Westcoast emt final study guide with complete solution
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West Coast EMT
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West Coast EMT
Westcoast emt final study guide with complete solution
Anatomy of lower airway
1. Thyroid cartilage (Adam's apple): forms the anterior part of the larynx
a. Tiny muscles open and close the vocal cords and control tension.
b. Sounds are created as air is forced past the vocal cords, making t...
westcoast emt final study guide with complete solution anatomy of lower airway 1 thyroid cartilage adams apple forms the anterior part of the larynx a tiny muscles open and close the vocal
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Westcoast emt final study guide with complete solution
Anatomy of lower airway
1. Thyroid cartilage (Adam's apple): forms the anterior part of the larynx
a. Tiny muscles open and close the vocal cords and control tension.
b. Sounds are created as air is forced past the vocal cords, making them vibrate.
2. Cricoid cartilage: immediately below the thyroid cartilage
3. Cricothyroid membrane: between the thyroid and cricoid cartilage
4. Trachea: below the cricoid cartilage
a. The trachea ends at the carina.
b. It divides into two tubes, the right and left main stem bronchi, which enter the lungs
and branch into smaller airways.
Ventilation
The physical act of moving air into and out of the lungs, which is necessary for
oxygenation and respiration to occur
inhalation and exhalation
oxygenation
1. The process of loading oxygen molecules onto hemoglobin molecules in the
bloodstream
2. Required for internal respiration to take place
a. Oxygenation does not guarantee that internal respiration is taking place.
b. Ventilation without oxygenation can occur—for example, in places where oxygen
levels in the breathing air have been depleted, such as in mines or confined spaces.
Tidal Volume
the amount of air that is moved into or out of the lungs during a single breathe.
Minute volume
Minute volume: the amount of air that moves in and out of the lungs in 1 minute minus
the dead space
respiration
Respiration: the exchange of oxygen and carbon dioxide in the alveoli and in tissues of
the body
internal respiration- exchange of oxygen and co2 between the systemic circulatory
system and the cells of the body. exchange of gas between blood and tissues
external respiration- gas exchange between inhaled air and blood
Asthma s/sx
produces a characteristic wheezing caused by partially obstructed airways
Left sided CHF s/sx
blood isn't pumped sufficiently in the heart so fluid backs up into the lungs. Fluid sitting
in the alveoli, can't get enough oxygen in. usually leads to right sided failure
s/sx: Rales, wet lung sounds. Left sided has right sided symptoms, but right sided
doesn't always have left sided symptoms.
,Anaphylaxis
s/sx may be similar to asthma
Croup
infection of the upper airway
s/sx- stridor (high pitched sound heard on inspiration as air tries to pass through an
obstruction in the upper airway), seal bark cough
Pneumonia
a. General term that refers to an infection of the lungs
b. Often a secondary infection that begins after an upper respiratory tract infection
c. Can be caused by a virus or bacterium, or by a chemical injury or direct lung injury
i. Bacterial pneumonia will come on quickly and result in high fevers.
ii. Viral pneumonia presents more gradually and is less severe.
d. Pneumonia especially affects people who are chronically and terminally ill.
e. Signs and symptoms of pneumonia include:
i. Rapid or labored breathing (in children)
ii. Blue or gray lips or fingernails
iii. Fever
iv. Dry skin
v. Decreased skin turgor
vi. Exertional dyspnea
vii. Productive cough
viii. Chest discomfort and pain
ix. Headache
x. Nausea and vomiting
xi. Musculoskeletal pain
xii. Weight loss
xiii. Confusion
xiv. Diminished breath sounds
f. If possible, assess temperature to determine presence of fever.
g. Provide airway support and supplemental oxygen.
Tuberculosis
a. TB is a bacterial infection that most commonly affects the lungs.
b. It also can be found in almost any other organ.
c. Can remain inactive for years before producing any symptoms
d. Patients often complain of fever, coughing, fatigue, night sweats, and weight loss.
e. With severe infection, patient will experience shortness of breath, coughing,
productive sputum, bloody sputum, and chest pain.
f. Prevalence is higher in homeless people, prison inmates, and nursing home
residents.
g. TB is also found in persons who abuse intravenous drugs or alcohol, or those with
HIV
h. If you suspect your patient may have active TB, you need to wear, at a minimum,
gloves, eye protection, and an N-95 respirator.
Upper vs lower lung sounds
contra: hypersensitivity, tachycardia; chest pain of cardiac origin
route: inhalation
tell patient to exhale completely before taking a puff and hold breath as long as they can
after taking a puff
Epinephrine
Indications: Anaphylactic reaction
Contra: hypersensitivity
Route: IM, IN
Autoinjector dose: 0.3mg (adult), 0.15mg (infant), concentration is 1:1000
Eases breathing problems caused by bronchial spasms- bronchodilator and
vasoconstrictor
contact med control to help administer patient's epi pen
side effects: high BP, pallor, headache, tachycardia
strengthens cardiac contrations and speeds up the heart rate
side effects are less bad if given IM
Nasal canula
- Low flow 1-6 l/min
-passive ventilation
-use only if patient can't tolerate a NRB
-delivers dry oxygen directly into the nostrils
-can provid 24%-44% oxygen
nonrebreathing mask (NRB)
high flow
preferred method
combo of mask and reservoir bag system
can deliver up to 95% oxygen
set to 10-15L/min
bag-valve mask (BVM)
most common method to ventilate
must be used to deliver high concentrations of O2 to patients who are not ventilating
, adequately
positive pressure ventilation
can deliver nearly 100% oxygen
continuous positive airway pressure (CPAP)
increases pressure in lungs, opens collapsed alveoli, pushes more oxygen across the
alveolar membrane and forces interstitial fluid back into the pulmonary circulation
increases pressure inside the chest and reduces the amount of blood flow returning to
the hear so CAUTION when considering CPAP in patient with low BP
contra: patients in respiratory arest, s/sx of pneumothorax or chest trauma, trach tube,
active GI bleeding, patient that is unable to follow verbal commands
Heart anatomy
right atrium, right ventricle, left atrium, left ventricle
Major veins- superior and inferior vena cava, pulmonary vein
pulmonary artery
coronary arteries supply the heart itself with blood. branches off from the aorta
Vessel system anatomy
arteries flow away from the heart, veins flow back to the heart
systemic circuit: body; carries oxygen rich blood from the left ventricle through the body
and back to the right atrium
pulmonary circuit: lungs; carries oxygen poor blood from the right ventricle through the
lungs and back to the left atrium
arteries -> arterioles -> capillaries -> venules -> veins
pulmonary artery: carries deoxygenated blood from right ventricle to lungs
pulmonary vein: carries oxygenated blood from lungs back to left atrium
Parts of the blood
plasma, red blood cells, white blood cells, platelets
1. Plasma- water, proteins, oxygen, CO2, Nitrogen, nutrients, cellular wastes
2. Red blood cells (erythrocytes)- contain hemoglobin, carry oxygen
3. White blood cells (leukocytes)- play a role in the body's immune defense to fight
infection
4. Platelets- essential in the initial formation of a blood clot
Electrical system
a. A network of specialized tissue that is capable of conducting electrical current runs
throughout the heart.
b. The flow of electrical current causes smooth, coordinated heart contractions.
c. The contractions produce the pumping action of the heart.
d. Each mechanical contraction is associated with two electrical processes.
i. Depolarization: electrical charges on the surface of the muscle cell change from
positive to negative
ii. Repolarization: the heart returns to its resting state, and the positive charge is
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