Case Study (Closed Head Injury) Pretest by whq15269

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									Utah EMSC Trauma Protocols Posttest

   1. Closed head injury is:
         a. non-penetrating traumatic brain injury
         b. total brain injury
         c. any trauma
         d. head injury with seizure

   2. A 3 year old child is involved in a motor vehicle crash. She suffered a loss of
      consciousness for an unknown period of time. Upon your arrival she is breathing
      about eight times per minute. Your interventions in order of implementation
      include:
          a. Spinal immobilization, airway positioning, oxygen by mask and IV
          b. Spinal immobilization, airway positioning, BVM w/oxygen and IV
          c. Spinal immobilization, control bleeding, giving oxygen by mask

   3. Upon further examination the above patient exhibits a “blown” pupil. The
      appropriate intervention for this is:
         a. Hyperventilate to get ETCO2 less than 30
         b. Increase respiratory/ventilatory rate by 10%.
         c. Target a normal respiratory rate for age
         d. Check the blood pressure

   4. TBI refers to:
         a. Total body injury
         b. Tibial brachial injury
         c. Traumatic brain injury
         d. Total brain ischemia

   5. A twelve year old who was jumping on the trampoline fell off and hit her head,
      but walks home. Is it necessary to put her in c-spine precautions?
          a. Yes
          b. No
          c. Depends on who is on at the hospital

   6. The most ominious signs of herniation listed is:
         a. Seizures
         b. One pupil “blown” (much larger than the other)
         c. Normotension
         d. Response to voice

   7. Hyperventilation is no longer recommended for children with head injuries
      because:
         a. It’s hard to get kids to breathe that fast
         b. It limits the amount of blood flow to the brain
         c. They need fluid more than breathing
   8. A child involved in a motor vehicle crash is in c-spine precautions, but does not
      have an IV or IO yet begins to have a seizure. At this time what is the drug/route
      of choice?
          a. Midazolam given Intranasal
          b. Diazepam given Rectally
          c. Phenobarbital given IM

   9. What is the dose you would use for the above patient:
        a. 0.2 mg/kg
        b. 0.1 mg/kg
        c. 10 mg
        d. 0.3 mg/kg

   10. Spinal immobilization Neurogenic shock
   11. Submersion, increasing ventilatory pressure
   12. Submersion, maintenance of body temperature
   13. Blunt trauma, Assigning GCS
   14. Blunt Trauma Pain management
   15. Burn, Potential Airway Compromise
   16. Burn, Fluid Resuscitation
   17. Burn, Wounds
   18. Penetrating trauma, possible Ca/Lung complications
   19. Penetrating trauma, stabilization of object
   20. Burn, Why are kids at risk? Circumferential burn? Child abuse?
   21. Anoxic brain injury?
   22. Submersion, complications of hypothermia




Trauma
Blunt Trauma
   1. Demonstrate proper spinal immobilization techniques, including pediatric cervical
       spine immobilization
   2. Verbalize appropriate resuscitation IV fluid and IV fluid volume
   3. Identify the components of the AVPU scale
   4. Assign correct Glasgow Coma Score (GCS)
   5. Verbalize need for pain management
Burn
   1. Classify extent and depth of burn
   2. Verbalize post-burn interventions to prevent further damage
   3. Describe physical findings in burn victims which may cause potential airway
      compromise
   4. Define proper fluid resuscitation measures
   5. Describe appropriate dressing on burn site to protect skin and prevent heat loss

Penetrating Trauma
   1. Direct stabilization of penetrating object
   2. Recognize possible respiratory or cardiac complications of penetrating chest
      trauma
   3. Discuss risks and benefits of various bleeding control measures
   4. Demonstrate proper spinal immobilization techniques, including pediatric cervical
      spine immobilization
   5. Verbalize appropriate resuscitation IV fluid and IV fluid volume
   6. Discuss need for pain management

Spinal Immobilization
   1. Verbalize special considerations for pediatric spinal immobilization
   2. Demonstrate proper cervical spinal immobilization techniques given resources
      available
   3. Discuss unusual pediatric circumstances requiring spinal immobilization
   4. Identify 3 signs or symptoms of neurogenic shock

Submersion
   1. Demonstrate proper spinal immobilization techniques, including pediatric cervical
      spine immobilization
   2. Discuss methods to measure and control victim’s body temperature
   3. Verbalize appropriate resuscitation IV fluid and IV fluid volume
   4. Demonstrate ways to increase ventilatory pressure
   5. Recognize possible cardiac complication of severe hypothermia
Closed Head Injury
   1. Define TBI
   2. Verbalize goal CO2 levels for TBI patients
   3. Differentiate slow respiratory rate from agonal respirations
   4. Identify signs of impending brain herniation
   5. Discuss respiratory interventions appropriate for impending herniation
   6. Provide the medication and dose used in case of seizure activity

								
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