Chapter 29 Trauma Systems and Mechanism of Injury Flashcards Preview

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Flashcards in Chapter 29 Trauma Systems and Mechanism of Injury Deck (64)
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1

 The acute physiologic and structural change that occurs in a patient's body when an external source of energy dissipates faster than the body's ability to sustain and dissipate it is called: A) injury. B) trauma. C) deceleration. D) kinematics.

- B) trauma. Page: 1483

2

The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy. A) kinetic, potential B) barometric, kinetic C) potential, kinetic D) chemical, potential

- C) potential, kinetic Page 1484

3

Knowledge of kinetics can help the paramedic: A) predict injury patterns found in a patient. B) determine which organs have been injured. C) quantify how much blood a patient has lost. D) differentiate between medical and trauma patients.

- A) predict injury patterns found in a patient. Page: 1484

4

The primary determinants of the extent of trauma a patient sustains are the: A) type of object that strikes a patient and the part of the body that sustains the most impact. B) amount of energy in the object and the mechanism by which the object is delivered to the body. C) size of the object that strikes the body and any secondary injuries that occur if the patient falls. D) physical size of the patient and the part of the body that sustains direct impact from an object.

- B) amount of energy in the object and the mechanism by which the object is delivered to the body. Page: 1484

5

Which of the following general statements regarding trauma is correct? A) Bullet impact is less if the energy in the bullet is applied to a small area. B) The position of the patient at the time of the event is considered to be an internal factor. C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. D) Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period.

- C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. Page: 1484

6

Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A) Index of suspicion B) Past medical history C) Age of the patient D) Mechanism of injury

- D) Mechanism of injury Page: 1484-1485

7

According to the American College of Surgeons, an injured patient should be transported to a Level I trauma center if his or her: A) heart rate is greater than 100 beats/min. B) systolic blood pressure is less than 90 mm Hg. C) respiratory rate is less than 14 breaths/min. D) Glasgow Coma Scale score is less than 15.

- B) systolic blood pressure is less than 90 mm Hg. Page: 1507-1508

8

Which of the following mechanisms of injury poses the LEAST threat for significant injury? A) Rear-end collision with restrained driver B) Death of an occupant in the same vehicle C) Motorcycle crash at greater than 20 mph D) Vehicular intrusion of greater than 12 inches

- A) Rear-end collision with restrained driver Page: 1509

9

Which of the following injuries would MOST likely require transport to a Level I trauma center? A) Two or more proximal long bone fractures B) Superficial burns to an entire lower extremity C) Lateral neck pain following a motor vehicle crash D) Penetrating injury that is distal to the elbow or knee

- A) Two or more proximal long bone fractures Page: 1507

10

If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: A) is older than 45 years of age. B) takes any kind of medication. C) is emotionally upset or angry. D) has a known bleeding disorder.

- D) has a known bleeding disorder. Page: 1509

11

A specific attribute of a Level I trauma center is that it: A) is involved in an injury prevention program. B) can initiate definitive care for all injured patients. C) has 24-hour in-house coverage by general surgeons. D) has rapid access to an off-site anesthesiologist.

- C) has 24-hour in-house coverage by general surgeons. Page: 1510

12

At a minimum, a Level II trauma center should: A) have an in-house neurosurgeon 24 hours a day. B) be able to initiate definitive care for all injured patients. C) have access to an emergency physician within 20 minutes. D) provide total care for every aspect of a patient's injuries.

- B) be able to initiate definitive care for all injured patients. Page: 1510

13

If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury: A) by ground to the Level I trauma center. B) to the closest hospital for stabilization. C) via air transport to the Level I trauma center. D) by ground to the Level II trauma center.

- C) via air transport to the Level I trauma center. Page: 1509-1511

14

Which of the following is NOT a factor when considering transport of a trauma patient via helicopter? A) The need for definitive airway management B) Distance from the scene to the landing zone C) Time it will take the aircraft to reach the scene D) Type of terrain on which the helicopter will land

- A) The need for definitive airway management Page: 1511

15

When summoning an air transport service to transport a critically injured patient, it is MOST important to: A) determine the flight crew's credentials. B) ensure that the fire department is present. C) predetermine the destination facility. D) activate the service as soon as possible.

- D) activate the service as soon as possible. Page: 1511

16

The "platinum 10 minutes" refers to the: A) maximum amount of time to extricate a patient. B) maximum time spent at a scene for a trauma patient. C) amount of time before decompensated shock occurs. D) amount of time taken to perform a rapid assessment.

- B) maximum time spent at a scene for a trauma patient. Page: 1505

17

An object increases its kinetic energy more by: A) decreasing its speed than by increasing its mass. B) increasing its velocity than by increasing its mass. C) decreasing its velocity than by decreasing its mass. D) increasing its mass than by increasing its velocity.

- B) increasing its velocity than by increasing its mass. Page: 1485

18

The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. A) 140, 50 B) 160, 30 C) 150, 40 D) 170, 30

- A) 140, 50 Page: 1484-1486

19

The law of conservation of energy states that: A) kinetic energy can be converted only to thermal or chemical energy. B) the force that an object can exert is the product of its mass multiplied by its acceleration. C) energy can be neither created nor destroyed; it can only change form. D) a body at rest will remain at rest unless acted upon by an outside force.

- C) energy can be neither created nor destroyed; it can only change form. Page: 1486

20

Sudden deceleration of a motor vehicle that is traveling at 60 mph: A) typically generates forces of up to 10 to 20 g. B) initially causes whiplash injuries to the patient's neck. C) dissipates tremendous forces and causes major injuries. D) causes the driver's body to stop moving at the same time.

- C) dissipates tremendous forces and causes major injuries. Page: 1486

21

Which of the following injury mechanisms would MOST likely result in blunt trauma? A) Small-caliber gunshot wound B) Explosion involving shards of glass C) Falling from a tree onto a fence D) The pressure wave caused by a blast

- D) The pressure wave caused by a blast Page: 1486

22

Penetrating trauma occurs when: A) internal organs are lacerated and bleed profusely. B) tissues are penetrated by single or multiple objects. C) blunt force trauma causes explosive open injuries. D) a fractured rib perforates the parenchyma of a lung.

- B) tissues are penetrated by single or multiple objects. Page: 1497

23

During abrupt deceleration: A) shearing or rupturing of internal organs can occur. B) the neck commonly sustains hyperextension injuries. C) the skull provides excellent protection for the brain. D) supporting structures of the aorta keep it attached.

- A) shearing or rupturing of internal organs can occur. Page: 1487, 1489

24

Unlike deceleration injuries, crush and compression injuries occur: A) at the time of impact. B) before impact occurs. C) after the initial impact. D) from penetrating mechanisms.

- A) at the time of impact. Page: 1489

25

The MOST common site of deceleration injury in the chest is the: A) heart. B) esophagus. C) aorta. D) vena cava.

- C) aorta. Page: 1489

26

The third phase of a motor vehicle accident involves: A) crush injuries to the body. B) impact by another vehicle. C) deceleration of internal organs. D) injuries caused by flying debris.

- C) deceleration of internal organs. Page: 1487

27

If the windshield of a wrecked vehicle is cracked or broken: A) you should assume that the driver has a severe intracerebral hemorrhage. B) the front seat occupant has a cervical spine injury until proven otherwise. C) the rear seat passenger was likely thrust from the seat into the windshield. D) it is likely that the vehicle was traveling at least 55 mph at the time of impact.

- B) the front seat occupant has a cervical spine injury until proven otherwise. Page: 1488

28

The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is: A) deformity to the driver's brake pedal. B) severe damage to the front rims of the tires. C) a trail of debris leading to the site of impact. D) the presence of tire skid marks at the scene.

- D) the presence of tire skid marks at the scene. Page: 1488-1489

29

The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT: A) objects inside the vehicle. B) the physical size of the patient. C) the design of the motor vehicle. D) safety features of the motor vehicle.

- B) the physical size of the patient. Page: 1489

30

The initial point of bodily impact when an unrestrained passenger takes the "down and under" pathway during a frontal collision is the: A) knees. B) pelvis. C) femurs. D) abdomen.

- A) knees. Page: 1489-1490