Chapters 22-23
When treating a patient who experienced a pulmonary blast injury, you should
Avoid giving O2 under positive pressure.
When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the
MOI
When assessing an elderly PT who fell, it is important to remember that
Osteoporosis can cause a fracture that may have resulted in the fall.
Early Signs and symptoms of intra-abdominal bleeding include
Pain and distention.
When a motor vehicle strikes a tree while traveling at 40 MPH, the unrestrained occupant
Remains in motion until acted upon by an external force.
When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is most important to
Remember That it could still deploy and seriously injure you (the EMT)
During transport of a 40 y/o female w/ acute abdominal pain, you note that she has stopped talking to you & has become extremely diaphoretic. You should
Repeat the primary assessment.
The systemic veins function by
Returning deoxygenated blood back to the heart.
What types of motor vehicle collisions present the greatest potential for multiple impacts
Rotational and Rollover
External bleeding from a vein is relatively easy to control because
Veins are under a lower pressure.
The sebaceous glands produce sebum, a material that
Waterproofs the skin and keeps it supple.
In older patients, the first indicator of nontraumatic internal bleeding may be
Weakness or dizziness.
Significant vital signs changes will occur if the typical adult acutely loses more than ______of his or her total blood volume.
20%
In nontrauma PT, and early indicator of internal bleeding is
Dizziness upon standing.
When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the ______ When the air bag deploys upon impact
Door
Following a blunt injury to the head, a 22 y/o female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concern w/ the possibility of
Intracranial bleeding.
Bleeding from the nose following head trauma
Is a sign of a skull fracture and should not be stopped
A diver involved in a rollover motor vehicle crash will Most likely experience serious injuries or death if he or she
Is ejected or partially ejected.
When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should
Stop twisting the stick when the bleeding stops.
During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred
During the tertiary phase.
If on or more occupants in the same vehicle are killed in a crash, the EMT should
Suspect that all living occupants experienced the same serious trauma.
The Severity of bleeding should be based on all of the following findings, EXCEPT
Systolic blood pressure
You arrive at the home of a 50 y/o female w/ severe epistaxis. As you are treating her, it is MOST important to recall that
The PT is at risk for vomiting and aspiration.
Which of the following statements regarding low-energy penetrating injuries is correct
The area of injury is usually close to the path the object took through the body.
What is the approximate blood volume of a 75-kg adult
5.25 L
The energy of a moving object is called
Kinetic Energy
An infant w/ a total blood volume of 800mL would start showing signs of shock when as little as ______of blood is lost.100 mL
100 mL
A fractured femur can result in the loss of ____ or more of blood into the soft tissues of the thigh.
1 L
During your assessment of a patient w/ a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest You should assign him a GCS score of
7
Your patient has a Glasgow Coma scale (GCS) score of 13, a systolic blood pressure of 80mm Hg, and a respiratory rate of 8 breaths/min Revised Trauma Score (RTS) is
9
Which of the following patients has experienced the MOST significant fall
A 4'6" patient who fell 13'.
Which of the following statements regarding the clotting of blood is correct
A person taking aspirin will experience slower blood clotting.
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply
A tourniquet proximal to the injury
Blood stasis, changes in the vessel wall, and certain medications affect the
Ability of the blood to effectively clot.
Which of the following splinting devices would be MOST appropriate to use for a PT who has an open fracture of the forearm w/ external bleeding
Air Splint
Which of the following injuries would MOST likely occur as direct result of the third collision in a motor vehicle crash
Aortic Rupture
Most cases of external bleeding from an extremity can be controlled by
Applying local direct pressure
When evaluating the mechanism of injury of a car vs. pedestrian collision, you should first
Approximate the speed of the vehicle that struck the pedestrian.
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the
Arterioles
A young male sustained a gunshot wound to the abdomen during an altercation w/ a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then
Assess for an exit wound.
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
Assist the patient's ventilations
An organ or tissue may be better able to resist damage from hypoperfusion if the
Body's temperature is considerably less than 98.6 F (37.0 C).
While assessing a young male who was struck in the chest w/ a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for
Bruising of the heart muscle.
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as
Cavitation.
Perfusion is MOST accurately defined as the
Circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
The germinal Layer of the epidermis contains pigment granules that are responsible for skin
Color
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The PT, a 29 y/o male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition
Compression of the head against the roof
A 39 y/o male accidentally cut his wrist while sharpening his hunting knife. He is conscious & alert w/ adequate breathing, but is bleeding significantly from the wound. You should
Control the bleeding w/ direct pressure.
Signs of a pulmonary blast injury include
Coughing up blood.
Air bags are designed to
Decrease the severity of deceleration injuries.
Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash
Deformed steering wheel.
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma
Deployment of the air bag.
Which of the following areas of the body has the thinnest skin
Ears
A 12 y/o male jumped approx. 12' from a tree & landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain
Energy transmission to the spine,
What layer of the skin forms a watertight, protective seal for the body
Epidermis.
Two of the MOST common mechanisms of injury for blunt trauma are
Falls and motor vehicle collisions.
In which of the following situations would external bleeding be the MOST difficult to control
Femoral artery laceration and a blood pressure of 140/90 mm Hg
A 39 y/o male sustained a large laceration to his leg during an accident w/ a chainsaw & is experiencing signs & symptoms of shock, You should
Follow appropriate standard precautions.
A 67 y/o male presents w/ weakness, dizziness, and melena that began approx.. 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mmHg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this PT is experiencing
Gastrointestinal bleeding.
According to the American College of Surgeons, and adult trauma patient meets Level I criteria if he or she
Has a GCS score of greater than or equal to 8 w/ a mechanism attributed to trauma.
In contrast to a Level III trauma center, a Level I Trauma center must
Have general surgeons that are in-house 24 hours a day.
A 40 y/o unrestrained female impacted the steering wheel of her vehicle w/ her chest when she hit a tree while traveling at 45 MPH. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience
Head injury
The cervical spine is Most protected from whiplash-type injuries when the
Headrest is appropriately positioned.
Gastrointestinal bleeding should be suspected if a PT presents w/
Hematemesis.
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to
How rapidly he or she bleeds.
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to
Identify contact points and predict potential injuries.
With regard to three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct
It is the most dramatic part of the collision and may make extrication difficult.
Approximately 25% of severe injuries to the aorta occur during
Lateral Collisions
All of the following body structures are lined w/ mucous membranes, EXCEPT for the
Lips
While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-yr old male who was riding in the front seat is involved. He further states that the child was only wearing lap belt and that the air bag deployed. On the basis of this information , you should be most suspicious that the child has experienced
Neck and facial injuries.
Which of the following statements regarding hemophilia is correct
PT's w/ hemophilia may bleed spontaneously.
When a person is exposed to a cold environment
Peripheral vessels constrict and divert blood away from the skin.
A 43 y/o man is experiencing a severe nosebleed. His blood pressure is 190/110 mmHg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this PT includes
Pinching the PT's nostrils and having him lean forward.
After applying a pressure dressing to a laceration on a PT's arm, you notice that blood is slowly beginning to saturate it. You should
Place additional dressings over the wound. .
By what mechanism is a person injured when he or she falls from a significant height
Potential Energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
A 30 y/o male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be most alert for
Potential airway compromise
A 22 y/o male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless & his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patients includes
Preparing for immediate transport.
When assessing a patient who experienced a blast injury, it is important to remember that
Primary blast injuries are typically the most obvious.
When the speed of a motor vehicle doubles, the amount of kinetic energy
Quadruples
Which of the following interventions is the MOST critical to the outcome of a patient w/ multisystem trauma
Rapid transport to a trauma center.
Hypoperfusion is another name for
Shock.
Which of the following organs can tolerate inadequate perfusion for up to 2 hours
Skeletal muscle.
Following blunt trauma to the abdomen, a 21 y/o female complains of left upper quadrant abdominal pain w/ referred 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
Spleen
A 15 y/o female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to
Stabilize her entire spine.
If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave
Stomach rupture
Hypovolemic shock occurs when
The body cannot compensate for rapid blood loss.
Internal injuries caused by gunshot wounds are difficult to predict because
The bullet may tumble or ricochet within the body.
Which of the following statements regarding the dermis is correct
The dermis contains hair follicles, sweat glands, and nerve endings.
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body
The filtering of blood cells in the spleen.
Which of the following processes occurs during the inflammation phase of the healing process
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
Functions of the skin include all of the following, EXCEPT
The productions of key antibodies.
Which of the following statements regarding gunshot wounds is correct
The speed of a bullet has the greatest impact on producing injury.
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT
The speed of the fall.
Whether you are using a commercial device or a stick & triangular bandage as a tourniquet, it is important to remember that
The tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the
Thoracic and Lumbar spine
According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if
Traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include
Transport to a trauma center.
Force acting over a distance defines the concept of
Work.
The index of suspicion is MOST accurately defined as
Your Concern for potentially serious underlying injuries.
