Exam 4 Flashcards
(416 cards)
1
Q
Carry oxygenated blood away from the heart
A
Arteries
2
Q
Have thick, muscular walls that enable dilation and constriction
A
Arteries
3
Q
Microscopic blood vessels
A
Capillaries
4
Q
Carry deoxygenated blood rich in carbon dioxide
back to the heart
A
Veins
5
Q
Contain one-way valves to prevent back flow of blood
A
Veins
6
Q
Dilation __ blood flow to skin
A
Increases
7
Q
Inadequate perfusion of body’s tissues and organs
A
Hypoperfusion
8
Q
Four main causes of shock
A
Volume problems
Pump problems
Blood vessel tone problems
Obstruction of blood flow
9
Q
A volume shock problem is known as
A
Hypovolemia
10
Q
Blood is lost, what kind of shock
A
Hypovolemia
11
Q
Relative Hypovolemia
A
Plasma is removed from circulatory system
12
Q
Cause of relative Hypovolemia
A
Dehydration or burns
13
Q
Hemorrhagic shock is
A
Loss of blood
14
Q
Both absolute and relative hypovolemia are called
A
Hypovolemic shock
15
Q
Not enough blood volume in the blood vessels, so
pressure falls
A
Hypovolemia
16
Q
Pump problems are usually related to a
A
Mechanical problem of the heart
17
Q
In pump problems, blood cannot be moved because
A
Drop in BP
18
Q
Pump problems are categorized as
A
Carcinogenic shock
19
Q
Root cardiac cause of hypoperfusion
A
Cardiogenic shock
20
Q
During blood vessel tone problems… all blood vessels
A
Dilate at same time and blood can’t fill entire circulatory system
21
Q
Blood vessel tone problem is known as
A
Distributive shock
22
Q
Types of distributive shock
A
Anaphylactic shock
Neurogenic shock
Septic shock
23
Q
Massive drop in BP because of systemic dilation
A
Distribute shock
24
Q
Spinal cord injury, messages to sympathetic nervous system gets interrupted and blood vessels constrict
A
Neurogenic shock
25
Body infection causes inflammatory response
Septic shock
26
What happens in septic shock
BV dilate and cap membrane becomes permeable
27
Blood flow blocked
Obstructive shock
28
Obstructive shock causes by
Pulmonary embolism, cardiac tamponade, tension pneumothorax
29
Constricted blood vessels in GI tract result in
Nausea and vomiting
30
Baroreceptors are located in
Aorta and carotid arteries and sense decreased pressure
31
Compensation aims to
Restore blood flow
32
Ways Compensation aims to restore blood flow.
Regulation of volume Vasoconstriction Cardiopulmonary response
33
Compensatory actions
Narrow pulse pressure, kidneys retain fluid, increased pulse and respiratory rate
34
In infants and children, Efficient compensating mechanisms maintain blood
pressure until
Half of volume is depleted
35
In pediatrics, what is a key indicator of shock
Fast heart rates
36
Compensated shock requires more
Fuel
37
When muscles run out of fuel for compensation,
| compensated shock becomes
decompensated shock
38
Indicators of decompensation
Drop in BP
Mental status changed
Slow heart rate and respiratory rate
39
lead to organ-system
| damage and death over time
Prolonged vasoconstriction
40
As organs fail…
Irreversible shock begins
41
Irreversible shock and death results in
Apnea and cardiac arrest
42
What kind of shock?
Wheezing=
Tension pneumothorax=
Anaphylaxis
| Obstructive shock
43
When assessing for shock, if distal pulses they are
Low Bp, narrowed pulse
44
Distributive shock causes what color skin
Flushing or rash
45
Identify shock by
Trends in vitals
46
Signs of shock: order
```
Pulse increases
Blood vessels constrict
Respiratory rate increases
Nausea
Decreasing BP
```
47
Deadly triad of trauma
Acidosis, hypothermia, coagulopathy
48
Decreases body PH, dangerous in hemorrhage shock
Acidosis
49
Bleeding control, rapid transport: what kind of shock
Hypovolemic
50
Request ALS, support blood pressure: what shock
Cardiogenic shock
51
Give epi, what shock
Distributive
52
Septic shock requires
Rapid transport, time sensitive disorder
53
Occurs outside of body after force penetrates skin and
| lacerates or destroys underlying blood vessels
External bleeding
54
Bright red color, spurting with heartbeat, oxygen rich : what kind of bleeding
Arterial bleeding
55
Darker in color, less pressure, volume of blood can create life threatening hemorrhage: What kind of bleeding
Venous bleeding
56
Occurs where appendages of the body connect to the
trunk.
- Large arteries and veins are not well protected
– Injury is likely to cause massive bleeding
Junctional hemorrhage
57
Caused by superficial wounds to surface of skin
Capillary bleeding
58
Identifying type of bleeding is
Irrelevant
59
Slow and oozing bleed
Capillary bleeding
60
Affects body’s ability to clot
Hypothermia
61
Identify and control massive hemorrhage within
first
| seconds of primary assessment
62
Control nonmassive bleeding only after
assessing and treating prior elements
63
Methods or controlling external bleeding
- Direct pressure
– Hemostatic agents
– Wound packing (don’t take dressings off)
– Tourniquet use on extremities (last)
– Specialized compression devices for junctional
bleeding
64
Control of bleeding is essential to preventing
Shock
65
Hold pressure until bleeding is controlled and check after
5-10 minutes
66
Coughing up blood
Hemoptysis
67
Once bleeding is controlled…
bandage a dressing firmly
| in place to form a pressure dressing
68
Presents natural cavities that promote profuse bleeding
Junctional areas
69
Direct pressure should be augmented by
Would packing
70
In wound packing, fill void spaces with
Hemostatic gauze
71
Pressure dressing steps
▪ Place several gauze pads on wound. ▪ Hold dressings in place with self-adhering bandage wrapped tightly over dressings and above and below wound site.
72
Designed to enhance direct pressure’s ability to control
| bleeding
Hemostatic agents
73
Best suited for wound packing
Hemostatic agents
74
- Use if bleeding is uncontrollable by direct pressure.
– Use only on extremity injuries.
– Always apply between the wound and the heart.
Tourniquet
75
Designed specifically to control hemorrhage in
| junctional areas of axilla and groin
Junctional tourniquets
76
Elevate injured area how
Above level of heart
77
Do not elevate if
musculoskeletal injury, impaled
| objects in extremity, or spine injury
78
Minimizes swelling, constricts blood vessels, and
| reduces pain
Cold application
79
From increased intracranial pressure, not direct
| trauma to ears or nose
Head injury
80
Stopping bleeding of head injury increases
Intercranial pressure
81
Allow head injury to
Drain freely
82
epistaxis
Nosebleed
83
Begin hemorrhage control with
Direct pressure
84
Blood loss commonly not seen in
Internal bleeding
85
Indication of what with these symptoms…
– Injuries to surface of body
– Bruising, swelling, or tenderness over vital organs
– Painful, swollen, or deformed extremities
– Bleeding from mouth, rectum, or vagina
Internal bleeding
86
Tender abdomen, coffee grounds are signs of
Internal abdomen
87
Internal injuries with no pathway from the outside to the injured site
Closed wound
88
Examples of closed wounds
Contusions, hematomas, closed crush injuries, rupture of hollow organ or solid organ injury, internal puncture
89
In a confusion what layers are damaged
Epidermis but not dermis
90
More tissue damage, larger blood vessels affected in a
Hematoma, rather than a contusion
91
– Force transmitted from exterior to internal structures
| – Crush or rupture internal organs
Closed crush injury
92
If bruise on head and neck, check for
Blood in holes
93
Bruise on trunk can cause
Coughing up blood, puncture lung, listen to lung sounds
94
Bruise on abdomen indicates
Injury to organs
95
What layers damages in abrasion
Epidermis
96
Perforating puncture wound has
Entrance and exit wound
97
Open crush injures
Extremity caught between heavy items
98
Mix of open and closed injures
Blast injuries
99
Blast injures: primary injuries
Secondary
Tertiary
Quaternary
1: high pressure and winds
2: projectile hitting patient (blast wave)
3: patient throw by blast (fracture, abrasion)
4: exposure to chemicals and burns
100
With open wounds patient care included
Expose wound, clean wound, control bleeding, care for shock
101
Always check __ with abrasions and lacerations
CMS
102
With penetrating search for an
Exit wound
103
With treating impaled objects…
Don’t remove object, expose area, direct pressure, apply layers of bulky dressing
104
With impaled objects, place bulky dressing
On opposite sides of object
105
Keep the cravets wide when treating impaled object, how long?
No less than 4 inches in width once folded
106
If object impaled in the cheek…
Position patient for drainage, motion airway, dress outside of wound
107
Apply what kind of protection with impaled eye
Rigid
108
What gauze used for puncture wound in eye
3 inch gauze or folded 4x4 on vertical axis
109
What is the only object you can take out if impaled
Cheek, if you see both sides
110
If avulsed parts of skin are completely torn away…
save in sterile dressing and keep moist with sterile saline.
111
Wrap an amputation site in
Sterile dressing and secure with self adhesive bandage
112
Classifying burns
– Agent and source
– Depth
– Severity
113
Solid organ can result in
Significant blood loss
114
– Involves only epidermis
| – Reddening with minor swelling
Superficial burn (1st degree)
115
Closed chest and abdominal wounds bear a high risk for
Underlying organ system damage and internal bleeding
116
– Epidermis burned through, dermis damaged – Deep, intense pain – Noticeable reddening – Blisters and mottling
Partial thickness burn (2nd degree)
117
– All layers of skin burned – Blackened areas or dry and white patches
Full thickness burn (3rd degree)
118
JVD and tracheal deviation are key differences in a
Tension pneumothorax vs pneumothorax
119
The rules of nine is used when
Determining severity of burns
120
In rules or nine, adult body is divided into __ areas, each representing __ of body surface
11, 9%
121
With the rule of palm, palm and fingers equal about __ of body surface area
1
122
What rule is Easier to apply to smaller or localized burns
Rule of palm
123
Infants and children have a greater…
Relationship of body surface area to total body size, greater fluid and heat loss from burned skin
124
Ceran wrap can be a type of
Occlusive dressing
125
With a chemical burn, apply a
Sterile dressing
126
Most radiation burns will present like
Thermal injures
127
See patient with a radiological burn only after they have been
decontaminated
128
After __ mL of blood loss, results in __
1000, hypovolemic shock
129
Any material applied to wound to control bleeding and prevent contamination
Dressing
130
Any material used to hold dressing in place
Bandage
131
Available for profuse bleeding, large wound
Universal dressing
132
Used to control bleeding
Pressure dressing
133
Used to form an airtight seal
Occlusive
134
With bandaging, do not cover
Tips of fingers or toes
135
To apply a self-adhering roller bandage, secure it with
several overlapping wraps.
136
Children under __ and adults over __ most severe age for burns
5, 55
137
Open or closed in reference to a
soft-tissue injury
138
must be evaluated with consideration to
| underlying anatomy and mechanism of injury.
Closed injuries
139
key concern when treating a patient with
| a burn or an electrical injury.
Safety
140
Adherence of lung tissue to chest wall due to serous fluid and a constant negative pressure, allows…
Lungs to expand and contract with movement of chest wall/diaphragm
141
Intercostals flex and expand chest outward in
Inhalation
142
Active process that uses negative pressure to draw air into the lungs
Inhalation
143
Passive process that uses positive pressure to push air out of the lungs
Exhalation
144
Superior border of abdomen
Diaphragm
145
Stomach located in
Gallbladder located in
Spleen located in
Liver located in
LUQ
RUQ
LUQ
RUQ
146
Solid organs
Spleen, liver, pancreas, kidneys
147
Hollow organs
Stomach, gallbladder, large and small intestine, bladder, ovaries and uterus
148
What type of organs tolerate trauma well
Hollow
149
Abdominal cavity is __ depending on location of .
Dynamic, diaphragm
150
There’s always __ in abdomen
A large volume of blood
151
Immediate concern with chest trauma
Disruption of breathing
152
Largest threat of chest trauma patient
Internal bleeding
153
What trauma doesn’t penetrate the chest wall
Blunt
154
Can fracture ribs, sternum, and costal (rib) cartilages
Blunt trauma
155
MOI that violates the integrity of the chest wall
Penetrating trauma
156
Bullets, knives, pieces of metal or glass, steel rods, pipes, other objects – Can damage internal organs and impair respiration
Penetrating trauma
157
Occurs when severe blunt trauma causes the chest to rapidly compress
Compression and shearing injuries
158
Shearing can damage the
Aorta and vena cava
159
Chest injuries are classified as
Open or closed
160
What type of chest injury is caused by a blunt mechanism
Closed
161
What blunt chest injury is most common in geriatrics and youth sports
Rib fractures
162
Reduces lung expansion
Hypo ventilation
163
Fracture of two or more consecutive ribs in two or more places
Flail chest
164
Flail chest leads to
Inadequate breathing and hypo ventilation.
165
Movement of flail segment is opposite to movement of the remainder of the chest cavities.
Paradoxical motion
166
Symptoms of rib fracture
Pain increases when breathing, tender, respiratory distress, self splinting
167
Flail chest assessment
Difficulty breathing, pain at sure, chest wall muscle contraction, late signs of shock and hypoxia
168
For flail chest, patient care
Self splint, pillow, request ALS
169
Hole in chest, negative pressure of breathing can draw air in through the hole
Sucking chest wound
170
In penetrating chest injuries, it’s difficult to
Tell what’s injured from entrance wound
171
Assume all wounds are life threatening in
Penetrating chest injuries
172
What injury listen to lung sounds
Penetrating
173
Lung damage signs and symptoms
Difficulty breathing, absent of unequal lung sounds, hemoptysis, hypoxia, low BP, tachycardia, tachypnea
174
For sucking chest wound patient care
Seal wound, apply occlusive dressing (at least two inches wider than wound)
175
dressing seals wound to stop movement of air
Occlusive
176
involve taping dressing in place and
| leaving a side or corner of dressing unsealed
Flutter valve dressings
177
In flutter valve dressing, as patient inhales…
Seal wound
178
Seals all the wound edges and have a valve that allows pressure relief
Asherman chest seal
179
Patients chest injury needs to be treated during
ABCs in primary assessment
180
When air accumulates in chest cavity, possibly
| causing lung collapse
Pneumothorax
181
Pressure from air in chest cavity puts pressure on the heart and vena cava
Tension pneumothorax
182
Patients with pneumothorax or tension pneumothorax typically have
JVD, trachea deviation (opposite side of injury), diminishes lung sounds
183
Chest cavity fills will blood.
Hemothorax
184
Chest cavity fills with both blood and air.
Hemopneumothorax
185
Sudden compression of chest forcing blood out of organs and rupturing blood vessels
Traumatic asphyxia
186
Neck and face are a darker color than rest of the body are a sign of
Traumatic asphyxia
187
In traumatic asphyxia, sternum and ribs can exert pressure on heart and lungs which
Forces blood out of right atrium and into jugular veins
188
Present with MOI of injury that can cause compression of chest
Traumatic asphyxia
189
Direct injury to heart causing blood to flow into the pericardial sac around the heart
Cardiac tamponade
190
Increased pressure on heart so chambers cannot fill
Cardiac tamponadeb
191
Becks triad
Muffled heart sounds, distanced neck veins, narrowing pulse pressure in cardiac tamponade
192
Systolic and diastolic blood pressure difference gets smaller over time
Narrowed pulse pressure
193
Cardiac tamponade usually a result of
Penetrating trauma
194
Largest artery in body, rush from left ventricle to chest
Aorta
195
Penetrating aortic injury can cause
| Blunt trauma aortic injury can
Direct damage
| Tear aorta
196
Inner layer of aorta begins to tear, blood flows between layers of aortas wall
Aortic dissection
197
Balloon like protrusion of aorta, rupture leads to death
Aneurysm
198
Aortic injury signs and symptoms
Chest, back pain, shock, differences in pulse or blood pressure between arms or legs
199
Differences in pulse of BP between right and left arms
Proximal aortic injury
200
Commotio cordis patient should be treated as a
VF patient
201
Trauma to chest when heart is vulnerable
Commotio cordis
202
In commotio cordis, impact occurs just when the heart is
Electrically vulnerable
203
Uneven chest wall motion is common with
Pneumothorax
204
Distended neck veins are present in tension pneumothorax unless
Hypovolemic
205
Coughing up frothy red blood present in
Hemothorax
206
Bloodshot and buldging eyes present in
Traumatic asphyxia
207
Cardiac tamponade blood pressure and pulse pressure
Low bp and decreasing pulse pressure
208
Tearing chest pain radiating to back
Aortic injury or dissection
209
Allow air to be expelled for
tension pneumothorax
210
Abdominal evisceration? Treatment?
Organs protruding through wound opening, moist dressing
211
Most commonly injured organ because of size and vascular, where is it located
Liver, RUQ under lower ribs
212
Blunt trauma to solid organs can cause
life-threatening
| blood loss
213
Serve irritation and peritonitis can cause involuntary control which leads to
Rigidity of abdominal wall
214
For patient care of abdominal injures, place patient
On back with legs flexed at knees to reduce tension on abdomen
215
For adnominal injuries give
Nothing by mouth
216
Do not touch or replace
Eviscerated organs
217
For eviscerated organs…
Apply sterile moist dressing then occlusive dressing, with bulky dressing to keep warm
218
Treatment for impaled object
Stabilize with bulky dressings, leave legs in position to avoid muscular movement
219
A flail chest is characterized by
Paradoxical motion
220
Cartilage located…
Outside bone end (epiphysis)
221
Over relief splint how many times
1
222
Never tie over a __ in splinting
Joint
223
Cirrhotic splinting
Pad voids
224
Patient assessment in pelvic injuries
Pain when pressure to iliac crests, can’t lift legs, lateral rotation of foot, pressure in bladder
225
Patients entire limb rotated outward, hip flexed
Anterior hip dislocation
226
▪ Rotation of leg inward and knee is bent.
▪ Foot may hang loose and unable to flex the foot or lift toes.
▪ Lack of sensation in limb
Posterior hip dislocation
227
With hip dislocation, patient care
Move to long board, immobilize limb with pillows. Care for shock
228
Hip fracture pain is
Localized
229
Patient assessment of hip fracture
Sensitive to pressure on greater trochanter, swelling, can’t move limb on back, foot on injured side turns outward, limb looks shorter
230
Femoral shaft fracture patient assessment
Intense pain, possible open fracture (severe angulation), limb may be shortened
231
What splints use for tib fib injury
Vacuum, air inflated, immobilize fracture with rigid board splits and apply single splint with ankle hitch.
232
If patient has multiple trauma or appears to have shock, don’t waste time
Splinting individual fractures
233
Pelvic fractures and femoral shaft fractures often indicate
More severe internal injuries
234
Connect bone to bone
Ligaments
235
Connect muscle to bone
Tendons
236
Bones made up of
Dense connective tissues
237
Bones are covered in
Periosteum
238
Where bones meet
Joints
239
Break causes soft tissue…
Swelling and a blood clot in fracture
240
Skeletal muscle
Voluntary
241
Chief concern in trauma
Skeletal
242
Smooth muscle is found in the
Walls of organs and digestive structures
243
__ less rigid than bone
Cartilage
244
Cartilage acts as an
Articulation surface
245
Allow for power of movement across joints
Tendons
246
Connects muscle to bone
Tendons
247
support joints by attaching bone ends to allow
| for stable range of motion
Ligaments
248
Connects bone to bone
Ligament
249
Mechanisms of musculoskeletal injury
Direct force, twisting force, and indirect force
250
MCL, ACL injury are an example of what kind of force
Twisting force
251
Force that is a sudden stop, falling back
Indirect force
252
Applies constant pull along length of leg to stabilize fractures and reduce muscle spasms
Traction splint
253
Early application of traction splint mortality rate from femur drops to
Less than 20%
254
Greenstick, incomplete breaks are common in
Children
255
Bone that’s broken in several places
Comminuted
256
Bent at angle break
Angulated
257
Coming apart of a joint
Dislocation
258
Soft tissue of joint capsule and ligaments must be stretched beyond normal range and torn
Dislocation
259
Stretching and tearing of ligaments (joint injuries)
Sprain
260
Overstretching or overexertion of muscle
Strain
261
A traction splint should be applied to a suspected
Femur fracture
262
Splinting an extremity with a suspected fracture helps
prevent blood loss from bone tissues
263
Severe swelling in the extremity as a result of fracture
Compartment syndrome
264
Fracture or crush injury causes
Bleeding and swelling in extremity
265
Six P’s of assessment
Pain, pallor, paresthesia, pulses diminished, paralysis, and pressure
266
pins and needles
Parasthesia
267
Nerve and blood vessel compromise occurs in
Compartment syndrome
268
During __ assessment, apply cervical collar is spine injury suspected
Secondary
269
Must immobilize what part in splinting
Adjacent joints and bone ends
270
Realigning an extremity is limited to
Angulated shafts of long bones
271
Splint in the position found unless..
distal extremity is cyanotic or lacks pulses
272
If extremity is cyanotic or lacks pulses, align joint to
Neutral position using gentle traction
273
Apply manual traction in direction of
Long axis of extremity
274
Effective splinting may require some
ingenuity
275
Three types of available splints on EMS units
Rigid, formable, traction splints
276
Splint that requires the greatest support
Rigid
277
Require limb to be moved anatomical position
Rigid splints
278
Immobilize joint injuries in position found
Formable splints
279
Align long-bone injuries to
anatomical position
280
Splint __ moving patient to stretcher
Before
281
Types of traction splints
Bipolar and unipolar
282
Exert and maintain a firm pull to prevent overriding, firm traction should be applied to align limb
Bipolar traction splint
283
Traction can be measured in
Unipolar splint
284
Amount of traction applied should be roughly __ percent of
patient’s body weight
– Not exceeding __ pounds
10, 15
285
Hair traction splint measured from
Ischial Tuberosity
286
Secure the patient’s torso and the traction splint to a
long spine board
287
Use a sling and swathe for what kind of injury
Shoulder girdle
288
Commercially available devices, can also use a sheet: Applied to patients who have pelvic deformity or instability
whether or not signs of shock are present
Pelvic wrap
289
To devise a pelvic wrap, lay a sheet, folded flat, approximately __ inches wide onto the backboard.
10
290
More than one serious injury
Multiple-trauma patient
291
One or more injuries serious enough to affect more
| than one body system
Multisystem-trauma patient
292
Determining Severity: Physiologic Criteria
Altered mental status, hypotension, abnormal respiratory rates
293
Altered mental status: GCS <
14
294
Abnormal respiratory rates below __ or over __
10, 29: <20 in infants
295
Determining Severity: Anatomic Criteria
Amputation proximal to wrist or ankle, pelvis, skull fracture, paralysis
296
Chest wall instability or deformity
Flail chest
297
How many proximal long bone fractures for severity of anatomical criteria
Two or more
298
Intrusion in high risk auto crash: on occupant side or any side
>12, >18
299
Who doesn’t effectively compensate for shock
Older adults after 55
300
systolic BP below __ may be shock after 65
110
301
Patients with special conditions when determining severity are
Taking anticoagulants (burns) and pregnancy’s >20 weeks
302
Assist ventilations at __ if high respiratory rate of __
12, 30
303
What is the “golden hour” for trauma patients
Need to critical trauma patients to get surgery within 1 hour of injury
304
Revised trauma score includes
GCS, systolic BP, respiratory rate
305
Three many ways body loses heat
Conduction, convection, radiation
306
Direct contact with hot or cold source, water chill
Conduction
307
Air or water carry away heat, wind chill
Convection
308
Heat is “picked up” by surrounding air or water.
Radiation
309
Body’s core temp
98.6
310
Occurs when the body sweats or gets wet
Exaporation
311
Loss of body heat through exhaled air
Respiration
312
The effects of cold temperature on older adults are
Immediate
313
Infants are unable to __ when cold due to __
Shiver, small muscle mass
314
Assessment of patients with hypothermia includes
Shivering, stiff posture, drowsy, numbness, rapid breathing and pulse to slow or absent breathing
315
With patients of hypothermia, perform CPR with
Only 1 shock
316
Passive vs active rewarming
```
Passive= cover patient, remove wet clothing
Active= apply external heat source
```
317
Transport a hypothermic patient unless
Mild case
318
Patient unconscious, no discernible vital signs
– Heart rate can slow to __ beats/minute.
– Very cold to touch
10, extreme hypothermia
319
Perform CPR on patient with hypothermia until
Back to normal body range
320
Treatment for early or superficial frostnip
Remove from cold and cover
321
Treatment for late deep frostbite
Oxygen, cover frostbite part
322
Patient with moist, pale, and normal or cool skin known as
Heat exhaustion
323
As sweating continues, the body loses salts, bringing on
| painful muscle
(heat) cramps
324
Apply __ over cramped muscles from heat
Moist
325
Temperature-regulating mechanisms fail, The body cannot rid itself of excessive heat (no sweating)
Heat stroke
326
To care for patient with heat stroke, apply cool packs to
Neck, groin, and armpits
327
As body temperatures decrease…
Muscles shiver, heart prone to dysthymias, CNS sluggish
328
As body temperature increases…
Sweating leads to evaporation and cool skin
329
___ relates to the diseases and ___ relates to death.
morbidity, mortality
330
During drowning, the reflex spasm of __ is triggered which seals airway
Larynx
331
Resuscitation should be started __ you immobilize neck and spine.
Before
332
If an ice shelf water accident, go around to the
Back side and secure from back
333
Diver holding breath, gas bubbles in bloodstream
Arterial gas embolism
334
Decompression sickness affects
Joints and muscles
335
Decompression sickness leads to
Air embolisms
336
Water rescue order
Reach
Throw and tow
Row
Go
337
Normal, healthy people who have adjusted to high altitudes have a __ oxygen saturation than do those at sea level because there is less oxygen to breathe.
Lower
338
What medication reduces inflammation for preparation of high altitudes
Dexamethasone
339
worse form of
| acute mountain sickness
High-altitude cerebral edema (H A C E)
340
Symptoms of HAPE
Rales , pulmonary edema, dyspnea
341
Never elevate legs or bite because
Keep it away from heart
342
most effective technique to slow venom spread
Pressure immobilization bandage
343
Constricting bands with bites placed
2 inch above and below body
344
Vitals in snakebite
Labored breathing, rapid pulse
345
Most common form of anaphylaxis
Insects
346
Consider using what with insects
Epi pen
347
Black widow spider releases
Neurotoxin
348
Brown recluse spider releases
Hematotoxin and dermonecrotic toxin
349
In brown recluse spider, bite sites become..
Ischemic and necrotic after a few days
350
Scorpions release
Neurotoxin and cardiotoxin
351
Lizards and snakes release
Neurotoxin
352
Tenacious in hanging
onto a victim – Localized pain, edema,
bleeding
Lizards
353
Always remove stinger from
Jellyfish or stingray
354
Rely on heat, immobilization
Marine animal injuries
355
Always treat what first with lighting strikes
ABCs
356
Who’s more likely to be struck by lighting? Highest incidence in children and adults?
Males 5x, children younger than 16 and adults between. 26-35
357
Rapid heating/cooling (and
| pressure) causes
Blast like trauma inside
358
Deliver to a level one trauma center if… respiratory rate is below __ and above __.
10, 29
359
3 things measured in GCS
Verbal, eyes, motor function
360
Becks triad…
Narrowing pulse pressure, muffled heart sounds, and JVD
361
Constructing bands avoid toxins going to…
Lymph nodes
362
Revised trauma score
BP, respiratory rate, Glasgow scale
363
Following commands, eyes following, but a little confused snd good verbal… what score on GCS
14
364
What score on GCS do you transport to level 1 trauma center
13
365
At what score of GCS do you use a bag valve mask
8
366
Suicide is most common in
Older men
367
Tylenol overdoses result in
Renal failure
368
Signs of renal failure and treatment
Jaundice, edema, weight gain, and CPAP
369
Body % of nitrogen and oxygen
79, 21
370
If an elderly lady falls on face, the major injury would be the
Proximal part of the femur
371
The proximal part of the femur break is classified as a… and signs include…
Hip fracture, slight shorter leg and rotates
372
Distal femur fracture includes the
Patella or knee fracture
373
Infant respiratory rate
30s
374
Respiratory rate less than __ and over __ for infants
20, 40
375
where fertilization
| usually occurs.
Fallopian tubes (oviducts
376
Muscular, hollow organ located along midline in
| women’s lower abdominal quadrants
Uterus
377
Uterus can hold mL normally and mL during pregnancy
5, 500
378
Muscular ring separating uterus and vagina
Cervix
379
How many weeks gestation needed for survival
20
380
Fetal stage begins at week
8
381
Heart beat forms…
15-18 days after conception
382
How many weeks of pregnancy
40
383
Fluid that allows fetus to float, cushions fetus, and maintains constant fetal body temperature
Amniotic sac
384
During pregnancy, the cardiovascular system makes…
50% more RBCs by 2nd trimester
385
Pregnant women increased cardiac output more prone to
Pulmonary embolism
386
Placenta, infant, and amniotic fluid total
20-24 lbs
387
When supine, Mass compresses inferior vena cava—cardiac output decreases and BP drops
Supine hypotensive syndrome
388
In shock skin color isn’t an indication with…
Septic shock, neurogenic shock
389
Irregular, not sustained, and not indicative of impending delivery—false pregnancy pains
Braxton-Hicks contractions
390
Fetus’s movement from high in the abdomen down toward birth canal
Lightening
391
When they last __ and are __ apart, delivery of the baby may be imminent
30 sec- 1 minute, 2–3 minutes
392
Fluid with meconium staining indicates that there may be
fetal distress
393
Pulse is in the ___ for infants and fetus
160s-170s
394
Amniotic sac breaks in what stage of labor
First
395
Third stage of labor lasts 
10-20 minutes
396
Gravita, pera
G: number of pregnancies
P: number of living children
397
Newborn=
| Neonate=
Within 2 hours
| 28 days of life
398
Give narcan to pregnant women at what week
35
399
What assesses the neonate
APGAR
400
APGAR stands for
Appearance, pulse (over 100), grimace, activity, respiratory effort: 7-8 is normal
401
Deep fundus massage role
Release oxytocin for vasoconstriction to stop vaginal hemorrhage
402
Apply clamps on pulseless umbilical cord at
10 and 7 inches from baby
403
If shallow, slow, gasping, or absent, provide positive
| pressure ventilation on neonate at a rate of
40-60 per minute
404
In neonate if less than __ bpm, continue positive pressure ventilations.
If less than __ begin chest compressions at __
100
| 60, 120
405
Deliver neonate resuscitation at a depth of
One-third to one-half of the chest
406
Most common abnormal delivery
Breech presentation
407
Meconium staining common with
Breeching
408
Position if breeched, limb presentation, and prolapsed cord
Doggy
409
Stains amniotic fluid greenish or brownish yellow color • Do not stimulate infant before suctioning.
Meconium
410
Placenta blocks birth canal
Placenta previa
411
Tearing pain, Placenta prematurely separates from uterine wall, Usually caused by trauma
Abruptio placentae
412
Ectopic pregnancy vitals
Low BP, Rapid weak pulse, often pain in one side
413
Seizure in pregnancy vitals
Preeclampsia, weight gain, swelling
414
Pregnant patient’s pulse ___ beats per minute
faster than nonpregnant women.
Blood loss may be __ percent before
signs/symptoms appear.
10 to 15
30 to 35
415
Displace uterus in cpr if child is more than
20 weeks
416
Position hands __ higher on sternum to
| make up for shifting of the heart by large uterus
1 to 2 inches
