Chapter 6

Emergency Care and Transportation of the Sick and Injured - Chapter 6 Assessment in Action Study Notes

Case Study Scenario

  • Situation: Dispatched to an unresponsive person at an automotive garage.

  • Patient Status: Middle-aged man lying face up on the ground by a tire rack.

Anatomical Orientation

  1. Observation of Body Planes

    • Question: As you look at the front side of the patient's body, which plane are you observing?

    • Answer: A. Coronal

    • Explanation: The coronal plane divides the body into front (anterior) and back (posterior) sections.

Patient Assessment

  1. Checking for Pulse

    • Question: Which artery are you palpating just lateral to the trachea?

    • Answer: B. Carotid

    • Explanation: The carotid artery is responsible for supplying blood to the head and neck.

  2. Assessment of the Lower Extremities

    • Observation: Marked swelling in the right thigh.

    • Question: What bone is in this location?

    • Answer: C. Femur

    • Explanation: The femur is the largest bone in the body, located in the thigh region.

Bone Composition

  1. Predominant Mineral in Bone

    • Question: Which substance serves as the predominant mineral for creating a hard structure?

    • Answer: D. Calcium

    • Explanation: Calcium is vital for bone density and strength, facilitating bone mineralization.

  2. Facial Bone Assessment

    • Observation: Bruising and instability of the right cheekbone.

    • Question: What is the proper name for this bone?

    • Answer: A. Zygoma

    • Explanation: The zygomatic bone (cheekbone) forms the prominence of the cheeks and part of the orbit.

  3. Forearm Bone Identification

    • Question: The larger bone of the forearm at the wrist is the:

    • Answer: C. radius

    • Explanation: The radius runs parallel to the ulna and is on the lateral side of the forearm.

Joint Types

  1. Joint Classification

    • Question: The elbow is an example of what type of joint?

    • Answer: A. Hinge

    • Explanation: A hinge joint permits movement primarily in one axis, allowing flexion and extension, as seen in the elbow.

Physiological Responses to Compromise

  1. Respiratory Compromise Explained

    • Definition: Respiratory compromise is the inability of the body to move gas effectively.

    • Causes: May occur due to impaired ventilation or respiration.

    • Consequences:

      • Heart and brain cells cannot survive without a constant supply of oxygen and will die within minutes.

      • Decreased oxygen forces cells from aerobic metabolism to anaerobic metabolism.

      • This leads to impaired cellular functions and the production of lactic acid as a by-product.

      • Excess lactic acid causes a drop in blood pH, leading to cellular death.

  2. Structures Responsible for Consciousness and Vital Signs

    • Question: Which brain structure is responsible for consciousness and vital signs?

    • Answer: The brainstem.

    • Explanation: The brainstem, comprising the midbrain, medulla, and pons, regulates:

      • Midbrain: Level of consciousness

      • Pons and Medulla: Regulate blood pressure, heart rate, and respiratory rate.

  3. Nervous System Response in Stress

    • Question: What part of the nervous system is responsible for increased pulse rate?

    • Answer: The autonomic nervous system, specifically the sympathetic nervous system.

    • Explanation: The autonomic nervous system has two divisions:

      • Parasympathetic Nervous System: Dominates during rest and relaxation.

      • Sympathetic Nervous System: Activates during stress, increasing vital signs to help the body adapt. The brainstem also plays a role in controlling heart rate.

Summary of Assessment Answers

  1. Coronal

  2. Carotid

  3. Femur

  4. Calcium

  5. Zygoma

  6. Radius

  7. Hinge

  8. Respiratory compromise is marked by impaired gas movement, leading to a shift to anaerobic metabolism and lactic acid production, impacting pH and cell viability.

  9. The brainstem, comprising the midbrain, pons, and medulla, regulates consciousness and vital signs.

  10. The sympathetic nervous system mediates increased vital signs in response to stress, influenced by the brainstem.