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