BLS Section 3 AI Flashcards
What should paramedics be aware of regarding a patient’s condition?
Potential to deteriorate and prepare accordingly
Attention should be paid to airway, breathing, circulation, neurovascular compromise, seizures, shock, alterations in mental status, and emesis.
What is the first action a paramedic should take for a patient with a traumatic injury?
Advise the patient to remain still if indicated by severity of injury
This is crucial to prevent further injury.
When should spinal motion restriction (SMR) be performed?
If indicated by the SMR Standard, prior to extrication
SMR is essential in cases of potential spinal injuries.
Under what conditions should extrication be performed?
If it is safe and either:
* Scene survey identifies immediate dangers
* Primary survey identifies conditions requiring interventions not possible at the scene
What should be done immediately after the primary survey?
Perform a rapid trauma survey unless indicated otherwise in the Standards
What factors should be considered when estimating blood loss?
Consider:
* Hemorrhage duration
* Rate of flow
* Presence of clots
* Quantity of blood-soaked materials
* Quantity of blood vomited
What should be done with impaled objects?
Make no attempt to remove; stabilize the object as found
Unless it compromises the airway or interferes with CPR.
What assessments should be made at the injury site?
Assess for:
* Contusions
* Lacerations
* Abrasions
* Penetrations
* Swelling
* Distension
Also palpate for tenderness, instability, and crepitus.
What is the guideline for splinting priorities?
Prioritize splinting in the following order:
* Spine
* Pelvis
* Femurs
* Lower legs
* Upper limbs
What are common causes of trauma in pregnant patients?
Most often associated with domestic violence
Signs of shock may not be obvious until well advanced.
What major causes of maternal and fetal death are associated with trauma in pregnant patients?
Hemorrhagic shock and associated fetal hypoxemia
What should be done for a patient with a complete or partial amputation?
Consider potential life/limb/function threats, assess the injury site, control hemorrhage, cleanse wound, and immobilize the affected extremity
What guidelines should be followed regarding amputated or avulsed parts?
Preserve all amputated tissue and cover the exposed end with moist, sterile dressing
If grossly contaminated, rinse with saline.
What is the protocol for blunt or penetrating injuries to the abdomen?
Consider potential life/limb/function threats such as rupture, perforation, or laceration of organs
What should be done for eviscerated intestines?
Make no attempt to replace intestines; cover with moist, sterile large, bulky dressings
What is the recommended action for a pelvic fracture?
Attempt to stabilize the pelvis and secure the patient to a spinal board
Avoid placing straps over the pelvic area.
What should be considered in bite injuries?
Consider threats to underlying organs, vessels, and specific issues related to snake bites such as anaphylaxis and shock
What potential risks should be recognized through bites?
Bacterial contaminations or disease transmission (e.g. rabies, Hepatitis B, HIV)
Important for assessing the severity of bites and appropriate response measures.
What should be determined about the source of a bite?
Source of bite and owner, immunization and communicable disease status of patient and bite source
Critical for evaluating the risk of infection and necessary interventions.
How long should bites be irrigated if the patient is stable?
Up to five minutes
This helps to reduce the risk of infection.
What steps should be taken if envenomation is known or suspected?
- Position the patient supine
- Immobilize the bite area at or slightly below heart level
- Do not apply cold packs
These steps help manage the effects of venom and prevent further injury.
What life/limb/function threats should be considered for chest injuries?
- Tension pneumothorax
- Hemothorax
- Cardiac tamponade
- Myocardial contusion
- Pulmonary contusion
- Spinal cord injury
- Flail chest
Each of these conditions requires immediate attention and specific interventions.
What should be auscultated in a patient with a chest injury?
Lungs for air entry and adventitious sounds
This helps identify any respiratory compromise.
What should be done for a patient with a penetrating chest injury?
- Assess entry and exit wounds
- Check for tracheal deviation
- Observe for jugular vein distension
- Evaluate airway and/or vascular penetration
Critical assessments to guide treatment decisions.
What is the protocol for an open or sucking chest wound?
- Seal wound with a commercial occlusive dressing with one way valve
- If not possible, use an occlusive dressing taped on three sides
- Apply dressing large enough to cover the entire wound
This prevents air from entering the chest cavity and worsening the injury.
What should be monitored for in a patient with an open chest wound?
Development of tension pneumothorax
Immediate recognition and management are crucial to prevent respiratory failure.
When ventilating a patient with suspected pneumothorax, what should be modified?
Use a lower tidal volume and rate of delivery
This prevents exacerbation of increasing intrathoracic pressure.
What should be done for a patient with a suspected eye injury?
- Assess as per the Head Injury subsection
- Assess eye as per Visual Disturbance Standard
- Leave eyelids shut if swollen shut
Protecting the eye is critical to prevent further damage.
What should be done if there is active bleeding from an eye injury?
Control bleeding using the minimum pressure required
Minimizing pressure helps avoid further injury.
If an eye is extruded, what should be done?
- Make no attempt to replace it inside the socket
- Cover the eye with a moist, sterile dressing
Proper care is essential to protect the eye and surrounding tissues.
What is the recommended position for transporting a patient with a head injury?
Supine, with head elevated approximately 30 degrees
This position helps reduce intracranial pressure.
What are the signs of cerebral herniation to monitor for in head injury patients?
- Deteriorating GCS <9
- Dilated and unreactive pupils
- Asymmetric pupillary response
- Unilateral or bilateral decorticate or decerebrate posturing
Recognizing these signs is critical for timely intervention.
What should be done for suspected concussions?
Transport for further assessment
Important for ensuring proper diagnosis and management.
What should be assessed in a patient with a penetrating neck injury?
- Vascular and airway lacerations/tears
- Decreased air entry and adventitious sounds in lungs
These assessments help identify life-threatening injuries.
How should burns be assessed?
- Estimate severity (area, depth, percentage of body surface area)
- Assess distal neurovascular status in burned extremities
- Assess for signs of smoke inhalation and upper airway injury
Accurate assessment is crucial for treatment planning.
What is the Rule of Nines used for?
To estimate percentage of body surface burned
This helps determine the severity of burns and appropriate treatment.
What steps should be taken if a patient has a thermal burn?
- Stop the burning process
- Move to fresh air if in a smoke-filled environment
- Cool burns if <15% body surface area
These initial actions are vital to minimize damage.
What complications should be prepared for in burn patients?
- Airway obstruction
- Bronchospasm
- Orolingual/laryngeal edema
- Respiratory distress/arrest
Anticipating these issues can save lives.
What are the signs of smoke inhalation and upper airway injury?
- Decreased air entry
- Burns to lips or mouth
- Carbon particles in saliva or sputum
- Cough, drooling, stridor or hoarseness
- Shortness of breath
Recognizing these signs is critical for timely intervention.
What should be done for a patient with a cold injury?
- Remove the patient from the cold as soon as safe
- Prevent additional heat loss
Quick action can prevent serious complications.
What underlying disorders should be considered with cold injuries?
- Severe hypothermia
- Severe frostbite
- Alcohol/drug ingestion
- Hypoglycemia
- Trauma
These conditions can complicate treatment and recovery.
What are the life/limb/function threats associated with severe hypothermia?
Severe hypothermia, severe frostbite, underlying disorders/precipitating factors
Examples of underlying factors include alcohol/drug ingestion, hypoglycemia, and trauma.
What should be performed for patients with known or suspected hypothermia?
Pulse and respirations checks for up to ten seconds.
What two aspects should be determined regarding exposure in hypothermia cases?
- Duration of exposure
- Type of exposure
In a secondary survey for hypothermia, what is important regarding the exposure of areas?
Only expose areas being examined and cover them as soon as assessment is completed.
What should be determined if hypothermia is known or suspected?
The severity of hypothermia.
What should be determined if frostbite is known or suspected?
The severity of frostbite.
What are the indicators of frostbite severity?
- Mild blanching of skin (frostnip)
- Skin waxy/white, supple (superficial frostbite)
- Skin cold, hard and wooden (deep frostbite)
What is the significance of shivering in assessing hypothermia severity?
The presence or absence of shivering is an important indicator of severity.
What assumption should be made if shivering is minimal or absent and the level of consciousness is decreased?
Assume core temperature is below 32°C.
What should be done if clothing or jewelry is frozen to the skin?
Leave until thawing occurs
This is important to prevent further injury to the skin.
What is the recommended treatment for mild to moderate hypothermia?
- Wrap the patient’s body/affected parts in a blanket or foil rescue blanket
- Provide external re-warming using hot packs or hot water bottles to axillae, groin, neck, and head
For severe hypothermia, what should be done regarding airway manipulation?
Do not perform vigorous suctioning or airway manipulation
This may trigger ventricular fibrillation.
What should be done for frostbite?
- Wrap the affected parts in a blanket or foil rescue blanket
- Do not rub or massage the skin
- Leave blisters intact
- Dress digits separately
What is the first action a paramedic should take in an electrocution situation?
Make no attempt to touch a potential energized source or a patient in contact with it
Identify potential life/limb/function threats in electrical injury.
- Cardiopulmonary arrest
- Dysrhythmias
- Extremity neurovascular compromise
- Multiple and/or severe trauma
- Seizures
- Significant internal tissue damage
What should be assessed in a patient with an electrical injury?
- Type of current
- Voltage
What signs indicate significant electrical injury?
- Burns
- Cold/mottled/pulseless extremities
- Dysrhythmias
- Entry/exit wounds
- Muscle spasms
- Neurologic impairment
- Shallow/irregular respirations
What should a paramedic do for an extremity injury?
- Assess distal circulation, sensation, and movement before and after splinting
- Splint joint injuries as found
- Apply gentle traction if distal pulse is absent or fracture is severely angulated
How should open fractures be managed?
- Irrigate with saline or sterile water if gross contamination
- Cover ends with moist, sterile dressings and/or padding
What should be done if a foreign body is in the eye?
- Advise the patient not to attempt removal
- Assess the eye and flush if penetration of the globe is not suspected
In case of a foreign body in the ear, what should be considered?
The potential for a perforated ear drum if a blunt/penetrating object was inserted
What should be done if a foreign body is in the nose?
Leave the object in place
What life/limb/function threats should be considered with hazardous material exposure?
- Vision loss if chemical in eye
- Burns
- Systemic toxicity due to chemical absorption through the skin
What should be done if chemical injury occurs to the eye?
- Assess the eye as per the Visual Disturbance Standard
- Advise patient to remove contact lens if readily removable
What is the minimum irrigation time for an alkali burn?
20 minutes at the scene if the patient is stable
What is the recommended action for soft tissue injuries?
- Consider underlying injuries to deep structures
- Control wound hemorrhage
What is the first step in controlling hemorrhage for extremity wounds?
Apply well-aimed, direct digital pressure at the site of bleeding
What should be done if a tourniquet is applied?
- Document the time of application
- Do not remove in the pre-hospital setting
What is the protocol for packing a wound?
- Maintain pressure continuously while packing
- Ensure the wound cavity is completely filled with densely packed dressing material
What should be done with protruding tissue/organs?
Cover with non-adherent materials
In cases of open fractures, what should be done before splinting?
Dress and bandage open wounds
What should be done to assess neurovascular status after dressing?
Re-assess and monitor distal neurovascular status
What should a paramedic do in a submersion injury situation?
Request appropriate personnel for rescue operations if required
Involves coordination with other rescue teams.
In a submersion injury, what should a paramedic avoid unless authorized?
Participate in water or other types of rescue operations
Safety protocols limit direct involvement in hazardous environments.
List three life/limb/function threats to consider in submersion injuries.
- Asphyxia
- Aspiration
- Hypothermia
These threats can arise immediately or as a result of the submersion incident.
What are two scuba-diving related disorders a paramedic should consider?
- Barotrauma
- Decompression sickness
These conditions can occur due to changes in pressure during diving.
What must a paramedic attempt to determine regarding the submersion incident?
- Duration of submersion
- Presence of chemicals or pollutants in water
- Water temperature
This information is critical for assessing the patient’s condition.
When scuba-diving related symptoms occur, what timing is significant?
- Symptoms underwater
- Symptoms upon surfacing
- Symptoms within minutes of surfacing
- Symptoms more than 10 minutes after surfacing
Timing can indicate the type of diving-related injury.
What should be done if air embolism is suspected and the patient is on a spinal board?
Do not elevate the head 30 degrees if level of consciousness is decreased
This precaution helps prevent worsening the condition.
What does the guideline recommend regarding left-sided positioning for arterial gas embolisms?
It has not shown clear advantages for embolism movement but is recommended to reduce aspiration risk
Positioning can affect patient outcomes in various ways.
Fill in the blank: The paramedic should consider _______ as a potential underlying disorder in submersion injuries.
[drug or alcohol consumption]
Substance use can precipitate incidents leading to submersion injuries.
What is a potential consequence of hypothermia in submersion injuries?
Threat to life/limb/function
Hypothermia can rapidly impact physiological functions and requires urgent attention.
