Emergency Care and Transportation of the Sick and Injured 12e CH30

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade? Widening pulse pressure A rapid, irregular pulse Engorged jugular veins Diminished breath sounds

Engorged jugular veins

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what most likely occurred?

Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

Subcutaneous emphysema is an indication that:

air is escaping into the chest wall from a damaged lung.

An open pneumothorax is:

an open chest wound through which air moves during breathing.

Signs and symptoms of a tension pneumothorax include all of the following, except: profound cyanosis. unilaterally absent breath sounds. altered mental status. collapsed jugular veins.

collapsed jugular veins.

Hemoptysis is defined as:

coughing up blood.

Common signs and symptoms of a chest injury include all of the following, except: localized pain. hematemesis. tachypnea. chest wall ecchymosis.

hematemesis.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support.

The most critical treatment for a tension pneumothorax involves:

inserting a needle through the rib cage into the pleural space.

When a person is lying supine at the end of exhalation, the diaphragm:

might rise as high as the nipple line.

A rapid, irregular pulse following blunt trauma to the chest is most suggestive of a:

myocardial contusion.

A spinal cord injury at the level of C7 would most likely result in:

paralysis of the intercostal muscles.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be most suspicious that this patient has experienced a:

pericardial tamponade.

To avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

pneumothorax.

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

provide ventilation assistance with a bag valve mask.

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress, and his oxygen saturation is 78%. His breath sounds are equal bilaterally, and his jugular veins are normal. You should suspect:

pulmonary contusion.

When assessing a patient with a hemothorax, you will most likely find:

signs and symptoms of shock.

Elevation of the rib cage during inhalation occurs when:

the intercostal muscles contract.

Pleural fluid is contained between the:

visceral and parietal pleurae.