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EMT Exam 4 Study
Terms in this set (214)
The term used for the delivery of oxygen and nutrients from the blood through the thin capillary walls into the cells and the removal of carbon dioxide and other waste products from the cells is:
Microscopically small structures in the circulatory system that supply every cell in the body are:
Gas exchange of oxygen for carbon dioxide occurs at the cellular level of the body between:
capillaries and body cells.
In shock states, what general principle can be observed regarding perfusion?
Perfusion in some areas is inadequate because the circulatory system malfunctions.
Which of the following is most likely to cause cardiogenic shock?
A massive MI that impairs the pump function of the heart
Which of the following is true regarding decompensated shock?
During decompensated shock, the body can no longer compensate adequately.
Hemorrhagic shock is due to:
All shock involves:
inadequate tissue perfusion.
You are assessing a 53-year-old male with severe blood loss from a wound that is covered with a pressure bandage. Bleeding appears to have stopped. The patient's pulse and respiration are elevated, but blood pressure is falling. The patient's skin around the lips shows signs of cyanosis, and the patient's pupils are dilated. What is a sign that the patient has entered decompensated shock?
When a patient has significant blood loss, which of the following clinical findings would you expect to find that signifies the presence of shock?
Rapid heart rate
Which of the following principles may help the most in ensuring the survival of a patient who is suffering from shock due to massive trauma?
Rapid transport to an appropriate facility
You are treating a 64-year-old female patient complaining of weakness and abdominal pain. You find the patient pale, cool, and diaphoretic, leaning against the wall adjacent to her toilet. You note the presence of bright, red blood in the toilet. Based on these findings, what treatment option will improve the body's ability to clot?
Cover the patient in a blanket to prevent hypothermia.
It is characteristic of arterial bleeding to be:
During severe bleeding, which of the following structures is most sensitive to hypoxia from blood loss?
The method of bleeding control that is the first and most successful method to try is:
Once a pressure dressing has been applied, the EMT should next:
ensure that bleeding is controlled.
A bulky dressing that is held in place by a tightly wrapped bandage and is used to control bleeding is called a:
If you find a major bleed during your initial assessment of the patient, you should:
immediately apply direct pressure to the site with your gloved hand.
In applying a tourniquet, which of the following is the proper technique?
Place the tourniquet at least 2 inches above the bleeding wound.
The signs and symptoms of internal bleeding include:
poor peripheral perfusion.
Which of the following provides the greatest chance of survival for a critical trauma patient?
An internal injury with no open pathway from the outside is called:
The skin is the largest organ of the body. It is composed of three layers, including the:
epidermis, dermis, subcutaeous
In a contusion, what remains intact?
Swelling or deformity at the site of a bruise indicates a:
possible underlying fracture.
A puncture wound that is shallow or deep is a:
penetrating puncture wound.
The structures within the dermis include:
Crush injuries often can be identified by what?
Mechanism of injury
Abdominal bruising should be considered a sign of possible:
internal organ damage.
To control bleeding, start with:
direct pressure and elevation.
A degloving injury is an example of a(n):
A burn injury should be considered to be:
an injury with the potential for many far-reaching effects.
Your patient has burns to the entire right arm and the anterior chest. What is the estimated surface area involved?
White and dry to dark brown or black and charred skin is a sign of a:
Your patient has sustained a chemical burn to her hands from dry lime. How is this treated in the field?
Brush off the powder before using water to flush.
The sterile material that is placed directly on a wound is termed the:
A way of identifying the seriousness of a burn is by its degree. Which of the following statements is true?
A full-thickness burn is also known as a third-degree burn.
What is the first step in removing dry chemicals from the body?
Brush off the excess material.
A patient with an electrical injury is least likely to present with which of the following signs and symptoms?
After treating an actively bleeding head laceration with a sterile dressing and bandage, you notice that the dressing has become blood-soaked and that blood is seeping through the bandage. You should:
reapply pressure and place additional sterile dressings over the blood-soaked dressing.
It is characteristic of hemostatic dressings to:
stop or slow bleeding.
A movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is called:
Bullet wounds are what type of trauma?
Bullet wounds are a type of penetrating trauma, and involve both internal and external injuries.
An open abdominal wound with protruding organs is called:
Cardiac tamponade occurs when:
blood enters the pericardial sac surrounding the heart.
You are treating a patient who was stabbed in the right side of the anterior chest wall. He has shortness of breath, weakness, and rapid breathing. Aside from administering oxygen, what is the most appropriate treatment for this patient?
Apply an occlusive dressing on the chest wall, and tape the dressing on three sides.
Which of the following best describes an open chest wall injury?
Knife wound to the left anterior chest
Your patient has received a blunt trauma injury to the chest from being hit with a baseball bat. You notice a flail segment, lung sounds are diminished, and the patient is having difficulty breathing. You note that the patient's trachea is deviating toward the uninjured side. You suspect:
a tension pneumothorax.
You are treating a patient who was diagnosed with multiple rib fractures following a motor vehicle collision. You note equal chest rise and fall. He appears short of breath as well as pale, cool, and diaphoretic. Given the patient's presentation as well as his acute medical history, what condition is he most likely to suffer?
Which of the following signs and symptoms would lead you to believe that your patient had a tension pneumothorax?
Severely decreased or absent breath sounds on the injured side
What organ in the abdomen is most commonly injured by blunt trauma, and can bleed profusely enough to threaten the patient's life?
Why should the EMT complete a full assessment on a patient with a bullet wound to the abdomen?
To determine the probable extent of injuries
Rapid, shallow breathing; pale, cool, clammy skin; and a low blood pressure in a patient with an abdominal injury are signs of:
Some local protocols recommend that an abdominal evisceration should be covered with a sterile dressing moistened with sterile saline, followed by:
an occlusive dressing.
You arrive on scene to an alert 27-year-old male patient with an obvious abdominal evisceration. He is restless, pale, cool, and diaphoretic. After administering high-concentration oxygen, you should immediately:
cover the wound with a dressing moistened with saline.
A fracture in which the broken bone segments are at an angle to each other is called:
an angulated fracture.
Which element of the musculoskeletal system belongs to the lower extremities of the appendicular skeleton?
A 23-year-old male sustained a musculoskeletal injury to his leg while playing organized football. He reports that his cleated foot was planted into the field when he was hit with a force that caused him to rotate. He heard a snap at this point. What mechanism of injury was applied?
What must happen for a joint to dislocate?
Soft tissue and ligaments must be stretched.
A muscle injury resulting from overstretching or overexertion of the muscle is a:
The muscles that are of chief concern in trauma and musculoskeletal injury are the ________, or voluntary, muscles.
Most injuries to the upper extremities are caused by:
forces applied to an outstretched arm.
A patient has been exercising too much, which has led to a muscle injury in his right shoulder due to too much strenuous activity involving that muscle. This is a:
You arrive on scene to a private residence, where you find a 56-year-old female patient sitting in her living room complaining of pain, paresthesia, and pressure in her lower right leg. She states that a few days ago, she slipped on her way downstairs, and has had pain in her leg ever since, but she has not been to the doctor. During your examination, you note that her right lower leg is pale and pulseless. You see swelling and palpate hardness compared with the uninjured left lower leg. Based on these findings, the patient is most likely experiencing which of the following conditions?
Guidelines for splinting long-bone injuries include:
immobilizing the hand or foot in the position of function.
Your patient has a nontraumatic fracture of the left wrist. Appropriate treatment would be to:
splint with a padded rigid splint.
When treating a patient with musculoskeletal injuries, after addressing any life-threatening conditions, splint:
any suspected extremity fracture.
As you care for a patient with a possible lower leg injury, you should assess the distal pulse, motor function, and sensation:
both before and after applying a splint to the leg.
You are treating a 17-year-old female who fell while playing basketball. Her right thigh is painful, swollen, and deformed. She is in considerable pain. The most appropriate device for splinting her injury would be a:
If a commercial pelvic splint is not available, the next best alternative is:
a pelvic wrap improvised from a sheet.
When an individual sustains blunt-force trauma to the head that results in a brief disruption of the neural network without any physical evidence or lasting residual effects, this would be termed a:
An injury to the cranium would directly affect:
the bony structure making up the forehead and top, back, and upper sides of the skull.
You arrive on scene at a motor vehicle crash, where you notice that the patient has severe bleeding from her head with gray matter showing. This type of injury is a(n):
open skull fracture.
The 12 vertebrae in the upper back are known as the:
Skull injuries divide into two general categories, which are:
open and closed.
Which of the following findings is least likely in a patient with nontraumatic brain injury?
When treating a patient with damage to the facial bones, you should have a high index of suspicion for:
injury to the brain.
You respond to the scene of an assault, where you find a 26-year-old male patient with a knife impaled in the left lobe of his skull near the temporal membrane. He is alert but disoriented. How should you manage this patient's injury?
Stabilize the knife with bulky dressings
The three sections of the Glasgow Coma Scale (GCS) include:
Which of the following is a component of Cushing reflex?
Decreased heart rate
Your patient responds to painful stimulus with decorticate posturing (arms bent to his chest, fists clenched, and legs straight out), his eyes do not open to pain, and he makes incomprehensible sounds when you pinch him. What score would you give him on the Glasgow Coma Scale?
A large puncture wound or laceration to the neck must be immediately sealed with an occlusive dressing to prevent:
an air embolus.
What is your first priority for a patient with massive facial trauma?
Keeping the airway open
If a standard medically approved occlusive dressing is not available, what material might be effective in treating an open neck wound?
A piece of heavy plastic that is at least 2 inches larger in diameter than the wound site
Another term for a compression injury to the spine is:
Which of the following is most likely to have associated spinal injury?
Shock, or hypoperfusion, caused by a spinal cord injury is classified as:
If your patient is wearing a helmet, you should leave it in place if:
there are no impending airway or breathing problems.
A diver struck his head on the bottom of the swimming pool and now complains of neck pain and numbness in his lower extremities. You suspect:
Paralysis of the extremities is probably the most reliable sign of spinal cord injury:
in patients who are conscious.
A patient with more than one serious injury:
is a multiple trauma patient
Your patient fell 15 feet from a roof. He has a deformed lower leg and a decreased level of consciousness. You designate the patient as a multisystem trauma patient who should be taken to a nearby trauma center. This is a:
You are caring for an adult trauma patient. Which of the following is a definitive sign that your patient is in shock?
Systolic BP below 90 mmHg
According to the CDC, which of the following factors should be taken into consideration in triaging a trauma patient?
Which of the following patients would most likely be triaged to a trauma center?
A pregnant multisystem trauma patient
When you are caring for a victim of multisystem trauma, which of the following is LEAST likely to be a part of scene treatment?
Providing appropriate fluid resuscitation
If you are computing a Revised Trauma Score and the patient's GCS score is 14 with a respiratory rate of 30/min., a blood pressure of 102 systolic, and a heart rate of 104, what is the patient's total Revised Trauma Score?
The Revised Trauma Score rates the:
Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
Which of the following is a transport decision for a multisystem trauma patient?
Deciding on a hospital destination
Which of the following statements about insect bites and stings is true?
Brown recluse bites are usually painless.
Which of the following is a poisonous snake native to the United States?
You are treating a patient at high altitude who complains of shortness of breath at rest. She has a dry cough and a mild fever. While you are gathering her history, she begins coughing up blood. You should suspect:
high-altitude pulmonary edema.
How does the body compensate in the short term for the increased atmospheric pressure—and resulting decreased amount of air to breathe—at increased altitudes?
A person breathes more rapidly and more deeply.
How does the body compensate in the short term for the increased atmospheric pressure—and resulting decreased amount of air to breathe—at
A person breathes more rapidly and more deeply.
A boating accident may produce a range of injuries, such as:
fractured bones, bleeding, soft-tissue injuries, and airway obstructions.
One rescuer in deep water should, when finding a patient facedown in the water, swim to a position beside the patient, support the patient's head with one hand and the mandible with the other, rotate the patient by ducking under the patient, and:
continue to rotate until the patient is faceup.
A 38-year-old male is in the water, and requires rescue. Which of the following would be best to extend to him to pull him to safety?
A 72-year-old woman lives in an apartment without air conditioning. There is currently a severe heat wave with high humidity. The woman's neighbor finds her responsive only to pain, and with hot, red, dry skin. What assessment finding would you LEAST suspect with this patient?
Which of the following is the highest priority in managing a patient with a heat-related emergency?
Move the patient to a cool environment.
What can deceive people into overexertion and hyperthermia?
A man is spending a day fishing in an area where temperatures are over
90°F. Which of the following conditions would be most likely to increase his risk of a heat-related emergency?
Having a few beers while fishing
Which of the following is an acceptable method of actively rewarming a hypothermic patient?
Place heat packs on the groin, neck, armpits, and chest.
Which of the following is a risk of active rewarming?
A disoriented elderly patient is found in his apartment with inadequate breathing. It's the middle of winter, and the temperature outside is below freezing. What other factor involved in this patient's situation may most make you suspect hypothermia?
You find the patient lying on the floor of his room.
Which of the following interventions is indicated for all hypothermic patients?
During primary assessment of a hypothermic patient, you should:
check the patient's orientation to person, place, and time, if the patient is awake.
Which of the following factors contributes LEAST to the risk of hypothermia for an elderly patient?
Which of the following descriptions best characterizes deep frostbite?
Body tissue becomes frozen.
Your adult trauma patient has a score of 14 on the Glasgow Coma Scale, a systolic blood pressure of 90 mm Hg, and a respiratory rate of 10. You should:
address whether the patient meets the anatomic criteria for transport to a trauma center.
During an environmental emergency, patients who are under the influence of alcohol:
tend to be affected more rapidly and severely.
According to CDC trauma triage guidelines, special patient or system considerations include age, burns, pregnancy, and:
anticoagulants and bleeding disorders.
Which of the following is a sign of severe hypothermia?
Absence of shivering
Which of the following is the highest priority for your multisystem trauma patient?
Your patient is immersed in cold water. Which of the following will cause the fastest loss of body heat?
Your patient has a Revised Trauma Score of 3. This means that:
the patient's condition is critical.
Cooling or freezing particular parts of the body is:
Which of the following statements about environmental emergencies is true?
Environmental emergencies can occur in any
rural, suburban, and urban.
Which of the following is typically a source of heat for the body?
Keys to effectively managing an environmental emergency are _____________ and providing prompt and proper emergency care.
recognizing the patient's signs and symptoms
When palpating a fracture site on a patient's mid-thigh, you notice a grating sensation. This is known as:
A 14-year-old girl has fallen from her bicycle. She sustained injuries when she landed with her arm extended to catch her fall. According to the principles of indirect mechanisms of injury, which of the following bones is least likely to have been injured in this fall?
What is the primary concern about a splint that is applied too loosely?
It could allow the bone fragments to move, which could cause further damage.
For a high-priority, unstable patient with musculoskeletal injuries, you should:
immobilize the whole body on a long spine board and "load and go."
The regions on the surface of the body that individually are innervated by a single spinal nerve are called:
The catcher at a baseball game is struck on the front of his head by a thrown bat. He sustains a cerebral bruise on the front of his brain but also has a contusion on the back of his brain. The bruise on the back of his brain is called a(n):
You find out that one of your patients from an earlier car wreck suffered bleeding that caused the blood to collect and pool within the patient's skull. Based on this information, you know that the patient most likely suffered which type of brain injury?
You are treating a 22-year-old male who was stabbed in the neck during a bar fight. What is an important part of the treatment of this injury?
Sealing the wound with an occlusive dressing
Manual cervical stabilization should be provided to all patients with a significant mechanism of injury until:
completion of the assessment.
You are evaluating a 45-year-old male car wreck victim. Your evaluation of this patient is based on specific characteristics that will be assigned a specific score. What is this score known as?
Knowing what you will do on scene and how that relates to what your partner will do is part of:
You arrive on scene to a patient with an arterial bleed from his right lower leg. The patient is lethargic, and has many other injuries. What should you do first?
Stop the hemorrhage with direct pressure
Your patient was involved in a motor vehicle collision. You have decided to transport him to a trauma center because another occupant in the same vehicle died. Your decision is based on:
mechanism of injury.
What is your overall goal in caring for a multisystem trauma patient?
To treat immediate threats to life
Which of the following is an example of an environmental emergency?
Deep local cold injury
Which of the following statements best describes conductive heat loss?
The transfer of heat from one material to another through direct contact
Which of the following statements is true about pediatric and geriatric patients?
Pediatric and geriatric patients are especially at risk for hypothermia.
When considering a water rescue of a patient, it is most important to consider:
the safest way to rescue the patient for both you and the patient.
Ventilating a drowning victim too quickly or forcefully will likely cause:
significant gastric distention.
What is a sign or symptom common to air emboli and decompression sickness?
Which of the following symptoms is seen in high-altitude cerebral edema but not in acute mountain sickness?
Altered mental status
Which of the following is most common after an insect bite?
Localized pain or itching
You are treating a patient for an insect sting, and during your assessment you see the stinger. You should:
remove the stinger as quickly as possible by the best available means.
function of blood
to carry oxygen to the tissues (transport of respiratory gases, nutrients, wastes, and other substances)
Blood vessels that carry blood away from the heart
Blood vessels that carry blood back to the heart
thin-walled, microscopic blood vessels where the oxygen/carbon dioxide and nutrient/waste exchange with the body's cells take place. They allow oxygen and nutrients to pass through the body cells
What is shock?
The bodies in ability to circulate blood adequately to the body cells to supply them with oxygen and nutrients, which is a life-threatening condition also known as hypo perfusion. (Lack of perfusion)
What are the types of shock?
Cardiogenic shock (due to heart problems)
Compensated shock (developing shock)
Decompensated shock (no longer comp)
Distributive shock (blood vessel tone)
Hemorrhagic shock (blood loss)
Hypovolemic shock (low blood volume)
Anaphylactic shock (due to allergic reaction)
Septic shock (due to infection)
Neurogenic shock (damage to nervous system)
Hearts inadequate pumping action resulting in a heart attack or congestive heart failure
When the patient is developing shock but the body still able to maintain perfusion
When the body can no longer compensate for low blood volume or lack of perfusion late signs such as decreasing blood pressure become evident
Lack of blood vessel tone blood vessel dilation leads to a decrease in pressure within the circulatory system
shock resulting from blood loss
shock resulting from blood or fluid loss
Severe shock caused by an allergic reaction.
Shock caused by severe infection, usually a bacterial infection.
a state of shock (hypoperfusion) caused by nerve paralysis that sometimes develops from spinal cord injuries
Compensation vs decompensation
Compensation is the body being able to keep up and take measures to maintain blood pressure decompensation is when the body fails to keep up
The body taking extra measures to keep up and succeeding
The body trying to take extra measures but fails to keep up
What is irreversible shock?
When the body has lost the battle to maintain perfusion to vital organs (last phase of shock)
What is epistaxis?
Acute hemorrhage from the nostril nasal cavity or nasalpharynx it is also called a nose bleed
Layers of skin?
epidermis, dermis, subcutaneous
Types of musculoskeletal injuries?
Soft Tissue Injuries (closed and open)
Strains, Sprains and Dislocation
How to treat Avulsion
- Apply field dressing to avulsed area (For extremely large or deep avulsions, several pressure dressings may be necessary or an air splint and dressing).
- Prevent further contamination
Figure 8. Avulsion of the palm
- Ensure avulsed flap is lying flat and that it is aligned in its normal position
- If the avulsed part is completely pulled off, make every effort to preserve it. Wrap the part in a saline or water soaked field dressing, pack wrapped part in ice, and whenever possible be careful to avoid direct contact between the tissue and ice.
- Transport the avulsed part to the BAS with the patient but keep it well-protected from further damage and out of view of the patient
- Immobilize extremity or body part as indicated by the severity of the avulsion
How to treat Lacerations
- treatment is generally the same as for abrasions:
- Control hemorrhage
- If major tendons and muscles are completely severed, immobilize limb to prevent further damage.
- Treat for shock
How to treat Abrasions
- Hemorrhage is usually so minimal that primary treatment may only require cleansing of the wound.
- Small bandages may be applied but tactical situations will usually preclude applying field dressings that are needed for more serious injuries.
- A large amount of dirt may be ground into the wound, therefore secondary treatment measures should focus on preventing or stopping infections.
How to treat Fractures
-Treat associated injuries
- Control hemorrhage
- Treat for shock
- Check distal pulses before and after splinting
- Immobilize the fracture using splints
- Recheck PMS (pulse, motor, and sensation)
- Relieve pain (see medication appendix at the back of Block 2 for more information)
- DO NOT reduce fractures in field unless distal pulses are not present
How to treat Strains, Sprains and Dislocation
Supportive strapping or bandaging
- Immobilize by splinting so that affected muscle is in relaxed position, if injury is severe
-R.I.C.E. (Rest, Ice, Compression, Elevation)
How to treat Amputations
- Hemorrhage Control - Apply a tourniquet. If a tourniquet is applied, mark the patient's forehead with a "T" (indicating the time it was applied)
- Place the patient in shock position (Head down, feet elevated)
- Make every effort to preserve the amputated part and evacuate the patient as soon as possible
- Wrap amputated part in sterile dressing, place in ice and send with patient. When possible, prevent direct contact between tissue and ice.
What is rule of palm?
a method used for estimating the extent of a burn. The palm and fingers of the patient's own hand, which make up about 1% of the body's surface area, are compared with the patient's burn to estimate its size.
What is rule of nine?
A method for estimating the extent of a burn. For an adult each of the following areas represent 9% of the bosy 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.
Levels of burns? Signs and symptoms of each?
2nd/partial thickness (blisters)
What is flail chest?
A fracture of two or more sites on two or more adjacent ribs, or when rib fractures produce a free-floating sternum.
When patients chest expands to inhale negative pressure air into lungs
What can cause JVD?
Know the various traumatic chest injuries?
compression and shearing
What is an evisceration? How to treat?
An intestine or other internal organ protruding through around in the abdomen
Treat by covering the wound with a clean wet bandage
Tough tissue that covers the joint ends of bones and helps to form certain body parts such as the year
Tissue that connects muscle to bone
Tissue that connects bone to bone
What is periosteum?
the tough white fibrous membrane that covers the outside of the bone
The stretching and tearing of ligaments
Muscle injury resulting from overstretching or over exertion of the muscle
What is crepitus?
grating sound created by the rubbing of bone fragments
Indication and contraindications of traction splint?
Injuries close or to the knee and People with osteoporosis and fragile skin
The six P's
Pain - or tenderness
Pallor - pale skin or poor capillary refill
Paresthesia - sensation of pins and needles
Pulses - diminished or absent in the injured extremity
Paralysis - The inability to move
What is a dermatome?
An area of the skin that is innervated by a single spinal nerve
What does the autonomic nervous system do to us?
Regulate certain body processes such as blood pressure and the rate of breathing and does not require a conscious effort
Most vulnerable part of spine?
The lumbar spine
What are the regions of the spine
cervical, thoracic, lumbar, sacrum, coccyx
How many bones are in the spine
How many bones are in the cervical part of the spine
How many bones are in the thoracic part of the spine
How many bones are in the lumbar part of the spine
How many bones are in the sacrum part of the spine
How many bones are in the coccyx part of the spine
What is ICP? Signs and symptoms?
Also known as intracranial pressure which happens when pressure increases inside of the school when a hematoma develops the symptoms include a severe headache a decrease in heart rate and an increase in blood pressure also known as Cushing reflex
What is battle's sign?
A bruise behind the ear which is a late sign of cranial fracture or brain injury
What is multisystem trauma?
One or more injuries that affect more than one body system
Ways heat is lost
radiation, conduction, convection, evaporation
How are heat cramps formed?
When the body loses salts bring on painful cramps in the muscle apply moist cool packs to neck groin and armpits
The presence of air in the veins, which can lead to cardiac arrest if it enters the heart. It's usually caused by diving too deep
A condition resulting from nitrogen trapped in the body's tissues caused by coming up too quickly from a deep, prolonged dive. A symptom of decompression sickness is "the bends" or deep pain in the muscles and joints.
What is Acute Mountain Sickness and the treatment for it?
When the body is unable to adjust to dinner either
Rest and rehydration
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