Could You Pass an EMT Exam?

"Body substance isolation" is the somewhat formal name given to protections from blood, saliva, mucus and other body fluids. These can transmit infectious diseases.

Hypoglycemia is a common result of diabetes; put another way, diabetes is the underlying illness, which can express itself in either hypo- or hyperglycemia. Whether diabetes is Type I or Type II, the body has difficulty maintaining a healthy range of blood sugar.

This is not to be confused with "shock" overall. That's a more common response in emergencies, not narrowly affecting the immune system.

Tuberculosis is a lung disease and can be spread by airborne methods (e.g., coughing or sneezing). Though an EMT is almost certainly going to be inoculated against TB, wearing a mask is advised around patients suspected to be tubercular, in part because of the rare, but still possible, chance of an inoculation-resistant strain.

Dilated pupils can indicate one of several medical conditions. When only one is dilated, it can mean a serious head injury.

You'll hear this shorter term a lot for the brain and spinal cord. CNS injuries can have especially grave implications for future health.

To be specific, "respiratory" is a little broader, with "pulmonary" referring to the lungs alone. For example, an "upper respiratory infection" is a cold, affecting the nose and throat. (It's also not usually an issue for an EMT, of course).

Certainly, if someone was assaulted, they are a victim, but EMTs rarely use that word. As some EMT instructors like to tell students, '"Victims' are patients who get lousy treatment."

All of these are signs of diabetes, but the first two indicate an "emergent" situation. Frequent urination, like thirst, is a more general symptom of diabetes. An evaluation by a patient's primary-care doctor is indicated, by not necessarily urgent.

The aorta is the largest artery in the body. It leads away from the heart, beginning the process of transporting oxygenated blood to the rest of the body.

To assess a pulse as tachycardic requires a bit of advance knowledge. A normal heart rate is different for different age groups, and if a patient has just finished a burst of exertion -- like running to get help after an accident -- the rapid pulse may not be cause for concern.

Generally speaking, heart rate is highest at birth, and slows throughout life. However, endurance athletes might have lower heart rates at age 35 than a non-exerciser at 50 -- there are variables in play.

Anaphlylaxis is a life-threatening allergic reaction. One of the more common ones is to bee stings.

"Type 2" (or Type II) is a more accurate term, because children and teenagers can develop it. The main thing that differentiates it is that in Type 2 diabetes the body has lost sensitivity to insulin, rather than being unable to produce it (which is Type 1). This can be managed through changes in diet and exercise and through medication.

"Size-up" is an important concept in first-responder work. Rushing in can lead to injury to the EMT or to missing important clues to the overall crisis.

These are the top three things a first responder should take care of. If the patient doesn't have a blocked airway, is breathing, and his/her heart is working and circulating blood, there is a good chance they will survive to get secondary medical treatment. Note that "circulation" also includes bleeding -- if the patient's circulation is resulting in uncontrolled blood loss from a wound, that needs to be taken care of right away.

One of the things that EMT students learn is good body mechanics. The job requires lifting and carrying, and without good skills in this area, first responders can be injured.

EMTs sometimes administer oxygen to patient in the field or in the ambulance. A flowmeter lets the medic adjust the rate of oxygen flow, measured in liters per minute.

It's not true that a slow pulse is never cause for concern. An underperforming heart cannot get oxygen and vital nutrients to tissues of the body, which is a serious health concern.

EMTs are allowed to, and supposed to, put their own physical safety first. But not approaching a patient because of concern for evidence in a crime is not sufficient reason. Nor is a patient's initial apparent refusal to be treated.

Scalpels are for surgeons. The other three are often used in paramedic work. EMT shears are especially nifty -- they are thin and blunt at the tip, so an EMT can slide them right under tight clothing without cutting the patient, then use them to cut off through that clothing and access wound sites.

Saying "airway" is handy when you don't know exactly where an obstruction is. Any blockage in the airway, from nose to lungs, is dangerous.

This is significant because first responders are often called on to find a "radial pulse." This is done by laying two fingers on the wrist, over the radial artery.

Many things can cause confusion, hallucination, anxiety or combativeness. Even if a patient's mental state is caused by substance use, it is important not to respond with judgment or irritation, which can get in the way of a good treatment outcome.

A stroke can be difficult to assess at the scene, since symptoms can appear to resolve, then return. Prompt transport to a hospital for a doctor's diagnosis is essential.

Signs of hypoxia include a bluish tinge to the lips and confusion/altered mental status. This is a problem that can trouble anyone who travels to altitudes higher than 8,000 or 9,000 feet, especially without advance cardiovascular training.

There are some "breathing gurus" that encourage people to get their breathing rate down as low as 4 breaths per minute. But most medical experts agree this is an unnecessary goal: 12 to 20 is fine in an adult.

TV and movies give the impression that cutting into a patient's throat and inserting a tube of some sort below a blockage is fairly easy -- the sort of thing a Boy Scout might do with his penknife and a drinking straw at a restaurant. In truth, tracheotomy is very difficult and has a high risk of either not working or severing an artery. It is not included in EMT training.

Some ambulance services do not allow EMTs to use a blood glucose monitor; nearly all allow them to administer glucose, and require them to carry it. But diagnosis itself is a job for an MD. You'll often hear an EMT referring to "assessing" a patient, but not "diagnosing" them.

This position is useful because it allows vomit or other fluids to drain safely from the mouth. If you want to impress co-workers, call it the "lateral recumbent position."

The pancreas makes insulin, but in some people, the amount is insufficient and has to be supplemented. However, even the insulin administered externally has natural origins -- it is generally made from cow or pig pancreases.

"SAMPLE" is an acronym for a history-taking method. It goes Signs and Symptoms, Allergies, Medications, Pertinent past history, Last oral Intake (food or drink) and Events leading to 911 call.

Anaphylaxis is a severe immune response. Some swelling in response to an immune threat --a foreign substance in the body -- is normal. But when the airway begins to close as a result, it becomes potentially fatal.

In other words, this is the person who called 911 (at least, that's usually how the process gets started). In radio communications, you'll often hear the short version, "RP."

A drunken patient or one on drugs still has the right to refuse care. The EMT's responsibility is to make sure he or she understands their medical situation and makes as informed a decision as possible before signing the refusal-of-care form.