Class7.txt

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Author:
dodgybarnet
ID:
103239
Filename:
Class7.txt
Updated:
2011-09-21 00:29:42
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EMR class
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Description:
EMR class 7
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  1. Osteoarthritis Arthritis?
    Results from cartilage loss and ware and tear of the joints (common in the elderly)
  2. Sprain vs Strain?
    • Sprain: The stretching or tearing of ligaments. Occurs at a joint, most commonly the knee and ankle
    • Strain: The stretching or tearing of tendons or muscles. AKA: “muscle pull”
  3. Delegate in this order for trauma MOI?
    • 1. C-Spine
    • 2. Deadly Bleed
    • 3. Fracture
  4. Rheumatoid Arthritis?
    an autoimmune disorder that damages joints and surrounding tissues
  5. Closed fracture
    A fracture that does not break the skin
  6. Open fracture
    external wound associated with fracture
  7. Nondisplaced fracture
    Simple crack of the bone with no deformity
  8. False motion?
    Appearance of a joint where there shouldn’t be one
  9. Displaced fracture
    Fracture in which there is actual deformity
  10. Kyphosis?
    Hunch-back - unusual curvature of upper spineMinute fractures in the spine (usually as a result of osteoporosis) causes bone growth and change of spinal shape
  11. Broken limbs CMS?
    Still do CMS, but for Motor limit it too "Can you wiggle your toes?"
  12. Scoliosis
    An abnormal curvature of the spine, results in S-curving of the spine laterally
  13. How to Splint: RICE
    • Rest
    • Immobilize
    • 1. Assess CMS function
    • 2. Prepare equipment prior to Pt movement
    • 3. 1 move allowed to position patient for splinting
    • 4. If resistance is met or pain increases, splint in deformed position
    • 5. Generously pad the splint
    • 6. Splint above & below injury site
    • 7. Immobilize the joint above & below
    • 8. Cover the minimum amount of anatomy required, ensure visibility of deformity site
    • 9. Reassess pulse, motor & sensory function
    • 10. Requires one EMS practitioner to maintain stabilization as the other applies splinting materials
    • Cold
    • Elevate
  14. If circulation is impaired, attempt to reposition to anatomical position, any...?
    • grossly deformed MID-SHAFT fractures of extremities
    • Never EVER EVER EVER realign if it could be a JOINT
    • Only 1 attempt can be made
  15. Mid-shaft is defined as:
    • More than 1 hand-width (the patients hand!) away from the joint
    • If they have a pulse - leave it in place!
  16. # Femur: Foot flops...
    out (lateral)
  17. # Hip: Foot flops...
    in (medial)
  18. Contraindications for traction of # femur?
    • Hip, knee, lower-leg or ankle injury on affected side
    • Inability to properly size the device (really tall Pt’s)
    • Ensure the rear-ambulance doors to not impact the traction splint as it sticks out about 12” past the Pt’s heel (ouch!)
  19. In-line Traction Splinting of a?
    • Used only for mid-shaft femur fracture, single or bilateral if you have a bilateral sager splint
    • Injury must be located one hand-width distal to the hip joint and one hand-width proximal to the knee
  20. When tying triangular bandages, make sure the knot is on the?
    outside - not touching the Pt.
  21. The following tissues/organs require a constant supply of blood:
    • Brain
    • Heart
    • Lungs
    • Kidneys
  22. The following tissues/organs only require a supply of blood when active:
    • Muscles
    • GI tract
  23. For external bleeds only:
    • Direct Pressure
    • Pressure dressing (same as above really, but a ∆ bandage holds the gauze - check CMS)
    • Pressure point (push on a pulse area - check CMS)
    • Elevation
    • Tourniquet (call medical control 1st!)
  24. If nose bleed (or any bleed really) lasts more than 10 mins?
    Transport
  25. CSF from ears?
    Gauze it to absorb, but don’t plug the leak - it could be a pressure relief response
  26. The reason we use moist dressings for burns is?
    because it helps cool the wound & control their pain, not because the wounds are moist any way
  27. Burns get dealt with at what stage?
    • during PRIMARY you get your partner to cool and deal with the burn.
    • As it has been dealt with, you don’t need to do anything extra during secondary
  28. Significance of Bleeding?
    • The body will tolerate a 10%loss of blood rapidly, or a 20%loss of blood over a period of time
    • Adults: 10% is ≈ 500 mL
    • Children: 10% is ≈ 150 mL
  29. Loss of blood over what the body can handle will result in?
    • Re-prioritization of blood flow
    • Radical change in vital signs
    • BP DOWN (late finding in Decompensated shock)
    • Increased Heart Rate
    • Increased Respiratory Rate
  30. Dressing vs Bandage?
    • Dressing: Thing next to the wound
    • Bandage: Thing that holds the dressing onto the wound
  31. Subdural Bleeds?
    Between brain and DuraS/S may not present for many days or even weeks (VENOUS bleed)
  32. Neck wounds?
    Use occlusive dressing to stop air getting in (which'd cause air embolisms in the brain etc)
  33. Epidural Bleeds?
    • Between Dura and Skull
    • brief period of unconsciousness and headache, followed by a “lucid period” then rapid decline in LOC, to a point where the patient is unresponsive (ARTERIAL bleed)
  34. Intracerebral Bleed?
    • In the brain itself
    • Varies with location within the brain (stroke-like symptoms)
  35. Concussion?
    • A blow to the head that causes a temporary loss or
    • alteration of part or all of the brain’s abilities to function without actual physical damage to the brain
  36. Eye injuries?
    • MOIST sterile dressing if they cant close their eye (say a
    • pencil stuck through it) so it doesn't dry out.
    • If they can close their eye then just use a dry dressing
    • Don’t squish it!
  37. Scalp heavy bleeding?
    If Skull # suspected don’t apply lots of pressure! You will force bits into the brain!
  38. In fact ALL CRITICAL INTERVENTIONS get fixed when?
    in the Primary
  39. Rule of 9's for adult?
    • HEAD: 9
    • CHEST: 9
    • ABDOMEN: 9
    • UPPER BACK: 9
    • LOWER BACK: 9
    • EACH WHOLE ARM: 9
    • EACH WHOLE LEG: 18
    • GROIN: 1
  40. Rule of 9's for Child?
    • HEAD: 18
    • CHEST: 9
    • ABDOMEN: 9
    • UPPER BACK: 9
    • LOWER BACK: 9
    • EACH WHOLE ARM: 9
    • EACH WHOLE LEG: 14
    • GROIN: 1
  41. your GREAT VESSELS?
    The Aorta, Vena Cava, and Pulmonary Arteries
  42. Moving Prone Pt.s?
    • Do Pt. Overview
    • Delegate C-Spine
    • Now flip 'em
    • 1. C-Spine EMS holds head with thumbs facing in the direction of person is face
    • 2. You at shoulders
    • 3. One EMS at feet
    • 4. You assess DCAPPBTLS and TIC Posterior
    • 5. Move back board next to patient on side that they are facing away from (unless contraindicated by injuries to a side)
    • 6. Keep backboard like one inch away from the Pt. to give them space to rotate onto the board
    • 7. You and leg EMS knee on BBoard
    • 8. At Head EMS's timing roll them onto their side
    • 9. Get off the board one at a time
    • 10. Roll onto back
    • 11. V slide
    • 12. Etc

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