Paramedic Study Guide

This page was created to help you prepare for the National Registry exam as a paramedic. I have including many of the topics you need to know before you take your test. Read and study these topics to prepare for the exam along with purchasing my preparatory, practice questions, and you will have no problem passing the exam.


Some Common Facts You Need to Know About Diabetes


Summary: The following article compiles some basic information about the diabetes, it types, causes, symptoms and also give the readers a brief idea about insulin and its role, pancreas and its role, and some common complication that arise in diabetes.



Diabetes is a metabolic disorder which is characterized by high levels of blood sugar over a prolonged time period. The symptoms of these increased blood sugar levels are polydipsia, polyphagia and polyuria.

There are two types of diabetes

Type 1 diabetes: Also known as Insulin dependent diabetes mellitus or juvenile diabetes. This is usually caused by the autoimmune disorder and appears early in the life. This is caused by the autoimmune disorder where body’s own immune system destroys the islets of langerhans, the cells which produce the insulin in the body.

Type 2 diabetes: Also known as non-insulin dependent diabetes mellitus or adult onset diabetes mellitus. The cause for this type of diabetes is the insulin resistance. Insulin resistance is a condition in which the cells fail to respond to insulin and as the disease progress the insulin deficiency also occurs. This is generally caused by the lack of exercise or physical activity and increased body weight.

There is a third type of diabetes known as the gestational diabetes which occurs in the pregnant women without a pre existing history of this pathological condition.

Both the conditions of hyperglycemia and hypoglycemia can occur in a diabetic patient.

Signs and symptoms of hyperglycemia: The signs and symptoms of hyperglycemia includes

  • Increased thirst
  • Headaches
  • Trouble in concentrating
  • Blurred vision
  • Frequent peeing
  • Fatigue (weak, tired feeling)
  • Weight loss
  • Blood sugar more than 180 mg/dL

Prolonged hyperglycemia results in

  • Vaginal and skin infections
  • Slow-healing cuts and sores
  • Worse vision
  • Nerve damage causing painful cold or insensitive feet, loss of hair on the lower extremities, or erectile dysfunction
  • Stomach and intestinal problems such as chronic constipation or diarrhea
  • Damage to your eyes, blood vessels, or kidneys

Signs and symptoms of hypoglycemia: The signs and symptoms of low blood sugar appears generally hen the blood sugar levels falls to 70 mg/dL. Acute symptoms of low blood sugar includes

  • Confusion
  • Dizziness
  • Feeling shaky
  • Hunger
  • Headaches
  • Irritability
  • Pounding heart; Racing pulse
  • Pale skin
  • Sweating
  • Trembling
  • Weakness
  • Anxiety

And if it remains untreated then more severe symptoms may appear which includes

  • Poor coordination
  • Poor concentration
  • Numbness in mouth and tongue
  • Passing out
  • Nightmares or bad dreams
  • Coma

Insulin and its role: Insulin is a pancreatic hormone which plays an important role in the regulation of blood glucose levels. Any condition that causes the deficiency of insulin in the body results in a pathological condition known as diabetes. Insulin is a key player in the metabolism of blood glucose. It carries blood glucose from the blood into the cells for metabolism. A lack of this hormone will result in increased levels of the blood glucose and lead to diabetes. Diabetes is characterized by three main symptoms and when these arise one should immediately gets his blood sugar levels checked. These three main symptoms are

Polyphagia: It is a medial term that describes the increased appetite or extreme hunger.

Polyuria: It is a medical term used to describe the excessive or abnormally large production of the urine usually more than 2.5 to 3 liters over a period of 24 hours in adults. It also describes the frequent urination.

Polydipsia: This is a medical term used to describe excessive thirst accompanied by prolonged dryness of the mouth.

Pancreas and its hormones:  Pancreas is an exocrine gland secreting pancreatic fluid into the duodenum after a meal.

However, scattered through the pancreas are several hundred thousand clusters of cells called islets of Langerhans. These islets are endocrine tissue containing four different types of cells. These includes

  • beta cells, which secrete insulin and amylin;
  • alpha cells, which secrete glucagon;
  • delta cells, which secrete somatostatin, and
  • gamma cells, which secrete pancreatic polypeptide.

Effects of low blood sugar on the brain: The insufficient supply of glucose to the brain, results in impairment of brain function (neuroglycopenia). The effects can range from mild dysphoria to more serious issues such as seizures and unconsciousness, and (rarely) permanent brain damage or death.

Hyperosmolar Hyperglycemic Non-ketotic Syndrome (HHNS): Hyperosmolar Hyperglycemic Non-ketotic Syndrome, or HHNS, refers to a serious pathological condition that occurs mostly in older individuals. HHNS can appear both in people with either type 1 or type 2 diabetes that is not being managed properly, but it occurs more frequently in patients with type 2.

Diabetic Ketoacidosis: Diabetic ketoacidosis (DKA) is an acute and life-threatening complication of the well known pathological condition diabetes that mainly occurs in patients with type 1 diabetes, but can also appear in some patients with type 2 diabetes. This condition is characterized by a complex disordered metabolic state that involves hyperglycemia, ketoacidosis, and ketonuria.

Sugar and how it damages skin tissue in diabetic neuropathy: The prolonged blood sugar levels leads to the peripheral neuropathy which damages the nerves of the limbs, especially the feet. Nerves on both sides of the body are affected. Common symptoms of neuropathy include:

  • Numbness or insensitivity to pain or temperature
  • Tingling, burning, or prickling
  • Sharp pains or cramps
  • Extreme sensitivity to touch, even light touch

Head injuries

Things You Need To Know About Head And Spinal Injuries

Summary: The following article includes the causes, signs and symptoms, vital signs and the first aid treatment of the head and spinal injuries.

Introduction: Any injury that results in the trauma to the brain, scalp or skull can be called as a head injury. The injury may be a negligible bump or may be a serious brain injury.

Head injury can be classified into two types depending upon the injured area.

An open head injury or a closed head injury.

A closed head injury is the non-penetrating or non –missile injury in which the Dura mater remains intact and the injury does not penetrates the skull.

An open injury is a penetrating injury in which the skull is broken and an object penetrates into the Dura mater and inside the brain. This is a serious condition and most likely results in the death. The reasons for this type of injury include moving at a high speed i.e. in a high speed vehicle and going through the windshield or a gunshot wound to the head.

Signs and symptoms: The head injuries may lead to bleeding in the brain the surrounding layers. The symptoms for the head injury can occur immediately or may develop slowly over a longer period of time ranging from several hours to several days. The signs and symptoms involves

  • Leakingcerebrospinal fluid from nose ear or mouth indicate a basilar skull fracture and the destruction of sheaths that surrounds the brain and may lead to brain infections.
  • Visible deformity or depression in the head or face.
  • An eye that cannot move or is deviated to one side.
  • Wounds or bruises on the scalp or face.

Spinal Injury: In addition to the head injury in case of any accident or assault, the spinal injury may also be present. In case of spinal injury patient must be treated with the spinal precautions. These precautions involve stabilizing of the head and neck by placing both your hands on each side of the injured person’s head. The head should be kept in line with the spine and prevent any movement and wait for the medical help. A full spinal immobilization is an essential precaution in this case.

Levels of Spinal Injury: In case of the spinal injury the higher the injury on the spinal cord the more dysfunction it causes. Thus the severe cases of the spinal injuries are those which involve the injury of the cervical spine. It is classified into two sub categories

Higher spine injury includes spinal disc from C1 to C4 and most severe spinal injuries occurs in this section causing paralysis of hands, arms, legs and trunk. Patient may also lose the involuntary functions like breathing, coughing bowel control or bladder movements. The speech is also disturbed. The patients require complete assistance in its daily routine activities such as getting in bed, bathing, walking, dressing and even eating. The patient would not be able to drive a car and needs a 24 hour personal care.

In case of low cervical injury (From disc C5 to C8), the person may be able to breathe on their own and can speak normally. The breathing maybe weakened. Remaining problems will be present.

The injuries in the mid thoracic spine will affect the trunk and legs also known as paraplegia. Muscles, upper chest, abdominal muscles and mid-back may also be affected. But arm and hand functions remain normal.

Loss of Sympathetic Tone: The spine injuries of cervical and thoracic region may also result in the loss of sympathetic tone which is caused due to disruption in the autonomic pathways within these parts of the spinal cord. This results in vasodilation and pooling of blood in the lower extremities and consequently results in the hypotension and slowed heart rate.

Left Sided Heart Failure

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Right Sided Heart Failure

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Paramedic Skills Sheets

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