what mechanism of a blast injury is most easily overlooked?
primary blast injuries
What must you remember when caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact?
that the airbag can still deploy causing harm to the patient or yourself
what factors should be considered when assessing a patient who has fallen?
height of fall, type of surface struck, part of the body that hit first followed by a path of energy displacement
force acting over a distance defines the concept of _____.
what are the two MOST common mechanisms of injury for blunt trauma?
motor vehicle collisons and falls
a 40 year old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert but is experiencing significant chest pain and shortness of breath. what injuries should you hold a high index of suspicion?
the force in which the internal bodies organs hit the internal structures
What are air bags designed to do?
decrease the severity of deceleration injuries
a 30 year old male sustained a stab wound to the neck when he was attacked outside a nightclub. during your assessment, what should you be MOST alert for?
airway compromise in the form of air getting into the wound or airway damage
why should the EMT evaluate the interior of a crashed motor vehicle during extrication?
can give insight to severity of injuries
according to the association of air medical services (AAMS), when should you consider air medical transport of a trauma patient?
extended extrication, distace of 20-25 miles from destination, for ALS when no ground ALS is available
what intervention is the MOST critical to the outcome of a patient with multisystem trauma?
When a motor vehicle strikes a tree while traveling at 40mph, what happens to an unrestrained occupant?
the body will continue to stay in motion at 40mph until stopped by an outside force
why are internal injuries caused by gunshot wounds difficult to predict?
because the breath of the projectile isn't always easy to predict. And the pressure wave of bullit
if one or more occupants in the same vehicle are killed in a crash, what should the EMT consider?
all occupants could have life threatening injuries
What is the energy of a moving object called?
when assessing the interior of a crashed moto vehicle for damage, what are you gathering?
signs of contact points that could have caused injury
when the speed of a motor vehicle doubles, the amount of kinetic injury ____.
your patient has has a glascow coma scale score of 12, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his revised trauma score (RTS) is:
What organs can tolerate inadequate perfusion for up to 2 hours?
skeletal muscle cells
once apllied, why shouldn't a tourniquet be removed except at the hospital?
high pressure bleeding will rapidly return
when does hypovolemic shock occur?
when there is low blood volume resulting in inadequate perfusion
what is bleeding from the mose following trauma a sign of?
what is the approximate blood volume of a 85-kg adult?
approx 6 liter (5.95)
(70 ml per kg of body weight)
how can most cases of external bleeding from an extremity be occured?
applying direct local pressure to the bleeding site
in older patients, what may be the first indicator of nontraumatic internal bleeding?
dizziness, syncope, or weakness
if direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, what should you do?
what is the ability of a person's cardiovascular system to compensate for blood loss directly related to?
how rapidly they bleed
You arrive at the home of a 50 year old female with severe epistaxis. what do you need to be concerned with?
if she fell be concerned with a skull fracture causing bleeding. Hypovolemic shock
what are some early signs and symptoms of intra-abdominal bleeding?
pain and distension. Bruising
significant vital sign changes will occur if the typical adult acutely loses more than ____ of their total blood volume.
a 22 year old male was kicked in the abdomen multiple times during an attack by a gang. he is conscious but restless and his pulse is rapid. your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. What urgency should be placed on transport?
rapid transport due to internal bleeding possiblity (liver)
as red blood cells begin to clump together to form a clot, ____ reinforces the clumped red blood cells.
what is another name for hypoperfusion?
after applying a pressure dressing to a laceration on a patients arm, you notice that blood is slowly begining to saturate it. What should you do to manage this situation?
add more dressing and pressure. pressure point
when is an organ or tissue better able to resis damage from hypoperfusion
when freezing cold
what disorder may cause a patient to bleed spontaneously?
in contrast to animal bites, why should the bite of a human concern you?
because it contains a wide range of viruses and virulant bacteria
the sebaceous glands produce sebum, what is the purpose of this material?
waterproofs the skin and keeps it supple
what is a closed soft tissue injury characterized by swelling and ecchymosis called?
what are the functions of the skin?
*protect*keep pathogens out and water in *regulate temperature *reports to the brain on the environment
why are burns to pediatric patients generaly considered more serious than burns to adults?
have more surface area relative to total body mass which means greater fluid and heat loss making them more likely to go into shock, have airway problems, or suffer from hypothermia.
what are the functions of dressings and bandages?
protect the wound from futher damage
prevent contamination and dehydration
a 56 year old male has an incomplete avulsion to his right forearm. What should your treatment be after controlling any bleeding from the wound?
place avulsed shin flap back in place and wrap
you and your partner arrive at the scene of a house fire where fire fighters have rescued a 50 year old make from his burning house. the patient has superficial and partial thickness burns to his face and chest. his nasal hairs are singed and he is coudhing up sooty sputum. what should you be MOST concerned with?
what are some common signs and symptoms of airway burns?
singed nasal hairsoot around the nose and mouth hoarseness hypoxia
how would you best describe a laceration?
a jagged, open wound
during what phase of the healing process does the immune system release histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling?
the germinal layer of the epidermis contains pigment granules that are responsible for skin ____.
as you approach a young male who was involved in an industrial accident, you note that his eyes are closed and he is not moving. you can see several large contisions to his arms, a laceration to his forhead with minimal bleeding, and a closed deformity to his right leg. what should your next action be?
Try to elicit a response.AVPU
How would you best define an abdominal laceration?
an open wound in the abdominal cavity that exposes an internal organ
Durinf your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a ______.
a 17 year-old male was shot in the right anterior chest during an altercation with a gang member. as your partner is applying 100% O2, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. What is the MOST appropriate treatment?
cover with occlusive dressing with a one way valve
in addition to severe bleeding, what is the MOST life-threatening complication associated with an open necj injury?
what layer of the skin forms a watertight, protective seal for the body?
where is the mastoid process located?
about 1" posterior to the external opening of the ear is a prominent bony mass at the base of the skull
how is the term "hyphema" best defined?
bleeding into the anterior chamber of the eye
what is the only complete circular cartilage of the trachea?
you are transporting an immobilized patient with severe facial trauma. as you are preparing to give your radio report to the hospital, the patients begins vomiting large amounts of blood. What is the MOST important thing to do next?
turn patient on side; rapid transport
a 22 year old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. What is the most appropriate treatment?
brush sand out of eye. flush eye w/saline and check for sand under eyelid
how is bleeding from soft-tissue injuries to the face MOST effectively controlled?
apply direct manual with a dry sterile dressing
where can the superficial temporary artery be palpated?
a patient who is complaining of seeing flashing lights, specks, or "floaters" in his of her field of vision has MOST likely experienced ____.
what should an EMT do prior to caring for a patient with an open facial injury?
assess ABC's and care for life threats
What is the function of the sternocleidomastoid muscle?
it allows the head to move (muscles of the neck)
a 29 year old male has anterior mosebleed after he was accidently elbowed in the nose. his is conscious and alert with adequate breathing. What is the MOST appropriate care for this patient?
pinch the nostrils together, have them sit in a sniffing position
what is the lower jawbone called?
a 6 year old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway managment, what intervention will MOST likelt improve her chance of survival?
a 44 year old male sustained a laceration to his left ear during a minor car accident. your assessment reveals minimal bleeding. What is the MOST appropriate care for this injury?
place padded dressing behind ear, apply pressure, apply a roller dressing
a 50 year old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. How should you handle this situation?
remove contact lens and flush eyes
when would you MOST likely observe abnormal variations in pupil size reactions?
head injurybrain injury aniscorcia
anterior nosebleeds ususally originate from the ____ and bleed ____.
what is the opening in the center of the iris, which allows light to move to the back of the eye called?
when should a cervical collar be used?
anytime a neck or spinal injury is suspected
what is the ideal procedure for moving an injured patient from the ground to a backboard?
four person log roll
when confronted with a threatening situation, how does the sympathetic nervous system react?
releasing adrenaline (fight or flight)
what are some common signs of a skull fracture?
bleeding from the ears and noseracoon eyes deformities of the head battle signs
the body's functions that occur without conscious effort are regulated by the ____ nervous system.
the ___ contain(s) about 75% of the brain's total volume.
what is an indicator of an expanding intracranial hematoma or rapidly progressing brain swelling?
how is moderate elevation in the intracranial pressure with middle brain stem involvement characterized?
widened pulse pressure with bradycardia; non reactive pupils, deep rapid respirations, decerabrate posture
When should a tight fitting motorcycle helmet be removed
can't immobilize spineobstructs an airway
when immobilizing a trauma patients spine, when is it ok for the EMT who is manually stablizing the head to let go?
once the patient has been completely secured to the backboard
when immobilizing a child on a long board, what should you consider?
require additional padding; maintain in-line neutral position
a patient with a head injury presents with abdominal flexion of his extremeties. What numeric value should you assign to him for motor response?
a female patient with an suspected spinal injury is breathing with a marked reduction in tidal volume. What is the most appropriate airway managment for her?
postive pressure ventilations with an bvm
what causes compression injuries or bruising to the anterior portion of the brain, and stretching or tearing to the posterior portion of the brain?
coup countre coup
what is the most important treatment for patients with a head injury, regardless of severity?
immobilization; avoiding any head movement
what part of the nervous system controls the body's voluntary activities?
what is a patient experiencing when they cannot remember the events that preceded his or her head injury?
what is the function of the motor nerves?
carries information from the CNS to muscles
What are the five sections of the spinal column, in descending order?
the ___ is the best protected part of the CNS and controls the functions of the cardiac and respiratory systems
what is the MOST appropriate treatment for a patient who presents with profound cyanosis following a chest injury?
immediate ventilation and oxygenation (100%)
the phrenic nerves control the diaphragm. Where do they exit the spinal cord?
C3, C4, C5
you are transporting a stble patient with a possible pneumothorax. The patient is recieving 100% oxygen and has an oxygen saturation of 95%. during your reassessment, you find that the patient is now confused, hypotesive, and profusely diaphoretic. What is MOST likely causing this patients deterioration?
the ___ nerves control the disphragm?
what would a spinal cord injury at the level of C7 MOST likely result in?
intercostal muscle paralysis
a 37 year old male was pinned between a flatbed truck and a loading dock. on exam, you find bruising to the chest, distended neck weins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. how should you best manage this patient?
treat abc's aggressivelyals treat for shock rapid transport
what is immediate death from blunt chest trauma following a mvc MOST often the result of?
large vessels torn inside the chest
a 28 yr old male was struck in the chest with a baseball bat during an altercation. he is conscious and alert and complains of severe chest pain. your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. in addition to applying 100% o2, what intervention will MOST improve this patients chance of survival?
treat for shockals rapid transport
during a hemothorax, where is pleural fluid contained?
in pleural cavity
how is hemoptysis best defined?
coughing up blood
what is flai chest?
3 or more ribs broken in 2 or more places
at the end of exhalation, how high may the diaphragm rise when a person is lying supine?
how is pneumothorax best defined?
air in the pleural space
you arrive at the scene of a major mvc. the patient a 50 year old female, was removed from her vehicle prior to you arrival. bystanders who removed her state that she was not wearing a seatbelt. the patient is unconcious, tachycardic, and diaphoretic. your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. Whar should you be MOST suspicious of?
during your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. what should you be doing while your partner is administering oxygen to the patient?
use gloved hand to stabilize a flailed segment
when may a spontaneous pneumothorax likely occur?
strenous physical activity, coughinh forceably
what organs or structures reside within the mediasternum?
heart, great vessels, esophagus, trachea, major bronchi
following a wound to the left anterior chest, a 25 yr old male presents witha decreased loc and signs of shock. what signs and symptoms increase your index of suspicion for a cardiac tamponade?
j.v.d. on both sidesnarrowing b.p. muffled heart sounds ams
what is the term for membranous fold that attaches the intestines to the walls of the body?
a 22yr old male was punched in the abdomen several times. you find him lying on his left side with his knees drawn up. he is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. his bp os 142/82, his pulse is 110 and strong and his respirations are 22 and regular. in what position shoul this patient be transported?
suspine on a backboard
you are transporting a patient with blunt trauma. the patient is unstable and experiencing obvious sins and symptoms of shock. your estimated time of arrival at the hospital is less than 10 minutes. what should you do while en route wih this patient?
high flow o2shock position thermoregulation alert hospital
when worn properly, where should the seatbelt lie?
over the iliac crest of the pelvis
why is it important to provide prompt transport to the hospital with a trauma patient who has an open abdominal wound?
unseen injuriesinternal damage to organs shock
what organ is MOST at risk for injury as a result of a pelvic fracture?
what organs would most likely bleed profusely when injured?
what generally causes compression injuries to the abdomen that occur during a mvc?
a poorly placed lap belt
peritonitis, is an intense inflammatory reaction of the abdominal cavity. when does this typically occur?
when hollow organs are ruptured and teir contents are spilled into the abdominal cavity causing infection
you are transporting a 42yr old male who experienced blunt abdominal trauma. he is recieving oxygen at 12l/min via a nonrebreathing mask, and a full spinal precautions have been applied. during you reassessment, you note that his loc has decreased and his respirations have become shallow. what should your next course of treatment be?
positive pressure ventilationstreat for shock
during your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising aound the umbilicus. what is this a sign of?
internal abdominal bleeding
after a hollow organ is punctured during a penetrating injury to the abdomen, how long may it take for peritonits to develop
few hours to days
relieve a patients severe thirst
wet cloth in mouth
hollow organs of the abdomen
stomach, intestines, ureters, bladder
what does bone marrow produce?
a "hip" fracture is usually a facture of the _____.
proximal femur (upper)
what is it called when there is a disruption of a joint in which the bone ends are no longer in contact?
a person who experiences a calcaneus fracture after jumping and landing on their feet would most likely experience an accompanying fracture of the _____.
what muscles are under direct voluntary control of the brain?
skeletal muscle is also refered to as:
when splinting a fractured foot why is it important for the emt to leave the toes exposed?
to asses neurovascular funtion
skeletal muscle is attached to the bone by tough, ropelike fibrous structures called ____.
during your rapid secondary assessment of a 19yr old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femor. her skin is diaphoretic and her pulse is rapid and weak, your partner has appropriately managed her airway and is maintaining manual stabilization of her head. what is the most appropriate treatment for this patient at this point?
c collarimmobilization traction splint
when is it appropriate to move a patient prior to splinting musculoskeletal injuries?
the patients life or yours is in immediate danger
most shoulder dislocations occur
what fracture has the greatest potential for internal blood loss and shock?
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