FISDAP Paramedic Trauma Exam Graded A+ 2023

If you see a cracked windshield in a MVC... what will the pt represent with? - ANSWER-Bruised or lacerated head or face. Brain injury, *cervical spine injury (always until proven otherwise), tracheal injury. If you see a deformed steering column in a MVC... what will the pt represent with? - ANSWER-Bruised neck, bruised chest. Sternal or rib fracture, flail chest, myocardial contusion, *pericardial tamponade, pneumo/hemothorax, aortic tear. If you see a deformed dashboard in a MVC... what will the pt represent with? - ANSWER-Bruised abdomen, bruised knee, misplaced kneecap. Ruptured spleen, liver, bowel, diaphragm. Fractured patella, dislocated knee, *femoral fracture, dislocated hip. Phases of Deceleration - ANSWER-1) Deceleration of the vehicle, occurs when the vehicle strikes another object & comes to a stop. 2) Deceleration of occupant, which starts during sudden braking & continues through the whole crash. 3) Deceleration of internal organs, that consist of internal organs that continue forward momentum until they're stopped by anatomical restraints. 4) Secondary collisions, which occur when a vehicle occupant is hit by objects moving within the vehicle (loose objects). 5) Additional impacts, that the vehicle may receive when it is hit by a second vehicle or is deflected into another. Seat Belt Use - ANSWER-All arguments against seat belt use are unfounded. Primary Blast Injury - ANSWER-Injuries due to the wave blast itself, usually causing damage to the lungs, eardrums and other compressible organs (air filled cavities). Burns also may occur. Secondary Blast Injury - ANSWER-Injuries due to missiles being propelled by blast force (struck by flying debris). Tertiary Blast Injury - ANSWER-Injuries due to body impact with another object (when a person is hurled by the force against stationary objects). Perfusion - ANSWER-Circulation of blood within an organ or tissue in adequate amounts to meet the cells needs. Autonomic Nervous System - ANSWER-Monitors the body's needs from moment to moment, adjusting the blood flow as required. Maintains homeostasis & is divided into the parasympathetic & sympathetic components that oppose each other and keep vital functions in balance. Compensated Shock (Phase 1) - ANSWER-Tachycardia, NORMAL BP, thirst, anxiety, clammy/cool skin. Decompensated Shock (Phase 2) - ANSWER-AMS, DROP IN BP, thready/absent peripheral pulse, labored or irregular breathing. Wet Dressing - ANSWER-Used for small, superficial burns. Rhabdomyolysis - ANSWER-The destruction of muscle tissue leading to a release of potassium and myoglobin. Chemical Burns - ANSWER-Flush the area off with water, remove pt's clothing & jewelry. Hydrofluoric Acid (HF) - ANSWER-Is found in drain cleaner, and for etching glass, and in industrial settings. Pt will complain of burning, and will not stop with copious amounts of flushing. Calcium chloride will work to relieve the pain/burning. How to assess a electrical injury...? - ANSWER-The first thing is to protect yourself and bystanders. If powerlines are down on a car, you tell your pt to remain in the car and do not go near it. Le Fort 1 Fracture - ANSWER-From the bottom of the nose down. Involves the mandible and the maxilla. Le Fort 2 Fracture - ANSWER-Involving the nasal bone and the maxilla. Le Fort 3 Fracture - ANSWER-A fracture of all midfacial bones, seperating the entire midface from the cranium. Includes the eyes. Foreign Body in the Eye - ANSWER-Shards of metal, wood, etc. can become embedded into the globe of they eye. It can cause irritation and conjunctivitis. When this happens, attempt to flush out the eye from inside (tear duct) to out (outer corner). Dysconjugate Gaze - ANSWER-For paralysis of gaze or discoordination between the movements of the two eyes. When a foreign body is impaled in the globe... you should? - ANSWER-DO NOT remove it! Stabilize it, cover the eye with a moist, sterile dressing, place a cup or other protective barrier over the object & secure it in place with a bulky dressing. Cover the unaffected eye to prevent movement. When an impaled object is in the neck... you should? - ANSWER-Not remove the object, but try to stabilize it and control the bleeding from it. The ONLY exception for removing the object is if it interferes with your ability to manage the airway. In some cases, an emergency cric may be necessary. Frontal Lobe - ANSWER-(Forehead) Important for voluntary motor action and personality traits. Injury to the frontal lobe may result in seizures or placid reactions (flat affect). Parietal Lobe - ANSWER-Controls the somatic or voluntary sensory and motor functions for the opposite side of the body, as well as memory and emotions. Occipital Lobe - ANSWER-(Back of the head) Responsible for processing visual information. Temporal Lobe - ANSWER-(Side of the head) Speech area, hearing, taste and smell. Treating a pt with Head Trauma - ANSWER-Lidocaine to reduce ICP, maintain O2 sats above 95%, administer high flow O2 if pt is breathing on their own, avoid hyperventilation, restrict your use of IV fluids (unless hypotensive, then give fluid to keep systolic above 110 or 120), and do not give dextrose. Diaphragm - ANSWER-Phrenic nerve (C3-C5). Injury occurring at or above C3-C4 may cause diaphragmatic paralysis, that is seen with abdominal breathing and accessory muscle use. Levels of ICP - ANSWER-Mild- cheyne-stokes, increased BP, decreased HR, pupils stil reactive, AMS, vomiting. Moderate- widening pulse pressure w/ bradycardia, pupils are non-reactive, hyperventilation, posturing. Severe- blown pupil, biot's respirations, flaccid paralysis, irregular pulse rate, fluctuating BP (usually hypotension). Cheyne- Stokes Respirations - ANSWER-Respirations that are fast and then become slow, with intervening periods of apnea. Common in people with head injuries/ICP. Biots Respirations - ANSWER-Characterized by irregular rate, pattern, and volume of breathing with intermittent periods of apnea. Babinkski Reflex - ANSWER-Occurs when the toes move upward in response to stimulation of the sole of the foot. Under normal circumstances, the toes move downward. Coup Contrecoup - ANSWER-Front and rear injury. Brain slams into the front of the skull, and then slams into the back end of the skull. Autoregulation - ANSWER-The body responds to a decrease in CPP by increasing the MAP. Resulting in cerebral vasodilation and increased cerebral blood flow. However, this is a vicious cycle cause it actually increases ICP. Decorticate - ANSWER-Flexor posturing. Pt's limbs will be facing toward their core, involving flexion of the arms and legs.