Exam 4 condensed

1. What organs are in each abdominal quadrant?

Spleen for pain in upper left quadrant.

RUQ: liver, gallbladder, right kidney, parts of pancreas/colon. LUQ: stomach, spleen, left kidney, pancreas, parts of liver/colon. RLQ: appendix, cecum, small intestine, right ovary/tube. LLQ: descending/sigmoid colon, small intestine, left ovary/tube. Some organs span quadrants.

2. What is Cushing’s triad, and why is it concerning?

Increased intercranial pressure (increased bp, decreased HR, Irregular respiration)

Increasing blood pressure, often with widening pulse pressure; decreasing heart rate; irregular respirations. It is a late sign of increased intracranial pressure that threatens brain perfusion. Support ABCs and transport urgently.

3. What is the correct water-rescue order?

Reach → throw → row → go. Start with the safest option that keeps you out of the water. “Go” requires properly trained and equipped rescuers.

4. Which AED uses lower energy and adjusts delivery for patient impedance?

Biphasic. Current travels in two directions, allowing effective defibrillation at lower energy than older monophasic devices. Follow the AED’s prompts.

5. How do you care for an amputated body part?

First control the patient’s bleeding and manage shock. Wrap the part in plastic sterile pakage and keep it cool. Do not freeze or immerse the tissue directly in water. Send it with the patient.

6. ALS arrives just as the AED is ready to deliver an indicated shock. What do you do?

Deliver the shock safely, immediately resume CPR, and coordinate the handoff. Do not delay an available shock just to change equipment or give a report.

7. What is the preferred position for a patient stabbed in the abdomen?

Generally supine or on side so fowler and semi fowler with knees bent if tolerated and other injuries allow. This reduces abdominal muscle tension. Adjust for breathing, shock, and associated injuries; do not force positioning.

8. What is the difference between frostnip and frostbite?

skin from red to white (blanch) would = superficial.

Frostnip is a mild superficial cold injury without the deep tissue destruction of frostbite. Frostbite involves frozen tissue that may be hard, waxy, numb, swollen, or blistered after thawing. Protect the area and assess for hypothermia.

9. Approximately how much blood can fractures conceal?

Pelvic ring fracture would be worst. Also one liter of each femur is 1L and pelvis is 1 liter for 3.

Pelvis: potentially several liters. One femur: about 500–1,500 mL in your Chapter 32 review. Humerus: about 500 mL. These are estimates, not limits; pelvic injury carries the greatest shock risk in the slide comparison.

10. Why avoid rough handling of a hypothermic patient?

to prevent further damage and not send into v fib.

The severely cold heart is vulnerable to dangerous dysrhythmias. Handle gently, minimize unnecessary movement/exertion, prevent further heat loss, and monitor closely.

11. What do you do for chemicals in the eyes?

run into ambo take back into eyewash station for 15-20 mins.

immediately irrigate with copious water or saline using gentle flow. Hold lids open, remove contacts if easily possible, and direct runoff away from the other eye. Continue at least 15–20 minutes or longer as directed for the chemical; do not attempt chemical neutralization.

12. Why must you avoid rubbing frostbitten extremities?

Frozen tissue is fragile. Rubbing or massaging can worsen tissue and muscle damage. Protect and handle gently.

13. Should you lift dressings to check bleeding?

NO

Generally no—repeated lifting disrupts clot formation. Maintain pressure and reassess control; add material as appropriate. Escalate promptly for continued life-threatening bleeding rather than repeatedly stacking dressings.

14. Which bones or skeletal regions can cause major blood loss?

Look for pelvic ring fracture

The pelvis and femur are major concerns. Other long-bone fractures and multiple fractures also contribute. Significant internal hemorrhage can occur without an open wound.

15. Arterial versus venous bleeding: which is usually the course answer for greater danger?

Artery (bright red blood) Femoral

Arterial: usually bright red, pulsatile, and difficult to control because of pressure. Venous: usually darker, steady flow. Clinically, either can be fatal—judge the amount/rate and patient perfusion, not color alone.

16. What can happen with repeated allergen exposure?

worse reaction

Sensitization can make later exposure produce a more severe reaction, including anaphylaxis. A previously mild reaction does not guarantee the next one will be mild; worsening is not inevitable every time.

17. How do you manage an abdominal evisceration?

Look for moist sterile dressing to keep in place.

Do not replace organs or apply pressure to them. Cover with sterile saline-moistened dressings and an appropriate protective covering per protocol. Keep warm, manage shock, and transport promptly. No food or drink.

18. How do you package a patient with spinal curvature?

Pad void spaces

Support the patient’s existing alignment and pad gaps. Do not force a curved spine flat against a board. Maintain appropriate spinal motion restriction without worsening pain, breathing, or neurologic findings.

19. What concerns accompany multiple rib fractures?

Lung puncture or contusion

Pain-related shallow breathing, lung contusion, pneumothorax, hemothorax, and a possible flail segment. Assess air movement and oxygenation; assist ventilation if inadequate and transport promptly.

20. What do skin findings tell you in a trauma patient?

Going from warm and dry to cool and moist

Color, temperature, and moisture help assess perfusion. Pale, cool, clammy skin supports concern for shock, especially with tachycardia or altered status. Consider environment and the whole patient.

21. Why might you defer the secondary trauma assessment?

Immediate life threats (Look for sucking chest wound)

unsafe conditions, critical instability, or urgent transport. Treat primary problems first and complete the examination during transport when feasible.

22. How do you displace the uterus during CPR?

For CPR manually displace fundus to left so we get circulation to fetus.

Keep the patient supine for effective compressions and manually displace the uterus toward the patient’s left when the fundus is at or above the umbilicus. This relieves aortocaval compression and improves venous return.

23. What injury has a particularly high risk of venous air embolism?

An open neck wound involving a large vein, such as the jugular.

Air may enter the circulation through the injured vein. Manage bleeding and cover appropriately while protecting the airway.

24. How do abrasion, contusion, hematoma, avulsion, and laceration differ?

Abrasion: road rash scrape. Contusion: bruise. Hematoma: localized collection of blood. Avulsion: tissue partly/completely torn away. Laceration: cut or tear. Assess bleeding and associated injury in each.

25. What function may be lost with a spinal cord injury?

Lumbar lower half of body paralysis to lower half of body.

Cervical=7 Thoracic=12 Lumbar=5, Sacrum=5 (fused) Coccyx 4 (Fused)

, depending on severity/completeness. High cervical injuries may impair breathing. Not every cord injury causes complete paralysis.

26. What is a definitive sign of a fractured extremity?

Look for mid shaft angulation (deformatie)

Visible exposed broken bone ends directly demonstrate a fracture. Crepitus, false motion, and deformity strongly suggest fracture, but never deliberately produce them. Point tenderness is important but does not prove a fracture.

27. What is the best way to prevent frostbite?

Dress Warmly

Limit cold exposure, keep skin protected and dry, use insulating layers, replace wet clothing, and avoid constrictive clothing that reduces circulation.

28. How long should you remain on scene with a bleeding patient showing shock?

Less than 10 mins

Traditional critical-trauma goal: about 10 minutes or less when feasible. Complete essential lifesaving care and transport promptly; do not delay for an elaborate secondary examination.

29. What does profoundly hypotensive mean?

Inadequate perfusion for vital organs.

Extremely low blood pressure with concern for severe circulatory compromise. There is no single universal cutoff for this phrase; assess mental status, pulses, skin, and overall perfusion urgently.

30. Why reassess patients with spinal cord injuries?

swelling, pressure build up, and paralysis could appear.

Neurologic deficits, breathing, and circulation may worsen. Recheck extremity pulse, motor function, and sensation, especially before/after movement, and compare with baseline.

31. Compensated versus decompensated shock?

Decompensated is drop in BP while other vitals are elevated.

Compensated: the body maintains blood pressure despite poor perfusion, often with tachycardia and cool skin. Decompensated: compensation fails, causing hypotension and worsening mental status/perfusion. Normal BP does not exclude shock.

32. What are the general rules of splinting?

Above and below joint to immobilize

Manually stabilize the injury; assess distal PMS; manage wounds/bleeding; pad and immobilize appropriately; then recheck PMS. Generally immobilize joints above/below a shaft fracture. Do not force alignment or delay critical transport for lengthy splinting.

33. What is paresthesia?

Abnormal sensation such as tingling or pins-and-needles. Sensory nerve injury

It can indicate nerve injury or impaired perfusion; document and reassess.

34. Why and how do you apply a tourniquet?

High and tight when direct pressure doesnt stop bleeding.

For life-threatening extremity bleeding when indicated. Place 2–3 inches above a visible wound, avoiding joints, and tighten until bleeding stops and distal pulse is absent. Secure, record time, reassess, and do not routinely loosen. Follow device/protocol instructions.

35. What is the mammalian dive reflex?

Body sends signals to keep blood flow to brain and heart.

Cold-water facial stimulation may trigger bradycardia and peripheral vasoconstriction, helping conserve oxygen. It does not guarantee survival or justify delaying rescue breathing/CPR.

36. What findings suggest hip fracture versus posterior hip dislocation?

Hip dislocation could be one limb shortened than other and rotated internal adduction and rotation.

Hip fracture: pain, difficulty bearing weight, often a shortened externally rotated leg. Posterior dislocation: severe pain, resistance to movement, often shortening with internal rotation/adduction. Support as found, check PMS, and do not attempt field reduction.

37. How do you treat burns?

Remove jewelry and keep warm and remove from burning area

Ensure safety, stop exposure, and assess ABCs/airway injury. Cool appropriate recent thermal burns with cool water per protocol, remove nonadherent clothing/jewelry, cover appropriately, and prevent hypothermia. No ice, ointments, or blister popping. Chemical/electrical burns need mechanism-specific precautions.

38. How do you treat an open chest wound?

Occlusive dressing to cover the hole

Your slides teach prompt occlusive coverage. Use the approved chest-seal technique/device under protocol; a vented seal may be appropriate in a spontaneously breathing patient. Reassess breathing frequently, look for other wounds, support ventilation/oxygenation, and transport urgently.

39. When might a short spine board or KED be used in vehicle extrication?

If they are in a stable seating position

For a selected stable seated patient needing controlled extrication when indicated by training/protocol. Do not delay urgent removal or resuscitation to apply it in an unstable patient or unsafe scene.

40. How do you treat an impaled object?

Transport, provide o2, stablize.

Usually leave it in place, stabilize with bulky dressings, control bleeding around it, and transport. Removal can worsen tissue damage or release bleeding. Remove only for specific lifesaving/protocol exceptions.

41. Heat cramps versus heat exhaustion versus heat stroke?

27 year old leg and abdomial pain, heat cramps so electrolyets imbalance.

Cramps: painful muscle spasms during/after exertion. Exhaustion: sweating, weakness, dizziness, nausea, possible fainting. Stroke: heat exposure with major CNS dysfunction such as confusion, seizure, or coma—begin rapid cooling and emergency care. Heat-stroke patients may still sweat.

42. What does PERRL mean, and how do you assess pupils?

Pupils Equal, Round, Reactive to Light. Compare size, shape, equality, and response to light; document abnormalities and trends. Unequal pupils may suggest neurologic/eye injury but are not diagnostic alone.

43. Active versus passive warming?

Passive: shelter, dry clothing, blankets, and prevention of heat loss. Active: an applied heat source or advanced internal warming under protocol. Protect skin from burns; do not thaw frozen tissue when refreezing is likely.

44. Open versus closed soft-tissue injury?

Open soft tissue injury is burise, closed is stab.

Open: skin barrier broken, such as abrasion, laceration, or avulsion. Closed: skin intact, such as contusion or hematoma. Both can involve significant bleeding.

45. When should you remove a helmet?

When you can not mannage an airway. sport trainer?

When it prevents airway/ventilation care, fits poorly, prevents appropriate alignment, or interferes with necessary stabilization/assessment. Use trained coordinated removal with manual stabilization. Do not remove automatically if it can safely remain.

46. How do you manage an open neck wound?

Direct pressure, bubbling air hit trachea.

Assess airway, control bleeding with targeted direct pressure, and apply appropriate occlusive coverage per protocol. Never wrap tightly around the entire neck or compress both carotids. Watch for airway swelling and air embolism.

47. When may an impaled object need removal for CPR?

when it affects airway or impededes CPR

When it physically prevents effective chest compressions or essential airway care, following training/protocol. This is an exception to the usual leave-in-place rule.

48. How should a patient with abdominal trauma be positioned?

Positition of comfort, hunched over less tension. ( lie on the side) Knees flexed

Usually supine with knees flexed if tolerated and other injuries permit, reducing abdominal tension. Modify for airway/breathing and shock. Avoid prone positioning and pressure on wounds or exposed organs.

49. Why consider spinal precautions after lightning, and what else concerns you?

A fall, blast, or violent muscle contraction may cause trauma. Assess for spinal injury, cardiac/respiratory arrest, dysrhythmias, burns, and neurologic injury. The patient holds no electrical charge; provide indicated CPR/ventilation promptly once the scene is safe.

50. What is a pneumothorax?

Air in the pleural space that can collapse the lung. Tension pneumothorax adds rising pressure that compromises ventilation and venous return, causing obstructive shock. Watch for worsening distress, reduced breath sounds, and poor perfusion.

51. What is cardiac tamponade?

Fluid, often blood after trauma, compresses the heart inside the pericardial sac, reducing filling and cardiac output. Classic findings: hypotension, JVD, muffled heart sounds; the full triad may be absent. Support ABCs and transport urgently.

52. What are the degrees of burns?

Superficial: top layer partial thickness redness

2nd degree: epidermis and parts of dermis

Full thickness : charred leathery all skin layers.

Superficial/1st: epidermis, red/painful, no blisters. Partial-thickness/2nd: epidermis plus some dermis, often moist/blistered/painful. Full-thickness/3rd: entire skin destroyed, leathery/charred/pale, reduced central sensation. Fourth-degree: extends into deeper tissue such as muscle/bone.

53. What fracture types should you recognize?

Transverse opposite direction (complete break)

Spiral twisting, domestic

Green stick incomplete (children)

Commuted high impact fragment shatters into pieces

Transverse: straight across. Oblique: diagonal. Spiral: twisting line. Comminuted: more than two fragments. Greenstick: incomplete break, common in children. Impacted: fragments driven together. Compression: crushed/collapsed bone. Epiphyseal: growth plate. Pathologic: weakened bone. Open: communicates with a wound; closed: skin remains intact.

Upper right Q 4 inch blade stab

Liver, pancreas, gallbladder, large intestine

Pelvis hip

bone joint

6 year old girl from monkey bars falls and profusely bleeding from genital area

keep female teacher present and do exam and dress wounds

Stab in chst, vomiting blood RR 20/min SPO2 93 what Oxygen tecnique?

Non rebreather

Question 36. Work in factory and co workers slices arm off

Grap a plastic bag

More common finding in dislocation than fracture

Absent distal pulse(dislocation can sit on artery.

Reliable sign patient has spinal injury

Paralysis to extremities

When to leave helmet on

interferes with damage to airway

Airway maintence important for CPR

to improve ventilation and reduce gastric destension

hypothermia

core temp below 35 degrees celcius or 95 farenhight.

Skills =traction splint

Move pt carefully w femur fracture, look for step offs on spine when log rolling