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101 Cards in this Set
- Front
- Back
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Trauma emergencies |
Occur as a result of physical forces applied to the body |
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Medical emergencies |
Include illnesses and conditions not caused by outside forces. |
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Index of suspision |
Your awareness and concern for potentially serious underlying and unseen injuries. |
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Mechanism of injury (MOI) |
The way in which traumatic injuries occur; it describes the forces or energy acting on the body to cause injury. |
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Work |
A force acting over a distance |
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Kinetic energy |
Energy of a moving object. KE=1/2M x V^2 |
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Potential energy |
The product of mass (weight), force of gravity, and height. Mostly associated with the energy of falling objects. |
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Multi system trauma |
Injuries to more than one body system. |
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Arterial air embolism |
Alveolar disruption with subsequent air embolization in the pulmonary vasculature. Can be a blast injury. |
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Primary (direct) brain Injury |
Injury to the brain and associated tissues resulting instantaneously from impact to the head. |
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Primary (direct) brain Injury |
Injury to the brain and associated tissues resulting instantaneously from impact to the head. |
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Secondary (indirect) brain injury |
Increase the severity of a primary brain injury. Hypoxia and hypotension are the most common causes. |
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Cerebral edema |
Brain swelling from increased CSF. Can occur immediately or hours after injury. |
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What can increased systolic, decreased pulse rate and irregular respiration signify? |
Increased Intracranial Pressure resulting from a head injury. (Cushing's Triad) |
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What happens to the pupils during a hematoma? |
The pupil on the opposite side of the hematoma becomes fixed and dilated (blown). |
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Retrograde vs. anterograde amnesia |
Retrograde forgets the events leading up to an injury. Anterograde forgets events after an injury. |
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Skeletal muscle |
Attaches to bones and makes up the major muscle mass of the body. Also called voluntary muscle. |
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Smooth muscle |
Found within blood vessels and intestines (stomach growl). |
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Fascia |
Fibrous tissue that covers all skeletal muscle. |
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Which vertebrae keep the Diaphragm functioning? |
C3, 4 and 5 keep the diaphragm alive. |
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Where does brain tissue go when its swelling? |
It's forced down the Foramen Magnum |
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What level of pain or loss of sensation is indicative of a spine injury? |
50% of patients report no pain or loss of sensation during an exam. |
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Symptoms of an epidural bleed |
-Always arterial,rapid -Lucid interval -15-20% mortality |
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Symptoms of a subdural bleed |
-Venous, slow -No lucid interval. Feel better, deteriorate fast. -50-80% mortality |
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Symptom progression for a closed head injury |
1. Confusion (normal vitals) 2. Combative (Increased pulse, BP & resp) 3. LOC (Cheyne-Stokes, Cushing Triad) 4. Seize 5. Death |
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Cheyne-Stokes respirations |
Irregular breathing pattern characterized by progressively deeper, faster respirations followed by Apnea. |
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Physical signs of a CHI |
-Bruised eyes -Battle sign -CSF leaking from ears |
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Six P's |
1. Pain (1-10) 2. Pallor (pale skin) 3. Pulses (present or absent) 4. Paresthesia (pins & needles) 5. Paralysis (can't move an extremity) 6. Pressure (swelling or edema) |
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Basic principles for treating musculoskeletal trauma |
-Life threats first -Check CSM before and after -Splint above and below injury -Don't get distracted by gruesome non-life threats |
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When should you realign a fracture? |
If there's no pulse in the extremity |
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Severe burn red flags |
-Full thickness in critical areas -Airway -30% partial thickness -Any moderate criteria in Geriatrics or pediatrics -Circumfirential -Painful deformity from swelling/blisters |
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Moderate burn red flags |
-Full thickness 2-10% of BSA -Partial thickness 15-30% of BSA -Superficial more than 50% BSA |
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Components of an EMS system |
-public access -communications -clinical care -HR -medical direction -legislation and regs -integration of health services -evaluation -information systems -finance -education -prevention & public education -EMS research |
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HIPAA |
-Health Insurance Portablility and Accountability Act -protects patients PHI -PHI can only be shared for treatment, payment or operational needs. -All other releases require written consent from patient |
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M1 hold |
A 72-hour involuntary hold of an individual posing a threat to their own safety or the safety of others. |
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M1 hold |
A 72-hour involuntary hold of an individual posing a threat to their own safety or the safety of others. |
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Who can issue an M1 hold in Colorado? |
-Certified peace officer -Physician or psychologist -RN with mental health training -Clinical social worker |
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D tank |
350L |
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D cylinder |
350L |
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Jumbo D cylinder |
500L |
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E cylinder |
625L |
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M cylinder |
3,000L |
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M cylinder |
3,000L |
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G cylinder |
5,300L |
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M cylinder |
3,000L |
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G cylinder |
5,300L |
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H cylinder |
6,900L |
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What medications can EMT-Bs administer? |
-Activated charcoal -Albuterol -ASA -Epi -Nitro (tab or spray) -Oral Glucose gel -O2 -Tylenol -MUST CALL PHYSICIAN FOR ALL BUT O2 |
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Five rights |
Right patient Right drug Right dose Right route Right expiration |
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ASA |
-Indicated by cardiac chest pain -Contraindicated by allergy, GI bleed, Airway -Dose: 324mg chewable -Inhibits platelet aggregation (thins blood) |
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Nitroglycerin |
Indications -Cardiac chest pain Contraindications -BP less than 100 systolic -Viagra Dose -.04mg sublingual -Max of 3 Action -Dilates cardiac muscle -Decreases peripheral resistance Side effects -Headache, dizzy, burning under tongue, hypotension & orthostatic changes
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Cardiac medications |
ASA and Nitro |
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Treatment progression of cardiac events |
1. High O2 2. 5 rights 3. Vitals 4. ASA 5. Nitro 6. Tx |
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COPD |
-Inflammatory, obstructive -Lower airway -Athsma, Emphysema, Bronchitis |
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Activated charcoal |
-Absorbs toxic substances in digestive tract Indications -Oral poison, OD Contra -OD of corrosives, Caustics, Petroleum Dose -Oral, 50g adult & child Side effects -Nausea, vomiting, constipation, black stool |
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Metered Dose Inhaler (MDI) |
Indications -Asthma, difficult breathing with wheezes, must be prescribed. -Bronchodilator Contra -Hypersensitivity, Tachycardia, MI Side effects -Hypertension, Tachycardia, anxiety, restless |
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Oral Glucose |
Indications -Altered mental status, sugar less than 80 (Hypoglycemic) Contra -Lowered LOC, nausea, vomit, can't swallow, no gag reflex -Pt must be awake and alert Dose -10 to 30g orally, 30 max Side effects -Nausea, vomiting |
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Albuterol |
Indications -Asthma, bronchospasm Contra -Hypersensitivity to Albuterol, peanuts Dose -2.5 to 5mg inhaled Side effects -tremors, anxiety, tachycardia, hypertension |
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Epinephrine |
Vasoconstrictor and Bronchodilator Indications -Anaphylaxis, shock, hypotension, airway swell Contra -MI, hypothermia, hypertension Dose -Epi Pen 0.3mg adult, 0.15mg kids, leg injection Side effects -Tremors, anxiety, dizzy, tachycardia |
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Epinephrine considerations |
-Pregnancy -Cardiac disorders -Hypertension -Geriatrics |
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GERD |
-Failure of lower esophageal sphincter -Substernal burning pain -Associated with obesity, large meal, pregnancy, supine position, heartburn |
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Musculoskeletal chest pain |
-Caused by chest wall abnormality -Pleuritic pain increased by palpation -Associated with Hx of trauma, cough, low fever, spine injury and muscle strain, Herpes Zoster (shingles) |
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Psychological chest pain |
-Caused by anxiety, hypocarbia, esophageal spasm -Chest pain of any variety -Associated with life events, stress, panic disor ders, bipolar, depression, GAD -25 to 56% of chest pain proves psychological |
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Pulmonary Embolus |
-Specific, sharp pleuritic pain, hypoxia, cough hemoptysis, wet lungs -Associated with sedentary lifestyle, hypercoagulopathy, DVT, recent surgery -Consider spont. pneumo, bronchitis, tumor |
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Pleurisy |
-Inflammation or irritation of pleural lining -Unilateral pleuritic pain, chest wall splinting, fever -Associated with cough, Hx of lower respiratory infections, possible autoimmune disorder |
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AAA |
-Weakness in layers of aortic vessel -Burning, ripping, tearing midline anterior pain -Associated with Hx of hypertension or vascular disease, unilateral pulse weakness, Marfan's, Pulsitile mass |
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History taking (OPQRST) |
Onset -Sudden or acute Provocation -Makes it better or worse Quality -Sharp, dull, burning, tearing Radiation Severity Time |
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Visceral pain |
-Tends to affect hollow organs -Described as gas type pain/cramping -Increases & decreases -Caused by appendicitis, Pancreatitis |
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Somatic Pain |
-Sharp or stabbing -Constant & localized -Pt position is guarded -Caused by ulcers in intestines, bacterial or chemical irritation of nerve fibers in peritoneum, appendicitis |
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Kidney stones |
-Retroperitoneal cavity -Extreme acute sharp pain, nausea, vomiting |
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Appendicitis |
-Abdominal pain & cramping, nausea, vomiting, chills, low fever -Pain generated in periumbilical region progress ing to right lower quadrant |
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Cholecystitis |
-Inflammation of Gallbladder -30 to 50 year old white women, often obese -Bitter vomiting, right upper quadrant pain -Associated with fatty diet |
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Pancreatitis |
-Nausea, vomiting, abdominal tenderness and distention -Severe pain radiating from umbilicus to back |
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Upper GI bleed |
-Account for 75% of GI bleeds -Hematemesis/coffee grounds -Melena |
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Lower GI bleed |
-Rectal hemmorhage often from Diverticulitis -Frank red blood (Hematochezia) -10 to 20% morbidity & mortality -Massive hemmorhage possible, often need 5 units blood |
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Esophageal Varisces |
-Rupture of mucosa in esophagus -Potentially life threatening, bright red Hematemesis -25% mortality -Associated with Hx of Hepatic disease, ETOH abuse, chronic use of NSAIDS |
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Gastroenteritis |
-Inflammation of stomach & intestines -Nausea, vomit, ab discomfort, diarrhea -No blood |
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Colitis |
-Inflammation of large intestine -Diarrhea, weight loss, pain, bloody stool -Highly hereditary -Form of lower GI bleed |
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Diverticulitis/osis |
-Sac develops around wall of colon -Commonly geriatric -osis has no pain, itis does |
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Causes of Altered mental status |
-Shock -Hypo/hyperglycemia -Seizure -TBI -Stroke -OD |
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Normal blood sugar |
70-110. Symptoms don't present until below 45. |
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Hypoglycemia |
-AKA Insulin shock -Pts become confused, combative, unconscious, seize, die -Same progression as head injury, shock -CHECK SUGAR |
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Hypoglycemia symptoms |
-Decreased mentation -Diaphoresis -Dilated pupils -High pulse (100-150) -Normal/low BP -Same as Hypovolemia |
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Care of altered mental with history of Diabetes |
Use a Glucometer to assess sugar. NEVER put sugar in the mouth of an unconscious Pt. Use instant Glucose when PT is conscious. |
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Hyperglycemia/Diabetic coma/DKA |
-Pts are insulin dependent -Normal mentation -Glucometer says High -Inadequate insulin production -Brain is happy, body isn't -Body breaks down fat for sugar but produces Ketons in the process resulting in DKA |
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DKA |
-Slow onset (days) -Pt will hyperventilate until completely dehydrated -Normal mentation/unconscious -High pulse |
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Treating Hyperglycemia |
-MAINTAIN hyperventilation, don't try to slow breathing -High O2 -Call ALS (administer Bicarb) -Tx emergent -Treat for shock |
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Seizure causes |
-Hypoxia -Hypoglycemia -Head injury -Disorder -Temperature (Febrile) -OD/poison -90% benign |
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Grand Mal seizure (Complex) |
-Tonic (stiff) -Clonic (shake) |
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Petite Mal (Simple) seizure |
-Zone out for a minute -No post-ictle phase |
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Focal seizure |
Single body part spasm. Indicative of a tumor. |
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Post-ictle phase |
Progression of patient from unconscious to confused when coming out of a seizure. Same progression as head injury but in reverse. |
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Status seizure |
Seizure followed by post-ictle and seizure again. A potentially lethal event that requires ALS. |
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Treating seizures |
-Nothing in the mouth -Don't hold them down -Pad the back of the head -Tell everyone to FO -High O2 once in post-ictle -Call ALS -Rapid Tx if they start seizing again |
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Acute stroke (CVA) |
-Bleed or clot, 88% clot -Decreased mentation -Neurodeficits -Headache -High BP -Seizure |
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Stroke assessment |
-Check sugar -Check for incontinence -Check pupils -Cincinnatti -Strokes can be treated within 7hrs -When was the Pt last seen normal? |
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Cincinatti Stroke Scale |
-Hold arms forward, eyes closed -Arm will drift if stroke occurred -Facial droop -"You can't teach an old dog new tricks" |
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Treating a stroke |
-High O2 ONLY if saturation is below 90 -Position of comfort -Call ALS -Last seen normal -Rapid Tx |
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CHF |
-Wet lungs indicative of left side pump fail -Dependent pedal edema means right pump fail -Increased HR and enlarged left ventricle no longer make up for decreased pump function. |
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Hypertensive emergencies |
-Systolic over 160 -Severe headache -strong, bounding pulse -Ears ringing -Nausea, vomiting -Dizzy, warm skin -Nosebleed |
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Hypoglycemia symptoms |
-Decreased mentation -Diaphoresis -Dilated pupils -Elevated pulse (100-150) -Normal/low BP |
