Study

Chapter 54 Review End

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  • Rapid transport should be considered when:
    Internal or external hemorrhage is suspected and uncontrolled
  • When is a pressure dressing most effective?
    On extremity or scalp wounds with significant bleeding
  • What is the only medication routinely used in prehospital hemorrhage care?
    Tranexamic acid (TXA)
  • What component is assessed first in the primary assessment of a shock patient?
    Mental status and general impression
  • During the primary assessment, CUPS is used to:
    Categorize patient priority
  • What should EMS do first when arriving at a trauma scene with suspected hemorrhage?
    Perform scene size-up and ensure standard precautions
  • What is the fluid of choice for significant blood loss?
    Whole blood
  • What pharmacological intervention is used in cardiogenic shock?
    Vasopressors and dopamine (myocardial contusion, valvular disruption, coronary dissection, or rib fracture-associated penetrating trauma)
  • A patient with barely palpable pulses, air hunger, and anxiety is likely in what stage of hemorrhage?
    Class III
  • Which vascular component contains the largest percentage of blood volume?
    Veins
  • When managing a head wound with bleeding, EMS should:
    Use finger pressure at the scalp edge without compressing the skull
  • Which method can control all but the most persistent external bleeding?
    Direct pressure
  • What systolic BP is typically the target for initial resuscitation?
    90–100 mmHg
  • What signs are providers looking for when suspecting internal bleeding?
    Signs of local injury and unexplained shock
  • A tilt test may be used to evaluate:
    Syncope or orthostatic hypotension
  • Which patient group may NOT present typical signs of hemorrhage?
    Children, elderly, pregnant, intoxicated, and athletic patients
  • What is true regarding tourniquet use?
    It must exceed systolic blood pressure and remain in place until definitive care
  • Which sign on chest assessment may indicate a life-threatening injury?
    Muffled heart sounds or asymmetrical movement
  • What is a key feature of venous bleeding?
    Dark red, steady flow that usually stops in a few minutes
  • A secondary assessment should NOT be performed if:
    The ABCs are unstable and cannot be corrected
  • What are the three factors that determine stroke volume?
    Preload, cardiac contractility, afterload
  • In a large-scale incident, scene oversight should involve:
    A structured incident management system assigning team roles
  • What occurs during the coagulation phase?
    Clotting factors form fibrin strands that trap red blood cells
  • What is the role of oncotic pressure?
    Draws fluid back into venous circulation via plasma proteins
  • A patient who shows minimal or no response to fluids may have:
    An ongoing uncontrolled hemorrhage or obstructive issue like tamponade
  • Positive-pressure ventilation may be necessary when:
    Respirations are shallow and ineffective
  • How much blood can be lost from a femur fracture?
    Up to 1,500 mL
  • The chief complaint and medications fall under which assessment step?
    Medical history
  • What should be done first during a rapid trauma assessment?
    Control immediate hemorrhage
  • How does TXA (tranexamic acid) help in hemorrhage control?
    It prevents fibrinolysis, helping clots remain intact
  • What are essential components of reassessment?
    Repeat of primary assessment, vitals, GCS, and monitoring
  • Which population is most at risk for trauma-related death?
    Young adult males
  • Which of the following medications can impair platelet aggregation and worsen bleeding?
    Plavix and aspirin
  • A fractured pelvis can result in:
    Significant internal hemorrhage
  • When is a detailed physical exam appropriate in a trauma patient?
    After transport has been initiated and life threats managed
  • What finding during neck assessment is concerning in a trauma patient?
    Jugular vein distention or subcutaneous emphysema
  • Why is temperature control important in shock management?
    To improve clotting and reduce hypothermia effects
  • Why is keeping a trauma patient warm essential?
    Hypothermia slows and impairs the clotting process
  • The oxyhemoglobin dissociation curve describes:
    The relationship between hemoglobin and oxygen at various pressures
  • Anticoagulants such as heparin or warfarin affect hemostasis by:
    Interfering with the generation of protein fibers necessary for stable clot formation
  • Which of the following are common signs of compensated shock?
    Tachycardia, narrow pulse pressure, clammy skin, tachypnea
  • What is the primary goal of wound packing?
    To tightly fill the wound and apply pressure directly to the bleeding source
  • What should be done if bleeding continues after pressure dressing application to an extremity?
    Apply a tourniquet above the site
  • What percentage of blood volume is found in the arteries?
    13%
  • Children in shock should receive an initial fluid bolus of:
    20 cc/kg
  • In neck wounds, which intervention is appropriate?
    Occlusive dressing with caution to avoid airway compromise
  • What is a physiological effect of tourniquet use?
    Anaerobic metabolism and lactic acid buildup distal to the site
  • What is included in scene size-up for hemorrhagic trauma?
    MOI, time since injury, hazards, and patient presentation
  • The coagulation process generally completes in:
    7–10 minutes
  • What are the three top priorities when managing a trauma patient with suspected hemorrhage?
    Airway, breathing, circulation/hemorrhage control
  • A focused trauma assessment is performed when:
    The patient is stable with no significant MOI or systemic signs
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