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Jgernns
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3 factors affecting exposure to radiation
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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
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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
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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
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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.
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What is diffuse axonal injury
Type of brain injury characterized by shearing stretching and tearing of nerve fibers with subsequent axonal damage
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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.
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What is Cushing's reflex
Response to cerebral ischemia that causes an increase in systemic blood pressure, which maintains cerbral perfusion during increased ICP
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Cheyne-stokes respirations
Breathing pattern of alertnating periods of apena and tachypnea
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Cushing triad
The combination of increasing blood pressure, slowing pulse,and erratic respirations in response to increased ICP
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Name 3 types of radiation waves
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Differance between Active and Passive transoport
Active-requires the use of energy
Passive-Requires no energy(Osmosis&Diffusion)
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Name 4 major Cations
- Sodium
- Potassium
- Calcium
- Magnesium
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Name major Antions
- Chloride
- Bicarbonate
- Phosphate
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Normal Ranges of Acid base balance
- PH 7.35-7.45 Below life 6.9-7.8
- Pco2- 35-45
- HCO3- 22-26
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Causes of Metabolic Alkalosis
- Diuretics
- Vomiting
- Ant-acid overdose
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Causes of Respiratory Alkalosis
- Hyperventation
- Anxiety
- Asprin O/D
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Causes of Respirtory Acidosis
- COPD
- Narcotic O/D
- Diabetic
- CHF
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Cause of Metabolic Acidosis
- Increase in exercise
- Cardiac arrest
- DKA
- Alcoholics
- Renal Failure
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Names types of shock
- Cardiac
- Nero
- Hypovolomic
- Septic
- Anaphalactic
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Name drugs that can be adminster Nasaly
- Fentanyl
- Narcan
- Adovan
- Verssed
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Name 2 types of Isotonic solutions
- Lactaed ringers
- normal saline
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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
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IV access complications
- Pain
- local infection
- allergic reaction
- catheter shear
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What position to place a pt to adminster an EJ
Place in trendelumburg
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What angle do you adminster Sub-Q shots at
45 degrees
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3 body systems that reglate Acid/Base
- Buffer-first
- Respirtory kicks in second 2-3 min
- Renal(metabolic) last, longer acting
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Signs of respiroty distress
- Altered mental status
- Shortness of breath
- Retractions
- Cyanosis
- Aubilbe sounds
- Abnormal rate and pattern
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What is Decorticate/Decrebrate posturing
Decorticate-arms flexed to core, legs extended
Decrebrate- arms and legs extended
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What type of injury is Axail loading
compression fractures of the spine
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Water accounts for how much of body weight
Adult's- 60%
Peds- 80%
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Stage 1 hemorrhage
- Less than 15 %
- Vasoconstriction Increased
- Pulse rate increase
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Stage 2 hemorrhage
15-25% blood loss
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Stage 3 hemorrhage
25-35% blood loss
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Stage 4 hemorrhage
Greater than 35% blood loss
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What is the difference between Osmosis/Diffusion
Diffusion-The movement of solute in the solution.
Osmosis- the movement of the solvent usually water.
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How much medication can you adminster in the Deltoid/Thigh
Deltoid- up to 2mL
outer and medal thigh- Up to 5 ML
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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.
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What is Hyperkalemia
Abnormally high Potassium
Low potassium Hypokalemia
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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.
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Name 2 drugs for Intubation
Etomidate/Amidate
Midazolam/Versed
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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
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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.
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ADH
Vasoprin
From: Posterior pituitary
- Action: Increase peripheral vasc resistance
- Increase water retention
- Splenic vasoconstriction
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Aldostrone
From: Adreal gland
Action: renal retention od Na and water
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Epinephrine
From: Adrenal gland
Action: Vasoconstriction, Incrrease heart rate and contractility
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Angiotensin II
from Kidneys
Action: Potent Vasconstrictor, Stimulates release of ADH,aldosterone and epinephrine
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Clotting Phases
phase 1- Vascular phase- constriction
Phase 2- Platelet phase- Aggregation
Phase 3- Coagulation phase-fibrin release
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Adverse factors in clotting
Movement of the site
Aggressive fluid therapy
Temperature changes
Medications- Asprin, ibuprofen(NSAIDS), Heparin,plaix, coumadin/warfarin
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Alpha 1 receptor
Peripheral Vasoconstriction
Increased contractile force
Decreased heart rate(Negative chrontropic effect)
Decreased catacholamines in cirrulation(Vasodiliation and drecreased blood pressure)
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Beta 2 receptors
bronchodilation
Uterine smooth muscle relaxation
Gastrointestinal smooth muscle relaxtion
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