colon, sigmoid colon, female stuff, ileum
```
ABD pain, peritonitis in LLQ =
colitis
diverticulitis
ureteral colic
ovarian cysts or PID
```
155
Difference between alpha and beta adrenergic medications
alpha drugs mostly cause vasoconstriction
beta 2 drugs relax bronchi smooth muscle
156
Components of the LAPSS screening
Age > 45 years
No history of seizure disorder
New onset (past 24 hrs) of neurologic symptoms
Patient was ambulatory at baseline (prior to event)
Serum glucose level 60-400
157
Examination of the LAPSS screening
Facial smile or grimace
Grip
Arm weakness
158
Disturbances in O2 diffusion, carrying, offloading, or use is ____ shock
metabolism/respiratory shock
because inadequate breathing for long periods causes abnormal cellular metabolism, resulting in the buildup of metabolic products.
159
Normal minute volume for adult at rest
6000 mL
160
Differentiate between epidural and subdural bleeds
Epidural is low-velocity impact/deceleration injury bleeds; almost always is associated w/ a skull fracture, commonly in the temporal region
Subdural bleeds are low-pressure venous bleeding; common association is cerebral contusion
161
Visceral vs. parietal pleura
```
visceral = innermost layer which contacts the lung
Parietal = outermost layer; contacts the thoracic wall
```
162
the scope of practice which determines what an EMT can and cannot do is determined by the
state legislature
163
Arteriosclerosis vs atherosclerosis
Arteriosclerosis is the stiffening or hardening of the artery walls.
Atherosclerosis is the narrowing of the artery because of plaque build-up. Atherosclerosis is a specific type of arteriosclerosis.
164
when you see "urticaria" think
allergic reaction
165
rales vs. rhonchi
rales = crackles = fluid in lungs; bubbling/popping sound, pneumonia, copd, lung infections
rhonchi = rattling = chronic lung problems (chronic smokers)
166
Diverticulitis
definition
who's at risk
S/s
Small pouches (diverticular) along the wall of the intestine fill w/ feces and become inflamed & infected
People > 40 w/ low fiber diet
S/S: LLQ pain
167
Distributive shock includes
neurogenic, septic, and anaphylactic
168
In proving negligence, what is "causation"
“proximate cause” The injury to the plaintiff was, at least in part, directly due to the EMT’s breech of duty.
169
arterial, venous, capillary
epidural bleeding is____
subdural bleeding is ____
epidural bleeding is arterial
subdural bleeding is venous
170
Differentiate primary, secondary, and tertiary blast injuries
Primary blast injury is due to the sudden change in environmental pressure.
Secondary injury is due to being struck by a flying object.
Tertiary injury is due to the victim being thrown through the air and striking the ground or other objects.
171
ligaments connect _____
while tendons connect ____
sprains happen in ____
Strains happen in ____
Ligaments = bone::bone
Tendons: muscle::bone
```
sprain = ligaments
strain = muscle + tendon
```
172
hyphema
Blood in the anterior chamber of the eye
173
The umbilical cord is made up of
__ artery/arteries
__vein/veins
2 arteries
| 1 vein
174
pale skin, dilated pupils, narrow pulse pressure, tachynpea = ___ shock
hypovolemic shock
175
```
Class II hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
```
```
Class II Hemorrhage
Blood loss: 15-30%
BP: orthostatic hypotension
HR: 100-120
RR: 20-30
Urine output: 20-30cc/h
CNS status: agitated
Capillary refill: slight delay / cool
```
176
```
Class I hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
```
```
Class I hemorrhage
Blood loss: <15%
BP: normal
HR: <100
RR: normal
Urine output: >30cc/h
CNS status: normal
Capillary refill: normal
```
177
```
Class III Hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
```
```
Class III Hemorrhage
Blood loss: 30-40%
BP: marked decrease
HR: >120
RR: 30-40
Urine output: 5-15cc/h
CNS status: confused
Capillary refill: significant delay/cool
```
178
```
Class IV Hemorrhage
Blood loss %
BP
HR
RR
Urine output
CNS status
capillary refill
```
```
Class IV Hemorrhage
Blood loss: >40%
BP: profound decrease
HR: >140
RR: >35
Urine output: <5cc/h
CNS status: obtunded
Capillary refill: significant delay/cold
```
179
gland that is both exocrine and endocrine
pancreas
180
Differentiate b/t type 1 and type 2 respiratory failure
type 1 = blood O₂ less than 60
| type 2 = blood CO₂ greater than 50
