NREMT EMT 7: Medical Quizzes and Glossary - Evidence-Based Guidelines and Best Practices, CPR Updates, EBM Reviews, Use of the LUCAS Device, Whole Blood Administration for AEMTs/Paramedics

What This Is: Evidence-Based Guidelines and Best Practices for Emergency Care

In emergency situations, evidence-based guidelines and best practices help us provide the best possible care. Think of it like a recipe for saving lives. Just as a recipe has specific steps and ingredients, we have guidelines and best practices that help us respond to emergencies effectively. For example, when someone's heart stops beating, every minute counts, and following the right steps can make all the difference.

Key Steps / Core Facts:

• CPR Compression Depth: At least 2 inches (like pushing down a soda can) to ensure blood flow to the brain. (OPQRSTI)
• CPR Compression Rate: 100-120 compressions per minute (like a metronome) to match the heart's natural rhythm.
• CPR Chest Rise: At least 1/3 to 1/2 inch (like a small balloon) to ensure air is entering the lungs.
• CPR Ratio: 30:2 (30 compressions to 2 breaths) for adults and children, and 30:3 for infants.
• CPR Duration: Continue for at least 2 minutes before moving the person, and then continue until EMS arrives.
• LUCAS Device: A mechanical chest compression device that can be used in place of manual compressions, but only by trained professionals.
• Whole Blood Administration: For AEMTs and paramedics, whole blood can be administered to patients with severe bleeding, but only in specific situations and with proper training.
• EBM Reviews: Regular reviews of evidence-based medicine to ensure we're using the most effective treatments and techniques.
• CPR Updates: Regular updates to CPR guidelines, such as the 2020 American Heart Association (AHA) guidelines, which emphasize the importance of high-quality compressions.
• AED Use: Automated External Defibrillators (AEDs) can be used by anyone, but only if they're properly trained and follow the device's instructions.
• Airway Management: Maintaining a patent airway is crucial, like keeping a straw unclogged to drink from.
• Breathing: Providing adequate ventilation, like blowing up a balloon, to ensure oxygen is reaching the brain.
• Circulation: Maintaining blood flow, like keeping a hose flowing, to prevent tissue damage.

What Laypeople Can Do:

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder to see if they respond.
• If the person is unresponsive, call 911 or your local emergency number and start CPR if you're trained.
• If you're not trained in CPR, provide any other assistance you can, such as keeping the person calm and comfortable.
• If you're with a child or infant, follow the same steps as for adults, but use a child or infant CPR technique.
• If you're with someone who's choking, encourage them to cough or try to dislodge the object with your fingers.

Common Mistakes:

• Mistake: Not checking for danger before approaching a collapsed person.
• Fix: Always check for danger first, then approach the person and try to rouse them.
• Mistake: Not providing adequate ventilation during CPR.
• Fix: Make sure to provide 2 breaths for every 30 compressions to ensure oxygen is reaching the brain.
• Mistake: Using an AED without proper training.
• Fix: Only use an AED if you're properly trained and follow the device's instructions.

Quick Practice Scenarios:

• A 30-year-old man collapses while playing basketball. What should you do first?

Answer: Check for danger, then shout and tap his shoulder to see if he responds.

• A 2-year-old child stops breathing after choking on a piece of food. What should you do first?

Answer: Encourage the child to cough, and if they can't cough, try to dislodge the object with your fingers.

• A 70-year-old woman is experiencing severe bleeding after a fall. What should you do first?

Answer: Call 911 or your local emergency number and provide any other assistance you can, such as applying pressure to the wound.

Last-Minute Exam Cram:

• Agonal breathing is NOT normal breathing – start CPR.
• Normal heart rate: 60-100 beats per minute.
• Normal blood pressure: 90-120 mmHg systolic and 60-80 mmHg diastolic.
• Normal body temperature: 97.7-99.5°F (36.5-37.5°C).
• Normal respiratory rate: 12-20 breaths per minute.
• Normal oxygen saturation: 95-100%.
• Do NOT use an AED on a person with a pacemaker or implantable cardioverter-defibrillator (ICD).
• Do NOT use an AED on a person who is in a bathtub or shower.
• Do NOT use an AED on a person who is in a pool or body of water.
• Do NOT use an AED on a person who is in a vehicle that is in motion.
• Do NOT use an AED on a person who is in a vehicle that is in a hazardous location.
• Do NOT use an AED on a person who is in a location where it is not safe to use an AED.