Trauma: Chapter 28

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Compression injury is most likely due to which of the following?

Improperly placed lab belt

Which of the following is true regarding injury to the kidneys?

Injury to the kidneys usually indicates injury to other organs also.

When should you visually inspect the external genitalia on your patient?

Only when there is a complaint of severe pain or other injury

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

Why is it so important for you to maintain a professional presence w/ a pt who has a genitourinary injury?

The pt is embarrassed & may not trust you

While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find:

a deformed steering wheel

You should suspect a kidney injury anytime the patient presents with _______.

a hematoma in the flank region

The mesentery is:

a membranous fold that attaches the intestines to the walls of the body.

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

a poorly placed lab belt

guarding

a sign or peritonitis

Other than applying a moist, sterile dressing covered w/ a dry dressing to treat an abdominal evisceration, an alternative form of management may include:

applying an occlusive dressing, secured by trauma dressings

Injuries to the external male genitalia _______.

are rarely life-threatening.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ.

Your documentation on a sexual assault victim should _______.

be objective and factual.

When worn properly, a seatbelt should lie:

below the anterior superior iliac spines of the pelvis and against the hip joints.

The term "hematuria" is defined as:

blood in the urine

Why is the assessment of abdominal injuries difficult?

causes of injury may be apparent, but resulting tissue damage may not be

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

control any external bleeding, administer oxygen, and transport at once.

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

guarding

When a patient stiffens the muscles of the abdomen, it is known as _______.

guarding.

A sign of kidney damage following blunt trauma is:

hematuria

Even when seatbelts are worn properly & the air bags deploy, injury may occur to the:

iliac crests

Abdominal pain, vomiting, and fever are most likely due to _______.

infection

A 16 yr old boy was playing football & was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his:

kidney

In pediatric patients, the liver and spleen are _______.

larger in proportion to the abdomen.

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene.

You are transporting a pt w/ possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume?

legs drawn up

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

lift the air bag and look for deformity to the steering wheel.

All of the following are hollow abdominal organs, EXCEPT for the:

liver

Which of the following organs would MOST likely bleed profusely if severely injured?

liver

When a hollow organ is punctured during a penetrating injury to the abdomen:

peritonitis may not develop for several hours.

solid organs

solid masses of tissue where much of the chemical work of the body take place

Peritonitis would MOST likely result following injury to the:

stomach

hollow organs

structures through which materials pass

peritoneal cavity

the abdominal cavity

Which of the following statements regarding intra-abdominal bleeding is FALSE?

the absence of pain & tenderness rules out intra-abdominal bleeding

evisceration

the displacement of organs outside of the body

A 22-year-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 blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:

transport him in the position in which you found him.

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

urinary bladder

When caring for a female w/ trauma to the external genitalia, the EMT should:

use local pressure to control bleeding