ch7: acute injuries: assessment and disposition

Question 1

what should an ERP/EAP contain

Answer 1

• personnel, their qualifications and their roles
• equipment needed to carry out the tasks
• mechanism of communication to the emrgency care providers and mode of transport
• facilities where pt will be taken

Question 2

red flags to activate ERP

Answer 2

• unconscious
• loss of consciousness in the presence of head trauma
• respiratory distress, failure or airway obstruction
• no pulse
• severe chest or abd pain
• excessive arterial bleeding
• severe heat illness
• severe shock
• suspected spinal injury
• fx invoving several ribs, femur, pelvis
• severe hypoglycemia
• collapse in response to sickling episode
• extreme ranges deviating from normal BP, pulse, or respiratory rates

Question 3

decerebrate rigidity

Answer 3

extension of all 4 extremities

Question 4

decorticate rigidity

Answer 4

extension of the legs
flexion elbow, wrist
fingerrs

Question 5

anisocoria

Answer 5

unequal pupils

Question 6

gcs

Answer 6

eye opening (4)
- spontaneous
- to voice
- to pain
- no response
verbal response (5)
- normal convo
- disoriented
- words, not coherent
- sounds
- decerebrate
motor response (6)
- normal
- localise pain
- withdrawal to pain
- decorticate
- no response

Question 7

racoon eyes
battle sign

Answer 7

indicate skull fx

Question 8

rapid weak pulse indicate

Answer 8

shock
internal hemorage
hypoglycemia
heat exhaustion
- hyperventilation

Question 9

rapid bounding pulse indicate

Answer 9

• heat stroke
• fright
• fever
• hypertension
• apprehension
• hyperglycemia
• normal exertion

Question 10

slow bounding pulse

Answer 10

• skull fx
• stroke
• drug use
• cardica prob
• exertion

Question 11

no pulse

Answer 11

• blocked artery
• low bp
• cardiac arrest

Question 12

shallow breathing

Answer 12

• shock, heat exhaustion
• insulin shock
• chest injury
• cardiac prob

Question 13

rapid deep breathing

Answer 13

• diabetic coma
• hypervent
• lung disease

Question 14

slowed breathing

Answer 14

• shock
• head innjury
• chest injury
• drugs

Question 15

crowing breathing

Answer 15

spasm of the larynx

Question 16

low BP

Answer 16

• hypotensin caused by shock
• hemmorhage
• heart attack
• internal injury
• poor nutrition

Question 17

high bp

Answer 17

• hypertension caused by meds
• oral contraceptives
• anabolic steroids
• amphetamines
• chronic alcohol use
• obesity

Question 18

red skin color indicate

Answer 18

• fever
• hypertension
• heat stroke
• carbon monoxide poisining
• diabetic coma
• alcohol abuse
• ## infectious disease

Question 19

white ashen skin colour

Answer 19

• emotional stres
• anemia
• heart attack
• hypotension
• heat exhaustion
• ## insulin shock

Question 20

blue cyonic skin colour

Answer 20

• heart failure
• respiratory disorder
• ## poisining

Question 21

constricted pupils

Answer 21

• opiate-based drug
• poison

Question 22

unequal pupils

Answer 22

• head injury
• stroke

Question 23

dilated pupils

Answer 23

• shock
• hemorrhage
• heat stroke
• stimulant drugs
• coma
• cardiac arrest
• death

Question 24

vital signs

Answer 24

• pulse
• respiratory rate
• BP
• temperature

Question 25

respiratory rate adult child

Answer 25

adult; 10-25 child: 20-25

Question 26

normal spo2

Answer 26

95-100

Question 27

systolic vs diastolic BP

Answer 27

systolic: when left ventricle contracts and expels blood into aorta Diastolic: residual pressure in the aorta btw heart beets

Question 28

diplopia

Answer 28

see 2 image instead of one failure of ext muscle to work in coord manner

Question 29

red flags indicating TBI

Answer 29

LOC - avpu less than A - GCS <9 - initial loss of consciousness, lucid, decline mental status - coma - convulsion REFLX - +ve babinski - +ve oppenheim BP - rising BP PULSE - rapid, weak or failing RESPIRATORY - irregular - abnormal patterns PEARRLA - unequal - inability to tract - inability to react to light

Question 30

bld sugar levels in mild hypoglycemia

Answer 30

60-70 mg/dl

Question 31

10-15g of fast acting carbs

Answer 31

- 4oz apple juice - 1 tbs honey - 2 tbs raisns - 4 packets sugar - 4-5 saltinae crackers

Question 32

heat stroke criteria

Answer 32

- body temp >104-105 f - CNS dysfunction

Question 33

exertional sickling

Answer 33

- RBC change shape from round to sickle clump together, causing log jam

Question 34

cramps vs sickling

Answer 34

CRAMPS - m. twinge prior to onset of cramping - extremely painful m. cramping - hobble to ground - muscle cramp visible SICKLING - no muscle twinging prior - muscle cramping present, lim pain - drops to ground due to weakness - musculature appears normal, athlete relatively quiet

Question 35

what to do if exertional sickling suspected

Answer 35

- athlete removed from activity - high flow oxygen at 15L/min using NRB - ERP