Trauma knowledge 2

A 74-year-old man experienced partial- and full-thickness burns to his arms and chest resulting from a fire that started after he fell asleep while smoking his cigar. The patient's son, who arrived at the scene shortly after you, states that his father has congestive heart failure, rheumatoid arthritis, and atrial fibrillation. In addition to administering supplemental oxygen, it is MOST important for you to:

• avoid narcotic analgesics because of his medical history.

• auscultate his breath sounds before administering IV fluids.

• obtain a 12-lead ECG to assess for signs of cardiac ischemia.

• apply cold, moist dressings to his burns to provide pain relief.

Dry powder chemicals:

• will react violently with water and should not be irrigated.

• cause coagulation necrosis if they are absorbed by the body.

• should be brushed off the skin before irrigation with water.

• are effectively neutralized on the skin with isopropyl alcohol.

Thermal burns are MOST commonly caused by exposure to:

• hot liquids.

• hot solid objects.

• an open flame.

• superheated steam.

Several attempts at endotracheal intubation of a patient with severe upper airway burns have failed, and attempts to ventilate with a bag-mask device do not produce chest rise. What should you do?

• Squeeze the bag-mask device with more force.

• Perform a surgical cricothyrotomy.

• Insert a supraglottic airway device.

• Administer albuterol and reattempt intubation.

Supraglottic damage following a burn is MOST often caused by:

• the inhalation of superheated gases.

• exposure to carbon monoxide or cyanide.

• the inhalation of hot particulate steam.

• direct flame exposure to the oropharynx.

________ radiation is very penetrating and easily passes through the body and solid materials.

• Alpha

• Beta

• Gamma

• Ionizing

Full-thickness circumferential burns to the chest:

• require the paramedic to incise the burn to decompress it.

• may cause significant restriction of respiratory excursion.

• are generally not significant unless the skin is unyielding.

• necessitate immediate intubation and ventilatory support.

A conscious but combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. You suction her oropharynx, but her mouth quickly refills with blood. You should:

• preoxygenate the patient with a bag-mask device for 2 minutes and then perform nasotracheal intubation.

• roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation.

• alternate suctioning of her oropharynx for 15 seconds and assisting ventilations for 2 minutes until her airway is clear of blood.

• continually suction her oropharynx until it is clear of blood, apply oxygen via nonrebreathing mask, and administer a sedative drug.

Signs and symptoms of retinal detachment include:

• flashing lights, specks, or floaters in the field of vision.

• double vision and partial or complete loss of peripheral vision.

• immediate pain and total loss of vision following blunt eye trauma.

• paralysis of upward gaze and greater than 50% loss of central vision.

Which of the following cranial nerves innervates the muscles that cause motion of the eyeballs and upper eyelids?

• Optic

• Ophthalmic

• Oculomotor

• Trigeminal