EMS Module 5: Trauma Review

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Hemorrhagic Hypovolemic Shock

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Hemorrhagic Hypovolemic Shock

Shock caused by blood loss

  • Loss of whole blood from medical or traumatic causes

  • Results in decreased perfusion pressure and decreased oxygen-carrying capacity

  • Treated by stopping the bleeding and replacing blood or blood components

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2

Patient was in a high speed head on collision and hit the steering wheel without the deployment of the air-bag. What type of problems would be present with this pattern?

Hitting the steering wheel with chest

  • Chest and respiratory problems

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3

What is the first step to control external bleeding?

Direct Pressure

  • First methods to use to control bleeding

  • A pressure dressing can be used

  • Do not apply pressure to or remove impaled objects

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4

Pedestrian was hit by a pick-up truck. What are all the injuries labeled as?

Life threats

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5

Patient was stabbed in the chest under the right nipple. What type of injuries are present?

Chest and Abdominal

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6

Commonly known as a bruise

Contusion

  • Injury to blood vessels in the dermis

  • Swelling, discoloration (ecchymosis)- caused by blood leaking from damaged vessels and accumulating in the surrounding tissues

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7

What can trauma to the pelvis cause?

Extreme/high blood loss

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8

Patient has trauma to the head with multiple scalp injuries. What is going to be present?

Bleeding that is hard to control

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9

What type of head injury results in death?

Brain Stem

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10

The Pediatric Assessment Triangle (PAT)

Helps with formation of general impression

  • PAT assesses appearance, work of breathing, and circulation of the skin

  • PALS assesses consciousness, breathing, and color

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11

Types of heat lose besides: radiation, convection, conduction, evaporation

Respiration or Breathing

  • Think of breathing on a cold day

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12

What does a patient multi-system trauma involve?

More than two body systems

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13

Patient presents with a low grade fever, confused, UTI, a rapid pulse, and poor skin trigger. What is this patient suffering from?

Hypovolmevmia (dehydration)

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14

A victim of a vehicle crash was hit in the back. Thoracic, lower legs, and pelvis were injured. What is likely to happen?

Head and neck won’t move.

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15

What happens when external bleeding is poorly controlled?

Hypovolemic

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16

What is the main reason that someone with a pneumothorax can’t breath?

The alveoli in the lungs are unable to exchange gasses when the lung is collapsed.

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17

Patient was just injured in a fight and now has his knees pulled to his chest. What kind of question should you ask him?

Where or what kind of pain are you experiencing?

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18

Why is an injury to an extremity joint so serious?

Long term disability

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19

The patient was hit in the face by a baseball and his eye began to swell. What was injured?

The orbital bone

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20

An elderly patient was released from the ER after hitting her head. Days later she went unconscious. What type of head trauma is she suffering from?

Subdural brain bleed

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21

A 1 year old was in a head-on collision. What type of injury should be suspected?

Cervical Spine injury

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22

If a patient is in cold water, how are they loosing body heat?

Conduction

  • Body heat is lost to nearby objects through direct physical touch

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23

Pedestrian is in a pool of blood around the lower leg. What is the first thing you should do?

Apply pressure and control bleeding

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24

5 year old child was hit by a car. What are the suspected injuries?

Head, Chest, and Abdominal injuries

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25

A women thrown from a horse now has LLQ pain. What is she suffering from?

Internal bleeding

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26

Patient was beaten with a baseball bat with bruising stating to form. Now the pt. can’t breath. What is causing this?

Pulmonary contusion

  • Bleeding occurs in the lung tissue in and around the alveoli and in the interstitial space.

  • Gas exchange is severely impaired leading to severe hypoxia.

  • A patient who has suffered a direct blow or any other blunt trauma to the chest may have a pulmonary contusion.

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27

Football player has leg pain.

Sprain or strain type

  • A sprain is an injury to a joint capsule, with damage to the connective tissue, usually the ligaments.

  • A strain occurs when overexertion or overstretching causes muscle fibers to tear.

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28

There is a large pool of blood on the floor of the car. How should you care for the patient?

Control the bleeding and treat for shock

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29

A car was found in a ditch with a patient that has bruising around their eyes and behind the ears. What is going on?

Basilar skull fracture

  • involves the floor of the cranium

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30

A football player was hit by multiple players and was found under a large stack and unconscious.

Spinal cord injury

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31

A 2 year old in injured and is placed onto a backboard. Where should the padding go?

Under the shoulders and hips

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32

There was a vehicle crash where the first responder placed a traction splint and the patient then loses feeling the leg. What did the 1st responder forget to do?

Reassess the patient

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33

Young women is frightened by seeing blood and her nervous system shuts down. What is happening.

The women will pass out

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34

Victim was involved in a head on MVA with injuries to the lower back and pelvis. What could have caused this?

The seat belt was not being used properly (behind the body in the top portion).

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35

Patient had a stab wound to the upper thigh with a lot of bleeding. The paramedic was unable to find a peripheral vein for an IV. Why?

Shock

  • Taking blood from arms and legs

  • Blood goes to the vital organs and vessels constrict

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36

Patient has an open wound to the chest. An occlusive dressing is applied. What is the purpose of an occlusive dressing?

Prevents air from entering the chest

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37

How should you position a patient with a lower abdomen laceration and evisceration (intestines coming out)?

Supine, legs to chest

  • Stop muscles from stretching

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38

Triathlon: Patient has distal leg injury with a large contusion and now has no pulse. How would you label this patient?

Critical

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39

Patient has electrical burns at a construction sight, is lethargic, has and AMS, based on limited info, what can you determine?

Internal injuries

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40

Patient was struck to the face by a ball and nose began to bleed heavily. What is the 1st step to treating a nose bleed?

Lean forward and pinch the nostrils

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41

Child was thrown in a vehicle in a head on crash. How should you transport the child?

Leave the child in their car seat

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42

Patient is suffering from abdominal bleeding and a fractured pelvis

She won’t be able to compensate and will go into shock

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43

4 yr. old was in a crash in cold weather with minimal clothing. What is most likely going to occur?

Hypothermia

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44

Crash scene with 1 year old victim. What should be assessed?

Work of breathing: AKA PAT

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45

Patient is suffering from itchy hands and feet, is throwing up, pale, and diaphoretic. What type of shock is present?

Anaphylatic shock

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46

Man jumped from a two story building. What type of injuries are present besides feet?

Vertebrae from shock absorption

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47

Why was a patient in the ER vomiting after experiencing a bloody nose?

The pt. swallowed too much blood

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48

What makes a tension pneumothorax different from a pneumothorax?

It is an immediate life threat

  • Air accumulates in the pleural space with no route of escape, increasing pressure in the thoracic cavity.

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49

Man cut his arm using a chain saw, bone and muscle are showing, and the blood in bleeding through the pressure dressing. What is the next step?

Tourniquet

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50

Skin is very red and blistered

Partial thickness burn (2nd degree)

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51

Patient was in a snowmobile accident and the neck was injured. How would you manage this injury

An occlusive dressing

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52

Patient was shot and now has no feeling in his legs. Where was he shot?

The spinal cord

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53

Why should you turn a pregnant women on her side?

To block the baby from the Vena cava

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54

Patient feel in water and is unable to rewarm herself. What should you check?

Her temperature

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55

8 yr. old girl is crying and holding her arm after falling off the swings. What can be concluded from this?

Arm fracture

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56

Blood pressure on patient was good then went bad.

Decompensated shock

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57

Gun shot to the chest, check back of patient, no bullet…

Look for exit wound

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58

Patient got their hand stuck in press, once released arm began to bleed profusely. What is the next step?

Apply a tourniquet

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59

Patient fell from a 2nd story window, lots of chest pain and began to go into shock

Hemothorax

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60

Patient hit a tree without a seat belt or airbag and abrasions to the chest and abdomen, what could happen?

Development of shock with underlying causes

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61

Patient fell down a flight of stairs. What is the first thing you should look for?

Life threats

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62

Patient dropped a chemical on the leg and it starts to burn. What is the first step in treatment?

Wait for the burning to stop

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63

Child was found unconscious, the woke up and starting talking. What is the underlying cause?

Head injury, brain bleed

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64

Patient was found on the side walk, stating “neck hurt”, open neck wound, no head trauma

Spinal cord injury/paralysis

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65

Patient in her 3rd trimester and was hit in the thorax and now has pain in the abdomen. What is happening?

Abruptio Placentae

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66

Patients skin is hot and dry

Heat stroke

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67

Football player hit by another player, chest was not moving symmetrically

Flail chest

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68

Traction split was placed and PMS is present, then when reassessed it was not.

Femur bone is pinching

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69

Patient was sweaty, slightly pale, vomiting and confused

Transport

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