Cardiac
What does AED stand for, and what type of cardiac rhythms does it treat?
Automated External Defibrillator; it treats ventricular fibrillation (V-fib) and pulseless ventricular tachycardia (V-tach).
What are the two types of strokes, and which one is more common?
The two types are ischemic stroke (caused by a clot) and hemorrhagic stroke (caused by a bleed). Ischemic stroke is more common.
In which situation is a traction split indicated for a patient
Closed Midshaft femur fractures with no suspected pelvic or hip injuries.
When is it appropriate to withhold oxygen administration from a patient who is breathing adequately?
If the patient's SpO2 is above 94% and they do not show signs of hypoxia, oxygen administration may not be necessary in some cases.
What does DCAP-BTLS stand for in a trauma assessment?
Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling.
What is the indication for nitroglycerin administration in cardiac patients, and what are the key contraindications?
Nitroglycerin is indicated for chest pain associated with suspected myocardial ischemia. Contraindications include systolic BP less than 100 mmHg, recent use of erectile dysfunction medications, and suspected right-sided MI (Inferior MI)
In a right-sided MI, the right ventricle of the heart is affected. The right ventricle is responsible for pumping blood into the lungs to be oxygenated.
The right ventricle is preload-dependent, meaning it relies on venous return (the amount of blood coming into the heart) to maintain adequate cardiac output and blood pressure.
Administering nitroglycerin reduces venous return to the heart, which drastically lowers the preload. In a right-sided MI, the right ventricle may not be able to compensate for the reduced preload, leading to a dangerous drop in blood pressure and shock.
What is the most common cause of seizures in pediatric patients
Febrile seizures, caused by a sudden spike in body temperature due to infection or illness.
How should you treat a patient with a suspected sucking chest wound?
Apply an occlusive dressing to the wound to prevent air from entering the chest cavity.
What is the appropriate end-tidal CO2 (EtCO2) range for a patient with adequate ventilation, and why is it important to monitor?
The normal EtCO2 range is 35-45 mmHg. Monitoring is important to ensure proper ventilation and perfusion, as abnormal levels may indicate hypoventilation or hyperventilation.
What is the recommended rate of ventilations for an apneic adult with a pulse using a bag-valve mask (BVM)?
One breath every 5-6 seconds (approximately 10-12 breaths per minute).
What two medications should be given to a patient with suspected MI? What is the mechanism of action for each of those medications?
Aspirin - Platelet aggregation (Makes the blood slippery) To inhibit platelet aggregation, reducing the risk of further clot formation in the coronary arteries.
Nitroglycerin - is a vasodilator, meaning it relaxes the smooth muscles in blood vessel walls, causing the vessels to widen (dilate). This dilation occurs primarily in the veins, but also in the arteries, including the coronary arteries.
By dilating the veins, nitroglycerin reduces venous return to the heart (decreased preload), which reduces the amount of work the heart has to do to pump blood. This also decreases the oxygen demand of the heart.
What does the GCS (Glasgow Coma Scale) assess? What is the lowest score, and what is the highest score?
GCS assesses eye opening, verbal response, and motor response. The total possible score is 15 (best possible response). Lowest 3 and Highest is 15
What is the primary concern with a burn patient who has circumferential burns around the chest?
The potential for respiratory compromise due to restricted chest wall movement.
What are the potential complications of over-ventilating a patient with a bag-valve mask?
Over-ventilation can lead to gastric distention, which may cause vomiting and aspiration, and can also decrease cardiac output by increasing intrathoracic pressure, impairing venous return to the heart.
What is the term used to describe a grating sound or sensation that occurs when broken bone ends rub together?
Crepitus
What is cardiac tamponade, and what are the classic signs of this condition (Beck’s Triad)?
Cardiac tamponade occurs when fluid accumulates in the pericardial sac, compressing the heart and impairing its ability to pump blood. Beck’s Triad includes muffled heart sounds, jugular vein distention (JVD), and hypotension.
What are the three components of the Cincinnati Prehospital Stroke Scale (CPSS)?
Facial Droop, Arm Drift, Abnormal Speech
What is the difference between compensated and decompensated shock, and what are the signs/symptoms that shock has become decompensated?
In compensated shock, the body can still maintain adequate perfusion to vital organs despite a reduction in circulating blood volume or pressure. The body's compensatory mechanisms include increasing heart rate, constricting blood vessels, and maintaining blood flow and blood pressure. Decompensated shock occurs when the body’s compensatory mechanisms begin to fail, and it can no longer maintain adequate perfusion to the vital organs. Hypotension, Altered Mental Status, Rapid shallow respirations, pale, cool and clammy skin, diminished capillary refill
Describe the differences between the adult and pediatric airway, and how these differences impact airway management.
Pediatric airways are smaller, have proportionally larger tongues, and their larynx is more anterior and superior compared to adults, making airway obstruction more likely. Airway adjuncts and equipment must be sized appropriately, and care must be taken with head positioning during airway management.
Describe the process of conducting a primary assessment in a trauma patient and explain the importance of identifying life threats. What are the components of the primary assessment
What is the purpose of using capnography during CPR, and what EtCO2 level is considered a sign of effective chest compressions?
Capnography measures the amount of carbon dioxide in exhaled air and is used to assess the effectiveness of chest compressions during CPR. An EtCO2 level of greater than 10-20 mmHg indicates adequate perfusion during compressions.
After each pause during CPR, coronary perfusion pressure (CPP) rapidly decreases, and it takes several chest compressions to build it back up to an effective level. Specifically, research suggests that it can take approximately 30 seconds or about 10-15 chest compressions to restore CPP to an optimal level that supports the return of spontaneous circulation (ROSC) after an interruption.
Coronary perfusion pressure (CPP) during CPR refers to the pressure gradient that drives blood flow to the heart’s coronary arteries, specifically the myocardium (heart muscle). This pressure is a critical factor in the effectiveness of CPR, as it determines how much oxygenated blood is delivered to the heart muscle, which is essential for the heart’s recovery during resuscitation.
CPP is the difference between aortic diastolic pressure (the pressure in the aorta during the relaxation phase of the heart) and right atrial pressure (the pressure in the right atrium). In simple terms, CPP measures how well blood flows through the coronary arteries to supply the heart muscle with oxygen.
Formula:
CPP = Aortic Diastolic Pressure - Right Atrial Pressure
Explain the difference between chronic obstructive pulmonary disease (COPD) and asthma, and describe how each condition affects the respiratory system.
COPD is a chronic, progressive condition often caused by smoking that includes emphysema and chronic bronchitis, leading to obstructed airflow and poor gas exchange. Asthma is a reversible airway obstruction caused by bronchoconstriction and inflammation, typically triggered by allergens or exercise. Both conditions cause shortness of breath and wheezing but differ in their progression and triggers.
Components of Cushings Reflex
Hypertension:
The body increases blood pressure to overcome the high ICP and maintain adequate cerebral blood flow. This is the body's attempt to "push" blood into the brain despite the pressure within the skull.
Bradycardia:
As blood pressure increases, the body's baroreceptors (pressure sensors) detect the high blood pressure and trigger the parasympathetic nervous system to slow the heart rate in an attempt to counteract the hypertension.
Irregular or decreased respirations:
The increased pressure within the brain can affect the brainstem, which controls breathing. This leads to abnormal, irregular, or slow respirations, a condition known as Cheyne-Stokes respiration in some cases
In an asthma attack, why might a patient's wheezing disappear despite a worsening condition, and what treatments should you provide to this patient?
Silent chest can indicate complete airway obstruction due to bronchoconstriction. Immediate treatment with aggressive airway management and transport is required. CPAP, Albuterol
Describe the steps of oxygen administration in a patient with suspected hypoxia. What are three common oxygen delivery devices used to treat shortness of breath with suspected hypoxia? Describe whether those devices are ventilatory assist or oxygenation and the approximate oxygen delivery % for each device.
Nasal cannula: For mild hypoxia or patients with stable vitals, administer at 1-6 L/min, providing 24-44% oxygen.
Non-rebreather mask: For moderate hypoxia, administer at 10-15 L/min, providing up to 90% oxygen.
Bag-valve mask (BVM): For severe hypoxia or patients with inadequate respirations, assist ventilations at 15 L/min, delivering nearly 100% oxygen.