Emr Lab 1-4 Notes

Front 1

UPPER RIGHT ABDOMINAL QUADRANT

Back 1

-liver -gallbladder -right kidney -colon -large intestine -pancreas

Front 2

UPPER LEFT ABDOMINAL QUADRANT

Back 2

-liver -pancreas -spleen -left kidney -stomach -large intestine

Front 3

LOWER RIGHT ABDOMINAL QUADRANT

Back 3

-colon -ureter -colon -appendix -small intestine

-major artery and veins of right leg -large intestine

Front 4

LOWER LEFT ABDOMINAL QUADRANT

Back 4

-colon -small intestine -major arteries and veins of left leg -ureter -large intestine

Front 5

ANATOMICAL TERMS

Back 5

-supine= lying face up, on back

-prone= lying face down, on stomach

-recovery= lying on side

-superior= towards head

-inferior= towards feet

-anterior= towards front of body

-posterior= towards back of body

-medial= towards midline of body

-lateral= away from midline of body

-proximal= closer to point of origin

-distal= further from point of origin

Front 6

GUIDELINES FOR CARE OF PATIENT IN ANAPHYLACTIC SHOCK

Back 6

1)primary assesment-treat life threats, provide basic life support if needed.

2)administer 100% oxygen- adequate breathing= NRB, if patient needs provide artificial ventilations

3)assist with epi-pen or antihistamines

Front 7

GUIDELINES FOR CARE TO PATIENT WITH ACUTE ABDOMINAL DISTRESS

Back 7

1)maintain open airway- be alert to vomiting and aspiration. Nauseated= recovery position.

2)administer oxygen via NRB 10-15L/min

3)be alert for shock- if vitals or observations point to it, position patient on his/ her back with legs elevated. No shock=position of comfort.

Front 8

GUIDELINES FOR CARE TO PATIENT WITH ALTERED MENTAL STATUS

Back 8

1)asses and monitor airway and breathing closely. Patients may not be able to protect an airway. Unconscious=secure airway w/ adjunct suction if needed.

2)position patient- if no suspected head/spine injury place patient in recovery. Continue to monitor breathing closely.

3)administer high flow oxygen, breathing adequately= NRB, inadequate= BVM w/ oxygen source

Front 9

GUIDELINES FOR CARE TO PATIENT WITH NON-SPECIFIC COMPLAINTS:

Back 9

1)monitor airway and breathing

2)if patient is conscious and theres no suspected spinal injury, allow them to get into position of comfort.

3)perform ongoing assesment until incoming paramedics take over care. - report and changes.

Front 10

GUIDELINES FOR EMRG CARE FOR RESPIRATORY DISTRESS

Back 10

1)asses breathing to determine if adequate. Monitor throughout call. If respirations and inadequate provide artificial ventilations

2)place patient in adequate breathing postion (sitting)

3)administer oxygen via NRB 12-15L/min

4)comfort and reassure them

5)activate ems sys.

Front 11

GUIDELINES FOR EMERG CARE FOR CHEST PAIN

Back 11

1)have patient cease all movement

2)place conscious patient in position of comfort (sitting/semi-reclined)

3)make sure airway is open, administer high flow oxygen via NRB mask or artificial ventilations if needed

4)loosen tight clothes

5)maintain body temp. as close to normal

6)comfort and reassure patient

7)activate ems sys.

Front 12

PELVIC CAVITY ORGANS

Back 12

-bladder -rectum -internal female reproductive organs

Front 13

SPINAL CAVITY ORGANS

Back 13

-spine

Front 14

CRANIAL CAVITY ORGANS

Back 14

-brain

Front 15

THORACIC CAVITY ORGANS

Back 15

-heart -lungs

Front 16

ABDOMINAL CAVITY ORGANS

Back 16

-liver -gallbladder -spleen -pancreas -kidneys

-stomach -small intestine -large intestine

-rectum

Front 17

FUNCTION OF THE NERVOUS SYSTEM

Back 17

1)communication and control: allows person to be aware of and react to environment, communicate within the body and control the body.

5 major functions:

1)sensation 2)integration 3)regulation 4)intellectual activity 5)muscle and gland control

Front 18

FOUR PARTS THAT MAKE UP THE NERVOUS SYSTEM

Back 18

1)brain stem:connects brain w/spinal cord. every message is passed through here.

2)diencephalon:lies above brain stem. includes thalamus and hypothalamus. thalamus=relaying sensory info. like smell, sound pain. hypothalamus=heart beat, digestion and body temp

3)cerebrum:largest part of brain, divided into specific areas that interpret sensory impulses from body

4)cerebrum:located below cerebrum behind brain stem, maintains balance and coordination

Front 19

ORGANS OF NERVOUS SYSTEM

Back 19

-brain -spinal cord

Front 20

5 SECTIONS OF SPINAL COLUMN

Back 20

1)cervical-7

2)thoracic-12

3)lumbar-5

4)sacral-5

5)coccygeal-4

Front 21

AUTONOMIC NERVOUS SYSTEM FUNCTION

Back 21

-regulates involuntary actions of heart, intestines, lungs, gallbladder and other components of the NS

Front 22

SYMPATHETIC NS

Back 22

-controls most of body's internal organs -works to aid body in response to stress

"fight or flight"

Front 23

PARASYMTHETIC NS

Back 23

-works in opposition, complementary of the sympathetic NS.

"rest and digest"

Front 24

FUNCTION OF THE RESPIRATORY SYSTEM

Back 24

-delivers oxygen to the lungs and also removes carbon dioxide from the lungs

Front 25

ORGANS OF THE RESPIRATORY SYSTEM

Back 25

-pharynx (oropharynx & nasopharynx)

-nose

-mouth

-trachea (windpipe)

-bronchi

-alveoli

Front 26

INSPIRATION

Back 26

-breathing in

-muscles of thorax contract, ribs move outward and up and diaphragm contracts and lowers

-expanding chest cavity causing air to flow in

Front 27

EXPIRATION

Back 27

-breathing out

-muscles relax, ribs move inward and diaphragm relaxes and moves up

Front 28

HOW OXYGEN IS CARRIED IN BLOOD STREAM

Back 28

-exchange of oxygen occurs in the lungs and alveoli

-oxygen is carried in the blood by hemoglobin in red blood cells

Front 29

FACTORS THAT AFFECT THE OXYGEN CARRYING CAPACITY OF BLOOD

Back 29

-blood loss: results in smaller number of red blood cells resulting in smaller level of hemoglobin

-low iron levels: may have small number of hemoglobin molecules available, smaller number of hemoglobin= reduced oxygen carrying capacity of blood

Front 30

WHERE DOES GAS EXCHANGE OCCUR IN THE BODY

Back 30

-alveoli in the lungs

Front 31

FUNCTION OF CARDIOVASCULAR SYSTEM

Back 31

-transports nutrients ( oxygen,chemicals and sugars) to body tissues

-transports wastes (carbon dioxide and metabolic byproducts) to organs to be excreted out of the body.

-act as major body defence housing many cells that are a part of the immune system.

-prevents bleeding

-transports hormones

Front 32

ORGANS OF CARDIOVASCULAR SYSTEM

Back 32

-heart

-arteries and arterioles

-capillaries

-veins and venules

-blood

Front 33

FUNCTION OF BLOOD AND HOW MUCH BLOOD ADULT BODY HAS

Back 33

-functions as transport medium

-brings continuous supply of oxygen and nutrients to cells

-removes co2 and wastes

-fluid and electrolyte balance

-temp regulation

-prevention of fluid loss and disease prevention

-4-6L in average person

Front 34

THREE LAYERS OF HEART

Back 34

1)epicardium: outer layer, visceral layer

2)myocardium: middle layer, strong cardiac muscle fibres responsible for pumping action

3)endocardium: smooth, inner layer lining heart. Covers fibrous skeleton of valves.

Front 35

CHAMBERS OF THE HEART

Back 35

1)right atrium: upper chamber, receives oxygen depleted blood from body through superior vena cava

2)left atrium:upper chamber, receives oxygen rich blood from lungs through pulmonary veins

3)right ventricle:lower chamber, receives oxygen depleted blood via right atrium and pumps it to lungs

4)left ventricle:lower chamber, receives oxygen rich blood via left atrium and pumps it to body

Front 36

FUNCTION OF HEART VALVES

Back 36

1)atrioventricular valves (AV): prevent back flow into atria when ventricles contract

2)semilunar valves (SL): prevent back flow into ventricles

Front 37

ROUTE OF BLOOD CIRCULATING THROUGH HEART TO LUNGS

Back 37

right atrium, tricuspid valve, right ventricle, pulmonary semi lunar valve, pulmonary arteries, lungs, left atrium, pulmonary semilunar valves

Front 38

3 WAYS BODY PREVENTS BLOOD LOSS

Back 38

1)vascular spasm: smooth muscle in blood vessel walls contract immediately, as soon as the blood vessel is broken. this response reduces blood loss for some time while the other mechanisms become active

2)platelet plug formation: when blood platelets come into contact with a damaged blood vessel they form a platelet plug to help close the gap in the broken vessels

3)blood clotting: clotting is the process by which liquid blood is transformed into a solid state. This complex process involves many factors that activate each other.

Front 39

FUNCTION OF BONES

Back 39

1)support: provide framework that supports body

2)protection: vertebrae protect the spinal cord, skull protects brain

3)movement: skeletal muscles attach to bones, making movement possible

4)mineral storage: bones store minerals like calcium and phosphate and release them into bloodstream for use

5)blood cell formation: almost all blood cell formation occurs in bone marrow

Front 40

FUNCTION OF CARTILAGE

Back 40

-connective tissue covering ends of some bones

-provides smooth operation of joints between bones and also provides some shock absorption

Front 41

FUNCTION OF TENDONS

Back 41

-muscles to bones

-create power needed for movement

-injury= joint unable to move or limited movement

Front 42

FUNCTION OF LIGAMENTS

Back 42

-bone to bone

-support for joints

-helps make sure movement only occurs in desired directions

-injury=abnormal range of motion, lack of stability

Front 43

3 TYPES OF JOINTS IN THE BODY

Back 43

1)fibrous joints: fibrous tissue, no joint cavity, immovable (skull)

2)synovial joints: fluid containing cavity, moveable (shoulder, knee)

3)cartilaginous joints: cartilage, no joint cavity, some movement (intervertebral)

Front 44

PARTS OF AXIAL SKELETON

Back 44

-skull (22 cranial bones)

-vertebral column

-33 vertebrae

-thorax- chest bones (breastbone and ribs)

Front 45

PARTS OF APPENDICULAR SKELETON

Back 45

-pectoral girdle

-pelvic girdle

-extremities

Front 46

3 DIFFERENT TYPES OF MUSCLES AND THEIR FUNCTIONS

Back 46

1)skeletal muscle: attached to bones, largest tissue mass, voluntary control, over 600, change from relaxation to contraction with speed and power, straited, short stamina.

2)smooth muscle: lines internal organs, blood vessels and glands, 2nd most abundant, involuntary control, slow, smooth movement, great stamina, non-straited

3)cardiac muscle: only in heart, involuntary control, never maintains contraction, started (less than skeletal)

Front 47

THREE DIFFERENT LAYERS OF THE SKIN

Back 47

1)epidermis: outer layer, waterproof quality and color

2)dermis: 2nd layer, own blood supply, sweat glands (collect water and wastes from blood stream) hair roots, oils glands, sensory neurons

3)subcutaneous: 3rd inner layer, fatty tissue providing cushion and insulation for organs lying beneath skin

Front 48

FUNCTION OF SWEAT GLANDS

Back 48

(exocrine glands) used for body temperature regulation, found in most regions of skin, tiny tube that originates as ball shaped coil in dermis, secretes sweet for cooling

Front 49

FUNCTION OF OIL GLANDS

Back 49

all over body except palms and soles of feet, secrets sebum, keeps hair and skin from drying

Front 50

FUNCTION OF HAIR

Back 50

covers most of body, several functions; eyebrows keep sweat from eye, nose and ear hair filter dust from air, scalp hair protects head from sunburn

Front 51

FUNCTION OF NAILS

Back 51

develop from epidermis and is located at ends of fingers and toes, helps with scratching and grasping objects and protects fingers and toes

Front 52

FUNCTION OF SIMPLE (1 CELL THICK) AN STRATIFIED (2+ CELLS THICK) EPITHELIUM

Back 52

1)secretion: (through glands) epithelium secretes various chemical substances (hormones)

2)sensation: special epithelium senses stimulus from surrounding environment, these tissues can be found in skin, tongue and other areas of body

3)protection: protects underlying tissue and organs from injury and water loss

4)absorption: absorbs nutrients in food we digest

5)excretion:in skin & kidneys excrete waste products to help maintain homeostasis

6)diffusion:simple epithelium are involved in diffusion of gases, liquids and nutrients

Front 53

FUNCTIONS OF CONNECTIVE TISSUE

Back 53

1)structural support:maintaining anatomical forms of organs and organ systems, connective tissue in tendons and ligaments help movemuscoskeletal system and give ability to walk and run

2)diffusion:gases, liquids and nutrients from blood pass and diffuse through connective tissue, waste products also diffuse through connective tissue before returning to blood capillaries

3)storage:insulation: adipose function as energy storage in the form of lipids and provide thermal insulation

4)defence:protects body from infection and injury, helps repair injured tissue resulting in formation of scar tissue

Front 54

HOW SKIN PROTECTS BODY FROM HOT CONDITION

Back 54

below 32 degrees celsius, sweat glands secrete unnoticeable amounts of sweat (less than 0.5L/day) when body temp rises blood vessels near surface of skin dilate (larger) allowing more blood to pass by surface of skin, sweat glands are stimulated to produce sweat, prolonged exposure/ elevated temp occurs they can secrete up to 12L/day. Evaporation of sweat from skins surface helps cool blood, as cooled blood circulates around body temp goes down.

Front 55

HOW SKIN PROTECTS FROM COLD CONDITIONS

Back 55

when external environment is cold, sweat stops being produced, blood vessels near surface of skin constricts (smaller) allowing less blood to pass by the skin. Ensuring blood remains warm and is kept near core of body to help maintain normal body temp. Resulting in skin temp dropping to match temp of environment if exposed long enough. Hair on skin stand on end providing an insulating layer, trapping heat. muscles start shivering and increase heat production which also helps body in cold conditions

Front 56

FUNCTION OF THE GASTROINTESTINAL SYSTEM

Back 56

-breakdown of foods into nutrients

-absorption of nutrients into body

-movement of food throughout body

-removes waste products

Front 57

COMPONENTS OF THE GASTROINTESTINAL SYSTEM

Back 57

1)mouth

2)esophagus

3)stomach

4)small intestine

5)large intestine

6)liver

7)gall bladder

8)pancreas

9)appendix

Front 58

FUNCTION OF THE STOMACH

Back 58

storage, mixing organ for ingested food and fluids when food enters stomach, gastric juices are secreted by wall of stomach to breakdown food into substance called chyme, small amount of digestion and absorption occurs here

Front 59

FUNCTION OF LIVER

Back 59

located just below diaphragm functions in digestive system by producing bile which contains digestive enzymes that help breakdown fats and helps maintain normal blood glucose level

Front 60

FUNCTION OF PANCREAS

Back 60

endocrine and exocrine gland that produces several hormones and pancreatic juices, pancreatic juices contain digestive enzymes and other substances that neutralize the hydrochloric acid in the digestive juices entering the small intestines

Front 61

FUNCTION OF GENITUOURINARY SYSTEM

Back 61

-remove waste products from blood

-produce urine from waste products

-stores urine until its eliminated

-eliminate urine from body

Front 62

COMPONENT OF GENITOURINARY SYSTEM

Back 62

-kidneys

-ureters

-bladder

-urethra

Front 63

FUNCTION OF KIDNEYS

Back 63

located behind abdominal cavity of right and left side of body, these organs take blood from the renal arteries and remove water and wastes from blood, making urine. Helps regulates BP. Balance chemicals in body. Produces RBCs

Front 64

FUNCTION OF BLADDER

Back 64

located in pelvis, hollow organ which collects urine from kidneys and stores it until bladder is ready to empty

Front 65

FUNCTION OF ENDOCRINE SYSTEM

Back 65

-growth and developement

-mobilization of body defences (immune system)

-maintaining chemical balances in the blood including ions, water and nutrients

-regulation of metabolism

Front 66

WHAT IS A HORMONE AND HOW DO THEY FUNCTION

Back 66

hormone is a steroidal or amino-acid based molecule that is released to the blood that act as chemical messengers to regulate specific body functions. Regulate many functions of the human body including; mood, growth and metabolism

they are released into blood stream, travel through circulatory system where they bind wi specific receptor sites located throughout body, once bound to receptor site, hormone initiates specific response. may be immediate or long term

Front 67

THYROID GLAND HORMONE AND LOCATION AND FUNCTION

Back 67

location- neck inferior to thyroid cartilage

hormone-thyroid hormone

function-metabolic rate of body

Front 68

TESTES LOCATION HORMONE AND FUNCTION

Back 68

location-scrotum of males

hormone-testosterone

function-controls development of male sex characteristics and reproductive system

Front 69

PANCREAS LOCATION HORMONE AND FUNCTION

Back 69

location-cluster cells called islets of langerhans

hormones-insulin, glucagon

function- insulin= lowers blood sugar level, glucagon=raises blood sugar levels

Front 70

HOMEOSTASIS

Back 70

state of body equilibrium/stable internal environment of the body which is regulated by various body systems including the endocrine sys.

Front 71

PATHOPHYSIOLOGY

Back 71

study of the changes to normal mechanical, physical and biochemical functions within the body as a result of disease or an abnormality

Front 72

CHRONIC AND ACUTE CONDITIONS

Back 72

chronic-diseases/abnormalities that have existed in a patient for quite some time.

acute-dieases/abnormalities that have arisen suddenly.

Front 73

HOW DO NOSE MOUTH AND EYES PROTECT BODY FROM INFECTION?

Back 73

mucus, saliva and mast cells in these passageways help trap and kill bacteria

Front 74

HOW DOES HIGH FEVER HELP FIGHT BODY INFECTIONS

Back 74

higher than normal body temp usually caused by infection is triggered by body's immune system to help raise body temp to destroy infections and disrupt ability of virus/bacteria to multiply. Infection fighting cells of the immune system are also signalled by fever to help fight infection

Front 75

PURPOSE OF PRIMARY SURVEY

Back 75

to identify and treat injuries or illness your patient is experiencing

Front 76

COMPONENTS OF SCENE OVERVIEW

Back 76

1)site: is it an industrial site? school? sports area? private residence? highway?

2)BSI gear: reduces risk when working with patients with disease or infections. Includes safety glasses, gloves and aprons.

3)MOI: critical info, where suspect injury may be, why they're having chest pain.

4)number of patients: when theres more patients you can deal with,helps determine additional resources if needed.

5)additional resources: rescue teams, law enforcement, animal control etc.

Front 77

COMPONENTS OF PATIENT OVERVIEW

Back 77

1)position and distress

2)fractures or blood

3)skin color and condition

Front 78

AVPU

Back 78

A=alert- aware of his or her surroundings, name etc.

V=verbal-discriented but responds when spoken to, incorrect response to questions. responds to verbal stimulus

P=pain-responds only to painful stimulus, doesn't respond to questions, doesn't open eyes.

U=unresponsive-doesnt respond to any stimulus, most likely critical condition and in definite need of airway and other support care

Front 79

CRITERIA FOR LOAD AND GO

Back 79

1)altered LOC

2)airway compromise

3)respiratory compromise

4)circulatory compromise

Front 80

EMERGENCY SITUATIONS WHERE YOU SHOULD MOVE PATIENT QUICKLY

Back 80

1)bilateral femur fractures

2)fractured pelvis

3)distended abdomen

4)chest pain

5)stroke

Front 81

4 PIECES OF EQUIPMENT EMR CAN USE TO MOVE PATIENTS

Back 81

1)multilevel stretcher- most commonly used

2)scoop stretcher- bilader fractures, fractured hip, fractured pelvis

3)chair stretcher-tight narrow areas such as stairs and narrow hallways

4)extremities- moving patient from sitting position to multilevel stretcher

Front 82

LOCATIONS TO FIND COMMON PULSES

Back 82

1)carotid-located on neck

2)radial-located on lateral side of wrist

3)femoral-located in thigh

4)papillae- located above knee

Front 83

3 FACTORS TO BE CONCERNED WITH WHEN ASSESSING PULSE

Back 83

1)palpate artery with tip of index finger (avoid thumb)

2)adult pulse best found in carotid and radial

3)infants= brachial artery

Front 84

NORMAL PULSE RATES

Back 84

adult-60-80

child-80-150

infant-120-150

Front 85

3 WAYS TO OBTAIN RESPIRATORY RATE

Back 85

1)placing hand on patients chest/abdomen

2)observing stomach/chest watching it rise and fall

3)placing stethoscope over chest, listening for air entry in and out

Front 86

3 FACTORS TO BE CONCERNED WITH WHEN ASSESSING RESPIRATIONS:

Back 86

1)rate-normal? slow (bradypnea)? fast(tachypnea)? absent(apnea)?

2)rhythm:regular? irregular?

3)quality:laboured? deep? shallow? gasping?

Front 87

RESPIRATORY RANGES

Back 87

adult-12-20

child-20-40

infant-up to 60

Front 88

SIGNS OF RESPIRATORY DISTRESS

Back 88

1)accessory muscle use, breathing requires extra effort, group of muscles in neck and chest and abdomen called accessory muscles aid in inspiration and expiration expanding the thoracic cavity.

2)paradoxial respirations: breathing movement in reverse of normal movement, patients can experience this after blunt trauma to chest resulting in multiple rib fractures and airway obstruction

3)tracheal deviation:trachea is pulled to one side of body, most common cause is tension pneumothorax

4)intercostal indrawing: retractions of skin of chest wall, seen mostly in infants and young kids

5)nasal flaring: enlargement of opening of nostrils during breathing sign of distress mostly in infants and young children

6)grunting:can be heard from patients in times of distress during exhalation

7)stridor:high pitched breathing sounds caused by blockage in upper airway by an object, spasm of tissue and swelling of tissue patients with anaphylactic shock or upper airway burns

Front 89

ABNORMAL BREATH SOUNDS

Back 89

wheezes- sounds heard during inspiration or expiration, or both that are caused by air moving through airways narrowed by constricting or swelling, have high pitched/ squeaking musical quality

crackles-poling sounds when air is forced through respiratory passages taster narrowed by fluid, mucus or pus. fine medium or course sound

Front 90

SYSTOLIC VS DIASTOLIC BLOOD PRESSURE

Back 90

systolic-blood pressure when heart is constricting, which forces blood through arteries

diastolic-blood pressure resulting from relation of heart between contractions

Front 91

NORMAL BLOOD PRESSURE RANGES

Back 91

adult-120/80 (male systolic=age+100 (up to 150mmHg, diastolic=65-90mmHg)(female systolic=age+100 up to 140)

Infant-2x patients age + 80=systolic, 50-80mmHg=diastolic

Front 92

SYMPTOMS OF HIGH AND LOW BLOOD PRESSURE

Back 92

high blood pressure-over 140/90, headaches,fatigue,dizziness,nausea, vision problems,chest pains,breathing problems, irregular pulse, blood in urine.

low blood pressure-under 100/60, blurred vision, dizziness, fainting, nausea, weakness, pale cool skin and palpations.

Front 93

2 METHODS USED TO OBTAIN BLOOD PRESSURE

Back 93

1)blood pressure by auscultation: take manual blood pressure of patient using a sphygmomanometer and a stethoscope to listen for the characteristic sounds

2)blood pressure by palpation: take manual BP of patient by palpating radial or brachial pulse with finger tips. Technique used when there is on much noise around the patient to use a stethoscope

Front 94

CONDITION THAT CAUSES SKIN TO BECOME PALE

Back 94

-constricted blood vessels, possibly resulting from shock, hypotension, cancer, frostbite, heat disease and diabetes

Front 95

CONDITIONS THAT CAUSE SKIN TO BECOME FLUSHED

Back 95

-exposure to heat, fever, allergic reaction, emotional excitement or carbon monoxide poisoning

Front 96

CONDITIONS THAT CAN CAUSE SKIN TO BE COOL AND CLAMY

Back 96

-shock, heart attack, low blood sugar and anxiety

Front 97

SEVERAL DIFFERENT WAYS THE EMR CAN TAKE TEMP OF PATIENT

Back 97

1)feeling the skin of patient with back of hand on forehead. note if it feels warm, hot or cold

2)3 different types of thermometers; digital, tympanic (ear) and temporal (forehead)

Front 98

NORMAL BODY TEMP. RANGE

Back 98

36.5-37.2 degrees celsius

Front 99

WHAT HAPPENS TO THE PUPILS WHEN EXPOSED TO BRIGHT LIGHT AND WHEN EXPOSED TO REDUCED LIGHT

Back 99

bright light-they're small (constricted)

dim light- they're bigger (dilated)

Front 100

3 CONCERNES WHEN ASSESSING PUPILS

Back 100

1)size- normally they will both be equal in size 2-6mm, assess size after eyelids have been opened and pupils have adjusted to light

2)symmetry-both pupils same size and shape

3)reactivity-both pupils quickly constrict to light and quickly dilate when light source is removed

Front 101

CONDITIONS THAT CAN CAUSE UNEQUAL PUPILS

Back 101

-stroke -head injury -eye injury -artificial eye

Front 102

PERL

Back 102

p-pupil

e-equal

r-reactive

l-light

Front 103

WHAT PULSE OXIMETER MEASURES

Back 103

oxygen saturations of hemoglobin

Front 104

PULSE OXIMETER READINGS

Back 104

mild hypoxia-94%-96%

moderate hypoxia-90%-94%

sever hypoxia-below 90%

Front 105

FACTORS AND CONDITIONS THAT CAN CAUSE AN ABNORMAL PULSE OXIMETRY READING

Back 105

-asthma -bronchitis -emphysema -pneumonia

-poor circulation -heart disease -infections

-smoking -medications/drugs -exposure to cold

-shock

Front 106

4 LIMITATIONS TO PULSE OXIMETRY EQUIPMENT

Back 106

1)carbon monoxide poisoning

2)hypothermia

3)shock

4)cardiac arrest

Front 107

WHAT DOES A GLUCOSE METER MEASURE?

Back 107

-blood glucose levels, through a small blood sample. blood goes onto glucose test strip

Front 108

AVERAGE NORMAL BLOOD GLUCOSE LEVEL

Back 108

4.0mmol/L to 8.0mmol/L

Front 109

HYPOGLYCEMIA

Back 109

low blood glucose level, low levels of blood glucose can be caused by meds, liver disease, diabetes and alcoholism

Front 110

HYPERGLYCEMIA

Back 110

high blood glucose level, high levels of blood glucose, diabetes, drugs, disease and physiological stress

Front 111

INDICATIONS FOR PERFORMING A BLOOD GLUCOSE TEST

Back 111

-patients with diabetes

-patients with altered LOC

-patients with experiencing stroke

-patients who experience a fainting or near fainting episode

Front 112

FOUR REASONS THAT ITS IMPORTANT TO GATHER PATIENT HISTORY

Back 112

1)helps determine the presenting complaint

2)allows you to gather all relevant associated information

3)helps determine any secondary complaints

4)can aid in treatment of patient

Front 113

DIFFERENT SOURCES OF INFORMATION FOR GATHERING PATIENT HISTORY

Back 113

-use SAMPLE-signs & symptoms, allergies, meds, past medical history, last oral intake and events leading up.

ask "what happened?" question family and bystanders

Front 114

GENERAL HISTORY

Back 114

collected early on in patients assesment in both your scene overview. consists of; MOI, scene observation, medical alert bracelets and medical patches

Front 115

FOCUSED HISTORY

Back 115

collected after primary surgery and consists of AMPLE and OPQRST

Front 116

AMPLE

Back 116

A-allergies

M-medications

P-past medical history

L-last oral intake

E-events leading up to

Front 117

OPQRST

Back 117

O-onset; what were you doing when pain started

P-provocation; what provoked the complaint

Q-quality;what does the pain feel like

R-radiates;where is the pain? does the pain go away?

S-severity; asking severity of pain 1-10?

T-time; how long ago did the pain start?

Front 118

FLOW RATE FOR NASAL CANNULA

Back 118

1-6L/min-24%-40%

Front 119

FLOW RATE FOR NON-REBREATHER MASK

Back 119

10-15L/min- up to 90%

Front 120

FLOW RATE FOR BVM

Back 120

10-15L/min- up to 90%

Front 121

CARDIAC RHYTHMS AED WILL DEFIBRILLATE

Back 121

-ventricular fibrillation; chaotic, unorganized hearth rhythm, cannot create a pulse or circulate blood to sustain life

-ventricular tachycardia; more organized, very rapid and inefficient. capable of producing pulse

Front 122

TREATMENT FOR FINGER AMPUTATION

Back 122

-apply pressure dressing to amputated stump

-wrap amputated finger in moist,sterile dressing, place in labelled plastic bag and place that bag in a pan with water and keep cool by ice or cold packs

-transport patient quickly to surgical intervention in order to improve chances of re-implantation

Front 123

MECHANISMS OF INJURY FOR WHICH YOU WOULD TAKE SPINAL PRECAUTIONS

Back 123

1)flexion injury

2)compression injury

3)hyperextension injury

4)distraction injury

5)flexion-rotation injury

6)penetration injury

Front 124

STEPS FOR SECURING PATIENT TO SPINE BOARD

Back 124

1)maintain patients head and neck in neutral, in-line position

2)roll patient on side

3)a bystander or one of the three rescuers should move the long backboard into place

4)lower patient onto long backboard

5)pad gaps between patient and backboard

6)immobilize neck, head then feet

Front 125

WHAT MUST BE ASSESSED PRIOR TO AND AFTER SPLINTING EXTREMITY

Back 125

-distal pulse

-motor power

-sensation

Front 126

HOW MUCH TRACTION SHOULD BE USED WITH A TRACTION SPLINT

Back 126

15lbs or 10% of patients body weight

Front 127

MANUAL C-SPINE CONTROL

Back 127

-attendant delegates team member to hold patients head

-if not already there, team member moves patients head to an anatomically correct position, assuming there are no contradictions for doing so

Front 128

CLEAR PATIENTS AIRWAY

Back 128

-if airway is occluded with liquid or loose foreign matter (blood or vomit) the attendant delegates a team member to roll the patient and suction the airway until clear

-if airway is occluded by a foreign body that haw become lodged in the airway chest compressions as outlined by the HSFC must be performed until clear

Front 129

VENTILATE PATIENT

Back 129

-if patients respiratory rate is absent, too fast, too slow or too shallow, delegate a team member to use a BVM to assist with the patients breathing.

-use of BVM is usually in conjunction with the insertion of an OPA.

Front 130

SUCKING CHEST WOUND

Back 130

-delegate team member to cover wound with gloved hand, another team member will have to prepare and correctly apply occlusive dressing over wound

-apply dressing

Front 131

5 MAIN SUBSTANCES FROM WHICH DRUGS ARE MANUFACTURED

Back 131

1)minerals:many mineral substances are used in drug prep. ex. magnesium sulphate

2)plants:some drugs are derived from plants ex. atropine, digitals, morphine

3)animals:tissues and body fluids of certain animals are the source of specific drugs ex.hormones, antitoxic serums (snakes), gamma globulin (humans)

4)synthesis:some drugs contain artificial creations of new chemical compounds ex. epinephrine

5)microorganisms:bacteria or fungi produce chemical chemical substances, some of which are sources of drugs ex.penicillin and vaccines

Front 132

ASA - contradictions

Back 132

-hypersensitivity

-asa and other nasaids may include an acute asthma attack in up to 20% of asthmatic patients

-patients with active ulcer disease

Front 133

ASA- dosage

Back 133

160-325 mg po x1; chew table before swallowing, this hastens absorption

baby ASA is recommended because it is more palatable

Front 134

ASA-route

Back 134

oral (po)

Front 135

ASA- precautions

Back 135

-patient receiving anticoagulant therapy (such as warfarin) ASA may potentate effect

-diabetics should be monitored closely for pronounced hypoglycemia

Front 136

ASA- adverse effects

Back 136

-GI: GI bleeding, ulcerations, gastrits, N/V

-skin: urticaria

Front 137

ASA- actions

Back 137

-inhibits the formation of blood clots by blocking platelet aggregation

Front 138

ASA- indications

Back 138

-early in the treatment of MI in order to reduce infarct size and mortality

Front 139

ASA= GENERIC NAME

ASPRIN=TRADE NAME

CLASSIFICATION

Back 139

-platelet aggregation inhibitor

Front 140

ORAL GLUCOSE- special considerations

Back 140

-oral glucose must be swallowed because the glucose molecule is too large to be absorbed sublingually

-oral glucose has a short duration of action because it is provided in the form of a simple carbohydrate. therefore follow drug administration with an oral complex carbohydrate to maintain adequate blood sugar levels

Front 141

ORAL GLUCOSE- supplied

Back 141

-bottle: 300 mL/bottle

-gel paste: glucose pastes and gets in various forms (glucose gram concentration caries from supplier to supplier, so beware of the concentration you are delivering)

Front 142

ORAL GLUCOSE- dosage

Back 142

-25g administered slowly until a feeling of improvement is noted

Front 143

ORAL GLUCOSE- route

Back 143

-oral (po)

Front 144

ORAL GLUCOSE- contradictions

Back 144

-decreased level of consciousness with no gas reflex

-n/v

Front 145

ORAL GLUCOSE- adverse effects

Back 145

-GI: N/V

Front 146

ORAL GLUCOSE- action

Back 146

provides quickly absorbed form of glucose to increase blood glucose levels

Front 147

ORAL GLUCOSE- indications

Back 147

-conscious patients with suspected hypoglycaemia and intact gag reflex

Front 148

ORAL GLUCOSE- classification

Back 148

-Hyperglycemia

Front 149

EPINEPHRINE-

TRADE NAME- ADRENALIN- classification

Back 149

-sympathomimetic

Front 150

EPINEPHRINE- indications

Back 150

-anaphylaxis

Front 151

EPINEPHRINE- action

Back 151

-inhibits histamine release

Front 152

EPINEPHRINE- adverse effects

Back 152

-CVS: tachycardia, palpitations. hypertension, increased oxygen demand leading to arrhythmias

-CNS: nervousness

-GI: N/V

Front 153

EPINEPHRINE- contradictions

Back 153

-none in anaphylactic shock

Front 154

EPINHEPHRINE- route

Back 154

-IM

Front 155

EPINEPHRINE- dosage

Back 155

-0.3 mg=adult

-0.15mg=child

Front 156

VENTOLIN (TRADE NAME)

SALBUTAMOL (GENERIC)

classification

Back 156

bronchodilator

Front 157

VENTOLIN- indications

Back 157

-treatment of bronchospasm from asthma, chronic bronchitis or emphysema

Front 158

VENTOLIN- actions

Back 158

-bronchodilation, some peripheral vasodilation

Front 159

VENTOLIN- adverse effects

Back 159

-CNS: nervousness, tremor, dizziness

-CVS: tachycardia, palpitation

-RESP: serve paradoxical bronchospasm from repeated use

Front 160

VENTOLIN- route

Back 160

-inhaled

Front 161

VENTOLIN- dosage

Back 161

-administered metered dose inhaler pm

Front 162

ATROVENT (TRADE NAME)

IPRATROPIUM (GENERIC NAME)

classification

Back 162

-bronchodilator

Front 163

ATROVENT- indications

Back 163

-treatment of acute asthma attack and acute exacerbation of chronic abstractive pulmonary disease (CO)

Front 164

ATROVENT- action

Back 164

-bronchodilation

Front 165

ATROVENT- adverse effects

Back 165

-GI: dry mouth/ throat, bad taste

-MS: tremors

Front 166

ATROVENT- route

Back 166

-inhaled

Front 167

ATROVENT- dosage

Back 167

-administered meter does inhaler pm

Front 168

CHEMICAL NAME

Back 168

-these names are quite complex

-used to describe the medications molecular structure

-due to their complexity they are only used by chemists and scientists

Front 169

TRADE NAME

Back 169

-names drugs manufactures assign to their products

-always capitalized and are copyright protected

-usually refer to the condition they're designed to treat

-always followed by trademark symbol which indicates that the name is registered and only to be used by the drug manufacturer

-several different trade names may be used for one drug

Front 170

GENERIC NAME

Back 170

-names that have been assigned to the medication by independent council when a drug manufacturer chooses to market a new medication.

-never capitalized

-usually abbreviated version of the chemical name

Front 171

PHARMACODYNAMICS

Back 171

-study of how drugs affect living tissues in the body

Front 172

PHARMACOKINETICS

Back 172

-movement of drugs through the whole body

Front 173

4 PROCESSES OF PHARMACOKINETICS

Back 173

1)absorption:movement of drugs through the whole body

2)distribution:movement of drug from its concentrated from at the administration site to its diluted (and usually therapeutic) level distributed throughout the body

3)metabolism:chemical alteration of the drug (most often by the liver or kidneys although occasionally by other organs) to facilitate elimination

4)elimination:removing drugs from the body usually via urinary/digestive system and occasionally via the lungs or through the skin

Front 174

MEDICAL CONTROL

Back 174

-emr,emt or paramedics can only perform their scope of practice skill under the medical control of a physician and with ongoing medical audit.

-medications an EMR can administer to a patient falls under strict restrictions of medical control. any deviation would place EMR in violation of EMT regulation of the health discipline act and would be subject to disciplinary action

-orders within registered members scope of practice defining patient management

Front 175

SCOPE OF PRACICE

Back 175

actions and care legally allowed to be provided by EMR

Front 176

6 RIGHTS OF DRUGS ADMINISTRATIONS

Back 176

1)right patient

2)right medication

3)right dose

4)right route

5)right time and frequency

6)right documentation

Front 177

INHALED POISON

Back 177

enters body by being breathed into lungs

Front 178

INJECTED POISON

Back 178

enters body by bites, stings or injection by needles

Front 179

ABSORBED POISON

Back 179

enters body through skin

Front 180

INGESTED POISON

Back 180

enters body through swallowing or coming into contact with mouth or lips

Front 181

SIGNS AND SYMPTOMS OF INGESTED POISON

Back 181

-nausea -vomiting -jaundice -burns around lips, mouth and throat and abdomen -hyperactivity or drowsiness -ringing in ears -deep rapid breathing -diarrhea -odd breath odours

Front 182

SIGNS AND SYMPTOMS OF INHALED POISON

Back 182

-slow pulse -drooling -sweating -nausea -vomiting -diarrhea -respiratory distress -constricted pupils -headache -agitation -confusion -cherry red skin -breathing difficulty -chest pain -cough -cyanosis -seizures

Front 183

SIGNS OF NARCOTIC OVERDOSE

Back 183

-unconscious -extremely low or high bp

-breathing difficulty or inability to maintain open airway -sweating -abnormal/ irregular pulse -tremors -hallucinations -fever -vomiting with altered mental status or without gag reflex

-seizures -digestive problems

Front 184

SIGNS OF ALCOHOL INTOXICATION

Back 184

1)unconsciousness

2)paranoia

3)violence

4)low/high BP

5)lack of interest/ loss of memory

6)slurred speech and uncoordinated muscle movement

Front 185

UPPER

Back 185

stimulants that affect the CNS and excite users

Front 186

DOWNER

Back 186

depressants that relax the user by affecting CNS

Front 187

NARCOTICS

Back 187

affect CNS and many of body normal activities, produce intense state of relaxation and euphoria

Front 188

HALLUCINOGENS

Back 188

affect CNS and can produce intense state of excitement and distort perception of surroundings

Front 189

AEIOU-TIPS

Back 189

A-alcohol

E-epilepsy

I-insulin (hypoglycemia or hyperglycemia)

O-overdose

U-uremia (kidney faliure)

T-trauma

I-infarction (cardiac or cerebral)

P-poisoning, psychological

S-sepsis (infection)

Front 190

SIGNS AND SYMPTOMS OF STROKE

Back 190

-weakness or paralysis on one side of body

-loss of sensation

-speech problems

-facial drooping

-memory problems

-vision problems

-seizures

-unconsciousness

Front 191

TREATMENT FOR ASTHMA

Back 191

1)maintain and support patients airway

2)provide oxygen or ventilations using BVM

3)support vital signs and transport patient in sitting (fowlers) position to hospital

4)assist patient in taking their ventolin or atrovent inhalers as directed by their own prescription

5)reassess ABCs and vitals often and reassure patient

Front 192

ARTERIOSCLEROSIS

Back 192

chronic condition that causes artery walls to thicken, harden and lose their elasticity

Front 193

ACUTE CORONARY SYNDROME

Back 193

patient suffering from chest pain and other symptoms caused by the heart not getting enough blood

Front 194

HYPERTENSION

Back 194

high blood pressure, patients BP is over 240/90 mmHg on a regular basis

Front 195

HYPOTENSION

Back 195

low blood pressure, may occur due to anemia (lack of iron)

Front 196

ANGINA

Back 196

chest discomfort that occurs when theres a decrease in blood oxygen to area of heart muscle

Front 197

TREATMENT FOR PATIENT WITH MYOCARDIAL INFARCTION

Back 197

1)maintain and support patients airway

2)provide oxygen or ventilations using BVM

3)support cardiovascular system and be prepared for us of AED and CPR

4)support vital signs and transport patient in position of comfort

5)administer 160 mg of ASA if no contradictions

6)reassess ABCs and vitals often and reassure patient

Front 198

SIGNS AND SYMPTOMS OF HYPOGLYCEMIA

Back 198

-hunger

-cool clammy skin

-rapid pulse rate

-headache

-confusion

-rapid onset of decreased level of consciousness

-weakness

-irritability

-trembling

-seizures

-patient may appear intoxicated

Front 199

SIGNS AND SYMPTOMS OF HYPERGLYCEMIA

Back 199

-hunger

-thirst

-frequent urination

-flushed, dry, warm skin

-headaches

-blurred vision

-blurred vision

-weakness

-sweet fruit, acetone breath

-rapid weak pulse

-decrease LOC

-patient may appear intoxicated

Front 200

SIGNS AND SYMPTOMS OF ANAPHYLAXIS

Back 200

-upper airway stirdor, hoarsness, laryngeal edema

-lower airway wheezing

-decreased breath sounds

-bronchospams

-increased HR

-hypotension

-chest tightness

-edema

-dizziness

-weakness

Front 201

HOW TO PALPATE ABDOMEN

Back 201

1)ask where it hurts

2)assess that site last to get accurate assesment if theres pain elsewhere too

Front 202

COUP INJURY

Back 202

occur at the site of impact

Front 203

CONTRECOUP

Back 203

rebound effect causing injury to opposite side of brain

Front 204

SIGNS AND SYMPTOMS OF INCREASED INTRACRANIAL PRESSURE

Back 204

early signs; headache, nausea, vomiting, subtle changes in LOC

late signs; high blood pressure, decreased pulse rate, irregular breathing, seizures, dilated and sluggish pupils, decreased LOC, mechanism of injury

Front 205

TREATMENT FOR FLAIL SEGMENT

Back 205

1)control c-spine if suspected

2)maintain and support airway

3)provide oxygen or ventilations via BVM

4)splint chest with heavy dressing over injury site

5)treat for shock

6)treat any soft tissue injuries

7)support vitals

8)reassess ABCs and vitals often

Front 206

PNEUMOTHORAX

Back 206

-collection of free air in chest outside lungs, causing lung to collapse

Front 207

HEMOTHORAX

Back 207

-accumulation of blood in pleural space caused by bleeding from lungs or damaged vessels

Front 208

TREATMENT FOR OPEN PNEUMOTHORAX

Back 208

1)c-spine control if suspected

2)maintain and support airway

3)provide oxygen/ ventilations via BVM

4)apply occlusive dressing to open chest wound

5)support vitals

6)heart any soft tissue injuries

7)treat shock

8)reassess vitals and ABCs

Front 209

FIRST DEGREE BURN

Back 209

-superficial, causes local inflammation of skin, could be sunburn

-damage to epidermis

-pain and redness with mild swelling and tender to touch

Front 210

SECOND DEGREE BURN

Back 210

-deeper in addition to pain, redness and inflammation, blistering -damage to epidermis and dermis

Front 211

THRID DEGREE BURN

Back 211

-all layers of skin damaged, killing areas of never and blood vessel damage, skin appears white and leathery, relatively no pain

Front 212

BASILAR SKULL FRACTURE

Back 212

fracture of bones that form a base (floor) of the skull that results from severe blunt head trauma. commonly connects to sinus cavities, which may allow fluid to enter the inside of skull which could cause infection

Front 213

FRACTURES OF THE MANDIBLE

Back 213

facial injury, results in jaw bone breaking or moving out of position

Front 214

CLOSED HEAD INJURY

Back 214

no object actually penetrates the brain, can be diffuse meaning that they affect cells and tissues throughout the brain or focal meaning the damage occurs in one area.

can be mild to sever

Front 215

BRAIN CONTUSION

Back 215

bruise of brain tissues, caused by small blood vessel leaks.

Front 216

ASSESSING HEAD TRAUMA

Back 216

use methods of assessment which include observation, palpation, auscultation and history taking

establish LOC using AVPU and Glasgow coma scale

obtain full history from patient or bystander if unconscious

assess motor function and sensation of extremities

if patient is altered perform blood glucose test and remember AEIOU-TIPS

Front 217

GLASGOW COMA SCALE

Back 217

System for assessing LOC

eye opening; spontaneous=4, to voice=3, pain=2, none=1

verbal response;oriented=5, confused=4, inappropriate words=3, incomprehensible sounds=2,none=1

motor response;obeys commands=6, localize pain=5, withdraw(pain)=4, flexion(pain)=3, extension(pain)=2, none=1

score of 13-15=mild head trauma

8-12=moderate injury

8 and under=severe head injury

Front 218

TREATING HEAD TRAUMA

Back 218

1)take c-spine control if suspected

2)maintain an open and clear airway, be prepared to suction

3)quickly act with oxygen therapy and ventilations when needed

4)if signs and symptoms of intracranial pressure are present, elevate patients head

5)be prepared for seizures

6)transport to hospital

Front 219

FLAIL CHEST

Back 219

occurs when two or more adjacent ribs are fractured in two or more places, resulting in loss of body continuity and overall integrity of chest wall

Front 220

TREATING CHEST AND ABDOMINAL TRAUMA

Back 220

1)take c-spine control is needed

2)maintain open airway; be prepared for suction

3)quickly act with oxygen therapy and ventilation when needed

4)treat open chest wound with cclusive dressing taped on 3 sides

5)treat soft tissue injuries and control bleeding

6)treat for shock

7)transport to hospital qucikly

Front 221

ASSESING BURNS

Back 221

-scene safety

-determine mechanism of burn

-use methods of assessment;observation, palpation, osculation and history taking

-establish LOC

-assess burn type and depth

-calculate body surface area of burn

-obtain full patient history

Front 222

TREATING BURNS

Back 222

1) c-spine control if suspected

2)stop burning process. be careful with chemical burns

3)maintain open and clear airway

4)quickly act with oxygen and ventilation when needed

5)if burns=less than 10% of body surface area, cover burns with cool moist dressing

if burns=more than 10% of body surface area, remove cool dressings and cover with dry burn sheets or dressings

6)keep patient warm

7)treat for shock

8)with electrical burns treat possible fractures and cardiac arrest

9)transport to hospital or burn centre if critical

Front 223

SPRAINS

Back 223

occur as injury to ligament when joint is carried through range of motion greater than normal. results in partial tearing of ligament. may also result in damage to surrounding blood vessels, muscles, tendons and nerves

Front 224

FRACTURES

Back 224

brak in continuity of bone or cartilage. further classified as open (compound) or closed.

open=can have further complications with bleeding and infection

Front 225

DISLOCATIONS

Back 225

joint dislocation occurs when articulating ends of two or more bones are displaced, shoulders, knees and hips are common sites

Front 226

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL INJURIES

Back 226

-deformity or angulation

-pain and tenderness

-grating or crepitus

-swelling

-bruising or discolouration

-exposed bone ends

-joint locked in place

-snap or crack heard by patient

Front 227

ASSESING MUSULOSKELETAL TRAUMA

Back 227

-determine mechanism of injury

-establish LOC

-use methods of assessment; observations, palpation, auscultation and history taking

-expose fracture and asses dital pulse, motor function and sensation

Front 228

TREATING MUSCULOSKELETAL TRAUMA

Back 228

1)take c-spine control if suspected

2)maintain open and clear airway

3)act with oxygen and ventilations when needed

4)manually stabilize injury if resources available

5)splint extremity injuries to reduce pain and swelling, assess pulses before and after splinting

6)treat soft tissue injuries

7)remember RICE- rest,ice,compression, elevate

8)treat for shock

9)transport to hospital

Front 229

TREATMENT FOR BLEEDING

Back 229

1)apply direct pressure to wound

2)elevate bleeding extremity

3)asses bleeding

4)use pressure points

Front 230

TOURNIQUET APPLICATION

Back 230

1)select bandage 10cm wide and 6-8 layers deep

2)wrap it around extremity twice at a point above but as close as possible to wound

3)tie knot in bandage and place a stick or rod on top of it, tie the ends of the bandage around the stick

4)twist stick until bleeding stops, then secure rod or stick in position

5)note time

6)notify paramedics who take over patient care that you applied tourniquet

Front 231

NOSEBLEED TREATMENT

Back 231

1)keep patient still and calm, have them lean forward to prevent aspiration or blood into lungs

2)apply pressure by pinching nostrils together

3)apply cold compress to nose and face

4)instruct patient to avoid blowing nose for several hours

Front 232

INTERNAL BLEEDING TREATMENT

Back 232

1)maintain open and clear airway and adequate breathing, supply high flow oxygen via NRB, artificial ventilations if needed

2)control any external bleeding with direct pressure, elevation and pressure points

3)keep patient warm

4)treat for shock

Front 233

SOFT TISSUE INJURY TREATMENT

Back 233

1)assess and treat all life threats

2)expose the entire injury site

3)control bleeding

4)prevent further contamination

5)dress and bandage wound

Front 234

IMPALED OBJECT TREATMENT

Back 234

1)manually secure object to prevent any movement

2)expose entire wound area

3)control bleeding, applying direct pressure to edges of wound

4)use bulky dressing to help stabilize object

Front 235

IMPALED OBJECT IN CHEEK

Back 235

1)while maintaining open airway feel to see if objected penetrated cheek completely

2)remove object in direction it entered

3)control bleeding from outside cheek, dress wound

4)if object penetrated cheek completely pack inside of mouth between cheek wall and teeth with sterile gauze

5)continue to monitor airway

Front 236

LARGE OR OPEN NECK WOUNDS

Back 236

1)place gloved hand over wound to control bleeding

2)apply occlusive dressing make sure it extends beyond wound on all sides to prevent it from being sucked in, tape on all 4 sides

3)cover occlusive dressing with regular one then apply enough pressure to control the bleeding

4)once bleeding is controlled, apply pressure dressing, don't restrict airflow or compress major blood vessels

Front 237

SHOCK

Back 237

a condition where tissues in body don't receive enough oxygen and nutrients to allow cells to function- leading to cellular death and progressive organ failure and death

Front 238

CARDIOGENIC SHOCK

Back 238

results from cardiac pump not being able to deliver adequate circulating blood volume for tissue perfusion

Front 239

NEUROGENIC SHOCK

Back 239

(spinal) results from vasomotor paralysis below the level of injury, normal vasomotor tone through sympathetic NS control is lost and there is a result of decrease in peripheral vascular resistance

Front 240

HYPOVOTEMIC SHOCK

Back 240

results from lack of circulating volume via hemorrhage/ dehydrating caused by urns, hemorrhage, diarrhea and vomiting

Front 241

SEPTIC SHOCK

Back 241

results from serious systemic bacterial infection

Front 242

CAUSES OF SHOCK

Back 242

-failure of the heart

-abnormal dilation of blood vessels

-blood volume loss

Front 243

ASSESSING SHOCK

Back 243

-determine MOI

-establish LOC

-use methods of assessment; observation, palpation, auscultation and history gathering

-asses for signs of poor perfusion

Front 244

STAGES OF SHOCK

Back 244

1)compensated shock- body uses it's defence to try to maintain normal function

2)decompensated shock- body can no longer make up for reduced perfusion

3)irreversible shock- blood flow is so low body cells are dying

Front 245

TREATING SHOCK

Back 245

1)take c-spine control if needed

2)maintain open and clear airway

3)supply oxygen and ventilations as needed

4)treat musculoskeletal and soft tissue injuries

5)control bleeding

6)treat for shock, elevate legs if no contradictions and keep patient warm

7)transport to hospital

8)reassure patient frequently

Front 246

FEMALE GENITALIA INJURY

Back 246

1)control bleeding with local pressure using compresses that's moist

2)dress wounds, bandage then with diaper like bandage

3)use cold packs over dressing to relieve pain and swelling

4)treat for shock

Front 247

MALE GENITALIA INJURY

Back 247

1)wrap injured penis in soft, sterile dressing that is moist

2)apply cold pack to relieve pain

3)never remove impaled objects (stabilize them)

4)if you can find avulsed skin, wrap it in sterile gauze that has been moistened

Front 248

FARM EQUIPMENT MECHANISMS OF INJURY

Back 248

1)pinch points: two objects meet to cause pinching or pulling action

2)wrap points: an aggressive component moves in a circular motion

3)shear points: two objects move close together to cause cutting action

4)crush points: two large objects come together to cause a crushing action

5)stored energy: hazards remain agter machinery has been shut down

Front 249

SILO GAS REACTIONS

Back 249

-eye irritation

-cough, possibly laboured breathing

-fatigue

-n/v

-cyanosis

-dizziness or sleepiness

Front 250

HYDROGEN SULPHIDE POISONING SYMPTOMS

Back 250

-cough

-irritation of mucus membranes

-nausea

-sudden collapse and respiratory paralysis (with high concentrations)

Front 251

HEAD INJURY SYMPTOMS

Back 251

-altered mental status

-unconsciousness

-irregular breathing

-open wounds to scalp

-penetrating wounds to head

-softness or depression of skull

-blood or CSF leaking

-facial bruises

-bruising around eyes

-bruising behind ears

-abnormal pulse, movement and sensation

-headache severe enough to be disabling or sudden

-n/v

-unequal pupil size w/ altered mental status

-seizure activity

Front 252

TREATMENT FOR HEAD INJURY

Back 252

1)manual stabilization of head and spine

2)make airway top priority

3)control bleeding and dress open wounds

4)apply rigid cervical immobilization device

5)monitor vital signs closely

6)calm and reassure patient

Front 253

EYE INJURY

Back 253

orbits: bones in skull that hold the eyeball check for bruising, swelling, lacerations, tenderness, deformity

eyelids:check for bruising, swelling, and lacerations

mucus membranes:check for redness,pus and foreign objects

globes (eyeballs): check for abnormal colouring, laceration, and foreign objects

pupils: check for size, shape, equality and check for reaction to light, pupils should be black, round and equal in size, should react to light by constricting

eye movement: check to see that eyes can move gaze or pain upon movement

Front 254

RULES FOR CARE FOR EYE INJURY

Back 254

-dont put direct pressure on eyeball, fluids inside are irreplaceable

-do not put salves or medications in injured eye

-dont remove blood or blood clots from eye, you can sponge it from face

-dont try to force eyelid open unless you have to flush chemicals

-dont let patient with eye injury walk without help

-patch both eyes

-dont allow patient to eat or drink

-never panic

Front 255

FOREIGN OBJECTS IN EYE

Back 255

-hold eyelids apart and flush eye with clean water

-if object is under upper lid, draw upper lid down over lower lid

-grasp eyelashes of upper lid and turn lid over cotton swab

-if under lower lid, pull down lower lid to expose inner surface

-use corner of piece of sterile gauze to remove object

Front 256

EYELID BLEEDING

Back 256

apply pressure only if not damage to eyeball itself

Front 257

CHEMICAL BURNS TO EYEBALLS

Back 257

-immediate and constantly irrigation with water while holding patients eyelid open

-pour water from inside corner across eyeball to outside edge. irrigate for 30-60 min

-remove any solid particles with moist cotton swab

Front 258

EXTRUDED EYEBALL

Back 258

-dont try to replace it, cover with moist dressing and protective cup. no pressure!

apply bandage that covers both eyes

Front 259

GENERAL RULES OF SPLINTING

Back 259

-be sure you have taken BSI precautions before splinting

-dont release manual stabilization of injured extremity until it is properly and completely immobilized

-never intentionally replace protruding bones or push them back

-you can't assess what you can't see, tear away all clothing

-control bleeding and dress all open wounds before applying splint

-if long bone is injured immobilize joints above and below

-if injured joint, immobilize it and bones above and below

-if limb is severely deformed by injury or limb has no pulse or is cyanotic below injury site, align mental manual traction (pulling)

-pad splint before applying it

-before and after applying splint assess pulse, movement and sensation below injury site.

-reassess every 15 min

Back 260

life threatening-injury, illness ore environmental conditions have affected hypothalamus, part of brain that acts as thermostat, resulting in loss of ability to control body temp. resulting in body temp rising.

if body temp exceeds 41 degrees celsius it can be fatal

Front 261

HEAT EXHAUSTION

Back 261

not life threatening- body is depleted of salt and water. occurs in people who are in hot, humid environments, more common in elderly and children

Front 262

SIGNS AND SYMPTOMS OF HEAT STROKE

Back 262

-skin temp=hot

-skin colour=flushed

-skin condition=dry

-respiration=panting

-pulse=increased, strong, regular

-loc=disoriented, nauseous, vomiting

Front 263

SIGNS AND SYMPTOMS OF HEAT EXHAUSTION

Back 263

-skin temp=cool

-skin colour=pale

-skin condition=moist

-respiration=rapid and shallow

-pulse=increased, regular, weak

-loc=minimal decrease possible syncope

Front 264

HEAT STROKE AND EXHAUSTION TREATMENT

Back 264

if patient is experiencing temperature increase, actively cool them to return body temp to 37 degrees celsius

Front 265

HEAT CRAMPS

Back 265

muscle cramps (usually in lower extremities and abdomen) occur as result of profuse sweating and subsequent loss of sodium due to high temperatures or humidity

Front 266

FROSTBITE

Back 266

localized injury occurring when exposed to cold causes body tissue to freeze. usually affecting fingers, toes, ears and nose

caused when tissue is exposed to cold environment, vasoconstriction of peripheral blood vessels occur resulting in cellular damage. ice crystals begin to form in extra cellular spaces and draw water from cell, dehydrating it and resulting in cellular shrinkage, electrolyte concentrations increase to toxic levels and destroy cellular proteins

Front 267

FROST NIP

Back 267

comes on slowly, generally not painful. seen if patient looks in mirror and sees pallor of nose or ears

Front 268

SUPERFICIAL FROSTBITE

Back 268

limited to skin and subcutaneous tissue. skin may be white and waxy, loss of sensation, stiff on palpation but underlying tissues are soft

Front 269

DEEP FROSTBITE

Back 269

serious injury, usually affects hands and feet, looks white or yellowish and way, cold hard and insensitive to touch.

major tissue damage occurs not from freezing of tissues but from thawing process.

Front 270

HYPOTHERMIA

Back 270

mild hypothermia= 32-35 degrees celsius (shivering, lethargy, poor judgment, ataxia, loss of fine motor coordination)

moderate hypothermia=29-32 degrees celsius(stupor, delirium, slow reflex, dysrhythmia)

sever hypothermia=below 29 degrees celsius (coma, unresponsive, hypotension, asystole)

Front 271

SCENE HAZARDS- environmental emergency (scene survey)

Back 271

scene is potentially a hazard and cause of injury or illness. patients are found outside, cold or hot environment could be a hazard

Front 272

DECISION FOR BACKUP-environmental emergency

(scene survey)

Back 272

backup may be important with regard to back country rescue or managing patient who is altered or in cardiac arrest

Front 273

NUMBER OF PATIENTS-environmental emergency

(scene survey)

Back 273

most calls involving environmental emergency require management of one patient, but may be times where theres groups of people

Front 274

MOI-environmental emergency

(scene survey)

Back 274

primary mechanism is exposure to cold or hot, must be aware that these may not always be outside. (suspect injury without outdoor emergencies)

Front 275

BSI EQUIPMENT- environmental emergencies

(scene survey)

Back 275

wearing protective equipment will reduce risk of exposure to bodily fluids, and elements of outdoors

Front 276

PATIENT OVERVIEW-environmental emergency

Back 276

observe patient for signs of distress along with signs of illness and injury

looking for mechanisms of spinal injury

Front 277

LOC-environmental emergencies

Back 277

prepare to manage unconscious and altered patients. may appear intoxicated and aggressive if they have hypothermia

Front 278

ABCs-envronmental emergencies

Back 278

airway: open and clear?

breathing:rate, rhythm and quality

circulation:rate, rhythm and quality

Front 279

HEAD TO TOE EXAMINATION-environmental emergencies

Back 279

signs and symptoms will vary depending on patient and type and length of exposure, rapid assessment of patient, looking for injuries or abnormalities will help identify and treat presenting problems

assess face and extremities for local cold injuries like frostbite

Front 280

HISTORY-environmental emergencies

Back 280

-AMPLE history from patient, bystander or scene

-where did exposure occur?

-how long was the patient exposed?

-what effects is patient experiencing?

-what interventions have already been done?

Front 281

TREATMENT-environmental emergencies (cold)

Back 281

1)c-spine control if suspected

2)treat airway problems, provide oxygen, ventilations and suction as needed

3)remove patient from cold environment and handle gently

4)remove wet and cold clothing and warm patient

5)transport

6)reassure patient

Front 282

TREATMENT-environmental emergencies (hot)

Back 282

1)c-spine control if suspected

2)treat airway problems, provide oxygen, ventilation and suction as needed

3)remove patient from hot environment

4)cool patient by loosening and removing clothing, apply ice pack to neck, armpits and groin

5)transport

6)reassure patient

Front 283

REASSESSMENT-environmental emergencies

Back 283

-perform ongoing assessment with monitoring of vitals and any patient care being provided

-reassess ABCs and vital often

Front 284

TRANSPORT DECISION

Back 284

1)scene overview

2)patient overview

3)primary survey with critical interventions

load and go; stay and stabilize;

4)history 4)history

5)package 5)vitals

6)transport 6)reassessment survey

7)vitals 7)treatment

8)reassessment survey 8)package

9)treatment 9)transport

Front 285

SCENE SURVEY

Back 285

-any hazards? (electrical, animals, vehicles, violent people, chemicals?)

-how many patients?

-what BSI equipment do I need?

-do i need other resources? (fire, police?)

-what is the MOI? (injury? illness?)

-is there bystander info?

Front 286

PATIENT OVERVIEW

Back 286

-what is the patients position and level of distress?

-any angulated fractures? pooling of blood?

-skin colour and condition?

-am i ruling c-spine in or out? (if suspected, delegate someone to hold c-spine)

Front 287

LOC

Back 287

-state name, i am an EMR, whats your name? can you take a deep breath? does it hurt anywhere?

-AVPU

Front 288

ABCs

Back 288

-airway clear and open?

-any abnormal sounds from airway (snoring or gurgling?) critical interventions= open airway, suction, airway adjunct

-is patient breathing? rate, rhythm and quality of breathing. critical interventions=oxygen therapy ventilation support

-do they have a pulse at radial and carotid? rate, rhythm and quality of circulation? skin colour and condition. critical interventions=chest compressions, AED, control major bleeding)

Front 289

HEAD TO TOE EXAM- HEAD

Back 289

-any pain or discomfort?

-DCAPBLSTIC

-battle signs and racoon eyes. (nose, mouth, eyes and ears for fluid)

Front 290

HEAD TO TOE EXAM-NECK

Back 290

-pain or discomfort?

-DCAPBLSTIC

-JVD (jugular vein distension)

-medical alert necklace?

-tracheal deviation

(delegate someone to put on c-collar if suspected)

Front 291

HEAD TO TOE EXAM-CHEST

Back 291

-pain or discomfort?

-DCAPBLSTIC

-sucking chest wound or flail segment

-equal chest expansion, accessory muscle use, medical patches, scars, implanted pacemakers or defibrillators

-listen for breath sounds, present and equal? any odd sounds? (wheezing or crackles?)

Front 292

HEAD TO TOE EXAM-ABDOMEN

Back 292

-does patient have any pain or discomfort

-DCAPBLSTIC

-distension, rigidity and tenderness (DRT)

-needle marks or scars?

-pulsating masses?

Front 293

HEAD TO TOE EXAM-PELVIS

Back 293

-any pain or discomfort?

-DCAPBLSTIC

-incontinence orpriapism

Front 294

HEAD TO TOE EXAM-LOWER EXTREMITIES

Back 294

-pain or discomfort?

-DCAPBLSTIC

-circulation, motor and sensation (CMS)

-needle marks and medical alert

Front 295

HEAD TO TOE EXAM-HIDDEN BLEED CHECK

Back 295

-feel under hollows of body for any significant bleeding or fluids

Front 296

HEAD TO TOE EXAM-UPPER EXTREMITIES

Back 296

-pain or discomfort?

-DCAPBLSTIC

-circulation, motor and sensation (CMS)

-needle marks and medical alert

Front 297

HEAD TO TOE EXAM-BACK

Back 297

-pain or discomfort?

-DCAPBLSTIC

Front 298

LOAD AND GO CRITERIA

Back 298

1)altered LOC

2)airway compromise

3)respiratory compromise

4)circulatory compromise

5)bilateral femur fractures

6)fractured pelvis

(delegate patient packaging as history is being done)

*VITALS ARE NOT DONE ON SCENE WITH LOAD AND GO PATIENT*

Front 299

REASSESSMENT SURVEY

Back 299

-reassess for LOC

-reassess airway, breathing and circulation

-reassess treatment and critical intervention done

-perform another head to to exam

*PERFORM VITALS AGAIN AND PATCH HOSPITAL BEFORE ARRIVAL*

Back 300

-reassess for LOC

-reassess airway, breathing and circulation

-reassess treatment and critical intervention done

-perform another head to to exam

*PERFORM VITALS AGAIN AND PATCH HOSPITAL BEFORE ARRIVAL*

Front 301

FOUR PROCESSES OF PHARMACOKINETICS-

absorption

Back 301

movement of drug from site of administration into body

affecting factors:food in stomach, shock, vomiting and diarrhea

effect:slows absorption of pills, shunt blood to core, inadequate absorption before vomiting, inadequate absorption prior to elimination

Front 302

FOUR PROCESSES OF PHARMACOKINETICS-

distribution

Back 302

movement of drug from concentrated form at administration site to its diluted (usually therapeutic) level distributed throughout body

affecting factor:shock

effect:shunts blood to core away from desired areas of distribution

Front 303

FOUR PROCESSES OF PHARMACOKINETICS-

metabolism

Back 303

chemical alteration of drug (most often by liver or kidneys, occasionally by other organs) to facilitate elimination

Front 304

FOUR PROCESSES OF PHARMACOKINETICS-

elimination

Back 304

removing drugs from body, usually via urinary or digestive system and occasionally via lungs or through skin

affecting factor: liver disease, renal disease

effects:most drugs are metabolized by liver or kidneys, drugs that are not metabolized usually exert effects longer

Front 305

HALF-LIFE

Back 305

length of time it take initial dosage of a drug to be reduced to half its original size or concentration

Front 306

THERAPEUTIC INDEX

Back 306

measure of relative safety of a drug. drug with a high therapeutic index can be administered with less risk than a risk with a low one

Front 307

PEAK LEVEL

Back 307

stage at which highest concentration of a drug is present in a patients bloodstream

Front 308

LETHAL DOSE

Back 308

dosage of a drug that if administered to patient would be fatal

Front 309

ONSET OF ACTION

Back 309

amount of time it take for a medication to start working

Front 310

DURATION

Back 310

length of time particular dosage of drug will be active in body, duration a drugs remains active depends on onset of action and how quickly the drug metabolized or degraded, also depends on whether or not there is an antagonist present

Front 311

AGONIST

Back 311

substance that binds to receptor and alters the state of that receptor resulting in biological effect

Front 312

ANTAGONIST

Back 312

substance that limits or slows effect of medication by preventing it from binding to receptor

Front 313

DROWNING

Back 313

death from suffocation due to submersion. can be a result of cold, fatigue, injury and disorientation, intoxication and limited swimming ability

Front 314

FRESH WATER DROWNING

Back 314

water passes through the patients lugs into blood stream there it may cause hemodilution (thinning of blood by excess water) and destruction of RBCs.

more commonly simple suffocation is the cause of death

Front 315

SALTWATER DROWNING

Back 315

aspirated water is saltier than body fluids so water leaves blood and enter lungs to help dilute salt, air in lungs mixes with fluids and form frothy foam which act a barrier for oxygen exchange which can result in death

Front 316

WET DROWNING VS DRY DROWNING

Back 316

wet:occurs when fluid is aspirated into lungs

dry:when severe muscle spasm of larynx closes it and prevents aspiration and respiration (10%-40% of all drownings are dry)

Front 317

WARM VS COLD WATER DROWNING

Back 317

cold water (below 20 degrees celsius): result in successful resuscitations even up to 90 min after submersion, slows down body's metabolism and reduces need for oxygen

Front 318

GENERAL GUIDELINES FOR EMERGENCY CARE FOR DROWNINGS

Back 318

1)scene assessment

2)patient condition (conscious? injuries? location? water visibility? water temperature? is it moving water? how deep is it? any other hazards? rescuers and special resources?

Front 319

EMERGENCY MEDICAL CARE FOR DROWNING WHEN PATIENT IS CONSCIOUS AND NO SPINAL INJURY

Back 319

1)remove patient from water

2)complete primary assessment- administer oxygen

3)conserve patients body heat-remove wet clothing place patient on blanket and then cover with another blanket

4)perform secondary assessment and patient history

Front 320

EMERGENCY MEDICAL CARE FOR UNCONSCIOUS PATIENT IN SHALLOW WATER

Back 320

1)get alongside patient

2)extend patients arms straight up alongside head, press arms against head to create splint

3)make sure patient is in horizontal position

4)rotate patient by bringing arm father away toward you and pushing the arm closest to you downward. as you rotate lower yourself into water until water is at shoulder level

5)maintain stabilization of patients head, with one hand between their arms and other hand on patients lower back

Front 321

NPA AIRWAY ADJUNCT

Back 321

1)BSI gear

2)check for gag reflex- used when patient has gage reflex

3)measure NPA from corner of patients mouth to tip of earlobe

4)lubricate NPA

5)insert NPA- bevelled side towards septum, if you meet resistance gently rotate into place, try other nostril if you still meet resistance

6)confirm correct placement- flange of NPA should be against patients nostril

7)monitor patient closely-check to see if air is moving as patient breathing or as you ventilate

Front 322

OPA AIRWAY ADJUNCT

Back 322

1)BSI gear

2)check for gag reflex- used when patient has no gag reflex (brush eyelashes with finger to see if they have gag reflex)

3)measure OPA from corner of moth to tip of earlobe

4)open patients mouth using cross finger technique

5)insert OPA- insert upside down along roof of mouth, rotate 180 degrees when you meet resistance

6)confirm correct placement-should be against patients lips/teeth

7)monitor patient closely- anytime patient gags remove OPA

Front 323

OXYGEN THERAPY

Back 323

1)BSI gear

2)prepare equipment- Oxygen tank and regulator, NRB or NC

3)inform patient of procedure

4)select apporiate oxygen delivery device- NC=minor respiratory distress/illness

NRB:moderate to sever respiratory distress/illness

5)set litre flow to appropriate rate- NC=2-6L/min, NRB=10-15L/min (allow reservoir bag to fill first)

6)gently secure oxygen delivery device

7)monitor patient-signs of improvement, decreased respiratory rate, increased oxygen saturation, improved skin colour, decreased HR and improved LOC

Front 324

SUCTIONING

Back 324

1)BSI gear

2)prepare suction equipment-msuction tubing, catheters and container of sterile water

3)if possible-rotate patient on side

4)open patients mouth using cross finger technique

5)suction mouth- rigid tip-only suction to base of tongue, flexible catheter=measure it from patients earlobe to corner of mouth, apply suction as you move catheter side to side while withdrawing catheter from mouth

*NEVER SUCTION LONGER THAN 15 SEC*

6)reassess airway-airway for fluids, oxygenate patient

7)monitor patient closely- suction airway again if needed

Front 325

VENTILATION

Back 325

1)BSI gear

2)prepare ventilation equipment- pocket mask, BVM, supplementary oxygen

3)position yourself at patients head, open airway; no trauma=head-tilt chin life, spinal injury=jaw thrust manoeuvre, insert OPA or NPA

4)apply mask to patient-place mask over nose and lower to the chin, obtain seal

5)ventilate patient-using pocket mask=slow full breaths into one way valve, BVM=squeeze bag until patients chest rises; adults 10-12 breaths/min, infants and children=12-20 breaths/min

6)monitor patient-look for good signs of airway management.

Front 326

WOUND CARE

Back 326

1)BSI gear

2)inform patient of procedure

3)manually stabilize and support limb in neutral position

4)cut away clothing

5)control bleeding-apply manual pressure with gloved hand, abdominal pad or 4x4 dressings

6)select appropriate bandage/equipment-dont delay transport of load and go patient for bandaging, stabilize joints above and below injury site, maintain sterile techniques and cover wound, secure bandage snugly

7)reassess distal pulse, motor power and sensation after bandaging

8)monitor patient closely-treat with ice and elevate limb, reassess managed wound for pain and swelling

Front 327

TRACTION SPLINTS

Back 327

1)BSI gear

2)inform patient of procedure

3)delegate team member to apply manual traction

4)cut away clothing, bandage wounds and control bleeding

5)assess distal pulse, motor power and sensation prior to splinting

6)prepare traction splint- confirm indications for use of traction splint-closed mid-shaft femur fracture, confirm no contradictions-no pelvis, hip,knee, lower leg injury

7)apply traction splint- position splint and secure proximal end to hip, secure ankle on injured side to hitch, apply traction until pain is relieved or 10% of patients weight (max 15LB), secure splint to uninjured leg, avoiding strapping over injury site

8)monitor patient- distal pulse, motor power and sensation

Front 328

SPLINTING

Back 328

1)BSI gear

2)inform patient of procedure

3)manually stabilize extremity in neutral postion

4)cut away clothing, bandage wounds and control bleeding

5)asses distal pulse, motor power and sensation

6)select appropriate splinting device-dont delay load & go for splinting. immobilize joint above & below injury, pad splint before applying, avoid strapping over injury and joints

7)reassess distal pulse, motor power & sensation

8)monitor patient closely- treat with ice and elevation, reassess for pain and swelling

Front 329

SPINAL IMMOBILIZATION- SPINE BOARD

Back 329

1)BSI gear

2)inform patient of procedure

3)manually stabilize head, don't release c-spine until fully secure

4)apply c-collar

5)postion spine board next to patient

6)roll patient- team member at head is in control, examine back for signs of injuries, roll patient onto spine board as unit

7)secure torso to spineboard-chest and pelvis first

8)secure head to spine board- use blanket roll or head block, tape head to backboard

9)secure arms and legs if patient is altered or unconscious

10)monitor closely- distal pulse, motor power and sensation

Front 330

SPINAL IMMOBILIZATION- SCOOP STRETCHER

Back 330

1)BSI gear

2)inform patient of procedure

3)manually stabilize patients head- don't let go until full immobilized

4)apply c-collar

5)position scoop stretcher next to patient, use scoop stretcher for patients you cannot roll

6)secure two places of scoop stretcher under patient

7)secure chest and pelvis first

8)secure head with blanket roll or head block and tape head

9)secure arms and legs if patient is unconscious or altered

Front 331

SPINAL IMMOBALIZATION-KED

Back 331

1)BSI gear

2)inform patient of procedure

3)manually stabilize patients head- don't release until patient is fully immobilized

4)apply c-collar

5)positon KED- slide patient forward as a unit

6)secure patient to KED-chest straps and groin straps tight enough to secure patient, torso immobilized prior to head being secured

7)secure head with head straps and pad behind head if necessary

8)move patient and secure to long backboard- release leg straps before securing patient to backboard

Front 332

CPR AND AED

Back 332

1)BSI gear

2)determine patient is not breathing- look, listen and feel, check for no more than 10 seconds

3)ventilate patient-open airway & insert OPA, give 2 ventilations to patient using pocket mask or BVM with O2, if chest doesn't rise, reposition airway

4)check patients for pulse-palpate carotid, check for no more than 10 seconds

5)start chest compressions-30-2 chest compressions to ventilations, perform 2 min of CPR before AED use

6)turn on AED

7)analyze- stop CPR and clear patient, push analyze

8)deliver shock- say "I'm clear, you're clear, everybodys clear!" if shock advised, press shock, if no shock advised, check for pulse if not pulse start cps, if pulse reassess ABCs

9)continue CPR- no pulse after shock delivery, continue CPR for 5 cycles/2min

10)reanalyze and shock if needed

11)transport patient

Front 333

PRIMARY SURVEY

Back 333

1)scene survey-BSI,MOI, # patients, need for backup

2)patient overview-patient position and level of distress, angulated fractures and pooling of blood, skin color and condition

3)patient LOC and ABCs- communicate with patient, evaluate airway and breathing and circulation

4)primary assessment-perform head to toe assessment

5)tranport decision-load & go or stay and stabilize

6)overall review, systemic and uninterrupted assessments, communication with patient throughout

Front 334

PULSE OXIMETRY

Back 334

1)BSI gear

2)inform patient of procedure

3)turn pulse oximeter on

4)place oximeter on patients finger; make sure they don't have nail polish, patients toe can be used

5)observe for numerical reading- pulse reading and SPO2 reading

6)document pulse rate accurately and completely- document the oxygen saturation, document if patient is on oxygen during reading, be alert to changes between readings- treat patients complaint and not the oximeter

Front 335

RESPIRATION

Back 335

1)BSI gear

2)inform patient of procedure

3)observe patients chest and watch until you se it rise and fall-you can also place patients arm across chest and feel chest rise and fall or place stethoscope over chest and count respirations

4)accurately measure, rate, rhythm and quality- count number of times chest rises for 15 seconds, if irregular or difficult to obtain count number of times it rises in 30 seconds

5)perform examination of airway and chest for any signs of respiratory distress- look for accessory muscle use, listen for crackles and wheezes

6)document respiratory rate, accurately and completely- using 24 hour clock, rate rhythm and quality.

Front 336

SKIN CONDITION

Back 336

1)BSI gear

2)inform patient of procedure

3)assess skin condition- feel skin with back of hand, use forehead for assessment

4)take temp of patient- using thermometer of patient

5)document skin colour and condition and body temp- use 24 hour clock record temp in celsius

Front 337

PUPILS

Back 337

1)BSI gear

2)inform patient of procedure

3)assess pupil size and symmetry

4)assess pupil reactivity- dim light and use pen light to shine into eyes

5)document pupils size, symmetry and reactivity- 24 hour clock, size in mm

Front 338

BLOOD GLUCOSE

Back 338

1)BSI gear

2)inform patient of procedure

3)cleanse puncture site with alcohol swab

4)use lancet to puncture skin

5)apply small amount of blood to test strip

6)dispose of testing supplies in biohazard container

7)document-using 24 hour clock, results in mmol/L

(4-8=good reading)

Front 339

INHALED MEDICATION

Back 339

1)BSI gear

2)inform patient of procedure

3)complete vitals and patient history

4)determine need for medication and ensure no contradictions

5)check 6 rights

6)patient much be conscious

7)prepare medication for use-shake canister for 30-60 sec

8)administer medication to patient- get patient to exhale and then place inhaler mouthpiece in mouth and inhale deeply, hold breath for 10 sec

9)repeat if needed

10)reassess patient follow medication- LOC,ABCsl and vitals, document medication administration patient changes

Front 340

INTRAMUSCULAR MEDICATION

Back 340

1)BSI gear

2)inform patient of procedures

3)complete vital signs and patient history are done

4)determine need for medication and ensure no contradictions

5)check 6 rights

6)locate appropriate injection site-lateral aspect of patients thigh midway between waist and knee

7)prepare eli-pen- remove safety cap

8)administer medication to patient-push injector firmly against thigh until spring loaded need is deployed and medication is injected- hold at least 10 seconds

9)dispose of auto injector- withdraw needle from skin quickly and place in bio-hazard (sharps) container

10)reassess patient-LOC,ABCs and vitals, document medication administration and patient changes

Front 341

ORAL MEDICATION ADMINISTRATION

Back 341

1)BSI gear

2)inform patient of procedure

3)complete vitals and patient history are done

4)determine need for medication and ensure no contradictions

5)check 6 rights

6)patient must be conscious

7)prepare medication for use- 160 mg of ASA and place in patients hand, place tube of oral glucose in patients hand

8)administer medication to patient- have patient chew ASA and swallow, have patient squeeze liquid glucose into mouth swallow

9)reassess patient following medication administration- LOC,ABCs vitals, document medication administration and patient changes

Front 342

PULSE

Back 342

1)BSI gear

2)inform patient of procedure

3)locate appropriate pulse; radial, brachial,carotid,posterior tibialis, dorsalis pedis

4)accurately palpates appropriate pulse point-palpate artery walk with tips of index and middle fingers

5)accurately measure rate, rhythm and quality of pulse- count number of beats for 15 seconds, if difficult to obtain palpate for 30 seconds

Front 343

BLOOD PRESSURE BY PALPATION

Back 343

1)BSI gear

2)inform patient of procedure

3)position cuff and stethoscope- appropriate sized cuff snugly around upper arm, palpate radial artery first if not found the brachial artery

4)inflate cuff- with valve closed inflate cuff- when you no longer feel radial or brachial pulse inflate cuff 20-30mm higher

5)obtain systolic pressure-slowly release air from cuff- note point on the gauge when radial or brachial pulse returns

6)document blood pressure- use 24 hour clock, document systolic pressure by palpation- ex. 120/P

Front 344

PULMONARY CIRCULATION

Back 344

-deoxygenated blood enters right atrium from the superior vena cava, inferior vena cava and the coronary sinus

-deoxygenated blood is passes through tricuspid valve into right ventricle

-from right ventricle the deoxygenated blood is passed through the pulmonary semilunar valve into the pulmonary arteries delivering the blood to lungs

-gas exchange takes place in lungs which oxygenates the blood and removes waste products

-oxygenated blood enters left atrium through the pulmonary semilunar valves via the four pulmonary veins

Front 345

SYSTEMIC CIRCULATION

Back 345

-from left atrium oxygenated blood is pumped through the mitral valve into left ventricle

-oxygenated blood is then pumped through aortic valve in aorta

-oxygenated blood leaves top of heart pumping through arterial system and supplies oxygen and nutrients to the tissues as it reaches capillaries

-after body cells have used the oxygen and nutrients from blood then venous system returns the deoxygenated blood back to right side of heart through the superior vena cava and inferior vena cava

-the cycle begins again in right atrium with total systemic circulation taking about one minute