Trauma

Question 1

What are the criteria for transport to a trauma center step 1

Answer 1

glascow < 13
systolic bp < 90
RR < 10 or > 29

Question 2

What are the criteria for transport to a trauma center step 2

Answer 2

penetrating injury proximal to elbow or knee
Chest wall instability
2 or more proximal long bone fracture
crushed, degloved, mangled, pulseless extremity,
amputation proximal to wrist or ankle
pelvic fracture
open or depressed skull fracture
paralysis

Question 3

What are the criteria for transport to a trauma center step 3

Answer 3

falls 
adults > 20ft
children > 10 ft
high risk auto crash
intrusion
ejection
death in same passenger compartment
vehicle telemetry data consistent with high risk of injury
auto vs pedestrian/bicyclist
motorcycle crash

Question 4

What are the criteria for transport to a trauma center step 4

Answer 4

older adults with 
children
anti coagulants and bleeding disorders
burns with trauma mechanism
pregnancy > 20 wk
EMS provider judgment

Question 5

adult burn area calculation

Answer 5

ful arms or full head = 9
full front chest + abd = 18
full back = 18
full leg = 18

Question 6

infant burn area calculation

Answer 6

18 for chest and abd, full back, head
9 for full arm
13.5 for full leg

Question 7

children burn area calculation

Answer 7

18 for chest + abd, full back
12 head
16.5 for full leg
9 for full arm

Question 8

Major burn severity classification

Answer 8

hands, feet, face, major joints, or genitalia, circumferential
full thickness burns more than 10%
partial thickness on 25% age 10 to 50 or 20% younger than 10 or older than 50
respiratory injury
trauma
high voltage electrical
chemical
burns on pt younger than 5 that would be moderate on young adults

Question 9

Moderate burns classification

Answer 9

full thickness on 2 to 10% of the TBSA
partial thickness burns on 15 to 25% age 10 to 50
10 to 20% younger than 10 or older than 50
superficial on more than 50%
low voltage electrical
no major burn classification

Question 10

Superficial burn classification

Answer 10

involves only the epidermis

Question 11

partial thickness or second degree burn classification

Answer 11

involves some of the dermis but not the entire thickness of the skin. mottled , white to red skin often with blisters

Question 12

full thickness or third degree burns.

Answer 12

all layers of skin and may involve muscle and subcutaneous tissue. dry leathery and often white or charred skin.

Question 13

GCS determination

Answer 13

eyes
normal,speech,pain,none
verbal
orientated,confused,inappropriate,sounds,none
motor
obey,localizedpain,flexion,decorticate,decerebrate, none

Question 14

normal ETCO2

Answer 14

between 35 and 40 mm hg or 30 to 35 in severe cases of herniation. never below 25

Question 15

What is becks triad?

Answer 15

signs of a pericardial tamponade. Muffled heart sounds, hypotension, JVD.

Question 16

S/S pericardial tamponade

Answer 16

Becks triad, electrical alternans, almost the same as pnuemothorax except for breath sounds will be equal and trachea will always be midline.

Question 17

Treatment of abdominal evisceration

Answer 17

Apply a normal saline soaked sterile dressing over the top of the evisceration. cover the injured area to keep it warm.

Question 18

S/S of neurogenic shock

Answer 18

hypotension, spinal injury, no sweating, loss of body temperature control.

Caused by spinal injury. dilates the blood vessels which ruins hemodynamics and cellular perfusion.

Question 19

S/S of retinal detachment

Answer 19

seeing stars, floaters, shady area of vision. Usually caused by blunt facial trauma but can be spontaneous. Usually occurs in patients 50 and older.

Question 20

Treating an eye injury

Answer 20

Cover both eyes to prevent sympathetic eye movement in the injured eye. If the eye is ruptured, possible spinal injury is present so use spinal precautions. elevate the head to decrease intraocular pressure.
Do not exert pressure on the injured eye. Cover both eyes. apply moist dressing if the globe is exposed to prevent drying.

Question 21

Brown Sequard syndrome

Answer 21

Spinal lesion causing weakness or paralysis on one side of the body and loss of sensation on the other side.

Question 22

Decorticate posturing

Answer 22

Flexion of elbows, wrists, and fingers. Legs extended and rotated inwards.

Question 23

Decerebate posturing

Answer 23

extension of the elbows, wrists, and fingers. Back arched, legs extended and rotated inwards.

Question 24

Traumatic asphyxiation S/S

Answer 24

Cyanosis of the head shoulders and torso above the area of compression. Occular hemorrhage. Possible eye protrusion.

Question 25

Traumatic asphyxiation treatment

Answer 25

Spinal immobilization, oxygen, 2 large bore IV’s.

Question 26

S/S epidural hematoma

Answer 26

Loss of consciousness immediately after the injury occurs. regains consciousness and is coherent during a brief period. Lapses back in to unconciousness. Usually occurs due to trauma to the temporal blow.

Question 27

Le Forte Fracture

Answer 27

Facial fracture that seperates the facial part of the skull from the rest.

Question 28

Le Forte Fracture classification

Answer 28

I, above upper teeth
II, above nose
III, eyes.