NREMT EXAM REAL EXAM 2024/2025 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VER, Exams of Nursing

Download NREMT EXAM REAL EXAM 2024/2025 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VER and more Exams Nursing in PDF only on Docsity! 1 NREMT EXAM REAL EXAM 2024/2025 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ cardiogenic shock - CORRECT ANSWER>>-the type of shock caused by inadequate function of the heart. This develops when the heart cannot maintain sufficient output to meet the demands of the body -caused by any disease or event which prevents heart pumping -can occur directly after AMI up to 24 hours Obstructive shock - CORRECT ANSWER>>The type of shock that results when conditions that cause mechanical obstruction of the cardiac muscle also impact pump function ex. cardiac tamponade, tension pneumothorax Beck's triad - CORRECT ANSWER>>Signs of a cardiac tamponade. JVD, narrowing BP pressures, muffled heart sounds Distributive shock - CORRECT ANSWER>>The type of shock when there is widespread dilation of the small arterioles, venules, or both. Blood pools in the expanded vascular beds and tissue perfusion decreases Types of distributive shock - CORRECT ANSWER>>Septic shock caused by severe infections; neurogenic shock caused by damage to the spinal cord (bradycardia, low BP, warm skin); anaphylactic shock caused by allergic reaction; psychogenic shock Hypovolemic shock - CORRECT ANSWER>>The type of shock that results from an inadequate amount of fluid or volume in the system -15% of blood volume How do you treat for shock? - CORRECT ANSWER>>Keep the patient warm, control bleeding, put the patient in a position of comfort, and administer high-flow oxygen brain damage without oxygen - CORRECT ANSWER>>-without enough oxygen, cardiac arrest or brain damage occurs within about 4 minutes -permanent brain damage within 6 minutes -death likely within 10 minutes FBAO - CORRECT ANSWER>>-signs of blockage include inability to cough or speak or inability to ventilate patient 2 -bending patient forward at the waist, support chest with one hand, use heel of hand to give 5 back blows between shoulder blades -then 5 abdominal thrusts -alternate between the two until object is dislodged -if patient loses consciousness, give CPR starting with chest compressions -given even if patient has a pulse, so don't check -before giving breaths, look inside mouth for any visible objects FBAO in children - CORRECT ANSWER>>-using thigh for support, lay facing down along forearm; ensure head is lower than the body -give 5 firm back blows between blades -5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples. push down 1.5 inches. -alternate, unless lose consciousness, then CPR mouse to mouth/mouth to nose - CORRECT ANSWER>>-mouth to mouth performed when patient does not have adequate breathing and artificial ventilation not available -open airway -place barrier device -pinch nose and form seal around patient's mouth -check for FBAO if you do not see chest rise and fall -give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds Steps of CPR - CORRECT ANSWER>>Determine unresponsiveness. Check for breathing for up to 10 seconds. Check carotid pulse for up to 10 seconds. Begin CPR until AED is available. Give 30 compressions at 100 beats/min and then 2 breaths over the course of 1 second. Once an advanced airway is inserted, ventilate at a rate of 8-10 breaths/min and do not stop compressions. This is exactly the same for children, except two-rescuer CPR is 15:2. If patient experiences a return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min. compression to breath ratios - CORRECT ANSWER>>under 8 years old: -2 provider: 15:2 -1 provider: 30:2 -one third of chest diameter older: -30:2 always -2 inches AED procedure - CORRECT ANSWER>>-if cardiac arrest was not seen by EMS, give 5 cycles of 30:2 before defibrillating -if cardiac arrest was seen, one EMT begins compressions and the other applies AED 5 Kussmaul respirations - CORRECT ANSWER>>Help the body blow off excess acids (CO2) which are deep, rapid breaths Signs of hyperglycemia - CORRECT ANSWER>>gradual onset, warm and dry skin, fruity breath, Kussmaul respirations (rapid and deep), restlessness, slurred speech, gradual response to treatment, diabetic coma Diabetic coma - CORRECT ANSWER>>Or hyperglycemic crisis. A state of unconsciousness resulting from ketoacidosis, hyperglycemia, and dehydration Signs of hypoglycemia - CORRECT ANSWER>>Rapid onset, pale, cool, moist skin, normal or rapid breathing, irritability, confusion, immediate response to treatment, insulin shock Insulin shock - CORRECT ANSWER>>Hypoglycemic crisis Signs of opioids - CORRECT ANSWER>>Depressant, like heroin or oxycodone. Causes hypoventilation or respiratory arrest, pinpoint pupils, sedation or coma, hypotension. Everything "depresses" Sympathomimetics - CORRECT ANSWER>>Stimulants, like epinephrine or cocaine. Causes hypertension, tachycardia, dilated pupils, agitation, hyperthermia. Everything "stimulates" Sedative-hypnotics - CORRECT ANSWER>>Type of depressant, like alcohol. Slurred speech, sedation or coma, hypoventilation, hypotension. Induces sleep. Anticholinergics - CORRECT ANSWER>>Type of stimulant, like atropine. Tachycardia, hyperthermia, hypertension, dilated pupils. Same as sympathomimetics. Cholingergics - CORRECT ANSWER>>excess defecation or urination, pinpoint pupils, airway compromise, salivation, nausea/vomiting Signs of chlamydia - CORRECT ANSWER>>Lower abdominal pain, low back pain, nausea, fever Signs of gonorrhea - CORRECT ANSWER>>No symptoms for a while, painful urination, discharge Blood volume during pregnancy - CORRECT ANSWER>>Can increase as much as 50% Umbilical cord - CORRECT ANSWER>>Contains two arteries and one vein. The vein carries oxygenated blood and arteries carry deoxygenated blood from the fetus to the woman. delivering a baby! - CORRECT ANSWER>>-position mother with knees drawn up and spread apart; hips elevated and feet flat on the surface -apply gentle pressure to head avoiding fontanelle to prevent explosive deliver 6 -check for nuchal cord. remove it. if you can't and there isn't a chance of multiple deliveries, place two clamps 2-3 inches apart and cut between clamps -as soon as head is delivered, suction mouth and then nose -dry and wrap in a blanket; place at level of vagina until umbilical cord is cut -cut when pulsations stop (first clamp 6 inches from infant's abdomen and second 9 inches) -up to 500 mL is normal 1st stage of labor - CORRECT ANSWER>>"dilation" Begins with the onset of contractions and ends when the cervix is fully dilated (10 cm) can last about 18+ hours 2nd stage of labor - CORRECT ANSWER>>"expulsion" Begins when the fetus enters the birth canal and ends when the infant is born can last about an hour Preeclampsia - CORRECT ANSWER>>Pregnancy-induced hypertension. Headache, seeing spots, edema, anxiety, high BP -greater than 140/90 or increase in SBP of greater than 30 or increase in DBP of greater than 15 delivery is imminent if - CORRECT ANSWER>>-there are signs of crowning -contractions are less than 2 minutes apart and last from 60-90 seconds -patient has strong urge to push -abdomen is very hard *before deciding to deliver on scene, contact medical direction for permission 3rd stage of labor - CORRECT ANSWER>>"placental" Begins with the birth of the infant and ends with the delivery of the placenta 5 to 20 minutes after delivery of baby para/gravida - CORRECT ANSWER>>para - number of births carried to term (includes stillbirths) gravida - number of times pregnant Eclampsia - CORRECT ANSWER>>Seizures that occur as a result of hypertension Abruptio placenta - CORRECT ANSWER>>Usually results with trauma and causes massive bleeding and severe pain. When the placenta separates prematurely from the wall of the uterus Placenta previa - CORRECT ANSWER>>When the placenta develops over and covers the cervix -painless vaginal bleeding in third trimester ruptured uterus - CORRECT ANSWER>>-can result in severe blood loss and death of fetus -tearing sensation in abdomen, constant and severe abdominal pain, ability to palpate fetus 7 Emergency pregnancy situations - CORRECT ANSWER>>1. More than 30 minutes elapse and the placenta has not delivered 2. There is more than 500 mL of bleeding before delivery of the placenta 3. There is significant bleeding after the delivery of the placenta Prolapsed umbilical cord - CORRECT ANSWER>>A situation in which the umbilical cord comes out of the vagina before the infant. The infant's head will compress the cord, cutting off its own circulation. Place the woman with her hips elevated and insert your hand into the vagina to push the infant's head away from the cord Breech presentation - CORRECT ANSWER>>Can be delivered in the field - butt first. The only other time to insert your hand into the vagina is to push the walls of the vagina off the infant's airway as the head comes out. limb presentation - CORRECT ANSWER>>-position mother so that hips are elevated -transport asap APGAR Appearance - CORRECT ANSWER>>Pink = 2 Pink and blue = 1 Blue = 0 APGAR Pulse - CORRECT ANSWER>>100 beats/min = 2 Fewer than 100 = 1 Absent pulse = 0 APGAR Grimace - CORRECT ANSWER>>Infant cries and moves foot from stimulus; grimaces = 2 Weak cry (facial grimace) = 1 Does not cry or react = 0 APGAR Activity - CORRECT ANSWER>>Resists attempts to straighten knees or hips = 2 Infant makes weak attempts to resist straightening = 1 Infant is limp with no muscle tone = 0 APGAR Respiration - CORRECT ANSWER>>Rapid respirations = 2 Slow respirations = 1 Absent respirations = 0 When is blow-by oxygen indicated on a newborn? - CORRECT ANSWER>>Indicated for infants with cyanosis that is not dissipating heart rate between 100-180 spontaneous breathing When is artificial ventilations indicated on a newborn? - CORRECT ANSWER>>Indicated for infants with cyanosis and a heart rate of less than 100 or if the infant is apneic 10 tension pneumothorax - CORRECT ANSWER>>-build-up of air within pleural space -allows air to escape into pleural space but not to return -positive pressure ventilation may exacerbate this effect -can occur with chest trauma respiration assessment - CORRECT ANSWER>>-work of breathing/labored breathing -depth of breathing -LOC -respiratory rate agonal gasps - CORRECT ANSWER>>-abnormal pattern of breathing and brainstem reflex characterized by gasping, labored breathing, accompanied by strange vocalizations and myoclonus -respiratory center in the brain continues to send signals to respiratory muscles -NOT effective breaths pulse oximetry - CORRECT ANSWER>>-measures oxygen saturation of hemoglobin in the capillary beds Cheyne-Stokes respiration - CORRECT ANSWER>>-pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum level, followed by a decrease, resulting in apnea -may be caused by damage to respiratory centers, congestive heart failure -heart failure, stroke ataxic respiration - CORRECT ANSWER>>-abnormal pattern of breathing characterized by complete irregularity of breathing with irregular pauses and increasing periods of apnea capnography - CORRECT ANSWER>>-monitoring of the concentration or PP of carbon dioxide -usually presented as a graph of expiratory CO2 plotted against time end-tidal CO2 - CORRECT ANSWER>>-normally 35-45 mm Hg -partial pressure of CO2 detected at the end of exhalation -obtained via capnography airway opening maneuvers - CORRECT ANSWER>>-place supine -head tilt chin lift - preferred; gently lift mandible while simultaneously pressing down on forehead, places patient in sniffing position -jaw thrust; should be used in patients who have suspected spine or neck injury. move jaw upward by placing fingers behind the angles of the jaw and gently lifting suction catheters - CORRECT ANSWER>>-rigid tip catheter - Yankauer. for suctioning mouth. tonsil tips. no further than base of the tongue -soft tip flexible catheter - French. for suctioning nose or trachea 11 hypopnea - CORRECT ANSWER>>-shallow or inadequate tidal volume suctioning technique - CORRECT ANSWER>>-turn on and set to 300 mm Hg -place tip only as far as you can see -apply as you are withdrawing catheter from mouth -limit time to 15 seconds in adults and 10 seconds in children and 5 seconds in infants oropharyngeal adjunct - CORRECT ANSWER>>-inserted to prevent tongue from relaxing and blocking airway -can be used in patients who are breathing and those who require manual ventilation -only in patients who are unresponsive and do not have intact gag reflex nasopharyngeal adjunct - CORRECT ANSWER>>-better tolerated in patients who have intact gag reflex -also those who have ALOC but not able to protect airway position to maintain airway - CORRECT ANSWER>>-recovery position -roll body onto one side, extend lower arm and place upper hand under cheek -prevents tongue from blocking airway and decreases risk of aspiration pressure regulator - CORRECT ANSWER>>-decreases pressure of oxygen being released to safe level of 40 psi to 70 psi procedures of O2 administration - CORRECT ANSWER>>-inspect cylinder and remove seal -cylinder needs to be cracked, which involves opening and closing valve with tank key -attach regulator and flowmeter to tank -attach mask/nasal cannula to nipple on flowmeter/regulator -turn flowmeter to desired LPM oxygen delivery equipment - CORRECT ANSWER>>-nasal cannula -NRB -bag mask NRB - CORRECT ANSWER>>-preferred -should be set to 10 to 15 LPM; two one-way valves -can deliver 95% O2 -used in patient who are breathing on their own but hypoxic -prevent inhaling the exhaled gases -combination mask and reservoir bag system -should be used with oxygen flow rate high enough to inflate reservoir bag, which is a minimum of 10 LPM; if it collapses O2 flow not high enough nasal cannula - CORRECT ANSWER>>-1 to 6 L/m 12 -good for patients who do not tolerate a mask -24 to 44 percent oxygen bag mask - CORRECT ANSWER>>-used to deliver O2 in patients who require ventilatory assistance -15 L/m -can deliver close to 100 percent O2 partial RB - CORRECT ANSWER>>-Gives 60-75% -6-11 L -Will breathe out some O2 receiving → rebreathe 1/3 what is being exhaled; rest exhaled goes through vents; one two-way valve venturi mask - CORRECT ANSWER>>-a face mask and reservoir bag device that delivers specific concentrations of oxygen by mixing oxygen with inhaled air; controlled oxygen therapy assisted ventilation - CORRECT ANSWER>>-can be provided with bag mask device, CPAP, or mechanical ventilator BiPAP - CORRECT ANSWER>>-bilevel positive airway pressure -like CPAP -non-invasive form of therapy for sleep apnea -bipap has pressure for inhalation and lower pressure for exhalation -allows patient to get more air in and out of lungs -given to spontaneously breathing patients -typically used for COPD, asthma, CHF, pulmonary edema -only used on patients that are alert enough to obey commands, maintain their own airway, breath on their own stoma - CORRECT ANSWER>>-if delivering O2 to patient with stoma, use tracheostomy mask -if you have to ventilate patient manually, attach bag-mask to trach tube to ventilate -if only stoma, child's mask can be connected to bag and placed over stoma to ventilate signs of airway obstruction (partial and complete) - CORRECT ANSWER>>partial - wheezing, stridor, weak cough complete - cyanosis, inability to speak, loss of consciousness wheezing - CORRECT ANSWER>>-caused by narrowing or obstruction of lower airways -high-pitched whistling sound -can be heard without stethoscope stridor - CORRECT ANSWER>>-strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx (upper airway obstruction) -brassy, crowing sound 15 -20-25 breaths -SBP: 90 to 110 -96.8 to 99.6 school-age children vital signs - CORRECT ANSWER>>6-11 years old -70 to 110 bpm -15-20 breaths -SBP: 90-120 -98.6 adolescent vital signs - CORRECT ANSWER>>-12 to 18 years -60-100 bpm -12-20 breaths -100 to 120 -98.6 adult vital signs - CORRECT ANSWER>>-60-100 bpm -12 to 20 breaths -110/70 to 130/90 -98.6 acute coronary syndrome - CORRECT ANSWER>>-description of all symptoms brought on my myocardial ischemia -two categories are angina pectoris and AMI angina pectoris - CORRECT ANSWER>>-decrease O2 or arterial spasm -can be present during stress or physical exertion -squeezing, pressure sensation, like reflux or GERD -may be jaw, arm pain, nausea acute myocardial infarction - CORRECT ANSWER>>-the condition in which a portion of the myocardium dies as a result of oxygen starvation -nausea, sweating, chest pressure/squeezing, arm, jaw, lower back/abdom pain nitroglycerin - CORRECT ANSWER>>-used to relieve chest pain through vasodilation -forms used by patients usually include sublingual tablets or sprays and transdermal patches -contraindications: -have taken erectile dysfunction meds within the past 24 hours, SBP below 100 -side effects: -tachycardia -max dosage is 3 doses every 5 minutes congestive heart failure - CORRECT ANSWER>>-heart's pumping mechanism is weaker -fluid stasis around heart and congestion in lungs 16 dependent edema - CORRECT ANSWER>>-gravity-related swelling in lower body hypertensive emergency - CORRECT ANSWER>>-ideal BP: 120/80 -HTN: 140/90 or higher -normally over 180 -evidence of impending irreversible organ damage to at least one system (brain, heart, etc.) 12 lead EKG - CORRECT ANSWER>>-10 electrodes: V1-V6 & 4 limbs take different angles of the heart 5 links in chain of survival - CORRECT ANSWER>>The system components of CPR 1. Early Access 2. Early CPR 3. Early defibrillation / AED 4. Early advanced care 5. Integrated post-arrest care AED with pacemakers/implanted defibs - CORRECT ANSWER>>-avoid placing AED pads over these devices -place AED pad directly below the device -the anterior/posterior pad position may also be used AED with wet patients - CORRECT ANSWER>>AED should not be used in these conditions lateral recumbent (recovery) position - CORRECT ANSWER>>-the patient is lying on their left or right side -if lying on one side for more than 30 minutes, turn to other side Fowler position - CORRECT ANSWER>>-patient is lying on back with upper body elevated at 45 to 60 degree angle Semi-Fowler - CORRECT ANSWER>>-the same as Fowler, but upper body elevated at less than 45 degrees Trendelenburg position - CORRECT ANSWER>>-patient lying on back on an incline with their legs up and head down -no longer recommended shock position - CORRECT ANSWER>>-lying on back with feet and legs elevated 12 inches -no longer recommended for shock -may be used for patients that have fainted and do not have spinal injuries spinal column - CORRECT ANSWER>>-cervical (7) 17 -thoracic (12) -lumbar (5) -sacral (5) -coccyx (4) adrenal glands - CORRECT ANSWER>>produce epinephrine, norepinephrine, cortisol, aldosterone thyroid glands - CORRECT ANSWER>>produces hormones that regulate metabolism, body heat, and bone growth parathyroid glands - CORRECT ANSWER>>regulate amount of calcium and phosphorus in the body quadrants - CORRECT ANSWER>>RUQ - liver, kidney, gallbladder LUQ - spleen, kidney, stomach, pancreas RLQ - appendix, ovary LLQ - ovary small + large = everywhere systolic and diastolic BP - CORRECT ANSWER>>systolic - measure of cardiac output, pressure in arteries when heart contracts diastolic - pressure when heart is at rest, measure of systemic vascular resistance 3 types of stress - CORRECT ANSWER>>-acute - in response to experiencing or witnessing a traumatic event -delayed - develops a stress response after the event (like PTSD) -cumulative - develops over a long period of time after repeated exposure to stressful events AIDS mode of transmission/signs symptoms - CORRECT ANSWER>>-blood, semen, vaginal fluid, transplacental -fever, fatigue, loss of appetite, recurrent infections, flu-like symptoms Hep B and C - CORRECT ANSWER>>-blood, semen, vaginal fluid, transplacental -loss of appetite, jaundice, yellowing of eyes and skin tuberculosis - CORRECT ANSWER>>-respiratory secretions, airborne or direct contact -persistent cough, night sweats, fatigue, hemoptysis influenza - CORRECT ANSWER>>-airborne droplets, direct contact with body fluids 20 -move patients from bed to cot -each EMT stands on opposite sides of patient; one pushes and one pulls log roll technique - CORRECT ANSWER>>-non-urgent -should have 3 EMTs -roll as a single unit -use to place patient on backboard or assess posterior prehospital care report (PCR) - CORRECT ANSWER>>-becomes part of patient's permanent medical record -correcting errors - draw line through, initial, and write correct info beside it -should include: -patient information -administration information/run data -vital signs -patient narrative special situations (documentation) - CORRECT ANSWER>>-transfer of care: fill out transfer of care form containing minimum set of patient data and obtain transfer for care signature; complete full PCR later -MCIs: triage tag providing info such as chief complaint, vital signs, treatment given. this will be used later to write full report snoring sounds - CORRECT ANSWER>>suggests airway may be partially blocked by tongue pulse ox values - CORRECT ANSWER>>-adults between 96-98% -infants and children at 95-100% -goal of artificial ventilation is to maintain at least 94% -do not interrupt for more than 30 seconds ventilation rate for newborns - CORRECT ANSWER>>-with pulse: 1 every 1-1.5 seconds -without pulse: 1 ventilation per 3 compressions -with advanced airway/without pulse: 1 per 3 compressions ventilation rate for children - CORRECT ANSWER>>-with pulse: 1 every 3-5 seconds -without pulse: 2 per 30 or 2 per 15 compressions -with advanced airway: 1 every 6 to 7.5 seconds; compressions not stopped ventilation rate for adult - CORRECT ANSWER>>-with pulse: 1 every 5-6 seconds -without pulse: 2 per 30 compressions -with advanced airway: 1 every 6-7.5 seconds; compressions not stopped the pulse of an unconscious person should be checked every - CORRECT ANSWER>>30 seconds 21 methods of artificial ventilation - CORRECT ANSWER>>-mouth to mouth/mouth to nose (not preferred bc of risk) -mouth to mask mouth to mask - CORRECT ANSWER>>-must have oxygen inlet that allows for delivering O2 at 15 lpm -must have a one way valve ventilation port 1. connect a one-way valve to the mask's ventilation port and connect the oxygen supply tube to the mask's oxygen inlet 2. position yourself at the patient's head in 2 person CPR and side if using 1 person 3. use C-E grip and open airway 4. place mouth around the one-way valve and blow -preferred method of artificial ventilation bag valve mask - CORRECT ANSWER>>-consists of self-inflating bag, one-way NRB valve, mask, intake reservoir valve, and oxygen reservoir -can deliver 1600 mL -child size 450-500 mL -without an O2 source, deliver 21% O2 -higher risk of hyperventilation -airway adjuncts should be used 1. position at the top of the patient's head 2. insert adjunct to maintain airway if necessary 3. use C-E grip 4. connect bag valve to mask 5. begin ventilation by squeezing the bag; connect to O2 after 1 minute of ventilation if there is 1 EMT flow restricted oxygen powered ventilation device FROPVD - CORRECT ANSWER>>-manually triggered ventilation device -delivers 100% oxygen -peak flow rate under 40 lpm of 100% oxygen -only used on adults 1. connect FROPVD to mask 2. open airway 3. adjunct if necessary 4. use C-E technique 5. activate valve by pressing and holding button. release the bottom when chest starts to rise automatic transport ventilator (ATV) - CORRECT ANSWER>>-automatically adjust to patient's RR and TV -ability to deliver 50-100% O2 -should not be used on patients experiencing lung pressure issues 1. call medical direction to determine ATV settings 22 2. attach mask to ATV 3. open airway, airway adjunct, C-E 4. turn on ATV and monitor patient for signs of adequate ventilation O2 cylinder - CORRECT ANSWER>>-M usually -3000L -2000 psi; refill at 200 when to give O2 - CORRECT ANSWER>>1. any patient using positive pressure ventilation 2. any patient with signs of hypoxia 3. any patient with pulse oximetry readings or blood O2 less than 94 4. any patient w ALOC or unresponsive 5. injuries to CNS component 6. multiple fractures and soft tissue injuries 7. severe bleeding 8. shock 9. exposed to toxins like CO pulse - CORRECT ANSWER>>-check radial in patients 1 year or older; check carotid if you can't feel radial -check brachial in younger than 1 year -measure for 30 seconds -if irregular, measure for 1 minute pulse pressure - CORRECT ANSWER>>-normal: between 25-35% of systolic pressure -widened: greater than 50% of systolic. may indicate a head injury -narrow: less than 25% of systolic pressure. may indicate hypo perfusion, tension pneumo, pericardial tamponade orthostatic vital signs - CORRECT ANSWER>>-if PT suspected of having blood or fluid loss, take vital signs when in supine -have them stand for 2 minutes and take vitals standing up -HR increases by more than 10-20 bpm, signs of significant blood loss patient history - CORRECT ANSWER>>SAMPLE -signs and symptoms -allergies -medications -pertinent medical history -last oral intake -events leading up to the incident OPQRST (info about complaints) -onset 25 -small volume nebulizer side effects of MDI and SVN - CORRECT ANSWER>>-tachycardia -hypertension retractions - CORRECT ANSWER>>-early sign of respiratory distress in children -late sign in adults who does not present normally with heart attack? - CORRECT ANSWER>>-diabetics -women -elderly status epilepticus - CORRECT ANSWER>>-prolonged seizures (greater than 10 minutes) -recurring seizures without a period of responsiveness 4 stages of seizure - CORRECT ANSWER>>-aura (warning stage) -tonic (muscle rigidity) -tonic-clonic (convulsions) -postictal (LOC improves in about 30 minutes) normal glucose level - CORRECT ANSWER>>80-120 mg/dL hypoglycemia - less than 60 hyperglycemia - greater than 120 hypoglycemia - CORRECT ANSWER>>signs: AMS, bizarre or violent behavior, intoxicated appearance -tachycardia -pale, cool skin -rapid, shallow breathing when can oral glucose be given? - CORRECT ANSWER>>-known diabetes diagnosis or blood glucose reading below 60 -AMS -ability to swallow 3 types of abdominal pain - CORRECT ANSWER>>-visceral (generalized, dull) -parietal (localized and sharp or stabbing) -referred (felt somewhere other than its source) UTI - CORRECT ANSWER>>-infection of urethra and/or bladder -painful and frequent or difficult urination kidney stones - CORRECT ANSWER>>-salt and other minerals found in the urine stick together -severe pain in side/back 26 -spreads to lower abdomen and groin -discolored urine -painful/frequent urination acute renal failure - CORRECT ANSWER>>-kidneys lose filtering ability, buildup of toxins in the blood -can lead to heart failure and metabolic acidosis -oliguria (urine output of less than 500 mL a day), anuria, hypertension, tachycardia, pain/distention of abdomen deep vein thrombosis - CORRECT ANSWER>>-painful swelling and tenderness in one leg -warm skin -deep ache in clot area -redness in skin body loses heat in five ways - CORRECT ANSWER>>-radiation (most) -convection -conduction -evaporation -respiration hypothermia - CORRECT ANSWER>>-body temp drops to less than 95 -coma occurs when temp drops to 79 -patients can die within 2 hours of hypothermia onset 1. shivering. stops below 90 2. decreased muscle function 3. decreased responsiveness 4. slow pulse and resp rate 5. death tx 1. move to warm environment and remove wet clothes 2. dry and insulate (mostly head) 3. do not allow patient to walk or exert themselves 4. provide O2 5. no active rewarming; too quickly can lead to cardiac arrest local cold injury - CORRECT ANSWER>>1. move to warm environment 2. O2 3. remove jewelry and wet/restrictive clothing 4. do not massage 5. start thawing procedures if no danger of refreezing. submerge in warm water path (104F); keep area in water until it is soft and color/sensation is returned 27 6. cover affected area with dressings 7. elevate heat cramps - CORRECT ANSWER>>-muscle cramps due to overheating tx 1. move to cool environment 2. medical direction/local protocols for low concentration salt water 3. moist towel to forehead heat exhaustion - CORRECT ANSWER>>-occurs when patient physically exert themselves for prolonged periods in hot and humid environment -profuse sweating, dizziness, low blood pressure upon standing, rapid pulse heat stroke - CORRECT ANSWER>>-body's heat-regulating mechanisms are unable to cool the body -core body temp of 104F -AMS -hot/dry skin -nausea -rapid breathing and heart rate car accidents 3 collisions - CORRECT ANSWER>>1. vehicle hits another object 2. passenger hits interior of the vehicle or safety restraint system 3. internal organs of body hit the internal structures of the body control external bleeding - CORRECT ANSWER>>-apply direct pressure to injured area (do not remove bandages you have applied) -tourniquet; proximal to source of bleeding. don't remove. -should not be used for more than 2 hours because nerve damage and tissue necrosis can occur within 6 hours puncture/penetrating wounds - CORRECT ANSWER>>-should never be removed by EMT unless it obstructs the airway, prevents airway management, or gets in the way of CPR treatment for amputations - CORRECT ANSWER>>-wash amputated or partially amputated part with sterile water or saline; do not immerse -use a dry or wet dressing to wrap the part and place in a plastic bag -place in a cooler with ice, but not directly on ice crush syndrome - CORRECT ANSWER>>-occurs after a crushing injury -includes shock and renal failure -patients may appear stable, but complications can occur when object crushing patient is removed 30 -interferes with spinal immobilization -cardiac arrest eye injuries - CORRECT ANSWER>>-don't force it open unless it is to wash out chemicals -do not remove lenses if it is injured (unless this is chemical burn injury) -never apply pressure -cover BOTH eyes -flush for 20 minutes if chemical burn -for 1 hour if alkali chemical nose injuries - CORRECT ANSWER>>-should be taken to ER if bleeding does not stop in 15-20 minutes neck injuries - CORRECT ANSWER>>-apply occlusive dressing and tape on all four sides to prevent air from entering -cover with regular dressing -control bleeding by applying pressure -after bleeding is controlled, apply pressure dressing flail segment - CORRECT ANSWER>>-2 or more adjacent ribs are broken in 2 or more places -paradoxical breathing -stabilize flail segment; splint treatment of chest wounds - CORRECT ANSWER>>-control bleeding -immediately seal open wounds with gloved hand -apply occlusive dressing to prevent open pneumothorax -leave one side of dressing untaped to allow exhaled air to escape to prevent tension pneumothorax -immobilize spine if significant MOI Kehr's sign - CORRECT ANSWER>>referred pain down the left shoulder; indicative of a ruptured spleen or ectopic pregnancy treatment of evisceration - CORRECT ANSWER>>-use sterilized moistened gauze to cover all exposed organs -apply occlusive dressing loosely over moistened dressing and tape on all sides trauma in pregnant women - CORRECT ANSWER>>-more susceptible to shock bc of increased blood volume -more susceptible to tension pneumothorax bc diaphragm is higher -similar care, but tilt longboard to the left if woman is in third trimester or obviously pregnant to prevent supine hypotensive syndrome (fetus compresses inferior vena cava) first degree burn - CORRECT ANSWER>>-superficial 31 -affects epidermis only -painful and red second degree burn - CORRECT ANSWER>>-affects epidermis and parts of dermis -painful, red, blisters third degree burn - CORRECT ANSWER>>-affects entire dermis -no pain -white, waxy, black, charred rule of 9s - CORRECT ANSWER>>head + neck = 9 left arm = 9 right arm = 9 chest = 9 abdomen = 9 upper back = 9 lower back = 9 leg = 18 leg = 18 genitals = 1 -only applies to 2nd and 3rd degree burns rule of 9s in children (don't think this is a thing?) - CORRECT ANSWER>>-same as adults but -head + neck = 12 -each leg = 16 rule of 9s in infants - CORRECT ANSWER>>-same as adults but -head+neck = 18 -each leg = 14 minor burn injury - CORRECT ANSWER>>-first degree less than 50% -second degree less than 15% -third degree less than 2% moderate burn injury - CORRECT ANSWER>>-first degree over more than 50% -second degree from 15-30% -third degree 2-10% severe burn injury - CORRECT ANSWER>>-burns that affect the respiratory tract -moderate burn injury in under 5 or over 55 -third degree over 10% -second or third to respiratory tract, face, hands, feet, genitlia -burns with associated trauma 32 -second degree over 30% treatment of burns - CORRECT ANSWER>>-remove from source; flush area with water or saline (unless third degree) -remove clothing unless it's clinging to skin -if source was solid or liquid, flush with water or saline -dry chemicals should be brushed away before flushing with water -cover burned area with dressing -keep warm primary assessment of pediatric patients - CORRECT ANSWER>>-general impression using pediatric assessment triangle (PAT) -followed by assessing AVPU, ABC -PAT: appearance, work of breathing, circulation -appearance: TICLS (muscle Tone, interactivity, consolability, look/gaze, speech/cry) febrile seizures - CORRECT ANSWER>>-seizures that result from sudden high fevers, particularly in children -cooling should be done (at 104) in a slow and controlled manner unless it is greater than 106.9 to prevent seizures heart attack in geriatrics - CORRECT ANSWER>>-may not experience chest pain -weakness, dizziness, trouble breathing central painful stimuli technique - CORRECT ANSWER>>-trapezius pinch -supraorbital pressure -earlobe pinch -armpit pinch peripheral painful stimuli - CORRECT ANSWER>>-nailbed pressure -pinching toes and fingers if local protocol allows, you should give patients suffering from angina or MI... - CORRECT ANSWER>>aspirin