Exam 4 study guide Flashcards
how to treat spinal injuries
1.Ensure oxygenation and normal ventilation.
2. treat severe bleeding
3. pay attention to blood glucose levels
4. spinal motion restriction: Cervical collar, Rigid Spine board, scoop stretcher, and vacuum mattress.
A collection of blood between the brain and dura
subdural hematoma
blood between the dura and skull?
epidural hematoma
when blood pools within the brain
intracerebral hematoma
Mouth closed head injury without detectable damage to the brain complete recovery is usually expected but effects may linger for weeks months or even years
Concussion.
Scattered areas of bleeding on the surface of the brain, most commonly along the undersurface and poles of the frontal and temporal lobes. When the brain strikes a Ridge on the skull or a fold in the dura matter.
Cerebral contusion
Open head versus close head injury and how are they treated?
And open head injury is when the bones of the cranium are fractured. A closed head injury is if the scalp is lacerated but the cranium is intact.
You treat them by:
1. taking appropriate standard precautions.
2. Consider the possibility of a spine injury.
3. Open and maintain airway.
4. Monitor the unconscious patient for changes in breathing.
5. If indicated, apply a rigid cervical collar and initiate spinal motion restriction. 6.Control bleeding.
7. Keep the patient at rest.
8. Talk to the patient and provide emotional support, dress and bandage open wounds
9. manage the patient for shock.
10. Be prepared for vomiting.
11. Transport patient promptly monitor vital signs every 5 minutes.
The transfer of heat from one material to another through direct contact.
Conduction.
Carrying away of heat by currents of air, water, Or other gases or other liquids.
Convection.
Sending out energy such as heat in waves into space.
Radiation.
The change from liquid to gas when the body perspires or gets wet.
Evaporation.
What does a bench steering wheel indicate?
It indicates if a patient suffered a chest or abdominal injury.
A burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. A common example is a sunburn.
Superficial or first degree burn.
A burn in which the epidermis is burned through and the dermis is damaged. Burns of this type cause reddening, blistering and a molted appearance, also called a second degree burn
Partial thickness burn.
A burn in which all the layers of the skin are damaged. They are usually areas that are charred, black or areas that are dry and white.
Full thickness burn.
A method for estimating the extent of a burn. The palm and fingers of the patient’s own hand, which make up about 1% of the body’s surface area, are compared with the patient’s burn to estimate its size.
Rule of Palm.
steps for controlling bleeding
1.Ensure Scene is safe
2.Use proper PPE
3.determine how aggressive to be with bleeding control
4. If bleeding is massive, make it your first priority. If not, continue through the airway and breathing steps.
5. Treat for Bleeding using direct pressure hemostatic agents wound packing tourniquet use on extremities or specialized compression devices for junctional bleeding.
Hypoperfusion caused by a spinal cord injury that results a systemic vasodilation
Neurogenic shock
increased work of breathing a sensation of shortness of breath
respiratory distress
fluid build up in the lungs
Pulmonary Edema
A brain injury or another medical condition that can cause growing pressure inside your skull
Increased Intercranial Pressure ICP
Blockage of blood supply to organs caused by bubbles in an artery
arterial gas embolism aka air embolism
as a scuba diver descends pressure increases causing nitrogen to be absorbed in the body’s tissues what is this called
decompression sickness or the bends Think 47 meters now when Mandy Moore started having dizziness and vertigo and she was like hallucinating and **
Bruise of the heart muscle
myocardial contusion
What is epistaxis and how is it treated
Nosebleed, treat it by:
1. Having patient sit down and lean forward
2. Direct pressure to the fleshy portion around the nostrils.
3. Keep the patient calm and quiet and advise the patient not to snort or forcibly wipe the precious nose once pressure is released.
4. Do not let patient lean back.
5.if the patient becomes unconscious or unable to maintain own airway place in recovery position and be prepared to provide suction and aggressive airway management
when someone gets hit in the center of the chest just when the heart is electrically vulnerable
commotio cordis
When air builds up in the chest cavity causing the lung to collapse
pnuemothorax
When blood fills up in the chest cavity
hemothorax
When blood and air fills up in the chest caivity
hemopneumothorax
Injury caused by a blow that does not penetrate the skin or other body tissues.
blunt force trauma
an injury when an object passes through the skin or other body tissues.
penetrating trauma
stages of hypothermia
Shivering: 96 to 95 degrees Fahrenheit, 37.0 t0 35.5 celsius
Intensive shivering: 95-91 fahrenheit or 35.5-32.7 celsius
strong muscular rigity 90-86 f or 32.0-30.0 c
patient becomes irrational
cardiac dysrhythmia may develop: 85-81 F or29.4-27.2 C.
Patient loses consciousness 80-78 F or 26.6-20.5 C
as the body loses salts bringing on painful muscle cramps
heat cramps
patient presents with moist, pale skin that feels normal or cool to the touch.
heat exhaustuion
when a persons temp regulating mechs fail and the patient has hot skin that is dry or moist
heat stroke
how to treat heat exhaustion and cramps
- remove patient from hot enviorment and place in coolIf there are signs of hypoxia or the patient’s vital signs indicate or suggest the potential for shock administer oxygen.
2.Loosen or move clothing and cool the patient by fanning without chilling patient. Watch for shivering.
3.Put the patient in the supine position.
If the patient is responsive and not nauseated and you will not transport, give the patient small sips of water to drink. If this causes nausea or vomiting, do not give anymore water.
4.If patient experiences muscle cramps, apply moist towels over cramped muscles.
5.Transport the patient.
how to treat heat stroke
1.remove patient from the hot environment
2. remove clothing and apply cooling packs to the neck groin and arm pits.
3. administer high concentration oxygen
4. transport immediately
The sternum and the ribs exert severe pressure on. the heart and forcing some blood out of the right atrium up into the jugular veins in the neck.
Traumatic asphyxia.
when sudden changes in air or water pressure damage your body
barotrauma
Muscle injury caused by overstretching or overexertion of the muscle.
strain
stretching or tearing of ligaments
sprain
how to treat altitude sickness
arrange immediate descent
high concentration oxygen
provide supportive treatment
hyper and hypothermia related body temps
hyper 105.8 F or 41 C
hypo 91.5 F or 33 C
Identifies pericardial effusion and hemoperitoneum
focused trauma exam
How does the body compensate for heat and for cold
For cold the body reduces perspiration and circulation to the skin shutting down avenues by which the body usually gets rid of excess heat
For heat, conduction, convection, radiation, evaporation and respiration
how long do you flush eyes for
20 minutes or until you arrive at the appropriate facility
a fracture in which the bone is broken in several places
comminuted fracture
a fracture in which the broken bone segments are at an angle to each other
Angulated fracture
an incomplete fracture
Greenstick fracture Think about when you’ve bend a toothpick. It doesn’t break all the way, but you see like the follicles coming apart.
What is the primary assessment in trauma
ABC’S and transport decision
How to check CSM for an extremity injury
- Feel for radial pulse
- assess motor by checking patients’ ability to move hands
3.assess strength by having patient squeeze your fingers - assess sensation by asking patient which finger I am touching don’t let them see. If the patient is unresponsive pinch the back of hand and watch and listen for a response
- check distal circulation via posterior tibial pulse or dorsalis pedis pulse at top of the foot
- assess distal motor function by checking patients’ ability to move feet
- Assess strength in feet and legs by asking the patient to push against hands.
- sensation ask which toe I am touching if patient is unresponsive pinch top of foot check for response.
bleeding that occurs in the body, the bleeding itself is not visible S/S?
this is internal bleeding
S/Bleeding from mouth rectum vagina or penis, bruising swelling and tenderness over vital organs, injuries to surface of the body, Gi bleeds, painful swollen or deformed extremities
rule of nine
This determines the extent of a burn so. basically. your face, your upper back, your lower back, your legs, your arms total up. Each is 9% part of your body. and it totals up to 99% in the other one percentage of genitalia. So just determines how much of your body was burned and you would do it based off of that
chemical burn treatments
- wash away chemical with flowing water. if it’s a dry chemical continuous flow of water
- Apply sterile dressing or burn sheet.
- treat for shock
transport
force or forces that may have caused the injury
Mechanism of injury
different types of MVC’s and injuries to suspect.
- Head on collisions: head, neck, chest, abdominal, hip, knee, leg injuries
- Rear end collision: neck head and chest injuries
- Side impact: chest, abdomen, pelvis and thighs
- roll over: multiple injuries due to multiple types of impact
What is down and under when referring to MVC?
the patient follows a pathway down and under the steering wheel causing knee leg and hip injuries.
What is up and over referring to MVC?
The patient follows a pathway up and over the steering wheel commonly striking the head on the windshield. causing head and neck injuries. the patient may strike the chest and abdomen on the steering wheel while causing chest injuries or breathing problems and internal organ injuries.
signs of a motor vehicle collision
you see airbags, you see seatbelt abrasions, the car is visibly damaged like something crashed into it. A bent or damaged steering wheel
How should one splint a deformity with or without a pulse?
- Care for life threatening problems first
- expose the injury site
- assess distal CSM
- Align long bone injuries to anatomic position (only if a severe deformity is present or distal circulation is compromised)
- Do not push long bones back into place
- immobilize injury and adjacent joints
- Choose a method of splinting: (splint each site individually. Secure limb to torso or an uninjured leg. secure the entire body to a spine board.)
- splint before moving the patient to a stretcher or another location if possible
- Pad the voids
a neck injury due to forceful, rapid back and forth movement of the neck like the cracking of a whip
Whiplash
Major mechanisms of injury
MVC’s, Falls, blunt force and penetrating trauma.
when the bruising of the brain occurs on the side of the blow and when the bruising of the brain occurs on the opposite side of the blow.
coup injury occurs on the side and countercoup occurs on the opposite side of the blow.
outer layer of the skin
epidermis
the inner layer of the skin found beneath the epidermis. it is rich in blood vessels and nerves
Dermis
layers of fat and soft tissues found below the dermis
subcutaneous layers
A bruise
contusion
the tearing away or tearing off of a piece or flap of skin or other soft tissue. eye pulled or tooth dislodged from its socket
Avulsion
a scratch or scrape
Abrasion
when something penetrates the skin
puncture
what part of the spine controls respirations
third fourth and fifth cervical nerves
Shock resulting from blood loss
Hemorrhagic shock
how to treat shock
Initiate transport to an appropriate destination
Prevent hypoxia via high concentration oxygen
prevent heat loss
consider shock positioning
request als if necessary
Fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment.
Flail Chest
movement of the ribs in a flail segment that is opposite to the direction of movement of the direction of movement of the rest of the chest wall.
paradoxical motion
When an injury to the heart causes blood to flow into the surrounding pericardial sac and to compress the heart
cardiac tamponade
how to treat a sucking chest wound
- Scene safety
- Consider the need for ALS
- Maintain open airway
- identify and seal open chest wound
- Apply occlusive dressing to seal an open chest wound.
- if possible, allow patient to remain in a position of comfort
- administer high concentration oxygen
- treat for shock
- transport ASAP
how to treat an evisceration
- be alert for vomiting and keep the airway open
- place patient on the back legs flexed at the knees
- administer supplemental oxygen for hypoxia
- Treat for shock
- give nothing to the patient by mouth
- Constantly monitor vitals
- Transport as soon as possible
How to identify an anterior hip dislocation?
The patient’s entire lower limb is rotated outward and the hips are usually flexed.
How to identify a posterior hip dislocation?
The patient’s leg was rotated inward. The hip is flex and the knees are bent. The foot may hang loose and the patient is unable to flex the foot or lift the toes.
three components of Cushing’s Triad
increase in systolic BP
decrease in heart rate
and decrease in respirations.
this deals with ICP
The opposite of what some one that is in shock is experiencing
Bulging of the neck veins
Jugular Vein Distention it indicates heart failure and other heart and circulatory issues
What is becks triad
3 medical siggns associated with cardiac tamponade
1. Low arterial blood pressure
2. Distended neck veins
3. Muffled heart tones
How do you treat hypothermia
Passive rewarming, active rewarming, and central rewarming
Precautions moving a patient with hypothermia.
Avoid ruff handling, this can cause ventricular fibrillation (life threatening heart rhythm)
An injury sustained at the site of external force (hit by a ball, bat, or person)
Direct injury
an injury sustained from an internal force (pulled hamstring or a sprained ankle)
Indirect injury
Injuries to the body that effect more than one body system (a fall, or a car crash)
multisystem trauma
A body in motion will remain in motion unless acted upon by an outside force example the body will keep moving until it hits a wall or tree.
inertia
What is your first priority in trauma patient
rapidly identify and treat life threatening injury
a break of a bone in the base of the skull
Basilar skull fracture
Air molecules slam into one another, creating a pressure wave moving outward from the blast center, causing pressure injuries
pressure wave primary blast injury
Instantaneous combustion of the explosive agent creates superheated gases. The resulting pressure blows the bomb casing apart pieces of the bomb become projectiles that cause injuries by impacting the patient.
Blast wave/ Secondary injury
The blast wind may propel the patient to the ground or against objects
tertiary blast injury or patient displacement
burns, inhalation lung injury and asphyxia caused by inhalation of combustion explosion materials
Quaternary blast injury
how to apply a cervical collar
- Make sure its the appropriate size
- ensure inline stabilization
- slide collar under neck then under jaw
GCS
Glasgow coma scale
1. eye opening
2. verbal response
3. motor response
bleeding, has pulsating flow, spurting blood, and is bright red color
arterial bleeding
bleeding: steady slow flow, dark red color
venous bleeding
bleeding: slow even oozing flow
capillary bleeding
How to treat bleeding
Direct pressure
Hemostatic agents
wound packing
tourniquet uses on extremities.
specialized compression devices for junctional bleeding
RUQ organs
right portion of liver, gallbladder, right kidney , small portion of the stomach, duodenum, part of small intestine.
RLQ organs
appendix, part of the small intestine right ureter, and right half of the female productive system
LUQ organs
left portion of liver, larger portion of stomach, pancreas, left kidney spleen, part of small intestine.
LLQ organs
large intestine, left ureter, left female productive organs.
