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63 Cards in this Set

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What is the first component of the patient assessment?
scene size-up (p. 241)
Marco, a new EMT has ensured that the scene is safe and that the scene has been controlled. He is now prepared to begin the ____________________ ____________________.
initial assessment (p. 242)
What is the main purpose of the initial assessment?
To identify and manage immediately life threatening conditions to the airway, breathing, or circulation. (p. 242)
True or false: Any life-threatening condition that is identified must be treated immediately as found--before moving on to the next portion of the initial assessment.
True. A life threat found during the initial assessment must be treated immediately after being identified. (p.243)
What are the six steps of the initial assessment?
1) form a general impression of the patient
2) assess mental status
3) assess airway
4) assess breathing
5) assess circulation
6) establish patient priorities
(p. 243)
What are the two main types of trauma?
penetrating and blunt force trauma (p. 243)
As you form your general impression of the patient, you may categorize the patient as being ______________ or __________________.
injured (trauma patient)
ill (medical patient)
(p.246)
The _________________ _____________ is the patient's answer to the question, "Why did you call EMS today?"
chief complaint (p. 245)
You arrive on scene to a patient who has blood flowing steadily from a open stab wound to the chest. Should you place your gloved hand on his chest to stop the bleeding, or continue with the steps of the initial assessment?
This is an immediate life threat that needs to be treated before moving through all the steps of the assessment. Place your gloved hand over the wound until your partner can prepare and apply the appropriate dressing--then continue with the steps of the assessment. (p. 246)
What technique do you use if you suspect a spinal injury during the assessment?
manual in-line stabilization. (p. 247)
True or false. If you find the patient in a prone position, you should leave him that way.
False. Log roll the patient after a quick assessment (DCAPBTLS) of the anterior.
(p. 247)
What does AVPU stand for?
A - Alert
V - Responds to Verbal Stimulus
P - Responds to Painful Stimulus
U - Unresponsive
In this type of posturing, the patient arches the back and flexes the arms inward.
flexion (decorticate) posturing (p. 249)
In this type of posturing, the patient arches the back and extends the arms straight out, parallel to the body.
extention (decerebrate) posturing
(p. 249)
What techique would you use to open the airway of a medical patient?
head tilt, chin lift (p. 250)
What are four noises that may indicate partial airway obstruction?
snoring
gurgling
crowing
stridor (high pitched)
(p. 251)
What is the best method to assess breathing?
Look, listen, feel
(p.252)
What are three key steps to assess breathing?
1) determine if breathing is adequate or inadequate
2) if adequate, determine need for 02 therapy
3) if inadequate, provide positive pressure ventilation with supplemental 02
What does PENMAN stand for?
Personnel/Patient Safety
Environmental Hazards
Number of Patients
Mechanism of Injury
Additional Resources (special equipment)
Need for extrication/spinal mobilization
What are four key things should you look for when assessing breathing?
Rate
Effort
Tidal Volume
Breath sounds
What are four key things should you look for when assessing cirulation?
Pulse (rate, rhythm, quality)
Skin - color, temp, moisture
Bleeding
Cap refill
A respiratory rate that is too slow is ______________.
bradypnea (p. 253)
___________ is inadequate oxygen delivered to the tissues.
hypoxia (p. 253)
True or False: flexion and extension posturing are signs of serious head injury.
True (p. 249)
A respiratory rate that is too fast is _______________.
tachypnea (p. 253)
dyspnea means what?
difficulty in breathing (p. 254)
You take a pulse oximeter reading on a patient, and it reads 92%. Is this patient receiving adequate oxygenation?
No. A pulse oximeter reading of 95% or greater is an indicator of adequate breathing. (p. 254)
____________ is the sufficient supply of oxygen to the body's cells that results from adequate circulation of blood through the capillaries.
perfusion (p. 257)
Assess cap refill in infants and childrenless than ____ years of age.
6 years of age (p. 257
True or false: Cyanosis is an early sign of poor perfusion.
False. Cyanosis is a late sign of poor perfusion. (p. 257)
What do you do after the initial assessment?
Perform a focused history and physical exam. (p. 241)
What do you do after you perform a focused history and physical exam?
Perform a detailed physical exam (p. 241)
What do you do after you perform a detailed physical exam?
Perform an ongoing assessment. (p. 241)
What's the last step in the patient assessment?
communication and documentation (p. 241)
What three key steps are completed during the focused history and physical exam?
1. Conduct a physical exam
2. Take baseline vital signs
3. Obtain a SAMPLE history (p. 261)
What is the treatment for shock?
Control any serious bleeding. If possible, splint any bone or join injuries (but only if there's no delay in transport), elevate patient's feet 8-12 inches if no spine injury, apply positive pressure ventiliation with supplemental 02, keep patient warm, immediate transport (p. 258)
A patient presents with an extremely high temperature of 104. Should you perform a detailed physical or rapidly transport?
rapidly transport (p. 261)
True or false. For a trauma patient, you will perform the physical exam and vital signs before the history, because the most significant information about injuries will usually come from the physical exam.
True (p. 262)
What does SAMPLE stand for?
Signs and Symptoms
Allergies
Medications
Pertinent Past History
Last oral intake
Events leading to injury or illness
What are the criteria to check if a person is alert and oriented?
TIME - Do you know what year, month and day it is?
PLACE - Can you tell me where you are right now?
PERSON - WHo is this with you right now? What is your full name? (p. 267)
You check if a person is alert and oriented. He can tell you his name, but he doesn't know where he's at and he can't tell you the date. How would you document this?
Alert and oriented X 1 (or A/O X 1) p. 267. If he can answer all three questions then it's A/O X 3)
What are the 3 categories used to rank the patient's level of consciousness on the Glascow Coma Scale?
Eye Opening
Best Verbal Response
Best Motor Response (p. 267)
A GCS score of ____ or less iindicates a severe alteration in brain function.
8 or less (p. 269)
What does DCAPBTLS stand for?
Deformities
Contusions
Abrasions
Punctures/Penetrations
Burns
Tenderness
Lacerations
Swelling
You are completing an assessment and notice an extreme shift of the patients trachea. This may be a sign of what?
Lung injury with excessive fluid build up in the plueral space (tension pneumothorax)(p. 276)
You are performing an assessment and notice that the patient's skin on the neck is bloated and inflated. This is a sign of what?
This could be subcutaneous emphysema and indicates there is an air leak somewhere in the respiratory tract, lungs, or esophagus. (p. 277)
True or false: It's okay to let go of manual in-line stabilization once the c-collar is applied to the patient.
False. Even after the c-collar is applied, in-line spinal stabilization must be maintained until the patient is placed on a backboard. (p. 278)
What is paradoxical movement?
Paradoxical movement occurs when a section of the chest sinks inward upon inhalation while the rest of the chest is moving outward, and upon exhalation bulges outward while the rest of the chest is moving inward. (p. 278) AKA Flail Segment or Flail Chest when two or more adjacent ribs are fractured in two or more places.
What does PMS stand for?
Pulse
Motor Function
Sensation (p. 282)
What does OPQRST stand for?
Onset
Provocation
Quality
Radiation
Severity
Time
What are the 3 key steps of the detailed physical exam?
1) Perform the detailed physical exam
2) Reassess the vital signs
3) Continue emergency care
What are the 5 key steps of the ongoing assessment?
1) repeat initial assessment
2) Reassess and record vital signs
3) Repeat the focused assessment for other complaints or injuries
4) check interventions
5) note trends in the patient's condition (p. 321)
What is orthopnea?
Shortness of breath while lying flat. (p. 293)
An AED can be used on a child, as long as he or she is ____ year old.
1 year old.
If a ______________ pulse is palpable, the systolic pressure is at least 60 mmHg.
radial
true or false: Sluggish pupils may indicate an inadequate oxygen supply.
True
When assessing the chest, you should inspect it for adequate rise and fall, and auscultate breath sounds where?
At the midclavicular line and at the 4th or 5th intercostal space, midaxillary line.
The mnemonic for remembering the questions to ask when assessing the patient's chief complain or major symptoms is _____________?
OPQRST
The "R" in OPQRST stands for what?
Radiation (radiating pain)
The "S" in OPQRST stands for what?
Severity
True or false: Our exhaled breath is 16% oxygen.
True.
True or False: No matter what its size, an oxygen tank is full at a pressure of 2,000 psi.
True.
True or False: Nail polish will not adversely affect the accuracy of a pulse oximeter reading.
False.