Trauma

Question 1

How do all providers control bleeding from near or complete amputations?

Answer 1

Apply direct pressure and utilize a tourniquet early to decrease severe bleeding.

Question 2

What is the appropriate care for an amputated part if recovered?

Answer 2

1. remove gross contaminations with saline
2. wrap the part in a moist sterile dressing and place the part in a plastic bag or container
3. If possible place the bag or container into another bag or container with ice packs to keep the part cool. DO NOT allow the part to freeze.

Question 3

What are the indications in order to refer a patient to a burn center?

Answer 3

1. 2nd degree burns greater than 10%
2. 3rd degree burns great than 1%
3. electrical injury (greater than 200 volts)
4. suspected inhalation injury
5. Significant burns to face/head, hands, feet, major flexion joints or perineum

Question 4

What is compartment syndrome?

Answer 4

A limb- and life-threatening condition seen when perfusion pressure falls below tissue pressure in an anatomical space.

Question 5

What common injuries can lead to compartment syndrome?

Answer 5

1. Long bone fractures
2. High energy trauma
3. Penetrating injuries/ GSW’s / stab wounds
4. Venous injuries
5. Crush injuries

Question 6

What hospital do all providers contact to activate the “GO Team”

Answer 6

George Washington University Hospital (H-8)

Question 7

For significant eye pain, due to exposure of chemical agents or non-penetrating foreign objects, what shall all providers administer?

Answer 7

2 drops of Tetracaine HCL

Question 8

In regards to traumatic cardiac arrest, what is the age of the patients that should be transported to Childrens National Medical Center

Answer 8

less than 15 years of age

Question 9

What patients SHALL all EMS providers immobilize the entire cervical and thoracic spine with a back board, head rolls and c-collar?

Answer 9

1. Pt’s suffering from blunt trauma with an AOC
2. Pt has spinal pain/tenderness to palpation of spine
3. Pt. has neurological complaints (numbness, eg.)
4. Pt has anatomical deformity of the spine
5. High energy MOI and any of the following:
   drug or alcohol intoxication, inability to communicate, significant distracting injury

Question 10

When should patients with penetrating trauma to the head, neck or torso not be immobilized?

Answer 10

When there is NO EVIDENCE of neurological compromise. (immobilization procedures delay transport and have no proven benefits)

Question 11

What patients can have spinal precautions maintained by application of a rigid cervical collar and by being secured firmly to the EMS stretcher?

Answer 11

1. Pts who are found ambulatory at the scene
2. Pts who must be transported for a protracted period of time prior to inter-facility transport
3. Pts for whom a backboard is not otherwise indicated

Question 12

What criteria must be met for EMS providers to withhold spinal mobilization under the selective spinal immobilization algorithm?

Answer 12

1. Normal LOC (GCS=15)
2. No spinal tenderness to palpation
3. No neurological findings or complaints
4. No significant distracting injuries
5. No intoxication
6. Ability to actively provide Hx and participate in exam
7. No complaint of neck pain on movement

Question 13

What ages may the selective spinal immobilization algorithm be applied to?

Answer 13

2 years of age and older

Question 14

Without using a back board, what is the proper way to secure a patient to the EMS stretcher?

Answer 14

Using the 5-point restraints and head blocks with tape