Chapter 26 Emergency Care 13th Edition

Your patient has sustained a burn injury that is about the size of five of his palms. This burn would cover approximately __________ of the patient's total body surface area.

5%

You are treating a 45 year old female patient who has partial-thickness burns totally covering her legs, chest, and abdomen. Using the rule of nines, approximate the size of the burn area.

54%

The age of the patient is an important factor in burns. Patients under ________ and over ________ year of age have the most severe body response to burns.

5; 55

contusion

a bruise

universal dressing

a bulky dressing

full-thickness burn

a burn in which all the layers of the skin are damaged; also called a third-degree burn; usually an area of the skin that is charred black or an area that is dry and white

partial-thickness burn

a burn in which the epidermis is burned through and the dermis is damaged; also called a second degree burn. Burns of this type cause reddening, blistering and a mottled appearance

superficial burn

a burn that involves only the epidermis, the outer layer of skin; also called a first-degree burn. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn.

laceration

a cut

pressure dressing

a dressing applied tightly to control bleeding

rule of nines

a method for estimating the extent of a burn. For an adult, each of the following areas represents 9% of the body surface, the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region

rule of palm

a method for estimating the extent of a burn. The palm of the patient's hand, which equals about 1% of the body's surface area, is compared with the patient's burn to estimate the size of the burn

abrasion

a scratch or scrape

hematoma

a swelling caused by the collection of blood under the skin or in damaged tissue as a result of an injured or broken blood vessel

An 8 year old female patient crashed her bike and slid along the road on the rainy pavement. The oozing of blood from her capillary beds is from an injury called a(n):

abrasion

Your patient has a suspected air bubble that may have been sucked into a large vein in her neck. This is called a(n):

air embolus

crush injury

an injury caused when force is transmitted from the body's exterior to its internal structures. Bones can be broken; muscles, nerves, and tissue can be damaged; and internal organs can rupture, causing internal bleeding

open wound

an injury in which the skin is interrupted; exposing the tissue beneath

closed wound

an internal injury in which there is no open pathway from the outside

puncture wound

an open wound that tears through skin and destroys underlying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit wound

occlusive dressing

any dressing that forms an airtight seal

dressing

any material used to cover a wound in an effort to control bleeding and prevent contamination

bandage

any material used to hold a dressing in place

You are treating a 30 year old male patient who was involved in a knife fight. The tip of his nose was cut or torn off by the knife. This is a(n):

avulsion

Which of the following is not a function of the skin?

blood insulation

You are dispatched to the scene of an explosion. On arrival, you find a 35 year old female who bystanders say was in an area of the explosion. In terms of injuries, you expect to find a(n):

mixture of open and closed injuries

A partial-thickness burn that involves between 10% and 20% of the body surface area of a child under 5 years of age is considered a ________ burn.

moderate

A partial-thickness burn that involves between 15% and 30% of the body surface area is classified as a ________ burn.

moderate

Your 32 year old male patient was taking money out of ATM when someone slashed his throat from behind and stole his money. To treat a neck laceration like this, you should use a(n):

occlusive dressing

Critical burns include all of the following except

partial thickness burns on the wrist

Which of the following types of burns will result in deep, intense pain; blisters; and mottled skin?

partial-thickness

You are treating a 35 year old male whose lower leg has been amputated by a train. The most effective treatment for an amputation is to:

place a sung pressure dressing over the stump

You are treating a 37 year old female patient who inadvertently suck her hand in the chute of an operating snow blower. She was severely injured, and all of her fingers are severed. The amputated parts torn from her body should be wrapped and placed in a:

plastic bag on top of a sealed bag of ice

Your patient is a 22 year old male who sustained an electrical burn when improperly installing an outlet. Electrical burns are of special concern because they:

pose a great risk of severe internal injuries

Blast injuries often include all of the following except:

potentially infectious disease

Which of the following is not correct about an injury caused by an impaled object?

pressure should be applied to the object to stabilize it

When a sharp or pointed object, such as an ice pick or a bullet, passes through the skin or other tissue, a(n) ______ wound has occurred.

puncture

You are on the scene of a local bar where there was just a shooting. The police are there, and the scene is considered "safe at this point." Various types of guns, when fired at close range, can cause all of the following except:

significant cold injuries

You are treating a 38 year old female who has a large shard of glass impaled in her right leg. Emergency care in the field for this patient includes:

stabilizing the object in place

Shock absorption and insulation are major functions of the _____ layer of the skin.

subcutaneous

A burn that involves only the epidermis is called a(n) ________ burn.

superficial

Your 33 year old male patient fell off a fence and sustained an injury that tore open his left leg. There is no break in the bone, but a large avulsed flap of tissue has been torn loose but not off. You should do all of the following except:

tear off the remainder of the flap and put it on ice

The soft tissues of the body include all of the following except

teeth, bones, and cartilage

dermis

the inner layer of the skin found beneath the epidermis; rich in blood vessels and nerves

subcutaneous layers

the layers of fat and soft tissues found below the dermis

epidermis

the outer layer of the skin

amputation

the surgical removal or traumatic severing of a body part, usually an extremity

avulsion

the tearing away or tearing off of a flap of skin or other soft tissue; may also refer to an eye pulled from the socket or a tooth dislodged from the gums

List three types of burns 1 2 3

1-thermal 2-chemical 3-electrical 4-light 5-radiation

List five signs and symptoms of an electrical injury: 1 2 3 4 5

1-burns where energy enters and exits 2-disrupted nerve pathways displaying as paralysis 3-respiratory difficulties or respiratory arrest 4-irregular heartbeat or cardiac arrest 5-muscle tenderness with or without muscle twitching 6-restlessness or irritability if conscious, or loss of consciousness 7-visual difficulties 8-fractured bones and dislocations from severe muscle contractions or from falling 9-seizures

List the parts of the adult body that account for 9% each, using the rule of nines: 1 2 3 4 5 6 7 8

1-head and neck 2-each upper extremity 3-chest 4-abdomen 5-upper back 6-lower back and buttocks 7-front of each lower extremity 8-back of each lower extremity

You are treating a 35 year old male patient who has partial-thickness burns to his entire left arm, chest, face, and neck. Using the rule of nines, approximate the size of the burn area.

22%

Why should an alkali burn be irrigated for a longer time than an acid burn?

Because the alkali burn generally causes more damage to the cells and takes more water to neutralize.

Which acid is the exception to the rule of being irrigated for a longer time than an acid burn?

Hydrofluoric acid is the exception to the rule; it is very dangerous because it penetrates very deep into the tissue.

You are assessing an 18 year old male who was running with a sharp tool and tripped, impaling the tool in his right cheek. Which of the following is false about the impaled object?

It should never be removed

You are treating a 35 year old male patient who sustained an injury from an impact with a blunt object. There is no bleeding. the wound is called a ______ injury.

closed

If a 22 year old female patient has an impaled object in her right eye, the care that you provide should include use of a:

combination of 4x4s and a paper cup

When applying pressure to the major neck wound, be sure you do not:

compress both carotids at the same time

The treatment of neck vein injury includes all of the following except:

compressing the region of injury

You are evaluating a 52 year old male patient who was the driver of a vehicle that was involved in a head-on collision. He was not wearing his seat belt. When he pitched forward, he smashed his chest into the steering column. This type of injury is called:

compression injury

A patient has experienced a soft-tissue injury from a force that caused a rupture or bleeding of internal organs. This injury is called a ________ injury.

crush

Specialized nerve endings in the _______ are involved in the senses of touch, cold, heat, and pain.

dermis

Examples of agents that can cause burns include all of the following except:

distilled water

When caring for a 22 year old male who was burned

do not neglect assessment to begin burn care

To distinguish between a partial-thickness burn and full-thickness burn, look for ________, which indicate(s) a full-thickness burn.

dry and white areas

If ______ is the burn agent, brush it from the patient's skin and then flush the patient's skin with water.

dry lime

You are treating a 22 year old female patient who was burned. She is having visual difficulties, is restless and irritable, and has an irregular pulse rate and muscle tenderness. This patient probably suffered a(n) _________ burn.

electrical

Your patient has serious thermal burns to her face and forearm. In addition to the physical damage caused by burns, patients often suffer

emotion and psychological problems

The ______ is the layer of the skin that is composed of dead cells, which are rubbed or sloughed off and are replaced continuously.

epidermis

The layers of the skin include all of the following except

epithelial

Your 19 year old male patient has sustained a very serious injury, and it will be necessary to apply an occlusive dressing to the wound. An occlusive dressing is used to:

form an airtight seal

A patient has experienced a closed wound involving tissue damage and a collection of the blood at the injury site. This is called a

hematoma

A 28 year old male sustained a cut on his hand while slicing carrots for a stew. The wound that he sustained is called a(n):

laceration

Burns to the face are of special concern because they

may involve airway injury

A patient was working in a chemistry lab sustained a burn when a beaker of a strong acid spilled all over her. Chemical burns are of special concern because they:

may remain on the skin and continue to burn for hours

The primary care for a patient with a chemical burn is to:

wash away the chemical with flowing water

A 22 year old male patient who has a partial-thickness burn to the entire back should be:

wrapped in a dry-sterile burn sheet