Medic General Review II

Clear lung sounds are not considered a sign or symptom indicating a tension pneumothorax. Tension pneumothorax is a condition where air accumulates in the pleural space, causing the lung to collapse and putting pressure on the heart and other structures. Dyspnea, hyperresonance to percussion, and distended jugular veins are commonly associated with tension pneumothorax due to the compromised lung function and increased pressure in the chest. However, clear lung sounds suggest that there is no obstruction or abnormality in the airways, which is not consistent with tension pneumothorax.

Fentanyl would be the most acceptable alternative to morphine for analgesia in patients with an acute coronary syndrome because it is a potent opioid analgesic that provides effective pain relief. It has a rapid onset and short duration of action, making it suitable for acute pain management. Additionally, fentanyl has less potential for causing respiratory depression and hemodynamic instability compared to morphine, which is important in patients with acute coronary syndrome who may already have compromised cardiovascular function.

Salt tablets should not be administered as a treatment for heat exhaustion because they can actually worsen the condition. Heat exhaustion is caused by excessive sweating, which leads to the loss of both water and electrolytes, including sodium. Administering salt tablets can further disrupt the electrolyte balance and potentially lead to dehydration. Therefore, it is important to focus on rehydrating the patient with fluids such as normal saline, placing them in a cool environment, and removing any excessive clothing to promote cooling.

This is a national registry question... keep in mind how national standards look at lower energy doses for defibrillation with a biphasic monitor

http://www.mycprpros.com/2010-cpr-guidelines

The child's symptoms of increased work of breathing, fever, increased cough, pale appearance, slow response, and obvious nasal flaring indicate respiratory distress. The respiratory rate of 8 per minute is significantly lower than the normal range, suggesting impending respiratory failure. These findings suggest that the child is in respiratory distress with impending respiratory failure.

The patient is presenting with symptoms of chest pain, difficulty breathing, low blood pressure, and bradycardia (heart rate of 42). These symptoms indicate a possible heart block, specifically a type of heart block called symptomatic bradycardia. Atropine is a medication commonly used to treat bradycardia by blocking the action of the vagus nerve, which slows down the heart rate. Therefore, administering atropine 0.5 mg would be the appropriate treatment for this patient to increase his heart rate and improve blood flow.

The correct answer is "geography can interfere with the system or signals." This means that one of the disadvantages of using a cellular telephone for EMS communications is that the geographical location can affect the quality of the system or signals. This can lead to dropped calls, poor reception, or difficulty in establishing and maintaining communication in remote or rural areas with weak cellular coverage.

The given parameters indicate a normal P-R interval (0.16 seconds), a normal QRS duration (0.08 seconds), and a regular R-R interval. These findings are consistent with a sinus rhythm, which is the normal electrical activity of the heart. Atrial fibrillation would show an irregular R-R interval and no discernible P-R interval. Sinus rhythm with first-degree heart block would show a prolonged P-R interval. Supraventricular tachycardia would show a rapid heart rate, which is not indicated in the given parameters. Therefore, the correct answer is sinus rhythm.

In a case of hypoglycemia, the appropriate drug to administer is 25% dextrose. Dextrose is a form of glucose that can be given intravenously to rapidly increase blood sugar levels. It is commonly used in emergency situations to treat low blood sugar levels, especially in children. The 25% concentration is preferred over 50% dextrose as it is less likely to cause complications such as tissue irritation or extravasation. Glucagon can also be used to raise blood sugar levels, but it is typically administered when IV access is not available. Instant glucose is not typically used in IV administration and is more commonly used for oral administration in milder cases of hypoglycemia.

A Glasgow Coma Scale (GCS) score of 7 represents significant injuries. The GCS is a neurological scale that assesses a person's level of consciousness following a head injury. It evaluates three components: eye-opening response, verbal response, and motor response. The maximum score on the GCS is 15, indicating normal brain function. A score of 7 suggests a severe impairment in consciousness, indicating significant injuries.

Tricyclic antidepressants (TCAs) can block cardiac sodium channels, leading to a decrease in the rate of depolarization and prolongation of the action potential duration. This can result in widening of the QRS complex on the ECG. Additionally, TCAs can also block cardiac potassium channels, leading to a prolonged QT interval. Therefore, the correct answer is "Wide QRS complexes with a prolonged QT interval." This combination of ECG findings is characteristic of TCA overdose and can predispose the patient to potentially life-threatening ventricular arrhythmias such as torsades de pointes.

The recommended dose of vasopressin in v-fib or pulseless v-tach is 40 units IV in a single dose. This is the correct answer because vasopressin is a medication used in cardiac arrest situations to increase blood pressure and improve blood flow to the heart and brain. The recommended dose of 40 units IV in a single dose is based on clinical guidelines and studies that have shown its effectiveness in these specific situations.

Epinephrine is the correct answer for managing pediatric bradycardia with significant signs and symptoms related to cardiac or respiratory compromise. Epinephrine is a medication that stimulates the heart and increases the heart rate, making it an appropriate choice for treating bradycardia. Atropine is commonly used for bradycardia in adults, but it may not be as effective in pediatric patients. Lidocaine is used for managing certain types of arrhythmias, but it is not the first-line treatment for bradycardia. Sodium bicarbonate is used for managing acidosis and certain drug overdoses, but it is not indicated for bradycardia.

The initial dose of adenosine that should be administered is 6 mg rapid IV push followed by a 20 cc fluid bolus. This is the correct answer because adenosine is used to treat supraventricular tachycardia (SVT), and the recommended initial dose is 6 mg given rapidly through an IV. The fluid bolus is given immediately after to help flush the medication into the systemic circulation and improve its effectiveness. Repeating the dose or waiting longer periods of time before repeating the dose are not the recommended initial treatment approaches for SVT.

The initial treatment for a thermal burn patient involves covering the burn area with dry bulky dressings to protect it from further injury and infection. Keeping the patient warm helps to prevent hypothermia, which can occur due to the loss of body heat from the burn. This treatment approach promotes wound healing and provides comfort to the patient.

The patient's signs and symptoms, such as nausea, headache, profuse sweating, cool clammy skin, and an elevated temperature, are consistent with heat exhaustion. Heat exhaustion occurs when the body becomes dehydrated and is unable to cool itself effectively in hot weather conditions. This can lead to symptoms such as weakness, dizziness, and fatigue. The patient's vital signs, such as a weak pulse and shallow respirations, further support the diagnosis of heat exhaustion. Heatstroke, on the other hand, is a more severe condition that involves a dangerously high body temperature and can be life-threatening.

The correct answer is 0.05-0.1 mg/kg IV/IO. This range represents the recommended pediatric dose of lorazepam for the treatment of seizures. It is important to administer the medication intravenously or intraosseously. This dose range ensures that the medication is administered in a safe and effective manner, taking into account the weight of the child.

The management of cardiogenic shock may include the administration of IV dopamine. Dopamine is a medication that helps to increase blood pressure and improve blood flow by stimulating the heart. In cardiogenic shock, the heart is unable to pump enough blood to meet the body's needs, leading to low blood pressure and organ failure. IV dopamine can help to support the heart's function and improve cardiac output, thereby improving the patient's condition.

Again... think national standards, not PA protocol.

As individuals age, the elasticity of their chest wall decreases, leading to decreased chest wall compliance. This means that the chest wall becomes stiffer and less able to expand and contract effectively during breathing. This reduced compliance can result in a decreased ability to take in an adequate amount of air, leading to a less effective respiratory system. The other options, such as weakened diaphragm muscles or increased tidal volume, do not directly relate to the decreased effectiveness of the respiratory system in geriatric patients.

Though we kept the math simple in class, in reality the Weight in Kg is really equal to 0.9 x half the weight in pounds. Or, divide the weight in pounds then subtract ten percent.

Oxygen is essential for newborns, and depriving them of oxygen can lead to serious complications. However, it is important to administer oxygen carefully and avoid oxygen toxicity, which can also be harmful. Therefore, the correct statement is that a newborn should never be deprived of oxygen for fear of oxygen toxicity.

The patient is presenting with chest pain and shortness of breath, indicating a possible cardiac issue. The blood pressure and pulse are within normal range, but the respiratory rate is elevated. The ECG shows sinus bradycardia with a prolonged PR interval. Crackles in the lung bases suggest fluid overload, which could be due to heart failure. Given these findings, the most appropriate management would be nitroglycerin, as it helps relieve chest pain and improves blood flow to the heart. The other options, such as fluid bolus, atropine, or transcutaneous pacing, are not indicated based on the given information.

http://www.ncbi.nlm.nih.gov/pubmed/9144052