Injuries

Question 1

What associated problems would a patient have with an incision sound to the scalp?

Answer 1

Head/brain injury

Spinal injury

Question 2

Name the different types of wound

Answer 2

Incision - bleeds freely, made by a sharp object
Laceration - snagging/ tearing of tissues, bleeds freely
Puncture - pointed object, small wound, cause damage to tissues or organs
Contusion - blunt instrument, underlying fractures/ crushed tissues
Gunshot - bullet, shot or shrapnel- may have an exit wound

Question 3

Complications with a wound

Answer 3

Bleeding -external/ internal
Damage to underlying structures (bones, organs, vessels)
Infection
Foreign bodies

Question 4

How would you manage bleeding with a head wound?

Answer 4

Positioning of the patient (toward the injury)
Direct pressure (only if no foreign objects)
Dressing, larger than the wound and sterile

Question 5

Different types of bleeding

Answer 5

Internal

External

Question 6

Compensated system

Answer 6

Tachycardia
White, cool and moist
Normal range BP
Unaltered LOC

Question 7

Decompensated system

Answer 7

Tachycardia can progress to bradycardia
White, waxy, cold, diaphoresis
Lowered blood pressure
Altered LOC

Question 8

Different pressure points

Answer 8

Carotid
Subclavian
Brachial
Femoral

Question 9

How would you reassure the patient?

Answer 9

Get down to their level
Use a toy or parent to show what you’re going to do
Don’t stand over them
Use someone they know to provide support
Explain what you’re doing as you do it

Question 10

What pain relief can be given to the child?

Answer 10

Paracetamol
Entonox
Morphine given by paramedic

Question 11

Why is blood loss in an infant more important than in an adult?

Answer 11

They have a smaller blood volume

Their blood volume per KG is higher at 80mls/kg

Question 12

What happens to blood volume in pregnancy? What effect does this have upon stages of shock?

Answer 12

Blood volume increases by up to 50%
Plasma production does not relate to blood cell formation so leads to haemodilution and potentially anaemia
Pregnant people compensate better and don’t show signs of shock for a while (can loose up to 35%)

Question 13

What are the signs of a fracture?

Answer 13

Bruising 
Swelling 
Loss of function 
Irregularities 
Pain 
Deformities (shortening of the limb) 
Unnatural movement 
Crepitus 
Tenderness

Question 14

Complications with this injury and how to overcome them?

Answer 14

Blood loss- tourniquet
Circulatory impairment- straighten the limb
Infection- maintain aseptic procedures

Question 15

How would you immobilise the injury?

Answer 15

Built up dressing over the wound

Vacuum splint

Question 16

Following immobilisation, what would you check for regularly?

Answer 16

Pulse
Motor function
Sensation
Dressings and splint stability