St. John Ambulance Study Cards

Front 1

What is chronic bronchitis?

Back 1

Progressive disease where the bronchi and bronchioles thicken and distort the lining of the tubes.

Features a productive cough that has been present for at least 3 months of the year over the past 2 years

Front 2

What are the symptoms of chronic bronchitis?

Back 2

- Neck and chest muscles assist breathing
- Usually coughing with wheezes and rattles that can be heard when auscultating the lungs
- High pitched wheezing AND snoring can be heard on inhalation/exhalation

Front 3

What are the symptoms of emphysema?

Back 3

- Respirations rapid, few breath sounds which are very distant and difficult to hear
- May purse his lips during exhalation
- May cough but only produce a small amount of mucus
- Barrel shaped chest

Front 4

What is the treatment for chronic bronchitis and emphysema?

Back 4

1.) ESM/Scene Survey
2.) Primary Survey and administer oxygen (NRB @ 15Lpm)
3.) Comfortable position/loosen clothing
4.) Complete secondary survey (history, vitals, head to toe)
5.) Encourage them to cough

Front 5

What is croup and who does it commonly affect?

Back 5

Characterized by an increased respiratory effort with a barking cough and sometimes a slight fever. It usually occurs after the child has been put to sleep.

It most commonly affects children aged 3 months to 8 years

Front 6

What is the treatment for croup?

Back 6

1.) EMS/Scene Survey
2.) Primary Survey
3.) Position pt. with parents or in a semi-sitting position for easier respiratory effort
4.) Ventilate the area the pt. is in
5.) Administer oxygen

Front 7

What is epiglottitis and it's signs/symptoms?

Back 7

Epliglottitis is the inflammation of the epiglottis. History of sore throat, fever with painful swallowing that leads to drooling are some signs/symptoms. The pt. is most commonly sitting bolt upright with a fast pulse and may be disoriented.

Front 8

What is the treatment for epiglottitis?

Back 8

1.) Scene Survey
2.) Primary Survey
3.) Evaluate the adequacy of respirations
4.) If epiglottitis is suspected DO NOT inspect the airway, doing so may aggravate the condition further
5.) Place in comfortable position that helps drainage
6.) Administer oxygen

Front 9

What is the treatment for asthma?

Back 9

1.) Make sure the medication is the pt's
2.) Follow pt. instruction on how to use it or read them
3.) Do not force help if they do not want it
4.) It must be a true breathing emergency to help them
5.) Never use a medication that doesn't belong to the pt
6.) Check expiry date

Front 10

What does EMCAP stand for?

Back 10

E - Environment (is the environment safe, will it stay safe, what hazards are present?)

M - Mechanism of Injury (was there blunt force trauma involved, burns, falls or is it medical in nature?)

C - Number of casualties

A - Is there any assistance needed at the moment?

P - Personal Protective Equipment (PPE)

Front 11

What are the steps of the Primary Survey?

Back 11

1.) AVPU - Assess the level of awareness of the patient

2.) Stabilize the C-spine if a spinal injury is suspected

3.) A of ABC - Does the patient have an open airway? If you ask for consent this and the LOA will be checked judging by the pt's answer

4.) B of ABC - What is the pt's breathing like? Look, listen and feel for breathing. Auscultate lungs if needed.

5.) C of ABC - Circulation, what is their circulation like? Check their pulse and skin colour

6.) D - Defibrilate if necessary at this point (if pt is not breathing/no pulse)

7.) Rapid Body Survey - A quick check for any gross bleeds or any other life threatening injuries that may have been overlooked.

8.) Oxygen administration

Front 12

What are the signs and symptoms of a severe chest injury?

Back 12

- Pain associated with breathing
- Shortness of breath
- Fast heart rate
- Point tenderness (a specific spot that hurts)
- Penetrating wounds to the chest
- Uneven movement of the chest cavity from one side to the other
- Pale or cyanotic skin

Front 13

What are the two GENERAL types of chest injuries?

Back 13

Closed: Where the skin is unbroken, or more specifically where there is no air entering or escaping from the chest cavity. Usually caused by a blunt trauma mechanism of injury.

Open: Where the skin is broken and the chest wall has been punctured.

Front 14

What are some more specific chest injuries?

Back 14

- Rib Fracture
- Embedded object
- Flail chest
- Pneumothorax
- Hemothorax
- Blast injury

Front 15

What is a rib fracture?

Back 15

A fracture of one of the ribs usually caused by a direct blow to the chest. The injury may show no signs of an external injury, and it is usually not life threatening.

Front 16

What are the signs of symptoms of a rib fracture?

Back 16

- Shallow breathing
- Guarded movement
- Grating sounds on movement
- Sharp pain at fracture site, gets worse with movement
- May cough up frothy blood and have increased difficulty breathing if the lungs have been damaged
- Guarded movement (bracing affected area)
- Bruising/deformity at the injury site

Front 17

What is the management for a rib fracture?

Back 17

1.) Scene Survey
2.) Primary Survey (ABC's, expose injured area)
3.) Administer oxygen
4.) Expose and assess the injured area
5.) Apply a tubular sling to transfer the weight off of the injured side to the good side. Place in a comfortable position. Provide treatment for any wounds present (penetrating, bruising, etc.)
6.) Complete a secondary survey

Front 18

What is a flail chest?

Back 18

When several ribs are broken in more than one place and becomes detached from the rest of the chest wall. It is usually caused by high energy forces so asses for HEAD AND SPINAL INJURIES. As the patient inhales the chest will move inward, the opposite of the rest of the chest, this opposite movement is called paradoxical movement.

Front 19

What are the signs and symptoms of a flail chest?

Back 19

- Abnormal movement of the injured portion of the chest wall upon breathing
- Painful breathing
- Labored, ineffective breathing

Front 20

What is the management of a flail chest?

Back 20

1.) Scene Survey (note the MOI and LOC)
2.) Primary Survey (Upon noticing a breathing problem, expose the flail chest and have the pt. support it with their hand, if they can't, you must do it)
3.) Supplemental oxygen
4.) Stabilize the injured portion with a bulky dressing or pillow, do not encompass the whole chest, this will only make breathing harder. It does not have to be extremely tight, this will also hamper breathing efforts. Tape is recommended.
5.) The pt should be COMPLETELY IMMOBILIZED because of the risk of a C-spine injury

Front 21

What is a pneumothorax? What are the 3 types?

Back 21

A pneumothorax is a life threatening condition caused by an injury that allows air to build up in the pleural space of the chest cavity.

The three types are:

1.) Open pneumothorax (sucking chest wound) - When there is a penetrating injury that is causing air to move into the pleural space.

2.) Closed pneumothorax - This is caused by air entering the pleural space from the INSIDE of the body. Can be caused by an injury like a fractured lung or by a trauma (sudden deceleration) that causes a laceration or tear to the lung.

3.) Tension pneumothorax - This occurs if the air continues to build up in the pleural space. Air continues to build up which then collapses the lung(s), and also puts pressure on the heart which is then not able to pump. Pressure is also put on the good lung which reduces it's effectiveness.

Front 22

What are the signs and symptoms of a pneumothorax?

Back 22

- Pain during breathing
- Labored breathing
- Bloodstained bubbles at the injury site when breathing OUT
- Decreased ability to expand one or both sides of the chest
- Sound of air being sucked in when breathing IN
- Decreased breathing sounds on the affected side
- Signs of shock
- Coughing up frothy blood

Front 23

What is the management of a pneumothorax?

Back 23

1.) Scene Survey
2.) Primary Survey
3.) Expose the area and IMMEDIATELY cover the wound with a gloved hand to stop further air entry
4.) Administer oxygen
5.) Occlusive dressing should be placed over the wound with one corner open to facilitate the escape of air
6.) IF there is an exit wound, this should be covered entirely by an occlusive dressing
7.) Complete a secondary survey

Front 24

What is a hemothorax?

Back 24

An injury that caused blood to pool in the chest cavity as opposed to air (pneumothorax).

Front 25

What is the management for a hemothorax?

Back 25

The management is the same for a hemothorax as it is the pneumothorax. If possible, with a hemothorax, incline the person to the injured side.

Front 26

What is angina?

Back 26

Angina is chest pain that occurs because of the hardening of the arteries (athersclerosis), which in turn reduces the amount of oxygenated blood that can reach the heart muscle. This causes chest pain that may spread into the jaw, neck, arm and shoulders. It generally doesn't last more than 10 minutes and if the pt is on prescription medication it is usually resolved by taking it.

Front 27

What is myocardial infarction?

Back 27

Myocardial infarction (aka heart attack) is when heart muscle tissues dies off because of a lack of blood flow to the heart. This usually occurs when a blood clot blocks one of the coronary arteries. It is different form angina in that it will last longer than 10 minutes, medications do nothing to help,

Front 28

What are the signs and symptoms of heart attacks and angina?

Back 28

- Nausea, vomiting
- Fear, fatigue
- Crushing, tightness, heaviness, squeezing, pressure, vise-like pain
- Pale, cool, clammy skin
- Denial
- Unconsciousness
- Shortness of breath

Front 29

What is the treatment for heart attack/angina?

Back 29

1.) Scene Survey
2.) Primary Survey
3.) Administer 02
4.) Do a secondary survey (SAMPLE, vitals)
5.) Place the pt in a comfortable position, or let them reposition themselves
6.) Loosen any tight clothing from around the neck, chest and waist
7.) Assist the patient with any medication (remember 6 rights), that they may have. Make sure BP is above 100 systolic, and they are not on any erectile dysfunction drugs (viagara, cialis, etc.)

Front 30

What is cardiac arrest?

Back 30

Cardiac arrest is when the heart loses it's ability to pump blood, for a variety of reasons.

Front 31

What is the management of cardiac arrest?

Back 31

1.) Scene Survey (EMCAP)
2.) Primary Survey
- secure airway
- no breathing give 2 breaths
- begin CPR

Front 32

What are the steps for CPR (adult/child/infant)?

Back 32

1.) Begin by giving 30 compressions followed by 2 ventilation's (30:2)
2.) Continue this until:
- an AED is applied
- another first responder takes over
- advanced medical help takes over
- you are too exhausted to go on
- pt begins to breathe

Front 33

What is congestive heart failure (CHF)?

Back 33

CHF is when the heart loses it's ability to circulate blood properly. When this happens blood begins to back up in the lungs causing breathing difficulties. It may also back up in other parts of the body (e.g. the ankles)

Front 34

What are the signs and symptoms of CHF?

Back 34

- Cyanosis around the lips, fingernail beds, ears, other parts of the body
- Coughing up frothy, pink fluid
- Increased difficulty breathing when lying flat
- Inappropriate shortness of breath
- Swelling of ankles

Front 35

What is the management for CHF?

Back 35

1.) Scene Survey
2.) Primary Survey
3.) Oxygen admin
4.) Assist ventilation's if necessary
5.) Perform a complete secondary survey
6.) Position in a comfortable position and loosen tight clothing

Front 36

What is a stroke?

Back 36

A stroke, also known as a Cerebrovascular Accident (CVA) or Transient Ischemic Attack (TIA) is when an artery in the brain becomes blocked by a blood clot, or ruptures. The tissue beyond the clot/damage ends up being starved of oxygen, which then dies. Various body functions will be affected based on the part of the brain that was damaged. Less severe strokes can cause brain damage, while more severe ones can cause death.

Front 37

What is a TIA?

Back 37

A TIA has the same signs and symptoms as a stroke but is not as serious. The main difference between a CVA and TIA is that a TIA generally lasts for 24 hours and leaves no lasting affect. A TIA is also a warning sign that a stroke may soon follow.

Front 38

What are the signs and symptoms of a stroke?

Back 38

- Arm/Leg numbness or weakness particularly on one side of the body.
- Paralysis of face muscles
- Difficulty speaking, swallowing
- Dizziness or sudden fall
- Decrease in LOC
- Mental confusion
- Unequal pupil sizes
- Double vision or loss of vision
- Severe headache
- Loss of bladder control

Front 39

What is the management for a stroke?

Back 39

1.) Scene Survey (EMCAP)
2.) Primary Survey
3.) Administer 02
4.) Secondary Survey
5.) If patient is conscious place in semi-sitting position, if unconscious place in recover position with unaffected side down
6.) Loosen tight clothing around neck, chest and waist
7.) Reassure and keep the pt warm

Front 40

What is FAST?

Back 40

FAST is an acronym to remember the steps in assessing for a stroke.

F - Facial Droop: one side of the face doesnt respond as well as the other

A - Arm Drift: hold both arms out, one arm may not move or drifts down compared to the other

S - Speech: pt slurs words, uses incorrect words or is not able to speak

T - Time: get immediate medical help, the earlier a stroke is treated the better the outcome

Front 41

What is FAST?

Back 41

FAST is an acronym to remember the steps in assessing for a stroke.

F - Facial Droop: one side of the face doesnt respond as well as the other

A - Arm Drift: hold both arms out, one arm may not move or drifts down compared to the other

S - Speech: pt slurs words, uses incorrect words or is not able to speak

T - Time: get immediate medical help, the earlier a stroke is treated the better the outcome