EMT-B Exam 3

  1. List the six rights of administering medications to a patient
    • Patient
    • Time
    • Dose
    • Route
    • Drug
    • Documentation
  2. List four reasons medications are administered to a patient
    • Hypoxia
    • Overdose
    • Myocardial Infarction
    • Anaphylaxis
    • Bronchoconstrictive disease
    • Hypoglycemia
  3. List five signs and symptoms of a hypoxic patient
    • Accessory muscle use
    • Retractions
    • History of respiratory disease
    • Pallor
    • Cyanosis
    • Diminished breath sounds
    • Altered or decreased LOC
  4. List five signs and symptoms of a patient experiencing an MI
    • Chest pain
    • Shortness of breath
    • Pallor
    • Diaphoresis
    • Nausea
    • Vomiting
    • Tachycardia
    • Bradycardia
    • Epigastric discomfort
  5. List four signs and symptoms of a patient with angina.
    • Chest pain
    • Sudden onset
    • Brought on by activity
    • Relieved by rest
    • Relieved by nitroglycerin
    • Short acting
  6. What is the classification of epinephrine?
  7. What is the primary indication for the use of epinephrine by an EMT-B?
    • Anaphylaxis
    • Anaphylactic Shock
  8. List three actions of epinephrine.
    • Increased conduction
    • Increased contractions
    • Increased automaticity
    • Increased irratibility
    • Increased work demand
    • Increashed O2 demand
    • Bronchodilation
    • Vasoconstriction
  9. List three side effects of epinephrine
    • Nervousness
    • Tachycardia
    • Palpitations
    • Headache
    • Nausea
    • Tremors
  10. What is the primary reason to give epinephrine for anaphylactic shock?
  11. What is the classification of Nitroglycerine?
    Antianginal nitrate
  12. What is the primary indication an EMT-B assists a patient with nitroglycerin?
    Chest pain of suspected cardiac origin
  13. List three actions of nitroglycerin
    • Vasodilation
    • Increased venous pooling
    • Decreased preload
    • Decreased wall tension
    • Decreased afterload
    • Decreased work demand
    • Decreased O2 demand
    • Coronary artery dilation
  14. List two side effects of nitroglycerin
    • Headache
    • Hypotension
    • Burning sensation under the tongue
    • Tachycardia
    • Lightheaded
  15. What is the primary reason to administer nitroglycerin to a patient with a possible myocardial infarction?
    Decrease pain and dilate the vasculature
  16. What is the classification of inhalers?
    Sympathomimetic bronchodilator
  17. What is the primary indication an EMT-B assists a patient with inhalers?
    Bronchoconstrictive disease
  18. List the primary action of inhalers.
  19. List two side effects of inhalers.
    • Palpitations
    • Tremors
    • Nervousness
    • Headache
    • Tachycardia
  20. What is the key to having an inhaler work?
    Have patient take a deep breath while taking a puff of the inhaler then holding their breath for no less than 2 seconds
  21. What is the classification of aspirin?
  22. What is the primary indication an EMT-B assists a patient with aspirin?
    Chest pain of suspected cardiac origin
  23. List the primary action of aspirin.
    Inhibits platelet aggregation
  24. What is the proper dose of aspirin.
    160 – 325 mg
  25. What is the route of administration for aspirin?
  26. What instructions should you give the patient?
    Chew the aspirin, do not swallow
  27. What is the classification of insta-glucose?
  28. What is the primary indication an EMT-B administers glucose?
    • Hypoglycemia with signs and symptoms
    • Altered LOC
  29. What is a contraindication of glucose?
    Decreased LOC
  30. What is the proper dose of insta-glucose.
    One tube
  31. Briefly describe how to administer glucose?
    Put it on a tongue depressor and put in their mouth between their cheek and gum, and let it absorb
  32. Describe what needs to be done prior to and after administering a medication.
    • Assess the patient to determine the need (VS-Meds-allergies-LOC-Severity)
    • Call medical control
    • Deliver report and request medication desired
    • Repeat orders that are given back to physician
    • Deliver as directed
    • Reassess the patient
    • Document any outcomes whether they are good, bad or no changes noted
  33. List three components of blood and a function of each
    • Plasma – protein ; fibrinogen ; IG
    • Red Blood Cells - Transport nutrients, waste, and oxygen
    • White Blood Cells - Protection from infection, immune system
    • Platelets - Clotting
  34. List ten signs and symptons of a patient experiencing an acute coronary syndrome (ACS)
    • Chest pain
    • Chest discomfort
    • Pallor
    • Diaphoresis
    • Radiating pain
    • Altered or decreased LOC
    • Tachycardia
    • Bradycardia
    • Cyanosis
    • Shortness of breath
    • Impending sense of doom
    • Hypotension
    • Nausea
    • Vomitting
  35. List four cardiac problems a patient may present with.
    • Acute coronary syndrome (ACS)
    • Angina
    • Right heart failure
    • Left heart failure
    • Tamponade
    • Unstable angina
  36. Briefly describe what angina pectoris is and four specific signs and symptoms
    • A hypoxic cardiac event that can be relieved by rest or nitroglycerin
    • It is a warning sign of an acute coronary syndrome (ACS)
    • Pain with exertion, activity or stress
    • Mild to moderate chest discomfort or pain
    • Pallor
    • Relieved by rest
    • Relieved by nitroglycerin
    • Usually short duration
  37. Briefly describe what an Acute Coronary Syndrome is and six signs and symptoms noted with a patient
    • A cardiac event that leads to cardiac ischemia, injury or infarction due to coronary artery occlusion
    • Chest pain or discomfort
    • Pallor
    • Diaphoresis
    • Cyanosis
    • Shortness of breath
    • Radiating pain
    • tachycardia
    • Bradycardia
    • Altered or decreased LOC
    • Hypotension
  38. Briefly describe what congestive heart failure is
    A situation in which the heart muscle is damaged and is no longer able to function at a level to maintain adequate cardiac output, this can occur on the right, left, or both sides
  39. List four specific signs and symptoms noted in a patient with left sided heart failure
    • Shortness of breath
    • Pallor
    • Diaphoresis
    • Chest discomfort
    • Rales or crackles
    • Paroxysmal Nocturnal Dyspnea (PND)
    • Orthopnea
    • Dyspnea
    • Pulmonary edema
  40. What is paroxysmal nocturnal dyspnea?
    • Acute dyspnea appearing suddenly at night, usually waking the patient from sleep
    • Caused by pulmonary congestion with or without pulmonary edema that results from left-sided heart failure following mobilization of fluid from dependent areas after lying down.
  41. Briefly describe the physiology of an arrest
    • 1st phase – shock phase (0-4 min) – perfusion pressure still adequate coarse v-fib immediate defib needed
    • 2nd phase – CPR phase (4-10 min) – toxins, acids and decreased pressures, need CPR x 2 minutes then defib
    • 3rd phase – metabolic phase(>10 min) – may be past the point of no return, CPR, defib
  42. Briefly describe how to treat a patient exhibiting signs and symptoms of an acute coronary syndrome (ACS).
    • Assessment
    • Oxygen
    • History
    • VS
    • Asparin 162-325 mg
    • Nitro 0.4 mg every 5 minute to three doses
    • Rapid transport
    • Consider ALS rendezvous
  43. List the four links in the chain of survival and why it is important.
    • Early access
    • Early CPR
    • Early defibrillation
    • Early ALS
    • If used in an appropriate and timely manner it can potentially reduce death from cardiac arrest
  44. Briefly describe what each letter of the S.O.A.P stand for
    • Subjective - What you are told
    • Objective - What you find
    • Assessment - What you think is wrong and the priority
    • Plan - What you did
  45. Describe the proper way to correct a notation in a report
    • Draw a single line through it
    • Initial near the line
    • Correct the notation
  46. List three formats used to write a report
    • Chart
    • SOAP
    • Timeline
  47. List four reasons to write a report.
    • Continuity of care
    • Minimum data set
    • Legal record
    • Administrative tool
    • Research
  48. List the three sections of a report to fill out.
    • Patient info
    • Crew info
    • Narrative
  49. What does AMA stand for?
    Against Medical Advice
  50. Why do patients need to be informed of and sign a HIPPA form?
    Right to Privacy
  51. List five pieces of specific information to put on the narrative section of a report.
    • Age
    • Gender
    • Chief complaint
    • Medications
    • Allergies
    • Positive findings
    • Pertinent negatives
    • Suspected problem
    • Interventions
    • Outcomes
    • Transport code
  52. Is it important to write a report for a refusal? Briefly explain why.
    Yes; it is going to be your best defense if there is an issue, the refusal is not the best form of protection
  53. List eight points of information to relay to the receiving facility when giving a radio report.
    • Your agency or squad number
    • Chief complaint
    • Age of patient
    • Vital signs
    • Mental Status
    • Priority
    • Treatments administered
    • Outcomes of treatments
    • Pertinent findings
    • Ask about orders
  54. List 5 points that you do not do when giving a radio report.
    • Diagnose
    • Use abbreviations or “personal terminology”
    • Use codes and/or dispatch language
    • Give a complete patient history
    • Exceed 1- 2 minutes for your report
    • Talk excessively fast
    • Walk on other peoples traffic
  55. List 5 points to remember when conducting interpersonal communication with the patient.
    • Make and keep eye contact
    • Position yourself at a level lower than the patient
    • Be honest
    • Use language the patient can understand
    • Be aware of your body language
    • Speak clearly, slowly, and distinctly
    • Use the patient's proper name
    • If a patient has difficulty hearing, speak clearly with lips visible
    • Allow the patient enough time to answer
    • Act and speak in a calm, confident manner.
  56. List three system components of a communication system.
    • Radio frequencies that are assigned and licensed by FCC
    • Portable radios
    • Mobile radios
    • Repeaters
    • Base stations
    • Cell phones
  57. Drug Card - Aspirin
    • Classification: Salicylate
    • Actions: Inhibits platelet aggregation
    • Indications: Acute chest pain, suspecting an MI
    • Contraindications: Allergies, recent GI bleeds, stroke
    • Side Effects: Flushing, nausea, vomiting, GI Bleed, dizziness
    • Dose: 160 - 325 mg
    • How supplied:2-4 81 mg children chewable tablets, 325mg adult tablet
    • Route: P.O.
  58. Drug Card - Glucose
    • Classification: Carbohydrate
    • Actions: Essential for normal metabolism, increases the amount of sugar available for use in the body.
    • Indications: Hypoglycemia
    • Contraindications: Decreased LOC
    • Side Effects: May be aspirated if no gag reflex
    • Dose: One tube
    • How supplied: 15 - 24 grams / tube
    • Route: Buccal
  59. Drug Card - Nebulized Inhaler
    • Classification: Beta 2 agonist, synthetic sympathomimetic
    • Actions: Relaxation of bronchial smooth muscle, bronchodilation
    • Indications: Relief of bronchospasm (asthma, COPD, anaphylaxis)
    • Contraindications: Excessive tachycardia, not patient's med
    • Side Effects: Anxiety, shakiness, tachycardia, headache, tremors
    • Dose: 90 – 100 micrograms
    • How supplied: Metered dose inhalers
    • Route: Inhalation
  60. Drug Card - Nitroglycerin
    • Classification: Antianginal Nitrate
    • Actions: Smooth muscle relaxant, vasodilator, increased venous pooling, decreased preload, ventricular wall tension and afterload, decreased myocardial work, demand and O2 consumption, coronary artery dilator
    • Indications: Chest pain of cardiac origin
    • Contraindications: BP <100; Use of phosphdiesterase (ED) inhibitors within 24-48 hours, allergies, tachycardia, bradycardia
    • Side Effects: Headache, hypotension, burning under tongue
    • Dose: 0.4 mg every 3 – 5 minutes x 3
    • How supplied: Tablet or metered dose spray
    • Route: Sub-lingual
  61. Drug Card - Epinephrine
    • Classification: Sympathomimetic; Endogenous catecholamine
    • Actions: Beta 1 - Increased rate, conduction, contraction, automaticity, V-fib threshold, irritability, MVO2, workload. Beta 2 -Increased respiratory effort, bronchodilation. Alpha 1 - Increased peripheral vascular constriction, blood pressure
    • Indications: Anaphylaxis, asthma
    • Side effects: Tachycardia, palpitations, anxiety, headache, tremors, nausea, and vomiting
    • Dose: 0.3 to 0.5 mg adult, 0.15mg child
    • How supplied: 1 epinephrine pen
    • Route: Intramuscular
  62. Drug Card - Narcan
    • Classification:Narcotic antagonist
    • Actions: Blocks opiate receptor sites
    • Indications: Known narcotic overdose
    • Contraindications: Hypersensitivity
    • Side Effects: Tachycardia, hypertension, nausea, vomiting, withdrawal, use with caution
    • Dose: 0.4 - 2.0mg titrated to effect, may repeat to a total of 10mg
    • How supplied: Multi dose vial 10mg / 10 ml. Multi dose vial 4 mg / 10 ml pre-filled syringe 1mg / ml
    • Route: IV (intravenously), ET, IM (intramuscular), SQ (subcutaneous) and nasally
  63. Drug Card - Oxygen
    • Classification: Gas
    • Actions: Oxygenate the body. Increase the amount of oxygen available for the body's tissues
    • Indications: Always. Hypoxia, respiratory distress, respiratory failure, all arrests, every patient.
    • Contraindications: None for a patient requiring oxygen.
    • Side effects: Light headed
    • Dose: 100%
    • How supplied: Nasal Cannula 2-6L, Nonrebreather 8-15L, Bag valve mask 15L+
    • Route: Inhalation
  64. What are two names given to medications?
    • Chemical
    • Trade
  65. List four ways meds may be administered.
    • Oral - Asparin
    • Sub-lingual - Nitroglycerin
    • Injectable (intramuscular) - Epinephrine
    • Buccal - Glucose
    • Inhaled - Inhaler and oxygen
    • Intravenously - Narcan
    • Subcutaneous - Narcan

    • List five points to know about medications
    • Class
    • Action
    • Indications
    • Contraindications
    • Side effects
    • Dose
    • Route
  66. List two medications an EMT-B can assist with
    • Inhalers
    • Nitroglycerin
  67. List three medications an EMT-B can administer
    • Oxygen
    • Asparin
    • Oral glucose
    • Epinephrine
  68. Drug Names and descriptions
    • Chemical Name - Chemical structure and makeup
    • Generic Name - Ibuprofen
    • Trade name - Advil, Motrin
  69. What are the two types of drug effects?
    • Local effect - Affect the local region around administration. Affects a limited portion of the body.
    • Systemic effect - Absorbed into the blood stream, circulates around the body, and affects the entire body.
  70. What are the four types of drug forms?
    • Solid
    • Liquid
    • Gas
    • Powder
  71. After you administer a drug, what are the following steps?
    • Document the time the drug was given
    • Document any response to the drug
    • Monitor the patient
    • Reassess vitals
    • Document changes in patient status
  72. What are the two categories of drug administration?
    • Medications you can administer
    • Medications you can assist administering
  73. What is shock?
    Hypo-perfusion in the body. Inadequate circulation of blood through tissue in the body.
  74. What are 5 signs and symptoms of shock?
    • Restlessness
    • Anxiety
    • Altered mental status
    • Pale
    • Cyanotic
    • Cool and clammy skin
    • Rapid weak pulse
    • Rapid, shallow breathing
    • Nausea
    • Vomiting
    • Reduction in total blood volume
    • Low or decreasing blood pressure
  75. What is cardiovascular disease?
    Disease of the heart and blood vessels
  76. What is coronary heart disease?
    Disease of the coronary arteries and complications that result
  77. What is coronary artery disease?
    Disease that slows or stops the flow of blood through the arteries to the heart
  78. What are acute coronary syndromes?
    A temporary or permanent block of the coronary arteries.
  79. What is ACS responsible for?
    • Angina
    • Unstable angina
    • Myocardial infarction
  80. What are the two main causes of ACS?
    • Arteriosclerosis - Hardening of the coronary arternies
    • Atherosclerosis - Constriction and thickening of coronary arteries
  81. What are the three types of risk factors and examples of each?
    • Modifiable factors - Weight, exercise, smoking
    • Non-modifiable factors - Genetics, race, age, gender, family history
    • Contributing factors - Stress, depression, heavy alcohol intake
  82. What is ischemia?
    Decreased blood flow to an organ or tissue?
  83. What is MONA used for and what does it stand for?
    • It is used in patient's with a suspected MI
    • M - Morphine (ALS only)
    • O - Oxygen
    • N - Nitroglycerin
    • A - Aspirin
  84. What happens when a ventricle fails to pump blood?
    • Left side - Fluid backs up into the lungs
    • Right side - Fluid backs up into the body system and causes congestion in organs and tissues
  85. What is sudden cardiac death?
    Unexpected death from cardiac causes very early after symptom onset, 1 minute to an hour, or without the onset of symptoms. About 2/3rds of sudden deaths are prehospital
  86. What are the modes of transmission?
    • One-way - A one way radio, one person talks, other receives
    • Simplex - One signal can be transmitted at a time
    • Duplex - A dual person radio. Both can talk or receive, channel can be used simultaneously
    • Multiplex - Many sources can talk at the same time
  87. What is the physiology of CPR?
    • Coronary perfusion is based on good CPR
    • Supply oxygen to the myocardium
    • Good chest rise is needed to the blood to go back to the heart during relaxation
    • Venous blood return depends on difference in interthoracic and abdominal pressure
    • Interthoracic pressure increases with chest compressions, failure to allow full chest recoil, excessive air with ventilation
  88. Define agonist
    Stimulates cell activity
  89. Cardiac Arrest
    • Contractions of the heart stop.
    • Confirmed by unresponsiveness, absent breathing, absent pulses
  90. Palpitations
    Awareness of one's own heartbeat
  91. What are the three kinds of shock?
    • Compensating
    • Decompensating
    • Irreversible
  92. What happens during compensating shock?
    • Blood returns to the five major organs for survival.
    • Heart
    • Brain
    • Lungs
    • Liver
    • Kidneys
    • Tachycardia - 120
    • Increased respirations
    • Pallor
    • Diaphoresis
    • Slow CR
    • Altered LOC
    • General Weakness
    • Poor Peripheral Pulses
    • Cool extremities
    • Dilated Pupils
  93. What happens during decompensating shock?
    • The blood is removed from the kidneys, liver, and brain
    • Mentations decreased
    • Hypotension
    • Tachycardia - 130-140
    • Decreased urine output
  94. What happens during Irreversible shock?
    • Bradycardia
    • Systole under 60
    • Death
  95. Define vasodilator
    A drug that initiates vasodilation. Vasodilation is widening of the blood vessels resulting from relaxation of the muscular vessel walls
  96. Define preload
    The stretched condition of the heart at the end of a diastole, just before a contraction
  97. Define afterload
    The force against which a ventricle contracts
  98. Define stimulant
    A drug that produces a temporary increase of the functional activity or efficiency of an organism or any of its parts.
  99. Define platelet aggregation
    The clumping together of platelets in the blood
  100. Define inhibitor
    A drug that interferes with a chemical reaction, or a drug that reduces the activity of another substance.
  101. Define action
    The main function of drugs.
  102. Define hypoglycemia
    Low blood suger. <70mg/dL in adults
  103. Define acute coronary syndrome (ACS)
    Conditions caused by temporary or permanent blockage of a coronary artery. Results from coronary artery disease.
  104. Sublingual
    Route of drug administration under the tongue
  105. Intramuscular
    Route of drug administration in skeletal muscle
  106. Chief complaint (CC)
    A subjective statement made by the patient describing the most significant or serious symptoms of signs of illness that caused him/her to call for medical help.
  107. Indication
    The signs and symptoms for which a drug has documented usefulness
  108. Contraindication
    Condition where a drug should not be administered to a patient because doing so may cause harm to the patient or offer no improvement to their status
  109. Side effect
    Expected and usually unavoidable effects of a drug other than the main action
  110. Agonist
    Stimulation of physiologic activity at cell receptor sites similar to that of the normal cellular function
  111. Antagonist
    Nullify the physiologic activity at a cell receptor site. Blocks binding sites so function of that substance stops.
  112. Catecholamine
    A group of sympathomimetic amines including epinephrine, norepinephrine, and dopamine.
  113. Classification
    Grouping based on similar traits
  114. Beta 1
    Sympathetic receptor that functions on the heart
  115. Beta 2
    Sympathetic receptor that functions on the lungs
  116. Sympathomimetic
    Stimulation of the sympathetic nervous system in physiological responses
  117. Bronchodilator
    Relating to or causing expansion of the bronchial air passages
  118. Antianginal
    Prevent or relieve angina pectoris. Increases oxygen supply to the heart
  119. Does
    Amount of medication given to a patient
  120. Sympathetic nervous system
    Division of the autonomic nervous system that mobilizes energy such as fight or flight
  121. Autonomic nervous system
    Governs involuntary action such as secretions, vasoconstriction, and peristalsis. Consists of sympathetic and parasympathetic nervous systems.
Card Set
EMT-B Exam 3
Exam 3