Emergency Medical Procedures and Treatments, Exams of Nursing

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West Coast Emt Study Guide Final

Anatomy of lower airway - Trachea, bronchioles, main bronchi, and alveoli Ventilation - movement of air in and out of the lungs Oxygenation - The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs. tidal volume - Amount of air that moves in and out of the lungs during a normal breath Minute Volume - The volume of air breathed in one minute without conscious effort. Minute volume = Tidal Volume x (breaths/minute) Respiration - Inhalation and exhalation of air. Asthma - A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing. Left sided CHF - slow onset, often over several days- may not be noticed till acute Dyspnea, Shortness of Breath (SOB), productive cough Orthopnea difficulty breathing when lying straight (supine) Sitting up- often found propped p on pillows- may have spent the last evening in a chair Pulmonary edema- from excessive pulmonary capillary pressure and increased respiratory effort= greater inspiratory vacuum Anaphylaxis - a severe response to an allergen in which the symptoms develop quickly, and without help, the patient can die within a few minutes. croup - an acute respiratory syndrome in children and infants characterized by obstruction of the larynx, hoarseness, and a barking cough Pneumonia signs and symptoms -

• Shortness of breath with or without exertion
• Coughing
• Fever and severe chills
• Chest pain (often sharp and pleuritic)
• Headache
• Pale, sweaty skin
• Fatigue

• Confusion Tuberculosis signs and symptoms - Chronic fever, weight loss, cough, sputum production Upper vs Lower Lung sounds - Upper=Stridor Lower=Crackles albuterol(MDI) - Used to treat asthma Epinephrine(as it relates to breathing) - Relaxes muscles around airway to relax opening airway Nasal Canula-Low Flow - Stable Patient, goes through nose NRB-High Flow - Patient can breath unassisted BVM - Bag-Valve-Mask Resuscitator hand held device attached to a resuscitation mask that is used to ventilate a victim in respiratory arrest or when performing CPR. It requries two rescuers: one to maintain a tight seal fro the mask, one to squeeze the bag CPAP - continuous positive airway pressure, sleep apnea the heart - A hollow, muscular organ that pumps blood throughout the body. vessel system - Arteries=02 blood away from heart Capillaries=connect veins to arteries Veins=02 back to heart Parts of Blood - plasma, red blood cells, white blood cells, platelets Electrical system of the heart - SA node, internodal pathways, AV node, Bundle of His, Purkinje fibers Angina - a condition of episodes of severe chest pain due to inadequate blood flow to the myocardium Ami - acute myocardial infarction (heart attack) CHF (congestive heart failure) -

condition in which the heart cannot pump enough blood to the rest of the body cardiogenic shock - Shock caused by inadequate function of the heart, or pump failure. aortic aneurysm - A weakness in the wall of the aorta that makes it susceptible to rupture. Aspirin - prevents blood clots from becoming bigger, Nitroglycerin - nitrate drug used in the treatment of angina, dilates blood vessels and makes it easier for heart to pump blood Seizure treatment - do not restrain, stay calm and time the duration of seizure. protect the patient from contact with hard, sharp or hot objects, loosen ties or anything around the neck, temporary non breathing is norm. after seizure turn on back and make sure breathing isnt obstructed, if patient doesnt begin breathing after seizure, begin rescue breathing Generalized seizures symptoms - Stiff Muscles, loss of consciousness, jerking of body or legs, no breathing, cry or groan Complex Seizure Symptoms - stare blankly, pick at clothing or body, swallow smack lips status epilepticus - A condition in which seizures recur every few minutes or last more than 30 minutes. febrile - fever, mainly in children Cause of seizures - abnormal electrical activity in the brain that causes one or more of a number of symptoms Hypoglycemia blood glucose levels - less than 70mg/dL Normal glucose levels - 70-110 mg/dL Hyperglycemia glucose levels - 180- DKA - 250 Hyperglycemia symptoms -

• Polydipsia (excessive thirst)
• Polyuria (excessive urination)

• Polyphagia{Excessive Hunger) Acetone Breath Hypoglycemia symptoms - hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin Kussmaul respirations - very deep, labored breathing (usually associated with diabetic acidosis and renal failure) Anaphylaxis symptoms - abdominal pain, anxiety, chest discomfort, cough, diarrhea, difficulty breathing ,difficulty swallowing, dizziness, hives, nasal congestion, nausea, vomiting, palpations, skin redness, slurred speech, and wheezing. Epinephrine and what it does to the body - improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat. Narcotic overdose symptoms - shallow breathing, confusion, lessened alertness, and loss of consciousness. Narcotic overdose treatment - naloxone (Narcan) -narcotic antagonist -used for narcotic overdoses Activated Charcoal - a substance that absorbs many poisons and prevents them from being absorbed by the body Ischemic Stroke - a type of stroke that occurs when the flow of blood to the brain is blocked hemorrhagic stroke - occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed TIA - transient ischemic attack....mini stroke, no dead tissue. We transport - on affected side Cincinnati Stroke Scale - Facial droop, arm drift, abnormal speech Epidural bleed - between the subdural and the skull; the ones that don't immediately effect you - these are arterial and dangerous - lots of blood; ICU for 24; evacuation of blood Subdural Bleed - caused by a venous bleed between dura and arachnoid

slow onset with lower pressures Subarachnoid Bleed - blood in the subarachnoid space Intracerebral bleed - bleed within the brain tissue. trauma or ruptured aneurysm, vascular tumor, or ruptured vessel from hypertension. Could resolve or possible surgery. Cushing Triad - sign of increased ICP -Widening of pulse pressure, -Slowing HR -Slowing Respiration pneumothorax treatment - chest tube placement

1. chest pain; 2) dyspnea 3) apprehension, 4) cyanosis; 5) decreased breath sounds on affected side;
2. abnormal chest x-ray findings Open Pneumothorax Treatment - An open or penetrating chest wall wound through which air passes during inspiration and expiration, creating a sucking sound; also referred to as a sucking chest wound. 1. Three-sided dressing: Monitor for tensioning should this fail to provide an adequate venting mechanism. 2. Ventilatory support 3. Rapid transport Tension pneumothorax treatment - Prompt insertion of large-bore needle or chest tube for decompression A life-threatening collection of air within the pleural space; the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side. Commotio Cordis treatment - defib helpful sometimes A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat. Three collisions - car to car body to restraint organs to body Windshield - Head trauma Steering Wheel - Chest trauma Dashboard - lower extremity trauma Hematoma - a solid swelling of clotted blood within the tissues.

contusion - bruise, injury Abrasions - scrapes Avulsions - injury in which a portion of the skin and sometimes other soft tissue is partially or completely torn away Punctures and Penetrations - holes in the body Lacerations - a cut with either jagged or smooth edges, usually from a sharp object. Can also result when a blunt force splits the skin Parts of blood - plasma, red blood cells, white blood cells, platelets Capillary bleeding - bleeding from capillaries, which is characterized by a slow, oozing flow of blood Venous bleeding - bleeding from a vein, which is characterized by dark red or maroon blood and a steady, easy-to-control flow. Arterial Bleeding - Bleeding from an artery, which is characterized by bright red blood that is rapid, profuse, and difficult to control Tourniquets - devices used to stop bleeding in an emergency wound healing process - -Regeneration In epidermal wounds No scar -Primary intention Clean surgical incision/edges approximated Minimal scarring -Secondary intention Wound edges not approximated Tissue loss Heals from inner layer to surface -Tertiary intention Granulating tissue brought together Delayed closure of wound edges

Hyperthermia symptoms - profuse sweating. cool clammy and pale skin. a rapid, weak pulse. light headed. unable to concentrate. Hyperthermia treatments - cease the activity, remove from environment, rehydrate with water and use of fans heat exhaustion - a form of physical stress on the body caused by overheating heat stroke - a dangerous condition in which the body loses its ability to cool itself through perspiration Hypothermia - abnormally low body temperature When does shivering stop - below 90 degress Hypothermia CPR - body below 30 degrees gve three shocks then keep warm and give compressions Air Embolisms sign and symptoms - Chest pain, joint pain, anxiety, blurred vision Air embolism treatment -

1. clamp catheter immediately; 2) place pt on left lateral trendelenburg position; 3) notify physician immediately; 4) oxygen therapy; 5) arterial blood gases; 6) electrocardiogram drowning - The process of experiencing respiratory impairment from submersion or immersion in liquid. Drowning treatment - Airway, breathing, compressions neurogenic shock - a state of shock (hypoperfusion) caused by nerve paralysis that sometimes develops from spinal cord injuries Obstructive Shock - Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues. Cardiogenic Shock - Shock caused by inadequate function of the heart, or pump failure. hypovolemic shock - Shock caused by fluid or blood loss.

Hemorragic shock - shock resulting from blood loss non-hemorrhagic shock - dehydration, loss of fluids without loss of RBCs Anaphylactic Shock - A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death. psychogenic shock - Shock caused by overwhelming emotional factors. Sudden dilation of blood vessels results in fainting because of lack of blood supply to the brain. septic shock - Shock caused by severe infection, usually a bacterial infection. shock treatments - Keep warm, lay supine, elevate feet Compensated Shock - The early stage of shock, in which the body can still compensate for blood loss. Emergency Medical Responder - A member of the EMS system who has been trained to render first aid care for a patient and to help EMTs at the emergency scene Emergency Medical Technician(EMT) - An individual who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications. Advanced Emergency Medical Technician (AEMT) - Provides both basic and limited advanced emergency medical care and transportation to patients in the prehospital environment. The AEMT provides all of the skills of the EMT with the addition of the use of advanced airway devices, monitoring of blood glucose levels, initiation of intravenous and introsseous (in-the-bone) infusions, and administration of a select number medications paramedic - An individual who has extensive training in advanced life support, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills. Federal-NHTSA - leadership and coordination to the EMS community in assessing, planning, developing, and promoting comprehensive, evidence-based emergency medical services and 9-1-1 systems State-State EMS Office - Controls emts and what main criteria is Medical Director -

sets protcols for emts Implied consent - Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment. informed consent medical - getting permission expressed consent - A type of consent in which a patient gives verbal or nonverbal authorization for provision of care or transport. Who can refuse treatment? - Adults who are competent; adults who are informed; not mentally impaired Abandonment - Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training. Negligence - failure to take proper care in doing something Acute Stress - a temporary bout of stress that calls forth alertness or alarm to prompt the person to deal with an event Delayed Stress - Any stress that lies buried for a period and then resurfaces Cumulative Stress - The sum of the effects of exposure to stressors over time. PTSD - an anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience CISM critical incident stress management - A process that confronts the responses to critical incidents and defuses them, directing the emergency services personnel toward physical and emotional equilibrium. quid pro quo sexual harassment - a form of sexual harassment in which employment outcomes, such as hiring, promotion, or simply keeping one's job, depend on whether an individual submits to sexual harassment Jump kit - A portable kit containing items that are used in the initial care of the patient, also bring back board, and O Oxygen Tank - check tank daily. should have 2000 psi. any under 1500 psi should be exchanged, 15 m/l

KED -

kendrick extrication device-used for non-urgent move backboard - A device that is used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury. Also called a spine board, trauma board, and longboard. Sling - A bandage or material that helps to support the weight of an injured upper extremity. CPR rate & ratio and Depth for Adults - The ratio of chest compressions to breaths for CPR is 30 compressions to 2 breaths the rate is at 100-120 compressions per minute and the depth is at least 2 inches. CPR rate & ratio and Depth for Child - The ratio of chest compressions to breaths for CPR is 30 compressions to 2 breaths the rate is at 100-120 compressions per minute and the depth is 2 inches. CPR rate & ratio and Depth for Infant - The ratio of chest compressions to breaths for CPR is 30 compressions to 2 breaths the rate is at 100-120 compressions per minute and the depth is 1 1/3 inches AED use -

1. Turn ON
2. Bare/prepare chest
3. Attach Pads
4. Follow Prompts — AED analyzes heart rhythm.

• Stand clear.
• Verbally and visually clear area with hand sweep — If shock is necessary:
• Stand clear.
• Verbally and visually clear area with hand sweep.
• Follow audio/visual prompts and press SHOCK.
• Follow audio/visual prompts to perform CPR for two minutes. — If no shock is necessary: CPR for two minutes.
• Continue to follow audio/visual prompts until another trained individual can assist. NOTE: Do not remove AED defibrillation pads even if no shock advised. AED continues to monitor patient while attached. pulseless during transport - Common airway obstructions - Choking on food Dentures Aspiration of vomitus or secretions Clearing airway obstruction - Hemlech

Steps for birth - Delivery consists of 3 parts: delivery of the head, delivery of the shoulders, and delivery of the body and legs then do APGAR Pre-eclampsia/eclampsia - Hypertension during pregnancy. Eclampsia is seizures during pregnancy. abruptio placentae - premature separation of the placenta from the uterine wall placenta previa - implantation of the placenta over the cervical opening or in the lower region of the uterus breach birth - type of birth where the baby comes out feet first prolapsed umbilical cord - when the umbilical cord presents first and is squeezed between the vaginal wall and the baby's head GCS - Glasgow Coma Scale (or Score) rule of nines - A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burn area. rule of palm - a method for estimating the extent of a burn. The palm of the patient's own hand, which equals about 1 percent of the body's surface area, is compared with the patient's burn to estimate its size. Apgar scale - appearance, pulse, grimace, activity, respiration Vesicant(Actinomycin D, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitomycin C, Vinblastine, Vindesine, Vincristine, and Vinorelbine.) - substance that can broduce blistering on direct blistering on direct contact with skin or mucous membrane substance that can cause tissue necrosis and damage Single Issue Terrorism - terrorism that is motivated by a single grievance Doomsday Terrorism - Aleph? idk Religious Terrorism - terrorism carried out based on motivations and goals that have a predominantly religious character or influence.

political terrorism - directed at people or groups who oppose the terrorists political ideology or whom the terrorists define as outsiders who must be destroyed Skeletal Anatomy - 206 bones The supportive framework for the human body Most bones involved in producing movement. Learn names and locations of 19: Skull, Cervical Verterae, Clavicle, Scapula, Sternum, Thoracic Vertebrae, Ribs, Lumbar Vertebrae, Sacrum, Coccyx, Ischium, Humerus, Ulna, Radius, Femur, Patella, Fibula, Tibia Major bones of the body - Skull Scapula Clavicle Sternum Ribs Humerus Ulna Radius Os Coxae Femur Patella Tibia Fibula Vertebra - vertebrae How to take pulse - o Thumb side of inside of wrist, o Tips of index and middle fingers, o Take for 20 sec & x3, How to take blood pressure -

• Inflate cuff to exceed systolic pressure in artery usually to 200
• Release air in cuff until pressure in cuff matches systolic pressure
• When no sounds are heard anymore, diastolic pressure value has been reached How to take pupils - Shine eyes and look for abnormalities How to hear lung sounds - Use stethascope and listen on 8 points of back, listening when the exhale and inhale on each point How to get capillary refill - pinch fingernail and see how long it take for color to return What does pulse mean -

the force of the pumping expands the arterial wall and cause a pressure wave Systolic and diastolic blood pressure - Systolic = blood pressure when the left ventricle contracts -measures effectiveness of left ventricle pump Diastolic = blood pressure when the left ventricle is at rest between contractions -measures resistance in the arteries Who can access PCR - Only people with proper medical clearnece relating to pateint What if you make an error - seen has mis handled care What happens to pulse has you get older - same What happens to pulse has you get older -