FISDAP!

paramedic studies

176 cards·by nasonrumfield

2017

Study this deck

If an intubation attempt is unsuccessful, what should you do?

Immediately deflate the cuff, remove the tube, and ventilate with 100% oxygen for 15-30 seconds before reattempting.

The distal tip of an ET tube should be inflated with how many mL's?

The cuff should be inflated to 10mL's to prevent any air leaks around the tracheal cuff seal.

When placing an ET tube during CPR, how long should CPR be withheld while placing an ET tube?

Chest compressions should not be interrupted for anything longer than 10 seconds.

What are some signs and symptoms for Chronic Bronchitis?

-Typically overweight -Productive cough with sputum. -Coarse rhonchi -Chronic cyanosis-Mild, chronic dyspnea -Resistance on inhale/exhale

What is a common complaint with somebody who has asthma??

Chest tightness

Hemoptysis

Coughing up blood

Treatment for hyperventilation

Calming and reassurance

Most common type of viral pneumonia

Influenza A

Status asthmaticus

A severe, prolonged asthma attack that has not been stopped with repeated doses of bronchodilators.

Signs and Symptoms of ARDS

Tachypnea, labored breathing, and impaired gas exchange.

What are some signs and symptoms for emphysema?

-Thin, barrel chest appearance. -Nonproductive cough. -Wheezing and rhonchi -Pink complexion -Extreme dyspnea on exertion -Pursed lip breath

How many lobes are in the lungs?

5 (three in the right, two in the left)

What is the name of the passageway shared by the digestive and respiratory systems for air and food?

Pharynx

What leaf-shaped structure closes during swallowing to prevent foods and foreign objects from entering the trachea?

Epiglottis

What part of the respiratory system contains the vocal cords?

Larynx

What is the most common location for an airway obstruction?

Pharynx

What is the name of the hollow, semi-flexible tube that carries inhaled air from the larynx to the lungs?

Trachea

What happens to your diaphragm during inhalation?

Contracts

Where is Sellick's Maneuver applied?

Cricoid cartilage

What is the name of the muscular structure that divides the chest cavity front eh abdominal cavity?

Diaphragm

What is directly posterior to the nose?

Nasopharynx

What are the small sacs in the lungs that are responsible for gas exchange?

Alveoli

What area is directly posterior to the mouth?

Oropharynx

What is the name of the cartilaginous ridge in the trachea at which the right and left lungs split?

Carina

What is the normal respiratory rate for an adult?

12-20

What ring-shaped structure forms the lower portion of the larynx?

Cricoid cartilage

33 year old male is lying supine on the floor after falling off a ladder. He has an obvious head injury and bleeding. What should you do?

Assess his level of consciousness

35 yo female's spouse meets u at "unk emergency." Tells u that wife is depressed, and she locked herself in a room where gun is...

Move to a safe place and request law enforcement

What should you do to determine if your patient is breathing?

Put your ear to his mouth

In which position should you hold the patient while applying manual stabilization?

Neutral position

78 year old male is unresponsive and lying supine on his bed. What should you do?

Assess him for respiratory efforts

During your primary assessment you palpate the chest and note crepitus to the left lateral ribs. What should you do?

Listen to lung sounds

A 38 year old female was in a car crash and is unresponsive. Her head is slumped forward against the steering wheel and she has snoring resp

Open her airway

An 18 year old male has a deep laceration to his wrist that is squirting bright red blood. What should you do?

Place a gloved hand over the wound

What should you do after completing the scene size-up and primary survey for a trauma patient?

reconsider the mechanism of injury

A 39 year old female is lying supine in her yard next to a 25 foot ladder. She has an obvious leg fracture. What should you do?

Manually stabilize the c-Spine

Car flipped over on its roof - 2 people are trapped inside. They are suspended upside down, seat belts on. Fluids are leaking from car...

Ensure scene safety

20 year old male has a strong odor of alcohol on his breath. He is cutting his arm with a knife and the bleeding is severe. You should?

Call law enforcement

You are the first to arrive at the scene of a multiple vehicle collision. What should you do?

Perform a scene size-up

You have approached your patient and formed a general impression. What should you do?

Assess the level of consciousness

14 y/o male is lying supine at a high school football game. He is unresponsive, cyanotic, and has snoring respirations. What should u do?

Open the airway with a manual maneuver

What is the intention of the primary survey?

Find and treat life threats

Which mental status is the most life-threatening?

Unresponsive

How should a properly sized cervical collar fit?

the collar rests on the clavicles

Unresponsive 43 year old male was hit by a car and is lying supine in the street. You can hear loud, snoring respirations. What should u do?

Airway obstructions

64 year old male is not breathing. What should you do after initiating ventilations with a bag valve mask?

Look for the rise and fall of his chest

42 y/o male with SOB after sprayed w/ super-hot steam. Burns to face/neck/upper chest. Vitals: BP 112/66, P 124, R 28(shallow/labored)...

Assist his ventilations

67 y/o male w/ mild respiratory distress. Smokes 4 packs a day, has cough/resp. infections/bilateral rhonchi. What should you suspect?

Chronic bronchitis

What is the amount of air that normally reaches the alveoli in an adult?

350 mL

What is the normal range of breaths per minute for an adult?

12-20

What are the small air sacs at the end of the airway that are responsible for gas exchange?

Alveoli

56 year old female has a complete airway obstruction from a piece of food. She becomes unconscious while your assess her. What should u do?

Begin chest compressions

How should you insert a nasopharyngeal airway?

Face the bevel towards the septum

18 y/o m, cyanotic/complains of sharp chest pain/diff. breathing after lifting weights. Vitals: BP 110/66, P88, R22. Most likely cause?

Spontaneous pneumothorax

What is the term for high-pitched whistling sounds heard during expiration?

Wheezing

What are the structures that branch off the trachea into the lower airway?

Bronchi

75 y/o f with sudden onset of right-sided chest pain and dyspnea. She is recovering from a recent hip surgery. What should u suspect?

Pulmonary embolism

53 year old male is sleepy, diaphoretic, difficult to arouse, and breathing 8 times a minute. What should you suspect?

Respiratory failure

77 y/o f, has dyspnea, speaks in short word bursts, breathes w/ pursed lips. Lung sounds:diminished/distant/clear. What do u suspect?

Emphysema

82 year old female complains of difficulty breathing. Before you assist her with her prescribed inhaler, who will you need permission form?

Online medical control

The use of accessory muscles and nasal flaring are signs of what kind of breathing

Labored

What is the term for abnormal breath sounds that result from an obstructed airway?

Stridor

An alert 32 year old female complains of difficulty breathing. She can only speak in 2 to 3 word sentences. What should you do?

Administer high-flow oxygen

Febrile 44 y/o m, shortness of breath/dull chest pain. Has been coughing up "rusty" septum for the last 3 days. Most likely cause?

Pneumonia

Unresponsive 43 year old male is cool, pale, diaphoretic, and breathing 6 times a minute. Which device should you use to administer oxygen?

Bag-valve mask

45 year old female complains of weakness, shortness of breath, back pain, and pressure in her chest. What should you suspect?

Myocardial infarction

56 y/o m, epigastric pain started 1 hour ago. He is diaphoretic and the pain is radiating into his left arm. What should you suspect?

Myocardial infarction

What patient that's refusing care would have the highest risk of a negative outcome?

A 75 year old male taking Coumadin who fell on the sidewalk

What is the term for a pulse rate above 100?

Tachycardia

61 y/o m, chest pain, took 1 dose of nitro prior to your arrival. He has experienced no relief. Vitals: BP 88/44, R22. What should u do?

assist with the administration of aspirin

Unresponsive 72 year old female is pale with peripheral cyanosis. She has a pulse of 20 hearts per minute. What should you do?

transport rapidly

What respiratory condition can be directly caused by congestive heart failure?

pulmonary edema

55 y/o f, skin cool/clammy/ashen. Level of consciousness begins to decrease, and you can no longer palpate radial pulse. What should u do?

assess the carotid pulse

Where does the heart receives its nutrition from the blood passing through?

Coronary artery

A 57 year old male with chest pain news assistance taking his medication. What should you do?

Assess his vital signs

42 year old map dis unresponsive. He was found behind a restaurant and bystanders are unsure how long he has been there. What should you do?

check for carotid pulse

Diaphoretic 65 year old male is experiencing a sudden onset of left jaw pain. Vital signs are BP 118/80, P 70, R 18. What should u suspect?

Acute coronary syndrome

Which of the following signs is most indicative of hypo perfusion?

altered mental status

When assessing an extremely hypothermic patient, what should you do?

expect the pulse check will take more time than normal

48 y/o m, suddenly becomes confused after taking nitro. He is sitting upright but is unable to follow your directions. What should u do?

place him in a supine position

An AED delivers a "no shock indicated" message for a patient with no palpable carotid pulse. What should you suspect?

Pulseless electrical activity

66 y/o f, severe SOB, started during the night. Denies chest pain. Vitals: BP 180/92, P 110/irregular, R 24, crackles. Most likely cause?

Congestive heart failure

Which of the following would suggest a syncopal episode?

brief period of unconsciousness

42 year old female has a pulse and is breathing adequately after a single shock from the AED. in which position should you place her?

recovery position

92 year old male complains of a headache, difficulty breathing, slurred speech, and loss of grip in his left hand. What should you suspect?

Stroke

What artery supplies the heart muscle with blood?

Coronary

What is the chamber of the heart that pumps blood into the lungs?

Right ventricle

What chamber of the heart receives blood from the venue cavae?

right atrium

What is considered a central pulse?

femoral

What element of the blood is affected by sickle cell anemia?

erythrocytes

What chamber of the heart pumps blood into the aorta?

left ventricle

What is hypo perfusion?

inadequacy of cellular gas exchange

Which artery is located in the neck?

Carotid

When checking a patient's pulse during CPR, which artery should you palpate?

Carotid

What pressure is created when the heart contracts and forces blood into the arteries?

Systolic

What is the name for the chambers of the heart that contract simultaneously to pump blood out of the heart?

Ventricles

What is the term for adequate circulation of blood through the body's tissue?

Perfusion

What chamber of the heart is the most muscular?

left ventricle

What component of the blood helps the body resist infection by killing germs and producing antibodies?

white blood cells

What are the 2 upper chambers of the heart?

atria

44 year old male has a partial airway obstruction. He is leaning forward and drooling. What should you do?

perform an abdominal thrust

Where is the radial pulse located?

wrist

61 year old female is in respiratory arrest with a bradycardic heart rate. What should you do?

Assist her ventilations

4 year old male is choking on a piece of food. He has stridor and is drooling. What should you do?

Perform abdominal thrusts

48 y/o m, in cardiac arrest. ALS crew has intubated him with an endotracheal tube. What is the ratio of ventilations to compressions?

continuous compressions with 8 breaths per minute

78 year old male is unresponsive and lying supine on the his bed. What should you do?

assess him for respiratory efforts

Where should you place your palms when you perform chest compressions?

middle section of the sternum

A 6 month old female is unresponsive and she has a pulse of 40. What should you do?

Start chest compressions

What vessel returns oxygen-deleped blood to the heart?

vena cava

56 year old male is having a stoke. what is the most important question to ask his family members before making a transportation decision?

What time did the patient last appear normal?

What condition has stroke-like symptoms and resolves within 24 hours?

Transient ischeimic attack

What is the correct compression-to- breath ratio for a pulseless patient with an unsecured airway?

30:2

While transporting a 90 year old female on hospice care to her doctor's office she becomes apneic and pulseless. What should you do?

begin CPR

Where is the carotid pulse located?

Neck

44 year old female is unresponsive and has atonal respirations. What should you do?

assess the radial and carotid pulse

54 y/o f, in cardiac arrest. After 2 shocks w/ AED, she's breathing adequately/has strong carotid pulse/SpO2 66%. What should u do?

apply high flow oxygen by non rebreather mask

12 y/o f, pulseless/apneic, immediately after being removed from a frozen lake. She was submerged under water for 15 mins. What should u do?

start chest compressions

62 year old female complains of chest pain. While assessing her she suddenly goes pulseless and apneic. What should you do?

start chest compressions

How long will it take for irreversible brain damage to occur if the brain is not receiving adequate blood flow?

4-6 minutes

What should you do after attaching the AED and administering the 1st shock to a patient in cardiac arrest?

begin chest compressions

During cleanup after a fire, FF has headache/dizziness/diff. breathing, he says he didn't have airpack on for past 30 mins. U suspect what?

carbon monoxide poisoning

14 y/o m, swearing, not following directions. Friend tells u, "he had a few beers." Vitals: BP 118/66, P 100, R24, SpO2 94%. What do u do?

Transport him on his side

49 y/o m, severe RUQ abdominal pain/nausea. Jaundiced/febrile. Vitals: BP 89/60, P92, R16. What should you suspect?

Hepatitis

43 y/o f, bitten by rattlesnake on her lower leg. Swelling/redness at the bite site. She's cool/pale/clammy. What should you do?

splint her leg

83 y/o f, diaphoretic, has altered mental status. Her caregiver states,"she's more out of it than normal." What should u suspect?

hypoglycemia

A 19 year old male was stuns by a bee and the stinger is still embedded in his skin. He is allergic to bees. What should you do?

remover the stinger by scraping the skin with a card

20 y/o m, agitation/nausea. Says "I feel like my heart's going to jump out of my chest." Vitals: BP 142/90, P140, R24. Which drug suspected?

amphetamines

Febrile 24 y/o m, sharp abdominal pain. He states that pain worsened when u lift ur hands from his abdomen after palpation. How transport?

in the fetal position

41 year old male brings to shake violently while you administer oral glucose to him. What should you do?

abandon glucose administration

Unresp. 19 y/o f, overdosed on unk. med. Has pinpoint pupils/cool skin. Vitals: BP 84/50, P 72, R 8, SpO2 82%. What class of med u suspect?

narcotic

40 y/o m, hist. of bipolar/hearing voices/throwing clothing off. Law enforcement on scene. Has bloody lacerations to forearm. What do u do?

detain the patient and treat his injuries

confused 56 y/o f, complaint of a headache and presents with pale diaphoretic skin. She has haddiarrhea for 2 days. most likely cause?

Dehydration

Confused 62 y/o diabetic says he's not been feeling well for several days. Vital signs are BP 140/90 P120, R34/deep. what should u suspect?

hyperglycemia

Dispatch sends you to a possible seizure. As you arrive, you are advised the seizure has stopped. which phase is the patient most likely in?

postictal

5 y/o f, is sitting in a chair with left-sided facial droop and slurred speech. She has an acetone odor on her breath. wut should u suspect?

hyperglycemia

32 y/o m, supine/responding to voice commands with unintelligible gurgling noises. He's an epileptic, just had seizure. What should you do?

roll him onto his side and suction his airway

unresponsive 22 year old male was found outside on a hot and humid day. His skin is hot and moist what should you do?

move him to air conditioned ambulance

10 y/o m, allergic to peanuts. Shared food w/ classmates, throat felt itchy. teacher says his face looks swollen. what should u do?

Help him self-administer his epinephrine auto injector

18 year old female complains of pain in he lower right quadrant with rebound tenderness. What should you suspect?

appendicitis

50 y/o m, complains of a sudden onset of abdominal pain and appears pale and weak. Vitals are BP 84/50, P110, R22. What should u suspect?

gastrointestinal bleed

A newborn is pink all over and has a pulse of 130. As you dry her off, she begins to cry vigorously and kick her legs. What is her APGAR?

newborn has weak cry, is curling his arms & legs. His extremities are blue, his body is pink. P90 and week respirations. What is his APGAR?

newborn has a pink torso, but his hands and feet are blue. He has a weak cry when stimulated and can straighten his legs. P110/R40. APGAR?

baby girl was born 2 minutes ago. Her arms and torso are pink. She is wiggling around and has a strong cry. Vitals: P 120, R 28. APGAR?

what is a typical one minute APGAR score for a newborn?

8-10

Beginning at which Apgar school should you start aggressive resuscitation efforts?

Newborn: blue torso, pale extremities. She grimaces in response to stimuli, has limited muscle movement. Vitals: P 88, R30. APGAR?

A newborn has a strong cry and is actively moving his blue extremities when stimulated. Vital signs are P 140, R 48. what is his APGAR?

A newborn is pale and limp with a sunken abdomen. She has bradycardic pulse and shows little respiratory effort. What is her APGAR score?

A newborn is actively crying in response to your bulb syringe. His body is pink dn her is moving his BLUE extremities. P110. APGAR?

newborn has pink torso/blue extremities, is limp/does not respond to stimulation. HR of 60 and is taking slow, gasping breaths. APGAR?

the Medical Practice Act is...

the minimum qualifications of those who may perform various health services

strategic deployment

The staging of ambulances to strategic locations within a service area to allow for coverage of emergency calls

What long-acting medication should you administer for status asthmaticus that is refractory to initial medications?

Methylprednisolone

What chemical do muscle cells release after being damaged?

potassium

22 y/o m, suffered blunt trauma to the sternum. Has severe chest pain. ECG reveals a sinus rhythm w/ frequent multifocal PVCs & ST elevation

This is most likely caused by a "Myocardial contusion"

JumpSTART triage

A sorting system for pediatric patients younger than 8 years or weighing less than 100 pounds. Also an adaptation for infants.

Suspect spleen lacerations if...

9th through 10th ribs are fractured - LUQ tenderness - Hypotension - Tachycardia - Left shoulder pain appears 1 to 2 hours after injury

How do you treat a patient with compartment syndrome?

Elevate extremity, cold packs, o2, IV fluids - compartment syndrome? Goal is to get them to the hospitalbefore extremity becomes pulseless.

What happens to the body with hyperventilation?

Hyperventilation decreases carbon dioxide content of the blood (hypocarbia). Decrease in ETCO2 and increase in PH.

Croup (Definition)

Viral infection of the upper airway and the most common cause of upper airway emergencies in young children.

Racemic Epi Dose

2.25%) is 0.5 mL mixed in 3 mL of normal saline.

When to administer nebulized epi?

For Pts w/ stridor at rest, moderate to severe resp. distress, poor air exchange, hypoxia, altered appearance.

Drugs for Ethylene Glycol poisoning....

Glucose, Thiamine, Poss. Sodium bicarb, Poss. Calcium gluconate

Ethylene Glycol which poisoning stage? Renal damage with flank pain and no urine production

Stage 3. Up to 72 hours

Ethylene Glycol; which stage of poisoning? Tachypnea tachycardia mild hypertension rales CHF Cardio collapse

Stage 2 12 hours - 24 hours

Ethlylene glycol What stage of poisoning? CNS depression looks drunk no smell nausea vomiting seizures coma

Stage 1. Up to 12 hours after ingestion

Toxicity can keep going for ... days

3 or so.

Ethylene Glycol found in..

antifreeze coolant polishes paints

A dose of methanol as small as ... can be toxic and possibly lethal

30ml

Peak blood levels of methanol hit ...

at 30 - 90 minutes

What does bleeding at the site of a snake bite mean?

Envenomation has occured

If you see a cracked windshield in a MVC... what will the pt represent with?

Bruised or lacerated head or face. Brain injury, *cervical spine injury (always until proven otherwise), tracheal injury.

If you see a deformed steering column in a MVC... what will the pt represent with?

Bruised neck, bruised chest. Sternal or rib fracture, flail chest, myocardial contusion,*pericardial tamponade, pneumo/hemothorax

If you see a deformed dashboard in a MVC... what will the pt represent with?

Bruised abdomen, bruised knee, misplaced kneecap. Ruptured spleen, liver, bowel, diaphragm. Fractured patella, dislocated knee

If you see the rear end of the vehicle is damaged in a MVC... what will the pt represent with?

Secondary anterior injuries, esp if the pt wasn't restrained. "Wiplash" injuries, *coup contrecoup injury.