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EMT Test 4 > Trauma to the Head, Neck & Spine > Flashcards

Trauma to the Head, Neck & Spine Flashcards

1
Q

Nervous System Overview

A

• Controls thought, sensations, and motor

functions

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2
Q

Central nervous system

A

– Brain, spinal cord

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3
Q

Peripheral nervous system

A

– Vertebral nerves
– Cranial nerves
– Body’s motor and sensory nerves

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4
Q

Anatomy of the Head - what are the bones

A 
• Cranium
• Facial Bones (14)
– Mandible
– Maxillae
– Nasal bones
– Malar (zygomatic)
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5
Q

Anatomy of the Spine - Vertebrae - what are the bones

A 
– Cervical (7)
– Thoracic (12)
– Lumbar (5)
– Sacral (5)
– Coccyx (4)
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6
Q

Scalp Injuries- characteristics

A

– Lots of blood vessels

– Profuse bleeding

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7
Q

Skull Injuries - types

A

– Open head injury

– Closed head injury

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8
Q

Traumatic Brain Injuries (TBI) - types

A 
– Concussion
– Contusion
• Coup
• Contrecoup
– Laceration
– Hematoma
• Subdural Hematoma
• Epidural Hematoma
• Intracerebral Hematoma
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9
Q

Think about it - Trauma to the Head, Neck & Spine

A
  • Does my patient have a serious or potentially serious head injury? Should the patient be transported to a trauma center?
  • Do my patient’s complaint and MOI indicate spinal stabilization? Is immobilization warranted?
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10
Q

Injuries to the Head & Face

A 
• Cranial injuries with impaled objects
– Stabilize object in place
• Injuries to the face and jaw
– Primary concern: Airway
– When possible, position to allow for drainage from mouth
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11
Q

Nontraumatic Brain Injuries

A
  • Many signs of brain injury may be caused by an internal brain event (hemorrhage, blood clot)
  • Signs are the same as for traumatic injury, except no evidence of trauma and no MOI.
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12
Q

Glasgow Coma Scale (GCS)

A

• May use GCS in addition to AVPU for ongoing neurological assessment
• Considerations for use of GCS
– Eye opening
– Verbal response
– Motor response
• Do not spend extra time at the scene calculating

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13
Q

Wounds to the Neck

A
  • Large, major vessels close to surface create the potential for serious bleeding
  • Pressure in large vein is lower than atmospheric pressure
  • Great possibility of air embolus being sucked through
  • Treatment: stop bleeding, prevent air embolism
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14
Q

Treatment: Open Neck Wound

A
  • Ensure open airway
  • Place gloved hand over wound
  • Apply occlusive dressing
  • Apply pressure to stop bleeding
  • Bandage dressing in place
  • Immobilize spine if MOI suggests cervical injury
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15
Q

Injuries to the Spine

A

• Assume possible cervical-spine injury if MOI exerts great force on upper body or if soft-tissue damage to head, face, or neck
• Spinal cord is a relay between most of body and brain for sending messages
• Neurogenic shock: form of shock resulting from nerve paralysis; causes uncontrolled
dilation of blood vessels

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16
Q

Assessment: Spinal Injury - what to consider

A
  • Paralysis of extremities
  • Pain without movement
  • Pain with movement
  • Tenderness anywhere along spine
  • Impaired breathing
  • Deformity
  • Priapism
  • Loss of bowel or bladder control
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17
Q

Treatment: Spinal Injury

A
  • Provide manual in-line stabilization
  • Assess ABC’s
  • Rapidly assess head and neck; apply rigid cervical collar
  • Rapidly assess for sensory and motor function
  • Apply appropriate spinal immobilization device
  • Reassess sensory and motor function
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18
Q

Steps for Applying a Cervical Collar

A

• Always maintain manual stabilization
• Use in conjunction with a long
backboard

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19
Q

Immobilizing a Seated Patient

A

• Low priority: Use a short board or vest-immobilization device
• High priority: Maintain manual
stabilization while moving patient

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20
Q

Steps for Applying a Long Backboard

A 
• Log roll patient
• Pad voids between board and head/torso
• Secure head last
• If pregnant, tilt board to left after
immobilizing
21
Q

Standing Patient - Steps

A

• Rapid takedown

– Requires three providers, cervical collar, and long backboard

22
Q

Patient Found Wearing a Helmet - when should it be left in place

A

• When to leave helmet in place
– Fits snugly, allowing no movement
– Absolutely no impending airway or breathing issues
– Removal would cause further injury
– Proper spinal immobilization can be done with helmet in place

23
Q

Patient Found Wearing a Helmet - when should it be removed

A 
• When to remove helmet
– Interferes with ability to assess and manage airway
– Improperly fitted
– Interferes with immobilization
– Cardiac arrest
24
Q

Chapter Review: Trauma to the Head, Neck & Spine

A
  • The two main divisions of the nervous system are the central nervous system and the peripheral nervous system.
  • Maintain a high index of suspicion for head or spine injury whenever there is a relevant mechanism of injury.
25
Q

Chapter Review: Trauma to the Head, Neck & Spine

A
  • Provide cervical spine stabilization before beginning any other patient care when head or spine injury is suspected.
  • Altered mental status is an early and important indicator of head injury. Monitor and document your patient’s mental status throughout the call.
26
Q

Chapter Review: Trauma to the Head, Neck & Spine

A

• A traumatic brain injury is any injury that disrupts function of the brain and may include anything from a slight concussion
to a severe hematoma.
• Always secure the torso to the backboard before the head.

27
Q

Remember: Trauma to the Head, Neck & Spine

A

• The key components of the nervous system are the brain and the spinal cord.
These organs regulate thought,
sensations, and motor functions.
• The skull, vertebrae, and cerebrospinal fluid efficiently protect the brain and spinal
cord.

28
Q

Remember: Trauma to the Head, Neck & Spine

A
  • In a closed head injury, the skull remains intact. This is dangerous, for the skull is a closed container with little room for bleeding or swelling.
  • Neck wounds are at risk for massive bleeding and air entry, causing emboli.
29
Q

Remember: Trauma to the Head, Neck & Spine

A

• The spine is injured most often by compression or excessive flexion, by extension, or rotation from falls, by diving injuries, and by motor-vehicle collisions.
These injuries can interrupt nervous system control of body functions.

30
Q

Remember: Trauma to the Head, Neck & Spine

A

• In-line immobilization of 33 spinal bones is the essential component of spinal injury
immobilization.
• Specific procedures apply to different immobilization and extrication situations.
EMTs should be proficient in handling the basics of these procedures.

31
Q

Questions to Consider: Trauma to the Head, Neck & Spine

A
  • Does my patient have a mechanism of injury that would indicate the need for spinal immobilization?
  • Do my patient’s potential head or spine injuries require prompt transport to a trauma center?
32
Q

Critical Thinking: Trauma to the Head, Neck & Spine

A

• You are treating a patient with a head injury. He has an altered mental status and a significant MOI to the head. Your partner thinks you should hyperventilate.
When should you hyperventilate? What are the signs and symptoms that would indicate this is necessary?

33
Q

sensory nerves - sensed the hot plate

motor

A

.

34
Q

mandible

A

.

35
Q

7, 12, 5 5 4

A

of spine

36
Q

concussion

A

mild closed head injury without detectable damage to the brain.

37
Q

contusion

A

in brain injuries, a bruised brain is caused when the force of a blow to the head is great enough to rupture blood vessels

38
Q

basalar fractures

A

battle signs, CSF

4x4 - halo efect

39
Q

coup / contrecoup

A

.

40
Q

752

Meninges
dura mater - tough mother
arachniod space
pia mater

subdural bleed - th pt is bleeding btwn the dura mater & arachnoid space

epidural - outside the dural mater

intercerebral

A

knowing that the brain and spinal cord have covering

41
Q

intracranial pressure

Cushings Triad

A

increase BP
decrease Pulse
slow & altered response

pupils on the affected side will dilate

1st sign of head trauma
-altered mental status

2nd Dialated pupil
-pressure on the

Then Cushings Traid
very high BP

exactly opposite than shock

42
Q

PP = Perfusion Pressure
B/P - ICP (intercranial pressure)
90 =120-30
90=150-60

Body wants a constant perfusion pressure

perfusion pressure wants to stay constant at 90

A

.

43
Q

biggest problem to head and face injuries

A

airway injury

44
Q

gcs

A

used to measure LOC

45
Q

761

A

assume possible spinal injury if…

injuries to the spine must be considered whenever there is serious trauma to any part of the body

46
Q

Assessment of Spinal Injury

A

.

47
Q

priapism

A

.

48
Q

when to leave a helmet in place

A

review - airway and breathing is the reason you leave it on.

EMT Test 4 (11 decks)

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