EMT Chapter 12/14

You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a:

combination of a medical and trauma emergency

Assessment of the medical patient is usually focused on the

nature of illness

You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________.

peripheral vasoconstriction

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:

repeat the epinephrine injection after consulting with medical control.

Inadequate circulation of blood throughout the body is called ________.

shock

Distributive shock occurs when:

widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Basic causes of shock include

All of these answers are correct

Blood pressure is a rough measurement of

Perfusion

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?

Rapid transport to a trauma center

Which of the following is NOT a sign of cardiogenic shock?

Strong, bounding pulse

Which of the following statements regarding anaphylactic shock is correct?

Subsequent exposure after sensitization often produces a more severe reaction.

Clinical signs of compensated shock include all of the following, EXCEPT:

absent peripheral pulses.

The determination of whether a medical patient is high-priority or low-priority transport is typically made

after the primary assessment has been completed

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:

apply a tourniquet proximal to the wrist.

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound.

When assessing a patient with signs and symptoms of shock, it is important to remember that:

blood pressure may be the last measurable factor to change in shock.

A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

cardiogenic hypoperfusion.

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.

cardiogenic shock

Pulmonary edema and impaired ventilation occur during:

cardiogenic shock.

When treating an 80-year-old patient who is in shock, it is important to remember that:

changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:

check her airway for obstructions.

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation called ___

compensated shock

You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted.

Neurogenic shock occurs when:

failure of the nervous system causes widespread vasodilation.

In an acute injury setting, neurogenic shock is commonly accompanied by

hypothermia.

You and your EMT partner arrive at the residence of a 50-year-old man who complaints of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:

manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem?

medical history

You should suspect shock in all of the following execpt:

mild allergic reaction

Hypovolemic shock caused by severe burns is the result of a loss of:

plasma.

You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:

reassess his condition in 5 minutes.

Shock due to severe infection is called ________.

septic shock

You are called to a construction site where a 27-year-old worker has fallen from the second floor. He landed on his back and is drifting in and out of consciousness. A quick assessment reveals no bleeding or blood loss. His blood pressure is 90/60 mm Hg with a pulse rate of 100 beats/min. His airway is open and breathing is within normal limits. You realize the patient is no shock. The patient's shock is due to an injury to the:

spinal cord

Blood flow through the capillary beds is regulated by

the capillary sphincters .

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:

the skin.

When should nonlifesaving interventions be performed for your multisystem trauma patient?

En route to the hospital

You respond to the local nursing home for an 85-year-old woman who has altered mental status. During your assessment, you notice that the patient has an elevated body temperature. She is hypotensive and her pulse is tachycardic. The nursing staff tells you that she has been sick for several days and that they called because her mental status continued to decline. You suspect the patient is in septic shock. The shock is due to

widespread dilation

Nerogenic shock is caused by

a radical change in the size of the vascular system

Foods, medications, and insects are common causes of ________.

anaphylactic shock

Noncardiovascular causes of shock include respiratory insufficiency and:

anaphylaxis

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

61-year-old man with signs and symptoms of a stroke and a ground transportation time of 50 minutes

Which of the following MOST accurately describes septic shock?

Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Which of the following injuries would MOST likely cause obstructive shock?

Cardiac tamponade

Regulation of blood flow is determined by

Cellular need

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?

Control the bleeding.

Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?

Decompression of the injured side of the chest

What are the three components of the "perfusion triangle"?

Heart, blood vessels, blood