119 Mod 2 (Bleeding, Shock, and Fluids)

Question 1

Answer 1

SVT

Question 2

Answer 2

Junctional Escape

Question 3

Answer 3

V Tach

Question 4

Answer 4

I

Question 5

Answer 5

A Fib

Question 6

A 25 year old female patient has sustained burns to the back of the right arm, posterior trunk, front of the left leg, anterior head and neck, and perineum. Using the Rule of Nines, calculate the total body surface area percentage that is burned.

A. 46%

B. 57%

C. 36%

D. 28%

Answer 6

57

Question 7

A laceration to a large artery can exsanguinate in less than ___ mins

Answer 7

2

Question 8

A partial thickness burn is also known as ____________ and ________ degree burns (2)

A full thickness burn is also known as?

Answer 8

First and second - partial

3rd - Full - every layer - needs skin graft

Question 9

A patient fell from a roof and has normal pink skin, BP 98/62, HR 70, RR 18, and is unable to move or feel legs. What type of shock is this?

Not decomp comp irreversible

Answer 9

Neurogenic- Spinal

Question 10

A patient fell from a roof and is presenting with flushed skin, BP 80/42, HR 54, RR 0, and absent reflexes. What shock are they suffering from?

Not comp decomp irreversible answer

Answer 10

Neurogenic shock

Question 11

A patient fell from the roof and presents with pale skin, BP 82/52, HR 124, RR 22, unstable pelvis. What shock is it?

Neurogenic

Hypovolemic

Spinal

Obstructive

Answer 11

Hypovolemic shock

Question 12

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but their bp drops to 82/40 and is disoriented is in _____________ shock

Comp decomp or irreversible

Answer 12

Decompensated shock

Question 13

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but is normotensive (normal bp) is in _____________ shock

Answer 13

Compensated shock

Question 14

According to the ___________ formula for burns, you give ______% in the first 8hours

Answer 14

Parkland burn formula

50% in the first 8 hours

Question 15

Acetaminophen

class / dose / for / contra

Answer 15

for mild discomfort, FEVER, 100.4

dose: 325mg

contra: head injury, hypotension, resp dis, vomit, liver disease, allergic, less that 3 mos

Question 16

Acetazolamide

Answer 16

Diamox

for: edema from CHF, glaucoma

Question 17

Battle signs vs Raccoon Eyes are a sign of fractures where?

Answer 17

Battle - basilar skull
Raccoon - anterior cranial fossa

Question 18

Beck’s Triad is indicative of what?

Answer 18

Cardiac tamponade

Question 19

Cheyne-Stokes
Biots,
and
Apneustic,

symptoms

Answer 19

Cheyne-Stokes - gradual increase and decrease with periods of apnea
(brain inj)

Biot’s - ABNORMAL, equal depth, with regular apnea
(brain stem inj)

Apneustic - prolonged inspire with prolonged expire (ICP)

Question 20

Bleeding or swelling occurs within a compartment in a patient with which of the following conditions?

cardiac tamponade

crush injury

compartment syndrome

commotio cordis

Answer 20

compartment syndrome

Question 21

BP 188/101, and a hx of blood thinners. Sudden severe headache, blurry vision, and AMS.

Subdural hematoma

epidural hematoma

intracranial hematoma

Answer 21

intracranial hematoma

Question 22

Burn shock is what type of shock?

Answer 22

Hypovolemic shock - loss of plasma/fluid

Question 23

Burning Epigastric Pain affects which organ?

Answer 23

Stomach

Question 24

Calculate the TBSA using the rule of 9s (1st degree burns – entire back, entire left arm, back of leg)

Answer 24

0%

Question 25

Calculate the TBSA using the rule of 9s (3rd degree and 2nd degree burns – entire back, entire left arm, back of leg)

Answer 25

36%

Question 26

Commotio cordis occurs at what part of the cardiac cycle?

Answer 26

the upstroke of the T wave Blow to the chest disrupting the heart. During the precise moment of the heart repolarizing leading to arrhythmia. Can lead to V-Fib , needs cpr and rapid defib.

Question 27

Coughing blood is called

Answer 27

Hemoptysis

Question 28

What are the 3 Cushings Triad signs? and when would you expect it? how would you treat?

Answer 28

Bp - up Hr - down RR - Irregular may be seen in patients with increased ICP from head trauma or tumors. Hyperventilate - to 30-35 ETCO (20 BPM) to vasoconstrict blood

Question 29

Define Afterload

Answer 29

the force the heart must overcome to pump blood out to the body. (Pressure of vascular resistance).

Question 30

Define ARDS

Answer 30

Acute Respiratory Distress Syndrome low O2 in blood, caused by sepsis, trauma, flail chest, pneumo, signs are severe dyspnea SOB, hypoxemia (low oxygen levels in the blood), tachypnea (rapid RR)

Question 31

Define Biots

Answer 31

Irregular pattern, rate, periods of apnea ICP

Question 32

Define Blood Pressure in an equation (___x___)

Answer 32

Cardiac output x Vascular Resistance Blood pressure is the force of blood pushing against the walls of blood vessels, measured as systolic/diastolic pressure.

Question 33

Define Brown-Sequard Syndrome

Answer 33

cervical spinal injury resulting in paralysis (hemiparaplegia) on one side of the body and loss of sensation on the opposite side (hemianesthesia)

Question 34

Define Cardiac output

Answer 34

amount of blood pumped by the heart per minute

Question 35

Define cardiac output in an equation (___x___)

Answer 35

HR x Stroke Volume

Question 36

Define Cauda Equina Syndrome

Answer 36

compression of the spinal nerve roots, resulting in motor and sensory deficits caused by a herniated disk, tumor, trauma, or spinal stenosis.

Question 37

Define Cheyne - Stokes

Answer 37

Increasing rate, gradual decrease, intermittent periods of apnea brainstem injury

Question 38

Define Critical Burns

Answer 38

partial more than 30% full more than 10 Inhalation injuries Partial or Full involving hands, feet, joints, face, genitalia (2nd or Third)

Question 39

Define Ejection fraction

Answer 39

Percentage of blood leaving the heart each time it contracts

Question 40

Define Epithelialization

Answer 40

Formation of fresh tissue to heal a wound

Question 41

Define Exsanguation

Answer 41

loss of the total blood volume, death

Question 42

Define Hyperextension Hyperflexion Compression Rotation Lateral Stress Distraction (spinal traumas)

Answer 42

Hyperext - head neck movement (mvc, neck inj, dive) hyperflexion - head onto chest (thrown, dive) compression - downward fall Rotation - roll fall (mvc, bike) Lateral - direct lat force (t-bone) Distraction - strectching - hanging

Question 43

Define Joule's Law

Answer 43

The relationship between heat, current and resistance

Question 44

Define Myositis

Answer 44

Inflammation of the muscle, caused by infection

Question 45

Define Preload

Answer 45

the amount of blood that fills the heart before it pumps it out to the body.

Question 46

Define Preload

Answer 46

pre contraction pressure in the heart, which increases as the blood builds up

Question 47

Define Sterlings Law

Answer 47

the bigger the pump the harder the squeeze. the heart will pump harder when it is filled with more blood.

Question 48

Define Stroke Volume

Answer 48

the amount of blood pumped out of the heart with each beat.

Question 49

Define Systole

Answer 49

the period when the heart contracts and pumps blood out to the body.

Question 50

Define the 6 types of shock, signs, and treatment

Answer 50

1. Hypovolemic shock: This occurs when there is a significant loss of blood or other fluids in the body. Signs include low blood pressure, rapid heart rate, cold and clammy skin, decreased urine output, and altered mental status. Treatment involves stopping the bleeding, replacing fluids and blood products, and addressing the underlying cause. 2. Cardiogenic shock: This occurs when the heart cannot pump enough blood to meet the body's needs. Signs include low blood pressure, rapid heart rate, shortness of breath, chest pain, and cool and clammy skin. Treatment involves addressing the underlying cause, such as a heart attack, and supporting the heart's function. 3. Distributive shock: This occurs when there is widespread vasodilation, causing blood to pool in the body's tissues and not enough blood to circulate to vital organs. Types of distributive shock include septic shock, anaphylactic shock, and neurogenic shock. Signs include low blood pressure, rapid heart rate, warm and flushed skin, and altered mental status. Treatment involves identifying and treating the underlying cause, providing supportive care, and administering vasoactive medications. 4. Obstructive shock: This occurs when there is a blockage in the circulatory system, preventing blood from flowing properly. Examples include pulmonary embolism, cardiac tamponade, and tension pneumothorax. Signs include low blood pressure, rapid heart rate, shortness of breath, and chest pain. Treatment involves addressing the underlying cause, such as removing the blockage, and providing supportive care. 5. Dissociative - Co poisioning Oxgenation 6. Neurogenic damage to symp ns - epi/nor-epi give epi, fluids, and pace if needed

Question 51

Define Hematuria Hematachezia Hematocrit

Answer 51

Hematuria - blood in urine Hematachezia - bright red stool Hematocrit - red blood cells in total blood volume

Question 52

Delivering a patient to a facility before the loss of pulses is important in patients with which of the following conditions? Pick one: cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 52

compartment syndrome

Question 53

Describe signs for each degree of burns

Answer 53

First Degree - redness - just epidermis Second Degree - blisters - epi to dermis Third Degree - Charing, cap refill absent, full

Question 54

Dexamethasone class / dose / for / contra

Answer 54

Steroid dose: 10mg IV for: Severe Asthma, Anaphylaxis, croup contra: hypersensitive, fungal infection, premature infant

Question 55

Diastole is

Answer 55

the period when the heart is RELAXED and fills with blood.

Question 56

Difficulty swallowing

Answer 56

DysphaGIA

Question 57

Do you remove contacts with Eye burns

Answer 57

No, flush only

Question 58

Dobutamine

Answer 58

Sympathomimetic dose: 5-20 mcg per kg/min for: heart failure, low cardiac output

Question 59

Dopamine class / dose / for / contra

Answer 59

alpha beta adrenergic receptor stim / dopaminergic dose: 2-20 mcg/kg/min IV drip for: shock (hypovolemic, anaphylactic, septic, cardio contra: dysrhythmia, uncorrected hypovolemia

Question 60

Epinephrine 1:1 (for allergic) class / dose / for / contra

Answer 60

Adrenaline dose: 1mg in 1ml for: severe allergic reaction with resp dis, severe asthma contra: none during anaphylaxis

Question 61

Euphoria, Tingling, and AMS are signs of what Water Emergency

Answer 61

Nitrogen Narcosis

Question 62

Fentanyl class / dose / for / contra

Answer 62

Opioid dose: 1mcg/kg (max 200mcg) for: severe pain contra: allergic, uncorrected resp distress, hypo 90

Question 63

Flank Pain and Hematuria is a sign of what organ affected? also what is Hematuria?

Answer 63

Kidneys - Retroperitoneal Cavity Hematuria - Blood in urine

Question 64

For a severe burn patient which step is first Intubate or Vitals?

Answer 64

Put out fire Open airway O2 INTUBATE nasogastric tube stomach IV VITALS remove clothes Determine burn % Dress burns, sterile

Question 65

for High Altitude PE (HAPE) what is contra indicated

Answer 65

Signs - pulmonary hypertension No Nitro No Furosemide poss CPAP and lower altitude

Question 66

For Pelvic Binder what should you do before applying what location are you looking for

Answer 66

Empty pockets look for "Greater Trochanter"

Question 67

Capital Regional and Southern MD are what Level Trauma centers?

Answer 67

Level II

Question 68

The part of the brain which controls body temperature is called:_______________

Answer 68

Hypothalamus

Question 69

How do you avoid Supine Hypotension Syndrome?

Answer 69

Do not lay Pregnant woman on her back, tilt to her Left.

Question 70

How does a paramedic determine which level trauma center (according to nancy and her life on the streets)

Answer 70

with life threats... to the closest appropriate trauma center, with preference given to Level I or Level II trauma centers (pg 1428) consider the specific resources of each (pg 1429)

Question 71

How does the body react when cold or hot does it vasoconstrict or vasodilate?

Answer 71

to warm up (when cold): it vasoconstricts to cold down (when hot): it vasodilates

Question 72

How long do you Irrigate chem burns

Answer 72

atleast 15-20 mins

Question 73

How many c is 98.5f (normal) how many c is 90f how many c is 82f how many c is 100.4f

Answer 73

98.5°F = (98.5 - 32) / 1.8 = 36.94°C 90°F = (90 - 32) / 1.8 = 32.22°C 82°F = (82 - 32) / 1.8 = 27.78°C 100.4°F = (100.4 - 32) / 1.8 = 38°C

Question 74

How many collisions does a patient suffer in an MVC?

Answer 74

3

Question 75

How many Shocks do you give a Hypothermia patient?

Answer 75

1

Question 76

How much blood can the abdominal cavity hold?

Answer 76

Over 3000mL

Question 77

How much blood loss would you expect to lose from a femur fracture?

Answer 77

1500mL

Question 78

How would you most likely treat flail chest if the pt was found to be unresponsive? High flow O2 BVM ventilations Pain management and O2

Answer 78

BVM ventilations

Question 79

HR x Stroke Volume =

Answer 79

Cardiac Output

Question 80

If your patient is dehydrated their lab values would show?

Answer 80

Increased blood urea nitrogen (BUN): Dehydration can cause the BUN level to rise, as the kidneys reabsorb more water and concentrate the urea in the blood. Increased hematocrit (Hct): Dehydration can cause the Hct level to rise, as the blood becomes more concentrated due to a loss of fluid volume. BUN levels are 10-20mg/dL normal hematocrit levels are 38-52%.

Question 81

If your patient is hypoventilating, what will happen to their ETCO2 levels?

Answer 81

ETCO2 will increase

Question 82

In a Near Drowning patient what might you consider for treatment

Answer 82

Airway, C-Spine, Rescue Breathing Then on land: 02 pulse, abc, CPR, suction, IV Poss: PEEP, if ET - nasogastric tube place on side

Question 83

In MD, TXA can be administered how many hours after the injury?

Answer 83

1 Hour in MD, 3 hours Nat Reg

Question 84

In the rule of 9s how much is the patients palm?

Answer 84

1%

Question 85

TBI patient without suspicion of herniation syndrome should be ventilated at a rate of ___.

Answer 85

10-12 bpm (ETCO2 35-45)

Question 86

Increased pressure leads to reduced blood flow (ultimately causing muscle ischemia and muscle death in patients with which of the following conditions? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 86

compartment syndrome

Question 87

Infection caused by "Clostridium perfringens", tissue destruction

Answer 87

Gangrene

Question 88

Ketamine class / dose / for / contra

Answer 88

Sedative-hypnotic; analgesic for PAIN: dose: 0.2mg/kg (over 1-2 mins) max dose 20mg 2nd dose: same as above 0.2/max20 for SEDATIVE: dose: 1mg/kg (max 100mg) IV, 4mg/kg IM (max 400) contra: Eye injury, CP, AB pain, Headache, Pregnant/Breastfeed, hypersensative

Question 89

LeFort fracture I, II, III symptoms of each

Answer 89

LeFort I: involves a horizontal fracture of the maxilla above the teeth, causing mobility of the upper jaw and nasal septum. Symptoms: mobility of upper jaw, nasal septum, and teeth; facial swelling, pain, and bruising. Treatment: stabilization of the jaw, pain management, and surgery. LeFort II: involves a triangular-shaped fracture that extends from the nose to the maxilla to the orbits. Symptoms: mobility of the entire midface, including the nose and orbits; facial swelling, pain, and bruising. Treatment: stabilization of the jaw and midface, pain management, and surgery. LeFort III: involves a fracture that separates the facial bones from the skull base. Symptoms: mobility of the entire midface and orbits, including the zygomas and maxilla; facial swelling, pain, and bruising; possible CSF leak. Treatment: stabilization of the jaw and midface, pain management, and surgery.

Question 90

Low blood volume and Hypoperfused tissue are signs of what type of shock?

Answer 90

Hypovolemic Shock

Question 91

Medications typically do not relieve the pain of which of the following conditions? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 91

compartment syndrome

Question 92

Midbrain, pons, and medulla, collectively

Answer 92

Brainstem

Question 93

Mild Abdominal Pain Radiating to the back is a sign of what organ affected?

Answer 93

Pancreas

Question 94

Morphine class / dose / for / contra

Answer 94

Opioid dose: 0.1mg/kg (max initial dose 20mg) 2nd dose: 0.05mg/kg (max of 10mg) for: severe pain contra: allergic, uncorrected resp distress, hypo 90

Question 95

Name one of the primitive reflexes

Answer 95

Moro (startle)

Question 96

Name the organs in the RUQ and LUQ

Answer 96

RUQ - Gall bladder, Intestine, Liver LUQ - Pancreas, Intestine, Spleen, Stomach

Question 97

Name two indications for ketamine.

Answer 97

Sedative and treatent of pain, or excited dlirium. 

Question 98

Numbness and tingling occurs in patients with which of the following conditions? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 98

compartment syndrome

Question 99

On GCS Scale what does decorticate vs decerebrate get

Answer 99

cort - 3 arms to the core cerebrate - 2 arms extended

Question 100

Out of the following pairs of acute coronary syndrome imitators which ones normally have a narrow QRS

Answer 100

Benign early repolarization and LVH

Question 101

Pain in the Left Shoulder is a sign of what nerve affected? and what organ affected?

Answer 101

Left Shoulder = Phrenic Nerve, (c3, c4, c5 - keep diaphram alive) Diaphragmatic irritation Spleen (LUQ)

Question 102

Pain that is out of proportion to the injury is commonly seen in which of the following? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 102

compartment syndrome

Question 103

Parkland Burn Formula

Answer 103

4mL x TBSA x kg, given over 24 hours

Question 104

Part of the brain for movement

Answer 104

Cerebellum

Question 105

Patient fell from a roof – pale skin, absent radial pulses, weak and rapid carotid pulse, JVD, hyperresonance right side. What type of shock do they have?

Answer 105

Hypovolemic Shock

Question 106

Patient was involved in MVC 1 week ago. Now complaining of blurry vision, projectile vomiting, and confusion. What do they have? Subdural hematoma epidural hematoma intracranial hematoma

Answer 106

Subdural hematoma

Question 107

Protruding organs of any kind should be covered in what type of dressing?

Answer 107

Moist sterile

Question 108

Pt has hx of alcoholism, hit on head with beer bottle. Initially unconscious but then woke. AMS. Subdural hematoma epidural hematoma intracranial hematoma

Answer 108

epidural hematoma The hit caused a temporal bone fracture and tear in meningeal artery

Question 109

Pump Failure would cause what type of shock?

Answer 109

Cardiogenic Shock

Question 110

Searing or burning pain that is localized are symptoms of which of the following conditions? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 110

compartment syndrome

Question 111

Seizures, Headache, Joint pain and EYElid twitching are signs of what Water Emergency

Answer 111

Decompression Sickness

Question 112

Shock secondary to an INFECTION in the blood is ______________ shock

Answer 112

Distributive shock

Question 113

Signs of Hyperkalemia include what would their ecg look like? Treatment?

Answer 113

hyperkalemia - peaked T waves, widened QRS complexes, and a loss of P waves. In severe cases, hyperkalemia can cause ventricular fibrillation or asystole. Treatment Fluids Calcium chloride 0.5-1g Slow IV over 3-5mins max 1g Sodium bicarb 50 mEq IV over 5mins peds less. Crush syndrome - sodium bicarb

Question 114

Solution that does not contain proteins or other large molecules, used in shock fluid resuscitation

Answer 114

Crystalloids

Question 115

structure and function of the epidermis: how many layers what is the outer-most layer what is the job of the epidermis

Answer 115

5 layers Outermost (dead skin) - stratum corneum epidermis (outermost) - barrier against water, dust, dirt, microorganisms

Question 116

Supra Pubic Tenderness (above pubic bone) affects which organ?

Answer 116

Bladder

Question 117

Tension Pneumothorax is _____________ shock

Answer 117

Obstructive shock

Question 118

The area of concern may feel firm in a patient with which of the following conditions? (Pick one of the following) cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 118

compartment syndrome

Question 119

The body cannot tolerate blood loss of _____ it is a class III hemorrhage

Answer 119

30-40%

Question 120

The effect of one medication is greatly enhanced by the presence of another medication, which does not have the ability to produce the same effect," is the definition of _______________?

Answer 120

Potentiation

Question 121

The larges portion of the brain, for reasoning

Answer 121

Cerebrum

Question 122

The most common infection of the hand in the US

Answer 122

Paronylhia

Question 123

True of False: When percussing over solid organs or fluids, you would expect to hear a dull sound?

Answer 123

True

Question 124

True or False a tourniquet can only be used for arterial bleeding?

Answer 124

False

Question 125

True or False Posturing is a sign of Herniation Syndrome

Answer 125

TRUE

Question 126

True or False: A fall from less than 10 feet fits a trauma transport

Answer 126

False... 20 feet

Question 127

True or false: blunt force trauma can cause dissection of major arteries.

Answer 127

True

Question 128

True or false: the axial skeleton includes the skull, chest, and spine.

Answer 128

True

Question 129

True or false? A hip fracture is the same as a pelvic fracture.

Answer 129

False

Question 130

True or false? All gunshot wounds will have an exit wound.

Answer 130

False

Question 131

True or false? All trauma arrest patients do not require bilateral needle decompression.

Answer 131

False

Question 132

True or false? An epidural bleed is bleeding that happens between the brain and the dura.

Answer 132

False

Question 133

True or false? An epidural bleed is considered an arterial bleed.

Answer 133

True

Question 134

True or false? Burn patients will be hypotensive right after a severe burn due to burn shock.

Answer 134

False

Question 135

True or false? Compartment syndrome can compromise circulation and nerves.

Answer 135

True

Question 136

True or False? Crush syndrome can only happen when a large object for a long period of time.

Answer 136

True

Question 137

True or false? For gunshot wounds, exit wounds are typically smaller than the entrance wound.

Answer 137

False

Question 138

True or false? Sodium bicarb will reduce potassium levels

Answer 138

False

Question 139

True or false? The s/s of neurogenic shock is very similar to “traditional shock”, such as hypovolemic shock.

Answer 139

False

Question 140

True or False? There is a high chance that a crush syndrome pt will go into cardiac arrest when rescued.

Answer 140

True

Question 141

True or false? Water is one of the best for treating chemical injuries.

Answer 141

True

Question 142

True or false? You can potentially lose 1500-3000mL of blood from a pelvic fracture.

Answer 142

True

Question 143

True or False Do NOT give hypovolemia patient anything by mouth

Answer 143

True, they will vomit

Question 144

True or False You should NOT rub a patient with frost bite

Answer 144

True do not rub

Question 145

Using the consensus formula, how much of the total amount of fluid needs to be administered in the first 8 hours? A. 50% B. 75% C. 25% D. 10%

Answer 145

50%

Question 146

What 2 things can occur hours or days after a near drowning

Answer 146

PE and Pneumonia

Question 147

What accounts for more than half of the bodys blood volume

Answer 147

Plasma

Question 148

What are 3 signs/symptoms of Inferior Wall STEMI with right ventricular involvement

Answer 148

hypotension JVD clear lungs

Question 149

What are signs of Heat Stroke (3)

Answer 149

Irritable dehydration Red, Hot, and Dry

Question 150

What are signs of High Alt Cerebral Edema (HACE)

Answer 150

Headache, ATAXIA, ams

Question 151

What are signs of High Alt PE (HAPE)

Answer 151

Dysnea, COUGH, cyanosis, Frothy Sputum

Question 152

What are the 3 forms of radiation and which is most harmful

Answer 152

Alpha Beta Gamma- Most dangerous also note: Ionizing - most dangerous nonionizing - safe

Question 153

What are the 3 layers of meninges?

Answer 153

dura mater (outer layer), arachnoid mater (middle layer), and pia mater (innermost layer).

Question 154

What are the 3 Paralytic drugs and their doses

Answer 154

Succinylcholine 1-2mg/kg Vecuronium 0.1mg/kg Rocuronium 1mg/kg

Question 155

What are the 2 types of Distributive Shock? (and their causes and treatment for each)

Answer 155

Anaphylactic - Allrg React Fluids/Pressor (epi) /Diphan Septic - Infected blood - Fluid/Pressors (epi) /Antibiotic

Question 156

What are the 3 zones of burn injuries and 3 layers of skin

Answer 156

zones: hyperemia - outer stasis - middle coagulation - inner skin: epidermis - top dermis - middle hypodermis - bottom

Question 157

What are the 6 types of shock

Answer 157

Cdd hon Cardiogenic Distributive Dissociative Hypovolemic Obstructive Neurogenic

Question 158

What are the 5 blast injuries

Answer 158

1. primary - blast wave 2. secondary - blast force 3. Tertiary - impact with object 4. Quaternary - burns, inhalation 5. Qunary - long term damage

Question 159

What are the steps of an Airway Management Plan (things you may do in order)

Answer 159

A. Airway Adjuncts - positioning, opa, npa, bvm, suction B. SGA - iGel, King, CPAP, BiPAP C. Intubation/RSI D. Cric Surgery/Needle Decompress

Question 160

What are the contraindications of dopamine

Answer 160

tachycardia, arrhythmias (vfib) Note: give fluids first for hypovolemia

Question 161

what are the adverse reactions of fentanyl

Answer 161

respiratory depression, hypotension, bradycardia, and nausea/vomiting.

Question 162

what are the adverse reactions of morphine

Answer 162

respiratory depression, hypotension, bradycardia, and nausea/vomiting.

Question 163

What are the bodys 4 ways of cooling

Answer 163

Radiation Conduction Convection Evaporation

Question 164

What are the components of Beck’s Triad?

Answer 164

Hypotension, JVD, muffled heart tones

Question 165

What are the components of Beck’s Triad?

Answer 165

Hypotension, JVD, muffled heart tones

Question 166

What are the different types of burns?

Answer 166

thermal, chemical, and electrical.

Question 167

What are the following terms as far as bites Hymenoptera Erythema Angioedema Pruritus Loxoscelism Melittin

Answer 167

Hymenoptera - bees and ant venom Erythema - redness Angioedema - swelling of face/lips/tounge Pruritus - itching Loxoscelism - tissue damage (spider bite) Melittin - pain from venom

Question 168

What are the Level 1 trauma centers in dc and va (northern)

Answer 168

Medstar WHC Inova Fairfax

Question 169

What are the Level 2 trauma centers in dc and va (northern)

Answer 169

Medstar Georgetown Alexandria (PG and Suburban in MD)

Question 170

What are the ligaments of the Knee

Answer 170

ACL, LCL, MCL, PCL

Question 171

What are the parts of the spinal column

Answer 171

cervical 7 thoracic 12 Lumbar 5 7 12 and 5

Question 172

What are the signs and symptoms of a basilar skull fracture, and how should it be managed?

Answer 172

Signs and symptoms include raccoon eyes, Battle's sign, CSF leakage from the ears or nose, and vertigo. Management involves maintaining a patent airway and transporting the patient to the hospital for further evaluation.

Question 173

With an open abdominal wound, and how should it be managed?

Answer 173

Management involves covering the wound with a moist sterile dressing and transporting the patient to the hospital.

Question 174

What are the signs and symptoms of heat stroke?

Answer 174

Confusion, altered mental status, hot and dry skin, and rapid pulse. aggressive cooling and hydration, along with supportive care. This may include moving the patient to a cool environment, removing excess clothing, applying cool water to the skin, and using ice packs or cooling blankets. Intravenous fluids may be given to maintain hydration, and medications such as benzodiazepines or muscle relaxants may be used to control seizures or muscle rigidity. In severe cases, intubation and mechanical ventilation may be necessary.

Question 175

What are the signs and symptoms of hypothermia, and how should it be managed?

Answer 175

Signs and symptoms include shivering, confusion, lethargy, and bradycardia. Management involves rewarming the patient gradually and administering warm fluids.

Question 176

What are the signs of compensated shock?

Answer 176

Vital signs: Normal blood pressure, tachycardia, tachypnea, mild decrease in urine output Symptoms: Anxiety, restlessness, increased thirst, mild peripheral vasoconstriction, normal or slightly elevated body temperature

Question 177

What are the signs of decompensated shock?

Answer 177

Vital signs: Hypotension, tachycardia, tachypnea, decreased urine output Symptoms: Weakness, altered mental status, cool and clammy skin, decreased peripheral pulses, delayed capillary refill, decreased skin turgor, oliguria

Question 178

What are the signs of irreversible shock?

Answer 178

Vital signs: Profound hypotension, bradycardia, respiratory failure, hypoxia Symptoms: Unresponsive, dilated and fixed pupils, absent peripheral pulses, cool and mottled extremities, anuria, metabolic acidosis

Question 179

What are the signs of Neurogenic Shock and not Herniation or TBI and how do we treat?

Answer 179

Neuro- low bp low hr Flush RED skin loss of sympathetic tone give epi drip and pressors

Question 180

What are the steps for a Morgan Lens (specifically which direction for eyes)

Answer 180

Instruct patient to look DOWN insert under upper lid THEN look UP, drop into lower lid

Question 181

What are the steps for RSI

Answer 181

Assess and prepare the patient: Make sure that the patient has adequate ventilation and oxygenation, establish vascular access, and administer pre-oxygenation with 100% oxygen for at least three minutes. Pre-medicate: Administer sedative agents such as etomidate, midazolam, or ketamine to induce unconsciousness, and administer a paralytic agent such as succinylcholine or rocuronium to facilitate intubation. Intubation: Once the patient is sedated and paralyzed, the paramedic will insert the laryngoscope and visualize the vocal cords, then insert an endotracheal tube (ETT) into the trachea. Once the ETT is in place, confirm correct placement using waveform capnography or chest auscultation. Confirm and secure the airway: Secure the ETT in place, confirm that the patient is still adequately oxygenated, and monitor the patient's vital signs and oxygen saturation.

Question 182

What are the symptoms and treatment of a flail chest?

Answer 182

Symptoms: paradoxical chest wall movement, chest pain, and dyspnea. treatment: Oxygen therapy, pain management, positive pressure ventilation, and possible surgical fixation.

Question 183

What are the symptoms and treatment of a hemothorax?

Answer 183

symptoms: Dyspnea (SOB), CP, decreased breath sounds on the affected side, and signs of SHOCK. treatment : Chest tube and fluids

Question 184

What are the symptoms and treatment of a pulmonary contusion?

Answer 184

symptoms: Dyspnea, chest pain, hemoptysis, and decreased breath sounds on the affected side. Treatment: Oxygen therapy, analgesia, positive pressure ventilation, and fluid resuscitation.

Question 185

What are the symptoms and treatment of a spinal cord injury?

Answer 185

Symptoms: Paralysis, loss of sensation, and loss of bowel/bladder control. Treatment: Immobilization, spinal precautions, and transport to a trauma center.

Question 186

What are the symptoms and treatment of a tension pneumothorax?

Answer 186

symptoms: Dyspnea, tracheal deviation, hypotension, JVD, and absent breath sounds on the affected side. treatment: Needle decompression followed by chest tube insertion.

Question 187

What are the symptoms and treatment of a traumatic brain injury?

Answer 187

Symptoms: Altered mental status, headache, vomiting, and seizures. Treatment: Airway management, hyperventilation (herniating) to lower intracranial pressure, and transport to a trauma center.

Question 188

What are the symptoms and treatment of cardiogenic shock?

Answer 188

Symptoms: Tachycardia, hypotension, pulmonary congestion, and signs of poor tissue perfusion. Treatment: Oxygen therapy, vasopressor support, inotropic support, and possible mechanical circulatory support.

Question 189

What are the symptoms and treatment of hypovolemic shock?

Answer 189

Symptoms: Tachycardia, hypotension, cool/pale/clammy skin, and altered mental status. Treatment: Rapid fluid resuscitation with crystalloids or blood products.

Question 190

What are the symptoms and treatment of neurogenic shock? Besides can’t feel legs.

Answer 190

Symptoms: Bradycardia, hypotension, and warm/dry skin. Treatment: Vasopressor support, fluid resuscitation, and spine immobilization.

Question 191

What are the symptoms and treatment of septic shock?

Answer 191

Symptoms: Fever or hypothermia, tachycardia, hypotension, and altered mental status. Treatment: Antibiotics, fluid resuscitation, and vasopressor support as needed.

Question 192

What are the three classic signs of shock?

Answer 192

Tachycardia, tachypnea (RAPID HR), and hypotension.

Question 193

What are the three components of the "Trauma Triad of Death"?

Answer 193

Hypothermia, acidosis, and coagulopathy.

Question 194

What are the two Level 1 trauma centers in Maryland

Answer 194

Shock Trauma (UM) Hopkins

Question 195

What are the two main types of forces that can cause injury in a motor vehicle accident?

Answer 195

contact forces and non-contact forces.

Question 196

What are the two types of Direct Brain Injury Categories

Answer 196

Focal - epi/sub (slow) dural hematoma (brain bleeds) coup-countrecoup injury Diffuse - concussion, axonal injury (whole brain) cushings, decor/decereb

Question 197

What are the typical injuries from a head on crash (8, name atleast 4)

Answer 197

facial, abdominal, neck trauma pulmonary contusion flail chest myocardial contusion pericardial tamponade pneumo or hemo thorax ruptured aorta fractured sternum, rib

Question 198

What are two concerns for a burn patient

Answer 198

infection hypothermia

Question 199

What area in the meninges is located between the arachnoid and the pia mater in which CSF flows?

Answer 199

The subarachnoid space

Question 200

What can you check, for patient with initial hemorrhagic shock

Answer 200

absent cap refill

Question 201

What can you give High Altitude Cerebral Edema (HACE)

Answer 201

Signs - AMS, LOC Dexamethasone 8mg + O2

Question 202

What Category Trauma would someone over 55 y/o, on Blood thinners, Provider Judgement

Answer 202

Cat D - All others

Question 203

What Category Trauma would someone with 12 inch intrusion in car, or fall greater 20ft, death in same compartment?

Answer 203

Cat C - Mechanical

Question 204

What Category Trauma would someone with a GCS less than 13 be?

Answer 204

Cat A - physio

Question 205

What Category Trauma would someone with gunshot or 2 long bone fractures, or stab wound be?

Answer 205

Cat B - physical

Question 206

What Category Trauma would an infant with resp less than 20?

Answer 206

Cat A - physio

Question 207

What chart does the hospital use for burns?

Answer 207

Lund and Browder Chart

Question 208

What class of drug is Naproxen

Answer 208

NSAID

Question 209

what class of drug is paroxetine

Answer 209

SSRI

Question 210

What class of medication is diltiazem?

Answer 210

Class IV, antiarrhythmic

Question 211

What defines Neurogenic Shock

Answer 211

Injury above T6 loss of epi/nor-epi loss of autonomic function

Question 212

What does a Level 1 trauma center have that level 2 does not?

Answer 212

Level 1 should have cardiac, microvascular both have Ortho and Neuro, anesthesiologist

Question 213

What does a Level 1 trauma center have that level III does not

Answer 213

cardiac, orthopedic, neurosurgical, and anesthesiology care and surgeons

Question 214

What does a positive halo test look like?

Answer 214

Ring around a blood sample on a 2x2

Question 215

What does an ECG with hypokalemia look like?

Answer 215

Hypokalemia, which is a low level of potassium in the blood, can cause several ECG changes, including: ST segment depression Shallow T-wave inversions Appearance of a U wave Prolonged QT interval Increased risk of ventricular arrhythmias, such as torsades de pointes.

Question 216

What does clubbing of the fingernails indicate?

Answer 216

Chronic respiratory disease

Question 217

What does elastin do?

Answer 217

Elastin is a protein found in the extracellular matrix. It allows tissues to stretch and then return to their original shape, elastin helps maintain the elasticity of the vessels, allowing them to constrict and dilate

Question 218

What does Kehr’s Sign indicate?

Answer 218

Splenic injury

Question 219

What does the Babinski test assess?

Answer 219

It test damage to the corticospinal tract for voluntary motor control

Question 220

What does TXA do?

Answer 220

It SLOWS the break down of clots and fibrin

Question 221

What drug to you give for Torsades?

Answer 221

Mag Sulfate 2g over 2mins

Question 222

What effects will administering a Beta-2 agonist have on the respiratory system?

Answer 222

Bronchodilation

Question 223

What fluid is prefered for Burn shock

Answer 223

Lactated Ringers - electrolytes

Question 224

What gives red blood cells its reddish color?

Answer 224

Hemoglobin

Question 225

What indicates Kehr’s Sign? Left shoulder pain Right shoulder pain Left leg pain

Answer 225

Left shoulder pain

Question 226

What is a 4th Degree burn

Answer 226

burn to bone, mostly chem burns full thickness past muscle and tissues, all

Question 227

What is a "decompression sickness"?

Answer 227

a condition caused by a rapid decrease in pressure, leading to the formation of nitrogen bubbles in the blood.

Question 228

What is a "hemothorax"?

Answer 228

a collection of blood in the pleural cavity.

Question 229

What is a Neutral Sedative? (and dose)

Answer 229

Etomidate - 0.3mg/kg good for low bp

Question 230

What is a "secondary injury"?

Answer 230

an injury that occurs after the initial traumatic event and is often caused by hypoxia or hypoperfusion.

Question 231

What is a sign of TBI (not in Neuro, or Herniation) what should the bp be?

Answer 231

nausea, vomitting, AMS keep bp 110

Question 232

What is Boyles Law

Answer 232

Gas Pressure decrease as volume increase (and vice versa)

Question 233

What is it called, a person lacking blood clotting factors

Answer 233

hemophilia

Question 234

What is missing from a Level III trauma center

Answer 234

They do not have surgeons

Question 235

What is most affected by a primary blast injury?

Answer 235

Hollow organs

Question 236

What is normal body temp? What is hypo and and hyper

Answer 236

norm = 98.6 = 37 c hypo = 95 and below hyper = 100.4 and above

Question 237

Profuse diaphoresis is a sign of what type of heat stroke

Answer 237

exertional

Question 238

What is TBI (brain injury)

Answer 238

Traumatic Brain Injury

Question 239

What is the appropriate fluid resuscitation for a patient with hypovolemic shock?

Answer 239

crystalloid

Question 240

What is the best treatment for an avulsed scalp injury?

Answer 240

Replace the avulsed tissue back in place and apply a moist sterile dressing to the wound.

Question 241

What is the body's physiologic response to hemorrhage (3 things)

Answer 241

Clotting is activated, vasoconstriction, platelet aggregation

Question 242

What is the contraindicated Sedative for low Bp and Trauma bleeds and dose

Answer 242

Versed - benzo, lowers bp (0.05 - 0.1mg/kg)

Question 243

What is the correct anatomic location of V8

Answer 243

Level with v6 on the mid scapular line

Question 244

What is the definition of colloid solutions?

Answer 244

Solutions that contain large molecules that remain in the intravascular space.

Question 245

What is the definitive treatment for an open femur fracture?

Answer 245

Traction splint

Question 246

What is the Detailed version of the rule of nines chart TBSA

Answer 246

Lund-Brower

Question 247

What is the difference between 1st, 2nd, and 3rd degree burns and treatment of each

Answer 247

1st degree burn: involves the epidermis only, causing redness, pain, and mild swelling. Treatment: cool water, pain management. 2nd degree burn: involves the epidermis and part of the dermis, causing blistering, severe pain, and swelling. Treatment: cool water, sterile dressings, pain management, and possible fluid resuscitation. 3rd degree burn: involves the entire epidermis and dermis, and may involve deeper tissues. The skin may appear charred or white, and the person may experience no pain due to nerve damage. Treatment: IV fluids, wound care, pain management, and possible surgery.

Question 248

What is the difference between a concussion and a contusion?

Answer 248

A concussion is a temporary loss of consciousness or cognitive function, while a contusion is a bruise on the brain.

Question 249

What is the difference between a coup and contrecoup injury?

Answer 249

coup injury - occurs at the site of impact, contrecoup injury - occurs on the opposite side of the brain due to the brain bouncing off the skull.

Question 250

What is the difference between a hematoma and an ecchymosis?

Answer 250

A hematoma is a collection of blood outside the blood vessels, while an ecchymosis is a bruise.

Question 251

What is the difference between a partial-thickness and a full-thickness burn?

Answer 251

A partial-thickness burn - affects the outer layer of the skin and may cause blistering, while a full-thickness burn - affects all layers of the skin and may cause charring.

Question 252

What is the difference between a simple and a comminuted fracture? (Not compound)

Answer 252

A simple fracture is when the bone breaks but does not penetrate the skin, while a comminuted fracture is when the bone is broken into multiple pieces.

Question 253

What is the difference between a simple and a compound fracture?

Answer 253

Asimple fracture - is a closed break in the bone, compound fracture - is an open break in the bone with a wound that communicates with the fracture site.

Question 254

What is the difference between a simple pneumo and a tension pneumo?

Answer 254

hemodynamic stability

Question 255

What is the difference between an epidural and subdural hematoma?

Answer 255

An epidural hematoma - occurs between the skull and dura mater subdural hematoma - occurs between the dura mater and brain.

Question 256

What is the difference between arterial and venous bleeding?

Answer 256

Arterial bleeding is bright red, spurting, and rapid, venous bleeding is dark red, oozing, and slower.

Question 257

What is the difference between compensated and decompensated shock?

Answer 257

Compensated shock is when the body is still able to maintain blood pressure and tissue perfusion, decompensated shock is when the body's compensatory mechanisms fail.

Question 258

What is the difference between "hypovolemic" and "hemorrhagic" shock?

Answer 258

Hypovolemic shock - is caused by a loss of fluid, hemorrhagic shock - is caused by a loss of blood.

Question 259

What is the difference between isotonic, hypotonic, and hypertonic solutions?

Answer 259

Isotonic solutions have the same osmotic pressure as blood hypotonic solutions have a lower osmotic pressure than blood hypertonic solutions have a higher osmotic pressure than blood.

Question 260

What is the difference between Ligaments and Tendons

Answer 260

Ligaments - Bone to Bone Tendons - Muscle to Bone

Question 261

What is the difference between synthetic and natural colloids?

Answer 261

Synthetic colloids are made from non-biological materials, while natural colloids are made from blood products or albumin.

Question 262

What is the dose of Mag Sulfate for asthma?

Answer 262

2 grams of magnesium sulfate in 100 mL of normal saline to be administered intravenously over 20 minutes for the treatment of acute severe asthma.

Question 263

What is the dose of TXA?

Answer 263

1g

Question 264

What is the formula for Kinetic Energy

Answer 264

KE=m/2 x v^2

Question 265

What is the hallmark sign of a third-degree burn?

Answer 265

Charring or white, leathery skin.

Question 266

What is the hallmark sign of compartment syndrome?

Answer 266

Pain out of proportion to the injury that is worsened with passive stretching. accompanied by paresthesias, pallor, pulselessness, and paralysis.

Question 267

What is the initial treatment for a partial-thickness burn?

Answer 267

Cool water for 10-15 minutes

Question 268

What is the maximum volume that may be administered in a single IM administration?

Answer 268

5mL

Question 269

What is the most common burn agent in an industrial setting?

Answer 269

Hydrofluoric acid

Question 270

What is the most common cause of airway obstruction in trauma patients?

Answer 270

Blood

Question 271

What is the most common cause of burns in children?

Answer 271

Scald injuries from hot liquids or food.

Question 272

What is the most common cause of death in a patient with a head injury?

Answer 272

Brain herniation

Question 273

What is the most common cause of death in a patient with multiple trauma?

Answer 273

Hypovolemic shock

Question 274

What is the most common cause of hypovolemic shock?

Answer 274

Hemorrhage

Question 275

What is the most common cause of irreversible shock?

Answer 275

Prolonged hypotension

Question 276

What is the most common cause of obstructive shock?

Answer 276

Pulmonary embolism

Question 277

What is the most common mechanism of injury in a penetrating trauma incident?

Answer 277

Gunshot wound

Question 278

What is the most common sign of a basilar skull fracture?

Answer 278

Racoon eyes (periorbital ecchymosis) and Battle's sign (postauricular ecchymosis)

Question 279

What is the most common sign of a significant chest injury?

Answer 279

Dyspnea and tachypnea

Question 280

What is the most common sign of hypovolemic shock?

Answer 280

Tachycardia

Question 281

What is the most common type of lightning injury?

Answer 281

Flash injuries from close proximity to the lightning strike. treatment: managing any life-threatening injuries or complications, such as cardiac arrest or respiratory distress. The patient should be assessed for burns, fractures, or other injuries, and appropriate interventions should be taken. Cardiac monitoring and electrolyte management may be necessary, as lightning strikes can cause cardiac arrhythmias and electrolyte imbalances.

Question 282

What is the most concerning for pulmonary blast injuries

Answer 282

Arterial air embolism

Question 283

What is the most effective treatment for a patient with a flail chest?

Answer 283

Positive pressure ventilation with endotracheal intubation

Question 284

What is the most effective treatment for a patient with a suspected pelvic fracture and hypotension?

Answer 284

Pelvic binder and fluid resuscitation

Question 285

What is the most effective treatment for a patient with heat exhaustion?

Answer 285

Move the patient to a cool, shaded area and provide fluids for rehydration. Rest, fluids, and cooling measures

Question 286

What is the most important factor in determining the severity of a burn?

Answer 286

Total body surface area (TBSA) involved

Question 287

What is the most reliable indicator of a tension pneumothorax?

Answer 287

Hypotension and tracheal deviation away from the affected side

Question 288

What is the most reliable indicator of shock in the pediatric population?

Answer 288

Tachycardia

Question 289

What is the most reliable indicator of shock?

Answer 289

Altered mental status

Question 290

What is the order in which a Wound Heals? (4 steps, HINC)

Answer 290

1. Hemostasis - vasocontrict/clotting 2. Inflammation - wbc combat 3. Neo-Vascularization - New vessels form 4. Collagen Synthesis - scar tissue

Question 291

What is the Parkland formula

Answer 291

4mL x KG x % BSA half of this in first 8 hours ONLY 2nd degree burns or greater

Question 292

What is the parkland formula for 80kg with 20% burns (and how much in first 8)

Answer 292

4mL x 80 kg x 20% = 6,400 mL 3200 in first 8

Question 293

What is the "platinum 10 minutes"

Answer 293

Goal of max time spent on-scene for critical trauma patient

Question 294

What is the preferred type of fluid for a patient with a traumatic brain injury?

Answer 294

Isotonic crystalloid, such as normal saline, due to its ability to maintain intravascular volume without causing cellular edema. page 911

Question 295

What is the preferred type of fluid in a patient with suspected internal bleeding?

Answer 295

Crystalloid solution such as normal saline

Question 296

What is the primary concern in treating a patient with a snake bite?

Answer 296

Preventing the spread of venom throughout the body. Treatment: administering appropriate antivenom if available. The patient should be assessed for signs of systemic toxicity, such as respiratory distress, hypotension, or altered mental status. The affected limb should be immobilized and kept below the level of the heart to slow the spread of venom. Pain management and fluid resuscitation may be necessary, and the patient should be transported to a hospital as soon as possible.

Question 297

What is the primary concern in treating a patient with frostbite? and treatment?

Answer 297

Preventing further tissue damage and rewarming the affected area. should be done in a controlled manner to avoid causing further damage. The patient should be moved to a warm environment and any wet clothing should be removed. The affected area can be soaked in warm water (104-108°F) for 15-30 minutes, or until the skin becomes soft and pliable. Pain medication may be given to help manage discomfort, and the patient should be monitored for signs of infection.

Question 298

What is the primary goal in the treatment of hypovolemic shock?

Answer 298

Fluid replacement

Question 299

What is the primary treatment for a patient in neurogenic shock?

Answer 299

Administer vasopressors to increase vascular tone and blood pressure

Question 300

What is the primary treatment for a patient in septic shock?

Answer 300

Broad-spectrum antibiotics and fluid resuscitation

Question 301

What is the primary treatment for a patient with severe hypothermia?

Answer 301

rewarm the body gradually and avoid rapid rewarming, which can cause cardiac arrest.

Question 302

What is the proper treatment for a chemical burn?

Answer 302

Remove contaminated clothing and flush with cool water for 20-30 minutes

Question 303

What is the recommended fluid replacement for a patient in hemorrhagic shock?

Answer 303

Balanced crystalloid solution (such as lactated Ringer's solution)

Question 304

What is the Trauma Lethal Triad

Answer 304

hypothermia, coagulopathy (poor blood clotting), and acidosis

Question 305

What is the treatment for a chemical burn to the eye?

Answer 305

Flushing with copious amounts of water for at least 20 minutes

Question 306

What is the treatment for decompensated shock?

Answer 306

Rapid fluid resuscitation, vasopressors, and identification and management of the underlying cause.

Question 307

What is treatment for a severe spider bite or stingers

Answer 307

remove - scrape out stinger 1. epi IM (1mg in 1ml) 1:1,000 2. diphenhydramine (25-50mg) (ped 1-2mg) 3. poss dexamethasone 4. Albuterol and Atrovent abc's and poss pain meds

Question 308

What is Waddell’s Triad?

Answer 308

Injuries you see on a pediatric patient when they get hit by a car (head trauma, leg trauma, and chest trauma)

Question 309

What is your first action after getting ROSC

Answer 309

Initiate targeted Temp

Question 310

What is your primary concern with a patient with burns to the face and tongue?

Answer 310

Airway management

Question 311

What kind of triage should you do for several lightning strike patients

Answer 311

reverse triage, dead may be in respiratory arrest transport all

Question 312

What labs indicate that the patient has an infection?

Question 313

What medication should be administered to a patient in anaphylactic shock?

Answer 313

Epinephrine

Question 314

What organ is primarily responsible for medication removal from the body?

Answer 314

Kidneys

Question 315

What part of the brain regulates temp

Answer 315

Hypothalamus

Question 316

What percent 2nd degree burn gets Fluid

Answer 316

over 20% 2nd degree start IV FLUIDS

Question 317

What percent burn is a child both legs (also what is % for face)

Answer 317

33% (just face is 12) Child 1 year to 15 Infant birth to 1

Question 318

What percent burn is a infant with face, torso, and 1 leg

Answer 318

49.5%

Question 319

What percent burn is an adult with torso, 1 arm, and face?

Answer 319

36%

Question 320

What percent of partial thickness burn goes to burn center

Answer 320

over 10%

Question 321

What sedative is contraindicated for occular trauma or ICP what is it good for and dose

Answer 321

Ketamine - good for bp and airway (Beta 2 properties) but bad for ocular/icp (dose 1mg/kg)

Question 322

What should you do (and not do) for snake bites

Answer 322

Do: place extremity below heart, avoid constriction (jewelry), clean w/ antimicrobial note the time and type of snake Dont: ice or suck venom out

Question 323

What should you first do to manage a crush syndrome patient?

Answer 323

Ensure a rescue plan is being developed

Question 324

What should you not do as far as treatment when it is below 30 degrees outside

Answer 324

With hold IV meds (too cold out), defib and pace might not work

Question 325

What site do you NDT on an adult patient

Answer 325

5th intercostal ANTERIOR axillary (above the 6th rib)

Question 326

What solution do you use to keep broken teeth

Answer 326

dont rinse place teeth in normal saline (lactated ringers - for electrolytes) in a cup (go to UM, has dental school)

Question 327

What temp does a patient CBT stop shivering

Answer 327

90-82 degree stops shivering (too cold) 95-90 shivering

Question 328

What triad indicates herniation syndrome?

Answer 328

Cushings Triad

Question 329

What type of bruising is behind the ear?

Answer 329

Battle signs

Question 330

What type of bruising pattern is around the belly button?

Answer 330

Cullen’s sign

Question 331

What type of burn is this?

Answer 331

3rd Degree Full thickness - fluid oozing, pus (plasma)

Question 332

What type of burn is this?

Answer 332

2nd Degree

Question 333

What type of burn is this?

Answer 333

2nd Degree

Question 334

What type of burn is this?

Answer 334

Third Degree (Eschar)

Question 335

What type of burn is this?

Answer 335

2nd Degree Deep partial thickness

Question 336

What type of burns are full thickness?

Answer 336

3rd Degree

Question 337

What type of burns are partial thickness?

Answer 337

2nd Degree

Question 338

What type of burns are superficial?

Answer 338

1st Degree

Question 339

What type of burns have blistering?

Answer 339

2nd Degree

Question 340

What type of posturing has the arms moving inward?

Answer 340

Decorticate

Question 341

What type of shock and treatment? A 50-year-old female who has been bleeding from a ruptured ectopic pregnancy. She is in decompensated shock with a blood pressure of 70/40 mmHg, heart rate of 120 beats per minute, respiratory rate of 30 breaths per minute, and decreased urine output.

Answer 341

Decompensated Treatment: rapid fluid resuscitation, oxygen via non-rebreather mask, and transport to the hospital. low bp is an early sign, rr is also an indication of decompensated.

Question 342

What type of shock and treatment? A 30-year-old male who has been in a car accident and is experiencing mild shock. His blood pressure is 110/70 mmHg, heart rate is 110 beats per minute, respiratory rate is 20 breaths per minute, and he has mild diaphoresis.

Answer 342

Compensated Treatment: oxygen via non-rebreather mask and IV fluids. in compensated shock, the body's compensatory mechanisms are able to maintain adequate organ perfusion, and the patient's vital signs are relatively stable. The patient may have an elevated heart rate and respiratory rate, but their blood pressure is maintained within normal limits, and they do not have signs of inadequate organ perfusion.

Question 343

What type of shock is burn shock fall under

Answer 343

Hypovolemic shock

Question 344

What type of shock? An 80-year-old male who has had a ruptured aortic aneurysm. with a blood pressure of 50/30 mmHg, heart rate of 40 beats per minute, respiratory rate of 8 breaths per minute, and unresponsive with fixed and dilated pupils. Is it Comp decomp or irreversible

Answer 344

Irreversible shock

Question 345

What type of shock? ARDS, renal failure, liver failure and sepsis Comp decomp or irreversible

Answer 345

Irreversible

Question 346

What type of shock? Diaphoretic, hypotensive, narrowing pulse pressure, nausea and vomitting Comp decomp or irreversible

Answer 346

Decompensated

Question 347

What type of shock? Vitals organs begin to die because of inadequate perfusion

Answer 347

Irreversible

Question 348

What type of trauma looks like a lemon?

Answer 348

epidural

Question 349

What type of trauma may be most likely caused by secondary blast injuries?

Answer 349

Penetrating trauma

Question 350

What would Grey Turner’s sign look like?

Answer 350

retroperitoneal bruising (flanks)

Question 351

Whats the difference between Decompression sickness (Bends) and Nitrogen Narcosis?

Answer 351

Decompression sickness (DCS), divers who ascend too quickly from a deep dive. It is caused by the formation of nitrogen bubbles in the blood and tissues due to rapid decompression. Symptoms-DCS joint pain, skin rash, dizziness, and difficulty breathing. Nitrogen narcosis - diver is exposed to high partial pressures of nitrogen at depth Nitro-symptoms: euphoria, confusion, and impaired judgment. Nitrogen narcosis is a reversible condition that resolves when the diver ascends to shallower depths, DCS may require hyperbaric oxygen therapy to treat.

Question 352

Whats the difference between Dopamine and Dobutaline

Answer 352

Dopamine and dobutamine are medications used to treat heart failure and shock. Dopamine increases blood pressure and cardiac output Dobutamine specifically targets the heart's beta-1 receptors to increase cardiac output.

Question 353

Whats the difference between Neurogenic shock and spinal shock

Answer 353

Neuro- spinal inj abv T6 disruption of sympathetic from T1-L2 loss of epi/nor-epi Spinal - injury, bleeding

Question 354

Whats the dose of TXA (and how many drops a min with a 15 drop set)

Answer 354

1g (1,000 mg) mixed in 100mL of Normal Saline (over 10 mins) 15 drop set, 100mL = 150 gtts/min

Question 355

What’s the GCS score? Eyes do not open, no response to sound, decorticate posturing.

Answer 355

5

Question 356

What’s the GCS score? Eyes open to pain, incomprehensible sounds, and withdraws from pain.

Answer 356

8

Question 357

When are vasopressors used?

Answer 357

Dopamine for Hypovolemic shock and Cardiogenic shock. Dopamine is given at a dose of 2 to 20 mcg/kg/min as a continuous infusion. Epinephrine: It is a potent vasoconstrictor for Distributive shock, such as septic shock and anaphylactic shock. Epinephrine is given at a dose 1g to 1mL

Question 358

When assessing a trapped crush injury pt, what can help you determine if a pt has crush syndrome?

Answer 358

12 Lead

Question 359

When do we use TXA?

Answer 359

Suspected HEMORRHAGIC shock due to Trauma (BP less than 90) Less than 3 hours (md 1 hour) Older than 15 y/o TXA is last step after manage life threats

Question 360

When do you fly a burn patient out?

Answer 360

If the patient is more than 30 mins by ground from burn center

Question 361

When do you give magnesium sulfate

Answer 361

for Torsades and

Question 362

When providing O2 to patients whats the rate for: 1. Herniation 2. Head- injury how many per min for children and infants with herniation?

Answer 362

1. herniation - 20 bpm (q 3 secs) 2. head injury - (10-12 bpm) child - 25bpm infant - 30bpm

Question 363

When should Spinal precautions be taken?

Answer 363

spinal pain, deformity loss of sensation, neuro deficit younger than 15: neck pain mvc torso injury (and/or can't assess) (at min c collar) but if they cant walk, GCS less thann 15, unresponsive BOARD THEM.

Question 364

Where do you place a tourniquet

Answer 364

Both 3" above, high and tight in axilla or groin is acceptable depending on the situation. But distal is recommended.

Question 365

Where do you transport a patient with trauma and burns?

Answer 365

To the Trauma center first for initial care

Question 366

Where do you transport Chemical burns?

Answer 366

To the closest hospital for decon before burn center

Question 367

Which endocrine gland is often referred to as the "master gland".

Answer 367

Pituitary

Question 368

Which if the following is not considered a toxin released by the body due to crush syndrome? Potassium Myoglobin Calcium Lactate

Answer 368

Calcium

Question 369

Which imitator normally has a widened QRS complex

Answer 369

AV sequential pacemaker

Question 370

Which Level trauma center will be able to provide ATLS - advanced Trauma Life support BEFORE transfer to higher level trauma center

Answer 370

Level IV (lowest level)

Question 371

Which Newton’s Law of Motion States: An object in motion will remain in motion unless acted on by another force.

Answer 371

1st Law

Question 372

Which Newton’s Law of Motion States: For every action there is an equal and opposite reaction.

Answer 372

3rd Law

Question 373

Which Newton’s Law of Motion States: force = mass (kg) x acceleration (m/s2).

Answer 373

2nd Law

Question 374

Which of the following conditions can be caused by a long compressive force? (Pick one) cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 374

crush injury

Question 375

Which of the following conditions may result in immediate cardiac arrest? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 375

commotio cordis

Question 376

Which of the following conditions occurs after a direct blow to the thorax, directly over the heart? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 376

commotio cordis

Question 377

Which of the following conditions occurs due to the inelasticity of fascia? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 377

compartment syndrome

Question 378

Which of the following conditions occurs during the critical portion of the heart's repolarization period? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 378

commotio cordis

Question 379

Which of the following does not meet the burn center criteria? Burns to the hands 6% partial thickness burns Inhalation burns 4% full thickness burns

Answer 379

6% partial thickness burns

Question 380

Which of the following is not considered a life threatening injury that should be found during primary assessment? Airway comp Cardiac tamponade Tension pneumo Flail chest

Answer 380

Cardiac tamponade

Question 381

Which of the following is not likely considered a cause of compartment syndrome? Closed fracture Tree fell on pt Open compound fractures

Answer 381

Open compound fractures

Question 382

Which of the following is not typically an immediate concern for a burn pt? Airway management Infection Fluid resuscitation Hypothermia

Answer 382

Fluid resuscitation

Question 383

Which of the following is true about managing a severe burn patient? A) Apply moist dressings over the burns to prevent the skin from drying out. B) Do not start transporting before at least 2 IVs are established C) Focus on giving pain medications first since you know that burns can be painful. D) If your patient is hypotensive, look for alternative causes.

Answer 383

D) If your patient is hypotensive, look for alternative causes.

Question 384

Which of the following vitals would you see in a patient in hemorrhagic shock?

Answer 384

Increased HR, decreased BP, increased RR

Question 385

Which of the following would not be considered an early sign of increased intracranial pressure? Confusion Increase in BP Nausea/vomiting Blurry vision

Answer 385

Increase in BP

Question 386

Which patients go to a burn center? (5)

Answer 386

Electrical (lightning or more than 120 volts) 2nd Degree greater than 10% All 3rd Degree Burns to the face, hands, feet, major joints, genitals, perineum Circumfrential burns to extremities or torso Extra note: Smoke inhalation (hyperbaric)

Question 387

Why are ped patient injuries different from adult (ped struck)

Answer 387

children are shorter so the are more likely to be run over

Question 388

With a serious bleeding patient the first thing you should do is?

Answer 388

PPE!

Question 389

With Electric burn what are the two rhythms to expect

Answer 389

VT/ VFIB (use early defib/cpr)

Question 390

With facial burns what simple thing can you do to minimize edema

Answer 390

Elevate stretcher 30 degrees avoid pillow if ears burned

Question 391

With the Rule of Nines what are the percents for: Head One Arm One Leg (for Infant, Child, Adult)

Answer 391

ADULT Head 9 One Arm 9 One Leg 18 CHILD Head 12 One Arm 9 One Leg 16.5 INFANT (not the most accurate) Head 18 One Arm 9 One Leg 13.5 (or their palm 1% area) ALL: TORSO 18 on each side //crotch 1

Question 392

You are hyperventilating your head injured patient who has signs of cerebral herniation. What is your target ETCO2 for your hyperventilation?

Answer 392

Ventilate between 30-35 

Question 393

You are treating a patient with altered mental status, a blood pressure of 70/40, and no peripheral pulses. You attach the patient to the cardiac monitor/defibrillator and the patient is in atrial fibrillation at a rate of 190. What is the preferred treatment, including dose? (Oxygen has already been applied, and IV access already obtained)

Answer 393

Synchronized Cardiovert at 120-200 jules

Question 394

You have treated a sucking chest wound with a dressing. They experience SOB. What should you do?

Answer 394

Burp the dressing

Question 395

Your patient is having an ST segment elevation MI (STEMI) with ST segment elevation in leads V5, v6, an I. Which coronary artery is likely involved?

Answer 395

LCX left circumflex artery

Question 396

Your patient was assaulted and presents with diminished R lung sounds, slight SOB, and strong radial pulses. NDC?

Answer 396

Manage with O2, perform reassessment during transport

Question 397

What is Nexium for

Answer 397

Gerd

Question 398

What is Nexium for

Answer 398

Gerd

Question 399

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but is normotensive (normal bp) is in _____________ shock

Answer 399

Compensated shock

Question 400

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but their bp drops to 82/40 and is disoriented is in _____________ shock Comp decomp or irreversible

Answer 400

Decompensated shock

Question 401

Acetazolamide

Answer 401

Diamox for: edema from CHF, glaucoma

Question 402

Flank Pain and Hematuria is a sign of what organ affected? also what is Hematuria?

Answer 402

Kidneys - Retroperitoneal Cavity Hematuria - Blood in urine

Question 403

What is the order in which a Wound Heals? (4 steps, HINC)

Answer 403

1. Hemostasis - vasocontrict/clotting 2. Inflammation - wbc combat 3. Neo-Vascularization - New vessels form 4. Collagen Synthesis - scar tissue

Question 404

What Category Trauma would someone with a GCS less than 13 be?

Answer 404

Cat A - physio

Question 405

Define Afterload

Answer 405

the force the heart must overcome to pump blood out to the body. (Pressure of vascular resistance).

Question 406

What is the difference between a partial-thickness and a full-thickness burn?

Answer 406

A partial-thickness burn - affects the outer layer of the skin and may cause blistering, while a full-thickness burn - affects all layers of the skin and may cause charring.

Question 407

What are the symptoms and treatment of a tension pneumothorax?

Answer 407

symptoms: Dyspnea, tracheal deviation, hypotension, JVD, and absent breath sounds on the affected side. treatment: Needle decompression followed by chest tube insertion.

Question 408

What are the symptoms and treatment of a pulmonary contusion?

Answer 408

symptoms: Dyspnea, chest pain, hemoptysis, and decreased breath sounds on the affected side. Treatment: Oxygen therapy, analgesia, positive pressure ventilation, and fluid resuscitation.

Question 409

What are the three classic signs of shock?

Answer 409

Tachycardia, tachypnea (RAPID HR), and hypotension.

Question 410

What type of shock and treatment? A 50-year-old female who has been bleeding from a ruptured ectopic pregnancy. She is in decompensated shock with a blood pressure of 70/40 mmHg, heart rate of 120 beats per minute, respiratory rate of 30 breaths per minute, and decreased urine output.

Answer 410

Decompensated Treatment: rapid fluid resuscitation, oxygen via non-rebreather mask, and transport to the hospital. low bp is an early sign, rr is also an indication of decompensated.

Question 411

The part of the brain which controls body temperature is called:_______________

Answer 411

Hypothalamus

Question 412

On GCS Scale what does decorticate vs decerebrate get

Answer 412

cort - 3 arms to the core cerebrate - 2 arms extended

Question 413

Which of the following is not considered a life threatening injury that should be found during primary assessment? Airway comp Cardiac tamponade Tension pneumo Flail chest

Answer 413

Cardiac tamponade

Question 414

What type of trauma may be most likely caused by secondary blast injuries?

Answer 414

Penetrating trauma

Question 415

What is Waddell’s Triad?

Answer 415

Injuries you see on a pediatric patient when they get hit by a car (head trauma, leg trauma, and chest trauma)

Question 416

Which of the following does not meet the burn center criteria? Burns to the hands 6% partial thickness burns Inhalation burns 4% full thickness burns

Answer 416

6% partial thickness burns

Question 417

Calculate the TBSA using the rule of 9s (3rd degree and 2nd degree burns – entire back, entire left arm, back of leg)

Answer 417

45%

Question 418

What type of burns have blistering?

Answer 418

2nd Degree

Question 419

What type of burns are superficial?

Answer 419

1st Degree

Question 420

What type of burns are full thickness?

Answer 420

3rd Degree

Question 421

What type of burns are partial thickness?

Answer 421

2nd Degree

Question 422

What’s the GCS score? Eyes do not open, no response to sound, decorticate posturing.

Answer 422

5

Question 423

What’s the GCS score? Eyes open to pain, incomprehensible sounds, and withdraws from pain.

Answer 423

8

Question 424

How much blood can the abdominal cavity hold?

Answer 424

Over 3000mL

Question 425

How much blood loss would you expect to lose from a femur fracture?

Answer 425

1500mL

Question 426

In the rule of 9s how much is the patients palm?

Answer 426

1%

Question 427

TBI patient without suspicion of herniation syndrome should be ventilated at a rate of ___.

Answer 427

10-12 bpm (ETCO2 35-45)

Question 428

Beck’s Triad is indicative of what?

Answer 428

Cardiac tamponade

Question 429

What type of posturing has the arms moving inward?

Answer 429

Decorticate

Question 430

You have treated a sucking chest wound with a dressing. They experience SOB. What should you do?

Answer 430

Burp the dressing

Question 431

True or false: blunt force trauma can cause dissection of major arteries.

Answer 431

True

Question 432

Commotio cordis occurs at what part of the cardiac cycle?

Answer 432

the upstroke of the T wave Blow to the chest disrupting the heart. During the precise moment of the heart repolarizing leading to arrhythmia. Can lead to V-Fib , needs cpr and rapid defib.

Question 433

What should you do (and not do) for snake bites

Answer 433

Do: place extremity below heart, avoid constriction (jewelry), clean w/ antimicrobial note the time and type of snake Dont: ice or suck venom out

Question 434

A partial thickness burn is also known as ____________ and ________ degree burns (2) A full thickness burn is also known as?

Answer 434

First and second - partial 3rd - Full - every layer - needs skin graft

Question 435

What type of burn is this?

Answer 435

2nd Degree Deep partial thickness

Question 436

What percent of partial thickness burn goes to burn center

Answer 436

over 10%

Question 437

Define Critical Burns

Answer 437

partial more than 30% full more than 10 Inhalation injuries Partial or Full involving hands, feet, joints, face, genitalia (2nd or Third)

Question 438

What solution do you use to keep broken teeth

Answer 438

dont rinse place teeth in normal saline (lactated ringers - for electrolytes) in a cup (go to UM, has dental school)

Question 439

What are the typical injuries from a head on crash (8, name atleast 4)

Answer 439

facial, abdominal, neck trauma pulmonary contusion flail chest myocardial contusion pericardial tamponade pneumo or hemo thorax ruptured aorta fractured sternum, rib

Question 440

What are the 5 blast injuries

Answer 440

1. primary - blast wave 2. secondary - blast force 3. Tertiary - impact with object 4. Quaternary - burns, inhalation 5. Qunary - long term damage

Question 441

When providing O2 to patients whats the rate for: 1. Herniation 2. Head- injury how many per min for children and infants with herniation?

Answer 441

1. herniation - 20 bpm (q 3 secs) 2. head injury - (10-12 bpm) child - 25bpm infant - 30bpm

Question 442

True or False Posturing is a sign of Herniation Syndrome

Answer 442

TRUE

Question 443

Whats the difference between Pharmacodynamics and Pharmacokinetics

Answer 443

Pharmacodynamics: how Drugs affect the body. Pharmacokinetics: how the body affects drugs.

Question 444

What does Rhonchi indicate?

Answer 444

Pneumonia

Question 445

What is Lovastatin for?

Answer 445

Cholesterol

Question 446

Whats the dose of Iptroprium bromide

Answer 446

500mcg

Question 447

Whats the difference between heat stroke and heat exhaustion

Question 448

What med do you give for wheezing

Answer 448

Albuterol

Question 449

How many times to you a pulseless hypothermia patient?

Answer 449

Defib once ASAP

Question 450

What med do you give for a black widow bite with muscle spasms

Answer 450

Midazolam

Question 451

A 5 y/o has seizures after a dog bite, what might she have?

Answer 451

Rabies

Question 452

What are the signs of an Arterial Gas Emboli?

Question 453

How does Over pressure happen?

Answer 453

Holds breath during accent

Question 454

How many jules do you defib a hypothermic vfib patient?

Answer 454

200j biphasic

Question 455

With a hypothermic patient, what is different when administering meds?

Answer 455

Increase intervals between cardiac meds the metabolism of drugs may be decreased, leading to slower clearance and prolonged effects.

Question 456

What meds slow the clotting process?

Answer 456

blood thinners and beta blockers

Question 457

Pericardial tamponade is what kind of shock

Answer 457

Obstructive

Question 458

What type of shock is an MI

Answer 458

cardiogenic

Question 459

Define Preload

Answer 459

is the volume of blood present in the ventricles at the end of diastole, just before systole begins. It determines the initial length and tension of the myocardial fibers and influences stroke volume.

Question 460

What is the main concern for dental injuries?

Answer 460

Airway compromise

Question 461

What would cause the rupture of the abdominal aorta

Answer 461

Blunt Trauma

Question 462

If a patient struggles to breathe with an occlusive dressing what should you do first

Answer 462

Burp it

Question 463

What are the signs and symptoms of hypovolemic shock?

Answer 463

tachycardia, hypotension, cool and clammy skin, altered mental status, and decreased urine output. Other signs may include pale skin, weak or absent peripheral pulses, and delayed capillary refill time.

Question 464

How should fluids be administered in the prehospital setting to a patient in shock?

Answer 464

Two large-bore IV catheters or One intraosseous drilled needle The initial fluid bolus should be 20 mL/kg of isotonic crystalloid solution

Question 465

What is the difference between compensated and decompensated shock?

Answer 465

decompensated shock occurs when these compensatory mechanisms fail and blood pressure falls, Compensated - vasoconstriction and tachycardia, BP level, resp irregular but up

Question 466

What are the early signs of TBI

Answer 466

loss of consciousness, confusion, disorientation, memory loss, headache, dizziness, nausea or vomiting, blurred vision, sensitivity to light or noise, and fatigue.

Question 467

What are the early signs of Herniation

Answer 467

Cushings Triad - brady, irreg rr, hypertension (opposite direction of shock) altered mental status, confusion, agitation, restlessness, and lethargy. Other signs may include pupillary changes, such as unilateral or bilateral dilation or non-reactivity, and motor deficits decerebrate or decorticate posturing. (doesnt have to be both cushings and posturing, either or)

Question 468

What are the signs and symptoms of Cardiac Tamponade

Answer 468

Becks Triad dyspnea (difficulty breathing), tachycardia (rapid heart rate), hypotension (low blood pressure), jugular venous distension, muffled heart sounds, pulsus paradoxus (a decrease in systolic blood pressure during inspiration), and signs of shock

Question 469

What are the signs and symptoms of Pulmonary Contusions?

Answer 469

dyspnea (difficulty breathing), chest pain, tachypnea (rapid breathing), hemoptysis (coughing up blood), cyanosis (blue discoloration of the skin and mucous membranes), and signs of shock

Question 470

Is a shrapnel injury considered a primary or secondary blast injury?

Answer 470

Secondary

Question 471

the physiological process of hemostasis is achieved through ___________________

Answer 471

vasoconstriction and platelet aggregation

Question 472

Organs that lay in the retro parentaneal space

Answer 472

kidneys and adrenal glands, ureters, aorta, inferior vena cava, pancreas, and parts of the duodenum and colon.

Question 473

Describe GCS pneumonic you use

Question 474

What are the head and legs burn percent for adult, child and infant

Answer 474

Question 475

19 y/o M, Unbelted MVC, steering wheel deformed, Lefort III fracture, clinched teeth, O2 84% you should do what?

Answer 475

RSI

Question 476

What are the injuries for Waddell's Triad?

Answer 476

Fracture of the femur Dislocation of the hip joint Injury to the pelvic ring

Question 477

Which burn patients go to the burn center?

Answer 477

Burns involving the face, hands, feet, genitalia, perineum, or major joints Second-degree burns greater than 10% Third-degree burns greater than 5% Electrical burns Chemical burns Inhalation injuries or burns Burn injuries in patients with preexisting medical conditions that could complicate care, such as diabetes or heart disease Burn injuries in patients who require special social, emotional, or rehabilitative support, such as children or elderly patients.

Question 478

when a person jumps and lands on their feet, the axial load injury that can occur is called a?

Answer 478

compression fracture of the vertebrae, blunt trauma skull, brain, spine, chest, abdominal organs, pelvis, femur fractures

Question 479

What organs may be injured from pressure changes from an explosion

Answer 479

Lungs, Ears, G.I. tract, Brain, Cardiovascular system, aortic rupture

Question 480

What directly affects cardiac output

Answer 480

stroke volume

Question 481

Whats the blood return to the heart called

Answer 481

Preload

Question 482

Define Afterload

Answer 482

The pressure against vascular resistance

Question 483

What burns are suspicious for abuse?

Answer 483

Patterns, outlines Hands, Feet, Butt, genitals Various stages of healing Inconsistent with story Other signs of abuse, bruises, etc

Question 484

A condition in which blood volume results in inadequate perfusion?

Answer 484

hypovolemic shock

Question 485

What type of shock is pump failure?

Answer 485

Cardiogenic shock

Question 486

when applying a tourniquet, the provider should remember to

Answer 486

Apply the tourniquet proximal to the bleeding site, 2-3 inches above the wound. Tighten the tourniquet until the bleeding stops or the distal pulse is no longer palpable. Secure the tourniquet in place and note the time of application.

Question 487

What type of shock is Pericardial Tamponade?

Answer 487

Obstructive shock

Question 488

What two type of meds interfere with the blood clotting process

Answer 488

Blood thinners and beta blockers

Question 489

Statin is for?

Answer 489

Cholesterol

Question 490

What would percussion of the chest be able to indicate?

Answer 490

Hemothorax - dullness pneumothorax - hyperresonance

Question 491

Prolonged exposure to CO could lead to what kind of shock

Answer 491

Dissociative shock

Question 492

Flushed red skin sitting in closed up car on a hot day could indicate? Temp 104

Answer 492

Classic Heat stroke

Question 493

Ecg is Vtach, Pulseless and apneic, 90 degrees out, how would your treatment differ from any other patient?

Answer 493

increase intervals between cardiac meds

Question 494

Rattle snake in the ankle how would you treat?

Answer 494

place at heart level and rapid transport

Question 495

Patient with core temp of 82 has V-Fib what do you defib at

Answer 495

Defib at 200j biphasic

Question 496

Accended 5 mins later mild chest pain, dysnea, and then goes unresponsive what is the cause?

Answer 496

Arterial gas emboli

Question 497

Pump Failure would cause what type of shock?

Answer 497

Cardiogenic Shock

Question 498

Tension Pneumothorax is _____________ shock

Answer 498

Obstructive shock

Question 499

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but is normotensive (normal bp) is in _____________ shock

Answer 499

Compensated shock

Question 500

A person in a MVC is tachypneic (rapid rr) and tachycardic (rapid hr) but their bp drops to 82/40 and is disoriented is in _____________ shock Comp decomp or irreversible

Answer 500

Decompensated shock

Question 501

Shock secondary to an INFECTION in the blood is ______________ shock

Answer 501

Distributive shock

Question 502

Dobutamine

Answer 502

Sympathomimetic dose: 5-20 mcg per kg/min for: heart failure, low cardiac output

Question 503

What is the body's physiologic response to hemorrhage (3 things)

Answer 503

Clotting is activated, vasoconstriction, platelet aggregation

Question 504

Pain in the Left Shoulder is a sign of what nerve affected? and what organ affected?

Answer 504

Left Shoulder = Phrenic Nerve, (c3, c4, c5 - keep diaphram alive) Diaphragmatic irritation Spleen (LUQ)

Question 505

Mild Abdominal Pain Radiating to the back is a sign of what organ affected?

Answer 505

Pancreas

Question 506

Flank Pain and Hematuria is a sign of what organ affected? also what is Hematuria?

Answer 506

Kidneys - Retroperitoneal Cavity Hematuria - Blood in urine

Question 507

What is a "decompression sickness"?

Answer 507

a condition caused by a rapid decrease in pressure, leading to the formation of nitrogen bubbles in the blood.

Question 508

What are the signs of compensated shock?

Answer 508

Vital signs: Normal blood pressure, tachycardia, tachypnea, mild decrease in urine output Symptoms: Anxiety, restlessness, increased thirst, mild peripheral vasoconstriction, normal or slightly elevated body temperature

Question 509

What are the signs of decompensated shock?

Answer 509

Vital signs: Hypotension, tachycardia, tachypnea, decreased urine output Symptoms: Weakness, altered mental status, cool and clammy skin, decreased peripheral pulses, delayed capillary refill, decreased skin turgor, oliguria

Question 510

What are the signs of irreversible shock?

Answer 510

Vital signs: Profound hypotension, bradycardia, respiratory failure, hypoxia Symptoms: Unresponsive, dilated and fixed pupils, absent peripheral pulses, cool and mottled extremities, anuria, metabolic acidosis

Question 511

What type of shock and treatment? A 30-year-old male who has been in a car accident and is experiencing mild shock. His blood pressure is 110/70 mmHg, heart rate is 110 beats per minute, respiratory rate is 20 breaths per minute, and he has mild diaphoresis.

Answer 511

Compensated Treatment: oxygen via non-rebreather mask and IV fluids. in compensated shock, the body's compensatory mechanisms are able to maintain adequate organ perfusion, and the patient's vital signs are relatively stable. The patient may have an elevated heart rate and respiratory rate, but their blood pressure is maintained within normal limits, and they do not have signs of inadequate organ perfusion.

Question 512

What type of shock? An 80-year-old male who has had a ruptured aortic aneurysm. with a blood pressure of 50/30 mmHg, heart rate of 40 beats per minute, respiratory rate of 8 breaths per minute, and unresponsive with fixed and dilated pupils. Is it Comp decomp or irreversible

Answer 512

Irreversible shock

Question 513

What are the 6 types of shock

Answer 513

Cdd hon Cardiogenic Distributive Dissociative Hypovolemic Obstructive Neurogenic

Question 514

Define the 6 types of shock, signs, and treatment

Answer 514

1. Hypovolemic shock: This occurs when there is a significant loss of blood or other fluids in the body. Signs include low blood pressure, rapid heart rate, cold and clammy skin, decreased urine output, and altered mental status. Treatment involves stopping the bleeding, replacing fluids and blood products, and addressing the underlying cause. 2. Cardiogenic shock: This occurs when the heart cannot pump enough blood to meet the body's needs. Signs include low blood pressure, rapid heart rate, shortness of breath, chest pain, and cool and clammy skin. Treatment involves addressing the underlying cause, such as a heart attack, and supporting the heart's function. 3. Distributive shock: This occurs when there is widespread vasodilation, causing blood to pool in the body's tissues and not enough blood to circulate to vital organs. Types of distributive shock include septic shock, anaphylactic shock, and neurogenic shock. Signs include low blood pressure, rapid heart rate, warm and flushed skin, and altered mental status. Treatment involves identifying and treating the underlying cause, providing supportive care, and administering vasoactive medications. 4. Obstructive shock: This occurs when there is a blockage in the circulatory system, preventing blood from flowing properly. Examples include pulmonary embolism, cardiac tamponade, and tension pneumothorax. Signs include low blood pressure, rapid heart rate, shortness of breath, and chest pain. Treatment involves addressing the underlying cause, such as removing the blockage, and providing supportive care. 5. Dissociative - Co poisioning Oxgenation 6. Neurogenic damage to symp ns - epi/nor-epi give epi, fluids, and pace if needed

Question 515

What type of shock? Vitals organs begin to die because of inadequate perfusion

Answer 515

Irreversible

Question 516

What type of shock? Diaphoretic, hypotensive, narrowing pulse pressure, nausea and vomitting Comp decomp or irreversible

Answer 516

Decompensated

Question 517

What type of shock? ARDS, renal failure, liver failure and sepsis Comp decomp or irreversible

Answer 517

Irreversible

Question 518

True or false? A hip fracture is the same as a pelvic fracture.

Answer 518

False

Question 519

How many collisions does a patient suffer in an MVC?

Answer 519

3

Question 520

BP 188/101, and a hx of blood thinners. Sudden severe headache, blurry vision, and AMS. Subdural hematoma epidural hematoma intracranial hematoma

Answer 520

intracranial hematoma

Question 521

Patient was involved in MVC 1 week ago. Now complaining of blurry vision, projectile vomiting, and confusion. What do they have? Subdural hematoma epidural hematoma intracranial hematoma

Answer 521

Subdural hematoma

Question 522

What does Kehr’s Sign indicate?

Answer 522

Splenic injury

Question 523

What indicates Kehr’s Sign? Left shoulder pain Right shoulder pain Left leg pain

Answer 523

Left shoulder pain

Question 524

How much blood can the abdominal cavity hold?

Answer 524

Over 3000mL

Question 525

How much blood loss would you expect to lose from a femur fracture?

Answer 525

1500mL

Question 526

A patient fell from a roof and is presenting with flushed skin, BP 80/42, HR 54, RR 0, and absent reflexes. What shock are they suffering from? Not comp decomp irreversible answer

Answer 526

Neurogenic shock

Question 527

Which of the following would not be considered an early sign of increased intracranial pressure? Confusion Increase in BP Nausea/vomiting Blurry vision

Answer 527

Increase in BP

Question 528

Patient fell from a roof – pale skin, absent radial pulses, weak and rapid carotid pulse, JVD, hyperresonance right side. What type of shock do they have?

Answer 528

Hypovolemic Shock

Question 529

True of False: When percussing over solid organs or fluids, you would expect to hear a dull sound?

Answer 529

True

Question 530

A patient fell from the roof and presents with pale skin, BP 82/52, HR 124, RR 22, unstable pelvis. What shock is it? Neurogenic Hypovolemic Spinal Obstructive

Answer 530

Hypovolemic shock

Question 531

How would you most likely treat flail chest if the pt was found to be unresponsive? High flow O2 BVM ventilations Pain management and O2

Answer 531

BVM ventilations

Question 532

Pain that is out of proportion to the injury is commonly seen in which of the following? cardiac tamponade crush injury compartment syndrome commotio cordis

Answer 532

compartment syndrome

Question 533

What are signs of Heat Stroke (3)

Answer 533

Irritable dehydration Red, Hot, and Dry

Question 534

Burn shock is what type of shock?

Answer 534

Hypovolemic shock - loss of plasma/fluid

Question 535

Seizures, Headache, Joint pain and EYElid twitching are signs of what Water Emergency

Answer 535

Decompression Sickness

Question 536

What are signs of High Alt PE (HAPE)

Answer 536

Dysnea, COUGH, cyanosis, Frothy Sputum

Question 537

What type of shock is burn shock fall under

Answer 537

Hypovolemic shock

Question 538

True or False a tourniquet can only be used for arterial bleeding?

Answer 538

False

Question 539

True or False Posturing is a sign of Herniation Syndrome

Answer 539

TRUE

Question 540

What are the signs of Neurogenic Shock and not Herniation or TBI and how do we treat?

Answer 540

Neuro- low bp low hr Flush RED skin loss of sympathetic tone give epi drip and pressors

Question 541

What are 3 signs/symptoms of Inferior Wall STEMI with right ventricular involvement

Answer 541

hypotension JVD clear lungs