Component 8: Care for the Trauma Patient Flashcards
A review of common injuries, treatments, and the NREMT Management of the Trauma Patient skill sheet as well as NREMT Splinting and NREMT Bleeding Control skill sheets.
What law of motion states that every object in uniform motion will remain in that state unless acted upon by an external force?
Newton’s First Law - Law of Inertia
What law of motion states that force equals mass times acceleration, expressed as :
f(t) = ma(t)
Newton’s Second Law
What law of motion states that for every action, there is an equal and opposite reaction?
Newton’s Third Law
What is the equation for kinetic energy?
KE = 1/2 mv2
F = ma, where a can represent acceleration or deceleration depending on its sign.
List the types of motor vehicle collisions.
(MVCs)
- frontal
- rear
- rotational
- rollover
- lateral
What are the two types of injuries resulting from force(s) being exerted on the human body?
penetrating and blunt force(s)
What are the terms profile, tumble, and fragmentation used to describe?
ballistics
True or false.
Every gunshot victim will have exit wounds.
False
Define:
Index of Suspicion
- maintaining a heightened awareness of surroundings and safety.
- Also, as potential patient injuries or illnesses that may not have yet presented with signs and symptoms or have developed.
Which phase of a blast would result in ruptured eardrums, eye hemorrhage, and possibly abdominal hemorrhage and/or perforation?
primary blast or phase one
During the tertiary phase of a blast, what happens to the body?
The body is lifted, tossed, and/or thrown.
True or false.
Understanding and evaluating the forces or mechanisms of injury to our patients will help us to provide quality patient care.
True
Which level of trauma facility is best for the treatment and care of a patient suffering multiple systems trauma?
Level I
Define:
- Capillary bleeding
- Venous bleeding
- Arterial bleeding
- Capillary Bleeding: slow, oozing, dark red in color
- Venous Bleeding: steady flow, not as dark in color as capillary bleeding, although still darker than arterial bleeding
- Arterial Bleeding: spurts consistent with the patient’s pulse and bright red in color
True or false.
When blunt force trauma is applied, it is imperative to maintain a high index of suspicion of internal bleeding.
True
Whether or not the patient initially presents with any signs/symptoms. Also, keep a high index that hypovolemic/hemorrhagic shock will develop.
What are the signs/symptoms of hypovolemic/hemorrhagic shock for a patient suspected of having internal bleeding?
- dry mouth
- tachycardia and thready pulse
- anxiety
- clammy skin
- delayed capillary refill
- progressive drop in blood pressure
- lethargy or altered mental status potentially progressing to unconsciousness
Fill in the blank.
Prior to applying a tourniquet for bleeding control, we should _________ __________ _________.
apply direct pressure
If bleeding does not become controlled, apply a tourniquet.
Fill in the blank.
When applying a tourniquet, we tighten and twist until _________ ________.
Define:
epistaxis
It is the medical term for a nose bleed.
True or false.
Ecchymosis is another medical term for a contusion or bruise.
True
What are the two layers of the skin that are on top of the subcutaneous tissue?
- epidermis
- dermis
What are the types of closed soft-tissue injuries?
- contusion
- hematoma
- compartment syndrome
Are abrasions, lacerations, and penetrating wounds considered to be open or closed?
open
Which position, if possible, should the flap of an avulsed tissue be placed?
Return it to the place it was torn from.
Why should the application of a splint be considered for open or closed soft-tissue injuries?
Depending on the mechanism of injury and the forces causing the injury, there may be musculoskeletal damage as well. Splints may also provide for additional patient comfort.
When treating a soft-tissue injury, we may use the mnemonic RICES. What does RICES stand for?
Rest
Ice
Compression
Elevation
Splinting
What type of open abdominal injury requires applying a moist sterile dressing secured with an occlusive dressing?
abdominal evisceration
When are the two times an impaled object can be removed?
An impaled object can be removed only when:
- The object interferes with airway management
- Performing CPR
Otherwise, stabilize in place and transport.
Why should an occlusive dressing be applied to a patient with an open, bleeding, anterior/lateral neck laceration?
The application will prevent an air embolism or particulates from being sucked into an open neck wound.
What layer(s) of the skin are involved in a 2o or partial thickness burn?
epidermis and dermis
True or false.
It is best practice to place a burn sheet over a patient suffering moderate or severe burns with a large body surface area (BSA) affected.
True
Using the rule of nines, calculate the percentage of body surface area (BSA) burnt:
The adult patient has partial and full-thickness burns to their anterior chest, abdomen, and the front and back of the left arm. What is the BSA?
The chest and abdomen is 18% plus the left arm at 9%.
The total BSA is: 18 + 9 = 27%
List the types of burns.
- thermal
- electrical
- chemical
- radiation
Why should we evaluate the severe burn patient’s airway?
The patient may have inhaled heat causing swelling of the airway tissues and/or inhaled chemicals/toxins from the burn.
How long should we irrigate chemical eye exposures?
No less than 20 minutes with copious amounts of saline.
Differentiate primary (direct) injury and secondary (indirect) injury.
- Primary Injury: is the actual direct damages to tissues from the force/contact.
- Secondary Injury: is the additional damages done to the tissues from the direct impact. For instance swelling, ischemia, infection.
What are the anticipated/potential signs/symptoms of a patient who has been hit in the occipital region of the skull with a baseball bat?
- battle signs
- racoon eyes
- basilar skull fracture
- cervical spine injury
- traumatic brain injury
- paralysis
Name the layer of meninges that is very thin and delicate and is adhered to the contours of the brain and spinal cord.
pia mater
Other meningeal layers are the arachnoid and the dura mater.
What are the signs/symptoms of a concussion?
- dizziness
- generalized weakness
- bisual disturbances (“sees stars”)
- retrograde and/or anterograde amnesia
- nausea/vomiting
- Approximately 90% of patients will not have suffered a loss of conciousness.
Define:
Cushing’s reflex/triad
It may develop from a closed head injury. The combination of the three are signs of increased intracranial pressure (ICP).
- hypertension
- bradycardia
- normal, or altered respiratory pattern
What are CSMs in relation to potential neurological trauma?
Circulation, Sensation, and Movement: it is a quick assessment if neurological trauma is suspected.
Define:
Paresthesia
It would be described by a patient with potential neurological trauma as pins and needles, numbness, or tingling in their hands and/or feet.
True or false.
When providing cervical spine precautions by immobilization, the chest, pelvis then feet should be immobilized before securing the patient’s head to the device.
True
Fill in the blank.
An injury or damage to a patient’s cervical spine at C-3 or above will cause the patient to ________ _________.
stop breathing
C-3 and above damage will cause the patient’s diaphragm to no longer contract causing the patient to stop breathing.
Upon palpation of the patient’s chest, what is the term used when you feel the sensation of bones rubbing together under the skin?
crepitus
Why would patients with chest wall injuries have tachypnea (rapid/shallow breathing)?
Adequate chest wall expansion will cause pain and possibly further damage to the chest wall. Patients will compensate with tachypnea.
What is the chest wall motion called when there is a flail segment?
Paradoxical Movement/motion
When assessing a patient’s chest for DCAP-BTLS, we note a sucking chest wound. What is our first treatment?
Place a gloved hand over the wound and hold until an occlusive dressing can be placed.
What is the term used when describing the attached picture?
Pneumothorax
If jugular venous distention (JVD) and hypotension are present with this injury, it would be called a tension pneumothorax.
If a pneumothorax means air in the pleural space(s), what do we call blood in the pleural space?
Hemopneumothorax
Where does the blood/fluid collect on a patient suffering from expected cardiac tamponade?
Blood/fluid fills the pericardial sac inhibiting the heart’s capability of filling and contracting.
What are the types of fractures?
- Greenstick
- Oblique
- Spiral
- Transverse
- Comminuted
- Epiphyseal
What are the signs/symptoms of a closed fracture?
- deformity/swelling
- tenderness
- guarding
- bruising
- pain
- crepitus
True or false.
Dislocations should be reduced before splinting.
False
Differentiate sprain from strain.
- Sprain: when a joint extends outside of its normal range of motion, resulting in a stretched or torn ligament and/or tendon.
- Strain: it is the stretching and/or tearing of a muscle.
What is the treatment for an amputated part?
Wrap the part in a sterile dressing and place it in a plastic bag. Local protocol will determine ice or no ice.
When preparing to apply a splint, what assessment should be done before and after application?
Assess for circulation, sensation, and movement (CSM) before and after applying a splint.
What joints should be immobilized when splinting an injury?
Immobilize the joints above and below the injury
Shortening of the leg and medial or lateral rotation is most likely a sign of what injury?
hip fracture or dislocation
What are the downfalls of inadequate/improper splinting?
- pressure on the nerves, vasculature, and tissues
- time delay- when possible, splinting should be done while en route to a hospital
- inhibition of distal circulation
- further damage to the initial injury
List the mechanisms of heat loss.
- convection
- conduction
- respiration
- radiation
- evaporation
With a patient suffering from severe hypothermia, what would their level of consciousness be?
unconscious/unresponsive and possibly dead
True or false.
Warm water with a brisk rubbing should be applied to deep frost-bitten fingers and toes immediately.
False
What cooling mechanism will stop when a patient has progressed from heat exhaustion to heatstroke?
sweating
What is the first treatment priority when treating a patient suffering from extreme heat exposure?
Safely remove them from the heated environment.
Define:
Diving Reflex
It is when the heart rate slows down due to cold water exposure/immersion.
What is the medical term for the condition commonly referred to as “the bends”?
“The bends” is a lay term for decompression sickness.
This condition occurs when divers ascend too quickly, causing nitrogen gas to form bubbles in the bloodstream and other tissues.
What is the definitive treatment for a patient with severe decompression sickness?
Hyperbaric Oxygen Chamber Therapy
(HBO)
What do the acronyms HAPE and HACE stand for?
- HAPE: High Altitude Pulmonary Edema
- HACE: High Altitude Cerebral Edema
The treatments for patients suffering from Acute Mountain Sickness (High Altitude Sickness), HAPE and/or HACE?
- high flow oxygen
- positive pressure ventilation (PPV) as needed
- immediate and rapid descent in altitude
In what environmental emergency situation do we consider reverse triage?
Lightning strikes with multiple patients.
Describe:
How a Hymenoptera stinger is removed from the skin?
Using a driver’s licence or a credit card, scrape the stinger away from the body/skin to avoid injecting the venom sac. Watch for signs of anaphylaxis.
