Don't Go Breaking My Heart
What are the primary contraindications and side effects of nitroglycerin
C/I: Systolic BP < 100 bpm, recent ED medications within the last 24-48 hrs
SE: headache, low BP, dizziness
Infants have proportionately large heads. How can you compensate for this when providing rescue breaths or CPR
How does are pulse assessment change with considerations for hypothermia?
We assess pulses for 60 seconds; carotid.
Describe signs and symptoms of shock.
Increased HR, Increased RR, pale cool clammy skin, decrease in BP, changes in LOC, decreased urine output, anxiety
What are the 5 instances in which we withhold CPR?
When a DNR is present (signed/current), provider exhaustion/safety, a physician tells you to stop, or ROSC, or you hand off to higher care
What is an APGAR score? How often to we obtain this?
Appearance
Pulse
Grimace
Activity
Respiration
We obtain it at 1 and 5 minutes after birth.
Name the four mechanisms of heat transfer/loss
What is 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/s of needing inhaler
Med direction/protocols
Confirm expiration date
Complete your 6 rights of administration
Shake inhaler to prime; administer dose (2 puffs)
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
An EMT is aware that it is best practice to transport pregnant patients in left lateral recumbent position to avoid this.
What is supine hypotensive syndrome
List the things that are required to prove negligence lawsuit again an EMT
Duty to act, breach of duty, causation, and harm
What are the items included in a Cincinnati Prehospital Stroke Scale assessment?
Face, Arm, Speech
**TIME!
FAST exam
Blood leaves the heart via the ________ to pick up O2 in the lungs and then returns to the heart via the ________.
"the pulmonary artery" and "the 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.
What is 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.
An EMT suspects what?
What is a deep vein thrombosis (DVT)
* bonus: how do we treat? what is a complication?
What are some signs and symptoms we may expect with heart failure?
Trouble breathing
Rales (fine crackles) on auscultation of lung
Edema in lower extremities
Jugular vein distention
Abdominal distention
Irregular heart rates
Medication history (diuretics, beta blockers, etc)
You arrive on scene and your pregnant's 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. This call should be escalated to ALS 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
2. Skin signs: pale/cool clammy vs. hot/dry and red
3. Breath: hyperglycemia patients have ketone breath ("fruity breath")