EMT Trauma Fisdap Exam 2024

EMT Trauma Fisdap Exam Treatment for a patient with full-thickness burns - ✔High-flow oxygen; dry, sterile dressings; thermal management (keep patient warm); provide rapid transport What should you do if there is a major hemorrhage in a patient? - ✔Apply a proximal tourniquet to stop the bleeding immediately. Then turn to patient's airway and breathing status (CAB) How do you care for a partially amputated extremity? - ✔Control bleeding with bulky compression (pressure) dressings and splint extremity to prevent further injury Injury to the cervical spine from a hanging occurs through - ✔distraction, or stretching, of the vertebrae and spinal cord What is a subluxation - ✔a partial or incomplete dislocation; this is an injury, not an injury mechanism Injuries related to Hyperextension mechanisms - ✔Patients who strike their head on the windshield during a mvc Axial Loading MOI - ✔The spinal column is compressed vertically; injuries after diving head first into shallow water and lumbar spine injuries after a fall from a significant height and landing feet first What does cold, pale skin and an absent distal pulse indicate in a limb? - ✔Indicates that blood flow distal to the injury is compromised How do you make one attempt to restore distal circulation? - ✔By applying gentle manual traction in line with the long axis of the limb What can you do to a limb after distal circulation is restored? - ✔Splint the limb in whatever position allows the strongest distal pulse, elevate limb above level of the heart to help minimize swelling, and an icepack may also help reduce pain and swelling What is a flail chest? - ✔Occurs when several ribs are fractured in more than one place; the result is a free-floating section of ribs (flail segment) that collapses during inhalation and bulges out during exhalation (paradoxical chest movement) What happens as the flail segment (flail chest) collapses? - ✔The lung is compressed and ventilation is impaired. Treatment should include PPV and prompt transport.

12 Injuries or clinical findings that warrant transport to a high level trauma center: - ✔GCS equal or less than 13 after trauma -systolic BP less than 90 mm Hg -Resp. rate less than 10 or greater than 29 breaths/min -need for ventilatory support -all penetrating injuries to the head, neck, torso or extremities proximal to the knee or elbow -chest wall instability or deformity (flail chest) -two or more proximal long bone fractures -a crushed, degloved, mangled or pulseless extremity -amputation proximal to the ankle or wrist -pelvic fractures -open or depressed skull fracture -paralysis What happens to the skin of the body when the body attempts to compensate for shock? - ✔Peripheral vasoconstriction shunts blood away from the skin to the more vital organs in the body What should you do if your patient's condition deteriorates en route to a trauma center?

- ✔Ex: increased respiratory rate; immediately repeat the primary assessment and adjust your treatment accordingly. After stabilization, reassess vital signs, including oxygen sat., and notify the receiving facility Primary blast injury - ✔Direct result of the pressure wave that occurs during an explosion. Hollow organs are most susceptible and ruptured tympanic membrane is most common injury Secondary blast injury - ✔When shrapnel and other debris are propelled away from explosion, resulting in impalement injuries Tertiary blast phase - ✔Blunt traumatic injuries (skull fracture, spinal injury) when the person is propelled away from the explosion and strikes a solid object Hyphema - ✔blood in the anterior chamber of the eye resulting from blunt trauma.

Obscures a portion of or the entire iris Fracture of orbital floor (blowout fracture) symptoms - ✔Double vision and an inability to move eyes above the midline (paralysis of upward gaze) following blunt facial trauma Mechanism of an orbital blowout fracture - ✔Fragments of fractured bone can entrap some of the muscles controlling eye movement anisocoria - ✔Unequal pupils following head trauma indicated increased intracranial pressure

What conditions make external bleeding difficult to control? - ✔The larger the size and type of blood vessel (artery vs. vein) injured and the higher the patient's blood pressure Most common Decompensated shock sign - ✔Hypotension Early signs of shock - ✔restlessness, anxiety, pale skin, tachycardia (high HR), tachypnea (high RR), diaphoretic Treatment for patient with significant head injury - ✔-high flow oxygen -assisting ventilations -immobilizing entire spine -transporting promptly -monitor for vomiting Most reliable indicator of a a fracture to a spinal vertebra - ✔Presence of palpable pain (point tenderness directly over injury site) GCS assesses three neurologic parameters: - ✔-eye opening -verbal response -motor response Asymmetrical chest wall movement - ✔When one side of the chest moves less than the other; indicates decreased air movement into one lung (pneumo or hemothorax).

Overall sign of decreased air movement into one lung Care for musculoskeletal injuries - ✔Assessing distal circulatory, sensory and motor functions before and after applying a splint S/S of severe brain trauma - ✔-decreased LOC -hypertension -bradycardia -irregular breathing -posturing Hemopytsis - ✔Coughing up blood--suggests injury to or bleeding within the lungs Hematemesis - ✔Vomiting of bright or dark red blood--suggests GI bleeding Intra-abdominal bleeding signs - ✔Presents with signs of shock as well as: -abdominal pain -guarding -rigidity -bruising -distention

Adult Rule of Nines - ✔Burn assessment.

Head-9 Chest and abdomen-18 Full back-18 Full arm-9 Groin-1 Full leg-18 Two immediate life threats from Jugular vein lacerations: - ✔Entrainment of air into the wound (causing fatal air embolism) and severe external bleeding. Apply occlusive dressing and then cover occlusive dressing with bulky (pressure) dressings to control external bleeding S/S of closed head injuries - ✔-pupillary abnormalities -Cushing's triad: hypertension, bradycardia, abnormal breathing (slow and irregular to rapid and deep) Cushing's triad - ✔three classic signs—bradycardia, hypertension, and bradypnea— (slow and irregular to rapid and deep) Pericardial tamponade (usually caused by a penetrating chest trauma): - ✔Blood collects in the pericardial sac, preventing heart from filling during diastolic phase and causing a decrease in cardiac output and blood pressure S/S of pericardial tamponade - ✔-Muffled/distant heart tones -rapid, weak pulse -hypotension -jugular venous distention (JVD) -narrowing pulse pressure Treatment for pericardial tamponade (penetrating trauma) - ✔-Adequate oxygenation and ventilation -covering chest wound with occlusive dressing -controlling any external bleeding -transport rapidly S/S of upper airway burns - ✔-Respiratory distress -singed facial and/or nasal hairs -brassy cough -difficulty breathing -coughed up sooty sputum Beck's triad - ✔Classic presentation of pericardial tamponade: -JVD (blood backing up into venous system because of impaired cardiac filling)

-muffled or distant heart sounds -narrowing pulse pressure -tachycardia, weak pulses, hypotension Commotio cordis - ✔A blunt chest injury caused by a sudden, direct blow to the chest that occurs only during the critical portion of a person's heartbeat. It can cause immediate cardiac arrest from V-Fib S/S of hemorrhagic shock - ✔Hypotension, tachycardia, tachypnea Hematoma - ✔Larger blood vessels are ruptured and the internal bleeding forms a 'lump' Mottling - ✔Occurs when skin takes on a blotched purple appearance and is a sign of shock (hypoperfusion) Neurogenic shock S/S - ✔Interruption of nervous system's control over the diameter of the blood vessels. Blood vessels dilate, patient's blood pressure falls, and bradycardic Control for any open injury: - ✔controlling external bleeding, then manually stabilizing the injury site, applying a sterile dressing and assessing distal perfusion and pulse, motor and sensory functions (PMS), then stabilizing the injury with an appropriate splint. subcutaneous emphysema (crepitus) - ✔Air escapes into the tissues, dissects fascial planes under the skin and accumulates making areas appear puffy. Slight finger pressure produces a crackling sound and feel. Lightly dot the area tension pneumothorax - ✔Air fills the pleural space and progressively collapses the lung. In the process, the vena cavae are compressed and blood return to the heart is reduced (clinically manifesting in JVD as blood backs up into systemic venous system) Hemothorax - ✔Blood fills the pleural space.

-Breath sounds are decreased or absent on affected side -jugular veins collapse instead of distention due to blood volume being lost into the chest cavity Posterior hip dislocation - ✔Flexed hip joint and internal rotation of thigh Anterior hip dislocation - ✔Limb is in opposite position, extended straight out, externally rotated and pointing away from the midline of the body Displaced fracture of the proximal femur - ✔Leg externally rotated and shorter than uninjured leg

Patients with increased intracranial pressure present with: - ✔Hypertension, bradycardia, and irregular respirations that are fast or slow (Cushing's triad) Subdural hematoma - ✔Bleeding occurs between the dura mater and the surface of the brain; typically caused by venous bleeding Epidural hematoma - ✔bleeding between the skull and dura mater; usually caused by arterial bleeding. Patient presents with immediate S/S Goal of primary assessment - ✔To rapidly identify and correct all life-threatening injuries or conditions