AEMT NREMT Study Guide: Essential Concepts and Practice Questions, Exams of Chemistry

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marking scheme

Compression/ Ventilation ratio for one rescuer? Two? - Correct Answer 1 rescuer = 30:

2 rescuers = 30:

Pediatric 2 rescuer is 15:2 but otherwise stays the same

What is the proper compression rate in CPR? - Correct Answer 100-120 per minute

Compression rate for: Adults

Children?

Infants: - Correct Answer Adults: 2 inches

Children: 1/3 depth of chest or 2 in

Infants: 1.5 inches

What are 2 rhythms are considered "shockable" rhythms? - Correct Answer Ventricular Fibrilation

Pulseless Ventricular Tachycardia

Use the following terms to describe the flow of blood throughout the body:

Atrium, Ventricle, arteries, veins, aorta, pulmonary artery, pulmonary vein, capillaries, vena cava, arterioles. - Correct Answer 1. Deoxygenated blood travels through the superior and inferior vena cava to the right atrium

2. The blood is pumped by the right ventricle to the pulmonary artery to the lungs. This is where the blood is oxygenated before being sent back through pulmonary veins to the left atrium.
3. Blood flows into the left ventricle, which is responsible for pumping blood into the aorta and out through arteries to the body.

4. Arteries branch off into arterioles, then to capillaries, which is where nutrient exchange occurs with cells.
5. Last, blood flows back into the veins, into the superior and inferior vena cava before returning to the heart.

What are two important roles of red blood cells? - Correct Answer Transport oxygen to the cells

Transport carbon dioxide to the lungs

7 signs of cardiac comporomise - Correct Answer 1. abnormal blood pressure

2. pain, pressure, or discomfort in the chest or abdomen
3. shortness of breath
4. palpitations
5. anxiety or irritability
6. abnormal pulse
7. Sudden onset of nausea or vomiting

You auscultate your patient's lungs and find crackles with difficulty breathing. Which side of the heart is affected and why? - Correct Answer Shortness of breath with crackles in the lungs is indicative of left-sided heart failure. Failure of the left ventricle to pump blood effectively causes blood to be backed up to into the lungs (congested)

Right-sided heart failure causes blood to backup into body, causing pitting edema throughout the body. What's the cause and name of this condition? - Correct Answer Cor Pulmonale. The usual cause is pulmonary disease, such as pulmonary hypertension or pulmonary stenosis (obstruction in the P.A)

Preload - Correct Answer Preload, also known as the left ventricular end-diastolic pressure (LVEDP), is the amount of ventricular stretch at the end of diastole. Think of it as the heart loading up for the next big squeeze of the ventricles during systole. Some people remember this by using an analogy of a balloon - blow air into the balloon and it stretches; the more air you blow in, the greater the stretch

Afterload - Correct Answer Afterload, also known as the systemic vascular resistance (SVR), is the amount of resistance the heart must overcome to open the aortic valve and push the blood volume out into the systemic circulation. If you think about the balloon

In Normal Sinus Rhythm, P-R interval must fall between - Correct Answer .12-. seconds.

The P-wave is representative of what cardiac event? - Correct Answer Atrial Depolarization

The morphology of multifocal PVC's have: - Correct Answer a variety of configurations.

Multifocal PVC's have a variety of configurations due to the fact that the spot of origination moves. It's never in the same spot causing a variety of different looking waves and morphology

Every little box on a 12-lead EKG is representative of how many seconds of recording? - Correct Answer .04 seconds

PVC's that appear in every third beat are referred to as: - Correct Answer Trigenmeny.

Just as Bigeminy PVCs in every two beats, Trigeminy PVCs regularly appear in every third beat.

The morphology associated with unifocal PVC's have: - Correct Answer Unifocal PVC's have constant configuration because they originate from the same spot every time- wherever the pacemaker may be. No change in morphology.

Your patient is a 23-year-old college student. He states that he has had an intermittent fluttering sensation in his chest since this morning. He further states that he was up all night cramming for his final exams today. When asked if the patient had taken anything, he replies that throughout the night he had consumed about 4 large energy drinks, had some "No-Doz" anti-sleep medication and a few cups of coffee. The patient is most likely exhibiting PVC's, which are: - Correct Answer Single irritable beats

A premature ventricular contraction (PVC) is a single irritable beat.

Every big box on a 12-lead EKG is representative of how many seconds of recording? - Correct Answer .2 seconds.

A basic rule for ventricular arrhythmia's is that the QRS measurement will be: - Correct Answer .12 seconds or greater

Ventricular rhythms are wide in complex, thus signifying where it originates from, with a .12 seconds or greater measurement

On an EKG, Supraventricular Tachycardia can be identified by - Correct Answer an absent p-wave with a very high rate

ECG paper on a normal EKG will move at which rate of speed? - Correct Answer 25mm/sec

You respond to a nursing home to find a 90-year-old male complaining of chest pain and shortness of breath. The nurse tells you that the patient has an extensive cardiac history, but she cannot find his chart to explain the exact history. You take his vital signs and find that he is tachycardic with a blood pressure of 100/50 and a pulse oximetry of 97%. You place him on a cardiac monitor and find the following rhythm which you identify as - Correct Answer Atrial fibrilation.

A patients EKG shows a rhythm at a rate of 42 beats per minute, regular RR intervals, a PR interval of .16 seconds, and a QRS of .12 seconds. This best fits the criteria for: - Correct Answer Sinus bradycardia

All of the intervals fall within the normal range except for the rate of 42 beats per minute. Signifying Bradycardia.

You place the 4-lead cardiac monitor on a patient with general weakness during transport for monitoring purposes. When considering Einthoven's triangle, which lead placement is where the positive/negative poles intersect? - Correct Answer Left Arm

The positive end of lead I and the negative end of lead III intersect at the left arm. This point on the ECG is opposite lead II on the triangle and creates the wave for lead II seen on the monitor

Explain Einthoven's triangle. - Correct Answer

An inotropic effect refers to one that effects the heart's? - Correct Answer rhythm

ino refers to muscles

You are on scene at the local health club with a 42-year-old accountant who was working out after work. Bystanders report that the patient had been running on the treadmill for an hour when he "passed out" and hit his head as he fell off the treadmill. The patient has a weak, rapid pulse and has hot, dry skin. A manual blood pressure reads 70/P. What component of stroke volume is most likely the cause of the patient's condition? - Correct Answer Decreased preload.

Preload is the amount of returning blood that puts pressue against the walls of the ventricles just before they contract. Factors that affect preload are circulating blood volume, volume of blood returning to the heart, and strength of atrial contraction. The patient is dehydrated and hypotensive. This should clue you into a problem with preload

Which cranial nerve is responsible for pupil size, shape, and reactivity? - Correct Answer Oculomotor (III)

Prinzmetal angina ( variant angina ) - Correct Answer Type of unstable angina in which a coronary artery spasm is the cause for diminished blood flow. Like unstable angina, onset cannot be predicted

Most classic features of MI - Correct Answer Dull chest pain radiating typically to the left shoulder, neck, jaw, or back

Difference between myocardial infarction and myocardial ischemia - Correct Answer Infarction is death of the tissue, at the end of ischemia. Result of absence of blood supply to the heart

Ischemia is decrease in blood supply to the heart leading to chest pain or angina

Signs of Right-Sided Heart Failure - Correct Answer Results in congestion of blood in vena cava

Jugular venous distention

Peripheral edema

Enlarged liver

Probably hypotension

Signs of Left-Sided Heart Failure - Correct Answer Congestion of blood in lungs

Respiratory distress

Pulmonary edema

Lung sounds crackles or cardiac asthma

Le Fort II fracture - Correct Answer Term used to describe fractures to the face including the maxillary and nasal bones. Usually by blunt force

Dose for epinephrine - Correct Answer .3-.5mg for adults

.01mg/kg for pediatric

Classic symptom of subarachnoid hemorrhage - Correct Answer Thunderclap headache

Your patient responds to your commands, is oriented and converses, and localizes pain. What is his GCS and give each score - Correct Answer Total GCS is 13. 3 for verbal command, 5 for oriented and converses, 5 for oriented and converses.

subdural hematoma - Correct Answer Collection of blood over the surface of the brain between the dura mater and arachnoid meninges

What stage of contraction is blood delivered to the arteries? - Correct Answer Diastole.

The rest of the body is perfused during systole

pulsus paradoxus - Correct Answer abnormal decrease in systolic pressure during inspiration. Due to decreased cardiac output. Usually more than 10mmhg

Parkland burn formula - Correct Answer BSA x 4ml x kg body weight. 50% in first 8 hours, 50% the next 16

Lactated ringer's for fluid replacement

BSA is body surface area %

Cushing's Triad - Correct Answer Shows signs of increased intracranial pressure

Hypertension, bradycardia, and irregular respiratory rate (usually decreasing)

slow the heart rate and correct the problem, before resorting to the more invasive Adenosine.

Bundle of His has an intrinsic firing rate of approximately how many bpm - Correct Answer 20-

What is the intrinsic rate for impulses originating in the atria? - Correct Answer 60bpm

symptoms is most consistent with a patient presenting with new onset atrial fibrillation - Correct Answer Atrial fibrillation is a heart rhythm that does not adequately perfuse the body with blood due to abnormal electrical impulses in the atria, leading to a usually rapid and irregular heart rhythm. During A-fib, the atria fire at approximately 400-600 beats per minute. Hypotension is common due to the inefficiency in contractions of the heart. Altered LOC is commonly seen with A-fib due to lack of adequate blood flow, specifically to the brain

In short, Tachycardia, Hypotension, and altered LOC

Bell's Palsy - Correct Answer condition that affects the 7th cranial nerve and causes facial paralysis. This condition can mimic the signs/symptoms of a stroke or CVA.

What do the 4 sections of an NFPA placard represent? - Correct Answer Blue- Health Hazard

Red- Fire Hazard

Yellow- Reactivity

White- Specific agents ex: Corrosive, acid, or oxidizer

0= normal - 4 = very volatile

Tool on ambulances to help identify hazardous substances? - Correct Answer ERG- Emergency resource guidebook

NIMS - Correct Answer National Incident Management System

Command, finance, logistics, planning, operations

Asthma - Correct Answer Chronic inflammatory disorder of the airways. Increased sensitivity of the lower airways to irritants and allergens. This causes bronchospasm and inflammation to the lining of the bronchioles

Acute bronchitis - Correct Answer Bronchial tubes become inflamed, sputum production can increase creating a productive cough.

chronic bronchitis - Correct Answer Related to COPD. Inflammation, swelling, and thickening of the lining of the bronchi and bronchioles. Thick mucus restricts airflow to alveoli so they don't expand fully causing respiratory distress.

bronchiolitis - Correct Answer Diagnosis given to young PT's who have acute onset of lower and upper airway inflammation. Disturbs V/Q ratio and causes labored breathing

pneumothorax - Correct Answer air in the pleural cavity caused by a puncture of the lung or chest wall. Causes resp. distress. Open pneumo comes from outside, closed comes from air escaping a hole in the lung into the pleural space

tension pneumothorax - Correct Answer condition in which air entrapped in the pleural space puts pressure on the lung and heart.

cystic fibrosis - Correct Answer Commonly causes pulmonary dysfunction due to changes of mucus secreting glands. Mucus lining all over respiratory tree is normally watery and warm. Abnormal gene causes an overabundance of mucus that's very thick and sticky. As this thick layer develops, blockage of airways occurs with increase of infections that can readily grow in thick mucus. Repeated infections cause scarring of lung tissue. Resp. function diminishes as ability to clear thick mucus is decreased which leads to pulmonary failure and death.

tension pneumothorax - Correct Answer

spontaneous pneumothorax - Correct Answer

Diaphragm and intercostal muscles do what during inspiration? - Correct Answer Contract. Chest wall expands and diaphragm drops.

Hypocarbia symptoms - Correct Answer Hyperventilation

Numbness in fingers and toes