Chapter 28-31 Flashcards
1
Q
What are extremities?
A
portions of the skeleton that include the clavicles, scapulae, arms, wrists, and hands (upper extremities) and the pelvis, thighs, legs, ankles and feet (lower extremities)
2
Q
What are bones?
A
hard but flexible living structures that provide support for the body and protection of vital organs made from dense connective tissue providing body’s framework strong to provide support and protection for internal organs and flexible to withstand stress store salts and metabolic materials providing site for production of red blood cells and are very vascular with blood loss from the bone itself. Bones become more brittle with less calcium stored in them
3
Q
What is peritoneum?
A
bones are covered by strong, white, fibrous material. Blood vessels and nerve pass through this membrane as they enter and leave the bone and when it was exposed from injury don’t remove objects hold firmly in place
4
Q
What are breaks or fractures?
A
result in swelling of soft tissue and formation of a blood clot in area of fracture due to loss of blood from bone and surrounding tissue causing death to cells at injury site with nearby cells replacing and forming surrounding fracture and making new bone taking weeks or months must be immobilized to properly heal with possibility of more soft tissue damage tkaing longer to heal resulting in possible permanent disability
5
Q
What are joints?
A
places where bones articulate, or meet ability to move
6
Q
What are muscles?
what are the three kinds of muscles?
A
tissues or fibers that cause movement of body parts and organs
Skeletal- voluntary connected to bone in tongue, pharynx and upper esophagus
Smooth- involuntary walls of organs and digestive structures moving food through this system.
And cardiac- myocardial walls of heart
7
Q
What is a muscle injury?
what are the different kinds/
A
Direct force- person struck by something causing crush tissue and fractures (excessive force curhsing or rupturing internal (generally solid organs) ex. Falls direct causes injuries to feet and ankles
Twisting or rotational forces- stretching or tearing of muscles and ligaments and broken bones with sports ex. Falls force causing injureis to knees, femurs, pelvis and spinal column
8
Q
What is carriage?
A
tough tissue that covers the joint ends of bones (epiphysis) and helps to form certain flexible structures body parts such as the ear, trachea, and connections between ribs and sternum acts as surface for articulation, with smooth movement at joints
9
Q
What are tendons?
A
tissues that connect muscle to bone power of movement across joints
10
Q
What are ligaments?
A
tissues that connect bone to bone
11
Q
What are traction splints?
A
splint that applies constant pull along the length of a lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. Traction splints are used primarily on femoral shaft fractures
12
Q
What are fractures?
what are typical extreme fractures?
A
any break in a bone. breach of bone itself and it can be open or closed.
Pelvis fracture- leads to a loss of 3-4 pints of blood
Femur fracture- leads to 2 pints of blood
Tibia-fibula fracture- 1 pint of blood
13
Q
What is a comminuted fracture?
A
fracture in which bone is broken in several places. multiple fractures of the same bone multiple hairline fractures . Compoudnd is usually associated with complete fracture
14
Q
What is a greenstick fracture?
A
an incomplete fracture. incomplete break commonly seen on wrists of kids.
15
Q
What is an angulated fracture?
A
fracture in which broken bone segments are at an angle to each other. bent at angle one chance to realign fracture and only going to do it if it isnt going to break skin and if multiple people are going to hold depending on standing procedurs if you meet resistance you stop, if you lose CMS you stop, if so painful you stop.
If dont have CMS because of angle want to attempt dont mess with joint injury. Put in pillow splint and give pain meds . do knee like you would do a joint
16
Q
what is a dislocation?
A
disruption or “coming apart” of a joint soft tissue of joint capsule and ligaments must be stretched beyond normal range of motion and tear
17
Q
What is a sprain?
A
stretching and tearing of ligaments joint injuries. stretching and rearing of ligaments. More painful take longer to heal and feels as intense as fracture
18
Q
What is a strain?
A
muscle injury resulting from overstretching or overexertion of the muscle. overstretching or overexertion of muscle
19
Q
What is a closed extremity injury?
A
an injury to an extremity with no associated opening in the skin
20
Q
What is open extremity injury?
A
an extremity injury in which the skin has been broken or torn through from the inside by an injured bone or from the outside by something that has caused a penetrating wound with associated injury to the bone with increased likelihood of contamination and infection
expose wound, clean surfance, control bleeding, cut away contaminated clothing. Dont walk patient to ambulance and now bleeding under control isnt because of increased heart rate. Stab or gunshot think along potential line. Stab wounds are considered serious if in a vital area of body as how long and serrated or not to tlel you more about what type of internal injuries. Is the offender male or female. Men stab up women stab dwon with less damage.
21
Q
What is compartment syndrome?
A
injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast and need to remove pressure or may lose limb may complain of pressure with reduced CMs and may feel hard
severe swelling in extremity as a result of fracture. Causing bleeding and swellin gin extremity and can no longer prefuse tissues against pressure going to immobilize area, document it especially if loss of CMS to area. Blood flow to area is lost and limb may be lost
22
Q
What appears in a musculoskeletal injury?
A
six P’s (pain or tenderness, pallor (pale skin or poor cap refill), paresthesia (sensation of pins and needles), pulses diminished or absent in injured extremity, paralysis or inability to move, pressure
Pain and tenderness- pain when part moved will hold it still or guard to minimize pain ask him to point examine injured part to see others
Deformity or angulation- force of trauma causes bones to fracture and become deformed, or angulated out of anatomic position comparing to uninjured side
Grating or crepitus- a grating sensation or sound made when fractured bone ends rub together can be painful to patient.
Swelling- bones break and soft tissue is torn, bleeding causes swelling increasing the proportions of a deformity and things can restrict this tissue cutting them off.
Bruising- ecchymosis large black-and-blue discoloration of the skin, indicates an underlying injury hours or days old with obvious ones needing splinting.
Exposed bone ends- protruding through skin indicate fracture more gruesome appearance ore temptation don’t kill.
Joints locked into position- locking into different positions need to be splinted as found
Nerve and blood-vessel compromise- examine for pulses, sensation, and movement distal to the injury must do before and after splinting
23
Q
What is manual traction?
A
the process of applying tension to straighten and realign a fractured limb before splinting in direction of long axis of extremity, if feel resistance or may come through skin stop realignment and splint in position found. Used when painful, swollen, deformed mid-thigh with no joint or lower leg injury and is contraindicated with a pelvis, hip or knee injury if avulsion or partial amputation meaning it could separate or injury to lower third is bad
24
Q
What is splinting?
A
immobilize adjacent joints and bone ends minimizing movement of disrupted joints and broken bone ends decreasing patient’s pain prevent additional injury such as nerves, arteries, veins, and muscles preventing closed form becoming open can help minimize blood loss with
25
What does realigning do?
restoring effective circulation to extremity. IF not realigned splint may be ineffective causing increased pain and possible further injury and increasing nerve artery and vein comprised. Pain is reduced by effective splinting. When do you realign with angulated injuries to tibia, fibula, femur, radius, ulna or humerus cannot fit into rigid splint and realign the bone. Re-aligning long bone when distal extremity is cyanotic or lack pulses indicating compromised circulation
26
What are rigid splints?
can be used a piece of lumber, cardboard, roll of newspaer, umbrella, cane, broom handle, catcher’s shin guard, or a tongue depressor. Rigid splints require limbed to be moved to anatomic position with greatest support in long=bone injuries with velcro, pneumatic, air splints and vacuum and antishock splints
27
What is formable splints?
allow for considerable movement immobilizing in position found using pillows and blankets.
28
What is a shoulder injury?
pain in shoulder indicating several types of injury such as a dropped shoulder holding against sign of chest indicating fracture of clavicle or with scapula injury if blow to that site.
29
What is a pelvis injury?
pain in pelvis, hips, groin, or back significant if mechanism of injury indicates possible fracture with obvious deformity associated with pain, cannot lift legs, foot on injured side turned outward pressure on bladder and bleeding from urethra, rectum or vaginal in high impact mechanism from injury. Straighten legs, support hips, stabilize lower limbs putting blanket between legs and bind together upper thigh above knee, below knee and above ankl
30
What is a pelvic wrap?
| how do you do one?
applied to patients who have pelvic deformity or instability (upon palpation) without signs of shock. Fold sheet ten inches wide across backboard rolling patient on backboard and center sheet at patient’s greater trochanter (proximal end of femur), bring sides to front tying them around iliac crests
31
What is hip dislocation?
| What are the two kinds of dislocations?
head of femur pulled or pushed from pelvic socket with hit replacements commonly getting them. Use a scoop style stretcher immobilize with pillows or blankets
Anterior dislocation- patient's entire lower limb is rotated outward, and hip is usually flexed
Posterior (most common)- patient’s leg rotated inward, hip is flexed and knee is bent foot may hang loose unable to flex foot or lift toes may not feel leg
32
What is a hip fracture?
fracture of proximal femur and pelvis at head neck or below neck of bone with localized pain perhaps down to knee, and sensitive at hip, discovered, swelling unable to move limb unable to stand foot points outward and limb shorter. To treat bind legs together cushion at armpit and crotch padding all voids
33
What is a knee injury? What is the difference between a knee and patella injury?
knee is bent immobilize knee in position where leg is found trying to thigh and above ankle so held in place using pillow to support leg. Knee is straight or returned to anatomic position- two padded board splints or single padded splint placing one medially and laterally is best.
Knee- tibia forced anteriorly or posteriorly.
Patella might be injured lower leg and knee twist such as skiing stuck in flexion and kneecap displaced laterally
34
What is a tibia fracture and what do you do?
treat for shock, applying air-inflated spling sliding over hand until lwoer edge clears wrist grap foot sliding it over the injured leg wrinkle free on injury site and inflate check periodically especially in temperature changes
35
What is an ankle injury and what do you do?
have three cravats below and tie them over a pillow rapped aorund ankela dn elevate it.
36
What is the nervous system?
provides overall control of thought, sensation, and the body’s voluntary and involuntary motor functions. The components of the nervous system are the brain and spinal cord as well as the nerves that enter and exit the brain and spinal cord and extend to the various parts of the body. Controls thought, sensations, and motor function. When bones surrounding these areas are injured expect injuries to these sites
37
What is the central nervous system?
the brain and spinal cord have neurons that are specialized cells transmitting impulses throughout body
38
What is the peripheral nervous system?
nerves that enter and exit the spinal cord between the vertebrae, the twelve pairs of cranial nerves that travel between the brain and the organs without passing through the spinal cord, and all of the body’s other motor (messages from brain to muscles such as voluntary movement those we control like running or grasping) and sensory nerves (messages from brain to body).
39
What is the autonomic nervous system?
controls involuntary functions such as heartbeat, breahting, control of diameter of vessels, round sphincter muscles enclosing bladder and bowel, and digestion
40
What is the cranium?
bony structure making up the forehead, top, back, and upper sides of the skull fused together to form immovable joints called sutures
41
What is the mandible?
lower jawbone
42
What are temporal bones?
bones that form part of the side of the skull and floor of the cranial cavity. There are right and left temporal bones
43
what is the temporomandibular joint?
movable joint formed between the mandible and the temporal bone, TMJ
44
What is the maxillae?
two fused bones forming the upper jaw
45
What is the nasal bone?
the bones that form the upper third, or bridge of the nose
46
Why is the malaria?
cheekbone or zygomatic bone
47
What are orbits?
bony structures around the eyes; eye sockets
48
What is the foramen magnum?
the opening at the base of the skull through which the spinal cord passes from the brain
49
What is cerebrospinal fluid?
fluid that surrounds the brain and spinal cord
50
What is vertebrae?
the bones of the spinal column (singular vertebra) held together by ligaments and muscles allow for specific movements and rotation but protecting against movements that would threaten integrity of channel. Seven cervical, twelve thoracic, five lumbar, five sacral, and four coccygeal (sacral and cocygeal fused forming posterior protion of pelvis)
51
What is spinous processes?
the bony bump on a vertebra
52
What are scalp injuries?
result in profuse bleeding control by applying direct pressure. Open head injury when bones of cranium are fractured. If scalp lacerated but cranium is intact it is a closed head injury
53
What are the two kinds of brain traumas?
Direct- can occur in open head injureis with brian being lacerated, punctured, or bruised by broken bones or foreign objects like a bullet
Indirect- brain may occur with either closed or open head injuries shock of impact on skull trasnferred to brain creating consussions and contusions
54
What is a concussion?
mild closed injury without detectable damage to the brain. Complete recovery is usually expected but effects may linger for weeks, months or even years. When hits head certain amount of force is transferred through skull to brain feel groggy have headache, short loss of consciousness possible, staring off into space, loss of memory and repetitive questions, altered level of consciousness feeling sluggish and difficulty concentrating or “feeling off or not right, slurred speech, headache, nausea, blurred or distorted vision, and sensitive to light or loud noises.
55
What is a contusion?
in brain injuries, a bruised brain caused when the force of a blow to the head is great enough to rupture blood vessels. Collision or blow causing brain to hit inside of skull bounce then rebound bruising on side of blow is coup on opposite side it’s a contercoup
56
What is a laceration?
in brain injuries, a cut to the brain same forces causing contusion as inner skull has many sharp bony ridges
57
What is a hematoma?
in a head injury, a collection of blood within the skull or brain named according to location subdural, epidural (dura and skull), intracerebal (within brain)
58
What is ICL?
inter cranial pressure hematoma develops and increased pressure inside skull increasing pressure inside the skull leading to neurological abnormalities such as decreasing levels of consciouness and one-sided weakness pressure reducing vital perfusion to brain can range in time with increasing blood pressure, and slows heart or from compression of the vagus nerve with more carbon dioxide increasing brain swelling more it goes downward in foramen magnum compressing brainstem which affect breathing creating irregular patterns, decreased heartbeat, and increased blood pressure dilated pupils
59
What are cheyne strokes breathing?
a distinct pattern of breathing characterized by quickening and deepening respirations followed by a period of apnea
60
What is central neurogenic hyperventilation?
a pattern of rapid and deep breathing caused by injury to the brain
61
What is taxis respiration's?
a pattern of irregular and unpredictable breathing commonly caused by brain injury
62
What is herniation?
pushing of a portion of the brain downward toward the foramen magnum as a result of increased intracranial pressure resulting in decorticate or decerbrate psoturing flexing arms and rwrists and extending legs and feet
63
What is the sequence of bleeding on the brain?
patient falls and hits head with possible brief loss of consciousness, altered mental status 10 minutes later as hematoma begins to place pressure on hemispheres, altered mental status worsens responding only to loud verbal stimulus by moaning increasing blood pressure, unresponsive high bp and pulse is dropping with unequal or nonreactive pupils, irregular respiration, decerebrate and seizure with death. Subdural can results with symptoms 12-24 hours later with possible bruising behind ear or black eyes under both eyes as late signs with irrational behavior temperature increased multiple image vision impaired hearing or ringing projectile vomiting equilibrium problems as a major sign but doesn’t cause shock. Put on a loose dressing and let blood drain out keep them resting stabilize objects
64
What are facial injuries?
bone fragments may lodge in back of pharynx and cause airway obstruction such as blood, blood clots, dislodged teeth, or a separated palate possibly blocking airway. Perhaps indicating also a brain injury, may have difficulty speaking
65
What is the glasgow coma scale?
eye opening with spontaneous eye opening means patient opens eyes without you having to do anything if closed have them try to open with normal voice, shoot, use painful stimuli, if more than minor eye injuries don’t do. Verbal response- oriented (AVPU), confused (cannot answer previous questions but speaks in phrases and sentences), inappropriate words (requirng physical stimulaton and curses), incomprehensible sounds (mumbling, moaning or groaning), no verbal response (to painful and vocal sounds) motor response (obeys commands and instructions, localized pain (attempt to remove hand from firm pressure to nails), withdraws after painful stimulatoin (elbow flexes moves slowly appearance of stiffness), posturing after painful stimulation (legs and arms extend and stiffness), no motor response.
66
What is an air embolism?
a bubble of air in the bloodstream
67
What is a pulmonary embolism?
a blockage in the blood circulation of lung caused by a blood clot or air bubble
68
What is an open neck wound?
occlusive dressing thick material not sucked into wound and extend 2 inches past side of wounds sealing on all four sides. Apply pressure and hemostatic agents don’t compress carotid arteries at once
69
What are spinal cord injuries?
primary injuries as a result in direct force have irreversible outcomes with nervous tissue not healing and permanent nervous transmission lacking such as paralysis. Secondary injuries- cause same and even more harm with hypoxia, shock swelling of the cord and hypoglycemia leading to devastating spinal cord damage. With all injuries having a serious trauma to any part of body including extremities potentially causing it. Usually caused by forcing movement of spine beyond its normal range of motion moving bone into area where spinal cord would be with flexion and extension injuries such as whiplash injury in rear end collision. Axial loading- shallow-water diving injury. With the cervical and lumbar are more susceptible to injury with osteoporosis also making you susceptible as well as ligament laxity such as in pregnant patients and down syndrome as does ankylosing spondylosis causing spine to fuse together being more vulnerable
70
What are mechanisms of high risk for spinal injuries?
falls from greater than 1 meter or down more than 5 stairs, axial loading (compression injuries) such as those that occur in diving injuries, high-speed motor-vehicle crashes, especially with rollover or ejection of the patient, motorized recreational vehicle (ATV) crashes, bicycle
71
What is dermatome?
an area of the skin that is innervated by a single spinal nerve and are used to identify loss of function that is associated with a particular areas of the spinal cord
72
What are the indications of spinal injury?
paralysis of extremities, changes in neurological function such as loss of sensation or motor function (pins and needles), pain with movement, tenderness along midline spine, impaired breathing slight movement of abdomen with little or no movement of chest or tight muscle spasms) neurogenic shock
73
What is neurogenic shock?
a state of shock (hypoperfusion_ caused by nerve paralysis that sometimes develops from spinal cord injuries. Cervical neck 3-5 are crucial (phrenic nerve controlling diaphragm is in C4. Injury to sympathetic in thoracic or lumbar spine affecting heart rate, vascular tone, and dilation of bronchiolar smooth muscle
74
What is spinal motion restriction?
he immobilization of the spinal column as if it were a single bone to prevent movement of individual vertebrae limiting secondary damage. Using vacuum mattress helps better conform to patient than rigid board but can deflate. If rapidly extricating slide longbaord unde rthem and three people hold them turning them lowering them on board and lifting them out onto stretcher and lifitng them out lower
75
What are indications for leaving a helmet in place?
helmet fits snugle, allowing little or no movment of patient’s head within helmet, no impending airway or breathing problems nor any reason to resuscitate or ventilate the patient, removal would cause further injury, proper spinal immobilization done with helmet in place, no interefereance with ability to assess airway or breathing
76
What are the indications for removing a helmet?
ehlemet intereferes with EMT’s abiility to assess and manage airway and breathing, imporperly fitted allowing excessive head movmenet, intereferes iwth immbolizaiton, cardiac arrest is present. If have shoulder pads remove both or dont either. Take off holding lower jaw and holding helmet stable, stabilizes occipital pull ears out of holes,
77
What are signs of compensated shock?
increased anxiety, increase pulse, 88-100 is when we should pay attention to heart rate.
78
What are signs of decompensated shock?
pulse pressure starts to close, nauseous
79
What is the misnomer for shock to find what is contributing to shock?
CHAMPSRN
Cardiogenic- something wrong with heart as pump or cardiac tamponade pressure on heart, pericarditis
Hemorrhagic/hypovolemic- bleeding, vomiting, burns
Anaphylaxis- allergic reaction respiratory distress, hives, swelling in eyes nose, mouth, tongue,
Metabolic- diabetes, thyroid storm- severe onset of hyper or hypothyroidism
Psychogenic- only self correcting form of shock
Systemic- cut or wound not healing, surgery, pneumonia history meaning they have an infection somewhere
Respiratory- lungs
Neurogenic- seizure, spinal cord trauma head trauma with increased intracranial pressure
80
What is cavitation?
tissue damaged around injury from penetration action
81
What do you do if you cannot find the source of shock on a patient?
call helicopter
82
What do you do if there is a gunshot wound to the head and neck?
immobilize. No sudden jarring of patient dont dig around for a bullet
83
How do you treat an avulsion?
Skin torn away just lay it back on with sterile water if completely evulsed take skin with you with a moist dressing in a ziploc bag on ice
84
What do you look for in burns?
What are source, agent, depth and severity of burn. Face, genitals, hands, and feets put severity into critical. Electircal burn make sure that the circuit is off and patient isnt still connected. Care fires electricutions. Burns much more critical in infants. Burns on chiildren hand and feet. Doughnut burns potty training pick the child up and put butt in boiling water and butt isnt burnsed but donut burn around genitalia and skin critical kids. Cigarette burns in kids and not intentional are face, chest, belly, unintentional.
85
What is abuse?
any bruise with identifiable markers
86
What is coining?
ub hot or warm coins along surface of skin similar to cupping. Anything causes chang eor breach in skin surface is abuse.
87
What is the surface area of a burn of an adult?
nine for head, front and back each nine, each arm circumferentially, front of legs or back of legs, genitalia is 1 %. Head is twice as much taking from legs. Infant is exactly same as child
88
What is a burn like for a geriatric patient?
Moderate burn in young adult can be fatal to geriatric adult and it leadds to infection much greater that is fatal. Suffer from hypothermia from plasma
89
How do you treat a burn?
No ice on burn going to flush it with room temperature water or cool tempid to stop the burning process and there is osmething still on the skin and 2nd or third degree put dry sterile dress qst degree dont cover at all. Lost finger with wedding ring. Using dental floss to preserve it and have time enough to do that. Don put burn or cream lotion on if have aloe plant and first degree superficial but any breach in skin dont put anything on. Separate digits on hands and feet. Dry chemical bursh away and then flush after
90
How do you treat radiological?
Radiological dry sterile dressing no water treat like warm burn
91
What is a dressing?
| what are the different kinds
Dressing- directly on skinwantt to be as sterile as possible, dont remove one layer when it bleeds through put another layer on top
Universal dressing- abdominal dressing or large trauma dressing can absorb up to 1000cc of fluid
Pressure dressing- couple layers on and using gauzze or trainagular bandage wrapping around switch it up and change direction over x adding pressure to injury without restricting complete vascular access and make sure not too tight
Occlusive dressing on abdominal evisceration
Semi-occulsive over lung
92
What is a bandage?
Badnage- hold dressing in place
93
What are the different kinds of connective tissue and bone?
```
Ligaments bone to bone
tendons - connects muscle to bone
Irregular bone- vertebra
Long- femur
Short bone- phalanges carpals and tarsals
Flat bones- sternum scapula
```
94
Why is splinting important?
Splinting is a good way to prevent closed injury from beocming an open injury. So we splint ot prevent further injury. Warn patient of increased pain adn once aligned pain decreases signifcantly
95
What are the signs and symptoms of musculoskeletal injuries?
pain and tenderness, deformity and angulation, grating (creptius), swelling and brusiing, exposed bone ends, joints locked into position, nerve/blood vessel compromise, compartment syndrome with vascular injuries usually have nerve injuries as well
96
What is multiple trauma?
more than one serious injury
97
What is multi system trauma?
one or more injuries that affect more than one body system
98
How do you determine severity based on anatomy?
penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee, chest wall instability or defomity, two or more proximal long-bone fractures, crushed, degloved, mangled, or pulseless extremity. Ampation proximal to wrist or ankle, pelvic fractures, open or depressed skull fracture, and paralysis.
99
How do you determine the severity for mechanism of injury?
falls in adults >20 feet, children >10 feet or 2-3 times height of child. High risk auto- intrustion of roof, ejection, death in passenger, motorcycle >20mh.
100
What are some considerations for special populations?
older adults have increased risk fo injury and death after 55, systolic blood pressure 20 weeks, taking anticoagulants and bleeding disorders
101
What are the symptoms of a pneumothorax?
diminshed or absent lung sounds on one side, respitatory distress, elevated pulse, possible injury on that side
102
What are the symptoms of a tension pneumothorax?
very labored breathing, absent lung sounds on one side, distened neck veins, altered mental status, low blood pressure, narrowing pulse pressure, increased pulse and respirtoins, possibe injury (penetrating) to chest, tracheal deviation (late sign)
103
What are the symptoms of cardiac tamponade?
distended neck veins, low blood pressure, narrowing pulse pressure, increased pulse and respirations, peentrating injury to chest
104
What are the symptoms of solid organ damage?
profuse bleeding causing shock, mask bleed and pain delaying diagnosis, sharp and predictable patterns in should,
105
What are the symptoms of hollow organ damage?
severe and diffuse pain
106
In critical patients what do you limit scene treatment to?
statbilizing cervical spine, suctioniing airway, inserting an oral or nasal airway, restoring a patient airway by sealing a sucking chest wound, ventiliateing with a bag-valve mask, aadministering high concentration O2, controlling bleeding, immobilizng patietn with cervical collar and long backbaord
107
What do you do if the situation isn't ideal?
If person is stuck in a situation evaluate them as much as you can you may have to change things to get them to work like ventilating
108
What is a trauma score?
a system of evaluating trauma patients according to a numerical rating system to determine the severity of the patient’s trauma. Determining severity based on physiological : any time you have a person with an altered mental status with a GCS 29 and
109
What is conduction?
the transfer of heat from one material to another through direct contact. Warm goes to other colder objects
110
What is water child?
chilling caused by conduction of heat from the body when the body or clothing is wet water conducts heat away from body 25 times faster than air.
111
What is convection/
carrying away or heat by currents of air, water, or other gases or liquids
112
What is wind chill?
chilling caused by convection of heat from the body in the presence of air currents. The faster thewind speed the greater the heat loss
113
What is radiation?
sending out energy, such as heat, into waves of space. Heat is picked up by surrounding air or water most occurs from person’s head and neck
114
What is evaporation?
the change from liquid to gas. When the body perspires or gets wet, evaporation of the perspiration or other liquid into the air has a cooling effect on the body
115
What is respiration/
breathing. During respiration, body heat is lost as warm air is exhaled form the body
116
What is hypothermia?
generalized cooling that reduces body temperatures below normal, which is a life threatening condition in its extreme. 99-96oF shivering occurs, 95-91 intense shivering and difficulty speaking. 90-86 strong muscular rigidty affecting muscle coordination less clear things less comprehended and amnesia. 85-81 irrational loses contactwith environent drifitn ginto stuporous state muscle rigidity and pulse and respirations slow. 80-78- patient loses consciousness no longer responding to spoken words cease reflects and heart slows as cardiac rest occurs.
117
What are some things that speed up or increase chances of hypothermia?
shcok, burns, head and spinal injuries, infection, and diabetes, alcohol, aged and very young.
118
What are the signs and symptoms of hypothermia?
shivering in early stages when core is above 90 or when shivering is decreased or absent in bad cases, numbness or reduced or lost sense of touch, stiff or rigid posture, drowsiness and/or unwillingness or inability to do even simplest activites irrationl and drift into sutporous state, rapid breathing and pulse in early stages and slow or absent breathing and pulse in prolonged cases with low or undetecatble blood pressure. Loss of motor coordination, poor balance, staggering, inablity to hol thingds, joint/muscle stiffnss or muscle rigidity, decreased level of consciousness or unconsciousness. Cool abdominal skin temp, skin appering red and prolonged pale or cyanotic and frozen
119
What is passive rewarming?
convering a hypothermic patient and taking other steps to prevent further ehat loss such as removing wet lothing and help the body rewarm itself.
120
What is active rewarming?
application of an external heat. Source to rewarn the body of ahypothermic patient who are alret and responding appropriatbly can be bad if patient is serious
121
What do you do when a hypothermic patient is responding appropriately?
remove wet clothing, keep dry, dress in dry clothing or wrap in dry warm blanket, keep still handle gently dont exert or massage extremities. Trasnport active reward with heat packs, water bottles, heating pads, warm air, and radiators or body heat not too quickly because will have stagnated cold blood move to vital center ptovide warm and humidified oxygen. Warm liquids at slow rate dont eat or drink stimulants. Centrally rewarm them dont rewarm limbs
122
What do you do when a hypothermic patient is unresponsive?
passive rewarming protect from further heat loss warm humidified oxygen, wrap in blankets, insulating, handle gently to avoid ventricular fibrillatoin dont take stimulants or massage. If find unconscious patient with no pulse check for long time and start CPR,
123
What is central rewarming?
application of heat to laterl chest, neck, armpits, and groin of a hypothermic patient
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What is local cooling/
cooling or freezing of particular (local) parts of the body. Early or superficial and late or deep affecting ears, nose, face, hands, finger,s feet and toes. Tissues freeze gangren. Exposed skin reddens in light-skinned or darkens in dark-skinned and approaches blanched- frostnip. Skin turns gray or white blochy becomes numb and sensation lost- frostbite muscles, bones, deep blood vessels, and oxygen membranes become froen. Warm area and s;pint it and dont massage may feel burning or tingling.
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How do you rewarm frozen parts when they are not close?
warm water, container to immerse without touching sides or bottom, heat water to 100-105oF not discomfort when touch, remove clothing of area that might swell, dont let touch sides when immerse nor put pressure and stir water when water cools belwo 100oF dd mrore water pain is a good indication of rewarming when it turns red and isnt frozen dry area and apply sterile dressing and place between fingers and toes covering with blankets. Keep at rest keep entire patient warm and cover head can assist circulation by raising and lower limb warm water, container to immerse without touching sides or bottom, heat water to 100-105oF not discomfort when touch, remove clothing of area that might swell, dont let touch sides when immerse nor put pressure and stir water when water cools belwo 100oF dd mrore water pain is a good indication of rewarming when it turns red and isnt frozen dry area and apply sterile dressing and place between fingers and toes covering with blankets. Keep at rest keep entire patient warm and cover head can assist circulation by raising and lower limb
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What is hyperthermia?
an increase in body temperature above normal, which is a life-threatening condiiton in its extreme. Associated with high outside temperatures and humidity head lost through lungs or skin. Moist heat tires people quickly and stops them from harming themselves through overexertion dry heat decives people remain exposed to excess heat far beyond what they can tolerate. Preexisting conditions such as dehydration, diabetes, fever, fatique, high blood pressure, heart disease, lung problems or obesity may hasten or intensity effects of heat exposure such as alcohol and drugs. Elderly effected by thermoregulatioin, prescription medications, and lack of mobility.105.8 is critical point of body temperature
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What is heat exhaustion?
prolonged heat exposure with patient presenting moist, pale skin feeling normal or cool to the touch. Perspires heavily drinking lots of water body loses salt creating muscle cramps esoecially with more ecvervise. Dizziness, weak pulse, lots of perspiration, brief loss of consciousness. Drank little bits of water
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What is heat stroke?
skin is hot whether dry or most is emergency
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What is drowning?
the process of experiencing respiratory impairment from submersion/immersion in liquid, which may result in death, morbidity (illness or other adverse effects), or no morbidity. Can lead to respiratory distress and a heart attack. Struggles to keep afloat starting to submerge taking a breath and water enters airway with coughing and swallowing actions inhaling and swallowing water flowing past epiglottis spasming larynx so only small amount reaches lungs causing hypoxia and unconsciousness. People in cold water can be revived 30 more in cardiac arrest if below 70oF.
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What is rescue breathing in water?
do it in water holding the patient in supine and hold manual spine if necessary dont dive in deep water if cant or not certified do ventilations more forcefully and usually causes air to go into stomach because of swollen airways so put patient on side suction and push on epigrastric area to releieve distention. Keep body straight and get them out of water as fast as possible if life saving providing CPR only on land
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What do you do if you find a facedown patient?
put arms over head and rotate hold neck in aligment a you come up. Letospital know fresh or salt water warm or cold and if it is related to diving. Place on side for things to drain
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What are diving accidents?
most to head and neck, from great heights with water, from normal heights with the bototm. Do full secondary assessment to see if anything esle injured
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What is an air embolism?
gas bubble in the bloodstream. The plural is air emboli the more accurate term is arterial gas embolism (AGE). gases leaving damaged lung and entering bloodstream with severe damage leading to collapsed lung from holding breath or consderve air when diving
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What is decompression sickness?
a condition resulting from nitrogen trapped in the body’s tissues, caused by coming up too quickly from a deep, prolonged dive. A symptom of decompression sickness is “the bends,” or deep pain in the muscles and joints. Develops 1-48 hours after a dive when nitrogen bubbles in the blood and especially if they fly afterwards.
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What are toxins?
substances produced by animals or plants that are poisonous to humans
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What is venom?
toxin (poison_ produced by certain animals such as snakes, spiders, and some marine life forms. Brown recluse has rash appearing 12 hours later, black widow appears much sooner. 1 kind of scorpioin is dangerous to children.
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What are the signs and symptoms of air embolisms?
blurred vision, chest pains, numbness and tingling sensations in extremities, generalized or specific weakness possible paralys, frothy blood in mouth or nose, convulsions, rapid lapse into unconsciousness, rrespiratory arrest and cardiac arrest. keep warm and on side
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What are the signs and symptoms of decampression sickness?
personality changes, fatigue, deep pain to muscles and joints, itchy blotches or mottling of skin, numbeness or paralysis, choking, coughing, labored breathing, behavior similar to intoxication (staggering) chest pains, collapse leading to unconsciousness. keep warm and on side
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How do you rescue someone in the water?
when responsive and close to shore or poolside try to reach them. If person is conscious and alert but too far away to reach and pull from water, throw object that will float lifejacket or ring buoy or inflatable splints try towing ashore. Patient is too far from shore to throw or tow row a boat dont if you cant swim wear floation tell to grab oar or stern. Go in a last resort must be a good swimmer
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How do you rescue someone in ice?
wear cold-water submersion suit and personal floatation, toss rope with loop in it to them and have them wrap it around. Small-flat bottoms boat for ice rescue and ladders are helpful
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What are the signs and symptoms of insect bites and stings?
altered state of awareness, noticeable stings or bites on skin, punctures marks (fingers, forearms, toes and legs), blotchy (mottled) skin, localized pain or itching, numbeness in limb or part, burning sensation at site followed by pain throughout limb, redness, swelling or blistering at site, weakness or colapse, difficult breathing and abnormal pulse rate, headache and dizziness, chills, fever, nausea and vomiting, muscle cramps, chest tightening, joint pains, excessive saliva formation, profuse sweating anaphylaxis. If unknown what caused it should go to hopsital bring with you if you have it. Just pull venom or stick out as fast as possible remove jewlery place constriciting bands above and below site loose enough to slide finger immobilizing limb
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What are the complications that arrive with snack bites?
pit vipers (rattlesnakes, copperheads, and water moccasins) and coral snakes less than half of these bites have venom death doesnt occur rapible surviving two days. Dont transport live snake in ambulance note size and coloration dont delay care to catch snake. Call medical control to determine where antivenom will be available.
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what are the signs and symptoms of snake bites?
noticeable bit on skin, discoloration; pain and swelling in area of bite slow to develop, rapid pulse and labored breathing, progressive general weakness, vision problems (dim or blurred), nausea and vomting, seizures, drowsiness or unconsciousness.
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What are some problems with marine life?
stings form jellyfish etc. poor vinegar to lessen pain but dont poor in eyes or mouth. Stepping on stingray sea urchin spiny catch soak with nonscalding hot water for as long as possible to break down venom but not delay transport
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What are the respiratory indications of shock?
patton, cheyne stokes, biots,
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What is considered a rapid transport?
Crushed, degloved, mangled or pulseless extremities great bleeding
Falls, intrusions into a vehicle, ejection. Pregnant patient outside any normal limits. 2-3 minutes and then in trimit
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What do you limit scene time to?
Limit scene treatment to stabillize cervical spine, suction airway, insert OPA or NPA, restore patent airway, ventilate with BVM, administer High O2, control bleeding, immobilize patient
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How many blankets do you put on someone?
2 blankets under a person for every 1 over them
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What is the difference versus heat exhaustion and stroke?
Heat exhaustion vs. heat stroke over 105 kid could handle 105 and be able to, the difference is that they are no longer sweating (unnatural opposite of what you normally feel so feeling cold) by that point, altered mental status, vomiting, rapid heart rate, seizure.
