NREMT Paramedic Study Guide Exam Containing 837 Questions with Definitive Solutions 2024-2, Exams of Nursing

Download NREMT Paramedic Study Guide Exam Containing 837 Questions with Definitive Solutions 2024-2 and more Exams Nursing in PDF only on Docsity! NREMT Paramedic NREMT Paramedic Study Guide Exam Containing 837 Questions with Definitive Solutions 2024-2025. what is HHNK? - Answer: Hyperglycemic Hyperosmolar Non-ketosis coma, complication of DM Type 2. S&S of DKA but no fruity breath or kussmauls breathing. what are the two types of immunity? - Answer: natural and acquired NREMT Paramedic what type of reaction is an allergic reaction? what type of protein is the antibody? *High pt* - Answer: antigen-antibody reaction. IgE immunoglobulins When histamine is released, what is the effect on the body? - Answer: vasodilator, increases capillary permeability, bronchoconstriction what is S&S of anaphylactic reaction? - Answer: wheezing, stridor, urticaria, itching, angioedema, laryngeal edema, increase HR, decrease BP What is angioedema? - Answer: swelling of the tongue, lips, and eyes treatment for allergic reaction? - Answer: airway, o2, bronchodilator(albuterol), antihistamines (Benadryl), epi 1:1 IM, IV fluids, vasopressors, corticosteroids, magnesium sulfate why do patients go into anaphylactic shock? - Answer: due to 3rd space fluid loss and vasodilation Most common cause of anaphylactic shock - Answer: penicillin injection and Hymenoptera stings (like a bee) what is an anaphylactoid reaction? - Answer: same clinical effects as anaphylaxis but *NOT IgE mediated*... more common in *Pts taking beta blockers* or NSAIDS, exercise NREMT Paramedic Mumps virus - Answer: viral infection that affects salivary gland Measles virus - Answer: high contagious viral infection that causes red rash Rubella virus - Answer: German measles. when rash appears, lasts about 3 days Pertussis (whooping cough) - Answer: An airborne bacterial infection that affects mostly children younger than 6 years. Patients will be feverish and exhibit a "whoop" sound on inspiration after a coughing attack; highly contagious through droplet infection. Influenza virus - Answer: flu; highly contagious viral infection mononucleosis - Answer: infectious disease marked by increased numbers of mononuclear leukocytes and enlarged cervical lymph nodes herpes simplex I - Answer: Recurring viral infection that often presents as a fever blister or cold sore. most common STDs - Answer: #1 chlamydia #2 gonorrhea what is a common way to get chlamydia in elder patients? - Answer: nursing home NREMT Paramedic S&S of gonorrhea in men - Answer: pain when urination and discharged from penis S&S of gonorrhea in women - Answer: fever, vaginal discharge, PID Syphilis - Answer: Syphilis causes sores on your genitals (called chancres). The sores are usually painless, but they can easily spread the infection to other people Scabies - Answer: Scabies is not an infection, but an infestation. Tiny mites called Sarcoptes scabiei set up shop in the outer layers of human skin. The skin does not take kindly to the invasion. As the mites burrow and lay eggs inside the skin, the infestation leads to relentless itching and an angry rash. what is salmonella bacterium, salmonellosis, staphylococcus? - Answer: a common bacterial disease that affects the intestinal tract. Salmonella bacteria typically live in animal and human intestines and are shed through feces. Humans become infected most frequently through contaminated water or food. s/s of salmonella - Answer: nausea, vomiting, abdominal pain, diarrhea, fever, weakness, symptoms with a few hours or days what is botulism- clostridium bacteria? - Answer: The viral toxin causes paralysis. Paralysis starts in the face and spreads to the limbs. If it reaches the breathing muscles, respiratory failure can result. spread through contaminated food and water. NREMT Paramedic S&S of botulism? - Answer: blurred vision, difficulty speaking, walking, numbness, paralysis, respiratory paralysis, death, onset 1-4 days after ingestion septic shock - Answer: due to overwhelming infection S&S of septic shock - Answer: high or low temp, tachycardia, tachypnea, AMS, hypotension, decreased urine output treatment for septic shock - Answer: o2, fluids, dopamine, antibiotic in the hospital Cause on tetanus - Answer: puncture wound or contaminated street drugs S&S of tetanus - Answer: painful muscle contractions, rigidity of neck, face and jaw, hydrophobia, and drooling management of tetanus - Answer: supportive care, airway, ventilation, tetanus immune globulin(in hospital), tetanus booster every 10 years. cause of Rabies - Answer: bit from infected animal S&S of rabies - Answer: fever, chills, malaise, neurological signs-hydrophobia, seizures, bizarre behavior, paralysis, coma NREMT Paramedic Name 4 anxiety disorders - Answer: panic, anxiety, PTSD, phobias schizophrenic - Answer: may be lucid and then delusional what is delusion - Answer: false belief such as delusions of grandeur or paranoia what is hallucinations? - Answer: sensation that appear real- seeing things, hearing voices, etc. agitated delirium - Answer: acts bizarre, agitated, paranoid, does not feel pain, has exceptional strength, hyperthermia what causes agitated delirium? - Answer: stimulant drugs- cocaine, PCP, meth, alcohol Management: Agitated Delirium - Answer: law enforcement present, try to calm patient, restrain(if necessary), be prepared for respiratory or cardiac arrest. violent patients - Answer: restrain (if necessary), move fast, prefer 4-5 people. restrain on back or side, one arm above head, one at side and ankles together. check circulation frequently, protect airway and breathing. do not remove unless no circulation or need access. NREMT Paramedic 4 ways drugs can enter the body - Answer: inhalation, ingestion, injection, absorption narcotic. examples, S&S, treatment - Answer: examples- opium-heroin, fentanyl, morphine, codeine, etc. S&S- respiratory and central nervous system depression, decrease reparations and level of consciousness, small pupils. Treatment- protect airway, suction, BVM if low respirations, naloxone. Stimulants- examples, S&S, treatment - Answer: examples- meth, cocaine. S&S- dilated pupils, increased HR and RR and BP, agitated/restless, seizures, v-fib. Treatment- seizures treatment, Benzes, EKG, IV Cannabis- examples, S&S, treatment - Answer: marijuana. S&S- drowsy, short term memory impairment, paranoia, hallucinations. Treatments- emotional support, transport, may have mixed drugs. blood pressure formula - Answer: BP=cardiac output x peripheral/systemic vascular resistance what is pulse pressure? does it narrow or widen in shock and increased intracranial pressure? - Answer: difference between systolic and diastolic pressure. Narrows shock and widens in increased ICP. NREMT Paramedic what is orthostatic vital signs? what type of change suggests hypovolemia? - Answer: when supine, sitting, and standing your vitals change. hypovolemia- decrease in systolic, increase in diastolic, and increase in HR. MAP? normal range? how to calculate ? - Answer: mean arterial pressure. Add diastolic + 1/3 of pulse pressure. normal range between 70-110 mmHg what do you do when you reass a patient? - Answer: identify change in condition, treatments, and vitals. repeat primary, vitals, and check chief complaints how often do you reass a stable vs unstable pt? - Answer: stable- 15 min and unstable - 5 min physical and mental changes of aging in the central nervous system - Answer: atrophy of brain tissue, memory loss, delayed verbal response, decrease in vision, hearing, and pain response, can mask an MI (silent MI) changes of aging in integumentary system - Answer: difficult adjusting body temp to enviornment( hypo and hyperthermia) changes of aging in the musculokeletal system - Answer: atrophy of the muscles what is the medical term for degenerative loss of bone - Answer: osteoporosis NREMT Paramedic pulse ox. what does it read? normal range? limitations? - Answer: normal 95%- 100%. noninvasive measurement of 02 saturation of hemoglobin molecule. Limitations hypo perfusion, dehydrated, cold, vasopressors, anemia, CO, nail polish, methemoglobinemia, cyanide poisoning alcohol- examples, S&S, treatment. what age group is common in? - Answer: common in the elderly. S&S CNS changes- agitation to unconscious, decrease in RR, nausea and vomiting, altered coordination, ascites, muscle wasting. Treatment- protect airway, suction as needed, protect from injury, delirium tremens(tremors, severe sweating hallucinations, seizure(treat as needed). Alcoholism is common in the elderly. what is ascites? - Answer: accumulation of fluid in the peritoneal cavity(abdominal). due to liver damage. sedatives and hyponotics/barbiturates- examples, S&S, treatment - Answer: examples- sleeping pills. S&S-respiratory depression, decrease in loss of consciousness (may be suicide attempt, possible mixed medication overdose) treatment- airway, BVM, suction as needed, prepare for vomiting. hallucinogens- examples, S&S, treatment - Answer: examples- PCP, LSD, Angel dust, mushrooms. S&S- behavioral changes, paranoid, could be danger to self/others, increase BP and HR. treatment- emotional support, watch carefully, do not leave alone, law enforcement. NREMT Paramedic huffing agents-examples, S&S, treatment - Answer: examples- spray paint, markers, etc. S&S- seizures, psychosis, cadiovascular collapse. Treatment- airway and ventilation, seizure and cardiac drugs as needed. Tricyclic antidepressants *high point* OD and exposures. examples, S&S, and treatment. - Answer: examples- mellaril, tofranil, elavil(amitriptyline). S&S- dry mouth, blurred vision, hyperthermia, AMS, seizure, EKG changes due to blockage of Na channels-wide QRS, heart block, tornados, v-tach. Treatment- sodium bicarb. Salicylates *high point* OD and exposures. examples, S&S, and treatment. - Answer: examples- aspirin, S&S- metabolic acidosis, respiratory alkalosis, hyperventilation, tachycardia, fever, sweating, ring in the ears(tinnitus). Treatment- large amounts of IV fluids, may need dialysis. Organophasphate *high point* OD and exposures. examples, S&S, and treatment. - Answer: examples- pesticides, and WMD(weapons of mass destruction). S&S- SLUDGE, constricted pupils(miosis), bradycardia. treatment- scene safety, large doses of atropine. what is SLUDGE? - Answer: Salivation Lacrimation Urinary Diarrhea Gastrointestinal symptoms NREMT Paramedic Emesis What is miosis? - Answer: constriction of the pupil carbon monoxide. OD and exposures. S&S, and treatment. - Answer: S&S- headache, confusion, cyanosis, cherry-red lips. treatment- scene safety, remove from source, high flow o2, CO monitor, hyperbaric. chemicals OD and exposures. examples, S&S, and treatment. - Answer: examples- acid and alkali. S&S- skin burns, drooling, difficulty talking or swallowing, SOB, shock. treatment- scene safety, flush with water if on skin, transport rapidly, NPO. Hydrocarbons OD and exposures. examples, S&S, and treatment. - Answer: examples- propane, natural gas. S&S- skin burns, wheezing, and dyspnea, AMS. treatment- flush if on skin, NPO, rapid transport. poisonous plant examples (4) - Answer: china berry, foxglove, mistletoe, dieffenbachia. Difficult to ID if not familiar with it. *high point* Tylenol/acetaminophen antidote? - Answer: treated in hospital with N-acetylcyyteine, Mucomyst *high point* Cyanide antidote? - Answer: amyl nitrate, sodium nitrite, sodium thiosulfate NREMT Paramedic circulation changes, deformity, airway compromise, visual or hearing changes. treatment- airway, ventilation, suction, bandage/patch, control bleeding, transport considerations. what is epistaxis? - Answer: nose bleed what is otitis externa? - Answer: external ear infection what is otitis media? - Answer: middle ear infection what is Ludwig's angina? - Answer: oral bacterial cellulitis under tongue on floor of mouth gynecology anatomy - Answer: uterus, fundus (top of uterus), cervix(inferior portion of uterus), Fallopian tubes, ovaries, external genitalia, perineum(area between vagina and rectum. Menstrual cycle. what is the proliferative phase? - Answer: first two weeks of cycle, increase estrogen, causes endometrium to thicken and become engorged with blood. menstrual cycle. what is the secretory phase? - Answer: 2nd phase. time surrounding ovulation NREMT Paramedic menstrual cycle. what is the ischemic phase? - Answer: 3rd phase. if fertilization docent occur, estrogen and progesterone decrease. What is the role of estrogen? - Answer: Estrogen is also produced by fat cells and the adrenal gland. At the onset of puberty, estrogen plays a role in the development of so-called female secondary sex characteristics, such as breasts, wider hips, pubic hair and armpit hair. it is involved with female reproduction. what is the role of progesterone? - Answer: mainly to regulate the condition of the inner lining (endometrium) of the uterus. Progesterone is produced by the ovaries, placenta, and adrenal glands. also to help with a good pregnancy. What is menarche? - Answer: first menstrual cycle, onset of menses What is menopause? - Answer: ending of menses, irregular bleeding treatment for vaginal bleeding? - Answer: POC, O2 if necessary, IV fluids, NPO what is PID? S&S? - Answer: pelvic inflammatory disease. most common cause of gonerrhea. S&S- pain in both lower quadrants, fever, foul selling discharge, fever. What is mittelschmerz? - Answer: abdominal pain caused by ovulation what is endometriosis ? - Answer: Growth of endometrial tissue outside of uterus NREMT Paramedic What is ovarian torsion? - Answer: Twisting of the ovarian artery, which reduces the blood flow to the ovary. what is ovarian cyst? - Answer: a sac within the surface of the ovary what is bartholin's abscess? - Answer: A fluid-filled swelling (cyst) in the Bartholin's glands, which lubricate the vagina. sexual assault. treatment and responsibilities? - Answer: treat any injuries/ provide psychological support. do not clean wounds. preserve evidence in brown paper bags for each item of clothing. May be best to have same sex medic treat patient. S&S of pregnancy? - Answer: increased urination, abdomen and breasts enlarge, nausea and vomiting what is amenorrhea? - Answer: absence of menstruation what is AB mean? - Answer: number of abortions or miscarriages what is bloody show? - Answer: blood-tinged mucus plug from cervix, occurs during cervical dilation. what is cephalic delivery? - Answer: head first NREMT Paramedic late pregnancy emergencies 3rd trimester - Answer: abrupt placenta- tearing away of placenta from wall of uterus, vaginal bleeding- dark red and abdominal pain(tearing pain). may be caused by trauma- deceleration injury. placenta previa- placenta implanted completely or partially over cervical opening. vaginal bleeding- bright red and no abdominal pain. ruptured uterus- labor, history of c-section, tearing pain, shock treatment of late pregnancy emergencies - Answer: left side, high flow O2, high priority transport, fluids. CO monitor. how does it bind?effects of CO? limitations? normal range? smokers normal range? treatment normal range? - Answer: CO binds to hemoglobin to form carboxyhemoglobin. effects of CO- CNS depression, headache, dizziness, confusion, seizures, coma, cardiac ishemia limitations- pulso ox, hypo perfusion normal range- <5% smokers normal range- up to 8% treatment range- exceed 10-12% NREMT Paramedic supine hypotensive syndrome in pregnancy. what occurs? S&S? treatment? - Answer: SHS- is pressure on the vena cava which causes decreased blood return to heart. S&S-syncope, dizzy, hypotensive. treatment- left side even if on a backboard. does domestic abuse increase or decrease during pregnancy? - Answer: increase what is the effect of drug abuse during pregnancy? - Answer: affect growth and development of fetus , also can affect baby on delivery. When is preterm labor? - Answer: before 38th week of gestation during preterm labor what meds do you use to stop contractions? (not prehospital treatment) - Answer: terbutaline/brethine what is the reason for premature rupture of membrane? - Answer: possibility of infection of uterus and fetal death hypertensive syndrome of pregnancy. what trimester does this occur? S&S? treatment? - Answer: AKA toxemia- preeclampsia. preeclampsia before seizures and eclampsia after seizure. occurs during the 3rd trimester. S&S- hypertension, swelling, epigastric pain, hyper reflexes, protein in urine. treatment- mag first if seizing then valium if continued seizing. NREMT Paramedic Gestational diabetes. when does it occur? treatment? - Answer: occurs only during pregnancy. must be on insulin during pregnancy. What is hyperemesis gravidarum? - Answer: excessive vomiting during pregnancy what is Rh- to Rh+? when does it usually occur? - Answer: mother produces antibodies which attack baby's RBCs. usually occurs in future pregnancies if mother did not get Rhlg-RhoGam. Stages of labor. - Answer: 1st- start of labor to complete dilation 2nd- delivery of baby-expulsion 3rd- delivery of placenta delivery procedures - Answer: 1-PPE- gown, googles, mask, sterile gloves(OB kit) 2- provide privacy 3-O2 for mother as needed 4-position on back with knees and hips flexed, butt raised 5- place towels from kit under butt, below vagina opening, and on abdomen 6- control head with gentle pressure and place other hand over perineum to prevent explosive delivery 7- support head as it comes out of vagina 8-check for umbilical cord around neck(if around neck, try to slip off and if not clamp and cut) 9- guide head downward to allow upper shoulder to deliver 10- guide babes body upward to allow delivery to lower shoulder NREMT Paramedic premature birth. description? treatment? - Answer: description- lss than 5 lbs or before 38 weeks. treatment- prone to hypoxia and hypothermia. dry completely, assess breathing carefully. prolapsed cord. description? treatment? *high point* - Answer: description- cord protruding through vagina, pressure on cord cuts off babys circulation treatment- place mother in knee-chest position, sterile glove hand in vagina and raise presenting part off cord, do not push cord back, keep cord moist(wrap in sterile saline soaked towel) pulmonary embolus. description? treatment? *high point* - Answer: description- during or right after delivery(can even be up to 2 weeks after delivery) SOB, chest pain treatment- O2, treat for shock. A in APGAR - Answer: Appearance. 0-completely blue or pale 1- body pink, extremities blue 2- completely pink P in APGAR - Answer: PULSE / HEART RATE 0 = Absent 1 = <100, Slow and irregular 2 = > 100 NREMT Paramedic G in APGAR - Answer: GRIMACE (response to nasal catheter) 0 = None 1 = Grimace or weak cry 2 = Sneeze, cries, cough A in APGAR - Answer: activity. 0-limp, no movement 1- some flexion 2- active movement R in APGAR - Answer: RESPIRATIONS 0 = Absent 1 = Gasping 2 = Good Crying acrocyanosis - Answer: pink body, blue extremities what does APGAR evaluate? - Answer: evaluates physical condition of newborn and determine if resuscitation needed, performed at 1 and 5 minutes. Maximum and minimum of APGAR? - Answer: max- 10 and min-0 Resuscitation of the newborn - Answer: 1-warm, position, dry, clear airway if needed, stimulate to breathe NREMT Paramedic 2-supplemental oxygen 3-BVM 4-intubate 5-chest compressions 6-medicaitons if bleeding from umbilical cord? - Answer: reclamp proximal and do not remove first clamp when do you start compressions on a newborn? - Answer: after you intubate or if HR is <60 meconium? - Answer: baby poop. if fetal distress, aggressive airway management most common problems with newborns? - Answer: 1-respiratory distress 2-hypothermia if newborn is bradycardia? - Answer: sign of hypoxia, do not use atropine, use oxygen what is the dose for fluid replacement in a newborn? - Answer: 10mL/kg average weight at birth, 6 moths, and 1 year old? - Answer: birth- 7 lbs 6 months- 14 lbs one year- 21 lbs NREMT Paramedic what is law of inertia? - Answer: a body in motion or at rest will remain in motion or at rest unless acted upon by an outside force what is law of conservation of energy? - Answer: energy can not be created or destroyed but can be changed form one form to another. what is kinetic energy law? - Answer: energy an object has while in motion, speed is most important factor kinetic energy formula - Answer: KE= mass(weight) x velocity(speed)^2 divided by 2 what is most impacted on a frontal impact? - Answer: steering wheel and air bag. head, neck, chest two pathways toward the dashboard? - Answer: 1- up and over: head, neck, and chest 2- down and under- knee, femur, hip, pelvis what is impacted on a rear-end collision? - Answer: neck, and back what is hurt on a fall and land on feet? - Answer: fractured calcaneus(heel bone) and lumbar spine injury/fracture what are the four types of blast injury? - Answer: 1-primary phase NREMT Paramedic 2-secondary phase 3-tertiary phase 4-quarternary injuries what occurs in the primary phase? - Answer: pressure waves, hollow and air filled organs affected what occurs in the secondary phase? - Answer: struck by shrapnel what occurs in the tertiary phase? - Answer: injuries due to patient being thrown into air what occurs in the quaternary injury? - Answer: crush, asphyxia, burns, toxic exposure Methemoglobinemia. what is it? what causes it? S&S? - Answer: hemoglobin that is oxidized; O2 can't attach. Causes are- amyl nitrate, benzocaine, nitrates, nitro, nitroprusside, cyanide S&S-color change from gray to cyanotic, CNS change, delirium, death what are cardiac biomarkers? name four. - Answer: CB purpose is to help diagnose cardiac disease. 1-creatine kinase 2-lactic dehydrogenase 3- myoglobin NREMT Paramedic 4-troponin Creatine Kinase (CK). found? causes of elevation? - Answer: found- CK-I: brain and smooth muscle CK-II: heart CK-III: skeletal muscle causes of elevation- 1. increase of CK from IM injection or trauma 2. CK is first enzyme to elevate in an MI Lactic dehydrogenase (LDH or LD). found? causes of elevation? - Answer: found- muscle: heart, skeletal, liver, RBC, kidney causes of elevation- acute MI's, and other organ that produce LDH Myoglobin. found? causes of elevation? - Answer: found- striated muscle causes of elevation: damage to cardiac or skeletal muscle troponin. found? causes of elevation? - Answer: found- cardiac muscle causes of elevation- very specific to cardiac injury name the positive and negative types of electrolytes? - Answer: cation and anion what is a cation? - Answer: A positively charged ion what is an anion? - Answer: A negatively charged ion NREMT Paramedic interstitial? - Answer: around cell fluid replacement for blood? - Answer: fluid of choice for hemorrhage fluid replacement for colloid? - Answer: does not leak out of vessels fast has large particles/ proteins. fluid replacement for crystalloid? - Answer: all other IV solutions i.e NS, LR, 5% DW what is osmosis? - Answer: fluid movement from an area of less particle concentration to an area of greater concentration. no energy what is isotonic? - Answer: stays in blood vessels longer, fluid replacement ie NS or LR what is hypertonic? - Answer: more particles, fluid moves intravascular space ie 10%dexrose what is hypotonic? - Answer: fluid movement out of vascular space into cells, ie 1/2 NS What is 5% Dextrose used for? - Answer: not fluid replacement. used for MI, CHF, giving drugs, KVO NREMT Paramedic what is the job of plasma? - Answer: Transports nutrients, antibodies, enzymes, and hormones to the tissues of the body, gets rid of wastes from tissues. what is RBC and its job? - Answer: erythrocyte. carry hemoglobin which carries O2. iron containing molecule. what % of rBC in whole blood? - Answer: approx. 45% what is WBC? what its job? - Answer: leukocytes. fights infection what are platelets? what its job? - Answer: thrombocytes. promotes clotting. what the universal type of blood? - Answer: O negative What's the universal recipient of blood? - Answer: AB+ S/S of dehydration in adult and infant/children? - Answer: adult- cracked tongue, AMS, dry mucus membranes, decreased urine output, decreased cap refill, flat neck veins, tenting of skin infant/children- sunken fontanels, decreased urine output, no tears, eyes sunken, dry diapers treatment of dehydration in adult/child and infant? - Answer: adult/ children: 20ml/kg infant: 10ml/kg NREMT Paramedic what are shocks due to trauma? name 3 - Answer: hypovolemic, hemorrhagic, or burn shock what is hypo perfusion? - Answer: decrease in delivery of O2 to cells and removal of carbon dioxide and other waste products what is aerobic? - Answer: with O2 what is anaerobic? - Answer: without oxygen what are the three stages of hypovolemic shock? *high point* - Answer: 1- compensatory 2-decompensated 3-irreversible what are S&S of compensatory stage of shock?? *high point* - Answer: able to maintain perfusion, BP is normal fr the patient, anxiety to restless to combative, thirst, weakness, dilated pupils what are S&S of decompensated stage of shock?? *high point* - Answer: low BP(late sign), decreased LOC to unconsciousness, unable to feel pupils what are S&S of irreversible stage of shock?? *high point* - Answer: irreparable damage to vital organs, bradycardia is a terminal sign NREMT Paramedic name the 3 layer of skin. - Answer: epidermis, dermis, subcutaneous what is the epidermis and its job? - Answer: outermost layer, no blood vessels, provides waterproofing, barrier against bacteria what is the dermis and its job? - Answer: connective tissue, sebaceous glands, blood vessels and nerves what is the subcutaneous and its job? - Answer: adipose tissue, conserves body temperature name 3 types of closed injuries - Answer: contusion, hematoma, crush injury what is a contusion? - Answer: bruise, bleeding under the skin what is a hematoma? - Answer: collection of blood outside the blood vessel what is a crush injury? - Answer: injury resulting from a crush how to treat closed injuries? - Answer: use cold and splint if necessary name types of skin open injuries? - Answer: abrasion, laceration, puncture wound, avulsion, amputation NREMT Paramedic what is an abrasion? *high point* - Answer: scraping of the epidermis what is a laceration? *high point* - Answer: sharp object tearing the skin what is a puncture wound? *high point* - Answer: pointed object into the skin What is an avulsion? *high point* - Answer: pulling or tearing away. never remove skin flap, replace flap to anatomical position if possible before dressing what is an amputation? *high point* - Answer: Complete removal of an extremity, moist sterile dressing, plastic bag, place bag on crushed ice( do not freeze), transport part if possible. impaled object. treatment. - Answer: stabilize, only remove in check if airway obstructed, in mid chest and need to do compressions, or interferes with transport complication of a bite? - Answer: infection complications of open soft tissue injuries? - Answer: bleeding, pain, infection name the four types of burns. - Answer: thermal, inhalation, electrical/lighting, and chemical NREMT Paramedic what is a superficial, partial thickness burn? *high point* - Answer: red, painful, not blisters What is a deep partial-thickness burn? *high point* - Answer: red, painful, blisters what is a full thickness burn? *high point* - Answer: black(eschar), yellow, white, no pain, no blisters what percentage is considered a minor burn? - Answer: superficial- <50% partial- <10% what percentage is considered moderate burn? - Answer: superficial- >50% or partial- 10-30% or full<10%, or any partial or full of hands, feet, joints, face or genitalia what percentage is considered critical burn? - Answer: partial >30% or full >10% or inhalation injury Rule of nine Burns (adult) - Answer: head and neck- 9% chest and abdomen- 18% back and buttocks- 18% each arm- 9% each leg- 18% perineum- 1% NREMT Paramedic treatment for electrical and lighting strikes - Answer: scene safety, spinal immobilization, ACLS, burn center name 2 types of chemical burns. - Answer: acid and alkali Chemical burns. acid - Answer: coagulation necrosis and immediate pain chemical burns. alkali. pain or no pain? what does it do to your body? examples? - Answer: liquefaction necrosis. little pain but deep penetrating injury. it is a breakdown or protein and collagen, dehydration of tissues, thrombosis of blood vessels. examples- oven cleaner, fertilizers, dry chemical which burn is worse, acid or alkali? why? - Answer: alkali because it continuously burns treatment of chemical burns - Answer: flush with large amounts of water what to do with dry lime burn? - Answer: brush off first then flush what is to abduct? - Answer: to move away from the body what is to adduct? - Answer: toward the body NREMT Paramedic what is dislocation? - Answer: bone ends are displaced from joint what is flexion? - Answer: angle of joint decreases what is extension? - Answer: angle at joint increases what is a ligament? - Answer: Connects bone to bone what is medical vs lateral? - Answer: position closer to midline of the body vs farther from the body what is proximal vs distal? - Answer: nearer to the center of the body vs further from the center of the body what is a sprain? - Answer: injury to a ligament what is a strain? - Answer: injury to muscle or tendon what is subluxation? - Answer: partial displacement of a bone at a joint what is a tendon? - Answer: connects bone to muscle What is a transverse fracture? - Answer: break straight across the bone What is a greenstick fracture? - Answer: bone breaks incompletely NREMT Paramedic What is a oblique fracture? - Answer: diagonal break of bone What is a spiral fracture? - Answer: a fracture that twists around the shaft of the bone What is a impacted fracture? - Answer: broken bone ends are forced into each other What is a comminuted fracture? - Answer: When the bone is splintered or crushed and has multiple fragments what is epiphyseal fracture? - Answer: fracture at the growth plate in children What is a torus fracture? - Answer: Buckling of the compression side of the cortex of a long bone. Occurs secondary to trauma What are the 6 Ps of fracture assessment? - Answer: 1-pain 2-pallor 3-paresthesia(numbness) 4-paralysis 5-pressure 6-numbness What is paresthesia? - Answer: numbness and tingling NREMT Paramedic causes of compartment syndrome. name 4 - Answer: circumferential burns, tight casts, snake bites, crush injury(most common) treatment for compartment syndrome? - Answer: rapid transport, pain management what is one way a pulmonary embolus caused by in trauma? *high point* - Answer: fat emboli from long bone fracture brain. *high point* name 3 main parts of the brain. - Answer: cerebrum, cerebellum, and brain stem what is the job of the cerebrum? - Answer: The cerebrum is the part of the brain that controls memory, senses, consciousness, and reasoning, intelligence, and personality. along with eyesight in occipital area what is the job of the cerebellum? - Answer: fine motor movement, balance and coordination what is the job of the brain stem? - Answer: AKA medulla oblongata. all vital functions- BP, HR, RR, consciousness where are the meninges? - Answer: covering of the brain and spinal cord- due mater, arachnoid, Pia mater NREMT Paramedic in the peripheral nervous system, what is afferent? - Answer: ascending, sensory nerves bringing messages from the body to the brain. in the peripheral nervous system, what is efferent? - Answer: descending, motor nerves taking messages from the brain to the body. what is the order of the spinal column vertebrae? - Answer: cervical-7, thoracic- 12, lumbar-5, sacrum, coccyx what is common in facial bone fractures? - Answer: airway obstruction name facial bones. - Answer: nasal, maxillae, zygomatic, mandible, lacrimal, palatine, inferior nasal conchae, vomer what is a contraindication of facial bone fractures? - Answer: nasal airways what should you always consider with facial bone fracture? - Answer: c-spine Le Fort Fractures I, II, III *high point* - Answer: I- above the upper teeth but below the nose II- involves above the upper teeth and the nose III- involves above the upper teeth, the nose, the cheeks and the eyes. Neck anatomy - Answer: esophagus, carotid veins and arteries, thyroid and cricoid cartilage, upper part of trachea. NREMT Paramedic what is subcutaneous emphysema? - Answer: crackling under the skin if you have changes in voice, what is injuries? - Answer: larynx if you have difficulty swallowing , what is injured? - Answer: esophagus jugular vein laceration. treatment? - Answer: possible air embolus, occlusive dressing on 4 sides with pressure and position on left side. what is the sclera and its job? - Answer: white outer layer of the eyeball. what is the cornea and its job? - Answer: transparent front part of the eye that covers the iris, pupil, and anterior chamber. what is the pupil and its job? - Answer: hole located in the center of the iris of the eye that allows light to strike the retina what is the iris and its job? - Answer: circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. Eye color is defined by that of the iris what is the aqueous and vitreous humor and its job? - Answer: clear fluid filling the space in the front of the eyeball between the lens and the cornea NREMT Paramedic subdural hematoma. what is it? venous or arteriole? - Answer: bleeding between the dura and arachnoid. usually venous coup/ contracoup. *high point* - Answer: injury to tissues under site of impact and injury to opposite side. front to back or side to side. coup-brain hits the the back of head contracoup- brain hits the from of head what is a cerebral concussion? *high point* - Answer: occurs in brain stem, loss of consciousness then wakes up, no permanent damage what is a cerebral contusion? *high point* - Answer: occurs in cerebrum, patient is awake with focal signs such as difficulty talking or double vision skull fractures. name 4. *high point* - Answer: linear, depressed, open, basilar Linear skull fracture - Answer: Fractured skull without alteration in fragment simple fracture depressed skull fracture. - Answer: Inward indentation of the skull with possible pressure on brain Open skull fracture - Answer: Fracture of the skull with an overlying laceration or open wound NREMT Paramedic basilar skull fracture. - Answer: fracture at the base of the skull. battle's sign and raccoon eyes increasing intracranial pressure. what is normal range? S&S, treatment? *high point* - Answer: normal range- 2-12mmHg early signs- vomiting without nausea, headache, AMS treatment- spinal precautions, ventilate/assist to maintain PO2 of 90 mmHg what is Cushing's response?*high point* - Answer: increase in BP, decrease in pulse, irregular respirations. for ICP. spinal injuries. *high point* S&S? - Answer: S&S-pain, deformity, numbness, paralysis, weakness, Loss of sensation, priapism. what is quadriplegia? - Answer: paralysis of all four limbs what is paraplegia? - Answer: paralysis of lower extremities if C1, C2, C3 injuries, what happens? - Answer: quadriplegia and no breathing if C4, C5, C6, C7 injuries, what happens? - Answer: quadriplegia and yes breathing. where in the vertebra is paraplegia? - Answer: nipple line, T4 or belly button T10 NREMT Paramedic S&S of hypo shock? - Answer: increase HR, decrease/narrows BP, and increase RR S/S of increased intracranial pressure - Answer: decrease HR, increase/widens BP, and irregular RR S&S of neuro shock - Answer: normal or decreased HR, narrows decreased BP, and does not affect RR neurogenic shock. S&S? treatment? - Answer: inability to stimulate sympathetic nervous system, vasodilation. decreased BP but not tachy may be Brady. skin warm, dry, flush below injury but pale, clammy above. treatment- fluids and dopamine spinal shock. S&S - Answer: temporary if cord not seriously injured. flaccid paralysis, loss of feeling below level of injury, loss of bowel and bladder control, temp affected Brown-Sequard Syndrome *high point* - Answer: puncture injury to one side of the cord, ipsilateral hemiplegia and loss of sensation(injuried side), pain and temp perception loss of contralateral(uninjured side) central cord syndrome - Answer: hyperextension of c-spine, weakness or loss of feeling both upper extremities but not lower NREMT Paramedic pleural decompression(for tension pneumo) - Answer: inert just above the third midclavicular or just above the 6th rib midaxillary. over the top of rib because bottom of rib has blood vessels and nerves what happens if the first needle decompression didn't work? - Answer: perform another sucking chest wound. - Answer: impaired gas exchange. pneumo with opening in chest wall and may have bubbling from wound. treatment - occlusive dressing, taped on 3 sides. neck and abdomen tape on all 4 sides traumatic asphyxia - Answer: impaired ventilation. high mortality. -mechanism is crush injury to upper abdomen or lower chest -S&S severe cyanosis especially of face and upper chest, bulging eyes and tongue JVD, chest injuries Cardiac tamponade *high point* mechanisms? - Answer: pressure on heart- cant refill properly, decreased cardiac output), obstructive shock -pt needs paracardial sentisis Beck's triad S&S mechanism- direct blow to chest such as steering wheel or air bag What is Beck's triad? *high point* - Answer: muffled heart sounds, JVD due to increase in venous pressure, hypotension due to decrease in arterial pressure NREMT Paramedic What is pulses paradoxus? *high point* - Answer: decrease in systolic BP during inspiration. narrow pulse pressure commotion cordis *high point*what is it? when is the heart disturbed? - Answer: disruption of rhythm of heart usually due to direct blow to chest in young men, CPR and defib. hit on the t wave and goes into v fib other S&S with chest injuries - Answer: hoarseness, stridor, voice changes, difficulty swallowing, cough assisting with chest tube insertion, managing, and monitoring. - Answer: Chest tube insertion is a common therapeutic procedure used to provide evacuation of abnormal collections of air or fluid from the pleural space. RUQ - Answer: liver, gall bladder, stomach, adrenal gland on right kidney LUQ - Answer: spleen, stomach, liver, pancreas, adrenal gland on left kidney RLQ - Answer: appendix, right ovary and tube, bladder if distended LLQ - Answer: left ovary and tube, bladder if distended NREMT Paramedic what is in all quadrants? - Answer: large and small intestine and kidneys name solid organs *high point* - Answer: blood loss- kidney, liver, spleen, gall bladder, pancreas, adrenal glands name hollow organs *high point* - Answer: stomach, lungs, bowel, bladder S&S of abdominal injury - Answer: pain, guarding, distension, discoloration of abdominal wall, right abdomen- peritonitis but more likely blood from solid organs kidney injury*high point* S&S - Answer: grey turners sign- hematoma in flank, and hematuria what is hematuria? - Answer: blood in the urine evisceration treatment *high point* - Answer: moist sterile saline dressing, keep warm, do not replace organs, IV, tape on 4 sides, tell pt not to cough pelvic fractures - Answer: may have multiple fractures that bleed and can loose large amount of blood into abdominal cavity, damage to underlying structures male and female genitalia injuries treatment - Answer: heart as soft tissue injuries, emotional support NREMT Paramedic frostbite treatment - Answer: remove wet clothing, thaw in warm water less then 106 degrees, do not massage frozen part heat cramps- cause, S&S, treatment? *high point* - Answer: cause-sodium and water loss S&S- abdominal and leg cramps, sweating treatment- move to cool place, oral fluids if not nauseated heat exhaustion- cause, S&S, treatment? *high point* - Answer: cause-sodium and water loss S&S- increase HR, sweating, pale, dizzy, hypotension, temp slightly elevated treatment- cool down, IV of normal saline heat stroke- cause, S&S, treatment? *high point* - Answer: cause- unable to regulate heat, hypothalamus problem S&S- decrease LOC, skin hot, dry, red, very high body temp(105 and above),seizures, death treatment- rapid cooling, protect airway, O2, IV near drowning in salt water *high point* - Answer: pulmonary edema, draws water into the alveoli near drowning in fresh water *high point* - Answer: hemodilution, electrolyte imbalance, fib, washed away surfactant NREMT Paramedic in fresh and salt water near drowning- - Answer: both metabolic and respiratory acidosis, hypoxia, and hypothermia which is better for survival cold or hot water? - Answer: cold water what is happening in the airway of growing pt? - Answer: water or vomitius, breathing-coughing, atonal respirations, respiratory arrest treatment for drowning patient - Answer: consider c-spine, O2, BVM, suction frequently, intubation, all must be transported Diving Accidents - Answer: ascending rapidly associated with most diving injuries decompression sickness - Answer: bubbles formed from expansion of nitrogen in blood and tissue S&S-numbness, paralysis, severe pain, cough, cyanosis, respiratory distress treatment-high flow O2, keep warm, hyperbaric chamber air embolus - Answer: chest pain, blood from nose and mouth, seizures, arrest altitude illnesses *high point* - Answer: rapid ascend to altitudes above 8,000 ft symptoms due to hyperbaric pressure(low atmospheric pressure)- causes hypoxia of CNS and respiratory system NREMT Paramedic hyperventilation causes respiratory alkalosis, and if compensation, metabolic acidosis acute mountain sickness *high point* - Answer: light-headed, dizzy, GI problems, symptoms, weakness respiratory alkalosis high altitude pulmonary edema*high point* - Answer: dyspnea and can get pulmonary edema high altitude cerebral edema *high point* - Answer: changes in mental status and ataxia how to treat altitude sickness - Answer: bring as close to sea level, O2, descent, evacuation, symptomatic treatment, portable hyperbaric chamber if evacuation not possible pit viper bite *high point*S&S, venom, and treatment? - Answer: rattlesnake most common- severe swelling tissue damage, can affect blood and nervous system, pain, N&V, seizures, changes in LOC venom- necrotoxic, severe tissue damage(high point) treatment- mark site of bite and time, no tourniquet, no ice, no elevation, keep at heart level NREMT Paramedic what is orthopnea? - Answer: difficulty breathing when supine what is phrenic nerve? - Answer: innervates the diaphragm what is surfactant? - Answer: lubricant that keeps alveoli from collapsing amount of air in one breath what is tidal volume? - Answer: what is diffusion*high point* - Answer: gas movement from area of greater to and area of lesser concentration O2 diffuses into alveolar capillary CO2 diffuses into alveoli(pulmonary respiration removes CO2) stimulation to breathe *high point* - Answer: -increased in CO2 sensed by chemoreceptors in the brain stem(medulla) -decreased in pH in arterial blood and CSF inspiratory and expiratory process *high point* - Answer: inspiration- diaphragm contracts and moves downward, intercostal muscles contract, chest wall gets larger, pressure inside less and the air moves in pressure equalizes inside and out NREMT Paramedic expiration- diaphragm relaxes and moves upward, intercostals relax, chest wall gets smaller, pressure inside greater and air moves out is expiration active or passive? what about inspiration? - Answer: expiration- passive inspiration- active three ways of airway assessment - Answer: 1-identify inadequate airways 2-identify unstable airway 3-identify potentially difficult airways how to open airway in a trauma patient? - Answer: jaw thrust maneuver for OPA in child, how to insert? - Answer: straight in for OPA in adult, how to insert? - Answer: 180 degree turn how to size OPA? - Answer: earlobe to side of mouth how to size NPA? - Answer: earlobe to tip of nostril suctioning. hard or rigid tip - Answer: don't touch back of airway, can cause gauge reflex, insert the tip as far as I can see NREMT Paramedic soft(French) how to measure? - Answer: from tip of nose to tip of ear or corner of mouth to tip of ear how long do you suction? children and adults? - Answer: no longer then 10 seconds then ventilate for 2 min then repeat in kids- 5 seconds -ONLY ON THE WAY OUT -IF STILL HAS SECRETIONS AFTER 10 SECONDS CONTINUE SUCTIONING TIP FOR QUESTION ON SUCTIONING - Answer: look for suction when necessary, gurgling sound indicates need to suction complications of suctioning - Answer: hypoxia, bleeding, dysrhythmias when suctioning a neonate.. - Answer: bradycardia complication if rough in back of throat. only when needed. anticipations on difficult airways. - Answer: trauma bleeding in airway mouth opening mallampati classifications obstructions neck mobility facial hair NREMT Paramedic -use of accessory muscles, increase effort, dyspnea, retractions, abnormal sounds -skin pale or cyanotic, cold and clammy, agonal respiration, nasal flaring, AMS, restless and anxious artificial ventilation devices-BVM and if ET missed what happens? - Answer: - BVM: compliance stiffness/flexibility of lungs- decrease of compliance -if ET missed: pneumothorax, tension pneumothorax, and pulmonary edema If no chest rise, what to do next? - Answer: reposition, if still no chest rise then may have an airway obstruction gastric distention - Answer: inflation of the stomach with air, may vomit PEEP. - Answer: positive end expiratory pressure. increase of air pressure in air passages near the end of expiration. increase amount of air remains in lungs following expiration. BiPAP - Answer: bilevel positive airway pressure. noninvasive airway pressure CPAP - Answer: continuous positive airway pressure. -must be breathing and conscious to use. -remove CPAP and use BVM if breathing stops NREMT Paramedic Automatic transport ventilator - Answer: A device that provides positive pressure ventilations. It includes settings designed to adjust ventilation rate and volume, is portable, and is easily carried on an ambulance. -must have BVM available -can interfere with timing of chest compressions -can cause lung damage due to pressure Oxygen delivery devices - Answer: nasal cannula- flow 1 to 6L/min, 24-44% O2 nonrebreathing mask- flow 10-15L/min, up to 90% O2 bag-mask w/reservoir- flow 15L/min, nearly 100% O2 mouth-to-mask device-flow 15L/min, nearly 55% O2 what is humidified O2 good for? - Answer: helps reduce drying of mucous membranes- asthma patients Ventri mask is good for pts with - Answer: COPD. Chronic lung disease because it delivers a more precise oxygen concentration tracheostomy *high point value* - Answer: breathe through hole/tube in anterior neck -do not perform head- tilt chin lift or jaw thrust maneuver -prone to obstruction due to mucus build up, suction carefully so swelling does not occur. -use face mask over tach site if oxygen needed and specific trach mask not available NREMT Paramedic -peds trach/stoma - use infant or child mask BVM over stoma if ventilation required. Laryngectomy - Answer: surgical removal of larynx -if partial removal, seal nose and mouth to prevent back flow of air when ventilations stoma- release during expiration. anatomical differences of pediatric airway. name 6. - Answer: -mouth and nose are smaller, easily obstructed -tongue larger- takes up more space in airway -use diaphragm to breath, abdomen rises, less chest rise -trachea narrow and flexible, don't hyperextend head, can close off airway -occiput(back of head) large, pad shoulders to eep airway aligned -smallest part of pediatric airway is cricoid ring how to measure for ET tube in pediatric. name 3 ways *high point* - Answer: - measure by fingernail of pinky finger of child -use broselow tape(length based tape) -or formula age+ 16 / 4 what age do you use an uncured tube until? - Answer: 8 years old if pt has less oxygen reserves and higher metabolic rate? - Answer: hypoxic faster what is the most common cause of cardiac arrest in pediatrics? - Answer: hypoxia NREMT Paramedic what makes patients breathe when O2 decrease? - Answer: hypoxic drive treatment for COPD - Answer: aimed at treating hypoxia -O2, high flow if respiratory distress, otherwise NC or Venturi mask, bronchodilator Asthma S&S? - Answer: SOB, expiratory wheezing -first, then inspiratory and expiratory, silent chest -humidifed O2, bronchodilator epi, mag sulfate ENSEMF Pneumonia S&S? more common in? - Answer: infection in lungs, bacterial, viral, fungal -SOB, high fever, chills, tachypnea, dyspnea, productive cough-yellow or green, crackles or ronchi, sick for several days -more common in elderly and children viral respiratory infections S&S - Answer: sneezing, sore throat, yellow or green sputum, fever- use mask on you and/or the patient pulmonary embolus S&S, EKG, Predisposed factors? - Answer: shock, respiratory distress, sudden onset, pleuritic chest pain- more on inspiration, JVD, cyanotic from nipple line up -EKG changes- S wave in lead 1, Q wave in III, 20% of PEs have inverted T in lead III NREMT Paramedic -predisposed- post surgery, deep vein thrombosis, cellulitis of the leg, bed ridden, during or post delivery, long bone fracture, long plane ride hyperventilation - Answer: -respiratory alkalosis due to hypocarbia, carpal/pedal spasm -if due to emotional event, slow breathing down, does not need O2 general treatment for respiratory emergencies? - Answer: position, O2, pulse ox foreign body aspiration - Answer: partial obstruction upper airway-stridor -unilateral wheezing: foreign body in lower airway upper airway stridor (pediatrics) CROUP S&S? what age? - Answer: laryngotracheobronchitis -slow onset, usually under 4y/o -viral, not a high fever, seal barking cough, epi, do not lay flat, humidified O2, keep calm Epiglottitis S&S? age? - Answer: inflammation of epiglottis. -rapid onset, 4-6 years old -bacteria, high fever, tripod position, drooling -do not put anything in mouth, can stimulate laryngospasm, transport in position of comfort bacterial tracheitis - Answer: similar to croup but due to bacteria not viral NREMT Paramedic lower airway- wheezing. name 3. AGE? - Answer: bronchiolitis - under age of 1 y/o, viral -asthma- over age of 1 -pertussis(whooping cough) in tennis shot, highly contagious, whooping sound when coughing cystic fibrosis - Answer: genetic, thick mucus which can cause life threatening infections. ventilations: increase tidal volume valves and blood vessels on the right side of the heart - Answer: tricuspid and pulmonary valves and blood vessels on the left side of the heart - Answer: bicuspid or mitral and aortic layers of heart - Answer: endocardium, myocardium, epicardium/pericardium coronary arteries on left and right side - Answer: left- LAD, circumflex right-right posterior, marginal electrical conduction of the heart. SA, AV, purkinjie fibers? normal firing rates. - Answer: SA node, primary pacemaker, 60-100 AV node/ bundle of his, 40-60 purkinjie fibers, below 40 NREMT Paramedic What is Grey Turner's? - Answer: - Bruising over the flanks Indicates possible hemorrhagic pancreatitis What is Cullen's sign? - Answer: Blue discoloration over the umbilicus What is Rovsing's sign? - Answer: Pain over the RLQ in appendicitis What is Murphy's sign? - Answer: Deep palpation under the ribs What do you do if jaw-thrust doesn't open airway? - Answer: Head tilt-chin-lift Penetration injury in the chest which will cause living to be harmed? - Answer: Visceral pleura to the lungs & parietal pleura to the inner chest wall What type of stroke is caused by: chronic hypertension Atherosclerosis? - Answer: CH: Hemorrhagic A: occlusive ie. emboli or thrombi Stages of death - Answer: Depression Anger Bargaining Denial Acceptance NREMT Paramedic Percussion sounds of the thoracic cavity? - Answer: hyper-resonant (Like a drum) = air dull sound = blood How to find a positive tilt test? - Answer: pts. hydration status. 20/10/20 systolic BP 20 Pulse of 20 Diastolic BP by 10 When do you use fibrinolytic in a stroke pt? what are the side effect(s)? - Answer: Only if within 3 hours of when symptoms started. side effects include bleeding NOT admin in the field, need CT scan first What is a seizure? - Answer: Electrical disruption in the brain Alpha Beta Consumer Dilate Beta 1? Beta 2? - Answer: Beta 1 - cardiac Beta 2 - respiratory vasodilation bronchoconstriction NREMT Paramedic What is a stroke or TIA? - Answer: Stroke or transient ischemic attack - caused by blood clot thrombosis - or IV particles or clot that moves (embolus) - or cerebral bleed TIA symptoms resolve after hours grand mal seizure What are the types of seizures? - Answer: Generalized seizure * Aura(perception or sensation prior to seizure) - loss of consciousness > tonic (stiffening) *Postictal (altered state of consciousness) *Clonic (contracting & relaxing of muscles) Treatment of seizure? - Answer: Protect pt, suction or Oz, glucose, position, Benzo -diazepam -valium (no nasal, rectal, IV, IM) -ativan lorazepam (no rectal) -midazolam(versed)(no rectal), IV, IM, IN NREMT Paramedic What is syncope, and what is the treatment? - Answer: Brief period of unconsciousness due to lack of blood supply to the brain Treatment- lay them supine, BGL, IV, O2, 12 lead Causes of syncope? - Answer: Cardiac dysrhythmias, stroke, hypoglycemia, hypoxia, vasovagal, emotional reaction to stress situation CNS Neoplasm - Answer: Brain & spinal cord tumor - weakness or paralysis or change in sensation of one or more limbs or side or face S & S: dizzy, diplopia (double vision), signs similar to stoke Neurological Disorders Muscular Sclerosis; what is it? S&S? *High pts* - Answer: -Inflammation of nerve cells followed by demyelination (loss of myelin sheaths), inhibits nerve impulses, progressive disease S&S: diplopia, nystagmus( involuntary movement of eyes usually side to side), weakness, impaired coordination, speech difficulty Guillain-Barre syndrome - Answer: -Inflammation & destruction of myelin sheath NREMT Paramedic - viral - can be fatal if diaphragm involved - usually recovers within several months Parkinson's disease. * High pts* - Answer: -Chronic & progressive disorder - impaired voluntary movements, tremors, rigidity, impaired coordination What is Delirium? *High pts* - Answer: Sudden state of confusion which is reversible *drugs or alcohol What is Dementia *High pts* - Answer: Chronic deterioration of memory, reasoning, judgment - usually not reversible ie. Alzheimer's Alzheimer's disease what is the cause and S&S? *High pts* - Answer: Cause- neurons die, buildup or plague in brain S&S- memory loss, confusion, can be aggressive & violent; eventually can't communicate & requires complete care. NREMT Paramedic V1 and V2. where is it looking and what artery? - Answer: septal (anterior)- LAD V3 and V4. where is it looking and what artery? - Answer: anterior LAD I, AVL, V5, and V6. where is it looking and what artery? - Answer: lateral wall and circumflex II, III, AVF. where is it looking and what artery? - Answer: inferior wall(right vertical primarily) and right coronary artery V3, V4, V5, V6. what wall is it looking at? - Answer: anterior lateral if elevation in V2-V4, what artery? - Answer: LAD what are the 5 H's ? - Answer: -hypovolemia -hypothermia -hypoxia -hydrogen ion acidosis -hyper, hypokalemia what are the 5 T's? - Answer: thrombus pulmonary -thrombus cardiac -tension pneumo -cardiac tamponade