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Sinclair Paramedic 2150 > 3- Trauma- Bleeding, Shock, Burns > Flashcards

3- Trauma- Bleeding, Shock, Burns Flashcards

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1
Q

What is the largest organ of the body

A

Skin

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2
Q

What are the 4 functions of skin

A
  1. Mechanical barrier
  2. Protective barrier
  3. Sensory organ
  4. Temperature regulation
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3
Q

What happens to body temp when skin is burned

A

Hypothermia

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4
Q

5 steps of treatment for soft tissue injuries

A
  1. Stop any significant bleeding
  2. Maintain the airway
  3. Assess for life threats
  4. Prompt transport
  5. Prevent infections
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5
Q

What are tension lines of the body

A

Natural patterns in the surface of the skin revealing tension within

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6
Q

What are 3 types of closed wounds

A
  1. Contusions (bruises)
  2. Hematomas (blood bump under skin)
  3. Crush injuries
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7
Q

What are 7 types of open wounds

A
  1. Abrasions
  2. Lacerations
  3. Incisions
  4. Punctures
  5. Impaled objects
  6. Avulsions
  7. Amputations
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8
Q

What is an amputation

A

Missing part of body including bone

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9
Q

What is an avulsion

A

Flap of full skin still hanging on

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10
Q

What is a crush injury

A

Injury where once object is removed an indentation remains

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11
Q

What is an abrasion

A

From friction, skin stays in its location

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12
Q

What is a laceration

A

A splitting open/division of skin

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13
Q

What are 3 types of hemorrhage

A
  1. Arterial
  2. Capillary
  3. Venous
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14
Q

How to identify an arterial bleed

A

Spurting/pulsating flow of bright red blood

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15
Q

How do identify a venous bleed

A

Steady flow of dark red blood

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16
Q

How to identify a capillary hemorrhage

A

Slow even flow of blood

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17
Q

About how much blood is lost from a Rib, Radius/Ulna, Humerus, Tib/Fib, Femur, and Pelvis fracture

A 
Rib- 125ml
Radius/Ulna- 250-500ml
Humerus- 500-750ml
Tib/Fib- 500-1000ml
Femur- 1000-2000ml
Pelvis- 1000-3000ml
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18
Q

Management for head wounds

A
  • Gentle direct pressure

- Do not try to stop drainage from ears and nose

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19
Q

Management for neck wounds

A
  • Consider direct digital pressure

- Occlusive dressing

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20
Q

Management for gaping wounds

A
  • Bulky trauma dressing
  • Sterile nonadherent dressing
  • Compression dressing
  • Fill the wound
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21
Q

Management for crush injury

A
  • Consider and air splint and pressure dressing

- Consider constricting band or tourniquet

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22
Q

Sources of burns (4)

A
  • Thermal
  • Electrical
  • Chemical
  • Radiation
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23
Q

What 2 things does the severity of a burn depend on

A
  • Extent

- Depth

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24
Q

What 5 things happen to the body when skin is los

A
  1. Hypovolemia
  2. Hypothermia
  3. Hemoconcentration (Excessive RBCs)
  4. Systemic fluid shift
  5. Damaged cells release electrolytes
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25
Q

What 4 things happen in burn shock

A
  1. Decreased cardia output by 30-50%
  2. Increased metabolic acidosis
  3. Paralytic ileus (Bowel stops working)
  4. Interstitial edema
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26
Q

3 burn depth classifications

A
  1. Superficial
  2. Partial thickness
  3. Full thickness
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27
Q

What is Eschar

A

-Darkened worthless skin, fully dead

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28
Q

Main problem of electrical burns

A

Damage can not be determined by external findings

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29
Q

Chemical burns, acid vs base

A

Acid- Burn and coagulate

Base- Liquify and burn deep

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30
Q

Rule of 9s for an adult

A 
9 - Head
18 - Front torso
18 - Back torso
9 - Each arm
18 - Each leg
1 - Groin
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31
Q

Rule of 9s for Peds

A 
18 - Head
18 - Front torso
18 - Back torso
9 - Each arm
14 - Each leg
1 - Groin
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32
Q

Most important care for for a burn patient

A

STOP THE BURN

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33
Q

Treatment for burns (5)

A
  • Put them out
  • Keep them warm
  • Transport
  • Replace fluid
  • Analgesics
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34
Q

What is the parkland formula

A

4mL x BSA% x KG = (X/2) / (8hrs)

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35
Q

What do most burn patients die from

A

HYPOXIA

36
Q

6 inhalation injuries

A
  1. CO poisoning
  2. Toxic gas inhalation
  3. Smoke inhalation
  4. Heat inhalation
  5. Steam inhalation
  6. Asphyxiation
37
Q

Signs of inhalation injury (6)

A
  1. Burns to face
  2. Singed facial hair
  3. Soot in sputum
  4. HOARSE VOICE OR STRIDOR
  5. Cough or dyspnea
  6. History of exposure in enclosed space
38
Q

Inhalation injury treatment (3)

A
  1. Airway with high flow O2 (May need size smaller)
  2. May need intubation
  3. Maintain high pulse ox
39
Q

Treatment for chemical exposure, wet vs dry

A

Dry- Brush off then flush

Wet- Flush

40
Q

Use of other chemicals to stop chemical burns

A

HELL NO

41
Q

Extent of electrical burns depends on (4)

A
  • Type of current
  • Amount of current
  • Path of current
  • Duration of contact
42
Q

Most serious immediate injury from electricity

A

Cardia Arrhythmias

43
Q

3 types of injury patterns from electricity

A
  • Skin burns
  • Deep tissue injury
  • Fractures
44
Q

What 2 routes does electricity travel through the body

A
  1. Blood vessels
  2. Nerves

*Follows the path of least resistance

45
Q

Which current is more dangerous and why DC or AC

A

AC- Alternating current contracts the muscles to possible stay connected to the source

46
Q

Main interventions for electrical injuries

A
  • Remove source if possible

- IV, O2, Monitor

47
Q

Types of of injuries from electricity

A
  • True electrical
  • TASER effect
  • Arc or Flash burn
  • Flame burn
48
Q

2 most common causes of death from electrical injury

A
  • Asphyxia

- Cardiac arrest

49
Q

Can electrical injury cause fluid shifts in the body?

A

YES

50
Q

Main sign of a lighting strike injury

A

Feathering pattern on the skin

51
Q

3 types of ionizing radiation in order from weakest to strongest

A
  1. Alpha
  2. Beta
  3. Gamma
52
Q

What units is radiation measured in

A

REM- Radiation equivalent in man

RAD- Radiation absorbed dose

53
Q

What’s is Acute Radiation Syndrome (ARS)

A

Serious illness from high short term exposure

54
Q

Major goals of blast injuries

A
  • Contain the incident

- Contain the people

55
Q

Where does most force from a blast go

A

Up

56
Q

Blast injury physiology: Spalling

A

Shock waves through tissues

57
Q

Blast injury physiology: Implosion

A

Entrapped gases in hollow organs

58
Q

Blast injury physiology: Shearing

A

-Tissues moving at different speeds tear form each other

59
Q

Blast injury categories (5)

A
  1. Primary
  2. Secondary
  3. Tertiary
  4. Quaternary
  5. Quinary
60
Q

Damages from each blast injury category

A

Primary: Hollow organ rupture

Secondary: Penetrating injuries

Tertiary: Fractures and soft tissue trauma

Quaternary: Injuries from effects of the blast but not the blast itself

Quinary: Dirty bomb

61
Q

What is a blast front and positive wave pulse

A
  • The leading edge of an explosion

- Pressure front higher than atmospheric pressure

62
Q

What is Brisance in blasts

A

Shattering effect of a wave and its ability to cause bodily damage

63
Q

Negative wave pulse in blasts

A

After initial pos pressure wave, air returns to the negative space left

64
Q

What effects speed, duration and pressure of a shock wave in blasts

A
  • Size of charge
  • Surrounding medium
  • Distance from explosion
  • Reflecting surfaces
65
Q

Blast injury: Lungs s/s, treatment

A

S/S

  • Diff breathing
  • Chest pain, shock

Treatment

  • O2, CPAP
  • Intubate if needed
  • Fluids with caution
66
Q

Blast injury: Tympanic membrane s/s, treatment

A

S/S

  • Hearing loss
  • Ringing in ears
  • Blood in ear canal

Treatment
-Cover bleed, but dont prevent it

67
Q

What are 4 WMD agent types

A
  1. Chemical
  2. Blood
  3. Choking
  4. Radiological
68
Q

Biological warfare is also known as

A

The poor mans nuclear weapon

69
Q

Key points from 2004 Project Bioshield (3)

A
  • Relax spending procedures for radiation exposure treatment
  • Gov guarantee to purchase counter measures
  • Permit emergency use of unapproved countermeasures
70
Q

Chemical nerve agents

Examples
S/S
Treatment

A

Examples
Sarin, Tabun, V agents, Organophosphates

S/S
SLUDGEM

Treatment
Duodote injection
- Atropine and 2-PAM

71
Q

Chemical blister agents

Examples
S/S
Treatment

A

Examples
Mustard gas, Lewsite

S/S (Take a while to present)

  • SOB
  • Eye/skin irritation
  • Blisters

Treatment

  • Level A protection
  • Decon
72
Q

Blood agents

Examples
S/S
Treatment

A

Examples
-Arsenic, Cyanide, CO

S/S

  • Hypoxia, convulsions, apnea
  • Smell of bitter almonds

Treatment

  • Decon
  • O2
73
Q

Choking agents

Examples
S/S
Treatment

A

Examples

  • Chlorine
  • Ammonia
  • Phosgene

S/S

  • Varying resp complaints
  • Nausea, chest tightness, SOB

Treatment
-O2, BVM, Suction

74
Q

Radiological Agents

Examples
S/S
Treatment

A

Examples
-Detonated dirty bomb

S/S

  • Severe trauma, burns
  • Fever, disorientation, vomiting
  • Rectal bleeding

Treatment
Unknown

75
Q

Burn Center transport criteria

A

5% Full thickness burns

10% Partial or Superficial under 10 y/o or over 50 y/o

20% Partial or Superficial at any age

76
Q

Different types of thermal burn injuries (5)

A
  1. Flame
  2. Scald
  3. Contact
  4. Steam
  5. Flash
77
Q

Burn zones

A
  1. Zone of coagulation
  2. Zone of stasis
  3. Zone of hyperemia
78
Q

5 compensatory mechanisms of shock

A
  1. Baroreceptors
  2. Renin-Angiotensin-Aldosterone
  3. Chemoreceptors
  4. ADH
  5. Fluid return
79
Q

Explain Baroreceptors location and role in shock

A

Location
Atria, Vena cava, aortic arch, carotid sinus

Role
Tell SNS to secrete Epi and NorEpi for Alpha and Beta effects
Tell PNS stops signal to vagus nerve, increase HR, vasocon

80
Q

Explain the Renin-Angiotensin-Aldosterone response in shock (6)

A
  1. BP falls
  2. Renin released from kidneys to circulation
  3. Renin+Blood plasma becomes Angiotensin 1
  4. Angiotensin converting enzyme (ACE) turns Angiotensin 1 into Angiotensin 2, a potent vasoconstrictor
  5. Aldosterone is released form Adrenal Cortex which stimulates kidney to reabsorption sodium
  6. Urine output decreases to maintain fluids
81
Q

Explain the Chemoreceptors role in shock

A

Find change in pH due to Lactic acid build up from Anaerobic metabolism

Increase rate and depth of respiration’s to blow off CO2

82
Q

Explain the role of Antidiuretic Hormone (ADH) shock

A
  • ADH secreted form pituitary gland

- Decreases production of urine

83
Q

Explain the role of Fluid return in shock

A

Splenic squeeze- Veins in spleen constrict releasing 200mL of stored blood into circulation via diffusion

84
Q 
Capillary sphincters
Normal
Compensated shock
Late compensated shock
Early Decompensated shock
Late Decompensated shock
Irreversible
A

Normal
Pre-Open, Post-Open

Compensated
Pre-Closed, Post-Open

Late Compensated
Pre-Closed, Post-Closed

Early Compensated
Pre-Open, Post-Closed

Late Decompensated
Pre-Open, Post-Open

Irreversible
Pre-Open, Post-Open

85
Q

4 types of shock

A
  1. Hypovolemic
  2. Distributive
  3. Cardiogenic
  4. Obstructive

Sinclair Paramedic 2150 (16 decks)

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