Unit 5 EMT - Allied Medical Training

arterial bleeding

bleeding from an artery, which is characterized by bright red blood that is rapid, profuse, and difficult to control.

capillary bleeding

bleeding from capillaries, which is characterized by a slow, oozing flow of blood.

cardiogenic shock

shock, or lack of perfusion, brought on not by blood loss but by the heart’s inadequate pumping action. Itis often the result of a heart attack or congestive heart failure.

compensated shock

when the patient is developing shock but the body is still able to maintain perfusion.

decompensated shock

when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.

distributive shock

hypoperfusion due to a lack of blood vessel tone. Blood vessel dilation leads to decreased pressure within the circulatory system.

hemorrhage

bleeding, especially severe bleeding.

hemorrhagic shock

shock resulting from blood loss.

hemostatic agents

substances applied as powders, dressings, gauze, or bandages to open wounds to stop bleeding.

hypoperfusion

the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients.

hypovolemic shock

shock resulting from blood or fluid loss.

neurogenic shock

hypoperfusion caused by a spinal cord injury that results in systemic vasodilation

obstructive shock

a term commonly used to describe the different conditions that block the flow of blood and cause hypoperfusion.

perfusion

the supply of oxygen to and removal of wastes from the body’s cells and tissues as a result of the flow of blood through the capillaries.

pressure dressing

a bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding.

Shock

the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients, which is a life-threatening condition.

tourniquet

a device used for bleeding control that constricts all blood flow to and from an extremity.

venous bleeding

bleeding from a vein, which is characterized by dark red or maroon blood and steady, easier-to-control flow.

Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues. Which of the following is not a major type of shock?

Hypervolemic

Which of the following vessels has thick muscular walls that allow constriction and dilation?

Arteries

Which of the following types of vessels have valves to maintain one-way blood flow?

Veins

Which of the following blood vessels cannot stop bleeding by constricting?

Capillaries

Which of the following vessels contain blood under the highest amount of pressure?

Arteries

Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels?

Capillaries

Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the best sequence of steps in the management of this patient?

Direct pressure, high-concentration oxygen, and splinting the leg

Which of the following is not recommended when controlling epistaxis?

Having the patient tilt the head backward to elevate the nose

Which of the following is the least effective method of controlling bleeding?

Elevation

Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except:

it should be applied directly to the skin and will not be effective if anything is between the cold agent and the wound.

Your patient is a 28-year-old male who cut his thigh with a chain saw. It appears that he has lost about 600 cc of blood. Which of the following is not part of the proper management of this patient?

Replacing fluid level by giving the patient adequate amounts of water

If you do not have a commercial tourniquet available, what common supply found on the ambulance can be used as a substitute?

Triangle bandage

The most common form of hemostatic agent is:

gauze or dressings.

Which of the following should increase the EMT's suspicion of internal bleeding?

All of the answers are correct

As an EMT, your best clue indicating the possibility of internal bleeding may be the presence of:

the mechanism of injury.

Which of the following is an important early indicator of hypoperfusion?

Altered mental status

Which of the following is responsible for most of the early signs and symptoms of shock?

The body's attempts at compensation for blood loss

Which of the following is part of the body's compensatory response to blood loss?

Blood vessels constrict and the heart rate increases.

Which of the following signifies a failure in the patient's compensatory response to blood loss?

Hypotension

Although many of the signs and symptoms of shock are the same no matter what the cause, the symptoms follow a logical progression as shock develops and worsens. Arrange the following signs and symptoms in the order that they will most likely appear. 1. Altered mental status 2. Dropping blood pressure 3. Nausea and vomiting 4. Pale, cool, and clammy skin 5. Increased pulse 6. Increased respirations

1, 4, 3, 5, 6, 2

Which of the following is the major cause of shock that the EMT will encounter?

Hemorrhage

Which of the following is a hallmark of irreversible shock?

Cell damage and death in the vital organs

Which of the following is not a purpose for making airway management the highest priority in shock patients with nonmassive bleeding?

It promotes bronchoconstriction of the smaller airways.

Which of the following is not indicated in the management of a patient in shock?

Engaging in high-speed ambulance transportation

Which of the following best explains the reason for minimizing scene time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?

It is essential to get the shock patient to more definitive care.

What differentiates a Level 2 Trauma Center from a Level 1 Trauma Center?

Level 1 provides more immediate specialists

What is the primary objective of field triage in trauma scenarios?

Make decisions on transport and facility

A trauma patient has a score of 5 on the motor response portion of the GCS. You should transport this patient to:

A level 1 trauma center

A trauma patient presents with penetrating injuries to the head and torso. What is the appropriate action based on the 2021 Triage Guidelines?

Transport the patient to the highest-level trauma center within geographic constraints

Which one of the following indicates a moderate risk for serious injury?

An unrestrained 8-year-old child in a motor vehicle accident

A trauma patient exhibits a respiratory rate of 30 breaths/min and is unable to follow commands. Which category of criteria does this fall under?

Red Criteria: Mental Status and Vital Signs

You are assessing a trauma patient who is responsive to speech, is confused, but follows commands. According to their GCS score this would correspond to:

Minor brain injury

When performing a secondary trauma assessment, what is the primary focus of a rapid secondary assessment?

Focusing on apparent life threats

You are called to a 40-year-old man who was the restrained driver in a high-speed motor vehicle accident on a suburban highway. While your partner applies inline C-spine stabilization you carry out a primary assessment. He is alert, breathing adequately, has a rapid pulse and appears pale, cool and clammy. Your next best step is to :

Apply oxygen via NRB at 15 liter/minute

You are called to a 40-year-old man who was the restrained driver in a high-speed motor vehicle accident on a suburban highway. While your partner applies inline C-spine stabilization you carry out a primary assessment. He is alert, breathing adequately, has a rapid pulse and appears pale, cool and clammy. Subsequently, after treating for shock, you obtain vital signs on this patient HR is 110, Bp is 92/60 and RR is 24. He should be preferably transported to:

A level 1 trauma center

A 51-year-old female is thrown off a horse, she has slurred speech and responds in a lethargic manner, she denies neck pain. You should immediately:

Perform spinal precautions

After c-spine stabilization of a trauma patient, your next step is to:

Perform a primary assessment

All of the following criteria are considered a high risk for serious injury except:

RR rate of 26

According to the 2021 guidelines, which of the following is an indication to take the patient to a level 1 trauma center?

Unable to follow commands

Your patient has an open skull fracture. You will treat this patient by transporting to ______.

Highest level of trauma care

Which of the following in a 5 year old child would indicate a high risk for serious injury?

A SBP of less than 80

Your 34 year old patient is in an industrial facility where his hand got mangled in the machine he was using. His vitals seem stable. Where should he be transported?

The highest-level trauma center available within the regional trauma system's geographic constraints

Your patient is elderly with a diagnosis of diabetes type 2 and atrial fibrillation. Her medications include Coumadin. She was in the middle of the rear seat in a car crash and has no obvious injuries. Where should she be transported?

The nearest trauma center

Which of the following patients would meet the criteria for transport to a trauma Center?

Elderly male involved in a MVC with no apparent injuries and a dead passenger

Which of the following patients meet criteria for moderate risk of serious injury?

Pregnant woman in last trimester who appears uninjured after MVC

A 10-year-old female was knocked off her bicycle which was hit by a car traveling about 20mph. She fell off the bicycle and has abrasions and is complaining of pain in her left shoulder and abdomen. Fortunately, she was wearing a helmet. Which of the following is the preferred place to transport this patient?

Pediatric Trauma Center

While attempting to repair his roof your 68-year-old neighbor falls off onto his driveway. He is alert and complaining of severe back pain. He can move all limbs. What yellow criteria is positive in this case?

Fall from over 10 feet in height

A 22-year-old man falls while climbing from a height of about 15 feet. Which of the following findings would be considered high risk for severe injury?

HR greater than SBP

Which of the following would indicate a moderate risk for serious injury?

A 3-week-old baby with an angulated fracture of the humerus

You are assessing a 46 year old man who jumped out of a 3rd story window to escape a burning apartment. He has 3rd degree burns on 20 percent of his body and is responding to pain only. He should be transported to which of the following preferentially?

A level 1 trauma center

You respond to a gas explosion and find an elderly female patient with 3rd degree burns on her upper body. She is unresponsive and apneic but has a pulse. You initiate BVM with 100% O2. Her Heart rate is 110 and her BP is 90 systolic. She has chest wall instability. In addition to her flail chest, low Systolic BP and HR greater than SBP, which other finding indicates a high risk for serious injury?

The need for respiratory support

You are responding to a 12-year-old girl who was shot in her left forearm by her 7-year-old brother. Bleeding is being controlled with a tourniquet. Which one of the following statements is true?

She meets criteria for serious injury because a tourniquet was required to control bleeding