Patient Assessment
What is the first step of a scene size-up?
Ensure Scene Safety
What is the most basic and immediate step in airway management?
Open the airway
What term refers to how a medication acts within the body?
Pharmacodynamics
What is the definition of Shock?
Hypoperfusion of tissues, organs, membranes
What is the first step in using an AED?
Turn it on and follow prompts
DCAP-BTLS
Deformity
Contusions
Abrasions
Penetrations/Punctures
Burns
Tenderness
Lacerations
Swelling
What is the primary indication for using a Nasopharyngeal Airway (NPA)?
Unresponsive patient with an intact gag reflex
What are the Big Six rights for medication administration
Patient - Medication - Dose - Route - Time - Documentation
Bonus
Right to Refuse - Right Education - Right Indication - Right Response/Evaluation
What are the three main causes of shock?
Pump failure, low fluid volume, and vascular dysfunction
What does CAB stand for? Why does this differ from traditional order of priority?
Circulation, Airway, Breathing
Circulation takes priority in an effort to continue perfusion of critical tissues organs with what oxygen remains
List 4 signs/symptoms of compensated and decompensated shock
Compensated Shock - Tachycardia, Pale, Cool, Clammy skin, Anxiety/Agitation, Restlessness, sense of doom, thready pulse, Shallow/Rapid Breathing, Cap Refill >2 seconds, Thirst,
Decompensated Shock - Hypotension, AMS, ALOC, Labored/Irregular Breathing, Mottled/Cyanotic Skin, Absent peripheral pulses, dilated pupils, low urinary output.
What are the two manual airway maneuvers commonly used and what are their indications?
Head Tilt-Chin lift, Apnea/Agonal Breathing, suspected airway obstruction
Jaw-Thrust - Apnea/Agonal breathing WITH a suspected spinal injury
What must be done before and after taking administering a medication?
Obtain vitals and reassess
Fever/Hypothermia, Tachycardia, Hypotension, History of Infection, AMS
What is the maximum pause duration between chest compressions while performing CPR?
10 seconds
AMS/ALOC, Respiratory rate <8 or >28, systolic BP <90mmHg
Explain how the use of positive pressure ventilation can affect cardiac output and why this is significant in airway management.
It increases intrathoracic pressure, decreasing venous return and cardiac output. Detrimental in hypotension or patients in shock
What is the mechanism of action for Nitroglycerin and why is it a serious contraindication for some patients?
Sensitive to patients who are hypotensive or take medications to treat ED
Define Obstructive shock and provide two examples and their respective treatment
Mechanical Obstruction of Blood Flow
Tension Pneumothorax - Needle Decompression
Cardiac Tamponade - Rapid transport, Pericardiocentesis
Pulmonary Embolism - Rapid Transport, Percutaneous Embolectomy
What considerations must take place before determining termination of resuscitation efforts in the field?
Evidence of signs incompatible with life or signs of irreversible death, lack of response to prolonged CPR/AED use, local protocols, consultation with medical control
What is the significance of paradoxical chest movement, and what injury does it suggest?
Flail Chest (Multiple rib fractures). Dangerous to the organs, tissues, and vessels in the thoracic cavity, suggests high MOI.
What is a skill BLS providers can perform leading up to an ALS provider attempting an ETT Intubation. Explain why this skill is important
Preoxygenation with a BVM. Increases oxygen reserve in order to delay Hypoxia during apnea/intubation attempt
Explain the difference between agonist and antagonist drugs used at the EMT scope. Provide an example of each
Agonist's stimulate receptors (Epinephrine)
Antagonist's Block/Inhibit receptor activity (Naloxone)
What hemodynamic changes occur in the early vs late stages of hypovolemic shock?
Early: vasoconstriction and increased HR
Late: decreased cardiac output and hypotension
Explain the implications of Ventricular Fibrillation/pulseless Ventricular Tachycardia vs. Pulseless Electrical Activity on AED analysis and treatment
VF/pVT: shockable rhythms
PEA: non-shockable, requires CPR and reversible cause treatment