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| First degree. Involve only epidermis. The skin turns red but does not blister or actually burn through. |
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| Second Degree. Burns involve some of the dermis, but they do not destroy the entire thickness of the skin. The skin is mottled, white to red, and is often blistered |
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| 3rd degree. Extend through all layers of the skin and may involve sucurtaneous tissue and muscle, the skin is very dry, leathery and often either white or charred. |
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| Superficial Burn Presents |
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| Pink or red with little or no swelling |
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| Using the surface of the patient's palm represents approximatley 1% of body surface area and is used to estimate percentage of burns |
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| Full thickness Burn Presents |
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| White, Waxy and painless. |
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| Twisted out of shape in no particular order or fashion. |
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| When C-Spine is suspected |
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| Manually stabilize C-Spine |
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| Prolinged compression forces applied to soft tissue. |
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| An injury in which soft tissue is torn completely loose or is hanging as a flap. |
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| A temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain. |
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| If direct pressure has failed to prevent bleeding control the next step is to apply tourniquet. |
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| Compartment Sydrome Signs |
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| Pain, paralysis, Paresthesias (tingling, Pressure and pulseless. |
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| Swelling in a confined space that produces dangerous pressure may cut off blood flow or damage sesitive tissue frquently seen in closed fractures below the elbow, knees and shoulder. |
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| Compartment Sydrome Treat. |
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| If the elbow align with gentle traction until resistance is met. |
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| Patient stabbed in the lower left quadrant. He has minor bleeding from the wound. What should you do? |
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| Apply an occlusive dressing. Occlusive dressing will help prevent the abdomen from becoming infected. If there was profuse bleeding, a sterile dressing would be appropriate. |
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| A bruise from an injury that causes bleeding beneath the skin withour breaking the skin. |
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| Blood fills the pericardial sac around the heart. The blood does not allow for the heart to fully expandand decrease cardiac output. Narrowing of the blood pressure. |
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| Open femur facture first thing you should do. |
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| Assess for a distal pulse. |
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| tear in the aorta. Signs Pain that radiates to the back. Verify obtain bilateral upper arm blood pressures |
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| Can develop into tension pneumothorax and is life threatening. |
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| Pain on inhalation and shortness of breath. A puncture wound between the nipples to umbillical |
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| Patient comes out of a burning building. First thing you should do? |
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| Remove any smoldering clothing |
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| Loss of superficial layer of skin due to body part scraping across rough or hard surface. |
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| Piece of glass impaled in eye. |
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| Stableize with a paper cup. |
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| Tension Pneumothorax Signs |
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| Hypotension, absent radial pulse, absent lung sounds, tracheal deviation and jugular vein distension. |
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| Tension Pneumothorax Pathology |
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| The affected side is hyperinflated and is stopping blood from returning to the heart. The onesided lung sounds,left lung is not exchanging air because air is trapped in the plural space. |
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| Blood in the Pleural of the lung |
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| When blood and air are present in the pleural space of the lung. |
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| 1. None 2. Pain 3. Responds to speech 4. Spontaneous |
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| 1. None 2. Incomprehesible 3. Inappropriate words 4. confused 5. oriented |
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| 1. None 2. Abnormal extension 3. Abnormal flexion 4 withdrawls from pain 5 localizes pain 6 obeys commmands |
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| Signs and symptoms of referred pain. |
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| Pain felt in an area of the body other than the area where the cause of pain is located. |
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| Left shoulder pain caused by blood in the peritoneal cavity |
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| A characteristic crackling sensation felt on the palpation of the skin, caused by the presence of air in soft tissues. |
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| A grinding sensation caused by fractured bone ends or joints rubbing together; alos airbubbles under the skin that produce crackling sound or crinkly feeling. |
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| Techniques for opening the airway |
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| Pathophysiology of CushingÕsÕ reflex |
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| Cushing tirade Ð the brain swells, Increased blood pressure and pulse goes down irregular respirations |
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| Complications of spinal cord injuries |
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| Numbness and tingling to the extremities |
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| Indications for spinal immobilization |
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| Car accident or high impact collision |
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| Signs and symptoms of commotion cordis |
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| Trauma to the heart at the correct point during venerable period. Puts patient into V-FIB. Treat with AED. |
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| Signs and symptoms of chest wall injuries (such as, but not limited to, sucking chest wound and tension pneumothorax) |
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| Worry about ribs breaking and puncturing through the lungs. Wound anywhere form the belly button to the clavical could be a respiratory issue |
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| If we donÕt know the back story we always put the patient in C-Spine |
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| Evaluate barriers from inhibiting CPR |
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| Remove impaled object in chest or airway that inhibit airway or ability to perform CPR |
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| Treat a patient with an abdominal evisceration |
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| Put sterile moist dressing over abdominal evisceration. C-Spine. |
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| Solid masses of tissue where much of the chemical work of the body takes place ( liver spleen, pancreas, and kidneys. |
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| Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and bladder. |
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| If one area is affected in the abodomen that is the last area we palpate. |
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| Low velocity something that is held in the hand, Medium velocity hand guns, High velocity military weapons. |
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| Treat a patient with a scalp injury |
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| High flow oxygen. Control bleed and don't apply pressure to open compressed skull injury. |
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| Only remove object if it interferes with CPR or airway and control bleeding with direct pressure and stabilizet he object using bulking dressing to prevent movement, tabe rigid object over impaled item and badaging. |
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| Treat a patient with soft tissue injury avulson |
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| If avulsion is complete wrap in sterile gauges and bring it to emergency room. Replace if not visibly contaminated with dirt and other forgien materials |
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| Treat a patient with a thermal injury |
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| Stop the burning source, cool burned area if appropriate and remove all jewlrey, suspect inhalation injuries, Dry dressing applied, |
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| Calculate percent of body surface area burned |
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| Differentiate between traumatic brain injury (TBI) patterns. |
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| Decreased mentation, irregular breathing pattern, slow heart rate, brusng about the eyes or ear. CSF leakage. Unequal Pupil size. Failure of puples to respond to light loss of sensation or motor function. Seizures. Abnormal behavior |
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| Brusing behind the ear over the mastoid process. From skull fracture. |
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| Treat a patient with an amputated extremity |
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| Use tornequt, Bring extremity to hospital, control bleeding, Immobilize part if partial amputation.Wrap complete part in sterile dressing in plastic bag, Pack on ice. |
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| Brusing around eyes due to skull fracture |
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| A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function. Hypopurfusion. Blood pressure changes is a late sign of shock]Compensation does not last forever. |
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| Decreased, absent lung sounds tracheal deviation. There is a hole in a lung and a shift in the lungs, which affects the other lung. Air in the parietal sac. Difference in lung sounds narrowing pressure. Each lung has its own sac but they share the same cavity and are subject to the same pressure. |
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| Tension Pneumothorax Treatment |
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| Pressure on the pericardial sac |
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| Some kind of obstruction. Ex. Tension pneumothorax |
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| In adequate function of the heart, pump failure. |
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| Severe Infection (meningitis is the most common. Have the patient move their neck forward if they have stiffness in the neck) |
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| Damage to the spinal cord |
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| Patient faints(syncope) due to stressful situations |
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| Loss of fluid or lack of fluid, Hemorrhagic (involves blood), Internal or external bleeding, Non-hemorrhagic (does not involve blood), Dehydration, Vomiting, Diarrhea |
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| Compensated, Decompensated, Irreversible, First things to change are pulse and AVPU |
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| Hypoperfusion that is leading to potential cellular death. |
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| Cells need a constant flow of these items. Oxygen, water, sugar and electrolytes (sodium potassium calcium. EMTs cannot figure this out) |
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| When we do not do a good job making sure there is no air in the lines |
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| On the neck or the thorax and put what type of dressing |
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| Spontaneous pneumothorax Tall thin skinny people. |
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| Any injury to the diaphragm or above should be assumed to impact the airway |
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| Signs of excessive bleeding page 784 |
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| Internal, External Ð clotting on the outside of the body |
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| Indications for tourniquet use |
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| When to us tourniquet,Direct pressure. More direct pressure, If you can not stop bleeding with direct pressure in 2 min try something elsepressure-dressing then tourniquet |
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| Call Hazmat What substance was involved |
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| Brush dry chemical off the skin and clothing before flushing the patient with water |
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| Inhalation burns are associated with stridor causes swelling |
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| CO is carbon monoxide is associated with combustion. Binds to hemoglobin much more readily than Oxygen. |
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| Amputation of hand or leg |
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| Out it in a bag. Put it on ice and attach it to a patient. So it does not get lost |
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| Face and neck bleed a lot |
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| Unequal pupils point to head injury and the big one does not react to light. |
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| Give to als, Swelling underneath skin, Crackling sensation |
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