NSER 7410 MOD 1 ACTUAL EXAM WITH COMPLETE SOLUTIONS
What is "the golden hour" and why is it called "the silver half hour" for infants and children?
The first hour following traumatic injury for adults
"Silver half hour" for kids b/c kids may deteriorate more quickly with same injuries
Implies that morbidity and mortality are affected if care is not instituted within the first hour
after injury
Goals of EMS
1. Prevention of further injury
2. Initiation of resuscitation
3. Timely and appropriate transfer to receiving facility.
Explain the "trimodal distribution of death"
Evolution of management and education in trauma care is based on the concept that there
is a trimodal distribution of mortality in trauma outcomes
Approximately 50% of all patients that die as a result of trauma die at the scene as a direct
result of the mechanism of injury.
30% die within minutes to hours of injury.
20% die within days to weeks following injury.
, Trauma triad of death
Hypothermia
Acidosis
Coagulopathy
How does hypothermia affect the triad
Coagulopathy
- Slows clotting
- Reduces production of clotting factors
- Sequesters clotting factors in liver and spleen
- Impairs platelet aggregation and adherence
Acidosis
- Causes vasoconstriction >> dec peripheral perfusion >> anaerobc metabolism >> lactic
acidosis
Leading cause of preventable death after injury
Hemorrhage
3 most common causes of death related to traumatic injury (hemorrhage is the leading
cause of preventable death after injury)
Acidosis
Hypothermia
What is "the golden hour" and why is it called "the silver half hour" for infants and children?
The first hour following traumatic injury for adults
"Silver half hour" for kids b/c kids may deteriorate more quickly with same injuries
Implies that morbidity and mortality are affected if care is not instituted within the first hour
after injury
Goals of EMS
1. Prevention of further injury
2. Initiation of resuscitation
3. Timely and appropriate transfer to receiving facility.
Explain the "trimodal distribution of death"
Evolution of management and education in trauma care is based on the concept that there
is a trimodal distribution of mortality in trauma outcomes
Approximately 50% of all patients that die as a result of trauma die at the scene as a direct
result of the mechanism of injury.
30% die within minutes to hours of injury.
20% die within days to weeks following injury.
, Trauma triad of death
Hypothermia
Acidosis
Coagulopathy
How does hypothermia affect the triad
Coagulopathy
- Slows clotting
- Reduces production of clotting factors
- Sequesters clotting factors in liver and spleen
- Impairs platelet aggregation and adherence
Acidosis
- Causes vasoconstriction >> dec peripheral perfusion >> anaerobc metabolism >> lactic
acidosis
Leading cause of preventable death after injury
Hemorrhage
3 most common causes of death related to traumatic injury (hemorrhage is the leading
cause of preventable death after injury)
Acidosis
Hypothermia
