HM MAN ch 21: Emergency medical care procedures Flashcards
1
Q
what encompasses all international law regulating the conduct of nations and individual engaged in armed conflict?
A
law of armed conflict
2
Q
what are the five priorities for non-tactical triage?
A
Priority I- Immediate Priority II- Delayed Priority III- Minor Priority IV- Expectant Priority V- Dead
3
Q
what priority of non-tactical triage involves casualties whose injuries are critical but who will require only minimal time or equipment to manage and who have a god prognosis for survival?
A
Priority I- Immediate
4
Q
What is an example of injuries that would fall into Priority I, immediate, for non-tactical triage?
A
compromised airway or massive external hemorrhage
5
Q
what priority of non-tactical triage involves casualties whose injuries are debilitating but who do not require immediate management to salvage life or limb.
A
Priority II- delayed
6
Q
What would be an example of injuries for priority II of non-tactical triage?
A
long bone fracture
7
Q
What priority of non-tactical triage involves casualties, often called walking wounded?
A
Priority III- minor
8
Q
what priority of non-tactical triage involves casualties whose injuries are so severe that they have only minimal chance of survival?
A
Priority IV-expectant
9
Q
what are the four tactical triage categories?
A
immediate
Delayed
Minimal
Expectant
10
Q
what are the two types of suction catheters?
A
tonsil tip (yankauer) Flexible (French or whistle tip)
11
Q
Never suction for how long in an adults mouth?
A
15 seconds
12
Q
Never suction for how long in a child’s mouth?
A
10 seconds
13
Q
Never Suction for how long in an infant’s mouth?
A
5 seconds
14
Q
how do you measure the appropriate size for a flexible catheter suction?
A
from the patient’s earlobe to the corner of the mouth or center of the mouth to the angle of the jaw
15
Q
when can a combitube be used?
A
for an unconscious casualty that has no cervical spine injury
16
Q
what size ET Tube is preferred for use during the field insertion of a cricothyrodiotomy?
A
6.0 to 7.0
17
Q
how long of an incision is used and where for a cricothyroidotomy?
A
1-1/2 inch vertical incision through the skin over the cricothyroid membrane
18
Q
what size needle is used for chest decompression?
A
3.25 in
14 gauge
19
Q
what are the land marks for chest decompresion
A
second intercoastal space
mid clavicular
20
Q
___ is a state of inadequate tissue perfusion resulting in decreased amount of oxygen to vital tissues and organs?
A
Shock
21
Q
what are the three major types of shock?
A
hypovolemic
distributive (vasogenic)
cariogenic
22
Q
Which of the three major types of shock is describes as a loss of intravascular volume, which may occur from blood, plasma, or fluid loss.
A
hypovolemic
23
Q
Which of the three major types of shock is describes as hemorrhagic shock?
A
hypovolemic
24
Q
what is Hypovolemic shock also known as?
A
hemorrhagic
25
Which of the three major types of shock is describes as occurring when the vascular container dilates without a proportional increase in fluid volume?
distributive or vasogenic
26
As a result of what type of shock, the heart's preload decreases and thus cardiac output falls leaving the tissues hypoxic and starve for energy
distributive or vasogenic
27
what are the three types of distributive shock?
neurogenic shock
septic shock
psychogenic shock
28
Which type of shock is caused by the failure of the nervous system to control the diameter of blood vessels.
Neurogenic
29
Which type of shock is caused by the presence of severe infection which leads to vasodilation?
septic shock
30
Which type of shock is typically mediated through the para-sympathetic nervous system?
Psychogenic shock
31
which type of shock involves stimulation of the vagus nerve producing bradycardia which can lead to fainting?
psychogenic
32
Which of the three major types of shock is describes as being caused by the heart failing to pump blood adequately to all vital parts of the body?
cardiogenic
33
which stage of shock is also known as non-progressive?
compensated
34
which stage of shock is also known as progressive?
decompensated
35
at what stage of shock is the blood pressure maintained, however there is a narrowing of the pulse pressure?
compensated (non-progressive)
36
At what stage of shock is the blood pressure falling because the blood volume has dropped 15-25%?
decompensated (progressive)
37
decompensated (Progressive) stage of shock is caused by the blood volume dropping by what amount?
15-25%
38
Which stage of shock involves the arterial blood pressure to be abnormally low?
irreversible shock
39
how much blood does the average adult have?
5-6 litters
40
Normally a loss of how much total blood volume will create a life threatening condition?
25-40%
41
massive hemorrhage may be fatal with in how much time?
60-120 seconds
42
the brain can go how long with out oxygen before permanent damage or death?
four to six minutes
43
how many classes of hemorrhagic shock are there?
4
44
which stage of hemorrhagic shock has few clinical manifestations?
Class I shock
45
which stage of hemorrhagic shock is able to maintain blood pressure and tissue perfusion though various mechanisms of the sympathetic nervous system?
class II shock
46
which stage of hemorrhagic shock has unfavorable signs begin to appear?
class III shock
47
which stage of hemorrhagic shock is severe and truly have only minutest to live?
class IV shock
48
what causes septic shock?
a systemic infection
49
how is septic shock dangerous?
toxins cause the blood vessels in the periphery to dilate which pulls the blood away from critical areas like the brain and heart.
50
how long does it typically take for septic shock to develop?
5-7 days
51
the casualty with neurogenic shock, in the absence of traumatic brain injury, is alert, orientated, and lucid when in what position?
supine
52
what is the treatment for psychogenic shock?
place the casualty in a horizontal position
53
cardiogenic shock can be caused by what two factors?
intrinsic and extrinsic
54
what is a CVA?
cerebrovascular accident
55
what is the name for a stoke or apoplexy?
CVA
56
Emergency treatment for a cerebrovascular accident is mainly what?
supportive
57
how should a CVA patient be placed?
a semi reclining position
or
on the paralyzed side
58
convulsive episodes occur in what percent of the general population?
1-2%
59
___ is a condition characterized by an abnormal focus of activity in the brain that produces severe motor responses or changes in consciousness.
epilepsy
60
___ is the more serious type of epilepsy.
grand mal
61
Grand mal seizures may be but is not always preceded by what?
an aura
62
___ seizures are short in duration and are characterized by an altered state of awareness or partial LOC, and muscular contrations.
Petit mal
63
which type of seizure has a warning?
grand mal
64
which type of seizure has no memory of the attack after it is over?
petit mal
65
What is OPQRST?
```
Onset
Provocation
Quality
Radiation
Severity
Time
Interventions
```
66
what are three conditions that are commonly referred to as heart attacks?
angina pectoris,
acute myocardial infarction
Congestive heart failure
67
what causes angina pectoris?
insufficient oxygen being circulated to the heart muscle
68
how is angina differentiated from other forms of heart problems?
angina's pain is a result of exertion and subsides with rest
69
what is the cause of an acute MI?
when a coronary artery is severely occluded by arteriosclerosis or completely blocked by a clot.
70
The pain associated with ___ is similar to that of angina pectoris but is longer in duration, not related to exertion or relieved by nitro, and leads to death of heart muscle tissue.
Acute MI
71
which heart condition is accompanied with an overwhelming feeling od doom?
Acute MI
72
which heart condition is caused by prolonged hypertension, valve disease, or heart disease?
Congestive Heart Failure
73
in CHF the heart will try to compensate for decreased function by doing what?
increasing the size of the left ventricular pumping chamber and increasing the heart rate.
74
in CHF patients, ___ leads to rapid shallow respirations, the appearance of pink frothy bubbles at the nose and mouth and distinctive rattling sounds in the chest?
Pulmonary edema caused by hypertension
75
how much IV fluids do PTs with CHF need?
as little as possible.
| slowest rate possible
76
which solution of epinephrine is used as treatment for an anaphylactic reaction?
1:1000
77
after administering epi to an anaphylactic patient, vital signs must be assessed how frequent?
every 3-5 minutes until the casualty is stable.
78
what is the usual adult dose of activated charcoal?
25-50 grams
79
Adults and children: __ grams of activated charcoal/kg of body weight
1
80
what is the usual pediatric dose of activated charcoal?
12.5-25 grams
81
Activated charcoal is contraindicated for patients that have an altered mental status that are suspected of swallowing what? or have an inability to swallow
acids or alkalis
82
what is the most common cause of diabetic ketoacidosis?
forgetting to take insulin or from taking too little insulin to maintain a balanced condition
83
The lack of glucose in the cells leads to an increase in metabolic acids in the blood. What is this called?
acidosis
84
what is the most common of all diabetic emergencies?
hypoglycemia
85
what is a concussion cause by?
a violent jar or shock to the head
86
what is a contusion?
| head injury
an internal bruise or injury
87
If the time between contraction is less than ___, then delivery is approaching.
less than 3 minuets
88
in a breech delivery, if the head does not emerge within 3 minutes what must you do?
try to maintain an airway by gently pushing fingers into the vagina. then push the vaginal away from the baby's face and open their mouth with one finger.
89
what must be done if the umbilical cord precedes the baby?
protect it with moist, sterile wraps
90
in the case on a prolapsed cord during child birth, if the physician cannot be reached quickly what must be done for the mother?
put her in an extreme shock position and give her oxygen
91
in combat, if a PT has a penetrating eye trauma ensure that they take what medication?
400 mg moxifloxacin tablet
found in the combat pill pack
92
what two medications should be carried by the combatant and self administered as soon as possible after the wound is sustained?
Mobic 15mg PO
| Tylenol 650mg
93
what is the most effective of all pain relieving drugs?
morphine
94
how is morphine most commonly available?
in pre measured doses in syrettes or tubexes
95
what is the adult does of morphine?
10-20 mg repeated if necessary in no less than 4 hours
96
what type of wound are torn, rater than cut?
laceration
97
what type of wound is the tearing away of tissue from a body part?
avulsion
98
what is hematemesis?
vomiting right red blood
99
what is it called when a patient vomits bright red blood?
hematemesis
100
what is hemoptysis?
coughing up bright red blood
101
what is it called when a patient coughs up bright red blood?
hemoptysis
102
what is melena?
excretion of tarry black stools
103
what is it called if a PT excretes tarry black stools?
melena
104
what is hematochezia?
excretion of bright red blood from the rectum
105
what is it called when a patient excretes bright red blood from the rectum
hematochezia
106
what is epistaxis?
nose bleed
107
what is a nose bleed?
eepistaxis
108
what is ecchymosis?
pooling of the blood near the skin surface
109
what is pooling of the blood near the skin surface called?
ecchymosis
110
what is the advice to HMs regarding the suturing of wounds?
DO NOT ATTEMPT IT
111
what is the medical word for brining together?
coaptation
112
what are the four types of non-absorbable sutures?
```
silk
cotton
linen
synthetic materials
rust-proof metal
```
113
which type of suture frequently reacts with tissue and can be "spit" from the wound?
silk
114
Which type of suture loses tensile strength with each autoclaving?
cotton
115
which type of suture is better than silk or cotton but more expensive?
linen
116
what is an example of synthetic material sutures?
nylon
| dermalon
117
rust proof metal sutures are made of what?
stainless steel wire
118
what is an example of an absorbable suture?
catgut
119
though it is referred to as "catgut", surgical gut is derived from what?
submucosal connective tissue of the first one-third of the small intestine of health government-inspected sheep
120
what are the available sizes of catgut?
6.0-0
1 to 4
4 being the largest
121
what are the four types of gut?
A: plain
B: Mild
C: medium
D: extra
122
what is the absorption time for type A gut?
10 days
123
what is the absorption time for type B gut?
20 days
124
what is the absorption time for type C gut?
30 days
125
what is the absorption time for type D gut?
40 days
126
what are the four characteristics of suture needles?
size
taper point
cutting edge point
atraumatic
127
what is the most common local anesthetic used?
xylocain
128
what are the various strengths of xylocain?
0.5%
1%
2%
129
Xylocain with Epi is contraindicated for patients with what four diagnosis?
hypertension
diabetes
CHF
130
what are the thre methods of anesthesia administrations?
topical
local infiltration
nerve block
131
what size needle is used to infiltrate into the lateral and medial aspects of the base of the digit for anesthesia?
25 or 26 gauge
132
what is the maximum recommended amount of Xylocain t be used?
50 ml for 1% solution or the equivalent
133
what is the general rule for time to apply sutures?
6-14 hours old may be closed if they are not grossly contaminated and are meticulously cleaned
14-24 hours old should not be closed
134
what suture size should be used to suture in G- tube or chest tubes?
2-0
135
what suture size should be used on the foot or deeply in the chest, abd, or back?
3-0
136
what suture size should be used on the scalp, chest, abd, foot, extemiteies?
4-0
137
what suture size should be used on the scalp, brown, oral, chest, abd, hands, penis
5-0
138
what suture size should be used on the ear, lids, brow, nose, lip, face, penis?
6-0
139
what suture size should be used on eyelids, lips, or face?
7-0
140
as a general rule how many days should you wait to remove facial sutures?
4 or 5
141
as a general rule how many days should you wait to remove body and scalp sutures?
7 days
142
as a general rule how many days should you wait to remove sutures on the soles, palms, back, or over joints?
10 days
143
as a general rule how many days should you wait to remove wire sutures?
10-14 days
144
When a bone is forcibly displaced from it joint, the injury is called what?
dislocation
145
___ are injuries to the ligaments and soft tissues that support a joint.
sprain
146
___ are injuries caused by the forcible overstretching or tearing of muscles
strain
147
___ is characterized by ischemia and muscle damage.
crush syndrome
148
with ____ there is an efflux of potassium, nephrotoxic metabolites, myopglobin, purine,, and phosphorous into the circulation, resulting in cardiac and renal dysfunction.
rhabdomyolysis
149
what is rabies sometimes called?
hydrophobia
150
is rabies in man fatal?
normally yes
151
When a person has been bitten by an animal what should be done to that animal?
every effort must be made to catch the animal and keep it confined for a minimum of 8-10 days
DO NOT kill it
152
First degree burns affect what layer of skin?
epidermal layer
153
second degree burns affect what layer of skin?
epidermal and dermis
154
which type of burn is referred to as full thickness?
third degree
155
what are two names for white phosphorus?
WP
| Willy Peter
156
what is the treatment for White phosphorus?
continually flush the area and pull out the WP with tweezers
157
Under no circumstances should copper sulfate be applied to what?
a wet dressing
158
What is the most common condition caused by working or exercising in hot environments?
heat exhaustion
159
what is the mortality rate for heat stroke?
20%
160
what is the temperature of a heat stock victim?
105
161
death results as the core temperature approaches what?
80 degrees F
162
___ is a mild cold injury caused by prolonged and repeated exposure for several hours to air temperatures from above freezing to as high as 60 degree
chilblain
163
____ occurs in the hands and feel as a result from prolonged exposure to wet cold at temperatures ranging from just above freezing to 50 degrees F.
immersion foot
164
Never do what to a frostbite area?
rub it
165
___ is defined as damage to tissues caused by a change in ambient pressure.
barotrauma
166
what is the most common type of barotrauma and how can it be experienced?
middle ear squeeze
| simply jumping in a swimming pool and swimming to the bottom
167
what is barotrauma of the lungs?
pulmonary over inflation syndrome (POIS)
168
___ is the tearing of the lung with air leaking out and remaining inside the chest cavity.
mediastinal emphysema
169
___ is tearing of the lung with air leaking out of the lung then migrating up and out the chest cavity and stopping at the base of the neck.
subcutaneous emphysema
