EMT Chapter 30 Flashcards

Questions and Answers

Accumulation of blood in the abdominal cavity will MOST likely cause:

Diffuse bruising

Nausea or vomiting

Referred pain

Distention (correct)

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?

Pelvic fracture

Femur fracture

Shoulder fracture (correct)

Lumbar spine fracture

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

Stomach

Liver (correct)

Kidney

Spleen

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

Guarding Signup and view all the answers

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

Intra-abdominal bleeding Signup and view all the answers

Early bruising following abdominal trauma often manifests as:

Red areas of skin Signup and view all the answers

Peritonitis usually occurs when:

Hollow abdominal organs are damaged and spill their contents into the peritoneal cavity Signup and view all the answers

The mesentery is:

A membranous fold that attaches the intestines to the walls of the body Signup and view all the answers

The presence of tachycardia following a significant abdominal injury:

Should be assumed to be a sign of shock Signup and view all the answers

When worn properly, a seatbelt should lie:

Below the anterior superior iliac spines of the pelvis and against the hip joints Signup and view all the answers

The MOST appropriate treatment for a patient with an avulsion to his penis is:

Applying direct pressure with a dry, sterile dressing Signup and view all the answers

Abdominal pain, vomiting, and fever are most likely due to _____

infection Signup and view all the answers

All of the following are hollow abdominal organs, EXCEPT the:

Spleen Signup and view all the answers

Because the depth of an open abdominal wound is often difficult to determine:

Prompt transport to the hospital is essential Signup and view all the answers

Compression injury is most likely due to which of the following?

Improperly placed lap belt Signup and view all the answers

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

Diaphragm Signup and view all the answers

In pediatric patients, the liver and spleen are _____

Larger in proportion to the abdomen Signup and view all the answers

Injuries to the external male genitalia _____

Are rarely life-threatening Signup and view all the answers

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

May decrease the amount of blood that returns to the heart Signup and view all the answers

When a hollow organ is punctured during a penetrating injury to the abdomen:

Peritonitis may not develop for several hours Signup and view all the answers

When a patient stiffens the muscles of the abdomen, it is known as _____

guarding Signup and view all the answers

When should you visually inspect the external genitalia on your patient?

Only when there is a complaint of severe pain or other injury Signup and view all the answers

Which of the following is true regarding injury to the kidneys?

Injury to the kidneys usually indicates injury to other organs Signup and view all the answers

Which of the following organs would MOST likely bleed profusely when injured?

Liver Signup and view all the answers

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist Signup and view all the answers

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a non-rebreathing mask. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

Insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM Signup and view all the answers

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. After treating the patient appropriately, you should:

Closely monitor him and reassess him frequently Signup and view all the answers

You should suspect a kidney injury anytime the patient presents with _____

A hematoma in the flank region Signup and view all the answers

Your documentation on a sexual assault victim should _____

Be objective and factual Signup and view all the answers

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. You note an impressive amount of blood on her clothes. You should:

Control any external bleeding, administer oxygen, and transport at once Signup and view all the answers

Study Notes

Abdominal and Genitourinary Injuries

Abdominal Distention: Accumulation of blood in the abdominal cavity often leads to distention, a key indicator of internal injuries.
Injury Overlook: A shoulder fracture can cause injuries to the liver or spleen to be missed due to the lack of clear external signs.
Liver Injury Indicators: Bruising in the right upper quadrant suggests possible liver injury, a critical consideration during assessment.
Guarding Response: Guarding refers to the abdominal muscles tensing due to pain, indicating potential injury.
Umbilical Bruising: Bruising around the umbilicus can signal intra-abdominal bleeding, warranting immediate evaluation.
Bruising Manifestation: Early bruising post-abdominal trauma may show as red areas of skin rather than darker colors.
Peritonitis Cause: This condition often arises when hollow abdominal organs rupture, spilling contents into the abdominal cavity.

Anatomical and Physiological Concepts

Mesentery Definition: The mesentery is a membranous fold that anchors intestines to body walls, crucial for structural stability.
Sign of Shock: Tachycardia following significant abdominal trauma should be viewed as a potential indicator of shock.
Proper Seatbelt Placement: A correctly worn seatbelt lies below the anterior superior iliac spines and against the hip joints to minimize injury risk.
Penile Avulsion Treatment: Direct pressure with a dry, sterile dressing is vital for managing bleeding after penile avulsion.

Symptoms and Management

Fever and Abdominal Pain: These symptoms, along with vomiting, typically point toward infection, a serious concern.
Hollow vs Solid Organs: The spleen is a solid organ, crucial to note when assessing for abdominal injuries, as other organs may bleed if hollow organs are impacted.
Emergency Transport: Due to the uncertainty of abdominal wound depth, prompt transport to a hospital is crucial for appropriate care.
Compression Injury Cause: These injuries are often linked to improperly placed seatbelts, stressing the importance of safe driving practices.
Respiratory Complication: Difficulty breathing paired with a sunken abdominal wall may indicate a ruptured diaphragm, requiring urgent attention.

Pediatric and Genitourinary Considerations

Pediatric Organ Size: In children, the liver and spleen are proportionally larger compared to the abdomen, increasing risk of injury.
External Genitalia Injury: Injuries to external male genitalia are typically not life-threatening, but care must still be taken to assess and treat them properly.
Supine Position Concerns: In late pregnancy, a supine position may lead to hypotension by compressing large vessels, potentially jeopardizing maternal-fetal circulation.
Delayed Peritonitis: After hollow organ puncture, signs of peritonitis may not manifest for several hours, complicating timely diagnosis.

Patient Assessment and Documentation

Repeated Guarding: When a patient stiffens abdominal muscles, this is known as guarding, a protective reflex indicating pain.
Visual Inspection Protocol: External genitalia should only be visually inspected if there are complaints of severe pain or related injuries.
Kidney Injury Association: Kidney injuries frequently indicate potential damage to other abdominal organs due to their vulnerable positioning.
Organ Bleeding Risk: The liver is among the organs that can bleed profusely when injured, making it crucial to assess during emergency situations.
Evisceration Care: In cases of abdominal evisceration, warming and moistening protruding organs can prevent further complications.

Handling Critical Situations

Subsequent Monitoring: Patients with blunt abdominal trauma in shock should be closely monitored and reassessed frequently during transport.
Kidney Injury Suspicions: A hematoma in the flank region is a strong indicator of possible kidney injury and warrants careful evaluation.
Objective Documentation: Documenting information about sexual assault victims should be objective and fact-based, avoiding subjective language or personal opinions.
Sexual Assault Response: In cases of sexual assault with bleeding, immediate actions should focus on controlling bleeding, oxygen administration, and transport.

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Test your knowledge on abdominal and genitourinary injuries with these flashcards from EMT Chapter 30. This quiz covers key concepts and terms essential for understanding trauma assessment and management in emergency medical situations. Challenge yourself and reinforce your learning today!