ch. 8 review:
the recommended dimensions for a helicopter landing zone are:
100 x 100 feet. -on a hard or grassy surface that is level. the landing zone should be clear of loose debirs and power lines.
if fertilization has not occured within about ____ days following ovulation, the lining of the uterus begins to separate and menstruation occurs:
14
at what speed will the ambulance begin to hydroplane when there is water present on the roadway:
30 mph. -at speeds of 30 mph or greater the tires can lift off the pavement as water piles up under the tires. this takes the control out of the drivers hands. if hydroplaning occurs, you should gradually slow down instead of jamming on the brakes to avoid losing control of the vehicle.
a newborn is considered to be "term" if it is born after ______ weeks and before _____ weeks:
37, 42 -term gestation ranges between 37 and 42 weeks. an infant who is born before 37 weeks gestation (or weigh less than 5 lb, regardless of gestational age) is considered premature. an infant born after 42 weeks is considered past due.
the 1 min apgar score of a newborn reveals that the baby has a heart rate of 90 beats per min, a pink body but blue hands and feet and rapid respirations. the baby cries when the soles of its feet are flicked and resists attempts to straighten its legs. you should assign an apgar score:
8 -the apgar score, which is obtained 1 and 5 minutes after birth, assigns a numeric value to the following five areas: appearance, pulse, grimace, activity and respirations. a heart rate below 100 beats min is assigned a 1; a pink body with blue hands and feet is a 1; rapid respirations is a 2; a strong cry in reactions to a painful stimulus is a 2; and resistance against an attempt to straighten the hips and knees is a 2. added together the apgar score for this infant is 8.
all of following are examples of passive rewarming techniques, except:
administering warm fluids by mouth -passive rewarming involves allowing the patients body temp to rise gradually and naturally. removing cold wet clothin; turning up het in ambulance and covering the patient with warm blankets are examples of passive rewarming. administering warmed fluids by mouth or intravenously is an example of active rewarming; this should be avoided in the uncontrolled prehospital setting.
when caring for a patient with facial trauma, the emt should be most concerned with:
airway compromise -no airway, no patient. injuries to the fact often cause obstruction of the upper airway, either by clotted blood or associated swelling. additionally, large amounts of blood can be swallowed, which increases the risks of vomiting and aspiration. bleeding control, spinal trauma and associated injuries are important factors and should be treated accordingly; however airway comes first.
when assessing a conscious and alert 9 year old child, you should:
allow the child to answer your questions -9 year old capable of answering questions. by allowing a child to answer ur questions, you can gain his or her trust and build a good rapport which facilitates further assessment and treatment. do not isolate the child from their parent, yet do not allow the parent to do all talking, unless the child is unable to communicate. when assessing any patient, you should place urself at or slightly below the patients eye level. this position is less intimidating and helps minimize patient anxiety.
shortly after ascending rapidly to the surface of the water while holding his breath, a 29 year old driver begins coughing up pink, frothy sputum and complains of dyspnea and chest pain. you should and treat this patient for:
an air embolism -signs of an air embolism, which presents after a person rapidly ascends to the surface of the water while holding his or her breath, include skin mottling, pink froth at the mouth or nose, muscle or joint pain, dyspnea and or chest pain, dizziness, nausea or vomiting, visual impairment, paralysis or coma and even cardiac arrest.
when the chest impacts the steering wheel during a motor vehicle crash with rapid deceleration, the resulting injury that kills almost one third of patients usually within seconds is:
aortic shearing -when the chest impacts the steering wheel following rapid fprward decerleration, aortic injuries (shearing or rupture) are the cause of death in nearly two thirds of patients. the aorta is the largest artery in the body; when it is sheared from its supporting structures or ruptures outright, exsanguination (bleeding to death) occurs, usually within matter of seconds.
other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include:
applying an occlusive dressing, secured by trauma dressings -although preferred management for an abdominal evsiceration includes applying mois sterile dressing covered by dry dressing, protocols in some ems systems call for an occlusive dressing, secured by trauma dressings. an occlusive dressing may help prevent loss of body heat thru an abdominal wound.
which of the following mechanisms of injury would most likely cause a crushing trachea injury of larynx and or trachea:
attempted suicide by hanging. -any crushing injury of upper part of neck is likely to involve the larynx or trachea. examples include the anterior neck impacting a steering wheel, hanging mechanisms, and clothesline injuries.
the term hematuria is defied as:
blood in urine -following trauma, the presence of hematuria suggests injury to the urinary bladder or kidneys. bright red blood in the stool is called hematochezia; dark tarry stools are called melena. vomiting up blood is called hematemesis.
as you are assessing a 24 year old man w a large laceration to the top of his head, you should recall that:
blood loss from scalp laceration may contribute to hypovolemic shock in adults. -although scalp is highly vascular and tends to bleed heavily when injured, scalp injuries are rarely the sole cause of hypovolemic shock in adults. however, they can contribute to hypovolemia caused by injuries elsewhere in body. scalp lacerations, whether deep or superficial, should prompt you to look for more serious underlying injuries, such as a skull fracture. if the injury involves an avulsion, the avulsed flap of skin should be carefully replaced to its original position, not cut away.
shivering in the presence of hypothermia indicates that:
body is trying to generate more heat thru muscular activity
the brain, a part of the CNS is divided into the:
cerebrum, cerebellum and brain stem. -brain and spinal cord comprise the CNS. the brain is divided into 3 major regions: cerebrum (largest), cerebellum, and brain stem. each region of brain carries out specific functions.
what is the narrowest portion of the uterus:
cervix -the ovaries are the primary female repro organ. the developing embryo travels into the uterus thru the fallopian tube. the embryo attaches to the uterine wall and continues to grow. the narrowest portion of the uterus is the cervix which opens into the vagina.
if an injured patient needs to be moved but is not in immediate danger from fire or building collapse, you should first:
check patients airway, breathing and circulation -the only time your attention should be directed away from the primary assessment of the patient is when the patients life or your life is in immediate danger.
immediately after delivering of the infants head, you should:
check the position of the umbilical cord -immediately following delivery of the infants head, you should check the position of the umbilical cord to make sure it is not wrapped around the babys neck (nuchal cord) if a nuchal cord is not present suction the infants mouth and nose.
signs of a cardiac tamponade include all of the following except:
collapsed jugular veins -cardiac tamponade which is almost always caused by penetrating chest trauma, occurs when blood accumulates in pericardial sac. this impairs the hearts ability to contract and relax; as a result, the systolic blood pressure decreases and the diastolic blood pressure increases (narrowing blood pressure). because the heart cannot adequately eject blood, blood backs up beyond the right atrium, resulting in jugular venous distention. in some cases heart tones may be muffled or distant. other signs include a weak rapid pulse and hypotension.
a 14 year old baseball player was hit in the chest w a line drive. he is in cardiac arrest. which of the following is the most likely explanation:
commotio cordis -this is blunt chest injury caused by a sudden direct blow to the chest that occurs only during the critical portion of a persons heartbeat. the result may be immediate cardiac arrest. the blunt force causes ventricular fibrillation that responds positively to defibrillation within the first 2 minutes after injury.
a 44 year old man was struck in the back of the head and was reportedly unconscious for approx 30 seconds. he complains of a severe headache and seeing stars and states that he regained his memory shortly before your arrival. his presentation is most consistent w a:
concussion -a concussion occurs when the brain is jarred around inside the skull. it may result in a brief loss of consciousness and occasionally amnesia. seeing stars is a common finding following trauma to the back of the head (occiput) as this region is primarily responsible for vision. concussion is least severe of all closed head injuries and typically does not result in physical damage of the brain. compared to a concussion, a contusion, subdural hematoma, and intracerebral hemorrhage are usually associated with a more prolonged loss of consciousness.
when a person is looking at an object up close the pupils should:
constrict -the pupils which allow light to move to the back of the eye, constrict in bright light and dilate in dim light. the pupils should also constrict when looking at an object farther away; this is called pupillary accommodation. these pupillary adjustments occur almost instantaneously.
when a person is exposed to cold temps and strong winds for an extended period of time, he or she will lose heat mostly by:
convention -convention occurs when heat is transferred to circulating air, as when cool air moves across the body surface. a person wearing lightweight clothing and standing outside in the cold, windy weather is losing heat to the environment mostly by convection.
you are assessing a 27 year old woman with a heat related emergency. her skin is flushed, hot and moist and her loc is decreased. after moving her to a cool environment, managing her airway, and administering oxygen, you should:
cover her with wet sheets and fan her -this patient is experiencing heat stoke. after moving her to a cooler area, managing her airway, and administering oxygen, the single most important treatment for her involved rapid cooling. turn on the ac in the back of the ambulance, cover her with a wet sheet and begin fanning her. consider applying chemical ice packs to her groin and axillae. untreated heat stroke almost always results in death due to brain damage.
while assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. she tells you that she feels the urge to push. you should:
cover the arm with a sterile towel and transport immediately. -limb presentations do not deliver in the field- period. if the mother feels the urge to push, instruct her to stop; she should pant instead. cover the protruding limb with a sterile towel, administer high flow oxygen to the mother and transport immediately. delivery must take place in the hospital.
during your assessment of a patient who was stabbed, you see an open wound to the left anterior chest. your most immediate action should be to:
cover the wound with an occlusive dressing -if you encounter an open chest wound, you must cover it with an occlusive dressing. this will prevent air from moving in and out of wound. after the dressing is applied, you must monitor the patient for signs of developing tension pneumothorax.
the presence of subcutaneous emphysema following trauma to the face and throat is most suggestive of:
crushing tracheal injury -crushing injuries or fractures of the larynx or trachea can result in leakage of air into the soft tissues of the neck. the presence of air in soft tissues produces a characteristic crackling sensation called this.
a patient experienced a severe compression to the chest when trapped between a vehicle and a brick wall. you suspect traumatic asphyxia due to the hemorrhage into the sclera of his eyes and which other sign:
cyanosis in face and neck -the sudden increase in intrathoracic pressure results in a characteristic appearance, including distended neck veins, and hemorrhage into the sclera of the eyes, signaling the bursting of small blood vessels.
while inspecting the interior of a wrecked automobile, you should be most suspicious that the driver experienced an abdominal injury if you find:
deformed steering wheel -airbags save lives when used in conjunction with properly worn seatbelts. unfortuately, not all drivers wear their seatbelts. if unrestrained the drivers abdomen may strike the steering wheel, resulting in signif trauma. suspect this if you life the airbag and note that the lower part of the steering wheel if deformed.
when using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall the D stands for:
delay in seeking care -stands for: consistency of injury with childs developmental age, history inconsistent with the injury, inappropriate parental concerns, lack of supervision, delay in seeking care, affect, bruises of varying stages, unusual injury patterns, suspicious circumstances and environmental clues. a delay in care may happen when the parent or caregiver does not want the abuse noted by other people.
which of the following can cause vaginal bleeding:
ectopic pregnancy, spontaneous abortion, trauma.
the most effective way to prevent cardiopulmonary arrest in a newborn is to:
ensure adequate oxygenation and ventilation. -cardiopulmonary arrest in infants and children (including newborns) is most often the result of respiratory arrest. therefore ensuring adequate oxygenation and ventilation at all times is critical. it is also important to maintain the infants body temp to prevent hypothermia.
a patient who experiences an immediate loss of consciousness followed by a lucid interval has an:
epidural hematoma -epidural hematomas are caused by injury to an artery usually middle meningeal artery that lies in between the skull and brain. patients w an epidural hematoma typically experience an immediate loss of consciousness followed by a brief period of consciousness (lucid interval) as intracranial pressure increases. subdural hematomas are the result of injury to a vein; therefore they tend to bleed slowly and usually cause a progressive decline in level of consciousness. concussions and contusions may cause a loss of consciousness but is typically brief.
you respond to a sick child late at night. the child appears very ill, has a high fever, and is drooling. he is sitting in a tripod position; struggling to breath. you should suspect:
epiglottitis -this child has all the classic signs of epiglottitis: high fever, drooling, and severe respiratory distress. epiglottitis is a potentially life-threatening bacterial infection that causes the epiglottis to swell rapidly and potentially obstruct the airway.
the purpose of the eustachian tube is to:
equalize pressure in the middle ear when external pressure changes. -the middle ear is connected to the nasal cavity by the eustachian tube, which permits equalization of pressure in the middle ear when external atmospheric pressure changes.
the globe of the eye is also called the:
eyeball. -the lens which sits behinds iris focuses on images in the retina; the light sensitive area at the back of the globe. the globe is located within the bony socket in the skull called the orbit.
which of following statements regarding the adams apple is false:
false: it is inferior to the cricoid cartilage. -most obvious prominence in the center of the anterior neck is the adams apple. this prominence is the upper part of larynx, formed by thyroid cartilage. more prominent in men than in women. other portion of larynx is the criciod cartilage which is a firm ridge that is inferior to the thyroid cartilage.
which of the following statements regarding febrile seizures is correct:
febrile seizures usually last less than 15 min and often do not have postictal phase -most common seizures in pediatric patients; they are common between the ages of 6 months and 6 years. most pediatrics seizures are due to fever alone- hence the name febrile seizure. however, seizures and fever may indicate a more serious underlying condition such as meningitis. febrile seizures are characterized by generalized tonic clonic activity and last less than 15 min; if a postictal phase occurs, it is generally very short.
which of following techniques is considered to be an emergency move?:
firefighters drag -one person technique that is used when a patient must be removed from a life-threatening sitch immediately.
paradoxial chest movement is typically seen in patients with:
flail chest -occurs when an area of the chest wall bulges out during exhalation and collapses during inhalation. this type of abnormal chest movement is seen in patients w flail chest- a condition in which several adjacent ribs are fractured in more than one place, resulting in a free floating segment of fractured ribs.
a 30 year old male who has been playing softball all day in a hot environment complains of weakness and nausea shortly after experiencing a syncopal episode. approp treatment for this patient includes all of following except:
giving a salt-containing soultion by mouth -treatment for heat exhaustion begins by moving the patient to a cooler environment. remove excess clothing, admin oxygen as needed and place patient supine. elevating the patient legs may improve blood flow to the brain and prevent another syncopal episode. if the patient is not nauseated, give a salt containing solution by mouth. give nothing by mouth if the patient is nauseated; doing so increases the risk of vomiting and aspiration.
three ambulances respond to a golf course where a group of six golfers were struck by lighting. two of the golfers are conscious and alert w superficial skin burns (group 1). the next two golfers have minor fractures and appear confused (group 2). the last two golfers are in cardiac arrest (group 3). according to reverse triage, which group of golfers should be treated first.
group 3 -the process of triaging multiple patients who were struck by lighting differs from standard traige; it is called reverse triage. if the patients are alive at the scene, survival is likely. delayed cardiac arrest following a lighting strike is uncommon. if the patient are in cardiac arrest, there is a good chance that they can be resuscitated with early, high quality CPR and defibrillation. therefore group 3 should be treated first.
a distraction injury to the cervical spine would most likely occur following:
hanging type mechanisms -excessive traction on the neck, such as what occurs during hanging-type mechanisms can cause a distraction injury of the cervical spine. distraction injuries can cause separation of the vertebrae and stretching or tearing of the spinal cord.
a 40 yr old man who was unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. he has a large bruise over the sternum and an irregular pulse rate of 120 beats per min. you should be most concerned that he:
has injured his myocardium -a myocardial contusion or bruising of the heart muscle is usually the result of blunt trauma- specifically to the center of the chest. in some cases, the injury may be so severe that it renders the heart unable to maintain adequate cardiac output; as a result, blood pressure falls. the pulse rate if often irregular; however lethal cardiac dysrhythmias such as ventricular tachycardia and ventricular fibrillation are uncommon.
the primary purpose of a jump kit is to:
have available all of the equipment that will be used in the first 5 min. -jump kits= 5 minute kit. containing anything u might need in the first 5 minutes w the patient. it is during this 5 min period that will find and manage immediate life threats.
when a small child falls from a signif height, the _____ most often strikes the ground first:
head -compared to adults pediatric patients have proportionately larger heads. when they fall from a signif height, gravity usually takes them headfirst. this is why head trauma is the most common cause of traumatic death in the peds patient.
signs and symptoms of a chest injury include all of the following except:
hematemesis -signs and symptoms of chest injury include bruising to the chest, chest wall instability, increased pain with breathing, asymmetrical chest movement if pneumothorax is present and hemoptysis (coughing up blood) if intrapulmonary bleeding is occurring. hematemesis (vomiting blood) indicates bleeding in the GI tract- usually esophagus or stomach not chest cavity.
even when seatbelts are worn properly and the airbags deploy injury may occur to the:
iliac crest -seatbelts should be positioned over the iliac crest of the pelvis. if they are positioned higher, signif intra abdominal injury can occur. even when seatbelts are properly positioned and the airbags deploy, injury to the iliac crests may occur as the locking mechanism of the seatbelt engages during a motor vehicle crash that involves rapid deceleration.
the most common and often most serious ambulance crashes occur at/on:
intersections. -always be alert and careful when approaching an intersection. whether at an intersection w stop lights or stop signs you should momentarily come to a complete stop, look in both directions for other motorists or pedestrians and then carefully proceed thru the intersection.
what purpose does a one way "flutter valve" serve when used on a patient with an open pneumothorax:
it allows the release of air trapped in the pleural space. -a one way flutter valve is used to treat patients with an open pneumothorax (sucking chest wound) and serves two purposes; it allows air trapped in the pleural space to escape during exhalation and it prevents air from entering the pleural space during inhalation. these combined effects alleviate pressure on the affected lung, which allows it to reexpand.
which of following statements about helicopters is true:
it is possible that the main rotor blade will dip to within 4 feet of the ground. -because the main rotor blade of a helicopter is flexible, it can dip as low as 4 feet from the ground. use extreme caution when approaching a helicopter with the rotors on. if the helicopter must land on a grade, approach it from the downhill side. when moving from one side of heli to the other, move around the front of the aircraft- not under it and not behind it.
what is the first rule of lifting?:
keep back in straight position. -straight, upright positions, use powerful muscles of ur thighs. never twist while lifting.
a 16 year old boy was playing football and was struck in the left flank during a tackle. his vital signs are stable however he is in severe pain. you should be most concerned that he has injured his:
kidney -the flanks are located laterally in the back and overlie the kidneys. during football, spearing injuries occur when a player is struck in the flank by another players helmet. this can result in injury to the kidney ranging from bruising to severe bleeding. injury to the liver, spleen and bladder would more likely occur following blunt trauma to the anterior abdomen.
you are transporting a patient with possible peritonitis following trauma to the abdomen. which position will he most likely prefer to assume:
legs drawn up -patients with peritonitis often lie very still and tend to have their legs drawn up into abdomen. this relieves strain on the abdominal muscles and may provide pain relief.
it is important to remove a drowning victim from the water before laryngospasm relaxes because:
less water will have entered the patients lungs -even small amounts of salt or fresh water will irritate the larynx, causing it to spasm (laryngospasm). this is the bodys protective mechanism. if the emt can safely remove the patient from the water before the laryngospasm relaxes, the amount of water that enters the lungs will be minimized. it will also be easier to ventilate the patient.
which of following organs would be the most likely to bleed profusely if severely injured:
liver -highly vascular solid organ and contains approx 40% of bodys total blood volume at any given time. if severely injured, bleeding from liver would be profuse and rapid. other solid organs, such as the spleen and kidneys may also produce severe bleeding if injured though not as rapid as the liver. stomach and gallbladder are hollow organs; if lacerated they would spill contents into abdominal cavity resulting in peritonitis.
what is the most common presenting sign of PID:
lower abdominal pain
upon delivery of babys head, you note that the umbilical cord is wrapped around its neck. you should:
make one attempt slide the cord over the head -if the umbilical cord is wrapped around the babys neck (nuchal cord) you should make one attempt to gently remove the cord from around the babys neck. if this is not possible, the cord should be clamped and cut. keep the cord moist, administer high flow oxygen to the mother, and transport at once.
a 4 year old girl fell from a second story balcony and landed on her head. she is unresponsive; has slow irregular breathing; has a large hematoma to the top of her head; and is bleeding from her nose. you should:
manually stabilize her head, open her airway with the jaw thrust maneuver, insert an airway adjunct and begin assisting her ventilations with a bag valve mask. -child has severe head injury and is not breathing adequately. you must manually stabilize her head to protect her spine, open her airway with the jaw thrust maneuver, suction her airway if needed, insert an oropharyngeal airway, and assist ventilations w a bag valve mask. the full body scan is performed after u have performd a primary assessment to detect and correct any life threats. the nasopharyngeal airway is contraindicated for this child; she has a head injury and is bleeding from her nose.
a man is found slumped over the steering wheel, unconscious and making snoring seconds, after an automobile accident. his head is turned to the side and his neck is fixed. you should:
manually stabilize his head and move it to a neutral in line position. -the patients snoring sounds indicate an airway problem, which must be corrected or he may die. manually stabilize his head; carefully move it to a neutral in line position; and reassess his breathing. do not rotate or hyperextend the neck of a patient w a possible spinal injury; the results could be disastrous.
your patient is a 21 year old male who has massive face and head trauma after being assaulted. he is laying supine, is semiconscious and has blood in his mouth. you should:
manually stabilize his head, log roll him onto his side and suction his mouth. -blood or other secretions in the mouth place the airway in immediate jeopardy and must be removed before they are aspirated. at the same time, you must protect the patient spine due to mechanism of injury. therefore, you should manually stabilize the patients head, log roll onto is side (allows for drainage of blood from his mouth) and suction his mouth for up to 15 seconds. after ensuring that his airway is clear, assess his breathing and give high flow oxygen or assist in ventilations. nasal airways should not be used in patients w severe facial and head trauma.
the onset of menstruation is called:
menarche -typically between 11 and 16 yrs.
the purpose of a shunt is to:
minimize pressure within the skull. -a VP shunt is a tube that extends from the ventricles (cavities) of the brain to the peritoneal cavity. vp shunts are used to drain excess fluid from the brain, thus preventing increased pressure within the skull.
treatment for a semiconscious child who swallowed an unknown quantity of pills includes:
monitoring the child for vomiting, admin oxygen and transporting -if semi or unconscious child has ingested pills, poisons or any other type of harmful substance, closely observe for vomiting, give high flow oxygen (assist ventilations if necessary) and rapidly transport to the emergency department. do not give activated charcoal to any patient who is not conscious and alert enough to swallow. induction of vomiting is not indicated for anyone regardless of age.
you are transporting a woman who is 8 months pregnant. to prevent supine hypotensive syndrome, how should you position this patient:
on her left side -to prevent supine hypotensive syndrome, the patient must be positioned on her left side. this tops the weight of the fetus from compressing the inferior vena cava, which can cause low blood pressure.
the avpu scale is used to monitor a patients level of consciousness. what does the p stand for:
painful -if patient is responsive to pain they should withdraw from it.
a 21 year old male has a large laceration to his neck. when you assess him, you note that bright red blood is spurting from the left side of his neck. you should:
place your gloved hand over the wound. -laceration of the carotid artery as evidenced by bright red blood spurting from the wound, can cause profuse bleeding, profound shock and death very quickly. you must immediately control the bleeding with the use of direct pressure. cover wound w ur gloved hand initially and then apply a bulky pressure dressing. after the bleeding has been controlled, apply high flow oxygen and transport promptly.
when lifting a stretcher using the power lift, you should:
place your hands palms up on the litter handle -when lifting any heavy object, your hands should be placed palms up; this provides better lifting power and is not as stressful on the wrists.
when two emts are lifting a patient on a long backboard, they should:
position the strongest emt at the head of the board -since more than half the patients weight is distributed to the head end of a backboard or stetcher, you should always ensure the strongest emt is at that positions. this will reduce risk of injury to less strong personnel as well as risk of dropping patient.
a 23 year old woman who is 24 weeks pregnant with her first baby, complains of edema to her hands, a headache, and visual disturbances. when you assess her vital signs, you note that her blood pressure is 160/94 mm hg. she is most likely experiencing:
preeclampsia -also called pregnancy induced hypertension- usually develops after the 20th week of gestation and most commonly affects primagravida (first pregnancy) patients. it is characterized by headache, visual disturbances, edema of the hands and feet, anxiety, high blood pressure. preeclampsia can lead to eclampsia, a life threatening condition that is characterized by seizures.
when caring for a chemical burn to the eye, the emt should:
prevent contamination of the opposite eye. -when irrigating a chemical burn to the eye, it is important to direct the stream away from the uninjured eye. if you do not, you will likely flush the chemical into the unaffected eye. after irrigating the eye for the approp amt of time, cover both eyes with a sterile dressing.
which of the following signs is least indicative of a head injury:
pupillary constriction to bright light. -the pupils normally constrict in bright light and dilate in dim light. suspect a head injury if the pupils do not react appropriately, are asymmetrical (unequal), do not move together or if the patient is unable to look upward.
proper guidelines for correct reaching include all of following except:
reaching no more than 30 inches in front of ur body. -avoid twisting back, avoid hyperextension of ur back, keeping back in a locked in position. do not reach more than 15-20 inches in front of your body.
a woman has frostbite in both feet after walking several miles in a frozen field. her feet are white, hard and cold to the touch. treatment at scene should include:
removing her wet clothing and covering her feet with dry sterile dressings. -remove any wet clothing and cover injured area with dry sterile dressings. do not break any blisters and do not apply heat to try to rewarm the area.
the need for and extend of newborn resuscitation is based on:
respiratory effort, heart rate and color. -the need for and extent of newborn resuscitation is based on respiratory effort, heart rate and skin color. apgar score is not used to determine if resuscitation is needed; the first score is not assigned until the newborn is 1 min of age. resuscitation if needed should commence immediately.
a young male was involved in a motor vehicle accident and experienced a closed head injury. he has no memory of the events leading up to the accident but remembers he was going to a birthday party. what is the correct term to use when documenting his memory loss:
retrograde amnesia -amnesia= loss of memory; it is common in patients who have experienced a cerebral concussion. amnesia of events leading up to an injury is called retrograde amnesia. anterograde amnesia also called posttraumatic amnesia is inability to remember events that occurred or will occur after injury.
which of following drugs is commonly used to facilitate sexual assault:
rohypnol -sedative that is used by criminals to facilitate sexual assault by depressing the victims central nervous system.
a 13 year old girl is found floating face down in a swimming pool. witnesses tell you that the girl has been practicing diving. after you and your partner safely enter the water, you should:
rotate the entire upper half of her body as a unit, supporting her head and back -when caring for a patient who is in the water and has possibly been injured, rotate the upper half of the body as a unit, supporting the head and neck until the patient is face up. open the airway with jaw thrust maneuver and begin artificial ventilation.
an injured hang glider is trapped at the top of a large mountain and must be evacuated to the ground. the terrain is very rough and uneven. which of following devices would be safest and most approp to use:
stokes basket -a basket stretcher should be used to carry patients over rough or uneven terrain that is inaccessible by ambulance. its close-ended sides protect patient from falling out.
all of the following are examples of standard patient transfer equipment except:
stokes baskets. -each ambulance should carry a primary wheeled ambulance stretcher, a wheeled stair chair for use in narrow spaces, a long backboard, and a short backboard or short immobilization device. a stokes basket also called a basket stretcher- specialized peice of equipment that is used for moving patients up or down rough terrain. most ambulances do not carry stokes baskets; they are usually carried by rescue vehicles or fire apparatus.
peritonitis would most likely result following an injury to the:
stomach -in general, solid organs bleed when injured and hollow organs spill their contents into abdominal cavity resulting in peritonitis- inflammation of the intraabdominal lining. of choices listed, the stomach is only hollow organ.
it is impractical to apply a vest type extrication device on a critically injured patient to remove him or her from a wrecked vehicle because it:
takes too long to correctly apply -this is too much time to waste when treating a critically injured patient. a long backboard would be more appropriate. vest type immobilization devices, when applied correctly provide adequate spinal stabilization and are ideal to use in stable patients who need to be removed from their vehicle.
the rapid extrication technique is:
technique used to quickly remove a patient from a vehicle and onto a backboard -with this technique, a seriously injured patient can be moved from a sitting position in a vehicle to a supine position on a backboard while protecting the spine at the same time.
which of following statements regarding intra-abdominal bleeding is false:
the absence of pain and tenderness rules out intra-abdominal bleeding -intra abdominal bleeding is common following blunt force trauma to abdomen. signs include abdominal distention, rigidity, bruising (may not occur immediately) and in some cases pain to palpation. however, unlike gastric juices and bacteria, blood within the abdominal cavity does not provoke an inflammatory response; therefore the absence of pain and tenderness does not rule out internal bleeding.
to extract a patient from the basement of a building, you must transport the patient up a flight of stairs. in doing this, you must ensure that:
the elevated head of the backboard goes first -when you carry a patient upstairs or up any inclines, you must ensure that the elevated head of the backboard or stretcher goes first. this will help to equally distribute the weight.
you have been dispatched to a call for an unresponsive patient. what is the most important information that you should obtain from the dispatcher initially:
the exact physical location of the patient. -must first determine the exact location of the patient. you cannot help patient if u cannot find them. while en route, you should try to ascertain more specific patient info.
you should not remove an injured football players helmet if:
the face guard can easily be removed and there is no airway compromise. -in general, you should leave a helmet on if it fits snugly and does not allow movement of head within the helmet. the patients airway is patent, no airway probs are anticipated and the patient is breathing without difficulty. if you can easily remove the face guard (often case w football helmets) and there are not airway problems, do so but leave the helmet on. if helmet is loose, the airway is in anyway compromised, or patient has difficulty breathing or is in cardiac arrest, the helmet must be removed.
how does pediatric anatomy differ from adult anatomy:
the head is proportionately larger. -several important anatomic differences between peds patient and adult patients. the head- specifically the occiput- is proportionately larger. their tongue and epiglottis are also proportionately larger, and the epiglottis is floppier and more omega-shaped. the childs airway is narrower at all levels and the trachea is less rigid and easily collapsible.
during immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until:
the patient is fully immobilized on a long backboard. -manual stabilization of the patients head must be maintained until they are fully secured on the long backboard. this includes the application of an extrication collar, straps, and lateral immobilization (head blocks). pulse motor and sensory functions must be checked before and after the immobilization process. do not assess range of motion in a patient with a possible spinal injury; this involves moving patients neck and may cause further injury.
the first stage of labor ends when:
the presenting part of the baby is visible. -first stage of labor begins with the onset of contractions and ends when the cervix is fully dilated. however, since cervical dilation cannot be assessed in field, the first stage of labor is considered over when the presenting part of the baby is visible at the vaginal opening (crowning).
what is emts first priority when dealing with a patient experiencing excessive vaginal bleeding:
treat patient for shock and transport -determining cause of bleeding is less important than treating for shock and transporting. emts can control bleeding by using sanitary pads on the external genitalia. when treating for shock, the emt must place the patient in the approp position, keep her warm and apply oxygen.
upon arrival at a scene where hazardous materials are involved, you should park the ambulance:
upwind from the scene
you should discourage a rape or sexual assault victim from doing which of the following:
urinating, cleaning herself, changing clothes. -showering, urinating, changing clothes, moving bowels or rinsing out mouth should be discouraged in order to preserve evidence.
when caring for a female w trauma to the external genitalia, the emt should:
use local pressure to control bleeding -bleeding from external genitalia should be controlled by applying a dry sterile dressing and local direct pressure. never pack anything into the vagina to try to control bleeding; this increases the risk of infection and anything you place into vagina will only need to be removed at the hospital. impaled objects in the genitalia should be carefully stabilized in place not removed.
when obtaining a sample history, which of following pieces of info is important to obtain:
use of birth control device or pills, date of last menstrual period, possibility of pregnancy.
which of the following is not guideline for safe ambulance driving:
use one way streets whenever possible. -avoid one way streets they may become clogged. do not go against the flow of traffic on a one way street unless absolutely necessary.
what is the outermost cavity of a womans reprodutive system:
vagina
when caring for a patient with signs of a pneumothorax, your most immediate concern should be:
ventilatory inadequacy -a pneumothorax occurs when air enters the pleural space and progressively collapses the lung. this impairs the ability of the lung to move air in and out (ventilate). as the lung collapses further, ventilatory efficiency decreases, resulting in hypoxemia; this should be your most immediate concern. some patients w a pneumothorax may also experience intrathoracic bleeding and associated myocardial injury depending on the mechanism of injury and the force of the trauma.
while en route to a call for a major motor vehicle collision, the most important safety precaution that you and your partner can take is /are:
wearing seat belts and shoulder harnesses at all times -the en route to the scene phase of a call is the most dangerous. regardless of the nature of rhe call to which you are responding, wearing seat belts and shoulder harnesses is the most important safety precaution that you and your partner must take. furthermore, you must drive defensively and remain aware of traffic around you.
