Hatzalah Miami Dade

Midterm Review Chapters 1-14

  1. Paramedics are trained in cardiac monitoring, pharmacological interventions, and other advanced treatment skills (pg 10)
  2. Diff. between a stroke and hypoglycemia
  3. Medical control is either off-line (indirect) or on-line (direct), as authorized by the Medical Director. On-line medical control; consists of direction given over the phone or radio directly from the Medical Director or designated physician. Off-line medical control consists of standing orders, training, and supervision authorized by the Medical Director. (Pg 12)
  4. Blood pressure contains 2 separate components: Systolic pressure and Diastolic pressure. Systolic pressure is the increased pressure that is caused along the artery with each contraction (Systole) of the ventricles and the pulse wave that it produces. Diastolic pressure is the residual pressure that remains in the arteries during the relaxing phase of the heart’s cycle (diastole), when the left ventricle is at rest. (Pg 157)
  5. Oxygen & Carbon Dioxide pass rapidly across the walls of the alveoli and the capillaries through diffusion. Diffusion is a passive process in which molecules move from an area of higher concentration to an area of lower concentration. (pg 218).
  6. Distal describes structures that are farther from the trunk, or nearer to the free end of an extremity. For example, the elbow is Distal to the Shoulder and Proximal to the wrist & hand. (Pg 93).
  7. When a patient refuses treatment, you must assess whether the patient’s mental condition is impaired. If the patient refusing treatment is delusional or confused, you cannot assume that the refusal is an informed refusal. When in doubt, it is always best to proceed with treatment. If the patient is competent and is refusing treatment or transport, you must make sure the he/she understands, or is informed about, the potential risks, benefits, treatments and alternative to treatment. You must also fully inform the patient about the consequences of refusing treatment and encourage the patient to ask questions. Remember they have the right to refuse treatment. Document refusals and obtain signature, preferably from a family member of the patient, to protect yourself later (Pg 78)
  8. The nonrebreathing mask is the preferred way to give Oxygen in the prehospital setting to patients who are breathing adequately but are suspected of having or are showing signs of Hypoxia. If the patient will not tolerate a nonrebreathing mask, you will have to use a Nasal Cannula, which some patients find more comfortable. (Pg 240-241)
  9. What to do after you assist a patient with an MDI? Instruct him to hold his breath for as long as he comfortably can.(pg 386-388)
  10. Why not supposed to give patient anything by mouth when they have acute abdominal pain
  11. What is carbon dioxide deficiency?
  12. What is an informed refusal?
  13. Legal Duty to Act begins once your ambulance responds to a call or treatment. It is your responsibility to provide care. ( pg 74)
  14. When clearing the patient before and AED shock, ensure the no one is touching the patient and that no object is touching the patient, including the stretcher or other furniture if the patient is not on the floor or ground (Page 422 – EMT-B Safety box)
  15. The State EMS Office is responsible for authorizing, auditing and regulating all EMS services, training institutions, courses, instructors, and providers within the state. (Pg 13)
  16. Diff. bet. Angina pectoris and an AMI

AMI is a classic Heart Attack. It occurs when

Chest pain does not always mean that the person is having an AMI. When, for a brief period of time, heart tissue are not getting enough oxygen, the pain is called Angina Pectoris, or Angina. Although Angina can result from a spasm of the artery, it is most often a spasm of atherosclerotic coronary artery disease.

  1. Know what scene safety
  2. Know what medications people take for seizures
  3. The 2 processes that occur during respiration are: inspiration and expiration
  4. Deff. Of dyspnea
  5. Signs and symptoms of high blood pressure
  6. Negligence- deviation from the standard of care and may result in further injury(chapter3-pg 74)
  7. Know laypeople
  8. Process of the patient assessment(initial assessment)
  9. Palpating factors
  10. Weight distribution(chapter 6-pg174)
  11. Know how far to extend arms to pull a patient( I think never, always keep your back straight in locked position)
  12. How to perform an emergency move(chapter 6-pg 184)
  13. Scoop stretcher is designed to be split into two or four pieces. These sections are fitted around a paitient who is lying on the ground or another flat surface. Uses of the scoop stretcher include patients with hip injuries, patients with multiple injuries, older patients with brittle bones, and carrying patients up and down stairs. (chapter 6- pg-203-203)
  14. Bodily Fluids such as vomits, tears, and saliva, may transmit an infectious disease, if they contain visible amounts of blood.
  15. Cumulative Stress Reaction is when an EMT-B is exposed to many insignificant stressors over a period of several months or years.
  16. Know the purpose for focused history exam on a conscious medical patient
  17. Know when to call the hospital with an encoding and when its important
  18. Pharmocalogy is the study of drugs and their actions to the body (chapter 10- pg 344)
  19. What causes the brain to stimulate breathing to increase? Increase of carbon dioxide(Chapter 11-pg 366-367)
  20. The epiglottis is the leaf shaped structure located superior to the larynx (chapter 7- pg 214)
  21. Slurred speech and difficult to understand? Receptive aphasia
  22. Know the detailed physical exam- what it consists of (chapter 8)?
  23. Know what rate, rhythm, quality
  24. Ectopic pregnancy- when a fertilized egg comes to lie in an area outside the uterus, usually in a fallopian tube. The fallopian tube is not large enough to support the growth of a fetus, so when it ruptures, it produces massive internal hemorrhage and abrupt abdominal pain. (chapter 14- pg 469)
  25. Know about diff. kinds of consent?
  26. Know about OPA suctioning and the most significant complications associated with it
  27. Best protection against legal liability
  28. Know about hemoragic stroke
  29. Consent, see #42
  30. Know about acute abdomen, significant complications(pg 466-467)
  31. Eye protection(chapter 2)
  32. Abondenment
  33. Function of the skin (chapter 4)
  34. Know about defiralating a patient with aicd (chapter 12)
  35. Consent, see #42
  36. Know about nitro, when the patient can take it
  37. Know late signs of shock- low bp, cyanosis,
  38. Know about avpu and what it stands for- Alert, Verbal, Pain, Unresponsive
  39. Kow about patient care report, what kind of document
  40. Acute hyperventilation syndrome
  41. Why is a Rapid physical exam done? to find unrecognized life threats
  42. Know about millimeters of mercury in relation to suctioning? Should be at least 300 mm Hg
  43. The left ventricle thickest wall bec? It pumps blood to the whole body
  44. Know about pulminary gas exchange
  45. Emergency Medical Dispatcher(EMD) are provided with training and scripts to help them relay relevant instructions to the callers. It also helps them select appropriately resourced units to respond to a request for assistance. It is the dispatchers duty to relay all relevant and available information to the responding crews in a timely manner. (chapter 1-pg 11)
  46. Know deff. Of diff postions (chapter 4-pg 95)
  47. Know the functions of the av node (chapter 12 pg 403, 121)
  48. SARS is a viral infection that often begins with flu like symptoms (chapter 11- pg 370)
  49. If s/1 is foaming at the mouth, make sure to suction to clear airway before breathing
  50. The following routes of administrations have immediate rates of absorption: intravenous (IV) & intraosseous (IO). The following are rapid: Inhalation, Rectal, & sub-lingual. Intramuscular is moderate. The slowest are Subcutaneous, ingestion, & transcutaneous. (Page 345 – Table 10-1)
  51. Know about the heppa mask (chapter 2
  52. Routes of medication
  53. One of the signs associated with Decompensated shock is low blood pressure
  54. Technique for suctioning in the oropharynx
  55. OPA can be used in: an unconscious patient without a gag reflex, or any apneic patient being ventilated with a BVM. (chapter 7 pg 226))
  56. Flow Meters- there are 2 types of flowmeters that are commonly used called: (1) pressure-compensated flowmeters- incorporates a float ball within a tapered calibrated tube. The float rises or falls according to the gas flow in the tube. It is affected by gravity and must always be kept upright for an accurate flow reading.(2) Bourdongauge flow meters- commonly used because its not affected by gravity and can be used in any position. It records the flow rates. The mjor disadvantage of this flowmeter is that it does not compensate for backpressure, therefore it will usually record a higher flow rate when there is any obstruction to gas flow downtrem. (chapter 7-pg 237-238)
  57. Know what left atrium does- pumps blood into LT ventricle through mitral valve
  58. Know what is more common in women than men (chapter 14-pg 468)? Cystitis
  59. Signs and symptoms Inadequate breathing(chapter 11, pg 379)
  60. Know about the communications- duplex, asuplex(chapter 9)
  61. Know the symptoms of cholecystitis(chapter 14-pg 468)? Right upper quadrant pain
  62. The formof medication determines the route by which it will be administered(chapter 10-pg 346)
  63. Signs and symptoms of acute abdomen: Pain and tenderness (chapter 14-pg 470)
  64. See #63
  65. Know when to use a non rebreather mask
  66. Diff. between refered pain and radiating pain(chapter 14-pg 466)
  67. See #40
  68. Most significant in regards to general impression(chapter 8)? Life threatening injuries
  69. Relaying info via radio(chapter 9)
  70. Know what to do after you get call from dispatch? Repeat back word for word
  71. Know about the left ventricle when it relaxes? Diastolic pressure
  72. A symptom mostly described with angina pectoris(chapter 12-pg 408, the Q of OPQRST)
  73. Know what part of brain controls what(chapter 13-pg 440)
  74. Know what a syspention, solution, elixir, tablet(chapter 10-pg 347)? Solution cant be filtered out
  75. Know CQI(chapter 1- pg 13)? continuous internal and external review and audit of all ems calls
  76. Basket stretcher is the most appropriate carrying device to use when moving a patient across rough or uneven terrain(chapter 6-pg 202)
  77. What do you look for when examining the head? Early signs of head trauma
  78. What organs are in the 4 quadrents(chapter 4-pg95)
  79. The Spinal Column is composed of 33 bones divided into 5 sections: Cervical-7, Thoracic-12, Lumbar-5, Saccrum-5, Coccyx-4(chapter 4-pg99 chart)
  80. Know the drugs carried on a BLS truck(Chapter 10-pg 349)? Oxygen, oral glucose, and activated charcoal
  81. What causes seizures, conditions (chapter 13-pg 451)? Epilepcy, high fever, obstructual problems in brain, medoboic or chemical problems in body
  82. Know that ambulances can’t drive over a bridge where water flowing over it
  83. Abandonment
  84. A Sympotom is the problem or feeling the patient reports to you. These can not be felt or observed by others. (chapter 5- pg 147)
  85. Aspirin reduces fever, reduces, pain, and reduces inflammation and inhibits platelet aggregation (clumping). The reason why it’s used is because platelet aggregation under certain conditions in the coronary arteries is one of the direct causes of heart attacks. During a potential heart attack, aspirin may be lifesaving. (chapter 10-pg351)
  86. Gas exchange
  87. Bronchitis(chapter 11-pg 370)
  88. The Hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.(chapter 11-pg 368)
  89. Gas exchange
  90. Asthma, also known as “reactive airway disease,” can be a life threatening condition. Therefore, some patients use epinephrine inhalers to relieve bronchial spasms quickly. The trade names of some of these inhalers are Primatene Mist, Bronitin Mist, Bronkade Mist, and Medihaler-Epi. Because epinephrine tends to increase the heart rate and blood pressure, most patients with Asthma use certain chemical cousins of epinephrine that produce fewer side effects. Metaproterenol (Alupent or Metaprel) and albuterol (Proventil or Ventolin) work more on the bronchial spasms and less on the cardiovascular system. Give repeated doses per medical control and /or local protocol. (Page 354)
  91. Know where vocal chords are located? Upper airway
  92. Know anatomical directions(chapter 4-pg 93)
  93. An Emergency move is used to move a patient before your initial assessment and care are provided when there is some potential danger, and you and the patient must move to a safe place to avoid possible serious harm or death. The only time to use this move is if you cannot provide the patient with the proper care necessary because of his location or position. (chapter 6-pg 184)
  94. Know cyanosis
  95. Hepitatis b vaccine program(chapter 2-pg 51-52)
  96. How to insert an NPA: 1) size the airway by measuring from the tip of the nose to the patients earlobe. Coat the tip with a water-soluble lubricant. 2) Insert the lubricated airway into the larger nostril with the curvature following the floor of the nose. If using the right nare, the bevel should face the septum. If using the left nare, insert the airway, with the tip of the airway pointing upward, which will allow the bevel to face the septum. 3) gently advance the airway. If using the left nare, insert the NPA until resistance is met. Then rotate it 180 degrees into position. This is not required if using the right nostril. 4) continue until the flange rests against the skin. If you feel any resistance or obstruction, remove the airway and insert into other nostril (chapter 7-pg 228-229)