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Primary concern when a person cannot stop coughing/clearing their throat following house fire/smoke? - ANSWER-Airway/Intubate Lab evidence of cellular perfusion - ANSWER-Base Excess (Less than -6 is BAD) Multiple people are in the ER of different ages who all go to the same church. They all have the same symptoms. What is the most likely cause? - ANSWER-Biologic Suspected shock type with a spinal cord injury - ANSWER-Distributive Shock (Includes neurogenic) Patient has GCS of 3, unequal pupils (one sluggish, one blown), and is posturing. What is the cause? - ANSWER-Herniation Middle Meningeal Artery - ANSWER-Epidural Hematoma (results from collection of blood that forms between dura mater and skull) Prior to having a concussion (TBI), the patient had a brain injury that was not fully healed. What is the cause? - ANSWER-2nd Impact Syndrome Bowel sounds heard in the L chest. What is this a symptom of? - ANSWER-Ruptured diaphragm Symptoms of __________________: include muffled heart sounds and hypotension - ANSWER-Pericardiocentesis How should you dress a severed limb? - ANSWER-Sterile gauze with normal saline THEN put ice on it Amylase level looks at _____________ - ANSWER-Pancreas What should you do if your patient has hyphema (collection of blood inside the front part of the eye?) - ANSWER-Sit HOB up to 30 degrees Principle that people have to take action after suffering a loss in order to decrease severity, seriousness, or painfulness - ANSWER-Mitigation What organ is most at risk following a gunshot - ANSWER-Liver 8 year old child with longitudinal thigh lacerations - ANSWER-Sign of child abuse Bleeding around belly button - ANSWER-Cullen's Sign What would cause an inaccurate reading from an 02 saturation probe? - ANSWERCarboxyhemoglobin (increase FiO2 to 100%) General study of forces and their effects on living tissue and the human body - ANSWER-Biomechanics Study of energy transfer as it applies to identifying actual or potential injuries - ANSWER-Kinematics Refers to the separation of tissue resulting from a sound and/or hydraulic wave forcethe effect is a crushing pressure wave which creates a temporary cavity, followed by a rapid and violent closing of the cavity. - ANSWER-Cavitation This rapid motion can lead to crushing, tearing, and shearing forces on tissue - ANSWER-Cavitation Used in OR; does not provide protection against aspiration and not recommended in patients who have eaten recently. It is a supraglottic airway. - ANSWER-Laryngeal Mask Airway Single tube retroglottic device inserted into the esophagus and traps the glottis opening between an esophageal cuff and an oropharyngeal cuff. Designed with 2 ports/lumens each with a separate cuff. Does NOT provide protection against aspiration and is not indicated in children. It is a retroglottic airway. - ANSWER-King Tube Types of Shock (4) - ANSWER-Hypovolemic, Obstructive, Cardiogenic, Distributive Hemorrhage is the leading cause. Can result from vomiting, diarrhea, and burn trauma. Decreased circulating volume -- decreased preload. Therapy includes replacing the type of volume that was lost. - ANSWER-Hypovolemic Shock Results from hypo perfusion of tissue due to an obstruction in either the vasculature or heart. Therapy aimed at relieving the obstruction and improving perfusion. - ANSWERObstructive Shock Two classic examples of obstructive shock - ANSWER-Cardiac tamponade and tension pneumothorax Results from pump failure in the presence of adequate intravascular volume. Lack of CO and end-organ perfusion secondary to a decrease in myocardial contractility and/or valvular insufficiency. Therapy includes inotropic support, antidysrhythmic medications, and correction or treatment of underlying cause. - ANSWER-Cardiogenic Shock Results from the misdistribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. Treatment is to provide volume replacement, increase systemic vascular resistance with medications (pressors) and possible antibiotics. - ANSWER-Distributive Shock Examples that can cause distributive shock - ANSWER-Anaphylactic shock, septic shock, neurogenic shock
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