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 Contents
Preface and How to Use These Cards
Acknowledgments
Section 1: Preparatory
EMS Systems
Workforce Safety and Wellness
Medical, Legal, and Ethical Issues
Communications and Documentation
The Human Body
Life Span Development
Section 2: Pharmacology
Principles of Pharmacology
Section 3: Patient Assessment
Patient Assessment
Section 4: Airway
Airway Management
Section 5: Shock and Resuscitation
Shock and BLS Resuscitation
Section 6: Medical
Medical Overview
Respiratory Emergencies
Cardiovascular Emergencies
Neurologic Emergencies
Gastrointestinal and Urologic Emergencies
Endocrine and Hematologic Emergencies
Immunologic Emergencies
Toxicology
Psychiatric Emergencies
Gynecologic Emergencies
Section 7: Trauma
Trauma Overview
Bleeding
Soft Tissue Injuries
Face, Eye, and Neck Injuries
Head and Spine Injuries
Chest Injuries
Abdominal and Genitourinary Injuries
Orthopedic Injuries
Environmental Injuries
Section 8: Special Patient Populations
Obstetrics and Neonatal Care
Pediatric Emergencies
Geriatric Emergencies
Special Challenge Patients
Section 9: EMS Operations
Incident Management
Terrorism Response and Disaster Management
 Preface and How to Use These
Cards
Using flashcards is a very effective strategy for studying. Flashcards
are two-sided study aids that have a cue, a question, a concept on
one side, and the answer on the other or opposite side. You should
read all of the flashcards and divide them into 3 groups or
categories. Group 1 should be the cards with questions that you are
confident in your knowledge to answer. Group 2 should be cards
with questions to which you know some or part of the answers.
Group 3 should be the cards with questions to which you do not
know the answers at all.
Start with the Group 3 cards, focusing on understanding why the
answer is what it is and refer to your class notes and textbooks.
Once you become confident in answering these cards, move them
over to the Group 2 pile. Once all of your Group 3 cards have been
moved over to your Group 2 pile, begin working on your Group 2
pile. Once you become confident in answering these cards, move
them over to the Group 1 pile. Once all of your Group 2 cards have
been moved over to your Group 1 pile, begin working on your Group
1 pile.
Focus on filling the gaps in your knowledge when using these
study cards. Remember to allot time for studying and give yourself
plenty of rest before an examination.
I hope you will share your comments about these cards,
especially the ways you prefer to use them, so that we can make
improvements for the next edition.

Peter A. DiPrima, Jr., EMT-Paramedic/CIC

p.diprima@hotmail.com
 Scott S. Coyne, MD
docscott@optonline.net
 Acknowledgments
Dedicated to my wonderful family.

PAD
 Section 1: Preparatory
EMS Systems

Matching
a. An individual who has extensive training in
advanced life support, including
endotracheal intubation, emergency
1. Medical pharmacology, cardiac monitoring, and
director advanced assessment and treatment skills.
2. Paramedic b. Federal legislation passed in 1996 that
3. EMT limits availability of patients’ health care
information.
4. HIPAA
c. The physician who authorizes or delegates
5. Patient
to the EMT, the authority to provide medical
advocacy
care.
6. Online
d. Protection of patient rights.
medical
direction e. Individual who has training in basic life
support, including AED, use of definitive
7. Offline
airway adjuncts, and assisting patients with
medical
certain medications.
direction
f. Physician instructions given directly over the
phone or radio.
g. Protocols/standing orders.
1. Medical director: (c) The physician who authorizes or delegates
to the EMT, the authority to provide medical care.
2. Paramedic: (a) An individual who has extensive training in
advanced life support, including endotracheal intubation,
 emergency pharmacology, cardiac monitoring, and advanced
assessment and treatment skills.
3. EMT: (e) Individual who has training in basic life support,
including AED, use of definitive airway adjuncts, and assisting
patients with certain medications.
4. HIPAA: (b) Federal legislation passed in 1996 that limits
availability of patients’ health care information.
5. Patient advocacy: (d) Protection of patient rights.
6. Online medical direction: (f) Physician instructions given directly
over the phone or radio.
7. Offline medical direction: (g) Protocols/standing orders.

Quality improvement (QI) is a system of internal/external reviews

and audits of all aspects of an EMS system. QI is important to an
EMS system to identify aspects needing improvement; this ensures
that the public receives the highest quality of prehospital care. List
the roles EMTs play in QI.

• Neat, legible, and accurate documentation

• Attending continuing medical education (CME) that includes run
review and call audits
• Gathering feedback from patients and hospital staff
• Conducting preventive maintenance
• Maintaining mastery of skills performance

Workforce Safety and Wellness

Matching
1. Posttraumatic a. (“Not me.”): Defense mechanism
stress disorder creating a buffer between shock of
(PTSD)
 2. Infection control dying and dealing with the
3. Bargaining illness/injury.
4. Denial b. (“Why me?”): EMTs may be the target
of aggression.
5. Acceptance
c. (“OK, but first let me …”): Agreement
6. Depression
that, in the patient’s mind, will
7. Anger postpone death for a short time.
d. (“OK, I am not afraid.”): Does not
mean the patient will be happy about
dying. The family will usually require
more support during this stage than
the patient.
e. (“OK, but I haven’t …”): Characterized
by sadness and despair. The patient is
usually silent and retreats into his own
world.
f. Delayed stress reaction.
g. Procedures to reduce transmission of
infection among patients and health
care personnel.
1. Posttraumatic stress disorder: (f) Delayed stress reaction.
2. Infection control: (g) Procedures to reduce transmission of
infection among patients and health care personnel.
3. Bargaining: (c) (“OK, but first let me …”): Agreement that, in the
patient’s mind, will postpone death for a short time.
4. Denial: (a) (“Not me.”): Defense mechanism creating a buffer
between shock of dying and dealing with the illness/injury.
5. Acceptance: (d) (“OK, I am not afraid.”): Does not mean the
patient will be happy about dying. The family will usually require
more support during this stage than the patient.
6. Depression: (e) (“OK, but I haven’t …”): Characterized by
sadness and despair. The patient is usually silent and retreats into
 his own world.
7. Anger: (b) (“Why me?”): EMTs may be the target of aggression.

Medical, Legal, and Ethical Issues

Matching
1. Abandonment a. Care that an EMT is able to provide.
2. Duty to act b. Legal responsibility to provide care.
3. Expressed c. Unilateral termination of care.
consent d. Specific authorization to provide care
4. Implied consent expressed by the patient.
5. Negligence e. Legal assumption that treatment was
6. Standard of care desired.
7. Scope of f. Failure to provide the standard of care.
practice g. Accepted level of care.
1. Abandonment: (c) Unilateral termination of care.
2. Duty to act: (b) Legal responsibility to provide care.
3. Expressed consent: (d) Specific authorization to provide care
expressed by the patient.
4. Implied consent: (e) Legal assumption that treatment was
desired.
5. Negligence: (f) Failure to provide the standard of care.
6. Standard of care: (g) Accepted level of care.
7. Scope of practice: (a) Care that an EMT is able to provide.

Define abandonment.
Abandonment is leaving a patient, for whom you have an
established duty to act, without the consent of the patient or
arranging for transfer of patient care to another medical provider
trained to the same level (or higher) as you. Once you have an
established duty to act, you cannot leave, for any reason (short of
protecting your own life), without that consent or transfer of patient
care.

Define negligence.
Negligence is a failure to provide the level of care for which you
are responsible. Four elements must have occurred for the legal
determination of “negligence” to be reached:
1. There must have been a duty to act;
2. There must have been a breach of that duty, in whole or in part;
3. There must have been some injury or loss;

and

4. There must be a reasonable connection between the breach of

duty and the injury or loss.

Define dependent lividity.

After a person has died and circulation stops, the blood begins to
pool in the dependent areas (areas on the bottom part of the body
in the position of death). This is called dependent lividity and
starts within a few minutes after death, beginning in the extremities
and progressing to the rest of the body.
Lividity appears as a discoloration, resembling a blotchy black-
and-blue or reddish mark. As time passes, the discoloration becomes
more widespread and pronounced. It is caused when red blood cells
in the blood vessels settle down to the lower areas of the body. This
color change is less striking in skin with dark pigmentation. Lividity is
also called livor mortis.

Define rigor mortis.

Over the first few hours after death, chemical changes occur in the
cells of the body. Muscle cells contract and stay contracted, causing
a rigidity known as rigor mortis. This stiffening of the body begins
with small muscles, including those of the fingers, neck, and jaw,
and progresses to the extremities and pelvis.
As still more time passes (12 hours or longer), the protein in the
muscles degrades, causing the stiffening to relax and the body to
become limp.

Explain the reasons for withholding

resuscitation.
You may withhold or stop resuscitation if any of the following are
present:
• Injuries incompatible with life (decapitation)
• Advance directive (do not resuscitate, medical orders for life-
sustaining treatment, etc.) stating resuscitation should be withheld
• Dependent lividity, rigor mortis

List some do not resuscitate (DNR)

caveats.
• Do not resuscitate (DNR) means, for the patient in cardiac or
respiratory arrest, no chest compressions, ventilation, defibrillation,
endotracheal intubation, or medications.
• If the patient is not in cardiac or respiratory arrest, full treatment
for all injuries, pain, difficult or insufficient breathing, hemorrhage,
and/or other medical conditions must be provided.
• Relief of choking caused by a foreign body is usually appropriate,
although if breathing has stopped, ventilation should not be
assisted.
• Cardiopulmonary resuscitation (CPR) must be initiated if no out-of-
hospital or facility DNR is presented. If a DNR order is presented
after CPR has been started, stop CPR.

One of the EMT roles and responsibilities

is patient advocacy. This means that, as
the emergency care provider, the EMT is
responsible for what?
Protecting the patient’s rights

Communications and Documentation

Across
1. Transmission of information to another person—verbally or
through body language.
2. A base station that receives messages and signals on one
frequency and automatically retransmits them on a second
frequency.
3. Small computer terminals inside ambulances that directly receive
data from the dispatch center.
4. The use of a radio signal and a voice or digital message
transmitted to “beepers.”
5. Encouraging the patient to talk more or provide more
information.
6. Type of question that allows the patient to answer in very short
responses.

Down
1. Federal agency that has jurisdiction over interstate
communications.
2. Type of question that allows the patient to answer in detail.
3. Radio frequencies between 300 and 3000 MHz.
4. A document that ensures continuity of patient care.
5. Ability to transmit and receive simultaneously.

Direct telephone or radio contact with a

physician to obtain guidance in
emergency care is called?
Online medical direction

The Human Body

 Identify the 2 gases that are exchanged
during breathing.
Oxygen (O2) and carbon dioxide (CO2)

The human body consists of how many

bones?
There are 206 bones in the human body.

Describe the regulation of ventilation.

Although breathing can be altered voluntarily, it is primarily
controlled involuntarily by the autonomic nervous system. A large
part of the regulation is related to maintaining normal gas exchange
and normal blood gas levels. Receptors within the body constantly
measure the amount of oxygen (O2), carbon dioxide (CO2), and
hydrogen ions (pH) and signal the brain to adjust the rate and depth
of respiration. Centers responsible for ventilatory control are the
chemoreceptors, lung receptors, and specialized centers in the
brainstem.

What is the function of chemoreceptors?

Chemoreceptors are specialized receptors that monitor the number
of hydrogen ions (pH), and the carbon dioxide and oxygen levels in
the arterial blood. There are 2 different types of chemoreceptors:
central and peripheral.
 Define hypoxic drive.
A person’s ventilation is normally controlled by the strong stimulus
provided by the amount of CO2 in the arterial blood. This is referred
to as a hypercapnic drive or hypercarbic drive. However, some
patients with chronic obstructive pulmonary disease (COPD), such as
emphysema or chronic bronchitis, have a tendency to retain CO2 in
their arterial blood from poor gas exchange. Because the CO2 level is
chronically elevated, the central chemoreceptors become
desensitized to fluctuations that typically would stimulate a change
in the rate or depth of ventilation. Because of the desensitization of
the central chemoreceptors, the peripheral chemoreceptors become
the primary stimulus to control ventilation. Thus, hypoxia, rather
than CO2, becomes the stimulus for the person to breathe; this is
referred to as a hypoxic drive.

Name 3 receptors that are located in the

lungs.
Three different types of receptors are found within the lungs:
irritant receptors, stretch receptors, and J-receptors.
The irritant receptors are found in the airways and are
sensitive to irritating gases, aerosols, and particles. Irritant receptors
will cause a cough, bronchoconstriction, and an increase in the rate
of ventilation.
The stretch receptors are located within the smooth muscle of
the airways. These are responsible for measuring the size and
volume of the lungs. To prevent overinflation when stimulated by
high tidal volumes, these receptors decrease the rate and volume of
ventilation when stretched.
 J-receptors are located in the capillaries surrounding the alveoli
and are sensitive to increases in pressure within the capillary. When
activated, these receptors stimulate rapid, shallow respiration.

What are the normal breathing rates for

adults, children, and infants?
Adult: 12-20 times per minute
Child: 24-30 times per minute
Infant: 30-60 times per minute

Name the 10 systems of the body.

1. Integumentary
2. Skeletal
3. Muscular
4. Nervous
5. Endocrine
6. Cardiovascular
7. Lymphatic
8. Respiratory
9. Digestive
10. Reproductive

What are the functions of the skeletal

system?
Functions of the skeletal system:
• Protect organs
• Support body
• Allow movement
• Produce blood cells
• Store minerals

What are the functions of the lymphatic

system?
Functions of the lymphatic system:
• Remove foreign substances
• Combat disease
• Maintain fluid balance
• Absorb fat

What are the functions of the digestive

system?
Functions of the digestive system:
• Perform mechanical and chemical process of digestion
• Absorption of nutrients
• Elimination of wastes

1. Name the upper chambers of the heart and their functions.

2. Name the lower chambers of the heart and their functions.

1. Right atrium: Receives oxygen-poor blood from the veins of the

body.
 Left atrium: Receives oxygen-rich blood from the lungs via the
pulmonary veins.

2. Right ventricle: Pumps oxygen-poor blood to the lungs.

Left ventricle: Pumps oxygen-rich blood to the body.

1. Stratum corneum
2. Sweat gland
3. Arrector pili muscle
4. Arteriole
5. Venule
6. Motor nerve
7. Sensory nerve
8. Hypodermis
9. Dermis
10. Epidermis
 1. Superior vena cava
2. Right atrium
3. Tricuspid valve
4. Right ventricle
5. Papillary muscle
6. Aorta
7. Pulmonary artery
8. Left atrium
9. Tricuspid valve
10. Septum

Define cardiac output.

Cardiac output = (stroke volume) × (heart rate)
• Defined as the amount of blood pumped by the heart in 1 minute
(stroke volume × heart rate = cardiac output)
• Expressed in liters per minute
• An increase in stroke volume or heart rate = increased cardiac
output
• A decrease in stroke volume or heart rate = decreased cardiac
output

Define blood pressure.

Blood pressure is defined as cardiac output × peripheral vascular
resistance (afterload).
• Increased afterload = increased blood pressure
• Decreased afterload = decreased blood pressure

1. Trachea
2. Nasopharynx
3. Oropharynx
 4. Larynx
5. Lung
6. Bronchus
7. Alveoli

1. Radius
2. Humerus
3. Clavicle
4. Mandible
5. Manubrium
6. Xiphoid process
7. Lumbar
8. Femur
9. Patella
10. Tibia
1. Cerebrum
2. Corpus callosum
3. Pons
4. Spinal cord
5. Cerebellum
1. Pituitary gland
2. Thyroid
3. Thymus
4. Adrenal gland
5. Pancreas
6. Ovaries
7. Testis
1. Vagina
2. Cervix
3. Uterus
4. Fallopian tube
5. Ovary
6. Fimbria
 1. Testis
2. Epididymis
3. Vas deferens
4. Urethra
5. Prostate
6. Seminal vesicle
7. Bladder
8. Prostate
9. Penis
10. Urethra

Directional terminology. Define the following terms:

• Torso
• Midline
• Medial
• Lateral
• Proximal
• Distal
• Superior
• Inferior

• Torso: trunk of the body

• Midline: imaginary line running vertically from the nose through
the umbilicus (belly button)
• Medial: toward the midline
• Lateral: away from the midline
• Proximal: closer to the trunk
• Distal: away from the trunk
• Superior: above
• Inferior: below

Directional terminology. Define the following terms:

• Midaxillary line
• Anterior
• Posterior
• Midclavicular line
• Bilateral
• Dorsal
• Ventral
• Palmar
• Plantar
• Prone
• Supine
• Fowler position
• Trendelenburg position
• Midaxillary line: imaginary line running vertically from the middle
of the armpit to the ankle
• Anterior: toward the front
• Posterior: toward the rear
• Midclavicular line: imaginary line drawn vertically from the middle
of the clavicle to the pelvis
• Bilateral: pertaining to both sides
• Dorsal: toward the back
• Ventral: toward the front
• Palmar: relating to the palm
• Plantar: relating to the sole of the foot
• Prone: lying face down
• Supine: lying face up
• Fowler position: sitting up
• Trendelenburg position: feet up, head down position (also known
as the shock position)

What does whole blood contain?

• Red blood cells
• White blood cells
• Platelets
• Plasma
• Clotting factors

1. What are 2 types of metabolism?

2. What is the primary fuel for metabolism within a cell?
3. What is the primary catalyst for metabolism within a cell?
 4. What is the breakdown of molecules such as glucose within the
cells when oxygen is present?
5. What is the breakdown of molecules such as glucose within the
cells when oxygen is not present?
6. An energy source required by the cell to release more energy and
a necessity for cells to carry out certain functions such as
contraction of muscles.
7. What provides for alternating movement of sodium out of and
potassium into the cells, which is required for cells to perform
their special functions?
8. What is needed for the sodium/potassium pump to work?
9. The delivery of oxygen, glucose, etc., to the cells and elimination
of waste products from the cells.
10. It is important to ensure that the concentration of oxygen a
patient is breathing is at least _____%.
11. A contraction of the vocal cords that causes them to close and
prevents air from passing into the trachea.
12. The concept that the volume of a gas is inversely proportionate
to the pressure.
13. The amount of air moved in and out of the lungs in 1 minute.
14. The volume of air breathed in with each breath.

1. Aerobic and anaerobic metabolism

2. Glucose
3. Oxygen (O2)
4. Aerobic metabolism
5. Anaerobic metabolism
6. Adenosine triphosphate (ATP)
7. The sodium/potassium pump
8. Adenosine triphosphate (ATP) and cellular energy
9. Perfusion
10. 21
11. Laryngeal spasm
12. Boyle’s law
13. Minute ventilation or minute volume
14. Tidal volume (Vt)

Life Span Development

1. A child from birth to 1 month of age
2. A child from 1 month to 1 year of age
3. An instantaneous and involuntary movement resulting from a
stimulus
4. Soft spots on a baby’s skull that allow the head to pass through
the birth canal during delivery and to expand during development
5. A child from 1 to 3 years of age
6. A child from 3 to 6 years of age
7. A child from 6 to 12 years of age
8. Involuntary bed-wetting at night

1. Neonate
2. Infant
3. Reflex
4. Fontanels
5. Toddler
6. Preschooler
7. School-age child
8. Nocturnal enuresis
 Section 2: Pharmacology
Principles of Pharmacology
1. The process by which medications travel through body tissues
until they reach the bloodstream.
2. The therapeutic effect of a medication on the body.
3. An oral medication that binds and absorbs ingested toxins in the
gastrointestinal tract, for the treatment of some poisonings and
medication overdoses. Charcoal ground into a very fine powder
that provides the greatest possible surface area for binding
medications that have been taken by mouth; it is carried on the
EMS unit.
4. To bind or stick to a surface.
5. Situations in which a medication should not be given because it
would not help or may actually harm a patient.
6. The amount of medication given based on the patient’s size and
age.
7. Medication that increases heart rate and blood pressure but also
eases breathing problems by decreasing muscle tone of the
bronchiole tree; the EMT may be allowed to help the patient self-
administer the medication.

1. Absorption
2. Action
3. Activated charcoal
4. Adsorption
5. Contraindication
6. Dose
7. Epinephrine
1. A semiliquid substance that is administered orally through
capsules or plastic tubes
2. The original chemical name of a medication (in contrast to one of
its “trade names”); not capitalized
3. An abnormally low blood glucose level
4. A therapeutic use for a specific medication
5. Breathing into the lungs; a medication delivery route
6. Injection into a muscle; a medication delivery route
7. Injection into the bone; a medication delivery route
8. Injection directly into a vein; a medication delivery route
9. A miniature spray canister through which droplets or particles of
medication may be inhaled

1. Gel
2. Generic name
3. Hypoglycemia
4. Indication
5. Inhalation
6. Intramuscular (IM) injection
7. Intraosseous (IO)
8. Intravenous (IV) injection
9. Metered-dose inhaler (MDI)

What are the 6 rights of medication

administration?
1. Right medication
2. Right dose
3. Right time
4. Right route
5. Right patient
6. Right documentation

What 3 factors alter drug responses?

• Age
• Pediatric or geriatric
• Immature or decreased hepatic or renal function
• Weight
• Big patients “spread” drug over larger volume
• Gender
• Difference in sizes
• Difference in fat/water distribution

1. Medication that increases cardiac perfusion by blood flow by

causing arteries to dilate; the EMT may be allowed to help the
patient self-administer the medication
2. By mouth; a medication delivery route
3. A simple sugar that is readily absorbed by the bloodstream; it is
carried on the EMS unit
4. Medications that are purchased directly by a patient without a
prescription
5. A gas that all cells need to metabolize; the heart and brain,
especially, cannot function without it
6. Through the mouth; a medication delivery route; same as oral
7. Through the rectum; a medication delivery route
8. The study of the properties and effects of medication
9. Medications distributed to patients by pharmacists according to a
physician’s order
1. Nitroglycerin
2. Oral
3. Oral glucose
4. Over-the-counter (OTC) medications
5. Oxygen
6. Per os (PO)
7. Per rectum (PR)
8. Pharmacology
9. Prescription medications
 Section 3: Patient Assessment
Patient Assessment
1. A force that impacts or is applied to the body but is not sharp
enough to penetrate it
2. Bringing the patient’s head into a neutral position in which the
nose is lined up with the navel and holding it there manually
3. AVPU mnemonic for assessment of mental status

1. Blunt trauma
2. In-line stabilization
3. A: Alert
V: Responds to Verbal stimulus
P: Responds to Painful stimulus
U: Unresponsive

1. AVPU mnemonic for assessment of mental status

2. Back arched, arms flexed inward toward the chest
3. Back arched, arms extended straight out parallel to the body
4. Closed or blocked; not patent
5. Open, not blocked
6. A respiratory rate that is too fast
7. Absence of breathing; respiratory arrest
8. Shortness of breath or perceived difficulty in breathing
9. Four things to include when checking circulation

1. A: Alert
V: Responds to Verbal stimulus
 P: Responds to Painful stimulus
U: Unresponsive
2. Flexion posturing or decorticate posturing
3. Decerebrate posturing or extension posturing
4. Occluded (as in occluded airway)
5. Patent (as in patent airway)
6. Tachypnea
7. Apnea
8. Dyspnea
9. Pulse; Possible major bleeding; Skin color, temperature, and
condition; Capillary refill

1. Treatment for:
obvious blood, vomitus, secretions, or other obstructions in the
airway
2. Treatment for:
obvious open wound to the anterior, lateral, or posterior chest
3. Treatment for:
paradoxical movement of the chest
4. Treatment for:
major bleeding that is spurting or flowing steadily
5. Treatment for:
mechanism of injury that might produce spinal injury

1. Immediately suction or clear the obstruction.

2. Immediately cover the open wound with a nonporous or
occlusive dressing.
3. Stabilize the segment with your hand or provide bag-valve-mask
ventilation if necessary.
4. Apply direct pressure to the site of bleeding.
5. Establish and hold manual in-line stabilization of the head and
neck.

1. Treatment for:
altered mental status to include a patient who is confused, who
responds only to verbal or painful stimuli, or who does not
respond
2. Treatment for:
airway occluded from the tongue (sonorous sounds)
3. Treatment for:
inadequate respiratory rate (too slow or too fast, with other signs
of inadequate breathing)
4. Treatment for:
inadequate tidal volume (shallow breathing or poor chest rise)
5. Treatment for:
rapid and weak pulses

1. Closely assess airway and breathing status and administer high-

concentration oxygen.
2. Immediately perform a head-tilt, chin-lift, or jaw-thrust maneuver
if a spine injury is suspected.
3. Immediately begin positive-pressure ventilation (PPV) with
supplemental oxygen connected to the ventilation device.
4. Immediately begin PPV with supplemental oxygen connected to
the ventilation device.
5. Apply a nonrebreather mask at 15 L/min and assess for shock.

1. Treatment for:
carotid pulse present, but absent peripheral pulses
2. Treatment for:
pale, cool, clammy skin
3. Treatment for:
 capillary refill greater than 2 seconds with other signs of poor
perfusion
4. Treatment for:
absent carotid pulse in the adult or child; absent brachial pulse in
the infant
5. A clear fluid that surrounds and cushions the brain and spinal
cord

1. Apply a nonrebreather mask at 15 L/min and treat for shock

(hypoperfusion).
2. Apply a nonrebreather mask at 15 L/min and treat for shock.
3. Apply a nonrebreather mask at 15 L/min and treat for shock.
4. Immediately begin cardiopulmonary resuscitation (CPR) and
apply AED.
5. Cerebrospinal fluid (CSF).

1. How do you check for facial symmetry?

2. A section of the chest that moves in the opposite direction to the
rest of the chest during the phases of respiration.
3. A protrusion, or pushing, of a portion of the brain through the
cranial wall.
4. Breathing a foreign substance into the lungs.
5. Treatment for jugular venous distention (JVD) with a patient at a
45-degree angle or excessively engorged jugular veins.
6. Treatment for tracheal deviation.
7. Shortness of breath while lying flat.
8. Crowing and stridor are both commonly associated with
____________.
9. In assessing the circulation of an infant less than 1 year of age,
which pulse do you check?
10. The appropriate sequence for checking circulation during the
primary assessment.
11. Pale skin typically indicates _____________.

1. Have the patient grin

2. Paradoxical movement
3. Brain herniation
4. Aspiration
5. Rapid transport, consider ALS intercept, establish airway, begin
PPV if inadequate respiratory rate is present
6. Rapid transport, consider ALS intercept, establish airway, begin
PPV if inadequate respiratory rate
7. Orthopnea
8. Swelling or muscle spasms of the airway
9. Brachial pulse
10. a. Palpate for a pulse.
b. Check for major bleeding.
c. Assess skin signs.
d. Determine capillary refill time.
11. Shock

An emergency medical technician (EMT)

can estimate a systolic blood pressure by
palpating specific pulses. Identify the
pulse locations and the systolic values.
Blood Pressure Estimation
• Radial pulse: 80 systolic
• Femoral pulse: 70 systolic
• Carotid pulse: 60 systolic
Another random document with
no related content on Scribd:
 »Sen vietävä, veit multa varman paistin.»
— »Vai minä, kun tuulta vain haistin»,

se siihen kettu, »on syyttää somaa, kun on syy ja tyhmyys

omaa. Kuka käskikin veräjäks aukoa suuta, olis viisas tehnyt
muuta:

olis henkeä vetäin ihan sydämestä vain virkkanut:

iitäisestä!»
KÄRÄJILLÄ

Oli kilua, kalua pihamaa taas käräjäpaikan täynnä, meni

sisälle toiset synkkinä ja toiset jo oli käynnä.

Ja toiset portaissa tupakoi

ja vuoroa vaiti vuotti,
ja nurkan takana supattain
joku advokaattiaan juotti.

Sudet, asianajajat, salkkuineen

eestaas ne tärkeinä kulki,
ja närhi, käräjäpukari,
taas oli juopunut julki.

Se rentona olla terhenti

koko pihan sankarina,
kun juuri esille huudettiin
se ketun ja karhun kina.

Ovi aukes: pöllö-laamanni

näkyi tuomaripöydän takaa,
lakikirjat ja kynttilät edessään.
Mies muuten viisas ja vakaa,
 sadesäällä vaan kovin kärttyisä,
kun vaivas se vanha leini.
Oli kriivariks viereen kivunnut
— jopa jotain! — jo varpus-teini

Ja lautamiehet, varikset,
ne nuokkui penkkejä pitkin,
väsyneinä seistä nuuhotti
jo korpit, viskaalitkin.

Niin kettu esihin viipotti

ja vilhui lautakuntaan;
tuli tassutti perässä karhu, kuin
heränneenä kesken untaan.

Rykäs tuomari, korjas pänsneitään,

»no», sanoi, »no kuulla antaa,
mite teille on, vanhat skurkit, taas,
mite kantaja peelle-kantaa?!»

— »Sitä vaan, hyvä laki ja oikeus,

sitä vaan», sanoi nöyränä kettu,
»täss' anoisin, että kuoma tää
olis sakkoon langetettu.

Se herjas mua, paki paraastaan

minut rosvoks ja ryöväriks pani,
ketun leikkas kansalaiskunniaa,
niin rehellistä ani.»

Oven suussa karhu hämillään

käsissänsä lakkia käänsi.
Jo suuttui: »Ja varas sinä oletkin.»
Se lähemmäs astua väänsi.

»Jo lyö, hyvät miehet auttakaa»,

huus kettu ja tieltä väisti —
»Veit muorin kesävoin», nyrkillään
jo karhu sanoja säisti.

»Suu poikki», kiljaisi tuomari,

»sinull' ollako vierastamiestä?»
Mut karhu vihelsi halveksuin:
»Koko oikeus pitäis piestä.»

— »Mite sano sinä lurjus, hunsvotti,

ja mite se on kieltä, sinä keyte»,
ihan sähisi tuomari, — »fiskaali,
pane kiinni se, kyllä minä näytä.»

Ne panivat karhun rautoihin

ja kettu sai kannetta ajaa,
ja ketulla oli monta myös
valan päältä todistajaa.

Ne muistivat kaikki kuin eilisen

saman tapauksen: sanaharkan
ja loukatun kansalaiskunnian,
selon tehden tiukan, tarkan.

Tuli tuomio: varojen puutteessa

pääs karhu kärsimähän,
ketun kunnia maksoi paljon näät
ja oikeudenkin vähän.
 Ja niin oli vedelle ja leivälle
siks karhu langetettu,
kun karhun muorilta kesävoin
vei petoksella kettu.
VIISI JYVÄÄ

»Niin, tervetultua vierahaks!

Olis meille se suureks kunniaks —
jos muuten tulla passaa.»

Kana-emo vieraaks joutsenen pyys nöyrästi, syvään

niiaten, kädet esiliinan alla.

Oli pidot nähkääs. Mitämaks, tuli joutsen kanan vierahaks.

Kanat tervehti hymyin makein —

ja siinäkös sitten niiattiin ja kaarreltiin ja kursailtiin, emot

vilkas tyttärihinsä.

Mut kana se vast' oli olevinaan

— aiai! — ja pöyhkeä vieraastaan
»Sukulainen!» suhkas se muille.

Ja kukko löi olalle joutsenen:

» Veli, saatpas herkut herkkujen —
tuo meidän muija se osaa!»
 Oli lasten nenät niistetyt.
Kana raapaisi jalkaa: »Pöytään nyt,
hyvät vieraat, joutsen ensin!»

Mitkä kestit luona purtilon

ja konverseeraus kohta on!
On ruokaakin monta jyvää.

»Ja olkaa hyvät ja vassakuu!»

kana pyytelee ja punastuu
omanarvon tärkeyttään.

»Ei kiitos, söin jo kylliksein,

ihan koko jyvästä selvän tein»,
kananeidit hienostelee.

Mut silloin sattuu jotakin.

Kaikk' katsovat vaiti toisihin:
syö joutsen — viisi jyvää.

Pojat tyrskii ja tyrkkii toisiaan.

Kana-emäntä katsoo kauhuissaan:
kokonaista viisi jyvää!

Mikä riettaus, puolet ateriaa!

No onkos kuultu mokomaa —
se on häpeäks koko perheen!

Mikä tahdittomuus! Mikä nolaus!

Mikä hienojen tapojen kolaus!
Tämä ihan vatsahan koskee!
 »Sukulainen!» nauraa naapurit.
»Syö muutamat niinkuin ryövärit»,
kana ähkyy… »en tarkoita ketään!»

Mut joutsen ei ole tietääkseen:

»Miks syö ei toiset? Ma parhaani teen,
tässä juuri aioin alkaa.»

» Voi taivas!» kana kiljahtaa…

»niin tietysti… alkakaa, alkakaa!»
Kana katsoo tiukasti kukkoon.

Mut kukko väistää katsehen.

Muut kaikki vaihtavat silmäyksen.
Kana pahoin voi ja poistuu.

Syö, juo ja lähtee joutsenkin.

Muut katsein viilein ja säälivin
sen vastaa kumarrukseen.

Mikä kaakatus, mikä kotkotus,

kun vihdoin päättyy surkeus
ja joutsen on varmasti poissa!

»Tuo ukkokin niitä ystäviään —

Ei sukua ole se ensinkään!»
huus parantunut kana.

Kaikk' käyvät lähemmä toisiaan

Ei nouse joutsen kunniaan.
Ajatelkaa, viisi jyvää!
 Mikä hyvien tapojen häväistys!
Mikä rakkaan nuorison villitys!
Kokonaista viisi jyvää!

Koko päivän kanat kaakattaa:

ihan vaarassa on isänmaa,
ajatelkaa — viisi jyvää!
YKSIMIELISYYS ON VOIMAA

Oli susien puoluekokous. »Pois karhu asemastaan!» oli tehty

jo ponsi ja huudettu koko harvainvaltaa vastaan.

Vai karhu se vaan tässä mettä jois

ja karhun vaan olis valta!
Ja sudet sais rehkiä yksinään —
työn orjat, sorron alta!

Vai karhu se vaan tässä yksin sais

koko talven vetää unta!
On laiskuus kunnallistettava!
Pois, alas koko yhteiskunta!

Tämä huutoäänin päätettiin.

Soraääntä ei ollut väärää.
Ain' eläköön yksimielisyys!
— »Mutta kuka se sitten määrää?»

huus joku, »ja kuka saa hunajan?»

huus siihen heti joku toinen.
Puheenjohtaja koputti nuijallaan —
Oli melu ihan hurjanmoinen.
 Ja yhä vaan alkoi sakeammat
sanat sinkoilla ja soida…
Sitä kaikkea oikein hävettää
näin lehtiin referoida.

Ja siitä on paras ihan vaieta,

mitä tehtiin vielä muuta.
Vaan totuushan ei pala! — paikalle
jäi monta leukaluuta.
LAHORASTAS JA RÄKÄTTIRASTAS

Lahorastas metsässä laulupuullaan

se lauloi Jumalan suomalla suullaan.

Koko kuulaan keväisen yön ja ehtoon

sen sävelet soi ja satoi lehtoon.

Mut ottipas parvessa kuulijakuoron

nuor' räkättirastas myös suunvuoron.

Ja arvostelunsa se juoksutti julki,

näin viisaina, vuolaina sen sanat kulki:

»No jaa, miksei! Kyllä serkkukin laulaa!

Kukin tietysti laulaa kuinka on kaulaa!

On heleänlainen jo pianissimo,
mut vahveta paljon saa fortissimo.

On sijoitus heikko ja tukea puuttuu,

taka-äänet ne vielä kurkkuhun juuttuu.

Yhä kurkku siis kaipaa koulutusta,

alaleuan käyttökin ohjausta.
 Suru sanoa, lisäks ei persoonallinen
ole oikein laulu, vaan muiden mallinen:

sehän soi kuin soikin riemua mielen,

haa! — selvästi aihe myös satakielen!

Pahin viimeiseks, hyvät herrasväet!

Miten sanoisinkaan, mutta minusta, näet,

kovin pitkään serkku lauleskeli,

ihan liian hyvä oli kielen keli!

Jos ei niin leikiten laulu soisi,

tosi konstia vasta silloin se oisi!»
HAUTAJAISET

Oli kaste viel' yli kukkien, kun kuoli päiväperhonen, joka lensi
tuokion vain… Niin niin Ja se aamulla haudattiin.

Koko ihanan päivän se elänyt ois…

jo aamulla sen piti pois.

On murhe saleissa ruohiston.

Surutaloon ystävät tulleet on.

Ja ne katsovat pientä vainajaa ja sen siipien kultaa

koskettaa ne hiljaa, hellävaroin, ja kuiskaa äänin aroin, päät
nyökkyen, silmin kostehin: »Miten kaunis vieläkin!»

Surusaatto lähtee verkalleen läpi heinien metsän

matkalleen. Vaikk' aurinko juuri koittaa, niin murheinen on
taivas, maa, sinikellot hiljaa humajaa, surumarssia sirkat
soittaa.

Tien varsilla vaiti on naapurit. Kaikk' kasteen kirkkaat

timantit kukat koruiksi arkulle antaa. Sitä muurahaiset kantaa.
Havuneuloin peitetty on tie, joka vainajain viitaan vie.
 Kas, pappi, suruperhonen, jo vartoo ja vaihtaa jalkaa, ja
kuoro leppäkerttujen veräjällä virren alkaa. Se aamunsuuhun
väräjää;

joku saattojoukossa nyyhkyttää. ja heinät murhein huhuu…

Sh! hiljaa! pappi puhuu — Kaikk' katsoo ääneti hautahan… Ja
turilaan, haudankaivajan, — joka karski ja paljon nähnyt on —
käsi pyyhkii selkäpuolla pois salaa kyynelkarpalon: »On
kovaa niin aamulla kuolla!»
KIURUN TUPA

Suviyö oli valkea, hiljainen.

Jo vaikeni laulut lintujen.

Sadat aarteet kukkain aarnion

ne kasteen hopeahelmiss' on.

Vähän häilyy metsä heinien,

joku käy ohi kiurun tupasen.

Joku kulkee kautta kesäyön.

Ihan säikkyin lyö emo kiurun syön.

Emo kiuru raotti oveaan:

»Kuka siellä? — meillä jo nukutaan.»

Kävi polkua neito ja onneaan

hän lauloi yöhön valkeaan.

Kukat taipui alla askelen

ja laulun onnenkylläisen.

Sydän pienen kiurun värähtää

sitä kuullen laulun helinää…
 kunis sävelet hiljaa häipyy pois
kuin hopeiset tiu'ut soineet ois.

»Hän laulaa laulua armaalleen»,

hymys kiuru tupaansa pienoiseen.

Yli sinisen salmen rantahan

joku souti neitoa vastahan.

Ja yö oli vaiti ja valkea niin.

Taas kiurun tuvassa nukuttiin.
PELTOSIRKKU

– Miks maantien tomussa laulatkaan? Mikäs kylän arkiseen

pauhinaan sa säveles soida annat? Miks vaihdoit peltoon
harmaaseen sinimetsät runon-saleineen ja ihanat ilmain
rannat?

– Tomu maantien, pelto harmahin runon-sali on mulle

armahin, siks sävelten soida annan! Liki sen ma majani
pienen tein – ja miss' on majani, ylitsein nään ihanan ilmain
rannan!
HEINÄ

Sua, Tahdon laulain kiittää, ettäs olemahan loit sa mun.

Vaikka viikate mun kohta niittää, näinhän sentään, tunsin
sentään sun

aamutuuli, kiuru taivahalla, suven sade — mikä kohtalo!

Laulan vielä viikattehen alla: ylistetty olkoon aurinko!
SYKSY

Kaksi vanhaa, vanhaa varista

nuokkuu hiljaa pellon aidalla.

Ruskea on rinta kaisliston,

taivas harmaa. Sataa. Syksy on.

»Kurkikin jo lähti», veljelleen

toinen virkkaa niinkuin itsekseen.

Pitkä hiljaisuus. Jo toinenkin

»niin maar; lähti», sanoo takaisin.

Sitten vanhukset taas vaikenee.

Järven pintaan sade soittelee.

Sukii siivenselkää toisen pää.

Toinen joskus silmää siristää.

Höyhenihin niskat kyyristyy.

Sataa. Hiljaista on. Hämärtyy

yli pellon mustan kynnöksen.

Tuntuu riihen tuoksu etäinen.