Chapter 22 Trauma Overview Flashcards by Debbie Lewis

An evaluation tool used to determine level of consciousness, which evaluates and assigns point values (scores) for eye opening, verbal response, and motor response, which are then totaled; effective in helping predict patient outcomes.

Glasgow Coma Scale (GCS) score

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Injury caused by objects, such as knives and bullets, that pierce the surface of the body and damage internal tissues and organs.

penetrating trauma

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Emergencies that require EMS attention because of illnesses or conditions not caused by an outside force.

medical emergencies

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Dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds.

coup-contrecoup injury

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Awareness that unseen life-threatening injuries may exist when determining the mechanism of injury.

index of suspicion

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Any object propelled by force, such as a bullet by a weapon.

projectile

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Emergencies that are the result of physical forces applied to a patient’s body.

trauma emergencies

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Resistance that slows a projectile, such as air.

drag

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The eardrum; a thin, semitransparent membrane in the middle ear that transmits sound vibrations to the internal ear by means of auditory ossicles.

tympanic membrane

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Trauma that affects more than one body system.

multisystem trauma

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The product of force times distance.

work

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The slowing of an object.

deceleration

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A score that relates to the likelihood of patient survival with the exception of a severe head injury. It calculates a number from 1 to 16, with 16 being the best possible score. It takes into account the Glasgow Coma Scale (GCS) score, respiratory rate, respiratory expansion, systolic blood pressure, and capillary refill.

trauma score

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Air bubbles in the arterial blood vessels

arterial air embolism

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The way in which traumatic injuries occur; the forces that act on the body to cause damage.

MOI

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An impact on the body by objects that cause injury without penetrating soft tissues or internal organs and cavities.

blunt trauma

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The path a projectile takes once it is propelled.

trajectory

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A phenomenon in which speed causes a bullet to generate pressure waves, which cause damage distant from the bullet’s path.

cavitation

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A scoring system used for patients with head trauma.

Revised Trauma Score (RTS)

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Pulmonary trauma resulting from short-range exposure to the detonation of explosives

pulmonary blast injuries

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The product of mass, gravity, and height, which is converted into kinetic energy and results in injury, such as from a fall.

potential energy

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The mass of energy

kinetic energy

Which of the following statements regarding the mechanism of injury (MOI) is correct?: a) The MOI may allow you to predict the severity of a patient’s injuries; b) A nonsignificant MOI rules out the possibility of serious trauma; c) The exact location of a patient’s injuries can be determined by the MOI; d) A significant MOI always results in patient death or permanent disability

a) The MOI may allow you to predict the severity of a patient’s injuries

An unstable patient should be reassessed every:

5 minutes.

External bleeding from and extremity can usually be controlled by a combination of:

Direct pressure and elevation

When is it MOST appropriate to consider requesting additional ambulances at an accident scene?

When you determine there are multiple patients

When assessing a patient's abdomen, you will typically evaluate for all of the following, EXCEPT: a) subcutaneous emphysema; b) open wounds or eviscerations; c) gross bleeding and tenderness; d) rigidity and obvious bleeding

subcutaneous emphysema

The focused history and physical exam of a stable trauma patient consists of:

a focused trauma exam, vital signs, and history

Observations made when forming a general impression of a patient would include all of the following, EXCEPT: a) level of distress; b) pulse strength; c) race and gender; d) appearance

pulse strength

The goal of a rapid physical exam is to:

identify life threats

After the first 60 minutes of experiencing a significant injury:

the body's ability to compensate for shock decreases

You respond to the scene of a motor-vehicle collision. Upon arrival, you find a young female sitting on the curb. Other than a small abrasion to her forehead, she does not appear to be seriously injured. As you are performing your initial assessment on the patient, a police officer advises you that her husband, the driver of the vehicle, was killed in the accident. What is your MOST appropriate next action?

Complete the initial assessment and perform a rapid trauma assessment.

if a pulse cannot be palpated at the radial artery, you should:

assess the carotid pulse.

A 50-year-old male presents with an altered mental status. His wife tells you that he had a “small stroke” 3 years ago, but has otherwise been in good health. The patient is responsive, but unable to follow commands. After administering oxygen, you should:

prepare for immediate transport.

Which of the following conditions would be LEAST likely to cause an altered mental status?: a) Hypoglycemia; b) Acute anxiety; c) Hypoxemia; d) Acute stroke

b) Acute anxiety

When evaluating a patient with multiple complaints, the EMT-B's responsibility is to:

determine which complaint poses the greatest threat to the patient's life.

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

apply direct pressure to the wound

Which of the following situations or conditions warrants immediate transport?: a) Decreased ability to move an extremity; b) Mild pain in the upper abdominal quadrants; c) Responsive and able to follow commands; d) Chest pain with a systolic BP of 80 mm Hg

Chest pain with systolic BP of 80

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should:

open his airway with the jaw-thrust maneuver.

Which of the following actions would you be LEAST likely to perform during the detailed physical exam?: a) Requesting ALS backup; b) Modifications in treatment; c) Full spinal immobilization; d) Head-to-toe assessment

Full spinal immobilization

Which of the following would be the MOST significant observation when approaching a patient and forming a general impression?: a) Major bleeding; b) Smell of alcohol; c) Obvious pain; d) Clammy skin

major bleeding

On which of the following patients should you perform a rapid trauma assessment?: a) A 51-year-old restrained female who struck a utility pole while traveling approximately 20 MPH; b) A 34-year-old female who fell approximately 10 feet from a ladder and landed on her left side; c) A 29-year-old male involved in a motor-vehicle crash in which the driver of the same car was killed; d) A 40-year-old male who amputated his index and middle fingers while working with a table saw

A 29-year-old male involved in a motor-vehicle crash in which the driver of the same car was killed

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to:

wiggle his or her toes on command

When you pinch the neck muscles of a patient who is responsive to painful stimuli only, you should expect him or her to:

try to push your hand away.

Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients?: a) Pursed-lip breathing; b) Accessory muscle use; c) Nasal flaring; d) Rapid respirations

c) Nasal flaring

You respond to a call for a female pedestrian that has been struck by a car. As your partner maintains manual stabilization of her head, you perform an initial assessment. She is unconscious, has ineffective breathing, and bloody secretions in her mouth. You should:

immediately suction her oropharynx

A rapid physical exam should be performed on:

patients with a significant MOI and unresponsive medical patients

As you assess the head of an unconscious trauma patient, your partner should:

maintain stabilization of the head.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

Jaw Thrust

What accurately describes paradoxical movement of the chest wall?

Only one section of the chest rises on inspiration while another area falls

During your assessment of a patient with a possible upper extremity fracture, you note a grinding feeling in the bones when the patient moves. This finding is MOST appropriately called:

Crepitus

When performing a detailed physical exam on a trauma patient, you note the presence of Battle's sign. This is defined as:

bruising behind the ear.

The presence of subcutaneous emphysema could indicate all of the following conditions, EXCEPT: a) myocardial rupture; b) pneumothorax; c) laryngeal fracture; d) crushed trachea

myocardial rupture

A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 110 beats/min. Which of the following would NOT be appropriate for this patient?: a) Gentle palpation of the pelvis; b) A focused physical exam; c) Treating her for possible shock; d) 100% supplemental oxygen

gentle palpation of the pelvis