NREMT Paramedic flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Oropharyngeal airway use

Inserted in an unresponsive patient who has no gag reflex; it lifts the tongue off the posterior pharynx. It is contraindicated when the patient has an intact gag reflex.

Nasopharyngeal airway contraindication

Avoid with severe midface fractures or suspected basilar skull fracture because the tube could enter the cranial vault; use cautiously with coagulopathy or significant nasal obstruction.

Adult BVM without reservoir

Delivers only about 21% oxygen through room-air entrainment; adding a reservoir and 15 L/min flow raises the delivered oxygen concentration to nearly 100%.

Ventilation rate with advanced airway

During cardiac arrest with an endotracheal tube or supraglottic device, give one breath every 6 seconds (10 per minute) without pausing chest compressions.

End-tidal CO2 normal range

A normal capnography reading is 35 to 45 mmHg. A sudden drop toward zero suggests tube dislodgement, while a rise during CPR suggests return of spontaneous circulation.

ET tube depth adult

Average adult oral intubation depth is 21 to 23 cm at the incisors for men and 20 to 21 cm for women; confirm with waveform capnography and bilateral breath sounds.

CPAP contraindications

Do not use in patients who are hypotensive, have altered mental status or cannot protect their airway, or who have facial trauma or an untreated pneumothorax.

Adult compression depth

Push at least 2 inches (5 cm) but no more than 2.4 inches (6 cm) at 100 to 120 per minute, allowing full chest recoil between compressions.

Compression-to-ventilation ratio

Use 30:2 for a single rescuer of any age and for two-rescuer adult resuscitation; use 15:2 for two-rescuer child and infant resuscitation.

Biphasic defibrillation energy

The initial biphasic shock for ventricular fibrillation or pulseless VT is 120 to 200 joules per the manufacturer recommendation; monophasic devices use 360 joules.

Cardiac arrest epinephrine dose

Give 1 mg of epinephrine 1:10,000 IV or IO every 3 to 5 minutes during cardiac arrest, regardless of whether the presenting rhythm is shockable.

Adenosine SVT dosing

For stable narrow-complex SVT give 6 mg rapid IV push followed by a saline flush; if the rhythm does not convert, give a single 12 mg dose.

Amiodarone refractory VF dose

Give 300 mg IV/IO push for ventricular fibrillation or pulseless VT that persists after defibrillation, followed by a second dose of 150 mg.

Inferior STEMI leads

ST elevation in leads II, III, and aVF indicates inferior injury, often from right coronary artery occlusion; obtain right-sided leads to assess right ventricular involvement.

Beck triad

Hypotension, distended neck veins, and muffled heart sounds indicate cardiac tamponade; treatment is rapid transport, with pericardial decompression reserved as a field last resort.

Needle decompression site

Insert a large-bore needle at the second intercostal space in the midclavicular line, or the fifth intercostal space at the anterior axillary line, for tension pneumothorax.

Rule of nines adult

Head 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, and perineum 1% are used to estimate partial- and full-thickness burn surface area.

Tourniquet placement

Apply 2 to 3 inches proximal to the wound, never directly over a joint, and tighten until hemorrhage stops; record the time the tourniquet was applied.

Class III hemorrhage signs

Blood loss of 30 to 40% of volume produces tachycardia, marked hypotension with narrowed pulse pressure, tachypnea, and confusion as compensatory mechanisms begin to fail.

Pelvic binder placement

Center the binder over the greater trochanters and tighten it symmetrically to reduce pelvic volume and limit bleeding in a suspected unstable pelvic fracture.

Sucking chest wound

Cover the wound with a vented or three-sided occlusive dressing, then monitor closely for tension pneumothorax, which requires immediate needle decompression.

Hypoglycemia treatment

For a blood glucose below 70 mg/dL with symptoms, give oral glucose if the patient can swallow; otherwise give dextrose IV/IO or glucagon intramuscularly.

Anaphylaxis epinephrine dose

Adults receive 0.3 mg of 1:1000 epinephrine IM in the anterolateral thigh; children receive 0.15 mg; repeat every 5 to 15 minutes as needed.

Status epilepticus definition

Continuous seizure activity, or repeated seizures without regaining consciousness, lasting more than 5 minutes; first-line treatment is a benzodiazepine such as midazolam.

Stroke thrombolytic window

Intravenous thrombolysis may be given up to 4.5 hours from the last known well time, so document exactly when the patient was last seen normal.

Cincinnati Prehospital Stroke Scale

Tests for facial droop, arm drift, and abnormal speech; any single abnormal finding makes stroke likely and warrants transport to a stroke center.

Naloxone route and dose

Give 2 mg intranasally or 0.4 to 2 mg IV/IO for suspected opioid overdose with respiratory depression, titrating to adequate breathing rather than full wakefulness.

START triage assessment

Rapid triage assigns categories based on ability to walk, breathing, perfusion, and mental status, aiming to sort each patient in under 30 seconds.

Triage tag colors

Red indicates immediate, yellow delayed, green minor or walking wounded, and black deceased or expectant; gray is sometimes used for no treatment possible.

Hazmat hot zone entry

Only responders trained in hazardous materials response and wearing appropriate chemical protective clothing enter the hot zone; the warm zone is for decontamination.

Incident command span of control

One supervisor should manage roughly 3 to 7 subordinate elements; beyond that the span of control is exceeded and the organization must be divided.

Helicopter landing zone size

A landing zone should be at least 100 by 100 feet, flat, free of loose debris, and secured from bystanders, vehicles, and overhead wires.