Ch 27, 28, 29, 30, & 31 Flashcards
(217 cards)
1
Q
The ——— refers to how a person was injured
A
Mechanism of injury
2
Q
The science of analyzing MOI’s, sometimes called the ———, helps you to predict the kind and extent of injuries as a basis for your priority decisions regarding continuing assessment care, and transport
A
Kinetics of trauma
3
Q
The ——— is used for determining the level of responsiveness, the systolic blood pressure, the respiratory rate, and the anatomical type or location of injury
A
Glasgow coma scale
4
Q
— is nearly always the result of two or more bodies colliding with each other
A
Trauma
5
Q
— is the branch of mechanics dealing with movements of bodies, so understanding — is helpful in understanding MOI and trauma
A
Kinetics
6
Q
The energy contained in a moving body is called ——
A
Kinetic energy
7
Q
What is the formula for kinetic energy?
A
Kinetic energy = body’s mass x body’s velocity/2
8
Q
The ———, which is one of the laws of motion described by sir Isaac newton, states: a body at rest will remain at rest, and a body in motion will remain in motion unless acted upon by an outside force
A
Law of inertia
9
Q
The rate at which a body in motion increases its speed is known as —
A
Acceleration
10
Q
The rate at which a body in motion decreases its speed is known as —
A
Deceleration
11
Q
Which type of collision happens when the vehicle is suddenly stopped and gets bent out of shape?
A
Vehicle collision
12
Q
Which type of collision happens when the patient comes to a quick stop on some part or parts of the inside of the vehicle, such as a steering wheel, causing injury to the chest?
A
Body collision
13
Q
Which type of collision happens when the patients internal organs, which are all suspended in their places by tissue, come to a quick stop, sometimes striking and inside surface of the body (the inner chest wall or inner skull)?
A
Organ collision
14
Q
Motor vehicle collisions can be classified as:
A
-frontal
-rear end
-rotational or rollover
-lateral
15
Q
In the ——, the driver continues to move forward at the same speed the vehicle is traveling
A
Frontal impact
16
Q
—— occurs when the heart is caught between the sternum and the spine, which can bruise the heart muscle
A
Compression force
17
Q
—— tends to pull the aorta at the ligament, which can tear or transect the aorta
A
Shear force
18
Q
Air trapped in the lungs by sudden closure of the epiglottis is compressed between the ribs and spine, this is known as a ———, because it is like blowing up a paper bag and then popping it in your hands
A
Paper bag injury
19
Q
In the ———, the patients head and neck are immediately whipped back
A
Rear end impact
20
Q
If the vehicle does not have headrests or they are improperly positioned, the neck is hyperextended during a rear end impact and the anterior spinal ligaments are often stretched or torn, this is known as a — injury
A
Whiplash injury
21
Q
When a vehicle is struck —, or directly on the side, it can be crushed inward, impinging on the occupants
A
Laterally
22
Q
Injuries from — crashes are those in which the vehicle spins around the point of impact, causing the occupants who are not restrained to strike the mirror, posts, and doors, resulting in many injuries
A
Rotational
23
Q
During a —, the vehicle hits the ground multiple times and in various places, the occupant changes direction every time the vehicle does
A
Rollover
24
Q
— injuries can occur from the use of restraints in motor vehicles, including air bags and seat belts
A
Hidden injuries
25
When a —— impact occurs, the motorcycle tends to tip forward because of the location of its center of gravity
Head on
26
In — motorcycle impacts, the rider strikes an object, usually a protruding object, at an angle
Angular
27
After a motorcycle collision, — occurs if the rider clears the handlebars
Ejection
28
This is an evasive action on the part of the rider, designed to prevent ejection and separation of the driver from the bike in an impending collision, this is known as:
“Laying the bike down”
29
What is the most common MOI?
Falls
30
A —— landing causes energy to travel up the skeleton
Feet first
31
In —— falls, the pattern of injury begins with the arms and extends up to the shoulders
Head first
32
— injuries are caused by any object that can penetrate the surface of the body, such as bullets, nails, darts, and knives
Penetrating
33
Penetrating injuries can be classified as:
-low velocity
-medium velocity
-high velocity
34
A low velocity penetrating injury usually occurs with?
A knife or other object impaled in the body
35
A medium to high velocity penetrating injury usually occur with?
Pellets or bullets
36
Most handguns or shotguns fire at what velocity?
Medium
37
High speed rifles such as an M-16 or 30-30 Winchester fire at what velocity?
High
38
The damage caused by medium and high velocity projectiles depends on what two factors?
-trajectory
-dissipation of energy
39
— is the path or motion of a projectile during its travel
Trajectory
40
——— is the way energy is transferred to the human body from the force acting on it
Dissipation of energy
41
— are the factors that slow a bullet down, such as wind resistance.
Drag
42
The impact point of the bullet is its —
Profile
43
Sometimes called pathway expansion, — is the cavity in the body tissues formed by a pressure wave resulting from the kinetic energy of the bullet
Cavitation
44
— occurs when a bullet breaks up into small pieces or releases small pieces upon impact increasing the body damage
Fragmentation
45
Of fatal wounds that occur from firearms, —% involve the head, thorax, and abdomen
90%
46
The — is often secondarily injured when the chest is injured
Abdomen
47
— injuries can occur because of explosions from, for example, natural gas, gasoline, fireworks, improvised explosive devices, and grain elevators
Blast
48
Every explosion has what 5 phases?
-primary
-secondary
-tertiary
-quaternary
-quinary
49
In the — phase of an explosion, air molecules slam into one another, creating a pressure wave moving outward from the blast center, causing pressure injuries
Primary phase
50
In the — phase of an explosion instantaneous combustion of the explosive agent creates superheated gases. The resulting pressure blows the bomb casing apart. Pieces of the bomb can cause — injuries by striking the patient
Secondary
51
In the — phase of an explosion, the blast wind may propel the patient to the ground or against objects causing further injuries
Tertiary
52
In the — and — phases of an explosion, the patient may also be exposed to harmful chemicals or toxins or may be injured by structural collapse
Quaternary and quinary
53
The —— has been established as a parameter for emergency care because severely injured patients have the best chance for survival if intervention takes place as quickly as possible from the time of injury
Golden period
54
Some EMS systems refer to the ———, this means that in cases of severe trauma, 10 minutes is the maximum time the EMS team should devote to on scene activities, with patient assessment, emergency care for life threats, and preparation for transport all being accomplished within 10 minutes of arriving on the scene
Platinum 10 minutes
55
The —— is designed to provide immediate surgical intervention for patients with internal trauma if necessary, extensive intensive care services specific to trauma, and rehabilitation services
Trauma system
56
What level trauma center can manage the full range of traumatic injuries 24 hours a day, 7 days a week?
Level 1 regional trauma center
57
What level trauma center can manage the vast majority of trauma with surgical capabilities 24 hours a day, 7 days a week and are capable of stabilizing more specialized trauma patients and then transferring them to a level 1 center?
Level 2 area trauma center
58
What level trauma center has some surgical capability and specially trained emergency department personnel to manage some traumatic injuries, this type of center focuses on stabilizing the seriously injured trauma patient and then transferring to a higher level center?
Level 3 community trauma center
59
What level trauma center is typically a small community hospital in a remote area capable of stabilizing seriously injured trauma patients and then transferring them to a higher level trauma center?
Level 4 trauma facility
60
Blood loss of —% of blood volume or more is considered significant and can lead to shock
15%
61
The middle layer of a blood vessel consists of smooth muscle (tunica media) that gives it the capability to — when injured
Constrict
62
A — (across) cut of a vessel causes the vessel to retract, thickening the smooth muscle layer at the cut end of the vessel and reducing the diameter of the vessel, which reduces blood flow and enables clotting to occur more easily
Transverse
63
What are the three types of bleeding?
-arterial
-venous
-capillary
64
— bleeding will cause bright red, spurting blood, from a wound usually indicates a severed or damaged artery
Arterial bleeding
65
A — bleed will cause dark red blood that flows steadily and briskly from a wound usually indicates a severed or damaged vein
Venous
66
A — bleed will cause slowly oozing blood that is dark or intermediate color of red usually indicates damaged capillaries
Capillary bleed
67
What are some methods that are used to control major external hemorrhage?
-direct pressure with hand
-compression or pressure dressing
-tourniquet
-wound packing
-hemostatic agent
-junctional tourniquet
68
Up to — mL of blood can be lost around each femur and — mL around the tibia and fibula
-1,500 mL
-500-750 mL
69
Possible causes of bleeding from the nose, mouth or ears include:
-skull injury
-facial trauma
-digital trauma (nose picking)
-sinusitis
-clotting disorders
-esophageal disease
70
—, or nosebleed, is bleeding from the nose, which can result from injury, disease, or the environment
Epistaxis
71
A — is a contained collection of blood
Hematoma
72
The two most common sources of internal bleeding are:
-injured or damaged internal organs
-fractured extremities
73
There can be internal bleeding with no obvious distinction, — L can distend the abdomen only 1 inch
1-2L
74
What are some factors that can interfere with the clotting process and increase bleeding?
-movement
-low body temp
-medications
-intravenous fluids
-removal of dressings or bandages
75
— is most often the direct result of inadequate perfusion of tissue from the loss of blood volume
Shock
76
When the fluid loss results from bleeding or hemorrhage it is known as ——
Hemorrhagic shock
77
———, also referred to as a wound or wounds, involves injuries to the skin and underlying tissues
Soft tissue trauma
78
Wounds to the skin can be categorized as :
-closed
-open
-single
-multiple
79
A wound in which there is no break in the skin is called a ——
Closed injury
80
What are the 3 specific types of closed injuries?
-contusions
-hematomas
-crush injuries
81
A —, or bruise, is an injury to the tissue and blood vessels contained within the dermis
Contusion
82
The patient can have discoloration at the injury site of a contusion caused by blood leaking from damaged vessels and accumulating in the surrounding tissues, the black and blue discoloration is called —
Ecchymosis
83
A — is similar to a contusion, except it usually involves damage to a larger blood vessel and a larger amount of tissue
Hematoma
84
A —— is one in which force great enough to cause injury has been applied to the body
Crush injury
85
When the continuity of the skin is broken, the wound is called an ——
Open injury
86
What are the six general types of open injuries?
-amputation
-avulsion
-crush injury
-puncture
-abrasion
-laceration
87
An — generally is caused by scraping, rubbing, or shearing away of the epidermis, the outermost layer of the skin
Abrasion
88
A break in the skin of varying depth, a — can be linear (regular) or stellate (irregular)
Laceration
89
— lacerations are usually created by a knife, razor, or broken glass
Linear
90
— lacerations are commonly caused by a blunt object
Stellate
91
An — is a loose flap of skin and underlying soft tissue that has been torn loose (partial) or completely pulled off (total or complete)
Avulsion
92
An — involves a disruption in the continuity of an extremity or other body part
Amputation
93
A — or — injury generally is the result of a sharp, pointed object being pushed or driven into the soft tissues
Penetration or puncture
94
Human bites can cause — (inflammation of the liver)
Hepatitis
95
A — injury occurs when a body part is caught or strangled by some piece of machinery, a tool, or other object or equipment
Clamping injury
96
An —— is a dressing for a wound that can form an airtight seal
Occlusive dressing
97
Abdominal wounds sometimes result in an —, meaning that abdominal organs protrude through the wound
Evisceration
98
An ——, an object that is still embedded in a wound, should never be removed in the field, unless it is impaled in the cheek or in the neck with obvious obstruction of airflow through the trachea
Impaled object
99
What is an air embolism?
An air bubble under the skin
100
A — covers an open wound to aid in the control of bleeding and to prevent further damage or contamination
Dressing
101
The dressing should be —, or free of any organisms (bacteria, virus, or spore) that can cause infection
Sterile
102
After a dressing is applied, a — is used to secure a dressing in place
Bandage
103
A — burn is formerly referred to as a first degree burn, involves only the epidermis, is usually caused by a flash, hot liquid, or the sun
Superficial
104
Formerly known as a second degree burn, a —— burn involves not only the epidermis but also portions of the dermis, can occur from contact with fire, hot liquids or objects, chemical substances, or the sun
Partial thickness
105
Partial thickness burns can be classified as either:
-superficial partial thickness burns
-deep partial thickness burns
106
Superficial partial thickness burns typically present with:
-thin walled blisters
-skin is red and weeping
-skin blanches with pressure
-skin is soft and tender to touch
107
Deep partial thickness burns typically present with:
-thick walled blisters that often rupture
-variable color with patchy areas that are red to cheesy white
-skin is wet or waxy dry
-patient can still feel pressure
-poor capillary refill time
108
Formerly known as a third degree burn, a —— burn involves all the layers of the skin, usually results from extreme heat sources such as hot liquids or solids, flames, chemicals, or electricity
Full thickness burn
109
The tough and leathery dead soft tissue formed in the full thickness burn injury is called an —
Eschar
110
What are the most important factors to consider when determining burn severity?
-depth
-location
-patients age
-preexisting medical conditions
-percentage of body surface area burned
111
— burns, which encircle a body area such as an arm, a leg, or the chest and especially ones that encircle joint areas are critical because of the circulatory compromise and nerve damage that potentially can occur
Circumferential
112
The ——— is a standardized way to quickly determine the amount of skin surface, or the body surface area (BSA) percentage of a burn
Rule of nines
113
The rule of nines is only applied to what type of burns?
Partial thickness and full thickness burns
114
The head, neck, and both arms represent how much % of the body burned in the rule of nines in an adult?
9% head and neck total
9% each arm
115
The posterior trunk, anterior trunk, and each leg accounts for how much % of the body burned in regards to the rule of nines in an adult?
18% each
116
The external genitalia represent how much % of the body burned in regards to the rule of nines in an adult?
1%
117
The head, neck, posterior trunk, and anterior trunk represent how much % of the body burned in the rule of nines in an infant?
18% each
118
Each arm of an infant represent how much % of the body burned in the rule of nines?
9% each
119
Each leg of an infant represent how much % of the body burned in the rule of nines?
14% each
120
An alternative way to determine the BSA estimate is to compare it to the patients palm surface area with the fingers closed which equals approx 1% of the BSA, this is known as the ———
Rule of ones or rule of palms
121
— burns are associated with heat applied to the body, caused by flames, hot water, and steam
Thermal burns
122
— burns are associated with high temp air or steam that is inhaled and causes damage to the mucosa of the upper airway, results in edema that could restrict airflow and lead to airway obstruction
Inhalation burns
123
Hot water causes thermal burns called —
Scalds
124
— burns are caused by acids, alkalis, and other heat generating chemicals
Chemical burns
125
— burns result from resistance to electrical current flow in the body, the burns are primarily internal, the electricity can interfere with the conduction system of the heart and result in cardiac arrest
Electrical burns
126
— burns occur from the absorption of radiation into the body
Radiation burns
127
A — burn occurs when the patient comes into contact with an open flame
Flame burn
128
A — burn normally occurs when a patient comes into contact with a hot object
Contact burn
129
A — burn is caused when a patient comes into contact with a hot liquid
Scald burn
130
A — burn is caused by hot steam and is often more severe than flame burns, because of the high heat capacity of the steam
Steam burn
131
A — burn occurs when a patient comes into contact with hot gases
Gas burn
132
A — burn is a type of flame burn, but it is the result of a flammable gas or liquid that ignites quickly
Flash burn
133
When treating a burn patient, you should cover the burned area with a sterile dressing or a disposable, sterile and particle free ——
Burn sheet
134
What are some substances that can cause chemical burns?
-dry lime
-hydrofluoric acid (delayed burn reaction)
-carbolic acid (phenol)
-sulfuric acid
135
— connect muscle to bone
Tendons
136
— connect bone to bone
Ligaments
137
— is an extension of the bone and is composed of connective tissue, allows for bone to ride over each other and absorb shock
Cartilage
138
This bending motion moves the extremity towards the body:
Flexion
139
This bending motion moves the extremity away from the body:
Extension
140
This is a movement of a body part towards the midline:
Adduction
141
This is a movement of a body part away from the midline:
Abduction
142
This movement turns the body along the axis of a bone or joint:
Rotation
143
This is a movement through an arc of a circle or in a circular motion from a central point:
Circumduction
144
What are the six basic components of the skeletal system?
-skull
-spinal column
-thorax
-pelvis
-lower and upper extremities
145
The axial skeleton is made up of:
The head, thorax, and vertebral column
146
The appendicular skeleton is made up of:
The extremities, to include the shoulder girdle and the pelvis
147
A — is a break in the continuity of a bone
Fracture
148
An — fracture is a fracture associated with an open wound
Open fracture
149
If there is no break in the skin associated with a fracture, it is called a — fracture
Closed
150
A — fracture is a small crack in the bone that doesnt create instability
Hairline
151
— is a degenerative bone disorder associated with an accelerated loss of minerals, primarily calcium, from the bone
Osteoporosis
152
A — is an injury to muscle or tendon, possibly caused by overextension, or overstretching
Strain
153
A — is an injury to a joint capsule, with damage to or tearing of the connective tissue, and usually involves ligaments
Sprain
154
A — is the displacement of a bone from its normal position in a joint
Dislocation
155
The injury from ——, or a direct blow, occurs at the point of impact
Direct force
156
With ——, the force impacts on one end of a limb, causing injury some distance away from the point of impact
Indirect force
157
In ——, one part of the extremity remains stationary while the rest twists
Twisting force
158
Grating, or —, the sound or feeling of broken fragments of bone grinding against each other
Crepitus
159
The skin distal to the injury site might be pale and capillary refill delayed if an artery is compressed or torn, this is known as:
Pallor
160
A patient with a fracture may complain of numbness or a tingling sensation in the fractured extremity, can indicate nerve damage, this is known as :
Paresthesia
161
Suspect a — when deformity and pain are found at joint
Dislocation
162
Any device used to immobilize a body part is called a —
Splint
163
— splints are commercially manufactured and made of wood, plastic, cardboard, or compressed wood fibers
Rigid
164
An — splint is soft and pliable before being inflated, but they are rigid after they are applied and filled with air
Air splint or pressure splint
165
— splints provide a counter pull, alleviating pain, reducing blood loss, and minimizing further injury
Traction
166
— splints are a type of rigid splint that is malleable enough to conform to a deformed or angulated extremity
Formable
167
— splints are soft, pliable, splints that are easily formed to deformed extremities, the air is sucked out of the splint, causing it to become rigid in its position of placement
Vacuum
168
A — or — is often used to provide stability to a painful and tender shoulder, elbow, or upper numerous injury
Sling or swathe
169
A ——— or ———— is a full body splint, used in the case of a critical injury when extremity fractures cannot be splinted at the scene
Spine board or full body vacuum mattress
170
A ———— is sometimes used to splint a suspected pelvic injury when turned upside down
Vest type immobilization device
171
—— can occur when an extremity is fractured or injured, if the pressure in the space around the capillaries exceeds the pressure needed to perfuse the tissues, the blood flow is cut off and the cells become hypoxic, leading to ——
Compartment syndrome
172
A ——, or pathological fracture, results from a disease that causes degeneration and dramatically weakens the bone, making it prone to fracture
Nontraumatic fracture
173
The brain, which occupies 80 to 90% of the space inside the skull, is surrounded by plates of large, flat bones that are fused together to form a helmet like covering called the ——
Cranial skull
174
The ——, or floor of the skull, is made up of many separate pieces of bone and is the weakest part of the skull
Basilar skull
175
Within the skull, the brain is cushioned in a dense, serous substance called ——
Cerebrospinal fluid
176
Inside the skull, the brain is protected by 3 —, or layers of tissue that enclose the brain, what are the 3 layers?
-meninges
-duramater (outermost )
-arachnoid (middle layer)
-pia mater (innermost)
177
Bleeding that occurs between the arachnoid membrane and the surface of the brain is called a ——
Subarachnoid hemorrhage
178
The — is the largest part of the brain, compromises three fourths of the brains volume , responsible for most conscious and sensory functions, the emotions, and the personality
Cerebrum
179
The — also called the little brain, controls equilibrium and coordinates muscle activity
Cerebellum
180
The — is the brains funnel shaped inferior part, is the best protected part of the brain and controls most automatic functions of the body, including cardiac, respiratory, and vasomotor (blood pressure)
Brain stem
181
A ———, which is the most common type, resembles a line. There is no gross deformity in a —— fracture and can be diagnosed through a radiograph
Linear skull fracture
182
A ——— occurs when the bone ends are pushed inward toward the brain, the depression is palpated in the area of the fracture
Depressed skull fracture
183
A ——— is an injury in which the skull is fractured but there isn’t an open wound to the overlying scalp
Closed skull fracture
184
An ——— is a fracture of the skull with an associated open wound to the scalp
Open skull fracture
185
A ——— is a fracture to the floor or bottom of the cranium, these often leak cerebrospinal fluid from the ears, nose or mouth
Basilar skull fracture
186
The thinnest portion of the skull is the — region
Temporal
187
A — brain injury is the result of trauma to the brain that occurs at the time of insult from direct impact, acceleration/deceleration, or a penetrating wound
Primary brain injury
188
A — brain injury occurs from a complex cascade of pathophysiologic processes following the primary brain injury, which can continue for hours to days
Secondary brain injury
189
Whenever ICP rises, the brain is compressed and pushed out of its normal position, downward and through the foramen magnum (the large opening in the base of the skull) is referred to as:
Brain herniation
190
What are Cushing reflexes?
Increased systolic blood pressure and decreased heart rate
191
In cases of ———, the scalp or skull can be lacerated but the skull remains intact and there is no opening to the brain
Closed head injury
192
Brain damage within the intact skull can, nonetheless, be —
Extensive
193
An ——— involves a break in the skull and a break in the scalp, such as that caused by impact with a windshield or by an impaled object
Open head injury
194
Injury to the brain that results from shearing, tearing, and stretching of nerve fibers is called a ———.
Diffuse axonal injury
195
A — normally causes some disturbance in brain function, ranging from momentary confusion to complete loss of responsiveness, and it usually causes a headache.
Concussion
196
A —, or bruising and swelling of the brain tissue, can accompany concussion
Contusion
197
In ———, damage can be at the point of a blow to the head and or damage on the side opposite to the blow as the brain is propelled against the opposite side of the skull.
Coup/contrecoup injury
198
In ———, typical of a car crash, the head comes to a sudden stop but the brain continues to move back and forth inside the skull, resulting in bruising (possibly severe) to the brain
Acceleration/deceleration injury
199
—— is a collection of blood between the dura mater and the arachnoid layer of the brain
Subdural hematoma
200
What are the two types of Subdural hematomas?
-acute
-occult or chronic
201
—— accounts for only about 2% of all head injuries that require hospitalization, most commonly occurs from low velocity impact to the head or from a deceleration injury
Epidural hematoma
202
Like a contusion, a — of brain tissue can occur in either an open or closed head injury. It often occurs when an object penetrates the skull and lacerates the brain
Laceration
203
Nontraumatic injuries to the brain can be caused by:
Clots or hemorrhaging
204
When a patient tries to move away from or remove the pain it is known as a:
Purposeful response
205
When the patient responds to pain by inappropriately moving parts of his body, reacting to the pain but not trying to stop it, this is known as an:
Nonpurposeful response
206
Patients who have an upper level brain stem injury often are found with — posturing in which their arms are flexed across their chest with their legs extended
Flexion or decorticate
207
patients with a lower level brain stem injury often present with — posturing where they extend both arms down at their sides, extend their legs and often arch their backs
Extension or decerebrate
208
If a patient has a GCS score of 14-15, how severe would their head injury be?
Mild
209
If a patient has a GCS score of 9-13, how severe would their head injury be?
Moderate
210
If a patient has a GCS score of 3-8, how severe would their head injury be?
Severe
211
Both pupils should constrict the same when a light is shined in only one of the pupils, this reflex in the unstimulated eye is known as a ——
Consensual reflex
212
A purplish discoloration of the soft tissues around one or both eyes is known as a ——, and can be an indication of intracranial injury
Raccoon sign
213
——, a purplish discoloration of the mastoid area behind the ear, is another delayed and late sign of a basilar skull fracture
Battle sign
214
What is diplopia?
Double vision
215
In —— the patient is unable to remember circumstances leading up to the incident
Retrograde amnesia
216
In ——, the patient is unable to remember circumstances after the incident
Anterograde amnesia
217
——— is a brain injury that results from the abuse of an infant or toddler where they are shaken forcefully and repeatedly
Shaken baby syndrome
