SPRING 2023 FINAL REVIEW

AMA- Against Medical Advice Negligence- Failure to provide same care that a person with similar training would provide Breach of duty- When the EMT does not act within an expected and reasonable Standard of Care Liability - the state of being responsible for something, especially by law. HIPAA - (Health Insurance Portability and Accountability Act) Protects information that can be used to identify the patient, such as Name Confidentiality- the state of keeping or being kept secret or private. DNR- (Do Not Resuscitate) Written documentation by physician giving permission to medical personnel not to attempt resuscitation in event of cardiac arrest. USUALLY SIGNED BY PATIENT AND PHYSCIAN POLST- Physician orders for Life-Sustaining Treatment. Paper describing acceptable interventions for patient Abandonment- Termination of care without patient consent and transferring of care to another medical professional. • Define mandated reporter & what cases is the EMT obligated to report [pg.92] Situations when you are legally mandated to report your findings. Some cases would be child abuse, elderly abuse, self harm, etc. • List & explain the definitive signs of death [pg.95-96] Obvious mortal damage- For example, decapitation Dependent lividity- Blood settling to the lowest point of the body, causing discoloration of the skin Rigor Mortis- Stiffening of body muscles caused by chemical changes in muscle tissues (2-12 hours) Algor Mortis- Cooling of the body until it matches the ambient temperature Putrefaction- Decomposition of body tissues usually between 40-96 hours • What makes a DNR valid? [pg.93] 1) Clear statement of the patient’s medical problems 2) Signature of the patient or legal guardian 3) Signature of one (or more) physicians or other licensed health care provider 4) SOME STATES, DNR have expiration dates. Must be dated in the preceding 12 months to be valid Chapter 4 – Communications & Documentations (6) • List general guidelines for effective radio communication [pg.153 TABLE 4-10] Far too much to list all, but KEY points would be, 1) Ensure clear frequency before speaking 2) Simplicity 3) Speak in clear calm voice 4) Hold mic 2-3 inches away 5) acknowledge transmission asap, 6) Don’t use names • Radio frequencies are assigned by? [pg. 150] The Federal communications commission (FCC) allocate specific radio frequencies for use by EMS providers • Acceptable forms of documentation [pg.139] Acceptable forms are Patient Care Report (PCR) or ePCR (electronic patient care report) • What dispatch obtains from the caller to relay to EMS [pg.152] 1) Nature and severity of the injury, illness, or incident. 2) Exact location of the incident 3) Number of patients 4) Responses by other public safety agencies 5) Special directions or advisories 6) Time at which the unit or units are dispatched • What should and should not be included in a radio call-in & verbal report [pg.132,154-156] Too much info, but KEY points would be 1) Patient name may be stated in verbal report, but NOT radio call-in 2)Never use codes with medical control call-ins 3) repeat order, word by word, with medical control call-in • How are mistakes on PCRs fixed? [pg.142 FIGURE 4-13] If you make a mistake on a hand written report, the proper way to correct it is to draw a single horizontal line through the error, initial it, and write the correct information next to it. Chapter 5- Medical Terminology (5)

A depressed fontanelle may indicate dehydration where as a bulging fontanelle is often a sign of increased intracranial pressure. • Age ranges that the fontanelles fuse The posterior fontanelle fuses by 3 months. The anterior fontanelle fuses between 9 and 18 months of age. • What is important to each age group? [I honestly just got this from a mix of google and the book] • Stressors in early adulthood & late adulthood [pg.263-265 & 268] (included Middle Adulthood as well) Early Adulthood: “Settling down”, getting married starting a family, and striving for career achievements. Middle Adulthood: Pressure to accomplish their professional and relational goals, need to adjust after adult children leave home, and worries that come with assessing whether they will have the financial means to retire Late Adulthood: Financial stress from healthcare cost, realization of their mortality, and sometimes no social support which increase isolation/depression • Review Vitals/HR/RR/Temp Chart [pg.254]

1) Probe- Look or ask to confirm the problem or make sense of situation 2) Alert -Communicate problem to team leader, 3) Challenge -If issue is not corrected, challenge team’s current course of action 4) Emergency -If the problem is clear and critical, communicate emergency with entire team. Chapter 10 - Patient Assessment (18) • Define Golden Hour & Platinum 10 [pg.364 FIGURE 10-16] The Golden Hour is the time from injury to definitive care The Platinum 10 is the initial assessment, intervention and packaging of patient. • Differentiate between Sign vs. Symptom & give an example of each [pg.342] A symptom is a subjective condition the patient feels and tells you about, while a sign is an objective condition you can observe or measure about the patient. Example would be a headache, and then the blood pressure. • What is included in the general impression [pg.351] Age, Sex, weight, Level of distress, Overall appearance/hemorrhages • What is included in the reassessment? [pg.405,406] 1) Perform a reassessment at regular intervals during the assessment process, 2) repeat the primary assessment 3) reassess vital signs 4) reassess the chief complaint, 5) recheck interventions, 6) identify and treat changes in the patient’s condition, 7) Reassess patient (stable 15 unstable 5) • How fast should a rapid exam be performed? [pg.361] No more than 90 seconds • In trauma, what is assessed in the neck & chest? [pg.383] Airway obstruction, as well as JVD, breath sounds, and respiratory rate • What does off-set pressure mean? [Can’t find ☹ ] A motion with hands on each side of a extremity, and with hands being off set from each other, apply pressure • What categories make up GCS? What is the lowest number a patient can score and the highest number? [pg.395 TABLE 10-8] Eye opening, Best verbal response, and Best motor response, with 15 being the highest and 3 is at the lowest • What does a full set of vitals include? [Actually using our vitals sheet as reference :p] Blood pressure, pulse, respiration, Lung sounds, skin (color, temp, moisture) capillary refill, and pupils • Know the average respiratory rate & pulse rate for an adult [Vitals sheet again] 12-20 for respiration, and 60-100 for an adult • Know the normal range for an SPO2 [Gotta read that vitals sheet] 94-100% • Know the different kinds of skin signs & what they mean (color, moisture, & temp) [Vitals sheeeet] Cyanosis-blue, jaundice-yellow, pale-white, flushed-red; cool, warm, hot; diaphoretic- wet, normal or dry • Differentiate between an immediate & delayed cap refill [Vitals Skill to pay the bills…sheet] Immediate is less than 2 seconds, while delayed is more than 2 seconds • What does the acronym PERRL mean? [pg.396] Pupils, Equal, And, Round, Regular in size, React to light • When should a stable vs. unstable patient be reassessed? [pg.364] Stable patient should be reassessed every 15 minutes while an unstable should be every 5 min Chapter 11 – Airway Management (25) • List the upper airway structures [pg.418-420] Nose, Mouth, Oral cavity, Pharynx, Larynx • List the lower airway structures [pg.420-422] the trachea, lungs, the bronchi, bronchioles, and alveoli. • What is the dividing structure of the upper & lower airway? [pg.420] The Larynx marks where the upper airway ends and the lower airway begin.

Drug/Dose- What is the drug name and how much do you need to give? Integrity- Does the drug or device that you are going to use to deliver the medication look like it is functional. If a needle is bent, or a sealed bag or container is open, it should not be used. Clarity- Medications should be clear and free of floaters. If it is not or looks suspicious, that’s a no-no Expiration- Look at the expiration date, if it has expired it is not appropriate for patient use. • Know MOA, Indication, Contraindication, Side Effects, Route, & Dose of all medications [pg.508 & 833] Activated Charcoal Binds to specific toxins & prevents absorption Ingestion of certain toxins, usually pills ALOC, inability to swallow, and certain poisons PO Constipation, black stool, possible vomit in which the dose would be repeated ??? 1g per KG of bodyweight Adult dose 30g-100g Peds dose 15-30g Patient must be awake, have control of airway, and be able to follow commands Chapter 13 – Shock (4)

• Types of Medical Emergency & Examples of Conditions [pg.605 TABLE 15-1] Types Related condition Respiratory Asthma, emphysema, chronic bronchitis Cardiovascular Heart attack, Congestive heart failure Neurologic Seizure, stroke, syncope Gastrointestinal Appendicitis, diverticulitis, pancreatitis Urologic Kidney stones, bladder infection, Endocrine Diabetes mellitus Hematologic Sickle cell disease, hemophilia Immunologic Anaphylactic reaction Toxicologic Substance abuse, food/plant/chemical poison Behavioral Alzheimer disease, schizophrenia, depression, suicide Gynecologic Vaginal bleeding, STD, pelvic inflammatory disease, ectopic pregnancy • MOI & NOI [pg.346] 1) Mechanism of injury -The forces, or energy transmission, applied to the body that causes injury. 2) Nature of illness - The general type of illness a patient is experiencing • Differentiate between Epidemic & Pandemic [pg.613,614] 1) Epidemic- Occurs when new cases of disease in a human population substantially exceed the number expected based on recent experience 2) Pandemic- An outbreak that occurs on a global scale • Define & cause of infectious disease, communicable disease, Influenza (H1N1, MERS, SARS), Hepatitis, Meningitis, TB, Whopping Cough (Pertussis), Ebola, & MRSA [pg.613-620 with TABLE 15-2] 1) Infectious disease- A medical condition caused by the growth and spread of small, harmful organisms within the body 2) communicable disease - A disease that can be spread from one person or species to another 3) Influence - A virus that has crossed the animal/human barrier and kills thousands annually 4) Meningitis - Inflammation of the meningeal covering of the brain and spinal cord, caused by virus or bacterium 5) Whooping cough - Also called pertussis, airborne diseases caused by bacteria that mostly affects children younger than six 6) Ebola -Disease that started in west Africa with a near 70% fatality rate 7) Tuberculosis - Chronic bacterial diseases that usually affects the lungs but can affect other organs. Spread by cough 8) MRSA - AKA Methicillin-resistant Staphylococcus aureus, Bacterium that causes infection in different parts of body and resistant to antibiotics. Type Route of infection Incubation time Chronic? Vaccine Treatment Hep A Fecal-oral, infected food 2-6 wk No Yes/life immunity no specific treatment Hep B Blood, sexual contact, body fluids 4-12 wk 10% of patients Yes minimally effective Hep C Blood, sexual contact 2-10 wk 90% of patients No costly but effective Hep D Blood, sexual contact 4-12 wk common No no specific treatment Chapter 16 - Respiratory Emergencies (5) • List everything on the Albuterol medication sheet (MOA, Indication, Dose, etc.) Refer to picture above in this study guide on CH 12 Pharma. • Define upper & lower airway sounds & when each would be heard (conditions) [pg.650,651 TABLE 16-5]

Brainstem-Controls most basic functions of body such as breathing, blood pressure, swallowing, pupil constriction. Cerebellum- Controls muscles and body coordination; responsible for coordinating complex tasks that involve many muscles such as walking, writing, playing piano, etc. Cerebrum- Largest part of brain, divided into right and left hemispheres, each controls activities on the opposite side of the body. • What does AEIOU TIPS stand for? [pg.736] A lcohol E pilepsy, Endocrine, Electrolytes I nsulin O piates, and Other drugs U remia (Kidney failure) T rauma I nfection P oisoning, psychogenic causes S hock, Stroke, Seizure, Syncope(passing out), Space-occupying lesion, Subarachnoid hemorrhage •Different signs and symptoms of a stroke effecting the right versus the left hemisphere? [pg.730] Left Side Symptoms/Signs Right Side Symptoms/Signs Aphasia (inability to produce or understand speech; speech disorder) Neglect: Patient may be oblivious to problems and body compensates. (Ask to lift left arm, right arm raises instead) Paralysis on right side of body Paralysis on left side of body Speak Clear, trouble understanding Speak slurred, able to understand Back side may affect vision, but body will compensate and will be hard to tell on field. •List the different types of strokes & their causes [pg.728-730] Ischemic stroke Hemorrhagic stroke Transient ischemic attack (TIA) Most common, accounting for 87% of all strokes Accounts for 13% of strokes About 1/3 of patients who have a TIA will experience a stroke soon after. Occurs when blood flow to a specific part of the brain is stopped by a blockage (blood clot) inside a blood vessel. Occurs when blood vessel ruptures, leading to blood clot which compresses brain tissue Same cause as others strokes (atherosclerosis/clot in brain) but difference is last 24 hours or less Blood clot can be caused by Thrombosis, Embolus, and Atherosclerosis Things that increase risk are stress, exertion, extremely high blood pressure/long term untreated hypertension, No actual deaths of tissue occur, however still treat as emergency. •How should the EMT preform a stroke assessment [pg.741-pg.745 reference Tables] A part of the secondary assessment, Stroke scales evaluate the face, arms, and speech. BE-FAST mnemonic, The Cincinnati Prehospital Stroke Scale and the Los Angeles Prehospital Stroke Screen, 3-Item Stroke Severity Scale (LAG) {Level of consciousness, Arm drift, Gaze} Los Angeles Motor Scale (LAMS) Facial droop (Absent=0 Present=1) Arm Drift (Absent=0 Slow drift=1 Rapid Fall=2) Grip strength (Normal=0 Weak grip=1 No grip=2)

• Define parietal peritoneum & visceral peritoneum & what they line in the abdominal cavity [pg.758] The abdominal cavity is lined by a membrane called the peritoneum. The peritoneum also covers the organs of the abdomen. Parietal peritoneum: lines the walls of the abdominal cavity Visceral peritoneum: covers the organs • List organ locations & functions [Whole chapter] Just going to list the notable organs in chapter. LEFT SIDE SOLID RIGHT SIDE HOLLOW Organ Function Stomach main organ of the digestive system. Gastric juices break down food. liver assists in digestion. Secretes bile Filters toxic substances produced by digestion. Creates glucose stores Produces substances necessary for blood clotting and immune function gallbladder reservoir for bile. small intestine helps to further digest food coming from the stomach. Consists of three sections: Duodenum Jejunum & Ileum Colon (large intestine) Food not broken down and used moves into the colon as waste product. Water is absorbed and stool is formed. kidneys Controls discharge of certain waste materials filtered from blood • List the digestive Process [Pg.756-757] Digestion begins when food enters mouth  salivary glands break down food  Travels through esophagus to stomach  stomach then breaks down food with gastric juices  Food then travels down into small intestine where it goes through three parts in this order. Duodenum Jejunum Ileum . (DJI)  Food not broken down is then pushed into the large intestine which converts it to stool  which passes through the rectum  and out the anus . • Differentiate between all the gastrointestinal & urologic conditions [pg.760-765] Complication Define Ulcers protective layer of the mucous lining erodes, allowing acid to eat into the

organ Gallstones May form and block the outlet from the gallbladder Pancreatitis inflammation of the pancreas Appendicitis inflammation or infection in the appendix Gastrointestina l hemorrhage Symptom of another disease, not a disease itself, May be acute or chronic Esophagitis lining of the esophagus becomes inflamed by infection or acids from the stomach Also called GERD Esophageal varices Amount of pressure within blood vessels surrounding the esophagus increases, frequently as a result of liver failure. Mallory-Weiss syndrome: junction between the esophagus and the stomach tears Gastroenteritis Infection combined with diarrhea, nausea, and vomiting Diverticulitis Fecal matter becomes caught in the bulges, allowing bacteria to collect, and resulting in inflammation and infection. Hemorrhoids created by swelling and inflammation of blood vessels surrounding rectum Cystitis (UTI) bladder inflammation Hernia Protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong • What is referred pain & give an example [pg.760] Referred pain is the results from the connection between the body’s two separate nervous systems. Example ; Acute cholecystitis may cause right shoulder pain because the autonomic nerves serving the gallbladder lie near spinal cord at the same anatomic level as the spinal sensory nerves that supply the skin of the shoulder. Chapter 20 – Endocrine & Hematologic Emergencies (9) • What two hormones play a major role in glucose metabolism? [pg.779] Glucagon & Insulin • Define the function of the endocrine system [pg.778-779] The endocrine system is a communication system that controls functions inside the body by the release of hormones into the bloodstream. • What is the average glucose reading? [pg.783] Normal blood glucose level is between 80 & 120 mg/dL • Differentiate between hypoglycemia & hyperglycemia [pg.780] Hypoglycemia- An abnormally low blood glucose level Hyperglycemia- An abnormally high blood glucose level • List everything on the Glucose medication sheet (MOA; Indication; Dose; etc.) [pg.508 TABLE 12-4] REFER TO PICTURE IN THIS STUDY GUIDE FROM CH.12 • Differentiate between DM Type 1 & 2 [pg.782-785] Type 1 Diabetes An autoimmune disorder in which the immune system produces antibodies against the pancreatic beta cells; Missing the pancreatic hormone insulin Type 2 Diabetes Caused by resistance to the effects of insulin at the cellular level Obesity predisposes patients to type 2 diabetes. The pancreas produces more insulin to make up for the increased levels of blood glucose and dysfunction of cellular insulin receptors. • Differentiate between DKA & HHNS [pg.783 & 785] DKA (Diabetic KetoAcidosis)- Form of hyperglycemia in uncontrolled diabetes in which certain acids accumulate when insulin is not available.

HHNS (Hyperosmolar Hyperglycemic nonketotic syndrome) - Life threatening condition resulting from hyperglycemia that typically occurs in older adults and which causes altered mental status, dehydration, and organ damage • List & functions of the four components of blood. [pg.793] Erythrocytes (Red blood cells) Contain hemoglobin, which carries 97 % of the oxygen in the blood; Makes up 42%-47% of blood. Leukocytes (White blood cells) Respond to infection and collect dead cells for their correct disposal; Makes up 0.1%-0.2% of blood Platelets- Assist in forming a clot to stop bleeding; Makes up 4%-7% Plasma - Serves as the transportation medium for blood components, proteins, and mineral; Makes up 55% of blood • Define & complications of sickle cell disease, hemophilia, thrombophilia, & DVT [pg.793-796] Sickle cell disease- An inherited blood disorder that affects Red Blood Cells (RBC) Found predominantly in people of African, Caribbean, and South American ancestry Sickle cell disease cause misshapen RBCs that lead to dysfunction in oxygen binding and unintentional clot formation. Sickled cells have a short life span, resulting in more cellular waste products in the bloodstream and contributing to sludging (clumping) of the blood. Complications associated with sickle cell disease include: Anemia Gallstones Jaundice Splenic dysfunction Vascular occlusion with ischemia The patient is also more susceptible to infections. Hemophilia Rare: only about 20,000 Americans have the disorder. Hemophilia A affects mostly males. People with hemophilia A have a decreased ability to create a clot after an injury Patients with hemophilia A can be prescribed medications to replace missing clotting factors, release stored clotting factors, or prevent the breakdown of blood clots. Complications Long-term joint problems Bleeding in the brain Thrombosis due to treatment Thrombophilia A disorder in the body’s ability to maintain the smooth flow of blood through the venous and arterial systems Thrombophilia is a general term for many different conditions that result in the blood clotting more easily than normal. Results from either inherited (genetic) disorders, medications or other factors Patients with cancer are at an increase risk Complications Clots can spontaneously develop in the blood of the patient. Deep vein thrombosis (DVT) A common medical problem in sedentary patients and in patients who have had recent injury or surgery Complications A clot from DVT can travel from the patient’s lower extremity to the lung, causing a pulmonary embolus Chapter 21 – Allergy & Anaphylaxis (6)  Signs and symptoms of anaphylaxis [[pg.805-806] o Signs  Urticaria (hives)  Angioedema (localized swelling)  Wheezing  Stridor may be heard on inspiration if there is upper airway narrowing.  Hypotension due to vasodilation may occur, as well as increased capillary permeability. o Symptoms  Nausea

 Vomiting  Abdominal cramps.  Know epinephrine: MOA, Indication, dosage (peds and adults), route, etc. [pg.508 TABLE 12-4] o REFER TO PICTURE IN THIS STUDY GUIDE FROM CH.12  Understand the properties of Epi (Alpha, Beta 1, & Beta 2) [pg.219 TABLE 6-9] All part of Sympathetic nervous system Receptor Stimulation area Effect when stimulated Alpha-1 Blood vessels Constricted blood vessels; skin becomes pale, cool, clammy Beta-1 Heart Increase heart rate Increased force of heart contraction Beta-2 Lungs Bronchodilation  Differentiate between an allergen & antibody [pg.804] o Allergen  A substance that causes an allergic reaction o Antibody  a blood protein produced in response to and counteracting a specific antigen  Which antibody is responsible for the immune response of an allergic reaction? [pg.804 & google] o Immunoglobulin E (IgE) is the antibody that releases a chemical called histamine o Also leukotrienes contribute to allergic reaction  List the common allergens [pg.806] o Food  Certain foods (shellfish, peanuts) may be the most common trigger of anaphylaxis. o Medication  The second most common source of anaphylactic reactions  Antibiotics  Nonsteroidal anti-inflammatory agents  If the medication is injected, the reaction may be immediate (within 30 minutes) and severe.  Reactions to oral medications may take more than 30 minutes to appear, but can also be very severe. o Plants  Dusts, pollens, and other plant materials can cause a rapid and severe allergic reaction.  Common plant allergens include ragweed, ryegrass, maple, and oak. o Chemicals  Certain chemicals, makeup, soap, hair dye, latex, and various other substances can cause severe allergic reactions.  Latex is of particular concern to health care providers. o Insect bites and stings  Envenomation: the process of an insect injecting its venom  The reaction can be localized or may be severe and systemic. Chapter 22 – Toxicology • Differentiate between toxicology, poison, & toxin [pg.822] Toxicology- The Study of toxic or poisonous substances Poison- Any substance whose chemical action can damage body structure or impair body function Toxin- A poison substance produced by bacteria, animal, or pants • List the four routes’ poisons can enter the body [pg.824] Inhalation Absorption Ingestion Injection • Effects of poison depends on what? [Google?!?] The Substance, Amount, and type of contact • What questions would the EMT ask a patient that has overdosed? [pg.832]

What is the substance involved? When did the patient ingest or become exposed to the substance? How much did the patient ingest or what was the level of exposure? Over what period did the patient take or was the patient exposed to the substance? Has the patient or a bystander performed any intervention? Has the intervention helped? How much does the patient weigh? • List everything on the Activated Charcoal & Narcan medication sheet o REFER TO PICTURE IN THIS STUDY GUIDE FROM CH.12 • Treatment for inhaled poisons & carbon monoxide [pg.826-827] Move to fresh air, remove clothing, Be prepared to use supplemental oxygen via a nonrebreathing mask and/or ventilatory support with a bag-mask device, if necessary Make sure a suctioning unit is available in case the patient vomits. • What are sympathomimetics? [pg.839-840] CNS stimulants that mimic the effects of the sympathetic nervous system. Examples including Cocaine, Ecstasy, Methamphetamine • What does the opiate triad consist of? [poyo!] pinpoint pupils, unconsciousness, and respiratory depression • Treatment for dry material, liquid material, & chemical agents in the eyes [pg.827-828] If dry powder has been spilled, brush off the powder, then flood the area with water for 15 to 20 minutes, then wash skin with soap and water. If liquid has been spilled onto the skin, flood for 15 to 20 minutes. If a chemical agent is introduced to the eyes, irrigate them quickly and thoroughly. • Define DUMBLES & SLUDGEM [pg.842] D iarrhea U rination M iosis, muscle weakness B radycardia, bronchospasm, bronchorrhea E mesis L acrimation S eizures, Salivation, Sweating S alivations, Sweating L acrimation U rination D efecation, drooling, diarrhea G astric upset and cramps E mesis M uscle twitching/miosis • Define DTs & when after how many days of not drinking are they seen? [pg.835] A patient in alcohol withdrawal may experience frightening hallucinations called delirium tremens (DT) Occur about 1-7 days after a person stops drinking.

Chapter 23 – Behavioral Health Emergencies • When should you assess PMSC when applying restraints to a patient? [pg.861] I couldn’t really find much detail, but the closest I got was after the restraints are applied, every 5 min • What is excited delirium? [pg.864] A serious behavioral condition in which a person exhibits agitated behavior combined with disorientation, hallucinations, or delusions. • Organic brain syndrome vs. functional [pg.857] Organic brain syndrome- a temporary or permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain tissue . Causes: Sudden illness, Traumatic brain injury, Seizure disorders, Drug and alcohol abuse, overdose, or withdrawal, Diseases of the brain, such as Alzheimer disease and meningitis Functional disorders - A physiologic disorder that impairs bodily function when the body seems to be structurally normal. Examples: schizophrenia, anxiety conditions, depression • List key techniques when assessing a psychiatric patient [pg.858-859] -Begin your assessment from the doorway or from a distance. Perform a rapid physical exam; look for any signs of trauma. Observe the patient’s behavior closely. Use the APVU scale to check for alertness, Establish a rapport with the patient and family members. Most medical or trauma situations will include a behavioral component. Unless the patient is unstable from a medical problem or trauma, prepare to spend time at the scene with the patient. • Define reflective listening, what it involves, & what it encourages? [pg.860] Reflective listening is a technique frequently used by behavioral health professionals to gain insight into a patient’s thinking. It involves repeating in question form, what the patient has said, encouraging the patient to expand on his or her thoughts. • Difference between 5150 and 5250 [Found off of the interwebs] 5250 holds are an extension of a 5150 hold. While 5150 holds can only last up to 72 hours, 5250 holds can include up to 14 days of involuntary mental health treatment. • Define PTSD & signs and symptoms [pg.871] Posttraumatic stress disorder is a delayed reaction to a prior incident. Often the result of one or more conditions concerning the incident. S&S are feeling of helplessness, anxiety, anger, and fear. Also people avoiding things that remind them of the trauma. Chapter 24 – Gynecologic Emergencies • GYN Anatomy & Physiology [pg.882-883] External female genitalia; Vaginal opening, Labia majora and labia minora, Clitoris , Perineum Internal structures; Ovaries lie on each side of the lower abdomen and produce an ovum (egg), Fallopian tubes connect each ovary with the uterus, The uterus is the muscular organ where the fetus grows during pregnancy, The narrowest part of the uterus is the cervix , which opens into the vagina, The vagina is the outermost cavity of a woman’s reproductive system.

• Menstruation, Menarche, & Menopause [pg.883] Menstruation : the process in a woman of discharging blood and other materials from the lining of the uterus. Menarche : ( onset of menstruation) usually occurs between age 11 and 16 years. Any female who reaches menarche is capable of becoming pregnant. Menopause: The end of menstrual activity usually occurs around age 50 years. • Differentiate between pelvic Inflammatory Disease, Chlamydia, Bacterial Vaginosis, Syphilis, HIV, & Gonorrhea [pg.884-885 & google] Condition Define Pelvic inflammatory disease (PID) Infection of the fallopian tubes and the surrounding tissues of the pelvis Chlamydia Most common STD in the United States; Infection of the cervix can spread to the rectum and can progress to PID. Bacterial vaginosis The most common vaginal infection to afflict women ages 15–44 years; Overgrowth f bacteria in the vagina Gonorrhea An STD that causes severe infections present with cramping and abdominal pain, nausea, vomiting, and bleeding between periods. syphilis a chronic bacterial disease that is contracted chiefly by infection during sexual intercourse HIV HIV (human immunodeficiency virus) is a virus that attacks the body's immune system • What causes PID & what is a distinct characteristic? [pg.884] Pelvic inflammatory disease (PID) is an Infection of the upper organs of reproduction that occurs almost exclusively in sexually active women. Causes/Risk factors are multiple sex partners and/or a partner who has had multiple sex partners, Untreated sexually transmitted disease, Past history of PID, Being sexually active, Younger than 26 years of age, Douching, Using an IUD for birth control • What is the most common STD? [pg.885] Chlamydia • Treatment for sexual assault patients [pg.890-892] Medical treatment of patient, Psychological care of patient, & Preserve evidence. Take the patient’s history and limit any physical examination to a brief survey for life-threatening injuries. Chapter 25 - Trauma Overview • Where should the ambulance be parked when there are no apparent hazards & When there are apparent hazards? [pg.1439] If there is no apparent hazards, park 100ft beyond the scene, with vehicle facing towards the exit. If there is apparent hazards, park uphill/upwind of the scene if smoke or hazardous materials are present. Park 100 ft before the scene to prevent your vehicle from being blocked in and park where vehicle is facing towards the exit • Differentiate between injury patterns for collapsed/bent steering wheel, shattered windshield, head on collision (up & over vs. down & under), rear end collision, sideimpact collision, roll over collision, rotational impact collision, & car vs. pedestrian [pg.904-912]

MOI Injury Pattern Collapsed/bent steering wheel Serious chest and abdominal injuries Shattered windshield Head and spinal injuries head on collision Injuries from Seatbelt and airbags such as chest, face, head. Rear End Collision Whiplash-type injuries Side Impact Collision Lateral chest and abdomen injuries on the side of impact Roll over collision Most common life-threat is if ejection of passenger Rotational Impact collision Similar to rollover but also including object that car strikes Car vs Pedestrian Often graphic and serious unseen injuries • Height of falls (adult vs. ped) & important information to gather about the fall [pg.913 Adults: 20 ft Peds: 10 ft (or 2-3 times their height) The height of the fall, the type of surface struck, and the part of the body that hit first, followed by the path of energy displacement • Differentiate between penetrating trauma vs. blunt force trauma [pg.931] Blunt Trauma- An impact on the body by objects that cause injury without penetrating soft tissues or internal organ and cavities Penetrating trauma -Injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs • What constitutes for a significant MOI? [pg.904] Injuries to more than one body system, such as fall from heights, motor vehicle, GSW • Define low velocity, medium velocity, & high velocity and given an example of each [pg.913-915] Low velocity Knife Medium Velocity Handgun High Velocity Assault Rifle • Define cavitation [pg.914] Cavitation- Phenomenon in which speed causes a bullet to generate pressure waves, which cause damage distant from the bullet’s path

• Define primary, secondary, tertiary, & quaternary blast injuries • Differentiate between Level 1 & 2 Trauma Centers [pg.923]

• Differentiate between Level 3 & 4 Facilities Refer to picture above • Differentiate between GCS & RTS, when they are used & what categories are involved List common abbreviations [pg.926]

Chapter 26 – Bleeding (10) • Differentiate between arteries, veins, & capillaries [pg.211-214] Arteries carry rich oxygenated blood away from heart, to tissues eventually leading to capillaries where the blood becomes oxygen poor, and returning back to the heart via veins • What is the blood vessel pathway from the heart? [pg.935] Aorta  arterioles  Capillaries  venules  Veins  back to heart • Differentiate between perfusion & hypoperfusion [pg.936,937] 1) Hypoperfusion- Condition in which circulatory system fails to provide sufficient circulation to maintain normal cellular function, aka SHOCK 2) 2) perfusion – Circulation of blood within an organ or tissue in adequate amounts to meet current needs of cells • Death time for brain cells, spinal cord, lungs, & kidneys [pg.937] Body part Death time Brain cells 4-6 minutes without perfusion spinal cord 4-6 minutes without perfusion lungs 15-20 minutes without perfusion kidneys 45 minutes without perfusion Skeletal Muscles 2-3 HOURS • What is a significant amount of blood loss for an average adult and a child? [pg.938+ class notes] Significant blood loss for an adult would be 20% of total blood volume, or about 2 pints (1 Liter) For a child,10% For an infant 100-200 ml

• What are various causes of internal bleeding and signs/symptoms? [pg.940,941] Causes of internal bleeding would be high-energy MOI such as blunt or penetrating force. Signs/symptoms would be pain, hematemesis (vomit blood) melena, (blood in stool) , bruising, guarding, swelling, tenderness. • What is a hemostatic agent? [pg.946] Usually paired with hemostatic dressing, it is a chemical compound that slows or stops bleeding by promoting clot formation • Where would a tourniquet be applied in reference to an injury? [pg.949] Proximal to the injury • What does the halo test indicate? [pg.1028] If cerebrospinal fluid (CSF) is present within blood from injury (usually blood comes from ear). • Differentiate between arterial, venous, and capillary bleeding [pg.939 FIGURE 26-7A] 1) Arterial bleeding is usually bright red and spurts with pulse 2) Venous bleeds darker and flows steadily 3) capillary bleeding is dark red and oozes form wound slowly but steadily Chapter 27 – Soft Tissue Injuries (9) • What are the three main layers of the skin? [pg.963 FIGURE 27-1] Epidermis, Dermis, and subcutaneous tissue • What are the signs and symptoms of compartment syndrome? [pg.1192] Signs and Symptoms of compartment syndrome would be pain out of proportion to injury, pain on passive stretch of muscles within compartment, altered sensation, pallor skin, and decreased power. • Differentiate between closed and open injuries (abrasion, laceration, amputation, etc.) [pg.964-969] Open injuries is where there is a break in the surface of the skin or mucous membrane, exposing deeper tissues to potential contamination Closed injuries are soft-tissue damage beneath ski but surface remains intact Injury Description Contusion Bruise Abrasion Superficial injury caused by friction Laceration Jagged cut in skin, tears tissues Avulsion Injury that separates various layers of soft tissue amputation Body part is severed Penetration Pierced object • How do you treat an evisceration? [pg.978 FIGURE 27-13A] Cover exposed organ with sterile gauze compresses moistened with sterile saline solution, then place an o occlusive dressing over the compresses and secure it in place with tape • What are the two exceptions when you can remove an impaled object? [pg.978] If the object is either in the check/mouth due to breathing obstruction, or object is in chest blocking CPR • How should you treat a neck wound? What are the risks of neck injuries? [pg.980 FIGURE 27-15] Cover neck wound with airtight dressing and apply manual pressure. Be sure to not compress carotid arteries. • Know your burn percentages of child and adult & be able to calculate them [pg.985 FIGURE 27-19]

• What are the different signs and symptoms of 1 st degree, 2 nd degree, and 3 rd burns? [pg.984 [FIGURE 27-18] 1) First degree burn is superficial, only involving the epidermis. Skin turns red and does not blister 2) 2 nd degree burn involves some of dermis, intense pain with blisters and moist 3) 3 rd degree burn all skin layers, charred, and usually non-painful due to nerve damage • What is the rule of palm? [pg.985] Patients palm is equal to about 1% Chapter 28 – Face & Neck Injuries (4) • What are the 6 main bones of the face? [pg.1006] The Nasal Bone, the two axillae, the two Zygomas, and the mandible • What is the iris, pupil, cornea, and retina of the eye? [pg.1008-1009] Iris - The Muscle and surrounding tissue behind the cornea that dilate and constrict pupil. Eye color Pupil- Circular opening in the middle of the iris that admits light to the back of the eye Cornea- The transparent tissue layer in the front of the pupil and iris of the eye Retina- Light Sensitive area of eye where images are projected Sclera - The white of the eye • How to prevent an air embolism with a neck wound [pg.1032[ Apply direct pressure, and apply sterile occlusive dressing to ensure air does not enter a vein • Differentiate between a LA Fort 1, 2, & 3 [google!!!]

Chapter 29 – Head & Spine Injuries (6) • What are the three layers of the meninges? [pg.1042] Dura mater, the arachnoid, and the pia mater The outer layer, the dura mater, is a tough, fibrous layer that forms a sac to contain the CNS. The inner two layers, called the arachnoid mater and the pia mater, contain the blood vessels that nourish the brain and spinal cord • Injury to what parts of the spinal column result in quadriplegia and paraplegia? [pg.1094] Vertebrae, particularly c1-c7 • What are the three main signs/symptoms of Cushing’s Triad? [pg.1063 Increased BP, decrease Heart Rate, and irregular respiration (Cheyne stokes respiration) • Differentiate between decorticate & decerebrate posturing & injuries involved [???+ 1045] Usually head injuries where decorticate is a sign of severe brain damage, where decerebrate is a sign of intracranial pressure

• Differentiate between subdural hematoma, epidural hematoma, & intracerebral hematoma [p.1089] Subdural hematoma - An accumulation of blood beneath the dura mater but outside brain Epidural Hematoma - An accumulation of blood between skull and dura mater Intracerebral hematoma- Bleeding within the brain tissue itself • Signs and symptoms of basilar skull fracture [pg.1047] CSF drainage from nose & ears & raccoon eye Chapter 30 – Chest Injuries (6) • Muscles of ventilation & cervical spinal cord injuries [pg.1092] Intercostal muscles. Injuries at C5 and below bay cause belly breathing Injuries at C3-C5 are nerves that supply the diaphragm • Differentiate & treatment for closed chest injuries, open chest injuries, & impaled objects [pg.1095] Closed Chest injury- Chest injury where the skin is not broken. Open chest Injury- Injury to the chest in which the chest wall itself is penetrated by fractured rib. Impaled Chest Injury- Injury where something is impaled into the chest. Treatment is leaving the object in place, (unless absolutely needing to) securing the object in place, and transport • Differentiate & treatment between pneumothorax, hemothorax, hemopneumothorax, & tension pneumothorax [pg.1102-1106] Pneumothorax- Accumulation of air or gain in pleural cavity. Apply flutter valve if necessary.

Hemothorax- A collection of blood in pleural cavity. Transport Hemopneumothorax- Accumulation of blood and air in pleural space in chest. Transport Tension Pneumothorax- Accumulation of air or gas in pleural cavity that progressively increases pressure in chest that interferes with cardiac function Apply occlusive dressing and open on one side • What are the three main signs and symptoms of Beck’s Triad? [pg.1106] JVD, narrowing pulse, and muffled heart sounds • Differentiate between subcutaneous emphysema, flail chest & paradoxical motion.[pg.921 & 1098 & 1107 Subcutaneous Emphysema- Air trapped in subcutaneous tissue, producing a crackling sound when palpated Flail chest- Condition in which 3 or more adjacent ribs are fractured in 2 or more places Paradoxical motion- An abnormality associated with multiple fractured ribs in which one segment of the chest wall moves opposite of the rest of the chest. That is out with expiration and in with inspiration, • Differentiate between cardiac tamponade (know the beck’s triad), traumatic asphyxia, & commotio cordis[pg.1109-1112] Cardiac Tamponade- Compression of heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output. Traumatic Asphyxia - An accumulation of air or gas in pleural cavity that progressively increases pressure in chest that interferes with cardiac function Commotio Cordis- Blunt chest injury caused by sudden direct blow to chest that occurs only during critical portion of person heart beat Chapter 31 – Abdominal & Genitourinary Injuries (4) • Define & treatment of eviscerations [pg.1130-1131] Evisceration is an open abdominal wound from which internal organs protrude. Cover the wound with MOISTENED sterile dressing, and occlusive dressing, Secure dressing with bandage/tape & transport • How a AAA occurs [pg.1362] An Abdominal aortic Aneurysm tends to develop in people who have a history of hypertension and atherosclerosis. The Walls of the aorta weaken, and blood begins to leak into layers of vessel, causing the aorta to bulge like a bubble on a tire. • Penetrated or ruptured diaphragm [pg.1124] If the diaphragm is penetrated or ruptured, loops of bowel may herniate into the thoracic cavity. This will cause displace lung and vital capacity causing dyspnea. • Common findings of kidney injuries[pg.1133-1135] Abrasion, laceration, or contusion in flank, Penetrating wound in flank or upper abdomen, fractures on either side of the lower thoracic or upper lumbar vertebrae, and Hematoma in flank

Chapter 32 – Orthopedic Injuries (9) • What are the differences between ligaments, tendons, joints, muscles, strain, sprain, and cartilage? [pg.1197] Ligament s Tissues that connect bone to bone Tendons Extension of Fascia (fibrous tissues, attach skeletal muscle directly to bone Joints Place where two bones come into contact, helps with bending Muscles 3 types of muscles, smooth, skeletal, and cardiac Strain Stretching or tearing of muscle or Tendon Sprain Sprain occurs when a join is twisted or stretched beyond normal range Cartilage Pearly white substance that allows ends of bone to glide easily • Examples of irregular bones, flat bones, long bones, and short bones [Google] Irregular bones mandible, vertebrae, coccyx Flat bones Scapula, rib bones, parts of skull Long Bones Fibula, Femur, Humerus Short Bones Tarsals, carpal bones • Three types of muscles and location [pg.1146-1148] 1) Cardiac muscles- which are found in the heart 2) Skeletal muscles -attaches to bone and usually crosses over a joint 3) Smooth muscles - Intestine muscles • What are the different types of fractures? [pg.1153] Comminute d A fracture in which the bone is broken into more than two fragments Epiphyseal A fracture that occurs in a growth section of a child’s bone and may lead to growth abnormalities Greenstick An incomplete fracture that passes only partway through the shaft of a bone Incomplete A fracture that does not run completely through the bone Oblique A fracture in which the bone is broken at an angle across the bone Pathologic A fracture of weakened or diseased bone generally produced by minimal force Spiral A fracture caused by a twisting force, causing an oblique fracture around the bone and through the bone Transverse A fracture that occurs straight across the bone • Define compartment syndrome, signs & symptoms, and treatment [pg.1192] Compartment syndrome is a limb-threatening condition characterized by localized tissue swelling withing compartment. Signs and Symptoms: Pain out of proportion to injury, Pain on passive stretch of muscles within compartment, altered sensation, pallor skin, and decreased power. Treatment for EMS is splint affected limb, keep it at level of heart, and transport immediately while checking neurovascular status • What are signs/symptoms of a hip fracture/dislocation? [pg.1180] Severe pain, resistance to movement, tenderness on palpation, and the ability to palpate the femoral head deep within the muscles of the buttock

• Use of different types of splints [pg.1165-1168] 1) Rigid (non-formable) splints -made from firm material and are applied to the sides, front, and/or back of an injured extremity to prevent motion at the injury site. 2) Formable splints- You are most likely to use structural aluminum malleable (SAM) splints and vacuum splints. Other examples include air splints, pillow splints, and sling and swathe bandages. A vacuum splint can be easily shaped to fit around a deformed limb. 3) Pelvic binders- Used to splint the pelvis to reduce hemorrhage from bones ends, venous disruption, and pain. • Define PMSCs and when to check them [from Medical and Trauma] PMSC stands for Pulse, Motor, Sensory and Capillary Refill, we check before and after splinting a patient • When splinting, how is it secured? [pg.1166,1167 FIGURE 32-25 & SKILL DRILL 32-2] Secure with soft roller bandages, or any form of binding. Chapter 33 – Environmental Emergencies • What is the difference between conduction, convection, evaporation, radiation, and respiration? [pg.1202] Evaporation - Conversion of liquid to gas. Like boiling water converting to steam Respiration - Causes body heat loss as warm air in lungs is exhaled. • Differentiate between active & passive rewarming [pg.1209] Passive rewarming - Placing the patient in warm environment, removing wet clothes, applying heat packs. Active rewarming - Aggressive strategies to introduce heat such as warm IV fluids, lavage with warm fluids, and rewarming blood outside body before reintroduction. • Define & signs/symptoms of heat cramps, heat exhaustion, and heat stroke [pg.1210-1212] Heat Cramps- Painful muscle spasms that occur after vigorous exercise. S&S are sudden onset of abdominal cramps Heat Exhaustion- Heat emergency in which significant amount of fluid and electrolyte is loss due to heaving sweating. S&S are Dizziness, weakness, syncope, cold, clammy skin with ashen pallor, dry tongue Heat Stroke- Life-threatening condition of severe hyperthermia caused by exposure to excessive heat.

S&S are warm dry skin, severe altered mental status, irreversible coma • Four basic rules of water rescue [pg.1219] Reach, throw, Row, Go • Define & signs/symptoms of air embolism & decompression sickness [pg.1222] Air Embolism- The presence of air in veins which can lead to cardiac arrest. S&S are Blotching, froth at nose, severe pain, dyspnea, Nausea, cough, cyanosis, irregular pulse Decompression Sickness- Painful condition seen in divers who ascend too quickly in which gas forms bubbles in blood vessels. S&S can show up 24-48 hours later being, abdominal or join pain. • Define & reasons for hyperbaric chamber [pg.1223] Hyperbaric chamber – is a chamber that is pressurized to a level higher than the atmospheric pressure, to equalize the patients lung pressure. • Disease the ticks carry [pg.1234] Ticks carry Rocky Mountain spotted fever and Lyme Disease • Define homeostasis [pg.1200 Homeostasis - A balance of all systems of the body Chapter 34 – OB & Neonatal Care • What are the three stages of labor? [pg.1255] The three stages of labor are (1) dilation of the cervix, (2) delivery of the fetus, and ( 3) delivery of the placenta. • Differentiate between the amniotic sac, the placenta, true labor, & false labor[pg.1245 & 1256] Amniotic sac - a fluid-filled, baglike membrane, helps insulate and protect the floating fetus Placenta - The placenta is a disk-shaped structure attached to the uterine wall that provides nourishment to the fetus. • How is supine hypotensive syndrome caused & what is the treatment? {pg.1248}

Caused by compression of the descending aorta and the inferior vena cava by the pregnant uterus when the patient lies supine. Treatment is positioning the patient on her left side • What does the mnemonic APGAR stand for? What is the minimal and maximum score? How often do you assess it? Be able to calculate an APGAR score. [Pg.1269 ] Calculated at 1 min after birth and again at 5 minutes. Score of 7 or higher is generally considered reassuring. • What hormone is released during breastfeeding? [Google] Prolactin and Oxytocin . • What are the signs/symptoms of preeclampsia, abruptio placenta, and placenta previa? [pg.1248-1249] Preeclampsia signs and symptoms are Severe hypertension, Severe or persistent headache, Visual abnormalities such as seeing spots, blurred vision, or sensitivity to light, Swelling in the hands and feet (edema), Upper abdominal or epigastric pain, Dyspnea and/or retrosternal chest pain, Anxiety, Altered mental status Abruptio Placenta signs and symptoms are severe pain and possible signs of shock such as weakness, rapid pulse and pale, cool, diaphoretic skin. Placenta Previa signs and symptoms are Heavy vaginal bleeding when cervix dilates. • What is ectopic pregnancy? [Pg.1249] Ectopic pregnancy, when an embryo develops outside the uterus, most often in a fallopian tube. • What does meconium indicate? [pg.1254 The presence of meconium can indicate newborn distress, and it is possible for the fetus to aspirate meconium during delivery • What are the various complicated birth deliveries? [pg.1270-1273]

Complication Define breech presentation. the buttocks are delivered first, limb presentation. the presenting part of the fetus is neither the head nor the buttocks, but a single arm, leg, or foot Spina bifida A developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly outside of the body Premature birth 8 months (36 weeks) or weighs less than 5 lb. at birth is considered premature. Post term pregnancy pregnancies lasting longer than 41 weeks of completed gestation Fetal demise Fetus died • What is rescue breathing for a neonate? [pg.1266] If signs of good tone and adequate ventilation are NOT present after approx. 30 seconds, then positive-pressure ventilation with a BVM may be necessary. • What is neonate resuscitative compression ratio? When do start compressions on a neonate? [pg.1267] Perform bag-mask ventilation during a pause after every third compression, using a compression-to-ventilation ratio of 3:1. Hands-only CPR is not as effective as ventilation with CPR. Applicable when HR below 60/min Chapter 35 – Pediatric Emergencies (13) • What is the pediatric triangle and what are the three components? [pg.1295] Appearance, Work of Breathing, Circulation to Skin • What does the mnemonic TICLS stand for? [pg.1295] • What is the equation to determine the average systolic blood pressure for children 1-10 years of age? [pg.1306] 70 + (2 x Child’s age in years) = Lowest expected Systolic Blood Pressure • Common causes of shock in pediatrics [pg.1320] Common causes are Traumatic injury with blood loss, dehydration from diarrhea/vomit, severe infection, neurologic injury, anaphylaxis shock, disease of heart, collapsed lung, blood or fluid around heart.

• Common causes of fever in pediatrics [pg.1327] Infection, Status Epilepticus, Cancer, drug ingestion, Arthritis and systemic lupus erythematosus, high environmental temp • Know & define the types of abuse [pg.1336-1339] Physical Abuse Emotional Abuse Neglec t- Refusal or failure on the part of the caregiver to provide life necessities Children who are neglected are often dirty or too thin or appear developmentally delayed because of lack of stimulation. Sexual abuse- Children of any age and of either gender can be victims of sexual abuse. • What are you looking for when a pediatric patient is having difficulty breathing? [pg.1309] Ineffective cough, Inability to speak, increasing respiratory difficulty with stridor, cyanosis, Loss of consciousness • What is the Wong-Bakers Faces Rating Scale used for? [pg.1335] For patients who have a limited vocabulary to access their pain level • Common medical conditions in Peds [A bit vague of a question, but I just found ever instance of the word common in the chapter, and added it to the list] Common medical conditions for peds are Airway Obstruction, Asthma, Pneumonia, Croup, Epiglottitis, Bronchiolitis, Pertussis, GI upset from ingestion, appendicitis, dehydration (from vomit/diarrhea), Fever, Febrile seizure, drowning, head injuries, abdominal injuries • What is the Broselow Tape & what is it used for? [pg.1313] A tape used to estimate a pediatrics weight on the basis of body length. • What is tenting & turgor? [pg.1327 FIGURE 35-35] Tenting/Turgor- The ability of the skin to resist deformation; rested by gently pinching skin on the forehead or back of head.

• What are some signs and symptoms of child abuse? [pg.1337] • What dies SIDS stand for, what is recommended to prevent it, & treatment? [pg.1339-1341] Sudden Infant death syndrome Preventatives: Be placed on their back on a firm mattress to sleep, in crib free of bumpers, blankets, and toys, baby sleep in same room but not on same mattress, breastfeeding and use of pacifier Being emotionally supportive to the family. Chapter 36 – Geriatric Emergencies • What age defines a geriatric? [pg.1350] 65 years of age • Communication techniques when speaking with geriatrics [pg.1351] Identify yourself Be Aware of how you present yourself Look directly at the patient at eye level and ensure good lighting Speak slowly and distinctively Have One person talk to the patient and ask only one question at a time Don’t assume that all older patients are hard of hearing Give the patient time to respond unless the conditions appears urgent Listen to the answer the patient gives you Explain what you are going to do before you do it Don’t talk about the patient in front of them as though the patient is not there.

• What are common conditions & leading causes of death for geriatrics [pg.1352] • Differentiate between Dementia & Alzheimer [pg.1359] Dementia- The slow onset of progressive disorientation, shortened attention span, loss of cognitive function. Alzheimer- A common cause of dementia, the disease results in loss of brain tissue. • What is kyphosis & considerations when back boarding [pg.1364-1365] Kyphosis- Forward curling of the spine Placing a patient on a backboard can cause significant injury to the patient’s skin. Be sure to have padding • What is osteoporosis & what does this make them more prone for? [pg1364-1365] Osteoporosis- Decrease in bone mass and density, increasing susceptibility to fractures • What are decubitus ulcers? [pg.1365] Sores caused by pressure of skin against a surface for long periods; can range from discoloration of skin to a deep wound that may invade into bone or organ • What extra vital sign should you assess with a syncopal patient? [pg.736] Blood Sugar Level ??? • What type of medication causes concerns with fall patients? [pg.1378] Blood pressure medication • Why is depression & suicide concerning in this age group? [pg.1367-1368] Depression for geriatrics can spawn from substance abuse, isolation, prescription medication use, and chronic medical conditions. Suicide concerns can spawn when faced with a terminal illness or debilitating cardiac/neurologic condition. • What does the GEMS stand for? [pg.1369 TABLE 36-3] Geriatric Patients Environmental Assessment Medical Assessment Social Assessment

• What is elder abuse & what can it result from? [pg.1383] Chapter 37 – Patients With Special Challenges • Differentiate between down syndrome, spina bifida, & cerebral palsy [pg.1394 & 1400 & 1401] Down Syndrome- A genetic chromosomal defect that can occur during fetal development and results in intellectual impairment. There are THREE copies of chromosome 21 instead of usual 2. Spina Bifida - Development defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly even outside of the body, usually at the lower third of the spine in lumbar area Cerebral Palsy- A group of disorder characterized by poorly controlled body movement. • What is the purpose of a shunt? [pg.1410] Tubes that drain excess Cerebrospinal fluid from ventricles of the brain to keep pressure from building up in the brain • What is the purpose of a colostomy bag? It is a bag from the result of a surgical procedure that allows for elimination of waste products. • What is an LVAD? [pg.575] LVAD is a mechanical pump that is implanted in the chest and helps pump blood from the left ventricle to the aorta • What does DOPE stand for? [pg.1404]

• What are the ABCs of autism? Awareness, basics, clarity Chapter 38 – Transport Operations • Four types of ambulances [pg.1426] TYPE IV not listed in book… and I suck at taking notes. • What is “due regard”? [pg.1443-1444] To be attentive, prudent, and vigilant and have safety of others in mind. • Factors that affect response [?] I could not find an exact response from the book, but if I had to guess, possibly stuff like weather, trains, car accidents, etc. • Safe parking zones on calls for ambulances on scene [pg.1438-1439] Pick a position that will allow for efficient traffic control and flow around an emergency scene. Park 100 feet before or past a crash scene to create a barrier between you and traffic. Do not park alongside a scene; you may block the movement of other emergency vehicles. Park uphill and/or upwind of a scene with smoke or hazardous materials. Leave your warning lights or devices on. Keep a safe distance between your vehicle and operations at the scene. Stay away from fires, explosive hazards, downed wires, and unstable structures. Set the parking brake. Park as close to the scene as possible to facilitate emergency medical care and rapid transport from the scene. If it is necessary to block traffic to unload equipment or load patients, do so quickly and safely. • Phases of an ambulance call [pg.1426]

• What are the qualifications for a safe landing zone for a helicopter? [pg.1455] An appropriate site for a landing zone should be: A hard or grassy level surface 100 × 100 feet (recommended) and no less than 60 × 60 feet Cleared of loose debris Clear of overhead or tall hazards Chapter 39 – Vehicle Extrication & Special Rescue • Ten phases of extrication [pg.1466] • Simple access verses complex access [pg.1472] Simple access- Access that is easily achieved without the use of tools or force, e.g. using door handle Complex access - Entry that requires special tools and training and includes the use of force. • What does FAILURE stand for? [pg.1479]

Chapter 40 – Incident Management (11) • What defines an MCI per your book & per ICEMA? [pg.1496 and notes Book states 3 or more patients however ICEMA states a MCI is 5 or more ambulances or 10 or more patients. • How should EMS park on hazmat incidents? [pg.1513-1514] Park upwind or uphill • What is the name of the boo that identifies hazmat materials? [pg.1510] Emergency Response Guidebook • Differentiate between cold zone, warm zone, and hot zone [pg.1515] 1) Cold zone - A safe area at a hazardous materials incident for the agencies involved in the operations 2) Warm Zone- The warm zone is where personnel and equipment transition into and out of the hot zone. 3) Hot Zone - The hot zone is the area immediately surrounding the release, which is also the most contaminated area. • What is the purpose of triage? [pg.1497] The goal of doing the greatest good for the greatest number means that the triage assessment is brief, and the patient condition categories are basic. • What does the acronym START stand for? [pg.1499] Simple Triage And Rapid Treatment • What are the branches of the ICS organizational structure? (IC, operations, logistics, etc.) [pg.1488-1490] The general staff includes command, finance, logistics, operations, and planning. • Differentiate between START triage & JUMPSTART triage [pg.1500-1501] JUMPSTART triage is targeted for pediatrics under 100 lbs. and 8 years. There are several differences within the respiratory status assessment compared with that in START. For example, If you find that a pediatric patient is not breathing, immediately check the pulse, If there is no pulse, label the patient as expectant (black). If the patient is not breathing but has a pulse, open the airway with a manual maneuver. If the patient does not begin to breathe, give five rescue breaths and check respirations again. A child who does not begin to breathe should be labeled expectant. The most common cause of cardiac arrest in children is respiratory arrest. • What does RPM stand for in reference of triage? [google] RPM stands for respiration, Perfusion, and mental status , which is measured by respiratory rate (less than 30), cap refills immediate, and able to follow commands • What are the four triage categories & give examples of each? [pg.1498] Immediate (red), Delayed (yellow), Minor or minimal (green; hold), Expectant (black; likely to die or dead) • Be able to triage a patient? [pg.1497] Yes (I don’t understand what this question is asking, maybe what conditions must be met to triage a patient, in that case it usually is the initial moments of an MCI) Chapter 41 – Terrorism Response & Disaster Management • What is the medical treatment for nerve agent exposure? [1539-1540] You can greatly increase the patient’s chances of survival simply by providing airway and ventilatory support. Also may use Duo Dote Auto-Injector which contains 2.1 mg of atropine and 600 mg of pralidoxime chloride (2-PAM)

• Differentiate between the different types of odors for chemicals covered in this chapter (sulfur mustard, chlorine, phosgene, cyanide, tabun)? [pg.1542] • What does smallpox look like? [pg.1543] Looks very similar to other forms of skin disorder • List the blistering agents (Vesicants), pulmonary agents, and nerve agents Refer to Table above • International vs. domestic terrorism [pg.1528] Domestic terrorism- Terrorism that is carried out by people in their own country. International Terrorism- Terrorism that is carried out by people in a country other than their own. • Observations to determine the potential for a terrorist attack & location [pg.1532-1533] Type of location Type of call Number of patients Victims statements Pre incident indicators • Define Weapons of Mass Destruction & what is the weapon of choice? [pg.1531] Weapons of Mass Destruction is any agent that is designed to bring about mass death, casualties, and or massive damage to infrastructure. Weapons of choice are usually Biologic, nuclear, incendiary, chemical, and explosive. (B-NICE) • What does B-NICE & CBRNE stand for? [pg.1531] B-NICE: Biologic, nuclear, incendiary, chemical, and explosive CBRNE: Chemical, biologic, radiologic, nuclear, and explosive

• What does DUMBLES & SLUDGEM stand for? [pg.1539] • What is Time, Distance, & Shielding when it comes to radiation? [pg.1552] Time- Radiation has a cumulative effort on the body. The less time that you are exposed, the less effects will be. Distance - Radiation is limited as to how far it can travel. Shielding - Radiation can be stopped by specific objects. TECC (6) (Unable to find most of this information in the book, probably just the note taking from last week, too bad I can’t read my own writing ☹ . With that being said, since I can’t fact check via book, double check yourself) • What does the acronym MARCH stand for? Massive hemorrhage, airway, respiration, circulation, and Hypothermia/head injury • What does TCCC stand for? Tactical combat casualty care • Where can tourniquets be applied? Proximal to bleeding site but not on joint • Once a tourniquet is applied what do you need to document? Time and initial • What is the Neutral Zone? The Zone where the Media and family are located at. • What does RTF stand for? Rescue Task Force