Chapter 7

Question 1

Primary sites of massive internal hemorrhage include the chest admin in the retroperitoneal space and also long boots

Answer 1

Primary sites

Question 2

Patient’s overall circulatory status can be determined by

Answer 2

Checking the post and the skin color temperature and moisture

Question 3

If a radial pulse is not palpable in an uninsured extremity

Answer 3

The patient has likely entered the decompensated phase of shock a late sign of the patients critical condition

Question 4

The combination of compromised perfusion and impaired breathing should prompt the prehospital care provider to consider

Answer 4

Tension pneumothorax

Question 5

Changes in color usually appear in

Answer 5

Lips gums and fingertips

Question 6

Dry skin indicates good perfusion moist skin is associated with shock and decreased perfusion this decrease in perfusion is caused by blood being shunted to the core organs of the body as a result of vasoconstriction of peripheral vessels

Answer 6

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Question 7

A decreased LOC alerts a prehospital care provider to the following for possibilities

Answer 7

One. Decreased cerebral oxygenation caused by hypoxia or hypo perfusion. Two. Central nervous system injury. Three. Drug or alcohol overdose. For. Metabolic do rangement diabetes seizure cardiac arrest.

Question 8

If patient is intubated the GCS score contains

Answer 8

Eye and motor scales

Question 9

A patient who attempts to push away a painful stimulus is considered

Answer 9

Localizing

Question 10

Abnormal flexion

Answer 10

Decorticate posturing

Question 11

Abnormal extension

Answer 11

Deceiver it posturing

Question 12

And title carbon dioxide monitoring

Answer 12

Monitoring the ET CO2 can be useful in confirming into intratracheal placement of an endotracheal tube as well as indirectly measuring the patients arterial carbon dioxide level while ET CO2 may not always correlate well with the patients PaCO2 especially in multiple trauma patients trending of ET CO2 maybe useful and guiding ventilatory rate

Question 13

Another important step and resuscitation is the restoration of the cardiovascular system to an adequate perfusing volume as quickly as possible

Answer 13

This step does not involve restoring blood pressure to normal but rather providing enough fluid to ensure the vital organs are being perfused

Question 14

For the critical trauma patient a complete set of vital signs are evaluated and recorded every

Answer 14

3 to 5 minutes, as often as possible, or at the time of any change in condition or a medical problem.

Question 15

Sample history

Answer 15

Symptoms, allergies, medications, past medical and surgical history, last meal, events,

Question 16

Crepitus of the Lenix, hoarseness, and subcutaneous emphysema constitute a triad classically indicative of

Answer 16

Laryngeal fracture

Question 17

Hey line traced from the fourth intercostal space enter early to the sixth intercostal space laterally and to the eighth intercostal space posteriorly defines the

Answer 17

Upward excursion of the diaphragm at full expiration

Question 18

A penetrating injury that occurs below this line or with a path that may have taken it below this line should be considered to have traversed

Answer 18

Both the thoracic and abdominal cavity’s

Question 19

Except for the eyes and hands the stethoscope is the most important instrument a prehospital care provider can use for

Answer 19

Chest examination

Question 20

Crackles heard posteriorly when the patient is live rolled or laterally may indicate

Answer 20

Pulmonary contusion

Question 21

Cardiac Tampa nod is characterized by

Answer 21

Distant heart sounds

Question 22

Diminished or absent breath sounds indicate

Answer 22

Possible pneumothorax, tension pneumothorax, or hemothorax

Question 23

The abdomen should be examined carefully for a tale tale transverse contusion which suggest that in incorrectly worn seatbelt has called underlying injury almost 50% of patients with the sign will have an intestinal injury lumbar spine fractures may also be associated with the seatbelt sign

Answer 23

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Question 24

If an extremity is immobilized

Answer 24

Pulses movement and sensation should be rechecked after splinting

Question 25

As with the other regional examinations described the neurologic examination in the secondary assessment is conducted in much greater detail than in the primary assessment.

Answer 25

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Question 26

Unequal pupils in an unconscious trauma patient may indicate

Answer 26

Increased intracranial pressure or pressure on the third cranial nerve, caused by either cerebral edema or rapidly expanding intracranial hematoma direct eye injury can also cause unequal pupils

Question 27

The field triage decision scheme

Step one

Answer 27

Physiologic criteria this section includes alteration in mental status hypertension and respiratory abnormalities

Question 28

The field triage decisions game step to

Answer 28

Anatomic criteria if response times our brief patients may not yet have developed significant alterations and physiology despite the presence of life-threatening injuries the section list and atomic findings that may have associated with severe

Question 29

The field three hours decision scheme step three

Answer 29

Mechanism of injury criteria these criteria identify additional patients who may have a cult injury not manifested was physiologic the rangement or obvious X ternal injury in general patients to meet one of these criteria I have about 20% chance of having an ISS greater than 16

Question 30

Field triage decision scheme step for

Answer 30

Special considerations these criteria identify health factors such as age use of anticoagulants or the presence of burns or pregnancy should affect the decision to transport to a trauma center

Question 31

Resuscitation efforts are not indicated when the patient has sustained an obviously fatal injury decapitation or went evidence exists of dependent lividity rigor mortise or decomposition for victims of blunt trauma resuscitation efforts maybe withheld if the patient is

Answer 31

Pulseless and apneic on arrival of prehospital care providers

Question 32

For victims of penetrating trauma resuscitation efforts may be withheld if

Answer 32

There are no signs of life no pupillary reflexes and spontaneous movement no organize cardiac rhythm on ECG greater

Question 33

I Deleigh before deciding to withhold CPR

Answer 33

Hey central pulse carotid or femoral should be palpated for a minimum of 30 to 60 seconds

Question 34

Pulseless electrical activity PEA

Answer 34

Patient found in PA should be assessed for the presence of hypervolemia, hypothermia, tension pneumothorax, and cardiac tamponade. Fluids, warming, and chest decompression should be performed if indicated. Epinephrine and atropine may be administered

Question 35

Bradycardia and a systole.

Answer 35

Patient found in this room should be assessed for severe hypoxia and hypovolemia. The location of the airway should be confirmed and volume resuscitation initiated. Epinephrine and atropine may beAdministered

Question 36

Ventricular fibrillation pulseless ventricular tachycardia

Answer 36

The primary therapy for these dysrhythmias is defibrillation. If you’re available to favor later is biphasic a shot of 120 to 200 J is delivered if they might’ve phasic defibrillator is present a shock of 360 Jules is used