Oct 16 • General discussion
These are my notes maybe they will help someone
Capstone/NREMT study guide
Thursday, September 18, 2025
9:55 AM
🔹 1. Airway, Respiration & Ventilation (18–22%)
Adult Airway
• Upper airway structures: nose, mouth, pharynx, larynx
• Lower airway: trachea → bronchi → alveoli
• Techniques: head tilt–chin lift, jaw-thrust (if trauma)
• Adjuncts: OPA (unconscious, no gag reflex), NPA (conscious or semi-conscious, no head injury)
• Suctioning: no more than 15 sec adult, 10 sec child, 5 sec infant
• Ventilation rates:
○ Adult: 1 breath every 5–6 sec (10–12/min)
○ With advanced airway during CPR: 1 breath every 6 sec (10/min) continuous compressions
Pediatric Differences
• Larger tongue, smaller airway diameter
• Epiglottis is floppier and U-shaped
• Narrowest point: cricoid cartilage (not vocal cords as in adults)
• Higher oxygen demand → faster desaturation
• Ventilation rates:
○ Child/Infant: 1 breath every 3–5 sec (12–20/min)
• BVM size: infant, child, adult → always check chest rise
🔹 2. Cardiology & Resuscitation (20–24%)
Adult
• CPR: 30:2 compression to ventilation ratio (single rescuer, all ages)
• Compression depth: 2–2.4 in (5–6 cm)
• Rate: 100–120/min
• AED: use ASAP
• Shockable rhythms: VFib, pulseless VTach
Pediatric
• Compression depth:
○ Child: about 2 in (5 cm)
○ Infant: about 1.5 in (4 cm)
• Two-rescuer CPR: 15:2 ratio
• First line of cardiac arrest cause = respiratory failure, not cardiac disease (opposite of adults)
🔹 3. Trauma (14–18%)
Bleeding
• Arterial: bright red, spurting
• Venous: dark red, steady flow
• Capillary: oozing
• Control: direct pressure → tourniquet if uncontrolled
Shock
• Early signs (peds): tachycardia, delayed cap refill, poor perfusion
• Early signs (adults): restlessness, tachycardia, cool clammy skin
• Late signs: hypotension, altered LOC
Head & Spine Trauma
• Cushing’s triad: bradycardia, hypertension, irregular respirations → ↑ ICP
• Spinal precautions: C-collar + manual stabilization
Chest Trauma
• Tension pneumothorax: absent breath sounds, tracheal deviation, JVD, hypotension
• Flail chest: paradoxical movement
Pediatric Differences
• Bones more flexible, greenstick fractures common
• Larger head → higher risk of head trauma
• Abdominal organs more exposed → greater injury risk
🔹 4. Medical & OB/GYN (27–31%)
Respiratory Emergencies
• Adult: COPD, asthma, pneumonia, PE
• Pediatric: croup (barking cough, stridor), epiglottitis (drooling, tripod position, medical emergency)
Diabetic
• Hypoglycemia: altered LOC, diaphoresis, tremors, “drunk-like”
• Hyperglycemia: polyuria, polydipsia, polyphagia (3 P’s), fruity breath (DKA)
Neuro
• Stroke (FAST assessment: Face, Arm, Speech, Time)
• Seizures: status epilepticus = >5 min or back-to-back
Allergic Reactions
• Mild: hives, itching
• Severe (anaphylaxis): airway swelling, hypotension, wheezing → treat with epinephrine auto-injector
OB/GYN
• Imminent birth: crowning, contractions 2 min apart, urge to push
• APGAR score for newborn: Appearance, Pulse, Grimace, Activity, Respirations
• Neonatal resuscitation:
○ Dry, warm, stimulate
○ If HR <100 → BVM
○ If HR <60 → CPR + BVM + consider ALS for meds
🔹 5. EMS Operations (10–14%)
• Scene size-up: BSI, scene safety, number of patients, MOI/NOI, need for additional resources
• Triage (START):
○ Green = walking wounded
○ Yellow = delayed
○ Red = immediate
○ Black = deceased/expectant
• Ambulance operations: safe driving, loading patients
• Hazmat: recognize, isolate, call HazMat, do not enter “hot zone”
• ICS: command structure, span of control
🩺 Psychomotor Skills (Capstone Stations)
You must perform in order, verbalize steps, and manage life threats immediately.
Core Stations
1. Patient Assessment – Trauma
○ BSI, scene safety → GCS → expose injuries → treat life threats
○ SAMPLE, OPQRST, DCAP-BTLS
2. Patient Assessment – Medical
○ Primary assessment → vitals → secondary assessment → field impression
3. Cardiac Arrest / AED
○ CPR high quality, integrate AED quickly
4. Airway / BVM Ventilation
5. Oxygen Administration by Non-Rebreather
6. Bleeding Control / Shock Management
7. Immobilization (joint, long bone, spine)
8. Random skills (suctioning, traction splint, childbirth)
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These are my notes maybe they will help someone
