Emergency Medical Care Chapter 28
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Questions and Answers

What is the most appropriate airway management for a female patient with a suspected spinal injury who has a marked reduction in tidal volume?

Assisting ventilations at an age-appropriate rate.

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, what should you instruct your partner to do?

Instruct him to assist her ventilations while you perform a rapid assessment.

What should you do for a 45-year-old male who fell approximately 12′ and is conscious with stable vital signs?

Immobilize his spine and perform a focused secondary exam.

What term describes a temporary loss or alteration of part or all of the brain's abilities to function without physical damage?

<p>Cerebral concussion.</p> Signup and view all the answers

What is an indicator of an expanding intracranial hematoma?

<p>A rapid deterioration of neurologic signs.</p> Signup and view all the answers

In which situation would it be most appropriate to perform a focused secondary assessment?

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

What is the most common and serious complication of a significant head injury?

<p>Cerebral edema.</p> Signup and view all the answers

What is the most important treatment for patients with a head injury?

<p>Establish an adequate airway.</p> Signup and view all the answers

What condition is indicated if a patient cannot remember the events that preceded his or her head injury?

<p>Retrograde amnesia.</p> Signup and view all the answers

Which of the following statements regarding a basilar skull fracture is correct?

<p>The absence of raccoon eyes or Battle's sign does not rule it out.</p> Signup and view all the answers

What is bleeding within the brain tissue itself called?

<p>Intracerebral hematoma.</p> Signup and view all the answers

When immobilizing a trauma patient's spine, when should the EMT stabilizing the head let go?

<p>The patient has been completely secured to the backboard.</p> Signup and view all the answers

Which of the following statements regarding motor nerves is correct?

<p>They carry information from the CNS to the muscles.</p> Signup and view all the answers

Which of the following head injuries would cause the patient's condition to deteriorate most rapidly?

<p>Epidural hematoma</p> Signup and view all the answers

When should a tight-fitting motorcycle helmet be left in place?

<p>Unless it interferes with your assessment of the airway.</p> Signup and view all the answers

When immobilizing a child on a long backboard, what should you do?

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

What is an epidural hematoma?

<p>Bleeding between the skull and dura mater.</p> Signup and view all the answers

What two components make up the central nervous system (CNS)?

<p>Brain and spinal cord.</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</p> Signup and view all the answers

When immobilizing a patient on a long backboard, what should you do first?

<p>Ensure that you secure the torso before securing the head.</p> Signup and view all the answers

Which of the following statements regarding motor nerves is correct?

<p>They carry information from the CNS to the muscles.</p> Signup and view all the answers

What is the difference between a cerebral concussion and a cerebral contusion?

<p>A cerebral contusion involves physical injury to the brain tissue.</p> Signup and view all the answers

The body's functions that occur without conscious effort are regulated by the __________ nervous system.

<p>Autonomic</p> Signup and view all the answers

What hormone is responsible for the actions of the sympathetic nervous system?

<p>Epinephrine.</p> Signup and view all the answers

What are the five sections of the spinal column, in descending order?

<p>Cervical, thoracic, lumbar, sacral, and coccygeal.</p> Signup and view all the answers

What is the most reliable sign of a head injury?

<p>A decreased level of consciousness.</p> Signup and view all the answers

When immobilizing a seated patient, when should you apply a cervical collar?

<p>After assessing distal neurovascular functions.</p> Signup and view all the answers

When the parasympathetic nervous system is activated, what happens to heart rate and blood vessels?

<p>The heart rate decreases and the blood vessels dilate.</p> Signup and view all the answers

Coordination of balance and body movement is controlled by which part of the brain?

<p>Cerebellum.</p> Signup and view all the answers

What can lacerations to the scalp indicate?

<p>They may be an indicator of deeper, more serious injuries.</p> Signup and view all the answers

Which of the following nerves carry information from the body to the brain via the spinal cord?

<p>Sensory nerves</p> Signup and view all the answers

Which of the following sets of vital signs depicts Cushing's triad?

<p>Blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min</p> Signup and view all the answers

What should you do for an unconscious male who has rapid, irregular respirations and bloody secretions from his mouth and nose?

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

What injuries does rapid deceleration of the head cause?

<p>Compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.</p> Signup and view all the answers

What numeric value should you assign to a patient with abnormal flexion of his extremities for motor response?

<p>C.</p> Signup and view all the answers

What is most important to monitor in a patient with a possible head injury?

<p>Level of consciousness.</p> Signup and view all the answers

What GCS score should you assign to a 20-year-old female who opens her eyes spontaneously, is confused, and obeys commands?

<ol start="14"> <li></li> </ol> Signup and view all the answers

What should you do if you do not have the appropriate size cervical collar?

<p>Use rolled towels to immobilize the patient's head.</p> Signup and view all the answers

What is the least likely skull fracture to present with palpable deformity or other outward signs?

<p>Linear.</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.</p> Signup and view all the answers

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

<p>Constricted pupils</p> Signup and view all the answers

The __________ contains about 75% of the brain's total volume.

<p>Cerebrum</p> Signup and view all the answers

What is an indicator of an expanding intracranial hematoma or rapidly progressing brain swelling?

<p>A rapid deterioration of neurologic signs.</p> Signup and view all the answers

What should you do when assessing a conscious patient with an MOI that suggests spinal injury?

<p>Determine if the strength in all extremities is equal.</p> Signup and view all the answers

What characterizes moderate elevation in intracranial pressure with middle brain stem involvement?

<p>Sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.</p> Signup and view all the answers

You should be most suspicious of a significant head injury if a patient's pulse is:

<p>Slow.</p> Signup and view all the answers

What is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems?

<p>Brain stem.</p> Signup and view all the answers

What function do the meninges and cerebrospinal fluid provide?

<p>Acting as a shock absorber for the brain and spinal cord.</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 nerves</p> Signup and view all the answers

How should you control bleeding from a scalp laceration with a suspected underlying skull fracture?

<p>Avoid excessive pressure when applying the bandage.</p> Signup and view all the answers

When opening the airway of a patient with a suspected spinal injury, which maneuver should you use?

<p>Jaw-thrust maneuver.</p> Signup and view all the answers

What should you do after your partner assumes manual in-line stabilization of the patient's head?

<p>Assess distal neurovascular status in the extremities.</p> Signup and view all the answers

What are the frontal and parietal bones of the skull especially susceptible to?

<p>Compressed skull fractures.</p> Signup and view all the answers

What may lacerations to the scalp indicate?

<p>They may be an indicator of deeper, more serious injuries.</p> Signup and view all the answers

Which of the following statements regarding secondary brain injury is correct?

<p>Hypoxia and hypotension are the two most common causes of secondary brain injury.</p> Signup and view all the answers

Distraction injuries of the spine are most commonly the result of:

<p>Hangings.</p> Signup and view all the answers

Study Notes

Airway Management

  • For a female patient with suspected spinal injury and reduced tidal volume, assist ventilations at an age-appropriate rate.
  • In a semiconscious patient with closed head trauma, maintain manual in-line stabilization while assisting ventilations during rapid assessment.

Trauma Assessment and Management

  • For a 45-year-old male who fell from a height, immobilize the spine and perform a focused secondary exam; he's stable with lower back pain.
  • A focused secondary assessment is indicated for patients who fainted from a standing position.

Head Injuries

  • A cerebral concussion refers to a temporary loss of brain function without physical damage.
  • An expanding intracranial hematoma is indicated by rapid deterioration of neurologic signs.
  • Cerebral edema is the most common and serious complication following a significant head injury.

Treatment Protocols

  • Establish an adequate airway as the most critical treatment for all head injury patients.
  • Retrograde amnesia is the inability to remember events preceding a head injury.

Skull Fractures

  • The absence of raccoon eyes or Battle’s sign does not rule out a basilar skull fracture.
  • Bleeding within brain tissue is termed an intracerebral hematoma.

Spinal Injury Management

  • When immobilizing a trauma patient's spine, ensure the head is stabilized until secured to the backboard.
  • Secure the torso first when immobilizing a patient on a long backboard.

Nervous System Overview

  • The central nervous system consists of the brain and spinal cord, while the peripheral nervous system comprises 31 pairs of spinal nerves and 12 cranial nerves.
  • The autonomic nervous system regulates involuntary bodily functions, influenced by the hormone epinephrine during sympathetic activation.

Signs of Significant Head Injury

  • Cushing’s triad is characterized by high blood pressure, bradycardia, and irregular respirations.
  • A decreased level of consciousness is regarded as the most reliable sign of a head injury.

Glasgow Coma Scale (GCS)

  • Assess a patient who opens eyes spontaneously, is confused, and follows commands with a GCS score of 14.
  • Assign a numeric value of c for abnormal flexion of extremities after a head injury.

Patient Positioning and Assessment

  • Use a jaw-thrust maneuver to open the airway in suspected spinal injury cases.
  • Assess distal neurovascular status once manual in-line stabilization is in place.

Scalp Injuries and Protocols

  • Monitor scalp lacerations as they may indicate deeper injuries; avoid excessive pressure when controlling scalp bleeding with a suspected skull fracture.
  • The brain stem controls vital functions and is highly protected within the central nervous system.

Other Key Points

  • Rapid deceleration incidents may cause anterior brain compression injuries and posterior brain stretching.
  • Sluggishly reactive pupils and widened pulse pressure can indicate moderate intracranial pressure with brainstem involvement.
  • Distraction injuries are most commonly associated with hangings, highlighting the importance of careful assessment in such situations.

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Description

This quiz focuses on airway management techniques as discussed in Chapter 28 of Emergency Medical Care. It covers critical scenarios involving respiratory distress and assessment of patients with spinal injuries and head trauma. Test your knowledge on appropriate interventions and emergency response.

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