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