PA Notebook Guide EMS Chapter 8Assessment Vocabulary Kneeca A grating or grinding sensation caused by p; a fractured bone ends or joints
rubbing specia together; also air bubbles under the skin lized that produce a crackling sound or crinkly feeling.compartment syndromeInjury of bone the abdomen caused by a penetrating or that piercing instrument or force, in which the lies within skin is lacerated or perforated and the cavity is opened to the atmosphere; also the tendon called penetrating injury.One-way valve of the that allows air to leave the chest cavity quadri but not return; formed by taping three sides of an occlusive dressing to the chest ceps wall, leaving the fourth side open as a muscle valve.eustachian tubeArea of the head .point above the ears and eyes; the skull. The tender cranium contains the nessTe brain.avulsionedemaSwelling or nderne enlargement of a part of an artery, ss resulting from weakening of the arterial that wall.epistaxisecchymosisBruise, or is ecchymosis.Kinematics of TraumaA sharpl technique used to gain insight into a y patient''s thinking, involving repeating, in locali the form of a question, what the patient zed at has said.The loss of body heat as warm the air in the lungs is exhaled into the atmosphere and cooler air is site of the inhaled.evaporationA substance that injury causes an allergic reaction.referred painSwelling in the part of the body , found closest to the ground, caused by collection of fluid in the tissues; a by gently possible sign of congestive heart failure palpat (CHF).A disorder in which the heart loses part of its ability to effectively pump ing along blood, usually as a result of damage to heart muscle and usually resulting in a the backup of fluid into the bone lungs.BradycardiaComplete absence of with heart electrical the activity.HyperventilationEpiglottitisoral tip of glucoseA miniature spray canister one through which droplets or particles of finger medication may be inhaled.injection into .posit a muscle; a medication delivery ion of route.IndicationsEpinephrineMED functi channelsradio hardware containing onHand transmitter & receiver/located in a fixed positi place.Subcutaneous on in EmphysemaSAMPLE which HistoryResponsivenessOPQRSTAccessor the y Muscles 9/27/2011tance69487272.docD1er9/27/2011id not contact medical 1fo9/27/2011 not check medication f1pti
wrist Section 7. Trauma, is slight ly dorsif lexed and all finger joints are modera tely flexed .pubic symphy sisHar d bony promin ence that is found in the midlin e in the lowerm ost portio n of the abdome n.radi usBone on the thumb side of the forear m.redu ceRetu rn a disloc ated joint or fractu red bone to its normal positi on; set.re troper 9/27/2011tance69487272.docD2er9/27/2011id not contact medical 2fo9/27/2011 not check medication f2pti
itonea l spaceT he space betwee n the abdomi nal cavity and the poster ior abdomi nal wall, contai ning the kidney s, certai n large vessel s, and parts of the gastro intest inal tract. scapul aShoul der blade. sciati c nerveM ajor nerve to the lower extrem ity; contro ls much of muscle functi on in the leg, and 9/27/2011tance69487272.docD3er9/27/2011id not contact medical 3fo9/27/2011 not check medication f3pti
sp lintFl exible or rigid ang damage to suppor ting ligame 9/27/2011tance69487272.docD4er9/27/2011id not contact medical 4fo9/27/2011 not check medication f4pti
. muscle .sensat ion in most of the leg and foot.s keleta l muscle Muscle that is attach ed to bones and usuall y crosse s at least one joint. striat ed. or volunt ary.sling Bandag e or materi al that helps to suppor t the weight of an injure d upper extrem ity.
ul naInne r bone of the forear m.docD5er9/27/2011id not contact medical 5fo9/27/2011 not check medication f5pti
.s watheB andage that passei ssue that attach es a skelet al muscle to aa struct ure.nts. and someti mes pa a muscle pull. zone of injury Area of potent ially damage d soft tissue . on the side opposi te the thumb. adjace nt nerves . and blood vessel s surrou nding an injury to a bone or a 9/27/2011tance69487272.
joint. Chapte r 30Head and Spine Injuri esante rograd e (postt raumat ic) amnesi aInabi lity to rememb er events after an injury .auton omic (invol untary ) nervou s system Part of the nervou s system that regula tes functi ons that are not contro lled by consci ous will, such as digest ion and sweati 9/27/2011tance69487272.docD6er9/27/2011id not contact medical 6fo9/27/2011 not check medication f6pti
ng.Bat tle''s signBr uising behind an ear over the mastoi d proces s that may indica te skull fractu re.bra in stemAr ea of the brain betwee n the spinal cord and cerebr um, surrou nded by the cerebe llum; contro ls functi ons, necess ary for life, ie respir ations .centr al nervou s system (CNS)B rain and spinal cord.n 9/27/2011tance69487272.docD7er9/27/2011id not contact medical 7fo9/27/2011 not check medication f7pti
ondisp laced fractu reSimp le crack in the bone that has not caused the bone to move from its normal anatom ic positi on; also called a hairli ne fractu re.fra ctureB reak in the contin uity of a bone.g lenoid fossaP art of the scapul a that joins with the humera l head to form the glenoh umeral joint. hematu riaPre 9/27/2011tance69487272.docD8er9/27/2011id not contact medical 8fo9/27/2011 not check medication f8pti
bruisi ng. 9/27/2011tance69487272.sence of blood in the urine.jo intPla ce where two bones come into contac t.docD9er9/27/2011id not contact medical 9fo9/27/2011 not check medication f9pti
.fem urThig h bone. humeru sSuppo rting bone of the upper arm. ecchym osisDi scolor ation of the skin associ ated with a closed wound.liga mentBa nd of the fibrou s tissue that connec ts bones to bones. It suppor ts and streng thens a joint.
which extend s from the pelvis to the knee and is respon sible for format ion of the hip and knee.docD10er9/27/2011id not contact medical 10fo9/27/2011 not check medication f10pti
.f ibulad isplac ed fractu redisl ocatio nDisru ption of a joint in which ligame nts are damage d and the bone ends are comple tely displa ced.Sw elling in a confin ed space that produc es 9/27/2011tance69487272. longes t and larges t bone in the body.
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.danger ous pressu re. may cut off blood flow or damage sensit ive tissue .crepi tusclo sed fractu reFrac ture in which the skin is not broken .clavi cleart icular cartil agePea rly layer of specia lized cartil age coveri ng the articu lar surfac es (conta ct surfac es on the ends) of bones in synovi al joints 9/27/2011tance69487272.
perit onitis hollow organs Struct ures throug h which materi als pass. such as the stomac h. Region of the lower rib cage.docD12er9/27/2011id not contact medical 12fo9/27/2011 not check medication f12pti
. small intest ines. large intest ines.g uardin gDispl acemen t of organs outsid e the body. and bladde r.Pres ence of blood in the urine.acrom ioclav icular (A/C) jointC hapter 29peri toneal cavity Abdomi nal cavity .. ureter s.c 9/27/2011tance69487272.
also called blunt abdomi nal injury .docD13er9/27/2011id not contact medical 13fo9/27/2011 not check medication f13pti
.Chapt er 28spon taneou s pneumo thorax Pneumo thorax that occurs when a weak area on the lung ruptur es in the absenc e of major injury .losed abdomi nal injury Any injury of the abdome n caused by a nonpen etrati ng instru ment or force. allowi 9/27/2011tance69487272. in which the skin remain s intact .
pneum othora xParti al or comple te accumu lation of air in the pleura l space. suckin g chest woundO pen or penetr ating chest wall wound throug h which air passes during inspir ation and expira tion. tachyp neaRap id respir ations .docD14er9/27/2011id not contact medical 14fo9/27/2011 not check medication f14pti
.ng air to leak into the pleura l space. creati ng a suckin g sound. perica rdial tampon adeCom 9/27/2011tance69487272.
pressi on of the heart due to a buildu p of blood or other fluid in the perica rdial sac.he moptys isSpit ting or coughi ng up of blood.Oint formed where the mandib le and craniu m meet.Ch apter 27turb inates Layers of bone within the nasal cavity .docD15er9/27/2011id not contact medical 15fo9/27/2011 not check medication f15pti
. just in front 9/27/2011tance69487272. which lies betwee n the extern al and middle ear. Eardru m.
tr agusSm all. occipu tforam en magnum Large openin g at the base of the skull throug h which the brain connec ts to 9/27/2011tance69487272. and lodge the upper teeth.of the ear.docD16er9/27/2011id not contact medical 16fo9/27/2011 not check medication f16pti
. fleshy bulge that lies immedi ately anteri or to the ear canal. and the palate . rounde d. Upper jawbon es that assist in the format ion of the orbit. the nasal cavity .
avul sedPul led or torn away.the spinal cord.cr aniumA ir bubble s in the blood vessel s.docD17er9/27/2011id not contact medical 17fo9/27/2011 not check medication f17pti
.m andibl eBone of the lower jaw.A dam''s appleF irm promin ence in the upper part of the larynx formed by the 9/27/2011tance69487272.h ematom aMass of blood in the soft tissue s beneat h the skin.ma stoid proces sPromi nent bony mass at the base of the skull behind the ear.
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. which are carrie d by the optic nerve to the brain. lensTr anspar ent part of the eye 9/27/2011tance69487272. It is more promin ent in men than in women. a layer of cells at the back of the eye that change s the light image into electr ical impuls es. retina Lightsensit ive area of the eye where images are projec ted.thyroi d cartil age.
lacrim al glands Bleedi ng into the anteri or chambe r of the eye. 9/27/2011tance69487272. regula ting the amount of light that enters the eye. pigmen t in this tissue gives the eye its color.docD19er9/27/2011id not contact medical 19fo9/27/2011 not check medication f19pti
.Muscl e and surrou nding tissue behind the cornea that dilate and constr ict the pupil.throug h which images are focuse d on the retina .
cornea rabidD escrib es an animal that is 9/27/2011tance69487272.g lobeEy eball. Eye injuri esblow out fractu reFrac ture of the orbit or of the bones that suppor t the floor of the orbit.obscur ing the iris.co njunct ivitis Inflam mation of the conjun ctiva.docD20er9/27/2011id not contact medical 20fo9/27/2011 not check medication f20pti
. conjun ctivaD elicat e membra ne lining the eyelid s and coveri ng the expose d surfac e of the eye.
i ncisio nSharp or smooth cut.Rule of NinesS ystem that assign s percen tages to sectio ns of the body. allowi ng calcul ation of the amount of skin surfac e involv ed in the burn area.docD21er9/27/2011id not contact medical 21fo9/27/2011 not check medication f21pti
.Ma ss of blood in the soft tissue s beneat h the skin.f ullthickn ess burnep idermi sOuter layer of skin 9/27/2011tance69487272.infect ed with rabies .
and blood vessel s. needle s.that acts as a watert ight protec tive coveri ng. or ecchym osis. or a patien t''s body. water. wounds .docD22er9/27/2011id not contact medical 22fo9/27/2011 not check medication f22pti
. food. sweat glands .c ontusi onBrui se. nerve ending s.d ermisI nner layer of the skin. contai ning hair follic les.con tamina tionPr esence of infect ious organi sms on or in object s such as dressi ngs.ecch 9/27/2011tance69487272.
9/27/2011tance69487272. bruisi ng. toxic chemic als.ymosis Discol oratio n of the skin associ ated with a closed wound.An injury in which soft tissue either is torn comple tely loose or is hangin g as a flap.docD23er9/27/2011id not contact medical 23fo9/27/2011 not check medication f23pti
.b urnInj ury in which the soft tissue receiv es more energy than it can absorb withou t injury from therma l heat. fricti onal heat. electr icity.
cl osed injury Develo ping a sensit ivity to a substa nce that initia lly caused no allerg ic reacti on.per fusion 9/27/2011tance69487272.or nuclea r radiat ion.sep tic shockC ircula tory failur e caused by paraly sis of the nerves that contro l the size of the blood vessel s.docD24er9/27/2011id not contact medical 24fo9/27/2011 not check medication f24pti
. leadin g to widesp read dilati on. seen in spinal cord injuri es.
h ypothe rmiaCo nditio n in which the intern al body temper ature falls below 95 degree s F (35 degree s C) after exposu re to a cold enviro nment.docD25er9/27/2011id not contact medical 25fo9/27/2011 not check medication f25pti
. homeos tasisB alance of all system s of the body.Circul ation of oxygen ated blood within an organ or tissue in adequa te amount s to meet the cells' ' curren t needs. 9/27/2011tance69487272.
result s in inadeq uate perfus ion.L oss of water 9/27/2011tance69487272.hypovo lemic shockC onditi on in which low blood volume .docD26er9/27/2011id not contact medical 26fo9/27/2011 not check medication f26pti
.Pr esence of abnorm ally large amount s of fluid betwee n cells in body tissue s. causin g swelli ng of the affect ed area. due to massiv e intern al or extern al bleedi ng or extens ive loss of body water.
c yanosi scardi ogenic shockS tate in which not enough oxygen is delive red to the tissue s of the body. caused by low output of blood from the heart.docD27er9/27/2011id not contact medical 27fo9/27/2011 not check medication f27pti
. It can be a severe compli cation of a large acute myocar dial infarc tion.c ompens ated shocka utonom ic nervou s system 9/27/2011tance69487272. and other condit ions.from the tissue s of the body.
that are not contro lled volunt arily.The part of the nervou s system that regula tes functi ons.ana phylax isExtr eme. Chapte r 23Shoc kanaph ylacti c shockS evere shock caused by an allerg ic reacti on. such as digest ion and sweati ng. possib ly lifethreat ening system ic allerg ic reacti on that may 9/27/2011tance69487272.docD28er9/27/2011id not contact medical 28fo9/27/2011 not check medication f28pti
h emophi liaCon genita l condit ion in which 9/27/2011tance69487272.aneu rysmCi rculat ion of oxygen ated blood within an organ or tissue in adequa te amount s to meet the cells' ' curren t needs. pneuma tic antish ock garmen t (PASG) hemato maMass of blood in the soft tissue s beneat h the skin.docD29er9/27/2011id not contact medical 29fo9/27/2011 not check medication f29pti
.includ e shock and respir atory failur e.
and then on to the cells.docD30er9/27/2011id not contact medical 30fo9/27/2011 not check medication f30pti
. into and out of the inters titial fluid.cont usionS mall blood vessel s that connec t arteri oles and venule s. variou s substa nces pass throug h capill ary walls.the patien t lacks one or more of the blood' 's normal clotti ng factor s. coagul ationF ormati on of clots to plug openin 9/27/2011tance69487272.
consis ting of three layers of tissue and smooth muscle that carrie s blood away from the heart. such as from a fall.a rteryB lood vessel . gravit y. conver ted into kineti c energy and result s in injury . potent ial energy Produc t of mass.gs in injure d blood vessel s and stop blood flow.docD31er9/27/2011id not contact medical 31fo9/27/2011 not check medication f31pti
.k inetic 9/27/2011tance69487272. and height .
energy energy of a moving object . which cause damage distan 9/27/2011tance69487272.index of suspic ionblu nt trauma An impact on the body by object s that cause injury withou t penetr ating soft tissue s or intern al organs and caviti es.docD32er9/27/2011id not contact medical 32fo9/27/2011 not check medication f32pti
.cav itatio nPheno menon in which speed causes bullet to genera te pressu re waves.The slowin g of an object .
caused by a distur bance in the physic al or physio 9/27/2011tance69487272.refle ctive listen ingTem porary or perman ent dysfun ction of the brain. energy transm ission thru brain tissue causes injury on opposi te side of origin al impact .c oupcontre coup brain injury Brain injury that occurs when force is applie d to head.docD33er9/27/2011id not contact medical 33fo9/27/2011 not check medication f33pti
.t from the bullet 's path.
psycho logica l. physic al. chemic al. or biolog 9/27/2011tance69487272.logic functi oning of brain tissue .docD34er9/27/2011id not contact medical 34fo9/27/2011 not check medication f34pti
. geneti c.m ental disord erAn illnes s with psycho logica l or behavi oral sympto ms and/or impair ment in functi oning caused by a social .psych ogenic A sympto m or illnes s that is caused by mental factor s as oppose d to physic al ones.
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. Turgor The abilit y of the skin to resist deform ation.ic distur bance. tested by gently pinchi ng skin on the forehe ad or back of the hand.r everse triage A triage proces s in which effort s are focuse d on those who are in respir atory and 9/27/2011tance69487272. behavi orHow a person functi ons or acts in respon se to his or her enviro nment.
cardia c arrest . and differ ent from conven tional triage where such patien ts would be classi fied as deceas ed.docD36er9/27/2011id not contact medical 36fo9/27/2011 not check medication f36pti
. near drowni nghypo thermi aA condit ion in which the intern al body temper 9/27/2011tance69487272. Used in triagi ng multip le victim s of a lightn ing strike .Scuba Respir ationA severe constr iction of the larynx and vocal cords.
ature falls below 95 degree s F (35 degree s C) after exposu re to a cold enviro nment.docD37er9/27/2011id not contact medical 37fo9/27/2011 not check medication f37pti
. 9/27/2011tance69487272.h yperba ric chambe rA lifethreat ening condit ion of severe hypert hermia caused by exposu re to excess ive natura l or artifi cial heat.3 degree s C) or more. hypert hermia A condit ion in which core temper ature rises to 101 degree s F (38.
fr ostbit eDamag e to tissue s as the result of exposu re to cold. frozen or partia lly frozen body parts.C onvers ion of water or anothe r fluid from a liquid to a gas. heat cramps Painfu l muscle spasms usuall y associ ated with 9/27/2011tance69487272.marked by warm.docD38er9/27/2011id not contact medical 38fo9/27/2011 not check medication f38pti
. dry skin. severe ly altere d mental status . and often irreve rsible coma.
also called heat prostr ation or heat collap se.docD39er9/27/2011id not contact medical 39fo9/27/2011 not check medication f39pti
.vigoro us activi ty in a hot enviro nment.cor e temper atureThe temper
of the centra l part of the body 9/27/2011tance69487272. heat exhaus tionA form of heat injury in which the body loses signif icant amount s of fluid and electr olytes becaus e of heavy sweati ng.
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. also called "the bends.deco mpress ion sickne ssA painfu l condit ion seen in divers who ascend too quickl y. and vital organs ). "divin g reflex Slowin g of the heart rate caused by submer sion in 9/27/2011tance69487272. forms bubble s in blood vessel s and other tissue s.(eg. especi ally nitrog en. lungs. in which gas. the heart.
drowni ngDeat h from suffoc ation by submer sion in water.docD41er9/27/2011id not contact medical 41fo9/27/2011 not check medication f41pti
.bra dycard iaSlow heart rate.cold water. 9/27/2011tance69487272.bends Common name for decomp ressio n sickne ss. A serum that counte racts the effect of venom from an animal or insect . electr olytes Certai n salts and other chemic als that are dissol ved in body fluids and cells.
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.less than 60 beats/ min.Cha pter 18 Enviro nmenta l Emerai r emboli smAir bubble s in the blood vessel s.pois onA substa nce whose chemic al action could damage struct ures or impair functi 9/27/2011tance69487272.con ductio nVomit ed materi al.br eathholdin g syncop eLoss of consci ousnes s caused by a decrea sed breath ing stimul us.
deliri um tremen s (DTs)A severe withdr awal syndro me seen in alcoho lics who are depriv ed of 9/27/2011tance69487272.A sleepinduci ng effect or agent. taking a substa nce by mouth. ingest ionSwa llowin g.hem atemes isVomi ting blood.on when introd uced into the body.docD43er9/27/2011id not contact medical 43fo9/27/2011 not check medication f43pti
. opioid sAny drug or agent with action s simila r to morphi ne.
charac terize d by restle ssness .ethyl alcoho l. fever. and seizur es.docD44er9/27/2011id not contact medical 44fo9/27/2011 not check medication f44pti
. sweati ng. disori entati on.hallu cinoge nsAgen ts that produc e false percep tions in any one of the five senses .Subs Abuse/ Poison addict ionA state of overwh elming obsess ion or physic al need 9/27/2011tance69487272.em esisVo miting . can be fatal if untrea ted. agitat ion.
crowin g inspir atory sound. such as the sound often heard in acute laryng eal (upper airway ) obstru ction. ToxinA poison or harmfu l substa nce.Ur ticari aSmall spots of genera lized itchin g and/or burnin g that appear as multip le raised areas 9/27/2011tance69487272. highpitche d.docD45er9/27/2011id not contact medical 45fo9/27/2011 not check medication f45pti
. strido rA harsh.to contin ue the use of a drug or agent.
epinep hrineA medica tion that increa ses heart rate and blood pressu re but also eases breath ing proble ms by decrea sing muscle tone of the bronch iole tree. hives. enveno mation The act of inject ing venom. you may be allowe d to help the patien t selfadmini ster the medica tion.docD46er9/27/2011id not contact medical 46fo9/27/2011 not check medication f46pti
.on the skin.h istami nesSub stance releas ed by 9/27/2011tance69487272.
possib ly lifethreat ening system ic allerg ic reacti on that may includ e shock and respir atory failur e.the immune system in allerg ic reacti ons that are respon sible for many of the sympto ms of anaphy laxis.docD47er9/27/2011id not contact medical 47fo9/27/2011 not check medication f47pti
. An extrem e.alle rgic reacti onThe body'' s exagge rated immune respon se to an intern al or 9/27/2011tance69487272.
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. type II diabet esThe type of diabet ic diseas e that usuall y starts in later life and often can be contro lled throug h diet and oral medica tions. Chapte r 16Alle rgic Reacti onsall ergent ype I diabet esThe type of diabet ic diseas e that usuall y starts in childh ood and requir es insuli 9/27/2011tance69487272.surfac e agent.
n for proper treatm ent and contro l.docD49er9/27/2011id not contact medical 49fo9/27/2011 not check medication f49pti
. used in synthe tic form to treat and contro l diabet es mellit us.ins ulin shockU nconsc iousne ss or 9/27/2011tance69487272.Insu linA hormon e produc ed by the Islets of Langer hans (an exocri ne gland on the pancre as) that enable s glucos e in the blood to enter the cells of the body.
rapid breath ing.Kuss maul respir ations Deep. usuall y the result of excess ive exerci se and activi ty or failur e to eat after a routin e dose of insuli n. caused by signif icant hypogl ycemia .altere d mental status in a patien t with diabet es. usuall y the result of an accumu l ation of
certai n acids when 9/27/2011tance69487272.docD50er9/27/2011id not contact medical 50fo9/27/2011 not check medication f50pti
insuli n is not availa ble in the body. often the result of excess ive urinat ion.Polyu riaAn abnorm 9/27/2011tance69487272.docD51er9/27/2011id not contact medical 51fo9/27/2011 not check medication f51pti
.Po lyphag iaExce ssive eating . in diabet es. the inabil ity to use glucos e proper ly can cause a sense of hunger .P olydip siaExc essive thirst persis ting for long period s of time despit e reason able fluid intake .
stra ngulat ionper itoneu mThe membra ne lining the abdomi nal cavity (parie tal perito neum) and coveri ng the abdomi nal organs (visce ral perito neum).ally low blood glucos e level. ulcerP ain felt in an area of the body other than the area where the cause of pain is locate d. perito nitisI nflamm ation of the perito 9/27/2011tance69487272.docD52er9/27/2011id not contact medical 52fo9/27/2011 not check medication f52pti
creati ng abdomi nal discom fort.hern iaThe protru sion of a loop of an organ or 9/27/2011tance69487272.e mesisV omitin g. an effort to protec t the inflam ed abdome n.docD53er9/27/2011id not contact medical 53fo9/27/2011 not check medication f53pti
.neum.d iverti culiti sBulgi ng out of intest inal rings in small pocket s at weak areas in the muscle walls.guar dingIn volunt ary muscle contra ctions (spasm ) of the abdomi nal wall.
colicA cute. interm ittent crampi ng abdomi nal pain. arisin g from any one of severa l causes .pa ncreat itisIn flamma tion of the gallbl adder.docD54er9/27/2011id not contact medical 54fo9/27/2011 not check medication f54pti
.ileu sParal ysis of the bowel. stops contra ctions that move materi al throug h the intest ine.A condit ion of sudden onset of pain within the abdome 9/27/2011tance69487272.tissue throug h an abnorm al body openin g.
usuall y indica ting perito nitis.docD55er9/27/2011id not contact medical 55fo9/27/2011 not check medication f55pti
.an eurysm A swelli ng or enlarg ement of a part of an artery .n. immedi ate medica l or surgic al treatm ent is necess ary.C lottin g of the cerebr al arteri es that may result in the interr uption 9/27/2011tance69487272.a norexi aLack of appeti te for food. result ing from weaken ing of the arteri al wall.
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.tonic clonic A type of seizur e that featur es rhythm ic backandforth motion of an extrem ity and body stiffn ess.tr ansien t ischem ic attack (TIA)A disord er of the brain in which brain cells tempor arily stop workin g becaus e of insuff icient oxygen . 9/27/2011tance69487272.of cerebr al blood flow and subseq uent stroke .
Peri od follow ing a seizur e that lasts betwee n 5 and 30 minute s. Chapte r 14 status epilep ticusA condit ion in which seizur es recur every few minute s.causin g stroke -like sympto ms that resolv e comple tely within 24 hours of onset.docD57er9/27/2011id not contact medical 57fo9/27/2011 not check medication f57pti
. or last more than 30 minute s. charac terize d by labore d respir ations and 9/27/2011tance69487272.
some degree of altere d mental status . uncoor dinate d muscul ar activi ty associ ated with loss of consci ousnes s.i schemi c stroke One of the two 9/27/2011tance69487272.docD58er9/27/2011id not contact medical 58fo9/27/2011 not check medication f58pti
. a convul sion.recep tive aphasi aA speech disord er in which a person has troubl e unders tandin g speech but is able to speak clearl y.seiz ureGen eraliz ed.
infa rcted cellsh ypogly cemiaA n abnorm ally low blood glucos e level. Seizur e charac terize d by 9/27/2011tance69487272.docD59er9/27/2011id not contact medical 59fo9/27/2011 not check medication f59pti
. occurs when blood flow to a partic ular part of the brain is cut off by a blocka ge (eg.main types of stroke . a clot) inside a blood vessel .Loss of bowel and bladde r contro l due to a genera lized seizur e.
feb rile seizur esConv 9/27/2011tance69487272. also known as a grand mal seizur e.hemi paresi sexpre ssive aphasi aA speech disord er in which a person can unders tand what is being said but cannot produc e the right sounds in order to speak proper ly.docD60er9/27/2011id not contact medical 60fo9/27/2011 not check medication f60pti
.severe twitch ing of all the body'' s muscle s that may last severa l minute s or more.
partic ularly in childr en.a theros cleros isA disord er in which choles terol and calciu m build up inside the walls of blood vessel s.art erial ruptur eRuptu re of a cerebr al artery that may contri bute to interr uption of cerebr al blood flow.docD61er9/27/2011id not contact medical 61fo9/27/2011 not check medication f61pti
. formin g plaque 9/27/2011tance69487272.ulsion s that result from sudden high fevers .
cerebr al emboli smObst ructio n of a cerebr al artery caused by a 9/27/2011tance69487272. serves as a warnin g sign that a seizur e is about to occur..aur aA sensat ion experi enced prior to a seizur e. which eventu ally leads to partia l or comple te blocka ge of blood flow and the format ion of clots that can break off and emboli ze.docD62er9/27/2011id not contact medical 62fo9/27/2011 not check medication f62pti
docD63er9/27/2011id not contact medical 63fo9/27/2011 not check medication f63pti
.com aA state of profou nd uncons ciousn ess from which one cannot be roused .clot that was formed elsewh ere in the body and travel ed to the brain. cerebr ovascu lar accide nt (CVA)A n interr uption of blood flow to the brain that result s in the loss of brain functi on.coupcontre coup brain injury A 9/27/2011tance69487272.
docD64er9/27/2011id not contact medical 64fo9/27/2011 not check medication f64pti
.dysar thriaC hapter 13 Neurol ogic Emerge ncyabs ence seizur eSeizu re that may be charac terize d by a brief lapse of attent ion in which the patien t may stare 9/27/2011tance69487272.brain injury that occurs when force is applie d to the head and energy transm ission throug h brain tissue causes injury on the opposi te side of origin al impact .
and does not respon d. Also known as petit mal seizur e.apha siaVen tricle One of two (right and left) lower chambe rs of heart. left ventri cle receiv es blood from left atrium (upper chambe r), delive rs blood to aorta. right ventri cle receiv es blood from right atrium , pumps into pulmon ary artery .Perfu 9/27/2011tance69487272.docD65er9/27/2011id not contact medical 65fo9/27/2011 not check medication f65pti
sionci rculat ion of oxygen ated blood within an organ or tissue in adequa te amount s to meet the cells' ' curren t needs. The inside diamet er of an artery or other hollow struct ure.My ocardi umThe heart muscle .Occlu sionBl ockage , usuall y of a tubula r struct ure such as a blood vessel .Infer iorThe part of the 9/27/2011tance69487272.docD66er9/27/2011id not contact medical 66fo9/27/2011 not check medication f66pti
body, or any body part, nearer to the feet.d epende nt edemaA blood vessel that carrie s blood and nutrie nts to the heart muscle .conge stive heart failur e (CHF)A systol eaorti c valveT he oneway valve that lies betwee n the left ventri cle and the aorta. It keeps blood from flowin g back into the left ventri 9/27/2011tance69487272.docD67er9/27/2011id not contact medical 67fo9/27/2011 not check medication f67pti
Aor taacut e myocar dial infarc tion (AMI)H eart attack . death of heart muscle follow ing obstru ction of blood flow to it. One of four heart valves .docD68er9/27/2011id not contact medical 68fo9/27/2011 not check medication f68pti
. Acute 9/27/2011tance69487272.The front surfac e of the body. the side facing you in the standa rd anatom ic positi on.cle after the left ventri cle ejects its blood into the aorta.
docD69er9/27/2011id not contact medical 69fo9/27/2011 not check medication f69pti
.pulm onary edemaB uildup of fluid 9/27/2011tance69487272.Str idorRh onchiC oarse breath sounds heard in patien ts with chroni c mucus in the airway s."C hapter 12 Cardio vascul ar Emerge ncyPot ential ly lifethreat ening viral infect ion that usuall y starts with flulike sympto ms.in this contex t means "new" or "happe ning right now.
lowers blood carbon dioxid e levels below normal .Pneum othora xpleur itic chest painhy poxic drive" Backup system " contro lling respir ation. senses drops in oxygen in blood. Rapid or deep breath ing.docD70er9/27/2011id not contact medical 70fo9/27/2011 not check medication f70pti
.Emphy semaDi 9/27/2011tance69487272.in lungs.Infe ctious diseas e of the lung that damage s lung tissue . usuall y as a result of conges tive heart failur e.
docD71er9/27/2011id not contact medical 71fo9/27/2011 not check medication f71pti
.commo n coldvi ral infect ion usuall y associ ated with swolle n nasal mucous membra nes and the produc tion 9/27/2011tance69487272. one form of chroni c obstru ctive pulmon ary diseas e (COPD) . eventu al destru ction of pulmon ary alveol i w/poor exchan ge of oxygen . carbon dioxid e.sease of lungs w/extr eme dilati on.
CroupI nfecti on of the airway below the level of vocal cords.of fluid from the sinuse s and nose. lining pharyn x. caused by a virus.docD72er9/27/2011id not contact medical 72fo9/27/2011 not check medication f72pti
. a sign of lower airway obstru ction. this 9/27/2011tance69487272.C rackle sCrack ling breath sound caused by the flow of air throug h liquid in the lungs. Diphth eriaIn fectio us diseas e in which a membra ne forms.
lining can severe ly obstru ct the passag e of air into the larynx .docD73er9/27/2011id not contact medical 73fo9/27/2011 not check medication f73pti
.Dyspn eaShor tness of breath or diffic ulty breath ing.Ast hmaDis ease 9/27/2011tance69487272.Em bolusM edicat ions that are design ed to be absorb ed throug h the skin (trans cutane ously) .Chapt er 11 Respir atory Emerge ncyAll ergenS ubstan ce that causes an allerg ic reacti on.
of the lungs in which muscle spasm in the small air passag eways and the produc tion of large amount s of mucus with swelli ng of the mucus lining of the respir atory passag es result in airway obstru ction.docD74er9/27/2011id not contact medical 74fo9/27/2011 not check medication f74pti
. carbon dioxid e retent ionA condit ion charac terize d by a chroni cally high blood level of carbon dioxid e in which 9/27/2011tance69487272.
from either infect ious diseas e or irrita nts such as smoke.chro nic bronch itisIr ritati on of the major lung passag eways. Transc utaneo usmixt ure of ground partic les that are distri buted evenly throug hout a liquid but do not dissol ve.sub lingua 9/27/2011tance69487272.the respir atory center no longer respon ds to high blood levels of carbon dioxid e.docD75er9/27/2011id not contact medical 75fo9/27/2011 not check medication f75pti
metere d-dose inhale r (MDI)g eneric nameor iginal chemic al name of medica tion (in contra st with one of its "trade names" ).l (SL)So lution liquid mixtur e. study of the proper ties and effect s of medica tions. name is not capita lized. cannot be separa ted by filter ing or allowi ng mixtur e to stand.docD76er9/27/2011id not contact medical 76fo9/27/2011 not check medication f76pti
. medica tion that 9/27/2011tance69487272.
a condit 9/27/2011tance69487272. you may be allowe d to help the patien t selfadmini ster the medica tion.increa ses heart rate and blood pressu re but also eases breath ing proble ms by decrea sing muscle tone of the bronch iole tree. for exampl e.docD77er9/27/2011id not contact medical 77fo9/27/2011 not check medication f77pti
.C ontrai ndicat ionsCo nditio ns that make a partic ular medica tion or treatm ent inappr opriat e.
ion in which a medica tion should not be given becaus e it would not help or may actual ly harm a patien t. Charco al is ground into a very fine powder to provid e greate st 9/27/2011tance69487272.Dose oral medica tion binds & adsorb s ingest ed toxins in gastro intest inal tract for treatm ent of some poison ings & medica tion overdo ses.docD78er9/27/2011id not contact medical 78fo9/27/2011 not check medication f78pti
possib le surfac e area for bindin g medica tions taken by mouth.docD79er9/27/2011id not contact medical 79fo9/27/2011 not check medication f79pti
. or ASA)A medica tion that is an antipy retic (reduc es fever) . antiinflam matory (reduc es inflam mation 9/27/2011tance69487272.aspi rin (acety lsalic ylic acid. carrie d on EMS unit. analge sic (reduc es pain).A dsorpt ionpro cess of bindin g or sticki ng to a surfac e.
).U HF (ultra -high freque ncy)Ra dio freque ncies betwee n 300 and 3.docD80er9/27/2011id not contact medical 80fo9/27/2011 not check medication f80pti
.000 MHz. and potent inhibi tor of platel et aggreg ation (clump ing).A bsorpt ionpro cess which medica tions travel thru body tissue s until reach bloods tream. Action The therap eutic effect of a medica tion on the body.VH F (very high freque ncy)Ra dio freque ncies 9/27/2011tance69487272.
transm ission s can occur in either direct ion but not simult aneous ly in both. the other can only receiv e. party that is transm itting is unable to 9/27/2011tance69487272. VHF spectr um is furthe r divide d into "high" and "low" bands.betwee n 30 and 300 MHz.docD81er9/27/2011id not contact medical 81fo9/27/2011 not check medication f81pti
. Chapte r 10 Single freque ncy radio. when one party transm its.
receiv e.Te lemetr yA proces s in which electr onic signal s are conver ted into coded. signed by EMS system 's medica l direct or. audibl e signal s. permis sions. these signal s can then be transm 9/27/2011tance69487272.docD82er9/27/2011id not contact medical 82fo9/27/2011 not check medication f82pti
. prohib itions for patien t care.stan ding orders Writte n docume nts. AKA protoc ols. outlin e specif ic direct ions.
docD83er9/27/2011id not contact medical 83fo9/27/2011 not check medication f83pti
.itted by radio or teleph one to a receiv er at the hospit al with a decode r.Sc annerA radio receiv er that search es or "scans " across severa l freque 9/27/2011tance69487272.Repe aterA specia l base statio n radio that receiv es messag es and signal s on one freque ncy and then automa ticall y retran smits them on a second freque ncy.
ncies until the messag e is comple ted.Rappo rtFede ral Commun icatio ns Com (FCC)f ederal agency w/juri sdicti on over inters tate & intern ationa l teleph one & telegr 9/27/2011tance69487272. the proces s is then repeat ed.use of a radio signal .docD84er9/27/2011id not contact medical 84fo9/27/2011 not check medication f84pti
. a voice or digita l messag e transm itted to pagers ("beep ers") or deskto p monito r radios .
docD85er9/27/2011id not contact medical 85fo9/27/2011 not check medication f85pti
. all of which may involv e EMS activi ty.Quick assess ment of the scene and the surrou ndings made to provid e inform ation about its safety 9/27/2011tance69487272.aph servic es & satell ite commun icatio ns.Dup lexSev ere breath ing proble m in which a patien t can speak only two to three words at a time withou t pausin g to take a breath .
R honchi Retrac tionsR alesCr acklin g.docD86er9/27/2011id not contact medical 86fo9/27/2011 not check medication f86pti
. before you enter and begin patien t care. breath sound that signal s fluid in the air spaces of the lungs. rattli ng.Abb reviat ion for key terms used in evalua ting a patien t''s signs and sympto ms: 9/27/2011tance69487272.and the mechan ism of injury or nature of illnes s. also called crackl es.
onset.A VPUMet hod of assess ing a patien t''s level of consci ousnes s by determ ining whethe r a patien t is Awake and alert. region /radia tion.docD87er9/27/2011id not contact medical 87fo9/27/2011 not check medication f87pti
. provoc ation or pallia tion. used princi pally in the initia l assess mentBo dy 9/27/2011tance69487272. qualit y. respon sive to Verbal stimul us or Pain. severi ty. and timing of pain. or Unresp onsive .
usuall y assess ed with a stetho scope.docD88er9/27/2011id not contact medical 88fo9/27/2011 not check medication f88pti
.B reath Sounds Indica tion of air moveme nt in the lungs. Capill ary Refill Abilit y of the circul atory system to restor e blood to the capill ary 9/27/2011tance69487272.Substa nce Isolat ion (BSI)I nfecti on contro l concep t and practi ce that assume s that all body fluids are potent ially infect ious.
docD89er9/27/2011id not contact medical 89fo9/27/2011 not check medication f89pti
.Con juncti vaDeli cate membra 9/27/2011tance69487272. evalua ted by using a simple test.C hief Compla intRea son a patien t called for help. the patien t''s respon se to questi ons such as "what' 's wrong? " or "what happen ed?"Co agulat eTo form a clot to plug an openin g in an injure d blood vessel and stop bleedi ng. Also.system .
Cya nosisB luish color of the skin result ing from poor oxygen ation of the circul ating blood. DCAPBTLSMn emonic for assess ment in which 9/27/2011tance69487272.ne lining the eyelid s and coveri ng the expose d surfac e of the eye.docD90er9/27/2011id not contact medical 90fo9/27/2011 not check medication f90pti
.Cr epitus Gratin g or grindi ng sensat ion or sound caused by fractu red bone ends or joints rubbin g togeth er.
Det ailed Physic al ExamTh e part of the assess ment proces s in which a detail ed areabyarea exam is perfor med on patien ts whose proble ms cannot be readil y 9/27/2011tance69487272. Lacera tions. Tender ness. Contus ions. Abrasi ons. Punctu res/Pe netrat ions.docD91er9/27/2011id not contact medical 91fo9/27/2011 not check medication f91pti
. and Swelli ng. Burns.each area of the body is evalua ted for Deform ities.
F ocused Histor y And Physic al ExamPa rt of the assess ment proces s in which the patien t''s major compla ints or any proble ms that are immedi ately eviden t are furthe r and more specif 9/27/2011tance69487272.docD92er9/27/2011id not contact medical 92fo9/27/2011 not check medication f92pti
.identi fied or when more specif ic inform ation is needed about proble ms identi fied in the focuse d histor y and physic al exam.
based on the patien t''s surrou ndings .Go lden 9/27/2011tance69487272. frozen body parts.ically evalua ted. and the chief compla int. Genera l Impres sionOv erall initia l impres sion that determ ines the priori ty for patien t care. signs and sympto ms.Fr ostbit eDamag e to tissue s as the result of exposu re to cold. the mechan ism of injury .docD93er9/27/2011id not contact medical 93fo9/27/2011 not check medication f93pti
docD94er9/27/2011id not contact medical 94fo9/27/2011 not check medication f94pti
. during which treatm ent of shock or trauma tic injuri es should occur becaus e surviv al potent ial is best.HourTi me from injury to defini tive care.Hypo thermi aA condit ion in which the intern al 9/27/2011tance69487272.G uardin gInvol untary muscle contra ctions (spasm ) of the abdomi nal wall. an effort to protec t the inflam ed abdome n.
J aundic eYello w skin or sclera color 9/27/2011tance69487272. Initia l Assess mentPa rt of the assess ment proces s that helps you to identi fy any immedi ately or potent ially lifethreat ening condit ions so that you can initia te lifesa ving care.docD95er9/27/2011id not contact medical 95fo9/27/2011 not check medication f95pti
.body temper ature falls below 95 degree s F (35 degree s C) after exposu re to a cold enviro nment.
Mechan ism Of Injury (MOI)F orces or energy transm ission applie d to the body that cause injury .docD96er9/27/2011id not contact medical 96fo9/27/2011 not check medication f96pti
.Ongoi ng 9/27/2011tance69487272.that is caused by liver diseas e or dysfun ction.Nasal Flarin gFlari ng out of the nostri ls. indica ting that there is an airway obstru ction. Nature Of Illnes s (NOI)G eneral type of illnes s a patien t is experi encing .
9/27/2011tance69487272.pate llaOut er and smalle r bone of the two bones of the lower leg.Fr acture in which bone fragme nts are
One of the three major subdivisions of the brain. coordinates the various activities of the brain. sometimes called the "little brain". cerebe llumop en fractu reAny break in a bone in which the overly ing skin has been damage d.docD97er9/27/2011id not contact medical 97fo9/27/2011 not check medication f97pti
.Assess mentPa rt of the assess ment proces s in which proble ms are reeval uated and respon ses to treatm ent are assess ed. particularly fine body movements.
Co llarbo ne.S imple joint where the bony projec tions of the scapul a and the clavic le meet at the top of the should er. it is latera l to the sternu m and medial to the scapul a.docD98er9/27/2011id not contact medical 98fo9/27/2011 not check medication f98pti
.Mus culosk eletal caresu pine hypote nsive syndro meLow blood pressu re 9/27/2011tance69487272.calc aneusH eel bone.separa ted from one anothe r and not in anatom ic alignm ent.
pancre as. spleen .result ing from compre ssion of the inferi or vena cava by the weight of the pregna nt uterus when the mother is supine .docD99er9/27/2011id not contact medical 99fo9/27/2011 not check medication f99pti
.ope n abdomi nal 9/27/2011tance69487272.Infla mmatio n of the perito neum. and kidney s).s olid organs Solid masses of tissue where much of the chemic al work of the body takes place (eg. the liver.
hematu riafla nkevis cerati onAbdo men & genita lia injuri estens ion pneumo thorax Accumu lation of air or gas in the pleura l cavity that progre ssivel y increa ses the pressu re in the 9/27/2011tance69487272. a sign of perito nitis.docD100er9/27/2011id not contact medical 100fo9/27/2011 not check medication f100pti
.injury Involu ntary muscle contra ctions (spasm ) of the abdomi nal wall in an effort to protec t the inflam ed abdome n.
alumin um foil.chest with potent ially fatal result s.occlu sive dressi ngDres sing made of Vaseli ne gauze. or plasti c that preven 9/27/2011tance69487272. hemoth oraxCo llecti on of blood in the pleura l cavity .myoca rdial contus ionBru ise of the heart muscle .docD101er9/27/2011id not contact medical 101fo9/27/2011 not check medication f101pti
.pulm onary contus ionBru ise of the lung.p ericar diumFi brous sac that surrou nds the heart.
by an extern al object such as a bullet or knife. 9/27/2011tance69487272. open chest injury Injury to the chest in which the chest wall itself is penetr ated. parado xical motion Motion of the chest wall sectio n that is detach ed in a flail chest.ts air and liquid s from enteri ng or exitin g a wound. more freque ntly.docD102er9/27/2011id not contact medical 102fo9/27/2011 not check medication f102pti
. by a fractu red rib or.
fl ail chestC onditi on in which two or more ribs are 9/27/2011tance69487272.the motion is exactl y the opposi te of normal motion during breath ing (ie. usuall y due to blunt trauma .docD103er9/27/2011id not contact medical 103fo9/27/2011 not check medication f103pti
. in during inhala tion. out during exhala tion). Chest injuri esclos ed chest injury Injury to the chest in which the skin is not broken .dyspn eaDiff iculty breath ing.
fractu red in two or more places or in associ ation with a fractu re of the sternu m so that a segmen t of chest wall is effect ively detach ed from the rest of the thorac ic cage.st ernocl eidoma stoid muscle sMuscl es on 9/27/2011tance69487272.pinn aExter nal. visibl e part of the ear.docD104er9/27/2011id not contact medical 104fo9/27/2011 not check medication f104pti
.f lutter valvet ympani c membra neMost poster ior portio n of the craniu m.
causin g a charac terist ic crackl ing sensat ion on palpat ion.e xterna l audito 9/27/2011tance69487272.te mporom andibu lar joint (TMJ)m axilla eBranc h of the intern al audito ry canal that connec ts the middle ear to the oropha rynx.s ubcuta neous emphys emaPre sence of air in soft tissue s.either side of the neck that allow moveme nt of the head.docD105er9/27/2011id not contact medical 105fo9/27/2011 not check medication f105pti
fibrou s.op tic nerveC ranial nerve that 9/27/2011tance69487272. white portio n of the eye that protec ts the more delica te inner struct ures. leads to the tympan ic membra ne.docD106er9/27/2011id not contact medical 106fo9/27/2011 not check medication f106pti
.air emboli smscle raToug h.ry canalE ar canal.C hapter 26Face and Throat Injuri esreti nal detach mentSe parati on of the retina from its attach ments at the back of the eye.
also called tear glands .su perfic 9/27/2011tance69487272. orbitB ony eye socket .Gl ands that produc e fluids to keep the eye moist.transm its visual inform ation to the brain.docD107er9/27/2011id not contact medical 107fo9/27/2011 not check medication f107pti
.pupil Circul ar openin g in the middle of the iris that admits light to the back of the eye.irish yphema Transp arent tissue layer in front of the pupil and iris of the eye.
charac terize d by skin that is red but not bliste red or actual ly burned throug h.docD108er9/27/2011id not contact medical 108fo9/27/2011 not check medication f108pti
.ial burnBu rn affect ing only the epider mis.C hapter 25lace ration Jagged open wound. mucous membra neLini ng of body caviti es and passag es that are in direct contac t with the outsid e enviro 9/27/2011tance69487272. tradit ionall y called a firstdegree burn.
docD109er9/27/2011id not contact medical 109fo9/27/2011 not check medication f109pti
. or plasti c that preven ts air and liquid s from enteri ng or exitin g a wound. exposi ng deeper tissue to potent ial contam inatio n. alumin um foil.part ialthickn 9/27/2011tance69487272. open injury Injury in which there is a break in the surfac e of the skin or the mucous membra ne.nment. occlus ive dressi ngDres sing made of Vaseli ne gauze.
p enetra ting woundI njury result ing from a sharp.ess burnBu rn affect ing the epider mis and some portio n of the dermis but not the subcut aneous tissue . tradit ionall y called a second degree burn. moist. charac terize d by bliste rs and skin that is white to red.docD110er9/27/2011id not contact medical 110fo9/27/2011 not check medication f110pti
. and mottle d. pointe d object 9/27/2011tance69487272.
leavin g the area dry. dark brown.docD111er9/27/2011id not contact medical 111fo9/27/2011 not check medication f111pti
. muscle . or charre d.e viscer ationD isplac ement of organs outsid e the body. tradit ionall y called a thirddegree burn. and white.hemat omaBur n that affect s all skin layers and may affect the subcut aneous layers . and intern al organs . bone.I njury in which 9/27/2011tance69487272.. leathe ry.
usuall y a bacter ial infect ion.sh ockCon dition in 9/27/2011tance69487272.docD112er9/27/2011id not contact medical 112fo9/27/2011 not check medication f112pti
.Shock caused by severe infect ion. may cut off blood flow or damage sensit ive tissue .damage occurs beneat h the skin or mucous membra ne but the surfac e remain s intact .compa rtment syndro meSwel ling in a confin ed space that produc es danger ous pressu re.
also called hypope rfusio n. by contra cting.docD113er9/27/2011id not contact medical 113fo9/27/2011 not check medication f113pti
. constr ict a duct.sphi ncters Circul ar muscle s that encirc le and.which the circul atory system fails to provid e suffic ient circul ation so that every body part can perfor m its functi on. tube. or openin g.sync opeFai nting spell or transi ent loss of consci ousnes 9/27/2011tance69487272.
s.psyc hogeni c shockS hock caused by a sudden . tempor ary reduct ion in blood supply to the brain that causes fainti ng (synco pe).se nsitiz ationi rrever 9/27/2011tance69487272.Chap ter 24Soft tissue injuri esabra sionLo ss or damage of the superf icial layer of skin as a result of a body part rubbin g or scrapi ng across a rough or hard surfac e.docD114er9/27/2011id not contact medical 114fo9/27/2011 not check medication f114pti
dehy dratio nEarly stage of shock.sible shockF inal stage of shock. in which the body can still compen sate for blood loss.docD115er9/27/2011id not contact medical 115fo9/27/2011 not check medication f115pti
. caused by reduce d levels of oxygen in the blood. decomp ensate d shockL ate stage of shock when blood pressu re is fallin g.A n 9/27/2011tance69487272. result ing in deathn euroge nic shockB luishgray skin color.
or abdomi nal cavity . pelvis . used to splint the lower extrem ities or pelvis or to contro l bleedi ng in the lower extrem ities.press ure pointP oint where a blood vessel lies near a bone. useful when direct pressu re and elevat ion do not contro l bleedi ng.inflat able device that covers the legs and abdome n.docD116er9/27/2011id not contact medical 116fo9/27/2011 not check medication f116pti
also called hypope rfusio n.ckCond ition in which the circul atory system fails to provid e suffic ient circul ation so that every body part can perfor m its functi on.docD117er9/27/2011id not contact medical 117fo9/27/2011 not check medication f117pti
. used only when all other method s have failed & the patien 9/27/2011tance69487272.tour niquet Bleedi ng contro l method of last resort that occlud es arteri al flow.
result s in inadeq uate perfus ion.docD118er9/27/2011id not contact medical 118fo9/27/2011 not check medication f118pti
.veins Blood vessel s that carry blood from the tissue s to the heart. hemorr hageBl eeding hypovo lemic shockC onditi on in which low blood volume .t''s life is in danger . due to massiv e intern al or extern al bleedi ng or extens ive loss of body water.pe rfusio nNoseb leedDi scolor ation of the 9/27/2011tance69487272.
Chapte r 22Blee dingme chanis m of injury (MOI)f orces or energy transm ission applie 9/27/2011tance69487272.skin associ ated with a closed wound.docD119er9/27/2011id not contact medical 119fo9/27/2011 not check medication f119pti
. bruisi ng.a rterio lesSma llest branch es of arteri es leadin g to vast networ k of capill aries.cap illari esaort aPrinc ipal artery leavin g left side of heart and carryi ng freshl y oxygen ated blood to the body.
such as knives and bullet s.penet rating trauma Injury caused by object s. that pierce surfac e of body and damage intern al tissue s and organs .Aware ness that unseen lifethreat ening injuri 9/27/2011tance69487272.multi system trauma patien tA patien t who experi enced trauma that affect s more than one body system .d to body that cause injury .docD120er9/27/2011id not contact medical 120fo9/27/2011 not check medication f120pti
docD121er9/27/2011id not contact medical 121fo9/27/2011 not check medication f121pti
. and discou rageme nt.fu nction al disord erA disord er in which there 9/27/2011tance69487272. may be a sympto m of many differ ent mental and physic al disord ers.decel eratio norgan ic brain syndro medepr ession A persis tent mood of sadnes s. or it may be a disord er on its own.es may exist when determ ining mechan ism of injury . despai r.
behav ioral crisis The point at which a person ''s reacti ons to events interf ere with activi ties of daily living .is no known physio logic reason for the abnorm al functi oning of an organ or organ system . this become s a psychi atric emerge ncy when it causes a major life interr uption .docD122er9/27/2011id not contact medical 122fo9/27/2011 not check medication f122pti
. such as attemp ted 9/27/2011tance69487272.
suicid e.docD123er9/27/2011id not contact medical 123fo9/27/2011 not check medication f123pti
. dressi ng. and bathin g.Chap ter 19 Behavi or Emerge ncyact ivitie s of daily living (ADL)T he basic activi ties a person usuall y accomp lishes during a normal day.alte red mental status A change in the way a person thinks and behave s that may signal diseas e in the centra l nervou s system 9/27/2011tance69487272. such as eating .
after suffoc ation in water.A system that delive rs air to the mouth and lungs at variou s atmosp heric pressu res. stands for selfcontai ned underw ater breath ing appara tus. increa sing with the depth of the dive.Su rvival .docD124er9/27/2011id not contact medical 124fo9/27/2011 not check medication f124pti
. Radiat ionThe transf er of heat to colder object 9/27/2011tance69487272. at least tempor arily.or elsewh ere in the body.
s in the enviro nment by radian t energy .l aryngo spasmA chambe r. pressu rized to more than atmosp heric pressu re. usuall y a small room.conv ection The loss of body 9/27/2011tance69487272. when a body part comes into contac t with a colder object ).hea tstrok eThe loss of heat by direct contac t (eg. for exampl e heat gain from a fire.docD125er9/27/2011id not contact medical 125fo9/27/2011 not check medication f125pti
heat caused by air moveme nt (eg, breeze blowin g across the body). ambien t temper atureT he temper ature of the surrou nding enviro nment. antive ninsti mulant An agent that produc es an excite d state. substa nce abuseT he misuse of any substa nce to produc e some desire d effect .toler anceTh e need for increa sing amount s of a 9/27/2011tance69487272.docD126er9/27/2011id not contact medical 126fo9/27/2011 not check medication f126pti
drug to obtain the same effect .toxin A poison or harmfu l substa nce.vo mituss edativ eA substa nce that decrea ses activi ty and excite ment.h ypnoti cantid oteA substa nce that is used to neutra lize or counte ract a poison .Chapt er 17 WhealA raised , swolle n, welldefine d area on the skin result ing from 9/27/2011tance69487272.docD127er9/27/2011id not contact medical 127fo9/27/2011 not check medication f127pti
an insect bite or allerg ic reacti on.Whe ezingA highpitche d, whistl ing breath sound, charac terist ically heard on expira tion in patien ts with asthma or COPD.l eukotr ienesC hemica l substa nces that contri bute to anaphy laxis; releas ed by the immune system in allerg ic reacti ons.an aphyla xisThe passag e of 9/27/2011tance69487272.docD128er9/27/2011id not contact medical 128fo9/27/2011 not check medication f128pti
Chapt er 15 Diabet ic Emerge ncyAci dosisA pathol ogic condit ion result ing from the accumu lation of acids in the body.an unusua lly large volume of urine in a given period .d iabete s mellit usA 9/27/2011tance69487272. Erosio n of the stomac h or intest inal lining . this can result from wastin g of glucos e in the urine.docD129er9/27/2011id not contact medical 129fo9/27/2011 not check medication f129pti
. in diabet es.
usuall y becaus e of a lack of insuli n.metabo lic disord er in which the abilit y to metabo lize carboh ydrate s (sugar s) is impair ed. and acidos is in diabet es.diab etic comaUn consci ousnes s caused by dehydr ation.dia betic ketoac idosis (DKA)A form of acidos is in uncont rolled diabet 9/27/2011tance69487272. very high blood glucos e levels .docD130er9/27/2011id not contact medical 130fo9/27/2011 not check medication f130pti
for cellul ar metabo lism. Hyperg lycemi aAbnor mally 9/27/2011tance69487272.H ormone A chemic al substa nce that regula tes the activi ty of body organs and tissue s. it is the primar y fuel.docD131er9/27/2011id not contact medical 131fo9/27/2011 not check medication f131pti
.es in which certai n acids accumu late when insuli n is not availa ble. along with oxygen . produc ed by a gland.Gl ucoseO ne of the basic sugars .
appe ndicit isInfl ammati on of the append ix.docD132er9/27/2011id not contact medical 132fo9/27/2011 not check medication f132pti
.cho 9/27/2011tance69487272. Hypogl ycemia Comple te obstru ction of blood circul ation in a given organ as a result of compre ssion or entrap ment.cys titisI nflamm ation of the bladde r.Infla mmatio n of the pancre as. an emerge ncy situat ion causin g death of tissue .high glucos e level in the blood.
lecyst itisAc ute Abdome nacute abdome nstrok eA loss of brain functi on in certai n brain cells that do not get enough oxygen during a CVA. Usuall y caused by obstru ction of the blood vessel s in the brain that feed oxygen to those brain cells.docD133er9/27/2011id not contact medical 133fo9/27/2011 not check medication f133pti
. thromb osispo sticta l statei schemi aA lack of oxygen that depriv es 9/27/2011tance69487272.
tissue s of necess ary nutrie nts. potent ially revers ible becaus e perman ent injury has not yet occurr ed.Cel ls in the brain that die as a result of loss of blood flow to the brain.docD134er9/27/2011id not contact medical 134fo9/27/2011 not check medication f134pti
. result ing from partia l or comple te blocka ge of blood flow. incont inence Weakne ss on one side of the body.h emorrh agic stroke 9/27/2011tance69487272.
occurs as a result of bleedi ng inside the brain.docD135er9/27/2011id not contact medical 135fo9/27/2011 not check medication f135pti
. genera lized seizur eThe inabil ity to pronou nce speech clearl y.ventr icular fibril 9/27/2011tance69487272. often due to loss of the nerves or brain cells that contro l the small muscle s in the larynx .The inabil ity to unders tand or produc e speech .One of the two main types of stroke .
may result in inadeq uate blood flow. eventu ally deteri orate into cardia c 9/27/2011tance69487272.ventr icular tachyc ardia (VT)Ra pid heart rhythm . electr ical impuls e begins in ventri cle (inste ad of atrium ).lation Disorg anized .docD136er9/27/2011id not contact medical 136fo9/27/2011 not check medication f136pti
. ineffe ctive twitch ing of the ventri cles. result ing in no blood flow and a state of cardia c arrest .
Poste riorba ck surfac e of the body. more than 100 beats/ min. or any body part.Sup eriorp art of the body.arrest .Tach ycardi aRapid heart rhythm .S yncope Fainti ng spell or transi ent loss of consci ousnes s.docD137er9/27/2011id not contact medical 137fo9/27/2011 not check medication f137pti
.Is chemia lack of oxygen that depriv es 9/27/2011tance69487272. side away from you in standa rd anatom ic positi on. nearer to the head.
Lu menInf arctio nDeath of a body tissue .Dilat ionWid ening of a tubula r struct ure such as a corona ry artery . usuall y caused by interr uption of its blood supply .docD138er9/27/2011id not contact medical 138fo9/27/2011 not check medication f138pti
.tissue s of necess ary nutrie nts.Defib rillat eTo shock a fibril lating (chaot ically beatin g) heart with specia lized electr ical curren t in an attemp 9/27/2011tance69487272.
caused by low output of blood from the heart.t to restor e a normal rhythm ic beat. It can be a severe compli cation of a large acute myocar dial infarc tion.c oronar y artery cardio genic shockA state in which not enough oxygen is delive red to tissue s of body. less than 9/27/2011tance69487272.docD139er9/27/2011id not contact medical 139fo9/27/2011 not check medication f139pti
.S low heart rate. as well as other condit ions.
60 beats/ min. even if muscul ar and electr ical activi ty contin ues in the heart. Athero sclero sisA disord er in which choles terol 9/27/2011tance69487272.ca rdiac arrest A state in which the heart fails to genera te an effect ive and detect able blood flow. pulses are not palpab le in cardia c arrest . Atrium Upper chambe r of the heart.docD140er9/27/2011id not contact medical 140fo9/27/2011 not check medication f140pti
A rrhyth miaAn irregu lar or abnorm al heart rhythm .and calciu m build up inside walls of blood vessel s.a ngina pector isTran sient (short 9/27/2011tance69487272.The princi pal artery leavin g the left side of the heart and carryi ng freshl y oxygen ated blood to the body.docD141er9/27/2011id not contact medical 141fo9/27/2011 not check medication f141pti
. eventu ally leadin g to partia l or comple te blocka ge of blood flow.
lived) chest discom fort caused by partia l or tempor ary blocka ge of blood flow to the heart muscle . charac terist ically heard on expira tion 9/27/2011tance69487272.docD142er9/27/2011id not contact medical 142fo9/27/2011 not check medication f142pti
. whistl ing breath sound.Anter iorHar sh. highpitche d. barkin g inspir atory sound often heard in acute laryng eal (upper airway ) obstru ction. Wheezi ngHigh pitche d.
s evere acute respir atory syndro me (SARS) pulmon ary emboli smBloo d clot that breaks off from a large vein and travel s to the blood vessel s of the lung. stabbi ng pain 9/27/2011tance69487272.P artial or comple te accumu lation of air in the pleura l space. Sharp. causin g obstru ction of blood flow.docD143er9/27/2011id not contact medical 143fo9/27/2011 not check medication f143pti
.in patien ts with asthma or COPD.
Pneum oniapl eural effusi onColl ection of fluid betwee n lung and chest wall that may compre ss lung. tissue s do not have enough oxygen .Infec 9/27/2011tance69487272. often caused by inflam mation or irrita tion of the pleura .docD144er9/27/2011id not contact medical 144fo9/27/2011 not check medication f144pti
.H ypoxia Condit ion in which the body's cells.in the chest that is worsen ed by a deep breath or other chest wall moveme nt.
epiglo ttis become s inflam ed. Blood clot or other substa nce in circul atory system that travel s to a blood vessel where it causes blocka ge. 9/27/2011tance69487272.chr onic obstru ctive pulmon ary diseas e (COPD) A slow proces s of dilati on and disrup tion of the airway s and alveol i. enlarg ed. may cause upper airway obstru ction.tious diseas e.docD145er9/27/2011id not contact medical 145fo9/27/2011 not check medication f145pti
transd ermal medica tionst opical medica tionsL otions .docD146er9/27/2011id not contact medical 146fo9/27/2011 not check medication f146pti
. trade namebr and name a manufa cturer gives a 9/27/2011tance69487272. creams . Throug h the skin. a medica tion delive ry route.caused by chroni c bronch ial obstru ction. a medica tion delive ry route. ointme nts applie d to the surfac e of the skin and affect only that area.
medica tion. Suspen sionsu bcutan eous (SC) inject ionInj ection into the tissue betwee n the skin and muscle . a medica tion delive ry route. Under the tongue . a medica tion delive ry route.p rescri ption medica tionsM edicat 9/27/2011tance69487272.docD147er9/27/2011id not contact medical 147fo9/27/2011 not check medication f147pti
. the name is capita lized. side effect sAny effect s of a medica tion other than the desire d ones.
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. the heart and brain. Polyph armacy use of multip le medica tions on a regula r basis. 9/27/2011tance69487272. a medica tion delive ry route.ions that are distri buted to patien ts only by pharma cists accord ing to a physic ian''s order. Oxygen gas that all cells need for metabo lism. Pharma cology per rectum (PR)Th rough the rectum .
s imple sugar readil y absorb ed by bloods tream.especi ally.per os (PO)Th rough the mouth.docD149er9/27/2011id not contact medical 149fo9/27/2011 not check medication f149pti
. it is carrie d on EMS unit. cannot functi on withou t oxygen . same as oral. a medica tion delive ry route.o verthecounte r (OTC) medica tionsM edicat ions purcha sed direct ly by a patien t withou t a prescr iption 9/27/2011tance69487272.
intrav enous (IV) inject ioninj ection 9/27/2011tance69487272. you may be allowe d to help the patien t selfadmini ster the medica tion. a medica tion delive ry route.OralB y mouth. a medica tion delive ry route. Nitrog lyceri nmedic ation that increa ses cardia c perfus ion by causin g arteri es to dilate .i ntraos seous (IO)In to the bone.docD150er9/27/2011id not contact medical 150fo9/27/2011 not check medication f150pti
Gelsem iliqui d substa nce that is admini stered 9/27/2011tance69487272. muscul ar part of breath ing that draws air into airway and lungs. intram uscula r (IM) inject ionHyp oglyce miaabn ormall y low blood glucos e level.direct ly into a vein. therap eutic uses for a specif ic medica tion. a medica tion delive ry route.docD151er9/27/2011id not contact medical 151fo9/27/2011 not check medication f151pti
.I nhalat ionact ive.
docD152er9/27/2011id not contact medical 152fo9/27/2011 not check medication f152pti
. amount of medica tion given on the basis of the patien t''s size and age.ac tivate d charco alPhar magolo gySimp lexA trusti ng relati onship that you build with your patien t.orally in capsul e form or throug h plasti c tubes. FCC has design ated exclus ively for EMS use.VHF & UHF channe ls.Pa gingTh e abilit 9/27/2011tance69487272.
y to transm it and receiv e simult aneous ly."Chan nelass igned freque ncy or 9/27/2011tance69487272." cellul ar teleph onelow -power portab le radio that commun icates thru an interc onnect ed series of repeat er statio ns called "cells . AKA "hot line.ded icated linesp ecial teleph one line used for specif ic pointtopoint commun icatio ns.docD153er9/27/2011id not contact medical 153fo9/27/2011 not check medication f153pti
Cha pter 9 Commun icatio n & Doc Vocabu laryba se statio n Presen ce of air in soft tissue s.docD154er9/27/2011id not contact medical 154fo9/27/2011 not check medication f154pti
.freque ncies used to carry voice and/or data commun icatio ns. causin g a charac terist ic crackl ing sensat ion on palpat ion.Tr iagePr ocess of establ ishing treatm ent and transp ortati on priori ties accord ing to severi ty of injury 9/27/2011tance69487272.
To ThreeWord Dyspne aScler aTough .docD155er9/27/2011id not contact medical 155fo9/27/2011 not check medication f155pti
. crowin g inspir atory sound. fibrou s.and medica l need. highpitche d. Brief histor y of a patien t''s 9/27/2011tance69487272. white portio n of the eye that protec ts the more delica te inner struct ures.T wo. such as the sound often heard in acute laryng eal (upper airway ) obstru ction.S tridor Harsh.
pertin ent past histor y.condit ion to determ ine signs and sympto ms. last oral intake . allerg ies.docD156er9/27/2011id not contact medical 156fo9/27/2011 not check medication f156pti
. lowpitche d breath sounds heard in patien ts with chroni c mucus in the upper airway s.Move ments in which the skin pulls 9/27/2011tance69487272. medica tions. and events leadin g to the injury or illnes s.Scen e SizeUpCoar se.
Way in which a patien t respon ds to extern al stimul i. includ ing verbal stimul i (sound ). the motion is exactl y the opposi 9/27/2011tance69487272.in around the ribs during inspir ation. and painfu l stimul i.Para doxica l Motion Motion of the chest wall sectio n that is detach ed in a flail chest.docD157er9/27/2011id not contact medical 157fo9/27/2011 not check medication f157pti
. tactil e stimul i (touch ).
place (curre nt locati on). and event (what happen ed).te of normal motion during breath ing (ie. and approx imate date). Palpat eExami ne by touch. out during exhala tion). in during inhala tion. Orient ationM ental status of a patien t as measur ed by memory of person (name) .Se condar y muscle s of 9/27/2011tance69487272.docD158er9/27/2011id not contact medical 158fo9/27/2011 not check medication f158pti
. month. time (curre nt year.
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.respir ation Newton ’s first law states that object s at rest tend to stay at rest and object s in motion tend to stay in motion unless acted on by some force. Newton ’s second law states that force (F) equals mass (M) times accele ration (A). F = M × A. in which acceleratio n is the change in 9/27/2011tance69487272. that is.
such as walking.peripheral nervous systemPart of the nervous system that consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.retrograde amnesiaInability to remember events leading up to a head injury. and writing. speech. visual perception. hearing.Glasgow Coma ScaleMethod of evaluating level of consciousness that uses a scoring system for neurologic responses to specific stimuli. pain. talking.connecting nervesNerves that connect the sensory and motor nerves in the spinal cord. emotions.sensory nervesNerves that carry sensations of touch.docD160er9/27/2011id not contact medical 160fo9/27/2011 not check medication f160pti
9/27/2011tance69487272.open head injuryInjury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue. made up of several lobes that control movement.four-person log rollRecommended procedure for moving a patient with a suspected spinal injury from the ground to a long backboard. and personality. sometimes called the "gray matter". cold. taste.somatic (voluntary) nervous systemArt of the nervous system that regulates our voluntary activities.meningesThree distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal. Newton ’s third law states that for every action .eyes-forward positionHead position in which the patient''s eyes are looking straight ahead and the head and torso are in line. there is an equal and opposi te reacti on Chapte r 21 cerebral edemaSwelling of the brain. heat.motor nervesNerves that carry information from the central nervous system to the muscles of the body.veloci ty (speed ) that occurs over time. or connecting nerves. These peripheral nerves may be sensory nerves.intervertebral diskCushion that lies between two vertebrae. balance.cerebrumLargest part of the three subdivisions of the brain.voluntary activitiesActions that we consciously perform.distractionAction of pulling the spine along its length. or other modalities from the body to the central nervous system.raccoon eyesBruising under the eyes that may indicate skull fracture. in which sensory input or conscious thought determines a specific muscular activity.concussionTemporary loss or alteration of part or all of the brain''s abilities to function without actual physical damage to the brain.closed head injuryInjury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding.involuntary activitiesActions that we do not consciously control. motor nerves.
the body changes to accommo. This system assigns a number value (0. Normally.tem by making the joints more “loose” or less stable. shallow. Grimace or irritability. begin ventilations with a bagmask device.pirations and heart rates or is pronounced dead by a physician. Check the newborn for central cyanosis. If the infant presents in distress. A perfect score is 10. especially during the first few breaths. Activity or muscle tone. Abnormal or complicated deliveries include breech deliveries (buttocks first). Assess the newborn’s skin color. expulsion of the fetus. 5. make the chest rise with each ventilation. limb presentations (arm. in addition to assisted ventilation. 1. The umbilical cord connects the mother and fetus through the placenta. Blue skin all over or blue mucous membranes signal a central cyanosis. and begin ventilation with high-flow oxygen at a rate of 40 to 60 breaths/min.cal cord first). Quickly transport patient w/limb presentation or prolapsed umbilical cord to hospital. you can mea. the infant will resist attempts to straighten them out. there is usually time to transport the patient to the hospital during the first stage of labor. Once CPR has been started. Second stage of labor. to some degree. continue CPR and rapidly transport. Do not give up! Many infants have survived without brain damage after prolonged periods of effec. who may have a sudden cardiac arrest. crying. do not waste time on the assessing the Apgar score. Complications of pregnancy include hypertensive disor. If a stethoscope is unavailable. A newborn should not be floppy or limp.skinned newborn infant and the mucous membranes of a dark-skinned infant should turn pink. If the infant does not begin breathing on his or her own or does not have an adequate heart rate. In situations in which assisted ventilation is required. Respirations. Most newborn infants will have a score of 7 or 8 at one minute and a score of 8 to 10 four minutes later.loskeletal systems. or 2) to five areas of activity of the newborn infant: Appearance. With gentle pres. Unlike adults. but hands and feet should “pink up” quickly. change the pad as often as necessary. If the respirations are slow. you have two patients to consider—the woman and the unborn fetus. This alone may increase the newborn infant’s heart rate. 2. If the newborn is breathing well. adminis. begins with birth of infant and ends with delivery of placenta. do not stop until the infant responds with adequate res. Increased hormone levels affect the musculoskeletal sys.tion.tory insufficiency and need assistance with ventila. First stage of labor. contractions of the uterus will propel the neonate through the birth canal.sure. you will probably not transport the patient until the placenta has delivered. You should request a second unit as soon as possible if you determine that the newborn infant is in any distress and will require resuscitation.
9/27/2011tance69487272. Cover the newborn’s mouth and nose with the mask. begin resuscitation immediately. Newborn infants often have cyanosis of the extremities for a few minutes after birth. once the
infant has been born. or withdrawing in response to stimuli is normal in a newborn and indicates that the newborn infant is doing well. or foot first). The Apgar score should be calculated at 1 minute and 5 minutes after birth. you should next check the pulse rate by feeling the brachial pulse or the pulsations at the base of the umbilical cord. cardiovascular. The degree of muscle tone indicates the oxygenation of the newborn infant’s tissues. a pregnant patient’s respiratory capacity changes with increased respiratory rates and decreasing minute volumes. and. The way to test this is to snap a finger against the sole of the infant’s foot. The primary systems involved with these changes are the respiratory. you now have two patients. bleeding. A pregnant patient’s blood volume increases by as much as 50%. Any trauma to the woman will have a direct effect on the condition of the fetus.Chap 20 Obstetric/GynecologicInside the uterus. During the third stage of labor.sure pulsations with your fingers in the umbilical cord or at the brachial pulse. Complete absence of respirations or crying is obviously a very serious sign. During a trauma call that involves a pregnant woman. Normally.ter blow-by oxygen by holding oxygen tubing at high-flow (10 to 15 L/min) close to the newborn infant’s face. CPR may be necessary. and the heart rate increases by 20%. Third stage of labor. If they do not. You should place a finger or hand into the vagina only to keep the walls of the vagina from compressing the infant’s airway during a breech presentation or to push the infant’s head away from the cord when the cord is prolapsed. Remember. The Apgar score is the standard scoring system used to assess the status of a newborn. the skin of a light. the hips and knees are flexed at birth. Therefore. begins when the cervix is fully dilated and ends when the infant is born. delivery of placenta. Suctioning and stimulation should result in an immediate increase in respirations.ders. During the second stage of labor. and
prolapse of the umbilical cord (umbili. the newborn’s respirations are regular and rapid. newborn infants who are in cardiac arrest usually have a respiratory arrest first. the newborn infant may have respira. you should use a newborn bag-mask device. Pulse. Shortly after birth.tive CPR. and take all used pads to the hospital for examination. leg. however. Quickly calculate the Apgar score to establish a baseline on the newborn’s status. It may be necessary to bypass the pop-off valve to accomplish this. you must begin ventilations with a bag-mask device. 4. begins with the onset of contractions and ends when cervix is fully dilated. Cover the vagina with a sterile pad.docD161er9/27/2011id not contact medical 161fo9/27/2011 not check medication f161pti
. with a good strong cry. As a result of enlargement of the uterus. Grimacing. The total of the five numbers is the Apgar score. or labored. the developing fetus floats in the amniotic sac. Eventually. and diabetes. Reassess respirations and heart rate at least every 30 seconds to make sure that the pulse rate is increasing and that respirations are becoming spontaneous. If it is not. 3. or you do not think the skin color is normal for a newborn. you must decide whether to deliver the infant at the scene or transport the patient. Once labor has begun. Throughout pregnancy. it cannot be slowed or stopped. or if the cry is weak. dilation.date the fetus. The pulse rate should be at least 100 beats/min. Follow these steps in assessing a newborn infant: 1. Excessive bleeding is a serious emergency. and muscu. it is essential to keep the infant ventilating and oxygenating well. If present. Make sure you have a good mask-to-face seal. An infant with no pulse requires immediate CPR.
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.Apgar Scoring ScoreArea of Activity21 0Appeara nceEntire infant is pink.Body is pink. but hands & feet remain blue.Pulse More than 100 beats/min Fewer than 100 beats/min Absent pulseGrim ace or irritability Infant cries & tries to move foot away from finger snapped against sole of foot.Infant gives a weak cry in response to stimulus. Activity or muscle toneInfant resists attempts to straighten hips and knees.Entir e infant is blue or pale.Infa nt makes 9/27/2011tance69487272.I nfant does not cry or react to stimulus.
weak attempts to resist straighteni ngInfant is completel y limp.Abruptio placenta A premature separation of the placenta from the wall of the uterus. miscarriag e. baglike membrane in which the fetus develops. w/no muscle tone. Apgar scoreScori ng system for assessing the status of a newborn that assigns a number value to 9/27/2011tance69487272.docD163er9/27/2011id not contact medical 163fo9/27/2011 not check medication f163pti
.Respi rationRapi d respiration sSlow respiration sAbsent respiration s Chapter 20 AbortionD elivery of the fetus and placenta before 20 weeks.Am niotic sacFluidfilled.
or neck.Cro wningApp earance of the infant''s head at the vaginal opening during labor. of the uterus.docD164er9/27/2011id not contact medical 164fo9/27/2011 not check medication f164pti
.Blo ody showSmal l amount of blood at vagina that appears at beginning of labor and may include a plug of pinktinged mucus that is discharge d when cervix begins to dilate.each of five areas of assessmen t.Bre ech presentati onDeliver y in which the buttocks come out first.Cervi xLower third.Birth canalVagi na and cervix.Ecla mpsiaSeiz ures (convulsio ns) resulting from 9/27/2011tance69487272.
characteri zed by physical and mental retardatio n and a variety of congenital abnormali ties.Embr yo The fertilized egg that is the early stages of a fetus.
9/27/2011tance69487272.Endo metrium The lining of the inside of the uterus. typically in a fallopian tube.severe hypertensi on in a pregnant woman.Fet al alcohol syndrome Condition of infants who are born to alcoholic mothers.docD165er9/27/2011id not contact medical 165fo9/27/2011 not check medication f165pti
.Ec topic pregnancy Pregnancy that develops outside the uterus.
FetusDeveloping, unborn infant inside the uterus.Fundus dome-shaped top of uterus.Gestational diabetesDiabetes that develops during pregnancy in women who did not have diabetes before pregnancy.Lightening sensation felt by pregnant patient when fetus positions itself for delivery.Limb presentationDelivery in which the presenting part is a single arm, leg, or foot.MeconiumDark green material in the amniotic fluid that can indicate disease in newborn; meconium can be aspirated into the infant''s lungs during delivery; baby's first bowel movement.MiscarriageDelivery of the fetus and placenta before 20 weeks; spontaneous abortion.MultigravidaWoman who has had previous pregnancies.MultiparaWoman who has had more than one live birth.Nuchal cordUmbilical cord that is wrapped around the infant''s neck.Pelvic inflammatory diseaseInfection of the fallopian tubes and the surounding tissues of the pelvis.PerineumArea of skin between the vagina and the anus.PlacentaTissue attached to uterine wall that nourishes fetus thru umbilical cord.Placenta abruptioPremature separation of the placenta from the wall of the uterus.PreeclampsiaCondition of late pregnancy that involves headache, visual changes, swelling of hands and feet; also called pregnancy-induced hypertension.Pregnancyinduced hypertensionCondition of late pregnancy that involves headache, visual changes, and swelling of the hands and feet; also called preeclampsia.Presentation Position in which an infant is born; part of infant that appears first.PrimigravidaWoman who is experiencing her first pregnancy.PrimiparaWoman who has had one live birth.Prolapse of the umbilical cord Umbilical cord comes out of the vagina before the infant.Spina bifidaDevelopmental defect in which a portion of spinal cord or meninges may protrude outside of the vertebrae and possibly even outside of body, usually at lower third of spine in lumbar areaSupine hypotensive syndromeLow blood pressure resulting from compression of inferior vena cava by weight of pregnant uterus when mother is supine.Umbilical cord Conduit connecting mother to infant via placenta; two arteries, one vein.UterusMuscular organ where fetus grows, also called womb; responsible for contractions during labor.VaginaOutermost cavity of a woman''s reproductive system; lower part of birth canal.Vertex presentation A delivery in which the head comes out first. HYPERLINK "http://www.coursesmart.com/9780763789527/1104" \o "Section 8. Special Patient Populations" µSectSection 8. Special Patient Populations, 1104§ HYPERLINK "http://www.coursesmart.com/9780763789527/1146" \o "Chapter 32. Pediatric Emergencies" µChapter 32. Pediatric Emergencies, 1146§ HYPERLINK "http://www.coursesmart.com/9780763789527/1214" \o "Chapter 33. Geriatric Emergencies" µChapter 33. Geriatric Emergencies, 1214§ HYPERLINK "http://www.coursesmart.com/9780763789527/1260" \o "Chapter 34. Patients With Special Challenges" µChapter 34. Patients With Special Challenges, 1260§ Children are not only smaller than adults and more vulnerable, they are also anatomically, physiologically, and psychologically different from adults in some important ways. Infancy is the first year of life. If possible, allow the parent or caregiver to hold the infant during the assessment. The toddler is 1 to 3 years of age. Toddlers may experi- ence stranger anxiety but may be able to be distracted by a special object (blanket) or toy. Preschool-age children are 3 to 6 years of age. Preschool- age children can understand directions and can identify painful areas when questioned. Tell these children what you are going to do before you do it. This action can help prevent the development of frightening fantasies. School-age children are 6 to 12 years of age. These chil- dren are familiar with the physical examination pro- cess. Talk about their interests to distract them during a procedure. Adolescents are 12 to 18 years of age. Respect the ado- lescent’s modesty. Remember that even though this age group is physically similar to adults, adolescents are still children on an emotional level. General rules for dealing with pediatric patients of all ages include appearing confident, being calm, remaining honest, and keeping parents or caregivers together with the pediatric patient as much as possible. The growing bodies of the pediatric patient create some special considerations. The tongue is large relative to other structures, so it poses a higher risk of airway obstruction than in an adult. An infant breathes faster than an older child. Breathing requires the use of chest muscles and the diaphragm. The airway in a child has a smaller diameter than the air- way in an adult and is therefore more easily obstructed. A rapid heart beat and blood vessel constriction helps pediatric patients to compensate for decreased perfusion.
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Children’s internal organs are not as insulated by fat and may be injured more severely, and children have less circulating blood, so that, although children exhibit the signs of shock more slowly, they go into shock more quickly, with less blood loss. Children’s bones are more flexible and bend more with injury and the ends of the long bones, where growth occurs, are weaker and may be injured more easily. Because a young child might not be able to speak, your assessment of his or her condition must be based in large part on what you can see and hear yourself. Families may be helpful in providing vital information about an acci- dent or illness. Use the pediatric assessment triangle to obtain a general impression of the infant or child. You will need to carry special sizes of airway equipment for pediatric patients. Use a pediatric resuscitation tape measure to determine the appropriately sized equipment for children. The three keys to successful use of the bag-mask device in a child are: (1) have the appropriate equipment in the right size; (2) maintain a good face-to-mask seal; and (3) ventilate at the appropriate rate and volume. Signs of shock in children are tachycardia, poor capillary refill time, and mental status changes. You must be very alert for signs of shock in a pediatric patient because they can decompensate rapidly. Febrile seizures may be a sign of a more serious problem such as meningitis. The most common cause of dehydration in children is vomiting and diarrhea. Life-threatening diarrhea can develop in an infant in hours. Fever is a common reason why parents or caregivers call 9-1-1. Body temperatures of 100.4°F (38°C) or higher are considered to be abnormal. Trauma is the number one killer of children in the United States. A victim of sudden infant death syndrome (SIDS) will be pale or blue, not breathing, and unresponsive. He or she may show signs of postmortem changes, including rigor mortis and dependent lividity; if so, call medical control to report the situation. Carefully inspect the environment where a SIDS victim was found, looking for signs of illness, abusive family interactions, and objects in the child’s crib. Provide support for the family in whatever way you can, but do not make judgmental statements. Any death of a child is stressful for family members and for health care providers. In dealing with the family, acknowledge their feelings, keep any instructions short and simple, use the child’s name, and maintain eye contact. Be prepared to respond to philosophical as well as medi- cal questions, in most cases by indicating concern and understanding; do not be specific about the cause of death. Be alert for signs of posttraumatic stress in yourself and others after dealing with the death of a child. It can help to talk about the event and your feelings with your EMS colleagues. Chapter 30PediatricsAdolescentsChildren between 12 to 18 years of age.apparent life-threatening event (ALTE) An event that causes unresponsiveness, cyanosis, and apnea in an infant, who then resumes breathing with stimulation.blanching Turning white. bradypnea Slow respiratory rate; ominous sign in a child that indicates impending respiratory arrest.central pulses Pulses that are closest to the core (central) part of the body where the vital organs are located; include the carotid, femoral, and apical pulses.child abuse A general term applying to all forms of child abuse and neglect.generalized tonic-clonic seizure A
seizure that features rhythmic back-and-forth motion of an extremity and body stiffness.infancy The first year of life.grunting An “uh” sound heard during exhalation; reflects the child’s attempt to keep the alveoli open; a sign of increased work of breathing.nares The external openings of the nostrils. A single nostril opening is called a naris.neglect Refusal or failure on the part of the caregiver to pro- vide life necessities.Neisseria meningitides A form of bacterial meningitis charac- terized by rapid onset of symptoms, often leading to shock and death.pediatric assessment triangle (PAT) A structured assessment tool that allows you to rapidly form a general impressioof the infant or child without touching him or her; consists of assessing appearance, work of breathing, and circulation to the skin.pediatric resuscitation tape measure A tape used to estimate an infant or child’s weight on the basis of length; appropri- ate drug doses and equipment sizes are listed on the tape.pediatrics A specialized medical practice devoted to the care of the young.pertussis An acute infectious disease characterized by a catarrhal stage, followed by a paroxysmal cough that ends in a whooping inspiration. Also called whooping cough.preschool-age Children between 3 to 6 years of age.school-age Children between 6 to 12 years of age.shaken baby syndrome A syndrome seen in abused infants and children; the patient has been subjected to violent, whiplash-type shaking injuries inflicted by the abusing individual that may cause coma, seizures, and increased intracranial pressure due to tearing of the cerebral veins with consequent bleeding into the brain.sniffing position.Optimum neutral head position for the unin- jured child who requires airway managementsudden infant death syndrome (SIDS) Death of an infant or young child that remains unexplained after a complete
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autopsy.toddler The period following infancy until 3 years of age.tachypnea Increased respiratory rate.work of breathing An indicator of oxygenation and ventila- tion. Work of breathing reflects the child’s attempt to compensate for hypoxia.Chapter 31Pediatric EmergenciesadolescentsChildren between 12 to 18 years of age.apparent life-threatening event (ALTE)event that causes unresponsiveness, cyanosis, and apnea in an infant, who then resumes breathing with stimulation.child abuseAny improper or excessive action that injures or otherwise harms a child or infant; includes neglect and physical, sexual, and emotional abuse.dehydrationstate in which fluid losses are greater than fluid intake into the body, leading to shock and death if untreated.dependent lividityBlood settling to the lowest point of the body, causing discoloration of the skin.febrile seizureSeizure relating to a fever.gastrostomy tubefeeding tube placed directly through the wall of the abdomen; used in patients who cannot ingest liquids or solids.generalized tonic-clonic seizureseizure that features rhythmic back-and-forth motion of an extremity and body stiffness.hypoventilationReduced minute volume, either from reduced rate and/or depth of breathing.infancyfirst year of life.meningitisinflammation of the meningeal coverings of the brain and spinal cord; it is usually caused by a virus or a bacterium.Neisseria meningitidisform of bacterial meningitis characterized by rapid onset of symptoms, often leading to shock and death.neonatalfirst month after birth.occiputmost posterior portion of the skull.pediatricsspecialized medical practice devoted to the care of the young.pneumatic antishock garment (PASG)inflatable device that covers the legs and abdomen; used to splint the lower extremities or pelvis, or to control bleeding in lower extremities, pelvis, or abdominal cavity.preschool-ageChildren between 3 to 6 years of age.rigor mortisStiffening of the body; a definitive sign of death.school-ageChildren between 6 to 12 years of age.shaken baby syndromeBleeding within the head and damage to the cervical spine of an infant who has been intentionally and forcibly shaken; a form of child abuse.shunttube that diverts excess cerebrospinal fluid from the brain to the abdomen.sudden infant death syndrome (SIDS)Death of an infant or young child that remains unexplained after a complete autopsy.toddlerperiod following infancy until 3 years of age.tracheostomy tubetube
inserted into the trachea in children who cannot breathe on their own; passes through the neck directly into the major airways.Chapter 32Pediatric Assessment and Managementanemiadeficiency of red blood cells or hemoglobin.apneaperiod of not breathing.AVPU scalemethod of assessing level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment.blanchingTurning white.bradycardiaSlow heart rate, less than 60 beats/min.bradypneaSlow respiratory rate; ominous sign in a child that indicates impending respiratory arrest.capillary refill time (CRT)amount of time that it takes for blood to return to the capillary bed after applying pressure to the skin or nailbed; indicates the status of end-organ perfusion; reliable in children younger than 6 years.central pulsesPulses that are closest to the core (central) part of the body where the vital organs are located; include the carotid, femoral, and apical pulses.cracklesCrackling, rattling breath sounds signaling fluid in the air spaces of the lungs.croupinfectious disease of the upper respiratory system that may cause partial airway obstruction and is characterized by a barking cough; usually seen in children.cyanosisbluish-gray skin color that is caused by reduced levels of oxygen in the blood.end-organ perfusionstatus of perfusion to the vital organs of the body; determined by assessing capillary refill time (CRT).epiglottitisinfectious disease in which the epiglottis becomes inflamed and enlarged and may cause upper airway obstruction.grunting"uh" sound heard during exhalation; reflects the child''s attempt to keep the alveoli open; a sign of increased work of breathing.head bobbinghead lifts and tilts back during inspiration, then moves forward during expiration; a sign of increased work of breathing.meconiumdark green material in the amniotic fluid that can indicate disease in the newborn; the meconium can be aspirated into the infant''s lungs during delivery; the baby''s first bowel movement.naresexternal openings of the nostrils. A single nostril opening is called a naris.nasal flaringFlaring out of the nostrils, indicating that there is an airway obstruction.pediatric assessment triangle (PAT)structured assessment tool that allows you to rapidly form a general impression of the infant or child without touching him or her; consists of assessing appearance, work of breathing, and circulation to the skin.pediatric resuscitation tape measuretape used to estimate an infant or child''s weight on the basis of length; appropriate drug doses and equipment sizes are listed on the tape.retractionsMovements in which the skin pulls in around the ribs during inspiration.septumcentral divider in the nose.sniffing positionunusually upright position in which the patient''s head and chin are thrust slightly forwardstridorharsh, high-pitched, crowing inspiratory sound, such as the sound often heard in acute laryngeal (upper airway) obstruction.tachypneaRapid respirations.tentingcondition in which the skin does not quickly return to its original shape after being pinched; indicates dehydration.tidal volumeamount of air that is exchanged with each breath.tragussmall, rounded, fleshy bulge that lies 9/27/2011tance69487272.docD168er9/27/2011id not contact medical 168fo9/27/2011 not check medication f168pti
As the body ages. the bones become more fragile. assess the injuries and carefully look for the cause of the injury. A slow.arteriosclerosisdisease that is characterized by hardening. typically following a period of prolonged immobilization.atric patients. hearing and vision deficits. aneurysm. characteristically heard on expiration in patients with asthma or COPD. geriatric patients are more likely to present with pneumonia. and the effects of multiple medications. causing it to bulge. deep venous thrombosis. Chapter 33Geriatric EmergenciesAlthough assessment of geriatric patients involves the same basic approach as that for any other patient.advance directivesWritten documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions. the body can still compensate for blood loss. deliberate approach to the patient history. you should determine the patient’s chief complaint on that day and what initial problem caused the patient to be admitted to the facility. Dementia and delirium must be carefully evaluated in geriatric patients. orthostatic hypotension. When you treat a geriatric trauma patient.aneurysm An enlargement of a part of an artery. elderly patients.work of breathingindicator of oxygenation and ventilation. and calcification of the arterial walls. Depression is treatable with medication and therapy but is a risk factor for suicide if it remains untreated in geri.docD169er9/27/2011id not contact medical 169fo9/27/2011 not check medication f169pti
. eventually leading to partial or complete blockage of blood flow. This leads to a higher risk of fracture in geriatric patients.compensated shockearly stage of shock. heart attack. Chapter 33Geriatric Emergenciesabdominal aortic aneurysm (AAA)condition in which the walls of the aorta in the abdomen weaken and blood leaks into the layers of the vessel. When responding to nursing and skilled care facilities. To obtain an accurate history for a geriatric patient. Atypical presentations are seen mostly in women. range from a pink discoloration of skin to deep wound that may invade into bone or organs. Sores caused by pressure of skin against a surface for long periods.sclerosis.wheezinghigh-pitched. A medical condition such as fainting could actually be the cause of a fall.immediately anterior to the ear canal. when blood pressure is falling.decubitus ulcers AKA bedsores. with one EMT asking questions.cataractsClouding of the lens of the eye or its surrounding transparent membranes.collagenprotein that is the chief component of connective tissues and bones. The risk of serious injury or death is more common in elderly patients who experience a traumatic injury. cartilaginous lower tip of the sternum. venous stasis. cataracts Clouding of the lens of the eye or its surrounding transparent membranes. Many patients do not present with the classic symptom of chest pain when experiencing a heart attack. heart failure. stiffening heart valves. thickening. only appropriate if the child''s condition is stable.deep venous thrombosis Formation of a blood clot within larger veins of an extremity. is generally the best strategy. and patients with diabetes. Changes in the cardiovascular system can lead to athero.xiphoid processnarrow. Polypharmacy and changes in medications can cause serious problems for geriatric patients.ascites Fluid in the abdomen.delirium More or less sudden change 9/27/2011tance69487272. whistling breath sound. complicated medical history. such as a decreased ability to cough. Work of breathing reflects the child''s attempt to compensate for hypoxia.tripod positionupright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward. and stroke. The injuries from the fall and the medical condition will need to be addressed. also called living wills. you must take a more wary approach.atherosclerosisdisorder in which cholesterol and calcium build up inside the walls of blood vessels. patience and good communication skills are essential.decompensated shocklate stage of shock. With changes in the respiratory system.transition phasetime period that allows the infant or child to become familiar with you and your equipment. Assessing an elderly person can be challenging because of communication issues. resulting from weakening of the arterial wall. alteration in consciousness.
elder abuse Any action on the part of an older person’s family member.hypoxiadangerous condition in which the body tissues and cells do not have enough oxygen.polypharmacy Use of multiple medications by patient. tarry stools. cardiac tamponade.elastinprotein found in elastic tissues such as skin and artery walls.pneumonia Inflammation/infection of lung from a bacterial. property. or tension pneumothorax.syncope A fainting spell or transient loss of consciousness. and maintain attention.urinary tract infection Bacterial infection that affects the urinary tract. resulting in distortion of signals to or from the brain.jugular vein distention A visual bulging of the jugular veins in the neck that can be caused by fluid overload. or other associated person that takes advantage of the older person’s person.Methicillinresistant Staphylococcus aurcus (MRSA)A bacterium that causes infections in different parts of the body and is often resistant to commonly used antibiot. or fungal cause. think logically. pressure in the chest. or emotional state. presbycusis
Age-related condition of ear that produces progressive bilateral hearing loss.dyspnea Shortness of breath or difficulty breathing.in mental status marked by the inability to focus.vasoconstrictionNarrowing of a blood vessel.pulmonary embolism Condition causes sudden blockage of pulmonary artery by venous clot.unilateral pedal edema Pedal edema is a swelling of foot and ankle caused by fluid overload.
9/27/2011tance69487272. shortened attention span. in surgical wounds.ics.geriatrics The assessment and treatment of disease in some. can be found on the skin.neuropathy A group of conditions in which the nerves leav. in which there is a reduction in the amount of bone mass leading to fractures after minimal trauma in either sex.kyphosisforward curling of the back caused by an abnormal increase in the curvature of the spine. caregiver. also called granny beating and parent battering. typically seen in elderly. lungs. commonly associated with postmenopausal women.peptic ulcer disAbrasion of the stomach or small intestine. in the bloodstream.ing the spinal cord are damaged.melena Black.docD170er9/27/2011id not contact medical 170fo9/27/2011 not check medication f170pti
.dementia Slow onset of progressive disorientation. most noted at higher frequencies. and urinary tract. loss of cognitive function. viral.vasodilationWidening of a blood vessel.osteoporosisgeneralized bone disease.respiratory syncytial virus Highly contagious virus causes an infection of upper and lower respiratory system. often caused by an interruption of blood flow to brain. unilateral would present in only one extremity.one who is 65 years or older.
polypharmacyuse of multiple medications on a regular basis. The first rule of safe driving in an emergency vehicle is that speed does not save lives. must be available on the ambulance at all times. Learning how to properly operate your vehicle is just as important as learning how to care for patients when you arrive on the scene. or sitting down forcefully. During the postrun phase. – A medical evacuation is commonly known as a medivac and is generally performed exclusively by helicopters. chemical. good care does.unstable spinal injuryspinal injury that has a high risk of permanent neurologic deficit or structural deformity. Chapter 35Ambulance OperationsToday’s ambulances are designed according to strict government regulations based on national standards. air ambulancesFixed-wing aircraft & helicopters modified for medical care. and the emergency obstetric kit. 9/27/2011tance69487272.Chapter 34Geriatric Assessment and Managementacetabulumdepression on the lateral pelvis where its three component bones join. which is more pronounced in the upper extremities than the lower extremities. as dictated by state and juris. evacuate. transport patients w/life-threatening injuries to treatment facilities.tion equipment.ambulancespecialized vehicle for treating and transporting sick and injured patients. An ambulance call has nine phases: Preparation for the call Dispatch En route Arrival at scene Transfer of the patient to the ambulance En route to the receiving facility (transport) At the receiving facility (delivery) En route to the station Postrun Certain items. you should complete and file any additional written reports and inform dispatch of your status. Check all medical equipment and supplies at least daily. and availability. typically results from an ejection or occurs in those wearing only a lap belt without a shoulder harness. the jump kit.stable spinal injuryspinal injury that has a low risk of leading to permanent neurologic deficit or structural deformity.tine inspection to ensure that the ambulance is ready to respond to the next call. from simply bending over. Perform a rou. – There are two basic types of air medical units: fixed-wing and rotary-wing. or other visible contaminants from a surface. dressings and bandages.blind spotsAreas of the road that are blocked from the driver''s sight by their own vehicle or mirrors.docD171er9/27/2011id not contact medical 171fo9/27/2011 not check medication f171pti
. The six-pointed Star of Life® emblem identifies vehicles that meet federal specifications as licensed or certified ambulances. Air ambulances are used to evacuate medical and trauma patients.compression fracturesStable spinal cord injuries in which often only the anterior third of the vertebra is collapsed.cleaningprocess of removing dirt.dictional requirements. Some services may operate with a non-EMT driver and a single EMT in the patient compartment. other hazardous material from clothing. – The second rule is that the driver and all passengers must wear seatbelts and shoulder restraints at all times. Every ambulance must be staffed with at least one EMT in the patient compartment whenever a patient is being transported. backboards and other stabiliza. with a distraction component (energy being dispersed in two opposite directions) that causes a fracture through the entire vertebral body and bony arch.CPR boarddevice that provides a firm surface under the patient''s torso. otherwise known as helicopters.burst fracturesCompression fractures of the vertebrae that typically result from a higher energy mechanism such as a motor vehicle crash or fall from substantial height.decontaminateRemove or neutralize radiation. location. results in weak or absent motor function. splints. rising from a chair. However.cushion of safetyKeeping a safe distance between your vehicle and other vehicles to any side of you. like sterile gloves. two EMTs are strongly recommended.seat belt-type fracturesFractures that involve flexion.septicemiadisease state that results from the presence of microorganisms or their toxic products in the bloodstream. blood. whether or not a disease process is present. This type of fracture often results from minimal trauma. dust. in which the femoral head fits snuglybacteremiapresence
of bacteria in the blood. including all the oxygen supplies.central cord syndromeform of incomplete spinal cord injury in which some of the signals from the brain to the body are not received.
personnel to scenes of medical emergencies. or container with no way out or to have a limb or other body part trapped. room. and ensuring the efficient use of resources. as well as private-sector and nongovernmental organizations. to work together effectively and efficiently. identifies vehicles meets federal specifications as licensed or certified ambulances. supporting technologies.
9/27/2011tance69487272.disentanglementremoval of a motor vehicle from around the patient. preparedness.ously mentioned situations. you must first step back and assess the situation. office.first-responder vehiclespecialized vehicle used to transport EMS equipment.equipment.command postlocation of the incident commander at scene of an emergency. poisonous. The major NIMS components are command and management. and
transport of the injured. making vehicle feel like it is floating.technical rescue groupteam of individuals from one or more departments in a region who are trained and on call for certain types of technical rescue. ie.technical rescue situationrescue that requires special technical skills. particularly if you see a patient. There are four basic triage categories that can be recalled using the mnemonic IDME: Immediate (red) –Delayed (yellow) –Minimal (green.Chapter 37Special OperationsThe National Incident Management System (NIMS) provides a consistent nationwide template to enable federal. warehouse. hazardous materials (HazMat) incidents. toxic substances.entrapmentTo be caught (trapped) within a vehicle. or other building. may not involve personal injuries. and local governments. the incident commander should appoint someone as the medical group or branch leader.special weapons and tactics team (SWAT)specialized law enforcement tactical unit.Ambulance Types I Truck Cab Chassis with Modulalar Body/ Pass thru II Standard Van/Integrated Cab & Body III Speciality Van/Integrate Cab & Body/Driver Compartment/Pt Comp Chapter 36Gaining AccessSteps for Access c-spine Airway Oxygen Ventilate Stop bleeding Treat Critical Injuryaccessability to gain entry to an enclosed area and reach a patient. robbery.complex accessComplicated entry that requires special tools and training and includes breaking windows or using other force. recover from domestic incidents. regardless of cause. This can be very stressful. apartment building. lethal rays.jump kitportable kit contains items used in initial care of patient. where command.extricationRemoval of patient from entrapment or dangerous situation or position.Sterilizationprocess.emergency modeuse of lights and sirens. any situation that places such a great demand on available equipment or personnel that the system would require a mutual aid response.simple accessAccess that is easily achieved without the use of tools or force. or any incident that has a potential to create one of the previ. This person will supervise the primary roles of the medical group: triage. state. plant.spotterperson who assists a driver in backing up an ambulance to compensate for blind spots at back of vehicle. respond to. and ongoing management and maintenance. building collapse. The goal of triage is to do the greatest good for the greatest number. or other situation in which armed conflict is threatened or shots have been fired and the threat of violence remains. control. At incidents that have a significant medical factor.self-contained breathing
apparatus (SCBA)Respirator with independent air supply used by firefighters to enter toxic and otherwise dangerous atmospheres.Star of Lifesix-pointed star.structure firefire in a house. broken glass.high-level disinfectionkilling of pathogenic agents by using potent means of disinfection. likely to die or dead) A disaster is a widespread event that disrupts functions and resources of a community and threatens lives and property. that removes microbial contamination. Many disasters. A mass-casualty incident refers to any call that involves three or more patients. ignition or explosion of hazardous materials. hold) –Expectant (black. NIMS is used to prepare for. treatment. flammable. incident commanderindividual who has overall command of the scene in the field. dive rescue. including catastrophic terrorism.tactical situationhostage. The purpose of the incident command system is ensuring responder and public safety. industrial accident. resource management. prevent. vehicles. When you arrive at the scene of a HazMat incident. removal from wrecked vehicle.ning done before an incident occurs. size. cave rescue. achieving incident management goals. communication are centralized. technical rope rescue. This means that the triage assessment is brief and the patient condition categories are basic. Preparedness involves the decisions made and basic plan.. coordination. such as a drought. or complexity. ie. radioactive. communications and information management.hydroplaningcondition in which tires of a vehicle may be lifted off road surface as water "piles up" under them. school. or explosive and causes injury or death with exposure.docD172er9/27/2011id not contact medical 172fo9/27/2011 not check medication f172pti
. equipment in specialized rescue areas.hazardous materialAny substance that is toxic. personnel.medivacMedical evacuation of a patient by helicopter.disinfectionkilling of pathogenic agents by direct application of chemicals. such as heating.danger zone (hot zone)area where of exposure to sharp metal edges. Your agency should have written disaster plans that you are regularly trained to carry out.
decontamination areadesignated area in a hazardous materials incident where all patients and rescuers must be decontaminated before going to another area. casualty collection areaarea set up by physicians.incident commanderindividual who has overall command of the scene in the field.danger zonearea where individuals can be exposed to toxic substances.hazardous materials incidentincident in which a hazardous material is no longer properly contained and isolated.mutual aid responseagreement between neighboring EMS systems to respond to mass-casualty incidents or disasters in each other''s region when local resources are insufficient to handle the response. treated. patients. Here. Face Mask D Work Clothes. also known as an incident management system (IMS).transportation officerindividual in charge of the transportation sector in a mass-casualty incident who assigns patients from the treatment area to awaiting ambulances in the transportation area.transportation areaarea in a mass-casualty incident where ambulances and crews are organized to transport patients from the treatment area to receiving hospitals. workers are medically monitored and receive any needed care as they enter and leave the scene. lethal rays.sector commanderindividual delegated to oversee and coordinate activity in an incident command sector. and communication are centralized. treat on site wait for transport 4 BLACK … NO POINT TO TRANSPORT Toxicity Levels Little Irrittion Temporary Damage Extreme Hazard Death on Exposure Protection Levels A Fully Encapsulated with SCBA B Non Encapsulated with SCBA C Non-permeable clouthing.treatment officerindividual. medical care. other hospital staff near a major disaster scene where patients can receive further triage. citizens'' lives. gloves.Tags 1 High (Red) Immediate Transport 2 Temp wait (Yellow) 3 Low (Green) walking wounded.disasterwidespread event that disrupts community resources and functions.triage officerindividual in charge of the incident command triage sector who directs the sorting of patients into triage categories in a mass-casualty incident.incident command systemorganizational system to help control. and monitored until transport to the hospital. flammable. nurses. who is in charge of and directs EMS personnel at the treatment area in a mass-casualty incident.command postlocation of the incident commander at scene of emergency and where command.treatment areaLocation in a mass-casualty incident where patients are brought after being triaged and assigned a priority. in turn threatening public safety.Chemical Transportation Emergency Center (CHEMTREC)agency that assists emergency personnel in identifying and handling hazardous materials transport incidents. or explosive and cause injury or death with exposure. control.docD173er9/27/2011id not contact medical 173fo9/27/2011 not check medication f173pti
. radioactive. or ignition or explosion of hazardous materials. where they are reassessed.decontaminationprocess of removing or neutralizing and properly disposing of hazardous materials from equipment. and coordinate emergency responders and resources. poisonous. and rescue personnel.toxicity levelsMeasures of the risk that a hazardous material poses to the health of an individual who comes into contact with it.triage areaDesignated area in a mass-casualty incident where the triage officer is located and patients are initially triaged before being taken to the treatment center.mass-casualty incidentemergency situation involving three or more patients or that can place great demand on the equipment or personnel of the EMS system or has the potential to produce multiple casualties. Eye protection. works under the incident commander. direct.A valuable resource for determining what the hazardous material is and what you should do is CHEMTREC.hazardous materialsAny substances that are toxic. usually a physician.triageprocess of establishing treatment and transportation priorities according to severity of injury and medical need. eye protection Homeland Security Advisory System 9/27/2011tance69487272.personal protective equipment (PPE) levelsMeasures of the amount and type of protective equipment that an individual needs to avoid injury during contact with a hazardous materialrehabilitation areaarea that provides protection and treatment to fire fighters and other personnel working at an emergency. coordination. and property.
Toxicity levels are measures of the health risk that a sub. Chemical agents are manufactural substances that can have devastating effects on living organisms. Wait for assistance. Both levels 1 and 2 are considered slightly hazardous but require use of selfcontained breathing apparatus (SCBA) if you are going to come into contact with them.stance poses to someone who comes into contact with it. technology terrorists. There are five toxicity levels: 0. Types of groups that tend to use terrorism include violent religious groups/doomsday cults. Explosive and incendiary devices come in various shapes and sizes. The higher the number. Level 3 includes materials that are extremely hazard. and 4. and explosive weapons (B-NICE). Biologic agents include viruses such as smallpox and those that cause viral hemorrhagic fevers.Red Orange Yellow Blue Green Hazmat Classes 1 2 3 4 5 6 7 8 9
Severe Severe Risk of Terrorist Attach High High Risk ElevatedSignificant Risk Guarded General Risk or Terrorist Attack Low Low Risk of Terrorist Attacks Explosives Gases Flam Liq Flam Solid Oxide Poison Radiation Corrossive Miscellaneous
Chapter 38Response to Terrorism and Weapons of Mass DestructionAs a result of the increase in terrorist activity.tle. health hazard if you came into contact with them. You must be mentally and physically prepared for the possibility of a terrorist event. For level 4 substances. Biologic agents are organisms that cause disease. and preincident indicators. even without treatment. If you have any doubt that it may not be safe. thus injuring responders and media coverage.ous to health. These can be biologic. you need specialized gear that is designed for protection against that particular hazard. Contact with these materials requires full protective gear so that none of your skin surface is exposed. Nuclear or radiologic weapons can create a massive amount of destruction. the EMT. number of patients.docD174er9/27/2011id not contact medical 174fo9/27/2011 not check medication f174pti
. as follows: Level 0 includes materials that would cause lit. incendiary. type of call. airports. nuclear. and neurotoxins such as botulinum toxin and ricin. casualties. chemical. do not enter. ensure that the scene is safe. tunnels.rary damage or residual injury unless prompt medical treatment is provided. victims’ statements. bacteria such as those that cause anthrax and plague. Level 1 includes materials that would cause irritation on contact but only mild residual injury. it is possible that you. It is important to be able to identify an object you believe is a potential device and notify the proper authorities. while safely evacuating the area. A weapon of mass destruction (WMD) is any agent designed to bring about mass death. Ionizing radiation is energy that can enter the human body and cause damage. the greater the toxicity. Constantly assess and reassess the scene for safety. 2. Level 2 includes materials that could cause tempo. extremist political groups.
9/27/2011tance69487272. 1. Level 4 includes materials that are so hazard.ous that minimal contact will cause death. Indicators that may give you clues as to whether the emergency is the result of a terrorist attack include the type of location. If you suspect that a terrorist or a weapon of mass destruction event has occurred. The route of exposure is how the agent most effectively enters the body. could witness a terrorist event. if any. and/or massive damage to property and infrastructure (bridges. 3. Terrorists may set secondary devices that are designed to explode after the initial bomb. and seaports). and single-issue groups.
to another animal. causing over 25 million deaths.cyanideAgent. poisoning 9/27/2011tance69487272. colorless gas. called buboes. ie. 0 – Normally stable. location. with the exception of 0.bacteriaMicroorganisms that reproduce by binary fission. When introduced into the body. the germ is released from the spore when exposed to the optimal temperature and moisture. May undergo rapid change when exposed to elevated heat or temp 1 – Normally stable but may become unstable under elevated heat or pressure. odor similar to almonds. or nature of the attack. is slightly more penetrating than alpha.cross-contaminationOccurs when a person is contaminated by an agent as a result of coming into contact with another contaminated person. It has a distinct odor of bleach. ToxicityLevels of Hazardous MaterialsLevelHealth HazardProtection Needed0Little or No HazardNone1Slightly hazardousSCBA (level C suit) only2Slightly hazardousSCBA (level C suit) only3Extremely hazardousFull protection. inflamed lymph nodes that appear as lesions.communicabilityDescribes how easily a disease spreads from one human to another human. also called a skin hazard.botulinumProduced by bacteria. this neurotoxin affects the nervous system''s ability to function and causes botulism. once infected. require respiratory and chemical protec.W Radiation Hazard Explosive – EXP3 (Blue)Left Point of Diamond Health Hazard4.OXY Acid – ACID Alkali – ALK Corrosive. it is the least harmful penetrating type of radiation and cannot travel fast or through most objects. and the formation of tender. Full protective clothing.contagiousperson infected with a disease that is highly communicable. Special materials full protective clothing required. cutaneous.anthraxdeadly bacteria (Bacillus anthracis) that lays dormant in a spore (protective shell). w/no exposed skin (level A or B suit)4Minimal exposure causes deathSpecial HazMat gear (level A Suit) NFPA PlacardsHazardous MaterialsClassifications2 (Red)Top of Diamond Fire Hazard Flash Points4 Below 73 F (Extremely flammable or volatile gases or liquids 3 .coat. gloves. transmitted by infected fleas and characterized by acute malaise. These single-cell creatures reproduce rapidly.contact hazardhazardous agent that gives off very little or no vapors. Some can form spores (encysted variants) when environmental conditions are harsh.chlorine (CL)first chemical agent ever used in warfare. bands around legs and arms 2 .covertAct in which the public safety community generally has no prior knowledge of the time.disease vectoranimal that spreads a disease.Below 100 F (Can be ignited at almost any temperature) 2 . this is a very potent neurotoxin. Initially it produces upper airway irritation and a choking sensation. affects body's ability to use oxygen. or gastrointestinal (from consuming food that contains spores).dirty bombName given to a bomb used as a radiological dispersal device (RDD).betaType of energy that is emitted from a strong radiological source.further describes the four hazard classes. and creates a green haze when released as a gas. fever. enlarged.COR Use No Water. also called the Black Death. boots.Hazardous Full face mask and eye protection required 1 – Slightly Hazardous 0 – No Significant Health Risk Chapter 38Response to Terrorism & WMDAlphaType of energy that is emitted from a strong radiological source. self contained breathing appartus. The route of entry is inhalation.disseminationmeans terrorist will spread a disease. pants.Lethal atmosphere. a material that is unstable attempts to stabilize itself by changing its structure.docD175er9/27/2011id not contact medical 175fo9/27/2011 not check medication f175pti
. the skin is the primary route for this type of chemical to enter the body.Below 200 F Needs only moderate heat to burn 1 – Above 200 F (Must be preheated to burn) 0 – Will not burn1 (Yellow)Right Point of Diamond Reactivity Hazard4 – Capable of detonation at normal temperature 3 – Capable of detonation if exposed to heat or pressure 2 – Unstable. The effects begin on the cellular level and are very rapidly seen at the organ system level.buboesEnlarged lymph nodes (up to the size of tennis balls) that were characteristic of people infected with the bubonic plague. 3 – Extremely Hazardous.decayNatural process.bubonic plagueepidemic that spread throughout Europe in the Middle Ages.You must note that all health hazard levels.tive gear that is not standard on most ambulances and specialized training.W (White)Botton of Diamond Specific HazardOxidizer. and requires a layer of clothing stop it.
casualties.persistencyTerm used to describe how long a chemical agent will stay on a surface before it evaporates.route of exposureManner by which a toxic substance enters the body.LD50amount agent or substance that kills 50% of people exposed to this level.MARK 1nerve agent antidote kit containing two auto-injector medications.NAAKnerve agent antidote kit containing two autoinjector medications.nerve agentsclass of chemical called organophosphates.Lewisite (L)blistering agent w/rapid onset of symptoms and produces immediate intense pain & discomfort on contact. or large ships.smallpoxhighly contagious disease.state-sponsored terrorismTerrorism funded and/or supported by nations w/close ties to terrorist groups. AKA weapon of mass destruction (WMD). product of combustion. fruity smell.Special Atomic Demolition Munitions (SADM)Small suitcase-sized nuclear weapons that were designed to destroy individual targets.weapon of mass casualty (WMC)Any agent designed to bring about mass death.V agent (VX)G agent. both as contact & inhalation hazard.off-gassingemitting of agent after exposure. soman. might be produced in a fire at a textile factory or house.gamma (X-rays)Type of energy emitted from a strong radiological source. leading to death. airports. AKA cross-border terrorism. neutron energy is fastest moving. 36 times more persistent than sarin and approx half as lethal. agent cultivated. and the use of over-thecounter medications. 2-PAM chloride (pralidoxime chloride). changes structures of DNA in body's cells.soman (GD)nerve agent. tunnels. bridges. causes pulmonary edema and respiratory and circulatory failure. atropine.ricinNeurotoxin derived from mash that is left from the castor bean. developed by German scientists in the period after WWI and into WWII. far faster and stronger than alpha and beta rays.radioactive materialAny material that emits radiationradiological dispersal device (RDD)Any container that is designed to disperse radioactive material.weaponizationcreation of weapon from a biological agent generally found in nature that causes disease. primary route of entry for vesicants is thru the skin. aka a weapon of mass casualty (WMC). extremely persistent. function by blocking an essential enzyme in nervous system. brownish-yellowish oily substance. antidotes. usually hours. and/or mutated to maximize target population's exposure to the germ.neurotoxinsBiological agents. twice as persistent as sarin and five times as lethal. of patients presenting to emergency departments and alternative care facilities.domestic terrorismTerrorism carried out by native citizens of the country being attacked. casualties. odorless liquid that turns from liquid to gas w/in seconds to min at room temperature. Easily penetrate thru human body and require several inches of lead or concrete to prevent penetration. most powerful form of radiation. and seaports).syndromic surveillancemonitoring. require several feet of concrete to stop them.docD176er9/27/2011id not contact medical 176fo9/27/2011 not check medication f176pti
.weapon of mass destruction (WMD)Any agent designed to bring about mass death.secondary deviceAdditional explosives used by terrorists. AKA Nerve Agent Antidote Kit (NAAK).tabun (GA)nerve agent.components used to manufacture agent are easy to acquire. from a person's clothes exposed to agent. most deadly substances known to humans. or aerosolizing agent into the air or ventilation system of a building.points of distribution (POD)Strategically placed facilities pre-established for mass distribution of antibiotics.neutron radiationType of energy emitted from a strong radiological source. unique . atropine.phosgene oxime (CX)blistering agent that has a rapid onset of symptoms and produces immediate intense pain and discomfort on contact.volatilityhow long a chemical agent will stay on a surface before it evaporates. can enter body thru skin absorption & respiratory tract. also known as plague pneumonia. burn out.lymphatic systempassive circulatory system that transports plasma-like liquid called lymph. the recording of EMS call volume. quickly absorbed into skin and/or mucous membranes. oily agent that has no odor.pneumonic plaguelung infection. over 100 times more lethal than sarin..of the water supply. easy to manufacture.G agentsEarly nerve agents. most contagious when blisters begin to form. or particles.phosgenepulmonary agent. with other medications and supplies. blood vesselsvirusesGerms that require a living host to multiply. Yellow Fever viruses among others. and seaports). damages. and tabun. as a result of type of alcohol used. tunnels.viral hemorrhagic fevers (VHF)group of diseases that include the Ebola. looks like baby oil. that is the result of inhalation of plague bacteria. G agents.ionizing radiationEnergy emitted in the form of rays. ie. include botulinum toxin and ricin.sarin (GB)nerve agent.vesicantsBlister agents.lymph nodesArea of the lymphatic system where infection-fighting cells are housed.incubationDescribes time period from a person being exposed to a disease to the time when symptoms begin. There are three agents: sarin. Rift Valley.mutagenSubstance mutates. generally very persistent. when released. fruity odor. synthesized. clear. tunnels. such as important buildings. distinct smell of garlic or mustard. and/or massive damage to property and infrastructure (bridges. causes body's organs to overstimulate. AKA MARK 1-kit. 2-PAM chloride (pralidoxime chloride). This group of viruses causes the blood in the body to seep out from tissues. Phosgene is a very potent agent.
or from metalwork or burning Freon. highly volatile colorless. G agents. set to explode after initial bomb. thin fluid that bathes tissues of the body. G agents. has a delayed onset of symptoms. begins irreversible process damaging cells.vapor hazardagent that enters the body thru the respiratory tract. vaccinations. Neutrons easily penetrate thru lead. airports. and/or massive damage to property &/or infrastructure (bridges.miosisBilateral pinpoint constricted pupils.international terrorismTerrorism carried out by those not of host's country.sulfur mustard (H)vesicant.
usually by local or state health departments.
increasing the size of the chest cavity. Other cells in the body that are not as dependent on a constant oxygen supply can tolerate short periods with.laryngeal mask airway (LMA)advanced airway device blindly inserted into the mouth to isolate the larynx for direct ventilation. Air breathed in during inhalation travels through the airways to the alveoli. some cells. dome.endotracheal intubationInsertion of an endotracheal (ET) tube directly thru larynx between vocal cords and into trachea to maintain. Oxygen in the alveoli crosses over into the blood-stream. and/or blood from the patient’s mouth. After the airway has been cleared. The increased size of the chest cavity allows air to flow into the lungs.Section 8 ALS Techniques Anatomy and Physiology of the Airway The respiratory system consists of all the structures in the body that are used for breathing. and capillaries give up oxygen to the cells. contraction of the intercostal muscles pulls the rib cage up and out. need a constant supply of oxygen to survive. The diaphragm moves up. 3. allow removal gas. 2. throat (pharynx). and the size of the chest cavity decreases. cells in the brain and ner. allows better visualization of vocal cords. Cells give up carbon dioxide into the capillaries. disposable indicator.vents food and liquid from entering the lower airway during swallowing. brain. This rule applies to the basic and advanced levels of airway management. As this oxygen-rich air enters the alveoli. mouth. Dead brain cells can never be replaced. Contraction of the diaphragm pulls the chest cavity down. toxins or to instill medications. air flows out of the lungs.end-tidal carbon dioxide detectorPlastic. You should use the head tilt–chin lift maneuver in a patient with no suspected spinal injury and the jaw-thrust maneuver in a patient you suspect may have a spinal injury. Advanced airway techniques are begun only after proper basic airway management has been completed. pressure is applied on either side of cricoid cartilage to prevent gastric distention & aspiration. Chapter 39Advanced Airway Managementcricoid cartilagefirm ridge of cartilage that forms the lower part of the larynx. such as those in the heart. you should assess the airway and evaluate the need for suctioning to remove foreign bodies. The lower airway includes the trachea. Cells in the heart will be damaged if the oxygen supply is interrupted for more than a few minutes. protect airway.decompressTo release from pressure or compression. The diaphragm is a thin.laryngoscopeinstrument 9/27/2011tance69487272.vous system begin to die. and the ribs move in. a process that takes place on two levels: the alveolar-capillary exchange and the capillary-cellular exchange. The alveolar-capillary exchange works in the following way: 1. Carbon dioxide in the blood from the capillaries crosses over into the alveoli. and larynx (vocal cords). The mechanical process of breathing occurs through the use of the diaphragm and intercostal muscles (mus.out oxygen and still survive. subdividing into bronchioles (smaller passages) down to the alveoli. extending into each lung. During the passive phase of breathing (exhalation). dual-lumen tube with two cuffs. where the exchange of oxygen and carbon dioxide occurs. Brain damage and other permanent changes in the body result from damage caused by a lack of oxygen.docD177er9/27/2011id not contact medical 177fo9/27/2011 not check medication f177pti
. The basic airway adjuncts that are already available to you are oropharyngeal and nasopharyngeal airways. The upper airway begins with the nose. nutrition. After you have opened the airway. bronchi. The larynx is typically considered to be the dividing line between the upper and lower airway.gastric tubeadvanced airway adjunct provides a channel directly into a patient's stomach.Esophageal Tracheal Combitube (ETC)multilumen airway that consists of a single. After 4 to 6 minutes without oxygen. consists of a tube. blood.extubationRemoval of a tube after it has been placed. The diaphragm and intercostal muscles contract during the active phase of breathing (inhalation).cles between the ribs). creating a shift of oxygen and carbon dioxide. and lungs. mask or cuff that inflates to seal around laryngeal opening. The first step in airway management is opening a patient’s airway. AKA Sellick maneuver. The epiglottis is a leaf-shaped structure located at the glottic opening (covering the larynx) that pre. The bronchi and other air passages branch off from the trachea. Each living cell in the body requires a regular supply of oxygen. liquid.cricoid pressuretechnique used with intubation. The respiratory system delivers oxygen to the body and removes carbon dioxide. Basic Airway Management Always assess the airway first in an injured or ill patient. oxygen-poor blood is circulated through the capillaries around each alveolus.mine whether the patient needs an airway adjunct.shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm and intercostal muscles relax. The capillary-cellular exchange occurs throughout the body’s cells. you need to deter. signals by color change when an endotracheal tube is in the proper place. and nervous system.
vasovagal reactionSudden hypotension. will work whether placed in trachea or esophagus. and a regular heart rate between 60 and 100 beats/min. It is inversely proportional to true diameter of catheter.Chapter 40Assisting With Intravenous Therapyaccess portsealed hub on admin set designed for sterile access to IV fluid.normal sinus rhythmrhythm that has consistent P waves. pharyngeotracheal lumen airway.multilumen airwaysAdvanced airway devices. includes leads V1. a bite blockSellick maneuvertechnique used to prevent gastric distention.keep-the-vein-open (KVO) IV setupPhrase that refers to the flow rate of a maintenance IV line established for prophylactic access.catheterFlexible.butterfly catheterRigid.styletplastic-coated wire gives rigidity.chest leadsLeads that are used only with a 12-lead ECG. V4.isotonic crystalloidsMain type of fluids used in the prehospital setting for fluid replacement because of the ability to support blood pressure by remaining within the vascular compartment. right leg. and a regular heart rate that is more than 100 beats/min. heparin.saline locktype of IV apparatus.sinus tachycardiarhythm that has consistent P waves. receives tip of a curved laryngoscope blade during endotracheal intubation. include limb leads.4-lead ECGECG w/4 leads attached to patient's skin.external jugular IVIV access established in external jugular vein of neck. two masks. have multiple tubes to aid in ventilation.cardiac monitoringviewing electrical activity of heart thru use of ECG machine or cardiac monitor.Jamshedi needletype of intraosseous double needle consisting of a solid. which originate in the electrocardiograph machine and contain electrodes that attach to the patient''s chest and/or limbs.used to give a direct view of the patient's vocal cords during endotracheal intubation.macrodrip setAdmin set named for large orifice between piercing spike and drip chamber.
9/27/2011tance69487272. allows rapid fluid flow into vascular system. left leg. a blood vessel. AKA cricoid pressure.local reactionMild to moderate reaction to an irritant without systemic consequence. causing contractions of heart.docD178er9/27/2011id not contact medical 178fo9/27/2011 not check medication f178pti
.limb leadsfour leads used w/4-lead ECG. severed piece can enter circulatory system.phlebitisInflammation of a vein. ideally suited for medication admin. after admin of medications.arrhythmiairregular or abnormal heart rhythm.lighted styletinstrument used to aid in blind insertion of an endotracheal tube.intraosseous (IO) needleRigid. ineffective twitching of the ventricles.systemic complicationModerate to severe complication affecting systems of the body.over-the-needle catheterprehospital standard for IV cannulation.Chapter 41Assisting With Cardiac Monitoring12-lead ECGECG w/12 leads attached to patient's skin.ECG Electrocardiogramelectronic tracing of the heart''s electrical activity through leads. produce pumping of blood.asystoleComplete absence of heart electrical activity.pharyngeotracheal lumen airway (PtL)multilumen airway consists of two tubes. V2. sharpened plastic spike on end of admin set designed to pierce sterile membrane of IV bag.ventricular tachycardiapresence of three or more abnormal ventricular complexes in a row with a rate of more than 100 beats/min.laryngospasmsevere constriction of the larynx and vocal cords. boring catheter placed into a bone to provide IV fluids. shape to endotracheal tube.piercing spikehard.microdrip setAdmin set named for small orifice between piercing spike and drip chamber. allows for carefully controlled fluid flow. steel needle.administration setTubing connects IV bag access port. and V6.proximal tibiaAnatomic location for intraosseous catheter insertion. resulting in no blood flow and a state of cardiac arrest. must be placed exactly. heparin lock. Esophageal Tracheal Combitube. usually of a tubular structure.occlusionBlockage.gaugemeasure of interior diameter of catheter.sinus rhythmrhythm in which the SA node acts as the pacemaker. called buff cap. reaction might be systemic. chest.sinus bradycardiarhythm that has consistent P waves. pressure is applied to the cricoid cartilage.nasotrachealintubationEndotracheal intubation through the nose.valleculaspace between base of tongue and epiglottis. V3. placed on or close to right arm. consistent P-R intervals. boring needle inside a sharpened hollow needle. catheter to deliver IV fluid.ventricular fibrillationDisorganized.infiltrationescape of fluid into the surrounding tissue. venous cannulation device identified by plastic "wings" act as anchoring points for securing catheter. ie.drip chamberarea of admin set where fluid accumulates so tubing remains filled with fluid. include limb. fainting assoc w/traumatic or med event. consistent P-R intervals. hollow structure that drains or delivers fluids.orotracheal intubationEndotracheal intubation through the mouth. wide portion of tibia located directly below knee. and a regular heart rate that is less than 60 beats/min. V5.electrical conduction systemnetwork of special cells in heart thru which an electrical current flows.catheter shearcutting catheter by needle during improper rethreading of catheter with needle. consists of a hollow tube over a laser-sharpened.drip setsAnother name for administration sets. left arm. hollow. consistent P-R intervals. Often assoc w/clot in vein.
sensory & distal circulation in extremeties5. sensory. sensory and circulatory function in the injured extremity BOTH BEFORE AND AFTER 9/27/2011tance69487272. If the leg is elevated at all. sensory. sensory. sensory and circulatory function in the injured extremity3 Directs application of manual stabilization of the injured legApplies the distal securing device (e. Take/verbalizes bsi/scene safe2 Directs assistant to place/maintain head in neutral in-line position3.Spinal Imobilzation – Seated PateientCritical Skills__ Immediately direct/take/maintain manual immobilization of the head__ Releases or orders release of manual immobilization before it was maintained mechanically__ Patient manipulated or moved excessively causing potential spinal compromise__ Devices moves excessively up. ischial strap)Applies mechanical tractionRe-evaluates the proximal / distal securing devices6 Reassesses motor. ankle hitch)4 Positions the splint appropriately to the injured leg5 Positions / secures the support strapsPrepares/adjusts splint to the proper length measuring with the UNINJURED leg 1Directs application of manual traction ***See note belowApplies the proximal securing device (e. circulatory function are present & normal"4 Selects the proper splinting material5 Immobilizes the site of the injury6 Immobilizes the bone above the injured joint7 Immobilizes the bone below the injured joint8 Reassesses motor.g. and pads as necessary10 Secure pt head to device11 Verbalizes moving pt to long board12 Reassesses motor. Assesss motor. Directs assistant to maintain manual immobilztion of head4. sensory. left or right on patient’s torso__ Head immobilization allows excessive movement__ Torso fixation inhibits chest rise resulting in respiratory compromise__ Upon completion of immobilization. sensory and circulatory function in the injured extremityNote: examiner says "motor.Process1 Demonstrates / verbalizes initial or continued BSI precautions2 Assesses motor.symptoms indicative of hypoperfusionProperly positions the patientApplies high concentration oxygenInitiates steps to prevent heat loss from patientIndicates need for immediate transportationTotal:10 IMMOBILIZATION SKILLS(JOINT INJURY)Critical Criteria__ Did not support the joint so that the joint did not bear distal weight__ Did not immobilize the bone above and below the injured site__ Did not reassess motor. application of manual traction is not necessary. second dressing does not control bleeding.docD179er9/27/2011id not contact medical 179fo9/27/2011 not check medication f179pti
. distal circulation in extremeties Immobilzxation Skills Traction SplintingCritical Criteria__ Loss of traction at any point after it was applied__ Did not reassess motor.Locates and applies pressure to appropriate arterial pressure pointexaminer now informa candidate that bleeding is controlledBandages the woundexaminer now tells candidate patient is showing signs. circulatory function are present & normal"Total:11 IMMOBILIZATION SKILLS (LONG BONE INJURY)Critical Criteria__ Grossly moves the injured extremity__ Did not immobilize the joint above and the joint below the injury site__ Did not reassess motor. sensory & distal circulation after immobilization__ Immobilized head to board before securing torso Process1. down. Appropriately sizes and correctly applies extrication collar6 Positions immobilization device behind patient7 Secures device to pt torso (M-B-I-T-H)8 Evaluates torso fit and adjusts as needed9 Evaluates AND VERBALIZES need for padding. head is not in neutral position__ Did not reaccess motor. circulatory function are present & normal"Note: examiner asks candidate how to prepare patient for transportVerbalizes correctly securing patient and splint to long board 1Total:13 BLEEDING CONTROL/SHOCK MANAGEMENTCritical Criteria__ Did not apply high flow oxygen with appropriate mask__ Applied a tourniquet before attempting other methods of bleeding control__ Did not control hemorrhage in a timely manner__ Did not indicate a need for immediate transportationProcessDemonstrates / verbalizes initial or continued BSI precautionsApplies direct pressure to the woundElevates the extremityApplies a dressing to the woundExaminer must now inform the candidate that the wound continues to bleed. sensory and circulatory function in the injured extremity BOTH BEFORE AND AFTER splintingProcess1 Demonstrates / verbalizes initial or continued BSI precautions2 Directs application of manual stabilization of the injured joint3 Assesses motor. sensory and circulatory function in the injured extremityexaminer says "motor.g. The candidate should be awarded one (1) point as if manual traction were applied.Applies an additional dressing to the woundExaminer now informa candidate that wound continues to bleed. The ankle hitch may be applied before elevating the leg and used to provide manual traction. sensory and circulatory function in the injured extremity BOTH before AND after splinting__ The foot was excessively rotated or extended after splint was applied__ Did not secure the ischial strap before taking traction__ Final Immobilization failed to support the femur or prevent rotation of the injured leg__ Secured the leg to the splint before applying mechanical traction***Note: If the Sagar splint or the Kendricks Traction Device is used without elevating the patient's leg. sensory and circulatory function in the injured extremityexaminer says "motor. manual traction must be applied before elevating the leg.
circulatory function are present & normal"4 Measures the splint5 Applies the splint6 Immobilizes the joint above the injury site7 Immobilizes the joint below the injury site8 Secure the entire injured extremity9 Immobilizes the hand/foot in the position of function10 Reassesses motor.splintingProcess1 Demonstrates / verbalizes initial or continued BSI precautions2 Directs application of manual stabilization of the injury3 Assesses motor. sensory and circulatory function in the injured extremityexaminer says "motor. sensory and circulatory function in the injured extremityexaminer says "motor. sensory. sensory. circulatory function are present & normal"Total:11
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Cardiac Arrest Mgt AEDCritical Criteria__ Did not provide high flow / concentration of oxygen__ Did not confirm patient to be PULSELESS and APNEIC__ Did not direct initiation / resumption of ventilation / compressions at appropriate times__ Did not assure all individuals were clear of patient before delivering each shock__ Did not operate the AED properly (inability to deliver shock). MUST NOT turn off AED__ Did not correctly place pads on patientProcessDemonstrates / Verbalizes initial or continued consideration of BSI precautionsBriefly questions the rescuer about arrest eventsDirects rescuer to stop CPRVerifies absences of spontaneous pulse (skill station examiner states “no pulse”)Directs resumption of CPRTurns on defibrillator powerAttaches automated defibrillator to the patientDirects rescuer to stop CPR and ensures all individuals are clear of the patientInitiates analysis of the rhythmDelivers shockImmediately directs resumption of CPRVerbalizes or directs insertion of a simple airway adjunct (oral / nasal airway)Ventilates or directs ventilation of the patientAssures high flow / concentration of oxygen is delivered to the patientAssures CPR continues without unnecessary / prolonged interruptionConfirms effectiveness of CPR (ventilation and compressions)Re-evaluates patient / CPRRepeats defibrillator sequenceVerbalizes transportation of patient
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. MUST NOT turn off AED__ Did not correctly place pads on patientProcessDemonstrates / Verbalizes initial or continued consideration of BSI precautionsBriefly questions the rescuer about arrest eventsDirects rescuer to stop CPRVerifies absences of spontaneous pulse (skill station examiner states “no pulse”)Directs resumption of CPRTurns on defibrillator powerAttaches automated defibrillator to the patientDirects rescuer to stop CPR and ensures all individuals are clear of the patientInitiates analysis of the rhythmDelivers shockImmediately directs resumption of CPRVerbalizes or directs insertion of a simple airway adjunct (oral / nasal airway)Ventilates or directs ventilation of the patientAssures high flow / concentration of oxygen is delivered to the patientAssures CPR continues without unnecessary / prolonged interruptionConfirms effectiveness of CPR (ventilation and compressions)Re-evaluates patient / CPRRepeats defibrillator sequenceVerbalizes transportation of patient Cardiac Arrest Mgt AEDCritical Criteria__ Did not provide high flow / concentration of oxygen__ Did not confirm patient to be PULSELESS and APNEIC__ Did not direct initiation / resumption of ventilation / compressions at appropriate times__ Did not assure all individuals were clear of patient before delivering each shock__ Did not operate the AED properly (inability to deliver shock).
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.Ephinephrine auto-injectorCritical Criteria__ D.