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EMT Basic vocabulary and lists for Test 5 (1st 175 cards)

perfusion

The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries.

hypoperfusion

Inability of the body to adequately circulate blood to the body's cells to supply them with oxygen and nutrients.

shock

The inability of the body to adequately circualte blood to the body's cells to supply them with oxygen and nutrients. A life-threatenting condition.

hemorrhage

Excessive bleeding; bursting forth of blood

arterial bleeding

Bleeding from an artery, which is characterized by bright red blood and as rapid, profuse, and difficult to control.

venous bleeding

Bleeding from a vein, which is characterized by dark red or maroon blood and as a steady flow, easy to control.

capillary bleeding

Bleeding from the capillaries, which is characterized by a slow oozing flow of blood.

pressure dressing

A bulky dressing held in position with a tightly wrapped bandage to apply pressure to help control bleeding.

pressure point

A site where a main artery lies near the surface of the body and directly over a bone. Pressure on such a point can stop distal bleeding.

brachial artery

the main artery of the upper arm

femoral artery

the major artery supplying the leg

tourniquet

A device used for bleeding control that constricts all blood flow to and from an extremity.

compensated shock

When the patient is developing shock but the body is still able to maintain perfusion.

hypovolemic shock

Shock resulting from blood or fluid loss.

hemorrhagic shock

shock resulting from blood loss

sprain

The stretching and tearing of ligaments.

strain

overexertion of muscle

signs of bone injury

1. Pain and tenderness 2. deformity or angulation 3. grating or crepitus 4. swelling 5. bruising 6. exposed bone ends 7. joints locked in position 8. nerve and blood vessel compromise

7 steps in patient care for injuries

1. standard precautions 2. initial assessment (ABCs) 3. rapid trauma exam 4. apply cervical collar 5. splint 6. apply dressing to wounds 7. cold pack/elevate

load and go

initial assessment reveals unstable patient address ABCs use long spine board do not splint individual extremities

splinting

immobilize adjacent joints and bone ends decreases pain and movement * prevents additional injury

realignment

if extremity is cynotic or lacks pulse restores effective circulation splint may be ineffective otherwise decreases circulatory compromise reduction in pain

compound fracture

Fracture in which the bone is broken and bone extends through the skin

3 rules for realignment

1. grasp distal extremity for support 2. splint in position found (realign if extremity is cyanotic or lacks pulse) 3. manual traction ( resistance - stop realignment and splint in position no resistance - maintain traction until splint applied)

ways to treat bone injury

1. treat life - threats first 2. expose 3. assess distal pulse, motor function, and sensation before and after 4. align long bone to anatomical position 5. choose method to be used 6. do not push protruding bones 7. immobilize both injury site and adjacent joints 8. pad voids

how to apply traction splint

1. standard precautions 2. expose 3. stabilize injury site 4. assess pulses and circulation, motor function, and sensation 5. check for disability 6. realign if deformed or if distal extremity is cyanotic or pulseless 7. measure or adjust the splint 8. maintain manual stabilization or traction 9. apply or secure the splint 10. reassess CMS

3 indications for using traction splint

1. painful 2. swollen 3. deformed thigh with no joint or lower leg pain

10 guidelines for traction splints

1. standard precautions 2. manual stabilization and traction 3. assess CMS 4. adjust splint to proper length 5. apply proximal securing device (ischial strap) 6. apply distal securing device (ankle hitch) 7. apply mechanical traction 8. position and secure support straps 9. reevaluate 10. secure torso and traction splint to long board

5 steps in patient care for shoulder girdle injuries

1. assess distal PMS function 2. rigid splint is not practical 3. sling and swathe 4. do not attempt to straighten or reduce dislocations 5. reassess distal PMS function

9 steps in patient care for pelvic injuries

1. limit patient movement 2. determine CMS distally 3. straighten and stabilize lower limbs 4. apply pneumatic anti-shock garment (PASC) when BP less than 90 5. immobilize on long spine board 6. reasses 7. provide 02 and treat shock 8. transport 9. monitor vital signs

signs and symptoms of hip dislocation

anterior - lower limb rotated outward and hip flexed posterior - lower limb rotated inward, hip flexed, knee bent, foot may hang loose

7 steps in patient care for hip

1. asses distal CMS 2. apply long spine board 3. immobilize limb with pillows or blankets 4. secure patient 5. reassess distal CMS 6. treat shock and provide o2 7. transport

signs and symptoms of hip fracture

localized pain (sometimes in the knee) sensitive to pressure laterally (greater trochanter) discolored tissue swelling unable to move limb unable to stand foot rotated outward injured limb appears shorter

femoral shaft fracture

pain open fracture with deformity closed fracture with deformity injured limb shortened

5 steps in patient care for femoral shaft fracture

1. control any bleeding with direct pressure 2. manage patient shock 3. assess distal PMS function 4. apply a traction splint 5. reassess distal CMS function

knee injury

pain and tenderness swelling * deformity with obvious swelling

7 steps in patient care for knee injury

1. assess distal CMS function 2. padded board splints 3. pillow 4. reassess distal CMS funtion 5. immobilize with padded board splint 6. pad the voids 7. reassess distal CMS function

tibia or fibula injury

pain and tenderness swelling * deformity

10 steps in patient care for ankle/foot injury

1. assess distal CMS 2. stabilize and lift limb 3. place 3 cravats on ground and put pillow on top 4. leg onto pillow 5. tie pillow to ankle/foot 6. 4th cravat loosely at arch of foot 7. elevate with 2nd pillow or blanket 8. reassess distal CMS 9. check for shock 10. apply ice pack

skeletal system

Supports and protects the body

nervous system

controls thought, sensations, and motor functions (brain and spinal cord)

subsystems of nervous system

central nervous system and peripheral nervous system

peripheral nervous system

nerves enter and exit spinal cord between vertebrae 12 pairs of cranial nerves * motor and sensory nerves

autonomic nervous system

controls the involuntary actions of the body (heartbeat, breathing, control of diameter of vessels, sphincter muscles)

brain

master organ sends and receives messages susceptible to injury cerebral spinal fluid

3 meninges

1. dura mater 2. arachnoid 3. pia mater

dura mater

thick, outermost layer of the meninges surrounding and protecting the brain and spinal cord

arachnoid

cerebral spinal fluid flows through this middle meninges layer.

pia mater

innermost layer of the brain

mandible

only movable bone of the skull

cerebellum

part of the brain that controls balance and coordination

how many vertebrae are there?

33

how many bones are in the cervical part of the spine?

7

how many bones are in the thoracic part of the spine?

12

how many bones are in the lumbar part of the spine?

5

how many bones are in the sacral part of the spine?

5

how many bones are in the coccygeal part of the spine?

4

spinous process

the bony bump on the bottom of the spine

scalp injury

blood vessels bleeds profusely control bleed dress and bandage * caution when applying pressure

skull injury

cranium and facial fractures open and closed

concussion

a bruiselike injury of the brain that occurs when the soft tissue of the brain collides against the skull (mild, no detectable damage, may/may not lose consciousness, headache)

laceration

cut, open head injury, caused by sharp bony ridges, object penetrates cranium

contusion

injury that doesn't break the skin, characterized by pain, swellin, and discoloration; bruise

hematoma

the collection of blood within the tissue from damaged blood vessels. (names bases on location in brain - subdural, epidural, and intracerebral)

concussion

a violent shaking up or jarring of the brain that may result in a temporary loss of awareness and function

cushing triad

increased blood pressure, decreasing pulse, and sometimes irregular breathing

subdural hematoma

below the dura mater bleeding due to tearing of blood vessels on the surface of brain * 3 types (acute, subacute, chronic)

epidural hematoma

above the dura mater usually rapid bleeding * bleeding between skull and protective covering of brain

9 steps in patient care for head injuries

1. standard precautions 2. stabilize c-spine 3. evaluate breathing 4. provide o2 5. control bleeding 6. keep patient at rest 7. emotional support 8. treat shock 9. transport

5 things to do with impaled objects

1. do not remove 2. stabilize in place 3. pad around object 4. use hacksaw if needed 5. consult medical control

9 possible injuries to face and jaw

1. fractures 2. bone fragments 3. dislocations 4. airway management 5. suction 6. jaw thrust 7. control bleeding 8. c-spine precautions 9. treat shock

non-traumatic brain injuries

caused by internal brain events (hemorrhage or blood clot) no evidence of trauma * no mechanism of injury

7 steps in patient care for spinal injury

1. manual in-line stabilization 2. asses ABCs 3. rapid trauma exam 4. asses sensory and motor function 5. apply spinal immobilization device 6. provide o2 7. reassess motor function

immobilization of seated patient (low priority)

use short spine board extrication vest * transfer to long spine board

immobilization of seated patient (high priority)

rapid extrication immobilize manually * transfer to long board

KED

kendrick extrication device

6 indications of when to leave the helmet in place

1. helmet is snug 2. no impending airway or breathing problems 3. no resuscitation needed 4. removal would cause further injury 5. immobilization can be done with it in place 6. no interference with airway and breathing assessment

6 indications of when to remove the helmet

1. interferes with assessment 2. airway and breathing issues 3. improperly fitted 4. interferes with immobilization 5. cardiac arrest 6. per medical direction

cardiogenic shock

Shock, or lack of perfusion, brought on not by blood loss, but by inadequate pumping action of the heart. It is often the result of a heart attack or congestive heart failure.

neurogenic shock

Hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dialation of blood vessels that increses the volume of the circulatory system beyond the point where it can be filled.

decompensated shock

Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.

irreversible shock

When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.

epidermis

outer layer of skin

dermis

second layer of skin, holding blood vessels, nerve endings, sweat glands, and hair follicles

subcutaneous layer

the layer of fat and connective tissues below the dermis of the skin

closed wound

An internal injury with no open pathway from the outside.

cardiac muscle

the muscle tissue of the heart

cartilage

connective tissue outside of the bone (epiphysis) surface for articulation smooth movements of joints less rigid * forms flexible structures (septum of nose, external ear, trachea, connections between ribs and sternum

bone marrow

soft tissue inside of bones which produce red and/or white blood cells

tendon

strong connective tissue that attaches muscle to bone

ligament

strong connective tissue that holds bones together in movable joints

fracture

break (a bone)

dislocation

an injury in which a bone comes out of its joint

bone

hard but flexible living structures that provide support for the body and protect vital organs

extremity

portions of the skeleton that includes the clavicles, scapulae, arms, wrists, and hands (upper extremities) as well as the pelvis, thighs, legs, ankles, and feet (lower extremities)

occlusive dressing

any dressing that forms an airtight seal

universal dressing

A bulky dressing.

bandage

Any material used to hold a dressing in place.

dressing

any material (preferably sterile) used to cover a wound that will help control bleeding and help prevent additional contamination

rule of nines

a method of estimating the extent of a burn. For an adult, each of the following surfaces represents 9% of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region. For an infant or child the percentages are modified so that 18% is assigned to the head, 14% to each lower extremity.

full thickness burn

a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third-degree burn.

partial thickness burn

a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence. (Also called second-degree burn).

superficial burn

a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn. Also called a first-degree burn.

evisceration

An intestine or other internal organ protruding through a wound in the abdomen.

tension pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping

pneumothorax

air in the chest

sucking chest wound

An open chest wound in which air is "sucked" into the chest cavity.

paradoxical motion

movement of ribs in a flail segment that is opposite to the direction of the rest of the chest cavity.

flail chest

fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment.

air embolus

A bubble of air in the blood stream.

amputation

The surgical removal or traumatic severing of a body part, usually an extremity.

avulsion

the tearing away or tearing off of a piece or flap of skin or other soft tissue. Also, an eye pulled from its socket or a tooth dislodged from its socket

puncture wound

An open wound that tears through the skin and destroys underlaying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit wound.

abrasion

an injury caused by rubbing or scraping off the skin

open wound

An injury in which the skin is interrupted, exposing the tissue beneath.

crush injury

an injury caused when force is transmitted from the body's exterior to its internal structures. Bones can be broken, muscles, nerves, and tissues damaged, and internal organs ruptured, causing internal bleeding

joint

place where two or more bones meet

muscle

tissue composed of fibers that can contract, causing movement of an organ or part of the body

traction splint

A splint that applies constant pull along the lenght of the lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. Traction splints are used primarily on femoral shaft fractures.

closed extremity injury

An extremity injury with no opening in the skin.

open extremity injury

An extremity injury in which the skin has been broken or torn through.

crepitus

A grating sensation caused by fractured bone fragments rubbing against each other

manual traction

The process of applying tension to straighten and realign a fractured limb before splinting. Also called tension.

central nervous system

The brain and spinal cord

cranium

bony structure making up the forehead, top, back, and upper sides of the skull

temporal bone

bone that forms parts of the side of the skull and floor of the cranial activity. There is a right and left temporal bone.

temporomandibular joint

the movable joint formed between the mandible and the temporal bone, also called the TMJ.

maxillae

the two fused bones forming the upper jaw

nasal bones

the bones that form the upper third, or bridge, of the nose.

zygomatic bone

Cheek bone; also called malar

orbit

bony structures around the eyes; eye sockets

cerebrospinal fluid (CSF)

plasma like clear fluid circulationg in and around the brain and spinal cord

vertebrae

bones of the spinal column

artery

thick-walled muscular blood vessel that carries blood away from the heart

capillary

a tiny blood vessel where substances are exchanged between the blood and the body cells

vein

vessel that carries unoxygenated blood to the heart from body tissues

4 steps in patient assessment of bleeding

1. estimate amount of external blood loss 2. triage 3. predict potential shock 4. control external bleeding ****important to find the bleed and stop it****

5 steps of patient care for external bleeding

1. standard precautions 2. open airway 3. monitor respirations 4. ventilate if necessary 5. control bleeding ****airway is ALWAYS the main concern****

3 steps in controlling external bleeding

1. direct pressure 2. elevation 3. tourniquet

4 steps in direct pressure

1. apply pressure to wound 2. hold pressure firmly 3. bandage 4. don't remove dressing

5 steps to elevation

1. used at the same time as direct pressure 2. above the level of the heart 3. gravity helps 4. slows bleeding 5. do NOT use with impaled objects or spinal injury ****works better for veinous bleed than arterial bleed****

4 facts about a tourniquet

1. device that closes off blood flow to and from an extremity 2. controls life-threatening bleeding 3. commonly used in military and tactical settings 4. direct pressure and elevation are usually successful

5 steps of application for tourniquet

1. select site 2. tighten tourniquet 3. attach notation to patient 4. BP cuff may be used 5. contact medical direction

epistaxis

nose bleed

5 steps in controlling nosebleeds

1. have patient sit down and lean forward 2. apply or instruct patient to apply direct pressure 3. keep patient quiet and calm 4. do not let patient lean back 5. position patient on side if unconscious ****encourage to spit blood out, don't swallow it****

3 types of penetrating trauma

1. gunshot wound 2. stab wound 3. impaled wound

8 signs of internal bleeding

1. injuries to surface of body 2. bruising 3. painful, swollen, or deformed extremities 4. bleeding from mouth, rectum, vagina, etc 5. tender, rigid, or distended abdomen 6. vomiting 7. dark, tarry stools or bright red blood 8. signs and symptoms of shock

4 steps of patient care of internal bleeding

1. maintain ABCs 2. administer high flow o2 via NRB 3. control external bleeding 4. prompt transport ****surgery is the only way to save the patient****

4 causes of shock

1. inability of heart to pump 2. decreased supply of blood 3. lack of integrity in blood vessels 4. failure of vessels to dilate and constrict

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