TBI, Assault, Enviro, Peds, Geri

Question 1

Main contributor to secondary brain injury

Answer 1

Cellular hypoxia

Question 2

Cerebral perfusion pressure formula?
Surrogate?

Answer 2

MAP - ICP
Surrogate is systolic blood pressure in EMS

Question 3

GCS and TBI severity

Answer 3

Mild: 14-15
Moderate: 9-13
Severe: 3-8

Question 4

Concussion def:

Answer 4

A trauma induced alteration in mental status that may or may not include a loss of consciousness
Any alteration

Question 5

Typical duration of concussion

Answer 5

7-10 days

Question 6

% of women that experience IPV worldwide
Risk factors

Answer 6

30%
Separated or divorced
Disabled
Pregnant
Transgender
Lower SES

Question 7

Most common time for IPV

Answer 7

Right around time partner is leaving

Question 8

4 types of IPF (Per Johnson)

Answer 8

Situational couples: both sides violent
Coercive controlling: one partner with goal to maintain power
Violent resistance: One controlling, other resisting
Separation-instigated: nonviolent until separation (both M and F equal)

Question 9

4 Cardinal rules for EMS safety

Answer 9

Never confront abuse
Never get between couple that is arguing
Always ensure that you have an escape route
Never let abuse block your exit

Question 10

4 Rs for IPV

Answer 10

Recognize
Respond
Refer
Record

Question 11

Don’t have what present when trying to help IPV in field

Answer 11

Children - they can snitch

Question 12

4 Rs’ for trauma informed approach

Answer 12

Realization
Recognition
Response
Resisting re-traumatization

Question 13

AMP model of human trafficing

Answer 13

Action - recruits, transports, obtains victims
Means - forced, fraud, coersion
Purpose - commercial sex or labor services (2 types of sex trafficking)

Question 14

Most common trafficker

Answer 14

Family members (36%)

Question 15

Goal of what when suspecting human trafficking

Answer 15

NOT disclosure or in depth interview
Gather enough info to provide necessary resources

Question 16

Most common form of child abuse

Answer 16

Neglect (60%) - acts of omission

Question 17

child abuse risk factors

Answer 17

<1 years old
Non verbal
Chronic diseases
no gender difference

Question 18

4 mechanisms of losing heat

Answer 18

Radiation
Convection
Conduction
Evaporation

Question 19

Mild hypothermia

Answer 19

32-35
Shivering, progressive loss of function

Question 20

Moderate Hypothermia

Answer 20

28-32
loss of shivering
cardiac arrhythmias
confusion

Question 21

Severe hypothermia

Answer 21

<28
Muscular rigidity
Loss of vital signs
V-fib, LOC

Question 22

Trenchfoot description

Answer 22

before treatment: limb is blanched and yellowish white, edematous, not painful
after treatment: hyperemic phase - hot, red swollen and painful. Bilsters over weeks
Post hyperemic: cold sensitivity and paresthesias that may last years

Question 23

Rescuer ppl for altitude

Answer 23

Acclimatization
Chemoprophylaxis (acetazolamide, dexamethasone)
O2 supplementation

Question 24

Decent equivalent for portable hyperbaric chamber

Answer 24

3000 ft

Question 25

3 diving injuries at depth

Answer 25

Nitrogen narcosis O2 toxicity Immersion pulmonary edema (even with just swimming)

Question 26

3 diving injuries of ascent

Answer 26

Overpressure - barotrauma Arterial gas embolism Decompression sickness

Question 27

Why reverse triage in lightning

Answer 27

Temporary loss of respiratory drive (medulla)

Question 28

Two ABCDE caveats in peds

Answer 28

1. AVPU for airway 2. Caveat on Exposure, very prone to hypothermia

Question 29

HR to promp action in kids

Answer 29

>220 in infants >180 in children <60 and symptomatic

Question 30

BP formula for kids

Answer 30

70 + (2 x age)

Question 31

Best pain scale for kids 4-12

Answer 31

Pictorial (Wong Baker Faces)

Question 32

Best pain scales < 4

Answer 32

Observational : 1. FLACC - Face, Legs, Activity, Cry, Consolability 2. CHEOPS

Question 33

What to give sick croup kids

Answer 33

Nebulized epi *Mist does not work*

Question 34

BRUE criteria

Answer 34

Sudden, brief (<1 minute), resolved with 1 of: cyanosis or pallor, irregular breathing, change in tone, decreased responsiveness

Question 35

BRUE age range

Answer 35

<1 year, highest in <3 months

Question 36

% of pediatric responses that are seizures?

Answer 36

10%

Question 37

What % of children will have febrile seizures

Answer 37

5%

Question 38

Most common finding in pediatric shock

Answer 38

Tachycardia

Question 39

Higher ROSC in non shockable adult vs bed arrest?

Answer 39

Peds (but numbers still low)

Question 40

Waddels triad

Answer 40

1. Femur fx 2. Chest + Abd trauma 3. Head injury

Question 41

Lap belt complex

Answer 41

Hyperflexion during deceleration in MVC Abdominal trauma (hollow viscous) + vertebral compression fractures

Question 42

Most common technology dependent child device

Answer 42

G or J tubes

Question 43

What terminates seizure from vagal stimulator

Answer 43

Magnets But if benozs are option use that first

Question 44

Test for cognitive decline

Answer 44

Six item screener 3 words Date, month, year recall 3 words

Question 45

Patient health questionnaire 2 tests?

Answer 45

Depression

Question 46

Age as "special consideration" for trauma transfer Systolic BP cutoff?

Answer 46

>55 Systolic of 110

Question 47

Drugs to consider as IBW dosing

Answer 47

Opioids, Ketamine Propofol, versed, etomidate

Question 48

Non weight based EMS drugs

Answer 48

Haldol Quetapine