Trauma Flashcards
1
Q
MOI
A
Mechanism of injury
2
Q
coup brain injury
A
occurs under the area of impact with an object; associated with cerebral contusions
3
Q
contrecoup bran injury
A
occurs opposite side of area that was hit; associated with cerebral contusions
4
Q
3 key assessments for fall injuries
A
- distance fallen (>15 or 3x patients height)
- surface struck
- body part landed on
5
Q
primary blast injury
A
injuries due to pressure wave of the blast
6
Q
secondary blast injury
A
injuries due to flying debris
7
Q
tertiary blast injury
A
injuries caused by being thrown against a stationary object
8
Q
miscellaneous blast injury
A
injuries due to burns, inhalation injury, etc.
9
Q
minimum/maximum score for glasgow coma scale
A
3/15
10
Q
level 1 trauma center
A
all types of trauma 24/7
11
Q
level 2 trauma center
A
stabilize trauma patients and transferring to level 1 trauma center
12
Q
level 3 & 4 trauma center
A
limited services and ability to stabilize patients
13
Q
arteries (what does blood look like)
A
spurting, bright red blood
14
Q
veins (what does blood look like)
A
steady flow of dark red blood
15
Q
capillaries (what does blood look like)
A
slow oozing dark red blood, might be mixed with clearish fluid
16
Q
How do you control external hemorrhages
A
first method: apply direct pressure with dry sterile dressing
second method: tourniquet
third: hemostatic agent with direct pressure
17
Q
how do you control soft tissue injuries
A
direct pressure, elevate area
tourniquet if needed
18
Q
compartment syndrome
A
caused by compression of nerves, blood vessels, and muscle in a closed space within the body; tissue cannot receive adequate blood supply
19
Q
5 basic interventions for bleeding
A
- direct pressure for external bleeding
- high-flow oxygen
- place patient supine
- prevent heat loss
- high-priority transport
20
Q
epistaxis
A
noseblood
21
Q
superficial (first degree burns)
A
epidermal damage only
painful, red, no blisters
22
Q
partial thickness (second degree burns)
A
epidermal and partial dermal injury
painful, blisters present
23
Q
full thickness (third degree burns)
A
injury completely through dermal layer
dry, leathery skin; no pain
24
Q
strain
A
stretching injury to muscle or tendon
25
sprain
injury to ligament
26
what are the life threatening orthopedic injuries
- pelvic fractures (>hypovolemic shock, embolism, pneumonia, sepsis)
- femur fracture (can cause hypovolemic shock, pulmonary embolism)
- amputation (bleeding)
27
pelvic binder
commercial splint used to stabilize pelvis and reduce bleeding
28
when do you assess distal pulse, motor, and sensation (PMS) when splinting?
BEFORE AND AFTER
29
when splinting, where do you immobilize in relation to the injury
above and below
30
what should you do if the distal pulse is absent with a deformed injury?
make one attempt to realign with gentle in line traction (pulling) and reassess distal circulation
31
crepitus
a grating sound or sensation produced by friction between bone and cartilage or the fractured parts of a bone
32
what do you use a traction splint
closed, midshaft femur fractures
33
contraindications to a traction splint
open femur fracture, or injury to hip, knee, lower leg, or ankle on same side as femur fracture
34
linear skull fracture
skull fracture that does not present with a deformity or depression; there is a break in the bone, but it does not move the bone
35
depressed fracture
type of fracture usually resulting from blunt force trauma; comminuted fractures in which broken bones displace inward.
36
basal skull fracture (and symptoms)
occurs at the base of the skull. Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum. A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and may result in fluid leaking from the nose or ear.
37
cerebral contusion (and symptoms)
heterogeneous zone of brain damage that consists of hemorrhage, cerebral infarction, necrosis, and edema
signs include signs of concussion and at least one of the following:
decreasing mental status, unresponsive, pupillary changes, changes in vital signs, obvious behavioral abnormalities
38
epidural hematoma
bleeding beneath skull but above dura matter; extremely dangerous due to increase arterial bleeding and increased intracranial pressure
39
subdural hematoma
bleeding above brain
40
cardiac tamponade
when blood or other fluid accumulates in the pericardial sac and compresses the heart
41
what is beck's triad
indicates cardiac tamponade:
1. JVD
2. muffled heart sounds
3. hypotension
- also narrowing pulse pressure (difference between systolic and diastolic pressures)
42
what is a subcutaneous emphysema?
crackling sensation upon palpation due to air escaping the fatty tissue
43
hollow organs ____ their contents when injured; solid organs _____their contents when injured
```
hollow = spill
solid = bleed
```
44
orbital fractures can be indicative of what other injury
spinal injury; usually indicate extreme MOI
45
when do you remove an object in the cheek
if it is causing an airway obstruction
46
priorities for neck injuries
1. secure the airway
2. control life-threatening bleeding
3. apply occlusive dressing to large open neck injury to reduce risk of air embolism
47
how do you transport a knocked out tooth
rinse in saline and transport in saline-soaked gauze
48
is there shivering during extreme hypothermia?
no
49
vital signs during severe hypothermia
bradycardia, bradypnea, hypotension (vitals are so depressed, patient can appear in cardiac arrest)
50
what happens if you warm too rapidly
can cause ventricular fibrillation
51
should you rub frostbite/frostnip?
no
52
should you apply heat to frostbite/frostnip?
no
53
when you suspect heatstroke, where should you place cold packs?
groin, neck, armpits
54
how does cardiac output change during pregnancy?
increases by 30-40%
55
when is CPR, beginning with chest compressions, indicated for unresponsive children?
if their pulse is under 60 bpm
56
which medication is intended to decrease myocardial workload and increase myocardial blood flow?
nitroglycerin - vasodilator, so it can increase blood flow to the heart and reduce systemic vascular resistance
57
How does nitroglycerin work?
it is a vasodilator, so it can increase blood flow to the heart and reduce systemic vascular resistance
58
Your patient is unresponsive following blunt trauma to the head. Which of the following is the EMT's first priority for an unresponsive patient?
Determine if CPR is indicated
59
proximal vs. distal
```
proximal = closer to the midline
distal = farther away
```
60
You are caring for an apneic patient with a suspected overdose. You have loaded the patient into the ambulance and entered the patient compartment. You should first:
Put on your seat belt.
61
T/F Infants typically breathe through their nose
True
62
are infants more susceptible to hypoxia than adults?
Yes
63
is hypoxia is a common cause of bradycardia in infants?
yes
64
what is seesaw breathing
indicative of the severity of the airway obstruction
65
left side of the heart receives oxygenated blood from the _______
pulmonary veins
66
What provides oxygenated blood directly to the heart?
coronary arteries
67
What carries deoxygenated blood away from heart to the lungs
pulmonary arteries
68
The pulmonary veins are the only veins which carry _________ blood.
oxygenated
69
T/F The parasympathetic nervous system exerts control over digestive functions.
true
70
Nerve agents and choking agents are _____agents
chemical
71
How does aspirin work?
Aspirin reduces platelet aggregation in the coronary arteries
72
T/F primary assessment must be conducted before determining if an epi-pen should be administered.
True
73
You respond to a preschool facility for an ill child. Upon arrival, you find an unresponsive 8-month-old. The infant has a palpable pulse of 50 beats per minute. Your next action should be to:
begin chest compressions
74
what is the CAB sequence
for unresponsive patients - chest compressions first, then airway and breathing
75
what is the correct compression to ventilation ratio for two-person CPR on a child
15 compressions to 2 breaths
76
what is the correct compression to ventilation ratio (any age) with a single rescuer
30 to 2
77
what are the three components of circulation that should be included in the primary assessment?
Pulses, bleeding, and skin condition
78
where should you assess circulation in unresponsive patients over one year of age?
carotid pulse
79
when is rapid extrication indicated?
for patients with potential life-threatening injuries
80
what's the first priority for an unresponsive patient?
initiate CPR!!!!
81
what is supine hypotensive syndrome?
weight of the fetus and uterus compresses the inferior vena cava. This reduces the return of blood to the heart, reducing cardiac output and blood pressure.
82
solid organs
liver, spleen, kidneys, adrenal glands and pancreas (much more likely to cause internal bleeding)
83
hollow organs
stomach, intestines, gallbladder, bladder, and rectum (more likely lead to infection)
84
normal capillary refill time?
2 seconds
85
Peripheral vasodilation helps the body dissipate/conserve body heat.
dissipate; peripheral vasoconstriction helps the body conserve body heat
86
when should penetrating chest wounds be covered with an occlusive dressing?
before applying trauma dressing (and before continuing to assess vitals)
87
T/F Adult AED pads should be used on a pediatric patient if no pediatric pads are available.
True
88
how do you treat supine hypertensive syndrome
place the patient on the left side
89
Acute hypoglycemia causes sudden/gradual loss of consciousness
sudden b/c it's a sudden drop in blood glucose levels
90
T/F Manual c-spine precautions should be taken before applying a cervical collar, assessing PMS, or performing a secondary assessment.
True
91
how to tell difference between pneumothorax vs hemothorax
pneumothorax will have hyper-resonance to percussion, but a hemothorax will have a hypo-resonance to percussion
92
how long should you check for a pulse before starting CPR
10 seconds
93
coke overdose pupils
dilated pupils
94
graves disease
thyroid disease
| symptoms - bulging eyes, tachycardia
95
what is the most common cause of airway obstruction
the tongue
96
subtypes of distributive shock
sepsis, neurogenic, anaphlaxis
97
4 types of shock
cardiogenic, distributive, hypovolemic, obstructive
98
tension pneumothorax signs
affected side will have diminished lung sounds (b/c it is collapsing)
tachycardia
hypoxia
late stage sign - trachea will go over to the side that isn't being compressed
99
what's a risk factor for abruptae placenta
cocaine
100
which condition makes you cough up pink frothy sputum?
CHF (coughing up blood tinge)
101
signs of CHF
rales, pink frothy sputum, hypertension, JVD
102
what condition makes you cough up green yellow sputum
pneumonia - think infection
103
difference between CHF vs pneumonia
CHF = pink frothy sputum
| pneumonia - infection in body, yellow/green sputum, tachycardia, hypoxia
104
what should be secured to a backboard first
upper torso
105
patients with suspected shock should be placed in what position
supine
106
signs of decompensated shock
falling blood pressure, weak pulse, loss of consciousness, cold skin
107
what is systemic vascular resistence?
also called peripheral vasoconstriction
108
what is nasal flaring a sign of
pediatric respiratory distress
109
what is pursed lip breathing a sign of
COPD
110
what is respiratory alkalosis and the cause
high levels of carbon dioxide disrupt the blood’s acid-base balance
- breathing excessively (fever, hyperventilation, aspirin overdose, etc)
111
anticholinergic agents block ________nerves
parasympathetic
112
mallory weiss syndrome
partial tearing of the esophagus
113
unstable patients should be assessed every ___ minutes
5 minutes
114
how does albuterol work
relaxes bronchial muscles (bronchodilator)
115
right shoulder pain coupled with rigid distended abdomen can mean ____
lacerated liver
116
left upper quadrant pain can indicate a______
spleen injury
117
areas to assess in the rapid exam
head, neck, chest, abdomen, pelvis, extremities, back
