Thoracic Park (Chest)
What is it called when: two or more adjacent ribs are fractured in two or more places or in association with a fracture of the sternum so that a segment of the chest wall is effectively detached from the rest of the thoracic cage
Flail chest
How should an abdominal evisceration be managed in the field?
Cover them with a moist sterile dressing then an occlusive dressing; do not push them back into the abdomen.
What is the MOST common complication of applying a splint or bandage improperly?
Impaired circulation
What heat emergency involves painful involuntary muscle spasms following strenuous activity in a hot environment?
Heat cramps
When should wound packing be used instead of a tourniquet?
When the major bleeding is junctional, occurring where an ordinary limb tourniquet cannot be effectively applied.
During CPR on an adult, an advanced airway has been placed. How does the ratio of compressions to breaths change?
With an advanced airway, you should give continuous chest compressions without pausing for breaths, with 1 ventilation given every 6 seconds.
A temporary alteration in brain function following trauma, often without structural brain damage visible on imaging, is called:
a concussion
A section of the chest moves inward during inhalation and outward during exhalation; name this abnormal movement.
Paradoxical chest motion
What type of abdominal organs are more likely to cause major hemorrhage when injured?
Solid organs
What's the difference between a sprain and a strain?
A sprain involves tearing of a ligament, a strain involves tearing of a muscle or ligament.
A diver ascends too rapidly and later develops joint pain and neurologic symptoms because dissolved nitrogen formed bubbles in the tissues. What condition is this?
Decompression sickness / the bends
There are 3 main treatments for all types of shock: provide oxygen, lay them supine, keep them warm. Which of these is MOST important in treating for shock?
Providing oxygen
Provide at least 3 different indications that CPR should not be started on a patient with no pulse or breathing.
Patient has a DNR.
Injuries not compatible with life (decapitation, etc.)
Rigor mortis
Dependent lividity
Putrefaction
Incineration (Full-thickness burns to more than 90% of body surface area, complete absence of body hair, and charred skin.)
Algor Mortis
A motorcyclist wearing a properly fitted full-face helmet has crashed at high speed. In general, would you prefer to remove the helmet or leave it on?
Leave it in place if it fits properly; remove if it interferes with airway management or appropriate spinal care
A patient with multiple rib fractures has a flail segment with obvious paradoxical motion. The patient is becoming exhausted, developing an altered mental status, and SpO₂ is still falling despite supplemental oxygen. What intervention is the most important for this patient?
Positive-pressure ventilation with a BVM and high-flow oxygen.
Following a MVA, a restrained driver has lower abdominal bruising from the lap belt. She is initially stable but develops increasing lower abdominal pain and tenderness. Injury to what organ should be strongly considered?
Urinary bladder (Go pee before you drive!)
A patient involved in a high-speed collision is alert and confused, has an obvious midshaft femur fracture, and bruising to the abdomen. Is this patient a good candidate for a traction splint?
No, they're confused. Any issues with mental status or ABCs indicates that rapid transport should take higher priority than a traction splint
What injury is most common following being struck by lightning?
Cardiac arrest / cardiac injuries
What is the BEST indication that a patient is experiencing neurogenic shock?
Warm, flushed and dry skin below the level of injury
There are 5 sections of the spinal column. Name them (in order from top to bottom) and the amount of vertebrae each one has.
Cervical- 7
Thoracic- 12
Lumbar- 5
Sacral-5
Coccyx-4
Why is considering mechanism of injury particularly important in high-energy trauma?
Serious internal injuries may exist even when external findings are minor
A trauma patient has severe dyspnea, hypotension, distended neck veins, and absent breath sounds on the right. What injury best explains the combination of respiratory compromise and obstructive shock?
Tension pneumothorax
What injury would you suspect in a patient with sharp pain in the RUQ after blunt force trauma from MVA?
Lacerated liver
An injury to what part of the body can result in one of the greatest amounts of internal blood loss from a fracture?
Pelvis
What finding or findings are most useful for distinguishing heat exhaustion from heatstroke?
Mental status and CNS function. Heat exhaustion generally has normal mental status, whereas confusion, altered behavior, seizures, or decreased consciousness indicate heatstroke. Heat stroke CAN have dry skin due to the body's inability to cool itself, but it's not required.
A trauma patient with severe hemorrhage is becoming progressively hypothermic. What is the BEST reason to prioritize preventing further heat loss?
Hypothermia impairs coagulation, making it harder for the patient to form clots and potentially worsening hemorrhage.
Excessive ventilation during CPR can decrease blood return to the heart by increasing what pressure?
Intrathoracic pressure
What is the major difference between a primary brain injury and a secondary brain injury?
Primary injury occurs at the moment of trauma; secondary injury develops afterward from processes such as edema, hypoxia, ischemia, or increased ICP
A patient with severe chest compression presents with facial cyanosis, neck vein distention, hemorrhaging into the sclera of the eye, and petechiae above the level of injury. What condition best explains these findings?
Traumatic Asphyxiation
A patient struck in the abdomen complains primarily of pain in the left shoulder, even though the shoulder was not injured. What internal injury should this referred pain make you especially suspicious of?
Splenic injury/rupture (the referred left-shoulder pain is Kehr sign)
An injured extremity is severely angulated and has no distal pulse. What should you do before splinting?
Make ONE attempt to gently realign the extremity in an effort to restore distal circulation
A patient has generalized hypothermia with frostbitten hands and feet. You have blankets and heat packs available. What area of the body should you begin to rewarm first? Why?
The core — especially the chest, neck, and trunk — rather than the extremities. Rewarming extremities first will actually lower the core body temperature more.
You have 2 patients who initially presented with major bleeding. Patient A is anxious, restless, and keeps saying 'I'm dying'. Patient B is quiet, says 'I feel better', and is just tired. Which patient are you more concerned about?
Patient B. The unusual calmness and lethargy can indicate worsening cerebral hypoperfusion and progression of shock.
What is the mechanism that makes cardiac tamponade life-threatening?
Blood or fluid builds up in the pericardial sac, compressing the heart so it cannot fill adequately between beats, which reduces cardiac output.
Why do geriatric patients following a head injury often remain relatively symptom-free longer than a younger patient with a similar amount of bleeding?
Brain atrophy leaves additional space inside the skull, allowing blood to accumulate before intracranial pressure rises enough to cause symptoms.