Module 4

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Module 4
2010-07-04 19:35:29

EMT Study Module 4 Chapters 10-18
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  1. Define Pulmonary Edema
    The accumulation of fluid in the space between the alveoli and the pulmonary capillaries
  2. Define Tachycardia
    Rapid beating of the heart 100 beats/min or more
  3. Define Hypertension
    An arterial disease characterized by the elevation of the blood pressure, especially the diastolic pressure
  4. Define Edema
    Fluid into the interstices of cells in the tissue spaces or into the body cavities
  5. Define Hypotension
    Lowered blood pressure. A disease or condition characterized by this symptom
  6. Define Aneurysm
    Swelling or enlargement of part of an artery, resulting from weakness of the arterial wall
  7. Define Bradycardia
    Usually slow beating of the heart, 60 beats/min or less
  8. Define Angina
    Pain caused by the heart tissue not getting enough oxygen
  9. Define Dyspnea
    Shortness of Breath
  10. What medications can be administered by the EMT-B
    • Epi-Pen
    • Actiated Charcol
    • Oral Glucose
    • Aspirin
    • Nitroglycerin
    • Oxygen
    • MDI
  11. What medications can be carried by the EMT-B
    • Activated Charcol
    • Oral Glutos
    • Oxygen
    • Epi Pen
    • Aspirin
  12. Define Indication
    Reason for administering
  13. Define Contraindication
    Condition that makes it not used
  14. Define Mechanism of action
    Effects of the drug
  15. Define Dose
    The safe amount of the drug that can be administered
  16. Define Route
    Method in which the drug is given
  17. Define Side effects
    Actions of the drug other than the main effect or "Mechanism of Action"
  18. What is MDI
    Meter Dose Inhaler
  19. What is a spacer device
    A tube that is applied between the inhaler and the patient for proper intake of the medication
  20. Indications for Nitroglycerin
    Chest pain, Doctor prescribed, Medical Control approved
  21. Contraindications for Nitroglycerin
    Blood pressure below 100 systolic, head injury, child or infant, 3 doses have been taken
  22. Dose for Nitroglycerin
    1 tablet or spray under the tongue, maye repeaded 3 to 5 minutes if no relief, Blood pressure remains greater than 100 systolic, Medical Control must approve
  23. Side Effects of Nitroglycerin
    Vessel dilation, headache, drop in blood pressure, pulse rate change
  24. Indications for Oral Glucose
    Altered Mental Status, History of Diabetes, Ability to swallow
  25. Contraindications for Oral Glucose
    Unconscious, unable to swallow
  26. Dose for Oral Glucose
    One tube
  27. Side effects for Oral Glucose
    Airway obstruction without gag reflex
  28. Indications for Epi-Pen
    Sever allergiv reation, prescribed by doctor, orders from Medical Control
  29. Contraindication for Epi-Pen
    None, For Life threating allergic reactions
  30. Dose for Epi-Pen
    Auto injector, Adult = .3mg Child & Infant = .15mg
  31. Side Effects of Epi-Pen
    Increassed heart rate, pale skin, dizziness, chest pain, headache, nausea, vomitting, excitablility, anxiousness
  32. Indications for Activated Charcol
    Poison by mouth, administer after orders from Medical Control or Poison Control
  33. Contraindications for Activated Charcol
    Altered Mental Status, swallowed acids or alkalis, unable to swallow
  34. Dose for Activated Charcol
    • 1 gram per kilogram of body weight
    • Adult = 25-50 grams
    • Infant/child = 12.5 - 25 grams
  35. Side effects of Activated Charcol
    Blackening of Stool, possible vomitting
  36. Indications for Aspirin
    Chest pain suggestive of Acute Myocardia Infarction
  37. Contraindication of Aspirin
    Bleeding ulcer, hemorrhagic state, hemophilla
  38. Dose for Aspirin
    160 - 325 mg (2-4 peds 81mg each)
  39. Side Effects of Aspirin
    Caution in paitents with Asthma
  40. Indication for MDI
    Signs & Symtoms of breathing difficulty, patient has prescibed inhaler from doctor, Medical Control Approved
  41. Contraindications for MDI
    Not responsive to use, not prescribed, Max dose has been reached, denied by Medical Control
  42. Dose for MDI
    Delivers precise dose, Number of puffs can be determined by prescription or Medical Control
  43. Side Effects for MDI
    Tachycardia, Tremors, Shakiness, Nervousness, Dry Mouth
  44. How can you distinguish between Respiratory Distress and Respiratory Failure
    • Distress is difficulty breathing - blockage of the airway
    • Failure is the inability to exchange gases - Infection of the airway
  45. Indentify the three muscle layers of the heart
    • Endocardium - Inner
    • Myocardium - Middle
    • Pericardium - Outer
  46. Indentify the heart's three inherent pacemakers
    • SA Node
    • AV Node
    • Bundle of His
  47. What is a myocardial Infarction
    • A blood clot blocking the lumen of the artery, causing tissue downstream from the clot to loose oxygen adn possible die.
    • A classic heart attack
  48. List the signs & Symptoms of Myocardial Infarction
    • Chest pain, dizziness, sense of doom or death, swetting, polmenary edema,
    • pain/discomfort/pressure in
    • lower jaw,
    • arms,
    • back,
    • abdomen, or neck
  49. List several signs & symptoms of respiratory distress
    • Breathing rate slower than 12 breaths/min or faster than 20 breath.min
    • Unequal chest expansion
    • descreased breath sounds on 1 or both sides of the chest
    • Muscle retraction above the clavicle, between the rib cage, especially in children
    • Pale or cyanotic skin
    • Cool, damp, (clammy) skin
    • Shollow or irregular respirations
    • pursed lips
    • nasal flaring
  50. Trace blood through the heart and circulatory system starting at the aorta
    • The right side recieves blood from the veins of the body, blood enters from the superior and inferior canea into the right antrium, passes through the tricuspid valve to the right venticle, then flows into the pulmonary artery and the pulmonary circulation.
    • The left side recieves oxygenated blood from the lungs the the pulmonary viens into the left atrium, passes through the mitral valve in to the left ventricle, then pumps into the aorta and then to the arteries of the body.
  51. Define Infarction
    Death of tissue
  52. What is Congestive heart failure
    When ventricular heart muscle is so damaged that it can no longer keep up with the return of blood from the atria
  53. Signs & Symptoms of Congestive Heart Failure
    • Easier to breath sitting up
    • Mild or severely agitated
    • chest pain may or may not be present
    • Distended neck veins that do not collapse when sitting
    • swolloen ankles from dependant adema (back-up of fluids)
    • High blood pressure, rapid heart rate, rapid respirations
    • use of accessory breathing muscles of the neck & ribs
    • Rale sounds of the lungs
  54. What is Cardiogenic Shock
    The heart lacks the proper power to force the volume of blood through the circulatory system
  55. Signs & Symptoms of Cardiogenic Shock
    • Anxiety or restlessness as the brain becomes starved of oxygen, "Air hunger"
    • Pale, clammy skin
    • pulse rate will be higher than normal, possibly 120 beats/min or higher
    • rapid or shallow breathing
    • nausea and vomiting
    • decrease in body temp
    • late stage the bllod pressure will fall below 90 systolic
  56. Identify the treatment of respitory distress
    • Oxygen by NRB mask or PPV with 15 lpm high flow
    • Positioning the patient'
    • possible OPA or NPA
  57. Identify the treatment for respitory failure
    • Huidified oxygen
    • sucction the ariway
    • Insert an OPA
    • get patient in position of comfort
    • Transport promptly
  58. What are the indications of the AED
    • Pulseless
    • unresponsive patient
  59. What are the contraindications for the AED
    • A moving patient by transport
    • responsive with rapid heart rate
    • pulse
  60. When should the AED be used for a witnessed cariac arrest
    Immediatly or witin 2 minutes from the cariac arrest, depending on when it is ready.
  61. When should the AED be used for a patient with an exptended down time
    After 5 sysles of CPR, to prime the pump and remove the metabolic waste
  62. The correct placement of the AED pads for an Adult and Child
    • Adult = Upper right of the sternum, just below the clavicle, left lower chest 2" to 3" below the armpit
    • Child = Anterior of the right chest, posterior of the left chest
  63. When using an AED, when should you transport a patient in cardiac arrest
    • The patient regains a pulse
    • Six to nine shocks are deliverd
    • AED gives 3 consecutive messages (seperated by 2min of CPR) that no shock is advised
  64. Describe how an AED can be used while transporting a patient
    • Stop the vehicle
    • perform CPR until AED is available
    • Analyze rythm
    • Deliver shock
    • Continue resuscitation
    • repeat
    • continue transport
  65. Identify the signs & Symptoms of a diabetic emergency
    • Normal or rapid respirations
    • pale, moist, clammy skin
    • diaphoresis (sweating)
    • dizziness, headache
    • rapid pulse
    • normal to low blood pressure
    • altered mental status
    • anxiuos or combative behavior
    • hunger
    • seizure, fainting, comma
    • weakness on one side of the body
  66. What is the difference between fully automated and semi-automated AED's
    • Automated is faster, has stick on pads to deliver the shock
    • Semi has paddles that the EMT has to hold to administor the shock and is slower to analyze
  67. What is DKA and the signs & Symptoms
    • Diabetic Ketoacidosis - An accumulation of certain acids accurs when insulin is not available in the body
    • Vomitting
    • abdominal pain
    • deep, rapid breathing called Kussmaul respirations
  68. What is Isulin Shock, Signs & Symptoms
    • Hypoglycemia, Insuficiant glucose in the blood
    • Normal or rapid respirations
    • pale, moist skin
    • Diophoresis (sweating)
    • dizziness, headache
    • rapid pulse
    • normal to low blood pressure
    • altered mental status
    • anxious or combative behavior
    • hunger
    • seizures, fainting, coma
    • weakness on one side of body
  69. hat are the three clasic signs of untreated DKA
    • Unconsiousness
    • Diabetic coma
    • death
  70. Describe the difference in onset of DKA v. insulin shock
    • DKA - Is uncontrolled diabettes and may be reversed over hours of hospilization
    • Insulin Shock - is insuficient glucose in the blood and can be quickly reversed
  71. Define Hypoglycemia and Hyperglycemia
    • Hypoglycemia - Below normal, low glucose level in the blood
    • Hyperglycemia - Above normal, high glucose level in the blood
  72. What is a "normal" glucose level
    80 - 100 mg/dl
  73. What is the difference between Type I and Tpe II diabetes
    • Type I - Do not produce insulin at all, they are insulin dependant (100m)
    • Trype II - Inadequate production of insulin or they produce normal amounts but the insulin does not function properly
  74. What are the signs & Symptoms of Anaphylaxis
    • Symptoms = respitory destress, or cardiovascualr distress in the form of shock, anxious and the feeling of death, itching or burning, chest tightness, abdominal cramps
    • Signs = wheezing, urticaria, hives, wheals, swelling or lips & tongue, broncho spasm, dysphea, anxiety, hypotension, respitory failure
  75. Describe the management of anaphylaxis
    • Treat the ABC's
    • Focused exam or rapid assessment
    • SAMPLE history
    • Mental status
    • Skin condition
    • Epinephrine and ventilation supprot
    • Treat shock
    • ice area of bite of sting
    • transport
  76. What is the difference between an allergic reaction and anaphylaxis
    • Reaction is an exaggerated ammune response to any subatance. It's reaction by the body's ammune system to combat the stimulus
    • Anaphylaxis is an extreme allergic reaction that is usually like threatening and typically involves multipule organ systems
  77. Identify common causes of anaphylxis
    • Insect bites
    • medications
    • plants
    • food
    • chemicals
  78. List various ways that poisons can enter the body
    • Inhalation
    • aborption
    • ingestion
    • injection
  79. describe the management of a patient experiancing a poisoning emergency
    • Dilute or decontamiate
    • oxygen
    • flush with water
    • remove contaminated clothing
    • use activated charcol
    • transport
    • manage ABC's
  80. What are signs & Symptoms of opioid poisoning emegerency
    • Hypoventilation
    • pinpoint pupils
    • sedation or coma
    • hypotension
  81. What are signs & Symptoms of Sympathomimetic poisoning emegerency
    • Hypertension
    • tachycardia
    • dilated pupils
    • agitation or seizures
    • hyperthermia
  82. What are signs & Symptoms of Desative-Hypnotics poisoning emegerency
    • Slurred speech
    • sedation or coma
    • hypovenilation
    • hypotension
  83. What are signs & Symptoms of Anticholinergics poisoning emegerency
    • Tachycardia
    • hyperthermia
    • hypertension
    • dialted pupils
    • dry skin and mucous membranes
    • sedation, agitation, seizures, coma, or delirium
    • decreased bowel sounds
  84. What are signs & Symptoms of Cholinergics poisoning emegerency
    • Excess defecation or urination
    • muscle fasciculations
    • pinpoint pupils
    • excess lacrimation (tearing) or salvation
    • airway comprimise
    • mausea or vomiting
  85. What are the general effects of heat on blood vessels and metabolic rate
    • It diolates the vessels to bring blood to the skin in order to cool it
    • It speeds up rate until it can't handle the heat and then fails slowing the heart rate and blood pressure
  86. what are the general effects of cold on blood vessels and metabolic rate
    • It constricts the blood vessels at the skin to retain heat
    • The metabolic rate slows to protect the organs
  87. Decribe the various ways the body loses heat
    • Conduction - Contact
    • Convection - Air
    • Evaporation - Sweating
    • Radiation - Invisble light that transfers heat
    • Respiration - warm air in lungs is expelled to the atmophere and cooler air is inhaled
  88. What is the difference between a local and systemic enviromental emergencey
    • Local are injuries
    • Systemic are illnesses
  89. what are the signs & symptoms of mild to moderate hypothermia
    Mild = shivering, rapid pulse and respirations, red pale cyanotic skin
  90. What are the signs & Symptoms of sever hypothermia
    • Shivering stops
    • musclar activity ceases
    • Eventually all muscle activity stops
  91. Desribe the management of a patient in hypothermia
    • Transport or move to warmer place
    • Don't allow patient to walk, eat or use stimulants
    • remove any wet clothing
    • place dry blanket uners and over patient
    • give warm humidified oxygen
    • * Do not message extermities
  92. Describe the management of a patient with frostbite
    • Remove any jewelry from injuried body part
    • cover injury loosely with a fry sterile dressing
    • transport
  93. What is heat exhaustion
    Loss of water and electrolytes from heavy sweating
  94. Signs & symptoms of Heat exhaustion
    • Dizziness, weakness, or fainting
    • nausea or headache
    • sweating heavily
    • cold, clammy skin with ashen pallor
    • dry tongue and thirst
    • normal vitals
    • rapid pulse with diastolic BP low
    • Normal or slightly elevated body temp
  95. What is heat stroke
    Body is subjected to more heat that it can handle and normal mechanisms are overwhelmed
  96. what are the signs & symptoms of Heat Stroke
    • Change in behavior
    • unresponsive
    • pulse becomes weak & BP goes down
  97. What is the management of Heat Stroke
    • Move patient
    • Max air conditioning
    • remove clothing
    • give oxygen
    • apply cool packs
    • cover with wet towels or sheet
    • aggresively fan
    • transport
    • notify hospital
  98. Describe the management of a pedicatric near drowning victum
    • Remove from water
    • C-spine
    • artificial ventilations
    • trun patient on left side for water to drain
    • abdominal trusts if needed
    • keep warm
    • transport
    • vitals
  99. What are the general management principles of a patient witha bite or sting
    • Provide BLS
    • ABC's
    • Transport
    • Vitals
    • Bring the spider or snake
  100. Identify various physiological and psychological causes of a behavioral emergency
    • Interruption in daily routine
    • Job loss
    • Divorce
    • Social
    • Genetic
    • Physical
    • chemical
    • biologic disturbances
  101. Identify special scene saftey precausions when on the scene of a behavioral emergency
    • Spend extra time
    • definite plan of action
    • identify youself calmly
    • be direct
    • assess the scene
    • stay with patient
    • encourage purposeful movements
    • express intrest in patient story
    • don't get to close
    • aviod fighting
    • be honest and reassuring
    • do not judge
  102. When can a patient be physically restrained
    • To protect yourself or others from bodily harm
    • to prevent the patient from harming themselves
    • * PD should always be present
  103. What must the EMT do when carring for a restrained patient
    Monitor for vomiting, airway obstruction, cardiovascular stability, and ABC's
  104. List possible risk factors for a suicidal patient
    • Unsafe objects
    • is the enviornment unsafe
    • is there evedence of self-distructive behavior
    • imment treat to patient or others
    • underlying medical problems
  105. When should the EMT assess a patients blood glucose
    • When they show signs or state the have diabetes
    • Heart disease
    • visual disturabnaces
    • renal failure
    • stroke
    • ulcers
    • infections of feet or toes
    • seizures
    • altered mental status
  106. What should be reassessed after the EMT administers a drug to the patient
    • Chief complaint
    • vitals
    • side effects
  107. What are common signs & symptoms that the left heart is pumping ineffectively
    • Congestive heart failure
    • easier to breath when sittingup
    • mild or severly agitated
    • distended neck veins
    • high blood pressure
    • rapid heart rate
    • rapid respirations
    • use of accessory muscles (Neck & ribs)
    • rail sounds - crackles
  108. what are the common signs & symptoms that the right heart is pumping inefeectively
    • Acute myocardiac infraction
    • sudden weakness
    • nausea
    • sweating without obvious cause
    • chest pain/discomfort/pressure that does not change with each breath
    • sudden arrhythmia with synocope/fainting
    • shortness of breath/dyspnea
    • pulmonary edema
    • sudden death
  109. The AED recognizes 2 shockable rythms
    • Ventricular tachycardia
    • ventricular fibrillation
  110. Name several advantages of the AED v. a manual monitor defibrillator
    • its faster
    • can be delivered within 2 minutes
    • its easier
    • can be given through remote, adhesive pads
    • pad area is larger than paddles
    • more efficiant
    • pictures when the pads are to placed
    • voice prompts
  111. What is CVA
    Cerebrovascular accident - loss of blood flow to the brain resulting in the loss of brain function
  112. What is Grand Mal Seizure
    Unconsiousness and generalized severe twitching of all body muscles lasting several minutes or longer
  113. What is status epilepticus
    Seizure that continues every few minutes without regaining consciousness or last longer that 30 minutes
  114. What are the phases of a seizure
    • Aura - a warning phase
    • Tonic - Bilateral movement by muscle rigidity and relaxation
    • Postictal state - unresponsive at first and gradually regains consiousness
  115. what are the components of the Cincinnati Stroke Scale, what is it used for
    • Facial Droop
    • Arm drift
    • Speech
    • to assess if a patient is haveing a stroke
  116. What is TIA
    • Transient Ischemic Attack
    • Mini stroke - stroke symptoms that go away on there own within 24 hours
  117. List various casues of seizures (AEIOUTIPS)
    • A - alcohol
    • E - electrolytes
    • I - insulin
    • O - opiates
    • U - uremia - kidney failure
    • T - trauma
    • I - infection
    • P - psychogenic causes
    • S - Seizure, syncope
  118. What are febrile seizures, descibe the management
    • Seizure resulting from a high fever particularly in children
    • Transport to hospital
    • Protect the patient
    • Assess vitals
  119. What are petit or "absence" seizures
    • Brief lapse of consiousness without the loss of composure which the patient stares without response
    • Also, lip smacking
    • eye blinking
    • isolated convulsion or jerking
  120. What happens to blood vesssel and blood pressure during anaphylxis
    vessels conrtact and BP goes down
  121. Describe the assessment and managemnt of a patient complaining of adominal pain
    • check the AVPU scale
    • Assess ABC's
    • treat any life threats
    • inspect and paplate the 4 quaderants
    • Transport
  122. Whay should patients with abdominal pain, especially females, be transported for evaluation
    It could be there normal menstrual cycle or an ectopic pregnancy
  123. Define Bronchoconstriction
    Narrowing of the airway that occurs in Asthma attacks
  124. Define Bronchodilation
    A widening of the lumen of the bronchi, allowing increased airflow to and from the lungs
  125. What does it mean when a patient with abdominal pain is "guarding"
    Arms and legs bend toward the abdomin to be comfortable and guard the area of pain