Patient Assesment

Assessing vital signs is an important EMT function. You will take vital signs on every patient you encounter. These vital signs are typically the first one's taken in the emergency situation and are often used as the baseline from which the medical team gauges changes in the patients condition. You will take several sets of vital signs to attempt to identify trends in the patients condition and if he is improving or deteriorating.

The six vital signs you will be taking are respiration's, pulse, skin, pupils, blood pressure, and pulse oximetry.

If the patient is stable you assess every 15 mins. For an unstable patient, you assess every 5 mins.

Obtaining history is important in determining the condition of the patient and what emergency care is necessary, especially in the medical patient.

Closed-ended questions are used in the trauma patient.
Open-ended questions are used for a medical patient.

Communication

Communication is a very important aspect of am EMT being successful or not. You must know the standards of communicating within your area. a basic way of communicating when you are communicating to dispatch is the acronym :
SBAR.
S-situation
B-background
A-assessment
R- recommendation

Be sure to look up the standards in your area.

Ch. 10 Airway Management , Artificial Ventilation, and Oxygenation

Ch.9 Life Span Development-Objective

This chapter will insure your understanding of Life Span Development.

Identify the age ranges associated with each following terms:

• neonate: refers to the child from birth to 1 month of age
• infant: refers to the child from one month to 1 year.
• toddler: a child 1-3 years
• preschooler: child from 3-6years
• school age: child from 6-12 
• adolesent: child between 12-18
• early adulthood: from 20-40 years
• middle adulthood: from 41-60
• late adulthood:  age 61 and older

Discuss the key physical and psycho-social characteristics of individuals in each of the following age groups:

• neonates and infants: 
• toddlers
• preschool-age 
• school-age
• adolescents
• early adulthood
• middle adulthood
• late udulthood.

Ch. 8 Pathophysiology Key Term-Definition

• aerobic metabolism: is the breakdown of molecules such as glucose through a series of reactions energy within cells in the presence of oxygen.
• galycolysis: occur in the fluid portion of the cell and does not require oxygen.
• anerobic metabolism: is the breakdown of molecules in the cells without the presence of oxygen 
• laryngeal spasm: a contraction of the vocal cords that causes them to close and prevents air from passing through into the trachea.
• Boyle law:the concept that the volume of gas is inversely proportionate to the pressure.
• airway resistance: the restriction of airflow that is related to the diameter of the airways.
• compliance:the measure of the ability of the chest wall and lungs to stretch, distend, and expand.
• dead air space: (Vd) anatomical areas in the respiratory where no gas exchange occurs but air collects during inhalation
• central chemoreceptors:
• chemorreceptors: monitor arterial content of oxygen, CO2 and blood.
• periphearal chemorereceptors: locate in the aortic arch and the cartid bodies.
• stretch reseptors:
• apneustic center: the respiratory center in the brain stem that intensifies and prolongs inhalation.
• dorsal respiratory group:
• pneumotaxic center: the respiratory center in the brain stem that intensifies and prolongs inhalation.
• respitory  control centers:
• ventilation/perfusion (V?Q) ratio
• ventral repiratory group:
• deoxyhhemoglobin: it does not have any oxygen moleules attached.
• oxyhemoglobin: hemoglobin that has atleast 1 oxegen molecule attached to it.
• hydrostatic pressure: the, effect forces fluid out of the inside a capillary bed generated  by the conraction of the heart and the blood pressure that exerts, push that forces out of the vessel.
• plasma oncotic pressure: the force responsible for keeping fluid inside a vessel, pull.
• cardiac output: the volume of the blood generated by the left ventricle.
• Frank-starling law of the heart: the stretch of the muscle fiber in the left ventrical at the end of distial determins the force necessary to eject the blood contained with in it.
• stroke volume:
• preload: the pressure generated in the ventrical in resting phase.
• afterload: the force of contraction that the left ventricle has to generate to overcome the resistance in the aorta to eject the blood.
• glycosis:
• stsemic vascular resistance: the resistance of blood flow through a vessel based on the diameter of the vessel.
• micracirculation:  the flow of blood in the site of exchange of gases, nutirents, and waste products with the cells.
• baroreceptors: stretch sensitve receptors located in the aortic arch and carotoid bodies that constantly measure the blood pressure

Ch. 7 Definitions of the human body. Q and A

Describe each of the following terms of position:                             

•  Anatomical position: unless otherwise indicated , all references to the human body assume the anotomical position.
•  Supine: The patient id lying on his back.
•  Prone: The patient is lying face down on his stomach
• Lateral recumbant: the patient is lying on his left or right side.
• Fowler position: the patient on his back with his upper body elevated at a 45 dgrees 
• Semi-Fowler position: the patient is lying on his back with his upper body elevated less than 45 degree.
• Trendelenburg position: The patient is lying on his back with his legs elevated higher than the head and the body is on a inclined plane.
• Shock position: the feet and legs are elevated approximatly  12 inches.

Identify each of the following anatomical terms:

• Midline: Visualize the normal anatomic position (patient facing you).Now imagine a line vertically from the middle of the patient's body. it divides the body into equal halves.
• Sagittal plane: a vertical plane that does not have to be equal on both sides.
• Frontal plane: divides the body into front and back halves.
• Transverse: horizontal plane which is parallel with the ground and divides the upper and lower body in half. axial plane.
• Midaxillary line: the patient is standing in profile. this plane go vertically from the armpit to the ankle.
• Midclavicular line: refers to the center of each of the collarbones 
• Anterior and posterior'anterior id toward the front. Posterior is toward the back.
• Dorsal and ventral: Dorsal means toward the back or backbone spine. Ventral means toward the front or belly.
• Right and left: always the patients right or left.
• Superior and inferior: superior means toward the head or above the point of reference. In inferior means toward the feet.
• Medial and lateral: medial means toward the midline or center of the body. Lateral refers to the left or right of the midline, or away from the midline of the body.
• Proximal and distal: near the point of reference. Distal is distant, or far from the point of reference.
• Plantar: refers to the sole of the foot..
• Palmar: refers to the palm of the hand.
• Abdominal quadrants: 
• left upper quadrant: liver (small portion), spleen, left kidney, stomach,colon, pancreas(small portion),small intestines.
• left lower quadrant: colon, small intestines,left ureter, left ovary (female), left fallopian tube(female)
• right upper quadrant: Liver, rt. kidney, colon, pancreas(small portion) gallbladder, small intestines.
• right lower quadrant: colon, small intestines, right ureter,appendix, right ovary (female), right fallopian tube (female)

State the function of each of the following musculoskeletal system structures:

• Skeletal muscle: makes it 
• Tendons
• Ligaments
• bone

Describe each of the following components of the skeleton, including it's location, the bones that make it up, and it's function:

• Skull
• Cranium
• Face

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• Spinal column
• Cervical spine
• Thoracic spine
• Lumbar spine
• Sacral spine
• Coccyx

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• Thorax:
• sternum (including manubrium, body, and xiphoid process)
• Ribs

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• Pelvis
• Ilium and iliac crest
• Ischium
• pubis
• Acetabulum:

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• Upper extremities:
• Clavical
• Scapula, including olecranon process
• Carpals
• Metacarpals
• Phalanges

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• Lower extremities:                                                                      
• Femur                                                                                              
• Patella
• Tibia, including medial malleolus
• Fibula, including lateral malleolus
• Tarsals, including the calcaneus
• Metatarsals
• Phalanges 

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Demonstrate each of the following joint movements:

• Flexion and extension
• Adduction and abduction
• Circumduction
• Pronstion and supination

Describe each of the following types of joints:

• Ball-and-socket
• Hinge
• Pivot
• Gliding
• Saddle
• Conyloide

Differentiate between skeletal (voluntary), smooth (involuntary), and cardiac muscle:

Identify the basic functions of the repirtory system:

Identify the following structures of the respiratory system:

• Upper airway: nose, mouth, pharynx, nasopharynx, larynx:
• Lower airway: trachea, bronchi, bronchioles, alveoli
• epigottis
• lungs
• pleura
• diaphram

Identify important difference in respirtory system anatomy in children:

Describe the basic maechanics and physiology of normal ventilation, respiration, and oxygenation, including:

• Inhalation and exhalation
• use of intercostal muscles and diaphragm
• negitive and positve pressure
• nervous system control of respiration
• alveolar/capillary exchange of oxygen and carbon dioxide
• Capillary/cell exchange of oxygen and carbon dioxide

Identify characteristics of both adequate and inadequate breathing.

List the functions of the circulatory (cardiovascular) system.

Describe the anatomy and physiology of the heart to include:

• location and size                                                                                   
• tissue layers
• chambers
• valves
• blood supply
• blood flow through the heart
• Conduction system

Discuss the anatomy and physiology of the blood, circulation, purfusion, and metabolism to convey basic comprehension of:

• Arteries and arterioles
• capillaries
• veins and venules
• blood composition
• perfusion and capillary exchange
• cell metabolism

Describe the basic functions of the nervous system.

Differentate between the structural components and basic functions of the central nervous system and peripheral nervous system:

• voluntary (somatic) nervous system
• involuntary (autonomic) nervous system
• sympathetic division
• parasympathetic division

Describe the basic role of the reticular activationg systems (RSM) and cerebral hemisheres in conciousness and unconsciousnes.

Explain the overall function of the endocrine system:

• Tyroid gland 
• parathyroid glands
• adreal glands 
• gonads
• islets of langerhans of the pancreas of the pancreas, insulin, and glucagon
• pituatary gland

Describe the general actions of epinephrine and norepinephrine on beta1, beta2, alpha1, alpha2 receptors of the symathetic nervous system.

List the general fuctions of the integumentary system.

Identify  the structures of the integumentary system, including the epidermis, dermis, and subcutanous layer.

Describe the basic anatomy and physiology of each of the following structures of the digestive system:

• stomach
• pancreas
• liver
• gallbladder
• small in testine (duodenum, jejun, ileum)
• colon

List the basic structure and function of the organs of the urinary or renal system to include:

• kidneys
• ureters
• uninary bladder
• urethra

State the basic structure function of the organs of the male and female reproductive systems:

• Male
• testes
• accessory glands
• penis
• Female
• ovaries
• fallopian tubes
• uterus
• vagina
• external genitalia

                                                                                                                                                                                                                        

                                                                                                               






































                                                                                                               

                                                                                         

Part 2-Ch.7 "Anatomy, Physiology, and Medical terms" Key terms

• Anatomy: The study of the structure of the body and the relationship of it's parts to each other.
• circulatory system: the body system that transports blood to all parts of the body. Includes the heart, blood vessels, and blood. Also called the cardiovascular system.
• digestive system; the structure and organs that ingest and carry food so that absorption and waste elimination can occur..
• endocrine system: a system of ductless glands that produce hormones that regulate body functions.
• integumentary system: the skin.
• musculoskeletal system: the systems of bones and muscle plus connective tissue that provides support and protection to the body.
• nervous system: the body system including the brain, spinal cord, and nerves that controls the voluntary and involuntary activity of the human body. 
• physiology: the study of the function of the living body and it's parts.
• reproductive system: the male and female organs of reproduction.
• respiratory system: the organs involved in the exchange of gases between an organism and the atmosphere.
• urinary/renal system: the organs and structures that filter and excrete wastes from the blood.