Adult emergencies 3 Flashcards
within the cranal vault there are 3 space occupying substances. what are they
brain tissue, CSF, Blood
whati si the most widely accepted tool to assess LOC in a head injured patient
GCS
Describe the components of the GCS
best eye, best verbal, best motor response to stimulus
Why is using the GCS important
can pick up any trending
what is the cause of a fixed and dilated pupil
pressure on the 3rd cranial nerve,the oculomotor nerve, usually from compression or herniation of the tentorium of the brain
An epidural bleed us a what kind of bleed
arterial
a sub dural bleed us what kind of bleed
venous
of the 2 types of head bleeds which has more sudden onset
Arterial
as pressure from swelling occurs in the cranial vault, you may see the classic cushings triad. What are these classic signs
increase in BP, Decrease in HR, Erratic respirations
what is your first priority in the management of closed head injury
airway
name 2 interventions that are done pre hospital which can increase ICP
suctioning, intubation, poor alignment, tight c collar
your are assessing a patients “posturing”
describe decorticate and decerbrate
decorticate: flexing of upper extermities to protect the core
decerebrate: extension
what are the 3 most important prehospital interventions to enhace the outcome of a Closed head injury patient are
good outcome from a bad CHI is directly related to airway maintenane, great oxygenation and pefussing pressure
significant facial trauma can challenge the skills f the best Paramedic because
airway obstructions, difficulty maintaining an airway
in facial injury a mojor distracter to a life threat is
lots of blood
any patient with a major facial injury is considered to have an accompanying
head and neck injury
which cranial nerve controls eye movement
number 3
which type of facial fracture will produce total craniofacial separation
Le Fort 3
which type of fracture causes enophthalmos
orbital fracture, also causes entrapment fo the eye, eye is unable to move due to bone fragments/ pressure impinging on the nerve
list 3 things to assess for when suspicious of a mandible gracture
malocclusion, inability to open mouth, numbness on chin
you are palpating for a zygoma gracture, what are you assesing for
flatness fo the cheek
you are assessing a hockey player for a possible larynx fracture. what are symptom/s are you listening for
hoarsness, stridor
what are symptom/s ou palpate for when looking for a larynx fracture
sub Q emphysema
the most common facial fracture is
nasal fracture
define transfer of energy
as relates to trauma, the transfer of energy from an external source to human tissue. the injury is dependant upon the amount of force applied, the type of tissue that the force is applies to
transfer or energy to a hollow organ such as the small bowel will cause the bowel to
burst like a balloon
transfer of energy to a solid organ such as the liver will cause the liver to
fracture
the amount of energy required to fracture an adult femur is more than the amount of energy required to fracture an adult ulnar bone. Why
related to mass and density
when MOI involves a shearing force, the greatest shear occurs where?
at the points of attachment
what are several anatomical points where shearing forces can cause damage. Name 2 of these
Ligament of Trietz in abdomen, Ligamentum Atteriosum off the aorta
what mechanism suggests why is a car crash at 70 MPH more deadly than a head on a 10 MPH
high velocity vs low velocity, the sudden deceleration of 70 mph vs 10 mph
true or false, penetrating injury from a bullet always follows a straight pathway once in the body
false
name 3 types of forces, besides shearing forces, which are involved in MOI’s
comprssion, acceleration-deceleration, penetrating
what is the best score on the GCS
15
list the motor response in the GCS….remember 4.56
6-obey comands 5-localize to stimuli 4-withdraws from stimuli 3-abnormal flexion-decorticate 2-extensor response-decerebrate 1-no response
list the verbal response in the GCS
5-alert and oriented 4-confused yet coherent, speech 3-inappropriate words and jumbles phrases 2-incomprehensible sounds 1-no sounds
list the eye opening response in the GCS
4-spontaneous eye opening
3-eyes open to speech
2-eyes open to pain
1-no eye opening
how much blood loss can occur in your pelvis
2L
how much blood loss can occur in your thigh
1L
how much blood loss can occur in your tibia
500ml
where should you always splint a limb
above and below the injury
when do you document CMS
before and after splinting
what is volkmanns contracture
claw like contraction of hand and arm deformity from ischemia
where is a boxer’s fracture
5th metatarsal
what organs can pelvic fractures damage
bladder, urethra, reproductive organs, and sacral nerve
what are the six P’s of compartment syndrome
- Pain
- Pallor
- Pulses
- Pressure
- Paralysis
- Parasthesia
what is lafort 1 injury
separates hard palate, teeth, from maxilla
what is lafort 2 injury
pyramid fracture of mid face separates nasal and lower maxilla from facial skull and cranial bones
what is lafort 3 injury
separates the entire mid face from the cranium
Name what each cranial nerve represents..1,2,3,6,7
1- olfactory 2-optic 3- ocular movement 6-facial nerve 7- auditory nerve
