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 t o 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 Hypere xtension 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 signifi cant 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 swelli ng, 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 ou t 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 wa rrant 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, tor so 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 t o 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 stabiliz ation, 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 com mon 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 fro m 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 t o 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
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, tor so 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 t o 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 stabiliz ation, 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 com mon 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 fro m 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 t o 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
