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94 Cards in this Set
- Front
- Back
- 3rd side (hint)
What are the six major categories for the NREMT test?
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Airway and breathing, Cardiology, Medical, Trauma, OB/Gyn/Peds, and Operations.
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REA page 4
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Define living wills
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A legal document that allows people to specify the kinds of medical treatments they wish to receive when the need arises.
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REA page 8
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Define advance directies
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A document created to ensure that certain treatment choices are honeored when a patient is unconscious or otherwise unable to express a treatment choice.
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REA page 8
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Define beneficenece
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To do good.
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REA page 10
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Define malfeasance
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Doing harm.
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REA page 10
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Define autonomy
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Refers to a competent adult patient's right to determine what happens to his or her body.
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REA pg 10
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Define justice
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The paramedic's obligation to treat all patients fairly.
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REA pg 10
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What are the four fundamental principles or values that apply to bioethics?
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Beneficence, malferasance, autonomy, and justice
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REA pg 10
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Define Atrophy
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A decrease in cell size resulting from a decrease workload.
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REA pg 18
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Define Hypertrophy
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An increase in cell size resulting from an increase workload.
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REA pg 18
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Define Dilation
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An abnormal enlargement resulting from pathology, as sometimes occurs in the heart. Dilation can be a normal process, such as papillary dilation when you enter a dark room.
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REA pg 18
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Define Hyperplasia
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An increase in number of cells resulting from an increase work load or from a precancerous condition.
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REA pg 18
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Define Mitosis
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The process by which cells divide.
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REA pg 18
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Define Metaplasia
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The replacement of one type of cell by another type of cell that is not normal for that tissue.
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REA pg 18
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Define Dysplasia
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A change in cell size, shape, or appearance caused by an external stressor.
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REA pg 18
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How will a patient in neurogenic shock appear?
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Skin will be normal to flushed and typically have reflex bradycardia and hypotension as a result of vasodilation.
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REA pg 26
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Define Kussmaul respirations
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Deep, slow or rapid, and gasping breathing commongy found in patients in DKA.
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REA pg 36
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Define Cheyne-Stoke respirations
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Breathing that is progressively deeper and faster, alternating gradually with shallow, slower breathing, signifies brain stem injury.
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REA pg 36
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Define Biot respirations
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Breathing with an irregular pattern or rate and depth and sudden, periodic episodes of apnea, indicate increased intracranial pressure.
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REA pg 36
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Define Agonal respirations
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Shallow, slow or infrequent breathing.
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REA pg 36
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What is the normal tidal volume for an average-sized adult at rest:
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500mL
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REA pg 68
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When are falls considered predictor of a serious internal injury for an adult?
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Falls higher than 20 feet.
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REA pg 90
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Define visceral and parietal pleura
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The parietal pleura is a thin membrane that covers the inner chest wall. The visceral pleura covers the lungs.
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REA pg 92
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What does subcutaneous emphysema primarily indicate?
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Primarily indicates pneumothorax, also suspect trachea tear.
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REA pg 92
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A nasal cannula wil deliver what % of oxygen at 6 lpm?
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40%
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Barron's pg 29
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CO2 is an
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ACID
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CO2 and its effects on blood vessels and crebral perfusion
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CO2 is a very potent vasodilator. When a patient is hyperventilated, CO2 is removed and the vessels will becomme constricted. This vasoconstriction leads to decreased cerebral pressure by decreasing cerebral blood flow.
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Barron's pg 28
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Spontaneous abortions typically occur before...
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the 12th week of pregnancy.
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REA CD
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Aerobic vs Anaerobic
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Aerobic metabolism requires oxygen and is the most efficient. Anaerobic metabolism yields much less energy and results in toxic by-products, such as lactic acid.
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REA CD
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Different effects of dopamine per dose
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At 2-10 mcg/kg/min, dopamine primarily affects the beta receptors causing increase force, and automaticity of the heart..
At 10-15 mcg/kg/min, it affects bot the alpha and the beta receptors with the additional alpha effect of vasoconstriction. At 15-20 mcg/kg/min, it primarily affects alpha receptors. |
REA pg 172 and notes
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Kinetic energy is equal to
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(Mass x Velocity to the 2nd) / 2
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REA pg 190
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What are the stages of labor?
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The first stage of labor is dilation. The second stage is delivery of the infant. The third stage is delivery of the placenta or afterbirth.
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REA pg 190
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Define arteriosclerosis
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A disease of the arterial vessel marked by thickening, hardening, and loss of elasticity in the arterial wall.
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Barron's pg 65
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Define artherosclerosis
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The most common form of arteriosclerosis, usually involving medium-sized and large arteries.
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Barron's pg 65
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What is the point of maximal impulse?
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An excellent place to auscultate heart sounds and apical pulse and is located in the left anterior chest, in the midclavicular line at the fifth intercostal space.
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Barron's pg 65
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What effects does hypocalcemia and hypomagnesemia have on the heart?
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Hypocalcemia results in decreased contractility and increased myocardial irritability. Hypomagnesemia results in increased myocardial irritability.
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Barron's pg 65
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Vasopressin is indicated for management of:
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of ventricular fibrillation and pulseless ventricular tachycardia.
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Barron's page 72
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Notes on Procainamide (Pronestyl)
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Antiarrhythmic given in cardiac arrest with VF/VT at 50mg/minute via IV drip.
Given for A-Fib, VT, TSVT with WPW at 20 mg/minute until dysrhythmia is converted, hypotension or QRS/QT widening develops. Max 17mg/kg Contra:2nd and 3rd degree blocks, torsades de pointes, lupus, digitalis toxicity, myasthenia gravis Side effects: Wideining PR. QRS, and QT, AV block, cardiac arrest, hypotension, Sz, and N/V. |
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Common s/s of Grave's disease
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Agitation, emotional changes, insomnia, heat intolerance, weight loss, and exophthalmos (bulging of the eye anteriorly out of the orbit).
The result of thyrotoxicosis, excessive thyroid hormone. Endocrine disorder. |
Barron's page 113
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What is Cushing's syndrome and what is it associated with?
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Cushing's syndrome is a hormone disease caused by high levels of cortisol in the blood.
It is associated with hypoglycemia due to excessive cortisol level. |
Wikipedia and Barrons pg 113
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S/s of Cushing's syndrome
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NEED TO LOOK UP
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What is Adddisonian crisis and what are common serious s/s?
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Adrenal insufficiency which causes cardiovascular collaspe, hypotension, and hypoglycemia. These serious s/s are attributeed to major disturbances in water and electrolyte balance within the body.
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Barron's page 114
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IV Dose Epi for anaphalaxis
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3 to 5 mL of Epi 1:10,000
recommended when pt demonstrates cardiovascular and respiratory collaspe. |
Barron's pg 114
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Define Melena
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Dark, tarry, foul-smelling stool that indicates the presence of partially digested blood.
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Barron's pg 114
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What is Mallory-Weiss tear?
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An esophageal tear or laceration that results from excessive vomiting. Difficult to be diagnosis in the field, do not rule out more serious causes of upper GI bleeding.
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Barron's pg 115
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A pt with severe vomiting presents with the scleras of his eyes dramatically blood red. What is most likely the cause?
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A subconjunctival hemorrhage involves the rupture of small blood vessels in the subconjunctival spaces resultin in the "white" of the ey becoming blood red. May occur after a strong sneeze or excessive vomiting. While it looks dramatic it usually clears up without intervention.
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Barron's pg 115
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Initial dose of succinylcholine
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1.5-2.0 mg/kg
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Barron's pg 116
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Murphy's sign vs McBruney's point
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Murphy's sign is pain caused when an inflammed gallbladder is palpated by pressing uder the right costal margin.
McBurney's point is a common site of pain from appendicitis located one to two inches above the anterior illia creast in a direct line with the umbilicus. LOOK UP |
Barron's pg 117
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Normal dose for Demerol
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25-50mg IV titrated for pain relief
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Barron's 117
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What is the golden rule of tx frostbite?
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Never thaw if there is any possibility of refreezing!
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Barron's pg 119
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Bradycardia and hypotension following dialysisi treatment are most indicative of...
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hypokalemia!!!
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Barron's pg 120
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What will the body do with a chronic state of low blood oxygen levels?
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As part of the body's own compensatory mechanism, it will increas production of red blood cells (polycythemia) that gives the patient's skin a pink color.
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Barron's pg 122
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What is normal peak flow in liters/min?
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400-650 liters/min is the normal range
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Barron's pg 123
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What is adult respiratory syndrome (ARDS)?
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A form of pulmonary edema that occurs as a response to a wide variety of lung injury insults.
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Barron's pg 123
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What is a complex partial seizure disorder?
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A seizure originating in the temporal lobe, causing usual short loss of contact with their surroundings, they do not lose motor tone.
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Barron's 125
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What are petit mal seizures?
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Also known as absence seizure characterized by a brief loss of awareness for 10 to 30 seconds. Usually occurs in childhood and disappears after the age of 20.
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Barron's 125
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GCS for eye opening
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The same for infant to adult
4-Spontaneously 3-To speech 3-To pain 1-No response |
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GCS for verbal response for child/adult
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5-Orientated
4-Confused 3-Inappropriate words 2-Incomprehensible 1-No response |
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GCS for verbal response for infant
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5-Coos, babbles
4-Irritable cries 3-Cries to pain 2-Moans, grunts 1-No response |
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GCS for motor response for child/adult
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6-Obeys commands
5-Localizes pain 4-Withdraws from pain 3-Flexion/decorticate 2-Extensions/decerebrate 1-No response |
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GCS for motor response for infants
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6-Spontaneous
5-Localizes pain 4-Withdraws from pain 3-Flexion/decorticate 2-Extensions/decerebrate 1-No response |
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Fluid resuscitation for burns with transport less than one hour
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Current fluid resuscitations recommends that two large-bore IVs and a bolus of 0.5 mL/kg multiplied by the percentage of BSA burned of NS.
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Barron's page 152
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Treatment of flail chest injury
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Positive pressure ventilation reverses the mechanism that causes the paradoxical chest wall movement, restoring tidal volume, and reducing pain of chest wall movement.
LOOK UP |
Barron's page 155
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What is Brown-Sequard's Syndrome?
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Penetrating injury that affects one side of the spinal cord with loss of sensory and motor. Pain and temperature perception are lost on the oppoiste side of the body becuase of the switching of the associated nerves as they enter the spinal cord.
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Barron's page 158
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What are tertitary injuries from blast or explosion?
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Any injury sustained from being thrown and impacting the ground or other objects.
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Barron's page 158
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Rules of nine
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Look up
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Furosemide is a potent diuretic that inhibits the reabsorption of...
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sodium and chloride in the proximal tubule and loop of Henle. IV doses can also reduce cardiac preload by increasing venous capacitance.
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REA's CD
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Your patient has a chronic reduction in arterial Po2 and an increased red blood cell production known as polycythemia. With which condition is the elevation of hematocrit or polycythemia most seen?
Emphysema or Chronic bronchitis |
This is more common in patients with chronic bronchitis ("blue bloater" patients) than in those with emphysema ("pink puffer" patients).
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REA's CD
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What is the max dose of diazepam?
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30mg given
In seizures it is commonly given in 5 to 10mg increments. |
REA
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Define PEL
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Permissible exposure limit is the maximum time-weighted concentration at which 95% of exposed healthy adults suffer no adverse effects.
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REA pg 294
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Define TLV-STEL
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Threshold limit value, short-term exposure limit is a 15-minutes time-weighted average exposure that should not be exceeded at any time and not repeated more than four times a day, with 60 minute rest periods required between each exposure.
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REA pg 294
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How do you position a patient with a prolapsed cord?
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With the hips elevated as much as possible or in the knee-chest position in an attempt to relieve pressure on the cord.
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Barron's page 190
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To prevent over or undertransfusion of blood from the umbilical cord to the newborn, correct positioning of the newborn until the umbilical cord is clamped should be...
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at the same level of the vagina with the head slightly lower than the rest of the body. This will prevent over or undertransfusion of blood and facilitate drainage of secretions from the nose and mouth to help prevent aspiration.
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Barron's page 192
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Contractions count
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Intervals correctly measured from the start of one to the start of the next. Lenth is correctly measured from the start of one to the end of that one.
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Barron's page 192
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Formulating ET and OG size
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(age+16) / 4= ET tube size
for OG just double ET tube size |
Barron's pg 193-194
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Ratio for two person CPR in infant
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15:2
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Barron's pg 194
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What is the drug of choice for symptomatic bradycardia in pediatric patient?
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Epineprine
Atropine is not because bradycardia is not often a result of parasympathetic stimulation in pediatric pts. Dose of 0.01mg/kg of 1:10,000 IV/IO |
Barron's pg 194 and 197
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What will a TCA overdose cause on the monitor?
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Prolonged QT interval along with widening of the QRS complex.
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Barron's pg 195
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What is the next step after defibrillation?
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5 cycles of CPR (2 minutes), reassess the rhythm and pulse and treat as indicated. Do not waste time checking pulse immediately after defibrillation.
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Barron's pg 195
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Common s/s of cocaine or amphetamine use?
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HTN, tachycardia, diaphoresis, and mydriasis (dilated pupils).
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Barron's pg 196
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CNS effects of Lidocaine
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Drowsiness, decrease mental status, muscle twichting, and possibily seizures.
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Barron's page 196
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Cuffed endotracheal tubes are not indicated for children under the age of ___.
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eight.
In a child less than eight, the normal anatomic narrowing at the level of the cricoid cartilage provides a "functional cuff." and eliminates the need for a cuffed tracheal tube under most circumstances. |
Barron's pg 199
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What is medical practice act?
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Legislation that governs the practice of medicine and may prescribe a physician's ability to delegate authority to perform medical acts by the paramedic.
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Barron's pg 222
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Involountary consent
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Treatment and transport directed by law enforcement for a patient who threatens himself or others.
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Barron's pg 222
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What is proximate cause?
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Proof that your actions cause the inury. Must be proven in negligence claims.
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Nancy page 4.11
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What is the mammalian dive reflex?
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A protective physiologic response when emerged in cold water, which increases survivability by shunting blood to the core, decreasing heart rate and dropping blood pressure. These factors are affected by the person's age and health status and the water temperature.
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Barron's pg 223
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START triate acronym
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Simple Triage And Rapid Treatment
Assessment of the ability to walk, respiratory status, hemodynamic status, and neurolgic status. |
Nancy page 47.14
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What are the three phases of the body's reponse to stress?
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Alarm reaction, resistance, and as body sustains increasing stress the level of resistnace to stress rises and higher levels of stress must occur for the alarm reaction to occur; exhaustion as stress continues coping mechanisms begin to fail.
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Barron's pg 225
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Ambulance Types
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Type I Conventional, truck-cab chassis with a modular ambulance body that can be transferred to a newer chassis as needed.
Type II Standard van, forward control integral cab-body ambulance. Type III Specialty van, forward-control integral cab-body ambulance. |
Nancy page 11-8
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Dopamine increases
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myocardial oxygen demand is is seen as a potential adverse effect.
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Barron's CD
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CO2 is a potent ________________.
What happens to cerebral pressure with hyperventilation. |
CO2 is a potent vasodilator.
Whe blown off it causes vessels to constrict leading to decrease cerebral peressure by decreasing cerebral blood flow. |
Barron's CD
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Decrease ET CO2 indicates
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nonperfusing, severe acidosis, pulmonary emboli, shock, brochospasms, or airway obstruction.
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Barron's CD
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Hypoxic drive
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Common with COPD pts.
Regulated by a low PaO2 (partial pressure of oxygen). |
Barron's CD
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Common RSI drugs and dose
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Preoxygenate
If increase ICP give Lidocaine at 1.5mg/kg IV For Sedation one of the following: Midazolam 0.1-0.3mg/kg IV Thiopental 1-3 mg/kg IV Ketamine 1-2mg/kg IV Etomidate 0.3mg/kg IV Diazepam 0.2mg/kg (max 20mg IV. Pts less than 2yr give Atropine at 0.02mg to block reflex bradycardia For paralytic give one of the following: Succinylcholine 1-1.5mg/kg IV Rocuronium 0.6-1.2mg/kg IV Vecuronium 0.1mg/kg IV All doses are under 3mg/kg |
EMS Field Guide
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