Traumatic Asphyxia This is a term used to describe a severe crushing injury to the chest and/or abdomen. It results from an increase in intrathoracic pressure. This pressure increase forces blood from the right side of the heart into the veins of the upper thorax, neck, and face. Signs and Symptoms include: - Redish purple discoloration of the face and neck - JVD - Swelling or hemorrhage of the conjunctiva (petechiae may appear) ... See MoreSee Less
Your patient is conscious, has an intact gag reflex, but is intoxicated and unable to properly protect his airway. Which of the following would be the most appropriate way to protect his airway?
A) An oral airway (OPA) B) By intubating the trachea with an appropriately sized ET tube C) By inserting a nasal airway (NPA) D) By suctioning his oropharynx with a rigid catheter
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Cardioversion! Cardioversion is used for patients in an irregular rhythm, such a atrial fibrillation or v-tach with a pulse. An important thing to remember in cardioversion is that the shock is synchronized to the R wave. Shocking during the absolute refractory period (T-wave) will likely create asystole. Make sure sync button is on and you see R-wave capture. This is usually represented by a little dot or arrow at the top of the R-wave on the monitor. ... See MoreSee Less
So it’s not an irregular rhythm....it’s a symptomatic Tachy-arrhythmia not responsive to other treatments. What about AVRT, AVRNT, SVT’s?
When would V-Tach with a pulse be irregular?
Cardioversion is also recommended for the treatment of the following :
Supraventricular tachycardia due to reentry
Monomorphic VT with pulses
Some of the information you give is either incomplete or incorrect based on changes to ACLS recommendations
Cerebrospinal Fluid (CSF) The cerebrospinal fluid aids in the protection of the brain, spinal cord, and meninges by acting as a watery cushion surrounding them to absorb the shocks to which they are exposed.
If you suspect a skull fracture and there is evidence of bleeding from the nose or ears (any bleeding from the skull when a fracture is suspected) you can sometimes determine the presence of CSF in the blood with a Halo Test: If possible - take a drop of the suspected blood and let it drip onto a sheet, paper towel or filter paper (coffee filters work great in a pinch). - Watch the drop of blood for signs of the CSF leaving the denser blood and producing the tell-tale Halo sign. You will see a distinct lighter ring around the coagulating blood drop, suggesting a skull fracture and determining your patient to be a definite Load-N-Go! ... See MoreSee Less
You are called to a local industrial center for a 23-year-old man with facial burns. The foreperson informs you that the patient was working on a gas-powered generator when the equipment flashed. On arrival, the fire is out and the patient is in the restroom, washing his face. You note that this patient has sustained serious inhalation burns of the upper airway. Which would be the most appropriate therapy?
a) High-concentration of oxygen, intubation, and bronchoconstrictors b) Insertion of a laryngeal mask airway (LMA) c) High-concentration of oxygen, intubation, bronchodilators d) Low-concentration of humidified oxygen
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Grey-Turner’s Sign and Cullen’s Sign Signs of Internal Bleeding are easy to find but, it can be harder to determine to the source of the bleed.
Grey-Turner’s sign and Cullen’s sign can be easily confused with one another because they are both characterized by the same physical findings in different locations.
Grey-Turner’s sign is located on the flanks. Cullen’s sign is located around the umbilicus (periumbilical).
These signs can be seen when bleeding occurs inside the abdomen or in the retroperitoneal location. This is most commonly thought to be due to necrotizing pancreatitis, but it can also happen in other conditions such as an abdominal aortic aneurysm (AAA) and Ectopic Pregnancy.
The mnemonic for remembering how to distinguish between these signs: Grey-TURNer’s sign is located when you TURN towards your flank and CUllen’s sign is located around the Umbilicus. ... See MoreSee Less
You are dispatched to a pregnant patient who is experiencing contractions. Upon assessment, you decide that delivery is imminent. As she pushes, you notice a prolapsed cord. Do you know what to do next?!? ... See MoreSee Less
Not sure I agree with pushing the fetus back with a prolapsed cord. Medical Control. There was a huge lawsuit where a nurse pushed the baby back, causing some sort of nerve damage to the woman's vaginal area. I also would not suggest listening for fetal sounds unless you are specifically trained for it. But good information otherwise all in one place.
Rapid transport keep cord moist, high O2 for mom IV monitor pulse ox get prepare if mom starting to delivery. Never pull on the cord just keep moist. Have your partner to call the hospital for you and give them your report on the patient. You continue monitor mom and the baby for delivery and the cord moist. Make sure you have 2 IV be prepared for the unknown
A quick method of estimating the date of a pregnancy is by measuring fundal height. This is the distance from the symphysis pubis to the top of the uterine fundus. The fundus is measured by running a measuring tape vertically from the top of the pubis bone to the top of the fundus. Each centimeter of fundal height is considered equal to one week of gestation. For example, if the patient measures 20 cm, she would be approximately 20 weeks gestation. ... See MoreSee Less
You and your partner made an unsuccessful attempt to resuscitate a 65-year-old female that was in cardiac arrest. The family sues your EMS organization for negligence. You and your partner will have to prove that your actions during the resuscitation:
a) exceeded the standards set forth by the AHA b) were extraordinary and heroic c) were similar to the actions a reasonably prudent person would do under similar circumstances d) were not within their duty to act
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Diverticulitis is the inflammation (often due to infection) of diverticula--small, bulging pouches that can form in the lining of the digestive system. It is most often found in the lower part of large intestine.
Signs and Symptoms include: LLQ (left lower quadrant) abdominal pain Pain often constant and persisting for several days with nausea and vomiting Fever Abdominal tenderness Constipation Diarrhea ... See MoreSee Less
You arrive on scene to find a 7-year-old male patient with an arrow from an archery set imbedded approximately 1.5 inches into his right eye. What is the best way to manage this patient?
Getting near test time, or getting ahead for next year? Right now you can get 3 months for the price of 2! Try our 90 day special NOW! MedicTests.comGetting near test time, or getting ahead for next year? Right now you can get 3 months for the price of 2! Try our 90 day special NOW! MedicTests.com... See MoreSee Less
Put another apple on his head and try again. But seriously, stabilise the arrow, cover both eyes, spinal immobilisation, pain management and transport to nearest paediatric trauma centre.
15 hours ago
Cover good eye. Immobilise arrow. Child won't be able to see so keeping mammy or daddy beside him is vital to his comfort.
3 days ago
Same plus eyepatch or pad to cover good eye, remember eyes my synchronously. Treat for shock. Appropriate analgesia if required
4 days ago · 1
That is an impaled object.protect the other eye. cover it to protect the muscle so that it's could relaxed.do not try to removed it.badage the inmpale object and transport the patient to hospital
4 days ago
Stabilize the arrow. Cover the other eye so patient doesn’t try look around and have the other eye move too. Treat for shock. Check pupil resource of other eye. 18g IV, fluids, transport, pain management.
4 days ago · 1
Stabilize , cover both eyes, IV, monitor and perhaps something to help calm him, treat pain.. Flight to a Childrens center if transport to one is long..
4 days ago
Stabilize and immediate transport making sure to cover the other eye also
3 days ago
Stabilize the arrow, cover another eye, do shock management, bring him to hospital. Carry him with stretcher or carrying chair rather than let him walk.
4 days ago
Stabilize with rolled gauze wrapped around the base by the eye. Cover other eye so that patient doesn't look around. Treat for shock
4 days ago
Stabilize with a styrofoam or paper cup
4 days ago
As above, transport flat to save viscous fluid
4 days ago
3 days ago
Stabilize the arrow. Cover other eye and transport.
Remember that even Isotonic only stays in the system for relatively short of time, it will eventually be absorbed after about 1.5 hours. Also D5W in theory an isotonic, but once body metabolized the dextrose, it will turned into pure water thus hypotonic.
Nephrolithiasis (Kidney Stones) Kidney stones are clumps of crystals that form in the kidneys. They may be as small as a grain of sand or, in rare instances, become as large as a golf ball. Kidney stones can be caused by infection, problems with metabolism of minerals, dehydration, or urinary stasis, which occurs when the bladder is not emptied completely. The symptoms of kidney stones are classic and intense.
Pain is the primary symptom of kidney stones that patients present to EMS with. A kidney stone travels from the kidney where it formed down the tubes called ureters, which drain the kidney into the bladder. As a kidney stone passes through a ureter, patients typically feel flank pain. Flank pain is described as pain over the lower back, starting below the rib cage, and extending down to the top of the hip. The pain is often described as colicky and spastic, coming in waves.
Transport to the hospital is mainly supportive with perhaps O2 via NC, EKG (just in case), Saline lock and perhaps obtain dr orders for pain relief meds and possibly Zofran for N/V if present. ... See MoreSee Less
You are assessing GCS score in a 90 year old trauma patient. Your patient's eyes open in response to speech, but he is nonverbal, and only appears to make localizing, purposeful movement towards painful stimuli. What's your best estimate of this patient's GCS score?
a) 13 b) 7 c) 9 d) 11
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I was recently dispatched to a BLS transport company unit requesting ALS intercept for impending respiratory arrest. Apparently none of their company's medics were available When I got there, one of the EMTs had three months on the job, the other was on his first shift that wasn't training or riding as a third.
I jumped on their bus. The guy was serious but not as bad as they thought. They had done everything right and were super excited to help me as I hooked him up to the monitor, put a line in etc. The "senior" EMT told the first day guy to drive. He hit the lights and sirens and we went, my partner following in our bus.
We get to the ER and the kid driving is so excited he leaves for the siren blaring as we back in the ER bay, then jumps out and opens the back door, sirens still screaming. My partner gets out of our bus, walks over and shuts it off.
Kid grabs the head of the stretcher, so excited about his first emergency triage. Until the triage PA yelled "Are you the idiot that made us all deaf with that f'ing siren"?!
Poor kid looked like he was gonna cry. I felt terrible for him, but had to laugh remembering when I was just like him. When we were done my partner and I had them follow us to Dunkin' and bought them some "Welcome to EMS" coffee and donuts.
Angina! Angina Pectoris is simply ischemic chest pain that can be felt in various regions of the body. Nitroglycerin is effective for the treatment of the ischemic chest pain (angina pectoris). It also has beneficial hemodynamic effects including dilation of the arterioles, veins in the periphery, and coronary arteries, which decreases preload. In turn, lowering the workload and myocardial oxygen demand of the heart muscle. Because of it's powerful hemodynamic effects, nitroglycerin should not be used in patients with: - Hypotension (systolic pressure < 90 mm Hg) - Bradycardia (< 50 bpm) - Tachycardia (> 100 bpm) - Recent use of erectile dysfunction medication (< 24 hrs) Nitro should be administered cautiously in patients suspected of having an inferior wall MI with possible right ventricular involvement. ... See MoreSee Less