Complete Midterm Review PDF

Ray’s Midterm Review 1. Know the pathophysiology, signs and symptoms, treatment, and any special assessment parameters (i.e. GCS or Cincinnati Stoke Scale) for the following disease processes: a. Emphysema b. Chronic Bronchitis c. Asthma / Status Asthmaticus...

Ray’s Midterm Review 1. Know the pathophysiology, signs and symptoms, treatment, and any special assessment parameters (i.e. GCS or Cincinnati Stoke Scale) for the following disease processes: a. Emphysema b. Chronic Bronchitis c. Asthma / Status Asthmaticus d. Pneumonia e. Pulmonary Embolism f. Spontaneous Pneumothorax g. Pulmonary Edema h. Hyperventilation Syndrome i. Acute Coronary Syndrome / Coronary Artery Disease j. Angina k. Myocardial Infarction l. Aneurysm / Dissection – Thoracic and Abdominal m. Congestive Heart Failure n. Peritonitis o. Appendicitis p. Pancreatitis q. Cholecystitis r. GI Bleeding s. Esophageal Varices t. Kidney Stones u. Hypoglycemia v. Hyperglycemia w. Allergic Reaction x. Anaphylaxis y. Ischemic Stroke z. Hemorrhagic Stroke aa. Transient Ischemic Attack bb. Generalized Seizure / Status Epilepticus cc. Absence Seizure dd. Febrile Seizure ee. Simple Partial Seizure ff. Complex Partial Seizure gg. Syncope hh. Ingested Poisoning ii. Inhaled Poisoning jj. Injected Poisoning kk. Absorbed Poisoning ll. Organophosphate/Pesticide Exposure mm. Carbon Monoxide Poisoning nn. Alcohol Withdrawals oo. Narcotic Overdose  pp. CNS Stimulants qq. CNS Depressants rr. Spontaneous Abortion ss. Ectopic Pregnancy tt. Placenta Previa uu. Abruptio Placenta vv. Ruptured Uterus ww. Preeclampsia/Eclampsia xx. Supine Hypotensive Syndrome yy. Prolapsed Cord zz. Breech Birth aaa. Limb Presentation bbb. Meconium Staining ccc. Postpartum Hemorrhage 2. Know the names, indications, contraindications, form, dosage, actions, side effects, and any special information regarding administration for the following medications a. Multidose Inhalers b. Nitroglycerin c. Aspirin d. EpiPen e. Oral Glucose f. Activated Charcoal g. Naloxone h. What are the 5 rights? 3. Ensure that you can recall the patient assessment skill sheet by memory (look for questions that end in “you should”). Recall all parts of Scene sizeup, primary assessment, secondary assessment (including SAMPLE, OPQRST, rapid secondary assessment instead of OPQRST for ALOC/unresponsive patients), and reassessment. 4. All legal issue definitions, including 5150, AMA, emancipation, advanced directives, consents 5. All aspects of CPR (see attached short powerpoint entitled “CPR for the EMT student) 6. Airway maneuvers a. Know indications, measurements, and usage for the following i. Rigid/tonsil tip suction ii. French/soft suction iii. NPA iv. OPA b. Know O2% and liter flow per minute for the following i. Nasal canula ii. Non-rebreather mask iii. Bag Valve Mask iv. FROPVD 7. Early / Late signs of hypoxia 8. Stages of labor 9. Apgar scoring  Ray’s Midterm Study Group Discussion Questions 1. Leaving your patient with a person of lower medical authority than you is considered: 2. Touching a patient without consent is considered: 3. What are the 4 things that need to be proven to be deemed negligent? 4. What is the Good Samaritan law? 5. Your legal obligation to provide care while on duty. 6. What skills you are legally allowed to do in the State of California or National Registry. 7. Consent given by an awake and oriented patient. 8. Consent given by a patient who would consent to care if they were awake and oriented. 9. A legal order, signed by a doctor and patient, stating resuscitation wishes. 10. Who can place a patient on a 5150? 11. A person can be placed on a 5150 if they are either a… (3 things) 12. If you suspect child or elder abuse, you need to notify CPS/APS __________ and follow up with a written report in ___________ hours. 13. What is your compression to ventilation ratio for an adult, 2 person CPR? 14. What is your compression to ventilation ratio for a child, 1 person CPR? 15. What is your compression to ventilation ratio for an infant/child, 2 person CPR? 16. What is our treatment for unconscious choking patients of any age? 17. What is the flow of a drop of blood through the heart? 18. What arteries feed the heart with blood? 19. Blood enters what vessel after it leaves the right ventricle? 20. Blood enters what vessel as it leaves the heart? 21. What side of the heart is the bicuspid valve? 22. What two bones in the body, if fractured, can lead to massive blood loss? 23. What are the 6 steps of your scene survey? 24. What are the steps of your primary survey? 25. What mnemonic do we use to investigate a medical chief complaint? 26. What mnemonic do we use to investigate a trauma or ALOC patient? (Both NR and SD county) 27. Define SAMPLE history. 28. Define PRBELLS. 29. What are the 3 components of a Glasgow Coma Scale? 30. What airway adjunct do we use for an unresponsive patient with no gag reflex? 31. When measuring a NPA, we measure from the earlobe to the what? 32. How much O2 does a NRB provide? 33. How much O2 does a nasal cannula provide? 34. How long do we suction an adult? A child? 35. Which suction catheter can we only use on adults? 36. What “grip” do we use to hold down a mask for a BVM? 37. What is the liter flow range for a cannula? An NRB? 38. What is the flow meter set at for a demand valve (FROPVD)? 39. What resp disease is characterized by wheezing, pursed lipped breathing, and tripoding from a patient who appears barrel chested and is probably on home O2? 40. What resp disease is characterized by rhonchi, congestion, productive cough, and a high fever? 41. What resp disease is characterized by reversible wheezing and accessory muscle use in a younger adult due to a specific cause (exercise, pollen, pet dander, etc)? 42. Why isn’t asthma technically considered COPD? 43. What is the definition of chronic bronchitis? 44. What resp disease is characterized by an unexplained shortness of breath with clear lungs and pinpoint chest pain? What are the main causes of this disease? 45. What are the signs and symptoms of hyperventilation syndrome? 46. What is the stereotypical patient who gets a spontaneous pneumothorax? 47. What are the signs and symptoms of a simple pneumothorax (we will get to tension pneumo in test 4 review)? 48. Why does angina type chest pain go away with rest and nitro (think coronary disease)? 49. What are the signs and symptoms of a myocardial infarction? 50. What side of the heart usually gets congestive heart failure first? 51. JVD, pedal edema are signs of what side CHF? 52. Pulmonary edema, rales/crackles, and pink, frothy sputum are signs of what side CHF? 53. What are the indications of NTG? 54. What are the contraindications of NTG (don’t kill them!)? 55. What is the dose of NTG and how many doses can you administer? 56. What are the actions of NTG (how does it work)? 57. What patients can we assist with an MDI? 58. What is our dose of aspirin? 59. How does an MDI help an asthma patient? 60. What are the signs/symptoms of a suspected AAA? 61. Abdominal emergency characterized by right upper quadrant pain, referred pain to the right shoulder, and projectile vomiting (I added that last part)? 62. What abdominal emergency is characterized by right lower quadrant pain that radiates to the umbilicus and rebound tenderness upon palpation? 63. What are some hollow organs in the abdomen? 64. What are some solid organs in the abdomen? 65. What substance does our body use for fuel? 66. How is our fuel stored in the liver? What hormone is needed to convert it back to glucose? 67. Where is insulin made? 68. What are the signs/symptoms of hypoglycemia (think really, really hangry)? 69. What is normal blood sugar? 70. What are the signs and symptoms of hyperglycemia? Is it a faster or slower onset than hypoglycemia? 71. What are the two types of strokes? Which is more common? 72. What are the general signs/symptoms of a stroke? 73. Define a TIA. Onset, time until symptoms resolve… 74. Define the symptoms of a mild allergic reaction. 75. Define the symptoms of a severe allergic reaction / mild anaphylaxis. 76. Define anaphylactic shock. 77. What is general seizure disorder called? 78. What is the definition of status epilepticus? 79. What are the stages of a seizure? 80. What is the most common cause of seizures in children? 81. What are the indications for an epi pen? 82. How does an epi pen work? 83. What are the indications for oral glucose? 84. What is the dose of an oral glucose tube of paste? 85. What are the indications for activated charcoal? 86. What is the adult and child dose of activated charcoal per NR? 87. What are the contraindications of charcoal? 88. What are the 4 ways poisons can enter your body? 89. What stage of alcohol withdrawal do we find seizures? 90. What are the signs/symptoms of someone on a stimulant (think fight or flight)? 91. What are the signs/symptoms of someone on a narcotic? 92. Third trimester bleeding that is painless but profusely bleeding. 93. First trimester bleeding with tissue discharge. 94. First trimester bleeding following intense abdominal pain and possible shock. 95. Third trimester emergency with tons of pain, but possibly no external bleeding (doesn’t mean she isn’t bleeding on the inside!)? 96. Third trimester emergency that is almost always fatal to the fetus and caused by trauma or previous C-section. 97. Signs and symptoms of pre-eclampsia. 98. When does pre-eclampsia become eclampsia? Why is this dangerous? 99. Name the stages of labor (3 of them). 100. What is our treatment for a breech birth? 101. What is our treatment for limb presentation? 102. When are the 2 times that you are allowed to insert fingers into the birth canal? 103. What are the signs of imminent delivery (meaning its go time!)? 104. Define APGAR (you will NEED to know this). CPR Review for the EMT Student We are professionals now!  Information and Facts For the Class ” Cardiac arrest means ” Unresponsive ” Not Breathing ” No Pulse ” Dead ” Most common reason for cardiac arrest ” Adults – Cardiac problems ” Children – Respiratory problems  Cardiac Arrest Terms ” Downtime – From cardiac arrest until effective CPR performed ” Total downtime – From cardiac arrest until the outcome ” Possible outcomes – ROSC, patient delivered to hospital, etc. ” Return of Spontaneous Circulation (ROSC) – when 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 – the EMT witnessed the patient go into cardiac arrest ” Does not refer to the layperson watching the patient collapse ” Unwitnessed – the EMT arrived to a patient already in cardiac arrest  Chain of Survival Adult Pediatric  Ages ” 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  Recognition of Cardiac Arrest ” Determine unresponsiveness ” Shake and shout, use painful stimuli ” Check breathing and pulse ” Can be done at the same time ” 10 seconds max ” Check carotid pulse on YOUR SIDE ” Send someone to call 911 and get AED  Start CPR - Adult ” Compression to ventilation ratio is 30:2 ” One or two rescuer CPR ” 100-120 compressions/minute ” Depth of compression 2-2.4” ” Two hands, center of chest ” Below sternal notch, above xyphoid process  Start CPR - Child ” Compression to Ventilation ratio ” One rescuer – 30:2 ” Two rescuer – 15:2 ” Rate 100-120/minute ” Depth ” 1/3 diameter of chest, about 2” ” Hand placement – one or two hands, center of chest  Start CPR - Infant ” Compression to Ventilation ratio ” One person – 30:2 ” Two person – 15:2 ” Rate ” 100-120/min ” Depth ” 1/3 diameter of chest, about 1.5” ” Hand placement ” One person and two person – 2 hand, encircling thumb technique ” This is new for 2020  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  Let’s Say You Got Pulses Back… ” ROSC (Return of spontaneous circulation) ” Recheck ABC’s! ” Always recheck ABC’s after a change in patient status, positive or negative ” This will be a recurring theme throughout the next 16 weeks!  What If the Patient Vomits ” Very Common… ” Roll patient on their side, clear airway/suction, then roll back and resume  Automated External Defibrillator ” To be used on a patient who is: ” Unresponsive ” Not breathing ” Pulseless ” AED will defibrillate the following rhythms: ” Ventricular Fibrillation (Vfib) ” Ventricular Tachycardia (Vtach)  Automated External Defibrillator ” To be used as soon as it arrives ” Never touch patient during the analyzing phase ” Always clear victim before pressing SHOCK button ” Transporting in ambulance? Must pull to side of road and stop every time you analyze…  AED Cautions ” Remove medication patches ” Never use in water / dry off patient ” Avoid pacemakers ” Shave them if you have to ” Remove all clothing, bra included  Rescue Breathing ” When the patient is not breathing, but has a pulse ” Adults ” 1 breath every 5-6 seconds ” 10-12 / minute ” Children / Infants ” 1 breath every 2-3 seconds ” 20-30 / minute (this is new for 2020) ” Do not use rescue breathing rate during CPR!  Obstructed Airway / Choking ” Conscious Patients ” Adult / Child ” Abdominal thrusts / Heimlich maneuver ” Infant ” 5 back blows, 5 chest thrusts ” Continue treatment, over and over, until: ” Obstruction is relieved ” Patient becomes unresponsive ” Other rescuers arrive  Obstructed Airway / Choking ” Unconscious / Unresponsive ” Adult / Child ” CPR ” Look in mouth prior to giving breaths ” Infant ” 5 back blows, 5 chest thrusts, attempt ventilations ” Look in 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