EMS1055 Midterm Study Guide PDF

EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 If you are employed by an agency as an EMR and you are dispatched to the scene of an accid...

EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 If you are employed by an agency as an EMR and you are dispatched to the scene of an accident or illness, you have a duty to act. you must proceed promptly to the scene and render emergency medical care within the limits of your training and available equip- ment. Know the medical legal responsibilities of an EMR, such as Duty Failure to respond or render care leaves you and your agency to Act and Standard of Care. vulnerable to legal action. The standard of care is the manner in which you must act or behave You must meet two criteria: -You must treat the patient to the best of your ability -You must provide care that a reasonable, prudent person with similar training would provide under similar circumstances. Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organi- standard of care zations so that patients are not exposed to unreasonable risk or harm. a set of regulations and ethical considerations that define the scope of practice scope, or extent and limits, of the EMT's or EMS job Your legal responsibility to do something in the case of an emer- Duty to Act gency Leaving a patient after care has been initiated and before the Abandonment patient has been transferred to someone with equal or greater medical training. expressed implied consent for minors Know the levels of patient consent consent for mentally ill patients refusal of care Advanced directives The patient actually lets you know—verbally or nonverbally—that he or she is willing to accept treatment expressed consent The patient must be of legal age and able to make a rational decision. The patient does not specifically refuse emergency care. implied consent Do not hesitate to treat an unconscious patient. Under the law, minors are not considered capable of speaking for themselves. Emergency treatment must wait until a patient or legal guardian Consent for minors consents to the treatment. If permission cannot be quickly obtained, do not hesitate to give appropriate medical care. If the person appears to be a threat to self or others, place this person under medical care. Consent of the Mentally Ill Know your state's legal mechanisms for handling these patients. Do not hesitate to involve law enforcement agencies. A document that indicates what medical intervention an individual living will wants if he or she becomes incapable of expressing those wishes. DNR (do not resuscitate) an order that tells medical professionals not to perform CPR An unwillingness to receive first aid or medical refusal of care treatment expressed by a victim (or the victim's parent or guardian) who must give consent. 1 / 11  EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 carotid 60mm Hg femoral 70mm Hg radial 80mm Hg Know the pulse points and what blood pressure is required for pedal 90-100mm Hg them to be palpated systolic pressures Remember head to toes in anatomic position the pulse felt along the large carotid artery on either side of the carotid pulse neck. Blood pressure is at least 60 systolic Pulse felt on either side of the groin; Femoral artery. blood pressure femoral pulse is at least 70 systolic. brachial pulse the pulse felt in the upper arm. (often used for infants.) radial pulse the pulse felt at the wrist. blood pressure is at least 80 systolic. The pulse rate obtained on the top of the foot. blood pressure is pedal pulse at least 90-100 systolic how to take pulse count for 15 sec and multiply beats by 4 A: alert V: verbal P: pain (sternal rub) U: unresponsive Know how to assess an AVPU score are you okay? shake gently gentle sternum rub no response: unconscious head tilt chin lift jaw thrust maneuver clear possible obstructions airway adjuncts OPA Know how to open an airway and when you use each method NPA King tube Intubation if you can talk then you have an airway must check airway for a patient that is not alert -place patient on back -place on hand on forehead and apply firm pressure backward -place tips of your fingers under the bony part of the lower jaw -lift chin forward and tilt back the head DO NOT USE on suspected c-spine injury head tilt-chin lift maneuver -use if you suspect a neck injury -place patient on back -place fingers behind the lower jaw and move the jaw forward jaw-thrust maneuver -tilt head back to a neutral or slight sniffing position -use your thumbs to pull down the lower jaw opening the mouth enough to allow breathing 2 / 11  EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 potential blocks include: secretions such as vomit, mucus or blood. foreign objects: candy, food, or dirt checking and removing possible obstructions if you find anything in the patient's mouth remove it by finger sweep or suction (do not suction more than 15 seconds) yankauer if mouth is clear use an airway device oral airway nasal airway Airway Adjuncts king tube intubation (OPA) used in patients with no gag reflex always try to place an airway on patients you're breathing for. displaces the tongue and opens airway Know how to measure an OPA and when to use it measure from the edge of the mouth to the angle of the jaw to determine correct size insert with the tip pointing to the top of the head then rotate 180 degrees until in position (NPA) or nasal trumpet can use on patient with a gay reflex patients who are snoring or have ETOH are common Know how to measure an NPA and when to use it measure from nare to tip of earlobe use surgical lube to help with insertion RIGHT NARE is largest use twisting motion as you insert children: sizes by weight Adults: sizes by height king tube the percent of oxygen being inhaled: can be expressed as percent or decimal. controlled % given to a patient that has experienced some kind of trauma. assessing O2 levels using (BVM, non-re- Know what FiO2 means and how it applies to oxygen devices breathing, venturi mask, nebulizer, nasal cannula.) fraction of inspired oxygen the 60 minute time period after a severe injury and initiation of Know what the Golden Hour means and how it applies to trauma surgery for the injured trauma patient. Starts when injury happens, patients. ends in surgery. The Golden Hour begins at the moment a patient is injured. When When the patient gets to surgery does it end? primary- air blast that happens... hollow organs are in most danger secondary - penetrating or blunt trauma Know the phases of a blast injury and what injuries occur tertiary -same injuries as someone being ejected quaternary -thermal burns, heat, fire quinary - chemical, biological, radiological XABC- X- eXsanguinating hemorrhage A- airway B-Breathing C-Circulation 3 / 11  EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 Obtain baseline vital signs If altered mental status: Know how to assess a trauma patient according to ITLS Trauma Brief neurological exam¡Pupils, GCS, and signs of cerebral her- Assessment niation Look for medical alert tags Consider other causes recovery supine Know the names of patient positioning prone fowlers trendelenburg used in breathing patient protects the airway and prevents aspirations does NOT protect c-spine recovery position lying on the back supine lying face down prone used in neonates and ICU 30 degrees used for head bleeds/CVA ultimate airway position used with CHF COPD< and other respiratory emergencies Fowlers position on back feet elevated higher than head shock and hypotension 10-15 degree leg lift. Trendelenburg use the scale given on exam to determine the patient's score. 15 is highest, 3 is low. 3 either means dead or completely unresponsive. Know how to assess for a GCS anything below 8 is in a coma. eyes, verbal, motor 4 / 11  EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 Stridor: strained, high pitched sound heard on inspirations. caused by upper airway obstruction in pharynx or larynx in: above vocal cords out: below vocal cords corse rales: fluid in lungs, crackly (like someone sucking up pop) Know the lung sounds taught in lecture and what they mean. fine rales: same as corse, but more low pitched and crackly wheezes: continuous high pitched whistling sound. bronchioles restricts. asthma, COPD, anaphylaxis. rhonchi: in the bronchi, rattling noise, mucous in lungs, and upper airway 1. cardiac arrest 2. airway obstruction Know the reasons to stop a primary survey in trauma 3. life-threatening bleed (arterial) hemorrhage 4. scene is no longer safe - Scene size-up( number of patients, need for other resources, MOI, PPE?) - Initial assessment (general impression, hemorrhage?, LOC, chief complaint, CABC's) - Rapid trauma survey vs. focused exam MOI: unknown or generalized: rapid trauma Know the components of the primary and secondary survey in MOI: localized: focused trauma patients secondary: a head-to-toe physical assessment; an additional as- sessment of a patient to determine the existence of any injuries other than those found in the primary survey any obvious injuries to head/neck, chest..... breathing sounds? deformaties contusions abrasions penetrations burns Know what DCAP-BLS-TIC means lacerations swelling tenderness instability crepitus the grating sound created by the rubbing of bone fragments what is crepitus 5 / 11  EMS1055 Midterm Study Guide Study online at https://quizlet.com/_9yp8c2 onset : when did the pain start palliation: what makes the pain better? Provolation: what makes the pain worse? Know what OPPQRST means and when to use it quality: describe your pain radiation: does it radiate or go anywhere else in your body also referred as the sacred 7 Severeity: on a scale of 1-10... 10 being the worst pain you have ever felt and 1 being very little pain... how would you rate your pain? time: how long has the pain been going on for? compensated Know 3 phases of shock decompensated irreversible SBP >100 15-25% blood volume pallar tachycardia narrowed pulse pressure compensated shock thirst delayed capillary refill low blood volume, but still able to maintain blood pressure and organ perfusion by increasing the HR and constricting the blood vessels SBP