The Victim S Injured Extremities Were Immobilized Before Transport. Immobilized Means

Case Study 5-1: Emergency Care

During a triathlon, paramedics responded to a scene with multiple patients involved in a serious bicycle accident. B.R., a 20-year-old woman, lost control of her bike while descending a hill at approximately 40 mph. As she fell, two other cyclists collided with her, sending all three crashing to the ground.

Case Study, continued

At the scene, B.R. complained of pain in her head, back, chest, and leg. She also had numbness and tingling in her legs and feet. Other injuries included a cut on her face and on her right arm and an obvious deformity to both her shoulder and knee. She had slight difficulty breathing.

The paramedic did a rapid cephalocaudal assessment and immobilized B.R.'s neck in a cervical collar. She was secured on a backboard and given oxygen. After her bleeding was controlled and her injured extremities were immobilized, she was transported to the nearest emergency department.

During transport, the paramedic in charge radioed ahead to provide a prehospital report to the charge nurse. His report included the following information: occipital and frontal head pain; laceration to right temple, superior and anterior to right ear; lumbar pain; bilateral thoracic pain on inspiration at midclavicular line on right and midaxillary line on the left; dull aching pain of the posterior proximal right thigh; bilateral paresthesia (numbness and tingling) of distal lower legs circumferentially; varus (knock-knee) adduction deformity of left knee; and posterior displacement deformity of left shoulder.

At the hospital, the emergency department physician ordered radiographs for B.R. Before the procedure, the radiology technologist positioned a lead gonadal shield centered on the midsagittal line above B.R.'s symphysis pubis to protect her ovaries from unnecessary irradiation by the primary beam. The technologist knew that gonadal shielding is important for female patients undergoing imaging of the lumbar spine, sacroiliac joints, acetabula, pelvis, and kidneys. Shields should not be used for any examination in which an acute abdominal condition is suspected.


Multiple choice: Select the best answer and write the letter of your choice to the left of each number.

_ 1. The term for the time span between injury and admission to the emergency department is:

a. preoperative b. prehospital c. pre-emergency d. pretrauma e. intrainjury

_ 2. A cephalocaudal assessment goes from_to_.

a. stem to stern b. front to back c. head to toe d. side to side e. skin to bone

_ 3. The victim's injured extremities were immobilized before transport. Immobilized means:

a. abducted as far as they will go b. internally rotated and flexed c. adducted so that the limbs are crossed d. rotated externally e. held in body alignment to keep them from moving

Case Study, continued

_ 4. A cervical collar was placed on the victim to stabilize and immobilize the a. uterus b. shoulders c. chin d. neck e. pelvis

_ 5. The singular form of acetabula is:

a. acetyl b. acetabulum c. acetabia d. acetab e. acetabulae

Draw or shade the appropriate areas on one or both diagrams for each question.

6. Draw a dot over the area of the victim's occipital and frontal pain.

6. Draw a dot over the area of the victim's occipital and frontal pain.

Cephalocaudal Assessment

7. Draw a dash (—) over the area of the right temporal laceration—superior and anterior to the right ear.

8. Shade the area of lumbar pain.

Case Study, continued

9. Shade the anterior area of thoracic pain at the midaxillary line on the left.

10. Draw a star at the area of the pain on the right proximal posterior thigh.

11. Shade the area of the bilateral paresthesia of the distal lower legs, circumferentially.

12. Draw an arrow to show the direction of the varus adduction of the left knee.

13. Draw an arrow to show the direction of the posterior displacement of the left shoulder.

14. Draw a fig leaf to show the gonadal shield on the midsagittal line above the symphysis pubis.

15. Draw a circle around the area of the sacroiliac joints.


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Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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