EMT-B.txt

Lungs

Heart

Stomach

Liver

Nerves

Nose

Mouth

Lungs

Away

Toward

Before

Slow

Against

Difficulty

High

Low

Between

Around

Many

After

Before

Above

Fast

One

Pertaining to

Pain

vomiting

inflammation

the study of

Paralysis

breathing

discharge

contraction

pertaining to

specialist

Frontal or Coronal

Coronal Plane

Medial or saggital

saggital

Tranverse

Posterior or dorsal

Dorsal

ventral

anterior or ventral

superior

inferior

Lateral

medial

mid-axillary

mid-clavicular

Right and Left halves

The top

Front

RUQ, LUQ, RLQ, LLQ

Lying on back

Lying on stomach

Recovery, on side laying wiuth elbow under head.

liver kidney colon pancreas gallbladder

Liver Spleen Kidney Stomach Colon Pancreas

Kidney colon SI arteries and veins of lower legs ureter appendix

kidney colon SI arteries ureter

Siting, slightly leaned back

slightly more leaned back than fowler

maxilla

scapula

Lateral

Cervical-7 Thoracic-12 Lumbar-5 Sacral-5 Coccyx-4 33 total

Atlas

Axis

12 pairs of ribs

2

they are not attached to the sternium anteiroly

The 12 thoracic vertebrae.

Manubrium Body Xiphoid process

Acromium process

skeletal, cardiac, smooth

Scapula

oropharynx

nasopharynx

Pharynx

glottis

epiglottis

larynx

top of the trachea

cricoid cartliage

Ring shaped

trachea

Carina

Into the two bronchi

into each lung

bronchioles

alveoli

phrenic nerve

active

bigger porportionally

smaller porportionally and softer

cellular

CO2 and Sodium Bicarbonate

pancreas and stomach are two main producers, kidneys also produce some.

Superior and Inferior Venae Cavae to the right atrium to the tricuspid valve to the right ventricle to the pulmonary arteries to the lungs to the pulmonary veins to the left atrium to the mitral (bicuspid) valve to the left ventricle to the aortic valve to the aorta. superior and inferior venae cavae right atrium tricuspid valve pulmonary arteries lungs pulmonary veins left atrium mitral (bicuspid valve) left ventricle aortic valve aorta

intraventricular septum

comes off of left ventricle going upwards (ascending) then it arches and the coronary arteries come off of this arch then it starts to descend

1. Sinoatrial node (pacemaker) 2. atriventricular node 3. Atrioventricular bundle (Bundle of His) 4. Bundle branches 5. Purkinje fibers

Navel

illiac arteries

Artery, neck

artery and groin

upper arm

Brachial artery

lower arm thumb side of wrist and artery

artery, medial malleoloeus posterior

artery, dorsal part of foot, lateral to tendon on big toe

Artery arteriole capillary venule vein

Water electrolytes large proteins

RBCS WBCS Plasma Platlets

Platlets

They release clotting factors which form clots

Complicated question, depends of source of clot... common componenets.. Fibrin Platlets Polyhedrocytes

Femoral and carotid

Inadequate Perfusion

acidosis

VQ match

Have you had a masectomy? If yes, take the BP on the opposite side as to not damage remaining lymphatic tissue of side that had the masectomy.

Brain and spinal cord

Sensory and motor

Peripheal Nervous System

Autonomic Nervous System

Involuntary nerve conduction

Parasymphathetic and Symphathetic

Symphathetic

Parasymphathetic

Duodenum Jejunum Ileum

Bile Detox Sugar Storage Creates Blood componenets

To break down fat

Gallbladder

To secrete insulin and other chemicals that help with the breakdown of nutrients and molecules

The spllen

Lymphatic tissue

Epidermis- dead skin dermis- cappilaries, nerve receptors subcutaneous- fat, arteries, veins, nerves

Adrenal glands

beta 1 Receptors- increased HR and contractility Beta 2 receptors- dilation of bronchioles and arteries

Urea

Filter Urea from blood regulates fluid levels by balancing levels of sodium creates bicarb

Midline of lower quadrants

Sodium Potasium Magnesium

FiO2

Mouth or nose Pharynx vocal cords (in larynx) larynx Trachea Right and Left Main Bronchi Secondary Bronchi Tertiary Bronchi Bronchioles Alveoli

patent

Nose and Mouth Pharynx

Upper Airway is everything above (not including) the larynx. The upperairway is everything above the opening to the trachea, the trachea opening is the larynx.

Infection Foreign Object Burn Trauma Inflammation

Tidal volume

minute volume

dead air space: volume of air that is inhaled but does not reach the alveoli air in respiratory tract, not in lungs

Medulla Oblongata

CO2

Brain control pressure of thoracic cavity Lung tissue function and perfusion

Force of heart beat pushes fluid out of the vessel towards our cells

Water naturally flows away from cells towards large proteins in plasma such as albumen

lack of plasma oncotic pressure because the large proteins in our plasma which draw water towards our vessels away from our tissues and cells are produced in the liver.

1. Loss of Tone- smooth muscle control 2. Excessive Permeability- high altitude or sepsis 3. Hypertension

Systemic Vasculature Resistance- pressure our heart beats against, this pressure is a result of our vasculature health and tone.

hypovolemic distributive (vasogenic)- blood vessel tone cardigenic obstructive- restricted blood flow

anxiety and doom ^RR ^HR delayed cap refull PCC sweating

decreasing BP altered LOC

Pediatric- relies more on increased HR Adult- relies more on vasculature constriction

Edema

Edema creation and Airway constriction

Startled baby throws arms out and spreads fingers

grasps finger in palm

touch cheek moves heads toward touch

stroke lips and baby will start sucking

Fontanelle shrinkage or expansion

One year

Trachea Esophagus Spinal Column

Speak? Visual inspection/ finger sweep (not blind)

It is never okay

Horse raspy voice abdominal muscle breathing nasal flaring retracting of clavicular muscles

Stridor

An almost complete obstruction of the upper airway (above the trachea)

Partial obstruction of upper aiway

1. Unconcious patient 2. No gag reflex 3. No vomitus

Corner of mouth to earlobe

OPA is not tolerated due to gag reflex or FACIAL TRAUMA

nostril to earlobe

Right Nose Bevel towards septum LUBE

10 seconds no blind suctioning suction back to front insert suction off then turn on

cellular

Hypercapnia

^RR ^HR Positional Change

Patient is having difficulty breathing but their breathing is adequate because of compensatory mechanisms

Normal LOC Normal Skin color Normal SP02

inadequate breathing

no breathing

Rate Depth Diminished or absent breath sounds Stridor snoring gurgiling gasping Cyanosis

assist breaths with a BVM

No chest rise no air movement by feel no breath sounds extremely low SP02

Artificial ventilation with BVM with 15 LPM O2

every 5 seconds

every 3 seconds

1-2 word sentences very sweaty very anxious

12-20

Emphysema

knocking out hypoxic drive/haldane effect. Use oxygen to get them to 88-92 percent SPO2, make sure they have chronic Obstructive Pulmonary Disease first though aka COPD.

Oxygenation of the blood results in a decreased ability of Haemoglobin to carry CO2

1. Reduced Cardiac Output and Blood Pressure 2. Hyperventilation=hypocapnia=vasoconstriction 3. Asyphyxiation from pushing vomit/fluid into lungs 4. abdominal distension Lack of negative pressure that helps heart fill with blood results in -decreased cardiac output -decreased BP another risk is distension of abdomen also hyperventilation=hypocapnia, because with more O2 in blood, the haldane effect kicks in which reduces haemoglobins ability to carry Co2=vasoconstriction. Pushing Vomit into Lungs This is taken advantage of with patients with rising ICP, you should hyperventilate to induce a hypocapnic state which causes vasoconstriction reducing blood flow to the brain and hopefully reducing edema and swelling that kills brain tissue.

Lowers them, pt. is hypocapnic

One does pumping One does head tilt chin lift or jaw thrust with suspected spinal injury and seals mask around the face.

Continuous positive airway pressure patient need helps breathing, but can maintain their own patent airway basically it is a replacement for assisted BVM ventilations. NOT FOR RESPIRATORY ARREST

Chest rise and fall

Call for ALSCheck pulse look into airway for vomit finger sweep (not blind) suction if needed insert airway of some sort likely OPA Use pocket face mask, preferred if single rescuer attach pocket facemask to O2 if another person arrives or switch to BVM with O2 at 15 LPM

surgical opening in neck for patients who often have upper airway obstructions prior

suction stoma use pediatric facemask to create seal around it, if BVM does not attach directly for some reason.

Flow restricted oxygen powered ventilation device

100 percent O2 at 40 LPM it is like an automated bag for a BVM

Automatic transport ventilator

1. Cardiac or Stroke 2. Adequate breathing 3. Above 95 percent SPO2 4. No other signs of difficulty breathing -PCC -Altered LOC -Cyanosis -Visible difficult

2,000 PSI

200 PSI

crack main tank valve with wrench then close valve check gasket close regulator flowmeter attach regulator to bottle tighten regulator open main valve attach delivery device to regulator pt. consent and device placement set flow rate on regulator secure cylinder remove delivery device from pt. close main valve of tank bleed regulator flowmeter remove regulator from tank

12-15 LPM 80-90 percent

1-6 LPM at 24-50 percent O2

You need to put padding behind their shoulders to open their airway.

Laryngoscope

Blind insertion airway device

test to see if the balloon inflates

You have to ensure that it has been placed into the trachea, not too far and not into the esophagus. If it has been placed to far it will likely go into the right main bronchus. This results in diminished breath sounds of the left, or none at all. Fix this by pulling it out a little. The other problem is it has not been placed correctly into the glottic opening. This results in distension of the abdomen. Fix this by replacement and better visualization of the glottic opening.

Capnography.

End Tidal capnography

35-45 mmHG

CO2 will not have enough time to build up. this will result in lowered ETCO2.

Preoxygenate, BVM at every 3 seconds, instead of 5, 2 to 3 times.

pressure wave penetration

SPNMAC Safe? PPE? Number? MOI? ALS? C-spine?

Emergency Response Guidebook

ERG Emergency Response Guidebook

50 ft

100 ft park uphil and upwind

All the way around their pivot zone (their radius. circumference)

Vehicle Object Pt. Vehicle Pt. Organs hitting inside of Pt.

Up and over Down and under

Adult is over 20 feet child under 15 is 10 ft, or 2-3x their height

Life threats

immediately once you notice vomitus

SPNMAC Safety? PPE? Number of Patients? Mechanism of Injury? ALS? C-spine? XLOCP/C Arterial Bleeds? - that are visible Level of Conciousness? - AVPU and AOx3 Pulse/Chief Complaint ABCOD Airway- inspect, sunction if needed, open(jaw thrust or heald tilt chin lift), adjunct if needed Breathing- feel air movement, feel chest rise, O2 if needed Circulation- 6 sec pulse, skin (PCC), blood sweep, shock blanket Decision- Load and Go? SPNMAC-XLOCP/C-ABOCD

On the way to the ambulance or while your partner is getting the stretcher.

Onset Provoke or Palliate Quality Radiates Severity Time

Symptoms Allergies Medications Past History Last in and out Events leading up

Alert Verbal Pain Unresponsive

Balled up first on chest, sign of MI

Alert to Person Place Time

Unrepsonsive altered LOC ABC threat Severe Pain

2 seconds

It is all about TRENDS

HR RR BP ETCO2 SPO2 BGL PERRL PCC

60-100

weak pulse indicative of SHOCK

ICP

harsh sound on inhale

Size Equality Reactivity

15 minutes

5 minutes

60-80 mg/dl

"30 mmhg past the point where you can no longer hear a pulse. Release pressure 3mm/hg per second. systolic is the first sounds you hear return with the stethescope to the elbow crease diastolic is the first fading of the sound, or when no sound is present at all IF the sound just dissapears instead of ""fading"""

Glasgow Coma Scale EYE OPENING spontaneous and blinking 4 opens to words 3 opens to pain 2 no response 1 TALKING Oriented 5 Confused 4 Weird Words 3 Incomprehensible 2 No response 1 MOVING moves on commands 6 purposeful movement to pain 5 withdrawl from pain 4 flexion in response to pain (decorticate posturing) 3 extension in response to pain (decerebrate posturing) 2 no response 1 Scale of 3-15 8 or below - severe 9-12 - moderate 13-15 - mild

Physical exam history vitals

Jugular Vein Distension

Circulation Sensation Motion CSM

SMILE CLOSE EYES AND YOUR HOLD ARMS STRAIGHT OUT YOU CANNOT TEACH OLD DOGS NEW TRICKS Facial Droop Arm Drift Speech FAS

Facial Drooping Arm Weakness Speech Difficulties Time, record when symptoms started

Usually for trauma load and go JVD Breath Sounds Feel Abdomen Incontinence CSM at extremities SPO2

Stabalize C-spine (if you have not already) Request ALS (if not already) Rapid Trauma Vitals Brief History Load and Go

All the types of injuries, deformities, contusions, ect.

Wounds, Tenderness, Deformities

Bruise behind hear think skull fracture

CSF Leak (Halo Test) Bruising around Eyes

Cardiac tamponade

Fluid or air builds in pleural cavity collapsing the lungs and keeping them collapsed.

Priapism, sign of spinal cord injury or brain injury

Severe Trauma (to see if there are any hidden injuries that you missed) Unconcious Pt. rarer for medical or minor trauma

Yes some JVD in a patient lying down is fine, but never for a patient sitting up.

Scene size up Primary Vitals Rapid trauma physical History reassess primary detailed physical if unresponsive or significant MOI repeat vitals

to the back

Availability

Representativeness

Confirmation bias

Anchoring

Search Satisfying

2 way radio at a fixed site

in a vehicle

on person

Process of recording and sending data wirelessly, like ekg, vitals, ect.

emergency medical dispatcher

identify yourself est. time of arrival pt. age and sex CC pertinent history past illnesses LOC vitals, trends physical results care given response to care as md if they want you to do anything

Prehospital Care Report

Oxygen aspirin nitroglycerin oral glucose inhalers epinephrine naloxone activated charcoal

inhaler nitro epinephrine *depends on local rules*

before medicine usage person drug dose time route documentation