EMT Ch 21-30 Block Exam 3
Sympathomimetics (ex epinephrine, albuterol, cocaine, methamphetamine
Speeds up things: hypertension, tachycardia, dilated pupils, agitation or seizures, hyperthermia
When worn properly, a seatbelt should lie
below the anterior superior iliac spine of the pelvis & against the hip joints
An epidural hematoma is MOST accurately defined as
bleeding between the skull & dura mater
Mediastinum
space within chest that contains heart, major blood vessels, vagus nerve, trachea, major bronchi, & esophagus located between 2 lungs
Secondary injury in collision in motor vehicle crash likely caused by?
steering wheel collapsing
In a non trauma patient with internal bleeding
take an orthostatic pressure, standing & sitting or sitting & standing or laying down & sitting etc
Cerebral Concussion
temporary loss or alteration of brains ability to function
Which of the following statements regarding basilar skull fracture is correct?
the absence of raccoon eye or battle signs doesn't rule it out
Airbags main purpose
to decrease severity of deceleration
Cerebellum
underneath great mass of cerebral tissues, "little" brain
In general, INJECTED poisons are impossible to dilute or remove because
usually absorbed quick into body
Which of the following statements regarding physical exam of a patient with behavioral problems is correct?
Although physical exam can be difficult, the patients emotional state may be determined by noting facial expression, pulse rate, & respiration
Someone is in shock/hypoperfusion
maintain heat, apply O2 & transport
Linear Skull Fracture
(non displaced skull fractures) account for 80 of skull fractures; occur in temporal-parietal region of skull; not associated with deformity of skull; if scalp laceration, risk of infection & bleeding inside brain
Activated charcoal dose
1g of activated charcoal of body weight; usual adult dose 30-100g; child dose 15-30g for children under 13
when will significant amount of blood loss show in a child?
3-6 oz (100 -200mL) blood loss, the body can't tolerate blood loss greater than 20% of total blood volume
During altercation in. a bar, 2 patrons got into fist fight. The 1st patient, 44 year old female, was struck in mouth & refuses EMS care. 2nd patient, 39 year old female, has small laceration to her left knuckle & also refuses EMS care. Which of the following statements regarding scenario is correct?
39-year old is at high risk for infection
Which of the following is a severe burn in a 35-year old patient?
Circumferential partial-thickness burn to chest
Activated charcoal may be indicated for a patient who ingested?
Aspirin
During your assessment of a patient with blunt chest trauma, u note patient has shallow breathing & paradoxical movement of left chest wall. You should
Assist ventilations with bag valve mask
Female experienced laceration to left eyeball from flying glass when her bf broke a soda bottle against a wall. Theres moderate bleeding & patient states she can't see out of injured eye. You should
Avoid applying pressure to the globe when u are covering the eye
The phrenic nerve control the diaphragm & exit spinal cord at
C3, C4, C5
What is rape?
Criminal diagnosis not medical; sexual intercourse inflicted on another person against that persons will
Worst head injury?
Epidural hematoma, accumulation of blood between skull & dura mater; usually result of blow to head that produces linear fracture of temporal bone & damages middle meningeal artery
What may be causing hematemesis (vomit in blood)?
Gastric bleeding
Common Activated charcoal names?
InstaChar; Actidose, & liquidChar
Which of the following is of LEAST importance when initially assessing severity of a burn?
Known drug allergies
Conscious patient in behavioral crisis or psychiatric emergency will not answer your questions
Look at patients eyes; blank gaze or rapidly moving eyes may be experiencing central nervous system dysfunction
22 year old male with history of clinical depression called 911 & stated attempted to kill himself, he is unresponsive & cyanotic, with empty bottle of pills
Open airway
Airborne substances are diluted with?
Oxygen
A patient who presents with profound cyanosis following a chest injury
Requires prompt ventilation & oxygenation
Pinned between a flatbed truck & loading dock. on exam, find bruising to chest, distended neck vessels, bilaterally diminished breath sounds & bilateral scleral hemorrhaging. You should
aggressively manage airway
A 17 year old male was shot in the chest during altercation, As ur partner apply oxygen, u perform rapid assessment & find open chest wound with small amount of blood bubbling from it. You should
apply an occlusive dressing to wound & continue ur assessment
Chest wound is bubbling what do you do?
apply occlusive bandage
Head injury intervention
apply positive pressure ventilation & immediately asses to make sure working
When assessing soft-tissue injuries
be alert for more serious underlying injuries; critical mistake neglecting more life threatening conditions
Phrenic Nerve
c3,c4, c5; innervates the diaphragm muscle, allowing it to contract; necessary for adequate breathing; controls diaphragm
The MOST common & serious complications of a significant head injury is
cerebral edema
Patient experiences syncope (fainting)
check for shock 1st
Someone who overdoses on opiate, whats the 1st thing you do?
check the airway
39-year-old female experienced severe closed head injury. She is unresponsive with her eyes slightly open, her pupils are bilaterally dilated & slow to react. In addition to managing problems with ABCs, u should
close her eyes and cover them with moist dressing
Live & spleen injuries to abdomen overlooked
closed injury to abdomen; liver & spleen injuries & bleeding into peritoneal space, pain is referred to shoulder; can be misleading if shoulder is also injured; blunt force trauma, some type of impact to body, results in injury to ab without breaking skin; ex motor cycle crashes, falls, blast injuries, pedestrian injuries, compression, deceleration
Rapid deceleration of head, such as when it impacts windshield, causes
compression injuries or bruising to anterior portion of brain & stretching or tearing to the posterior portion of the brain
Frontal & parietal bones of skull are especially susceptible to
depressed skull fracture
A partial thickness burn involves outer layer of skin and a portion of
dermal layer
A Patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced
detached retina
Accumulation of blood loss in abdominal cavity will MOST likely cause
distention
Rollover motor vehicle collision
eject or partially ejected most dangerous
Kinetic energy
energy of moving object; reflects the relationship between the mass (weight) of object & velocity (speed) at which it is traveling
Fall and land on feet
energy transmitted to spine, sometimes producing spinal injury in addition to pelvis & legs; adults fall more than 20 ft & child more than 10 ft; or unrestrained passenger smashes into interior of vehicle; immobilize c-spine, focused exam check back
If you faint and fall from standing position
focus exam should be on what caused the fainting
Work
force acting over distance ex force needed to bend metal multiplied by distance over which metal is bent is the work that crushes the front end of a vehicle that is involved in a frontal impact
Reflective listening technique
frequently used by health professionals to gain insight into patient's thinking; Repeating, in question form, what patient said, encouraging the patient to expand on his or her thoughts
Whenever possible, a female sexual assault victim should be
given the option of being treated by a female EMT
When a woman present with abdominal pain or other vague symptoms, EMT is often unable to determine the nature of problem until he or she
has gathered patient history information
Cushing Triad
head injury significant enough; increased blood pressure (hypertension), decreased heart rate (bradycardia), & irregular respirations
Depressed Skull Fracture
high-energy direct trauma to head with blunt object (ex baseball bat); frontal & parietal bones of skull most susceptible thin; bony fragments may be driven into brain; loss of conscious
Basilar Skull Fracture
high-energy trauma, usually occur following diffuse impact to head (ex falls,motot vehicle crashes); extension from linear fracture to the base of the skull & diagnosed with CT scan
spinal injury steps
hold manual c-spine, check pos, apply collar, & secure to board
an organ or tissue maybe better able to resist damage from hypoperfusion
if the body temp is considerably less than 98.6
Mesentery
intestinal blood supply; fold of tissue that contains a web of vessels, both arteries & veins, nerves, & lymphatic tissue; connects small intestine to posterior of ab wall; vascular, blunt & penetrating injuries can bleed into peritoneal cavity; bruising around belly button
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around umbilicus. This is a sign of
intra-abdominal bleeding
Circumferential burns of chest
is most severe and can compromise airway
laceration
jagged cut in the skin caused by sharp object or a blunt force tears the tissue; it is NOT a clean cut with a scalp
If patient has slow breathing & want to bring it up, if we have the ability to measure ECTO2
keep it between 30-35 mm of mercury
Cerebrum
largest part of brain (gray matter); composed of 4 lobes frontal, parietal, temporal, occipital; one side of brain controls opposite of body
Retina
light sensitive area of eye where images projected; layer of cells at back of eye changes light image into electric impulses, which are carried by optic nerve of brain
Vagus Nerve
longest cranial nerve, contains motor & sensory fibers, passes thru neck & thorax to abdomen
In a gynecologic emergency, main focus
maintain ABCs & transport without delay
Early signs of intra-abdominal bleeding include
pain & distention
The _____nerves control the diaphragm
phrenic
Potential Energy
product of mass (weight), force of gravity, & height & is mostly associated with energy of falling objects ( as worker falls from height, potential energy converted into kinetic energy, as worker hits ground, kinetic energy is converted into work, work of brining body to a stop & thereby fracturing bones & damaging tissue
Mucous Membrane
protection barrier against bacterial invasion, secrete watery substance that lubricates openings; mouth, nose, anus, vagina (not cover by skin)
Early bruising following abdominal trauma often manifests as
red areas of skin
The Optic nerve (cranial nerve transmits visual info to brain) endings are located within
retina
White portion of eye
sclera
What do motor nerves do
send impulse to muscle
Retinal Detachment
separation of retina from its attachment of back of eye
Open Skull Fracture
severe forces applied to head & associated with trauma to multiple body systems; brain tissue may be exposed, increases bacterial infection (bacterial meningitis) high mortality rate
The presence of tachycardia following a significant abdominal injury
should be assumed to be a sign of shock
Which of the following organs can tolerate inadequate perfusion for 2-3 hours
skeletal muscles
Activated charcoal side effects
vomiting, nausea, constipation, black stool