Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
84 Cards in this Set
- Front
- Back
|
Law of Inertia |
A body at rest will remain at rest and a body in motion will remain in motion unless acted upon by an outside force |
|
|
Blunt injuries |
- rapid forward deceleration (collisions) - rapid vertical deceleration (falls) - energy transfer from blunt objects |
|
|
Penetrating injuries
|
- break the skin ex: Projectiles, Knives, falls upon fixed objects
|
|
|
Motor Vehicle Collision (clues to injury) |
- Vehicle damage - Damage to interior surfaces - Injury patterns on the patient - Restraints? |
|
|
"Three Collision" concept |
1) vehicle collision 2) body collision 3) internal organs move |
|
|
Head-on collision injuries |
- Up and Over - Down and Under - Combination |
|
|
Lateral-impact collision |
- highest fatality rate - head, neck, chest, abdominal, pelvic injuries |
|
|
Rear-impact collision |
- initial backward movement with potential to neck injury (whiplash) - Then up and over OR down and under injuries |
|
|
4 types of motorcycle impacts |
1) head-on collision 2) angular collision 3) ejection 4) controlled crash |
|
|
Fall injury - factors |
1) distance of fall 2) anatomic area impacted 3) surface hit |
|
|
Injuries to the head |
- disability and unseen injury to the head may occur - bleeding/swelling in skull = life threatening - include frequent neurologic examinations in assessment
|
|
|
Injuries to Neck and Throat |
- penetrating injuries may result in air embolism - crushing injury may cause the cartilage of the upper airway and larynx to fracture |
|
|
Injuries to the Chest |
- chest contains: heart, lungs, large blood vessels - Life threatening injuries = broken ribs (hinder breathing), heart may be bruised, large vessels may be torn, open chest wound |
|
|
Injuries to the Abdomen |
- solid organs may tear, lacerate or fracture - hollow organs may rupture and leak acid like digestive chemicals - rupture of large blood vessel can cause serious unseen bleeding |
|
|
Physiology of Hypoperfusion: Shock |
- inadequate widespread tissue perfusion - inadequate delivery of O2 and nutrients to the body tissues - inadequate elimination of metabolic waste - multiple system hypoxia and hypercarbia |
|
|
Perfusion requirements |
1) properly beating heart 2) adequate transport medium, blood and hemoglobin 3) intact functioning vessel system (no leaks) 4) functioning respiratory system |
|
|
Cardiac output: factors |
- rate - rhythm - force of contractions |
|
|
Cardiac Output: formula |
C.O. = S.V. x H.R.
- stroke volume = amount of blood expelled with each contraction (about 70 mm) - heart rate = number of contractions per minute |
|
|
Blood Pressure: formula |
B.P. = C.O. x peripheral vascular resistance
- cardiac output = amount of blood expelled from heart over a minute - peripheral vascular resistance = the resistance of the arteries to the flow of blood |
|
|
Physiology of Circulation: the fluid |
- vessels must be full of blood at all times - hemoglobin must be present in adequate amounts and be free to carry O2, nutrients and CO2 - can be blood or plasma loss (from sweating, vomit, diarrhea, urine) |
|
|
Stages of Shock: classic shock syndrome |
1) Compensated 2) Decompensated 3) Irreversible |
|
|
Classifications of Shock |
1) Hypovolemic shock 2) Obstructive 3) Cardiogenic 4) Distributive |
|
|
Hypovolemic Shock |
AKA classic shock - most common - Hemorrhagic/Blood loss - Non-hemorrhagic (dehydration/fluid loss/burns) |
|
|
Obstructive shock |
- pulmonary embolism (blocked pulmonary circulation) - tension pneumothorax (increased intrathoracic pressure) - cardiac tamponade (pressure on myocardium) |
|
|
Cardiogenic shock |
Heart (pump) failure - bradycardia - tachycardia - decreased stroke volume - dysrythmia |
|
|
Distributive Shock |
- Neurogenic - Anaphylactic - Septic - Psychogenic |
|
|
Hemorrhagic Shock - Compensated: S/s |
Mental status: alert or slight anxiety Skin:becomes cool, pale. Sweating Blood pressure: normal Pulse: normal to rapid Respiration:normal to rapid Other: thirst |
|
|
Hemorrhagic Shock - Decompensated: S/s |
Mental status: lethargic, sleepy, combative Skin:cool, moist, pale. Mottling: cyanosis (nose --> extremities) B.P: begins to fall. Capillary refill delayed. Pulse: rapid and weak Respiration: rapid and shallow Other: decreased urination |
|
|
Hemorrhagic Shock - Irreversible: S/s |
Mental status: decreased LOC. becomes unresponsive Skin: grey, mottled, cyanotic, waxen. Sweating stops. B.P: decreases ==> undecteable Pulse: slows the disappears Respiration: agonal Other: irritable heart. Bradycardia. Asystole. |
|
|
Shock: general treatment |
- assure airway - administer O2 - assist ventilations if necessary - position patient to assist perfusion (elevate head/shoulders if pulmonary edema) - keep patient warm - perform focused history and physical - adjust O2, IV, ECG, pulse ox |
|
|
Golden minute principle |
no more than 10 minutes on scene rapid diagnosis and field stabilization is critical |
|
|
Golden hour principle |
shock must be stopped within one hour of cause
treat during transport whenever possible |
|
|
Signs of a Strain/Sprain/Fracture |
- pain - ecchymosis - edema |
|
|
Fractures |
- Closed: does not break skin - Open: external wound assoc. with fracture - Nondisplaced: simple crack of bone, no angulation - Displaced: actual deformity |
|
|
Fracture: S/s |
- pain - tenderness - ecchymosis - edema - guarding - deformity - crepitus - false motion - exposed fragments - locked joint |
|
|
Dislocation: S/s |
- deformity - swelling - pain - tenderness on palpation - virtually complete loss of joint function - loss of ROM - numbness or impaired circulation to the limb and digit |
|
|
classic sign of hip fracture? |
shortening of the leg with external rotation |
|
|
Evaluating neuromuscular function |
Examination of the injured limb should include assessment of the following before and after splinting:
- pulse - motor function - sensation - capillary refill and skin color (compare to uninjured side) |
|
|
Musculoskeletal injuries: treatment |
- I.C.E.S. - completely cover open wound - apply appropriate splint - if swelling ==> ice/cold packs - transport |
|
|
Types of bleeding |
- Arterial: blood is bright red and spurts - Venous: blood is dark red and oozing - Capillary: blood oozes out and is controlled easily. settles on surface |
|
|
Controlling external bleeding |
- BSI - Direct pressure - Tourniquet if severe |
|
|
Types of closed injuries |
- contusion - hematoma - crushing injury |
|
|
Closed soft tissue wounds: treatment |
I.C.E.S. - ice slows bleeding - compression slows bleeding - elevation above heart level reduces swelling - splinting decreases bleeding and reduces pain |
|
|
Types of Open Wounds |
- abrasions - penetrating wound - laceration - avulsion |
|
|
Open soft tissue wounds: treatment |
- BSI - rinse PRN - control bleeding PRN - secure dressing with pressure bandage - apply additional bandages if needed - splint the area PRN to minimize movement |
|
|
Chest wounds |
- a penetrating wound to the chest may cause air to enter the chest - this results in air in pleural space = sucking chest wound - care includes providing O2 and sealing wound with an occlusive dressing |
|
|
Abdominal wounds |
- may expose organs - organs protruding through abdomen = evisceration - cover organs with moist sterile dressing!! - consider bandage with occlusive dressing - NO vaseline on evisceration |
|
|
Major functions of the skin |
- assist in temperature regulation - sensory organ - barrier & protection - cosmetics
|
|
|
First degree burns |
"Superficial" - involve only top skin layer |
|
|
Second degree burns |
"Partial-thickness" - involve the epidermis and dermis - moist appearance - blister formation - tactile and pain sensors in tact |
|
|
Third degree burns |
"full-thickness" - extends through all layers of the skin |
|
|
Critical burn areas |
- face - respiratory system - hands - feed - joint surfaces - perineum - genitalia |
|
|
Critical burns |
- respiratory involvement - associated injuries or fractures - involvement of critical areas - 2nd degree burn of greater than 30% BSA - 3rd degree burn of greater than 10% BSA - all electrical burns (can affect cardiac cycle) |
|
|
Respiratory burn: S/s |
- productive cough - sooty sputum - dyspnea - singed facial and/or nasal hairs - sore throat |
|
|
Emergency care for Burns |
- BSI - move patient from burning area - stop burning process - rinse with saline or water - cover with dry, sterile dressing - give O2 if the patient has a critical burn - prevent body heat loss - estimate burns severity - check for traumatic injuries - treat for shock - provide prompt transport |
|
|
Chemical burns |
- occurs when toxic substance contacts the body - strong acids or alkalis cause most chemical burns - eyes are particularly vulnerable - removing the chemical from the patient is a priority
|
|
|
Chemical burns: treatment |
- remove chemical from patient - if powder, brush off - remove all contaminated clothing - flush burn area with large amount of water for 20 minutes - transport quickly |
|
|
Electrical burns |
- may result from high or low voltage energy - body is great conductor of electricity - make sure power is off before touching patient - there will be two wounds (entrance and exit) to bandage - transport and be prepared to administer CPR |
|
|
Chest injuries: general management |
- O2 - airway management - spinal immobilization - occlude open wounds - stabilize chest |
|
|
Rib fractures: assessment |
- pain on inspiration - pain on palpation - crepitus - patient may be splinting chest - patient may be hypoventilating
|
|
|
Rib fractures: management |
- splint - supplemental O2 - assess for other chest injuries(underlying organs in upper abdomen, lung sounds) |
|
|
Flail segment |
- 3 or more ribs fractured in 2 or more places - causes free floating segment of chest wall - mortality = 20-40% - high suspicion of other internal injuries - respiratory failure (inadequate bellows action; pulmonary contusion) |
|
|
Flail segment: assessment |
- contusion - crepitus - paradoxical movement of the chest - pain on inspiration/palpation |
|
|
Flail segment: management |
- splint (pillow or towel) - position supine or lateral OR position of comfort - maintain patent airway - ventilate |
|
|
Pneumothorax |
- 10-30% of blunt trauma - almost 100% of penetrating trauma - can be open or closed - causes collapse of lung |
|
|
Pneumothorax: S/s |
- difficulty breathing - open wound to chest - "sucking" sound - subcutaneous emphysema - possible diminished breath sounds - assess for rib fracture or flail segment |
|
|
Pneumothorax: management |
- O2 by mask or BVM - occlude open wounds - treat rib fracture or flail segment if present |
|
|
Hemothorax |
- same as pneumothorax except blood instead of air - massive hemp indicated great vessel or cardiac injury ==> poor patient outcome - chest can hold 2-3,000 mL of blood - assess and treat same as pneumo |
|
|
Tension pneumothorax: assessment |
- diminished to unilateral absent breath sounds - progressive dyspnea - cyanosis - subcutaneous emphysema - hypotension (narrow pulse pressure) - JVD - tracheal deviation |
|
|
Pericardial tamponade |
- rapid accumulation of fluid ==> increased intrapericardial pressure - occurs in <2% of trauma to chest - low mortality if isolated tamponade
|
|
|
Pericardial tamponade: assessment |
- hypotension - dyspnea - cyanosis - Beck's Triad (narrow pulse pressure, JVD, muffled heart tones) |
|
|
Myocardial contusion |
- hemorrhage with edema and fragmentation to myocardium - conduction defects - dysrhythmia - inability to pump effectively - reduced cardiac output
|
|
|
Myocardial contusion: assessment |
- irregular pulses - rib fractures
|
|
|
Commotio cordis |
blow to chest at point of ventricular depolarization ==> V.fib or V.tach |
|
|
Pulmonary contusion |
- should always be suspected in a patient with a flail chest - the pulmonary alveoli become filled with blood, and fluid accumulates in the injured area ==> hypoxic |
|
|
Traumatic asphyxia |
- sudden, severe compression of the chest which produces a rapid increase in pressure within the chest - suggests underlying injury to the heart and possible a pulmonary contusion
|
|
|
Traumatic asphyxia: S/s |
- distended neck veins - cyanosis in the face and neck - hemorrhage into the sclera of the eye |
|
|
Primary vs. Secondary brain injury |
- Primary: immediate from bruising or penetrating objects
- Secondary: from hypoxia or perfusion of the brain |
|
|
Skull fracture and Basilar skull fracture: S/s |
*Indicates significant force - obvious deformity - visible crack in the skull - raccoon eyes - battle's sign |
|
|
Cerebral contusion |
- brain can sustain bruise when skull is struck - there will be bleeding and swelling - bleeding will increase the pressure within the skull
|
|
|
Intracranial bleeding |
*Laceration or rupture of blood vessel in brain - subdural - epidural - intracerebral - subarachnoid |
|
|
Complications of head injury |
- cerebral edema - vomiting - leakage of CSF - convulsions and seizures - disability - death |
|
|
Increasing ICP and Herniation Syndrome: S/s |
- dizziness - history of loss of consciousness -decreasing LOC - projectile vomiting - dilation of ipsilateral or both pupils - contralateral hemi paresis - Cushing's Reflex (hypertension, bradycardia, respiration changes) - flexion/extension movements
|
|
|
Spinal injuries: S/s |
- look for changes in LOC - pain, tenderness, weakness, numbness and tingling - may lose sensation or become paralyzed - may become incontinent |
