EMT FISDAP FINAL 2023, Exams of Advanced Education

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EMT FISDAP FINAL 2023 what do you do for labored, contstriction, or lack of tidal volume - assist ventilations with BVM What do you do for acid in eyes - irrigate, if contacts take them out Signs and Symptoms of tension pneumothorax - progressive shortness of breath increased altered level of consciousness neck vein distention tracheal deviation What organ could be affected by trauma to the upper right quadrant - liver flail chest is charcterized and defined by - paradoxical motion 2 or more ribs broken in two or more places subcutaneous emphysema what is it and how to treat - A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues. treat by positive pressure ventilations Daughter is power of attourney and wants father to recieve care, father is AxO x4 and does not want care - Respect patient wishes because he is concious without altered mental status Open fracture and bleeding PPE - gloves, mask, goggles What EMS statistic is needed to reduce speed limit in given area - Fatalities and injuries that have happened on that stretch of road Triage color green - ambulatory, yellow - delayed red - immediate black - dead/ expectant you are treating a 300 pound male who cannot walk what should you do - call for assistance triage in the - cold zone Pedatric/ infant breath rate - 18-30 Cardiac arrest in children is caused most likely by - hypoxia, resp distress or failure Croup is characterized by - hoarseness, "barking" cough, inspiratory stridor and varying degrees of respiratory distress resulting from swelling in or obstruction in the region near the larynx. Steps to treating bleeding - first direct pressure then tourniquet is direct pressure does not stop the bleeding Signs and symptoms of meningitis - fever, rash, stiff neck, altered mental status specifcally in infants: Swelling of fontanelles Apgar scale - appearance, pulse, grimace, activity, respiration woman is bleeding after sexual assualt - use pad or sterile gauze and put under her to collect the blood breech birth - Baby is delivered feet or buttocks first when can you insert a gloved finger into the vaginal canal - if umbillical cord is around the babies neck perineum tearing - tearing from vagina to anus after delivery preciptitous delivery - perineum tearing and emergency delivery bleeding from shunt - don't let this question confuse you hold pressure at place of bleeding Pancreatitis symptoms - upper abdominal pain, swollen and tender abdomen, nausea, vomiting, fever, increased heart rate, weight loss, and diabetes. important to note if they are chronic drinkers petite mal seizure - blank out for 3-5 seconds, still conscious, eyes may flutter zone out Focal Motor Seizure - Starts in a group of muscles a "focus" May progress to include the whole entire arm May progress to a Grand Mal Seizure grand mal seizure - They may have an "aura" Tonic-Clonic phase Loss of consciousness clenched teeth, biting the cheek or tongue, incontinence post-itcal phase status epilepticus - A condition in which seizures recur every few minutes or last more than 5 minutes. example question: Patient is zoned out, could be poison, OD or low blood sugar or seizure, question gives you the age of the patient and no other signs or symptoms, because of the lack of signs of poison or pills or history of diabetes it is most likely - seizures Appendicitis signs and symptoms - rebound tenderness, young, pain near umbilical region, right lower quad eptopic pregnancy - implantation of the fertilized egg in any site other than the normal uterine location happens in first trimester abruptio placentae - premature separation of the placenta from the uterine wall, third trimester placenta previa - implantation of the placenta over the cervical opening or in the lower region of the uterus, third trimester spontaneous abortion - when the fetus and placenta deliver before the 20th week of pregnancy; commonly called a miscarriage subarachnoid hemorrhage - worst headache, assess bp will be low, cushing triaid, slow pulse, unbalanced respirations Left sided heart failure - shortness of breath right sided heart failure - 1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) steps when assessing unconc patient - check for responsiveness, check for pulse, check for chest rise and fall communicable disease PPE and decom - mask, gloves, goggles, disinfect with approved germicidal agent Oral Glucose Indications - hypoglycemia, able to swallow when to extricate before giving care - direct life threat/ scene saftey threat ex: fire in car OPIOD indications - pinpoint pupils, respiratory arrest, cyanosis, track marks Cholecystitis - inflammation of the gallbladder Cholecystitis S/S - severe midepigastric or right upper quadrant pain radiating to back and referred to right scapula usually after meals fat intolerance flatulence indigestion diaphoresis agonal respirations treatment - BVM Heart Failure S/S - Shortness of breath, fatigue, and weakness, weilling in the legs, feet abdomen. Reapid or irregular heartbeat with S3 or S4 heart sounds, persistent cough or wheezing, and weight gain from fluid etention. Treatment: balance of medication, devices, and lifestule changes to heald the heart contract normally. TIA - mimic stroke, symptoms go away in 24 hours CVA - ruptured artery in brain hemmorragic shock Ischemic stroke symptoms - facial droop, weak, slurred speech, time cardiogenic shock - post MI, irregular pulse, low BP, thready pulse rate fast, pale, cool, clammy BVM if respirations are - under 12 or over 20 (not exact) and do not have good lung sounds, under 8 ventilate wheezing - High pitched sound heard in the lungs with asthmatics or lung disease lower airway Rhonchi - Rattling noise of mucous in the lungs, upper airway crackles - (rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration lower airway stridor - upper airway, indicated foreign object if ventilations are not going in what should you do - resposition Nasal Canula flow rate - 1-6 BVM flow rate - 15-25 NRB flow rate - 10-15 LPM Nebulizer flow rate - 6-8 lpm if patient collaspes with airway obstruction - check for pulse, start w chest compressions what to ask when approaching chocking vicitm - Are you chocking? Tell them to cough, when no air is entering the lungs start back blows and chest thrust threat patient w humidified oxygen if - swollen throat, croupy cough, assessory muscle use, or stridor, not if anaphylatic when patient is having trouble breathing, to get their history ask - yes or no questions landing zone - 100 by 100 ft when to request additional assitance - too many for your team to handle, requested before even exiting ambulance Quaility improvement for EMS - critiquing what went well and what could be improved upon, internal and external review Rapid extraction - can be necessary even if CSPine is indicated BSi PPE for profuse bleeding - Gloves, eye protection, mask Notify law enforcement when hospice death - doesn't add up to natural causes USing TC - extracation when needing to remove piece of car from patient Minor on scene transporting parent - take them in ambulance with you or call law enforcement to transport them Using power grip hand go - 10 inches apart When driving proceed through intersections - like no one can hear the sirens when correcting an error on document - line through it and initial triage where - in cold zone community relations example - offer BP check to whole community WHn patient is unoconcious and unrepsonsive first always - check pulse and start CPR black and tarry stool - upper GI bleed bubbling/ bleding from chest apply - fully occulsive dressing femur fracture - lower than hip, deformities, less angulation that hip dislocations hip discolation - rotates whole leg knife is implaed - stablilize with bulky dressings pulmonary contustion - trauma to the chest aorta dissection - tearing pain to the back Annurism - when a vessel wall weakens and balloons aorta rupture - dead Nose bleed - lean forward and pinch nose Rule of (s - arm - 9, 1/2 arm 4.5, head 9, palm 1 neck puncture wound - occlusive dressing spleen - -Upper left of the abdomen, behind the stomach and below diaphragm. -Lymphoid tissue -Blood vessels are *connected* to the spleen by *splenic sinuses*. -*Function*: Filter unwanted materials from the blood (including old RBC) and to help fight infections. -Up to 10% of the population has one or more accessory spleens that tend to form at the hilum of the original spleen. eccomosis - bruising, often caused by internal bleeding solid organ rupture - results in internal bleeding, abdominal distention, eccomosis any kind of abdominal pain first thing you do - two Es: expose and examine region pulmonary embolism - A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.