Medical and Obstetrics/​Gynecology Study Guide for the EMT Test

General Information

These types of questions will test your understanding of emergencies and their appropriate procedures in all sorts of medical and the obstetrics/gynecology fields. To fully study these aspects of emergency care, you will need to use your EMT textbook for further explanation of concepts listed here. This study guide should serve as an outline of topics to study.

Medical Emergencies

Paramedics and EMTs usually respond to medical emergencies or traumas. It’s helpful to understand the difference between the two. Medical emergencies occur due to an illness, such as pneumonia, and diseases, such as heart disease. An example of a medical emergency is an asthma attack or stroke. A trauma is an injury due to force exerted on the body. An example of a trauma is a broken leg due to a car accident.

Types

There are many types of medical emergencies, and they can be categorized according to what body system they affect. It is important to know the details of each type of emergency, including typical causes, common symptoms, and difficulty of management.

Terms/Concepts to Know: trauma emergency, medical emergency, common medical emergencies: cardiovascular, respiratory, neurological, immunological, gastrointestinal, urologic, endocrine, hematologic, psychiatric, gynecologic

Assessment

Assessing a medical emergency is different from assessing a trauma patient. The main focus in a medical assessment is the patient’s symptoms and nature of his/her illness.

Assessing the Scene

The first step in treating a medical patient is assessing the scene. Scene assessment is done to make sure it’s safe for you to enter and also to determine if you need additional resources. While you’re assessing the scene, you can also determine what personal protective equipment (PPE) you need. Regardless of the type or medical problem, making sure the scene is safe is the first step.

Primary Assessment

A primary assessment is your first impression of the patient’s condition. It’s during your primary assessment that you determine if there are any life-threatening symptoms that require immediate interventions. Visual clues to look for during a primary assessment include bleeding, trouble breathing, and an altered level of consciousness.

Secondary Assessment

A secondary assessment is a little more involved than a primary assessment. The goal is to identify hidden injuries or causes that may not have been found during the primary assessment. The secondary assessment should involve checking vital signs, oxygen level, and, possibly, breath sounds. A secondary assessment may vary based on the patient’s symptoms and condition. For example, in some cases you may examine the abdomen for tenderness or swelling. In other cases, you might check the pupils.

History

Obtaining a history is an important part of your patient assessment. If the patient cannot give a history, you can obtain information from a family member who is at the scene. Ask questions regarding the patient’s current condition, such as when symptoms started. You can also ask if similar symptoms have occurred in the past. Find out what, if any, medications the patient is taking and if other medical conditions exist. Obtaining a history is sometimes combined with your primary assessment.

Reassessment

During transport, you should continue to reassess your patient. A reassessment is done to determine if there have been any significant changes to your patient’s condition, such as altered level of consciousness (ALOC), trouble breathing, or a change in pain level.

Terms/Concepts to Know: nature of illness, index of suspicion

Next Steps

After completing a patient assessment, patient management and transport are the next steps. In some instances, your time on the scene should be very brief to allow for rapid transport. In other cases, patient management may need to be a little more extensive on the scene.

Management

Management of the patient’s condition may depend on his/her symptoms and your scope of practice. Medical management may include life-saving interventions, such as airway management and CPR, as well as administration of medications. The exact management varies widely.

Transport

Once the decision to transport the patient is made, it’s essential to decide if you should transport the patient with the lights and sirens on or without. Lights and sirens are needed for patients with life-threatening conditions where minutes may affect the outcome. A low-priority transport is one without the lights and sirens and is considered safer.

Destination

Selecting the best emergency department (ED) is also important and can affect patient outcomes. There may be instances where choosing the closest ED is the best choice. There are other cases when a hospital that specializes in certain conditions, such as stroke, is the best choice.

Terms/Concepts to Know: scene time, low-priority transport, high-priority transport

Infectious Diseases

Patients with an infectious disease require special considerations to protect yourself and other people. Understanding the route of transmission and what precautions are needed is an essential part of managing patients with infectious conditions.

Assessment and Management

Patients with infectious disease are assessed like other medical patients. Scene size-up, primary assessment, history, secondary assessment, and reassessment should all be performed. Patients with an infectious disease can present with many different symptoms including fever, SOB, vomiting, and ALOC. Be sure to follow your agency’s policies for sterilizing equipment after treating an infectious patient.

Epidemics and Pandemics

A pandemic involves a global outbreak of a disease. A disease or illness is considered an epidemic if the number of people affected exceeds what is expected. To reduce further spread of an infectious disease, it’s vital to take precautions, such as using personal protective equipment, proper disposal of needles, and sterilization of medical equipment used to treat the patient.

Other Common or Serious Communicable Diseases

There are numerous communicable diseases that EMTs and paramedics encounter. Common conditions with which to become familiar include meningitis, tuberculosis, influenza, herpes, HIV, and hepatitis. Understanding how each disease is transmitted is an important aspect of the job. For example, influenza can be transmitted through droplets or through contact. HIV can be transmitted through contact with blood or sexual contact. Hepatitis can be transmitted through various routes, including sexual contact, blood, and contaminated food. Herpes is contracted through close personal contact with someone who has an infection.

Terms/Concepts to Know: epidemic, pandemic, herpes simplex, influenza, meningitis, tuberculosis, whooping cough

Other Global Issues

There are many global health issues of which it is important to be aware. Since global health issues are vast and can change over time, it’s impossible to be familiar with every condition. But it’s useful to understand a few of the most common ones. For example, ebola is an infectious disease with such symptoms as diarrhea, fatigue, and fever. A patient suspected of ebola should immediately have a mask placed on their face to prevent spread of the disease.

Another condition to be aware of is Middle East respiratory syndrome coronavirus (MERS-CoV). The illness was first found in Saudi Arabia, but, in recent years, cases have also been diagnosed in the United States and Europe. The condition can cause diarrhea, fever, muscle aches, and cough. It is important to know if a patient has traveled internationally, since certain infections and germs may be most common in specific parts of the world.

Terms/Concepts to Know: Middle East respiratory syndrome coronavirus, ebola