Signs of Shock Quiz

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Questions and Answers

Which of the is the first sign of shock that usually appears in patients

Altered mental status (correct)

Nausea and vomiting

Pale, cool and clammy skin

Changes in vital signs

A tachypneic 17 year old male has an open gunshot wound to the right anterior chest. What should you do?

Begin Bag valve mask ventilation

Administer high-flow oxygen

Apply an occlusive dressing (correct)

Decompress the right chest

A 34 year old male was hit in the chest with a baseball bat. Portions of his chest move in opposite directions when he breathes. What should you suspect?

Pulmonary contusion

Pneumothorax

Flail Chest (correct)

Rib Fracture

What is a contraindication of a traction splint?

Pelvic fracture Signup and view all the answers

An alert 75 year old male after slipped on his wet sidewalk. He is sober and denies hitting his head. He states his legs just went out from under him and he fell to his right knee. His right leg is internally rotated and shortened. Vital signs are BP 110/40, P 96, R 18. What should you suspect?

Hip Dislocation Signup and view all the answers

If transport is delayed or prolonged, and if circulation is impaired, an attempt should be made to reposition a grossly deformed fracture or dislocated joint (if allowed by medical control or protocol). The exception is an injury to the _____

Hip Signup and view all the answers

A factory worker has a 3/4 inch laceration on his forehead that bleeds through the dressings despite direct pressure. What should you do?

Continue direct pressure and apply additional dressings Signup and view all the answers

A 20 year old female has burns on her chest, abdomen, and on the anterior side of her right arm. What percentage of body is burned?

22.5 % Signup and view all the answers

What is the correct technique when splinting a suspected finger fracture?

Apply a straight, flat and rigid splint to the finger Signup and view all the answers

A 50 year old female presents with narrow complex tachycardia and has the following signs and symptoms: respiratory rate of 22 and non labored, BP of 117/68, radial pulse rate of 176 strong and regular, and skin is pink, warm, and dry. What would be the most appropriate first treatment.

Vagel Manuevers Signup and view all the answers

Match the following medications with their primary usage:

Morphine = Analgesic for pain relief Ondansetron = Antiemetic for nausea and vomiting Atropine = Anticholinergic for bradycardia Ipratropium bromide = Bronchodilator for improving breathing Signup and view all the answers

Match the following properties with the corresponding medication class:

Pain relief = Analgesics Nausea and vomiting control = Antiemetics Improved breathing by airway dilation = Bronchodilators Increased blood pressure through vascular resistance = Vasopressors Signup and view all the answers

Match the following characteristics with the appropriate medication effects:

Reduction in heart rate in bradycardia = Atropine (Anticholinergic) Relaxation of smooth muscle tissue in airways = Ipratropium bromide (Bronchodilator) Prevention of nausea and vomiting = Ondansetron (Antiemetic) Elevation of blood pressure in shock states = Phenylephrine (Vasopressor) Signup and view all the answers

Match the following medications with their primary usage in emergency situations:

Morphine sulfate = Relieve moderate to severe pain Promethazine (Phenergan) = Prevent nausea and vomiting Atropine = Counteract cholinergic overdose Epinephrine = Increase blood pressure and heart rate Signup and view all the answers

Match the following medications with their effects on patients:

Morphine sulfate = Provides sedating effects along with pain relief Dexamethasone = Alleviates symptoms of acute nausea quickly Atropine = Increases heart rate and corrects certain cardiac issues Norepinephrine = Raises blood pressure in hypotensive states Signup and view all the answers

Match the following medications with their characteristics:

Anticholinergics = Include atropine and glycopyrrolate Vasopressors = Used to address hypotension and shock Bronchodilators = Help treat respiratory distress and wheezing Antiemetics = Prevent vomiting during patient transport Signup and view all the answers

Match the following medications with their specific applications:

Fentanyl citrate = Smaller doses needed due to high potency Promethazine (Phenergan) = Treatment for motion sickness and chemotherapy-related emesis Albuterol = Effective in bronchospasm and asthma exacerbation Norepinephrine = Used in septic shock to improve blood pressure Signup and view all the answers

Which of the following is NOT a characteristic sign of inflammation?

Fever Signup and view all the answers

Which process is responsible for dissolving excess clots by breaking down cross-linked fibrin strands?

Fibrinolysis Signup and view all the answers

What are the chemical signals released by cells lining blood vessels that increase capillary permeability?

Vasoactive amines Signup and view all the answers

What role does the immune system play in the inflammatory response?

Promoting healing and defending the body Signup and view all the answers

What is the function of memory within the immune system in the context of inflammation?

Recognizing previous threats for a faster response Signup and view all the answers

Study Notes

Essential Medications for Paramedics

Analgesic medications relieve pain without causing unconsciousness, with examples including morphine sulfate (powerful relief from moderate to severe pain with sedating effects) and fentanyl citrate (faster-acting alternative with higher potency).
Antiemetic medications prevent nausea and vomiting, with examples including promethazine (Phenergan, used for motion sickness, postoperative nausea, or chemotherapy-related emesis, but with side effects like drowsiness) and dexamethasone (quick relief from acute nausea).
Anticholinergic medications are used by paramedics, with examples including atropine (treats bradycardia caused by overdoses or other underlying issues) and glycopyrrolate (safer alternative for cases where heart rhythm isn't affected).
Bronchodilator medications relax smooth muscle tissue lining airways, allowing them to dilate and improve breathing, with examples including salbutamol (quick treatment of asthma exacerbations) and ipratropium bromide (provides prolonged action for patients who continue to experience wheezing).
Vasopressor medications raise blood pressure levels by increasing peripheral vascular resistance, with examples including ephedrine (less frequently used due to risks associated with excessive catecholamine release), phenylephrine, and norepinephrine (primary options for treating shock states).

The Extrinsic Pathway

The extrinsic pathway initiates hemostasis outside blood vessels due to tissue disruption, involving the interaction between tissue factors (TF) and circulating VII (tissue factor pathway inhibitor-dependent) or IX and X (tissue factor pathway inhibitor-independent).
Tissue factor binds with its specific receptor, factor VII, forming a TF-VIIa complex, which activates factors X and IX, leading to prothrombin conversion to thrombin.

Understanding Clotting Cascades

The human body relies on two interconnected mechanisms, the intrinsic and extrinsic pathways of blood coagulation, to prevent excessive bleeding while maintaining proper circulation.
The intrinsic pathway is initiated through contact with negatively charged surfaces, primarily contributing to coagulation after vascular injury.
The extrinsic pathway starts with the exposure of blood to tissue factor released by injured cells.

The Intrinsic Pathway

The intrinsic pathway involves the interaction between factor XII, prekallikrein, high molecular weight kininogen, and endothelial cell surface receptors known as thrombomodulin.
Factor XII gets activated, converting prekallikrein into kallikrein, which activates factor XI, leading to the activation of factor IX and subsequent protein conversions.

The Common Pathway

The common pathway is the final phase where the intrinsic and extrinsic pathways merge, involving the formation of the prothrombinase complex, which catalyzes the transformation of prothrombin to thrombin.
Thrombin catalyzes the production of fibrin strands, ultimately forming a stable clot.

Coagulation Factors

There are twelve coagulation factors participating in the clotting cascade, each playing specific roles in generating or inhibiting clots.
Factors serve as precursors of enzymes required for clot initiation or help control thrombin activity or prevent abnormal clot growth.

Fibrinolysis

Fibrinolysis is the process of dissolving excess clots via the action of plasmin, which breaks down cross-linked fibrin strands back to their original constituents.
Plasminogens convert to active plasmins through a series of activators such as tPA (tissue plasminogen activator) and urokinase-type plasminogen activator (uPA).

Understanding Inflammation

Inflammation is a complex biological process serving as one of the body's primary defense mechanisms against disease, infection, injury, and cellular dysfunction.
The inflammatory response involves multiple signaling cascades within cells, classified into innate immunity pathways and adaptive immunity pathways.

Inflammation Pathways

Innate immunity pathways represent a frontline defense mechanism activated by macrophages, neutrophils, dendritic cells, and natural killer cells upon encountering foreign invaders.
Adaptive immunity pathways lead to highly specific responses tailored to target particular antigens once introduced to the body.

Acute Inflammation

Acute inflammation is a rapid localized reaction lasting hours to days following tissue injury or infection, characterized by redness, warmth, swelling, and pain.
Cells lining blood vessels release chemical signals called vasoactive amines, increasing capillary permeability and attracting leukocytes, leading to fluid accumulation around injured areas.

Cytokines

Cytokines are critical messengers within the inflammatory response, regulating and coordinating various aspects of immune function.
They exist in both pro-inflammatory and anti-inflammatory forms, allowing for dynamic control over the extent and duration of inflammation.
Key examples of cytokines associated with acute inflammation include tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, and IL-8.

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Description

Test your knowledge on identifying the first sign of shock that typically appears in patients. Learn about the initial symptoms that indicate the onset of shock.