Emergency Care: Trauma and Shock

What can cause post-traumatic stress disorder? a. fighting as a soldier in war b. being seriously injured in a fall c. losing a close family friend in a tragic accident d. all of the above

d. all of the above

Shock patients should be treated quickly because a. shock is emotionally stressful b. shock patients always require CPR c. the symptoms of shock disappear soon after they start d. shock patients' health can decline very rapidly

d. shock patients' health can decline very rapidly

Partial-thickness burns affect a. all layers of skin b. the top layer of skin c. the bottom layer of skin d. the top two layers of skin

d. the top two layers of skin

A worker in a laboratory spills a dangerous chemical onto her hand. What is the appropriate response? a. flushing the burn with water for at least twenty minutes b. flushing the burn with water and covering it with a moistened, sterile dressing c. wiping the chemical off the hand and covering it with a sterile dressing d. smearing the burn with ointment and keeping the hand in a well-ventilated area

a. flushing the burn with water for at least twenty minutes

The patient has come into the emergency room with a burn on his right hand. What is the approximate severity of this patient's burn? a. one percent b. five percent c. nine percent d. eighteen percent

a. one percent

superficial burn

a burn that affects only the top layer of skin

partial-thickness burn

a burn that affects the top two layers of skin

shock

a condition caused by a lack of adequate blood flow throughout the body

psychogenic shock

a condition caused by a temporary lack of blood flow to the brain; commonly known as fainting; not a medical emergency

emotional trauma

a form of psychological damage that may be felt immediately after a difficult incident or develop over time with long-term abuse

triage

a method of prioritizing victims based on their immediate medical needs

light burn

a mild burn, such as a sunburn or a burn caused by exposure to UV light from welding tools

posttraumatic stress disorder (PTSD)

a poem of emotional trauma that comes from experiencing war or another traumatic event

trauma

a serious physical or emotional wound

cognitive-behavioral therapy (CBT)

a specialized counseling method aimer at altering a person's way of thinking and acting

splint

a sturdy piece of material that is strapped to keep the injured body part from moving

rule of nines

a technique that divides the body into equal parts and is used to estimate the percentage of the body affected by a burn

blunt trauma

a trauma caused by a blunt object that does not break the skin

penetrating trauma

a trauma caused by an object that breaks through the skin

counseling

a type of therapy in which a person talks through issues with a counselor trained in treating trauma victims

Which of the following burns are considered major burns? Check all that apply. a. a burn on the face b. a chemical burn on the arm c. a superficial burn that covers twenty-five percent of the body d. a full-thickness burn that covers five percent of the body

a, c, and d

Which of the following patient signs and symptoms would suggest physical trauma? Check all that apply. a. bruising b. vomiting c. red, swollen skin d. shortness of breath

a, c, and d

A man was lying on the beach wearing a pair of pants but no shirt. He burned his entire back. What percent of his body is affected by the burn? a. nine percent b. eighteen percent c. twenty-seven percent d. fifty percent

b. eighteen percent

A victim of a home fire is being treated at the scene. The emergency medical technician reports that the burn has affected all layers of the skin and appears to have damaged some muscle, too. What is the depth of the burn? a. superficial b. full thickness c. partial thickness

b. full thickness - A full-thickness burn affects all layers of the skin and some of the underlying tissue.

A person is thrown from a bicycle and crashes into the pavement. _______

blunt

two major types of physical trauma:

blunt trauma and penetrating trauma

Which of the following patient signs and symptoms would suggest emotional trauma? Check all that apply. a. bleeding b. experiencing dizziness c. having difficulty sleeping d. suddenly less social

c and d

A visitor in a cafeteria spills a cup of hot coffee on his leg. It is estimated that four percent of his body is affected with a superficial thermal burn. He has a steady pulse. What should someone do to help him? a. call 9-1-1 b. cover the burn with a moistened dressing c. flush the burn with cool water and cover it with a dry, sterile dressing d. cover the burn with ointment and a dry, sterile dressing

c. flush the burn with cool water and cover it with a dry, sterile dressing - For minor burns, provide treatment. Additional medical assistance is required for major burns for victims who are showing signs and symptoms of shock.

cardiogenic shock

shock caused by a damaged heart not pumping enough blood and thus not doing its job

septic shock

shock caused by a massive bacterial infection

anaphylactic shock

shock caused by an allergic reaction to a medication, food, or an insect sting

hypovolemic shock

shock caused by excessive blood loss

hypoglycemic shock

shock caused by very low blood sugar

If the victim has an open, bleeding head wound and a suspected ankle, what does the first responder treat first?

the head wound

Select the best answers to complete the following statements. Shock is often associated with _______________. _______________ shock is caused by excessive blood loss. _______________ shock is caused by an intense allergic reaction.

trauma, hypovolemic, anaphylactic

triage breakdown

1. Victims with major medical issues or massive physical trauma must be handled first. 2. Victims with minor or non-life threatening medical conditions and injuries are treated next. 3. Victims who are hurt but able to move around normally are treated last.

The steps for responding to physical trauma are:

1. assess the scene for safety 2. call 9-1-1 3. put on gloves 4. count the number of victims 5. assess the victims' injuries

major types of burns are:

- thermal - electrical - chemical - light burns

Common Injuries and Treatments:

- Bleeding wounds should be covered with sterile dressings. Pressure can be applied to the wound to try to stop the bleeding. - Deep lacerations, or cuts, may be sewn up with stitches. Any cut that gapes open usually requires stitches. - Victims with life-threatening injuries may receive oxygen treatments or IV medications to stabilize them. Surgery or other advanced treatments are also typically required. - Broken bones may require splinting as immediate first aid. Broken bones are typically set and casted at a hospital. Severe breaks may require surgery or other further treatment.

First responders on the scene where a victim has been burned will do the following tasks:

- assess the safety of the scene - put on gloves if they are available - assess the victim's airway, breathing, and pulse - call 9-1-1 for all major burns - provide treatment for all minor burns

signs and symptoms of penetrating trauma include:

- bleeding - difficulty breathing - signs of internal bleeding, such as pain and lightheadedness

shock can result from:

- blood loss - damage to the heart - a severe allergic reaction - a temporary lack of blood flow to the brain

signs and symptoms of blunt trauma include:

- bruising and swelling - suspected broken bones

a first responder at the scene of an electrical burn should:

- call 9-1-1 or send for advanced medical help right away - make sure that the scene is safe and turn off the source of electricity that caused the accident - look for two burns on the victim, where the electricity entered and exited the body, and apply sterile dressings to both burn sites - treat the patient for shock

a first responder at the scene of an chemical burn should:

- call 9-1-1 or send for advanced medical help right away. - make sure that the scene is safe. - flush the burned area with running water for at least twenty minutes. It is important to know the type of chemical causing the burn. Some chemical burns should not be treated with water, because mixing water with some dry chemicals can cause additional burning. - place a dry, sterile dressing over the burn. If the victim complains of additional burning, the first responder should repeat the flushing process. If the burn affects the eyes, the first responder should use a moist sterile dressing after flushing the eyes with water.

A major burn:

- completely surrounds a body part - is estimated to cover more than fifteen percent of the body - affects the victim's ability to breathe - is a serious partial-thickness burn or a full-thickness burn

treatments for emotional trauma typically involve long-term therapies like:

- counseling - cognitive-behavioral therapy

three main causes for the body going into shock:

- excessive blood loss - dilated (relaxed) blood vessels - too little blood pumped by the heart Each of these three responses means that the organs are not getting enough blood.

types of shock:

- hypovolemic shock - cariogenic shock - anaphylactic shock - hypoglycemic shock - septic shock - psychogenic shock

common signs and symptoms of emotional trauma:

- nightmares - constant fear - feelings of helplessness - social distance and withdrawal - nausea - insomnia

signs and symptoms of burns include:

- red skin - severe pain - moist skin - blisters - waxy or white skin - blackened, charred skin

signs and symptoms of shock include:

- shallow, rapid breathing - anxiety or restlessness - skin that is pale, cool, and clammy - dazed-looking eyes - massive amounts of bleeding or vomiting

first responders treat a thermal burn by:

- stopping the burning process if possible - flushing minor burns with cool running water - covering the burn with a dry, sterile dressing; if the eyes or eyelids are burned, the dressing is moistened with sterile water; no ointments or creams should be used - placing sterile dressings in between the affected fingers or toes are burned

first responders may try to calm and relax the victim by:

- telling the victim their level of medical training - reassuring the victim that they are there to help and that more help is on the way

care for patients who are presently showing symptoms of shock and for patients who are suspected to be at risk for shock:

1. assess the scene, put on gloves, and call 9-1-1 2. control bleeding if necessary, examine the patient for injuries 3. help the patient lie down, cover the patient with clothing or a blanket to help him or her stay warm 4. make sure that the patient does not eat or drink anything 5. elevate the patient's legs on a chair or box if there are no broken bone in the legs or pelvis; if the patient is having trouble breathing, assist the patient in sitting up a little 6. monitor the patient's heart rate and respiration rate every five minutes until more advanced medical care arrives

A patient arrives at the hospital with multiple injuries. Prioritize the injuries by putting the patients in order of treatment. ___ suspected wrist fracture ___ bleeding from a large wound ___ blocked airway

3, 2, 1

Three people are hurt at the scene of an accident. Prioritize the victims by putting the patients in order of treatment. _____ The patient is complaining of a hurt shoulder but walking around normally. _____ The patient has a fractured leg. _____ The patient has a massive, bleeding chest wound.

3, 2, 1

full-thickness burn

a burn that affects all layers of the skin and may even damage tissues beneath the skin, such as muscles and bones

Which procedures should a physician follow when examining a patient at the scene of an electrical burn? Check all that apply. a. make sure that the source of electricity is turned off b. look for two burn sites on the body c. call 9-1-1 only if the burn covers over fifteen percent of the body d. flush the burn with plenty of cool water

a and b

What should a first responder do to help a patient who has suffered both physical and emotional trauma? Check all that apply. a. reassure the victim that help is on the way b. attempt to give the patient trauma counseling c. tell the victim their level of medical training d. treat just the physical trauma and ignore any signs of emotional trauma

a and c - A first responder's job is to be aware of and sensitive to the signs and symptoms of emotional trauma. They should treat patients with kindness and care but leave counseling to trained professionals.

What can cause thermal burns? Check all that apply. a. fire b. sunlight c. chemicals d. hot objects e. electricity

a and d

Which of the following problems are classified as trauma? Check all that apply. a. burns b. choking c. heart attacks d. broken bones

a and d

Which of the following steps should be taken to treat a patient suspected of going into shock? Check all that apply. a. cover the patient with a blanket b. provide food and water to the patient c. have the patient get up and walk around d. monitor heart rate and breathing every five minutes

a and d

physical trauma

a bodily injury usually caused by a sudden force on the body

chemical burn

a burn caused by contact with a strong acid or strong alkaline substance, such as a drain cleaner

electrical burn

a burn caused by downed power lines or frayed wires

thermal burn

a burn caused by heat, such as by a person touching a hot object or leaning over a fire

A marathon runner trips and breaks a bone. The medical staff on site needs to stabilize the runner's bone by a. using a splint b. providing oxygen c. stitching up the wound d. giving painkilling medication

a. using a splint - The most immediate medical treatment for a suspected bone break is a splint. The splint stabilizes the broken bone until the victim can seek advanced medical care.

burn

an injury to the skin and underlying tissue caused by heat, electricity, chemicals, or different types of radiation

Which of the following statements correctly describe what a first responder should do to treat a chemical burn? Check all that apply. a. stop flushing the burn area after twenty minutes b. make sure that the scene is safe before treating the victim c. use a moist, sterile dressing after flushing the eye if the burn affects the eye d. flush all suspected chemical burns with water, regardless of the chemical

b and c - Not all chemical burns are alike. While most are treated by flushing them with water, some chemicals react dangerously with water. Chemical burns that require flushing should be flushed for a minimum of twenty minutes.

A patient is being treated for a head injury. The doctor notices some signs and symptoms of shock. Which of the following symptoms did the doctor likely observe? Check all that apply. a. increased alertness b. shallow, rapid breathing c. a dazed look in the patient's eyes d. pale, cool, and clammy skin

b, c, and d

Which of the following patients are at risk for developing shock? Check all that apply. a. a child who has a broken finger b. a gunshot victim who has lost a great deal of blood c. a firefighter who had an emotionally difficult day at work d. a patient who is having an extreme allergic reaction to a bee sting e. a patient who has a massive bacterial infection

b, d, and e - Shock primarily occurs as a result of blood loss or an inability for the heart to pump enough blood through the body. Shock can also occur due to severe allergic reaction or a bad infection.

A person takes the lid off of a steaming, boiling pot of water and is burned in both eyes. What is the best treatment? a. having the person sit down in an area away from the stream b. carefully putting ointment on both of the person's eyes c. flushing the person's eye with cool water and covering them with with a moist dressing d. holding the person's head in ice water until the burning sensation stops

c. flushing the person's eye with cool water and covering them with with a moist dressing

Emotional trauma... a. is not treatable b. usually goes away on its own c. is treatable with specialized counseling d. heals itself once the cause of the trauma is removed

c. is treatable with specialized counseling

A child falls off her bike and scrapes her hands and knees on the pavement. Bits of broken glass are stuck in her hands, and both of her knees are bruised. She is crying and shaken. Which type(s) of trauma has she experienced? a. blunt trauma b. penetrating trauma c. emotional trauma d. all of the above

d. all of the above

A patient is at no risk of spinal injury and has no broken bones, but a healthcare provider suspects that she is going into shock. How should the patient be positioned? a. the patient should be positioned on her side b. the patient should sit up straight in a chair c. the patient should remain in the same position d. the patient should lie down with her feet slightly elevated

d. the patient should lie down with her feet slightly elevated - Patients may be moved and have their legs elevated only if there is no evidence of injury to the head or neck and if they do not have untreated fractures in the legs or pelvis. Elevating the legs improves blood flow.

A person is verbally abused for years and feels depressed. _____________

emotional

Determine the type of trauma in each case. A person steps on a nail and receives a puncture wound. ____________

penetrating