Exam 3: 11-14 Flashcards
What is scene size-up?
steps taken when approaching the scene of an emergency call: checking scene safety, taking Standard Precautions, noting the mechanism of injury or nature to the patient’s illness, determining the number of patients, and deciding what, if any, addditional resources to call for. one ambulance per patient. ex, look for dark areas, smoke, traffic, wires
What are body substances?
include blood, saliva, and any other body fluids or contents can be infected via bleeding, coughing or sneezing, body substance can enter through cuts or openings like eyes, nose and mouth. ex. when have tuberculosis or something spread through air wear N-95 or high efficiency particulate (HEPA) respirator to filter out airborne particles patient exhales or expels
What is danger zone?
the area around the wreckage of a vehicle collision or other incident within which special safety precautions should be taken. ex. never parjk ambulance within or fifty feet in all directions from wreckage if fuel spilled (dont use flares use reflective) 100 feet upwind, if hazardous material park 2000 feet. ex. crime scene or vioelnce see or hear fighitng, threateneing words or actions, weapons visible, signs of alcohol or other stuff, silence, prior violences
What are the three kinds of collision?
first- vehicle with object, second- patient’s body strikes interior of vehicle 3- organs of patient strike within body
What happens in a head on collision?
potential for great injury for everyone with two types of injuries present, up-and-over (up and over steering wheel striking head on widnshield head, neck and chest injuries and breathing problems esp. not wearing seat belt) and down and under (striking knees on dash, cuasing knee, leg, and hip injuries).
What are different kinds of injuries?
injuries to bones and joints- usually associated with falls and vehicle collisions
burns- common to fire and explosions
penetrating soft-tissue injuries- gunshot wounds
collapsed steering wall suggests driver has suffered chest-wall injury with possible rib, lung or heart damage
blood-spattered windshielf- forehead or scalp laceration and a severe blow to head causing head or spinal injury,
What is a side-impact collision?
injuries to neck with head, chest, abdomen, pelvis, and thighs can be struck directly. shearing inuries (aorta off tendon) to the elderly
What is a rollover collision?
multiple impacts can be most serious injury. flying objects and body if not belted, rotational forces with multiple impacts
What is a rotational collision?
involve cars struck then spin causing subseqnet impacts with multiple injury patterns
What is a rear-end collision?
common causes of neck and head injuries
What happens in falls?
height from which patient fell, surface the patient fell onto, part of patient that hit surface and anything interrupts fall. adult- falling 20 feet, child under 15 10 feet, or three times childs heat is a severe fall and should be transproterd to trauma center
height from which patient fell
surface patient fell onto
part of patient that hit surface
anything that interrupted fall
What is penetrating trauma?
injury caused by an object that passes through the skin or other body tissues ex. low velocity usually limited to area that was penetrated, medium velocity- handguns and shotguns arrow, high velocity- high-powered assalt rifle cause damage almost anywhere in body causing damage in path depending on bullet size, path and cavity formed, and fragments.
what organs under there and it is classified by the velocity of the item that caused the injury and is it still in there only one or two wounds? high velocity stuff will go through not leaving a lot of cavitation but shotgun doe sa lot of damage around it. never cut through bullet or knife hole go around it.
What is blunt-force trauma?
injury caused by a blow that does not penetrate the skin or other body tissues ex. blow will cause travel through body causing serious injury to and even rupture internal organs and vessels with hemmorrhage or spilling oforgan may cause ore problems than pentrative may appear reddened so look for mechanism of injury. signs are often subtle and easily missed, index of suspicion is based on MOI.
What is the index of suspicion?
awareness that there may be injuries
What is the nature of illness?
what is medically wrong with the patientreason patient called EMS
general impression
information may be obtained from many sources
the patient
family membrs or bystanders
the scene
What is primary assessment?
focus exclusively on life threats like those interfering with airway, breathing and circulation. the first element in a patient assessment; steps taken for the purpose of discovering and ealing with any life-threateneing problem. 1) forming a general impression 2) assessing mental status 3) assessing airway 4) assessing breathing 5) assessing circulation 6) determining the priority of the patient for treatment and transport ot the hospital
What happens if the patient is lifeless and has no pulse?
if lifeless and has no pulse do not use ABC, instead use CAB (circulation [compressions], airway, breathing) based on who needs it most
steps on things to do: vomit in airway enters lungs can be serious and fatal should do first
exsanguinating (very severe, life threateneing) bleeding must be stopped immediately) with damage to major vessels, especially arteris possibly causing death extremely rapidly from bleeding and the bleeding must be controlled
breathing and circulation- vital especially breathing adequately
then shift to oxygen
What are interventions?
actions taken to correct or manage a patient’s problems
What are general impressions?
impression of a the patien’s condiiton that is formed on first approaching the patient based on the patient’s environment chief complaint and appearance
What do you do to patients who appear lifeless?
patients who appear lifeless, or have altered mental status, or who are pale and swetay (shock), bvious trauma to the head chest abdomen or pelvis (head bleeds a lot, airway problems, pelvis fatal bleeding), tripod (breathing) or levine (chest pain or discomfort)
What is a chief complaint?
in emergency medicine, the reason EMS was called, usually in the patient’s own words
What is a clinical judgement?
judgement based on experience in observing and treating patients
What is a mental status?
level of responsiveness if lower than alert provide high concentration oxygen by nonrebreather mask
What is AVPU?
a memory aid for calssifying a patient’s level of presponsiveness or mental status. the letters stand for alert, verbal response, painful response, unresponsiveness
What are ABCs?
airway, breathing, and circulation
When do you assist with breathing?
if patient is in respriatory arrest with pulse perform rescue breathing
patient not alert and breathing inadequate (insufficient minute volume from decrease rate depth or both) provide pressure ventilaitons with 100% oxygen
patient alert but breathing inadequate- assist with 100% oxygen based on own respirations
patients breathing is adequate but signs or symptoms suggesting respriatory distress or hypoxia
What is circulation?
once breathing problems corrected, assess patient’s circulation by taking pulse if lifeless on approach so assess pulse, skn and bleeding if skin at wrist warm pink and dry good circulation if pale and clammy- shock. look at pulse for normal limits or if unusually slow or fast.
What is priority?
the decision regarding the need for immediate transport of the patient versus further assessment and care at the scene
What are the different kinds of stability?
stable, potentially unstable or unstable, unstable- high priority
When is a patient stable?
patient needs to have vital signs in normal range or only slightly abnormal, small deviations,
What is potentially unstable or stable?
threat to airway, breathing or circulation, actual or imminent rules out stable with depressed level of responsiveness has an immediate priority for transport to hopsital with assessment and care contnuing en route.
What is a high priority?
priority: poor general impresssion, unresponsiveness, responsive but not following, difficult breathing, shcok, complicated childrbirth, chest pain consistent with cardiac problems, uncontrolled bleeding, severe pain
What are the vital signs?
outward signs of what is going inside the body, including respiration; pulse, skin color, temperature, and condition (plus capillary refill in infants and children); pupils; and blood pressure and oxygen saturatioin
What is pulse?
the rhythmic beats felt as the heart pumps blood through the arteriolespulse rate- the number of pulse beats per minute wantingto see rate and quality
What is pulse rate?
number of pulse beats per minute is normal, rapid or slow with age, physical condition, degree of excercise, medications, blood loss, stress, and temperature influence with 60-100 beats per minute if fluctuating normal if syaying high or low bad. if have ventricular assist device wont feel pulse at all
What is tachycardia?
a rapid pulse; any pulse rate above 100 beats per minute
What is bradycardia?
a slow pulse; any pulse rate below 60 beats per minute
What is pulse quality?
the rhythm (regular or irregular) and force (strong or weak) of the pulse
What is radial?
the pulse felt at the wrist taken in people one year or older