Exam 6 Study Guide

Question 1

An 80-kg patient has a lacerated brachial artery with severe bleeding. Based on his weight, what is the maximum amount of blood loss that his body can tolerate developing severe shock?

Answer 1

The body will not tolerate an acute blood loss of greater than 20% of this blood volume. If the typical adult loses more than approximately 2 pints (1L) of blood, substantial changes in vital signs occur.

Question 2

Hemostasis - Definition

Answer 2

Formation of clots to plug openings in injured blood vessels and stop blood flow; the body’s natural blood-clotting mechanism.

Question 3

In general for women (any age), normal hematocrit values are within which range?

Answer 3

Women (any age): 36.1% to 44.3%, Men 40.7 to 50.3

Question 4

Red blood cells are approximately what fraction of hemoglobin?

Answer 4

1/3 of HGB

Question 5

A 1-year-old female sustained blunt abdominal trauma following a motor-vehicle crash in which she was not properly restrained. Significant signs and symptoms will most likely occur after as little as ___mL of blood loss?

Answer 5

Symptoms of blood loss will occur after 3 to 6 ounces (100 to 200mL) of blood loss

Question 6

A 19-year-old male sustained major head trauma following a motorcycle crash. During your assessment, you note the presence of blood draining for his left ear. What is the most important reason for not attempting to control the flow of this bleeding?

Answer 6

Applying excessive pressure to the injury may force the blood leaking through the ear or nose to collect within the head. This could increase intracranial pressure and possibly cause permanent damage.

Question 7

Damage control resuscitation focuses on:

Answer 7

a systematic approach to the treatment of the trauma PT with severe injuries, Focuses on maintaining circulating volume, controlling HH, and correcting the lethal triad

Question 8

During times of decreased perfusion, the autonomic nervous system?

Answer 8

Redirects blood to the most vital organs of the body

Question 9

The trauma triad of death includes?

Answer 9

Hypothermia, acidosis, and coagulopathy

Question 10

TXA - definition

Answer 10

is another option for controlling internal hemorrhage. TXA works by reducing fibrinolysis by inhibiting the activation of plasminogen to plasmin, which also reduces clot breakdown.

Question 11

Ruptured aortic aneurysm - Definition

Answer 11

Can cause massive internal bleeding, which is usually fatal

Question 12

Laceration to the spleen
Signs and Symptoms

Answer 12

when fractures of the 9th through 10th ribs on the left side are present or when the patient reports left upper quadrants tenderness, hypotension, and tachycardia.

Question 13

Bleeding within the brain
Signs and Symptoms

Answer 13

No Answer on Study Guide

Question 14

Laceration to the Liver
Signs and Symptoms

Answer 14

No Answer on Study Guide

Question 15

Cardiac arrest following a crush injury is most often the result of?

Answer 15

May result almost instantaneously on freeing the limb if substantial amounts of potassium (hyperkalemia) are suddenly returned to circulation

Question 16

Rhabdomyolysis
Definition

Answer 16

The destruction of muscle tissue leading to a release of potassium and myoglobin

Question 17

Compartment syndrome
Definition

Answer 17

A elevation of pressure within the fascial compartment, characterized by extreme pain, decreased pain sensation, pain on stretching of affected muscles, and decreased power; most frequently seen in fractures below the elbow or knee in children.

Question 18

Zone of coagulation
Definition

Answer 18

the reddened area surrounding the leathery and sometimes charred tissue that has sustained a full-thickness burn; point of maximum damage.

Question 19

Zone of stasis
Definition

Answer 19

the peripheral area surrounding the zone of coagulation that has decreased blood flow and inflammation; it can undergo necrosis within 24 to 48 hours after the injury, particularly if perfusion is compromised because of burn shock.

Question 20

Zone of hypermia

Answer 20

in a thermal burn, the area that is least affected by the burn injury; an area of increased blood flow where the body is attempting to repair injured but otherwise viable tissue.

Question 21

Zone of injury

Answer 21

the entire affected area in a bone or joint injury, which may include the surrounding soft tissue, especially to the adjacent nerves and blood vessels.

Question 22

Necrotizing fasciitis

Answer 22

Death of tissue from bacterial infection, caused by more than one infecting organism—most commonly, Staphylococcus aureus and hemolytic streptococci; this condition has a high mortality rate.

Question 23

You are dispatched to an industrial plant for a worker who was exposed to an unknown chemical. Upon arrival, you find the patient sitting outside of the plant. He has a white, dry powder covering his right arm. Care for this patient’s exposure includes?

Answer 23

Brush dry chemicals off the skin and clothing before flushing the patient with water. Remove the patients clothing, including shoes, stockings, and gloves, and any jewelry or eye glasses, because there may be small amounts of chemicals in the creases.

Question 24

All of the following are characteristic of a closed soft tissue injury, except?

Need the List.

Answer 24

Deformity of a short bone

Question 25

Abdominal evisceration

Answer 25

Occurs when organs are protruding out of a penetrating wound. It can be a small loop of intestine leaking out of a stab wound or an entire open abdomen with many exposed organs. In the case of eviscerations, do not attempt to replace organs back inside the body.

Question 26

Radiation Sickness

Answer 26

can cause premature aging or even death. If the does is fatal, death usually occurs within 2 months. The symptoms of radiation sickness include nausea, weakness, hair loss, skin burns, and diminished organ function.

Question 27

Death immediately following a burn is most commonly the result of?

Answer 27

Sepsis is the leading cause of death after burn injury

Question 28

Laryngeal injury

Answer 28

whenever injury to the larynx is a possibility, suspect a c spine injury, don’t remove impaled objects (unless they interfere with breathing or cpr), maintain a high index of suspicion, provide O2 and ventilate/ apply c collar

Question 29

Frequent reassessment of patients with face or neck injuries are most important because:

Answer 29

often affect associated systems (RR,CV,Neuro)

Question 30

Significant trauma to the face should increase the AEMT’s index of suspicion for an?

Answer 30

Spinal column injury

Question 31

Exsanguination

Answer 31

severe, possible life-threatening loss of blood

Question 32

Anterior nosebleeds

Answer 32

usually originate from the area of the septum and bleed fairly slowly; they are usually self-limited and resolve quickly.

Question 33

Which semicircular bone “floats” in the superior aspect of the neck just below the mandible?

Answer 33

The Hyoid bone floats in the superior aspect of the neck just below the mandible

Question 34

A 50 year old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should?

Answer 34

Place one or two drops of saline in the eye, gently pinch the lens between your glove thumb and index finger, and lift it off the surface of the eye. Place the contact lens in a container filled with sterile saline solution to prevent damage to the contact lens.

Question 35

Retinal injuries that are caused by exposure to extremely bright light?

Answer 35

Permanent damage to vision, ultraviolet rays from arc welding, light from prolonged exposure to a sunlamp, reflected light from a bright snow covered area

Question 36

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the?

Answer 36

Conjunctiva

Question 37

Blunt or penetrating trauma can be especially lethal in pregnant patients because the?

Answer 37

The gravid uterus is highly vascular

Question 38

In the absence of obvious external trauma, an abdominal injury would be most difficult to assess for in a?

Answer 38

Unresponsive patient

Question 39

In the absence of pain when palpating a trauma patients abdomen does not rule out the possibility of intraabdominal bleeding because?

Answer 39

blood within the peritoneal cavity does not provoke an inflammatory response

Question 40

Peritonitis

Answer 40

Inflammation of the peritoneum

Question 41

Which of the following seatbelt positions will most likely result in severe intraabdominal injuries when a vehicle suddenly decelerates?

Answer 41

Shoulder harness and lap belt placed superior to the iliac crest

Question 42

A 29 year old female had a glass bottle inserted into her vagina during a sexual assault. She is conscious and alert and has stable vital signs, but she is in severe pain. How should you manage this patient?

Answer 42

Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly

Question 43

In addition to providing 100% oxygen and controlling external bleeding, the most appropriate management for a patient with a knife impaled in the abdomen includes?

Answer 43

Stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion

Question 44

Increasing the blood pressure with IV crystalloids in a patient with intraabdominal bleeding would most likely?

Answer 44

Exacerbate the internal bleeding

Question 45

Kehr sign

Answer 45

Left shoulder pain caused by blood in the peritoneal cavity due to rupture of the spleen

Question 46

Testicular torsion

Answer 46

twisting of the testicle on the spermatic cord, from which it is suspended; associated with scrotal pain and swelling, and is a medical emergency.

Question 47

Blunt Abdominal trauma may result in tearing of the mesentery, which is/are?

Answer 47

membranous folds that attach the intestines to the abdominal wall

Question 48

In addition to controlling bleeding and immobilizing the spine as needed, appropriate care for a patient with a penetrating abdominal wound and signs of shock includes?

Answer 48

maintaining adequate perfusion with IV fluids and transporting, ensuring adequate ventilation

Question 49

The most commonly injured organs of the genitourinary system is/are the?

Answer 49

The kidneys

Question 50

During an explosion, a metal worker sustained a large laceration to the left side of his neck by flying debris. He is conscious but restless; the wound is moderately bleeding. Appropriate care for this patients injury includes?

Answer 50

Preventing air from entering the wound and apply a pressure dressing

Question 51

High voltage burn injuries occur most frequently in?

Answer 51

Utility workers

Question 52

How much IV fluid (per bolus) should you administer to a kg patient with extensive burns and shock?

Answer 52

1,300mL

Question 53

When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should?

Answer 53

Treat any injuries and provide privacy and reassurance

Question 54

Which of the following medications or medical devices may inhibit the body’s tachycardia response during shock?

Answer 54

Beta blockers