EMT Chapter 26: Soft-Tissue Injuries

Which of the following is a severe burn in a 35-year-old patient?

Circumferential partial-thickness burn to the chest

______ develops when edema and swelling result in increased pressure within a closed soft-tissue space

Compartment syndrome

Which of the following statements regarding electrical burns is correct?

Entrance wounds are small relative to the amount of internal tissue damage.

What layer of the skin forms a watertight, protective seal for the body?

Epidermis

_____ burns may involve the subcutaneous layers, muscle, bone, or internal organs.

Full-thickness

Which of the following should NOT be used as an occlusive dressing:

Gauze pads

Which of the following is NOT a factor that can aid in determining the severity of a burn?

If the patient is between 20 and 30 years old

____ is an acute, potentially fatal viral infection of the CNS that affects all warm-blooded animals

Rabies

Produce oil, which waterproofs the skin and keeps it supple

Sebaceous glands

____ burns cause intense pain

Second degree

___ burns involve only the epidermis

Superficial

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is correct?

The 39-year-old female is at high risk for an infection.

Which of the following statements regarding the rule of nines is correct?

The anterior trunk of an adult is equal to 18% of the BSA.

Which of the following statements regarding the dermis is correct?

The dermis contains hair follicles, sweat glands, and nerve endings.

A laceration may be all of the following EXCEPT:

a scrape

Using elastic bandages to secure dressings may result in ____ if the injury swells or if the bandages were applied improperly

additional tissue damage

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:

administer oxygen and prepare for rapid transport.

An open neck injury may result in _____ if enough air is sucked into a blood vessel.

an air embolism

A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should:

apply an occlusive dressing to the wound and continue your assessment.

An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):

avulsion

The skin regulates temperature in a cold environment by:

constricting blood vessels

All open wounds are assumed to be ____ and present a risk of infection

contaminated

A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should:

control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.

Open soft-tissue wounds include all of the following EXCEPT:

contusions

A partial-thickness burn involves the outer layer of skin and a portion of the:

dermal layer

Treatment for an abdominal evisceration includes:

flexing the knees and legs to relieve pressure on the abdomen

A _____ occurs whenever a large blood vessel is damaged and bleeds

hematoma

More extensive closed injuries may involve significant swelling and bleeding beneath the skin, which could lead to:

hypovolemic shock

Treatment of electrical burns includes all of the following EXCEPT:

immersion in water

Functions of dressings and bandages include all of the following, EXCEPT:

immobilization of the injury.

A laceration:

is a jagged cut caused by a sharp object or blunt force trauma.

Burns are diffuse soft-tissue injuries created by destructive energy transfers from all of the following sources EXCEPT:

kinetic sources

With regard to the pediatric rule of nines, the:

legs are proportionately smaller than an adult's.

All of the following body structures are lined with mucous membranes, EXCEPT for the:

lips.

Splinting an extremity, even when there is no fracture, may:

make it easier to move a patient

During the normal wound-healing process, bleeding may occur from even a minor injury because:

new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.

When a person is exposed to a cold environment:

peripheral vessels constrict and divert blood away from the skin.

During the primary assessment of burns, it is important to remember to:

prevent heat loss

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should:

rapidly assess the patient after ensuring that the power line is not live.

Splinting an extremity even when there is no fracture can help to:

reduce pain, minimize damage to an already-injured extremity, make it easier to move the patient.

The skin covering the _____ is quite thick.

scalp

The most important consideration when dealing with electrical burns is:

scene safety

The ____ is our first line of defense against external forces

skin

Patients with full-thickness (third-degree) burns generally do not complain of pain because:

the nerve endings have been destroyed.

Because shootings usually end up in court, it is important to factually and completely document:

the treatment given

You respond to a house fire with the local fire department. They bring a 48-year-old woman out of the house. She is unconscious but her airway is open. Her breathing is shallow at 30 breaths/min. Her pulse is 110 beats/min, strong and regular. Her blood pressure is 108/72 mm Hg. She has been burned over 40% of her body. The burned area appears to be dry and leathery. It looks charred and has pieces of fabric embedded in the flesh. You know that this type of burn is considered a:

third-degree burn

Significant airway burns may be associated with all of the following EXCEPT:

vomiting

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:

begin CPR and apply the AED.

Which of the following is a severe burn in a 2-year-old child?

Any full-thickness burn, regardless of its location on the body

Which of the following is of LEAST importance when initially assessing the severity of a burn?

Known drug allergies

A(n) _____ occurs when a great amount of force is applied to the body for a long period of time.

crushing injury

Closed soft-tissue injuries are characterized by all of the following EXCEPT:

damage of the protective layer of skin

As the cells on the surface of the skin are worn away, new cells from in the _____ layer

germinal

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status.

When assessing a patient with a closed soft-tissue injury, it is MOST important to:

remain alert for more severe underlying injuries.