Shock
What is the most common type of shock in trauma patients?
Hemorrhagic shock
What is the first step in managing a patient with life-threatening external bleeding?
Apply Direct Pressure to the Wound
Describe what a partial-thickness burn looks like.
Typically, the skin is moist, mottled, and white to red. Blisters are present. Partial-thickness burns cause intense pain.
What are battles signs and raccoon eyes signs of?
Basal skull fracture
After placing a patient on a backboard using a log roll, in what order do you secure the patient to the backboard to immobilize them?
1) Torso
2) Legs
3) Head
What is the most definitive sign that a patient in shock has progressed into decompensated shock?
Blood pressure will fall. Decompensated shock is also called hypotensive shock
A child was hit in the face causing a nosebleed and has blood flowing from both nostrils. How should you attempt to control the bleeding?
Have the patient lean forward, pinch the nostrils together, and apply ice.
What type of wound can be described as “an injury in which soft tissue is torn completely loose or is hanging as a flap”?
An avulsion
You're treating a patient with a burn to their eye. How long do you flush the affected eye?
At least 20 minutes
What is the purpose of spinal motion restriction?
Minimizing further damage to the spinal cord
Provide 2 causes of non-hemorrhagic shock.
1. Severe dehydration
2. GI fluid loss (profuse vomiting/diarrhea)
3. Burns
4. Excessive sweating/heat illness
5. Renal fluid loss (overuse of diuretics or from endocrine disorders)
6. Malnutrition/starvation
Provide 2 examples of mechanisms of injuries that would increase suspicion of internal bleeding.
Motor vehicle collisions – especially with high speed, rollover, or ejection.
Falls from height – particularly >20 feet in adults or >2–3 times the child’s height in pediatrics.
Blunt (especially abdominal) trauma
Penetrating trauma –internal bleeding can be secondary to external bleeding
Assaults – blunt force trauma to the chest or abdomen.
Industrial/Machinery/Crush injuries
Falls onto an object – e.g., landing on a bicycle handlebar or fence post.
Blast injuries – explosions causing blunt or penetrating trauma.
Sports injuries – high-energy collisions (e.g., football or hockey)
Non-traumatic causes can be ulcers, ectopic pregnancies, aneurysms, etc.
You have a 35-year-old male who was in a house fire suffering from partial-thickness burns to: entire right arm, anterior chest and abdomen, anterior right leg
Use the rule of nines to determine the Total Body Surface Area (TBSA) burned
Entire right arm = 9%
Anterior chest & abdomen (front of the torso) = 18%
Anterior right leg = 9%
Total Body Surface Area (TBSA) burned = 9% + 18% + 9% = 36%
Why would an EMT use an occlusive dressing on an open neck injury? To control bleeding and prevent the possibility of an _____ _____
Air embolism.
What are the 3 layers of the meninges?
1. Dura mater - tough, outermost layer composed of dense connective tissue
2. Arachnoid mater - thin, web-like membrane with threadlike strands extending from it
3. Pia mater - innermost layer, a delicate membrane that closely adheres to the surface of the brain and spinal cord
What are the 3 stages of shock?
Compensated -> Decompensated -> Irreversible
A patient is bleeding from the ear or nose following a head injury. You loosely cover the site with a gauze pad and notice stain shaped like a halo/target. What fluid may be present that would indicate a skull fracture?
Cerebrospinal fluid (CSF) will create the halo/target around the blood
What condition can develop when swelling in a confined space results in increased pressure within soft-tissues that produces dangerous pressure; may cut off blood flow or damage sensitive tissue?
Compartment syndrome
What kind of injury involves a fracture of the orbit or of the bones that support the floor of the orbit, often causing displacement?
A blow-out fracture
An epidural hematoma is usually the result of a blow to the head that produces a linear fracture of the temporal bone and damages the middle meningeal artery. Blood accumulates between the _____ _____ and the _____.
Dura matter and the skull.
How much blood loss can the average adult lose before showing signs of shock? Answer can be in pints, liters, or percentage.
The body cannot tolerate an acute blood loss of greater than 20% of this total blood volume, or more than 2 pints (approximately 1 L) in the average adult.
Why is blood loss (or fluid loss in general) a bigger concern in infants and children than in healthy adults?
Pediatrics have smaller fluid reserves
What assessment must you do after applying a splint/tourniquet/bandage to assess if it was improperly done?
PMS to check for impaired circulation
Fractures of the larynx or trachea can cause air to leak from the airway into the subcutaneous tissues. The presence of air in the soft tissues produce a crackling sensation called _____ _____.
Subcutaneous emphysema
What are the signs of Cushings triad and what do they indicate?
1. Hypertension w/ widening pulse pressure
2. Bradycardia
3. Irregular respirations
It indicates Increased Intracranial Pressure (ICP)