Random Anatomy
What makes up the Appendicular Skeleton?
Arms, Legs, Pelvic Girdle, Shoulder Girdle
What is negative pressure breathing?
Normal ventilation process
Volume of the lungs increases as diaphragm contracts/drops down and intercostal muscles lift the ribcage up and out -->The Pressure in the thoracic cavity to drop
Why is the left ventricle larger than the right?
It pumps blood to aorta and systemic circulation.
What is distributive shock? What are the 4 types of Distributive Shock?
Problem with the cardiovascular system specifically with the blood vessels, Neurogenic, Anaphylactic, Psychogenic, Septic
Common Meds to administer as an EMT and routes of administration, indications for each
O2 (IN), (shock, chest pain, respiratory problems, hypoxia, poor perfusion, severe pain...etc)
NTG (Sub lingual and Transcutaneous) (chest pain of suspected cardiac origin) 0.4mg dissolvable tablet
ASA (PO) (chest pain of suspected cardiac origin), 4, 81mg chewable tablets
Epinephrine via Epi-pen (IM), 0.3mg for adult, 0.15mg for peds anaphylactic rxn with respiratory compromise/lower airway swelling (wheezing)/upper airway swelling (stridor)
Albuterol via MDI (IN) asthma, obstructive pulmonary disease, respiratory symptoms (dyspnea, cyanosis, increased RR, labored breathing) w/or wo wheezing
Narcan (IN) suspected opioid overdose with respiratory depression, 2mg total 1mg/nostril
Activated Charcoal (PO) suspension given to toxin ingestion,
Glucose, (hypoglycemia) 15g/15min pt has to be able to protect their airway
What is Dyspnea?
SOB or Difficulty Breathing
What can cause acute pulmonary edema?
Left Sided CHF and Toxin inhalation
Pulmonary Circulation vs Systemic Circulation
Systemic Circulation: Oxygenated blood leaves the left ventricle via the Aorta and travels around the body through the arteries to the tissues where O2 is exchanged at capillary beds via diffusion and deoxygenated blood is transported back up to the heart via veins to the Superior/Inferior Vena Cava
Pulmonary Circulation: Deoxygenated Blood travels from the Right Ventricle via Pulmonary Artery to the Lungs to be oxygenated via External Respiration at the alveoli. Oxygenated blood travels via Pulmonary Vein to the Left Atrium
What are the 3 main conditions associated with Obstructive shock?
Cardiac Tamponade
Pulmonary Embolism
Tension Pneumothorax
If you are off-duty and witness a child go into cardiac arrest what should you do first?
If you come across a pt (it is unwitnessed) what should you do?
call 911 then begin CPR
if your phone is not nearby and you do not witness then do CPR first and go to call 911 after 2 minutes of CPR
What abdominal organ does Cirrhosis/Hepatitis mainly affect?
Liver
What is Hypoxic Dive? What population is this commonly found in?
Backup body pathway that causes inspiration based on O2 levels instead of CO2 levels. COPD patients
What is stable Angina? How is it different than an AMI?
Heart cell injury that leads to chest pain that resolves with rest or nitroglycerin administration
NOT a heart attack (AMI) because the heart cells are still alive
What are the two types of Hypovolemic shock and what can cause them?
Hemorrhagic: trauma: external bleeding amputation, internal bleeding, GI/GU bleed
Non-Hemorrhagic: dehydration from excessive exercise/sweating, vomiting, diarrhea
If a pt has a 30 point drop in BP and complains of dizziness post NTG administration
Lay pt supine
List areas of the spinal column in descending order with number of vertebrae for each and total
Cervical (7), thoracic (12), lumbar (5) sacral + coccyx (9) = total of 33 vertebrae
If a pt is breathing rapid and shallow with copious amounts of blood in their mouth how do we manage their airway?
Alternating suctioning with Positive Pressure Ventillations
What is AMI and what causes it?
heart muscle cell death
poor cardiac tissue perfusion due to a blocked coronary artery leading to ischemia. heart cells build up lactic acid and CO2 waste products of metabolism, then burst leaking their contents into other nearby cells --> rapid progression of heart cell death
What defines Compensated vs Decompensated Shock?
Decomponsataed shock occurs when the compensatory mechanisms get overwhelmed and fail, systolic blood pressure drops below 90
What are agonal respirations indicative of?
Guppy breathing = Not effective ventilation
Need Positive Pressure Ventilation.
Can be found in CPR status patients
What is the function of the Sympathetic Nervous System
To compensate for changes (fight-or-flight)
Dilates blood vessels in muscles, heart, lungs
Increases RR
Increases HR
Constricts BV to skin/periphery, and GI
Upper Airway vs Lower Airway sounds
Upper:
stridor or seal bark cough
Grunting
Snoring
Bubbling, gurgling
Lower: wheezing, Ronchi (course crackles), Rales (fine crackles),
Describe electric pathway conduction though the heart. & Why is there a pause at the AV node?
SA -> Internodal pathway -> AV -> bundle of his -> L/R bundle branches --> Purkinje fibers
Pause at the AV node allows ventricles to fill with blood
Skin signs associated with each type of shock
Psychogenic: pale, cool, diaphoretic
Anaphylactic: warm, flushed, sweaty, urticaria, angioedema
Septic: warm, pink, dry or diaphoretic
Neurogenic: pale, cool, diaphoretic above and warm, pink, normal below line of injury
Cardiogenic: pale, cool, diaphoretic
Obstructive: pale, cool, diaphoretic
Hypovolemic: pale, cool, diaphoretic
Hypoxia