Card Set Information
Injuries Head Neck Chest Spine Abdomen
Thurston County EMT
Per Thurston County protocol, if pt exhibits posturing, and/or provider-witnessed dilation of one pupil and is unconscious, you should....
ventilate with BVM at 24 breaths per minute
Per Thurston County protocol, if pt has an impaled object to the chest, you should...
stabilize impaled object(s) with bulky dressing and transport with object in place
Per Thurston County protocol, general pt care procedure for an open chest wound is to...
apply occlusive dressing and secure on three sides. if pt develops increased respiratory difficulty or tension pnuemothorax, remove dressing and roll onto affected side.
Per Thurston County protocol, rapid extrication is indicated with spinal trauma when...
the scene is unsafe
critical injuries are affecting airway, breathing, circulation
pt is blocking access to a pt with critical injuries affecting airway, breathing, or circulation
Per Thurston County protocol, an ALS upgrade for head and neck trauma is required when...
the pt is repetitive (perseverative)
severe or multiple episodes of vomiting
Per Thurston County protocol, indications and contraindications for helmet removal are...
: pt wearing helmet who requires airway preservation, stabilization of head to backboard, in line stabilization for transfer
: do not remove football helmets unless airway is compromised. if you must, ensure shoulder pads are removed.
MOIs with high index of suspicion
ped vs vehicle
penetrating trauma to head, neck, torso
unconscious trauma victims
Signs and symptoms of Spine Injury
normal heart rate and low BP
tenderness in area of injury
pain with movement
pain independent of movement/palpation
obvious deformity of spine upon palpation
associated soft tissue injuries
numbness, weakness, or tingling in extremities
loss of sensation or paralysis below suspected lvl of injury and/or upper or lower extremities
What does DCAP-BTLS stand for?
What are the layers of the meninges?
What is Cushing's reflex?
What is Cushing's Triad?
All these things are the body's response to a build up of ICP
What is decorticate posturing?
person is stiff with bent arms, clenched fists, and legs held out straight; indicates severe damage to the brain
What is decerebrate posturing?
the head is arched back, the arms are extended by the sides, and the legs are extended, allover rigidity, and clenched teeth
What are the three main open or closed insults to the brain?
What are the three main insults to the meninges?
subderal, epideral, or subarachnoid hematomas
What is a coup contracoup injury?
a brain injury that occurs both at the site of the trauma and the opposite side of the brain
Signs and symptoms of a skull injury
contusions, lacerations, hematomas to scalp
deformity to skull
blood/CSF leakage from ears or nose
soft area or depression upon palpation
altered or decreasing mental status
irregular respiratory pattern
nausea and/or vomiting
When should you remove an impaled object?
when it is through the cheek
anything that gets in the way on compressions
Define the Glasgow Coma Scale.
a test which scores the severity of a patient's injury (and prognosis) using the result of three tests: eye opening, verbal score, and motor response. best score of 15, worst score of 3
Patients with thoracic trauma die from...
conditions which interrupt or obstruct proper ventilation of the alveoli
conditions which interrupt or obstruct proper lvls of circulation and result in hypoperfusion
Define a flail chest.
Two or more ribs fracture in two or more places OR two or more fractured ribs with fractured sternum
Signs and symptoms of flail chest
paradoxical chest wall movement
loose, moveable segment and crepitus upon palpation
When talking about chest trauma, changes in diffusion can happen from...
When talking about chest trauma, changes in circulation can happen from...
a collection of air or gas in the chest or pleural space that causes part or all of a lung to collapse
What are the key warning signs of pnuemothorax?
increased dyspnea despite oxygenation
Define a hemothorax.
Blood in the pleural space
What are the causes of an aortic tear?
frontal impact deceleration
lateral impact acceleration
Define pericardial tamponande.
pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium)
What steps should the EMT take when dealing with eviscerations?
do not try to place organs back into abdomen
cover with 4-sided occlusive dressing if possible
protect against heat loss
When should you suspect internal hemorrhage with abdominal trauma?
when pt is showing signs and symptoms of shock that are not explained by any injury
Define a subdural hematoma.
blood gathering between the dural and arachnoid matter.
Define an epidural hematoma.
blood gathering between the dura mater and the skull