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NREMT –MUST KNOW QUESTIONS
WITH SOLUTIONS.
Medical Direction - Answer-Oversight of the patient-care aspects of an EMS system by the Medical Director. Protocols - Answer-lists of steps, such as assessments and interventions, to be taken in different situations. Protocols are developed by the Medical Director of an EMS system Offline Direction - Answer-consists of standing orders issued by the medical director that allows EMTs to give certain medications or perform certain procedures without speaking to the medical director or another physician. Online Direction - Answer-consists of orders from the on-duty physician given directly to an EMT-B in the field by radio or telephone. Standing Orders - Answer-A policy or protocol issued by a Medical Director that authorizes EMT-Bs and others to perform particular skills in certain situations. HEPA Mask - Answer-High Efficiency Particulate Air respirator; used for patients with suspected TB; worn by the EMT provider to prevent airborne transmission Hepatitis B - Answer-infectious inflammation of the liver caused by the hepatitis B virus (HBV) that is transmitted sexually or by exposure to contaminated blood or body fluid Hepatitis C - Answer-inflammation of the liver caused by the hepatitis C virus, transmitted by exposure to infected blood (rarely contracted sexually) Tuberculosis - Answer-Infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Most commonly affects the respiratory system and causes inflammation and calcification of the system. Acute Stress - Answer-short term ; fight or flight response ; effects disappear quickly after it is over Scope of Practice - Answer-What we are allowed to do or trained to do Standard Care - Answer-the degree of care that a reasonably prudent person should exercise under the same or similar circumstances Duty to Act - Answer-an obligation to provide care to a patient
Good Samaritan - Answer-a person who voluntarily offers help or sympathy in times of trouble Expressed Consent - Answer-Permission that must be obtained from every conscious, mentally competent adult before emergency treatment may be provided Implied Consent - Answer-The consent it is presumed a patient or patient's parent or gaurdian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed. Treatment of a Minor - Answer-Must be given by legal guardian Involuntary - Answer-Mentally incompetent person Advanced Directive - Answer-a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care; may also be called a living will or durable power of attorney for health care Polst - Answer-Physicians orders for life sustaining treatment. May include order for DO NOT RESUSCITATE PCR - Answer-Prehospital care report Emergency Move - Answer-a move made when there is an immediate danger to the patient. Urgent Move - Answer-Move used if a scne factor causes a decline in patient's condition, or if the treatment of a patient requires a move. Non urgent move - Answer-No immediate threat to life, are carried out in such a way as to prevent injury and to avoid discomfort and pain. bariatric stretcher - Answer-Stretcher for obese patients scoop stretcher - Answer-this cot splits in tow or four sections, so it can be used where larger stretchers cannot fit. basket stretcher - Answer-designed to surround and protect the patient, this stretcher is used to move a patient from one level to another to over rough terrain. flexible stretcher - Answer-made of canvas or rubberized or other flexible material, often with wooden slats sewn into pockets and three carrying handles on each side. can be useful in restricted areas or narrow hallways
palmar - Answer-Palm of hand quadrants of the abdomen - Answer-Describing where an abdominal organ or pain is located is made easier by dividing the abdomen into four imaginary quadrants. *Right upper quadrant (RUQ) *Left upper quadrant (LUQ) *Right lower quadrant (RLQ) Left lower quadrant (LLQ) vertebrae - Answer-the 33 bones of the spinal column Ribs - Answer-Vertebrosternal = 'True ribs" -ribs 1-7 attach directly to the sternum through their costal cartilage. Vertebrochondral = "False ribs" =ribs 8-10 costal cartilage articulate indirectly with the sternumb by joing the costal cartilages of ribs above. Vertebral Ribs = "Floating ribs" ribs 11 and 12 no anterior attachment. upper airway - Answer-(Nose, mouth, pharynx, larynx)FUNCTION:Conducts air to lower airway *Protects lower airways *Warms, filters & humidifies air lower airway - Answer-trachea, bronchi, bronchioles, and aveoli (gasses travel through the structers to and from the blood) cricoid cartilage - Answer-the ring-shaped structure that forms the lower portion of the larynx diaphragm - Answer-muscular partition that separates the thoracic cavity from the abdominal cavity and aids in respiration by moving up and down phrenic nerve - Answer-stimulates the diaphragm edema - Answer-swelling perfusion - Answer-The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. hypo perfusion - Answer-Also known as shock (decreased blood flow through an organ, as in hypovolemic shock; if prolonged, it may result in permanent cellular dysfunction and death.) cerebrum - Answer-large part of the brain that controls the senses and thinking cerebellum - Answer-the "little brain" attached to the rear of the brainstem; its functions include processing sensory input and coordinating movement output and balance
brain stem - Answer-the part of the brain continuous with the spinal cord and comprising the medulla oblongata and pons and midbrain and parts of the hypothalamus epinephrine - Answer-adrenaline; activates a sympathetic nervous system by making the heart beat faster, stopping digestion, enlarging pupils, sending sugar into the bloodstream, preparing a blood clot faster noepinephrine - Answer-A neurotransmitter from nerve endings and a hormone from the adrenal gland. It is release in times of stress and is involved in hunger regulation, blood glucose regulation and other body processes. alpha1 and Alpha2 - Answer-Alpha1 vessels constrict and release sweat Alpha2 try's to regulate alpha beta 1 - Answer-increases HR, inotrophy (forced contraction of heart) increases electrical impulse in heart beta 2 - Answer-relaxes smooth muscle such as bronchioles and some vessels pulse pressure - Answer-difference between systolic and diastolic pressure no more than 25% respiration - Answer-..., the bodily process of inhalation and exhalation pulmonary ventilation - Answer-..., Movement of air into and out of the lungs internal respiration - Answer-..., exchange of gases between the blood and the cells of the body external respiration - Answer-..., exchange of gases between the lungs and the blood cellular respiration - Answer-..., process that releases energy by breaking down glucose and other food molecules in the presence of oxygen carina - Answer-..., the fork at the lower end of the trachea where the two mainstem bronchi branch. bronchioles - Answer-..., smallest branches of the bronchi pleura - Answer-..., membrane surrounding the lungs visceral pleura - Answer-..., inner layer of pleura that surrounds each lung
tonsil tip - Answer-... Rigid suction french tip - Answer-...Soft suction oropharyngeal - Answer-..., -curved plastic device used to establish an airway in a patient by displacing the tongue from the posterior wall of the oropharynx -used in unconscious patients who do not have a gag reflex nasopharyngeal - Answer-..., flexible airway inserted through the patients nose retractions - Answer-..., Movements in which the skin pulls in around the ribs during inspiration. respiratory failure - Answer-..., a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high respiratory arrest - Answer-..., When breathing completely stops. agonal respiration - Answer-..., Shallow, slow or infrequent breathing tachypnea - Answer-..., fast breathing, an abnormally rapid rate of respiration, usually >20 breaths per minute bradypnea - Answer-..., slow respiratory rate, usually below 10 respirations per minute methods of artifical ventilation - Answer-...Mouth to mask Two person bag valve Fropvd One person bag valve cricoid pressure - Answer-..., Pressure on the trachea, prevents air from entering the esophagus/stomach and vomiting FROPVD - Answer-..., flow-restricted, oxygen-powered ventilation device: a device that uses oxygen under pressure to deliver artifical ventilations. Its trigger is placed so that the rescuer can operate it while still using both hands to maintain a seal on the face mask. Has automatic flow restriction to prevent overdelivery of oxygen to the patient. rales - Answer-..., abnormal crackling sound made during inspiration rhonchi - Answer-..., lower-pitched sounds like snoring or rattling, secretions in larger airways (pneumonia, bronchitis, aspiration)
paradoxus pulsus - Answer-blood pressure declines as one inhales and increases as one exhales capillary refill - Answer-..., tested by pressing the nail tip briefly and watching for color change. A normal finding is the pink tone returns immediately when pressure is released. An abnormal finding is slow (greater than 2 seconds) return of pink tonewith respiratory or cardiovascular diseases that cause hypoxia. Penetrating truma - Answer-Made a cut through Blunt force trauma - Answer-No cut but internal problem Hypercapnia - Answer-Too much carbon dioxide Flexion posturing - Answer-(Formerly known as decorticate posturing). Client flexes one or both arms on the chest and may extend the legs stiffly. Indicates nonfunctioning cortex. Lesions of cerebral hemispheres or internal structures of brain cause this posturing. Extension posturing - Answer-A posture in which the pt arches the back and extends the arms straight out parallel to the body. A sign of serious head injury Occluded - Answer-closed off Dyspnea - Answer-difficult or labored respiration Hypoperfusion - Answer-inadequate perfusion also known as shock Secondary assessment - Answer-after immediate life- or limb-threatening injuries/illnesses have been identified, this more thorough evaluation is performed to identify more subtle, yet still important, injuries Physical exam, Baseline vitals, History - Answer-Three major steps in secondary assessments Cerebrospinal fluid - Answer-clear liquid produced in the ventricles of the brain Jugular vein distention - Answer-the visible bulging of the jugular vein when the Pt is in semi-fowlers position or full fowlers position. this is indicative of inadaquate blood movement through the heart and/or lungs Tension pneumothorax - Answer-a pneumothorax with rapid accumulation of air in the pleural space causing severely high intrapleural pressures with resultant tension on the heart and great vessels
Shock - Answer-Inadequate tissue perfusion Also know as hypoperfusion Types of shock - Answer-Hypovolemic Distributive Cardiogenic Obstructive Hypovolemic shock - Answer-shock caused by severe blood or fluid loss Distributive shock - Answer-less distribution of blood to areas = venous pooling, most common in general anesthesia and spinal cord injuries and septic shock (bacterial infection where toxins in blood). cause: general anesthesia and spinal cord injuries and septic shock Cardiogenic shock - Answer-shock that results from failure of the heart in its pumping action. Obstructive shock - Answer-mechanical obstruction or compressing that prevents blood from reaching the heart Tension pneumonthorax - Answer-A type of pneumothorax in which air can enter the pleural space but cannot escape via the route of entry. This leads to increased pressure in the pleural space, resulting in lung collapse. The increase in pressure also compresses the heart and vena cavae, which impairs circulation. Pericardial tamponade - Answer-filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart. Stages of shock - Answer-1. Compensatory Shock 2. Decompensatory Shock 3. Irreversible Stage If patient been in cardiac arrest for more than 5 min and no CPR has been done what do you do - Answer-Provide 2 min of CPR before ard aed shock then pulse check? - Answer-No aed shock then 2min CPR then pulse check V-fib - Answer-completely erratic rhythm with no identifiable waves; fatal V-tach - Answer-Ventricular tachycardia (an increased ventricular heart rate). Asystole - Answer-the absence of a heartbeat Pea - Answer-pulseless electrical activity. Heart is doing something but not pumping
Stop ambulance when using aed - Answer-True and shut off engine Can I aed on 1-8 year olds - Answer-Yes but prefer to use less electrical dose If u can't it is ok How many shocks can I give - Answer-2-3 with CPR in-between Common diseases from wheezing - Answer-Asthma Emphysema Chronic bronchitis Common diseases from rhonchi - Answer-Aspiration Pneumonia Emphysema Chronic bronchitis Common diseases from crackles - Answer-Pneumonia Pulmonary edema Dyspnea - Answer-difficult or labored respiration Apnea - Answer-absence of breathing Hypoxia - Answer-deficient amount of oxygen in tissue cells Respiratory Distress - Answer-Indicates that a patient is breathing but is having trouble doing so. May lead to respiratory arrest. Respiratory Failure - Answer-The reduction of breathing to the point where oxygen intake is not sufficient to support life Respiratory arrest - Answer-When breathing completely stops. COPD - Answer-chronic obstructive pulmonary disease; chronic bronchitis - bronchiole lining inflamed, excess mucus formed; emphysema - walls of alveoli break down; HYPOXIC DRIVE (not in asthma) Emphysema - Answer-obstructive pulmonary disease characterized by overexpansion of the alveoli with air, with destructive changes in their walls resulting in loss of lung elasticity and gas exchange Chronic bronchitis - Answer-obstructive pulmonary disease characterized by excessive production of mucus and chronic inflammatory changes in the bronchi, resulting in a cough with expectoration for at least 3 months of the year for more than 2 consecutive years.
Aortic aneurysm - Answer-congenital or developed weakness in wall of lower lumbar region (aorta), balloons out, anterior abdominal wall pulses, untreatable if ruptures Aortic Dissection - Answer-damage may result in fatal bleeding, dissection is a condition where the inner layer of the wall of the aorta begins to tear; patient may complain of pain in the chest, abdomen or back will exhibit signs of shock CHF - Answer-Congestive Heart Failure failure of the heart to pump blood away from the heart causing accumulation of fluid in the tissues and lungs Cardiac arrest - Answer-The heart and breathing stop suddenly and without warning Neurological deficit - Answer-any deficiency in the nervous system's functioning, typically exhibited as a motor, sensory, or cognitive deficit Stroke - Answer-A medical injury to brain that is not related to truma Ischemic stroke - Answer-the most common kind of stroke Hemorrhagic stroke - Answer-stroke caused by the rupture of a blood vessel in the brain Thrombotic stroke - Answer-type of stroke caused by a blood clot blocking an artery in the brain Embolic stroke - Answer-a type of ischemic stroke that causes a clot to travel to the brain, mostly from the left side of the heart TIA - Answer-transient ischemic attack; temporary interference with the blood supply to the brain Seizure - Answer-sudden, transient disturbances in brain function resulting from abnormal firing of nerve impulses (may or may not be associated with convulsion) Epilepsy - Answer-chronic brain disorder characterized by recurrent seizure activity Status epilepticus - Answer-a condition in which there are continuing attacks of epilepsy without intervals of consciousness Grand mal - Answer-generalized tonic-clonic (it is sudden cry, fall, rigidity, followed by muscle jerking; shallow, irregular breathing; possible loss of bladder or bowel control; usually lasts seconds to minutes, followed by some confusion, a period of sleep (postical lethargy), and then return to full consciousness.
Simple partial seizures - Answer-begins in one area can move, patient aware and conscious, expreience change in taste/smell cause nausea Complex partial seizure - Answer-impairment of consciousness for a few min or less; usually has rhythmic movements of face or extremities Petit mal - Answer-milder form with loss of consciousness for a few seconds. Common in children. May disappear by late adolescence Febrile seizure - Answer-convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body. Syncope - Answer-a sudden, and generally temporary, loss of consciousness and postural tone, due to inadequate flow of oxygenated blood to the brain (fainting) Glucose and sodium bring what with them? - Answer-Water Glycogen - Answer-Storage form of glucose Glucagon - Answer-a hormone secreted by the pancreas Normal glucose - Answer-80- Glucose after meal - Answer-120- Glucose after 8-10hr of no food - Answer-80- Hypoglycemia symptoms - Answer-hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin Hyperglycemia symptoms - Answer-lots of eating, peeing, drinking. blurred vision, fatigue, weight loss Type 1 - Answer-this type of diabetes mellitus is an autoimmune situation. The pancreas produces and releases NO insulin, so no glucose transport. Type 2 - Answer-Diabetes mellitus initially begins with INSULIN RESISTANCE, where the cells are not able to use the insulin properly and pancreas loses its ability to produce adequate quantities of insulin. Where do I put epipen when done - Answer-Sharp object container Acute abdomen - Answer-sudden, sever abdominal pain that is less than 24 hours in duration
What temp and humidity are bad for the body to regulate temp - Answer-90 degrees and 75 humidity Low velocity injuries - Answer-A knife or other impailed object in the body exerts damage to the immediate area of impact and it's underlying structures. The length of the object used is important Medium and high velocity injuries - Answer-Med/High velocity projectiles are from pellets or bullets. The damage caused, depends on the Trajectory and the dissipation of energy. Dissipation of energy is affected by Drag,Profile,Cavitation, & Fragmentation. Primary phase injuries - Answer-Are due to the pressure wave of the blast. Injuries primarly effect the gas-containing organs, such as the lungs, stomach, intestines, inner ears and sinuses. Death may occur from this stage w/o any sign of external injury Cavacation - Answer-Is the cavity that is formed by a pressure way Secondary phase injuires - Answer-Are due to flying debris propelled by the blast They are usually lacerations fracture burns Tertiary phase injuries - Answer-Are due to being throw and then landing on the ground similar to being ejected out of a car A loss of 15% of blood volume is - Answer-Significant and can lead to shock When can I apply a splint on scene - Answer-To extremity fractures only if the patient is stable and there is no life threat Epistaxis - Answer-bleeding from the nose Good indicator of internal blood loss - Answer-Weak pulse the into fast pulse Also no radial pulse body brings blood to core Narrow pulse pressure indicates - Answer-Significant loss of blood Factors that may increase bleeding - Answer-Movement Low body temp clotting less effective Medication anticlotting like aspirin Intravenous fluids Removal of bandages Epidermis - Answer-an outer layer of cells designed to provide protection Dermis - Answer-second layer of skin, holding blood vessels, nerve endings, sweat glands, and hair follicles
Hypodermis - Answer-tissue layer beneath the dermis; contains adipose tissue, a connective tissue that includes fat-storing cells and blood vessels Superficial burn - Answer-a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn. Also called a first-degree burn. Partial thickness burn - Answer-a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence. (Also called second-degree burn). Full thickness burn - Answer-a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third-degree burn. Rule of nines - Answer-A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burn are, a method of estimating the extent of a burn. For an adult, each of the following surfaces represents 9% of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region. For an infant or child the percentages are modified so that 18% is assigned to the head, 14% to each lower extremity. Acetabulum - Answer-the cup-shaped hollow in the hipbone into which the head of the femur fits to form a ball-and-socket joint What are two critical fractures - Answer-Femur and pelvis Subdural hematoma - Answer-pertaining to below the dura mater, tumor of blood Epidural hematoma - Answer-temporoparietal skull fracture; tear middle meningeal artery Secondary assessment for trauma major injury - Answer-Rapid trauma assessment Vitals Sample Secondary assessment for trauma minor injury - Answer-Focused on injury Vitals Sample Then detailed exam in the back of truck Secondary assessment for medical unresponsive - Answer-Rapid trauma assessment
Body wide vessel dilation Example of obstructive shock - Answer-Pulmonary edema Blood can't move forward Pericardial tamponade Tension pneumothorax Both put pressure on Herat and can't fill appropriately Example of cardiogenic shock - Answer-Heart attack Congenital heart failure Abnormal rhythm Beta blockers Bloody show - Answer-the pink-tinged secretions that follow the loss of the mucous plug b/c of exposed cervical capillaries. this is a sign that labor will begin within 24- hours. Umbilical cord blood vessels - Answer-Unique cause they do opposite Veins bring oxygen blood Arteries bring deoxygenated blood Red blood cell - Answer-erythrocyte White blood cell - Answer-blood cell that functions in defending the body against infections and cancer cells; also called a leukocyte Antepartum - Answer-occurring or existing before birth What should I do with someone had a spontaneous abortio. - Answer-Transport because there is lots of blood that may be lost Placenta previa - Answer-pregnancy in which the placenta is implanted in the lower part of the uterus (instead of the upper part) What is a sign of placenta previa - Answer-Bleeding but no pain Ruptured uterus sign - Answer-Searing or tearing feeling in abdomen Ectopic pregnancy - Answer-pregnancy resulting from gestation elsewhere than in the uterus Eclampsia - Answer-a toxic condition characterized by convulsions and possibly coma during or immediately after pregnancy
Preeclampsia - Answer-abnormal state of pregnancy characterized by hypertension and fluid retention and albuminuria Supine hypertensive syndrome - Answer-Pressure on the vena cava by baby when mother is in supine position Gravida - Answer-the number of the pregnancy that a woman is in Para - Answer-(obstetrics) the number of live-born children a woman has delivered Three stages of labor - Answer-1) dilation 2) expulsion 3) placenta Dilation stage - Answer-first stage of labor; the uterine muscle contracts strongly to expel the fetus; the fetus presses on the cervix and causes it to dilate or expand Expulsion stage - Answer-When the baby is expelled from its mother's body Placenta stage - Answer-placenta is expelled-afterbirth Perineum - Answer-the general region between the anus and the genital organs Nuchal cord - Answer-Umbilical cord around the neck; assess by as soon s the head is out of the vagina, run index finger around the neck; if unable to stretch over the babies head, clamp cord 2" apart and cut, then deliver as normal.
