EMT - Emergency Medical Technician

Melodie Kolmetz

• Editorial: QuickStudy Reference Guides
• Año: 2018
• ISBN:
  9781423237280
• Categoría: Medizin
• Categoría: Medizinische Theorie, Praxis & Referenz

Don't go through your EMT training course without this handy reference! Packed with valuable information on scene size-up and patient assessment, this guide is an essential study tool for EMTs in training and an excellent refresher for EMTs already in the field. This guide also features a large section on anatomy, physiology, and pathophysiology of all major body systems, along with common disorders and injury management. Helpful illustrations and tables are included for quick reference.

Anatomy, Physiology & Pathophysiology

Integumentary

Structure

1. Epidermis: The outer layer of the skin; consists of five layers at the palms of the hand and soles of the feet and four layers elsewhere; outer layers are composed of dead cells; does not contain blood vessels or nerves
2. Dermis: The layer of skin below the epidermis; contains blood vessels, nerves, glands, and hair follicles
3. Subcutaneous layers: Layers of fat and soft tissue below the dermis; responsible for insulation and shock absorption

Functions

1. Protection: Serves as a barrier to keep out unwanted substances (chemicals, organisms, etc.)
2. Fluid balance: Prevents water loss and keeps excess water from entering the body
3. Temperature regulation: Through dilation of blood vessels, the skin allows heat to radiate out of the body; through constriction of blood vessels, the body is able to conserve heat
4. Excretion: Sweat glands cool the body by producing perspiration, which evaporates and cools the body; salts can be removed from the body through this process
5. Shock absorption: Provides protection against minor impacts and pressure

Injury Management

1. Closed wounds: No opening to the outside
   1. Contusion: Pain, swelling, and discoloration; commonly known as a bruise
   2. Hematoma: A swelling or collection of blood often resulting from damage to a blood vessel
   3. Crush injury: An injury caused when force is transmitted from the outside to the inside of the body
2. Open wounds: Open to the outside, exposing the tissue beneath
   1. Abrasion: A scraping away of a portion of the skin or mucous membrane
   2. Laceration: A cut; edges can be smooth or irregular
   3. Puncture: A hole or wound made by a sharp object
   4. Avulsion: Skin or tissue is torn loose or pulled off
   5. Amputation: The complete removal or severing of an extremity
   6. Crush injury: Can be an open wound
   7. Burn: Tissue injury resulting from exposure to a thermal, electrical, chemical, or radioactive agent
3. General wound care: Expose the wound, clean if possible, control bleeding (use a tourniquet if needed), care for shock, and dress and bandage the wound
4. Impaled objects: In addition to general wound care, stabilize the object in place; if the object is in the cheek, remove it if bleeding compromises the airway, and be prepared to suction; if the object is impaled in the eye, stabilize the object, protect the area, and dress and bandage both eyes
5. Care of amputated parts: Wrap the part in sterile dressing, then wrap or place the object in a plastic bag; seal the bag and place it on cool water; never immerse the amputated part directly into water or saline; never place it directly on ice

Burns

1. Classification:
   1. By agent or source: Chemical, electrical, thermal, or radiation
   2. By depth
      1. Superficial: The burn involves the epidermis; symptoms include redness, swelling, and pain
      2. Partial thickness: The burn is through the epidermis and into the dermis; symptoms include intense pain, redness, and blistering; skin may appear mottled
      3. Full thickness: The burn involves all layers of the skin; skin may appear waxy and white; may be charred or black
   3. By severity: Consider agent or source, body area involved, depth, extent, age of patient, and other medical conditions
      1. Rule of palm: The patient’s hand equals about 1% of the patient’s total body surface area (TBSA)

2. Rule of nines: A mathematical method of estimating BSA involved in burns
3. Burn center transport criteria:
   1. Partial thickness burns greater than 10% of TBSA
   2. Burns that involve the face, hands, feet, genitalia, perineum, or major joints
   3. Third-degree burns
   4. Electrical burns, including lightning injury
   5. Chemical burns
   6. Inhalation injury
   7. Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
   8. Any patient with burns and concomitant trauma, such as fractures, in which the burn injury poses the greatest risk of morbidity or mortality; if the trauma poses the greater immediate risk, the patient may be initially stabilized in a trauma center before being transferred to a burn unit; physician judgment will be necessary and should be in concert with the regional Medical Control plan and triage protocols
   9. Burned children who are in hospitals that do not have qualified personnel or equipment for the care of children
   10. Burn injury in patients who will require special social, emotional, or rehabilitative intervention

Musculoskeletal

Structure

1. Skeletal system: The bones of the body, including the skull, spine, ribs and sternum, upper and lower extremities, and pelvis; bones are classified according to appearance (i.e., long, short, flat, or irregular)
2. Muscular system: Includes muscles, tendons, and ligaments
   1. Muscles contract to cause body movement; there are three types of muscles:
      1. Voluntary muscle is skeletal muscle
      2. Involuntary muscle is smooth muscle found in other systems of the body
      3. Cardiac muscle is found in the heart
   2. Tendons connect muscles to bone
   3. Ligaments connect bones to other bones at joints; some joints are moveable, and some are not
   4. Cartilage is tough tissue that covers the ends of bones and allows for smooth movement
3. Spine: Consists of 33 vertebrae
   1. Vertebrae are divided into 5 sections
      1. Cervical: Neck (7 vertebrae)
      2. Thoracic: Upper to middle back (12 vertebrae)
      3. Lumbar: Lower back (5 vertebrae)
      4. Sacral: Pelvis (5 vertebrae)
      5. Coccygeal: Tailbone (4 vertebrae)
   2. The spinal cord runs up the middle of the vertebrae; nerves divide off bilaterally at each vertebral level
4. Thorax: A cage that protects vital organs of the chest
   1. Ribs: There are 12 pairs: 10 pairs attach to the sternum, and 2 pairs are floating ribs
   2. Sternum: Consists of three parts: the manubrium (upper part), the body (middle part), and the xiphoid process (lower, triangular-shaped tip)
5. Pelvis: Provides support for the spine and provides attachment for the lower extremities; has a right and a left half; consists of three portions:
   1. Ilium: Anterior, superior portion
   2. Ischium: Posterior, inferior portion
   3. Pubis: Anterior portion where the two halves join
6. Upper extremities: Consist of (moving proximally to distally) the clavicle (collarbone), scapula (shoulder blade), humerus (upper arm), radius (lateral forearm), ulna (medial forearm), carpals (bones of the wrist), metacarpals (bones of the hand), and phalanges (bones of the fingers)
7. Lower extremities: Consist of (moving superiorly to inferiorly) the acetabulum (hip joint socket), femur (upper leg), patella (kneecap), tibia (medial lower leg), fibula (lateral lower leg), tarsals (bones of the ankle), metatarsals (bones of the foot), and phalanges (bones of the toes)

Functions

1. Provides support for the body
2. Stores minerals such as calcium
3. Produces blood cells in the long bones that contain bone...