Emergency Care Chapter 29 Flashcards
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Questions and Answers

A short backboard or vest-style immobilization device is indicated for patients who:

  • Are sitting in their car and are clinically unstable
  • Are found supine and have stable vital signs
  • Are in a sitting position and are clinically stable (correct)
  • Require prompt extrication from an automobile

When assessing a conscious patient with a mechanism of injury that suggests spinal injury, you should:

  • Ask the patient to move his or her head to assess for pain
  • Determine if the strength in all extremities is equal (correct)
  • Defer spinal immobilization if the patient is ambulatory
  • Rule out a spinal injury if the patient denies neck pain

After your partner assumes manual in-line stabilization of the patient's head, you should:

  • Thoroughly palpate the patient's head for deformities
  • Apply an appropriately sized rigid cervical collar
  • Use four people to log roll the patient onto a backboard
  • Assess distal neurovascular status in the extremities (correct)

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

<p>Instruct him to assist her ventilations while you perform a rapid assessment (B)</p> Signup and view all the answers

In the setting of a head injury, hypertension, bradycardia, and Biot respirations indicate:

<p>Herniation of the brain stem (B)</p> Signup and view all the answers

The most important immediate treatment for patients with a head injury, regardless of severity, is to:

<p>Establish an adequate airway (B)</p> Signup and view all the answers

A patient who cannot remember the events that preceded his or her head injury is experiencing:

<p>Retrograde amnesia (A)</p> Signup and view all the answers

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

<p>Rupture of the tympanic membrane following diffuse impact to the head (B)</p> Signup and view all the answers

When caring for a patient with a possible head injury, it is most important to monitor the patient's:

<p>Level of consciousness (B)</p> Signup and view all the answers

Which of the following statements regarding the cranium is correct?

<p>Eighty percent of the cranium is occupied by brain tissue (A)</p> Signup and view all the answers

Bleeding within the brain tissue itself is called a(n):

<p>Intracerebral hematoma (A)</p> Signup and view all the answers

The Glasgow Coma Scale (GCS) is used to assess:

<p>Eye opening, verbal response, and motor response (A)</p> Signup and view all the answers

When immobilizing a child on a long backboard, you should:

<p>Place padding under the child's shoulders as needed (B)</p> Signup and view all the answers

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?

<p>Connecting (B)</p> Signup and view all the answers

A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

<p>Immobilize his spine and perform a focused secondary exam (C)</p> Signup and view all the answers

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

<p>3 (A)</p> Signup and view all the answers

Which of the following skull fractures would be the least likely to present with palpable deformity or other outward signs?

<p>Linear (A)</p> Signup and view all the answers

The ___________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

<p>Brain stem (D)</p> Signup and view all the answers

It would be most appropriate to perform a focused secondary assessment on a patient who:

<p>Fainted and fell to the ground from a standing position (A)</p> Signup and view all the answers

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

<p>14 (C)</p> Signup and view all the answers

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

<p>Suction his oropharynx for up to 15 seconds (B)</p> Signup and view all the answers

An epidural hematoma is most accurately defined as:

<p>Bleeding between the skull and dura mater (A)</p> Signup and view all the answers

Coordination of balance and body movement is controlled by the:

<p>Cerebellum (D)</p> Signup and view all the answers

In contrast to a cerebral concussion, a cerebral contusion:

<p>Involves physical injury to the brain tissue (C)</p> Signup and view all the answers

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

<p>It causes a problem managing the airway (D)</p> Signup and view all the answers

Signs and symptoms that might be found in a patient who has experienced a concussion include:

<p>Nausea and ringing in the ears (C)</p> Signup and view all the answers

The __________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

<p>Peripheral (A)</p> Signup and view all the answers

The central nervous system (CNS) is composed of the:

<p>Brain and spinal cord (A)</p> Signup and view all the answers

The frontal and parietal bones of the skull are especially susceptible to:

<p>Depressed skull fractures (C)</p> Signup and view all the answers

The hormone responsible for the actions of the sympathetic nervous system is:

<p>Epinephrine (B)</p> Signup and view all the answers

The ideal procedure for moving an injured patient from the ground to a backboard is:

<p>The four-person log roll (D)</p> Signup and view all the answers

The most reliable sign of a head injury is:

<p>A decreased level of consciousness (B)</p> Signup and view all the answers

The spinal cord is encased in and protected by the:

<p>Spinal canal (D)</p> Signup and view all the answers

The tough, fibrous outer meningeal layer is called the:

<p>Dura mater (A)</p> Signup and view all the answers

What part of the nervous system controls the body's voluntary activities?

<p>Somatic (B)</p> Signup and view all the answers

When a patient experiences a severe spinal injury, he or she:

<p>Might lose sensation below the level of the injury (C)</p> Signup and view all the answers

When opening the airway of a patient with a suspected spinal injury, you should use the:

<p>Jaw-thrust maneuver (B)</p> Signup and view all the answers

When placing a patient onto a long backboard, the EMT at the patient's __________ is in charge of all patient movements:

<p>Head (A)</p> Signup and view all the answers

Which of the following interventions may be used to help reduce intracranial pressure?

<p>30-degree elevation of the head (D)</p> Signup and view all the answers

You should be most suspicious that a patient has experienced a significant head injury if his or her pulse is:

<p>Slow (B)</p> Signup and view all the answers

Flashcards

Short backboard/vest

Used for stable, sitting patients; immobilizes torso & head.

Spinal injury assessment

Assess strength equally in all limbs.

Distal neurovascular status

Check pulse, movement, and feeling below the injury.

Rapid assessment (head trauma)

Assist ventilations while you quickly examine the patient.

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Brain stem herniation signs

Hypertension, bradycardia, and irregular breathing pattern.

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Airway management (head injury)

Ensuring the patient can breathe adequately.

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Retrograde amnesia

Loss of memory for events before the injury.

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Bloody fluid from ear

May indicate skull fracture and possible brain damage.

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Level of consciousness

How awake and aware the patient is.

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Cranial occupancy (%)

Brain tissue takes up this percentage of the skull.

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Intracerebral hematoma

Bleeding inside the brain tissue itself.

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Glasgow Coma Scale (GCS)

Assesses eye, verbal, and motor responses.

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Child backboard padding

Padding goes under here.

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Connecting nerves function

Transmit signals between nerves.

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Spinal injury after a fall

Immobilize and examine.

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Motor score of 3

Abnormal flexion (decorticate posturing).

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Linear skull fractures

These types of fractures are typically not displaced.

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Brain stem function

Controls breathing and heart rate.

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Focused secondary assessment

Useful after fainting spells.

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GCS score of 14

Spontaneous eye opening and confusion.

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Suctioning (head trauma)

Clear airway of fluids.

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Epidural hematoma

Bleeding between skull and dura.

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Cerebellum function

Coordination and balance.

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Cerebral contusion

Physical brain injury present.

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Cervical collar rule

Only remove if it blocks airway.

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Nausea and tinnitus

Can indicate head trauma.

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Peripheral nervous system

Nerves outside brain and spinal cord.

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Central nervous system

Brain and spinal cord.

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Skull fracture locations

These bones are more prone to this type of injury.

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Epinephrine's Role

Key hormone for 'fight or flight'.

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Study Notes

Immobilization and Assessment

  • Short backboard or vest-style immobilization is recommended for patients in a sitting position and clinically stable.
  • In cases suggesting spinal injury, ensure strength in all extremities is equal during patient assessment.
  • After applying manual in-line stabilization to a patient's head, assess distal neurovascular status in the extremities.

Primary Assessment and Response

  • In a case of a semiconscious patient with closed head trauma, instruct assistance with ventilations while performing a rapid assessment.
  • Symptoms of head injury such as hypertension, bradycardia, and Biot respirations suggest brain stem herniation.
  • The most crucial immediate treatment for head injuries is establishing an adequate airway.

Types of Amnesia and Symptoms

  • Retrograde amnesia occurs when a patient cannot recall events preceding their head injury.
  • Thin, bloody fluid from the ear signals a potential tympanic membrane rupture from a head impact.
  • The level of consciousness is a critical measure in head injury patient care.

Anatomy and Physiology

  • Eighty percent of the cranium is occupied by brain tissue.
  • An intracerebral hematoma indicates bleeding within brain tissue.
  • The Glasgow Coma Scale assesses eye opening, verbal response, and motor response.

Pediatric Care and Nerve Function

  • When immobilizing a child on a long backboard, use padding under the shoulders for comfort.
  • Connecting nerves facilitate sensory and motor impulses between nerves.

Patient Scenarios and Injury Management

  • For a patient with spinal complications after a fall, immobilize the spine and conduct a focused secondary examination.
  • A motor response score of 3 indicates abnormal flexion of extremities.
  • Linear skull fractures are least likely to present deformities.

CNS Structure and Protection

  • The brain stem is the most protected part of the CNS; it governs cardiac and respiratory functions.
  • A focused secondary assessment is warranted if a patient fainted from standing.
  • After head injuries, a GCS score of 14 indicates spontaneous eye opening and confusion.

Emergency Protocols

  • Immediate suctioning may be necessary for unconscious patients with severe head trauma to clear secretions.
  • Epidural hematomas result from bleeding between the skull and dura mater.
  • Coordination of balance and movement is primarily managed by the cerebellum.

Concussions vs. Contusions

  • A cerebral contusion involves physical injury to the brain, unlike a concussion that may not cause such injury.
  • It is crucial to keep the cervical collar in place unless it negatively impacts airway management.

Signs and Symptoms of Injury

  • Nausea and ringing in the ears can signal a concussion.
  • The peripheral nervous system consists of spinal and cranial nerves, crucial for overall body function.

CNS Composition

  • The central nervous system is composed of the brain and spinal cord.
  • Depressed skull fractures are particularly susceptible in the frontal and parietal bones.

Sympathetic Nervous System Response

  • Epinephrine is the key hormone driving sympathetic nervous system reactions.
  • Use a four-person log roll for safe patient transfer from the ground to a backboard.

Intracranial Pressure Management

  • A slow pulse in a patient raises suspicion of significant head injury.
  • Elevating the head at a 30-degree angle can help reduce intracranial pressure.

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Test your knowledge on the key concepts from Chapter 29 of Emergency Care. These flashcards cover assessments and immobilization devices used in emergency situations. Perfect for students preparing for exams or reviewing critical information.

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