Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
104 Cards in this Set
- Front
- Back
|
Define "conduction."
|
The transfer of heat from one material to another through direct contact.
|
|
|
How does the body attempt to adjust to lost heat?
|
Reducing perspiration
Reducing circulation to the skin Generating muscular activity in the form of shivering Increasing the rate at which food is burned as fuel |
|
|
What are the five ways that the body loses heat?
|
1) Conduction
2) Convection 3) Radiation 4) Evaporation 5) Respiration |
|
|
In what cases is conduction (heat lost from one material to another through direct contact) sped up?
|
Patient lying on cold floor
Patient wearing wet clothes (water chill) |
|
|
Define "water chill."
|
Chilling caused by conduction of heat from the body when the body or clothing is wet
|
|
|
How much faster does water conduct heat away from the body than air?
|
25 times faster
|
|
|
Define "convection."
|
Carrying away of heat by currents of air or water or other gases or liquids.
|
|
|
Define "wind chill."
|
Chilling caused by convection of heat from the body in the presence of air currents.
|
|
|
Define "radiation."
|
Sending energy, such as heat, in waves off into space. The body loses heat by radiation, especially in the areas of the head and neck.
|
|
|
Define "evaporation."
|
Liquid turning into gas. When the body gets wet or perspires, heat is lost as the liquid on the skin vaporizes and leaves the skin.
|
|
|
Define "respiration."
|
Breathing. The body loses heat when warm air is exhaled.
|
|
|
What three factors determine how much body heat is lost due to respiration?
|
Ambient temperature
Rate of respirations Depth of respirations |
|
|
Define "hypothermia."
|
Generalized cooling that reduces core body temperature below normal, life threatening in its extreme.
|
|
|
What ten populations are specifically susceptible to hypothermia?
|
1) Patients with injuries
2) Patients with chronic illness 3) Patients in shock 4) Patients with burns 5) Patients with head/spinal injuries 6) Patients with generalized infection 7) Patients with diabetes with hypoglycemia 8) Patients under the influence of drugs or alcohol 8) Infants and young children 9) The elderly |
|
|
What symptoms would you see in a patient whose core temperature has dropped to 96º to 99º Fahrenheit?
|
Shivering
|
|
|
What symptoms would you see in a patient whose core temperature has dropped to 91º to 95º Fahrenheit?
|
Intense shivering
Difficulty speaking |
|
|
What symptoms would you see in a patient whose core temperature has dropped to 86º-90º Fahrenheit?
|
Shivering decreasing
Strong muscular rigidity Poor muscle coordination Unclear thinking, poor mentation |
|
|
What symptoms would you see in a patient whose core temperature has dropped to 81º-85º Fahrenheit?
|
Patient becomes irrational
Patient loses orientation Patient lapses into stupor Bradycardia Bradypnea |
|
|
What symptoms would you see in a patient whose core temperature has dropped to 78º-80º Fahrenheit?
|
Patient loses consciousness
Patient becomes unresponsive Reflexes cease to function Severe bradycardia leading to cardiac arrest |
|
|
Even if another condition may be the more obvious problem, in what six cases must you also always be thinking of hypothermia?
|
1) Ethanol ingestion
2) Underlying illness 3) Overdose or poisoning 4) Major trauma 5) Outdoor resuscitation 6) Decreased ambient temperature |
|
|
Why are infants more prone to hypothermia than adults?
|
They have a high skin surface area in comparison to their total body mass. They have little body fat. Their small muscle mass impairs shivering.
|
|
|
Why are the elderly more prone to hypothermia than middle-aged adults?
|
Failing body systems, chronic illness, poor diet, certain medications, lack of exercise
|
|
|
If you respond to an elderly patient with a broken hip who has been lying in a room that's heated to 68º Fahrenheit for some time, what must you consider?
|
The possibility of hypothermia. The elderly require higher ambient temperatures than the young, and conduction of heat to the floor speeds up the cooling of the body.
|
|
|
If you respond to an auto collision and have to work for hours extricating a patient, what steps can you take to reduce the chance of hypothermia?
|
Cover patient with blankets, towels, or articles of clothing -- especially head and neck
Plug holes in wreckage with towels if wind is coming through Rotate warm blankets from the heated ambulance |
|
|
What are some signs and symptoms of hypothermia?
|
Shivering (early stages)
Red skin (early stages) Rapid breathing and pulse (early stages) Numbness Stiff or rigid posture Drowsiness or inability to do simple activities Slow breathing and pulse (mid- to late stages) Loss of coordination Stiffness Decreased level of consciousness Cool abdominal skin temperature |
|
|
Define "passive rewarming."
|
Covering a hypothermic patient and taking other steps to prevent further heat loss and help the body rewarm itself.
|
|
|
Define "active rewarming."
|
Application of an external heat source to rewarm the body of a hypothermic patient.
|
|
|
When can an EMT use active rewarming to help a hypothermia patient?
|
When local protocols dictate. Certain EMS systems do not permit active rewarming procedures.
Patient must be alert and responding appropriately Rewarming should be done en route to receiving facility |
|
|
What six steps must be followed for the treatment of a hypothermic patient who is alert and responding appropriately?
|
1) Remove all wet clothing
2) Cover with dry clothing or blankets 3) IF ALLOWED BY LOCAL PROTOCOLS, actively rewarm the patient. Do not warm the patient too quickly, or you run the risk of increased circulation passing cold distal blood quickly to the internal organs, actually dropping core temperature and worsening the situation. 4) Provide care for shock 5) Give alert patient warm liquids slowly. Do not allow patient to consume stimulants. 6) Except in the mildest cases (shivering), transport the patient |
|
|
What four guidelines should always be followed during active rewarming?
|
1) Rewarm the patient slowly
2) Use central rewarming -- heat should by applied to lateral chest, neck, armpits, groin. DO NOT rewarm the limbs. 3) If transport must be delayed, a warm bath is very helpful, but not TOO warm, and make sure that the patient remains responsive and doesn't drown. 4) Keep patient at rest. |
|
|
Define "central rewarming"
|
Active rewarming of the body by application of heat to the lateral chest, neck, armpits, and groin of a hypothermic patient.
|
|
|
What four steps must be followed for the treatment of a patient who is hypothermic and unresponsive or not responding appropriately?
|
1) Ensure an open airway
2) Provide high-concentration oxygen that has been passed through a warm-water humidifier 3) Wrap patient in blankets 4) Transport immediately PASSIVE REWARMING ONLY, HANDLE PATIENT GENTLY! |
|
|
How slow can the heart rate drop in a patient with severe hypothermia?
|
Lower than 10 BPM
|
|
|
If you find a patient with suspected severe hypothermia (unresponsive and cold), what are the two main steps to remember in caring for the patient?
|
1) Assess the carotid pulse for 30 to 45 seconds. If there is no pulse, start CPR and prepare AED
2) If there is a pulse, follow care steps for a patient who is unresponsive or not responding properly |
|
|
You're not dead until...
|
...you're warm and dead.
|
|
|
Define "local cooling."
|
Cooling or freezing of particular parts of the body
|
|
|
How do you classify a localized cold injury?
|
Early or superficial, or late or deep
|
|
|
What body parts are most prone to local cooling injuries?
|
Ears, face, nose, hands, feet
|
|
|
What exactly happens during a local cooling injury?
|
Distal blood vessels constrict
Ice crystals form Tissues freeze In the worst cases, gangrene can set in and lead to amputation |
|
|
What's another word for early or superficial local cold injuries?
|
Frostnip
|
|
|
What are the signs and symptoms of an early or superficial local cold injury?
|
Affected area in light-skinned patients reddens
Affected area in dark-skinned patient lightens In all patients, the skin eventually blanches Affected area goes numb |
|
|
What three steps do you take to care for an early or superficial cold injury?
|
1) Get patient out of cold environment
2) Warm the affected area 3) If injury is to an extremity, splint and cover. DO NOT massage, DO NOT re-expose to cold. |
|
|
What is a common symptom of a local cold injury as it begins to warm?
|
Tingling or burning sensations.
|
|
|
What are signs and symptoms of a late or deep cold injury?
|
Affected skin appears white and waxy
When actual freezing occurs, skin turns mottled or blotchy, skin turns grayish yellow and then grayish blue Swelling and blistering may occur Affected area feels frozen on the surface, but tissue is resilient inside |
|
|
What's another word for a deep or late local cold injury?
|
Frostbite
|
|
|
What three steps do you take to care for a patient with frostbite, or a late or deep local cold injury?
|
1) Administer high-concentration oxygen
2) Transport to medical facility without delay 3) Keep patient indoors, keep him warm. DO NOT allow patient to drink, smoke, or drink coffee, and handle patient gently! |
|
|
How often is active rewarming of frozen body parts recommended?
|
Rarely. There is a high chance of permanently damaging tissues.
|
|
|
Do some EMS systems have standing orders to actively rewarm frozen body parts?
|
Yes, but not many.
|
|
|
In the rare case that you're instructed to actively rewarm a frozen body part, what twelve steps do you take?
|
1) Heat water in container to 100º-105F
2) Remove clothing, jewelry, etc., from affected area 3) Fully immerse injured part -- do NOT allow part to touch sides or bottom of container. 4) Continuously stir water 5) Add fresh warm water when water temp falls below 100ºF 6) Gently dry affected area and apply sterile dressing once part no longer feels frozen and is turning red or blue. Separate toes and fingers with sterile dressings. Cover area with blankets 7) Keep patient at rest 8) Make sure that patient is kept warm 9) Continue to monitor patient 10) Assist in circulation according to local protocol 11) Do not allow limb to refreeze 12) Transport ASAP with limb slightly elevated |
|
|
Define "hyperthermia."
|
An increase in body temperature above normal, life-threatening in its extreme
|
|
|
Why is hyperthermia a great risk in dry, hot conditions?
|
Because moist heat generally tires people more quickly, whereas dry heat deceives people into working far past their exertion point.
|
|
|
What pre-existing conditions can hasten and intensify effects of heat exposure? (8)
|
1) Dehyrdration
2) Diabetes 3) Fever 4) Fatigue 5) High blood pressure 6) Heart disease 7) Lung problems 8) Obesity |
|
|
When a patient is falling victim to a heat exposure emergency, how will their skin appear?
|
Moist, pale, and normal or cool to the touch
|
|
|
What are heat cramps?
|
Painful muscle cramps that result from extended sweating and electrolyte loss due to exposure to heat.
|
|
|
What is heat exhaustion?
|
Heat exhaustion is a form of shock brought about by fluid and salt loss.
|
|
|
Who suffers most frequently from heat exhaustion?
|
Firefighters, construction workers, dock workers, those employed in poorly ventilated warehouses.
|
|
|
What are some signs and symptoms of a heat emergency patient with moist, pale, normal-to-cool skin?
|
1) Muscular cramps, usually in the legs and abdomen
2) Weakness or exhaustion, sometimes dizziness or periods of faintness 3) Rapid, shallow breathing 4) Weak pulse 5) Heavy perspiration 6) Loss of consciousness is possible for brief periods of time |
|
|
What steps do you follow in order to treat a heat emergency patient with moist, pale, normal-to-cool skin?
|
1) Remove patient from hot environment
2) Administer oxygen by nonrebreather mask at 15 lpm 3) Loosen or remove clothing to cool the patient by fanning without chilling him. Watch for shivering 4) Put patient in supine position with legs elevated. Keep him at rest. 5) If patient is responsive and not nauseated, have him drink small sips of water. Stop if patient becomes nauseated. 6) If patient experiences muscular cramps, apply moist towels over cramped muscles 7) transport |
|
|
What is heat stroke?
|
This is a term used to describe the condition of a heat emergency patient with hot skin.
|
|
|
When is it most common to find a patient in heat stroke (hot, dry skin)?
|
On hot, humid days.
|
|
|
What are some signs and symptoms you'll see in a heat emergency patient with hot and dry or moist sin?
|
1) Rapid, shallow breathing
2) Full and rapid pulse 3) Generalized weakness 4) Little or no perspiration 5) Loss of consciousness or altered mental status 6) Dilated pupils 7) Seizures may be seen 8) No muscle cramps |
|
|
How do you care for a heat emergency patient with hot skin?
|
1) Remove patient from hot environment
2) Remove clothing. Apply cool packs to neck, groin, and armpits. Keep skin wet by applying water by sponge or wet towels. Fan aggressively 3) Administer oxygen by nonrebreather mask at 15 lpm 4) Transport immediately. Should transport be delayed, immerse patient to neck in cool water. (for infants and children, start with lukewarm water) 5) Continuously monitor vital signs |
|
|
What types of medical emergencies are common during water-related accidents?
|
Fractured bones
Bleeding Soft tissue injuries Airway obstructionCardiac arrest Signs of heart attack Injuries to head and neck Hypothermia Substance abuse Drowning |
|
|
Who should attempt a deep water rescue?
|
Only those trained in water safety and rescue.
|
|
|
Define "drowning."
|
The process of experiencing respiratory impairment from submersion in liquid, which may result in death, morbidity, or no morbidity.
|
|
|
What happens during drowning?
|
A person in the water struggles to stay afloat and inhales water. As water flows past the epiglottis, a reflex spasm of the larynx seals the airway so effectively that little more water enters the lungs, and hypoxia begins to set in.
|
|
|
What percentage of people who die from drowning die just from lack of air?
|
About 10 percent
|
|
|
What is the cause of death for about 90 percent of drowning victims?
|
Either their final attempt at breathing draws water into the lungs, or water flows freely into the lungs when they lose consciousness.
|
|
|
Why must an EMT attempt to resuscitate a drowning patient even if it seems they suffered from cardiac arrest 30 minutes ago?
|
Because some patients in cold water can be resuscitated. When water temperature falls below 70ºF, biological death may be delayed.
|
|
|
Is it sometimes necessary to begin treatment of a drowning patient before they leave the water?
|
Yes. Rescue breathing and spine immobilization may be necessary.
|
|
|
How is ventilating a drowning patient different than ventilating other patients?
|
You may find some resistance and have to exert more force in ventilating a drowning patient.
This is due to possible gastric distension from water ingestion, and from a partially closed airway. |
|
|
What should you do if gastric distension interferes with ventilating a patient?
|
Roll the patient into recovery position. Have suction available. Place hand over epigastric region and apply firm pressure to relieve distension.
|
|
|
In terms of the spine, what should an EMT assume in the case of an unconscious patient in a water-related emergency?
|
Assume that the patient has spine injuries.
|
|
|
What comes first -- CPR or spinal immobilization?
|
CPR
|
|
|
What steps do you take to care for an unconscious patient in a water related emergency if you either have to wait on shore while they're rescued, or if the patient is already out of the water?
|
1) Do initial assessment and protect the spine
2) Provide rescue breathing. If no pulse, begin CPR and prepare AED. 3) Look for and control profuse bleeding. Take pulse over a full minute in the case of cold-water situations 4) Provide care for shock 5) Transport |
|
|
Define "air embolism."
|
Gas bubble in the blood stream. The more accurate term is "arterial gas embolism (AGE)"
|
|
|
Define "decompression sickness."
|
A condition resulting from nitrogen trapped in the body's tissues caused by coming up too quickly form a deep, long dive. A symptom is "the bends," or deep pain in muscles and joints.
|
|
|
If spinal injury is not suspected in a water-based emergency, what position should the patient be transported in?
|
Recovery position. Have suction available.
|
|
|
If resuscitation and immediate transport of a water-based emergency patient are NOT required, what do you do?
|
Cover patient to conserve body heat, complete focused history and physical exam
|
|
|
Should a drowning patient be allowed to walk?
|
No.
|
|
|
What pieces of information must you provide to medical control when calling in a drowning patient?
|
1) Fresh or salt water
2) Cold or warm water 3) Diving accident related? |
|
|
What two special problems are seen in scuba diving accidents?
|
Air emboli and decompression sickness
|
|
|
How long does it take decompression sickness to appear?
|
1 to 48 hours. 90 percent of cases will show signs within 3 hours.
|
|
|
What should divers NOT do within 12 hours of a dive, and why?
|
They shouldn't fly, because that may bring on decompression sickness.
|
|
|
What are some signs and symptoms of an air embolism?
|
Blurred vision
Chest pains Numbness and tingling in extremities Generalized or specific weakness Paralysis Frothy blood in mouth or nose Convulsions Sudden unconsciousness Respiratory arrest Cardiac arrest |
|
|
What are some signs and symptoms of decompression sickness?
|
Personality changes
Fatigue "The bends," or deep muscle and joint pains Itchy blotches or mottled skin Numbness or paralysis Choking Coughing Labored breathing Behavior similar to intoxication Chest pains Collapse and unconsciousness Rashes that keep changing in appearance |
|
|
What steps do you take in order to care for a patient with an air embolism or decompression sickness?
|
Maintain an open airway
Administer high flow oxygen Rapidly transport Contact medical direction regarding which facility to transport to Keep patient warm Position patient either supine or on the side |
|
|
What mnemonic device is used to remember how to retrieve a patient stuck in the water?
|
Reach
Throw and tow Row Go |
|
|
Define "venom."
|
A toxin produced by certain animals such as snakes, spiders, and some marine life forms.
|
|
|
What percent of the population will have an allergic reaction from insect stings or bites?
|
About 5 percent
|
|
|
How long does it usually take a brown recluse bite to produce a lesion
|
After about 12 hours, and this only happens with about 10 percent of cases
|
|
|
Which spider has a bite with a more immediate reaction -- black widow or brown recluse?
|
Black widow.
|
|
|
What are some signs and symptoms of an injected poisoning from an insect?
|
Altered states of awareness
Noticeable stings or bites on skin Puncture marks Blotchy skin Localized pain or itching Numbness in a body part Burning sensation that spreads Redness Swelling or blistering Weakness or collapse Difficult breathing and abnormal pulse rate Headache and dizziness Chills Fever Nausea and vomiting Muscle cramps, chest tightening, joint pains Excessive salivation and sweating Anaphylaxis |
|
|
What do you do with a poisonous, biting insect or animal that you find at the scene of a biting incident?
|
If safe, collect it and bring it with you. Make sure it's safe!
|
|
|
How do you care for a poisonous insect bite or sting?
|
1) Treat for shock
2) Call medical direction 3) Remove stinger or venom sac 4) Remove jewelry in affected limbs 5) If local protocol permits and wound is on an extremity (not a joint), place constricting bands above and below the bite site. It must be loose enough to slide a finger underneath. 6) Keep wound immobilized |
|
|
How many people in the US are bitten by poisonous snakes every year?
|
About 8000
|
|
|
How many people in the US die from snakebites a year?
|
about 10
|
|
|
What are some signs and symptoms of a snakebite?
|
1) Noticeable bite -- might just be a discoloration
2) Pain and swelling in area of bite. This can take 30 minutes to several hours 3) rapid pulse and labored breathing 4) Progressive weakness 5) Vision problems 6) Nausea and vomiting 7) Seizures 8) Drowsiness or unconsciousness |
|
|
What steps do you take to care for a snakebite victim?
|
1) Call medical direction
2) Treat for shock and conserve body heat 3) Locate fang marks and clean site with soap and water -- there may be only one fang mark 4) Remove any constricting items from extremity 5) Immobilize extremity, and keep extremity at or below level of heart 6) Apply light constricting bands if ordered by medical direction 7) Transport patient |
|
|
How far should constricting bands be from a bite wound?
|
2 inches above and 2 inches below
|
|
|
Should you ever place constricting bands on both sides of a joint?
|
No.
|
|
|
What is the most common life-threatening emergency that stems from a marine animal sting or poisoning?
|
Anaphylactic shock
|
|
|
What's the best device for an ice rescue?
|
A flat-bottomed aluminum boat.
|
|
|
Why shouldn't you rub a frozen body part?
|
Microscopic ice crystals can cause serious damage
|
