Paramedic

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firemedic
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31293
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Paramedic
Updated:
2010-08-28 18:09:27
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Paramedic
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For Paramedic Exam
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  1. Parity (para)
    the number of liveborn children a woman has delivered
  2. nulliparity (nullipara)
    A woman who has never completed a pregnancy beyond 20 weeks or a women that is pregnant for the first time.
  3. Midazolam (Versed) Action, Use and Dose
    To induce sedation and amnesia prior to cardioversion and other painful procedures

    • Adult dose: 1.0 to 2.5 mg slow IV 0.07-0.08 mg/kg IM (5mg is the usual dose)
    • Ped dose: 0.05 to 0.20 mg/kg IV 0.10 to 0.15 mg/kg IM 3 mg intranasal

    • Short acting benzodiazepine with CNS depressant, muscle relaxant, anticonvulsant and anterograde amnestic effect.
    • Calms the pt, relaxes skeletal muscles and in high doses produces sleep. Has less muscle relaxant properties than diazepam
  4. Midazolam (Versed) contraindications and considerations
    Contraindicated in pts with acute narrow-angle glaucoma, shock, coma, and acute alcohol intoxication. Use w/caution in pts with COPD, chronic renal failure, CHF, and elderly

    • IV injection should be diluted to concentration of 0.25mg/mL in NS or D5W. Aviod rapid injection which may cause respiratory depression
    • Verify with a physician before IV administration to neonates and infants
    • Inspect IV site for signs of extravasation during injection.
    • If pt is premedicated w/a narcotic agonist analgesic(pain reliever), the conscious sedation period may be marked by hypotension
    • Effects are prolonged in obese pts because half life is prolonged, so monitor vitals for entire recovery period
  5. Midazolam (Versed) overdose symptoms
    • somnolence (drowsiness)
    • confusion
    • sedation
    • diminished reflexes
    • coma
    • untoward effects on vital signs (adverse)
    • difficulty breathing
    • coordination problems (ataxia)
    • dysarthria (motor speech disorder)
  6. Cystitis
    inflammation of inner lining of bladder usually caused by bacterial infection
  7. Dysmenorrhea
    severe uterine pain during menstruation
  8. Pelvic Inflammatory Disease (PID)
    spectrum of infections in the female upper reproductive tract that starts in the vagina and travels to the fallopian tubes, ovaries and uterus
  9. Treatment of PID
    • adequate hydration
    • pain relief
    • monitor vitals if BP drops pt is going into septic shock
  10. Parkland Burn Formula
    Used to guide fluid resuscitation in burn pts within the first 24 hours

    TBSA (Total body surface area that was burned) x kg (weight of pt) x 4mL equals total amount of fluids to be given within 24hrs. Half of the total should be given within the first 8 hours. Rest of the total given over the next 16 hrs
  11. Ductas Venosus
    • the vascular channel in the fetus passing through the liver and joining the umbilical vein with the inferior vena cava. Before birth it carries highly oxygenated blood from the placenta to the fetal circulation. It closes shortly after birth as pulmonary circulation is established and as the vessels in the umbilical cord collapse and become occluded. Usually structurally closes within 3 to 7 days after term birth.
    • After it closes becomes know as ligamentum venosum.
  12. Esophageal Varice
    Develops when blood flow to liver is blocked and the blood backs up into smaller vessels in esophagus causing them to swell. The vessels can rupture causing a life threatening condition.
  13. Esophageal Varice Causes
    • Causes:
    • Cirrohosis (liver failure)
    • Alcohol use
    • Severe CHF
    • Acid Reflux
  14. Esophageal Varice S & S
    • Vomiting blood
    • Black, tarry or bloody stools
    • Decreased urination from unusually low blood pressure
    • Excessive thirst
    • Lightheadedness
    • Shock, in severe cases
  15. Myosis (Miosis)
    Constriction of the pupils

    • caused by:
    • Opions, morphine, codeine, fentylal, herion, methadone
    • antipsychotic: haloperidol, thorazine, olanzapine, quetiapine
    • cholinergic (acetylcholine)
    • Organophosphates
    • Some MAO inhibitors
  16. Pelvic Inflammatory Disease (PID) S & S
    • Pelvic Pain and discomfort
    • abdominal tenderness
    • fever
    • don't like to move will shuffle
    • Purulent (foul smelling) vaginal fluid discharge
    • history of painful intercourse
    • midline, diffuse cramping pain that is visceral (poorly localized)
    • guarding of adominal
  17. Signs of Brain herniation
    • AMS (persistent unconsciousness)
    • decerebrate posturing (abnormal extension)
    • flaccid paralysis
    • 1 or both pupils dilated and unresponsive to light
    • Cushing’s Triad (rising BP, slowing pulse, and irregular respiratory pattern and increase in temp).
  18. Stroke
    • Disruption of blood supply to brain caused by hemorrhage or ischemic (clot)
    • 3rd leading cause of death and leading cause of disability of adults
    • hypertension and diabetes are most common risk factors and they lead to atherosclerosis (build up of plaque in blood vessels)
  19. S & S of Seizure
    • May have aura prior to event
    • sudden loss of LOC that persists for several minutes
    • tonic-clonic activity
    • incontinent of urine and feces
    • gradual return to consciousness
    • injury may occur
  20. Treament of Seizure
    • Maintain and protect airway
    • protect pt from injury
    • administration of benzodiazepine
  21. S & S of Syncope
    • Light headed or dizzy prior to event
    • sudden onset of LOC with immediate return once pt is prone or supine
    • skin is cool, moist and pale
    • may have muscle twitching but not resembling tonic-clonic
  22. Headache needing prompt medical attention:
    • Sudden severe headache
    • Sudden headache with a stiff neck, fever, seizures, confusion, loss of consciousness or following a blow to the head
  23. S & S of Meningitis
    • Sudden fever
    • Headache
    • Stiff neck
    • Vomiting
    • Increased sensitivity to light
    • Confusion
    • Irritability
    • Seizures
    • Loss of consciousness

    Viral meningitis usually resolves in 10 days

    Bacterial meningitis can be deadly if not treated promptly
  24. S & S of Neoplasms (brain tumors)
    • Headache
    • Personality changes
    • Seizures
    • Stroke
  25. Tremors
    Rhythmic oscillatory movements around a joint
  26. Chorea
    Abnormal movement characterized by irregular, unpredictable, involuntary muscle jerks that impair voluntary activity
  27. Dystonia:
    Sustained abnormal postures
  28. Athetosis:
    Slow writhing movements
  29. S & S of Multiple Sclerosis (MS)
    • Destruction of the myelin sheath in the CNS
    • Numbness
    • Paresthesias (tingling, numbness, prickling, or burning sensation of skin)
    • Double vision
    • Ataxia (lack of coordination of muscle movements)
    • Bladder control problems
  30. S & S of Muscular Dystrophy (MD)
    • Inherit disorder characterized by progressive muscle weakness and wasting
    • Muscle weakness
    • Stiff muscles
    • Skeletal deformities
    • Muscle contractures (muscle and tendons shorten, reduced flexibility)
    • Possible cardiac involvement
    • Intellectual retardation
  31. Hemiparesis
    Weakness on one side of the body
  32. S & S Bell’s Palsy:
    • Viral immune medicated disease that involves the segmental demyelination of the facial nerve (cranial nerve VII)
    • Diabetes are more likely to develop this disease
    • Unilateral facial numbness
    • Paralysis
    • Decreased tearing

    Facial droop from forehead to chin that doesn’t involve hemiparesis (weakness on one side of body)
  33. S & S of Lou Gehrig’s disease (Amyotrophic lateral sclerosis ALS)
    Degenerative disease caused by the selective destruction of motor neurons in the peripheral nervous system

    • Slowly progressive muscle weakness and wasting starting in the muscles of the limbs
    • Weakness becomes widespread and involves respiratory muscles, speech and swallowing muscles
  34. Stage 1 of Hemorrhage (Compensated Shock)
    • Up to 750mL of blood loss or up to 15%
    • Pluse rate is less then 100
    • Normal BP
    • Normal or increased Pulse Pressure
    • Normal RR
    • Urine output greater then 30 mL/hr
    • Slightly Anxious
    • Slightly pale, clammy skin
    • Release of catecholamines: Epi and norepinephrine
    • Compensated by constriction of vascular bed
  35. Stage 2 of Hemorrhage (Early Decompensated Shock)
    • 750 to 1500 mL or 15% to 25% blood loss
    • Pulse rate greater then 100
    • BP normal
    • RR increased (20-30)
    • Pulse Pressure decreased
    • Decreased pulse strength
    • 20 to 30mL/hr urine output
    • Mildly anxious and agitation
    • Cool, clammy skin
    • Thirst
    • Significant catecholamine release
    • cardiac output can't be maintained by arteriolar constriction
  36. Stage 3 of Hemorrhage (Late Decompensated Shock)
    • 1500 to 2000 or 25% to 35% blood loss
    • Weak, thready rapid pulse
    • Increased RR 30-40
    • Narrowing pulse pressure
    • BP decreased
    • Urine output 5 to 15 mL/hr
    • Anxiety and restlessness
    • Decreased LOC and AMS
    • Pale, cool, clammy skin
  37. Stage 4 of Hemorrhage (Irreversible Shock)
    • Greater then 2000mL or greater then 35% of blood loss
    • Increase HR
    • Decreased BP
    • Decreased Pulse pressure
    • RR greater then 40
    • Negligible Urine output
    • Confused, Lethargic, Unresponsive
    • Cool, Diaphoretic and very pale skin

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