Adult 2 Test 3

the emergency department nurse is giving discharge instructions to the mother of a child who bumped his head on a table. which statement by the mother indicates understanding of the instructions?
a) "he can run and play as he usually does, as long as he doesn't climb"
b) "i should take him back to the ED for weakness or slurred speech"
c) "there is really nothing to worry about. it was just a bump on his head"
d) "i should not let him fall asleep today or during the early evening"

b) "i should take him back to the ED for weakness or slurred speech"

which patient should be triaged as emergent?
a) 59 y/o man with severe unilateral back pain and previous HX of kidney stones
b) 6 y/o with temperature of 101 F and flu like symptoms
c) 23 y/o woman with severe abdominal pain, positive home pregnancy test, and BP 80/40
d) 10 y/o girl with vomiting, diarrhea, and abdominal cramps onset 4h after eating fish

c) 23 y/o woman with severe abdominal pain, positive home pregnancy test, and BP 80/40

the nurse is helping the healthcare provider treat a patient with a tension pneumothorax. what type of equipment does the nurse obtain to immediately alleviate this life-threatening condition?
a) tracheotomy tray
b) transvenous pacemaker insertion
c) large adult endotracheal tube
d) chest tube insertion tray

d) chest tube insertion tray

the nurse is interviewing a homeless patient in the triage area. the patient says "i'm a nurse too. flying pictures say god is me. i'm a god, taking noise away." the patient then stands up and kicks over the garbage can. what should the nurse do first?
a) run toward the panic button and immediately push it
b) gently take the patient's arm and lead her to a quiet space
c) remain calm and slowly step away from the patient
d) call for help and instruct bystanders to get out of the way

c) remain calm and slowly step away from the patient

which action would be assessed during the primary survey?
a) stabilize a fracture
b) insert a nasogastric tube
c) establish a patent airway
d) insert a urinary catheter

c) establish a patent airway

for which circumstance would the use of standard precautions be adequate to ensure the safety of the nurse, staff, and other patients?
a) assisting with intubation of a patient with symptoms of tuberculosis
b) assessing a child with a fever and rash, known exposure to chickenpox
c) performing hygienic care for a patient with copious watery diarrhea
d) initiating a peripheral IV access on a patient who is hiv positive

d) initiating a peripheral IV access on a patient who is hiv positive

an elderly woman is brought to the emergency department by her son, who tells the nurse, "mom just seems weak, tired, and more confused than usual." which combination of question and assessment is the nurse more likely to perform for this patient?
a) inquire if she has any changes in urination and auscultate the lung fields
b) ask if she has noticed a vaginal discharge and observe gait and balance
c) question her about appetite changes and check for pupillary response
d) ask if she has difficulty sleeping and observe for pedal edema

a) inquire if she has any changes in urination and auscultate the lung fields

a nurse is triaging patients in the emergency department. which patient would the nurse classify as "nonurgent"?
a) a 79 y/o with a temperature of 104 F
b) a 44 y/o with chest pain and diaphoresis
c) a 50 y/o with chest trauma and absent breath sounds
d) a 62 y/o with a simple fracture of the left arm

d) a 62 y/o with a simple fracture of the left arm

upon admission to the ER, the nurse is performing a secondary survey. during this survey, the 'f' in F, G, H, I includes which 5 interventions?
a) BP, HR, fluids, pain, family involvement
b) heart monitor, pulse ox, NG, foley, labs
c) HR, pulse, IV access, foley
d) ABGs, BP, 12 lead, fluids, HR

b) heart monitor, pulse ox, NG, foley, labs

a patient comes to the ED after being in a MVA. which of the following symptoms will the nurse expect to see if she suspects the patient has a pneumothorax? SATA
a) tracheal deviation
b) bradypnea
c) subcutaneous emphysema
d) pleuritic chest pain
e) clear breath sounds

a) tracheal deviation
c) subcutaneous emphysema
d) pleuritic chest pain

a client comes into the ED after a motorcycle accident. the patient is unconscious. upon first glance, only the right side of the patient's chest is moving and his neck veins are distended. when the nurse listens to his breath sounds, they are absent in the left lobe. his HR is 122, BP 80/43, RR 8. which of the following does the nurse suspect the patient has?
a) flail chest
b) tension pneumothorax
c) pneumothorax
d) hemothorax

b) tension pneumothorax

the nurse suspects a patient who was brought in following a MVC is presenting with s/s of a pulmonary contusion. what clinical findings would support this diagnosis? SATA
a) bloody sputum
b) crackles and wheezing
c) hypotension
d) diminished breath sounds
e) asymmetrical chest movement

a) bloody sputum
b) crackles and wheezing
d) diminished breath sounds

what are the priority interventions for a patient with a thoracic spine injury? SATA
a) immobilization
b) foley catheter
c) ct scan
d) prevent hypotension
e) maintain oxygenation

a) immobilization
d) prevent hypotension
e) maintain oxygenation

a patient has been diagnosed with a subdural hematoma. which of the following clinical manifestations support this diagnosis? SATA
a) late hemiparesis
b) unilateral or bilateral pupil dilation
c) stupor progressing to a coma
d) symptoms mimicking a stroke

a) late hemiparesis
b) unilateral or bilateral pupil dilation
d) symptoms mimicking a stroke

a patient is admitted for a concussion. which physician's order would the nurse question?
a) activity limitation for the next 48h
b) keep the room brightly lit
c) ROM exercises q2h
d) morphine 10 mg q4h for pain

d) morphine 10 mg q4h for pain

a patient is brought into the ED after a MVA and is suspected of having a TBI. in addition to admitting symptoms of HA, dizziness, and vomiting, the patient is now lying with his upper and lower extremities extended. the nurse knows that this position is known as what?
a) decorticate
b) fencing response
c) decerebrate
d) opisthotonos

C) decerebrate

the elementary school nurse is teaching children how to prevent injuries from cold exposure in the winter. which student statement demonstrates that the teaching has been effective?
a) "dressing in layers is important"
b) "i will drink lots of water when i exercise"
c) "wearing cotton socks to stay warm is very important"
d) "taking frequent breaks will help me rest"

a) "dressing in layers is important"

the nurse is providing reminders to a community group about safety procedures to prevent drowning. which situation does the nurse identify that poses the greatest risk for drowning?
a) a couple swimming together at a local lake
b) college students going to a swimming party at a boat house
c) families gathering at someone's house to swim
d) children swimming at the community pool

b) college students going to a swimming party at a boat house

which client does the nurse identify at greatest risk for heat exhaustion?
a) 34 y/o police officer
b) 42 y/o swimming instructor
c) 24 y/o construction worker
d) 78 y/o gardener

d) 78 y/o gardener

a high school athlete recently suffered heat exhaustion. the school nurse is instructing the student on how to prevent a recurrence of this situation. which student statement demonstrates that the teaching has been effective?
a) "taking frequent rests is important when in a hot environment"
b) "i will limit my fluids to drinking 'sports' drinks after exercise"
c) "wearing dark colored clothing will deflect the sun away from me"
d) "i should try to exercise between noon and 3 pm"

a) "taking frequent rests is important when in a hot environment"

a client presents to the ED stating "i got bit by something when i was cleaning out the basement." on assessment, the nurse notices a bite mark with a bluish-purple center on the client's posterior calf. what treatment would the nurse anticipate delivering?
a) elevation of affected extremity
b) direct application of ice to bite
c) localized wound care
d) initiation of transfer to trauma center

c) localized wound care

on a hot summer day, an older adult is found by a neighbor lying on the floor, agitated and confused. after calling 911, the neighbor places ice bags on the client's groin area and armpits. upon arrival at the hospital, which action does the ED nurse perform first?
a) administer high flow O2
b) place a cooling blanket on the client
c) monitor vital signs
d) contact family members for a history

a) administer high flow O2

a client comes to the ED, reporting being bitten by a scorpion. which action will the nurse perform first?
a) contact the poison control center
b) apply an ice pack to the sting site
c) assess vital signs
d) administer a tetanus shot

c) assess vital signs

the nurse is teaching a class of park ranger trainees about prioritizing care for clients who have received snakebites. which ranger's statement demonstrates a need for further teaching?
a) "ems should be called to transport the client"
b) "do not allow the victim to ingest any alcohol or caffeine"
c) "the extremity should be kept below the level of the heart"
d) "you should place a tourniquet above the site of the bite"

d) "you should place a tourniquet above the site of the bite"

while at a soccer match, a player drops to the ground with heat exhaustion and a diminished level of consciousness. after ensuring the client's airway is clean, what is the team nurse's next action?
a) move the player to the shade
b) give salt tablets
c) provide a cool electrolyte fluid drink
d) place warm packs under the arms

a) move the player to the shade

while on the school playground, a teacher is stung on the hand by a bee, resulting in redness and swelling. the school nurse is nearby when it happens. what is the appropriate nursing action?
a) administer an epinephrine pen
b) gently scrape stinger out with a credit card
c) remove the bee and save it for identification
d) place an occlusive dressing over the sting

b) gently scrape stinger out with a credit card

a golfer who is caught in a thunderstorm is struck by lightning. a fellow golfer, who is a nurse, runs to the victim's aid. what action will the nurse take first?
a) stabilize the spine
b) palpate to check for the presence of a pulse
c) apply a dressing over the skin burn where the lightning entered
d) immediately begin CPR

b) palpate to check for the presence of a pulse

a hiker begins to feel ill within 48 hours of climbing a mountain. symptoms include poor activity tolerance, tachycardia, tachypnea, and a dry cough. which treatment will the telehealth nurse recommend?
a) lower altitude
b) acetazolamide sodium
c) bedrest for 24h
d) O2

a) lower altitude

a 21-year-old client slipped and fell into the community swimming pool, and does not resurface. what does the lifeguard, who is a nurse, do after the rescue when the client is unconscious?
a) initiate airway clearance
b) deliver abdominal thrusts to clear lungs of water
c) begin chest compressions
d) stabilize the spine

d) stabilize the spine

clients who have been admitted to the ED are assessed by the ED triage nurse for an oncoming shift. which client is most appropriate for the nurse to assign to an LPN/LVN?
a) a client with heat exhaustion, receiving an IV of normal saline, with a temp of 37 C (98.6 F)
b) a client reporting right forearm swelling secondary to a 'bug bite' with capillary refill in the right hands of greater than 3 sec
c) a client stung by an unknown insect who reports shortness of breath
d) a client who was hiking and is now confused, and has crackles throughout all lung fields

a) a client with heat exhaustion, receiving an IV of normal saline, with a temp of 37 C (98.6 F)

the nurse is caring for a client who was admitted after a diving accident in a lake. which task is appropriate to delegate to an experienced AP?
a) assessing the client's lung sounds and neurologic status
b) notifying the flight team of a possible transfer
c) drawing ABGs and communicating results to the HCP
d) helping to maintain cervical spine stability during transfer to a stretcher

d) helping to maintain cervical spine stability during transfer to a stretcher

the nurse is coordinating care for a client who was bitten by a black widow spider. which nursing action can be delegated to the LPN/LVN?
a) assessing the client for neurologic changes
b) administering tetanus toxoid vaccine IM
c) providing discharge instructions to the client when the family arrives
d) monitoring for respiratory compromise in the client

b) administering tetanus toxoid vaccine IM

after receiving a change-of-shift report, the client with which condition would be assessed by the ED nurse first?
a) severe muscle cramps after running
b) suspected spider bite with a red and swollen forearm
c) bite on the hand from a stray dog with minimal bleeding
d) bee sting on the jawline with difficulty swallowing

d) bee sting on the jawline with difficulty swallowing

which type of drug does the nurse identify that is contraindicated for a client who was stung by a scorpion? SATA
a) acetaminophen
b) lorazepam
c) secobarbitol
d) tetanus toxoid
e) hydrocodone

b) lorazepam
c) secobarbitol
e) hydrocodone

the nurse is caring for a client who reports being bitten by a brown recluse spider. what assessment finding does the nurse anticipate? SATA
a) tiny papule at the site of the bite
b) systemic NM complications
c) N/V
d) HTN
e) central bite mark with edema and erythema
f) severe abdominal pain
g) center of the bite turning bluish-purple

e) central bite mark with edema and erythema
g) center of the bite turning bluish-purple

a client is admitted to the emergency department after reporting being raped. who is the best team member for the admitting nurse to contact to provide care for this client?
a) forensic nurse examiner
b) social worker
c) psychiatric crisis nurse
d) physician or healthcare provider

a) forensic nurse examiner

a client with a gunshot wound is brought to the ED. which nursing intervention is appropriate?
a) blood and body fluid precautions
b) metal detector screening of the client
c) admission to a negative pressure room
d) placement of a security guard

a) blood and body fluid precautions

there has been an explosion at a local refinery with numerous reported injuries. which client does the nurse identify as the priority for treatment?
a) older adult with heavy bleeding
b) child with open fracture of the arm
c) teenager with contusions of the lower extremities
d) adult with a head injury

a) older adult with heavy bleeding

the nurse is caring for a client who may be the victim of domestic violence. when the health care provider discharges the client to home, what is the appropriate nursing action?
a) consult with social services
b) call the police
c) instruct the client to go to a neighbor's house
d) discharge per the HCP orders

a) consult with social services

a client comes into the ED clutching the chest. which core competency for ED nurses is the first one used in this situation?
a) completing documentation
b) performing assessment
c) setting priorities
d) interpret findings

b) performing assessment

an air medical helicopter arrives on the scene of a high-speed motorcycle collision with a train. the client was not wearing a helmet and is very confused, with a GCS score of 13. there is an apparent partial amputation of both hands. vital signs are stable and the airway is secure. which level of trauma center would be the most appropriate destination for this client?

level 1

the nurse is caring for a client after a motor vehicle crash whose vital signs are BP 110/70, HR 98, R 18, SaO2 98% on room air. after assessing the GCS score as 15, and noting no apparent injuries other than a seat belt abrasion, what will the nurse do next?
a) discharge to home
b) clean the seat belt abrasion
c) perform ongoing monitoring
d) obtain blood alcohol level

c) perform ongoing monitoring

EMS arrives at the scene of an automobile crash. on primary assessment, the driver is found to be unresponsive, not breathing, and has a grossly deformed left leg with no pulse. what is the first resuscitation intervention to be performed?
a) perform artificial respirations
b) apply a cervical collar to the neck
c) realign the leg and recheck for pulse
d) clear the airway of secretions

d) clear the airway of secretions

resuscitation for a client who sustained cardiac arrest in the ED was unsuccessful. which nursing intervention is appropriate when the family members ask to view the body? SATA
a) contact the chaplain to accompany the family while viewing the client
b) cover the client with a sheet, leaving the face exposed
c) brighten the lights in the room so the family can better see the client
d) remove lines and indwelling tubes unless a forensic investigation is anticipated
e) express sympathy by stating "the client is in a better place now"

b) cover the client with a sheet, leaving the face exposed
d) remove lines and indwelling tubes unless a forensic investigation is anticipated

during a mass casualty, which client condition does the nurse prioritize for care?
a) open fracture of the left forearm
b) sucking chest wound
c) sprained ankle
d) abdominal evisceration

b) sucking chest wound

a client comes to the emergency department covered with an unknown substance. what action will the nurse take first?
a) administer medication as prescribed
b) provide emotional support
c) triage for care
d) escort to a decontamination room

d) escort to a decontamination room

during a mass casualty, staff roles are defined. if the triage officer is incapacitated, who is the best choice for replacement?
a) medical command physician
b) hospital incident commander
c) triage nurse
d) communications officer

c) triage nurse

which client will the nurse responding to a mass casualty event provide with a yellow tag? SATA
a) client with a foot injury who cannot walk
b) client with multiple lacerations and contusions
c) client with a missing lower extremity and hemorrhage
d) client with an open leg fracture and normal vital signs

a) client with a foot injury who cannot walk
d) client with an open leg fracture and normal vital signs

the nurse has just received report on a group of clients on the neurosurgical unit. which client is the nurse's first priority?
a) client who consistently demonstrates decortication when stimulated
b) client whose DTR have become hyperactive
c) client who displays plantar flexion when the bottom of the foot is stroked
d) client whose GCS has changed from 15 to 13

d) client whose GCS has changed from 15 to 13

the nurse is caring for a client who had a lumbar puncture. what priority action would the nurse perform to ensure client safety?
a) monitor for IICP, such as decreased LOC
b) observe the needle insertion site for CSF leakage or infection
c) give an analgesic for client report of a HA if it is moderate or severe
d) take VS q1h after the procedure until the client is stable

a) monitor for IICP, such as decreased LOC

a client is admitted with a spinal cord injury at the seventh cervical vertebra secondary to a gunshot wound. which nursing intervention is the priority for the client at this time?
a) positioning the client to maximize ventilation potential
b) taking VS q2h
c) inserting an indwelling urinary catheter
d) monitoring the client's nutritional status

a) positioning the client to maximize ventilation potential

to prevent the leading cause of death for clients with spinal cord injury, collaboration with which component of the primary health care team is a nursing priority?
a) nutritional therapy
b) physical therapy
c) respiratory therapy
d) occupational therapy

c) respiratory therapy

the nurse is providing instructions to a client with a cervical spinal cord injury about caring for the halo fixator device. the nurse plans to include which instructions?
a) avoid using a pillow under the head while sleeping
b) begin driving 1 week after discharge
c) keep straws available for drinking fluids
d) swimming is recommended to keep active

c) keep straws available for drinking fluids

the nurse is caring for a client who sustained a complete cervical spinal cord injury and is at risk for autonomic dysreflexia. which assessment findings would the nurse anticipate if this complication occurs? SATA
a) goose bumps above and/or below the injury level
b) sudden and severe HTN
c) severe throbbing HA
d) profuse sweating above the injury level
e) nasal congestion and blurred vision
f) facial and skin flushing

a) goose bumps above and/or below the injury level
b) sudden and severe HTN
c) severe throbbing HA
d) profuse sweating above the injury level
e) nasal congestion and blurred vision
f) facial and skin flushing

the nurse is monitoring a client admitted with a closed TBI for indications of IICP. which assessment finding would the nurse report to the primary HCP immediately?
a) decreased LOC
b) BP 140/88
c) temp 100 F (37.8 C)
d) apical pulse of 90 or greater

a) decreased LOC

the nurse is caring for a mechanically ventilated client who has an organ donation card and a severe traumatic brain injury. which assessment findings indicate that the client will be declared as brain dead? SATA
a) hypothermia
b) absence of brainstem reflexes
c) apnea not due to drugs or diseases
d) irreversible loss of consciousness
e) hypotension

b) absence of brainstem reflexes
c) apnea not due to drugs or diseases
d) irreversible loss of consciousness

which client does the oncoming ED nurse see first when assigned to care for 4 clients?
a) 21-year-old with a skin rash who has been waiting two hours to see a provider
b) 30-year-old with influenza who has infusing IV fluids and is resting quietly
c) 47-year-old who fell off of a curb resulting in a sprained ankle
d) 56-year-old reporting chest pain and diaphoresis that started 30 minutes prior

d) 56-year-old reporting chest pain and diaphoresis that started 30 minutes prior

what mechanism of injury will the nurse document for a client in a motor vehicle accident whose airbag deployed when the car struck a tree at 40 miles per hour? SATA
a) blast
b) blunt
c) laceration
d) penetration
e) acceleration-deceleration

b) blunt
e) acceleration-deceleration

upon entry to the ED of a client who fell from a roof, what is the nurse's priority action?
a) place nasal cannula to administer oxygen
b) apply pressure to small bleeding wounds
c) assess airway and stabilize cervical spine
d) initiate large-bore IV to infuse normal saline

c) assess airway and stabilize cervical spine

what is the nurse's priority action for the unconscious patient who is breathing who has been brought to the ED?
a) assess breath sounds and respiratory efforts
b) establish vascular access with a large-bore catheter
c) remove clothing to perform a complete physical assessment
d) evaluate LOC using the GCS

a) assess breath sounds and respiratory efforts

after assessing four clients, which will the triage nurse identify to be seen first in the ED?
a) client with fever of 101.2 F
b) client who reports slurred speech
c) client who reports bilateral ear pain
d) client with urinary burning and frequency

a) client with fever of 101.2 F

what teaching will the nurse provide to an older adult who has a history of heat exhaustion? SATA
a) take frequent rest breaks when doing activities
b) drink caffeinated beverages before going in the sun
c) wear dark clothing to protect the skin from burning
d) stay indoors in an air-conditioned room when possible
e) take warm baths or showers to regulate the body temperature

a) take frequent rest breaks when doing activities
d) stay indoors in an air-conditioned room when possible
e) take warm baths or showers to regulate the body temperature

when caring for four clients, which does the nurse identify as at the highest risk for frostbite?
a) 19-year old who takes antihistamines
b) 28-year old who is a vegetarian
c) 41-year old who is being treated for hypothyroidism
d) 57-year old who drinks 4-5 beers per day

d) 57-year old who drinks 4-5 beers per day

in addition to calling 911, what is the appropriate nursing response when a client calls the telehealth nurse to report being bitten on the arm by an unknown type of snake?
a) apply ice to the site of the wound
b) extract venom by sucking the wound
c) apply a tourniquet to the affected arm
d) immobilize the extremity at the level of the heart

d) immobilize the extremity at the level of the heart

a nurse is caring for a client who has a halo fixator device with vest for a complete cervical spinal cord injury. which assessment finding will the nurse report to the primary health care provider?
a) purulent drainage from the pin sites on the client's forehead
b) painful pressure injury under the collar
c) inability to move legs or feet
d) oxygen saturation of 95% on room air

a) purulent drainage from the pin sites on the client's forehead

mass casualty event (TB)

number of casualties is greater than resource capabilities

lichtenburg figure/ keraunographic markings/ erythrocytic arborization

branching/feathering marks on skin post lighting strike

rhabdomyolysis

breakdown/disintegration of muscle tissue from myoglobin in urine

where are snakes more likely to hide?

warm nights
tall grass, rock piles, ledges, crevices, woodpiles, brush, boxes, cabinet

how long is a snakes striking distance?

up to 2/3 length of snake

how early are snakes able to produce venom?

from birth- avoid poisonous baby snakes too

how long does the bite reflex on a snake last?

up to 1 hr postmortem

s/s no grade of pit viper envenomation

fang marks, no local/systemic reaction

s/s minimal grade of pit viper envenomation

fang marks, local swelling and pain

s/s moderate grade of pit viper envenomation

fang marks, swelling past bite site
systemic s/s: n/v, hypotension, paresthesia

s/s severe grade of pit viper envenomation

fang marks, increasing swelling of the extremity, SQ ecchymosis, severe s/s like coagulopathy

lightning strike prevention

if you cannot leave: crouch on balls of feet and tuck head down, do not lie down or put hands on ground, avoid phone lines (can transfer through and cause H/N trauma (cataracts, tympanic membrane disruption))

how can you tell if a lightning strike is imminent?

hair stands on end, blue halo around objects, high pitched/crackling noise

s/s mild hypothermia

shivering, dysarthria, decreased muscle coordination, impaired cognition, diuresis

s/s moderate hypothermia

muscle weakness, increasing loss of coordination, acute confusion, apathy, incoherent, possible stupor, decreased clotting

s/s severe hypothermia

bradycardia, severe hypotension, bradypnea, cardiac dysrhythmias, decreased neurological reflexes to coma, decreased pain response, acid base imbalance

ED specialty nursing

forensic nurse examiners (rape, DV, child abuse), psychiatric crisis, ER, flight

ED staff safety concerns

disease transmission/exposure: standard precautions at all times, airborne precautions if suspect airborne illness, exposure to hazardous materials, needle sticks
physical safety: escape route, security guard/police officer, metal detectors, remote door access or panic button, bullet proof glass

emergent triage

risk for loss of life or limb- requires TX immediately

examples of emergent triage (TB)

angina with diaphoresis, hemorrhage, respiratory distress, stroke, vital sign instability

urgent triage

no threat to loss of limb or life at the moment but requires TX quickly- must continuously reassess if unable to see MD quickly bc may lead to increase in category

examples of urgent triage (TB)

severe abdominal pain, displaced and/or multiple fractures, renal colic, respiratory infection, complex and/or multiple soft tissue injuries

nonurgent triage

can wait several hours before TX- no risk of deterioration

examples of nonurgent triage (TB)

simple fracture, rash, UTI, strain, sprain

disaster triage tagging: black

dead/expected to be dead
ex- massive head trauma, extensive full thickness burns, high cervical SCI needing mechanical ventilation

disaster triage tagging: red

critical
airway obstruction, shock, multiple fractures and cannot breathe, head injury

disaster triage tagging: yellow

TX within 30 min-2hr
open fracture with distal pulse, minor burns, eye injuries, minor spinal injury, stable abdominal injury

disaster triage tagging: green

minor TX that can be done in 2+ hr ("walking wounded")
closed fracture, sprain, strain, abrasion, contusion

what do social services help ED patients with?

discharge needs IN hospital

what do case managers help ED patients with?

discharge needs OUTSIDE of hospital

level 1 trauma center

provide full spectrum of health care with availability of nearly all resources
research capability and community education programs
usually on large teaching hospitals and serve high density underprivileged populations

level 2 trauma center

located in community hospitals and can care for most injuries
cannot meet resource needs for very complex injuries such as those requiring multisystem injury intervention
may need to transfer patients to level 1

level 3 trauma center

located in small rural hospitals where level 1 and 2 are not available
in communities that are less densely populated
have general and ortho surgeon available- focus is to stabilize and transfer via CCT in helicopter or ambulance

level 4 trauma center

located in rural or remote area with no access to higher level trauma center
very limited resources including MD
provides ALS and transfer

blunt trauma

soft tissue, vessels, bones injury from impact forces
blast effect, accel/decel, coup/countrecoup