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EMT-Basic(Medical Emergencies)


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Primary Intervention
Which makes the greatest difference in the survival of a Cardiac Arrest patients?
Two most common types of AEDs(Automated External Defibrillators)
1. Semi-Automatic - Uses a computer voice synthesizer to advise operator steps to take base on analysis of patient rhythm.

2. Fully Automatic - Requires no action on part of the operator other than to hook up defibrillator patches and turn unit on.
Generally Recognized age and weight criteria for using AEDs(Automated External Defibrillator)
8 Years of age and older and 80lbs or more.
Indication for administration of oral glucose.
Patients with altered mental status who have a known history of diabetes that is controlled by medication.
What are two contraindications for administration of oral glucose.
1. Patient is unable to swallow.

2. Patient is unresponsive.
Suggested method for managing a violent patient who is spitting on EMTs.
Cover the patient's face with a surgical mask.
Important consideration if a patient in a moving ambulance becomes pulseless and apneic and an AED is available.
Stop the vehicle prior to attempting defibrillation to allow the AED to analyze the rhythm.
Definition of an indication for a medication's use.
The indication refers to the most common uses of the medication in treating a specific illness.
Definition of a contraindication for a medications use.
A contraindication refers to a situation in which a medication should not be used. This may be because it may cause harm to the patient or because it has no effect in improving the patient's illness or condition.
Definition of a side effect related to a medication's use.
Side effects are any actions of a medication other that the desired ones.
Three medications which the EMT-Basic may assist a patient in taking.
1. Nitroglycerin
2. Prescribed Inhaler
3. Epinephrine
Three Medications which may be carried on an EMT-Basic unit.
1. Oxygen
2. Oral Glucose
3. Activated Charcoal
Eight forms in which the medications an EMT-Basic carries on an EMS unit or assists patients in taking are found.
1. Gas (Oxygen)
2. Gel (Oral Glucose)
3. Suspension (Activated Charcoal)
4. Compressed Powder Or Tablet (Nitroglycerin)
5. Sub-lingual Spray (Nitroglycerin)
6. Liquids For Injection (Epinephrine)
7. Fine Powder For Inhalation (Prescribed Inhaler)
8. Liquid/Vaporized Fixed Dose Nebulizer (Prescribed Inhaler)
Position a patient experiencing Cardiac Compromise should be placed in.
Place the patient in a position of comfort.
Two forms in which Nitroglycerin administered by EMT-Basics is found.
1. Tablet
2. Spray
Route of administration for Nitroglycerin administered by EMT-Basics.
Sub-lingual(Under the toungue) regardless of whether the medication is in tablet or spray form.
Blood pressure criteria for administering Nitroglycerin.
Blood pressure must be greater than 100 systolic.
Time intervals between doses of Nitroglycerin and recommended maximum number of doses.
Time Interval Between Doses: 3-5 minutes between doses if chest pain persists
Maximum Number Of Doses: 3 doses
Three side effects of Nitroglycerin administration.
1. Headache
2. Hypotension
3. Pulse Rate Changes
Three criteria which must be met prior to assisting with the administration of Epinephrine.
1. The patient must exhibit assessment findings of an allergic reaction.
2. The medication must have been prescribed for this patient.
3. Medical direction must authorize use for this patient.
Two primary actions of Epinephrine.
1. Dilates The Bronchioles (Making Breathing Easier)
2. Constricts Blood Vessels (Raising blood pressure and improving perfusion)
Contraindications for administering Epinephrine.
There are no contraindications when Epinephrine is used in a life-threatening situation.
Dosages for Epinephrine Adult, Child, Infant.
Adult: One adult Auto-Injector(0.3mg)
Child and Infant: One infant/child Auto-Injector(0.15mg)
When assisting with the administration of an Epinephrine Auto-Injector, the tip should be placed...?
On the lateral portion of the patient's thigh, midway between the waist and the knee.
Procedure that should be followed after Epinephrine Auto-Injector activates.
- Hold the injector in place for approximately 10 seconds after hearing the click(to allow medication to be fully injected.
- Record the activity and time.
- Dispose of the Auto-Injector in an appropriate biohazard container.
Eight side effects of Epinephrine administration.
1. Increased Heart Rate
2. Pallor
3. Dizziness
4. Chest Pain
5. Headache
6. Nausea
7. Vomiting
8. Excitability And Anxiousness
Action of inhaled medications which makes breathing easier.
The medication dilates the bronchioles, thereby reducing airway resistance and make breathing easier.
Four contraindications for using a Prescribed Inhaler.
1. Patient is unable to use the device.
2. The Inhaler was not prescribed for the patient.
3. Medical Direction does not give permission for its use.
4. Patient has already met the maximum prescribed dose of the medication prior to arrival of the EMT-Basic.
Important instructions the EMT-Basic should give to a patient prior to their inhaling a prescribed medication.
- Have the patient exhale deeply.
- Instruct the patient to hold his or her breath as long as he or she comfortably can after inhaling the medication to allow it to be absorbed.
Three possible side effects that may be seen after a patient inhales a medication.
1. Increased Pulse Rate.
2. Tremors.
3. Nervousness.
Six common causes of altered mental status.
1. Hypoglycemia
2. Head Injury
3. Decreased Oxygen Levels
4. Seizures(Primarily seen post seizure)
5. Poisoning/Overdose/Intoxication
6. Infections
Usual Dosage of oral glucose.
One Tube.
Method for administering oral glucose.
Administer the glucose between the patient's cheek and gum.
Side effects of oral glucose.
None when administered properly.
Four methods by which poisons enter the body.
1. Ingestion
2. Inhalation
3. Injection
4. Absorption
Important Point to remember when managing a patient who has been poisoned by contact with a chemical.
Wash or brush off any remaining chemical.
Length of time an eye exposed to a poison should be irrigated.
Irrigate the affected eye(s) for at least 20 minutes with clean water.
Indication administration of activated charcoal.
Poisoning by mouth.(ingested poison)
Three contraindications for administration of activated charcoal.
1. Patient has an altered mental status.
2. Patient is unable to swallow.
3. Patient ingested an acid or alkali.
Dosages for activated charcoal Adult, Child, Infant.
1 Gram per kilogram of body weight.
Usual Doses:
Adult: 15-50 Grams
Child And Infant: 12.5-25 Grams
Recommended procedure to follow if a patient vomits shortly after taking activated charcoal.
Repeat the original dose once.
Five ways the body loses heat.
1. Radiation
2. Convection
3. Conduction
4. Evaporation
5. Breathing
Important early consideration when managing a heat emergency patient with Hot, Dry or Moist skin.
- Place the patient in a cool environment.
- Remove the patient's clothing
- Apply cool packs to the patient's neck, armpits and groin.
- Keep the patient's skin wet.
- Fan the patient aggressively.
Two basic types of cold emergencies.
1. Generalized Cold Emergency/Hypothermia.
- An abnormal lowering of general body temperature.
2. Local Cold Injuries.
Generally Classified as:
- Early or superficial
- Late or deep
Minimum Number of persons that should be used to restrain a violent patient.
Minimum of four persons, one assigned to each limb.
Recommended position a restrained violent patient should be placed on the stretcher.
Face Down
(The patient should be closely monitored to guard against airway compromise. Always follow local protocols when restraining patients, including guidelines on what position to place the patient in)
Recommended procedure when transporting a patient who has regained a pulse following defibrillation.
Keep the AED attached to the patient during transport.
Recommended point at which a patient who is connected to an AED should be transported(if no ALS personnel are on the scene)
After six shocks are delivered on the scene(Three initial shocks and three additional shocks after 1 minute of CPR)
If the machine advises three consecutive times(separated by 1 minute of CPR)that no shock is appropriate.
If the patient regains a pulse.
Two cardiac rhythms for which difibrillation is appropriate.
1. Ventricular Fibrillation (also called V-Fib or VF)
2. Ventricular Tachycardia (also called V-Tach) - a very fast heart rhythm originating in the ventricles.

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