Based on chapter 9 and 10 of Nancy Carolines emergency care in the streets.
Decreased systemic vascular resistance
Circulation through the pulmonary system
Increased blood flow through the placenta
Increased pulmonary vascular resistance
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Were too forceful
Caused gastric distention
Were too slow for the infants age
Did not produce visible chest rise
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12 months
18 months
24 months
36 months
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Track objects with his or her eyes
Differentiate family from strangers
Respond when his or her name is called
Sit upright in a chair unassisted
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Hugged
Punished
Carried
Rejected
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They put things in their mouths
They do not produce antibodies
Of a loss of passive immunity
They are exposed to other children
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Act almost purely to avoid punishment
Make decisions guided by their conscience
Act out so that they can get what they want
Seek approval from their peers and society
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Girls typically experience a growth spurt later in life that boys do
Blood volume typically remains unchanged during a growth spurt
Boys generally experience this stage of growth later in life than girls do
When this period of growth has finished, girls are generally taller than boys
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Work
Stress
Family
Anxiety
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Overall health
Living conditions
Medications taken
Past medical history
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Increased,decreases
Decreases,decreases
Decreases,increases
Increases, increases
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Age-related shrinkage of the brain stretches the bridging veins that return blood from the brain to the dura mater
Older adults experience an increase in intracranial blood flow as well as predisposition to falls
Excessive alcohol use. which is very common in older adults. causes the brain to atrophy prematurely
Age-related hypertension weakens the cerebral veins, which predisposes them to damage from even minor trauma
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Is more likely to provide competent care
Inspires confidence in his or her patients
Will be respected by his or her coworkers
Is less likely to be held liable for negligence
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Sympathy
Active listening
Passive communication
An exchange of information
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Move the patient to the ambulance as soon as you can
Tell noisy patrons or bystanders to be quiet or leave
Yell info the patient's ear so he or she can hear you
Find the source of the noise and remove it if possible
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Ask the patient if her or her spouse is okay
Use a calm and steady tone of reassurance
Tell him or her that everything will be okay
Repeat the patient's statement's word for word
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Address the patient by his or her first and last name
Put the patient at easy by calling him or her dear
Use the patient's first name to allay his or her anxiety
Ask the patient how he or she wishes to be addressed
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How did you feel when you woke up today
Is there anything you would like to discuss
Can you described the pain you are feeling
Does the pain radiate to your arm or jaw
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The situation appears grim, but you should not lose all hope
It is possible, and you should prepare yourself for the worst
That question is best answered by the physician at the hospital
He is very sick, but we are doing everything we can to help him
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Maintain eye contact
Use complicated medical terminology
Answer the patient's questions truthfully
Treat him or her as one of your loved ones
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Touch the patient on a neutral part of his or her body
Touch the patient in the center of the chest or on the thigh
Remember that most patients take offence to being touched
Not touch the patient if he or she leans toward the paramedic
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Give consent for any and all treatment
Forsake his or her own personal beliefs
Take your advice instead of a loved ones
Be reassured that you will handle the crisis
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You should suspect deceased blood flow to the brain
He or she is most likely scared and unable to remember
He or she likely has an intracerebral hemorrhage or lesion
You should ask him or her questions that require more thought
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Suspect that the patient has a psychiatric illness and be prepared for him or her to become violent
Respect the patient's silence and explain everything that you are doing to his or her family member
Maintain eye contact and let the patient know that it's all right if he or she does not wish to speak
Advise the parient that his or her silence will only hamper your ability to determine whats wrong
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Many older patients lose the ability to understand simple terminology, thus requiring the paramedic to gear his or her questions accordingly
Their illnessess may be more complex because they may have more than one disease process and may be taking several medications concurrently
The ability to hear and see is naturally impaired due to the process of aging, and the paramedic must accommodate these disabilities appropriately
Older patients are generally poor historians regarding their medical history, and the paramedic should interview a family member or friend instead
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Agree with the patient's cultural differences
Know the specifics about the patient's culture
Treat the patient with utmost respect at all times
Use his or her own culture as the sole reference
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Ensure you stretch the skin taunt
Inquire about any medication allergies
Look in the barrel of the syringe for blood
Pull back on the plunger to aspirate for blood
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With inadequate peripheral perfusion
Who are morbidly obese or very thin
Who require less than 5 mL of a drug
With a systolic BP greater than 140 mm Hg
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Cause the medication to enter the patient's central circulation rapidly
Result in too much of the medication entering the patient's circulation
Cause the medication to flow up the tubing and away from the patient
Negate the need to follow the IV bolus with a 20 mL normal saline flush
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Add 100 mL of sterile saline to dilute the premixed medication
Draw 20 mL of fluid from the premixed solution to use as a flush
Be aware of the concentration of the drug in the premixed solution
Use the drug within 36 hours removing it from its foil covering
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Rapid administration of any drug you give
Placing a pressure infuser device around the IV bag
Flushing with 20 mL of saline after the drug is given
Clamping off the tubing proximal to the injection port
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Scar tissue under the patch
Peripheral vascular disease
A low systolic blood pressure
Skin that is thin or nonintact
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Narcan is the only emergency medication that can be administered intranasally with the MAD
The MAD is used to inject a straight stream of select emergency drugs directly into the nasal canal
When administering a drug with the MAD , you should spray half the dose into each nostril
Drugs administered with the MAD have an onset of action that is slightly lower than the intramuscular route
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Proventil
Albuterol
Isoetharine
Ipratropium
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Subcutaneous, intramuscular, sublingual, inhalation, intravenous
Intramuscular, sublingual, subcutaneous, intravenous, inhalation
Intravenous, inhalation, sublingual, subcutaneous, intramuscular
Subcutaneous, sublingual, inhalation, intramuscular, intravenous
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Apply downward manual traction below the venipuncture site to stabilize the vein in position
Apply the constricting band to a distal location
Use a through-the-needle IV catheter in order to gain better control over the rolling vein.
Place a chemical heat pack over the vein for 10 minutes in order to decrease movement of the vein
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Gently manipulate the catheler and reassess the flow
Discontinue the IV and reestablish it in the other arm
Ensure that the constricting band has been removed
Use a pressure infuser device to improve the IV flow
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An air embolus
An allergic reaction
Circulatory overload
A pyrogenic reaction
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Extravasation due to an inappropriate angle of IO catheter insertion
Inadvertent entry of a large vein, causing infiltration
Fracture of the bone with leakage of bone marrow into the soft tissue
Acute osteomyelitis secondary to inappropriate cleansing of the site
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5.5
6.2
6.5
6.8
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contact your medical director at once
Ask the physician to repeat the order
Refuse to administer the ordered dose
Confirm the correct dose in your field guide
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The patient may require another dose of the same drug
The dose was too low for the patient's clinical condition
The IV tubing was occluded proximal to the injection port.
You diluted the bolus by following it with a 20 mL saline flush
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Instruct the patient not to bear down
Use a large uncuffed endotracheal tube
Ensure that the patient is fully conscious
Recall that the rectal musoca are relatively avascular
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Toxic ingestion in patients with a depressed swallowing mechanism
In the absence of vascular access in a patient who is clinically unstable
Acute overdose to lavage the stomach and prevent ingestion of the drug
To instill nutritional substances in patients who cannot swallow effectively
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Intraosseous
Intravenous
Percutaneous
Intramuscular
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The needle gauge that you will need and the appropriate size syringe
How much of the drug is needed and how many doses are in the vial
If the medication has completely settled to the base of the container
The appropriate amount of air that you will need to inject into the vial
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It does not require you to draw up each individual medication dose
They are made of plastic and are less likely to break or get damaged
There is no need to expel air from the syringe prior to giving the drug
All of the contents of a prefilled syringe are administered at one time
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A subcutaneous injection involved using a 20 or 21 gauge needle
The needle is inserted at a 90 degree angle during a subcutaneous injection
Volumes of a drug given subcutaneously are typically 1 mL or less
The rectus femoris muscle is a common site for subcutaneous injections
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