EMT chapter 26

Which of the following statements regarding an electrical injury is​ FALSE?

injury is usually limited to the area around the source and ground burns

Which of the following is MOST likely to be the consequence of a closed crush​ injury?

internal organs are ruptured

The emotional and psychological damage from burn​ injuries:

begins at the emergency scene.

When​ crushed, the liver and​ spleen:

bleed profusely and cause shock.

When using the rule of palm to estimate the approximate body surface area​ burned, the​ patient's palm and fingers equal about what percentage of the​ body's surface area​ (BSA)?

1%

Your patient has burns to the entire right arm and the anterior chest. What is the estimated surface area​ involved?

18 percent

According to the rule of nines for infants and young​ children, the​ patient's head and neck account for what percentage of the total body surface​ area?

18%

Your patient is a​ 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his​ knees, and circumferentially around both legs. Using the rule of​ nines, which of the following MOST accurately represents the extent of body surface area​ burned?

18%

Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso​ (chest and​ abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface​ burned?

22.5 percent

While assessing a patient with partial thickness burns to his chest and​ neck, after stopping the burning​ process, what should be your HIGHEST priority​ (even if there are no symptoms​ presently)?

Airway

A way of identifying the seriousness of a burn is by its degree. Which of the following statements is​ TRUE?

A​ full-thickness burn is also known as a​ third-degree burn.

In bandaging a hand​ wound, what important consideration is​ necessary?

Bandage the hand in the position of function.

What is the FIRST step in removing dry chemicals from the​ body?

Brush off the excess material.

Your patient has sustained a chemical burn to her hands from dry lime. How is this treated in the​ field?

Brush off the powder before using water to flush.

You assess a​ 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the​ burn, you notice a white powder on the burn. What should be your next​ step?

Brush the powder off the​ patient's arm and​ hand, and then flush with copious amounts of water.

Which of the following layers of the skin is the MOST important in insulating the body against heat​ loss?

Subcutaneous layer

A patient has​ partial-thickness burns over 35 percent of her​ body, including both feet. Which of the following classifications does this​ patient's burns fall​ under?

Critical

Which of the following statements about puncture wounds is​ correct?

Even​ insignificant-looking puncture wounds can cause devastating injuries.

A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can talk and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the HIGHEST priority in this​ patient's assessment and​ treatment?

Fully immobilize the patient.

You are caring for a​ 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be MOST preferred in managing this​ wound?

Gloves and a face shield

A patient with an electrical injury is LEAST likely to present with which of the following signs and​ symptoms?

Hypotension

You are called to the scene of a metal fabrication plant where you are presented with a​ 30-year-old male patient complaining of bilateral severe eye pain. Upon​ examination, you notice both eyes are red and irritated. Patient states that one of the dyes he was working with splashed into his eyes. How would you manage this​ patient's injury?

Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.

Damage to which of the following organs is LEAST likely in the case of abdominal​ bruising?

Lungs

The skin serves which of the following​ functions?

Protection

Which of the following is NOT a major function of the​ skin?

Regulates the pH balance of the body

You are dispatched to an auto repair shop for an accident. You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a​ high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you​ do?

Remove the ice from the​ wound, then elevate and splint the limb. Transport the patient high priority.

Which of the following is recommended when caring for an amputated​ part?

Seal the part in a plastic bag kept cool with cold packs.

You are dispatched to the local high school for a​ "person struck with a​ baseball." You arrive on the scene and find a​ 16-year-old male sitting on the bench.​ Apparently, he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next​ step?

Take appropriate Standard​ Precautions, apply​ high-concentration oxygen by nonrebreather​ mask, and transport the patient​ ASAP, carefully monitoring the patient during transport.

A​ 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury​ site?

The nail should not be removed.

Possible injury to the cervical spine or brain could be indicated​ by:

a bruise on the head or neck.

An injury in which the epidermis remains​ intact, but blood vessels and cells in the dermis are​ injured, is​ called:

a contusion

Which of the following is NOT a type of​ avulsion?

a finger is cut off with a butchers saw

Which of the following BEST describes an​ avulsion?

a flap of skin that is partially or completely torn away from the underlying tissue

You are performing a secondary assessment on your​ 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point​ to?

a punctured lung

A wound in which the epidermis is scraped away with minimal​ bleeding, such as commonly occurs when a child falls on his knees on a​ sidewalk, is​ called:

abrasion

All burns are to be treated as more serious​ if:

accompanied by other injuries or medical problems.

Which of the following statements about electrical burns is​ TRUE?

all tissues between he entrance and the exit wounds will potentially be injured

When a flap of tissue is traumatically​ removed, this condition is​ called:

an avulsion.

A burn injury should be considered to​ be:

an injury with the potential for many​ far-reaching effects.

Your patient is a​ 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this​ wound?

application of antibiotic ointment

Your patient is a​ 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and​ painful, but without blisters. When caring for this injury in the prehospital​ setting, which of the following is​ appropriate?

apply a dry sterile dressing

A​ 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you​ do?

apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient

Your patient is a​ 14-year-old male who crashed his​ bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his​ hands, arms,​ chest, and knees. The patient has small pieces of​ gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine​ immobilization?

asses for additional injuries, brush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport

Your patient suffered a severe electrical burn injury. In your emergency​ care, you should​ always:

assess for an entrance and exit wound

When would you use your stethoscope to listen for equal air entry and unusual breath​ sounds?

bruising on the trunk or signs of damage to the ribs or sternum

Your patient is a​ 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his​ hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the BEST way to manage this​ situation?

brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose

How does the skin provide temperature​ regulation?

by altering the blood flow to the skin and controlling perspiration

You are dispatched to an industrial plant for a burn. You arrive and find a​ 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you​ do?

care for the burn and do a complete patient assessment, including cervical spine precautions

Which of the following is NOT considered soft​ tissue?

cartilage

For a young child with isolated genital​ injuries, you​ should:

consider the possibility of abuse and treat the child with sensitivity.

Which of the following is NOT an open tissue​ injury?

contusion

You are caring for a​ 46-year-old female who accidentally sustained burns to her left hand up to the wrist from boiling water. You arrive moments after the incident. Of the​ following, which should you do​ FIRST?

cool the bburned area to stop the burning process

A patient has partial thickness burns over 18 percent of his​ body, including both feet. Which of the following classifications does this​ patient's burns fall​ under?

critical

The layer of skin that is rich with blood​ vessels, nerves, and specialized structures is​ the:

dermis

Bleeding from​ soft-tissue injuries should initially be controlled with which one of the following​ techniques?

direct pressure

To control​ bleeding, start​ with:

direct pressure and elevation.

The sterile material that is placed directly on a wound is termed​ the:

dressing

When managing an electrical​ burn, the EMT​ should:

ensure the scene is safe before entering.

The skin is the largest organ of the body. It is composed of three​ layers, including​ the:

epidermis

Which of the following is the outermost layer of the​ skin?

epidermis

Generally when providing emergency care of open​ wounds, the first thing you would do​ is:

expose the wound

A burn extending into the subcutaneous fat would be classified as which type of​ burn?

full thickness

White and dry to dark brown or black and charred skin is a sign of​ a:

full thickness burn.

Which of the following statement is​ TRUE?

geriatric patients might not survive burn injuries of an intensity and body area involvement that younger patients would

A wound under the skin that involves the collection of blood from injury to a large blood vessel is called​ a:

hematoma

Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is​ this?

hematoma

You are assessing a​ 30-year-old male patient who was accidentally injured by a​ high-pressure industrial sprayer. By the time you​ arrive, he has been freed. The patient tells you that he does not understand why you were​ called, but as you inspect the injured​ limb, you notice a small puncture wound. You should have a high index of suspicion of which of the following​ injuries?

high pressure injection

Which of the following statements concerning the proper transport of an avulsed ear is​ FALSE?

it should be wrapped in a dry sterile dressing

Your patient is a​ 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital​ setting?

leave the hook in place and try not to disturb

While assessing a​ 78-year-old male patient who escaped an apartment fire with partial thickness burns to both​ arms, the EMT must be aware of which of the​ following?

medical conditions may be aggrevated by the burn

You are assessing a patient and notice red discoloration with blisters on the legs. This type of burn would be classified​ as:

partial thickness.

Which type of wound has a small opening into the​ skin, but may be quite​ deep, and is often caused by instruments such as​ nails, ice​ picks, or​ pencils?

puncture

Swelling or deformity at the site of a bruise indicates​ a:

possible underlying fracture

Your patient is a​ 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being​ "hit in the face and kicked and punched in his ribs and​ stomach." Your examination reveals contusions and swelling around both​ eyes, bleeding from the​ nose, a laceration of his upper​ lip, and multiple contusions of the​ chest, abdomen, and flanks. This patient is showing signs of all of the following possibilities EXCEPT which​ one?

punctured lung

You are called to an injured person to find a​ 27-year-old male with a laceration on his anterior forearm. Bleeding is dark​ red, steady, and fast. You control bleeding with direct pressure and then dress the wound. After you dress the​ wound, the bleeding restarts. You​ should:

reapply pressure and apply additional dressing material over the top of the original dressing

What is the primary risk for electrical injury​ patients?

resp or cardiac arrest

Burns involving the airway often lead​ to:

respiratory compromise.

All dressings used in the prehospital management of open wounds should​ be:

sterile

Which layer of the skin provides shock absorption and​ insulation?

subcutaneous

Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical​ wire?

the extent of tissue damage may be much greater than it appears on the surface

The rule of palm is a method for measuring the extent of the burn that compares the size of the burn​ with:

the size of the palm and fingers of the​ patient's hand.

Which of the following BEST describes a partial thickness​ burn?

the skin is red and moist with blister formation

Burns pose greater risks to infants and children than to adults​ because:

their body surface area is greater in relation to their total body size

Which of the following statements concerning lacerations is​ FALSE?

then may be degloving injuries to the skin or tissues

Which of the following is required in the management of all open​ soft-tissue injuries?

use standard precautions by the emt

Which of the following is a guideline for the treatment of chemical​ burns?

wash away the chemical with flowing water

You are dispatched to a local industrial plant for an electrical injury. You arrive on scene and find a​ 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious​ person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next​ step?

while on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam

In caring for an amputated​ part, it is important​ to:

wrap the part in sterile gauze and keep it cool

You are treating the amputation of three fingers on a​ 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated​ fingers?

wrap them in a sterile dressing moistened with sterile saline, put them in a plastic bag, and keep them cool

You are caring for a​ 23-year-old female who fell off a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are​ torn, and you can see most of the wound. What is the NEXT​ step?

you need to expose the wound completely, clean the surface by simply removing large pieces of foreign matter if any, control bleeding, and dress and bandage the wound

A bruise on the abdomen could indicate injury to which of the​ following?

​Spleen, liver, or kidneys