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Emergency Care: Castro > Quiz 4: SCI, Traumas/Mass Casualty, Burns > Flashcards

Quiz 4: SCI, Traumas/Mass Casualty, Burns Flashcards

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1
Q

T/F: The spinal cord can regenerate.

A

False. The spinal cord cannot regenerate.

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2
Q

T/F: The location of spinal cord injuries is not relevant.

A

False.

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3
Q

If a patient is injured above C3-C5, what type of injury may occur?

A

Total respiratory muscle paralysis and death if not treated immediately.

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4
Q

If a patient is injured at C3-C5, what type of injury may occur?

A

Severely reduced respiratory muscle strength and will initially require a ventilator.

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5
Q

What percent of patients can potentially be weaned from the ventilator after a C3-C5 injury?

A

80%

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6
Q

If a patient suffers an injury to the thoracic area, what type of injury could occur?

A

Diaphragm function intact, accessory muscles and thoracic muscles weakened/paralyzed.

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7
Q

Paralysis of one limb is called:

a. Monoplegia
b. Diplegia
c. Paraplegia
d. Hemiplegia

A

a. Monoplegia

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8
Q

Paralysis of of both upper or lower limbs is called:

a. Monoplegia
b. Diplegia
c. Paraplegia
d. Hemiplegia

A

b. Diplegia

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9
Q

Paralysis of both lower limbs is called:

a. Monoplegia
b. Diplegia
c. Paraplegia
d. Hemiplegia

A

c. Paraplegia

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10
Q

Paralysis of upper limb, torso, and lower limb on one side of the body is called:

a. Monoplegia
b. Diplegia
c. Paraplegia
d. Hemiplegia

A

d. Hemiplegia

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11
Q

Paralysis of all four limbs is called:

a. Monoplegia
b. Quadriplegia
c. Paraplegia
d. Hemiplegia

A

b. Quadriplegia

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12
Q

Tetraplegia is another word for:

a. Quadriplegia
b. Hemiplegia
c. Diplegia
d. Paraplegia

A

a. Quadriplegia

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13
Q

What is priaprism?

A

Prolonged erection without arousal. Disruption in automatic regulation of vasculature.

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14
Q

How is hypotension caused in spinal cord injuries?

A

Neurogenic shock from loss of sympathetic vascular tone.

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15
Q

What are the limitations of xray films?

  1. May fail to detect up to 50% of all bony structures
  2. Can miss secondary injuries of the spine
  3. Both 1 and 2
A
  1. Both 1 and 2
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16
Q

Which of the following are benefits of using CT?

  1. Inadequate/suspicious x-ray films
  2. Finding bony structures
  3. Any fracture / displacement on x-rays
  4. High clinical suspicion of injury despite normal x-rays
  5. All of the above
A
  1. All of the above
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17
Q

T/F: CT is better for soft tissue than MRI.

A

False. MRI is better for soft tissue.

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18
Q

What kind of patients are best for MRI?

A

Spinal cord injury without radiographic Abnormality.
Central cord syndromes
Concerning symptoms
Suspected surrounding soft injury

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19
Q

T/F: RTs are allowed to remove collars from spinal cord injury patients.

A

False. Let the MD make the call.

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20
Q

What is the priority for RTs during treatment for trauma patients?

A

Identifying life threatening problems and providing respiratory support if needed. Airway and breathing.

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21
Q

What are the three types of MVA impacts?

A
  1. Vehicle impact
  2. Body impact
  3. Organ impact
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22
Q

What is it called when skin is broken by a penetrating trauma?

A

Cavitation

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23
Q

What is the golden hour?

A

One hour from the time of injury to surgical intervention. Can enhance survival and reduce complications.

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24
Q

What acronym do you use for trauma evalutation?

A

A-B-C-D-E

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25
Q

What is normal heart rate in adults?

A

60-100 BPM

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26
Q

What is normal respiratory rate in adults?

A

10-20/min

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27
Q

What is normal MAP in adults?

A

80-100 mmHg

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28
Q

T/F: If a child is declining, the BP will be the last to change.

A

True

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29
Q

What is an ominous vital sign in children?

A

Bradycardia

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30
Q

What are the three main causes of chest injury?

A
  1. blunt trauma
  2. penetrating trauma
  3. compression injury
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31
Q

What are the three types of pneumothorax?

A
  1. Simple/closed pneumothorax
  2. Open pneumothorax
  3. Tension pneumothorax
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32
Q

What is the main cause of a simple/closed pneumothorax?

a. penetrating trauma
b. pericardial tamponade
c. compression injury
d. blunt trauma

A

d. blunt trauma

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33
Q

T/F: A simple/closed pneumothorax is usually self correcting.

A

True

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34
Q

If a pneumothorax is large, what should the immediate treatment be?

A

Chest tube

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35
Q

T/F: With a tension pneumothorax, the trachea moves toward the affected side.

A

False. Tracheal deviation goes away from the pathology.

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36
Q

What is the prehospital protocol for tension pneumothorax?

a. needle aspiration/decompression
b. thoracostomy tube (chest tube) and suction with water seal
c. just suction with water seal
d. tracheostomy

A

a. needle aspiration/decompression

37
Q

What is the in-house hospital protocol for a tension pneumothorax?

a. needle aspiration/decompression
b. thoracostomy tube (chest tube) and suction with water seal
c. just suction with water seal
d. tracheostomy

A

b. thoracostomy tube (chest tube) and suction with water seal

38
Q

For needle decompression, where should the needle be inserted?

a. locate 3rd intercostal space midclavicular line
b. lnserted 4th or 5th intercostal space, mid to anterior axillary line
c. locate 2nd intercostal space midclavicular line over the top of the rib
d. locate 2nd intercostal space midclavicular line under the rib

A

c. locate 2nd intercostal space midclavicular line over the top of the rib

39
Q

Why should you not go under the rib during needle decompression procedure?

A

Nerve, artery, and vein run along bottom of rib

40
Q

T/F: When removing the needle from a decompression procedure, you should remove the catheter with it.

A

False. Needle comes out, catheter stays in.

41
Q

T/F: For needle decompression, you should use the nipple line along with the mid-clavicular line for reference.

A

False. You should ONLY use the mid-clavicular line. NOT the nipple line.

42
Q

The sternal rib (angle of Louis) is level with which rib?

A

2nd rib

43
Q

Where is chest draining tube inserted?

a. locate 3rd intercostal space midclavicular line
b. locate 4th or 5th intercostal space, mid to anterior axillary line
c. locate 2nd intercostal space midclavicular line over the top of the rib
d. locate 2nd intercostal space midclavicular line under the rib

A

b. locate 4th or 5th intercostal space, mid to anterior axillary line

44
Q

What are the size ranges for chest drainage tubes depending on the patient?

a. 10-20F
b. 30-50F
c. 6-20F
d. 6-40F

A

d. 6-40F

45
Q

The 3 chamber water seal (chest drainage) system only bubbles when what?

a. when there is a leak
b. when there is an obstruction
c. it is not working properly
d. it is overfilled

A

a. when there is a leak

46
Q

T/F: JVD is a sign of hemothorax.

A

False. Typically no JVD associated with hemmothorax.

47
Q

Which of the following are treatments for pericardial tamponade?

  1. Stabilize and secure airway
  2. Pericardiocentesis
  3. Pericardial Window
  4. Chest tube insertion
A

1, 2, and 3 only

  1. Stabilize and secure airway
  2. Pericardiocentesis
  3. Pericardial Window
48
Q

T/F: Traumatic aortic or myocardial rupture is nearly 100% fatal.

A

True

49
Q

Which of the following are signs of traumatic asphyxia?

  1. distended neck veins
  2. swollen tongue/lips
  3. burning sensation in chest
  4. diffuse ecchymosis
  5. petechiae
A

1, 2, 4, and 5

50
Q

T/F: In severe cases, bowel/gastric sounds can be heard in chest cavity of affected side of a diaphragmatic rupture.

A

True

51
Q

Bleeding in interstitial and alveolar region of the lungs is called:

A

Pulmonary contusion

52
Q

What would appear on a CXR for pulmonary contusion?

a. blunted costophrenic angels
b. radiolucency
c. hyperinflation
d. “white out” ground glass

A

d. “white out” ground glass

53
Q

T/F: if object is penetrated in the body, you should never pull it out.

A

True

54
Q

T/F: RTs main focus in emergencies is preventative or basic therapeutic modalities.

A

False. Our focus shifts primarily to the stabilization of patients… not preventative or basic therapeutic modalities.

55
Q

What acronym is used for determining priority of care?

A

S-T-A-R-T

56
Q

What acronym is used when assessing LOC?

A

P-E-R-R-L-A

57
Q

Injury by flame, flash, scald, or contact with hot objects is a:

a. chemical burn
b. electrical burn
c. radiation injury
d. thermal burn

A

d. thermal burn

58
Q

Tissue injury or destruction from reactive/corrosive substances is a:

a. chemical burn
b. electrical burn
c. radiation injury
d. thermal burn

A

a. chemical burn

59
Q

Burn caused by intense heat from flow of electrical current is a:

a. chemical burn
b. electrical burn
c. radiation injury
d. thermal burn

A

b. electrical burn

60
Q

Inhaling hot air or noxious chemicals is a:

a. chemical burn
b. electrical burn
c. radiation injury
d. smoke/inhalation injury

A

d. smoke/inhalation injury

61
Q

Injury from radioactive particles is a:

a. chemical burn
b. electrical burn
c. radiation injury
d. smoke/inhalation injury

A

c. radiation injury

62
Q

T/F: the lint trap for dryers is a fire hazard.

A

True

63
Q

Which of the following are functions of the skin?

  1. barrier against infection and injury
  2. prevents burns
  3. holds in fluids and electrolytes
  4. regulates body temperature
A

1, 3 and 4

64
Q

The nonvascular outer layer of the skin is the:

a. epidermis
b. dermis
c. subcutaneous tissue

A

a. epidermis

65
Q

T/F: The dermis is thicker than the epidermis.

A

True

66
Q

The part of skin that contains connective tissue, blood vessels, hair follicles and nerve endings, and sweat glands is the:

a. epidermis
b. dermis
c. subcutaneous tissue

A

b. dermis

67
Q

The part of the skin that contains major vascular networks, fat, nerves and lymphatics is the:

a. epidermis
b. dermis
c. subcutaneous tissue

A

c. subcutaneous tissue

68
Q

T/F: Subcutaneous tissue acts as a shock absorber and heat insulator.

A

True

69
Q

Which of the following are relevant for determining severity of burns?

  1. depth of burn
  2. size of burn
  3. location of burn
  4. lung involvement
  5. inhalation of toxic gases
A

all of the above

70
Q

Partial thickness burn is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

b. 2nd degree burn

71
Q

A superficial burn is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

a. 1st degree burn

72
Q

Full thickness burn is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

c. 3rd degree burn

73
Q

If damage is limited to the epidermis it is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

a. 1st degree burn

74
Q

If a burn involves the epidermis and dermis it is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

b. 2nd degree burn

75
Q

A patient comes in with blisters, the skin appears moist and white. What type of burn do they have?

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

b. 2nd degree burn

76
Q

A patient comes in with waxy white and charred black skin, and you can see bone. What ype of burn does the patient have?

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn

A

c. 3rd degree burn

77
Q

T/F: A 3rd degree burn involves all dermal layers, above fascia.

A

True

78
Q

If a burn involves muscles and bones, it is a:

a. 1st degree burn
b. 2nd degree burn
c. 3rd degree burn
d. 4th degree burn

A

d. 4th degree burn

79
Q

What rule is used to estimate percent of body surface damage sustained in burns?

A

Rule of nines

In adults, most body areas can be roughly divided into 9%

80
Q

T/F: the Lund Browder chart is most accurate and useful for pediatric patients.

A

True

81
Q

CO poisoning can cause falsely elevated:

A

PaO2. Flush appearance. CO causes formation of COHb

82
Q

How are CO levels tested?

A

Hemoximetry (co-oximetry)

83
Q

More than what percentage of CO is severe?

a. 5%
b. 6-15%
c. 20%
d. 40%

A

c. 20%

> 20% IS SEVERE

84
Q

What percent of CO leads to a coma and is often fatal?

a. >20%
b >30%
c. >40%
d. >60%

A

d. >60%

85
Q

What is normal MAP?

A

80-100 mmHg

86
Q

What is normal BP for both systolic and diastolic?

A

90-140 systolic

60-90 diastolic

87
Q

Lund Browder calculation is more accurate than Rule of Nines.

A

True

88
Q

What is Fluoroscopy used for?

A

Definitive diagnosis of diaphragmatic paralysis. “Sniff test”

89
Q

T/F: Diaphragmatic ruptures are usually more common on the left side.

A

True. Liver helps protect the right side of the diaphragm.

Emergency Care: Castro (5 decks)

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