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EMT > Chapter 22 - 30 Trauma > Flashcards

Chapter 22 - 30 Trauma Flashcards

1
Q

Scene Size-up

A 
Ensure Scene Safety
MOI / NOI
Take Standard Precautions
Determine Number of Patients
Consider Additional Resources
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2
Q

Primary Assessment

A

Form General Impression
Level Of Consciousness - AVPU
Orientation - Person / Place / Time / Event
Pupils - PEARRL
Airway, Breathing, Circulation - Fix Immediate Threats
Rapid Scan
Priority of Care / Transport Decision

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3
Q

History Taking

A

Chief Complaint
History - SAMPLE
Pain - OPQRST

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4
Q

Secondary Assessment

A

Physical Assessment - DCAP-BTLS

Assess Vital Signs - BP, Pulse, Resp, O2 Sat

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5
Q

Reassessment

A 
Repeat Primary Assessment
Reassess Vital Signs
Reassess Chief Complaint
Recheck Interventions
Identify and Treat Changes
(Unstable every 5 min; Stable every 15 min)
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6
Q

Awareness and concern for potentially serious underlying and unseen injuries.

A

Index of Suspiscion

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7
Q

Force acting over distance.

A

Work

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8
Q

Energy of a moving object.

A

Kinetic Energy

One half of Mass x Velocity Squared

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9
Q

The energy of falling.

A

Potential Energy

Mass, Force of Gravity, Height

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10
Q

Compression injury to the anterior portion of brain and stretching of the posterior portion.

A

coup-contracoup brain injury

can also occur when heart hits sternum and shears aorta

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11
Q

Significant mechanisms of vehicular collision injury are suggested by:

A

Death of vehicle occupant
Severe deformity of vehicle
Altered mental status
Ejection from vehicle

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12
Q

Four types of motorcycle impacts:

A

Head-on Collision - Drag injury or secondary collision
Angular Collision - Crushing of rider lower extremities
Ejection - Drag injury or secondary collision
Controlled Crash - Rider tries to leave bike, may work

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13
Q

Types of blast injury:

A

Primary - Damage to body by pressure wave. Hollow organs most susceptible.
Secondary - Struck by flying debris.
Tertiary - Patient hurled by force into stationary object.
Miscellaneous - Burns, toxic gasses, crush from building collapse.

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14
Q

Key elements for Trauma Centers

A

I - comprehensive regional resource
II - able to initiate definitive care for all injured patients
III - able to provide prompt assessment, stabilization (general surgeons, anesthesiologist can be available)
IV - able to provide advanced life support and has transfer agreement with higher level

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15
Q

Glasgow Coma Scale - Eye Opening

A

4 Spontaneous
3 To Voice
2 To Pain
1 None

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16
Q

Glasgow Coma Scale - Verbal Response

A 
5 Oriented
4 Confused
3 Inappropriate Words
2 Incomprehensible Words
1 None
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17
Q

Glasgow Coma Scale - Motor Response

A 
6 Obeys commands
5 Localizes pain
4 Withdraws from pain
3 Flexes from pain
2 Extends from pain
1 None
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18
Q

Revised Trauma Score

A 
4  GCS 13-15, SBP>89, RR 10-29
3  GCS  9-12, SBP 76-89, RR>29
2 GCS 6-8, SBP 50-75, RR 6-9
1 GCS 3, SBP 0 RR 0 
Sum points on 3 measures to get rating from 0 to 12
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19
Q

Signs and symptoms of Hypovolemic Shock.

A 
Rapid, weak pulse
Changes in mental status
Cool, clammy skin
Cyanosis
Low blood pressure (late)
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20
Q

Location of pressure points.

A 
superficial temporal
external maxillary
carotid
brachial
ulnar
radial
femoral
dorsalis pedis
posterior tibial
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21
Q

Injury that causes bleeding beneath the skin, but does not break the skin.

A

Contusion

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22
Q

Buildup of fluid and blood beneath the skin.

A

Ecchymosis (black discoloration)

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23
Q

Buildup of fluid from a large blood vessel.

A

Hematoma

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24
Q

When a body part is trapped under weight for more than four hours.

A

Crush Syndrome

can lead to renal failure and death

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25
Pain out of proportion to injury.
Compartment Syndrome | swelling compresses blood vessels cutting off blood flow
26
An injury separates layers of soft tissue so that they either completely detach or hang as a flap.
Avulsion
27
Treatment for human bites.
Apply dry, sterile dressing Immobilize area with splint or bandage Provide transport to ED for surgical cleaning of wound
28
Depth of burns.
superficial - 1st degree partial-thickness - 2nd degree full thickness - 3rd degree
29
Rule of nines.
Sections of adult body divided by 9%: arms 9% each, legs 18% each, head 9%, torso back 18%, torso front 18%, genitalia 1% Child - legs are 16.5%, head is 12% Infant - legs are 13.5%, head 18%
30
Types of burns
Thermal - caused by heat - flame, scald, contact, steam Inhalation Radiation Chemical
31
Classification of burns.
``` Severe Full thickness on hands, feet, face, upper airway or genitalia Full thickness more than 10% surface area Partial thickness more than 30% Younger than 5 or older than 55 Moderate Full thickness 2 - 10% surface area Partial thickness 15 - 30% Superficial burns > 50% Minor Full thickness < 2% Partial thickness <50% ```
32
Parts of the ear.
Pinna - visible outer tragus - round fleshy bulge anterior to ear canal external auditory canal - leads to ear drum tympanic membrane - ear drum hammer, anvil, stirrup cochlea eustacian tube
33
The presence of air in soft tissues.
subcutaneous emphysema - crackling sensation | also Crepitus
34
Layers of tissue that suspend the brain and spinal cord.
Menenges Dura mater - tough fibrous outer layer Arachnoid mater and Pia mater - thin, contain blood vessels that nourish brain
35
Signs of skull fracture.
Basilar skull fracture ecchymosis: under eyes - raccoon eyes behind ear over Mastoid Process - Battle's sign
36
Patient can remember everything up to the injury
retrograde amnesia
37
Patient unable to remember events after the injury.
anterograde amnesia
38
Effect of pulling on spine.
Distraction
39
Vertebrae out of alignment.
Subluxation of the spine
40
Loss of sensation with severe spinal injuries.
Quadriplegia - C5 to C6 injury | Paraplegia - L1 injury
41
Irregular respirations, bradycardia and hypertension.
Cushing's triad is a clinical triad variably defined as having: Irregular respirations (impaired brainstem function) Bradycardia Hypertension Associated with increased intracranial pressure.
42
When blood or other fluid fills the pericardial sac.
Cardiac tamponade
43
Blunt chest injury caused by sudden, direct blow to the chest at a critical point in the heartbeat.
Commotio Cordis | Causes ventricular fibrillation and possible death
44
Signs caused by blood in the peritoneal cavity.
Kehr sign - Left shoulder pain, ruptured spleen Cullen sign - periumbilical ecchymosis, takes 24-48 hours to appear and can predict acute pancreatitis Grey Turner's sign - bruising of the flank, indicative of pancreatic necrosis Blumberg sign - rebound tenderness, indicative of peritonitis
45
Types of fractures
``` Greenstick - incomplete, occurs in children Comminuted - broken into more than 2 fragments Pathologic - weakened or diseased Epiphyseal - occurs in growth plate Oblique - broken at an angle Traverse - straight across Spiral - twisting, child abuse Incomplete - nondisplaced partial crack ```
46
Common complication of fracture of tibia or forearm in children.
Compartment syndrome develops within 6 to 12 hours characterized by pain out of proportion to injury
47
An object at rest tends to stay at rest.
Newton's First Law
48
Force equals mass times acceleration.
Newton's Second Law
49
For every action, there is an equal and opposite reaction.
Newton's Third Law
50
Signs and symptoms of hypovolemic shock.
``` rapid, weak pulse change in mental state cool, clammy skin cyanosis (lips, oral membranes, nail beds) low blood pressure (late sign) ```
51
Bright red blood coughed up by patient.
Hemoptysis
52
Management of closed soft tissue injuries (RICES).
``` Rest Ice Compression Elevation Splinting ```
53
Five basic interventions for external bleeding with signs and symptoms of shock.
``` Direct pressure High flow oxygen Prevent heat loss Trendelenburg position High priority transport ```
54
Signs and symptoms of inhalation injury.
``` Stridor Dyspnea Coughing Wheezing Facial burns Hoarse voice Airway edema Singed facial hair Soot in mouth or nose ```
55
Evaluation of electrical burn.
Possible unseen injury between entrance and exit. High risk of respiratory and cardiac arrest. All electrical burns require transport and evaluation by physician.
56
Signs and symptoms of concussion.
``` Altered LOC that gradually improves Nausea Vomiting Irritability Repetitive questioning Vision problems Amnesia ```
57
Signs and symptoms of cerebral contusion.
``` S/S concussion and a least one of: decreasing mental status unresponsive pupillary changes changes in vital signs obvious behavioral abnormalities ```
58
Signs and symptoms of epidural hematoma.
``` Brief loss of consciousness Headache Seizures Vomiting Posturing Hypotension Bradycardia Changes in respiration Pupillary changes ```
59
Signs of increased intracranial pressure.
Cushing's response: Hypertension Bradycardia Altered respiratory pattern
60
Signs and symptoms of spinal injury.
tenderness around injured area motor and/or sensory deficits paralysis below injury possible respiratory arrest in high cervical injury (C5 or above)
61
Signs and symptoms of neurogenic shock.
Any sign or symptom of spinal injury Priapism Hypotension without tachycardia Warm skin, normal color
62
Signs of cardiac tamponade (Beck's Triad).
Jugular vein distension (JVD) Muffled heart sounds Narrowing pulse presssure
63
What is the most important intervention for a flail chest with respiratory compromise?
Positive pressure ventilation and oxygenation.
64
Five mechanisms of heat loss.
``` Conduction Convection Evaporation Respiration Radiation ```
65
Signs and symptoms of hypothermia.
``` Cold skin on torso Pale skin / cyanotic Shivering (absent in extreme) Loss of coordination (stiff muscles, difficult speaking) Altered LOC Bradycardia Bradypnea Hypotension ``` Prehospital rewarming is limited to passive measures.
66
Signs and symptoms of heat exhaustion.
``` Hx of exertion in a warm climate Dizziness, weakness Nausea, vomiting Headache Possible muscle and abdominal cramps Thirst Tachycardia ```
67
Signs and symptoms of heat stroke.
Similar to heat exhaustion altered or decreased LOC skin may be hot and dry or wet seizures
68
Management of systemic heat emergencies
Move to cooler environment Water for completely alert patient Rapid and aggressive cooling for heat stroke. Expose patient Cool with water, wet towels, ice packs Ice packs best to groin, neck, arm pits Rapid transport Be alert for vomiting and/or seizures
69
Pneumatic antishock garment (PASG).
For the most part, the pneumatic antishock garment (PASG) is no longer routinely used in EMS. It may be useful to stabilize pelvic fractures, especially if the patient has accompanying signs of shock. In general, the PASG should not be used for patients with blunt or penetrating trauma to the head, chest, or abdomen. Under NO circumstances should the device be used on any patient with pulmonary edema, as evidenced by shortness of breath, crackles in the lungs, or a history of left-side congestive heart failure.

EMT (28 decks)

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