Emergency Medical Transport and Shock Management
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Questions and Answers

What is the criteria for determining which hospital to transport a patient to?

  • Child's height and velocity of the crash (correct)
  • Distance from the hospital
  • Availability of a specialist
  • Severity of the injury

    • What is a complication of crush injuries?

  • Electrolyte imbalance
  • Hypervolemia
  • Respiratory failure
  • Rhabdomyolysis (correct)

    • What is a sign of compensated shock?

  • Weak, rapid pulse (correct)
  • Labored breathing
  • Altered mental status
  • Hypotension

    • What is supine hypotensive syndrome?

    <p>A condition where the pregnant uterus compresses the inferior vena cava</p> Signup and view all the answers

    What is the management of supine hypotensive syndrome?

    <p>Tilt the backboard 15 degrees and place the patient in a left lateral recumbent position</p> Signup and view all the answers

    What is the cause of cardiogenic shock?

    <p>Heart is unable to circulate sufficient blood to maintain adequate peripheral oxygen delivery</p> Signup and view all the answers

    What is the treatment for anaphylactic shock?

    <p>Administer epinephrine</p> Signup and view all the answers

    What is a sign of decompensated shock?

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

    What is a complication of spinal cord injuries?

    <p>All of the above</p> Signup and view all the answers

    What is the 6 P's?

    <p>Pain, paralysis, parenthesis, pallor, pulselessness, pressure</p> Signup and view all the answers

    What is the primary concern in treating an abdominal evisceration?

    <p>Covering the injured area with a moist, sterile dressing</p> Signup and view all the answers

    What is the indication for fluid resuscitation in hemorrhagic shock?

    <p>Systolic blood pressure less than 90 mmHg</p> Signup and view all the answers

    What is a sign of cardiac tamponade?

    <p>Muffled heart tones</p> Signup and view all the answers

    What is the treatment for a tension pneumothorax?

    <p>Needle decompression</p> Signup and view all the answers

    What is the primary goal of management in a traumatic brain injury?

    <p>Maintaining a patent airway</p> Signup and view all the answers

    What is the sign of a retinal detachment?

    <p>Seeing flashes of light</p> Signup and view all the answers

    What is the treatment for a lacerated spleen?

    <p>Surgical intervention</p> Signup and view all the answers

    What is the indication for a cricothyrotomy?

    <p>Upper airway obstruction</p> Signup and view all the answers

    What is the primary concern in treating a patient with a spinal cord injury?

    <p>Maintaining spinal immobilization</p> Signup and view all the answers

    What is the treatment for a severe head injury?

    <p>Elevating the head of the stretcher 15-30 degrees</p> Signup and view all the answers

    Study Notes

    Abdominal/GU Trauma

    • Anatomy and Physiology of the Abdomen
      • GLASSS-P ( RUQ, RLQ, LLQ, LUQ)
      • Diaphragm (thoracic cavity, 4th and 5th intercostal space, 12th rib)
      • Peritoneal cavity (upper and lower areas, contents)
      • Retroperitoneal cavity (area posterior to peritoneal lining, contents)
      • Pelvis (iliac vessels, organs, and structures)
      • Solid and hollow organs (liver, spleen, pancreas, kidneys, etc.)
    • Signs and Symptoms of a GI Bleed
      • Hematuria (dark brown or bright red)
      • Upper GI bleed (coffee ground emesis)
      • Lower GI bleed (bright red blood)
      • Distention, tenderness, and Cullen sign (ecchymosis around the umbilicus)
      • Grey-Turner sign (ecchymosis of the flank)
    • Signs and Symptoms of a Ruptured Diaphragm
      • Abdominal pain, acute respiratory distress
      • Decreased breath sounds, abdominal sounds in the chest
      • Subcutaneous emphysema, sunken abdomen, associated injuries
      • Right-sided diaphragmatic tear (liver injury)
      • Left-sided diaphragmatic tear (spleen injury)

    Bleeding

    • Anatomy and Physiology of Hemorrhagic Shock
      • Internal and external bleeding
      • Blunt or penetrating injuries to vessels or organs
      • Long bone or pelvic fractures
      • Multisystem injury
    • Indication for Fluid Resuscitation
      • Internal hemorrhage ( fluid bolus of 250 ml of normal saline or lactated ringers)
      • Hemorrhagic shock (fluid bolus of 250 ml, titrate to systolic BP of 80-90 mmHg)
    • Signs and Symptoms of Hemorrhagic Shock
      • Initial stage (low circulating blood volume with minimal signs of hypoperfusion)
      • Compensated shock (agitation, anxiety, restlessness, etc.)
      • Decompensated shock (altered mental status, hypotension, etc.)

    Chest Trauma

    • Identification of Beck's Triad
      • Cardiac tamponade (excessive fluid in the pericardial sac)
      • Beck's Triad (muffled heart tones, hypotension, JVD)
    • Signs and Symptoms of a Cardiac Contusion
      • Local tissue contusion and hemorrhage
      • Edema, sharp retrosternal chest pain
      • EKG changes (sinus tachycardia, A-Fib, etc.)
    • Signs and Symptoms of a Pneumothorax
      • Small pneumothorax (mild dyspnea, pleuritic chest pain)
      • Large pneumothorax (increasing dyspnea, respiratory compromise, hypoxia)
      • Open pneumothorax (defect in the chest wall, sucking chest wound)

    Cranial Trauma

    • Pathophysiology of a Traumatic Brain Injury
      • Primary brain injury (injury to the brain and its associated structures)
      • Secondary brain injury (consequence of primary injury, abnormal processes)
    • Signs and Symptoms of a Traumatic Brain Injury
      • Pupillary abnormalities (anisocoria, sluggish or nonreactive pupils)
      • Period of unconsciousness, confusion, or disorientation
      • Repeatedly asking the same questions (perseveration)
      • Amnesia, combativeness, or other abnormal behavior
      • Numbness or tingling in the extremities
      • Loss of sensation and/or motor function
      • Focal neurologic deficits
      • Seizures
      • Cushing triad (hypertension, bradycardia, irregular or erratic respirations)

    Facial, Neck, and Spinal Trauma

    • Anatomy and Physiology of the Head
      • 28 bones make up the cranium and face
      • Base of the skull (ethmoid, sphenoid, occipital, frontal, temporal)
      • Brain (cerebrum, cerebellum, brainstem, meninges)
    • Signs and Symptoms of Spinal Cord Injuries
      • Paresthesia, paralysis, temp-sensation numbness
      • Spinal shock (flaccid paralysis, flaccid sphincters, absent reflexes)
      • Neurogenic shock (hypotensive, bradycardiac, skin warm, flushed, and dry)
      • Neurons deficits (paralysis of small bowel, paralytic ileus)

    Multisystem Trauma

    • Calculating Mechanism of Injury
      • Use trauma triage guidelines
      • Falls, ejection from a vehicle, etc.
    • Complications of a Crush Injury
      • Rhabdomyolysis (muscle tissue becomes ischemic and dies)
      • Electrolyte imbalances and acidosis
      • Renal dysfunction leading to electrolyte abnormalities
      • Renal failure
    • Complications of Hypovolemia
      • Electrolyte imbalances
      • Compensated shock (agitation, anxiety, restlessness, etc.)
      • Decompensated shock (altered mental status, hypotension, etc.)

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    Description

    Test your knowledge of emergency medical transport criteria, shock management, and associated complications. Covers crush injuries, compensated shock, supine hypotensive syndrome, and cardiogenic shock.

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