Component 8: Care for the Trauma Patient

Question 1

What law of motion states that every object in uniform motion will remain in that state unless acted upon by an external force?

Answer 1

Newton’s First Law - Law of Inertia

Question 2

What law of motion states that force equals mass times acceleration, expressed as :
f(t) = ma(t)

Answer 2

Newton’s Second Law

Question 3

What law of motion states that for every action, there is an equal and opposite reaction?

Answer 3

Newton’s Third Law

Question 4

What is the equation for kinetic energy?

Answer 4

KE = 1/2 mv²

F = ma, where a can represent acceleration or deceleration depending on its sign.

Question 5

List the types of motor vehicle collisions.

(MVCs)

Answer 5

• frontal
• rear
• rotational
• rollover
• lateral

Question 6

What are the two types of injuries resulting from force(s) being exerted on the human body?

Answer 6

penetrating and blunt force(s)

Question 7

What are the terms profile, tumble, and fragmentation used to describe?

Answer 7

ballistics

Question 8

True or false.

Every gunshot victim will have exit wounds.

Answer 8

False

Question 9

Define:

Index of Suspicion

Answer 9

• maintaining a heightened awareness of surroundings and safety.
• Also, as potential patient injuries or illnesses that may not have yet presented with signs and symptoms or have developed.

Question 10

Which phase of a blast would result in ruptured eardrums, eye hemorrhage, and possibly abdominal hemorrhage and/or perforation?

Answer 10

primary blast or phase one

Question 11

During the tertiary phase of a blast, what happens to the body?

Answer 11

The body is lifted, tossed, and/or thrown.

Question 12

True or false.

Understanding and evaluating the forces or mechanisms of injury to our patients will help us to provide quality patient care.

Answer 12

True

Question 13

Which level of trauma facility is best for the treatment and care of a patient suffering multiple systems trauma?

Answer 13

Level I

Question 14

Define:

• Capillary bleeding
• Venous bleeding
• Arterial bleeding

Answer 14

• Capillary Bleeding: slow, oozing, dark red in color
• Venous Bleeding: steady flow, not as dark in color as capillary bleeding, although still darker than arterial bleeding
• Arterial Bleeding: spurts consistent with the patient’s pulse and bright red in color

Question 15

True or false.

When blunt force trauma is applied, it is imperative to maintain a high index of suspicion of internal bleeding.

Answer 15

True

Whether or not the patient initially presents with any signs/symptoms. Also, keep a high index that hypovolemic/hemorrhagic shock will develop.

Question 16

What are the signs/symptoms of hypovolemic/hemorrhagic shock for a patient suspected of having internal bleeding?

Answer 16

• dry mouth
• tachycardia and thready pulse
• anxiety
• clammy skin
• delayed capillary refill
• progressive drop in blood pressure
• lethargy or altered mental status potentially progressing to unconsciousness

Question 17

Fill in the blank.

Prior to applying a tourniquet for bleeding control, we should _________ __________ _________.

Answer 17

apply direct pressure

If bleeding does not become controlled, apply a tourniquet.

Question 18

Fill in the blank.

When applying a tourniquet, we tighten and twist until _________ ________.

Answer 18

bleeding stops

To learn more click here.

Question 19

Define:

epistaxis

Answer 19

It is the medical term for a nose bleed.

Question 20

True or false.

Ecchymosis is another medical term for a contusion or bruise.

Answer 20

True

Question 21

What are the two layers of the skin that are on top of the subcutaneous tissue?

Answer 21

1. epidermis
2. dermis

Question 22

What are the types of closed soft-tissue injuries?

Answer 22

• contusion
• hematoma
• compartment syndrome

Question 23

Are abrasions, lacerations, and penetrating wounds considered to be open or closed?

Answer 23

open

Question 24

Which position, if possible, should the flap of an avulsed tissue be placed?

Answer 24

Return it to the place it was torn from.

Question 25

Why should the **application of a splint** be considered for open or closed soft-tissue injuries?

Answer 25

Depending on the **mechanism** of injury and the forces causing the injury, there may be musculoskeletal damage as well. **Splints** may also provide for additional patient comfort.

Question 26

When treating a soft-tissue injury, we may use the mnemonic RICES. What does **RICES** stand for?

Answer 26

**R**est **I**ce **C**ompression **E**levation **S**plinting

Question 27

What type of **open abdominal injury** requires applying a moist sterile dressing secured with an occlusive dressing?

Answer 27

abdominal evisceration

Question 28

When are the **two** times an **impaled object** can be removed?

Answer 28

An impaled object can be removed **only** when: 1. The object interferes with airway management 2. Performing CPR Otherwise, stabilize in place and transport.

Question 29

Why should an **occlusive dressing** be applied to a patient with an open, bleeding, anterior/lateral neck laceration?

Answer 29

The application will **prevent an air embolism** or particulates from being sucked into an open neck wound.

Question 30

What **layer(s) of the skin** are involved in a 2^o or partial thickness burn?

Answer 30

**epidermis** and **dermis**

Question 31

# True or false. It is best practice to place a burn sheet over a patient suffering moderate or severe burns with a large body surface area (BSA) affected.

Answer 31

True

Question 32

Using the **rule of nines**, calculate the percentage of body surface area (BSA) burnt: The adult patient has partial and full-thickness burns to their anterior chest, abdomen, and the front and back of the left arm. What is the **BSA**?

Answer 32

The chest and abdomen is 18% plus the left arm at 9%. The total BSA is: 18 + 9 = **27%**

Question 33

List the **types of burns**.

Answer 33

* thermal * electrical * chemical * radiation

Question 34

Why should we evaluate the **severe burn** patient's airway?

Answer 34

The patient may have **inhaled heat** causing swelling of the airway tissues and/or **inhaled chemicals/toxins** from the burn.

Question 35

How long should we irrigate **chemical eye exposures**?

Answer 35

**No less than 20 minutes** with copious amounts of saline.

Question 36

**Differentiate** primary (direct) injury and secondary (indirect) injury.

Answer 36

* **Primary Injury:** is the actual direct damages to tissues from the force/contact. * **Secondary Injury:** is the additional damages done to the tissues from the direct impact. For instance swelling, ischemia, infection.

Question 37

What are the anticipated/potential **signs/symptoms** of a patient who has been hit in the occipital region of the skull with a baseball bat?

Answer 37

* battle signs * racoon eyes * basilar skull fracture * cervical spine injury * traumatic brain injury * paralysis

Question 38

Name the **layer of meninges** that is very thin and delicate and is adhered to the contours of the brain and spinal cord.

Answer 38

pia mater ## Footnote Other meningeal layers are the arachnoid and the dura mater.

Question 39

What are the **signs/symptoms** of a concussion?

Answer 39

* dizziness * generalized weakness * bisual disturbances ("sees stars") * retrograde and/or anterograde amnesia * nausea/vomiting * Approximately 90% of patients will not have suffered a loss of conciousness.

Question 40

# Define: Cushing's reflex/triad

Answer 40

It may develop from a **closed head injury**. The combination of the three are signs of increased intracranial pressure (ICP). * hypertension * bradycardia * normal, or altered respiratory pattern

Question 41

What are **CSMs** in relation to potential neurological trauma?

Answer 41

**Circulation, Sensation, and Movement**: it is a quick assessment if neurological trauma is suspected.

Question 42

# Define: Paresthesia

Answer 42

It would be described by a patient with potential neurological trauma as pins and needles, numbness, or tingling in their hands and/or feet.

Question 43

# True or false. When providing cervical spine precautions by immobilization, the chest, pelvis then feet should be immobilized before securing the patient's head to the device.

Answer 43

True

Question 44

# Fill in the blank. An injury or damage to a patient's cervical spine at C-3 or above will cause the patient to \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_.

Answer 44

stop breathing ## Footnote C-3 and above damage will cause the patient's diaphragm to no longer contract causing the patient to stop breathing.

Question 45

Upon palpation of the patient's chest, what is the term used when you feel the sensation of **bones rubbing together** under the skin?

Answer 45

crepitus

Question 46

Why would patients with chest wall injuries have **tachypnea** (rapid/shallow breathing)?

Answer 46

**Adequate chest wall expansion will cause pain** and possibly further damage to the chest wall. Patients will compensate with tachypnea.

Question 47

What is the chest wall **motion** called when there is a flail segment?

Answer 47

Paradoxical Movement/motion

Question 48

When assessing a patient's chest for DCAP-BTLS, we note a **sucking chest wound**. What is our **first treatment**?

Answer 48

Place a gloved hand over the wound and hold until an occlusive dressing can be placed.

Question 49

What is the **term** used when describing the attached picture?

Answer 49

Pneumothorax ## Footnote If jugular venous distention (JVD) and hypotension are present with this injury, it would be called a tension pneumothorax.

Question 50

If a pneumothorax means air in the pleural space(s), what do we call **blood** in the **pleural space**?

Answer 50

Hemopneumothorax

Question 51

Where does the **blood/fluid** collect on a patient suffering from expected **cardiac tamponade**?

Answer 51

Blood/fluid fills the **pericardial sac** inhibiting the heart's capability of filling and contracting.

Question 52

What are the types of fractures?

Answer 52

* Greenstick * Oblique * Spiral * Transverse * Comminuted * Epiphyseal

Question 53

What are the signs/symptoms of a closed fracture?

Answer 53

* deformity/swelling * tenderness * guarding * bruising * pain * crepitus

Question 54

# True or false. Dislocations should be reduced before splinting.

Answer 54

False

Question 55

**Differentiate** sprain from strain.

Answer 55

* **Sprain:** when a joint extends outside of its normal range of motion, resulting in a stretched or torn ligament and/or tendon. * **Strain:** it is the stretching and/or tearing of a muscle.

Question 56

What is the **treatment** for an amputated part?

Answer 56

Wrap the part in a sterile dressing and place it in a plastic bag. Local protocol will determine ice or no ice.

Question 57

When preparing to apply a splint, what **assessment** should be done before and after application?

Answer 57

Assess for **circulation, sensation, and movement** (CSM) **before and after** applying a splint.

Question 58

What **joints** should be immobilized when splinting an injury?

Answer 58

Immobilize the joints **above and below** the injury

Question 59

**Shortening of the leg and medial** or lateral rotation is most likely a sign of what **injury**?

Answer 59

**hip fracture** or **dislocation**

Question 60

What are the downfalls of **inadequate/improper splinting**?

Answer 60

* pressure on the nerves, vasculature, and tissues * time delay- when possible, splinting should be done while en route to a hospital * inhibition of distal circulation * further damage to the initial injury

Question 61

List the mechanisms of **heat loss**.

Answer 61

* convection * conduction * respiration * radiation * evaporation

Question 62

With a patient suffering from **severe hypothermia**, what would their level of consciousness be?

Answer 62

**unconscious/unresponsive** and possibly dead

Question 63

# True or false. Warm water with a brisk rubbing should be applied to deep frost-bitten fingers and toes immediately.

Answer 63

False

Question 64

What **cooling mechanism** will stop when a patient has progressed from heat exhaustion to heatstroke?

Answer 64

sweating

Question 65

What is the **first treatment** priority when treating a patient suffering from extreme heat exposure?

Answer 65

Safely **remove** them from the heated environment.

Question 66

# Define: Diving Reflex

Answer 66

It is when the **heart rate slows down** due to cold water exposure/immersion.

Question 67

What is the **medical term** for the condition commonly referred to as "the bends"?

Answer 67

"The bends" is a lay term for **decompression sickness**. ## Footnote This condition occurs when divers ascend too quickly, causing nitrogen gas to form bubbles in the bloodstream and other tissues.

Question 68

What is the definitive **treatment** for a patient with severe decompression sickness?

Answer 68

Hyperbaric Oxygen Chamber Therapy | (HBO)

Question 69

What do the acronyms **HAPE** and **HACE** stand for?

Answer 69

* **HAPE:** **H**igh **A**ltitude **P**ulmonary **E**dema * **HACE:** **H**igh **A**ltitude **C**erebral **E**dema

Question 70

The treatments for patients suffering from **Acute Mountain Sickness (High Altitude Sickness), HAPE and/or HACE**?

Answer 70

* high flow oxygen * positive pressure ventilation (PPV) as needed * immediate and rapid descent in altitude

Question 71

In what environmental emergency situation do we consider **reverse triage**?

Answer 71

**Lightning strikes** with multiple patients.

Question 72

# Describe: How a **Hymenoptera** stinger is removed from the skin?

Answer 72

Using a driver's licence or a credit card, **scrape the stinger away from the body/skin to avoid injecting the venom sac**. Watch for signs of anaphylaxis.