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147 Cards in this Set
- Front
- Back
Online Medical Direction |
Direction given over the phone or radio directly from the medical director or designated physician |
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Off-Line Medical Direction |
Consitsts of standing orders, training, and supervision authorized bt the medical director |
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Direct Protocols |
Written Document |
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Standing Orders |
Written Documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols |
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Indirect Protocols |
Unwritten Document |
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What is the EMT's first priority |
Personal Safety |
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What is the simplest yet most effective way to prevent disease? |
Proper Handwashing |
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Know the blood-borne pathogens EMS providers would be at risk for contracting and what prevention strategies are availible for the various pathogens |
Blood-borne Pathogens: HIV, Hep B, Hep C Prevention Strategies: Wear gloves and make sure to be vaccinated |
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In patients who are responsive but unable to provide expressive speach, what can the provider do to alleviate fears and concerns for the patient |
~Do not assume an aggressive posture ~Make good eye contact, but do not stare ~Speak calmly, confidently, and slowly ~Never threaten the patient, either verbally or physically ~Be attentive to facial expressions, body language, and eye contact - your own and your patients ~Constant communication |
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Expressed Consent |
Specific authorization to provide care expressed by the patient |
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Implied Consent |
Legal assumption that treatment was desired |
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Informed Consent |
Permission for treatment given by a competent patient after the potential risks, benifits, and allternitives to treatment have been explained |
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HIPPA |
Health Insurance Portability and Accountability Act |
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How does HIPPA affect EMS providers? |
Ensures the Patient information is protected |
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What are the components of negligence (4) |
1. EMT's duty to act 2. Cause 3. Breach of duty 4. Real or perceived damage |
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What are some factors to consider when communicating with an elderly patient? |
~You should present yourself as competent, confident, and caring. ~You must take charge of the situation, but do so with compassion. ~Approach an older patient slowly and calmly. ~Allow plenty of time for the patient to respond to your questions. ~Watch for signs of confusion, anxiety, or impaired hearing/vision. ~The patient should feel confident you are in charge and that everything possible is being done for them. |
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What are some tips for EMS providers when doing radio transmission? |
~Ensure clear frequency before speaking. ~Wait one second before speaking. ~Hold microphone 2-3" away from mouth. ~Address the unit you're callling and provide the name of your unit. ~Keep transmission brief. ~Use clear text. ~Avoid using codes or agency-specific terms. ~ Use clear, calm and monotone voice. ~Avoid using slang. ~Remember airwaves are public and can be picked up by scanners. ~Do not use names, protect the privacy of the patient. ~Indicate end of transmission by saying "over". ~Do not provide a diagnosis of the patient's problem. ~Use EMS transmissions only for EMS communications. ~Monitor background noise. |
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Distal |
Farther away from the orgin of a body part or the point of attachment of a limb to the body trunk |
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Proximal |
Closer to the origin of the body part or the point of attachment of a limb to the body trunk |
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Superior |
Toward the head end or upper part of a structure or the body; above |
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Inferior |
Away from the head end or the lower part of a structure or the body; below |
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Medial |
Toward or at the midline of the body; on the inner side of |
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Lateral |
Away from the midline of the body; on the outer side of |
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Posterior |
Toward or at the back of the body; behind |
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Anterior |
Toward or at the front of the body; in front of |
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Coronal |
Also known as the frontal plane- is any vertical plane that divides the body into ventral and dorsal (belly and back) sections |
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Transverse |
Divided into top and bottom |
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Supine |
Lying face up |
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Saggital |
Divided into left and right |
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Prone |
Lying face down |
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Fowler's |
Sitting upright |
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Shock Position |
Person who is laying flat on his or her back with the legs elevated approximately 8-12 inches |
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Recovery |
Referes to one of a series of variations ona a lateral recumbent or 3/4 prone postition of the body |
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Palmar |
Foward facing part of the hand in the anatomic postion |
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Plantar |
Bottom of the foot |
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Dorsal |
Posterior surface of the body, including the back of the hand |
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Adduction |
Motion towards the midline |
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ABbduction |
Motion away from the midline |
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Superficial |
Toward or at the body surface |
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Deep |
Away from the body surface |
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Intermediate |
Between a more medial and a more lateral structure |
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Why should EMT's have a strong working knowledge of medical terminology? |
~Understanding key terms, acronyms, symbols, and abbriviations is important for effective communications and dcocumentation. ~Help you determine the meaning of an unknown term by breaking the word apart ~Once you understand medical jargon, you will be able to communicate effectively with other members of the EMS, healthcare, and public safety. |
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Know the parts of the Brain: |
Cerebrum Occipital lobe Parietal lobe Frontal lobe Temporal lobe Cerebellum |
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Know the parts of the Brain Stem |
Midbrain Pons Medulla Oblongata |
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Know the parts of the Spinal Column |
Spinal cord Bony spine (vertebrae) |
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Know the parts of the CNS |
Brain Spinal cord |
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What is the normal Blood Pessure range for an adult |
90-130 Systolic BP |
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What is the normal Pulse Rate for an adult |
60-100 BPM |
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What is the normal Respiratory rate for an adult? |
12-20 Breathes Per Minute |
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Atherosclerosis |
Disorder in which cholesterol and calcium bouild up inside the walls of the blood vessels, formind plaque, which eventually leads to partial or complete blackage of blood flow |
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Arteriosclerosis |
A disease that causes the arteries to thicken, harden, and calcify |
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How should an Emt properly restrain a patient |
Speak in a calming matter. Develop a plan Minimum of 5 personnel Establish a team leader Place patient supine Secure to stretcher Secure one arm above the patient and the other at the side Secure the legs |
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How can you stop the spread of disease on equiptment and surfaces |
Decontaminate after each use |
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Standard Precuations |
Protecive measures that have traditionally been developed by the CDC |
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When should Standard Precuations be used |
In dealing with objects, blood. body fluids, and other potential exposure risks of communicable disease |
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What does an intial assessment address |
General impression Mentation, AVPU, PPTE Chief Complaint Airway Breathing Circulation |
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Pupil Assesment |
PEARRL Pupils Equal and Round Regular in size React to light |
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What are some Negative Findings when doing a Pupil Assessment |
Become fixed with no reaction to changes in light Dilate with introduction of a bright light and constrict when the light is removed React sluggishly instead of briskly Become unequal in size Become Unequal when a bright light is introduced into or removed from the eye |
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What causes the Negative Findings in a Pupil Assessment |
Injury of the brainstem or brain Trauma or Stroke Brain tumor Inadequate oxygenation or perfusion Drugs or toxins (CNS depressions) |
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How should the airway of a truama patient be opened? |
Insert an oral airway (oropharyngeal) Insert a nasal airway ( Nasopharyngeal) Jaw thrust maneuver |
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How should the airway or a medical patient (not trauma) be opened |
Head tilt chin lift Jaw thrust |
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What is a Chief Complaint |
Most serious thing a patient is concerned about |
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Hypoxia |
A dangerous conditon in which the body tissue and cells dont have enough oxygen |
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How is Hypoxia Treated? |
Give additional oxygen to the patient and into the body (blood) as quickly as possible |
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What occurs when a patient is breathing rapidly and shallowly? |
Sign of Tachypnea. Could be indication of respiratory disorder. The tidal volume will decrease. The minute volume would change depending on the numer of respirations |
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Tidal volume |
Amount of air moved during one breath |
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Minute Volume |
The volume of air moved through the lungs in one minute. Calculated by multiplying tidal volume and respiratory rate; also reffered to as minute ventilation |
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Hypoxic Drive |
Backup system to control respiration |
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What percentage of oxygen does a NRB (Non-Rebrether Mask) deliver? |
90% |
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What percentage of Oxygen does a BVM (Bag Valuve Mask) deliver |
100% |
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What percentage of oxygen does a NC (Nasal Canula) deliver |
24-44% |
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What percentage of oxygen does Mouth to Mask delvier? |
16% |
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What does Weezing indicate? |
Indacates a narrowing of the lower airway |
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What does Rhonchi Indicate? |
Indicates a presence of mucus in the lungs |
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What does Rales (Crackles) indicate? |
Indicates fluid in the lungs |
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What does Stridor indicate? |
Indicates that the patient has an airway onbstruction in the neck or upper part of the chest |
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What does Snoring indicate? |
indicates an upper airway obstruction, usually caused by the tounge or a foreign body |
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Dose |
Amount of mediaction given |
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Indication |
Reson for which a medication is given |
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Contraindication |
Situation in which a drug should not be given |
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Side effect |
Any action of a drug other than the desired one |
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ADsorption |
To bind or stick to a surface |
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ABsorption |
Process by which medications travel through body tissues |
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Suspension |
The state of a substance when its particles are mixed with, but undissolved, in a fluid or solid |
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What is meant by medical direction approval related to EMT medications |
As an EMT, you can only administer medications for which you have an order from medical control |
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What are the 6 patient rights |
Right patient Right medication Right dose Right route Right time Right documentation Right to refuse |
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What is the mechanism of action for Oral Glucose |
When absorbed, provides glucose for cell use |
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What is the mechanism of action for Activated Charcoal |
Absorbs toxic substances in the digestive tract |
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What is the mechanism of action for Nitro |
Relaxes vascular smooth muscle causing vasodilation which results in increase coronary blood flow |
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What is the mechanism of action for Asprin |
Decreses paltelet aggregation, thus increasing blood flow through the coronary arteries |
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What is the mechanism of action for Albuterol |
Dilates brinchial smooth muscle |
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Whar is the mechanism of action for Epinephrine |
Bronchodilator and vasoconstriction |
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What is the mechanism of action for Oxygen |
Reverses hypoxia, provides O2 to be absorbed by lungs |
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What is the mechanism of action for Narcan |
Compete with opiates at the opiate receptor sites |
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What is the mechanism of action for MDI |
Bronchodilation |
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Tachycardia |
Rapid sinus rhythem; over 100BPM |
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Hypertension |
High blood pressure; systolic over 140 |
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Bradycardia |
Slow sinus rhythem; under 60 |
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Hypotension |
Low blood pressure; systolic under 90 |
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What are the three components of the perfusion triangle |
Pump-heart Pipes- vessels Container- blood |
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Septic shock |
~Severe bacterial infection ~Signs and syptoms: Warm skin or fever, Tachycardia, low Bp ~Treatment: Transport promply, admisister high-flow O2, assist ventilations, keep patient warm, consider ALS |
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Neurogenic shock |
~Damaged cervical spine, which causes widespread blood vessel dilation ~SS: Bradycardia, Low BP, SIgns of neck injury ~T: Secure airway, Spinal immobilization, Assist ventilations, Administer high-flow oxygen, Preserve body heat, Transport promptly, Consider ALS |
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Anaphylactic shock |
~Extreme life-threatening allergic reaction ~SS: can develop within seconds, Mild itching or rash, Burning skin, Vascular dilation, Generalized edema, Coma, Rapid death ~T: |
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Hypovolemic Shock |
Loss of blood or fluid |
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Distributive Shock |
Widespread dilation off the small arterioles, small venuales, or both |
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Cardiogenic Shock |
Inadequate heart function, disease of muscle tissue, impaired electrical system, disease or injury |
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Psychogenic shock |
Shock due to emotional stress or to seeing an injury or accident |
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What are the physical changes that happen in the Compensated stage of Shock |
Altered mental status, weak rapid or absent pulse, shallow rapid breathing, air hunger, feeling of impending doom |
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What are the physical changes that happen is the Decompensated stage of Shock |
Falling blood pressure, ashen, mottled or cyanotic skin, dilated pupils, poor urinary output |
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What are the physical changes that happen in the Irreversable stage of Shock |
Shock has progressed to far |
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During cheast compression what are some pearls to ensure they are effective? |
Recoil! 2-2.4 (5cm) in adults 2 in children 1/3 in peds |
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What is the correct compressio to ventilation ratio for adult cpr |
30:2 |
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What is defined as BLS care? |
Noninvasive emergency life saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest |
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What should the EMT do if a pateint who requires the use of an AED has a medication patch |
Remove the patch |
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Why do infants and children go into cardiac arrest? |
Respiratory arrest |
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What does the assessment of the medical patient usually focused on |
Oral history |
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What is required during a comprehensive neurologic assessment |
~Evaluate level of conscious (AVPU) ~Determine orientation (PPTE) ~Use the Glasgow Coma Scale on a patient with an altered mental status |
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How can an EMT prevent the infection of certian communicable diseases such as whooping cough or pertussis |
Be current on your DTaP vaccine. Put a mask on your patient and yourself |
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What is a HEPA or N-95 Mask? |
A type of rebreather mask that you would where around patients with potential tuberculous |
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What four items are assessed during a respiratory assessment |
Rate of breath quality sound depth |
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In what area does respiration occur? |
Alveoli |
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What is the difference between respiration and ventilation |
Respiration is the exchange of gasses in the alveoli and ventilation is the exchange of air between the lungs and the environment |
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Asthma is a respiratory issue that is a response of what system |
Immune system |
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Know blood flow through the heart |
Superior/Inferior Vena Cava Right Atrium Tricuspid valve Right Ventricle Pulmonary Artery Lungs Pulmonary Vein Left Atrium Mitral Valve Left Ventricle Aorta |
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Sinoastril Node |
Elecrical current begins and passes through both atria |
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Atrioventricular Node |
Bridge of special electrical tissue between atria and ventricle |
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Bundle of His |
Between ventricles |
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Purkinje fibers |
In each side of ventricle |
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What are the risk factors of an AMI (modifiable) |
Smiking, physical activity, cholesterol levels, hypertension, diabetes, obesity |
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What are the risk factors of an AMI (non-Modifiable) |
Gender, heredity, genetics, age |
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What are the Contraindications for Oral Glucose |
Nausea, vomiting, inability to swallow/ no gag reflex |
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What are the Contraindications for Activated Charcoal |
OD of corrosives, caustics, or petroleum substances |
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What are the Containdications for Nitro |
Cerebral hemorrhage, use sexual enhancement drug within 24-36 hours, systolic bp less than 100 |
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What are the Containdications for Asprin |
Bleeding disorders or GI bleeding |
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What are the Containdications for Albuterol |
tachydysrhythmias or MI |
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What are the Containdications for Epinephrine |
None in anaphylaxis |
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What are the Containdications for Oxygen |
Very rarely in patients with COPD DON'T use near open flames as it will support combustion. Never withhold oxygen from a patient |
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What are the Containdications for Narcan |
None in the emergency setting |
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What are the Containdications for MDI |
Tachycardia, MI |
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What are the Structures of the upper airway |
Nose Mouth Tongue Jaw Pharynx Larynx |
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What are the Structures of the Lower airway |
Trachea Bronchi Lungs Alveoli |
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How is a NPA inserted |
Size airway, lubricate tip, insert into larger nostril, face bevel owards septum, gently advance airway until resistance is met, rotate 180* and continue to insert |
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How is an OPA inserted |
Size airway, open pts mouth, hold airway upside down, rotate airway 180*, insert airway until the flange rests on the patient's lips |
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How does Nitro help cardiac patients increase blood flow in the coronary arteries |
Relaxes vascular smooth muscle causing vasodilation which results in increased coronary blood flow |
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How does Aspirin help cardiac patients increase blood flow in the coronary arteries |
Decreases platelet aggregation, thus increasing blood flow through the coronary artery |
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Why is an epi-auto injector an advantage to administer epinephrine |
It is a pre-metered dose prescribed to the patient |
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How often do you reassess stable patients |
Every 15mins |