Paramedic trauma final + midterm latest 2023 graded A+

Paramedic trauma final + midterm latest 2023 graded A+ Care for an amputated part includes all of the following except : submerging in a bucket of ice Your patient has been hit accidently in the upper arm by a piece of lumber in a construction site. The arm displays an area that is purple in color and painful to the touch. No deformity is noted. Patient displays good distal pulses, finger dexterity and sensation to the hand and fingertips. His injury is most probably a(n): hematoma When should an EMS crew released a field placed tourniquet Never Your patient has 2' burns to her entire back and both arms. Her BSA based on the Rule of Nines would be : 36% Why do major burn patients experience hypothermia so easily ? the way that the body regulates body temperature is through expansion and contraction of capillaries close to the surface of the skin along with perspiration through sweat glands of the skin. these mechanisms are disrupted when the skin is damaged through burns. The areas of sensory controlled by specific spinal nerves are know as : dermatomes A LeFort fracture occurs : in the face Your patient has been hit in the face by a falling tree branch. He displays bleeding into the anterior chamber of his left eye globe. The blood is in front of the iris. This condition is known as a(n): hyphema Your patient is found with a blood pressure of 210/118 , a pulse rate of 46 and a significantly irregular respiratory pattern. He most probably is experiencing : a closed head injury Distended neck veins, cyanosis, hyperressonance , hypoperfusion and tracheal shift are symtomology of: Tension pneumothorax Flat neck veins, "dull" percussive sounds, hypoperfusion and dyspnea are symptomology of: hemothorax Distended neck veins, midline trachea, narrowing pulse pressure and muffled heart sounds are symptomology of : Simple pneumothorax Pericardial tamponade Your patient has a softball size hematoma noted to his ULQ. This is secondary to an assault he was involved in. He is pale and diaphoretic. His injury is very tender to the touch. No other trauma is noted. He most probably has: a spleenic injury Muscle connects to bone via : tendons Bone connects to bone via ligaments Hemostasis events consists of all the following except: vascular spasms platelet plugs fibrin net generation Correct! increase in red blood cells The human body looses heat by all of the following except: Correct! thermogenesis radiation convection respiration Whose "law" states that the total mixture of gasses is equal to the sum of the partial pressures of the individual gases ? Dalton We have an expert-written solution to this problem! Whose "law" states that the volume of a gas is inversely proportional to its pressure if temperature is kept constant ? Boyle In ref to high altitude events, the higher you go in altitude, the higher the pressure the body experiences. False In ref to heat emergencies, heat stroke causes bleeding in the brain. False The purpose of the rapid trauma survey to find every single injury, both minor and major, False All hypovolemic trauma patients should be "flooded" with fluid in order to obtain an average blood pressure of 120/80. False Significant trauma patients should be kept cool in the back of an EMS transport unit, in order to causing vasocontriction and therefore lead to shunting blood to core. False Gravid patients who are placed supine can develop a hypotensive event caused by the fetus pressing down on the aorta. False Fluid loss and infection are the 2 biggest "killers" of serious burn patients. True Your patient was found in the passenger side of a crashed automobile. His vitals are HR 36, RR 10, BP 210/108. He is most probably suffering a hypovolemic event. False Objects that are impaled should be removed so that the wound track can be evaluated in the field. false Kinetic energy is directly related to both speed of the object and its weight. true Briefly describe 4 of the potential"blast injuries" that a patient may experience. (Hint: I DO NOT want "primary" , "secondary", etc. Tell me what those are.) Blast wave - rapid expansion of products of combustion that moves outward from source of blast. short lived, most energy. Blast wind - similar to blast wave less energy longer duration. high levels of heat. Shrapnel- blast wind throws objects that damage surroundings to include personnel personnel displacement- personnel are physically moved by the blast resulting in fall injuries. Please list and explain 2 different co-morbidities that geriatric patients may have/experience that can hamper their response to trauma. (Hint: I dont want 2 different diseases listed). decreased cardiovascular capacity. - the body elevated respiratory and cardiovascular rates in order to compensate to trauma. elderly loose some of that capacity each year resulting in a decreased ability to compensate. osteoporosis. - many elderly patients have osteoporosis which degrades the skeletal system causing decreased bone density causing them to injure themselves with less force. they also have a decreased ability to heal. Briefly explain why major trauma patients can easily become acidotic. your body creates byproducts of metabolism. these byproducts must be removed or cause the blood to become acidic. when a trauma looses blood volume, the amount of byproducts the body is capable to transport decreases. this causes metabolism byproducts to accumulate causing a acidotic state Briefly explain the "tension" in tension pneumothorax. the potential space in the lungs is full of air. this presses on the vasculature and heart which stops them from fully filling before contracting. This extra pressure from the ruptured lung puts tension on the heart causing a drop in blood pressure. Briefly explain why the paramedic ( that's YOU!) should always check pulse, motor and sensation before and after doing an orthopedic treatment. pms is how we determine whether or not a limb has been compromised due to trauma. if we establish that it was their originally and the check again after we apply splinting and the PMS is no longer present then we know that our intervention has had a harmful affect. the reverse is also true in that our intervention may improve PMS. Briefly describe the 4 examination techniques. (Hint: Don't just name them!! ) (BTW, your're welcome!!) Look- by visually assesing patients we can see crucial info such as skin condition, mental status, life threatening hemorage, chest rise and fall, and visible signs of truama Listen- listening to our patients allows us to differentiate different possible causes of problems for example listening can determine if a patient has stridor or rhonci. one is indicative of airway restriction the other is indicative of fluid accumulation. Feel- tactile sensation can be used to determine the severity of injuries in patients who may not be able to communicate. A unconscious person cant tell you that their pelvis is broken but a good trauma exam you will be able to feel it. Thump- is a subset of listening. you listen while providing stimulus and note how the patient reacts. if you thump the chest of a patient and hear a dull sound it indicates that there is fluid. hyper resonance is indicative that there is air in that cavity. Your patient has a tension pneumothorax. Describe the technique ( location, equipment, procedure) of the proper field treatment for this. the technique is needle decompression. the location is the second intercostal space just above the third rib. you should use a 14 ga iv that is 1.5 to 2 inches. sterilize the area if time allows. palpate the intercostal space. place the needle just above the 3rd rib. the iv should puncture the cavity and a release of air should be heard. retract the needle and advance the catheter. secure in-place. Define Trauma a injury to the body caused by an external force. Define Golden Hour the time it takes from the infliction of a traumatic injury to the time it takes to get into surgery at a trauma center. if done in less than one hour the odds of surviving greatly increase. Define Axial Loading axial loading is when forced is transmitted through the body alon the plane of head to feet or feet to head. this cause force to be applied along the axis of the spine. commonly causes compressive fractures. Define Hemoptysis coughing up blood Define Caliber diameter of projectile Define homeostasis maintenance of a stable internal environment Define Leukocyte a component of the blood. the role is to help the body fight infection. commonly known as white blood cell. Define Hematoma a injury under the skin that cause a vessel to rupture. Bruise. Define erythema redness Define Systole contraction of the ventricles. Define Epidermis outermost layer of skin Define Amputation complete removal of appendage. Define Exsanguination internal bleeding. Define Ecchymosis bruising Define Eschar a hard leather like presentation of skin caused by severe burns. Define Necrosis dead rotting tissue Define BSA body surface area A child is about to be hit by an automobile. Which direction will he probably turn? toward the automobile List one mechanism that is associated with an explosion. shrapnel List one factor that injuries from a fall are dependent on fall height What can cause a low velocity wound ? stabbing What is a pericardial tamponade? pericardial tamponade is when the sac surrounding the heart fills with blood. this decreases the ability of the heart to fill and contract resulting in lowered cardiac output. Explain how a patient can be hypovolemic and NOT be bleeding. a patient can be suffering from a illness that causes severe diarrhea. this would cause the loss of body fluid through repeated bowel movement causing hypovolemia. Define the relationship between speed (velocity) and kinetic energy. Please be specific. kinetic energy increases exponentially as velocity increases. as speed doubles the energy that object caries as kinetic energy increases by a factor of 4. What sympathetic response does the body take in response to hypotension related to decreasing volume? the body stimulates the sympathetic nervous system. increasing the heart rate and decreasing perfusion to the extremities. List one type of burn. (HINT: I do not want "degrees" or thickness. Think "causes".) Chemical burn. Caustic substances with high PH cause the skin to degrade resulting in a chemical burn. Your patient has second degree burns to his entire back and his entire left arm. Using the rule of nines, what is his percentage of burned area? 27% Your patient has soot on his gums, a burnt moustache and raspy voice. What type of injury might he be experiencing? smoke inhalation burn. What differentiates second degree burns from third degree burns? a second degree burn breaks the epidermis. the third degree burn goes all the way through the layers of tissue and involves nerves and even bone. What is one of the "killers" of badly burned patients? hypothermia. Your patient is a 35 y/o female with 25% BSA of full thickness burns. She weighs 140 lbs. Use the PARKLAND formula ( 4cc x Pt's weight in kg x BSA ). How much fluid will she receive ? (63 kg x 4 x 25%) (152 x 25) 2675 cc NS List one of the body cavities that can hold a large quantity of blood. area around pelvis your patient has rhabdomyolosis. What does this mean? metabolised muscle tissue that is in the blood stream. can cause acute renal failure. How does cardiogenic shock differentiate from hypovolemic shock? hypovolemic shock is when the heart is beating effectively but there is not enough volume for the heart to move to the tissues in order for perfusion to take place. cardiogenic shock is when there is plenty of fluid needed to facilitate perfusion but the heart is not pumping effectively enough to transport the fluid. In a motor vehicle collision there are 3 (and sometimes 4) separate collisions that occur in very rapid sequence. The first is the vehicle colliding with an object. What is another of the collisions? the patient colliding with the inside of the vehicle. List one reason why a trauma patient with a large traumatic wound (who is losing a large amount of blood) should NOT be flooded with fluid over a large period of time. fluids do not clot and they do not transport oxygen. if you flood them with fluid the ability of the body to clot is diminished. fluids help the body distribute the remaining blood but fluid alone will not be able to perform perfusion. List a complication of improper bandaging technique. a wound could be over tightened. this effectively would create a tourniquet when one is not warranted. Your patient has been involved in a front end style motor vehicle accident. He is the unrestrained front seat passenger. The passenger side airbag has deployed. What possible injuries (BE SPECIFIC!!!) might he incur from THE BAG? since the passenger was unrestrained there was nothing stopping the passengers torso from moving forward. the air bag deployed causing a counter force pushing the passengers head back. this counter force of the torso moving one way and the head being force in another could cause severe damage to the vulnerable cervical spine. Why are impaled objects left in place? the impaled object's depth can not be verified and if it has lacerated a vessel or organ removal of the object will remove any pressure or occlusion provided by the object causing the wound to free flow. retroauricular ecchymosis black-and-blue discoloration over the mastoid process (just behind the ear) that is characteristic of a basilar skull fracture. (Also called Battle's sign.) keloid Thick scar resulting from excessive growth of fibrous tissue inertia The tendency of an object to resist a change in motion yaw A side-to-side motion of the nose of the aircraft. extravascular pertaining to (the area) outside a vesse