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146 Cards in this Set
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Definition of the Midpoint and how it is applied
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Mean=average
Median=Midpoint Mode=most frequent so 20-30 midpoint =25 |
1.17
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Protocols and their correlation to national standards
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A protocol is a tx plan for a specific illness or injury.
Protocols are usually developed in conjunction with national standards. |
1.15
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Attributes of a self-motivated Paramedic:
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-Integrity
-Empathy -Self-motivation -Team work and Respect -Patient Advocate -Injury Prevention -Careful Delivery of Service |
1.12
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The main purpose of EMS research
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To determine if tx is effective or not.
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1.17
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Definition of integrity
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Being open, honest, and truthful with your pts.
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1.12
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Components of the National EMS eduction and practice blueprint
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Outlines the minimum knowledge base that the paramedic must possess in order to function in the field.
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1.10
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The main purpose of continuing education
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To keep you up-to-date on new new techniques and skills.
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1.10
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Benefits of On-Line Medical Control
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Provides an immediate and specific pt care resource.
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Licensure and its state requirements
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Being licensed is similar to being certified, a person who has shown a degree of competancy in a specific occupation and is granted ability to function through a government body. State and local guidelines determine whether you're going to be licensed or certified. You still have to work under medical direction/physician.
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1.11
1.20 |
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Standing order and their applications
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Outlines specific direction, permission and sometimes prohibitions regarding pt. care that is rendered prior.
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1.15
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Expectations of Dispatchers (regarding pre-arrivals)
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EMD's have the task of giving simple medical direction (CPR, bleeding control,etc)
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1.9
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The steps in competing a research process:
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1. Prepare a question.
2. Write a hypothesis. 3. Decide what you will measure and best method to use. 4. Outline the populations you will use. 5. Identify expected study limitations. 6. Acquire approval of the study by an institutional review board. 7. Obtain needed consent from the population(s) used. 8. Gather data. 9. Analyze the date. 10. Decide what you will do with your final research product. |
1.18
Table 1-5 |
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Stress responses and adaption of the pts
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Pts. response to emergencies are determined by their personal methods of adapting to stress.
Most of the psychological stress responses are not under the pts conscious control. |
2.11
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Steps in reporting an exposure
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Wash immediately with soap and water.
Comply with all reporting requirements. See doctor. Obtain boosters. Document after the call and the actions taken to reduce chances of infection. |
2.22
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Behavior modification (youth vs adult)
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Patterns of living you develop in your youth are harder to modify in later life and impose.
Need to read 2.4 |
2.4
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S/s of the fight or flight response
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2.7 and 2.10
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Injury Prevention
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Take care of yourself and at the same time presenting a role model for others.
Some ex include: Public Ed: Require car manufactures to install auto seat belts and airbags. Practice what you preach. Read 3.13 |
3.13
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Serious injury risk in children
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Their developing bodies, including a larger head in proportion to the body, thinner skin and a smaller airway, putting them at higher risk of injury.
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3.11
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Definition of abandonment
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Abrupt termination of contact with the pt without giving the pt sufficient opportunity to find another suitable health care professional to take over his/her medical tx.
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4.12
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Definition of implied consent
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Assumption on behalf of a person unable to give consent that he/she would have done so.
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4.14
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The difference between laws and ethics
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Ethics are a set of values in society that differentiates right from wrong. Laws define our obligations and protect our rights and the rights of others.
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4.3
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Definition of false imprisonment
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The intentional and unjustified detention of a person against their will.
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4.5
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Due process (in relation to licensing)
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Due process is a right to fair procedure for the action the agency proposes to take. Consist of 2 components: "Notice" and "The opportunity to be heard" The paramedic must be notified.
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4.13
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Definition of EMS enabling legislation
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Defines how EMS is structured.
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4.4
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Pitfalls of a tier EMS system
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BLS arrives first and may make an improper determination that the pt does not need ALS, exposing the system to liability.
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4.12
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Definition of Libel
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Making a false statement in written form tht injures a person's good name.
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Chap 4 vital vocab
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EMS personnel reportable cases
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-Neglect or abuse of children
-Neglect or abuse of elder -Domestic violence -Drug related injuries -Rape -Animal bites -Certain communicable diseases -Childbirth occurring outside a licensed medical facility. -Injury sustained during the commission of a felony, or specific injuries considered to be of suspicious origin ie. gunshots, stabbing, etc. |
4.20
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Definition of Ethics
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A set of values in society that differentiates right from wrong.
The philosophy of right and wrong, of moral duties, and of ideal professional behavior. |
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Definition of surrogate decision maker
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A person designated by a pt to make health care decisions for them when they are unable to make decisions for themselves.
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5.8
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Organ Donation
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Kidneys and liver are not appropriate after prolonged hypotension or CPR, however skin and corneas may be very valuable.
Read 5.8 2nd half organ donations |
5.8
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Causes of Hyponatremia
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Low sodium.
May be cause by excess sweating from hot environmental, exercise, as well as gastrointestinal loss through vomiting, diarrhea, inappropriate IV fluids, or diuretics. |
6.11
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Rheumatic fiver and its side effects/outcomes
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Read 6.20 right before CA section
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S/s of breast CA
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Early symptoms are usually detect by the woman during self exams, and include a small, sometimes painless lump, thick or dimpled skin or a change in the nipple.
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6.21
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Causes of potassium shift into the cells
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Albuterol, Bicarbonate, and insulin shift potassium intocells during a 15-30 min period.
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Read 6.12 under hyperkalemia
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Blood osmolarite as a negative feedback system
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Read 6.10
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________ do not produce exotoxins or endotoxins while ________ do.
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Viruses
bacteria |
6.17
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Characteristics of the resistance stage of stress reaction
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The body's way of adapting to stressors, it does so by primarily stimulating the adrenal gland.
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6.46
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Total body fluid loss required to alter homeostasis
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In health adults, loss of more than 30% of total body fluid is required to alter homeostasis.
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6.6
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Plasma Composition in the body
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Plasma makes up 55%of the blood
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6.9
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The net effects of osmosis
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The movement of a solvent, such as water, from an area of low solute concentration to one of high concentration through a selectively permeable membrane to equalize concentration of a solute on both sides of the membrane.
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6.8
Table 6.1 |
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The chief WBC of Immune Response
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Lymphocytes
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6.33
Table 6.5 |
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Where does RNA come from?
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The cell's Nucleus.
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Definition of Homeostasis
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A tendency to constancy or stability in the body's internal environment.
A dynamically steady state. |
6.5
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Side effects of loss of normal sympathetic nervous system tone
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Neurogenic shock usually results from SCI. The effect is loss of normal sympathetic nervous system tone and vasodilation. Often pts. have fluid-refractory hypotension due to the degree of vasodilation.
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6.29
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Cardiac muscle definition, type and basic functions
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Striated involuntary muscle of the heart that has the ability to both contract and generate impulses.
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6.5
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Primary Intention and Wound Healing
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Healing by primary intention occurs in clean wounds with opposed margins (ex:clean surgical wounds)
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6.40
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Physiologic Effects of Tricyclic Antidepressants
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Tricyclic Antidepressants (TCA's) block the neurotransmitters norepinephrine and serotonin from being reabsorbed in the brain, and block acetylcholine from reaching its receptors which may lead to tachycardia, and block alpha-1 receptors which may produce orthostatc hypotension.
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7.26
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Dromotropic effect on the heart
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A drug that alters the velocity of the conduction of electricity through the heart.
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7.28
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Effects of Beta-1 Adrenergic Receptor Stimulation
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Increase the heart rate, cause cardiac muscle to contract, produce automaticity and trigger cardiac electrical conduction.
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7.27
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Considerations of pediatric medication administration
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Do not achieve the same hepatic function as adults until 6 month so they have a reduced metabolic capacity. Can metabolize some meds faster, requiring more or more often a dose. Incomplete development of the gastrointestinal tract slow absorption and delays elimination.
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7.10
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Schedule III vs Schedule IV Drugs
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Schedule III drugs have a lower potential for abuse (than I or II) and may lead to low or moderate physical dependance or high psychologic dependance (codeine derivitives) IV drugs have a low abuse potential and limited dependance potential (depressants, accepted medical uses, ie. Valium).
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7.7
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Definiton of Agonist
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A substance that mimics the actions of specific neurotrasmitter or hormone by binding to the specific receptor of the naturally occurring substance.
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7.14
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Definition of Loading dose
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A large dose of the same concentration that temporarily exceeds the body's ability to eliminate the medication to reach therapeutic level.
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7.19
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Definition of Pharmakokinetics
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The study of the metabolism and actions or medications with particular emphasis on the time required for absorption, duration of action, distribution in the body and method of excretion.
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7.18
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Protease Inhibitor Medications, Their Actions and What They're Prescribed For-
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Class of drugs for treating HIV infection-interrupts the virus during replication, a later steps in the life cycle.
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7.32
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Definition of a generic medication name
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A general name for drug that is not manufacturer-specific; usually the name given to the drug by the the company that first manufactures it.
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7.5
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Definition of Parasympathetic Nervous System and What Response System it Controls
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A subdivision of the autonomic nervous system that is involved in control of involuntary, vegetative functions, mediated largely by the vagus nerve through the chemical acetylcholine. "Feed and Breed"
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7.13
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Beta-1 Receptor Stimulation and Epinephrine
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We often agonize the beta-1 receptors in an attempt to treat cardiac arrest and hypotension. Stimulation of these receptors increases myocardial contractility. In contrast, antagonizing the beta-1 receptors lowers the blood pressure by limiting myocardial contractility and heart rate ventricular contractile force. It also decrease impulse generation in heart and slows the conduction at the atrioventricular node, so it treats increase cardiac.
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The nervous system that transmits the effects of emergency medications to te heart and vessels
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Autonomic nervous system is particularly vulnerable to the administration of prehospital medication
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7.12
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Requirements of a medication to carry the USP label
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Laws an regulations also outline standards for drug manufacturers to ensure that drugs produced by different manufacturers are of uniform strength and purity.
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7.22
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Components of the narcotic control act of 1956
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It increased the penalities for violation of the Harrison Act, made the possession of heroin illegal and outlawed the acquisition and transportation of marijuana.
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7.7
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Components of Calcium and how it is used
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C++ is the principal cation needed for bone growth. It also plays an important part in the functioning of heart muscle, nerves and cell membranes and is necessary for proper blood clotting.
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8.4
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The use of Volutrol (Buretrol) in Pediatrics
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Allow you to fill a 100-200mL calibrated drip chamber with a specific amount of fluid and administrater only that amount to avoid inadvertant fluid overload. Commonly used in ped. pts.
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8.10
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IO Infusions and Its Components
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Intraosseous means "within the bone." IO is technique of administering fluids, blood and blood products, and meds into the intraosseous space of a long bone, usualyy tibia.
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8.23
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Vital Sign Ranges of the Newborn
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Pulse rate=90-180bpm
Respirations=30-60bpm BP systolic=50-70 Temp=98-100 Degrees F |
9.4
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Airway and alveoli changes in the older adult
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The size of the airway increases and the surface area of the alveoli decreases. The natural elasticity of the lungs also decrease.
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9.12
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Teething and its side effects
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Emergence of baby teeth. Teeething can be painful and accompained by a fever.
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9.8
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Definition of the Moro reflex
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An infant reflex in which, when an infant is caught off guard, the infant opens his/her arms wide, spreads the fingers, and seems to grab at things.
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9.4
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Infancy age parameters
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Infants are 1 month or 1 year
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9.3
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Pt modesty and family considerating
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It is important to remember that if a pt is not personally sensitive to modesty because of an impaired mental state: the pts family likely will be.
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Defintion of communications
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The act of tranmission of information to another person-whether it be verval or throuh body language.
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eye to ey contact conveys
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That you are honest and concern.
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10.10
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Components of partial laryngectomy
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Entails surgical removal of a portion of the larynx. People who have had this procedure are called "partial neck breathers" because they breathe through both the stoma and the nose or mouth.
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11.103
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Quality question
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Does it come and go?
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10.7
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Components of pt pain documentation
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Documenting pain severit ratins is important also to note how distressed the pt appears: mild, moderate, or severe
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12.14
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Edema in heart failure
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CHF bilateral dependant edema
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13.25
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Indications of the 4th heart sound
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S4 is a "gallop" rhythm is moderately pitched sound that occurs immediately before the normal S1 sound. Int is always abnormal and represents either decreased stretching (compliance) of the left ventricle or increased pressure in the atria.
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13.25
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Blood pressure is product of
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cardiac output and peripheral vascular resistance.
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13.6
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Rales do not present with
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bronchospasm
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Dysarthria
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A pt with slurred speech.
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How do we asses tidal volume in the field
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Adequate, bilateral chest rise and fall.
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Protocols or standing orders, specify the paramedis performace parameters, which:
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Define what the paramedic can or cannot do without direct medical control.
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An unresponsive pt who has been breathing slowly and shallowly for an extended period of time would most likely have _________ skin.
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cyanotic
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Hormonal effects on the paramedic can
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diminish your ability to concentrate.
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Definition of medical ambiguite
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Uncertainty regarding the specific cause of the pts condition/problem.
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The main disadvantage of pt care algorithms is that they:
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only address classic pt presentations.
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When reading an MVC we are not concern with what?
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Who is at fault
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15.11
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Definition of frequency
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In radio communications, the numer of cycles per second of a signal, inversely related to the wave length.
How frequently a radio wave occurs in a given time. |
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Biotelemetry is
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The capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.
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Obtaining refusals in the pt with AMS
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For purposes of refusing medical care, a pts mental staus may be considered impaired if he/she is makes nonsensical statements.
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16.21
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The accuracy of your PCR depends on all of the following factors, except:
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The severity of the pt's condition
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Which of the following documentation styles would be most difficult and time consuming to apply in EMS
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Body system approach
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Time of inital assessment
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is not commonly documented.
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Motorcyele helmets worn properly
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will not protect the c-spine
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17.13
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Where will the most severely injured pt found in a rotational impact?
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At the greatest point of deceleration
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What medication impedes further release of chemical mediators in anaphylactic shock?
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Benadryl/Dyphenhydramine
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18.28
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Prehospital tx of internal hemorrhage and shock
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ABCs, O2, IV fluid, trendelenburg, rapid trasport and no anelegesics.
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18.14
18.8 |
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Classic pulse of dehydration
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rapid pulse
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8.6
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Tx of cardiogencic shock
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Occurs when the heart is unable to circulate sufficient blood to maintain adequate peripheral oxygen delivery. Expedite transport with pt in supine position, secure ABCs, monitor SpO2 via NRB, apply monitor, establish IV and consider 200mL Fluid challenge, auscultate lungs. Consider meds.
No Atropine No MAST pants |
18.27
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Blood voulme drops by more than 30% is
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Decompensated shock
decreasing BP |
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Respiratory rate during compensated shock
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An increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset metabolic acidosis.
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What does hypoperfusion not result from?
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An increased systemic vascular resistance (increasing BP)
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What kind of drug has a negative effect on the body's process of homeostasis
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Anticoagulants use
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What is the BP of septic shock
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Systolic of 90mmHg or a decrease of 40mmHg from baseline.
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18.18
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Characteristics of MODS
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Progressive condition characterized by combined failure of several organs.
Not increased lactase metablism of the liver. |
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What does diabetes do to wound healing?
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Drastically impairs healing of the wound.
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19.7-8
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Characteristics of the outer layer of the epidermis
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The epidermis consists of 5 layers: an outermost layer (stratum corneum) of hardened, nonliving cells, which are continuously shed through a process called desquamation; and four layers of living cells that constantly divide to give rise to the cells of the stratum corneum.
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19.5
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The subcutaneous layer consist mainly of..
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adipose tissue (fat)
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19.6
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Definition of gangrene
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An infection commonly caused by C perfreingens. The result is tissue destruction and gas productiong that may lead to death.
Necrosis of tissue caused by an anaerobic toxing-producing bacterium called gangrene. |
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Fever is secondary to
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infection
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19.8-9
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When assessing a burn pt it is most important to:
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be alert for occult trauma that could effect pt outcome.
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While standing by a scene of a structure fire, it is most important to remember that :
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toxic gases are often present, even after the fire is out
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20.8
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Cardiac arrest after lightening injuries
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Lightening acts as a soxmic defribrillator, depolarizing the entire heart. The heart may resume beating spontaneously shortly after the shock or 5 cycles/2mins of CPR started immediately. Continue ventiliatory support because respiratory arrest is apt to start.
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20.13
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Intubating the burn pts in reference to tube cutting
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Never cut an ET tube. Use the biggest tube possible without causing additional damage.
Be aware that edema may cause tube dislodgment. |
20.11
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Characteristices of the outer zone in an electrical burn
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(Bull's Eye Burn) Central, charred zone of full-thickness burns; a middle zone of cold, gray, dry-tissue; and an outer redzone of coagulation necrosis. May signal devastating injury inside the body.
The outer zone of an entrance or exit wound caused by a contact electrical burn is:the red zone of coagulation necrosis. |
20.11
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What is the most acute complication of large body surface burns?
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Hypothermia
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S/s or Radiation Exposure and Predictable Outcomes
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Unconscious or vomit within 10mins. Will not survive: vomit wionin an hour have severe exposure and 30--80 survival rate, vomit witon 1-2 hours have moderate exposure and have 95 to 100% survival rate.
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20.13
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S/s of retinal detatchment
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Seperation of inner layers of retina. The painless condition produces flashing lights, speckes or "floaters" in the field of vision and a cloud or shade over the pts vision.
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20.19
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What may an injury to the cerebral cortex cause?
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May result in paresthesia, weakness and paralysis of the extremities.
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21.12
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Suction considerations in the spinal immobilized pts
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Put pt on their side
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The term for a scalp laceration with nondisplaced skull fx
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Open skull fx
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21.30
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s/s of zygomatic fx
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Loss of senation below the orbit, flatteining of pts cheek, and paralysis of upward gaze.
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21.16
Table 21.1 |
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Outcome of a ruputered tympanic membrane
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Injury is typically painful, the tympanic membrane typically heals spontaneously and without complication.
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21.24
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Definition of Galea Aponeurotica
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Tough, tendinous layer of scalp. A tendon expansion that connects the frontal and occipial muscles of the cranium.
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21.4
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Primary cause of compression or burst fx of the cervical spine
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They typically result from a direct blow to the crown of the skull.
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22.8
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Causes of intervertebral disc herniation
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Compression forces can cause the herniation of disks, subsequent compression on the spinal cord, nerve roots, and fragmentation into the canal.
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Disadvantages of the use the scoop stretcher in spinal immobilization
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Although the pt can still be palpated with this method, inability to conduct visual inspection of the area is a disadvantage.
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22.13
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Are the lungs located in the mediastinal?
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NO
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23.5
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What kind of breathing would you not expect to find a pt with flail cx?
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Hyperpnea (fast breathing) because it hurts.
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Aorta route through the thorax
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As it exits the left ventricle, it ascends towards the right shoulder before it turns left and proceeds inferiorly toward the abdomen.
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23.5
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Characteristics of a tension pneumothorax
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Absent breath sounds on the affected side, tachycardia, JVD an trachial deviation
Air accumulation in the pleural space when a perforation in the lungs parenchyma acts as a one way valve. |
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Kehr's signs
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Left shoulder pain that may indicate a ruptured spleen.
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Distension in abdominal trauma
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A late sign, all blood volume can be held in the abdomen death is emmenant.
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Reducing mortality and morbity from abdominal trauma and the EMS provider
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Need for rapid transport has made a significat reduction
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24.3
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Diaphragm attachment
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12th rib and peaks in the center ath the 4th intercoxtal space.
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24.6
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Major complication associated with hollow organ injuries
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Release of its contents causnign peritonitis and spesis.
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24.6
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Grey Turners
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Ecchymosis of the flanks and is indicator or retroperitoneal bleeding.
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Cullen's sign
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Ecchymosis around the umbilicus.
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At least 2/3 or abdominal injuries involve:
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blunt trauma
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Definition of Diathroses
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Also know synovial joint, and is the most mobile joints of the body.
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25.7
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The appendiculr skeleton is didvided into the:
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pectoral girdle, the pelvic girdle and the bones of the upper and lower extremities.
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25.4
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S/s of Achilles Tendon Rupture
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Most immediate indications are pain from the heel to the calf and a sudden inability for plantar flexion (bending of the foot toward the ground) of the foot.
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25.17
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Crush injury complications scondary to return of myoglobin
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The primary substances of concern are lactic acid, potassium, and myoglobin. The return of myoglobin decreases blood pH, hyperkalemia, and renal dysfunction.
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25.28
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Estrogen and bone density in women 35yrs +
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In women, this decrease in density is further accelerated once menopause is reached because of the loss of estrogen, a bone that helps promote bone formation.
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25.7
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What type of muscle allows the body to maintain its posture to sit or stand?
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skeletal
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25.9
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Characteristics of an oblique fx
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An oblique fx is at an angle across the bone. Caused by a dired or twisting force.
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25.17
Table 25-2 |
