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124 Cards in this Set
- Front
- Back
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What Causes most hemothoraces
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Chest trauma, tears of lung parenchyma, penetrating wounds, rib fractures, injury to liver, spleen, aorta, intercostal arteries
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List the types of viral hemmorrhagic feaver
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Ebola, Rift Valley, Yellow fever viruses
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Pt with kidney or liver failure likely will devlop increase in what type of fluid
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interstitial fluid! thanx Chloe
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Morphine Dosage range
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Adult 2-8 mg. Pedi 0.1-0.2 mg/kg
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why is hypoxia less likely with nasotracheal intubation
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It is performed on pts with spontaneous breathing
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What is concept formation
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pattern of understanding based on initially obtained information
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IN OPQRST, what question is appropriate for S
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severity - usually expressed as a value on a scale of 1-10
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What type collision would a pt likely be trapped between steering wheel and seat
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Head-on or frontal AND REAR END MIKE ( I think she means the front of the car that hit the other car?)... found it again here's the page, lol
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Most common sign of measles
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blotchy red rash
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Why is Pulse ox inaccurate when CO poisoning present
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PO measures gas attached to hemoglobin; it cannot differentiate between O2 and CO
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Describe an ECG Delta wave
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Indication of Wolff-Parkinson-White syndrome; an accessory pathway between atria and ventricles
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Decresed ventilation compliance with intubated pt may indicate
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gastric distention, esophogeal intubation, or tension pneumothorax
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When should IV/IO access be established in child in compensated shock
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en route to the hospital
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what class of drug has alpha and beta properties
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sympathomimetic
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abnormal immune response due to exposure to allergen
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allergic reaction
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when contents leave stomach, what is next structure encountered
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the pyloris - circumferential muscle at the end of the stomach - then to the duodenum
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most commonly heard breath sounds; normal sounds
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soft, breezy vesicular sounds in the preriphery
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Describe febrile seizure
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simple: brief generalized tonic-clonic <15 minutes; complex: focal, occur in child with a baseline developmental or neurological abnormality or severe illness >15 minutes
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When does water-depleted exhaustion occur
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when fluids are not adequately replaced -- ie geriatric patient dehydrated from meds. or immobility or athlete who exerts in heat and doesn't replenish fluids
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describe what happens to brain in coup-contrecoup
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in rapid deceleration, the body is thrown forward - then the brain slams into the frontal skull, then the body is thrown backward and the brain is slammed into the back of the skull
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history of c-section in pregnant woman my suggest highest risk for what
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uterine rupture
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highest risk of newborn complications if amniotic sac...
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contains green or dark meconium or if the sac ruptured many hours before delivery
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layers of wall of heart
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epicardium - outermost; endocardium - innermost; myocardium - middle, muscular layer
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purpose for PAT
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make slide show as interesting as possible; provide EMS workers with a "from the doorway" general impresion of peds. 3 elements: child's appearence, work of breathing, circulation
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what judicial branch does
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enforces and interprets laws and resolves disputes based on interpretation of laws
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List inhaled beta 2 agonist bronchodilators
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Albuterol (Ventolin, Proventil) Isoetharine (Bronkosal) Metaproternol (Alupent)
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describe partial thickness burns
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involve the epidermis and part of the dermis; painful and blisters
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what type burns require transport to burn center
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partial thickness >10% of body surface; burns that involve face, hands, feet, genitals, perineum or major joints; full thickness in any age group; electrical; chemical; inhalation; injuries in conjunction with preexisting medical condition; combined with trauma where injury poses greatest risk of morbidity/mortality; will require special social, emotional or long term rehab.
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in triage, what conditions warrant a red tag
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patients breathing >30 bpm; patients not breathing but simple airway maneuver caused patient to breath; hysterical patients; no radial pulse; decreased LOC; patient that cannot follow simple commands
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most important step when replacing ostomy device
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??? my best guess from page 45.22 is either wash your hands or make sure you don't spill contents due to severe irritation to skin ....
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what happens when blood is too acidic
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metabolic acidosis (pH lowered) - maybe from sepsis, DKA, salicylate poisoning; results in CNS depression
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risk factors for suicide
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loss of loved one, loss of job, being white, male, >55, single, widowed or divorced, alcohol or other drugs, depression or sudden improvement from depression, recent loss of spouse, social isolation, chronic/dibilitating illness, schizophrenia, family Hx of suicide, person who talks about suicide or plans it
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medications that caused most IgE reactions
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penicillin
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examples of "act of commission"
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doing more than you are trained to do, ie stitching a laceration, surgery, etc. this is in the book, but from the definition other examples include purposefully beating someone or causing any harm - not from neglect or omission, but intentionally
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In triage, next step after finding strong radial pulse
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assess patient's neurologic status by asking to follow simple command
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Most common seizure in premature infants
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tonic - most commonly caused by Hypoxic ischemic encephalopathy
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significance of fractured mandible
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the significant FORCE that would have been applied in order to fracture the mandible
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Describe electrolytes
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It's ALL about electrolytes! ie Potassium is necessary for neuromuscular control, reg. of 3 types of muscle, acid/base balance, intracellular enzyme reactions & maintenance of intracellular osmolarity
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after any immobilization procedure, what should be done
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check Pulses, motor function and sensation
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Step prior to displacing vehicles roof
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Cover and protect all occupants. Remove all glass
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what happens to nonencapsulated bacteria in body
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they are destroyed by phagocytes
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define nulliparous
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a woman who has never delivered
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Describe bruits
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an abnormal "whoosh" like sound of turbulent blood flow moving through a narrowed artery
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s&s of meningitis
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Sudden onset of fever, severe headache, stiff neck, photosensitivity & a pink rash Change in mental status
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Define a term infant
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37 - 42 weeks
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what chemical do spray paints and lacquer thinner contain
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Hydrocarbon
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What is the leading cause of death from injury
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I believe since head injury is the leading cause of traumatic death - this is it, but so many many stats ... for sure unintentional injuries are the leading cause of injury deaths ...
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What happens at the cellular level during depolarization
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muscle fibers are stimulated; changes in concentration of electrolytes occurs across the cell membrane - sodium & calcium rush into the cell and the net charge of the cell changes causing muscle contraction
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S&S and ECG findings of Wolff-Parkinson White
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delta wave is present; accessory pathway between atria and ventricles - bundle of Kent; ss -dizziness, shortness of breath, syncope - susceptible to MI and SVT's
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Early warning signs of stress
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Heart palpitations, rapid breathing, chest tightness and sweating
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Area in heart where electrical activity arises
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Pacemaker
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What does fine v-fib indicate
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nothing - no such thing - asystole
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Examples of open-ended questions
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How are you feeling?... Questions that do not have a yes/no answer, provoke a longer response
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Functions of pancrease
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It secretes enzymes into the bowel that aid in digestion. Also secretes the hormone insulin, which is responsible for helping glucose enter the cells.
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What happens to vocal cords during forceful inhalation
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During forceful inhalation, the vocal cords open widely to provide minimum resistance to air flow
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describe dual luman airway device
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long tube that is blindly inserted into the airway, can be used for either esophageal obturation or endotracheal intubation, devices have two lumens, have proximal cuff that is inflated to eliminate the need for a face mask
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What do lower airway emergencies involve
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*NOT SURE WHAT QUESTION WANTS* Obstructive airway diseases are diffuse obstruction to airflow within the lungs, most common are COPD, emphysema, asthma
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what damage is possible from IV in joints
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Nerve, Tendon, Ligament Damage... Improper identification of anatomic structures around the IV site lead to perforation, IV sites near joints increase risk for perforation
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What is reiter syndrome
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an autoimmune condition that develops in response to an infection in another part of the body. (reactive arthritis) "patient can't see, can't pee, can't bend the knee"
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what happens in diarrhea
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the colon fails to complete the reabsorption of water
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Violent Pediatric patients require what other resources
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Law enforcement - if they can't be talked down or restrained safely
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How is APGAR score used in resucitation
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helps determine the need for and the effectiveness of resuscitation
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What does increased intravenous pressure cause
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Increased preload
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What medications can interfere with homeostasis
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crystalloid solutions
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Circumflex branch supplies what area
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Left ventricle of the heart along with the interventricular septum & part of the right ventricle.
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Define DNR
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An advance directive that describes which life-sustaining procedures should be performed in the event of a sudden deterioration in a pt's medical condition.
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Assessment of epiglottitis
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Pt typically drools and has a fever, hoarse voice & purposeful hyperextension
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What does rales possibly indicate
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lung tissue consolidation, atelectasis, edema, mucos collection, hemmorhage
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How does renal insuficiency affect medication administered
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If the kidneys are not working properly, medications may not be excreted efficiently, so the concentration of a drug may build up inside the body until it reaches toxic levels
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When are allergies acquired
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Allergies are acquired with the first exposure to a foreign substance
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What is asymmetric chest wall movement
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Asymmetric chest wall movement is when one side of the chest moves less than the others, indicating decreased airflow into one lung
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what effect does epinephrine have
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Epinephrine is a sympathetic agent that causes a strong increase in heart rate, dilation of bronchi and a peripheral vasoconstrictor effect
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what med should not be given to child with fever
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Aspirin should not be given to children with a fever because it is linked with Reye's syndrome, which can result in cerebral edema and liver failure
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when does child's immune system fully develop
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The immune system is not fully developed until the child is between 2 and 3 years old
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Precordial leads view what areas of heart
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These leads look at the heart in the horizontal plane so they provide a picture of the heart taken from the front (anterior wall of the heart) & from the left side(anterolateral). V1 and V2 look at the septum, V3 and V4 look at the anterior wall of the left ventricle, and V5 and V6 look at the lateral wall of the left ventricle
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what does trigeminial nerve conrol
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Motor: chewing, Sensory: Face, Sinuses, Teeth
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Most common risk factors for type 2 diabetes in elderly
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more than one chronic disease, family history, genetics, age, diet, obesity, sedentary lifestyle
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what occurs if the sodium potassium pump is impaired
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sodium accumulates inside the cells and causes cells to swell
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how to treat patients with DNR
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pain medication, supplemental oxygen therapy, nutrition, hydration
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When might you see anxious avoidant attachment in an infant
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when infant is repeatedly rejected by parents or caregivers
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What is circadian rhythm
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The body's natural timing system
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What meds commonly seen in patients who has had an organ transplant
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Immunosuppressant medications are intended to inhibit the body's ability to attack the "foreign" organ. They inhibit lymphocytes and T cells from carrying out their immune functions
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meningococcal meningitis with sepsis presents with what S&S
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Typically characterized by a petechial or purpuric rash in addition to the other symptoms of meningitis
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Where should a patient in shock be transported
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to a hospital with capabilities to provide early surgical intervention or even comprehensive cardiac care capabilities
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Describe the cricothyroid membrane
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small space between the thyroid and cricoid cartilages, site for emergency surgical and nonsurgical accesss to the airway (cricothyrotomy), bordered laterally and inferiorly by thyroid gland; covered only by skin and minimal subcutaneous tissue
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Describe chemical nature of sodium
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positively charged ion
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age related hypertension is exacerbated by what
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diabetes, atherosclerosis, renal compromise
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What does potassium do
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necessary for neuromuscular control, regulation of the three types of muscles, acid-base balance, intracellular enzyme reactions and maintenance of intracellular osmolarity
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Define affinity
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The attraction between a med and its receptors. The stronger the affinity between the two, the stronger the resulting bond.
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What are signs of abuse in nursing home
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Undocumented decubitus, ulcers, tied-off catheters and dangerous use of restraints
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Why do elderly experience slower response to hypoxemia
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decreased PaO2, respiratory drive becomes dulled due to decreased sensitivity to changes in arterial blood gases or decreased CNS response to such changes
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How does shock affect IM and SQ administration
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IM and SC depends on adequate blood flow to muscles and peripheral tissues, therefore should be given only to patients with adequate perfusion
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What hormone does the adrenal cortex produce
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the adrenal cortex produces corticosteroids.
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primary component of the immune system
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white blood cells
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Most common cause of tubo-ovarian abscess
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gonorrhea
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Treatment for HHNC
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follows pathway for dehydration and altered mental status; ET intubation may be indicated, C-spine immobilization for unresponsive patients found down, Large-bore IV access then bolus of 500ml 0.9% NS,
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Benefit for using prefilled syringe
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designed for ease of use, quicker to use a prefilled syringe than to draw up individual doses
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Most significant factor that determines how well body compensates for blood loss
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Compensation is related to how rapidly they bleed, rapid loss is more likely to cause shock
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When can prescription meds be given over the counter
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Prescription-only medicines can be given OTC status only if they are considered safe enough that most people will not hurt themselves accidentally by taking the medication as instructed
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What causes Mallory Weiss syndrome
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during the act of vomiting, pressure within the stomach can increase so greatly as to cause a failure of the structure of the esophagus, junction between the esophagus and the stomach tears
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When does uterine inversion occur
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the placenta fails to detach properly and adheres to the uterine wall when it is expelled; when excessive pressure is placed on the uterus during fundal massage or by exerting strong traction on the umbilical cord in an attempt to hasten delivery of the placenta
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Left main coronary artery subdivides into what
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circumflex coronary arteries and left anterior descending branch
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Most commonly used medication route in EMS
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IV administration is the route most commonly used in the prehospital setting and is generally the quickest route
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what does a prolonged QT interval indicate
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The heart is experiencing an extended refractory period, making the heart more vulnerable to arrhythmias
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Corticosteroid therapy vs bronchodilator therapy
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Corticosteroids treat pulmonary edema, bronchodilators treat bronchospasm
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Safe practices for parking emergency vehicle on roadway at night
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Drivers may become distracted and drift into parked emergency vehicles, consider using emergency flashers instead of all the overhead lights, to avoid blinding drivers turn off headlights
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What type of terrorist attacks technological infrastructure
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Technology Terrorists
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Head on motorcycle collisions likely result in what injuries to rider
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bilateral femur or tibia fractures and severe foot injuries, severe anterior-posterior compression injuries to the pelvis, open pelvic fractures
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Symptomology of aortic aneurysm
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Typical pt is a man in his 50's or 60's, if stable, patient will usually be asymptomatic. Symptoms include: abdominal pain near the umbilicus or back pain in the lower back. Pain is constant and moderate to severe and cannot be relieved by changes in position. Tends to radiate to thigh and groin. If aneurysm is leaking blood int the retroperitoneal space, the pt may complain of an urge to defecate. Sometimes a syncopal episode occurs before the onset of symptoms. Most characteristic finding is a pulsatile mass palpable in the abdomen.
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Step prior to injecting med on IM or SQ administration
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BSI, determine need, obtain H&P/allergies/vitals, Check med/right patient/route/dose/, advise pt, assemble equipment, cleanse area, pull skin taut
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S&S of heatstroke
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changes in behaviour, confusion, delirium, coma, tremors, seizures, constricted pupils, decerebrate or decorticate posturing, markedly elevated temperature usually above 104F, tachycardia, hyperventilation, BP normal or decreased
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S&S of overaggressive dialysis
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hypokalemia causes hypotension and cardiac dysrhythmias (usually bradycardias)
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Steps to take if parent insists on monitoring your conversation with adolescent child
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Some adolescents may be hesitant to reveal pertinent history in the presence of family and friends. If the adolescent gives incomplete answers or appears uncomfortable during the interview, interview the patient privately. Be alert to the possibility of alcohol or drug abuse (Brady Paramedic Text). If necessary, enlist the help of other family members or law enforcement personnel (to distract the parent).
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Why is cricothyroid membrane ideal site for surgical opening
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No important structures lie between the skin and the airway, The airway at this level lies close to the skin and is easy to enter
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Most effective way to maintain knowledge of medical terminology
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continuing education (1.1) ongoing review of the anatomy & physiology chapter (16.19) and you should always know the acceptable medical terminology for your service
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Where is 1/2 of body magnesium stored
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The bones(50%) also Body cells(49%) and ECF(1%)
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Purpose of spacer on MDI
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The device that collects the medication as it is released from the canister, allowing more to be delivered to the lungs
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Contraindications of fibrinolysis
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Evidence of intracranial hemorrage, uncontrolled hypertension, witnessed seizure at stroke onset, active internal bleeding or acute trauma, within 3mo of intracranial or intraspinal surgery,history of intracranial hemorrage... See table 28-10
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What causes most spinal cord injuries
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mva's 35-40%, acts of violence 24.5%, falls especially in elderly 21.8%, recreational/athletic activities (especially diving) 7.2%
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What effect does supplemental oxygen have on acute MI
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oxygen may limit ischemic myocardial injury and reduce the amount of ST-element elevation.
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Define acute renal failure
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a sudden decrease in filtration through the glomeruli
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When using succinylcholine, what med can reduce muscle fasciculations
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non-depolarizing neuromuscular blockers -- pancuronium and vecuronium
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What conditions will increase circulating CO2 levels
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COPD(emphysema and chronic bronchitis) and hypoventalation cause increased carbon dioxide level
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What effect occurs within first 5-10 minutes of lasix administration
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it has a venodilating effect, increasing peripheral pooling of blood
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