NREMT pocket prep explanations

Subdural hematoma typically occurs with a sudden _____________/__________ injury, and tearing of the __________ _____ of the dura, resulting in a __________ between the dura mater and arachnoid.

acceleration/deceleration, bridging veins, hematoma

An epidural hematoma results from...

a collection of blood in the potential space between the skull and the dura mater.

Epidural hematoma mechanism of injury

Blunt trauma to the temporal or temporoparietal area with an associated skull fracture and disruption of the middle meningeal artery

Dura matter definition

tough outermost meningeal layer covering the brain and spinal cord

Knowing the dura's location helps distinguish bleeds:

epidural is outside the dura, while subdural is beneath it

The classic presentation of EDH involves...

significant blunt trauma, with a loss of consciousness or altered mental status, followed by a " lucid interval" of indeterminate duration; the patient then quickly declines in status, with a rapid neurologic demise.

Epidural Hematoma

Bleeding between skull and dura matter

Epidural Hematoma is a result of..

arterial injury like rupture of middle meningeal artery after skull fracture

Epidural Hematoma may present with...

brief loss of consciousness, lucid interval, then rapid deterioration making it a neurosurgical emergency

Ecchymosis

bruising caused by bleeding under the skin

In trauma questions, the location of ecchymosis can hint at deeper injury, such as...

Battle sign behind the ear suggesting possible basilar skull fracture

Somnolent

drowsy and difficult to keep awake, but pt can still be aroused

On the NREMT, worsening somnolence after head injury suggests...

declining brain function and possible increasing intracranial pressure or bleeding

What is a acceleration/deceleration injury

occurs when the brain moves rapidly within the skull as the head speeds up or stops suddenly

What can acceleration/deceleration mechanism cause

tear veins or injure brain tissue, making it a classic cause of subdural hematoma.

Acceleration/deceleration is a classic cause of what

subdural hematoma

A basilar skull fracture is associated with...

high-energy trauma and occurs following diffuse impact to the head

Basilar skull fracture signs and symptoms

Cerebrospinal Fluid (CSF) draining from the ears, " raccoon eyes," or a Battle sign ( ecchymosis behind one ear over the mastoid process)

Patients with leaking CSF are at risk for

bacterial meningitis

What is bacterial meningitis

a serious infection of the protective membranes covering the brain and spinal cord

What is a concussion?

a mild traumatic brain injury, leading to impairment of brain function without overt hemorrhage or gross lesion

What GCS might someone with a concussion have?

14 or 15

Pulmonary contusion

bruising of the lung tissue caused by blunt trauma, leading to bleeding and swelling within the alveoli that impairs gas exchange

Difference between pulmonary contusion and tension pneumothorax?

Symptoms often worsen gradually over time rather than causing the sudden one-sided absent breath sounds and shock seen with tension pneumothorax

Tension pneumothorax is suggested by what?

sudden deterioration after chest trauma with severe respiratory distress, absent breath sounds on one side, tachycardia, and hypotension

What does flail chest present with?

paradoxical chest wall motion

What does simple pnuemothorax? How is it different from a tension pneumo?

It may cause decreased or absent breath sounds on one side, but unlike tension pneumothorax, it usually does not cause severe hypotension or rapid cardiovascular collapse.

Rule of Nines (adult)

head 9%

each arm 9%

anterior torso 18%

posterior torso 18%

each leg 18%

and genitalia 1%

diaphoretic definition

sweating heavily

what can diaphoresis be a warning sign of

a patient may be unstable even if they are still awake and talking

How often should unstable patients be reassesed?

5 minutes

Stable patients without distress, significant injury, or medical emergency and with vital signs within normal limits may be monitored every

15 minutes

A patient in a prehospital setting with multiple severe fractures, abdominal or chest injuries, spinal injuries, a severe infection, a major heart attack, or anaphylaxis is considered...

not stable

heat exhaustion presentation

profuse sweating, a normal or slightly elevated body temperature, and an intact mental status.

heat stroke presentation

confusion, a high core body temperature, and the absence of sweating

hematuria

bloody urine

Hematuria indicates what?

bleeding in urinary tract

Coffee-ground emesis

classic sign of upper gastrointestinal bleeding and suggests the bleeding is not fresh and brisk at the moment

melena

Black tarry stool

Melena indicates what?

digested blood passing through the gastrointestinal tract, most often from an upper gastrointestinal source.

hematemesis

blood in vomit

hematemesis, suggests...

ctive upper gastrointestinal bleeding

hemorrhagic stroke signs

severe hypertension, sudden neurologic deficits, and confusion

Cerebral hypoperfusion

Reduced blood flow to the brain.

The components of START are what

breathing (respirations >30 or

What are the three factors of the trauma triad

acidosis, coagulopathy, hypothermia

what is acidosis

inadequet o2 delivery leading to buildup of acid in the body and worsening shock

coagulopathy

blood cannot clot properly, hard to control bleeding