EMT Chapter 17 Flashcards
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Questions and Answers

What should you do when an AED indicates a shock for a patient with an automatic implantable cardiac defibrillator (AICD)?

  • Administer medication first
  • Continue CPR without using the AED
  • Deliver the shock followed by immediate resumption of CPR (correct)
  • Do not shock the patient

    • What should you assess for a 49-year-old male presenting with acute crushing chest pain?

    Assess the adequacy of his respirations.

    What should you suspect for a 55-year-old male whose chest pain was relieved with nitroglycerin?

    Angina pectoris

    What should you administer to a 65-year-old female suspected to be having an acute myocardial infarction?

    <p>Aspirin</p> Signup and view all the answers

    What should you do for a 65-year-old male who is not breathing and pulseless, with an AED stating 'no shock advised'?

    <p>Continue CPR</p> Signup and view all the answers

    What should you administer to a 66-year-old female with substernal chest pressure and no prescribed nitroglycerin?

    <p>Oxygen and 324 mg of aspirin</p> Signup and view all the answers

    What do the signs and symptoms of a 66-year-old woman with significant blood pressure difference between arms likely indicate?

    <p>Dissecting aortic aneurysm</p> Signup and view all the answers

    What should treatment include for a 67-year-old woman with chest discomfort and congestive heart failure?

    <p>Placing her in an upright position</p> Signup and view all the answers

    What should you do if a 67-year-old female with severe chest pain becomes unresponsive during transport?

    <p>Stop the ambulance, begin CPR, and attach the AED.</p> Signup and view all the answers

    What should you suspect for a 70-year-old female with difficulty breathing and bilateral rales?

    <p>Congestive heart failure</p> Signup and view all the answers

    What occurs when a dissecting aortic aneurysm happens?

    <p>The inner layers of the aorta become separated.</p> Signup and view all the answers

    What should the EMT do if a patient in cardiac arrest has an external defibrillator vest interfering with CPR?

    <p>Remove the battery from the monitor and then remove the vest.</p> Signup and view all the answers

    What condition should you suspect for a patient with a left ventricular assist device (LVAD)?

    <p>Acute myocardial infarction</p> Signup and view all the answers

    What can be expected during the assessment of a patient with a left ventricular assist device (LVAD)?

    <p>Absence of a palpable pulse</p> Signup and view all the answers

    What causes angina pectoris?

    <p>Myocardial oxygen demand exceeds the supply.</p> Signup and view all the answers

    What is the mechanism of action for a percutaneous transluminal coronary angioplasty (PTCA)?

    <p>Dilating the affected coronary artery with a small inflatable balloon.</p> Signup and view all the answers

    What is Acute coronary syndrome (ACS)?

    <p>A group of symptoms caused by myocardial ischemia.</p> Signup and view all the answers

    What should you do after assisting a patient with nitroglycerin?

    <p>Reassess the blood pressure within 5 minutes.</p> Signup and view all the answers

    What should you do after an AED has delivered a shock?

    <p>Immediately resume CPR.</p> Signup and view all the answers

    What occurs during an acute myocardial infarction (AMI)?

    <p>Myocardial tissue dies secondary to an absence of oxygen.</p> Signup and view all the answers

    What rhythm does an automated external defibrillator (AED) detect and defibrillate?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What is the function of blood ejected from the right ventricle?

    <p>It flows into the pulmonary arteries.</p> Signup and view all the answers

    What may cause cardiac output to decrease?

    <p>If the heart beats too rapidly, not enough time between contractions for the heart to refill completely.</p> Signup and view all the answers

    What causes cardiogenic shock following AMI?

    <p>Decreased pumping force of the heart muscle.</p> Signup and view all the answers

    What common side effect is associated with nitroglycerin?

    <p>Hypotension</p> Signup and view all the answers

    What are common signs of a hypertensive emergency?

    <p>A bounding pulse, severe headache, and dizziness.</p> Signup and view all the answers

    What is typically NOT a symptom of an Acute Myocardial Infarction (AMI)?

    <p>Pain exacerbated by breathing.</p> Signup and view all the answers

    How should defibrillator pads be placed on a patient's chest?

    <p>With one pad to the right of the upper sternum and the other pad to the left lower chest, below the armpit.</p> Signup and view all the answers

    Where does deoxygenated blood return in the heart?

    <p>Right atrium</p> Signup and view all the answers

    What does a 'no shock advised' message from an AED indicate?

    <p>The patient is not in ventricular fibrillation.</p> Signup and view all the answers

    How does a dissecting aortic aneurysm typically present?

    <p>It presents with pain that is maximal from the onset.</p> Signup and view all the answers

    In contrast to an AICD, what does an external defibrillator vest do?

    <p>Delivers high-energy shocks, similar to an AED.</p> Signup and view all the answers

    What is the difference between sympathetic and parasympathetic nervous systems?

    <p>Parasympathetic slows the heart and respiratory rates.</p> Signup and view all the answers

    What is ischemic heart disease most accurately defined as?

    <p>Decreased blood flow to one or more portions of the myocardium.</p> Signup and view all the answers

    When is it most appropriate for a patient to take prescribed nitroglycerin?

    <p>When experiencing chest pain that does not immediately subside with rest.</p> Signup and view all the answers

    What are the major risk factors for AMI?

    <p>Family history</p> Signup and view all the answers

    What is the maximum number of doses of nitroglycerin for an 82-year-old male with chest pain?

    <p>3</p> Signup and view all the answers

    What is the effect of most AEDs adjusting the voltage based on the impedance?

    <p>It is the resistance of the body to the flow of electricity.</p> Signup and view all the answers

    How many doses of nitroglycerin are patients recommended to take before calling EMS?

    <p>Three</p> Signup and view all the answers

    What do you call narrowing of coronary arteries due to fatty deposits?

    <p>Atherosclerosis</p> Signup and view all the answers

    When is nitroglycerin contraindicated?

    <p>In patients who have experienced a head injury.</p> Signup and view all the answers

    How does nitroglycerin relieve chest pain?

    <p>By dilating the coronary arteries and improving cardiac blood flow.</p> Signup and view all the answers

    What must an EMT do prior to assisting a patient with nitroglycerin?

    <p>Obtain authorization from medical control.</p> Signup and view all the answers

    What should a chest be if it's wet before attaching the AED?

    <p>Dry the chest.</p> Signup and view all the answers

    Before defibrillating a patient with an AED, what is most important?

    <p>Ensure that no one is touching the patient.</p> Signup and view all the answers

    Why is prompt transport of a suspected AMI patient important?

    <p>The patient may be eligible to receive thrombolytic therapy.</p> Signup and view all the answers

    What does rapid, labored breathing in an AMI patient indicate?

    <p>Congestive heart failure</p> Signup and view all the answers

    What risk factors for AMI cannot be controlled?

    <p>Family history</p> Signup and view all the answers

    What would likely delay signs and symptoms of a hypertensive emergency?

    <p>Chronic hypertension</p> Signup and view all the answers

    What causes sudden death following AMI?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What is automaticity in cardiac muscle cells?

    <p>The ability to contract spontaneously without a stimulus.</p> Signup and view all the answers

    What is the next action after a shock delivered by the AED following 2 minutes of CPR?

    <p>Reassess airway and breathing and treat accordingly.</p> Signup and view all the answers

    What is the most advantageous aspect of an AED for EMTs?

    <p>It delivers prompt defibrillation to patients with ventricular fibrillation.</p> Signup and view all the answers

    What do you call the dilation at a weakened area of the aorta?

    <p>Aneurysm</p> Signup and view all the answers

    What is the level of the umbilicus where the descending aorta divides?

    <p>At the level of the umbilicus.</p> Signup and view all the answers

    Where does the electrical impulse from the heart originate?

    <p>Coronary sinus</p> Signup and view all the answers

    What controls the electrical stimulus from the heart's primary pacemaker?

    <p>The autonomic nervous system.</p> Signup and view all the answers

    When should an EMT use an AED on a child?

    <p>If pediatric pads and an energy-reducing device are available.</p> Signup and view all the answers

    What supplies oxygenated blood to the head and brain?

    <p>Carotid arteries</p> Signup and view all the answers

    What do the iliac arteries subdivide into?

    <p>Femoral arteries</p> Signup and view all the answers

    Where does the inferior vena cava return deoxygenated blood?

    <p>To the right side of the heart.</p> Signup and view all the answers

    What is the left side of the heart responsible for?

    <p>Receiving oxygen-rich blood from the pulmonary vein.</p> Signup and view all the answers

    Why does the left ventricle have the thickest walls?

    <p>It pumps blood into the aorta and systemic circulation.</p> Signup and view all the answers

    What is the main legal risk in using an AED?

    <p>Failing to deliver a shock when one is needed.</p> Signup and view all the answers

    What is the most common error associated with using an AED?

    <p>Failure to ensure the battery is charged.</p> Signup and view all the answers

    What is the common reason many experiencing AMI do not seek immediate medical attention?

    <p>They are in denial.</p> Signup and view all the answers

    What supplies oxygenated blood to the myocardium?

    <p>Coronary arteries originating from the aorta.</p> Signup and view all the answers

    Where can the posterior tibial pulse be palpated?

    <p>Behind the medial malleolus, on the inside of the ankle.</p> Signup and view all the answers

    What does the right coronary artery supply blood to?

    <p>To the right ventricle and inferior wall of the left ventricle.</p> Signup and view all the answers

    What is the volume of blood that passes through the heart in 1 minute called?

    <p>Cardiac output</p> Signup and view all the answers

    What is important upon arriving at a residence with a possible cardiac problem?

    <p>Assess the scene for potential hazards.</p> Signup and view all the answers

    Why does ventricular tachycardia cause hypotension?

    <p>The left ventricle does not adequately fill with blood.</p> Signup and view all the answers

    What heart rhythm is characterized by disorganized quivering of the ventricles?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What area of conduction in the heart originates normal electrical impulses?

    <p>Sinus node</p> Signup and view all the answers

    What is the minimum systolic blood pressure necessary to administer nitroglycerin?

    <p>100 mm Hg</p> Signup and view all the answers

    What is the primary cause of a dissecting aneurysm?

    <p>Uncontrolled hypertension</p> Signup and view all the answers

    What happens when the electrical impulse reaches the AV node?

    <p>It is slowed for a brief period of time so that the sinoatrial (SA) node can reset and generate another impulse.</p> Signup and view all the answers

    How should the EMT document a patient's chest pain description?

    <p>Use the patient's own words.</p> Signup and view all the answers

    What position should the patient be in when obtaining a 12-lead ECG?

    <p>In a supine position with legs uncrossed.</p> Signup and view all the answers

    Where should the 'LL' and 'RL' electrodes be placed for a 12-lead ECG?

    <p>On the thighs or ankles.</p> Signup and view all the answers

    Where should the V1 and V2 electrodes be placed for a 12-lead ECG?

    <p>On either side of the sternum.</p> Signup and view all the answers

    What happens when the myocardium requires more oxygen?

    <p>The arteries supplying the heart dilate.</p> Signup and view all the answers

    What is assumed when treating a patient with chest pain?

    <p>The cause of the pain cannot be diagnosed in the field.</p> Signup and view all the answers

    Which artery supplies blood to the right atrium, right ventricle, and part of the left ventricle?

    <p>Right coronary artery</p> Signup and view all the answers

    Which blood vessel transports oxygenated blood?

    <p>Pulmonary veins</p> Signup and view all the answers

    What cardiac dysrhythmia has the greatest chance of deteriorating into a pulseless rhythm?

    <p>Ventricular tachycardia.</p> Signup and view all the answers

    Which equation represents cardiac output?

    <p>Stroke x heart rate</p> Signup and view all the answers

    What is a major difference between angina pectoris and AMI?

    <p>Anginal pain typically subsides with rest.</p> Signup and view all the answers

    What is NOT considered a common sign or symptom of malfunctioning implanted cardiac pacemaker?

    <p>Rapid heart rate.</p> Signup and view all the answers

    What is NOT a function of the sympathetic nervous system?

    <p>Constriction of blood vessels in the muscles.</p> Signup and view all the answers

    What is the absence of all electrical activity in the heart called?

    <p>Asystole.</p> Signup and view all the answers

    What does excessive movement of the patient cause on a 12-lead ECG tracing?

    <p>Artifacts on the tracing.</p> Signup and view all the answers

    What is the most reliable method of estimating a patient's cardiac output?

    <p>Assess the heart rate and strength of the pulse.</p> Signup and view all the answers

    What medication is commonly given to patients with chest pain to prevent blood clots?

    <p>Aspirin.</p> Signup and view all the answers

    Which patient is most likely suffering from congestive heart failure?

    <p>A 64-year-old male with uncontrolled hypertension, dependent edema, and dyspnea.</p> Signup and view all the answers

    Study Notes

    Cardiac Emergencies and Interventions

    • In cardiac arrest scenarios, if a patient has an AICD and the AED indicates a shock is needed, deliver the shock immediately followed by CPR.
    • Assess respirations in patients with acute crushing chest pain and diaphoresis, vital for evaluating oxygenation.
    • Chest pain relieved by nitroglycerin in a patient suggests angina pectoris, a temporary condition due to oxygen demand exceeding supply.

    Myocardial Infarction Management

    • Administer aspirin to patients suspected of having an acute myocardial infarction (AMI) to prevent further clotting.
    • For unresponsive, pulseless patients, continue high-quality CPR even if the AED indicates "no shock advised."
    • In cases with chest pressure and a history of hypertension, administer oxygen and aspirin while monitoring vitals.

    Indications of Cardiac Conditions

    • Stabbing chest pain radiating to the back with significant blood pressure difference between arms indicates a dissecting aortic aneurysm.
    • Congestive heart failure presents with difficulty breathing and bilateral rales, typically in patients with past heart issues.

    Cardiac Assessment and Diagnostics

    • A history of left ventricular assist device (LVAD) suggests the patient may have experienced an AMI and displays absence of a palpable pulse during assessment.
    • The coronary arteries supply oxygen-rich blood to the myocardium from the aorta.

    Treatment Protocols and Precautions

    • For patients with chest pain, it's critical to reassess blood pressure after assisting with nitroglycerin, looking for signs of hypotension.
    • AEDs are designed to detect life-threatening rhythms like ventricular fibrillation; immediate CPR should resume after delivering a shock.

    Understanding Cardiac Functionality

    • Symptoms of AMI can include severe chest pain but are often not exacerbated by breathing; pain may present variably among individuals.
    • A sudden increase in heart rate and decreased stroke volume may indicate cardiogenic shock after an AMI due to diminished myocardial contractility.

    Risk Factors and Prevention

    • Unmodifiable risk factors for AMI include family history; however, lifestyle choices and management of conditions like hypertension play crucial roles.
    • Hypertension emergencies present with bounding pulses and severe headaches, warning of potential cardiovascular complications.

    Anatomy and Physiology

    • The left ventricle's muscular thickness allows effective blood pumping into systemic circulation, essential for oxygen delivery.
    • Coronary arteries originate from the aorta and are crucial for myocardium perfusion.
    • Automaticity refers to cardiac muscle's ability to contract without nervous stimulation, a key feature in maintaining rhythm.

    ECG and Monitoring

    • Ensure the patient is supine and legs uncrossed during a 12-lead ECG to avoid artifacts; proper electrode placement is vital for accurate readings.
    • Artifacts during ECG readings may be caused by patient movement, emphasizing the need for stillness during monitoring.

    Medication Use and Administration

    • Nitroglycerin is contraindicated in patients with head injuries due to risk of increased intracranial pressure; ensure blood pressure is adequate before administration.
    • Aspirin is commonly administered for chest pain, acting to prevent further clot formation.

    Defibrillator and Shock Protocols

    • Defibrillator pads should be placed correctly to ensure effective defibrillation; uphold safety by ensuring no one is in contact with the patient during shock delivery.
    • The presence of an aortic aneurysm signifies a weak area in the aorta which may rupture if untreated.

    Patient Interaction and History Taking

    • Use the patient's own words to describe symptoms, enhancing accuracy in reporting and understanding their experience.
    • When evaluating patients, be vigilant in documenting their history of hypertension and compliance with regimens, which can impact their current condition.

    Common Cardiac Dysrhythmias

    • Ventricular fibrillation represents a chaotic rhythm; it is critical not to confuse it with other dysrhythmias which may not require shock delivery.
    • Understanding the differences between AMI and angina pectoris is crucial for prompt and effective treatment delivery.

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    Test your knowledge with these flashcards from Chapter 17 for EMT training. These cards cover critical scenarios you may encounter in the field, including cardiac arrest and the use of AEDs. Perfect for review and preparation for real-life emergency situations.

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