Lecture 5: Bleeding Control, Soft-Tissue Injuries, Abdominal and Genitourinary Injuries, Chest Injuries, Face and Neck Injuries, and Toxicology

There are approximately _____ liters of blood within the body.

5 to 6

There are 4 components of blood: _____ (which is mostly _____/_____), _____ (which contain the _____ that carries _____), _____ (responsible for _____), and _____ (responsible for _____).

Plasma; fluid/water; red blood cells; hemoglobin; oxygen; white blood cells; fighting infection; platelets; clotting

_____ is the most common cause of shock from trauma.

Bleeding

If significant bleeding occurs, the _____ is responsible for redirecting blood flow to the _____, _____, _____, and _____.

Autonomic nervous system; heart; lungs; brain; kidneys

Males have approximately _____ mL of blood per pound, coming out to about _____ mL of blood for a 200-lb male.

32; 6500

Females have about _____ mL of blood per pound, coming out to about _____ mL of blood for a 165-lb female.

30; 5000

Acute blood loss of approximately _____ can cause shock; in a 200-lb male, this would be about _____ mL of blood, and in a 165-lb female, this would be about _____ mL of blood. In a newborn, blood loss of _____ mL can cause shock.

10%; 650; 500; 30

Acute blood loss of approximately _____ can cause death.

20%

The quicker the blood loss, the quicker the patient will develop symptoms of _____.

Hypovolemic shock

Arterial bleeding is _____ in color and comes out _____, making it the _____. Venous bleeding is _____ in color and does not _____, making it _____. Capillary bleeding _____ out, making it the _____. The higher the _____, the more difficult it is to control bleeding.

Bright red; in spurts; hardest to stop; dark red; spurt out; less difficult to stop; oozes; easiest to stop; blood pressure

Vital signs changes associated with bleeding include an increase in _____ and _____ and a decrease in _____.

Heart rate; respiratory rate; blood pressure

Blood clotting normally takes _____, consisting of _____ and _____ before the bleeding stops. Some _____ interfere with clotting, including _____, _____, _____, and _____. Some injuries will not clot, particularly if they are located _____. Hemophiliacs lack _____, making bleeding especially serious.

10 minutes; vasoconstriction; coagulation; medications; aspirin; warfarin; heparin; coumadin; along the length (longitudinal) of the blood vessel; clotting factors

Injury to internal organs is often difficult to detect, creating the potential for _____. Potential causes of internal bleeding include _____ and other _____; _____, particularly in the _____; ruptured _____; _____ or _____ injuries; and _____, particularly in the _____, _____, and _____.

Hypovolemic shock; stomach ulcers; gastrointestinal bleeding; aneurysms; aorta; ectopic pregnancies; liver; spleen; fractures; ribs; femur; pelvis

Signs and symptoms of internal bleeding include ecchymosis (_____/_____, often _____), hematoma (_____), hematemesis (_____), melena (_____), hemoptysis (_____), and hematuria (_____).

Contusion/bruising; the only sign of internal bleeding; bleeding underneath the skin; bloody vomit; black and bloody stool; bloody cough; bloody urine

To manage internal bleeding, treat for _____, including administering _____, providing a _____, placing the patient in the _____ position, and monitoring vitals. Definitive care involves _____.

Shock; oxygen; blanket; supine; surgery or other hospital intervention

To manage external bleeding, you must _____.

Control bleeding when you see it

The main tenets of bleeding control are _____, _____, _____ (per local protocol), and _____.

Direct pressure; elevation; appropriate dressings; tourniquets

To initially control bleeding, first _____. If an object is protruding from the wound, then _____. Next, _____, ensuring you are still able to _____. Depending on local protocol, you can then use _____ with _____. In LA County, 911 EMTs are allowed to use _____. If none of the above are successful, apply a _____. Using a _____, apply _____ to the injury (_____ the level of bleeding), _____ the band, _____ the knob, _____ the knob, then place _____. A _____ can be used in the absence of a formal instrument. Never _____ nor _____.

Apply pressure over a sterile dressing; stabilize the object using a bulky dressing; firmly wrap a sterile bandage around the dressing; palpate a distal pulse; hemostatic dressings; chemicals that stop bleeding; combat gauze; tourniquet; wide material; proximal; above; tighten; crank; secure; padding under the tourniquet; triangular bandage and wood stick; place a tourniquet over a joint; loosen or remove a tourniquet until directed to

Additional types of bleeding control devices include junctional tourniquets, which can be used in areas where standard tourniquets are not useful, such as the _____. _____ can also act as a pressure dressing for an entire extremity while _____. A pelvic binder is a type of splint used for a _____.

Junction of the torso with the arms or legs; splints; suspected closed unstable pelvic fracture

Bleeding from the nose, ears, and/or mouth can be caused by _____ fracture, _____ injuries, _____, and high _____. To manage epistaxis (a _____), _____ or _____. This places pressure on the _____, 1 of 5 arteries that supply the nasal septum. _____ can also help relieve pain.

Skull; facial; sinusitis; blood pressure; nosebleed; pinch nostrils and lean forward; place gauze under the upper lip; Kiesselbach’s plexus; ice

When assessing a patient with bleeding, ask the patient about use of _____ when obtaining SAMPLE history. You should also stay vigilant of _____ in the head, _____ in the abdomen, and _____ in the extremities.

Blood-thinning medications; scalp lacerations; tenderness or rigidity; CMS

The integumentary system consists of the _____, _____, and _____, and functions to provide _____, regulation of _____, and transmission of _____.

Hair; skin; nails; protection from the environment; body temperature; information to the brain

The skin consists of 3 layers: the _____, _____, and _____. Skin varies in thickness based on age and body location. Skin is generally thinner in the _____ and _____. Skin is also thinner on the _____, _____, and _____ than on the _____, _____, and _____.

Epidermis; dermis; subcutaneous layer; young; old; eyelids; lips; genitals; scalp; palms; feet

After _____ in a soft-tissue injury has stopped, the next step in the healing process is _____, which is the removal of _____ and _____. After this step, new _____ and _____ form, and then _____ helps to close the tissue.

Bleeding; inflammation; foreign material; damaged skin cells; cells; blood vessels; collagen

The general management of a soft tissue energy consists of _____ bleeding, preventing _____, and applying _____.

Controlling; further contamination and damage; sterile dressings and bandages

A closed soft-tissue injury means there is _____. An open soft-tissue injury means there is _____ and therefore _____. _____ are another category of soft-tissue injury, and can be caused by _____, _____, _____, _____, _____, or _____. Death is often related to _____ or _____ and therefore _____ or _____.

No break in the skin; a break in the skin; risk for infection; burns; thermal; friction; inhalation; chemical; electrical; radiation; hemorrhage; infection; hypovolemic shock; septic shock

In a closed soft-tissue injury, the _____ remains intact, with _____ damage beneath. The _____ in the _____ are bleeding.

Epidermis; soft tissue; capillaries; dermis

A hematoma is a special type of closed injury in which damage to the _____ causes _____. In extreme cases, _____ around the _____ cannot expand to accommodate, creating the potential for _____ about 6 to 12 hours post injury. In this condition, _____ and _____ create increased _____ on the blood vessels, impairing the delivery of _____ and removal of _____. This condition can be characterized by the 6 Ps: _____, _____, _____, _____, _____, and _____, the last of which is a late sign; it is therefore important to monitor _____.

Large blood vessels; blood to pool underneath the skin; fascia; muscle; compartment syndrome; edema; swelling; pressure; oxygen; metabolic waste; pain; paresthesia (tingling); paralysis; poikilothermia (inability to regulate body temperature); pallor; and pulselessness; distal CMS

A crush injury is a special type of closed injury in which the crush initially _____, but once pressure is released, _____ is released into the body, which can cause _____ and _____, otherwise known as _____. The damage depends on the _____ and _____, with anything over _____ potentially fatal.

Stops blood flow; cellular waste; renal failure; cardiac arrest; crush syndrome; amount of force; length of time the force was applied; 4 hours

Closed soft-tissue injuries should be managed using RICES: _____, _____, _____, _____, and _____.

Rest; ice; compression; elevation; splinting

Abrasions are a type of open soft-tissue injury caused by _____. They carry the potential for infection, so they should be managed with a _____.

Friction; dry sterile dressing

Lacerations are another type of open soft-tissue injury caused by _____ or _____. They should be managed by _____ and _____.

Sharp edges; jagged cut; controlling bleeding; applying a dry sterile dressing

Avulsions are another type of open soft-tissue injury in which the skin is _____. They should be managed by _____ and _____.

Hanging on by a flap; replacing the flap; applying a dry sterile dressing

Amputations are another type of open soft-tissue injury in which _____. They should be managed by _____, _____, then _____. Never allow the amputation to _____.

Organs are coming out of the body; wrapping the amputation in a dry sterile dressing; placing in a plastic bag; placing in cool water; freeze

Penetrating wounds can be caused by _____ or _____, creating the potential for _____. It is important to ask about the _____. To manage such an injury, _____, then _____. Penetrating wounds can also be caused by _____. To manage such an injury, _____, making sure to _____.

Shootings; stabbings; multiple penetrating injuries; type of weapon used; strip and flip to find all wounds; treat for shock; impaled objects; secure the object; only remove the object if it interferes with the airway or need to perform CPR

Eviscerations are a particularly concerning open soft-tissue injury characterized by _____. They should be managed by _____ (being careful not to _____), _____, _____, and _____.

Organs coming out of the body; covering the organs with a soaked sterile dressing; touch the organs; secure with plastic; keep the patient warm; transport immediately

Animal bites are another potential source of open soft-tissue injury. Because they have the potential to carry _____, they should be evaluated by a _____. Rabies is a rare but potentially fatal viral infection of the _____, transmitted through _____ and/or _____ by animals like _____, _____, _____, _____, _____, and _____.

Virulent bacteria; physician; central nervous system; bites; licking open wounds; bats; squirrels; skunks; foxes; raccoons; stray dogs;

Human bites can also cause open soft-tissue injury. Because the human mouth contains _____ and _____, human bites can cause _____ and should be treated as a _____. They should be managed with a _____, _____, and _____.

Viruses; bacteria; serious infection; life-threatening injury; dry sterile dressing; immobilization; transport

Soft-tissue injuries to the chest can cause a pneumothorax, which is _____, potentially causing the _____. It is characterized by _____, _____, and _____.

An open pneumothorax is caused by _____. If suspected, evaluate the patient for a _____ and manage the injury by applying a _____ (making sure the open side is aligned with _____) or _____. If S/S of tension (_____) develop, then _____ the dressing and _____.

Air in the pleural space; lung to collapse; dyspnea; pleuritic chest pain; diminished breath sounds on one side; a hole in the chest wall; sucking sound; 3-sided occlusive dressing; gravity; vented chest seal; air trapped in the dressing; burp/remove; reapply

Soft-tissue injuries to the neck can cause _____ and therefore an _____. They should be managed by _____, then _____.

Air to enter the veins; air embolism; controlling bleeding; applying a 4-sided occlusive dressing to prevent air from entering

Burns occur when the body _____.

Receives more radiant energy than it can absorb

The severity of a burn should be evaluated by assessing the _____ of the burn, the _____ of the burn, any _____ involved, any _____ or _____, and the _____ of the patient (<_____ and >_____ of particular concern).

Extent; depth; critical areas; pre-existing conditions; other injuries; age; 5; 55

The extent of a burn can be evaluated using the Rule of Palm or the Rule of 9s.

The Rule of Palm is helpful for burns less than _____ of the body’s total body surface area (TBSA).

The Rule of 9s divides the body into parts that compromise about 9% of TBSA. The head and neck make up _____. Each arm makes up _____, for a total of _____. The torso makes up _____, broken down into 9% each for the _____, _____, _____, and _____. Each leg makes up _____, for a total of _____. The genitals make up _____.

9%; 9%; 18%; 36%; anterior chest; anterior abdomen; posterior chest; posterior abdomen; 18%; 36%; 1%

The depth of a burn can be broken down into three categories.

In a first-degree/superficial burn, only the _____ is affected.

In a second-degree/partial-thickness burn, the _____ is also affected.

In a third-degree/full-thickness burn, the _____ is also affected.

Epidermis; dermis; subcutaneous layer

Critical areas for a burn involve any areas that may sustain a loss of _____, _____, or _____.

These include _____ burns on the _____, _____, _____, _____, _____, or _____ burns (burns that _____). Burns that encircle a limb create the potential for _____, while burns that encircle the torso have the potential to _____.

Additional burns that are considered critical are third-degree burns over _____ of TBSA, or second-degree burns over _____ of TBSA.

Burns with _____ injury are also considered critical. They should be suspected if a patient presents with _____, _____, or exposure to _____, with _____ being particularly concerning.

Life; limb; function; third-degree; hands; feet; face; airway; genitals; circumferential burns; encircle the limbs or torso; compartment syndrome; compromise breathing; 10%; 30%; respiratory; shortness of breath; soot in the nose or mouth; toxic gases; edema

Burns complicated by _____ or _____ are also considered critical.

Fractures; internal injuries

Burns that are considered moderate include third-degree burns between _____ of TBSA, excluding _____; second-degree burns between _____ of TBSA; and first-degree burns over _____ of TBSA.

2% to 10%; critical areas; 15% to 30%; 50%

Burns that are considered minor include third-degree burns under _____ of TBSA, second-degree burns less than _____ of TBSA, and first-degree burns less than _____ of TBSA.

2%; 15%; 50%

Pre-existing conditions that may aggravate injuries sustained from a burn include _____, _____, and _____.

Diabetes; hypertension; heart disease

In a patient under 5 or over 55, _____ burns are considered critical.

Children in particular have more _____ relative to body mass than adults. When responding to a child who has been burned, report any suspected _____.

Moderate; TBSA; child abuse

Because burn patients have a high risk for _____, _____, _____, and _____, general management of burns consists of providing _____, maintaining _____, and _____ accordingly.

Shock; infection; hypothermia; hypothermia; high-flow oxygen; body temperature; positioning

Thermal burns are burns caused by _____, _____ _or _____. They should be managed by _____ the burn with _____, removing _____, treating for _____, rapidly estimating the _____ of the burn, applying a _____, and checking for _____ and _____ injuries.

Scalds; open flames; hot objects; stopping and cooling; water; jewelry; shock; severity; dry sterile dressing; inhalation; traumatic

Inhalation burns are burns that occur in _____, resulting in upper airway _____ and lower airway damage from inhalation of _____ and _____. These burns are characterized by _____ when breathing, _____ voice, _____, _____, and burns to the _____. These burns should be managed with _____, with _____ acting as definitive treatment.

Enclosed spaces; swelling; chemicals; particulate matter; stridor; hoarse voice; soot in the nose and mouth; singed nasal and facial hairs; face; high-flow oxygen; hyperbaric oxygen

_____ poisoning is a particularly concerning type of inhalation burn. Because this chemical binds to _____, patients may present with _____, _____, and _____, in addition to _____ and _____. If multiple people in the same place report this system, you should _____. _____ in such patients may not be accurate, so you should _____ anyway.

Carbon monoxide; hemoglobin; cherry red skin; lips; nails; nausea; vomiting; manage your personal safety; pulse oximeters; administer oxygen

Chemical burns are burns caused by _____ and _____, with severity depending on the _____ of chemical, _____, and _____ of exposure. These burns should be managed by considering _____ (such as _____ and _____), calling for _____, removing the patient’s _____, _____ the patient by _____ dry chemicals and _____ liquid chemicals _____ for _____ (including in the _____).

Strong acids; alkali; type; concentration; duration; additional BSI; chemical-resistant gloves; eye protection; hazmat support; clothing; decontaminating; brushing off; irrigating; medial to lateral; 15 to 20 minutes; eyes

Electrical burns result from contact with _____. The dangers of such burns include _____, _____, and _____. They should be managed by initiating _____ if indicated, treating for _____, _____ (including _____), applying _____, monitoring for _____, and initiating _____.

High- or low-voltage electricity; deep tissue injury; cardiac arrest; respiratory arrest; BLS; shock; stripping and flipping to find all wounds; entrance and exit wounds; dry sterile dressings; dysrhythmias; rapid transport

Taser injuries can create complications for patients with underlying disorders like _____, resulting in the potential for _____. They should be managed by ensuring access to an _____ and making sure to _____.

Excited delirium; cardiac arrest; AED; not remove taser darts until instructed

Radiation burns come in three types: _____ burns (_____ penetrating energy, stopped by _____), _____ burns (_____ penetrating energy, stopped by _____), and _____ burns (_____ penetrating energy, easily passes through the body). They should be managed by ensuring _____ by limiting _____ of exposure, increasing _____ from the source, and placing _____ between yourself and the source of radiation; calling _____ for decontamination, _____ open wounds, _____ the hospital, and identifying the _____ and _____ of exposure.

Alpha; little; skin; beta; greater; clothing; gamma; highest; personal safety; duration; distance; shields; hazmat; irrigating; notifying; source; duration

As a general note, all patients reporting abdominal pain or injuries should be monitored for _____ and treated as needed, with _____ indicated because _____ are difficult to identify and wound size may not correspond with the _____.

Shock; rapid transport; specific injuries; extent of injury

The hollow organs are the _____, _____, _____, _____, _____, _____, _____, _____, _____, _____, and _____. Damage to these organs causes the _____, resulting _____, and potential _____.

Stomach; gallbladder; bile duct; small intestine; large intestine; rectum; ureter; urinary bladder; appendix; uterus; fallopian tubes; leaking of contents into the peritoneal cavity; peritonitis; septic shock

Peritonitis is an abdominal infection resulting from the _____. Potential causes include a ruptured _____, _____ (pouches in the colon), and perforations of the _____, _____, and _____. Peritonitis is characterized by _____ (if present in multiple quadrants, it is considered _____), _____, _____, _____ and _____, and _____ that causes _____. It is important to recognize that peritonitis may not occur for _____ after rupture of a hollow organ.

Inflammation of the peritoneum; appendix; diverticulum; stomach; intestine; gallbladder; abdominal pain; diffuse; tenderness; guarding; nausea; vomiting; ascites; distention; hours

The solid organs are the _____, _____, _____, _____, _____ and _____. Damage to these organs can cause _____ and potentially _____.

Liver; spleen; pancreas; kidneys; adrenal glands; ovaries; internal bleeding; hypovolemic shock

Signs and symptoms of an abdominal injury include any obvious _____, pain on _____, _____ and _____ (heart signs), _____, _____, and _____ skin, a _____ abdomen, _____ sign/_____ bruising (which indicates significant _____), and _____ sign (_____ pain caused by the irritation of the _____ due to _____).

DCAP-BLS-TIC; palpation; tachycardia; hypotension; pale; cool; diaphoretic; distended; Cullen/peri-umbilical; bleeding; Kehr; shoulder; diaphragm; blood and other irritants int he abdominal cavity

Closed abdomen injuries result from _____. Potential damage that may result from such an injury include _____ on the abdominal wall, laceration of the _____ and _____, ruptured _____, _____, and _____, intra-abdominal _____, and tears in the _____ (which support the _____). These injuries should be managed by _____.

Blunt trauma; bruising; liver; spleen; intestines; kidneys; bladder; hemorrhage; mesentery; intestines; treating for shock

Open abdominal wounds result from _____. They should be managed by _____, applying _____ (except in the case of an _____, in which _____ should be used instead), and _____ impaled objects to _____.

Penetrating trauma; stripping and flipping to find all wounds; dry sterile dressings; evisceration; soaked sterile dressings; stabilizing; control bleeding and minimize movement

Injuries to the male genitalia should be managed by using _____ to _____, allowing the patient to _____ if able, _____ to control bleeding, _____ impaled objects, and _____ to the hospital.

Sterile moist compresses; cover areas stripped of skin; assist; applying direct pressure; stabilizing; bringing avulsed parts to the hospital

Although the female genitalia is not often injured, the _____ and _____ are vulnerable to blunt and penetrating trauma. These cases should be managed by applying _____ as indicated.

Pregnant uterus; unborn child; moist sterile compresses

When responding to potential cases of sexual assault, call law enforcement to ensure _____, only do an _____ if necessary, discourage the patient from _____, _____, _____, or _____ until they are examined, and _____ carefully to _____.

Scene safety; external exam; bathing; urinating; defecating; changing; documenting; preserve evidence

Chest injuries may involve vital organs like the _____, _____, and _____. The heart and lungs are protected by the _____, which connect to the _____ posteriorly and _____ anteriorly. The lungs have two layers of _____, one that lines the chest cavity (_____) and another that lines the lung itself (_____). In between these layers is _____, which help to keep the lungs _____ and breathing _____. The mediastinum contains the _____, _____, _____, and _____. The _____ separates the thoracic cavity from the abdominal cavity.

Heart; lungs; great vessels; ribs; vertebrae; sternum; pleura; parietal; visceral; pleural fluid; inflated; friction-free; heart; great vessels; esophagus; trachea; diaphragm

During the inspiration stage of ventilation, the intercostals contract _____, while the diaphragm contracts _____. During the expiration stage of ventilation, the intercostals and diaphragm _____, and the diaphragm moves _____.

Outward; downward; relax; upward

Minute volume refers to the _____. Minute volume demonstrates that when tidal volume decreases, respiratory rate _____. Tidal volume in a normal adult is _____, so you should be careful not to _____ if indicated for a patient.

Amount of air moved in and out of the lungs in one minute; increases; 500 mL/breath; overventilate

Injuries to the spine can affect ventilation. Injuries below _____ indicate that the phrenic nerve is _____ and the patient can therefore breath with their _____, even though their _____ may be affected. Injuries above _____ mean that the patient _____ and should be _____.

C5; unaffected; diaphragm; intercostal muscles; C3; may lose the ability to breath; ventilated

Closed chest injuries are caused by _____, with the skin _____. Potential consequences of a closed chest injury include cardiac/pulmonary _____, which can decrease _____ and result in _____, as well as decrease _____. _____ may also result from closed chest injuries, resulting in organ _____ and potential _____.

Blunt trauma; not penetrated; contusion; cardiac output; cardiogenic shock; gas exchange; rib fracture; puncture; hypovolemic shock

Open chest injuries are caused by _____, with the skin _____. Potential consequences of an open chest injury include cardiac/pulmonary _____, internal _____, and lacerated _____.

Penetrating trauma; penetrated; laceration; hemorrhage; great vessels

People with chest injuries generally present with _____ and _____ because _____.

Tachypnea; shallow respirations; it hurts to take a deep breath

An open pneumothorax/sucking chest wound results from a _____. Management involves _____, providing _____, and applying a _____ or _____ with the _____ side out.

Hole in the chest wall; clearing and managing the airway; oxygen; 3-sided occlusive dressing; vented chest seal; gravity

A tension pneumothorax can be caused by _____, a _____ puncturing the lung, or a _____ pneumothorax. These injuries are characterized by obvious _____, _____ distress, _____ (related to oxygen), _____ neck veins, _____ deviation, _____ and _____ (related to the heart), _____ or _____ on palpation, _____ or _____ lung sounds, and _____ (related to the skin). Management involves _____, _____, _____, and _____.

Sealing all 4 sides of an occlusive dressing; fractured rib; spontaneous; injury; respiratory distress; cyanosis; distended; tracheal; tachycardia; hypotension; pain; crepitus; diminished; absent; subcutaneous emphysema; managing the airway; assisting ventilations as needed; burping dressings as indicated; rapid transport or rendezvous with ALS

Hemothorax refers to _____. Hemothorax is characterized by _____ and _____. A hemopneumothorax refers to when _____.

Blood in the pleural space; shock; decreased breath sounds in the lower lobes; both air and blood are in the pleural space

Spontaneous pneumothorax can occur in people born with _____ (_____), which may _____ spontaneously, causing _____. _____ and people with _____ are more vulnerable to spontaneous pneumothorax. This condition is characterized by _____ and _____.

Blebs; air-filled spaces on the surface of the lungs; rupture; air to enter the pleural space; tall, white, and skinny males; COPD; shortness of breath, sudden onset pleuritic chest pain

Rib fractures are common in _____ and have the potential to _____, leading to a _____ or _____. Rib fractures are characterized by _____ breathing and the patient _____. Rib fractures should be managed with _____.

Older people; puncture the lungs; pneumothorax; hemothorax; rapid and shallow; holding the affected side to minimize discomfort; oxygen

Flail chest refers to _____, resulting in _____.

3 or more ribs fractured in 2 or more places; paradoxical motion

Sternal fractures create an increased index of suspicion for _____.

Organ injury

Clavicle fractures can result in possible damage to the _____. Stay vigilant of _____ development.

Neurovascular bundle; pneumothorax

Pulmonary contusions refer to _____. _____ fill with blood, leading to _____. Suspect pulmonary contusions in patients affected by _____ or _____, and manage the condition through _____ and _____.

Bruising of the lung; alveoli; hypoxia; MVAs; flail chest; breathing support; oxygen

Myocardial contusions refer to _____, resulting in an _____. Manage this condition with _____ and _____.

Bruising of the heart; irregular heartbeat; oxygen; rapid transport

Pericardial tamponade refers to when the _____, preventing the heart from _____. This condition is characterized by _____ (_____, _____ with _____, and _____), and a _____ but _____.

Pericardial sac fills with blood or fluid; pumping enough blood; Beck’s triad; muffled heart sounds; hypotension with narrowing pulse pressure; jugular vein distention; weak pulse; equal breath sounds

Traumatic asphyxia refers to the _____, creating the potential for underlying injury to the _____ and _____. This condition is characterized by _____, _____ in the face and neck, and _____ in the sclera.

Sudden, severe compression of the chest; heart; lungs; jugular vein distention; cyanosis; hemorrhage

Laceration of the great vessels can lead to _____. Manage this condition through _____, _____, _____, and _____.

Fatal hemorrhage; CPR; breathing support; oxygen; rapid transport

Commotio cordis refers to the _____, which may cause _____. Thankfully, _____ responds to _____.

Sudden, direct blow to the chest during a critical portion of the heartbeat (T-wave); cardiac arrest; V-fib; early defibrillation

Injuries to the face and neck often lead to partial or complete obstruction of the _____. Heavy facial bleeding can produce _____. Direct injuries to the nose, mouth, larynx, and trachea can lead to significant _____ and _____. Teeth or denture injuries can cause _____. _____ associated with soft tissue damage can also cause obstructions. Injuries to the brain or cervical spine can cause abnormal _____.

Upper airway; blood clots; bleeding; respiratory compromise; teeth to get lodged in the throat; swelling; respirations

Mandible fractures are characterized by _____ of teeth, _____ of the chin, and _____ the mouth.

Misalignment; numbness; inability to open

Maxillary fractures are characterized by facial _____, instability of _____, and _____ of teeth.

Swelling; facial bones; misalignment

If an injury exposes the brain or eye, exposed parts should be covered with a _____.

Moist sterile dressing

Facial fractures are characterized by _____ in the mouth, inability to _____ or _____, absent or loose _____, and movable _____. These are generally not acute emergencies unless there is _____.

Bleeding; swallow; talk; teeth; bone fragments; serious bleeding

Your primary responsibility to a patient who has been poisoned is _____. The signs and symptoms of poisoning vary according to the agent, so you should obtain more information during the _____ on _____, the _____, and _____. You can try to determine the nature of the poison by _____ or _____.

Recognizing that a poisoning has occurred; SAMPLE history; how much they ingested; antidote, weight; scanning the scene for bottles or needles; taking suspicious material with you

In general, poisonings can be managed by calling for _____ to provide _____, moving the patient into _____, responding to _____ quickly by providing _____, providing _____, _____ the patient using the _____ technique, and initiating _____.

Hazmat; decontamination; fresh air; vomit; suction; oxygen; decontaminating; brush and flush; rapid transport