Airway, Breathing, and Circulation Concerns

Question 1

What problems are common in patients with head and spinal injuries?

Answer 1

Airway and breathing problems

These problems may result in death if not recognized and treated immediately.

Question 2

What is the first step in assessing the airway of a patient with a suspected spinal injury?

Answer 2

Manually hold the patient’s head still

This is important to avoid movement of the cervical spine.

Question 3

What maneuver should be used to open the airway in a patient with a suspected spinal injury?

Answer 3

Jaw-thrust maneuver

This maneuver is preferred to prevent cervical spine movement.

Question 4

What is the last resort maneuver for providing an airway if the jaw-thrust is unsuccessful?

Answer 4

Head tilt-chin lift maneuver

This may cause further injury to the spine.

Question 5

What types of airways may assist in maintaining an airway?

Answer 5

Oropharyngeal and nasopharyngeal airway

These adjuncts can help maintain airway patency.

Question 6

What factors determine the decision to use an oropharyngeal or nasopharyngeal airway?

Answer 6

• Patient’s ability to maintain own airway
• Presence of a gag reflex
• Extent of facial injuries

Question 7

What may occur in a patient with a head injury that necessitates airway management?

Answer 7

Vomiting

Large amounts of emesis may require log rolling to clear the airway.

Question 8

What is the correct technique for log rolling a patient to clear the airway?

Answer 8

Keep the body in as straight a line as possible

This minimizes spinal injuries.

Question 9

What type of breathing irregularity may result from increased pressure on the brain?

Answer 9

Cheyne-Stokes respirations

This can occur due to bleeding or swelling in the cranium.

Question 10

What is indicated for patients with head and spinal injuries regarding oxygen?

Answer 10

Prehospital administration of high-flow oxygen

This is crucial for maintaining adequate oxygenation.

Question 11

What pulse oximeter value is critical for patients with head injuries?

Answer 11

Values should not fall below 90%

Ideally, values should be 95% or higher.

Question 12

Fill in the blank: Positive pressure ventilations are not always necessary; however, they should be provided if the patient’s breathing rate is too slow or too fast and _______.

Answer 12

shallow

Question 13

What should be avoided in the management of head injuries due to its controversial nature?

Answer 13

Hyperventilation

Hyperventilation can increase the severity of head injuries.

Question 14

What is the recommended end-tidal carbon dioxide (ETCO2) level when hyperventilation is used?

Answer 14

Between 30 and 35 mm Hg

This should only be done when capnography is available.

Question 15

What does XABCs stand for in the context of assessing an unconscious patient?

Answer 15

Exsanguinating hemorrhage, Airway, Breathing, Circulation

This sequence is crucial for patient assessment.

Question 16

What indicates a serious condition in a patient with a head injury?

Answer 16

A pulse that is too slow

This can be a sign of significant underlying issues.

Question 17

What is the consequence of a single episode of hypoperfusion in a patient with a head injury?

Answer 17

Significant brain damage and even death

This emphasizes the importance of monitoring perfusion.

Question 18

What types of forces may cause bleeding in head and spinal injuries?

Answer 18

• Blunt forces
• Penetrating forces

Question 19

What should be avoided when bandaging the head of a patient with a suspected spinal injury?

Answer 19

Do not move the neck

This is crucial to prevent further injury.

Question 20

What should not be applied if a skull fracture is suspected when bandaging?

Answer 20

Pressure

This could worsen the injury.

Question 21

What often occurs together with head injuries?

Answer 21

Spine injuries

This relationship is important to remember during assessment.