Don't Go Breaking My Heart
What are the three routes of administering nitroglycerin?
Patch, Sublingual, and Spray
Infants have proportionately large heads. How can you compensate for this when providing CPR?
Place padding underneath their shoulders.
How does a pulse assessment change with considerations for hypothermia?
We assess pulses for 60 seconds; carotid.
How many liters of blood are in an average adults body
5-6 liters
In what situations do we withhold CPR?
When a DNR (POLST) is present (signed/current), provider exhaustion/safety, a physician tells you to stop, or ROSC; after 30 minutes of CPR in remote setting
What is an APGAR score? How often to we obtain this?
Appearance, Pulse, Grimace, Activity, and Respiration
At 1 and 5 minutes after birth
Name the four mechanisms of heat transfer.
Radiation, Convection, Conduction, and Evaporation
You have a patient with respiratory distress. You learn they have a history of asthma. What are the steps you take to assist this patient with their inhaler?
Recognize s/sx of needing inhaler
Med direction/protocols
Confirm expiration date
Complete your 6 rights of administration
Shake inhaler to prime, Coach them to slow their breathing and administer dose (2 puffs), Have them hold their breath for 10 seconds (if possible)
Document/Reassess
What is the difference between angina and a myocardial infarction?
Angina is an ischemic event due to coronary narrowing due to plaque/spasm/atherosclerosis
Myocardial infarction is when tissue death occurs (infarction) due to partial or complete blockage in the coronary arteries innervating the myocardium
It is best practice to transport pregnant patients in left lateral recumbent position to avoid what?
Supine hypotensive syndrome
What is our treatment of frost-nip or frostbite in the field?
Skin-to-skin contact. Pad between digits with a soft, sterile dressing, and avoiding re-warming if we cannot keep area warm.
What are the items included in a Cincinnati Prehospital Stroke Scale assessment?
Face, Arm, Speech,**TIME! = FAST exam
Updated is BEFAST, includes Balance and Eyes
Blood leaves the heart via the ________ to pick up O2 in the lungs and then returns to the heart via the ________.
Heart to Lungs --> Pulmonary Artery
Lungs to Heart --> Pulmonary Vein
What is the correct way to time contractions? What is the timing/frequency we expect when birth is imminent?
Time from the beginning of a contraction to when relaxation occurs; the frequency is the beginning of one contraction to the beginning of another.
Imminent birth: 30 sec-1 min long; 2-3 minutes apart.
This altitude illness has a unique sign and symptom of ataxia.
high altitude cerebral edema (HACE)?
My left leg is super swollen, red, painful. I have been recovering from a broken ankle and sitting around more than usual. What should you expect?
Deep Vein Thrombosis (DVT)
What is heart failure?
Inadequate ejection of blood from the the ventricles.
You arrive on scene and your pregnant pts water has broken. You notice the fluid is dark brown, discolored. What do you suspect the cause of this is and how does it change your call?
Meconium, which is fetal stool. This is a sign of fetal stress. You should initiate rapid transport and you need to prepare for neonatal resuscitation
What are the colors and priorities we assign to patients during a mass casualty incident (MCI)?
Green/Priority 3/Minimal
Yellow/ Priority 2/Delayed
Red/Priority 1/Immediate
Black/Priority 4/Expectant or Dead
List 3 differences on assessment findings that could help differentiate between hypo- and hyper- glycemia.
1. Timing of onset, rapid vs. slow
2. Skin signs, pale/cool/clammy vs. hot/dry/red
3. Breath, hyperglycemia patients have ketone breath ("fruity breath") and polydipsia/polyuria