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PHTLS- Kinematics, Scene, Shock
PHTLS-Kinematics, Scene, Shock
88
Medical
Professional
07/03/2010

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Cards

Term
What are the 3 phases of a CRASH?
Definition
precrash, crash, postcrash
Term

(Which Crash??)    

 

All the events that preced the incident, sich as the ingestion of alcohol or drugs.

Definition
precrash  
Term

(which crash??)

 

the time of impact between one moving object and a second object.

Definition
crash phase
Term
3 impacts normally occur in most vehicular crashes. What are they??
Definition

1) impact of the 2 objects

2) impact of the occupant into the vehicle

3) impact of the vital organs inside the occupants

Term

(which crash??)

 

when the information is gathered about the crash

Definition
postcrash
Term
The process of surveying the scene to determine what injuries might have resulted from the forces and motion involved is called?
Definition
kinematics
Term
What is Newtons first law of motion?
Definition
a body at rest tends to stay at rest and a body in motion will stay in motion unless acted on by an outside force.
Term
What is the law of conservation of energy?
Definition
energy can not be created or destroyed but can change form.
Term
What has a greater effect on the amount of kinetic energy produced mass or velocity?
Definition
velocity
Term
What is the formula for kinetic energy?
Definition
One-half the mass times the velocity squared
Term
The whole or cavity created when a solid object strikes the human body and those tissues are knocked out of there normal position is called?
Definition
Cavitation
Term
What are the 2 types of cavities created?
Definition
A temporary cavity and a permanent cavity
Term
Which type of cavity is visible to first responders or in the hospital setting and why?
Definition
the permanent cavity because it does not rebound to its original shape
Term
What kinds of trauma are associated with blunt trauma and the human body?
Definition
shear tears and cavitation
Term
The result of one organ or structure changing speed faster then another organ or structure is called what?
Definition
Shear
Term
the result of an organ or structure being directly squeezed between other organs or structures.
Definition
Compression
Term
What is the most common form of blunt trauma?
Definition
MVC's
Term
What organs are subject to shear injuries?
Definition

kidneys

spleen

liver

Term
A dislocated knee with torn ligaments, tendons, and other supporting structures are scene with what type of MVC?
Definition
Down and Under path
Term
Because the _________  __________   lies close to the knee joint, dislocation of the joint often is associated with injury to this vessel.
Definition
popliteal artery
Term
In what type of MVC does a restrained patient often sustain sheraing type injuries because of the significant force created?
Definition
Rollover
Term
In what MVC does the head of the femur get pushed through the acetabulum, splenic injuries occur, and the head hits impacts the frame on the door?
Definition
Lateral impact
Term
The proper use of restraints transfers the impact from where?
Definition
the patients body to the restraint system
Term
What types of injuries are scene with as a result of seatbelts and the abdominal cavity during a MVC?
Definition
Compression
Term
What type of compression injuries occur to the organs between the abdominal wall and the seatbelt?
Definition

spleen

liver

pancreas

Term
An airbag deploys and deflates within?
Definition
.5 seconds
Term
Failure to use helmets has been shown to increase head injuries in motorcyclists by more then ____ ?
Definition
300%
Term
What are the effects of a MCV on a child? Where does the car hit? Are they thrown clear? Do they run away? Etc.
Definition

Children are not usually thrown clear

Normally drug by the vehicle under the front end

Normally will turn towards the car out of curiosity.

 

Term
The type of surface in which a person lands in a fall and it's _________ have an effect on stopping distance.
Definition
degree of compressibility = ablility to be deformed by the transfer of energy.
Term
The pattern of falls where you land feet first is called?
Definition
Don Juan Syndrome
Term
What kinds of injuries are associated with Don Juan syndrome?
Definition
bilateral fractures to the calcaneus, ankles, tib/fib, and femur.
Term
If a person falls forward with hands outstretched and lands on their hands what are the fractures of the wrist called?
Definition
Colles' fractures
Term
Pulmonary bleeding, pneumothorax, air emboli, perforation of the GI organs are all ________ injuries of a Blast?
Definition
Primary
Term
The classic sign of a blast injury and indicative of a pneumothorax is a....?
Definition
tympanic rupture
Term
The most common cause of death due to a primary blast is?
Definition
Cardiac arrest and pulmoary injury aka "blast lung"
Term
When fragmentation occurs in a blast and a patient is struck by primary fragments is what phase?
Definition
Secondary injuries
Term
When the victim is thrown against an object or hit with a large object propelled by a blast?
Definition
Tertiary injuries
Term
The injuries in a blast imposed by heat or fumes created by the explosion.
Definition
Quaternary injuries
Term
The myriad of health affects caused by additives to bombs such as bacteria, radiation, and chemicals.
Definition
Quinary injuries
Term
When a patient takes a deep breath and holds it just before impact of a MVC. This closes the glottis sealing off the lungs, the lungs burst like a bag full of air.
Definition
Paper Bag Effect
Term
The weakest of all the walls or structures surrounding the abdominal cavity is the
Definition
diaphragm
Term
What happens if you rupture the diaphragm?
Definition

The "bellows" effect is lost

 

Abdominal organs can enter the thoracic cavity

 

blood can cause a hemothorax

Term
What term decribes an objects initial size and whether that size changes at the time of impact?
Definition
Profile
Term
What term describes whether the object tumbles and assumes a different angle inside the body than the angle assumes as it entered the body?
Definition
Tumble
Term
What term describes whether or not the object breaks up after it enters the body?
Definition
fragmentation
Term
Damage produced by a knife depends on what?
Definition
movement of the blade inside the victim
Term
The round or oval wound produced by a gunshot is called?
Definition
stellate (starburst)
Term
When the muzzle is touching the patient at the time the weapon is discharged what kind od wound?
Definition
Contact
Term
What kind of wounds has a 85-90 % mortality rate?
Definition
Contact
Term
What is the highest level of protection required by OSHA for workers on highways at night time?
Definition
Level 3
Term

What are the Violent Scene Safety Rules?

(There are 4)

Definition

1) Dont be there

2) Retreat

3) Diffuse

4) Defend

Term
The incubation period of HBV is usually?
Definition
60-90 days
Term
What is the incubation period for HCV?
Definition
6 to 9 weeks
Term
Hepatitis C is primarily transmitted by?
Definition
blood
Term
Hepatitis B is usually transmitted by?
Definition
Blood or sexual contact
Term
Most IV drug users have what form of Hepatitis?
Definition
HCV
Term

Regarding HIV, unless obvious blood is present..

tears, urine, sweat, feces, and saliva are all ___?

Definition
noninfectious
Term
What is the difference between Incident Command and Unified Command?
Definition
Unified Command takes into account the needs of coordinating agencies.
Term
Who is solely responsible for incident management?
Definition
IC
Term
Regarded as the state of generalized HYPOperfusion?
Definition
Shock
Term

What type of shock?

 

 

primarily hemorrhagic, related to the loss of circulating blood volume

Definition
hypovolemic
Term

What type of shock?

 

 

Related to the abnormaility in vascular tone arising from several different causes

Definition
Distributive
Term

What type of shock?

 

related to the interferrence with the pump action of the heart

Definition
cardiogenic
Term
What is the most common form of Shock?
Definition
Hemorrhage = Hypovolemic
Term
The difference between the systolic blood pressure and the diastolic is called?
Definition
pulse pressure
Term
What is MAP
Definition
Mean arterial pressure and it is the average pressure in the vascular system.
Term
What marks the switch from compensated shock to decompensated shock?
Definition
a drop in BP
Term
What defines CLASS 1 shock??
Definition

Amount of blood loss <750ml

Heart rate usually normal

Ventilatory rate usually normal

Term
What defines Class 2 Shock??
Definition

Blood loss  750-1500ml

Heart Rate  > 100

Ventilatory rate 20-30

Term
What defines Class 3 shock??
Definition

Amount of blood loss 1500-200 ml

Heart Rate > 120

Respiratory Rate 30-40

Term
What defines Class 4 Shock??
Definition

Blood loss > 2000 ml

Heart Rate > 140

Respiratory Rate > 35

Term
What is the main diffrence between Neurogenic shock signs and all other forms of shock?
Definition

Skin signs are warm, dry and pink

Lucid interval

Term
Heart muscle damage and dysrhymias are what type of cause for Cardiogenic shock?
Definition
Intrinsic
Term
A cardiac tamponade and tension pneumothorax are what type of cause for cardiogenic shock?
Definition
Extrinsic
Term
If a patient presents tachycardic, white cool and moist, with a normal BP and LOC are they in compensated or decompensated shock?
Definition
Compensated
Term
If a patient presents with tachycardia, white cold and waxy skin and a decreased BP and Altered LOC are they in Compensated or Decompnsated shock?
Definition
Decompensated   pg 117
Term
Who has the most ability to compensate for blood loss?
Definition
children and young adults
Term
A broken rib can create how much blood loss?
Definition
125cc
Term
A broken radius or ulna can create how much blood loss?
Definition
250-500 cc
Term
A broken Humerus can create how much blood loss?
Definition
500-750 cc
Term
A broken Tib/Fib can create how much blood loss?
Definition
500-1000 cc
Term
A broken femur can create how much blood loss?
Definition
1000-2000 cc
Term
A broken pelvis can create how much blood loss?
Definition
1000-massive
Term
What are contraindications to the use of MASG pantalones?
Definition

penetrating thoracic trauma

splinitng of a lower extremity

evisceration of abodominal organs

impaled objects in the abdomen

pregnancy

traumatic cardiopulmonary arrest.

Term
When the velcro straps between to crackle on MASG pants the pressure is usually between?
Definition
60-80 mmHg
Term
What is the isotonic solution of choice for management of shock?
Definition
Lactated Ringers (LR)
Term
Any IV fluid given to a shock patient should be warm, ideally around what?
Definition
102 degrees
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