emt exam 6

What are the 4 most likely injuries you will find on the patient closest to the impact when a car is t boned?

1. head 2. upper spine 3. pelvis 4. long bones

How is the pattern of injury in an auto-pedisterian collision different between adult and child?

child will turn towards vehicle

What is the most improtant factor in determining the amount of kinetic energy of a moving object?

velocity

What other area should be examined if a 23 y/o female falls from s second story window, landing on her feet?

upper lumbar spine

What is most likely to occur when a person is holding their breath when his chest impacts against a solid object?

alveoli may rupture, called a "paper bag" injury

What is it called when a bullet creates a path through a soild organ that is wider than the bullet itself, thereby increasing the damage?

cavitation

What is a priority action that should occur on scene when you have established that your patient has a high risk mechanism of injury and is a priority trauma patient?

spinal immobilization

What 3 impacts are involved when a car runs into a telephone pole?

1. organs against interior of body 2. auto into pole 3. driver into car interior

What 5 aspects are a potential type of damage from a blast injury?

1. body striking another object 2. penetrating wounds 3. fractured limbs 4. internal organs striking inside body 4. shock wave damage

What 3 organs may be possibly injured if your patient was stabbed in an upward direction by a 6 inch blade just under the costal margin on the right side of his body?

1. liver 2. lung 3. bowel

What would be a possible complication if your patient was stabbed with a 6 inch knife in the anterior part of the chest?

1. infect 2. bleeding in the chest

What is the most appropriate management of the avulsed segment of tissue if your patient has suffered a skin avulsion of the upper arm that is still attached to the body by a small piece of skin?

place skin over wound and dress with sterile dressing

What si an occlusive dressing?

does not allow air to penetrate

A tongue caught in the mouth of a beer bottle is an example of clamping injury? T or F

true

What would you most likely expect if your motorcycle rider "laid the bike down" and was not wearing protective gear?

multiple abrasions

What 3 things may a crush injury cause?

1. substantial bleeding 2. self healing 3. cause cardiac arrest

What action is most appropriate if your patient has a hematoma and swelling along teh middle of her left forearm following an assualt with a baseball bat?

splinting for possible fracture

What is a hematoma?

large collection of blood under the skin

What is an avulsion?

flap of skin that has been torn off underlying tissues

What is a puncture?

woud that is deeper than it is wide

What is abrasion?

part or all of the epidermis is scraped off

What is a contusion?

discoloration and swelling within the dermis

What is a laceration?

linear cut or tear through the skin

How do you treat a patient that has a small laceration below his right eye which is bleeding profusely?

pressure dressing

What is the most appropriate treatment for the stump wound with a patient with an amputated thumb?

indirect pressure

What is the most appropriate action if you have applied an occlusive dressing to a sucking chest wound and after this your patient complains of increasing difficulty breathing and his BP starts to drop?

remove dressing and then reapply

Which statement is most true of bandaging and dressing a wound?

a dressing should be sterile and held in place by the which need not to be sterile

What is the 3 things true of amputations?

1. may not bleed 2. amputated part must be found an dkept cool 3. trasnported to specialty facility

What is the 6 classic sequences in controlling teh bleeding if your patient has spurting, bright red blood coming from a laceration on his leg?

1. direct pressure 2. pressure dressing 3. additional guaze pads 4. elevate extremity 5. apply pressure to pressure point 6. tourniquet

What is the best method for handling an impaled object in the cheek or mouth that is not and will not obstruct the airway?

leave in place and stabilize with bulky dressing

How do you treat an injury if you had a patient running with a screw driver in his hand and tripped over his dog and the screwdriver went into his chest just below the clavical?

stabilize the screwdriver with a bulky dressing and be prepared to treat the patient for shock

What is the most correct treatment for this patient that you and your partner respond to an MVC and the driver appears unresponsive and you see major bleeding across his lower abdomen. upon inspection you find a small area of bowel protruding through teh

apply a sterile moist dressing, then an occlusive dressing and be prepared to treat for shock

What is your primary concern for this baby if you are called for a baby whose big brother pushed her down and she bit her tongue and it is bleeding profusley?

airway

What is the layer of skin that contains nerves, blood vessels, sweat and subceous glands and hair follicles?

dermis

What are burns that are characterized by charred or leathery consistency with no pain sensation called?

full thickness

What is the estimated burn percentage if an adult has suffered a partial thickness-burn to the anterior portions of both arms, chest and abdomen, using the rule of nines?

27

What si a burn that goes completely around a limb or torso called?

circumferential

What kind of burn are large fluid filled blisters?

partial thickness

Which is the most appropriate first step in teh mangement of a skin exposure to a dry cuastic chemical?

brush off chemical

What is the first step in caring for a patient that has suffered an electrical burn to the leg after falling on a downed power line?

confirm poer is off

Which should be removed from a burn patient?

rings and jewelry

What is the most appropriate first treatment for an injury of battery acid has splashed into both eyes of the patient?

irrigate copiously with water

What makes the circumferential burns so dangerous besides the burn itself?

possibility of compartment syndrome

What is teh severity of a partial thickness burn encompassing 22% of the BSA of a child less than age 5?

critical

What is the tough fibrous tissue that connects muscles to bones?

tendon

What will you do if you have applied the PASG to a suspected femur fracture: you are at 11,000 feet and your ED is at 5,000 feet?

increase pressure in PASG

What must you do to correctly splint a long bone?

immobilize joints above and below injured bone

What is the bone of the upper extremity?

humerus

What is the most appropriate action when you are 30 mins from a hospital from the hospital with a patient who has a midshaft injury of the humerus and there are no distal pulses palpable in the left arm?

contact medical control and obtain permission to manupulate the injury

What is your first step in teh treatment if your patient has suffered a fracture of the lower leg with the ends of the bones exposed and the patient is talking to you and crying.

cover wound with sterile guaze

What splint is best suited for a shoulder fracture or dislocation?

sling and swathe

What is teh most appropriate splinting technique for your patient who has suffered an open femur fracture 3 inches above the knee?

traction splint

What effects does applying ice to an injured extremity accomplish?

vasoconstriction and decrease swelling

What is this type force when a patient falls on an outstretched hand and fractures the radius at the elbow?

indirect

What will your next action be when you have just applied a long bone splint to a suspected tibia fracture when you reassess PMS and you find that the pulse is no longer palpable?

lossen splint and recheck PMS

What is the most appropriate field term for a suspected fracture?

swollen, painful deformity

What assessment would you us for your patient that fell from a bed and suffered an injury to the left shoulder. His only complaint is pain in teh anterior shoulder. There was no loss of concious and the patient has an patent airway?

focused physical

What is an injury that causes teh bones at a joint to be seperated from each other?

dislocation

What is the most appropriate way to manage the wound if your patient has an evisceration from a gun shot wound?

cover organs with moist sterile dressing then occlusive dressing

What do you ned to evaluate your patient with your patient was the restrained driver in a frontal impact at 65 MPH and as you examine, you note bruising over the abdomen which is tough and rigd?

hypovolemic shock

What si caused when you are palpating injured patients chest and note a crackling or bubbly sensation with your fingers?

air beneath skin

What is teh appropriate care for a MVC patient that has bony crepitus and tenderness when you press on the pelvis and teh genitalia show swelling and discoloration?

bleeding from uretha

What 2 aspects cause the pulonary contusions to be life threatening injury?

1. reduces oxygen exchange 2. may cause pressure on heart

What is teh current treatment for an emt to give with a flail chest?

stabilize chest with bulky dressing

What is your first action when yoru patient has an open wound to his left chest?

open airway and check for breathing

What is teh most likely cause when your patient has suffered a closed injury and presents with decreased breath sounds on one side, JVD and hypotension?

Tension pneumothorax

What is a flail segment?

2 adjacent ribs fractured in 2 or more places

What organ is most likely to cause infection in a blunt injury to abdomen?

ruptured bowel

What is teh significance of this substances presence if your patient that has been struck in the eye by a piece of pipe and you see a clear gel-like substance on teh surface of the eye?

globe has been ruptured

What structure is not a part of the neck?

mandible

What is the seond action when your patient has recieved a knife wound to his lateral neck?

pressure dressing covered by an occlusive dressing taped on 4 sides

What is the best method for handling an avulsed tooth?

hold by the crown and transport in solution

What is the medical term for the white of the eye?

sclera

What is the most life-threatening problem associated with facial injuries?

airway obstruction

How do you treat your patient with splashed chemical into his left eye?

rinse eye copiously with water or saline: continue during transport

What is an injury that involves the eye being pulled from its socket?

extrusion

What is the best method for handling an object impaled in the eye?

stabilize with bulky dressing

What is your first action if your patient was assualted with a knife and recieved a laceration to the lateral neck and you note steady bleeding?

place a gloved hand over the laceration

What is teh sign called when your patient was injured in a high speed motorcycle accident. His helmet was cracked and there is no evidence of trauma to his face but there is purple discoloration around both eyes?

racoon eyes

What has a patient suffered if he fell and struck his head on teh ground. He is unconcious for several minutes, then arouses. His nuero exam is normal.

concussion

What set of vital signs is most consistient with a severe head injury with increased intracranuial pressure?

160/104, p56,r34

What sign or symptom is most indicative of a severe head injury?

prolonged loss of concious

What is the most appropriate airway and breathing management if a patient was struck in teh face with a bat. He is unconcious with shallow respirations after applying c-spine precautions?

oropharyngeal with BVM

What is the most critical part of management for the patient with significant head trauma?

airway management

What functions are controlled by the brainstem?

breathing and heart rate

What is the appropriate rate of ventilations fo a patient with severe head injury?

10-12 / min

What is the response called when your patient suffered a severe head injury in a fall?

decerabrate posturing

What is teh term if the pressure inside teh cranium becomes severe and teh brain may be forced down through the foramen magnum?

herniation