Bleeding
The body cannot tolerate an acute blood loss of greater than
20% of total blood volume
More than 2 pints
Blast Injuries
Primary Blast Injury - injuries caused by blast wave itself
Secondary Blast Injury - Injuries caused by flying debris
Tertiary Blast Injury - Injuries to body from being thrown or hurled by force of explosion
What is a primary concern in an open neck injury?
Possibility of air embolism
Axial Loading Injuries
You are dispatched to an assault in downtown. You find the patient who is holding his swollen face, a lready beginning to show signs of early bruising. When you attempt to get a history, he mutters his answers through gritted teeth, which are crooked when you attempt to examine it. When asked if he feels any pain, he shakes his head.
Mandible fracture
Hemostatic Dressing
dressing impregnated with chemical compound that slows or stops bleeding by promoting clot formation
Compartment Syndrome
develops when edema and swelling
What cartilage forms the Adam's apple?
Thyroid cartilage
Spinal Column
Cervical (7) Thoracic (12) Lumbar (5) Sacral (5) Coccyx (4)
You are dispatched to a home in the suburbs where a man explains he has new symptoms. When you arrive, you notice the patient has racoon eyes, and upon further assessment, you identify battle signs and CSF leaking from his ears.
Basilar skull fractures
S/S of Internal Bleeding
Bonus: Most common?
Pain, tenderness, bruising, guarding, swelling, distention, tachycardia, melena, hematemesis, hematuria, hemoptysis, hematoma
B: Pain
Three functions of bandages and dressings
To control bleeding, protect wound from further damage, prevent further contamination
Hyphema
Bleeding into the anterior chamber of the eye that obscures part or all of the iris
What signifies increased ICP?
Cushing Reflex: increased systolic blood pressure, decreased heart rate, irregular respirations
You are dispatched to a local gym where a man has been hit in a boxing spar. He denies having any pain when asked, but he responds that he is seeing floaters in his field of vision and flashing lights. He says it kind of feels like he's looking through a cloud.
Retinal detachment
Methods to control bleeding, in order
Direct pressure, pressure dressing, tourniquet, splinting device
Classify the three degrees of burns
Superficial - involve only epidermis, often painful
Partial Thickness - Involve epidermis and some portion of dermis, skin is moist, mottled, white to red, blisters present
Full Thickness - Extend through all skin layers, may involve subcutaneous layers, muscle, bone, internal organs, burned area is dry, leathery, may appear white/dark brown/charred, burned area may have no feeling
What kind of burn to the eye is often not painful at first but may become so 3-5 hours after injury?
Light burns
Central Neurogenic Hyperventilation
Abnormal breathing pattern associated with increased ICP, characterized by rapid and deep breathing
You are dispatched to a patient who has hit her head. She complains of a sudden severe headache and a sort of stiffness in her neck. Upon further assessment, you determine there is a change in pupils and there is a fluctuating level of consciousness.
Subarachnoid hemorrhage
Describe arterial bleeding, venous bleeding, and capillary bleeding
Arterial - Bright red, spurts in time with pulse
Venous - Darker red than arterial, can flow rapidly/slowly depending on size of vein
Capillary - Dark red, oozes slowly but steadily
Write out the Rule of Nines as per the Limmer Education
Adult - 9% head, 18% torso/back, 9% arms, 18% legs, 1% groin
Child/Infant - 18% head, 18% torso/back, 9% arms, 14% legs, 1% groin
Blow-Out Fracture, S/S
Blunt trauma causes a displaced fracture of the orbit
Pain, double-vision, decreased vision
Write out GCS
Eye opening: Spontaneous (4) Response to Sound (3) Response to Pressure (2) None (1)
Verbal: Oriented (5) Confused (4) Inappropiate Words (3) Incomprehensible Sounds (2) None (1)
Motor: Obey Commands (6) Localizes Pressure (5) Withdraw from Pressure (4) Abnormal flexion (3) Abnormal extension (2) None (1)
You are dispatched to an MVC where the driver is semiconscious in the front seat. The steering wheel has slight damage to the front, and there are fast and then slow respirations, decreased pulse rate, sluggish pupils, and decerebrate posturing.
Increased ICP
Coup-contrecoup