Mometrix Flashcards: Domain III Critical Incident Management

Putting these into terms I understand and WILL memorize. These are 100% true and best practices

The Meissner’s corpuscle is part of the _ organ and it’s purpose is…

Integumentary (skin), sense light touch

The Pacinian corpuscle is part of the _ organ and it’s purpose is…

Integumentary (skin_, sense deep pressure

What are the 5 layers of the epidermis

1. Stratum corneum

2. Stratum lucidum

3. Stratum granulosum

4. Stratum spinosum

5. Stratum basale

6. Melanocyte

The spinal cord is protected by vertebrae. How many cervical, thoracic, lumbar and sacrum?

C7, T12, L5, S5 that are fused

HIPAA release form needs (6)

1. What medical information can be disclosed

2. Who may release the information

3. Who the information may be released to

4. Purpose for disclosing the information

5. Expired date of authorization

6. To be signed and dated by the patient

If a personal representative is signing the HIPAA release form, what is needed?

Representative’s authority to sign for patient must be identified

What is the purpose of HIPAA (3)

Governs how patient’s PMI is protected and what steps must be taken for PMI to be shared.

• Ensures patients have access to their own PMI

• Offers added control over how PMI is shared

• Sets consequences if PMI is not kept private

Define duration of action and half life

length of time which blood level is adequate to provide minimum therapeutic results. this is based on the drug’s half life - time required to reduce blood level to the drug by half

Define frequency of administration

half life of the drug

steady state means what has been reached

when the amount of the drug ingested equals that which is metabolized

what are the differences between short half lives and longer half lives

short half lives - (2hrs) will reach steady state within 3 doses

longer half lives - (12hrs) will reach steady state within 2-3 days

what is SMART goal setting and how does it increase compliance in rehabilitation

specific, measurable, achievable, relevant, time bound

collaboration with patients on LT and ST goals will increase patient responsibility, increasing optimal results. this can be used to decrease stress of injury.

goal setting produces positive reinforcement and integrates time management

possible sociological responses to injuries (4) and role of the AT in providing social support (5)

1. decreased sense of belonging

2. decreased identity

3. isolation

4. question their self worth

You are to help them cope by:

1. actively listening

2. show authentic concern

3. build rapport

4. explain injury in human words

5. include patient in decision making

when patient is showing sociological responses with their injury, what technique should you use?

imagery & negative thought stopping as a stress decreasing technique

during an EAP, one person has a role. what are they? (4)

• one person calls 911

• one person meets EMP & directs them

• one person keeps spectators away

• one person goes with patient to hospital

PPE and supplies are needed to properly practice universal precautions when exposed to blood or bodily fluids. What does the ATR need to have (7)

1. PPEs

2. disposable containers for biohazardous materials

3. sharp disposals container

4. disinfectants that are EPA approved

5. chlorine bleed

6. antiseptics

7. contaminated laundry separated from others laundry in biohazardous bags

the name of the form needed to provide treatment to minors

Consent to Treat Minors - obtain at start of season; bring it when traveling along with parents contact information

what is the importance of triage when managing multiple patients suffering from various injuries

triage - who needs to receive medical care first

a responsible adult monitor the less injured one until the more injured is cared for or transported away

histmine’s role during anaphylaxis syndrome

causes initial erythema & edema by inducing vasodilation.

define anaphylaxis syndrome

an acute systemic inflammatory response with a sudden onset that affects the cardiopulmonary system and other systems. the response may be immunoglobulin E mediated or non-immunoglobulin E mediated

define immunoglobulin E mediated VS non immunoglobulin E mediated in anaphylaxis shock syndrome

IgE - mediated response against allergen. this is the most common type (anaphylactic shock)

non-IgE = non-mediated response. a systemic reaction to triggers e.g. infection, exercise, radio contrast material (anaphylactoid reaction)

Anaphylaxis syndrome includes symptoms of cardiopulmonary, dermatological, gastrointestinal response. What are the symptoms (8)

1. sudden onset of: weakness, dizziness, and confusion

2. severe generalized edema and angioedema (deep swelling)

3. urticaria (hives)

4. increased permeability of vascular system & loss of vascular tone

5. severe hypotension that leads to shock

6. laryngospasm/bronchospasm, airway obstruction, dyspnea, wheezing

7. nausea, vomiting, diarrhea

8. seizures, coma, death

Immediate treatment for anaphylaxis syndrome

1. establish airway

2. provide oxygen at 100% high flow

3. monitor vital signs

4. admin epinephrine (epi-pen or 1:1000 solution 0.1mg/kg) if available

5. transfer to ED for treatment (like IV fluids)

hyperventilation symptoms (7)

1. rapid, often deep breathing

2. tachynpea (>40bpm)

3. dyspnea (SOB or distressed breathing)

4. lightheadedness

5. dizziness

6. anxiety

7. agitation

If prolonged, calcium levels may drop and paresthesia with numbness, tingling, spasm may occur.

what is your role during a patient’s hyperventilation

reassurance and calmy coach to breath more slowly: in through nose, hold for short period, exhale slowly until breathing slows

DO NOT use the bag-breathing technique. This does little to alter blood gas and will stress cardiopulmonary system more

define seizures

sudden, involuntary abnormal electrical disturbances in brain that can manifest as alterations of consciousness, spastic tonic and clonic movements, convulsions and LOC.

define tonic-clonic seizures

tonic period - (10-30s) eyes rolls upward, LOC, arms flexed, body stiffens in symmetric contractions. may experience cyanosis and salivation

clonic period - (30s+) violent, rhythmic jerking with contractions, relaxation, sometimes, incontinence of urine and feces

You should refer patients for medical care for a patient who just experience a seizure under two circumstances

1. if it was their first seizure

2. if it lasted >5minutes

common post-symptoms of a patient who just experience a seizure episode (5)

1. confusion

2. disorient

3. impaired motor activity, speech, vision for several hours

4. headache

5. nausea, vomiting

skull fractures are an medical emergency, why? (3)

if seeing battle sign or raccoon ears = immediate referred for advance medical care and be seen by a neurosurgeon. It is the complication of intracranial bleeding, bone fragments on the brain, and possible infection

second-impact syndrome is a life threatening condition. what are some signs and the definition

suffering an injury to the head before fully recovering from a prior head injury. this 2nd impact will result in quick swelling and herniation of the brain and condition will rapidly deteriorate. (blow to chest creating sudden movement to head is a common mechanism)

prevention of second-impact syndrome is your primary defense; to prevent it from occurring.

subdural hematomas are life threatening medical conditions resulting from…what are the signs and symptoms (6)

resulting from acceleration and deceleration forces that cause injury to the brain causing bleeding & increased intracrainial pressure

1. headache that gets increasingly worse

2. dilation of one pupil

3. nausea

4. dizziness

5. lethargy

6. unconsciousness

those need immediate medical care for the best possible results

mandibular fracture define, sign and symptoms, and proper management

a blow to lower jaw MC in contact sports and is 2nd MC facial injury. Remember to inspect for possible head injury.

1. mandible deformity

2. malocclusion of teeth with possible bleeding

3. numbness of lower lip

4. pain with biting

5. trismus (reduced ability to open jaw)

Manage with immobilization with elastic wrap, refer out. A physician must reduce and fixate mandible.

Full return to play following a mandibular fracture may take how long

2-3mo

Maxillary fracture MC mechanism of injury

powerfull blow to upper jaw (hit by hockey puck or ball traveling at high speed) and is the 4th MC fracture to the face.

Le Fort fracture is a severe fracture of the maxilla, where its detached from the skull.

Maxillary fracture sign and symptoms, and management

1. swelling over maxilla

2. possible numbness if involvement of the infraorbital foramen and nerve

3. epistaxis (bleeding out of nose)

4. significant malocclusion of teeth and epistaxis with Le Fort fracture

How to manage if…

no malocclusion or epistaxis: RICE, ibuprofen, refer to physician within 24hrs
numbness present: referred for CT scan ASAP to determine proper care

Zygomatic complex fracture mechanism of injury, sign and symptoms

usually forceful blow to area.

1. Pain and swelling

2. possible trismus (reduce opening of jaw)

3. possible numbness

there will not be an obvious deformity unless all three attachments to facial bones are fractured. if zygoma usually rotates downwards creating prominence of cheekbone if severe/obvious.

Zygomatic complex fracture management

Depends on the severity:

• Obvious = immediate referral

• fracture not displaced = RICE, ibuprofen, referral to physician within 24hrs is sufficient

Tooth subluxation (3), luxation, and avulsion: mechanism, sign and symptoms

Mechanism: blow to the mouth

subluxation -

1. slight looseness without misalignment

2. doesn’t “feel right”

3. sensitive to touch or biting

luxation - very loose and out place shifted forwards or backwards

avulsed - completely knocked out

Orbital fractures: mechanisms, sign and symptoms, management

blow to the eye creating eye to be pushed backwards into the socket. this creatss compressive force (possible fracture to surrounding structures)

1. limited eye mobility

2. diplopia

3. edema

4. affected eye appearing downwardly displaced

5. pain or numbness to area

management = immediate referral for advance medical care. most fractures require surgical repair and antibiotics

Tooth sublux/lux/avulsion management is dependent on the extent of injury. What are managements for each levels

Luxation = attempt to realign if easily moved & referred for immediate dental care

Avulsion = tooth rinsed clean but not scrubbed or scrapped, try to replant the tooth (sooner the better)

Regardless of if the tooth can be reimplanted or not, patient is referred for immediate dental care

Tooth avulsion injury: what solutions options to leave tooth in

Store tooth in patient’s saliva in a plastic bag, milk, saline, or inside patient’s mouth between cheek and gum

* The revised trauma scoring system is used for…what score requires treatment in trauma center?

to rapidly assess persons involved in trauma often done at scene of accident.

score of 11 and less requires treatment in trauma center. scores often used to predict patient outcomes.