Chapter 13
Bleeding, Shock, and
Soft-Tissue Injuries
National EMS Education
Standard Competencies (1 of 10)
Pathophysiology
Uses simple knowledge of shock and
respiratory compromise to respond to life
threats.
National EMS Education
Standard Competencies (2 of 10)
Shock and Resuscitation
Uses assessment information to recognize
shock, respiratory failure or arrest, and
cardiac arrest based on assessment findings
and manages the emergency while awaiting
additional emergency response.
National EMS Education
Standard Competencies (3 of 10)
Trauma
Uses simple knowledge to recognize and
manage life threats based on assessment
findings for an acutely injured patient while
awaiting additional emergency medical
response.
National EMS Education
Standard Competencies (4 of 10)
Bleeding
Recognition and management of
• Bleeding
Head, Facial, Neck, and Spine Trauma
Recognition and management of
• Life threats
National EMS Education
Standard Competencies (5 of 10)
Chest Trauma
Recognition and management of
• Blunt versus penetrating mechanisms
• Open chest wound
• Impaled object
National EMS Education
Standard Competencies (6 of 10)
Abdominal and Genitourinary Trauma
Recognition and management of
• Blunt versus penetrating mechanisms
• Evisceration
• Impaled object
National EMS Education
Standard Competencies (7 of 10)
Soft-Tissue Trauma
Recognition and management of
• Wounds
• Burns
– Electrical
– Chemical
– Thermal
• Chemicals in the eye and on the skin
National EMS Education
Standard Competencies (8 of 10)
Multi-system Trauma
Recognition and management of
• Multi-system trauma
National EMS Education
Standard Competencies (9 of 10)
Medicine
Recognizes and manages life threats based
on assessment findings of a patient with a
medical emergency while awaiting additional
emergency response.
National EMS Education
Standard Competencies (10 of 10)
Immunology
Recognition and management of shock and
difficulty breathing related to
• Anaphylactic reactions
Diseases of the Eyes, Ears, Nose, Throat
Recognition and management of
• Nosebleed
Introduction
• Damage to internal soft tissues and organs
can cause life-threatening problems.
– Internal bleeding results in shock.
– Shock is a state of collapse of the cardiovascular system that results in inadequate
delivery of blood to the organs.
– More trauma patients die from shock than from
any other condition.
Patient Assessment for Bleeding,
Shock, and Soft-Tissue Injuries (1 of 3)
Patient Assessment for Bleeding,
Shock, and Soft-Tissue Injuries (2 of 3)
• Follow the steps of the patient assessment
sequence.
– The scene size-up needs to ensure safety both
for you and your patient.
– You may need to halt the primary assessment if
the patient is losing too much blood.
– During the secondary assessment, be alert for
signs and symptoms of shock from internal or
external blood loss.
Patient Assessment for Bleeding,
Shock, and Soft-Tissue Injuries (3 of 3)
• Follow the steps of the patient assessment
sequence. (cont’d)
– When performing a reassessment, watch the
patient for signs and symptoms of shock:
• Pale skin
• Increasing pulse rate
• Decreasing blood pressure
Standard Precautions and
Soft-Tissue Injuries
• The concept of standard precautions
assumes that all body fluids are potentially
infectious.
• Take appropriate measures to prevent
contact with the patient’s body fluids.
– Wear gloves.
– If appropriate, wear a surgical mask and eye
protection.
Parts and Function of the
Circulatory System (1 of 9)
Parts and Function of the
Circulatory System (2 of 9)
• The pump
– The heart functions as the human circulatory
system’s pump.
– The heart consists of four separate chambers.
• The two upper chambers on the top of the
heart are the left and right atria.
• The two lower chambers on the bottom of the
heart are the left and right ventricles.
Parts and Function of the
Circulatory System (3 of 9)
Parts and Function of the
Circulatory System (4 of 9)
Parts and Function of the
Circulatory System (5 of 9)
• The pipes
– The arteries carry
blood away from the
heart.
– The capillaries form a
network that
distributes blood to all
parts of the body.
– The veins return the
blood from the
capillaries to the
heart.
Parts and Function of the
Circulatory System (6 of 9)
Parts and Function of the
Circulatory System (7 of 9)
• The fluid
– The liquid part of the
blood is plasma.
– Red blood cells carry
oxygen and CO2.
– White blood cells
consume bacteria and
viruses to combat
infections in the body.
– Platelets form clots
that help stop
bleeding.
Parts and Function of the
Circulatory System (8 of 9)
Parts and Function of the
Circulatory System (9 of 9)
• Pulse
– A pulse is the pressure wave generated by the
pumping action of the heart.
– In a conscious patient, you can easily find the
radial (wrist) pulse at the base of the thumb.
– If the patient appears to be in shock or is
unconscious, attempt to locate the carotid pulse
first.
Shock
• Shock is defined as failure of the circulatory
system.
• Circulatory failure has many possible
causes, but the three primary causes are:
– Pump failure
– Pipe failure
– Fluid loss
Pump Failure
• Cardiogenic shock occurs if the heart
cannot pump enough blood to supply the
needs of the body.
– Pump failure can result from a heart attack.
• Inadequate pumping of the heart can cause
blood to back up in the vessels of the lungs,
resulting in congestive heart failure (CHF).
Pipe Failure (1 of 4)
• Pipe failure is caused by the expansion of
the capillaries to as much as three or four
times their normal size.
– Blood pools in the capillaries.
– The rest of the body is deprived of blood.
– Blood pressure falls and shock results.
Pipe Failure (2 of 4)
• Shock induced by fainting (psychogenic
shock)
– Fainting is a short-term condition that corrects
itself once the patient is placed in a horizontal
position.
Pipe Failure (3 of 4)
• Anaphylactic shock
– Caused by an extreme allergic reaction to a
foreign substance
– The patient appears flushed, breathing may
become difficult, and blood pressure drops
rapidly.
– Death will result if prompt action is not taken.
Pipe Failure (4 of 4)
• Spinal shock
– May occur in patients who have sustained a
spinal cord injury
– The injury allows the capillaries to expand, and
blood pools below the level of the injury.
– The brain, heart, lungs, and other vital organs
are deprived of blood, resulting in shock.
Fluid Loss (1 of 3)
• Fluid loss caused by excessive bleeding
(hemorrhage) is the most common cause of
shock.
– Blood escapes from a wound and the system’s
total fluid level drops.
– The heart begins to pump faster to maintain
pressure in the pipes.
– The pump eventually stops pumping, resulting
in cardiac arrest.
Fluid Loss (2 of 3)
• External bleeding is easy to detect.
• With internal bleeding, the bleeding cannot
be seen, but you may see these signs:
– Bruising
– Swelling
– Rigidity in the affected area
– Severe pain in the immediate area
Fluid Loss (3 of 3)
• Whether the bleeding is external or internal,
if it remains unchecked, the result will be
shock, pump failure, and death.
• An average adult has about 12 pints (5.7 L)
of blood circulating in the system.
– The loss of 2 or more pints can lead to shock.
Signs and Symptoms
of Shock (1 of 2)
• Shock deprives the body of sufficient blood
to function normally.
– As shock progresses, the body alters its
functions in an attempt to maintain sufficient
blood supply.
• Signs and symptoms of shock
– Confusion, restlessness, or anxiety
– Cold, clammy, sweaty, pale skin
Signs and Symptoms
of Shock (2 of 2)
• Signs and symptoms of shock (cont’d)
– Rapid breathing
– Rapid, weak pulse
– Increased capillary refill time
– Nausea and vomiting
– Weakness or fainting
– Thirst
General Treatment
for Shock (1 of 3)
• Position the patient
correctly.
– If the patient has no
head injury,
extreme discomfort,
or difficulty
breathing, lay the
patient flat on his or
her back on a
horizontal surface.
– Elevate the legs 6"
to 12" off the floor.
General Treatment
for Shock (2 of 3)
• Maintain the patient’s ABCs.
• Treat the cause of shock, if possible.
• Maintain the patient’s body temperature.
• Do not allow the patient to eat or drink.
– Eating or drinking may cause vomiting.
– Patients in shock may need surgery and should
not have anything in their stomachs.
General Treatment
for Shock (3 of 3)
• Assist with other treatments.
– If you are trained in the administration of
oxygen, provide it to shock patients.
– AEMTs or paramedics can administer
intravenous (IV) fluids.
• Arrange for transport.
Treatment for Shock Caused
by Pump Failure
• Pump failure is a serious condition.
• Proper treatment and prompt transport by
ambulance to an appropriate medical facility
will give these patients their best chance for
survival.
Treatment for Shock Caused
by Pipe Failure
• Treatment for anaphylactic shock
– Transport as soon as possible.
– Some patients may carry an epinephrine autoinjector.
• Support the patient’s thigh and place the tip
of the auto-injector against the outer thigh.
• Push the auto-injector firmly against the thigh
and hold it in place for several seconds.
Treatment for Shock Caused
by Fluid Loss
• Shock caused by internal blood loss
– Bleeding from stomach ulcers, ruptured blood
vessels, or tumors can cause internal bleeding
and shock.
– Patients with internal bleeding may exhibit:
• Coughing or vomiting of blood
• Abdominal tenderness, rigidity, bruising,
distention
• Rectal bleeding
• Vaginal bleeding in women
Controlling External Blood
Loss (1 of 8)
Controlling External Blood
Loss (2 of 8)
• Capillary bleeding
– Most common type of external blood loss
– The blood oozes out.
– Apply direct pressure to the site.
• Venous bleeding
– Second most common type
– This bleeding has a steady flow.
– Apply direct pressure for at least 5 minutes.
Controlling External Blood
Loss (3 of 8)
• Arterial bleeding
– Most serious type of bleeding
– Arterial blood spurts or surges with each
heartbeat.
– Exert direct pressure and maintain pressure
until EMS arrives.
Controlling External Blood
Loss (4 of 8)
• Direct pressure
– Place a dry, sterile
dressing directly on
the wound and press
with a gloved hand.
– Wrap the dressing
and wound snugly
with a roller gauze
bandage.
Courtesy of Rhonda Beck
– Do not remove a
dressing after you
apply it.
Controlling External Blood
Loss (5 of 8)
• Elevation
– If direct pressure
does not stop
external bleeding
from an extremity,
elevate the injured
arm or leg as you
maintain direct
pressure.
Controlling External Blood
Loss (6 of 8)
• Tourniquets
– Indicated only in situations where extremity
bleeding cannot be controlled by direct pressure
or elevation
– Follow the steps in Skill Drill 13-1 to control
bleeding with a tourniquet.
Controlling External Blood
Loss (7 of 8)
• Pressure points
– Used in cases where a wound is too close to
the trunk to apply a tourniquet
– Prevent blood from flowing into the limb by
compressing the artery against the bone
– The brachial artery pressure point and the
femoral artery pressure point are the most
important.
Controlling
External Blood
Loss (8 of 8)
Standard Precautions and
Bleeding Control
• Wear nitrile or latex gloves whenever you
might come in contact with a patient’s blood
or body fluids.
– If you do get blood on your hands, wash it off as
soon as possible with soap and water.
– If you cannot wash your hands, use a waterless
hand-cleaning solution that contains an effective
germ-killing agent.
Wounds
• A wound is an injury caused by any physical
means that leads to damage of a body part.
– Wounds are classified as open or closed.
Closed Wounds
• The skin remains intact.
• The only closed wound is the bruise.
– Injury of the soft tissue beneath the skin
– Small blood vessels are broken.
– The area becomes discolored and swells.
– A simple bruise heals quickly.
• Bruising and swelling may be a sign of an
underlying fracture.
Open Wounds (1 of 8)
• An open wound results in a break in the
skin.
• Abrasion
– Also called a scrape, road rash, or rug burn
– Occurs when the skin is rubbed across a rough
surface
Open Wounds (2 of 8)
Open Wounds (3 of 8)
• Puncture
– Occurs when a sharp object penetrates the skin
– May cause deep injury that is not immediately
recognized
– Puncture wounds do not bleed freely.
– An impaled object sticks out of the skin.
– A gunshot wound is a special type of puncture
wound.
Open Wounds (4 of 8)
© E. M. Singletary, M.D. Used with permission.
Open Wounds (5 of 8)
• Laceration
– Most common type of open wound
– Commonly called a cut
– Minor lacerations may require little care.
– Large lacerations can cause extensive bleeding
and even be life threatening.
Open Wounds (6 of 8)
© English/Custom Medical Stock Photo
Open Wounds (7 of 8)
• Avulsions and amputations
– An avulsion is a tearing away of body tissue.
– If an entire body part is torn away, the wound is
called a traumatic amputation.
– Amputated parts should be:
• Located
• Placed in a clean plastic bag
• Kept cool
• Taken to the hospital for possible
reattachment
Open Wounds (8 of 8)
Principles of Wound Treatment
• Very minor bruises need no treatment.
• Other closed wounds should be treated by:
– Applying ice and gentle compression
– Elevating the injured part
• Splint all major contusions.
• Stop bleeding as quickly as possible using
the cleanest dressing available.
Dressing and Bandaging
Wounds (1 of 7)
• Dressings and bandaging are applied to:
– Control bleeding
– Prevent further contamination
– Immobilize the injured area
– Prevent movement of impaled objects
Dressing and Bandaging
Wounds (2 of 7)
• Dressings
– A dressing is an object placed directly on a
wound to control bleeding and prevent further
contamination.
– Once a dressing is in place, apply firm, direct
manual pressure on it to stop any bleeding.
– The three most common sizes are 4"  4" gauze
squares, 5"  9" heavier pads, and
10"  30" trauma dressings.
Dressing and Bandaging
Wounds (3 of 7)
• Dressings (cont’d)
– If bleeding
continues after you
have applied a
compression
dressing, put
additional gauze
pads over the
original dressing.
Dressing and Bandaging
Wounds (4 of 7)
• Bandaging
– A bandage is used to hold the dressing in place.
– Roller gauze and triangular bandages are
commonly used in the field.
Dressing and Bandaging
Wounds (5 of 7)
• Principles of bandaging
– Ensure that the dressing completely covers the
wound and extends beyond all sides of the
wound.
– Wrap the bandage just tightly enough to control
bleeding, but not so tightly that circulation is cut
off.
– Check circulation regularly.
– Secure the bandaging so that it cannot slip.
Dressing and Bandaging
Wounds (6 of 7)
• Standard precautions techniques for the
EMR
– Wear gloves to avoid contact with the patient’s
blood.
– Nitrile or latex medical gloves can be stored on
the top of your EMR life support kit or in a
pouch on your belt.
Dressing and Bandaging
Wounds (7 of 7)
Face and Scalp Wounds (1 of 4)
• A relatively small laceration to the face and
scalp can result in a large amount of
bleeding.
• You can control almost all facial or scalp
bleeding by applying direct manual
pressure.
– Direct pressure compresses the blood vessels
against the skull and stops the bleeding.
Face and Scalp Wounds (2 of 4)
Face and Scalp Wounds (3 of 4)
• For wounds inside the cheek:
– Hold a gauze pad inside the mouth.
– Always keep the airway open.
• Scalp lacerations can be associated with
skull fractures or brain injury.
– If any brain tissue or bone fragments are visible,
do not apply pressure.
– Cover the wound loosely.
Face and Scalp Wounds (4 of 4)
• With head injuries, the neck and spine may
also be injured.
– Move the head as little as possible and stabilize
the neck.
– Monitor the patient’s airway and breathing and
protect the spine.
Nosebleeds (1 of 2)
• Nosebleeds can result from injury, high
blood pressure, or dry air.
• A nosebleed with no apparent cause is
called a spontaneous nosebleed.
• Management
– Unless the patient is experiencing shock, have
the patient sit down and tilt the head slightly
forward.
Nosebleeds (2 of 2)
• Management
(cont’d)
– Pinch both nostrils
together for at least
5 minutes.
– If the nosebleed
persists or is very
severe, arrange for
transport.
Eye Injuries (1 of 2)
• When an eye laceration is suspected, cover
the entire eye with a dry gauze pad.
– Have the patient lie on his or her back and
arrange for transport.
• If a small foreign object is lying on the
surface of the eye, use a saline solution to
flush the object from the eye.
Eye Injuries (2 of 2)
• Impaled object
– Immediately place
the patient on his or
her back and cover
the injured eye with
a dressing and a
paper cup so the
impaled object
cannot move.
– Bandage both eyes.
– Arrange for
transport.
Neck Wounds (1 of 2)
• Use direct pressure to control bleeding.
• Once bleeding is controlled, dress the neck.
Neck Wounds (2 of 2)
• In rare cases, you may have to exert finger
pressure above and below the injury site to
prevent further neck bleeding.
• Major trauma to the neck may be
associated with airway problems and with
neck fracture or spinal cord injury.
– Maintain the patient’s airway.
– Stabilize the head and neck.
Chest and Back Wounds (1 of 2)
• Place the patient with a chest injury in a
comfortable position.
• If a lung is punctured, air can escape and
the lung will collapse.
– The patient may cough up bright red blood.
– Cover the open chest wound with an airtight
material (occlusive dressing).
– Administer oxygen.
Chest and Back Wounds (2 of 2)
• Chest wounds may damage the heart.
– Seal the wound and monitor the ABCs.
– Treat the patient for shock and perform CPR, if
necessary.
– If the patient’s breathing becomes more labored
after you seal the wound, remove the seal
briefly to allow excess air to escape, and reseal
the wound.
Impaled Objects (1 of 2)
• Apply a stabilizing dressing.
• Arrange for immediate prompt transport.
• Sometimes an impaled object is too long to
permit the patient to be transported.
– Stabilize the impaled object and carefully cut it
close to the patient’s body.
Impaled Objects (2 of 2)
• If an object is protruding from the abdomen:
– Do not attempt to remove it.
– Support the object so it cannot move.
– Place gauze or towels on either side of the
object and secure them with additional gauze.
Closed Abdominal Wounds
(1 of 2)
• Result of a direct blow from a blunt object
• Look for bruises or other marks on the
abdomen.
• Whenever a patient experiences shock,
there may be internal abdominal injuries.
– Place these patients on their backs and elevate
their legs 6".
– Use blankets to conserve their body heat.
Closed Abdominal Wounds
(2 of 2)
• If the patient is vomiting blood, it may be an
indication of bleeding from the esophagus
or stomach.
– Monitor the airway and vital signs.
– Give the patient nothing by mouth.
– Arrange for prompt transport.
Open Abdominal Wounds (1 of 2)
• Usually result from slashing with a knife or
other sharp object
• If the intestines are protruding:
– Place the patient on his or her back with the
knees bent.
– Cover the injured area with a sterile dressing.
– Do not attempt to replace the intestines inside
the abdomen.
Open Abdominal Wounds (2 of 2)
Genital Wounds
• Male and female genitals have a rich blood
supply, so injury to these areas can result in
severe bleeding.
• Apply direct pressure with a dry, sterile
dressing.
• Although it may be embarrassing to
examine the patient’s genital area, you must
do so if you suspect injuries.
Extremity Wounds (1 of 2)
• Apply a dry, sterile compression dressing
and bandage it securely in place.
• Elevate the injured part to decrease
bleeding and swelling.
• Splint all injured extremities prior to
transport because there may be an
underlying fracture.
Extremity Wounds (2 of 2)
Gunshot Wounds (1 of 2)
• Most deaths from gunshot wounds result
from internal blood loss.
• Gunshot wounds to the trunk and neck are
a major cause of spinal cord injuries.
• Treatment
– Open the airway and establish adequate
ventilation and circulation.
Gunshot Wounds (2 of 2)
• Treatment (cont’d)
– Control any external bleeding with dressings
and direct pressure.
– Examine the patient thoroughly to locate all
entrance and exit wounds.
– Treat for symptoms of shock.
– Arrange for prompt transport.
– Perform CPR if the patient’s heart stops.
Bites
• All bites carry a high risk of infection.
– Patients should seek treatment for all bites.
• Minor bites can be washed with soap and
water.
• With major bite wounds, control the
bleeding and apply a dressing and
bandage.
Burns
• The skin serves as a barrier that prevents
foreign substances from entering the body.
• It also prevents loss of body fluids.
– When the skin is damaged, it can no longer
perform these essential functions.
Burn Depth (1 of 3)
• Superficial burns
(first-degree burns)
© Amy Walters/ShutterStock, Inc.
– Reddened and
painful skin
– The injury is
confined to the
outermost layers of
the skin.
– The patient
experiences minor
to moderate pain.
Burn Depth (2 of 3)
• Partial-thickness burns
(second-degree
burns)
– Do not damage the
deepest layers of the
skin
– Blistering
– Fluid loss and
moderate to severe
pain
– Usually heal within 2
to 3 weeks
© E. M. Singletary, M.D. Used with permission.
Burn Depth (3 of 3)
• Full-thickness burns
(third-degree burns)
– Damage all layers of
the skin
– Pain is absent
because the nerve
endings have been
destroyed.
– Patients lose large
quantities of body
fluids and are
susceptible to shock
and infection.
Extent of Burns (1 of 2)
• Rule of nines
– Method for determining what percentage of the
body has been burned
– In an adult, the head and arms each equal 9%
of the total body surface.
– The front and back of the trunk and each leg are
equal to 18% of the total body surface.
– This formulation is slightly modified for children.
Extent of Burns (2 of 2)
Cause or Type of Burns (1 of 7)
• Thermal burns
– Caused by heat
– Place the burned area in clean, cold water.
– Cover it with a dry, sterile dressing or a burn
sheet.
– Do not break blisters.
– Patients with large burns must be treated for
shock and transported to a hospital.
Cause or Type of Burns (2 of 7)
• Respiratory burns
– A burn to any part of the airway
– Look for signs and symptoms:
• Burns around the face
•
•
•
•
Singed nose hairs
Soot in the mouth and nose
Difficulty breathing
Pain while breathing
• Loss of consciousness as a result of fire
Cause or Type of Burns (3 of 7)
• Respiratory burns (cont’d)
– Breathing problems can develop rapidly or
slowly.
– Administer oxygen and be prepared to perform
CPR.
– Arrange for prompt transport.
• Chemical burns
– Many strong substances can cause chemical
burns.
Cause or Type of Burns (4 of 7)
• Chemical burns (cont’d)
– The longer the chemical remains in contact with
the skin, the more damage it does.
– Initial treatment
• Remove as much of the chemical as
possible.
• Brush away any dry chemical.
• Flush with water for at least 10 minutes.
• Cover the area with a dry, sterile dressing.
• Arrange for prompt transport.
Cause or Type of Burns (5 of 7)
• Chemical burns (cont’d)
– Chemical burns to the eyes cause extreme pain
and severe injury.
• Flush the eye(s) with water for at least
20 minutes.
• Hold the eye open to allow water to flow over
its entire surface.
• Loosely cover the injured eye(s) with gauze
bandages.
• Arrange for prompt transport.
Cause or Type of Burns (6 of 7)
• Electrical burns
– Occur when an electrical current enters the
body at one point, travels through the body
tissues and organs, and exits at the point of
ground contact
– Electricity causes major internal damage.
– Patients may experience irregularities of cardiac
rhythm or full cardiac arrest and death.
Cause or Type of Burns (7 of 7)
• Electrical burns (cont’d)
– Be certain that a patient is not still in contact
with the electrical power source before you
touch or treat him or her.
– Call for assistance from the power company or
from a qualified rescue squad.
– Monitor the ABCs of electrical burn patients and
arrange for prompt transport.
Multi-system Trauma
• Multi-system trauma is an injury that affects
more than one system of the body.
• You are not expected to diagnose a
patient’s injuries.
– Several body systems may be injured in
situations that involve significant trauma.
– Be alert for signs and symptoms of injury.
Summary (1 of 4)
• You must take appropriate standard
precautions to prevent contact with the
patient’s body fluids.
• The three parts of the circulatory system are
the pump (heart), the pipes (arteries, veins,
and capillaries), and the fluid (blood cells
and other blood components).
Summary (2 of 4)
• The three primary causes of shock are
pump failure, pipe failure, and fluid loss.
• Three types of external blood loss are
possible: capillary (blood oozes out),
venous (bleeds at a steady flow), and
arterial (blood spurts or surges). Most
external bleeding can be controlled by
applying direct pressure to the wound.
Summary (3 of 4)
• A wound is an injury caused by any physical
means that leads to damage of a body part.
Wounds are classified as closed (skin
remains intact) or open (skin is disrupted).
• Open wounds are classified as abrasions,
punctures, lacerations, and avulsions or
amputations.
Summary (4 of 4)
• Control bleeding by applying direct
pressure, elevating an extremity, applying a
tourniquet, or using pressure points.
• Three classes of burns are distinguished
based on depth: superficial, partialthickness, and full-thickness. Burns may be
caused by heat, chemicals, or electricity.
Review
1. Which of the following statements
regarding standard precautions is true?
A. Standard precautions assume that all body
fluids are potentially infectious.
B. Standard precautions assume that some body
fluids are potentially infectious.
C. Standard precautions apply to paramedics
who perform invasive procedures.
D. EMRs are only required to wear gloves to
comply with standard precautions.
Review
Answer:
A. Standard precautions assume that all
body fluids are potentially infectious.
Review
2. Appropriate management of impaled
objects in the eye includes:
A. bandaging only the affected eye.
B. rinsing the eyes with saline.
C. bandaging both eyes.
D. removing the object to prevent further
damage.
Review
Answer:
C. bandaging both eyes.
Review
3. Patients with full-thickness burns generally
do not complain of pain because:
A. blister formation protects the burn.
B. the nerve endings have been destroyed.
C. deep burns produce a natural pain killer in the
patient’s system.
D. the patient is generally not conscious.
Review
Answer:
B. the nerve endings have been destroyed.
Credits
• Opener: © Mark C. Ide
• Background slide images: © Jones & Bartlett
Learning. Courtesy of MIEMSS.