Exam 6 Study Guide Flashcards
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?
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.
Hemostasis - Definition
Formation of clots to plug openings in injured blood vessels and stop blood flow; the body’s natural blood-clotting mechanism.
In general for women (any age), normal hematocrit values are within which range?
Women (any age): 36.1% to 44.3%, Men 40.7 to 50.3
Red blood cells are approximately what fraction of hemoglobin?
1/3 of HGB
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?
Symptoms of blood loss will occur after 3 to 6 ounces (100 to 200mL) of blood loss
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?
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.
Damage control resuscitation focuses on:
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
During times of decreased perfusion, the autonomic nervous system?
Redirects blood to the most vital organs of the body
The trauma triad of death includes?
Hypothermia, acidosis, and coagulopathy
TXA - definition
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.
Ruptured aortic aneurysm - Definition
Can cause massive internal bleeding, which is usually fatal
Laceration to the spleen
Signs and Symptoms
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.
Bleeding within the brain
Signs and Symptoms
No Answer on Study Guide
Laceration to the Liver
Signs and Symptoms
No Answer on Study Guide
Cardiac arrest following a crush injury is most often the result of?
May result almost instantaneously on freeing the limb if substantial amounts of potassium (hyperkalemia) are suddenly returned to circulation
Rhabdomyolysis
Definition
The destruction of muscle tissue leading to a release of potassium and myoglobin
Compartment syndrome
Definition
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.
Zone of coagulation
Definition
the reddened area surrounding the leathery and sometimes charred tissue that has sustained a full-thickness burn; point of maximum damage.
Zone of stasis
Definition
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.
Zone of hypermia
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.
Zone of injury
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.
Necrotizing fasciitis
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.
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?
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.
All of the following are characteristic of a closed soft tissue injury, except?
Need the List.
Deformity of a short bone
Abdominal evisceration
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.
Radiation Sickness
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.
Death immediately following a burn is most commonly the result of?
Sepsis is the leading cause of death after burn injury
Laryngeal injury
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
Frequent reassessment of patients with face or neck injuries are most important because:
often affect associated systems (RR,CV,Neuro)
Significant trauma to the face should increase the AEMT’s index of suspicion for an?
Spinal column injury
Exsanguination
severe, possible life-threatening loss of blood
Anterior nosebleeds
usually originate from the area of the septum and bleed fairly slowly; they are usually self-limited and resolve quickly.
Which semicircular bone “floats” in the superior aspect of the neck just below the mandible?
The Hyoid bone floats in the superior aspect of the neck just below the mandible
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?
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.
Retinal injuries that are caused by exposure to extremely bright light?
Permanent damage to vision, ultraviolet rays from arc welding, light from prolonged exposure to a sunlamp, reflected light from a bright snow covered area
The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the?
Conjunctiva
Blunt or penetrating trauma can be especially lethal in pregnant patients because the?
The gravid uterus is highly vascular
In the absence of obvious external trauma, an abdominal injury would be most difficult to assess for in a?
Unresponsive patient
In the absence of pain when palpating a trauma patients abdomen does not rule out the possibility of intraabdominal bleeding because?
blood within the peritoneal cavity does not provoke an inflammatory response
Peritonitis
Inflammation of the peritoneum
Which of the following seatbelt positions will most likely result in severe intraabdominal injuries when a vehicle suddenly decelerates?
Shoulder harness and lap belt placed superior to the iliac crest
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?
Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly
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?
Stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion
Increasing the blood pressure with IV crystalloids in a patient with intraabdominal bleeding would most likely?
Exacerbate the internal bleeding
Kehr sign
Left shoulder pain caused by blood in the peritoneal cavity due to rupture of the spleen
Testicular torsion
twisting of the testicle on the spermatic cord, from which it is suspended; associated with scrotal pain and swelling, and is a medical emergency.
Blunt Abdominal trauma may result in tearing of the mesentery, which is/are?
membranous folds that attach the intestines to the abdominal wall
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?
maintaining adequate perfusion with IV fluids and transporting, ensuring adequate ventilation
The most commonly injured organs of the genitourinary system is/are the?
The kidneys
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?
Preventing air from entering the wound and apply a pressure dressing
High voltage burn injuries occur most frequently in?
Utility workers
How much IV fluid (per bolus) should you administer to a kg patient with extensive burns and shock?
1,300mL
When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should?
Treat any injuries and provide privacy and reassurance
Which of the following medications or medical devices may inhibit the body’s tachycardia response during shock?
Beta blockers
