NREMT Test Prep and EMT Lectures - Podcast

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The EMT student should understand how to manage trauma-related issues of the head and spine. The student will learn how to recognize life threats associated with these injuries as well as the need for immediate spinal stabilization and, potentially, airway and breathing support.  We will discuss the anatomy and physiology of the nervous system and the pathophysiology, assessment, and management of traumatic brain and spinal cord injuries. We will also discuss traumatic brain injury (TBI), including initial mechanism of injury, and primary (direct) versus secondary (indirect) injury. Transport considerations are discussed with a focus on potential deterioration. Last we will discuss helmet removal.

Knowledge Domains: The EMT student should know the anatomy and physiology of the nervous system, including its divisions into the central nervous system (CNS) and peripheral nervous system (PNS), and the structures and functions of each. You should know the functions of both the somatic and autonomic nervous systems. You must know the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system. You need to explain the different types of head injuries, their potential mechanism of injury (MOI), and general signs and symptoms of a head injury that the EMT should consider when performing a patient assessment. You should know what traumatic brain injury (TBI) is.

The EMT should know the difference between a primary (direct) injury and a secondary (indirect) injury; include examples of possible MOIs that may cause each one. You should know the different types of brain injuries and their corresponding signs and symptoms, including increased intracranial pressure (ICP), concussion, contusion, and injuries caused by medical conditions. You should be able to describe the different types of injuries that may damage the cervical, thoracic, or lumbar spine; include examples of possible MOIs that may cause each one.

The EMT must explain the steps in the patient assessment process for a person who has a suspected head or spine injury, including specific variations that may be required as related to the type of injury as well as list the mechanisms of injury that cause a high index of suspicion for the possibility of a head or spinal injury. The EMT must know the medical care of a patient with a head injury; include the three general principles designed to protect and maintain the critical functions of the CNS and ways to determine if the patient has a traumatic brain injury. You should also know the medical care of a patient with a spinal injury; include the implications of not properly caring for patients with injuries of this nature, the steps for performing manual in-line stabilization, implications for sizing and using a cervical spine immobilization device, and key symptoms that contraindicate in-line stabilization.

The EMT should be able to explain the process of preparing patients who have suspected head or spinal injuries for transport; include the use and functions of a long backboard, short backboard, and other short spinal extrication devices to immobilize the patient’s cervical and thoracic spine. Last the EMT should know the different circumstances in which a helmet should be left on or taken off a patient with a possible head or spinal injury and the steps to follow to remove a helmet, including the alternate method for removing a football helmet.

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After the podcast the EMT student should have an understanding on how to manage trauma-related issues with the face and neck. The student will learn how to recognize life threats associated with these injuries and the correlation with head and spinal trauma. We will identify the detailed anatomy and physiology of the head, neck, and eye, and discusses injuries including trauma to the mouth, penetrating neck trauma, laryngotracheal injuries, and facial fractures.  The EMT student will learn information on dental injuries and blast injuries to the eye. Management of common eye injuries such as foreign objects, puncture wounds, lacerated eyelids, burns, impaled objects, and complications from blunt trauma are included.

Knowledge Domains

The EMT student should be able to describe the anatomy and physiology of the head, face, and neck; include major structures and specific important landmarks of which EMTs must be aware as well as discuss the factors that may cause obstruction of the upper airway following a facial injury. You should know the different types of facial injuries and patient care considerations related to each one. The EMT student should be able to explain the emergency care of a patient who has sustained face and neck injuries; include assessment of the patient, review of signs and symptoms, and management of care. You should also be able to explain the emergency care of a patient with soft-tissue wounds of the face and neck.

The EMT student should be able to explain the emergency care of a patient with an eye injury based on the following scenarios: foreign object, impaled object, burns, lacerations, blunt trauma, closed head injuries, blast injuries and describe the three different causes of a burn injury to the eye and patient management considerations related to each one. The EMT student should understand the emergency care of a patient with injuries of the nose and ear and the associated medical treatments. The EMT should know and understand the physical findings and emergency care of a patient with a facial fracture, dental and cheek injuries and an avulsed tooth.

Last, the EMT student should be able to explain the emergency care of a patient with an upper airway injury caused by blunt trauma as well as the emergency care of a patient with a penetrating injury to the neck including how to control regular and life-threatening bleeding.

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Students should have an understanding of types of open and closed soft-tissue injuries; how to care for soft-tissue injuries, including the use of dressings and bandages; and the assessment and care of different types of burns, including thermal, chemical, and electrical burns.

Knowledge Domains

The EMT should be able to describe the anatomy of the skin; include the layers of the skin as well as the the functions of the skin. The EMT should be able to name the three types of soft-tissue injuries as well as describe types of closed soft-tissue injuries and open soft-tissue injuries. The EMT should be able to explain the assessment of closed and open injuries as well as the associated medical care for these injuries. The EMT should also be aware of airway management as it relates to these injuries. The EMT should have an understanding of the medical care for an open wound to the abdomen, an impaled object and injuries to the neck. The EMT should know the steps of the emergency treatment of small animal bites, human bites, and rabies.

13. The EMT should be able to explain how the seriousness of a burn is related to its depth and extent and be able to define superficial, partial-thickness, and full-thickness burns, including the characteristics of each burn. The EMT should be able to explain the primary assessment of a burn patient and the emergency medical care for burn injuries. The EMT student should be able to describe the emergency management of chemical, electrical, thermal, inhalation, and radiation burns as well.

Last the EMT should know the functions of sterile dressings and bandages.

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The EMT student should have an understanding of the structure and function of the circulatory system, the significance and characteristics of bleeding, the importance of personal protective equipment when treating a bleeding patient, the characteristics of external and internal bleeding, how to conduct a patient assessment, and methodologies for controlling bleeding.

Knowledge Domains:

EMT's should be able to describe the general structure of the circulatory system and the function of its different parts, including the heart, arteries, veins, and capillaries. Explain the significance of bleeding caused by blunt force trauma, including the importance of perfusion and discuss hypovolemic shock as a result of bleeding, including the signs of shock. Students should know the importance of following standard precautions when treating a patient with external bleeding. and describe the characteristics of external bleeding, including the identification of the following types of bleeding: arterial, venous, and capillary. Additionally students should be able to explain how to determine the nature of the illness (NOI) for internal bleeding, including identifying possible traumatic and nontraumatic sources.

Students should know the signs and symptoms of internal bleeding and discuss internal bleeding in terms of the different mechanisms of injury (MOI) and their associated internal bleeding sources. The EMT student should be able to explain how to conduct a primary assessment, including identification of life threats beyond bleeding, ensuring a patent airway, and making a transport decision. Last, students should be able to explain the emergency medical care of the patient with external and internal bleeding. 

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The EMT, following this lecture should have an understanding of the basic concepts of energy and its effect on the human body; the general injury patterns associated with different types of impacts, falls, and penetrating trauma; and the basic application of laws of physics on the assessment of trauma patients. Students will also understand some common injury patterns to major body systems.

Knowledge Domains:

The EMT student should be able to define the terms: mechanism of injury (MOI), blunt trauma, and penetrating trauma. You should be able to explain the relationship of the MOI to potential energy, kinetic energy, and work. Describe the five types of motor vehicle crashes, the injury patterns associated with each one, and how each relates to the index of suspicion of life-threatening injuries. Discuss the three specific factors to consider during assessment of a patient who has been injured in a fall. Discuss the effects of high-, medium-, and low-velocity penetrating trauma on the body and how an understanding of each type helps EMTs form an index of suspicion about unseen life-threatening injuries. Discuss primary, secondary, tertiary, and miscellaneous blast injuries and the anticipated damage each one will cause to the body. Describe multisystem trauma and the special considerations that are required for patients who fit this category. Explain the major components of trauma patient assessment; include considerations related to whether the method of injury was significant or nonsignificant. Discuss the special assessment considerations related to a trauma patient who has injuries in each of the following areas: head, neck and throat, chest, and abdomen. Explain a general overview of multisystem trauma patient management and patient management in relation to scene time and transport selection. List the Association of Air Medical Services criteria for the appropriate use of emergency air medical services as well as talk about the American College of Surgeons’ Committee on Trauma classification of trauma centers. Last, explain, the American College of Surgeon’s Committee on Trauma and the Centers for Disease Control and Prevention field triage decision scheme as it relates to making an appropriate destination selection for a trauma patient.penetrating trauma.

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The EMT student should have an understanding of the anatomy, physiology, and pathophysiology of hypersensitivity disorders and anaphylactic reactions. Additionally, students will have the knowledge and skills to recognize and allergic and anaphylactic reactions.

Knowledge Domains:

The EMT student should be able to define the terms allergic reaction and anaphylaxis and know the difference between a local and a systemic response to allergens. The EMT should be able to list the five categories of stimuli that could cause an allergic reaction. Students should know how to conduct a primary assessment for a patient with a systemic allergic or anaphylactic reaction and understand the importance of managing the ABCs of these patients. The EMT student should know the emergency medical care to a patient who is experiencing an allergic reaction including the use of an EPI-Pen.

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The EMT student will have an understanding of diabetes, sickle cell disease, clotting disorders, and the complications associated with each. EMT students should be able to understand the characteristics of type 1 and type 2 diabetes and be able to list the appropriate steps for assessment and prehospital treatment of diabetic emergencies. Students should also be able to discuss hematologic emergencies, and describe sickle cell disease, hemophilia, thrombophilia, and deep vein thrombosis.

Knowledge Domains

Describe the anatomy and physiology of the endocrine system and its main function in the body and discuss the role of glucose as a major source of energy for the body as well as its relationship to insulin.

Define the terms diabetes mellitus, hyperglycemia, and hypoglycemia and understand the differences between hypo and hyperglycemia to include the signs and symptoms of both. 

Understand the interventions for providing emergency medical care to both a conscious and unconscious patient with an altered mental status and a history of diabetes who is having symptomatic hyperglycemia or hypoglycemia.

Identify the steps the EMT should follow when conducting a primary and secondary assessment of a patient with an altered mental status who is a suspected of having diabetes.

Know the indications, and contraindications for giving oral glucose to a patient with a decreased level of consciousness who has a history of diabetes.

Know the composition and functions of blood as well as describing the pathophysiology of sickle cell disease, complications, and management of sickle cell disease.

Describe two types of blood clotting disorders, and the risk factors, characteristics, and management of each.

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The EMT student should understand the anatomy and physiology of the gastrointestinal, genitourinary, and renal systems as well as being able to assess and manage various patient populations with numerous related gastrointestinal/genitourinary complaints, which include, but are not limited, to direct or referred abdominal pain, hypoglycemia, hyperglycemia, shock related to acute (medical versus trauma) or chronic gastrointestinal disorders, hemorrhage, peritonitis, and complications related to the renal system (renal dialysis).

Knowledge Domains:

Describe the basic anatomy and physiology of the gastrointestinal, genital, and urinary systems and define the term acute abdomen. Describe pathologic conditions of the gastrointestinal, genital, and urinary systems and explain the concept of referred pain. Identify the signs and symptoms, and common causes, of an acute abdomen and explain the procedures to follow in the assessment and management of acute and chronic gastrointestinal hemorrhage, peritonitits, and ulcerative diseases. List the most common abdominal emergencies, with the most common locations of direct and referred pain. Describe how to manage the patient with shock associated with abdominal emergencies as well as the emergency medical care of the patient with gastrointestinal or urologic emergencies. Last explain the principles of kidney dialysis.

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The EMT student should understand the significance of the anatomy and physiology of the nervous system, common disease processes, assessment and basic care management involving patients with neurologic emergencies (including performing tests for speech, facial movement, and arm movement).

Knowledge Domains:

Anatomy, presentations, and management of

Decreased level of responsiveness, seizures, and strokes

Anatomy, physiology, pathophysiology, assessment, and management of

Stroke/transient ischemic attack, seizures, status epilepticus patients, and headaches

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This is a bonus lecture for the Cardiovascular Emergency lecture. We discuss the use of OPQRST for the chest pain patient.