CH 29, CH30, CH31, CH32

A​ 23-year-old male sustained a musculoskeletal injury to his leg while playing organized football. He reports that his cleated foot was planted into the field when he was hit with a force that caused him to rotate. He heard a snap at this point. What mechanism of injury was​ applied?

Twisting force

The skin is the largest organ of the body. It is composed of three​ layers, including​ the:

epidermis

A type of musculoskeletal injury involving the bones that can be classified as open or closed is​ a:

fracture

White and dry to dark brown or black and charred skin is a sign of​ a:

full thickness burn

What is the primary risk for electrical injury​ patients?

Respiratory or cardiac arrest

What must happen for a joint to​ dislocate?

Soft tissue and ligaments must be stretched.

Which layer of the skin provides shock absorption and​ insulation?

Subcutaneous

What is an example of classifying a burn by agent and​ source?

Thermal burn from excessively hot coffee

Your patient has burns to the entire right arm and the anterior chest. What is the estimated surface area​ involved?

18%

Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso​ (chest and​ abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface​ burned?

22.5%

Which of the following physiological events generally indicates the onset of decompensated​ shock?

A drop in the​ patient's blood pressure

Which of the following is most likely to cause cardiogenic​ shock?

A massive MI that impairs the pump function of the heart

When assessing a​ patient, consider the possibility of closed​ soft-tissue injuries whenever there is​ swelling, pain, or​ deformity, as well​ as:

A mechanism of blunt trauma

Which of the following statements is true of a compression​ injury?

A mechanism of injury involving a compression injury could be a driver striking his chest on a steering column.

You are performing a secondary assessment on your​ 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point​ to?

A punctured lung

It is characteristic of arterial bleeding to​ be:

ABUNDANT

In a patient with uncontrolled hemorrhage due to a traumatic​ amputation, which of the following interventions is likely to be most​ effective?

Application of a tourniquet

You are treating a patient who was stabbed in the right side of the anterior chest wall. He has shortness of​ breath, weakness, and rapid breathing. Aside from administering​ oxygen, what is the most appropriate treatment for this​ patient?

Apply an occlusive dressing on the chest​ wall, and tape the dressing on three sides.

Which of the following statements is​ true?

Arteries carry blood from the heart.

You are called to the scene of a patient who was burned by an electrical shock while installing a washing machine. On your​ arrival, the patient is lying beside the washing machine on which he was working. What is your first consideration for this​ patient?

Assume the source of electricity is still active.

A patient with an abdominal injury will likely want to keep the legs in what position to reduce​ pain?

BENT

In bandaging a hand​ wound, what important consideration is​ necessary?

Bandage the hand in the position of function.

What type of injury is likely to produce a flail​ segment?

Blunt trauma

During severe​ bleeding, which of the following structures is most sensitive to hypoxia from blood​ loss?

Brain

Your patient has sustained a chemical burn to her hands from dry lime. How is this treated in the​ field?

Brush off the powder before using water to flush

TRUE STATEMENT

Bullet wounds are a type of penetrating​ trauma, and involve both internal and external injuries.

You are caring for a victim who was rescued from a burning building by the fire department. The patient is alert and oriented with superficial burns to the​ arms, chest,​ neck, and face. He complains that he cannot breathe well. What is this​ patient's most critical​ injury?

Burns to the face

How does the skin provide temperature​ regulation?

By altering the blood flow to the skin and by controlling perspiration

You are dispatched to the local​ park, where a​ 15-year-old male is in sudden cardiac arrest after being struck in the chest by a ball. As you arrive at the​ patient, you should immediately do which of the​ following?

Confirm pulseless arrest and begin CPR

A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can​ talk, and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the highest priority in this​ patient's assessment and​ treatment?

Care for spine​ injuries, head​ injuries, and severe fractures.

You arrive on scene to a private​ residence, where you find a​ 56-year-old female patient sitting in her living room complaining of​ pain, paresthesia, and pressure in her lower right leg. She states that a few days​ ago, she slipped on her way​ downstairs, and has had pain in her leg ever​ since, but she has not been to the doctor. During your​ examination, you note that her right lower leg is pale and pulseless. You see swelling and palpate hardness compared with the uninjured left lower leg. Based on these​ findings, the patient is most likely experiencing which of the following​ conditions?

Compartment syndrome

You are dispatched to the scene of a construction site where a​ 33-year-old male has been impaled with a piece of rebar to his right anterior chest near the clavicle. The rebar is too long to allow transport of the patient. The patient is alert and seated on the ground. How should you manage this​ injury?

Contact medical control and ensure someone stabilizes the object while it is gently cut to the desired length.

You are caring for a​ 46-year-old female who accidentally sustained burns to her left hand up to the wrist from boiling water. You arrive moments after the incident. Of the​ following, which should you do​ first?

Cool the burned area to stop the burning process.

When treating a patient with an open musculoskeletal injury to the​ thigh, how would you best treat the open​ wound?

Cover the open wound with a sterile​ dressing, elevate the​ extremity, and apply a cold pack to the area to help reduce swelling.

The layer of skin that is rich with blood​ vessels, nerves, and specialized structures is​ the:

DERMIS

You suspect that your patient has a tension pneumothorax. During patient​ assessment, which of the following findings would most lead to this​ suspicion?

Diminished or absent lung sounds on side affected by​ trauma; jugular venous​ distention; signs of shock

Which method is the least invasive and can control bleeding in most​ cases?

Direct pressure

Which of the following outlines the​ steps, in order of​ preference, for controlling​ bleeding?

Direct​ pressure, use of hemostatic​ agents, and tourniquet application

You arrive on scene to the local​ park, where you are presented with a​ 20-year-old male complaining of severe left shoulder pain. The patient states he fell on the ground and immediately felt a sharp pain in the shoulder. As you evaluate the​ shoulder, you note that the left shoulder sits lower than the right. He has intact distal​ pulse, motor, and sensory​ function, but his shoulder is locked in place and he cannot move it without severe pain. Based on the assessment​ findings, the patient is most likely suffering from which of the​ following?

Dislocation

Which of the following is true regarding decompensated​ shock?

During decompensated​ shock, the body can no longer compensate adequately.

You arrive on scene to a residence where you find a​ 16-year-old female patient who was shocked while plugging in an appliance in the garage. Her father states that he heard the shock and saw her get​ "thrown to the​ ground." The patient is awake and​ alert, and still lying on the ground. Based on the​ patient's presentation, how should you manage this​ patient's injury?

Evaluate the patient for spine injuries and stabilize the spine.

Which of the following statements about puncture wounds is​ correct?

Even​ insignificant-looking puncture wounds can cause devastating injuries.

Which patient most likely has an abdominal​ injury?

Patient tries to lie still with legs drawn up.

You are on scene with a​ 45-year-male who lacerated his hands while working in his garage. The bleeding is dark red and has a steady flow. What is the best way to manage this​ patient's hemorrhage?

Firmly bandaging a dressing in place

What is the resulting injury called when the burn penetrates all the way to the bottom layer of​ skin?

Full thickness

You are caring for a​ 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be most preferred in managing this​ wound?

Gloves and a face shield

Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is​ this?

Hematoma

The skin serves which of the following​ functions?

Protection

A​ 49-year-old male patient was injured with a chain saw while cutting down a tree. He sustained a​ deep, jagged laceration to his left thigh. On​ arrival, you find him to be conscious but breathing​ rapidly, with a rapid pulse and​ cold, clammy skin. What type of shock would you suspect that he is​ in?

Hypovolemic shock

In trauma​ patients, which form of shock is the most​ common?

Hypovolemic shock

You are called to the scene of a metal fabrication​ plant, where you are presented with a​ 30-year-old male patient complaining of bilateral severe eye pain. Upon​ examination, you notice both eyes are red and irritated. Patient states that one of the dyes he was working with splashed into his eyes. How would you manage this​ patient's injury?

Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility

What is the primary concern about a splint that is applied too​ loosely?

It could allow the bone fragments to​ move, which could cause further damage.

What organ in the abdomen is most commonly injured by blunt​ trauma, and can bleed profusely enough to threaten the​ patient's life?

LIVER

You arrive on scene to an assault. Law enforcement has secured the scene. Your patient is a​ 23-year-old male with a​ blood-soaked shirt. The patient states that the assailant​ "slashed at him with a box​ opener." You expose the chest and note a jagged cut on his left anterior chest with​ steady, dark red hemorrhaging. Based on this assessment​ finding, the wound is most likely which of the​ following?

Laceration

Which element of the musculoskeletal system belongs to the lower extremities of the appendicular​ skeleton?

Legs

In a​ dislocation, what structures other than the joint capsule are likely to be​ injured?

Ligaments

You arrive on scene to a​ 34-year-old male gunshot victim lying in his living room​ disoriented, pale,​ cool, and​ diaphoretic, with shallow respirations. You note blood on his shirt at the chest and​ abdomen, and the puncture wound appears to be through the chest. What is your first priority in treating this​ patient?

Locate the gunshot wound on the​ chest, and place your gloved hand over the injury

Damage to which of the following organs is least likely in the case of abdominal​ bruising?

Lungs

In treating open wounds to the neck or​ abdomen, which type of dressing is​ preferred?

Occlusive dressing

SIX P'S

PAIN, PALLOR, PARESTHESIA,PULSES,PARALYSIS,PRESSURE

The term used for the delivery of oxygen and nutrients from the blood through the thin capillary walls into the cells and the removal of carbon dioxide and other waste products from the cells​ is:

PERFUSION

Which of the following is the best sign of a pelvic​ injury?

Pain in the​ pelvis, significant mechanism of​ injury, obvious deformity

In shock​ states, what general principle can be observed regarding​ perfusion?

Perfusion in some areas is inadequate because the circulatory system malfunctions.

To stabilize a hip​ fracture, how should you bind the legs​ together?

Place a folded blanket between the​ patient's legs and bind the legs together with wide​ straps, Velcro-equipped​ straps, or wide cravats.

When a patient has significant blood​ loss, which of the following clinical findings would you expect to find that signifies the presence of​ shock?

Rapid heart rate

Which of the following principles may help the most in ensuring the survival of a patient who is suffering from shock due to massive​ trauma?

Rapid transport to an appropriate facility

Which of the following should be applied to provide stability for an upper arm​ injury?

Sling and swathe

Injury to which of the following organs would be most likely to cause​ peritonitis?

Small intestine

A bruise on the abdomen could indicate injury to which of the​ following?

Spleen, liver, or kidneys

While assessing the abdomen of a​ 25-year-old female, you note that she has a large piece of glass sticking out of her right upper quadrant. What should you​ do?

Stabilize the glass

An open chest wound that pulls air into the thoracic cavity is known as what type of​ injury?

Sucking

Which of the following is most clearly an example of an open chest​ injury?

Sucking chest wound

You respond to the scene of a​ 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his​ chest, where you notice a puncture wound. From what is this patient most likely​ suffering?

Tension pneumothorax

In a​ contusion, what remains​ intact?

The epidermis

Why is it so important to seal holes in the chest from penetrating trauma as early as​ possible?

The lungs may collapse if air and blood displace lung tissue.

A​ 14-year-old girl has fallen from her bicycle. She sustained injuries when she landed with her arm extended to catch her fall. According to the principles of indirect mechanisms of​ injury, which of the following bones is least likely to have been injured in this​ fall?

Thoracic vertebra

What is the purpose of a​ flutter-valve occlusive​ dressing?

To allow air to escape but not enter

You are treating a​ 42-year-old male assault victim who presents with​ nausea, vomiting, and sharp abdominal pain. While inspecting his​ abdomen, you note redness to his right upper quadrant. Based on your assessment​ findings, the patient is most likely suffering from which of the​ following?

Traumatic hemorrhage of the liver

Your​ 35-year-old female patient has accidentally cut her forearm with a kitchen knife. You notice that the blood is dark red and has a steady flow. The patient is concerned she may have​ "cut an​ artery." Based on this​ finding, you should tell her that the source of the hemorrhage​ is:

VEIN

Which of the following is a guideline for the treatment of chemical​ burns?

Wash away the chemical with flowing water

Why does a patient in shock secondary to blood loss develop​ pale, cool, and clammy​ skin?

When the body senses low blood​ volume, it diverts blood from nonvital areas to vital organs.

If you see angulation when assessing a​ patient, then:

a bone or bones are out of anatomical position.

The first step in the progression of compartment syndrome is​ that:

a fracture or crush injury causes bleeding or swelling in an extremity.

The severity of external bleeding is influenced by several​ factors, including the bleeding​ person's:

ability to clot.

All burns are to be treated as more serious​ if:

accompanied by other injuries or medical problems.

A fracture in which the broken bone segments are at an angle to each other is​ called:

an angulated fracture.

Severe abdominal trauma and blood loss may cause signs and symptoms of​ shock, which​ include:

an increased heart rate.

A burn injury should be considered to​ be:

an injury with the potential for many​ far-reaching effects.

Some local protocols recommend that an abdominal evisceration should be covered with a sterile dressing moistened with sterile​ saline, followed​ by:

an occlusive dressing.

The humerus is an example of​ a(n):

appendicular bone.

Your patient suffered a severe electrical burn injury. In your emergency​ care, you should​ always:

assess for an entrance and an exit wound.

When performing a primary assessment of a patient with musculoskeletal​ injuries, you​ should:

avoid your focus being distracted by the most dramatic extremity injuries.

When a flap of tissue is traumatically​ removed, this condition is called​ a(n):

avulsion

When​ crushed, the liver and​ spleen:

bleed profusely and cause shock.

Cardiac tamponade occurs​ when:

blood enters the pericardial sac surrounding the heart.

Shock is typically caused by a problem with the​ heart, fluid​ volume, or:

blood vessels.

In the case of a large​ evisceration, you should place layers​ of:

bulky dressings over a dressing moistened with saline.

Microscopically small structures in the circulatory system that supply every cell in the body​ are:

capillaries

Jugular venous distention is most likely observed​ with:

cardiac tamponade

You are caring for a​ 62-year-old male patient who complains of chest​ pain, shortness of​ breath, and nausea. His heart rate is more than​ 120, and his blood pressure is​ 90/60. You notice some pallor and peripheral cyanosis on his​ cool, clammy skin. He is most likely suffering​ from:

cardiogenic shock.

It is true that all bleeding involving external blood​ loss:

carries the risk of transmitted infection.

An internal injury with no open pathway from the outside is​ called:

closed

A fracture that results in multiple bone pieces at the fracture site is termed​ a:

comminuted fracture

When palpating a fracture site on a​ patient's mid-thigh, you notice a grating sensation. This is known​ as:

crepitus. Crepitus is a grating sensation or sound made when fractured bone ends rub together.

​Rapid, shallow​ breathing; pale,​ cool, clammy​ skin; and a low blood pressure in a patient with an abdominal injury are signs​ of:

developing shock.

To control​ bleeding, start​ with:

direct pressure and elevation.

The method of bleeding control that is the first and most successful method to try​ is:

direct pressure.

The sterile material that is placed directly on a wound is termed​ the:

dressing

Application of a cervical collar to a patient should​ happen:

during the secondary assessment.

Once a pressure dressing has been​ applied, the EMT should​ next:

ensure that bleeding is controlled.

​Generally, when providing emergency care of open​ wounds, the first thing you would do​ is:

expose the wound.

A fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment is called​ a:

flail chest

A swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel is​ a(n):

hematoma

An open wound to the​ chest, if an occlusive dressing is not​ available, should be​ sealed:

immediately with a gloved hand.

For a​ high-priority, unstable patient with musculoskeletal​ injuries, you​ should:

immobilize the whole body on a long spine board and​ "load and​ go."

Guidelines for splinting​ long-bone injuries​ include:

immobilizing the hand or foot in the position of function.

Hypoperfusion​ is:

inadequate blood flow to the tissues.

An injury to the hollow organs in the abdomen typically leads​ to:

inflammation and infection.

When caring for a patient with an impaled object in the​ abdomen, the EMT​ should:

leave the impaled object in place and stabilize it with bulky dressings.

The tough connective tissues that bind bone ends together at joints are​ termed:

ligaments

Burns to the face are considered critical​ because:

of the potential for respiratory compromise or eye injury.

A fracture may be classified​ as:

open or closed

A movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is​ called:

paradoxical motion

Bones are covered by a​ strong, white, fibrous material called​ the:

periosteum

When air is present in the chest​ cavity, the injury is called​ a:

pneumothorax

The signs and symptoms of internal bleeding​ include:

poor peripheral perfusion.

Swelling or deformity at the site of a bruise indicates​ a:

possible underlying fracture.

A primary reason for splinting a bone or joint injury​ is:

preventing movement to reduce the chance for further injury.

Burns involving the airway often lead​ to:

respiratory compromise

A​ 22-year-old female patient slipped running down​ stairs, and has injured her right tibia and fibula. You have used an air splint to splint the injury. To test the​ splint, you​ can:

see if you can cause a slight dent in the plastic with fingertip pressure.

Your patient was just involved in a motor vehicle collision. She is breathing very fast and shallowly. You auscultate her lung sounds and find diminished breath sounds on the right side. You suspect that the patient is most likely suffering​ from:

simple pneumothorax

Your patient has a nontraumatic fracture of the left wrist. Appropriate treatment would be​ to:

splint with a padded rigid splint.

Twisting force​ involves:

stretching or tearing of muscles and ligaments.

To see the effect of direct​ force, you would look​ at:

the area of the point of impact.

The first effects of a bone injury are swelling of soft tissue​ and:

the formation of a blood clot in the area of the fracture.

To realign an​ extremity, an EMT grasps the distal extremity while a partner places one hand above and one hand below the injury​ site, and​ then:

the partner supports the site while the first EMT creates gentle manual traction in the direction of the long axis of the extremity.

Burns pose greater risks to infants and children than to adults​ because:

their body surface area is greater in relation to their total body size.

In caring for an amputated​ part, it is important​ to:

wrap the part in sterile gauze and keep it cool.

In treating a puncture wound of the​ eye, if you bandage both​ eyes, it is​ because:

you want to avoid sympathetic eye movement

Internal bleeding may result from a variety of causes. If you suspect that your patient has internal​ bleeding, you should remember​ that:

your suspicion of internal bleeding may be based only on the mechanism of injury.

You are assessing a​ patient, and notice red discoloration with blisters on the legs. This type of burn would be classified​ as:

​partial-thickness.