Trauma

Question 1

Diving Related Ilnesses

Answer 1

AGE
The Bends
Nitrogen Narcosis

Question 2

Altitude Related Illnesses

Answer 2

HAPE
HACE
AMS

High-altitude pulmonary edema (HAPE), high-altitude cerebral edema (HACE), and acute mountain sickness (AMS)

They occur in individuals ascending to high elevations, leading to hypoxia-related symptoms due to low atmospheric pressure and oxygen levels.

Question 3

Class I Hemorrhage

Answer 3

< 15% Blood Loss
< 750 mL
- COMPENSATED SHOCK

S/S:
- Minimal signs

Question 4

Class II Hemorrhage

Answer 4

15-30% Blood Loss
- COMPENSATED SHOCK

750–1500 mL

S/S:
- Tachycardia,
- Anxiety

Question 5

Class III Hemorrhage

Answer 5

30-40% Blood Loss
- DECOMPENSATED SHOCK

1500–2000mL

S/S:
- Hypotension
- Confusion

Question 6

Class IV Hemorrhage

Answer 6

> 40% Blood Loss
- IRREVERSIBLE SHOCK

> 2000 mL

S/S:
- Pre-Arrest
- SHOCK

Question 7

Administer O2 to Pt’s in SHOCK even at 97% room air??

Answer 7

YES!!

Even though the SpO2 is 97%,
patients in SHOCK have
IMPAIRED Tissue O2 Delivery.

High-Flow O2 IMPROVES
O2 Content in the Blood & Compensates for DECREASED Hemoglobin due to Blood Loss.

It’s a STANDARD INTERVENTION to SUPPORT Perfusion in
SHOCK states,
Especially in ELDERLY or COMPROMISED Pts.

Question 8

Transient quadriplegia

Answer 8

A temporary condition characterized by the loss of motor and sensory function in all four limbs, often occurring after a head or neck injury in athletes.

It resolves within a short period without permanent damage.

Question 9

Axial loading

Answer 9

is a force applied along the axis of the spine, such as when the head is compressed downward during a collision, which can cause cervical spine injuries like transient quadriplegia.

Question 10

Hyperflexion

Answer 10

refers to excessive forward bending of the neck, often occurring during sports injuries, which can stretch or damage the spinal cord and lead to temporary or permanent neurologic deficits.

Question 11

Spinal shock

Answer 11

TEMPORARY LOSS of ALL Neurologic Activity
- BELOW the LEVEL of INJURY, INCLUDING:
- Reflexes,
- Motor &
- Sensory Function,

Usually Presenting with
- FLACCID PARALYSIS
That May Later Become Spastic.

Question 12

Neurogenic shock

Answer 12

A type of SHOCK resulting from a SUDDEN LOSS of SYMPATHETIC NERVOUS SYSTEM Signals Leading To:
- DECREASED BP & HR
Often Seen in
- SPINAL CORD INJURIES

Question 13

Central Cord Syndrome

Answer 13

INCOMPLETE SPINAL CORD INJURY

Typically Due To:
- HYPEREXTENSION
where there is Greater Weakness in
UPPER Extremities than LOWER.

MOST COMMONLY seen in
- Older Adults.

Question 14

Priority Treatment for a MULTI-SYSTEMS
TRAUMA Pt?

Answer 14

X.A.B.C.

X - Exsanguinating or Life-Threatening
Bleeding
A - AIRWAY
B - BREATHING
C - CIRCULATION

Question 15

FLAIL CHEST

Answer 15

Occurs when a SEGMENT of The RIB CAGE
Breaks Due to TRAUMA & Becomes Detached from the Rest of the Chest Wall,
LEADING To:
- Paradoxical Movement During Breathing &
- Impaired Ventilation.

Question 16

FLAIL CHEST TREATMENT:

Answer 16

IF NO SUSPECTED SPINAL INJURY:
- Place a patient on the affected side

SUSPECTED SPINAL INJURY:
- Secure the Segment with a BULKY DRESSING Taped to the Chest
- Be Prepared to Provide Bag-Mask Ventilator Support.

Question 17

Preferred Method of ACTIVE ReWarming in the PreHospital environment?

Answer 17

Warm IV FLUIDS
- Does NOT Cause ReWarming SHOCK

Question 18

PASSIVE ReWarming methods?

Answer 18

Warm Blankets

Warm Heat from Ambulance Heater

Question 19

Resuscitate BEFORE you Intubate

Answer 19

Emphasizes Stabilizing
- Pt’s Vital Signs,
Particularly
- Oxygenation & Circulation,
BEFORE Attempting INTUBATION.

This Approach HELPS
PREVENT Further Deterioration
During The Intubation Process.

Question 20

The Electrolyte of the Greatest Concern in HEAT ILLNESSES is:

Answer 20

SODIUM

Question 21

Techniques a Paramedic can use to REDUCE the RISK of being INJURED by LIGHTNING?

Answer 21

Squat Down LOW with MINIMAL CONTACT with the Ground.

AVOID EXTREMES of HIGH GROUND like Rocky Cliffs for Shelter.

IMMEDIATELY Get OUT Of & AWAY From
- Ponds
- Lakes
- Other Bodies of WATER.

IF You MUST SEEK SHELTER in Trees,
Find a BUNCH of TREES that are UNIFORM in SIZE.

NEVER SHELTER UNDER an ISOLATED TREE & AVOID
Staying OUT in the OPEN, Especially
Where YOU Are The TALLEST OBJECT.

Question 22

Brainstem Herniation

Answer 22

Life-Threatening Condition where INCREASED ICP FORCES Brain Tissue To SHIFT from its Normal Position, COMPRESSING The BRAINSTEM.

This Can DISRUPT VITAL FUNCTIONS
- Breathing &
- Heart Rate,
Often Presenting With
- FIXED & DILATED PUPILS &
- ABNORMAL DECEREBRATE
POSTURING.

Question 24

Cheyne-Stokes Respirations

Answer 24

A Pattern of Breathing Characterized By
- Gradual INCREASE in DEPTH &
- Sometimes RATE,
Followed by a DECREASE Resulting in
- APNEA.

It is OFTEN Associated with DAMAGE to -
- The BRAINSTEM or
- INCREASED ICP

Question 25

The Order of IMMEDIATE ARTERIAL HEMORRHAGE Techniques?

Answer 25

1. APPLY DIRECT PRESSURE: The first and most immediate hemorrhage control technique is direct pressure. 2. COVER WOULD with HEMOSTATIC DRESSING If bleeding persists or the wound is deep, using a hemostatic agent helps to activate clotting locally. 3. APPLY a TOURNIQUET: If direct pressure and hemostatic dressings fail and bleeding is life-threatening and not controllable by other means, the tourniquet is indicated. 4. ELEVATE the LIMB: Elevation may assist venous return, but is secondary and not sufficient alone for arterial bleeding.

Question 26

THOMPSON TEST

Answer 26

Clinical examination used to assess the integrity of the Achilles tendon. During the test, the patient lies prone with feet hanging off the edge of a table, and the examiner squeezes the calf muscle. A lack of foot movement indicates a positive test, suggesting a possible Achilles tendon rupture.

Question 27

Symptoms of Achilles Tendon Rupture

Answer 27

Pain from the heel to calf Ecchymosis of the posterior calf No movement of the foot when squeezing the calf muscle, known as the Thompson test

Question 29

"90-90-9 Rule"

Answer 29

A single-digit drop below 90% SpO2 significantly increases the patient's chance of death. A single-digit drop in systolic BP below 90 mmHG significantly increases the patient's chance of death. A single drop of 2 points or more in the patient's prior best GCS Score of less than 9 increases the patient's chance of death

Question 30

Baroreceptors

Answer 30

Specialized Nerve Endings Located at The WALLs of BLOOD VESSELS - The AORTIC ARCH - CAROTID SINUSES They Detect CHANGES in BP & HELP - REGULATE CARDIOVASCULAR Function By Signaling the BRAIN To: - ADJUST HEART RATE & - VESSEL DIAMETER

Question 31

Central Chemoreceptors

Answer 31

Located in the MEDULLA OBLONGATA RESPOND to CHANGES in the - LEVELS of Carbon Dioxide (PCO2) & - pH in the Cerebrospinal Fluid, Play a CRUCIAL ROLE in REGULATING - Respiratory Rate & Depth

Question 32

Peripheral Chemoreceptors

Answer 32

Sensory Receptors Located in the - AORTIC & CAROTID Bodies That DETECT CHANGES in - BLOOD OXYGEN (PO2), - Carbon Dioxide (PCO2) & - pH LEVELS, Helping to REGULATE - Respiratory & - Cardiovascular Responses.

Question 33

Needle Thoracostomy

Answer 33

A medical procedure involving the insertion of a needle into the pleural space to relieve pressure from a tension pneumothorax, Typically Performed at the - 2nd Intercostal Space at the - MidClavicular LINE. 10G Needle 3.5in Long

Question 34

Your adult patient is exhibiting signs and symptoms of hemorrhagic shock secondary to multiple stab wounds from an assault. You initiate 2 IV lines in bilateral arms. You administer fluid boluses in increments of 250 ml. What blood pressure range should you titrate the fluids to maintain? A 100-120 mmHg B 70-100 mmHg C 80-90 mmHg D 60-80 mmHg