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1st semester Paramedic
Various topics from 1st semester of paramedic class.
58
Medical
Professional
12/04/2012

Additional Medical Flashcards

 


 

Cards

Term

What organizations first developed EMS training programs?

 

Definition
1966 Congress passed the Highway Safety Act of 1966 which created the NHSTA which required states to develop effective EMS training programs or they would lose up to 10% of their federal funding.
Term
When are "off line"  (indirect) medical directives used?
Definition

"Off line" Medical Direction consists of standing medical orders and protocols.  These orders are used in "routine" medical care for anticipated medical emergencies/situations. 

 

 

"On-line" is when you need to contact medical control for a situation that is outside of standard protocols and SMO's.

Term
Describe proper lifting techniques.
Definition
  • Only move a pt. you can handle safely; get additional help if needed
  • Move forward instead of backward if possible
  • Take short steps
  • bend at the hips and knees NEVER THE WAIST
  • Lift with your legs
  • Keep the load close (18" or less) to your body
  • Communitcate
Term
List the phases of Stress Response in order.
Definition
  • Alarm reaction
  • fight or flight
  • autonomic nervous system
  • coordinated by hypothalamus
  • BP up, HR up, Pupils dialate, Bronchus dialate
  • Resistance
  • You get used to it and nolonger have alarm react.
  • Exhaustion
  • Coping fails, person may become ill or psycological breakdown
Term

Describe "Diffusing" and "Debriefing."

 

Definition

 

Diffusing is done immediately (same shift, before sleeping) and is designed to let people involved in the incident "blow off steam" and to assure them that their feelings are normal.


Debriefing is done normally within 72 hours and is a chance for people both involved and uninvolved to discuss their feelings and how the event affected them and to provide contact info for agencies that can provide counseling if necessary.

 

Term

List the 5 stages of grief in order.

 

 

Definition
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
Term

What is and is not a "teachable moment?"

 

Definition

A teachable moment is "The time after an injury has occurred when the patient and observers remain acutely aware of what has happened and may be more receptive to being taught ways that the event or illness could have been prevented."

 

Not days or weeks later, not DURING an emergency.

Term
What are the 5 types of Law and define each?
Definition

1) Administrative Law

             Regs developed by a government agency, to provide details about the function and process of a law.

 

2) Civil Law

          Deals with "private" complaints brought by one person (plaintiff) against another person (defendant) aka tort law.

 

3) Legislative Law

       Laws made by legislative branches of government. (Congress)

 

4) Common law

         Societal acceptance of customs or norms over time, aka case law, aka judge made law

 

5) Criminal law

         When a federal, state or loval government prosecutes people for violating a law

Term
Definition of Scope of Practice?
Definition

The range of duties and skills that paramedics are ALLOWED and EXPECTED to perform when necessary.

 

Term
What are EMS personnel mandatory reporters of?
Definition
  1. Child Abuse
  2. Elder Abuse
Term
What are the 4 elements of Negligence?
Definition
  1. Duty to Act - required to help
  2. Breach of Duty- did not maintain "standard of care"
  3. Damage or harm to Pt occured
  4. Proximate cause - my actions caused the damage/harm
Term
Types of "Breach of Duty?"
Definition
  1. Malfeasance - performing wrongful or unlawful act
  2. Misfeasance - performing a legal act in a harmful manner
  3. Nonfeasance - failure to perform a required act or duty
Term

What is the relationship between a Medical director and a paramedic?

 

Definition
A paramedic works under the Medical Director's license.  Therefore, the M.D. is liable for all actions of the paramedic.
Term

What are the types of consent?

 

Definition
  1. Informed Consent/Expressed Consent - based on full disclosure of risks, pt knows, understands and agrees to treatment. Expressed is verbal or written aggreance. (Expressed also counts if patient allows care to be provided after understanding, even without speaking or signing.)
  2. Implied Consent - based on assumption that a reasonable person in same situation would consent. (this is what you get in the case of an unconsious pt.)
  3. Involuntary Consent - Consent is granted by authority of law. Obtained for pts held involuntarily for mental health evaluation and pts who are under arrest or in custody.
  4. Special Consent situations - Emancipated Minors (under 18 but declared an adult by a judge, a pregnant female, living away from home and financially self supporting.)
Term

What are some types of crimes paramedics can be charged with?

 

Definition
  1. Abandonment - terminating medical care without legal excuse or turning pt care over to people with equal or higher medical training.
  2. False Imprisonment - Intentional and unjustifiable detention of a person.
  3. Assult - Creating apprehension; also unauthorized handling and treatment of a patient.
  4. Battery - Physical contact with a person without consent and without legal justification.
Term
What are some situations that would dictate whether or not a paramedic should or should not resuscitate?
Definition

DO NOT RESUSCITATE

  • Valid Signed Original DNR order present
  • Obvious Death (decapitation, rigormortis etc)
  • Unsafe scene

RESUSCITATE

  • all other situations
  • In presence of DNR but family insists on resuscitative efforts
Term
How should a paramedic approach ethical dilemmas?
Definition

"What is in the patient's best interest?"

  • Apply the Impartiality Test - "Would you accept the action if you were in the patients place?"
  • Apply the Universibility Test - "Would you feel comfortable having this action performed in all relavantly similar circumstances?"
  • Apply the Interpersonal Justifiability Test - "Are you able to provide good reasons to justify and defend your actions to others?"

Seek the opinion of others if time allows, but do not allow others opinions alone to dictate your actions.

Term

What are the anatomical direction terms and what do they mean?

 

Definition
[image]
Term
What is the function of the Nucleus?
Definition

It is the central controlling body of the cell. Contains DNA.

The nucleus controls cell division and control of genetic information.

Term

What are the major muscles for IM injection and where are they located?

 

Definition
[image]
Term
What organs make up the integumentary system?
Definition
  • Skin
  • Hair
  • Nails
  • Sense Receptors
  • Sweat Glands
  • Oil Glands
Term

What makes up the Nervous system?

 

Definition

Brain

Spinal cord

Nerves

Term
What organs and glands make up the Endocrine System?
Definition
  • Pituitary gland
  • Pineal gland
  • Hypothalamus
  • Thyroid gland
  • Parathyroids
  • Thymus
  • Adrenals
  • Pancreas
  • Ovaries
  • Testes
Term
What makes up the Circulatory System?
Definition

Heart

Blood Vessels

Blood

Term

What makes up the Lymphatic System?

 

Definition

Lymph nodes

Lymph vessels

Thymus

Spleen

Tonsils

Term
What makes up the Respiratory System?
Definition
  • Nose
  • Pharynx
  • Larynx
  • Trachea
  • Bronchi
  • Lungs

 

Term
What makes up the Digestive System?
Definition
[image]
Term
What makes up the Urinary System?
Definition

Kidneys

Ureters

Urinary Bladder

Urethra

Term
What makes up the Male reproductive system?
Definition

Gonads

Testes

Vas Deferens

Urethra

Prostate

Penis

Scrotum

Term
What makes up the Female reproductive System?
Definition

Gonads

Ovaries

Uterus

Fallopian tubes

Vagina

Vulva

Mammary Glands (breasts)

Term
What are the actions of Sympathetic stimulation?
Definition

Heart rate - Increase

Most Blood Vessels - constrict

Skeletal muscle Blood Vessels - Dialate

Digestive Tract - Slows/stops/decreases juices secretion

Anus - closes

Bladder - relaxes (decreases desire to urinate)

Eye - Dialates pupils

Skin - Goose bumps and sweat

Adrenals - secrete epinepherine

Term
What are the actions of ParaSympathetic Stimulation?
Definition

Heart Rate - Slows

Most Blood Vessels - NO EFFECT

Skeletal Muscle Blood Vessels - NO EFFECT

Digestive Tract - Increases digestion and juice secretion

Anus - opens for defecation

Urinary Bladder - Stimulates/Constricts Bladder (want to urinate)

Eye - Constricts Pupils

Adrenals - NO EFFECT

Skin - NO EFFECT , NO SWEAT

Term

Name the valves and chambers of the Heart and the path of blood flow through it (including travel to and from the lungs).

 

Definition

Vena Cava →No Valve→Right Atrium→Tricuspid Valve→

Right Ventricle→Pulmonary SemiLunar Valve→Pulmonary

Artery→Lungs→Pulmonary Vein→No Valve→Left Atrium→

Bicuspid (Mitral) Valve→Left Ventricle→Aortic Semilunar Valve→Aorta to body

 

Term
Regarding the conduction system of the heart, what are the parts in order, and what are their respective intrinsic firing rates?
Definition
  1. SA Node (60-100/min)
  2. AV Node (40-59/min)
  3. Bundle of His (0)
  4. Purkinje Fibers (1-39/min)
Term

What is an acceptable time frame for capillary refill?

 

Definition
< 2 seconds
Term
What heart rates are considered Brady/Tachy and what is normal?
Definition

Bradycardia  < 60 bpm

Tachycardia > 100 bpm

Normal 60 - 100 bpm

Term

What are the priorities in scene assessment?

 

Definition

Is the scene safe?

Do we need additional resources?

Determine NOI / MOI

Term
What is the purpose of CQI (continuous quality improvement)?
Definition
CQI is a management approach to customer service and organizational performance that includes constant monitoring, evaluation, decisions, and actions.  It focuses on making improvements to the system as a whole, NOT on improving one individual. It is LESS rigid than Quality Assurance (QA).
Term
Rank the different drug administration routes in order according to the speed at which the drug can be absorbed into the blood stream.
Definition

IV/IO - Immediate

Sublingual - Rapid

Endotrachael - Rapid

Pulmonary - Rapid

IM - Moderate

Topical - Moderate

Subcutaneous - Slow

Enteral (absorbed at any point along the GI tract) - Slow

 

Term
Describe how to perform a Needle Chest Decompression and name locations at which the needle can be inserted.
Definition

A large bore needle (10 or 14 gauge) is inserted into the affected plural space either anteriorly in the 2nd intercostal space in the mid-clavicular line just above the rib, or in the 4th or 5th intercostal space, laterally on the involved side, just above the rib.

 

An audible rush of air will be noted if treatment is effective.  The needle should be removed, but the catheter should remain in place and taped to secure.

Term
What are the signs and symptoms of a tension-pneumothorax?
Definition
  • Anxiety
  • Cyanosis
  • Increasing Dyspnea
  • Trachael Deviation (a late sign)
  • Tachycardia
  • Hypotension and unexplained signs of shock
  • Diminished or absent breath sounds on the injured side
  • Distended neck veins (unless pt is hypovolemic)
  • Unequal expansion of the chest
  • Subcutaneous emphysema

 

Term
What are the components of the Glascow Coma Scale?
Definition
  • Eye Opening
  • Verbal Response
  • Motor Response
Term
What burn injuries count in the "rule of nines?"
Definition

Only partial (2nd degree) and full thickness (3rd degree) burns are considered to count toward the "rule of nines."

[image]

Term
What are the classifications/sources of Burns?
Definition
  • Thermal
  • Chemical
  • Radiological
  • Electrical
Term
What steps should be taken to control hemorrhage?
Definition
  • Direct Pressure
  • Immobilization (splinting)
  • Pneumatic antishock garments
  • Tourniquet

(slide 106 says pressure points & elevation no longer recomended.)

Term
Define "crush injury" and"compartment syndrome" and compare and contrast the two.
Definition

Compartment Syndrome is a result of crush injury, and less often a result of electrical injury, High Pressure injection (dry cleaner accident). Edema and internal hemorage and swelling lead to decreased blood supply to extremity.

 

Crush Syndrome can be caused by prolonged Compartment syndrome.  More often caused by prolonged (4-6 hours) compression injuries (ie building collapse, earthquake). When pt is released from entrapment, blood that had been displaced rushes back into extremety causing hypovolemia, toxic waste products of anarobic metabolism enter blood stream causing metabolic acidosis, and Myoglobin is released from damaged muscle cells causing renal failure

Term
What are the 5 types of shock?
Definition

Hypovolemic

Cardiogenic

Neurogenic

Anaphylactic

Septic

 

Term
What is Hypovolemic Shock and how should it be treated?
Definition

Inadequet volume most often through blood loss, but also possible because of dehydration.

 

Treat with IV Fluids

Consider Pneumatic Antishock Garment

Term
What is Cardiogenic Shock and how should it be treated?
Definition

Bad pump. Heart is not pumping effectively enough to move blood through cardiovascular system to maintain perfusion.

 

Treat with IV Fluids

Drugs such as Antidysrhythmics, vasopressors, vasodilators, inotropic drugs

Be aware of potential tension pneumothorax and cardiac tamponade as causes of cardiogenic shock

 

Term
What is Neurogenic Shock and how should it be treated?
Definition

Most often caused by head injury. Swelling causes ICP which presses down on brain stem causing loss of sympathetic impulses leading to vasodilation and increased container size.  Increased container size means that "normal" amount of blood volume is no longer enough to fill the container, leading to hypoperfusion.

 

Treatment is similar to Hypovolemic shock

Monitor lung sounds for wet lungs

Term
What is Anaphylactic shock and how is it treated?
Definition

Caused by severe allergic reaction.  Arterioles and Capillaries dilate and capillary membrane becomes more permeable. Intravascular fluid leaks into interstitial space and leads to decreased volume.

 

Treatment IM Epinepherine

IV or IM Benadryl

Bronchodilators (Albuterol)

Steroids to reduce inflammatory response

Term
What is Septic Shock and how is it treated?
Definition

Caused by infection

 

Treatment includes IV Fluids

Correction of Acid/Base balance

Vasopressors to improve cardiac output

Respiratory Support

Term

What are the signs and symptoms of Compensated vs. Uncompensated (Decompensated) shock?

 

Definition
[image]
Term
In relation to ballistics and projectiles, which has a greated effect on the damage incurred, Size or Speed?
Definition
Speed
Term
What are the components of a blast injury?
Definition
  1. Primary - Pressure wave hits person
  2. Secondary - Flying debris hits person
  3. Tertiary - Person hit object (like a building)
  4. Quaternary/Miscellaneous - All other injuries caused by blast (ie building falls on person/radiation exposure/inhalation of dust and toxic gasses)
Term
What class of unintentional injury accounts for the most $$$ lost per year?
Definition

Motor Vehicle Accidents

$255.7 Billion

Term
What are all the different collisions that occur during a motor vehicle crash?
Definition
  1. Vehicle hits something
  2. Person hits vehicle
  3. Organs hit inside of body cavity
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