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182 Cards in this Set
- Front
- Back
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What differences are there in adult and pediatric vital signs?
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Pediatrics have lower BP, faster heart rate and more respirations
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Another name for the sympathetic nervous system
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Adrenergic
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Another name for the Parasympathetic nervous system
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Cholinergic
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Acetylcholine
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A neurotransmitter, widely distributed in body tissues, with the primary function of mediating the synaptic activity of the nervous system.
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4 terms that indicate Stimulation in the Sympathetic Divison
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Sympathomimetic
Sympathetic agonist Adrenergic Adrenergic agonist |
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What is a late sign of shock in the pediatric patient?
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Hypotension
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4 terms that indicate Stimulation in the Parasympathetic Divison
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Parasympathomimetic
Parasympathetic agonist Cholinergic Cholinergic agonist |
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5 terms that indicate Inhibition in the Sympathetic Divison
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Sympatholytic
Adrenergic blocker Sympathetic blocker Antiadrenergic Sympathetic antagonist |
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6 terms that indicate inhibition in the Parasympathetic Divison
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Parasympatholytic
Cholinergic blocker Parasympathetic blocker Anticholinergic Parasympathetic antagonist Vagolytic |
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Chronotrope positive and negative effects refer to a...
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A subsatnce that affects the heart rate.
Positive Chronotrope increase heart rate Negative Chronotrope decrease heart rate |
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Inotrope positive and negative effects refer to a...
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A substance that affects myocardial contractility
Positive Inotrope increase force of contraction Negative Inotrope decrease force of contraction |
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Cholinergic Drugs mimic what actions
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The parasympathetic nervous system
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At what time interval do you perform the APGAR test?
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1 minute and 5 minutes
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How would you position a pregnant patient that was punched in the stomach?
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Left Lateral Recumbant
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What is indicated from the S3 heart sound?
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Made by a failing right ventricle; usually indicative of CHF
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Anatomical and functional terms for the Autonomic nervous system what are the Anatomical name, Functional Term, Primary Neurotransmitter
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Sympathetic
Adrenergic Norepinephrine Parasympathetic Cholinergic Acetylcholine |
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What is the most likely medical problem with an army soldier running in hot weather that passed out?
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Heatstroke
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What do you do if a DNR/Comfort Care is produced after you have already begun CPR and/or ACLS measures?
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Leave IV's and Tube in place (chemical code)
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How do you care for a leg fracture?
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CSM x 3 and splint as found
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What is the proper care for a female patient with IUD bleeding?
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Establish IV and rapid transport
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How do you treat a powder burn patient?
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Dust off as much of the substance as possible, then wash off with COPIOUS amounts of water
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You have a 100mL of a 30% solution. How many grams are in the solution.
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Step 1: Convert 30% to .30 by moving the decimal to the left 2 spaces.
Step 2: Multiply 100 X .30 Step 3: 30 grams |
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What is the correct treatment of an eye injury?
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Rinse with copious amounts of water
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Remember the following when you are considering ratio measures:
Prescription 5:1,000 |
HAVE 5:1,000 solution
KNOW 5 parts drugs 1,000 parts solution WANT Ratio Solution |
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What common illness is associated with skin color and eye color that is jaundiced?
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Hepatitis C
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When setting up the ratio proportion, you must ask yourself the following:
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What do I HAVE? (strength/volume of drug on hand)
What do I WANT? (prescribed dosage of drug) |
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What is the most commonly used over the counter drug to treat heat emergencies?
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Aspirin
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How do you change grams to milligrams; change 0.5 g to milligrams
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By moving the decimal point three places to the right
0.5 = 500 |
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What is the recommended treatment of a 27 yo patient with difficulty breathing?
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Albuterol-1.25-2.5mg in 3mL via Nebulizer
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How would you treat a knife wound to the stomach?
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Sterile moist dressing
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Where would you most likely see pain associated with the pancreas?
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Mid-sternum, radiating to the back
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What is the recommended treatment for a sucking chest wound?
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3 sided occlusive dressing
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C7 Signa and symptoms of Hypernatremic Dehydration
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Dry and sticky mucous membrane, Flushed dry skin, Intense thirst, Increased body temp, Altered mental status
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What injury would you suspect a pregnant woman with a tearing feeling and associated bleeding has?
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Abruptio Placenta
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C7 Hypernatremic Dehydration treatment
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Volume replacement with isotonic solution.
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How many mL bolus would you give if your order was 3mg and the medication came packaged 10mg in 5mL?
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3
------------- = 1.5 mL 10 x 5 |
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C7 Hyponatremic Dehydartion signs and symptoms
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Muscle cramps, seizures, Rapid thready pulse, profuse sweating, cyanosis
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C7 Hyponatremic Dehydartion traetment
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IV fluid replacement
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C7 A shortage of potassium in body fluids may cause
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A potentially fatal condition known as hypokalemia, typically resulting from diarrhea, increased diuresis and vomiting. Deficiency symptoms include muscle weakness, paralytic ileus, ECG abnormalities, decreased reflex response and (in severe cases) respiratory paralysis, alkalosis and arrhythmia.
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C7 Hyperkalaemia Cause
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Renal failure, burns, crush injuries, severe infection
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Signas and symptoms of DKA
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Sluggish, extreme tiredness.
Fruity smell to breath/compare to nail polish remover, similar to peardrops. Extreme thirst, despite large fluid intake. Constant urination Extreme weight-loss. |
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C7 Treatment for DKA
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Administration of normal saline for volume repletion
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What are some common causes associated with rectal bleeding in the elderly?
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Liver Cancer, Hemorrhoids, and Chronic Diseases
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C7 Respiratory alkalosis
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results from increased alveolar respiration (hyperventilation) leading to decreased plasma carbon dioxide concentration.
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What is a common drug that can be associated with elderly patients and overdoses?
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Beta-Blockers
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C7 Respiratory alkalosis treated in filed by:
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Low concentration of O2, Calming measures to slow and control breathing
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What is the job of the team-leader?
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Obtain history, physical exam, present patient to the hospital, documentation, EMS commander at an MCI
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C7 Metabolic alkalosis
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is a metabolic condition in which the pH of the blood is elevated beyond the normal range. Ingetion of large amounts of tums, other antacids
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C7 Metabolic alkalosis treated
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Voume replacement with isotonic solution
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What are the major intracellular cation and the major extracellular cation?
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Potassium is the major intracellular cation; Sodium is the major extracellular cation
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Whihc hormone influences the amount of urine produced by the kidney?
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The amount of urine produced each day by the kidneys is influenced by Aldosterone and ADH levels.
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What injury would you suspect with a patient who fell yesterday and today presents with nausea, vomiting, change in mental status, and one pupil larger than the other?
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Subdural Hemorrhage
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What are two major functions of K?
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Maintining cell electroneytrality and cell osmolality, directly affecting cardiac muscle contraction & electrical conductivity, aiding neuromuscular transmission of nerve impulses, and playing a major role in acid-base balance
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What size BP Cuff is recommended for 5-7 yo patients?
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7 cm
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What size BP Cuff is recommended for 1-3 yo patients?
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5 cm
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How does the body attempt to compensate for metabolic acidosis?
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The lungs compensate by increasing the rate and depth of respirations and greater elimination of C02
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What is the recommended treatment for blunt eye trauma?
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Cover both eyes
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What are 4 assessments findings in an ECF volume excess?
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Weight gain, distended neck vein, elevated blood pressure, full bounding pulse, crackles, dyspnea
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What size blade is recommended for 3-10 yo patients?
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2 miller
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What are 3 cause of ICF Volume excess?
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IV administration, hypotonic solution, tap water enemas
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How does the body compensate for metabolic acidosis?
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Through hyperventilation
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Where do you clamp the cord of a newborn?
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10" then 2-3" prior
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What is the most common Acid-Base imbalance for the Pt. with respiratory insufficiency
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Respiratory acidosis
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Which acid base imbalcne would be seen with vomiting?
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Metabolic Acidosis
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Which imbalce is most commonly seen in diuretic use
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Hypokalemia is the most common imbalnce associated with diuretic use.
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What sign indicates a patient has meningitis?
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Kernig's Sign (Unable to extend knee when supine with hip bent and knee at 90 deg. angle)
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1-8-08 What breathing pattern is characterized by long, deep breaths that are stopped during inspiratory phase and seperated by periods of apnea?
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Apneustic respirations (seen in stroke or severe central nervous system disease
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Ataxic respirations are characterized by:
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repeated episodes of gasping ventilations seperated by periods of apnea. This pattern is seen in Pt. w/ increased intracranial pressure.
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Deep, rapid respirations that are caused by strokes or injury to the brainsteam. In this case, there is a loss of normal regulation of ventilatory controls and respiratory alkalosis is often seen is known as?
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Central neurogenic hyperventialtion
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Ventilatory pattern with progressively increasing tidal volume, followed by declining voulme, seperated ny periods of apnea at the end of expiration.
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Cheyne-Stokes Seen in older Pt. with terminal illness or brain injury.
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What are six classsic signs of respiratory distress:
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Nasal Flaring: Widening of the nares W/ respiration
Tracheal tugging: Retraction of tissue of the neck. Intercostal muscle retraction Accessory respiratory muscles cyanosis, pursed lips |
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Life threatening respiratory problems in adult. In order of most ominous to least severe:
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Altered mental status
Severe central cyanosis Absent brath sounds Audible stridor 1-2 word dyspnea (with breath after each word) Tachycardia > 130 beats a minute Pallor & diaphoresis Intercostal retraction Accessory muscle use |
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Define:
Dyspnea Orthopnea pleuritic |
Difficult or labored breathing a sensation of SOB
Dyspnea while lying supine Sharp or tearing, a pain description |
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Sputum Color:
Thick green or brown Thin yellow pale-gray Pink frothy Bloody sputum |
Lung infection
Allergic Severe pulmonary edema cancer,TB and Bronchial infection |
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A sign of chronic emphysema?
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Clubbed fingers
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A high pitched sound resulting from turbulent gas flow in the upper airway. associated with laryngeal constrictiobn or edema
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Stridor
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A continuous, coarse, whistling sound produced in the respiratory airways during breathing
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Wheeze, wheezes to occur, some part of the respiratory tree must be narrowed or obstructed
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What are the most common injuries from accidents?
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Cervical and lumbar injuries
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The "coarse rattling sound somewhat like snoring, usually caused by secretion in bronchial airways".
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Rhonchi
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A patient that falls from a roof and lands on his feet, commonly has what type of injuries?
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Hip dislocation and spinal compression
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What are the clicking, rattling, or crackling noises heard on auscultation of (listening to) the lung with a stethoscope during inhalation.
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Rales, crackles or crepitations,
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Sounds, like dried pieces of leather rubbing together; occurs when the pleura become inflamed, as in pleurisy
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Pleural Friction Rub
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The order in which a hospital report should be reported to CMED is?
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Age, gender, Chief complaint, etc.
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The most important part of report is?
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Chief complaint
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A female jogger who has experienced fluid loss is in what type of shock?
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Hypovolemic shock
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A child who has been sick for a few days with a fever has a seizure. What kind of seizure is it?
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Febrile seizure
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ET Tube Indicators:
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1.Respiratory / cardiac Arrest
2.Unconsciousness w/ no gag reflex 3.Risk of aspiration 4.Obstruction due to foreign bodies,trauma,burns or anaphlaxis 5.Respiratory extremis due to disease 6.Pneumothorax,hemothorax, hemopneumothorax w/ respiratoory difficulty |
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ET Tube Complication include:
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1.Equipment malfunction
2.Teeth breakage & soft tissue laceration 3.Hypoxia 4.Esophageal intubation 5.Endobronchial intubation 6.tension pneumothorax |
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A patient that was in a high speed MVA that hit a wall, you should suspect what type of injury?
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Ruptured Aorta
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Your patient is an 18 y/o F who has been spotting a fe drops, her last period was 6-8 weeks ago, you should suspect?
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Ectopic Pregnancy
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Name indictions of esophagel intubation
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1.absent chest rise & fall & breath sounds
2.Gurgling sound over the epigastrium w/ breaths 3.Abdomen distention 4.Absence of breath condensation in tube 5. Air leak despite inflation of cuff 6.Cyanosis and worsening Pt. condition 7.Phonation(nosie made by the vocal cords) 8.No color change w/ colorinetric ETC2 detector 9.Falling pulse oximetry reading |
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Digital intubation may be indicated in what situations:
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1.An unconscious trauma Pt. with cspine injury
2.A Pt with facial injury that distort the anatomy 3.An entrapped Pt. who cannot be positioned 4.Pt. with copious amounts of fluids in the airway |
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Indication of rapid-sequence intubation.
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1.Impending respiratory failure
2.Acute disorder that threats airway 4.Altered mental status w/ risk of aspiration 5.Glasgow coma scale of 8 or less |
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Name 4 common paralytic agents
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1.Succinylcholine
2.Vecuronium 3.Atracurium 4.Pancuronium |
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TIA within 24 hours OK?
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TIA's usually resolve within 24 hours, CVA's do not
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Succinylcholine guidelines
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Dose 1.5mg/kg IV bolus in adults
Onset 60-90 seconds Duration 3-5 minutes Contraindication: Penetrating eye injuries, Pt with burns greater than 8 hours, duration, massice crush injuries and neuro injury greater than 1 week. |
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When splinting an elbow you should remember to splint it in the?
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Position found
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In the Tubeing of children under 8, it is recommended that the P use:
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An uncuffed E Tube & straight blade
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When dealing with a stabbing victim (must list injury type)?
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Treat the wound with a pressure dressing and transport immediately
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Indications of nasotrachel intubation
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1.Spinla injury
2.Clenched teeth 3.Fractured jaw, oral injuries 4. Significant angioedema (facial/airway swelling) 5.Obesity 6.Arthritis, preventing placement in the sniffing position |
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The guide for fluid resuscitation in children is to?
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Administer 20mL/kg for children older than 1 and.... 10mL/kg for children under 1
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Contarindication of nasotrachel intubation
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1.Suspected nasal fracture
2.Suspected basilar skull fracture 3.Significant deviated nasal septum or other nasal obstruction 4.cardia and respiratory arrest 5.Unresponsive Pt. |
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A cric should not be perforemd on a Pt. 12 years of age or younger becasue:
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The cricothyroid membrane is small and underdeveloped
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In regards to animal bites, your patient was bitten by a snake, your treatment should be?
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Keep the patient at rest, immobilize the affected area in a neutral position
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The location for needle decompression is?
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Midclavicular line, between the 2nd and 3rd rib (over the 3rd)
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A reactive airway disease that is stimulated by both intrinsic and extrinsic factors is known as:
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Asthma
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How should you care for an amputated part?
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Clean wound surface, control bleeding, bulky dressing, direct pressure, place amputated part wrap in guaze dry or with NS/LR, place in pastic bag, place on ice
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One factor that may help differentiate pneumonia from COPD is the presence of:
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fever
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Epiglotitis is?
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A life-threatening bacterial infection in children ages 3 - 7 but can occur at any age. Symptoms: edema/swelling of epiglottis & supraglottic structures. Pt. may experience inspiratory stridor.
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A condition that exists when the capillaries in the lung have greater permeability, which leads to rales and stiff alveoli, is known as:
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ARDS
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With a high suspect of spinal injury what airway should be used on a Pt.
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Nasal intubation
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The difference between oral endotracheal intubation and oral intubation
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OEI is used for cervical spine injury.
OI is used for unconscious Pt. with no C Spine injury |
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If you have a PT. with PO2 of 70 mm Hg. What does that mean.
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Less than 3 mL of 02 is disolved in 1L of blood. 80-100 is the normal value for PO2
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Respiratory chemoreceptors are found in what parts of the body?
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Medulla, aortic bodies, carotid bodies
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The Pt. on a nasal cannula at 5L/min. is receiving approxinately how much 02:
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50%
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Innate rate of Purkinje fibers
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15-40
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Innate rate of the SA Node
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60-100
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Innate rate of the av node
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40-60
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Atropine, lidocaine, adenosine are in whihc group of drugs
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antidysrhythmics
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urgent noncardiac causes of chest pain include
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peptic ulcer disease
pneumathorax pulmonary embolism esophagel disease |
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Cardiogenic shock can come from
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Subendocardial MI
Tension pneumo Pulmonary embolism Diffuse myocardial ischemia |
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Signa or symptoms of abdominal aortic aneurysm
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Hypotention
Back pain Urge to defecate abdominal pain |
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ECG Findings
Pathological Q wave ST segment elevation T wave inversion St segment depression |
Infarcted tissue or transient ischemia
Myocardial injury Myocardial ischemia Myocardial ischemia |
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name diagnoises
30 minutes of acute chest pain not relieved by nitro |
Acute MI
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Diagnosis
progressive fluid accumulation in lungs |
left ventricular failure
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heart pumping ability does not meet body need
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heart failure
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Unresponsivenss with apnea and pulselessness
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Cardia arrest
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Jugular vein distention, edema and tachycardia
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Reight ventricular failure
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Pulsus paradoxus and electrical alternana
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Pulmonary edema
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Dyspnea, orthopenia, decreased systolic BP narrowing pulse pressure
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cardiac tamponade
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Orthopenea
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Relief of dyspnea when sitting up
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Pulsus paradoxus
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drop of more than 10 mmHg in systolic BP w/ inspiration
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As single monitoribng lead cannot identtify
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Prsence of infarct, location of infarct, axis deviation information, quality of pumping action
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Single monitoring lead can provide:
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heart rate, regularity, time it takes to conduct an impulse through the parts of the heart
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Causes of dysrhythmias include
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Myocardia iscemia, PH imbalnce, CNS & sutonomic nerveous damage and drug effects
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What medication should never be used for 3rd degree blocks
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lidocaine
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Caffine, tobaco, alchol and sympathomimetic drugs are common casue of:
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Premature junctional contraction
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What can casue paroxysmal junctional tach:
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smoking, caffine, stress, overexertion
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Possible cause of PEA
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Hypovolemia, tension pneumo, pulmonary emboli, cardiac tamponade
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Pulmonary Embolism
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No pulse w/ CPR, JVD Thrombolytics, surgery
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Acidosis
(preexisting) |
Diabetic/renal patient, ABGs Sodium bicarbonate,
hyperventilation |
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Tension pneumothorax
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No pulse w/ CPR, JVD, tracheal deviation Needle thoracostomy
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Cardiac
Tamponade |
No pulse w/ CPR, JVD, narrow pulse pressure prior to arrest Pericardiocentesis
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Hyperkalemia
(preexisting) |
Renal patient, EKG, serum K level Sodium bicarbonate, calcium chloride, albuterol nebulizer, insulin/glucose, dialysis, diuresis, Kayexalate
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Hypoxia
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Airway, cyanosis, ABGs Oxygen, ventilation
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P E A Algorthym
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P Problem search Treat accordingly.
E Epinephrine 1 mg IV/IO q3-5 min. Or vasopressin 40 U IV/IO, in place of the 1st or 2nd dose of epi. A Atropine 1 mg IV/IO q3-5 min. (3mg max.) Consider termination of efforts if asystole persists despite appropriate interventions. |
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Circulatory Compromise Scale
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Symptoms: shortness of breath, chest pain, altered level/loss of consciousness
Signs: mild hypotension, pulmonary congestion, CHF, hypotensive shock Mild (Severity) Critical Click Here to Close Window Copyright 2006, ACLS.net. All rights reserved. |
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Mnemonic directs preparations for synchronized electrical cardioversion of unstable tachycardia with circulatory compromise due to the fast rate (do not delay shocking if seriously unstable):
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Oh Say It Isn't So
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Oh Say It Isn't So
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Oh = O2 Saturation monitor
Say = Suctioning equipment It = IV line Isn't = Intubation equipment So = Sedation and possibly analgesics |
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Ischemic stroke is when:
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Blood vessels supplying the brain is blocked
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Hemorrhagic Stroke is when:
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When a cerebral artery bursts
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Thrombotic stroke charcteristics
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Most common, due to narrowing of brain vessels, occurs due to lack of 02
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Embolic Stroke charcteristics
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Material from outside brain becomes lodged in brain, may be fat,air, plaque, lodged were arteries branch
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Indications for cardiac pacing include
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Hemodynamically unstable bradycardia.
Bradycardia with ventricular escape beats. Some cases of asystole. |
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Leads 2 and 3 are what type of leads
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Inferior
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Lead 1 looks at the heart from what view
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Lateral
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Leads V1 & V2 are:
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Septal leads:
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Deep and inverted T waves may be indicative of:
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cardiac Ischemia
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Sinus Tach
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RR constant
Rate 100-160 P wave uniform in all QRS Pri .12-.20 QRS measure less .12 |
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SVT rules
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Rate 150-250
P buried Pri may be shortned Rhythm might be regualr except onset & termination |
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Tachycardia Narrow QRS RX
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Vagal maneuvers
Adenosine 6mg |
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hallmark of atrial fib
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irregular irregular
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Atrail fib therapy is performed how:
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synchronized countershock with 100 joules
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Symptom matic PVC are treated with:
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O2 antidysrhythmic drugs EG beat blocker
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B blocker end in what
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LOL but include lidocaine
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Type 2 2nd degree heart block
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Rr constant
rate 60-100 P wave upright and uniform more P waves then QRS PRI if seen is contant QRS less than .12 |
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Type 2 heart block is considered
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Serious regardless of signs and symptoms
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TX for 2nd degree heart block include
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pacing and possibly atropine
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3rd degree heart block
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regu: Both p&R are firing regular
Rate: p 60-100 20-60 ventr P more than QRS upright PRI: none QRI: -.12 |
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How does atropin effect ventric rate in 3rd degree HB
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Because it works on the VN and the VN works on the atria. 3rd degree is ventric focus so it would not work
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The 3 charcteristics of Wolff-Parkinson-White Syndrome are
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Short PR intravla, QRS widening and delta wave (abnormal notching of the QRS)
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Drug therapy for cadiogenic shock include
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Dopamine 1-5 mcg/kg/min
dobutamine 2-20 mcg/kg/min |
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Cardiac tampnade Pt is treated how when hypotensive is showing
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Fluid bolus
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A depreesed ST segment suggests
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Ischemia
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Adenosine is treatment of
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Narrow complex SVT
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Hypotention in anaplyxis is due to
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vasodialation
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Major cause of upper GI hemorrahge include
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Gastritis
Espphageal varix peptic uclers- Mallory-white syndrome -esopagel laceration dur to Vomiting |
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Acute pancreatitis is caused by:
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gallstones and excesive use of alchoal
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Persistenat abdominal pain lasting how many hours can be classfied as surgicl emergencey
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6
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The most common casue of lower GI hemorrhage is
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diverticulosis
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The most common surgical emergencey in the field is:
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appendicitis
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Upper right quadrant pain is caused by
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gallbladder
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