NREMTP Review-Raphael E. 🚑🚒
Why do you think you did not pass?
I did not fully understand what they were asking me
I did not know my signs/symptoms
I struggled with knowing my prioritizations & order of operations
I did not understand the medical terminology
I was being asked about topics I have never seen and did not know
Thrombus/Thrombosis
A static blood clot. It does NOT move or travel
DVT (a static blood clot in the deep veins of the leg)
Embolus/Embolism
A blood clot that moves and travels in the body
What is a blood clot?
RBCs stuck together
Platelets stuck together
Air bubble
Piece of fat
BLOOD NEEDS TO STAY IN CONSTANT MOTION, IF IT STOPS MOVING, IT CLOTS!!!!!
Risk factors for a blood clot
Recent Surgery
Obesity
prolonged travel
A-Fib
Women on BCP
Pregnancy
Pulmonary Embolism
Patho-A blood clot that traveled from somewhere in the body (DVT), that gets stuck and wedged in the pulmonary artery
EMT Level
Acute onset of CP/SOB
Dyspnea
Pleuritic CP (CP on inhalation)
Tachycardia
Low Spo2
Paramedic level
JVD
Hemoptysis
Hypotension
Q1S1T3 pattern on EKG
48 female, c/o acute dyspnea, pleuritic CP, JVD and 12 lead shows a Q1S3T3 pattern
Your patient presents w/ a severe asthma attack. Unable to speak in complete sentences, audible bilateral wheezing, + AMU, and marked cyanosis. All of the following are appropriate except what?
WHAT WILL BENEFIT THE PATIENT, THE MOST, RIGHT NOW!!!!!
A. High flow oxygen
B. Initiate a duoneb treatment w/ albuterol/atrovent
C. Initiate CPAP/BiPap
D. Administer 2 gm of mag sulfate
E. Administer solu-medrol
F. Administer Epi IM at 0.3 mg
Peritonitis
Caused by a ruptured hollow organ
Ruptured appendix
Perforated bowel
Ovarian rupture
Diffuse abdominal pain
Abdominal rigidity (Guarding)
Abdominal distention
Absent bowel sounds
Shock (Hypovolemic & Septic)
Rebound tenderness
N/V
Fever
Chronic Kidney Disease
Kidney Failure=he cannot make urine or urinate
Urea=Toxins
Fluid accumulation, toxins, electrolyte imbalances
Fluid=JVD, pedal edema, crackles
When potassium goes high it becomes an ACID!!!!!!
Hyperkalemia=Metabolic Acidosis
Metabolic Acidosis due to Hyperkalemia
Calcium Chloride-is a cardiac protectant. It protects the heart from fatal dysrhythmias (V-fib or V-tach)
Sodium Bicarbonate-Buffers and neutralizes acid, it increases the Ph level
Albuterol-Pulls potassium out of the bloodstream and puts it back into the cells
Epinephrine
Vasoconstriction
Opens the upper airway and decreases laryngeal spasms
bronchodilation
+ Chronotropic
Histamine
An inflammatory chemical release during an allergic/anaphylactic reaction causing hives and itching
Hemorrhagic Stroke
Due to a ruptured aneurysm
cause of a hemorrhagic Stroke=Uncontrolled HTN
ICP
1.Increased SBP
Bradycardia
Depressed/Irregular respirations
Wernicke's Encephalopathy
Patho-A severe deficiency of Vitamin B1 (Thiamine)
Thiamine
An essential vitamin responsible for neuro and Brain function
We do NOT naturally produce thiamine
We get it from food and nutrition
!!!!Seen in malnutrition, alcoholism, and recent GI surgeries
Classic Triad
AMS
Ocular Nystagmus
Ataxic gait (weakness in the lower extremities)
Paramedic Treatment
Thiamine 100 mg IV
D50W 1 amp
RICE
Rest
Ice
Compression
Elevation