Term
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Definition
Wear gloves & eye protection
Wear mask & gown if possible
Wash hands properly & thoroughly
Dispose of sharps carefully & safely |
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Term
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Definition
| If it within EMt scope of practice it is. The EMT "duty to act" |
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Term
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Definition
4 criteria: negligent party must e in a position where they had a "duty to act"
breach of duty occurs
Damage occurred physical or psychological
Damage was a direct of EMT not performing their duty to the standard of care expected. |
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Term
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Definition
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Term
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Definition
| Critical Incident Stress Debriefing, meeting held w/in 24 to 72 hours after a critical incident to provide support & suggestions on how to deal w stress incurred due to the incident |
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Term
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Definition
| Minimum accepted care based on sources such as state law |
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Term
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Definition
12-20 adults
15-30 child
25-50 infant |
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Term
Tidal volume
Summary of normal breathing |
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Definition
Depth of breath = tidal volume
Normal- rate, rhythm, quality, and depth |
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Term
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Definition
CO2 levels rise in body, the need to exhaled is cued
Increased levels of CO2 in the body cause the brain to send a signal to the breathing muscles: the diaphragm & the inter stale. Movement of these muscles expands the chest & creates negative pressure causing the lungs to expand & air to enter thru airway. |
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Term
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Definition
| Tiny capillaries where gas exchange occurs. Capillaries release CO2 (cellular waste) into alveoli & blood cells absorb O2 which turns them bright red arterial blood. Increase level of CO2 in alveolar sacs signals the body to exhale. |
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Term
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Definition
| Active breathing, diaphragm contracts by flattening out & pulling down the abdomen; the intercostals muscles contract & open up the rib cage or thoracic cavity. Increased volume inside the vacuum of thoracic cavity, creates neg pressure, lungs expand, & fill a vacuum, air flows into the lungs thru airways |
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Term
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Definition
Passive part of breathing
Diaphragm relaxes which brings it upward while the intercostal muscles release & the spaces between ribs become smaller. This reduces size of thoracic cavity, which causes pressure to expel air fr lungs. |
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Term
| Signs of inadequate breathing |
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Definition
Breathing rate less than 12 or greater than 20 bpm adults
Less than 15 & greater than 30 children
Less than 25, greater than 50 in infant.
Skin color bright pink, red, or blue
Nasal flaring
Minimal air flow
Chest movement is not rhythmic; breaths not even in volume
Extra muscles help in breathing; look for abdominal, neck & shoulder movement
Sounds made fr airway
Skin is damp & clammy |
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Term
Gurgling sounds
Snoring
Stidor
Crowing
Wheezing
Rales
Rhonchi |
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Definition
G= fluid or mucous in upper airway
S= partial blockage of tongue or other obstruction
stridor high pitched coming fr upper airway during inhalation- may indicate blockage at larynx
Crowing = lower pitched noise noise heard upon exhalation
Wheezing = lower airway problem caused by asthma
Rales= fluid w/in alveoli of lungs, crackling sound is heard
Tho chi= snoring-like sound fr either upper or lower airway & is continuous, it may imply excess of mucous in airway |
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Term
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Definition
Develops when body tissues are not receiving enough oxygen. Initially present w disoriented, irritable, nervous, & have rapid pulse
late stages labored breathing ch pain in extreme cases patients turn blue
Conditions= heart attack, asthma, smoke inhalation, drug OD, shock & fluid in lungs. |
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Term
| Auctioning to clear airway |
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Definition
Sm obstruction, auctioning my clear it, is used to clear mucous, blood, blood, vomit, & fluid. 2 type of catheters 1. Tonsil tip - rigid tubes or 2. french tip - softer & flexible tubes.
Measuring:measured so it does not go past the base of the tongue
Soft/French tip - removing fluids from nasopharynx
Hard/tonsil tip - oropharynx & mouth preferable for removing small obstructions, as they do not collapse. |
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Term
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Definition
(NPA) can be used on semi-conscious patients who have a gag reflex
Well-lubricated measured from tip of patient's nose to their earlobe.Insert by rotating airway back & forth in a spiral direction. |
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Term
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Definition
Upper airway adjunct is inserted thru mouth to assist in maintaining airway latency. Unconscious, can't be used on a patient w gag reflex it will cause vomiting.sizing by measuring from earlobe to teeth.
insert upside down slide bk of soft palate until resistance is met & so that it's base sits against the patient's teeth. |
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Term
| Heimlich maneuver (abdominal thrusts) |
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Definition
| Used to clear airway of conscious patient, not on pregnant woman, instead use chest compressions. Chest thrusts as used in CPR, can be used for pregnant women & are considered effective for dislodging obstructions from an unconscious person as they can be done concurrent w CPR ministering. |
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Term
| Opening airway in infants patients |
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Definition
| Assess breathing from distance before introducing the cold & scary stethoscope. watch for chest rise & fall;assess color & movement or lack of before handling infant. don't hyperextend head, use blow by O2 @ 6lpm. Suctioning w bulb syringe. when inserting OPA inset w tongue depressors in upright position, using rotation technique not to damage soft palate. |
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Term
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Definition
| Volume of air that is inhaled during a regular or normal breath.Measure of the depth of patient's breath. Hand on chest helps determine the amount of chest movement during respiration. |
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Term
| Cricord pressure or Sellick maneuver |
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Definition
Preventative measure to block the esophagus & thus prevent gastric distention & vomiting during ventilation. used on unconscious patients, especially if they r receiving mask or BVM ventilation & endotracheal intubation can't be performed.
Technique: apply downward pressure to ring of cricord cartilage that lines the bottom of larynx., this blocks the esophagus & ensures ventilated air enters the lungs. |
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Term
| Oxygen delivery equipmentb |
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Definition
Simple mask:6-10 liters,40-60% oxygen
Nasal cannula :1-6lpm or 20-40%
no rebreather masks 10-15lpm or 70-100%, 1way valve prevents from inhaling exhaled CO2.
Bag Valve Masks: BVM requires perfect alignment of patient's head |
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Term
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Definition
| Device used to determine the oxygenation of the blood in a non-invasive manner. In fared light absorption determine how red & how oxygen saturated the blood is over the period OD a pulse using the difference in infrared absorption between venous & arterial blood to determine the mat of O2 being used by the tissues.This does not monitor CO2 levels of the blood or ventilation in general. |
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Term
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Definition
| Flow restricted oxygen ventilation device is an oxygen powered device that can provide ventilation w/out physical input from the rescuer, it uses high pressure (50psi) to deliver oxygen thru a demand valve on a mask which is held in place by the rescuer. It can deliver 100% O2.Not used on patients w possible obstructions including COPD, patients w possible neck injuries, children, & infants. |
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Term
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Definition
| Laying patient on their side w top leg & top side arm on the ground anteriorly to prevent the patient fr falling onto their back. Position allows drainage fr mouth & can prevent a patient fr choking on their vomit. |
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Term
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Definition
| Allergic reaction or reaction to stress that causes the smooth muscle of bronchioles to contract; referred as bronchi spasm. Constricts the airway & may even completely block them. Production of excessive mucous can also block the airway further. The resulting symptoms can include coughing, wheezing, hypoxia & increased respiration respiration rate. Patient is likely be using accessory muscles to try to catch their breath, but are actually trying to expel trapped air. Asthma can be treated w brochodilater inhaler, since in an allergic reaction, epinephrine in inhaled form may be administered by med practitioners. |
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Term
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Definition
| Presents itself as a history of lung infections, excessive mucous that is loosened upon coughing, wheezing or tho chi & difficulty breathing due to inefficient gas exchange. Caused by in increased number of mucous cells. Their secretions smother the alveoli making it difficult for the capillaries to release CO2. both emphysema & chronic bronchitis r associated w smoking & may cause het failure. |
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Term
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Definition
| Dilated bronchioles allowing air movement to occur readily. EMT-B must have permission fr med officer to overseer to go ahead w the dose. |
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Term
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Definition
Heart, arterial system & the venous system
Heart acts as pump that pushes blood to the lungs & then out thru the arteries, to arterioles & then capillaries where oxygenated blood is picked up by the cells.
Arteries r under pressure & have smooth muscle in their lining to help move blood along the capillaries.
Capillaries r midpoint between the arteries & veins at both the lungs & cellular level. Their twin walls allow for gas exchange, & the delivery of nutrients & the removal of waste products.
Veins: venous system low pressure, thin walls, w/out musculature.Venous system consists of veins, venues, & capillaries. Capillaries deliver deoxygenated blood to venues where it is moved along to the veins, carries blood bk towards the heart for re-oxygenation & removal of CO2. |
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Term
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Definition
2 aground, 2 ventricles. Atria receive blood, ventricles send blood.right atrium receives deoxygenated blood fr the Vena Cava, which is the final vein of the circulatory system. Blood moves thru the tricuspid atrioventricular valve into the right ventricle. Right ventricle pumps blood into the lungs the the pulmonic valve via pulmonary artery.
Oxygenated blood returns to hrt thru left atrium, flows down thru the mitral valve to the left ventricle & is pumped out thru the aorta thru to thebrest of the body via arteries. |
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Term
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Definition
| Aka aortic arch or ascending aorta receives blood from left ventricle & distributes it thru the arterial system to the body; very thick-walled for high pressure. |
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Term
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Definition
| Receive blood from the pulmonary trunk & send it out to the lungs |
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Term
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Definition
| Return oxygenated blood from lungs to left atrium |
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Term
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Definition
| Receives deoxygenated blood from the right ventricle and sends it via the pulmonary arteries to the lungs. |
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Term
| Superior & inferior vena cava |
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Definition
Superior vena cava- returns blood from the upper body to the heart.
Inferior vena cava- returns blood from the lower body to the heart. |
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Term
| Left & right coronary artery |
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Definition
Left coronary artery-returns blood from the upper body to the heart.
Right coronary artery-supplies blood to the right atrium. |
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Term
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Definition
| Received most of the deoxygenated blood from the heart muscle, receives blood from the great cardiac vein & the middle cardiac vein. |
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Term
| Conduction system of the heart |
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Definition
Small % of cardiac muscle cells are auto rhythmic in that they contract continually, setting the beat for the rest of the heart muscle.
SA node produces electrical charge at top of rt atrium, produced by their contraction then moves to the Atrioventricular (AV) node, which lies on the wall between the rt atrium & rt ventricle. Signal produced in AV node is sent down the atrioventricular bundle, aka bundle of his, which lies between 2 branches are purkinje fibers, wh initiate the contraction of the ventricles fr the bottom up.
The result is recognizable double beat of the heart w the contraction of the atria staggered slightly, but perfectly fr that of the ventricles. |
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Term
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Definition
| Blood supply to heart muscle is blocked. Usually occurs @ left ventricle & results in damage to cardiac muscle.left ventricle pumps blood to rest of body, & receives oxygenated blood from the lungs via the right atrium. When it's musculature isn't working, blood pools in the left ventricle-called congestive hrt failure (CHF) & result in death. Symptoms:SOB, increased hrt rate, chest noises will be heard as blood & fluid accumulate in lungs. |
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Term
| AMI -acute myocardial infarction |
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Definition
Result of hrt muscle not receiving blood due to a blockage of coronary arteries. As soon as blood supply to the hrt muscle or myocardial tissue stops, the tissue begins to die & this impairs the gets ability to pump blood.
Symptoms of hrt attack: tightening sensation or pain w/in the chest which can radiate out to the left arm, neck, & jaw. Patient can feel faint, nauseous & or short of breath. Pale, & damp skin, pulse rapids, slow or irregular, there will be a change in BP. |
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Term
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Definition
| Consequence of hrt attack, shock is physiological state of a body w/out enough blood supply. Tissue damage caused by initial hrt attack is spread due to the inefficiency of the muscle near the damaged area. The results similar to CHF as the hrt is unable to distribute the blood it receives, which builds up & backs up into the lungs. |
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Term
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Definition
Heart seizes to generate an effective beat to provide circulation, usually result of arrhythmias, hearts electrical impulse no longer functions & pulse is not produced. A patient can be conscious during a heart attack but once cardiac arrests occurs, they will no longer be conscious.
Muscle damage caused by a heart attack can lead to cardiac arrest lasting 4-6 minutes leads to to death due to brain damage caused by lack of oxygen to brain. |
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Term
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Definition
Catch all phrase that there are signs associated w heart condition.
Pale or grey in color, cold hands & feet due to poor circulaton,
Perspiring excessively
Rapid or irregular pulse
Hav a feeling of impending doom or feel very anxious |
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Term
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Definition
Used on unconscious, not breathing, no signs OD circulaion
Over age 8, & weighs more than 55 pounds
Not used on person w pacemaker |
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Term
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Definition
4-step process
Early Access
Early CPR
Early defibrillation
Early advanced care. Can include endotracheal intubation in order to make patient more responsive to AED & administering medications to ensure the heart retains a regular rhythm once resuscitated. |
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Term
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Definition
Low BP lower than 135/85 , feeling faint or dizzy & weak,
Causes: reduced blood volume, by blood loss or dehydration, or inefficient circulation which can be a result of impaired heart function or medications, some related causes are cardiac muscle damage due to disease or heart attack, valve malfunction or a malfunction in the conductive system of the heart. |
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Term
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Definition
Chest pain that results in partial blockage of coronary arteries leads to poor blood supply to heart muscle. Reduced blood supply depletes oxygen available to the muscle cells ( hypoxia) & makes it hard for them to contract. Cramp in heart muscle, commonly occurs during times of physical stress when the heart is working hard & needs more oxygen.
Heart attack is complete blockage. Angina pain can be alleviated w nitro. |
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Term
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Definition
| 1st occurrence of angina as a symptom of coronary artery disease CAD & resulting in Ischemia. Usually result of plaque build up in artery damaging the wall of the artery, this causes the body to try to heal it with blood clotting platelets. The scab that is formed increases the blockage even more, subsequently increasing the ischemia of the effected tissue. |
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Term
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Definition
| Or Prinzmetal's syndrome is a type of unstable angina where the diseased artery goes into spasm. Unstable angina is always a cardiac emergency. |
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Term
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Definition
| A form of arterriosclerosis where the walls of the arteries thicken due to an increase in smooth muscle fiber & fatty deposits known as plaque. This condition is often associated w coronary artery disease. |
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Term
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Definition
| Disease which results in the hardening of arteries due to thickening & loss of elasticity. |
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Term
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Definition
| Shock - oxygen & nutients are not reaching the tissue of the body as a result of poor circulation or lack of blood volume. |
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Term
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Definition
| Volume of blood pumped thru the heart in 1 minute, affected by blood pressure & heart rate. |
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Term
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Definition
| The bulging out of an arterial wall at a weak point. Weaknesses in the walls are often created by atherosclerosis. These weak point can burst & cause a person to bleed vessel wall. |
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Term
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Definition
| Term used to describe a blood clot that has broken loose from the blood vessel wall. |
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Term
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Definition
| Any debris floating thru the bloodstream; it could be a blood clot, or other debris caused by an injury that breaks lose & enters the bloodstream. An embolus can block an artery & prevent blood flow to a major organ such as the heart thus becoming an obstruction. |
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Term
| Veins that carry blood to heart |
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Definition
Major veins: femoral vein -ea leg, inner thigh
Jugular veins- neck on either side of the trachea, from the brain & head
Pulmonary veins- from the lungs to the heart
Renal veins-from the kidneys
Superior vena cava- upper body to the heart
Inferior vena cava- lower body to the heart |
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Term
| Arteries vessels that carry blood away from the heart.Major arteries are: |
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Definition
Abdominal aorta-from the aortic arch through the abdomen
Renal artery- to the kidnys
Carotid arteries-neck on either side of the trachea,feeds the brain & head
Pulmonary arteries- from heart to lungs
Coronary arteries-blood supply or the cardiac muscle
Femoral artery- each leg, inner thigh
Brachial artery-each arm, insde |
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Term
| Baseline vitals are taken during focused physical exam after initial assessment |
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Definition
Level consciousness GCS score
Pulse: wrist 15 seconds
Respirations: breaths per minute & access the quality of breathing
Skin: to assist in determining quality of circulation; feel for temperature & dampness, observe skin color.
Capillary refill: nail blanch test helps determine quality of circulation,press nail bed w finger & count the seconds it takes to go from white to pink. Pulse ox can also be used to determine quality of circulation. |
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Term
| Glasco coma scale is standardized scale used to assess brain injury or level of conscious |
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Definition
Eye: 1-no eye opening 2-open to pain 3- open to voice4- open spontaneously
Verbal response:1-no response 2- makes incomprehensible sounds 3- uses inappropriate words 4-shows confusion 5- orientated-able to communicate.
Motor response 1-no response,2-extends to painful stimulus 3-flexion to painful stimulus 4-pulls away from painful stimulus 5-patient can indicate where pain is 6-patient can follow commands. The GCS is part of trauma score. |
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Term
| Revised trauma score used by ER to determine the severity of patient's trauma, it helps to determine if a patient needs to be transported & which treatment center. |
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Definition
GCS:13-15 scores 4
9-12 score 3
6-2 scores 2 and less than 4 = 0
Systolic # above 89mmHg = 4
between 88-76mmHg = 3, from 50-75 mmHg = 2
no BP = 0
Respiratory rate:
10-29 breaths per minute = 4
higher than 29 = 3
6-9 breaths per minute= 2
1-5 = 1
0 = non breathers |
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Term
| Rapid Trauma Assessment, after scene survey initial assessment, the rapid trauma assessment is used if it appears that the MOI warrants it, also referred to DCAP-BTLS, sequence |
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Definition
Factors to remember: apply appropriate size cervical collar immediately after inspection of head & neck
Painful areas do not always need to be palpated, do not palpated a painful pelvis
Decision to transport can be made at any point during the Rapid Trauma Assessment |
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Term
| Rule of Nines: standard method used to quickly estimate % of body burned, it gives body 9% portions, or multiples of nine, based on the hand being equivalent to 1% |
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Definition
Head-Neck - 9 %
each Arm- 9%
Torso front- 18%
torso back-18%
Each leg-18%
Perineum-1%
Remove that is still burning, clothing or hot jewelry or chemical that is still on the body.
Next clear airway, then cool the burn area ASAP, preferably done w sterile saline water. Chemical burn, continuous flushing w water is a good idea wash away any remaining chemical & neutralize any further reaction.Infection major concern once cooled, cover w sterile dressing, keep patient warm & remove any wet clothing.Hypothermia can be a concern when patients are wet & cold & waiting for transport. |
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Term
| Signs of CNS injury: signs of spinal cord damage or brain injury included: |
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Definition
Paresthesia of 1 or more extremity
Loss of bladder or bowel control
Priapism - a painful penile erection
Neurogenic shock
Breathing difficulties
Pupils dilated, different sized or non-responsive to light
Change in mental status
Leakage of cerebrospinal fluid from injury ears or nose |
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Term
| Spine board considerations |
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Definition
| When using spine board for a suspected spinal injury, the patient should first be stabilized w cervical collar. 3 people preferably should be involved in placing the patient on board. 1 person stabilizes head & neck all times, & isbresponsible for calling the shots, patient is rolled forward, the board is placed beneath him & then he is lowered onto the board. During the roll forward, an assessment of posterior side should be carried out. |
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Term
| Shock - is hypo perfusion, or lack of blood supply to tissues. The type of shock defines what is causing the hypo perfusion. |
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Definition
Hypovolemic - due to loss of blood volume caused by bleeding or severe dehydration
Cardiogenic- heart is not functioning sufficiently for effective circulation
Neurogenic - caused by injury to nervous system, including the spinal cord or brain; damage to the sympathetic nervous system
Anaphylactic- severe allergic response where body releases excessive histamine which causes vasodilation & a dramatic reduction in BP
Septic shock - infection, usually bacterial, that leads to tissue damage & affects circulation |
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Term
| Shock - is hypo perfusion, or lack of blood supply to tissues. The type of shock defines what is causing the hypo perfusion. |
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Definition
Hypovolemic - due to loss of blood volume caused by bleeding or severe dehydration
Cardiogenic- heart is not functioning sufficiently for effective circulation
Neurogenic - caused by injury to nervous system, including the spinal cord or brain; damage to the sympathetic nervous system
Anaphylactic- severe allergic response where body releases excessive histamine which causes vasodilation & a dramatic reduction in BP
Septic shock - infection, usually bacterial, that leads to tissue damage & affects circulation |
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Term
| Shock - is hypo perfusion, or lack of blood supply to tissues. The type of shock defines what is causing the hypo perfusion. |
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Definition
Hypovolemic - due to loss of blood volume caused by bleeding or severe dehydration
Cardiogenic- heart is not functioning sufficiently for effective circulation
Neurogenic - caused by injury to nervous system, including the spinal cord or brain; damage to the sympathetic nervous system
Anaphylactic- severe allergic response where body releases excessive histamine which causes vasodilation & a dramatic reduction in BP
Septic shock - infection, usually bacterial, that leads to tissue damage & affects circulation |
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Term
| Shock - is hypo perfusion, or lack of blood supply to tissues. The type of shock defines what is causing the hypo perfusion. |
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Definition
Hypovolemic - due to loss of blood volume caused by bleeding or severe dehydration
Cardiogenic- heart is not functioning sufficiently for effective circulation
Neurogenic - caused by injury to nervous system, including the spinal cord or brain; damage to the sympathetic nervous system
Anaphylactic- severe allergic response where body releases excessive histamine which causes vasodilation & a dramatic reduction in BP
Septic shock - infection, usually bacterial, that leads to tissue damage & affects circulation |
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Term
| Typical signs of shock of Compensated shock |
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Definition
Where the body is still try to make up for blood loss
a) slight increase in HR, BP normal or a little high
b) lethargic, irritability, slight confusion
c) skin is cool & damp
d) rapid breathing |
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Term
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Definition
a) moderate increase in HR, weak pulse, BP below normal
b) confused or unconscious, dilated pupils
c) skin begins to turn grey or bluish, especially at lips & nail beds as oxygenated blood is reduced |
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Term
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Definition
a) coma
b) HR less than 60bpm, BP extremely low
c) excessive perspiration
d) slow & ineffective breathing |
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Term
| Emergency medical care of shock victim |
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Definition
Airway management, open airway, O2 BVM to assist ventilations if patient is having difficulty breathing or use advanced measures as necessary
Control bleeding, once done place patient in a supine position w feet elevated & keep them warm w blankets. Transport patient immediately |
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Term
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Definition
| Origin of bleeding to determine severity |
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