General Principles

Question 1

What is the difference between ischemia and infarction?

Answer 1

Ischemia = starving tissue (not enough blood flow to area)

Infarction = tissue death

Question 2

What are your two primary concerns with a patient that has an abnormal mental status/level of consciousness?

Answer 2

Quality of oxygenation and perfusion.

Ability to maintain their airway (keep it open).

Question 3

What is the most important field diagnosis?

Answer 3

Determining if the problem is serious or not serious.

Question 4

What is the maximum time frame in which swelling typically occurs?

Answer 4

24 hours

Question 5

What does “Generic to Specific” mean? Give an example.

Answer 5

Generic is a list of all things that could cause the problem at hand. Treat all causes at first. Causes can be ruled out in time with further investigation and by observing the results of the treatments performed. As this occurs, the provider can narrow in on the root cause.

Question 6

What is the difference between “ideal” and “real”? How does it apply to a situation where access to definitive care is delayed?

Answer 6

Ideal = how we would treat a patient if we had all the resources needed available and in a perfect environment.

Real = what we deal with in the field (i.e., limited resources, weather, terrain, time).

Question 7

What are two sources of swelling? Give an example for each.

Answer 7

Bleeding – blood escaping pipe (internal bleeding)

Edema – fluid oozing out of pipes (specifically the capillaries)

Question 8

Ischemia

Answer 8

Tissue starvation; Local loss of perfusion due to swelling, deformity, or obstruction; can result in infarction.

Question 9

What happens when one critical system fails? Give an example.

Answer 9

It creates a cascade of events leading to other critical systems failing.

Example: a blocked airway (respiratory system failure) does not allow oxygen to fill the lungs. No oxygen to the blood results in no oxygen reaching the cells which leads to heart failure (circulatory system) and brain failure (nervous system).

Question 10

What is the serious anticipated problem of swelling?

Answer 10

Ischemia (starving tissue) – swelling puts pressure on tissue which restricts blood flow to area.

Question 11

Why are both oxygenation and perfusion important in the body?

Answer 11

Cells require oxygen to function. Tissue deprived of oxygen dies. If oxygenation is not delivered to the blood via the lungs, the circulatory system has nothing to deliver to the cells. If there is something wrong with the circulatory system, oxygen transferred to the blood at the lungs will not be delivered. Both are serious problems.

Question 12

When analyzing different solutions to help a patient, rescuers should weigh risks to whom?

Answer 12

Everyone – rescuers in the field, rescuers coming to help, patients, bystanders.

Question 13

Irritated tissue __________.

Answer 13

Irritated tissue swells.

Question 14

Generic to Specific Principle

Answer 14

An assessment tactic that intentionally moves from a generic diagnosis to one that is more specific after ruling out possible diagnoses. It is important to remember that the most important diagnosis is serious or not serious.

Question 15

The job of the first responder is to recognize problems ______ and prevent the problem from ________________.

Answer 15

The job of the first responder is to recognize problems early and prevent the problem from getting worse.

Question 16

Perfusion

Answer 16

The generation of enough pressure in the circulatory system to force blood around the body and through the capillary beds where oxygen can be delivered to cells and metabolic wastes can be removed.

Question 17

Mental Status

Answer 17

Describes the level of brain function.

Question 18

List the three critical systems.

Answer 18

Circulatory System
Respiratory System
Nervous System

Question 19

Oxygenation

Answer 19

Oxygen transferred from the lungs to the blood and from the blood to the cells.

Question 20

Level of Consciousness

Answer 20

Describes the level of brain function in terms of responsiveness to specific stimuli (AVPU scale): A = awake, V = responds to verbal stimuli, P = responds to painful stimuli, U = unresponsive to any stimuli.

Question 21

Risk vs Benefit Principle

Answer 21

A risk management tool used to aid in the decision-making process.

Question 22

What is the difference between oxygenation and perfusion?

Answer 22

Oxygenation = oxygen transferred from the lungs to the blood and from the blood to the cells.
Perfusion = generation of enough pressure in the circulatory system to force blood around the body and through the capillary beds where oxygen can be delivered to cells and metabolic wastes removed.

Question 23

Ideal to Real Principle

Answer 23

A concept that reminds rescuers to get as close to ideal as possible under the given circumstances. In most cases, the ideal is not possible, and rescuers must forgive themselves for not being able to provide the ideal treatment and move on with a real plan that reduces risk and increases benefit for all involved.

Question 24

Probability vs Consequence Principle

Answer 24

A risk management tool used to assess the level of risk and the needs for mitigation.

Question 25

Wilderness Context

Answer 25

A situation where access to definitive medical care is delayed by distance, logistics, or danger.

Question 26

What is the best tool rescuers have to detect developing critical system problems?

Answer 26

Measuring vital sign patterns.

Question 27

Describe how the brain may compensate for the effects of an injury or illness.

Answer 27

Increase respirations to increase oxygenation.

Increase heart rate to keep blood pressure stable.

Constrict blood vessels to non-vital organs to keep blood moving/to deliver enough oxygen to critical systems.

Question 28

Infarction

Answer 28

Tissue death caused by ischemia. Tissue death not caused by ischemia is referred to as necrosis.