EMT Study Sheet

EMT CHEAT SHEET 1. Scene Size-up a. Personal Protective Equipment b. Scene safe c. Mechanism of injury/Nature of illness d. Number of patients e. Help, call for ALS if needed f. Spinal precautions 2. Initial Assessment General Impression/Rapid scan (treat life threats) Position/Signs/Activity Responsiveness “Hey, Hey are you okay?” (AVPU) (1) Alert (2) Verbal stimulus (3) Painful Stimulus (4) Unresponsive Expose the patient and (ABCD) Airway assessment (open, OPA) Breathing assessment (chest rise,BVM,O2,injury) Circulation assessment (bleeding, pulse, skin, shock) Determine Patient Priority 3A. Rapid Focused Physical and History 3B. Rapid Physical and History (MEDICAL) (TRAUMA) a. Evaluate chief complaint (OPQRST) (1) Onset (2) Provocation (3) Quality (4) Radiation (5) Severity (6) Time a. Rapid focused history (SAMPLE) [if possible] (1) Signs (2) Allergies (3) Medications (4) Pertinent medical history (5) Last oral intake b. Rapid focused history (SAMPLE) (1) Signs (2) Allergies (3) Medications (4) Pertinent medical history (5) Last oral intake (6) Event c. Rapid focused physical exam (1) Head (2) Neck (3) Chest (4) Pelvis (5) Abdomen (TRDG) Tenderness Rigidity Distention Guarding (6) Extremities (7) Back d. Baseline vitals (BP, P, R, Pox, Gluc) e. On-going assessment (Stable=15, Unstable=5) 1. Repeat initial exam 2. Repeat vital signs & compare to baseline vitals 3. Recheck what was found during focused exam 4. Recheck interventions b. Rapid head-to-toe physical exam (using DCAPBLS-TIC) (1) Head & Face (2) Neck (3) Chest (4) Pelvis (5) Abdomen (TRDG) Tenderness Rigidity Distention Guarding (6) Extremities (7) Back Signs of Trauma Deformities Contusions Abrasions Punctures/Penetrations/Paradoxical movement Burns Lacerations Swelling Tenderness Instability Crepitus c. Baseline vitals (BP, P, R, Pox, Gluc, LOC) d. On-going assessment (Stable=15, Unstable=5) 1. Repeat initial exam 2. Repeat vital signs & compare to baseline vitals 3. Recheck what was found during head-to-toe exam 4. Recheck interventions ACRONYMS PCR Pre-hospital Care Report PPE Personal Protective Equipment LOC Level of Consciousness PTSD Post Traumatic Stress Disorder OSHA Occupational Safety and Health Administration DABDA Denial Anger Bargaining Depression Acceptance CISD Critical Incident Stress Debriefing PEARL Pupils Equal And React to Light ABBREVIATIONS/MEANINGS AMI Acute Myocardial Infarction ASHD Arteriosclerotic Heart Disease BP Blood Pressure C Centigrade CA Cancer CCU Cardiac Care Unit CHF Congestive Heart Failure COPD Chronic obstructive Pulmonary Disease CSF Cerebrospinal Fluid CVA Cerebrovascular Accident DX Diagnosis ECG Electrocardiogram F Fahrenheit FX Fracture GI Gastrointestinal GM Gram ICU Intensive Care Unit IV Intravenous O2 Oxygen RN Registered Nurse RX Treatment P Pulse R Respiration SHOCK Secure the Airway Heat Conservation of the Body Oxygenation Core perfusion improved by laying patient flat Keep the field time short Compensated – Hypoperfusion/Hypoxia starts – constricted blood flow in peripheral increased respiratory rate increased force of heart contractions Uncompensated – Decreased perfusion of organs – no longer maintains normal BP Irreversible – Compensators cease to function – little can be done TYPES: Hypovolemic: low volume Cardiogenic: pump failure Neurogenic: loss of vessel tone Psychogenic: emotional Septic: infections cause leaking vessels Anaphylactic: allergic reaction ROOT WORDS/MEANINGS PREFIXES/MEANINGS SUFFIXES/MEANINGS CARDI Heart OSTE Bone GASTR Stomach NEPHR Kidney PHLEB Vein TRACHE Trachea THORAC Chest AMBI- Both, Both Sides PRE- Before, In Front HYPO- Below, Low EPI- Upon INTER- Between POST- After, Behind TACHY- Fast BRADY- Slow HYPER- Above, High -ECTOMY Excision -ITIS Inflammation -CENTESIS Surgical Puncture -METER Instrument to Measure -SCOPY Visual Exam -PARESIS Partial Paralysis -GRAPH Recording COMMON DIRECTIONAL TERMINOLOGY TORSO Trunk of the body (The chest is located in the TORSO) MIDLINE Line vertically down the middle (The nose is located in the MIDLINE) MEDIAL Toward the midline (The heart is MEDIAL to the right arm) LATERAL Away from the middle (The ear are located LATERAL to the head) PROXIMAL Closer to the trunk (The elbow is PROXIMAL to the shoulder) DISTAL Farther from the trunk (The wrist is DISTAL to the elbow) SUPERIOR Above (The head is SUPERIOR to the shoulders) INFERIOR Below (The feet are INFERIOR to the knees) MIDAUXILLARY Line down mid armpit to ankle; Divides body into anterior and posterior ANTERIOR Toward the front (The abdomen is located ANTERIOR to the spine) POSTERIOR Toward the rear (The spinal column is located POSTERIOR to the heart) MIDCLAVICULAR Line down clavicle to pelvis (The nipples are located in the MIDCLAVICULAR line) BILATERAL Pertaining to both sides (The patient had BILATERAL wrist deformities) DORSAL Toward the back (The buttocks are located on the DORSAL side of body) VENTRAL Toward the front (The belly button is located on the VENTRAL side of body) PALMAR Relating to the palm (The patient had a PALMAR wart) PLANTAR Relating to sole of the foot (The patient had a PLANTAR wart) PRONE Lying face down (The patient was found PRONE) SUPINE Lying face up (The patient was found SUPINE) FOWLER position Sitting up (The patient was placed in the FOWLER position) TRENDELENBURG position Feet up, head down (The patient was placed in the TRENDELBERG position) RECOVERY position Laying on left side, head up (The patient was placed in the RECOVERY position) INTEGUMENTARY SYSTEM Largest organ of the body, protects the body from environment, controls temp 3 Layers Epidermis Dermis Subcutaneous BODY CAVATIES Skull Cavity Thoracic Cavity Abdominal Cavity (divided into four quadrants) Pelvic Cavity SKELETON CARTLIDGE between bones lubricate and cushion TENDONS attach muscles to bone LIGAMENTS hold bones together 206 Bones divided into eight parts 1) JOINTS connect bone to bone Ball and Socket, Hinged, Pivot, Fused/Sutured, Ellipsoid, Saddle, Plane/Gliding 2) SKULL (4 major areas: Frontal Occipital Temporal Parietal) 3) BONES of the FACE (5 major bones: Nasal - 2 Maxilla - 2 Zygomatic – Mandible – Orbit) 4) SPINAL COLUMN 33 bones called vertebrae: 7 Cervical, 12 Thoracic, 5 Lumbar, 5 Sacrum, 4 Coccyx 5) THORAX 12 Ribs attached posteriorly to thoracic vertebra (of 12 only 10 attached anteriorly to the sternum) Sternum divided into 3 parts: 1) Manubrium 2) Body 3) Xiphoid Process Shoulder divided into 3 parts: 1) Scapula 2) Acromion 3)Clavicle 6) PELVIS Iliac Crest, Ischium, Pubis 7) UPPER EXTREMITIES Humerus, Ulna, Radial Hand (Carpals, Metacarpals, Phalanges) 8) LOWER EXTREMITIES Femur Patella Tibia Fibula Foot (Tarsals, Metatarsals, Phalanges) RESPIRATORY Nose, Nasopharynx Mouth, Oropharynx Pharynx, Epiglottis Larynx, Vocal cords Trachea, Carina Bronchi, Bronchioles, Alveolus Lungs 3 lobes right/ 2 left (room made for the heart called cardiac notch) Mediastinum, cavity behind lungs Diaphragm, innervated by phrenic nerve Visceral Pleura, covers the lungs Partial Pleura, lines the thoracic wall Intercostal muscles, between ribs Ventilation rates 12-20 adult 15-30 child 30-60 infant Measure – Rate/Rhythm/Quality/Depth Tidal Volume = 500ml is normal CARDIOVASCULAR SYSTEM 3 components: 1)Heart (Pump) 2)Vessels (Pipes) 3)Blood (Fluid) Two circuits: Pulmonary (Lungs) & Systemic (Body) Heart made of 3 layers, Epicardium (outer), Myocardium (middle) & Endocardium (inner) Pericardium is the tough sack around the heart Arteries flow away from the heart/Veins flow to the heart Aorta, Arteries, Arterioles, Capillaries, Venules, Veins, Vena Cava Artery: Aorta, Coronary, Carotid, Femoral, Brachial, Radial, Iliac, Pedis, Tibial, Veins: Vena cavas, Iliac, Femoral, Great saphenous, Jugular 4 Heart Valves: Tricuspid, Pulmonary, Mitral(bicuspid), Aortic “Toilet Paper My Ass” Pulmonary arteries- take waste blood to the lungs Pulmonary veins- bring O2 rich blood to the heart Adult have 5-6 liters of blood (5000ml), Infants 800 ml, Newborn 300ml Blood composed of plasma and three types of cells Plasma, suspends the blood cells and nutrients (45% blood fluid) Red cells (erythrocytes) contain hemoglobin (binds O2 to tissue White cells (leukocytes) (fights infection) (5 types) Platelets (thrombocytes) (clots blood) (damaged red cells) Blood pressure: Adult normal is 120/80 (females normally 10 lower) Systolic (left ventricle contracts) high number on top Diastolic (left ventricle rests) low number on bottom Perfusion: circulation of blood through organs/structures Stroke Volume: amount of blood pumped out of the heart each beat Cardiac Output: amount of blood the heart pumps out in 1 minute. Pulse check: Rate, Rhythm, Character (Radial most used pulse, Carotid easiest to find) Rate: normal: Adult=60–100 / Child=80–100 / Infant=100–140 Newborn=130-140 Rhythm: Intervals between beats, regular/irregular Character: Full=Strong, Bounding=Extremely Strong, Thready = Weak NEUROLOGICAL SYSTEM The Central Nervous System (CNS) composed of Brain and Spinal column Command center of the body Brain = Cerebrum, Cerebellum, Brain Stem The Peripheral Nervous System (PNS) composed of 2 types of nerves: Sensory and Motor Sensory nerves (carry messages from body to CNS) Motor nerves (carry messages from CNS to body) Somatic nervous system carries out voluntary actions Autonomic nervous system carries out involuntary actions (two parts) Sympathetic- gets body ready to fight or flee (adrenaline) Parasympathetic – gets body back to normal after fight or flee (acetylcholine) DIGESTIVE SYSTEM Processes solids and liquids Transcends oral, thoracic, abdominal, and pelvic cavities Food taken into mouth, esophagus, stomach, small intestine, large intestine, colon, rectum ENDOCRINE SYSTEM Secretes chemicals called hormones from glands into bloodstream The hormones regulate body activities and functions Two major hormones Epinephrine (adrenalin) is produced by adrenal glands and gets the body ready to fight or run in emergencies Insulin is produced by the pancreas and carries glucose into the cells for energy MUSCULAR SYSTEM TENDONS connect bone to muscle creating pull when the muscle contracts Muscles divided into 3 types 1) Skeletal, striated Voluntary: contracts/relaxes at will Extension (muscle relaxes) Flexion (muscle contracts) 2) Smooth Involuntary, out of the control of the consciousness Found in organs and vessel walls 3) Cardiac Found in heart Generates own contraction (automaticity)