Download NREMT AEMT PREP Questions with Answers 2024 and more Exams Nursing in PDF only on Docsity! NREMT AEMT PREP Questions with Answers 2024 M.O.I. โ Mechanism of Injury, vehicles, falls etc. what do you generally set oxygen to? โ 15L/M How to open airway for a trauma victim? โ chin lift/jaw thrust apneic โ not breathing N.O.I โ nature of illness AVPU โ Alert, verbal/vocal, pain, unconscious skin CTC โ color,temperature, condition (normal is warm,pink and dry) hypoperfusion โ Shock.... decreased delivery of oxygen and nutrients to cells) OPQRST โ for conditions occuring right now (medical) Onset, Provocation, quality,radiation, severity, time Onset โ What were you doing when this happened? did it happen suddenly or gradually? could ...... have caused this? Provocation โ What makes your pain feel better or worse? does it hurt when you do .........? quality โ How would you describe your pain? what does your pain feel like? radiation โ Where does it hurt the most? is it staying in one spot? where was it when the pain started severity โ on scale of 1 to 10 how bad is your pain? time โ how long has it been since the pain started? signs versus symptoms โ signs: something you see symptoms: something they tell you nitroglycerin โ vasodilation of coronary arteries What is first priority after personal safety? โ patient care brady (root) โ below normal, slow tachy (root) โ above normal, rapid tachypnea โ rapid breathing plegia โ paralysis of the limbs quadraplegia (four limbs) quad=4 bilateral โ both sides dorsal/ventral โ dorsal: back of body ventral: front of body palmar/plantar โ palmar: palm of the hand plantar: sole of the foot where to place stethescope for lung sounds? โ mid-clavicular lines fowler position โ sitting up integumentary system systemic vascular resistance (SVR) โ pressure that the heart must overcome to pump blood into a specific system stroke volume โ amount of blood ejected from the heart with one contraction V/Q match โ ventilation perfusion match, optimum exchange of oxygen and carbon dioxide edema โ swelling, when water moves into the interstitial space meningines โ protective layers of the brain and spinal chord graves disease โ overproduction of thyroid hormone fontanelle โ soft spot where bones meet anterior fontanelle โ you can look at it and get a good idea of how hydrated a baby is if sunken they are dehydrated, if it is bulging they are overhydrated larynx โ voice box cricoid ring โ extend 360 degrees around the trachea and is also the top ring stridor โ high pitched sound generated from obstruction in upper airway When not to use oropharyngeal airway โ When they have a gag reflex or they re gain a gag reflex what not to use nasopharyngeal airway โ if there is clear cerebrospinal fluid coming out from the nose or ears (indication of a skull fracture) suctioning rules โ no longer than 10 seconds, place the tip where you want to start and suction on the way out, done best when the patient is on their side how can altered mental status affect the airway of a patient โ muscle tone decreases, so the muscles that keep the airway open can relax pulmonary respiration โ exchange of oxygen and carbon dioxide between the alveoli and circulation blood in cappilaries cellular respiration โ the exchange of oxygen and carbon dioxide between cells and circulating blood (oxygen goes into cells, co2 goes out) study page 199-200 โ cyanotic โ blue skin color note โ non rebreather mask requires adequate breathing to pull oxygen into the lungs, it does not provide ventilation to a patient who is not breathing or breathing inadequately diaphoretic โ very sweatye artificial ventiliation โ forcing air or oxygen into the lungs when a patient has stopped breathing bvm with conscious patient โ use for patients in severe respiratory distress, ventilate as the patient inhales when to administer oxygen โ when saturation is below 94%, pale skin, altered mental status, cyanosis, difficulty breathing) When to use nasal cannula โ only if patient will not tolerate non-rebreather mask.. (nasal cannula has low concentration of oxygen) Tracheostomy mask โ mask that is designed to be placed over a stoma signs of respiratory distress โ accessory muscle use, rapid breathing,tripod signs of respiratory failure โ altered mental status, cyanosis, dropping pulse oximetry What approach to take if patient is lifeless? โ CAB circulation, airway, breathing Signs of shock โ unusually anxious, pale, and sweaty levine's sign โ hand clenched over chest, indicates chest pain priority types โ stable, potentially unstable, unstable stable โ patients vital signs must be in the normal range or just slightly abnormal, any threat to abc's rules out the stable category potentially unstable โ when you believe a patients condition may deteriorate unstable โ any life threatening condition cannot be controlled or threatens to reoccur, or a depressed level of responsiveness rapid, regular and full pulse โ fright, fever, high blood pressure, first stages of blood loss rapid, regular, and thready pulse โ shock and later stages of blood loss jaundiced (yellow skin) โ abnormalities of the liver best places to assess skin color on adults โ inside of cheek, nail beds, inside of lower eyelid effect of light on pupils โ more light= constriction less light= dilation what to say at end of every assessment โ treat for shock and transport what could cause a pulse oximetry of 100% โ carbon monoxide or anxiety attack normal blood glucose levels โ swollen, or enlarged Battle's sign โ bruising behind the ear flat neck veins โ think blood loss paradoxical motion โ when broken ribs move in the opposite direction of rib cage ( during inspiration broken ribs move in, while the rest of the ribcage moves out) when to give a detailed physical exam โ if there is a significant mechanism of injury, or if the patient is unconscious what to do if you have an unconcious patient for unknown reasons? โ check blood glucose hypovelimic โ low volume of blood symptoms of hyperglycemic โ has acetone breath and will be thirsty postical phase โ after a patient has a seizure they will be a little cloudy unresponsive medical patient โ you need to do a rapid physical exam paradoxical motion of the chest โ part of the chest goes in when the patient inhales and part of the chest goes out when exhaling visceral pain โ originates from an organ and is hard to localize parietal pain โ localized, intense pain, from lining of a cavity Appendicitis โ nausea and pain in right lower quadrant symptom of a GI bleed โ usually smells very bad rhonchi โ lower pitched sounds the resemble snoring or rattling, occurs in upper airway, CONTINUOUS what to do before helping with inhaler โ make sure patient exhales deeply first, have them hold it in for as long as possible ACS (acute cornoary syndrome) โ feeling of impending doom, blanket term where you dont get any air to heart muscle embolism โ a thrombus that breaks loose to become an embolism and occlude blood flow somewhere down stream angina pectoris โ pain in the chest infarct โ small area of dead tissue from lack of blood supply congestive heart failure โ failure of heart to pump efficiently, leading to excessive blood or fluids in the lungs, body, or both reticular activating system โ series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping skin ctc hyper vs hypo glycemic โ hyper: warm, red, dry skin hypo: cold, pale, moist, or clammy skin tonic-clonic seizures โ most common seizure that EMS is called for, patient loses conciousness and has jerking movements tonic phase โ body becomes rigid, bladder and bowel control may be lost Clonic Phase โ body jerks violently status epilepticus โ a prolonged seizure or situation where a person suffers from 2 or more seizures without fully recovering syncope โ fainting, quick loss of conciousness with a rapid recovery eptopic pregnancy โ baby growing in fallopian tubes, happens at the beginning of the pregnancy braxton hicks contractions โ irregular, fake contractions what to do for a breech delivery โ reach hand in and try to create air space around babies mouth APGAR score โ appearance, pulse, grimace (reaction to suctioning or flicking of the feet), activity, respiratory effort (scored out of 2) opiate triad โ coma, pinpoint pupils, and respiratory depression peritonitis โ lining of the abdomen, very sensitive to foreign substances, happens a lot with appendicitis cholecystitis or gallstones โ patient will experience severe pain in the upper right quadrant, which may radiate to the shoulder, may be caused by ingestion of high fat foods what could be a cause pancreatitis โ common in patients with chronic alcohol problems hernia โ hole in the abdominal muscle wall adbominal palpation โ always palpate the area of the most pain last. ability of cardiac muscle to contract spontaneously without a stimulus โ automacticity where does the myocardium receive blood from? โ aorta and coronary ateries what can relieve angina pectoris? โ rest Cushings triad โ above aspirin adult dose โ 324mg (2 baby aspirin) nitroglycerin adult dose โ .4 milligrams epinephrine dose โ .3 to .5 for adults, .15 for children CPAP (or bipap) โ used on patients with sleep apnea, gives mild air pressure to keep airway open epistaxis โ nose bleed evisceration โ removal of an organ (protrudes through an open wound) significant falls โ 20 ft. for adults and 10 feet for children Effect on blood vessels during anaphylaxis โ blood vessels dilate endotracheal tube โ opens up the airway, isolates trachea from esophagus sellick's maneuver โ reduce risk of vomiting by intubation by collapsing the esophagus 5 rights โ right, patient, time, medication, dose, route most common cause of anaphylaxis? โ penicillin emphysema โ group of lung diseases that block air flow and make it difficult to breath. CISD team โ counseling after a severe injury power grip โ both hands facing foward blue slip โ doctor says that he is a threat and that the cops can arrest him white slip โ person is crazy another name for the mitral valve โ bicuspid valve how many vertebrae for each section? โ C: 7 T:12 L:5 FiO2 โ the percentage of air that we breath that is actually oxygen what could be causing drooling or spitting? โ problems with the esophagus or upper airway suctioning times โ infant: 5 child: 10 adult: 15 active rewarming โ application of external heat source DO NOT USE FOR SEVERE HYPOTHERMIA passive rewarming โ coveing a hypothermic patient and taking other steps to prevent heat loss early stages vs late stages of hypothermia โ in early stages, you will be shivering where as in late stages, your muscles will be rigid. rapid breathing and pulse in early stages and slow to absent breathing in late stages Central rewarming โ application of heat to the lateral chest, neck, armpits, and groin of the patient difference in vitals between hot skin hyperthermic and cool skin hyperthermic โ hot skin hyperthermic has rapid full pulse, cool skin hyperthermic has weak pulse skin during heat stoke โ HOT; doesnt matter if it is moist or dry pericardial tamponade โ compression of the heart caused by fluid collecting in the sac around the heart etiology โ the cause or causes of conditions BETa-2 drugs โ used for COPD (albuterol) rule of nines โ used to assess the extent of burns 2 arms front= 9% head= 9% chest and abdomen= 9% each 2 arms back= 9% lower back and buttocks= 9% upper back= 9% newborn pulse rate โ 120-160 blood pressures of younger ages โ are normally lower than older ages parenteral โ refers to a route of medication that does not involve the GI tract, such as an IV enteral โ referring to a route of medication that uses the GI tract how long do you hold an epi pen for? โ 10 seconds How long does it take for epinenphrine to kick in? โ 1 minute what route to most poisenings occur through? โ ingestion acetominophen overdose side effects โ central nervous system depression function of beta-2 specific drugs โ relaxation of the smooth muslce fibrinolytics โ the use of drugs to dissolve a clot doses for activated charcoal โ 25-50 grams for adults and 12.5 to 25 grams for kids PID โ pelvic inflammatory disease warm zone โ uncontaminated environment, which contaminated victims, first responders and equipment are brought ovum โ egg cell venturi mask โ Venturi mask a face mask and reservoir bag that delivers specific concentrations of oxygen by mixing oxygen with inhaled air what percentage of oxygen does nasal cannula deliver? โ 22-44 percentage of oxygen delivered with bvm without supplemental oxygen โ 50 mid axillary line is basically the same as the... โ frontal plane how many vertebrae for sacral and coxyx? โ 5 and 4 how many ribs in the thorax? โ 12, 10 are connected to the sternum parts of the sternum โ manubrium (superior), middle body, and xyphoid process tension pneumothorax โ when air enters but does not leave the space around the lungs (pleural space) upper right quadrant โ liver, right kidney, colon, pancreas, gallbladder upper left quadrant โ liver, spleen, left kidney, stomach, colon and pancreas right lower quadrant โ colon, small intestine, ureter, and appendix left lower quadrant โ colon, small intestines, and ureter function of parathyroid hormone โ metabolism of calcium and phosphorus av node vs sa node? โ islet of langerhans โ affected by diabetes pms โ pulse motor sensation chyene stokes โ periodic respiration how many times should you contact dispatch on each call? โ how many rescuers for a patient over 250 pounds? โ at least 4 when pulling a patient you how for should extend your arms out? โ no more than 15 to 20 inches What are ambulances allowed to do with lights on in most states? โ exceed the speed limit area where ambulances meet during MCI? โ staging area where should you park the ambulance in a hazmat situation? โ upwind at least 100 feet away nerve agent โ phosphorus containing organic chemicals cold zone โ where incident command post and support functions are located, where ems equipment and personnel are located emergency response guidebook โ provides the names of chemicals and thorough description cold zone vs warm zone โ cold zone is where personnel are located, warm zone is where decontamination takes place poison vs toxin โ -a poison is any substance that can harm the body - a poisonous substance secreted by bacteria, plants, or animals most common cause of hospitalization of overdose patients โ acetominophen When do symptoms occur in acetaminophen poisoning? โ 4 to 12 hours they may be throwing up, after 2 days they will be jaundiced absorbed poisons โ poisons that go through the skin referred pain โ pain felt in a place other than where the pain originates Renal colic โ stones descend into the ureter "writhing" cannot find a position of comfort priaprism โ painful prolonged eretions dialysis โ the process by which toxins are removed from the body independent of the kidneys neurogenic shock โ can occur after injuries to the cns, resulting in low blood pressure what happens to the pulse during shock? โ it will gradually increase, and then it gets thready what happens to respirations as shock progresses? โ they become shallower last vital sign that will change during shock? โ blood pressure hemostatic agents โ substances applied such as powders, dressings, gauze or bandages compensated vs decompensated shock โ venom lack titrate therapy โ giving the patient what they need most protected portion of the brain? โ brain stem subdural vs epidural hematoma โ sub dural is more serious (damages a larger area) distraction injury โ when the vertebrae of the spine are literally pulled apart hoarseness โ voice is changing over time... could be a sign of the airway closing off. sign that immediate suction is necessary โ gurgling is respiratory distress adequate breathing? โ yes conjunctiva โ mucous membrane that covers the front of the eye and lines the inside of the eyelids peforate โ pierce of make a hole emphysema can also mean โ copd guarding โ spasm of muscles affected by injury hematochezia โ bright red blood in the stool (symptom of GI bleed) open fracture โ overlying skin is no longer intact below what temperature is considered hypo thermia? โ 95 degrees what could rough handling of a hypothermic patient cause? โ vfib dysplasia โ enlargement of tisse How many LPM and mmhg to be an effective suction unit? โ 30,300 what do you do with dentures during ventilation? โ leave them in place what to do with an evisceration? โ leave the organ in place, and cover it with a bulky dressing what layers of skin does a partial thickness burn involve? โ dermis and epidermis where should the safe zone be? โ upwind and at at the same level at least 100 feet away pressure of the walls of an artery as the left ventricle contracts โ systolic diastolic blood pressure โ the pressure remaining in the arteries, when the left ventricle relaxes and refills minimum psi in an oxygen tank? โ 200psi how to assess skin color of dark skinned patient โ assess the lips and nail beds how long should you assess the pulse of a severely freezing patient? โ 45 seconds how do pupils react to fights, drug use, and eye drops? โ dilate can you perform blind finger sweeps on an infant or child? โ no nuchal chord โ when the umbilical chord is wrapped around the neck how to place the baby after delivery โ with the head slightly lower than the rest of the body how to stop bleeding of mother in a delivered baby? โ massage mother's abdomen and allow the baby to nurse how much blood loss in considered significant? โ 500ml what temperature should you keep the ambulance when delivering a newborn? โ 90-95 degrees embryo vs fetus โ 0-8 weeks and 8 weeks to birth amniotic sac โ bag of waters that surrounds the developing fetus contraction times what delivery is imminent โ they last 30 seconds and they are 2 to 3 minutes apart cephalic presentation โ when the baby comes head first, (this is normal) average time of labor for first birth? โ 16-17 hours what to do if crowning occurs in the ambulance? โ stop the ambulance and prepare for delivery when is it best to transport a delivering mother? โ always, unless you expect delivery within a few minutes what to do if amniotic sac has not ruptures upon delivery? โ poke a hole in it what do do if chord is wrapped around the babies neck? โ clamp the chord in two spots and clip it in the middle (only if you cannot pull it over the babies head before hand) what must the infant be doing before you cut the chord? โ the infant must be breathing on his own. where to place clamps? โ 7 and 10 inches away from the baby what to do with placenta if it is delivered with the baby? โ place it at the same level as the baby or slightly higher โ long and deep respirations, usually with DKA cricoid pressure acronym โ "BURP" what kind of shock happens during a cardiac tamponade and a tension pneumo? โ obstructive shock rales โ CRACKLING Beck's triad (cardiac tamponade indicator) โ narrowing pulse pressure, muffled heart sounds, jugular distention amiodarone, lydocaine function โ treat heart dysrhythmias when performing CPR, when can you give breaths every 6 seconds? โ when there is an advanced airway placed how to prepare aerosol albuterol โ 2.5ml of albuterol to 3ml of saline what nerve controls vitals? โ vagus nerve what portion of airway is trachea? (upper or lower) โ lower when would albuterol not be helpful with respiratory emergencies? โ when you have a problem with the upper airway (it is a bronchiole dilator) orthopnea โ shortness of breath when lying flat what kind of pain is associated with AMI โ Crushing pain depolarization vs repolarization โ de= heart contraction re= heart resets can you give aspirin and nitro for strokes? โ NO! (to both) Coma of unknown etiology โ think glucose combitube contraindication โ under 5 feet tall, over 7 feet tall, under 16 years old, esophageal diseases what authority has jurisdiction over radio transmissions made during a call? โ FCC how should messages be transmitted over the radio? โ in plain english 1st stage of labor โ when the cervix dilates (ends when it is fully dilated where is another place that a brachial pulse can be found โ the cubital fossa how many sides do you tape an occlusive dressing? โ 3 not 4, b/c you want air to escape but not to enter maximum amount of traction to apply to a traction splint? โ no more than 10% of patient body weight (or 15 pounds) halo sign โ cererbrospinal fluid coming from ears weighted dose of activated charcoal โ 1G/Kg AAA symptoms โ radiating back pain ACTH โ pituitary gland vastus lateralis โ lateral muscle on the thigh electrolyte that regulates extracellular fluid, and is responsible for control of stomach ph โ chloride lactated ringer's โ hypovolemic shock, do not use in congestive heart failure or renal failure pursed lips breathing โ think emphysema dura mater vs pia mater โ dura coats the skull, pia coats the brain diverticulitis โ inflamed small pockets, chills and fever Islet of langerhans โ secrete insulin and glucagon narcan dose โ .4-2 mg lacrimation โ crying SLUDGE โ used for organophosphates, salivation, lacrimation, urination, defication, gastrointestinal distress, and emisis symptoms previa vs abruptio โ previa= bright red bleeding abruptio= dark bleeding sig. fall โ greater than 3x patients height melena โ black stool that contains blood which eye should you cover for impaled objects to the eye? โ BOTH! lacrimal glands โ tear glands le fort fractures โ the higher the #, the higher the fracture on the skull traumatic asphyxia (Perte's syndrome) โ intense compression of the thoracic cavity, causing venous back flow to the right side of the heart peri prefix โ about or around something