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147 Cards in this Set

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Online Medical Direction

Direction given over the phone or radio directly from the medical director or designated physician

Off-Line Medical Direction

Consitsts of standing orders, training, and supervision authorized bt the medical director

Direct Protocols

Written Document



Standing Orders

Written Documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols

Indirect Protocols

Unwritten Document

What is the EMT's first priority

Personal Safety

What is the simplest yet most effective way to prevent disease?

Proper Handwashing

Know the blood-borne pathogens EMS providers would be at risk for contracting and what prevention strategies are availible for the various pathogens

Blood-borne Pathogens: HIV, Hep B, Hep C


Prevention Strategies: Wear gloves and make sure to be vaccinated

In patients who are responsive but unable to provide expressive speach, what can the provider do to alleviate fears and concerns for the patient

~Do not assume an aggressive posture


~Make good eye contact, but do not stare


~Speak calmly, confidently, and slowly


~Never threaten the patient, either verbally or physically


~Be attentive to facial expressions, body language, and eye contact - your own and your patients


~Constant communication

Expressed Consent

Specific authorization to provide care expressed by the patient



Implied Consent

Legal assumption that treatment was desired



Informed Consent

Permission for treatment given by a competent patient after the potential risks, benifits, and allternitives to treatment have been explained



HIPPA

Health Insurance Portability and Accountability Act

How does HIPPA affect EMS providers?

Ensures the Patient information is protected

What are the components of negligence (4)

1. EMT's duty to act


2. Cause


3. Breach of duty


4. Real or perceived damage



What are some factors to consider when communicating with an elderly patient?

~You should present yourself as competent, confident, and caring.


~You must take charge of the situation, but do so with compassion.


~Approach an older patient slowly and calmly.


~Allow plenty of time for the patient to respond to your questions.


~Watch for signs of confusion, anxiety, or impaired hearing/vision.


~The patient should feel confident you are in charge and that everything possible is being done for them.

What are some tips for EMS providers when doing radio transmission?

~Ensure clear frequency before speaking.


~Wait one second before speaking.


~Hold microphone 2-3" away from mouth.


~Address the unit you're callling and provide the name of your unit.


~Keep transmission brief.


~Use clear text.


~Avoid using codes or agency-specific terms.


~ Use clear, calm and monotone voice.


~Avoid using slang.


~Remember airwaves are public and can be picked up by scanners.


~Do not use names, protect the privacy of the patient.


~Indicate end of transmission by saying "over".


~Do not provide a diagnosis of the patient's problem.


~Use EMS transmissions only for EMS communications.


~Monitor background noise.



Distal

Farther away from the orgin of a body part or the point of attachment of a limb to the body trunk



Proximal

Closer to the origin of the body part or the point of attachment of a limb to the body trunk



Superior

Toward the head end or upper part of a structure or the body; above



Inferior

Away from the head end or the lower part of a structure or the body; below



Medial

Toward or at the midline of the body; on the inner side of

Lateral

Away from the midline of the body; on the outer side of

Posterior

Toward or at the back of the body; behind



Anterior

Toward or at the front of the body; in front of

Coronal

Also known as the frontal plane- is any vertical plane that divides the body into ventral and dorsal (belly and back) sections

Transverse

Divided into top and bottom

Supine

Lying face up

Saggital

Divided into left and right

Prone

Lying face down

Fowler's

Sitting upright

Shock Position

Person who is laying flat on his or her back with the legs elevated approximately 8-12 inches

Recovery

Referes to one of a series of variations ona a lateral recumbent or 3/4 prone postition of the body

Palmar

Foward facing part of the hand in the anatomic postion

Plantar

Bottom of the foot

Dorsal

Posterior surface of the body, including the back of the hand

Adduction

Motion towards the midline

ABbduction

Motion away from the midline

Superficial

Toward or at the body surface



Deep

Away from the body surface

Intermediate

Between a more medial and a more lateral structure

Why should EMT's have a strong working knowledge of medical terminology?

~Understanding key terms, acronyms, symbols, and abbriviations is important for effective communications and dcocumentation.


~Help you determine the meaning of an unknown term by breaking the word apart


~Once you understand medical jargon, you will be able to communicate effectively with other members of the EMS, healthcare, and public safety.

Know the parts of the Brain:



Cerebrum


Occipital lobe


Parietal lobe


Frontal lobe


Temporal lobe


Cerebellum

Know the parts of the Brain Stem

Midbrain


Pons


Medulla Oblongata

Know the parts of the Spinal Column

Spinal cord


Bony spine (vertebrae)

Know the parts of the CNS

Brain


Spinal cord



What is the normal Blood Pessure range for an adult

90-130 Systolic BP

What is the normal Pulse Rate for an adult

60-100 BPM

What is the normal Respiratory rate for an adult?

12-20 Breathes Per Minute

Atherosclerosis

Disorder in which cholesterol and calcium bouild up inside the walls of the blood vessels, formind plaque, which eventually leads to partial or complete blackage of blood flow

Arteriosclerosis

A disease that causes the arteries to thicken, harden, and calcify

How should an Emt properly restrain a patient

Speak in a calming matter.


Develop a plan


Minimum of 5 personnel


Establish a team leader


Place patient supine


Secure to stretcher


Secure one arm above the patient and the other at the side


Secure the legs

How can you stop the spread of disease on equiptment and surfaces

Decontaminate after each use

Standard Precuations

Protecive measures that have traditionally been developed by the CDC

When should Standard Precuations be used

In dealing with objects, blood. body fluids, and other potential exposure risks of communicable disease

What does an intial assessment address

General impression


Mentation, AVPU, PPTE


Chief Complaint


Airway


Breathing


Circulation

Pupil Assesment

PEARRL


Pupils Equal and Round Regular in size React to light



What are some Negative Findings when doing a Pupil Assessment

Become fixed with no reaction to changes in light


Dilate with introduction of a bright light and constrict when the light is removed


React sluggishly instead of briskly


Become unequal in size


Become Unequal when a bright light is introduced into or removed from the eye

What causes the Negative Findings in a Pupil Assessment



Injury of the brainstem or brain


Trauma or Stroke


Brain tumor


Inadequate oxygenation or perfusion


Drugs or toxins (CNS depressions)



How should the airway of a truama patient be opened?

Insert an oral airway (oropharyngeal)


Insert a nasal airway ( Nasopharyngeal)


Jaw thrust maneuver



How should the airway or a medical patient (not trauma) be opened

Head tilt chin lift


Jaw thrust



What is a Chief Complaint

Most serious thing a patient is concerned about

Hypoxia

A dangerous conditon in which the body tissue and cells dont have enough oxygen

How is Hypoxia Treated?

Give additional oxygen to the patient and into the body (blood) as quickly as possible

What occurs when a patient is breathing rapidly and shallowly?

Sign of Tachypnea. Could be indication of respiratory disorder. The tidal volume will decrease. The minute volume would change depending on the numer of respirations



Tidal volume

Amount of air moved during one breath



Minute Volume

The volume of air moved through the lungs in one minute. Calculated by multiplying tidal volume and respiratory rate; also reffered to as minute ventilation



Hypoxic Drive

Backup system to control respiration



What percentage of oxygen does a NRB (Non-Rebrether Mask) deliver?



90%

What percentage of Oxygen does a BVM (Bag Valuve Mask) deliver

100%



What percentage of oxygen does a NC (Nasal Canula) deliver

24-44%



What percentage of oxygen does Mouth to Mask delvier?

16%



What does Weezing indicate?

Indacates a narrowing of the lower airway

What does Rhonchi Indicate?

Indicates a presence of mucus in the lungs



What does Rales (Crackles) indicate?

Indicates fluid in the lungs



What does Stridor indicate?

Indicates that the patient has an airway onbstruction in the neck or upper part of the chest



What does Snoring indicate?

indicates an upper airway obstruction, usually caused by the tounge or a foreign body



Dose

Amount of mediaction given

Indication

Reson for which a medication is given



Contraindication

Situation in which a drug should not be given

Side effect

Any action of a drug other than the desired one



ADsorption

To bind or stick to a surface



ABsorption

Process by which medications travel through body tissues

Suspension

The state of a substance when its particles are mixed with, but undissolved, in a fluid or solid

What is meant by medical direction approval related to EMT medications

As an EMT, you can only administer medications for which you have an order from medical control



What are the 6 patient rights

Right patient


Right medication


Right dose


Right route


Right time


Right documentation


Right to refuse

What is the mechanism of action for Oral Glucose

When absorbed, provides glucose for cell use



What is the mechanism of action for Activated Charcoal

Absorbs toxic substances in the digestive tract


What is the mechanism of action for Nitro

Relaxes vascular smooth muscle causing vasodilation which results in increase coronary blood flow



What is the mechanism of action for Asprin

Decreses paltelet aggregation, thus increasing blood flow through the coronary arteries



What is the mechanism of action for Albuterol

Dilates brinchial smooth muscle



Whar is the mechanism of action for Epinephrine



Bronchodilator and vasoconstriction



What is the mechanism of action for Oxygen

Reverses hypoxia, provides O2 to be absorbed by lungs



What is the mechanism of action for Narcan

Compete with opiates at the opiate receptor sites

What is the mechanism of action for MDI

Bronchodilation

Tachycardia

Rapid sinus rhythem; over 100BPM



Hypertension

High blood pressure; systolic over 140



Bradycardia

Slow sinus rhythem; under 60

Hypotension

Low blood pressure; systolic under 90



What are the three components of the perfusion triangle

Pump-heart


Pipes- vessels


Container- blood



Septic shock

~Severe bacterial infection


~Signs and syptoms: Warm skin or fever, Tachycardia, low Bp


~Treatment: Transport promply, admisister high-flow O2, assist ventilations, keep patient warm, consider ALS


Neurogenic shock

~Damaged cervical spine, which causes widespread blood vessel dilation


~SS: Bradycardia, Low BP, SIgns of neck injury


~T: Secure airway, Spinal immobilization, Assist ventilations, Administer high-flow oxygen, Preserve body heat, Transport promptly, Consider ALS



Anaphylactic shock

~Extreme life-threatening allergic reaction


~SS: can develop within seconds, Mild itching or rash, Burning skin, Vascular dilation, Generalized edema, Coma, Rapid death


~T:



Hypovolemic Shock

Loss of blood or fluid



Distributive Shock

Widespread dilation off the small arterioles, small venuales, or both



Cardiogenic Shock

Inadequate heart function, disease of muscle tissue, impaired electrical system, disease or injury



Psychogenic shock

Shock due to emotional stress or to seeing an injury or accident



What are the physical changes that happen in the Compensated stage of Shock

Altered mental status, weak rapid or absent pulse, shallow rapid breathing, air hunger, feeling of impending doom



What are the physical changes that happen is the Decompensated stage of Shock

Falling blood pressure, ashen, mottled or cyanotic skin, dilated pupils, poor urinary output



What are the physical changes that happen in the Irreversable stage of Shock

Shock has progressed to far



During cheast compression what are some pearls to ensure they are effective?

Recoil!


2-2.4 (5cm) in adults


2 in children


1/3 in peds



What is the correct compressio to ventilation ratio for adult cpr

30:2



What is defined as BLS care?

Noninvasive emergency life saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest



What should the EMT do if a pateint who requires the use of an AED has a medication patch

Remove the patch



Why do infants and children go into cardiac arrest?

Respiratory arrest



What does the assessment of the medical patient usually focused on

Oral history



What is required during a comprehensive neurologic assessment

~Evaluate level of conscious (AVPU)


~Determine orientation (PPTE)


~Use the Glasgow Coma Scale on a patient with an altered mental status



How can an EMT prevent the infection of certian communicable diseases such as whooping cough or pertussis

Be current on your DTaP vaccine.


Put a mask on your patient and yourself



What is a HEPA or N-95 Mask?

A type of rebreather mask that you would where around patients with potential tuberculous



What four items are assessed during a respiratory assessment

Rate of breath


quality


sound


depth

In what area does respiration occur?

Alveoli

What is the difference between respiration and ventilation

Respiration is the exchange of gasses in the alveoli and ventilation is the exchange of air between the lungs and the environment



Asthma is a respiratory issue that is a response of what system

Immune system



Know blood flow through the heart

Superior/Inferior Vena Cava


Right Atrium


Tricuspid valve


Right Ventricle


Pulmonary Artery


Lungs


Pulmonary Vein


Left Atrium


Mitral Valve


Left Ventricle


Aorta

Sinoastril Node

Elecrical current begins and passes through both atria



Atrioventricular Node

Bridge of special electrical tissue between atria and ventricle

Bundle of His

Between ventricles

Purkinje fibers

In each side of ventricle

What are the risk factors of an AMI (modifiable)

Smiking, physical activity, cholesterol levels, hypertension, diabetes, obesity

What are the risk factors of an AMI (non-Modifiable)

Gender, heredity, genetics, age

What are the Contraindications for Oral Glucose

Nausea, vomiting, inability to swallow/ no gag reflex

What are the Contraindications for Activated Charcoal

OD of corrosives, caustics, or petroleum substances



What are the Containdications for Nitro

Cerebral hemorrhage, use sexual enhancement drug within 24-36 hours, systolic bp less than 100

What are the Containdications for Asprin

Bleeding disorders or GI bleeding

What are the Containdications for Albuterol

tachydysrhythmias or MI



What are the Containdications for Epinephrine

None in anaphylaxis

What are the Containdications for Oxygen

Very rarely in patients with COPD


DON'T use near open flames as it will support combustion.


Never withhold oxygen from a patient



What are the Containdications for Narcan

None in the emergency setting

What are the Containdications for MDI

Tachycardia, MI

What are the Structures of the upper airway

Nose


Mouth


Tongue


Jaw


Pharynx


Larynx



What are the Structures of the Lower airway

Trachea


Bronchi


Lungs


Alveoli

How is a NPA inserted

Size airway, lubricate tip, insert into larger nostril, face bevel owards septum, gently advance airway until resistance is met, rotate 180* and continue to insert

How is an OPA inserted

Size airway, open pts mouth, hold airway upside down, rotate airway 180*, insert airway until the flange rests on the patient's lips



How does Nitro help cardiac patients increase blood flow in the coronary arteries

Relaxes vascular smooth muscle causing vasodilation which results in increased coronary blood flow

How does Aspirin help cardiac patients increase blood flow in the coronary arteries

Decreases platelet aggregation, thus increasing blood flow through the coronary artery

Why is an epi-auto injector an advantage to administer epinephrine

It is a pre-metered dose prescribed to the patient



How often do you reassess stable patients

Every 15mins