Bleeding & Shock
A patient presents after a minor MVC. He has no obvious bleeding, is alert, but states "I feel weird". Skin is slightly pale, radial pulses are weak, HR 110.
What is the most important conclusion?
What is SHock can be present without obvious injury or hypotension
A burn patient is screaming in pain with blistering burns.
What does this indicate about the burn severity?
What is severe pain=nerve endings in tact (partial thickness burn)
A patient answers questions correctly but responds slowly after a head injury.
What does this indicate?
Slowed responses suggest declining brain function and possible worsening head injury.
A patient with blunt chest trauma has equal lung sounds but complains of increasing chest tightness. What should you be concerned about?
You should not rely solely on initial lung sounds, as a serious chest injury may still be developing internally.
After splinting a fracture, a patient reports increasing tightness and tingling, but pulses are still present. What should you do?
You should reassess and adjust the splint because this may indicate early neurovascular compromise.
A trauma patient has BP 118/76, HR 118, RR 22, cool skin, and delayed cap refill.
Which finding would MOST influence your decision making?
What is skin signs and perfusion
A burn patient is stable and you are 10 minutes from the hospital. What is your priority?
A patient has a GCS of 14 due to confusion but otherwise stable vital signs.
What is the most important interpretation?
Any altered mental status is significant and indicates a potential brain injury regardless of normal vital signs.
You apply an occlusive dressing to an open chest wound. What complication must you monitor for?
You must monitor for the development of a tension pneumothorax as air may become trapped in the chest.
A patient denies pain but has a rigid abdomen after trauma. What does this indicate?
A rigid abdomen is a serious sign of internal injury and possible bleeding, even if the patient denies pain.
You applied a tourniquet and bleeding as stopped. The patient reports severe pain and numbness distal to the injury.
What is the correct action?
Leave tourniquet in place (life or limb)
You have one burn patient and one patient with severe bleeding. Who is your priority?
You are ventilating a patient with a head injury too rapidly. Why is this dangerous?
Hyperventilation decreases carbon dioxide levels, which can reduce cerebral blood flow and worsen brain injury.
After applying an occlusive dressing, the patient becomes more short of breath. What should you do?
You should lift or “burp” the dressing to allow trapped air to escape and relieve pressure.
A patient has bilateral femur fractures but is alert and talking. Why is this still a high-priority patient?
Bilateral femur fractures can cause significant internal bleeding and lead to shock even if the patient appears stable.
A trauma patient becomes suddenly calm after being anxious, and heart rate begins to drop.
Why is this concerning?
A burn patient has soot around their mouth but is speaking clearly and denies breathing difficulty.
What is your biggest concern?
You should anticipate airway compromise because inhalation injuries can worsen rapidly even if the airway currently appears normal.
A head injury patient becomes increasingly restless and attempts to sit up despite spinal precautions. What is your best action?
You should maintain spinal motion restriction while addressing possible hypoxia or worsening brain injury by ensuring adequate oxygenation.
A trauma patient has hypotension, tachycardia, and respiratory distress, but lung sounds are difficult to assess due to noise. What should guide your decision-making?
You should rely on signs of shock and the mechanism of injury rather than unreliable lung sounds.
You have three patients:
An open fracture with severe pain
A closed fracture with minimal pain
A patient with minor injuries but pale skin and confusion
Who is the highest priority and why?
The third patient is highest priority because signs of shock indicate a life-threatening perfusion problem.
Two patients
Patient A: controlled bleeding, HR 130, confused
Patient B: uncontrolled bleeding, alert, yelling
Who do you treat first?
Who is patient B- uncontrolled bleeding = highest priority
A burn patient begins to develop stridor during transport.
What is your most critical action?
You should prioritize rapid transport and airway management because stridor indicates airway swelling and impending obstruction.
A head injury patient begins vomiting and develops snoring respirations. What is your first priority?
You must immediately manage the airway by suctioning and positioning the patient to prevent aspiration and maintain airway patency.
A chest trauma patient is alert with mild pain, but their blood pressure is dropping and mental status is worsening. What is the most critical mistake to avoid?
You must avoid focusing on the patient’s pain level and instead recognize the signs of shock as the primary life threat.
A patient from an MVC is confused, has an obvious leg deformity, pale and diaphoretic skin, and a heart rate of 128.
What is your first priority?
The first priority is managing airway and breathing with oxygen and initiating rapid transport.