Union Test Prep (EMT) - Trauma for Paramedics PDF

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EMT Union test prep notes for Trauma. Paramedics. Covers content for the FISDAP exam, NRMT. National standard curriculum....

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Union Test Prep (EMT) - Trauma: Flashcards: https://uniontestprep.com/emt-test/flashcards/trauma/pages/1 General Information Many EMT calls require expertise in dealing with some sort of trauma. This study guide provides an outline of the topics you might see on the test. Take time to fully research each one in your EMT textbook to be fully informed on all terms and procedures. The EMT Cognitive Exam Test Plan is expected to have 14%-18% questions related to Trauma. The questions included are made up of 85% Adult and 15% Pediatric.

Trauma Basics Trauma is defined as serious physical and/or emotional injury or damage. It can be a physical wound or injury to the body, as from an accident or act of violence. It can also be an emotional response to a terrible event like rape or natural disaster. Immediately after the event, shock and denial are typical.

Terms/Concepts to Know: trauma emergencies, medical emergencies

Energy and Trauma Three concepts of energy relate to patient injuries, with special consideration given to the discipline of physics. The content of Newton’s Laws of Motion is fundamental knowledge that plays a key role in the EMT’s proficiency and competency with injured patients during the physical assessment.

Terms/Concepts to Know: kinetic energy, work energy, potential energy, Newton’s Laws of Motion, energy impacts on injury

Mechanism of Injury Profiles An injury can occur in many ways. This can be thought of as the how, what, and where of an injury. You need to know all three of these as they pertain to every injury you treat.

Terms/Concepts to Know: mechanism of injury, significant and non-significant injury, multisystem injury

Blunt Trauma Blunt trauma is one of the two categories of trauma. This type of trauma is noninvasive and does not break the skin barrier. However, it can often be more serious than it appears on the outside due to the potential for internal bleeding and/or organ involvement.

Terms/Concepts to Know: blunt and penetrating trauma, coup and contrecoup brain Injury, deceleration, mechanism of injury, signs, symptoms, and index of suspicion

Penetrating Trauma Penetrating trauma is the second of the two categories of trauma. This type of trauma penetrates at the skin level as well as at various levels below the skin. Both external and internal wounds are evident in penetrating trauma.

Terms/Concepts to Know: cavitation, drag, projectiles, trajectory, mechanism of injury

Blast Injuries Blast injury may occur in four ways: primary, secondary, tertiary, and quaternary. The type of injury differs based on the mechanism of occurrence. It is not uncommon for a patient to have more than one type of blast injury.

Terms/Concepts to Know: primary, secondary, tertiary, and quaternary blast trauma, arterial air embolism, pulmonary blast injuries, tympanic membrane

Multisystem Trauma The type of trauma termed multisystem indicates injuries where more than one body system is impacted. When there are multiple systems impacted/injured, the patient can be in a life-threatening situation. These impacts create a high acuity level and may require extensive care from an interdisciplinary medical team.

Terms/Concepts to Know: golden principles, golden hour/period

Patient Assessment The patient assessment is the act of identifying/collecting information to use in addressing the patient’s healthcare needs based on the situation. In the case of trauma, this process requires organized, thorough, and timely completion. Focus on identifying injuries through chief complaint, visual clues, vital signs, and symptoms in collaboration with the physical assessment.

Terms/Concepts to Know: components of the patient assessment, important/key assessment points specifically related to injury of the neck/throat, chest, head, and abdomen

Transport and Destination It is vital for the EMT to have a working knowledge of the transportation resources and Trauma Center levels when handling injured patients. A major goal of the emergency medical system is to ensure safe, timely, quality, and efficient treatment for an injured patient in the prehospital phase. This includes travel in the most effective, efficient mode of transportation to the most appropriate level trauma center required based on the patient acuity.

Terms/Concepts to Know: classification system of Trauma Centers, revised trauma score (RTS), trauma score, Glasgow Coma Scale (GCS), scene time, platinum 10, types of transportation resources

Review of the Cardiovascular System The cardiovascular system’s main job is to maintain adequate blood flow, pressure, and supply throughout the body. The word system is key, as there is more to it than the heart; the system also includes veins, capillaries, and arteries.

Terms/Concepts to Know: function and location of the heart, arteries and capillaries, the three parts of the cardiovascular system, aorta, venules, veins, and arterioles

Pathophysiology and Perfusion The Merriam-Webster medical dictionary describes perfusion as “the pumping of fluid through an organ or tissues.” You need to understand the importance of adequate perfusion. Your knowledge needs to include

the symptoms and disease processes that impact organs and systems when there is not adequate perfusion.

Terms/Concepts to Know: perfusion as it relates to blood flow, inadequate perfusion impact to critical organs and systems, time frames for death/damage to an organ or system without adequate perfusion

External Bleeding It is critical to understand the characteristics and significance of external bleeding. In addition, knowledge of total blood volume and the body’s ability to handle acute and profuse blood loss is important.

Terms/Concepts to Know: hemorrhage, hypovolemic shock, hemophilia, vasoconstriction, coagulation, the characteristics and significance of external bleeding

Internal Bleeding Internal bleeding is just that: bleeding inside, with no significant visible bleeding outside. This makes detection much more difficult. There are, however, physical signs and symptoms that are important to know for early detection and treatment. Understanding the nature of the illness, identifying signs and symptoms, and knowing the mechanism of injury (MOI) are key to providing appropriate care.

Terms/Concepts to Know: contusion, ecchymosis, hematuria, hematemesis, melena, signs and symptoms of internal bleeding in trauma and medical patients

Patient Assessment Patient assessment is the act of identifying and collecting information that will be used to address the healthcare needs of the patient based on the situation. The assessment for a patient with external or internal bleeding must be organized, thorough, and timely. It must include: scene size-up, primary assessment, history, secondary assessment, and reassessment.

Terms/Concepts to Know: five components of the patient assessment, important/key assessment considerations that are specifically related to internal and external bleeding, AVPU, DCAP-BTLS

Emergency Care for External Bleeding External bleeding can be as basic as an abrasion or as complicated as profuse bleeding. You need to know the standard precautions and the steps for care and control of general external bleeding, including bleeding from the ear, nose, and mouth.

Terms/Concepts to Know: use of standard precautions, common methods to control external bleeding, basic techniques to control bleeding, hemostatic agents, tourniquets, epistaxis

Emergency Care for Internal Bleeding In most cases, internal bleeding requires hospital-based care and, often, surgery. You need to know the symptoms and appropriate steps in prehospital care, including procedures to prevent further damage from internal bleeding.

Terms/Concepts to Know: steps to identify and care for internal bleeding, pelvic binder, open book pelvic fracture Soft Tissue Injuries It is important to be able to identify and care for patients with soft tissue injuries. The functions, disease, assessment, and management of this type of injury require complete knowledge of the soft tissue anatomy and the procedures used to treat damage to these tissues. Skin Anatomy and Physiology Skin is considered an organ. It is, in fact, the largest organ of the body. One can only imagine the potential impact from trauma and/or injury to this organ. The EMT must know details about the skin’s makeup, function, types of skin and soft tissue injuries, and how to identify and manage these injuries. Terms/Concepts to Know: epidermis, dermis, mucous membranes, the three types of soft tissue injury, contusion, ecchymosis, hematoma, crushing injury, crush syndrome, compartment syndrome, contamination abrasion, laceration, incision, avulsion, fascia, amputation, penetrating wound, impaled objects Open and Closed Injuries These injuries are two of the three types of soft tissue injuries. A competent EMS (Emergency Medical Services) worker is well versed in the identification of this type of injury and knows the importance of assessment and appropriate management. Knowing how to handle these emergencies will aid in the avoidance of common complications related to shock, infections, and bleeding.

Pathophysiology The skin has several functions. The main functions include temperature regulation, nerve pathway, and shielding to maintain fluids inside the body and keep bacteria out. Understanding these functions will help during your treatment of skin injuries. Patient Assessment The patient assessment of open and closed injuries includes scene size-up/MOI, primary assessment, patient history, secondary assessment, and reassessment. Critical points to consider involve the difference in presentation of the closed versus open injury. Open wounds are more obvious and can be difficult to triage as even a simple and small exposed surface area is at risk for bleeding and contamination. Paying attention to a closed wound with high acuity symptoms is critical for preventing hypovolemic shock and other critical complications. Emergency Medical Care Medical care of open and closed injuries during an emergency requires immediate assessment and triage. Deciding what injuries require immediate attention is key and should be the priority of emergency care. Critical open wounds include abdominal, impaled objects, neck injuries, compound fractures, and bites. Examples of closed wounds include complete or closed fractures. Terms/Concepts to Know: RICES, evisceration, rabid, key treatment skills for abdominal, impaled, neck, and bites

Burns Burns occur when there is exposure to heat, radiation, toxins, chemical substances, and/or electricity. Injuries of this type not only include burns, but also burn-related exposure injuries. Burns are classified according to the degree of severity. Pathophysiology The disease potential of a burn is multifaceted. Depending on the type and severity of the burn, there can be increased capillary permeability, which creates plasma leakage in and around tissue. This increases the risk of edema, impact to blood volume, and cardiac output concerns. Complications The impact from burns breaches the protective barrier between external exposures and the skin. Complications from this breach may include: pain, infection, dehydration, neurovascular compromise, compartment syndrome, body temperature irregularity, shock, and even airway issues. Severity

The degree of severity includes five factors that help to guide assessment and emergency treatment regimens. Another consideration about the degree of severity relates to the trauma level of the hospital to which the patient will be transported. Patient Assessment The burn patient assessment requires not only an indication of degree of severity, but also making note of the patient’s age, as additional considerations exist if they fit into a special population category. The EMT will perform scene size-up/MOI, primary assessment, history, secondary assessment, and reassessment. Emergency Care Nine key steps must be followed when treating an emergency burn patient. You should memorize and use them because they are important for decreasing the risk of further injury. Managing the care of burns depends on the classification and degree of the burn. The use of high flow oxygen, cool water, and dry sterile bandages or clean sheets are standard treatment regimes. Dressings and bandages are used to prevent these things: further trauma to the open area, bleeding, and contamination. Terms/Concepts to Know: types of burns: thermal (contact, scald, steam, flame, flash), chemical, inhalation, electrical, taser, and radiation; excited delirium; occlusive dressing; the first two factors of importance in determining burn severity; three questions that are important for burn severity rating; skin layer involvement with first, second and third-degree burns; classification of burns for adults, children, and infants; rule of nines; key factors to identify during respiratory assessment of a burn patient

Face and Neck Injuries This chapter overviews the identification, management, and emergency care for patients with face and neck injuries, including injury to the eyes, ears, nose, neck/throat, mouth, and dental areas. These parts of the body have special concerns that are related to potential for airway obstruction, bleeding, and disfiguring scars. Anatomy and Physiology Understanding the anatomy and physiology of the face and neck area is key to identifying potential life-threatening injuries there. Since this area includes the airway, it is critical to understand the connections between the ear, nose, and throat. Additionally, knowledge of the structure of the facial and skull bones will help you understand the impacts to these areas when bleeding, bruising, or a penetrating wound is present. The Eye The eyes serve as one of the five senses. The eye is approximately 1 inch in diameter and is surrounded by bones, muscles, and nerves. Considering how small the eyes are, it is amazing that they play such a major role in how human beings obtain information.

Terms/Concepts to Know: orbital socket and bones, extraocular muscles, lens, optic nerve, retina, cornea, iris, pupil, sclera, conjunctiva, globe, vitreous and aqueous humor, major components of the eye, symptoms of retinal detachment, anisocoria Injuries Injuries to the face and neck area may often seem benign, especially if there are no open wounds or penetrating injuries. Understanding how injuries occur and present in these areas will help to identify potential concerns and promote prompt identification and treatment. Soft Tissue Due to the abundance of veins in the facial area, soft tissue injuries here commonly cause bleeding. Skin that has been broken by penetration or abrasion may emit copious amounts of blood. Injury where the skin is intact may present in the formation of a hematoma, or bruise. Dental Dental injuries can range from a broken/cracked tooth to lip, gum, tongue, frenulum, or cheek laceration. In some instances, foreign objects can cause injury. An example is that caused by broken braces or other sharp objects. Terms/Concepts to Know: avulsion, hematoma Patient Assessment The patient assessment of facial and neck injuries includes scene size-up/MOI, primary assessment, patient history, secondary assessment, and reassessment. Special attention should be given to the airway, depending on the location of bleeding and anatomical location of face/neck injury. Terms/Concepts to Know: major facial bones Emergency Care Emergency care of soft tissue injury to the face and neck area requires the use of respiratory and neurological assessment and precautions. Soft tissue in the face/neck area has high risk of bleeding. There are also many bones located in this area. A careful view of the entire area, including the removal of clothing, eyeglasses, and hats, is critical to ensure there is no sign of compound fractures, bleeding, or airway obstruction. Take care to use appropriate first aid techniques to address wounds, impaled objects, and fractures. Eyes Eye injuries can be as minor as an irritated contact lens to the catastrophic penetration of a sharp foreign object. High-risk injuries may potentially cause blindness or loss of the eye. The important thing to remember with emergency eye problems or injuries is that time is important for positive patient outcomes. Basic care can include flushing the eye with saline, guarding/covering the eye, and stabilizing the impaled object until medical/surgical care can be provided.

Nose Nose injuries may present with varied symptoms. A basic and common symptom of a nose injury is bleeding. Other symptoms of nose injuries may be bruising around the eyes, difficulty breathing through the nose, blunt or penetrating injuries, and even swelling of, or around, the nose. Ear Ear injuries may present with chief complaints related to the inner, middle, or outer areas. Understanding the anatomy and physiology of the ear is critical to observe for signs and symptoms that can impact hearing loss or high acuity injuries. Ear injuries can be stabilized in an emergency situation and almost always require a physician to examine and/or treat. Fractures Fractures can be very serious. The facial bone structure is multifaceted, as it supports and involves the nose, eyes, ears, teeth, cheeks, jaw, dental, and even part of the skull. Fractures of facial bones can present various emergency conditions, including bleeding and difficulty breathing. Emergency care should include preparation to handle these delicate injury types. Dental Emergency care for injury to dentition and surrounding areas require knowledge of first aid treatment for pain, bleeding, and broken, loose, or dislodged teeth. Be aware of these potential injuries to provide a time-sensitive response. The mucous membrane, gums, and bones of the mouth are all at risk for injury. Use first aid techniques as appropriate, and be sure to recover chipped or broken teeth, if possible. Handle these teeth or parts on the crown side only. Cheek Several bones make up the cheeks. Injury to them may present with pain caused by swelling, muscle, and/or nerve involvement. Some injuries may cause indentation or misalignment of the cheek bones. In some cases, these injuries will prevent the patient from being able to open the mouth or jaw. Prehospital care would include stabilization of the injury and addressing bleeding, impalement, or fracture. Neck Injury of the neck can occur at a superficial, venous, or arterial level. There may also be impacts to the upper airway or bones. Injures to this area can affect function and be life threatening. If injury occurs in any of the seven vertebrae present in the neck area, precaution must be taken to stabilize it and prevent further injury. It is important to know the MOI related to these types of injuries for insight into providing safe care and treatment. Laryngeal Injury to the larynx may present with symptoms of hematoma, bleeding, edema, and subcutaneous emphysema. These injury types can be caused by a crushing, blunt, or penetrating trauma. Injury to the

larynx can put a patient at risk for respiratory and airway difficulties. Emergency care includes managing wounds and bleeding, while watching for any signs of a compromised airway. Terms/Concepts to Know: blow out fracture, tragus, turbinates, subcutaneous emphysema, sternocleidomastoid muscles, temporomandibular joint, mastoid process, air embolism Head and Spine Injuries An EMS worker needs to know all of the standards for identification, management, and care of a patient with head and spine injuries. This patient population will benefit from an EMT who is well versed about the potential impacts from injury to the nervous system, skull, and spinal column.

Anatomy and Physiology The nervous system is the master link to every body function. It is made up of two parts: the central and peripheral nervous systems. The skul...