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A

Abandonment to leave an injured or sick patient before more highly trained EMS personnel arrive. Leaving the scene without giving patient information may be viewed as a form of abandonment.

ABC method the sequence of operations required in car-diopulmonary resuscitation. A stands for airway, B stands for breathing, and C stands for circulation.

ABCs of emergency care these letters stand for the words airway, breathing, and circulation as they relate to the initial assessment.

Abdomen (AB-do-men) the region of the body between the diaphragm and pelvis.

Abdominal cavity the anterior body cavity that is located between the diaphragm and the bones of the ring of the pelvis. It houses and protects the abdominal organs, glands, major blood vessels, and nerves.

Abdominal quadrants the four zones that are assigned to the anterior abdominal wall. These zones are used for quick reference for the location of structures, injuries, and pain.

Abdominal thrusts manual thrusts that are delivered to the midline of the abdomen, between the xiphoid process and the navel, to create pressure to help expel an airway obstruction. See manual thrusts.

Abdominopelvic (ab-DOM-i-no-PEL-vik) the front (anterior) cavity below (inferior to) the diaphragm.

Abortion (ah-BOR-shun) the spontaneous or induced delivery of the fetus and placenta before the 28th week of pregnancy. See miscarriage.

Abrasion (ab-RAY-zhun) a scratch.

Abscess (AB-ses) a contained or otherwise limited structure that collects the pus associated with tissue death and infection.

Acetone breath a sweet breath with a fruitlike odor. This is a sign of diabetic coma.

Achilles (ah-KEL-ez) tendon the common term for the ten-don that connects the posterior leg muscles to the heel. The calcaneal (kal-KA-ne-al) tendon.

Acid being acidic, as opposed to being neutral or basic (al-kaline). Associated with free hydrogen ions.

Acquired immune deficiency syndrome (AIDS) a contagious disease that is usually fatal. The infectious agent is HIV. This agent may be passed from person to person by sex-ual contact, blood transfusion, sharing needles, or across the placenta from mother to fetus (unborn child). The virus is found in blood, body fluids, and wastes. It is also associated with mucous membranes. Even though it is found in saliva, there is no clear evidence of the disease being transmitted in this substance.

Activated charcoal a very fine, treated powder of charcoal that is available in premixed form or ready to mix with water. When taken by mouth, it may absorb some forms of ingested poisons, thus preventing or reducing absorption by the patient’s body.

Acute to have a rapid onset. Sometimes the term is used to mean severe.

Acute abdomen the sudden onset of severe abdominal pain. Abdominal distress related to one of many medical conditions or specific injury to the abdomen.

Acute myocardial infarction (AMI) (my-o-KARD-e-al in-FARK-shun) a heart attack. The sudden death of heart muscle due to oxygen starvation. Usually caused by a narrowing or blockage of one of the blood vessels (coronary arteries) supplying the heart muscle.

Advanced cardiac life support (ACLS) prehospital emergency care that involves the use of intravenous fluids, drug infusions, cardiac monitoring, defibrillation, intubations, and other advanced procedures. See basic life support.

Afterbirth the placenta, part of the umbilical cord, and some tissues of the womb’s lining that are delivered after the birth of the baby.

Agonal respirations sporadic noises from the patient’s airway, without chest movement; these occur just prior to death.

AIDS See acquired immune deficiency syndrome.

Air embolism gas bubbles in the bloodstream.

Air sacs the microscopic parts of the lung where gas exchange takes place. The medical term is alveoli (al-VE-o-li).

Air splint See inflatable splint.

Airway the passageway for air from the nose and mouth to the exchange levels of the lungs. The term can also be used to mean artificial airways, such as an oropharyngeal airway.

Airway adjunct a device that is placed in the patient’s mouth or nose to help maintain an open airway. Oral airway adjuncts may help to hold the tongue clear of the airway.

Alkali a substance that is basic, as opposed to being acid or neutral.

Allergen (AL-er-jin) any substance that can cause an allergic response.

Allergy shock the most severe type of allergic reaction, in which a person goes into shock when he comes into contact with a substance to which he is allergic. Also called anaphylactic (AN-ah-fi-LAK-tik) shock.

Alveoli (al-VE-o-li) See air sacs.

Amnesia the short- or long-term loss of memory. This loss usually has a sudden onset.

Amniotic sac See bag of waters.

Amputation the surgical or traumatic removal of a body part. The most common usage applies to traumatic amputation of an extremity or one of its parts.

Analgesic a pain reliever.

Anaphylactic (an-ah-fi-LAK-tik) shock See allergy shock.

Anatomical position the standard reference position for the body in the study of anatomy. The body is standing erect, facing the observer. The arms are down at the sides and the palms of the hands face forward.

Anatomy the study of body structure.

Anesthetic to be free of pain and feeling. Commonly used to mean a substance that will block pain or feeling.

Aneurysm (AN-u-RIZ-m) the dilated or weakened section of an arterial wall. A blood-filled sac formed by the localized dilation of an artery or vein.

Angina pectoris (an-JI-nah PEK-to-ris) the chest pains often caused by an insufficient blood supply to the heart muscle. This is not a heart attack as defined by the average patient. Also angina.

Angulation the angle formed above and below a break in a bone. The fracture changes the straight line of a bone into an angle. Also angulated fracture.

Ankle bones the tarsals (TAR-sals).

Anterior the front. See posterior.

Antiseptic a substance that will stop the growth of or prevent the activities of germs (microorganisms).

Anus (A-nus) the outlet of the large intestine.

Aorta (a-OR-tah) the major artery that carries blood from the heart out to the body.

Apical pulse the heartbeat felt over the lower portion of the heart.

Apnea (ap-NE-ah) the temporary cessation of breathing.

Apoplexy (AP-o-plek-see) the loss of consciousness, movement, and awareness of sensation that is caused by a stroke (CVA).

Appendicular (ap-en-DIK-u-ler) skeleton collarbones, shoulder blades, and the bones of the arms, forearms, wrists, hands, pelvis, thighs, legs, ankles, and feet. The bones of the upper and lower extremities. See axial skeleton.

Arm the body part from the shoulder to elbow.

Arrhythmia (ah-RITH-me-ah) disturbance of heart rate and rhythm. Sometimes the term dysrhythmia is used to mean the same thing.

Arterial bleeding the loss of bright red blood from an artery. The flow may be rapid, spurting as the heart beats. See capillary bleeding and venous bleeding.

Arteriole (ar-TE-re-ol) the smallest of the arteries that typically lead into capillary beds. See venule.

Arteriosclerosis (ar-TE-re-o-skle-RO-sis) "hardening of the arteries" caused by calcium deposits. See also atherosclerosis.

Artery any blood vessel carrying blood away from the heart.

Articulate to join together. To unite to form a joint.

Artificial breathing See artificial respiration.

Artificial respiration the process of forcing air or oxygen into the lungs of a patient who is in respiratory arrest or who does not have adequate breathing. Also called artificial ventilation and artificial breathing.

Artificial ventilation See artificial respiration.

Aseptic clean, free of particles of dirt and debris. This does not mean sterile.

Asphyxia (as-FIK-si-ah) suffocation resulting in the loss of consciousness caused by too little oxygen reaching the brain. The functions of the brain, heart, and lungs will cease.

Aspiration to inhale materials into the lungs. Often used to describe the breathing of vomitus.

Asthma (AS-mah) the condition in which the bronchioles constrict, causing a reduction of airflow and creating congestion. Air usually will enter to the level of the air sacs (alveoli), but it cannot be exhaled easily.

Asystole (a-SIS-to-le) when the heart stops beating. This is cardiac standstill.

Atherosclerosis (ATH-er-o-skle-RO-sis) the buildup of fatty deposits on the inner wall of an artery. This buildup is called plaque. If calcium is deposited in the plaque, the arterial wall will become hard and stiff. See arteriosclerosis.

Atrioventricular (a-tre-o-ven-TRIK-u-lar) or AV node node in the upper chamber of the heat where electrical wave is delayed and then transferred to the lower chambers of the heart.

Atrium (A-tree-um), a superior chamber of the heart. The heart has a right and left atrium. Pl., atria.

Auscultation (os-kul-TAY-shun) listening to sounds that occur within the body.

Automated external defibrillator (AED) an electrical apparatus that can detect certain irregular heartbeats (fibrillations) and deliver a shock through the patient’s chest. This shock may allow the heart to resume a normal pattern of beating. The AED does not "jump-start" a dead heart. See defibrillation.

AVPU a system for measuring patient level of responsiveness (consciousness). The letters stand for alert, verbal response, _painful response, unresponsive.

Avulsion (ah-VUL-shun) a piece of tissue or skin that is torn loose or pulled off by injury.

Axial (AK-se-al) skeleton the skull, spine, breastbone (sternum), and ribs. See appendicular skeleton.

Axilla (ak-SIL-ah) the armpit.

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B

Bag of waters the fluid-filled sac that surrounds the fetus. The medical term is amniotic sac.

Bag-valve-mask ventilator an aid for artificial ventilation. It has a face mask, a self-inflating bag, and a valve that allows the bag to refill while the patient exhales. It can be attached to an oxygen line.

Bandage an item, such as gauze or tape, that can be used to hold a dressing in place.

Basic life support (BLS) the ABCs of emergency care. Those events related to the findings of the initial assessment. See ABC method.

Battle’s sign discoloration behind the ear which suggests a fracture at the base of the skull.

Behavioral emergency a situation in which a patient exhibits abnormal behavior that is unacceptable or intolerable to the patient, family, or community.

Bilateral existing on both sides of the body.

Bile fluid formed in the liver and sent to the small intestine. It may be stored in the gallbladder. Bile has many functions, including changing the speed at which the intestine moves things along (intestinal motility) and helping to digest fatty foods.

Biological death when the patient has stopped lung and heart activity and his brain cells die. Lethal changes usually begin to take place in the brain within four to six minutes after breathing stops. This process may be delayed by cold temperatures. See clinical death.

Bladder usually referring to the urinary bladder located in the pelvic cavity.

Blanch to become pale or to turn white.

Bleeding shock caused by the loss of blood or plasma. Also known as hypovolemic (HIpo-vo-LE-mic) shock.

Blood the formed elements (blood cells and platelets) and the fluids of the bloodstream that flow in the closed circulation that is pumped by the heart.

Blood pressure the pressure caused by blood exerting a force on the walls of blood vessels. Usually, arterial blood pressure is measured.

Blunt trauma an injury caused by an object that was not sharp enough to penetrate the skin.

Body fluid shock caused by the loss of body fluids, as in cases of severe vomiting or diarrhea. Also called metabolic shock.

Body mechanics the proper use of the body to facilitate lifting and moving and prevent injury.

Body substance isolation a form of infection control that assumes all body fluids should be considered potentially infectious. See universal precautions.

Bones the living tissues of the skeletal system that have a matrix of calcium (for hardness) and protein fibers (for limited flexibility). Bones provide attachment points for skeletal muscles, and in some cases bone marrow makes blood cells.

Bourdon (bor-DON) gauge a gauged flowmeter that indicates the flow of a gas in liters per minute.

Bowel the intestine.

Brachial (BRAY-ke-al) artery pressure point the pressure point used to help control bleeding from the upper limb.

Brachial (BRAY-ke-al) pulse the pulse measured by compressing the major artery of the upper arm. This pulse is used to detect heart action and circulation in infants.

Bradycardia (bray-de-KAR-de-ah) an abnormal condition where the heart rate is slow. The pulse rate will be below 50 beats per minute.

Breastbone the sternum.

Breech birth a delivery where the buttocks or both legs of the baby are born first.

Bronchiole (BRONG-ke-ol) the small branches of the airway that carry air to and from the air sacs of the lungs.

Bronchus (BRON-kus) the portion of the airway connecting the trachea to the lungs. Pl., bronchi.

Bruise a contusion. The simplest form of closed wound; blood flows between tissues causing a discoloration.

Bulky dressing a thick, single dressing or a buildup of thin dressings used to help control profuse bleeding, stabilize impaled objects, or cover large open wounds.

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C

Capillary a microscopic blood vessel through which ex-change takes place between the bloodstream and the body tissues.

Capillary bleeding the slow oozing of blood from a capillary bed. See arterial bleeding and venous bleeding.

Capillary refill the return (refill) of capillaries after blood has been forced out by fingertip pressure applied by the rescuer to the patient’s nail bed. Usually a normal refill time is two seconds or less. This is an assessment technique for measuring distal circulation for pediatric patients.

Cardiac (KAR-de-ak) in reference to the heart.

Cardiac arrest when the heart stops beating.

Cardiogenic (KAR-de-o-JEN-ik) shock See heart shock.

Cardiopulmonary resuscitation (KAR-de-o-PUL-mo-ner-e re-SUS-ci-TA-shun) CPR. Heart–lung resuscitation where there is a combined effort to artificially restore or maintain respiration and circulation.

Carotid (kah-ROT-id) pulse the pulse felt at the large neck artery found on each side of the neck, which is of great importance in the initial assessment and in CPR.

Carpals (KAR-pals) the wrist bones.

Catheter a flexible tube passed through a body channel (such as the urethra or a blood vessel) to allow for drainage or the withdrawal of fluids.

Central nervous system (CNS) the brain and spinal cord.

Cerebrospinal (ser-e-bro-SPI-nal) fluid (CSF) the clear, watery fluid that helps to protect the brain and spinal cord.

Cerebrovascular accident (CVA) See stroke.

Cervical (SER-vi-kal) spine the seven bones of the spine that are located in the neck.

Cervix (SUR-viks) the lower (inferior) end of the uterus where it enters the vagina.

CHEMTREC the Chemical Transportation Emergency Center that provides immediate expert information to emergency personnel at the scene of a hazardous materials incident.

Chief complaint typically the reason why the EMS system was alerted as told by the patient, the caller, or bystanders.

Child the AHA standard identifies a child as a person who is one to eight years of age.

Child abuse assault of an infant or child that produces physical and/or emotional injuries. Sexual assault is included as a form of child abuse.

Chronic the opposite of acute. It can be used to mean long and drawn out or recurring.

Chronic obstructive pulmonary disease (COPD) a group of diseases and conditions in which there is a progressive decline of the lungs in their ability to exchange gases. COPD includes chronic bronchitis, emphysema, and miner’s black lung disease.

Circulatory system the heart, blood vessels, and blood; system that moves blood, carrying oxygen and nutrients to the body’s cells and removing wastes and carbon dioxide from these cells.

Clavicle (KLAV-i-kul) the collarbone.

Clinical death the moment when breathing and heart action stop. See biological death.

Closed fracture a simple fracture where the skin is not broken by the fractured bones. The fracture site is not exposed to the outside world.

Closed wound an injury where the skin is not broken, such as in the case of a bruise (contusion). Also closed injury.

Clot the formation composed of fibrin and entangled blood cells that acts to help stop the bleeding from a wound.

Coccyx (KOK-siks) the lowermost bones of the spinal column. They are fused into one bone in the adult.

Collarbone the clavicle (KLAV-i-kul).

Coma the state of complete unconsciousness. The depth of unconsciousness may vary.

Compensated shock when a patient’s body is still able to maintain perfusion even though shock is developing. See decompensated shock, hypoperfusion, perfusion, and shock.

Concussion caused by a blow to the head, often producing a mild state of stupor or temporary unconsciousness. There is no laceration to or detectable bleeding in the brain.

Confidentiality to keep patient information private (ex-cept for medical reporting, medical records, and certain court subpoenas), including the details of the patient and the patient’s behavior during the rendering of all aspects of care.

Congestive heart failure (CHF) the condition in which the heart cannot properly circulate the blood. This causes a backup of fluids in the lungs and other organs.

Consent oral or written permission from the patient to render care to the First-Responder level. See expressed consent and implied consent.

Constant flow sector valve a meterless device that allows the user to adjust the flow of supplemental oxygen by selecting the flow in stepped increments (2, 4, 6, 8, . . . , 15 liters per minute).

Constricting band used to restrict the flow of venom.

Contraction time the period of time a contraction of the womb lasts during labor. It is measured from the start of the uterus contracting until it releases. See interval time.

Contraindicated any condition, sign, symptom, or existing treatment that makes a particular course of treatment or care procedure inadvisable.

Contusion (kun-TU-zhun) a bruise.

Convulsion uncontrolled skeletal muscle spasm, often violent.

COPD See chronic obstructive pulmonary disease.

Core temperature the body temperature measured at a central point, such as within the rectum.

Cornea (KOR-ne-ah) the transparent tissue covering that lies over top of the iris and pupil of the eye.

Coronary artery disease the narrowing of one or more places in the coronary arteries brought about by atherosclerosis. Blockage (occlusion) will eventually occur in many cases.

CPR cardiopulmonary resuscitation.

CPR compression site the mid-breastbone (mid-sternal) point found by placing the hand approximately two fingerwidths above (superior to) the substernal notch. During CPR of adults and children, compressions are delivered to this site. For the infant, compressions are delivered with two or three fingertips placed one finger-width below an imaginary line drawn directly between the nipples.

Cranial (KRAY-ne-al) cavity braincase of the skull which houses the brain and its specialized membranes.

Cranium (KRAY-ne-um) the braincase of the skull. Many people use the term skull when they mean cranium.

Cravat a piece of cloth material that can be used to secure a dressing or splint.

Crepitus (KREP-i-tus) a grating noise or the sensation felt when broken bone ends rub together.

Critical incident stress debriefing (CISD) sessions that are held after a disaster or emergency incident to address the needs of rescuers who may have been influenced by the scene and the stress generated in providing emergency care.

Croup (kroop) a general term for a group of viral diseases that produce swelling of the larynx.

Crowing an atypical sound made when a patient breathes. It usually indicates airway obstruction.

Crowning when the presenting part of the baby first bulges out of the vaginal opening. It is usually in reference to a normal head-first delivery.

Crush injury injury produced when a body part (usually an extremity) is caught between two objects that generate a great deal of pressure or weight. The injury may be restricted to soft tissues; however, hard tissues may also be crushed.

Cut an open wound with smooth edges (incision) or jagged edges (laceration).

Cyanosis (si-ah-NO-sis) when the skin color changes to blue or gray because of too little oxygen in the blood.

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D

Danger zone the area around a traffic accident or other emergency event in which special safety procedures must be followed. The size and type of zone is often dependent on the type of accident and environmental conditions.

DCAP-BTLS a study aid used to remember patient assessment factors (signs and symptoms). The letters stand for deformity, contusions, abrasions, _punctures/penetrations, burns, tenderness, lacerations, and swellings.

Decompensated shock takes place when the patient’s body can no longer maintain perfusion as shock develops. Usually there is a pronounced fall in blood pressure. See compensated shock, hypoperfusion, perfusion, and shock.

Decompression sickness the "bends." In most cases, this involves SCUBA divers who have surfaced too rapidly. Nitrogen is trapped in body tissues and may find its way into the divers’ bloodstreams.

Deep frostbite See freezing.

Defibrillation to apply an electric shock to a patient’s heart in an attempt to disrupt a lethal rhythm and allow the heart to spontaneously reestablish a normal rhythm. This is done with a defibrillator. See automated external defibrillator (AED).

Dehydration fluid loss which results from vomiting and diarrhea.

Delirium tremens (DTs) a severe, possibly life-threatening reaction related to alcohol withdrawal. The patient’s hands tremble, hallucinations may be present, behavior may be unusual, and convulsions may occur.

Dermis (DER-mis) the inner (second) layer of the skin. It is the layer that is rich in blood vessels and nerves found below the epidermis.

Detailed physical exam an assessment used for unconscious or what may be severely injured patients. The assessment is done more slowly than a rapid trauma assessment and includes a complete head-to-toe examination.

Diabetes (di-ah-BE-teez) a disease caused by the inadequate production of insulin. See hyperglycemia and hypoglycemia.

Diabetic coma severe hyperglycemia. The result of an inadequate insulin supply that leads to unconsciousness, coma, and eventually death unless treated.

Diaphragm (DI-ah-fram) a dome-shaped muscle that separates the chest cavity (thorax) from the abdominal cavity (abdominopelvic cavity). It is the major muscle of respiration.

Diaphragmatic (DI-ah-FRAG-mat-ik) breathing weak and rapid respirations with little or no chest movement. There may be slight movement of the abdomen. The patient’s attempt to breathe with the diaphragm alone.

Diastolic (di-as-TOL-ik) blood pressure the pressure exerted on the internal walls of the arteries when the heart is relaxing. See systolic blood pressure.

Digestive system system that stores and digests food, eliminates waste, and utilizes nutrients.

Dilation to enlarge, having expanded in diameter.

Direct pressure the quickest, most effective way to control most external bleeding. Pressure is applied directly over the wound site.

Dislocation the displacement (pulling or pushing out) of a bone end that forms part of a joint.

Distal away from a point of reference, such as the shoulder or the hip joint. When used with the word proximal (closer to), distal means more distant to. See proximal.

Distal pulse a pulse measured at the distal end of an extremity. Usually, this is the radial pulse for the upper extremity and the dorsalis pedis pulse for the lower extremity. See radial pulse and dorsalis pedis pulse.

Distended inflated, stretched, or swollen.

Dorsalis pedis (dor-SAL-is PED-is) pulse a foot pulse. See pedal pulse.

Downer a depressant. A substance that affects the central nervous system to relax the user.

Dressing a protective covering for a wound that will help control bleeding and reduce contamination.

Drowning death caused by water reaching the lungs and either causing lung tissue damage or spasms of the airway that prevent the inhalation of air. See near-drowning.

Duodenum (du-o-DE-num or du-OD-e-num) the first por-tion of the small intestine, connected to the stomach. It is more rigid than the other portions, causing it to suffer greater injury in accidents.

Duty to act a legal position of responsibility to provide care to one’s level of training. There may be no specific state laws that apply to off duty or citizen (civilian) First Responders.

Dyspnea (disp-NE-ah) difficult or labored breathing.

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E

Early or superficial local cooling minor damage to the skin surface related to cold exposure. Also called frostnip.

Eclampsia (e-KLAM-se-ah) a life-threatening complication of pregnancy that produces convulsions and may result in coma or death.

-ectomy (EK-toe-me) a word ending meaning surgical removal.

Edema (e-DE-mah) swelling due to the accumulation of fluids in the tissues.

Embolism (EM-bo-liz-m) movement and lodgement of a blood clot or foreign body (fat or air bubble) inside a blood vessel. The clot or foreign body is called an embolus (EM-bo-lus).

Emergency care the prehospital assessment and basic care provided for the sick or injured patient. The care is started at the emergency scene and is continued through transport and transfer at the medical facility. During this care, both the physical and emotional needs of the patient are considered.

Emergency Medical Services (EMS) system a chain of services linked together to provide care for the patient at the scene, during transport to the hospital, and upon entry at the hospital.

Emergency medical technician (EMT) a professional-level provider of emergency care, trained above the level of the First Responder. This individual has received formal training equal to or greater than the standard DOT emergency medical technician training program and is state certified. The EMT-Basic classification.

Emergency move a patient move which is carried out quickly when the scene is hazardous, care of the patient requires repositioning, or you must reach another patient needing life-saving care.

Emesis (EM-e-sis) vomiting.

Emotional emergency when a patient’s behavior is not considered to be typical for the occasion. Often this behavior is not socially acceptable. The patient’s emotions are strongly evident, interfering with his or her thoughts and behavior.

Emphysema (EM-fi-SEE-mah) a chronic disease in which the lungs suffer a progressive loss of elasticity. See chronic obstructive pulmonary disease.

Endocrine (EN-do-krin) system the system that produces chemicals called hormones, which help regulate most body activities and functions.

Enhanced 911 service that allows for caller information (e.g: phone number and address) to be received electronically.

Epidermis (ep-i-DER-mis) the outer layer of skin.

Epiglottis (EP-i-GLOT-is) a flap of cartilage and other tissues that is at the top of the voice box (larynx). It closes off the airway and diverts solids and liquids down the esophagus.

Epiglottitis (ep ih glot I tis) swelling of the epiglottis, causing an airway obstruction; a potentially life-threatening condition that can be caused by bacterial infection.

Epilepsy (EP-i-lep-see) a medical disorder characterized by attacks of unconsciousness, with or without convulsions.

Epinephrine medicine used to treat severe allergic reactions; it relaxes the air passages so breathing becomes easier, and constricts the enlarged blood vessels.

Episodic a medical problem that affects the patient at regular intervals.

Epistaxis (ep-e-STAK-sis) a nosebleed.

Esophageal obturator airway (EOA) a breathing tube that is inserted partway into the esophagus. It has vents in its tube that will deliver air into the larynx. Typically, this device is used by EMTs.

Esophagus (e-SOF-ah-gus) the muscular food tube leading from the throat to the stomach.

Evisceration (e-VIS-er-a-shun) usually applies to the intestine protruding through an incision or wound.

Expirations breathing out. To exhale. See inspirations.

Expressed consent informed consent by a rational adult patient, usually in oral form, to accept emergency care.

External auditory canal the opening of the external ear and its pathway to the middle ear.

External chest compressions applied to help create circulation of the blood, these measured compressions are performed during CPR at a set rate at the CPR compression site.

Extrication any actions that disentangle and free from entrapment.

Extruded when an organ, bone, or vessel is pushed out of position.

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F

Fainting the simplest form of shock, occurring when the patient has a temporary, self-correcting loss of consciousness caused by a reduced supply of blood to the brain. Also called psychogenic (SI-ko-JEN-ic) shock.

Febrile feverish.

Femoral (FEM-o-ral) artery the main artery of the upper leg (thigh). It is a major pulse location and pressure point site.

Femoral (FEM-o-ral) artery pressure point the pressure point in the thigh that can be used to help control bleeding from the lower limb.

Femur (FE-mer) the thigh bone.

Fetus (FE-tus) the developing unborn child. It is an embryo until the third month, when it becomes a fetus until birth.

Fibrillation uncoordinated contractions of the heart muscle (myocardium) that are produced from independent individual muscle fiber activity. The totally disorganized activity of heart muscle. See ventricular fibrillation and defibrillation.

Fibula (FIB-yo-lah) the lateral lower leg bone.

Finger bones the phalanges (fah-LAN-jez).

Finger sweeps a procedure used to clear the mouth of airway obstructions. The rescuer’s gloved fingers are used to sweep and lift away objects, clots, and debris—but only when they are visible. Blind finger sweeps should not be used for pediatric patients.

First-degree burn a mild partial-thickness burn, involving only the outer layer of skin. See superficial burn.

First Responder an individual who has received training in emergency care in order to provide for the patient before EMTs arrive. The level of training allows this individual to assist EMTs at the emergency scene.

Flail chest the condition where the ribs and/or the breastbone are fractured in such a way as to produce a loose section of the chest wall that will not move with the rest of the wall during breathing.

Flexion to lessen an angle of a joint. To bend, as in bending the knee or bending at the elbow.

Flowmeter a Bourdon, pressure-compensated, or constant flow selector valve device used to indicate supplemental oxygen flow in liters per minute.

Flow-restricted, oxygen-powered ventilation device (FROPVD) device that delivers oxygen through a regulator from a pressurized cylinder.

Focused assessment a patient assessment that includes the required physical exam, a patient history, and vital signs. Procedures differ for trauma and medical patients.

Focused history and physical exam this follows the initial assessment and can be modified as to the type of patient—trauma or medical. At the First Responder level, it includes for the seriously injured patient a rapid trauma assessment (or head-to-toe exam for unconscious patients), gathering vital signs, and obtaining a history. If injury is not serious, the physical exam can be focused on a specific area, often suggested by the patient. For medical patients, a history is followed by a focused physical exam and the gathering of vital signs.

Fontanelles areas in the infant skull where bones have not yet fused; soft spots.

Foot bones the metatarsals (meta-TAR-sals).

Forearm bones the ulna and radius.

Fracture a break, crack, split, chip, or crumbling of a bone.

Freezing an injury due to cold involving the skin and the layers below the skin. Deep structures such as bone and muscle may be involved. See late or deep local cold injury.

Frostbite superficial frostbite. The skin is frozen, but the layers below it are still soft and have their normal bounce. See freezing and late or deep local cold injury.

Full-thickness burn a burn that damages all the layers of skin. Deep structures may also be burned. See third-degree burn.

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G

Gag reflex a retching action, hacking, or vomiting that is induced when something touches a certain level of the patient’s throat.

Gallbladder an organ attached to the lower back of the liver. It stores bile.

Gastric distention inflation of the stomach.

Gastro- (GAS-tro) used as a beginning of words in reference to the stomach.

Genitalia (jen-i-TA-le-ah) the external reproductive organs.

Genitourinary (jen-eh-to-U-reh-NER-e) system reproductive and urinary systems.

Glucose (GLU-kohs) a simple sugar that is the primary source of energy for the body’s tissues.

Good Samaritan laws a series of laws written to protect emergency care personnel. These laws require a standard of care to be provided in good faith, to the level of training, and to the best of ability.

Grand mal a severe epileptic seizure.

Gurgling an atypical sound of breathing made by patients having airway obstruction, lung disease, or lung injury due to heat.

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H

Hallucinogen a mind-affecting drug that acts on the central nervous system to excite the user or distort his or her perception of the surroundings.

Hand bones the bones of the palm of the hand, known as the metacarpals (meta-KAR-pals).

Handoff the orderly transfer of the patient, patient information, and patient valuables to more highly trained personnel.

Hazardous materials incident any accident or emergency incident, including chemical and radiation accidents, that releases harmful materials into the environment.

Head-tilt, chin-lift maneuver a procedure for use on patients who do not have neck or spinal injury. It opens the mouth, moves the tongue away from the throat, and provides for an open airway in most cases. See jaw-thrust maneuver.

Heart attack a general term used to indicate a failure of circulation to the heart muscle that damages or kills a portion of the heart.

Heart shock caused by the heart failing to pump enough blood to all parts of the body. Also known as cardiogenic (KAR-de-o-JEN-ik) shock.

Heat cramps a condition brought about by the loss of body fluids and possibly salts. It usually occurs in people working in hot environments. Muscle cramps occur in the legs and abdomen. See heat emergencies.

Heat emergencies patients with moist, pale, normal-to-cool skin and hot, dry or moist skin due to exposure to excessive heat that leads to fluid and salt loss. The extreme case is the development of shock or the loss of the body’s heat-regulating mechanisms.

Heat exhaustion a form of shock that is caused by the loss of fluids and salts. This is heat prostration. See heat emergencies.

Heat stroke a true emergency caused by the failure of the body’s heat-regulating mechanisms. The patient cannot cool his overheated body. See heat emergencies.

Hematoma (hem-ah-TO-mah) the collection of blood under the skin or in tissues as a result of an injured blood vessel.

Hemorrhage (HEM-o-rej) internal or external bleeding.

Hemothorax (he-mo-THO-raks) the condition of blood and bloody fluids in the area between the lungs and the walls of the chest cavity.

HEPA in the EMS system, this refers to a high efficiency particulate air filter, mask, or respirator.

Hepatitis a disease that inflames and damages the liver. It may be caused by infectious viral agents, which exist in several different forms. Some hepatitis viruses are very infectious and can lead to life-long illness or death. It is a real danger for rescuers who fail to follow standard safety procedures.

Hip the joint made between the pelvis and the thigh bone (femur). Some people use this term to refer to the upper portion of the thigh bone.

Hives slightly elevated red or pale areas of the skin that may be produced as a reaction to certain foods, drugs, infections, or stress. Often there is an itching sensation associated with hives. See wheal.

Human immune virus (HIV) virus that causes AIDS. See acquired immune deficiency syndrome.

Humerus (HU-mer-us) the upper arm bone.

Humidifier a device that is attached to a supplemental oxygen delivery system to add moisture to the dry oxygen coming from the cylinder.

Hyperextension the overextension of a limb or body part.

Hyperglycemia (hi-per-gli-SE-me-ah) an excess of sugar in the blood. See diabetic coma.

Hyperthermic (HI-per-THURM-ik) an increase in body core temperature above its normal temperature.

Hyperventilation an increased rate and depth of breathing. This may occur as a condition brought on by stress or it may be a sign of a more serious problem (for example, allergy shock, impending heart attack, respiratory distress).

Hypoglycemia (hi-po-gli-SE-me-ah) too little sugar in the blood. See insulin shock.

Hypoperfusion the failure of the body to provide adequate circulation to all its vital parts. The development of shock is actually the development of the state of hypoperfusion. See compensated shock, decompensated shock, perfusion, and shock.

Hypothermia a general cooling of the body.

Hypovolemic (HI-po-vo-LE-mik) shock the state of shock that develops due to excessive loss of whole blood or plasma.

Hypoxia (hi-POK-se-ah) an inadequate supply of oxygen to the body tissues.

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I

Ileum (IL-e-um) the upper portions of the pelvis that form the wings of the pelvis.

Iliac (IL-e-ak) crest the upper, curved boundary of the wings of the pelvis. See ileum.

Immobilize to fix or hold a body part in place in order to reduce or eliminate motion.

Implied consent a legal position that assumes an unconscious patient (or one so badly injured or ill that he cannot respond) would consent to receiving emergency care. Implied consent may apply to children, the developmentally disabled, and emotionally or mentally disturbed patients when parents or guardians are not at the scene.

Incident management system a system designed to allow EMS personnel to manage all phases of a multiple-casualty incident. It must include provisions for command at different stages, safety, assessment, care, and transport.

Incision a smooth cut produced by a sharp object.

Infant the AHA standard identifies an infant as a person who is younger than one year of age.

Infarction (in-FARK-shun) localized tissue death due to the discontinuation of its blood supply. Sometimes used to mean a myocardial (heart muscle) infarction.

Infectious disease any disease produced by an infectious agent such as a bacterium or virus.

Inferior away from the top of the body. Usually compared with another structure that is closer to the top (superior). See superior.

Inflammation the pain, heat, redness, and swelling of tissues as they react to infection, irritation, or injury.

Inflatable splint a soft plastic splint that can be inflated with air to become rigid enough to help immobilize a fractured extremity.

Informed consent actual consent given after the patient knows your level of training and what you are going to do.

Initial assessment the part of a patient assessment that is used to detect and immediately correct life-threatening problems that primarily involve the airway, breathing, and circulation.

Inspiration the process of breathing in; to inhale air. See expirations.

Insulin (IN-su-lin) a hormone produced in the pancreas that is needed to move sugar (glucose) from the blood into cells.

Insulin shock severe hypoglycemia. A state of shock resulting from too much insulin in the blood, causing low sugar levels for the brain and nervous system.

Intercostal (in-ter-KOS-tal) muscles the muscles found between the ribs. These muscles contract during an inspiration, lifting the ribs. This helps to increase the volume of the chest (thoracic) cavity.

Interval time during labor this term means the time from the start of one contraction until the beginning of the next. See contraction time.

Intravenous (IV) into a vein.

Iris the colored portion of the anterior eye. It adjusts the size of the pupil.

Ischium (IS-ke-em) the lower, posterior portions of the pelvis.

-itis (I-tis) a word ending used to mean inflammation.

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J

Jaundice (JON-dis) the yellowing of the skin, usually associated with liver or bile apparatus (gallbladder and bile ducts) injury or disease.

Jaw-thrust maneuver a means of correcting blockage of the airway by moving the jaw forward without tilting the head or neck. Used when trauma, or injury, is suspected to open the airway without causing further injury to the spinal cord in the neck. See also head-tilt, chin-lift maneuver.

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K

Ketoacidosis (KE-to-as-i-DO-sis) a condition that occurs when a diabetic breaks down too many fats trying to obtain energy. Toxic ketone bodies form in the blood and the blood becomes acid.

Kidneys excretory organs located high in the back of the abdominal region. They are behind the abdominal cavity.

Kneecap the patella (pah-TEL-lah).

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L

Labor the three stages of childbirth, including the beginning of contractions, delivery of the child, and delivery of the afterbirth (placenta, umbilical cord, and some of the lining tissues of the uterus).

Laceration a jagged cut with rough edges. See cut.

Laryngectomy (lar-in-JEK-to-me) the total or partial removal of the voice box (larynx). The patient is called a neck breather or a laryngectomee.

Larynx (LAR-inks) the airway between the throat and the windpipe. It contains the voice box.

Late or deep local cooling tissue damage directly related to exposure to cold temperatures. Surface tissues are frozen (frostbite) and in most cases tissues below are also frozen (freezing or deep frostbite).

Lateral to the side, away from the midline of the body. See medial.

Ligament fibrous tissue that connects bone to bone.

Liter (LE-ter) the metric measurement of liquid volume that is equal to 1.057 quarts. One pint is almost equal to one-half liter. Also spelled litre.

Liver the largest gland in the body, having many functions. Located in the upper-right abdominal region, extending over to the central abdominal region.

Localized cold injury freezing or near freezing of a body part.

Log roll a procedure for moving a patient while keeping the patient’s head, neck, and torso aligned (head and spine remain aligned). Two rescuers may be used, but at least four are recommended for the procedure.

Lumbar (LUM-bar) spine the five bones (vertebrae) of the lower back.

Lung shock caused by too little oxygen in the blood due to some sort of lung failure. Also called respiratory shock.

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M

Major burn any full-thickness (third-degree) burn; a partial-thickness (second-degree) burn involving an entire body area, joint, or crucial area; a superficial (first-degree) burn that covers a large area; any burn to the face (other than simple sunburn); or any burn that involves the respiratory system. See minor burn.

Mammalian diving reflex a reaction that occurs when a person dives into cold water and submerges the face. Breathing is inhibited, heart rate slows, and the major blood flow is directed to the heart, lungs, and brain. Oxygen is diverted to the brain.

Mandible (MAN-di-bl) the lower jaw bone.

Manual thrusts abdominal or chest thrusts provided to expel an object causing an airway obstruction.

Manual traction a stabilizing procedure that precedes the application of a rigid splint.

Mechanisms of injury forces that caused the injury. Consideration is given to the type of force, its intensity and direction, and the body part it affects.

Meconium stain amniotic fluid that has a green or brownish-yellow color due to fetal fecal contamination. This is often the result of fetal and/or maternal stress during labor. See bag of waters.

Medial toward the vertical midline of the body. See lateral.

Medical Practices Act requiring an individual to be licensed or certified in order to practice medicine or to provide certain levels of care.

Meninges (me-NIN-jez) the three membranes surrounding the brain and spinal cord.

Meningitis inflammation of the lining of the brain and spinal cord.

Metabolic shock See body fluid shock.

Metacarpals (meta-KAR-pals) hand bones.

Metatarsals (meta-TAR-sals) foot bones.

Midline an imaginary vertical line drawn down the center of the body, dividing it into right and left halves.

Minor burn a superficial or partial thickness (first- or second-degree) burn that involves a small portion of the body with no damage to the respiratory system, face, hands, feet, groin, buttocks, or major joints. See major burn.

Minor’s consent a form of implied consent used when a minor is seriously ill or injured and the parents or guardians cannot be reached quickly.

Miscarriage the natural loss of the embryo or fetus before the twenty-eighth week of pregnancy. A spontaneous abortion.

Moves a general term used to describe any organized procedure that is employed to reposition or move a sick or injured person from one location to another. See emergency moves and non-emergency moves.

Multiple-casualty incident (MCI) an EMS system term for any accident, disaster, or medical emergency that produces more than one patient.

Musculoskeletal system all the muscles, bones, joints, and related structures such as tendons and ligaments that enable the body and its parts to move and function.

Myocardium (mi-o-KAR-de-um) heart muscle. The cardiac muscle that makes up the walls of the heart.

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N

Narcotic a class of drugs that affects the central nervous system for the relief of pain. Illicit use is to provide an intense state of relaxation.

Nasogastric (NA-zo-GAZ-trik) tube (NG tube) a flexible tube inserted through the nose to reach the stomach to allow drainage and/or feeding. Some patients under home care may have an NG tube. There are cases where this tube may be inserted in the field; however, this is NOT a First Responder-level procedure.

Nasopharyngeal (na-zo-fah-RIN-je-al) airway a flexible plastic tube that is lubricated and then inserted into a patient’s nose down to the level of the nasopharynx (back of the throat) to allow for an open upper airway. Supplemental oxygen may be delivered through this tube.

Nature of illness (NOI) what is medically wrong with a patient.

Near-drowning when the process of drowning is stopped and is reversible. Vital signs may or may not be present; however, the patient can be resuscitated. Complications may still cause death at a later date (e,g., pneumonia). See drowning.

Negligence at the First Responder level, this usually is the failure to provide the expected standard of care, leading to additional injury of the patient.

Neonate newborn to one month of age.

Nervous system the system of brain, spinal cord, and nerves that govern sensation, movement, and thought.

Neurogenic (NU-ro-jen-ic) shock caused when the nervous system fails to control the diameter of the blood vessels. The vessels remain widely dilated, providing too great a volume to be filled by available blood. Also called nerve shock.

Non-emergency move a patient move which is carried out if there are other factors at the scene causing the patient to decline, you must reach other patients, part of the care required forces you to move the patient, or the patient insists on being moved.

Nonrebreather mask an oxygen delivery system mask that has an oxygen reservoir bag. This mask delivers a high concentration of oxygen and expels all of the patient’s expired air.

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O

Occlusion blockage. A blocked artery has an occlusion.

Occlusive dressing covering a wound and forming an airtight seal.

Off-line medical direction protocols developed by an EMS system that authorizes rescuers to perform particular skills in certain situations without actually speaking to the Medical Director.

Ongoing assessment a process that may be initiated at the scene and continued through transport and patient transfer. It allows for re-evaluation of the patient’s condition and the effectiveness of care procedures. Often, First Responders may help the EMTs re-assess vital signs.

On-line medical direction orders to perform a skill or administer care from the on-duty physician given by radio or phone to the rescuer.

Open fracture when a bone is broken and bone ends or fragments cut through the skin. Also called a compound fracture. If a wound opens the fracture site to the outside world (for example, gunshot wound), the fracture is classified as an open fracture.

Open wound when the skin is broken. Also open injury.

OPQRST questions a learning device for the questions asked of medical patients to help the rescuer obtain signs and symptoms. The letters stand for: onset, _provokes, _quality, radiation, severity, time.

Oral glucose a form of glucose that comes in a gel and is packaged in different-size tubes like toothpaste. It can be given to a patient with an altered mental status and a history of diabetes by placing it inside the mouth.

Orbits refers to the orbits of the eyes, called the eye sockets.

Oropharyngeal airway (or-o-fah-RIN-je-al) a curved breathing tube inserted into the patient’s mouth. It will hold the base of the tongue forward.

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P

Packaging part of the procedure of preparation for removal of the patient at an accident scene. It may involve applying splints and dressings, neck and spine immobilization, and stabilizing impaled objects.

Palpate to feel a part of the body as to palpate the abdomen or palpate a radial pulse. To use a blood pressure cuff while feeling the radial pulse in order to determine the approximate systolic blood pressure.

Pancreas (PAN-cre-as) the gland in the back of the upper portion of the abdominal cavity, behind the stomach. It produces insulin and digestive juices.

Paradoxical motion (movement) when a loose segment of an injured chest wall moves in the opposite direction to the rest of the wall during breathing movements. This is associated with flail chest.

Paralysis complete or partial loss of the ability to move a body part. Sensation in the area may also be lost.

Partial-thickness burn a burn in which the first layer of skin (epidermis) is burned through and burn damage is done to the second layer (dermis). Pain, reddening, blister formation, and fluid loss are typical. Another classification for this burn is a second-degree burn.

Patella (pah-TEL-ah) the kneecap.

Pathogen organism that causes infection, such as a virus or bacteria.

Patient assessment the systematic gathering of information through interviews and a physical examination in order to determine the possible nature of a patient’s injury or illness.

Pedal pulse a foot pulse.

Pelvic cavity the lower anterior body cavity that is surrounded by the bones of the pelvis.

Penetrating wound a puncture wound with only an entrance wound.

Perforating wound a puncture wound having an entrance and an exit wound.

Perfusion the constant adequate blood flow to all cells. See hypoperfusion.

Pericardium (per-e-KAR-de-um) the sac that surrounds the heart.

Perineum (per-i-NE-um) the region of the body located between the genitalia and the anus.

Peritoneum (per-i-to-NE-um) the membrane that lines the abdominal cavity.

Personal protective equipment (PPE) equipment used to protect the rescuer from infectious disease. Includes latex or vinyl gloves, eye protection, face masks, and gowns. See universal precautions.

Petit mal the minor epileptic attack that is noted by a momentary loss of awareness, with no major convulsive seizures.

Phalanges (fah-LAN-jez) the bones of the toes and fingers.

Pharmacology the study of drugs, their origins, nature, chemistry, effects, and use.

Pharynx (FAR-inks) the throat.

Placenta (plah-SEN-tah) an organ made of both maternal and fetal tissues to allow for exchange between the circulatory systems of the mother and fetus without having a mixing of blood.

Plasma (PLAZ-mah) the fluid portion of the blood. It is the blood minus the blood cells and other structures.

Platelet (PLAT-let) element of the blood that releases factors needed to produce blood clots.

Pleura (PLOOR-ah) a double-membrane sac. The outer layer lines the chest wall and the inner layer covers the outside of the lungs.

Pleural (PLOOR-al) cavities the right and left portions of the chest cavity (thorax) that contain the lungs and the pleura membranes.

Pneumatic anti-shock garment (PASG) garment similar to the air splint that can be used to control bleeding from the lower extremities by direct pressure.

Pneumothorax (NU-mo-THO-raks) the collection of air in the chest cavity to the outside of the lungs, caused by punctures to the chest wall or the lungs.

Pocket face mask a device designed to aid the delivery of ventilations and mouth-to-mask resuscitations. The mask prevents rescuer contact with the patient’s mouth. A one-way valve and HEPA filter must be part of the mask to protect the rescuer from blood, body fluids, vomitus, and the transfer of disease-causing agents.

Position of function the natural position of a body part. For example, the natural position of the hand is slightly flexed.

Posterior the back. See anterior.

Premature infant any newborn weighing less than 5.5 pounds or born before the thirty-seventh week of pregnancy.

Prescribed inhaler a device that holds medication in an aerosol form which can be sprayed into the mouth and inhaled in order to dilate (enlarge) the air passages of someone with a chronic respiratory disease, such as asthma.

Pressure regulator a device that is connected to an oxygen cylinder to reduce the cylinder pressure to a safe working level, thus providing a safe pressure for delivery to the patient.

Priapism (PRE-ah-pizm) persistent erection associated with spinal damage in the male patient.

Prolapsed cord abnormal delivery where the umbilical cord is presented first.

Prone lying face down.

Protocols a specific set of steps to be taken in different situations that are part of an EMS system’s guidelines for safety, assessment, care, transport, and transfer. Protocols are developed by the EMS system’s Medical Director.

Proximal close to a point of reference such as the shoulder or hip joint. Used with distal, meaning away from. See distal.

PSD an abbreviation for painful, swollen, deformed.

Psychogenic (SI-ko-JEN-ic) shock See fainting.

Pubic (PYOO-bik), Pubis (PYOO-bis) the middle, anterior region of the pelvis. The region associated with the external genitalia.

Pulmonary (PUL-mo-ner-e) applies to the lungs.

Pulmonary resuscitation (PUL-mo-ner-e re-SUS-ci-TAY-shun) providing rescue breaths (ventilations) to a patient in an attempt to artificially maintain lung function.

Pulse the alternate expansion and contraction of artery walls as the heart pumps blood.

Pulseless electrical activity (PEA) condition in which the electrical activity of the heart is within normal range, but the heart muscle is too weak and damaged to pump blood efficiently.

Puncture wound an open wound tearing through the skin and destroying tissue in a straight line. See penetrating wound and perforating wound.

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R

Radial pulse the wrist pulse.

Radius the lateral forearm bone.

Rapid trauma assessment a quick but safely done survey of the patient as a modified head-to-toe examination. Both signs and symptoms are gathered. See focused history and physical exam and patient assessment.

Rectum (REK-tum) the lower portion of the large intestine, ending with the anus.

Red blood cells (RBCs) the circulating blood cells that carry oxygen to the tissues and return carbon dioxide to the lungs. The erythrocytes (e-RITH-ro-sitz).

Referred pain the pain felt in a region of the body other than where the source or cause of the pain is located. For example, pain in the gallbladder may be felt over the right shoulder blade (scapula).

Reproductive system system that produces all structures and hormones needed for sexual reproduction.

Respiration the act of breathing. The exchange of oxygen and carbon dioxide that takes place in the lungs.

Respiratory arrest the cessation of breathing.

Respiratory distress any difficulty in breathing. Sometimes the problem is severe enough to require emergency care. Once distress begins, it is difficult to predict the short-term course of the problem.

Respiratory shock See lung shock.

Respiratory system system that exchanges air to bring in oxygen and expel carbon dioxide. It includes the nose, mouth, structures in the throat, lungs, and associated muscles.

Resuscitation (re-SUS-eh-TA-shun) any effort to restore or provide normal heart and/or lung function artificially.

Rigid splint a stiff device made of a material with very little flexibility (such as metal, plastic, or wood) that is long enough to immobilize an extremity and the joints above and below the injury site.

Rule of nines a system used for estimating the amount of skin surface that is burned. The body is divided into 12 regions. Each of 11 regions equals 9% of the body surface and the genital region is 1%.

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S

Sacrum (SA-krum) the fused bones (vertebrae) of the lower back that are immediately inferior to the lumbar spine.

SAMPLE history a system of information gathering now being used by EMS systems, which allows the rescuer to ask questions about past or present medical or injury problems. The letters that direct the questioning stand for signs/symptoms, allergies, medications, _pertinent past history, last oral intake, events leading to the injury or illness. It is understood that efficiency at asking pertinent questions improves with experience; however, the level of training of the rescuer is a limiting factor.

Sanitize a rigid standard of cleaning, often to the point of practical sterilization.

Scapula (SKAP-u-lah) the shoulder blade.

Scene size-up the first steps in rescuer safety and patient assessment. An assessment of the scene conditions, number of patients, mechanism of injury and/or nature of illness, and needed resources.

Sclera (SKLE-rah) the "whites" of the eyes.

Scratch an abrasion. An open wound that damages the surface of skin without breaking all the skin layers.

Second-degree burn a partial-thickness burn. The outer layer of skin (epidermis) is burned through and the second layer (dermis) is damaged. See partial-thickness burn.

Seizure in general, any event in the brain that causes uncontrolled muscle contractions (convulsions).

Septic shock caused by infection-producing poisons.

Septum a structure that divides two chambers, such as the septum in the nose that separates the two nostrils.

Shock the reaction of the body to the failure of the circulatory system to provide an adequate blood supply to all the vital organs of the body. The failure of perfusion. See hypoperfusion and perfusion.

Shoulder blade the scapula.

Side effect any unwanted action or reaction of a drug other than the desired effect.

Sign any observed evidence of injury or illness.

Sinoatrial (si-no-A-tre-al) node a small region of modified tissue in the heart which sends out electrical waves; also called the pacemaker.

Skeletal system all the bones and joints of the body. The skeletal system provides body support and organ protection, enables movement, and produces blood cells.

Sling a large triangular bandage or other cloth device that is applied as a soft splint to immobilize painful, swollen, deformed injuries (possible fractures and dislocations) of the shoulder girdle and upper extremity.

Soft splint a device, such as a sling and swathe or a pillow secured with cravats, that can be applied to immobilize a painful, swollen, deformed (PSD) extremity.

Soft tissues the tissues of the body that make up the skin, muscles, nerves, blood vessels, fatty tissues, and the cells that line and cover organs and glands. Bones, cartilage, and teeth are hard tissues.

Sphygmomanometer (SFIG-mo-mah-NOM-eh-ter) an instrument used to measure blood pressure commonly called blood pressure cuff.

Spinal cavity the area within the spinal column that contains the spinal cord and its coverings, the meninges (me-NIN-jez).

Spleen an organ located to the left of the upper abdominal cavity behind the stomach. It stores blood and destroys old blood cells.

Splinting to apply a device that will immobilize a painful, swollen, deformed (PSD) extremity. See soft splint and rigid splint.

Sprain an injury in which ligaments are partially torn.

Stabilize to steady a body part in order to help reduce involuntary movement caused by pain or muscle spasm.

Standard of care the minimum accepted level of emergency care. It is set forth by law, administrative orders, guidelines published by medical and emergency care organizations and societies, local protocols and practices, and precedent (what has been accepted).

START plan a four-step simple triage and rapid treatment (care) program designed for use in multiple casualty incidents. It is usually employed by the First Responder when additional help will be late in arriving.

Sterile free of all life forms.

Sternum (STER-num) the breastbone.

Stethoscope an instrument used to amplify body sounds.

Stillborn infant that is born dead or dies shortly after birth.

Stoma (STO-mah) any permanent opening that has been surgically made; the opening in the neck of a neck breather.

Strain injuries to muscles caused by overexertion.

Stressor any factor that causes wear and tear on the body’s physical or mental resources.

Stroke the result of blockage or damage to an artery supplying oxygenated blood to the brain. Headache, confusion, paralysis (often to one side only), impaired vision, impaired speech, unequal pupil size, and many other signs and symptoms are possible. This is a cerebrovascular accident or CVA.

Subcutaneous (SUB-ku-TA-ne-us) beneath the skin. It refers to the fats and connective tissues found immediately below the dermis.

Substernal notch referring to the area of the lower breastbone to which the ribs attach.

Sucking chest wound an open chest wound into which air is sucked through the wound and into the chest cavity each time the patient breathes.

Sudden infant death syndrome (SIDS) sudden unexplained death during sleep of an apparently healthy baby in its first year of life.

Superficial burn a term used to classify a burn to the outer layer of skin (epidermis). There may be pain, reddening, and sometimes swelling. See first-degree burn.

Superficial frostbite See frostbite.

Superior toward the top of the body. See inferior.

Supine lying flat on the back.

Swathe a large cravat, usually made of cloth. It is used to secure a sling or rigid splint and sling to the body. It may be used to hold an upper limb to the chest.

Sympathetic eye movement the coordinated movement of both eyes in the same direction. If one eye moves, the other eye will carry out the same movement.

Symptom what a patient tells you about his or her injury or illness.

Syrup of ipecac (IP-e-kak) a compound used to induce vomiting in certain conscious poisoning patients. Its use must be approved by the EMS system medical advisory board and be directed for use by the poison control center or medical direction for each case unless otherwise stated in very special local protocols. Generally, it is considered to be a medication and is not used by civilian First Responders.

Systemic (sis-TEM-ik) referring to the entire body.

Systolic (sis-TOL-ik) blood pressure the force exerted on the artery walls when the heart is contracting. See diastolic blood pressure.

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T

Tachycardia (tak-e-KAR-de-ah) rapid heartbeat, usually 100 or more beats per minute.

Tarsals (TAR-sals) the ankle bones.

Tendon fibrous tissue that connects muscle to bone.

Thigh bone the femur (FE-mur).

Third-degree burn a full-thickness burn, where all layers of the skin are damaged. Deep structures may also be burned. See full-thickness burn.

Thoracic (tho-RAS-ik) cavity the anterior body cavity above (superior to) the diaphragm. It protects the heart and lungs. Also chest cavity or thorax.

Thorax (THO-raks) the chest.

Tibia (TIB-e-ah) the medial lower leg bone.

Toe bones the phalanges (fah-LAN-jez).

Tongue-jaw lift a procedure used to open the mouth of an unconscious patient. The rescuer grasps the tongue and lower jaw between thumb and fingers to move the tongue away from the back of the throat.

Tourniquet the last resort used to control bleeding. A band or belt is used to constrict blood vessels to stop the flow of blood.

Trachea (TRAY-ke-ah) the windpipe.

Tracheostomy (TRA-ke-OS-to-me) a surgical opening made in the anterior neck that enters into the windpipe (trachea).

Traction a part of the action taken to pull gently along the length of the limb to stabilize a broken bone to prevent any additional injury. See manual traction.

Trauma physical injury caused by an external force. See blunt trauma.

Trendelenburg (trend-EL-un-berg) position a position in which the spine-stable patient’s feet and legs are higher than the head and shoulders.

Triage a method of sorting patients according to the severity of their injuries.

Tuberculosis a lung infection that can be transmitted by airborne aerosolized droplets.

Tympanic (tim-PAN-ik) membrane the eardrum.

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U

Ulna (UL-nah) the medial lower arm bone.

Umbilical (um-BIL-i-kal) cord the structure that connects the body of the fetus to the placenta.

Umbilicus (um-bi-LIK-us or um-BIL-i-kus) the navel.

Universal precautions recommendations from the Centers for Disease Control for medical and emergency care personnel to wear latex or vinyl gloves, eye protection, masks, and gowns to avoid contact with the patient’s blood, body fluids, wastes, and mucous membranes. Pocket face masks with one-way valves and HEPA filters or other approved methods of resuscitation are recommended to prevent infectious diseases resulting from resuscitative efforts.

Upper a stimulant that will affect the central nervous system to excite the user.

Urinary system system that removes chemical wastes from the blood and helps balance water and salt levels of the blood; it includes the bladder, ureters, and kidneys.

Uterus (U-ter-us) the muscular structure in which the fetus develops. The womb.

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V

Vagina (vah-JI-nah) the birth canal.

Vascular referring to the blood vessels.

Vein any blood vessel that returns blood to the heart.

Venae cavae (VE-ne KA-ve) the superior and inferior vena cava. The two major veins that return blood from the body into the heart.

Venous bleeding the loss of blood from a vein. It is dark red to maroon in color. Loss is as a steady flow and can be very heavy.

Ventilation supplying air to the lungs.

Ventral front of the body. See anterior.

Ventricle one of the two lower chambers of the heart. Ventricles pump blood from the heart.

Ventricular fibrillation the totally disorganized contractions of the myocardium of the lower heart chambers. See defibrillation.

Ventricular tachycardia (tak-e-KAR-de-ah) a very fast heart rate in the heart’s lower chambers.

Venule (VEN-yul) typically the smallest of veins that begin at the end of capillary beds and return blood to the larger veins. See arterioles and capillaries.

Vertebra (VER-te-brah) each individual bone of the spinal column.

Vial of Life a program designed to aid emergency care personnel by having certain patients place information and medications in special vials in their refrigerators. A "Vial of Life" sticker is placed on the main outside door, closest window to the main door, or refrigerator door.

Viscera (VIS-er-ah) the internal organs. Usually refers to the abdominal organs.

Vital signs at the First Responder level, these include pulse, respiration, and relative skin temperature and condition. They may also include blood pressure and pupil assessment.

Vitreous (VIT-re-us) fluid transparent, jellylike substance that fills the posterior cavity of the eye.

Volatile chemicals vaporizing chemicals that will cause excitement or produce a "high" when breathed in by the abuser.

Vulva (VUL-vah) the external female genitalia.

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W

Wheal the localized collection of fluid under the skin that may be accompanied by itching and a change in skin coloration. A hive.

Wheeze a whistling breathing sound. This sound is often associated with asthma when air is trapped in the air sacs and cannot be expired easily.

White blood cells (WBCs) the blood cells that destroy microorganisms and produce antibodies to help fight off infection. The leukocytes (LU-co-sites).

Womb See uterus.

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X

xiphoid (ZI-foid) process the inferior portion of the sternum.

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Z

zygomatic (ZI-go-MAT-ik) bones the cheekbones.