EMS Training Institute
Office: (219) 947-6874 or (219) 947-6347
Fax: (219)947-6119
1500 South Lake Park Avenue, Hobart, IN 46342
E- Continuing Education
July 2013- Trauma
Due August 20, 2013
BLS portion:
2 hours
ALS portion: 4 hours
Complete packet:
6 hours
See Robert Boby, Jessica Lawley, Jeffrey Lawley, or Robert Scott for CEU signatures
Basic Life Support Research and Review (AAOS EMT 10th edition, PHTLS, 7th ed)
Define the following:
Kinetic energy
1.
Potential energy
2.
Index of suspicion
3.
Mechanism of injury
4.
5. What percentage of ejected occupants die?
6. Describe anatomical landmarks relating to proper seatbelt usage, and explain why this decreases injury:
7. Describe injuries seen when a seatbelt is not properly worn:
8. What are the typical “3 collisions” that occur in an MVC?
9. Complete the following:
Blast Injury type
Primary
Secondary
Tertiary
Quaternary
Caused by
Injuries seen
10. Decorticate posturing indicates damage to what portion of the brain?
11. Decerbrate posturing indicates damage to what portion of the brain?
12. What percentage of blood or fluid volume is lost before we see signs of decompensated shock? (i.e. low
blood pressure)
13. How does hypothermia and/or alcohol use effect bleeding and the trauma patient?
14. When is a tourniquet indicated?
15. Explain how to apply to CAT (combat application tourniquet), or an acceptable “home-made”
tourniquet:
16. After BSI and scene safety, what action should an EMT perform first for the patient with an open neck
or chest injury? (assume pt is breathing and had patent airway).
17. Differentiate between a simple pneumothorax and a tension pneumothorax:
18. Supraclavicular subcutaneous emphysema indicates what has happened to your patient?
19. How do you manage an impaled object in the eye?
20. Describe treatment for a patient with an abdominal evisceration:
21. Describe the “hallmark” signs and symptoms of an epidural bleed?
22. Why do the above signs/symptoms occur?
Advanced Life Support Research and Review (PHTLS 7th ed, Brady Paramedic Care Volume 5)
1. Complete the Haddon Matrix and list examples:
Host
Agent
Environment
Pre-event
Event
Postevent
2. Define CUPS and list an example of each:
Stands for:
Trauma Patient Example
C
U
P
S
3. Describe intent behind the 2011 CDC Field Triage Guidelines:
4. List the patient criteria for Steps 1 and 2 of the 2011 CDC Field Triage Guidelines:
Step 1:
Step 2:
5. Per the Indiana Trauma Triage Rule, explain when a trauma patient must be transported to a trauma center:
6. Explain how alcohol consumption (even below the legal limit) can impact the trauma patient negatively:
7. Explain the pathophysiology behind compartment syndrome:
8. What are the classic “P’s” associated with compartment syndrome?
9. Why can “crush syndrome” be nephrotoxic?
10. What medication carried in your ambulance may decrease toxic effects on the kidneys if administered to a patient
with a crush injury during a prolonged extrication?
11. Describe the process of hemostasis:
-Vascular phase-
-Platelet phase-
Coagulation phase12. List 5 common conditions or medications that inhibit normal hemostasis
13. Blood flow through the microcirculation is regulated by: ____________ and _______________ ________________.
14. Explain the role of baroreceptors, as it relates to shock:
15. Explain the role of chemoreceptors, as it relates to shock:
16. Explain the role of ADH, as it relates to shock:
17. Explain “capillary washout:”
18. Complete:
Early signs/symptoms of
internal bleeding
Late signs/symptoms of
internal bleeding
Very late signs/symptoms of
internal bleeding
19. The target blood pressure for a trauma patient is:
20. Describe how IV fluids should be administered to the decompensated trauma patient:
21. Why is Lactated Ringer’s often the “fluid of choice” for the trauma patient?
22. Explain “mean arterial pressure:”
23. What is the formula to calculate Cerebral Perfusion Pressure?
24. Explain what this means and how it correlates to the patient with TBI:
25. Define primary brain injury:
26. Explain secondary brain injury:
27. List five common causes of secondary brain injury:
28. Acute anisocoria is indicative of:
29. How should you treat this patient?
30. How does hypoglycemia affect the outcome of the TBI or stroke patient?
31. Describe the pathophysiology behind epidural bleeding and why sign/symptoms may be delayed in presentation up
to 10 days:
32. You are caring for a TBI patient that requires you to aggressively manage her airway, including sedation and
intubation. Why is lidocaine in the protocol as the first medication to give for sedation for intubation?
b. Should you neglect to administer the lidocaine, list the possible negative effects that could impact your patient:
c. Etomidate, versed, and fentanyl all have synergist /potentiating effects on each other. Explain what this means:
d. Per manufacturer instructions, etomidate is to be administered slowly over a period of 30-60 seconds. What can
occur that can negatively affect your ability to intubate this patient, should you administer this medication too rapidly?
33. While on this call, this patient displays signs of Cushing’s triad. Give an example of what these signs may be:
34. Commotio cordis is:
35. Blunt traumatic injury to the chest makes one suspect for tension pneumothorax and pericardial tamponade.
List associated clinical findings of each of these conditions:
a. Tension pneumothorax:
b. Cardiac tamponade:
37. You are assessing an unconscious, breathing patient that fell from 30 feet and struck a large tree limb prior to
striking the ground. Patient is non-responsive, has sonorous respirations at 12 (relieved by jaw-thrust, and the skin is
pale and cool. No life-threatening bleeding is seen. Upon assessment, you see redness to the abdomen and the anterior
thorax, ausculate bowel sounds in the left chest and note subcutaneous emphysema to the face. What injuries to you
suspect based on these findings alone?
b. How are you going to manage this patient’s condition?