Trauma 1

signs and symptoms of a simple pneumothorax

Absent or decreased breath sounds in the apex of the lung, Asymmetrical chest, Subcutaneous emphysema

What is one of the most serious findings in a patient with an eye injury (difficult to assess and needs rapid treatment)

Blood in the anterior chamber of the eye

Geriatric patients when it comes to shock

Do not tolerate well and will most likely suffer more complications from even with proper care.

Which of the following responses should receive a Glasgow Coma Scale score of 8?

Eyes only open to pain; speaks incomprehensible sounds; withdraws from painful stimuli

signs and symptoms of a hemothorax (collection of blood in pleural space)

Narrow pulse pressure, hypotension, Absent or decreased breath sounds in the base of the lungs

GCS of 15

Normal

Which assessment findings should cause you to suspect a gunshot victim is in irreversible shock?

Oozing wounds, thready pulse, irregular respirations

A 26 year old male has an anterior dislocation of his left hip. How should you manage this injury?

Splint his legs together and immobilize him

Which of the following is the most important factor that affects the amount of injury a patient suffers as a result of a car crash?

The speed the vehicles were moving (speed kills)

Flail segment or flail chest

a fracture of two or more ribs in two or more places

When a patient has a tension pneumothorax, the major complication is

a lack of perfusion pressure to the tissues (causes hypoperfusion)

A 68 year old male was the restrained driver of a car that was struck on the driver's side door with 20 inches of intrusion. You observe irregular chest wall movement on the left side (indicates flail chest). You should suspect fractures of

adjacent ribs in more than one place

when should you use sterile saline?

any time you are transporting an amputated or avulsed part because it has the same salt content as the body

what does blood not carry

bacteria

Osteomyelitis

bone infection

A 19 year old male was shot in his right upper arm. You see active bleeding and bone fragments in the wound. His vital signs are P 108, R 16, and BP 86/68. (vital signs represent severe blood loss so venous is not an option) You should suspect a laceration of the

brachial artery

dry powder chemicals should be

brushed away

A 42 year old male was the unrestrained driver involved in a single-car crash in a rural area at 3:00 AM. When you arrive at 3:45 he is unresponsive and slumped over the steering wheel. You observe a large bruise over his chest. After initial stabilization, you determine his vital signs are P 86 and irregular, R 18, and BP 116/82. You should suspect (not a cardiac tamponade because there is no puncture wound to chest wall)

cardiac contusion

a detached retina

causes spotting in a patients vision

A 78 year old male was struck by a car while crossing the street. When you arrive, he is lying in the roadway, has a scalp laceration, and angulation of the right radius and femur. His pelvis is unstable. As you begin to package him, he becomes unresponsive and apneic. You should first

check for pulse (then if no pulse, begin CPR)

Atelectasis

collapsed lung

Internal bleeding and muscle damage around the site of a fibula fracture can lead to

compartment syndrome which occurs when there is bleeding within a muscle sheath without an avenue for that bleeding to exit the sheath

A narrow pulse pressure and tachycardia in an upset patient indicate

compensated shock

GCS of 3

critical

cause of hypovolemic shock

dehydration and diabetes (specifically hyperglycemia)

A 26 year old female who is two months postpartum is found at home hanged with a rope around her neck. What type of injury should you suspect?

distraction (body is distracted from the head)

The most reliable sign of hemorrhage from kidney trauma is

ecchymosis (contusions) in the flanks of the abdomen

what does cardiac tamponade do

expands the pericardial sac and thus reduces the space available for ventricular contractions

Which of the following would suffer the loss of heat most rapidly? A patient who

fell into icy water.

an absorbed chemical should be

flushed with copious amounts of water

The origin of Clostridium tetani (the bacteria that causes tetanus)

found in fecal matter of animals (not human mouths)

On examination of the abdomen immediately following blunt trauma, the abdomen will be soft even if there is bleeding because

fresh blood is not an abdominal wall irritant

hollow organ

gas filled organ

osteosclerosis

hardening of the bones

A 21 year old male fell from his motorcycle. He responds to your questions by moaning. He has multiple rib fractures and a stable chest wall. His vital signs are P 108, R 18, BP 96/74 (hypotension is causing bleeding in the chest), and SpO2 is 92% on room air. You should suspect

hemopneumothorax

Which impaled object should never be removed?

in the abdomen, joint or eye

what's the best way to see if someone is hypothermic

insert your hand below her clothing and feel her abdomen

anterior hip dislocation

internal rotation and shorten the leg

An unresponsive 42 year old male was struck by a car while crossing the street. He has a scalp laceration and an angulated lower left leg. His breath sounds are clear. His vital signs are P 124, R 16, and BP 92/68. You should suspect (vital signs show he is in hypovolemic shock)

intra-abdominal bleeding

liver

large and a solid organ that's prone to bleeding

Hypovolemic shock signs (decompensated)

lethargic, pale, cold, sweaty, breathing greater than 30/min, pulse greater than 120/min, and bp is less than 100 mm Hg

A patient who has cardiac tamponade will have hypoperfusion of the brain due to a/an

loss of cardiac afterload which means there is no blood flow after ventricular contractions

Which of the following is most likely to be injured by the primary blast of an explosion?

lungs (hollow organs are more commonly injured by these)

left upper leg is shortened, angulated, and deformed. He is in severe pain. You should suspect

mid-shaft femur fracture

What is measuring the circumference of someone's legs going to help with?

might tell you something about swelling in the leg

Decreased breath sounds

more common with pneumothorax and uncommon in hemothorax

open chest wound

must be covered as soon as it is discovered (this may be first over airway at times)

The amount of external pressure that must be applied (depth matters) to a wound to stop arterial bleeding is

one mmHg greater than the systolic pressure of the artery causing the hemorrhage

A 21 year old male soccer player is unable to ambulate following an injury to his right lower leg. He has a 2 cm laceration on his tibial crest. His leg is not angulated. You should suspect a/an

open fracture because bone most likely protruded through the skin and then went back in under the skin

patient; feeling faint when moving from a sitting or lying position to standing upright (in trauma setting)

orthostatic hypotension

A bone condition that mostly affects females who are post-menopausal is

osteoporosis (loss of estrogen which affects bone density leads to this)

Hypovolemic shock signs (compensated)

pale, breathing less than 30/min, pulse is less than 120/min, and bp is greater than 100 mm Hg

When a patient has been shot in the abdomen, the organ that is least likely to be injured is the

pancreas (small and thin gland, found behind the stomach)

when do you assess for JVD?

patient sitting at a 45-degree angle

cause of cardiogenic and obstructive shock

pericarditis

A 12 year old male fell from his bike striking his clavicle against a curb. On examination, you find a fracture of the clavicle and the first and second ribs. You should suspect an underlying

pneumothorax and major vessel injury

A 19 year old male was shot in the abdomen with a small caliber weapon. When you arrive he is conscious and upset about being shot. He complains of no other injuries. His vital signs are P 104, R 14, BP 108/82. You should first

prepare for transport (this patient needs definitive care for internal breathing which is surgery)

A stab wound which perforates the stomach (contains acid) will cause

rapid, chemical peritonitis (inflammation of the lining of the abdomen)

A 22 year old male received blunt trauma to his abdomen. During your assessment, you hear bowel sounds in his right chest. You should suspect

ruptured diaphragm

Which of the following is a commonly associated complication of a severe head injury?

seizure

Why should you strike the heel of a suspected leg fracture?

sends a slight shock wave up the bone structure and if there is a bone fracture in the leg the patient will have an increase in pain

glenohumeral artery is located in the

shoulder

spleen

small but can bleed severely when injured

A 56 year old male is in respiratory arrest following a head-on car crash while not wearing a seat belt. He has significant facial and torso trauma. You palpate an irregularity to his cervical spine at C-4. You should suspect his arrest is due to

spinal cord compression above the C-4 level

cause of distributive shock

spinal cord injury

hemiplegia is more common in

spinal injuries

A 12 year old male fell from his bicycle and complains of upper leg pain. Before you begin your assessment, he screams, "Don't touch my leg!" In order to assess if he has a fracture, you should

strike his heel with the palm of your hand

epiphyseal plate

the place where bones grow longer in children up to the age of 24

A 22 year old female was the restrained driver in a single car crash where her car glanced alongside a utility pole. She is crying but does not complain of pain. She tells you she is 14 weeks pregnant. You should (this patient is stable)

transport her routinely without lights and siren

A 26 year old was struck by lightning while playing golf. When you arrive, he has amnesia and an irregular pulse. You observe his skin is pale, cool, and diaphoretic. As you prepare to transport him you should

utilize spinal motion restriction precautions (spinal fractures are possible in lightning strikes)

when is it best to assess chest sounds?

when a patient is sitting up

ruptured vessels in sclera causes

whites of the eye to be bloodshot

When is cardiac tamponade (fluid or blood accumulates around the heart) most likely present?

with chest wall punctures or stab wounds over the heart

femoral neck fracture (hip fracture)

would shorten the injured leg and cause rotation of the foot

During a fight a 19 year old male had a lower tooth knocked out. Your partner finds the tooth while you control bleeding. You should

wrap the tooth in saline-soaked gauze