EMR Final Exam 2023 with 100% correct questions and answers

EMS System A network of resources to provide emergency care and transport victims of sudden illness and injury Enhanced 911 System Allows caller to be identified by the dispatch system by providing the callers phone numbers and address from which they are calling Seven Levels of EMS training 1. Emergency Medical Responder (DOTrans, Basic, Advanced) 2. EMT Basic 3. AEMT (Advanced EMT) 4. Intermediate 85,99 5. EMT Paramedic 6. Critical Care Paramedic 7. TEMS (Tactical EMS) Five Roles / Responsibilities of the EMR 1. Personal Health and Safety 2. Caring Attitude, Maintaining Composure 3. Neat, Clean, and Professional Appearance 4. Keep Up to Date knowledge and skills 5. Put Patients needs as a priority Eustress Good Stress Distress Bad Stress Five Common Causes of Stress mass casualty violence amputations death Pediatric patients Five Stages of the Grieving Process 1. Denial (Disbelief) 2. Anger 3. Bargaining 4. Depression 5. Acceptance Five Signs of Stress irritability can't concentrate difficulty sleeping anxiety (guilt) loss of appetite Four Lifestyle Changes to Deal with Stress 1. Eat healthier 2. Exercise (Meditation) 3. Balance Work 4. Listening to Family and friends CISD Critical Incident Stress Debriefing Critical Incident Stress Debriefing: Purpose Deals with Traumatic Incidents, a debriefing is a confidential group meeting which encourages open discussion of the incident. The goal is to assist the EMS personal in dealing with the stress related to the incident Four Types of Body Substance Isolation Hand washing Proper disposal of medical equipment use of personal protective equipment Scene Safety (?) Scene Safety Assessment of scene (surroundings) that will provide information to the first responder and will help ensure their well-being Scope of Practice The legal duties to the patient, medical director, and public Standard of Care care expected based on training and experience taking into account the conditions under which the care is rendered Competence The ability to understand questions and to the implication of decisions made ( do you know who / where / what you are? ) Expressed Consent The patient must be told in an easy to understand nature and the extent of the procedure to be preformed as well as the possible risks involved Implied Consent Consent based on the assumption that the unresponsive patient would consent to life saving interventions Advanced Directives Written documentation that specifies what medical treatment a patient wishes to have and what to withhold should the patient become unable to make a decision Assault and Battery Unlawfully touching a patient without consent providing emergency medical care when a competent patient does not consent to the emergency medical care Abandonment Terminating care of the patient without insuring that care will continue at the same level or higher Four Components of Negligence 1. Duty to act (legal obligation) 2. Breach of Duty (failure to act) 3. Injury where Inflicted (some injury occurred) 4. Proximate Cause (the actions of the EMR caused injury) Negligence Deviating from the accepted standard of care resulting in further injury of the patient Good Samaritan Law State Laws intended to protect care providers from liability if they deliver the standard care in good faith to the level of their training and to the best of their ability. Don't protect from Wanton, Gross, or Willful Negligence Anatomical Position body is erect facing forward, arms are at the sides palms face forward Anterior / Posterior Front / Back Medial / Lateral Toward the Middle / Toward the side Superior / Inferior Toward the Head / Toward the Feet Skeletal Gives the Body its shape protects vital internal organs Axial Skull only movable bone is the mandible Muscular Gives the Body shape Protects interal organs provides for movement Muscles are Voluntary (cardiac is involuntary) Respiratory Delivers oxgen to the body removes carbon Circulatory Delivers oxgen and nutrients to the tissues and removes waste products from the tissues Central Nervous System Brain and Spinal Cord Peripheral Nervous System Does not regenerate when injured Skin Protects the body from the environment, bacteria and other organisms regulates temperature and prevents dehydration Senses heat/cold touch pressure and pain transmits to the brain and spinal cord The Breathing Process Trachea to Bronchiole Tubes to Bronchiole to Alevoli Body Mechanics The proper use of the body to facial lifting and moving to prevent injury Rules of Body Mechanics to prevent Injury weight of patient and need for help know your physical ability and limitations lift without twisting and feet properly communicate clearly with partner Reasons for using an Emergency Move immediate danger to the patient if not moved life saving care cant be given further injury is potential Lifting techniques The Firefighter's Carry Blanket Lift Drag Direct Ground Lift Chair Lift (Extremity Lift) Recovery Position Left Side Unresponsive without trauma Right Side Unresponsive without drama Allow the patient to assume a position of comfort Injuries which require spinal immobilization Spine Neck Head Clinical Death The moment that breathing and heart activity stops, this death can be reversed Biological Death Death of brain cells this death irreversible occurs 6-10 minutes of respiratory arrest Brain Damage begins within 4 to 6 minutes opening the air way: unresponsive, gag reflex Nasal Airway Using a Nasal Airway measure nose to corner of mouth insert longer side down right nostril one breath every 5 seconds (adult) opening the air way: unresponsive, no gag reflex Oral Airway Using an Oral Airway measure earlobe to corner of mouth insert curved part up until tension is felt then rotate and insert rest of the way One breath every 5 seconds (adult) Maintain an Open Airway Nasal Airway Oral Airway Open a patient's Airway Head Tilt / Chin Lift Jaw Thrust Clearing an Airway The Recovery Position Finger Sweeps Suctioning Max Suction Time adult 15 sec child 10 sec infant 5 sec Normal Resp. Rate adult 12-20 breaths pm child 15-30 breath pm infant 25-50 breath pm Five Methods for Ventilating a Patient mouth to mask two person valve mask mouth to barrier device one person bag valve mask mouth to mouth Rates for Rescue Breathing (breath : second) Adult 1:5 Child 1:3-5 Infant :3-5 Newborn: 1:1.5 Oxygen Flow Rate: Non-rebreather face mask 12-15 liter per minute 80-95% oxygen Oxygen Flow Rate: Nasal Cannula 2-8 liters per minute 22-44% oxygen Five Components of Patient Assessment Scene Size Up Primary Secondary Reassess Patient Care Report Scene Size Up BSI Scene Safety Mechanism of Injury Number of Patients Additional Resources if Needed (EMR) CSI (Consider Spine Immobilization) Components of Primary Assessment General Impression (intro, whats the problem) Assess Responsiveness (AVPU) Check Airway, Breathing, Circulation (stop any bleeding if there is any) (ABC) Identify Priority Patients Update EMS AVPU Alert Verbal Pain Unresponsive DCAP BTLS Deformities Contusions (brusises) Abrasions (scrapes) Penetrations (puncture) Burns Tenderness Lacerations Swelling SAMPLE Signs and Symptoms (OPQRST) Allergies Medication Past Med History Last Oral Intake Event (what was going on before?) OPQRST Onset (when did it start) Palliation (what makes it better) Quality (describe pain) Radiation (does it spread anywhere else) Severity (1-10 scale) Time (when medical attention was needed) Chief Complaint main injury (cause for distress) Sign first responder observations (see hear feel smell in relation to the injury or illness) Symptom patient tells about how they feel Heart Attack failure of circulation to the heart muscle that damages or kills a portion of the heart (pressure on chest) shortness of breath is common as well Congestive Heart Failure medical emergency affects the lungs and heart occurs when the heart can not circulate blood properly. the fluid can lead to respiratory difficulty. may complain of swelling due to fluid build up Chronic Obstructive Pulmonary Disease (COPD) variety of lung problems related to disease including emphysema and chronic bronchitis. Usually occurs in middle age or older people. Altered Mental Status a sudden or gradual decrease in their responsiveness and understanding ranging from disorientation to unresponsiveness. Cerebrovascular Accident (Stroke) blocking (bursting) of a verse that supplies blood to the brain an inadequate supply of oxygen to a portion of the brain causing death Seizures Irregular electrical activity in the brain causing serious change in behavior and usually related to a nervous system malfunction. Rarely life threatening. Diabetes prevents individuals from producing enough insulin or utilizing insulin efficiently Hyperglycemia high blood sugar can produce a coma takes several days to develop Hypoglycemia low blood sugar caused by too high a level of insulin in the blood (produces a drop in blood sugar) Anaphylactic Shock Allergic Reaction Hypothermia general cooling of the body which creates a state of low body temperature Hyperthermia Heat Stroke Four Routes of Poison Ingestion Inhalation Absorption Injection Five Causes of Anaphylactic Shock bees food inhaled chemicals medicine Six Causes for Altered Mental Status Strokes Diabetes Heat Cold Seizures Poison Three Types of External Bleeding Arterial Venous Capillary Arterial Bleeding Blood Spirt (from wound) Bright Red (oxygen rich) Venous Bleeding Blood Flows (steady) Dark Red (oxygen poor) Capillary Bleeding Blood Oozes (clotting quickly) High Chance of Infection Abrasions damages the surface of the skin, but not all layers Lacerations Jagged cuts where tissue along the edge of the wound is torn and a rough edge is produced Puncture Wounds Puncturing objects tear through skin damages all tissues in its path, can be shallow or deep (internal bleeding) Sucking Chest Wounds puncture wounds to the chest patients may cough up blood the chest may collapse (lungs) (because air is in-between the lungs and check wall) Avulsions large flaps of skin are torn loose or off, replace before removing Amputations cutting or tearing off of the fingers, toes, hands, feet, arms, or legs Impaled Objects Object is still protruding from the body. Impaled Object should be removed when it impales the airway preforming CPR Evisceration abdominal organs protrude through soft tissue injury Four Quadrants of the Abdomen (going clockwise) right upper quadrant left upper quadrant right lower quadrant left lower quadrant Best Way to Control Bleeding Direct Pressure Amputated Part Care Put it in a bag or wrapped in something then on ice (NOT directly) Penetrating Chest Wound link n log (that bitch) Shock failure of the circular system to provide enough blood to the vital organs of the body Eight Types of Shock (RN CHAMPS) Respiratory Neurogenic Cardiogenic Hypovolemic Anaphylactic Metabolic Psychogenic Septic Respiratory Shock breathing shock from failure of the respiratory system Neurogenic Shock Nerve shock from failure of the blood vessels to constrict Cardiogenic Shock Heart Shock from damage to the heart Hypovolemic Shock Bleeding Shock from fluid loss Metabolic Shock Body fluid shock from loss of fluids from vomiting and diarrhea Psychogenic Shock Shock from fainting, from interruption of blood flow to the brain Septic Shock Blood Stream Shock caused by infections Signs of Shock altered mental status rapid or weak pulse skin is pale (cool clammy cyanotic) nausea (w/ vomit and thirst) dizziness Emergency Care for Shock wrap in blanket (heat) place the patient in a position of comfort (comfort) elevate legs (unless spinal injury) Three Types of Burns Superficial (first degree) Partial Thickness (second degree) Full Thickness (third degree) Treatment for Burns Stop burning process by flushing the burned area with cool water remove clothing around burned area (minor: wet dress major: dry dress) Mechanism of Injury a force or forces that may have caused the injury Three Forces that cause musculoskeletal Injuries ???? Fracture any break crack chip split or crumbling of a bone Dislocation occurs when one end of a bone that is part of a joint is pull or pushed out of place Sprain partial or complete tearing of a ligament Strain overstretching or tearing of a muscle Six Symptoms of a Fracture Deformity (angulation) Pain (Tenderness Numbness) Sound of Breaking Swelling Slow Capillary Refill Bruising PSD Pain Swelling Deformity Manual Stabilization to steady a body part in order to help reduce involuntary movement caused by pain or muscle spasms Five Symptoms of Spinal Injury Tenderness (in the area of the injury) Pain Associated with movement Numbness Weakness Loss of Bowel Control Five Symptoms of Head Injury Unresponsive Deep Cuts (or tears exposed brain tissues) Swelling and discoloration (under eyes) fragements of bone (through the skin) (Deformity of the Skull) Placenta Organ of pregnancy, composed of maternal and fetal issues (organ where exchange between mother and fetus occurs) Umbilical Cord structure that connects fetus to the placenta Amniotic Sac "bag of water" (fluid sack surrounds the fetus) Three Stages of Labor First: contracts begin, ends with cervix being fully dilated (allows baby to enter birth canal) Second: baby moves through birth canal and is expelled Third: birth to placenta being delivered Three Steps to stimulate newborn breathing vigorously rub back ventilate at rate of 40 beats terminate suction Neonate birth to one month Infant one month to one year Child one year to eight years Adult over eight years Five Differences between adult and pediatric anatomy head is larger and heavier than the body children are more vulnerable to spinal injuries togue is large for the mouth infants are nose breathers (use accessory muscles to breathe) airways are narrow and easily obstructed Five Common Medical Emergencies in Children Airway obstruction Seizures Child Abuse Respiratory (emergency) Circulatory Failure Five Symptoms of Respiratory Distress in a Child wheezing or exhaling with effort inadequate breathing drooling altered mental status sitting in a tripod position Six causes of Seizure in a child fever infection poison low blood sugar hypoxia head injury SIDS Sudden Infant Death Syndrome Abuse Improper or excessive action to injure or cause harm Neglect giving insufficient attention or respect to someone who has a claim to that attention SALT Sort Assess Life-saving intervention Treatment Immediate Triage Red Medical Attention now Expectant Triage Gray Can be treated if additional resources arrive Dead Black Dead Minimal Green Don't need much attention Delayed Yellow Will need attention eventually Five Vital Signs Blood Pressure Pulse Skin Breathing Rate/ Quality Pupils Normal Adult Resp. Rate 12-20