FISDAP - Paramedic Trauma Unit Exam Review/Study
Guide
Paramedic Trauma Unit Exam Review:
Fisdap
Understand the Concepts:
Disseminating intravascular coagulation: it is a condition in which small blood clots develop
throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the
platelets and clotting factors needed to control bleeding, causing excessive bleeding.
Hemorrhagic compensatory mechanisms: the reduction of blood during acute blood loss causes
the body to use its compensatory mechanisms. The body has a number of compensatory
mechanisms that become activated in an attempt to restore arterial pressure and blood volume
back to normal, such as: baroreceptor reflexes, chemoreceptor reflexes, circulating
vasoconstrictors, renal reabsorption of sodium and water, activation of thirst mechanisms,
reabsorption of tissue fluids.
Pathophys of referred pain (such as Kehr’s sign): Referred pain is characterized as pain in a
location not associated with the affected origin. Kehrs sign is an example of this because it is
pain in the shoulders due to blood or fluids in the peritoneal cavity.
Pleural decompression: This is performed when a pt presents with an open pneumothorax and the
symptoms associated with that condition (JVD, unequal breath sounds, chest trauma, tracheal
deviation). To perform this treatment you must first identify the 2 landmarks for needle placement
on the affected side (1st - second intercostal space, midclavicular line, just above the third rib to
avoid the nerve endings that lie just inferior to the rib above) (2nd- fifth intercostal space,
midaxillary line, just above the 6th rib), then cleanse the site, insert a large bore IV (>16g) at a 90
degree angle to the skin and push it all the way to the hub. Then remove the needle from the
catheter leaving the catheter in place - air, blood or both may be visualized or heard coming from
the catheter.
Rhabdomyolysis: the breakdown of skeletal muscle, which releases myoglobin into the
bloodstream. This is caused by prolonged crush injuries, which in turn releases toxins/waste
products into the body and can cause acute renal failure if not treated aggressively.
Subcutaneous emphysema: This is air that has escaped the lungs and become trapped in the
skin. Palpating this area will feel like there is popping under the skin or inflated.
Transected aorta: AKA traumatic aortic disruption, is arguably the most severe of all deceleration
injuries. The body stops moving suddenly from a relatively high speed, but the heart continues
its forward momentum and swings on the aorta, which is securely attached to the posterior chest
wall. With sufficient speed, the aorta wall fails and tears. With a large enough tear, the patient will
bleed out into the chest cavity within 1-2 minutes of the collision. The treatment for this patient is
largely supportive. Only very few patients with this condition survive until EMS arrives and even
fewer survive until arrival of the hospital. Maintenance of BP, provision of airway and 02, and CPR
if needed are the mainstays of treatment for this patient.
, FISDAP - Paramedic Trauma Unit Exam Review/Study
Guide
Perform the Skills:
Assess a patient with a tension pneumo: Assessment of a pt with a pneumo should include
Guide
Paramedic Trauma Unit Exam Review:
Fisdap
Understand the Concepts:
Disseminating intravascular coagulation: it is a condition in which small blood clots develop
throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the
platelets and clotting factors needed to control bleeding, causing excessive bleeding.
Hemorrhagic compensatory mechanisms: the reduction of blood during acute blood loss causes
the body to use its compensatory mechanisms. The body has a number of compensatory
mechanisms that become activated in an attempt to restore arterial pressure and blood volume
back to normal, such as: baroreceptor reflexes, chemoreceptor reflexes, circulating
vasoconstrictors, renal reabsorption of sodium and water, activation of thirst mechanisms,
reabsorption of tissue fluids.
Pathophys of referred pain (such as Kehr’s sign): Referred pain is characterized as pain in a
location not associated with the affected origin. Kehrs sign is an example of this because it is
pain in the shoulders due to blood or fluids in the peritoneal cavity.
Pleural decompression: This is performed when a pt presents with an open pneumothorax and the
symptoms associated with that condition (JVD, unequal breath sounds, chest trauma, tracheal
deviation). To perform this treatment you must first identify the 2 landmarks for needle placement
on the affected side (1st - second intercostal space, midclavicular line, just above the third rib to
avoid the nerve endings that lie just inferior to the rib above) (2nd- fifth intercostal space,
midaxillary line, just above the 6th rib), then cleanse the site, insert a large bore IV (>16g) at a 90
degree angle to the skin and push it all the way to the hub. Then remove the needle from the
catheter leaving the catheter in place - air, blood or both may be visualized or heard coming from
the catheter.
Rhabdomyolysis: the breakdown of skeletal muscle, which releases myoglobin into the
bloodstream. This is caused by prolonged crush injuries, which in turn releases toxins/waste
products into the body and can cause acute renal failure if not treated aggressively.
Subcutaneous emphysema: This is air that has escaped the lungs and become trapped in the
skin. Palpating this area will feel like there is popping under the skin or inflated.
Transected aorta: AKA traumatic aortic disruption, is arguably the most severe of all deceleration
injuries. The body stops moving suddenly from a relatively high speed, but the heart continues
its forward momentum and swings on the aorta, which is securely attached to the posterior chest
wall. With sufficient speed, the aorta wall fails and tears. With a large enough tear, the patient will
bleed out into the chest cavity within 1-2 minutes of the collision. The treatment for this patient is
largely supportive. Only very few patients with this condition survive until EMS arrives and even
fewer survive until arrival of the hospital. Maintenance of BP, provision of airway and 02, and CPR
if needed are the mainstays of treatment for this patient.
, FISDAP - Paramedic Trauma Unit Exam Review/Study
Guide
Perform the Skills:
Assess a patient with a tension pneumo: Assessment of a pt with a pneumo should include
