Download West Coast EMT Block 4 Exam Study Guide Questions and Answers Latest Update 2023,2024, and more Exams Nursing in PDF only on Docsity!
West Coast EMT Block 4 Exam Study
Guide Questions and Answers Latest
Update 2023,2023,100%
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Know what cavitation is
- ☑️☑️☑️ Results 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
- ☑️☑️☑️ The 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
- ☑️☑️☑️ The 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
- ☑️☑️☑️ The 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:
- ☑️☑️☑️ The 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:
- ☑️☑️☑️ The 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.
What is the purpose of a head rest? What can it prevent?
- ☑️☑️☑️ Headrests decrease the extension of the head and neck during a crash and help reduce injury (mainly whiplash injury). Arteries
- ☑️☑️☑️ A blood vessel, consisting of three layers of tissue and smooth muscle, that carries blood away from the heart. Arterioles - ☑️☑️☑️ The smallest branch of arteries leading to the vast network of capillaries. Capillaries - ☑️☑️☑️ The smallest blood vessels that connect arterioles and venules; various substances pass through capillary walls, into and out of the interstitial fluid, and then on to the cells. Venules - ☑️☑️☑️ Small, thin-walled blood vessels of the veins. Veins
- ☑️☑️☑️ Blood vessels that carry blood from the tissues to the heart. What affects the ability of the blood to clot? - ☑️☑️☑️ Movements, disease process, certain medications (blood thinners), removal of bandages, the external environment, or body temperature
What happens after soft tissue has been damaged? (*hint, look up the wound healing process) - ☑️☑️☑️ The wound healing process starts. First stage is to stop bleeding through blood clotting in order to maintain homeostasis. Second stage, inflammation, additional cells move into the damaged area to begin repair. White blood cells migrate to the area to combat pathogens that have invaded the exposed tissue. 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
- ☑️☑️☑️ Heart: 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.
seconds in infants and children, weak rapid pulse, decreasing blood pressure, and altered level of consciousness. When should we suspect a GI bleed? - ☑️☑️☑️ Vomiting 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 - ☑️☑️☑️ Early: Contusion/ ecchymosis caused by the accumulation of blood around Late: Hypovolemic Shock How do we control external bleeds? - ☑️☑️☑️ Direct even pressure Pressure dressing and/or splint Tourniquets What's the most effective way to control arterial bleeds? - ☑️☑️☑️ Direct pressure and tourniquet. Know the rule of 9's + differences between adults and children in relation to TBSA - ☑️☑️☑️ Adult 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 Groin: 1% Know differences in burns (1st, 2nd & 3rd degree) - ☑️☑️☑️ Superficial (first-degree) burn: Involves only the top layer of the skin, the epidermis. The skin turns red but does not blister or burn through this top layer. often painful. Partial-thickness (second-degree) burns: Involves the epidermis and some portion of the dermis. These burns do not destroy the entire thickness of the skin nor is the subcutaneous tissue injured.
- Skin is moist, mottled, and white to red. Blisters are present. Pain. Full-thickness (third-degree) burn: Extends through all layers of skin, sometimes muscle bones, and internal organs are affected too.
- Dry and leathery. Feels hard to touch. Appear white, dark brown, or even charred. Severely burned areas may not feel anything. Know electrical burns - ☑️☑️☑️ There must be a complete circuit between the electrical source and ground for the electricity to flow. Any substance that prevents this flow is an insulator, any substance that allows the flow of current is a conductor.
Immediate emergency medical car and transport. Clear and maintain the airway and provide oxygen and us occlusive dressings to seal the open wound and prevent air from being sucked into the chest. What should you suspect with a patient who suffered a closed soft-tissue injury? - ☑️☑️☑️ Suspect internal bleeding and damaged internal organs. Remain alert for signs of shock. Know what the mandible is - ☑️☑️☑️ Jaw bone Where is the mastoid process located? - ☑️☑️☑️ One 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? - ☑️☑️☑️ The other portion of the larynx. A firm ridge of cartilage below the thyroid cartilage. What is another name for your eyeball? - ☑️☑️☑️ The globe What is conjunctiva & sclera? - ☑️☑️☑️ Conjunctiva: 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:
- 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 - ☑️☑️☑️ Chemical 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 - ☑️☑️☑️ Laceration: 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 - ☑️☑️☑️ Painless but flashing lights, specks, or "floaters" in the field of vision.
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? - ☑️☑️☑️ Cerebrospinal 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. It acts as a shock absorber. The brain and the spinal cord float in this fluid, buffered from injury. Another protective layer. What is the purpose of sensory nerves? - ☑️☑️☑️ Perceive only one type of information, carry that information from the body to the brain via the spinal cord. What is the purpose of the parasympathetic nervous system? How can you tell when it's activated? - ☑️☑️☑️ The parasympathetic nervous system has the opposite effect of the fight-or-flight mode causing blood vessels to dilate, slowing heart rate, and relaxing the muscle sphincters. When this system is activated, the body shunts blood to the digestive organs. What organs are contained in the mediastinum? - ☑️☑️☑️ Heart, thymus gland, great vessels, portions of the esophagus, and trachea. What does the phrenic nerve do and where does it exit the spinal cord? - ☑️☑️☑️ Innervates the diaphragm muscle. Originates at the C3 through C5 which exists the spinal cord at the neck root and descends caudally, parallel to the pericardial sac.
What is peritonitis? - ☑️☑️☑️ Inflammation of the peritoneum. The first signs of peritonitis are severe abdominal pain, tenderness, and muscular spasm. Later, bowel sounds diminish or disappear as the bowel stops functioning. A patient may feel nauseous and vomit; the abdomen may become distended and firm to the touch; and infection may occur. Peritonitis is serious and may become life threatening. Bruising to the liver would be indicative of what? - ☑️☑️☑️ Blunt trauma, closed injury. What is the mesentery? - ☑️☑️☑️ The intestinal blood supply comes from the mesentery The term refers to any fold of tissue that attaches an organ to the body wall. Usually used in reference to the intestinal mesentery: a fold of tissue that contains a web of vessels, both arteries and veins, as well as nerves and lymphatic tissues. What are distention & guarding from DR-GERM? - ☑️☑️☑️ Distention: Abdominal distention or swelling that occurs between the xiphoid process and the groin is often the result of free fluid, blood, or organ contents spilling into the peritoneal cavity. Guarding: Contracting the stomach muscles to minimize the pain of abdominal movements; a sign of peritonitis. How should a seatbelt be worn? - ☑️☑️☑️ Seat belt should lie below the anterior superior iliac spines of the pelvis and against the hip joints.
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) - ☑️☑️☑️ Remember 1 liter per femur! (also 1 liter = 1,000mL....hint, hint) What is the most common & severe complication of dislocations to the knee? - ☑️☑️☑️ Posterior 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? - ☑️☑️☑️ The clavicle or collarbone What is a Colles fracture? - ☑️☑️☑️ Fracture of the distal radius. How do you splint the wrist? - ☑️☑️☑️ Step 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? - ☑️☑️☑️ Skeletal muscles that attach to the bones and usually cross at least one joint. Voluntary What is atrophy? - ☑️☑️☑️ Decrease 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) - ☑️☑️☑️ Place 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? - ☑️☑️☑️ Insert the thermometer in the rectum. When does a person lose their ability to shiver? - ☑️☑️☑️ As cold exposure worsens and hypothermia gradually becomes severe. Know S&S generalized hypothermia - ☑️☑️☑️ Signs 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 - ☑️☑️☑️ Risk 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? - ☑️☑️☑️ The most efficient way is sweating (evaporation) and dilating skin blood vessels to increase the rate of heat radiation.
High humidity will also decrease the evaporation of sweat Know S&S of heat stroke, when/how it occurs - ☑️☑️☑️ Signs and symptoms include: Hot, dry, flushed skin, altered level of consciousness, unconsciousness, seizures in some cases, pulse becomes weak and blood pressure falls. Occurs when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed. The body temperature rises rapidly to the level at which the tissues are destroyed Risk factors of heat stroke - ☑️☑️☑️ Risk factors include patients who are involved in vigorous physical activity or when they are outdoors or in a closed, poorly ventilated, humid space. Also occurs during heat waves among people who live in buildings with no air conditioning or with poor ventilation. May also occur in children left unattended in locked vehicles on a hot day. How would diuretics affect a person experiencing heat-related emergencies? - ☑️☑️☑️ Dehydration will occur quicker Why would pulse oximetry readings be inaccurate in hypothermic patients? - ☑️☑️☑️ Because of the lack of perfusion in the extremities.
How can you reduce heat loss? (*hint why do we wear beanies in the winter?) - ☑️☑️☑️ Layers of clothing that provide good insulation, such as wool and synthetic fabrics. Protective clothing traps perspiratio and prevents evaporation. Keep head, hands, and feet covered.
