Trauma

Question 1

traction splints

Answer 1

used to counterbalance the pulling force of the muscles to reduce pain and prevent bleeding; immobilizes fractured limb to prevent further injury; used for femur fractures

Question 2

rigid splints

Answer 2

made of plastic, wood, cardboard to hold injured body part in a comfortable position

Question 3

compartment syndrome

Answer 3

after injury- bleeding and inflammation in the surrounding tissues causes pressure increases outside the blood vessels; excessive pressure can cut off blood supply to that area, making those cells hypoxic

Question 4

contusion

Answer 4

bruising

Question 5

neurogenic shock

Answer 5

also called neurogenic hypertension; results from injury to spinal cord that interupts nerves; without nerve imput, arteries dilate–>hypotensive, normal HR, skin is warm and flushed, disruption of autonomic pathways within spinal cord; different from hypovolemic shock because pulse/HR is normal rather than elevated and skin is warm and pink

Question 6

subdermal hematoma

Answer 6

buildup of blood between dura and arachnoid layers from veins rupturing under dura; slow bleeding; pressure builds and pushes on brain, may not see symptoms for a few days

Question 7

epidermal hematoma

Answer 7

bleeding between skull and dura layer; emergency situation; usually skull fractures are seen as well because only occurs with large force to head; rapid arterial and venous bleeding

Question 8

laceration

Answer 8

penetration wound

Question 9

basilar skull fracture symptoms

Answer 9

raccoon eyes, Battle’s sign, CSF leakage

Question 10

Cushing reflex

Answer 10

a reflex used when intracranial pressure is high after head injury to relieve this pressure: late sign of high ICF; leads to Cushing’s triad: increased blood pressure, decreased heart rate, irregular breathing

Question 11

meninges

Answer 11

layers of tissue protecting the brain; dura, arachnoid, pia

Question 12

consensual reflex

Answer 12

when you shine a light in one eye, both eyes should constrict, not just eye that was hit with light

Question 13

nonpurposeful reactions to pain

Answer 13

indicates deep state of unresponsiveness; 2 types: flexion-flex arms across chest and extend legs, and extension- arms down at side, extend legs, arch back

Question 14

potential signs of brain herniation

Answer 14

significant dilation of pupils more than 4mm, asymmetrical pupils, unresponsiveness to painful stimuli

Question 15

priaprism

Answer 15

involuntary erection seen in males who undergo spinal shock

Question 16

pericardial tamponade

Answer 16

fluid buildup in pericardial space within sac around the heart; puts pressure on the heart which decreases ventricular filling- decreases CO; Aka Beck’s triad: JVD, weak pulse, drop in blood pressure (Paradoxus); treatment: pericardiocentesis- put a needle in and suck air out

Question 17

Types of closed soft tissue injuries

Answer 17

Contusion (bleeding of dermal blood vessels), hematoma, crush injury

Question 18

Types of open soft tissue injuries

Answer 18

Laceration, penetration/puncture, abrasion (capillary bleeding on surface), crush injury, avulsion (loose flap of skin), amputation

Question 19

DCAP BTLS

Answer 19

deformities, contusions, abrasions, puncture burns, tenderness, lacerations, swelling

Question 20

multiple casualty incident (MCI)

Answer 20

not enough resources to deal with the patient load from an emergency; open MCI if easy access to situation site; closed if situation site is difficult to get to and get patients out of

Question 21

active situation/incident

Answer 21

the force that caused the disaster is still going on; there is danger to anyone in the area- including first responders

Question 22

closed situation

Answer 22

forces that led to the accident is contained/exhausted

Question 23

3 stages of triad

Answer 23

1. triage of patients, label with tag
2. treatment of patients after moving to safe area
3. Only if needed- treatment at field hospital created on site

Question 24

Color scheme- Triage

Answer 24

Red- critical condition, needs treatment immediately, but with treatment has good chance of survival; Yellow- delayed/urgent, no signs of shock but may die if no treatment soon; Green- no major injuries; Black- dead, no signs of life/ability to save them

Question 25

START triage

Answer 25

Simple Triage And Rapid Treatment; initial assessment for each patient takes no longer than 30 seconds; initial treatment should only focus on life threatening conditions

Question 26

RPM’s of triage

Answer 26

3 things to check: Respirations- open airway, if not breathing still- label black, if RR >30 or <10, label as red, move on to “P” if between 10-30; next assess Perfusion-if no pulse or capillary refill >2, label as red, if has pulse and cap. <2, check Mental status: If unconscious or AMS or can’t follow simple commands, label as red. If able to follow simple commands, label as yellow. “30, 3, can do”

Question 27

Drowning

Answer 27

respiratory impairment due to submersion in water; classified as death, morbidity, no morbidity; lack of ventilation leads to hypoxia and the cardiac arrest; symptoms: cough, apnea or dyspnea, AMS or LOC, vomiting

Question 28

Aspirated water and drowning

Answer 28

10-20% of drowning patients don’t aspirate any water, due to laryngospasm; victims that do aspirate water usually aspirate only a little bit; aspirated water can wash off surfactant- leads to alveoli collapse-respiratory arrest

Question 29

ABCDE’s of trauma

Answer 29

airway, breathing, circulation, disability (GCS), exposure (remove clothing)

Question 30

mediastinum

Answer 30

central cavity inside the chest, contains trachea, heart, major vessels, esophagus

Question 31

lobes of the lungs

Answer 31

right has 3, left has 2

Question 32

Pleural space

Answer 32

potential space between the parietal pleura (lines thoracic cavity) and visceral pleura (covers the lungs); usually this space does not contain anything; if air gets in space-pneumothorax, if blood gets in space-hemothorax

Question 33

2 types of chest injuries

Answer 33

penetrating/open: something goes through you (gunshot, stabbing), blunt/closed: extreme force causes injury usually to multiple body systems

Question 34

pulmonary contusion

Answer 34

bruise of the lungs; blossoms (gets larger) with time; give oxygen and ventilation

Question 35

Flail chest

Answer 35

3 or more ribs fractured in 2 or more places; have a floating segment that has paradoxical motion- floating segment moves independently of main ribs; ventilation/O2 if needed; monitor for pneumothorax, bulky dressing

Question 36

subcutaneous emphysema

Answer 36

bubble wrap/rice krispies- air gets trapped under the skin as result of rupture of part of airway; suspect pneumothorax until proven otherwise

Question 37

Pneumothorax

Answer 37

air accumulation in pleural space, lung fails to oxygenate blood and may collapse; 2 types- open: penetrating injury goes all the way through to the lungs, more and more air gets trapped; closed: blunt injury, skin not broken, could be from rib hitting lung; can remove air with chest tube or three sided dressing (flutter valve)

Question 38

tension pneumothorax

Answer 38

can be open or closed; tension physiology- worsening of pneumothorax leads to completely collapsed lung, cuts off blood flow to the heart, increased pressure can displace mediastinum cavity; symptoms: hypotension, tracheal deviation, heart compressed from increased pressure, hypoxia, unequal chest rise, JVD, absent breath sounds on affected side, severe dyspnea, tachypnea

Question 39

treatment tension pneumothorax

Answer 39

vent occlusive dressing, needle or finger decompression: create second hole to help let air out, second intercostal space midclavicular line

Question 40

hemothorax

Answer 40

blood fills pleural space usually due to lacerated blood vessel; can’t use decompression- need to put in a chest tube, 5th intercostal space mid axillary line

Question 41

cardiac contusion

Answer 41

bruise of the heart, causes chest pain and arrhythmia/tachycardia, heart cell death, irregular pulse

Question 42

ischemia

Answer 42

inadequate blood flow to organ or part of body; 5 P’s of ischemia: pain, pulselessness, paralysis, paresthesia (tingling sensation), pallor

Question 43

peripheral nerve injury

Answer 43

nerves injured more easily than arteries; symptoms include tingling (paresthesia, numbness, pain, loss of motor ability)