NREMT Advanced-EMT Questions and
Answers.
Initial Assessment: B-SMNAC -
- BSI (body substance isolation);
- Scene Safety;
- Mechanism of Injury (MOI)/Nature of Illness (NOI);
- Number of Patients;
- Assistance (additional units, Fire, Police, etc.);
- C-spine (and/or C-collar)
Initial Assessment: G-CAAT -
- General Impression;
- Chief Complaints, Life Threats (hemorrhage);
- AVPU;
- ABC's (airway, breathing, circulation);
- Transport Decision (Load and Go or Stay and Play)
Components of General Impression -
ASSS-FLOP-VD:
- Apparent state of health;
- Skin color, obvious lesions;
- Signs of distress;
- Sexual development;
- Facial expressions;
- Level of consciousness;
- Odors;
- Posture, Motor, Gait;
- Vital statistics;
- Dress, Grooming, Hygiene
Components of AVPU -
- Alert;
- responds to Verbal stimuli;
- responds to Painful stimuli;
- Unresponsive
Secondary Assessment: OPQRST-I -
especially for Respiratory and Cardiac patients:
- Onset;
- Provocation/Palliation;
,- Quality;
- Radiation;
- Scale/Severity;
- Time;
- Interventions
What is OPQRST? -
a mnemonic for remembering the questions to ask when assessing the patient's chief
complaint or major symptoms
Onset -
- When and how did the symptom begin?
- Ask the patient if the onset was sudden or gradual.
- Also determine if the onset was associated with a particular activity.
Provocation/palliation: -
- What makes the symptom worse?
- What makes the symptom better?
Quality -
How would you describe the pain?
Radiation -
- Where do you feel the pain?;
- Where does the pain go?
Scale/Severity -
- On a scale from 0 to 10, with 10 being the worst.
- How bad is the symptom?
Time -
- Determine if the symptom has been present for minutes, hours, days, weeks, months,
or years;
- The length of time the symptoms are present is important to document
Secondary Assessment: SAMPLE -
- Signs and Symptoms (history of present issues);
- Allergies;
- Medications;
- Past Medical History, Pertinent Negatives;
- Last Oral Intake;
- Events (leading to present: trauma or medical)
Secondary Assessment: V-FITD -
- Vital Signs, baseline (VS);
- Focused Physical Exam (performed);
,- Interventions (RX's per medical direction, etc.);
- Transport (re-evaluate decision);
- Detailed Physical Exam (verbalized);
Order of Initial Assessment -
- B-SMNAC;
- G-CAAT;
Order of Secondary Assessment -
- OPQRST-I;
- SAMPLE;
- V-FITD
S1 -
"Lub"
Caused by the closing of the Mitral (Bicuspid) and Tricuspid atrioventricular valves.
S2 -
"Dub"
Caused by blood closing the semilunar valves (aortic and pulmonic).
S3 -
"Ta"
Oft referred to as the galloping heart, caused by blood sloshing around in a compliant
left ventricle.
S4 -
A rare noise in the middle of "lub," caused by a failing left ventricle and best heard in the
cardiac apex.
Ta-LUB-dub, ta-LUB-dub
Septum - 2 Sub Types -
Separates the two halves of the heart.
Interatrial and Interventricular
NSAID -
Nonsteroidal Anti-inflammatory Drug
Antipyretic Agent -
Inhibits Prostaglandins
Acts on hypothalamus, heat regulation center.
Vasodilation & Sweating
Platelet Inhibitor -
Prevents formation of thromboxane A2
, Decreased Afterload Effects -
Decreased Arteriole Pressure = Decreased Aortic Pressure = Left Ventricle Works
Better
Decreased Preload Effects -
1. Venous Dilation = Decreased Preload = Decreased Heart Size
2. Decreased Heart Size = Increased Blood Flow to Coronary and Collateral Vessels =
Myocardial Perfusion is Improved
A parasympatholytic drug blocks the effects of the parasympathetic nervous system by?
-
Binding to receptors and blocking the release of acetylcholine.
Sympathetic Nervous System - Other Name -
Adrenergic Nervous System
Medications typically administered via the subcutaneous route? -
Insulin
Epinephrine
Which of the following is NOT a form of liquid drug? -
Capsule
Which of the following physiologic responses would you expect to occur following
administration of a drug that possesses alpha-1 (α1) properties? -
Peripheral Vasoconstriction
The function of a drug or the particular action of a drug on an organism is called: -
Mechanism of Action
Cushing's Reflex (Define) -
Attempt by the body to compensate for a decline in cerebral perfusion by increasing the
mean arteriole pressure.
Cushing's Triad -
SxS of Increased Intracranial Pressure
Increased Systolic Pressure
Widened Pulse Pressure
Decreased Pulse and Respiratory Rate
PAT: Pediatric Assessment Triangle -
General Appearance
Work of Breathing
Circulation to the Skin
TICLS -
Answers.
Initial Assessment: B-SMNAC -
- BSI (body substance isolation);
- Scene Safety;
- Mechanism of Injury (MOI)/Nature of Illness (NOI);
- Number of Patients;
- Assistance (additional units, Fire, Police, etc.);
- C-spine (and/or C-collar)
Initial Assessment: G-CAAT -
- General Impression;
- Chief Complaints, Life Threats (hemorrhage);
- AVPU;
- ABC's (airway, breathing, circulation);
- Transport Decision (Load and Go or Stay and Play)
Components of General Impression -
ASSS-FLOP-VD:
- Apparent state of health;
- Skin color, obvious lesions;
- Signs of distress;
- Sexual development;
- Facial expressions;
- Level of consciousness;
- Odors;
- Posture, Motor, Gait;
- Vital statistics;
- Dress, Grooming, Hygiene
Components of AVPU -
- Alert;
- responds to Verbal stimuli;
- responds to Painful stimuli;
- Unresponsive
Secondary Assessment: OPQRST-I -
especially for Respiratory and Cardiac patients:
- Onset;
- Provocation/Palliation;
,- Quality;
- Radiation;
- Scale/Severity;
- Time;
- Interventions
What is OPQRST? -
a mnemonic for remembering the questions to ask when assessing the patient's chief
complaint or major symptoms
Onset -
- When and how did the symptom begin?
- Ask the patient if the onset was sudden or gradual.
- Also determine if the onset was associated with a particular activity.
Provocation/palliation: -
- What makes the symptom worse?
- What makes the symptom better?
Quality -
How would you describe the pain?
Radiation -
- Where do you feel the pain?;
- Where does the pain go?
Scale/Severity -
- On a scale from 0 to 10, with 10 being the worst.
- How bad is the symptom?
Time -
- Determine if the symptom has been present for minutes, hours, days, weeks, months,
or years;
- The length of time the symptoms are present is important to document
Secondary Assessment: SAMPLE -
- Signs and Symptoms (history of present issues);
- Allergies;
- Medications;
- Past Medical History, Pertinent Negatives;
- Last Oral Intake;
- Events (leading to present: trauma or medical)
Secondary Assessment: V-FITD -
- Vital Signs, baseline (VS);
- Focused Physical Exam (performed);
,- Interventions (RX's per medical direction, etc.);
- Transport (re-evaluate decision);
- Detailed Physical Exam (verbalized);
Order of Initial Assessment -
- B-SMNAC;
- G-CAAT;
Order of Secondary Assessment -
- OPQRST-I;
- SAMPLE;
- V-FITD
S1 -
"Lub"
Caused by the closing of the Mitral (Bicuspid) and Tricuspid atrioventricular valves.
S2 -
"Dub"
Caused by blood closing the semilunar valves (aortic and pulmonic).
S3 -
"Ta"
Oft referred to as the galloping heart, caused by blood sloshing around in a compliant
left ventricle.
S4 -
A rare noise in the middle of "lub," caused by a failing left ventricle and best heard in the
cardiac apex.
Ta-LUB-dub, ta-LUB-dub
Septum - 2 Sub Types -
Separates the two halves of the heart.
Interatrial and Interventricular
NSAID -
Nonsteroidal Anti-inflammatory Drug
Antipyretic Agent -
Inhibits Prostaglandins
Acts on hypothalamus, heat regulation center.
Vasodilation & Sweating
Platelet Inhibitor -
Prevents formation of thromboxane A2
, Decreased Afterload Effects -
Decreased Arteriole Pressure = Decreased Aortic Pressure = Left Ventricle Works
Better
Decreased Preload Effects -
1. Venous Dilation = Decreased Preload = Decreased Heart Size
2. Decreased Heart Size = Increased Blood Flow to Coronary and Collateral Vessels =
Myocardial Perfusion is Improved
A parasympatholytic drug blocks the effects of the parasympathetic nervous system by?
-
Binding to receptors and blocking the release of acetylcholine.
Sympathetic Nervous System - Other Name -
Adrenergic Nervous System
Medications typically administered via the subcutaneous route? -
Insulin
Epinephrine
Which of the following is NOT a form of liquid drug? -
Capsule
Which of the following physiologic responses would you expect to occur following
administration of a drug that possesses alpha-1 (α1) properties? -
Peripheral Vasoconstriction
The function of a drug or the particular action of a drug on an organism is called: -
Mechanism of Action
Cushing's Reflex (Define) -
Attempt by the body to compensate for a decline in cerebral perfusion by increasing the
mean arteriole pressure.
Cushing's Triad -
SxS of Increased Intracranial Pressure
Increased Systolic Pressure
Widened Pulse Pressure
Decreased Pulse and Respiratory Rate
PAT: Pediatric Assessment Triangle -
General Appearance
Work of Breathing
Circulation to the Skin
TICLS -
