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EMT 106 > Midterm > Flashcards

Midterm Flashcards

1
Q

Emphysema

A

PP:
- Destruction of the alveolar walls/ distention of alveolar sacs

SxSx:
- “Pink Puffers”
- Thin, Barrel chested
- Pursed lips
- Difficulty breathing on exertion
- Tachypnea, Tachycardia, Wheezing

Tx:
- Sit patient up
- High flow O2
- Inhaler
- Rapid transport

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2
Q

Chronic Bronchitis

A

PP:
- Excessive mucus production
- Inflammation, swelling and thickening of the bronchi and bronchioles

SxSx:
- Hypoxia
- Overweight
- “Blue Bloaters”
- Productive cough
- Rhonchi

Tx:
- Sit patient up
- High flow O2
- Inhaler
- Rapid transport

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3
Q

Asthma/ Status Asthmaticus

A

ASTHMA
- Sensitivity in lower airways to allergens and irritants
- Causes: Bronchospasm, Edema, Increased mucus secretion

SxSx:
- Accessory muscle use
- Tripod
- Wheezing/ silent chest
- Anxiety/ apprehension
- Chest tightness

Tx:
- Sit up patient
- High flow O2
- Inhaler
- Rapid Transport

STATUS ASTHMATICUS
- Does NOT respond to O2 or meds

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4
Q

Pneumonia

A

PP:
- Acute infectious disease/ infection in lower airway
- Fluid/ pus filled alveoli = poor gas exchange

SxSx:
- History of illness/ antibiotics
- Dehydrated ?
- Fever/ hot skins
- Shortness of breath/ chest pain
- Rhonchi, but can have wheezing/ rales

Tx:
- Sit up
- High flow O2

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5
Q

Pulmonary Embolism

A
  • Obstruction of blood flow in pulmonary arteries
  • Causes: Deep vein thrombosis, immobile patient, recent surgery, long bone fractures, birth control, smokers

PP:
- Blockage of blood flow in pulmonary artery or arteriole
- Hypoxia because poor blood flow/ gas exchange
- Severity based on clot size/ location

SxSx:
- Fear/ Anxiety
- Sudden onset of dyspnea and sharp/ stabbing chest pain
- Hypoxia signs (sense of doom, tachypnea)
- Cough (blood?)
- Clear lungs

Tx:
- Sit up patient
- High flow O2
- Rapid transport

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6
Q

Spontaneous Pneumothorax

A
  • “Collapse lung”
  • Usually males, young, thing
  • Coughing, lifting heavy objects or straining

PP:
- Lining rupture = air entering pleural cavity = lung collapse
- Pressure builds= decrease gas exchange in affected lung

SxSx:
- Tachypnea
- Pale/ cyanotic
- Subcutaneous emphysema
- Dyspnea
- Chest pain
- Diminished/ absent lung sounds on affected side

Tx:
- Sit up patient
- O2
- Rapid Transport

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7
Q

Pulmonary Edema

A

PP:
- Excessive amount of fluid that builds between alveoli and capillaries
- Can result in hypoxia

SxSx:
- Tripod with legs dangling
- Pale/ cyanotic
- JVD
- Swollen ankles
- Dyspnea
- Chest pain
- PINK, frothy sputum
- Crackles/ rales

Tx:
- Sit up with dangle legs
- High flow O2/ PPV
- Rapid transport

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8
Q

Hyperventilation Syndrome

A

PP:
- “Blow off” excessive amounts of CO2
- Eliminating too much CO2 = signs will worsen

SxSx:
- Fatigue
- Nervousness/ anxiety
- Chest tightness
- Numbness/ tingling around mouth, hands, feet
- Tachypnea
- Tachycardia
- Carpopedal spasms

Tx:
- Remove from environment
- Calm/ reassure
- DO NOT USE O2

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9
Q

Acute Coronary Syndrome/ Coronary Artery Disease

A

ACS: sudden, reduced blood flow to the heart

CAD: Plaque build up in the wall of the arteries that supply blood to the heart, which are called coronary arteries. (TWO TYPES)

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10
Q

Atherosclerosis

A

Fatty plaque build up

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11
Q

Arteriolosclerosis

A

Hardening of the arteries

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12
Q

Angina

A

-Worsening symptoms/ not relieved = AMI

PP:
- Inadequate O2 supply to the heart (Myocardial Infarction)
- Stress endued
- Pain will go away

SxSx:
- Chest discomfort possibly radiating to left arm or neck
- Cool, clammy, possibly sweating profusely
- Shortness of breath
- Nausea or vomiting

Tx:
- O2, low flow, O2 sat of >94%
- Keep patient calm
- NTG/ ASA if prescribed

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13
Q

Myocardial Infarction

A

PP:
- Complete blockage of coronary artery

SxSx: (SAME AS ANGINA)
- Chest discomfort possibly radiating to left arm or neck
- Cool, clammy, possibly sweating profusely
- Shortness of breath
- Nausea or vomiting

Tx:
-NTG and or ASA

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14
Q

Aneurysm/ Dissection- Thoracic and Abdominal

A

Aortic Aneurysm
- Weakening in lining of aorta = ballooning

Aortic Dissection
- Tear in inner lining of aorta
- Blood enters= separation of the linings

SxSx:
- Described as “tearing” or ripping”
- Radiate to back, flank, arm

Tx:
- High flow O2
- Rapid transport to facility with surgical resources

Abdominal Aortic Aneurysm (AAA)
- Like thoracic but in abdomen
- Same SxSx
- Pulsating mass in skinny folks

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15
Q

Congestive Heart Failure (CHF)

A
  • Heart isn’t adequately eject blood out of the ventricle
  • Left and Right sided heart failure
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16
Q

Left Heart Failure

A

PP:
-Lung side
- Left ventricle cannot pump blood out to the body effectively
- “Traffic jam” of blood from the lungs

SxSx:
- Chest pain/ shortness of breath
- Rales
- Pale, cool, sweaty skins
- Anxiety
- High BP/ rapid heart rate
- Pink frothy sputum (late/ serious)

Tx:
- Sit up, dangle legs
- High flow O2, PPV
- Rapid transport

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17
Q

Right Heart Failure

A

PP:
- Right ventricle cannot pump blood out to the lungs

SxSx:
- Lower extremity edema
- JVD
- Abdominal distention

Tx:
- Sit up, dangle legs
- High flow O2, PPV
- Rapid transport

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18
Q

Peritonitis

A

PP:
- Inflammation of the peritoneum
- Usually from blood, pus, bacteria, etc leak into the peritoneal cavity

SxSx:
- Abdominal pain or tenderness
- Nausea, vomiting, diarrhea
- Fever and chills
- Positive markle
- DOES NOT WANT TO MOVE

Tx:
- O2 as needed
- Position of comfort
- Transport!
- Control airway

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19
Q

Appendicitis

A

PP:
- Inflammation of the appendix
- Can lead to rupture, peritonitis, and shock

SxSx:
- Umbilical pain, localized to the RLQ
- Nausea, vomiting
- Fever
- poor skin signs
- Hypotension
- rebound tenderness upon palpation

Tx:
- O2 as needed
- POC
- Transport
- ALS
- control airway

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20
Q

Pancreatitis

A

PP:
- Inflammation of the pancreas
- Triggered by alcohol, gallstones, or infection

SxSx:
- ABD pain in the epigastric area
- ABD tenderness and distention
- Mild Jaundice
- Severe ABD pain that can radiate from umbilical region to back of shoulders
- Fever
- Shock

Tx:
- POC
- Treat for shock
- Transport
- O2 as needed

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21
Q

Cholecystic

A

PP:
- Inflammation of the gallbladder

SxSx:
- RUQ pain, referred pain to the right shoulder
- Projectile vomit
- Shock

Tx:
- Same treatments

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22
Q

GI Bleeding

A

PP:
- Bleeding in GI tract

SxSx:
- Hematemesis- vomiting of blood
- Hematochezia- pooping of blood
- Melena- digested blood/ poop
- Fowel smelling bowel movements and vomit
- ALOC
- Poor skins/ shock
- Syncopal episodes
- ABD pain/ discomfort

Tx:
Same plus ALS if unstable patient=

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23
Q

Esophageal Varices

A

PP:
- Bulging, engorgement or weakening of the blood vessel
- Common in alcoholics

SxSx:
- Vomit large amounts of blood
- No ABD pain
- Signs of shock
- Jaundice skins
- Dyspnea
- Tachycardia

Tx:
- Fowlers position
- Same as GI bleeding

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24
Q

Kidney Stones

A
  • Calcium or uric acid crystals that form in the kidney and pass through urinary system
  • Pain, usually in flanks
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25
Hypoglycemia
-AKA insulin shock - EMERGENCY - Inadequate amount of glucose in the blood stream - Can mimic: head injuries, alcohol intoxication, drug use, seizure disorder, behavioral disorders, hypoxia, stroke SxSx: - Rapid onset - Cool, moist skins - Decreased LOC - Maybe combative - Headache - normal BP/ pulse - shallow respirations - hungry Tx: - 15 grams of glucose or 3 tablets
26
Hyperglycemia
- Aka Diabetic Ketoacidosis - Abnormally elevated blood sugar - Not enough insulin to transport sugar into cells/ too much sugar SxSx: - Slow onset - Dry, warm skins - Acetone breath (fruity odor) - Increased thirst/ polyuria - Kussmaul respirations - Dehydrated, hypotensive, tachycardia, nausea/ vomiting, abd pain, ALOC Tx: Insulin
27
Allergic Reaction
- Hives, urticaria
28
Anaphylaxis
- Mild symptoms + angioedema, bronchocontriction, signs of shock
29
Ischemic Stroke
- Cerebral artery is blocked - Thrombus: clot forms in artery (most common) - Embolus: Clot travels from another part of the body and lodges in cerebral artery (faster onset)
30
Hemorrhagic Stroke
- Rupture of an artery or a burst aneurysm - Very sudden onset - "WORST HEADACHE EVER"
31
Transient Ischemic Stroke
- Same s/s as CVA - Symptoms resolve (1-2 hours) - Precursor for strokes
32
Generalized Seizure/ Status Epilepticus
- Grand Mal - Last longer than 5 min - Recurrent seizures without lucid interval - Four stages: Aura, Tonic, Clonic, Postictal state
33
Absence Seizures
- Petite Mal - Blank stare, unaware of surrounding - Last a few seconds
34
Febrile Seizures
- Caused by high fever (Rapid spike) - 6 months- 6 years
35
Simple Partial Seizure
- One part of the body - Generally stays awake - Can spread into generalized
36
Complex Partial Seizure
- Same as a simple partial, but patient isn't aware of surroundings
37
Syncope
- Fainting/ sudden and temporary loss of consciousness - Generally from a standing position - Becomes responsive after becoming supine
38
Glucose
- Simple sugar absorbed through digestive tract and used as fuel
39
Insulin
- Produced in pancreas - Secreted when glucose levels are high - Assists glucose to moves from blood into cells
40
Glycogen
- Stores many simple glucose molecules together in liver
41
Glucagon
- Produced in pancreas - Secreted when glucose levels - Converts glycogen backs into glucose
42
FAST ED BE
Face drooping Arm weakness Speech Difficulty Time to call 911 Eye deviation Denial Balance Eye
43
Carbon Monoxide Poisoning
-Sticks better than O2 - Tasteless, colorless, odorless gas - Caused by incomplete combustion SxSx: - Headache - Nausea, vomiting - Confusion - Late sign: CHERRY RED SKINS
44
Alcohol Withdrawls
STAGE ONE: - 8 hours from last drink - Nausea, insomnia, sweating, tremors STAGE TWO: - 8-72 hours from last drink - Worsening symptoms - Hallucinations start STAGE THREE: - 48 hours plus from last drink - Same S/S - Seizures can happen in this stage STAGE FOUR: - 1-14 days since last drink - Delirium Tremens/ DT's - True medical emergency, life threatening - Loss of memory, hallucinations, fevers, sweating, insomnia, confusion, psychosis - Can last three days
45
Narcotic Overdose
- Respiratory depression or arrest - Pinpoint pupils - Hypotension
46
CNS Stimulants
- Excite the CNS - Cocaine, crack, meth, PCP, diet pills, MDMA/ ecstacy SxSx: - Excitable - Nervous - Hypertension - Dilated Pupils - Tachycardia
47
CNS Depressants
- Depresses the CNS - Alcohol - Benzodiazepines (Xanax/ Alprazolam, Ativan, Valium) SxSx: - Euphoria - Drowsy - Dilated pupils - Sluggish - Bradypnea
48
Stroke SxSx
- Slurred speech/ difficulty breathing - Facial droop - Paralysis/ weakness to one side of body - Headache
49
Stroke Treatment
- Monitor ABC's - O2 sat >94%, O2 not needed unless ABC issue - Check blood sugar - Position of comfort - Rapid transport
50
Ingested Poisoning
- Most common - Absorbed into the GI tract/ small intestine SxSx: - Swelling or burns around mouth - Nausea, vomiting, diarrhea - ALOC (AEIOUTIPS) - ABD pain Tx: - Activated Charcoal an hour with in ingestion
51
Activated Charcoal
Indications: - Ingested poison with in a hour of ingestions Contradictions: - ALOC - Acids or Alkalis (Bleach, ethyl, alcohol) - UNABLE to swallow Dosage: - 1g/ kg body weight - Adults 30- 100g - Children: 12.5- 25g Action: - absorbs poison in the stomach, preventing absorption into the blood stream (coats the drug) Side effects: - Black Stool - Vomtting (repeat dose if patient vomits with in 30 mins)
52
Inhaled Poisoning
- Breathing in a poison - Rapid absorption and onset - Can be accidental or abused SxSx: - Dyspnea - Chest pain - Stridor, hoarseness, coughing, wheezing, crackles - Dizzy, headache, ALOC, seizures
53
Injected Poisoning
- Under the skin, into the muscle or directly into bloodstream SxSx: - Swelling at injection site - Euphoria - Nausea/ vomiting - Weakness, fever, chills
54
Absorbed Poisoning
- Enters the body through skin or mucous membrane contact SxSx: - Liquid or powders on skin - Burns - Itching, reddness, swelling - rashes - oozing blisters
55
Organophosphate/ Pesticide Exposure
- includes insecticides and nerve agents - Salvation - Lacrimation - Urination - Defecation - GI upset - Emesis (vomiting) - Miosis (construction of pupils)
56
Emphysema vs Chronic Bronchitis
Emphysema: - Thin, barrel chested - Pink complexion - Non productive cough Chronic Bronchitis - Overweight - Blue complexion - Productive cough
57
Asthma Types
Extrinsic: - "Allergic Asthma" - Irritants in the air Intrinsic: - Infection, emotional distress, or exercise
58
Two types of Pulmonary Edemas
Cardiogenic - CHF, left sided Acute Reparatory Distress Syndrome - Destruction of capillary bed = fluid leakage - Pneumonia, aspiration, drowning, OD, etc
59
Wheezing
PP: - High pitched, musical whistling sound - Bronchoconstriction - Mostly heard on exhalation DISEASES: - Asthma, Emphysema, Chronic Bronchitis, Pneumonia
60
Rhonchi
PP: - Snoring, rattling noise - Thick mucous - Obstruction in larger airways DISEASES: - Pneumonia, Chronic Bronchitis, Emphysema
61
Rales (Crackles)
PP: - Bubbling, crackling heard on inspiration - Fluid build in alveoli DISEASES: - CHF and Pulmonary Edema
62
Types of Respiratory Distress
DISTRESS: Adequate tidal volume and rate; maintain SpO2 94% or greater FAILURE: Inadequate volume and or rate; PPV ARREST: No tidal volume/ rate; PPV
63
Multi- Dose Inhaler
Actions: - Relaxes the bronchiole smooth muscle and dilates lower airways (improves airflow in alveoli) Side Affects: - Tachycardia - Tremors, shakiness - Nervousness - Dry mouth - Nausea, vomiting
64
Silent MI
- MI with no chest pain/ vague symptoms - common in the elderly, women, and diabetic
65
Nitroglycerin (NTG)
Indications: - SS of chest pain or discomfort, consistent with acute coronary syndrome - Prescription - Approval to administer Contradictions: - Viagra in the past 24 h (can cause DEATH) - HR less than 50 bpm or more than 100 bpm - 3 doses have been taken Action: - Relieves chest pain - Dilates coronary arteries/ increased blood flow - Reduces workload of the heart -Decreases cardiac oxygen demand Side effects: - Headache - BP drop - Change in pulse rate Dosage: - .4mg x3
66
Aspirin (ASA)
Indications: - Chest pain/ discomfort that is suggestive of acute coronary syndrome - Medical direction to give Contradictions: - Not given to patient who are known to be allergic (hypersensitive to drug) Actions: - Does not allow platelets to stick together = prevents vessel blockage Side effects: -- Overall a very good drug - Stomach irritation Dosage: - 160-325mg
67
AEIOUTIPS
Alcohol Epilepsy Insulin Overdose Uremia Trauma Infection Psychological Shock
68
Cincinnati Prehospital Stroke Scale
- Facial droop: have patient smile - Arm drift: have patient hold arms out for 10 seconds - Speech: have patient speak a simple sentence
69
Seizure Treatment
- Ensure airway - Let them have the seizure - Prevent injury - Nothing in the mouth - Status epilepticus: NPA- BVM
70
Seizure
Sudden and temporary altercation in brain function caused by massive, continuing electrical discharges in the brain
71
Cerebrovascular Accident (CVA)/ Stroke
- Inadequate amount of blood being delievered to a portion of the brain (Blood clot or Hemorrhage)
72
Poison
Any substance that impairs health or causes death by its chemical action when it enters the body or comes in contact with skin
73
Toxicology
Study of toxins, antidotes, and the effects of toxins on the body
74
Antidotes
Substance that will neutralize or counteract the effects of a poison
75
Spontaneous Abortion
- Miscarriage - Passage of tissue before the 20th week or gestation - USUALLY in the first trimester, between 8-12 weeks gestation
76
Ectopic Pregnancy
- First trimester - Fertilized egg implants anywhere but the uterus - Usually in fallopian tubes - Egg starts to grow and develop, rupturing the fallopian tubes SXSX: - Intense lower quadrant abd pain described as dull, then sharp, and knife like - Can lead to internal bleeding and signs of shock possible
77
Placenta Previa
- 3rd trimester emergency - Placenta implants itself over the cervix SXSX: - LOTS of vaginal bleeding - NO pain
78
Abruptio Placenta
- Common in 1st pregnancy - 3rd trimester emergency - Placenta prematurely tears away from the uterine wall - High mortality rate for mom and baby - Many causes, from hypertension to trauma SXSX: - LOTS of pain - LITTLE/ NO bleeding (infants head is covering the cervix)
79
Ruptures Uterus
- 3rd trimester - Spontaneous or traumatic rupture of the uterine wall - Release fetus into abdominal cavity Special question: - Has the patient has a c- section before?
80
Preeclampsia/ Eclampsia
- 3rd trimester - Characterized by hypertension and swelling of the extremities - Preeclampsia turns into Eclampsia when the mother has seizures - Pregnancy related seizures have high mortality rate for mother and baby
81
Supine Hypotensive Syndrome
- 2nd and 3rd trimester - Uterus and growing fetus compress the inferior vena cava when the mom lays flat on her back - Leads to hypotension when laying down - Prop a pillow or similar under the patients right side to ensure the fetus does not compress the inferior vena cava
82
Prolapsed Cord
- Umbilical cord presents before the head - TRUE EMERGENCY - Baby can compress the cord, cutting off blood supply - Can insert gloved hand into birth canal to lift presenting part of the baby off of the cord
83
Breech Birth
- Butt or legs present first - Allow deliver to happen - If head gets stuck, after 2 minutes, may insert gloved hand into birth canal to make an airway for the baby
84
Limb Presentation
- Single arm or leg is presenting - TRUE EMERGENCY, cannot deliver in the field - Patient will need c section
85
Meconium Staining
- Baby had a bowel movement in the amniotic sac - When water breaks, fluid is greenish or brown - Tells you that the baby was in distress at one time
86
Postpartum Hemorrhage
- Any bleeding over 500cc after baby is born - Place mom on high flow O2 - Massage fundus - Baby to breast
87
Epipen
Indications: - Allergic reaction/ anaphylaxis - Mucosal signs - Angioedema/ respiratory symptoms - Poor perfusion Contradictions: - None is administered for life threatening anaphylactic emergencies Actions: - Reverses reaction by mimicking sympathetic response (turns off histamine/ does nothing to pre existing histamine) - Bronchodilation - Vasoconstriction - Reverses capillary permeability Side affects: - Tachycardia - Dizzy/ excitability - Chest pain - Nausea/ vomiting Dosage: - Adults- .3mg - Children- .15mg
88
Oral Glucose
89
Naloxone/ Narcan
Indications: - suspected opioid intoxication with respiratory depression Contradictions: - known hypersensitivity Actions: - Opioid antagonist - Binds to opioid receptors to reverse respiratory depression Side affects: - Acute withdrawal Dosage: - Intranasal 1 mg per nostril = 2 mg
90
Hypoxia Signs
EARLY: - Tachypnea, dyspnea, anxiety, apprehension, pale skins LATE: - ALOC, Cyanosis, dyspnea
91
Birth Stages
STAGE ONE: - Dilation phase - Beginning of true labor until full dilation of the cervix - Braxton hicks contractions: False labor STAGE TWO: - Expulsion phase - Full dilation of the cervix until the baby is born - Look for Nuchal Cord: cord wrapped around babys neck SXSX: - Contractions 2-3 minutes apart and lasting 60-90 seconds - Urge to bear down - Crowing STAGE THREE: - Placenta phase - Delivery of the baby until delivery of the placenta - 5-20 minutes after
92
APGAR out of 10
APPEARANCE: 0-2 PULSE: 0-2 - 1: <100 - 2: >100 GRIMACE: 0-2 ACTIVITY: 0-2 RESPIRATIONS: 0-2
93
APGAR Scoring
- 7-10: only routine care - 4-6: Simulate baby, O2 - 0-3: BVM, CPR as needed
94
5 Patient Rights
- Right patient - Right drug - Right dose - Right route - Right time
95
Normal blood sugar
70-140 mg/dl
96
Glycogen
- Stores unused glucose - Stores many simple glucose molecules together in the liver
97
Insulin
- Moves glucose into cells - Secreted when glucose levels are high - Produced in pancreas
98
Glucagon
Converts glycogen into glucose - Produced in pancreas
99
Nasal Canula
- 2-6 lpm - Low flow
100
Non rebreather mask
- 10-15 lpm - High flow
101
Bag valve
- 10-25 lpm - assisting in ventilation
102
RUQ
Liver S Right Kidney S Colon H Gallbladder H
103
RLQ
Colon H Small intestine H Major Artery/ vein to the right leg Ureter Appendix H
104
LLQ
Colon H Small intestine H Major artery/ vein to the left leg Ureter
105
LUQ
Liver S Spleen S Left Kidney H Stomach H Pancreas S

EMT 106 (18 decks)

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