EMT-B

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Author:
kongaroo
ID:
39946
Filename:
EMT-B
Updated:
2010-11-11 17:26:42
Tags:
EMT EMS
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Description:
EMT-B Review
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  1. Focused History: OPQRST
    • O: Onset - when did the problem start?
    • P: Provoking factors - does this make it better/worse?
    • Q: Quality of pain - sharp, dull, deep, surface, throbbing, etc.
    • R: Radiation - is the pain spreading
    • S: Severity - pain on a scale of 1-10
    • T: Time - how long have you had this problem?
  2. SAMPLE History
    • S: Signs and Symptoms
    • A: Allergies
    • M: Medications
    • P: Pertinent Past Medical History
    • L: Last oral intake
    • E: Events leading to injury or illness
  3. Chief Complaint
    The major sign and/or symptom the patient reports
  4. Symptoms vs Signs
    • Symptoms: problems or feelings reported by patient
    • Signs: conditions that can be seen, heard, felt, smelled, or measured
  5. Vital Signs
    • BP
    • Pulse
    • Respirations
    • Pupils
    • Skin
  6. Blood Pressure
    • Systolic/Diastolic
    • "normal" = 120/80
    • Systolic: estimate 100 + age for male, 90 + age (until age 40)
    • too high: hypertension
    • too low: hypotension
  7. Respirations
    • Look for:
    • Rate: normal rate 12-20 breaths per minute for adult, 15-30 children, 25-50 infants
    • Quality: normal, labored, noisy
    • Rhythm: regular, irregular
    • Strength: shallow or deep
  8. Pulse
    • Look for:
    • Rate: 60-100 bpm
    • Strength: strong, weak
    • Rhythm: regular or irregular
    • too fast = tachycardia
    • too slow = bradycardia
    • Radial: wrist, bp > 80
    • Carotid: neck, bp > 60
    • Brachial: inner arm
    • Femoral: inner thigh, bp > 70
    • Dorsalis pedis: top of foot
  9. Pupils
    • PERRL
    • Pupils Equal Round, Reactive to Light
  10. Skin
    • Check CTC
    • Color: pale, blue, red, normal
    • Temperature: hot, cold, normal
    • Condition: dry, sweaty/clammy, normal
  11. AVPU alertness scale
    • A: Alert, responsive
    • V: Response to verbal stimulus
    • P: Response to painful stimulus
    • U: Unconscious, unresponsive
  12. Patient Assessment
    • 1. BSI
    • 2. Scene Safe
    • Approach patient
    • 1. Medical vs Trauma
    • 2. LOC
    • 3. ABC
    • 4. D - decision: go or stay
  13. BSI
    Body Substance Isolation - gloves, goggles, gown
  14. ABC's
    • 1. Airway
    • - open, clear, maintain
    • - if responsive, ask 'open your mouth, stick out your tongue'
    • - normal respirations: 12-20 breaths per minute (15-30 children, 25-50 infants)
    • - less than 10 per minute ==> BVM
    • - more than 29 per minute + 2 signs of hypoxia (blue, tachycardia, sweat, etc.) ==> BVM
    • - ventilate once per 5 seconds

    • 2. Breathing
    • - IPASS GAS: Inspect, Palpating, Auscultate, Seal, Stabilize, O2
    • - Inspect: look
    • - Palpating: feel, 5 points
    • - Auscultate: listen - stethoscope, both sides, front back
  15. A
  16. B
  17. C
    • Circulation
    • - check pulse
    • - check CTC
    • - check bleeding
  18. RMA
    Refusal of Medical Assistance
  19. PCR
    Pre-hospital or Patient Care Report
  20. AMS
    Altered Mental Status
  21. LOC
    • Level of Consciousness
    • AVPU, A+O x4
  22. Expressed Consent vs Implied Consent
    • Must get consent to treat
    • Implied if:
    • unconscious
    • minor w/o parents
    • AMS
    • mentally incompetent
  23. Assault vs Battery
    • Assault - includes verbal
    • Battery - physical harm
  24. DNR
    • Do Not Resuscitate
    • Document applicable for patients no breathing and have no pulse
    • Requires name of patient, signature, doctor's signature within 90 days (3 months)
    • Must have on person at site
    • If not, then Duty to Act
  25. MOLST
    • Medical Orders for Life Sustaining Treatment
    • document applicable for patients on life support
  26. A + O x 4
    • Alert and Oriented x4
    • 1. Who - what is your name?
    • 2. Where - do you know where you are?
    • 3. Day - what day of the week / today's date? year?
    • 4. Recall - what happened?

    • exceptions:
    • 1. vacation - lost sense of time
    • 2. children - don't know date or address, etc.
    • 3. elderly - ask things like SSN, DOB, who is the president of the USA
  27. Special Reporting Requirements
    • Child abuse
    • Child birth
    • Exposure to infectious disease
    • Crime scene
    • Death
  28. DOA
    Dead On Arrival
  29. Signs of Death
    • Dependent lividity: blood pooling, gravity dependent, < 1 hr death
    • Rigor mortis: jaw locked
    • Putrefaction - body decomposition
  30. Shock Position
    Feet raised 6-12 inches
  31. Vertebrae
    • 7-12-5-5-4
    • C-T-L-S-C
  32. Cardiac electrical firing rate
    • SA node: 60-100 bpm
    • AV node: 40-60 bpm
    • Purkinje fibers: 20-40 bpm
  33. Peripheral Nervous System
    • Check PMS
    • Pulse, Motor, Sensory
  34. Stop CPR if:
    • S: starts breathing/pulse
    • T: transferred care to equal or higher
    • O: out of strength (bad)
    • P: physician tells you to stop
  35. BVM
    Bag-Valve Mask
  36. MCI
    Multiple Casualty Incident
  37. COPD
    Chronic Obstructive Pulmonary Disease
  38. Scene Size-up
    • 1. BSI
    • 2. Scene Safety
    • 3. # of Patients
    • 4. Additional Resources?
    • 5. MOI/NOI
  39. DCAP-BTLS
    • Deformity
    • Contusion
    • Abrasion
    • Perforation/Puncture
    • Burns
    • Tenderness
    • Laceration
    • Swelling

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