PANB EXAM PREP EXAM | 597 QUESTIONS LATEST UPDATE 2024/2025 WITH 100% DETAILED VERIFIED, Exams of Health sciences

Download PANB EXAM PREP EXAM | 597 QUESTIONS LATEST UPDATE 2024/2025 WITH 100% DETAILED VERIFIED and more Exams Health sciences in PDF only on Docsity!

PANB EXAM PREP EXAM | 597

QUESTIONS LATEST UPDATE 2024/

WITH 100% DETAILED VERIFIED

ANSWERS

Identify approved drugs for IO medication administration: Any medication that can be given IV can go IO Evaluate medical conditions and indications for sublingual medication administration: Rapid absorption of meds with systemic delivery - Nitro for cardiac pts List approved drugs that can be administered via sublingual: Nitroglycerine, Ativan, etc Discuss the benefit of sublingual medication administration: Absorbed very rapidly into the system and directly into the bloodstream without going through the digestive system Explain how to administer S/L medications: Tongue to roof of mouth, sprayed or placed under tongue for absorption Evaluate medical conditions and indications for buccal administration: Diabetics/oral glucose admin List approved drugs for buccal administration: Oral glucose Explain the benefit to buccal medication administration: Good for admin of hormones and enzymes

Identify medical conditions and indications for topical administration of a medication: Cardiac patients someone who needs an approved topical medication applied Identify approved drugs that can be administered topically: Polysporin, polymyxin, Nitro, Nicotine, Fentanyl Evaluate medical conditions and indications for oral med admin: Cardiac issue, pain, fever, indications: patient must be able to swallow and vomit and able to maintain own airway List approved drugs that can be administered orally: ASA, Acetaminophen, activated charcoal, capoten, etc Explain the benefit to oral med admin: Longer lasting affect able to admin many types of meds List medical conditions and indications for rectal administration of a medication: Unconscious, vomiting, patients who cannot cooperate with oral or IV admin List approved drugs to be administered rectal: Diazepam, Tylenol, Kexelate Evaluate medical conditions and indications for inhalations administration of a medication: Respiratory disease, patient must have adequate tidal volume and respiration rate List approved drugs to be given by inhalation: Albuterol, Salbutomol List approved medications that can be administered by inhalation: Albuterol, Salbutomol Explain how to administer a medication via inhalation: In a conscious patient use an aerochamber, instruct the patient to exhale place the chamber to the lips and inhale after the medication is sprayed and to hold their breath as long as they can. If pt is

unresponsive then you can use a BVM if it has a medication port, attached MDI to medication port spray the medication and then give a couple of breaths. If the patient is conscious and not able to comply you can use an aerosol mask and the patient will receive the medication when they breath. Evaluation medications and indications for intranasal med admin: Unable to obtain IV access and you need to give them an approved intranasal medication List approved drugs to be administered via intranasal: Analgesics, anticonvulsants, Narcan

. Evaluate the benefit to medication administration via intranasal: Avoids first pass metabolism, safety (no needles), absorbed well, convenient and do not need IV access Explain how to prepare a patient for intranasal med admin: Draw up the medication in the appropriate syringe and attach an atomizer, desired dose shouldbe divided in half amongst each nare. Identify components of a maintenance check: Check with the off-going crew to assure that vehicle is in good operating conditions: lights, sirens, the cab, under the hood, all operating equipment Identify components of a safety check: Check all supplies/equipment, electronic equipment List conditions that require removal of a vehicle from service: Flat tire, dangerous mechanical problems, broken seatbelts, stretcher problems Describe principles of defensive driving techniques: Cover the brake when going through an intersection, pass cars on the left, be in control of the vehicle at all times, be prepared to stop, drive as if no one can see you, etc Distinguish between driving characteristics of an ambulance and a passenger vehicle: Different braking distance, different handling, different center of gravity, etc

Describe relevant legislative requirements regarding the operation of an emergency vehicle: There are laws governing the operation of an ambulance and they must be adhered to such as coming to a stop at a red light before proceeding through an intersection. The government also has a document with the requirement equipment *refer to Ambulance Standards Act Discuss potential reactions from the other drivers: Speeding up, stopping, moving left and not right, lack of due care and attention Describe driving techniques for maximizing the safety of the working environment: Be prepared to stop, expect the unexpected, do not expect people to see you and obey the law of pulling over, do not expect people to give you the right of way, etc List requirements and elements of a safe landing zone: 30x30m with <8° slope, clear of wires, towers, people and loose objects Describe procedure to create a safe landing zone: 30 large steps on each side, describe terrain/landmarks, mark with a single flare in the upwind position, approach aircraft in a crouch with approval of flight club. Discuss the technique for safely approaching a fixed wing aircraft: In a crouch with approval of flight crew Describe the technique for approaching a rotary wing aircraft: Approach with extreme caution from the side, staying clear of the tail rotor. Approach in a crouch when directed by the flight crews. If landed on an incline, approach from the down-hill side. identify the critical patient care principles for air medical transport: Critical criteria for air medical transport: trauma score <12, GCS <10, penetrating trauma to (abdomen, chest, neck, head), spinal, spinal cord injury or penetrating injury, extremity amputations, 1 or more long bone fracture, pelvis fracture, crush injury to abdomen, chest or head, major burns, serious traumatic events in patients <12>55, pt with near drowning, adult patients with - systolic, BP<90mmHg, Respirations<10 or 735, HR <60 or 7120, no response to verbal stimuli, MOI that are serious or difficult access to patient

Describe preparation of a patient for air medical transport: Specific backboards may be required; IV's converted to pressure infuser bags. Patient may need to be wrapped in a disposable blanket or placed in a body bag. Intubation may be required due to limited airway space with fluid, instead of air in the cuffs, no air in IV tubing, etc. List environmental factors and stressed experienced in flight: Weather/environmental restrictions to flying, altitude limitations/airspeed limitations. Cabin space can restrict amount of crews and equipment, in flight climate control may not meet expectations, inside lighting is limited. Financially taxing. List environmental factors and stressed that may affect air medical patients: Altitude, weather, rough terrain, when transporting to air medical transport List community emergency response agencies: Fire, Saint John Ambulance, DND, police, Red Cross, Salvation Army, etc. Describe the roles of relationship to other emergency response agencies: Police, fire, first responders all work cohesively to provide prompt medical care to the community Discuss mutual aid agreement and tiered response: A multi-aid agreement ensure that help is available when needed i.e. neighbouring departments, municipalities, provinces etc will all help each other. Tiered response system: that allows multiple vehicles to arrive at an EMS call at different times, often proving different levels of care or transport. Identify a variety of incident management systems: Singular command: process in which a single individual is responsible Coordinating on incident: useful in single jurisdictional incident Unified command: process which managers from different jurisdictions(fire, EMS, police) coordinate and share commands/responsibilities Describe the principles of IMS:

National system used for the management of multiple casualty incidents. Involving assumption of responsibility for command and designation and coordination of such elements as triage treatment, transport and staging, sometimes called ICS (incident command survey) Explain various participant roles in IMS: Safety officer, liaison officer, public information officer, critical incident stress management team (ISM) Difference between primary, secondary and tertiary care strategies: TTC: (4 hour trauma) pediatric, adult center designated and funded by a provincial or territorial ministry of health, usually a regional referral. Typically affiliated with a university. DTC: designated by a heath authority and may function as a trauma center in a smaller community, supports TTC. PTC: accredited by a regional trauma program, smaller rural, nursing station, triage Explain the purposes of health promotion and prevention strategies: To prevent illness and injury Explain common health promotion and prevention strategies: Primary prevention: preventing the injury from happening Secondary prevention: medical care after an injury or illness that helps prevent further problems Tertiary prevention: rehabilitation after injury or illness that helps further problems Describe tissue/organ donation programs: Some programs/services have EMS follow donation protocol i.e. circulatory support through IV fluids and CPR and support via endotracheal tube Explain the purpose of injury prevention and public safety initiatives: Education on injury prevention to the public helps lessen the amount of individuals who end up injured, reducing the amount of hospitalization and the cost that is associated with everything. Describe injury prevention strategies for individuals, households, workplaces and communities: Paramedics are encouraged to participate in public relations as to educate the public on things that they can do or things that can be done in the workplace or in communities to reduce the risk of injury

. List other members of the healthcare community: Doctors, Nurses, LPN, RT's, ECG Techs, Radiologists, etc Identify common community support programs: Red Cross, Salvation army, etc Discuss situations that may require expertise of community support agencies: MCI, Natural disaster, etc. List common CBRN agents: Cyanide, Mustard Agent, Nerve Agents, Toxic Industrial Chemicals, Anthrax, etc. Discuss signs and symptoms due to agent exposure: Pinpoint pupils, red or irritated eyes and skin, choking and coughing, shortness of breath, tightening in the chest, vomiting and nausea, runny nose, dizziness or loss of consciousness, convulsions or seizures, etc. Identify potential dissemination devices: Stay upwind, respect zones, wear the appropriate PPE, etc. Discuss the importance of PPE: Wear it to protect yourself, if you become a patient you are no good for the patient you went for. List levels of PPE: Level A: provides the highest level of respiratory and splash protection Level B: offers full respiratory protection when there is a lover probability of dermal hazard Level C: includes a nonpermeable suit, boots, and gear for protecting eyes and hands Level D: consists of structural firefighting or turnout gear Discuss limitations of PPE: Selecting/having access to the appropriate gear Describe how to safely perform CBRNE scene-size up:

Consider life safety, incident stabilization, and property conservation - identify the Chemical and refer to proper guidelines to set up a safety parameter around the incident, ensure proper PPE is used, etc. Describe agent/hazard avoidance techniques: Avoid the attack and protect responding personnel Describe how to define and establish inner and outer perimeters: Reference to the Emergency Response Guidebook or other similar resources will help identify what these areas are - The Hazardous Material will dictate how large these zones are - these zones can be identified by using cones or drawing circles around the area. Describe the principles of triage specific to CBRNE: Triage must be ongoing, as patient conditions can change rapidly What are decontamination processes: 2 step - removal of clothing and personal effects, gross decontamination x 8 step process - rescuers must complete to leave the hot zone (book1, pg 198) Discuss directed first-aid and explain when its use is appropriate: In a CBRNE situation a patient may be in a Hot Zone and unable to attend to. FA direction may be given to a patient verbally until approachable. List chemical counter measures: Adjunct medications: treatment of convulsions - Valium/drazepam, Ativan, Midazdam (versed) Identify precautions to be taken when transporting patients (CBRNE): They may still have some contamination in or on them. When possible protect crew from secondary decontamination by placing a semi decontaminated patient in a stretch decontamination pool. Identify possible support requirements by hospitals: Decontamination Recognize psychological impact of CBRNE incidents on the community resources and first responders: Acute stress disorder, grief, anger and blame, contagious somatisation

Define Dignity The state or quality of being worthy of honor or respect. Identify cultural differences that impact patient dignity Language barriers, cultural stereotyping, eye contact, personal space and social norms Discuss legislative and regulatory requirements related to patient confidentiality: The principle of law that prohibits the release of medical or other personal information about a patient without the patients consent Explain common quality assurance and enhancement process: A program designed to maintain continuous monitoring and measurement of the quality of clinical core delivered to patients Describe the characteristics of local emergency medical services: Provision of EMS is delegated to the municipalities, cities, EMS departments. Maintain separate from fire/police, but EMS standards are still provincially set. Describe EMS characteristics in Canada: Canadian EMS systems have remained a provincial or territorial responsibility Identify professional associations for paramedics in Canada: The paramedic association of Canada, Paramedic associations of various provinces and territories Describe the professional role of paramedic associations: The NOCP gives licensing and professional bodies a way to compare programs from different jurisdiction standards and works by enabling the mobility act. Define ethics The rules or standards that govern the conduct of members of a particular group or profession Define patient advocacy

Performing in the best interests of the patient despite the wishes/demands of other parties, despite personal/religious beliefs, and while maintaining patient confidentiality. List situations where patient advocacy Child abuse, elder abuse, inability to cope or assault What is professional development Only through continuing education and recertification can the public be assured that quality patient care is being developed consistently Discuss strategy for professional improvement Mentoring programs, research projects, MCI drills, in hospital rotations, refresher course, self study exercises - Brady Volume 1 page 35 Distinguish qualitative and quantitative research methodology Qualitative Research - usually deals with data that are nonnumeric; i.e. male/female Quantitative Research - numerical in nature; i.e. temperature Brady Volume 1 page 859

15. Define evidence based practice: The practice in health care in which the practitioner systemically finds, appraises and uses the most current and valid research findings as the bars for clinical data. Define scope of practice Range of duties and skills paramedics are allowed and expected to perform Brady Volume 1 page 920 What is medical oversight? Is a responsibility of the medical director; a physician responsible legally for all clinical and patient care aspects of an EMS system What is a protocol The policies and procedures for all components of EMS; principles for managing certain patient conditions - Brady Volume 1 page 919 What is a standing order

Preauthorized treatment procedures; a type of treatment protocol; a standardized approach to common patient problems - Brady Volume 1 page 921 Define directives and guidelines: Medical directives are designed to guide a paramedic in the provision of timely and appropriate care to ill and injured patients in pre-hospital Describe the process to be followed if no protocol, standing order, directive or guideline covers it: Protocols are established for special circumstances such as DNR, abuse, refusal termination of CPR etc. Although protocols standardize field practices, they should also allow the paramedic the flexibility to improvise and adapt to special circumstances What are the rights of the patient? Rights to: respectful care, to obtain info, physician info, to refuse treatment, privacy, patient records remaining confidential, accredited EMS care, continuity of care, see bill, rules Describe criminal law as it applies to the paramedic practice Division of the legal system that deals with the wrongs committed against society or its members; it applies to paramedicine because paramedics need to know how to make good medical and legal decisions - Brady Volume 1 page 908 Describe the role of the paramedic in the management of a real or potential crime scene: Preserve evidence, document evidence, on scene observations. *Main priority and role of the paramedic in a crime scene is your/the paramedics safety and crime scene awareness. Describe the requirements of a legal testimony: In law and in religion, testimony is a solemn attestation as to the truth of a matter obtained by a witness Describe the ethical and legal requirements for reporting real or suspected situations of abuse; from ethical and legal perspectives: Duty to act in a formal contractual or informal legal obligation to provide care List the components of effective communication

A genuine liking for people, a sincere desire to be part of a helping profession. Understanding the human strength and weaknesses, empathy, ability to view world through others eyes while remaining true to self. Build trust and rapport. Describe the components of a telecommunication report: D of unit, scene description, patient age, sex, weight, chief complaint, HPI, OPQRST, Past medical history, secondary assessment, findings, treatment, response to patient, Eta hospital List the components of effective verbal communication: Ask open ended questions, use direct questions PRN, do not use leading questions, ask only one question at a time, and allow for complete answers. Use appropriate language for patient, try to allow for minimal interruptions. List the components of patient history: Chief complaint, history of present illness, past history, current health status, family history, psychosocial history, review of systems. List factors that contribute to stress in patients, relatives and by standers. Include loss of something valuable, injury or the threat of injury, poor health or nutrition, general frustration and ineffective coping mechanisms. List techniques used to maximize the effective communication: Trust and rapport, professional behaviours, non verbal communication, eye contact, compassionate touch, open ended questioning, effective listening and feedback. Identify basic communication needs: Encode - to created a message Decode - to interpret a message Feedback - to respond to a message List common items of professional correspondence: First impressions, patient interviews, end of call/final word Describe non-verbal behaviours:

Gestures, mannerisms, and postures by which a person communicates with others, also called body language Define active listening: Requires the listening to feedback what they hear to speaker by a way of restating or paraphrasing what they have heard in their own words List behaviors that help establish trust: Use patients name, address patient appropriately, modulate your voice, use professional but compassionate voice, explain everything, keep a kind expression, use appropriate communication Identify behaviours diffuse hostility: Don`t seem threatening, avoid confrontation, explain benefits and advantages of cooperation, observe scene, question bystanders, set limits, establish boundaries, appropriate distance, appropriate show of force Identify behaviours that provoke hostile behaviours: Position based discussion that involves someone being right or wrong. Dominant style approaches when pressured. Define Respect A feeling of admiring someone or something that is good, valuable, important, etc. A positive feeling of admiration or deference for a person or other entity (such as a nation or a religion), and also specific actions and conduct representative of that esteem. Respect can be a specific feeling of regard for the actual qualities of the one respected. It can also be conduct in accord with a specific ethic of respect. Respect can be both given and/or received. Respect should not be confused with tolerance. Powerpoint Section 0101 - Professionalism Define empathy Identification with and understanding of another's situation, feelings, and motives - Powerpoint Section 0101 - Professionalism Define compassion

Deep awareness of the suffering of another coupled with the wish to relieve it - Powerpoint Section 0101

• Professionalism Define sympathy A feeling or an expression of pity or sorrow for the distress of another; compassion or commiseration - Powerpoint Section 0101 - Professionalism List common coping mechanisms: Relaxation, talking with friends/family, find source of the problem, aid in finding solution, physical exercise, drinking alcohol, being aggressive Define confidence Feeling of assurance; especially self-assurance - Powerpoint Section 0101 - Professionalism Define diplomacy The art of dealing with people in a sensitive and effective way - Powerpoint Section 0101 - Professionalism Define tact Acute sensitivity to what is proper and appropriate in dealing with others, including the ability to speak or act without offending - Powerpoint Section 0101 - Professionalism Define discretion The quality of behaving or speaking in such a way as to avoid causing offence or reliving confidential matter Define conflict; A serious disagreement or argument, typically a protected one List the components of a balances, healthy lifestyle Cardiovascular endurance, strength and flexibility, nutrition, weight control, disease prevention, freedom from harmful habits and addictions and back safety Define stress:

A hardship or strain; a physical or psychological arousal to stimulus Define stress disorder: ost traumatic stress disorder (PTSD); mental health condition triggered by a terrifying event Discuss techniques to manage stress: Controlled breathing, deal with negative thoughts, attend to medical needs to the patient What is critical incident stress management? A system of related interventions usually preformed by specifically trained mental health workers List the effects of shift work on physical and mental health: Sleep deprivation, GI symptoms, obesity, diabetes, cardiovascular disease, depression, pregnancy complications, and cancer Describe the physical capabilities required of a paramedic: Cardiovascular endurance, strength and flexibility, nutrition and weigh control, disease prevention, back safety, no harmful addictions. Define safe body mechanics: Is the safest and most efficient method of using your body to gain a mechanical advantage List strategies used to reduce risk of injury: Protection of EMS (BSI), education of EMS, data collection (records of illness/injuries, financial support (donations), empowerment of EMS provider List equipment for patient transfer: Stretchers, stair chair, scoop, short backboard, long backboard, ked Explain techniques of patient transfer using specific equipment: Sheets, keds, spine board Describe emergency lifting techniques: Shirt drag, shoulder and forearm drag, firefighter drags, piggyback, crutch, cradle carry, sheet drag

Define scene safety: Doing everything possible to ensure a safe environment Describe factors contributing to scene safety: You, your crew, responding personnel, your patients, bystanders, people's behaviour, surroundings, bystanders information List potential occupational hazards: Infection/contamination, physical injury, stress, burnout, driving hazards Describe basic, non-mechanical patient extraction: Non mechanical patient extrication does not include motorized equipment such as firefighter pincers, Jaws of Life, ext. Describe methods of diffusing: Use appropriate tone and volume, active listening, empathy not sympathy, refrain from using emotional responses, apologize when warranted Describe methods of self protection: BSI: Body substance Isolation - goggles, gloves, hazmat gear, helmet, mask, respirator What is Hazmat and WHMIS: Hazmat - hazardous material WHMIS - Workout hazardous materials information system Describe common routes for transmissions of disease and infection: Direct - direct contact, droplet spread Indirect - airborne, vehicle route, vector borne (mechanical, biological) Define infection control precautions: BSI (protective gloves, masks, protective eyewear, HEPA, gowns), disposable resuscitation devices Describe the appropriate procedures for the disposal of sharps and contaminated supplies:

By law, every medical organization must have biological hazard must have a biological exposure plan. Sharps container, biohazard bag, container. Describe techniques used to clean and disinfect: Clean - refers to washing an object with soap and water Disinfecting - includes cleaning with a disinfecting agent, which should kill many microorganisms on the surface of an object. What is triage? A method of sorting patients by the severity of their injury What triage system does AMB NB use? Start - simple triage and rapid transport Name and describe MCI Roles: Safety officer - monitors all on scene actions and ensure that they do not create any harmful conditions Liaison officer - coordinates all incident operations that involve outside agencies Public Info officer - collects data about the incident and releases them to the press Critical incident stress management team - monitors the emotional status of all on-scene personnel, supports workers, and attempts to reduce stress, also conducts on-scene debriefing if necessary. How will patient allergy knowledge affect patient core? Could prevent complications in the ER, in anaphylactic patients, ask about allergies to drugs, food, environmental - >bees

. What are the components of an incident history? Survey scene through windshield, potential hazards, determine MOI. 3 priorities, life safety, incident stabilization and property consultation Components of a medical history include: Preliminary date (age, data), chief complaint, present illness - >OPQRST, past history, current health status, review of systems . List situations when information about a patients last oral intake may be required:

GI, GU, diabetic, possible surgical (MSK etc.) patients, altered level of consciousness Explain primary assessment: Goal is to identify and correct life threats to the ABC`s. 1 - form a general impression. 2 - Stabilize c-spine as needed. 3 - Assess baseline mental status. 4 - Airway. 5 - Breathing. 6 - Circulation. 7 - Determine priority of transport What is the difference between trauma assessment and primary medical assessment? Rapid trauma survey vs. Wet check - Questioning Explain secondary assessment: Consists of focused history, vital signs, physical assessment, is based on primary assessment and chief complaint. Assessment will differ depending on type of patient: responsive medical, unresponsive medical, trauma List assessment techniques for cardiovascular history: Consists of; assess the carotid pulse, auscultate for bruits, measure jugular venous pressure, palpate for the apical impulse (PMI), percuss for the PMH. Auscultate for heart sounds. List neurological assessment techniques: mental status, speech, memory, alertness, slurred speech Cranial nerves: 12 - > identify smells, shrug shoulders against resistance, etc. Motor system: muscle tone, ROM, arm drift, grip strength, coordination Sensory system: test light touch, pain - reflexes, biceps, triceps etc. List respiratory assessment techniques: Auscultate breath sounds; inspect symmetry, chest wall abnormalities, AMU List obstetrical assessment techniques: Obtain gravidity, length of gestation, measure fundal height, take vitals with patient lying on left side, examine genitals for discharge, progression of labour. List gastrointestinal assessment techniques: Inspect before transport, ecchymosis in the periumbilical area, ecchymosis in the flank, tilt test

List genitourinary assessment techniques: Urine, bowel input/output, last meal, last BM, hydration habits, fever, auscultate bowel sounds

. List integumentary assessment techniques: Temp, turgor, colour, deformity, texture, edema, skin condition Define neonatal patient: Birth to 1 month of age Distinguish between "mentally unwell" and "mentally well" person: Suffering from severe mental illness of unsound mind" vs. a unaffected person from mental illness List psychiatric assessment techniques: Any history of mental illness? Is your patient being treated for a condition? Has your patient had thoughts or attempts of suicide? Tailor questions for patients with mental illness, i.e. don't be aggressive, be patient, ask simple questions, don't rush Define pediatric patient: Neonatal to adolescence (1 month - > 18 years) Explain developmental parameters: Refers to the biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence. Explain the development diameters for pediatric: Newborns - first hours after birth Neonates - birth - 1 month Infants - 1 - 12 months Toddlers - 1 - 3 years Preschoolers - 3 - 5 years School aged children - 6 - 12 years Adolescents - 13 - 18 years Define geriatric patient:

A person aged 65 or greater Discuss the effects of the aging process: The body becomes less efficient with age. Decrease in one organ system may result in the deterioration of other systems. Explain the variation in geriatric assessment findings: BSI. Increase risk of TB - > consider HEPA or N-95, remain alert to environment, prescription drugs. Define bariatric patient: Defined as anyone regardless of age who has limitations in health and social care due to their weight and physical size, shape, width and mobility. BMI - > 40kg/m2 and/or are 40kg above weight Discuss the effects of obesity: Life span may be reduced by 10-15 years, more prone to chronic illness, cardiac disease, hypertension, respiratory disease, diabetes, osteoarthritis, stress incontinence, depression, and gallbladder disease Explain variations in assessment findings for bariatrics: Treat patient with dignity and respect, may require different position for patient safety and comfort, and anticipate airway difficulty Define pulse: A rhythmical throbbing of the arteries as blood is propelled through them List pulse locations: Temporal, carotid, brachial, radial, ulnar, femoral, popiteal, dorsalis pedis, posterior tibial Pulse for various ages, normal vs abnormal Adult - normal (60-100) Tachy (100+) Brady (60-) Factors that influence pulse: Temperature, pain, PMI, emotional response, drugs, exercise, obesity, exhaustion Explain respirations:

The exchange of gases between a lining organism and its environment. Exchange of oxygen and carbon dioxide during inhalation/exhalation in lungs/cellular level Factors that influence respiratory rate: Fever, anxiety, shock, sleep, metabolic disorders, diabetic, ketoacidosis, spinal meningitis, renal failure, exercise, head injury Factors that influence body temperature: Extreme cold, hypothermia, heat waves, exercise, infection Describe the physiology of blood pressure: Force of blood against arterial walls as heart contracts and relaxes. Systolic - force against arteries when ventricles contract. Diastolic - force against arteries when arteries relax Explain auscultation vs. palpation BP: Auscultation is the act of listening to Karotkoff sounds with a stethoscope as opposed to palpation in which you feel for a distal pulse. Factors that influence blood pressure: Anxiety, position (orthostatic pressure), smoking, exercising, eating, patient medical history, trauma (blood loss) Explain the physiology behind blood pressure by palpation: Inflate the cuff until the pulse of the artery you're palpating disappears, slowly deflate the cuff until the pulse return. This measurement is systolic. A diastolic measurement cannot be obtained with this method. Why use non-invasive blood pressure? Can be continuous, allows for free movement and multitasking accuracy (when still), non invasive What are the 4 parameters for assessing skin? Skin turgor, moisture, temperature, and colour Factors that affect skin temperature, colour, moisture and turgor:

Smoking, medications, cold/hot weather, chronic conditions, allergies (reaction) List the three parameters used to access pupils: Pupil size, pupil equality, speed of response Identify the cranial nerve that regulates eye movement and contraction: Occulomotor Identify conditions that effect pupil size, symmetry and reactivity: Increased intracranial pressure, adverse drug effect, opiate overdose, brain death, hypoxia, bright/dim lighting Identify factors that asses patients mental status: General appearance and behaviour, speech and language, mood, thought and perceptive insight and judgement, memory and attention. Explain AVPU: AVPU describes patients general mental status. A = alert (eyes open, tracking) V = responds to verbal stimulus P = responds to painful stimulus U = unresponsive ( patient comatose and doesn't respond to painful stimulus) Explain GCS: Standardized evaluation method to measure patient level of unconsciousness. Assesses best eye opening, verbal and motor responses, awarding points for each. Fully alert = 15, comatose/dead = 3 Identify the factors that effect accuracy of pulse oximeter: Nail polish, fluorescent lights, CO poisoning, hypovolemia, irregular heartbeats, COPD/smoking Describe the physiological properties of oxygen: An odorless, colourless, tasteless gas essential for life. One of the most important emergency drugs. Explain end-tidal carbon dioxide monitoring: Used to confirm tube placement with intubation. Confirms the presence of CO2 with exhalation which will only come from the lungs.

Explain the factors that may limit the reliability of end-tidal carbon dioxide monitoring: Ventilator settings, malfunctions, leaks, tubing obstruction Explain the relationship of end-tidal carbon dioxide to arterial blood gas measurement of partial pressure of arterial carbon dioxide: Under normal physiologic conditions the difference between arterial PCO2 from ABG and alveolar PCO2 is 2-5 mmHg. This difference is termed the PaCO2 - PETCO gradient or the a-ADCO2 and can be increased by COPD, ARDS, leak in the sampling system or around the tube. Differentiate between sidestream, microstream and mainstream end-tidal carbon dioxide: Sidestream are located away from the airway, require gas sample to be continuously aspirated from the breathing circuit - > transported by means of a pump. Advantage - > mainstream sensors are fast responsive time and elimination of water Identify indications for glucometric testing: Altered mental status, seizure, diabetic emergency, strokes Factors that affect glucometric testing results: Alcohol from the swab, calibration of glucometer Describe the physiological mechanism of glucose: Glucose works by providing the body with energy. It comes in the forms of carbohydrates or simple sugars and is naturally found in plants and commercially in food products. Identify indications for providing peripheral venipunction: Blood draws, IV - > because illness, diagnostic, medical administration, hydration Differentiate between core and peripheral temperature monitoring. Core - body temp of deep tissues, which does not normally vary for than a degree or so Define central venous catheterization: Surgical puncture of the internal jugular or femoral vein. Indications for central venous catheterization:

Central ones are larger than peripheral veins and will not collapse after long term use. Explain the electrophysiologic principles of the heart and cardiac conduction: Parts of the conductive system: S-A node: known as the hearts natural pacemaker, the SA has special cells that create the electricity that makes your heart beat. A-V node: the AV node is the bridge between the atria and ventricles. Electric signals pass from the atria down to the ventricles through the AV node. HIS-Purkinje system: the His-Purkinje system carries the electrical signals throughout the ventricles to make them contract. The parts of His-Purkinje system include, Bundle(start of system) right bundle branch, left bundle branch, Purkinje fibers (the end of the system) The SA node normally produces 60-100 electrical signals per minute, this is your heart rate. With each pulse, signals from the SA node follow a natural electrical pathway through the heart walls. The movement of the electrical signals cause your hearts chambers to contract and relax. Indications for ECG monitoring: Chest pain, suspected cardiac origin, shock, syncope, altered LOC, general weakness, trauma, etc. Technique for obtaining a three lead ECG: Turn on the machine, prepare the skin, apply the electrodes, ask the patient to relax and remain still, check the ECG, print the ECG strip, continue patient care. Describe the principles of interpretation of cardiac rhythms: 1 - Analyze the rate: 6 second method, triplicate method 2 - Analyze the rhythm : occasionally irregular, regularly irregular, irregular 3 - Analyze the P waves: present? Regular? Upright or inverted? 4 - Analyze the P-R interval: 0.12 - 0.20 sec (3-5 small boxes) 5 - Analyze the QRS complex: 0.01-0.12 sec (3 small boxes) do all of the QRS complexes look the same? Identify potentially lethal cardiac rhythms: Ventricular, fibrillation, asystole, atrial fibrillation Identify indications and rational for performing urinalysis:

Suspected UTI, kidney disorders, change in urine/bowel habits Common assessments associated with urinalysis by Qualitive method: Blood/hemoglobin, erythrocytes, white blood cells, pH, glucose, ketones, proteins Methods of relieving the symptoms of airway obstruction: Determine if it's a complete obstruction or poor air exchange, if unconscious, use the head tilt/chin lift, jaw thrust, insert NPA, attempt 2 breaths. Reposition if failed breath, if all fails attempt CPR - > Magill forceps Types of airway opening manoeuvres for various patients Head tilt/chin lift, jaw thrust, Sellicks manoeuvre Indications and contraindications for performing airway manoeuvres: Indications: remove blood or other secretions, vomit Contraindications: acute neck, facial or head injury, nasal/oral burns, due to infection risk, raised ICP Purpose and indication for oropharyngeal suctioning: Assist patient to clear excessive secretions, upper airway, to assist patient who is unable to cough effectively and is retaining secretions to clear vomit, blood, foreign object. Describe suctioning equipment: Handheld, O2 powered, battery powered, non-portable, rigid, tip, whistle tip(soft top) Identify pressure limitation for suctions various age groups: For pediatrics: decrease pressure to less than 100 mmHg in infants, Suction less than 10 seconds, avoid stimulation of vagus nerve, constantly check for bradycardia. Identify indications for suctions beyond the oropharynx Patients with tracheostomy, tube to remove secretions and mucus plugs. Identify equipment for suctioning beyond the oropharynx Endotracheal tube, lubricant, oxygen, sterile water