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EMT Diseases
A review of EMT diseases and injuries
| Question | Answer |
|---|---|
| What is cardiac tamponade? | In cardiac tamponade the fluid in the pericardium (the sac around the heart) builds up, resulting in compression of the heart. |
| What are some of the causes of cardiac tamponade? | Cardiac tamponade can be caused by chest trauma, myocardial infarction, and pericarditis along with some other conditions. |
| What are the common symptoms of cardiac tamponade? | Low blood pressure, jugular vein distension, and quiet heart sounds (Beck Triad) Along with all other symptoms of obstructive shock. |
| What is cardiogenic shock? | Cardiogenic shock is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart. |
| What are the symptoms of cardiogenic shock? | Anxiety and altered mental state (often the first symptom), low blood pressure, rapid weak and ready pulse, Cool and clammy skin, Jugular vein distension (JVD), rapid breathing (hyperventilation), hypoxia |
| What are the common causes of cardiogenic shock? | Myocardial infarction, arrhythmias (especially tachycardias), mechanical failure of heart (heart valve failure) |
| What is Hemorrhagic shock? | Hemorrhagic shock is a form of hypovolemic(low blood volume) shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level. |
| What causes hemorrhagic shock? | Severe blood loss due to heavy bleeding, internal bleeding or severe burns, severe dehydration |
| What is distributive shock? | Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs |
| What causes distributive shock? | Anaphylaxis, sepsis (infection), drug toxicity (overdose), damage to central nervous system |
| What is obstructive shock? | Obstructive shock is a form of shock caused by physical obstruction of the great vessels or the heart itself. |
| What are the common causes of obstructive shock? | Tension pneumothorax, cardiac tamponade, pulmonary embolism |
| What are the symptoms of obstructive shock? | Symptoms of obstructive shock are generally the same as cardiogenic shock: Anxiety and altered mental state, low blood pressure, rapid weak and ready pulse, Cool and clammy skin, Jugular vein distension (JVD), rapid breathing (hyperventilation), hypoxia |
| What are the great vessels? | The great vessels are the major arteries and veins of the heart. They are the aorta, the pulmonary artery, the pulmonary vein and the vena cava. |
| What is tension pneumothorax? | Tension pneumothorax is a life threatening condition in which damaged tissue of the lung creates a one way valve causing air to gather and pressure to continually build in the pleural space between the lung and chest wall. |
| Why is there sometimes an increase in diastolic blood pressure in the early stages of shock? | The diastolic BP is maintained by vascular tone. An increase in vascular tone (constricting the vessels) results in an increase in diastolic blood pressure. This is seen in compensated shock and contributes to a narrowing of the pulse pressure. |
| Name the four mechanisms by which the body loses heat and briefly explain each. | Convection is carrying heat away by currents of air or water. Conduction is transfer of heat from two materials through direct contact. Evaporation is when liquid changes to a gas like during perspiration. Respiration is body heat lost by exhalation. |
| Shock from anaphylaxis is best described by which mechanism (i.e. what kind of shock) and why? | Distributive shock. Anaphylaxis causes distributive shock by loss of vascular tone. |
| Describe what happens to pulse and respiration rate when people go into shock. | In shock the pulse and respirations both increase. This is an attempt to increase cardiac output and maximize the amount of circulating oxygen. This is known as a compensating mechanism. |
| Describe the parameters and associated scores for "Eye Opening" on the Glasgow Coma Scale. | No response - 1, In response to pain - 2, In response to speech - 3, Spontaneous - 4 |
| Describe the parameters and associated scores for "Best Verbal Response" on the Glasgow Coma Scale. | None - 1, Incomprehensible sounds - 2, Inappropriate words - 3, Confused conversation - 4, Oriented conversation - 5 |
| Describe the parameters and associated scores for "Best Motor Response" on the Glasgow Coma Scale. | None - 1, Abnormal extension - 2, Abnormal flexion - 3, Withdraws to pain - 4, Localizes pain - 5, Obeys commands - 6 |
| Name the two parameters that indicate anaphylaxis over an allergic reaction. | Difficulty breathing and hypoperfusion (shock). Chest tightness indicates difficult breathing. |
| What should the EMS provider never do in case of profuse bleeding from the vagina? | The EMS provider should never pack any dressings into the vaginal opening. |
| At what depth should compressions be delivered on an adult when performing CPR? | When performing CPR the compressions should be delivered straight down for 2-4 inches. The hands should be placed on the sternum between the nipples and the same amount of time should be spent on compressions as the time the compression is released. |
| Your AED has delivered a shock. What should you do next and why? | After the AED delivers a shock you will immediately begin compressions. Even if a pulse returns, it generally isn't strong enough to perfuse blood initially and compressions will do no harm. |
| Describe the most common signs of opiate overdose specifically in regards to eyes, breathing, pulse and blood pressure. | Pinpoint pupils that do not react to changes in light; Breathing slow, erratic or apneic; Pulse slow, erratic (arrhythmia), or none; Blood pressure low (hypotensive) |
| A patient having a severe anaphylactic reaction has an EpiPen available. What is the proper location for the injection? | The correct site for giving an auto-injector (EpiPen) is the lateral portion of the thigh midway between the waist and knee. Once the location is indentified push the injector firmly against the thigh and hold in place for 10 seconds. |
| Which part of the spine bears most of the body weight and often sustains the most damage in a feet first fall? | Lumbar spine |
| How should a pregnant female be transported? | Pregnant females needing immobilization or regular transport on the cot, always tilt the patient to her left side. This removes the weight of the gravid uterus off the inferior vena cava. Failure to do so may result in a "supine hypotensive syndrome." |
| In cases of cardiac arrest, CPR should always be initiated except for these 3 exceptions: | 1. Scene is unsafe 2. Obvious signs of death 3. Do Not Resuscitate (DNR) order or no-CPR order. Must be signed by patient, physician and witnesses. |
| Who is responsible for giving the "clear" signal prior to administering a shock with an AED? | The EMT operating the defibrillator. Only the person who is activating the shock should be advising those present to be clear of the patient. |
| When evaluating AVPU, name 3 acceptable ways to elicit a pain response. | 1. Squeeze the trapezius muscle (between neck and shoulder) 2. Pinch the earlobe 3. Rub the skull above the eye with a knuckle |
| Name 3 indications for the use of an EpiPen. | 1. Anaphylaxis that causes airway obstruction such as swelling of trachea or larynx (stridor). 2. Anaphylaxis that is causing distressed breathing (wheezing). 3. Anaphylaxis that is causing circulatory shock (Hypotension). |
| In what situation would an EpiPen be contraindicated? | None in a life threatening emergency. However, consult medical control with geriatric patients and patients with a history of heart disease. |
| Why does a pressure bandage need to be reassessed and what should you be looking for? | A pressure bandage should not cut off distal circulation because it is not a tourniquet. You should frequently reassess a pressure bandage to be sure it has not accidentally become a tourniquet. You can do this by palpating for a distal pulse. |
| If you are treating a patient alone that needs artificial ventilation, what device is the best way to do this with? | A flow-restricted, oxygen-powered ventilation device (FROPVD). The use of an FROPVD device by one rescuer is easy to do, limits the providers exposure, and allows for the administration of oxygen. One person BVM is more difficult. |
| Name the 3 parts of the Cincinnati Prehospital Stroke Scale used to assess for a stroke. | Checking for facial droop to observe if one side of the face does not move, determining if one arm drifts compared to the other, and listening to see if the patient's speech is slurred or if inappropriate words are used. |
| Which nerve controls the diaphragm? | Phrenic nerve |
| What property of epinephrine results in smooth muscle relaxation in the bronchioles and ease the wheezing? Describe the other actions of epinephrine. | Beta 2 causes bronchiole smooth muscle relaxation. Beta 1 Beta 1 results in stimulation of the heart to increase its activity, and Alpha 1 and Alpha 2 work in concert with each other to help regulate vascular smooth muscle tone (causing constriction). |
| What is Commotio cordis and how does it present? | Commotio cordis occurs when a powerful blunt force interrupts the normal depolarization of the heart. It usually presents as sudden cardiac arrest. |
| What is polypharmacy and how can it affect a patient? | Polypharmacy is the concurrent use of multiple medications prescribed by multiple doctors. It happens most often in the elderly and can lead to accidental overdose and increased drug interactions. |
| What is a hemothorax and how does it present? | Hemothorax is the accumulation of blood in the pleural cavity which causes pressure against the lungs. It presents with chest pain, difficulty breathing and diminished lung sounds on affected side. |
| What is the average blood volume of an infant, a child and an adult? | An infant between 500ml and 1 liter. A child about 2 liters. An adult between 4 - 5 liters. |
| What are the 3 elements of the Pediatric Assessment Triangle and what is it used for? | Determining 1. appearance, 2. work of breathing, and 3. circulation to the skin. It is used to form a general impression the first time the medical professional views the patient, usually within seconds. |
| What is SIDS and what age patient is affected? | Sudden Infant Death Syndrome. Newborn to 1 year old. |
| What is ataxia? | Ataxia is a loss of coordination. This is usually caused by injury to, or diseases of, the central nervous system. |
| What is epistaxis and what is the first line treatment? | Nose bleed. Pinch the nose. |
| What is Ecchymosis? | Ecchymosis is a discoloration of the skin resulting from bleeding underneath, typically caused by bruising |
| What is Cushing's Reflex and why is it important? | 1. Hypertension (plus widening pulse pressure) 2. Bradycardia 3. Respiration changes. Signs of increasing cranial pressure after head injury or stroke. |
| What is delirium tremens? Name the most common signs and symptoms. | Delirium tremens is severe alcohol withdrawal. It is characterized by severe shaking, altered mental status (confusion), fever, and high blood pressure. |
| START Triage | |
| Describe primary and secondary prevention. | Primary prevention strategies are designed to prevent illness or injuries (e.g. helmet safety classes). Secondary prevention strategies are designed to monitor and prevent progression of diseases already present |
| What is fundal massage and when is it used? | Fundal massage is used to stimulate the uterus to contract and may be necessary to stop postpartum hemorrhage. |
| What is melena and what causes it? | Dark-tarry stools, known as "melena" is a common finding in a patient with a GI bleed. |
| What is Hemoptysis and what causes it? | Hemoptysis is coughing up blood. It occurs when there is bleeding in the lungs or airway. |
| What is hematemesis and what causes it? | Hematemesis is vomiting blood. It is caused by bleeding in the upper GI tract. Bright red blood indicates bleeding in esophagus. Dark Coffee grounds indicates bleeding in stomach. |
| What is cholecystitis and how does it present? | Inflammation of the gallbladder. Severe pain in the right upper quadrant radiating to right shoulder and back. Tenderness, ever, nausea. |
| Name the most common physical signs of excited delirium. | Hypertension, tachycardia, diaphoresis, dilated pupils. |
| Based on guidelines put forward by the CDC, a blood pressure of less than how much requires rapid transport to a trauma center? | 90 mm Hg |
| Explain the difference between a sprain and a strain. | A sprain is a stretch or a tear of a ligament. A strain is a stretch or a tear of a muscle or tendon. |
| In what position should a patient with suspected increasing ICP be transported? | Usually this patient will be on a backboard for suspicion of spinal injury in addition to head injury. The head should be elevated 30 degrees. This can be achieved by placing towels under the backboard. |
Created by:
Nikno