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Nick Kiermaier
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‎EMT/clutter/ABC-rough.md‎

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# More detail
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# A – Airway
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## 1. Assessment
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* Is the airway patent (open)?
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* Listen for gurgling, snoring, or silence (signs of obstruction).
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* Look for vomit, blood, secretions, or the tongue blocking the airway.
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## 2. Interventions
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* Manual maneuvers:
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* Head-tilt/chin-lift (if no trauma suspected)
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* Jaw-thrust (if trauma is suspected or cannot be ruled out)
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* Suction:
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* Use a rigid suction catheter (Yankauer) to clear the airway
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* Especially important if patient vomited or has secretions
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* Airway adjuncts:
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* OPA (Oropharyngeal airway) for unresponsive patients without gag reflex
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* NPA (Nasopharyngeal airway) if the patient has a gag reflex or clenching
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* Goal: Establish and maintain a clear, open airway
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---
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# B – Breathing
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## 1. Assessment
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* Look for chest rise/fall
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* Listen for breath sounds
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* Count respiratory rate
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* Feel for air movement
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* Use pulse oximetry (if available)
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* Note work of breathing (shallow, labored, absent)
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## 2. Interventions
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* Assist ventilations with a Bag-Valve-Mask (BVM):
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* Deliver 1 breath every 5–6 seconds (10–12 breaths/min)
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* Ensure tight seal, use EC-clamp grip
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* Watch for adequate chest rise
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* Administer high-flow oxygen:
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* Use 15 L/min with oxygen reservoir attached to BVM
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* If breathing resumes but remains slow, continue assisting
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* Monitor for gastric distension (may need to decompress)
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* Goal: Provide adequate oxygenation and ventilation
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---
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# C – Circulation
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## 1. Assessment
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* Check pulse (rate, rhythm, quality)
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* Check skin: color, temperature, moisture
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* Assess for signs of shock: hypotension, pale/cool/clammy skin, weak pulse
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* Capillary refill time (if used in your region)
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* Use BP cuff and monitor if available
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## 2. Interventions
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* IF NO PULSE → start high-quality CPR
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* 30 compressions, 2 breaths, rate of 100–120 compressions/min
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* Use AED as soon as available
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* IF PULSE is present but bradycardic and patient is unstable:
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* Paramedic: Atropine or external pacing per ACLS
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* Establish IV or IO access (paramedic)
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* Begin fluid resuscitation if signs of hypovolemia or shock
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* Treat underlying causes:
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* Naloxone for opioid overdose
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* Consider trauma, sepsis, cardiac causes, electrolyte imbalances
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* Goal: Support circulation and perfusion, identify and treat reversible causes
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---
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# Transport & Monitoring
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* Rapid transport to hospital with early notification
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* Continuous monitoring:
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* Recheck vitals frequently
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* Monitor LOC, pupils, airway status
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* Prepare for deterioration (e.g., cardiac arrest)
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* Document interventions and response
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‎EMT/notes/ABC.md‎

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A – Airway
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3-
1. Assessment
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5-
Is the airway patent (open)?
6-
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Listen for gurgling, snoring, or silence (signs of obstruction).
8-
9-
Look for vomit, blood, secretions, or the tongue blocking the airway.
10-
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2. Interventions
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Manual maneuvers:
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Head-tilt/chin-lift (if no trauma suspected)
17-
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Jaw-thrust (if trauma is suspected or cannot be ruled out)
19-
20-
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Suction:
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Use a rigid suction catheter (Yankauer) to clear the airway
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Especially important if patient vomited or has secretions
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Airway adjuncts:
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OPA (Oropharyngeal airway) for unresponsive patients without gag reflex
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NPA (Nasopharyngeal airway) if the patient has a gag reflex or clenching
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> Goal: Establish and maintain a clear, open airway
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---
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B – Breathing
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1. Assessment
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Look for chest rise/fall
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Listen for breath sounds
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Count respiratory rate
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Feel for air movement
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Use pulse oximetry (if available)
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Note work of breathing (shallow, labored, absent)
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2. Interventions
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Assist ventilations with a Bag-Valve-Mask (BVM):
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Deliver 1 breath every 5–6 seconds (10–12 breaths/min)
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Ensure tight seal, use EC-clamp grip
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Watch for adequate chest rise
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Administer high-flow oxygen:
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Use 15 L/min with oxygen reservoir attached to BVM
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If breathing resumes but remains slow, continue assisting
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Monitor for gastric distension (may need to decompress)
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> Goal: Provide adequate oxygenation and ventilation
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---
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C – Circulation
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1. Assessment
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Check pulse (rate, rhythm, quality)
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Check skin: color, temperature, moisture
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Assess for signs of shock: hypotension, pale/cool/clammy skin, weak pulse
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Capillary refill time (if used in your region)
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Use BP cuff and monitor if available
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2. Interventions
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If no pulse → start high-quality CPR
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30 compressions, 2 breaths, rate of 100–120 compressions/min
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Use AED as soon as available
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If pulse is present but bradycardic and patient is unstable:
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Paramedic: Atropine or external pacing per ACLS
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Establish IV or IO access (paramedic)
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Begin fluid resuscitation if signs of hypovolemia or shock
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Treat underlying causes:
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Naloxone for opioid overdose
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Consider trauma, sepsis, cardiac causes, electrolyte imbalances
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> Goal: Support circulation and perfusion, identify and treat reversible causes
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---
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Transport & Monitoring
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Rapid transport to hospital with early notification
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Continuous monitoring:
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Recheck vitals frequently
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Monitor LOC, pupils, airway status
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Prepare for deterioration (e.g., cardiac arrest)
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Document interventions and response
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### ABC
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* airway
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* assess
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* obstruction(silence, gurgling, snoring)
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* scene? drugs, blood, vomit, etc.
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* intervention
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* suction
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*
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* adjunct?
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* OPA
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* measure from corner of mouth to angle of jaw
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* NPA
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* can be used on conscious or semi-conscious responsive patients with gag reflexes
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* it is often the preferred airway adjunct in such cases
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* supraglottic:
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* if OPA isn't working after bagging for a while
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* iGel
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* on side of iGel is kg weight to pick correct size
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* 2.2 kg to pounds
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* king
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* on side of the king: how much air to fill up, height, etc.
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* head tilt/ chin lift/ jaw thrust(if suspected spinal injury)-only if non responsive
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* put patient on side(recumbent) if aspirating
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* if patient is responsive and in mild distress-> have them sit up
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* breathing
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* assess
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* respiratory rate
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* normal adult -> 12-20 bpm
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* pulse oximetry
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* observe breathing -> air movement, chest rise/fall
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* if breathing: irregular?, work of breathing/acessory muscles
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* intervention
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* BVM -> 1 breath every 5-6 seconds
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* only use if breathing rate or depth is abnormal -> too low or too high
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* 15 LPM oxygen attached to BVM(thats 15 * 4% = 60% + 21% = 81% can continue up to 100%)
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* look for gastric distention
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* ensure proper seal with EC hand method and watch for chest rise
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* supraglottic
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*
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* NC or NRB -> if rate/depth is fine but low oxygyn via oximetry
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* asthma, lung disease, emphysema->can breathe normally but not exchanging Oxygen correctly
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* circulation
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* assess
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* pulse 60-100bpm in adult
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* BP -> systolic
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* intervention
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* if no pulse -> CPR
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* if bradycardic -> monitor, atropine?, 60-100 bpm
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* other
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* if suspected overdose -> can give narcan(nalexone)
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* will not hurt if there's no overdose
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* if signs of hypovolemia or shock -> begin fluid resuscitation
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### other
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* CPAP
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* no adjunct
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* patient alert
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* concious, breathing rate normal
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* oxygen is 4% additional Oxygen per liter!!
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* normal oxygen is 21% so if you add 1liter that will be 4% increase to be 25% total
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* excess oxygen can make heart attacks worse
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* respiratory:
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* distress
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* increased work breathing but can still maintain ventilation
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* mental status intact
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* acessory muscle, tripod, nasal flaring, anxious, rapid breathing
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* failure(loss of mental function),
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* mental status altered or semi-concious
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* cyanosis
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* fatigue
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* shallow, irregular breathing
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* arrest(unconsious)
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* no breathing at all(no chest rise or air movement)
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* unconcious/near death
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*
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* suction
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* Gently insert into the mouth (or nose/trachea)
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* Advance as far as needed (visible secretions, or until resistance/gag)
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* Cover suction vent (if present) and suction on the way out
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* Use a circular motion to clear as much as possible
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]\
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';lkjvpo1 SEWQ

‎EMT/notes/CPR.md‎

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* BSI, Scene safe
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* ask are you ok?
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* look, listen, feel for pulse/breathing
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* check pulse
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* if has pulse and normal breathing->just monitor until Emergency gets there
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* if has pulse and abnormal breathing -> just use BVM and check pulse every 2 min
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* either you or partner: call 911/or activate emergency response system, get AED
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* compressions
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* start compressions 30 @ 100 to 110 pm
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* then 2 breaths @ 1 second each
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* 5 rounds
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* Have 10 seconds between giving compression
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* repeat twice
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* AED
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* power on
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* plugin pads
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* apply pads:
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* upper right chest and lower left abdomen
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* instructions on the pads
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* say clear before it shocks
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* repeat compressions
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‎EMT/notes/class_notes/6-19-25.md‎

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#### Oxygen amounts
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* Nasal Cannula -> 1-6LPM
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* Nasal Cannula -> 2-6LPM
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* Nebulizer -> 6-8 LPM
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* NRB -> 10-15 LPM
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* BVM -> 15 LPM

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