Trauma

Question 1

How much should you ventilate a pt who has signs of cerebral herniation?

Answer 1

20 breaths per min

Question 2

What nerves originate in the thoracic spine?

Answer 2

sympathetic nerves

Question 3

Injury of the sympathetic nerves in the thoracic spine inhibit the release of?

Answer 3

epinephrine and norepinphrine

Question 4

A deep partial thickness burn damages what layer of the dermis?

Answer 4

basal layer of the dermis

Question 5

What characteristics are associated with partial deep thickness burns?

Answer 5

edema, blisters and decreased sensation

Question 6

Three types of Distrubutive Shock

Answer 6

Sepsis, Anaphylactis, neurogenc

Question 7

How do you treat severe oropharyngeal bleed?

Answer 7

suction the airway for 15 seconds and ventilate for 2 minutes, then continue the alternating pattern until clear or until secured with an ET tube

Question 8

Can you give pt with severe epistaxis, oxymetazoline hydrochloride or phenylephrine hydrochloride to stimulate the alpha adrenergic receptors causing localized vasoconstriction.

Answer 8

yes

Question 9

What happens if pressure from injury to the face causes the retina out of the eye?

Answer 9

Irreparable damage or blindness

Question 10

How do you remove rust and metal from an eye?

Answer 10

They require removal from a physcian

Question 11

What is hyphema?

Answer 11

Bright red bleeding into the anterior chamber of the eye that obscures vision

Question 12

Symptoms of retinal detachment, separation of the inner layers of the retina from the choroid

Answer 12

flashing lights, specks, “floaters”, cloud or shade over the pt’s vision

Question 13

What eye injury is common in pt older than 50 years and is usually caused by thrombosis?

Answer 13

central retina vein occlusion which can cause necrosis of the retina and permanent damage to vision

Question 14

Signs and symptoms to of acid burn to the eyes

Answer 14

cornea will appear white and opaque, loss in vision, facial skin burns

Question 15

Alkalis is most commonly found in _________?

Answer 15

dry cleaner, lye, concrete

Question 16

What do alkaline burns to the eyes cause?

Answer 16

liquefactive necrosis, scarring of the cornea leading to permanent vision loss

Question 17

How do you treat chemical burns to the eye?

Answer 17

flush the eye with water or sterile saline solution

Question 18

what is conjunctivitis?

Answer 18

Eye becomes red, inflamed and produces tears

Question 19

What can cause superficial burns to the eyes?

Answer 19

UV rays from welding and sunlamp, snow blindness

Question 20

Double vision usually points to trauma involved in what?

Answer 20

extraocular muscles and fracture of the orbit

Question 21

what is dysconjugate gaze?

Answer 21

paralysis of gaze, or discoordination between the movement of the two eyes

Question 22

Can an abrasion to the eye be more painful when exposed to the air?

Answer 22

yes

Question 23

What topical anesthetic can relieve symptoms of corneal abrasion?

Answer 23

tetracaine

Question 24

What is sympathetic eye movement

Answer 24

the movement of both eyes in unison

Question 25

What should you avoid with injury to the globe of the eye?

Answer 25

Exert pressure or manipulate the globe

Question 26

What should you do if part of the globe is exposed?

Answer 26

gently apply moist, sterile dressing

Question 27

If you suspect hypema or rupture of the globe, you should take what kind of precautions?

Answer 27

spinal motion restriction

Question 28

What is one thing you can do to decrease intraocular pressure?

Answer 28

elevate the pt head 40 Hdegrees and avoid activities that may increase pressure, like coughing

Question 29

How do you treat an avulsed eye globe?

Answer 29

Cover the eye with moist, sterile dressing and stabalize both eyes, place in supine position to avoid eye fluid loss, transport

Question 30

For folks who have trouble keeping their eyes open while irrigating, what medication can you administer to anesthetize the eye?

Answer 30

tetracaine hydrochloride

Question 31

How do you treat for burns of the eye?

Answer 31

cover eyes with sterile, moist pad and eye shield, lay supine

Question 32

How do you treat chemical burns of the eye?

Answer 32

Irrigate immediately with water or saline only

Question 33

Should you remove a pt's eye contacts if you suspect eye injury?

Answer 33

no

Question 34

What is the only indication for removing contact lenses?

Answer 34

chemical burns to the eye

Question 35

How long should you irrigate the eye for alkali or strong acid burns?

Answer 35

20 minutes

Question 36

what should you do if you encounter an eye injury from the use of anhydrous ammonia (used while cooking meth)?

Answer 36

irrigate promptly

Question 37

The carilaginous pinna is complicated by what due to it's poor blood supply?

Answer 37

infection

Question 38

How do you handle an avulsed tooth?

Answer 38

only touch the crown of the tooth, rinse tooth in saline or milk, don't let the tooth dry

Question 39

Injuries to what zone of the neck have the highest mortality rate?

Answer 39

Zone 1 ( cricoid and clavicle)

Question 40

What is a special danger associated with open neck injuries where the jugular veins are exposed and air is sucked in during inhalation?

Answer 40

venous air embolism

Question 41

Signs of neurogenic shock

Answer 41

hypotension, normal or slow pulse rate, warm and dry

Question 42

what is mediastinitis?

Answer 42

inflammation of the mediastinum due to leakage of gastric content into the thoracic cavity

Question 43

A pt may still be able to use their diaphragm but lose control of their intercostal muscles if the spinal cord is damaged ?

Answer 43

below C5

Question 44

UNequal pupils is a result of pressure against on what structures?

Answer 44

ocular motor nerve

Question 45

During a refractory period, what happens to the cardiac cell?

Answer 45

It is unable to be stimulated

Question 46

What are high levels of carbon dioxide in the blood called?

Answer 46

hypercapnia

Question 47

What are sprains?

Answer 47

stretching or tearing of ligaments

Question 48

What is a strain?

Answer 48

stretching or tearing of a muscle or tendon

Question 49

When applying a backboard, scoop stretcher, vaccuum mattress it is essential to do what?

Answer 49

check CSM's

Question 50

Open fractures have a high or low risk of compartment syndrome?

Answer 50

high

Question 51

What do mast cells release as part of the body's response in the early stages of inflammation?

Answer 51

histamine

Question 52

What does histamine cause?

Answer 52

Dilation of blood vessels, increasing blood flow, redding, warmth in the area, swelling

Question 53

What is epithelialization?

Answer 53

a new layer of epithelial cells being built in this region

Question 54

How do you treat degloving injuries, unraveling of the skin from the hand?

Answer 54

irrigate and

Question 55

What does occult mean?

Answer 55

hidden

Question 56

What type of injuries have a high risk of neurovascular compromise bc of the ulnar nerve's and brachial artery location?

Answer 56

elbow injuries

Question 57

Order for tourniquet

Answer 57

direct pressure, elevate, tournequet

Question 58

What is an incision?

Answer 58

a clean linear cut

Question 59

What is a laceration?

Answer 59

a jagged wound that tears the tissue

Question 60

What is the most common injury associated with improper lifting techniques?

Answer 60

lumbar

Question 61

Signs and symptoms of shock

Answer 61

increased HR, increased RR, hypotension

Question 62

Referred left shoulder pain is caused by?

Answer 62

diaphragmatic irritation

Question 63

Difficulty seeing with a dark curtain blocking the vision

Question 64

What is a potential life-threatening complication of a long bone?

Answer 64

pulmonary embolism -fat embolis

Question 65

Cushing's Triad

Answer 65

bradycardia, irregular breath sounds, widening pulses, hypertension

Question 65

What is the disruption in the balance of procoagulants inhibitors thrombosis formation and lysis following a traumatic injury

Answer 65

disseminated intravascular coauglopathy

Question 65

Should a pt be taken to a Level 1 Trauma center is the pt has a GCS of 6 or less?

Answer 65

yes

Question 66

What type of penetrating trauma classifies for trauma level 1?

Answer 66

head, neck, torso, extremities proximal to the elbow or knee

Question 66

What respiratory rate classifies as level 1 trauma?

Answer 66

respiratory rate of less than 10 or greater than 29 breaths/min

Question 67

What systolic BP classifies as level 1 trauma?

Answer 67

70mm Hg for pt 0-9 90mm Hg for 10-64 110mm Hg for 65 yrs and older

Question 68

For high risk MVC, intrusion of what amount qualifies as trauma center?

Answer 68

12 inches for driver 18 inches for passenger/others

Question 69

What are the contraindications for aeromedical transport?

Answer 69

traumatic cardiac arrest, weather, obese, barotrauma

Question 70

Compression against the seat belt in an MVC may result in what?

Answer 70

ruptured bowl, bladder rupture, diaphragm tearing, spinal injuries

Question 71

What are the two major blood vessels in the abdomen?

Answer 71

Inferior vena cava and abdominal aorta

Question 72

What injuries can happen in a down and under pathway in an MVC?

Answer 72

fractured pelvis, femurs, hip dislocations, tibia fractures, spinal injuries

Question 73

Assume that pediatrics who follow the down and under pathway in an MCV have what?

Answer 73

pulmonary and cardiovascular injuries

Question 74

What often kills young patients in pedestrain vs driver?

Answer 74

TBI

Question 75

Lumbar spine axial loading results in what?

Answer 75

vertebral compression and burst fractures of T12-L1 and L2

Question 76

The vasomotor center of the medulla onblongata helps regulate what?

Answer 76

BP

Question 77

An artery that is incised across or transverse will often do what?

Answer 77

recoil

Question 78

What is the typical blood volume of an adult?

Answer 78

10 pints/5 L

Question 79

A femur fracture may result in a loss of how much blood?

Answer 79

2 pints/ 1 L

Question 80

What is a significant amount of blood loss for an infant>

Answer 80

3-6 ounces, 100-200mL

Question 81

What amount of blood loss in an adults causes signficant changes in vital signs, increase heart rate, decrease BP and increase respirations?

Answer 81

2 pints (1L)

Question 82

Bleeding tends to stop on it's in own within how many minutes?

Answer 82

10 minutes

Question 83

What are the steps of Hemostatis?

Answer 83

vasocrontriction, platlet aggregation, fibrin weaving into the clot

Question 84

What is hemophilia?

Answer 84

the lack of one or more clotting factors where bleeding may occur spontaneously

Question 85

What is the trauma triangle of death?

Answer 85

hypothermia, coagulapathy, acidosis

Question 86

What is coagilopathy?

Answer 86

distruption of the blood's ability to clot

Question 87

Hypoperfusion causes the cells to rely on what type of metabolism?

Answer 87

anerobic metabolism which releases acidic compounds

Question 88

What does acidosis in the blood cause to myocardial performance?

Answer 88

reduces performance, reduces oxygen delivery, increasing hypothermia

Question 89

What is hypovelemic shock?

Answer 89

inadequate volume -blood or fluids

Question 90

Crush injuries results in hypovelemic shock due to what?

Answer 90

blood and plasma loss from damaged vessels

Question 91

What are two examples of obstructive shock?

Answer 91

cardiac tamponade and tension pneumothorax

Question 92

What are late indications of shock?

Answer 92

hypotension and mental status

Question 93

How many minutes of direct pressure does an arterial bleeding require to form a clot?

Answer 93

5 or more minutes

Question 94

How long does TXA need to used within trauma?

Answer 94

Within 3 hours

Question 95

Do beta bloackers and calcium channel blockers, antidysrhythmic drugs interefere with the body's ability to compensate for shock?

Answer 95

yes

Question 96

What is hematuria?

Answer 96

blood in the urine

Question 97

Coffee ground emesis is a sign of what type of bleed?

Answer 97

upper GI bleed

Question 98

In the case of an animal bite, what should you do?

Answer 98

dry sterile dressings, rapid transport

Question 99

What are some key findings of brain injury?

Answer 99

posturing, hypotension or hypertension, abnormal pupils

Question 100

Ominous signs of cerebral herniation?

Answer 100

hypertension (widening pressures), bradycardia, cushings, posturing

Question 101

anterior cord syndrome

Answer 101

flexion injuries or fractures that displaces bony fragnents into the anterior portion of the spinal cord; loss of pain, temperature and touch perception

Question 102

Brown sequard syndrome

Answer 102

penetrating trauma; half dissection of the spinal cord, damage to all spinal tracts involved on that same side

Question 103

central cord syndrome

Answer 103

hyper extension injuries to cervical area that damage the dorsal column; hemorrage and edema