TEST 4 Flashcards

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1
Q

Facial/ Head injuries

A
  • Airway compromise
  • Watch LOC (changes for worse can mean rise in ICP)
  • Nausea/ vomiting
  • ALOC
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2
Q

Neck injuries

A
  • Airway compromise
  • Breathing compromise (C 3, 4, 5 keep the diaphragm alive)
  • Neuro compromise
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3
Q

Chest injuries

A
  • Breathing compromise
  • Bleeding compromise
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4
Q

Abdominal injuries

A
  • Bleeding compromise (spleen or liver)
  • Sepsis
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5
Q

Pelvic injuries

A
  • Bleeding compromise
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6
Q

Extremities

A
  • Femurs bleeding compromise
  • Threat to limb
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7
Q

Back

A
  • Bleeding compromise
  • Breathing compromise
  • Neuro compromise (priapism)
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8
Q

SXSX of Basilar skull fracture

A
  • Bleeding/ fluid coming from the ears or nose
  • Possible ALOC
  • Battle signs
  • Raccoon eyes
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9
Q

SXSX of Epidural bleed

A
  • Possible loss of consciousness initially then awakens with a lucid interval followed by loss of consciousness
  • NO loss of consciousness with a lucid interval followed by loss of consciousness
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10
Q

SXSX of Subdural bleed

A
  • Loss of consciousness or ALOC
  • Result of venous bleeding
  • Most common type of severe close head injury
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11
Q

SXSX of Intracranial pressure

A
  • ALOC
  • Rising blood pressure
  • Irregular respirations (Cheyne stokes)
  • Bradycardia
  • Unequal pupils
  • Posturing (decorticate or decerebrate)
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12
Q

Cushing’s triad

A
  • Hypertension with widening pulse pressures
  • Bradycardia
  • Irregular respirations
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13
Q

Hypovolemic shock

A
  • Fluid issue
  • Blood loss (hemorrhagic)
  • Burn
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14
Q

Obstructive shock

A
  • Pulmonary embolism
  • Tension Pneumothorax
  • Pericardial tamponade
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15
Q

Cardiogenic shock

A
  • Pump issue
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16
Q

Distributive shock

A
  • Vessel issue
  • Anaphylaxis
  • Neurogenic
  • Septic
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17
Q

Compensated shock

A
  • Body is trying to correct the cardiac output drop
  • Tachycardia
  • Tachypnea
  • Restless
  • Pale, cool, diaphoretic
  • GOOD BP
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18
Q

Decompensated shock

A

-Compensatory mechanisms are no longer able to maintain perfusion and BP
- Tachycardia (120-140)
- Tachypnea
- Altered/ agitated
- Pale, cool, diaphoretic
- POOR BP/ hypotensive
(LAST SIGN TO DROP)

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19
Q

How to control Venous bleeding

A
  • Direct pressure
  • Bandage
  • Treat for shock
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20
Q

How to control Arterial or any major hemorrhage

A
  • Direct pressure
  • Tourniquet
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21
Q

PASG- Pneumatic Antishock Garmet

A
  • Only National Registry
    Indications:
    Contradictions:
    -
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22
Q

Tendon

A

Attaches muscle to bone

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23
Q

Ligament

A

Attaches bone to bone

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24
Q

Cartilage

A

Cushion

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25
Q

Types of fractures

A
  • Greenstick
  • Transverse
  • Pathological
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26
Q

Greenstick

A
  • Bone bends and cracks, instead of breaking into separate pieces
  • Common in children
  • “GREEN” like green wood, bends instead of snaps
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27
Q

Transverse

A
  • Breaks straight across the bone
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28
Q

Pathological

A

Osteoporosis
- Degenerative bone disorder associated with loss of minerals from the bone
- Disease process
- Possible that a bone broke, causing the fall instead instead of the other way around

29
Q

Sprain

A
  • Injury to MUSCLE or a muscle/ tendon
  • Overextension or overstretching

SXSX:
- pain on palpation
- no edema or discoloration

30
Q

Strain

A
  • Injury to a joint
  • Damage or tearing to CONNECTIVE tissue

SXSX:
- immediate pain and swelling
- discoloration after several hours

31
Q

Dislocation

A
  • Displacement of a bone from it normal position in a joint
32
Q

Fracture OPEN

A
  • COMPOUND
  • break in the skin
33
Q

Fracture CLOSED

A
  • SIMPLE
  • No break in the skin
34
Q

Impaled objects

A
35
Q

Avulsion

A
  • Loose flap of skin
  • Partial (still attached) or Complete (unattached)
  • If complete, wrap in sterile dressing, put on ice and transport with patient to ER
36
Q

Abrasion

A
  • Scraping, rubbing, or shearing away of the epidermis
37
Q

Contusion

A
  • Bruise
  • aka Ecchymosis
38
Q

Laceration

A
  • Regular or irregular break in the skin of varying depth
39
Q

Hematoma

A
  • Similar to contusion
  • Usually involves larger blood vessel
40
Q

Crepitus

A
41
Q

What are the 6 P’s

A
  • Pain
  • Pallor
  • Pressure
  • Pulses
  • Paranesthesia
  • Paralysis
42
Q

Tension Pneumothorax

A
  • Compressing heart and other lung
  • Shortness of breath
  • Absent lung sounds on affected side
  • ALOC
  • Hypotension
  • Tracheal deviation
  • Difficult to ventilate (poor ventilatory compliance)
43
Q

Pulmonary Contusion

A
  • Shortness of breath
  • Hypotension
  • Altered lung sound
  • Clear or diminished lung sounds
  • Type of injury is caused by blunt force trauma
44
Q

Commotio Cordis

A
  • Condition we hear about on TV when a young athlete goes into cardiac arrest after being struck in the chest (Blunt force trauma)
45
Q

Cardiac Temponade

A
  • Narrowing pulse pressure
  • Hypotension
  • Pulsus Paradoxus
  • Becks triad:
    1. Low BP
    2. Distension of jugular veins
    3. decreased or muffled heart sounds
46
Q

Cardiac Contusion

A
  • Blunt force trauma to the chest
  • Irregular pulse (with no previous history of irregular pulse)
47
Q

Flail Segment

A
  • Closed chest injur
  • 2 or more consecutive ribs broking in 2 or more places
  • Paradoxical movement
48
Q

Penetrating/ Sucking chest wound

A
  • Seal with occlusive dressing
49
Q

Traumatic Asphyxia

A
  • Result of blunt force trauma to the chest
  • See ling of demarcation and petechiae above injury site
50
Q

GCS- Glasgow coma Scale

A
  • Eye opening (1- 4)
  • Verbal response (1-5)
  • Motor response (1-6)
51
Q

GCS rating

A
  • 13-15= MILD
  • 9- 12= MODERATE
  • 3-8 = SEVERE
52
Q

How to treat Evisceration

A
  • Control bleeding
    -Cover with saline soaked sterile dressing and the cover with occlusive dressings
  • DO NOT place eviscerated part back into abdomen
53
Q

General Rules for Splinting

A
  • Check PMS before and after
  • Immobilize joint ABOVE and BELOW injury
  • Remove/ cut away clothing around injury
  • Cover wounds before splinting
  • Try to splint before moving patients
  • No pulse? try to align the limb (EXCEPT FOR: wrist, elbow, knee, hi, or shoulder)
54
Q

Causes for shock

A
  • Inadequate blood volume
  • Inadequate pump function
  • Inadequate vessel tone
55
Q

Inadequate Volume

A
  • Fluid loss leading to decreased perfusion
  • Hemorrhage
  • Excessive vomiting/ diarrhea
  • Burns
56
Q

Inadequate Pump Function

A
  • Inability of pump to provide perfusion
  • Cardiogenic shock
  • Cardiac Tamponade
  • Tension Pneumothorax
57
Q

Inadequate Vessel Tone

A
  • Vasodilation leading to reduced blood pressure
  • Anaphylaxis
  • Septic shock
  • Neurogenic shock
58
Q

Categories of shock

A
  • Hypovolemic
  • Cardiogenic
  • Distributive
  • Obstructive
59
Q

Hemorrhagic shock

A
  • Loss of whole blood
  • includes not only volume, but oxygen carrying capacities as well
60
Q

Non- Hemorrhagic shock

A
  • Loss of plasma and water
  • Oxygen carrying abilities are still available
    -Dehydration/ HX of recent illness
  • Poor skin turgor
61
Q

Burn shock

A
  • Non-hemorrhagic
  • Damaged capillaries leak plasma into interstitial spaces
  • Swelling
  • Onset may take hours
62
Q

Septic shock

A
  • Distributive
  • Massive infection leading to wide spread vasodilation
  • Skins may be flushed/ hot/ dry

Sepsis SXSX:
- Temp > 100.9 or <96.88
- Heart rate >90 beats pm
- Resp rate >20 breaths pm
- Altered mental status
- Blood sugar <120 mg/dl

63
Q

Neurogenic shock

A
  • Spinal injury leading to loss of sympathetic vessel tone
  • Loss of muscle tone below injury site
  • Paralysis
  • Priapism
  • Hypotension
  • Possibly normal skins
  • Heart rate may be with in normal limits
64
Q

Cardiogenic shock

A
  • Pump failure
  • Chest pain
  • Shortness of breath
  • Rales (if CHF)
  • Hypotension
  • Pale/ cool/ diaphoretic
  • Tachycardia
65
Q

Multiple End Organ Failure

A
  • Aka irreversible shock
  • Progressed to where patient outcome is Death
  • Unresponsive
  • Extreme tachycardia or bradycardia
  • Absent peripheral pulses
  • May be extremely hypotensive
  • Cool, cyanotic skins
66
Q

Treatments for shock

A
  • Airway/ High flow O2
  • Control bleeding
  • Maintain body temp/ keep warm
  • Supine position
  • ALS for non-hemorrhagic types of shock
  • Epipen in anaphylaxis
67
Q

TBI/ ICP SXSX

A
  • Blown pupil on one side
  • Weakness or paralysis
  • Severe changes in mental status
  • Non- purposeful mov’t
    • Decorticate
    • Decerebrate
  • Cheyne- stokes
  • Crushing Reflex: high BP, slow pulse, resp pattern
68
Q

Epidural Hematoma

A
  • Hematoma or bleed between dura mater and skull
  • Usually arterial (middle meningeal)
  • TBI s/s PLUS lucid intervals of consciousness
69
Q

Subdural Hematoma

A
  • Intracranial bleed in subdural space (dura and arachnoid)
  • Generally venous (bridging veins)
  • Mortality rate higher than epidural