Chapter 28

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Which instruction is appropriate when helping a new EMT care for a male patient with a laceration to his left arm?

"Don't worry about removing embedded dirt from the wound, just the dirt around the laceration."

Which statement made by the EMT shows an understanding of dressing and bandaging a wound?

"I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation is possible."

A 29 year old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. EMRs have placed him on a nonrebreather face mask and are holding manual in line stabilization. Based on these assessment findings, which one of the following instructions should you provide to the EMRs?

"Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

While riding a bike, a young boy fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhage has clotted off and manual in line spinal stabilization is being maintained. Which one of the following instructions should you provide to the other EMT's on scene?

"Place an occlusive dressing over the wound and tape on all four sides."

Which one of the following statements shows an understanding of shock caused by internal bleeding;

"You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding.

Which statement demonstrates an understanding of shock caused by internal bleeding?

"You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding."

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

Which patient requires the EMT to remove an impaled object in the field?

A young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is flowing into her throat

Which one of the types of injuries is MOST likely to result in capillary bleeding​ only?

Abrasion

A patient was assaulted and sustained various and multiple injuries. Which injury does the EMT recognize as presenting the greatest risk for​ infection?

Abrasion to the right side of the face

A​ middle-aged male's arm became caught in a grinding machine and was then immediately removed by coworkers. As you approach the​ patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and​ anxious, and he has a patent airway. His breathing is​ adequate, and his left radial pulse is fast and weak. You note his skin to be cool and diaphoretic. Of the actions​ listed, which would be done first for this​ patient?

Administer oxygen through a nonrebreather mask.

You have been dispatched for a patient whose arm was caught in a grinding machine. Assessment reveals a deformed arm covered with a bloody towel. The patient is alert and anxious, and has a patent airway. His breathing is adequate. Radial pulse is fast but strong. Which one of the following should you do next?

Administer oxygen through a nonrebreather mask.

A middle-aged male's arm became caught in a grinding machine, and the arm was eventually extricated from the machine by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Given this information, which care would be provided first for this patient?

Administer supplemental oxygen

A patient presents with an arrow impaled in the right lower quadrant of his abdomen. He is in excruciating pain and states that he was accidentally shot by a friend while hunting. While there is no external bleeding coming from the​ injury, the surrounding skin is ecchymotic. Other assessment findings indicate early shock. Your partner manually provides stabilization to the arrow. Which action should the EMT perform​ first?

Administer supplemental oxygen.

A male patient has been shot in the chest with a​ small-caliber gun. What presentation indicates that he is in an early stage of​ shock?

Alert and​ anxious, pulse​ 96, BP​ 134/88 mmHg, pale and cool skin

You are called for an alert and oriented female who had a cesarean section several days ago. Today she bent over and tore the surgical incision open. There is a moderate amount of bleeding coming from the site. What should the EMT do to control the​ bleeding?

Apply a large dressing over the incision.

A construction worker has a metal rod impaled in his right forearm. Assessment of the injury indicates heavy bleeding from around the impaled object. What should you do​ first?

Apply direct pressure around the rod.

You have arrived on a scene where a young girl has pushed her arms through a plate glass window. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your paramedic partner yells for you to immediately apply direct pressure to the laceration to prevent further blood​ loss, while he works to control the airway. You have yet to apply latex​ gloves, but are wearing goggles and a gown. What would you do​ next?

Apply gloves prior to applying direct pressure over the injury site.

You have just applied a pressure dressing to the leg of a woman who suffered a deep laceration to her calf from a piece of broken glass. What should you do​ next?

Assess for a pedal pulse.

A young female was involved in an altercation and was stabbed in the abdomen with an ice pick. After being​ stabbed, she quickly removed the ice pick. She states that there was not much bleeding but does say that it​ "stings" quite a bit. Assessment reveals a small puncture wound to the right upper quadrant with some dried blood around the site. What BEST describes the primary focus of the EMT in caring for this​ patient?

Assessing for internal blood loss or shock

Assessment findings of a driver who was ejected from his vehicle in a rollover type collision include unresponsiveness and bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute. The skin is cool and clammy and the radial pulses are weak. Manual in line spinal stabilization is being maintained. Which one of the following is the EMT's initial intervention?

Assist respirations.

Which one of the following statements about dressings and bandage is true?

Bandages should not be applied until bleeding is controlled.

Which statement about dressings and bandages is​ TRUE?

Bandages should not be applied until bleeding is controlled.

Your patient sustained blunt trauma to the chest in a MVA, and you suspect shock. While conducting the reassessment, which one of the following findings best indicates that the patient is deteriorating?

Blood pressure 86/50 mmHg.

A​ 24-year-old female was an unrestrained driver of a car that struck a​ guardrail, causing her to sustain blunt trauma to the chest and abdomen. Vitals obtained by Emergency Medical Responders​ (EMRs) are pulse​ 120, respirations​ 22, blood pressure​ 100/58 mmHg, and SpO2​ 96%. As you transport her to the​ hospital, what finding indicates that the patient is acutely​ deteriorating?

Blood pressure​ 86/50 mmHg

A patient has fallen and suffers a contusion to her arm. Which one of the following statements about contusions is true?

Blood vessels in the dermal layer have ruptured.

What statement regarding contusions is​ true?

Blood vessels in the dermal layer have ruptured.

While en route to a domestic violence incident with possible injuries, the police contact you and report that a male patient has arterial bleeding from a stab wound to the arm. Given this information, which bleeding characteristics do you expect?

Bright red blood that is spurting with each beat of the heart

While you are en route to a domestic dispute with possible​ injuries, the police contact you and report a male patient with arterial bleeding from a stab wound to the arm. Given this​ information, what would you expect to see on​ arrival?

Bright red blood that is spurting with each beat of the heart

An alert and oriented patient has had a portion of his hand amputated by a table saw. Assessment reveals the patient to be in great pain with a moderate amount of dark red blood still coming from the injury site. His airway is​ open, and his breathing is​ fast, but adequate. The radial pulse is rapid and​ strong, and his skin is warm and dry. The​ patient's hand has been placed in a bag of ice by coworkers. What should the EMT do​ immediately?

Control the bleeding with direct pressure.

Assessment of an​ 88-year-old female who fell reveals bruising to her right buttock. The skin is intact and the patient complains of tenderness to the area when you palpate. As a knowledgeable​ EMT, you would recognize what type of​ injury?

Contusion

A patient was building a bomb in his garage when it accidentally detonated. Assessment findings from the rapid secondary assessment reveal intestine and a portion of the liver protruding from the right side of the abdomen. Proper care of this injury would include which of the​ following?

Covering the exposed organs with a large sterile dressing soaked with sterile water

Which sign or symptom of shock will be observed last?

Decreased blood pressure

Which signs and symptoms of shock will be observed​ last?

Decreased blood pressure

You suspect that a patient involved in a MVA is in shock. As a knowledgeable EMT, you know that which one of the following signs and symptoms of shock will be observed last?

Decreased blood pressure.

What BEST describes a topical hemostatic​ agent?

Dressing specially designed to stop bleeding

When assessing a patient, you note a bruise to his chest. On the prehospital care report, the discoloration due to this injury is properly documented as:.

Ecchymosis

In providing prehospital care to a patient with a​ soft-tissue injury, which statement is​ TRUE?

Hands must be washed even if gloves were worn during care.

When providing prehospital care to a female patient with a soft-tissue injury, which statement is true?

Hands should be washed even if gloves were worn during care

Your patient is confused and anxious after falling 20 feet from a ladder onto the grass below. What sign is most suggestive of​ shock?

Heart rate of 112

A patient is confused and anxious after falling 20 feet from a ladder onto the grass below. Which clinical finding described is most suggestive of shock?

Heart rate of 112 beats per minute

You are called for an​ 8-year-old boy who has fallen. On scene the​ boy's mother states that he was running while flying a kite and​ tripped, striking his face on a rock. Assessment reveals a large​ reddish-blue lump with intact skin under his left eye. When alerting the hospital emergency department of your​ arrival, you should inform them that the patient has what type of​ injury?

Hematoma

You are called for an 8 year old boy who has fallen. On scene the boy's mother states that he was running while flying a kite and tripped, striking his face on a rock. Assessment reveals a large reddish-blue lump with intact skin under his left eye. When alerting the hospital emergency department of your arrival, you should inform them that the patient has what type of injury?

Hematoma.

A pregnant​ 31-year-old has been shot in the neck.​ Currently, she is responsive to verbal​ stimuli, with an open airway and​ rapid, but adequate respirations. Her radial pulse is weak and fast. Vital signs are as​ follows: pulse​ 152, respirations​ 22, blood pressure​ 92/76, and SpO2 at​ 100% on​ high-concentration oxygen. When caring for this​ patient, what other intervention will most benefit this​ patient?

Immobilization and immediate transport

You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On scene the patient was alert and oriented with a patent airway and adequate respirations. There was minimal hemorrhage from the stab wound, which was covered with a sterile dressing. Oxygen was applied and transport was initiated. During the reassessment, which one of the following assessment findings should the EMT consider of most concern?

Increase in heart rate and unexplained restlessness

You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On​ scene, the patient was alert and oriented with a patent airway and adequate respirations. There was minimal hemorrhage from the stab​ wound, which was covered with a sterile dressing. Oxygen was​ applied, and transport was initiated. During the​ reassessment, which of the findings is of MOST​ concern?

Increase in heart rate and unexplained restlessness

A patient sustained a crush injury after being pinned by a car that fell off jack-stands while the patient was underneath the car working on it. The injury occurred to the left upper quadrant of the abdomen. Assessment shows bruising to that area, with instability noted to the lowest rib. The EMT's highest concern regarding this injury should be:

Injury to the spleen

A​ 62-year-old male was the restrained driver of a car that was hit on the​ driver's side. Emergency Medical Responders have extricated and fully immobilized him with a cervical collar and long board. When​ asked, he complains of dizziness as well as leg and arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with minor bleeding to the left side of his face. His airway is open and his breathing is labored. A rapid radial pulse is felt. Skin is cool and dry. What assessment finding would the EMT address​ first?

Labored breathing

A 62 year old male was the restrained driver of a car that was hit on the driver's side. EMR's have extricated and fully immobilized him with a cervical collar and long board. When asked, he complains of dizziness as well as leg and arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with mild bleeding to the left side of his face. His airway is open and his breather is labored. A rapid radial pulse is felt. Skin is cool and dry. Which assessment finding should the EMT address first?

Labored breathing.

A​ 49-year-old male was climbing on a truck at a construction site when he fell backward to the ground. He presents with a​ 2-inch linear wound to the top of his head. Bleeding has been controlled and the skull can be seen through the wound. How should you document this injury on the prehospital care​ report?

Laceration

A 49 year old male was climbing on a truck at a construction site when he fell backward to the ground. He presents with a two inch linear wound to the top of his head. Bleeding has been controlled and the skull can be seen through the wound. How should you document this injury on the prehospital care report?

Laceration.

Prior to your arrival on the scene of a motorcycle​ crash, an Emergency Medical Responder contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable​ EMT, you should anticipate which one of the​ following?

Loose flap of skin torn on her left arm

Prior to your arrival on the scene of a motorcycle crash, an EMR contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable EMT, you should anticipate which one of the following?

Loose flap of skin torn on her left arm.

Which patient would the EMT recognize as suffering from an evisceration​ injury?

Male patient with a loop of intestine protruding from an open surgical wound

A​ 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which one of the following dressings is best for this​ injury?

Occlusive dressing

A 54 year old male patient was involved in a car crash. Window glass has caused an open wound to his upper neck. Which one of the following dressings is best for this injury?

Occlusive dressing.

You believe that a patient who has been shot in the lower abdomen is bleeding internally and is in an early stage of shock. Which treatment shows appropriate prehospital care of this​ patient?

Oxygen therapy and rapid transport to the hospital

A 48-year-old male is in shock from injuries sustained in a motor vehicle collision. Which assessment finding(s) is (are) most suggestive that the patient may have internal bleeding?

Pelvic instability with a BP of 78/48 mmHg

Your patient is a​ 48-year-old male who is in shock from injuries sustained in a motor vehicle collision. Which assessment finding is an indication for the use of the pneumatic​ anti-shock garment​ (PASG)?

Pelvic instability with a BP of​ 78/48 mmHg

A​ 40-year-old homeless male was found lying in the street. On physical​ examination, you notice that the patient has a stab wound to the​ mid-chest. He is​ unresponsive, and his skin is cool to the touch. His respirations are snoring at 40 per​ minute, and his pulse is 120. What care would you provide​ first?

Perform a​ jaw-thrust maneuver.

While cleaning a gun, a 44 year old man accidentally shot himself in the abdomen. On arrival the patient is responsive to painful stiumuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following shows the correct sequence of events for caring for this patient?

Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.

While cleaning a​ gun, a​ 44-year-old man accidentally shot himself in the abdomen. On​ arrival, the patient is responsive to painful stimuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. What is the correct sequence of events in caring for this​ patient?

Perform the primary​ assessment, administer supplemental​ oxygen, perform the secondary​ assessment, transfer to the​ stretcher, and provide rapid transport.

A female patient has been involved in a motorcycle crash. Your scene​ size-up reveals her to be unresponsive and lying in the roadway. It also appears that her left leg has been amputated at the knee. What should you do​ immediately?

Perform the​ jaw-thrust maneuver.

The EMT is by the side of a young female who was cut while washing dishes. she has a jagged laceration to her left forearm that is bleeding steadily and heavily. when attempting to control the bleeding, the EMT should first:

Place a large sterile dressing over the site with hand pressure applied over top of the dressing.

A young male was riding a motorcycle when he lost control and was ejected. the patient is unresponsive and receiving positive pressure ventilation. The rapid secondary assessment reveals bright blood flowing from both nostrils. Management of this bleeding would include which one of the following interventions?

Place a loose dressing under the nose.

small metal rod was shot from a metal lathe and is impaled in a man's inner thigh. Assessment indicates that there is no active bleeding from the site, but the surrounding tissues are ecchymotic. The paramedic asks you to stabilize the rod with bulky dressings. You recognize this action as important because it will:

Prevent motion of the rod and further internal injury.

Severe external bleeding should be controlled during what phase of the patient​ assessment?

Primary assessment

A man has been bitten in his arm by his dog. He states that the bite occurred several hours earlier when he accidentally stepped on the​ dog's paw. When​ asked, he tells you that the dog is​ up-to-date on all of her​ shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment​ findings, which one of the following indicates the primary reason the patient should be seen in the emergency​ department?

Risk for infection

When performing the primary​ assessment, which of the following signs or symptoms best suggests that the patient is in​ shock?

Skin that is cool and diaphoretic

Which of the following describes the layers of the​ skin?

Subcutaneous, epidermis, dermis

A​ 66-year-old female patient has been struck by a car. Your assessment reveals gurgling​ respirations, rapid​ breathing, and​ cool, diaphoretic skin. You also observe bruising to the chest and abdomen. What should you do​ immediately?

Suction the airway.

You are called for a​ 78-year-old female who fell earlier in the day. As you enter her​ kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be blood on her pants. She is on oxygen and is breathing in a moderately labored manner. She states that she fell a few hours ago and now the pain and swelling in her arm are unbearable. Which one of the following would you do​ first?

Take manual​ in-line spinal stabilization.

In the human​ body, what occurs when a person is in​ shock?

The cells are not getting enough​ oxygen, and waste products are accumulating.

Another crew has called for your assistance in extricating an obese male with a nosebleed from a third floor bedroom. As you enter the room, which one of the following shows proper management of the patient's condition?

The patient is sitting upright, leaning forward, with nostrils pinched shut.

Another crew has called for your assistance in extricating an obese male with a nosebleed from a​ third-floor bedroom. As you enter the​ room, which observation indicates proper management of the​ patient's condition?

The patient is sitting​ upright, leaning​ forward, with nostrils pinched shut and an ice pack on the nose.

Which one of the following assessment findings best shows that the patient's injury should be classified as an abrasion?

The skin is scraped and red; blood oozing from the injury site.

Which observations direct the EMT to classify a​ patient's soft tissue injury as an​ abrasion?

The skin is scraped and​ red; blood oozing from the injury site

A patient has suffered a small, but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:

Use sterile gauze and wipe away from the site of injury.

In managing a patient with a​ soft-tissue injury, it is essential that the EMT perform which​ action?

Use the appropriate personal protective equipment.

A patient has cut his arm with a table saw. Assessment reveals dark blood flowing steadily from the wound. As an EMT, you should recognize this as what type of bleeding?

Venous.

A patient has had part of his right thumb amputated in an industrial accident. Co-workers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when he:

Wraps in in a dry sterile dressing.

Which one of the following patients requires the EMT to remove an impaled object in the​ field?

Young female with a broken pencil through her cheek and into the​ oropharynx; blood from the injury is flowing into her throat

Epistaxis​ is:

a nosebleed.

Your patient is a young man who fell down a flight of stairs and is now restless and confused. His airway is​ open, and he is breathing adequately at 18 times per minute. He has a radial pulse of 92 beats per minute and his skin is cool and diaphoretic. Your next action would be​ to:

administer supplemental oxygen.

Direct pressure has failed to control an arterial bleed on a​ patient's leg. The​ EMT's next action would​ be:

apply a tourniquet.

You arrive at a meat packing plant to find a​ 30-year-old male cut in the wrist with a sharp knife. The patient appears pale and blood is spurting from the laceration. Your immediate action would be​ to:

apply direct pressure to the laceration.

You are summoned to a patient who was attacked. As you approach a young male lying on the​ sidewalk, you observe an area of dark blood stains on his left pant leg. He appears​ lethargic, pale, and​ diaphoretic, and you can hear sonorous breathing. Your first action in caring for this patient would be​ to:

assess the airway.

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

axial loading

When assessing a​ patient, you note a bruise to his chest. On the prehospital care​ report, this injury is properly documented​ as:

ecchymosis.

The​ EMT's initial concern when treating a patient with a gunshot wound to the chest​ is:

ensuring an open airway.

A patient has suffered an open crush injury to his elbow. As you​ approach, you note the patient sitting upright holding a towel to his elbow. Although the towel is soaked with​ blood, the elbow does not appear to be actively bleeding. Your first action in caring for this patient should be​ to:

evaluate the​ patient's airway.

A patient sustained a crush injury after being struck with a baseball bat in the left upper quadrant of the abdomen. Assessment shows bruising to that area with instability noted to the rib cage. The​ EMT's highest concern regarding this injury should​ be:

injury to the spleen.

The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the bleeding, the EMT would first

place a large sterile dressing over the site with hand pressure applied over the top of the dressing.

The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the​ bleeding, the EMT would​ first:

place a large sterile dressing over the site with hand pressure applied over the top of the dressing.

A young male was riding a motorcycle when he lost control and was ejected. The patient is unresponsive and receiving positive pressure ventilation. The secondary assessment reveals bright blood flowing from both nostrils. Management of this bleeding would​ include:

placing a loose dressing under the nose.

A small metal rod was dislodged from a metal lathe and is now impaled in a​ man's inner thigh. Assessment indicates that there is no active bleeding from the​ site, but the surrounding tissues are ecchymotic. The paramedic asks you to stabilize the rod with bulky dressings. You recognize this action as important because it​ will:

prevent motion of the rod and further internal injury.

The EMT knows that a function of the skin is​ to:

regulate temperature.

A patient has suffered abrasions to the legs after falling on a moving treadmill. In relation to the function of the​ skin, the EMT should be most concerned​ about:

risk for infection.

Assessment findings of a driver who was ejected from his vehicle in a​ rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic​ areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute. His skin is cool and diaphoretic and the radial pulses are weak. Manual​ in-line spinal stabilization is being maintained. The​ EMT's next action would be​ to:

start positive pressure ventilation.

You are called for a​ 2-year-old boy who fell and cut his arm. While en route to the​ call, the dispatcher informs you that the patient has hemophilia​ (clotting disorder). As an​ EMT, you should recognize​ that:

the bleeding may be significant.

A patient has suffered a small but jagged laceration to her left hand. When cleaning the​ wound, it is important that the​ EMT:

use sterile gauze and wipe away from the site of injury.

A​ 24-year-old male has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the laceration. As an​ EMT, you would identify this bleeding​ as:

venous.

A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when​ he:

wraps it in a dry sterile dressing.

Which statement shows that the EMT understands the use of a tourniquet in controlling​ bleeding?

​"A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely​ stopped."

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she was first​ cut, blood spurted from the​ wound, and then within a second or​ two, it subsided to a mere trickle. She asks why this would happen. Which one of the following is the correct​ response?

​"Blood vessels tend to constrict quickly once they are​ injured."

Which instruction is appropriate when helping a new EMT care for a male patient with a laceration to his left​ arm?

​"Don't worry about removing embedded dirt from the​ wound, just the dirt around the​ laceration."

Which​ statement, made by the EMT shows an understanding of dressing and bandaging a​ wound?

​"I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation can be​ made."

You are having a difficult time controlling bleeding from a small skin avulsion on a​ patient's ankle. Which one of the following statements made by the patient best explains why control has been difficult to​ achieve?

​"I take Coumadin for my irregular​ heartbeat."

Which statement made by the EMT shows an understanding of bandaging an open​ wound?

​"I use bandaging material to secure a dressing in​ place."

Which statement describes the BEST way to determine the severity of a​ patient's blood​ loss?

​"I use the​ patient's signs and symptoms to judge the severity of the blood​ loss."

A​ 28-year-old male was cutting limbs from a tree when he lost his footing and fell 20 feet. He is unresponsive and breathing extremely shallow at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. Emergency Medical Responders​ (EMRs) have placed him on a nonrebreather face mask and are holding manual​ in-line stabilization. A blanket has also been applied and covers the man. Based on these assessment​ findings, what instruction would you give to the​ EMRs?

​"Let's take off the oxygen mask and start positive pressure ventilation to assist his​ breathing."

While riding a​ bike, a young boy fell onto a stick that was protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran​ home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhaging has clotted​ off, and manual​ in-line spinal stabilization is being maintained. Which instruction should you provide to the other EMTs on​ scene?

​"Place an occlusive dressing over the wound and tape it on all four​ sides."

Which statement indicates an understanding of the​ EMT's prehospital role in caring for the patient in​ shock?

​"Since shock is best treated in the​ hospital, the EMT should provide care to maintain perfusion to the vital organs and​ transport."

Which statement demonstrates an understanding of shock caused by internal​ bleeding?

​"You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external​ bleeding."


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