What do you do for pin point pupils and low respirations? - ANSWER Manage airway first, then give Narcan.
If a patient who has pin point pupils and low respirations is vomiting, what do you do first? - ANSWER Suction
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What do you do for pin point pupils and low respirations? - ANSWER Manage airway first, then give Narcan.
If a patient who has pin point pupils and low respirations is vomiting, what do you do first? - ANSWER Suction their airway
COPD and Pulmonary Emphysema patients usually have a history of what? - ANSWER AFib
What does AFib cause? - ANSWER Blood clots, which cause an increase risk for pulmonary embolisms
What is the Renin-Angiotensin-Aldosterone system? - ANSWER Body's response to low BP. Renin, which is released primarily by the kidneys, stimulates the formation of angiotensin in blood and tissues, which in turn stimulates the release of aldosterone from the adrenal cortex. This causes the body to retain water and increase BP.
What are the signs and symptoms of a pulmonary embolism? - ANSWER Sudden onset, SOB, chest pain, increased HR & RR, cool pale clammy skin, pink tinged sputum
What are the risk factors for a pulmonary embolism? - ANSWER Bed ridden pt., trauma or surgical pt., prolonged sitting, recent c-section or traumatic delivery, <40 y/o taking oral contraceptives, smokers
What causes respiratory alkalosis? - ANSWER Increased O2
Decreased CO2
What causes respiratory acidosis? - ANSWER Decreased O2
Increased CO2
What causes metabolic acidosis? - ANSWER Kidneys aren't removing enough acid from the body, so there is a build up. RR increases to blow off excess.
What are signs and symptoms of pericarditis? - ANSWER sharp pain, fever, and ST elevation in ALL leads
In pericarditis, what leads have ST elevation? - ANSWER All of them
What is the physiological event that comes from anaphylaxis? - ANSWER Vasodilation, swelling, itching
How does ARDS effect the alveoli and capillaries? - ANSWER Fluids build up in the alveoli, causing less oxygen exchange at the capillaries
What patients do CPAP work best on? - ANSWER COPD and pneumonia
Pt. must be AO, maintain own airway, breathing on their own
What are other names for normal saline? - ANSWER Isotonic crystalloid solution
What drug do you give to an organophosphate poisoning? - ANSWER Atropine
What do you give a patient who is actively seizing? - ANSWER Versed or Valium
What is another name for Versed? - ANSWER Midazolam
If a patient with low blood sugar is actively seizing, which do you fix first? - ANSWER the seizing, then treat the cause
If a patient is postictal, do you treat their seizures or what caused the seizure? - ANSWER treat what caused the seizure, so it doesn't happen again
What are signs and symptoms of organophosphate poisoning? - ANSWER SLUDGE
What type of breathing do you get with DKA? - ANSWER Kussmaul's
Do you get Kussmaul's with Hyperglycemic Hyperosmotic Nonketotic Syndrome (HHNS)? - ANSWER No
Anytime you see the word anxiety what type of respiratory problem do they have? - ANSWER Respiratory Alkalosis
What is the problem with your lung compliance the older you get? - ANSWER It decreases and becomes more brittle
What is Proximal Nocturnal Dyspnea? - ANSWER Can't lay down at night without getting shortness of breath
What patients generally have PND? - ANSWER CHF
What is another name for CHF? - ANSWER Left sided heart failure
Fever and history of upper respiratory infection, that also has increased water intake, orthostatic hypotension, and increased urination - ANSWER THINK ABOUT THAT
What is wrong if someone has increased urination, increased thirst, low BP, with warm, dry skin? - ANSWER DKA
Can an infection increase your temperature? - ANSWER Yes
Can an infection increase your blood sugar? - ANSWER Yes
If you are a diabetic with an infection, what are you more likely to go into? - ANSWER DKA
If I have a fever, HR through the roof, tremors, low BP, and a history of Grave's Disease, how do i manage this? - ANSWER Fluids, continuous 12 lead monitoring, Beta Blockers
What happens to Bicarb in metabolic acidosis? - ANSWER Increases
What happens to pH in metabolic acidosis? - ANSWER Decreases
What happens to CO2 in metabolic acidosis? - ANSWER Increases
What is the second process in the pathway of AMLS assessment? - ANSWER Look for immediate life threats
What is the first process in the pathway of AMLS assessment? - ANSWER Safety and initial observation
What does observing a patient's body positioning indicate? - ANSWER If they are sick or not sick
What is one of the most crucial things to do when you suspect a patient has a stroke? - ANSWER look at time, how long they've had symptoms
What type of bleeding occurs in a subdural hemorrhage? - ANSWER slow
What type of bleeding occurs in an epidural hemorrhage? - ANSWER fast
What type of hemorrhage has a thunder clap? - ANSWER subarachnoid
What type of hemorrhage has a person experienced if its fast onset, followed by a period of unconsciousness, waking up lucid? - ANSWER epidural
What type of hemorrhage has a person experienced that is slow onset, usually several days to a week? - ANSWER subdural
If I have urticaria and can't breath, what is going on? - ANSWER anaphylaxis
How do you treat anaphylaxis? - ANSWER Remove allergen, ABCs, Benedryl, Epi
When does someone need Epi, based on their vital signs? - ANSWER Hypotension, cardiac arrest
If someone has two cardiac stints and a family history, what information is most concerning? - ANSWER the two cardiac stints
Chest pain, shortness of breath, bed ridden after recent hip surgery, indicates what? - ANSWER Pulmonary Embolosim
Red rash and bumps after a knee replacement, indicates what? - ANSWER MRSA
What is the number one infection that people get in the hospital after surgeries? - ANSWER MRSA
What does a patient (or foreign exchange student) have with a flat rash, ill, fever, nuchal rigidity? - ANSWER Meningitis
If a patient has been ill for three days with abdominal cramping and vomiting, not due to alcohol, an epigastric problem, or lower right quadrant, what is likely the problem? - ANSWER Gastroenteritis, or the stomach flu
Involuntary leg movement when you flex your neck, or bend your knees your neck comes forward, is usually a sign of what? - ANSWER Meningitis (Brudzinski's sign)
Extreme thirst, diabetes, low BP, with 14 respirations a minute, indicates what? - ANSWER Hyperglycemic Hyperosmotic Nonketotic Syndrome (HHNS)
A firefighter that was doing overhaul presents with a bitter almond odor on the breath, what do you suspect? - ANSWER Cyanide poisoning
If someone has taken a lot of over the counter analgesic and now has abdominal pain, N/V, what over the counter pain med are they likely to have overdosed on? - ANSWER acetaminophen
Dark tarry stools are indicative of a bleed where in relation to the stomach? - ANSWER Before
Bright red stools are indicative of a bleed where in relation to the stomach? - ANSWER After
A bent over patient who has RLQ pain, lower back pain, right leg hurts when it is extended, has what? - ANSWER Appendicitis
What are signs/symptoms of appendicitis? - ANSWER Pain localized to right lower quadrant or right lower back. Pain classically begins in the periumbilical region than becomes more localized to RLQ and worse. Stretching can increase pain.
Discoloration around the umbilicus is called what? - ANSWER Cullen's sign
What is Cullen's sign? - ANSWER Periumbilical ecchymosis
What is usually caused from tricyclic antidepressants? - ANSWER Cardiac Dysrhythmias (wide QRS)
If I take all kinds of different meds and may have mixed them up, and my pulse is slow, respirations are slow and shallow, what type of medication did I overdose on? - ANSWER a BP medication
What is the most common type of BP medication that would slow HR and RR, is what? - ANSWER Beta blocker
What type of shock occurs in an untreated cardiac tamponade? - ANSWER Obstructive
What is Beck's Triad? - ANSWER Low BP
JVD
Muffled heart sounds
What type of breath sounds occur in a cardiac tamponade? - ANSWER Clear
Will a hemothorax have clear breath sounds? - ANSWER No
On an elderly female with upper abdominal discomfort and indigestion, what should you check? - ANSWER 12 Lead
Females can have what type of MI's? - ANSWER Atypical
What type of history do people with pancreatitis usually have? - ANSWER Alcoholism and Gallstones
Where does pain radiate to with pancreatitis? - ANSWER Right upper quadrant
Why does pain with pancreatitis radiate to the right upper quadrant? - ANSWER 1. Phrenic nerve
2. Acid build up backs up into the Gall Bladder and causes Gallstones
What is another name for Gallstones? - ANSWER Cholelithiasis
Lower abdominal pain and sharp stabbing during palpation, can indicate what? - ANSWER Diverticulitis or ectopic pregnancy in females
What type of shock might someone end up in if they've had a spinal cord surgery? - ANSWER Neurogenic or distributive
Quadrapolegic, high fever, dark foley, probably has what? - ANSWER UTI
Why is it hard to illnesses and infections in old people? - ANSWER because they always have underlying issues
What do night sweats and chest discomfort indicate? - ANSWER Tuberculosis
There is a near drowning at a lake, the patient was treading water for 25 minutes and has uncontrollable shivering, nausea, and weakness, what is wrong? - ANSWER hypothermia
What is severe hypothermia? - ANSWER Low temp with unconsciousness
What is mild hypothermia? - ANSWER Low temp with normal LOC and shivering
If I have fowl smelling diarrhea, abdominal cramping, post operation infection, and have been taking antibiotics for a long period of time, what could I have? - ANSWER Clostridium Difficile (C Dif)
What can women get from antibiotics? - ANSWER Yeast infections
Bronchitis has what signs and symptoms? - ANSWER Productive cough with a fever
Asthma has what signs and symptoms? - ANSWER Non productive cough and no fever
How do you treat bronchitis? - ANSWER Albuterol, Albuterol/Atrovent, SQ Epi in patient with no cardiac problems
How do you treat asthma? - ANSWER Albuterol and Atrovent after first dose
What population does bronchiolitis occur in? - ANSWER Young children (viral)
What population does bronchitis occur in? - ANSWER Both adults and kids
What is Septic Shock? - ANSWER Elevated temp, increased HR, decreased BP
How do you treat septic shock? - ANSWER Fluids, consider Dopamine
What are signs/symptoms of Obstructive ? - ANSWER Decreased BP, difficulty breathing, tachycardia,tachypnea,JVD,decreased breath sounds,muffled heart tones.
What are signs/symptoms of Hypovolemic shock? - ANSWER Loss of fluid volume, Increased HR & RR, decreased BP, cool, pale, clammy
What are signs/symptoms of Cardiogenic shock? - ANSWER Increased HR & RR, decreased BP, cool, pale, clammy, arrhythmias
How do you immobilize a CHF patient with osteoporosis that caused their neck to break in a trauma? - ANSWER With a KED sitting upright
Treatment for head injuries - ANSWER Don't hyperventilate above 24
Don't give Atropine
Don't give sugar
If several people are sick at the same time, what sort of problem is there? - ANSWER An environmental or food illness
If several people get sick at different times, what sort of problem is there? - ANSWER Flu like problem due to an incubation period
Anytime someone is acting weird, besides checking their sugar, what do you want to check? - ANSWER Pupils
What is the TKO rate of an IV? - ANSWER 25 CC's/hr
Pain, pinpoint pupils, low BP, low HR, indicates an overdose on what? - ANSWER Opiates
If someone overdosed on opiates, do you tube or give Narcan to them first? - ANSWER Narcan
What do you flush Narcan with? - ANSWER Normal saline
Isotonic crystalloid solution
Acting tired, going to the bathroom a lot, and eating a large meal, indicates what? - ANSWER High blood sugar
How do we treat people with high blood sugar? - ANSWER Fluids
After jogging, a female gets a sudden onset of abdominal pain, why? - ANSWER Rupture of ectopic pregnancy
What do you ask a female who is of child baring age? - ANSWER Is there a chance you are pregnant?
Anyone that tries to kill themselves usually takes what prior? - ANSWER Drugs or alcohol
Anytime you have an attempted suicide, what is the most important thing to watch for? - ANSWER A secondary attempt
What do you check on a postictal patient? - ANSWER Gag reflex first, then cause to prevent more seizures
How do you check for a head bleed? - ANSWER Cincinnati Stroke Scale
The Cincinnati Stroke Scale evaluates what? - ANSWER Fine motor and speech
If a Cincinnati Stroke test turns out negative, what type of hospital can a patient go to? - ANSWER Closest facility
What is Mild Anaphylaxis? - ANSWER Itching without airway involvement
What is Moderate Anaphylaxis? - ANSWER Itching with airway involvement, BP>90
What is Severe Anaphylaxis? - ANSWER Itching with airway involvement, BP<90
What are signs and symptoms of a thoracic aneurysm? - ANSWER Sudden onset, pain, ripping or tearing sensation, radiating to the neck and/or back, pulses in extremities are different
What are signs and symptoms of an abdominal aneurysm? - ANSWER Lower abdominal pain, lower back or flank pain, palpable abdominal pulse, unequal or absent distal pulses
How do we treat aneurysms? - ANSWER maintain BP, pt. needs surgery
What size of an IV do you use with an aneurysm? - ANSWER ??
Does an aneurism need an IV TKO or wide open? - ANSWER TKO, increasing BP could cause rupture
How do we treat cocaine overdoses? - ANSWER Swab nose to remove residual if cocaine was snorted. Standard treatment. Be ready for erratic or violent behavior. Higher risk for cardiac ishemia and hypothermia.
How do we treat heat stroke? - ANSWER Fluids, get them out of hot environment
How do we treat heat exhaustion? - ANSWER Fluids, get them out of hot environment
How do we treat hypothermia? - ANSWER Passive rewarming and gently handle them
How do you know sickle cell crisis is getting worse? - ANSWER More SOB and more pain
What is the biggest thing you can do to put a chemo or leukemia patient at risk? - ANSWER Give them an IV because they can't fight infection from even a small amount of bacteria on the skin
What does tetanus cause? - ANSWER lock jaw
What do you do for anyone who is unconscious? - ANSWER Protect their airway
What do you need to be prepared for in someone with a severe headache and altered LOC? - ANSWER Seize
What can a raccoon give you? - ANSWER Rabies
How do you treat a patient with a rattle snake bite? - ANSWER lay them flat and give them large amounts of fluids
What is a pheochromocytoma? - ANSWER a tumor on the adrenal gland
What can a tumor on the adrenal gland cause? - ANSWER increase in HR and BP
Anyone who has been vomiting because of alcohol is at risk for what? - ANSWER Aspiration pneumonia and pancreatitis
What are other options for a patient who as low blood sugar but you can't get an IV? - ANSWER Glucagon IM
What are signs and symptoms of diabetic ketoacidosis? - ANSWER high blood sugar
fruity odor on breath
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