Chapters 14-23: Test Question Guide

Hypertension, nausea, chest pain, cardiac arrhythmia, anxiety, tremors, nervousness

20 minutes

Try to take out the stinger with another object

Crushing pain in the chest

Weakness

The pain will travel to the left side

Possibly seizures in diabetic patients

Normal or shallow to rapid respirations

Moist and pale skin, pale and clammy

Low blood pressure

Rapid, weak pulse

Altered mental status, steadily deteriorating

Taken insulin but not eaten

Hyperventilating, rapid, deep breathing

Kussmaul respirations

Dry and warm skin

Normal blood pressure

Rapid, weak, thready pulse

A fruity odor on their breath: acetone/ketone odor

Altered mental status, steadily deteriorating

Eaten but not taken insulin

Cannot be supine, cannot breathe if supine

Labored breathing, respiratory distress

Crackles/Rhonchi

History of heart failure

History of high blood pressure

Treat them by putting them on CPAP

80-120 in adults

70 in neonates

General impression

AVPU

Chief complaint

ABCs

Transport decision

Child: under 4: 0.15

Adult: over 4: 0.30

Say CLEAR and administer the shock

Call medical control

On the affected side

Make it safe if you can

Call for appropriate resources

The lowered respiratory rate for OPIOIDS especially

Ventilate with a BVM, optimally at 100% O2 with 15 L/min

1. An amphetamine, not a benzodiazepine/barbiturate

2. A Sympathomimetic stimulant, not a Sedative-Hypnotic

   1. An agent that produces an excited state

   2. Ex: amphetamine, methamphetamine

3. Usually taken to make the user feel good

   1. Improve task performance

   2. Suppress appetite

   3. Prevent sleepiness

4. May produce irritability, anxiety, fear, lack of concentration, seizures

5. Paranoia and delusions are common signs of abuse

A Sympathomimetic stimulant, not a Sedative-Hypnotic

Agitation and restlessness

Panic attacks or severe anxiety

Severe confusion or disorientation

Hallucinations or delirium

Rapid heartbeat (tachycardia) or irregular heartbeat (arrhythmia)

High blood pressure

Nausea and vomiting

Blurred vision

Fainting or loss of consciousness

Hyperthermia (dangerously high body temperature)

Seizures

1. A Sympathomimetic stimulant, not a Sedative-Hypnotic

2. Classically inhaled into the nose and absorbed by the nasal mucosa

   1. Damaging tissue, causing nosebleeds (epistaxis), and eventually destroying the nasal septum

   2. In any form the immediate effects of a given dose, including excitement and euphoria, last an hour

3. Intense agitation or anxiety

4. Severe paranoia or hallucinations

5. Aggressive or violent behavior

6. Tremors or muscle twitches

7. Increased heart rate and blood pressure

8. Irregular heart rhythm

9. Chest pain or discomfort

10. Difficulty breathing

11. Nausea and vomiting

12. Seizures

13. Stroke

14. Coma

1. CNS depressants

2. Can cause respiratory depression

   1. Decreased volume of inspired air

   2. Decreased rate of respirations (below 10)

   3. This can lead to respiratory and cardiac arrest

3. Produce a high/kick when administered intravenously

4. Overdose can result in rare seizures, comatose condition

5. Patients appear sedated or unconscious

6. Exhibit cyanosis with pinpoint pupils (most specific sign)

1. The patient is unable to swallow

2. The patient has a severely altered mental status

   1. Very confused, cannot follow commands, etc.

3. The patient is unconscious

4. The glucose is expired

Airway swelling

Respiratory distress/arrest

Overdilation of blood vessels → shock

1. AMI pain differs from angina pain

   1. Once dead, cells cannot be revived.

   2. “Clot-busting” (thrombolytic) drugs or angioplasty within the first few hours prevent damage.

   3. Immediate transport is essential

2. Not always due to exertion

3. Lasts 30 minutes to several hours

4. Not always relieved by rest or nitroglycerin

5. AMI and cardiac compromise physical findings

6. Movement or palpation should not alter pain

7. Chest discomfort: Pressure, squeezing, fullness, pain, burning, or heaviness

8. Upper body discomfort: Neck, jaw, shoulder, arms, back

9. Shortness of breath: Shortness of breath, feeling light-headed, or unusually tired

10. Diaphoresis: Sweating

11. Nausea: Feeling nauseous

12. Peripheral cyanosis: Peripheral cyanosis, edema, pallor, diminished pulse volume, delayed rise, and delayed capillary refill

13. Pulse and neck-vein patterns: Pulse and neck-vein patterns may reveal other associated abnormalities

14. Cardiac bulge: Rarely, a cardiac bulge with a pace different from the pulse rhythm can be felt on precordial examination

Move them to a private area

Be respectful, supportive, and a good listener

Get some evidence, clothing, hair, nails, etc.

Wrap evidence materials in a paper bag, plastic degrades DNA

A transient ischemic attack

Stroke symptoms that resolve within 24 hours on their own with no deficit in function

Check the pulse

Check the airway

Check the breathing

Give ventilation if needed (NRB at 12-15 L/Min)

In the JB LEARNING world, ALWAYS VENTILATE for shallow respirations

Oxygen and position of comfort

Sitting up: Fowler’s or Semi-Fowler’s

1. A: Alcohol or drug abuse

2. E: Epilepsy, electrolyte imbalances, and endocrine problems

3. I: Insulin, inborn errors of metabolism, and overdose of oxygen

4. O: Overdose

5. U:  Underdose, uremia

6. T: Trauma

7. I: Infection, psychiatric, or poisoning

8. P: Psychosis

9. S: Stroke or subarachnoid hemorrhage (SAH)

Suction their airway

Severe internal bleeding

Its contents would spill out

This would lead to sepsis, bacterial infection

Chest rise

Skin is pink, warm, and dry

LOC is alert and oriented

Respirations between 12-20 for an adult, etc.

An oral airway until naloxone/Narcan is administered

Have to use an oral until Narcan is administered in two nostrils

Only suction if the person has vomitus or something in the mouth

Dilates the coronary arteries

Causes blood pressure to drop

• Over breathing to the point that arterial carbon dioxide falls below normal

  • May be an indicator of life-threatening illness

  • The body may be trying to compensate for acidosis

  • A buildup of excess acid in blood or body tissues

• This can result in alkalosis

  • The buildup of an excess base in body fluids

• Can cause symptoms of a panic attack:

  • Anxiety

  • Dizziness

  • Numbness

  • Tingling or painful spasms of the hands/feet

Size of the patient (weight)

What they took

When they took it

How much they took

Vomiting

PPE

Scene Safety

3-5 minutes

The patient is in a postictal state

5-30 minutes, depending on the initial seizure

That it does not get on the EMS provider

Ventilate with a BVM and give Narcan/naloxone

Turn them to their side

Move them out of the way of objects

Suction them

Give them a nasal airway

NEVER put anything into their mouths

Nonrebreather at 15 L/min

Trendelenberg/shock position

Keep them warm with a blanket

Rapid transport, if possible beat the cause of shock

Ex: if bleeding, stop the bleeding

Ex: if anaphylactic, give an EpiPen

Reassess every 5 minutes if unstable

Reassess every 15 minutes if stable

When the patient becomes a threat to themselves or others

Anaphylaxis deals with multiple body systems

At least one system has to be under a life threat

Anaphylaxis is life-threatening

Allergies are merely annoying

Changes in body language

Fists clenched, jaw clenched

Holding a bat and smashing windows

Give them a nasal cannula at 4-6 L/min

Whatever is appropriate

Give them a nonrebreather mask at 10-15 L/min

Whatever is appropriate

Give them a BVM mask at 15 L/min

Whatever is appropriate

Bleeding

Capillary refill/radial pulse

Skin tone, temperature

Sudden altered mental status

Severe hypoglycemia

Needs glucose immediately

This will result in loss of consciousness, brain damage, and death

More critical than hyperglycemia or diabetic ketoacidosis

Acidosis

Dehydration: needs IV fluid therapy

Severe hyperglycemia

Needs insulin immediately