NREMT Emergency Medical Technician (EMT) Cognitive Exam flashcards

Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless, bright red vaginal bleeding, typically in the second or third trimester of pregnancy.

• Painless vaginal bleeding is the hallmark symptom.
• Bleeding is usually bright red and can be heavy.
• Occurs in late pregnancy (after 20 weeks).
• Avoid vaginal exams, as they can worsen bleeding.

Memory trick: Painless, Bright Red, Pregnant: Placenta Previa's the dread!

The immediate emergency management of low blood sugar, often involving the administration of glucose.

• Oral glucose for conscious patients able to swallow.
• IV Dextrose (D50) or Glucagon for unconscious/unable to swallow patients.
• Symptoms include altered mental status, diaphoresis, weakness, hunger.
• Blood glucose < 60-70 mg/dL is typically considered hypoglycemic.

Memory trick: Low sugar, confused mind? Give glucose, leave no one behind!

The application of firm, continuous pressure directly over a bleeding wound to compress the injured blood vessels and promote clotting.

• First-line treatment for most external bleeding.
• Effective for both venous and arterial bleeding.
• Requires a sterile dressing or clean cloth.

Memory trick: Don't Let Blood Flow! Pressure is the Key!

The emergency care for an object that has penetrated the body and remains in place, focusing on stabilization and prevention of further injury.

• Do NOT remove the object unless it obstructs airway or CPR.
• Stabilize the object in place with bulky dressings.
• Control external bleeding around the object.
• Rapid transport to a medical facility.

Memory trick: Impaled: Don't Pull, Just Pad!

For an unconscious diabetic patient with hypoglycemia, rapid administration of glucose is critical. If IV access is not available or within scope, intramuscular glucagon is the next best option.

• Blood glucose < 60 mg/dL is generally considered hypoglycemic.
• Oral glucose is only for conscious patients with intact gag reflex.
• IV D50 is the most rapid and effective treatment.
• IM glucagon mobilizes glucose from the liver and is a good alternative when IV access is delayed or impossible.

Memory trick: No swallow? Glucagon to the muscle, or D50 to the vein!

Conditions where oral glucose should not be administered, primarily related to the patient's ability to protect their airway.

• Unconsciousness
• Inability to swallow safely
• Known allergy to glucose

Memory trick: No Glucose If You Choke, Or Cannot Speak a Joke!

Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that primarily causes bronchodilation.

• Stimulates beta-2 receptors in bronchial smooth muscle.
• Causes relaxation of airway muscles.
• Leads to bronchodilation and improved airflow.
• A rescue medication for acute bronchospasm.

Memory trick: Albuterol's a 'beta-2' friend, making tight airways expand and mend.

Hyperventilation syndrome is characterized by rapid, deep breathing often triggered by anxiety, leading to excessive carbon dioxide exhalation, and symptoms like lightheadedness, tingling, and chest pain.

• Caused by a decrease in arterial carbon dioxide (respiratory alkalosis).
• Symptoms include paresthesias (tingling), lightheadedness, carpopedal spasms, and chest pain.
• Treatment focuses on calming the patient and coaching slow, controlled breathing.
• Rule out other serious causes before diagnosing hyperventilation syndrome.

Memory trick: Calm the breath, calm the mind, no bag to bind!

The practice of rotating between different fever-reducing medications (e.g., acetaminophen and ibuprofen) due to their distinct pharmacokinetic profiles, particularly their metabolic pathways.

• Acetaminophen: Primarily liver metabolism (CYP450 system).
• Ibuprofen: Primarily liver metabolism (different CYP450 enzymes) and renal excretion.
• Different pathways reduce competition for enzymes and cumulative toxicity.
• Allows for sustained fever control while minimizing risk of overdose of a single drug.

Memory trick: Acetaminophen's liver task, Ibuprofen's different metabolic mask.

Injury to the abdomen caused by a non-penetrating force, often leading to internal organ damage and hemorrhage.

• Common causes include MVCs, falls, assaults.
• Signs include pain, rigidity, distention, ecchymosis, signs of shock.
• Internal hemorrhage is a major concern.

Memory trick: Baseball Bat to Belly? Bleeding is Bad!

Emergency management of seizures in infants/children associated with high fever, prioritizing airway and breathing, followed by fever reduction and transport.

• Common in 6 months to 5 years.
• Often related to rapid temperature rise.
• Airway management and oxygenation are paramount.
• Cooling measures are important for fever reduction.

Memory trick: Airway First, Then Cool

Emergency care for a patient with a core body temperature below 95°F (35°C), focusing on preventing further heat loss and gentle rewarming.

• Remove wet clothing, wrap in dry blankets.
• Move gently to a warm environment.
• Avoid aggressive rewarming in the field.
• Monitor cardiac rhythm carefully.

Memory trick: Cold Patient: Move, Insulate, Be Gentle!

The calculation and administration of the correct volume of albuterol solution for nebulization based on the prescribed dose and available concentration.

• Standard pediatric dose: 2.5 mg.
• Albuterol solutions come in various concentrations.
• Often pre-measured vials contain 2.5 mg in 3 mL.
• Administered via nebulizer until the solution is consumed.

Memory trick: Desired over Have, times the Volume is the math to solve.

A set of three clinical signs that indicate increased intracranial pressure (ICP): hypertension (widening pulse pressure), bradycardia, and irregular respirations.

• Indicates severe brain compression.
• A late and ominous sign of increased ICP.
• Requires immediate intervention to prevent herniation.

Memory trick: Cushing's: Pressure Up, Heart Down, Breath Slow!

The standard and most effective route of administration for epinephrine in the emergency treatment of severe allergic reactions (anaphylaxis) in the prehospital setting.

• Intramuscular (IM) injection is preferred.
• Lateral thigh is the recommended site.
• Auto-injectors deliver a precise IM dose.
• Provides rapid systemic absorption and action.

Memory trick: Anaphylaxis needs IM, quick and sure, to open airways and secure.

A condition in which three or more adjacent ribs are fractured in two or more places, creating a free-floating segment of the chest wall that moves paradoxically during respiration.

• Hallmark sign: paradoxical chest wall motion.
• Causes severe pain and impaired ventilation.
• Often associated with underlying lung injury.
• Management includes pain control, positive pressure ventilation if needed.

Memory trick: Flail: Free Segment, Paradoxical Air!

The recommended initial dose of naloxone for reversal of opioid-induced respiratory depression in adults in the prehospital setting.

• Common initial doses: 2 mg IN or 0.4 mg IM
• Can be repeated every 2-3 minutes as needed
• Goal is to restore adequate respirations, not necessarily full consciousness

Memory trick: Naloxone for Numbness: Two in the Nose, or Point Four in the Muscle!

Management of acute chest pain in patients with recent cocaine use, which can lead to myocardial ischemia or infarction due to coronary vasoconstriction and increased myocardial oxygen demand.

• Cocaine increases risk of MI/ACS.
• 12-lead ECG is crucial for diagnosis.
• Nitroglycerin use is cautious/contraindicated.
• Benzodiazepines may be used for agitation and to reduce cardiac workload.

Memory trick: ECG First, Then Treat

A device used to immobilize and apply continuous traction to isolated mid-shaft femur fractures, reducing pain, muscle spasm, and further injury.

• Primarily for isolated mid-shaft femur fractures.
• Contraindicated if fracture extends into knee or hip, or if there are other lower leg injuries.
• Reduces muscle spasm and pain.

Memory trick: Splinting: Keep it Still, Reduce the Thrill!

Acute cholecystitis is the inflammation of the gallbladder, usually caused by gallstones blocking the cystic duct. It is often triggered by fatty meals.

• Primary symptom is severe, constant pain in the right upper quadrant.
• Pain may radiate to the right shoulder or back.
• Often associated with nausea, vomiting, and fever.
• Onset typically follows consumption of fatty foods.

Memory trick: Fatty meal, RUQ pain, shoulder ache? Think 'Gall'!

A life-threatening condition in elderly patients caused by severe fluid loss, often due to dehydration, leading to inadequate tissue perfusion.

• Elderly are prone to dehydration.
• Symptoms include dry skin, poor turgor, hypotension, tachycardia, altered mental status.
• Rapid recognition and fluid resuscitation are critical.

Memory trick: Dehydration Drains, Shock Remains

The therapeutic use of nitroglycerin to reduce fluid accumulation in the lungs (pulmonary edema), particularly in cardiac-related causes.

• Primary effect: Venodilation.
• Reduces preload (blood returning to heart).
• Decreases pulmonary capillary hydrostatic pressure.
• Alleviates fluid leakage into lung tissues.

Memory trick: Nitro opens veins wide, letting lung fluid subside.

The immediate priority in suspected opioid overdose with respiratory depression is to ensure adequate ventilation and oxygenation.

• Respiratory depression is the primary life threat.
• Assisted ventilations precede naloxone administration if breathing is inadequate.
• Pinpoint pupils are a classic sign of opioid overdose.

Memory trick: Breathe FIRST, then Reverse the Dose!

Cocaine use can lead to acute coronary syndromes, including myocardial infarction, due to its effects on vasoconstriction, increased heart rate and blood pressure, and enhanced platelet aggregation.

• Can occur in young, otherwise healthy individuals.
• Presents with typical cardiac chest pain symptoms.
• Often accompanied by hypertension and tachycardia.
• Requires aggressive management similar to other acute coronary syndromes.

Memory trick: Stimulants can 'Coke' your heart!

A state of extreme agitation, often associated with stimulant drug use or psychiatric conditions, characterized by high body temperature, violence, and resistance to restraint, requiring immediate focus on safety and controlled intervention.

• Scene safety is paramount.
• Patients can be extremely dangerous.
• Chemical restraint often necessary.
• High risk of sudden cardiac arrest.

Memory trick: Safety First, Then Care

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. Rupture can lead to life-threatening internal hemorrhage.

• Symptoms include unilateral lower abdominal pain, vaginal spotting/bleeding, and signs of hypovolemic shock if ruptured.
• Always consider in women of childbearing age with abdominal pain and a positive pregnancy test.
• A medical emergency requiring rapid transport and surgical intervention.

Memory trick: Pregnant pain, one side, bleeding, shock: Think OUTSIDE the uterus!

A designated location in a Mass Casualty Incident (MCI) where patients are rapidly assessed and categorized based on the severity of their condition to determine priority for treatment and transport.

• First point of patient contact after initial rescue.
• Uses a systematic method (e.g., START triage) to categorize patients.
• Helps allocate limited resources effectively during MCIs.

Memory trick: Triage Treats Staged Rehab

A competent adult patient's right to refuse medical care or transport, even if it is against medical advice, after being fully informed of the risks.

• Patient must be legally competent to refuse.
• EMT must explain risks, benefits, and alternatives.
• Documentation (AMA form) is critical for legal protection.
• Attempt to have a witness present and sign the form.

Memory trick: Refusal means Explain, Document, Witness, Consult.

The individual responsible for coordinating patient movement from the treatment area to receiving hospitals during a Mass Casualty Incident (MCI).

• Communicates with hospitals to determine bed availability.
• Ensures patients are transported efficiently.
• Maintains a log of patient destinations and tracking information.

Memory trick: Triage tags, Treatment fixes, Transport ships, Staging waits.

A legal doctrine where an individual, not a biological parent or legal guardian, assumes the parental rights and responsibilities for a minor.

• Allows for consent for medical treatment of a minor.
• Applies to teachers, camp counselors, or babysitters.
• Requires the parent/guardian to be absent and the minor to need care.

Memory trick: Parents permit, Loco acts, Emancipated decides.

The choice of healthcare facility for patient transport, based on patient condition, mechanism of injury/nature of illness, and facility capabilities.

• Primary consideration is the patient's medical needs.
• Emergency departments are equipped for definitive care of most acute conditions.
• Trauma centers for severe trauma, stroke/cardiac centers for specialized conditions.

Memory trick: Condition, Capabilities, Coverage, Closest.

A designated location at a Mass Casualty Incident where arriving resources (personnel, ambulances, equipment) are gathered, organized, and prepared for deployment.

• Managed by a Staging Officer.
• Ensures organized deployment of resources.
• Helps prevent freelancing and congestion at the incident scene.

Memory trick: Commander leads, Triage sorts, Treatment heals, Staging gathers.

The right of a stable patient to choose their receiving hospital, provided the facility is appropriate for their condition and transport time does not pose a risk.

• Applies primarily to stable patients with non-life-threatening conditions.
• The requested hospital must be capable of providing appropriate care.
• If the patient is unstable or the requested hospital is inappropriate, EMS typically transports to the closest appropriate facility.

Memory trick: Stable Patients Choose, Unstable Closest Needs

Specific personal protective equipment required to protect against diseases transmitted by airborne particles (e.g., tuberculosis, measles).

• Primary protection is an N95 or higher-level respirator.
• Also includes standard precautions like gloves and eye protection.
• Patient should wear a surgical mask if tolerated.

Memory trick: Gloves Goggles Mask Gown

The principle that EMS personnel must ensure the scene is free from threats, especially from agitated or violent patients, before entering to provide care.

• Law enforcement should secure violent or agitated patients.
• EMT safety takes precedence over patient care in an unsafe environment.
• Never enter an unsecured scene with known threats.

Memory trick: Your safety first, then patient, then bystanders, then property.

EMTs may assist patients in taking their OWN prescribed medications (e.g., epinephrine, nitroglycerin, inhalers) if authorized by medical direction and certain conditions are met.

• Patient must be prescribed the medication.
• EMT typically helps guide the patient, not directly administer.
• Medication must be indicated for the current condition.
• EMT must check the '5 Rights' before assisting.

Memory trick: My Patient Needs Help, so I 'Assist' them to 'Self-Administer'.

The systematic process of identifying and correcting life-threatening conditions in a patient.

• Performed immediately after scene safety.
• Focuses on airway, breathing, and circulation (ABCs).
• Determines patient's priority for transport.

Memory trick: Safety First, Then Primary, Secondarily Look, Finally Transport.

Ensuring the safety of EMS personnel, the patient, and bystanders from electrical hazards, especially downed power lines, before initiating patient care.

• Never approach a vehicle with downed power lines until the power is confirmed off.
• Establish a safe zone (e.g., one full span of utility pole away).
• Call for the power company and fire department for assistance.

Memory trick: Your Safety First, Then Crew, Then Patient, Then Public.

Objective documentation includes factual, observable, and measurable data, while subjective documentation includes information directly stated by the patient or bystanders.

• Both types of information are crucial for a complete PCR.
• Discrepancies should be documented factually without judgment.
• Objective findings can include vital signs, physical exam findings, and observed medications.

Memory trick: Factual, Objective, Complete, Timely, and Legible documentation is key.

The paramount importance of identifying and mitigating electrical hazards before approaching a scene or patient to ensure the safety of EMS personnel and bystanders.

• Downed power lines are extremely dangerous and can energize vehicles and ground.
• Assume all downed lines are live.
• Establish a safe zone (typically one full span of utility poles away) and await utility company.

Memory trick: See Sparks, Stay Safe, Call Experts

The primary method for transmitting vital patient information, coordinating resources, and communicating with medical control and other agencies within EMS.

• Uses dedicated frequencies for emergency services.
• Requires clear, concise, and professional language.
• Essential for scene management, patient care, and transport logistics.

Memory trick: Radio for rapid, Phone for private, Report for record.

Specific personal protective equipment used to prevent transmission of diseases spread by airborne particles, such as tuberculosis.

• Requires an N95 respirator or higher-level mask.
• Also includes standard precautions like gloves and eye protection.
• Patient should wear a surgical mask if tolerated.

Memory trick: Standard for all, Droplet for coughs, Airborne for tiny, Contact for touch.

A Do Not Resuscitate (DNR) order must be physically present, valid, and clearly identify the patient to be honored by EMS personnel.

• Verbal statements are generally insufficient for honoring a DNR.
• If no valid DNR is present, full resuscitation efforts must be initiated.
• Contact medical control if there are questions or ambiguities.

Memory trick: Physical paper, patient match, physician's signature, no doubt.

A structured method for providing a concise, yet comprehensive, patient report to medical control or the receiving facility via radio.

• Includes unit ID, patient age/sex, chief complaint, vital signs, pertinent history, interventions, and ETA.
• Often uses mnemonics like MIST (Mechanism, Injuries, Signs/Symptoms, Treatment) or a modified SAMPLE.
• Focuses on critical information for handoff and preparation.

Memory trick: Unit, Age, Chief, Vitals, History, Treatment, ETA - Don't forget history!

EMTs may assist patients in self-administering certain prescribed medications under specific conditions and protocols.

• Medication must be prescribed to the patient.
• Patient must be able to self-administer or be assisted by the EMT.
• Commonly assisted medications include epinephrine auto-injectors, nitroglycerin, and inhalers.

Memory trick: Prescribed Patient Proper Protocol

Subjective data are symptoms reported by the patient, while objective data are signs observed or measured by the EMT.

• Subjective: 'Patient states...' or 'Patient complains of...'
• Objective: 'Patient's skin is pale and clammy,' 'BP 120/80.'
• Both are crucial for a complete patient assessment and documentation.

Memory trick: Subjective Speaks, Objective Observes

A Do Not Resuscitate (DNR) order only prohibits specific life-sustaining interventions explicitly listed, such as CPR or intubation, and does not preclude other medical care aimed at comfort or symptom relief.

• DNRs are specific; if an intervention isn't listed, it's generally permitted.
• Patients with DNRs still receive comfort care, oxygen, pain management, and transport.
• EMTs should err on the side of providing care if the DNR is ambiguous or incomplete regarding certain interventions.

Memory trick: DNR means NO to some, YES to comfort, and transport if not forbidden.

A concise, structured communication format used by EMS to report essential patient information to the receiving hospital.

• MIST stands for Mechanism/Medical, Injuries/Illness, Signs/Symptoms, Treatment.
• Often includes age, gender, chief complaint, mental status, and ETA.
• Designed for brevity and critical information transfer.

Memory trick: Age, Chief, Status, Vitals, ETA. MIST it up!

Information that is measurable and observable by the EMT or others, forming factual evidence.

• Based on facts, not opinions or interpretations.
• Can be seen, heard, felt, or smelled.
• Examples include vital signs, physical exam findings, and observable behaviors.

Memory trick: Objective is 'O' for 'Observable,' Subjective is 'S' for 'Spoken.'

Management of acute decompensated heart failure with pulmonary edema primarily involves improving oxygenation, reducing preload, and supporting cardiac function.

• High-flow oxygen administration.
• Positioning (Fowler's/semi-Fowler's) to reduce work of breathing.
• Consider CPAP if available and indicated.
• Diuretics (e.g., furosemide) and vasodilators (e.g., nitroglycerin) may be administered by ALS.

Memory trick: Fluid in lungs? Sit them up, pump in O2!

Aortic dissection is a surgical emergency characterized by sudden severe tearing pain, often with unequal pulses/blood pressures; immediate rapid transport is critical.

• High mortality if not treated surgically.
• Key signs: sudden severe tearing pain, pulse/BP deficits.
• Prehospital care focuses on rapid identification and transport.

Memory trick: Aorta tears, pulses unequal, time is a race – GO FAST!

The role of epinephrine as a universally indicated medication in advanced cardiac life support for all non-traumatic cardiac arrest rhythms.

• Vasoconstrictor (alpha-adrenergic effects).
• Increases myocardial and cerebral blood flow during CPR.
• Administered 1 mg IV/IO every 3-5 minutes.
• Indicated for VF, pVT, asystole, and PEA.

Memory trick: Epi for all, stand tall, make the heart recall!

When an Automated External Defibrillator (AED) indicates 'No Shock Advised,' it means the patient's cardiac rhythm is not a shockable rhythm (e.g., asystole or pulseless electrical activity).

• Indicates non-shockable rhythm (asystole/PEA).
• Requires immediate resumption of chest compressions.
• Minimizes interruptions in CPR.

Memory trick: No shock, no stop, just keep the beat!

Emergency treatment for a slow heart rate (usually <50 bpm) that causes signs of instability (e.g., hypotension, altered mental status, signs of shock, ischemic chest discomfort, acute heart failure).

• Recognize symptomatic bradycardia with instability.
• Administer Atropine (if available and not contraindicated).
• Prepare for transcutaneous pacing (TCP) if Atropine is ineffective or not indicated.
• Consider epinephrine or dopamine infusion if pacing fails or is unavailable.

Memory trick: Slow and low, if they're crashing, start the pacing, get them flashing!

The recommended depth for chest compressions during adult CPR is at least 2 inches (5 cm) and no more than 2.4 inches (6 cm).

• Essential for adequate blood flow to vital organs.
• Too shallow, and blood flow is insufficient.
• Too deep, and injuries can occur.

Memory trick: For adults, think 'Two to the chest, but no more than two point four, to keep them alive and wanting more!'

The specific steps to follow when an Automated External Defibrillator advises a shock.

• AED analyzes rhythm first.
• If shockable, AED advises shock.
• Clear patient and surroundings.
• Deliver shock.

Memory trick: Clear, Shock, Then compressions, don't block!

The number of chest compressions performed for every set of rescue breaths during cardiopulmonary resuscitation (CPR) for an adult.

• For single-rescuer adult CPR, the ratio is 30:2.
• Compressions should be at least 2 inches deep.
• Rate of 100-120 compressions per minute.
• Minimize interruptions to compressions.

Memory trick: Adult's arrest, 30-2 is best!

A state of inadequate tissue perfusion due to severe cardiac pump failure, often caused by a large myocardial infarction.

• Caused by heart's inability to pump enough blood.
• Commonly follows a large heart attack.
• Signs: hypotension, tachycardia, altered mental status, cool/clammy skin, pulmonary edema.
• Treatment focuses on improving cardiac output and maintaining perfusion.

Memory trick: H-C-O-D, the types of shock you see!

Pericarditis is inflammation of the pericardium, often causing sharp, pleuritic chest pain that may be relieved by leaning forward and worsened by deep breaths/coughing, often preceded by a viral illness.

• Pleuritic chest pain is a key feature.
• Pain often improves when leaning forward.
• Often follows a viral infection.

Memory trick: Sharp pain with every breath, after a bug, think 'Pericarditis is rough!'

Identification of a life-threatening condition where air enters the pleural space, cannot escape, and builds up pressure, collapsing the lung and shifting mediastinal structures.

• Unilateral absent or severely diminished breath sounds.
• Tracheal deviation away from the affected side.
• Jugular venous distention (JVD).
• Hypotension, tachycardia, severe dyspnea.

Memory trick: No breath, neck veins swell, trachea shifts, a tension spell!