Exam 4 – Orthopedics, Bleeding, Soft-Tissue, Burns & Environmental Emergencies

Vocabulary flashcards summarizing major concepts, conditions, assessments, and treatments from the lecture notes to aid exam preparation.

Traction splint

Device that applies constant pull to immobilize isolated mid-shaft femur fractures.

Hip dislocation presentation

Limb shortened and medially (internally) rotated with extreme pain.

Hip fracture presentation

Limb shortened and laterally (externally) rotated with swelling and bruising.

Splinting complication

Loss of distal pulse after application; remove and reapply correctly.

Bandage complication

Swelling can turn a bandage into a tourniquet and impair circulation.

Tourniquet drawback

Extremely painful but necessary to control life-threatening bleeding.

Purpose of splinting

Prevents movement that could worsen injury and maintains limb alignment.

Rigid splint

Firm material applied alongside an extremity; used for long-bone and spinal fractures.

Formable (vacuum) splint

Moldable splint for sprains, strains, tendon or ligament injuries.

Pelvic binder

External device that compresses the pelvis to reduce hemorrhage.

Sling and swathe

Combination that secures the shoulder or upper-arm to the torso.

Pulseless extremity management

Gently realign to restore circulation, reassess PMS, then splint.

PMS check

Assessment of Pulse, Motor, and Sensory function distal to an injury.

Fracture indicators

Pain, swelling, bruising, deformity, crepitus, and inability to bear weight.

Amputation

Complete severing of an extremity; preserve part in sterile dressing and cool container.

Stump care

Control bleeding, cover with sterile dressing, and prevent contamination.

Sprain

Stretching or tearing of ligaments; causes swelling, tenderness, limited motion, bruising.

Dislocation

Bone displaced from a joint producing deformity, swelling, and severe pain.

Steps of splinting

1-PMS, 2-apply splint, 3-secure above & below, 4-sling/swathe, 5-recheck PMS.

Primary survey bleeding check

Identify external hemorrhage early to prevent shock and death.

Arterial bleeding

Bright red, spurting with heartbeat; most serious external bleed.

Venous bleeding

Dark red, steady flow from damaged veins.

Capillary bleeding

Oozing blood from superficial wounds.

Dressing

Sterile material placed directly on a wound to absorb drainage and prevent infection.

Bandage

Material that secures a dressing, provides compression, and supports tissue.

Dialysis shunt bleed control

Direct gentle pressure; consider donut (galipot) device to avoid occluding flow.

Peritoneal dialysis port bleed

Apply direct pressure with sterile dressing and seek specialty care.

Scalp laceration

Apply direct pressure; beware of significant blood loss and hidden skull injury.

Hematoma

Localized pocket of blood in tissue, often presenting as a swollen bruise.

Laceration

Tear or jagged cut through skin and soft tissue with bleeding risk.

Abrasion

Superficial scraping of skin’s outer layer.

Crush injury

Tissue compression and destruction from significant force.

Evisceration

Protrusion of abdominal organs; cover with moist sterile dressing and do not replace organs.

Abdominal DCAP-BTLS exam

Inspect and palpate for Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling.

Impaled object management

Stabilize in place unless obstructing airway or CPR.

RUQ organs

Liver, gallbladder, duodenum, pancreas portion.

LUQ organs

Stomach and spleen.

RLQ organs

Appendix, portions of large and small intestine.

LLQ organs

Descending and left transverse colon.

Pediatric abdominal exam

Palpate quadrants starting farthest from pain, ending with most painful area.

Referred pain

Perceived pain at a site distant from injury due to shared nerve pathways.

Sucking chest wound

Open pneumothorax requiring immediate occlusive dressing (three- or four-sided).

Tension pneumothorax

Progressive pleural air trapping causing lung collapse, tracheal deviation, JVD, hypotension.

Flail chest

Segment of ribs broken in two places producing paradoxical movement.

Flail chest treatment

Stabilize segment with bulky dressing, provide high-flow oxygen, assist ventilations.

Pericardial tamponade

Fluid in pericardial sac leading to Beck’s triad: JVD, muffled heart sounds, hypotension.

Open chest wound care

Seal with occlusive dressing and monitor for developing tension pneumothorax.

Traumatic aortic transection

Catastrophic aortic rupture often from high-speed deceleration or air-bag injury.

Bubbling neck wound

Indicates air leak; immediately apply occlusive dressing.

Spinal cord injury signs

Numbness, tingling, weakness, paralysis, loss of bowel/bladder control.

Neck injury management

C-spine immobilization, bleeding control, occlusive dressing if air embolism suspected.

Cervical collar sizing

Measure from shoulder line to jaw-line to match collar height.

Child spinal immobilization

Pad under shoulders to offset proportionally large head when using backboard.

Epistaxis

Nosebleed; sit forward, pinch nostrils, avoid swallowing blood.

Jaw-thrust maneuver

Airway technique used when spinal injury is suspected.

Helmet removal rule

Remove if airway access difficult, cannot immobilize spine, allows excessive head movement, or patient in cardiac arrest.

Spinal motion restriction

Immobilizes head and trunk to prevent additional cord damage; do not force neutral alignment.

Intracranial swelling

Cerebral edema causing headache, vomiting, seizures, altered LOC; risk of herniation.

Concussion

Temporary brain function disturbance after jolt; usually no structural damage.

Contusion (brain)

Bruise to brain tissue; more serious than concussion due to bleeding risk.

First-degree burn

Superficial burn involving epidermis; red, painful, no blisters.

Second-degree burn

Partial-thickness burn of epidermis and dermis; blisters, intense pain.

Third-degree burn

Full-thickness burn destroying all skin layers; dry, leathery, possibly painless.

Acid burn treatment

Remove contaminated clothing, flush with copious cool water for ≥20 minutes.

Avulsion

Flap of skin torn partially or completely from underlying tissue.

Closed soft-tissue injury

Damage beneath intact skin, e.g., contusions and hematomas.

Open soft-tissue injury

Break in skin exposing deeper tissues, e.g., lacerations, abrasions, penetrating wounds.

Hyperthermia

Core temperature ≥101 °F (38.3 °C) with tachycardia, tachypnea; cool and hydrate patient.

Heat exhaustion

Most common heat illness; cool, clammy skin, dizziness, normal or slightly elevated temperature.

Heat stroke

Life-threatening failure of thermoregulation; hot dry skin, altered LOC, rapid rise in temperature.

Heat cramps

Painful muscle spasms after strenuous activity due to electrolyte loss.

Five methods of heat loss

Conduction, Convection, Evaporation, Radiation, Respiration.

Hypothermia ranges

Mild 95-90 °F, Moderate 90-82 °F, Severe <82 °F; treat with gradual rewarming.

Radiological dispersal device (RDD)

"Dirty bomb" combining explosives with radioactive material to spread contamination.

Primary explosive device

Initial bomb intended to cause immediate casualties.

Secondary explosive device

Delayed device targeting rescuers and bystanders after primary blast.

Trauma death leading cause

Traumatic brain injury (TBI).

Multisystem trauma

Injury to more than one body system requiring rapid assessment and transport.

Ecchymosis

Bruising caused by bleeding under the skin indicating potential underlying injury.

Scene safety priority

First step in trauma care to protect rescuers and patients from hazards.

Pelvic fracture limb position

Shortened limb with lateral (external) rotation.

Pelvic dislocation limb position

Medially (internally) rotated limb.

Beck’s triad

JVD, muffled heart sounds, hypotension—classic for cardiac tamponade.

Beck’s triad component – JVD

Jugular vein distention from impaired venous return during tamponade.

Paradoxical chest movement

Inward motion of flail segment during inspiration, outward on expiration.