EMT FISDAP FINAL what do you do for labored, contstriction, or lack of tidal volume - ✔assist ventilations with BVM What do you do for acid in eyes - ✔irrigate, if contacts take them out Signs and Symptoms of tension pneumothorax - ✔progressive shortness of breath increased altered level of consciousness neck vein distention tracheal deviation What organ could be affected by trauma to the upper right quadrant - ✔liver flail chest is charcterized and defined by - ✔paradoxical motion 2 or more ribs broken in two or more places subcutaneous emphysema what is it and how to treat - ✔A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues. treat by positive pressure ventilations Daughter is power of attourney and wants father to recieve care, father is AxO x4 and does not want care - ✔Respect patient wishes because he is concious without altered mental status Open fracture and bleeding PPE - ✔gloves, mask, goggles What EMS statistic is needed to reduce speed limit in given area - ✔Fatalities and injuries that have happened on that stretch of road Triage color green - ✔ambulatory, yellow - ✔delayed red - ✔immediate black - ✔dead/ expectant you are treating a 300 pound male who cannot walk what should you do - ✔call for assistance triage in the - ✔cold zone
Pedatric/ infant breath rate - ✔18-30 Cardiac arrest in children is caused most likely by - ✔hypoxia, resp distress or failure Croup is characterized by - ✔hoarseness, "barking" cough, inspiratory stridor and varying degrees of respiratory distress resulting from swelling in or obstruction in the region near the larynx. Steps to treating bleeding - ✔first direct pressure then tourniquet is direct pressure does not stop the bleeding Signs and symptoms of meningitis - ✔fever, rash, stiff neck, altered mental status specifcally in infants: Swelling of fontanelles Apgar scale - ✔appearance, pulse, grimace, activity, respiration when treating allergy primary concern is - ✔AIRWAY when to start chest compression on newborn - ✔pluse under 60 ruptured spleen in child - ✔bleeding and pain right upper quadrant - ✔Liver, Right Kidney, Colon, Pancreas, Gallbladder left upper quadrant - ✔liver, spleen, left kidney, stomach, colon, pancreas left lower quadrant - ✔Part of descending colon Sigmoid colon Left ovary and tube Left ureter Left spermatic cord right lower quadrant - ✔cecum, appendix, right ovary and tube, right ureter, right spermatic cord Signs and symptoms of epiglottitis - ✔Sudden onset, high fever "Hot-potato" voice Dysphagia, drooling No cough Prefers to sit upright, lean forward (tripod position) Appears toxic and stridulous when babies head appears out of vaginal canal check for - ✔nuhical cord
place baby where until umbillical cord is done pulsating - ✔at the height of the vaginal canal transport pregnant women in what position and why - ✔left lateral recumbant to take pressure of the heart and vena cava questions for pregnant mom - ✔how many weeks along are you how far apart are contractions Signs of imminent delivery - ✔Crowning, Urge to bear down or go to the bathroom, "It's Coming", and Contractions of increased frequency & intensity. preclampsia - ✔abnormal condition associated with pregnancy marked by high blood pressure proteinuria, and edema. eclampsia - ✔true toxemia of pregnancy characterized by high blood pressure, albuminuria, edema of the legs and feet, severe headaches, dizziness, convulsions, and coma ovarian cyst signs and symptoms - ✔lower pain on either side, nausea, bleeding, ask when last menstrutal cycle was PID signs and symptoms - ✔-onset is usually after menses -sudden pelvic pain, profuse vaginal exudate, fever, metrorrhagia, discharge When to massage fundus - ✔stops bleeding and cramping after delivery woman is bleeding after sexual assualt - ✔use pad or sterile gauze and put under her to collect the blood breech birth - ✔Baby is delivered feet or buttocks first when can you insert a gloved finger into the vaginal canal - ✔if umbillical cord is around the babies neck perineum tearing - ✔tearing from vagina to anus after delivery preciptitous delivery - ✔perineum tearing and emergency delivery bleeding from shunt - ✔don't let this question confuse you hold pressure at place of bleeding
Pancreatitis symptoms - ✔upper abdominal pain, swollen and tender abdomen, nausea, vomiting, fever, increased heart rate, weight loss, and diabetes. important to note if they are chronic drinkers petite mal seizure - ✔blank out for 3-5 seconds, still conscious, eyes may flutter zone out Focal Motor Seizure - ✔Starts in a group of muscles a "focus" May progress to include the whole entire arm May progress to a Grand Mal Seizure grand mal seizure - ✔They may have an "aura" Tonic-Clonic phase Loss of consciousness clenched teeth, biting the cheek or tongue, incontinence post-itcal phase status epilepticus - ✔A condition in which seizures recur every few minutes or last more than 5 minutes. example question: Patient is zoned out, could be poison, OD or low blood sugar or seizure, question gives you the age of the patient and no other signs or symptoms, because of the lack of signs of poison or pills or history of diabetes it is most likely ✔seizures Appendicitis signs and symptoms - ✔rebound tenderness, young, pain near umbilical region, right lower quad eptopic pregnancy - ✔implantation of the fertilized egg in any site other than the normal uterine location happens in first trimester abruptio placentae - ✔premature separation of the placenta from the uterine wall, third trimester placenta previa - ✔implantation of the placenta over the cervical opening or in the lower region of the uterus, third trimester spontaneous abortion - ✔when the fetus and placenta deliver before the 20th week of pregnancy; commonly called a miscarriage subarachnoid hemorrhage - ✔worst headache, assess bp will be low, cushing triaid, slow pulse, unbalanced respirations Left sided heart failure - ✔shortness of breath
right sided heart failure - ✔1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) steps when assessing unconc patient - ✔check for responsiveness, check for pulse, check for chest rise and fall communicable disease PPE and decom - ✔mask, gloves, goggles, disinfect with approved germicidal agent Oral Glucose Indications - ✔hypoglycemia, able to swallow when to extricate before giving care - ✔direct life threat/ scene saftey threat ex: fire in car OPIOD indications - ✔pinpoint pupils, respiratory arrest, cyanosis, track marks Cholecystitis - ✔inflammation of the gallbladder Cholecystitis S/S - ✔severe midepigastric or right upper quadrant pain radiating to back and referred to right scapula usually after meals fat intolerance flatulence indigestion diaphoresis n/v chills low grade fever possible jaundice clay-colored stools with common bile duct obstruction when approaching a psych patient - ✔calm them down, be reassuring, deescalate the situation carbon monoxide poisoning - ✔-carbon monoxide binds with hemoglobin and reduces oxygen supply to tissues -cannot be seen. smelled, or tasted -s/s include: nausea, vomiting, headache, weakness, and unconsciousness, Altered LOC, high SPO2 -death may occur with prolonged exposure -prevention by ensuring proper ventilation when using fuel-burning devices -gas-burning devices should be inspected annually -flues and chimneys should be unobstructed
-carbon monoxide detectors should be installed and inspected regularly NPA indications - ✔concious with gag reflex Suction Catheter for oropharynx - ✔yonker tip/ ridgid tip spontaneous pneumothorax - ✔increaed heart rate, hypoxia, chest pain Tension pneumothorax S/S - ✔JVD, diminished/absent lung sounds, tracheal deviation towards unaffected side, poor BVM compliance pneumonia - ✔swollen avoli, crackles, fever, warm dry and flushed, transport and give oxygen chronic bronchitis - ✔lungs constantly inflamed, barrel chest systolic pressure - ✔Blood pressure in the arteries during contraction of the ventricles. diastolic pressure - ✔Blood pressure that remains between heart contractions. Contraindications of nitroglycerin - ✔(Contraindications:) Cerebral hemorrhage, sexual enhancement drugs, hypotension-systolic blood pressure < 100. important stroke question to ask - ✔when was the last time they were seen normal pulmonary edema s/s - ✔Severe dyspnea and air hunger Cough productive of frothy, blood tinged sputum Tachypnea and tachycardia Cold, clammy skin Cyanosis Extreme apprehension Confusion, stupor caused by left sided heart failure transport shock patient in - ✔supine agonal respirations treatment - ✔BVM Heart Failure S/S - ✔Shortness of breath, fatigue, and weakness, weilling in the legs, feet abdomen. Reapid or irregular heartbeat with S3 or S4 heart sounds, persistent cough or wheezing, and weight gain from fluid etention. Treatment: balance of medication, devices, and lifestule changes to heald the heart contract normally.
TIA - ✔mimic stroke, symptoms go away in 24 hours CVA - ✔ruptured artery in brain hemmorragic shock Ischemic stroke symptoms - ✔facial droop, weak, slurred speech, time cardiogenic shock - ✔post MI, irregular pulse, low BP, thready pulse rate fast, pale, cool, clammy BVM if respirations are - ✔under 12 or over 20 (not exact) and do not have good lung sounds, under 8 ventilate wheezing - ✔High pitched sound heard in the lungs with asthmatics or lung disease lower airway Rhonchi - ✔Rattling noise of mucous in the lungs, upper airway crackles - ✔(rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration lower airway stridor - ✔upper airway, indicated foreign object if ventilations are not going in what should you do - ✔resposition Nasal Canula flow rate - ✔1-6 BVM flow rate - ✔15-25 NRB flow rate - ✔10-15 LPM Nebulizer flow rate - ✔6-8 lpm if patient collaspes with airway obstruction - ✔check for pulse, start w chest compressions what to ask when approaching chocking vicitm - ✔Are you chocking? Tell them to cough, when no air is entering the lungs start back blows and chest thrust threat patient w humidified oxygen if - ✔swollen throat, croupy cough, assessory muscle use, or stridor, not if anaphylatic when patient is having trouble breathing, to get their history ask - ✔yes or no questions
landing zone - ✔100 by 100 ft when to request additional assitance - ✔too many for your team to handle, requested before even exiting ambulance Quaility improvement for EMS - ✔critiquing what went well and what could be improved upon, internal and external review Rapid extraction - ✔can be necessary even if CSPine is indicated BSi PPE for profuse bleeding - ✔Gloves, eye protection, mask Notify law enforcement when hospice death - ✔doesn't add up to natural causes USing TC - ✔extracation when needing to remove piece of car from patient Minor on scene transporting parent - ✔take them in ambulance with you or call law enforcement to transport them Using power grip hand go - ✔10 inches apart When driving proceed through intersections - ✔like no one can hear the sirens when correcting an error on document - ✔line through it and initial triage where - ✔in cold zone community relations example - ✔offer BP check to whole community WHn patient is unoconcious and unrepsonsive first always - ✔check pulse and start CPR black and tarry stool - ✔upper GI bleed Lower GI bleed - ✔bright red stool When to remove a penetrating object? - ✔1. Obstructs airway 2. Impedes CPR usually just stablilize 3 year old is drooling and oesn't want to eat? what does he most liekly have? ✔epiglottitis
Signs of respiratory distress in children - ✔grunting, intercostal retractions, nasal flaring You arrive on scene and CPR is in progress what shuld you do - ✔apply AED AED Shockable Rhythms - ✔V-tach and V-fib what to do for gurgling respirtations - ✔suction pumonary edema - ✔Abnormal accumulation of fluid in the interstitial spaces of the lungs. Blood backs up into pulmonary circulation because left ventricle can't pump it forward (Can occur acutely, such as with MI Or can occur as an exacerbation of chronic HF) Emphysema - ✔A serious disease that destroys lung tissue and causes breathing difficulties. pink and skinny check pulse of hypothemic oatient for at least - ✔30 seconds signs and symptoms of congestive heart failure - ✔-Cough (frequent, productive, hemoptysis) -Progressive dyspnea with exertion -Orthopnea -Pitting edema of legs and feet or generalized edema of face, hands, or sacral area -Heart palpitations -Progressive fatigue or syncope with exertion -Moist rales in lower lobes, indicating pulmonary edema What does nitroglycerin do - ✔1. Vasodilator, opening up vessels to increase blood supply to the heart 2. Smooth muscle relaxant what position to place nitro patient in - ✔supine responding to cardiac arrest - ✔start w compressions then go to AED after delivery of baby - ✔dry and warm keep at vaginal opening level hypothermia treatment - ✔remove from cold, take off wet clothing, wrap in blankets, severe cases EMS ASAP gunshot wound, shortness of breath how to treat - ✔ventilate, immoblize, take vitals and apply occlusive dressing
puncture wound apply what - ✔3 sided occlusive dressing head inury and blood thinner causes - ✔hemorrraging bubbling/ bleding from chest apply - ✔fully occulsive dressing femur fracture - ✔lower than hip, deformities, less angulation that hip dislocations hip discolation - ✔rotates whole leg knife is implaed - ✔stablilize with bulky dressings pulmonary contustion - ✔trauma to the chest aorta dissection - ✔tearing pain to the back Annurism - ✔when a vessel wall weakens and balloons aorta rupture - ✔dead Nose bleed - ✔lean forward and pinch nose Rule of (s - ✔arm - 9, 1/2 arm 4.5, head 9, palm 1 neck puncture wound - ✔occlusive dressing spleen - ✔-Upper left of the abdomen, behind the stomach and below diaphragm. -Lymphoid tissue -Blood vessels are *connected* to the spleen by *splenic sinuses*. -*Function*: Filter unwanted materials from the blood (including old RBC) and to help fight infections. -Up to 10% of the population has one or more accessory spleens that tend to form at the hilum of the original spleen. eccomosis - ✔bruising, often caused by internal bleeding solid organ rupture - ✔results in internal bleeding, abdominal distention, eccomosis any kind of abdominal pain first thing you do - ✔two Es: expose and examine region pulmonary embolism - ✔A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.