EMS & Trauma Care Flashcards

Open injury vs. closed injury

Open injury: skin broken, tissue exposed. Closed injury: skin intact, internal damage possible.

Perfusion

Blood circulation to body tissues delivering oxygen/nutrients and removing wastes.

Arterial bleeding

Bright red blood that spurts or pulses with the heartbeat.

Venous bleeding

Dark red blood that flows steadily.

Capillary bleeding

Slow, oozing blood from small vessels.

Why is a pelvic fracture dangerous?

Causes severe internal bleeding, hypovolemic shock, and organ/nerve/vessel injury.

Pelvic fracture patient handling

Treat as serious trauma and minimize movement.

Bleeding control: step 1

Ensure scene safety and use PPE.

Bleeding control: step 2

Expose the wound and identify the bleeding.

Bleeding control: step 3

Apply firm direct pressure.

Bleeding control: step 4

For life-threatening extremity bleeding, apply a tourniquet when indicated.

Bleeding control: step 5

If tourniquet cannot be used, pack wound with gauze/hemostatic dressing and apply pressure.

Bleeding control: step 6

Apply a pressure dressing after bleeding is controlled.

Bleeding control: step 7

Reassess circulation, treat for shock, and transport promptly.

Postpartum hemorrhage care

Massage uterus if trained, monitor bleeding with pad, keep warm, treat for shock.

What should you NOT do for postpartum hemorrhage?

Do not pack the vagina or pull on tissue/placenta.

Epistaxis positioning

Sit patient upright and leaning slightly forward.

Epistaxis control

Pinch soft part of nose continuously; apply cold pack; monitor airway.

What should you NOT do for epistaxis?

Do not have the patient tilt their head backward.

Suspect internal bleeding when...

After significant trauma or when shock is present without obvious external bleeding.

Internal bleeding treatment

Maintain ABCs, keep warm, provide oxygen, minimize movement, treat for shock, transport.

What should you NOT give with suspected internal bleeding?

Do not give food or drink.

Hypovolemic shock

Shock caused by inadequate circulating blood or fluid volume.

Cardiogenic shock

Shock resulting from cardiac pump failure.

Distributive shock

Shock from abnormal vasodilation/maldistribution (septic, neurogenic, anaphylactic).

Obstructive shock

Shock from mechanical obstruction of flow (e.g., tamponade, tension pneumothorax).

Types of distributive shock

Septic, neurogenic, and anaphylactic shock.

Compensated shock

Body maintains BP via compensation; early signs include tachycardia and clammy skin.

Decompensated shock

Compensation fails, leading to hypotension and worsening mental status.

Irreversible shock

Prolonged poor perfusion causes fatal cellular and organ damage.

Occlusive dressing indication

Open chest wounds / penetrating chest injuries (sucking chest wounds).

Moist sterile dressing indication

Burns or exposed tissues requiring protection from drying.

Dry sterile dressing indication

Most open wounds and controlled bleeding to absorb blood and protect wound.

Tourniquet indication

Life-threatening extremity hemorrhage not controlled by direct pressure.

Paradoxical motion

An unstable chest section moving opposite to the rest of the chest during breathing.

What does paradoxical motion indicate?

Flail chest caused by multiple rib fractures; impairs ventilation.

Traction splint

A device providing continuous inline traction to an injured extremity.

Main use of traction splint

Isolated mid-shaft femur fractures to reduce pain, spasms, and bleeding.

Traction splint precaution

Do not use if contraindicated by injury (e.g., knee/ankle injury) or protocol.

Splinting rule: PMS before

Check distal pulse, motor function, and sensation before splinting.

Splinting rule: joints

Immobilize the joints above and below the injury site.

Splinting rule: position

Splint in position found unless realignment is required and allowed by protocol.

Splinting rule: padding

Pad the splint adequately and avoid applying it too tightly.

Splinting rule: PMS after

Reassess distal circulation, sensation, and motor function after splinting.

Splinting rule: movement

Splint injuries before moving the patient whenever practical.

Cartilage

Flexible connective tissue cushioning joints and supporting structures.

Tendon

Connective tissue connecting muscle to bone.

Ligament

Connective tissue connecting bone to bone and stabilizing joints.

First-degree/superficial burn

Involves epidermis only; skin is red, painful, and dry.

Second-degree/partial-thickness burn

Involves epidermis and dermis; skin is red, blistered, moist, and painful.

Third-degree/full-thickness burn

Destroys all skin layers; charred/leathery/white skin with decreased sensation.

Rule of Nines: purpose

Estimates percentage of total body surface area (TBSA) burned in adults.

Rule of Nines: head/neck

9% TBSA.

Rule of Nines: each arm

9% TBSA each.

Rule of Nines: anterior trunk

18% TBSA.

Rule of Nines: posterior trunk

18% TBSA.

Rule of Nines: each leg

18% TBSA each.

Rule of Nines: perineum

1% TBSA.

Burn TBSA calculation

Sum the Rule of Nines percentages for all burned regions.

Palm method for burns

Patient's palm with fingers represents ~1% TBSA for small/irregular burns.

GCS formula

GCS = Eye Response + Verbal Response + Motor Response.

GCS Eye: 4

Spontaneous eye opening.

GCS Eye: 3

Eye opening to voice.

GCS Eye: 2

Eye opening to pain.

GCS Eye: 1

No eye opening.

GCS Verbal: 5

Oriented conversation.

GCS Verbal: 4

Confused conversation.

GCS Verbal: 3

Inappropriate words.

GCS Verbal: 2

Incomprehensible sounds.

GCS Verbal: 1

No verbal response.

GCS Motor: 6

Obeys commands.

GCS Motor: 5

Localizes pain.

GCS Motor: 4

Withdraws from pain.

GCS Motor: 3

Abnormal flexion (decorticate).

GCS Motor: 2

Abnormal extension (decerebrate).

GCS Motor: 1

No motor response.

GCS total range

3 to 15.

What does a worsening GCS mean?

Indicates neurological deterioration requiring immediate reassessment and care.

Conduction

Direct transfer of heat from the body to a colder object.

Convection

Heat loss caused by air or water moving across the skin.

Radiation

Heat loss to surrounding environment without direct contact.

Evaporation

Heat loss when liquid on skin turns into gas/vapor.

Respiration and heat loss

Warming exhaled air contributes to body heat loss.

Passive rewarming

Removing cold/wet items, insulating, and letting body heat itself.

When is passive rewarming appropriate?

Mild hypothermia.

Active rewarming

Applying external heat sources (e.g. warm packs to trunk) per protocol.

Active rewarming precautions

Avoid direct heat contact on cold skin and rapid aggressive rewarming.

Why handle severe hypothermia gently?

Rough handling can trigger dangerous cardiac dysrhythmias.

Severely hypothermic patient handling

Handle gently, keep horizontal, and minimize unnecessary movements.

Acute mountain sickness (AMS)

Common high-altitude illness causing headache and systemic symptoms.

High-altitude cerebral edema (HACE)

Life-threatening high-altitude condition causing brain swelling.

High-altitude pulmonary edema (HAPE)

Life-threatening high-altitude condition causing fluid buildup in lungs.

Which high-altitude emergencies are life-threatening?

HACE and HAPE.

Treatment priority for severe high-altitude illness

Immediate descent/evacuation and oxygen administration.

Stage 1 of labor

Dilation stage: cervical effacement and dilation via contractions.

Stage 2 of labor

Expulsion stage: full cervical dilation through delivery of the baby.

Stage 3 of labor

Placental stage: delivery of the placenta.

Stage 4 of labor

Recovery stage: postpartum monitoring for hemorrhage and shock.

Signs of imminent delivery

Urge to push, crowning, intense frequent contractions, feeling bowel movement.

Imminent delivery risk factor

History of rapid past deliveries (multipara).