Understanding Injuries & Wound Healing: Cavitation, GI Bleeds, Burns, & Brain Injuries, Exams of Nursing

Download Understanding Injuries & Wound Healing: Cavitation, GI Bleeds, Burns, & Brain Injuries and more Exams Nursing in PDF only on Docsity! West Coast EMT Block 4 Exam Study Guide Questions and Answers 2024 100% Verified Answers by Experts. Know what cavitation is - ☑☑️☑️R️esults from rapid changes in tissue and fluid pressure that occur with the passage of the projectile, can result in serious injury to internal organs distant to the actual path of the bullet. Know Newton's First Law of Motion - ☑☑️☑️T️he first law states that objects at rest tend to stay at rest and objects in motion tend to stay in motion unless acted upon by an outside force. Kinetic Energy - ☑☑️☑️T️he energy of a moving object. Reflects the relationship between the mass (weight) of the object and the velocity (speed) at which it is traveling. Potential Energy - ☑☑️☑️T️he product of mass (weight), force of gravity, and height and is mostly associated with the energy of falling objects. The energy stored within an object. Know the 3 collisions that occur in a car accident. First Collision: - ☑☑️☑️T️he collision of the car against another car, a tree, or other objects. Does not directly affect patient care except making extrication difficult The damage to the car can indicate how severe the patient's injury is and help determine the mechanism of injury. Know the 3 collisions that occur in a car accident. Second Collision: - ☑☑️☑️T️he collision of the passenger against the interior of the car. This damage is caused by the kinetic energy produced by the passenger's mass and velocity is converted into the work of stopping the passenger's body. It can cause severe traumatic injury that can be apparent during the scene size up or primary assessment. The most dramatic injury occurs when the passenger is not restrained. Know the 3 collisions that occur in a car accident. Third Collision: - ☑☑️☑️T️he collision of the passenger's internal organs against the solid structures of the body. Next stage is to replace the damaged soft-tissue with a new layer of cells so cells can multiply quickly and redevelop across the edges of the wound. In cases of large wounds or injuries, scar tissue may form which is a structural protein that reinforces the damaged tissue. Last stage of the wound healing process, new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue. At last collage, a tough fibrous protein, provides stability to the damaged tissue and joins wound borders closing the open tissue. Know how long organs can tolerate inadequate perfusion - ☑☑️☑️H️eart: Needs constant perfusion to function optimally. Without it the cells within the brain and spinal cord die within 4-6 minutes. Lungs: Without adequate perfusion the lungs can only survive 15-20 minutes. Kidney: Damage occurs after 45 minutes without adequate perfusion. Skeletal muscles: Demonstrate damage after 2-3 hours of inadequate perfusion. Gastrointestinal tract: Can tolerate slightly longer periods of time. How can the body better sustain hypoperfusion (*hint it has to do with body temperature) - ☑☑️☑️A️n organ or tissue that is kept at a considerably lower temperature may be better able to resist damage from hypoperfusion. When would infants start showing S&S of hypovolemic shock? (*hint what is their total blood volume, and what is the least amount of blood they could lose before showing S&S of shock?) - ☑☑️☑️I️nfants and children have less blood volume compared with adults A 1 year old has a typical total blood volume of about 27 oz (800mL); the child will show significant symptoms of blood loss after only 3 - 6 oz (100 - 200 mL) of blood loss How successful a person is able to compensate for blood loss is related to what in particular? - ☑☑️☑️I️t is related to how rapidly the blood loss occurs. The age and pre-existing health of the patient should also be considered. Movement, removal of bandages, external environment, or body temperature may also affect the blood's clotting factors in cases of external bleeding. S&S of intra-abdominal bleeding (*know the early and late signs especially!) - ☑☑️☑️E️arly signs: Pain and distention. referred pain. Late signs: Tachycardia, weakness, fainting, or dizziness at rest, thirst, nausea and vomiting, cold moist skin, dull eyes and slightly dilated pupils, shallow rapid breathing, capillary refill time longer than 2 seconds in infants and children, weak rapid pulse, decreasing blood pressure, and altered level of consciousness. When should we suspect a GI bleed? - ☑☑️☑️V️omiting dark red blood (UPPER gi tract) Vomiting bright red blood and rectum (LOWER gi tract) Bloody diarrhea Know the early & late signs of non-traumatic GI bleeds - ☑☑️☑️E️arly: Contusion/ ecchymosis caused by the accumulation of blood around Late: Hypovolemic Shock How do we control external bleeds? - ☑☑️☑️D️irect even pressure Pressure dressing and/or splint Tourniquets What's the most effective way to control arterial bleeds? - ☑☑️☑️D️irect pressure and tourniquet. Know the rule of 9's + differences between adults and children in relation to TBSA - ☑☑️☑️A️dult Head: 4.5% each side = 9% whole head Torso: 9% chest & 9% abdomen = 18% one side (18% anterior and 18% posterior = 36% whole torso) Arms: 4.5% each side = 9% whole arm Legs: 9% each side = 18% whole leg Groin: 1% Infant Head: 8% each side = 18% whole head Torso: 18% each side = 36% whole torso Arms: 4.5% each side = 9% whole arm Leg: 6.7% each side = 13.5% whole leg Where is the mastoid process located? - ☑☑️☑️O️ne inch posterior to the external opening of the ear is a prominent bony mass at the base of the skull. Where is the cricoid cartilage located? - ☑☑️☑️T️he other portion of the larynx. A firm ridge of cartilage below the thyroid cartilage. What is another name for your eyeball? - ☑☑️☑️T️he globe What is conjunctiva & sclera? - ☑☑️☑️C️onjunctiva: The delicate membrane that lines the eyelids and covers the exposed surface of the eye. Sclera: The tough, fibrous, white portion of the eye that protects the more delicate inner structures. How to treat injuries to the eye: Foreign objects - ☑☑️☑️-️ Use a normal or sterile saline solution to flush out small particles from the eye. Flush from the nose side towards the outside - Removing small objects from under the eyelid with a moist, sterile, cotton-tipped applicator: 1) Gently pull the eyelid away from the eyeball 2) Gently place the cotton-tipped applicator horizontally along the center of the outer surface of the lid. 3) Roll the eyelid over the cotton-tip applicator. 4) Remove any small particles on the inside of the eyelid with a sterile cotton-tipped applicator. Objects that are impaled in the eye should only be taken out by a physician. The care for that requires stabilization and immediate transport. Bandage the object in place to support it, cover the eye with a moist, sterile dressing, and then surround the object with a doughnut-shaped collar made from a roller gauze or a small gauze pack. How to treat injuries to the eye: Burns - ☑☑️☑️C️hemical burns: Flush with water or sterile saline irrigation solution. After, apply a clean, dry dressing to cover the eye, and transport. Thermal burns: Cover both eyes with sterile dressing moistened with sterile saline. Transport promptly. Light burns: Cover each eye with a sterile, moist pad and an eye shield. Have patients lie down and transport. How to treat injuries to the eye: Laceration and Blunt Trauma - ☑☑️☑️L️aceration: Usually controlled by gentle pressure. Don't use pressure if the globe itself is bleeding. Apply a moist, sterile dressing to prevent drying. Cover the injured eye with protective metal eye shield or sterile dressing. Transport. Blunt Trauma: Cover the eye and provide transport. S&S of a detached retina - ☑☑️☑️P️ainless but flashing lights, specks, or "floaters" in the field of vision. Know what Cushing's Triad is & what it indicates - ☑☑️☑️I️t indicates a traumatic head injury. A Cushing Triad is increased blood pressure (hypertension), decreased heart rate (bradycardia), and irregular respiration such as Cheyne-Stokes respiration and Biot respiration. Also referred to as herniation syndrome where the intracranial pressure is so great it pushes the brainstem and midbrain through the foramen magnum (the hole at the base of the skull). Intracerebral hematoma - ☑☑️☑️B️leeding within the brain itself. It can occur following a penetrating injury to the head or because of rapid deceleration forces. Once symptoms appear the patient's condition often deteriorates. High mortality rate. Cerebral Concussion - ☑☑️☑️M️ild traumatic brain injury. A closed injury with temporary loss or alteration of part or all of the brain's abilities to function without demonstrable physical damage to the brain. Coup-contrecoup injury - ☑☑️☑️R️apid deceleration results in compression injury to the anterior of the brain along with stretching and tearing in the posterior of the brain. As the body moves forward, the brain strikes the front of the skull and begins its motion back; as the head hits the headrest the brain strikes the back of the skull. What is the most reliable sign of a head injury? - ☑☑️☑️D️ecreased level of consciousness What is Beck's Triad & what does it indicate? - ☑☑️☑️S️igns and symptoms of cardiac tamponade are referred to as Beck Triad. Jugular vein distention, muffled heart sounds, and narrowing pulse pressure, where systolic and diastolic blood pressures start to merge. What is CSF and what does it do? - ☑☑️☑️C️erebrospinal fluid is produced in a chamber inside the brain called the third ventricle. There is approximately 125 to 150 mL of CSF in the brain at any time. S&S of a dislocated AC joint - ☑☑️☑️T️he distal end of the clavicle will often stick out, and the patient will report pain, including point tenderness over the AC joint. When to apply a traction splint/when should you NOT apply a traction splint? What happens if your patient complains of intense pain while applying the traction splint? - ☑☑️☑️A️pply traction splint to the femoral shaft fractures Do not apply traction splint: - Injury to the upper extremities - Injury close to or involving the knee - Injury to the pelvis - Partial amputation s or avulsions with bone separation - Lower leg, foot, or ankle injury If the traction causes more pain, stop and splint the limb in the deformed position. When do we use a scoop stretcher & why. - ☑☑️☑️U️sed for patients who have been struck by a motor vehicle. It can be sectioned into two or four pieces and can be fitted around a patient who is lying on the ground or other relatively flat surface. Remember 1 liter per femur! (also 1 liter = 1,000mL....hint, hint) - ☑☑️☑️R️emember 1 liter per femur! (also 1 liter = 1,000mL....hint, hint) What is the most common & severe complication of dislocations to the knee? - ☑☑️☑️P️osterior knee dislocations, which results from hyperextension of the knee, are the most common. There is a high risk of injury to the popliteal artery. What is the most commonly fractured bone in the body? - ☑☑️☑️T️he clavicle or collarbone What is a Colles fracture? - ☑☑️☑️F️racture of the distal radius. How do you splint the wrist? - ☑☑️☑️S️tep 1: Support the injured limb and move the hand into the position of function. Place a soft roller bandage in the palm. Step 2: Apply a padded board splint on the palmar side with fingers exposed. Step 3: Secure the splint with a roller bandage. Know what striated muscle is and where it's found. Is it voluntary or involuntary? - ☑☑️☑️S️keletal muscles that attach to the bones and usually cross at least one joint. Voluntary What is atrophy? - ☑☑️☑️D️ecrease in the size of the muscle and its inherent ability to function. How do we assess a patient's general body temperature? (*besides using a thermometer) - ☑☑️☑️P️lace the back of your hand on the patient's skin at the abdomen. If the skin feels cool, he/she is likely experiencing a cold emergency. How can you get the most accurate reading of a patient's core body temperature? - ☑☑️☑️I️nsert the thermometer in the rectum. When does a person lose their ability to shiver? - ☑☑️☑️A️s cold exposure worsens and hypothermia gradually becomes severe. Know S&S generalized hypothermia - ☑☑️☑️S️igns and symptoms worsen as hypothermia progresses: Shivering, foot stamping, constricted blood vessels, rapid breathing, altered level of consciousness; withdrawn Loss of muscle coordination and muscle stiffness, slowing respiration and slow pulse, confused and sleepy Coma, weak pulse and dysrhythmia, unresponsive Apparent death and cardiac arrest Risk factors of generalized hypothermia - ☑☑️☑️R️isk factors of generalized hypothermia include geriatric, pediatric, and ill people. Patients with injuries such as burns, shock, head injury, stroke, generalized infection, injuries to the spinal cord, diabetes, and hypoglycemia. How does the body eliminate heat? What's the most efficient? - ☑☑️☑️T️he most efficient way is sweating (evaporation) and dilating skin blood vessels to increase the rate of heat radiation. Conduction: The transfer of heat from a part of the body to a colder object or substance by direct contact. Ex: Touching a cold object Convection: When heat is transferred to circulating air, such as when cool air moves across the body surface. Ex: Standing in windy weather