PHTLS Chuck
Average EMS response time and time on scene - ANS *6-8 min en route
*8-10 onscene
4 components of ethics (agreed upon set of moral principles) - ANS *autonomy
*nonmaleficence
*beneficence
*justice
Criteria for informed consent - ANS *decision making capacity
*ability to communicate their understanding of the situation
*ability to give consent or refusal voluntarily
*give a refusal or consent to treatment
Difference between POLST and DNR - ANS *DNR is for resuscitation only.
*POLST if more for general end of life care
How long can heart/brain, kidneys/liver/GI, muscle/bone/skin go without oxygen - ANS
*heart/brain/lungs-4-6 min
*kidneys/liver/GI-45-90 min
*muscle/skin/bone 4-6 hrs
What does aerobic metabolism use for fuel - ANS Oxygen
What does anaerobic metabolism use for fuel - ANS Stored body fat
Quick formula for MAP - ANS *DIA + 1/3 sysbp
Vasovagal (psychogenic) shock - ANS *when vagus nerve stimulated causing bradycardia and
vasodilation
Septic shock pathophysiology - ANS *Cytokines released in response to infection cause
damage to blood vessel walls and leakage of fluids into interstitial space.
Describe how shearing forces work, and common ones seen in mvc - ANS *One structure
moves faster than the other
*spleen, kidney, small intestine all tear away from points of attachment
*aorta tears away from defending arch which is tied to spine
Paper bag effect - ANS *results in pneumothorax
, *crash victim instinctively takes a breath and holds it right before impact
3 types of blunt injuries - ANS *cavitation
*compression
*shear
Liver lies more on which side - ANS Right side
What tears the liver during impact? - ANS *supported by diaphragm and ligamentum teres
which separates the left and right liver. When the liver keeps sliding past the ligamentum teres it
cuts it in half like a cheese where on a block of cheese
What is the formula for kinetic energy - ANS 1/2 x momentum x velocity squared
5 types of blast injuries - ANS *primary-pressure wave
*secondary-projectiles
*tertiary-propulsion of body into another object
*quaternary-heat and flames
*quinary-radiation, chemicals, bacteria
MCI start triage - ANS *"30-2-can do"
*if respirations are less than 30 (and more than 10), cap refill is less than 2 seconds, and they
are able to follow commands appropriately, they are categorized as yellow
*green gets up and walks to you
*red is failure of any the above 3
Allowable MCI interventions when triaging - ANS *reposition airway
*control life threatening bleeding
What GCS scores mean minor, moderate, and heavy injury - ANS *<3 heavy
*<*moderate (need to intubate
*<13 serious
*14-15 minor injuries
Regions/bones of the face - ANS *frontal
*parietal (sides of head and upper back of head)
*occipital (back lower part of the head)
*orbit-eye
*zygomatic-cheek
*nasal-nose
*maxilla-underneath eye and on the side of the nose
*mandible-upper and lower jaw
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