Emergency Medical Care: Blood Loss, Shock, Trauma & Head Injuries

What is the estimated blood loss for an adult?

1000 cc's (1 L)

What is the estimated blood loss for a child?

500 cc's

What is the estimated blood loss for an infant?

250 cc's

How much blood can be lost from a femur injury?

1 to 2 L

How much blood can be lost from a pelvis injury?

2 to 3 L

What is the maximum blood loss from an abdominal injury?

Up to 5 L

What are the characteristics of arterial bleeding?

Bright red and spurting

What are the characteristics of venous bleeding?

Dark red and steady stream

What are the characteristics of capillary bleeding?

Dark red and oozing

What is the first step in controlling bleeding?

Apply direct pressure to the wound

What should you do to control bleeding after applying direct pressure?

Elevate the injured area

What is a pressure point?

Pressing down on a major artery to reduce blood flow

When should a tourniquet be used?

As a last resort when all other methods fail

What should you do with an eviscerated organ?

Do not put it back in; keep it moist and warm

What is the care for an impaled object?

Never remove it; only stabilize it

What is the rule for amputation care?

Treat the patient first; preserve the amputated part in a plastic bag with ice or milk

What is the definition of shock?

Inadequate tissue perfusion, also called hypoperfusion

What are the three components of adequate perfusion?

Heart, blood vessels, and blood volume

What are the signs of compensated shock?

Increased respirations, agitation, tachycardia, and feeling of doom

What characterizes decompensated shock?

Hypotension and potential loss of consciousness

What is irreversible shock?

A near arrest or coma-like state

What is cardiogenic shock?

Shock due to heart failure

What is obstructive shock?

Shock caused by an obstruction of blood flow

What is distributive shock?

Shock caused by abnormal vasodilation

What is hypovolemic shock?

Shock due to significant blood loss or dehydration

What is the Rule of Nines for adult burns?

Entire arm = 9%, Entire leg = 18%, Chest = 9%, Abdomen = 9%, Entire back = 18%, Groin = 1%, Entire head = 9%

What is the palm rule for body surface area (BSA) in burns?

The palm of the hand represents approximately 1% of BSA

What type of burn is characterized by blisters?

Partial Thickness (2nd Degree) burns

What is the care for thermal burns?

Stop the burning, protect the airway, remove clothing, and wrap with a burn sheet

What should you do if you encounter a chemical burn?

Brush off chemical powder before flushing for 20 minutes and flush for 20 minutes even if it feels better.

What are the risks associated with electrical burns?

Electrical burns can cause small entrance wounds and large exit wounds, leading to major internal damage and respiratory/circulatory collapse.

What is the most common heart rhythm disturbance after an electrical shock?

Ventricular Fibrillation (V-Fib).

What are the types of splints used in injury care?

Hard, soft, air (pneumatic), and traction splints.

What is the rule regarding PMS in splinting?

PMS (Pulse, Motor, Sensory) should be checked before and after splinting.

What is an open fracture?

A fracture where the skin is open, commonly seen in tibia and fibula fractures.

What complications can arise from open fractures?

Internal hemorrhage, nerve damage, and contamination.

What is the difference between a strain and a sprain?

A strain involves tendon (muscle) damage, while a sprain involves ligament damage.

What are the signs of a fracture?

Swelling, unusual color, unusual position, crepitus, and loss of distal pulse.

What does LOC stand for in head trauma assessment?

Level of consciousness.

What is the purpose of cerebrospinal fluid (CSF)?

CSF bathes and cushions the spinal cord.

What are the layers of the meninges?

Dura, Arachnoid, and Pia.

What is Cushing's Triad?

Signs of increased intracranial pressure: increased BP, low pulse, widening pulse pressure, projectile vomiting, and irregular respirations.

What indicates a CSF leak?

Blood coming from the nose or ears after head trauma.

What is a coup-contrecoup injury?

An injury that occurs on the opposite side of the initial impact.

What is the Glasgow Coma Scale (GCS) used for?

To assess neurological function based on eye, verbal, and motor responses.

What is the significance of bilateral periorbital ecchymosis?

It indicates a possible skull fracture, commonly referred to as 'raccoon's eyes.'

What is a concussion?

A temporary loss of consciousness due to shaking of the brain, fully reversible.

What is the treatment for increased intracranial pressure (ICP)?

Limit glucose, elevate the head, and if critical, hyperventilate to reduce blood flow to the brain.

What characterizes a closed fracture?

The skin remains intact, but there may be hemorrhage into soft tissue.

What is the difference between a dislocation and subluxation?

A dislocation is a locked joint, while subluxation is when a joint pulls apart and goes back in.

What should you avoid doing with a depressed skull fracture?

Do NOT place pressure over the fracture.

What is a brain contusion?

A vessel rupture in the brain usually caused by shaking, leading to structural changes.

What are the signs of a hematoma?

Unusual colors like purple, black, or blue indicating bleeding under the skin.

What does the term 'crepitus' refer to in injury assessment?

The sound or sensation of bones grinding together.

What is neurogenic hyperventilation?

A fast and slow breathing pattern resulting from increased intracranial pressure (ICP) and Cushing's response, indicating potential brain stem injury.

What are the two types of posturing associated with brain stem injuries?

Decorticate (arms flexed) and Decerebrate (arms extended).

What does decorticate posturing indicate?

It indicates a high brain stem injury.

What does decerebrate posturing indicate?

It indicates a severe brain stem injury.

What are the two divisions of the nervous system?

Central nervous system (CNS) which includes the brain and spinal cord, and peripheral nervous system (PNS) which includes everything else.

What is the function of the autonomic nervous system?

It regulates involuntary bodily functions and has two divisions: parasympathetic (rest and digest) and sympathetic (fight or flight).

What is the significance of C1 and C2 in spinal anatomy?

C1 (atlas) allows a wide range of motion for the head, while C2 (axis) keeps C1 aligned and has the odontoid process to maintain spinal alignment.

What are important mechanisms of injury (MOIs) to look out for in spinal trauma?

Motor vehicle collisions (MVC), auto-pedestrian incidents, falls from heights, motorcycle crashes, hanging, and diving accidents.

What is the primary care for spinal injuries?

Maintain spinal alignment, perform ABCs (Airway, Breathing, Circulation), and log roll if necessary to access the airway.

What is the protocol for helmet removal in spinal injury cases?

Keep the helmet on if the airway is patent, it fits well, and backboarding can be done in a neutral position. If removal is necessary, it requires two rescuers.

What is ventilation in relation to respiration?

Ventilation is the mechanical movement of air in and out of the lungs.

What is the difference between pneumothorax and hemothorax?

Pneumothorax is air in the pleural space, while hemothorax is blood in the pleural space.

What are the signs and symptoms of a tension pneumothorax?

No breath sounds on the affected side and tracheal deviation to the unaffected side.

What is Beck's Triad in cardiac tamponade?

Muffled heart tones, jugular venous distension (JVD), and narrowing pulse pressure.

What is paradoxical motion in chest trauma?

It occurs when a flailed segment of the chest moves in the opposite direction of the rest of the chest during breathing.

What is a flailed chest?

A condition where two or more consecutive ribs are broken in two or more places, causing paradoxical motion.

What is traumatic asphyxia?

A mechanism of injury that compresses the chest wall, leading to signs like a blue face and bulging blue tongue.

What is an open chest wound?

Also known as a sucking chest wound, where air can enter the pleural space, potentially collapsing the lungs.

What is the care protocol for an open chest wound?

Transport the patient on their left side if possible, use an occlusive dressing, and tape it on three sides to create a flutter valve.

What is atelectasis?

The collapse of alveoli, decreasing surface area for gas exchange, often due to rib fractures.

What should be done for any unresponsive person regarding spinal injury?

Assume a spinal injury until proven otherwise.

What is the primary assessment for chest trauma?

Assess ventilation rate and respiratory rate, and look for signs of dyspnea and unequal chest rise.

What is the significance of checking PMS before and after moving a spinal injury patient?

PMS stands for Pulse, Motor, and Sensory; it ensures that circulation and nerve function are intact before and after movement.

What is the role of the KED in spinal injury management?

The KED (Kendrick Extrication Device) is used for stable, seated patients to immobilize the spine during transport.

What is the first sign of a pneumothorax?

Dyspnea (difficulty breathing).