EMT Module 2 Test

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195 terms · Emergency Care & Transportation of the Sick & Injured 10th Edition. Chapters 22-29

Index of Suspicion

Awareness that life threatening injuries may exist.

Types of Energy & Injuries

Potential-Could do
Kinetic-Does
Work-Force it requires

Velocity or Size

Speed

Rollover/Rotational

ejection, partial, head compression, spinal injury

Lateral

lateral whiplash, shoulder/thorax/upper xtremities/skull into door, w/ intrusion-chest, abdomen, lower xtremities, pelvis, ribs injuries

Rear End

Whiplash, head, spine injuries. Back seat w/ lap-thoracic & lumbar

Signs of Hi Energy Impact in Vehicular Collision

Vehicle deformity
Death
Altered Mental Status
Ejection

Unrestrained Passenger vs. Restrained

Shoulder only-lower xtremities/pelvis injuries
Seatbelts too low-hip dislocation
Too hi-abdominal injuries
No seatbelt-abrasions from air bag, frontal-knees, femur, pelvis & hip injuries. Chest, abdominal injuries, head too

Purpose of Airbags

Decrease severity of deceleration injuries by allowing seatbelts to be more compliant and by gently cushioning

What vehicle collision can cause an Aortic injury

Lateral

How to asses MOI of Car vs. Person

Estimate speed, thrown?, distance thrown?, struck?, pulled, structural damage

Factors for MOI from a Fall

Fall >15' or 3 times patients height
surface struck
part of body that hit first
injuries to lower xtremities, pelvic and spine when landing on feet
head and spine when landing on head

Hi/Med Energy Penetrating Injuries

Damage can be many times larger than wound.

Lo Energy Penetrating Injures

caused by sharp edges, knives, unseen damage

Clotting Process

Blood flows rapidly to cut, cut ends of vessels begin to narrow, clot plugs hole. Takes about 10 minutes.

Apoxia Timeframe for Organs

Heart-Constant perfusion
Brain/Spinal Cord-injury after 4-6 minutes
Kidneys-After 45 minutes
skeletal muscle- after 2 hours
GT-slightly longer
cold will delay

Hypoperfusion

AKA Shock. System fails to provide sufficient circulation for every body part to perform its function

How much blood loss can the body tolerate

Will not toletate an acute blood loss of >20% of blood volume. ex. 175 lb man=2 pints (1L)
symptoms: increased hrt/resp rates, decreasing blood pressure
ex. 800 ml infant=100-200mL

What effects clotting

Movement, medications, removal of bandages, external environment, body tmeperature, partial vessel wall

How to treat a nosebleed

Epistaxis. Have patient lean forward. Head forward. Direct pressure to fleshly part of nose for 15 minutes.

What happens when core receives poor perfusion

Damage to organ tissue, dysfuntion, failure and eventually death to organism

Signs of Compensated Shock

Early stage of shock when the body can still compensate for blood loss

Signs of Decompensated Shock

Late stage of shock of shock when blood pressure is falling

Signs of Irreversible Shock

...

ABC's associated with Shock

...

Treatment for Shock

...

Hematoma-Define and describe development

...

How do soft tissue injuries occur

...

Penetrating Trauma

...

Open Neck Injuries

...

Closed Neck Injuries

...

Bones in the Jaw

...

Bones in the Skull

...

Dividing line between body cavities

Umbilicus

Hematemesis

Throwing up blood

Hemoptysis

Coughing up blood

Melena

Pooping blood

Define Pleurisy

(also known as pleuritis) is an inflammation of the pleura, the lining of the pleural cavity surrounding the lungs.

Chest injuries

broken ribs-insufficient O2
Bruised heart-irregular heart beat
torn vessels-internal bleeding
bruised lungs-insufficient O2
Air in lung tissue/chest wall-insufficient O2 (pneumothorax)
blood in lung/chest-hemothorax
open chest wound

Pneumothorax-Symptoms & Treatment, and when

partial or complete accumulation of air in the pleural space

Tension Pneumothorax

life threatening collection of air w/i the plural space; the vol. and pressure have both collasped the involved lung and cause a shift of the mediastinal structures to the opposite side

Hemothorax

collection of blood in the pleural cavity

hemopneumothorax

accululation of blood and air in the pleural space

Symptoms of Mycardial Contusion

...

Peritonitus

inflammation of the peritoneum

Treatment of Abdominal Wounds

...

Symptoms of Abdominal Hemmorhage

...

Skeletal Muscle

muscle that is attached to bones and usually crosses at least one joint; striated, or voluntary muscle

Bone Marrow

a fibrous tissue that contains fluid, blood vessels, fat cells and blood-forming stem cells

Dislocations

...

Sprain

When ligaments are torn or stretched

Strain

injury to muscle

Fracture

break in the continuity of the bone

Connective Tissues

...

Types of Fractures

...

Crepidus

grating/grinding sensation cause by fractured bone ends or joints rubbing together

Severity of Fractures

...

Why ice/elevate extremities

...

Traction Splints

...

Treating Dislocations

...

Cerebrum Function

control movement, hearing, balance, speech, visual perception, emotions, and personality.

Cerebellum Function

coordinates the various activities of the brain, particularly fine body movements

Brain Stem Function

breathing, temperature control, heartbeat and blood pressure

Meninges

3 distinct layers of tissue that surround and protect the brain and spinal cord w/i the skull and the spinal canal

Contusions

aka bruises

Concussion

temp loss or alteration of part or all of the brain's ab ilities to function w/o actual physical damage to the brain.

Intercranial Bleeding

...

Subdural Bleeding

...

Ways to damage the spine

...

Symptoms of Head Injuries

confusion, seizures, vomiting, difficulty concentrating, increased mood swings, lethargy or aggression

Treatment for head injuries

...

Helmet removal

...

Proper Size C-Collar

...

Immobilization question

...

EC: Cushing's Triad

decreased pulse, increased blood pressure, and a widening pulse pressure associated with increased intracranial pressure; it is a late clinical sign and may indicate brainstem herniation

EC: Beck's Triad

rising venous pressure, falling arterial pressure, and small quiet heart; characteristic of cardiac compression

Newton's 1st Law

Object at rest will stay at rest until a force acts upon it.

Newton's 2nd Law

F=MassxAcceleration

Newton's 3rd Law

Every reaction has an = reaction

Seatbelts

Possibly prevent second collision, and lessen injuries of third collision

Car vs. Bicycle

same as vs. pedestrian + damage to bicycle and location of, helmet, spinal injuries until proven otherwise.

Temporary Cavitation

Acceleration of bullet, causes stretching and tearing of tissues.

Permanent Cavitation

Bullet path

Blunt/Penetrating Trauma to Neck

Symptoms: Noisy/labored breathing, Swelling
IOS: Bleeding in Airways, Airway Compromise

Blunt trauma to Chest Wall

Symptoms: Chest pain, Shortness of breath, asymmetrical chest movement
IOS: Cardiac/Pulmanary Contusion, Pneumothorax/Hemothorax, Broken ribs, breathing compromise

Blunt force trauma/penetrating injury from MVA

Symptoms: Neck/chest/abdomen/groin trauma, altered mental state, amnesia, combativeness, change in speech, probs w/ moving xtremities, headache, nausea, vomitting
IOS: internal/external bleeding, brain bruising and bleeding

blunt/penetrating trauma from hi fall

Symptoms: neck/back pain, probs moving arms/legs, loss of sensation, tingling
IOS: injury to bones/spinal column/cord

Primary Blast injuries

Done by the actual blast. Blood vessels, major organs especially hollow.

Secondary Blast Injuries

Projectiles in bomb.

Tertiary Blast Injuries

Blast hurls body, possible into a object. Can amputate limbs

Head Injuries

Bruising, bleeding, swelling. Frequent neuro exams

Signs of Serious Bleeding

Significant MOI
Poor gen'l appearance and is calm
Symptoms of Hypoperfusion
Significant blood loss
Cannot control bleed

Arterial Bleeding

Bright red, spurts, hi pressure, harder to stop

Venous Bleeding

Darker, flows, less pressure, easier to stop, more likely to clot spontaneously

Care for external bleeding

Direct, even pressure & elevation
pressure dressings/splints
tourniquets

comminuted

fracture where the bones are broken in more than two fragments.

When the EMT encounters a probable fracture, what should be assessed below the injury

pulse and capillary refill
sensation and motor function

Which of the following is not a contraindication to the use of the pneumatic antishock garment (PASG)

pelvis fracture

When you suspect an internal injury to the abdomen, you should always

take cervical and spinal precautions.
treat for shock.
administer high-flow oxygen

When dealing with an evisceration, the EMT should

cover the wound with a wet sterile dressing

Which organ in the urinary system is a solid organ

kidney

Because of supine hypotensive syndrome, a pregnant patient should be placed in what position when a backboard is not necessary

on her left side

An abdominal injury caused by a small caliber handgun would be considered a _________ injury

medium-velocity

tachypnea

rapid breathing

How many lobes does the right lung have

3

What is the normal breathing rate for an adult

12 to 20 breaths/min

What type of dressing should you apply to an open chest wound

occlusive

What should the EMT use to stabilize a flail chest?

a small pillow
a towel
a large bulky dressing

When blood or fluid collect inside the sac around the heart, it is called

pericardial tamponade

spontaneous pneumothorax is caused by

weak areas of the lungs

The most obvious sign of flail chest is/are

paradoxical motion

_________ should always be suspected in patients with a flail chest

Pulmonary contusion

Which of the following interventions is appropriate for all chest injuries

Apply oxygen via nonrebreathing mask at 15 L/min

What controls the body's vital organs

ANS

Bruising behind the ear is known as ________, and it is considered a later sign of a head injury.

Battle's sign

What is the most common complication of a head injury

cerebral edema

If you do not have a pediatric backboard, how should you stabilize a child on a regular backboard

Pad the shoulders

A(n) _________ bleed is bleeding that occurs outside the dura mater in the skull

epidural

What is the correct term for the white of the eye

sclera

In what manner should the EMT flush the eye when there is a foreign body in it

the nose to the outside of the eye

How long should the EMT irrigate a burn to the eye caused by a strong acid or alkali

20 minutes

When an eyeball has been displaced from its socket, what should the EMT do

Cover the eye.
Stabilize the eye.
Cover both eyes

What is another name for the skul

cranium

Anytime there are injuries to the face or head, the EMT should suspect

spinal injuries

halo test

a test for cerebrospinal fluid in the blood

subcutaneous emphysema

The presence of air in the soft tissue produces a characteristic crackling sensation known as

What should the EMT assess on a patient with a gunshot wound

the type of gun used
entrance and exit wounds
how many rounds were fired

Pain out of proportion to the injury is a hallmark sign of what condition

compartment syndrome

A ________ burn extends through all the layers of the skin and the patient may have no feeling to the burned area

full-thickness

After standard precautions, the first step in taking care of a patient covered in dry chemical is to

brush it off

For which of the following types of injury would an occlusive dressing be appropriate

evisceration
sucking chest wound
neck injury

When an adult patient quickly loses approximately 20% of his or her circulating blood volume, the patient's blood pressure will

decrease

The following are all indications for applying the pneumatic antishock garment (PASG) EXCEPT

control of massive bleeding in a pregnant woman

Which body structure is most likely injured during a passenger unrestrained rear-end collision?

cervical spine

In dealing with a car versus pedestrian collision, put in correct order the steps in evaluating the mechanism of injury: 1. Was the victim pulled under the vehicle or thrown clear? 2. Speed of the vehicle 3. Apparent injuries 4. Damage to the vehicle

2, 1, 4, 3

What should you suspect from a patient that has just fallen from a significant height

internal injuries

Shock is the result of

hypoperfusion to the cells of the body

Neurogenic shock occurs when

failure of the nervous system causes widespread vasodilation

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing

septic shock

Types of Shock

Hypovolemic Shock
Distributive Shock
Obstructive Shock
Hemorrhagic Shock
Cardiogenic Shock
Neurogenic shock
Hypoglycemic Shock
Septic Shock

Patients develop septic shock secondary to

poor vessel function and severe volume loss

Which of the following MOST accurately describes septic shock

bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Distributive shock occurs when

widespread dilation of the blood vessels causes blood to pool in the vascular beds

Which of the following injuries would MOST likely cause obstructive shock

cardiac tamponade

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes

psychogenic shock

All of the following conditions would make you suspect shock

anaphylaxis.
heart attack.
severe infection

You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should

reassess his condition in 5 minutes

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