NREMTP Review-Chris M. 🚒🚑
Clinical Judgement Questions
Always pay attention to the following things:
The age, history, risk factors, and home meds of the patient
Who are you working with? (Another medic, EMT, AEMT)
The time of day of the call
The weather and road conditions
Hospital destinations. ETA in miles or minutes
Always keep track of what you have done throughout the call
If you are going to go w/ an answer involving an intervention or giving a medication, make for DAMN sure, there are NO contraindications
Normal temp-Oral-97-98.9
Core (Rectal)-99-99.8 F
Fever-100.8 F
Hypothermia
Mild Hypothermia-90-95 F
Moderate-85-90 F
Crackles=Rales=Pulmonary Edema
Accumulation of fluid in the alveoli!!!!!
Atmospheric Oxygen
21% oxygen
Fio2-Fractional Inspired Oxygen
Nasal Cannula (1-6 lpm)-24-44% Fio2
1 L-24%
2 L-28%
3 L-32%
4 L-36%
5 L-40%
6 L-44%
When do you ventilate/BVM a Patient
Shallow/Decreased Tidal Volume
RR less than 10/min
RR above 36/min
When do we do a 12 lead?
Cardiac related CP
M.I
Angina
Epigastric or Upper abdominal
Syncopal episode
DKA & HHNK
Crush injuries
Suspected electrolyte imbalances
Renal failure
Hyperkalemia
Peaked T-waves
Absent P-waves
Widened QRS complex
-emia=Blood=Hema
Kidneys
Filters out toxins and electrolytes from the blood
Filters out blood, nitrogen, and waste products=Urea
The kidneys then convert Urea into urine
Regulate BP & Fluid balance
Uremia-Waste products in the bloodstream.
Those waste products can then travel to the brain, causing neurological deficits
cause coma, unresponsive, seizures, lead to ICP
Thrombus/Thrombosis
A static blood clot. It stays in 1 place, and does not move
Embolus/Embolism
A moving blood clot, that travels through the body
Pulmonary Embolism
Risks
Recent prolonged travel
Obesity
Not exercising
Birth control pills
Recent surgery
A-fib
Signs/Symptoms
Immediate/acute onset of SOB & Chest pain!!!!!
Tachycardia
Low Spo2
Hemoptysis (coughing up blood)
Hypotension
Potassium
Lives inside the cells
Intracellular electrolyte
Potassium is an ACID!!!!!!!
Hyperkalemia=Metabolic Acidosis
Hyperkalemia=Metabolic Acidosis
Crush injuries
Renal Failure
Calcium Chloride
Acts as a cardiac protectant. protects the heart from fatal dysrhythmias (V-fib/V-tach)
Sodium Bicarbonate
A neutralizing agent, it will get rid of the acidic state, and increase the pH level
Albuterol (nebulized)
Pulls the potassium out of the blood, and puts it back into the cells
CPAP/Bipap contras
ALOC/AMS
SBP less than 100
Facial/Head trauma
Apnea