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Trauma and Emergency Medical Care, Exams of Medicine

A wide range of topics related to trauma and emergency medical care, including geriatric injuries, gunshot wounds, blast injuries, skin layers and wound healing, cardiac conditions, hypothermia, hyperthermia, drowning, spider bites, oxygen therapy, pneumothorax, head injuries, and various types of injuries from car accidents. It provides detailed information on the symptoms, causes, and management of these medical emergencies, making it a valuable resource for healthcare professionals and students studying emergency medicine, trauma care, or related fields. The document delves into the pathophysiology, assessment, and treatment of these conditions, equipping readers with the knowledge to provide effective and evidence-based care in critical situations.

Typology: Exams

2024/2025

Available from 10/14/2024

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WEST COAST EMT BLOCK 4 EXAM STUDY

KIT WITH ACTUAL EXAM QUESTIONS AND

CORRCET ANSWERS RATED A+

What is the difference between penetrating and blunt trauma? Correct Answer Penetrating breaks through the skin while blunt trauma is a force to the body w/o breaking skin. What are two things to make sure of when dealing with penetrating trauma? Should you cut it? Correct Answer 1. Remove object if it obstructs the airway or compressions

  1. Make sure to stabilize the object
  • If unbolting is an option choose that What organs are in the upper right quadrant? What do they do? Correct Answer Liver: filters all the blood and toxins in the body, produces bile Gallbladder: stores bile What organs are in the left upper quadrant? What do they do? Correct Answer Stomach: Breaks down food with acids Spleen: filters red blood cells, produces antibodies, and is a blood reservoir What organs are in the right lower quadrant? What do they do? Correct Answer Appendix: Stores healthy bacteria Portion of large intestine (cecum) In a vehicle collision, what are the three main collisions? Correct Answer - Vehicle against another object
  • Victim against vehicle
  • Victims' organs against the victim

What is a flail chest? What can is lead to? Correct Answer - 2 or more consecutive rib fracture segments.

  • It can puncture a lung and lead to a pneumothorax. What are 3 conditions of becks triad? Correct Answer 1. muffled heart sounds
  1. Jugular vein disorder (JVD)
  2. Narrowing pulse pressure What are some evidences of secondary collision? Correct Answer
  • Spidering on windshield
  • Bent steering wheel
  • Dent in dashboard What are 6 types of vehicle crashes? Correct Answer - Frontal
  • Rear-end
  • Lateral
  • Rollover
  • Rotational
  • Auto vs. Ped, Bike When can a rollover be non fatal? Correct Answer when the patient is restrained with their seatbelt What is the proper position for a seatbelt? Correct Answer Below the anterior superior iliac sines of the pelvis and against the hip joint What is cullen sign? What is grey turner? Correct Answer Cullen: bruising around the umbilicus Grey turner: bruising in the flank What is the trauma criteria for Auto vs. Ped Correct Answer Over 20 mph or over/run-over by the car

What is considered a traumatic fall? Correct Answer over 20 feet or roughly 3x the height of the patient What are the 4 phases of the blast? Correct Answer 1. Primary: damage from wave, concerned about hollow organs (ear drum, lungs)

  1. Secondary: projectiles, concerned about solid organs
  2. Tertiary: body is thrown
  3. Quaternary: toxic chemicals What are the perfusion time frames for lungs, kidneys, and skeletal? What can last longer than skeletal? Correct Answer Lungs = 15-20 min Kidney = 45 min Skeletal = 2-3 hours ----- Gastrointestinal can last longer What is crush syndrome? What is the time frame? Correct Answer - When an area of the body is trapped and arterial blood flow is compromised
  • 4 hours What is an infants total blood volume? Correct Answer 800 ml What are some characteristics of venous bleeding? Arterial? Capillary? Correct Answer Venous: less pressure, dark, can be life threatening Arterial: bright red, always life threatening Capillary: small oozing, generally not life threatening What are 3 steps to clotting? Correct Answer 1. Vasoconstriction
  1. Platelets get sticky
  2. Solidifies into more stable version The body will not tolerate an acute blood loss of greater than _____ of blood volume Correct Answer 20%

What are some signs of internal bleeding? Correct Answer Distention, rigidity, tachycardia, pale, cool, melena, blood in urine, coughing up blood, bruising around umbilicus and flank What is the difference between a hematoma and a contusion? Correct Answer Hematoma: Big blood cells being ruptures (big bump) Contusion: Small blood vessels being ruptured What is the most effective way to control external bleeding? Correct Answer Direct pressure With pressure dressing what should you still be able to do? Correct Answer Palpate a distal pulse What is epistaxis? When are we concerned? What is the treatment? Correct Answer - Nose bleed

  • Concerned when there is white coloration meaning there is CSF in the blood. This means there is injury to the skull.
  • Lean forward and pinch the nose What happens during the healing process? Correct Answer During the normal wound-healing process, bleeding may occur from even a minor injury because new capillaries that stem from the intact capillaries are delicate and take time to become as stable as the preexisting capillaries. What is compartment syndrome? Where is it most common? When do symptoms arise? How is the pain? How do you transport and what treatment could cause this? Correct Answer - Edema and swelling result in increased pressure w/in a closed soft-tissue compartment. This closes off vascular flow to tissues distal to the injury.
  • Most common in low leg and forearm
  • symptoms arise 6-12 hours
  • pain out of proportion to the injury
  • It can be caused by air splints and you transport w/ extremity at heart level What are abrasions? Correct Answer Wound to superficial layer of skin (epidermis). What is a laceration? Correct Answer a jagged cut that separates various layers of tissue What is an avulsion? Correct Answer A wound that separates various layers of tissue that become completely detached or hang as a flap What is an amputation? Correct Answer Complete removal of an extremity What do you never do with an avulsion? Correct Answer Remove skin flap How do you handle an evisceration? Correct Answer Sterile moist dressing then put a 4-sided occlusive dressing over it What are 4 factors that contribute to burn severity? Correct Answer - Temp
  • Concentration
  • Amount of heat
  • Duration of exposure What are 4 things burn victims are at high risk for? Correct Answer - Hypothermia
  • Shock
  • Infection
  • Hypovolemia

In adults, what is the BSA for 2nd and 3rd degree burns? PEDs? Correct Answer Adults 2nd: >20% 3rd: >5% PEDs 2nd: >10% 3rd: Any % What are circumferential burns? why are they bad? Correct Answer - They burn all around the extremity

  • They can cause neurovascular compromise or disrupt blood flow What is a first degree burn? Correct Answer - Superficial burn involving epidermis
  • Caused by sunburns
  • Turns red and is painful What is a second degree burn? Correct Answer - Partial thickness burn involving all of the epidermis and part of the dermis
  • Causes redness and blistering What is a third degree burn? Correct Answer - Full thickness involving the subcutaneous tissue and beyond.
  • presents as white, brown, or charred
  • "painless" because it burns through the nerves What is the rule of 9 for adults? Infants? Correct Answer Adults: Head (9%), Arms (9%), Legs (18%), Anterior torso (18%), Posterior torso (18%), Genitalia (1%) Infants: Head (18%), Arms (9%), Legs (13.5%), Anterior torso (18%), Posterior torso (18%). If burned more than 10% use ______. If less than 10% use_______. Correct Answer dry, sterile (risk of hypothermia)

cold, sterile What's significant about electrical burns? Correct Answer They can cause a dysrhythmia. If we get to them quick enough with the AED we can get them back. What is paradoxical breathing? Correct Answer one side of the chest moving due to fracture How do you treat an open pneumothorax? Correct Answer 3 sided occlusive dressing What is a pneumothorax? Correct Answer air in the pleural space What is a closed pneumothorax? What is the breathing like? Correct Answer - hole in lung and visceral pleura

  • breathing is unilateral What is a tension pneumothorax? What are some signs and symptoms? Correct Answer - air can enter the pleural space but cannot exit s/s: JVD, tracheal deviation, low B.P (from obstructive shock). What is cardiac tamponade? What are some sign and symptoms? Correct Answer - blood in pericardium (protective membrane around heart)
  • s/s: becks triad (muffled heart sounds, narrowing B.P., and JVD) What is a hemopnuemothorax? Correct Answer collection of blood and air in the pleural space What is a pulmonary contusion? Correct Answer A bruise of the lung.

What is traumatic asphyxia? How would you treat? Correct Answer - sudden, severe compression of the chest which increases pressure w/in chest.

  • Aggressively manage the airway, provide ventilations, support with O2 and transport. What is commodis cordis? Correct Answer injury caused by a sudden, direct blow to the chest during critical portion of heartbeat What is the only complete circular cartilage of the trachea? Correct Answer Cricoid cartilage Why should you be worried if you punched someone in the mouth? Correct Answer You are at risk for an infection due to the bacteria in the mouth. What are 3 different eye injuries? and their treatments? Correct Answer - Contaminated: fine particles > irrigate 20 min
  • Embedded: small pieces of wood/metal > cover w/ sterile dressing on both eyes
  • Impalement: nail > stabilize, then cover both eyes What is a blow-out fracture? Correct Answer - fracture of the bottom of orbit trapping muscles from moving.
  • Eyes won't move in unison What is retinal detachment? Correct Answer - retina detaches
  • blindnes, "floaters" What is an air embolism? Correct Answer a vein has sucked air in from the outside What are we more worried about with a skull fracture? Correct Answer cerebral edema

What is a linear fracture? Correct Answer The least damaged, no deformity, need imaging to see What is a Basilar Fracture? What are some side effects? Correct Answer - Fracture to base of skull.

  • Racoon eyes and battle signs What is the secondary injury to the brain? Correct Answer coup- countrecoup What is an epidural hematoma? S/S? Correct Answer - Above dura matter and below skull
  • Arterials bleed fast
  • Fastest evolving symptoms into death
  • s/s: Initial LOC followed by brief lucid interval then rapid LOC What is a subdural hematoma? S/S? Correct Answer - Below the dura matter and above the arachnoid space
  • Venous bleed
  • Symptoms may take hours to days
  • s/s: dizziness, headache, cushings triad, transport at 30 degrees elevated What is intracerebral hemorrhage? Correct Answer - bleeding inside the brain
  • symptoms similar to hemorrhagic stroke What is a subarachnoid hemorrhage? s/s? Correct Answer - bleeding takes place under arachnoid space
  • blood mixed w/ CSF
  • s/s: neck stiffness, headache What is the difference between a contusion and a concussion? Correct Answer - Contusion: there is physical damage to the brain and there may be life-long neurological issues
  • Concussion: w/o physical damage to brain What do you do if c-collar doesn't fit? Correct Answer - Use pediatric collar
  • rolled up towel as backup What is a KED used for? contraindications? Correct Answer - used for seated patients
  • it takes too long to set up When do you remove a motorcycle helmet? Correct Answer - if destructing airway
  • if bending spine What is calcaneus fracture? Correct Answer - heel fracture
  • transfer energy up and possible fracture to lower spine What are early symptoms of intra-abdominal bleeding? Correct Answer - pain/pain in palpation
  • muscle spasms What are the fracture unique to kids? What are they? Correct Answer - Epiphyseal: break in growth plate
  • Greenstick: breaking like a greenstick
  • Colles: fork fracture, looks like a wrist fracture but is a fracture to distal radius What is reduced in terms of a dislocated joint? Correct Answer put the joint back into place What is the difference between a strain and a sprain? Correct Answer - a sprain is when the joint is twisted or stretched beyond normal range
  • strain is pulled muscle, damage to tendon not ligament

What are the 6 P's of the musculoskeletal assessment? Correct Answer (1) Pain, (2) Poikilothermia, (3) Paresthesia, (4) Paralysis, (5) Pulselessness, and (6) Pallor What are the steps when splinting? What do you do for joint and long bone? Correct Answer 1. Manual stabilization

  1. Put hand in functional position
  • if joint is broken > bone above/below
  • if bone is broken > joint above/below When do you use a traction splint? Correct Answer closed, mid- shaft femur fractures w/ no hip, knee, ankle damage What is the possible blood loss for a femur fracture? Correct Answer 500 - 1000 ml What is a swath? Correct Answer keeps arm attached to body after sling has been put on What could be a complication of knee ligament fracture? Correct Answer Neurovascular compromise newtons 1st law Correct Answer object in motion will stay in motion, object at rest stay at rest newtons 3rd law Correct Answer For every action there is an equal and opposite reaction what is blunt trama and 3 types of vehicle trama Correct Answer blunt trama is injury without breaking the skin
  1. vehicle against another vehicle 2.vehicle against another object
  2. victims organs against the victim

vehicle collision contact points Correct Answer steering wheel- chest and abdomen windshield- head or cerival spine dashboard- hip fracture or dislocation proper seatbelt position Correct Answer Below the anterior superior iliac sides of the pelvis and against the hip joints what does a seatbelt mark mean Correct Answer automatic trama falls (Calcaneus pain) Correct Answer if complaining of Calcaneus pain, assume energy was transfered through the legs to the lumbar spine how high is a significant fall Correct Answer 20 ft or 3x patient's height why are falls worse for geriatrics Correct Answer - Geriatrics are more prone to osteoporosis(weak bones)

  • Many geriatrics also take blood thinners
  • Ground level falls are more serious for geriatrics gunshot wounds Correct Answer exit wound is bigger, ricochets/bounces inside patient what to do when long projectile in patient that interferes with care Correct Answer assume you have tools, cut as short as you can without injuring the patient cavitation Correct Answer Result of rapid change in tissue and fluid pressure with movement of projectile/as the object enters the body, it creates a pressure wave which forces tissue out of the way, creating a cavity can be much larger than the object itself

temporary and permanent - temporary is displacement and permanent is after-the-fact displacement blast injuries what organs are the most susceptible Correct Answer middle ear, lungs, gastrointestinal track blast injuries zone Correct Answer primary blast injuries from blast itself secondary blast injury- injury from missiles from blast forces tertiary blas injury- injury due to impact with another object quaternary blast injury- collateral injury like burns,toxins etc trama order of acronyms Correct Answer same as bsi, except after primary assessment, vitals, then attempt SAMPLE for skills test what at beginning of secondary assessment Correct Answer DCAP BTLS Deformities contusion abrasion punctures burns tenderness lacerations swelling laceration vs incision Correct Answer incision is in a controlled environment layers of the skin Correct Answer epidermis: tough external layer dermis: inner layer of skin subcutaneous tissue

variation in skin thickness Correct Answer thinner skin on the young and old eyelids, lips, ears are thinner scalp, back, and soles of the feet are thicker body natural healing process Correct Answer During the normal wound-healing process, bleeding may occur from even a minor injury because new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. ^ in summary, normal reaction is increase in heart rate and cut ends of vessels will constrict contusion Correct Answer bruise Hematoma Correct Answer a solid swelling of clotted blood within the tissues. crush syndrome (how long and what happens) Correct Answer when area of body is trapped for longer than 4 hours and arterial blood flow is compromised when crushed beyond repair, muscles cells die and release harmful substances into surrounding tissues compartment syndrome Correct Answer crush syndrome of appendage abrasions Correct Answer wound of outer layer of skin (skinned outer layer) laceration Correct Answer cut that separated various layers of tissue incision is in controlled environment

avulsion Correct Answer cut where flap is hanging off eviseration Correct Answer where organs protrude out body/laceration medical care closed injuries (things to look out for, how to treat) Correct Answer beware of signs of shock, use icepack to help with vessel constriction cspine if spinal injury pneumonic for closed soft tissue injury Correct Answer RICERS Rest Ice Compression Elevation Splinting taking care of open wounds Correct Answer should be treated as contaminated don't remove material from open wound no matter how dirty when to remove an impaled object Correct Answer if in cheek or mouth and obstructs airway the object is in the chest and interferes with CPR burns higher than what temp Correct Answer 111 Depth of burn pnemonic Correct Answer SPF superficial partial thickness full thickness first degree burn Correct Answer just on outer layer

turns red but doesn't blister like a sunburn second degree burn Correct Answer partial thickness epidermis and some layers of dermis blisters third degree burns Correct Answer full thickness through all layers of skin leathery, white, dark brown rule of 9 and palmar method Correct Answer used to estimate burn area palmar method patients hand is 1% signs of severe upper airway swelling/burning , also TX Correct Answer Stridor, hoarse voice, singed nasal hair, burns of the face, carbon particles in the sputum. Apply cool mist, aerosol therapy, or humidified oxygen to help reduce minor edema. chemical burns how long to flush Correct Answer eyes (20 mins!) rest of body (15-20 mins) electrical burns symptoms Correct Answer either deep tissue injury or cardiac arrest taser what to bring Correct Answer aed types of bleeding and pressures Correct Answer Arterial- high pressure, spurting pluslating. bright red

Venous- low pressure flowing, dark red Capillary- extremely low pressure perfusion Correct Answer The circulation of blood in the body how to resist damage from hypoperfusion Correct Answer keep the body temp below 98.7 F how much blood can the body tolerate losing at once Correct Answer 20% what happens when significant blood loss Correct Answer Increase in HR, increase in RR, decrease in BP (demonstrates shock with internal bleeding) tourniquet (use and location and how to mark patient) Correct Answer direct pressure for 5 mins then tourniquet that bitch 2 - 4 inches about injury site then write "TK" and time on forehead hemostatic dressing Correct Answer either granular or gauze has agent to promote clotting usually used on NON extremities tendons and ligaments Correct Answer Tendons attach muscle to bone, ligaments attach bone to bone nerves (motor, sensory, relex arc) Correct Answer motor nerves- movement, brain to muscle sensory-feeling, extremity to brain reflex arc-bypass the brain to spinal cord for speed, controls reflex what happens if pressure on brain stem Correct Answer effects HR AND RR

cerebrospinal fluid (CSF) Correct Answer circulates throughout the brain and spinal cord main function is shock absobtion When injury penetrated, yellowish whitish may leak from nose, ears, or an open skull fracture Tramatic Brain Injury (TBI) primary and secondary Correct Answer primary - injury to brain itself secondary- occurs in the hours and days following the primary injury, often the more serious secondary TBI most common and most serious? Correct Answer hypotension and hypoxia are the two most common causes of secondary brain injury. cerebral edema is most common and serious secondary injury hemorrhage Correct Answer an escape of blood from a ruptured blood vessel, especially when profuse. hem, hema Correct Answer blood hematoma Correct Answer blood bruise epidural hematoma Correct Answer blood between skull and dura mater ludic interval: looks line then not shows symptoms quickest subarachnoid hemorrhage Correct Answer Bleeding into the subarachnoid space mixes with csf fluid

intercerebral hemorrhage Correct Answer bleeding within the brain itself concussion assessment and tx Correct Answer manual cspine neurologic exam (glasgow coma scale) dialated Pulse, Motor, Sensory, Cap Refill. cushing's triad (what is it and what are the s/s) Correct Answer Increase BP (hypertension) Decreased HR (bradycardia) Irregular respirations (cheyne stokes respirations or biot respiration) rising cranial pressure? helmet removal (when to remove helmet) Correct Answer airway compromise Spinal compromise Suspected airway compromise Face shield is not removable neurovascular bundle what is it Correct Answer network of nerves and arteries and veins together network of nerves arteries, and vein lying closely along the inferior and slightly posterior to the lowest margin of each rib. Pleura and what does it allow Correct Answer Membrane surrounding the lungs and thoracic cavity pleural fluid between the parietal and visceral pleura allows the lungs to move freely against the inner chest wall as a person breathes

parietal pleura Correct Answer inner chest wall lining visceral pleura Correct Answer covers the lung mediastinum Correct Answer heart, great vessels, esophagus, and trachea SX of closed chest injury Correct Answer difficulty refilling with blood heart not strong enough to pump blood cardiogenic shock Dyspnea Correct Answer trouble breathing hemopytsis Correct Answer coughing up blood hematachezia/hematemesis Correct Answer vomiting blood abdominal aortic aneurysm Correct Answer blood-filled bulge or ballooning in a part of your aorta that runs through your abdomen can swell and rupture/hemorrhage rupture leads to severe pain and massive internal bleeding, or hemorrhage open pneumothorax Correct Answer need a one way valve, must let air out and not in use 1 way valve or Improvised occlusive dressings, tape 3 side hole facing down on front, 4 sided on back Tx for pneumothorax Correct Answer High flow o Monitor oximeter readings and breath sounds tension pneumothorax Correct Answer movement of trachea

hemothorax Correct Answer Condition were blood collects in the pleural space from bleeding around the rib cage or froma lung or great vessel Hemopneumothorax Correct Answer The accumulation of blood and air in the pleural space of the chest. Cardiac tamponade Correct Answer protective membrane around the heart fills with blood or fluid Flail chest Correct Answer Segment of chest wall becomes detached from the rest of the thoracic cage Traumatic asphyxia (whats is characterized by, tx) Correct Answer Sudden severe compression of chest that creates high pressure Characterized by distended neck veins, cyanosis in the face and neck, and hemorrhage in the sclera of the eye Aggressively manage the airway/ provide ventilatory support with oxygen and monitor vital signs during immediate transport. FINAL aggressive isn't necessarily bad (probably the answer) Commotio cordis Correct Answer sudden blow to chest during specific period of heart beat usually in sports related questions puts heart into v fib what happens to pulse after brain injury Correct Answer slow embolism Correct Answer blockage of blood vessel

Emphysema Correct Answer lung condition that causes shortness of breath longterm hypertension lead to Correct Answer renal failure how heavy to sit in car seat Correct Answer 40 left side heart failure Correct Answer rales right side heart failure Correct Answer dependent edema /swelling of lower extremities enlargement of liver Correct Answer hepatomegaly angina Correct Answer ischemic chest pain dyspnea Correct Answer difficulty breathing/shortness of breath Apneic Correct Answer absense of breathing auto bvm Correct Answer hypoxia, cyanosis, apenic conduction vs convection Correct Answer conduction is directly touching something convection is losing heat by air respiration cooling body temp Correct Answer exchanging warm air with cold outside air hypothermia if body drops below ___ temp Correct Answer 95 body stops shivering if it drops below __ Correct Answer 90 F

whos at risk for hypothermia that you wouldnt expect Correct Answer burn patients how long do you check pulse for cold patients Correct Answer 1 min vs 5-10 seconds normally how to assess temperature with ppe Correct Answer pull back glove and touch with back of hand Gangrene Correct Answer hypothermia when affected part becomes black and dead hyperthermia temp if body of Correct Answer 101 heat exhaustion vs heat stroke Correct Answer stroke is more serious heat exhaustion: excessive sweating, cool clammy skin heatstroke: throbbing headache, no sweating drowning Correct Answer experiencing respiratory impairment from submersion immersion in a liquid air embolism what is it and S/S Correct Answer air bubbles in blood vessels blotching froth at mouth and nose abdominal or joint pain bends Correct Answer air bubbles block blood vessels brown recluse spider Correct Answer also know as violin spider as it has a violin on its head

bvm vs no rebreather Correct Answer 1 - 3 NRB 3 or more BVM immediate bvm is hypoxia, apenic, cianosis immediate BVM Correct Answer hypoxia, apenic, cianosis if less than 8 bvm! if its a volume issue! when to sit up vs supine Correct Answer if trouble breathing sit them up supine if in shock fowlers position Correct Answer patient sitting at 45 degree angle crepitus Correct Answer a crackling or grating sound usually of bones 1st Degree Burn Tissue Effected? Skin Color/Moisture/Appearance? Correct Answer Superficial Thickness (Only Epidermis) Red Skin No Blisters or burns 2nd Degree Burn Tissue Effected? Skin Color/Moisture/Appearance? Correct Answer Partial Thickness (epidermis and part of dermis) Not subcutaneous tissue Blistered/white to red/ moist and spotted 3rd Degree Burn Tissue Effected? Skin Color/Moisture/Appearance? Correct Answer Full Thickness

All skin layers including subcutaneous and beyond Dry/Leathery/white brown or black hemothorax Bleeding? s/s? Transport? Correct Answer pleural space fills with blood s/s: shock decreased breath sounds on affected side rapid transport Rule of 9's adults Head Chest Arms Abdomen Groin Legs Correct Answer Head - 4.5 Chest - 9 Arms - 4.5 Abdomen - 9 Groin - 1 Legs - 9 (this is per side aka front and back) anaphylaxis (anaphylactic shock) S/s Correct Answer Can develop within seconds, mild itching or rash, burning skin, vascular dilation, generalized edema, coma, rapid death cardiogenic shock S/s Pulse/Resp.'s/Blood Pressure? Skin CMT? Mental Status? Right vs Left Correct Answer P-Either R-Tachy BP-Brady and Narrowing Cool Pale and Clammy/ Cyanotic