emergency medical response team
responds to accidents, natural disasters, health emergencies in a remote or otherwise dangerous location
field emergency response team
paramedic, emergency medicine technician, disaster response technician, emergency medicine physician
facility emergency response team
emergency medicine nurse practitioner, emergency services coordinator, triage nurse, emergency communications specialists
What are the steps to sizing up a scene?
survey and assess, ensure safety before moving in (control situation, look for hazards, assess situation, protect yourself and bystanders and prioritize individuals in most need)
primary assessment
process used to rapidly determine any health conditions that may be life threatening to your patient
How long should a primary assessment take?
less than 15 seconds
What are the steps to primary assessment?
form general impression of patient, determine mechanism of injury, determine patient responsiveness, consider stabilizing the patient's spine, check ABCs
spinal board
device used to immobilize spine
cervical fracture
broken neck, could lead to permanent paralysis or death
ABC's initially
airway, breathing, circulation
stridor
noisy, wheezing breaths due to constricted airway
bag-valve-mask resuscitator
mask with handheld pump used for manual ventilation (providing air) of patient suffering respiratory emergency
How do you check breathing?
head tilt for adults, tilt only slightly for child, tilt into neutral for infants
bloodborne pathogens
disease-causing agents carried and transmitted by blood
secondary assessment
quickly complete a head-to-toe physical exam and take vitals
How long does secondary assessment take?
45 seconds
pupillary response
the involuntary changing of size of pupil, determine nervous system health in secondary assessment
consensual pupillary reflex
shine light into eye to get response in opposite eye
dilation
widening of pupil
constriction
narrowing of pupil
What does it mean if the consensual pupillary reflex does not occur or if the eye dilates in light / constricts in dark?
nervous system problems
patient vitals
medical device for obtaining more accurate readings, recording the patient’s pulse, blood pressure, and respiration rate
intubate
place a ventilation tube (endotracheal tube) down the patient’s trachea, to deliver air to them
skin turgor
the measure of the elasticity of the skin
What about skin turgor indicates dehydration?
skin remains raised after being pulled up
allergic reaction
when the immune system overreacts to a foreign substance, recognizing substances other than antigens or pathogens
What are common triggers for allergies?
nuts, fruits, medss, latex, metal, fabric, dye, insects stings
What are the mild symptoms of allergies?
itchy, watery eyes, runny nose
anaphylaxis
severe systemic allergic reaction affecting multiple organ systems; face, tongue, throat, airways swell and hives with flushed skin, nausea, dizziness
What do white blood cells do during allergic reactions?
use chemicals like histamines to attack allergen, causing blood vessels to widen, increased heart rate, gland secretion, and airway constriction
hives (urticaria)
raised, itchy welts on skin with well-defined edges, vary in size, grouped together over a large area
What causes hives?
inflammatory molecules from skin cells
enteral drugs
medications that enter through the digestive tract (orally or rectally)
parenteral drugs
medications that enter the body in a manner other than the digestive tract (inhaled, topical, injection, infusion)
intravenous injection
delivered medicine into muscle tissue where it can be quickly absorbed by the bloodstream
intramuscular injection
delivered medicine into muscle tissue where it can quickly be absorbed by the bloodstream
subcutaneous injection
delivers medicine to tissue layer under skin and above muscle
rank injection types from fastest to slowest
intravenous, intramuscular, subcutaneous
How is it decided to administer epinephrine?
by weight
intravenous (IV) therapy
the delivery of medication and / or fluids over a period of time through a vein
catheter
tube placed into vein (back of hand. inside bend of elbow) via a needle, administers medications and fluids
IV therapist
LPN or RN with additional IV therapy certification
homeostasis
cells and blood have same relative concentration
optimal saline
0.9% (isotonic)
What happens if a hypertonic IV is administered?
cells shrivel
What happens if a hypotonic IV is administered?
cells lyse
flight paramedic
gets patient bleeding under control
How are platelets an example of positive feedback?
send out signals to other platelets to join when stick in web of fibers around opening of wounded blood vessels
When does the positive feedback cycle of platelets stop?
when the blood clots
ABC for bleeding
alert, bleeding, compress
What does life-threatening bleeding look like?
does not stop, spurts, pools on ground, soaks everything, victim is unconscious or confused, victim has lost parts of or all of limbs
What does compression do to a wound?
helps broken blood vessels clot
tourniquet
applies extra pressure to the vessels within an arm or leg to slow the flow of blood to that limb
What happens if you leave a tourniquet on for more than 2 hours?
permanent tissue death
What should be assessed first about a scene?
is it safe
arterial bleeding
bleeding from an artery, high blood pressure makes more dangerous, spurts in large volumes
venous bleeding
bleeding from a vein, ligate by tying off with a suturing thread
When do you pack a wound with gauze and not a tourniquet?
when one is not available or the blood is from the neck, shoulder, or groin
triage
the process of prioritizing patients based on who is most in need of immediate care
triage nurse
experienced RN who makes urgency of patient care decisions
emergent
highest priority; care needed immediately or will die
urgent
care needed quickly; can be delayed temporarily
semi-urgent
care needed; can wait for other higher priority
non-urgent
lowest priority; minor conditions, not time-sensitive, care not needed immediately