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Chap. 25-32

Brady Prehospital care 8th Edition

Three Collisions that occur during a MVC (1)vehicle collision (2) Body collision (3) Organ collision
Vehicle Collision The vehicle is suddenly stopped and gets bent out of shape.
Body Collision the patient comes to a quick stop on some part or parts of the inside of the vehicle such as a steering wheel, causing injury to the chest
Organ Collision the patients internal organs, which are all suspended in their places by tissue, come to a quick stop, sometimes striking an inside surface of the body
PrimaGravida patient who is pregnant for the first time.
When is it a full term pregnancy lasts approximately 280 days from the first day of the last normal menstrual cycle
Medications that interfere with the clotting process Aspirin
The Golden Hour Established as a standard parameter from emergency care because studies have shown that a severely injured patient has the best chance for survival if surgical intervention takes place within 1 hour from the time of injury.
Platinum 10 Minutes Means that 10 minutes out of the golden hour is the maximum time the EMS team should devote to on-scene activities.
The spinal column the principal support system of the body
The spinal cord Composed of nervous tissue, exits the brain through an opening at the base of the skull
Tendons connect muscle to bone
Ligaments Connect bone to bone
Strain an injury to a muscle or a muscle and tendon, possibly by being overextended or stretched.
Sprain is an injury to a joint with possible damage to or tearing of ligaments.
Shock (Hypoperfusion) the insufficient supply of oxygen and other nutrients to some of the bodys cells that results from inadequate circulation of blood.
Avulsion is a loose flap of skin and underlying soft tissue that has been torn (patial avulsion) or pulled completely off (total or complete avulsion)
Penetration/ puncture injury generally is the result of a sharp, pointed object being pushed or driven into the soft tissues.
Contusion (or Bruise) is an injury to the tissue and blood vessels contained within the dermis
Abrasions Generally is caused by scraping, rubbing or shearing away of the epidermis(outer layer of skin)
Open fractures Presents with an open wound often with a bone end protruding through the skin.
Closed fractures has no associated open wound.
Rules of Nines is a standardized way to quickly determine the amount of skin surface, or the body surface area percentage of a burn.
:Adult Rules of Nines: Head and neck = 9%; Posterior trunk= 18%; Anterior Trunk= 18%; Each Upper Extremity= 9%; External Genitalia= 1%; Each Lower Extremity= 18%;
:infant 1 years of age or less: Head and Neck= 18%; Chest and abdomen= 18%; Entire Back= 18%; Each Upper Extremity= 9%; Each Lower Extremity= 14%;
Burn Classification Burns are classified according to depth of the injury
Superficial Burn referred to as a first degree burn. It is an injury that involves only the epidermis. Usually a superficial burn is caused by a flash, hot liquid, or the sun. the skin will appear pink to red and will be dry.
Partial Thickness Burn known as a second degree burn. It involves not only the epidermis but portions of the dermis as well. Partial thickness burns occur from contact with fire(flame or flash), hot liquids or objects, chemical substances, or the sun.
Full Thickness Burn known as third degree burns. Involves all of the layers of the skin. This type of burn results from contact with extreme heat sources(the skin will become dry hard, tough, and leathery and may appear white and waxy to dark brown or black and charred.)
Eschar the tough and leathery dead soft tissue formed in the full thickness burn injury.
Reasons for rapid extrication: Reasons for rapid extrication (1)the scene is not safe (because of the threat of fire or explosion, chemical spills, or gunfire)(2)the patients condition is so unstable you need transport him immediately(3)the patient blocks your access to a second, more seriously injured patient
Stages of Labor First stage- Dilation; Second Stage- Expulsion; Third Stage- Placental;
Dilation stage beginning of true labor (contractions)
Expulsion Stage begins with complete cervical dilation and ends with the delivery of the baby. Contractions are closer together (2 to 3 minutes apart and lasts longer 60 to 90 seconds each.
Placental Stage begins following the delivery of the baby and ends with the expulsion of the placenta. Placenta is usually delivered 5-20 minutes following the birth of the baby.
Subdural Hematoma is a collection of blood between the dura mater and the arachnoid layer of the brain. It typically is due to low pressure venous bleeding that results from small bridging veins that are torn during the impact to the head.
Three Types of Subdural Hematoma 1. Acute- signs and symptoms begin almost immediately after the injury 2. Subacute- signs and symptoms begin 3-7 days after the injury 3. Chronic- signs and symptoms begin 2-3 weeks after the injury
Paraplegia paralysis involving both legs only
Quadriplegia paralysis involving both arms and both legs
Muscle types (1) Voluntary (skeletal) (2) Involuntary (smooth) (3) Cardiac
Involuntary muscles are found in the walls of organs and help move food through the digestive system
Cardiac muscles are found only in the walls of the heart
Voluntary muscles are those that are under control of the persons will.
Autonomic Nervous System which is automatic and influences the activities of involuntary muscles and glands; the autonomic system is partly independent of the rest of the nervous system.
Function of the Uterus Its special arrangement of smooth muscle and blood vessels allows for great expansion during pregnancy and forcible contracting during labor and delivery.
Cushings reflex Is which the systolic blood pressure increases, the heart rate decreases, and the respiratory pattern changes.
Types of shock (1) Hypovolemic shock (2) Obstructive shock (3) Distributive shock (4) Cardiogenic shock
Hypovolemic shock the result of a decrease in the volume of blood available for perfusion of the bodys organs.
Obstructive Shock usually caused by a mechanical obstruction or compression that prevents blood from reaching the heart.
Distributive shock caused by an abnormal distribution of blood in the vessels or troughout the body, which causes an insufficient amount of blood returning to the heart.
types of distributive shock (1)Vasogenic or neurogenic shock (2)Anaphylactic shock (3)Septic Shock
Cardiogenic Shock a result of inadequate pumping of the heart.
Meninges layers of tissues that enclose the brain
Dura Mater outer most layer (‘hard mother’) composed of a double layer of tough, fibrous tissue.
Arachnoid 2nd layer
Piamater in contact with the brain (‘soft mother’)
Subarachnoid space separates the arachnoid membrane and the pia mater. It is a lattice of fibrous, spongy tissue filled with cerebrospinal fluid.
Epidural bleeding that occurs between the dura mater and the skull. Usually involves the brains outer most arteries.
Subdural bleeding occurs beneath the dura and is usually venous.
Subarachnoid hemorrhage bleeding that occurs between the arachnoid membrane and the surface of the brain.
parts of the brain (1)The cerebrum (2)The cerebellum (3)The brainstem
The cerebrum the largest part of the brain, the cerebrum comprises three-fourths of the brains volume. It is made up of four distinct lobes. It is responsible for most conscious and sensory functions, the emotions and personality.
The cerebellum sometimes called the “little brain”. It controls equilibrium and coordinates muscle activity. It controls muscle movement and coordination, predicts when to stop movement.
The brainstem controls most automatic functions of the body, including cardiac, respiratory, vasomotor (blood pressure), and other functions vital to life
Para refers to a women who has given birth. Example para II would mean she has given birth 2 times.
Gravida refers to pregnancy. Example.. gravida II means she has been pregnate 2 times.
Placing a c-collar (1)Kneel at the patients head and stabilize the head and neck (2)Set the collar in place (3)Secure collar (4)Continue to manually stabilize the head and neck
Spinal Injuries (1)Compression (2)Rotation (3)Distraction (4)Penetration (5)Lateral bending (6)Extension (7)Flexion
Electrical Burns All tissues between the entrance and exit of the current will potentially be injured due to the extreme heat created by the resistance of body structures to the electricity.
There are three main types of tracts within the spinal cord that will be tested in the assessment to determine if spinal cord injuries exist (1)Motor tract (2)Pain tract (3)Light touch tracts
Vehicle strike zones: (1)Frontal (2)Rear (3)Lateral (4)Rotational
Nose, Ear, and mouth bleeding: Possible causes include: (1) Skull injury (2) Facial trauma (3)Digital trauma (nose picking) (4)Sinusitis and other upper respiratory tract infections (5)Hypertension (high blood pressure) (6)Clotting disorders (7)Esophageal disease
Controlling a nosebleed: (1)Have the patient sit and lean forward (2)Pinch the fleshy part of the nostril together.
Amniotic Sac is filled with the amniotic fluid in which the infant floats, insulating and protecting it throughout the pregnancy.
Inertia objects in motion remain in motion in a straight line (unless acted upon by an outside force)
Cavitation sometimes called pathway expansion, it is the cavity in the body tissues formed by a pressure wave resulting from the kinetic energy of the bullet.
: The cervical spine is the most common area of spinal cord injuries.
Skull injuries can be open (where there is a break in the continuity of the skin and bone) or closed (with the scalp intact.)
The spinal column is made up of 33 irregualrly shaped bones called vertebra
Between each two vertebrae is a fluid-filled pad of tough elastic cartilage called a disc that acts as a shock absorber
Tendons and ligaments can be bruised, crushed, cut, or torn.
Splint joint injuries: 1)Manually stabilize the joint in the position found then assess distal pulse and motor and sensory functions (2)Apply splint to immobilize the bone about and below the joint (3)Reassess sensory function,pulses and motor function after splint is applied
Impaled objects should never be removed in the field, unless it is through the cheek or the neck where it is obstructing air flow through the trachea.
Benefit of applying a tracting splint Traction splints provide a counter pull, alleviating pain, reducing blood loss, and minimizing further injury.
Created by: LivLogik



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