Trauma Form/s,Def/s, #s

Question 1

!!!Parkland Burn Form for:
form:

Answer 1

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

Question 2

Parkland Burn Form for:
form:

Answer 2

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

Question 3

(60%) Fluid compartments % of water:

Answer 3

45% intracellular
15% extracellular (outside cell)
Interstitial 10.5% Intravascular 4.5%

Question 4

(Blood vol/ loss) Pelvis:
Femur:
Humorous:

Answer 4

= 2-3Liters
= 1.5Liters per femur
= 750ml per humorous

Question 5

(Burn depth) 2nd degree:

Answer 5

= Partial, EPi & Dermis burned: intense pain, fluid shift comes up thus blisters, RED to WHITE, moist & mottled w/ shifts

Question 6

(Burn depth) Degrees:

Answer 6

= 1st/Superficial, 2nd/partial, 3rd/full/complete

Question 7

(Class II Hemorrhage) 1 injuries:
2Compensation for blood:
3Blood Loss: 15 - 30%
4Pulse:
5Blood Pressure:
6Pulse Pressure:
7Capillary Refill:
8Ventilation Rate:
9Urine Output (mL/hr):
10Mental Status:

Answer 7

1= 1/2 Humorous fractures, a femur fracture, 1 full Hemopneumo
2= 1st line comp/ no longer maintain perfusion & 2ndary employed
3= 15 - 30% 750mLs-1.5L
4= > 100BPM
5= Normal
6= Starts to narrow
7= 2-3 secs
8= 20-30RR
9= (mL/hr) 20-30
10= Mildly Anxious

Question 8

(Class III Hemorrhage)1 injuries/fractures:
2 Compensation to blood:

3 Blood Loss:
4 Pulse:
5 Blood Pressure:
6 Pulse Pressure:
7 Capillary Refill:
8 Ventilation Rate:
9 Urine Output (mL/hr):
10 Mental Status:

Answer 8

1= 2 Humorous, 1-2femur, 1 full Hemopneumo
2= Both 1&2nd comp/ responses failing to maintain perfusion & entering/in Decompensated Shock! (SBP <90)
3= Blood Loss: 30 - 40%, (1500 - 2000 mL’s)
4= >120
5= Starts to decrease
6= Narrows more
7= 3-4secs
8= 30-40
9= 5-10mL/hr
10= Anxious/Confused

Question 9

(Class IV Hemorrhage) 1 injuries:
2= Compensation to blood:
3= blood loss:
4= Pulse:
5= Blood Pressure:
6= Pulse Pressure:
7= Capillary Refill:
8= Ventilation Rate:
9= Urine Output (mL/hr):
10= Mental Status:

Answer 9

1= GSWs, multiple major fractures, Pelvis
2= Irreversible Shock!
3= > 40% (>2000mLs) of total blood
4= > 140 & barely palpable in central arteries
5= Very low
6= Narrows more
7= > 5 seconds
8= > 40 or agonal
9= Negligible
10= Lethargic or Unconscious

Question 10

(Critical Criteria) 3rd & 2nd Degree criteria:
Any 2nd or 3rd degree burns involving:
Burn types that’re critical & Rx:

Answer 10

= 3rd>10% & 2nd>30%
= Face, Hands, Genitalia, Circumferential, Feet, (Dipping), Airway
= Chem, high voltage, Burns w/ major trauma go trauma center 1st then burn center

Question 11

(Non& Hemorrhagic treatment) If hemorrhage can be controlled:
If hemorrhage cannot be controlled:

Med for Sig/hemorrhage, in/external (after external controlled)

Answer 11

= IV/IO therapy (don’t delay transport) can administer 20 mL/kg bolus.
=administer just enough IV fluid to obtain a radial pulse (permissive hypotension therapy!)NO MORE SBP 80-90 (IV fluids Warm)
= Tranexamic Acid (TXA) Adult 1G/10 mins (mix in 50 mL of NS) follwed w/ 1G/8Hrs (500 mL bag) & Pediatric Not recommended

Question 12

(Thermal burn phases) Hypermetabolic phase:

Answer 12

3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)

Question 13

(Thermal burn phases) Resolution phase:

Answer 13

4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth

Question 14

(Trauma centers) Lvl 1:
Lvl 2:

Lvl 3:
Lvl 4:

Answer 14

= 1 (18tx) med-uni teaching, best care, everything to Neurovascular
= 2 (23 tx) everything BUT neuro, area trauma, surgical care capable all times, typically not teaching
= 3 general hospital w/ some special staff, TIB-FIB, try avoid w/ severe
= 4 basic ER, can stable but bandage, foot ran over

Question 15

(Wallace Rule of 9s) used only for:
Adult %s:
infants (0-1):
Form:

Answer 15

= burns >10%
= 1 genitals, 9 head thoracic & ABDMN, distal anterior (applies to other areas) arm 4 ½
= head 18, arm 9, legs 13.5, 18 front thoracic & ABDMN
= # of child -1 > take away from head then give to each leg (Applicable up 10y/o) For every year beyond age 1, subtract 1 from head / that # & add it evenly between the 2 legs.

Question 16

1Lymphatic system:

2Lymph node:
3Spleen relation:
4Lymphatic pathway:
5Sign lymphatic system not working:

Answer 16

1= “body’s garbage system” macrophages eats then system of channels to tissues 1 direction, no pump, dumps into a node
2= were garbage collects
3= Carries “trash” of pathogen destruction to nodes for macrophages
4= >Vessels> nodes> spleen> up to L/R subclavian vein, to kidneys
5= Gray poop

Question 17

Class 1 hem:
Class 2 hem:
Class 3 hem:
Class 4 hem:

Answer 17

= max15% (750 mL’s) SNS main compensatory
= 15-30% (750-1500 mL’s)RAAS
= 30-40% (1.5-2L’s) comp to decomp SBP90
= >40% (>2Ls) irreversible

Question 18

1Stages of healing:

Answer 18

1= Hemostasis, Inflam/, Epithelialization, Neovasc/, Collagen synthesis

Question 19

1Hemostasis:
2Inflammation:
3Epithelialization:
4Neovascular:
5Collagen synthesis:

Answer 19

1= vaso/strict, platelet aggregate, coagulation fibrin (normothermic)
2= Granulocytes, macrophages & Lymphocytes eat, Mast cells released
3= “rebuild” epithelial cells go to wound making scab ~48Hrs after cut
4= new capillaries made (neo new) via previous cap/s +exchanging
5 = fibroblasts go to wound & synthesize collagen creating scar (w/ tension lines quicker/better), Too much synthetization makes Keloid

Question 20

2 cyanide antidote regimens are available:

Sodium nitrite dose :
Sodium thiosulfate dose:

Answer 20

= Pasadena cyanide kit (amyl nitrite, Na nitrite, & Na thiosulfate) & newer antidote Cyanokit (hydroxocobalamin)
= 300 mg sodium nitrite over 2 to 4 minutes for adults.
= administer 12.5 g of for the adult.

Question 21

MVC) Phase 1:
Phase 2:
Phase 3:
Phase 4:
Phase 5:

Answer 21

= Vehicle collision (P1) deceleration
= Body collision (P2) decel/ of occupant
= Organ collision (P3) decel of internal
= 2ndary collision (P4) objects in car
= (P5) car rear end, trees,

Question 22

1 (Burn depth) 3rd degree:
2 feeling & appearance:

Answer 22

1= full thickness burn down to SCT may involve M. bone & organs
2= leather, looks Charred, dark brown or white, hard to touch “painless”

Question 23

% of all Trauma deaths:
% of GSW account for HT death:
%s of penetrating neck trauma:
%s of penetrating chest trauma are fatal:
% of great vessels injuries & due to:
minimal diameter for sucking chest wound

Answer 23

= 50% of all Trauma deaths is head trauma
= 35% GSW account for Head Trauma deaths
= 5-10% penetrating neck trauma (airway & neuro
= 70-80% penetrating chest fatal
= 90% all great vessels injuries due to a penetrating MOI
= At least ¾inch for penetrating Chest wounds to turn sucking

Question 24

Adult Men weight from:
Adult Women weight from:

Answer 24

=50 kg + 2.3 kg X (Height (in)- 60)
=45.5 kg + 2.3 kg X (Height (in)-60)

Question 25

1 Adults for the Rules of Nines, the head is awarded: 2 Adults for the Rules of Nines, the genitalia is awarded: 3 Adults for the Rules of Nines, the posterior trunk is awarded: 4 Adult for the Rules of Nines, each arm is awarded: 5 Adults for the Rules of Nines, each leg is awarded: 6 Adults for the Rules of Nines, the anterior trunk is awarded:

Answer 25

1= 9 % of body surface area. 2= 1 % of body surface area. 3= 9 % of body surface area. 4= 18 % of body surface area. 5= 18 % of body surface area. 6= 18 % of body surface area.

Question 26

Afferent nerves: Efferent nerves:

Answer 26

=sensory nerves “ahhh” =motor “effect”

Question 27

Any eye trauma PT: Zofran contra=

Answer 27

= vomiting &/ B/c +ocular pressure = prolonged QT

Question 28

AUTOPED) 1st impact: 2nd impact: 3rd impact: Off-road injuries: Kids Waddell's triad:

Answer 28

= auto strikes body = pedestrian thrown = body strikes ground or object = pop increased, usually remote areas, offer less protection, = turn toward bumper b/c stupid, bumper hits kids pelvis & femur, chest & ABDMN hit grill, head strikes ground b/c buckethead

Question 29

Shock & perfusion definitions:

Answer 29

= Perfusion: Adequate supply of well oxygenated blood & nutrients to all vital organs = Shock: body's lack of perfusion

Question 30

Beta radiation can travel and can penetrate

Answer 30

6 to 10 feet through air & a few layers of clothing.

Question 31

blast injuries) Primary: Secondary: Tertiary: Quaternary:

Answer 31

Primary: blast injuring hallow organs Secondary: shrapnel injuring Tertiary: thrown against something Quaternary: damage from other AFTER BLAST

Question 32

Pulse pressure: MAP: CPP Cerebral Perfusion:

Answer 32

= SBP-DBP = (PP/3) + DBP = (MAP-ICP) + 10

Question 33

Blood: Plasma: Leukocytes: Erythrocytes:

Answer 33

= Mixture of water, cells, proteins, & suspended elements. = makes up 55% of the blood volume = WBC & platelets make up the “Buffy Coat" = RBC make up 45%

Question 34

Blunt T. to head & neck mortality% & w/ MVC:

Answer 34

= 85% mortality (Focus head neck chest abdomen)

Question 35

Cardiac Output: Cardiac Output Formula: Blood Pressure formula:

Answer 35

= amount of blood pumped by the heart in 1 min (70mL) = SV x HR = CO x SVR

Question 36

Shock) Cardiogenic: Types & defined:

Answer 36

= Pump prob/ not working = Intrinsic: problem from w/in heart EX MI & Extrinsic: pob from outside hurting heart EX TPT

Question 37

Celsius# to degrees Fahrenheit form Fahrenheit# to Celsius form

Answer 37

C# to F=(C# -32) / 1.8 F# to C= (1.8 x F) + 32

Question 38

Child burn in water) 120 degrees 125 degrees 140 degrees 150 degrees

Answer 38

= 10 minutes 2 or 3 degree burn = 2 minutes = 6 secs = 2 sec

Question 39

1 Children for the Rules of Nines, the head is awarded: 2 Children for the Rules of Nines, each leg is awarded: 3 Children for the Rules of Nines, each arm is awarded: 4 Children for the Rules of Nines, the anterior trunk is awarded: 5 Children for the Rules of Nines, the posterior trunk is awarded:

Answer 39

1= 18 % of body surface area. 2= 13.5% of body surface area. 3= 9% of body surface area. 4= 18% of body surface area. 5= 18% of body surface area.

Question 40

(Class I Hemorrhage) 1 injuries: 2Compensation for blood: 3Blood Loss: 4Pulse: 5Vent rate, BP & Pulse Pressure: 6Cap-Refill: 7Urine Output (mL/hr): 8Mental Status:

Answer 40

1= Broken humorous 750mL 2= Healthy PTs can easily compensate for such blood volume loss 3= Blood Loss: < 15% (<750 mL’s) 4= Pulse: Slightly Tachy 5= all Normal 6= Cap-Refill <2secs 7= 30mL/Hr or more 8= Slightly Anxious

Question 41

Coagulation Phase of hemostasis:

Answer 41

3rd phase Clotting factors activated and released into bloodstream through a very complex cascade of events Triggers series of chemical reactions; formation of strong protein fibers (fibrin)

Question 42

Criteria for critical/moderate burn in adult & PT: Adult:

Answer 42

= Burns associated w/ resp injury aka inhalation burn, Chemical / high voltage, Burns w/ major trauma Adult: Superficial: BSA >50%, Partial: BSA <30%, Full thickness: BSA <10

Question 43

CUPS: C: U: P: S:

Answer 43

= Categories of PT severity = Critical: ABCs FUCKed = Unstable: hypotension, comp to decomp = Potentially unstable: pelvic fracture, stable can unstable = Stable: stable ex toenail fracture

Question 44

5 types of shock and treat them appropriately:

Answer 44

Hypovolemic, Cardiogenic, Distributive, Obstructive, Respiratory/Metabolic

Question 45

Dry dressing for burns: Wet dressing for burns:

Answer 45

= >10% = <10%

Question 46

Dynamic CO:

Answer 46

=1 up other down, L diastole P = L afterload, PVR pulmonary & oil

Question 47

(Thermal burn phases) Emergent phase:

Answer 47

Vtach, cells anaerobic Body's initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers

Question 48

End-tidal gradient= Difference between partial pressure of arterial CO2(PaCO2) & end-tidal CO2(ETCO2). Formula=

Answer 48

PaCO2 - ETCO2 = End - Formula gradient

Question 49

Eschar: Can be severe enough to :

Answer 49

= Burn destroys dermal cells; Skin constricts over wound site, increasing pressure of edema beneath & restricting flow of blood =occlude all blood flow into distal extremity (compartment syndrome)

Question 50

Escharotomy =

Answer 50

= release pressure w/ cutting burn to relief fluid pressure

Question 51

ETT size range~

Answer 51

Adults (6.0-9.0) women~7-8 & man~8-9 Pedi tubes(2.5-5.5)

Question 52

Evaluation:

Answer 52

= Repeat surveillance “good on paper but what about practice”

Question 53

Parkland Burn Form) EX: 32yo male found with 10% BSA 1st degree burns, 10% BSA 2nd degree burns, and 10% BSA 3rd degree burns. The patient is 110 pounds. 1. 4 mL x BSA x Weight (kg) 2. Total mL / 2 = (Amount to give for: 3. How many mL’s per hr? 4. How many gtts/min using a 10 gtt/mL IV drip set? 5. Know w/ formula:

Answer 53

1. 4mL X 20 (2nd + 3rd degree burns) X 50 (kg) = 4000 mL 2. 4000 mL / 2 = 2000 mL (Amount to give 1st 8 hours then next 16Hrs) 3. 2000 mL / 8 = 250 mL per/hour for 1st 8 hrs 4. 42 gtts/min 5. Pick closest option choice for gtts & Vol calculated. Use biggest bores& macro drips

Question 54

ETCO2 Lvs in head-injured intubated PT shouldn't drop below: When vent/ing a adult PT, each breath should have tidal volume of:

Answer 54

= 30 mmHg = approximately 500mL

Question 55

Falls: Examine: Axial loading: FOOSH (Fall onto an outstretched hand) Colles’ fracture: Smith's fracture: out >20ft greater risk of Aortic anyrusem to tear:

Answer 55

= most common blunt trauma, risk increase w/ age, sig fall 2-3x height = height, position, surface PT landed on, physical condition of PT = loading on axial skelton via falling (E starts heel to lumber) = influxing wrist fractures from fall impact = efflucing wrist fractures from fall impact "Palm out" = internal organ damage = pain tearing to chest shoulders back = tearing pain from chest goes to back

Question 56

Fluid accounts for ~% of the body’s weight, Only ~% of the fluid is contained in our vascular system

Answer 56

= 60% of the body’s weight, Only about 7% of the fluid is contained in our vascular system

Question 57

Fluid resuscitation is an important part of treating serious burns. The formula for the amount of IV fluid needed to be infused includes:

Answer 57

4 mL × patient weight (kg) × BSA burned

Question 58

Thermal burn phases) Fluid-shift phase:

Answer 58

2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area vasodilates & capillaries more permeable for phagocytosis

Question 59

Force: Force formula:

Answer 59

= force related to a objects mass(weight) and/or achange in velocity = mass x Acceleration

Question 60

Frank Starling law/mechanism: Vascular Resistance: SVR vs. PVR: SVR (Systemic Vascular Resistance): PVR (Pulmonary Vascular Resistance):

Answer 60

= more myocardium is stretched the more force/greater the next contraction will be (increase in preload increases contraction) = Resistance to overcome to push blood through circulatory system = Body's circulation resistance & Lung's circulation resistance = resistance blood faces in systemic circulation (arteries size) = resistance blood faces in pulmonic circulation EX CHF, R ventricle

Question 61

Frank Starling law/mechanism:

Answer 61

= more myocardium is stretched the more force/greater the next contraction will be (increase in preload increases contraction)

Question 62

Vascular Resistance:

Answer 62

= Resistance to overcome to push blood through circulatory system

Question 63

SVR vs. PVR:

Answer 63

= Body's circulation resistance & Lung's circulation resistance

Question 64

SVR (Systemic Vascular Resistance):

Answer 64

= resistance blood faces in systemic circulation (arteries size)

Question 65

Golden Period “hour”: Platinum 10:

Answer 65

= incident to surgery time 1 Hr from Crash to EMS to PT to surgery = no more than 10 mins on scene

Question 66

Hemostasis: Hemostasis order: Factors that effect hemostasis:

Answer 66

= Body’s response to a local hemorrhage w/ 3 phases = Vascular, Platelet, Coagulation "flow, stick, build" = Wound type(can pull w/in>cant constrict), M-nt, Temp, Meds( most blood thinners stop/prevent fibrin) Warfrin/Coumadin), IV Fluids

Question 67

How to estimate PEDI ET tube size: Uncuffed Cuffed

Answer 67

Uncuffed ET: (Age /4) + 4 OR (Age + 16) /4 Cuffed ET = (Age /4) + 3.5

Question 68

How to estimate pedi weight

Answer 68

(Age + 4) x 2 = Approximate weight in kg (Old Way) (Age x 3) + 7 = Approximate weight in kg (New Way

Question 69

Hyperkalemia) 1st line med: 2) One of two 2nd line meds: 3) One of two 2nd line meds: 4) Hospital only med: 5) Hospital only med to poop:

Answer 69

1= Calcium Chloride IV 0.5-1G/3 mins (Stabilizes doesn't fix) 2= Albuterol 10-20 mg LVN over 15 mins 3= Sodium Bicarb 50 mEq IV mil equivalent 4= Dextrose (25 grams)w/ Insulin IV (10 units) 5= Kayexalate to poop out hyperK via pull interstitial to GI

Question 70

Orthostatic hypotension

Answer 70

PT’s BP drops 20 HR+20 when moved from supine to a seated position

Question 71

Implementation:

Answer 71

= putting effective safety measures EX roads,

Question 72

Intervention dev:

Answer 72

= dev/mod of programs to reduce both incidence & seriousness of trauma

Question 73

Jacksons Theory of Thermal Burns 3 burn zones:

Answer 73

1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia

Question 74

Kinetic energy: Kinetic Energy form:

Answer 74

=energy of a object in motion (by objects mass & its velocity = (Mass x Velocity ^2)/ 2 ½ x mv^2

Question 75

Kinetic energy: kinetic energy formula: Increasing mass vs. velocity directly increases what:

Answer 75

= energy of an object in motion (Fn. of object’s mass & its velocity) = Kinetic energy=Mass(weight)×Velocity(speed)22 = kinetic energy > +velocity exponentially increases kinetic energy

Question 76

1 kinetics of penetrating trauma) Study of projectiles in motion & effects on objects 2 Curved path bullet follows after fired from a gun 3 Drag from wind 4 Outward "ballooning" motion of cavity due to projectiles 5 Speed of object in motion 6 Cross-section of bullet along its direction of travel 7 shape of object

Answer 76

1= Ballistics: 2= Trajectory: 3= Drag: 4= Cavitation: 5= Velocity: 6= Profile: 7= Shape:

Question 77

Lethal blood loss=

Answer 77

40%--> class 4 hemorrhage

Question 78

Life threatening injuries %: Most-life threatning trauma occurs to: Vol per lung & body: lethal blood loss:

Answer 78

= <10% traumas = head and/or chest = 3L per lung & 5L per body = >40% or ~2L

Question 79

Lightning can still strike you if proximity up to:

Answer 79

up to 50yrds can strike you

Question 80

Lightning strikes frequency & strike proximity

Answer 80

~100times a sec around world & up to 50yrds can strike you

Question 81

mechanism of injury (MOI):

Answer 81

the circumstances and events by which an injury occurs.

Question 82

Moderate criteria) Superficial: Partial thickness burns: Full thickness burns:

Answer 82

= BSA >50% = BSA <30% = BSA <10%

Question 83

MOI: Energy: Inertia:

Answer 83

= mech of injury how the injury happened = Ability to do work = law of Inertia (Newton’s 1st law) helps explain how objects in motion behave

Question 84

Morphine & fent drop BP by:

Answer 84

= body releasing Histamines

Question 85

(Newtons laws) inertia) 2nd law: force formula is summarized as:

Answer 85

= force is related to object’s mass (weight) & rate of its change in velocity (speed) = Force=Mass (weight)×Acceleration (or deceleration)2

Question 86

Normal blood pH range=

Answer 86

7.35 - 7.45 mmHg

Question 87

Ohm's law:

Answer 87

relationship between current (I), resistance (R), voltage (V)

Question 88

Tension pneumo & pulmonary emboli is which type of shock? Pericardial tamponade presents w/:

Answer 88

= Obstructive = Becks triad JVD, tachycardia, hypotension, & Muffled heart tones

Question 89

Pedi intubation ETT location=

Answer 89

ETT Insertion is 2-3 cm below the vocal cords

Question 90

Penetrating trauma: Perforating trauma: (3lvls of Penetrating trauma) 1st Lvl: 2nd Lvl: 3rd Lvl: Ballistics: Factors of bullet speed/damage: Trajectory: Cavitation: Profile:

Answer 90

= object pierces the skin and enters the body = object pierces through & through body = Low velocity: knifes, swords, ect = Medium: handguns = High-velocity: Rifles = study of projectiles in motion & effects on objects = Trajectory, Drag, Cavitation, Velocity, Profile, Shape: = curved path bullet follows after fired from a gun = Outward motion of cavity due to projectiles speed & vacuums = cross-section of bullet along its direction of travel

Question 91

Phrenic nerve location

Answer 91

C-3-5

Question 92

Platelet Phase of hemostasis:

Answer 92

2nd phase, Platelets aggregate, or collect and adhere. Slows hemorrhage from capillaries and small vessels- splint fractures to decrease of clots being broken down & bleeding again

Question 93

Preload: Afterload: Mean Arterial Pressure (MAP):

Answer 93

= pressure/vol/ w/in ventricles @ end of diastole “End-diastole vol/“ = resistance against which the heart must pump against (increase afterload= increase ventricular workload) = average pressure in arteries during a single cardiac cycle = pressure that drives blood to tissues (ensuring organ perfusion)

Question 94

Public health care model:

Answer 94

= Surveillance, Risk identification, intervention dev, implement, Eval/

Question 95

Respiration ratio=

Answer 95

1 sec inhalation 2 sec exhalation

Question 96

Risk analysis:

Answer 96

= Examines & determines factors that impact dev

Question 97

RSI Ideal Body Weight) Men formula Women formula

Answer 97

Men= 50 kg + (2.3 kg X (Height (in) - 60) Women= 45.5 kg + (2.3 kg X (Height (in) - 60)

Question 98

Rule of palm:

Answer 98

use of PT hand = 1% of BSA (burns <10%)

Question 99

"rule of thumb" for estimating the proper depth of an ETT=

Answer 99

Depth should be ~3x ETT size

Question 100

Seat belts: Maternal relation w/ seat belts: Cullen's sign: Most common organ injuries: SRS:

Answer 100

= vehicle restraints, reduced # of collision related deaths = US #1 maternal death, hips/pelvis not ABDMN = internal bleed abdominally = Spleen adults Liver kids = supplemental Restraint Systems (SRS) 1st used for front impacts, airbag inflation to cushion energy

Question 101

Shock) 1 Distributive: 2 Hives: 3 "warm shock/high space”: 4 Sick shock: 5 syncope:

Answer 101

1= uncontrolled vaso-dialation 2= Anaphylactic: release of histamine from Ige & b/c allergen 3= Neurogenic: warm b/c reverse shunting makes warm transient block of SNS 4= Wide spread of infection 5= Physcogenic: Sudden vasodilation physiological means EX hemophobic, arachnophobic

Question 102

Shock) 1 Obstructive & types: 2 pneumothorax: 3 Pericardium: 3 traveled Embolism to lungs:

Answer 102

1= something obstructing heart} PE, Tension/Pneumo, Pericard/tamp 2= Tension/pneum: plueras so full pushing on hearts atrium 3= Pericardial tamponade: pericardium filled with blood 4= PE: emboli so big obstructs pulmonic vein

Question 103

Shock) 1 Respiratory/Metabolic:

Answer 103

1= Disruption of O2 transfer into cells/cells unable to utilize O2 from Cyanide, CO poisoning, A change in the blood pH

Question 104

Shock) Normal S/S of shock: Compensate shock: Decompensated shock: Irreversible shock:

Answer 104

= Tachypnea&cardia, AMS, lower BP = body is compensating “fighting” to maintain homeostasis = can no longer maintain homeostasis = can’t come back to life

Question 105

Shock) How does hemophilia affect the body and the clotting of blood?

Answer 105

Does not have ability to properly clot due from ½ factors

Question 106

Shock) S/S of neurogenic shock: Cushing’s Triad:

Answer 106

= warm/flush, bradyC, HyperBP, AMS, Blown and/or unequal pupils = HyperBP, BradyC, cheyenne stokes or Biots ventalations

Question 107

Shock) Hypovolemic: Types:

Answer 107

= fluid loss Hemorrhagic: blood loss & Non-hemorrhagic: V/D, Sweating

Question 108

(Rad) S/S of Exposure: First sign: Lethal Dose Exposure: Organ shutdown:

Answer 108

= SLUDGEM PSNS S/S = slight nausea & fatigue = Emesis & malaise, Epistaxis, mouth, gums, & rectum (Vomiting usually lethal exposure = Death

Question 109

Site for pneumo decompression: needs: Never go under a rib b/c: Locating decompression site: Digital thoracostomy:

Answer 109

= Anterior 2nd ICS midclavicular/3rd rib & b/c air is always up/rising = At least 3in catheter, attach 1way valve: Could use 3way valve, glove, = vascular; have major thoracic arteries & nerves = palp/ then slide over 3rd rib = 1-2in incision between 4th & 5th ICS, ( “cut finger tube” )

Question 110

Special pop of burns: PT's cope less b/c:

Answer 110

= GERI, Pedi, & PTs ill/injured have >dif coping w/ burn injuries = Fluid retention,

Question 111

Specialty Centers:

Answer 111

= Neuro, Burn, Pedi trauma, Hand & limb replant microsurgery, Hyperbaric oxygen

Question 112

1staph: 2Strep: 3Lymphangitis: 4Tetanus (Lockjaw): 5Gangrene: 6Wet Gangrene: 7Dry Gangrene:

Answer 112

1= staphylococcus Anaerobic bacterium infection 2= Streptococcus Anaerobic bacterium infection 3= red lines along lymph lines b/c infection 4= Clostridium tetani>Attacks NS produces toxin >M. contrac/spasms 5= Clostridum perfringen>(diabetes>risk) infection lacks blood supply/flow> less WBC 6= bacteria to tissue & swells then fluids outside of tissue 7= blood supply cut off and dry

Question 113

Stretch blunt trauma: Sciwora:

Answer 113

= Tendons & Fibers that (tendons stronger) hold organs & other structures together are pulled & injured or torn = spinal cord injury with out r a (kids in wreck overstretching neck)

Question 114

Stridor w/ inhalation burns: Bad Airway burns might might need:

Answer 114

= AKA “crowing” larynx last defense against heat then swells 2/3s so intubate asap bc only worsens (Press chest & follow bubbles) = Might need to nasal endotracheal intubation w/ BAAM & Endotrol tube (ET w/ trigger) BAAM> High=inhale &Low=exhale

Question 115

Stroke volume: Cardiac Output (CO): CO form/: 3 factors that affect CO: Dynamic CO:

Answer 115

= blood amount ejected in 1 contraction> varies 60-100mL 70average = Amount of blood moved in 1min = HR X SV -> 5-6 L of blood moved in 1 min = preload, afterload, contractility = "1 up & other down"

Question 116

Suction catheter size w/ ETT~ form:

Answer 116

ETT# x2

Question 117

Suctioning catheter sizing form/=

Answer 117

Intubation ETT size # X 2

Question 118

Suctioning time limits:

Answer 118

Adults 15 secs max, Children= 10 secs max, Infants=5 secs max, ET/Trach tube= 5-10 secs max

Question 119

Surveillance:

Answer 119

= collection of data Epidemiology=study of disease based on med survey

Question 120

The blood volume of an infant or young child is proportionally: Population most at risk for trauma & trauma death:

Answer 120

= ~20%> than that of an adult = Young adult male

Question 121

The following burn patterns is usually seen with child abuse:

Answer 121

"Stocking burns" to lower legs, Circumferential burns on buttocks, Multiple circular burns of the same size to the arms and legs

Question 122

The most common & serious trauma associated w/ explosions is: The most lethal explosions are those: That cause structural collapse

Answer 122

= Pulmonary injury = That cause structural collapse

Question 123

Thermal burn phases:

Answer 123

Emergent, Fluid-shift, Hypermetabolic, & Resolution phase

Question 124

TXA) 1 Dynamics: 2 when do we admin/ it: 3 Correct dose: 4 Followed by:

Answer 124

1= Blocks fibrinolysis by binding to plasminogen, blocking plasminogen fibrin interactions. 2= Significant hemorrhage, either internal or external (after external hemorrhage has been controlled). 3= 1G/10mins (mix in 50 mL bag of NS) 4= 1G/8Hrs (500 mL bag)

Question 125

Waddells:

Answer 125

= turns to car pevils, thrown, head hits ground

Question 126

What are the 3 dif types of soft-tissue injuries?

Answer 126

Type: Open Type: Close: Infection Type: Burn

Question 127

What are the 3 different levels of penetrating trauma?

Answer 127

High velocity> sniper Medium velocity> pistol Low velocity> knife

Question 128

What are the three levels of penetrating trauma?

Answer 128

Lvl 1: entrance Lvl 2: cavation Lvl 3: exit

Question 129

Injury which opening occurs in skin & organs protrude through is:

Answer 129

Evisceration

Question 130

Jacksons Theory) Zone of Coagulation:

Answer 130

Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area

Question 131

Jacksons Theory) Zone of Hyperemia:

Answer 131

surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process Sig burns have sig swelling from shift of fluid

Question 132

Jacksons Theory) Zone of Stasis / “Ischemia”:

Answer 132

Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)

Question 133

“pressure” of electric flow

Answer 133

Voltage

Question 134

Child Burn form:

Answer 134

(age#-1 from the head) / between 2 legs

Question 135

Controlled hemo/ fluid dosing

Answer 135

20mL/Kg Warm NS