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1
Q

reduction of oxygen carrying capacity of the blood

A

hypoxia

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2
Q

3 types of poisons

A

ones inhaled, ingested, direct contact

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3
Q

Priority Action Approach

A

you must QUICKLY

  • find out who is injured
  • give first aid
  • inform BC EHS
  • make sure patient gets to hospital
  • ABC
  • resitrct spinal movement if you think you need to
  • rapid transport decision

it requires EFFICIENT USE OF TIME. major issues cannot be resolved in the field. get them to the hospital

  • know your workplace, ins and outs, evacuation routes, where first aid stuff is, train others, keep procedures updated, review plans,
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4
Q

hypoglycemia

A

not enough sugar in blood; associated with diabetes and insulin

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5
Q

hyperglycemia

A

too much glucose in blood; no production of insulin

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6
Q

head to toe examination

A

it is inpection and palpation; look and feel

  • proceed downwards from head (neck, chest, abdomen, pelvis, back, extremeties)
  • methodical, focused, takes several mins
  • look for injuries, painful areas that are not obvious
  • watch for sharp objects
  • any open wounds, lacerations, swelling, deformities (do NOT probe open wounds)
  • difficulty in breathing, stridor, hoarseness
  • breathing chest looks normal?
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7
Q

hydroxocobalamin

A

antidote to cyanide given intravenously by physician trained to do so

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8
Q

what is priapism, what is it assoacated with

A

persistent erection

spinal cord injury

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9
Q

syncope

A

fainting

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10
Q

trunk

A

torso of body (chest, abdomen, pelvis)

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11
Q

prone

A

lying on stomach

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12
Q

anterior

A

front of body

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13
Q

posterior

A

back of body

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14
Q

medial

A

closer to the midline

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15
Q

superior

A

closer to head

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16
Q

inferior

A

below, or closer to bottom of feet

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17
Q

distal

A

away from trunk

used only with respect to a limb

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18
Q

proximal

A

on limbs, toward the trunk

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19
Q

scene assessment

A

look for hazards
what was the mechanism for injury
number of patients

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20
Q

4 stages of PAA

A

scene assessment
primary survey
transportation decision
secondary survey

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21
Q

3 options for transportation decision

A
  1. RTC (ambulance)
    2, medical aid (needs aid, but not as quickly as possible. can use company car or taxi)
  2. return to work
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22
Q

the only interventions performed during primary survey

A

cardiac arrest
airway obstruction
severe bleeding
severe respiratory distress

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23
Q

what is AVPU

A

alert - is patient aware of surroundings, time, date, name
verbal - can they respond, do eyes open
pain - do they move or cry out in pain
unresponsive

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24
Q

agonal respiration

A

sporadi, ineffective, gasping, unusual rbreathing

common with cardiac arrest

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25
Q

dyspnea

A

shortness of breath

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26
Q

systole

A

conctraction of right and left ventricles

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27
Q

diastole

A

relaxation of heart while ventricles fill with blood

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28
Q

good amount of heart beats per minute

A

60 - 80, can change if theyre pregnant or athletes

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29
Q

definition of shock

A

state of inadequate perfusion of cells (not enough oxygen, too much CO2)
cells stop working, start to die, tissue dies, organs die

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30
Q

perfusion

A

flow of blood to and from the body cells

it carries nutrients, oxygen, gets rid of CO2

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31
Q

tachypnea

A

increased respiratory rate between 20 - 30 breaths per minute

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32
Q

pleuritic pain

A

pain made worse by breathing - sign of chest injury

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33
Q

closed pneumothorax

A

closed injury
lung tissue is torn and air leaks from lung into pleural space. its in thoracic cavity but outside lung
leads to lung collapse

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34
Q

hemothorax

A

blood collects within pleural space
can be form open or closed wounds
shock

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35
Q

pulmonary contusion

A

bruise of the lung
from blunt injury
blood vessels are injured, blood is lost into tissue

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36
Q

hypothermia

A

core body temp less than 35 C

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37
Q

3 Ps of hemorrhage Control

A

Pressure
patient position at rest - lying down

prevent movement

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38
Q

ecchymosis

A

bruise or discolouration of the skin

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39
Q

sprain

A

stretching and or partial or complete tearing of a ligament at a joint
very in severity

should be treated as fracture if unsure

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40
Q

how to tell a sprain from fracture

A

mechanism of injury (how it happened)

was it from usual lifting and twisting? probably sprain

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41
Q

ASTD

A

activity related soft tissue disorder

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42
Q

tendonitis

A

inflammation of the tendon

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43
Q

synovitis

A

inflammation of the sheath surrounding tendon

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44
Q

hyphema

A

bleeding within eyeball

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45
Q

atherosclerosis

A

arteries become narrower; build up of fatty deposits in inner wall of artery (plaque)

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46
Q

embolus

A

clot breaks off and forms a plug

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47
Q

nomarl pulse rate

A

60-80

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48
Q

pulse in anterior neck

A

carotid pulse

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49
Q

pulse felt at wrist on flexor surface at base of thumb

A

radial pulse

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50
Q

what controls blood pressure

A

blood volume and capacity of veins

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51
Q

what happens when blood pressure drops

A

organs no longer adequately perfused; cells not getting oxygen and removing CO2

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52
Q

what is shock

A

inadequate perfusion of cells

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53
Q

does shock = RTC?

A

yes

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54
Q

what is perfusion

A

flow of blood to and from body cells

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55
Q

3 main causes of inadequate perfusion

A

less blood volume (blood loss, fluid loss)
damaged heart (cardiogenic shock)
blood vessels dilate excessively

56
Q

blood pressure depends on

A

volume of blood

resistance to flow of circulating blood by arterioles

57
Q

arteriole resistance

A

back pressure exerted by arterioles on blood flow (like a nozzel on hose)

58
Q

cardiogenic shock

A

heart muscle doesnt pump enough blood to peripheral tissues, mainly due to heart attack

59
Q

other name for heart attac

A

myocardial infarction (MI)

60
Q

distinct sign of septic shock

A

confusion, high fever with warm flushed skin, later cool and pale

61
Q

when does a neurogenic shock occur

A

presence of cord injury with complete paralysis

rare

62
Q

what causes heart attack commonly

A

sudden obstruction of coronary artery or one of its branches

loss of blood supply and )2 to heart muscle

hypoxia of heart cells, then death

62
Q

what causes heart attack commonly

A

sudden obstruction of coronary artery or one of its branches

loss of blood supply and )2 to heart muscle

hypoxia of heart cells, then death

63
Q

leader of hearts electrical system

A

sinoatrial node (SA)

the pacemaker, 60 -100 impulses a minute

64
Q

ventricular fibrillation

A

uncoordinated electrical impulse across heart
no pumping action or pulse
heart quivvers
life threatening

65
Q

ventricular tachycardia (VT)

A

heart rhythm is so fast that heart may not have time to fill with blood

66
Q

asystole

A

no electrical or mechanical activity in the heart

67
Q

will AED work on VF?

A

yes

68
Q

will AED work on asystole?

A

no

69
Q

respiratory system

A

airway (nose, mouth, pharynx, trachea, bronchi)
lungs (bronchioles, alveoli, pleura)
thoracic muscles (intercostal moscules, diaphragm)
thoracic bones (ribs, sternum)

70
Q

what is pharynx

A

throat

71
Q

2 parts of pharynx

seperated by what at top

A

esophagus (food) and trachea (air to lungs)

seperated by epiglottis

72
Q

bronchi

A

left and right bronchus

2 main air tubes carry air to lungs from trachea

73
Q

bronchioles

A

branches in lung, subdivide again and again, forming smaller tubes. smallest are called bronchioles

74
Q

alveoli

A

cluster of sacs at the end of bronchioles

thin walls, many tiny capillaries, passageway for oxygen and CO2

75
Q

pleura

A

double walled sac surrounding lungs

one layer divides inside of chest cavity and other layer covers lungs
between them is pleural space

76
Q

pneumothorax

A

collection of air in plueral space

interferes with efficient respiration

77
Q

mediastinum

A

thoracic space between lungs

contains heart, major blood vessels, trachea, esophagus

78
Q

3 processes essential for transfer of oxygen to blood through lungs

A
  1. ventilation (air moves in and out of lungs)
  2. diffusion (spontaneous movement of gases between gas in alveoli and blood capillaries in lungs)
  3. perfusion (cardiovascular system pumps blood throughout lungs)
79
Q

what does it mean if patient is unresponsive and not breathing/agonal breathing? what should you do?

A

its cardiac arrest probably

CPR AED is initiated

80
Q

an early sign of partial airway obstruction?

other signs?

A

stridor; high pitched noise present on inspiration or expiration or both

gurgling, noisy, congested breathing

hoarseness

81
Q

early signs of complete airway obstruction?

A

cyanosis, no movements of chest
no air in and out of mouth
unable to vocalize (if conscious)

82
Q

most common cause of airway obstruction? next common? next?

A

tongue blockage; it falls backwards and obstructs airway

then its foreign objects

then swelling from injury of soft tissue of throat or larynx

83
Q

common causes of tissue damage in neck

A

direct blows to anterior of neck
facial fractures
smoke or chemica inhalation

84
Q

techniques for opening, clearing airway

A

cough (if conscious)
finger sweep; visual check first, lift jaw and tongue. may need to move neck, but be mindful of spinal injury

head tilt chin lift (if unresponsive)

backblows (if standing)

abdominal thrusts (only on conscious)

chest thrusts

chest compressions (unrepsonsive)

85
Q

when are backblows not affective

A

obstruction is due to swelling, secretions, bleeding, smoke, blunt neck or facial trauma

86
Q

what are not helpful if airway obstruction due to swelling, secretions, bleeding, smoke, blunt neck or facial trauma?

A

chest compressions, backblows, abdominal thrusts

87
Q

are patients with partial or complete airway obstruction RTC?

A

yes

88
Q

when should chest thrusts be used

A

if patient is too obese or pregnant

89
Q

what do you do once obstruction is cleared and breathing resumes for unresponsive patient

A

place in 3/4 prone and complete primary survey (circulation would be next)

90
Q

how would you know if partial obstruction has cleared

A

patient breathing normally

mouth is clear of fluids

91
Q

what to do if airway doesnt clear and patient still not breathing?

A

initiate CPR and AED

roll patient later, sweep to clear airway between sets of chest compressions

92
Q

T or F: leave patient in supine position unattended with a decreased level of consciousness

A

F: put in 3/4 prone

93
Q

causes of dyspnea

A 
inadequate oxygen in air
obstruction to flow in airway, trachea, bronchi
trauma
inhalation injury, asthma
injury to chest wall
collapsed lung
emphysema (lung tissue loses elasticity, no longer respond to breathing)
lungs full of fluid
infected lung tissue
94
Q

how to manage dyspnea

A

follow PAA, but

  • ensure open airway
  • if responsive, position for comfort (semi sitting, sitting, lying)
  • assess adequacy of patients respiration, coach patient to focus on breathing
  • complete primary survey (any wounds? chest injury?)
  • update BC EHS
95
Q

signs, symptoms of chest injury

A 
pain at injury site
pleuritic pain (hurts to breath)
shortness of breath
failure of one or both sides of ches to expand
coughing blood
rapid and weak pulse
cool, moist skin
cyanosis
subcutanous emphysema
anxiety, fear
96
Q

subcutanous emphysema

A

air under the skin tissues

97
Q

2 broad types of chest injury

A

closed (skin intact) , crush etcinjuries
and
open ( chest wall has been penetrated), rib fracture

98
Q

T or F; air should be allowed to excape from open chest wund

A

T

99
Q

signs, symptoms of rib fractures

A 
history of blow, compression to chest
pain at fracture site
pleural pain
patient leaning on injured side
patient wants to remain still
rib deformity
chest wall bruising
100
Q

manage rib fractures?

A

follow PAA
cannot do too much
position for comfort if not at risk to neck, back, internal bleeding

they likely have other injuries

you dont wrap, strap or tape

101
Q

flail chest

A

2 or more consecutive ribs are fractured in 2 or more places, or detached from the sternum

when patient inhales, flail part doesnt respond, and extrudes upon exhalation

causes bleeding of the lungs, very serioes, reduces volume of air into lungs

102
Q

closed pneumothorax

A

lung tissue is torn, air leaks form lung into pleural space
its still in thoracic cavity, but outside lung
reduces volume of lungs
hypoxia ensues

usually caused by rib fracture

103
Q

signs, symtoms of closed pneumothorax

A 
history of chest trauma
bruising at site
pain at site
pleuritic pain
hard to breathe
cyanosis
rapid, weak pulse
subcutanous emphysema
104
Q

open pneumothorax

A

penetrating wound of chest wall, collapses lung

air passes back and forth

105
Q

tension pneumothorax

A

accumulation of air in pleural space under pressure
collapses lung on side of injury, then displaces mediastinum away from air filled pleural space
can be from blunt or penetrating wound
increased pressure on heart and lung, leads to dyspnea and shock

106
Q

signs, symptoms of tension pneumothorax

A

severe progressive respiratory distress
distended neck veins due to obstruction of superior vena cava
marked overexpansion of chest on affected side
agitation and restlessness
deviation, shift of trachea away from side of tension

107
Q

hemothorax

A

blood collects within pleural space, caused by open or closed chest injury

hidden, severe

leads to shock

has general signs of chest injury

108
Q

pulmonary contusion

A

bruise of lung
associated with blunt injury
can mean significant blood losss into lung tissue
may lead to respiratory distress

109
Q

blast injury

A

sudden changes in air pressure in lungs leads to widespread damage and bleeding
alveoli fill with blood, prevent normal exchange of gases

110
Q

signs symptoms of smoke inhalation

A 
inflammation of mouth, larynx, trachea
sore throat, hoarseness, shortness of breath
cough
headache or dizziness, restlessness, confusion
cyanotic, pale
facial burns
fluid formation in lower airway, alveoli
can be delayed effects
111
Q

info important in smoke inhalation

A

location of worker when exposed
duration of exposure
presence of toxic substances
decreased level of consciousness?

112
Q

asthma

A

narrowing of airways that occur intermittently
can be mild shortness of breath to profound respiratory failure and death

causes bronchospasm

113
Q

bronchospasm

A

caused by asthma

contraction of smooth muscles of walls of airways (bronchi, bronchioles), leads to airway constriction

114
Q

severe prolonged asthmatic attack, doesnt respond to medications

A

status asthmaticus

115
Q

chronic obstructive pulmonary disease

A

COPD
long standing obstructive airway diseases
diffuse obstruction to airflow within lungs and dyspnea, both due to destruction of lung tissue

it is like emphysema and chronic bronchitis

usuallu caused by smoking

116
Q

chronic bronchitis

A

repeated infection of bronchial tree
usually caused by smoking

its inflammation, swelling, excesive mucus in airways

117
Q

pneumonia

A

dieases; exudation of serum and cels into alveolar spaces and small bronchioles

slows down blood supply surrounding alveoli, thickeing of alveolar walls by fluid and cells

causes hypoxia

118
Q

pulmonary edema

A

accumulation of fluid within alveoli
causes impairment of flow of oxygen from alveoli into the blood
usually caused by left ventricular failure

119
Q

heat is lost through 4 ways

A

evaporation
radiation
convection
conduction

120
Q

hyperthermia is above what temperature

another name for hyperthermia

A

41C
heatstroke
your brain, heart, kidney are unable to survive, organ dysfunction occurs

due to heat, not enough fluids and salts and some medications

121
Q

heat cramps

A

salt imbalance in muscle
occurs when you sweat alot
onset is usually delayed

replenish salts and fluids!
not salt tablets; theyll make you puke

122
Q

heat exhaustion

A

depletion of water and salt during long periods of exertion

123
Q

signs of heat exhaustion

A 
shallow respiration
increased respiratory rate
weak rapid pulse
cool, pale clammy skin
sweating
weakness, fatigue, dizziness
headache, nausea
fainting
124
Q

how to tell difference between heat exhaustion and heat stroke

A

absence of sweating is in heatstroke

same with hot, dry skin

125
Q

signs of heat stroke

A 
hot, dry flushed skin
no sweating
agitation, confusion
DLOC
headache
nausea, vomiting
seizures,
increased respiratory rate
irregular pulse
shock
cardiac arrest
126
Q

is heatstroke RTC?

A

yes

127
Q

what to do with heat stroke

A

RTC
do all you can do to lower body temp (cool spot in shade, supine unless vomiting)
- apply cold water by dousing or wet sheets
- fan patient
- oral fluids if not vomiting and conscious

128
Q

immersion foot

A

prolong exposure to cold water

pale and cold skin

129
Q

basic responses to cold injury

A

remove wet, cold clothing
get to warm space
rewarm affected part

130
Q

frostnip vs frostbite

A

nip: minor cold injury, no soft tissue damage
bite: damage to soft tissues

131
Q

who is more vulnerable to cold injuries?

A

those with pre existing circulatory disorders
if you wear constrictive clothing
working in cramped conditions (reduced blood flow)

132
Q

signs, symptoms of frostbite

A

pain, redness at first (body is trying to raise temp by pushing blood to area)
injury then becomes pale, numb, tingling
may appear white, mottled with blue and white patches

133
Q

management of frostbite

A

PAA; ABCs are priority
frostbite not as serious as hypothermia

remove wet cold clothing
limit exposure
apply dressing, wrap extremity in dry blankets
dont rub!
lightly cover affected part with sterile gauze dressings
dont break blisters
handle limb gently, immoboloize with splint
rewarm as quickly as possible

134
Q

PAA for hypothermia

A

should extract to safe environment
ABCs, stuff as usual
assess breathing for 30 seconds, as their metabolix demands are lower
hypothermia and rough handling can lead to cardiac arrest, but patient is less vulnerable to this in this state
RTC

135
Q

adrenalin and noradrenalin cause

A

increased heart rate, more forceful contraction
constriction of arterioles in non vital organs (skin, liver, kidneys, guts), redistributes blood to vital organs
profuse sweating; increases fluid loss, makes shock worse. key sign of shock

First Aid Level 2 (3 decks)

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