Week 6

An average adult weighing 154 pounds will have approximately how many liters of total blood volume?

6‒8 liters 8-10 liters Correct! 4‒5 liters 12-14 liters

For any splint to be effective, it must immobilize the extremity or joint ________ and _______ the injury.

Above and Below

When calculating BSA, the EMT should remember that the genital region represents ____ percent of the total BSA.

Correct! 1 2 3 9

When determining the BSA involved in a burn, the EMT should remember that the palm of the patient's hand is equal to about what percentage of total body area?

Correct! 1 percent 2 percent 3 percent 1⁄2 percent

Which of these patients would the EMT recognize as suffering from an evisceration injury?

Correct! A male patient with a loop of intestine protruding from an open surgical wound A female shot in the chest with "bubbling" coming from the wound as the patient breathes A male patient with a knife impaled in his right upper abdomen A female with a large flap of skin that has been torn loose from her scalp

As you approach a young male lying on the sidewalk who was called into 911 as an "unresponsive male," you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient would be to:

Correct! Assess the airway Cut the pants Elevate the leg Apply oxygen

Which statement concerning a flash burn is accurate?

Correct! Clothing will typically protect the skin from a flash burn A flash burn is the result of welding without proper protection A flash burn is caused by UV radiation Turnout gear does not provide adequate protection from a flash burn

A fair-skinned patient was exposed to the sun and has a painful superficial burn to her upper back. As a knowledgeable EMT, you would recognize that which layer(s) of the skin has been injured?

Correct! Epidermal Dermal Epidermal and dermal Subcutaneous

All of the following medications will affect clotting except

Correct! Lasix aspirin ibuprofen Coumadin

A 21-year-old male sustained a severe burn to his left leg while working on an industrial furnace. Coworkers immediately doused his flaming pants and removed them. Your primary assessment reveals no threats to the airway, breathing, or circulation. While performing the secondary assessment on his leg, which finding would be most critical?

Correct! Partial-thickness burn completely encircling the lower leg Pain described as "the worst I have ever felt" Blisters on the lower leg that are broken and draining fluid Skin on the posterior lower leg that is sloughing off

An industrial worker sustained partial- and full-thickness burns to his right hand after accidentally touching an electric furnace used to incinerate medical waste. Assessment reveals no threats to the airway, breathing, or circulation. Which action would the EMT perform next?

Correct! Pour cool saline water on the hand Apply an antibiotic ointment to the burn Open any blisters to relieve pressure on the burned tissue beneath Gently clean dead skin away from the burn

When applying the rule of nines to a 10-month-old child, the EMT should recognize which statement to be accurate?

Correct! The head of a child is considered to be 18 percent of the total body Both legs combined are approximately 18 percent of the total body The front and back of the torso are considered 72 percent of the total body The front of the arm is approximately 9 percent of the total body

A patient has suffered a small but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:

Correct! Use sterile gauze and wipe in a direction away from the site of injury Carefully remove any embedded particles from within the laceration Place saline-soaked gauze in the laceration Apply an antibiotic ointment prior to cleaning the injury

Epistaxis is another way of saying the patient has

Correct! a nosebleed abdominal bleeding high blood pressure increased plaque in his arteries

An open injury exposing the blood vessels and nerve tissue contained within the dermal layer of the skin is called a(n)

Correct! abrasion. avulsion. contusion. laceration.

All of the following are important factors to consider in determining burn severity except

Correct! ambient environmental temperature. percentage of body surface area involved. location of the burn. patient age and preexisting medical conditions.

In managing a burn correctly, an EMT may take all of the following steps except

Correct! apply ointments or sprays. apply dry, sterile dressings. keep the patient warm. keep the burn site clean.

When dealing with chemical burns, the EMT should remember that dry chemicals should be

Correct! brushed away before irrigating. irrigated without delay. removed with a damp sterile gauze pad. irrigated with neutralizing vinegar.

A burn that encircles a body area such as the chest, an arm, or a leg is called

Correct! circumferential. full thickness. immersional. severe.

The most important treatment for a patient who has sustained a chemical burn to the eyes is

Correct! copious irrigation with water. rapid application of dry, sterile dressings to both eyes. application of gauze pads soaked with saline. provision of oxygen via nonrebreather mask.

Burns are classified according to

Correct! depth of the injury. location of the injury. type of heat involved. amount of heat involved.

Absence of pain in a patient with a severe burn is most commonly associated with a

Correct! full-thickness burn. superficial burn. first-degree burn. deep partial-thickness burn.

A burn in which the epidermis and dermis are damaged is known as a

Correct! partial-thickness burn superficial burn. full-thickness burn. deep superficial burn.

When the EMT is dealing with a patient who has experienced an electrical burn, the primary concern should be

Correct! personal safety. patient care. rapid AED use. bystander history.

A partial-thickness (second-degree) burn will appear

Correct! reddened. dark brown. charred. black.

The innermost layer of the skin is the

Correct! subcutaneous endodermis. epidermis. dermis.

An example of a superficial burn would be a(n)

Correct! sunburn. severe scalding. eschar. thermal flame burn.

When applying an occlusive dressing to a chest wound, the dressing should be secured on how many sides?

Correct! three one two four

In cases of chemical burns to the eyes, the EMT should flood the eyes with

Correct! water vinegar baking soda and water hydrogen peroxide solution.

Burns are classified according to the of the ____ injury.

Depth

Three types of mechanisms that cause musculoskeletal injuries include ______ force, _______ force, and _____________ force.

Direct; Indirect; Twisting

The EMT should splint suspected dislocations in position unless ____________ are absent

Distal Pulses

List three considerations when treating burns of the eye.

Do not attempt to open eyelids if they are burned If dealing with a thermal burn, apply a dry, sterile dressing to both eyes to prevent simultaneous movement of both eyes Chemical burns should be flushed with water for at least 20 minutes while en route to the hospital Flush the eye from medial to lateral to avoid washing the chemical into the other eye

Which statement about dressings and bandages is true?

Dressings should be placed into open wounds Dressings are placed over bandages Correct! Bandages should not be applied until bleeding is controlled Dressings must be airtight to prevent contamination

List two signs and symptoms of superficial full-thickness burns.

Dry, hard, tough, leathery skin that appears white-waxy to dark brown or black and charred Little or no pain

burns can cause not only severe damage to soft tissues but also internal injuries to the body as a whole.

Electrical

A superficial burn is an injury that involves only the _________ layer of the skin.

Epidermis

The layers of the skin are the:

Epidermis Dermis Subcutaneous layer

The tough and leathery dead soft tissue formed in a full-thickness burn injury is called

Eschar

A traction splint is indicated if there is an isolated _________ fracture.

Femur

If the patient's thigh is painful, swollen, or deformed, the EMT should treat the patient as if the _______ is fractured.

Femur

A common type of bone injury is a break, or

Fracture

As components of the skeleton, bones provide the body's

Framework

A(n) __________-___________ burn, or third-degree burn, is a burn in which all layers of the skin are damaged.

Full Thickness

List the emergency care treatments for open neck wounds.

Place a gloved hand over the wound to control bleeding Apply an occlusive dressing Cover the occlusive dressing with a regular bandage Apply only enough coverage to control bleeding Once bleeding is controlled, apply a pressure dressing If there is suspected spinal injury, provide appropriate spine motion restriction

The ________ system is composed of all the bones, joints, and muscles of the body.

Musculoskeletal

An alternative to the rule of nines for estimating the BSA of a burn involving a small or irregular portion of the body involves using a comparison of the burned area to the patient's

Palm

List at least two of the most important factors in determining burn severity.

Percentage of BSA involved Location of burn Patient's age Preexisting medical conditions

When classifying a burn as either superficial, partial thickness, or full thickness, the EMT would need to determine the:

Percentage of body burned Time of heat exposure Agent causing the burn Correct! Depth of the burn

A patient was trapped in a burning apartment before being rescued by firefighters. As you approach him, you note that his legs and arms are burned. The patient is screaming in pain and coughing, but no longer actively burning. Given this information, which intervention would you perform first?

Perform a secondary assessment to determine if nonburn injuries are present Estimate the percentage of the patient's body that has been burned Determine whether the patient has partial-thickness or deep partial-thickness burns Correct! Decide whether to administer oxygen with a nasal cannula or nonrebreather mask

A patient was burned when he accidentally ignited gasoline while working on his car. When performing your assessment of the injury, which finding would indicate that the patient has suffered a partial-thickness burn?

Pink skin on the left lower leg that is dry and painful to the touch Correct! Painful skin on the abdomen that is moist and contains blisters Intact skin on the wrist that is red and dry and extremely painful when touched Leathery skin on the thigh that exhibits little pain when touched

A male patient has just been burned with hot water and has blisters on his left arm. The EMT would recognize that:

This burn can be classified as superficial Correct! Fluid has collected between the layers of skin Medium and large blood vessels have ruptured This burn shows signs and symptoms of infection

The second step in bleeding control of an extremity bleed when direct pressure has failed is the use of a(n)

Tourniquet

The _________ splint applies constant pull along the length of the femur to stabilize fractures and reduce muscle spasms.

Traction

Dramatic-looking or painful extremity injuries can sometimes distract an untrained person from looking for other life-threatening conditions.

True

If dry lime is the burn agent, do not irrigate the burn with _____ until it has been _________ off the patient.

Water; Brushed

Simple scrapes to the outer layer of the skin are known as

abrasion

The first step an EMT should take when encountering a patient with severe bleeding is to

apply pressure to the wound. Correct! use appropriate Standard Precautions. check the patient's blood pressure. apply a tourniquet.

When administering emergency medical care to a burn patient, clothing that has adhered to a burned area should be

orrect Answer cut around and left in place covered with an antiseptic ointment. covered with a dry, sterile dressing carefully removed from the burned skin.

A patient has full-thickness burns to the fronts of both legs and the entire left arm. Using the rule of nines, the EMT should estimate what percentage of the patient's body has been burned?

32 percent 45 percent Correct! 27 percent 36 percent

Which statement made by the EMT shows an understanding of dressing and bandaging a wound?

"I always bandage across the joint above the wound since this helps control bleeding by applying pressure to the proximal blood vessels." Correct! "I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation is possible." "If bleeding from a wound cannot be initially stopped with direct pressure, I apply a bandage and dressing so I can take care of other injuries." "When applying a bandage over a dressing, I apply it loosely so as not to interfere with circulation to the extremity."

Which statement shows that the EMT understands the palm method of estimating the BSA burned?

"I do not use the palm method on young children since it is inaccurate in this population." Correct! "I use the patient's palm to estimate the size of the burn area." "If I estimate that four palm areas fit into the burn, then the burn is about 8 percent BSA." "I use the palm of my hand to estimate the area of the burn."

A 51-year-old female patient tripped in the kitchen and fell against a deep fryer, splashing hot oil onto her right arm. Assessment reveals partial- and deep partial-thickness burns to her arm. You estimate that the burn covers 4 to 5 percent of her body. Which statement, made by the patient, provides the most important information for determining the overall severity of the burn from a medical standpoint?

"I had a burn like this several years ago." "I think that I lost control of my bladder." Correct! "I have had diabetes for several years." "The doctor said that I scar very easily."

You are having a difficult time controlling bleeding from a small skin avulsion on a patient's ankle. Which statement made by the patient best explains why control has been difficult to achieve?

"I take steroids for my lung disease." "I drank a lot of alcohol last night." "My blood pressure sometimes runs a little high." Correct! "I take Coumadin for my irregular heartbeat."

While riding a bike, a young boy fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhage has clotted off and manual cervical spine motion restriction is being maintained. Which instructions should you provide to the other EMTs on scene?

"Take some sterile gauze and carefully place it inside the open wound to prevent additional bleeding." Correct! "Place an occlusive dressing over the wound and tape it on all four sides." "Apply a sterile dressing over the wound and hold it in place by wrapping roller gauze around his neck." "Do not worry about covering the wound; just place a cervical collar on the patient and carefully transfer him to the long board."

A blood loss of _____ percent will affect the patient's vital signs.

15

A partial-thickness burn is also called a(n) ______ burn.

1st degree Correct! 2nd degree 3rd degree 4th degree

You respond to a single-car accident in which an unrestrained 3-year-old child was thrown from the back seat into the windshield, striking his head. As your partner applies spine motion restriction precautions, you note that the child has a patent airway, is breathing well, and is alert and oriented; however, you also notice that blood and fluid are draining from his right ear. How would you treat the bleeding?

Apply a hemostatic agent to the ear canal Correct! Apply a dressing loosely over the ear to absorb the blood and fluid Quickly cover the ear with your gloved hand Pack the external ear canal to control bleeding, being careful not to rupture the eardrum

A 40-year-old homeless male is found lying in the street. The physical examination reveals that the patient has a stab wound to the mid-chest. He is unresponsive and his skin is cool to the touch. His respirations are snoring at 40 breaths/min and his pulse is 120 beats/min. Which care should the EMT provide first?

Apply a sterile dressing to the wound Correct! Perform a jaw-thrust maneuver Listen to breath sounds Start positive pressure ventilations

The three major types of blood vessels are:

Arteries Capillaries Veins

List five signs and symptoms of partial-thickness burns.

Blisters Intense pain White to cherry-red skin Moist and mottled skin Pain on peripheral edges of burn

A hypoperfusion syndrome that can occur with moderate to major burns that cover sufficient body surface area (BSA) is called

Burn Shock

An intoxicated 28-year-old female has suffered burns to both legs after passing out next to a space heater, which ignited her pants. Emergency Medical Responders have removed her clothing and cooled the burns. Which action is most appropriate in the continued care of this patient?

Carefully wrap the burn with a sterile wet burn sheet Correct! Cover the burns with a clean, white, dry sheet Place ice packs to the burn to continue cooling Clean the burn with sterile saline and cover it with gauze

When managing a patient with a soft tissue injury, it is essential that the EMT performs which action?

Control bleeding with a tourniquet if the bleeding is arterial in nature Cover hematomas with occlusive dressings Thoroughly disinfect dirty lacerations Correct! Use the appropriate personal protective equipment

Burn injuries need to be ______ within approximately the first 10 minutes of injury.

Cooled

Which statement made by an EMT shows that he understands the major cause of death in the prehospital setting for a burn patient?

Correct! "Most burn patients who die before getting to the hospital die of airway or bleeding problems, not the burn itself." "Most patients who die before getting to the hospital die from burn shock, caused by massive fluid loss from the burns." "The most common cause of death for burn patients in the prehospital setting is infection, which can be minimized by applying a sterile burn sheet." "Burn patients most often die before reaching the hospital from the increased body temperature caused by the heat of the burns."

A(n) __________ should never be removed in the field unless it is in the cheek or neck and obstructing airflow through the trachea.

Impaled Object

List four of the factors that may increase bleeding.

Improper dressing application initially Movement Low body temperature Medications Intravenous fluids Removing bandages and dressings prematurely

You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On scene, the patient was alert and oriented, with a patent airway and adequate respirations. There was minimal hemorrhage from the stab wound, which was covered with a sterile dressing. Oxygen was applied and transport was initiated. During the reassessment, which assessment finding should the EMT consider to be of the greatest concern?

Increased redness and edema to the area surrounding the stab wound Correct! Increased heart rate and unexplained restlessness Statement that the pain at the injury is increasing Observation that blood is beginning to ooze from the injury

Which sign of cardiogenic shock would occur the latest?

Increased respiratory rate Increased pulse rate Thready pulse Correct! Decreased blood pressure

With _______ force, the force impacts one end of the limb, causing injury some distance away from the point of impact.

Indirect

Firefighters have pulled a middle-aged male from a burning bedroom. The patient is unresponsive and has obvious deformity of his left ankle. His respirations are rapid, stridorous, and shallow. Your partner inserts an oropharyngeal airway and begins ventilating the patient with a bag-valve mask appropriately. Which action would you perform next?

Instruct your partner to hyperventilate the patient Find out how long the patient was in the burning structure Secure the left ankle to a board splint Correct! Assess the patient's carotid pulse

are the places where bones meet and are a critical element in the body's ability to move.

Joints

All burns normally classified as moderate should be reclassified as __________ in a person younger than 5 or older than 55 years of age.

Major

You have arrived at a scene where a young girl tripped while running, and pushed her arms through a plate glass window while falling. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your partner yells for you to immediately apply direct pressure to the laceration to prevent further blood loss, while he works to control the airway. You have yet to apply gloves, but your uniform shirt has long sleeves, and you normally wear prescription glasses. What would you do next?

Place a tourniquet above the laceration, being careful not to get blood on your hands Control bleeding by pushing the skin of the laceration together until you can apply gloves Correct! Apply gloves prior to applying direct pressure over the injury site Apply direct pressure to the site with your forearm until someone with gloves can take over

he point of realignment of deformed extremities is to assist in restoring effective ________ , motor function, and ___________ .

Pulse; Sensation

List the four types of bandages.

Self-adhering bandage Gauze roll Triangular bandage Splint

A 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which dressing is best for this injury?

Self-adhering roller gauze Sterile gauze Moist sterile gauze Correct! Occlusive dressing

Severe internal bleeding can result in a rapid progression of hemorrhagic _________ and death in a matter of minutes.

Shock

A male patient has been shot in the chest with a small-caliber gun. Which presentation indicates that he is in an early stage of shock?

Slightly confused, pulse 116 beats/min, BP 112/90 mmHg, warm and flushed skin Confused, pulse 44 beats/min, BP 110/68 mmHg, cool and cyanotic skin Confused and anxious, pulse 144 beats/min, BP 82 mmHg/palpation, cool and mottled skin Correct! Alert and anxious, pulse 96 beats/min, BP 134/88 mmHg, pale and cool skin

Proper ________ and prehospital care of musculoskeletal injuries can help prevent closed injuries from becoming __________ injuries.

Splinting; Open

Whenever bleeding is suspected or discovered, the use of ____________ is essential for the EMT to avoid exposure of the skin and mucous membranes.

Standard Precautions

Examples of superficial burns include a minor_______ Injury

Sunburn

are bands of connective tissue that bind the muscles to the bones.

Tendons

Which statement regarding contusions is true?

The epidermis is open and actively bleeding Blood vessels in the subcutaneous layer have been broken Blood vessels in the epidermis have broken but the skin is intact Correct! Blood vessels in the dermal layer have ruptured

The type of shock most commonly caused by profound blood or fluid loss is

cardiogenic shock. irreversible shock. Correct! hypovolemic shock. vasogenic shock

Treatment for exposed internal abdominal organs can include all of the following except

flexing the patient's hips and knees in the absence of suspected spinal injury. Correct! placing the organs back into the opening. covering the organs with a sterile moist dressing applying high-flow oxygen.

A(n) _____ temperature may make the clotting process slower and less effective.

high body Correct! low body high room low room

A wound in which there is no open pathway from the outside to the injured site is called a(n):

impailed wound open wound superficial wound Correct! closed wound

An injury caused by scraping, rubbing, or shearing away of the skin is a(n)

laceration Correct! abrasion contusion avulsion