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219 Cards in this Set
- Front
- Back
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Trauma is the leading killer of people under ____ years of age
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44
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The best care for a trauma patient that is given by paramedics includes the following.
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C-spine
Maintain airway Assist in ventilation Ensure bleeding control is handled. Rapid Transport |
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A specialty service used to treat carbon monoxide poisoning is?
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Hyperbaric oxyenation centers
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When determining the mechanism of injury you will want to identify.
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The forces involved in the collision
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MOI is considered during what part of your assessments?
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Scene Size up
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The time period for EMS trauma treatment was changed from the ________ to the ________ because expediting a patient within a finite time is not always the best treatment.
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Golden hour
Golden period |
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Ideally you should provide the initial and rapid trauma assessment as well as stabilization and transport within ____ minutes.
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10
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Indirect route of travel is a limitation of air transport. T or F
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False
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In Quality improvement process, comittees look at selected care modalities to determine if designated standards of care are being met. These modalities are called:
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Inidicators
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How many people die a year of MVC's
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45,000
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How many people die a year of gunshot wounds
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30,000
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Approximately __ percent of patients who die from trauma die within minutes.
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50
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Approximately ___ percent of trauma patients who die from trauma, die within hours of injury.
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30
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Approximately ___ percent of trauma patients who die from trauma, die within days of injury.
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20
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The leading cause of deaths in a patient who is days beyond trauma are.
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MODS and Sepsis
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Serious trauma occurs in about ____ percent of all trauma cases.
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10
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Most fatal traumas are due to trauma to the ______ and ______ bleeding.
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Head
Internal |
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The "white paper" was a document titled "accidental death and disability: the neglected disease of modern society". It brought about what act?
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Highway Safety act of 1966
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_______ is the collection of data to identify the existence, significance, and characteristics of a disease or disease process.
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Sureveillance
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Overall the ____ percent of all ems calls are trauma related
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20
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The most common demographic that dies from trauma are
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Men from 16 to 24
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The Hadon Matrix is made up of 6 factors
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Host, Agent and environment
Pre-event activity, Post event activity, and even activity |
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_____ is accomplished b repeating the process of surveillance in order to identify the benefit or ineffectiveness of an intervention or program.
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Evaluation
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______ trauma center is a hopsital usuall a university teachin center, that is prepared and committed to andle all type of specialty trauma. 24 hours a day 7 days a week.
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Level 1 Trauma center
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This trauma center commits resources to addressing the most common type of trauma 24-7. They also have some specialty groups but in extreme cases may need to transport to level 1
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Level 2 Trauma center
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This center is trained to deal with basic trauma, however they will stabalize and arrange transport for specialty traumas
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Level 3 Trauma Center
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This trauma center acts as an outpost and is a satellite location for stabilization and transport via helicopter to a more intense trauma center.
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Level 4 Trauma Center
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What are the two obvious physical signs of serious trauma.
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Shock and ALOC or head injury
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What is hte most cost effective way to reduce mortality and morbidity in trauma?
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To prevent it in the first place
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A system used to compile trauma and patient information used to evaluate and improve the trauma system.
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Trauma registry
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Penetrating trauma is the most common trauma. T or F
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False Blunt trauma is the most common
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What are the two basic laws of kinetics
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Law of inertia
Law of energy conservation |
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Kinetic energy is determined by what two factors?
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Mass x Velocity
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An increase in mass generates more kinetic energy than an increase in velocity. True or false.
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False, velociy increases exert a much larger amount of kinetic energies than increases in mass
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What is newtons 1st law
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An object in motion will remain in motion until acted upon by another object. An object at rest will remain at rest until acted upon by another object
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What is newtons 2nd law
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Energy can neither be created nor destroyed it can only be changed from one form to another.
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_____ injury occurs as the blunt impact stops a portion of the body while inertia causes the remaining structures to continue in their motion.
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Compression
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In a _____ injury connective tissue and fibers that hold tissues together are pulled and thereby injured or torn.
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Stretch
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During ____ injurty,As the edge of an impacting force slows a part of the body, tissue along the impact border continues in motion.
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Shear
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What are the 4 stages of a motor-vehicle collision.
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Vehicle collision
Body Collision Organ collision Secondary collision |
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EMS personnel do not need to wear seat belts while in the patient care portion of the ambulance. T or F?
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False. Seat belts are required while driving and during patient care.
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What specially trained personnel can disable airbags?
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Fjre and rescue
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Application of forces of trauma along the axis of the spine as result of compression is referred to as.
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axial loading
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What percent of all injuries are to the extremities?
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60-80
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After completing triage tagging you should take a complete a set of vitals on the patient. T or F
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False
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When a child is hit by a car they tend to turn.
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They tend to turn toward the car
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When a adult is hit by a car they tend to turn.
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away from the car
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The major difference between a assault rifle and a hunting rifle is?
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The number of wounds a patient will receive.
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Bullet trauma is increased with Yaw, mushrooming and tumbling. T or F
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True
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Go-Carts are the recreational vehicle sited with the least amount of traumatic injuries T or F
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True
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A pregnant patient who is involved in a car accident is likely to suffer what type of trauma.
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Placenta Abrubtia
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The major purpose of identifying Level of Suspicion is.
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To anticipate the injuries suffered to the patient.
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You should always ausiltate a gun shot victims lung sounds at 6 points. T or F
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False
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A pressure wave is likely to cause what type of injury.
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Tension Pneumothorax
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A frontal impact of a motorcycle commonly causes what type of injuries?
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Intra-abdominal, Pelvic fractures, and tibia injuries
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When examining a patient with a gun shot wound what is a solid indicator of the damage done?
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The exit wound.
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Serious trauma is considered by the medical community as a type of?
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Surgical Disease
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Skin largest organ – ___ of body weight
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16%
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_____ % of wounds become infected
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6.5%
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The most outer layer of skin is the.
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Epidermis
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The upper most layer of skin is the
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Dermis
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The layer of skin that is related to heat retention and is made of adipose tissue is
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• Subcutaneous
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The average time it takes to form a complete blood clot is.
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7-10 minutes
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Crush Syndrome will develop if a limb i trapped for around
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4 hours
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An injection injury is when
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A high pressure fluid punctures the skin and stays within the body.
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A tourniquet should be at least ___" wide
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2 inches
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What is the proper dosage of morphine sulfate given to manage pain?
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2mG SIVP every 5 minutes up to a total of 10MG given
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What is the proper dosage of Fentanyl given to manage pain.
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• 25-50 mcg SIVP followed by an additional 25 mcg as needed
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If you notice ear secretions you should not stop them and preform a _______ test.
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Halo
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During splinting of a limb trauma you should place the limb in a position of ________ or ________.
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Function or in place.
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Any limb located during an amputation should be _______.
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Kept cool for transport but not be placed with direct contact with ice.
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It is only appropriate to remove a impaled object if.
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o In cheek and interferes with airway
o Interferes with CPR |
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_____ precent of burns can be prevented
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90%
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Burns are the _____ leading killer of children under the age of ____.
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2nd, 12
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The first stage of burns associated with tachycardia and the release of catacholemines is the.
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Emergent Phase
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The 2nd stage of burns associated with the movement of fluids in the body is the
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Fluid Shift
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The 3rd phase of burn healing that is associated with fluids and electrolytes moving to the vasculature is
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Hypermetabolic Phase
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The final stage of burn healing in which scars form is called the
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• Resolution Phase
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What are the four types of burns?
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• Thermal
• Electrical • Chemical • Radiation |
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What is Eschar
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Hard leathery product of a deep full thickness burn
Infection are the greatest risk to burn patients |
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Any burn to the _____ are considered serious burn
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Any burn to the face, hands, feet, joints, or genitalia considered a serious burn
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The axial skeleton refers to the ?
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Head thorax and spine
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Dislocation of the knee is associated with___ rate of amputation
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50%
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An important consideration with trauma to a young persons bones are.
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That they are soft and pliable and underlying damage to organs may not be as obvious
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____% GSW to the head mortality
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75-80%
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What demographic is at the highest likelyhood of head trauma?
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Male 15-24, infants, young children, elderly at the highest risk for head trauma
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The Brain
• Takes __% of the cranium • Receives __% or cardiac output • Consumes __% of body’s oxygen |
• Takes 80% of the cranium
• Receives 15% or cardiac output • Consumes 20% of body’s oxygen |
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Loss of blood supply to the brain will cause
o Unconscious with ___ seconds o Death in ____ minutes |
o Unconscious with 10 seconds
o Death in 4-6 minutes |
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What divides cerebrum into right and left hemisphere
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Central sulcus
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CNS Pressure usually less than ____ mmHg
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CNS Pressure usually less than 10 mmHg
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Mean Arterial pressure must be at least ____ MMHG to ensure profusion
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Mean Arterial pressure must be at least 50 MMHG to ensure profusion
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The proper dosages for RSI intubation is
Lidocaine ___ mG/KG Etomidate ____ MG/KG Succs _____ MG/KG Intubate Vec ____ mg/kg |
Lidocaine 1-1.5 mG/KG
Etomidate .1-.3 MG/KG Succs 1-1.5 MG/KG Intubate Vec .08-1mg/kg |
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During fluid maintenance of a shock patient you must keep a patients at the max BP of ____ mmHg
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90 mmHg is the maximum BP you want to set a patient to during fluid
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How does the integumentary system prevent pathogens from attacking the body?
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The skin provides a protective barrier against pathogens
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Of the open wounds presenting to emergency departments up to ____ percent will eventually become infected resulting in significant morbidity.
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6.5
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Glands within the dermis that secrete sweat are called.
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Sudoriferous glands.
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When an artery is ruptured but the skin is not broken blood can separate the tissues and pool in a pocket. This pocket of blood is a _____.
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Hematoma
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______ are typically the most minor of injuries that violate the protective envelop of the skin.
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Abrasions
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Specialized white blood cells capable of engulfing bacteria are called
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Phagocytes, macrophages, and granulocytes
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The anaerobic bacterium clostridium perfringens causes deep space infection called.
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Gangrene
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You have been called to a scene where a patient has caught one of his hands between two pieces of machinery. As the hand is removed from the machinery, there is no visible injury. You should expect the internal injuries to be
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Extensive
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What type of dressing is designed to be placed over a wound without sticking to the fluids or clotting agents?
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Non adherent
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As you begin to bandage a soft tissue injury you should continue to check distal pulses to ensure proper tissue perfusion. This is primarily because the bandage may fit properly at first but later become too tight and reduce circulation due to the ____
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Damaged tissue swelling
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When bandaging the foot and ankle to create pressure and control bleeding,wrap in a_____.
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Distal to proximal fashion to avoid forming a venous tourniquet
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When a soft tissue injury occurs, a process to stop bleeding start almost immediately . The vessels constrict, platelets clot, and the blood coagulates. This process is called.
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Hemostasis
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What is the Goal for pulse-oximeter reading
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94-99%
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Bowel sounds in the thorasic cavity indicates
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a damaged diaphragm
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During percussion hyperresonance indicates (________) Hyporesonance indicates a (_____________)
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Pneumothorax, Hemothorax
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Radial pulse indicates at least ___ systolic BP
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80-90
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A trauma patient who will need future blood administration used a ___G needle and place it at the ______ or above.
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16/ AC
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The most common rib fractures are _____
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3-8
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The most commons source of a rib fracture is _______.
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Blunt force trauma
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Sternal fractures occur to ____ of all blunt chest trauma.
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5-8%
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Pulmonary injury occur in ____-___ % in blunt chest trauma, and almost ____ in penetrating chest trauma.
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10-30% and 100%
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When you are decompressing a patient you are always to going to place the needle _________ the rib.
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Just above
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____ percent of patients will die immediately of a hemothorax.
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(50%)
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_____ of hemothorax patients live 5-10 minutes
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(25%)
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True or false JVD presents more clearly in a patient with a hemothorax.
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(False, the resistance generated by blood causes a lesser JVD)
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_____________ is the most common potentially lethal chest injury.
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(Pulmonary contusion)
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A ________ type of car collision will cause axial loading.
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(Up and over)
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What tool can detect heart and great vessel injuries?
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(EKG)
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How much blood does it take to acutely start a pericardial tamponade?
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(150-200 ml)
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Becks triad include _________ relate directly to pericardial tamponade
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(Narrowing pulse pressure, JVD, and muffled heart sounds)
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_____ % of traumatic auortic rupture die on scene.
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80-90%
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The primary treatment in the pre hospital setting for traumatic aortic rupture is __________.
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(Rapid transport, if possible by air.)
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The diaphragm is attached to the ____ and _____ ribs on the _______ side.
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(11th and 12th, posterior)
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What percent of burns are life threatening, and what demographic are most susceptible.
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3-5%, very young and old.
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Burns are the _______ leading cause of death in children under the 12 years of trauma; and the ________ leading cause of overall trauma deaths.
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Second and fourth
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What are the name of the glands that secrete sweat?
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Sudoriferous Glands
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The skin is thickest at the _____ and thinest at the ______.
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Heel, surface of the eye
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What are the 4 types of burn
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Thermal, electrical chemical and radiation.
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Molecules are in constant motion when they are at a temperature greater than__________.
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Absolute zero
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Thermal burns become more intense based on what three factors?
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Temperature, concentration of heat energy, and length of contact time with patients skin.
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Thermal burns become more devastating based on a _______ in the materials density.
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Increase
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The most damaged area of a burn is called the ____________. If this zone penetrates the dermis the resulting injury is termed a full thickness or third degree burn.
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Zone of coagulation
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The area surrounding the zone of coagulation that is marked by redness and pain but lesser damage.
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Zone of stasis.
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A burn that covers more than ____ to ___- percent of the patients body surface area may have profound pathological effects.
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15 to 20 precent
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Electricity is the result of an ________ flow from a point of high concentration to one of low concentration.
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Electron
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The amount of flow in a given time is termed the _____ and s measured in _______.
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Current , Amperes
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The relationship between current (I), Resistance (R) and voltage (V) is well known as _______.
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Ohm's Law
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The highest heat of an electrical burn is located at the ________ resistance.
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Greatest
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Electrical current may follow ______ and _________ because they offer less resistance than muscle and bone.
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Blood Vessel, Nerves
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Electrical currents greater than _____ mA may also disrupt the heart's electrical system.
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50
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Chemical burns denature the biochemical makeup of cell membranes (Primarily the _________) an destroy the cells.
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Protein
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A _______ burn must destroy the tissue before it can chemically burn any deeper.
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Chemical
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_____ burns usually form a thick insoluble mass called "coagulation necrosis."
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Acid
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_________ burns cause liquefaction and do not form a protective coagulum.
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Alkalis
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True or False acid burns are typically more severe than alkalis.
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False Alkali burns are predominantly more serious than acid.
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The process of changing a substance into separate charged protocols is.
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Ionization.
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______ radiation is only a significant hazard if the patient inhales or ingests contaminated material.
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Alpha
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Alpha radiation travels only _____.
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Inches
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Beta Radiation can travel _________ feet.
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6 to 10
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_______ radiation lacks mass or charge and helps it penetrate many inches of concrete and steel.
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Gamma
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_____ is a large subatomic particl with no charge.
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Neutron
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Neutron radiation is almost only found in __________ and _______.
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Nuclear reactors and bombs
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The two means of exposure for radiation are______ and _______.
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Direct exposure and contamination by dust and debris
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The most important factors for radioactive exposure are.
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Duration, distance and shielding
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Radiation exposure is measured in
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Rad or Gray
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1 Gray is equal to _____ rads
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100
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True or false, the eyes and bone marrow are the most vulnerable points of hte body to radiation.
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True
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The first signs of radiation exposure are ______ and _____.
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Nausea and vomiting
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______ inhalation injury occurs more frequently than thermal inhalation burns.
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Toxic
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Carbon monoxide has an affinity to hemoglobin more than _____ times greater than oxygen.
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200
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_____ to ____ percent of burn patients who die have an associated inhalation injury.
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60 to 70
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The rule of palms is a easier to use for local burns up to about _____ percent.
|
10
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Hypovolemia increase in likelihood if severe burns, in patients with _____ to ____ percent total body surface.
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15 to 20
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________ is the most persistent killer of burn victims
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Infection
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During burns cellular ______ in the blood stream effects the hearts electrical system, causing dysrhythmias.
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Potaium
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_____ can kill in as little as 15 seconds of exposure.
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Cyanide
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|
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Critical burns include
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Partial thickness > 30 percent
Full thickness >10 percent Inhalation injuries and any partial thickness burns involving hands feet joints or genitalia |
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What is the proper treatment for cyanide?
|
300 MG sodium nitrate over 2 to 4 minutes.
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You should irigate acid burns for at least ____ minutes.
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5 minutes
|
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You should irigate alkalis burns for at least
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15 minutes
|
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True or false. You should delay transport to irrigate a burn injury.
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False
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____ precent of total bone mass is replaced each year by the remolding process.
|
20 precent
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The hollow shaft found in the long bones are
|
Diaphysis
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Gliding joints provide movement in two directions. They are located at the joints of carpal bones in the wrist and between the clavicle and sternum.
|
Condyloid
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_____ joints provide a sliding motion in two planes, as between the wrist and the metacarpals.
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Ellipsodial
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____ joints allow for movement in two planes at right angles to each other examples are the base of the thumbs.
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Saddle
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________ joints permit full motin in a cone of about 180 degrees.
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Ball and joint
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________ are bands of connective tissue that hold bones together.
|
Ligaments
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Substance that lubricates the joints are _______.
|
Synovial Fluid
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|
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Sac contraining synovial fluid that cushions the adjacent structures are the
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Bursa
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Before birth the the skeleton is predominantly ________.
|
Cartilage
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Bones do not usually reach maximum strength until _______.
|
Early adulthood
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Skeletal muscles have comprise between ___ and ____ of body weight.
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40 to 50 precent
|
|
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Smooth muscles are controlled by the _______ nervous system.
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Autonomic
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_____ connect muscles to bones.
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Tendons
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State of slight contraction of muscles that gives them firmness and keeps them ready to contract.
|
Tone
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A patient who has compartment syndrome usually complain of ______.
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A deep burning that is not proportional to the injury.
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A ______ occurs when muscle fibers are overstretched by forces that exceed the strength.
|
Strain
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A _______ is a tearing of a join capsule, connective tissues, specifically a ligament or ligaments.
|
Sprain
|
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A grade __ sprain is minor or incomplete
|
1
|
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A grade ____ sprain is significant but incomplete tear
|
2
|
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A grade ____ complete tear of a the ligament
|
3
|
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______ is the partial displacement of a bone end from its position.
|
Subluxation
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_________ s a complete break in the bone that runs strait across at a 90 degree angle.
|
Transverse
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|
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A fracture that runs at an angle across the bone is considered ___________.
|
Oblique
|
|
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A fracture involving twisting motion may result in a curved break around the bone shaft.
|
Spiral
|
|
|
A break on the growth plate is called an
|
epyphyseal fracture.
|
|
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Fractures of ________ are likely to sever blood vessels and vital nerve endings.
|
Joint
|
|
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After a break there is a clot made of blood and collagen that forms at the break site called a
|
Fracture hematoma
|
|
|
ICP should exist at a state less than.
|
10mmHg
|
|
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Serious Trauma is considered by the medical community to be a _______ disease.
|
Surgical
|
|
|
A patient who is pregnant and has a front end collision and impacts the steering will is likely to suffer the injury?
|
Placenta Abruptia
|
|
|
The purpose of level of suspicion is to ?
|
Anticipate Injuries
|
|
|
One procedure you can forgo in a patient who has a gun shot wound is ?
|
Auscultation of the chest
|
|
|
The most common injury as result of a pressure wave is a?
|
Pneumothorax
|
|
|
Frontal impact during a motorcycle injury results in
|
Intra abdominal damages, pelvic and tibia fractures.
|
|
|
In a gun shot victim what is a good way of determining the damage through the body?
|
Exit wound size
|
|
|
A partial thickness burn to greater than 30% of the body is considered?
|
Critical
|
|
|
CPP=
|
CPP= MAP- ICP
|
|
|
Drowsiness post a head injury is a sign of loss of activity in the.
|
Ascending reticular activating system.
|
|
|
True or false. It is necessary that you transport a separated body part with the patient.
|
False
|
|
|
In a patient with blood glucose less than 60 you should.
|
Administer 25mg D50
|
|
|
MAP=
|
MAP= diastolic BP +1/3 Pulse perfusion
|
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Long bones should have a concern of injury of the epiphiseal plate or joint if?
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Less than 3 inches from the joint.
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The artery that runs behind the knee is the?
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Popotial artery
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Reduction of secondary brain injury is best accomplished with?
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Ventilation + BP
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