- AEMT vs EMT vs Paramedic
- EMT = basic life support; AEMT adds IV/IO, fluids, supraglottic airways & select meds; Paramedic adds intubation, cardiac monitoring/manual defib & most IV drugs.
- AEMT scope of practice
- Basic + IV/IO access, IV crystalloids, supraglottic (blind-insertion) airways, and a limited medication formulary — but NOT intubation, manual defibrillation, or cardiac rhythm interpretation.
- Can an AEMT intubate?
- No. Endotracheal intubation is a Paramedic skill. AEMTs use supraglottic/blind-insertion airway devices (King LT, i-gel, Combitube).
- Can an AEMT interpret ECG rhythms?
- No. Cardiac monitoring, rhythm interpretation, and manual defibrillation are Paramedic-level. AEMTs apply an AED for cardiac arrest.
- AEMT medication formulary (typical)
- Oxygen, oral glucose, aspirin, nitroglycerin (assist/admin), epinephrine (auto-injector/anaphylaxis), albuterol, naloxone, dextrose (D10/D50), glucagon, and nitrous oxide — per state/medical direction.
- Can an AEMT start an IV?
- Yes. Peripheral IV access and IV crystalloid fluid administration are core AEMT skills (EMTs cannot).
- Can an AEMT give IV/IO dextrose?
- Yes. AEMTs may give IV/IO dextrose (D10 or D50) for hypoglycemia — an advanced skill beyond the EMT oral-glucose-only level.
- National EMS Scope of Practice Model
- The NHTSA document that defines the four nationally recognized EMS levels (EMR, EMT, AEMT, Paramedic) and the skills/meds each may perform.
- Who certifies the AEMT nationally?
- The National Registry of Emergency Medical Technicians (NREMT).
- AEMT certification eligibility
- Current EMT certification + completion of a state-approved (often CAAHEP/CoAEMSP-accredited) AEMT course, including didactic, lab, and clinical/field competencies.
- AEMT recertification cycle
- Valid 2 years; recertify through the National Continued Competency Program (NCCP) continuing-education model + a current state EMS license.
- Medical direction: online vs offline
- Offline (indirect) = written standing orders/protocols. Online (direct) = real-time orders from a physician by radio/phone.
- Standing orders
- Protocols that let the AEMT perform interventions without contacting medical control first.
- Scope of practice vs standard of care
- Scope = what your level/state authorizes you to do; standard of care = how a reasonable provider of your level would act in the same situation.
- Duty to act
- The legal obligation to provide care while on duty (or when a pre-existing relationship/protocol requires it).
- Abandonment
- Stopping care without transferring the patient to someone of equal or higher training — a legal liability.
- Negligence (4 elements)
- Duty, breach of duty, damages/harm, and causation — all four must be present.
- Supraglottic airway
- A blind-insertion airway (King LT, i-gel, Combitube) seated in the hypopharynx above the glottis to ventilate without visualizing the cords — an AEMT advanced airway.
- i-gel airway
- A supraglottic airway with a soft non-inflatable gel cuff that molds to the laryngeal inlet; fast to place, no cuff to inflate.
- King LT airway
- A supraglottic dual-cuff tube; one cuff seals the esophagus, one the oropharynx, directing air to the trachea.
- Capnography (EtCO₂)
- Continuous measurement of exhaled CO₂; confirms ventilation/airway placement and detects respiratory depression earlier than SpO₂.
- Normal EtCO₂
- 35–45 mmHg.
- Waveform capnography in cardiac arrest
- A sudden rise in EtCO₂ suggests return of spontaneous circulation (ROSC); persistently low EtCO₂ suggests poor compressions or poor perfusion.
- Pulse oximetry (SpO₂) goal
- At least 94% for most patients; titrate oxygen to maintain it — avoid both hypoxia and unnecessary hyperoxia.
- CPAP indications
- Respiratory distress from pulmonary edema (CHF) or COPD/asthma in an awake, cooperative patient who can protect the airway.
- CPAP contraindications
- Apnea/respiratory arrest, hypotension, decreased LOC/can't protect airway, vomiting, pneumothorax, or facial trauma.
- Albuterol
- An inhaled beta-2 agonist (nebulized) that relaxes bronchial smooth muscle for wheezing/bronchospasm in asthma and COPD.
- BVM ventilation rate (adult)
- 1 breath every 5–6 seconds (about 10–12/min); avoid over-ventilation, which raises intrathoracic pressure and lowers cardiac output.
- BVM rate (child/infant)
- 1 breath every 2–3 seconds (about 20–30/min).
- Oxygen delivery: non-rebreather
- 10–15 L/min delivering ~90% FiO₂ — for the hypoxic, adequately breathing patient.
- Nasal cannula flow/FiO₂
- 1–6 L/min gives about 24–44% FiO₂ — for mild hypoxia.
- Signs of inadequate breathing
- Rate <8 or >24, shallow/irregular effort, accessory-muscle use, cyanosis, altered mentation, 1–2 word dyspnea.
- Tripod position
- Sitting upright leaning forward on the hands — a sign of severe respiratory distress.
- Silent chest in asthma
- Loss of wheezing/air movement in a tiring asthmatic — an ominous sign of impending respiratory failure.
- Stridor
- A high-pitched inspiratory sound = upper-airway obstruction (croup, epiglottitis, foreign body, anaphylaxis).
- Airway management priority
- Position, suction, basic adjuncts (OPA/NPA), and BVM first; advance to a supraglottic airway only when basic measures fail.
- OPA vs NPA
- OPA (oral) only for an unresponsive patient with no gag reflex; NPA (nasal) tolerated by patients with an intact gag — avoid NPA with suspected basilar skull fracture.
- Sellick maneuver / cricoid pressure
- Posterior pressure on the cricoid cartilage to reduce gastric insufflation/aspiration — no longer routinely recommended.
- Adequate vs inadequate respiration
- Adequate = normal rate/rhythm with good chest rise and clear lungs; inadequate = abnormal rate, poor tidal volume, or hypoxia — assist with BVM.
- Suctioning limit (adult)
- No more than 15 seconds per attempt (children/infants shorter) to avoid hypoxia.
- Cardiac chain of survival
- Early recognition/activation → early CPR → early defibrillation → advanced care → post-arrest care (+ recovery).
- Adult CPR compression rate
- 100–120 per minute.
- Adult CPR compression depth
- At least 2 inches (5 cm), no more than 2.4 inches (6 cm); allow full recoil.
- CPR compression-to-ventilation (adult, 1 rescuer)
- 30:2.
- Child/infant CPR ratio (2 rescuers)
- 15:2.
- AED use
- Apply as soon as available, ensure no one is touching the patient, and deliver a shock if advised; resume compressions immediately after.
- Aspirin in chest pain
- 162–324 mg chewed for suspected ACS (no allergy/active GI bleed) — it reduces platelet aggregation.
- Nitroglycerin
- A vasodilator for ischemic chest pain; reduces preload/myocardial workload. Sublingual, may repeat every 5 min up to 3 doses.
- Nitroglycerin contraindications
- SBP <90–100 mmHg, recent PDE-5 inhibitor (sildenafil 24 h / tadalafil 48 h), and suspected right-ventricular/inferior MI.
- STEMI
- ST-elevation MI — a fully occluded coronary artery; needs rapid transport for reperfusion (PCI). AEMTs cannot interpret the 12-lead but acquire/transmit it where equipped.
- Classic ACS presentation
- Crushing substernal chest pressure radiating to the arm/jaw, dyspnea, diaphoresis, nausea — may be atypical in women, elderly, and diabetics.
- OPQRST
- Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Time — the pain assessment for chest pain.
- Cardiogenic shock
- Pump failure (often after large MI): hypotension, pulmonary edema, cool clammy skin — supportive care and rapid transport.
- Acute pulmonary edema (CHF)
- Dyspnea, crackles, pink frothy sputum, JVD; sit upright, high-flow O₂/CPAP, nitroglycerin per protocol.
- Return of spontaneous circulation (ROSC)
- A palpable pulse returns after arrest; a sudden EtCO₂ rise is an early clue — then focus on oxygenation, ventilation, and transport.
- High-quality CPR elements
- Rate 100–120, depth at least 2 in, full recoil, minimal interruptions (under 10 s), avoid over-ventilation.
- When to withhold/stop CPR
- Obvious death (rigor, lividity, decomposition, decapitation) or a valid DNR — otherwise begin and continue.
- Epinephrine in cardiac arrest
- A Paramedic-level drug in arrest; AEMT epinephrine use is for anaphylaxis, not as a routine arrest med (per scope/protocol).
- Hypotension definition (adult)
- SBP < 90 mmHg (or signs of poor perfusion) — a marker of shock.
- Rule of nines (adult)
- Head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, genitals 1%.
- How to treat a burn
- Stop the burning, remove jewelry/clothing, cover with a dry sterile dressing, keep warm, and manage airway/fluids; do not pop blisters or apply ice.
- When to use a tourniquet
- Life-threatening extremity hemorrhage not controlled by direct pressure — apply high and tight, note the time.
- Hemorrhage control order
- Direct pressure → tourniquet (extremity) or wound packing/hemostatic gauze (junctional) for severe bleeding.
- Tension pneumothorax
- Air trapped in the pleural space: severe dyspnea, absent breath sounds (one side), JVD, tracheal deviation (late), hypotension — needs decompression.
- Flail chest
- Two or more adjacent ribs broken in two or more places, causing paradoxical chest-wall movement; support ventilation, give O₂.
- Sucking chest wound
- Open pneumothorax — seal with an occlusive (vented) dressing; burp it if a tension pneumothorax develops.
- Spinal motion restriction
- Manual stabilization and limiting movement for suspected spinal injury, guided by selective immobilization criteria — not automatic for every trauma.
- NEXUS criteria (clear spine)
- No midline tenderness, no focal deficit, normal alertness, no intoxication, no distracting injury — if all met, immobilization may be unnecessary.
- Signs of internal bleeding
- Tachycardia, hypotension (late), distended/rigid abdomen, bruising, pallor, altered mentation — high index of suspicion in trauma.
- Hypovolemic (hemorrhagic) shock
- Volume loss → tachycardia, narrow pulse pressure, cool/clammy skin; control bleeding, give O₂, IV fluids cautiously, keep warm, rapid transport.
- Permissive hypotension
- Titrating fluids to a lower target BP in uncontrolled hemorrhage to avoid disrupting clots — per protocol.
- Golden hour / golden period
- The principle that definitive surgical care soon after major trauma improves survival — minimize on-scene time for critical trauma.
- Trauma triage decision
- Use mechanism, vitals, and anatomy to decide transport to a trauma center; limit scene time for the critical patient.
- Beck's triad (cardiac tamponade)
- Hypotension, JVD, muffled heart sounds — from blood compressing the heart after chest trauma.
- Pelvic fracture risk
- Major internal hemorrhage; use a pelvic binder, handle gently, treat for shock.
- Head injury / increased ICP signs
- Decreasing LOC, unequal pupils, Cushing's triad (hypertension, bradycardia, irregular respirations) — maintain oxygenation/perfusion.
- Crush injury concern
- Prolonged compression releases potassium and myoglobin on extrication → hyperkalemia/renal injury; IV fluids before release per protocol.
- Impaled object
- Do not remove (except cheek/airway obstruction); stabilize in place and transport.
- Evisceration
- Cover exposed abdominal organs with a moist sterile dressing; do not push them back in.
- Signs of preeclampsia
- New hypertension after 20 weeks with headache, visual changes, edema, and upper-abdominal pain; risk of seizures (eclampsia).
- What is placenta previa?
- The placenta covers the cervical opening → painless, bright-red third-trimester vaginal bleeding; do not perform a vaginal exam, transport on the left side.
- What is abruptio placentae?
- Premature separation of the placenta → painful vaginal bleeding (may be concealed) with a rigid/tender uterus; a true emergency.
- APGAR score
- Newborn assessment at 1 & 5 min — Appearance, Pulse, Grimace, Activity, Respiration; each 0–2 (max 10).
- Normal newborn heart rate
- At least 100/min; if under 100 despite warming, drying, stimulation, and positioning, begin positive-pressure ventilation.
- Eclampsia
- Seizures in pregnancy from severe preeclampsia — protect the airway, position left lateral, transport rapidly.
- What is anaphylaxis?
- A severe, rapid, life-threatening allergic reaction with airway swelling, wheezing, hypotension, hives, and GI symptoms across multiple systems.
- Epinephrine in anaphylaxis
- First-line: epinephrine 1:1,000 IM (auto-injector 0.3 mg adult / 0.15 mg child) into the lateral thigh; may repeat in 5–15 min.
- Signs of hypoglycemia
- Altered mentation, diaphoresis, tachycardia, tremor, slurred speech, seizures — rapid onset; check glucose.
- Hypoglycemia treatment by route
- Conscious & can swallow → oral glucose; AEMT may give IV/IO D10/D50 or IM glucagon if unable to swallow.
- How to give oral glucose
- Only to a conscious patient with an intact gag reflex who can swallow; place between the cheek and gum.
- DKA (diabetic ketoacidosis)
- Hyperglycemia with ketosis/acidosis: Kussmaul (deep rapid) breathing, fruity breath, dehydration, abdominal pain; IV fluids and rapid transport.
- Cincinnati Prehospital Stroke Scale
- Three signs — facial droop, arm drift, abnormal speech; any one suggests stroke.
- Stroke priorities
- Identify last-known-well time, keep airway/oxygenation/glucose normal, and transport rapidly to a stroke-capable center.
- Naloxone (Narcan)
- An opioid antagonist that reverses respiratory depression/sedation from opioids; give IN/IM/IV and support ventilation first.
- Signs of opioid overdose
- Pinpoint pupils, respiratory depression, and decreased LOC — the classic toxidrome.
- Seizure care
- Protect from injury, do not restrain or put anything in the mouth, position to protect airway after, give O₂, check glucose.
- Status epilepticus
- A seizure lasting 5 min or longer, or repeated seizures without recovery — a true emergency; rapid transport (benzodiazepines are usually Paramedic-level).
- Glucagon
- A hormone that raises blood glucose by mobilizing liver glycogen; given IM/SQ for hypoglycemia when IV access/oral glucose isn't possible.
- SAMPLE history
- Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading up.
- Sepsis recognition
- Suspected infection plus signs of poor perfusion (fever/hypothermia, tachycardia, hypotension, altered mentation) — give O₂/fluids, rapid transport.
- Imminent delivery signs
- Crowning, urge to push, frequent strong contractions <2 min apart — prepare to deliver on scene.
- Nuchal cord
- Umbilical cord around the newborn's neck — gently slip it over the head; if tight, clamp and cut.
- Prolapsed cord
- Cord presents before the baby — relieve pressure (knee-chest/Trendelenburg, gloved hand off the cord), high-flow O₂, rapid transport.
- START triage
- Simple Triage And Rapid Treatment — sort by Respirations, Perfusion, Mental status into Immediate (red), Delayed (yellow), Minor (green), Deceased/expectant (black).
- Triage: red (immediate)
- Life threat needing immediate care — RR >30, no radial pulse/cap refill >2 s, or can't follow commands.
- Triage: black (expectant/deceased)
- No respirations even after airway repositioning.
- Incident Command System (ICS)
- The standardized NIMS management structure for organizing personnel and resources at an incident.
- Cold/warm/hot zones (hazmat)
- Hot = contamination/danger; Warm = decontamination corridor; Cold = safe support/command area. EMS stages in the cold zone.
- Scene size-up
- Scene safety, BSI/PPE, MOI/NOI, number of patients, and need for additional resources — done before patient contact.
- Standard precautions (BSI)
- Gloves, eye protection, gown, and mask as needed — treat all blood/body fluids as infectious.
- Air-medical (helicopter) activation
- For critical trauma/time-sensitive patients with prolonged ground transport; set up a safe, clear landing zone.
- Stages of extrication
- Gain access, perform rapid assessment/stabilization, disentangle, and remove — patient care priorities drive the process.
- CISM / mental-health support
- Critical Incident Stress Management — recognizing and addressing provider stress after difficult calls.
- Mass-casualty incident (MCI)
- An event whose patient needs exceed available resources — triage, ICS, and resource requests are key.
- Ambulance operation safety
- Use due regard with lights/siren, slow at intersections, and wear seatbelts — most crashes happen at intersections.
- Decontamination priority
- Protect yourself first; do not enter the hot zone without proper PPE/training; decon before transport.
- Documentation (PCR) importance
- The patient care report is a legal record, supports continuity of care, and protects the provider — accurate and objective.
- Refusal of care
- A competent adult may refuse; ensure they understand risks (informed), document thoroughly, and encourage care/follow-up.
- Clinical judgment model (NREMT)
- Recognize cues → analyze cues → form a hypothesis → generate solutions → take action → evaluate outcomes.
- Primary assessment (XABCDE)
- Address life threats in order: (exsanguinating) bleeding, Airway, Breathing, Circulation, Disability, Exposure.
- General impression
- The immediate sick/not-sick judgment formed on first sight that drives urgency.
- Reassessment interval
- Every 5 minutes for an unstable patient; every 15 minutes for a stable patient.
- AVPU scale
- Alert, responds to Verbal, responds to Pain, Unresponsive — a quick mental-status check.
- Glasgow Coma Scale (GCS)
- Scores Eye (4), Verbal (5), Motor (6); 3 (worst) to 15 (best); 8 or less = severe, can't protect airway.
- How to read GCS
- Add the best Eye + Verbal + Motor responses; a falling GCS signals deterioration.
- Pediatric Assessment Triangle (PAT)
- A from-the-doorway check of Appearance, Work of Breathing, and Circulation to the skin — rapid sick/not-sick in kids.
- Cushing's triad
- Hypertension (widening pulse pressure), bradycardia, and irregular respirations — a late sign of rising intracranial pressure.
- Shock (compensated vs decompensated)
- Compensated = tachycardia, anxiety, narrowing pulse pressure with normal BP; decompensated = falling BP and altered mentation (late, ominous).
- Cap refill normal
- <2 seconds — prolonged suggests poor perfusion (most reliable in children).
- Pulse pressure
- Systolic minus diastolic BP; a narrowing pulse pressure is an early shock sign.
- Vital sign trends > single readings
- Track changes over time — a worsening trend identifies deterioration before any single number looks abnormal.
- Pediatric vital sign rule
- Children compensate well then crash suddenly; bradycardia in a child usually means hypoxia until proven otherwise.
- Normal adult vital signs
- HR 60–100, RR 12–20, SBP about 90–140, SpO₂ at least 94%.
- Normal infant vital signs
- HR 100–160, RR 30–60 — much faster than adults.
- Transport decision (load and go vs stay and play)
- Critical/unstable patients = rapid transport with care en route; stable patients allow more on-scene assessment.
- Index of suspicion
- Anticipating injuries/illness based on mechanism, presentation, and history — drives a thorough assessment.
- Closed-loop communication
- Repeating back orders/handoffs to confirm understanding — reduces errors during care and transfer.
- Hand-off report (MIST/SBAR)
- A structured patient handoff: Mechanism/Injuries/Signs/Treatment, or Situation-Background-Assessment-Recommendation.
- EMR (Emergency Medical Responder)
- The most basic EMS level: initial care, CPR, AED, hemorrhage control, and basic airway — below the EMT.
- Consent: expressed vs implied
- Expressed = a competent patient agrees to care; implied = an unconscious/incompetent patient is assumed to consent to life-saving care.
- Minor consent
- A minor generally needs a parent/guardian's consent; emancipated minors and true emergencies are exceptions (implied consent).
- HIPAA
- Federal law protecting patient health information — share only with those involved in care or as legally required.
- Advance directive / DNR
- A legal document stating a patient's wishes to limit resuscitation; honor a valid DNR.
- Good Samaritan laws
- Provide limited legal protection for those who help in good faith within their training, off-duty.
- Quality improvement (QI/CQA)
- Ongoing review of care (chart audits, run reviews) to improve EMS system performance.
- Mandatory reporting
- AEMTs must report suspected abuse/neglect, certain injuries, and infectious-disease exposures per state law.
- End-tidal CO₂ in shock
- A falling EtCO₂ can reflect worsening perfusion (less CO₂ delivered to the lungs) even with good ventilation.
- Apneic patient
- No breathing — begin BVM positive-pressure ventilation immediately and consider an advanced airway.
- Gastric distension during BVM
- From over-ventilation/too-fast squeezing; raises aspiration risk — ventilate slowly with good seal.
- Hypoxic drive (COPD)
- A theoretical concern; still give oxygen to a hypoxic COPD patient — never withhold needed O₂.
- Cyanosis
- Bluish skin/mucous membranes from poor oxygenation — a late sign of hypoxia.
- Accessory muscle use
- Use of neck/intercostal muscles to breathe — a sign of increased work of breathing/distress.
- Pulse oximetry limitations
- Falsely high in carbon monoxide poisoning; unreliable with poor perfusion, cold, or nail polish.
- Croup vs epiglottitis
- Croup = barky cough, gradual, viral (kids); epiglottitis = rapid, drooling, tripoding, high fever — keep the child calm, do not inspect the throat.
- Foreign body airway obstruction (conscious adult)
- Abdominal thrusts (Heimlich) until relieved or the patient becomes unresponsive, then begin CPR.
- Asystole vs PEA
- Asystole = no electrical activity (flatline); PEA = organized rhythm with no pulse — both: high-quality CPR.
- Ventricular fibrillation (V-fib)
- Disorganized quivering ventricles, no pulse — the AED shocks it; AEMTs apply the AED, Paramedics manually defibrillate.
- Defibrillation goal
- Stop chaotic electrical activity so the heart's natural pacemaker can resume an organized rhythm.
- AED on a wet/metal surface
- Move the patient to a dry surface and dry the chest before applying pads to avoid arcing.
- AED on a patient with a pacemaker
- Place pads at least 1 inch away from the implanted device.
- Nitroglycerin and inferior MI
- Avoid — an inferior/RV MI is preload-dependent and nitro can cause profound hypotension.
- Chest pain that is cardiac vs not
- Cardiac pain is often pressure-like, exertional, with diaphoresis/dyspnea; reproducible/positional pain is less likely cardiac — but treat suspicious pain as ACS.
- Compression fraction
- The percentage of arrest time spent doing compressions — keep it high (>60-80%) by minimizing pauses.
- Switch compressors
- Every 2 minutes to prevent fatigue and keep compressions effective.
- MOI (mechanism of injury)
- How the injury occurred — guides the index of suspicion for hidden injuries (e.g., high-speed crash, fall >20 ft).
- Kinematics of trauma
- The study of energy transfer in injury — predicts injury patterns from the MOI.
- Compartment syndrome
- Rising pressure in a fascial compartment after injury: pain out of proportion, pallor, paresthesia, pulselessness — a surgical emergency; do not elevate or ice.
- Amputation care
- Control bleeding; wrap the part in moist sterile gauze, seal in a bag, and keep it cool (not directly on ice); transport with the patient.
- Eye injury / chemical exposure
- Irrigate the eye copiously with saline/water from the inner to outer canthus; cover both eyes for a penetrating injury.
- Hypothermia
- Lowered core temperature; handle gently (rough movement can trigger V-fib), remove wet clothing, rewarm passively, give warm O₂.
- Heat stroke
- Hot skin, altered mentation, possible loss of sweating — a true emergency; rapid active cooling and transport.
- Burn severity referral
- Significant/critical burns: airway burns, large BSA, full-thickness, circumferential, hands/face/genitals, or with trauma → burn/trauma center.
- Airway burn signs
- Singed nasal hair, soot in the mouth, hoarseness, stridor, facial burns — anticipate rapid airway swelling.
- Traction splint indication
- Isolated mid-shaft femur fracture without pelvic/lower-leg fracture — reduces pain and bleeding.
- Open vs closed fracture
- Open = bone breaks the skin (infection/bleeding risk); closed = skin intact. Splint, check distal CMS (circulation, motor, sensory).
- Distal CMS check
- Assess Circulation, Motor, and Sensory function distal to an injury before and after splinting.
- Toxidrome: cholinergic (SLUDGE)
- Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis — from organophosphates/nerve agents.
- Toxidrome: sympathomimetic
- Tachycardia, hypertension, hyperthermia, agitation, dilated pupils — from stimulants (cocaine, meth).
- Carbon monoxide poisoning
- Headache, nausea, confusion; SpO₂ reads falsely normal — give high-flow O₂ and remove from the source.
- Activated charcoal
- Binds some ingested poisons; give only per medical direction to an alert patient who can protect the airway.
- Asthma vs COPD
- Asthma = reversible bronchospasm, often younger, triggers; COPD = chronic (emphysema/bronchitis), older smokers — both wheeze and respond to albuterol.
- Allergic reaction (mild vs anaphylaxis)
- Mild = local hives/itching; anaphylaxis = multi-system with airway/breathing/circulation compromise → epinephrine IM.
- Hyperglycemia vs hypoglycemia
- Hyper = gradual, dehydration, fruity breath, Kussmaul; hypo = rapid, diaphoretic, altered/combative — both: check glucose.
- Stroke vs hypoglycemia
- Hypoglycemia can mimic stroke — always check blood glucose in any altered/focal-deficit patient.
- AEIOU-TIPS
- A mnemonic for altered mental status: Alcohol, Epilepsy, Insulin, Overdose, Uremia, Trauma, Infection, Psych, Stroke.
- Behavioral emergency safety
- Ensure scene safety, stay calm, set limits, and use restraints only when necessary, monitored, and per protocol — never prone/positional asphyxia.
- Excited delirium
- Severe agitation, hyperthermia, and superhuman strength — high risk of sudden death; minimize struggle, monitor, rapid transport.
- Postpartum hemorrhage
- Excessive bleeding after delivery — uterine fundal massage and rapid transport.
- Meconium-stained fluid
- Greenish amniotic fluid; if the newborn is not vigorous, suction the airway before stimulating breaths.
- Breech presentation
- Buttocks/feet first — support the body, avoid pulling; if the head doesn't deliver, create an airway and transport immediately.
- Supine hypotensive syndrome
- In late pregnancy the uterus compresses the vena cava when supine — transport the patient tilted to the left side.
- DCAP-BTLS
- Trauma exam findings: Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling.
- JumpSTART triage
- The pediatric version of START triage, accounting for children's physiology (includes 5 rescue breaths for an apneic child with a pulse).
- Secondary triage / re-triage
- Patients are re-assessed and may be re-categorized as their condition changes at an MCI.
- Staging area
- Where incoming units wait for assignment at a large incident — keeps the scene organized.
- Decontamination of equipment
- Clean/disinfect the stretcher and reusable gear after each call; dispose of sharps in approved containers.
- Exposure incident
- After a needlestick/body-fluid exposure: wash the area, report immediately, and follow post-exposure protocol.
- Lifting/moving: power lift
- Keep the back straight, lift with the legs, keep the load close — prevents provider injury.
- Emergency vs non-emergency move
- Emergency move only when there's immediate danger, you can't reach a critical patient, or you must access another patient.
- Recovery position
- Lateral recumbent position for an unresponsive breathing patient without trauma — protects the airway.
- Recognize cues
- Identify relevant signs, symptoms, and history that matter — the first step of clinical reasoning.
- Analyze cues
- Connect and prioritize the findings to figure out what is most likely happening.
- Take action
- Implement the highest-priority intervention within scope, then reassess its effect.
- Evaluate outcomes
- Reassess after every intervention to confirm it helped or to change the plan.
- Sick vs not-sick
- The rapid global judgment that determines transport urgency and the depth of assessment.
- Secondary assessment
- A head-to-toe (or focused) exam plus vitals and history, done after life threats are addressed.
- Rapid trauma assessment
- A quick head-to-toe survey for a significant MOI to find life threats.
- Focused assessment
- An exam targeted to the chief complaint for a stable patient with an isolated problem.
- Pertinent negatives
- Expected findings that are absent — documenting them strengthens clinical reasoning.
- Capnography for trending
- Use waveform EtCO₂ to monitor ventilation, CPR quality, and detect deterioration over time.
