Spinal Assessment
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SMR and C-Collar application are contraindicated in all cases of...
Isolated Penetrating Trauma
Administer normal saline 500ml IV/IO bolus prn to a total max of 2L, titrate systolic blood pressure to (blank) or presence of radial pulses.
90mm Hg
You arrive on scene to Willow Square nursing home. Your patient is 78 years old and laying in a seated position on the floor in the shower. Obvious distress and discomfort noted on approach.
C/C- 10/10 left hip pain.
HxCC- Patient fell from standing in shower.
OA- left lower external leg rotation, left leg looks longer than the right. Distal pulses present. Pelvis stable.
Give 1 Differential diagnosis and how we would move this patient to our stretcher.
Left hip dislocation. Consider pain analgesics prior to move.
Pelvic wrap
Scoop stretcher to ambulance stretcher.
Help to standing on good leg and sit on stretcher.
Burns 10% or greater apply:
Burns less than 10% apply:
Clean dry sheets
Clean moist dressing
Ideal positioning for a Head injury patient is how many degrees of head elevation?
30 degrees OR Low Fowlers position
The patient will be asked to perform a Range of Motion Examination to rule out Cervical injury by rotating their neck voluntarily how far to the left and right without resistance or pain?
45 Degrees
List 3 medical signs we would initially expect to see of a patient's vitals in hypovolemic shock.
Tachycardic
Normotensive/hypotensive
Increased Respiratory rate
This pelvic fracture pattern involves disruption of the pubic symphysis and sacroiliac ligaments.
Open book fracture
According to the Adult Burn protocol, full thickness burns involving what BSA of the body are considered critical?
5%
Late signs of "Racoon eyes or Battle signs" results from fractures at the base of the skull, also known as...
Basilar skull fracture
A long backboard is not required to achieve SMR and is contraindicated in patients who have long transport and/or wait times greater than ...
30 minutes
*TXA Treatment criteria must be met by two factors
Traumatic injury within the last 3 hours
Presents at any time with HR greater than 110bpm or systolic less than 90mmHg.
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Regarding the Pediatric Pain management protocol, a 2-year-old, who has severe visible left facial trauma from a dog attack is normotensive. What is the single max dosage of Fentanyl IV/IO for this patient?
50mcg IV q 5 minutes PRN max 150 mcg.
2nd degree, or "Partial thickness burns" involve what layers of the integumentary system.
Epidermis, and the Dermis.
Characterized by blisters that are easily unroofed, wet or waxy dry and variable color.
A respiratory pattern characterized by increasing and decreasing breathing volumes, followed by a period of apnea.
Cheyne-Stokes respirations
Name 3 "High Risk Factors" for spinal injury.
-Fall from 1m/5 stairs or greater
-MVC (speeds >100km/hr, rollover, ejection)
-Motorized recreational vehicle
-bicycle collision with object-
-Medical risk (DBD, prolonged steroid use)
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List the (4) contraindications of TXA.
Hypersensitivity
Active thromboembolic disease
Unable to initiate bolus within 3 hours of injury onset
If unable to contact OLMC, do not administer to patients less than 16 years of age.
This Hip fracture is often occult on initial Xray but should be suspected in elderly patients with shortened, externally rotated legs and inability to bear weight after a minor fall.
Femoral Neck Fracture
In relation to Fluid resuscitation, over resuscitation can cause (blank) of both the abdomen and extremities and puts the patient at risk for Acute Respiratory Distress Syndrome or "ARDS".
Compartment Syndrome
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This type of intracranial hemorrhage typically results from tearing of bridging veins and often presents with a gradual decline in mental status over hours to days.
Subdural Hematoma
During assessment of a 32-year-old patient involved in a rollover MVC, the patient is alert (GCS 15), ambulatory on scene, denies neck pain, and has no neurological deficits. The patient however has a visibly angulated femur fracture and is in significant pain. According to AHS MCP Spinal Assessment protocol, this finding may prevent you from clearing the spine.
Distracting Injury
During the early phase of traumatic hemorrhagic shock, this physiologic response temporarily maintains systolic blood pressure despite significant blood loss by increasing heart rate and vascular resistance. Because of this mechanism, patients may lose up to 30% of their blood volume before hypotension becomes apparent.
Compensatory vasoconstriction
Pain with passive stretch, tense compartments, paresthesia, and decreasing pulses suggest this limb-threatening complication of fractures.
Compartment Syndrome.
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In burn resuscitation, this physiological parameter-rather than blood pressure- is considered the most reliable early indicator of adequate fluid resuscitation.
Urine output
A patient presenting with a GCS drop of 2 or more from initial presentation, decorticate posturing, and a blown pupil are indicative of what life-threatening diagnosis.
Herniation syndrome.