Tuesday, February 5, 2013

NREMT-EMT Exam Study Tips

Warning: We always recommend audio paramedic study guide. You should get it for better grades. Also I recommend you to review our NREMT-EMT study guide and tips before the nremt exam. 

Today i want to share some last minute tips. This blog will be a free paramedic study guide soon. I will post free information everyday. (Hundred of questions are waiting you). Lets start with questions. 

1-) What is a placental abruption (abruptio placentae) ?
Answer: A placental abruption is when the uterus prematurely separates from the uterine wall. It occurs later in pregnancy and is often accompanied with abdominal pain and vaginal bleeding. The abruption may be partial or full. A total placental abruption is almost always fatal to the fetus.

2-) What is the condition called when the umbilical cord is presenting from the vagina before birth? What is the care for this condition?
- Prolapsed cord is the condition where the umbilical cord is presenting prior to birth. As the baby progresses through the birth canal, the head will compress the cord cutting off circulation to the baby. This is the only time you would insert your gloved hand into the vagina, lifting the baby's head off the cord. This is maintained throughout transport.

3-) What are the three components of the Cincinnati Prehospital Stroke Scale?
- Facial droop > Ask the patient to perform a big smile showing teeth. Look for asymmetry.
  Slurred speech > Ask the patient to say " You can not teach an old dog new tricks." and listen for slurred speech.
  Pronator drift > Ask the patient to close their eyes and place both arms out in front of their body. Look for asymmetry in the drift of the arms.

4-) What is preload and afterload ?
- Preload is the amount of blood filling or available to fill the hearth prior to contraction. Preload is also considered "stretch" of the hearth chamber since the more blood that enters, the more the hearth stretches. More stretch = stronger contractions (to a point) 
  Afterload is the amount of pressure the hearth must pump against to eject blood from the ventricle. Afterload may also be thought of as the amount of "squeeze" necessary to eject the blood into the aorta.

5-) List several stimulant and depressant abused or illegal medications. 
- Examples of stimulant substances include cocaine, methamphetamine, Ritalin. Stimulant overdose can cause agitation, seizures, stroke, very elevated vital signs and death.
- Depressant medications include heroin, diazepam ( Valium), morphine, prescription medications (percocet, oxycodone, dilaudid, methadone, vicodin, etc.). 
- Overdose of depressant medications causes decreased mental status and depressed respiratory effort which may lead to respiratory arrest and death.
Helps you in NREMT-EMT  exam  (plz  leave a comment)

6-) What are the types of shock by functional classification ?
-Hypovolemic (low volume)
-Cardiogenic (e.g. myocardial infarction, pump failure) 
-Obstructive (tension pneumothorax, pulmonary embolus)
-Distributive (anaphylaxis)

7-) What is the difference between ventilation and oxygenation ?
- Ventilating a patient is using positive pressure (e.g. BVM) to force air into the lungs. This is done when a patient is in respiratory arrest or respiratory failure.
-Oxygenation is providing supplemental oxygen  via nasal cannula, non-rebreather mask or venturi mask. In this case the patient must be breathing adequately to bring the oxygen in to lungs.

8-) Describe the following incomplete spinal cord injuries : Brown-Sequard Syndrome, Central Cord Syndrome, Anterior Cord Syndrome
-Brown-Sequard Syndrome ; is an injury to one side of the spinal cord. The patient will have loss of motor and light touch on the side of the injury and loss of pain on the side opposite the injury.
-Central Cord Syndrome ; is caused by injury to the center of the spinal cord. The spinal tracts for the upper extremities run closer to the center of the cord than lower extremities. This means there will be weakness, sensory problems or paralysis to the upper extremities while the lower extremities are relatively normal.
-Anterior Cord Syndrome; is caused by trauma to the anterior spinal cord. This results in loss of motor, temperature and pain sensation below the injury. The patient retains sensation of light touch below the injury (a posterior spinal column function.).

9-) What are the " 5 rights" of medication administration?
- Right patient, Right medication, Right dose, Right route, Right time. Some include a 6th "right" Right documentation.

10-) What rhythms will the AED shock?
- The AED will only defibrillate ventricular (v-fib) and ventricular tachycardia (v-tach).

11-) What is the normal range for blood glucose levels?
- While values range between clinical laboratories, blood glucose levels between 70-120 mg/dL are considered normal.

12-) How can you tell if a pediatric patient is dehydrated?
- Using the pediatric assessment triangle you may note that the patient's appearance is limp, lethargic or detached from the environment. The skin color may be pale and the capillary refill delayed. In children up to 18 months you may notice a sunken fontanelle. Also check to see if the patient has been wetting diapers at a normal rate (decreased may mean dehydration) and inquire about oral intake of solids and liquids. Perform a thorough history in regard to fever, illness and other recent events.

13-)Your patient is weak when they stand and have noted dark, tarry stools. What is the patient's likely problem?
- Gastrointestinal bleed. The dark tarry stools may indicate digested blood. The stool may also be foul-smelling. The weakness on standing (change of position) may be an orthostatic change in vital signs. Blood pressure drops, pulse increases and weakness and dizziness may be felt by the patient because of reduced perfusion to the brain.

14-) What is vascular tone?
- Vascular tone is the degree of constriction of a blood vessel. Smooth muscle in the walls of blood vessels (especially small arteries and arterioles) contract to provide vascular tone. Increased tone constricts a blood vessel. Decreased tone or loss of tone causes the vessel to dilate.

15-) Why do neck veins become distended? List several conditions that may cause this.
- Neck veins distend because blood is unable to return from the head into the chest because of hearth failure, obstruction or increased thoracic pressure. JVD may be seen in : Right hearth failure/CHF Tension pneumothorax Cardiac tamponade Pulmonary embolus.

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