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EMT Trauma Exam | GFAC

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kinetic energy
energy of a moving object
potential energy
product of mass, force of gravity, and height
significant injuries
-injury to more than one body system
-falls from heights
-motor vehicle crashes
-car vs. pedestrian
-gunshot wounds
-stabbings
three collisions in a car crash
-car against another car, tree, or object
-passenger's internal organs against solid structures of the body
-passenger against the interior of the car
frontal crashes
-evaluate restraint system (wearing seatbelt? airbags?)
-suspect injuries to extremities and internal organs
rear end crashes
-known to cause whiplash
-acceleration type injury to brain is possible
lateral crashes
-side impacts
-very common cause of death
-lateral whiplash injuries intrusion into the passenger compartment may be severe
rollover crashes
-large trucks and SUVs prone
-injuries depend on restraining
-ejection is most life threatening
car vs motorcycle crashes
-head on crash
-angular crash
-ejection
angular motorcycle crash
motorcycle strikes another object at an angle so that the rider sustained direct crushing injuries to the lower extremity
significant falls
falls from more than 20 feet
primary blast injury
injury due to blast wave itself
secondary blast injury
injuries due to missiles being propelled by blast force
tertiary blast injuries
injuries due to impact with another object
-hurled by the force of the explosion
quaternary blast injuries
collateral injuries such as burns, crush injuries, toxic inhalation
injuries to the head
-disability and unseen injury to the brain may occur
-bleeding or swelling inside the skull is often life threatening
-include frequent neurologic examinations in your assessment
-some patients will not have obvious signs and symptoms
injuries to neck and throat
-area of serious or deadly injuries
-airway problems may result
-look for DCAP-BTLS
-swelling may prevent blood flow to brain
-penetrating injury may result in air embolism
-crushing injury may cause cartilages of the upper airway and larynx to fracture
injuries to the chest
-a penetration of the integrity of the chest is called an open wound
injuries to abdomen
-abdomen contains vital organs that require a very high amount of blood flow
-solid organs may tear, lacerate, or fracture
-hollow organs may rupture and leak toxic digestive chemicals
-the rupture of large blood vessels can cause serious unseen bleeding
level I trauma facility
serves cities or heavily populated areas
-provides every aspect of trauma care
-usually university-based hospitals
level II facility
-located in less populated areas
-provide initial definitive care
level III facility
-provides assessment, resuscitation, emergency care, and stabilization
-transfers patients to level I or II when necessary
level IV facility
-found in remote outlying areas
-provides advanced trauma life support
how much blood loss can the body tolerate?
no more than 20% --> changes depending on the amount of time
changes in vital signs with significant blood loss
-increased HR
-increased RR
-decreased BP
causes for blood clot failing
-movement
-disease
-medications
-removal of bandages
-external environments
-body temperature
-severe injury
causes for internal bleeding
-stomach ulcer
-lacerated liver
-ruptured spleen
-broken bones, especially the ribs or femur
-pelvic fracture
signs of internal bleeding
-abdominal tenderness
-guarding
-rigidity
-pain
-distention
-dizziness, faintness, and weakness in elderly
hemostatic agents
any chemical compound that slows or stops bleeding by assisting with clot formation
causes for bleeding from nose, ears, mouth
-skull fracture
-facial injuries
-sinusitis
-high BP
-coagulation disorders
-digital trauma
functions of skin
-keeps pathogens out
-keeps fluid in
-helps body regulate temp
-nerves in the skin report to the brain on the environment and sensations
contusion
bruise
hematoma
blood collected within damaged tissue or in a body cavity
crush syndrome
when area of the body is trapped for longer than 4 hours
compartment syndrome
results from swelling that occurs whenever tissues are injured
types of open injuries
-abrasions
-lacerations
-avulsions
-penetrating wounds
abrasions
wound of superficial layer of skin
lacerations
jagged cut
avulsions
separates various layers of soft tissue so they become either completely detached or hangs as a flap
signs of developing shock
-anxiety or agitation
-changes in LOC
-increased HH and RR
-diaphoresis
-cool or clammy skin
-decreased BP
face bones
-nasal bone
-two zygomas
-two maxilla
-mandible
vitreous humor
clear, jelly-like fluid near the back of the eye
conjunctiva
membrane covering the eye
sclera
white fibrous tissue that helps maintain the eyes shape
cornea
transparent membrane on the front of the eye
-allows light to enter
pupil
allows light to move to the back of the eye
signs of mandible fractures
misaligned teeth, numbness in chin, inability to open mouth
signs of maxilla fractures
facial swelling, instability of the facial bones, misaligned teeth
what to do with portions of avulsed skin
-wrap in a sterile dressing
-place in plastic bag
-keep cool, but not directly on ice
-label and deliver to ED
head injury signs
-one pupil is larger than the other
-eyes not moving together
-failure to follow your finger
-bleeding under the conjunctiva
-protrusion or bulging of one eye
signs of facial trauma
-bleeding in the mouth
-inability to swallow or talk
-absent or lose teeth
-loose or moveable bone fragments
transport of avulsed tooth
-handle it my the crown, not the root
-place the tooth in tooth storage solution, cold milk, or sterile saline
-notify the hospital
-reimplantation possible
most common head injuries
motor vehicle crashes
signs of skull fracture
-patients head appears deformed
-visible cracks in the skull
-ecchymosis that develops under the eyes (raccoon eyes)
-ecchymosis that develops behind one ear over the mastoid process
battles sign
ecchymosis that develops behind one ear over the mastoid process
linear skull fracture
account for 80% of all skull fractures
-no physical signs
depressed skull fractures
-result from high energy direct trauma to the head with a blunt object
-frontal and parietal bones most susceptible
-bony fragments may be driven into the brain
basilar skull fractures
-associated with high energy trauma
-usuaully occurs following diffuse impact to the head
-signs include CSF drainage from ears, raccoon eyes, and battle's sign
signs of increased ICP
-cheyne stokes respirations
-ataxic respirations
-cushings reflex
cushings reflex
-increased BP
-decreased HR
-irregular respirations
epidural hematoma
-accumulation of blood between the skull and dura mater
-nearly always the result of a blow to the head that produces a linear fracture
subdural hematoma
-accumulation of bleed beneath the dura mater but outside of the brain
-occurs after falls or injuries involving strong deceleration forces
-may or may not be skull fracture
intracerebral hematoma
-bleeding within the brain tissue
-can occur following penetrating trauma to the head or rapid decoration forces
subarachnoid hemorrhage
-bleeding occurs into the subarachnoid space, where the CSF circulates
-results in bloody CSF and signs of meningeal irritation
cardiac tamponade
protective membrane around the heart fils with blood or fluid
-heart cannot pump adequate amount of blood
-signs and symptoms: becks triad and alter LOC
becks triad
-JVD
-narrowing pulse pressures
-muffled heart sounds
flail chest
-caused by compound rib fractures that detach a segment of the chest wall
-detached portion moves opposite of normal
commotio cordis
injury caused by sudden, direct blow to the chest during a critical portion of the heartbeat
-mayresult in immediate cardiac arrest
RUQ
liver, GB, duodenum, pancreas
LUQ
stomach and spleen
LLQ
descending colon, left transverse colon
RLQ
appendix, large and small intestines
guarding
stiffening of abdominal muscles
eviceration
bowel protrudes from peritoneum
liver injury
very vascular and can lead to hypo perfusion
-referred pain to right shoulder
signs of kidney damage
-abrasion, laceration, contusion on the flank
-penetrating would in region of flank or upper abdomen
-fractures on either side of the lower rib cage
-hematoma in flank region
comminuted fracture
bone is broken into more than two fragments
-feel crepitus
epiphyseal fracture
fracture in the growth plate
green stick
incomplete fracture that passes only partway through the shaft of a bone
incomplete fracture
a fracture that passes only partway through the shaft of a bone
oblique fracture
bone is broken at an angle across the bone
pathologic
a fracture of weakened or diseased bone
spiral fracture
caused by twisting force, causing oblique fracture around and through the bone
transverse fracture
occurs straight across the bone
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