Paramedic school

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Author:
Jgernns
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208776
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Paramedic school
Updated:
2013-03-24 14:53:13
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Week Burns hemrrhage IV Acid Base
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Week 3
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  1. 3 factors affecting exposure to radiation
    • Time
    • Distance
    • Shielding
  2. Name 5 systemic complications that occur in burns
    • Hypothermia
    • Hypovolemia
    • Eschar-hard leathery product of full thickness burns
    • Infection
    • Organ failure
    • Special factors-Health and age
  3. What is the parkland Burn formula
    • Used to know how fluid to give to a pt over time
    •  4mLxbody weight in KGx % of total body area burned

    • Hour formula
    • .25x kg x %TAB
  4. Injuries that benifit from Burn centers
    • Partial thickness greater than 15%
    • Full-thickness greater than 5%
    • Significant burns to the face,feet,hands, and perineal area
    • Inhalation Injuries
    • Chemical Burns
    • Associated signifcant injuries
  5. Differance between Acid/Alkalis burns
    Acid-usually form thick insoluble mass where they contact tissue.

    Alkalis- continue to destroy cell membranes through liquefaction,necrosis, allowing them to penetrate underlying tissue and causing deeper burns.
  6. What is diffuse axonal injury
    Type of brain injury characterized by shearing stretching and tearing of nerve fibers with subsequent axonal damage
  7. What is Retrograde/Anterograde amnesia
    Anterograde- Can not remeber events that occured after the trauma that caused the condition.

    Retrograde- Can not remember events that occured befoe the trauma that caused the condition.
  8. What is Cushing's reflex
    Response to cerebral ischemia that causes an increase in systemic blood pressure, which maintains cerbral perfusion during increased ICP
  9. Cheyne-stokes respirations
    Breathing pattern of alertnating periods of apena and tachypnea
  10. Cushing triad
    The combination of increasing blood pressure, slowing pulse,and erratic respirations in response to increased ICP
  11. Name 3 types of radiation waves
    • Alpha
    • Bata
    • Gamma
  12. Differance between Active and Passive transoport
    Active-requires the use of energy

    Passive-Requires no energy(Osmosis&Diffusion)
  13. Name 4 major Cations
    • Sodium
    • Potassium
    • Calcium
    • Magnesium
  14. Name major Antions
    • Chloride
    • Bicarbonate
    • Phosphate
  15. Normal Ranges of Acid base balance
    • PH 7.35-7.45 Below life 6.9-7.8
    • Pco2- 35-45
    • HCO3- 22-26
  16. Causes of Metabolic Alkalosis
    • Diuretics
    • Vomiting
    • Ant-acid overdose
  17. Causes of Respiratory Alkalosis
    • Hyperventation
    • Anxiety
    • Asprin O/D
  18. Causes of Respirtory Acidosis
    • COPD
    • Narcotic O/D
    • Diabetic
    • CHF
  19. Cause of Metabolic Acidosis
    • Increase in exercise
    • Cardiac arrest
    • DKA
    • Alcoholics
    • Renal Failure
  20. Names types of shock
    • Cardiac
    • Nero
    • Hypovolomic
    • Septic
    • Anaphalactic
  21. Name drugs that can be adminster Nasaly
    • Fentanyl
    • Narcan
    • Adovan
    • Verssed
  22. Name 2 types of Isotonic solutions
    • Lactaed ringers
    • normal saline
  23. Name factors that effect IV flow
    • Constricting band still in place
    • Edema at site
    • Against vein wall
    • IV bag to low
    • No longer in vein
    • IV bag height
  24. IV access complications
    • Pain
    • local infection
    • allergic reaction
    • catheter shear
  25. What position to place a pt to adminster an EJ
    Place in trendelumburg
  26. What angle do you adminster Sub-Q shots at
    45 degrees
  27. 3 body systems that reglate Acid/Base
    • Buffer-first
    • Respirtory kicks in second 2-3 min
    • Renal(metabolic) last, longer acting
  28. Signs of respiroty distress
    • Altered mental status
    • Shortness of breath
    • Retractions
    • Cyanosis
    • Aubilbe sounds
    • Abnormal rate and pattern
  29. What is Decorticate/Decrebrate posturing
    Decorticate-arms flexed to core, legs extended

    Decrebrate- arms and legs extended
  30. What type of injury is Axail loading
    compression fractures of the spine
  31. Water accounts for how much of body weight
    Adult's- 60%

    Peds- 80%
  32. Stage 1 hemorrhage
    • Less than 15 %
    • Vasoconstriction Increased
    • Pulse rate increase
  33. Stage 2 hemorrhage
    15-25% blood loss
  34. Stage 3 hemorrhage
    25-35% blood loss
  35. Stage 4 hemorrhage
    Greater than 35% blood loss
  36. What is the difference between Osmosis/Diffusion
    Diffusion-The movement of solute in the solution.

    Osmosis- the movement of the solvent usually water.
  37. How much medication can you adminster in the Deltoid/Thigh
    Deltoid- up to 2mL

    outer and medal thigh- Up to 5 ML
  38. What is the purpose of Sodium
    Plays a major role in water distribution because water is attracted to and moves sodium.

    Abnormal increase in relative amount of sodium is hypernatremia.
  39. What is Hyperkalemia
    Abnormally high Potassium

    Low potassium Hypokalemia
  40. What is MODS and its progression
    Multiple organ dysfunction syndrome

    Progressive imparment of 2 or more organ systems resulting from an uncontrolled inflammatory response to severe illness or injury.
  41. Name 2 drugs for Intubation
    Etomidate/Amidate

    Midazolam/Versed
  42. What are 2 major componets of off-line medical direction.
    Protocols- the policies and procedures for all componets of an EMS system/Standing orders-preauthorized treatment procedures: type of treatment protocol

    QA/QI process
  43. Cricoid pressure VS BRUP
    Cricoid pressure- Pressure applied by someone other than the person preforming the intubation to prevent vomit from entering the airway.

    BURP- Backward,UPward, Right, Pressure- Used by the person preforming the the intubation to see the vocal cords better.
  44. ADH
    Vasoprin

    From: Posterior pituitary

    • Action:  Increase peripheral vasc resistance
    • Increase water retention
    • Splenic vasoconstriction
  45. Aldostrone
    From: Adreal gland

    Action: renal retention od Na and water
  46. Epinephrine
    From: Adrenal gland

    Action: Vasoconstriction, Incrrease heart rate and contractility
  47. Angiotensin II
    from Kidneys

    Action: Potent Vasconstrictor, Stimulates release of ADH,aldosterone and epinephrine
  48. Clotting Phases
    phase 1- Vascular phase- constriction

    Phase 2- Platelet phase- Aggregation

    Phase 3- Coagulation phase-fibrin release 
  49. Adverse factors in clotting
    Movement of the site

    Aggressive fluid therapy

    Temperature changes

    Medications- Asprin, ibuprofen(NSAIDS), Heparin,plaix, coumadin/warfarin
  50. Alpha 1 receptor
    Peripheral Vasoconstriction

    Increased contractile force

    Decreased heart rate(Negative chrontropic effect)

    Decreased catacholamines in cirrulation(Vasodiliation and drecreased blood pressure)
  51. Beta 2 receptors
    bronchodilation

    Uterine smooth muscle relaxation

    Gastrointestinal smooth muscle relaxtion

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