Traumatic Injuries

Question 1

What are the essentials for major trauma?

Answer 1

-Rapidly obtained definitive, haemorrhage control
-Maximize tissue oxygenation
-Prevent or limit the development of hypothermia
-Minimize the use of crystalloid fluid or replacement
-Initiate rapid convenience to a lead trauma hospital

Question 2

what should your assessment and stabilization patient assessment model follow?

Answer 2

CABCDE approach
Catasphrophic bleeding
Airway
Breathing
Circulation
Disability
Exposure

Question 3

When our tourniquets indicated?

Answer 3

When bleeding cannot be controlled through direct pressure or wound packing

Question 4

When is wound packing indicated?

Answer 4

And there are penetrating wounds that cannot be controlled using direct pressure alone
It is also useful in junctional areas of the body like the groi where tourniquets cannot be well utilized

Question 5

when is the pelvic binder indicated?

Answer 5

When there is a pelvic injury that is suspected or when there is high mechanism of injury in an unconscious patient

Question 6

can you use a pelvic binder on a hip fracture or falls from standing?

Answer 6

No, they are both contraindicated

Question 7

when is a cervical collar indicated to be applied?

Answer 7

Multi trauma
Meeting Nexus criteria
High risk patience

Question 8

In terms of cervical collars, what do they mean multi trauma?

Answer 8

More than one simultaneous injury, such as multiple bone, fractures or major lacerations, and damage to internal organs

Question 9

What the Nexus criteria?

Answer 9

Is there midline tenderness?
Is there an altered LOC?
Are there new focal logical deficit?
Are they intoxicated?
Is there a major distracting injury?

No to all five of these questions there is no warrant to apply a cervical collar

Question 10

What are high risk patients in regards to a cervical collar?

Answer 10

Age greater than 65
Osteoporosis
Pre-existing spinal conditions

Question 11

what medication is used for suspected internal bleeding?

Answer 11

TXA

Question 12

what is the dosage for TXA?

Answer 12

2 g IV rapid push

Question 13

What do you do with a failed airway?

Answer 13

Transport to the nearest emergency department

Question 14

what do you do in a blunt traumatic arrest?

Answer 14

Trauma bundle
Call EPOS for early discontinuation

Question 15

what is considered the trauma bundle in traumatic cardiac arrest?

Answer 15

Securing an airway, preferably an ET tube
Decompressing both sides of the lungs in blunt traumatic arrest
IV or IO access
Pelvic binder applied
Patient in anatomical position
1 mg of epi

Question 16

In penetrating traumatic arrest are you to transport early or remain on seen?

Answer 16

Transport to the trauma hospital
Nearest emergency department of time from loss of pulse respiration to a rival at hospital is less than 15 minutes

Question 17

what are the physiological parameters indicating major trauma and pt. should be transported to the lead trauma hospital?

Answer 17

GCS less than 13
Systolic blood pressure less than 90
Respiratory rate less than 10 or greater than 30

Question 18

Do you stop CPR in traumatic cardiac arrest?

Answer 18

Yes, to treat all reversible causes which are included in the trauma bundle. CPR is to start again after all of these have been rectified.

Question 19

What are the three main acute concerns in crush injuries?

Answer 19

Electrolyte imbalances
Hypovolaemia
Metabolic acidosis

Question 20

What are the four delayed onset effects of crush injuries

Answer 20

Renal failure
ARDS
Coagulopathy
Severe sepsis

Question 21

What medication can be used to help facilitate potassium shifting intracellularly as a beta agonist?

Answer 21

Salbutamol, and is a consideration during crush injuries

Question 21

How much fluid should be administered prior to the release of a crush injury?

Answer 21

2 L

Question 22

if intravenous catheterization is unsuccessful in a crush injury, patient what other methods do ACPs have to gain access?

Answer 22

IO
External jugular cannulation

Question 23

what can ACP do to correct electrolyte disturbances in a crush injury?

Answer 23

Administer calcium chloride, there is no clinicall phone call required
Administer sodium bicarbonate, clinicall phone call is required

Question 24

what should your arterial pressure be in a TBI?

Answer 24

80 mmHg

Question 25

what two universal lethal conditions exacerbate a TBI?

Answer 25

Hypoxia
Hypotension

Question 26

should you hyperventilate or hypoventilate a patient with a TBI?

Answer 26

Neither, normal ventilation should be maintained

Question 27

What is the indications for needle thoracentesis?

Answer 27

For the decompression of tension pneumothorax with deteriorating vital signs which include decrease cardiac output, profound shock, or cardiac arrest

Question 28

is aggressive, fluid resuscitation warranted in abdominal trauma?

Answer 28

No, it is associated with higher mortality rates

Question 29

what are you to do with eviscerated injuries?

Answer 29

Cover them with a moist sterile dressing with an inclusive layer above

Question 30

what should you suspect when there’s blunt trauma to the abdomen other than blood filling the spaces?

Answer 30

A pelvic injury

Question 31

where is pain referred to when there is a spleen injury?

Answer 31

The upper left posterior shoulder

Question 32

where is pain referred to when there is a hepatic injury?

Answer 32

The upper right posterior shoulder

Question 33

when should pelvic binding be applied during your assessment?

Answer 33

In the primary assessment, it is a haemorrhage control intervention

Question 34

if a limb is pulse less and severely agulated, should it be repositioned?

Answer 34

Yes, it should be for the restoration of pulses

Question 35

What are the procedures in reducing a fracture?

Answer 35

Analgesia
Irrigation of open wounds with 500 mls to 1 L
Applying traction and reigning the limb
Any further manipulation of the lamb it should be done while under traction
Splint the limb following reduction

Question 36

when is procedural sedation indicated?

Answer 36

At any point where analgesia sedation and amnesia are required to allow paramedics to accomplish patient care tasks.

Examples of these are:
Extrication
Fracture management
Cardioversion
Airway management

Question 37

is clinicall required prior to procedural sedation?

Answer 37

Yes, in paediatrics <12 years of age
No in adults

Question 38

how long should paramedics cool burns for?

Answer 38

15 to 20 minutes

Question 39

what side of burn dressings should be applied to the patient?

Answer 39

The “shiny” side

Question 40

should paramedics have a low threshold for advanced airway placement in burned patient?

Answer 40

Yes, as edema increases the airway may close and you would have a failed airway. ACP should have a low threshold for airway intervention if there is burns soot, change your voice, coughing, or other respiratory signs that are caused for concern.

Question 41

If someone is struck by lightning, and is in cardiac arrest, what is the first thing that paramedics should try and do?

Answer 41

Defibrillate and CPR

Question 42

What type of injuries do high voltage electrical contact may occur in some patients?

Answer 42

Rhabdomyolysis
Hyperkalaemia