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EMT Final study Guide > Trauma > Flashcards

Trauma Flashcards

1
Q

What are the 3 concepts of energy ?

A

Potential Energy
Kinetic Energy
Energy of work

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2
Q

What is Kinetic Energy ?

A

Energy of a moving object . The weight of the object and the velocity at which it is traveling

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3
Q

What is the formula for kinetic energy ?

A

KE=1/2 mass x velocity2 (squared)

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4
Q

What is potential energy ?

A

The product of mass (weight), force of gravity, and height. Mostly associated with the energy of falling objects

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5
Q

What is Energy of work ?

A

Force acting over a distance.

Forces that bend, pull, or compress tissues beyond their limits results in the work that causes injury

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6
Q

What are non significant injuries ?

A

Injuries to an isolated body part or fall without loss of consciousness

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7
Q

What are significant MOI’s?

A
  1. Injury to more than one body system (multisystem trauma)
  2. Falls from heights
  3. Motor vehicle and motorcycle crashes
  4. Car versus pedestrian or bicycle
  5. Gunshot wound
  6. Standings
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8
Q

What is blunt trauma ?

A

The result of force to the body that causes injury without penetrating the soft tissues

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9
Q

What is penetrating trauma ?

A

Causes injury by objects that pierce and penetrate the surface of the body

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10
Q

What are 3 types of vehicular crash collisions ?

A
  1. Car against another car, tree, or object
  2. Passenger against the vehicles interior
  3. Passengers internal organs against solid structures of the body
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11
Q

What are the different types of vehicular crashes

A

Frontal crash
Rear end crash - whiplash
Lateral crashes - very common cause of death
Roll over and rotational crashes

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12
Q

What do you assess in Car vs Motorcycle accidents?

A
  1. Deformity of the motorcycle
  2. Side of most damage
  3. Distance of skid in the road
  4. Extent and location of deformity in helmet
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13
Q

What are the different types of Car vs Motorcycle crashes ?

A
  1. Head on crash
  2. Angular crash
  3. Ejection
  4. Controlled crash
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14
Q

What is an angular motorcycle crash ?

A

The motorcycle strikes an object at an angle so that the rider sustains direct crushing injuries to the lower extremity

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15
Q

What is a controlled crash?

A

Technique used to separate the rider from the body of the motorcycle

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16
Q

What is considered a significant fall ?

A

More than 20 feet

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17
Q

What should you take into account when a patient falls from significant heights ?

A
  1. Height of the fall
  2. Type of surface struck
  3. Parts of the body that hit first, followed by the path of energy displacement
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18
Q

What is cavitation ?

A

When a high energy projectile travels through the relatively liquid humans body, it forms a cavity along the track of the bullet

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19
Q

What are the different types of blast injuries and how are they defined ?

A
  1. Primary Blast
    •Due entirely to the blast itself, damage to the body caused by pressure
  2. Secondary Blast
    •Damage to the body results from behind struck by flying debris
  3. Tertiary blast
    • The victim is hurled by the force of the explosion against a stationary object
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20
Q

What ate Quaternary (miscellaneous) blast injuries ?

A
  1. Burns from hot gases or fires started by the blast
  2. Respiratory injury from inhaling toxic gases
  3. Crush injury from the cal lapse if buildings
  4. Suffocation, poisoning, other medical emergencies
  5. Contamination of wounds from Eliot mental, chemical or toxic substances

Most patients who survive an explosion will have some combination of the four types of injury

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21
Q

What organs are most susceptible to pressure changes ?

A
  1. Middle ear
  2. Lung
  3. Gastrointestinal tract

The ear is most sensitive to blast injuries

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22
Q

What is a pulmonary blast ?

A

Pulmonary trauma that results from short range exposure to the detonation of explosives , characterized by a lack of external visible injuries

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23
Q

What are the most concerning pulmonary blast injuries ? And what can they produce ?

A

The most concerning blast injuries is arterial air embolism, which occurs on alveolar disruption with subsequent air embolization into the pulmonary casualties.

Can produce

  1. Disturbance in vision
  2. Change in behavior
  3. Changes in state of consciousness
  4. Variety of other Neurologic signs
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24
Q

What is relatively protected from shock wave injuries ?

A

Solid organs; may be injured by secondary middles or a hurled body

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25
Q

What are the most common causes of death in blast injuries ?

A

Neurologic injuries and head trauma

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26
Q

What is multi-system trauma ?

A

Trauma that involuted more than one body system

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27
Q

What are the golden principles of prehospital trauma care ?

A
  1. Your main priority is to ensure
    • Your Safety
    • Safety of your crew
    • Safety of the patient
    2.Determine the need for addition personnel or equipment
  2. Evaluate the MOI
  3. Identify and manage life threats
  4. Then focus on patient care
  5. Transport immediately to the appropriate facility
  6. One scene time should be limited to 10 minutes
  7. Obtain SAMPLE history and complete a secondary assessment during transport
  8. Consider ALS intercept or air medical transportation
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28
Q

What are the different levels of hospital care ?

A
  1. Level 1 facility
    • provides every aspect of trauma care
  2. Level 2 facility
    • provides initial definitive care
  3. Level 3 facility
    • provides assessment, resuscitation, emergency care, and stabilization
  4. Level 4 facility
    • provides advanced trauma life support
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29
Q

Kinetic energy is a calculation of what ?

A

Mass and velocity. Energy cannot be destroyed, only converted

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30
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31
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32
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33
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34
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35
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36
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37
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38
Q
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39
Q

What does index of suspicion mean ?

A

Your awareness for potentially serious unseen injuries

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40
Q

What is drag ? (Penetrating trauma)

A

Air resistance slowing a projectile

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41
Q

What is the most common cause of shock following a traumatic injury ?

A

Uncontrolled bleeding

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42
Q

What are the 3 parts of the cardiovascular system ?

A
  1. The pump (Heart)
  2. Container (blood vessels)
  3. Fluid (blood and body fluids)
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43
Q

How long can organs last without a constant supply of blood ? (brain & spinal cord lungs, kidneys, skeletal muscles)

A
  1. Brain and spinal - 4 to 6 mins
  2. Lungs 15-20 mins
  3. Skeletal muscles - up to 2 hours

Times are based on normal body temperatures, colder temperatures will lengthen survival times.

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44
Q

How much blood loss can the body tolerate ?

A

Up to 20%

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45
Q

What are the changes in vital signs when significant blood loss occurs ?

A
  1. Increase in heart rate
  2. Increase in respiratory rate
  3. Decrease in blood pressure

Has the same affect on infants and children

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46
Q

How much blood can an adult comfortable donate ?

A

500mL over 15 to 20 mins

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47
Q

What is arterial bleeding ? And what happens ?

A
  1. Pressure causes blood to spurt and makes bleeding difficult to control
  2. Bright red (oxygen rich) and spurts in time with the pulse
  3. Decreases as the amount of blood circulating in the body drops because blood pressure drops
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48
Q

What are the signs of venous bleeding ?

A
  1. Dark red (low in oxygen)
  2. Flows slowly or tepidly depending on size of vein
  3. Does not spurt and is easier to manage
  4. Can be profuse and life threatening
  5. More likely to clot spontaneously than arterial blood
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49
Q

What are the situations in which clotting would fail ?

A
  1. Movement
  2. Disease
  3. Medications
  4. External environment
  5. Body temperature
  6. Severe injury
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50
Q

What is hemophilia ?

A

A condition that lacks blood clotting factors

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51
Q

What are the possible conditions of internal bleeding ?

A
  1. Stomach ulcer
  2. Lacerated liver
  3. Ruptured spleen
  4. Broken bones
  5. Pelvic fracture
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52
Q

What pneumonic us used for MOIs involving internal bleeding ?

A

DCAP-BTLS

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53
Q

What are causes for NOI’s involving internal bleeding ?

A
  1. Bleeding ulcers
  2. Bleeding from colon
  3. Ruptured ectopic pregnancy
  4. Aneurysms
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54
Q

What are the frequent signs for NOI’s involving internal bleeding ?

A
  1. Abdominal tenderness
  2. Guarding
  3. Rigidity
  4. Pain
  5. Distention
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55
Q

What is rigidity ?

A

Stuff or inflexible muscles

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56
Q

What can ulcers or other GU problems cause ?

A
  1. Vomiting of blood (hematemesis)
  2. Bloody urine (hematuria)
  3. Blood diarrhea (dysentery)
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57
Q

What are the signs and symptoms of internal bleeding ?

A
  1. Swelling in area of bleeding
  2. Distention
  3. Dyspnea, tachycardia, hypotension
  4. Hematoma
  5. Bruising
  6. Hematemesis
  7. Melena
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58
Q

What is a hematoma ?

A

Blood that is collected within damaged tissue or in a body cavity
•occurs whenever a large blood vessel is damaged and bleeds rapidly
•usually associated with extensive tissue damage

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59
Q

What are the early and late signs of hypoperfusion involving internal bleeding ?

A

Early signs
• Change in mental status
•Weakness, faintness, or dizziness on standing
•changes in skin color (pale skin)

Late signs 
•tachycardia
•weakness, fainting, or dizziness at rest
•thirst, nausea and vomiting
•Cold, moist, clammy skin
• Cap refill more than 2 seconds 
•Shallow, rapid breathing 
•slightly dilated pupils
• Weak rapid threads pulse
•decreasing blood pressure 
• ALOC
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60
Q

What are hemostatic agents ? What are the forms ?

A

Any chemical compound that slows or stops bleeding by assisting with clot formation

There are 2 forms
•granular powder.. can be inserted in a small wound to create a tight seal

•gauze impregnated with a clay substance- used with direct pressure

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61
Q

What does bleeding from the nose, ears, and mouth indicate ?

A
  1. Skull fracture
  2. Facial injuries
  3. Sinusitis, infections, use and abuse of nose drops , dried or cracked nasal mucosa
  4. High blood pressure
  5. Coagulation disorders
  6. Digital trauma
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62
Q

What is epistaxis ?

A

A nose bleed

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63
Q

What should you do when a patient is bleeding from the nose, ears and mouth ?

A
  1. Don’t attempt to stop blood flow
  2. Loosely cover the bleeding site with a sterile gauze pad
  3. Apply light compression with a dressing
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64
Q

What will you see if bleeding from the nose ears or mouth containing CSF?

A

A target or halo shaped stain on the gauze dressing

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65
Q

What is the treatment for internal bleeding ?

A
  1. Keep patient calm and quiet
  2. Provide high flow oxygen
  3. Maintain body temperature (blanket)
  4. Splint the injured extremity
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66
Q
A
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67
Q

What is a contusion ?

A

Medical turn for a bruise, also called ecchymosis.

  • Causes bleeding beneath the skin but does not break the skin.
  • Occurs from blunt force.
  • epidermis remains intact but cells within the dermis are damaged
  • build up of blood produces blue or black discoloration (ecchymosis)
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68
Q

What is a pelvic binder ?

A

Device used to reduce hemorrhage after a pelvic fracture

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69
Q

What are the different types or burns a patient could have ?

A
  1. Electrical
  2. Chemical
  3. Thermal
  4. Radiation
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70
Q

What are the different bites or wounds a patient could have ?

A
  1. Avulsions
  2. Bite wounds
  3. Lacerations
  4. Puncture wounds
  5. Incisions
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71
Q

What are the mechanisms in which soft tissues of the body can be injured ?

A
  1. Blunt injury
  2. Penetrating injury
  3. Barotrauma
  4. Burns
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72
Q

What are the areas of the body where skin is most thin ? What types of patients typically have thinner skin ?

A
  1. Eyelids
  2. Lips
  3. Ears

Very young and very old people typically have thinner skin

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73
Q

What are then two layers of the skin and what do they do ?

A
  1. Epidermis
    •external later that forms a a water tight covering for the body
  2. Dermis
    •inner layer of skin
    •contains hair follicles, sweat glands, and subcutaneous glands
    •blood vessels in the dermis provide the skin with nutrients and oxygen
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74
Q

What are the body’s openings line with ? And what is it’s function ?

A

Mucous membranes

  1. Provide a protective barrier against bacterial invasion
  2. Secrete a watery substance that lubricates the openings
  3. They are moist, whereas skin is generally dry
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75
Q

What are the functions of skin ?

A
  1. Keeps pathogens out
  2. Keeps fluid in
  3. Helps to regulate body temperature
  4. Has nerves that report to the brain on the environment and many sensations
  5. Nerve pathway connection that allows the body to adapt to the environment through responses in the skin and surrounding tissues
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76
Q

What are the types of soft tissue injuries ? And what do they mean ?

A
  1. Closed injuries
    •damage beneath skin or mucous membrane
    •surface is intact
  2. Open injuries
    •break in surface of skin or mucous membrane
    •exposes deeper tissues to contamination
  3. Burns
    •damage results from thermal heat, frictional heat, toxic chemicals, electricity, or nuclear radiation
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77
Q

What is the Pathophysiology or closed or open injuries ?

A
  1. Cessation if bleeding is the primary concern
  2. Healing stage (inflammation)
  3. Nerve layer of cells must be moved into the region of damage
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78
Q

What is a crushing injury ?

A

When a significant amount of force is applied to the body

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79
Q

What is crush syndrome ?

A

When an area of the body is trapped for longer than 4 hours and tissues are crushed beyond repair, muscles can die and release harmful substances into the surrounding tissues

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80
Q

What is the treatment for crush syndrome ?

A
  1. ALS should administer IV fluid before the crushing object is lifted
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81
Q

What is compartment syndrome ?

A

Develops when edema and swelling result in increased pressure within a closed soft tissue compartment.

  1. Pressure increases within the compartment, which interferes with circulation
  2. Delivery of nutrients and oxygen is impaired and by products of normal metabolism accumulate
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82
Q

What is an abrasion ?

A

Is a wound of the superficial layer of the skin, caused by friction when a body part rubs or scrapes across a tough or hard surface

Examples 
•road rash
•road burn
•strawberry
•rug burn
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83
Q

What is a laceration ?

A

A jagged cut caused by a sharp object or a blunt force that tears the tissue

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84
Q

What is an avulsion ?

A

Spectated various layers of soft tissue (usually between subcutaneous layer and fascia) so that they become either completely detached or hang as a flap

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85
Q

What is the mnemonic RICES stand for and why is it used ?

A

RICES is a used to treat a closed soft tissue injury

Rest
Ice
Compression
Elevate 
Splinting
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86
Q

What are the signs of developing shock ?

A
  1. Anxiety or agitation
  2. Changes in mental status
  3. Increased heart rate
  4. Increased respiratory rate
  5. Disaphresis
  6. Cool clammy skin
  7. Decreased blood pressure
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87
Q

How do you treat wounds of the chest ? Upper abdomen, and upper neck ?

A

With occlusive dressing

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88
Q

What is an eviscerstion ?

A

An open wound in the abdominal cavity that may expose internal organs

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89
Q

How do you treat eviscerstions ?

A
  1. Cover wound with sterile gauze moistened with sterile saline solution
  2. Secure the gauze with an occlusive dressing
  3. Keep the organs moist and warm
  4. Immediate transport
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90
Q

What are the only times an impaled object can be removed ?

A
  1. If it obstructs the airway

2. If the object interferes with CPR

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91
Q

What is rabies ?

A

An cute, potentially fatal viral infection of the CNS. The virus is in the saliva or an animal and is transmitted through biting or licking an open wound.

Treatment is by a series of special vaccine injections

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92
Q

Why are human bites worse than animal bites ?

A
  1. The human mouth contains an exceptionally wide range of bacteria and viruses, more so than small animals
  2. Can cause a serious infection if teeth penetrate through the skin
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93
Q

What is the prehospital treatment for bites?

A
  1. Apply s dry, sterile dressing
  2. Promptly immobilize the area with a splint or bandage
  3. Provide transport to the ED for surgical cleansing of the wound and antibiotic therapy
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94
Q

What are burns ?

A

Burns are soft tissue injuries that are created by the transfer of radiation, thermal, or electrical energy

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95
Q

When does thermal burns occur ?

A

When the skin is exposed to temperatures higher than 111 degrees Fahrenheit

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96
Q

Burns create a high risk for ?

A
  1. Infection
  2. Hypothermia
  3. Hypovolemia
  4. Shock
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97
Q

Why are burns to the airway so significant ?

A

The loose mucosa in the hypopharynx (throat) can swell and completely obstruct the airway

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98
Q

What is a circumferential burn ?

A

A full thickness burn that affects the entire circumference of a digit, extremity, or torso

Circumferential burns to the chest can compromise breathing

Circumferential burns to an extremity can lead to compartment syndrome, resulting in neurovascular compromis and irreversible damage

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99
Q

What are the five factors to help determine the severity of a burn ?

A
  1. What is the depth of the burn?
  2. What is the extent of the burn
  3. Are any critical areas involved ?
    •face, upper airway, hands, feet, genetalia
  4. Does the patient have any or existing medical conditions or other injuries?
  5. Is the patient younger than 5 or older than 55?
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100
Q

What are the different depths of burns? And examples

A
  1. Superficial (first degree) burns
    •top layer or skin; epidermis
    •example - sun burn
  2. Partial thickness (second degree) burns
    •epidermis and some parts of dermis
    •typically do not destroy the entire thickness of skin
    •skin is moist, mottled, and white to red
    •blisters are present
    •intense pain
  3. Full thickness (third degree) burns
    •extends through all layers of skin, may involve subcutaneous tissue layers, muscle, bone, or internal organs
    •burned area is dry and leathery and May appear white, dark brown or charred
    •if the nerve endings are destroyed, the burn may have no feeling
    •the surround area may be extremely painful
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101
Q

What is used to determine the extent of burns ?

A
  1. Rule of palm

2. Rule of 9s

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102
Q

Rule of 9s

A
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103
Q

What should you ask in SAMPLE history regarding burns ?

A
  1. Are you having difficulty breathing, or swallowing ?

2. Are you having any pain ?

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104
Q

What are thermal burns caused by ?

A

Heat

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105
Q

What are the 3 types of ionizing radiation ?

A
  1. Alpha
    •little penetrating energy
    •easily stopped by the skin
  2. Beta
    • can penetrate the skin but can be blocked by simple protective clothing designed for this purpose
  3. Gamma
    •vey penetrating and easily passes through the body and solid materials
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106
Q

How does burns cause Edema ?

A

Because of increased capillary permeability, which creates plasma leakage in and around tissue

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107
Q

How does the eye keep its shape ?

A

It keeps its shape as a result of pressure from the jelly like fluid contained within its two chambers.

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108
Q

What is the jellylike fluid near the front of the eye and back of the eye?

A

Front of the eye is called Aqueous Humor

Back of the eye is Vitreous Humor

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109
Q

What is the conjunctiva ?

A

A membrane that covers the eye

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110
Q

What are the lacrimal glands ?

A

Often called tear glands, produce fluid to keep the eye moist. When a person fluid is swept from the lacrimal glands over the surface of the eye, cleaning it .

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111
Q

What is the sclera ?

A

White fibrous tissue that helps maintain the globular shape

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112
Q

What is the sclera replaced by in the front of the eye ?

A

A clear, transparent membrane called the cornea.

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113
Q

What is the function of the cornea ?

A

Allows light to enter the eye

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114
Q

What is the iris ?

A

Circular muscle behind the cornea. Acts like a camera to adjust the size of the opening to regulate the amount of light that enters the eye.

Also is pigmented and gives the eye its color

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115
Q

What is the pupil?

A

The opening in the center of the iris. Also allows light to move to the back of the eye

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116
Q

What is anisocoria ?

A

Condition in which a person is born with different sized pupils

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117
Q

What is the lens of the eye ?

A

Lies behind the iris. Focuses images on the retina at the back of the globe

118
Q

What is the retina ?

A

Contains never endings which respond to light by transmitting nerve impulses through the optic never behind the brain

119
Q

What causes blindness ?

A

Retinal detachment; when the retina detached from the underlying choroid and sclera

120
Q

What is the choroid ?

A

Nourishes the retina by a layer of blood vessels between it and the back of the globe

121
Q

How can face and neck injuries lead to partial or complete airway obstruction ?

A
  1. Blood clots in the upper airway from heavy facial bleeding
  2. Direct injuries to the nose or mouth can cause patient to suffocate from choking in blood
  3. Injuries may cause teeth or dentures to become dislodged into the throat
122
Q

How do you treat detached avulsed skin?

A
  1. Wrap in a sterile dressing
  2. Place in a plastic bag
  3. Keep cool but I’d not place directly in ice
  4. Label and deliver to emergency department
123
Q

What is the treatment for foreign objects in the eye ?

A

Use a bulb syringe, nasal airway or cannula to direct saline into the affected eye; never attempt to remove an object that is stuck to the cornea

124
Q

What is hyphema ?

A

Bleeding in the anterior chamber of the eye

125
Q

What are you suppose to do if you find missing teeth at an accident ?

A

Place the tooth storage solution , cold milk, or sterile saline

126
Q

What are meninges ?

A

Protects the CNS. And is composed of 3 layers

  • Dura Mater (outside layer)
  • Arachnoid & Pia matter (inner two layers that contain the blood vessels)
127
Q

What is the most common MOI ?

A

Vehicle crashes

128
Q

What is a linear skull fracture ?

A
  1. Non displaced skull fracture
  2. Account got 80% of all skull fractures
  3. Radio graphs are required to diagnose
  4. Usually not life threatening
129
Q

What is a depressed skull fracture ?

A
  1. Results from high energy direct to the head with a blunt object
  2. Patients often present with numerologic signs
130
Q

What is a basilar skull fracture?

A
  1. Associated with high energy trauma, but usually occurs following diffused impact to the head (falls, Moro vehicle crashes)
  2. Usually result from extension of a linear fracture
  3. Signs include CSF drainage from the ears, raccoon eyes, and battle signs
131
Q

What is a traumatic brain injury ?

A

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes. Most serious of all head injuries.

132
Q

What categories are traumatic brain injuries classified into ?

A
  1. Primary brain injure results instantaneously from impact to the head
  2. Secondary brain injury increases the severity of the primary injury and may be caused by
    •cerebral edema
    •intracranial hemorrhage
    •increased ICP
    •cerebral is hex is
    •infection
133
Q

What is a coup-countercoup injury ?

A

When the head slams into an object, causing the brain to move forward until it comes to an abrupt stop by the skull

134
Q

What is ICP and increased ICP?

A

ICP
•accumulation of blood within the skull or swelling of the brain

Increased ICP
•squeeze the brain against the skull

135
Q

What are the signs of increased ICP ?

A
  1. Cheyne-Stokes respiration’s
  2. Ataxic respiration’s
  3. Decreasing BP
  4. Bradycardia
  5. Sluggish; no reactive pupils
  6. Decerebrate posturing
  7. Increased or widened blood pressure

Cushings triad
•bradycardia
•irregular respiration’s cheyne stokes
•hypotension widening pulse pressure

136
Q

What is an epidural hematoma ?

A

Accumulation of blood between the skull and dura mater. Causes ICP

137
Q

I get is a subdural hematoma ?

A

Accumulation of blood beneath the dura mater but outside the brain. Occurs after falls or injuries involving deceleration forces

138
Q

What is a intracerebral hematoma ?

A

Bleeding within the brain tissue itself

139
Q

What is a subarachnoid hemorrhage ?

A

Blessing occurs into the subarachnoid space, where the CSF circulates. Common causes include trauma or a rupture of an aneurysm

140
Q

What is a concussion ?

A

A closed injury with a temporary loss or alteration of part or all of the brains abilities to function without demonstrable physical damage to the brain. Patient may be confused or have amnesia, usually only lasts a short time

141
Q

What is a head contusion ?

A

A bruise to the brain. More serious than a concussion.

142
Q

What is the Glasgow coma scale?

A
  1. Eye opening
  2. Best verbal response
  3. Best motor response
143
Q

What is Cushings triad ?

A
  1. Increased blood pressure (hypertension)
  2. Decreased heart rate (bradycardia)
  3. Irregular respiration’s (Cheyne-stokes respiration’s or Biot respiration’s)
  4. Widening pulse pressure
144
Q

When should you remove a helmet for traumatic injuries ?

A

Never remove helmet unless

  1. It is a full face helmet
  2. Makes assessing it managing airway problems difficult
  3. Prevents you from properly immobilizing the spine
  4. Allows excessive head movement
  5. The patient is in cardiac arrest
145
Q

What are the different types of Pnuemothorax ?

A
  1. Open
  2. Simple
  3. Tension
146
Q

What are the different type of chest injuries ?

A
  1. Pneumothorax
  2. Cardiac tamponade
  3. Rib fractures
  4. Flail chest
  5. Commotio cordis
147
Q

Chest injuries can involve what organs ?

A
  1. Heart
  2. Lungs
  3. Great vessels
148
Q

What is the thoracic cage ?

A

The chest, extending from the lower end of the neck to the diaphragm

149
Q

What is the neurovascular bundle ?

A

Network of nerves, arteries and veins lying closely to the lowest margin of each rib. Can be a source of significant bleeding into the pleural space

150
Q

What is the mediastinum ?

A

The central part of the chest containing the heart, great vessels, esophagus, and trachea.

151
Q

What contracts during inhalation ?

A

The diaphragm and intercostal muscles

152
Q

What happens to the intrathoracic Pressure during inhalation ?

A

The pressure inside the chest decreases, creating a negative pressure differential

153
Q

What happens if a patient that injured their spinal cord below the c5 level ?

A

May lose the power to move the intercostal muscles
•diaphragm should still contract
• will still be able to breathe because phrenic nerve is still in tact

154
Q

What happens if a patient has a spinal injury at the c3 level and above ?

A

Can lose the ability to breathe entirely

155
Q

What is minute volume ?

A

The amount of air moved through the lungs in 1 minute

156
Q

What happens when a patient has decreased tidal volume ?

A

Patient will have an increased respiratory rate

157
Q

What could happen if you over ventilate a patient with a decreased tidal volume ?

A

Can increase thoracic pressure, reducing cardiac output and potentially worsening chest injuries such as pneumothorax

158
Q

What is a pneumothorax?

A

When air enters through a hole in the chest wall or surface of the lung

159
Q

What happened if the lung is collapsed past 30% to 40%?

A

You may hear diminished lung sounds

160
Q

What does absent lung sounds indicate ?

A

Tension Pneumothorax

161
Q

What does a sucking sound on inhalation and the sound of rushing air on exhalation indicate ?

A

That the chest wall has been penetrated (sucking chest wound)

162
Q

What is Hemothorax ?

A

When blood collects in the pleural space from bleeding around the rib cage or from a lung or great vessel

163
Q

What is cardiac tamponade ?

A

When the pericardial sac gets filled with blood or fluid. The heart won’t be able to pump an adequate amount of blood because it’s too compressed by the fluid

164
Q

What is becks triad ?

A

Utilized to determine cardiac tamponade
•JVD
•narrowing pulse pressure
•muffled heart sounds

165
Q

What type of chest injuries can fractures ribs cause ?

A
  1. Pnuemothorax
  2. Hemothorax
  3. Hemopneumothorax

Fractured rib could lacerate the surface of the lung

166
Q

What is flail chest ?

A

When a 3 or more ribs are broken in 2 more places causing a paradoxical motion

167
Q

What is a pulmonary contusion ?

A

When alveoli become filled with blood, leading to hypoxia

168
Q

What is traumatic Asphyxia regarding chest injuries ?

A

Characterized by
•Distended neck veins
•cyanosis in the face and neck
•hemorrhage into the sclera of eye

169
Q

What is asphyxia ?

A

A condition arising when the body is deprived of oxygen; the result of hypoxia

170
Q

What is commotio cordis ?

A

Blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a persons heartbeat

171
Q

How should you treat a patient with commotio cordis ?

A

CPR and apply AD within first 2 minutes of injury .

common in softball and baseball games

172
Q

What are the great vessels ?

A
  1. Superior Vena cava
  2. Inferior vena cava
  3. Pulmonary arteries
  4. Four main pulmonary veins
  5. Aorta and it’s major branches
173
Q

What is crepitus ?

A

Cracking sounds in joints or lungs

174
Q

What is subcutaneous emphysema ?

A

A crackling sensation felt on palpation or the skin

175
Q

What is the abdomen ?

A

Extends from diaphragm to pelvis. Contains the digestive, urinary, and genitourinary systems, solid and hallow injuries

176
Q

What organs are in each quadrant of the abdomen ?

A 
Right upper
•Liver
•Gall bladder
•Duodenum of intestines (small intestine)
•small portion of pancreas

Left Upper
•Stomach
•spleen

Left left quadrant
•The descending colon
•the left half of the transverse colon
•(both part of large intestines)

Lower right
•large and small intestines
•ascending colon and the right half of the transverse colon (large intestines)
•Appendix

177
Q

What are the hallow organs of the abdomen ?

A

Stomach, intestines, uterus, and bladder

178
Q

What happens when a hollow organ is ruptured or eviscerated?

A

The contents spill into the peritoneal cavity

  • Can cause an intense inflammatory reaction and infection
  • Peritonitis
179
Q

What is peritonitis ?

A

Inflammation caused by the rupture of a hollow organ.

Symptoms include
•abdominal pain
•tenderness
•muscular spasms

180
Q

Where does the blood supply for hollow organs come from ?

A

The mesentery which is a fold of tissue that connects the small intestine to the abdominal wall

181
Q

What are the solid organs of the abdomen and what do they do ?

A

Liver, spleen, pancreas, and kidneys

They perform the chemical work of the body

  • enzyme production
  • blood cleansing
  • energy production
182
Q

What is deceleration?

A

Person or the vehicle that he or she is traveling in strikes a large, immovable mass .

183
Q

What is guarding ?

A

Sign of closed abdominal injury. The stiffening of abdominal muscles

184
Q

What is abdominal distention? And what is it a result off ?

A

A sign of closed abdominal injury. Often the result of free fluid, blood, or organ contents spilling into peritoneal cavity.

185
Q

What is a low velocity injury ?

A

Caused by handheld or hand powered objects such as knives and other edged weapons

186
Q

What is a medium velocity injury ?

A

Caused by a smaller caliber handgun and shotguns

187
Q

What is a high velocity injury.

A

Cause by a large weapon, such as high powered rifles can and high power handguns

188
Q

What happens in solid organ injuries ?

A

Caused by blunt or penetrating trauma. Blood slowly oozes into peritoneal cavity

189
Q

What is the largest organ in the abdomen ?

190
Q

Where is pain referred when there is liver damage ?

A

To the right shoulder

191
Q

What should you expect if a patient has Hematuria ?

A

Damage to the kidneys

192
Q

What is the Genitourinary system and where is it located and what are it’s organs?

A

Controls reproductive functions and waste discharge located in the abdomen. The organs included are kidneys (solid organ), ureters, bladder, and urethra (hollow organs), female and male genitalia

193
Q

How are fractures described ?

A

By whether the bone is moved from its normal position

194
Q

What is a non displaced fracture ?

A

A simple crack of the bone

195
Q

What is a displaced fracture ?

A

Produces actual deformity or distortion of the limb by shortening, rotating, or angulating it.

196
Q

What is a comminuted fracture ?

A

A fracture in which the bone is broken into more than two fragments

197
Q

What is an epiphyseal fracture ?

A

A fracture in the growth of a child’s bone

198
Q

What is a green stick fracture ?

A

An incomplete fracture that passes only partway through the shaft of the bone. Occurs in children

199
Q

What is an incomplete fracture ?

A

A fracture that does not run completely through the bone

200
Q

What is an oblique fracture ?

A

A fracture in which the bone is broken at an angle across the bone

201
Q

What is a pathologic fracture ?

A

A fracture of weakened or diseased bone. Seen inpatients with osteoporosis or cancer

202
Q

What is a spiral fracture ?

A

A fracture caused by a. Twisting force causing an oblique fracture around and through the bone

203
Q

What is a transverse fracture ?

A

A fracture that occurs straight across the bone

204
Q

What is a dislocation?

A

A disruption of a joint in which the bone ends are no longer in contact

205
Q

What is a sprain?

A

Occurs when a joint is twisted or stretched beyond its normal range if motion; tearing of ligaments

206
Q

What is a strain?

A

A stretching or tearing of the muscle

207
Q

What are the two situations in which you just splint the limb in position of deformity.

A
  1. When the deformity is sever

2. When you encounter resistance or extreme pain when applying gentle traction to the fracture of a shaft of a long bone

208
Q

What is a farmable splint ?

A

An air splint

209
Q

What is the treatment for statins, sprains , and fractures ?

A

RICES

Rest
ice
Compression 
Elevation 
Splinting
210
Q

What is dysbarism?

A

Any condition resulting from changes in ambient pressure that occurs before the body can compensate.

211
Q

What are the type of environmental emergencies

A
  1. Heat and cold related emergencies
  2. Water emergencies
  3. Pressure related injuries
  4. Injuries caused by lightning
  5. Envenomation
212
Q

What are the conditions that can complicate environmental situations ?

A
  1. Air temperature
  2. Humidity level
  3. Wind
213
Q

What temperatures cause hypothermia ?

A

Between 30 & 50 degrees

214
Q

What temperatures do most heat strokes occur in ?

A

80 degrees and the humidity is 80%

215
Q

What are the 5 ways the body can lost heat ?

A

Conduction
•heat transfer from an person to object or object to person

Convection
•transfer or heat to circulating air; when cool air moves across the body

Evaporation
•conversion of any liquid to a gas (sweating)

Radiation
•transfer of heat by radiant energy
•heat loss when a person stands in a cold room

Respiration
•loss of body heat during normal breathing
•warm air goes into the atmosphere and cooler air is inhaled

216
Q

What ate the 3 ways the rate and amount of heat gain or loss can be modified ?

A
  1. Increase or decrease in heat production
  2. Move to an area where heat loss can be decreased or increased
  3. Wear appropriate clothing for the environment
217
Q

What is hypothermia ?

A

When the core temperature falls below 95 degrees and the body loses the ability to regulate it’s temperature and generate body heat.

218
Q

What is miles hypothermia ?

A

When core temperature is between 90 degrees and 95 degrees

219
Q

What are the signs of mild hypothermia ?

A
  1. Alert and shivering
  2. Pulse rate and respiration’s are rapid
  3. Skin May appear red, pale, cyanotic
220
Q

What is sever hypothermia?

A

When the core temperature is less than 90 degrees

221
Q

What are signs of sever hypothermia?

A
  1. Shivers stop
  2. Muscular activity decreases
    3 patient becomes lethargic and stops fighting the cold
222
Q

What happens if the body temperature drops below 80 degrees ?

A
  1. Pulse becomes slower and weaker
  2. Cardiac dysrythmias may occur
  3. Patient May appear dead .

A cold patient isn’t dead until they are warm and dead

223
Q

What is frost nip ?

A

Prolonged exposure to the cold, skin May freeze while deeper tissues are unaffected

224
Q

What is immersion foot ?

A

Occurs after prolonged exposure to cold water

225
Q

What is frost bite ?

A

The most serious local cold injury because the tissues are actually frozen. Can lead to gangrene (permanent tissue damage or cell death)

226
Q

What is the treatment fit mild hypothermia?

A
  1. Place patient in warm environment and remove wet clothing
  2. Apply heat packs or hot water to the groin, axillary, and cervical regions . Don’t place directly in skin
  3. Give them warm fluids by mouth
227
Q

What is the treatment for patients with moderate or sever hypothermia ?

A
  1. Remove patient from cold environment
  2. Remove wet clothing
  3. Cover with blanket
  4. Do not try to rewarm patient
228
Q

What should the temperature or water be when rewarming a body part that has frost nip ?

A

Between 102 and 104 degrees

229
Q

How does the body try to rid itself of excess heat ?

A
  1. Sweating
  2. Dilation of skin blood vessels
  3. Removal of clothing and relocation to a cooler environment
230
Q

What is a hyperthermia ?

A

Core temperature of 101 degrees or higher

231
Q

What are the 3 heat emergencies ?

A
  1. Heat cramps
  2. Heat exhaustion
  3. Heat stroke

All 3 forms may present the same

232
Q

What is a heat cramp ?

A

Painful muscle spasms in the leg or abdominal muscles that occur after vigorous exercise. Does not only occur when it’s hot

233
Q

What ate the most common causes of heat exhaustion ?

A
  1. Heat exposure
  2. Stress
  3. Fatigue
  4. Hypovolemia as the result of the loss of water and electrolytes
234
Q

What is a heat stroke ?

A

Occurs when the body is subjected to more heat than it can handle and normal mechanisms are overwhelmed. It can lead to death if untreated

235
Q

What are the signs of a heat stroke ?

A
  1. Hot dry flushed skin
  2. Patient may be wet from previous sweating
  3. Seizures
  4. Strong rapid pulse that deteriorates becoming weaker with falling blood pressure
  5. Lack of perspiration
236
Q

What are the skin conditions and what do they indicate ?

A
  1. Moist, pale, cool skin
    •excessive fluid and salt loss
  2. Hot dry skin
    •body is unable to regulate core temperature
  3. Hot moist skin
    •body is unable to regulate for temperature
237
Q

What is the treatment fit heat cramps ?

A
  1. Remove the patient from hit environment and loosen clothing
  2. Admistser oxygen if indicated
  3. Rest the cramping muscles
  4. Replace fluid by mouth
  5. Cool patient with water spray or mist
238
Q

What is the treatment for heat strokes ?

A
  1. Move patient out of hit environment to the ambulance
  2. Set air conditioning on max cooling
  3. Remove clothing
  4. Oxygen if indicated
  5. Ventilate if indicated
  6. Cover patient with wet towels or sheets
239
Q

What is near drowning ?

A

Refers to a patient who survives at least 24 hours after suffocation in water.

240
Q

When should you assume spinal injury for patients involved in submersion incidents ?

A
  1. Submersion resulted from a diving mishap or fall
  2. The patient is unconscious
  3. The patient complains of weakness, paralysis, or numbness
241
Q

What are the rules for trying to save someone in water ?

A

Reach, throw, row and then go

242
Q

What is a ascent emergency ?

A

Caused by the sudden increase in pressure as the person dives deeper into the water

243
Q

What is an air embolism ?

A

An ascent emergency where a diver holds there breathe during a rapid ascent into water. The pressure in the lungs remain at a high level while the external pressure on the chest decreases. The air inside the lungs expands rapidly causing the alveoli in the lungs to rupture

244
Q

What are the complications with air embolisms ?

A
  1. Air May enter the pleural space and compress the lungs (Pnuemothorax)
  2. Air May enter the mediastinum (pnuemomediastinum)
  3. Air May enter the bloodstream and create bubbles of air in the vessels (air emboli)
245
Q

What is decompression sickness ?

A

Also known as the bends, when bubbles of gas especially nitrogen obstruct the blood vessels.

246
Q

What are the conditions that cause decompression sickness ?

A
  1. Too rapid of an scent from a dive
  2. Too ling a dive at too deep a depth
  3. Repeated dives within a short period of time
  4. Driving a car up a mountain or flying in an unpressurized airplane that climbs too rapidly soon after a dive
  5. Nitrogen that is being breathes dissolved in the blood and tissues
247
Q

How do you distinguish an air embolism and decompression sickness ?

A
  1. Air embolism occurs immediately in return to the surface

2. Decompression sickness may take several hours

248
Q

What is the treatment for ascent emergencies ?

A

Decompression in a hyperbaric chamber

249
Q

What is paresthesia?

A

Numbness and tingling

250
Q

What is breath holding syncope ?

A

A person swimming in shallow water may experience loss of consciousness caused by a decreased stimulus for breathing. Treat same as a drowning patient

251
Q

What is altitude illness ?

A

Occurs when an unacclimatized person is exposed to diminished oxygen pressure in the air at high altitudes. The illness affects the CNS and pulmonary system

252
Q

What is acute mountain sickness ?

A
  • above 5000 feet
  • caused by ascending too high, too fast, or not being acclimatized to high altitudes

Signs and symptoms include
Headache, lightheadedness and fatigue

253
Q

What is HAPE?

A

High altitude pulmonary edema when someone goes above 8,000 feet.

254
Q

What is HACE ?

A

High altitude cerebral edema happens when a person goes above 12,000 feet

255
Q

What mostly gets injured in lightning strikes?

A

Respiratory and cardiac

256
Q

What are the categories of lighting injuries ?

A
  1. Mild
    •loss of consciousness, amnesia, confusion, tingling, superficial burns
  2. Moderate
    •seizures, respiratory arrest, dysrhythmias , superficial burns
  3. Sever
    •cardiac arrest
257
Q

What spiders deliver a serious life threatening bite ?

A

Brown recluse spider and black widow

258
Q

What is a sign and symptom of a black widow bite ?

A
  1. Agonizing Muscle spasms
  2. Localized pain
  3. Symptoms usually subsided over 48 hours
259
Q

What kind of venom does a black widow have ?

A

Latrotoxin which overwhelm nerve cells and cause immense pain

260
Q

What kind of venom does a brown recluse spider have ?

A

Cytotoxic which causes sever tissue damage. The bite isn’t painful at first but it becomes painful within hours. The area becomes swollen and tender developing a pale, mottled, cyanotic center

261
Q

What snakes are venomous?

A

Rattle snakes, copperheads, cottonmouth, water moccasins and corral snakes

262
Q

What kind of snakes are pit vipers?

A

Rattlesnakes, copperheads and cottonmouths. They have small outs that contain poison located at each nostril. The pit is a heat sensing organ that allows the snake to strike accurately at any warm target. The fangs are hollow teeth that act much like hypodermic needles connected to a sac containing a reservoir of venom

263
Q

What is the treatment for a pit viper bite ?

A
  1. Supine position

2. Locate the bite area and clean it gently with soap and water

264
Q

What is the saying to identify coral snakes ?

A

Red on yellow will kill a fellow, red in black venom will lack

265
Q

What kind of venom does a coral snake have and what can it do ?

A

Has a powerful neurotoxin that causes paralysis of the nervous system

266
Q

Scorpion stings

A

Very painful but not dangerous

267
Q

What is the exception to scorpion stings ?

A 
The centruroides sculpturatus . Venom can cause 
•circulatory collapse
•sever muscle contractions
•excessive salivation
•hypertension
•convulsions and cardiac failure
268
Q

What are some of the complications with tick bites?

A

Rocky Mountain spotted fever I high occurs within 7 to 10 days after the bite

Lime disease causes a bull eyes rash that may spread to several body parts, painful swelling of joints

269
Q

What is the treatment for a jellyfish sting ?

A
  1. Remove tentacles by scraping them off with the sharpie still edge like a credit card
270
Q

What is the treatment from the spines of stingrays?

A

Immobilize the affected area and soak in hot water for 30 minutes

271
Q

What are the stages of shock ?

A
  1. Compensated shock
    •the body attempts to compensate by maintaining homeostasis
  2. Decompensated shock
    •as shock progresses blood circulation slows and eventually ceases
  3. Irreversibleshock
272
Q

What is pulse pressure ?

A

The difference between systolic and diastolic blood pressure.

273
Q

What is blood flow through capillary beds regulated by ?

A

Capillary sphincters which are under control by the autonomic nervous system.

274
Q

What stimuli does capillary sphincters respond to ?

A
  1. Heat
  2. Cold
  3. Need for oxygen
  4. Need for waste removal
275
Q

What does the body need for adequate perfusion ?

A
  1. Working cardiovascular system
  2. Adequate diffusion
  3. Adequate glucose in the blood
  4. Adequate waste removal primarily through the lungs
276
Q

What are the types of shocks and causes ?

A
  1. Cardiogenic shock
    •obstructive shock
    are Tension Pnuemothorax, cardiac tamponade, and pulmonary embolism which cause pump failure
2. Distributive shock
•septic shock 
•neurogenic shock
•psychogenic shock 
•anaphylactic shock 
Caused by poor vessel function
  1. Hypovolemic shock
    •hemorrhagic shock
    •non-hemorrhagic shock
    Caused by low fluid volume
277
Q

What is Cardiogenic shock caused by ?

A

Most common is pulmonary embolism

278
Q

What causes obstructive shock?

A

Cardiac tamponade , tension pneumothorax, pulmonary embolism

279
Q

What is cardiac tamponade and what is the causes ?

A

Collection of fluid between pericardial sac and the heart which is called pleural effusion. Caused by blunt or penetrating trauma that causes hemorrhage around the heart

280
Q

What triad is used for cardiac tamponade?

A

Becks triad
•JVD
•muffled heart sounds
•narrowing pulse pressure

281
Q

What happens in distributive shock ?

A

•widespread dilation if small arterioles, small venules or both

282
Q

What is septic shock?

A
  • occurs as a result of sever infection in which toxins are generated by bacteria or by infected body tissues
  • toxins damage vessel walls causing increased cellular permeability
  • vessel walls leak and are unable to contract well
283
Q

What is neurogenic shock ?

A

Usually the result of a high spinal cord injury. Muscles in the blood vessel walls are cut if from the nerve impulses that cause them to contract. Which is why patients will look 2 toned

284
Q

What are the 4 categories of exposure for anaphylactic shock?

A

Injection, stings, ingestion, inhalation

285
Q

What is a major sign of Hypovolemic shock ?

A

Dehydration

286
Q

What types of poisoning last may affect the ability of cells to metabolize and carry oxygen ?

A

Carbon monoxide and cyanide

287
Q

How do you treat shock ?

A

With oxygen and keeping patient warm with blanket

288
Q

Should patients in Cardiogenic shock take nitroglycerin ?

A

No because it contraindicates due to hypotension

289
Q

What are signs or Cardiogenic shock ?

A
  1. Low blood pressure
  2. Weak, irregular pulse
  3. Cyanosis around lips/underneath fingernails
290
Q

What is the treatment for cardiac tamponade ?

A
  • increasing cardiac output is the priority

* apply high flow oxygen

291
Q

Treatment for tension pneumothorax

A

Administer high flow oxygen via non rebreather mask and call ALS

292
Q

How to treat septic shock ?

A
  • high flow of oxygen

* blanket

EMT Final study Guide (2 decks)

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