EMR Chapter 18
What is the estimated percentage of body surface area burned for a patient with partial thickness burns to both legs?
36 percent.
What is the estimated percentage of total body surface area burned for a patient with partial thickness burns to both legs?
36 percent.
What is the estimated total body surface area burned for a patient with partial thickness burns to the front and back of both legs?
36 percent.
In the recommended method for estimating the percentage of an adult's body that has been burned, each area of the body surface EXCEPT the genital area—such as chest, abdomen, backs of legs, and so on—is assigned a percentage value of:
9%
What is the definition of a dressing?
A dressing is material that is placed directly onto a wound to cover it.
What is a bandage?
A piece of material that holds a dressing in place.
Which of the following patients would be classified as a multisystem trauma patient?
A woman with a broken wrist and broken ulna
What should be done for a patient with suspected internal bleeding?
Administer oxygen.
What should you do first if a patient is bleeding profusely from their wrist and no dressings are available?
Apply direct pressure with a gloved hand.
As you approach your patient, you notice bright red blood is spurting from a cut on her upper arm. You should immediately:
Apply firm, direct pressure
You suspect your patient is bleeding internally. You should:
Apply oxygen if allowed and transport rapidly
How would you describe bright red blood spurting from a laceration?
Arterial bleeding.
What is severe, rapid, life-threatening bleeding also called?
Arterial bleeding.
Eva Guerra, age 11, sliced the pad of her finger with a razor blade while working at home on a class project. The wound is a smooth cut with straight edges. Her wound is classified as:
As an incision.
The material applied to hold a dressing in place is called a:
Bandage.
What is the term for nonpenetrating trauma?
Blunt trauma.
What is the best classification for bleeding that oozes from an abrasion?
Capillary bleeding.
What type of bleeding is characterized by oozing dark blood from an abrasion?
Capillary bleeding.
What type of bleeding is oozing a small amount of dark blood from an abrasion?
Capillary bleeding.
How should you rinse sand out of a child's eyes?
Carefully pour water into the corner of the eye nearest to the nose.
A 42-year-old male has been hit in the abdomen with a baseball bat and has a very large bruise. You recognize that this kind of ________ could mean significant internal blood loss.
Closed Wound
To keep a patient with an eye injury from moving their injured eye, the EMR should:
Cover both eyes.
What should be avoided when cutting away clothing to expose a wound?
Cutting directly through holes made by knives or bullets.
Signs of internal bleeding include which of the following?
Decreased level of consciousness, rapid and weak pulse, cool/pale/moist skin
What is the term for a burn that affects multiple layers of skin?
Deep burn.
What is the term for a wound that goes through several layers of tissue?
Deep wound.
You are holding firm, direct pressure on a wound that was spurting bright red blood. Blood is seeping through the gauze you are holding against the wound. What should you do?
Direct your partner to apply a tourniquet.
What should you cover burns with?
Dry, sterile dressings.
What is the rule of nines used for?
Estimating total body surface area affected by burns.
Your patient is complaining of eye pain after splashing bleach into her eye. You should direct her to:
Flush the eye with water for at least 20 minutes.
What is the primary method for caring for most chemical burns?
Flush with water for 20 minutes.
What is the correct way to bandage limbs?
From distal ends to proximal ends.
How should you remove superficial foreign matter from a wound?
Gently wipe with sterile gauze pad.
To evaluate an electrical burn, an EMR should do all of the following EXCEPT:
Help the patient before turning off the electricity
What is the term for a patient who has lost a significant amount of blood?
Hypovolemic.
A 53-year-old male patient has cut his leg with a chain saw. His airway is patent, he is breathing 18 times per minute with good tidal volume, and supplemental oxygen has been applied. Bleeding has been controlled with a tourniquet, and the patient is pale, diaphoretic, and anxious. In the past, it was thought that if a tourniquet was used, the patient would always lose the limb to which the tourniquet was applied. What will prevent this from happening?
Immediate transport to the hospital.
What will prevent a patient from losing a limb when a tourniquet is applied?
Immediate transport to the hospital.
What is the term for a wound that has smooth edges?
Incision.
What is the term for bleeding that occurs inside the body?
Internal bleeding.
What might be the cause of bruised skin, distended abdomen, and red streaks in vomit?
Internal bleeding.
Your patient presents with a wound to her forearm. Your exam reveals a 3 cm wound that has smooth edges and appears to go through several layers of tissue. This type of soft tissue injury is best classified as a:
Laceration.
What is the first step to treating a patient with any type of burn?
Make sure the burning process has stopped.
What is the first thing you should do when approaching the scene of a patient with electrical burns?
Make sure the source of electricity is turned off.
What is a dressing?
Material placed directly on an open wound to control bleeding and prevent contamination.
What is the term for injuries to multiple body systems?
Multisystem trauma.
What should the EMR do in impaled-object emergencies?
Not immediately remove the impaled object.
How would you classify burns that are blistered and extremely painful?
Partial thickness.
How would you classify burns that are blistered and very painful?
Partial thickness.
How would you classify burns that result in blisters and severe pain?
Partial thickness.
What should be done before bandaging a burned hand?
Place gauze in between the fingers.
Katie Garksy, 47, tripped in a supermarket parking lot and fell face forward into a concrete lamppost base, severely injuring her face. She is unresponsive and bleeding profusely from the nose. No skull fractures or spinal injuries are suspected. As the EMR providing care, you should:
Place her on her side with her head turned to provide drainage & pinch her nostrils shut to attempt to control the bleeding.
If a dressing covering a minor wound becomes soaked with blood during transport, the rescuer should:
Put additional dressings on top of the soaked one, so as not to interrupt the clotting process.
A 53-year-old male patient has cut his leg with a chain saw. His airway is patent, he is breathing 18 times per minute with good tidal volume, and supplemental oxygen has been applied. Bleeding has been controlled with a tourniquet, and the patient is pale, diaphoretic, and anxious. The patient is increasingly anxious and begins to thrash around. What should you do?
Reassure the patient, help them keep still, and initiate transport.
When you administer emergency care for patients with open wounds, what should you do about superficial foreign matter on the wound's surface?
Remove it with a sterile gauze pad.
What position should a responsive patient with a nosebleed be placed in?
Seated, leaning slightly forward.
What should be done with an impaled object?
Stabilize it in place.
How should you prepare a patient with an arrow impaled in their shoulder for transport?
Stabilize the arrow with bulky dressings.
How should you stabilize an arrow impaled in a patient's shoulder for transport?
Stabilize the arrow with bulky dressings.
How would you classify a burn that is red and painful to the touch with no blisters?
Superficial burn.
What is the term for a burn that affects the top layer of skin?
Superficial burn.
A partial-thickness burn involves which of the following?
The epidermis and underlying epidermis tissue.
The method used to determine what percentage of body surface area has been burned is called:
The rule of nines
What should you always be prepared for when caring for a patient with signs of internal bleeding?
The signs and symptoms of shock.
What should you be prepared for when caring for a patient with signs of internal bleeding?
The signs and symptoms of shock.
Why should bruises be taken seriously?
They may be a sign of serious internal bleeding.
A 5-year-old patient has a nosebleed. You should:
Tilt the head forward and pinch the nose.
What is the purpose of a bandage?
To hold a dressing in place.
What is the purpose of a hemostatic dressing?
To promote clotting using a chemical compound.
What is the purpose of a tourniquet?
To stop severe bleeding by constricting blood flow.
What should you expect to do for a patient who has experienced extensive blood loss?
Treat the patient for shock.
What is the first step when approaching a patient with electrical burns?
Turn off the source of electricity.
Your patient has gotten dry lime on her arm that has caused a painful burn. You should first:
Use a dry dressing brush off any remaining lime from the patient's skin.
In amputation emergencies, what should a rescuer do if bleeding is not controlled by direct pressure and a pressure bandage?
Use a tourniquet.
How would you classify slow bleeding with dark blood from a laceration?
Venous bleeding.
EMR London Orozco is on an emergency call in response to a 911 call from Carla Yaeger, 37, who is in childbirth at home and is bleeding heavily. What precautions, if any, should Orozco use to protect her own safety and the safety of her patient?
Wear protective gloves, a gown, and goggles and a mask because these help protect against blood-borne infectious disease.
Which of the following best describes why it is important for EMS providers to wear appropriate personal protective equipment such as gloves and masks when caring for someone who is bleeding?
Wearing protective equipment provides body substance isolation for both the patient and the provider.
What should be done with an amputated hand during transport?
Wrap it in a sterile dressing, place it in a plastic bag, and keep it cool.
What should you do with an amputated hand during transport?
Wrap it in a sterile dressing, place it in a plastic bag, and keep it cool.
What is the recommended care for a patient who has amputated their hand?
Wrap the amputated hand in a sterile dressing, place it in a plastic bag, and keep it cool during transport.
How should an amputated digit be handled?
Wrapped in gauze and placed in a plastic bag or wrap.
A wound that results in a flap of skin and tissue that is partially or completely torn away is called an:
avulsion
When you place gauze directly on a wound, you are applying a:
dressing
A dressing that has been treated with a chemical that promotes clotting is called a:
hemostatic dressing
Your patient was the driver in a head-on collision into a tree. Based on the mechanism of injury, the patient may have:
multisystem trauma
Your patient has experienced a burn. His skin is red, free of blisters, and extremely painful. This type of burn can be classified as:
superficial
