I have 2 questions...

[word2yamutha]

I was taking a emt-b test for a job and was wondering about them. I cant remember the questions exactly,but Ill make it to the point.

Had a patient would had a nitro patch on his chest. How would you deliberate him?

1. deb. with patch on pt.
2. remove patch on pt. then deb.
3. i cant remember 3 or 4

my other question was..

Had a pt. who was given a flu shot then passed out. The people around you agreed your pt. is in shock. What kind of shock is it?

1. nero
2. vaso
3. cardiac
4. i cant remember 4

 

[Shishkabob]

Deliberate? Why would I think about him?




Psychogenic shock.

 

[Cawolf86]

I was taking a emt-b test for a job and was wondering about them. I cant remember the questions exactly,but Ill make it to the point.

Had a patient would had a nitro patch on his chest. How would you deliberate him?

1. deb. with patch on pt.
2. remove patch on pt. then deb.
3. i cant remember 3 or 4

my other question was..

Had a pt. who was given a flu shot then passed out. The people around you agreed your pt. is in shock. What kind of shock is it?

1. nero
2. vaso
3. cardiac
4. i cant remember 4

Let me deliberate your question.....

You would remove the medication match, quick wipe the area, then "defibrillate" as normal.

The shock could be psychogenic (due to fear or stress) or it could be due to an adverse reaction to the vaccine (unlikely).

 

[Fox800]

You're an EMT-B but you don't know the difference between "deliberate" and "defibrillate"?

 

[Jay]

word2yamutha,

For your first question you will need to remove the patch, clean and/or shave as necessary and then shock. You only place pads around a cardiac pacemaker approx. 1 inch to the side/above/below them.

As for shock secondary to a vaccination, was anaphylactic shock an option? This would be shock due to allergy, perhaps the eggs that they would use to prep the flu vaccine as you should not administer this vaccine to someone with an egg allergy for this very reason.

 

[JPINFV]

1. Remove, clean, defibrillate.

2. Most likely vasovagal, but could be anaphalxtic.

 

[Melclin]

I was taking a emt-b test for a job and was wondering about them. I cant remember the questions exactly,but Ill make it to the point.

Had a patient would had a nitro patch on his chest. How would you deliberate him?

1. deb. with patch on pt.
2. remove patch on pt. then deb.
3. i cant remember 3 or 4

my other question was..

Had a pt. who was given a flu shot then passed out. The people around you agreed your pt. is in shock. What kind of shock is it?

1. nero
2. vaso
3. cardiac
4. i cant remember 4

First question: What on earth do you mean by deliberate?

Second question: Failing anaphylaxis, Its most probably a vasovagal reaction to the expectation of pain/fear of needles, I suppose. How that fits into the question you pose, I don't know, especially given first aid/EMT type curriculum's penchant for misrepresenting shock.

 

[JPINFV]

Here's a question, why should I care about what the people around me think? They aren't medical professionals. EMS providers are supposidly medical professionals. I don't treat by a vote of the bystanders.

 

[Jay]

2. Most likely vasovagal, but could be anaphalxtic.

A vasovagel response is not a type of shock so it could not be an answer to this question, rather it is a precursor to syncope. If actual shock is involved than it's anaphylaxis which is an actual classification of shock. This was a trick question and like all EMS or nursing style exams there is a close answer and a best answer but not both.

 

[JPINFV]

A vasovagel response is not a type of shock so it could not be an answer to this question, rather it is a precursor to syncope. If actual shock is involved than it's anaphylaxis which is an actual classification of shock. This was a trick question and like all EMS or nursing style exams there is a close answer and a best answer but not both.

I highly doubt that bystanders would classify anaphylaxis as a type of shock. Allergic reaction? Yes. Shock? No.

 

[8jimi8]

A vasovagel response is not a type of shock so it could not be an answer to this question, rather it is a precursor to syncope. If actual shock is involved than it's anaphylaxis which is an actual classification of shock. This was a trick question and like all EMS or nursing style exams there is a close answer and a best answer but not both.

it doesn't have to be anaphlactic, it could be psychogenic as Linuss first pointed out.

 

[Sassafras]

Isn't vasovagal a reaction of the nerves in the pharynx to sudden temperature changes?
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Nevermind, wiki to the rescue. It CAN be a reaction of the nerves, but I guess a shot can do it too...come to think of it vasovagal is starting to sound an aweful lot like "we don't know why the hell you passed out so we're gonna let it fall into the umberella category of vasovagal"

 

[Cawolf86]

We had a short lecture from one of our teachers today about how a "vasovagal" response is not possible because the Vagus nerve does not innervate the blood vessels. It's effects on the cardiovascular system are due to it's ionotropic, chronotropic, and dromotropic effects.

I was going to look into this more but since I see "vasovagal" thrown around here so much I thought I would get some opinions.

 

[Melclin]

We had a short lecture from one of our teachers today about how a "vasovagal" response is not possible because the Vagus nerve does not innervate the blood vessels. It's effects on the cardiovascular system are due to it's ionotropic, chronotropic, and dromotropic effects.

I was going to look into this more but since I see "vasovagal" thrown around here so much I thought I would get some opinions.

Good idea to look into is a bit more. I wouldn't trust an a paramedic instructor. I don't even trust out lecturers and they all have intensive care experience and post graduate qualifications in prehospital care and education.

My understanding is that the term is vasovagal syncope isn't really a condition as such, but a lose descriptor of the stimulation of the parasympathetic nervous system as well as the depression of the sympathetic nervous system to various degrees by all kinds of different stimuli. Yes the vagus nerve drops the heart rate but there may also be central nervous involvement and the depression of the sympathetic nervous system more than accounts for the vasodialation.

Also the increased intra-thoracic from a pain response, or the anticipation of pain may be enough to mildly occlude the vena cavae I suppose, so it would be vascular in that sense too.

 

[emt seeking first job]

re: patch, I remember was told to remove it with a gloved hand...

other question stumped me

 

[Tincanfireman]

How would you deliberate him?


:deadhorse: May I suggest a medical terminology class?

 

[jjesusfreak01]

:deadhorse: Thanks for posting what I was thinking... =)

My instructor always said "defibulate". It took a lot to keep from laughing. Also, we learned SHRIMP CAN as the pnemonic for types of shock.

Septic
Hypovolemic
Respiratory
Insulin
Metabolic
Psychogenic

Cardiac/Cardiogenic
Anaphylactic
Neurogenic

Of course, there is tons of overlap here, since things like septic and anaphylactic may lead to hypovolemic shock when the capillaries get leaky, but you get the idea.

 

[word2yamutha]

awww crap i meant defibrillate. My computer does that autofix with certain words and when I typed "defibrillate" in, it changed it into the other word. Thanks for the responses guys

 

[medicRob]

CDC Information on Flu Shot:

Can severe problems occur?

Life-threatening allergic reactions are very rare. Signs of serious allergic reaction can include breathing problems, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. If they do occur, it is within a few minutes to a few hours after the shot. These reactions are more likely to occur among persons with a severe allergy to eggs, because the viruses used in the influenza vaccine are grown in hens' eggs. People who have had a severe reaction to eggs or to a flu shot in the past should not get a flu shot before seeing a physician.

[taken from: http://www.cdc.gov/flu/about/qa/flushot.htm#whatare ]

 

[word2yamutha]

CDC Information on Flu Shot:

Can severe problems occur?

Life-threatening allergic reactions are very rare. Signs of serious allergic reaction can include breathing problems, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. If they do occur, it is within a few minutes to a few hours after the shot. These reactions are more likely to occur among persons with a severe allergy to eggs, because the viruses used in the influenza vaccine are grown in hens' eggs. People who have had a severe reaction to eggs or to a flu shot in the past should not get a flu shot before seeing a physician.

[taken from: http://www.cdc.gov/flu/about/qa/flushot.htm#whatare ]

thanks for the info