S/S
What is Cushing's Triad?
S/S and what it indicates
hypertension, bradycardia, and irregular respirations, indicating severe brain compression and late-stage increased intracranial pressure (ICP).
Your paramedic partner is preparing to perform an advanced airway procedure on a 5-year-old head injury patient who has a completely absent gag reflex. Regional procedure guidelines explicitly state that this type of advanced airway is the preferred option over orotracheal intubation for pediatric patients.
Supraglottic Airway
Then BVM
This type of advanced intubation technique is considered a relative contraindication in any patient with a suspected head injury
nasotracheal intubation
This is the mandatory clinical action that must be executed and explicitly recorded in the Patient Care Report (PCR) both immediately before and after any spinal motion restriction intervention
comprehensive neurological examination (motor and sensory status).
While preventing hypoxia is critical, providers must strictly avoid this specific treatment error during BVM ventilation, as it drops $EtCO_2$ and induces cerebral vasoconstriction, worsening ischemia
hyperventilation
This is the exact target ventilation range for End-Tidal $CO_2$ ($EtCO_2$) mandated to avoid cerebral vasoconstriction and minimize secondary brain injury in a patient with a traumatic brain injury
35 to 45 mmHg
When managing an infant or a child up to age 8 with suspected spinal trauma, this specific anatomical modification must be made during positioning to prevent natural cervical flexion caused by a prominent occiput.
additional padding under the shoulders
If a paramedic fails in two successive attempts at orotracheal intubation, protocol dictates they must immediately abandon the procedure and switch to one of these two ventilation modalities
Supraglottic Airway insertions or Bag-Valve-Mask (BVM)
This classic mechanism-of-injury category is explicitly listed as a scenario where a cervical collar is not routinely indicated unless a concrete focal neurological deficit is detected on exam.
isolated penetrating neck trauma
When applying the rule-out differential mindset to head trauma, providers should maintain a high index of suspicion for intracranial hemorrhage if a patient is taking these specific home medications, even after low-energy falls
What are anticoagulants (or blood thinners)
According to South Dakota Trauma System guidelines, this specific Glasgow Coma Scale (GCS) score boundary serves as a standalone "Disability Absolute" triggering an automatic Trauma Team Alert for both adult and pediatric patients.
GCS less than 10
You are treating an unresponsive 16-year-old male who crashed his motorcycle into a tree. His parents are not on scene, and no legal guardian can be reached. You can legally initiate rapid stabilization, advanced airway interventions, and immediate transport based on this legal doctrine
Implied Consent
An advanced head-trauma patient suddenly deteriorates en route to the hospital after a Paramedic successfully places an endotracheal tube. Before abandoning the airway, the provider must methodically execute troubleshooting steps using this 4-letter acronym.
DOPE (Dislodgement, Obstruction, Pneumothorax, Equipment failure)
When treating a trauma patient wearing a protective sports helmet and shoulder pads, this is the rigid operational rule governing equipment removal to avoid destroying neutral cervical spine alignment.
if you remove one, you must remove the other (remove both).
During a severe head injury assessment, if fluid or blood is noted draining from the nose or ears, the protocol mandates that the flow must never be blocked, specifically to prevent this dangerous secondary complication.
increase in intracranial pressure (ICP)
You are treating a 45-year-old male who was struck by a vehicle. He presents with an open skull fracture and an initial blood pressure of 88/54 mmHg. According to regional Traumatic Shock protocols, this is the exact fluid resuscitation trigger and target you must use for this specific patient
nitiating a fluid bolus for a Systolic Blood Pressure (SBP) below 100 mmHg (rather than the standard 90 mmHg) to combat secondary brain injury
This is the exact formula used to calculate the minimum expected normal systolic blood pressure for a pediatric patient between the ages of 1 and 10
90 + (2 \times \text{age in years})
70 + (2 \times \text{age in years} for Low
This specific physical phenomenon occurs when severe head trauma causes a rapid, massive surge of systemic catecholamines, resulting in sudden, severe hydrostatic pressure shifts that manifest as acute respiratory distress and frothy sputum.
Neurogenic Pulmonary Edema (NPE)? (A critical airway complication where severe central nervous system injury induces a sympathetic storm, forcing fluid into the alveoli
List four of the five objective physical/clinical criteria that, if present, automatically disqualify a provider from omitting Spinal Motion Restriction under standard clearance protocols.
Midline spine tenderness, neurological deficits/complaints, distracting injuries, altered mentation/intoxication, or a barrier to evaluate
For an infant or toddler who requires spinal stabilization following a collision, the protocol states that a car seat is completely acceptable to utilize for transpot
True Or False and based on what?
True provided its properly fitted and shows no structural cracking
You respond to an elderly patient who fell. The patient has a severe scalp laceration and an altered mental status. While assessing for shock, you must recognize that regional trauma guidelines define the threshold for geriatric systemic hypotension at an SBP below this distinct number.
110 mmHg
Under the regional physiological absolutes for a Pediatric Trauma Team Alert, these are the two separate, precise vital sign cutoffs (Heart Rate and Systolic Blood Pressure) that define decompensation for a patient aged 6 to 10 years.
What is a Heart Rate > 135 bpm
Systolic Blood Pressure < 85 mmHg
When managing an advanced head injury requiring positive-pressure ventilation, this specific mechanical ventilation artifact directly decreases cerebral perfusion pressure by increasing intrathoracic pressure and impeding venous drainage from this major vascular pathway.
decreased venous return through the internal jugular veins (or superior vena cava)
Under regional SMR exclusion guidelines, this specific demographic profile forms an absolute trap where a cervical collar cannot be omitted following any head trauma, regardless of a perfect neurological exam or lack of midline pain.
elderly/geriatric patient with a head injury
When assessing an injured athlete wearing protective gear, the protocol lists four strict criteria to keep the helmet and pads on:
hey must be snug, the airway must be accessible, neutral spine alignment must be maintained, and this component must be removable in a timely manner if needed.