Title: EMT-165
Tags: definition injury anatomy trauma 06 emergencies respiratory orthopaedic 31 15 terminology 05 mastery abbreviations 28 bleeding cardiovascular environmental neurologic 32 24 overview 18 11 17 pharmacology airway 21 09 10

Q: What are the solid organs in the abdominal cavity?
A: Liver, spleen, pancreas, kidneys, and women (in women).

Q: What are the hollow organs in the abdominal cavity?
A: Gallbladder, stomach, small intestine, large intestine, and urinary bladder.

Q: What does the liver do?
A: Assists in digestion by secreting bile, filters toxic substances, creates glucose stores, and produces substances necessary for blood clotting and immune functions

Q: What does the gallbladder do?
A: Acts as a reservoir for bile.

Q: What are the three sections of the small intestines?
A: duodenum, jejunum, ileum

Q: What does the pancreas do?
A: Aids digestion by secreting juice that contains enzymes that help break down starches, fats, and protein. Also releases amylase.

Q: Where does amylase come from and go into?
A: It comes from the pancreas and goes into the duodenum.

Q: What is bicarbonate?
A: It is an alkali and is part of the buffering system that neutraizes stomach acids in the duodenum. It also comes from the pancreas.

Q: What is insulin?
A: It regulates the amount of glucose in the bloodstream, and is produced in the pancreas.

Q: What is the jejunum?
A: It is the second part of the small intestine and pays a major role in the absorption of digestive products. It comprises much of the surface area of the small intestine.

Q: What kind of environment does the jejunum and ileum have?
A: They have a mostly pH-neutral environment for absorption.

Q: What is the ileum?
A: The ileum is the third part of the intestine, and is where soluble molecules are absorbed into the blood, and where proteins, fats, and starches are reduced to amino acids, fatty acids, and simple sugars.

Q: What is peristalsis?
A: It is a rhythmic movement that moves waste matter through the intestines.

Q: What is the spleen?
A: It is located is located in the abdomen but has no digestive function. It is part of the lymphatic system, assists in filtering blood, developing red blood cells and antibodies, and serves as a blood reservoir.

Q: What do the kidneys do?
A: They play an important role in the regulation of acidity and blood pressure, and remove sodium chloride from the body and therefore excess fluid.

Q: How much of the output of blood from the heart passes through the kidneys each minute?
A: Nearly 20% of the heart's output passes through them.

Q: What is the renal pelvis?
A: It is a cone-shaped collecting area that connects the ureter and the kidney.

Q: Where is the urinary bladder?
A: It is located immediately behind the pubis symphysis.

Q: How much urine does the average adult form each day?
A: They form 1.5 to 2L of it each day.

Q: How much blood circulates through the kidneys daily?
A: c. 1,500 L of blood flows through them daily.

Q: What lines the abdominal cavity?
A: The parietal peritoneum lines it.

Q: What lines the organs themselves?
A: The visceral peritoneum lines them.

Q: What is peritonitis?
A: This is irritation of the peritoneum.

Q: What is ileus?
A: This is paralysis of the muscular contractions that normally propel material through the intestines. It can lead to abdominal distention.

Q: What is emesis?
A: Vomiting caused by paralysis in the intestines.

Q: How do you gauge the degree of distention in a patient?
A: To do this, simply look at the patient's abdomen.

Q: What else is also associated with peritonitis?
A: It is also associated with a loss of body fluid into the abdominal cavity. This fluid shift decreases the volume of circulating blood and may lead to decreased blood pressure or even shock.

Q: If a patient has peritonitis that has progressed, what will they present with?
A: In this case, they will present with tachycardia and hypotension.

Q: What can parietal peritoneum nerves sense?
A: They can sense pain, touch, pressure, heat, and cold, and can easily localize pain.

Q: What can visceral peritoneum sense?
A: It can not localize sensation, so the patient will describe such pain as a "deep" pain.

Q: What is referred pain?
A: It is the result of connections between somatic and autonomic nervous system, so that pain may be perceived at a distant point of the body.

Q: Where might acute cholecystitis (AKA inflammed gallbladder) cause referred pain?
A: It may cause pain in the right shoulder, because the autonomic nerves serving the gallbladder lie near the spinal cord, at the same anatomic level as the spinal sensory nerves that supply the skin of the shoulder.

Q: Where might appendicitis cause pain?
A: It causes pain in the right lower quadrant (direct), around the navel (referred), and rebounding pain (pain felt on the rebound after palpation)

Q: Where might an ulcer cause pain?
A: It might cause pain at the upper mid-abdoman or upper part of back.

Q: Where might diverticulitis cause pain?
A: It might cause pain in the lower left quadrant.

Q: Where might an abdominal aortic aneurysm, A.K.A., an A.A.A., cause pain?
A: This condition might cause pain in the lower part of the back, or the lower quadrants.

Q: Where might cystitis, A.K.A. inflamed bladder, cause pain?
A: It might cause pain in the lower mid-abdomen, or retropubic area.

Q: Where might a kidney infection cause pain?
A: It might cause pain in the costovertebral angle, which is the acute angle formed on either side of the human back between the twelfth rib and the vertebral column.

Q: Where might kidney stones cause pain?
A: It might cause pain in the right or left flanks, radiating to the genitalia.

Q: Where might pancreatitis cause pain?
A: It might cause pain in the upper abdomen (both quadrants) and the back.

Q: Where might pneumonia cause pain?
A: It might cause pain in the upper abdomen (referred pain).

Q: Where might a hernia cause pain?
A: It might cause pain anywhere in the abdominal area.

Q: Where might peritonitis cause pain?
A: It might cause pain anywhere in the abdominal area.

Q: Why does early abdominal pain tend to be vague and poorly localized?
A: It tends to be vague and poorly localized because visceral peritoneum is usually irritated first.

Q: What is peptic ulcer disease (PUD)?
A: The protective layer is eroded, allowing the acid to eat into the organ itself over the course of weeks, months, or even years.

Q: What causes most peptic ulcers?
A: Most are caused by an infection of the stomach with Heliocobacter pylori. Another major cause is chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), as well as alcohol and smoking.

Q: What do patients experience with peptic ulcers?
A: They experience a classic sequence of burning or gnawing pain in the stomach that subsides or diminishes immediately after eating and then reemerges 2 to 3 hours later.

Q: Where might a peptic ulcer cause pain?
A: It might cause pain in the upper abdomen, but sometimes may be found below the sternum.

Q: What are common symptoms of a peptic ulcer?
A: Nausea, vomiting, belching, and heartburn are common symptoms of it.

Q: What are gallstones?
A: They form and block the outlet from the gallbladder, causing pain and inflammation.

Q: What is cholecystitis?
A: A condition in which the wall of the gallbladder becomes inflammed.

Q: How does cholecystitis present?
A: The condition presents as a constant, severe pain in the right upper or midabdominal region, and may refer to the right upper back, shoulder area, or flank.

Q: What are common symptoms of cholecystitis?
A: Symptoms include general gastrointestinal distress such as nausea and vomiting, indigestion, bloating, gas, and belching.

Q: When does cholecystitis produce symptoms?
A: It commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night.

Q: What causes pancreatitis?
A: It can be caused by an obstructing gallstone, alcohol abuse, and other diseases that cause inflammation of the pancreas.

Q: What is appendicitis?
A: It is inflammation or infection in the appendix.

Q: What are symptoms of appendicitis?
A: Symptoms are initially generalized and dull pain near the umbilical area. The pain later localizes to the right lower quadrant. A classic symptom is rebound tenderness.

Q: What is esophagitis?
A: It occurs when the lining of the esophagus becomes inflammed by infection or from the acids in the stomach (gastrophageal reflux disease).

Q: What causes esophageal varices?
A: They occur when the amount of pressure within the blood vessels surrounding esophagus increases.

Q: What causes Mallory-Weiss syndrome?
A: It occurs when the junction between the esophagus and the stomach tears, causing severe bleeding and eventually death.

Q: What is the principal symptom of Mallory-Weiss syndrome?
A: The principal syndrome is vomiting.

Q: What is acute gastroenteritis?
A: It comprises a family of conditions revolving around a central theme of infection combined with diarrhea, nausea, and vomiting.

Q: What causes diverticulitis?
A: It is caused when a lack of fiber leads to hard stool which requires more intestinal contractions, subsequently increasing pressure within the colon. In this environment, small defects within the colonic wall that would otherwise never pose a problem now fail, resulting in bulges in the wall. These small outcroppings eventually turn into pouches, called diverticula.

Q: What are the symptoms of diverticulitis?
A: Symptoms are abdominal pain in the left side of the lower abdomen, fever, malaise, body aches, chills, nausea, and vomiting, as well as constipation.

Q: What is cystitis?
A: It is bladder infammation.

Q: What is another name for cystitis?
A: Another name for it is urinary tract infection (UTI).

Q: Where do patients with UTI tend to have pain?
A: They have pain in their lower abdominal quadrants.

Q: What is uremia?
A: It is when a patient's kidneys fail, and the patient loses the ability to excrete waste from the body, and the urea remains in the blood instead of going into the urine.

Q: What is another name for kidney stones?
A: Renal Calculi is another name for it.

Q: Can acute renal failure be reversed?
A: It can be reversed with prompt diagnosis and treatment.

Q: What should you always consider with a woman with lower quadrant pain or tenderness?
A: You should always consider that she may have a problem with her ovaries.

Q: What is a cause of abdominal aoritc aneurysm (AAA)?
A: It is caused when in older people, the wall of the aorta develops weak areas that swell.

Q: What is a common complaint of AAA?
A: Back pain is a common complaint with it.

Q: What is a hernia?
A: It is a protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong.

Q: What causes hernia?
A: Causes of it include: A congenital defect, as around the umbilicus; a surgical wound that has failed to heal properly; a natural weakness in an area such as in the groin.

Q: What is a reducible hernia?
A: It is a hernia that can disappear back into the body cavity in which it belongs.

Q: What is an incarcerated hernia?
A: It is a hernia that cannot be pushed back into the body cavity.

Q: What is strangulation?
A: It is when a hernia is incarcerated, and its contents may become seriously compressed by the surrounding tissue, compromising the blood supply.

Q: What is an important question to ask a patient with possible gastrointestinal issues regarding bleeding?
A: Ask them if they have blood in their vomit (hematemesis) or black, tarry stool (melena).

Q: If a patient has drawn up their right knee, what condition might this be?
A: This stance may indicate appendicitis.

Q: If a patient is curled up to one side, what condition may this be?
A: This stance may indicate pancreatitis.

Q: What is guarding?
A: It is a broadlike muscle spasm, and can be seen with major problems, such as a perforated ulcer or pancreatitis.

Q: What is one way to decrease nausea?
A: Providing a patient low-flow oxygen often decreases it.

Q: What happens if a patient misses a dialysis treatment?
A: If this happens, weakness and pulmonary edema can be the first in a series of conditions that can become progressively more serious.

Q: What are some adverse affects of dialysis?
A: They include hypotension, muscle cramps, nausea and vomiting, hemorrhage from the access site, and infection at the access site.

Q: What is the endocrine system?
A: It is a complex message and control system that includes a network of glands that produce and secrete hormones.

Q: What are endocrine glands?
A: They secrete and release chemicals that are used inside the body.

Q: What is a hormone?
A: It is a substance produced by a gland that has special regulatory effects on other organs and tissues.

Q: What is homeostasis?
A: It is the maintaining of stability in the body's internal environment.

Q: What can cause endocrine disorders?
A: Hypersecretion or hyposecretion of a gland can cause it.

Q: How much of the population does diabetes affect?
A: It affects about 7% of the population.

Q: What is glucose?
A: It is one of the basic sugars used in the body and, in conjunction with oxygen, is the primary fuel for cellular metabolism. It is also called dextrose.

Q: What is the full name of diabetes?
A: Its full name is diabetes mellitus, which means "sweet diabetes".

Q: What is type 1 diabetes?
A: When patients do not produce insulin. It typically developments during childhood.

Q: What is type 2 diabetes?
A: When patients produce inadequate amounts of insulin, or what is produced does not function effectively. It is more common than type 1 diabetes, and on the rise due to obesity.

Q: What are some medications that treat diabetes?
A: Chlorpropamide (Diabinese), tolbutamide (Orinase), glyburide (Micronase), glipizide (Glucotrol), metformin (Glucophage), and rosiglitazone (Avandia) are some of these types of muscles.

Q: What kind of problem is type 1 diabetes considered?
A: It is considered an autoimmune problem, because the body becomes allergic to, and, therefore, destroys the insulin-producing cells of the endocrine glands in the pancreas.

Q: What is the normal level of blood glucose levels?
A: The normal amount is 80 to 120 mg/dL

Q: What are the "3 Ps" of uncontrolled diabetes symptoms?
A: They are polyuria (frequent urination), polydipsia (frequent drinking and thirst), and polyphagia (excessive eating).

Q: What happens when the body can't use glucose to supply energy for cells?
A: When this happens, fat is used as an immediate energy source, which produces ketones and fatty acids as waste products and are hard for the body to excrete.

Q: What is acidosis?
A: It is a condition caused by an accumulation of ketones in the blood and tissue.

Q: What is diabetic ketoacidosis (DKA)?
A: It is a type of hyperglycemic crisis. It a form of acidosis seen in uncontrolled diabetes.

Q: What are the signs and symptoms of DKA?
A: They are weakness, nausea, vomiting, abdominal pain, a weak and rapid pulse, and Kussmaul respirations

Q: What are Kussmaul respirations?
A: They are a type of deep, rapid breathing seen during DKA.

Q: What is often a result of type 2 diabetes?
A: A common result is HHNC, hyperosmolar hyperglycemic nonketotic coma.

Q: How do diabetes lead to dehydration?
A: The body tries to get rid of the excess sugar in the urine. The fluid follows the sugar, causing dehydration.

Q: What occurs with prolonged hyperglycemia?
A: It results in diabetic ketoacidosis.

Q: What occurs with prolonged hypoglycemia?
A: It progresses to unresponsiveness and eventually hypoglycemic crisis.

Q: What are common signs of both hyperglycemia or hypoglycemia?
A: Staggering and an intoxicated appearance or unresponsiveness are signs of both.

Q: What is hyperglycemic crisis?
A: It is a state of unconsciousness resulting from several problems, including ketoacidosis, hyperglycemia, and dehydration.

Q: What are some symptoms of hyperglycemic crisis?
A: Some symptoms of Kussmaul respirations, dehydration, sweet or fruity odor on the breath, a rapid thready pulse, normal or slightly low blood pressure, weakness, nausea, and the "3 Ps".

Q: What is a hypoglycemic crisis?
A: It occurs when the patient has taken too much insulin, not eaten enough food, or had an unusual amount of physical activity.

Q: What are the symptoms of hypoglycemia?
A: Symptoms include normal to shallow or rapid respirations, pale clammy skin, sweating, a rapid pulse, normal to low blood pressure, anxious or combative behavior, hunger, weakness on one side of the body, and rapid changes in mental status.

Q: How many grams of glucose does one tube contain?
A: It contains 15 grams of glucose.

Q: What are the contraindications to oral glucose?
A: They are an inability to swallow and unconsciousness, because aspiration can occur.

Q: What is hematology?
A: It is the study and prevention of blood-related diseases.

Q: What percentage of blood volume is red blood cells (erythrocytes)?
A: 47% in males and 42% in females is made up of it.

Q: What is the scientific term for white blood cells?
A: white blood cells are also know as leukocytes

Q: What is sickle cell disease?
A: It is an inherited blood disorder that affect the red blood cells. The cells are poor oxygen carriers, so patients may experience hypoxia.

Q: How often do normal red blood cells live compared to hemoglobin S in sickle cell disease?
A: Normal red blood cells live about 120 days. Hemoglobin S cells live only 16 days.

Q: What is thrombosis?
A: The development of a blood clot.

Q: What is thrombophilia?
A: It is the tendancy to develop blood clots, and affects approximately 5% to 7% of the Caucasian population of European descent in the United States.

Q: What is hemophilia?
A: It is a genetic disorder usually inherited from the mother, in which the blood is not able to control bleeding. It occurs mostly in males, in approximately 1 in every 5 to 10 thousand births.

Q: How many Americans die of allergic reactions every year?
A: At least 1,000 Americans die every year.

Q: What is immunology?
A: It is the study of the body's immune system.

Q: What is the immune system?
A: It is the system that protects the human body from substances and organisms that are foreign to the body.

Q: What is an allergic reaction?
A: It is an exaggerated immune response by the body's immune system, which releases chemicals to combat the stimulus.

Q: What are some chemicals released by the immune system?
A: histamine, leukotrienes

Q: What is anaphylaxis?
A: It is an extreme allergic reaction that is life threatening and involves multiple organ systems.

Q: What is one of the most common signs of anaphylaxis?
A: wheezing

Q: What is urticaria?
A: smalls areas of generalized itching or burning that appear as multiple, small, raised areas on the skin.

Q: What is envenomation?
A: Venom injected into the body by an animal or insect.

Q: What are five general catagories of allergens?
A: insect bites and stings
medications
plants
food
chemicals

Q: How many species of bees, wasps, and hornets are there?
A: There are more than 100,000 species of them.

Q: What is a wheal?
A: It is a raised, swollen, well-defined area of the skin.

Q: What is a special consideration for honeybee stings?
A: Their stingers remain in the wound for up to 20 minutes and continue to inject venom.

Q: What are some actions you should take with insect stings?
A: Position the injection site slightly below the level of the heart, and apply ice or cold packs to the area, but not directly on the skin. Don't use tweezers to remove the barb as squeezing it might release more venom.

Q: What position should you place a patient with an insect sting?
A: Place them in the shock position, and give oxygen if needed.

Q: What percentage of the population are allergic to the venom of the bee, hornet, yellow jacket, and wasp?
A: Approximately 5% are allergic.

Q: How many people die each year from reactions to stings?
A: About 200 people a year die from this.

Q: What are some common symptoms of an anaphylactic reaction to stings?
A: Patients may experience generalized itching and burning, widespread urticaria, wheals, swelling about the lips and tongue, bronchospasm and wheezing, chest tightness and coughing, dyspnea, anxiety, abdominal cramps, and hypotension.

Q: When do most terminal anaphylactic patients die?
A: Two-thirds of them die within the first half hour, so speed is essential.

Q: What is the definitive treatment for anaphylactic shock?
A: administration of epinephrine

Q: What is stridor?
A: It is a harsh, high-pitched inspiratory sound, and occurs when swelling in the upper airway (near the vocal cords and throat) closes off the airway and can eventually lead to total obstruction.

Q: What vital signs should you assess and reassess during reassessment?
A: Pulse, respirations, blood pressure, skin, pupils, and oxygen saturation.

Q: What is a useful method for assessing an allergic patient's perfusion status?
A: Pulse oximetry is a useful method for this.

Q: What kind of chemical is epinephrine?
A: It is a sympathomimetic, which means it mimics the sympathetic (flight-or-fight) response.

Q: How does epinephrine work?
A: It has various properties that cause the blood vessels to constrict, which reverses vasodilation and hypotension. This, in turn, elevates the diastolic pressure and improves coronary blood flow. It also increases cardiac contractility and relieves bronchospasm in the lungs.

Q: How much epinephrine do auto-injectable syringes contain?
A: The adult EpiPen system delivers 0.3 mg of  it via an automatic needle and syringe system; the infant-child system delivers 0.15 mg.
The Twinject auto-injector contains two doses of it and is also available in two strengths, 0.15 mg for those weighing 33 to 66 lbs., and 0.3 mg for those who weigh 66 lbs. or more.

Q: What are antihistamines?
A: These are agents that block the effect of histamines. They work relatively slowly, within several minutes to 1 hour.

Q: What is one thing you should do with all patients with suspected anaphylaxis?
A: They should be given high-flow, high-concentration oxygen.

Q: What are some common signs and symptoms of allergic reactions regarding the respiratory system?
A: They are shortness of breath (dyspnea), sneezing or an itchy runny nose, tightness in the throat or chest, irritating dry cough, hoarseness, respirations that become rapid, labored, or noisey, and wheezing and/or stridor (progressing to a silent chest with anaphylaxis).

Q: What are some common signs and symptoms of allergic reactions regarding the cardiovascular system?
A: They are a decrease in blood pressure as blood vessels dilate (hypotension), an increase in pulse rate (tachycardia), pale skin as the vascular system fails, and loss of consciousness and coma.

Q: What are some common signs and symptoms of allergic reactions regarding the skin?
A: They are flushing, itching, or burning skin, especially common over the face and upper part of the chest, urticaria over large areas of the body (internal or external), swelling (especially of the face, neck, hands, feet, and or tongue), swelling and cyanosis or pallor around the lips, and a warm, tingling feeling in the face, mouth, chest, feet, and hands.

Q: What are some additional common signs and symptoms of allergic reactions?
A: They are anxiety, abdominal cramps, headache, itchy, watery eyes, dizziness, and a decreasing mental status.

Q: How many children and adult suffer acute poisoning each year?
A: Approximately 5 million each year suffer from this.

Q: What are opoids?
A: They are medicines with actions similar to morphine.

Q: What is toxicology?
A: It is the study of toxic or poisonous substances.

Q: What is a poison?
A: It is any substance whose chemical action can damage body structures or impair body function.

Q: What is substance abuse?
A: It is the misuse of any substance to produce a desired effect.

Q: What is overdose?
A: It is when a patient takes a toxic dose of a drug.

Q: What should you do if you have even the slightest suspicion that a patient has taken a poisonous substance?
A: If you suspect this, you should notify medical control and begin emergency treatment at once.

Q: What does the presence of injuries such as burning or blistering around the mouth suggest?
A: It strongly suggests the ingestion of a poison, such as lye.

Q: What are some questions you can ask a patient you think might have ingested poison?
A: In this case, you can ask: "What substances did you take? When did you take it/ were you exposed to it? How much did you ingest? What actions have been taken? How much do you weigh?"

Q: What should you do if a possibly poisoned patient vomits in the ambulance?
A: If this occurs, you should try to collect the vomitus in a separate plastic bag so that it can be analyzed at the hospital.

Q: What is the telephone number for the Poison Help hotline?
A: The number is 1(800) 222.1222.

Q: What should you do if you believe that a patient has been poisoned?
A: If you think this has happened, you should immediately provide the poison center with all relevant information.

Q: In general, what is the most important treatment you can perform for a patient you believed poisoned?
A: In this situation, the most important treatment you can perform in general is to dilute and/or physically remove the poisonous agent.

Q: What are the four avenues through which poison can get into a patient's body?
A: They are: Inhalation, absorption (surface contact), ingestion, and injection

Q: What are some examples of inhaled poisons?
A: Some examples are natural gas, sewer gas, certain pesticides, carbon monoxide, chlorine, and other gases.

Q: What might have to happen if the patient is found inside a toxic environment?
A: In this case, patients may need to be decontaminated by specially trained personnel after they are removed from the environment. The patient's clothing should be removed in this process because it may contain trapped gases that can be released. You cannot administer emergency care until this step has been completed and there is no danger of the poison contaminating you.

Q: What are some signs and symptoms of inhalation of chlorine or other irritant toxics?
A: Symptoms of this include: burning eyes, sore throat, cough, chest pain, hoarseness, wheezing, respiratory distress, dizziness, confusion, headache, or stridor in severe cases. The patient may also have seizures or an altered mental status.

Q: What are some products that are very destructive on contact?
A: Acids, alkalis, and some petroleum (hydrocarbon) products are very destructive.

Q: What should you do when a large amount of material has been spilled in the eyes?
A: In this case, flooding the eyes for at least 20 minutes may be the fastest and most effective treatment.

Q: What should you not do to chemical burns?
A: In this case, do not spend time trying to neutralize substances on the skin with additional chemicals. This action may actually be more harmful.

Q: What should you do if you suspect that toxic or hazardous materials are present?
A: In this case, you should call for specialized resources such as the Hazardous Materials Team.

Q: When should you not irrigate the contact area with water?
A: When a patient has been contaminated with a poison that reacts violently to water, such as phosphorus or elemental sodium. Instead, brush the chemical off the patient, remove contaminated clothing, and apply a dry dressing to the burn area.

Q: What are some signs and symptoms of opiods?
A: Some examples are hypoventilation or respiratory arrest, pinpoint pupils, sedation or coma, and hypotension.

Q: What are some signs and symptoms of sympathomimetics?
A: Some symptoms are hypertension, tachycardia, dilated pupils, agitation or seizures, and hyperthermia.

Q: What are some signs and symptoms of sedative-hypnotics?
A: Some examples are slurred speech, sedation or coma, hypoventilation, hypotension.

Q: What are some signs and symptoms of anticholinergics?
A: Some examples are tachycardia, hyperthermia, hypertension, dilated pupils, dry skin and mucous membranes, sedation, agitation, seizures, coma, or delirium, and decreased bowel sounds.

Q: What are some signs and symptoms of cholinergics?
A: Some examples are excess defecation or urination, muscle fasciculations, pinpoint pupils, excess lacrimation or salivation, airway compromise, nausea or vomiting.

Q: How many people dies from alcohol every year?
A: 200,000 people die from this each year.

Q: What is the most common long-term effect of alcohol consumption?
A: It is liver damage, with estimates that up to 90% of heavy drinkers will develop some level of hepatitis and 10% to 20% will develop cirrhosis. Atrophy of the cerebrum is another long-term effect.

Q: What is alcohol?
A: It is a powerful Central Nervous System (CNS) depressant, a sedative, and a hypnotic (it induces sleep).

Q: What happens to a patient experiencing alcohol withdrawal?
A: They may experience hallucinations or delirium tremens (DTs), which may develop 1 to 7 days after a person stops drinking.

Q: What are some symptoms of alcohol withdrawal besides DTs?
A: They are agitation and restlessness, fever, sweating, tremors, confusion and/or disorientation, delusions, and seizures.

Q: What is a trade name of hydrocodone?
A: Vicondin

Q: What is a trade name of hydromorphone?
A: Dilaudid

Q: What is a trade name of meperidine?
A: Demerol

Q: What is a trade name of methadone?
A: Dolophine

Q: What is a trade name of oxycodone?
A: Percocet

Q: What is a trade name of oxycodone hydrochloride?
A: OxyContin

Q: What are signs and symptoms of opiod patients?
A: They are sedated or unconscious, cyanotic, and (most telling) pinpoint pupils.

Q: What treatment should EMTs provide to opioid paitent?
A: Treatment includes supporting the airway and breathing. You may try to arouse patients by talking loudly to them or shaking them gently. Always open the airway, give supplemental oxygen, and be prepared for vomiting.

Q: What position should you put opioid patients in?
A: In this situation, place them in the supine position; this will help compensate for likely hypotension.

Q: What should you NOT attempt to do with opioid patients?
A: In this situation, do NOT use home remedies, such as forcing milk or applying ice to the groin.

Q: How quickly with naloxone (Narcan) work?
A: It will work within two minutes.

Q: What is the only effective antidote to reverse the symptoms of opioid overdose?
A: The only one are certain narcotic antagonists such as naloxone (Narcan).

Q: What is an example "date-rape", "knock out", or "Mickey Finn" drugs?
A: One example is flunitrazepam (Rohypnol).

Q: What is a trade name for phenobarbital?
A: Luminal

Q: What is a trade name alprazolam?
A: Xanax

Q: What is the trade name of diazepam?
A: Valium

Q: What is a trade name of flunitrazepam?
A: Rohypnol

Q: What is a trade name of lorazepam?
A: Ativan

Q: What is a trade name of carisoprodol
A: Soma

Q: What is a trade name of chloral hydrate?
A: "Mickey Finn"

Q: What is ethyl alcohol?
A: This is drinking alcohol.

Q: What is isopropyl alcohol?
A: This is rubbing alcohol.

Q: What is an important precaution when dealing with patients who inhaled halogenated hydrocarbon solvents?
A: Patients who have used these have hearts that are hypersensative to the patient's own adrenaline, putting the patient at high risk for sudden cardiac death because of ventricular fibrillation; even the action of walking may release enough adrenaline to cause a fatal ventricular arrhythmia.

Q: What is a stimulant?
A: It is an agent that produces an excited state.

Q: What are cholinergic agents?
A: These agents overstimulate normal body functions that are controlled by the parasympathetic nerves, resulting in salivation, mucous secretion, urination, crying, and an abnormal heart rate.

Q: What does DUMBELS stand for?
A: Defecation
Urination
Miosis (constriction of the pupils)
Bronchorrhea (discharge of mucus from the lungs)
Emesis
Lacrimation
Salivation

Q: What is the most important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent.
A: The most important consideration is to avoid exposure yourself.

Q: What are the most common antidotes to nerve agents?
A: They are the Mark I kit and the DuoDote kit. The kits consist of an auto-injector of atropine and one of 2-PAM chloride (pralidoxime chloride).

Q: What is a trade name for phenothiazines?
A: Thorazine

Q: What is a trade name for tetrahydrozoline?
A: Visine

Q: What are the two types of food poisoning?
A: One type, the organism causes disease; in the other type, the organism produces toxins that cause disease

Q: What is Salmonella?
A: It is an organism that produces directs effects of food poisoning. It is characterized by severe gastrointestinal symptoms within 72 hours of ingestion, including nausea, vomiting, abdominal pain, and diarrhea.

Q: What is Staphylococcus?
A: It is a bacteria that is quick to grow and produce toxins in foods that have been prepared in advance and kept too long, even in the refrigerator. It results in sudden gastrointestinal symptoms, including nausea, vomiting, and diarrhea. Symptoms usually start within 2 to 3 hours after ingestion, up to 8 to 12 hours.

Q: What is one of the most severe forms of food poisoning?
A: It is botulism, which results from eating improperly canned food, in which spores of Clostridium bacteria have grown and produced a toxin.

Q: What are the symptoms of botulism?
A: They are neurologic: blurring of vision, weakness, and difficulty in speaking and breathing. It can also cause muscle paralysis and is typically fatal once it reaches respiratory muscles.

Q: When do symptoms of botulism first develop?
A: They develop as long as 4 days after ingestion, or as early as the first 24 hours.

Q: How many caes of poisoning from plants occur each year?
A: Several thousand cases of this occur each year.

Q: What is the scientific name for hemlock?
A: Conium maculatum

Q: What is the scientific name for lily of the valley?
A: convallaria majalis

Q: What is the scientific name for oleander?
A: Nerium oleander

Q: What is the scientific name for mistletoe?
A: Phoradendron

Q: What is another name for azalea?
A: Rhododendron

Q: What is the scientific name for nightshade?
A: Solarium nigrum

Q: What is the emergency treatment of diffenbachia?
A: This includes maintaining an open airway, giving oxygen, and transporting the patient promptly to the hospital for respiratory support.

Q: What is dieffenbachia?
A: This is also called "dumbcane". It causes irritation of skin and mucous membranes. When chewed, a single leaf ("elephant ears") may irritate the lining of the upper airway.

Q: What is the third leading cause of death in the States?
A: It is stroke, after heart disease and cancer.

Q: What are the statistics regarding gender and strokes?
A: Men have more, but they are more likely to be fatal in women.

Q: What ethnicities have a higher risk for stroke?
A: African Americans, Hispanics, and Asians have a higher risk for this.

Q: What are some of the causes of seizures?
A: They may occur as a result of a recent or an old head injury, a brain tumor, a metabolic problem, or simply a genetic disposition.

Q: What does A.M.S. stand for?
A: Altered Mental Status

Q: What are some possible causes of AMS?
A: Some possible causes are intoxication, head injury, hypoxia, stroke, metabolic disturbances, among others.

Q: What does TIA stand for?
A: Transient Ischemic Attack

Q: What are the 3 major parts of the brain?
A: The cerebrum, the cerebellum, and the brain stem.

Q: What does the brain stem control?
A: It controls the most basic functions of the body, such as breathing, blood pressure, swallowing, and pupil constriction.

Q: What does the cerebellum control?
A: It controls muscle and body coordination.

Q: How many cerebrum hemispheres are there, and what do they do?
A: There are two, and they each control the opposite side of the body.

Q: What does the front part of the cerebrum control?
A: It controls emotion and thought.

Q: What does the middle part of the cerebrum control?
A: It controls touch and movement.

Q: What does the back part of the cerebrum control?
A: It controls sight.

Q: How many cranial nerves are there?
A: There are twelve, running to the eyes, ears, nose, and face.

Q: Where and what are spinal nerves?
A: They are located at each vertebra, and branch out from the spinal cord and carry signals to and from the body.

Q: What is a possible sign that the primary problem of a patient is in the brain?
A: If the patient has signs and symptoms affecting only one side of the body, it may be because of this.

Q: How do the brain and skull feel pain?
A: They do not actually sense pain because neither contains pain receptors.

Q: What are meninges?
A: They are membranes that cover the brain and spinal cord.

Q: What are some possible life-threatening causes of headaches?
A: They can be caused by a stroke, tumor, infection of the central nervous system, or hypertension.

Q: What might a situation with more than one patient reporting a headache tell you?
A: It might signify carbon monoxide.

Q: What is the most common type of headache?
A: Tension headaches are the most common types.

Q: What causes tension headaches?
A: They are caused by muscle contractions in the head and neck are attributed to stress.

Q: What is the second most common type of headache?
A: Migraine headaches are the second most common.

Q: What causes migraines?
A: They are caused by changes in the blood vessel size in the base of the brain.

Q: What causes sinus headaches?
A: They are caused by pressure that is the result of fluid accumulation in the sinus cavities.

Q: What is a possible sign of a hemorrhagic stroke?
A: A sudden, severe headache, often described as the worst pain the patient has ever had.

Q: What causes the pain in a hemorrhagic stroke?
A: The blood from a ruptured blood vessel irritates the tissues of the brain and can cause increased intracranial pressure, resulting in this.

Q: What are some signs of increased intracranial pressure?
A: They are headache, vomiting, AMS, and seizures.

Q: What is bacterial meningitis?
A: It is an inflammation of the meninges caused by a bacterial infection, and is a central nervous system infection in which the patient may complain of a headache, stiff neck, fever, and sensitivity to light.

Q: What is another name for a stroke?
A: Another name for it is a cerebrovascular accident (CVA).

Q: What is a CVA?
A: It is an interruption of blood flow to the brain that results in the loss of brain function.

Q: What is ischemia?
A: It is a lack of oxygen that causes the cells not to function properly.

Q: What are the two types of strokes?
A: The two types are ischemic and hemorrhagic.

Q: What causes an ischemic stroke?
A: It is caused by a direct blockage of blood flow through the cerebral arteries.

Q: What causes a hemorrhagic stroke?
A: It is caused by a blood vessel rupturing, which causes increased pressure in the brain and subsequent brain damage.

Q: What is thrombosis?
A: It is when a clot forms at the site of blockage.

Q: What is embolus?
A: It is when a clot forms in a remote area, and then travels to the site of blockage.

Q: What percentage of strokes are ischemic?
A: More than 80% of all strokes are caused by this.

Q: What is atherosclerosis?
A: It is a disorder in which calcium and cholesterol build up, forming a plaque inside the walls of the blood vessels.

Q: Who is most at risk for hemorrhagic stroke?
A: People who have very high blood pressure or long-term elevated blood pressure. After many years of high pressure, the blood vessels in the brain weaken. If a vessel ruptures, the bleeding in the brain will increase the pressure inside the cranium.

Q: What is an aneurysm?
A: It is a swelling or enlargement of part of an artery resulting from weakening of the arterial wall.

Q: What is the likely cause of a hemorrhagic stroke in an otherwise healthy person?
A: The likely cause is often a weakness in a blood vessel called a berry aneurysm.

Q: What is a berry aneurysm?
A: This type of aneurysm resembles a tiny balloon (or berry) that juts out from the artery. When the aneurysm is overstreched and ruptures, blood spurts into an area between two of the coverings of the brain called the subarachnoid space. These types of strokes are called subarachnoid space.

Q: What is a transient ischemic attack (TIA)?
A: This is when stroke symptoms go away on their own in less than 24 hours. Some patients call these ministrokes.

Q: How many patients who have experienced a TIA will experience a stroke soon after?
A: Approximately 1/3 will experience one.

Q: What are the general signs and symptoms of stroke?
A: They include: Facial drooping, sudden weakness or numbness in the face, arm, leg, or one side of the body, loss of movement and sensation on one side of the body, ataxia, sudden loss of vision in one eye, difficulty swallowing, decreased or increased level of responsiveness, dysphasia, expressive aphasia, dysarthria, receptive aphasia, decreased or absent movement in one or more extremities, sudden or severe headache, sudden loss of balance or trouble walking, confusion, dizziness, weakness, combativeness, restlessness, tongue deviation, coma.

Q: What is aphasia?
A: It is an inability to produce or understand speech. It may be caused by a stroke in the left cerebral hemisphere.

Q: What are some signs that a patient's right cerebral hemisphere is not getting enough oxygen?
A: In this situation, patients will understand langauge and be able to speak, but their words may be slurred and hard to understand. If you ask the patient to life their left arm and they cannot, they will lift their right arm instead; they seem to have forgotten that the left arm even exists (neglect).

Q: What might high blood pressure be a result of regarding a cerebral hemorrhage?
A: High blood pressure can cause the bleeding, but many times the high blood pressure is a compensatory response to the bleeding itself.

Q: What happens when bleeding occurs inside the brain?
A: When this happens, the pressure inside the skull increases.

Q: What are three conditions may appear to be a stroke?
A: The three conditions are hypoglycemia, a postictal state, and subdural or epidural bleeding that presses on the brain.

Q: Why would a hypoglycemic patient present as someone having a stroke?
A: This is because oxygen and glucose are both needed for the brain's metabolism.

Q: What is a lucid interval?
A: It is the period between injury and deterioration (minutes to hours) during an epidural hemorrhage.

Q: How many EMS 911 calls involve a patient with a stroke?
A: As many as 30% of them involve this.

Q: How many people are estimated to have epilepsy?
A: c. 4 million people in the US have it.

Q: What is the leading cause of death in the United States among people under 40?
A: Traumatic Injuries are the leading cause of death for this group.

Q: What causes trauma emergencies?
A: They occur as a result of physical forces applied to the body.

Q: What are the three concepts of energy typically associated with injury (excluding thermal)?
A: They are potential energy, kinetic energy, and work.

Q: What is Newton's first law?
A: Newton's first law states that objects at rest tend to stay at rest and objects in motion tend to stay in motion, unless acted on by some force.

Q: What is Newton's second law?
A: It is that Force (F) equals Mass (M) times acceleration (A), that is: F=M(A)

Q: What is Newton's third law?
A: It is that for every action, there is an equal and opposite reaction.

Q: What is work?
A: It defined as force acting over a distance.

Q: What is kinetic energy?
A: It is the energy of a moving object.

Q: What is the equation for kinetic energy?
A: The equation is:
KE=m/2 x v^2

Q: What is relation between energy and speed regarding energy available to cause injury?
A: Notice that the energy available to cause injury doubles when an object's weight doubles, but quadruples when an object's speed doubles.

Q: What is potential energy?
A: It is the product of mass, force of gravity, and height, and is mostly associated with the energy of falling objects.

Q: What are some examples of significant MOIs?
A: They include multi-system trauma, falls from heights, motor vehicle and motorcycle crashes, car versus pedestrian, gunshot wounds, and stabbings.

Q: What are the two types of traumas?
A: They are blunt trauma and penetrating trauma.

Q: What is blunt trauma?
A: It is the result of force (or energy transmission) to the body that causes injury without penetrating the soft tissues or internal organs and cavities.

Q: What is penetrating trauma?
A: It is caused by objects that primarily pierce and penetrate the surface of the body and cause damage to soft tissues, internal organs, and body cavities.

Q: What are the five classifications of car crashes?
A: They are classified as frontal (head-on), rear-end, lateral (T-bone), rollovers, and rotational (spins).

Q: What are the three collisions in a typical vehicular impact?
A: They are: The collision of the car against another car, a tree, or another object; The collision of the passenger against the interior of the car; and the collision of the passenger's internal organs against the solid structures of the body.

Q: What are some common passenger injuries in a vehicular crash?
A: They include lower extremity fractures (knees into the dashboard), flail chest (rib cage into the steering wheel), and head trauma (head into the windshield).

Q: What is coup-contrecoup brain injury?
A: It is a result of trauma to the head that causes a compression injury (or bruising) to the anteior portion of the brain and streching (or tearing) of the posterior portion of the brain.

Q: What should you suspect if you see a contusion on the patient's forehead and the windshield is starred?
A: In this situation you should strongly suspect an injury to the brain.

Q: What should you always suspect whenever there is a significant impact to the head?
A: In this situation, you should also suspect a spinal injury.

Q: If one or more of the passengers in a vehicular crash are dead, what action must be taken?
A: In this situation, you should suspect that the other passengers have sustained serious injuries.

Q: What should you initially determine when investigating a frontal crash?
A: In this event, you should determine whether the passenger was restrained by a full and properly applied three-point restraint, as well as whether the airbag deployed. Identifying the types of restraints used and whether the airbags were deployed will help you identify injury patterns related to the supplemental restraint systems.

Q: Where should children shorter than 4'9" sit in a car?
A: This kind of person should ride in the rear seat or, in the case of a pickup truck or other single-seated vehicle, the air bag should be turned off.

Q: Where are seatbelts designed to be worn?
A: They are designed to be worn over the iliac crest of the pelvis in order to distribute the force over the bony surface.

Q: What type of injuries are associated with rear-end impacts?
A: This type of impact is known to cause whiplash-type injuries, particularly when the passenger's head and/or neck is not restrained by an appropriately placed headset.

Q: What is one type of injury to be aware of in a lateral (T-bone) collision?
A: In this type of collision, the car is typically struck above its center of gravity and begins to rock away from the side of the impact. This results in the passenger sustaining a lateral whiplash injury. The cervical spine has little tolerance for lateral bending.

Q: What is the most common life-threatening event in a rollover?
A: In this event, the most common life-threatening event is ejection or partial ejection of the passenger from the vehicle.

Q: What should the first step be when evaluating the MOI in a car-versus-pedestrian collision?
A: In this event, your first step should be to estimate the speed of the vehicle that struck the patient; next determine whether the patient was thrown through the air and at what distance or whether the patient was pulled under the vehicle.

Q: What should you presume in a bicycle collision?
A: In this event, you should presume that the patient has sustained an injury to the spinal column, until proven otherwise at the hospital.

Q: What are the four types of motorcycle impacts?
A: The four types are head-on collision, angular, ejection, and controlled crash.

Q: At what height should a fall be considered significant?
A: More than 15' or 3 times the patient's height is considered significant.

Q: What is something to consider in older patients who have suffered a fall?
A: In this situation, remember that the patient may have osteoporosis, and may have actually sustained a fracture before the fall.

Q: What does the CNS (Central Nervous System) include?
A: It includes the brain and the spinal cord, including the nuclei and cell bodies of most nerve cells, and long nerve fibers that link these cells to the body's various organs through openings in the spinal column.

Q: What is the cerebrum?
A: It contains about 75% of the brain's total volume, and controls a wide variety of activities, including most voluntary motor functions and conscious thought.

Q: What is the brain stem?
A: It controls virtually all the functions that are necessary for life, including the cardiac and respiratory systems and nerve function transmissions. It is deep inside the cranium and is the best-protected part of the CNS.

Q: What is grey matter composed of?
A: This is composed of neural cell bodies and synapses, which are connections between nerve cells.

Q: What does white matter consist of?
A: This consists of fiber pathways.

Q: What is the skull covered by?
A: It is covered by layers of muscle, superficial fascia, and thick skin.

Q: What protects the CNS?
A: It is protected by the meninges, three distinct laters of tissue that suspend the brain and the spinal cord within the skull and the spinal canal..

Q: What is the outer layer of the meninges?
A: It is the dura mater, a tough fibrous layer that closely resembles leather.

Q: What are the two inner layers of the meninges?
A: They are the arachnoid and the pia mater. They contain the blood vessels that nourish the brain and spinal cord.

Q: Where is CSF (Cerebral Spinal Fluid) produced?
A: This is produced inside a chamber in the brain, called the third ventricle.

Q: Where is cerebral spinal fluid, A.K.A. CSF, located?
A: This is located in the subarachnoid space below the arachnoid.

Q: How much CSF is in the brain at any one time?
A: There is approximately 125 to 150 ml of this in the brain at any one time.

Q: What is the primary purpose of CSF?
A: The primary purpose of this is to act as a shock absorber for the brain.

Q: How many anatomic parts does the peripheral nervous system have?
A: It has two parts: 31 pairs of spinal nerves and 12 pairs of cranial nerves.

Q: How many pairs of spinal nerves are there?
A: There are 31 pairs of these.

Q: What do the spinal nerves do?
A: They conduct sensory impulses from the skin and other organs to the spinal cord.

Q: What does the brachial plexus control?
A: This controls the arms.

Q: What does the lumbosacral plexus control?
A: This controls the legs.

Q: How many pairs of cranial nerves are there?
A: There 12 pairs of these.

Q: What are cranial nerves?
A: These emerge from the brain stem and transmit information directly to or from the brain. For the most part, they perform special functions in the head and face, including sight, smell, taste, hearing, and facial expressions.

Q: What are the two major types of peripheral nerves?
A: They are the sensory nerves and motor nerves.

Q: What do the sensory nerves do?
A: These carry information from the body to the brain via the spinal cord.

Q: What do the motor nerves do?
A: These carry information from the CNS to the muscles.

Q: What are connecting nerves?
A: These, found only in the brain and spinal cord, connect the sensory and motor nerves with short fibers, which allow the cells on either end to exchange simple messages.

Q: What are voluntary activities?
A: These are actions which are consciously perform, in which sensory input determines the specific muscular activity.

Q: What are involuntary activities?
A: These are actions that are not under a person's conscious control, such as breathing.

Q: What part of our nervous system controls our voluntary activities?
A: This is called the somatic or voluntary nervous system.

Q: What part of our nervous system controls many of our body's vital organs, over which the brain has no voluntary control?
A: This is called the autonomic nervous system.

Q: What are the names of the two parts of the autonomic nervous system?
A: They are called the sympathetic and the parasympathetic.

Q: What is the name of the groups of bones that compose the skull?
A: They are called the cranium, which protects the brain, and the facial bones.

Q: What is the cranium occupied by?
A: It is occupied by 80% brain tissue, 10% blood supply, and 10% CSF.

Q: What are the four major bones that make up the cranium?
A: These are the occiput in the posterior, temple or temporal regions at the lateral portions, the parietal regions between the occiput and temporal regions, and forehead anteriorly.

Q: What is the body's central supporting structure?
A: It is the spinal column.

Q: How many bones or vertebrae does the spinal column have?
A: It has 33 bones or vertebrae.

Q: What are the five sections of the spinal column, and how many vertebrae in each?
A: They are the cervical (7), thoracic (12), lumbar (5), sacral (5), and coccygeal (4).

Q: What connects and separates the vertebrae?
A: They are connected by ligaments and separated by cushions known as intervertebral disks.

Q: How many people in the US experience head injuries each year?
A: Approximately 4 million people experience this.

Q: How many death occur annually as a result of head injury?
A: 52,000 of these occur annually.

Q: What percentage of traumatic deaths are a result of head injuries?
A: 50% of all traumatic deaths result from this.

Q: What are closed head injuries?
A: These are injuries in which the brain has been injured but there is no opening into the brain.

Q: What is an open head injury?
A: This is an injury in which an opening from the brain to the outside world exists.

Q: What percentage of people involved in motor vehicle crashes experience a head injury?
A: More than 2/3s of people in motor vehicle crashes experience this.

Q: What are the general signs and symptoms of a head injury?
A: The general signs and symptoms of this are:
Lacerations, contusions, or hematomas to the scalp;
Soft area or depression on palpation;
Visible fractures or deformities of the skull;
Decreased mentation;
Irregular breathing pattern;
Widening pulse pressure;
Slow heart rate;
Ecchymosis about the eyes or behind the ear over the mastoid process;
Clear or pink CSF leakage from a scalp wound, the nose, or the ear;
Failure of the pupils to respond to light;
Unequal pupil size;
Loss of sensation and/or motor function;
A period of unconsciousness;
Amnesia;
Seizures;
Numbness or tingling in the extremities;
Irregular respirations;
Dizziness;
Visual complaints;
Combative or other abnormal behavior;
Nausea or vomiting;
Posturing (decorticate or decerebrate)

Q: Where is a skull fracture diagnosis usually made?
A: This is usually made in a hospital with a computed tomographic, or CT, scan.

Q: What are some signs of a skull fracture?
A: Some signs of this are ecchymosis (bruising) that develops under the eyes (aka raccoon eyes) or behind one ear over the mastoid process (aka battle's sign).

Q: What % of skull fractures are linear skull fractures (aka nondisplaced skull fractures)?
A: Appromixately 80% of all skull fractures are these kind.

Q: What causes compressed skull fractures?
A: These result from high-energy direct trauma to the head with a blunt object (such as a baseball bat to the head).

Q: What are basilar skull fractures?
A: These are associated with high-energy trauma, and usually occur following diffuse impact to the headj (e.g. falls, motor crashes). These injuries generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose with radiography (X-ray).

Q: What are the signs of a basilar skull fracture?
A: Signs of this include CSF drainage from the ears (a risk for bacterial meningitis), which indicates rupture of the tympanic membrane in the ear. Other signs include raccoon eyes or battle's sign.

Q: What is a traumatic brain injury (TBI)?
A: These are defined as "a traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes" (from the National Head Injury Foundation).

Q: What are the two broad catagories of TBI?
A: These are primary (direct) injuries and secondary (indirect) injuries.

Q: What are primary (direct) injuries?
A: These are injury to the brain and its associated structures that results instantaneously from impact to the head.

Q: What are secondary (indirect) brain injuries?
A: These refer to a multitude of processes that increase the severity of a primary brain injury and therefore, negatively impact the outcome.

Q: What are the two most common causes of secondary injuries to the brain?
A: The two most common causes of this are hypoxia and hypotension.

Q: What are some causes of secondary injuries to the brain?
A: These may be caused by cerebral edema, intracranial hemorrhage, increased intracranial pressure, cerebral ischemia, infection, and hypoxia and hypotension (the two most common causes).

Q: How long after a TBI can secondary brain injuries occur?
A: They can occur anywhere from a few minuters to several days following the injury.

Q: What is coup-contrecoup injury?
A: This is when the brain strikes the front and back of the skull due to rapid deceleration.

Q: What is cerebral edema?
A: This is swelling of the brain, and may not develop until several hours after the initial injury.

Q: What aggravates and improves cerebral edema?
A: This is aggravated by low oxygen levels in the blood, and improved by high ones. This is especially true if the patient is unconscious.

Q: Why is it not uncommon for a patient with a head injury to have a seizure?
A: This is not uncommon for a patient with a head injury as a result of excessive excitability of the brain, caused by direct injury or the accumulation of fluid within the brain (edema).

Q: What can lead to a rapid increase in intracranial pressure?
A: This can be caused by an accumulation of blood within the skull or swelling of the brain.

Q: What are the signs and symptoms of a mild elevation of intracranial pressure?
A: The signs and symptoms of this are:
Increased blood pressure and decreased pulse rate;
Pupils that are still reactive;
Cheyne-Strokes respirations (respirations that are fast and then become slow, with intervening periods of apnea);
Patient initially attempts to localize and remove painful stimuli, followed by withdrawal and extension;
[EFFECTS ARE REVERSIBLE WITH PROMPT TREATMENT]

Q: What are the signs and symptoms of moderate elevation in intracranial pressure?
A: The signs and symptoms of this are:
Widened pulse pressure and bradycardia;
Pupils that are sluggish or nonreactive;
Central neurogenic hyperventilation (deep, rapid respirations);
Decerebrate posturing;
[SURVIVAL IS POSSIBLE BUT NOT WITHOUT PERMANENT NEUROLOGIC DEFICIT]

Q: What are the signs and symptoms of marked elevation in intracranial pressure?
A: The signs and symptoms of this are:
Unilateral fixed and dilated pupils;
Ataxic respirations (characterized by irregular rate, pattern, and volume of breathing with intermittent periods of apnea), or absent respirations;
Flaccid response to painful stimuli;
Irregular pulse rate;
Diminished blood pressure;
NB: This level of ICP indicates that the lower portion of the brain stem is involved
[MOST PATIENTS DO NOT SURVIVE THIS LEVEL OF INTRACRANIAL PRESSURE]

Q: What is an epidural hematoma?
A: This is an accumulation of blood between the skull and dura mater.

Q: What is a common cause of epidural hematoma?
A: These are nearly always the result of a blow to the head that produces a linear fracture of the thin temporal bone, where the middle meningeal artery runs along and is vulnerable in the event of a fracture.

Q: What is the patients condition immediately following an injury that causes an epidural hematoma?
A: In this situation, the patient often loses consciousness immediately following the injury; this is often followed by a brief period of consciousness (aka lucid interval), after which the patient lapses back into unconsciousness.

Q: What is a subdural hematoma?
A: This is an accumulation of blood beneath the dura mater but outside the brain. They are more common than epidural hematomas and may or may not be associated with a skull fracture.

Q: Why do subdural hematomas and the signs of ICP develop more gradually than epidural hematomas?
A: These develop more gradually than epidural hematomas because these are associated with venous bleeding.

Q: What is an intracerebral hematoma?
A: This involves bleeding within the brain tissue itself. They have a high mortality rate.

Q: What is a subarachnoid hemorrhage?
A: This is when bleeding occurs into the subarachnoid space, where the CSF circulates.

Q: What are common causes of subarachnoid hematoma?
A: The common causes of this condition include trauma or rupture of an aneurysm.

Q: What is a common symptom of a subarachnoid hematoma?
A: A common symptom of this is a sudden, severe headache. Mortality rates are high, and permanent neurologic impairment is common.

Q: What is a concussion?
A: This is a mild TBI caused by a blow to the head or face. It is in general a closed injury with a temporary loss of alteration of part or all of the brain's abilities to function without demonstrable physical damage to the brain.

Q: What percentage of patients who sustain a concussion experience a loss of consciousness?
A: Apprixmiately 10% of these patients experience a loss of consciousness.

Q: What is retrograde amneisa?
A: This is when the patient can remember everything but the events leading up to the injury.

Q: What is anterograde (posttraumatic) amnesia?
A: This is when a patient is unable to remember events after the injury.

Q: What are some additional signs and symptoms you may see in concussion patients?
A: With these patients, you may see nausea or vomiting, ringing in the ears, slurred speech, and an inability to focus.

Q: What should you always assume with patients with symptoms of a concussion?
A: You should always assume that these patients have a more serious injury.

Q: What is a brain contusion?
A: A contusion involves physical injury to the brain tissue, and is therefore more serious than a concussion.

Q: What often causes spinal compression injuries?
A: These can occur as a result of a fall, regardless of whether the patient landed on his or her feet, coccyx, or on top of the head.

Q: What is a distraction?
A: This is when the spine is pulled along its length.

Q: What is subluxation?
A: This is an incomplete dislocation of a joint.

Q: What is the best way to protect a patient with a spinal injury's airway?
A: The best way to do this is to use advanced airway techniques employed by AEMT and paramedics.

Q: What does the absence of pain and/or the ability to move and feel extremities tell you about spinal injuries?
A: This does NOT rule out spinal injuries.

Q: What does a gradual and progressive deterioration in the patient's response to stimuli indicate?
A: This usually indicates serious brain injury that may need surgical treatment; physicians at the hospital will need to know when a loss of consciousness occurs.

Q: What is another name for Cushing's triad?
A: Another name for this is herniation syndrome.

Q: What are the signs of Cushing's triad?
A: The signs of this are: hypertension, bradycardia, irregular respirations (for example Cheyne-Stokes respirations), central neurogenic hyperventilation, and Biot respirations (irregular rate, pattern, and depth of breathing).

Q: What is Cushing's triad / herniation syndrome?
A: This is when the intracranial pressure is so great that it forces the brain stem and the midbrain through the foramen magnum.

Q: What is the prime concern for the patient when you perform the four-person log roll?
A: The prime concern in this situation is to ensure that the head, torso, and pelvis move as a unit, with your teammates controlling the movement of the body.

Q: What should you do with a patient wandering around after an accident whom you suspect of having a skull or spinal injuries?
A: In this situation, you should NOT have them lie down; immobilize them with a long backboard in the upright position.

Q: When should a helmet be left on an injured trauma patient?
A: This should always be left on provided: There are no impending airway or breathing problems; it does not interfere with assessment and treatment of airway or ventilation problems; and you can properly immobilize the spine.

Q: When should a helmet be removed?
A: This should be removed from a trauma patient if:
1) It makes assessing or managing airway problems difficult and removing of the face guard is not possible.
2) It prevents you from properly immobilizing the spine.
Or 3) It allows excessive head movement.
Remember to always remove in the event of cardiac arrest, and, most importantly:
ALWAYS CONSULT WITH MEDICAL CONTROL IF YOU DECIDE TO REMOVE THIS.

Q: What is an additional consideration for children with helmets and skull or spinal injuries?
A: In this situation, they may require additional padding to maintain the in-line neutral position due to their smaller airways and larger heads.

Q: How many emergency department visits are due to chest traumas in the US annually?
A: More than 700,000 of these are due to them each year.

Q: How many deaths are cuased by chest trauma in the US annually?
A: More than 18,000 deaths are caused by this annually.

Q: What are the intercostal muscles?
A: These muscles extend between the ribs, and are innervated from the spinal nerves originating in the cervical region C6 and C7, and allow the chest to expand on contraction and allow for the active portion of ventilation to occur.

Q: What is belly breathing?
A: This occurs when a patient is breathing entirely with their diaphragm, and is considered a clinical or positive diagnostic finding that indicates cord damage at or above the C6 or C7 level.

Q: What is a closed chest injury?
A: This is an injury in which the skin is not broken, and is generally caused by blunt trauma. These types of injuries often cause significant contusions in both the cardiac muscle and lung tissues (pulmonary contusions), impairing the function of these organs.

Q: What is an open chest injury?
A: This is when some object penetrates the chest wall itself.

Q: What kills almost 1/3 of all people who die immediately in car crashes.
A: 1/3 of these patients die as a result of traumatic rupture of the aorta.

Q: What are the signs and symptoms of chest injury?
A: Signs and symptoms of these are:
Pain at the site of injury;
Pain localized at the site of injury that is aggravated by or increasing with breathing;
Bruising to the chest wall;
Crepitus with palpation of the chest;
Any penetrating injury to the chest;
Dyspnea;
Hemoptysis (coughing up blood);
Failure of one or both sides of the chest to expand normally with inspiration;
Rapid, weak pulse and low blood pressure;
Cyanosis around the lips or fingernails

Q: What kind of breathing do chest trauma patients often have?
A: Patients with this injury often have tachypnea and shallow respirations, as it hurts to take a breath.

Q: What is pleuritic pain or pleurisy?
A: This is irritation of or damage to the pleural surfaces, which causes a characteristic sharp or sticking pain with each breath when these normally smooth surfaces slide on one another.

Q: In a patient with chest trauma, what does dyspnea indicate?
A: This indicates many things, including airway obstruction, damage to the chest wall, improper chest expansion because of the loss of normal control of breathing, or lung compression because of accumulated blood or air in the chest cavity.

Q: What does hemoptysis in a chest trauma patient indicate?
A: This indicates that the lung itself or the air passages have been damaged.

Q: What is paradoxical motion?
A: This is an abnormality associated with multiple fractured ribs, in which one segment (often referred to as a flail segment) of the chest wall moves opposite the remainder of the chest; that is, out with expiration and in with inspiration.

Q: What is occlusive dressing?
A: This is a dressing made of Vaseline-impregnated gauze, aluminum foil, or plastic that protects a wound from air and bacteria.

Q: What should you remember when treating a chest trauma patient with positive-pressure ventilation?
A: In this situation, it is important to remember that you are overcoming normal physiologic functions, and if your patient has pneumothorax, you can easily exacerbate the injury.

Q: What are the Deadly Dozen Chest Injuries that must be detected and managed during primary assessment?
A: These are:
1. Airway obstruction
2. Bronchial disruption
3. Diaphragmatic tear
4. Esophageal injury
5. Open pneumothorax
6. Tension pneumothorax
7. Massive hemothorax
8. Flail chest
9. Cardiac tamponade
[SECONDARY ASSESSMENT]
10. Thoracic aortic dissection
11. Myocardial contusion
12. Pulmonary contusion

Q: What should you always be alert for in elderly trauma patient?
A: With these patients, reduced bone density may cause a number of fractures to the rib cage.

Q: What is the difference between hypoxia and hypoxemia?
A: The first is a decrease in available oxygen; the second is a decreased number of red blood cells that can carry oxygen.

Q: What is an open pneumothorax?
A: This is an open or penetrating wound to the chest that  is also called a sucking chest wound. You can actually hear a sucking sound as the patient inhales and a rushing sound as they exhale.

Q: Past what percentage of collapse will you start to hear dimished breath sounds on a side of the lungs?
A: You will hear this after 30% to 40% of collapse.

Q: What should you do and in what order when faced with an open pneumothorax?
A: In this true emergency situation, you should:
1. Clear the airway;
2. Maintian airway;
3. Provide oxygen;
4. Rapidly seal the wound with a sterile occlusive dressing.

Q: What is a flutter valve?
A: This is a one-way valve that allows air to leave the chest cavity but not return. Careful obervation is required after the placement of this dressing.

Q: What should you do if signs of a tension pneumothorax develop?
A: If this develops, it is suggested that the occlusive dressing be partially removed to allow the chest to vent.

Q: What is the weakened area of the lung called?
A: This area is called a bleb.

Q: What is spontaneous pneumothorax?
A: This event is not related to any major injury but simply happens with normal breathing or may occur during times of strenous physical activity such as exercise or coughing forcefully.

Q: What is simple pneumothorax?
A: This condition is any pneumothorax that does not result in major changes in the patient's physiology.

Q: What is a tension pneumothorax?
A: This conditions occurs when there is significant ongoing air accumulation in the pleural space. This air gradually increases the pressure in the chest, first causing the complete collapse of the affected lung and then pushing the mediastinum (the central part of the chest containing the heart and great vessels) into opposite pleural cavity. This prevents blood from returning through the venae cavae to the heart, ultimately leading to shock and death.

Q: What are common signs and symptoms of tension pneumothorax?
A: Common signs and symptoms of this are: increasing respiratory distress, altered level of consciousness, distended neck veins, deviation of the trachea to the side of the chest opposite, and decreased breath sounds on the side of the injury.

Q: What is the most common cause of tension pneumothorax?
A: The most common cause of this is closed, blunt injury to the chest in which a fractured rib lacerates a lung or bronchus.

Q: What is hemothorax?
A: This is a condition in which blood collects in the pleural space of the thorax.

Q: What is hemopneumothorax?
A: This condition is the presence of air and blood in the pleural space of the thorax.

Q: What is cardiac tamponade (pericardial tamponade)?
A: This condition occurs more commonly in the presence of penetrating chest trauma, when the protective membrane around the heart (pericardial sac) fills with blood or fluid (pus from an infection). As the fluid amount increases, the heart is less able to fill with blood during relaxation, so the heart cannont pump an adequate amount of blood.

Q: What are the signs and symptoms of cardiac tamponade (pericardial tamponade)?
A: The signs and symptoms of this are referred to as Beck's triad, and include: distended or engorged jugular veins seen on both sides of the trachea, a narrowing pulse pressure (difference between systolic and diasystolic), and muffled heart sounds.

Q: What is the Frank-Starling mechanism?
A: This is the mechanism that streches the heart to create a good contraction to pump blood out of the heart's ventricles.

Q: What does crepitus (subcutaneous emphysema) indicate in a chest trauma patient?
A: This condition indicates that air escaping from a lacerated lung is leaking into the chest wall.

Q: What is flail chest?
A: This condition is when three or more ribs are fractured in two or more places, or if the sternum is fractured along with several ribs, and a segment of the chest wall may detach from the rest of the thoracic cage. This seriously interferes with the body's normal ventilation mechanics and must be addressed quickly.

Q: How should you treat a patient with a flail chest?
A: In this situation, you should maintain the airway, provide respiratory support if necessay, give supplemental oxygen, and perform ongoing assessments for possible pneumothorax or other respiratory complications. Treatment may also include positive-pressure ventilations with a bag-mask device. You can also immobilize the patient with a pillow that the patient can hold against the chest wall.

Q: What is a pulmonary contusion?
A: This the injuring or bruising of lung tissue that results in hemorrhage.

Q: When should you suspect pulmonary contusion, and what should you provide?
A: You should always suspect this in patients with flail chest, and should provide respiratory support and supplemental oxygen to ensure adequate ventilation.

Q: What is traumatic asphyxia?
A: This is result of a sudden, severe compression of the chest, which produces a sudden increase in intrathoracic pressure, and results in a characteristic appearance, including distended neck veins, cyanosis in the face and neck, and hemorrhage into the sclera of the eyes.

Q: How should you treat traumatic asphyxia?
A: This condition is severe and you should provide ventilatory support with supplemental oxygen and monitor the patient's vital signs as you provide IMMEDIATE transport.

Q: What is myocardial contusion?
A: This is the bruising of the heart muscle. Provide supplemental oxygen and transport immediately.

Q: What is commotio cordis?
A: This is a blunt chest injury caused by a sudden, direct blow to the chest over the heart that occurs during the critical portion of a heartbeat, possibly resulting in immediate cardiac arrest. The blunt force causes a lethal abnormal heart rhythm called ventricular fibrillation.

Q: How should you treat commotio cordis?
A: In this situation, the ventricular fibrillation that occurs from this injury responds well to early defibrillation if provided in the first 2 minutes after injury.

Q: What are the large blood vessels in the chest?
A: These are the superior vena cava, the inferior vena cava, the pulmonary arteries, four main pulmonary veins, and the aorta.

Q: What percentage of deaths due to blunt trauma include a transection of the aorta?
A: 20% of deaths due to blunt trauma include this.

Q: How many people die every year as a result of aortic or great vessel rupture?
A: 5,000 to 8,000 people die a year as a result of this.

Q: What are the sternocleidomastoid muscles?
A: These are muscles that originate from the mastoid process of the cranium and insert into the medial border each collarbone and the sternum at the base of the neck; they allow movement of the head.

Q: What is the most common cause of shock following trauma?
A: Bleeding is the most common cause of this after trauma.

Q: How long can cells in the brain, spinal column, and heart live without blood?
A: These can only survive for no more than a few minutes without blood.

Q: How long can cells in organs such as the kidneys and lungs survive without blood?
A: These cells can survive for almost an hour without blood.

Q: How long can skeletal muscle cells survive without blood?
A: These can survive for 2 hours without blood.

Q: What are the 3 main parts of the cardiovascular system?
A: These 3 parts are:
1) The pump (heart)
2) Containers (blood vessels that reach every cell in the body)
3) Fluid (Blood and body fluids)

Q: What does the heart and its muscles absolutely need at all times to function?
A: This requires a rich and well-dsitributed blood supply to function.

Q: From where does blood enter the right atrium?
A: Blood enters here from the vena cava.

Q: Where does the blood go as the right ventricle contracts?
A: From there, the blood flows into the pulmonary artery and the pulmonary circulation.

Q: Through what does oxygenated blood return to the left atrium?
A: The blood returns to here through the pulmonary veins.

Q: Why is the left side of the heart more muscular than the right?
A: This side of the heart is more muscular because it must pump blood into the aorta and on to the arteries throughout the body.

Q: Which chamber is responsible for providing 100% of the body with oxygen-rich blood?
A: The left ventricle is responsible for all of this.

Q: What are the five types of blood vessels?
A: These are:
1) Arteries
2) Arterioles
3) Capillaries
4) Venules
5) Veins

Q: Where does blood pass into as it leaves the left ventricle?
A: It passes into the aorta, the largest artery in the body.

Q: What are arterioles?
A: These are smaller vessels that connect the arteries and capillaries.

Q: What are capillaries?
A: These are small tubes, with the diamter of a single red blood cell, that pass among all the cells in the body, linking the arterioles and the venules.

Q: What are venules?
A: These are small, thin-walled vessels that connect the capillaries with the veins.

Q: What are veins?
A: These are blood vessels that return blood to the heart (usually through the vena cava)

Q: What are platelets?
A: These are found in the blood and are responsible for forming blood clots.

Q: What is fibrinogen?
A: This is a substance in the body that reinforces clumping red blood cells, helping to form a clot.

Q: What is one thing the autonomic nervous system does during emergencies?
A: This automatically redirects blood away from other organs to the heart, brain, lungs, and kidneys.

Q: How fast must blood pass through the cardiovascular system?
A: This must pass through the system at a speed that is fast enough to maintain adequate circulation throughout the body and slow enough to allow each cell time to exchange oxygen and nutrients for carbon dioxide and other waste products.

Q: When does one require a minimal blood supply?
A: When one is asleep is a good example of this.

Q: When does the gastrointestinal tract require a high flow of blood?
A: It requires a high flow after a meal.

Q: When may an organ or tissue be better able to resist damage from hypoperfusion?
A: In this situation, considerably colder temperatures may help resist damage.

Q: What is hemorrhage?
A: This another word for bleeding.

Q: What are some signs and symptoms of hypovolemic shock?
A: These signs include:
Rapid, weak pulse;
Changes in mental status (AMS);
Cool, clammy skin;
cyanosis;
low blood pressure (late sign).

Q: Up to what percentage of total blood volume loss can the body tolerate?
A: The body can not tolerate an acute loss of this greater than 20%.

Q: How much blood does the average person have per kilogram of body weight?
A: The average person has 70ml of this per kilogram.

Q: Appromixately how much blood does a person weighing 80 kg (175 lbs.) have
A: A person weighing this much has approximately 6 L (10-12 pints) of blood.

Q: At what level of blood loss will a typical adult experience significant changes in vital signs, including increasing heart rate, increasing respiratory rates, and decreasing blood pressure?
A: A typical adult will experience these changes if they lose more than 1 L (2 pints) of blood.

Q: How much total blood volume does a 1 year old infant have?
A: They have a total blood volume of only 800 mL.

Q: At what level of blood loss will significant symptoms appear in 1 year old infants?
A: Significant symptoms will occur in them after only 100 to 200 mL of blood loss (a soft drink can holds 355 mL)

Q: How much is 1 unit of blood?
A: This is 500 mL of blood.

Q: What are the characteristics of arterial bleeding?
A: Typically, this kind of bleeding results in brighter red blood (high in oxygen) and spurts in time with the pulse.

Q: What are the characteristics of venous bleeding?
A: This kind of bleeding results in blood that is darker (lower in oxygen) and flows slowly or severely, depending on the size.

Q: On its own, how quickly does manageable bleeding stop itself?
A: On its own, internal mechanisms can stop this within about 10 minutes.

Q: What is vasoconstriction?
A: This is a narrowing of blood vessels, a possible response to bleeding.

Q: What is coagulation?
A: This is a process whereby clots form and seal injured portions of the blood vessel.

Q: What can interfere with clotting?
A: A number of medications, including aspirin, can interfere with this.

Q: What is one common cause of severe internal blood loss?
A: Broken bones, and especially broken ribs, may cause this.

Q: What can easily result in the loss of 1 L or more of internal bleeding?
A: A broken femur can result in this amount of internal bleeding into the thigh.

Q: What are some of the only signs of internal bleeding?
A: Sometimes the only signs of this are local swelling and bruising.

Q: What is one way to assist the body's clotting process?
A: Keeping the patient's body as still and quiet as possible will aid in this process.

Q: At least how long should you hold uninterrupted pressure on an external wound to stop the bleeding?
A: You should hold uninterrupted pressure here for at least 5 minutes.

Q: What are some methods to control external bleeding?
A: These methods are:
Direct, even pressure and elevation;
pressure dressings and/or splints;
tourniquets

Q: What blood pressure should alert you to the presence of hypoperfusion?
A: A systolic blood pressure of less than 100 mm Hg with a weak, rapid pulse should suggest this to you.

Q: What are common potential bleeding sources for a fall from a ladder striking the head?
A: A common potential internal bleeding source for this MOI are head injury and hematoma.

Q: What are common potential bleeding sources for a fall from a ladder striking the extremities?
A: A common potential internal bleeding source for this MOI are possible fractures or the possibility of chest injury

Q: What are common potential bleeding sources for a child struck by a car?
A: A common potential internal bleeding source for this MOI are head trauma, chest and abdominal pain, or leg fractures.

Q: What are common potential bleeding sources for a fall on an outstreched arm?
A: A common potential internal bleeding source for this MOI are possible broken bones or joint injury.

Q: What are common potential bleeding sources for a child thrown or falling from a great height?
A: A common potential internal bleeding source for this MOI are head injury, owing to their top-heaviness.

Q: What are common potential bleeding sources for an unrestrained driver in a head-on collision?
A: A common potential internal bleeding source for this MOI are head and neck, chest, abdomen injuries, as well as knee, femur, hip, and pelvis injuries.

Q: What are common potential bleeding sources for an unrestrained front-seat passenger in a side impact collision with intrusion into the vehicle?
A: A common potential internal bleeding source for this MOI are broken humeruses exposing the chest wall (possible flail chest) and pelvis and acetabulum injuries.

Q: What are common potential bleeding sources for an unrestrained driver crushed against the steering column?
A: A common potential internal bleeding source for this MOI are chest and abdomen injuries, ruptured spleen, and neck trauma.

Q: What are common potential bleeding sources for a bike injury?
A: A common potential internal bleeding source for this MOI are fractured clavicles, road rash, and head trauma (esp. if not helmet is present).

Q: What are common potential bleeding sources for an abrupt motorcycle stop?
A: A common potential internal bleeding source for this MOI are fractured femur and head and neck injuries.

Q: What are common potential bleeding sources for diving into the shallow end of a swimming pool?
A: A common potential internal bleeding source for this MOI are head and neck injuries.

Q: What are common potential bleeding sources for an assault or fight?
A: A common potential internal bleeding source for this MOI are punching or kicking injury to the chest, the abdomen, or the face.

Q: What are common potential bleeding sources for a blast or explosive?
A: A common potential internal bleeding source for this MOI are injury from direct strike with debris, indirect and pressure wave in enclosed space; external injuries are dependent upon the anatomic area of the body injured. Internally, air-containing organs such as the middle of the ears and lungs are the most susceptible to injury.

Q: What is a good rule of thumb when entering a scene where you suspect there are multiple patients with bleeding?
A: In a situation such as this, place several pairs of gloves in your pocket for easy access.

Q: What is hemoptysis?
A: This is the coughing up of bright red blood.

Q: What are the later signs of hypoperfusion that suggest internal bleeding?
A: These signs include:
tachycardia;
weakness, fainting, or dizziness at rest;
thirst;
nausea and vomiting;
cold, moist skin;
shallow, rapid breathing;
dull eyes;
slightly dilated pupils that are slow to respond to light;
capillary refill of more than 2 seconds infants and children;
weak, rapid pulse;
decreasing blood pressure;
altered level of consciousness.

Q: What is hematemesis?
A: This is vomited blood.

Q: What is melena?
A: This is a black, tarry stool that contains digested blood.

Q: What are some of the common causes of nontraumatic internal bleeding?
A: These include bleeding ulcers, bleeding from the colon, ruptured ectopic pregnancy, and aneurysms.

Q: What are some possible signs of internal bleeding?
A: These include abdominal tenderness, guarding, rigidity, pain, and distention.

Q: What is the second leading cause of trauma death in the United States?
A: Penetrating trauma is the second leading cause of this in the United States.

Q: What is a proijectile's trajectory?
A: This is the path the projectile takes, and may be difficult to determine, as medium and high-velocity projectiles may flatten out, tumble, or even ricochet within the body.

Q: What is temporary cavitation?
A: This is caused by the acceleration of the bullet and causes a streching of the tissues.

Q: What is permanent cavitation?
A: This is caused by the bullet path and remains once the projectile has passed through the tissue.

Q: What is drag?
A: This is another term for air resistance, and over distance will slow the projectile, decreasing the depth of penetration and thus reducing damage to the tissues.

Q: What is one reason that exit wounds are often many times larger than entrance wounds?
A: One reason for this is that, much like a boat moving through water, the bullet disrupts not only the tissues that are directly in its path but also those in the wake.

Q: The abdomen contains organs from which systems?
A: This contains the organs for the digestive, urinary, and genitourinary systems.

Q: What percentage of all significant trauma involves the abdomen?
A: Eight percent of all significant trauma involves this.

Q: What percentage of all trauma patients have some form of genitourinary tract injury?
A: 10% to 20% of all trauma patients have some form of this.

Q: What organs are commonly found in the upper right quadrant?
A: The liver, gallbladder, duodenum, and a small portion of the pancreas are commonly found here.

Q: What organs are commonly found in the upper left quadrant of the abdomen?
A: The stomach and the spleen are commonly found here.

Q: What organs are commonly found in the lower left quadrant?
A: The descending colon, part of the transverse colon, and parts of the small intestine are commonly found here.

Q: What organs are commonly found in the lower right quadrant?
A: The distal end of the large intestines (aka the appendix), the ascending large intestines, and part of the small intestines are commonly found here,

Q: What is the peritoneal cavity?
A: This is another name for the abdominal cavity.

Q: What are the three parts of the large intestines?
A: The three parts of this are the cecum, the colon, and the rectum.

Q: What is the intestinal mesentery?
A: This is a fold of tissue that contains a web of vessels, both arteries and veins, as well as nerves and lymphatic tissues, that connects the small intestines to the posterior of the abdominal wall.

Q: What is the Cullen sign?
A: This is periumbilical ecchymosis.

Q: What is found in the retroperitoneal region?
A: The kidneys, bladder, ureters, a majority of the pancreas, the last portion of the colon, as well as the abdominal aorta and the inferior vena cava are found here.

Q: What are closed abdominal injuries?
A: These are in juries in which blunt force trauma results in injury to the abdomen without breaking the skin.

Q: What are some common MOI for closed abdominal injuries?
A: Common MOI for this include:
Motorcycle collisions
Falls
Blast injuries
Pedestrian injuries
Compression
Deceleration

Q: What is a clasp-knife injury?
A: This is a pattern of compression injury that is caused by a poorly placed lap belt.

Q: Why can pain in the abdomen frequently be deceiving?
A: In the abdomen, this can be deceiving because it is often diffuse in nature and may be referred from the site of injury to another location in the body.

Q: What is the Kehr sign?
A: This is often found in patients with liver and spleen injuries, in whom there is bleeding into the peritoneal space; pain is referred to the shoulder.

Q: When a patient reports pain that is tearing and reports it as going from the abdomen posteriorly, what is a frequent cause?
A: If the patient is reporting this kind of pain, he or she is often describing symptoms of an abdominal aneurysm that is undergoing dissection.

Q: What is a possible cause of pain that is following the angle from the lateral hip to the midline of the groin?
A: This kind of pain may be a result of damage to the kidneys or the ureters.

Q: What can pain located in the lower right quadrant indicate?
A: This kind of pain can indicate an inflamed or ruptured appendix.

Q: Where can pain from an injured or inflammed gallbladder be found?
A: Pain from this can be found just under the margin of the ribs on the right side or between the shoulder blades.

Q: What is guarding?
A: This is intentional or unintentional stiffening of the abdomen muscles, most often the rectus abdominis muscles. This is a natural attempt to splint the area to prevent unnecessary movement.

Q: What is often the cause of abdominal distention or swelling between the xiphoid process and the groin?
A: The cause of this is often free fluid, blood, or organ contents spilling into the peritoneal cavity.

Q: How long might it take for the contusions or hematomas of a closed abdominal injury to become present on the surface?
A: It might take several minutes to hours after the injury for these to become present on the surface.

Q: Where should a seatbelt properly be worn on the body?
A: This should be worn below the anterior superior iliac spines of the pelvis and against the hip joints.

Q: What is a concern for women in the later stages of pregnancy regarding seatbelts?
A: For these patients, the gravid uterus has displaced the bladder to the anterior. This anatomic change allows the normally protected bladder to become more susceptible to injuries from impacts and the seatbelt.

Q: What are open abdominal injuries?
A: These are injuries in which a foreign object enters the abdomen and opens the peritoneal cavity to the outside; they are also known as penetrating injuries.

Q: What are some observations to make for hospital personnel regarding vehicle accidents?
A: In these situations, be thorough in documenting whether the airbags deployed and the condition of the exterior and steering column.

Q: What are the 3 kinds of open abdominal injuries?
A: The three kinds of this are:
Low-velocity injuries (knives)
Medium-velocity injuries (low-caliber handguns and shotguns)
High-velocity injuries (high-powered rifles and handguns)

Q: What should you assume anytime you have a patient with an injury at or below the xiphoid process?
A: Anytime you have a patient with this, you should assume that the thoracic and peritoneal cavity have both been violated.

Q: What is one very common sign of significant abdominal injury?
A: One very common sign of this is tachycardia, because the heart is increasing its pumping action to compensate for blood loss.

Q: What are flanks?
A: These are the posterior region below the lower margin of the rib cage.

Q: What is Gary Turner sign, and what may it suggest?
A: This is bruising in the upper right quadrant, left lower quadrant, or flank, and may suggest injury to the liver, spleen, or kidney, respectively.

Q: What can air in the peritoneal cavity cause?
A: This can produce pain, irritate the tissues it contacts and can cause tissue ischemia and infarction.

Q: What will air in the peritoneal cavity typically do when a patient changes position?
A: This seeks the most superior space or void, and thus will change position as a patient it re-positioned.

Q: What is the largest organ in the abdomen?
A: This is the liver.

Q: When is the spleen often injured?
A: This is often injured during motor vehicle collisions (especially in the cases of improperly placed seatbelts or from steering wheels) falls from heights or onto sharp objects, and bicycle and motorcycle accidents where the patient hits the handlebars on impact.

Q: What are dysbarism injuries?
A: These are the signs and symptoms related to changes in barometric pressure.

Q: At what age do infants gain the ability to shiver in order to regulare their temperature at birth?
A: Infants do no gain this ability until about 12 to 18 months of age.

Q: Why are the elderly frequently cold?
A: They are frequently in this condition because they have lost subcutaneous tissues, reducing the amount of insulation they have.

Q: What is an important catalyst for much of our body's metabolism?
A: Water is an important catalyst for this.

Q: At what temperature do many hypothermia cases occur?
A: Many of these cases occur at temperatures between 30 and 50 F.

Q: At what temperature do most heat stroke cases occur?
A: Most of these cases occur when the temperature is 80 F and humidity is 80%.

Q: What is hypothermia?
A: This condition is when the entire (core) body temperature falls.

Q: What are the five ways the body loses heat?
A: They are:
Conduction
Convection
Evaporation
Radiation
Respiration

Q: What is conduction?
A: This is the direct transfer of heat from one part of the body to a colder object by direct contact; heat passes directly from the body to the colder object.

Q: What is convection?
A: This occurs when heat is transferred to ciculating air, such as when cool air moves across the body surface.

Q: What is evaporation?
A: This is the conversion of any liquid to a gas, a process that requires energy, or heat.

Q: What is radiation?
A: This is the transfer of heat by radiant energy, a type of invisible light that transfers heat.

Q: What kind of clothes provide good insulation?
A: Layers of clothes that trap air, as well as wool, down, and synthetic fabrics that have small pockets of trapped air are good for this.

Q: What is core temperature?
A: This is the temperature of the heart, lungs, and vital organs.

Q: What does the body normally do to protect itself against heat loss?
A: The body normally constricts blood vessels in the skin to protect against this, resulting in the appearance of blue lips and/or fingertips.

Q: How should you assess a patient's general temperature?
A: To do this, pull back on your glove and place the back of your hand on the patient's skin at the abdomen.

Q: What are the characteristics of mild hypothermia (93 to 95° Fahrenheit / 34 to 35° Celsius)?
A: At this stage, shivering and foot stamping occurs; vasoconstriction and tachycardia are common responses; and patient appears withdrawn.

Q: What are the characteristics of moderate hypothermia (89 to 92F/ 32 to 33C)?
A: At this stage, loss of coordination and muscle stiffness presents; respiration and pulse slows; and patient appears confused and lethargic.

Q: What are the characteristics of severe hypothermia (80 to 88F/ 27 to 31C)?
A: Patient is comatose and unresponsive; pulse is weak, respirations are very slow, and arrhythmias are present; cardiac arrest likely.

Q: What is frostnip?
A: This is when exposed parts of the body become very cold but not frozen.

Q: What are some factors to consider in determing the severity of a local cold injury?
A: Some underlying factors to consider include:
Exposure to wet conditions
Inadequate insulation from cold or wind
restricted circulation from tight clothing or shoes or ciculatory disease
Fatigue
Poor nutrition
Alcohol or drug abuse
Hypothermia
Diabetes
Cardiovascular disease
Older age

Q: What is immersion foot?
A: This is also called trench foot, and occurs after prolonged exposure to cold water.

Q: What are some possible mechanisms of damage from frostbite?
A: Though the exact causes are not known, the presence of ice crystals within the cells may cause physical damage, or the change in the water content may change the concentration of electrolytes.

Q: What is gangrene?
A: This is cell death, and may require amputation.

Q: What are some signs and symptoms of frostbite?
A: Signs and symptoms of this are:
Hard or waxy tissue
Red, purple, white, mottled or cyanotic skin

Q: What is the difference between superficial and deep frostbite?
A: In the second, more serious condition, the deeper tissues are frozen as well. Note that you will be unable to tell the difference in the field; even an experienced surgeon in a hospital setting may not be able to tell until several days have gone by.

Q: What kind of oxygen (if available) should you use on patients with hypothermia.
A: If available, use warmed and humidified oxygen in this situation.

Q: Why might pulse oximetry often be inaccurate with hypothermic patients?
A: Pulse oximetry will often be inaccurate in these kinds of patients due to the lack of perfusion in the extremities.

Q: What kind of clothing should you never remove from a patient's skin.
A: Never remove this if it's frozen to their skin.

Q: What should you not allow hypothermic patients to do when treating them?
A: With these patients, you should not allow the patients to eat, use any stimulants, such as coffee, tea, or cola, or to smoke or chew tobacco. Do not message the extremities.

Q: What can you do to patients with mild cases of hypothermia?
A: In this situation, you can give warm fluids by mouth, assuming that the patient can swallow without a problem.

Q: What should you never do with patients with moderate or severe hypothermia?
A: In these cases, you should never try to actively rewarm the patients, as this may cause a fatal cardiac arrhythmia that requires defibrillation. For this reason, passive rewarming is also best delivered at an appropriate facility.

Q: What should you do if prompt hospital care is not available and medical control instructs you to begin rewarming a hypothermic or frostbitten patient in the field?
A: In this situation, use a warm-water bath with a temperature of between 100 and 105F (38 and 40.5C).

Q: What is ambient temperature?
A: This is the temperature of the surrounding environment.

Q: What is hyperthermia?
A: This is a high core body temperature, usually 101F (38.3 C) or higher.

Q: How much water should a person drink a day when exertion or heat is involved?
A: In this situation, a person should consume 3 L of water.

Q: During vigorous exercise, how much sweat can lose an hour?
A: During this situation, the body can lose more than 1 L sweat

Q: What are the three forms of illness from heat exposure?
A: The three forms are:
Heat cramps
Heat exhaustion
Heatstroke

Q: Who are the persons at greatest risk for heat illnesses?
A: The people at greatest risk for these are:
Geriatric patients,
Newborns,
Infants,
patients with heart disease,
C.O.P.D.,
Diabetes,
Dehydration,
Obesity,
and patients with limited mobility.

Q: What are heat cramps?
A: These are painful muscle spasms that occur after vigorous exercise. Their exact cause is not understood, and may be related to a loss of essential electrolytes from the cells.

Q: What should you suspect with a patient with a sudden onset of abdominal cramps?
A: In this situation, you should suspect heat cramps.

Q: What is heat exhaustion?
A: This is the most common serious illness caused by heat, and is also called heat prostration; it is caused by hypovolemia as the result of the loss of water and electrolytes from heavy sweating.

Q: What are the signs and symptoms of heat exhaustion?
A: The signs and symptoms of this are:
Dizziness
Weakness
Fainting
Muscle cramping
Nausea and vomiting
Headache
Cold, clammy skin with ashen pallor
Dry tongue and thirst
Rapid and weak pulse
Low diastolic blood pressure

Q: What is heatstroke?
A: This is the least common but most serious illness caused by heat exposure. It occurs when the body is subjected to more heat than it can handle and normal mechanisms are overwhelmed. Untreated, it always results in death.

Q: What are some signs and symptoms of heat stroke?
A: Some signs and symptoms of this are:
A body temperature that may rise to 106F (41C)
A patient CAN still be sweating
A change in behavior
Decreasing consciousness, followed by unconsciousness
Increased respiratory rate.

Q: Can you treat heat cramps with hydration?
A: In this situation, you can treat with water or a diluted elctrolyte solution.

Q: What does moist, pale, cool skin indicate?
A: This indicates excessive fluid and salt loss.

Q: What does hot, dry or hot, moist skin indicate?
A: This indicates that the body is unable to regulate core temperature.

Q: What are some examples of non-ionized radiation?
A: Some examples of this are cell phones, microwave ovens, and UV sunlight.

Q: How long can it take for sunlight to burn unprotected skin?
A: This can burn in as little as 30 minutes.

Q: What is drowning?
A: This is the process of experiencing respiratory impairment from submersion/immersion in liquid.

Q: According to the CDC, how many unintentional drownings occur a day?
A: According to the CDC, 10 of these occur per day.

Q: What percentage of drownings are children younger than 14?
A: 25% of these are younger than 14.

Q: What is laryngospasm?
A: This occurs when very small amounts of either fresh or salt water can severely irritate the larynx.

Q: In what percentage of drowning cases is there significant amounts of water in the lungs of the victim?
A: In these situations, 85% to 90% of cases have these.

Q: When should you assume a drowning patient has a spinal injury?
A: You should assume this when:
The submersion has resulted from a diving mishap or long fall.
The patient is unconscious, and no information is available to rule out the possibility of a mechanism causing neck injury.
The patient is conscious but complains of weakness, paralysis, or numbness in the arms or legs.
You suspect the possibility of spinal injury despite what witnesses say.

Q: What does SCUBA stand for?
A: This stands for Self-contained Underwater Breathing Apparatus.

Q: How do you stabilize a suspected spinal injury in water?
A: In order to do this:
1. Turn the patient supine (always roate the entire upper half of the body as a single unit)
2. Restore the airway and begin ventilation
3. Float a buoyant back board under the patient as you continue ventilation.
4. Secure the trunk and head to the backboard to eliminate motion of the cervical spine. Do not remove the patient from the water until this is done.
5. Remove the patient from the water on the backboard.
6. Cover the patient with a blanket, give oxygen or initiate CPR depending on pulse and breath.

Q: When should you give up on resuscitating a cold-water victim?
A: You should never do this. When a person is submerged in water that is colder than body temperature, heat will be conducted from the body to the water. The resulting hypothermia can protect vital organs from the lack of oxygen.

Q: What is the diving reflex?
A: This is a slowing of the heart rate caused by submersion in cold water, and may cause immediate bradycardia. Loss of consciousness and drowning may occur; however, due to the slower metabolic rate, the patient may be able to survive for an extended period of time.

Q: What are descent emergencies?
A: These are usually caused by the sudden increase in pressure on the body as the person dives deeper into the water. The usual areas affected are the lungs, the sinus cavities, the middle ear, the teeth, and the area of the face surrounded by the diving mask.

Q: What is a special concern for a diver with a perforated tympanic membrane?
A: If cold water enters the middle ear through this, the diver may lose his or her balance and orientation.

Q: What are two particularly dangerous medical emergencies that result from ascent emergencies?
A: These are air embolisms and decompression sickness (aka "the bends").

Q: What is an air embolism?
A: This is a condition involving bubbles of air in the blood vessels. They can occur on a dive as shallow as 6'. The problem starts when the diver holds his or her breath during a rapid ascent. The air pressure in the lungs remains at a high level while the external pressure on the chest decreases. As a result, the air inside the lungs expand rapidly, causing the alveoli in the lungs to rupture.

Q: What injuries can result from a scuba air embolism?
A: The following injuries can result from this condition:
Air may enter the pleural space and compress the lungs (pneumothorax)
Air may enter the mediastinum
Air may enter the bloodstream and create bubbles of air in the vessels called air emboli.

Q: What are the signs and symptoms of an air embolism?
A: The signs and symptoms of this are:
Blotching (mottling of the skin)
Froth at the nose and mouth
Severe pain in muscles, joints, or abdomen
Dyspnea and/or chest pain
Dizziness, nausea, and vomiting
Dysphasia (difficulty speaking)
Cough
Cyanosis
Difficulty with vision
Paralysis and/or coma
Irregular pulse and even cardiac arrest

Q: What is decompression sickness (aka the bends)?
A: This occurs when bubbles of gas, especially nitrogen, obstruct the blood vessels. It results from too rapid an ascent from a dive, too long of a dive at too deep a depth, or repeated dives on the same day without the proper time intervals. During the dive, nitrogen that is being breathed dissolves in the blood and tissues because it is under pressure. When the diver ascends, the external pressure is decreased, and the dissolved nitrogen forms small bubbles within those tissues.

Q: What is the most striking symptom regarding decompression sickness?
A: The most striking symptom of this is joint pain so severe that the patient literally doubles up, or "bends".

Q: What is a danger to consider regarding decompression sickness?
A: In this case, even after a "safe dive", this can occur from driving up a mountain or flying in an unpressurized plane. The risk of this diminishes after 24 to 48 hours.

Q: What is the general rule regarding air embolism and decompression sickness?
A: As a general rule, the first occurs immediately on return to the surface, the second may not occur for several hours. However, the emergency is the same for both: BLS, then recompression in a hyperbaric chamber.

Q: What position should you place a conscious patient you suspect of having an air embolism or decompression sickness?
A: In this situation, you should place the patient in a left lateral recumbent position with their head down.

Q: What is breath-holding syncope?
A: This is a loss of consciousness caused by a decreased stimulus for breathing. This happens to swimmers who breathe in and out rapidly and deeply before entering the water in an effort to expand their capacity to stay underwater. Whereas this technique increases the swimmer's oxygen level, the hyperventilation involved lowers the carbon dioxide level. Because an elevated level of carbon dioxide in the blood is the strongest stimulus for breathing, the swimmer may not feel the need to breathe even after using up all the oxygen in his or her lungs.

Q: What are the 3 kinds of high altitude sickness?
A: These are:
1) Acute mountain sickness
2) High-Altitude Cerebral Edema (HACE)
3) High-Altitude Pulmonary Edema (HAPE)

Q: What is acute mountain sickness?
A: This is caused by diminished oxygen pressure in the air at altitudes above 8,000', resulting in hypoxia. It strikes those who ascend too fast and those not acclimated to high altitudes.

Q: What are the signs and symptoms of acute mountain sickness?
A: The signs and symptoms of this include a headache, lightheadedness, fatigue, loss of appetite, nausea, difficulty sleeping, shortness of breath, and swollen face.

Q: What is HAPE (high-altitude pulmonary edema)?
A: With this, fluid collects in the lungs, hindering the passage of oxygen in the bloodstream. It can occur at altitudes of 10,000'.

Q: What are the signs and symptoms of HAPE?
A: The signs and symptoms of this include:
Shortness of breath
Cough with pink sputum
Cyanosis
and a rapid pulse

Q: What is HACE (high-altitude cerebral edema)?
A: This occurs in climbers who climb above 12,000'. It may accompany HAPE and can quickly become life threatening.

Q: What are the signs and symptoms of HACE?
A: Signs and symptoms of this include:
Severe, constantly throbbing headache
Ataxia (lack of muscle coordination)
Extreme fatigue
Vomiting
Loss of consciousness

Q: How should you treat high altitude sickness?
A: Treatment for this consists of providing oxygen, descending from height, and transport.

Q: According to the National Weather Service, how many cloud-to-ground lightning flashes are there in the US each year?
A: There are 25 million of these each year according to the National Weather Service.

Q: How many documented deaths from lightning strikes are there annually in the US?
A: This causes 60-70 documented deaths in the United States annually.

Q: How many documented injuries from lightning are reported in the US every year?
A: There are about 300 of these reported each year in the US.

Q: What is the 3rd most common cause of death from isolated environmental phenomena?
A: This is lightning.

Q: What degree of energy is typically found in lightning?
A: This has a direct current of up to 200,000 volts and a potential of 100 million volts or more. Temperatures generated vary between 20,000 and 60,000 F.

Q: What are the three catagories of lightning injuries?
A: The three catagories are:
1) Mild (loss of consciousness, amnesia, confusion, tingling, superficial burns)
2) Moderate (seizures, respiratory arrest, cardiac asystole that spontaneously resolves, superficial burns
3) Severe (cardiopulmonary arrest; survival rare)

Q: What is a sure sign of an immenent lightning strike, and what should you do to prevent being hit?
A: If you suddenly feel a tingling sensation or your hair standing on end, make yourself as small as possible by squatting down into a ball, close to but not touching the ground.

Q: What is reverse triage?
A: This process differs from conventional triage, which emphasizes treating patients not in cardiac arrest. Here, you should focus your efforts on those who are in respiratory or cardiac arrest.

Q: What may occur following a massive direct current shock?
A: This can cause tetany (massive muscle spasms) that can result in fractures of long bones and spinal vertebrae. Therefore, always use the jaw-thrust maneuver.

Q: What is the black widow spider?
A: This spider's latin name is Latrodectus hesperus/mactans/variolus (depending on region), and the female measures approx. 2" long. It is usually black and has a distinctive, bright red-orange marking in the shape of an hourglass on its abdomen. The female is larger and more toxic than the male. They are found in every state except Alaska.

Q: What are the effects of a black widow spider bite?
A: Most of these bites cause localized pain and symptoms, including agonizing muscle spasms. In some cases, a bite on the abdomen cause muscle spasms so severe that the patient may be thought to have an acute abdominal condition, possibly peritonitis. The venom is a neurotoxic (damages to nerve tissues). Other symptoms include dizziness, sweating, nausea, vomiting, and rashes. These signs and symptoms generally subside over 48 hours.

Q: What is an antivenim?
A: This is a serum containing antibodies that counteract the venom.

Q: How are black widow spider bites usually treated?
A: For very severe bites, the aged or feeble, or children younger than five, the antivenim is used. Severe muscle spasms are usually treated with IV benzodiazepines. In field and if time permits, apply an ice pack to the bite area and clean the wound with soap and water.

Q: What is the brown recluse spider?
A: This spider's Latin name is loxosceles reclusa. It is dull brown and 1" in diamter. It has a violin-shaped mark on its back. They can be found throughout the US. Its venom is cytotoxic, which means it causes local tissue damage. Bites become swollen and painful within hours.

Q: What are hymentoptera?
A: This term refers to bees, wasps, ants, and yellow jackets.

Q: How many spider bites occur each year around the world?
A: There are 300,000 of these in the world annually.

Q: How many deaths are caused by spider bites in the world annually?
A: There are over 30 to 40,000 deaths annually attributed to this throughout the world.

Q: How many snakebite fatalities are reported in Southeast Asia and India each year?
A: There are 25,000 to 30,000 of these reported each year in SE Asia and India.

Q: How many snakebite fatalities are reported in South America each year?
A: There are 3 to 4,000 of these reported each year in South America.

Q: How many snakebites are reported annually in the States?
A: There are 40 to 50,000 reported each year in the States.

Q: How many snakebite fatalities are reported in the US each year?
A: There are 15 of these reported in the US every year.

Q: How many snake species are in the US, and how many are poisonous?
A: There are 115 of these, though only 19 are poisonous.

Q: What is the science name for rattlesnakes?
A: This is Crotalus.

Q: What is the latin name for copperheads?
A: This is Agkistrodon contortrix.

Q: What is a latin name for water moccasins?
A: This is Agkistrodon piscivorus.

Q: What states have major concentrations of snake bites?
A: These states are Louisiana, Georgia, Oklahoma, North Carolina, Arkansas, West Virginia, and Mississippi.

Q: Why do only a third of snake bites result in significant local or systemic injuries?
A: This is because envenomation does not always occur, as the snake has only a finite supply of venom.

Q: What are pit vipers?
A: These are venomous snakes, including rattlesnakes, copperheads, and cottonmouths, that take their name from the small heat-sensing pits located just behind each nostril and in front of each eye.

Q: What are the physical features of rattlesnakes?
A: These have colored diamond patterns, and can grow to 6' or more.

Q: What are the physical features of copperheads?
A: These are smaller than rattlesnakes, 2' to 3' long, typically reddish coppery brown with brown or red bands. Their venom is rarely fatal; it is, however, capable of destroying extremities.

Q: What are the physical features of cottonmouths?
A: These grow to about 4' in length, olive or brown with black cross-bands. Fatalities are rare, but tissue destruction may be severe.

Q: What are the signs of envenomation?
A: The signs of this are:
Severe burning pain at the site
Ecchymosis
Signs are evident 5 to 10 minutes after the unjury and spread over the next 36 hours
Distal bleeding (venom interferes with clotting mechanisms)
Weakness
Vomiting and Nausea
Seizures
Fainting
Shock

Q: How should you treat a pit viper bite?
A: To treat this type of injury:
1) Calm the patient (remind them that snake bites are rarely fatal) and place them in a supine position
2) Locate the bite area and clean with a mild antiseptic (no ice); Place a constricting band 4" to 6" above the wound if the patient is hypotensive.
3) Place the extremity below the level of the heart

Q: What are coral snakes?
A: These are small reptiles with red, yellow, and black bands. Their venom is highly toxic that causes paralysis of the nervous system.

Q: Which species of scorpion in the US is dangerous to humans?
A: This is the Centruroides sculpturatus, A.K.A., the Arizona bark scorpion. It is the most venomous scorpion in North America, and its venom can cause severe pain, typically lasting 24 to 72 hours. Symptoms in extreme reactions include numbness, frothing at the mouth, paralysis, and what may be confused as a seizure that makes breathing difficult. Fatalities are generally limited to children, the elderly, immuno-surpressed patients, and pets.

Q: What are the symptoms of a Centruroides sculpturatus sting?
A: The symptoms for this are: circulatory collapse, severe muscle contractions, excessive salivation, hypertension, convulsions, and cardiac failure.

Q: What are the symptoms of Rocky Mountain spotted fever?
A: Symptoms of this include nausea, vomiting, headache, weakness, paralysis, and possible cardiorespiratory failure.

Q: How long does it take for transmission of an infection from a tick to the host?
A: This transmission takes 12 hours.

Q: What are coelenterates?
A: These invertebrate animals include fire coral, Protuguese man-of-war, sea wasp, sea nettles, true jellyfish, sea anemones, true coral, and soft coral. They are responsible for more envenomations than any other marine animals. Their stinging cells are called nemocysts.

Q: What are common symptoms of nemocystic envenomation?
A: Symptoms of this include:
headache
dizziness
muscle cramps
fainting

Q: How should you treat coelenterate envenomation?
A: To treat this:
1) Keep the patient calm and reduce movement
2) Inactive the nemocysts with vinegar for at least 30 seconds, or isopropyl alcohol if vinegar is not available
3) Remove any remaining tentacles by scraping them off with the edge of a credit card or similar item.
4) Transport

Q: What is normal human body temperature?
A: This is 98.6 F (37 C).

Q: What can happen if the diaphragm is penetrated or ruptured?
A: If this happens, loops of bowel are likely to invade the thoracic cavity and can cause bowel sounds to be present during auscultation of the lungs. Patients will exhibit dyspnea.

Q: What is hematuria, and what might it indicate?
A: This is blood in the urine, and may indicate the kidneys are injured.

Q: What does blood on the urinary meatus indicate?
A: This indicates significant trauma to the genitourinary system.

Q: What is the urinary meatus?
A: This is the opening in the urethra, situated on the glans penis in males and in the vulva in females.

Q: What is something to remember in pediatric patients regarding abdominal injury?
A: In this situation, remember that the rib cage is so flexible that the chest can be flattened alsmot to the spine before rib fractures occur; the ribs then recoil to their normal position, and the patient is left with very few outward signs that an injury has occurred.

Q: What can you do with patients with abdominal pain without suspected spinal injury to help alleviate pain?
A: With these patients, you can allow the patient to stay in a position of comfort - with legs pulled up toward the abdomen.

Q: What should you do for patients with abdominal pain who you suspect of spinal injury to alleviate pain?
A: With these patients, place padding such as blankets or pillows under the patient's knees to help alleviate tension on the abdominal wall.

Q: What are axillae?
A: These are armpits.

Q: What should you report if you can't hear bowel sounds?
A: You should report that they are "hypoactive".

Q: When you begin palpating the abdominal region, what should you remember to do?
A: When you start this, remember to start palpating the quadrant farthest away from the quadrant that is exhibiting pain.

Q: Where are the kidneys located?
A: These are located in the flank region of the back.

Q: What may a patient who has a ruptured diaphragm have?
A: A patient with this may have an abdomen with a sunken anterior wall (scaphoid abdomen) and difficulty breathing because of bowel contents in the chest cavity. These patients should receive positive-pressure ventilation with a bag-mask device.

Q: What is the biggest concern in patients with closed abdominal injuries?
A: The biggest concern with these patients is the fact that you do not know the true extent of the injury. Therefore, expedient transport is essential.

Q: A patient with a blunt abdominal injury may have one or more of which injuries?
A: A patient with this injury may have one or more of the following injuries:
Severe bruising of the abdominal wall;
Laceration of the liver and spleen;
Rupture of the intestine;
Tears in the mesentery;
Rupture of the kidneys or avulsion of the kidneys from their arteries and veins;
Rupture of the bladder;
Severe intra-abdominal hemorrhage;
Peritoneal irritation and inflammation in response to the rupture of hollow organs.

Q: What position should you place a patient who has sustained a blunt abdominal injury?
A: You should log roll this kind of patient to a supine position on a backboard.

Q: What should you do with abdominal evisceration?
A: With these injuries, never try to replace an organ that is protruding from an abdominal laceration; cover it with sterile gauze compresses moistened with sterile saline solution and secure with a sterile dressing; do NOT use any material that is adherent or loses its substance when wet, such as toilet paper, facial tissue, paper towels, or absorbent cotton.

Q: What are PASG (Pneumatic AntiShock Garment)?
A: These were originally developed by the military for fighter pilots who wore them as g-suits. The military needed to increase the pilot's systolic blood pressure to keep the pilot from losing consciousness at high altitudes or while performing certain maneuvers; many studies have now shown that while the g-suit works very efficiently on healthy fighter pilots, it does not resolve shock in the typical trauma patient.

Q: What does the urinary system do?
A: This system controls the discharge of certain waste materials filtered from the blood by the kidneys.

Q: Where does the genital system lie in the male and female?
A: The male genitalia, except for the prostate gland and the seminal vesicles, lie outside the pelvic cavity. The female genitalia, except for the vulva, clitoris, and labia, are contained entirely within the pelvis.

Q: What is something to remember regarding penetrating and blunt kidney injuries?
A: With these injuries, it almost always involve other organs.

Q: When should you suspect kidney damage?
A: You should suspect this kind of damage if the patient has a history or physical evidence of any of the following:
An abrasion, laceration, or contusion in the flank.
A penetrating wound in the region of the lower rib cage (flank) or the upper abdomen.
Fractures on either side of the lower rib cage, the lower thoracic, or upper lumbar vertebrae,
And, A hematoma in the flank region

Q: What can sudden deceleration in a crash cause in a male patient?
A: This event can literally shear the bladder from the urethra.

Q: What should you remember regarding injuries of the external male genitalia?
A: With these injuries, it is important to remember that although these injuries are uniformly painful and generally a source of great concern to the patient, they are rarely considered life threatening and should not be given priority over other, more severe wounds.

Q: Why are injuries to the uterus particularly severe?
A: These injuries are particularly severe because the uterus has a rich blood supply during pregnancy.

Q: What is something important to cosider regarding the blood pressure of a patient in the last trimester of her pregnancy?
A: With these patients, remember that that uterus may obstruct the vena cava, decreasing the amount of blood returning to the heart if the patient is placed in a supine position (supine hypotensive syndrome). The patient should instead be placed on her left side so that the uterus will not lie on the vena cava.

Q: What should you not do regarding vaginal bleed?
A: In this situation, do not insert instruments, gloved fingers, or a tampon in the vagina as this can cause further damage.

Q: What are some common complaints associated with genitourinary injuries?
A: These include nausea, vomiting, diarrhea, blood in the urine (hematuria), vomiting blood (hematemesis), or abnormal bowel and bladder habits such as an increase in frequency or the absence of the need to void.

Q: What can cause lacerations of the urethra?
A: These injuries can result from straddle injuries, pelvic fractures, or penetrating wounds of the perineum.

Q: What can direct blows to the scrotum result in?
A: These can result in significant accumulation of blood around the testes; you should apply an ice pack to the scrotal area while transporting the patient.

Q: What are some causes of rectal bleeding?
A: This can be caused by sexual assault, hemorrhoids, colitis, or ulcer of the digestive track.

Q: What are some general steps to follow regarding sexual assault cases?
A: In these situations, remember to:
Take care to shield the patient from curious onlookers.
Because you may have to appear in court as much as 2 or 3 years later, you must document the patient's history, assessment, treatment, and response to treatment in detail.
Advise the patient not to wash, douche, urinate, or defecate until after a physician has examined him or her.
If the patient will tolerate being wrapped in a sterile burn sheet, this may help investigators to find any hair, fluid, or fiber from the alleged offender.
Place all articles or evidence in a paper bag, NOT plastic.

Q: How many visits to physicians occur annually as a result of complaints related to the musculoskeletal system?
A: There are almost 60 million of these every year.

Q: What percentage of Americans experience some type of musculoskeletal impairment, costing hundreds of billions of dollars a year?
A: Approximately one in seven Americans will experience this in their lives.

Q: What percentage of all patients with multiple system trauma have one or more musculoskeletal injuries?
A: An estimated 70% to 80% all patients with this trauma have this kind of injury.

Q: What are the three types of muscles?
A: These are:
skeletal
smooth
cardiac

Q: What are skeletal muscles (aka striated muscle)?
A: These muscles attach to the bones and usually cross at least one joint, forming the muscle mass of the body. This type of muscle is also called voluntary muscle, because it is under direct control of the brain.

Q: What attaches skeletal muscle to the bone?
A: This is attached to bone by tough, ropelike fibrous structures known as tendons, which are extensions of fascia that covers all skeletal muscle.

Q: What is smooth muscle?
A: This is also called involuntary muscle, because it is not under voluntary control of the brain. This type of muscle is found in the walls of most tubular structures of the body, such as the gastrointestinal tract and the blood vessels.

Q: How many bones are in the human skeleton?
A: There are 206 bones.

Q: What are the functions of bones?
A: These protect our vital organs, allow us to move, produce blood cells in the marrow, and serve as a reservoir for minerals and electrolytes.

Q: What protects the heart, lungs, and great vessels?
A: These are protected by the thoracic cage.

Q: What protects the liver and spleen?
A: These are protected by the lower ribs.

Q: What protects the spinal cord?
A: The spinal canal protects this.

Q: What is the pectoral girdle?
A: This consists of two scapulae and two clavicles.

Q: What is the scapula?
A: This is a flat triangular bone held to the ribcage by powerful muscles that buffer it against injury.  Also called a shoulder blade.

Q: What is the upper extremity?
A: This extends from the shoulder to the fingertips and is composed of the arm (humerus), elbow, forearm (radius and ulna), wrist, hand, and fingers. It joins the shoulder girdle at the glenohumeral joint.

Q: What bones make up the forearm?
A: This is made up of the radius and ulna.

Q: What are the three set of hand bones?
A: These sets of bones are the carpals, the metacarpals, and phalanges.

Q: When are carpals vulnerable to fracture?
A: These bones are vulnerable to fracture when a person falls on an outstreched hand.

Q: When are phalanges vulnerable to injury?
A: These bones are vulnerable to crushing injury.

Q: What is the pelvis?
A: This supports the body weight and protects the structures within the pelvis - the bladder, rectum, and female reproductive organs.

Q: What are the three bones in the pelvic girdle?
A: The three separate bones are:
the ischium
ilium
and pubis
These together make up the innominate bone.

Q: What connects the two pubic bones anteriorly?
A: These are joined by ligaments to each other at the pubic symphasis.

Q: What do the iliac bones connect to posteriorly?
A: These are joined by ligaments to the sacrum at the sacroliac joint.

Q: What is the femur?
A: This is a long, powerful bone that connects in the ball-and-socket joint of the pelvis and in the hinge joint of the knee.

Q: What is the head of the femur?
A: This is the ball-shaped part that fits into the acetabulum and is a common fracture point.

Q: What connects the head of the femur to the shaft?
A: These are connected by the femoral neck, a common site for fractures, especially in the older population.

Q: What is the name for the upper part of the femur?
A: This is called the greater trochanter.

Q: What is the name for the lower part of the femur?
A: This is called the lesser trochanter.

Q: What are the two bones of the lower leg?
A: This consists of two bones, the tibia and fibula.

Q: What is the tibia?
A: This connects to the patella to form the knee joint and runs down the front of the lower leg.

Q: What are the three classes of foot bones?
A: These 3 are:
the tarsals (ankle bones)
the metatarsals (foot bones)
and the phalanges (toe bones)

Q: What is the calcaneus?
A: This is the largest of the tarsal bones; it is also known as the heel bone, and is subject to injury when a person jumps from a height and lands on the feet.

Q: What is a joint?
A: This is formed whenever two bones come into contact.

Q: What holds joints together?
A: These are held together in a tough fibrous structure known as a capsule, and supported by bands of fibrous tissue called ligaments.

Q: What is the sternoclavicular joint?
A: This is where the sternum and the clavicle come together.

Q: What is articular cartilage?
A: This is a thin layer of cartilage that covers the ends of bones in moving joints; it is a pearly substance that allows the ends of the bones to glide easily.

Q: What is synovial fluid?
A: This bathes and lubricates joints. It is also known as joint fluid.

Q: What are skull sutures?
A: These are joints present in the first 18 months of life that fuse together during growth to create a solid, immobile, bony structure.

Q: What is a fracture?
A: This is a break in the continuity of the bone.

Q: What is a dislocation?
A: This is a disruption of a joint in which the bone ends are no longer in contact. The supporting ligaments are often torn, usually completely allowing the bone ends to separate completely from each other.

Q: What is fascia?
A: This is the fibrous tissue that surrounds and supports the muscles and neurovascular structures.

Q: What is a sprain?
A: This is an injury to ligaments, articular capsule, synovial membrane, and tendons crossing the joint. After the injury, the joint surfaces generally fall back into alignment, so the joint is not significantly displaced. The most severe sprains involve actual of the ligament and may allow joint dislocation. Mild sprains are caused by ligament streching rather than tearing. The most vulnerable joints are the knees, shoulders, and ankles.

Q: What is a strain?
A: This is a streching or tearing of the muscle, causing pain, swelling, and bruising of the soft tissues in the area.

Q: What is the zone of injury?
A: This is injury to soft tissues, especially to the adjacent nerves and blood vessels, surrounding an injury to bones and joints.

Q: What is the patella?
A: This is the kneecap.

Q: What is an indirect force injury?
A: This may cause a fracture or dislocation at a distant point, as when a person falls and lands on an outstreched hand. The direct impact may cause a wrist fracture, but the indirect force can cause dislocation of the elbow or a fracture of the forearm, humerus, or even clavicle.

Q: What is a closed fracture?
A: This is a fracture in which the skin is not broken.

Q: What is an open fracture?
A: This is a fracture in which there is an external wound, caused either by the same blow that fractured the bone or by the broken bone ends lacerating the skin.

Q: What is a nondisplaced fracture?
A: This is a simple crack of the bone in which the bone has not moved from its normal position. It is also called a hairline fracture.

Q: What is a displaced fracture?
A: This produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it; it can be associated with crepitus.

Q: What is a greenstick fracture?
A: This is an incomplete fracture that passes only partway through the shaft of a bone but may still cause substantial angulation; occurs in children.

Q: What is a comminuted fracture?
A: This is a fracture in which the bone is broken into more than two fractures.

Q: What is a pathologic fracture?
A: This is a fracture of weakened or diseased bone, seen in patients with osteoprosis or cancer, generally produced by minimal force.

Q: What is an epiphyseal fracture?
A: This is a fracture that occurs in a growth section of a child's bone and may lead to growth abnormalities.

Q: What is an oblique fracture?
A: This is a fracture in which the bone is broken at an angle across the bone. This is usually the result of a sharp angled blow to the bone.

Q: What is a transverse fracture?
A: This is a fracture that occurs straight across the bone. This is usually the result of a direct blow or stress fracture caused by prolonged running.

Q: What is a spiral fracture?
A: This is a fracture caused by a twisting force, causing an oblique fracture around the bone and through the bone. This is often the result of abuse in very young children.

Q: What is an incomplete fracture?
A: This is a fracture that does not run completely through the bone; a nondisplaced partial crack.

Q: What is the most reliable indicator of an underlying fracture?
A: This is point tenderness on palpation in the zone of injury.

Q: How long after a fracture may fluid build-up and swelling occur?
A: This may occur several hours after a fracture.

Q: What is crepitus?
A: This is a grating or grinding sensation that can sometimes be felt and/or heard when fractured bone ends rub together.

Q: What is flase motion?
A: This is motion at a point in the limb where there is no joint. Also called free movement, it is a positive indication of a fracture.

Q: What does it mean when a dislocated joint spontaneously reduces?
A: This means the joint will return to its normal position.

Q: What are the signs and symptoms of a dislocated joint?
A: The signs and symptoms of this are:
Marked deformity
Swelling
Pain that is aggravated by any attempt at movement
Tenderness on palpation
Virtually complete loss of normal joint motion (locked joint)
Numbness or impaired circulation to the limb or digit

Q: Where do sprains occur most often?
A: These occur most often in the knee and the ankle, though they can occur anywhere.

Q: What are the signs and symptoms of a sprain?
A: The signs and symptoms of this are:
Point tenderness can be elicited over the injured ligaments
Swelling and ecchymosis appear at the point of injury to the ligament as a result of torn blood vessels
Pain prevents the patient from moving or using the limb normally
Instability of the joint us indicated by increased motion, especially at the knee; however, this may be masked by severe swelling and guarding

Q: What should you general approach be with ankle trauama?
A: With this, always focus on determing the MOI.

Q: When does compartment syndrome most commonly occur, and when does it develop?
A: This most commonly occurs with a fractured tibia or forearm of children and is often overlooked, especially in patients with an altered level of consciousness. It typically develops within 6 to 12 hours after injury, usually as a result of excessive bleeding, a severely crushed extremity, or the rapid return of blood to an ischemic limb.

Q: What are the signs and symptoms of compartment syndrome?
A: This is characterized by pain that is out of proportion to the injury, pain on passive strech of muscles within the compartment, pallor, decreased sensation, and decreased power.

Q: Why is any suspected open fracture or vascular injury considered a medical emergency?
A: These are always considered medical emergencies, as in an extremity with anything less than complete circulation, prolonged hypoperfusion can cause significant damage.

Q: What are some examples of minor musculoskeletal injuries?
A: Some examples of this are minor sprains and fractures or dislocations of digits.

Q: What are some examples of moderate musculoskeletal injuries?
A: Some examples of this are open fractures of digits,
nondisplaced long-bone fractures,
nondisplaced pelvic fractures
major sprains of a major joint.

Q: What are some examples of severe musculoskeletal injuries?
A: Some examples of this are:
Displaced long-bone fractures
Multiple hand and foot fractures
Open long-bone fractures
Displaced pelvic fractures
Dislocations of major joints
Multiple digit amputations
Laceration of major nerves or blood vessels

Q: What are some examples severe, life-threatening musculoskeletal injuries (survival is probable)?
A: Some examples of this include:
Multiple closed fractures
Limb amputations
Fractures of both long bones of the legs (bilateral femur fractures

Q: What are some examples of critical musculoskeletal injuries (survival is uncertain)?
A: Some examples of this include:
Multiple open fractures of the limbs
Suspected pelvic fractures with hemodynamic instability

Q: What does a patient with bilateral fractures of the long bones (humerus, femur, or tibia) indicate?
A: This indicates that the patient has been subjected to a high amount of kinetic energy, which should dramatically increase your index of suspicion for serious unseen injuries.

Q: What are the 6 Ps of injured limb examination?
A: These are:
Pain,
Paralysis
Paresthesias (numbness or tingling),
Pulselessness,
Pallor,
and Pressure

Q: What should you always do before and after splinting a patient?
A: You should always check circulation, motor function, and sensation before and after this.

Q: What are the steps to follow when caring for a patient with musculoskeletal injuries?
A: With these types of patients, you should:
1) Remove any jewelry.
2) Completely cover any open wounds with dry, sterile dressing, and apply direct pressure to control bleeding (use a tourniquet if bleeding cannot be controlled).
3) Apply the appropriate splint, and elevate the extremity approx. 6" to minimize swelling.
4) If swelling is present, apply cold packs to the area.
5) Prepate the patient for transport.

Q: What is a splint?
A: This is a flexible or rigid device that is used to protect and maintain the position of an injured extremity.

Q: How is splinting useful?
A: This is useful as it prevents:
1) movement of fracture fragments, bone ends, dislocated joints, or damaged soft tissue, reducing pain.
2) further damage to muscles, spinal cords, nerves, and blood vessels.
3) laceration of the skin by broken bone ends (one of the primary indications for this is to prevent a closed fracture from becoming an open fracture.)
4) restriction of distal blood flow resulting from pressure of the bone ends on blood vessels
and
5) paralysis of extremities resulting from a damaged spine.

Q: What are the 13 general principles of splinting?
A: The 13 general principles of this are:
1) Remove clothing from the area so you can inspect for DCAP-BTLS
2) Take CSM
3) Cover all wounds with dry, sterile dressing
4) Do not move the patient prior to application unless there is immediate danger
5) In a suspected fracture of the shaft, be sure to stabilize the joints above and below the fracture
6) With injuries in and around the joint, be sure to stabilize the bones above and below the injured joint
7) Pad all straps
8) During application, maintain manual stabilization
9) If the fracture of a long-bone shaft has resulted in severe deformity, use constant, gentle manual traction to align the limb. This is especially important if the distal part of the extremity is cyanotic or pulseless.
10) If you erncounter resistance, perform the procedure with the limb in its deformed position
11) Stabilize all suspected spinal injuries in a neutral in-line position on a backboard
12) If the patient has signs of hypoperfusion, align the limb in the normal anatomic position, and provide transport
13) When in doubt, splint

Q: What is traction?
A: This is the act of pulling on a body structure in the direction of its normal alignment. It is the most effective way to realign a fracture of the shaft of a long bone so that the limb can be splinted more effectively.

Q: What should you NOT attempt to do with traction?
A: When doing this, remember you should not attempt to reduce the fracture or force all of the bone fragments back into alignment. This is the physician's responsibility.

Q: What should you do before applying a traction splint?
A: Before applying this, be sure to control any external bleeding.

Q: How much force is required for proper traction?
A: This varies, but often does not exceed 15 lb.

Q: What are the two situations in which you must splint the limb in the position of deformity?
A: You must do this when:
1) the deformity is severe, as is the case with many dislocations,
and
2) when you encounter resistance or extreme pain when applying gentle traction to the fracture of a shaft of a long bone.

Q: What is the most commonly used formable or soft splint?
A: The most commonly used one of these is the precontured, inflatable, clear plastic air splint.

Q: What is something to consider regarding air splints?
A: With these, remember that significant changes in the weather affect the pressure of the air in the splint, which decreases as the environment grows colder and increases as the environment grows warmer. The same thing happens when there changes in altitude, which can be a problem with helicopter transport of patients.

Q: When are traction splints primarily used?
A: They are used primarily to secure fractures of the shaft of the femur, characterized by pain, swelling, and deformity of the midthigh.

Q: When should you NOT use traction splints?
A: Do not use this for any of the following conditions:
1) Injuries of the upper extremity.
2) Injuries close to or involving the knee.
3) Injuries of the hip.
4) Injuries of the pelvis.
5) Partial amputations or avulsions with bone separation.
And 6) Lower leg, foot, or ankle injury.

Q: What are pelvic binders?
A: These are used to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain. They are easily applied by one person, and should allow access to the abdomen, perineum, anus, and groin for examination and diagnostic testing.

Q: When should you not use PASGs?
A: Do not use this if any of the following conditions exist:
Pregnancy,
Pulmonary edema,
Acute heart failure,
Penetrating chest injuries,
Groin injuries,
Major head injuries,
And a transport time of less than 30 minutes

Q: What is a general rule for PASGs?
A: As a general rule with these, gradually inflate the legs before inflating the abdominal portion.

Q: What are some hazards associated with the improper application of splints?
A: The following hazards are associated with this:
Compression of nerves, tissues, and blood vessels
Delay in transport of a patient with a life-threatening injury
Reduction of distal circulation
Aggravation of the injury
Injury to tissue, nerves, blood vessels, or muscles as a result of excessive movement of the bone or joint.

Q: What is one of the most commonly fractured bone in the body?
A: The clavicle, or collarbone, is this.

Q: What is a another name for the scapula?
A: Another name for this is shoulder blade.

Q: What is the acromioclavicular (AC) joint?
A: This is the joint between the outer end of the clavicle and the acromion process of the scapula. Dislocation of this is called an AC separation.

Q: What is a sling?
A: This is any bandage or material that helps support the weight of an injured upper extremity, relieving the downward pull of gravity on the injured site.

Q: What is a swathe?
A: This is a bandage that passses completely around the chest to stabilize the arm.

Q: What is the glenoid fossa?
A: This is the part of the scapula that joins with the head of the humerus, forming the glenhumeral joint (shoulder joint).

Q: What symptoms indicate a shoulder dislocation?
A: The symptoms of this condition are as follows:
The shoulder joint will usually be locked, and the sholder will appear squared off or flattened. The humeral head will protrude anteriorly underneath the pectoralis major on the anterior chest wall. As a result, the anxillary nerve may be compressed, causing a numb patch on the outer aspect of the shoulder. Be sure to document this finding.

Q: Why is stabilizing an anterior shoulder dislocation difficult?
A: This is difficult because any attempt to bring the arm in toward the chest will produce pain. You must splint the joint in whatever position is most comfortable for the patient, so if necessary, place a pillow or rolled blanket or towels between the arm and chest to fill up the space between them.

Q: Where do fractures of the humerus occur?
A: They occur either: proximally at the midshaft, or distally at the elbow.

Q: What is another name for a fracture of the distal humerus?
A: This is also known as a supracondylar or intercondylar fracture.

Q: What kind of fracture is common in children?
A: Fracture of the distal humerus (supracondylar or intercondylar fracture) are common with this group.

Q: What is a common deformity of a dislocated elbow?
A: A common deformity of this is the posterior displacement of the ulna and radius, which makes the olecranon process of the ulna much more prominent.

Q: What generally causes fractures of the radial head?
A: These are generally caused from direct or indirect forces and is often associated with lacerations and abrasions.

Q: What does a cold, pale hand or a weak or absent pulse and poor capillary refill in a patient with an elbow injury indicate?
A: These indicate that blood vessels have likely been injured. Notify medical control immediately and provide prompt transport.

Q: What should you do if a limb is pulseless and significantly deformed at the elbow?
A: In this situation, you should gently apply manual traction in line with the long axis of the limb to decrease the deformity. This may restore the pulse, but if no pulse returns after one attempt, splint in the most comfortable position for the patient.

Q: What is a nightstick fracture?
A: This is a fracture on the shaft of the ulnaas a result of a direct blow.

Q: What are Colles fractures?
A: These are fractures of the distal radius, and are common in elderly patients with osteoporosis.

Q: What is "silver fork deformity"?
A: This is the distinctive appearance of a distal radius fracture.

Q: What is something you can do to alleviate swelling in extremity fractures?
A: In this situation, you can elevate the injured extremity above the heart.

Q: What is a common wrist injury?
A: A common one of these is the isolated, nondisplaced fracture of a carpal bone, especially the scaphoid.

Q: What is the position of function?
A: This is a hand position in which the wrist is slightly dorsiflexed and all finger joints are moderately flexed.

Q: What is the retroperitoneal space?
A: This is the space between the abdominal cavity and the posterior abdominal wall, containing the kidneys, certain large vessels, and parts of the gastrointestinal tract.

Q: What is an important consideration regarding pelvic fractures?
A: These types of injuries may be accompanied by life-threatening loss of blood from the laceration of blood vessels affixed to the pelvis at certain key points. Several liters of blood may drain into the pelvic space and the retroperitoneal space. You must take immediate steps to treat shock, even if there is only minimal swelling.

Q: When should you suspect a pelvic fracture?
A: You should suspect this injury whenever a patient has sustained a high-velocity injury and complains of discomfort in the lower back or abdomen (deformity or swelling may be difficult to see).

Q: How should you palpate the pelvis?
A: To perform this palpation:
1) Place the palms of your hands over the lateral aspect of each iliac crest, and apply firm but gentle inward pressure on the pelvic ring.
2) With the patient lying supine, place a palm over the anterior aspect of weach iliac crest, and apply firm downward pressure.
3) Use your palm to firmly but gently palpate the pubic symphysis. The area will be tender if there is injury to the anterior portion of the pelvic ring.

Q: What most commonly causes hip dislocations?
A: These are most commonly caused by automobile accidents in which the knee meets with a direct force, such as the dashboard.

Q: What is a frequent complication of posterior dislocation of the hip?
A: A frequent complication of this is injury to the sciatic nerve.

Q: What is the sciatic nerve?
A: This is the most important nerve in the lower extremity; it controls the activity of muscles in the posterior thigh and below the knee and the sensation in most of the leg and foot.

Q: What is a sign of sciatic nerve injury?
A: Decreased sensation in the leg and foot, and the characteristic "foot drop" are signs of this.

Q: In what position do patients with posterior dislocation of the hip typically lie?
A: This type of patient typically lie with the hip joint flexed and the thigh rotated inwards toward the midline of the body over the top of the opposite thigh.

Q: What are the three types of proximal femur fractures?
A: The three types of this injury are:
1) a fracture through the neck of the femur
2) the intertrochanteric (middle) region
and
3) across the proximal shaft of the femur (subtrochanteric fractures).

Q: What typically occurs following a femoral shaft fracture?
A: Following this type of injury, muscles spasm in an attempt to "splint" the unstable limb, causing significant deformity and shorterning of the limb.

Q: How many mL of blood can be lost as a result of a fracture of the femur shaft?
A: As much as 500 to 1,000 mL of blood can be lost as a result of this injury.

Q: Which knee ligaments are most frequently injured?
A: The ligaments on the medial side of this joint are most frequently injured, typically when the foot is fixed to the ground and the lateral aspect is struck by a heavy object.

Q: What should you do with all suspected knee ligament injuries?
A: You should always splint all suspected injuries of this type. If you encounter resistance or pain when trying to straighten the limb, splint in the flexed position.

Q: How significant are knee dislocations?
A: These are true emergencies that may threaten the limb.

Q: What is the most common type of knee dislocations?
A: Anterior dislocations, which results from extreme hyperextension, are the most common kind of this injury.

Q: What are some possible complications from knee dislocations?
A: Complications of this type of injury include limb-threatening popliteal artery disruption, injuries to the nerves, and joint instability.

Q: How should you splint a knee dislocation if the knee is bent and the foot has a good pulse?
A: In this situation, splint the joint in the bent position.

Q: What may medical control direct you to do on rare occasions with knee dislocations?
A: In this situation, medical control may direct you realigned a deformed, pulseless limb to reduce compression of the popliteal artery, thus restoring distal circulation.

Q: What is it easy to confuse fractures about the knee with/
A: These can frequently be confused with ligament injuries.

Q: What should you do if there is an adequate distal pulse and no significant deformity with a fracture about the knee?
A: In this situation, splint the limb with the knee straight.

Q: What should you do if there is an adequate distal pulse and significant deformity with a fracture about the knee?
A: In this situation, splint the joint in the position of deformity.

Q: What should you do if there is no pulse below the level of the injury?
A: In this situation, suspect possible vascular and nerve damage, and contact medical control immediately for further instructions.

Q: What should you do if you suspect a fractured knee?
A: With this injury, never use a traction splint.

Q: Where does the patella usually displace to?
A: This usually displaces to the lateral side.

Q: How should you splint the knee with a dislocated patella?
A: With this injury, splint the knee in which you found it often moderately flexed).

Q: How should you stabilize fractures of the tibia and fibula?
A: With these injuries, the bones should be stabilized with a padded, rigid long leg splint, or an air splint that extends from the foot to the upper thigh. Once splinted, the affected leg should be secured to the opposite leg.

Q: How should you generally manage the wide spectrum of injuries to the ankle?
A: Manage these types of injuries as follows:
1) Dress all open wounds
2) Assess distal neurovascular function
3) Correct any gross deformity by gently applying longitudinal traction to the heel
4) Before releasing traction, apply a splint.

Q: What bone is most commonly fractured in foot injuries?
A: The most common fractured bone in this situation is the calcaneus.

Q: What should you be aware of when a patient who has fallen from a height complains of heel pain?
A: In this situation, be aware of back pain complaints, and check the spine for tenderness and deformity.

Q: What should you remember remember when splinting an injured foot?
A: When doing this, remember to leave a toe exposed so you can check for a distal pulse.

Q: If you have a pediatric patient with a fracture below the elbow or knee, what might the following symptoms indicate: extreme pain, decreased pain sensation, pain on streching of affected muscles, and decreased power?
A: In this situation, these symptoms indicate that the pressure within a fascial compartment is elevated.

Q: What indicates a strain?
A: This type of injury often has no deformity and only minor swelling; some patients report a "snap" when a muscle tears and complain of increased sharp pain with passive movement of the injured extremity.

Q: What is the general treatment of strains and sprains?
A: Treatment of this injury includes the following:
1) Immobilize or splint the injured area
2) Ice or cold pack over the injury
3) Compression with an elastic bandage
4) Elevation
5) Reduced weight bearing
6) Pain management

Q: What usually causes sprains?
A: These are usually caused by a sudden twisting of a joint beyond its normal range of motion that also causes a temporary subluxation.

Q: What usually characterizes a sprain?
A: These are typically characterized by pain, swelling (edema) at the joint, discoloration over the injured joint, and point tenderness.

Q: What is one of the first signs of hypoperfusion?
A: One of the first signs of this is a change in mental status, such as anxiety, restlessness, or combativeness.

Q: What are the later signs of hypoperfusion suggesting internal bleeding?
A: Later signs of this include:
Tachycardia
Weakness, fainting, or dizziness at rest
Thirst
Nausea and vomiting
Cold, moist skin
Shallow, rapid breathing
Dull eyes
Slightly dilated pupils that are non-reactive to light
Capillary refill of more than 2 seconds in infants and children
Weak, rapid (thready) pulse
Decreasing blood pressure
Altered level of consciousness

Q: When dealing with multiple bleeding patients, what should you remember to do?
A: When doing this, remember to place several pairs of gloves in your pocket for easy access.

Q: What does a systolic blood pressure of less than 100 mg Hg with a weak, rapid pulse suggest?
A: This suggests the presence of hypoperfusion in a patient who may have significant bleeding.

Q: When the MOI is a fall from a ladder striking the head, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is a head injury or hematoma.

Q: When the MOI is a fall from a ladder striking the extremities, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is possible fractures, and also possible chest injuries.

Q: When the MOI is a child striking a car, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is head trauma, chest and abdominal injuries, and leg fractures.

Q: When the MOI is a fall onto an outstretched arm, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is possible bone fractures and joint injuries.

Q: When the MOI is a child thrown or falls from a height, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is head injury.

Q: When the MOI is an unrestrained driver in a head-on collision, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is head and neck, chest, abdominal injuries, and knee, femur, hip, or pelvis injuries.

Q: When the MOI is an unrestrained front-seat passenger or side-impact collision with intrusion into the vehicle, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is a broken humerus exposing the chest wall (possible flail chest), as well as pelvic and acetabulum injuries.

Q: When the MOI is an unrestrained driver crushed against the steering column, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is a chest or abdomen injury, a ruptured spleen, and neck trauma.

Q: When the MOI is a fall over the handlebars of a bike, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI are a fractured clavicle, road rash, and head trauma if there was no helmet.

Q: When the MOI is an abrupt motorcycle stop, and the patient went over the handlebars, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI are fractured femurs, and head or neck injuries.

Q: When the MOI is diving into the shallow end of a swimming pool, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI are head and neck injuries.

Q: When the MOI is an assault or fight, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is injury to the abdomen, chest, and face.

Q: When the MOI is a blast or explosion, what is a potential internal bleeding source?
A: A potential internal bleeding source from this MOI is: injury from direct strike with debris; an indirect pressure wave in an enclosed space; and, internally, air-containing organs, such as the middle of the ears and lungs, are the most susceptible to injury.

Q: With a patient with obvious external bleeding, what is the very least PPE needed?
A: With these patients, BSI includes at the very least gloves and eye protection, and often a mask and possibly a gown.

Q: What are the methods available to control external bleeding?
A: The most commonly used method to do this include:
1) Direct, even pressure and elevation
2) Pressure dressings and/or splints
and
3) Tourniquiets

Q: How long (minimum) should you hold uninterrupted pressure on an open wound to stop bleeding?
A: You should do this for at least 5 minutes.

Q: What is a pressure point?
A: This is a spot where a blood vessel lies near a bone.

Q: What is one way to assist in the body's natural clotting process?
A: One way to do this is to keep the patient as still and quiet as possible.

Q: What are the signs and symptoms of blunt or penetrating trauma to the neck?
A: Signs and symptoms of this are: Noisy or labored breathing, and swelling of the face or neck.

Q: What is the index of suspicion of blunt or penetrating trauma to the neck?
A: The index of suspicion of blunt or penetrating trauma to the neck is:
Significant bleeding or foreign bodies in the upper or lower airway, causing obstruction;
Be alert for airway compromise

Q: What are the signs and symptoms of significant chest wall, blunt trauma from motor vehicle crashes, car-versus-pedestrian accidents, other crashes, and penetrating trauma to the chest wall?
A: Signs and symptoms of this are: Significant chest pain, shortness of breath, and asymmetrical chest wall movement.

Q: What are the signs and symptoms of any significant blunt force trauma from motor vehicle crashes or penetrating injury?
A: Signs and symptoms of this are: Blunt or penetrating trauma to the neck, chest, abdomen, or groin, blows to the head sustained during motor vehicle crashes, falls, or other incidents, producing loss of consciousness, altered mental status, inability to recall events, combativeness, or changes in speech patterns, and difficulty moving extremities and headaches, especially with nausea and vomiting.

Q: What are the signs and symptoms of any significant blunt force trauma, falls from a significant height, or penetrating trauma?
A: Signs and symptoms of this are: Severe back and/or neck pain, a history of difficulty moving extremities, and loss of sensation or tingling in the extremities.

Q: What is the index of suspicion of significant chest wall, blunt trauma from motor vehicle crashes, car-versus-pedestrian accidents, other crashes, and penetrating trauma to the chest wall?
A: The index of suspicion of this is:
Cardiac or pulmonary contusion;
Pneumothorax or hemothorax;
Broken ribs, causing breathing compromise

Q: What is the index of suspicion of any significant blunt force trauma from motor vehicle crashes or penetrating injury?
A: The index of suspicion of this is:
Injuries in these regions may tear and cause damage to the large blood vessels located in these body areas, resulting in significant internal and external bleeding.
Be alert to the possibility of bruising to the brain and bleeding in and around the brain tissue, which may cause the development of excess pressure inside the skull around the brain.

Q: What is the index of suspicion of any significant blunt force trauma, falls from a significant height, or penetrating trauma?
A: The index of suspicion of this is:
Injury to the bones of the spinal column or to the spinal cord.

Q: What organ system is most sensitive to blast injuries?
A: The ear is the organ system most sensitive to this.

Q: What happens to the tympanic membrane when hit by a pressure wave?
A: This has evolved to detect minor chasnges in pressure and will rupture at pressures of 5 to 7 pounds per square inch above atmosphere pressure.

Q: What are pulmonary blast injuries?
A: These are defined as pulmonary trauma (consisting of contusions and hemorrhages) that results from short-range exposure to the detonation of explosives.

Q: What should you avoid with victims of blast injuries with suspected lung injury?
A: With these patients, avoid giving oxygen under positive pressure (that is by demand valve), because that may simply increase the damage to the lungs.

Q: What is an arterial air embolism?
A: This is one of the most concerning pulmonary blast injuries, and occurs on alveolar disruption with subsequent air embolization into the pulmonary vasculature. This can produce disturbances in vision, changes in behavior, changes in state of consciousness, and a variety of other neurologic signs.

Q: What are petechiae?
A: These are pinpoint hemorrhages that show up on the skin, and are the dominant form of pathology for hollow organs injured by blast pressure waves.

Q: What are the most common causes of death from blast injuries?
A: Neurologic injuries and head trauma are the most common causes of death from this.

Q: What can trigger instant but transient unconsciousness, with or without retrograde amnesia?
A: This can be triggered not only by head trauma, but also by cardiovascular problems.

Q: What is something to remember about body armor in blast injury treatment?
A: This may limit or prevent shrapnel from entering the body, but it also "catches" more energy from the blast wave, possibly resulting in the victim being thrown backward, thus increasing the potential for spine and spinal cord injury.

Q: What is multisystem trauma?
A: This is a term that describes a preson who has been subjected to multiple traumatic injuries involving more than one body system.

Q: What kind of care do most patients with multisystem trauma require?
A: With these patients, definitive care requires surgical intervention; therefore, on-scene time should be limited to 10 minutes or less; this is referred to as the "platinum 10 minutes".

Q: What can a crushing injury to the upper part of the neck cause?
A: This injury can cause the cartilages of the upper airway and larynx to fracture. The can lead to the leakage of air into the soft tissue of the neck.

Q: What is subcutaneous crepitation?
A: This is when air is trapped in subcutaneous tissue.

Q: What is the appropriate use of emergency air medical services for trauma patients?
A: This medical service is appropriate for the following situations:
1) There is an extended period required to access or extricate a remote or trapped patient.
2) The distance to the trauma center is greater than 20 to 25 miles
3) The patient needs medical care and stabilizatio at the ALS level, and there is no ALS-level ground ambulance service available within a reasonable time frame.
4) Traffice conditions or hospital availability make it unlikely that the patient will get to a trauma center.
5) There are multiple patients who will overwhelm resources at the trauma center reachable by ground.
6) EMS systems require bringing a patient to the nearest hospital for initial evaluation and stabilization.
7) There is a mass-casualty incident.

Q: What key elements are in a Level I trauma center?
A: Key elements of this are:
1) 24 hour in-house coverage by general surgeons
2) Availability of care in specialties such as orthopaedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, and critical care
3) Should also include cardiac, hand, pediatric, and microvascular surgery and hemodialysis.
4) Provides leadership in prevention, public education, and continuing education of trauma team members.
5) Committed to continued improvement through a comprehensive quality assessment program and organized research to help direct new innovations in trauma care.

Q: What key elements are in a Level II trauma center?
A: Key elements of this are:
1) 24 hour in-house coverage by general surgeons
2) Availability of care in specialties such as orthopaedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, and critical care
3) Committed to trauma prevention and continuing education of trauma team members.
4) Provides continued improvement in trauma care through a comprehensive quality assessment program.

Q: What key elements are in a Level III trauma center?
A: Key elements of this are:
1) 24 hour in-house coverage by general surgeons
2) Committed to continued improvement through a comprehensive quality assessment program
3) Has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level iI trauma center.
4) Committed to continuing education of nursing and allied health personnel or the trauma team.
5) Must be involved with prevention and have an active outreach program for its referring communities.

Q: What key elements are in a Level IV trauma center?
A: Key elements of this are:
1) Include basic emergency department facilities to implement ATLS protocols and 24-hour laboratory coverage.
2) Transfer to higher level trauma centers follows the guidelines outlined in formal transfer agreements.
3) Committed to continued improvement of these trauma care activities through a formal quality assessment program.
4) Involved in prevention, outreach, and education within its community.

Q: What is a trauma score?
A: This is a way to calcualte a number from 1 to 16, that accurately evaluates the extent of trauma in a patient.

Q: In the Glasgow Coma Scale, how do you rate eye opening?
A: For this evaluation:
4 - Spontaneous
3 - To Voice
2 - To Pain
1 - None

Q: In the Glasgow Coma Scale, how do you rate verbal response?
A: For this evaluation:
5 - Oriented
4 - Confused
3 - Inappropriate Words
2 - Incomprehensible Words
1 - None

Q: In the Glasgow Coma Scale, how do you rate motor response?
A: For this evaluation:
6 - Obeys Commands
5 - Localizes Pain
4 - Withdraws (pain)
3 - Flexion (pain)
2 - Extension (pain)
1 - None

Q: What is the American College of Surgeons' Criteria for a Level I Patient?
A: Criteria for this are:
1) Confirmed blood pressure of less than 90 mg Hg at any time in adults, and age-specific hypotension in children.
2) Respiratory compromise, obstruction, and/or intubation
3) Receiving blood to maintain vital signs
4) Emergency physician's discretion
5) Glasgow Coma Scale (GCS) score of less than or equal to 8 with mechanism attributed to trauma
6) Gunshot wound to the abdomen, neck, or chest.

Q: What are the primary female reproductive organs?
A: These are the ovaries.

Q: How many ovum are produced each month?
A: Each ovary produces an ovum in alternating months and releases it into the fallopian tube.

Q: What is the term for when the ovum is released?
A: This is called ovulation.

Q: What are the fallopian tubes?
A: These connect each ovary with the uterus and are the primary location for fertilization of the ovum.

Q: What is the uterus?
A: This is the muscular organ where the fetus grows during pregnancy.

Q: What is the cervix?
A: This is the narrowest and lowest portion of the uterus, and opens into the vagina.

Q: What is the vagina?
A: This is the outermost cavity of a woman's reproductive system and forms the lower part of the birth canal. It is about 8 to 12 cm in length.

Q: What are the labia majora and labia minora?
A: These are folds of tissue that surround the urethral and vaginal openings.

Q: What is the perineum?
A: This is the area of skin between the vagina and the anus.

Q: What is pelvic inflammatory disease (PID)?
A: This is an infection of the female upper organs of reproduction (uterus, ovaries, and fallopian tubes) that occurs almost exclusively in sexually active women.

Q: What is an ectopic pregnancy?
A: This is a pregnancy that develops outside the uterus, most often in the fallopian tubes.

Q: What are the common presenting signs of PID?
A: Common signs of this include:
Lower abdominal pain
Abnormal and foul-smelling vaginal discharge
Increased pain with intercourse
Fever
General Malaise
Nausea and vomiting

Q: What is chlamydia?
A: This is a common sexually transmitted disease, affecting an estimated 2.8 million Americans each year. Symptoms include lower abdominal pain, low back pain, nausea, fever, pain during intercourse, and/or bleeding between menstrual periods.

Q: What is bacterial vaginosis?
A: This is one of the most common conditions to afflict women. Symptoms may include itching, burning, or pain.

Q: What is gonorrhea?
A: This is caused by Neisseria gonorrhoeae. Symptoms, which are generally more severe in men than in women, appear in approximately 2 to 10 days after exposure, and include painful urination, burning or itching, yellowish or bloody discharge, and blood associated with vaginal intercourse.

Q: What should you determine if a female patient has vaginal bleeding?
A: If she has this, determine how many pads she is using per hour.

Q: How should you intervene if the patient has vaginal bleeding?
A: In this situation, the patient should be treated for hypoperfusion or shock. Keep her warm, place her in a supine position with her legs elevated, and provide her with supplemental oxygen even if she is not experiencing difficulty breathing, then promptly transport.

Q: What should you remember about external genital injuries?
A: These have a rich nerve supply, making injuries very painful. Treat any external lacerations, abrasions, and tears with moist, sterile compresses, using local pressure to control bleeding and a diaper-type bandage to hold the dressings in place.

Q: What kind of pain will a patient with PID complain about?
A: A patient with this kind of PID will complain of abdominal pain. The pain generally starets during or after normal menstruation. The pain may be described as "achy" and may be made worse by walking. Other symptoms may include vaginal discharge, fever and chills, and pain or burning on urination.

Q: What percentage of women are raped in the US?
A: One in three are raped in their lifetimes.

Q: What percentage of women will be sexually molested in their lifetimes?
A: One in every four will be sexually molested, often before the age of 12.

Q: What special treatment principles should be applied to patients who have been sexually assaulted?
A: In addition to the usual treatment principles, in this situation you should also:
1). Document the patient's history, assessment, treatment, and response to treatment in detail because you may have to appear in court as long as 2 or 3 years later. Do not speculate. Record only the facts.
2) Make airway maintenance a major priority.
3) Complete the SAMPLE history objectively.
4) Follow any crime scene policy established by your system to protect the scene and any potential evidence for police, particularly that for evidence collection. If the patient will tolerate being wrapped in a sterile burn sheet, this may help investigators to find any hair, fluid, or fiber from the alleged offender.
5) Do not examine the genitalia unless there is major bleeding. If an object has been inserted into the vagina or rectum, do not attempt to remove it.
6) To reduce the patient's anxiety, make sure the EMT is the same sex as the patient, whenever possible.
7) Discourage the patient from bathing, voiding, or cleaning any wounds until the hospital staff has completed an assessment. Handle the patient's clothes as little as possible, placing articles and any other evidence in paper bags. If the patient insists on urinating, ask the patient to do so in a sterile urine container (if available). Also, deposit the toilet paper in a paper bag. Seal and mark the bag for the police. This can be critical evidence.

Q: What can cause a psychological or behavioral crisis?
A: These can be the result of the emergency situation, mental illness, mind-alternating substances, stress, or many other causes.

Q: What is the code for a psychiatric emergency?
A: This is referred to as a section 12.

Q: What is behavior?
A: This is what you can see of a person's response to the environment: his or her actions.

Q: What is a behavioral crisis?
A: This is any reaction to events that interferes with the activities of daily living or has become unacceptable to the patient, family, or community.

Q: How long a period does an abnormal or disturbing pattern last before it is regarded as a matter of concern from a mental health standpoint?
A: This is regarded as a matter of concern from a mental health standpoint if it lasts for at least a month.

Q: What is chronic depression?
A: This is a persistent feeling of sadness and despair, and may be a symptom of a mental or physical disorder.

Q: What is a psychiatric emergency?
A: This is an emergency in which abnormal behavior threatens a person's own health and safety or the health and safety of another person, for example when a person becomes suicidal, homicidal, or has a psychotic episode.

Q: What is a psychiatric disorder?
A: This is an illness with psychological or behavioral symptoms that may result in impaired functioning.

Q: According to the National Institute of Mental Health, however many Americans have some type of psychiatric disorder?
A: According to this institute, one in five Americans has some type of psychaitric disorder.

Q: What are some underlying causes of psychiatric disorders?
A: Some underlying causes of this include:
social and situational stress such as divorce or death of a loved one,
psychiatric diseases such as schizophrenia,
physical illnesses such as diabetic emergencies,
chemical problems such as alcohol or drug use,
or biologic disturbances such as electrolyte imbalances.

Q: What are the two basic categories of diagnosis that a physician will use for a behavioral crisis or psychiatric emergency?
A: A physician will diagnosis these as either organic (physical) or functional (psychological).

Q: What is organic brain syndrome?
A: This is a temporary or permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain tissue.

Q: What are some causes of organic brain syndrome?
A: Some causes of this include:
sudden illness
recent trauma to the head
seizure disorders
drug and alcohol intoxication, overdose, or withdrawal
and diseases of the brain, such as Alzheimer disease and meningitis.

Q: What is altered mental status?
A: This can arise from a low level of blood glucose, lack of oxygen, inadequate blood flow to the brain, and excessive heat or cold.

Q: What is a functional disorder?
A: This is one in which the abnormal operation of an organ cannot be traced to an obvious change in the actual structure or physiology of the organ or organ system.

Q: What are some examples of psychiatric disorders?
A: Some examples of this include schizophrenia, anxiety conditions, and depression.

Q: What are some safety guidelines for a behavioral crisis or a psychiatric emergency?
A: Safety guidelines for these include:
1) Be prepared to spend extra time
2) Have a definite plan of action
3) Identify yourself calmly
4) Be direct
5) Assess the scene
6) Stay with the patient
7) Encourage purposeful movement (getting dressed, packing for the hospital, etc.)
8) Express interest in the patient's story
9) Do not get too close to the patient
10) Avoid fighting with the patient
11) Be honest and reassuring
12) Do not judge

Q: When trying to determine the reason for the patient's behavioral state, what 3 major areas should be considered as possible contributors?
A: 3 major areas to consider as possible contributors to this should be:
1) Is the patient's central nervous system functioning properly?
2) Are hallucinogens or other drugs or alcohol a factor?
3) Are psychogenic circumstances, symptoms, or illness (caused by mental rather than physical factors) involved?

Q: In geriatric patients, what should you consider as a possible cause of abnormal behavior?
A: With these patients, you should consider Alzheimer disease as a possible cause of abnormal behavior.

Q: When dealing with psychiatric emergencies, what two primary goals does the SAMPLE assessment have?
A: This has two primary goals: recognizing major threats to life and reducing the stress of the situation as much as possible.

Q: When assessing a patient in a psychiatric emergency or behavioral crisis, what can be very useful?
A: In this situation, it can be very useful to gather information separately from a relative or caregiver.

Q: What is psychosis?
A: This is a state of delusion in which the person is out of touch with reality.

Q: What are some of reasons psychotic episodes occur?
A: These occur due to:
The use of mind-altering substances
Intense stress
Delusional disorders
Schizophrenia

Q: What are some symptoms of schizophrenia?
A: Some symptoms of this include delusions, hallucinations, a lack of interest in pleasure, and erratic speech.

Q: What guidelines should you follow when dealing with a psychotic patient?
A: When dealing with these patients, you should
Determine if the situation is a danger to yourself or others
Identify yourself clearly
Be calm, direct, and straightforward
Maintain an emotional distance. Do not touch the patient, and do not be overly friendly or effusively reassuring.
Do not argue.
Explain what you would like to do.
Involve people the patient trusts, such as family or friends, to gain patient cooperation.

Q: When the patient has risk factors associated with suicide, what warning signs should you be alert to?
A: When dealing with these patients, be alert for the following warning signs:
Does the patient have an air of tearfulness, sadness, deep despair, or hopelessness?
Does the patient avoid eye contact, speak slowly or haltingly, and give off a sense of vacancy?
Does the patient seem unable to talk about the future?
Is there any suggestion of suicide?
And,
Does the patient have any specific plans relating to death?

Q: What percentage of successful suicides are preceded by at least one attempt?
A: About 80% of these were preceded by at least one attempt.

Q: What group is particularly at risk of suicide?
A: Men who are older than 55 and are single, widowed, divorced, alcoholic, or depressed, have an especially high risk and are very often successful if they make an attempt.

Q: What is agitated delirium?
A: This is a condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions combined with restlessness or irregular physical activity.

Q: What are some common physical symptoms of agitated delirium?
A: Common physical symptoms include hypertension, tachycardia, diaphoresis, and dilated pupils.

Q: What does a section 35 code mean?
A: This is code for an under-the-influence situation.

Q: Should you err on the side of treatment or refusal when dealing with patients who deny treatment?
A: In this situation, err on the side of treatment and transport. It is far easier to defend yourself against charges of battery than it is to justify abandonment.

Q: What should you ALWAYS do before restraining a patient?
A: Before doing this, you should ALWAYS consult medical control and contact law enforcement.

Q: How many people should be present to carry out the restraint?
A: At least four people should be present.

Q: What percentage of violent attacks does depression account for?
A: This accounts for 20% of violent attacks.

Q: What is a seizure?
A: This is a temporary alteration in consciousness.

Q: What is a generalized seizure?
A: This is typically characterized by unconsciousness and a generalized severe twitching of all of the body's muscles that lasts several minutes or more. It results from abnormal discharges from large areas of the brain, usually involving both hemispheres.

Q: What is an absence seizure?
A: This is characterized by a brief lapse of consciousness in which the patient seems to stare and not to respond to anyone. It was formerly called a petit mal.

Q: What is a partial seizure?
A: This begins in one part of the brain and is classified as simple or complex.

Q: What is a simple partial seizure?
A: In this, there is no change in the patient's level of consciousness. Patients may complain of numbness, weakness, or dizziness. They may report visual changes and unusual smells or tastes. Twitching of extremities and brief paralysis are also possible.

Q: What is a complex partial seizure?
A: In this, the patient has an AMS. This results from abnormal discharges from the temporal lobe of the brain. Other characteristics may be lip smacking, eye blinking, isolated convulsions. Unpleasant smells, visual halluncinations, uncontrollable fear, repetitive physical behavior are also possible.

Q: What is an aura?
A: This is something a patient may experience prior to an seizure as a warning.

Q: What is a tonic phase?
A: This may occur right before a seizure, usually lasting only a few seconds, and involves constant muscle contraction and trembling, tongue biting, and bladder and/or bowel incontinence.

Q: What is a tonic-clonic seizure?
A: In this, the patient may exhibit bilateral movement characterized by muscle rigidity and relaxation usually lasting 1 to 3 minutes. During this, the patient exhibits tachycardia, hyperventilation, sweating, and intense salivation.

Q: How long do most seizures last?
A: These usually last 3 to five minutes.

Q: What is a postictal state?
A: This is a lengthy period (5 to 30 minutes) immediately following a seizure. The patient gradually regains consciousness, and the state is over when the patient regains a complete return of his or her normal level of consciousness.

Q: What is status epilepticus?
A: This condition is when seizures continue every few minutes without the person regaining consciousness or last longer than 30 minutes.

Q: What are some causes of seizures?
A: These include high fever, structural problems in the brain, or metabolic or chemical problems in the body.

Q: What are some medications for controlling seizures?
A: Some examples of these medications are phenytoin (Dilantin), phenobarbital, or carbamazepine (Tegretol).

Q: What is a cause of epileptic seizures?
A: One cause of these is congenital.

Q: What are some causes of structural seizures?
A: Some causes of these include: Tumors, infections, scar tissue from injury, head trauma, and strokes.

Q: What are some causes of metabolic seizures?
A: Some causes of these include: Hypoxia, abnormal blood chemical values, hypoglycemia, poisoning, drug overdose, and sudden withdrawal from alcohol or medications.

Q: What is a cause of febrile seizures?
A: This is caused by a sudden high fever. They are generally well tolerated by children, but transport to a hospital is necessary.

Q: What is a result of the constant muscle contraction during a seizure?
A: A result of this is that the muscles use a lot of oxygen. There is therefore a buildup of acids in the bloodstream, and the patient may turn cyanotic from lack of oxygen.

Q: What might a seizure cause in a diabetic patient?
A: In these kinds of patients, the blood glucose value may drop because of excessive muscular contraction of a seizure.

Q: What is one clue that an unconscious or confused patient may have had a seizure?
A: One clue that an unconscious or confused patient may have had one of these is to find that they were incontinent.

Q: What happens during the postictal state?
A: During this state, muscles become flaccid, breathing becomes labored in an attempt to compensate for the buildup of acids in the bloodstream.

Q: What is hemiparesis?
A: This is weakness on one side of the body, resembling a stroke.

Q: What is one way to differentiate between a patient who has had a stroke, and a hypoglycemic patient?
A: One way to differentiate between these two kinds of patients is:
A patient who has had a stroke may be alert and attempting to communicate normally, whereas a patient with hypoglycemia almost always has an altered or decreased level of consciousness.

Q: When should you especially consider hypoglycemia in a patient who has had a seizure?
A: You should especially consider this in the seizure patient if they have a history of diabetes.

Q: Is AMS a symptom or a disease?
A: Remember this is a symptom, not a disease.

Q: What are the Tips of the Vowels (for reviewing possible causes of AMS)?
A: T Trauma
I Infection
P Psychogenic causes
S Seizure / Syncope
A Alcohol
E Electrolytes
I Insulin
O Opiates
U Uremia (Toxic condition from kidney disease)

Q: What is the optimal treatment window for stroke victims?
A: The optimal treatment for this kind of patient is 3 hours.

Q: What does CT stand for?
A: This stands for computed tomography, and blood is easy to see on these scans.

Q: Why is it important to recognize a patient as a "stroke alert" and warn the hospital staff ASAP?
A: This is important because most hospitals do not have CT technicians available 24 hours a day.

Q: In the Glasgow coma scale, what are the 4 levels of eye opening?
A: They are:
4 Spontaneous
3 In reponse to speech
2 In reponse to pain
1 None

Q: In the Glasgow coma scale, what are the 4 levels of verbal response?
A: 5 Oriented conversation
4 Confused conversation
3 Inappropriate words
2 Incomprehensible sounds
1 None

Q: In the Glasgow coma scale, what are the 4 levels of motor response?
A: 6 Obeys commands
5 Localizes pain
4 Withdraws to pain
3 Abnormal flexion
2 Abnormal extension
1 None

Q: In the Cincinnati Prehospital Stroke Scale, what are the normal and abnormal results of the facial droop test (ask patient to show teeth or smile)?
A: Normal: Both sides of face move easily well.
Abnormal: One side of the face does not move as well as other.

Q: In the Cincinnati Prehospital Stroke Scale, what are the normal and abnormal results of the arm drift test (ask patient to close eyes and hold both arms out with palms up)?
A: Normal: Both arms move the same, or both arms do not move.
Abnormal: One arm does not move, or one arm drifts down compared with the other side.

Q: In the Cincinnati Prehospital Stroke Scale, what are the normal and abnormal results of the speech test (ask patient to say "the sky is blue in Cincinnati)?
A: Normal: Patient uses correct words with no slurring.
Abnormal: Patient slurs words, uses inappropriate words, or is unable to speak.

Q: According to the American Heart Association, how many Americans died of cardiovascular disease in 2017?
A: 868,662 Americans died of this disease in 2017.

Q: What percentage of deaths in America is caused by cardiovascular disease?
A: 35.5% of all deaths in America is caused by this.

Q: What divides the heart down the middle?
A: It is divided by a wall called the septum.

Q: What is the atrium?
A: This is the upper chamber of the heart that receives incoming blood.

Q: What is the ventricle?
A: This is the lower chamber of the heart, and pumps out the outgoing blood.

Q: What is the aorta?
A: This is the body's main artery, and it receives the blood ejected from the left ventricle and delivers it to all the other arteries.

Q: What does the right side of the heart do?
A: This side of the heart receives deoxygenated blood from the veins of the body, through the vena cava. After contraction of the ventricle on this side, blood flows into the pulmonary artery where the blood is oxygenated.

Q: How does the oxygenated blood return to the heart?
A: This returns to the heart through the pulmonary veins to the left side of the heart.

Q: What is automaticity?
A: This is a special characteristic foubd in cardiac muscle cells. It allows a cardiac muscle cell to contract spontaneously without stimulus from a nerve-source.

Q: What is the autonomic nervous system?
A: This is the part of the brain that controls the functions of the body that do not require conscious thought, such as the heartbeat, respirations, dilation and constriction of blood vessels, and digestion of food. It has two parts: The sympathetic nervous system and the parasympathetic nervous system.

Q: What does the sympathetic nervous system do?
A: This speeds up the heart rate, increases respiratory rate and depth, dilates blood vessels in the muscle, and constricts blood vessels in the digestive system.

Q: What does the parasympathetic nervous system do?
A: This directly opposes the other system, it slows the heart and respiratory rates, constricts blood vessels in the muscles, and dilates blood vessels in the digestive system.

Q: What is the mycardium?
A: This is heart muscle, and must have a continuous supple of oxygen and nutrients.

Q: What is stroke volume?
A: This is the volume of blood ejected with each ventricular contraction.

Q: What are coronary arteries?
A: These are blood vessels that supply blood to the heart muscle.

Q: What is occlusion?
A: This is another term for blockage.

Q: What is lumen?
A: This is the inside diameter of the artery. It narrows as a person ages.

Q: Where can the posterior tibial pulse be felt?
A: This can be felt on the inside of the ankle.

Q: Where can the dorsalis pedis pulse be felt?
A: This can be felt at the top of the foot.

Q: Where can the brachial pulse be felt?
A: This can be felt on the inside of the upper arm.

Q: What is a thromboembolism?
A: This is a blood clot that is floating through blood vessels until it reaches an area too narrow for it to pass.

Q: What is an acute myocardial infarction (AMI)?
A: This is a blockage that occurs in a coronary artery, and is also known as a heart attack.

Q: What is cardiac arrest?
A: This is the complete stopage of the heart, caused by infarction, or death of heart tissue. It is determined by the absence of a palpable pulse at the carotid artery.

Q: What is acute coronary syndrome (ACS)?
A: This describes a group of symptoms caused by myocardial ischemia, or a decrease blood flow to the heart, which leads to chest pain.

Q: What is angina pectoris?
A: This is when, for a brief time, heart tissues are not getting enough oxygen. It is often a symptom of atherosclerotic coronary artery disease.

Q: Why is fast action so critical in treating an A.M.I. (A.K.A. a heart attack)?
A: Fast action is critical in treating this because once dead, heart muscle tissue cannot be revived. Instead, they turn into scar tissue and become a burden to the beating heart.

Q: What is the timeline for an AMI?
A: During this, 30 minutes after blood flow is cut off, some cells begin to die. After 2 hours, as many as half. After 4-6, more than 90%.

Q: What are the signs and symptoms of AMI?
A: Signs and symptoms of this include:
Sudden onset fo weakness, nausea, and sweating without an obvious cause.
Chest pain, discomfort, or pressure that is often crushing or squeezing and that does not change with each breath.
Pain, discomfort, or pressure in the lower jaw, arms, back, abdomen, or neck.
Irregular heartbeat and syncope.
Shortness of breath, or dyspnea
Pink, frothy sputum
Sudden death

Q: How is the pain of an AMI different from the pain of angina?
A: It is different from angina in three ways:
It can occur during exercise OR when a person is sitting quietly or even sleeping.
It does not resolve in a few minutes; rather, it can last between 30 minutes and several hours.
It may or may not be relieved by rest or nitroglycerin.

Q: What are the physical findings of AMI?
A: These are:
Nausea, vomiting, sweating, pale skin, possible cyanosis, irregular or even a slowing of the pulse, bradycardia if the inferior portion of the heart has been damaged, difficulty breathing, and an impending sense of doom.

Q: What is an arrhythmia?
A: This is an abnormality of heart rhythm, whereby the heart is using up energy without pumping any blood. It is also known as ventricular fibrillation.

Q: What is tachycardia?
A: This is rapid beating of the heart, 100 BPM or higher.

Q: What is bradycardia?
A: This is unusually slow beating of the heart, 60 BPM or less.

Q: What is ventricular tachycardia?
A: This occurs when electrical activity starts in the ventricle instead of the atrium, causing a rapid heart rate of 150-200 BPM. Blood pressure falls, pulse drops, and may deteriorate into ventricular defibrillation.

Q: What is congestive heart failure
?
A: This is when the ventricular heart muscle is so damaged that it can no longer keep up with the return flow of blood from the atria. Blood backs up in the pulmonary veins, increasing pressure in the capillaries of the lungs and forcing water into the alveoli, causing pulmonary edema.

Q: What is dependent edema?
A: This is the collection of fluid in the part of the body that is closest to the ground.

Q: What is a hypertensive emergency?
A: This is when the systolic pressure is greater than 160 mm Hg.

Q: What is an aortic aneurysm?
A: This is a weakness in the wall of the aorta, making it susceptible to rupture.

Q: What is a dissecting aneurysm?
A: This occurs when the inner layers of the aorta become separated, allowing blood to flow between the layers.

Q: What is special consideration for atheltic patients?
A: These patients tend to have slower heart rates at rest.

Q: What is the difference between AMI and dissecting aneurysm regarding the onset of pain?
A: The difference between the two is:
AMI: Gradual, with additional symptoms.
Dissecting Aneurysm: Abrupt, without additional sympoms.

Q: What is the difference between AMI and dissecting aneurysm regarding the quality of pain?
A: The difference is:
AMI: Tightness or pressure
Dissecting aneurysm: Sharp or Tearing

Q: What is the difference between AMI and dissecting aneurysm regarding the severity of pain?
A: The difference is:
AMI: Increases with time
Dissecting aneurysm: Maximal from the outset

Q: What is the difference between AMI and dissecting aneurysm regarding the timing of pain?
A: The difference is:
AMI: May wax and wane
Dissecting Aneurysm: Does not abate once it has started

Q: What is the difference between AMI and dissecting aneurysm regarding the region/radiation of pain?
A: The difference is:
AMI: Substernal; back rarely involved
Dissecting Aneurysm: Back possibly involved, between the shoulder blades

Q: What is the difference between AMI and dissecting aneurysm regarding clinical signs?
A: The difference is:
AMI: Peripheral pulses equal
Dissecting Aneurysm: Blood pressure discrepancy between arms or decrease in femoral or carotid pulse.

Q: What is dyspnea?
A: Shortness of breath or difficulty breathing

Q: What structures make up the upper airway?
A: This consists of the nose, mouth, jaw, oral cavity, pharynx, and larynx.

Q: What divides the upper and lower airway?
A: These are divided by the larnyx.

Q: What is carbon dioxide retention?
A: This is the failure of the respiratory center in the brain to respond normally to a rise in arterial levels of carbon dioxide.

Q: What is the normal breathing rate of an adult patient?
A: This is 12-20 BPM.

Q: What are the signs and symptoms of asthma?
A: Signs and symptoms of this include:
Wheezing on inspiration / expiration
Bronchospasm

Q: What are the signs and symptoms of anaphylaxis?
A: Signs and symptoms include:
Flushed skin or hives
Generalized edema
Decreased blood pressure
Laryngeal edema with dyspnea

Q: What are the signs and symptoms of bronchitis?
A: Signs and symptoms include:
Chronic cough
Wheezing
Cyanosis
Productive cough

Q: What are the signs and symptoms of congestive heart failure?
A: Signs and symptoms include:
Dependent edema
Rales
Paroxysmal nocturnal dyspnea

Q: What are the signs and symptoms of croup?
A: Signs and symptoms include:
Fever
Barking cough
Mostly seen in pediatric patients

Q: What are the signs and symptoms of emphysema?
A: Signs and symptoms include:
Barrel chest
Pursed lip breathing
Dyspnea on exertion

Q: What are the signs and symptoms of pneumonia?
A: Signs and symptoms include:
Dyspnea
Chills, fever
Cough
Dark sputum

Q: What are the signs and symptoms of pneumothorax?
A: Signs and symptoms include:
Sudden chest pain with dyspnea
Decreased lung sounds/affected side

Q: What are the signs and symptoms of pulmonary embolism?
A: Signs and symptoms include:
Sharp, pinpoint pain
Dyspnea
Sudden onset
After childbirth or surgery

Q: What are the signs and symptoms of tension pneumothorax?
A: Signs and symptoms include:
Progressive shortness of breath
Increasing altered level of consciousness
Neck vein distention
Tracheal deviation

Q: What are the signs and symptoms of pertussis?
A: Signs and symptoms include:
Coughing spells
"Whooping" sound
Fever
Mostly seen in pediatric patients

Q: As you treat patients with disorders of the lungs, what situations should you be aware of?
A: While treating these kinds of patients, be aware of these situations:
Gas exchange between alveoli and pulmonary circulation is obstructed by fluid in the lung, infection, or collapsed alveoli (atelectasis)
The alveoli are damaged and cannot transport gases properly across their own walls
The air passages are obstructed by muscle spasm, mucus, or weakened floppy airway walls
Blood flow to the lungs is obstructed by blood clots
The pleural space is filled with air or excess fluid, so the lungs cannot properly expand

Q: What is atelectasis?
A: This is the collapse of the alveolar space in the lungs.

Q: What are the characteristics of bronchitis?
A: Characteristics of this are:
An acute or chronic inflammation of the air passages (bronchi and bronchioles) often due to infection, usually associated with productive cough, and usually presents without fever
Accumulation of fluid within the air passages, as well as swelling of the walls, resticts air flow and may lead to signs of asthma such as wheezing. It is often associated with rhonchi. Crackles are not usually present unless pneumonia has developed.
The breathing pattern in bronchitis does not indicate major airway obstruction, but the patient may experience tachypnea, an increase in the breathing rate, which is an attempt to compensate for the reduced amount of normal lung tissue and for the buildup of fluid.

Q: What is the pathophysiology of the common cold?
A: A viral infection usually associated with swollen nasal mucous membranes and the production of fluid from the sinuses and nose.

Q: What are the characteristics of TB?
A: Characteristics of this are:
A disease that can lay dormant in a person's lungs for decades, then reactivate.
Dangerous because many TB strains are resistant to many antibiotics.
Spread by cough. Droplet nuclei can remain intact for decades.
Use a high-efficiency air particulate, or HEPA, respirator.

Q: What are the characteristics of diphtheria?
A: Characteristics of this are:
Highly contagious and serious when it occurs
The formation of diphtheritic membrane lining the pharynx that is composed of debris, inflammatory cells, and mucus. This membrane can rapidly and severely obstruct the passage of air into the larynx.

Q: What are the characteristics of epiglottitis?
A: Characteristics of this are:
An inflammation of the epiglottis due to bacterial infection that can produce severe swelling of the flap over the larynx.
Can swell to two or three times its normal size, especially in young children.
The airway may become almost completely obstructed, sometimes quite suddenly.
Stridor (harsh, high-pitched, continued rough, barking inspiratory sounds) may be heard late in the development of airway obstruction.
Characterized in adults by a severe sore throat.

Q: What is the pathophysiology of croup?
A: Inflammation and swelling of the whole airway (pharynx, larynx, and trachea) typically seen in children 6 months - 3 years old.
Rarely seen in adults because that airways are larger.

Q: What is the pathophysiology of respiratory syncytial virus?
A: Causes an infection of the lungs and breathing passages; can lead to other serious illnesses that affect the lungs or heart, such as bronchiolitis and pneumonia.
Highly contagious and spread through droplets

Q: What is the pathophysiology of pertussis?
A: An airborne bacterial infection that affects mostly children younger than 6 years.
Highly contagious through droplet infection.
Does not cause the typical whooping illness in adults. It causes a severe upper respiratory infection that could be an entry pathway to pneumonia in older people.

Q: What are the characteristics of Severe Acute Respiratory Syndrome (SARS)?
A: Characteristics of this are:
A serious, potentially life-threatening viral infection caused by a recently discovered family of viruses best known as the second most common cause of the common cold.
Usually starts with flu-like symptoms, and may progress to pneumonia, respiratory failure, and, in some cases, death.
SARS is thought to be transmitted primarily by close person-to-person contact.

Q: What are the characteristics of Influenza type A?
A: Characteristics of this are:
A virus that has crossed the animal/human barrier and has infected humans.
A flu that has the potential to spread at a pandemic level.

Q: What are the characteristics of Meningococcal meningitis?
A: Characteristics of this include:
An inflammation of the meningeal coverings of the brain and spinal cord that can be highly contagious.
The bacteria can be spread through the exchange of respiratory and throat secretions through coughing and sneezing.
The effects are lethal in some cases. Victims who survive can be left with brain damage, hearing loss, or learning disabilities.
Patients may present with flulike symptoms, but unique to this are high fever, severe headache, photophobia, and a stiff neck in adults. Patients soemtimes have an altered level of consciousness and can have red blotches on skin.
Use respiratory protection, and report and potential cases.

Q: What is pulmonary edema?
A: This is a build up of fluid between the alveoli and the pulmonary capillaries, which interferes with the exchange of carbon dioxide and oxygen. It can result from heart muscle so injured after a heart attack or other illness that it cannot circulate blood properly; in these cases, the left side of the heart cannot remove blood from the lung as fast as the right side delivers it. Patients with this usually experience dyspnea with rapid, shallow respirations, or frothy pink sputum at the nose in mouth in severe cases.

Q: What is chronic obstructive pulmonary disease (COPD)?
A: The is the slow process of dilation and disruption of the airways and alveoli caused by chronic bronchial obstruction. An estimated 12.1 million adults are reported to have this disease, and is the fourth leading cause of death.

Q: What is chronic bronchitis?
A: This is an ongoing irritation of the trachea and bronchi; excess mucus obstructs small airways and alveoli. This can lead to right-sided heart failure and fluid retention, such as edema in the legs.

Q: What is emphysema?
A: This is a loss of the elastic material around the air spaces as a result of chronic stretching of the alveoli when inflamed airways (due to smoking for example) obstruct easy explusion of gases.

Q: What are the characteristics of COPD?
A: Characteristics of this are:
A disease of the lung characterized by shortness of breath and wheezing.
Home oxygen, bronchodilators, and steroids for treatment.
Breathing progressively worse over time.
Usually in long-term smokers
Shortness of breath mostly on exertion
Chronic coughing
Sputum may be thick
No jugular vein distention or dependent edema
Patient usually thin with a barrel chest

Q: What are the characteristics of congestive heart failure?
A: Characteristics of this are:
A disease of the heart characterized by shortness of breath, edema, and weakness.
Diuretics prescribed to help promote cardiac function and to reduce fluid loads on the heart.
Sudden onset of shortness of breath.
Patient may or may not smoke.
Shortness of breath all the time.
Coughing
Sputum may be pink and frothy.
Jugular vein distention and dependent edema.
May have distended abdomen.

Q: What is the sequence of events in anaphylaxis?
A: The sequence of events for this is:
A. The antigen is introduced to the body.
B. The antigen-antibody reaction at the surface of a mast cell.
C. Release of a cell chemical mediators.
D. Chemical mediators exert their effects on end organs.

Q: What is pneumothorax?
A: This is a partial or complete accumulation of air in the pleural space. It is often caused by trauma.

Q: When may spontaneous pneumothorax occur?
A: This tends to occur in patients with certain chronic lung infections or in young people born with weak areas of the lung, and often during severe coughing.

Q: What is pleuritic chest pain?
A: This is a sharp, stabbing pain on one side that is worse during inspiration and expiration or with certain movements of the chest wall.

Q: What is a pleural effusion?
A: This is a collection of fluid outside the lung on one or both sides of the chest. Patients will have decreased lung sounds and will feel better sitting upright.

Q: What is a tonic-clonic seizure?
A: This, also called a grand mal seizure, is one in which the patient has a sudden loss of consciousness, rapid muscle movement of the body, and often incontinence. This type of seizure typically only lasts minutes.

Q: What is status epilipticus?
A: This is when a patient continues to have seizures every few minutes without regaining consciousness, and/or the seizure lasts longer than 30 minutes. It could be life threatening.

Q: What is an embolus?
A: This is anything in the circulatory system that moves from it's point of origin to a distant site and lodges there, obstructing subsequent blood flow in that area.

Q: What is a pulmonary embolism?
A: This is the passage of a blood clot formed in a vein, usually in the legs or pelvis, that breaks off and circulates through the venous system, enters the pulmonary artery, where it becomes lodged, significantly decreasing or blocking blood flow. Arterial carbon dioxide rises, and oxygen level may drop enough to cause cyanosis.

Q: What are the signs and symptoms of pulmonary embolisms?
A: Signs and symptoms of these include:
Dyspnea
Acute chest pain
Hemoptysis (coughing up blood)
Cyanosis
Tachypnea
Vary degrees of hypoxia

Q: What is acidosis?
A: This is the buildup of excess acid in the blood or body tissues that results from the primary illness.

Q: What is alkalosis?
A: This is the buildup of excess base in the body fluids.

Q: What is Methicillin-resistant Staphylococcus aureus (MRSA)?
A: This is a bacterium that can cause infection in different parts of the body and is transmitted by different routes. It is resistant to many commonly used antibiotics.

Q: What is tuberculosis (TB)?
A: This is an infection most commonyl found in the lungs but can also affect any organ of the body, including the kidneys, bones, and meninges.

Q: What are adventitious breath sounds?
A: These are abnormal, decreased, or absent breath sounds.

Q: What are vesicular breath sounds?
A: These are normal breath sounds in a patient.

Q: What are some risk factors for congestive heart failure?
A: Risk factors for this include hypertension and a history of coronary artery disease and/or atrial fibrillation, a condition in which the atria no longer contract, but quiver.

Q: What are some signs and symptoms of congestive heart failure?
A: Signs and symptoms of this are:
cool, diaphoretic, and/or cyanotic skin
Adventitious breath sounds such as crackles, wheezing, or rales
A tachycardiac pulse.

Q: What is cystic fibrosis (CF)?
A: This is a genetic disorder that affects the lungs and digestive system. This disrupts the normal function of cells that make up the sweat glands in the skin and that also line the lungs and digestive and reproductive systems.

Q: How is croup treated?
A: This often responds well to humidified oxygen.

Q: What is proper treatment for hyperventilation?
A: Proper treatment for this consists of: reassuing the patient, supplying supplemental oxygen, and providing prompt transport to the emergency department.

Q: What is the proper treatment for pulmonary embolism?
A: Proper treatment for this consists of: Placing the patient in a comfrotable position, be aware of possible hemoptysis as an airway obstruction, and transport promptly, as this may cause cardiac arrest.

Q: What should you watch for in patients with COPD?
A: Oftentimes these patients will overuse their inhalers, so watch for side effects.

Q: What does PASTE stand for?
A: This stands for:
Progression: You want to know if the problem started suddenly or has worsened
Associated chest pain: Dyspnea can be a significant symptom of a cardiac problem.
Sputum: Mucus like sputum could indicate a respiratory infection, while frothy pink sputum indicates fluid in the lungs.
Talking tiredness: How many words a patient can saw between breaths.
Exercise tolerance: What activity was the patient doing before the problem started.

Q: What is wheezing?
A: This is a sound that is generally heard on exhalation as a high-pitched, almost whistling sound. It is extremely common in patients with asthma and sometimes in patients with COPD; it indicates constriction and/or inflammation in the bronchus.

Q: What are rales?
A: These are the sounds of air trying to pass through fluid in the alveoli. It is a crackling or bubbling sound typically heard on inspiration. There are high-pitched "fine" sounds and low-pitched "coarse" sounds. These often indicate congestive heart failure, pulmonary edema, or other fluid in the lungs.

Q: What are rhonchi and what do they indicate?
A: These are lower pitched sounds caused by secretions or mucus in the larger airway.
It indicates infections, pneumonia, or bronchitis.

Q: What is stridor?
A: This is a high-pitched sound heard on inspiration as air tries to pass through obstruction in the upper airway. This indicates a partial obstruction of the trachea and is seen in patients with anatomic or foreign body airway obstruction.

Q: What is an example of an endocrine condition?
A: An example of this kind of condition is diabetes mellitus.

Q: What are the 5 major components of patient assessment?
A: These are:
Scene size-up
Primary assessment
History taking
Secondary assessment
Reassessment

Q: What is the index of suspicion?
A: This is your awareness and concern for potentially serious underlying and unseen injuries or illness.

Q: Where can the pulse be most strongly palpated?
A: This can be most strongly palpated at the carotid artery.

Q: What kinds of patients are always considered in serious condition and should be transported immediately?
A: These kinds of patients include:
Patients who are unconscious or who have an altered mental status
Patients with airway or breathing problems
Patients with obvious  circulation problems such as severe bleeding or signs of shock

Q: How often should you recheck vitals?
A: You should recheck these every 5 minutes for unstable patients or every 15 minutes for stable patients.

Q: How much time should you spend on scene?
A: You should spend no more than 10 minutes here.

Q: What should you remember about stable patients who are also very old or very young?
A: You should remember that these types of patients should still be considered critical.

Q: What are some typical chief complaints?
A: Typical kinds of these include fever. nausea, rash, pleuritic chest pain, and difficulty breathing.

Q: What are some general management principles?
A: Some of these include:
Place the patient in the position of comfort on the stretcher to keep warm.
Be empathetic.
Always show respect for the feelings of the patient and family members.

Q: What is herpes simplex?
A: This is a common virus strain carried by humans. 80% of individuals carrying it are asymptomatic.

Q: What other virus is far more contagious than HIV?
A: Hepatitis B is far more contagious than this.

Q: How is syphilis transmitted?
A: This disease is transmitted both sexually and via bloodborne vectors.

Q: What is a common symptom of initial syphilis infection?
A: An initial infection of this disease is a lesion called a chancre, commonly located in the genital region.

Q: What is virulence?
A: This is the strength or ability of a pathogen to produce disease.

Q: How long can Mycobacterium tuberculosis remain alive?
A: As long as they are shielded from ultraviolet light, these bacterium can stay alive for decades.

Q: What is another name for H1N1?
A: Another name for this is the "swine flu".

Q: What are the characteristics of of Hepatitis A?
A: Characteristics of this are:
Route infection via fecal-oral, infected food, or drink
An incubation period of 2-6 weeks
A vaccine is available, and no treatment is available
Mild illness, approx. 2% or people die.
After infection, patient has life-long immunity

Q: What are the characteristics of of Hepatitis B?
A: Route of infection via blood, sexual contact, saliva, urine, breast milk
4-12 week incubation period
Chronic infection affect up to 10% of pateints and 90% of newborns
Vaccine available, treatment is minimally effective.
Up to 30% of patients may become chronic carriers; patients are asymptomatic and without signs of liver disease. Approx. 1-2% of patients die.

Q: What are the characteristics of of Hepatitis C?
A: Route of infection via blood or sexual contact
2-10 week of incubation
Chronic infection affects 90% of patients
No vaccine available, treatment minimally effective
Cirrhosis of the liver develops in 50% of patients; chronic infection increases the risk of liver cancer

Q: What are the characteristics of of Hepatitis D?
A: Route of infection via blood or sexual contact
4-12 weeks of incubation
Chronic infection common
No vaccine or treatment available
Occurs only in patients with active hepatitis B infection; fulminant disease may develop in 20% of patients.

Q: What are the characteristics of of Toxin-induced Hepatitis?
A: Characteristics of this are:
route of infection via inhalation, skin or mucus membrane exposure, oral ingestion, or intravenous administration
Incubation hours to days after exposure
Some chemicals may initiate an inflammatory response that continues to cause liver damage long after the chemical is out of the body.
No vaccine available.
Patients may have jaundice.

Q: What is the hantavirus?
A: This is a newly recognized disease, transmitted via rodent urine and droppings

Q: How is the West Nile Virus transmitted?
A: This virus' vector is the mosquito.

Q: What is the order of BLS if you suspect cardiac arrest?
A: If this is suspected, BLS order becomes CAB.

Q: What is the chain of survival?
A: This is:
1. Early access (ie Access EMS by calling 911)
2. Early CPR (keeps blood flowing)
3. Early defibrillation
4. Early advanced care
5. Integrated post-arrest care (including controlling temperature and maintaining glucose levels in the patient who is hypoglycemic)

Q: What is important to remember regarding time and CPR?
A: It's important to remember regarding this that few patients survive cardiac arrest if this is not administered within the first few minutes, and if the time from cardiac arrest to defibrillation is more than 10 minutes, the chance of survival is minimal.

Q: What is arrhythmia?
A: This is sudden cardiac rhythm disturbance.

Q: What is ventricular fibrillation?
A: This is the disorganized twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest.

Q: For each minute the patient remains in V-fib or pulseless V-tach, how much does the chance of survival decrease?
A: For each minute in these states, there is a 7% to 10% less chance of survival.

Q: What is a common cause of cardiac arrest in children?
A: Respiratory failure is usually the cause of this in children.

Q: Where should you place the AED electrode on patients with an implanted defibrillator or pacemaker?
A: If you see a patient with one of these, you should place the AED electrode at least 1 inch to the side of the device.

Q: On average, how much blood is pumped through the body when external chest compressions are performed as proficiently as possible?
A: Only one third of the blood that is normally pumped by is circulated through this method.

Q: Where should the patient's head be while administring chest compressions?
A: This should not be elevated at a level above the heart because this will further reduce blood flow to the brain.

Q: What kind of surface should a patient receiving chest compressions be placed on?
A: During this, the patient should be placed on the floor or have a board placed under the back.

Q: When performing CPR on an adult, how many chest compressions should be given a minute?
A: Give at least 100 compressions per minute for this type of patient.

Q: What is the recovery position?
A: This is a side-lying position (patient's hand under their head) used to maintain a clear airway in unconscious patients without injuries who are adequately breathing.

Q: What is the focus of pediatric BLS?
A: The focus of BLS for these types of patients is airway and breathing.

Q: Where do you check the pulse on infants?
A: You check the pulse on the brachial artery for these patients.

Q: Where do you check the pulse on children (1-12 years)?
A: You check the pulse on the carotid or femoral artery for these patients.

Q: What is the compression rate for infants and children in CPR?
A: For these patients, the compression rate is at least 100/min.

Q: What is the compression-to-ventilation ratio in CPR for infants and children?
A: For these patients, the compression-to-ventilation ratio is 30:2 for one rescuer, and 15:2 for 2 rescuers.

Q: With infants and children, what is the ventilation rate during CPR?
A: With these patients, the ventilation rate is 1 breath every 3-5 seconds.

Q: What should you do with a patient who has a mild airway obstruction?
A: With these patients, you should encourage him or her to cough or to continue coughing if they are already doing so.

Q: What is homeostasis?
A: This is a balance of all systems and conditions of the body; as shock progresses, this degrades.

Q: What are the three parts of the cardiovascular system?
A: The three parts of this system are:
A pump,
A set of pipes,
and the contents of the container.

Q: What is systolic pressure?
A: This is the peak arterial pressure, or pressure generated every time the heart contracts.

Q: What is diastolic pressure?
A: This is the pressure maintained within the arteries while the heart rests between the heartbeats.

Q: What are sphincters?
A: These are circular muscles that encircle and, by contracting, constrict a duct, tube, or opening.

Q: What are the three basic causes of shock?
A: The three basic causes of this are:
1. Pump failure (caused by: heart attack, trauma to heart, and obstructive causes).
2. Low fluid volume (caused by: trauma to vessels or tissues, and fluid loss from GI tract),
and,
3. Poor vessel function (caused by: infection, drug overdose, spinal cord injuries, and anaphylaxis).

Q: What does pump failure cause?
A: Cardiogenic and obstructive shock are caused by this kind of failure.

Q: What kinds of shock does poor vessel function cause?
A: Distributive shock, septic shock, neurogenic shock, anaphylactic shock, and psychogenic shock are caused by this kind of failure.

Q: What kinds of shock does low fluid volume cause?
A: Hypovolemic shock, hemorrhagic shock, and nonhemorrhagic shock are caused by this kind of failure.

Q: What causes cardiogenic shock?
A: This is caused by inadequate functioning of the heart, or pump failure.

Q: What is edema?
A: This is the presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.

Q: When does cardiogenic shock develop?
A: This develops when the heart cannot maintain sufficient output (or cardiac output) to meet the demands of the body.

Q: What is myocardial contractility?
A: This is the ability for the heart to contract.

Q: What is preload?
A: This is the precontraction pressure in the heart as the volume of blood builds up.

Q: What is afterload?
A: This is the force or resistance against which the heart pumps.

Q: What is obstructive shock?
A: This results when conditions that cause mechanical obstruction of the cardiac muscle also impact pump function.

Q: What are two of the most common examples of obstructive shock?
A: Two of the most common examples of this are cardiac tamponade and tension pneumothorax.

Q: What is a cardiac tamponade (A.K.A. a pericardial tamponade)?
A: This is a collection of fluid between the pericardial sac and the myocardium. It is caused by blunt or penetrating trauma and can progress rapidly.

Q: What happens during a cardiac tamponade?
A: When this occurs, blood leaks into the tough fibrous membrane known as the pericardium, causing an accumulation of blood within the pericardial sac. This accumulation leads to compression of the heart. Because the pericardium has a limited ability to stretch, each contraction of the heart allows more blood accumulation between the heart and the sac. The accumulated blood prevents the heart from opening up to allow complete refilling.

Q: What are the signs and symptoms of cardiac tamponade?
A: The signs and symptoms of this are referred to as Beck's Triad. They are:
1) Jugular vein distention.
2) Muffled heart sounds,
and
3) The merging of systolic and diastolic blood pressure.

Q: What causes tension pneumothorax?
A: This is caused by damage to the lung tissue. This damage allows air normally held within the lung to escape into the chest cavity. If this condition is allowed to continue untreated, a sufficient amount of air will accumulate within the chest cavity and begin applying pressure to the structures in the mediastinum. The trapped air begins to shift the chest organs toward the uninjured side, which creates the condition.

Q: What is distributive shock?
A: This is when there is widespread dilation of the small arterioles, small venules, or both.

Q: What is septic shock?
A: This is a result of severe infections, usually bacterial, in which toxins are generated by the bacteria or by infected body tissues; the toxins damage the vessel walls, causing increased cellular permeability. The vessel walls leak and are unable to contract well. Widespread dilation of vessels, in combination with plasma loss through the injured vessel walls, resulting in shock.

Q: What is usually the cause of neurogenic shock?
A: This is usually caused by damage to the spinal cord, particularly at the upper cervical level, which damages the part of the nervous system that controls the size and muscular tone of the blood vessels.

Q: What is an important consideration in patients in neurogenic shock?
A: One important consideration in these kinds of patients is that these patients lack the ability to regulate body temperature.

Q: What are signs of anaphylactic shock on the skin, in the circulatory system, and in the respiratory system?
A: Signs of this include:
On the skin:
Flushing, itching, or burning, especially over the face and upper part of the chest.
Urticaria, which may spread over large areas of the body.
Edema, especially of the face, tongue, and lips.
Pallor.
And,
Cyanosis about the lips.
In the circulatory system:
Dilation of peripheral blood vessels.
Increased vessel permeability.
A drop in blood pressure.
A weak, barely palpable pulse.
Dizziness.
And,
Fainting and coma.
In the respiratory system:
Sneezing or itching.
Tightness in the chest, with a persistent dry cough.
Wheezing and dyspnea.
Secretions of fluid and mucus into the bronchial passages, alveoli, and lung tissues, causing coughing.
Constriction of the bronchi.
Forced expiration accompanied by wheezing.
And,
Eventual cessation of breathing.

Q: What is psychogenic shock?
A: This is when a patient has had a sudden reaction of the nervous system that produces a temporary, generalized vascular dilation, resulting in fainting, or syncope.

Q: What are some causes of syncope that are potentially life threatening?
A: Causes of this that are potentially life threatening are an irregular heartbeat or brain aneurysm.

Q: What is hypovolemic shock?
A: This is the result of inadequate amount of fluid or volume in the system.

Q: What are some causes of hypovolemic shock?
A: Some causes of this kind of shock include hemorrhagic causes, non-hemorrhagic causes (such as vomiting and diarrhea), as well as severe thermal burns; in those cases, it is intravascular plasma that is lost, leaking from the circulatory system into the burned tissues.

Q: How does carbon monoxide affect the ability of cells to metabolize or carry oxygen?
A: This substance has a 250 times greater affinity for hemoglobin than oxygen. If a patient is in an environment with this substance, it will bind to the blood's hemoglobin, preventing oxygen from binding.

Q: What is compensated shock?
A: This is the early stage of shock, when the body can still compensate for blood loss. Signs and symptoms include:
Agitation,
Anxiety,
Restlessness,
Feeling of impending doom,
A.M.S.,
Weak, rapid, or absent pulse,
Clammy skin,
Pallor with cyanosis around the lips,
Shallow, rapid breathing,
Shortness of breath,
Nausea or vomiting,
And,
Marked thirst.

Q: What is decompensated shock?
A: This is a later stage of shock, when blood pressure falls. Signs and symptoms include:
Falling blood pressure (systolic blood pressure of 90 mm Hg or lower in an adult),
Labored or irregular breathing,
Ashen, mottled, or cyanotic skin,
Thready or absent peripheral pulses,
Dilated pupils,
And,
Poor urinary output.

Q: What is irreversible shock?
A: This is the last stage of shock, when shock has progressed to a terminal stage. A transfusion during this stage will not save the patient's life.

Q: What should you remember about blood pressure drops in children and infants?
A: Remember that these patients can maintain their blood pressure until they have lost more than half their blood volume. By the time their blood pressure drops in shock, they are close to death.

Q: Which conditions in patients should make you suspect shock?
A: You should expect this if a patient has any one of the following conditions:
Multiple severe fractures,
Abdominal or chest injury,
Spinal injury,
A severe infection,
A major heart attack,
And,
Anaphylaxis.

Q: What is the only real effective treatment for a severe, acute allergic reaction?
A: The only real effective treatment for this is to administer epinephrine.

Q: What are the signs and symptoms of cardiogenic shock, and how should you treat it?
A: Signs and symptoms of this include:
Chest pain,
Irregular pulse,
Weak pulse,
Low blood pressure,
Cyanosis of the lips and under the nails,
Cool, clammy skin,
Anxiety,
Rales,
and pulmonary edema.
Treat this by:
Positioning the patient comfortably, administering oxygen, assisting with ventilations, and transporting promptly.

Q: What are the signs and symptoms of obstructive shock, and how should you treat it?
A: Signs and symptoms of this are dependent on the cause, and include:
Dyspnea,
A rapid, weak pulse,
Rapid, shallow breaths,
Decreased lung compliance,
Unilateral, decreased, or absent breath sounds,
Decreased blood pressure,
Subcutaneous emphysema,
Cyanosis,
Tracheal deviation towards the unaffected side,
and,
Beck's Triad, which are: Muffled heart sounds, Jugular vein distention, and, The merging of systolic and diastolic blood pressure.
Treatment of this is also dependent on the cause, and includes:
ALS assist, and / or rapid transport.

Q: What are the signs and symptoms of septic shock, and how should you treat it?
A: Signs and symptoms of this include:
Warm skin,
Tachycardia,
and, low blood pressure.
Treatment for this includes:
Transporting promptly, administering oxygen en route, providing full ventilatory support, keeping the patient warm, and considering elevating the legs.

Q: What are the signs and symptoms of neurogenic shock, and how should you treat it?
A: Signs and symptoms of this include:
Bradycardia,
Low blood pressure,
and,
Signs of neck injury.
Treatment of this includes:
Securing the airway,
stabilizing the spine,
assisting ventilations,
administering high-flow oxygen,
preserving body heat,
and,
transporting promptly.

Q: What are the signs and symptoms of anaphylactic shock, and how should you treat it?
A: Signs and symptoms of this include:
Mild itching or rash,
Burning skin,
Vascular dilation,
Generalized edema,
Coma,
and,
rapid death.
Treatment for this includes:
Managing the airway,
Assisting ventilations,
administering high-flow oxygen,
assisting with administration of epinephrine,
and,
transporting promptly.

Q: What are the signs and symptoms of psychogenic shock, and how should you treat it?
A: Signs and symptoms of this include:
A rapid pulse,
and,
Normal or low blood pressure.
Treatment for this includes:
Determining the duration of unconsciousness,
Recording initial vitals and mental status,
Suspecting head trauma if the patient is confused or slow to regain consciousness,
and,
Transporting promptly.

Q: What are the signs and symptoms of hypovolemic shock, and how should you treat it?
A: Signs and symptoms of this include:
A rapid, weak pulse,
Low blood pressure,
A change in mental status,
Cyanosis of the lips and / or nails,
Cool, clammy skin,
and,
An increased respiratory rate.
Treatment for this includes:
Securing the airway,
Administering high-flow oxygen,
Controlling external bleeding,
Keeping the patient warm,
Possibly elevating the legs,
and,
Transporting promptly.

Q: How should you treat tension pneumothorax?
A: Treat this with high-flow oxygen via non-re-breathing mask. Be cautious about providing positive-pressure ventilation to a patient with this condition. Usually the only action that can prevent eventual death from this is decompression of the injured side of the chest. This can be performed by ALS personnel.

Q: What position should you place patients with neurogenic shock?
A: With these patients, slight elevation of the foot end spine board may help bring the blood that is pooling in the vessels of the legs to the vital organs. Placing the patient's arms across his or her chest without moving the spine will also return some pooled blood.

Q: When will brain tissue start to die without oxygen?
A: This will begin to die within 4 to 6 minutes.

Q: What anatomic structures make up the upper airway?
A: The nose, mouth, jaw, oral cavity, pharynx, and larynx are located here.

Q: What is the major function of the upper airway?
A: The major function of this is to:
Warm, filter, and humidify air as it enters the body.

Q: What is the pharynx and what is it composed of?
A: This is a muscular tube that extends from the nose and mouth to the level of the esophagus and trachea. It is composed of the nasopharynx, oropharynx, and the laryngopharynx (A.K.A. the hypopharynx).

Q: What is the lowest portion of the pharynx?
A: This is the laryngopharynx. At its base, it splits into two lumens, the larynx anteriorly, and the esophagus posteriorly.

Q: What is the nasopharynx?
A: This is formed by the union of the facial bones, and is lined with a cilated mucous membrane that keeps contaminants such as dust and other small particles out of the respiratory tract. The membrane also warms and humidifies air as it enters the body.

Q: What is the oropharynx?
A: This forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue.

Q: What is the larynx?
A: This marks where the upper airway ends and the lower airway begins.

Q: What is the thyroid cartilage?
A: This is a shield-shaped structure formed by two plates that join in a "V" shape anteriorly to form the larnygeal prominence known as the Adam's apple.

Q: What is the cricoid cartilage?
A: This lies inferiorly to the thyroid cartilage; it forms the lowest portion of the larynx. It is the only airway structure that forms a complete ring.

Q: What is the glottis?
A: This is space in between the vocal cords and the narrowest portion of the adult's airway.

Q: What is the trachea?
A: This is the conduit for air entry into the lungs. It is approximately 10 to 12 centimeters in length and consists of C-shaped cartilaginous rings. It descends anteriorly into the thoracic cavity.

Q: What is the carina?
A: This is the point at which the trachea bifurcates into the left and right mainstream bronchi.

Q: What is visceral pleura?
A: This is a thin, slippery outer membrane that covers all lung tissue.

Q: What is the parietal pleura?
A: This lines the inside of the thoracic cavity.

Q: What lies between the visceral pleura and the parietal pleura?
A: Between these is a small amount of fluid, which serves as a lubricant to prevent friction during breathing.

Q: What should you remember about children's airways?
A: With these patients' airway, remember that:
They have a proportionately smaller mandible and a proportionately larger tongue, both of which increase the incidence of airway obstruction.
They have a proportionately larger occipital lobe, so when positioning the airway, place a folded towel under the shoulders to maintain a neutral position.
In general, the airway of these patients are smaller and narrower at all levels.

Q: What is the mediastinum?
A: This is the space between the lungs, and is surrounded by tough, connective tissue. This space contains the heart, great vessels, esophagus, trachea, major bronchi, and nerves.

Q: What is the phrenic nerve?
A: This is one of the most important nervous structures in the body. It innervates the diaphragm muscle.

Q: What is ventilation?
A: This is the physical act of moving air into and out of the lungs.

Q: What is oxygenation?
A: This is the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

Q: What is respiration?
A: This is the actual exchange of oxygen and carbon dioxide in the alveoli as well as the tissues of the body.

Q: What is inhalation?
A: This is the active, muscular part of breathing.

Q: How much air does 1 breath draw in?
A: This is approximately 500 ml in an adult.

Q: What is partial pressure?
A: This is the term used to describe the amount of gas in air or dissolved in fluid, such as blood. It is measured in millimeters of mercury (Hg).

Q: What is the partial pressure of oxygen in air in the alveoli?
A: This pressure is 104 mm Hg.

Q: What is the partial pressure of carbon dioxide in air in the alveoli?
A: This pressure is 40 mm Hg.

Q: What is alveolar ventilation, and how is it determined?
A: This is the volume of air that reaches the alveoli, and is determined by subtracting the amount of dead space air from the tidal volume.

Q: What is tidal volume?
A: This is the amount of air that is moved into or out of the lungs during a single breath. The average volume for an adult man is approximately 500 ml.

Q: What is dead space?
A: This is the portion of tidal volume that does not reach the alveoli and thus does not participate in gas exchange. It contains the air that remains in the mouth, nose, trachea, bronchi, and larger bronchioles. This can add up to approximately 150 mL in adults.

Q: What is minute ventilation (A.K.A. minute volume)?
A: This is the amount of air moved through the lungs in 1 minute minus the dead space. An average adult male patient might have a rate of 4200 mL , (12 breaths per minute, a tidal volume of 500 mL per breath, and a dead space of 150 mL)

Q: What is vital capacity?
A: This refers to the amount of air that can be forcibly expelled from the lungs after breathing deeply.

Q: What is residual volume?
A: This is the air that remains after maximal expiration. It is approximately 1200 mL in the average adult male.

Q: What is exhalation?
A: This is the passive part of the breathing process, in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs.

Q: How are ventilation changes primarily regulated?
A: These are regulated primarily by the pH of the cerebrospinal fluid, which is directly related to the amount of carbon dioxide dissolved in the plasma portion of the blood.

Q: What is the hypoxic drive?
A: This is a condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; it is seen in patients with end-stage C.O.P.D.

Q: What is COPD?
A: This is when patients have difficulty eliminating carbon dioxide through exhalation; thus, they always have higher levels of carbon dioxide. This potentially alters their drive for breathing. The body uses a "backup system", the hypoxic drive, to control breathing. This is different from the primary control of breathing that uses carbon dioxide. Caution should be taken when administering high concentrations of oxygen to these kinds of patients, as providing high concentrations of oxygen over time will increase the amount of oxygen dissolved in plasma; this could potentially negatively affect their body's drive to breathe.

Q: What is another name for metabolism?
A: Another name for this is cellular respiration.

Q: What is the chemical composition of air on average?
A: On average, the chemical composition of this is about 21% oxygen, 78% nitrogen, and 0.3% carbon dioxide.

Q: What is surfactant?
A: This is a liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome.

Q: Under normal conditions, what percentage of hemoglobin receptor sites contain oxygen?
A: Under normal conditions, 96% to 100% of these contain oxygen.

Q: What is aerobic respiration?
A: This can proceed only in the presence of oxygen.  Energy in the form of adenosine triphosphate (A.K.A., A.T.P.) is produced through a series of processes known as the Krebs cycle and oxidative phosphorylation. Together, these chemical processes yield nearly 40 molecules of energy-rich ATP for each molecule of glucose metabolized.

Q: What are chemoreceptors?
A: These monitor the levels of O2, CO2, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time.

Q: How will an elevation in carbon dioxide levels affect the pH balance in CSF?
A: This will decrease the pH of the cerebrospinal fluid.

Q: What is the normal resting minute ventilation?
A: The normal rate of this is approximately 6000 mL per minute. About a third of this volume fills dead space; therefore, resting alveolar ventilation is approximately 4000 mL per minute.

Q: What is intrapulmonary shunting?
A: This is the bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart, inhibiting diffusion and perfusion.

Q: What is a bag-mask device?
A: This is a device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, this delivers more than 90% supplemental oxygen.

Q: What is the normal respiratory rate of adults?
A: For this group, the average respiratory rate is 12 to 20 breaths per minute.

Q: What is the normal respiratory rate of children?
A: The normal respiratory rate of this group is 15 to 30 breaths per minute.

Q: What is the normal respiratory rate of infants?
A: The normal respiratory rate of this group is 25 to 50 breaths per minute.

Q: What are retractions?
A: This is when the skin pulls in around the ribs or above the clavicle during respiration. It is a sign of inadequate breathing.

Q: What are agonal gasps?
A: These are occasional gasping breaths that occur after the heart has stopped. They occur when the respiratory center in the brain continues to send signals to the respiratory muscles.

Q: What are Cheyne-Stokes respirations?
A: This is an irregular respiratory pattern in which the patient breathes with an increasing rate and depth of respirations that is followed by a period of apnea, or lack of spontaneous breathing, followed again by a pattern of increasing rate and depth of respiration.

Q: What is ataxic respirations?
A: This is a pattern of irregular, ineffective respirations that may or may not have an identifiable pattern.

Q: What are Kussmaul respirations?
A: This is an irregular breathing pattern characterized as deep, gasping respirations commonly seen in patients with metabolic acidosis.

Q: What maneuver should you use on a patient if you suspect a cervical spine injury to open the airway?
A: In this situation, use the the jaw-thrust maneuver.

Q: What are the principle purposes of an oropharyngeal airway?
A: The principle purposes of this are to:
1) Keep the tongue from blocking the upper airway.
and 2) Make it easier to suction the the oropharynx if necessary.

Q: What is the only acceptable method of inserting an oral airway in children?
A: With this group, the only acceptable method of inserting an oral airway is to use a tongue blade to hold the tongue down.

Q: When should you consult medical control about inserting a nasopharyngeal airway?
A: You should consult medical control about this when a patient has sustained severe trauma to the head or face.

Q: How much airflow and vacuum should a suctioning unit be able to generate?
A: This should generate airflow of more than 40 L per minute, and a vacuum of more than 300 mm Hg when the tubing is clamped.

Q: What is a suction catheter?
A: This is a hollow cylindrical device used to remove fluid from the patient's airway.

Q: How long should you suction a patient's mouth or nose?
A: You should never do this for more than 15 seconds at a time for adults, 10 seconds for children, and 5 for infants.

Q: What is the pin-indexing system?
A: This is a system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.

Q: What is the flow rate and percent of oxygen delivered for a nasal cannula?
A: This device has a flow rate of 1000 to 6000 mL per minute, and delivers 24% to 44% oxygen.

Q: What is the flow rate and percent of oxygen delivered for a nonre-breathing mask?
A: This device has a flow rate of 10 to 15 L per minute, and delivers up to 90% oxygen.

Q: What is the flow rate and percent of oxygen delivered for a bag-mask device with reservoir?
A: This device has a flow rate of 15 litres per minute, and delivers nearly 100% oxygen.

Q: What is the flow rate and percent of oxygen delivered for a mouth-to-mask device?
A: This device has a flow rate of 15 litres per minute, and delivers nearly 55% oxygen.

Q: What is a partial rebreathing mask?
A: This is similar to a nonrebreathing mask except that there is no one-way valve between the mask and reservoir. Consequently, patients rebreathe a small amount of their exhaled air. This is advantageous for patients who you think are suffering from hyperventilation syndrome. You can easily convert a nonrebreathing mask to this by removing the one-way valve between the mask and the reservoir bag.

Q: What is the nature of air movement in normal ventilation versus positive-pressure ventilation?
A: Regarding this, in normal ventilation:
air is sucked into the lungs due to the negative intrathoracic created when the diaphragm contracts.
Whereas in positive-pressure ventilation:
Air is forced into the lungs through a means of mechanical ventilation.

Q: What is the nature of blood movement in normal ventilation versus positive-pressure ventilation?
A: Regarding this, in normal ventilation:
Normal breathing allows blood to naturally be pulled back to the heart.
Whereas in positive-pressure ventilation:
Intrathoracic pressure is increased, not allowing blood to be adequately pulled back to the heart. This causes the amount of blood pumnped by the heart to be reduced.

Q: What is the nature of airway wall pressure in normal ventilation versus positive-pressure ventilation?
A: Regarding this, in normal ventilation:
This is not affected during normal breathing.
Whereas in positive-pressure ventilation:
More volume is required to have the same effects as normal breathing. As a result, the walls are pushed out of their normal anatomic shape.

Q: What is the nature of esophageal opening pressure in normal ventilation versus positive-pressure ventilation?
A: Regarding this, in normal ventilation:
This is not affected during normal breathing.
Whereas in positive-pressure ventilation:
Air is forced into the stomach, causing gastric distention that could result in vomiting and aspiration.

Q: What is the nature of overventilation in normal ventilation versus positive-pressure ventilation?
A: Regarding this, in normal ventilation:
This is not typical of normal breathing.
Whereas in positive-pressure ventilation:
Forcing volume and rate results in increased intrathoracic pressure, gastric distention, and a decrease in cardiac output.

Q: For apneic patients with a pulse, what is the ventilation rate in adults?
A: For these patients, the rate is 1 breath every 5 to 6 seconds.

Q: For apneic patients with a pulse, what is the ventilation rate in children and infants?
A: For these patients, the rate is 1 breath every 3 to 5 seconds.

Q: When should you use a bag-mask device?
A: This should be used when you need to deliver high concentrations of oxygen to patients who not ventilating adequately. The device is also used for patients in respiratory arrest, cardiopulmonary arrest, and respiratory failure. You should use an oral or nasal airway adjunct.

Q: What is the volume capability of the adult bag-mask device?
A: The volume capability for this device is 1200 to 1600 mL.

Q: What is the volume capability of the pediatric bag-mask device?
A: The volume capability of this device is 500 to 700 mL.

Q: What is the volume capability of the infant bag-mask device?
A: The volume capability of this device is 150 to 240 mL.

Q: What is a manually triggered ventilation device, AKA a flow-restricted, oxygen-powered ventilation device?
A: This is a fixed flow/rate ventilation device that delivers a breath every time its button is pushed. The major advantage of this device is that it allows a single rescuer to use both hand to maintain a mask-to-face seal.

Q: What is compliance?
A: This is the ability of the alveoli to expand when air is drawn in during inhalation.

Q: What is CPAP?
A: This is a noninvasive means of providing ventilatory support for patients experiencing respiratory distress.
Indications for this include:
Patient must be alert and able to follow commands.
Patient is displaying obvious signs of moderate to severe respiratory distress from an underlying pathology, such as pulmonary edema or obstructive pulmonary disease.
The patient is breathing rapidly, such that it affects over-all minute volume.
And,
Pulse oximetry reading is less than 90%.
Contraindications include:
A patient who is in respiratory arrest.
Signs and symptoms of a pneumothorax or chest trauma.
Tracheostomy.
Active gastrointestinal bleeding or vomiting.
And,
The patient is unable to follow verbal commands.

Q: What are the steps in the assessment process?
A: This is divided into five main parts:
1) Scene size-up.
2) Primary assessment.
3) History taking.
4) Secondary assessment.
5) Reassessment

Q: Whether you are assessing a medical patient or trauma patient, what is the key in both situations?
A: The key to both of these situations, whether medical or trauma, is to remain organized.

Q: How is the underlying condition or problem of a patient often revealed to you?
A: It is frequently a combination of many signs and symptoms that reveals this to you.

Q: What is a symptom?
A: This is a subjective condition that the patient feels and tells you about.

Q: What is a sign?
A: This is an objective condition that you can observe about the patient.

Q: What is the minimum appropriate visibility gear?
A: This is an American National Standards Institute 207 certified high-visibility public safety vest.

Q: What is the way you typically leave a scene?
A: This is typically the exact same way you entered the scene.

Q: What is an important consideration for your patients in severe environmental conditions?
A: With this, remember: You are obliged to provide protection for the patient. Consider the scene factors.

Q: What is mechanism of injury?
A: This is the way in which traumatic injuries occur; the forces that act on the body to cause damage.

Q: What is the difference between 1) blunt trauma and 2) penetrating trauma?
A: With the first, the force of the injury occurs over a broad area, and the skin is usually not broken. However, the tissues and organs below the area of impact may be damaged.
With the second, the force of the injury occurs at a small point of contact between the skin and the object. The object pierces the skin and creates an open wound that carries a high potential for infection.

Q: What is nature of illness (NOI), how should you determine it, and what are some examples of it?
A: This is the general type of illness a patient is experiencing. To quickly determine it, talk with the patient, family, or bystanders about the problem. But at the same time, use your senses to check the scene for clues as to the possible problem.
Examples of it include seizures, heart attacks, diabetic problems, and poisonings.

Q: What is Personal Protective Equipment (AKA PPE)?
A: This is clothing or specialized equipment that provides protection to the wearer. Which type to use will depend on the specific job duties required during a patient care interaction.

Q: What are standard precautions?
A: These are protective measures that have traditionally been developed by the Centers for Disease Control and Prevention for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease.

Q: What is the incident command system?
A: This is a system implemented to manage disasters and mass-casualty incidents in which section chiefs - including finance, logistics, operations, and planning - report to the incident commander.

Q: What is triage?
A: This is the process of sorting patients based on the severity of each patient's condition.

Q: What is primary assessment, and what are its stages?
A: This is the second step in patient assessment. It begins when you greet your patient, and has a single goal: to identify and initiate treatment of immediate or potential life threats. It stages are:
1) Form a general impression.
2) Assess level of consciousness
3) Assess the airway: identify and treat life threats.
4) Assess the breathing: identify and treat life threats.
5) Assess circulation: identify and treat life threats.
6) Perform rapid scan.
And
7) Determine priority of patient care and transport.

Q: What is orientation?
A: This tests mental status by checking a patient's memory and thinking ability. The most common ways to evaluate this in a patient is to test the patient's ability to remember:
1) Person - Remembering his or her name.
2) Place - Identifying the current location.
3) Time - Identifying the current year, month, and approximate date.
4) Event - Describing what happened (the MOI or NOI)

Q: On the Glascow Coma Scale, what are the scores for eye opening?
A: On this scale:
4) Spontaneous opening.
3) In response to speech.
2) In response to pain
1) None

Q: On the Glascow Coma Scale, what are the scores for verbal response?
A: On this scale:
5) Oriented conversation.
4) Confused conversation.
3) Inappropriate words.
2) Incomprehensible sounds.
1) None

Q: On the Glascow Coma Scale, what are the scores for motor response?
A: On this scale:
6) Obeys commands.
5) Localizes pain.
4) Withdraws to pain.
3) Abnormal flexion.
2) Abnormal extension.
1) None.

Q: On the Glascow Coma Scale (AKA GCS), what are the score breakdowns?
A: On this scale:
13-15: May indicate mild dysfunction, although 15 is the score some with no neurologic disabilities would receive.
9-12: May indicate moderate dysfunction.
8 or less: Indicative of severe dysfunction.

Q: When a brighter light is introduced in one eye, what should happen?
A: In this case, both pupils should constrict equally to the appropriate size.

Q: What is anisocoria?
A: This is a condition in which patients exhibit unequal pupil size. If the patient or family cannot confirm the presence of this condition, you must assume the patient has depressed brain function.

Q: What can cause depressed brain function?
A: This can be caused by:
Injury of the brain or brain stem.
Trauma or stroke.
Brain tumor.
Inadequate oxygenation or perfusion.
Drugs or toxins (central nervous system depressants)

Q: What do opiates do to pupils?
A: These cause to pupils to constrict so significantly, regardless of light, that they become so small as to be described as pinpoint.

Q: What might ICP do to the pupils?
A: This might cause sufficient pressure against the oculomotor nerve on one side that the motor commands can no longer pass from the brain to that eye. When this occurs, the eye no longer receives commands to constrict, and its pupil becomes fully dilated and fixed. This is described as a blown pupil.

Q: What does PEARRL stand for?
A: This stands for:
Pupils,
Equal And Round,
Regular in size,
and react to
Light.

Q: What are spontaneous breathing (AKA spontaneous respirations)?
A: This is when a patient breathes without assistance.

Q: What is the ratio of inhalation and exhalation times?
A: These occur in a 1:3 ratio.

Q: What is the information you must obtain to assess breathing, and what questions should you be asking yourself?
A: When doing this, you must obtain:
Respiratory rate,
Rhythm (regular or irregular),
Quality or character of breathing,
and,
Depth of breathing.
You should be asking yourself:
Does the patient appear to be choking?
Is the rate too fast or too slow?
Are the respirations shallow or deep?
Is the patient cyanotic?
Do you hear abnormal sounds when listening to the lungs?
Is the patient moving air into and out of the lungs on both sides?

Q: A patient who coughs up thick, yellowish, or greenish sputum most likely has what?
A: Patients with this sign likely have an advanced respiratory infection.

Q: Where should you auscultate?
A: Because you can almost always hear a patients breath sounds better from the back, do this there if the back is accessible. Do this over the apices (upper lungs), bases (lower lungs), and over the major airways.

Q: What are rales, AKA crackles?
A: These are wet crackling sounds, usually on both inspiration and expiration.

Q: What are rhonchi?
A: These are congested breath sounds and may suggest the presence of mucus in the lungs. Expect to hear low-pitched, noisy sounds that are most prominent on expiration. The patient often has a productive cough associated with these sounds.

Q: What are the accessory muscles?
A: These include the neck muscles (sternocleidomastoid), the chest pectoris majors, and the abdominal muscles. They aid in respiration.

Q: What is nasal flaring?
A: This is seen in pediatric patients with inadequate breathing.

Q: What is the tripod position?
A: This is when a patient is sitting and leaning forward on outstreched arms with the head and chin thrust slightly forward; it indicates poor breathing.

Q: What is the sniffing position?
A: This is commonly seen in children. The patient sits upright with the head and chin thrust slightly forward, and the patient appears to be sniffing.

Q: What is the normal pulse rate for infants (1 month to 1 year)?
A: This is 100 to 160 beats per minute.

Q: What is the normal pulse rate for toddlers (1 to 3 years)?
A: This is 90 to 150 beats per minute.

Q: What is the normal pulse rate for preschool chldren (3 to 6 years)?
A: This is 80 to 140 beats per minutes.

Q: What is the normal pulse rate for school age children (6 to 12 years)?
A: This is 70 to 120 beats per minute.

Q: What is the normal pulse rate for adolescents (12 to 18 years) and adults?
A: This is 60 to 100 beats per minute.

Q: What is the sclera?
A: This is the normally white portion of the eye.

Q: Where should you determine capillary refill in newborns and young infants?
A: Press on the forehead, chin, or sternum to determine capillary refill in these patients.

Q: How long should the rapid scan of the patient take?
A: This should take 60 to 90 seconds.

Q: What conditions are examples of conditions that indicate high-priority patients who need to be transported immediately?
A: These conditions are:
Difficulty breathing,
Poor general impression,
Unresponsive with no gag or cough reflex,
Severe chest pain,
Pale skin or other signs of poor perfusion,
Uncontrolled bleeding,
Responsive but unable to follow commands,
Severe pain in any area of the body,
Inability to move any part of the body,
And,
Complicated childbirth.

Q: What is the Golden Period and the Platinum 10?
A: The first refers to the time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best. Second refers to the ideal time to assess, stabilize, package, and begin transport.

Q: Which patients benefit from remaining on scene and receiving continuing care?
A: An older patient with chest pain administered nitrogylcerin on scene and waiting for an ALS is an example of this.

Q: What is the chief complaint?
A: This is the reason the patient or someone else called 9-1-1

Q: NKA
A: no known allergies

Q: What are pertinent negatives?
A: These are findings that warrant no care or intervention. They also indicate that a thorough and complete examination and history were performed.

Q: When should you use close-ended questions?
A: Use these when patients say nothing or very little. Also note their silence is a clue to the patient's chief complaint.

Q: What should you always remember when determing the nature of the chief complaint?
A: Remember that there may be a number of possible medical or traumatic causes for this.

Q: What is one of the most common causes of confusion?
A: One of the most common causes of this is hypoxia.

Q: What is one way to deal with hearing impaired patients?
A: One way to deal with this is to use your stethoscope to function like a hearing aid; have the patient place the stethoscope in his or her ears and speak into the stethoscope bell, which will amplify the sound.

Q: What is the purpose of the secondary assessment?
A: The purpose of this is to perform a systematic physical examination of the patient. It may be a head-to-toe, full body scan or a systematic assessment that focuses on a a certain area or region of the body.

Q: What is a sphygmomanometer?
A: This is a blood pressure cuff.

Q: What is capnography?
A: This is a noninvasive method that can quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism.

Q: What is capnometry?
A: This is the use of a capnometer, a device that measures the amount of expired carbon dioxide.

Q: What is a full-body scan?
A: This is a systematic head-to-toe examination.

Q: What is a focused assessment?
A: This is generally performed on patients who have sustained nonsignificant MOIs or on responsive medical patients. It is based on the chief complaint.

Q: What is the normal range for blood pressure in adults?
A: This is 90 to 140 mm Hg (systolic).

Q: What is the normal range for blood pressure in children (1 to 8 years old)?
A: This is 80 to 110 mm Hg (systolic).

Q: What is the normal range for blood pressure in infants (newborn to 1 year)?
A: This is 50 to 95 mm Hg (systolic).

Q: What is subcutaneous emphysema?
A: This is a crackling sound produced by air bubbles under the skin.

Q: What is the reassessment phase?
A: This is performed at regular intervals and is to identify and treat changes in a patient's condition.

Q: What should you do if the patient's condition improves?
A: If this happens, continue whatever treatments you are providing.

Q: What is pharmacology?
A: This is the science of drugs.

Q: What is pharmacodynamics?
A: This is the process by which a medication works on the body.

Q: What is an agonist?
A: This is a medication that causes stimulation of receptors.

Q: What is an antagonist?
A: This is medication that binds to a receptor and block other medications.

Q: What is a medication's action?
A: This is the therapeutic effect or intended effect it is expected to have on the body.

Q: What should you remember about doses in the elderly population?
A: These may also need to be decreased for this population because they cannot process medications as efficiently as others.

Q: What are indication?
A: These are the reasons or conditions for which a particular medication is given.

Q: What are contraindications?
A: These are reasons or conditions for which a particular medication should not be given, even if it usually is indicated for that person's condition.

Q: What are side effects?
A: These are any actions of a medication other than the desired ones.

Q: What are unintended effects?
A: These are the effects that are undesirable but pose little risk to the patient.

Q: What are untoward effects?
A: These are the effects that can be harmful to the patient.

Q: What is the difference between a medication's generic name and its trade name?
A: The first is a simple, clear, nonproprietary name. The second is the brand name; as a proper noun, it begins with a capital letter.

Q: What are OTC medications?
A: These are medications that can be purchased without a prescription.

Q: What are enteral medications?
A: These are medications that enter the body through the digestive system.

Q: What are parenteral medications?
A: These are medications that enter the body by a route other than the digestive tract, skin, or mucous membranes. These are absorbed much more quickly and offer a more predictable and measurable dose.

Q: What is absorption?
A: This is the process by which medications travel through body tissues until they reach the bloodstream.

Q: What is the per retum (PR) route of administration?
A: This is medication administrated by the rectum. It is most commonly used with children and patients who cannot swallow or are unconscious.

Q: What is the intravenous (IV) route of administration?
A: This is medication administed into the vein. This is the fastest way to deliver a chemical substance.

Q: What is the intraosseous (IO) route of administration?
A: This is medication delivered into the bone, reaching the bloodstream via the bone marrow. This is very painful, and so this route is used most often in patients who are unconscious as a result of cardiac arrest or extreme shock, as well as children who have fewer available IV sites.

Q: What is the subcutaneous (SC or SQ) route of administration?
A: This is medication delivered beneath the skin as an injection into the tissue between the skin and muscle. Because there is less blood here than in the muscles, medications that are given by this route are generally absorbed more slowly, and their effects last longer. Daily insulin injections for patients with diabetes are given this way, as well as some forms of epinephrine.

Q: What is the intramuscular (IM) route of administration?
A: This is medication administered into the muscle. Usually, medications given this way are absorbed quickly because muscles have a lot of blood vessels. Possible problems with this method are damage to muscle tissue and uneven, unreliable absorption, especially in people with decreased tissue perfusion. Auto-injectors frequently use this method.

Q: What is the inhalation route of administration?
A: This is medication inhaled into the lungs so that they can be absorbed into the bloodstream more quickly, or so they work in the lungs. Generally, this minimizes the effects of the medication in other body tissues.

Q: What is the sublingual (SL) route of administration?
A: This is medication administered under the tongue. The medication enters through the oral mucosa under the tongue and are absorbed into the bloodstream within minutes. This method is faster than the oral route, and it protects medications from chemicals in the digestive system, such as acids that can weaken or inactivate them.

Q: What is the transcutaneous, or transdermal route of administration?
A: This is medication administered through the skin, and usually have longer-lasting effects. Nicotine patches or adhesive patches containing nitroglycerin are examples of this.

Q: What is the intranasal (IN) route of administration?
A: This is medication administered into the nostril, typically via a specialized atomizer device called a Mucosal Atomizer Device (AKA M.A.D.). Blood flow to the head and face is very high; therefore, absorption is rather quick with this route. Naloxone can be administered to some overdose patients via this route.

Q: What is a solution?
A: This is a liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand.

Q: What is a suspension?
A: This is a mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve. It is very important that you shake or swirl a suspesion before administering it to ensure that the patient receives the right amount of medication.

Q: What is a metered-dose inhaler (A.K.A. an MDI)?
A: This is a miniature spray canister used to direct such substances through the mouth and into the lungs. It delivers the same amount of medication each time it is used, and must be shaken vigorously before the medication is administered.

Q: What are topical medications?
A: These are lotions, creams, and ointments that are applied to the surface of the skin.

Q: What are the "Six Rights" of medication administration?
A: These are:
1) Right patient,
2) Right medication,
3) Right dose,
4) Right route,
5) Right time,
and 6) Right documentation

Q: What is the echo technique?
A: This is repeating the order you receive from the physician for the administration of a medication. It is essential that you do this anytime you receive an order from a physician.

Q: What are the three circumstances for administering medication?
A: These are:
1) peer-assisted medication (administering medication to yourself or your partner)
2) patient-assisted medication (assisting the patient with the administration of his or her own medication)
and,
3) EMT-administered medication (directly administering the medication to the patient.

Q: What are the medications that may be administered by EMTs (depending of course on local protocol)?
A: These medications are:
Oxygen,
Activated charcoal,
Oral glucose,
Aspirin,
Epinephrine auto-injector,
Meter-dose inhaler medications,
and,
Nitroglycerin.

Q: What is Lipitor AKA atorvastatin used for?
A: This is used to lower cholesterol.

Q: What is montelukast AKA Singulair used for?
A: This is used to help prevent asthma attacks.

Q: What is escitalopram AKA Lexapro used for?
A: This is used to treat depression.

Q: What is esomeprazole AKA Nexium used for?
A: This is used to treat gastric reflux.

Q: What is levothyroxine AKA Synthroid used for?
A: This is used to treat decreased thyroid functioning.

Q: What is clopidogrel AKA Plavix used for?
A: This is used to prevent stroke and heart attack.

Q: What is metroprolol AKA Toprol used for?
A: This is used to lower blood pressure.

Q: What is lansoprazole AKA Prevacid used for?
A: This is used to treat stomach ulcers.

Q: What is ezetimibe and simvastatin AKA Vytorin AKA Zetia used for?
A: This is used to lower cholesterol.

Q: What is fluticasone and salmeterol AKA Advair Diskus used for?
A: This is used to treat asthma.

Q: What is cetirizine AKA Zyrtec used for?
A: This is used to treat allergies.

Q: What is venlafaxine AKA Effexor used for?
A: This is used to treat depression.

Q: What is pantoprazole AKA Protonix used for?
A: This is used to treat gastic reflux.

Q: What is valsartan AKA Diovan used for?
A: This is used to treat high blood pressure.

Q: What is alendronate AKA Fosamax used for?
A: This is used to treat osteoporosis.

Q: What is potassium chloride AKA Klor-Con used for?
A: This is used to treat low potassium levels.

Q: What is valsartan and hydrochlorothiazide AKA Diovan HCT used for?
A: This is used to treat hypertension.

Q: What is levofloxacin AKA Levaquin?
A: This is an antibiotic.

Q: What is polypharmacy?
A: This refers to the use of multiple medications by one person.

Q: What is a common bronchodilator?
A: A common kind of this medication is albuterol (AKA Proventil or Ventolin).

Q: What is another name for asthma?
A: This is also known as reactive airway disease.

Q: What is the standard dose of epinephrine in an auto-injector?
A: The standard dose for this is 0.3 mg.

Q: What is epinephrine (AKA adrenaline), and what are its characteristics?
A: This is the main hormone that controls the body's fight-or-flight response and is the primary medication EMTs will administer IM. It is sympathomimetic, meaning it mimics the effect of the sympathetic nervous system.
Characteristics of this chemical are:
Secreted naturally by the adrenal glands.
Dilates passages in the lungs.
Constricts blood vessels, causing increased blood pressure.
Increases heart rate and blood pressure.
Contraindication for this include:
hypertension,
hypothermia,
myocardial infarction,
and,
no sign of wheezing or hypotension

Q: What is nitroglycerin?
A: The purpose of this is to increase blood flow by relieving the spasms or causing the arteries to dilate. It does this by relaxing the muscular walls of the coronary arteries and veins. Always take the patient's blood pressure before administering this; if systolic blood pressure is less than 100 mm Hg, do not administer this medication.
Contraindications for this include:
sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), or any other medications that are used for the treatment of erectile dysfunction taken in the previous 24 hours.

Q: What is the standard dose for nitroglycerin?
A: The standard dose for this is .4 mg / pill.

Q: How long should you wait between doses of nitroglycerin?
A: You should wait 5 minutes before administering another dose of this.

Q: What is aspirin (A.K.A. acetylsalicylic acid or A.S.A.)?
A: This is an antipyretic (fever reducer), analgesic (reduces pain), and anti-inflammatory medication that also inhibits platelet aggregation. Taken during a heart attack, this may prove lifesaving. It should not be given to children during episodes of fever-causing illness due to its association with Reye syndrome (which causes swelling in the brain and liver).

Q: What is adsorption?
A: This means to bind or stick to a surface.

Q: What is the usual dose for activated charcoal?
A: This is usually 1 to 2 grams per kilogram of body weight.

Q: As an EMT, what is the only way you can administer oral glucose?
A: As an EMT, you can only administer this orally.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of Acetaminophen / Tylenol?
A: For this medication:
Action: Analgesic and antifever
Indications: Relief of mild pain or fever, headache, and muscle aches
Contraindications: Hypersensitivity
Routes: PO
Side Effects: Allergic reaction
Interactions: Caution must be taken when EMTs are administering this to avoid potential overdosing.
Adult dose: 500 to 1000 mg every 4 hours as needed; dose is weight based for children.
Administration concerns: Weight of child is more important than age.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of activated charcoal / actidose with Sorbitol?
A: For this medication:
Action: Adsorbs toxic substances in the digestive tract.
Indications: Most oral poisonings; overdose.
Contraindications: Decreased level of consciousness; overdose of corrosives, caustics, or petroleum substances.
Routes: PO.
Side Effects: Nausea, vomiting, constipation, black stool.
Interactions: Bonds with and inactivates most medications / substance in the digestive tract.
Adult dose: 1 to 2 grams per kilogram
Administration concerns: Stains; protect patient and provider clothing; do not give when giving other PO medications.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of Aspirin / Bayer?
A: For this medication:
Action: Anti-inflammatory agent and anti-fever agent; prevents platelets from clumping, thereby decreasing formation of new clots.
Indications: Relief of mild pain, headache, muscle aches, chest pain when considering myocardial infarction.
Contraindications: Hypersensitivity, recent bleeding.
Routes: PO
Side Effects: Nausea, vomiting, stomach pain, bleeding, allergic reactions.
Interactions: Caution should be used in patients who are taking anticoagulants.
Adult dose: 160 to 325 mg for chest pain.
Administration concerns: Do not administer for pain cause by trauma or for fevers in children; patients with chest pain must be able to chew tablets.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of Albuterol / Proventil, Ventolin?
A: For this medication:
Action: Stimulates nervous system, causing bronchodilation.
Indications: Asthma / difficulty breathing with wheezing.
Contraindications: Hypersensitivity, tachycardia, myocardial infarction.
Routes: MDI / inhalation.
Side Effects: Hypertension, tachycardia, anxiety, restlessness.
Interactions: Increases effects of other nervous system stimulants.
Adult dose: 1 to 2 inhalations; wait 5 minutes before repeating dose.
Administration concerns: Patient must inhale all medication in 1 breath; coach patient to hold breath for 5 seconds after inhalation.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of diphenhydramine / Benadryl?
A: For this medication:
Action: Antihistamine.
Indications: Mild allergic reactions.
Contraindications: Asthma, glaucoma, pregnancy, hypertension, infants.
Routes: PO
Side Effects: Sleepiness, dry mouth, and throat.
Interactions: Do not take with alcohol or MAO inhibitors (a type of psychiatric medication).
Adult dose: 25 to 50 mg.
Administration concerns: Can use in severe allergic reaction; however, epinephrine is administered first.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of Epinephrine / EpiPen?
A: For this medication:
Action: Stimulates nervous system, causing bronchodilation.
Indications: Severe allergic reactions.
Contraindications: Myocardial infarction, hypothermia, hypertension.
Routes: IM (auto-injector).
Side Effects: Hypertension, tachycardia, anxiety, restlessness.
Interactions: Increases effects of other nervous system stimulants.
Adult dose: 1 auto-injector.
Administration concerns: Medication will last approximately 5 minutes; do not repeat dose; ensure ALS is en route for continuing treatment.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of ibuprofen / Advil, Motrin, Nuprin?
A: For this medication:
Action: Nonsteroidal anti-inflammatory drug that reduces inflammation and fever, analgesic.
Indications: Mild pain or fever, headache, muscle aches.
Contraindications: Hypersensitivity.
Routes: PO
Side Effects: Nausea, vomiting, stomach pain, bleeding, allergic reactions.
Interactions: Do not take with aspirin.
Adult dose: 200 to 400 mg every 4 to 6 hours; dose is weight based in children.
Administration concerns: Do not take for pain caused by trauma; weight of child is more important than age.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of nitroglycerin / Nitrostat?
A: For this medication:
Action: Dilates blood vessels.
Indications: Chest pain due to myocardial infarction or angina.
Contraindications: Hypotension, having taken sildenafil (Viagra) or another treatment for erectile dysfunction with the past 24 hours; head injury.
Routes: SL / Spray.
Side Effects: Headache, burning under tongue, hypotension, nausea.
Interactions: Increases dilating effects of other blood vessel-dilating medications.
Adult dose: 0.3 to 0.4 mg SL; 0.4 mg spray.
Administration concerns: Ensure ALS is en route.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of oral glucose / Glutose?
A: For this medication:
Action: When absorbed, provides glucose for cell use.
Indications: Hypoglycemia.
Contraindications: Decreased level of consciousness, nausea, vomiting.
Routes: PO
Side Effects: Nausea, vomiting.
Interactions: None.
Adult dose: 1/2 to 1 tube.
Administration concerns: Patient must have control of airway and be awake and able to follow commands.

Q: What are the action, indications, contraindications, routes, sides effects, interactions, adult dose, and administration concerns of oxygen?
A: For this medication:
Action: Reverses hypoxia, provides oxygen to be absorbed by lungs.
Indications: Hypoxia or suspected hypoxia.
Contraindications: Very rarely in patients with C.O.P.D.
Routes: Gas / Inhalation.
Side Effects: Decreased respiratory effort in rare cases in patients with C.O.P.D.
Interactions: Can support combustion.
Adult dose: Use oxygen delivery to administer 28% to 100% oxygen.
Administration concerns: No open flames nearby; do not withhold oxygen from patients in respiratory distress.

Q: What is a neonate?
A: This is a baby from birth to 1 month.

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of neonates (0 to 1 month)?
A: For this group:
Pulse: 90 to 180;
Respirations: 30 to 60;
Systolic Blood Pressure: 50 to 70;
and,
Temperature: 98 to 100° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of infants (1 month to 1 year)?
A: For this group:
Pulse: 100 to 160;
Respirations: 25 to 50;
Systolic Blood Pressure: 70 to 95;
and,
Temperature: 96.8 to 99.6° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of toddler (1 to 3 years)?
A: For this group:
Pulse: 90 to 150;
Respirations: 20 to 30;
Systolic Blood Pressure: 80 to 100;
and,
Temperature: 96.8 to 99.6° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of preschool age children (3 to 6 years)?
A: For this group:
Pulse: 80 to 140;
Respirations: 20 to 25;
Systolic Blood Pressure: 80 to 100;
and,
Temperature: 98.6° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of school age children (6 to 12 years)?
A: For this group:
Pulse: 70 to 120;
Respirations: 15 to 20;
Systolic Blood Pressure: 80 to 110;
and,
Temperature: 98.6° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of early adults (19 to 40 years) and middle adults (41 to 60 years)?
A: For these groups:
Pulse: 60 to 100;
Respirations: 12 to 20;
Systolic Blood Pressure: 90 to 140;
and,
Temperature: 98.6° Farenhait

Q: What are the pulse rate, respirations, systolic blood pressure, and temperature of adolescents (12 to 18 years)?
A: For this group:
Pulse: 60 to 100;
Respirations: 12 to 20;
Systolic Blood Pressure: 90 to 110;
and,
Temperature: 98.6° Farenhait

Q: What is the general rule for age and pulse rates / respirations?
A: The general rule is: the younger the person, the faster the pulse rate and respirations.

Q: What is the tidal volume in neonates?
A: In this age group, the tidal volume is 6 to 8 mL per kg.

Q: How much does a neonate usually weigh at birth, what percent of their weight does their head account for, and how much weight do they gain as they develop?
A: This group usually weighs 6 to 8 lbs (3 to 3.5 kg) at birth, with the head accounting for 25% of its body weight. In the first week, 5% to 10% of their birth weight is lost due to fluid loss. I n the second week, they start growing at a rate of about 30g a day.

Q: What are some important considerations regarding a neonate's pulmonary system?
A: In the group:
1) Their first breath is forceful, as they must inflate their lungs.
2) This group is particularly prone to nasal congestion, which causes upper respiratory infections. If you recieve a call for choking, make sure the nasal passages are clear and unobstructed by mucus.
3) Their rib cage is less rigid and the ribs sit horizontally. This explains their diaphragmatic breathing (AKA "belly breathing").

Q: What is barotrauma?
A: This is trauma resulting from pressure disequilibrium across body surfaces, for example from too much pressure in the lungs.

Q: What is the moro reflex?
A: This (AKA startle reflex) is when a neonate is caught off guard by something or someone; the neonate opens his or her arms wide, spreads the fingers, and seems to grab at things.

Q: What is the palmer grasp?
A: This is an infant reflex; when an is object is placed in their palm, they grasp at the object.

Q: What is the rooting reflex?
A: This takes place when something touches a neonate's cheek; the neonate will instinctively turn his or her head toward the touch.

Q: What is the sucking reflex?
A: This occurs when a neonate's lips are stroked.

Q: What are fontanelles?
A: These are areas where the infat's skull has not fused together; the posterior fuses by the third month; the anterior between 9 and 18 months.

Q: If an infant's fontanelles' is depressed or bulging, what does that mean?
A: If these are depressed, the infant is most likely dehydrated.
These bulging is indicative of increased intracranial pressure.

Q: What are the noticeable characteristics of an infant at 2 months?
A: At this age, the infant can recognize familar faces, and is able to track objects with their eyes.

Q: What are the noticeable characteristics of an infant at 3 months?
A: At this age, the infant can bring objects to the mouth, and can smile and frown.

Q: What are the noticeable characteristics of an infant at 4 months?
A: At this age, the infant can reach out to people and drool.

Q: What are the noticeable characteristics of an infant at 5 months?
A: At this age, the infant can sleep through the night, and can tell family from strangers.

Q: What are the noticeable characteristics of an infant at 6 months?
A: At this age, teething begins; the infant can sit upright in a chair, and one-syllable words are spoken.

Q: What are the noticeable characteristics of an infant at 7 months?
A: At this age, the infant is afraid of strangers, and has mood swings.

Q: What are the noticeable characteristics of an infant at 8 months?
A: At this age, the infant responds to "no", can sit alone, and plays peek-a-boo.

Q: What are the noticeable characteristics of an infant at 9 months?
A: At this age, the infant can pull himself or herself up, and places objects in mouth to explore them,

Q: What are the noticeable characteristics of an infant at 10 months?
A: At this age, the infant responds to his or her name, and crawls efficiently.

Q: What are the noticeable characteristics of an infant at 11 months?
A: At this age, the infant starts to walk without help, and can be frustrated with restrictions.

Q: What are the noticeable characteristics of an infant at 12 months?
A: At this age, the infant knows his or her name, and can walk.

Q: What a secure attachment?
A: This occurs when an infant understands that parents or caregivers will be responsive to his or her needs. This realization encourages a child to reach out and explore, knowing that the parents will provide a "safety net".

Q: What is anxious-avoidant attachment?
A: In this attachment style, children show little emotional response to their parents or caregivers and treat them as they would strangers. These children develop an isolated lifestyle where they do not have to depend on the support and care of others.

Q: What are some physical developments in toddlers and preschoolers?
A: In these age groups:
1) The children do not have well-developed lung musculature. This anomaly prevents them from sustaining deep or rapid respirations for an extended period of time.
2) They lose passive immunity and acquire their own immunity as the body is exposed to various viruses and germs.
3) The average age for completion of toilet training is 28 months of age.

Q: At what age do children transition from using language to communicate what they want to using language creatively and playfully.
A: This transition occurs by the age of 3 or 4.

Q: How much do most school age children grow each year?
A: This group grows about 4 lbs (2 kg) and 2 1/2 inches (6 cm) each year.

Q: What is pre-conventional reasoning?
A: In this stage of development, children act almost purely to avoid punishment and to get what they want.

Q: What is conventional reasoning?
A: In this stage of development, children look for approval from their peers and society.

Q: What is postconventional reasoning?
A: In this stage of development, children make decisions guided by their conscience.

Q: What is atherosclerosis?
A: In this disorder, cholesterol and calcium build-up inside the walls of blood vessels, forming plaque. More than 60% of people older than 65 years ahve atherosclerotic disease.

Q: What happens to the respiratory system of late adults?
A: In this group:
1) The size of the airway increases.
2) The surface of the alveoli decreases.
and
3) Factors such as loss of respiratory muscle mass and an increased stiffness of the thoracic cage leads to up to a 50% decresse of vital capacity by age 75.

Q: What happens to the endocrine system of late adults?
A: In this group:
As a person gains weight, more insulin is need to control the body's metabolism and blood glucose level. The pancreas may not be able to produce enough insulin for the person's body size, which can lead to diabetes mellitus.

Q: What happens to the digestive system of late adults?
A: In this group:
Blood flow may drop by as much as 50%, decreasing the ability of the intestines to extract vitamins and minerals from digested food.

Q: What happens to the renal system of late adults?
A: In this group:
1) The filtration function of the kidneys declines by 50% from age 20 to age 90.
2) Kidney mass decreases by 20% over the same span.
3) The number of nephrons (capillaries that perform filtering in the kidney) also decreases, which leads to a decrease in the ability to clear wastes from the body.

Q: What happens to the nervous system of late adults?
A: In this group:
1) The brain may shrink 10% to 20% by age 80, increasing the possibility of internal trauma.
2) The number of neurons (brain cells) declines over one's lifetime.
3) The peripheral nervous system also slows with age.

Q: What is the terminal drop hypothesis?
A: This is a theory that a person's mental function declines in the last five years of life.

Q: What percentage of single women of 60 years of age or older live at or below the poverty line in the United States.
A: More than 50% of this group live at or below the poverty line in the United States.

Q: What is topographic anatomy?
A: This is the landmarks of the surface of the body used to orient treatment.

Q: What is the anatomic position?
A: This is a position of reference in which the patient stands facing you, arms at the side, with the palms of the hands forward. To be consistent, health care providers use the patient's left and right as reference point.

Q: What are the three planes of the body?
A: These are:
1) Frontol (coronal) plane - Anterior vs. posterior.
2) Transverse (horizontal) plane - Superior vs. inferior.
and
3) Sagittal plane - medial vs. lateral.

Q: What is the opposite of superficial (closest to the surface of the skin)?
A: The opposite of this is deep (farthest from the surface of the skin).

Q: What is the palmar surface?
A: This is another term for the palm.

Q: What is the plantar surface?
A: This is another term for the bottom of the foot.

Q: What is the apex (plural apices)?
A: This is the tip of a structure.

Q: What is flexion?
A: This is the bending of a joint.

Q: What is extension?
A: This is the straightening of a joint.

Q: What is adduction?
A: This is motion toward the midline.

Q: What is abduction?
A: This is motion away from the midline.

Q: What does it mean if something is said to occur unilaterally?
A: This means something appears on only one side of the body.

Q: What are ligaments?
A: These connect bones to other bones.

Q: What are tendons?
A: These connect muscles to bones.

Q: What is cartilage?
A: This is the soft, semiflexible material that is found within the joints and serves as cushioning.

Q: What is the axial skeleton?
A: This forms the foundation on which the arms and legs are hung. It is composed of the skull, face, thoracic cavity, and vertebral column.

Q: What is the appendicular skeleton?
A: This is composed of the arms and legs, their connective points, and the pelvis.

Q: How many bones are there in the body?
A: There are 206 of these.

Q: What is the foramen magnum?
A: This is a large opening at the base of the skull.

Q: What are the maxillae?
A: These are the upper, non-moveable jawbones.

Q: What are the zygomas?
A: These are the cheekbones.

Q: What is the orbit?
A: This is the eye socket.

Q: How many vertebrae are there in the body?
A: There are 33 of these in the body.

Q: What are the five sections of the spine, and how many vertebrae in each?
A: These are the:
1) Cervical - 7
2) Thoracic - 12
3) Lumbar - 5
4) Sacrum - 5
5) Coccyx - 4

Q: How many pairs of ribs are there in the body?
A: There are 12 pairs of these.

Q: What is the sternum?
A: This is the midline of the chest. It's bordered superiorly by the easily palpable jugular notch. It has three components: the manubrium, the body, and the xiphoid process.

Q: What is the xiphoid process.
A: This is a narrow, cartilaginous tip which forms the inferior part of the sternum.

Q: What is the shoulder girdle?
A: This is where three bones (the clavicle, scapula, and humerus) come together, allowing the arm to be moved.

Q: What is the clavicle?
A: This overlies the superior boundaries of the thorax in front and articulates posteriorly with the scapula.

Q: What two bones compose the forearm?
A: This is composed of the ulna (medial, larger in the proximal) and radius (lateral, larger in the distal).

Q: What bones make up the pelvis?
A: This is made up of the sacrum and the two pelvic bones, each of which is formed by the fusion of three separate bones, the ilium, the ischium, and the pubis, joined posteriorly by the sacrum.

Q: What is the pubis symphysis?
A: This is a hard and bony cartilaginous prominence found at the midline in the lowest portion of the abdomen, where the two halves of the pelvic rings are joined by cartilage at a joint with minimal motion.

Q: What is the acetabulum?
A: This is the part of the pelvis where the lower leg connects, the "socket" in which the "ball" of the femur fits.

Q: What is the greater trochanter?
A: This is the projection on the lateral / superior portion of the femur.

Q: What is the lesser trochanter?
A: This is the medial / superior portion of the femur.

Q: What is the tibia (shine bone)?
A: This is the larger bone of lower leg. It lies in the anterior of the leg.

Q: What is the fibula?
A: This is the smaller of the bones in the lower leg. It lies on the lateral side of the leg.

Q: What is joint capsules?
A: These are fibrous sacs composed of ligaments at the end of bones, and assist in flexion.

Q: What is the synovial membrane?
A: This is special tissue on the inner lining of the joint capsule that is responsible for making a thick lubricant called synovial fluid. This fluid allows the ends of bones to glide over each other as opposed to grating.

Q: What is the difference between ball-and-socket joints and hinge joints?
A: The first allows rotation and bending (as in the shoulder joint), while the second restricts motion to one plane (as in the knee).

Q: What is the skeletal system responsible for?
A: This is resonsible for:
1) giving the body shape.
2) providing protection of fragile organs.
3) allowing for movement.
And,
4) helping with the creation of various types of blood cells.

Q: How many different muscles are there in the musculoskeletal system?
A: There are over 600 of these.

Q: What are skeletal muscles (AKA voluntary muscles)?
A: These attach to the bones of the skeleton and forms the major muscle mass of the body. They are under direct voluntary control of the brain and can be stimulated to contract or relax at will.

Q: What is cardiac muscle?
A: This is found only within the heart.

Q: What is the epiglottis?
A: These is a thin, leaf-shaped valve that protects the opening of the trachea.

Q: What is the location and function of the biceps?
A: This is located anterior to the humerus,
and,
flexes the lower arm.

Q: What is the location and function of the triceps?
A: This is located posterior to the humerus,
and,
extends the lower arm.

Q: What is the location and function of the pectoralis?
A: This is located anterior to the thorax,
and,
flexes and rotates the arm.

Q: What is the location and function of the latissimus dorsi?
A: This is located posterior to the thorax,
and,
extends and rotates the arm.

Q: What is the location and function of the rectus abdominis?
A: This is located anterior to the abdomen,
and,
flexes and rotates the spine.

Q: What is the location and function of the tibialis anterior?
A: This is located anterior to the tibia,
and,
points toes towards the heads.

Q: What is the location and function of the gastrocnemius?
A: This is located posterior to the tibia,
and,
points toes away from the head.

Q: What is the location and function of the quadriceps?
A: This is located anterior to the femur,
and,
extends the lower leg.

Q: What is the location and function of the biceps femoris?
A: This is located posterior to the femur,
and,
flexes the lower leg.

Q: What is the location and function of the gluteus?
A: This is located posterior to the pelvis,
and,
extends and rotates the leg.

Q: What is another name for the larynx?
A: Another name for this is the voice box.

Q: What is the cricothyroid membrane?
A: This lies between the thyroid and cricoid cartilage. It can be felt as a depression in the midline of the neck just inferior to the thyroid cartilage.

Q: What kind of muscle is the diaphragm?
A: This is unique because it has characteristics of skeletal and smooth muscle.

Q: How does the body detect decreased blood pressure, and what will it do as a result?
A: The body detects this situation by the baroreceptors, and will initiate the release of epinephrine and norepinephrine.

Q: What is the V/Q ratio?
A: This examines how much gas is being moved effectively and how much blood is gaining access to the alveoli.

Q: What is pathophysiology?
A: This is the study of the functional changes that occur when the body reacts to a particular disease.

Q: What is normal physiologic pH?
A: This is normally between 7.35 and 7.45 pH.

Q: What is sodium bicarbonate?
A: This is an alkaline and helps to buffer or neutralize the acidic waste products of the cells.

Q: What is lactic acid?
A: This is the metabolic end product of the breakdown of glucose that accumulates when metabolism proceeds in the absence of oxygen (AKA anaerobic respiration).

Q: What is the endocrine system?
A: This is a complex message and control system that uses hormones to stimulate the body.

Q: In a healthy adult, what percent of total body weight is delivered as fluid daily to the gastrointestinal tract?
A: About 7% of this is delivered daily. If significant vomiting or diarrhea occurs for more than 2 or 3 days, the person will lose a substantial portion of body composition and become severely ill.

Q: What are enzymes?
A: These are substance catalysts designed to speed up the rate of specific biochemical reactions.

Q: What are hormones?
A: These are substances formed in specialized organs or glands and carried to another organ or group of cells in the same organism. They regulate many body functions, including metabolism, growth, and body temperature.

Q: What is bile?
A: This is produced in the liver and stored in the gallbladder, and emptied as needed into the duodenum. Its major function is the digestion of fat.

Q: What is chyme?
A: This is ingested food converted in the stomach into a thoroughly mixed semisolid mass.

Q: How much saliva is produced daily?
A: Approximately 1.5 litres of this is produced daily.

Q: What is the average stroke volume (SV) of an adult heart?
A: This is 70 to 80 mL each on average.

Q: What is the average cardiac output (CO) of an adult?
A: This is 5 to 6 litres.

Q: What are the two electrical processes associated with the mechanical contraction of the heart?
A: These are:
1) depolarization, when the electrical charge on the muscle cell surface changes from positive to negative.
And,
2) repolarization, when the heart returns to its resting state and positive charge is restored to the surface.

Q: What is the path of the electrical impulse that produces the a smooth flow of electricity through the heart?
A: This begins high in the atria at the sinoatrial node, then travels to the atrioventricular node bundle of His, and moves through the Purkinje fivers to the ventricles.

Q: What is the chordae tendineae?
A: These are thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting.

Q: What is the tunica media?
A: This is the middle layer of the artery, and is where the smooth muscles are found that can contract and dilate to change the diameter of the blood vessels.

Q: What are the coronary arteries?
A: These supply the heart.

Q: What are the carotid arteries?
A: These supply the head.

Q: What are the hepatic arteries?
A: These supply the liver with blood.

Q: What are the renal arteries?
A: These supply the kidneys with blood.

Q: What are the mesenteric arteries?
A: These supply the digestive system with blood.

Q: What is systemic vascular resistance (SVR)?
A: This is the resistance to blood flow within all of the blood vessels except the pulmonary vessels.

Q: How much blood is in the spleen at any one time?
A: Approximately 450 mL of blood is in this organ at any one time. Virtually all the blood in the body passes through here during the day, where it is filtered.

Q: What is blood plasma composed of?
A: This is composed of:
92% water,
7% proteins such as albumin which regulates oncotic pressure,
and
the final 1% is oxygen, carbon dioxide, nitrogen, nutrients, cellular wastes, and other cellular products.

Q: How much blood does a child have in their body?
A: This group has approximately 2 to 3 litres, depending on their age and size.

Q: How much blood does an infant have in their body?
A: This group has only about 300 mL in their body.

Q: How much blood is in the heart, arteries, and capillaries versus the veins and venules?
A: The ratio is approximately 30% in the former group, and 70% in the later group.

Q: What is interstitial space?
A: This is the space between cells.

Q: What are alpha-adrenergic receptors?
A: These are portions of the nervous system that when stimulated can cause constriction of blood vessels.

Q: What are beta-adrenergic receptors?
A: These are portions of the nervous system that when stimulated can cause an increase in the force of the contraction of the heart, an increased heart rate, and bronchial dilation.

Q: What are the three parts of the brain stem?
A: These are:
1) the midbrain,
2) the pons,
and 3) the medulla oblongata.

Q: What is the parasympathetic nervous system?
A: This is the other half of the autonomic nervous system and generally slow down the body.

Q: What are the two layers of the skin?
A: These are:
1) The epidermis; at its base is the germinal layer, which continuously produces new cells.
2) The dermis; the sweat glands, sebaceous (oil) glands, hair follices, blood vessels, and specialized nerve endings are located here.

Q: How long does it take for cells produced in the germinal layer to rise to the stratum corneal layer?
A: This journey takes about 4 weeks.

Q: What is the location, function, and timing of the dorsal respiratory group (DRG)?
A: For this:
Location: Medulla.
Function: Causes inspiration when stimulated.
Timing: Normal, resting respirations; rhythmic, mechanical pattern.

Q: What is the location, function, and timing of the ventral respiratory group (VRG)?
A: For this:
Location: Medulla.
Function: Causes expiration or inspiration.
Timing: Speech, increased emotional or physical stress.

Q: What is the location, function, and timing of the Pneumotaxic (pontine) center?
A: For this:
Location: Pons.
Function: Inhibits the DRG; increases speed and depth of respirations.
Timing: Increased emotional or physical stress.

Q: What is the location, function, and timing of the apneustic center?
A: For this:
Location: Pons.
Function: Excites the DRG; prolongs inspiration, decreases rate.
Timing: Increased emotional or physical stress.

Q: What is the location, function, and timing of the Hering-Breuer inflation reflex (stretch reflex)?
A: For this:
Location: Chest.
Function: Detects lung expansion to a point and then tells VGR and pneumotaxic and apneustic centers to stop.
Timing: Increased emotional or physical stress.

Q: What is the location, function, and timing of the Hering-Breuer deflation reflex?
A: For this:
Location: Chest.
Function: Detects potential lung collapse and then tells VGR and pneumotaxic and apneustic centers to stop.
Timing: Increased emotional or physical stress.

Q: What is the location, function, and hormone produced in the adrenal gland?
A: For this gland:
Location: Above the kidneys.
Function: Stress response, fight or flight.
Hormones produced: Epinephrine, norepinephrine, and others.

Q: What is the location, function, and hormone produced in the ovary?
A: For this gland:
Location: Female pelvis.
Function: Regulates sexual function, characteristics, and reproduction.
Hormones produced: Estrogen and others.

Q: What is the location, function, and hormone produced in the pancreas?
A: For this gland:
Location: Retroperitoneal space.
Function: Regulates glucose metabolism and other functions.
Hormones produced: Insulin and others.

Q: What is the location, function, and hormone produced in the parathyroid?
A: For this gland:
Location: Neck (behind and beside the thyroid) (three to five glands)
Function: Regulates serum calcium.
Hormones produced: Parathyroid hormone.

Q: What is the location, function, and hormone produced in the pituitary gland?
A: For this gland:
Location: Base of skull.
Function: Regulates all other endocrine glands.
Hormones produced: Multiple, controls other endocrine glands.

Q: What is the location, function, and hormone produced in the testes?
A: For this gland:
Location: Male scrotum.
Function: Regulate sexual function, characteristics, and reproduction.
Hormones produced: Testosterone and others.

Q: What is the location, function, and hormone produced in the thyroid?
A: For this gland:
Location: Neck (over the larynx).
Function: Regulates metabolism.
Hormones produced: Thyroxine and others.

Q: What is one example of an additional skill that an AEMT can perform that a standard EMT-B cannot?
A: One example of this is esophageal-tracheal intubation.

Q: What are the responsibilities of the medical director?
A: This person uses their license to allow EMT-Bs to provide prehospital care, and is responsible for the quality of treatment given. They are also responsible for ensuring appropriate EMT education and continuing training, ensuring the appropriate standards are met by EMT-Bs, and serving as liaison with the medical community.

Q: What are standing orders?
A: These are specific policies issued by a medical director that authorizes an EMT to perform particular skills in certain situations (for example: "if a patient has a blood sugar below 60, administer oral glucose").

Q: What does continuous quality improvement (AKA CQI) involve?
A: This involves:
Remedial training as deemed necessary by the medical director.
Discussion of needs for improvement.
And,
Periodic reviews of run reports.

Q: Who is responsible for maintaining quality control?
A: This responsibility ultimately rests with the medical director.

Q: What is always an EMT-Bs first priority during a call?
A: This is always personal safety.

Q: What are some essential skills an EMT-B needs to learn?
A: Some examples of this include:
Verbal and written communication skills.
Dealing with medical, legal, and ethical situations,
and,
Delivering a baby.

Q: What are the ten standards identified by the "Technical Assistance Program Assessment Standards" provided by the National Highway Traffic Safety Administration?
A: These are:
1) regulation and policy,
2) resource management,
3) human resources and training,
4) transportation,
5) facilities,
6) communications,
7) public information and education,
8) medical direction,
9) trauma systems,
and
10) evaluation.

Q: What is online medical control?
A: This is when you are in direct contact with a doctor concerning the current patient.

Q: What is another term for medical direction?
A: Another term for this is medical control.

Q: What is the list of steps taken in different situations, and developed by a medical director, called?
A: These are referred to as protocols.

Q: What federal agency has developed standards for training and development of the EMS system?
A: This agency is the National Highway Traffic Safety Administration.

Q: What are some components of the EMS system?
A: Some components of this include:
911 Dispatchers,
Patients,
EMS personnel,
and First Responders.

Q: What is one of the most important safeguards against legal problems?
A: A complete, accurate report is one of the most important safeguards against this. The courts consider an incomplete or untidy report to be evidence of incomplete or unexpert care provided.

Q: What is an advanced directive (AKA health care directive)?
A: This is a written document that specifies medical treatment should a competent patient become unable to make decisions.

Q: What are DNR orders?
A: These are written documentation that give medical personnel permission not to attempt resuscitation.

Q: What is assualt?
A: This is anytime you unlawfully place a person in fear of immediate bodily harm without his consent.

Q: What is battery?
A: This is defined as unlawfully touching a person without his or her consent.

Q: What is abandonment?
A: This is unilateral termination of care by the EMT without the patient's consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient.

Q: What is defamation?
A: This is the communication of false information about a person that is damaging to that person's reputation or standing in the community.

Q: What is expressed consent (AKA actual consent)?
A: This is a type of consent in which a patient give express authorization for provision of care or transport.

Q: What is implied consent?
A: This is a type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.

Q: What is informed consent?
A: This is permission for treatment given by a compentent patient after the potential risks, benefits, and alternatives to treatment have been explained.

Q: What is breach of duty?
A: This is anytime the EMT-B does not act within an expected and reasonable standard of care. This includes providing care above the level of your training.

Q: How many watts of power do VHF mobile radios operate at?
A: These operate at 100 watts of power, and are mounted in mobile vehicles.

Q: What is the first key rule of lifting?
A: The first key rule of this is to always keep your back in an upright position and lift without twisting.

Q: What is the safest and most powerful way to lift?
A: The power lift is this kind of lift.

Q: How many rescuers should you use whenever possible, and who is responsible for coordinating the moves?
A: You should try to have four of these whenever resourcers allow; the team leader is responsible for this.

Q: What is the most commonly used device to move and transport patients?
A: The wheeled ambulance stretcher is the most commonly used one of these.

Q: What are devices used to carry patients?
A: Types of these devices include:
The wheeled ambulance stretchers,
Portable stretchers,
Flexible stretchers,
Backboards,
Basket stretchers (AKA Stokes litters),
Scoop stretchers,
and,
Stair chairs.

Q: What is bariatrics?
A: This is a branch of medicine concerned with the management, prevention and control of obesity and allied diseases.

Q: What is a basket stretcher (AKA a Stokes litter)?
A: This is a rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom.

Q: What is a diamond carry?
A: This is a carrying technique in which one EMT is located at the head end of the stretcher or backboard, one at the foot end, and one at each side of the patient; each of the EMTs at the sides use one hand to support the stretcher / backboard so that all are able to face forward as they walk.

Q: What is the direct ground lift?
A: This is a lifting technique that is used for patients who are found lying supine on the ground with no suspected spinal injury.

Q: What is an emergency move?
A: This is a move in which the patient is dragged or pulled from a dangerous scene before assessment and care are provided.

Q: What is an extremity lift?
A: This is a lifting technique that is used for patients who are supine or in a sitting position with no suspected extremity or spinal injury.

Q: What is a flexible stretcher?
A: This is a stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.

Q: What is a portable stretcher?
A: This is a stretcher with a strong rectangular tubular metal frame and rigid fabric stretched across it.

Q: What is a power grip?
A: This is a technique in which the litter or backboard is gripped by inserting each hand under the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb.

Q: What is the power lift?
A: This is a lifting technique in which the EMTs' back is held upright, with legs bent, and the patient is lifted when the EMT straightens the legs to raise the upper body and arms.

Q: What is the rapid extrication technique?
A: This is a technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than 1 minute when conditions do not allow for standard immobilization.

Q: AAA
A: abdominal aortic aneurysm

Q: abd
A: abdomen

Q: CHF
A: congestive heart failure

Q: MI
A: myocardial infarction

Q: "PASTE" is an alternate assessment tool for [...] patients
A: respiratory

Q: A pleural [...] is MOST accurately defined as fluid accumulation outside the lung.
A: effusion

Q: Asthma is caused by a response of the [...] system.
A: immune

Q: Crackles (rales) are caused by air passing through [...].
A: fluid

Q: In order for efficient pulmonary gas exchange to occur oxygen and carbon dioxide must be able to freely [...] across the alveolar-capillary membrane.
A: diffuse

Q: In what area of the lungs does respiration occur?
A: Alveoli

Q: When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has [...] breath sounds.
A: abnormal

Q: Cystic fibrosis is a genetic disorder that predisposes the patient to repeated [...] infections.
A: lung

Q: What must be assessed in every respiratory patient?
A: Lung sounds

Q: Low-pitched "rattling" sounds bilaterally at the bases on the lungs indicates aspiration [...].
A: pneumonia

Q: Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the [...] drive.
A: hypoxic

Q: Acute pulmonary edema would MOST likely develop as the result of toxic chemical [...].
A: inhalation

Q: Alkalosis is a condition that occurs when blood acidity is reduced by excessive [...].
A: breathing

Q: A regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest indicates adequate [...].
A: air exchange

Q: Common signs and symptoms of acute [...] syndrome include tachypnea and tingling in the extremities.
A: hyperventilation

Q: Dyspnea is MOST accurately defined as shortness of [...] or difficulty [...].
A: breath; breathing

Q: When the level of arterial carbon dioxide rises above normal- respirations increase in [...] and [...].
A: rate; depth

Q: Anaphylaxis is characterized by airway [...] and [...]tension.
A: swelling; hypo

Q: The hypoxic drive stimulates a person to breathe on the basis of [...] oxygen levels.
A: low

Q: Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of [...].
A: congestive heart failure

Q: Thromboembolism is a blood [...] floating through blood vessels until it reaches a narrow area and [...] blood flow.
A: clot; blocks

Q: Ischemia means lack of [...]. It is potentially reversible because permanent injury has not occured yet.
A: oxygen

Q: Infarction means [...] death.
A: tissue

Q: Cardiogenic shock can occur within [...] hours of a(n) Acute Myocardial Infarction
A: 24

Q: The only vein(s) in the body that carry oxygenated blood is/are the [...] veins.
A: pulmonary

Q: When, for a brief period of time, heart tissues do not get enough oxygen, the pain is called [...].
A: angina

Q: About [...] minutes after blood flow is cut off, some heart muscle cells begin to die.
A: 30

Q: Automaticity allows a cardiac muscle cell to contract spontaneously without a stimulus from a [...] source.
A: nerve

Q: [...] are inserted when the electrical control system of the heart is so damaged that it cannot function properly.
A: Pacemakers

Q: In general, a maximum of [...] dose(s) of nitroglycerin is/are given for any one episode of chest pain.
A: 3

Q: A percutaneous transluminal coronary angioplasty (PTCA) restores [...] to the ischemic myocardium by [...] the affected coronary artery with a small inflatable balloon.
A: blood flow; dilating

Q: [...] is a term used to describe a group of symptoms that are caused by myocardial ischemia.
A: Acute coronary syndrome (ACS)

Q: After assisting your patient with prescribed nitroglycerin, you should reassess his or her blood pressure within [...] minutes to detect [...].
A: 5; hypotension

Q: Blood that is ejected from the right ventricle flows into the [...] arteries.
A: pulmonary

Q: Cardiac output may [...] if the heart beats too rapidly because there is not enough time in between contractions for the heart to [...] completely.
A: decrease; refill

Q: [...] shock following AMI is caused by decreased pumping force of the heart muscle.
A: Cardiogenic

Q: A common side effect of nitroglycerin include [...].
A: hypertension

Q: A common sign and symptom of AMI includes pain exacerbated by [...].
A: breathing

Q: In contrast to AMI, a dissecting aortic aneurysm often presents with pain that is [...] from the onset.
A: maximal

Q: Ischemic heart disease is defined as decreased blood flow to one or more portions of the [...].
A: myocardium

Q: Most patients are instructed by their physician to take up to [...] doses of nitroglycerin before calling EMS.
A: 3

Q: Nitroglycerin relieves cardiac-related chest pain by [...] the coronary arteries and improving cardiac blood flow.
A: dilating

Q: Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for [...].
A: Congestive Heart Failure

Q: Sudden death following AMI is MOST often caused by [...].
A: ventricular fibrillation
Extra: Ventricular fibrillation is when electrical impulses in the heart start firing randomy in the lower chambers which makes the heart quiver and unable to beat properly.

Q: The descending aorta divides into the two iliac arteries at the level of the [...].
A: navel

Q: The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the [...] nervous system.
A: autonomic

Q: The head and brain receive their supply of oxygenated blood from the [...] arteries.
A: carotid

Q: The iliac arteries immediately subdivide into the [...] arteries.
A: femoral

Q: The MOST common error associated with the use of the AED is failure of the EMT to ensure [...]
A: the battery is charged.

Q: The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they are in [...].
A: denial

Q: The myocardium receives oxygenated blood from the [...] arteries, which originate(s) from the [...].
A: coronary; aorta

Q: The posterior [...] pulse can be palpated behind the medial malleolus, on the inside of the [...].
A: tibial; ankle

Q: The purpose of [...] is to stop the chaotic, disorganized contraction of the cardiac cells.
A: defibrillation

Q: Ventricular tachycardia causes [...] because the left ventricle does not adequately fill with blood.
A: hypotension

Q: [...] is the buildup of excess acid in the body or body tissues that results from a primary illness.
A: Acidosis

Q: [...] breath sounds are abnormal breath sounds such as wheezing, stridor, rhonchi, and crackles.
A: Adventitious

Q: [...] is the buildup of excess base (lack of acids) in the body fluids.
A: Alkalosis

Q: An [...] is a substance that causes allergic reaction.
A: allergen

Q: [...] is an acute spasm of the smaller air passages, called brochioles, associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages.
A: Asthma

Q: [...] is the collapse of the aveolar air spaces of the lungs.
A: Atelectasis

Q: [...] breath sounds are normal breath sounds made by air moving through the bronchi.
A: Bronchial

Q: [...] is the inflammation of the bronchioles that usually occurs in children younger than 2 and is often caused by the respiratory syncytial virus.
A: Bronchiolitis

Q: [...] is an acute or chronic inflammation of the lung that may damage lung tissue; usually associated with cough and production of sputum and, depending on its cause, sometimes fever.
A: Bronchitis

Q: [...] is a condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high blood levels of carbon dioxide.
A: Carbon dioxide retention

Q: [...] is an odorless, colorless, tasteless, and highly poisonous gas that results from incomplete oxidation of carbon in combustion.
A: Carbon monoxide

Q: Chronic [...] is an irritation of the major lung passageways from infectious disease or irritants such as smoke.
A: bronchitis

Q: [...] is a slow process of dilation and disruption of the airways and alveoli caused by chonic bronchial obstruction.
A: Chronic Obstructive Pulmonary Disease (COPD)

Q: [...] is an infectious disease in which a membrane form, lining the pharynx; this lining can severely obstruct the passage of air into the larynx.
A: Diptheria

Q: An [...] is a blood clot or other substance in the circulatory system that travels to a blood bessel where it causes a blockage.
A: embolus

Q: [...] is a disease in which the epiglottis becomes inflamed and enlarged and may cause an upper airway obstruction.
A: Epiglottitis

Q: [...] is an allergic response usually to outdoor airborne allergens such as pollen or sometimes indoor allergens such as dust mites or pet danders; also called allergic [...].
A: Hay fever; rhinitis

Q: [...] syndrom occurs in the absence of other physical problems and is rapid or deep breathing that lowers the blood [...] level below normal. The respirations of a person who is experiencing this syndrome may be as high as 40 shallow breaths/min or as low as only 20 very deep breaths/min
A: Hyperventilation; carbon dioxide

Q: [...] is a virus that has crossed the animal/human barrier and has infected humans, recently reaching a pandemic level with the H1N1 strain.
A: Influenza Type A

Q: [...] is sever dyspnea experienced when lying down and relieved by sitting up.
A: Orthopnea

Q: Paroxysmal [...] is severe shortness of breath, especially at night after several hours of reclining; the person is forced to sit up to breathe.
A: norcturnal dyspnea

Q: [...] is an airborne bacterial infection that affects mostly children younger than 6, in which the patient is feverish and exhibits a "whoop" sound on inspiration [...] a [...] attack; highly contagious through droplet infection.
A: Pertussis; after; coughing

Q: [...] is a collection of fluid between the lung and chest wall that may compress the lung.
A: Pleural effusion

Q: [...] chest pain is a sharp, stabbing pain in the chest that is worsened by a deep breath or other chest wall movement; often caused by inflammation or irritation of the pleura.
A: Pleuritic

Q: [...] is an infectious disease of the lung that damages lung tissue; its cause can be bacterial, viral, or fungal.
A: Pneumonia

Q: A [...] is a buildup of fluid in the lungs, usually as a result of congestive heart failure.
A: pulmonary edema

Q: Respiratory [...] virus (RSV) is a virus that causes an infection of the lungs and breating passages; can lead to other serious illnesses that affect the lungs or heart, such as bronchiolitis and pneumonia; highly contagious and spread through droplets.
A: syncytial

Q: A [...] is a respiratory device that holds liquid medicine that is turned into a fine mist. The patient inhales the medication into the airways and lungs as a treatment for conditions such as asthma.
A: small-volume nebulizer

Q: [...] is a chronic bacterial disease, caused by Mycobacterium tuberculosis, that usually affects the lungs but can also affect other organs such as the brain and kidneys; it is spread by cough and can lie [...] in a person's lungs for decades and then reactivate.
A: Tuberculosis; dormant

Q: [...] breath sounds are normal breath sounds made by air moving in and out of the alveoli.
A: Vesicular

Q: [...] syndrome is a group of symptoms caused by myocardial [...]; includes angina and myocardial infaction (MI).
A: Acture coronary; ischemia

Q: An [...] is a heart attack; death of heart muscle following obstruction of blood flow to it; in this context the attack is "new" or "happening right now"; ie. it is acute.
A: acute myocardial infarction (AMI)

Q: [...] is transient (short-lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle; also called [...].
A: Angina pectoris; angina

Q: An [...] is a weakness in the wall of the aorta that makes it susceptible to rupture.
A: aortic aneurysm

Q: The [...] is the one-way valve that lies between the left ventricle and the aorta and keeps blood from flowing back into the left ventricle adter the left ventricle ejects its blood into the aorta; one of the four heart valves.
A: aortic valve

Q: An [...] is a tracing on an ECG that is the result of interference, such as patient movement, rather than the heart's electrical activity.
A: artifact

Q: [...] is the complete absence of all heart electrical activity.
A: Asystole

Q: [...] is the ability of the cardiac muscle cells to contract without stimulation from the nervous system.
A: Automaticity

Q: [...] is when the heart fails to generate effective and detectable blood flow; pulses are not palpable, even if muscular and electrical activity continues in the heart.
A: Cardiac arrest

Q: [...] is a disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs.
A: Congestive heart failure

Q: [...] are the blood vessels that carry blood and nutrients to the heart muscle.
A: Coronary arteries

Q: To [...] is to shock a fibrillating (choatically beating) heart with specialized electric current in an attempt to restore a normal, rhythmic beat.
A: defibrillate

Q: [...] is swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of [...].
A: Dependent edema; congestive heart failure

Q: [...] is the widening of a tubular structure such as a coronary artery.
A: Dilation

Q: A [...] is a condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.
A: dissecting aneurysm

Q: [...] is an irregular or abnormal heart rhythm.
A: Dysrhythmia

Q: A [...] is an emergency situation created by excessively high blood pressure, which can lead to serious complications such as stoke or aneurysm.
A: hypertensive emergency

Q: An [...] is the death of a body tissue, usually caused by interruption of its blood supply.
A: infarction

Q: The [...] is the inside diameter of an artery or other hollow structure.
A: lumen

Q: The [...] is the heart muscle.
A: myocardium

Q: An [...] is a blockage, usually of a tubular structure such as a blood vessel.
A: occulsion

Q: A [...] is a blood clot that has formed within a blood vessel and is floating within the bloodstream.
A: thromboembolism

Q: [...] is disorganized, ineffective quivering of the ventricles, resulting in no blood flow and a state of cardiac arrest.
A: Ventricular fibrillation

Q: [...] is a rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest.
A: Ventricular tachycardia

Q: [...] is the inability to understand and/or produce speech.
A: Aphasia

Q: An [...] is a sensation experienced before a seizure; serves as a warning sign that a seizure is about to occur.
A: aura

Q: A [...] is an interruption of blood flow to the brain that results in the loss of brain function; also called a stroke.
A: Cerebrovascular accident (CVA)

Q: A [...] is a state of profound unconsciousness from which the patient cannot be roused.
A: coma

Q: [...] is a sudden change in mental status that is fenerally acut and reversible, characterized by disorientation, inability to focus, inattention, inability to think logically, memory loss, striking changes in personality and affect, hallucinations, delusions, or a decreased level of consciousness.
A: Delirium

Q: [...] is slurred speech.
A: Dysarthria

Q: [...] is a disorder in which abnormal electrical discharges occur in the brain, causing seizure and possible loss of consciousness.
A: Epilepsy

Q: [...] are seizures that result from high fevers; most often seen in children.
A: Febrile seizures

Q: A [...] is a seizure characterized by severe twitching of all the bodys muscles that may last several minutes or more; formerly known as a [...] and also known as a [...]
A: generalized seizure; grand mal seizure; tonic-clonic seizure

Q: [...] is one of the basic sugars; it is the primary fuel, in conjunction with oxygen, for cellular metabolism.
A: Glucose

Q: [...] is weakness on one side of the body.
A: Hemiparesis

Q: A [...] is a type of stroke that occurs as a result of bleeding inside the brain.
A: hemorrhagic stroke

Q: [...] is a loss of bowel and/or bladder control; may be the result of a generalized seizure.
A: Incontinence

Q: An [...] is a type of stroke that occurs when blood flow to a particular part of the brain is cut off by a blockage (eg, a blood clot) inside a blood vessel.
A: ischemic stroke

Q: A [...] seizure affecting a limited portion of the brain; also called a [...]
A: partial; focal seizure

Q: The [...] is the period following a seizure that lasts 5 to 30 minutes; characterized by labored respirations and some degree of altered mental status.
A: postictal state

Q: A [...] is a neurologic episode caused by a surge of electrical activity in the brain; can be a convulsion characterized by generalized, uncoordinated muscular activity, and can be associated with loss of consciousness.
A: seizure

Q: [...] is a condition in which seizures recur every few minutes or last longer than 30 minutes.
A: Status epilepticus

Q: [...] is a blood clot, either in the arterial or venous system. When the clot occurs in a cerebral artery, it may result in the interruption of cerebral blood flow and subsequent [...].
A: Thombosis; stroke

Q: A [...] is a disorder of the brain in which brain cells temporarily stop functioning because of insufficient oxygen, causing stroke-like symptoms that resolve completely within [...] hours of onset.
A: transient ischemic attack; 24

Q: [...] is a condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary.
A: Acute abdomen

Q: [...] is the inflammation or infection of the appendix.
A: Appendicitis

Q: [...] is the inflammation of the gallbladder.
A: Cholecystitis

Q: [...] is the inflammation of the bladder.
A: Cystitis

Q: [...] is inflammation in small pockets at weak areas in the muscle walls.
A: Diverticulitis

Q: [...] is another word for vomiting.
A: Emesis

Q: [...] is a condition in which the sphincter between the esophagus and the stomach opens, allowing stomach acid to move up into the esophagus, usually resulting in a burning sensation within the chest; also called [...].
A: Gastroesophageal reflux disease (GERD); acid reflux

Q: [...] is a term that means vomited blood.
A: Hematemesis

Q: A [...] is the protrusion of an organ or tissue through an abnormal body opening.
A: hernia

Q: [...] is the paralysis of the bowel, arising from any one of several causes; stops contractions that move material through the intestine.
A: Ileus

Q: [...] are solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing in the urine; may become trapped anywhere along the urinary tract.
A: Kidney stones

Q: [...] is balck, foul-smelling, tarry stool containing digested blood.
A: Melena

Q: [...] is inflammation of the pancreas.
A: Pancreatitis

Q: The [...] is the membrane lining the abdominal cavity and covering the abdominal organs.
A: peritoneum

Q: [...] is the inflammation of the peritoneum.
A: Peritonitis

Q: [...] is the pain felt in an area of the body other than the area where the cause of pain is located.
A: Referred pain

Q: [...] is the complete obstruction of blood circulation in a given organ as a result of compression of entrapment; an emergency situation causing death of tissue.
A: Strangulation

Q: [...] is severe kidney failure resulting in the buildup of waste products within the blood. Eventually [...] functions will be impaired.
A: Uremia; brain

Q: A [...] is a bacterial infection, usually of the lower urinary tract (urethra and bladder) that occurs when normal flora bacteria enter the urethra and grow.
A: urinary tract infection (UTI)

Q: [...] signs and symptoms include wheezing on inspiration/expiration and bronchospasm.
A: Asthma

Q: [...] signs and symptoms include flushed skin or hives, generalized edema, [...], and wheezing or stridor.
A: Anaphylaxis; hypotension

Q: [...]signs and symptoms include SOB, wheezing, coughing, fever, dehydration, [...]pnea, and [...]cardia
A: Bronchiolitis; tachy; tachy

Q: [...] signs and symptoms include chronic cough with clear or white sputum, wheezing, cyanosis, and [...]pnea.
A: Bronchitis; tachy

Q: [...] signs and symptoms include dependent edema, crackles, barrel chested, orthopnea, and paroxysmal nocturnal dyspnea, and produce pink frothy sputum
A: Congestive heart failure (CHF)

Q: [...] signs and symptoms include fever, barking cough, stridor, and is mostly seen in pediatric patients.
A: Croup

Q: [...] signs and symptoms include difficulty breathing and swallowing, sore throat, thick, gray buildup in the throat or nose, and a fever.
A: Diptheria

Q: [...] signs and symptoms include barrel chest,  pursed lip breathing, dyspnea on exertion, cyanosis and wheezing or decreased breath sounds.
A: Emphysema

Q: [...] signs and symptoms include dyspnea, high fever, stridor, drooling, difficulty swallowing, sore throat, tripod, or sniffing position.
A: Epiglottitis

Q: [...] signs and symptoms include cough, fever, sore throat, and fatigue.
A: Influenza A (flu)

Q: [...] signs and symptoms include coughing spells, whooping sound, and fever.
A: Pertussis

Q: [...] signs and symptoms include dyspnea, chills, fever, cough, green/red/rust colored sputum, and localized wheezing or crackles.
A: Pneumonia

Q: [...] signs and symptoms include sudden chest pain with dyspnea, decreased breath sounds (affected side), and subcutaneous emphysema.
A: Pneumothorax

Q: [...] signs and symptoms include sharp chest pain, sudden onset, dyspnea, [...]cardia, clear breath sounds initially.
A: Pulmonary embolus; tachy

Q: [...] signs and symptoms include severe shortness of breath, decreased/altered LOC, neck vein distention, tracheal deviation (late sign), hypotension; signs of shock (late sign)
A: Tension pneumothorax

Q: [...] signs and symptoms include cough, wheezing, fever, and dehydation
A: Respiratory syncytial virus (RSV)

Q: [...] signs and symptoms include cough, fever, fatigue, and productive/bloody sputum.
A: Tuberculosis

Q: [...] is a method of ventilation used primarily in the treatment of critically ill patients with respiratoy distress; can prevent the need for endotracheal intubation.
A: Continuous positive airway pressure (CPAP)

Q: [...] are rattling breath sounds signaling fluid in the air spaces of the lungs; formerly called [...].
A: Crackles; rales

Q: [...] is difficulty breathing or shortness of breath.
A: Dyspnea

Q: [...] is a disease of the lungs in which there is extreme dilation and eventual destrucion of the pulmonary alveoli with poor exchange of oxygen and carbon dioxide; it is one form of [...].
A: Emphysema; COPD

Q: [...] is a condition where the body's cells and tissues do not have enough oxygen.
A: Hypoxia

Q: [...] is a condition where chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases.
A: Hypoxic drive

Q: [...] is severe dyspnea experiences when lying down and relieved by sitting up
A: Orthopnea

Q: [...] is the process of delivering oxygen to the blood.
A: Oxygenation

Q: [...] is an outbreak that occurs on a global scale.
A: Pandemic

Q: [...] is a partial or complete accumulation of air in the pleural space.
A: Pneumothorax

Q: A [...] is a blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.
A: pulmonary embolism

The principal function of the lungs is respiration

Q: [...] are coarse breath sounds heard in patients with chronic mucus in the airways.
A: Rhonchi

Q: [...] is a harsh, high pitched barking inpiratory sound often heard in actute laryngeal ([...]) obstruction.
A: Stridor; upper airway

Q: [...] is a high pitched, whistling breath sound characteristically heard on expiration in patients with asthma or chronic obstructive pulmonary disease.
A: Wheezing

Q: Respiratory Medication Actions: Albuterol, Ipratropium bromide, Levalbuterol, Metaproterenol sulfate, and Salmeterol [...].
A: dilate the bronchioles

Q: Respiratory Medication Actions: Beclomethasone, Fluticasone, and Montelukast are [...] drugs and reduce [...]
A: anti-inflammatory; swelling

Q: Respiratory Medication Actions: Fluticasone and salmeterol decrease [...]
A: secretions.

Q: Respiratory Medication Actions: Cromolyn decreases the release of [...].
A: histamines

Q: [...] is the measure of volume of blood circulated by the heart in one minute, calculated by multiplying the [...] by the heart rate.
A: Cardiac output; stroke volume

Q: [...] is a state in which not enough oxygen is delivered to the tissues of the body caused by low output of blood from the heart.
A: Cardiogenic shock

Q: [...] is the return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest.
A: Return of spontaneous circulation (ROSC)

Q: [...] is the volume of blood ejected with each ventricular contraction.
A: Stroke volume

Q: [...] is an abnormally low blood glucose level.
A: Hypoglycemia

Q: [...] is the involuntary muscle contractions (spasm) of the abdominal wall; an effort to protect the inflamed abdomen.
A: Guarding

Q: AMI vs Dissecting Aneurysm?: Gradual onset with tightness or pressure
A: Acutemyocardial infarction

Q: AMI vs Dissecting Aneurysm?: Abrupt onset of sharp or tearing pain
A: Dissecting Aneurysm

Q: AMI vs Dissecting Aneurysm?: Pain increases with time and pain may wax and wane
A: Acutemyocardial infarction

Q: AMI vs Dissecting Aneurysm?: Pain is maximal from onset and does not abate once started
A: Dissecting Aneurysm

Q: AMI vs Dissecting Aneurysm?: Pain is localized substernal and does not radiate to back
A: Acutemyocardial infarction

Q: AMI vs Dissecting Aneurysm?: Pain possibly radiates to back or between the shoulder blades
A: Dissecting Aneurysm

Q: AMI vs Dissecting Aneurysm?: Clinical signs show the peripheral pulses as equal
A: Acutemyocardial infarction

Q: AMI vs Dissecting Aneurysm?: Clinical signs show a blood pressure discrepancy between arms or decrease in a femoral or carotid pulse
A: Dissecting Aneurysm

Q: Abdominal Pathologies (Localization of Pain): Right lower quadrant (direct) around navel (deferred) with rebound tenderness
A: Appendicitis

Q: [...] is pain felt on rebound after palpatation.
A: Rebound tenderness

Q: Abdominal Pathologies (Localization of Pain): Right upper quadrant (direct); right shoulder (deferred)
A: Cholecystitis

Q: Abdominal Pathologies (Localization of Pain): Upper midabdomen or upport part of back
A: Ulcer

Q: Abdominal Pathologies (Localization of Pain): Left lower quadrant
A: Diverticulitis

Q: Abdominal Pathologies (Localization of Pain): Low part of back and lower quadrants
A: Abdominal Aortic Aneurysm (AAA) - (ruptured or dissecting)

Q: Abdominal Pathologies (Localization of Pain): Lower midabdomen (retropubic)
A: Cystitis

Q: Abdominal Pathologies (Localization of Pain): Right or left flank, radiating to genitalia
A: Kidney stone

Q: Abdominal Pathologies (Localization of Pain): Costovertebral angle
A: Kidney infection

Q: Abdominal Pathologies (Localization of Pain): Upper abdomen (both quadrants); back
A: Pancreatitis

Q: Abdominal Pathologies (Localization of Pain): Referred pain to the upper abdomen
A: Pneumonia

Q: Abdominal Pathologies (Localization of Pain): Anywhere in the abdominal area
A: hernia or peritonitis

Q: If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should:
A: immediately begin CPR

Q: The diastolic blood pressure represents the [...] that is always present in the arteries.
A: minimum amount of pressure

Q: Capnography is used to determine how much [...] is being exhaled.
A: carbon dioxide

Q: [...] are medications that cause a patient's pulse rate to be slower than normal.
A: Beta-blockers

Q: Palliating factors regarding a patient's pain involve those that [...] the pain.
A: alleviate

Q: [...] is the part of the [...] process focused on obtaining additional information about the patient's chief complaint and any medical problems he or she may have.
A: History taking; patient assessment

Q: When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. You should administer supplemental oxygen if needed and then:
A: transport and consider requesting ALS

Q: When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called:
A: cyanosis

Q: A properly sized blood pressure cuff should cover [...] the length from the [...] to the crease at the [...].
A: 2/3; armpit; elbow

Q: Normal respiratory rates should not exceed [...] breaths per minute in toddlers and [...] breaths per minute in infants.
A: 40; 60

Q: A decrease in blood pressure may indicate loss of [...]
A: vascular tone.

Q: During a 30-minute transport of a stable patient, you should reassess him or her at least [...] times.
A: 2

Q: Supplemental oxygen without assisted ventilation would MOST likely be administered to patients with difficulty breathing an adequate [...]
A: tidal volume

Q: An adult patient who is NOT experiencing difficulty breathing will be able to speak in [...] without unusual pauses.
A: complete sentences

Q: When palpating the carotid pulse of a responsive patient, you should avoid [...] both carotid arteries simultaneously.
A: compressing

Q: In responsive patients who are older than 1 year of age, you should palpate the pulse at the [...] artery.
A: radial

Q: The pressure exerted against the walls of the artery when the left ventricle contracts is called the [...] pressure.
A: systolic

Q: You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that it has decreased significantly from previous readings. You should [...] of the ventilations you are delivering.
A: reduce the rate or volume

Q: The primary waste product of aerobic metabolism is [...].
A: carbon dioxide

Q: The [...] flowmeter is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder.
A: Bourdon-gauge

Q: The hypoxic drive is influenced by [...] levels.
A: low blood oxygen

Q: [...] is a passive process caused by [...] intrathoracic pressure.
A: Exhalation; increased

Q: While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should [...] and ventilate him with a [...].
A: remove the CPAP device; bag-valve mask

Q: While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:
A: stand behind him and administer abdominal thrusts.

Q: Complications associated with using a manually triggered ventilation device include [...] and [...].
A: lung tissue injury; gastric distention

Q: As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the:
A: mouth-to-mask technique with a one-way valve

Q: An unconscious patient found in a prone position must be placed in a supine position in case he or she requires [...]
A: CPR

Q: Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense slight increases in [...] or a decrease in the [...] of the cerebrospinal fluid.
A: carbon dioxide; pH

Q: Based on current guidelines, supplemental oxygen be administered when there is exposure to carbon [...] and an oxygen saturation of [...].
A: monoxide; 95%

Q: A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?
A: Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.

Q: With positive-pressure ventilation, more [...] is required to have the same effects as normal breathing.
A: volume

Q: Proper technique for suctioning the oropharynx of an adult patient includes suctioning while [...] the catheter from the oropharynx.
A: withdrawing

Q: Prior to applying a nonrebreathing mask to a patient, you must ensure that the:
A: reservoir bag is fully inflated

Q: The diaphragm is innervated by the [...] nerve, which allows it to contract.
A: phrenic

Q: Cyanosis is a late sign of [...].
A: hypoxia

Q: In mines or confined places, where oxygen levels are low, [...] may continue despite inadequate [...].
A: ventilation; oxygenation

Q: You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should remove her dentures, resume ventilations, and assess for adequate [...].
A: chest rise

Q: A mucosal atomizer device (MAD) is used to deliver certain medications via the [...] route.
A: intranasal

Q: Epinephrine is secreted naturally by the [...], [...] passages in the lungs, and [...] the blood vessels.
A: adrenal glands; dilates; constricts

Q: [...], when given to patients with cardiac-related chest pain [...] the walls of the coronary arteries.
A: Nitroglycerin; relaxes

Q: EMTs respond to a known heroin abuser who is unresponsive. If they give naloxone (Narcan) to this patient, the EMTs should recall that naloxone administration could cause [...] in this patient.
A: seizures

Q: A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should recall that geriatric patients often have slower [...] and [...] times, which may necessitate [...] of the dosing of certain drugs.
A: absorption; elimination; modification

Q: Nitroglycerin usually given by the EMT by the [...] route.
A: sulingual

Q: Aspirin is beneficial to patients suspected of having a heart attack because it prevents the aggregation of [...].
A: platelets

Q: A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:
A: repeat the epinephrine injection after consulting with medical control.

Q: A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
A: cardiogenic hypoperfusion.

Q: Neurogenic shock occurs when failure of the ... system causes widespread ...
A: -Nervous system
-Vasodilation

Q: [...] of the nervous system with widespread [...] describes [...].
A: Bacterial infection; vasodilation; septic shock

Q: In terms of anaphylaxis, subsequent or secondary exposure after sensitization often produces: [...]
A: a more severe reaction.

Q: You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:
A: determine if she was injured when she fainted.

Q: You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should reassess his condition in ... minutes.
A: 15

Q: You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
A: apply direct pressure to the wound.

Q: Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:
A: check her airway for obstructions.

Q: When assessing the pulse of an unresponsive infant, you should palpate the ... artery.
A: Brachial

Q: Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is in an advanced stage of pregnancy or who is very obese?
A: chest thrusts

Q: You are off duty at a park when you witness an apparently healthy 12-year-old child suddenly collapse. There are no bystanders around and your mobile phone is in your car. After confirming that the child is in cardiac arrest, you should:
A: perform CPR for 2 minutes and then call 9-1-1

Q: You are off duty at a park when you come across an apparently healthy 12-year-old child who had collapsed. You did not witness the event. There are no bystanders around and your mobile phone is in your car. After confirming that the child is in cardiac arrest, you should:
A: Perform 5 cycles of CPR and then call 9-1-1

Q: Initial treatment to dislodge a severe foreign body airway obstruction in a responsive infant involves [...].
A: back slaps

Q: You should deliver chest compressions to an unresponsive adult patient in cardiac arrest by compressing the [...] between the [...].
A: sternum; nipples

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve checking the radial pulse and noting the color, temperature, and condition of the skin.

Q: Reassessment of a patient with a medical complaint should begin by repeating the [...].
A: primary assessment

Q: Assessment of a patient's blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should obtain a obtain a [...].
A: manual blood pressure

Q: MRSA is a bacterium that causes [...] and is resistant to most [...].
A: infections; antibiotics

Q: The secondary assessment of a medical patient is not practical if the patient is [...] or your [...].
A: critically ill; transport time is short

Q: End-tidal carbon dioxide monitoring is clearly indicated for patients who present with [...]
A: respiratory distress.

Q: In contrast to viral hepatitis, toxin-induced hepatitis is not a [...] disease.
A: communicable

Q: Continuing education in EMS serves to [...], [...], and [...] the EMT's knowledge and skills.
A: maintain; update; expand

Q: Cardiac monitoring, pharmacologic interventions, and other advanced treatment skills are functions of the [...].
A: paramedic

Q: The [...] process is designed to identify areas of improvement and provide remedial training if needed.
A: continuous quality improvement (CQI)

Q: The standards for prehospital emergency care and the individuals who provide it are typically regulated by the [...] of EMS.
A: state office

Q: According to the National EMS Scope of Practice Model, an EMT would require special permission from the medical director and the state EMS office to A. insert a peripheral [...] catheter.
A: intravenous

Q: If an EMT candidate has been convicted of a felony or misdemeanor, he or she should contact the [...] and provide its staff with the [...].
A: state EMS office; required documentation

Which of the following skills would a layperson MOST likely be trained to perform before arrival of EMS?
A. Obtaining a manual blood pressure
B. Bleeding control using a tourniquet
C. Insertion of an oropharyngeal airway
D. Administration of supplemental oxygen

Q: Which type of medical direction do standing orders and protocols describe, offline or online orders?
A: Offline orders

Q: According to the National EMS Scope of Practice Model, an EMT should be able to ... a patient with certain prescribed medications.
A: Assist

Q: The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the [...]
A: medical director

Q: You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should explain the seriousness of the situation to him, but avoid causing undue ...
A: Alarm

Q: A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should:
A: retreat and notify law enforcement personnel.

Q: According to the Centers for Disease Control and Prevention (CDC), recommended immunizations and tests include a tetanus/diphtheria/pertussis booster every [...] years.
A: 10

Q: You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should [...] relay the bad news if possible.
A: let clergy or hospital staff

Q: The spread of HIV and hepatitis in the health care setting can usually be traced to:
A: careless handling of sharps.

Q: Which infectious disease confers no protection from reinfection after exposure?
A: Syphilis

Q: You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DNR) order is presented to you. When caring for this patient, you should:
A: make her comfortable and provide emotional support.

Q: If it is not possible to adequately clean your ambulance at the hospital following a call, you should clean the ambulance at ... in a designated area that is well ...
A: - in your station
- ventilated

Q: You are assessing a woman who was thrown from a horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should [...] in a position so that only your [...] are touching the ground.
A: crouch down; feet

Q: In relation to the wrist, the elbow is [...]
A: proximal

Q: Regarding medical terminology, a prefix is added to the beginnings of roots or words to [...] or [...] their meaning.
A: modify; qualify

Q: The inferior cartilaginous tip of the sternum is called the [...].
A: xiphoid process

Q: The [...] head forms a ball-and-socket joint with the [...].
A: femoral; acetabulum

Q: [...] pressure is the pressure exerted by a liquid that occurs when blood moves through an artery at relatively high pressures.
A: Hydrostatic

Q: Both areas of the [...] are used to augment respirations during emotional or physical stress.
A: pons

Q: The [...] is made up of the maxilla and zygoma, as well as the frontal bone of the cranium.
A: orbit

Q: [...] located throughout the body provide information to the brain regarding the [...].
A: Baroreceptors; blood pressure

Q: [...] transports the [...] and [...].
A: Plasma; blood cells; nutrients

Q: Stimulation of [...] receptors results in [...] of the blood vessels.
A: alpha-adrenergic; constriction

Q: Capillary sphincter closure during internal or external bleeding is detrimental because [...] are not removed and nutrients are not [...]
A: waste products; delivered to the cells.

Q: The body's backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called the [...]
A: hypoxic drive

Q: The primary organ responsible for absorption of the products of digestion is the [...]
A: small intestine

Q: [...]-pressure breathing involves a [...] in pressure within the chest cavity.
A: Negative; drop

Q: The [...] is unique because it is both a voluntary and an involuntary muscle.
A: diaphragm

Q: Which set of nerves is responsible for carrying information from the body to the central nervous system?
A: Sensory Nerves

Q: The largest portion of the brain is the .... which is commonly referred to as the "gray matter."
A: Cerebrum

Q: The anterior fontanelle fuses together between the ages of [...] months.
A: 9 and 18

Q: The decline in cardiac function that commonly occurs in late adulthood is MOST often related to [...].
A: atherosclerosis

Q: Age-related changes in the .... system result in a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed.
A: Renal

Q: At what age does separation anxiety typically peak in infants and small children?
A: 10 to 18 months

Q: In late adults, the amount of air left in the lungs after expiration of the maximum amount of air increases, which hampers ... because of the ... that remains in the alveoli.
A: -diffusion of gases
-stagnant air

Q: An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should apply a [...] and immobilize him with a vest-style device.
A: cervical collar

Q: You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. What should be your MOST appropriate action?
A: Rapidly remove the patients from their residence using a blanket or clothes drag.

Q: Situations in which you should use the rapid extrication technique include all of the following, EXCEPT:
A: a patient who can be properly assessed while still in the vehicle.

Q: When performing the rapid extrication technique to remove a patient from his or her vehicle, you should apply a cervical collar and immobilize the patient on a [...] backboard.
A: long

Q: A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should assess:
A: whether the patient's mental condition is impaired.

Q: When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of: [...]
A: negligence

Q: Deviation from the standard of care that may result in further injury is considered [...]
A: negligence

Q: [...] requires you to notify the appropriate authorities. Knife wounds, drug overdoses, and cardiac arrests do not.
A: Attempted suicide

Q: While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:
A: contact medical control and notify them of the error.

Q: You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:
A. obtain permission from law enforcement before moving anything.
B. quickly move the coffee table so you can access and treat the patient.
C. treat the patient where he is so that you do not destroy any evidence.
D. drag the patient into a larger area so that you can begin treatment.
A: B. quickly move the coffee table so you can access and treat the patient.

Q: [...] is a form of hyperglycemia in uncontrolled diabetes in which certain acids accumulate when insulin is not available.
A: Diabetic Ketoacidosis

Q: ... are glands that secrete or release chemicals that are used inside the body.
A: Endocrine glands

Q: [...] is the study and prevention of blood-related disorders.
A: Hematology

Q: [...] is a congenital abnormality in which the body is unable to produce clots, which results in uncontrollable bleeding.
A: Hemophilia

Q: [...] is an abnormally high blood glucose level.
A: Hyperglycemia

Q: Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is a life-threatening condition resulting from high blood glucose that typically occurs in older adults, and which causes [...], [...], and [...].
A: altered mental status; dehydration; organ damage

Q: [...] is a hormone produced by the islets of Langerhans (endocrine gland located throughout the pancreas) that enables glucose in the blood to enter cells; used in synthetic form to treat and control diabetes mellitus.
A: Insulin

Q: [...] are deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body.
A: Kussmaul respirations

Q: [...] is an excessive thirst that persists for long periods, despite reasonable fluid intake; often the result of excessive urination.
A: Polydipsia

Q: [...] is a metabolic disorder in which the ability to metabolize carbohydrates (sugars) is impaired, usually because of a lack of insulin.
A: Diabetes mellitus

Q: [...] is an excessive eating; in diabetes, the inability to use glucose properly can cause a sense of hunger.
A: Polyphagia

Q: [...] is when the passage of an unusually large volume of urine in a given period; in diabetes, this can result from the wasting of glucose in the urine.
A: Polyuria

Q: [...] is a hereditary disease that causes normal, round red blood cells to become oblong, or sickle shaped.
A: Sickle cell disease

Q: [...] is a state of unconsciousness resulting from several problems, including ketoacidosis, dehydration because of excessive urination, and hyperglycemia.
A: Symptomatic hyperglycemia

Q: [...] is severe hypoglycemia resulting in changes in mental status.
A: Symptomatic hypoglycemia

Q: [...] is a tendency toward the development of blood clots as a result of an abnormality of the system of coagulation.
A: Thrombophilia

Q: [...] is an autoimmune disorder in which the individual’s immune system produces antibodies to the pancreatic beta cells, and therefore the pancreas cannot produce insulin; onset in early childhood is common.
A: Type 1 diabetes

Q: [...] is a condition in which insulin resistance develops in response to increased blood glucose levels; can be managed by exercise and diet modification, but is often managed by medications.
A: Type 2 diabetes

Q: A [...] is ischemia and pain caused by sickle-shaped red blood cells that obstruct blood flow to a portion of the body.
A: vasoocclusive crisis

Q: [...] is a pathologic condition that results from the accumulation of acids in the body.
A: Acidosis

Q: [...] is metabolic disorder in which the ability to metabolize carbohydrates (sugars) is impaired, usually because of lack of insulin.
A: Diabetes mellitus

Q: [...] us a form of hyperglycemia in uncontrolled diabetes in which certain acids accumulate when insulin is not available.
A: Diabetic ketoacidosis (DKA)

Q: [...] are glands that secrete or release chemicals that are used in the body.
A: Endocrine glands

Q: The [...] regulates metabolism and maintains homeostasis.
A: endocrine system

Q: [...]is the study and prevention of blood related disorders.
A: Hematology

Q: A [...] is a chemical substance produced by a gland that regulates the activity of organs and tissues.
A: hormone

Q: [...]  is an abnormally high blood glucose level.
A: Hyperglycemia

Q: [...] is a blood clot, either in the arterial or venous system.
A: Thrombosis

Q: An [...] is the body’s exaggerated immune response to an internal or surface agent.
A: allergic reaction

Q: [...] is the act of injecting venom.
A: Envenomation

Q: [...] are chemical substances released by the immune system in allergic reactions that are responsible for many of the symptoms of anaphylaxis, such as vasodilation.
A: Histamines

Q: The [...] is the body system that includes all of the structures and processes designed to mount a defense against foreign substances and disease-causing agents.
A: immune system

Q: [...] is the study of the body's immune system.
A: Immunology

Q: [...] are chemical substances that contribute to anaphylaxis; released by the immune system in allergic reactions.
A: Leukotrienes

Q: [...] are small areas of generalized itching and/or burning that appear as multiple raised areas on the skin; hives.
A: Urticaria

Q: A [...] is a raised, swollen, well-defined area on the skin resulting from an insect bite or allergic reaction.
A: wheal

Q: An [...] is a substance that causes an allergic reaction.
A: allergen

Q: An [...] is the body's exaggerated immune response to an internal or surface agent.
A: allergic reaction

Q: [...] is an extreme, life-threatening, systemic allergic reaction that may include shock and respiratory failure.
A: Anaphylaxis

Q: [...] are localized areas of swelling beneath the skin, often around the eyes and lips, but it can also involve other body areas as well.
A: Angioedema

Q: [...] is a substance produced by the body (commonly called adrenaline), and a drug produced by pharmaceutical companies that increases pulse rate and blood pressure; the drug of choice for an anaphylactic reaction.
A: Epinephrine

Q: The immune [...] is the body's response to a substance perceived by the body as foreign.
A: response

Q: [...] is a harsh, high pitched respiratory sound, generally heard during [...], that is caused by a partial blockage or narrowing of the upper airway; may be audible without a stethoscope.
A: Stridor; inspiration

Q: A [...]  is a poison or harmful substance.
A: toxin

Q: [...] is a high-pitched, whistling breath sound that is most prominent on [...], and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis.
A: Wheezing; expiration

Q: [...] is a state of overwhelming obsession or physical need to continue the use of a substance.
A: Addiction

Q: An [...] is a substance that is used to neutralize or counteract a poison.
A: antidote

Q: A [...] is an agent that produces false perceptions in any one of the five senses.
A: hallucinogen

Q: [...] is also called swallowing; taking a substance by mouth.
A: Ingestion

Q: A [...] is a drug that produces sleep or altered mental consciousness.
A: narcotic

Q: An [...] is a subset of the opioid family, referring to natural, non-synthetic opioids.
A: opiate

Q: An [...] is a synthetically produced narcotic medication, drug, or agent similar to the opiate morphine, but not derived from opium; used to relieve pain.
A: opioid

Q: An [...] is an excessive quantity of a drug that, when taken or administered, can have toxic or lethal consequences.
A: overdose

Q: [...] is a substance whose chemical action could damage structures or impair function when introduced into the body.
A: Poison

Q: A [...] is a substance that decreases activity and excitement.
A: sedative

Q: A [...] is an agent that produces an excited state.
A: stimulant

Q: [...] is the misuse of any substance to produce a desired effect.
A: Substance abuse

Q: [...] is the need for increasing amounts of a drug to obtain the same effect.
A: Tolerance

Q: [...] is the study of toxic or poisonous substances.
A: Toxicology

Q: [...] are the basic activities a person usually accomplishes during a normal day, such as eating, dressing, and bathing.
A: Activities of daily living

Q: [...] is a change in the way a person thinks and behaves that may signal disease in the central nervous system or elsewhere in the body.
A: Altered mental status

Q: [...] is how a person funcions or acts in response to his or her environment.
A: Behavior

Q: A [...] is the point at which a person's reactions to events interfere with activities of daily living; this becomes a psychiatric emergency when it causes a major life interruption, such as attempted suicide.
A: behavioral crisis

Q: [...] is a persistent mood of saddness, despair, and discouragement; may be a symptom of many different mental and phsical disorders, or it may be a disorder on its own.
A: Depression

Q: [...] is a serious behavioral condition in which a person exhibits agitated behavioral combined with disorientation, hallucinations, or delusions; also called agitated delirium or exhaustive mania.
A: Excited delirium

Q: A [...] is a disorder in which there is no known physiologic reason for the abnormal functioning of an organ or organ system.
A: functional disorder

Q: [...] is a temporary or permanent dysfunction of the brain, causes by a disturbance in the physical or physiologic functioning of brain tissue.
A: Organic brain syndrome

Q: [...] is restriction of chest wall movements and/or airway obstruction; can rapidly lead to sudden death.
A: Positional asphyxia

Q: [...] is a delayed stress reaction that develops after a horrifying ordeal that involved physical harm or the threat of physical harm.
A: PTSD

Q: [...] are illnesses with psychological or behavioral symptoms and/or impairment in functioning caused by a social, psychological, genetic, physical, chemical, or biological distrubance.
A: Psychiatric disorders

Q: A [...] is one which adbnormal behavior threatens a person's own health and safety or the health and safety of another person, for example when a person becomes suicidal, homocidal, or has a psychotic episode.
A: psychiatric emergency

Q: [...] is a complex, difficult-to-identify mental disorder whose onset typically occurs during early adulthood. Symptoms typically become mroe prominent over time and include delusions, hallucinations, a lack of interest in pleasure or erratic speech.
A: Schizophrenia

Q: An [...] is a state of overwhelming obsession or physical need to continue the use of a substance.
A: addiction

Q: [...] is a severe withdrawl syndrome seen in alcoholics who are deprived of ethyl alcohol; characterized by restlessness, fever, sweating, disorientation, agitation, and seizures; can be fatal if untreated.
A: Delirium tremens (DTs)

Q: Another word for emesis is [...]
A: vomiting.

Q: [...] is another word for vomiting blood.
A: Hematesis

Q: A [...] is a form provided by manufacturers and compounders (blenders_ of chemicals, containing information about chemical composition, physical and chemical properties, health and safety hazards, emergency response, and waste disposal of a specific material; also known as a safety data sheet (SDS).
A: material safety data sheet (MSDS)

Q: A [...] is a drug that produces sleep or altered mental status.
A: narcotic

Q: [...] is the persistent mood of sadness, despair, and discouragement; may be a symptom of many different mental and physical disorders, or it may be a disorder on its own.
A: Depression

Q: A [...] is a disorder which there is no known physiologic reason for the abnormal functioning of an organ or organ system.
A: functional disorder

Q: [...] is a mental disorder characterized by the loss of contact with reality.
A: Psychosis

Q: [...] is an overgrowth of bacteria in the vagina; charcterized by itching, burning, or pain and possibly a "fishy" smelling discharge.
A: Bacterial vaginosis

Q: The [...] is the lower third, or neck, of the uterus; it is the narrowest portion of the uterus and opens into the vagina.
A: cervix

Q: [...] is a sexually transmitted disease caused by the bacterium Chlamydia trachomatis.
A: Chalmydia

Q: The [...] are the tubes that connect each ovary with the uterus and are the primary location for fertilization of the ovum.
A: fallopian tubes

Q: [...] is a sexually transmitted disease caused by Neisseria gonorrhoeae.
A: Gonorrhea

Q: The [...] are the outer fleshy lips covered with pubic hair that protect the vagina.
A: labia majora

Q: The [...] are the inner fleshy lips devoid of pubic hair that protect the vagina.
A: labia minora

Q: The [...] are the primary female reproductive organs that produce an ovum, or egg, that, if fertilized, will develop into a fetus.
A: ovaries

Q: [...] is an infection of the fallopian tubes and the surrounding tissues of the pelvis.
A: Pelvic imflammatory disease

Q: [...] is an attack against a person that is sexual in nature, the most common of which is rape.
A: Sexual assault

Q: The [...] is the muscular organ where the fetus grows, also called the womb; responsible for contractions during labor.
A: uterus

Q: The [...] is the outermost cavity of a woman’s reproductive tract; the lower part of the birth canal.
A: vagina

Q: [...] is the process in which an ovum is released from a follicle.
A: Ovulation

Q: [...] is the area of skin between the vagina and the anus.
A: Perineum

Q: [...] is sexual intercourse forbility inflicted on another person, against that person's will.
A: Rape

Q: [...] are air bubbles in the arterial blood vessels.
A: Arterial air embolism

Q: [...] is an impact on the body by objects that cause injury without penetratingg soft tissues or internal organs and cavities.
A: Blunt trauma

Q: [...] is a phenomenon in which speed causes a bullet to generate pressure waves, which cause damage distant from the bullet's path.
A: Cavitation

Q: A [...] brain injury is a brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of the original impact.
A: coup-contrecoup

Q: [...] is the slowing of an object.
A: Deceleration

Q: [...] is the resistance that slows a projectile, such as air.
A: Drag

Q: A [...] is an evaluation tool used to determine level of conciousness, which evaluates and assigns point values (scores) for eye opening, verbal response, and motor respose, which are then totaled; effective in helping predict patient outcomes.
A: Glasgow Coma Scale (GCS) score

Q: An [...] is awareness that unseen life-threatening injuries may exist when determining the mechanism of injury.
A: index of suspicion

Q: [...] is the energy of a moving object.
A: Kinetic energy

Q: The [...] are the forces, or energy transmission, applied to the body that cause injury.
A: mechanism of injury (MOI)

Q: [...] are emergencies that require EMS attention because of illnesses or condition not caused by an outside force.
A: Medical emergencies

Q: [...] is trauma that affects more than one body system.
A: Multi-system trauma

Q: [...] is injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs.
A: Penetrating trauma

Q: [...] is the product of mass, gravity, and height, which is converted into kinetic energy and results in injury, such as from a fall.
A: Potential energy

Q: A [...] is any object propelled by force, such as a bullet by a weapon.
A: projectile

Q: [...] is a scoring system used for patient with head trauma.
A: Revised Trauma Score (RTS)

Q: [...] is the path a projectile takes once it is propelled.
A: Trajectory

Q: [...] are emergencies that are the result of physical forces applied to a patient's body.
A: Trauma emergencies

Q: A [...] is a score calculated from 1 to 16, with 16 being the best possible score. It related to the likelihood of patient survival with the exception of a severe head injury. It takes into account the GCS score, respiratory rate, respiratory expansion, systolic blood pressure, and capillary refill.
A: trauma score

Q: The [...] is the eardrum, a thin, semi-transparent membrane in the middle ear that transmits soun vibrations to the internal ear by means of auditory ossicles.
A: tympanic membrane

Q: [...] is the measure of force over distance.
A: Work

Q: [...] are pulmonary traumas that result from short-range exposure to the detonation of explosives.
A: Pulmonary blast injuries

Q: The [...] is the main artery that recieves blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body.
A: aorta

Q: The [...] are the smallest branches of arteries leading to the vast network of capillaries.
A: arterioles

Q: An [...] is a blood vessel, consisting of three layers of tissue and smooth muscle, that carries blood away from the heart.
A: artery

Q: [...] are the small blood vessels that connect arterioles and venules; various substances pass through capillary walls into and out of the interstitial fluid and then on to the cells.
A: Capillaries

Q: [...] is the formation of clots to plug openings in injured blood vessels and stop blood flow.
A: Coagulation

Q: A [...] is a bruise from an injury that causes bleeding beneath the skin without breaking the skin.
A: contusion

Q: [...] is a building up  of blood beneath the skin that produces a characteristic blue or black discoloration as the result of an injury.
A: Ecchymosis

Q: [...] is another word for nosebleed.
A: Epistaxis

Q: [...] is vomited blood.
A: Hematemesis

Q: A [...] is a mass of blood that has collected withindamaged tissue beneath the skin or in a body cavity.
A: hematoma

Q: [...] is blood in the urine.
A: Hematuria

Q: [...] is a hereditary condition in which the patient lacks ones or more of the blood's normal clotting factors.
A: Hemophilia

Q: [...] is coughing up of blood.
A: Hemoptysis

Q: [...] is another word for bleeding.
A: Hemorrhage

Q: A [...] is a chemical compoud that slows or stops bleeding by assisting with clot formation.
A: hemostatic agent

Q: [...] is a condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular functions; also called shock.
A: Hypoperfusion

Q: [...] is a condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion.
A: Hypovolemic shock

Q: [...] is black, foul-smelling, tarry stool containing digested blood.
A: Melena

Q: An [...] is a life-threatening fracture of the pelvis caused by a force that displaces one or both sides of the pelvis laterally and posteriorly.
A: open-book pelvic fracture

Q: A [...] is a device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.
A: pelvic binder

Q: [...] is the circulation of blood within an organ or tissue in adequate amounts to meet the current needs of the cells.
A: Perfusion

Q: [...] is a condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular functions; also called hypoperfusion.
A: Shock

Q: A [...] is the bleeding control method used when a wound continues to bleed despite the use of direct pressure; useful if a patient is bleeding severely from a partial or complete amputation.
A: tourniquet

Q: [...] is the narrowing of a blood vessel, such as  with hypoperfusion or cold extremities.
A: Vasoconstriction

Q: [...] are the blood vessels that carry blood from the tissues to the heart.
A: Veins

Q: [...] are very small, thin-walled blood vessels.
A: Venules

Q: The main artery that receives blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body is the [...].
A: aorta

Q: An [...] is loss or damage of the superficial layor of skin as a result of a body part rubbing or scraping across a rough or hard surface.
A: abraision

Q: [...] is an injury in which part of the body is completely severed.
A: Amputation

Q: An [...] is an injury in which soft tissue is torn completely loose or is hanging as a flap.
A: avulsion

Q: [...] are injuries in which soft-tissue damage occurs as a result of thermal heat, frictional heat, toxic chemicals, electricity, or nuclear radiation.
A: Burns

Q: [...] are injuries in which damage occurs beneath the skin or mucous membrane but the surface of the skin remains intact.
A: Closed injuries

Q: [...] is swellingin a confined space that produces dangerous pressure; may cut off blood flow or damage sensitive tissue.
A: Compartment syndrome

Q: A [...] is a burn caused by direct contact with a hot object.
A: contact burn

Q: [...] is the presence of infective organisms or foreign bodies such as dirt, gravel, or metal.
A: Contamination

Q: [...] is a significant metabolic derangement that develops when crushed extremities or body parts remain trapped for prolonged periods. This can lead to renal failure and death.
A: Crush syndrome

Q: A [...] is an injury that occurs when a great amount of force is applied to the body.
A: crushing injury

Q: The [...] is the inner layer of the skin, containing hair follicles, sweat glands, nerve endings and blood vessels.
A: dermis

Q: [...] is the discoloration associated with a closed wound; signifies bleeding.
A: Ecchymosis

Q: [...] is the displacement of organs outside the body.
A: Evisceration

Q: The [...] is the outer layer of skin that acts as a watertight protective covering.
A: epidermis

Q: [...] is a serious behavioral condition in which a perosn exhibits agitated behavior combined with disorientation, hallucinations, or delusions; also called agitated delirium or exhaustice mania.
A: Excited delirium

Q: [...] is the fiberlike connective tissue that covers arteries, veins, tendonds, and ligaments.
A: Fascia

Q: A [...] is a burn caused by an open flame.
A: flame burn

Q: A [...] is a burn caused by exposure to very intense heat, such as an explosuon.
A: flash burn

Q: [...] (Third-degree burns) are burns that affect all skin layers and may affect the subcutaneous layers, muscle, bone, and internal organs, leaving the area dry, leathy, and white, dark, brown, or charred.
A: Full-thickness burns

Q: A [...] is blood collected within the body's tissues or in a body cavity.
A: hematoma

Q: [...] are objects that penetrate the skin but remain in place.
A: Impaled objects

Q: An [...] is a sharp, smooth cut in the skin.
A: incision

Q: A [...] is a deep, jagged cut in the skin.
A: laceration

Q: [...] are the linings of body cavities and passages that are in direct contact with the outside environment.
A: Mucous membranes

Q: [...] are dressings made of petroleum (Vaseline) gauze, aluminum foil, or plastic that prevent air and liquids from entering or exiting a wound.
A: Occlusive dressings

Q: [...] are injuries in which there is a break in the surface of the skin or the mucous membrane, exposing deeper tissue to potential contamination.
A: Open injuries

Q: [...] (Second-degree burns) are bruns that affect the epidermis and some portion of the dermis but not the subcutaneous tissue, characterized by blisters and skin that is white to red, moist, and molted.
A: Patrial-thickness

Q: A [...] is an injury resulting from a sharp, piercing object.
A: penetrating wound

Q: [...] means infected with rabies.
A: Rabid

Q: [...] is a system that assigned percentages to sections of the body, allowing calculation of the amount of skin surgace involved in the burn area.
A: Rule of nines

Q: A [...] is burn caused by hot liquids.
A: scald burn

Q: A [...] is a burn caused by exposure to hot steam.
A: stream burn

Q: [...] (first-degree) burns are burns that affect only the epidermis, characterized by skin that is red but not blistered or actually burned through.
A: Superficial

Q: [...] are burned caused by heat.
A: Thermal burns

Q: An [...] is the presence of air in the veins which can lead to cardiac arrest if it enters the heart.
A: air embolism

Q: [...] is naturally occuring uneven pupil size.
A: Anisocoria
Extra: Anice Bruce

Q: A [...] is a fracture of the orbit or of the bones that support the floor of the orbit.
A: blow-out fracture

Q: [...] is the delicate membrane that lines the eyelids and covers the exposed surgace of the eye.
A: Conjunctiva

Q: [...] is inflammation of the conjunctiva.
A: Conjunctivitis

Q: The [...] is the transparent tissue layer in front of the pupil and iris of the eye.
A: cornea

Q: The [...] is a branch of the internal auditory canal that connects the middle ear to the oropharynx.
A: eustachian tube

Q: The [...] is the ear canal; leads to the tympanic membrane.
A: external auditory canal

Q: The [...] of the eye is the eyeball.
A: globe

Q: The [...] is the muscle and surrounding tissue behind the cornea that dilate and construct the pupil, regulating the amount of light that enters the eye; pigment in this tissue gives the eye its color.
A: iris

Q: [...] are glands that produce fluids to keep the eye moist; also called tear glands.
A: Lacrimal glands

Q: The [...] is the transparent part of the eye through which images are focused on the retina.
A: lens

Q: The [...] is the prominent body mass at the base of the skull about 1 inch posterior to the external opening of the ear.
A: mastoid process

Q: The [...] is a cranial nerve that trasmits visual information to the brain.
A: optic nerve

Q: The [...] is the external, visible part of the ear.
A: pinna

Q: The [...] is the circular opening in the middle of the iris that admits light to the back of the eye.
A: pupil

Q: The [...] is the light-sensitive area of the eye when images are projected; a layer of cells at the back of the eyethat changes the light image into electric impulses, which are carried by the optic nerve to the brain.
A: retina

Q: [...] is the separation of the retina from its attachments at the back of the eye.
A: Retinal detachment

Q: The [...] is the tough, fibrous, white portion of the eye that protects the more delicate inner structure.
A: sclera

Q: The [...] are the muscles on either side of the neck that allow movement of the head.
A: sternocleidomastoid muscles

Q: A [...] is a characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues.
A: subcutaneous emphysema

Q: The [...] is the joint formed when the mandible and cranium meet, just in front of the ear.
A: temporomandibular joint

Q: The [...] small, rounded, fleshy bulge that lies immediately anterior to the ear canal.
A: tragus

Q: The [...] are layers of bone within the nasal cavity.
A: turbinates

Q: The [...] is the eardrum, which lies between the external and middle ear.
A: tympanic membrane

Q: [...] is the inability to remember events after an injury.
A: Anterograde (posttraumatic) amnesia

Q: [...] are injuries in which load is applied along the verticle or longitudinal axis of the spine, which results in load being transmitted along the entire length of the vertebral column; for example, falling from a height and landing on the feet in an upright position.
A: Axial loading injuries

Q: [...] usually occur following diffuse impact to the hear (such as falls, MVAs); generally result from extension of a linear fracture to the base of the skull and can be difficult to diagnose with a radiograph.
A: Basilar skull fractures

Q: A [...] is bruising behind an ear over the mastoid process that may indicate a skull fracture.
A: battle sign

Q: [...] is swelling of the brain.
A: Cerebral edema

Q: A [...]  is an injury in which the brain has been injured but the skin has not been broken and there is no obvious bleeding.
A: closed head injury

Q: A [...] is a temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain.
A: concussion

Q: [...] is dual impacting of the brain in to the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds.
A: Coup-contrecoup injury

Q: An [...] is an accumulation of blood between the skull and dura mater.
A: epidural hematoma

Q: [...] is a head position in which the patient's eyes are looking striaght ahead and the head and torso are in line.
A: Eyes forward position

Q: A [...] is the recommended procedure for moving a patient with a suspected spinal injury from the groun to a long backboard  or other spinal immobilization device.
A: four-person log roll

Q: The [...] is the cushion that lies between two vertebrae.
A: intrevertebral disk

Q: An [...] is bleeding within the brain tissue itself; also referred to as an intraparenchymal hematoma.
A: intracerebral hematoma

Q: [...] is the pressure within the cranial vault.
A: Intracranial pressure (ICP)

Q: [...] are actions of the body that are not under a person's conscious control.
A: Involuntary activities

Q: [...] account for 80% of skull fractures; also referred to as nondisplaced skull fractures; commonly occur in the temporal-parietal region of the skull; not associated with deformities to the skull.
A: Linear skull fractures

Q: The [...] are three distinct layers of tissue that surround and protect the brain and the spinal cord within the skull and the spinal canal.
A: meninges

Q: An [...] is an injury to the head often caused by a penetrating object in which there may be bleeding and exposed brain tissue.
A: open head injury

Q: A [...] is an injury to the brain and its associated structures that is a direct result of impact to the head.
A: primary (direct) injury

Q: [...] are bruising under the eyes that may indicate skull fracture.
A: Raccoon eyes

Q: [...] is the inability to remember events leading up to a head injury.
A: Retrograde amnesia

Q: [...] are the after effects of the primary injury; includes abnormal processes such as cerebral edema, increased intracranial pressure, cerebral ischemia and hypoziua, and infection; onset is often delayed following the primary brain injury.
A: Secondary (indirect) injury

Q: A [...] is bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.
A: subarachnoid hemorrhage

Q: A [...] is an accumulation of blood beneath the dura matter but outside the brain.
A: subdural hematoma

Q: A [...] is a traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.
A: traumatic brain injury (TBI)

Q: [...] are actions that we consciously perform, in which sensory input or conscious thought determines a specific muscular activity.
A: Voluntary activities

Q: [...] signs and symptoms include barrel chest, breathing through [...], dyspnea on [...], cyanosis and wheezing or decreased breath sounds.
A: Emphysema; pursed lips; exertion

Q: A [...] is the compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cadiac output.
A: cardiac (pericardial) tamponade

Q: A [...] is an injury to the chest in which the skin is not broken, usually caused by blunt trauma.
A: closed chest injury

Q: [...] is a blunt chest injury caused by a sudden, direct blow to the chest that occurs not only during the critical portion of a person's heartbeat.
A: Commotio cordis

Q: [...] is a grating or grinding sensation caused by fractured bone ends or joints rubbing together.
A: Crepitus

Q: [...] is a condition in which three or more ribs are fractured in two or more places or in association with a fracture of the sternum so that a segment of the chest wall is effectively detached from the rest of the thoracic cage.
A: Flail chest

Q: A [...] is a one-way valve that allows air to leave the chest cavity but not return; formed by taping three sides of an occlusive dressing to the chest wall, leaving the fourth side open as a valve; may also be part of a commercial vented occlusive dressing.
A: flutter valve

Q: A [...] is the accumulation of blood in the pleural space of the chest.
A: hemopneumothorax

Q: A [...] is a collection of blood in the pleural cavity.
A: hemothorax

Q: A [...] is the bruising of the heart muscle.
A: myocardial contusion

Q: An [...] is an airtight dressing that protects a wound from air and bacteria; a commercial vented version allows air to passively escape from the chest, while an unvented dressing may be made of petroleum jelly-based (Vaseline) gauze, aluminum foil, or plastic.
A: occlusive dressing

Q: An [...] is an injury to the chest in which the chest wall itself is penetrated by a fractured rib or, more frequently, by an external object such as a bullet or knife.
A: open chest injury

Q: An [...] is an open or penetrating chest wall would through which air passes during inspiration and expiration, creating a sucking sound; also referred to as a sucking chest wound.
A: open pneumothorax

Q: [...] is the motion of the portion of the chest wall that is detached in a flail chest; the motion- in during inhalation, out during exhalation- is exactly the opposite of normal chest wall motion during breathing.
A: Paradoxical motion

Q: The [...] is the fibrous sac that surrounds the heart.
A: pericardium

Q: A [...] is an accumulation of air or gas in the pleural cavity.
A: pneumothorax

Q: A [...] is any injury or bruising of lung tissue that results in hemorrhage.
A: pulmonary contusion

Q: A [...] is any pneumothorax that is free from significant physiologic changes and does not cause drastic changes in the vital signs of the patient.
A: simple pneumothorax

Q: A [...] is a pneumothorax that occurs when a weak area on the lung ruptures in the absence of major injury, allowing air to leak into the pleural space.
A: spontaneous pneumothorax

Q: A [...] is an open or penetrating chest wall wound through which air passes during inspiration and expiration, creating a sucking sound.
A: sucking chest wound

Q: [...] are rapid respirations.
A: Tachypnea

Q: A [...] is an accumulation of air or gas in the pleural cavity that progessively increases pressure in the chest cavity that interferes with cardiac function with potentially fatal results.
A: tension pneumothorax

Q: [...] is a pattern of injuries seen after a severe force is applied to the chest, forcing blood from the great vessels back into the head and neck.
A: Traumatic aphyxia

Q: A [...] is an injury in which there is soft-tissue damage inside the body but the skin remains intact.
A: closed abdominal injury

Q: An [...] is the displacement of organs outside of the body.
A: evisceration

Q: The [...] is the region below the rib cage and above the hip.
A: flank

Q: [...] is contracting the stomach muscles to minimize the pain of abdominal movement; a sign of peritonitis.
A: Guarding

Q: [...] are structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and urinary bladder.
A: Hollow organs

Q: [...] are black tarry stools.
A: Melena

Q: An [...] is an injury in which there is a break in the surface of the skin or mucous membrane, exposing deeper tissue to potential contamination.
A: open abdominal injury

Q: The [...] is the abdominal cavity.
A: peritoneal cavity

Q: The [...] is the membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs (visceral peritoneum).
A: peritoneum

Q: [...] are solid masses of tissue where much of the chemical work of the body takes place (eg, the liver, spleen, pancreas, and kidneys).
A: Solid organs

Q: An [...] is simple joint where the bony projections of the scapula and the clavicle meet at the top of the shoulder.
A: acromioclavicular (AC) joint

Q: An [...] is an injury in which part of the body is completely severed.
A: amputation

Q: The [...] is a pearly white layer of specialized cartilage covering the articular surfaces (contact surfaces on the ends) of bones in synovial joints.
A: articular cartilage

Q: The [...] is the heel bone.
A: calcaneus

Q: A [...] is any break in a bone in which the overlying skin is not broken.
A: closed fracture

Q: [...] is an elevation of pressure within a closed fascial compartment, characterized by extreme pain, decreased pain sensation, pain on stretching of affected muscles, and decreased power; frequently seen in fractures below the elbow or knee in children.
A: Compartment syndrome

Q: [...] is a greating or grinding sensation or sound caused by fractured bone ends or joints rubbing together.
A: Crepitus

Q: [...] is the dislocation of a joint in which ligaments are damaged and the bone ends are no longer in contact.
A: Dislocation

Q: A [...] is a fracture in which bone fragments are separated from one another, producing deformity in the limb.
A: displaced fracture

Q: [...] is bruising or discoloration associated with bleeding withing or under the skin.
A: Ecchymosis

Q: [...] is movement that occurs in a bone at a point where there is no joint, indicating a fracture; also called free movement.
A: False motion

Q: [...] are the fiberlike connective tissue that covers arteries, veins, tendons, and ligaments.
A: Fascia

Q: The [...] is the outer and smaller leg bone of the two bones of the lower leg.
A: fibula

Q: A [...] is a break in the continuity of a bone.
A: fracture

Q: The [...] is the part of the scapula that joins with the humeral head to form the glenohumeral joint.
A: glenoid fossa

Q: A [...] is where two bones come into contact.
A: joint

Q: A [...] is a band of fibrous tissue that connect bones to bones. It supports and strengthens a joint.
A: ligament

Q: A [...] is a simple crack in the bone that has not caused the bone to move from its normal anatomic position; also called a hairline fracture.
A: nondisplaced fracture

Q: An [...] is any break in a bone in which the overlying skin has been broken.
A: open fracture

Q: A [...] is a device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption and pain.
A: pelvic binder

Q: [...] is tenderness that is sharply localized at teh sit of the injury, found by gently palpating along the bone with the tip of one finger.
A: Point tenderness

Q: [...] is a hand position in which the wrist is slightly dorsiflexed and all finger joints are moderately flexed.
A: Position of function

Q: To [...] is to returned a dislocated joint or fractured bone to its normal position; to set.
A: reduce

Q: [...] is the space between the abdominal cavity and the posterior abdominal wall, containing the kidneys, certain large vessels, and parts of the GI tract.
A: Retroperitoneal space

Q: The [...] is the major nerve to the lower extermities; controls much of muscle function in the leg and sensation in most of the leg and foot.
A: sciatic nerve

Q: A [...] is a bandage or material that help to support the weight of an injured upper extremity.
A: sling

Q: A [...]  is a flexible or rigid device used to preotect and maintain the position of an injured extremity.
A: splint

Q: A [...] is joint injury involving damage to supporting ligaments and sometimes partial or temporary dislocation of bone ends.
A: sprain

Q: A [...] is the stretching or tearing of a muscle; also called muscle pull.
A: strain

Q: A [...] is abandage that passes around the chest to secure an injured arm to the chest.
A: swathe

Q: The [...] is the larger of the two lower leg bones responsible for supporting the major weight bearing surface of the knee and the ankle; the shinbone.
A: tibia

Q: A [...] is the bleeding control method used when a wound continues to bleed despite the us of direct pressure and elevation; useful if a patient is bleeding severely from a partial or complete amputation.
A: tourniquet

Q: [...] is the longitudinal force appled to a structure.
A: Traction

Q: The [...] is the area of potentially damaged soft tissue, adjacent nerves, and blood vessels surrounding an injury to a bone or joint.
A: zone of injury

Q: An [...] is air bubbled in the blood vessels.
A: air embolism

Q: [...] is the temperature of the surrounding environments.
A: Ambulent temperatures

Q: [...] is a serum that counteracts the effect of venom from an animal or insect.
A: Antivenin

Q: [...] is a common name for decomopression sickness.
A: Bends

Q: [...] is a loss of conciousness caused by a decreased breathing stimulus.
A: Breathe-holding syncope

Q: [...] is the loss of heat by direct contact (eg, when a body part come into contact with a colder object.)
A: Conduction

Q: [...] is the loss of body heat caused by air movement (eg, breeze blowing across the body.
A: Convection

Q: [...] is the temperature of the central part of the body (eg, the heart, lung, and vital organs.)
A: Core temperature

Q: [...] is a painful condition seen in divers who ascend too quickly in which gas especially nitrogen, forms bubbles iin blood vessels and other tissues.
A: Decompression sickness

Q: The [...] is the slowing of the heart rate caused by submersion in cold water.
A: diving reflex

Q: [...] is the process of experiencing respiratory impairment from submersion or immersion in liquid.
A: Drowning

Q: [...] are any signs and symptoms caused by the difference between the surrounding atmospheric pressure and the total gas pressure in various tissues, fluids, and cavities of the body.
A: Dysbarism injuries

Q: [...] is the conversion of water or another fluid from a liquid to gas.
A: Evaporation

Q: [...] is damage to tissues as the results of exposure to colg; frozen body parts.
A: Frostbite

Q: [...] are painful muscle spasm usually associated with vigorous activity in a hot environment.
A: Heat cramps

Q: [...] is a heat emergency in which a significant amount of fluid and electrolyte loss occurs because of heavy sweating; alsi called heat prostration or heat collapse.
A: Heat exhaustion

Q: [...] is a life-threatening condition of severehyperthermia caused by exposure to excessive natural or artificial heat, marked by warm, dry skin, severe altered mental status; often irrevesible coma.
A: Heat stroke

Q: [...] is a balance of all systems of the body.
A: Homeostasis

Q: [...] is a family of insects that includes bees, wasps, ants, and yellow jackets.
A: Hymenoptera

Q: [...] is a condition in which the body core termp rises to 101 degrees farenheit or more.
A: Hyperthermia

Q: [...] is a condition in which the body core temp falls below 95 degrees farenheitafter exposure to a cold environment.
A: Hypothermia

Q: [...] is the transfer of heat to colder objects in the environment by radiant energy, for example heat gain from a fire.
A: Radiation

Q: [...] is the loss of body heat as warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled.
A: Respiration

Q: [...] is a triage process used in treating multiple victims of a lightning strike, in which efforts are focused on those who are in respiratory and cardiac arrest. Reverse triage is different from conventional triage where such patients would be classified as deceased.
A: Reverse triage

Q: [...] is a system that delivers air to the mouth and lungs at various atmospheric pressures, increasing with the depth of the dive; stands for self-contained underwater breathing apparatus.
A: Scuba gear

Q: [...] is the ability of the skin to resist deformation; tested by gently pinching skin on the forehead or back of the head.
A: Turgor

Q: A [...] fracture is one which the bone is broken into more than two fragments.
A: comminuted

Q: An [...] fracture is one that occurs in a growth section of a child's bone and may lead to growth abnormalities.
A: epiphyseal

Q: A [...] fracture is an incomplete fracture that passes only partway through the shaft of a bone but may still cause substantial angulation; occurs in children.
A: greenstick

Q: An [...] fracture is one that does not run completely through the bone; a nondisplaced fracture.
A: incomplete

Q: An [...] fracture is one which the bone is broken at an angle across the bone. This is usually the result of a sharp angled blow to the bone.
A: oblique

Q: A [...] fracture is one of weakened of diseased bone; seen in patients with osteoporosis, infection, or cancer; often produced by minimal force.
A: pathologic

Q: A [...] fracture is one that is caused by a twisting or spinning force, causing a long spiral-shaped break in the bone. This is sometimes the result of abuse in young children.
A: spiral

Q: A [...] fracture is one that occurs straight across the bone. This is usually the result of a direct blow injury.
A: transverse

Q: [...] is MOST accurately defined as shortness of breath or difficulty breathing.
A: Dyspnea

Q: Acute pulmonary edema would MOST likely develop as the result of [...]
A: toxic chemical inhalation.

Q: A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:
A: provide reassurance and give oxygen as needed.

Q: Hyperventilation could be associated with all of the following, EXCEPT: [...]
A: narcotic overdose.

Q: A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: apply a ...... , monitor his blood pressure, and observe him for signs of improvement or deterioration.
A: CPAP device

Q: Common signs and symptoms of acute hyperventilation syndrome include [...].
A: tachypnea and tingling in the extremities

Q: When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should adjust the flow rate accordingly until you see symptom improvement, but be prepared to [...].
A: assist his or her ventilations

Q: An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with [...]
A: adequate air exchange.

Q: The hypoxic drive stimulates a person to breathe on the basis of [...].
A: low oxygen levels

Q: You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should insert [...] and begin assisted ventilation.
A: a nasopharyngeal airway

Q: Family history of hypertension is [...] important when obtaining a medical history from a patient complaining of chest discomfort compared to prescence of personal factors, hx of previous heart attack and history of cigarette smoking.
A: LEAST

Q: The head and brain receive their supply of oxygenated blood from the [...]
A: carotid arteries.

Q: After assisting your patient with prescribed nitroglycerin, you should: reassess his or her blood pressure within 5 minutes to detect [...]
A: hypotension.

Q: You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: [...], place him in a [...] and elevate his lower extremities, and prepare for immediate transport.
A: remove the nitroglycerin patch; supine position

Q: In contrast to the sympathetic nervous system, the parasympathetic nervous system [...]
A: slows the heart and respiratory rates.

Q: Ventricular tachycardia causes hypotension because [...]
A: the left ventricle does not adequately fill with blood.

Q: A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?
A: Deliver the shock followed by immediate resumption of CPR.

Q: When documenting a patient's description of his or her chest pain or discomfort, the EMT should [...]
A: use the patient's own words.

Q: You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should: [...] and transport immediately.
A: suction her oropharynx

Q: [...] is a metabolic cause of a seizure.
A: Poisoning

Q: You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:
A: monitor her airway and breathing status and assess her blood glucose level.

Q: A transient ischemic attack (TIA) occurs when a [...] causes temporary symptoms.
A: small clot in a cerebral artery

Q: You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:
A: initiate CPR and attach an AED as soon as possible.

Q: Febrile seizures are usually [...] but should be evaluated.
A: benign

Q: The spinal cord exits the cranium through the [...]
A: foramen magnum.

Q: The mental status of a patient who has experienced a generalized seizure is likely to improve over a period of [...]
A: 5 to 30 minutes.

Q: Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the [...]
A: liver.

Q: You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should:
A: repeat the arm drift test and ensure that her palms are facing downward.

Q: The visceral peritoneum is supplied by the same nerves from the spinal cord that supply the skin of the [...].
A: abdomen

Q: The ... assists in the filtration of blood, serves as a blood reservoir, and produces antibodies.
A: Spleen

Q: A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty and she is tachycardic. The EMT should suspect [...]
A: aortic aneurysm

Q: A [...] is a hernia that loses its blood supply due to compression by local tissues.
A: strangulated hernia

Q: Injury to a hollow abdominal organ would MOST likely result in [...]
A: leakage of contents into the abdominal cavity.

Q: The spleen, kidneys, and pancreas are all [...] organs.
A: solid

Q: The parietal peritoneum lines the [...]
A: walls of the abdominal cavity.

Q: Chronic renal failure is a condition that is often caused by [...].
A: hypertension or diabetes

Q: The kidneys help to regulate blood pressure by [...] from the body.
A: removing sodium and water

Q: What signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes?
A: weight loss and polyuria

Q: Kussmaul respirations are an indication that the body is attempting to [...]
A: eliminate acids from the blood.

Q: Ketone production is the result of [...] when [...] is unavailable.
A: fat metabolization; glucose

Q: Common side effects of epinephrine include: tachycardia, headache, anxiety and dizziness.
A: tachycardia, headache, and dizziness.

Q: Because the stinger of a honeybee remains in the wound following a sting it can continue to inject venom for up to [...]
A: 20 minutes.

Q: Immediately after giving an epinephrine injection, you should:
A: properly dispose of the syringe.

Q: Which physiologic actions does epinephrine produce when given for an allergic reaction?
A: Vasoconstriction and bronchodilation

Q: [...] is indicated for patients with an allergic reaction when wheezing and hypotension are present.
A: Epinephrine

Q: A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called a ...
A: Wheal

Q: When administering epinephrine via auto-injector, you should hold the injector in place for ....
A: 10 seconds

Q: The foreign substance responsible for causing an allergic reaction is called a(n): [...]
A: allergen

Q: In general, injected poisons are impossible to dilute or remove because they:
A: are usually absorbed quickly into the body

Q: Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which side effect would you expect the patient to experience?
A: dry mucous membranes

Q: A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should:
A: administer 15 g of activated charcoal.

Q: Signs and symptoms of a sympathomimetic drug overdose include: [...]
A: tachycardia

Q: A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:
A: insert a nasal airway and ventilate with a BVM.

Q: Before giving activated charcoal, you should:
A: obtain approval from medical control.

Q: You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:
A: attempting to calm him and giving him oxygen if tolerated.

Q: You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:
A: thoroughly suctioning her oropharynx.

Q: After administering activated charcoal to a patient, it is MOST important to:
A: be alert for vomiting

Q: The single most significant factor that contributes to suicide is:
A: depression

Q: A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
A: ask the daughter how her father normally behaves.

Q: Organic brain syndrome is defined as a dysfunction of the brain caused by
A: abnormal physical or physiological function.

Q: Pelvic inflammatory disease (PID) typically does NOT affect the [...]
A: urinary bladder.

Q: Painful [...] is a common symptom of gonorrhea in both men and women.
A: urination

Q: [...] would MOST likely lead to pelvic inflammatory disease if left untreated.
A: Chlamydia

Q: An [...] is an individual who has training in specific aspects of advanced life support, such as intravenous therapy, and the administration of certain emergency medications.
A: advanced EMT (AEMT)

Q: [...] are advanced lifesaving procedures, some of which are now being provided by the EMT.
A: Advanced life support (ALS)

Q: The [...] is a comprehensive legislation that is designed to protect people with disabilities against discrimination.
A: Americans With Disabilities Act (ADA)

Q: An [...] is a device that detects treatable life-threatening cardiac dysrhythmias (ventricular fibrillation and ventricular tachycardia) and deliver the appropriate electrical shock to the patient.
A: automated external difibrillator (AED)

Q: A [...] is a process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.
A: certification

Q: [...] is a healthcare model in which experience paramedics recieve advanced training to equip them to provide additional services in the prehospital environment, such as health evaluations, monitoring of chronic illnesses or condition, and patient advocacy.
A: Community paramedicine

Q: [...] is a system of internal and external reviews and audits of all aspects of an EMS system.
A: Continuous quality improvement (CQI)

Q: [...] is a system that assists dispatchers in selecting appropriate units to respond to a particular call for assistance and provides callers with vital instructions until the arrival of EMS crews.
A: Emergency medical dispatch (EMD)

Q: An [...] is the first trained professional, such as police officer, firefighters, lifeguard, or other rescuer, to arrive at the scene of an emergency to provide initial medical assistance.
A: emergency medical responder (EMR)

Q: [...] is a multidisciplinary system that represents the combined efforts of several professionals and agencies to provide prehospital emergency care to the sick and injured.
A: Emergency medical services (EMS)

Q: An [...] is an individual who has training in basic life support, including automated external defibrillation, used of a definitive airway adjunct, and assisting patients with certain medications.
A: emergency medical technician (EMT)

Q: HIPAA stands for [...]
A: Health Insurance Portability and Accountability Act.

Q: [...] is federal legislation passed in 1996. It's main effect in EMS is in limiting availability of patients' health care information andp enalizing violations of patient privacy.
A: HIPAA

Q: [...] is the delivery of medication direction into a vein.
A: Intravenous (IV) therapy

Q: [...] is the process whereby a competent authority, usually the state, allows people to perform a regulated act.
A: Licensure

Q: [...] are physician instructions given directly by radio or cell phone (online/direct) or indirectly by protocol/guidelines (offline/indirect), as authorized by the medical director of the service program.
A: Medical control

Q: The [...] is the physican who authorizes or delegates to the EMT the authority to provide medical care in the field.
A: medical director

Q: [...] is a method delivering health care which involves providing healthcare withing the community rather than at a physician's office or hospital.
A: Mobile integrated healthcare (MIH)

Q: The [...] is a document created by the NHTSA that outlines the skills perfored by various EMS providers.
A: National EMS Scope of Practice Model

Q: A [...] is an individual who has extensive training in advanced life support, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills.
A: paramedic

Q: [...] are efforts to prevent an injury or illness from ever occuring.
A: Primary prevention

Q: The [...] is the designated area in which the EMS agency is responsible for the provision of prehospital emergency care and transportation to the hospital.
A: primary service area (PSA)

Q: [...] is focused on examining that health needs of entire popilations with the goal of preventing health probelms.
A: Public health

Q: A [...] is a call center, staffed by trained personnel who are responsible for managing requests for police, fire, and ambulance services.
A: public safety access point

Q: [...] is the responsibility of the medical director to ensure the appropriate medical care stadards are met by EMTS on each call.
A: Quality control

Q: [...] are efforts to limit the effects of an injury or illness that you cannot completely prevent.
A: Secondary prevention

Q: [...] are reactions to stress that occur during a stressful reaction.
A: Acute stress reactions

Q: [...] is the spread of an organism via droplets or dust.
A: Airborne transmission

Q: [...] are pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus and HIV.
A: Bloodborne pathogens

Q: The [...] is the primary federal agency that conducts and supports public health activities in the US. It is part of the US Department of Health and Human Services.
A: Center for Disease Control and Prevention (CDC)

Q: A [...] is a disease that can be spread from one person to another.
A: communicable disease

Q: [...] is the use of objects to limit a person's visibility of you.
A: Concealment

Q: [...] is the presence of infectious organisms on or in objects such  as dressings, water, food, needles, wounds, or a patient's body.
A: Contamination

Q: [...] is the tactical use of an impenetrable barrier for protection.
A: Cover

Q: [...] is a process that confronts the responses to critical incidents and defuses them, directing the emergency services personnel toward physical and emotional equilibrium.
A: Critical Incident Stress Management (CISM)

Q: [...] are prolonged or excessive stress.
A: Cumulative stress reactions

Q: [...] are reactions to stress that occur after a stressful situation.
A: Delayed stress reactions

Q: The [...] is the individual in the department who is charged with the responsibility of managing exposures and infection control issues.
A: designated officer

Q: [...] is exposure or transmission of a communicable disease from one person to another by physical contact
A: Direct contact

Q: [...] is a situation in which a person has had contact with blood, body fluids, tissues, or airborne particles in a manner that suggests disease transmission may occur.
A: Exposure

Q: [...] is the contamination of food or water with an organism that can cause disease.
A: Foodborne transmission

Q: [...] is the body's respnose to stress that begins with an alarm response, followed by a stage of reaction and resistance, and then recovery or, if the stress is prolonged, exhaustion.
A: General adaptation syndrome

Q: [...] is inflammation of the liver, usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function.
A: Hepatitis

Q: A [...] is the organism or individual that is attacked by the infecting agent.
A: host

Q: [...] leads to acquired immunodeficiency symdorme, which damaged the cells in the bodys immune system so that the body is unable to fight infection or certain cancers.
A: Human immunodeficieny virus (HIV)

Q: [...] is the bodys ability to protect itself from acquiring a disease.
A: Immunity

Q: [...] is exposure or trasmission of disease from one person to another by contact with a contaminated object.
A: Indirect contact

Q: [...] is the abnormal invasion of a host or host tissues by oranisms such as bacteria, viruses, or parasites with or without signs or symptoms or disease.
A: Infection

Q: [...] are procedures to reduce transmission of infection among patients and health care personnel.
A: Infection control

Q: An [...] is a medical condition caused by the growtha nd spread of small, harmful organisms within the body.
A: infectious disease

Q: The [...] is the federal regulatory and compliance agency that develops, publishes, and enforces guidelines concerning safety in the workplace.
A: Occupational Safety and Health Administration (OSHA)

Q: A [...] is a microorganism that is capable of causing disease in a susceptible host.
A: pathogen

Q: [...] is protective equipment that blocks exposure to a pathogen or hazardous material.
A: Personal protective equipment (PPE)

Q: [...] is a delayed stress reaction to a prior incident. Often the result of one or morer unresolved issues concerning the inciden, and may relate to an incident that involved physical harm or the threat of physical harm.
A: Posttraumatic stress disorder (PTSD)

Q: [...] is the way in which an infectious disease is spread: contact, airborne, by vehicles or by vectors.
A: Transmission

Q: [...] are protective measures that have traditionally been developed by the CDC for use in dealing with objects, blood, body fluids, and other potention exposure risks of communicable disease.
A: Standard precautions

Q: [...] is the use of an animal to spread an organism from one person or place to another.
A: Vector-borne transmission

Q: [...] is the unilateral termination of care by the EMT without the patient's consent and without making provisions for transferring car to antoher medical professional with the skills and training necessary to meet the needs of the patient.
A: Abandonment

Q: [...] is a written document that specifies medical treatment for a competent patient if they become unable to make decisions; also called a [...] or [...]
A: Advanced directive; living will; health care directive.

Q: [...] is the manner in which principles of ethics are incorporated into professional conduct.
A: Applied ethics

Q: [...] is unlawfully placing a patient in fear of bodily harm.
A: Assault

Q: [...] is unlawfully touching a patient or providing emergency care without consent.
A: Battery

Q: [...] is the study of ethics related to issues that arise in health care.
A: Bioethics

Q: [...] is the disclosure of information without proper authorization.
A: Breach of confidentiality

Q: [...] is a process in which a person, institution, or program is evaluated and recognized as meeting a certain predetermined standards to provide safe and ethical patient care.
A: Certification

Q: [...] are damages awarded in a civil lawsuit that are intended to restore the plaintiff to the same condition that he or she was in prior to the incident.
A: Compensatory damages

Q: Someone who is [...] is able to make rational decisions about personal well-being.
A: competent

Q: [...] is the permission to render care.
A: Consent

Q: [...] is a legal defence that may be raised when the defendant feels that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff.
A: Contributory negligence

Q: [...] is an established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.
A: Credentialing

Q: [...] is the ability to understand and process information and make a choice regarding appropriate medical care.
A: Decision-making capacity

Q: [...] is the communication of false information about a person that is damaging to that person's reputation or standing in the community.
A: Defamation

Q: [...] is blood settling to the lowest point of the body, causing discoloation of the skin; a definitive sign of death.
A: Dependent lividity

Q: [...] are oral questions asked of parties and witnesses under oath.
A: Depositions

Q: [...] is the phase of a civil lawsuit where the plaintiff and defense obtain info from each other that will enable the attorneys to have a better understanding of the case and which will assist in negotiating a possible settlement or in preparing for trial. It includes depositions, interrogatories, and demands for production of records.
A: Discovery

Q: [...] are written documentation by a physcian giving permission to medical personnel not to attempt resuscitation in the event of cardiac arrest.
A: do not resuscitate (DNR) orders

Q: A [...] is a type of advanced directive executed by  a compettent adult that appoints anotheri ndividual to make medical treatment decisions on his or her behald, in the event that the person making the appointment loses decision making capacity.
A: durable power of attorney

Q: A [...] is a medicolegal term relating to certain personnel who either by statute or by function have a responsibility to provide care.
A: duty to act

Q: An [...] is a serious situation, usch as injury or illness that threatens the life or welfare of a person or group of people and requires immediate intervention.
A: emergency

Q: [...] is the principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs or alcohol, or the patient's age.
A: Emergency doctrine

Q: [...] is immediate care or treatment.
A: Emergency medical care

Q: [...] is the philosophy of right and wrong, of moral duties, and of ideal professional behavior.
A: Ethics

Q: [...] is a type of consent in which a patient fives verbal or nonverbal authorization for provision of care or transport.
A: Expressed consent

Q: [...] is the confinement of a person without legal authority or the person's consent.
A: False imprisonment

Q: [...] is the act of physically preventing an individual from initiating any physical action.
A: Forcible restraint

Q: [...] are statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is wanton, gross or willfull negligence.
A: Good samaritan laws

Q: [...] is the legal doctrine that can protect and EMS provider from being sued or which may limit the amount of the monetary judgement that the plaintiff may recover; generally applies only to EMS systems that are operated by government entities.
A: Governmental immunity

Q: [...] is the conduct that constitutes a willfull or reckless disregard for a duty or standard of care.
A: Gross negligence

Q: A [...] is a written document that specifies medical treatment for a competent patient, should they become unable to make decisions. Also known as a [...]
A: health care directive; living will.

Q: [...] are a type of advanced directive that is exceuted by a competent adult that appoints another individual to make medical treatment decisions on their behalf in the event that the person making the appointment loses decision making capacity. Also known as a [...]
A: Health care proxies; power of attorney.

Q: [...] is the type of consent that a patient who is unable to give consent  is given treatment under the legal assumption that he or she would want treatment.
A: Implied consent

Q: [...] is permission for treatment given by a competent patient after the risks, benefits, and alternatives to treatment are explained.
A: Informed consent

Q: [...] is the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.
A: In loco parentis

Q: [...] are written wuestions that the defense and plaintiff send to one another.
A: Interrogatories

Q: [...] is the seizing, confining, abducting or carrying away of another person by force, including transporting a competent adult for medical treatment without their consent.
A: Kidnapping

Q: [...] is false and damaging information about a person that is communicated in writing.
A: Libel

Q: [...] is the process were a competent authority, usually the state, allows people to perform a regulated act.
A: Licensure

Q: [...] is a term relating to medical, law, or forensic medicine.
A: Medicolegal

Q: [...] is a code of conduct that can be defined by society, religion, or a person, affecting character conduct and conscience.
A: Morality

Q: [...] is the failure to provide the same care that a person with similar training would provide.
A: Negligence

Q: [...] is a theory that may be used when the conduct of a person being sued is alleged to have occurred in clear violation of a statue.
A: Negligence per se

Q: [...] is the right of a patient to make informed choices regarding their health care.
A: Patient autonomy

Q: [...] is when a person who have a duty abuses it, and causes harm to another individual, the EMT, the agency or the medical director may be sued for negligence.
A: Proximate causation

Q: [...] are damages that are sometimes awarded in a civil lawsuit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public.
A: Punitive damages

Q: [...] is the decompisition of body tissues; this is a definitive sign of death.
A: Putrefaction

Q: [...] is when the EMT is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred.
A: Res ipsa loquitor

Q: [...] outlines the care that the EMT is able to provide for the patient; this is defined by state law.
A: Scope of practice

Q: [...] is false and damaging information about a person that is communicated by the spoken word.
A: Slander

Q: [...] is the written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.
A: Standard of care

Q: A [...] is a wrongful act that gives rise to a civil lawsuit.
A: tort

Q: The [...] is any radio hardware containing a transmitter and reciever that is located in a fixed place.
A: base station

Q: A [...] is a low power portable radio that communicates through interconnected series of repeater stations called "cells"
A: cell phone

Q: A [...] is an assign frequency that is used to carry voice and or data communications.
A: channel

Q: [...] is the transmission of information to another person.
A: Communication

Q: [...] is when one person imposes his or her believes on another because they believe their ideals are superior.
A: Cultural imposition

Q: A [...] is a special phone line that is used for specific point to point communications; also know as a [...]
A: dedicated line; hotline.

Q: [...] is the recorded portion of the EMT's patient interaction that becomes part of the patients permanent medical record.
A: Documentation

Q: A [...] is the ability to transmit and recieve simultaneously.
A: duplex

Q: [...] is when a person considers their own cultural values as more important when interacting with people of a different culture.
A: Ethnocentrism

Q: The [...] is the federal gency that has jusidiction over interstate and international phone and telegraph services and satellite communications, all of which may involve EMS activity.
A: Federal Communications Commission (FCC)

Q: An [...] is a communication system that uses voice-over-Internet-protocol (VoIP) technology to allow multiple agencies to communicate and transmit data.
A: interoperable communications system

Q: [...] are VHF and UHF channels that the FCC has designed exclusively for EMS use.
A: MED channels

Q: A [...] is a small computer terminal inside the ambulance that directly recieves data from the dispatch center.
A: mobile data terminal (MDT)

Q: [...] is the ability to transmit audio and data signals through the use of more than one communications channel.
A: Multiplex

Q: [...] is anything that dampens or obscures the true meaning of a message.
A: Noise

Q: [...] is the use of radio signal and a voice or digital message that is transmitted hrough pagers or desktop monitor radios.
A: Paging

Q: A [...] is the legal document used to record all patient care activities. This report has direct patient care functions but also administrative and quality control functions. Also known as [...].
A: patient care report (PCR); prehospital care reports

Q: A [...] is a trusting relationship that you build with your patient.
A: rapport

Q: A [...] is a special base station radio that recieves messages and signals on one frequency and then automatically retransmits them on a second frequency.
A: repeater

Q: A [...] is a radio reciever that seraches or scans across several frequencies until the message is completed; the process is then repeated.
A: scanner

Q: A [...] is a single-frequency radio, transmissions can occur in either direction but not simultaneously in both; when one party transmits, the other can only recieve, and the party that is tranmitting is unable to recieve.
A: simplex

Q: [...] are written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibition regarding patient care. Also called [...]
A: Standing orders; protocols.

Q: [...] is a process which electronic signals are converted into coded, audible signals; which can be transmitted by radio or phone to a reciever with a decoder at the hospital.
A: Telemetry

Q: [...] is the telecommunication systems that allow a computer to maximize utilization of a group of frequences.
A: Trunking

Q: [...] are verbal and non verbal communication techniques that encourage patient to express their feelings and to achieve a positive relationship.
A: Therapeutic communications

Q: [...] are radio frequencies between 300 and 3,000 MHz.
A: UHF (ultra high frequency)

Q: [...] are radio frequencies between 30 and 300 MHz and is divided into high and low bands.
A: VHF (very high frequency)

Q: [...] is the motion of a limb away from the midline.
A: Abduction

Q: [...] is the motion of a limb toward the midline.
A: Adduction

Q: The [...] is the pointed extremity of a conical strructure.
A: apex

Q: [...] means further from the trunk of the body.
A: Distal

Q: [...] means closer from the trunk of the body.
A: Proximal

Q: [...] is the straightening of a joint.
A: Extension

Q: [...] is the bending of a joint.
A: Felxion

Q: Parts of the body that lie closer to the midline are [...] or inner structures.
A: medial

Q: [...] is the forward facing part of the hand in the anatomic position.
A: Palmar

Q: [...] is the bottom surface of the foot.
A: Plantar

Q: The [...] is the part of a term that changes the meaning of the term.
A: prefix

Q: [...] is the position where a patient is lying face down.
A: Prone

Q: When something is [...] it is on the anterior side of the body.
A: ventral

Q: The [...] is the main part of a term that contains the primary meaning of the term.
A: word root

Q: The [...] is the body cavity that contains the major organs of digestion and excretion. It is located below the diaphragm and above the pelvis.
A: abdomen

Q: The [...] is the depression on the lateral pelvis where its three component bones join, in which the femoral head fits snugly.
A: acetabulum

Q: The [...] is a firm prominence of cartilage that forms the upper part of the larynx. It is more prominent in men than women. It is also called the [...]
A: adams apple; thyroid cartilage.

Q: [...] is the nucleotide involved in energy metabolism; used to store energy.
A: Adenosine triphosphate (ATP)

Q: The [...] are endocrine glands located on top of the kidneys that release adrenaline when stimulated by the sympathetic nervous system.
A: adrenal glands

Q: [...] is a term pertaining to nerves that release the neurotransmitter norepinephrine, or noradreniline; also pertains to the receptors acted on by norepinephrine.
A: Adrenergic

Q: The [...] is metabolism that can proceed only in the presence of oxygen.
A: aerobic metabolism

Q: [...] are abnormal breathing patterns characterized by slow, gasping breaths, sometimes seen in patients with cardiac arrest.
A: Agonal gasps

Q: [...] are portions of the nervous system that when stimulated can cause condtriction of blood vessels.
A: Alpha-adrenergic receptors

Q: The [...] are the air sacs of the lungs in which the exchange of oxygen and carbon dioxide take place.
A: alveoli

Q: [...] is the metabolism that takes place in the absence of oxygen; the main by-product is lactic acid.
A: Anarobic metabolism

Q: The [...] is the position of reference in which the patient stands facing forward, arms at the side with the palms of the hands forward.
A: anatomic position

Q: The [...] is the main artery leaving the left side of the heart and carrying freshly oxygenated blood to the body.
A: aorta

Q: The [...] is the portion of the skeletal system that comprimises the arms, legs, pelvis, and shoulder girdle.
A: appendicular skeleton

Q: The [...] is a small tubular structure that is attaached to the lower border of the cecum in the lower right quadrant of the abdomen.
A: appendix

Q: [...] is apearly layer of specialized cartilage covering the articular surgaces (contact surfaces on the ends) of bones in synovial joints.
A: Articular cartilage

Q: The [...] is one of the two upper chambers of the heart.
A: atrium

Q: The [...] is the part of the nervous sustem that regulates functions, such as digestion and sweating that are not controlled voluntarily.
A: autonomic nervous system

Q: The [...] is the part of the skeleton comprising the skull, spinal column and rib cage.
A: axial skeleton

Q: A [...] is a joint that allows internal and external rotation as well as bending.
A: ball and socket joint

Q: [...] are portions of the nervous system that when stimulated can cause an increase in the force of contraction of the heart, an increased heart rate, and bronchial dilation.
A: Beta-adrenergic receptors

Q: The [...] is the largemu scle that covers the front of the humerus.
A: bicep

Q: The [...] are the ducts that convey bile between the liver and the intestine.
A: bile ducts

Q: [...] is the pressure that the blood exerts against the walls of the arteries as it passes through them.
A: Blood pressure

Q: The [...] is the major vessel in the upper extremities that supplies blood to the arms.
A: brachial artery

Q: The [...] is the controlling organ of the body and center of consciousness; functions include perception, control of reactions to the environment, emotional responses, and judgment.
A: brain

Q: The [...] is the area of the brain between the spinal cord and cerebrum, surrounded by the cerebellum; controls functions that are necessary for life, such as respiration.
A: brain stem

Q: The [...] are the tiny blood vessels between the arterioles and venules that permit transfer of oxygen, carbon dioxide, nutrients, and waste between body tissues and the blood.
A: capillary vessels

Q: [...] is heart muscle.
A: Cardiac muscle

Q: [...] is the volume of blood circulated by the heart in 1 minute. Its calculated by multiplying the stroke volume by the heart rate.
A: Cardiac output

Q: The [...] is the major artery that supplies blood to the head and brain.
A: carotid artery

Q: The [...] is the smooth connective tissue that forms the support structure of the skeletal system and provides cushioning between bones.
A: cartilage

Q: The [...] is the first part of the large intenstine into which the ileum opens.
A: cecum

Q: The [...] consists of the brain and spinal cord.
A: central nervous system (CNS)

Q: The [...] is one of the three major subdivisions of the brain, sometimes called the little brain; coordinates the activities of the brain, particularly fine body movements.
A: cerebellum

Q: [...] is the fluid produced in the ventricles of the brain that flows in the subarachnoid space and bathes the meninges.
A: Cerebrospinal fluid (CSF)

Q: The [...] is the largest part of the three subdivisions of the brain, sometimes called the gray matter; it's made up of several lobes that control movement, hearing, balance, speech, visual perception, emotions and personality.
A: cerebrum

Q: The [...] is the portion of the spinal column consisting of the first seven vertabrae that lie in the neck.
A: cervical spine

Q: The [...] are thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting.
A: chordaw tendineae

Q: [...] is the substance that leaves the stomach. It is a combination of all the eaten foods with added stomach acids.
A: Chyme

Q: The [...] is the complez arrangement of connected tubes that move blood, oxygen, nutrients, carbon dioxide and cellular waste through the body.
A: circulatory system

Q: The [...] is the collar bone,it is lateral to the sternum and anterior to the scapula.
A: clavicle

Q: The [...] is the last three of four vertabrae of the spine; the tail bone.
A: coccyx

Q: The [...] is an imaginary plane where the body is divided into front and back parts.
A: coronal plane

Q: The [...] is the area of the head above the ears and eyes; the skull; it contains the brain.
A: cranium

Q: The [...] is a firm ridge of cartilage that forms the lower part of the larynx.
A: cricoid cartilage

Q: The [...] is a thin sheet of fascia that connects the thyroid and cricoid cartilages that make up the larynx.
A: cricothyroid membrane

Q: [...] is any portion of the airway that does contain air and cannot participate in gas exchange such as the trachea and bronchi.
A: Dead space

Q: The [...] is the inner layer of skin, containing hair follicles, sweat glands, nerve endings and blood vessels.
A: dermis

Q: The [...] is a muscular dome that forms the undersurface of the thorax, serparating the chest from the abdominal cavity. Contraction of this and the chest wall muscles brings air into the lungs. Relaxation allows air to be expelled from the lungs.
A: diaphragm

Q: [...] is the relaxation, or period of relaxation, of the heart, especially of the ventricles.
A: Diastole

Q: [...] is the movement of gas from an area of high concentration to an area of lower concentration.
A: Diffusion

Q: [...] is the processing of food that nourishes the individual cells of the body.
A: Digestion

Q: The [...] is the artery on the anterior surface of the foot between the first and second metatarsals.
A: dorsal pedis artery

Q: The [...] is the complex mesage and control system that integrates many body functions, including the release of hormones.
A: endocrine system

Q: [...] are substances designed to speed up the rate of specific biochemical reactions.
A: Enzymes

Q: The [...] is the outer layer of skin, which is made up of cells that are sealed together to form a water tight protective covering for the body.
A: epidermis

Q: The [...] is a thin, leaf-shaped valve that allows air to pass into the trachea but prevents food and liquid from entering.
A: epiglottis

Q: [...] is a hormone produced by the adrenal medulla that has a vital role in the function of the sympathetic nervous system.
A: Epinephrine

Q: The [...] is a collapsible tube that extends from the pharynx to the stomach; muscle contractions propel food and liquids through it to the stomach.
A: esophagous

Q: [...] is the amount of air that can be exhaled following a nromal exhalation.
A: Expiratory reserve volume

Q: [...] are long slender tubes the extend from the uterus to the region of the ovary on the same side and through with the ovum passes from the ovary to the uterus.
A: Fallopian tubes

Q: The [...] is the major artery of the thigh, a continuation of the external iliac artery. It suppplies blood to the lower abdominal wall, external genetalia, and legs. It can be palpated in the groin area.
A: femoral artery

Q: The [...] is the proximal end of the femur, articulating with the acetabulum to form the hip joint.
A: femoral head

Q: The [...] is the thigh bone; the longest and one of the strongest bones in the body.
A: femur

Q: The [...] is the large opening at the base of the skill through which the brain connects to the spinal cord.
A: foramen mgnum

Q: The [...] si the portion of the cranium that forms the forehead.
A: frontal bone

Q: The [...] is a sac on the undersurgace of the liver that collects bile from the liver and discharfes it into the dudenum through the common bile duct.
A: gallbladder

Q: The [...] is the reproductive system in men and women.
A: genital system

Q: The [...] is the deepest layer of the epidermis where new skin cells are formed.
A: germinal layer

Q: The [...] is a bony prominence on the proximal lateral side of the thigh, just below the hip joint.
A: greater tochanter

Q: [...] are small organs that produce hair.
A: Hair follicles

Q: The [...] is a hollow muscular organ that pumps blood throughout the body.
A: heart

Q: [...]is the number of heartbeats during a specific time.
A: Heart rate (HR)

Q: [...] are joints that can bend and straighten but cannot rotate; they restrict motion to one plane.
A: Hinge joints

Q: [...] are substances formed in specialized organs or glands and carried to another organ or group of cells in the same organism; they regulate many body functions including metabolism, growth and body temperature.
A: Hormones

Q: The [...] is the supporting bone of the upper body.
A: humerus

Q: [...] is the pressure of water against the walls of its container.
A: Hydrostatic pressure

Q: The [...] is the backup system to control respiration; senses drop in the oxygen level in the blood.
A: hypoxic drive

Q: The [...] is one of three bones the fuse to form the pelvic ring.
A: ilium

Q: The [...] is one of the two largest veins in the body; carries blood from the lower extremities and the pelvic and abdominal organs to the heart.
A: inferior vena cava

Q: The [...] is the amount of air that can be inhaled after a normal inhalationl the amount of air that can be inhaled in addition to the normal tidal volume.
A: inspiratory reserve volume

Q: The [...] is the space in between the cells.
A: interstitial space

Q: The [...] is one of three bones that fuse to form the pelvic ring.
A: ischium

Q: [...] is the place where two bones come into contact.
A: Joint articulation

Q: A [...] is the fibrous sac that encloses a joint.
A: joint capsule

Q: The [...] are two retroperitoneal organs that excrete the end products of metabolism as urine and regulate the body's salt and water content.
A: kidneys

Q: [...] is the use of muscles of the chest, back and abdomen to assist in expanding the chest; occurs when air movement is impaired.
A: Labored breathing

Q: [...] is a metabolic by-product of the breakdown of glucose that accumulates when metabolism proceeds in the absence of oxygen (anerobic metabolism).
A: Lactic acid

Q: The [...] is the portion of the digestive tube that encircles the abdomen around the small bowel, consisting of cecum, the colon, and the rectum. It helps regulate water balance and eliminate solid waste.
A: large intestine

Q: The [...] is the projection on the medial superior portion of the femur.
A: lesser trochanter

Q: A [...] is a band of fibrous tissue that connects the bones to bones. it supports and strengthens a joint.
A: ligament

Q: The [...] is a large, solid organ that lies in the right upper quadrant immediately below the disphragm; it produces biles, stores flucose for immediate use by the body and produces many substances that help regular immune responses.
A: liver

Q: The [...] is the lower back of the back formed by the lowest five nonfused vertabrae; also called the dorsal spine.
A: lumbar spine

Q: [...] are tiny, oval-shaped structures located in various places along the lymph vessels that filter lymph.
A: Lymph nodes

Q: The [...] is the bone of the lower jaw.
A: mandible

Q: The [...] is the upper quarter of the sternum.
A: manubirum

Q: The [...] are the upper jaw bones that assist in the formation of the orbit, the nasal cavity, and the palae and hold the upper teeth.
A: maxillae

Q: The [...] is nerve tissue that is continuous inferiorly with the spinal cord; serves as a conduction pathway for ascending and descenging nerve tracts; coordinates heart rate, blood vessel diameter, breathing, swallowing, vomiting, coughing, and sneezing.
A: medula oblongata

Q: The [...] also known as [...] are the biochemical processes that result in production of energy from nutrients within cells.
A: metabolism; cellular respiration

Q: The [...] is the part of the brain that is respondible for helping to regulate the level of consciousness.
A: midbrain

Q: The [...] plane or [...] is an imaginary vertical line drawn from the middle of the forehead through the nose and umbilicus to the flood, dividing the body into equal left and right halves.
A: midsagittal; midline

Q: [...] is the volume of air that moves in and out of the lungs per minute. You can calculate it by multiplying the tidal volune and respiratory rate. This is also called minute ventilation.
A: Minute volume

Q: [...] carry information from the CNS to the muscles of the body.
A: Motor nerves

Q: [...] are the lining of body cavities and passages that communicate directly or indirectly with the environment outside the body.
A: Mucous membranes

Q: [...] is the water secretion of the mucous membranes that lubricate the body openings.
A: Mucus

Q: The [...] consist of the bones and voluntary muscles of the body.
A: musculoskeltal system

Q: The heart muscle is called the [...]
A: myocardium.

Q: The [...] is the part of the pharynx that lies above the level of the roof of the mouth.
A: nasopharynx

Q: The [...] is the systen that controls virtually all activities of body, both voluntary and involuntary.
A: nervous system

Q: [...] is a neurotransmitter and drug sometimes used in the treatment of shock; produces vasoconstriction through its alpha-stimulator properties.
A: Norepinephrine

Q: The [...] is the most posterior portion of the cranium.
A: occiput

Q: [...] is the pressure of water to move, typically into the capillary, as the result of the presence of plasma proteins.
A: Oncotic pressure

Q: The [...] is the eye socket, made up of the maxilla and zygoma.
A: orbit

Q: The [...] are female glands that produce sex hormones and ova (eggs).
A: ovaries

Q: The [...]is a flat, solid organ that lies below the liver and the stomach; it is a major source of digestive enzymes and produces the hormone insulin.
A: pancreas

Q: The [...] is a subdivision of the autonomic nervous system, involved in control of involuntary function, mediated largely by the vagus nerve through teh chemical acetylcholine.
A: parasympathetic nervous system

Q: The [...] are the bones thatl ie between the temporal and occpital regions of the cranium.
A: parietal bones

Q: The [...]is the knee cap; and lies within the tendon of the quadriceps muscle.
A: patella

Q: [...] is the study of how normal physiologic processes are affected by disease.
A: Pathophysiology

Q: [...] is the circulation of oxygenated blood within an organ or tissue in adequate amounts to meet the cells curent needs.
A: Perfusion

Q: The [...] is the part of the nervous system that consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves; these may be sensory nerves, motor nerves, or connecting nerves.
A: peripheral nervous system (PNS)

Q: [...] is the wavelike contraction of smooth muscles by whichthe ureters of other tubular organs propel their contents.
A: Peristalsis

Q: [...] is a stick, yellow like fluid that carries the blood cells and nutrients and transports cellular waste material to the organs of excretion.
A: Plasma

Q: [...] are tiny disc shaped elements that are much smaller than the cells; they are essential in the intial formation of a blood clot, the mechanism that stops bleeding.
A: Platelets

Q: The [...] are serous membranes covering the lungs and lining the thorax, completely enclosing a potential space known as pleural space.
A: pleura

Q: [...] is the potential space between the parietal pleural and the visceral pleura; described as "potential" because under normal conditions, the space does not exist.
A: Pleural space

Q: The [...] is an organ that lies below th midbrain and above the medulla and contains numerous important nerve fibers, including those for sleep, respiration and the medullary respiratory center.
A: pons

Q: The [...] is the artery just behind the medial malleolus; supplies blood to the foot.
A: posterior tibial artery

Q: The [...] is a small gland that surrounds the male urethra where it emerges from the urinary bladdar; it secretes a fluid that is part of the ejaculatory fluid.
A: prostate gland

Q: [...] is a hard bony and cartilaginous prominence found at the midline in the lowermost portion of the abdomen where the two halves of the pelvic rings are joined by cartilage at a joint with minimal motion.
A: Pubic symphysis

Q: The [...] is one of the three bones that fuse to form the pelvic ring.
A: pubis

Q: The [...] is the major artery leading from the right ventricle of the heart to the lungs; carries oxygen-poor blood.
A: pulmonary artery

Q: [...] is the flow of blood from the right ventricle through the pulmonary arteries and all of their branches and capillaries in the lungs and back to the left atrium through the venules and pulmonary veins; also called the lesser circulation.
A: Pulmonary circulation

Q: The [...] are the four veins that return oxygenated blood from the lungs to the left atrium of the heart.
A: pulmonary veins

Q: A [...] is the wave of pressure created as the heart contracts and forces blood out the left ventricle and into the major arteries.
A: pulse

Q: The [...]  is the major artery in the forearm; it is palpable at the wrist on the thumb side.
A: radial artery

Q: Teh [...] is the bone on the thumb side of the forearm.
A: radius

Q: Th [...] is the lowermost end of the colon.
A: rectum

Q: [...] carry oxygen to the body's tissues; also called erythrocytes.
A: Red blood cells

Q: The [...] is a cone shapped area that collects urine from the kidneys and funnels it through the ureter into the bladder.
A: renal pelvis

Q: [...] is the air that ramines in the lungs after maximal expiration.
A: Residual volume

Q: [...]  is the inhaling and exhaling of air; the physiologic process that exchanges carbon dioxide from fresh air.
A: Respiration

Q: [...] is the inability of the body to move gas efficiently.
A: Respiratory comprimise

Q: The [...] consists of all the structures of the body that contribute to the process of breathing, consisting of the upper and lower airways and their component parts.
A: respiratory system

Q: The [...] is located  in the upper brain stem; responsible for maintenance of consciousness, specifically one's level of arousal.
A: reticular activating system

Q: The term retropetitoneal means [...]
A: behind the peritoneum.

Q: The [...] is the connection point between the pelvis and the vertebral column.
A: sacroiliac joint

Q: The [...] is one of three bones that make up the pelvic ring; consists of five fused sacral vertabrae.
A: sacrum

Q: The [...] or [...] is an imaginary line where the body is divided into left and right parts.
A: sagittal plane; lateral plane

Q: The [...] are the glands that produce saliva to keep the mouth and pharynx moist.
A: salivary glands

Q: The [...] is the thick skin covering the cranium, which usually bears hair.
A: scalp

Q: The [...] is the shoulder blade.
A: scalpula

Q: [...] are glands that produce an oily substance called sebum which discharges along the shaft of the hairs.
A: Sebaceous glands

Q: [...] are storage sacs for sperm which empty into the urethra at the prostate.
A: Seminal vesicles

Q: [...] are the nerves that carry sensations form the body to the CNS.
A: Sensory nerves

Q: [...] is an abnormal state associated with inadequate oxygen and nutrient delivery to the cells of the body, also known as [...]
A: Shock; hypoperfusion.

Q: The [...] is the proximal portion of the upper extremities made up of the clavicle, the scapula, and the humerus.
A: shoulder girdle

Q: [...] is msucle that is attached to vones and usually crosses at least one joint; striated, or voluntary, muscle.
A: Skeletal muscle

Q: The [...] is the framework that gives the body its recognizable form; also deisgned to allow motion of the body and protection of vital organs.
A: skeleton

Q: The [...] is the portion of the digestive tube between the stomach and cecum, consisting of the duodenum, jejunum, and ileum.
A: small intestine

Q: [...] is involuntary muscle; it constitutes the build of the GI tract and is present in nearly every organ to regulate automatic activity.
A: Smooth muscle

Q: The [...] is the part of the nervous system that regualr activites over which there is voluntary control.
A: somatic nervous system

Q: [...] are muscles arranged in circles that are able to decrease the diametes of tubes; found in the rectum, bladder and blood vessels.
A: Sphincters

Q: The [...] is an extension of the brain, comoposed of virtually all the nerves carrying messages between the brain and the rest of the body. IT lies inside of an is protected by the spina canal.
A: spinal cord

Q: The [...] is the breast bone.
A: sternum

Q: The [...] is the outermost or dead layer of the skin.
A: stratum corneal layer

Q: [...] is the volume of blood pumped forward with each ventricular contraction.
A: Stroke volume (SV)

Q: The [...] is tissue, largely fat, that lies directly under the dermis and serves as an insulator of the body.
A: subcutaneous tissue

Q: The [...] is one of the two largest veins in the body; carries blood from the upper extremities, head, neck, and chest into the heart.
A: superior vena cava

Q: [...] are the glands that secrete sweat, located in the dermal layer of the skin.
A: Sweat glands

Q: [...] is type of joint that has growth together to form a very stable connection.
A: Symphysis

Q: [...] is the lining of a joint that secretes synovial fluid into the joint space.
A: Synovial fluid

Q: [...] is the portion of the circulatory system outside of the body.
A: Systemic circulation

Q: [...] is the resistance that blood must overcome to be able to move withing the blood bessels; related to the amount of dilation or constrictions in the blood vessel.
A: Systemic vascular resistance (SVR)

Q: [...] is the contraction, or period of contraction of the heart especially that of the ventricles.
A: Systole

Q: The [...] is the lateral bones on each side of the cranium; the temples.
A: temporal bones

Q: The [...] are the fibrous connective tissue that attaches muscle to the bone.
A: tendons

Q: The [...] is the chest or rib cage
A: thoracic cage

Q: The [...] is the 12 vertebrae that lie between the cervical vertebrae and the lumbar vertebrae. One pair of ribs is attach to each side of these vertebrae.
A: thoracic spine

Q: The[...] is the chest cavity taht contains the heart, lungs, esophagus and great vessels.
A: thorax

Q: The [...] is a firm prominence of cartilage that forms the upper part of the larynx; the adams apple.
A: thyroid cartilage

Q: The [...] is the shin bone; the larger of the two bones of the lower leg.
A: tibia

Q: [...] is the amount of air moved in and out of the lungs in one relaxed breath.
A: Tidal volume

Q: [...] are the superficial landmarks of the body that serve as guides to the structures that lie beneath them.
A: Topographic anatomy

Q: The [...] is the windpipe; the main trunk for air passing to and from the lungs.
A: trachea

Q: The [...] or [...] is an imaginary line where the body is divided into top and bottom parts.
A: transverse plane; axial plane

Q: The [...] are the muscles in the back of the upper arm.
A: triceps

Q: The [...] is the middle and thickest layer of tissue of a blood vessel wall, composed of elastic tissue and smooth muscle cells that allow the vessel to expand or contract in response to changes in blood pressure and tissue demand.
A: tunica media

Q: The [...] is the inner bone of the forearm, on the side opposite the thumb.
A: ulna

Q: A [...] is a small, hollow, tube that carries urine from the kidneys to the bladder.
A: ureter

Q: The [...] is the canal that conveys urine from the bladder to the outside the body.
A: urethra

Q: The [...] is a sac behind the pubis symphysis made of smooth muscle that collects and stores urine.
A: urinary bladder

Q: The [...] are the organs that control the discharge of certain waste materials filtered from the blood and excreted as urine.
A: urinary system

Q: The [...] is the spermatic duct of the testicles; also called the vas deferens.
A: vasa deferentia

Q: [...] is the movement of air between the lungs and the environmet.
A: Ventilation

Q: A [...] is one of two lower changers of the heart.
A: ventricle

Q: The [...] are the 33 bones that make up the spinal column.
A: vertebrae

Q: [...] is a measurement that examies how much gas is being moved effectively and how much blood is flowing around the alveoli where gas exchange (perfusion) occurs.
A: V/Q ratio

Q: The [...] is the narrow, cartilaginous lower tip of the sternum.
A: xiphoid process

Q: The [...] is the quadrangular bones of the cheek, articulating with the frontal bone, the maxillae, and zygomaticp rocess of the temporal bone and the great winfs of the sphenoid bone.
A: zygomas

Q: An [...] is a young person age 12 to 18 years.
A: adolescent

Q: [...] is a disorder in which cholesterol and calcium build up inside the walls of the blood vessels, forming plaque which eventually leads to a partial ro complete blockage of blood flow.
A: Atherosclerosis

Q: [...] is an injury caused by pressure to enclosed body surfaces, for example too much pressure in the lungs.
A: Barotrauma

Q: [...] is a type of reasoning in which a child looks for approbal from peers and society.
A: Conventional reasoning

Q: An [...] is a young adult age 19 to 40 years.
A: early adult

Q: [...] are areas where the neonates or infants skull haas not fused together; usually disappear at appx 18 months of age.
A: Fontaelles

Q: An [...] is young child age 1 month to 1 year.
A: infant

Q: [...] is the average nnumber of years a person can be expected to live.
A: Life expectancy

Q: A [...] is an adult age 41 to 60 years.
A: middle adult

Q: The [...] is an infant reflex where an infant is caught off guard, the infant opens their arms wide, spreads their fingers and seems to grab at things.
A: moro reflex

Q: A [...] is age birth to 1 month.
A: neonate

Q: [...] are the basic filtering units in the kidneys.
A: Nephrons

Q: An [...] is an adult aged 61 years or older.
A: older adult

Q: [...] is an infatn reflex that occurs when something is placed in the infants palm; the infant grasps the object.
A: Palmar grasp

Q: [...] is a type of reasoning where a child bases decisions on their conscience.
A: Postconventional reasoning

Q: [...] is a type of reasoning where a child acts almost purely to avoid punishment to get what they want.
A: Preconventional reasoning

Q: A [...] is an infant reflex that occurs when something touches an infants cheek and the infant instictively turns their head toward the touch.
A: rooting reflex

Q: A person who is 6 to 12 years of age is [...]
A: school age.

Q: The [...] is an infant reflex in which the infant starts sucking when their lips are stroked.
A: sucking reflex

Q: A [...] is a young child ages 1 to 3 years.
A: toddler

Q: [...] refers to a stage of develpment form birth  to 18 months where the infant gains trust of their parenst of caregivers if their world is planned, organized and routine.
A: Trust and mistrust

Q: A [...] is a A long, flat board made of rigid, rectangular material that is used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury; also called a spine board, trauma board, and longboard.
A: backboard

Q: [...] is a branch of medicine concerned with the management (prevention or control) of obesity and allied diseases.
A: Bariatrics

Q: A [...] is a rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom; also called a Stokes litter. This is very useful in rough terrain.
A: basket stretcher

Q: [...] is the relationship between the body’s anatomical structures and the physical forces associated with lifting, moving, and carrying; the ways in which the body moves to achieve a specific action.
A: Body mechanics

Q: The [...] is a carrying technique in which one provider is located at the head end of the stretcher or backboard, one at the foot end, and one at each side of the patient; each of the two providers at the sides uses one hand to support the stretcher or backboard so that all are able to face forward as they walk.
A: diamond carry

Q: A [...] is a lifting technique that is used for patients who are found lying supine on the ground with no suspected spinal injury.
A: direct ground lift

Q: An [...] is a move in which the patient is dragged or pulled from a dangerous scene before assessment and care are provided.
A: emergency move

Q: An [...] is a lifting technique that is used for patients who are supine or in a sitting position with no suspected extremity or spinal injuries.
A: extremity lift

Q: [...] is the removal of a patient from entrapment or a dangerous situation or position, such as removal from a wrecked vehicle, industrial incident, or collapsed building.
A: Extrication

Q: A [...] is a stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.
A: flexible stretcher

Q: A [...] is a stretcher with a strong, rectangular, tubular metal frame and rigid fabric stretched across it.
A: portable stretcher

Q: [...] is a technique in which the stretcher or backboard is gripped by inserting each hand under the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb.
A: Power grip

Q: A [...] is a lifting technique in which the EMT’s back is held upright, with legs bent, and the patient is lifted when the EMT straightens the legs to raise the upper body and arms.
A: power lift

Q: The [...] is a technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than 1 minute when conditions do not allow for standard immobilization.
A: rapid extrication technique

Q: A [...] is a stretcher that is designed to be split into two or four sections that can be fitted around a patient who is lying on the ground or other relatively flat surface; also called an orthopedic stretcher.
A: scoop stretcher

Q: A [...] is a lightweight folding device that is used to carry a conscious, seated patient up or down stairs.
A: stairchair

Q: A [...] is a specially designed stretcher that can be rolled along the ground. A collapsible undercarriage allows it to be loaded into the ambulance; also called an ambulance stretcher.
A: wheeled ambulance stretcher

Q: The [...] are the secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.
A: accessory muscles

Q: [...] is any deviation from alert and oriented to person, place, time, and event, or any deviation from a patient’s normal baseline mental status; may signal disease in the central nervous system or elsewhere in the body.
A: Altered mental status

Q: To [...] is to listen to sounds within an organ with a stethoscope.
A: auscultate

DCAP-BTLS is a mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, and Swelling.

Q: A [...] is a type of physical assessment typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part.
A: focused assessment

Q: The [...] is the overall initial impression that determines the priority for patient care; based on the patient’s surroundings, the mechanism of injury, signs and symptoms, and the chief complaint.
A: general impression

Q: [...] is a step within the patient assessment process that provides detail about the patient’s chief complaint and an account of the patient’s signs and symptoms.
A: History taking

Q: [...] is a brief history of a patient’s condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the injury or illness.
A: SAMPLE history

Q: [...] is knowledge and understanding of one’s surroundings and the ability to recognize potential risks to the safety of the patient or EMS team.
A: Situational awareness

Q: [...] are the key signs that are used to evaluate the patient’s overall condition, including respirations, pulse, blood pressure, level of consciousness, and skin characteristics.
A: Vital signs

Q: A [...] is a device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.
A: bag-valve mask

Q: A [...] is a protective item, such as a pocket mask with a valve, that limits exposure to a patient’s body fluids.
A: barrier device

Q: A [...] is a normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.
A: gag reflex

Q: [...] is increased carbon dioxide level in the bloodstream.
A: Hypercarbia

Q: [...] is the bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.
A: Intrapulmonary shunting

Q: [...] is The process by which medications travel through body tissues until they reach the bloodstream.
A: Absorbtion

Q: [...] is the therapeutic effect of a medication on the body.
A: Action

Q: [...] is the process of binding or sticking to a surface.
A: Adsorption

Q: An [...] is a medication that causes stimulation of receptors.
A: agonist

Q: An [...] is a medication that binds to a receptor and blocks other medications.
A: antagonist

Q: [...] is a medication that is an antipyretic (reduces fever), analgesic (reduces pain), anti-inflammatory (reduces inflammation), and a potent inhibitor of platelet aggregation (clumping).
A: Aspirin

Q: [...] are conditions that make a particular medication or treatment inappropriate because it would not help, or may actually harm, a patient.
A: Contraindications

Q: [...] are medications that enter the body through the digestive system.
A: Enteral medications

Q: [...] is a medication that increases heart rate, blood pressure but also eases breathing problems by decreasing muscle tone of the bronchiole tree.
A: Epinephrine

Q: A [...] is a semiliquid substance that is administered orally in capsule form or through plastic tubes.
A: gel

Q: The [...] is the original chemical name of a medication (in contrast with one of its proprietary or trade names); the name is not capitalized.
A: generic name

Q: The [...] are the therapeutic uses for a specific medication.
A: indications

Q: An [...] is an injection into the bone; a medication delivery route.
A: intraosseous injection

Q: A [...] is a substance that is used to treat or prevent disease or relieve pain.
A: medication

Q: A [...] is the inappropriate use of a medication that could lead to patient harm.
A: medication error

Q: A [...] is a miniature spray canister through which droplets or particles of medication may be inhaled through the mouth and into the lungs.
A: metered-dose inhaled (MDI)

Q: A [...] is a device that is used to change a liquid medication into a spray and push it into a nostril.
A: mucosal atomizer device

Q: [...] is a medication that increases cardiac perfusion by causing blood vessels to dilate; EMTs may be allowed to assist the patient to self-administer the medication.
A: Nitroglycerin

Q: [...] is a simple sugar that is readily absorbed by the bloodstream; it is carried on the EMS unit.
A: Oral glucose

Q: [...] is a gas that all cells need for metabolism; the heart and brain, especially, cannot function without it.
A: Oxygen

Q: [...] are medications that enter the body by a route other than the digestive tract, skin, or mucous membranes.
A: Parenteral medications

Q: Per os (PO) means [...]
A: take by mouth.

Q: [...] is the process by which a medication works on the body.
A: Pharmacodynamics

Q: [...] is the study of the properties and effects of medications.
A: Pharmacology

Q: [...] is the use of multiple medications on a regular basis.
A: Polypharmacy

Q: [...] are any effects of a medication other than the desired ones.
A: Side effects

Q: A [...] is a liquid mixture that cannot be separated by filtering or allowing the mixture to stand.
A: solution

Q: A [...] is an injection into the fatty tissue between the skin and muscle; a medication delivery route.
A: subcutaneous injection (SC)

Q: A [...] is a mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve.
A: suspension

Q: The [...] is the desired or intended effect a medication is expected to have on the body.
A: therapeutic effect

Q: The [...] is the brand name that a manufacturer gives a medication; the name is capitalized.
A: trade name

Q: Transcutaneous means [...]; a medication delivery route.
A: through the skin

Q: [...] are actions that are undesirable but pose little risk to the patient.
A: Unintended effects

Q: [...] are actions that can be harmful to the patient.
A: Untoward effects

Q: The [...] is the force or resistance the heart pumps against when ejecting blood.
A: afterload

Q: An [...] is an abnormal enlargement of the wall of a blood vessel that results from weakening of the vessel wall.
A: aneurysm

Q: The [...] is the part of the nervous system that regulates involuntary activities of the body, such as heart rate, blood pressure, and digestion of food.
A: autonomic nervous system

Q: [...] is the compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output.
A: Cardiac tamponade

Q: [...] is a state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.
A: Cardiogenic shock

Q: [...] is the early stage of shock, in which the body can still compensate for blood loss.
A: Compensated shock

Q: [...] is the late stage of shock when blood pressure is falling.
A: Decompensated shock

Q: [...] is the loss of water from the tissues of the body.
A: Dehydration

Q: [...] is a condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.
(Ie. EXCESSIVE VASODILATION)
"DISTRIBUTED DILATION"
A: Distributive shock

Q: [...] is the presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
A: Edema

Q: [...] is a condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion. (Ie; VOLUME DEPLETION)
A: Hypovolemic shock

Q: [...] is the ability of the heart muscle to contract.
A: Myocardial contractility

Q: [...] is circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
A: Neurogenic shock

Q: [...] is shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body’s tissues.
A: Obstructive shock

Q: [...] is the flow of blood through body tissues and vessels.
A: Perfusion

Q: A [...] is a collection of fluid between the pericardial sac and the myocardium.
A: pericardial effusion

Q: [...] is the precontraction pressure in the heart as the volume of blood builds up.
A: Preload

Q: [...] is shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope).
A: Psychogenic shock

Q: A [...] is a blood clot that breaks off from a large vein and travels to the blood vessels of the lung causing obstruction of blood flow.
A: pulmonary embolism

Q: The [...] is the difference between the systolic and diastolic pressures.
A: pulse pressure

Q: [...] is the process of developing a sensitivity to a substance that initially caused no allergic reaction.
A: Sensitization

Q: [...] is shock caused by severe infection, usually a bacterial infection.
A: Septic shock

Q: [...] is a condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function;  also called hypoperfusion.
A: Shock

Q: The [...] is the preferred method to dislodge a severe airway obstruction in adults and children; also called the Heimlich maneuver.
A: abdominal-thrust maneuver

Q: [...] is a technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression); may increase the amount of blood that returns to the heart, and thus, the amount of blood ejected from the heart during the compression phase.
A: Active compression-decompression CPR

Q: [...] is noninvasive emergency lifesaving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest.
A: Basic life support (BLS)

Q: [...] is the combination of chest compressions and rescue breathing used to establish adequate ventilation and circulation in a patient who is not breathing and has no pulse.
A: Cardiopulmonary resuscitation

Q: [...] is the total percentage of time during a resuscitation attempt in which active chest compressions are being performed.
A: Chest compression fraction

Q: [...] is the rapid or deep breathing that lowers the blood carbon dioxide level below normal; may lead to increased intrathoracic pressure, decreased venous return, and hypotension when associated with BVM use.
A: Hyperventilation

Q: An [...] is a valve device placed between the endotracheal tube and a bag-valve mask that limits the amount of air entering the lungs during the recoil phase between chest compressions.
A: impedance threshold device

Q: [...] is a lack of oxygen that deprives tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred.
A: Ischemia

Q: A [...] is a circumferential chest compression device composed of a constricting band and backboard that is either electrically or pneumatically driven to compress the heart by putting inward pressure on the thorax.
A: load-distributing band

Q: A [...] is a device that depresses the sternum via a compressed gas-powered or electric-powered plunger mounted on a backboard.
A: mechanical piston device

Q: A [...] is the return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest.
A: return of spontaneous circulation (ROSC)

Q: [...] is the stiffening of the body muscles; a definitive sign of death.
A: Rigor mortis

Q: [...] is blood settling to the lowest point of the body; causing discoloration of the skin; a definitive sign of death.
A: Dependent lividity

Q: [...] occurs when new cases of a disease in a human population substantially exceed the number expected based on recent experience.
A: Epidemic

Q: [...] is a common virus that is asymptomatic in 80% of people carrying it, but characterized by small blisters on the lips or genitals in symptomatic infections.
A: Herpes simplex

Q: [...] is the awareness that unseen life-threatening injuries or illness may exist.
A: Index of suspicion

Q: [...] is a virus that has crossed the animal/human barrier and infected humans and that kills thousands of people every year.
A: Influenza

Q: [...] are emergencies that are not caused by an outside force; illnesses or conditions.
A: Medical emergencies

Q: [...] is an inflammation of the meningeal coverings of the brain and spinal cord; it is usually caused by a virus or a bacterium.
A: Meningitis

Q: [...] is an inflammation of the meningeal coverings of the brain and spinal cord; can be highly contagious.
A: Meningococcal meningitis

Q: [...] is a bacterium that can cause infections in different parts of the body and is often resistant to commonly used antibiotics; it is transmitted by different routes, including the respiratory route, and can be found on the skin, in surgical wounds, in the bloodstream, in the lungs, and urinary tract.
A: Methicillin-resistant Staphylococcus aureus (MRSA)

Q: A [...] is an outbreak that occurs on a global scale.
A: pandemic

Q: [...] are emergencies that are the result of physical forces applied to the body.
A: Trauma emergencies

Q: [...] is the strength or ability of a pathogen to produce disease.
A: Virulence

Q: While performing chest compressions in an adult patient, the EMT should compress the chest of an adult at a rate of [...]/min to a depth of at least [...] inches and should allow full recoil of the chest after each compression
A: 100 to 120; 2

Q: Altered mental status and unequal or fixed pupils are signs of [...] and should be treated with hyperventilation with BVM.
A: intracranial pressure (ICP)

Q: ABC
A: airway, breathing, circulation

Q: ac
A: before meals

Q: ACLS
A: advanced cardiac life support

Q: ad lib
A: as desired

Q: ADL
A: activities of daily living

Q: AIDS
A: Acquired Immuno-Deficiency Syndrome

Q: A&P
A: anatomy and physiology

Q: BS
A: blood
sugar <br> breath sounds <br> bowel sounds <br> bachelor of
science (degree)

Q: CVA
A: Cerebral Vascular Accident

Q: ICP
A: Intra-Cranial Pressure

Q: IM
A: Intramuscular also Intramedullary

Q: IV
A: Intravenous

Q: O/P
A: oropharynx

Q: PO
A: per oral

Q: PR
A: Per Rectum

Q: RSV
A: Respiratory Syncytial Virus

Q: SL
A: sublingual

Q: ā
A: before

Q: adduction
A: Motion of a limb toward the midline.

Q: anterior
A: The front surface of the body; the side facing you in the standard anatomic position.

Q: apex (plural apices)
A: The pointed extremity of a conical structure.

Q: bilateral
A: A body part or condition that appears on both sides of the midline.

Q: deep
A: Farther inside the body and away from the skin.

Q: distal
A: Further from the trunk or nearer to the free end of the extremity.

Q: dorsal
A: The posterior surface of the body, including the back of the hand.

Q: extension
A: The straightening of a joint.

Q: flexion
A: The bending of a joint.

Q: Fowler position
A: An inclined position in which the head of the bed is raised.

Q: inferior
A: Below a body part or nearer to the feet.

Q: lateral
A: Parts of the body that lie farther from the midline; also called outer structures.

Q: medial
A: Parts of the body that lie closer to the midline; also called inner structures.

Q: palmar
A: The forward facing part of the hand in the anatomic position.

Q: plantar
A: The bottom surface of the foot.

Q: posterior
A: The back surface of the body; the side away from you in the standard anatomic position.

Q: prone
A: Lying face down.

Q: proximal
A: Closer to the trunk.

Q: quadrants
A: Describes the sections of the abdominal cavity, in which two imaginary lines intersect at the umbilicus, dividing the abdomen into four equal areas.

Q: superficial
A: Closer to or on the skin.

Q: superior
A: Above a body part or nearer to the head.

Q: supine
A: Lying face up.

Q: ventral
A: The anterior surface of the body.

Q: AF, A-fib
A: atrial fibrillation

Q: AICD
A: automated implantable cardioverter defibrillator

Q: amb
A: ambulatory

Q: ant
A: anterior

Q: ASHD
A: arterioscleroticatherosclerotic heart disease

Q: BGL
A: blood glucose level

Q: bid/b.i.d/BID
A: twice daily

Q: BP, B/P
A: blood pressure

Q: bx
A: biopsy

Q: CC, C/C
A: chief complaint

Q: CCU
A: coronary care unit

Q: C diff
A: Clostridium difficile

Q: cm
A: centimeter

Q: c/o
A: complaining of

Q: C02
A: carbon dioxide

Q: COLD
A: chronic obstructive lung disease

Q: CP
A: chest pain OR chemically pure OR cerebral palsy

Q: CRNA
A: certified registered nurse anesthetist

Q: CRT
A: capillary refill time OR cathode ray tube

Q: DOA
A: dead on arrival

Q: DOE
A: dyspnea on exertion

Q: DON
A: director of nursing

Q: DPT
A: diphtheria and tetanus toxoids and pertussis vaccine OR Doctor of Physical Therapy

Q: DSD
A: dry sterile dressing

Q: DtaP
A: diphtheria and tetanus toxoids and acellular pertussis vaccine

Q: DTP
A: diphtheria and tetanus toxoids and pertussis vaccine

Q: Dx
A: diagnosis

Q: EDC
A: estimated date of confinement

Q: ENT
A: ears, nose, and throat

Q: EOC
A: Emergency Operations Center

Q: ET, ETT
A: endotracheal tube, endotracheal

Q: ETA
A: estimated time of arrival

Q: ETCO_2
A: end-tidal carbon dioxide

Q: °F
A: degrees Fahrenheit

Q: Fio_2
A: fraction of inspired oxygen

Q: Fe
A: iron

Q: FHR
A: fetal heart rate

Q: FHx
A: family history

Q: fl, fid
A: fluid

Q: fx
A: fracture

Q: Gl
A: gastrointestinal

Q: gtt
A: drop(s)

Q: gyn
A: gynecology

Q: h
A: hour

Q: H&P
A: history and physical

Q: HBV
A: hepatitis B virus

Q: Hct
A: hematocrit

Q: H2O
A: water

Q: hr
A: hour

Q: Hx
A: history

Q: l&O
A: intake and output

Q: ICS
A: incident command system OR intercostal space

Q: ICU
A: intensive care unit

Q: IMS
A: incident management system

Q: IO
A: intraosseous

Q: IPPB
A: intermittent positive pressure breathing

Q: kg
A: kilogram

Q: L/M, LPM
A: liters per minute

Q: MAE
A: moves all extremities

Q: MAEW
A: moves all extremities well

Q: mg
A: milligram

Q: Ml
A: myocardial infarction

Q: min
A: minute

Q: mL
A: milliliter

Q: mm
A: millimeter

Q: mm Hg
A: millimeters of mercury

Q: MVA
A: motor vehicle accident

Q: MVC
A: motor vehicle crash

Q: NA, N/A
A: not applicable

Q: NC
A: nasal cannula

Q: NRB, NRBM
A: nonrebreathing mask

Q: NTG
A: nitroglycerin

Q: N/V
A: nausea and vomiting

Q: N/V/D
A: nausea, vomiting, and diarrhea

Q: O_2
A: oxygen

Q: OBS
A: organic brain syndrome

Q: OPA
A: oropharyngeal airway

Q: OR
A: operating room

Q: oz
A: ounce

Q: p̄
A: after

Q: Pco_2
A: partial pressure of carbon dioxide

Q: PDR
A: Physicians' Desk Reference

Q: PEARL, PERL
A: pupils equal and reactive to light

Q: PEARLA
A: pupils equal and reactive to light and accommodation

Q: PEARRL
A: pupils equal and round, regular in size, react to light

Q: ped, peds
A: pediatric

Q: PEEP
A: positive end expiratory pressure

Q: psi
A: pounds per square inch

Q: PSVT
A: paroxysmal supraventricular tachycardia

Q: Pt
A: patient

Q: q̄
A: every

Q: Rh
A: Rhesus blood factor OR rhodium

Q: RN
A: registered nurse

Q: Rx
A: prescription

Q: s̄
A: without

Q: Sao_2
A: oxygen saturation

Q: SOB
A: shortness of breath

Q: Spo_2
A: saturation of peripheral oxygen

Q: S/S, S&S
A: signs and symptoms

Q: stat
A: immediately

Q: STEMI
A: ST-segment elevation myocardial infarction

Q: subcut
A: subcutaneous

Q: SVT
A: supraventricular tachycardia

Q: sym, Sx
A: symptoms

Q: tab
A: tablet

Q: TBA
A: to be admitted OR to be announced

Q: tech
A: technician OR technologist

Q: tid/t.i.d/TID
A: three times a day

Q: Tx
A: treatment

Q: VD
A: venereal disease

Q: VRE
A: vancomycin-resistant enterococcus

Q: W/
A: with

Q: WMD
A: weapon of mass destruction

Q: wt
A: weight

Q: x̄
A: except

Q: AO X 4, A/O X 4
A: alert
and oriented to person, place, time, and self

Q: BPM
A: beats per minute

Q: c̄
A: with

Q: °C
A: degrees Celsius (centigrade)

Q: CA
A: cancer <br> cardiac arrest <br> chronologic age <br> coronary artery <br> cold agglutinin

Q: HA,
H/A
A: headache

Q: Hb,
Hgb
A: hemoglobin

Q: VT/V
tach
A: ventricular tachycardia

Q: yo, y/o
A: year
old

Q: [...] possess specific knowledge, skills, abilities, equipment, and/or training
A: Special teams

Q: [...] consistently interact with the same partner or team
A: Regular teams

Q: [...] have EMTs who work providers with whom they do not regularly interact or may not even know
A: Temporary teams

Q: Examples of special EMS include:
A: Fire Team
Rescue Team
Hazardous materials (HazMat) Team
Tactical EMS Team
Special event EMS Team
EMS bike Team
In-hospital patient care technicians
MIH technicians

Q: Regular teams [...]
A: consistently interact with the same partner or team

Q: Special teams [...]
A: possess specific knowledge, skills, abilities, equipment, and/or training

Q: Temporary teams [...]
A: have EMTs who work providers with whom they do not regularly interact or may not even know

Q: What are the 5 essential elements of a group?
A: A common goal
An image of themselves as a “group”
A sense of continuity of the group
A set of shared values
Different roles within the group

Q: In [...] each individual is told what to do, and often how to do it, by his or her supervisor or group leader.
A: dependent groups

Q: In [...] each individual is responsible for his or her own area
A: independent groups

Q: In [...] individuals function as a true team.
A: interdependent groups

Q: PACE
A: Probe
Alert
Challenge
Emergency

Q: What are the steps for assisting an ALS process?
A: Patient preparation
Equipment
Performing the procedure
Continuing care
are the steps for this process.

Q: What are the steps for BE MAGIC?
A: B – Perform BVM preoxygenation
E – Evaluate for airway difficulties
M – Manipulate the patient
A – Attempt first-pass intubation
GI – Use a supraGlottic or Intermediate          airway if unable to intubate
C – Confirm successful intubation
are the steps for this process.

Q: What are the steps for patient prepation when assisting in an ALS procedure?
A: preoxygenation, and
apenic oxygenation
are the steps for helping with this procedure.

Q: What is the difference between a group and a team?
A: A team consists of a group of health care providers who are assigned specific roles and are working interdependently in a coordinated manner under a designated leader.

Q: What is the difference between an opiate and an opioid?
A: Opiates are a subset of the opioid family, referring to natural, non-synthetic opioids; opioids are not derived from opium.

Q: MOI
A: mechanism of injury

Q: NOI
A: nature of illness

Q: PTCA
A: percutaneous transluminal coronary angioplasty

Q: BVM
A: bag-valve mask

Q: NPA
A: nasopharyngeal airway

Q: NG
A: nasogastric

Q: GCS
A: Glasgow Coma Scale

Q: DNR
A: do not resuscitate

Q: NHTSA
A: National Highway Traffic Safety Administration

Q: What is the difference between assault and battery?
A: Assault is unlawfully placing a patient in fear of bodily harm, whereas battery is unlawfully touching without consent.

Q: FCC
A: Federal Communications Commission

Q: COPD
A: chronic obstructive pulmonary disease

Q: The principal function of the lungs is [...]
A: respiration

Q: What are the signs and symptoms of the common cold?
A: cough
runny or stuffy nose
sore throat

Q: SARS
A: severe acute respiratory syndrome

Q: What is the treatment for pneumonia?
A: Possible treatments include: airway support and providing supplemental oxygen.

Q: What are the signs and symptoms of pneumonia are common present in pediatric patients?
A: Children often present with unusually rapid or labored breathing or breathing characterized by grunting or wheezing sounds

Q: Which variant of pneumonia presents with more severe symptoms?
A: Bacterial pneumonia

Q: What are the variants of pneumonia?
A: Viral or bacterial pneumonia

Q: A [...] presents more gradually and is less severe
A: viral pneumonia

Q: MDI
A: metered-dose inhaler

Q: If the patient is life-like start with [...]
A: ABC

Q: If the patient is life-less start with [...]
A: CAB

Patient assessment order:
1. Scene Safe/ BSI / PPE
2. NOI
3. # of Patients
4. Request Additional Resources
5. Consider C-Spine
6. What is my general impression?
7. AVPU
8. "What seems to be the problem?"
9. Chief complaint is...
10. ABCs
10a. A: Airway patent?
10b. B: Check RRQ Lung Sounds
10c. C: Check RRQ Pulse, Check Skin, Check Capillary Refill
11. Take Vitals
12. FAST G (if applicable)
13. OPQRST
14. SAMPLE (FAST 4 & PORCH)
15. Fix Problem/ Call Medical Control / Administer Meds
16. "Stay & Play" or "Load and Go"
17. Secondary Assessment (FAST 5)
18. Secondary Vitals
19. Give Report & Diagnosis

Patient assessment order:
1. Scene Safe/ BSI / PPE
2. NOI
3. # of Patients
4. Request Additional Resources
5. Consider C-Spine
6. What is my general impression?
7. AVPU
8. "What seems to be the problem?"
9. Determine Chief Compaint & Life Threats
10. ABCs
10a. A: Airway patent?
10b. B: Check RRQ Lung Sounds
10c. C: Check RRQ Pulse, Check Skin, Control major bleeding (if present)
11. Shock Management (Position Properly & Conserve Body Heat)
12. Rapid Trauma Assessment
13. Transport (verbalize "trauma patient / trauma alert")
14. Focused Assessment
15. Vitals
16. SAMPLE
17. Reassessment

Q: The [...] is unique because [...]
A: diaphragm; this muscle characteristics of both skeletal and smooth muscle

Q: In most instances, you should move a patient on a wheeled ambulance stretcher by [...] of the stretcher while your partner [...] of the stretcher.
A: pushing the head; guides the feet

Q: [...] [...] oxygen and carbon dioxide.
A: Nonfunctional alveoli; inhibit the diffusion of

Q: A patient who [...] most likely has [...].
A: coughs up thick, yellowish, or greenish sputum; advanced respiratory infection

Q: UHF
A: ultra high frequency

Q: [...] drugs mimic the [...] (or [...] response.
A: Sympathomimetic; sympathetic; fight-or-flight)