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Paramedic Study Guide
firemanmoss

Front Back

Neonate ETT size?


small finger or weight based tape


Neonate fluid replacement?


10ml/kg


Order of Neonate resuscitaion?


Tactile stimulation, BVM etc.


Main concern of child drowning?


Hypoxia and acidosis


How do you mix Dopamine and what is the dose?


Mix 400 mg in 250ml equals 1600mcg; 5-10 mcg/kg/min


What is the maintance drip to lidocane?


2-4mg/min


If a patient has symptomatic bradycardia with PVC's, what do you give first?


Atropine then lidocane


Side effects of lidocane?


numbness, muscle twitching and seizures


What do you do for 3rd degree heart blocks?


TCP


Treatment of Pulmonary Edema?


O2, lasix, NTG, morphine


Why is morphine given in Pulmonary Edema?


to decrease preload and promote vasodilation


What is Stridor?


High pitched sound, upper airway obstruction


What is Wheezing?


whistle sounds, asthma, croup, emphysema


What is Rales?


fluid in the lungs, bubbling type sounds


S&S of Heat exhaustion?


High fever, diaphoretic, tachycardic


S&S of Heat Stroke?


Dry skin, confusion/altered LOC, tachycardic then slowing heart rate, low BP,high body temp, seizures


What is Atropine and side effects?


parasympathetic blocker that may cause blurred vision and given in <0.5mg doses may cause further bradycardia


What is the Pituitary Gland?


pea shaped master gland


When using a BVM on a patient, what may be corrected first?


respiratory acidosis


What is the key to the body's buffering system?


Bicarb


What is abandonment?


leaving a patient without turning them over to someone of equal or higher standard of care


You synchronized cardioverte a patient and that patient becomes pulseless.  What do you do next?


unsync the monitor and defibrillate


After defibrillation the patient shows a NSR on the monitor, what do you do next?


check for a pulse


Where do you place a Macintosh blade?


in front of the valecula


Paralization at the nipple line is at what vertebrae?


T4


S&S of spontaneous pneumothorax?


sudden, sharp chest pain, and dyspnea


S&S of tension pneumothorax?


SQ emphsema, no bfreath sounds, JVD


Treatment for tention pneumothorax?


Needle decompression, midclavicular between 2nd and 3rd rib


What can cause Pericardial tamponade (tramatic asphyxia)?


cause by compressing of the chest


S&S of pericardial tamponade?


JVD, distant heart tones, hypotension  aka Beck's triad


Routes Valiumcan be administered to children?


IV,IO,PR


MVC bus vs chemical truck; what is the first thing you do?


scene size-up


What are the stress responses?


alarm, resistance, exhaustion


The order of packaging a patient wit a pneumothorax?


C-spine, BVM, needle decompression, transport, IV in route


What are the injuries you may see with a MVC when the patient goes "down and under"?


fractured femurs


Patient receiving blood transfusion has a reaction, what should you do?


stop the transfusion


S&S and when will a spontaneous abortion happen?


vaginal bleeding and painful; 1st trimester


S&S of appendicitis?


RLQ pain, low grade fever, nausea, vomiting; Mcburney's Point is common sight for pain, 1-2 inches above iliac crest in a direct line with umbilicus


S&S of spleen injury?


pain radiates to the left shoulder (Kerns)


S&S  and when you might see Abruptio placenta?


Painful dark blood from the vagina and 3rd trimester


Symptomatic patient with A-flutter w/2-1 conduction and patient is on Dig would you cardiovert?


No, because pt is on Dig and you dont know the onset time of A-flutter


Treatment for prolapsed cord?


insert fingers into vaginal opening keeping to cord away from the vaginal wall allowing circulation through the cord


Treatment for a nucal cord?


remove it cause it leads to fetal compromise; asphyxiation


At am MCI what is the first thing you should do?


Triage


Who do you treat first at an MCI?


altered mental status first them suspected spinal injuries last


What is Cushing's Triad?


Increased BP, decreased heart rate, irregular respiration


S&S of DKA


Kussmauls respirations(deep and rapid),polyuria, polydipsia, polyphagia, warm and dry skin, fruity breath odor, decreased LOC


What is orthopnea?


difficulty breathing while lying down.  Transport in the sitting position; COPD


What is supine hypotension?


Seen in pregnat women who lay flat on their backs.  Place in left lateral recumbent postion at 15 degrees


Signs of organophosphate poisoning?


salvating, diaphoretic, dilated pupils.  Use 2-5mg of atropine.


How does neonates loose body heat?


evaporation


Synchronized cardioversion should hit on what wave?


R wave


What problems are associated with salt water drownings?


Salt water is hypertonic so inhalation of salt water draws water from the blood stream into the aveoli causing pulmonary edema.  This in turn causes profound shunting leading to non-oxygenation blod being circulated, metabloic acidosis


What problems are associated with fresh water drowning?


Fresh water is hypotonic, thus the water crosses the alveolar/capillary membrane into the vascular space, causing hemodilution which causes a decrease in red blood cells.  This also cause damage to the alveoli, causing them to lose surfactant, causing atelectasis, which causes shunting of non-oxygenated blood back into the blood stream


What is the drug of choice for an MI after O2?


Morphine


You hace a rhythm showing one good QRS then asystole then no electrical activity.  What do you do?


Check pulse then check leads


Trouble with lower shoulder in an OB delivery?


Guide head up gently; shoulder dystocia


Drug given to an adult with minor astma?


Albuterol


Wide complex tachycardia of unknown origin. What do you give?


give lidocane


Not a sign of dehydration in PEDS?


Polyuria (dry diapers)


Wide bizarre rapid QRS is?


V-tach


No lidocane for bradycardia with PVC's





If you find patient sitting in chair at a 45 degree angle with JVD, what might you have?


right sided heart failure


You should check breath sounds how?


Both anterior and posterior


What part of the brain controls motor skills


cerebellum


S&S of croup?


viral illness, inspiratory and expitatory stridor with seal bark like cough, cough is not a respiratory sound, most common in children under 3


Sign that you have inserted an EOA into the trachea


absent breath sounds


Vomiting commonly occurs after the removal of an EOA





What drug would you use for a hypertensive crisis


procardia (nifedipine)


How would you care for a hypothermic patient during transport


warm IV solution, heat, blankets, and remove any wet clothing


Indications for an NPA


patient needs some airway support, patient with a gag reflex


What is the dosage of Valium for 3rd trimester seizures


5-10 mg (mag sulfate)


Use D5W for medicated infusions and pulmonary edema





A sudden bursting headache during a workout


aneurysm


Known S&S of heat exhaustion


high temp, wet skin, rapid pulse


Ventilate a person with head injury 20-25 times per minute





Pedi has injested lye and is not seizing; what do you give him


milk and/or water


#1 cause of pediatric death


trauma


#1 cause of pediatric cardiac arrest


respiratory arrest


Placenta previa


painless third trimester bleeding


Placenta abruptio


painful third trimester bleeding


LUQ pain


spleen related


A coworker is having a normal response to an MCI. What should you do for him


give him a minute to regroup


Amount of air inhaled or exhaled in one breath is called


tidal volume


Chest injury where air exchanges with outside air is called


sucking chest wound


An arrangement between departments for use of resources is called


mutual aid


Main cause of transmitting HIV is


unprotected sex


PH above 7.45 is what


alkalodic


Person in diabetic coma (ketoacidosis) did not take what


insulin


When does respirationo begin


When the lungs have achieved a normal expiration and the pressure inside the thoracic cavity equals the atmospheric pressure


How do you stop acute bleeding in a woman who has just given birth


massage the fundus


How do you measure the PR interval


Beginning of the P-wave to the beginning of the QRS


A prolonged P-wave is greater than what


.20 seconds


Taking or needing more of a drug to get the same results is called what


tolerance


A car windshield is made of what


laminated safety glass


What do you do for a patient in PEA with a rate of 110


IV, fluid challenge, and EPI


Pediatric with sudden onset of fever, drooling, and tripoding


epiglotitis


Patient with rumbling breath sounds and a fever is what


pneumonia


When talking on a radio to a doctor and another doctor intervenes, who do you take orders from


the on-line doctor


In a "down and under" accident, what is the most common injury


femur fractures


The most important information to give a doctor about a patient is what


history of illness


How to splint fractures


splint above and below injury, don't straighten elbow injuries, dress wound first


Carpopedal spasm is often seen in hyperventilation syndrome, caused by hypocalcemia and low CO2 levels





A pituitary hormone that stimulates the cortex of the adrenal glands to produce adrenal cortical hormones


ACTH (adrenocortiotropic hormone)


Ethics


rules and standards governing the activity of a group or profession


Libel


written statements about a person that are wrong and injurious


IO infusion


usually performed 2-3 fingers from the tibial tuberosity on the medial side


Sub Q emphysema


crackling sounds found during palpation, air migrating through the tissue from the chest cavity


Flat jugular veins


indicator of hypovolemia


Exsanguinate


to bleed out to the point where life cannot be sustained


BLS airway management before ALS airway management





Osmosis


the movement of a solvent across a semi-permeable membrane from an area of lesser concentration to an area of greater concentration; purpose is to equal concentration on both sides


Automaticity


capability of self-depolarization. Refers to the pace-maker cells of the heart


S&S of neurogenic shock


injury to the brain or spinal cord causing the arteries to lose tone and dilate, enlarging the "container" and causing a relative hypovolemia. Warm, dry, red skin. Due to lack of compensatory catecholamine release, the patient will have low BP and a slow pulse even in early stages of shock


What protects people with AIDS from discrimination


Americans with Disabilities Act


Atropine blocks what nerve


vegus


S&S of ICP


high BP, low heart rate, irregular respiration (Cushings triad)


S&S of pericardial tamponode


distant or muffled heart sounds, hypotension, and JVD (Beck's triad)


Tendons


connects muscle to bone


Electrical burns cause damage to what


soft tissue


Early S&S of shock


anxiety, elevated heart rate, cool skin


If you have no feeling below the umbilicus, what vertebrae have you damaged


spinal damage at the T-10 level


What is the first step in extricating a patient


manual C-Spine control


Hypertonic solution (solution of higher osmotic pressure)


when introducing to normal hydrated person will cause a shift of solute from the intracellular to extracellular space


Ascites


free fluid within the abdominal cavity


Good Samaritan Laws


laws designed to protect people who assist at the scene of an emergency from liability


What organs are contained in the abdominal ULQ


spleen, tail of pancreas, stomach, left kidney, part of colon


Stridor or crowing


high pitched sound caused by restriction or obstruction of upper airway


Rebound tenderness


pain upon sudden release of examiner's hand while palpating the patient's abdomen


Kussmaul's respirations


very deep, gasping respirations associated with diabetic ketoacidosis (DKA)


Hypoxemia


reduced partial pressure of oxygen in the blood


In conjunction with bicarbonate buffer system, the body regulates acid base balance by respiration and kidney function





Stroke volume x heart rate =


cardiac output


Average tidal volume of an adult is


500ml


What are the side effects of atropine


blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, and confusion


What is the recommended dose for furosemide (lasix)


20-80 mg


What are the indications and recommended dosage for aminophylline


bronchial asthma, CHF, pulmonary edema; 250-500mg over 20-30 minuutes


Glucagon


causes the liver to release stored glycogen to create usable glucose


Contrecoup


an injury to the brain on the opposite side of impact


What is the best treatment for a patient with a flail chest


positive pressure ventilation


Blood pressure =


cardiac output x vascular resistance


On EKG graph paper, one small box = how much time


0.04 seconds


What identifies a-fib


irregular rhythm with no discernable p-waves


S&S of hypertensive emergency


rapid increase in diastolic BP accompanied by restlessness, confusion, blurred vision, nausea, and vomiting


Hypoglycemia


occurs when insulin levels are excessive


Grand mal seizure


seizures characterized by tonic/clonic muscle contractions


Focal motor seizures


begin as localized tonic/clonic movements


What organs are located in the URQ


liver, gall bladder, head of pancreas, part of duodenum, right kidney, hepatic flexture of colon


S&S of abdominal aortic aneurysm (AAA)


typically an older person, diffuse abdominal pain, sever back pain with a tearing sensation, pulsating sensation when palpating abdomen


Alcoholic withdrawal (delirium tremors)


may occur within first 48-72 hours of abstinence; seizures may occur within 24-36 hours post-abstinence


S&S of meningitis


malaise, low grade fever, headache, stiff or sore neck


Measles, mumps, and chickenpox are contagious. Shingles are not.





Treatment for heat exhaustion


remove patient from environment and provide fluid replacement with 0.9% sodium chloride or lactated ringers


What is the Vagus nerve neurotransmitter?


Acetylcholine


Carpal pedal spasm is a result of what


hyperventilation


Hyperkalemia causes what on an EKG?


peaked T waves


What perfuses the heart?


Coronary arteries


What is NOT a beta effect?


bronchoconstriction


A 17lb PED, what is the initial dose of lidocaine?


8mg


JVD with clear lung sounds and narrow pulse pressure indicates what?


Pericardial Temponade


What is the best method to use on a LSD patient?


talk down


A 110lb patient, what is the initial dose of lidocaine and maintenance dose?


50mg; 2-4mg/min


21 y/o male with asthma, what drug, dose and route?


Albuterol, 2.5mg, nebulizer


81 y/o male cardioverted and now is pulseless and in V-fib or V-tach, whatis the next action?


Defibrillate at 200j


60 y/o male, twisted ankle HR 54, BP 140/80 stable, what is the treatment?


splint and transport


S&S of spontaneous pneumothorax


Sudden "knife like pain", dyspnea


Effects of Verapamil (calcium channel blocker)?


decreases vasoconstriction, decreases conductivity


You clamped and cut the umbilical cord now its bleeding, what do you do?


clamp it again


In pulmonary edema after O2, monitor, IV, what is next?


NTG 0.4mg if BP is good


Whay is the intrinsic rate of the ventricles


20-40


What airway problem will cause stridor in PEDS?


croup


PED with flu, not acting right with n/v?


Reye's Syndrome (resulting sometimes after a viral infection)


Wide QRS rhythm with no P wave?


idioventricular


Which airway will cause vomiting when taen out?


EOA


MVA patient with HR 120, BP 40/palp.  Patient has?


Hypovolemic shock


What is NOT a sign of kidney stones?


frequent urination


Most critical patient at MCI?


Amnesia, crying, altered LOC


containdications of Verapamil?


pulmonary edema, cardiogenic shock


Chest pain with "tearing and shearing pain towards the neck", with no pedal pulse?


Disecting Aortic Aneurysm


When palpating the abdomen, you should?


palpate the area of pain last


electrical burns cause what?


superficial and deep damage


When do you perform a Cricothyrotomy?


laryngeal edema and/or facial trauma where no other airway can be established


What do you do before administeration of D50%?


check Glucose


Patient fell through a glass door and has a piece of glass stuck in his neck, what do you do?


C-spine immobilization, airway, occlusive dressing, stabilize the glass, transport


Complications of IV administration


Phlebitis, Emboli


Routes of EPI


IV, ETT, SQ


List the slowest to fastest routes of administration


PO, SQ, IM, ET, IV


Ambulance crashes, what is the court going to prove


lack of due regard


What is child CPR compression depth


1-1.5 inches


Head trauma with signs of shock?


Head trauma does not cause shock; look elsewhere


Respirations for DKA


Kussmaul's respirations


Patient is diabetic with blood glucose of 40. What should you NOT do


IV insulin


Patient is 6 years old with unilateral chest wheezing


Foreign body obstruction


Spleen is located where


LUQ


Mother gave birth 24 hours ago and has sudden onset of chest pains and dyspnea


pulmonary embolism


Oxygen rich blood leaves the pulmonary veins and goes into the


left atrium


Sympathetic nervous system does what


vasoconstriction and sphincter constriction


2 medics at MCI. 1st on scene finds 20yo in cardiac arrest; backup is 20 minuutes away.. What do you do


continue triage


SQ epi for


mild allergic reaction (IV epi could be used for anaphylaxic shock)


Body's tendency to stay constant


homeostasis


Chief extracellular cation


sodium


Chief intracellular cation


potassium


Name all cations in body


calcium, magnesium, potassium, and sodium


Woman faints after seeing bad accident


vasovagal


Seizure of one body part


focal-motor seizure


Common fracture of pediatric long bone


green stick


Complication of elbow or knee fracture


loss of distal circulation


Best place for chest needle decompression


mid-clavicular between 2nd and 3rd intercoastal space


Which drowning causes hemodilution and hemolysis


fresh water


What holds do alveoli open


surfactant


Fever, chills, night sweats, blood in cough


TB (w/o hemoptysis in cough, then HIV)


Endocrine system acts by


release of hormones


What rhythm is being described: irregularly/regular


A-Fib


Toxemia occurs during what trimester


3rd


Meconium staining is a sign of what


fetal distress


NOT a symptom of dehydration


decrease in HR


What is Valium dose for Status Epilepticus


2.5-10 mg slow IVP (5-10 mg is correct answer)


Other names for Verapamil


Calan and Isoptin


Sellick's maneuver is what


pressure on cricoid cartilage


Contraindications for EOA


under 16 yo, less than 5 ft or greater than 6'8", ingested caustic fluids, esophageal varices, positive gag reflex


What is lung compliance


elasticity or stiffness of lungs


Old lady thinking neighbors are "out to get her" what do you do


remove her from situation and keep her talking


Bright red blood with cramping in first trimester


spontaneous abortion


Adult in asthma attack, what is treatment


stop bronchial spasms


Pregnant with seizures?


Mag Sulfate drip first, if not successful use 5-10 mg of Valium


Most common cause of aspiration


removal of EOA


Most common place for IO infusion


proximal tibia


What is NOT a sign of infant dehydration


polyuria


Name of couple of antipsychotic meds


Haldol and Mellaril


What is not a bronchodilator


Benadryl


Secondary assessment does not include


determining life threatening injuries


Writing something derogatory is


libel


Side effects of Verapamil


tachycardia, WPW problems


Patient with history of WPW in PSVT with no S&S, what do you do


Adenosine, 6mg, rapid bolus


Describe v-tach


wide, bizarre, and regular


Describe a-fib


it is irregularly irregular rhythm without discernible p-waves


When is lidocaine not used


bradycardia with PVCs


Headache and stiff neck


meningitis


How do you transport a patient with epiglotitis


sitting up


Nipple line down?


T-4


Umbilicus down?


T-10


Abdominal bleed can take up to several hours to occur after injury





At an MCI, what is the LAST type of injury to go


spinal injury


At an MCI, what is the FIRST type of injury to go


Thirsty, anxious, and altered LOC


Lady sitting up with pink, frothy sputum


left side heart failure


Dopamine dosage and drips


5-10mcg/kg/min; 400mg into 250ml = 1600mcg/ml


Respiration is stimulated by what


increase in PCO2


Part of the myocardium most often damaged during an MI


left ventricle


SVT with WPW, what is the drug of choice


Adenosine


Pulmonary ventilation is very important because


the lungs have the ability to either expel or retain large amounts of CO2


What determines inspiration


decrease in thoracic pressure


Lower abdominal pain, vaginal bleeding, referred pain to shoulder


ectopic pregnancy


What is the length of a normal PR interval


.12-2.0 seconds


What is the measurement of the small square on the EKG graph paper


.04 seconds


Unconscious 3yo with hysterical mom, what DOESN'T the paremedic do


do not try to restrain the mother


What is the dose of Valium for a pregnant mom with eclampsia who is seizing


5-10mg IV


Name side effects of lidocaine


tremors, seizures, slurred speech, and parasthesia


What group of drugs are inotropic


EPI, isuprel, dopamine, dobutamine


How do you examine a toddler


toe to head


SIDS most often occurs at what age


1 week - 12 months


ASA overdose causes what


metabolic acidosis


What is the drug of choice for 3rd degree heart block


atropine


TCP would be contraindicated for


BP 120/80, HR 56


EKG shows v-tach, patient is conscious, what is drug of choice


lidocaine


If PVCs manifest after initial bolus of lidocaine and drip has been set, what is the next action to take


give half the initial bolus and increase drip


How many joules for initial defibrilation of a 10kg infant


20 joules (2j per kg, then 4 joules per kg)


What is the most important drug for a bradycardic infant


O2


First thing you do on scene of an MCI MVC with 7 patients


begin triage


Newborn, blue extremities, vigorous cry, poor movement, HR 120, respiration 32, what is APGAR


8


Order for 25mg of lidocaine, on hand is 10mg/ml. How many ml do you give?


2.5ml


Anaphylaxis septic shock and neurogenic shock: what side effects would they NOT include


hypertension


The patient's Dr. Is on scene and Wants to take care of the patient, what does the paramedic do?



Give control of the patient to the Dr. If the Dr. Is willing to assume responsibility


What kind of doctors' orders are received over the radio?



Direct/online



Where other respiratory chemoreceptors located?


The medulla



decorticate posturing is indicative of what type of injury?



At or above the upper brainstem


Eye's not moving together is called?


Dysconjugate


What is the first drug of choice for anaphylaxis?



Epi


What does a site effect of lasix


Hypokalemia


Patient has lost 750 cc of blood.  How much fluid replacement do you give?


2250 cc (3 x 750)


Patient has unequal and sluggish pupils, what is the cause?



Neurological damage


What is the name of the superior part of the uterus?


Fundus


Bleeding below the dura is called?


subdural hematoma


What controls the heart rate and respiratory rate?


The medulla



What is a sign of over hydration?


Rales


What is the best blood replacement in the field?


Lactated ringer's



Patient has MI.  What has the most important historical value?


History of chief complaint


Patient with emphysema.  What has the most important historical value?


The fact that the patient woke up with shortness of breath


What is the pneumonic for pain evaluation?


OPQRST


What is the first sign of shock?


Tachycardia



What is the best indicator of patient status?


LOC or change in mental status


Pediatric dose of epi for asthma?


0.01 milligrams per kilogram of 1:1000 SQ or 0.01mg/kg of 1:10,000 IV


What is the standard dose of Benadryl?


50 MG


Baby born with amniotic SAC intact.  What should the paramedic do?


Break the sac and suction



When do you not give a SQ injection?


When patient is in shock, not enough peripheral blood flow



Distant heart sound, JVD, pulsus paradoxes are signs of what?


Cardiac Tamponade



What keeps the alveoli open?


Surfactant



What are the two things to combat after drowning?


Acidosis and Hypoxia


What is Hypoxemia?


Decreased 02 in the blood


What is the name of the sac covering the heart?


Pericardium



Where is adrenalin produced?


In the adrenal gland



Patient refusals IV and the paramedic starts one anyway, what is the legal term?


Battery


What is the action of a paramedic at MCI?


Do primary survey then move on (triage)


What do you do when the patient LOC worses?


Go back to a primary survey



Head injury and increased ICP, what are the signs and symptoms?


Increased BP, decreased HR, increased or erratic respiration (cushing's triad)


Shock wave left behind in GSW?


Cavitation



What causes DKA?


Not enough insulin



What is a sign of elder abuse?


Unexplained trauma



Define osmosis


Movement of water from an area of lesser concentration to an area of greater concentrate(attempting to equal the concentration)


What does gestational diabetes?


The onset of diabetes during pregnancy



How does glucagons work?


It stimulate the liver to release it stores of glycogen



What determines completion of the second stage of birth?


Delivery of the baby



Define antepartum?


Before the onset of labor



What does the best way to ensure you always have enough equipment onboard?


Resupply after each run


Esophageal gastric tube airway (EG TA) is used for who?


 unconscious adult


What is the best treatment for DKA?


Lactated ringer's



What is the best drug for cardiogenic shock?


Dopamine



What is compliance?


The stiffness of the lungs


What are the distances to clamp and cut the umbilical cord?


Clamp that 10 cm and 15 cm, cut between


Patient fell from third story window, prioritize steps of treatment


C-Spine immobilization, O2, needle decompress chest, full c-spine package, transport, IV enroute


Cardioversion on the T-wave causes what?


V-fib



What is biochemical removal across a semi permeable membrane?


Dialysis



Patient hits steering wheel with signs and symptoms of cardiac tamponade


Distant heart tones, hypotension, JVD



Treatment for patient that hold dry ice in his hand?


Run water with two of 100-108° F over hand


Next treatment for each patient that has been cardioverted from V-fib?


Lidocaine Bolus start the maintenance drip



Patient has been hit in the cheek, eyes won't go up.  What kind of injury?


orbital blowout


Hepatoxin vs Hemotoxin


Hepatoin effects liver, Hemotoxin effects blood


Kinematics in collosion from?


vehicle to occupant to organ


Volume replacement for PEDS?


10-20ml/kg


Injury to C-1 thru C-4 causes what?


Respiratory paralysis


What are S&S of CVA?


Slurred speach, hemi paresis, confussion


Untreated hypoglycemia results in?


brain damage


What is a serious concern when giving D-50


infiltration


What is a sign of pneumothroax?


JVD


What is pulse pressure?


the differance in systolic diastolic pressures


Patient is riding a bike, showing S&S of heat exhaustion. What are they?


temp 101. sweating, tachycardia


Patient with S&S of heat stroke?


temp 106, dry skin, seizures


What is the peritoneal?


the lining of the stomach


Where is the spleen located?


LUQ


Fluid choice for hypovolemia?


LR wide open not TKO


What connects muscles to bones?


tendons


What is the proper placement of an IO?


Two fingers below the Tibial tuberosity


Proper placement of IO in PEDS?


Proximal tibia


What is atelectisis?


Alveoli collapse


What is the pattern and reason for Kussmaul's respirations?


Deep slow or rapid gasping respirations;the body is attempting to blow-off CO2


What is not a sign of sever shock?


Regular deep breathing


What is the most common cause of PEDS deaths?


Trauma


What dose an Inotropic drug do?


Increase contractility


What is Frank Starling reflex?


The greater the ventricle is stretched, to a point, the stronger the contraction will be.


O2 reaches the heart by what?


Coronary arteries


What causes prolonged PR interval?


Some type of delay in the AV node or ventricular ischemia


Where do you interview an emotionally disturbed patient?


Away from the family


Elavil and Tofanil are what type of drugs?


Antidepressants


What are common hazards with defibrillating a patient on Digoxin?


You may cause an emboli or clot


What will a decrease in Stroe volume do?


Decrease cardiac output


Know the characteristics of Alpha and Beta


Alpha 1:vasoconstriction, peripheral resistance, increase cardiac after load.
Alpha 2: inhibits further release of norepinepherine.
Beta 1: Increase HR, Increase in contractility, increase in cardiac muscle conductivity.
Beta 2:bronchodilator, dilation of smooth muscle in bowel.


A clot from deep vein thrombosis is likely to end up where?


The lungs


If you want to reduce to workload of the heart, what do you do?


decrease the afterload


Best drug therapy for SVT is what?


Adenosine and Verapamil


What are the effects of Coumadin?


Reduces blood clotting


If you administer 2mg of Narcan, what might the patient do?


Become aggressive


Unconscious Patient showing S&S of seizure and incontenance?


Grand Mal seizure


What don't you do for patient that is bleeding from nose and ears?


Don't stop the bleeding, it helps reduce ICP


What is the best position for a patient with ABD pain?


Lateral recumbent


What is the best position to trans port a patient with orthopnea?


Sitting up


What is the best position to detect JVD?


45 degree angle


Patient is vomiting green vomitus, suspect what?


Gall bladder


Stridor is common sign for (best answer)?


LTB-croup


When do you use syrup of ipecac?


OD on tricyclic antidepressent


Pleural effusion is what?


the escape of fluids into the lungs


In Florida the EMS is governed by what?


FS 401


Tort is what?


Wrongful act leading to a Civil suit, person vs person


What is the safest way to gain access to a patient of an MVC?


through the door


What is Conversion Reaction (Conversion Disorder)?


Patient sustains loss of function, usually the nervous system (blindness, paralysis) unexplained by any medical illness


What is most important to include in a patient report?


patient condition and treatment


Who has the most authority on the scene?


online Physician


If a paramedic suffers a normal stress reaction, you should what?


Assign them a simple, specific task


What is the treatment of PED with febrile seizures?


Use cool water not cold water or ice packs


What is the PED dose for Atropine?


0.02mg/kg


S&S of hemothroax?


Tracheal deviation to one side on inspiration, dull thoracic sound. Blood in the thoracic cavity


S&S of pericardial temponade?


Narrowing pulse pressure, JVD, distant heart sounds


Angina that begins with exercise or stress, but stops upon rest is what?


Stable angina


Is appropriate confinement considered elder abuse?


No


Will Narcan reverse the respritory depression caused by Darvon?


Yes


Mother of 4, RUQ pain?


Cholecystis


What is PEDS defibrillation settings?


2,4 and 4j/kg


Most MI result in damage to what part of the heart?


Left ventricle


Alpha receptors control what?


Peripheral vasconstriction, mild bronchoconstriction, and metabolism


Beta receptor stimulation results in what?


Increased HR, contraction, conduction, and bronchodilation


Complete heart block (3rd degree)IS ATTRIBUTED TO WHAT?


The absence of conduction between the atria and ventricles, at or below the AV node


What is the best splint for an ankle fracture?


Pillow splint


Treatment for stable patient with (mild discomfort) with dysrythmias?


Monitor, observe and transport without NO drug therapy


61 y/o female unconscious with a pulse and stable vitals, what is treatment?


O2, monitor, IV, transport


62 y/o female taking digitalis, c/o weak and dizzy. She is awake, alert, normal vitals. What is treatment?


O2, monitor, IV, Transport


What can lasix cause?


Hypokalemia


What is a clinical sign of a tension pneumothorax?


Increased movement of the cheast on the effected side


What is Primagravita?


First time pregnant


Measles, mumps, varocella are most commonly spread by what?


Air droplets


Chemoreceptors are found where?


Medulla


Baroreceptors are found where?


Aortic arch


When transporting an aggressive behavioral patient, the position of the patient should be what?


One arm restrained at its side and the other arm restraind above the head


Indications for Verapamil are all except?


Patient with V-tach


Thin person with barrel chest?


Emphysema


Define pneumothorax?


Air in the pleural space


Trauma patient with tension pneumothorax?


BVM, needle decompress, IV enroute


1 oz.=30cc
1 tsp=5cc
1 tbsp=15cc





Person ingested lye, what is treatment?


Give milk or water


Am ambulance driver has high heart rate and sweaty palms, this is a result of what?


Catecholamine release


51 y/o farmer has cramps and diarrhea, this indicates what?


Organophosphatet poison ( remember he's a farmer)


2nd stage of labor begins when?


From the dilation of the cervix and ends with deliver of the fetus


Air in the stomach makes ETT difficult due to what?


Vomiting


Male patient with partial airway obstruction, what do you do?


Leave him alone and encougre him to cough


An old lady is delusional, what do you do?


Remove her from the situation


21 y/o diabetic male with headache, what is first question?


How long ago did it start


Immobilize shoulder injury with what?


Sling and swath


Patient with one blown pupil and the other slow to react represents what?


Neurological crisis


What are ethics?


Set of rules tha govern the conduct of members of a group


Most common MVA?


Frontal impact


What is drug given to COPD patient?


Aminophylline


COPD with JVD, hypertenion, difficulty breathing on exertion?


Emphysema


Cardiac arrest with NSR and low BP, what drug do you use?


Dopamine


What drug do you give a patient in cardiogenic shock?


Dopamine


What question is important is patient is having trouble breathing?


When did the dyspnea start


What is the worst complication of RETAVASE?


Bleeding


Patient with epiglotitus, avoid lying them down





Patient with fever?


Use tepid towels


What are S&S of croup?


Slow onset, generally wants to sit up, barking cough, NO drooling.


What are S&S of epiglotitus?


Rapid onset, wants to sit up, NO barking cough, drooling, fever 102-104, occasional stridor


What is the primary location for IM injection?


Deltoid


What is the #1 priority at an emergency scene?


The rescuer's safety


Name a parasympathetic blocker


Atropine


Name the 3 section of Glscow Coma Scale?


Eyes, verbal, motor


If you do not defibrillate due to a dead battery and the family finds out, what might you be sued for?


Negligence


What is the key to effective management at a disaster scene?


Coordination of all activities


Name 2 types of frequencies used for medical communication?


UHF 450-470; VHF 150-170


You begin assessment of a call when?


As soon as the call comes in


A patient complains of SOB, pursed lips and barrel chest?


Emphysema


Chronic bronchitis is some times called what?


Blue bloaters


Ecchymosis over the mastoid process is called what?


Battle signs


What are the S&S of ICP?


Elevated BP, Dereased HR, irregular respirations


The purple lesions on the body of an AIDS patient are what?


Karposi Sarcoma


A mini drip set delivers how many drops per minute?


60gtts


Most complicated problem associated with IV therapy is what?


Air embolism


Patient in motorcycle accident with tension pneumothorax, BP 80/40, piulse 110. What is order of treatment?


C-spine, decompress, transport, IV enroute


What is a major side effect of certain types of diaretic therapy?


hypokalemia


How does Atropine work?


By blocking the effects of the vegus nerve


60 y/o patient weights 110 lbs and complains of palpations, pulse 140, BP 110/60, resiration 24. He has wide complex tachcardia, what is treatment?


Lidocaine 1-1.5mg/kg, then maintance drip


What is treatment for anaphylactic shock?


Epi 0.3mg and Benadryl 50mg


You give 25g of dextrose from a 100cc amp of 50% dextrose, how many cc did you give?


50 cc


What kind of drugs are Mellaril and Thoraxina?


Tricyclic antidepressants


What is the treatment for tricyclic OD?


Sodium Bicarb


Magnesium Sulfate is used to treat what conditions?


Calcium channel blocker OD, Torsades de Pointes, Eclampsia


What should you do if an arm or leg presents at birth?


transport immediatley


Treatment for 5 y/o with dyspnea and drooling are all EXCEPT?


Lying him flat


What do you do to avoid supine hypertensive syndrome?


Transport the patient on her left side


Pulsating mass in the ABD with back pain is most likely what?


Abdominal Aortic Aneurysm (AAA)


What is the primary concern with near drowning?


Hypoxia and acidosis


What is the purpose of Kussmal's respirations in a diabetic patient?


To combat metabolic acidosis


The biggest concern with angulated fracture is what?


Pinching and cutting of nerves and blood vessels, distal circulation


In a blast, where are the primary injuries?


To the hollow organs


A bullet wound is called a cavitation





Why should you not remove an impaled object from the eye?


Because fluid loss will occur


A patient has an evisceration, should you try to replace exposed ABD organs?


NO


What is common to all forms of shock?


In adequate tissue perfusion


What is a possible consequence to high cervical fractures (C-1,C-2)?


Interrupt or stop the respiratory system


How should you manage a patient with a jugular laceration and suspected air embolism?


Apply direct pressur to the wound and place the patient on their left side


A fractured clavical presents how?


With the shoulder on the injured side bent foward


A patients left pupil is fixed, dilated, and slow to respond to light. This represents what?


Neurological crisis


What is a more common name for the thyroid cartilage?


Adams apple


The most severe burns are caused by what?


Alkali's such as Drano and oven cleaners


Hypovolemic shock from major burns is a result of what?


Loss of blood plasma


What is definite necessary treatment for flail chest?


Positive pressure ventilations


A hemothorax is associated with hypovolemic shock why?


Because there is a pump problem, and loosing blood into the chest cavity


What is the correct order of inspection for the abdomen?


Auscultate before you palpate


Define cell


The smallest living unit of structure and function of the body


Define system


Group of related organs that work together to perform specific functions


What is the purpose of cerebral spinal fliud (CSF)?


To cushion the brain and spinal cord


Dilated pupils can be a response to what?


Epi, Atropine, cocaine, amphetamines, and cerebral hypoxia


Pinpoint pupils (miosis) can be a result of what?


Organophosphate poisoning and narcotic use


Define Cullen's Sign


Hematoma or bruising around the umbilicus, indicating internal abdominal injury


Kern's sign is what?


Referred pain to the left shoulder; may indicate an ectopic pregnancy or an injury to the spleen


The smaller the child the more likely the vital signs are how?


The lower the BP, the higher the pulse and respirations


In a patient with a head injury, how should the patient be transported?


With the head elevated


How many lobes do the lungs have?


3 on the right and 2 on the left


Suctioning can cause what?


Abnormal EKG's and hypoxia


Neurogenic shock can present how?


Warm dry skin, decreased BP and NON tachycardia


The first signs of shock are what?


Anxiousness and restlessness


The end of an EOA should be where?


Just below the carina


The adrenal gland secretes what?


Epi and norepi


What do the kidneys rely on for perfusion?


Systolic BP


The normal patients respirations are triggered by what?


An increase in atrial CO2


The Heimlich Maneuver is performed where?


The epigastrium region of the abdomen


COPD patients respiratory is triggered by what?


A decrease in O2


What is one result of Beta stimulation?


Vasodilation


Oxytocin and ATCH are excreated by what gland?


The pituitary gland


What is the order MAST Pants are inflated?


Left leg, right leg the abdomen


A subaracchnoid bleed occurs where?


Below the arachnoid


An epidural hematoma is where?


Between the skull and the dura


What are the possible S&S of a subarachnoid bleed?


Sudden onset of headache, blurred vision, and possible unconsciousness due to the vessel rupture


What is the usual progression of a subdural bleed?


The subdural bleed is usually slow due to it being a venous bleed


What is the progression of an epidural bleed?


Usually fast due to it being an arterial bleed


Why is decerebrate posturing ususally a worse sign than decorticate posturing?


Decerebrate posturing is usually indicative of a main brain stem injury, where decorticate posturing inducates an injury to the brain ABOVE the brain stem.


What are S&S of traumatic Asphyxia?


Bulging tongue and eyes, and cyanosis of the upper body


What is the movement of a flail chest?


Moves in on inspiration and out on exhalation


What ligament holds the thoracic aorta in place?


The Ligamentum Arteriosum


A SPRAIN is an injury to what?


Ligaments


A STRAIN is an injury to what?


Muscles


A traction splint is indicated for and used why?


A mid-shaft, closed femur fracture.  To maintain stabilization, maintain distal perfusion and pain relief