Soft Tissue Injuries
How do you treat/fix a pedicle?
(Nancy Caroline, Emergency Care in the Streets, p. 1869)
The pedicle is the avulsed piece of tissue.. attempt to replace it in its original anatomical location to preserve it.
(Nancy Caroline, Emergency Care in the Streets, p. 1869)
What are the three different types of burns commonly seen in EMS?
(Nancy Caroline, Emergency Care in the Streets, p. 1894)
Superficial, partial-thickness, and full-thickness burns.
(Nancy Caroline, Emergency Care in the Streets, p. 1894)
You suspect your pt has crush syndrome after the McDonald's famous "M" sign falls on his leg. What is your first line pharmacological treatment?
(Nancy Caroline, Emergency Care in the Streets, p.2143)
Sodium Bicarbonate: give 1 mEq/kg IV/IO followed by 0.5 mEq/kg in 10 minutes if needed.
(Nancy Caroline, Emergency Care in the Streets, p.2143 & Drug Cards)
You are treating a pt involved in an MVC and note JVD, a narrowing pulse pressure, and chest pain. What type of shock should you be suspicious of?
(Nancy Caroline, Emergency Care in the Streets, p.2303)
Obstructive Shock (pt shows signs of cardiac tamponade)
(Nancy Caroline, Emergency Care in the Streets, p.2303)
Abdominal injuries are most often the result of _____.
(Nancy Caroline, Emergency Care in the Streets, p.2096)
Blunt trauma.
(Nancy Caroline, Emergency Care in the Streets, p.2096)
What is the first step to treating a scalp bleed with a possible skull fracture underneath?
(Nancy Caroline, Emergency Care in the Streets, p. 1868)
Apply a bulky dressing to help reduce blood loss and prevent direct pressure to the injured portion of the skull.
(Nancy Caroline, Emergency Care in the Streets, p. 1868)
What are the three burn zones?
(Nancy Caroline, Emergency Care in the Streets, p. 1894)
Zone of coagulation, zone of statis, and zone of hyperemia.
(Nancy Caroline, Emergency Care in the Streets, p. 1894)
What is the preferred treatment for a HF acid burn? (Include dose/form/route)
(Nancy Caroline, Emergency Care in the Streets, p. 1911 & Drug Cards)
Calcium Gluconate topical gel: mix 1g with 30ml of sterile lubricating gel and apply topically to affected skin.
(Nancy Caroline, Emergency Care in the Streets, p. 1911 & Drug Cards)
You are treating a 74yo female after a car v. tree MVC. You note the deformity to the dashboard and steering wheel. Your pt is complaining of mild chest pain and you note bruising to around the pt's belly button. Your pt's vitals are 114/72, 72 HR, 22 RR, SpO2 89%, BGL of 65, and EtCO2 of 46. What medications might cause the pt to have these vitals?
(Simmons' Lecture on 06/22/2026; Nancy Caroline, Emergency Care in the Streets, p. 2296)
Antihypertensives like beta-blockers, ace-inhibitors, etc.
(Simmons' Lecture on 06/22/2026; Nancy Caroline, Emergency Care in the Streets, p. 2296)
While performing a rapid assessment on your pt, you notice his intestines are falling out (yay!). No other life threats or injuries noted. How do you treat the misplaced insides?
(Nancy Caroline, Emergency Care in the Streets, p.2105)
Apply a saline-soaked sterile dressing over the evisceration followed by another sterile dressing to hold the soaked dressing in place. Keep the pt warm (saline is cold btw).
(Nancy Caroline, Emergency Care in the Streets, p.2105)
You are treating a pt with a radial fracture, what should you do before and after splinting?
(Nancy Caroline, Emergency Care in the Streets, p. 1867)
Check for pulse, motor, and sensation in the afflicted arm before and after splinting.
(Nancy Caroline, Emergency Care in the Streets, p. 1867)
You are treating a 62yo female with extensive burns after a house fire. You note partial-thickness burns to both arms and partial-thickness burns covering the upper half of the pt's back. How would you classify the severity of the pt's burns?
(Nancy Caroline, Emergency Care in the Streets, p. 1903)
The pt has major burns due to the partial-thickness burns covering more than 20% of the pt's TBSA.
(Nancy Caroline, Emergency Care in the Streets, p. 1903)
Your pt has major burns covering 30% of their TBSA. Your pt tells you he weighs 154lbs. Using the consensus formula, how much fluid do you give him per hour?
(Nancy Caroline, Emergency Care in the Streets, p. 1906)
If you used 2ml = 262ml/hr
If you used 4ml = 525ml/hr
You note your burn pt's vitals are trending downwards even after pain management and wound dressing. What might be causing the downward trend and what type of shock would it be?
(Nancy Caroline, Emergency Care in the Streets, p.2311)
Extensive burns can lead to fluid shifting into the interstitial space to help with the inflammation process. This leads to systemic vasodilation and a drop in BP. Burns are a type of non hemorrhagic hypovolemic shock.
(Nancy Caroline, Emergency Care in the Streets, p.2311)
Upon physical examination, you note that your pt has Grey-Turner's sign. What may this indicate?
(Nancy Caroline, Emergency Care in the Streets, p.2104)
This sign indicates possible retroperitoneal bleeding 24-48 hours AFTER initial injury.
(to get the points, make sure to include time)
(Nancy Caroline, Emergency Care in the Streets, p.2104)
What are the physiological functions the skin performs?
(Nancy Caroline, Emergency Care in the Streets, p. 1855)
Protection, temperature regulation, fluid regulation, sensation, and inflammatory response.
(Nancy Caroline, Emergency Care in the Streets, p. 1855)
A burn pt is taken to a local emergency department for treatment. What procedure may the pt go through before being transferred to a burn center?
(Nancy Caroline, Emergency Care in the Streets, p. 1898)
The pt may get an escarotomy - a procedure where a surgical cut is placed on the burned tissue to allow for swelling.
(Nancy Caroline, Emergency Care in the Streets, p. 1898)
Your pt has an isolated mid shaft femur fracture after jumping off of a 50-foot tree. Your pt is complaining of severe pain even after using a traction splint and will not let you get an IV. How would you treat his pain?
(Nancy Caroline, Emergency Care in the Streets, p. 1909 & Drug Cards)
Fentanyl IN 2mcg/kg for pain.
(... or ketamine IM 0.5mg/kg for pain)
(Nancy Caroline, Emergency Care in the Streets, p. 1909 & Drug Cards)
Why is LR sometimes preferred over NS?
(Nancy Caroline, Emergency Care in the Streets, p.2302)
LR is less acidic than NS. The theory is that LR will have a better chance of decreasing acidosis than NS in pt's with hemorrhagic hypovolemia.
(... whole blood is totes better tho ngl)
(Nancy Caroline, Emergency Care in the Streets, p.2302)
Your pt was involved in a motorcycle accident and was launched off of her bike into the surrounding bush. Once you extricate the pt to a more level area you note a stick protruding from the pt's left lower abdomen. How would you treat the pt?
(Nancy Caroline, Emergency Care in the Streets, p.2105)
Stabilize the stick (by god if you remove the stick.. this is not the sword in the stone) with dressings and gauze to prevent further movement and injury.
(Nancy Caroline, Emergency Care in the Streets, p.2105)
A paramedic is assessing a 42yo male complaining of feeling sick. The paramedic notes track marks in the pt's left AC that are reddened and warm. The paramedic also notes red-purplish skin with small dark patches distal to the left AC. The pt also reports a fever, night sweats, chills, vomiting, and diarrhea. What should the paramedic be suspicious of?
(Nancy Caroline, Emergency Care in the Streets, p. 1879)
Necrotizing Fasciitis.
(Nancy Caroline, Emergency Care in the Streets, p. 1879)
What factors contribute to the severity of a chemical burn?
(Nancy Caroline, Emergency Care in the Streets, p. 1909)
The concentration and quality of the agent, the chemical state or temperature of the agent, the length of exposure, and the depth of penetration.
(Nancy Caroline, Emergency Care in the Streets, p. 1909)
You have just administered a 250ml bolus of NS to your pt from a MVC. Fire tells you they found an ejected passenger that was DOA. Your pt's vitals are as follows: 70/40, 136 HR, 24 RR, SpO2 84%, EtCO2 of 49. How would you treat your pt?
(Nancy Caroline, Emergency Care in the Streets, p. 2304 & Drug Cards)
Norepinephrine drip: 0.1-0.5mcg/kg/min IV infusion
(Nancy Caroline, Emergency Care in the Streets, p. 2304 & Drug Cards)
Your pt states he tripped and fell down a flight of stairs while running from his baby mama (to obvs avoid that gosh darn child support). By just conversing with him, you note the pt's skin condition is pink, warm, and dry. You also note a slow HR but the pt States he runs on the treadmill. Pt states he feels like he can't move his legs "due to the scare from the fall". You still take caution in moving the pt and extremity lift him...
You feel pretty good about the pt's status and drive non emergent to the local ER. Hours after dropping off the pt, the ER doctor confronts you after dropping off another pt and rips you a new one... why?
(Nancy Caroline, Emergency Care in the Streets, p.2308)
You didn't do a full physical assessment.. you would've found pale and cool lower extremities with no motor or sensory function... low heart rate and paralyzed extremities can indicate neurogenic shock. Do better.
(Nancy Caroline, Emergency Care in the Streets, p.2308)
Your pt got in an altercation with her neighbor over her chihuahua barking in the middle of the night. The pt states her neighbor hit her with a bat after she told him that his wife left him because he is bald. You note bruising and crepitus to the upper right side of the pt's abdomen. What should you be suspicious of?
(Nancy Caroline, Emergency Care in the Streets, p.2106)
Be suspicious of a liver laceration. If the pt was hit on her right side near her ribs (the source of the crepitus), there is a possibility that rib fragments may have cut or punctured her liver. Assess for any excessive bruising like Grey-Turners or changes in vitals if you suspect a liver laceration.
(Nancy Caroline, Emergency Care in the Streets, p.2106)