Trauma Flashcards
(375 cards)
1
Q
The leading killer of persons under age 44 in the United States is?
A
Trauma
2
Q
Injury caused by an object breaking the skin and entering the body
A
Penetrating trauma
3
Q
Injury caused by the collision of an object with the body in which the object does not enter the body
A
Blunt trauma
4
Q
Occurs when an arrow, bullet, knife or other object enters the body and exchanges energy with human tissue thereby causing injury
A
Penetrating trauma
5
Q
Injury that occurs as the energy and forces of collision with an object - not the object itself - enter the body and damage tissue
A
Blunt trauma
6
Q
Life treating problems such as _______ and _______ may occur with only subtle signs and symptoms
A
Internal bleeding and shock
7
Q
When assessing a trauma patient look beyond obvious injuries for evidence that suggests?
A
A life threatening condition
8
Q
Serious trauma is a surgical disease; its proper care is
A
Immediate surgical intervention to repair internal hemorrhage sites
9
Q
Commits resources to address all types of specialty trauma 24 hrs a day 7 days a wk
A
Level 1 - Regional Trauma Center
10
Q
Commits the resources to address the most common trauma emergencies with surgical capability available 24 hrs a day 7 days a wk; will stabilize and transport specialty cases to the regional trauma center
A
Level 2 - Area Trauma Center
11
Q
Commits to special emergency department training and has some surgical capability, but will usually stabilize and transfer seriously injured trauma pt’s to a higher level trauma center as needed
A
Level 3 - Community trauma center
12
Q
In remote areas, a small community hospital or medical care facility may be designated a trauma receiving facility, meaning that it will stabilize and prepare trauma patients with moderate to serious injuries for transport to a higher level facility
A
Level 4 - trauma facility
13
Q
A physical injury or wound caused by external force or violence
A
Trauma
14
Q
Neuro centers, burn centers, pediatric trauma centers and centers specializing in hand and limb re plantation by micro surgery
A
Specially Centers
15
Q
To help determine _______ Mentally recreate the accident from evidence available at the scene.
A
Mechanism of injury
16
Q
Guidelines to aid prehospital personnel in determining which trauma pt’s require urgent transportation to a trauma center.
A
Trauma triage criteria
17
Q
The process and forces that cause trauma
A
Mechanism of injury
18
Q
The information you gather during your consideration and reconsideration of the mechanism of injury suggest an
A
Index of suspicion for possible injuries
19
Q
Survival from trauma often depends on ?
A
The time from injury until the pt’s is in surgery
20
Q
The 60 minute period after a sever injury
A
The golden hour
21
Q
Primary pt assessment, emergency stabilization, pt packaging and initiation of transport should ideally take less than ?
A
10 min
22
Q
In applying trauma triage criteria, it is best to err on the side of
A
Precaution
23
Q
A data retrieval system for trauma pt’s information, used to evaluate and improve the trauma system
A
Trauma registry
24
Q
The most common cause of trauma death and disability?
A
Blunt trauma
25
Blunt trauma can be deceptive because the true nature of the injury is often hidden and evidence of the serious injury is?
Subtle or even absent
26
Is a branch of physics dealing with the forces of objects in motion and the energy exchanges that occur as objects collide
Kinetics
27
The law of inertia, as described by Sir Issac Newton and also known as
Newton's first law
28
A body in motion will remain in motion unless acted on by an?
Outside force
29
Tendency of an object to remain at rest or remain in motion unless acted on by an external force
Inertia
30
The process of changing place; movement
Motion
31
The capacity to do work in the strict physical sense
Energy
32
The energy an object has while it is in motion. It is related to the objects mass and velocity
Kinetic energy
33
A measure of the matter that an object contains; the property of a physical body that gives the body inertia
Mass
34
The rate of motion in a particular direction in relation to time
Velocity
35
The energy of an object in motion. It is a function of the object's mass and its velocity
Kinetic energy
36
Occurs when a body area is struck by or strikes an object
Blunt trauma
37
Events of vehicle collision:
* vehicle collision
* body collision
* organ collision
* secondary collision
* additional impacts
38
Results as the occupant contacts the vehicle's interior and slows or stops
Organ collisions
39
Occurs when a vehicle occupant is impacted by objects traveling within the auto.
Secondary collisions
40
Additional impacts occur when a vehicle receives a?
Second impact
41
Seat belt use should be mandatory for all
EMS personnel
42
Accounts for over half of the deaths in vehicular collisions
Up and over pathway
43
Application of the forces of trauma along the axis of the spine; this often results in compression fractures of the spine
Axial loading
44
The region of a vehicle designed to absorb the energy of impact
Crumple zone
45
Maintain a ________ of serious injury when assessing lateral impact collision because the degree of injury may be greater than the damage alone would indicate
Higher index of suspicion
46
Having a slanted position or direction
Oblique
47
Interferes with the pt's level of consciousness and masks signs and symptoms of injury
Alcohol
48
______ may be hard to differentiate from the signs of a head injury
Intoxication
49
Motor vehicle fatalities
By body area:
Head - 47.7%
Internal ( chest/abd/pelvic ) - 37.3%
Spinal and chest fracture - 8.3%
Fractures to the extremities - 2.0%
All other - 4.7%
50
Helmets reduce the incidence and severity of head injuries in motorcycle collisions but they have no effect on the incidence of
Spinal trauma
51
In pedestrian -vs- automobile collisions, adults tend to turn away from the on coming vehicle before impact while
Children turn toward it
52
An agent that enhances combustion of a fuel
Oxidizer
53
Area of over pressure that radiates outward from an explosion
Pressure wave
54
Underwater detonation increases the lethal range of an explosion
Threefold
55
Mechanisms associated with blasts:
* pressure wave
* blast wind
* projectiles
* personal displacement
* confined spaces and structural collapse
* burns
56
A rapid increase, then decrease in atmospheric pressure created by an explosion
Overpressure
57
The air movement caused as the heated and pressurized products of an explosion move outward
Blast wind
58
The most lethal explosions are those causing structural collapse followed by those in
Confined spaces
59
An agent that combusts easily or creates combustion
Incendiary
60
Primary blast injuries are caused by the heat of the explosion and the
Overpressure wave
61
Secondary blast injuries include trauma caused by
Projectiles
62
If the number of pt's exceeds the immediate capabilities of your EMS system
Employ disaster triage
63
The most common and serious trauma associated with explosion
Pulmonary injuries ( lung injuries )
64
Undissolved solid, liquid or gaseous matter in the blood stream that may cause blockage of blood vessels
Emboli
65
Labored or difficult breathing
Dyspnea
66
Expectoration of blood from the respiratory tract
Hemoptysis
67
Collection of air or gas in the pleural cavity between the chest wall and lung
Pneumothorax
68
Contact sports may result in the exchange of
Great kinetic force and produce serious injuries
69
Kinetic energy =
Mass (weight) X Velocity (speed)
_______________________________
2
70
The study of projectile motion and its interactions with the gun, the air and the object it contacts
Ballistics
71
The path a projectile follows
Trajectory
72
The outward motion of tissue due to a projectiles passage, resulting in a temporary cavity and vacuum
Cavitation
73
The size and shape of a projectile as it contacts a target; it is the energy exchange surface of the contact
Profile
74
Swing or wobble around the axis of a projectiles travel
Yaw
75
The portion of the bullet you would see if you looked at it as it traveled toward you
Profile
76
The anticipated outcome of a disease or injury
Prognosis
77
The damage done as the projectile strikes tissue, contuses and tears that tissue and pushes the tissue out of its way.
Direct injury
78
When a high velocity, high energy projectile strikes human flesh it creates a
Pressure shock wave
79
Is a space created behind the high energy bullet as tissue moves rapidly away from the bullets path
The temporary cavity
80
The movement that creates the temporary cavity crushes,stretches and tears
The affected tissue
81
Associated with most projectile wounds is a ______________ that extends beyond the permanent cavity
Zone of injury
82
Weapons such as knives, Ice picks, arrows or flying objects such as blast debris or wires thrown by a lawn mower can cause
Low velocity penetrating trauma
83
The tissue's connective strength and elasticity called__________, also influence how much tissue damage occurs with the kinetic energy transfer.
Resiliency
84
Solid organs such as the liver, spleen, kidneys, pancreas and brain have the density but not the resiliency of
Muscle and other connective tissue
85
Hollow organs such as the bowel, stomach, urinary bladder and heart are
Muscular containers holding fluid
86
Blood filling in the pericardial sac, thus limiting heart function
Pericardial tamponade
87
Injury to the lung tissue in cases of penetrating trauma is generally less extensive than can be expected with
Any other body tissue
88
Entrance wounds are usually the size of
The bullets profile
89
The exit wound is caused by the physical damage from both the passage of the bullet itself and from the
Cavitational wave
90
Since the pressure wave is moving forward and outward the wound may have a
Blown outward appearance
91
Make every effort to preserve evidence at a crime scene but remember that
Care of the pt takes priority
92
A _______ may more accurately reflect the potential damage caused by a bullets passage through the body than the __________?
Exit wound / entrance wound
93
A surgical incision into the cricothyroid membrane, usually to provide an emergency airway.
Cricothyrotomy
94
The introduction of a needle or other tube into the cricothyroid membrane, usually to provide an emergency airway
Cricothyrostomy
95
The loss of the body's most important medium, blood, is called
Hemorrhage
96
The transition between normal function ( homeostasis) and death is called
Shock
97
The paramedic must be able to recognize hemorrhage and shock on trauma pts in order to reduce
Mortality and morbidity
98
Types of hemorrhage:
* capillary
* venous
* Arterial
99
Capillary hemorrhage usually ________ from the wound and is normally ______ in coloration
Oozes / bright red - well oxygenated
100
Venous hemorrhage flows more quickly, though it too generally stops in a few minutes. Bleeding associated with with venous hemorrhage is generally __________ in coloration
Dark red because the blood has already given up its oxygen as it passed through the capillary beds o
101
Arterial hemorrhage flows rapidly often spurting from the wound. It is ________ and appears _______ in coloration as it escapes the wound
Well oxygenated / bright red
102
The body's response to local hemorrhage is a complex three-step process called
Clotting
103
Step in which smooth blood vessel muscle contracts, reducing the vessel lumen and the flow of blood through it
Vascular phase
104
To cluster or come together
Aggregate
105
Second step in the clotting process in which platelets adhere to blood vessel walls and to each other
Platelet phase
106
The third step in the clotting process which involves the formation of a protein called fibrin that forms a network around a wound to stop bleeding, ward off infection and lay a foundation for healing and repair of the wound
Coagulation
107
Protein fibers that trap red blood cells as part of the clotting process
Fibrin
108
Coagulation normally takes from
7-10 min
109
A clean lateral cut permits the vessel to retract and
Thicken its wall
110
A longitudinal cut to the vessel causes the wound to
Open
111
Method of hemorrhage control that relies on the application of pressure to the actual site of the bleeding.
Direct pressure
112
Use a tourniquet only as a
Last resort
113
A constrictor used on an extremity to apply circumferential pressure on all arteries to control bleeding
Tourniquet
114
Compound produced from pyruvic acid during anaerobic glycolyis
Lactic acid
115
Able to live w/o oxygen
Anaerobic
116
Employ this device only to halt persistent life threatening hemorrhage
Tourniquet
117
During the absence of perfusion, what accumulates in the stagnant blood?
Lactic acid, potassium and other anaerobic metabolites
118
If you must use a tourniquet use a
Wide cravat or belt or BP cuff. (Thin or narrow constricting devices may damage tissue)
119
Direct pressure on a wound or a combination of direct pressure and _________ work quite well in stopping the bleeding
Elevation
120
Hemorrhage is either
Internal or external
121
A fibrous membrane that covers, supports and separates muscles and may also unite the skin with underlying tissue
Fascia
122
Collection of blood beneath the skin or trapped within a body compartment
Hematoma
123
Humerus and tibia/fibula may account for ____________ of blood and bodily fluid loss
500-750 ml
124
Femur fractures may account for up to _______ ml of blood or bodily fluid loss
1500
125
Bleeding from the nose resulting from injury, disease or environmental factors
Epistaxis
126
Enlarged and tortuous esophageal veins
Esophageal varices
127
Black tarlike feces due to gastrointestinal bleeding
Melena
128
Rectal injury may be caused by
Pelvic fracture or direct trauma
129
Stage 1 hemorrhage is a blood loss up to
15% of the circulating blood volume
130
A reduction in the hemoglobin content in the blood to a point below that required to meet the oxygen requirements of the body
Anemia
131
Difference between the systolic and diastolic blood pressures
Pulse pressure
132
A hormone such as epinephrine or norepinephrine that strongly affects the nervous and cardiovascular systems, metabolic rate, temperature and smooth muscle
Catecholamine
133
Stage 2 hemorrhage occurs as
15 to 25% of the blood volume is lost
134
Blood loss of up to 15%, pt may display some nervousness and marginally cool skin with slight pallor
Stage 1 hemorrhage
135
Blood loss of 15 to 25%; pt displays thirst, anxiety, restlessness, cool, clammy skin, increased RR
Stage 2 hemorrhage
136
Blood loss between 25 and 35%; pt experiences air hunger, dyspnea, severe thirst, anxiety, restlessness; survival unlikely w/o rapid intervention
Stage 3 hemorrhage
137
Blood loss greater than 35% ; pulse barely palpable, respirations ineffective; pt lethargic, confused, moving toward unresponsiveness; survival unlikely
Stage 4 hemorrhage
138
In infants and young children, blood volumes approx _________ of body weight, volumes that are proportionally about _________ greater than those of adults
8 to 9% / 20%
139
Suspect hemorrhage early in cases of ______________ and treat aggressively
Child and infant trauma
140
Passage of stools containing red blood
Hematochezia
141
A decrease in BP that occurs when a person moves from a supine or sitting to an upright position
Orthostatic hypotension
142
Drop in the systolic BP of 20 mmHg or an increased or an increase in the pulse rate of 20 BPM when a pt is moved from a supine to a sitting position
Tilt test
143
Is stool with frank blood in it and reflects active bleeding in the colon or rectum
Hematochezia
144
A simple medical definition of shock is
A state of inadequate tissue perfusion
145
The total changes that take place in an organism during physiological process
Metabolism
146
A blockage in the delivery of oxygenated blood to the cells
Ischemia
147
The pressure of liquids in equilibrium; the pressure exerted by or within liquids
Hydrostatic pressure
148
Group of red blood cells that are stuck together
Rouleaux
149
Release of accumulated lactic acid, carbon dioxide (carbonic acid), potassium and Rouleaux into the venous circulation
Washout
150
Hemodynamic insult to the body in which the body responds effectively. Signs and symptoms are limited and the human system functions normally
Compensated shock
151
Continuing hemodynamic insult to the body in which the compensatory mechanisms break down. The signs and symptoms become very pronounced and the pt moves rapidly toward death
Decompensated shock
152
The initial shock state
Compensated shock
153
Begins as the body's compensatory mechanisms become unable to respond to a continuing blood loss
Decompensated shock
154
Final stage of shock in which organs and cells are so damaged that recovery is impossible
Irreversible shock
155
The most practical choice for prehospital fluid resuscitation is
Lactated Ringer's solution
156
The ideal catheter for the shock pt is
1 1/2 or shorter
157
Skin consisting of the epidermis, dermis and subcutaneous layers
Integumentary system
158
Closed wound in which the skin is unbroken, although damage has occurred to the tissue immediately beneath
Contusion
159
General reddening of the skin due to dilation of the superficial capillaries
Erythema
160
Blue-black discoloration of the skin doe to leakage of blood into the tissue
Ecchymosis
161
Collection of the blood beneath the skin or trapped within a body compartment
Hematoma
162
Mechanism of injury in which tissue is locally compressed by high pressure forces
Crush injury
163
Systemic disorder of severe metabolic disturbances resulting from the crush of a limb or other body part
Crush syndrome
164
Scraping or abrading away of the superficial layers of the skin; an open soft tissue injury
Abrasion
165
An open wound normally a tear with jagged borders
Laceration
166
Natural patterns in the surface of the skin revealing tension within
Tension lines
167
Very smooth or surgical laceration, frequently caused by a knife, scalpel razor blade or piece of glass
Incision
168
Specific soft tissue injury involving a deep narrow wound to the skin and underlying organs that carries and increased danger of infection
Puncture
169
Foreign body embedded in a wound
Impaled object
170
Forceful tearing away or separation of body tissue; may be partial or complete
Avulsion
171
Avulsion in which the mechanism of injury tears the skin off the underlying muscle, tissue, blood vessels and bone
Devolving injury
172
Severance, removal, or detachment either partial or complete of a body part
Amputation
173
The body's natural ability to stop bleeding ; the ability to clot blood
Hemostasis
174
New growth of the capillaries in response to healing
Neovascularization
175
Complex process of local cellular and biochemical changes as a consequence of injury or infection; an early stage of healing
Inflammation
176
Chemicals released by white blood cells that attracts more white blood cells to an area of inflammation
Chemotactic factors
177
White blood cells charged with the primary purpose of neutralizing foreign bacteria
Granulocytes
178
Immune system cell that has the ability to recognize and ingest foreign pathogens
Macrophage
179
Early stage of wound healing in which epithelial cells migrate over the surface of the wound
Epithelialization
180
Tough, strong protein that comprises most of the body's connective tissue
Collagen
181
Specialized cells that form collagen
Fibroblast
182
Stage in the wound healing process in which collagen is broken down and relaid in an orderly fashion
Remodeling
183
Inflammation of the lymph channels, usually as a result of a distal infection
Lymphangitis
184
Deep space infection usually caused by the anaerobic bacterium Clostridium perfringens
Gangrene
185
The body's main structural protein.
Collagen
186
One of the rarest and most and most feared wound complications is
Gangrene
187
A cellular component of blood, similar to plasma
Serous fluid
188
Muscle ischemia that is caused by rising pressures within an anatomical fascial space.
Compartment syndrome
189
Excessive scar tissue that extends beyond the boundaries of the wound
Keloid
190
Tissue death usually from ischemia
Necrosis
191
Acute pathologic process that involves the destruction of skeletal muscle
Rhabdomyolysis
192
It is important to note that compartment syndrome rarely occurs within the first
4 hrs
193
Alter the usual substance of something
Denature
194
Explanation of the physical effects of thermal burns
Jackson's theory of thermal wounds
195
Area in a burn nearest the heat source that suffers the most damage and is characterized by clotted blood and thrombosed blood vessels.
Zone of coagulation
196
Area in a burn surrounding the zone of coagulation that is characterized by decreased blood flow
Zone of stasis
197
Area peripheral to a burn that is characterized by increased blood flow.
Zone of hyperemia
198
First stage of the burn process that is characterized by a catecholamine release and pain-mediated reaction
Emergent phase
199
Stage of the burn process in which there is a massive shift of fluid from the intravascular to the extravascular space
Fluid shift phase
200
The volume contained by all the arteries, veins,capillaries and other components of the circulatory system
Intravascular space
201
The volume contained by all the cells (intracellular space) and the spaces between the cells (interstitial space)
Extravascular space
202
Stage of the burn process in which there is increased body metabolism in an attempt by the body to heal the burn.
Hypermetabolic phase
203
Final stage of the burn process in which scar tissue is laid down and the healing process is completed.
Resolution phase
204
The difference of electric potential between two points with different concentrations of electrons
Voltage
205
The process in which an acid, while destroying tissue forms an insoluble layer that limits further damage
Coagulation necrosis
206
The process in which an alkali dissolves and liquifies tissue
Liquefaction necrosis
207
The trauma system is predicted on the principle that serious trauma is a
Surgical disease
208
Serious trauma is a surgical disease, it's proper care is immediate surgical intervention to repair
Internal hemorrhage sites
209
What is the second part of the law of inertia
"A body at rest will remain at rest unless acted on by an outside force"
210
The liver is suspended in the abdomen by the
Ligamentum teres
211
Events of a vehicle collision:
* vehicle collision
* body collision
* organ collision
* secondary collision
* additional impacts
212
Types of vehicle impacts:
* rotational (38%)
* frontal (32%)
* lateral (15%)
* rear-end (9%)
* rollover (6%)
213
The up and over pathway accounts for __________ of the deaths in vehicular collisions
Over half
214
The unrestrained occupant slides downward as the vehicle comes to a stop
Down and under pathway
215
An injury process frequently associated with steering wheel impact is the
Paper bag syndrome
216
The heart which is not firmly attached in the central thorax moves violently toward the impact as the body
Accelerates
217
Occupants of a vehicle with a limited crumple zone may experience greater forces in a collision even though damage to the vehicle itself may not appear as severe as damage to a vehicle with a
Greater crumple zone involved in a similar collision
218
The lethal range for an explosive charge increased threefold with an
Underwater detonation
219
The extreme pressure damages or ruptures the thin and delicate alveolar walls, resulting in fluid accumulation, hemorrhage and possibly even
The entry of air directly into the blood stream from the alveoli
220
Coughing up of blood or blood -tinged sputum
Hemoptysis
221
Pressure of ventilations may induce ____________? By pushing air past blast-induced lung defects and into the pleural space
Pneumothorax
222
Pressure can disrupt blood flow to and through the limb causing
Anaerobic metabolism and some tissue death
223
Another consequence of the release of the crushing pressure is severe and difficult to control
Hemorrhage
224
If you double the mass of an object it will have twice the kinetic energy of the speed of the object
Remains the same
225
The ______ or _______ of an object has a squared relationship to its kinetic energy
Speed or velocity
226
Mass(weight) x velocity (speed) /2
Kinetic energy
227
Factors associated with the damage pathway of a projectile wound:
* direct injury
* pressure shock wave
* cavitation
* temporary cavity
* permanent cavity
* zone of injury
228
Filling of the pericardial sac with fluid which in turn limits the filling and function of the heart
Pericardial tamponade
229
Any large penetrating wound may permit air to be drawn into an open external jugular vein and immediately threaten life due to the resulting
Pulmonary emboli
230
A bullets exit wound often has a ___________ appearance
Blown outward
231
An exit wound may more accurately reflect the potential damage caused by a bullet's passage through the body than the
Entrance wound
232
Types of hemorrhage:
* capillary
* venous
* arterial
233
Certain categories of pt's - pregnant women, athletes, children and the elderly react different to
Blood loss
234
The blood volume of a woman in late pregnancy is _______ greater than normal
50%
235
The pelvic fracture can acct for blood loss of more than
2000 mL
236
The femur fracture can acct for up to _______ blood loss
1500 mL
237
A tibia / fibula or humerus fracture may contribute to a blood loss of
500 to 750 mL
238
Hematomas and large contusions may acct for a blood loss up to
500 mL
239
Extreme of Motion:
* hyperextension
* hyperflexion " kiss the chest "
* excessive rotation
* lateral bending
240
The sympathetic nervous system and the hormones it releases begin progressive response as hemorrhage causes blood to leave the
Cardio vascular system
241
Compensated shock:
* pulse rate increases
* pulse strength decreases
* skin becomes cool and clammy
* pt feels progressing anxiety, restlessness, combative
* pt experiences thirst, weakness, eventual air hunger
242
Decompensated shock:
* pulse becomes impalpable
* BP drops precipitously
* pt becomes unconscious
* respirations slow or cease
243
Irreversible shock:
Shortly after the pt enters Decompensated shock, the lack of circulation begins to have profound effects on body cells. As they are irreversibly damaged, the cells die, tissue dysfunction, organ dysfunction and the pt dies
244
Skin consisting of the epidermis , dermis, and subcutaneous layers
Integumentary system
245
Most common types of trauma injuries are?
Soft- tissue injuries
246
Closed wound in which the skin is unbroken, although damaged has occurred to the tissue immediately beneath.
Contusion
247
Blunt, nonpenetrating injuries that crush and damage small blood vessels
Contusions
248
General reddening of the skin due to dilation of the superficial capillaries
Erythema
249
Blue-black discoloration of the skin due to leakage of blood into the tissue
Eccymosis
250
Collection of blood beneath the skin or trapped within a body compartment
Hematoma
251
Mechanism of injury in which tissue is locally compressed by high pressure forces
Crush injury
252
Systemic disorder of severe metabolic disturbances resulting from the crush of a limb or other body part
Crush syndrome
253
Scraping or abrading away of the superficial layers of the skin; an open soft tissue injury
Abrasion
254
An open wound, normally a tear with jagged borders
Laceration
255
Natural patterns in the surface of the skin revealing tensions within
Tension lines
256
Very smooth or surgical laceration, frequently caused by a knife, scalpel, razor blade, or piece of glass
Incision
257
Specific soft- tissue injury involving a deep narrow wound to the skin and underlying organs that carries an increased danger of infection
Puncture
258
Foreign body embedded in a wound
Impaled object
259
Forceful tearing away or separation of body tissue, may be partial or complete
Avulsion
260
Occurs when a flap of skin, although torn or cut is not torn completely loose from the body
Avulsion
261
Avulsion in which the MOI tears the skin off the underlying muscle, tissue , blood vessels and bone
Degloving injury
262
Severance, removal, or detachment either partial or complete of a body part
Amputation
263
The body's natural ability to stop bleeding, ability to clot blood
Hemostasis
264
Early stage in wound healing in which epithelial cells migrate over the surface of the wound
Epithelialization
265
Complex process of local cellular and biochemical changes as a consequence of injury or infection
Inflammation
266
Chemicals released by white blood cells that attract more white blood cells to an area of inflammation
Chemotactic factors
267
White blood cells charged with the primary purpose of neutralizing foreign bacteria
Granulocytes
268
Immune system cell that has the ability to recognize and ingest foreign pathogens
Macrophage
269
Process in which a cell surrounds and absorbs a bacterium or other particle
Phagocytosis
270
Early stage of wound healing in which epithelial cells migrate over the surface of the wound
Epithelialization
271
The body responds to this increased demand by generating new blood vessels in a process called
Neovascularization
272
New growth of capillaries in response to healing
Neovascularization
273
Tough strong protein that comprises most of the body's connective tissue
Collagen
274
Specialized cells that form collagen
Fibroblasts
275
Stage in the wound healing process in which collagen is broken down and relaid in an orderly fashion
Remodeling
276
Inflammation of the lymph channels usually as a result of a distal infection
Lymphangitis
277
Deep space infection usually caused by the anaerobic bacterium Clostridium perfringens
Gangrene
278
Tetanus is caused by
Bacterium Clostridium tetani
279
A formation resulting from overproduction of scar tissue
Keloid
280
A cellular component of blood similar to plasma
Serous fluid
281
Muscle ischemia that is caused by rising pressure within an anatomical fascial space
Compartment syndrome
282
During the healing process, scar tissue sometimes develops abnormally. A ________ is excessive scar tissue that extends beyond the boundaries of a wound
Keloid
283
Tissue death usually from ischemia
Necrosis
284
Acute pathologic process that involves the destruction of skeletal muscle
Rhabdomyolysis
285
Dressings:
* sterile / nonsterile
* occlusive / nonocclusive
* adherent / nonadherent
* absorbent / nonabsorbent
* wet/ dry
286
Bandages
* self - adherent roller
* gauze
* adhesive
* elastic
* triangular
287
In addition to questioning the pt and inspecting the body regions, you should palpate the body's
Entire surface
288
The wound should be observed in such a way that it can later be
Described to the attending physician
289
The three objectives of bandaging are?
Control bleeding
Keep wound clean
Immobilize the wound site
290
To halt hemorrhage, apply form pressure to the site for at least
10 min
291
Do not use a tourniquet unless you cannot control bleeding by
Any other means
292
Once in place a tourniquet should be left in place until the pt arrives at the
Emergency room
293
Only remove impaired objects that obstruct the
Airway or prevent CPR
294
Basic types of burns:
* thermal
* electrical
* chemical
* radiation
295
Explanation of the physical effects of thermal burns
Jackson's theory of thermal wounds
296
Area in a burn nearest the heat source that suffers the most damage and is characterized by clotted blood and thrombosed blood vessels
Zone of coagulation
297
Area in a burn surrounding the zone of coagulation that is characterized by decreased blood flow
Zone of stasis
298
Area peripheral to a burn that is characterized by increased blood flow
Zone of hyperemia
299
First stage of the burn process that is characterized by a catecholamine release and pain-mediated reaction
Emergent phase
300
Stage of the burn process in which there is a massive shift of fluid from the intravascular to the extravascular space
Fluid shift phase
301
Stage of the burn process in which there is increased body metabolism in an attempt by the body to heal the burn.
Hypermetabolic phase
302
Final stage of the burn process in which scar tissue is laid down and the healing process is completed
Resolution phase
303
The process in which an acid, while destroying tissue forms an insoluble layer that limits further damage
Coagulation necrosis
304
The process in which an alkali dissolves and liquefies tissue.
Liquefaction necrosis
305
Usually form a thick, insoluble mass where they contact tissue through coagulation necrosis limiting burn damage.
Acids
306
Usually continue to destroy cell membranes through liquefaction necrosis, allowing them to penetrate underlying tissue and causing deeper burns
Alkalis
307
Alpha radiation:
Very weak, stopped by paper clothing or epidermis
308
Beta radiation:
More powerful than alpha; can travel 6-10 ft through air ; can penetrate some clothing and the first few mm of the skin
309
Gamma radiation:
Most powerful ionizing radiation; great penetrating power; protection requires thick concrete or lead shielding
310
Great penetrating power but uncommon outside nuclear reactors and bombs
Neutron
311
Referring to the upper airway
Supraglottic
312
Suspect __________ in any pt who was in an enclosed space during combustion
Carbon monoxide poisoning
313
Inhalation injury may be associated with burns, especially if the injury occurred in an
Enclosed space
314
Factors affecting exposure to radiation:
* Time
* Distance
* Shielding
315
Referring to the lower airway
Subglottic
316
Super heated steam is a common cause of
Airway burns
317
A burn that involves only the epidermis; characterized by reddening of the skin also called a first degree burn
Superficial burn
318
Burn in which the epidermis is burned through and the dermis is damaged; characterized by redness and blistering also called second degree burn
Partial- thickness burn
319
Stridor or high pitched "crowing" sounds on inspiration are ominous signs of
Impending airway obstruction
320
Amount of a pt's body affected by a burn
Body surface area (BSA)
321
Method of estimating amount of body surface area burned by a division of the body into regions, each of which represents approx. 9% of total BSA plus 1% genitalia region
Rule of nines
322
With burns cover 10% of body with a burn sheet soaked in
Normal saline ( Local cooling )
323
Critical burns
Partial >30% BSA
Full >10% BSA
324
Any partial or full thickness involving hands, feet, joints, face, or genitalia
Inhalation injury
325
Hard leathery product of a deep full - thickness burn; it consists of dead and denatured skin.
Eschar
326
Burns cause several systemic complications. These can affect the overall severity of a burn. Typical complications include
Hypothermia, hypovolemia, Eschar formation, and infection
327
If any of the clothing adheres to the burn or resists removal,
Cut around it as necessary
328
Burns to the face, hands, feet, joints, genitalia and circumferential burns are of
Special concern
329
Serious burns and the associated scar tissue make thermal hand or foot injuries very debilitating. Assess these areas and communicate the precise location of the injury and the degree of the burn to the
Receiving physician
330
Pay particular attention to burns that completely ring an extremity which includes the
Thorax, the abdomen, or the neck
331
Carefully assess any burn encircling a part of the body for
Distal circulation or other signs of vascular compromise
332
Burn severity: Minor
Superficial: BSA
333
Burn severity: Moderate
Superficial: BSA > 50%
Partial thickness:
334
Burn severity: Critical
Partial thickness: BSA > 30%
Full thickness: BSA > 10%
Inhalation injury
Any partial - or full- thickness burns involving hands, feet, joints, face or genitalia
335
4 mL x PT weight in kg x BSA burned = amount of fluids over 24 hrs
Parkland burn formula - used for burn tx in hx
336
Cool water immersion of minor localized burns may be effective if accomplished in
The first few min after a burn
337
Cover extensive partial and full thickness burns with
Dry sterile dressing, keep pt warm and initiate fluid resuscitation
338
Use soft nonadherent dressing between areas of
Full thickness burns, between fingers and toes to prevent adhesion
339
Twitching of the eyelids
Blepharospasm
340
Injury resulting from over stretching of muscle fibers
Strain
341
Tearing of a joint capsules connective tissue
Sprain
342
Grades of sprains:
Grade 1- minor and incomplete tear.
Grade 2 - significant but incomplete tear.
Grade 3 - complete tear of the ligament
343
Partial displacement of a bone end from its position I a joint capsule
Subluxation
344
Complete displacement of a bone end from its position in a joint capsule
Dislocation
345
This type of injury carries with it the danger of entrapping, compressing or tearing blood vessels and nerves
Dislocations
346
A pins and needles sensation
Paresthesia
347
Small crack in a bone that does not disrupt its total structure
Hairline fracture
348
Break in a bone in which the bone is compressed on itself
Impacted fracture
349
A break that runs across a bone perpendicular to the bones orientation
Transverse fracture
350
Break in a bone running across it at an angle other than 90 degrees
Oblique fracture
351
Fracture in which a bone is broken into several pieces
Comminuted fracture
352
A curving break in a bone as may be caused by rotational forces
Spiral fractures
353
Break in a bone associated with prolonged or repeated stress
Fatigue fracture
354
Partial fracture of a child's bone
Greenstick fracture
355
Weakening of bone tissue due to loss of essential minerals especially calcium
Osteoporosis
356
A gradual progressive decrease in bone mass and collagen structure begins at about age 40 and results in bones that are
Less flexible, more brittle and more easily fractured
357
Fractures near joints are more likely to compress or s
Sever blood vessels or nerves
358
Areas around the joints are further endangered because blood vessels supplying the epiphysis enter the long bone through the
Diaphysis
359
Thickened area that forms at the site of a fracture as part of the repair process
Callus
360
Acute or chronic inflammation of the small synovial sacs
Bursitis
361
Inflammation of a tendon and/or its protective sheath
Tendonitis
362
Inflammation of a joint
Arthritis
363
Inflammation of a joint resulting from wearing of the articular cartilage
Osteoarthritis
364
Pelvic fracture may account for hemorrhage of more than
2 liters
365
A femur fracture may account for as much as
1,500 mL of blood loss
366
The six P's
* pain
* pallor
* paralysis
* paresthesia
* pressure
* pulses
367
Place the limb in a position of ________ whenever possible
Function
368
Generally you should not attempt alignment of dislocations and serious injuries within _________ of a joint.
3 inches
369
Only attempt to manipulate such injury sites if the distal circulation is
Compromised
370
Immobilize the joint ______ and the joint _______the injury regardless of whether the injury occurs at a joint or mid shaft in a long bone.
Above and below
371
Is a comfortable splint for ankle and foot injuries
Pillow splint
372
Attempt reduction of a dislocation only when you are sure the injury is a dislocation, when you expect the pt's arrival at the emergency dept to be delayed or when there is a significant
Neurovascular deficit
373
Generally a femur fracture presents with the foot turned outward and the injured limb shortened when compared to
The other leg
374
The anterior dislocation presents with the foot turned outward, the hip and knee flexed and the head of the femur sometimes
Palpable in the inguinal area
375
Another concern with the knee injury is possible injury to the major blood vessel traversing the area the,
Popliteal artery
