I've fallen and I can't get up (& other trauma & burning desires)

Question 1

The trauma triad- diamond (an extra point)

Answer 1

1. Hypothermia
2. Acidosis
3. Decreased coagulability
4. Hypocalcemia

Question 2

Your patient has sustained a CHI. Your (2) biggest concerns are:

Answer 2

Hypoxia
Hypotension

Question 3

Beck’s Triad (name 3)- and is indicative of:

Answer 3

Narrowing pulse pressure
JVD
Muffled heart tones

Indicative of cardiac tamponade

Question 4

Parkland’s formula
SO fluid infusion

Answer 4

4 ml x BSA % x kg / 2 = infuse over the first 8 hours
500 ml

Question 4

Differentiate between simple and tension pneumothorax

Answer 4

Hemodynamic instability

Question 5

What is:

HR / SBP (normal range 0.4-0.7 with > 1 consistent with circulatory shock requiring fluid and potentially blood products)

Answer 5

SI (shock index score)

Question 6

An unrestrained patient in an MVC presents with a fractured pelvis and laceration above the R eye. GCS- 11 (4, 2, 5), pale, and diaphoretic. VS: HR- 143, BP- 60/40, RR- 30.

You suspect (what type of shock)?

Considering the CO equation, which component is primarily affected?

Answer 6

Hypovolemic/ Hemorrhagic
Preload

Question 7

A lucid interval is indicative of a(n)?
Which is usually a result of?

Answer 7

Epidural hemorrhage
Rupture to the middle meningeal artery

Question 8

Which information obtained by assessment ensures that the patient’s respiratory efforts are adequate?

A. The patient is able to talk.
B. The patient is alert and oriented.
C. The patient’s oxygen saturation is 97%.
D. The patient’s chest movements are uninhibited.

Answer 8

B. The patient is alert and oriented.

Question 9

Draw the (3) Types of Le Forte Fractures

Answer 9

Le Fort I: Fracture of Maxilla with hard palate and inferior maxilla involvement

Le Fort II: Fracture with a Pyramid shape, nasal bone, and inferior maxilla involvement

Le Fort III: Separates entire midface from the Cranium

Question 10

How should you manage this injury?

Answer 10

Immediately cover with an occlusive dressing.

Question 11

Differentiate between a sprain and a strain.

Answer 11

Sprain- overstretching of a ligament

Strain- overstreching of a muscle/ tendon

Question 12

A boxer reports vision concerns including flashing, light specks, and
“floaters.” You suspect:

Answer 12

Retinal detachment

Question 13

Direct blow to the left chest during ventricular repolarization, specifically during the upstroke of the T-wave before its peak results in:

Answer 13

Commotio Cordis

Question 14

Accumulation of air within the pleural cavity, causing decreased preload and intrathoracic pressure:

Answer 14

tension pneumothorax

Question 15

A patient presents with unequal chest rise, and crepitus to the R lateral/ anterior chest wall upon palpation.

The patient is dyspneic, SpO2 90% with poor excursion.

CI-
You should:

Answer 15

Flail chest
Provide PPV

Question 16

During assessment you note a scaphoid abdomen and auscultate bowel sounds in the patient’s chest.

CI-
You should:

Answer 16

Diaphragmatic rupture
Provide PPV

Question 17

A homeless patient with a history of alcohol abuse has an AMS. Their friend’s state they were assaulted last week. You are most concerned about:
Caused by:

Answer 17

Subdural hemorrhage

-Elderly and alcoholics
-atrophied brain and tearing bridging veins
bleeding into the space below the dura mater, a membrane between the brain and the skull.

Question 18

Accumulation of blood within the pleural cavity is:

Answer 18

Hemothorax

Question 19

Fluid accumulation within the pericardial sac is:

Answer 19

cardiac tamponade

Question 20

A patient fell 20 ft. You note a distended abdomen and the patient reports referred left shoulder pain.

This is called:
You suspect:

Answer 20

Kehr’s sign
Splenic injury

Question 21

A patient reports extreme pain, and you note pallor, paresthesia, pulselessness, paralysis in an extremity after being hit during a game of football the previous day. You suspect:

Answer 21

Compartment syndrome

Question 22

Damaged muscles release myoglobin, this is called

Answer 22

rhabdomyolysis

Question 23

A patient experienced an amputated foot. You should:

Answer 23

-Rinse debris
-Wrap part in loose saline-moistened gauze
-Seal in bag
-Place in cool container/ slushy water

Do NOT place directly on ice

Question 24

A patient has been crushed by a vehicle for an hour and has an extended extrication.

CI-
You should:

Answer 24

Crush injury

-Obtain IV NS prior to removal
-Sodium Bicarb 1 mEq/ kg

Question 25

Which radiation particles passes through the body and solid materials?

Answer 25

Gamma

Question 26

A patient presents with severely reddened and blistered skin after falling a sleep on the beach. This is a:

Answer 26

2nd degree or partial thickness burn

Question 27

A patient presents with, bleeding from their ear, periorbital and retroaurical ecchymosis. You suspect:

Answer 27

Basilar skull fracture

Question 28

A SCI that occurs most commonly in those who suffer a hyperextension injury. The patient presents with more significant strength impairments in the upper extremities compared to the lower extremities.

Answer 28

Central cord syndrome

Question 29

A patient reports ipsilateral sensory loss of all sensations, pressure, vibration, position and contralateral loss of pain and temperature.

Answer 29

Brown Sequard Syndrome

Question 30

A patient involved in a knife fight presents with abdominal contents protruding from the abdomen.

CI-
You should:

Answer 30

Eviseration

Cover with a moist sterile dressing

Question 31

Potential blood loss in femur

Answer 31

1000- 1500 ml

Question 32

A 220 lb patient has blistered skin over their upper anterior chest wall and their entire right arm and hand.

Calculate: %BSA
Calculate: fluid you should infuse in 1 hour using Parklands Formula

Answer 32

18%
Anterior upper chest: 9%
Right arm: 9%

(100kg)(18%)(4) = 7200/ 24 hr
3,600 ml/ 8 hrs

450 ml/hr

Question 33

A patient was climbing a mountain and experienced difficulty breathing and a dry cough. They are tachycardic and tachypneic with bilateral rales.

You suspect:

Answer 33

High Altitude Pulmonary Edema

Question 34

A patient ascended too quickly while scuba diving when they panicked upon seeing a shark.

You suspect:
Caused by:
Which gas laws (2) are in effect:

Answer 34

Decompression sickness

Nitrogen within the blood is forced into the tissues of the body

Henry’s Law: the amount of a particular gas dissolved in solution is proportional to the partial pressure of that gas over the solution.
Boyle’s Law: gas expands (volume increases) as pressure diminishes.

Question 35

A patient is experiencing nausea, vomiting, cramping and weakness after completing a triathlon.

You suspect:
You should:

Answer 35

Heat exhaustion

Move to a cool area
Remove clothing
Avoid shivering
O2, IV NS bolus

Question 36

AMS and a lack of shivering are indicative of:

Answer 36

Severe hypothermia

Question 37

Hyperventilation prior to breath holding while swimming may lead to:

Answer 37

Shallow water blackout