PHYSICAL WELL-BEING AND MENTAL/EMOTIONAL HEALTH. BOTH ARE ESSENTIAL FOR SAFE DELIVERY OF EMERGENCY CARE AND MANAGING INHERENT EMS STRESSORS.
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WHAT ARE THE SIX CATEGORIES OF NUTRIENTS?
CARBOHYDRATES, FATS, PROTEINS, VITAMINS, MINERALS, AND WATER. CARBOHYDRATES ARE THE BODY'S PRIMARY FUEL SOURCE UNDER NORMAL CIRCUMSTANCES.
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HOW DO SATURATED, UNSATURATED, AND TRANS FATS DIFFER IN THEIR EFFECT ON CHOLESTEROL?
SATURATED FATS RAISE LDL (BAD). UNSATURATED FATS (MONO- AND POLY-) LOWER CHOLESTEROL AND ARE HEART-HEALTHY. TRANS FATS RAISE LDL AND LOWER HDL - THE WORST COMBINATION; AVOID ENTIRELY.
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WHAT IS THE DIFFERENCE BETWEEN HDL AND LDL CHOLESTEROL?
HDL ('GOOD'): ABSORBS CHOLESTEROL AND CARRIES IT TO THE LIVER FOR REMOVAL; MAY HELP CLEAR ARTERY WALLS. LDL ('BAD'): ACCUMULATES ON ARTERY WALLS, INCREASING HEART DISEASE AND STROKE RISK.
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WHAT DISTINGUISHES COMPLETE FROM INCOMPLETE PROTEINS?
COMPLETE PROTEINS CONTAIN ALL ESSENTIAL AMINO ACIDS (FOUND IN MEAT AND DAIRY). INCOMPLETE PROTEINS ARE MISSING ONE OR MORE ESSENTIAL AMINO ACIDS (FOUND IN GRAINS AND VEGETABLES).
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WHAT IS THE DIFFERENCE BETWEEN ESSENTIAL AND NONESSENTIAL AMINO ACIDS?
ESSENTIAL: CANNOT BE MADE BY THE BODY; MUST COME FROM FOOD. NONESSENTIAL: CAN BE SYNTHESIZED BY THE BODY.
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WHICH VITAMINS ARE FAT-SOLUBLE? WHICH ARE WATER-SOLUBLE?
FAT-SOLUBLE: A, D, E, K (ADEK) - STORED IN BODY; DAILY INTAKE OFTEN NOT REQUIRED. WATER-SOLUBLE: VITAMIN C AND B-COMPLEX - CANNOT BE STORED; MUST BE OBTAINED DAILY.
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WHAT DOES VITAMIN K DO AND WHERE IS IT FOUND?
NEEDED FOR NORMAL BLOOD CLOTTING. SOURCES: SPINACH, BROCCOLI, BRUSSELS SPROUTS, KALE. CLINICALLY SIGNIFICANT: WARFARIN INHIBITS VITAMIN K, INCREASING BLEEDING RISK.
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WHAT IS IRON'S ROLE AND WHAT HAPPENS WHEN IT IS DEFICIENT?
IRON IS ESSENTIAL FOR HEMOGLOBIN PRODUCTION. DEFICIENCY CAUSES IRON-DEFICIENCY ANEMIA - FATIGUE, PALLOR, AND DYSPNEA. SOURCES: RED MEAT, LIVER, SHELLFISH, LEGUMES, FORTIFIED CEREALS.
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WHAT DOES POTASSIUM DO?
HELPS REGULATE FLUID BALANCE; MAJOR ROLE IN MUSCLE CONTRACTION, NERVE CONDUCTION, AND HEART FUNCTION.
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WHAT PERCENTAGE OF TOTAL BODY WEIGHT IS WATER, AND WHICH AGE GROUP HAS THE MOST?
50% TO 60% OF TOTAL BODY WEIGHT. INFANTS HAVE THE HIGHEST PERCENTAGE; OLDER ADULTS HAVE THE LOWEST.
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WHAT IS THE HEALTHY BMI RANGE AND THE ENGLISH-SYSTEM FORMULA?
18.5 TO 24.9 KG/M2. FORMULA: WEIGHT (LB) / [HEIGHT (IN)]2 X 703.
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HOW MANY CALORIES EQUAL 1 POUND? WHAT DAILY DEFICIT PRODUCES 1 LB/WEEK LOSS?
3,500 CALORIES = 1 POUND. A DEFICIT OF 500 CALORIES PER DAY = 1-POUND LOSS PER WEEK.
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WHAT ARE THE DESIRABLE LIPID PROFILE TARGETS FOR ADULTS?
TOTAL CHOLESTEROL: 125-200 MG/DL. LDL: LESS THAN 100 MG/DL. HDL: AT LEAST 40 MG/DL (MEN) / AT LEAST 50 MG/DL (WOMEN). NON-HDL: LESS THAN 130 MG/DL.
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WHAT IS THE NORMAL TARGET BLOOD PRESSURE FOR ADULTS?
SYSTOLIC LESS THAN 120 MM HG AND DIASTOLIC LESS THAN 80 MM HG. FOR DIAGNOSED HYPERTENSION, TARGET IS LESS THAN 130/80 MM HG.
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HOW MUCH WEEKLY PHYSICAL ACTIVITY DO ADULTS NEED?
AT LEAST 150 MINUTES OF MODERATE-INTENSITY ACTIVITY PER WEEK, PLUS STRENGTH TRAINING OF ALL MAJOR MUSCLE GROUPS AT LEAST TWICE PER WEEK.
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WHAT IS THE HEART RATE TARGET ZONE FORMULA?
(220 - AGE) X 70%. MAINTAIN THIS ZONE FOR AT LEAST 20 MINUTES DURING AEROBIC EXERCISE TO BUILD CARDIOVASCULAR ENDURANCE.
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WHAT IS THE DIFFERENCE BETWEEN ISOMETRIC AND ISOTONIC EXERCISE?
ISOMETRIC: NO JOINT MOVEMENT, CONTRACTION AGAINST IMMOVABLE OBJECT (E.G., WALL PUSH) - STRENGTHENS AT SPECIFIC ANGLE, MINIMAL BULK. ISOTONIC: JOINT MOVES THROUGH RANGE OF MOTION AGAINST FIXED RESISTANCE (E.G., BARBELL) - ADDS MUSCLE BULK.
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HOW MANY HOURS OF SLEEP DOES THE AVERAGE ADULT NEED?
7 TO 8 HOURS PER DAY. EMS ROTATING SHIFTS AND EXTENDED WORK HOURS CAUSE CIRCADIAN DISRUPTION AND SLEEP DEPRIVATION.
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WHAT REGULATE THE SLEEP-WAKE CYCLE?
MELATONIN (PINEAL GLAND): STIMULATED BY DARKNESS; PROMOTES SLEEPINESS. CORTISOL (ADRENAL GLANDS): INCREASES DURING DAYLIGHT AND STRESS; PROMOTES WAKEFULNESS.
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WHAT WERE THE FATIGUE ODDS RATIOS IN THE 2012 EMS FATIGUE STUDY?
FATIGUED EMS WORKERS: 1.9X GREATER ODDS OF INJURY, 2.2X GREATER ODDS OF MEDICAL ERROR, 3.6X GREATER ODDS OF SELF-COMPROMISING BEHAVIOR (E.G., SPEEDING). OVER 55% OF RESPONDENTS WERE FATIGUED.
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WHAT ARE THE THREE MAIN ENVIRONMENTAL CANCER RISK FACTORS?
SMOKING, SUNLIGHT (UV RADIATION), AND DIET. MOST COMMON CANCERS ARE LINKED TO AT LEAST ONE OF THESE THREE.
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WHAT DOES THE CAUTION MNEMONIC STAND FOR (7 CANCER WARNING SIGNS)?
CHANGE IN BOWEL/BLADDER HABITS, A SORE NOT HEALING, UNUSUAL BLEEDING/DISCHARGE, THICKENING/LUMP, INDIGESTION/DIFFICULTY SWALLOWING, OBVIOUS WART/MOLE/MOUTH SORE CHANGE, NAGGING COUGH OR HOARSENESS.
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WHEN WERE UNIVERSAL PRECAUTIONS INTRODUCED AND WHEN DID STANDARD PRECAUTIONS REPLACE THEM?
UNIVERSAL PRECAUTIONS: 1987 CDC - FOCUSED ON BLOODBORNE PATHOGENS. STANDARD PRECAUTIONS: 1996 CDC - APPLY TO ALL PATIENTS IN ALL SETTINGS REGARDLESS OF DIAGNOSIS.
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WHAT PPE AND DISEASES ARE ASSOCIATED WITH AIRBORNE PRECAUTIONS?
N95 MASK (CLINICIAN) + SURGICAL MASK (PATIENT). DISEASES: TUBERCULOSIS, MEASLES, COVID-19, CHICKENPOX. DROPLET NUCLEI REMAIN SUSPENDED IN AIR AND TRAVEL GREAT DISTANCES.
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WHAT PPE AND DISEASES ARE ASSOCIATED WITH DROPLET PRECAUTIONS?
1. GLOVES, 2. GOGGLES/FACE SHIELD, 3. GOWN, 4. MASK/RESPIRATOR. PERFORM HAND HYGIENE AFTER EACH STEP.
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HOW LONG SHOULD HANDS BE WASHED? WHAT ALCOHOL CONCENTRATION IS NEEDED FOR SANITIZER?
SOAP AND WATER: AT LEAST 20 SECONDS. HAND SANITIZER: AT LEAST 60% ALCOHOL. SANITIZER IS NOT EFFECTIVE AGAINST C. DIFF SPORES, NOROVIRUS, OR HEAVILY SOILED HANDS.
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WHAT ARE THE 8 POST-EXPOSURE STEPS AFTER BLOOD/BODY FLUID EXPOSURE?
1) WASH AREA WITH SOAP/WATER (WATER ONLY FOR EYES/MOUTH), 2) DOCUMENT, 3) DESCRIBE ACTIONS TAKEN, 4) REPORT TO HOSPITAL AND AGENCY OFFICER, 5) COOPERATE WITH INVESTIGATION, 6) GET SCREENED, 7) OBTAIN POSTEXPOSURE PROPHYLAXIS, 8) FULL MEDICAL FOLLOW-UP.
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WHAT IS THE #1 REASON EMS WORKERS LEAVE THE PROFESSION?
BACK INJURY. 1 IN 4 EMS WORKERS SUFFERS A CAREER-ENDING BACK INJURY WITHIN THE FIRST 4 YEARS. 47% HAVE SUSTAINED A BACK INJURY ON DUTY.
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WHAT WEIGHT REQUIRES TWO PEOPLE TO LIFT?
MORE THAN 60 POUNDS (27 KG).
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WHAT IS THE EMS OCCUPATIONAL FATALITY RATE COMPARED TO THE NATIONAL AVERAGE?
APPROXIMATELY THREE TIMES THE NATIONAL AVERAGE. MOST EMS DEATHS RESULT FROM MOTOR VEHICLE INCIDENTS OR AIRCRAFT CRASHES.
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WHAT DID THE 2013 LEADS STUDY FIND ABOUT EMS VIOLENCE?
69% OF EMS PERSONNEL EXPERIENCED AT LEAST ONE FORM OF VIOLENCE IN THE PRECEDING YEAR. PARAMEDICS ALMOST 3X MORE LIKELY THAN EMTS. APPROXIMATELY ONE-THIRD OF VIOLENT INCIDENTS GO UNREPORTED.
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WHAT ANSI VEST CLASS IS REQUIRED FOR ROADWAY WORK?
ANSI HIGH-VISIBILITY VESTS CLASS 2 OR HIGHER, WORN OVER TURNOUT GEAR. MINIMIZE TIME SPENT ON ROADWAYS.
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WHAT PERCENTAGE OF PHYSICIANS AND NURSES DEVELOP SUBSTANCE USE PROBLEMS?
APPROXIMATELY 10%.
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HOW MANY DEATHS PER YEAR DOES CIGARETTE SMOKING CAUSE IN THE US?
MORE THAN 480,000 DEATHS PER YEAR (DIRECT AND SECONDHAND SMOKE). NICOTINE IS THE PRIMARY ADDICTIVE SUBSTANCE.
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WHAT BODY CHANGES OCCUR AT 20 MINUTES AND 1 YEAR AFTER QUITTING SMOKING?
20 MINUTES: PULSE AND BP DECREASE. 1 YEAR: RISK OF HEART DISEASE DROPS TO HALF THAT OF A CONTINUING SMOKER.
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WHAT ARE THE WARNING SIGNS OF A SUBSTANCE USE DISORDER?
USING SUBSTANCE TO RELIEVE TENSION; USING INCREASING AMOUNTS; LYING ABOUT USE; GUILT ABOUT USE; AVOIDING DISCUSSION OF USE; SUBSTANCE INTERFERING WITH DAILY ACTIVITIES.
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WHAT IS THE DIFFERENCE BETWEEN EUSTRESS AND DISTRESS?
EUSTRESS = POSITIVE, PROTECTIVE, PERFORMANCE-ENHANCING STRESS. DISTRESS = NEGATIVE, DEBILITATING STRESS; SOURCE OF ANXIETY AND STRESS-RELATED DISORDERS.
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WHAT ARE SELYE'S THREE STAGES OF THE GENERAL ADAPTATION SYNDROME?
REPRESSION, REGRESSION, PROJECTION, RATIONALIZATION, COMPENSATION, REACTION FORMATION, SUBLIMATION, DENIAL, SUBSTITUTION, ISOLATION. REPRESSION IS THE FOUNDATIONAL MECHANISM UNDERLYING ALL OTHERS.
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WHAT ARE THE FOUR PHASES OF THE ADAPTATION PROCESS IN ORDER?
1. DEFENSE MECHANISMS, 2. COPING, 3. PROBLEM SOLVING, 4. MASTERY.
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WHAT IS BURNOUT?
PHYSICAL AND EMOTIONAL EXHAUSTION WITH NEGATIVE ATTITUDES RESULTING FROM CUMULATIVE CHRONIC STRESS THAT CANNOT BE MANAGED WITH USUAL COPING MECHANISMS.
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WHAT ARE THE FOUR STRESS MANAGEMENT TECHNIQUES?
REFRAMING (NEW EMOTIONAL VIEWPOINT), CONTROLLED BREATHING (FOCUS ON DEPTH/RATE TO ACHIEVE CALM), PROGRESSIVE RELAXATION (SYSTEMATICALLY TIGHTEN THEN RELAX MUSCLE GROUPS), GUIDED IMAGERY (VISUALIZING CALMING IMAGES WITH A GUIDE).
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HOW IS TACTICAL (SQUARE) BREATHING PERFORMED?
BREATHE IN 4 COUNTS, HOLD 4 COUNTS, EXHALE 4 COUNTS. REPEAT AT LEAST 3 TIMES. CONTROLS THE SYMPATHETIC FIGHT-OR-FLIGHT ALARM REACTION.