Midterm Flashcards
1
Q
XABCDE
A
- eXanguation
- airway
- breathing
- circulation
- disability
- expose/environment
2
Q
MARCH
A
- massive bleeding
- airway
- respirations
- circulation
- head
3
Q
event phase
A
- moment of actual trauma
- Actions taken during this phase aim to minimize injuries as a result of trauma.
- Motor vehicle safety restraint systems, air bags, and motorcycle helmets play a role in injury reduction.
4
Q
post event phase
A
- Outcome from a traumatic event.
- 1st phase of death occurs within first hour after an incident (hemorrhage)
- 2nd phase of death occurs within the first few hours of an incident -> Preventable with quality prehospital and hospital care.
- 3rd phase of death occurs several days to several weeks after the incident (multiple organ failure)
- Early and aggressive treatment of shock in prehospital setting can prevent come of these deaths.
5
Q
pre event phase
A
- Circumstances leading up to injury
- Primarily focuses on injury prevention
- Legal enforcement is aimed specifically to prevent traffic accidents.
- Preparation of prehospital care providers for events that are not preventable
- education
6
Q
principle vs preference
A
- principle- based on patient needs
- preference- how the principle is accomplished
- preferences may change depending on:
- situation at scene
- patient severity
- prehospital care provider knowledge and skills
- resources available
- PHTLS teaches the principles of care rather than focusing on preferences
- principle is what needs to be done for apt based on the pt assessment
- preference is how the principle is accomplished
7
Q
DCAP-BTLS
A
- D- deformities
- C- contusion
- A- abrasions
- P- punctures
- B- burns
- T- tenderness- pain only when you touch it
- L- lacerations
- S- Swelling
8
Q
the most important factor for seriousness of wound
A
type of tissue
9
Q
energy dissipation
A
process by which KE is transformed into mechanical energy
10
Q
factors affecting types of injury
A
- Ability of body to disperse energy delivered
- Force and energy
- duration and direction
- position of victim
11
Q
5 phases of trauma
A
-phase 1- deceleration of the motor vehicle
-phase 2- deceleration of the passenger
-phase 3- deceleration of internal organs
-phase 4- secondary collisions
phase 5- additional impacts received by the vehicle
12
Q
Impact patterns
A
- Rollovers- Patient may be ejected or struck hard against the interior of the vehicle -> Most dangerous because there is no protection**
- Lateral/side- Body is pushed in one direction while the head moves towards the impacting object -> seatbelt offers little protection
- Head on/frontal- Front end of car is hit, passengers decelerate at the same rate as the car -> unrestrained passengers either go down and under or up and over
- Rear- Energy is imparted to the front of the vehicle -> whiplash is common -> have the most survivors
- Rotational/quarter panel- Off center lateral crash -> forward energy becomes lateral
13
Q
four types of motorcycle impacts
A
- head on impact
- angular impact
- ejected
- laying the bike down
14
Q
3 predominant MOIs for pedestrains
A
- 1st impact- auto strikes body with its bumpers
- 2nd impact- adult is thrown on hood and/or grille of vehicle
- 3rd impact- body strike the ground or some other object
15
Q
Blast injuries
A
- Primary Blast- Pressure wave from the explosion carries a high risk of injury or death that can rupture membranes and affect organs ex. Lungs, ears
- Secondary Blast Caused by flying debris from wind -> can cause penetrating and blunt injuries -> Most common**
- Tertiary Blast- Occur when a person is hurled against stationary rigid obtectsion (ground shock) ex. Amputations, broken bones, penetrations
- Quaternary Blast- Occurs from miscellaneous events from the blast ex. Burns, respiratory injury, crushing injury, entrapment
- Quinary Blast- Caused by biologic, chemical, or radioactive contaminants in explosive ex. Dirty bombs
16
Q
cavitation
A
- Exit wounds occur when projectile’s energy is not entirely dissipated.
- Size depends on energy dissipated and degree of cavitation.
17
Q
types of shock
A
- Hypovolemic- Dehydration, Hemorrhage
- Distributive- Neurogenic, Septic, Anaphylactic, Psychogenic
- Cardiogenic- Pump failure (intrinsic versus extrinsic)
18
Q
cell dysfunction
A
- lactic acid buildup
- low pH
- autodigestion of cells- leads to cellular death and organ failure
- entry of sodium and water into the cell- cellular edema (swelling) worsens with overhydration
- if further loss of intravascular (blood) volume- the cycle continues
- inadequate ATP
- cells and organs do not function properly
- hypothermia- decreased heat production
19
Q
triangle of death
A
- acidosis- what little ATP is being produced is used to shiver and lactic acid production increases
- hypothermia
- coagulopathy- as body temperature drops, blood clotting becomes impaired
20
Q
cascade of death
A
- anaerobic metabolism
- decreased energy production
- cellular death
- organ death
- patient death
21
Q
neurogenic shock
A
- associated with spinal cord injury
- interruption of the sympathetic nervous system resulting in vasodilation
- patient has normal blood volume but vascular container has enlarged, thus decreasing blood pressure
- low BP
22
Q
starlings law
A
- heart must be an effective pump
- primed by return of blood through the vena cavae
23
Q
microvascular changes in shock
A
- early- pre and post capillary sphincters constrict -> ischemia -> anaerobic respiration
- as acidosis increases…- pre-capillary sphincters relax -> stagnation of blood in capillary beds
- final- pre and post capillary sphincters relax -> wash out -> release microemobli -> infarction of organs
24
Q
organ sensitivity to shock
A
- extremely sensitive- brain, heart, lungs
- moderately sensitive- kidneys, liver, gastrointestinal tract
- least sensitive- muscle, bone, skin
