Take Home Trauma

[ryan]

In the final hours the discussion grows heated over a handful of questions.

Questions no one could agree on (#22,25,26,80,106,116).

Bro's Thoughts:

22. C - p945 - Information on Airway Assessment starting on page 944 assumes that you have already ruled out trauma particularly to the spine.
Also consider c-spine is in the scene size up, before you would even get to assessing the airway.

25. B - p993 - This is a case of 'which of these things is not like the other', three of the four answers involve low BP, where as the fourth answer Vasoconstriction would actually raise blood pressure. A high BP can be bad for many reasons but it is not a typical cause of syncope in geriatric patients.
Refer to table 32-2 on page 993.

26. A - p1037 - "If you must park on the backside of a hill or curve, leave your warning lights or devices on. Do the same when parking at night." Seemed to us that procedures wouldn't change based on flow of traffic particularly since it isn't mentioned anywhere. However there is a line about how drivers are drawn towards flashing red and white lights at night, that does not seem sufficient enough of a reason to turn off all lights when parked in oncoming traffic. So the compromise is to turn off the headlights which could impair an oncoming drivers vision while leaving the warning lights on so that you aren't invisible to drivers.

80. C - A & D get ruled out up front, B & C are plausible. Decreased blood volume in decompensated shock would produce a slower heart rate; so would cardiac compression such as pericardial temponade. However these would be difficult to observe in the field therefore the most reasonable explanation is the beta blocking (heat slowing) medication Inderal.

106. B - Refer to table 37-2 Triage Priorities located on page 1083.

116. A - p999 - Decreased nervous system function. If nothing else it sounds official.

[timB]

So on #22 are you 100%? Everyone is all over Pg944 and I can see why.

Pge 950 has lay on flat surface as the first step, then padding. I agree with "scene size up" first thing is cspine.

Code Name: "Jude",,,,,, any thoughts??????

[JUDE]

Hmm, now I am a "code name", I've always wanted to be one!
I am at home now, but when I get into the office I will go over these questions and talk about them at the beginning of class, before scantrons are turned in. I like that peeps are actually looking for the answers and discussing the questions. It is good for the EMS brain and hones critical thinking skills.

[timB]

Double "O" JUDE and Team Trauma ( well at least the 6 or so of us who use this site) All you on lookers better join!!!
So JohnB and I have been going back and fourth on 127 via email for the past 15mins or so. I say A he says B.
B) If two people go down the hill how do four carry him out
A) Where is the helicopter or tow wench that is going to pull the basket out.

Assume that steep incline means more than 65 degrees. At which point my scene is not safe! So it is "E" noe of the above

[ryan]

Thinking A.

[JUDE]

Hmm, okay:
22. The question asks :waht should you do before POSITIONING the airway?" The correct answer works whether there is spinal considerations or not. Think also of whether compression may become an issue.

25. Ryan's discussion points on this one are spot on.

26. Ditto
80. Decrease blood volume would most likely, esp initially, cause tachycardia, however, beta blockers control HTN by slowing down the rate, usually to approx. 58-64 bpm. Technically, our pt is RELATIVELY tachycardic.

116. Ryan's arguement for his answer is incorrect.