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232 Cards in this Set

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What are the signs and symptoms of cardiac compromise?
Signs and symptoms of cardiac compromise

1. Pain, pressure, or discomfort in the chest or upper abdomen (epigastrium)
2. Difficulty breathing
3. Palpitations
4. Sudden onset of sweating and nausea or vomiting
5. Anxiety (feeling of impending doom, irritability)
6. Abnormal pulse
7. Abnormal blood pressure
What is the patient care for cardiac compromise?
1. Place the patient in a position of comfort
2. Apply high-concentration oxygen through a nonrebreather mask
3. Transport immediately if the patient has no history of cardiac problems, no nitroglycerin, or systolic blood pressure < 90
4. Decide where to transport the patient
5. With medical direction approval, assist patient with medication
What are the signs and symptoms of cardiac arrest?
1. No cartid pulse
2. Apnea (no breathing)
What is the patient care for cardiac arrest?
1. Begin or resume high-quality CPR
2. Determine whether or not the patient is a candidate for AED.
3. Bare the patient's chest and if necessary shave the area
4. Turn on the AED
5. Attach the monitor/defibrillaion electrode pads and cables to the patient
6. Advise all rescuers to STOP CPR so AED can analyze the patient's need for shock
7. AED advises to deliver shock. EMT should ensure no one is touching the patient
8. Immediately begin CPR after shock is delivered
9. Reassess the patient - after 2 minutes or 5 cycles of CPR
What are the signs and symptoms of diabetic emergencies?
1. Rapid onset of altered mental status; caused by taking insulin after missing a meal or vomiting a meal or excess exercise or work, or for no apparent reason
2. Intoxicated appearance, staggering, slurred speech, or unconsciousness
3. Cold, clammy skin
4. Elevated heart rate
5. Hunger
6. Uncharacteristic behavior
7. Anxiety
8. Combativeness
9. Seizures
What is the patient care for diabetic emergencies?
1. Determine if the patient meets the criteria for administration of oral glucose
2. If the patient meets the criteria, assist the patient with the administration of oral glucose
3. Reassess the patient
4. If patient can not swallow, treat like patient with altered mental status
5. Request an ALS intercept
What are the signs and symptoms of seizure disorders?
Because the EMT usually arrives after seizure has taken place, try to find out what happen

1. What was the person doing before the seizure?
2. Exactly what did the person do during the seizure?
3. How long did the seizure last?
4. What did the person do after the seizure?
What is the patient care for seizure?
If the EMT is there during the seizure:
1. Place the patient on the floor or ground
2. If no spine injury, place patient in recumbent position
3. Loose restrictive clothing
4. Protect the patient from injury
5. Do not hold the patient

After convulsions:
1. Monitor and manage ABC's
2. Treat injuries
3. Transport
What is the Cincinnati Prehospital Stroke Scale and how do you assess the patient?
The Cincinnati Prehospital Stroke Scale is a way to assess a conscious patient for stroke.

To assess the patient:

1. Ask the patient to grimace or smile, looking for facial droop
2. Ask the patient to close their eyes and extend both arms in front for 10 seconds. An abnormal response is for one arm to drift down or not move at all.
3. Ask the patient to speak, noting speech slurring, or the wrong words, or no speech at all
What are the signs and symptoms of stroke?
1. Confusion
2. Dizziness
3. Numbness, weakness, or paralysis (usually on one side of the body)
4. Loss of bowel or bladder control
5. Impaired vision
6. High blood pressure
7. Difficult respiration or snoring
8. Nausea or vomiting
9.Seizures
10. Unequal pupils
11. Headache
12. Loss of vision in one eye
13. Unconsciousness (uncommon)
What is the patient care for stroke?
Patient care for stroke

1. Treat the patient as you would any patient with similar symptoms
2. For a conscious patient who can maintain his airway:
- calm and reassure him
- monitor the airway
- administer high-concentrated oxgen
- transport in a semi-sitting position

For an unconscious patient:
- maintain an open airway
- provide high-concentration oxygen
- transport lying the patient on the affected side
What are the signs and symptoms of dizziness and syncope?
1. Usually recognized by the patient's complaint of a brief loss of conscious
What is the patient care for dizziness and syncope?
1, Administer high-concetration oxygen
2. Loosen any tight clothing around the neck
3. Get the patient flat and elevate the legs if there is no reason not to do so
4. Call ALS
5. Treat any associated injuries the patient may have incurred from the fall
7. Transport in a position of comfort
What are the normal attributes of adequate breathing?
1. Rate:
Adult: 12-20 breaths/minute
Child: 15-30 breaths/minute
Infant: 25-50 breaths/minute

2. Rhythm: Regular

3. Quality:
Breath sounds: Present and equal in both lungs
Chest expansion: Adequate and equal
Breathing Effort: Unlabored, normal respiratory effort
What are the various types of lung sounds?
1. Wheezes
2. Crackles
3. Rhonchi (resembles snoring or rattling)
4. Stridor
What is the respiratory assessment and condition associated with wheezing lung sounds?
1. Wheezes are high-pitched musical sounds through narrowed air passages
2. Common in asthma, emphysema, and chronic bronchitis
3. Usually heard during exhalation throughout the lungs
What is the respiratory assessment and condition associated with crackles lung sounds?
1. Usually heard with congestive heart failure
2. Heard in the lower lung lobes on inspiration
3. It is a fine crackling or bubbling sound
4. Caused by fluid in th alevoli
What is the respiratory assessment and condition associated with rhonchi lung sounds?
1. Lower-pitched sounds that resembles snoring or rattling
2. Caused by secretions in the larger airways as seen in pneumonia, or bronchitis
Name some respiratory conditions.
1. Chronic Obstructive Pulmonary Diseases (COPD) include emphysema, chronic bronchitis, black lung
2. Pneumonia
3. Asthma
What are some differences between adult and infant/child respiratory systems?
Differences between adult and infant/child respiratory systems

1, Respiratory problems are a leading killer in infants and children
2.Infant/children airway structure differences:
- airway structures are smaller and easily obstructed
- tongues are larger and take up more space than adults
- the trachea is smaller, softer, and can lead to swelling or trauma because of obstruction easier than adults
- seesaw breathing represents dependence on the diapharm for breathing
What are the pulse oximeter reading ranges?
Oxygen saturation readings:
1. 96-100% normal
2. 91-95% hypoxia
3. 86-90% significant hypoxia
4. <=85% severe hypoxia
Which questions should the EMT ask the during focused history for patients with respiratory emergencies?
O-Onset. When did it begin?
P-Provocation. What were you doing when this came on?
Q-Quality. Can you describe the feeling you have?
R-Radiation. Does the feeling seem to spread to other body parts? Do you have pain anywhere else?
S-Severity. On a scale of 1-10, how bad is your breathing?
T-Time. How long have you had this feeling?
What standard interventions can an EMT-B provide?
A. Application of an AED
B. Application of oxygen
C. Insertion of oral or nasal airways
How should an EMT handle a patient with multiple conditions or a familiar condition under unusual circumstances?
Assess the patient as usual
The patient has a disease which I am not familiar with. What should I do?
Ask the patient to tell you about the disease.
What should the EMT-B do when a patient is presenting with two or more medical conditions?
Consult with medical direction for advice
Which medical conditions could cause a patient to have slurred speech?
1. A stroke
2. An overdose
3. A seizure
4. Any combination of the above
A patient with chest pains may have any of the following conditions:
1. Angina pectoris
2. Acute myocardial infarction(AMI)
3. Seizure
A patient vomiting coffee-ground-like material probably has:
Internal bleeding
A wheeze is a common breathing sound found in a patient having at least one of following conditions:
1. An asthma attack
2. An allergic reaction
3. Bronchospasm
4. Any one of the above
Which patient problems have no specific EMT intervention?
1. Abdominal pain
2. Headache
3. Sickle-cell crisis
4. Post-surgical complications
What are the 9 interventions an EMT can use for medical patients?
1. Assist patient in using his inhaler
2. Assist patient with taking his nitroglycerin
3. Application of an AED
4. Administration of oral glucose
5. Assist patient with using his epinephrine auto-injector
6. Administration of active charocoal
7. Talking down or restraining a patient
8. Assist with delivery of infant
9. Properly cooling or warming a patient
Constriction, or blockage, of the bronchi that lead from the trachea to the lungs
bronchoconstriction
Another term for expiration
Exhalation
A passive process in which the intercostal (rib) mucles and the diapharm relax, causing the chest cavity to decrease in size and force air from the lungs
exhalation. Also called expiration
Another term for inspiration
inhalation
An active process in which the intercostal (rib) muscles and the diapharm contract, expanding the size of the chest cavity and causing air to flow into the lungs
inhalation. Also called inspiration
What are the signs of respiratory distress in infants and children?
1. Altered mental status
2. Flared nostrils
3. Pale or blueish lips or mouth
4. Stridor, grunting
5. Breathing rate > 60
6. Retraction of chest muscles
7. Wheezing, working hard at or struggling to breath
8. Decreased muscle tone (on arms)
9. Poor capillary refill ( poor peripheral perfusion)
10. Use of abdominal muscles to breath
What drugs may the EMT assist the patient in taking if they have been prescribed for him and with approval by medical direction
1. Prescribed inhlaer
2. Nitroglycerin
3. Epinephrine Auto-Injectors
What are some of the different forms medications can take?
1. Compressed powders or tablets (nitroglycerin)
2. Liquids (epinephrine)
3. Gels (oral glucose)
4. Suspensions (activated charocoal)
5. Fine powder (prescried inhaler)
6. Gases (oxygen)
7. Sublingual sprays (nitroglycerin spray)
8. Vaporizing liquids (fixed-dose nebulizer)
What are the various routes of administration for a drug?
1. Oral, or swallowed
2. Sublingual, or dissolved under the tongue
3. Inhaled
4. Intravenous, or injected into a vein
5, Intramuscular, or injected into a muscle
6. Subcantaneous, or injected under the skin
7. Endotracheal, or sprayed in a tube that is inserted in the trachea
A 71 yo male is semiconcious following a sudden, severe headache. There is vomitus on his face and he is beathing with slow, shallow respirations. The MOST apropriate INITIAL airway management is for this patient to:
perform oralpharyngeal suctioning
A 51 yo female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 24 breaths/min and regular. You should NEXT
administer 100 % oxygen via NRB mask
A 23 yo male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and is producing copious (abundant) bloody secretions from his mouth. How could you MANAGE his airway?
Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation
You are dispatched to residence where a middle-aged man was found unconscious in his front yard. There are no witnesses that can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your first action should be to:
log roll him as a unit to a supine position
What is the MOST appropriate management for an UNINJURED UNCONSCIOUS 40 yo male with respiration of 20 breaths/min and adequate tidal volume?
Place him on his left side (the lateral recumbent position/recovery) and administer oxygen via a NRB mask
A 19 yo female is found unconscious by her roommate. Your inital assessment reveals that her breathing is inadequate As you insert an oropharyngeal airway, she begins to gag violently. You should NEXT:
remove the airway and be prepared to suction her oropharynx.
You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilation with a BVM. After repositioning the mask several times, you are UNABLE to effectively ventilate the patient. You should NEXT:
begin ventilations using the mouth-to-mask technique.
Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked REDUCTION in tidal volume. You should NEXT:
explain to her that you will assist her ventilations
While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor and cyanosis around the lips. You should NEXT:
stand behind him and administer abdominal thrusts
A harsh respiratory sound due to any of various forms of obstruction of the breathing passages.
stridor
A 37 yo male has a partial foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes:
encouarging him to cough and transport
Your patient is a 55 yo female with a history of emphysema and congestive heart failure. As you assess her, you notice that she is semi-conscious, CYANOTIC and has severely labored respirations. In between her BROKEN sentences, she states that she has a prescibed inhaler. You should NEXT:
begin ventilatory assistance and contact medical control
A chronic, irreversible disease of the lungs characterized by abnormal enlargement of air spaces in the lungs accompanied by destruction of the tissue lining the walls of the air spaces.
emphysema
A condition in which the heart fails to pump adequate amounts of blood to the tissues, resulting in accumulation of blood returning to the heart from the veins, and often accompanied by distension of the ventricles, edema, and shortness of breath. Also called heart failure.
congestive heart failure
A 22 yo female patient is complaining of dyspnea, numbness, and tingling in her hands and feet after an argument with her fiance'. Her respirations are 40 breaths/min. You should NEXT:
provide reassurance and give oxygen as needed
A 60 yo male presents with acute respirtoy distress. He is conscious and alert, has pik and dry skin, and respiration s or 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient?
Oxygen via a NRB mask and a focused history and physical exam
A CONSCIOUS and alert 29 yo female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40 degrees Fahrenheit. On exam, you hear bilateral EXPIRATORY wheezing. After providing 100% oxygen, you should NEXT:
Determine if she has been prescribed a beta-agonist inhaler
You are dispatched to a residence for a 67 yo female that was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip SURGERY. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with:
acute pulmonary embolism
Embolism of a pulmonary artery or one of its branches that is produced by foreign matter and most often a blood clot originating in a vein of the leg or pelvis and that is marked by labored breathing, chest pain, fainting, rapid heart rate, cyanosis, shock, and sometimes death
pulmonary embolism
What can cause polyhydramnios?
neuromuscular disease and GI obstruction
You receive a call for a 70 yo female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should NEXT:
begin assisting her ventilations with a BVM
Why would you use a BVM instead of a NRB?
1. A BVM is used to VENTILATE a NONBREATHING patient (helps them to inhale)
2. It is also helpful to assist ventilations in the patient whose own respiratory attempts are not enough to support life, such as a patient in respiratory failure or drug overdose
Why would you use a NRB instead of a BVM?
1. A NRB is the best way to DELIVER high concentrated oxygen to a BREATHING patient.
2. Use for patients with inadequate breathing or who are cyanotic, cool, clammy, short of breath, suffering chest pain, or displaying an altered mental status.
You are assisting an asthma patient with his prescribed inhaler. After the patient takes a deep breath and depresses the hand-held inhaler, you should NEXT:
instruct him to hold his breath for as long as he can
A 59 yo male with ahistory of emphysema complains of a acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveal that he has a barrel-like chest, UNILATERALLY diminished breath sounds, and tachycardia (rapid heart beat). What is the MOST likely cause of this patient's condition:
Spontaneous pneumothorax
You are dispatched to an apartment comples where a 21 yo female has apparently overdosed on several naroctic medications. She is semiconscious and has slow, shallow respirations. You shuld NEXT:
insert a nasopharyngeal airway and begin assisted ventilation (use BVM)
________ complaints are among the most common reasons that people call EMS.
Respiratory
The ______ is a muscular structure that divides the chest cavity from the abdominal cavity.
diaphragm
______ is an active process that uses the contraction of several muscles to increase the size of the chest cavity.
Inspirations
Normal breathing may be determined by observing the _______, _______, and ________.
rate, rhythm, and quality
________ _______ are sporadic, irregular breaths that are usually seen just before respiratoy arrest.
Agonal respirations
Infants and small children in respiratory distress exhibit ________ ________, in which the movement of the diaphragm causes the chest and abdomen to move in opposite directions.
see saw breathing
A low or _______, pulse in infants and children in the setting of a respiratory emergency usually means trouble!
bradycardic
A high-pitched sound during breathing is called ________.
stridor
Use the letters ______ to remember which questions to ask when eliciting a history of a respiratory or cardiac disorders.
OPQRST
Emphysema - as well as chronic bronchitis and black lung - are examples of _______ _______ _______ _______.
chronic obstructive pulmonary diseases
The condition in which the brain learns to rely on low oxygen levels as the trigger to breathe is callled _________ _______
hypoxic drive
An _______ attack may be triggered by an allergic reation to something inhaled, swallowed, or injected into the body.
asthma
Blockage, due to narrowing of the bronchi that led from the trachea to the lungs, is known as _____________.
bronchoconstriction
Contact ______ _________ for specific authorization to help a patient self-administer a prescribed inhaler.
medical direction
OPQRST is a mnemonics which stands for the kinds of questions you should ask a patient with respiratory or cardiac disorders?
This is the list the mnemonic for evaluating a medical patient

O - Onset (this event)
P - Provoke, Palpation
Q - Quality
R - Region, Radiates
S - Severity
T - Time (relevant history)
Trauma is recognized as the leading cause of death for people betwen the age of
1 - 44
The acromyon MOI stands for
Mechanism of Injury
AEIOU-TIPS is a mnemonic for a list of general causes of a reduced level of consciousness
A - Alcohol
E - Epilepsy
I - Insulin
O - Overdose
U - Uremia
T - Trauma
I - Infection
P - Poisoning, Psychological
S - Sepsis
SAMPLE is an acronym use to ensure that all the details about the patient are recorded.
S - Signs & symptoms
A - Allergies
M - Medications
P - Past pertinent history
L - Last oral intake, liquid & solid
E - Events leading to the incident
DCAP-BTLS stands for a list of possible results of a traumatic insult.
D - Deformity
C - Crepitus, Contrusions
A - Abrasions
P - Punctures, Paradoxical movement
B - Burns
L _ Lacerations
T - Tenderness
S - Swelling
A&O X 4 means
The patient is (A) alert and (O) orientated to (1) person, (2) place, (3) time, and (4) event
ABC
Airway, Breathing, and Cirulcation
ALS
Advanced Life Support
BP
Blood pressure
BVM
Bag Valve Mask
CVA
Stroke
CHF
Congestive Heart Failure
COPD
Chronic Obstructive Pulmonary Diseases (COPD)
CPR
Cardiopulmonary resuscitation
ETOH
Ethanol (or drinking alcohol)
EKG
Electrocardiogram
IV
Intravenous - injection into the vein
IM
Intermuscular; injection into the muscle
SL
Sublingual; under the tongue
LOC
Level of Consciousness
NC
Nasal Cannula
NRB
Nonrebreather mask
NKA
No known allergies
PT
patient
PEARL
Pupils Equal and Reactive to Light
SOB
Shortness of Breath
TA
Transient ischemic attack(mini stroke)
VS
Vital signs
YO
years old
What are the focus history questions to ask a patient suffering from altered mental status?
Description of the epsiode?
Onset?
Duration?
Associated symptoms?
Evidence of trauma?
Interventions?
Seizures?
Fever?
What are the focus history questions to ask a patient suffering from allergic reactions?
History of allergies?
What were you exposed to?
How were you exposed?
Effects?
Progressive?
Interventions?
What are the focus history questions to ask a patient suffering from poisoning/overdose?
What substance was it?
When did you ingest/become exposed?
How much did you ingest?
Over what period of time?
Interventions?
Estimated weight?
What are the focus history questions to ask a patient suffering from environmental emergencies?
Source?
Environment?
Duration?
Loss of consciousness?
Effects - general or local?
What are the focus history questions to ask a patient suffering from behavior emergencies?
How do you feel?
Determine suicidal tendencies?
Is the patient a threat to self or others?
Is there a medical problem?
Interventions?
What are the focus history questions to ask a patient suffering from obstetric emergencies?
Are you pregnant?
How long have you been pregnant?
Pain or contractions?
Bleeding or discharge?
Do you feel the need to push?
Last menstrual period?
Do you have a need for a bowel movement?
Erythrocytes are also called
red blood cells
Routes of drug administration that a EMT might use includes:
SL - sublingual
inhaled
IM - intramuscular
The use of activated charcoal is a contraindication for
an unconscious patient
Signs and symptoms of respriatory distress is an indication for the use of a(n)
albuterol MDI
What route can a basic EMT use to administer albuterol?
inhalation
A portion of the myocardium dies from oxygen starvation; aka heart attack
acute myocardial infarction (AMI)
The dilation or ballooning of a weakened section of the wall of an artery
aneurysm
chest pain
angina pectoris
no breathng
apnea
an irregular or absent heart rhythm
arrhythmia/dysrhythmia
A hardening of the artery wall resulting from calcium deposits
arteriosclerosis
The heart has ceased generating electrical impulses
asystole
The process of plaque formation on the interior wall of an artery
atherosclerosis
When the heart rate is slow, usually below 60 beats per minute
bradycardia
A blanket term that refers to a heat problem with a rapid onset
cardiac compromise
The heart and blood vessels
cardiovascular system
The failure of the heart to pump efficiently, leading to excessive blood or fluids in the body
congestive heart failure(CHF)
Disease that affect the arteries of the heart
coronary artery disease (CAD)
Shortness of breath, labored or difficulty breathing
dyspnea
Swelling; results from fluid build up in tissues
edema
Blockage of vessel by a clot brought to the site by the blood current
embolism
Blockage of as an artery by fatty deposits
occlusion
Accumulation of fluid in the feet or ankles
pedal edema
Accumulation of fluid in the lungs
pulmonary edema
The heart's electrical rhythm remains relatively normal; yet the mechanical pumping activity fails to allow electrical activity, causing cardiac arrest
Pulseless electrical activity (PEA)
A cardiac arrest that occurs 2 hours after the onset of symptoms
sudden death
When the heart rate is fast, above 100 beats per minute
tachycardia
A clot formed of blood and plaque attached to an inner wall of the artery or vein
thrombus
A condition in which the heart's electrical impluses are preventing the heart from contracting normally
ventricular fibrillation (VF)
A rapid heart beat
ventricular tachycardia(V-tach)
What are the safety hazards of the AED?
1. Patient is wet or lying in water (dry the patient)
2. Patient wearing a nitroglycerin pad
3. People touching the patient while performing AED
4. Patient touching metal while performing AED
A 60 yo male with COPD who is on home oxygen at 2 lpm by nasal cannula is begin ranspoted for evaluation of a sprained ankle. What is the approapriate oxygen therapy for this patient during transport?
2 lpm by nasal cannula
After administration of oxygen the key to effectively treat a patient with asthma is the use of
bronchodilators
CC
Chief Complant
Spontaneous (miscarriage) or induced termination of pregnancy
abortion
A condition in which the placenta separates from the uterine wall; a cause of prebirth bleeding
abruptio placentae
The placenta, membranes of the amniotic sac, part of the unbilical cord, and some tissues from the lining of the uterus that are delivered after the birth of the baby
afterbirth
The "bag of waters" that surrounds the developing fetus
amniotic sac
When the baby's buttocks or both legs appear first during birth
breech presentation
When the baby appears head first during birth. This is the normal presentation.
cephalic (se-FAL-ik) presentation
The neck of the uterus at the entrance to the birth canal
cervix
When part of the baby is visible through the vaginal opening
crowning
A severe complication of the pregnancy that produces seizures and coma
eclampsia
(e-KLAMP-se-ah)
When implantation of the fertilized egg is not in the body of the uterus, occurring instead in the oviduct (fallopian tube), cervix, or abdominopelvic cavity
ectopic pregnancy
The baby as he develops in the womb
fetus
Explusion of a fetus as a result of deliberate actions taken to stop pregnancy
induced abortion
The three stages of the delivery of a baby that begin with contractions of the uterus and end with the explusion of the placenta
labor
When an infant's limb protrudes from the vagina before the appearance of any other body part.
limb presentation
Amniotic fluid that is greenish or brownish-yellow rather than clear as a result of fetal defecation; an indication of possible maternal of fetal distress during labor
meconium staining
Spontaneous abortion
misscarriage
When more than one baby is born
multiple birth
Fallopian tube; tube that carries eggs from an ovary to the uterus
oviduct
The surface area between the vagina and anus
perineum
(per-I-NE-um)
The organ of pregnancy where exchange of oxygen, foods, and wates occurs between a mother and fetus
placenta
A condition in which the placenta is formed in an abnormal location that will not allow for a normal delivery of the fetus; a cuse of excessive prebirth bleeding
placenta previa
A complication of pregnancy where the woman retains large amounts of fluid and has hypertension. She may also experience seizures and/or coma during birth, which is very dangerous to the infant
preeclampsia
Any newborn weighing < 5 1/2 pounds or born before the 37th week of pregnancy
premature infant
When the umbilical cord presents first and is squeezed between the vaginal wall and the baby's head
prolapsed umbilical cord
When the fetus and placenta deliver before the 28th week of pregnancy; commonly called a miscarriage
spontaneous abortion
born dead
stillborn
Dizzines and a drop in blood pressure caused when the mother is in a supine position and the weight of the uterus, infant, placenta and amniotic fluid compress the inferior vena cava, reducing return of blood to the heart and cardiac output
supine hypotensive syndrome
The fetal strucute containing the blood vessels that carry blood to and from the placenta
umbilical cord
The muscular abdominal organ where the fetus develops; the womb
uterus
The birth canal
vagina
What are the three stages of labor?
1. Dilation period
2. Baby in birth canal
3. Afterbirth delivery
The shortening and thinning of the cervix
effacement
Contractions of the uterus that last for 30 seconds to 1 minutes and repeat every 2-3 minutes
labor pains
The time from the beginning of contractions to when the uterus relaxes (from start to end)
contraction time, or duration
The time from the start of one contraction to the beginning of the next (from start to start)
contraction interval or frequency
vena cava compression syndrome
supine hypotensive syndrome
To counteract or avoid the possible drop in blood pressure, all third trimester patients should be transported
in recovery position, on their left side
Soft spot on the baby's skull
fontanelles
To clear the baby's airway during delivery, suction the _______ first and then the ________.
mouth; nostrils
Do not put the syringe tip more than _____ into the baby's nostril.
1/2 inch
Once the baby's feet deliver, lay the baby in the _________ position, at the same level as the mother's ________
trendelenburg; vagina
What are the normal newborn vital signs?
Pulse > 100
Easily breathing, or crying
Active extremity movement
Cynaosis on hands and feet only
What is the APGAR score?
A way to assign a number to a newborn's condition.
It does not take priority over care for the ABC's
What are the characteristics of the APGAR?
APGAR is the total of 5 values, and ranges from 0 -19. It is taken 1 minute after birth and again 5 minutes after birth
Keep newborn at vagina level until
the umbilical cord is cut.
If the newborn does not breathe on its own after suctioning, drying, and warming for ___ begin resuscitation
30 seconds
What are the steps to resuscitate a newborn?
1. Provide warmth and clear the baby's airway
2. Keep the baby in recovery position and suction the mouth and nose a second time
3. Assess the baby's breathing. If shallow, slow or absent, provide artifical ventaltions at 40-60 per minute.
4. Assess the infant's heart rate
5. If the face and torso are cynaotic, ventilate.
What are newborn CPR indications?
1. If the pulse is < 100, ventilate at a rate of 40-60 per minute
2. If the pulse is < 60, start chest compressions at 3 compressions for 1 ventilation
3. Provide blow-by ventilation if breathing is adequate and the face and toro are blue
How should you cut the umbilical cord?
1. Place the first clamp 10 inches from the baby.
2. Place the second clamp 7 inches from the baby
3. Cut the cord between the clamps
What PPE should the EMT wear during childbirth?
Gloves, gowns, caps, face masks, and eye protection
List some delivery compications
1. Umbilical cord around the neck
2. An unbroken amniotic sac
3. Infant apnea

Child birth emergencies:
4. Breech presentation
5. Prolapsed umbilical cord
6. Limb presentation
What is the patient care for breech presentation?
1. Initiate rapid transportation
2. Nenver pull on baby's legs to deliver
3. Provide high oxygen concentration
4. Place mother in trendelenburg position with pelivs elevated on pillows
5. If the baby's body delivers, insert gloved fingers into vagina and place one of each side of the baby's nose and life the head from the vaginal wall to allow breathing
5. Care for baby, cord, mother and placents as normal delivery
What is the patient care for prolapsed umbilical cord?
1. Elevate mother's hips, administer oxygen, and keep mother warm
2. Keep baby's head away from cord
3. Do not attempt to push cord back
4. Wrap cord in sterile moist towel
5. Transport and continue pressure on baby's head
What is the patient care for limb presentation?
1. If there is a prolapsed cord, follow prolapsed cord procedure.
2. Do not place your hand into the vagina unless there is a prolapsed cord.
When delivering twins, identify the babies:
in the order of birth (one and two, or A and B)
What is the patient care for multiple births?
1. Clamp the umbilical cors of the first baby before the second is born.
2. Assit with second baby delivery
3. Be sure to keep both babies warm.
What is the patient care for premature birth?
1. Keep baby warm, using plastic buble wrap, blankets, and stockinet cap
2. Keep airway clear, suctioning as needed
3. Monitor breathing and ventilate as needed
4. Watch for umbilical cord bleeding
5. Provide oxygen
6. Avoid contamination
7. Keep the ambulance warm
8. Call ER ahead
What is the patient care for meconium?
1. Suction the infant before stimulating breathing by drying and warming
2. Suction the mouth and then the nose
3. Maintain an open airway
4. Provide ventilation and/or chest compressions as needed
5. Transport
List the pre-delivery emergenices?
1. Excessive bleeding
2. Ectopic preganancy
3. Seizures in pregnancy
4. Miscarriage and abortion
5. Trauma (injury) in pregnancy
How do you determine a baby is stillborn>
Death is obvious by the presence of blisters, foul ordor, skin or tissue deterioration and discoloration, and a soft head
The conditions placenta previa and abruptio placenta are both ________ ___________ to the mother and infant
life threatening
Excessive bleeding in pregnancy can be contributed to:
placenta previa and abruptio placentae
What are the signs and symptoms of excessive prebirth bleeding?
1. Profuse bleeding from the vagina
2. Mother may or may not have abdominal pain
3. Look for signs of shock
4. A rapid heart beat could indicate significant blood loss
What is the patient care for excessive prebirth bleeding?
1. If shock exist, provide oxygen and rapid transport
2.Place sanitary napkin over vaginal opening.
3. Save all pads and tissue passed
What are the signs and symptoms of ectopic pregnancy?
1.Seen in early pregnancy
2. Woman may not know she is pregnant
3. Acute abdominal pain
4. Vaginal bleeding
Late Signs
5. Rapid and weak pulse
6. Low blood pressure (very late)
What is the patient care for ectopic pregnancy?
1. Transport immediately
2. Position patient for shock
3. Care for shock
4. Provide oxygen by NRB mask
5. No oral intake
What are the signs and symptoms of seizures in pregnancy>
1. Occurs late in pregnancy
2. Associated with high blood pressure, which increases the risk of abruptio placentae
3. Excessive weight gain
4. Extreme swelling of face, hands, ankles, and feet
5. Headache
What is the patient care for seizures in pregnancy?
1. Ensure and maintain an open airway
2. Oxygen by NRB mask
3. Transport in recovery position
4. Handle patient gently
5. Keep her warm
6. Be prepared to suction
7. Be prepared to assist with delivery
What are the signs and symptoms of miscarriage and abortion?
1. Severe cranping not like contractions
2. Severe bleeding
3. Discharge of tissue and blood from vagina
What is the patient care for miscarriage and abortion?
1. Obtain vital signs
2. Watch for shock and treat accordingly
3. Transport asap
4. Save sanitary napkins and tissue discharge
Trauma during an auto collison can cause ____ and _____ in the pregnant patient
hemorrhage (bleeding); shock
What are the signs and symptoms of trauma in pregnancy patient?
1. Pulse is 10 -15 beats faster than normal
2. Blodd volume is up by 48% higher than nonpregnant state
3. Shock is more difficult to assess
4. Conside MOI, look and/or ask about blows to abdomen, back or pelvis, or bleeding
What is the patient care for the trauma pregnancy patient?
1. CPR
2. Oxygen NRB
3. Suctioning
4. Transport asap, recovery position
What is the patient care for stillborn babies?
1. DNR dead babies
2. Provide basic life support for babies with pulmonary or cardiac arrest
What are the signs and symptoms of vaginal bleeding?
All women who have vaginal bleeding, esp with abdominal pain are treated as havimg potential life-threatening hypovolemic shock due to blood loss.
The manner in which a person acts
behavior
When a patient's behavior is not typical for the situation; when the patient's behavior is unacceptable or intolerable to the patient, his family, or the community; or when the patient may harm himself or others
behavioral emergency
Death of a person due to a body position that restricts breathing for a prolonged time
positional asphyxia
Name several conditions that can alter a person's mental status and behavior
1. Low blood sugar (diabetes)
2. Lack of oxygen
3. Inadequate blood to the brain or stroke
4. Head trauma
5. Mind-altering substances
6. Excessive cold
7. Excessive heat
What are the signs and symptoms of psychiatric emergencies?
1. Panic or anxiety
2. Unusual appearance
3. Agitated or unusal activity. reptive motions, withdrawn, threatening movements
4. Bizarre behavior
5. Suicidal or self-destructive behavior
6. Violent or aggressive behavior with threats or itent to harm others
What are the signs and symptoms of suicide?
1. Depression
2. High current or recent stress levels
3. Recent emotional trauma (job loss, arrest. imprisonment, loss relationship)
4. Age
5. Alcohol or drug abuse
6. Threats of suicide
7. Suicide plan
8. Previous attempts or suicide threats
9. Sudden improvements from depression