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NREMT - Medical Emergencies questions and answers with rated solutions
Angioedema A puffiness of face, lips, and neck due to swelling underneath the skin; common in allergic reactions Aura the state of mind just befor... [Show More] e the onset of a seizure; strange feeling, some may experience visions Diabetes type-I Juvenile diabetes requires daily insulin injection Diabetes type-II Adult onset diabetes, can be controlled by diet, exercise, and weight loss Dysarthria Slurred speech Expressive aphasia Loss of speech Hemorrhagic stroke Rupture of a blood vessel in the brain Hyperglycemia high blood sugar Hypoglycemia low blood sugar Insulin Hormone produced by the pancreas that regulates glucose metabolism (blood sugar) by signaling the cells of the body to intake sugar from the blood Ischemic Stroke A blocking of an artery of the brain which prevents blood flow and oxygen brain tissue, usually caused by atherosclerosis. This is the most common type of stroke Ketoacidosis A lowering of blood pH due to the use of fatty acids for energy. This happens when insulin is not present to allow glucose to enter the cells. It is usually associated with hyperglycemia Postictal After a seizure state, brain is recovering. Patient is likely confused and exhausted Receptive aphasia Loss of understanding Status epilepticus When seizures come one on top of the other, so that there is more than 3 per hour or they last progressively longer. This is a medical emergency. What is a behavioral emergency? When a person acts in a way that is not considered normal or appropriate by their family or community How many EMT's should be in charge of one situation? 1 Describe when someone can refuse care 18+, Can make informed decisions, not under the influence, understand the risks associated with refusing care, sign a release form What are the five rights? The right patient, the right time and frequency, right dose, right route of administration, right drug What are opioid analgesics? Painkillers, common cause of drug poisoning What are sedative hypnotics? Slow down body functions; cause decreased respirations What are anticholinergics? Antidepressants What are cholinergics? Causes excretion from orifices What are inhalants? Airplane glue, paint, nitrous oxide, decrease respirations What are sympthomimetics? Imitates adrenlaine- Meth, amphetamines, cocaine, epinephrine What are hallucinogens? Distorts thoughts, senses, and perception What is treatment of hypogylcemia? Insulin Shock What is one way of treating hyperglycemia? Oral Glucose What is hyperglycemia? When the body is not supplied with insulin How can you detect ketone production? Fruit Odor Breath T/F Hyperglycemic patients needs to be hospitalized True What is a seizure? Short circuit in the brain as a result of hyperactive firing of a neuron What is a grand mal seizure? Complete loss of consciousness followed by spasm of all the body's muscles What are petit mal seizures? Known as absence seizures; most common in children. lasting for seconds and is visible by twitching facial muscles/ hands What are focal motor seizures? Isolated muscular quivering or shaking What are febrile seizures? Occurs in seizures as a result of high fevers If someone has a history of diabetes what can you do? Administer oral glucose What is Transient Ischemic attack (TIA)? Passing of a blood clot through the brain that results in temporary stroke-like symptoms How long is a TIA? Few minutes to a few hours What are symptoms of anaphylaxis? Swelling of hands or feet, hives, angiodema, decreased blood pressure, coughing and difficulty breathing What is the biggest concern of anaphylaxis? Swelling of throat How can poisons enter the body? Injection, Ingestion, Inhalation, Absoprtion If there is H2S or other gas what do you do? Wait for the patient to be retrieved, ensure and maintain airway, administer high flow O2 If poison is through contact what do you do? Flush thoroughly What are the most common causes of food poisoning? E. Coli and Salmonella What is a major concern of food poisoning? Dehydration What are symptoms of food poisoning? Cramps, nausea, diarrhea and vomiting Review types of bites ... What is hypothermia? When the core body temp is below 94F What are stages of hypothermia? Shivering, coldness, torso feels cold, mental impairment, sleepiness, bradycardia, death When do rewarm a patient? When directed by a medical overseer If someone is frostbitten and you are to rewarm them what do you do? Immerse them in body temp water What is hyperthermia? When the core temp is above 99F How do you treat someone with hyperthermia? Take them out of heat and provide fluids Heat exhaustion is common in.... Seniors Symptoms of heat exhaustion... Heavy perspiring, nausea, and light headiness What are common risk factors for potential suicide? Mental disorders, previous suicide attempts, alcohol or drug abuse Suicide is most common with... 15-25, over 40 If you needed to restrain a patient what do you do? At least 5 people What is organic brain syndrome? A condition of the elderly as it refers to mental dysfunction What is peritonitis? Digestive organ bleeding, inflammation, or blockage When someone has acute abdomen pain, what do you do? Limit the on-scene time What do you not do if someone has acute abdomen pain? Nothin by mouth What is secondary survey? Observing the 4 quadrants, listening to sounds What is appendicitis? A rupture of the appendix in the right lower quadrant What is duodenal ulcer disease? Ulcers of stomach in upper half of the quadrant What are kidney stones? A mineral blockage in the kidneys, pain in lower back, radiating down to genital area What is cholecystitis? Inflammation of the gall bladder in upper right quadrant What is pancreatitis? Inflammation of the pancreas associated with heavy drinking What is referred pain? When the pain is occurring in a different place than the cause of the pain What is in the upper right? Liver, gallbladder, top of pancreas, right kidney, part of the duodenum, part of colon Upper left Spleen, end of pancreas, stomach, left kidney, part of colon Lower Right Appendix, ascending colon, stomach, left kidney, part of colon Lower Left Small intestine, descending colon, left ovary How do you treat genital injuries? The same as abdominal or soft tissue injury [Show Less]
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NREMT Airway Management and Ventilation questions and answers latest 2023
Airway management and ventilation are... FIRST and MOST critical steps in assessment of every patient you encounter. Lower airway anatomy trachea ... [Show More] (C-shaped rings) bronchi (main stems) bronchioles (bronchiole rings)-have unique property: stimulated by drugs alveoli (perfusion takes place)-surfactant keeps them open lung parenchyma pleura (parietal and visceral) Upper airway anatomy nose nasal cavity para-nasal sinus nasopharynx oropharynx laryngopharynx larynx Pediatric airway is different because... smaller jaw larger tongue cricoid cartilage is narrowest part of airway epiglottis is rounder and floppier respiration is... the exchange of gases between organisms and it's environment ventilation is.... the mechanical process of moving air IN and OUT of the lungs Pulmonary Circulation is... the perfusion of O2 and CO2 Diffusion... movement of gas from an area of HIGHER CONCENTRATION to area of lower concentration Diffusion transfers gases between??? LUNGS and BLOOD and BLOOD and PERIPHERAL TISSUES Normal arterial pressures oxygen(PaO2)=100 torr Carbon dioxide(PaCO2)=35-45 avg.=40 SPO2 and ETCO2 SPO2=94-100 ETCO2=40 Factors affecting O2 concentration in Blood... decreased hemoglobin concentration inadequate alveolar ventilation decreased diffusion across pulmonary membrane, when diffusion distance increases, or pulmonary membrane changes Ventilation/perfusion mismatch occurs when portion of alveoli collapses 00:18 01:42 Factors affecting CO2 concentrations in Blood... Lowers CO2 levels are due to increased respiratory rates or deeper respiration or hyperventilation and Higher CO2 levels are caused by: fever, muscle exertion, shivering, or metabolic processes resulting in the formation of metabolic acids So, a pt. w/ a PaCO2 of 30 will be... ALKALOTIC thus decreasing respiratory rate... Respiratory Rate is INVOLUNTARY however can be VOLUNTARILY controlled. chemical and physical mechanisms provide involuntary impulses to correct breathing irregularities chemoreceptors are located in... carotid bodies arch of the aorta and medulla baroreceptors in carotid artery regulate BP stimulated by decreased PaCO2, increased PaCO2, and decreased PH Cerebrospinal fluid (CSF)pH primary control of respiratory center main respiratory center medulla (neurons in medulla initiate impulses that produce respiration) apneustic center assumes respiratory control if the medulla fails to initiate impluse pneumotaxic center controls respiration Stretch receptors (HERING BREUER REFLEX) prevents over expansion of the lungs Normal respiratory rates: adults: 12-20 pedi: 18-24 infant: 40-60 airway obstruction caused by: foreign bodies trauma laryngeal spasm edema aspiration MOST COMMON OBSTRUCTION: YOUR TONGUE... Respiratory system assessment: is airway patent? is breathing adequate? look, listen, feel respiratory physical exam: inspection (mouth, nose) skin color (flush, pale, blue) pt. position dyspnea modified form of respiration rate, pattern, mentation, auscultation listen at mouth and nose for adequate air movement stethoscope for normal or abnormal air movement auscultation anterior and posterior kussmaul's respirations deep slow or rapid gasping (common in DKA) cheyne-stokes respirations progressively deeper, faster, breathing and alternating gradually with shallow, slower, breathing (indication of brain stem injury) agonal respirations shallow slow or infrequent (indicating brain anoxia) disruption in ventilation caused by nervous system trauma poison over dose disease airway sounds: stridor wheezing rales rhonchi snoring crackles palpate chest wall for: tenderness symmetry abnormal motion crepitus subcutaneous emphysema monitoring devices for airway ETCO2 electronic and colormetric SPO2 esophageal detector device EDD (bulb refills easily upon release indicates correct placement of ET tube) manual airway maneuvers head tilt/chin lift modified jaw thrust (used in trauma b/c C-collar) jaw-thrust maneuver sellick's maneuver (cricoid pressure) jaw lift maneuver basic mechanical airways nasopharyngeal airway (NPA) or oropharyngeal airway (OPA)-tip facing palate & rotate 180 degrees into position advanced airway management Endotracheal intubation is performed if basic airway management is NOT effective Laryngoscope blades: Macintosh blade (vallecula) or Miller blade (lifts up the epiglottis) ET intubation indicators: cardiac arrest, respiratory arrest, unconsciousness risk aspiration or obstruction from foreign bodies trauma, burns, anaphylaxis, respiratory extremis due to disease pneumothorax, hemo-thorax, hemo-pneumothorax w/ respiratory difficulty complications ET intubation: equipment malfunction teeth breakage or soft tissue lacerations hypoxia-esophageal intubation, endo-bronchial intubation, or due to TIME tension pneumothorax [Show Less]
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NREMT Paramedic Drugs questions and answers with rated content
ACETAMINOPHEN Class: Anti-pyretic Indications: Fever Contraindications: Liver failure; hypersensitivity; exceed max dose Side effects: Liver toxicity ... [Show More] Adult Dose: 1 g q 6 hours; max 4 g in 24 hours Pediatric Dose: 15 mg/kg q 6 hours Special info: Tylenol ADENOSINE TRADE NAME: Adenocard CLASS: Antiarrhythmic ACTIONS: Slows (decreases) AV conduction INDICATIONS: Symptomatic PSVT, including Wolff-Parkinson-White Syndrome (WPW) PHARMACOKINETICS: Onset: 20 - 35 seconds Peak Effect: 20 - 35 seconds Duration: 30 - 120 seconds Half Life: 10 seconds CONTRAINDICATIONS: Second or third degree heart block, sick-sinus syndrome, known hypersensitivity to the drug, dysrhythmias other than PSVT, reactive airway diseases like asthmea. PRECAUTIONS: Arrhythmias, including blocks, are common at the time of cardioversion. Use with caution in patients with asthma. SIDE EFFECTS: CNS: Dizziness, near syncope, syncope CV: PVCs, PACs, sinus tachycardia, sinus bradycardia, AV blocks, chest pain, facial flushing, headache Resp: SOB, bronchoconstriction GI/GU: Nausea DOSAGE: ADULT: 6 mg rapid IV bolus over 1-2s; after 1-2 minutes, 12-mg dose over 1-2 seconds. PEDIATRIC: Initial dose: 0.1mg/kg; max 1st does = 6mg; Rapid IV bolus w/5cc flush ROUTES: IV with 20cc flush ALBUTEROL TRADE NAME: Proventil, Ventolin CLASS: Sympathetic Agonist DESCRIPTION: Sympathomimetic bronchodilator selective for β2 adrenergic receptors ACTIONS: Selective direct acting β2 agonist INDICATIONS: Bronchial asthma, emphysema, chronic bronchitis, allergic bronchospasm, or other reversible bronchospasm PHARMACOKINETICS: Onset: 5 - 15 minutes Peak Effect: 1 - 1.5 hours Duration: 3 - 6 hours Half Life: < 3 hours CONTRAINDICATIONS: Know hypersensitivity to Albuterol. SIDE EFFECTS: CNS: Tremor, anxiety, dizziness, seizure CV: Headache, palpations, HTN, tachycardia, chest pain Resp: Bronchospasm (paradoxical effect) GI/GU: Nausea, vomiting, dry mouth DOSAGE For patients in emergency setting: ADULT: Nebulizer: 2.5mg in 3cc normal saline or 5mg in 6cc normal saline via HHN over 5 - 15 min. Repeat 10-20 min. prn, maximum 10mg/hr (4 treatments) MDI- 1-2 inhalations (90mcg each) many repeat every 15 minutes prn. PEDIATRIC: 0.15 mg/kg in 2.5-3.0 ml NS via HHN. Repeat prn. ROUTES: Nebulizer, metered-dose inhaler (MDI) PACKAGED: Premixed unit dose of 2.5mg in 2.5ml NS. AMIODARONE TRADE NAME: Cordarone, Pacerone CLASS: Antiarrhythmic ACTIONS: Prolongs action potential and refractory period. Slows the sinus rate; Increases PR and QT intervals. Decreases Peripheral vascular resistance. INDICATIONS: Life-threatening cardiac arrhythmias such as ventriculartachycardia and ventricular fibrillation. PHARMACOKINETICS: Onset: 2 minutes IV. Oral: 2-3 days Peak Effect: 6 - 20 minutes Duration: Varies Half Life: Varies, 30 - 100 days post oral administration CONTRAINDICATIONS: Hypersensitivity to Amiodarone, heart failure, severe sinus node dysfunction (sinus bradycardia, 2nd Œ 3rd degree blocks), cardiogenic shock SIDE EFFECTS: CNS: dizziness CV: Headache, bradycardia, hypotension, sinus arrest, prolonged PR, QRS, QT intervals, CHF, AV block, cardiogenic shock, palpations, chest pain Resp: Dyspnea, pulmonary fibrosis GI/GU: Nausea, vomiting DOSAGE: ADULT: V-Fib / V-Tach without pulses: 300 mg IV (max is 2.2g IV/24 hrs) Ventricular arrhythmias with a pulse: 150 mg over 10 minute. rpt every 10 min. Maintenance Infusion: 540mg IV over 18 hours (0.5mg/min) PEDIATRIC: Pulseless arrest: 5mg/kg rapid IV bolus, Perfusing tachycardia: 5mg/kg IV over 20-60 min. ROUTE: IV ASPRIN TRADE NAME: ASA, Bufferin, Ecotrin, Empirin, etc. CLASS: Platelet aggregate inhibitor, analgesic, non-steroidal anti-inflammatory (NSAID), antipyretic Description: Anti-inflammatory, inhibits platelet function ACTIONS: Blocks platelet aggregation. INDICATIONS: New-onset chest pain suggestive of MI signs and symptoms suggestive or recent CVA. PHARMACOKINETICS: Onset: 5 - 30 minutes Peak Effect: 15 - 120 minutes Duration: 1 - 4 hours Half Life: 15 - 20 minutes CONTRAINDICATIONS: GI bleed, ulcer, hemorrhagic stroke, bleeding disorders, kids with flu symptoms. Hypersensitivity to salicylates, relatively contraindicated in active ulcer disease & asthma. May cause GI upset/bleeding. Administer cautiously to patients with bleeding disorders and those who report allergies to non-steroidal anti-inflammatory (NSAID) drugs. Contraindicated in children 16 - 19 years of age with flu or chickenpox symptoms due to incidence of Reye's syndrome. SIDE EFFECTS: CV: Prolonged bleeding Resp: Wheezing, bronchspasm GI/GU: Nausea, vomiting, heartburn, GI bleeding DOSAGE: ADULT:324 mg PO (4 x 81 mg chewable preferred) as soon as possible after onset of chest pain. PEDIATRIC: Not recommended for use in the field with children. ROUTE: PO ATROPINE TRADE NAME: Atropine, Atropa CLASS: Anticholingeric Description: Anticholingeric, antimuscarinic, parasympatholytic ACTIONS: Decreases vagal tone resulting in positive chronotropic effect & increases AV conduction. Competitive antagonist for acetylcholine at muscarinic receptors. Atropine bronchodilates via parasympatholytic mechanism. INDICATIONS: Hemodynamically significant bradycardia and asystole. Cholinergic poisoning by certain mushrooms (Amanita spp.), insecticides (carbamates, acetycholinesterase inhibitors), and nerve gas. PHARMACOKINETICS: Onset: < 2 minutes Peak Effect: 2 - 4 min. IV (20 - 60 min. IM) Duration: 4 hours Half Life: 2 - 3 hours CONTRAINDICATIONS: No significant contraindications, however, may worsen bradycardia associated with Mobitz-Type 2 and complete heart block. Use transcutaneous pacing if available. Use with extra caution in patients with symptoms of myocardial ischemia. SIDE EFFECTS: CNS: Pupillary dilation, confusion, restlessness, drowsiness, seizure CV: Tachycardia, paradoxical bradycardia Resp: Can cause mucus plugs due to drying of secretions GI/GU: Dry Mouth INTERACTIONS: Additive anticholinergic effects with antihistamines, phenothiazines, antipsychotics, tricyclic antidepressants, procainamide, other anticholinergics drugs. Caution with SSRIs. DOSAGE: ADULT: Symptomatic Bradycardias 0.5 - 1.0mg IV push; may be repeated q 3-5 minutes to a maximum of 0.04mg/kg; (2.5 - 3mg adults) results in full vagal blockage. Doses of less than 0.5mg may cause further slowing of the heart rate. Asystole & PEA initially 1.0mg IV; may be repeated q 3-5 minutes for total of 3mg. ETT-2.0mg Poisoning initially 1mg rapid IV, 2nd 1mg slow IV; larger doses may be required. Dosage exceeding 4mg by physician order only. PEDIATRIC: 0.05mg/kg IV, IM, IO every 10-15 min. ROUTE: IV, IO, ET (May be administered via *ABT in some cases of bronchospasm. Smaller doses of atropine are indicated for the elderly.) NOTES: Monitor vital signs carefully. BENADRYL Packaged: 1cc (50mg/1ml) Ampoule or Vial. Dose: 25-50mg IV or 50mg IM max is 400mg per day Actions: An antihistamine with anticholinergic (drying) and sedative side effects. Prevents but does not reverse histamine mediated responses, particularly on the smooth muscles of the airway, GI tract, uterus, and blood vessels. CALCIUM CHLORIDE Packaged: 10 grams in 10ML Dose: 4mg/kg IV slow Actions: Increases the force of myocardial contraction; calcium may either increase or decrease systemic vascular resistance CARDIZEM Packaged: 25mg in 5cc Dose: .25mg/kg for first dose, .35mg/kg in second dose Actions: Calcium channel blocker that slows AV nodal conduction time and prolong AV refractoriness. DOPAMINE Packaged: 400mg in 250 cc's making for a 1600mcg/ml Dose: 400mg in 250cc for a 1600mcg/cc concentration Actions: It exerts an inotropic effect on the myocardium resulting in increased cardiac output, peripheral vasoconstriction and a marked increase in pulmonary occlusive pressure EPINEPHRINE Packaged: 1mg in 10cc for 1:10,000 concentration Dose: 1mg in 10cc IV 1:10,000 or for anaphylaxis .3mg sub Q 1:1,000 Actions: Sympathomimetic, which stimulates both alpha and beta adrenergic receptors causing immediate bronchodilation, increase in heart rate and increase in the force of cardiac contraction as well as increasing vascular resistance which may enhance defibrillation FUROSEMIDE TRADE NAME: Lasix CLASS: Diuretic DESCRIPTION: Potent diuretic. Causes venous dilation ACTIONS: Causes venous dilation and therefore decreases preload and cardiac workload. Blocks reabsorption of chloride and sodium primarily in the Loop of Henle thereby increasing urine volume/decreasing blood volume. INDICATIONS: Congestive heart failure, acute pulmonary edema, hypertensive crisis PHARMACOKINETICS: Onset: 5 - 10 minutes, diuresis in 5 - 30 minutes Peak Effect: 30 minutes. (IV) 1 - 2 hr (PO) Duration: 2 hours, Diuresis duration approx. 6 hours Half Life: 30 minutes CONTRAINDICATIONS: Hypersensitivity to furosemide or other sulfonamides. Renal failure. Use with caution in cases of known urinary retention. May cause birth defects, safety has not been established in pregnancy. Extreme caution in cases of pneumonia - creates mucus plugs. SIDE EFFECTS: CNS: Dizziness CV: Hypotension, hypokalemia, dehydration, dysrhythmias, headache GI/GU: Nausea, vomiting, diarrhea INTERACTIONS: Possible additive or synergistic effects with antihypertensives, nitrates, and other diuretics. Do not mix with amrinone (Inocor) - will precipitate. DOSAGE: ADULT: 40 - 80 mg slow IV push at 10-20mg/minute (4 mg/min. recommended). Titrate to maintain uterine tone PEDIATRIC: 1 mg/kg ROUTES: IV preferred, slow - moderate push. May be given IM if IV route is not available. NOTES: Protect from light, heat. Observe patient carefully during administration, especially elderly, during diuresis is essential. Currently, furosemide is rarely administered in the field, unless the patient is already taking furosemide. LIDOCAINE Packaged: 5ml Preload syringes (100mg/5ml) 250ml NS with IGM Lidocaine premixed. Dose: 1 - 1.5mg/kg max dose is 3mg/kg (Adult use 2% Peds. use 1% solution) or make a drip 1g in 250ml MAGNESIUM SULFATE TRADE NAME: Magnesium CLASS: Electrolyte, Anticonvulsant, Antidysrhythmic DESCRIPTION: Electrolyte, cation, Physiologic calcium channel blocker, CNS depressant and anticonvulsant. Acts as neuromuscular blocker. ACTIONS: Raising magnesium level inhibits calcium flux across cell membranes, corrects hypomagnesemia, depresses CNS and inhibits muscle cell activity. INDICATIONS: Convulsive states associated with severe preeclampsia and eclampsia, Torsades de Pointes, refractory/recurrent VF or pulseless VT, refractory bronchospasm PHARMACOKINETICS: Onset: Immediate in IV , IM: 1 hour Peak Effect: Varies Duration: 1 hour CONTRAINDICATIONS: Contraindicated in: High degree heart block, shock, patients on digitalis or who are on dialysis or who are hypocalcemic, or persistent hypertension. Use with caution in patients with other CNS depressants on board. Patients with impaired renal function may not be able to eliminate excess Mg++ Use with caution in patients with asthma. SIDE EFFECTS: CNS: Sedation, confusion, muscle weakness, paralysis CV: Hypotension, bradycardia, heart block Resp: Depression, arrest Other: Flushing, sweating, hypotension, hypocalcemia INTERACTIONS: Incompatible with many drugs. Those present in the prehospital arena include: digitalis, alcohol, salicylates, and sodium bicarbonate. DOSAGE: ADULT: VF/VT/Torsade: 1 - 2 grams. Maintenance infusion is indicated following initial IV dose at a rate of 0.5 - 1.0 g/hr. IV for control of Torsade. PEDIATRIC: VFVT/Torsade: 25 - 50 mg/kg IV/IM Eclampsia: 1 - 4 grams of 10% solution. Smallest effective dose should be used. Dose rate should not exceed 1.5 ml (150mg)/min. Bronchospasm: Adults 1 - 2 grams, Pediatric: 25 - 50 mg/kg ROUTES: IV over 1-20 minutes depending upon illness and seriousness. It is preferred to use a more dilute solution (10%) when administering IV. NOTES: Calcium is antidote if respiratory depression occurs. Continuous cardiac monitoring is essential. General signs of toxicity include: sedation, thirst, diarrhea, muscle weakness. MORPHINE SULFATE Packaged: 1ml Ampule (10mg/ml). Dose: 2-10mg IV Slowly every 5:00 until desired response max is 10mg Action: Narcotic analgesic, which depresses the CNS and sensitivity to pain. Increases venous capacitance, decreases venous return and produces mild peripheral vasodilatation. Also decreases myocardial oxygen demand. NALOXONE Packaged: 2cc Ampule (1mg/1ml.) 10ml Vial (4mg/10ml.) 1ml Ampule/Vial (0.4mg/1ml). Dose: 2mg IV, IM, ET, SC may repeat every 2-3:00 Action: antagonizes the effects of opiates by competing at the same receptor sites. When given IV the action is apparent within 2:00. IM or SC administration is slightly slower NITROGLYCERIN Packaged: Spray 0.4mg metered dose. Bottle 1/150gr = 0.4mg per tablet. Dose: .4mg (1 tablet or 1 spray) max is 3 doses Action: direct vasodilator which acts principally on the venous system although it also produces direct coronary artery vasodilatation as a result. There is a decrease in venous return which decreases the workload on the heart and thus decreases myocardial oxygen demand. OXYTOCIN TRADE NAME: Pitocin, Syntocinon CLASS: Uterotonic, pituitary hormone DESCRIPTION: Synthetic oxytocic hormone released from the posterior pituitary gland ACTIONS: Stimulates frequency and force of uterine contraction, decreasing bleeding from uterine vessels Stimulates lactation INDICATIONS: Postpartum hemorrhage not controlled by fundal massage PHARMACOKINETICS: Onset: 1 minute by IV Peak Effect: 5 minutes by IV Duration: 30 minutes post infusion end Half Life: 3 - 5 minutes CONTRAINDICATIONS: No contraindications in controlling excessive postpartum hemorrhage. Essential to assure the placenta has delivered and that no other fetus is present prior to administering oxytocin. Overdosage can cause uterine rupture Check fundus q 5 mins and message SIDE EFFECTS: CV: Hypo/hypertension, - rare, fluid retention, cardiac dysrhythmias, anaphylaxis Gi/GU: Nausea, vomiting, pelvic hematoma, uterine spasm/rupture INTERACTIONS: Additive or other synergistic effects possible with other uterotonics such as methyl ergonovine (Methergine) DOSAGE: ADULT: 10 - 40 units in 1,000 ml NS to be infused 250 ml then 200 ml/Hr. Titrate to maintain uterine tone PEDIATRIC: Not Used ROUTES: Continuous IV, infusion, can be given IM NOTES: Consider multiple large bore IV lines for fluid replacement. SODIUM BICARBINATE Packaged: 50ml syringe (1mEq/1ml). Dose: 1meq/kg Action: an alkalizing agent used to buffer acids present in the body during and after severe hypoxia. It combines with excess acids present in the body to form a weak volatile acid which is broken down into CO2 and H2O. Only effective with adequate ventilation VALIUM Packaged: Dose: 5-20mg IV 20mg is max Action: Benzodiazepine which depresses the limbic system, thalamus, and hypothalamus resulting in calming effects. Also a muscle relaxant VASOPRESSIN Packaged: Dose: 40 units in 2cc's Action: normally and anti diuretic hormone. In unnaturally high doses (more than needed for diuretic) vasopressin acts as a non adrenergic peripheral vasoconstrictor. Acts by direct stimulation of smooth muscle V1 receptors. During CPR increases coronary perfusion pressure, vital organ blood flow, ventricular fibrillation median frequency, and cerebral oxygen delivery. VERSED Packaged: 2mg/2ml, 10mg/2ml and 5mg/5ml vials Dose: 2mg IV slowly Action: Short-acting benzodiazepine CNS depressant that produces sedation and lack of recall. ACTIVATED CHARCOAL Class: Chemical adsorbent Indications: Oral poisonings/medication overdoses; can be used after evacuation of poisons Contraindications: Comatose pt; ingestion of caustic, corrosive, or petroleum distillates; simultaneous administration of other oral medications Side effects: may induce nausea/vomiting, constipation, black stool Adult Dose: 1-2 g/kg PO or via NGT Pediatric Dose: 1-2 g/kg PO or via NGT Special info: Doesn't adsorb cyanide, lithium, iron, lead, or arsenic ALBUTEROL Class: Sympathomimetic bronchodilator; relatively selective beta 2 adrenergic Indications: Treatment of bronchospasm in patients with reversible obsructive airway disease; also an adjunct to treat hyperkalemia Contraindications: Known hypersensitivity to albuterol or levalbuterol Side Effects: Restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, HBP, paradoxical bronchospasm Adult dose: 2.5-5.0 mg Neb Pediatric Dose: 2.5 mg Neb (0.15 mg/kg) Special Info: May precipitate angina pectoris and arrhythmias; beta blockers are antagonistic; may potentiate hypokalemia caused by diuretics AMYL NITRATE Drug Class: amyl and sodium nitrite = affinity for cyanide ions, reacts with hemoglobin to form methemoglobin. Sodium Thiosulfate combines with Cyanide to produce thiocyanate, which is then excreted. Indications: Cyanide Poisoning Contraindications: none Side Effects: excessive doses of the nitrites can cause life-threatening methemoglobinemia Adult Dose: Amyl nitrite pearl - crush and have pt inhale 30 seconds out of every minute; Sodium Thiosulfate and Sodium Nitrite, give IV dose based on antidote kit guidelines Pediatric Dose: Same as adult Special Info: must be used in conjuction with oxygen Brand Name: Lily Kit ASPRIN Drug Class:Platelet inhibitor, anti-inflammatory agent.; Prostaglandin inhibition. Indications: New onset chest pain suggestive of acute myocardial infarction Contraindications: Hypersensitivity. Relatively contraindicated in patients with active ulcer disease or asthma. Side Effects: Heartburn, GI bleeding, prolonged bleeding, nausea, and vomiting. Wheezing in allergic patients. Adult Dose: 162 (2 x 81mg) or 324 (4 x 81mg) or 325 (enteric coated - 1 x 325)mg PO (chew if not enteric coated) Pediatric Dose: Not given Special Info: Bayer; Overdose may need multiple doses of charcoal. COMPAZINE Drug Class: Antiemetic; phenothiazine Indications: To relieve severe nausea and vomiting; to manage acute psychosis Contraindications: patients with hypersensitivity to phenothiazines Side Effects: extrapyramidal reactions (akathisia, dystonia, or parkinsonism), persistent tardive dyskinesia, acute catatonia, sedation Special Info: Treat EPS with diphenhydramine Generic name: Prochlorperazine DEXAMETHASONE Drug Class: Corticosteroid; Suppresses acute and chronic inflammation; immunosuppressive effects. Indications: Anaphylaxis, asthma, spinal cord injury, croup, elevated intracranial pressure Contraindications: Hypersensitivity to product. Side Effects: Immunosupression; hyperglycemia Adult Dose: 4-24 mg IV/IM Pediatric Dose: 0.5-1.0 mg/kg Special Info: Brand Name: Decadron DEXTROSE Drug Class: Carbohydrate, hypertonic solution. Indications: Hypoglycemia; with insulin can be used to treat hypekalemia Contraindications: Intracranial hemorrhage (unless low BG) Side Effects: Extravasation leads to tissue necrosis. Adult Dose: usual 12.5 - 25g of D50 Adult Dose (oral glucose): 15 - 25g (must be able to swallow) Precautions (oral glucose): must be able to swallow and protect airway Pediatric Dose: 0.5-1 g/kg/dose slow IV; Newborn = D10 (5-10 mL/kg); children = D25 (2-4 mL/kg) Special Info: Administer thiamine prior to D50 in known alcoholic patients. Do not administer to patients with known CVA unless hypoglycemia documented. [Show Less]
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NREMT vocab questions and answers rated A+
aerobic metabolism Metabolism that can proceed only in the presence of oxygen. agonal gasps occasional, gasping breaths that occur after the heart... [Show More] has stopped airway The upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat. alveolar minute volume The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate. alveolar ventilation The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume. american standard safety system A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas. anaerobic metabolism The metabolism that takes place in the absence of oxygen; the principle product is lactic acid. apnea absence of spontaneous breathing aspiration In the context of airway, the introduction of vomitus or other foreign material into the lungs. ataxic respirations Irregular, ineffective respirations that may or may not have an identifiable pattern. automatic transport ventilator (ATV) A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated. bag-valve mask (BVM) A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen. barrier device A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids. bilateral A body part or condition that appears on both sides of the midline. Bronchioles Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli. capnography A noninvasive method to quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism; effectively measures the concentration of carbon dioxide in expired air over time. Capnometry The use of a capnometer, a device that measures the amount of expired carbon dioxide. carina Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi. Chemoreceptors Monitor the levels of O2, CO2, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time. compliance The ability of the alveoli to expand when air is drawn in during inhalation. continuous positive airway pressure (CPAP) A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation. dead space The portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange. Diffusion the process by which molecules move from an area of higher concentration to an area of lower concentration Dyspnea shortness of breath, difficulty breathing end-tidal CO2 The amount of carbon dioxide present in exhaled breath. Exhalation The passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs. external respiration The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration. gag reflex A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat. gastric distention A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation. glottis The space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening. good air exchange A term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard. head tilt-chin lift maneuver A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients. hypercarbia Increased carbon dioxide level in the bloodstream. Hypoxia A dangerous condition in which the body tissues and cells do not have enough oxygen. hypoxic drive A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases. Inhalation The active, muscular part of breathing that draws air into the airway and lungs. internal respiration Exchange of gases between the blood cells and the tissues intrapulmonary shunting Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart. jaw-thrust maneuver Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury. labored breathing Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles. Larynx A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box. manually triggered ventilation device A fixed flow/rate ventilation device that delivers a breath every time its button is pushed; also referred to as a flow-restricted, oxygen-powered ventilation device. Mediastinum Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs. metabolism (cellular respiration) The biochemical processes that result in production of energy from nutrients within the cells. mild airway obstruction Occurs when a foreign body partially obstructs the patient's airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress. minute volume The volume of air breathed in one minute without conscious effort. Minute volume = Tidal Volume x respiration rate (breaths/minute) nassal cannula an oxygen delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostirls; delivers 24% to 44% supplemental oxygen, depending the flow rate nasopharyngeal (nasal) airway airway adjunct inserted into the nostril of an unresponsive patient or a patient with an altered level of consciousness who is unable to maintain airway patency independently nasopharynx the nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants nonrebreathing mask A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide). oropharyngeal (oral) airway Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary. oropharynx Forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue. Oxygenation The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs. oxygen toxicity A condition of excessive oxygen consumption resulting in cellular and tissue damage. parietal pleura Thin membrane that lines the chest cavity. partial pressure The term used to describe the amount of gas in air or dissolved in fluid, such as blood. passive ventilation The act of air moving in and out of the lungs during chest compressions. patent open and clear; free from obstruction phrenic nerve Nerve that innervates the diaphragm; necessary for adequate breathing to occur. [Show Less]
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NREMT EMT Airway questions and answers with rated solutions
nasal cannula flow rate 1-6 L/min NRB flow rate 10-15 L/min BVM flow rate 15 + L/min nasal cannula oxygen delivery 24%-44% ... [Show More] NRB oxygen delivery <90% BVM oxygen delivery almost 100% adult ventilation rate (apneic with pulse) 1 breath every 5-6 seconds 10-12 breaths per minute child ventilation rate (apneic with pulse) 1 breath every 3-5 seconds 12-20 breaths per minute adult ventilation rate (ET tube, CPR in progress) 8-10 breaths per minute [Show Less]
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NREMT- E (emt-b) terms questions and answers with verified content
Types of Bleeding trauma Avulsion Laceration Abrasion Contusion ....... pleuritic chest pain sharp, stabbing pain made worse by deep breath or... [Show More] chest wall movement, often inflammation of pleura is cause. emphysema A disease of the lung, extreme dilation and eventual destruction of the pulmonary alveoli w/ poor exchange of Oxygen & CO2 (A form of COPD) Obese is considered to be 20-30% over the ideal weight Occiput most posterior portion of the cranium Intracerebral Hematoma bleeding within the brain tissue itself Subdural Hematoma Blood beneath the dura but outside of the brain ecchymosis bruising/discoloration associated with bleeding within or under skin Retractions Movement in which the skin pulls in around the ribs during inspiration DCAP-BTLS D-deformities C-contusions (aka bruise) A-abrasions (superficial layer of skin) P-punctures/penetrations B-burns T-tenderness L-lacerations S- swelling Dysbarism refers to medical conditions dealing with a change in ambient pressure, such as scuba diver or High altitude e.g. Barotrauma- injury due to pressure effect on air space Hematemesis Vomited Blood (Suspect GI bleed) Hematuria Blood in urine Hemoptysis coughing up blood Hyperventilation can be associated with -Resp. Infection -Aspirin overdose -Hyperglycemia Plasma sticky, yellow fluid carrying blood cells and nutrients and transports cellular waste to organs of excretion Remarkable vs Unremarkable Unremarkable is meaning normal finding decompensated shock late stage of shock where BP is falling ischemic stroke 1 of 2 main types of stroke; occurs when blood flow to particular part of brain is cut off by blockage(clot) inside a blood vessel ischemia a lack of oxygen that deprives the tissues of necessary nutrients , resulting from partial or complete blockage of blood flow, potentially reversible pneumonia inflammation or infection of lung by bacterial, viral or fungal cause s/s of tension Pneumothorax profound cyanosis bulging intercostal muscles unilaterally absent breath sounds s/s of late heatstroke weak, rapid pulse status epilepticus prolonged seizures without return of consciousness subcutaneous emphysema indicates air is escaping into chest wall from damaged lung tidal volume The amount of air (mL) moved in or out of the lungs in one breath minute volume amount moved in or out minus the dead space automaticity the ability of cardiac muscles to contract without stimulation from nervous system. anterior fontanelle fuses between ages? 9 and 18 months (which is the area between the 2 front and 2 parietal bones of skull) diving reflex slowing of heart rate in cold water paroxysmal nocturnal dyspnea attacks of severe shortness of breath and coughing occurring at night jugular vein distention bulging of jugular veins; may be result of tension pneumothorax, cardiac tamponade, pressure in chest, fluid overload Cardiac Tamponade compression of heart as a result of buildup of blood or other fluid in the pericardial sac, leads to decreased cardiac output [Show Less]
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NREMT - EMS Operations questions and answers with graded solutions (latest 2023)
The cold zone or clean zone is an area where adequate decontamination has ensured that there will be no spread of any hazardous materials and EMS are able... [Show More] to fully treat patients. Traffic law requires that an ambulance must stop for a stopped school bus and wait until the bus driver turns off the flashing lights and retracts the stop sign 01:05 01:42 When cutting the wires of a battery inside a vehicle... The negative battery cable, often black in color, should be cut first. This will create a break in the electrical circuit of the vehicle. Be sure not to touch any metal component of the vehicle while doing this! When approaching an intersection... Always drive as far left as reasonable You should never pass on the right because... drivers are taught to pull to the right when they see an emergency vehicle. Waiting for traffic to clear or taking a longer route may be safer but it... will greatly reduce your response time in an emergency. Use these as a last resort and have good justification. A mechanical-piston device and load distributing band device are capable of... providing constant chest compressions for the patient in cardiac arrest START triage uses the mnemonic RPM(Respirations, pulse, mental status). Using this tool allows you to quickly and accurately triage any number of patients. The cold, or green, zone is where the... majority of treatment will occur. Patients in the cold zone have been decontaminated but emergency personnel should still take appropriate safety precautions. If the pediatric patient is apneic but does have a pulse, you should.. reposition their airway and check for respirations. If they still are not breathing... you should administer 5 rescue breaths and then recheck respirations If the patient is still apneic, they should be triaged as.. Deceased 00:43 01:42 If the pediatric patient is apneic and pulseless, they should be... Deceased A windshield survey is a quick survey that will help you to form a general impression of the condition of the occupants in the vehicle and the resources you will need to help them. Command, triage, and transportation are the core of what all activities during a mass casualty incident are based on. Maintaining these three components creates a basic framework to help organize the mass casualty incident. Autonomy refers to the patient's right to refuse medical care. It also includes the patient's right to choose medical care. Despite having a life-threatening medical condition, you cannot force the patient to allow treatment or transport in this situation. CHART C- Chief Complaint H- Patient Medical history and history of incident A- Patient assesment R- Treatment T- Transport Red tags... (immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival. Yellow tags - (observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances. Green tags - (wait) are reserved for the "walking wounded" who will need medical care at some point, after more critical injuries have been treated. Mitigation involves early warning to disasters in an effort to try and reduce the destruction of an event. The six basic components of the incident command system are: command, operations, planning, logistics, finance, and safety. Decontamination is an important process at any hazardous materials incident and should be performed prior to placing patients in emergency apparatus. It is A process that involves removing, preventing, or reducing the spread of hazardous materials DUMBELS defecation, urination, miosis, bradycardia, emesis, lacrimation, salivation A disaster is an incident with 100 or more patients a MCI can have anywhere from twenty-six to ninety-nine patients Patients in cardiac arrest are an absolute contraindication for all types of aeromedical transport Medically stable patients should use ground transport A DNR or Do Not Resuscitate Order is another name for an advance directive A GCS of less than 10 may mean that a patient would benefit from aeromedical transport. HEPA stands for High Efficiency Particulate Air Hepatitis C is a condition in the liver that can lead to many life threatening conditions as the disease progresses throughout the patient's life. It is primarily spread through blood to blood contact. Fire Hazard - Red Flash Point-temp to incite air Scales from 1-4 with increasing deadliness HEALTH HAZARD - Blue Scales from 1-4 with increasing deadliness Reactivity (Instability) - Yellow Scales from 1-4 with increasing deadliness Specific Hazard - White OX or OXY Oxidizer W (with line through it) Use no water Alpha radiation is a very weak type of radiation that can be stopped by the skin. The primary blast injury is caused by the shockwave hitting the body. Secondary blast injuries are caused by fragments being propelled through the air and striking the body. Tertiary blast injuries are when the body is projected onto an object (i.e. thrown into a wall), or the object strikes them (i.e. a building collapsing onto someone). During a technical rescue incident. the safety of the rescue patient comes "last" When performing safe parking, ensure that you have parked far enough from the scene of the crash so that you have a safe working area as well as a buffer zone in case another vehicle strikes the emergency apparatus. When parking your emergency vehicle to block oncoming traffic at the scene of a crash... Park at a 45 degree angle to deflect traffic away from the incident if a vehicle does hit the emergency apparatus. If you need to shut down all lanes of the road, don't hesitate to do so. Your safety and the safety of all personnel at the scene is more important than keeping a road open for travel. Type I ambulances are a box-stylepassenger compartment on a truck chassis. Type II ambulances are a van chassis with a raised roof in the patient compartment. Type III ambulances are a box-stlye passenger compartment on a van chassis. A patient's HIV status is protected healthcare information and therefore should not be shared with the police unless you are presented with a formal subpoena The Safety Officer is ultimately in charge of deciding whether it is safe to proceed with a rescue operation. The multiplex system is made up of multiple duplex channels. Duplex systems send and receive data over the same frequency. Combining duplex systems allows for multiple tiers of communications to occur at once. The helicopter crew's first priority is to keep everyone safe. Approaching a helicopter without direction from a crew member is extremely dangerous and should never be done. A Physician Orders for Life Sustaining Treatment (POLST) form is a document created by you and your doctor that informs emergency care providers what kinds of treatments you want (and don't want) in a medical emergency. Presence of fluids, airbag deployment, and electrical system components are all categorized as vehicle hazards. Environmental hazards include time of day, weather, and temperature. A strike team is organized to include the same kind and type of resource. Each strike team should havee. a designated leader and have the ability to communicate between all single resources in the team. A strike team may be a part of a task force Spinal boards were introduced to EMS in 1968 originally for extrication of patients from diving accidents. Protocols were updated to include widespread use of spinal boards by the DOT in 1984. On-line medical control is through the use of radio or phone communication. Your standing orders or protocols all work off of off-line medical control. If you called to request additional medicine or something outside of your scope of practice, you are working off of on-line medical control. Incendiary devices are those that have decreased explosive power but increased heat production and potential to produce burns.. How far do you park from a fire hazard? 100 feet The street you responded to is not considered confidential True None of our senses can detect radiation. We must use a radiation detector in order to determine if it is present or not. In Any distance of 30 nautical miles, or more, from a care facility, the patient would get there faster by air. Thirty nautical miles is equal to 34.5 miles. Libel and slander are both defamatory statements, but libel is written and slander is spoken. Battery is unlawful contact. Malfeasance is a willful and intentional action that injures someone. Life jackets, or personal floatation devices, should be worn any time you are operating in or around water. Nonmaleficence requires the paramedic to provide the appropriate treatment to a patient while doing as little harm as possible. Cribbing is used to stabilize cars involved in motor vehicle crash while extrication is occurring. The highest level of training for technical rescue is the technician. The technician is trained to recognize a hazard, use specialized equipment, and supervise, perform, or participate in a technical rescue. Airbag deployment can mimic the classic starring pattern caused by a patient's head hitting the windshield True You should never leave an elderly suicidal patient alone. You may have to break into a house or room, especially if the patient is unconscious. You should always be prepared that a suicidal person has a weapon that could harm you, and you should call police as necessary. The type of anthrax that poses the largest threat to the human population is inhalation anthrax Most bodily fluids or secretions, with the exception of sweat, require standard precautions. Flashlights (especially white) should not be used while landing a helicopter as it could temporarily blind the pilot. Use of colored lights or traffic wands is preferred if they are available. The three phases of spinal immobilization of a water rescue patient are: in-water spinal immobilization, C-collar application, and backboarding and extrication of the patient from the water. Assault is the threat to commit harm to a person. Battery is actually committing the bodily harm to a person. If exposed to the actual agent, anthrax can infect people but transmission between one person and another does not occur readily Simplex radios systems are where only one person can transmit at a time. A duplex radio system enables both users to transmit and receive at the same time... a cellular phone is an example of a duplex radio system. The three "T's" of a mass casualty incident. You can be assigned to perform any of these duties. Triage, treatment, and transport [Show Less]
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Fisdap/NREMT Respiratory Practice Questions with correct answers rated A+
Where does the stimulus to breathe originate? A) spinal cord B) diaphragm C) heart D) brainstem D) brainstem What is the proper way to measure ... [Show More] an oropharyngeal airway? A) the nose to the xiphoid process B) from the center of the mouth to the angle of the jaw C) from the tip of the nose to the lobe of the ear D) by the size of the patient's thumb B) from the center of the mouth to the angle of the jaw During respiration, where does the process of gas exchange occur? A) trachea B) alveoli C) epiglottis D) bronchioles B) alveoli A conscious 32 y/o patient complains of difficulty breathing. He is coughing while pointing to his throat. What should you do? A) give four strong blows to the back B) place him supine and begin CPR C) encourage him to keep coughing D) administer abdominal thrusts C) encourage him to keep coughing A 34 y/o female has fallen from a height of 10 feet. She is unresponsive with snoring respirations. What should you do? A) use the jaw-thrust maneuver B) support her head and neck with a rolled towel C) attempt the chin lift maneuver D) apply a certerm-5vical collar A) use the jaw-thrust maneuver How much oxygen will a pocket mask on room air deliver? A) 92% B) 17% C) 10% D) 23% B) 17% An unresponsive 44 y/o male has an oral airway and is being ventilated. He suddenly regains consciousness and starts to gag. What should you do? A) insert a nasal airway B) request ALS to sedate the patient C) remove the airway and apply high-flow oxygterm-5en D) suction the airway and leave the adjunct in place C) remove the airway and apply high-flow oxygen Which of the following is a musical, squeaking or whistling sound heard on inspiration and expiration while auscultatingterm-67 lung fields? A) gurgling B) snoring C) stridor D) wheezing D) wheezing A 29 y/o male crashed his motorcycle. He is unconscious and the lower portion of his jaw is torn from his face. He has gurgling respirations with bleeding into the throat. What should you do? A) insert an OPA B) perform a head tilt-chin lift and apply a nonrebreather mask C) apply a nasal cannula and suction as needed D) apply a c-collar and administer blow-by oxygen C) apply NC and suction as needed An OPA is used to lift the tongue and requires supporting structures of the jaw, so an OPA would be ineffective for this patient. Oxygen should be administered, however, and the NC will provide greater concentration than any of the other listed methods. You find a patient in the tripod position. What should you suspect? A) a cardiac emergency B) GI distress C) respiratory distress D) a TIA C) respiratory distress A 54 y/o female is unresponsive and lying supine on the floor. What should you do? A) obtain a set of vital signs B) insert an oral airway C) start CPR D) check for a carotid pulse D) check for a carotid pulse What is the leading cause of infant and child death? A) congenital defects B) vascular stenosis C) allergic reactions D) respiratory arrest D) respiratory arrest What is the normal rate of breathing for an adult? A) 28-36 breaths/min B) 6-10 breaths/min C) 22-26 breaths/min D) 12-20 breaths/min D) 12-20 breaths/min What is the coarse sound of fluid movement heard on inspiration called? A) rhonchi B) snoring C) crackles D) gurgling A) rhonchi What is the area where the base of the tongue and the epiglottis meet called? A) vallecula B) alveoli C) carina D) bronchi A) vallecula A 57 y/o female is found unresponsive in bed. How should you assess her breathing? A) look for chest rise and fall B) apply oxygen via NRB C) apply a pulse oximetry monitor D) look for changes in skin color A) look for chest rise and fall Which tissues create the greatest surface area for gas exchange in the lungs? A) trachea B) bronchioles C) alveoli D) pleura C) alveoli A 4 y/o male is choking on a marble. He is coughing and drooling. What should you do? A) perform 5 abdominal thrusts B) perform 5 back blows C) visualize and remove the marble D) coach him to cough D) coach him to cough Which of the following structures serves as a passageway for both the respiratory and digestive systems? A) trachea B) esophagus C) cricoid cartilage D) pharynx D) pharynx When providing mouth-to-mouth ventilations, what percentage of oxygen are you providing? A) 35 B) 100 C) 21 D) 16 D) 16 The air that we exhale contains approximately how much oxygen? A) 6% B) 21% C) 35% D) 16% D) 16% A 20 y/o male was involved in a motorcycle accident. He has bits of broken teeth and blood in his airway. After 10 seconds of suctioning his mouth there is still active bleeding. What should you do? A) insert a roll of gauze to soak up the blood B) give two rescue breaths C) roll him onto his side D) remove the pieces of teeth with a finger sweep C) roll him onto his side A patient should not be suctioned for longer than 10 seconds. If you have been suctioning for longer than 10 seconds, you should pause and administer two rescue breaths before resuming suction. A 22 y/o intoxicated male responds to voice by moaning. You note vomit in his airway. What should you do? A) suction the mouth B) insert a nasal airway C) turn the patient on his side D) manually stabilize c-spine A) suction the mouth A 24 y/o male is lying supine and is unresponsive. You have opened his airway with a head tilt-chin lift maneuver and determined that he is apneic with a bradycardic pulse. You attempt to ventilate, but are unsuccessful. What should you do? A) check for a carotid pulse B) begin continuous chest compressions C) reposition the airway and give two ventilations D) attempt to give 2 more forceful ventilations C) reposition the airway and give two ventilations What is the name of the tracheal ring that sits directly inferior to the larynx? A) cuneiform cartilage B) corniculate cartilage C) thyroid cartilage d) cricoid cartilage d) cricoid cartilage Which structure contains the vocal cords? A) larynx B) trachea C) pharynx D) sternum A) larynx How much air is inspired during a single inhalation? A) 200 mL B) 150 mL C) 500 mL D) 750 mL C) 500 mL A 33 y/o male has respirations of 22 breaths/min. How should you administer oxygen to him? A) NRB at 15 L/min B) simple rebreather mask at 4 L/min C) BVM at 8 L/min D) Venturi mask at 8 L/min A) NRB at 15 L/min What is the normal TV in an adult male? A) 1000 mL B) 350 mL C) 750 mL D) 500 mL D) 500 mL An unresponsive 64 y/o male has a stoma. He is supine and apneic. What should you do? A) assist his ventilations with an adult BVM and cover the stoma B) place a pediatric-sized BVM over the stoma and ventilate C) obtain a set of vitals and place an AED D) apply a c-collar and perform a jaw thrust maneuver B) place a pediatric-sized BVM over the stoma and ventilate A stoma is an artificial opening used as an airway. They can create a unique challenge when ventilating a patient. You should place a smaller size mask over the opening and attempt to ventilate. These airways often become clogged with mucus. Prepare to suction as needed. What is the name of the smooth, moist epithelial layer that covers the lungs? A) parietal peritoneum B) visceral pleura C) visceral peritoneum D) parietal pleura B) visceral pleura Why is it important to avoid touching the back of the throat when suctioning? A) it causes the upper airway to spasm uncontrollably B) it will cause contamination of the catheter C) tachycardia can occur due to vagus nerve stimulation D) it can stimulate the gag reflex and cause vomiting D) it can stimulate the gag reflex and cause vomiting Room air contains what percentage of oxygen? A) 21 B) 100 C) 36 D) 10 A) 21 A 7 y/o boy is found supine at the base of a 15 foot high jungle gym. His teacher is unsure if he fell from the equipment. Vital signs are BP 100/90, RR 0, pulse 42 bpm, SpO2 93%. What should you do? A) open his airway with a jaw thrust maneuver B) start CPR C) insert an OPA D) open his airway with a head tilt-chin lift maneuver A) open his airway with a jaw thrust maneuver The patient is not breathing, so you first need to ensure that he has an open airway. The jaw thrust would be most appropriate to reposition his airway because you cannot be sure that the patient did not fall from the playground equipment and sustain a c-spine injury. It might also be appropriate to insert an OPA, but the airway should be repositioned first. A 36 y/o male complains of a sore throat with drooling. He is having difficulty breathing with stridor. His skin is pink and hot to the touch. What should you suspect? A) pneumonia B) bronchitis C) epiglottitis D) tonsillitis C) epiglottitis What is oxygen deficiency in the body called? A) hypoxemia B) hyperoxia C) hypoxia D) hypercarbia C) hypoxia An 18 y/o female with a suspected c-spine injury has a significant amount of blood in her mouth. What should you do? A) stabilize her head and suction her airway B) perform a jaw thrust and finger sweep in order to remove blood from her mouth C) perform a jaw thrust maneuver and attempt to ventilate her D) assess her RR for no longer than 30 seconds A) stabilize her head and suction her airway Which of the following is the MOST common cause of airway obstruction? A) the tongue B) trauma C) laryngeal spasm D) foreign bodies A) the tongue A 4 y/o male has snoring respirations. What should you do? A) insert an NPA B) perform a head tilt maneuver C) insert an OPA D) gently shake to wake up the patient B) perform a head tilt maneuver An 8 month old male is unresponsive to painful stimuli. Vital signs are HR 50 ppm and regular, RR 8 breaths/min and labored, and capillary refill is greater than 6 seconds. What should you do? A) apply an AED B) administer oxygen C) assist ventilations D) start CPR C) assist ventilations [Show Less]
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NREMT: Signs/Symptoms/Causes/Treatment 100% accurate answers latest 2023
Tuberculosis fever, night sweats, loss of energy/appetite, weight loss Pulmonary Edema dyspnea, pale/sweaty, hypertension,tachycardia, crackles/wh... [Show More] eezing, low SPO2 Pneumonia fever/chills, green mucos, shortness of breath, (sharp/plueritic) chest pain, headache, crackling Treatment of Pulmonary edema High o2 and CPAP Treatment of Pneumonia o2 and transport Spontaneous Pneumothorax tachycardia, low SPO2,cyanosis, wheezing, pain/swelling in 1 or both legs, >lung sounds in injured lung,shortness of breath Treatment of Spontaneous Pneumothorax May requires chest tube, o2, CPAP is contraindicated Pulmonary Embolism chest pain, wheezing, pain/swelling in one or both legs, shortness of breath, cough/anxiety Epiglotitis Sore throat/difficulty swallowing, stridor, tripod position, muffled voice Treatment of Epiglotitis Keep patient comfortable/calm, high o2, transport, do not inspect throat Cystic Fibrosis fatigue, frequent pneumonia, coughing up blood/copious mucous, chills, abdominal pain/distention Cystic Fibrosis Treat inadequate breathing and transport Viral Respiratory Infection infection of lungs, shortness of breath, coughing up yellow/green sputum, fever/chills Congestive Heart Failure fever, cough (green/dark sputum), ^levels of CO2 in blood Treatment of COPD o2: nasal cannula Appendicitis Persistent RLQ Pain, pain in umbilical region, rupture of appendix: sudden severe pain Peritonitis Abdominal pain and rigidity Cholecystitis Sharp RUQ or epiglastic pain, pain in shoulder (females 30-50 age group) Pancreatitis Epiglastic pain, pain in back or shoulder GI Bleeding abnormal stool (dark black/maroon), vomiting "coffee grounds", slow loss of blood (chronic gastrointestinal hemorrage), blood from rectum Acute Aortic Aneurysm (AAA) pulsating mass, vomiting, tearing pain from front to back, inequality in pedal pulses Treatment of AAA Transport immediately S&S Anemia pale,fatigue,shortness of breath Side effects of Epipen ^heart rate, pallor/dizziness, chest pain, headache/anxiety, nausea, ^heart workload Inhaled poisons dizziness, difficulty breathing, headache, nausea, cyanosis, AMS (altered mental status) Treatment for inhaled poisons high flow of o2, patient history, physical exam, vitals, transport. think of medical assessment skill Alcohol Abuse Swaying/slurred speech, slow reaction time, poor condition Alcohol withdrawls gross tremors, profuse sweating, seizures, hypertension, tachycardia Substance Abuse Shaking, anxiety, hallucinations, ^pulse and breathing noises, confusion/irritability, nausea Treatment for substance abuse physical exam, look for track marks, transport ASAP Renal Failure severe dehydration Treatment of missed dialysis ABC's, o2 w/NRB @15lpm, monitor, transport, supine/warm (treat for shock) Hypoglycemia AMS (altered mental status), drunken stupor, pale/sweaty, tachycardiaseizures Causes: HYPOglycemia >blood sugar, too much insulin, not enough food, overexterts (exercise) Treatment: HYPOglycemia Oral glucose and transport Aneurysm Headache, blurred vision, pass out, comma/death may occur Treatment for Aneurysm diuretic medications that removes fluid from circulatory system Congestive Heart Failure tachycardia, dyspnea, ^blood pressure, diaphoresis, pulmonary edema, pedal edema, engorged pulsating neck veins, enlarged liver and spleen w/distention, anxiety/confusion due to hypoxia SKIN allergic reaction itching, hives, swelling, warm/tingling [Show Less]
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Static Cardiology – NREMT questions and answers latest 2023
Sinus tach / Stable Routine care -Assess and manage ABCs -O2 maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess q 10 ... [Show More] minutes End 45y female with dyspnea for one hour. Alert; no JVD; heart regular without murmur; lungs clear. P 113 BP 143/91 RR 16 O2Sat 93% Asystole / Unstable Routine care -Assess and manage ABCs -O2 maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess at the beginning of each 2 min cycle Treatment -High quality CPR 30:2 (100-120 BPM) rotating compressors q 2min and -Epinephrine 1:10,000 1mg q 3 - 5 minutes -Consider advanced airway without interrupting CPR Continue this cycle until ROSC Treat underlying causes H's & T's (COLD PATCH) END Middle-aged male found down, no family or bystanders around. Appears to be unresponsive with no obvious signs of trauma. P none RR none SVT / stable Routine care -Maintain and manage ABCs -O2 to maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reasess 5 Treatment -vagal maneuvers -adenosine 6mg rapid IV push followed by 10ml flush -if needed q in 1-2min @ 12mg Treat underlying causes H's & T's (COLD PATCH) END 36 yo female complains of a thumping in her chest and is feeling anxious, alert, no JVD, lungs clear P 180 BP 147/89 RR 18 SpO2 97% SVT / unstable Routine care -Maintain and manage ABCs -O2 to maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess 5 min Treatment -Ketamine 1mg/kg -Ativan 1mg -Synchronized cardiovert @ 100 J -Expert consultation Treat underlying causes H's & T's (COLD PATCH) End 71 yo female complains of a thumping in her chest and is feeling anxious, ALOC, no JVD, lungs clear P 180 BP 147/89 RR 27 SpO2 89% 2nd type 2 / unstable Routine care -Maintain and manage ABCs -O2 to maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess 5 Treatment -Atropine 1mg IVP -If Atropine is ineffective consider Pacing *set rate at 70 *set mA until both electrical and mechanical capture *Increase 5mA or 10% (manufactures recommendation) -Patient hemodynamic unstable no sedation or pain meds OR Dopamine infusion - 2 - 20mcg/kg/min and titrate to effect OR Epinephrine - 2 - 10mcg/min titrate to effect -consider expert consultation Treat underlying causes H's & T's (COLD PATCH) END Pt complained of lightheadedness earlier today, but is currently sitting up and talking with you in mumbles. ALOC; no JVD, lungs few scattered crackles P 59 BP 81/54 RR 12 SpO2 86% 3rd block / unstable Routine care -Maintain and manage ABCs -O2 to maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess 5 Treatment -Atropine 1mg IVP -If Atropine is ineffective consider Pacing *set rate at 70 *set mA until both electrical and mechanical capture *Increase 5mA or 10% (manufactures recommendation) -Patient hemodynamic unstable no sedation or pain meds OR Dopamine infusion - 2 - 20mcg/kg/min and titrate to effect OR Epinephrine - 2 - 10mcg/min titrate to effect -consider expert consultation Treat underlying causes H's & T's (COLD PATCH) END Pt complained of lightheadedness earlier today, but is currently sitting up and talking with you in mumbles. ALOC; no JVD, lungs few scattered crackles P 50 BP 81/54 RR 12 SpO2 86% V-Fib / unstable Routine care -Maintain and manage ABCs -O2 maintain SPO2 94% -IV -Monitor 4 & 12 lead -Vitals / SAMPLE / OPQRST - Reassess at the beginning of each 2 min cycle Treatment -Defibrillation at maximum manufacturers recommended dose q 2minutes -High quality CPR 30:2 (100-120 BPM) rotating compressors q 2min -Epinephrine 1:10,000 1mg q 3 - 5 minutes -Amiodarone first dose 300mg repeat in 4min with 150mg Max 2 total doses Continue this cycle until ROSC Treat underlying causes H's & T's (COLD PATCH) Consider advanced airway at earliest convince without interrupting CPR END Pt you are transporting for cardiac evaluation becomes unresponsive enroute to the medical center. P none RR none MVT stable O2 IV monitor amiodarone 150mg in 50ml D5W, over 10min Q10min PRN end 59y anxious looking male complains of intermittent lightheadedness the past day or two. No lightheadedness currently and he denies any chest discomfort or dyspnea. P 180 BP 139/82 RR 16 SpO2 91% MVT unstable O2 IV monitor versed 2-5mg IV/IO; over 2-5min Q10-15min; <10mg or valium 2mg IV (<2mg/min) 59y diaphoretic male ALOC P 171 BP 93/62 RR 12 SpO2 81% Rhythm: Sinus bradycardia Diagnosis: Coronary artery disease that has caused damage to the electrical conduction system. The patient is unstable. Rx: BSI scene safe oxygen NC 2-4 LPM, maintain O2Sat>90% apply monitor obtain IV access atropine 0.5mg IV/IO 0.5-1.0mg Q5min total of 3mg or 0.04mg/kg Initiate transport TCP if atropine ineffective - a rate of 70 - > mA until capture - > 5 mA or 10% consider if TCP ineffective epinephrine (2-10 mcg/min) dopamine (5-10 mcg/kg/min) infusion Reassess after each intervention Hx: 69yo male complains of lightheadedness when he stands up. Denies chest pain or dyspnea currently. VS: P 50 BP(supine) 100/62 BP(seated) 88/42 RR 16 O2Sat89% PE: alert, cooperative; no JVD; heart slow, you think you might hear a murmur; bibasilar crackles in the lungs; 2mm pedal edema Rhythm: supraventricular tachycardia (SVT) Diagnosis: unstable SVT Rx: BSI Scene safe oxygen NC 2-4 LPM, maintain O2Sat>90% apply monitor obtain IV access provide sedation if it does not delay cardioversion cardiovert 50->100->200->300->360 joules initiate transport reassess after each intervention Hx: 44 yo male complains substernal chest pain and shortness of breath. VS: P 180 BP 105/74 RR 18 O2Sat 91% PE: alert, anxious and diaphoretic; holds right hand over his chest; no JVD; heart tachy; lungs clear Rhythm: Pulseless electrical activity (PEA), slow Diagnosis: reviewing the 6 H's and 6 T's, the most likely cause is drowning (Hypoxia) complicated by alcohol ingestion (Toxin) Rx: BSI Scene safe Call for help, initiate CPR Oxygen 15LPM BVM Intubate or use blind insertion device: 8-10 breaths/minute during continuous chest compressions Attach capnography to ventilation device Attach monitor, check in two leads to confirm asystole Initiate IV or IO Epinephrine 1mg IV/IO Q ea 3-5 minutes May substitute Vasopressin 40 Units IV/IO to replace epinephrine for the first or second dose of epinephrine Reassess after each intervention Is there a DNR? Patch in/follow local protocol when considering termination of resuscitation Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo/hyperkalemia Hypoglycemia Hypothermia Toxins Tamponade, cardiac Tension pneumothorax Thrombosis, coronary Thrombosis, pulmonary Trauma Hx: 18yo female pulled from the bottom of a swimming pool, bystander CPR initiated VS: CPR produces weak carotid pulse and bilateral breath sounds. Without CPR there is no pulse or respiration. PE: wet young female in swimsuit; vomit next to patient smells of alcohol; no obvious trauma [Show Less]
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