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65 Cards in this Set
- Front
- Back
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Composition of Blood & what deoes each component do?
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1. Plasma - carries cells &
platelets 2. Red Blood Cells - Carry nutrients, O2 & removes waste 3. White Blood Cells - fight infection 4. Platelets - coagulate |
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How much blood does an avg adult have?
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6 liters
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What is the largest Artery?
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Aorta
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Chat is the largest vein?
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Vena Cava
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Blood Vessels
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Arteries to Arterioles to Capillaries to Venules to Veins
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Locate the major arteries & Veins
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Aorta, Pulmonary, Carotid, Femoral, Brachial, Radial, Superior & Inferior Vena cava, Pulmonary, Jugular, Popliteal Artery
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Perfusion
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Circulation within tissues in adequate amounts to meet the cells needs for oxygen, nutrients, and waste removal
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Hypoperfusion = Shock
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Failure of the body to provide adequate circulation to all of the body
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Priority Demand for Oxygen
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1 = HEART
2 = Brain 3 = LUNGS 4 = Kidneys |
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Hemorrhage
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Bleeding
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20% Blood loss
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The body cannot tolerate greater then 20% loss (1liter)
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Pediatric Dangerous blood loss
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100 to 200 Millaliters of blood
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Possible Internal Serious Bleeding
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Significant MOI
Poor general impression Assessment reveals signs of shock - sweating & pale Significant amount of blood loss; You cannot control Internal bleeding |
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What are the characteristics of Bleeding?
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Arterial (deep) = Blood is bright red & spurts
Venus = Blood is dark red and does not spurt Capillary - oozes out and is controlled easy |
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Pressure on pressure point to control bleeding
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above - Proximal / Superior to the artery - Brachial or Femoral
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To Control Bleeding you...
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Apply Direct Pressure
Elevation Pressure to the pressure point proximal & superior Apply Tourniquet - (BP CUFF) Pressure Dressing - once bleeding is controlled |
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To control bleeding if bleeding continues
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apply pressure on pressure point
Apply pressure at Proximal pulse point will greatly slow circulation to the extremity |
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What are PASG/MAST?
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Pneumatic Antishock Garment
Military AntiShock Trousers |
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When are PASG's used
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Stabilize fratures of pelvis or femurs
Controls bloodloss assoc. with pelvis and femur fractures controls shock due to internal bleeding |
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Contraindications for PASG?
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Pulmenary Edema (COPD or CHF
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Relative Contraindications for PASG
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Pregnancy
Penetrating Chest Injuries Groin Injuries Major head injuries - hypertensive |
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Last resort to control bleeding
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Tourniqute
Write TK, Time, and Place on patient |
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Controlling a Nosebleed
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aka Epistaxis
Patient should sit up & lean forward Apply direct pressure by pinching nostrils Cold Pack to constrict blood flow Place a piece of gauze under the patients upper lip and press |
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What are the signs/symptoms of Internal Bleeding?
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Hema-tem-esis = Blood in vomit
Melena - Black, tarry stool Hemop-tysis- Cough up blood (lungs) Hema-turia - blood in urine Pain, tenderness, bruising, or swelling Broken ribs, bruises over chest, ridgid/distendedabdomen |
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Signs of Hypoperfusion (Shock)
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ALC
Tachycardia (rapid pulse) Weakness Thirst Nausea & Vomiting Cold, moist skin Shallow, rapid breathing labored, irregular breathing dull eyes Dialated pupils Decreased blood pressure |
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3 Causes of Shock
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Cardiogenic - the pump
Nerogenic - the container - stems from injuries to the spine Hypovelimic or Hemmoragic Shock = The fluid - bleeding |
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Types of Shock = SHRIMPCAN
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S - Septic Shock
H - Hemorrhagic Shock* R - Respiratory Shock M - Metabolic Shock P - Psychogenic Shock C- Cardiogenic Shock* A - Anaphylactic Shock N - Neurogenic Shock* |
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Causes of Cardiogenic Shock
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Pump failure
Inadequate function of the heart; heart muscle no longer can generate the pressure necessary to circulate blood; causes back up of blood in lungs; results in pulmonary edema |
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Causes of Hypovelemic Shock
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Fluid or Blood Loss; not enough blood to circulate; burns lead to loss of plasma; loss of water from the body tissues aggravates shock
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Orthostatic Blood Pressure
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Is taken at 3 times -
1 Lying down 2 sitting down 3 standing up |
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Causes of Neurogenic Shock
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Poor vessel function: Injury to the Cspine, all blood vessels dilate causing a severe drop in blood pressure; a rapid drop in bod temp also occurs
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Causes of Septic Shock
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Vessel and Content Failure
Caused by severe bacterial infections/toxins/ or infected tissues |
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Causes of Metabolic Shock
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Fluid Loss / Content Failure
Caused by gastrointestinal problems which lead to diarrhea and vomiting |
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Causes of Anaphylactic Shock
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Poor vessel function
Occures when a person reacts violently to a substance Injections Stings Ingestion Inhalation |
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NonCardiovascular Causes of Shock
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Respiratory - insufficient oxygen will produce shock
Psychogenic shock - caused by sudden reaction of the nervious system that produces a temporary generalized vascular dilation (Fainting) |
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3 levels of the Progression of Shock
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Compensated Shock - Early stages of shock, while the body can still compensate for blood loss
Decompensated Shock - Late stage - when blood pressure is falling Irreversible Shock - Last stage, when shock has progressed to a terminal stage |
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Compensated Shock - Early stages of shock, while the body can still compensate for blood loss
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BP = very little change
Heart Rate = 120's Respir Rate = little change LOC = Restless Skin Cond - Pale, cool, peripheral sweating |
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Decompensated Shock - Late stage - when blood pressure is falling
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BP = Decreased /0
Heart Rate = 140's Respir Rate = Elevated LOC = Confused Skin cond = Very pale, cold sweating, Dyapharetic |
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Irreversible Shock - Last stage, when shock has progressed to a terminal stage
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BP = None
Heart rate = slow Respir rate = Agonal LOC = CoMA Skin Cond = Mottled, cold, waxen, no sweat |
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Kinematics of Trama
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Injuries from trama are the leading cause of death for children and young adults, understanding the mechanisms that result in injuries is integral to recognizing visible and suspected injuries
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Top 5 leading causes of MOI Trama Deaths
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Motor Vehicle Collisions
Falls Poisoning by liquids or solids Fire & Burns Drowning |
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Kinematics =
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Gives us an indepth look at:
How the injury happnes to the body What possible injuries that trauma may have caused What internal organs/body systems may be involved |
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What is Newtons First Law
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A body at rest remains at rest and a body in motion remains in motion unless acted upon by some outside force
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Newtsons 2nd Law
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Energy cannot be created or destroyed but it can be changed in form (absorbed by the body)
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What are 3 types of Energy
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Potenial Energy
Kinetic Energy Work |
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Potential Energy is
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The product of weight, force of gravity, and Height
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Kinetic Energy is
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Energy that a body possesses as a result of its motion
Kinetic engery = Mass * velocity2 / 2 |
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Work Energy is
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A force exerted upon an object to cause that object to be displaced (car on person)
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Transfer of Energy
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Potential >Kinetic > Work
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MOI during rapid assessment
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useful in identifying & anticipating injury patterns for a traumatic incident
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8 Significat MOI
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Ejection from Vehicle
Death of another passenger Roll over of vehicle High speed crash 45mph adult Motorcycle crash Vehicle vs. Pedestrian Penetrating Trauma of Head/chest/abdomen Fall over 20' or 3 x patient height |
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Additional Significant MOI for children
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Falls from over 10' for 3 x the patient's height
Medium speed vehicle crash (25mph) Bicycle crash |
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Most Common MOI's
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MVA (most lethal)
Falls (most common) Penetrating GSW's Pentrating Knife or sharp instrument wounds Explosions |
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Types of Trauma
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Blunt or Closed - no external signs of injury
Penetrating or Open - involves invasive injury to the body where an opening is creating Yes you can have both |
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Blunt Trauma
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to Chest, the heart could be compressed between the sternum and the spine,
Compression injuries include contusions and lacerations of solid organs and repture of hollow organs Durring a change in speed the body accelerates & decelarates causes shearing of the organs |
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Coup Contra Coup
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Where the brain moves inside the skull with bruising to the brain in the front and back
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Coup Brain Injury
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Even after the forward motion of the skull has stopped the brain continues fwd inside the skull toward the point of impact
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Contracoup Brain Injury
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A specific ara of brain injury located directly opposite to the site of impact to the head that results from linear voilent collisions of the brain within the skul.
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3 type of Crashes in an MVA
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The Car against the object (vehicular collision)
Passenger's body against the inside of the car ( The Body Collision) Passenger's internal organs against the solid structures of the body (Organ collision) |
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5 Types of MVA's
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Frontal
Lateral Rear End Rotational Rollovers |
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Lateral or Side Impact
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25% of severe injuries to the aorta are a result of lateral collisions
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Phases of an Explosion
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Primary Phase - pressure wave injuries
Secondary Phase - injuries from flying debris Tertiary phase - injuries from being thrown by the blast and landing against something |
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Pedestrian v. Car Injuries
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Children tend to face the vehicle
Adults tend to turn away from the vehicle Size difference injruy patterns commonly present |
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Motorcycle collisions
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Head on
Angular Ejection |
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Bullet Wounds
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Entrance and Exit
Cavitation = the pressure wave that occurs as teh bullet passes through the tissues |
