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What is the pathophysiology of emphysema?
What is the pathophysiology of emphysema?
Destruction of the alveoli leading to reduced gas exchange.
What are the signs and symptoms of chronic bronchitis?
What are the signs and symptoms of chronic bronchitis?
Productive cough, shortness of breath, wheezing.
What is the treatment for asthma/status asthmaticus?
What is the treatment for asthma/status asthmaticus?
Bronchodilators, corticosteroids, oxygen therapy.
What are the common indications for the use of nitroglycerin?
What are the common indications for the use of nitroglycerin?
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Define the Good Samaritan law.
Define the Good Samaritan law.
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What is the compression to ventilation ratio for adult 1-rescuer CPR?
What is the compression to ventilation ratio for adult 1-rescuer CPR?
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List the stages of labor.
List the stages of labor.
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What are the signs and symptoms of hyperglycemia?
What are the signs and symptoms of hyperglycemia?
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What does APGAR stand for?
What does APGAR stand for?
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What is an indication for using an EpiPen?
What is an indication for using an EpiPen?
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What is classified as a hollow organ in the abdomen?
What is classified as a hollow organ in the abdomen?
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Child or elder abuse must be reported to CPS/APS within 48 hours.
Child or elder abuse must be reported to CPS/APS within 48 hours.
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How is insulin made?
How is insulin made?
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What is normal blood sugar?
What is normal blood sugar?
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Which factor is NOT typically a sign of acute coronary syndrome?
Which factor is NOT typically a sign of acute coronary syndrome?
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What is a characteristic symptom of pneumonia?
What is a characteristic symptom of pneumonia?
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Which of the following medications is indicated for the treatment of narcotic overdose?
Which of the following medications is indicated for the treatment of narcotic overdose?
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Which assessment tool is specifically used to evaluate stroke patients?
Which assessment tool is specifically used to evaluate stroke patients?
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What is a common treatment for hyperventilation syndrome?
What is a common treatment for hyperventilation syndrome?
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Which condition is typically associated with sudden onset chest pain and difficulty breathing due to the presence of air in the pleural space?
Which condition is typically associated with sudden onset chest pain and difficulty breathing due to the presence of air in the pleural space?
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What should be closely monitored in a patient experiencing a generalized seizure?
What should be closely monitored in a patient experiencing a generalized seizure?
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Which of the following is NOT typically a side effect of nitroglycerin?
Which of the following is NOT typically a side effect of nitroglycerin?
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What is the compression to ventilation ratio for an adult during 2-person CPR?
What is the compression to ventilation ratio for an adult during 2-person CPR?
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What should be provided to a patient with an Apgar score of less than 7?
What should be provided to a patient with an Apgar score of less than 7?
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Which airway maneuver is indicated for a patient with complete airway obstruction?
Which airway maneuver is indicated for a patient with complete airway obstruction?
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What is the maximum flow rate in liters per minute for a non-rebreather mask?
What is the maximum flow rate in liters per minute for a non-rebreather mask?
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Which of the following defines the concept of 'informed consent'?
Which of the following defines the concept of 'informed consent'?
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What is the first step in the primary assessment of a patient?
What is the first step in the primary assessment of a patient?
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What is the maximum time allowed for a written report to be submitted after notifying CPS/APS about child or elder abuse?
What is the maximum time allowed for a written report to be submitted after notifying CPS/APS about child or elder abuse?
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Which of the following is NOT an indication for the use of rigid/tonsil tip suction?
Which of the following is NOT an indication for the use of rigid/tonsil tip suction?
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What is the primary purpose of using the SAMPLE history in patient assessment?
What is the primary purpose of using the SAMPLE history in patient assessment?
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Which airway adjunct is appropriate for an unresponsive patient who lacks a gag reflex?
Which airway adjunct is appropriate for an unresponsive patient who lacks a gag reflex?
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What components are assessed in the Glasgow Coma Scale?
What components are assessed in the Glasgow Coma Scale?
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Which respiratory disease is characterized by wheezing and pursed-lipped breathing, often associated with a barrel-chested appearance?
Which respiratory disease is characterized by wheezing and pursed-lipped breathing, often associated with a barrel-chested appearance?
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What is the flow rate of oxygen delivered by a nasal cannula?
What is the flow rate of oxygen delivered by a nasal cannula?
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What is the appropriate duration for suctioning an adult patient?
What is the appropriate duration for suctioning an adult patient?
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What are the primary signs of congestive heart failure on the right side?
What are the primary signs of congestive heart failure on the right side?
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What is the maximum number of doses for administering nitroglycerin?
What is the maximum number of doses for administering nitroglycerin?
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What are the signs and symptoms of hypoglycemia?
What are the signs and symptoms of hypoglycemia?
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What is the definition of status epilepticus?
What is the definition of status epilepticus?
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What are the general signs and symptoms of a stroke?
What are the general signs and symptoms of a stroke?
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What are the symptoms of a severe allergic reaction?
What are the symptoms of a severe allergic reaction?
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What characterizes first trimester bleeding with tissue discharge?
What characterizes first trimester bleeding with tissue discharge?
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What is the most common cause of seizures in children?
What is the most common cause of seizures in children?
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What are the signs and symptoms of someone on a stimulant?
What are the signs and symptoms of someone on a stimulant?
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What is defined as anaphylactic shock?
What is defined as anaphylactic shock?
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What is the most common reason for cardiac arrest in adults?
What is the most common reason for cardiac arrest in adults?
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Which of the following is included in the definition of cardiac arrest?
Which of the following is included in the definition of cardiac arrest?
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During CPR for an adult, what is the recommended compression to ventilation ratio for one rescuer?
During CPR for an adult, what is the recommended compression to ventilation ratio for one rescuer?
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What is the depth of chest compressions recommended for an adult during CPR?
What is the depth of chest compressions recommended for an adult during CPR?
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What is the correct maximum duration for checking breathing and pulse during cardiac arrest recognition?
What is the correct maximum duration for checking breathing and pulse during cardiac arrest recognition?
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What does ROSC stand for in the context of cardiac arrest?
What does ROSC stand for in the context of cardiac arrest?
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When performing CPR on an infant, what is the recommended depth of compressions?
When performing CPR on an infant, what is the recommended depth of compressions?
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Which of the following is NOT a sign of imminent delivery?
Which of the following is NOT a sign of imminent delivery?
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What is the compression to ventilation ratio for child CPR when two rescuers are present?
What is the compression to ventilation ratio for child CPR when two rescuers are present?
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What should be minimized during CPR to ensure effectiveness?
What should be minimized during CPR to ensure effectiveness?
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Study Notes
Cardiac Arrest
- Cardiac arrest means the patient is unresponsive, not breathing, and has no pulse
- Most common reasons for cardiac arrest in adults are cardiac problems and in children respiratory problems
- Downtime is the time from cardiac arrest until effective CPR is performed
- Total downtime is the time from cardiac arrest until outcome, like ROSC, patient delivery to hospital, etc.
- ROSC (Return of Spontaneous Circulation) is when the patient regains a pulse
- Survival is a cardiac arrest patient who regains ROSC and is eventually discharged from the hospital neurologically intact
- Witnessed cardiac arrest is when the EMT witnessed the patient go into cardiac arrest.
- Unwitnessed cardiac arrest is when the EMT arrived to a patient already in cardiac arrest.
Chain of Survival
- The Chain of Survival is a sequence of actions that can improve survival rates for a patient experiencing cardiac arrest
Age Groups
- Infant: Birth to 1 year of age (Neonate: birth to one month)
- Child: 1 year until puberty (Boys: underarm hair, Girls: breast tissue)
- Adult: Puberty and above
Recognizing Cardiac Arrest
- Determine unresponsiveness by shaking and shouting, or using painful stimuli
- Check breathing and pulse for a maximum of 10 seconds, can be done simultaneously
- Check for a carotid pulse on your side
Starting CPR
-
For adults, the compression to ventilation ratio is 30:2 (one or two rescuer CPR).
-
Perform CPR at a rate of 100-120 compressions/minute
-
Compression depth should be 2-2.4 inches.
-
Use two hands, center of chest, below sternal notch, above xyphoid process.
-
For children, the compression to ventilation ratio is 30:2 (one rescuer) or 15:2 (two rescuer).
-
CPR rate should be 100-120/minute.
-
Compression depth is about 1/3 diameter of chest, about 2 inches.
-
Place hands on the center of the chest with one or two hands.
-
For infants, the compression to ventilation ratio is 30:2 (one person) or 15:2 (two person).
-
CPR rate is 100-120/minute.
-
Compression depth is 1/3 diameter of chest, about 1.5 inches.
-
Use two hands in an encircling thumb technique (new for 2020).
During CPR
- Allow full chest recoil
- Minimize compression interruptions to 10 seconds or less
- You should be able to feel a pulse WITH compressions, carotid or femoral
Return of Spontaneous Circulation (ROSC)
- Recheck all ABCs after a change in patient status, positive or negative
CPR When The Patient Vomits
- Roll the patient on their side, clear the airway/suction, then roll them back and resume CPR.
Automated External Defibrillator (AED)
- Use on a patient who is:
- Unresponsive
- Not breathing
- Pulseless
- The AED will defibrillate the following rhythms:
- Ventricular Fibrillation (Vfib)
- Ventricular Tachycardia (Vtach)
AED Usage
- Use an AED as soon as it arrives.
- Never touch the patient during the analyzing phase.
- Always clear the victim before pressing the SHOCK button.
- When transporting in an ambulance pull over and stop every time you analyze.
AED Cautions
- Remove medication patches
- Never use in water, dry off the patient
- Avoid pacemakers
- Shave patient if necessary
- Remove all clothing, including bra
Rescue Breathing
- Use when a patient is not breathing but has a pulse
- Adults: 1 breath every 5-6 seconds or 10-12/minute
- Children/Infants: 1 breath every 2-3 seconds or 20-30/minute (new 2020)
- Do not use rescue breathing rate during CPR!
Obstructed Airway/Choking
-
Conscious Patients:
- Adults/Child: Abdominal thrusts/Heimlich maneuver
- ** infant:** 5 back blows, 5 chest thrusts
-
Unconscious/Unresponsive:
- Adult/Child: CPR, look in the mouth prior to giving breaths
- Infant: 5 back blows, 5 chest thrusts, attempt ventilations, look in the mouth prior to giving breaths
Partially Obstructed Airway
- Patient appears to be choking but can still cough or move air.
- Encourage them to stay calm and continue working to relieve obstruction.
- DO NOT perform abdominal thrusts
Legal Issues
- Leaving your patient with a person of lower medical authority than you is considered abandonment.
- Touching a patient without consent is considered battery.
- To prove negligence you must prove 4 things:
- Duty to act
- Breach of duty
- Injury to the patient
- Causation
Good Samaritan Law
- Protects people who in good faith provide care to a person in an emergency.
Cardiac Arrest
- Cardiac arrest is unresponsive, not breathing, no pulse - dead.
- Most common reasons for cardiac arrest:
- Adults - Cardiac problems
- Children - Respiratory problems
Cardiac Arrest Terms
- Downtime - From cardiac arrest until effective CPR is performed
- Total downtime - From cardiac arrest until the outcome
- Possible outcomes: ROSC, patient delivered to hospital
- Return of Spontaneous Circulation (ROSC) - When a patient regains a pulse
- Survival - A cardiac arrest patient who regains ROSC and is eventually discharged from the hospital neurologically intact
- Witnessed vs. Unwitnessed Cardiac Arrest:
- Witnessed - EMT witnessed the patient go into cardiac arrest
- Does not refer to a layperson watching the patient collapse
- Unwitnessed - EMT arrived to a patient already in cardiac arrest
- Witnessed - EMT witnessed the patient go into cardiac arrest
Chain of Survival
- Recognizing Cardiac Arrest:
- Determine unresponsiveness - Shake and shout, use painful stimuli
- Check breathing and pulse simultaneously
- 10 seconds maximum
- Check carotid pulse on YOUR SIDE
- Send someone to call 911 and get an AED
- Start CPR
CPR - Adult
- Compression to ventilation ratio: 30:2
- One or two rescuer CPR
- 100-120 compressions per minute
- Depth of compression: 2-2.4 inches
- Two hands, center of chest
- Below sternal notch, above xyphoid process
CPR - Child
- Compression to Ventilation Ratio:
- One rescuer - 30:2
- Two rescuer - 15:2
- Rate: 100-120 per minute
- Depth: 1/3 diameter of chest, about 2 inches
- Hand placement: One or two hands, center of chest
CPR - Infant
- Compression to Ventilation Ratio:
- One person - 30:2
- Two person - 15:2
- Rate: 100-120 per minute
- Depth: 1/3 diameter of chest, about 1.5 inches
- Hand placement:
- One person and two person: 2 hand, encircling thumb technique
During CPR
- Allow full chest recoil
- Minimize all compression interruptions to 10 seconds or less
- Should be able to feel a pulse WITH COMPRESSIONS
- Carotid or femoral
Return of Spontaneous Circulation (ROSC)
- Recheck ABC's.
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Description
This quiz covers essential concepts about cardiac arrest, including definitions, causes, and survival rates. It also explores the Chain of Survival and its importance in improving patient outcomes. Test your knowledge on how to respond effectively during a cardiac event.