EMT 2060 - Trauma Emergencies

1. Describe the physiology of perfusion, including the role of the autonomic nervous system in controlling blood pressure.
2. Discuss cardiac output, heart rate, stroke volume, and systemic vascular resistance. 
3. Understand the pathophysiology of shock (hypoperfusion). 
4. Discuss myocardial contractility, afterload, and preload, and how they relate to shock. 
5. Describe how the body compensates for decreased perfusion. 
6. Explain how the body progresses to multiple-organ dysfunction syndrome (MODS). 
7. Recognize the causes of shock. 
8. Describe the three stages of shock. 
9. Describe the various types of shock, including cardiogenic shock, obstructive shock, distributive shock, hypovolemic shock, and respiratory insufficiency. 
10. Describe the signs and symptoms of shock. 
11. Explain the progression of shock, including the three distinct phases. 
12. Discuss the assessment of a patient who could be in shock. 
13. Describe the steps to follow in the emergency care of the patient with signs and symptoms of shock. 
14. Discuss the role of fluid administration in treating a patient in potential shock. (p 468)
15. Discuss special considerations in fluid resuscitation. 
16. Discuss the anatomy and physiology of the skin, including the layers of the skin. (pp 835-836)
17. Understand the functions of the skin. 
18. Discuss the pathophysiology of soft-tissue injuries, including closed injuries, open injuries, and burns. 
19. Describe the following types of closed soft-tissue injuries: contusion, hematoma, and crush injury. 
20. Describe the following types of open soft-tissue injuries: abrasions, lacerations, bite wounds, avulsions, and penetrating wounds. 
21. Describe the following types of burns: thermal, inhalation, chemical, electrical, and radiation.
22. Describe the assessment process for patients with a soft-tissue injury. 
23. Describe the relationship between airway management and the patient with closed and open injuries. 
24. Discuss emergency medical care of a patient with a soft-tissue injury. 
25. Discuss assessment and management of avulsions, amputations, gunshot wounds, open abdominal wounds, impaled objects, open neck wounds, and bites. 
26. Explain how the seriousness of a burn is related to its depth and extent. 
27. Define and give the characteristics of superficial, partial-thickness, and full-thickness burns.
28. Explain the steps involved in the assessment of burns. Describe and discuss the emergency management of burns, including chemical, electrical, thermal, inhalation, and radiation burns. 
29. Understand the functions of sterile dressings and bandages. 
30. Discuss the physiology of perfusion. 
31. Discuss the pathophysiology of external and internal bleeding. 
32. Describe the characteristics of arterial bleeding, venous bleeding, and capillary bleeding.
33. Discuss the body’s physiologic response to hemorrhaging. 
34. Describe the four stages of hemorrhaging. 
35. Describe the characteristics of external bleeding, including the identification of the following types of bleeding: arterial, venous, and capillary. 
36. List the signs and symptoms of hypovolemic shock. 
37. List the signs and symptoms of internal bleeding. 
38. Explain how to determine the nature of illness for internal bleeding, including identifying possible traumatic and nontraumatic causes. 
39. Describe what could be happening in the body when a patient with suspected internal bleeding becomes calm and still. 
40. Describe the assessment process for patients with external and internal bleeding. 
41. Discuss transport considerations for patients who are hemorrhaging. 
42. Explain the emergency medical care of a patient with external bleeding. 
43. Explain the emergency medical care of a patient with internal bleeding. 
44. Discuss situations in which a tourniquet may be used to control external bleeding. 
45. List precautions to follow when applying a tourniquet. 
46. Discuss the use of splints to control external bleeding. 
47. Describe situations in which using pneumatic antishock garments (PASG) to control bleeding may be an effective alternative. 
48. List contraindications for using PASG to control bleeding. 
49. Discuss assessment and management of bleeding from the nose, ears, and mouth. 
50. Discuss the anatomy and physiology of the head, face, and neck, including major structures and specific important landmarks of which the AEMT must be aware. 
51. Describe the factors that may cause obstruction of the upper airway following a facial injury.
52. Discuss the different types of facial injuries, including soft-tissue injuries, nasal fractures, mandibular fractures, Le Fort fractures, orbital fractures, and zygomatic fractures and patient care considerations related to each one. 
53. Describe the process of providing emergency care to a patient who has sustained face and neck injuries, including assessment of the patient, review of signs and symptoms, and management of care. 
54. List the steps in the emergency medical care of the patient with soft-tissue wounds of the face and neck. 
55. List the steps in the emergency medical care of the patient with an eye injury based on the following scenarios: foreign object, impaled object, burns, lacerations, blunt trauma, closed head injuries, and blast injuries. 
56. Describe the three different causes of a burn injury to the eye and patient management considerations related to each one. 
57. List the steps in the emergency medical care of the patient with injuries of the nose. (p 891)
58. List the steps in the emergency medical care of the patient with injuries of the ear, including lacerations and foreign body insertions. 
59. Describe the physical findings of a patient with a facial fracture, and list the steps related to providing emergency medical care to these patients. 
60. List the steps in the emergency medical care of the patient with dental and cheek injuries, including how to deal with an avulsed tooth. 
61. List the steps in the emergency medical care of patient with an upper airway injury caused by blunt trauma. 
62. List the steps in the emergency medical care of the patient with a penetrating injury to the neck, including how to control regular and life-threatening bleeding. 
63. List the major bones of the skull and spinal column and their related structures, and describe their functions as related to the nervous system. 
64. Describe the anatomy and physiology of the nervous system, including its divisions into the central nervous system (CNS) and peripheral nervous system (PNS) and the structures and functions of each.
65. Describe the regions of the brain, including the cerebrum, diencephalons, brainstem, and the cerebellum, and their functions. 
66. Discuss the different types of head injuries, their potential mechanism of injury (MOI), and general signs and symptoms of a head injury that the AEMT should consider when performing a patient assessment. 
67. Define traumatic brain injury (TBI) and explain the difference between a primary (direct) injury and a secondary (indirect) injury, providing examples of possible mechanisms of injury that may cause each one. 
68. Discuss the different types of brain injuries and their corresponding signs and symptoms, including increased intracranial pressure (ICP), concussion, contusion, and injuries caused by medical conditions.
69. Discuss the different types of injuries that may damage the cervical, thoracic, or lumbar spine, providing examples of possible mechanisms of injury that may cause each one. 
70. List the mechanisms of injury that cause a high index of suspicion for the possibility of a head or spinal injury.
71. Discuss age-related variations that are required when providing emergency care to a pediatric patient who has a suspected head or spinal injury.
72. Describe the steps in the patient assessment process for a person who has a suspected head or spine injury, including specific variations that may be required as related to the type of injury.
73. Describe the process of providing emergency medical care to a patient with a head injury, including the three general principles designed to protect and maintain the critical functions of the central nervous system and ways to determine whether the patient has a traumatic brain injury.
74. Discuss when it would be appropriate to establish intravenous access in a patient with a head or spinal injury, including the importance of judicious fluid administration. 
75. Describe the process of providing emergency medical care to a patient with a spinal injury, including the implications of not properly caring for patients with injuries of this nature, the steps for performing manual in-line stabilization, implications for sizing and using a cervical spine immobilization device, and key symptoms that contraindicate in-line stabilization. 
76. Describe the process of preparing patients who have suspected head or spinal injuries for transport, including the use and functions of a long backboard, short backboard, and other short spinal extrication devices to immobilize the patient’s cervical and thoracic spine. 
77. Explain the different circumstances in which a helmet should be either left on or taken off a patient with a possible head or spinal injury, and then list the steps AEMTs must follow to remove a helmet, including the alternate method for removing a football helmet. 
78. Define the term mechanism of injury (MOI), and explain its relationship to potential energy, kinetic energy, and work. 
79. Define the term index of suspicion and explain its relationship to the AEMT’s assessment of trauma. 
80. Define the terms blunt and penetrating trauma and provide examples of the MOI that would cause each one to occur.
81. Describe the five types of motor vehicle collisions, the injury patterns associated with each one, and how each relates to the index of suspicion of life-threatening injuries. 
82. Discuss the three specific factors to consider during assessment of a patient who has been injured in a fall, plus additional considerations for pediatric and geriatric patients. 
83. Discuss the effects of high-, medium-, and low-velocity penetrating trauma on the body and how an understanding of each type helps the AEMT form an index of suspicion about unseen life-threatening injuries. 
84. Discuss primary, secondary, tertiary, and miscellaneous blast injuries and describe the anticipated damage each one will cause to the body. 
85. Describe multisystem trauma and the special considerations that are required for patients who fit this category, and provide a general overview of multisystem trauma patient management.
86. Outline the major components of trauma patient assessment, including considerations related to whether the method of injury was significant or nonsignificant. 
87. Discuss the special assessment considerations related to a trauma patient who has injuries in each of the following areas: head, neck and throat, chest, and abdomen. 
88. Describe trauma patient management in relation to scene time and transport selection and list the Association of Air Medical Services criteria for the appropriate use of emergency air medical services. 
89. Discuss the facilities and transport resources available through EMS trauma systems.
90. Describe the American College of Surgeons’ Committee on Trauma classification of trauma centers and how it relates to making an appropriate destination selection for a trauma patient. 
91. Review the anatomy and physiology of the thorax. 
92. Understand the mechanics of ventilation in relation to chest injuries. 
93. Discuss specific chest injuries, including closed vs. open chest injury, blunt vs. penetrating trauma, and effects on cardiac output, respiration, and ventilation. 
94. Describe the assessment process for patients with a chest injury. 
95. List general signs and symptoms of a chest injury. 
96. Discuss the significance of various signs and symptoms of chest injury, including changes in heart rate, dyspnea, jugular vein distention, muffled heart sounds, changes in blood pressure, diaphoresis or changes in pallor, hemoptysis, and changes in mental status. 
97. Discuss the general management of a patient with a chest injury. 
98. Discuss the assessment and management of chest wall injuries, including rib fractures, flail chest, sternal fracture, clavicle fracture, and commotion cordis. 
99. Describe the complications of rib fractures.
100. Describe the complications of flail chest.
101. Discuss the assessment and management of lung injuries, including simple 103. pneumothorax,    open pneumothorax, tension pneumothorax, hemothorax, and pulmonary contusion.
102. Explain the complications associated with an open pneumothorax (sucking chest wound)
103. Differentiate between a pneumothorax (open, simple, and tension) and a hemothorax.
104. Discuss the assessment and management of myocardial injuries, including cardiac tamponade, myocardial contusion, and myocardial rupture.
105. Describe the complications of cardiac tamponade.
106. Discuss the assessment and management of vascular injuries, including traumatic aortic disruption and penetrating wounds of the great vessels.
107. Discuss the assessment and management of other thoracic injuries, including diaphragmatic injury, esophageal injury, tracheobronchial injuries, and traumatic asphyxia.
108. Describe the anatomy and physiology of the abdomen, including an explanation of abdominal quadrants and boundaries and the difference between hollow and solid organs.
109. Describe the anatomy and physiology of the female and male genitourinary systems, and distinguish between hollow and solid organs.
110. Describe some special considerations related to the care of pediatric patients and geriatric patients who have experienced abdominal trauma.
111. Define and discuss closed abdominal injuries, providing examples of the mechanisms of injury that are likely to cause this type of trauma in a patient, as well as key signs and symptoms.
112. Define and discuss open abdominal injuries, including ways to distinguish low-velocity, medium-velocity, and high-velocity injuries, examples of the mechanisms of injury that would cause each, and signs and symptoms exhibited by a patient who has experienced this type of injury.
113. Describe the different ways hollow and solid organs of the abdomen can be injured and include the signs and symptoms a patient might exhibit depending on the organ(s) involved.
114. Discuss the types of traumatic injuries that may be sustained by the organs of the male and female genitourinary system, including the kidneys, urinary bladder, and internal and external genitalia.
115. Discuss the assessment of a patient who has experienced an abdominal or genitourinary injury.
116. Discuss special considerations related to patient privacy when assessing a patient with a genitourinary injury.
117. Discuss the emergency medical care of a patient who has sustained a closed abdominal injury, including blunt trauma caused by a seatbelt or air bag.
118. Discuss the emergency medical care of a patient who has sustained an open abdominal injury, including penetrating injuries and abdominal evisceration.
119. Discuss the emergency medical care of a patient who has sustained a genitourinary injury related to the kidneys, bladder, external male/female genitalia, and rectum.
120. Explain special considerations related to a patient who has experienced a genitourinary injury caused by a sexual assault, including patient treatment, criminal implications, and evidence management.
121. Describe the function of the musculoskeletal system.
122. Understand the anatomy and physiology of the musculoskeletal system.
123. Describe the different types of musculoskeletal injuries, including fractures, dislocations, amputations, sprains, and strains.
124. Name the four types of force that can cause musculoskeletal injury.
125. Differentiate between open and closed fractures.
126. Discuss compartment syndrome and its assessment and management
127. Explain how to assess the severity of an injury.
128. Understand the emergency medical care of the patient with an orthopaedic injury.
129. Describe the emergency medical care of the patient with a swollen, painful, deformed extremity (fracture).
130. Understand the need for, general rules of, and possible complications of splinting.
131. Explain the reasons for splinting fractures, dislocations, and sprains at the scene versus transporting the patient immediately.
132. Recognize the characteristics of specific types of musculoskeletal injuries.
133. Describe the significance of pelvic fractures and their assessment and management.
134. Describe the emergency medical care of the patient with an amputation.
135. Demonstrate the assessment of neurovascular status. 
136. Demonstrate the care of musculoskeletal injuries. 
137. Demonstrate how to apply a rigid splint. 
138. Demonstrate how to apply a zippered air splint. 
139. Demonstrate how to apply an unzippered air splint. 
140. Demonstrate how to apply a vacuum splint. 
141. Demonstrate how to apply a Hare traction splint. 
142. Demonstrate how to apply a Sager traction splint.
143. Demonstrate how to apply a pneumatic antishock garment 
144. Demonstrate how to splint the hand and wrist. 
145. Demonstrate how to splint the clavicle, the scapula, the shoulder, the humerus, the elbow, and the forearm. 
146. Demonstrate how to care for a patient with an amputation. 
147. Demonstrate how to treat a patient in potential shock. 
148. Demonstrate how to complete an EMS patient care report for a patient with bleeding and/or shock. 
149. \Demonstrate the emergency medical care of closed soft-tissue injuries. 
150. Demonstrate how to control bleeding in an open soft-tissue injury.
151. Demonstrate the emergency medical care of a patient with an open abdominal wound.
152. Demonstrate how to stabilize an impaled object.
153. Demonstrate how to care for a burn.
154. Demonstrate the emergency medical care of a patient with a chemical, electrical, thermal, inhalation, or radiation burn.
155. Demonstrate emergency medical care of a patient with external bleeding using direct pressure.
156. Demonstrate emergency medical care of a patient with external bleeding using a commercial tourniquet.
157. Demonstrate how to use a PASG to control bleeding.
158. Demonstrate emergency medical care of a patient with epistaxis (nosebleed).
159. Demonstrate emergency medical care of a patient who shows signs and symptoms of internal bleeding.
160. Demonstrate the removal of a foreign object from under a patient’s upper eyelid.
161. Demonstrate the stabilization of a foreign object that has been impaled in a patient’s eye.
162. Demonstrate irrigation of a patient’s eye using a nasal cannula, bottle, or basin. 
163. Demonstrate the care of a patient who has a penetrating eye injury. 
164. Demonstrate how to control bleeding from a neck injury. 
165. Demonstrate how to perform a jaw-thrust maneuver on a patient with a suspected spinal injury.
166. Demonstrate how to perform manual in-line stabilization on a patient with a suspected spinal injury. 
167. Demonstrate how to immobilize a patient with a suspected spinal injury to a long backboard.
168. Demonstrate how to immobilize a patient with a suspected spinal injury who was found in a sitting position.
169. Demonstrate how to immobilize a patient with a suspected spinal injury who was found in a standing position.
170. Demonstrate how to apply a cervical collar to a patient with a suspected spinal injury.
171. Demonstrate how to immobilize a patient with a suspected spinal injury to a short backboard.
172. Demonstrate how to remove a helmet from a patient with a suspected head or spinal injury.
173. Demonstrate the alternate method for removal of a football helmet from a patient with a suspected head or spinal injury. 
174. Describe the steps to take in the assessment of a patient with a suspected chest injury.
175. Demonstrate the management of a patient with a sucking chest wound.
176. Demonstrate proper emergency medical care of a patient who has experienced a blunt abdominal injury. 
177. Demonstrate proper emergency medical care of a patient who has a penetrating abdominal injury with an impaled object. 
178. Demonstrate how to apply a dressing to an abdominal evisceration wound.