Scene size-up

Question 1

Steps of scene size-up:

Answer 1

1. Standard precautions.
2. Scene safety.
3. Initial triage.
4. Need for more help or equipment.
5. Mechanism of injury.

Question 2

Steps of ITLS Primary Survey:

Answer 2

Perform a scene size-up.
Perform initial assessment.
Perform a rapid trauma survey or focused exam.
Make critical interventions and transport decision.
Contact medical direction.

Question 3

Essential equipment:

Answer 3

1. PPE
2. Long back board with effective strapping and head motion-restriction device.
3. Appropriately sized rigid cervical extraction collar.
4. O2 and airway equipment.
5. Trauma box.

Question 4

Mechanism of injury:

Answer 4

The means by which the patient was injured.

Kinetic energy = 1/2 (M X V2)

Question 5

Potential injury patterns for frontal impact

(Deformed steering wheel, dashboard knee imprints, spiderweb deformity of windscreen):

Answer 5

C-spine #
Flail chest
Myocardial contusion
Pneumothorax
Aortic disruption
Spleen / liver laceration
Posterior hip dislocation
Knee dislocation

Question 6

Potential injury patterns with lateral impact (T-bone)

Answer 6

Contralateral neck sprain
C-spine #
Lateral flail chest
Pneumothorax 
Aortic disruption 
Diaphragmatic rupture
Laceration of spleen, liver, kidney
Pelvic #

Question 7

Potential injury patterns for rear impact:

Answer 7

C-spine injury

Question 8

Potential injury patterns for ejection:

Answer 8

Exposure to all mechanisms and mortality increased

Question 9

Potential injury patterns for pedestrian vs. car:

Answer 9

Head injury
Aortic disruptions
Abdominal visceral injuries
# lower extremities and pelvis

Question 10

3 separate events for MVA:

Answer 10

Machine collision
Body collision
Organ collision resulting in rupture, shearing and bruising

Question 12

Basic mechanisms of blunt motion injuries:

Answer 12

Rapid forward decelerations (collisions)
Rapid vertical decelerations (falls)
Energy transfer from blunt instruments (blackjack, baseball bat)

Question 13

MVAs forms:

Answer 13

Frontal impact or head-on collision 
Lateral impact or T-bone collision 
Rear-impact collision 
Rollover collision 
Rotational collision

Question 14

Basic mechanisms of penetrating motion injuries:

Answer 14

Projectiles
Knives
Falls on fixed objects

Question 15

What do you do when you approach a scene in your vehicle?

Answer 15

1. Determine nearest safe place to park.
2. Park facing away from scene.
3. Determine safety to approach patient.
4. Windshield survey.