Ed Review Test 1

The correct answer is C-Spine precautions. When a person falls from a height, especially from a ladder, there is a risk of cervical spine (C-Spine) injury. The impact from the fall can cause damage to the neck and spinal cord. Therefore, it is important to attend to C-Spine precautions first to prevent further damage and ensure the safety of the patient.

The potential complications of endotracheal intubation include esophageal intubation, which means the tube is mistakenly inserted into the esophagus instead of the trachea. This can lead to inadequate ventilation and oxygenation. Another potential complication is hypoxemia from prolonged intubation attempts, which can occur if the intubation process takes too long and the patient's oxygen levels drop. Lastly, endotracheal intubation can also result in the conversion of a cervical injury without neurological deficit to a cervical spine injury with neurologic deficits, possibly due to the manipulation and movement of the neck during the procedure.

Blunt trauma to the abdomen can cause injury to various organs, but the liver and spleen are the most commonly affected. This is because they are large and located in the upper abdomen, making them vulnerable to impact during accidents or falls. The liver is a solid organ that can be injured by direct force, while the spleen is more susceptible to rupture due to its fragile structure. These injuries can be severe and potentially life-threatening, requiring immediate medical attention.

The most important concern about a rib fracture is underlying organ injury. When a rib fractures, there is a risk of the broken bone fragment puncturing or damaging nearby organs such as the lungs, liver, or spleen. This can lead to serious complications and potentially life-threatening conditions such as pneumothorax or internal bleeding. Therefore, identifying and addressing any underlying organ injury is crucial in managing a rib fracture.

Endotracheal intubation is the most desirable method of achieving maximum control of the airway for trauma patients who are apneic or require assisted ventilation. This is because endotracheal intubation involves inserting a tube into the trachea, bypassing the pharynx and ensuring a secure airway. It allows for effective ventilation and oxygenation, as well as protection against aspiration of gastric contents. Other methods like the pharyngeal lumen airway, oral airway, and percutaneous transtracheal catheter ventilation may not provide the same level of control and protection in trauma patients.

In the pre-hospital setting, the proper way to dress most burn injuries is to use dry sterile dressings. This is because dry dressings help to protect the burn area from further contamination and infection. They also help to absorb any excess moisture and promote a dry healing environment. Moist dressings, on the other hand, can trap heat and increase the risk of infection. Water soluble gels and Silvadene may be used in certain cases, but dry sterile dressings are generally the recommended choice for most burn injuries in the pre-hospital setting.

Giving too much intravenous fluid to patients with pulmonary contusion can increase interstitial and intra-alveolar fluid and bleeding. This is because excessive fluid administration can lead to fluid accumulation in the lungs, causing pulmonary edema and worsening the bleeding. Therefore, it is important to carefully monitor fluid balance in these patients to prevent complications and optimize their respiratory function.

The biggest concern with electrical burns is cardiac arrest. Electrical burns can disrupt the normal electrical activity of the heart, leading to an abnormal rhythm or even a complete stoppage of the heart. This can be life-threatening and requires immediate medical attention. While the other options (Wick Effect, Tissue Loss, Entry and Exit Wounds) may also be concerns with electrical burns, cardiac arrest poses the most immediate and severe risk to the individual's life.

The head tilt, chin lift maneuver is not recommended for use on trauma patients because it can potentially worsen any existing neck or spinal injuries. This maneuver involves tilting the head back and lifting the chin to open the airway, but in trauma patients, there is a risk of causing further damage to the neck or spine. Therefore, other airway maneuvers such as the trauma mandible lift, trauma jaw thrust, or trauma chin lift should be used instead to maintain a patent airway in trauma patients.

Endotracheal intubation would be the most likely intervention to help the patient with a suspected flail chest who is experiencing increasing respirations and difficulty breathing. Intubation involves inserting a tube into the patient's trachea to establish an airway, which can help to stabilize the chest wall and improve ventilation. This intervention can also provide support for the patient's breathing and oxygenation while further treatment is initiated. Needle decompression and pericardiocentesis are not indicated for a flail chest, and while administration of an analgesic may provide pain relief, it would not directly address the patient's respiratory distress.

Chemoreceptors in the brain control respiration in a normal adult by sensing carbon dioxide (CO2). When CO2 levels rise in the body, the chemoreceptors detect this change and signal the respiratory system to increase the rate and depth of breathing in order to remove the excess CO2 and maintain a proper balance of gases in the body. Oxygen (O2) and nitrogen (N) are also important gases for respiration, but in this context, the control of respiration is specifically determined by the levels of carbon dioxide.

In unconscious patients, the muscles in the body relax, including the muscles in the tongue. This can cause the tongue to fall back and block the airway, leading to airway obstruction. This is known as a flaccid tongue blocking the hypopharynx. Crush injury to the trachea, foreign body obstruction, and edema of the vocal cords can also cause airway obstruction, but they are not as common as a flaccid tongue in unconscious patients.

When dealing with a crushing injury, one should assess for compartment syndrome. Compartment syndrome occurs when increased pressure within a muscle compartment restricts blood flow and can lead to tissue damage. This condition can be caused by a crushing injury and is characterized by severe pain, swelling, and decreased sensation in the affected area. It is important to monitor for compartment syndrome as it can result in permanent damage if not promptly treated.

Injuries to hollow organs in the abdomen can cause peritonitis, but it is not necessarily secondary to hemorrhage into the peritoneal cavity. Peritonitis can also be caused by infection, inflammation, or other factors. Therefore, the statement is false.

Since we are talking about patient management it is assumed that scene safety has already been assured.

An increased respiratory rate can be an early sign of developing respiratory compromise after trauma. This can occur due to various reasons such as pain, anxiety, or the body's attempt to compensate for decreased oxygen levels. The body tries to increase the respiratory rate in order to bring in more oxygen and remove carbon dioxide. Therefore, an increased respiratory rate can indicate that the body is struggling to maintain adequate oxygenation, which is an early sign of respiratory compromise.

In spinal shock, there is a disruption in the communication between the brain and the spinal cord, leading to a loss of sensation and motor function below the level of injury. One of the signs and symptoms of spinal shock is warm, dry skin temperature. This occurs because the disruption in the nervous system affects the body's ability to regulate blood flow and temperature. As a result, the skin may feel warm to the touch and appear dry.

A patient with a suspected simple pneumothorax will benefit from rapid transport because a pneumothorax can lead to a collapsed lung, which can be life-threatening. Rapid transport ensures that the patient reaches a medical facility quickly where they can receive appropriate treatment, such as chest tube insertion or other interventions to re-expand the lung and relieve symptoms.