EMT-B Test 2 Final Quiz

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EMT-B Test 2 Final Quiz
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2010-03-14 23:16:22
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EMT-B Test 2 - Final Quiz
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  1. Define airway
    Movement of air in or out with a single inspiration or exhalation.
  2. The name of the bifurcation in the trachea is called the ______ and it divides into the right and left ______.
    • 1) Carina
    • 2) Bronchus
  3. How far do you insert suction and what is the amount of time to suction?
    • As far as you can see, to the base of the tongue.
    • 15 seconds.
  4. What is the average alveolar ventilation in liters that a person will breathe in one minute?
    4 to 4.5 L/minute
  5. What is one cause of wheezing?
    • Lower airway obstruction
    • Asthma
    • Bronchitis
  6. List five structures of the upper airway
    • Nasopharynx (nose)
    • Orapharynx (mouth)
    • Tongue
    • Larynx
    • Epiglottis
    • Vocal Chords
  7. Name three complications of hyperventilating your patient.
    • Increases intrathoracic pressure
    • Barotrauma
    • Decreased preload
    • Decreased CO
    • Gastric distension
  8. What are the two primary muscles used in respiration?
    • Intercostals
    • Diaphragm
  9. Name two adjuncts used to maintain an open airway.
    • OPA
    • NPA
  10. List seven functions of the respiratory system.
    • Transfer of oxygen to the body
    • Removal of CO2 and waste
    • Temperature
    • Homeostasis
    • Phonation
    • Warm air
    • Moisten air
    • Filter
    • Acid-base balance
    • Oxygenation
    • Ventilation
    • Gas exchange
  11. List six structures in the lower airway.
    • Trachea
    • Mainstem Bronchus (L and R)
    • Bronchi
    • Bronchioles
    • Alveolar ducts
    • Alveoli
    • Lungs
  12. What is the difference between the right and left lungs?
    • Right has 3 lobes
    • Left has 2 lobes
  13. Define oxygenation and ventilation.
    • Oxygenation: Saturation of the body with oxygen.
    • Ventilation: Movement of air in or out of the body in a single inspiration or expiration
  14. Name to maneuvers to open an airway.
    • Head tilt chin lift
    • Jaw thrust
  15. What is the best indicator that a BVM is working properly?
    Equal chest rise and fall.
  16. What stimulates respiration?
    Hypoxic / CO2 drive
  17. Define dead air space.
    • Air between the mouth and alveoli.
    • Air that never reaches the alveoli.
  18. Describe how to measure an OPA. What are two advantages and disadvantages?
    • Measure: From the corner of the mouth to the ear.
    • Advantages: Blocks tongue from back of the throat, bite block, better than an NPA, can suction through them.
    • Disadvantages: Can trigger a gag reflex, cannot use on semi-conscious or conscious, can cause soft tissue trauma, may occlude airway
  19. Which structure prevents food from entering the trachea?
    Epiglottis.
  20. List the flow rate for a nasal cannula, non-rebreather, and bag valve mask.
    • NC: 2-6 L/min
    • NRB: 8-15 L/min
    • NVM: 15+
  21. Define respiratory distress.
    Inadequate ventilation and oxygenation
  22. What is the maximum suctioning time and why is there a limit?
    • Max: 15 seconds
    • Limit: Removal of potential oxygen from patient
  23. How do you measure an NPA? What are two advantages and disadvantages?
    • Measurement: Tip of the nose to tip of the ear.
    • Advantages: Can be used on conscious and semi-conscious patients, can be used in patients with a gag reflex, doesn't block the airway, suction through it.
    • Disadvantages: Soft tissue injury, epistaxis, easily occluded, may have troubling inserting with a piercing or abnormality, painful
  24. Define respiratory failure.
    Inability to ventilate and oxygenate.
  25. What is the mechanism that allows for gas exchange at the alveolar level?
    Diffusion
  26. What two techniques make for excellent BVM usage? What two ways can you hold the mask individually? What about with a partner?
    • Two techniques: good seal, good technique
    • Solo: EC and OK clamps
    • Two person: Double EC and thumb method
    • Always use two person ventilation if possible.
  27. What is the primary purpose of performing cricoid pressure when using a BVM?
    Prevent gastric distension.
  28. How often do you ventilate a patient in respiratory arrest with a pulse? What is the rate per minute?
    • Rate: 5-6 seconds
    • Minute rate: 10-12 times per minute
  29. What are possible causes of stridor?
    • Croup
    • Burns
    • Anaphylaxis
  30. What is the cause of rales/crackles
    • Pulmonary edema
    • Pneumonia
    • Congestive Heart Failure (CHF)
  31. How do you check fremitus?
    • Ask the patient to say "ninety-nine" several times in a normal voice
    • Palpate using the ball of your hand
    • You should feel the vibrations transmitted through the airways to the lung
    • Increased tactile fremitus suggests consolidation of the underlying lung tissues
  32. How do you change a regulator?
    • Check the bottle, make sure it's oxygen.
    • Check the expiration date.
    • Look for cracks, deformities etc.
    • Check the seal of the bottle.
    • Check the o-ring on the regulator.
    • Crack the bottle.
    • Attach the regulator to the tank.
    • Turn the tank on, two full turns to the left.
    • Apply apparatus to the tank.
    • Apply apparatus to the patient.
  33. What are you assessing when determining a general impression?
    Sick or not sick.
  34. AAOx4 stands for
    Alert, awake, and oriented to persons, place, time, and event.
  35. List four points to note while performing a scene size up
    • Scene safety
    • BSI
    • Number of patients
    • Need for additional resources
    • MOI or NOI
  36. The most important part of doing a medical assessment is to:
    Get a good history
  37. What are the four areas checked when a patient has a decreased LOC?
    • A: Alert
    • V: Verbal
    • P: Painful
    • U: Unresponsive
  38. What are the six phases of an assessment?
    • Scene size up
    • Initial assessment
    • Focused medical
    • Focused trauma
    • Detailed assessment
    • Ongoing assessment
  39. List the three areas and the high and low score of each.
    • Eyes: 1-4
    • Verbal: 1-5
    • Motor: 1-6
    • Total: 3-15
  40. What are two causes of unequal pupils?
    • Aniscoria
    • Cerebral Vascular Accident (CVA)
  41. Define aniscoria
    Unequal pupils that occur naturally.
  42. What is the pneumonic used in determining a patient's history?
    • S: Signs and symptoms
    • A: Allergies
    • M: Medications
    • P: Pertinent past medical history
    • L: Last oral intake / last menses
    • E: Events leading up to the problem
  43. List six findings to look for when assessing an airway
    • Sounds
    • Phonation
    • Mentation
    • Color
    • Edema
    • LOC
    • If it is obstructed
    • Position
    • Patency
  44. The primary cause of cyanosis is
    Hypoxia
  45. List five findings to look for when assessing breathing
    • Rate
    • Depth
    • Strength
    • Color
    • Phonation
    • Effort
    • Sounds
    • LOC
  46. List the five vital signs and the normal ranges for each
    • Pulse: 60-100 bmp
    • Respirations: 12-20 breaths/min
    • Skin: Warm, pink, dry
    • Pupils: PERRL
    • Blood pressure: 120/80
  47. List five findings when assessing circulation
    • Color
    • Strength
    • Central vs peripheral
    • Temperature
    • Bleeding
    • LOC
    • Rate
    • Quality
    • Texture
    • Capillary refill
  48. What is the pneumonic that supplements SAMPLE?
    • O: Onset
    • P: Palliation and provocation
    • Q: Quality
    • R: Rate
    • S: Severity
    • T: Time
  49. What are the four senses and two findings of each used in an assessment?
    • Sight - Smoke, DCAPBTLS, color, pupils
    • Sound: Breath, lung, BP, history
    • Touch: Pain, swelling, temperature, texture, deformity, rigidity
    • Smell: Drugs, alcohol, fruity breath, GI bleed
  50. List five devices you can use to move a patient
    • Stair chair
    • Butt bucket
    • Scoop stretcher
    • Gurney
    • Sheet
    • Back board
    • Slider board
    • KED
  51. List 8 mechanisms of injury that lead to a high index of suspicion.
    • Starred windshields
    • Deployed airbags
    • Ejection
    • Car vs car
    • Car vs human
    • Fall from 2x height onto solid surface
    • Death of another occupant
    • Sudden deceleration
    • Prolonged extrication
    • Greater than 12 inches protrusion into a vehicle compartment
    • Bent steering wheel
    • Puncture to the core of the body
  52. What is bradycardia? List three causes.
    • A slow heart rate.
    • Hypothermia
    • Late hypoxia
    • Depressant drugs
    • Coronary artery disease
  53. What does DCAPBTLS stand for?
    • D: Deformity
    • C: Contusion (scrape)
    • A: Abrasion (bruise) or amputation
    • P: Penetration or puncture
    • B: Burn
    • T: Tenderness
    • L: Lacerations
    • S: Swelling
  54. What is tachycardia? List three causes?
    • High heart rate.
    • Exercise
    • Hyperthermia
    • Hypoxia
    • Stimulants
    • Shock
    • Coronary Artery Disease
  55. List 4 colors you may see on a patient and two causes of each
    • Flushed: Hyperthermia, burns, high blood pressure, allergies, exertion
    • Black: Necrosis, death, burns
    • Cyanosis: Shock, hypothermia, hypoxia
    • Pale: Shock, poor perfusion, hypothermia, burns, hypoxia
    • Jaundice (yellow): Hepatitis, alcoholism, gall bladder and liver failure
  56. List five actions to prevent a back injury
    • Consider the patient's weight
    • Have appropriate number of people lifting
    • Lift with the legs
    • Keep feet a comfortable distance apart
    • Keep back locked
    • Don't reach more than 15 inches
    • Bend at needs
    • Tighten abdominal muscles
    • Avoid twisting
    • Keep back straight
  57. Decorticate posture is:
    • Abnormal flexxion
    • Arms rolled in, wrists bent
    • Legs twisted inward
  58. List three reasons to do an assessment:
    • Scene overview
    • Identify life threats
    • Identify the problem
    • Dictate interventions
    • Determine the interventions outcome
  59. Define decerebrate posture
    • Abnormal extension
    • Wrists pronated
    • Legs stiff and straight
  60. What two parts of the assessment are done after the focused assessment?
    Detailed and ongoing.
  61. List five devices used to lift and move a patient
    • Backboard
    • Scoop stretcher
    • Gurney
    • Stair chair
    • Butt bucket
    • Slider board
    • Sheet
  62. List five actions to take when lifting a pt to prevent back injury
    • When possible, use a stair chair
    • Know weight to be lifted
    • Ensure enough help is available.
    • Use at least two people
    • Use an even number of people to lift
    • Keep back locked.
    • Keep feet a comfortable distance apart
    • Avoid reaching more than 15-20 inches
    • Tighten your abdominal muscles
    • Keep feet flat on the ground
    • Keep the center of your body over the object
    • Straighten your legs as you lift.
    • Keep your back locked into position, don't twist
  63. List three emergency moves
    • Feet drag
    • Clothes drag
    • Blanket drag
    • Shoulder drag
    • Forearm drag
    • Cradle carry
    • Two person carry
    • Direct ground lift
    • Extremity lift
    • Direct carry
    • Draw sheet transfer
  64. Describe why it is important to do a detailed and on going assessment.
    In order to continue to identify any problems and also to note if there are any changes in the patient's status
  65. What does DCAPBTLS stand for?
    • Deformity
    • Contusion
    • Abrasion or amputation
    • Penetration or puncture
    • Burns
    • Tenderness
    • Laceration
    • Swelling
  66. What is the most important part of a focused trauma assessment?
    Doing the hands on
  67. What is the most important part of a focused medical assessment?
    Getting a good patient history
  68. List the four senses you must use during your assessment, and what you would note with each!
    • Sight: Skin color; pupils; bleeding; facial expressions; posturing
    • Smell: Diabetic keto Acidosis; vomit; blood; death; gangrene; GI bleed
    • Touch: Diaphoresis; pulse; fracture; dislocation
    • Hearing: Blood pressure; history; pain; breath sounds
  69. Six steps of the initial assessment
    • General impression
    • LOC
    • A
    • B
    • C
    • Priority
  70. Five findings for airway
    • Phonation
    • Color
    • Position
    • Sounds
    • Rate
    • LOC
    • Obstruction
  71. Five findings when assessing breathing
    • Rate
    • Depth
    • Volume
    • Color
    • Chest rise and fall
    • Color
    • Sounds
    • Quality
  72. Five findings when assessing circulation
    • Color
    • LOC
    • Mentation
    • Temperature
    • Bleeding
    • Central vs peripheral
    • Capillary refill
  73. Define ventilation
    The amount of air moved in or out during one inspiration or expiration
  74. Define oxygenation
    Saturation of the body with oxygen
  75. Define perfusion
    A constant flow of blood through the capillaries
  76. How often do you retake vital signs?
    • Every 5 minutes on an unstable patient
    • Every 15 minutes on a stable patient
  77. Four colors you may find and two causes of each
    • Pale: Shock, hypoxia, burns, poor perfusion
    • Cyanosis: Hypoxia, hypothermia
    • Red: Hyperthermia, CO poisoning, burns, exercise
    • Mottling: Cardiogenic shock, septic shock, hypovelemic shock
    • Yellow: Liver failure, gallbladder failure, hepatitis, alcoholism
    • Black: Necrosis, burns, frostbite
  78. List three ways you may find pupils and two causes of each.
    • Constricted: Light, narcotic overdose, organophosphates, barbiturates
    • Dilated: Head injuries, shock, cocaine, meth
    • Unequal: Aniscoria, head injuries
  79. List five causes of bradycardia and tachycardia
    • Bradycardia: Narcotics, hypothermia, head injury, late hypoxia, cardiac disease, beta blockers, calcium channel blockers, ACS
    • Tachycardia: Shock, anxiety, meth, cocaine, epinephrine, hyperthermia, dever, infection, exercise, ACS
  80. What does AVPU stand for? What is it used for?
    • Determining the responsiveness of a patient who has decreased awareness.
    • A: Alert
    • V: Verbal
    • P: Painful
    • U: Unresponsive
  81. What does GCS stand for? What are the scores for each section?
    • Eyes: Open - 4, Open to verbal command - 3, Open to painful stimuli - 2, No response - 1
    • Verbal: Alert - 5, Disoriented - 4, Inappropriate - 3, Incomprehensible - 2, No response - 1
    • Motor: Alert - Obeys command - 6, Localizes pain - 5, Withdraws from pain - 4, Decorticate (abnormal flexxion) - 3, Decerebrate (abnormal extension) - 2, None - 1

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