Chapter 25 EMT Notes/Quiz

Types of tourniquets

-MAT (mechanical advantage tourniquet) -CAT (combat application tourniquet -RMT (ratcheting medical tourniquet -SWAT-T (special weapons and tactics tourniquet

Applying pressure to an open wound should be how long?

5 minutes without interruption

Bleeding into the chest cavity or lung may cause what

-dyspnea -tachycardia -hemoptysis -hypotension

What two forms do hemostatic agents come in?

-granular powder (can be inserted into small wounds to create a tight seal) -gauze impregnated with a clay substance

The severity of bleeding should be based on all of the following findings, EXCEPT: A.systolic blood pressure. B.the mechanism of injury. C.clinical signs and symptoms. D.poor general appearance.

A. SBP

Internal bleeding into a fractured extremity is MOST often controlled by: A.splinting the extremity. B.applying chemical ice pack. C.applying a tourniquet. D.keeping the patient warm.

A. splinting the extremity

In older patients, the first indicator of nontraumatic internal bleeding may be: A.weakness or dizziness. B.diaphoresis and pale skin. C.a low blood pressure. D.a heart rate over 120 beats/min.

A. weakness or dizziness

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: A.a tourniquet proximal to the injury. B.digital pressure to a proximal artery. C.a splint and elevate the extremity. D.additional sterile dressings.

A.a tourniquet proximal to the injury.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: A.an aortic aneurysm. B.gastrointestinal bleeding. C.acute appendicitis. D.intrathoracic hemorrhaging.

B. GI bleeding

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: A.perform a secondary assessment. B.assist the patient's ventilations. C.obtain baseline vital signs. D.apply a nonrebreathing mask.

B. assist the patient's ventilations

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. A.hypoperfusion B.perfusion C.hemorrhage D.coagulation

B. perfusion

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: A.you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B.the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C.bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D.the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

B.the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? A.Skeletal muscle B.Brain C.Gastrointestinal system D.Kidneys

C. GI system

Which section of the heart receives deoxygenated blood? A.Ventricles B.Atria C.Right D.Left

C. Right

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? A.The patient has a history of hypertension. B.The patient had a stroke 5 years prior. C.The patient takes rivaroxaban (Xeralto). D.The patient has not eaten in 24 hours.

C. The patient takes rivaroxaban

Following blunt trauma to the abdomen, a 24-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: A.liver. B.gallbladder. C.spleen. D.pancreas.

C. spleen

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? A.Cardboard splint B.Vacuum splint C.Sling and swathe D.Air splint

D. Air splint

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. A.15%. B.10%. C.5%. D.20%

D. 20%

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. A.apply direct pressure first B.use large or small gauze pads or dressings depending upon the size of the wound C.cover the entire wound, above and below, with the dressing D.All of these answers are correct.

D. all of the above

What mechanism(s) does the body use to control bleeding? A.Clotting B.Coagulation C.Vasoconstriction D.All of these answers are correct.

D. all of the above

Which of the following statements regarding hemophilia is correct? A.Hemophiliacs take aspirin to enhance blood clotting. B.Hemophilia is defined as a total lack of platelets. C.Approximately 25% of the population has hemophilia. D.Patients with hemophilia may bleed spontaneously.

D. patients with hemophilia may bleed spontaneously

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: A.having the patient pinch his own nostrils and then lie supine. B.packing both nostrils with gauze pads until the bleeding stops. C.placing a rolled 4² × 4² dressing between his lower lip and gum. D.pinching the patient's nostrils and having him lean forward.

D. pinching the patient's nostrils and having him lean fwd

Which portion of the blood carries oxygen to and wastes away from body tissues? A.White blood cells B.Platelets C.Plasma D.Red blood cells

D. red blood cells

Hypovolemic shock occurs when: A.at least 10% of the patient's blood volume is lost. B.the patient's systolic blood pressure is less than 100 mm Hg. C.the clotting ability of the blood is enhanced. D.the body cannot compensate for rapid blood loss.

D. the body cannot compensate for rapid blood loss

A hematoma is

a mass of blood that has collected in the soft tissues beneath the skin, indicating blooding into soft tissues and may be the result of a minor or a severe injury

When CS fluid is present in blood/drainage, how will you determine it?

a stain in the shape of a target or halo will appear

When applying a tourniquet, where do you apply it?

above the level of bleeding

A hemostatic agent is?

any chemical compound that slows or stops bleeding by assisting with clot formation

Epistaxis is

bleeding from the nose

The first sign of hypovolemic shock is

change in mental status (such as anxiety, restlessness, or combativeness)

Hemoptysis is

coughing up blood

Later signs of hypovolemic shock suggest

internal bleeding and: -tachycardia, weakness/fainting/dizziness at rest, thirst, nausea/vomiting, cold moist skin, shallow/rapid breathing, dull eyes, slightly dilated pupils that are slow to respond to light, cap refill longer than 2 sec., weak rapid thready pulse, decreasing bp, and altered LOC

In the event of a skull fracture (nose or ears are bleeding), do you try to stop the bleeding?

no

Pallor is

paleness

Bleeding from the nose or ears following a head injury may indicate a

skull fracture

T/F: Bleeding will usually stop when the pressure of the dressing exceeds arterial pressure.

true