EMT Trama

In children a burn is considered critical when? It is on the buttocks It is less than 10% of the body It is on the chest It involves a hand or foot

It involves a hand or foot Rationale: Burns to children are considered critical if it involves the head, face, hands, feet, or genitals; or if a significant portion of the body is burned

Energy levels in penetrating trauma include all of the following except: High energy Low energy Medium energy Sonic energy

Sonic energy Rationale: Energy levels in penetrating trauma include: Low energy (stabbings), medium energy (handgun, some rifles), and high energy (military-grade weaponry).

Special unique considerations for pediatric patients involved in trauma include all of the following except: Sports injuries Burns Drowning Falls

Sports injuries Rationale: Special unique considerations for pediatric patients involved in trauma include: vehicle crashes, pedestrian versus vehicle collisions, drowning, burns, falls, and penetrating trauma.

You and your partner Monroe arrive on scene to a house fire that has just been put out. You are treating a female patient with a full thickness burn to her leg. Which of the burn zones is the one most likely to recover? Zone of stasis Zone of coagulation Zone of hyperemia Zone of hemoptysis

Zone of hyperemia Rationale: Zone of coagulation is the central part of the burn, zone of stasis has partial viable tissue out from that, and then there is the zone of hyperemia which is the part that will most likely recover from the injury.

When using the rule of palm to determine the extent of the burn, each palm is considered what percentage of the body surface? 2 percent 4 percent 3 percent 1 percent

1 percent Rationale: The palm is approximately 1% of the body surface. This scale may be used in adults, children, and infants.

How much blood loss is considered serious in an adult patient? 500cc 300cc 100cc 1000cc

1000cc Rationale: 1000cc is serious blood loss in the average adult.

Tenderness and pain in the abdomen upon palpation could likely mean? Intestinal leakage into the pleural space Blood pooling in the pletal space Blood irritating the peritoneal lining Pericardial hemorrhage

Blood irritating the peritoneal lining Rationale: Blood leaking into the peritoneal space would be the best choice for abdominal pain and tenderness. There is no pletal space and pericardial irritation refers to the sack around the heart.

Using the Glasgow Coma Scale, which score would indicate a mild head injury? > 15 8-12 13-15 < 8

13-15 Rationale: Under the Glasgow Coma Scale, head injuries are classified by score: mild - 13-15; moderate - 8-12; and severe <8. Fifteen is the highest possible score and indicates no neurologic disabilities.

You are doing clinical rotations at the local emergency room and have been assigned to assist in triage. Which of the following patients would require immediate attention? 1 14 y/o female that was thrown from her horse. She is arguing with her mother about being there, and wants to leave. The patient is complaining of tingling in her left arm and fingers, but says nothing else hurts. 2 7 y/o male with obvious deformity to left arm and wrist. Pt. is screaming in pain. 3 )32 y/o female that is complaining of a horrible headache. B/P 135/76, HR 76, RR 22. 4) 44 y/o male that has 2nd degree burns from his elbow down on his right arm. B/P 148/88, HR 100, RR 22. Pt. says he is hurting pretty badly.

14 y/o female that was thrown from her horse. She is arguing with her mother about being there, and wants to leave. The patient is complaining of tingling in her left arm and fingers, but says nothing else hurts. Rationale: The 14 y/o female is exhibiting signs of possible cervical injury and should be immediately placed in c-spine precautions. The mechanism of injury and the report of tingling in an extremity are clues that there may be a cervical fracture. All the other patients injuries are stable for a few more minutes until this one is addressed.

How many cc's of blood does the average man have per kilogram of body weight? 80 cc 90 cc 60 cc 70 cc

70 cc Rationale: On average, a man has approximately 70 cc of blood per kilogram of body weight.

A man of average size and weight has approximately how much blood per kilo of body weight? 60 ml 100 ml 70 ml 50 ml

70 ml Rationale: On average, a man has approximately 70 cc of blood per kilo of body weight.

You arrive on scene and find a 10 month old female with burns to her front torso and face. Using the Rule of nines, approximately what percent of her body has been burned? 38% 18% 27% 36%

27% Rationale: Using the Rule of nines would indicate that approximately 27% of her body has been affected by the burns (18% front torso + 9% face = 27%).

You arrive at a home and find a 9 month old female with burns to her back and head. Using the Rule of nines, approximately what percent of her body has been burned? You arrive at a home and find a 9 month old female with burns to her back and head. Using the Rule of nines, approximately what percent of her body has been burned? 18% 36% 9% 27%

36% Rationale: Using the Rule of nines would indicate that approximately 36% of her body has been affected by the burns (18% back + 18% head).

Blood loss can be significant with? A heart attack Anaphylaxis A fracture None of the above

A fracture Rationale: Fractures may produce severe bleeding in an open or closed fracture.

Convert 150 pounds into kilos 67.5 kilos 90 kilos 100 kilos 80 kilos

67.5 kilos Rationale: A quick way to convert pounds to kilos is to take half or 50% of the pounds and then take 10% of that and subtract it from your total. For Example: 50% of 150 is 75, and 10% of 75 is 7.5. Therefore, 7.5 subtracted from 75 equals 67.5. One other quick way of conversion is to divide pounds by 2.2.

Convert 150 pounds into kilos. 80 kilos 90 kilos 100 kilos 67.5 kilos

67.5 kilos Rationale: A quick way to convert pounds to kilos is to take half or 50% of the pounds and then take 10% of that and subtract it from your total. For Example: 50% of 150 is 75, and 10% of 75 is 7.5. Therefore, 7.5 subtracted from 75 equals 67.5. One other quick way of conversion is to divide pounds by 2.2.

How many bones are contained in the cervical spine? 5 6 7 3

7

A 57-year-old man was in a car accident. He is complaining of severe chest pain. He has a history of cardiac problems and has a prescription for Nitro spray but it is empty. His first blood pressure is 119/74. His second blood pressure is 109/88 and his respirations have increased from 16 to 22 per minute. This man has ________________________ and it was most likely caused by __________________. A good chance of survival if nitro is administered / his previous cardiac history Had a heart attack / a weakened right atrium A narrowing pulse pressure / impact to the steering wheel Likely suffered a ruptured aorta / disease processes

A narrowing pulse pressure / impact to the steering wheel Rationale: The fact that the systolic is so close to the diastolic makes it a narrow pulse pressure and can be indicative of cardiac tamponade. The pericardium rapidly fills with fluid preventing adequate filling of the ventricles.

What is the best indication of the need to apply a traction splint to a fracture of the femur? Severe pain in the injured limb Swelling in the thigh of the injured limb Shortening and rotation of the injured limb A pale, cool foot on the injured limb

A pale, cool foot on the injured limb Rationale: The best indication from the options listed would be the pale, cool foot. This indicates blood flow is compromised distally to the injury. Remember that you can only apply a traction splint if it is an isolated mid-shaft femur fracture.

Which of the answer choices is not part of the scalp? Bone Muscle Subcutaneous tissue Hair

: Bone Rationale: The scalp is made up of hair, subcutaneous tissue, and muscle.

Using the Glasgow Coma Scale, which score would indicate a severe head injury? 13-15 < 8 > 15 8-12

< 8 Rationale: Under the Glasgow Coma Scale, head injuries are classified by score: Mild - 13-15, moderate - 8-12, and severe <8. Fifteen is the highest possible score and indicates no neurologic disabilities.

The best definition of a partial-thickness burn is: A burn that extends through all layers of the skin and may involve muscle, bone, or internal organs A burn that involves less than 60% of the surface of the body A burn that involves only the top layer of the skin A burn that involves the epidermis and some of the dermis

A burn that involves the epidermis and some of the dermis Rationale: A partial-thickness (second-degree) burn involves the epidermis and some of the dermis but does not injure the subcutaneous tissue. The skin with partial-thickness burns will be moist, white to red, mottled, and blistered. The pain of a partial thickness burn will be intense.

The definition of multi-system trauma includes all of the following except: A patient considered to have "multi-system trauma" has one major system and one minor system or organ involved. A patient considered to have "multi-system trauma" has more than one major system or organ involved Multi-system trauma has a high level of morbidity and mortality Almost all trauma affects more than one system 12-10

A patient considered to have "multi-system trauma" has one major system and one minor system or organ involved. Rationale: The definition of multi-system trauma includes: trauma affecting more than one system; typically a patient considered to have "multi-system trauma" has more than one major system or organ involved; multi-system trauma treatment involves a team of physicians to treat the patient. This may include specialists such as a neurosurgeon, thoracic surgeon, and an orthopedic surgeon; multi-system trauma have a high level of morbidity and mortality.

According to the National Head Injury Foundation, what is the best definition of Traumatic Brain Injury (TBI)? A traumatic insult to the brain capable of producing emotional and social changes A traumatic insult to the brain that may result in injury to soft tissue or bony structure A traumatic insult to the brain capable of producing physical and intellectual changes A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes

A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes Rationale: Traumatic Brain Injury (TBI) is defined by the National Head Injury Foundation as: A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes.

Unique airway management and ventilation considerations for pregnant patients involved in trauma include all of the following except: Assure bilateral breath sounds are present Assist ventilation if inadequate Anticipate vomiting Administer oxygen simple mask

Administer oxygen simple mask Rationale: Unique airway management and ventilation considerations for pregnant patients involved in trauma include all of the following except: anticipate vomiting - have suction available, assure bilateral breath sounds are present, keep oxygenation levels high (100%) - administer oxygen by non-rebreather mask, assist ventilation if inadequate.

Which of the following would cause a person to become hypovolemic? Dehydration on a hot day Slow GI bleed Cut to the hand that is uncontrolled All of the above

All of the above Rationale: All of these have the potential for lowering the level of fluid in the body thus resulting in Hypovolemia.

Environmental factors that contribute to the risk of heat-related illness include ________________________ and _____________________. Humidity; wind speed Medical illness; wind speed Ambient temperature; medical illness Ambient temperature; humidity

Ambient temperature; humidity Rationale: Environmental factors that contribute to the risk of heat-related illness include ambient temperature and humidity.

Pathophysiology of local cold exposure includes all of the following except: Anaphylactic reaction Fingers and toes very susceptible Local blood flow impairment Temporary or permanent tissue damage

Anaphylactic reaction Rationale: Pathophysiology of local cold exposure include: ears, fingers, and toes are very susceptible, ice crystals may form, impairment of local blood flow, and temporary or permanent tissue damage that may lead to amputation.

You and your partner Willy have just arrived at a restaurant where a man has fallen through a glass door. He has a laceration across his lower leg approximately 10 inches long and 1.5 inches deep. Which of the following treatment sequences would be the MOST appropriate? Put gloves on - Bandage wound - Pressure to arterial pressure point Apply pressure to the wound - Elevate the legs - Transport Locate and apply pressure to appropriate arterial pressure point - Elevate leg - Transport BSI - Treat patient for shock - Elevate leg

Apply pressure to the wound - Elevate the legs - Transport Rationale: The only answer that has a correct sequence of treatment is the 2nd. The other answer choices are out of order and would cause failure of the critical criteria of the NREMT bleeding control/shock management practical skill sheet (Did not control hemorrhage in a timely manner). BSI is not included in the correct answer because it is not part of the treatment. The answer choices with BSI included fail the critical criteria. NOTE: Elevating the extremity is no longer part of skill sheet however, elevating the legs is for treatment of shock.

There is two feet of snow on the ground and you and your partner Rex have just arrived at a residential fire. A man is brought to the ambulance with severe circumferential burns to both of his arms and hands. Red and white blisters are forming and his flannel shirt is still smoldering. You can see he has soot marks around his mouth and is in extreme pain. Treatment for this patient should include: Popping the blisters to allow the fluid to drain and removing any rings from his hands that may cause a problem with the eventual swelling Packing the man's arms in snow to immediately reduce the burning Assessment of the airway and high flow O2 Application of severe burn ointment to the arms and then wrapped in sterile dressings

Assessment of the airway and high flow O2 Rationale: The only answer completely correct is to provide oxygen and assess the airway. Popping blisters should not be done in the prehospital setting. Snow or ice should not be used as it can further the thermal damage of the tissues. Ointments should not be applied either as it can increase the severity of the burn and possibly delay a clinical assessment. In the case of this scenario, the man's shirt should also be removed to prevent any further burning from the garment.

Your 94-year-old patient is complaining of pain in her pelvis after a fall down 2 stairs. Your assessment should include: Assumption of a pelvic fracture Palpation of the exterior pelvic area only Palpation of the pericardium Even left and right pelvic pressure

Assumption of a pelvic fracture Rationale: If a patient has a supporting mechanism of injury with an associated fall and pelvic pain, an assumption can be made that a pelvic injury has occurred and any palpation can exacerbate the injury.

All of the following are closed chest injuries except: Rib fractures Flail segment Sternal fracture C-spine fracture

C-spine fracture Rationale: Closed chest injuries include: Rib fractures, flail segment, sternal fracture, clavicle fracture, and commotio cordis among others.

All of the following may be complications of burn injuries except: Airway obstruction Hypovolemia Hypothermia Cardiac obstruction

Cardiac obstruction Rationale: Complications of burn injuries may include: Infection, shock, hypoxia, airway obstruction, hypothermia, and hypovolemia. Circumferential burns of the chest can effect breathing. When the skin, which serves as a barrier for the body, is burned, the barrier is destroyed and the body is then at risk for a lot of secondary complications.

The nervous system is made up of the _________________________ and ______________________. Brain and central nervous system Spinal cord and peripheral nervous system Central nervous system and peripheral nervous system Brain and spinal cord

Central nervous system and peripheral nervous system Rationale: The Nervous system is made up of the central nervous system and the peripheral nervous system.

The types of brain injuries include all of the following except: Contusion Concussion Cerebral laceration Complex fracture

Complex fracture Rationale: Brain injuries include: concussion, contusion, cerebral laceration, space occupying lesions, and penetrating wounds.

There is a thin membrane that covers the eye, it is called the? Conjunctiva Sclera Hyphema Retina

Conjunctiva The conjunctiva is the membrane that covers the eye.

Dispatch has called you to the scene of a U.S. mail truck that slid out of control on a dirt road and rolled over. Bystanders reported the truck has caught on fire and the driver is outside the truck trying to gather the dumped mail. As you arrive on scene the fire department is just getting the fire out and the driver of the truck is standing back watching the smoldering mess. You should: Do a focused assessment on the driver Get the driver to sign a transport refusal form Get a SAMPLE history on the driver Do a standing backboard technique on the driver

Do a standing backboard technique on the driver Rationale: Given the mechanism of injury of a rollover, you should take c-spine precautions for this patient with a standing backboard technique. Adrenalin can mask serious injury and although the driver is walking around/ standing, that does not mean they are free of neck or spinal trauma.

Which best describes the meninges? Coverings in the brain Pathways that conduct messages in the brain Composed of nerve cells Center for involuntary functions

Coverings in the brain

Unique management considerations for injured geriatric patients include all of the following except: 1 Curvature of the spine is a contraindication to immobilization 2 Decrease in muscle size in abdomen may mask abdominal trauma 3 Broken bones are common 4 Suctioning is important due to decrease of cough reflex

Curvature of the spine is a contraindication to immobilization Rationale: Unique management considerations for injured geriatric patients include: suctioning is important in elderly due to decrease in cough reflex, decrease in muscle size in the abdomen may mask abdominal trauma, prevent hypothermia, broken bones are common - traction splints are not to be used to treat hip fractures, falls leading to trauma must be investigated as to the reason for the fall.

Your patient was involved in a motorcycle accident. During your physical exam you observe unequal pupils and irregular respirations. Your partner tells you the patients BP is 170/89 with a pulse rate of 60. What do these signs describe? Cushing's Triad Becker's Reflex Pulsus Paradoxus Orthostatic Hypertension

Cushing's Triad Rationale: His vital signs, along with unequal pupils, describe Cushing's Triad, which is related to increased intracranial pressure.

Hair follicles are found in which layer of the skin tissue? Subcutaneous Pangaea Epidermis Dermis

Dermis Rationale: They are found in the dermis layer.

Which one would not be included in assessment findings for strains? Severe weakness of muscle Extreme point tenderness Sound of a "snap" when muscle tears Edema at joint

Edema at joint Rationale: Assessment findings for strains include: Sound of a "snap" when muscle tears, severe weakness of the muscle, sharp pain immediately with occurrence, and extreme point tenderness.

Classification of burns for infants and children include all of the following except: Extensive Severe Moderate Minor

Extensive Rationale: Classifictions of burns for infants and children include: Minor, partial-thickness burns that cover less than 10% of the whole body. Moderate, partial-thickness burns that cover 10-20% of the whole body. Severe, all full-thickness burns and partial-thickness burns that cover more than 20% of the whole body.

What are the 3 different tests used within the GCS scale to measure a person's level of responsiveness? Eye opening, verbal response, and motor response Speech, facial droop, and arm drift Pupillary response, level of consciousness, and motor response Level of consciousness, speech, and motor coordination 12-9

Eye opening, verbal response, and motor response Rationale: The GCS scale is based upon eye opening, verbal response, and motor response. Each has a possibility of from 6 to 4 points with no reaction being awarded 1 point.

What is considered the binding force or glue that helps complete the clotting process? Fibrin Elastinol Glucose Skelux

Fibrin Rationale: The final glue that holds a clot together is called fibrin.

The Mechanism of Injury in closed abdominal trauma may include all of the following except: MVC Deceleration Compression GSW

GSW Rationale: The MOI in closed abdominal trauma may include: Compression, deceleration, MVC (Motor Vehicle Collision), motorcycle collision, vehicle vs. pedestrian injuries, falls, assault, and blast injuries. GSW (Gun Shot Wound).

An incomplete fracture that passes only partway through a bone is known as a ________________ fracture. Greenstick Transverse Comminuted Oblique

Greenstick Rationale: A greenstick fracture passes only partway through the shaft of a bone but may still cause substantial angulation. This occurs most often in children. Oblique fracture is when the bone is broken at an angle across the bone. Transverse fracture is when the break occurs straight across the bone. Comminuted is when the bone fractures, splinters, or is crushed into many different pieces.

You are cleaning the back of your ambulance outside the hospital emergency room when a man walks up to you holding his stomach. He tells you that he is hurting really bad and asks if you can help him. What is the best response in this situation? 1 Have him sit on your stretcher and begin assessing him for any obvious life threats. 2 Tell him to walk down to the door marked 'Emergency Room' and talk to the lady at the front desk. 3 Assist him into the Emergency Room and help him to the Triage area. 4 Call dispatch and report a walk up medical and give your location. Incorrect

Have him sit on your stretcher and begin assessing him for any obvious life threats. Rationale: While telling him to go into the ER waiting room might seem like a good idea, it is not the most appropriate choice. Neither is assisting him there first. The best course of action would be to do a rapid assessment to determine if he has any immediate life threats. It could be that he has a gunshot wound or stab wound that requires you to not move him any more than necessary. Just because you are at the emergency room doesn't mean you shouldn't start good patient care with a quick and thorough assessment.

When a person breaks the tibia and fibula they are likely to? Have vessel damage Have trauma to the upper leg as well Best be treated with a traction splint All of the above

Have vessel damage Rationale: Fracture of the lower bones of the leg often include damage to the veins and arteries of the leg, as the sharp edges of the broken bones cut through them and other tissue during the break.

ou arrive on scene to find a male patient alone and suffering from Aphasia. Blood pressure is 110/70, respirations are 18, and pulse is 82. SpO2 sat is 98%. Getting a history from this patient will be difficult because? His blood pressure is low and he is likely hypoxic He cannot understand or produce speech He will try to give you incorrect medical history People from Aphasia are often shy

He cannot understand or produce speech Rationale: Aphasia is a condition that may result from a head injury where the patient is unable to speak or understand what is being said. This would make taking a history very difficult.

Death due to soft tissue trauma is often related to ______________ or ________________. Infection or diabetes Infection or tachycardia Hemorrhage or tachycardia Hemorrhage or infection

Hemorrhage or infection Rationale: Death as a result of soft tissue trauma is often related to hemorrhage or infection. As the soft tissue bleeds, it loses valuable oxygen that supplies the cells. In addition, an infection can be introduced causing a localized or systemic issue.

A patient is complaining of difficulty breathing after being struck in the ribs by a baseball, and is now cyanotic around the lips. Proper action would include: High flow oxygen via non-rebreather mask and rapid transport A bag-mask device with supplemental oxygen attached Sweeping the tongue out of the way to look for airway obstructions Advice on proper use of a mitt

High flow oxygen via non-rebreather mask and rapid transport Rationale: As long as the patient is able to talk and keep his/her respirations within range, then high flow Oxygen and transport would be the best choice.

General assessment of orthopedic trauma includes all of the following except: Guarding or self-splinting Standard precautions Mechanism of injury (MOI) Immobilization

Immobilization Rationale: General assessment of orthopedic trauma includes: Scene safety, standard precautions, mechanism of injury (MOI), determine life threat, six P's of assessment (pain, pressure, paralysis, paresthesia, pallor, and pulselessness), physical exam, bleeding, guarding/self-splinting, and associated injuries.

You and your partner arrive on the scene of an auto accident. The patient, who has hepatitis B, is bleeding from a cut on his arm. You and your partner both use standard precautions while handling the patient. Blood is transferred to the ambulance stretcher. If someone came in contact with the blood on the stretcher they could become infected. This would be an example of which route of transmission? Airborne transmission Vector-borne transmission Direct contact transmission Indirect contact transmission

Indirect contact transmission Rationale: Indirect contact involves the spread of infection through an inanimate object. Any inanimate object that has the ability to carry and spread infection is called a fomite.

The appendix is located? Posterior to the gall bladder Superior to the stomach Inferior to the liver Lateral to the aorta

Inferior to the liver Rationale: The appendix is located on the patient's right side below (inferior) the liver.

Signs and symptoms of black widow bites include: Hematuria Lower extremity paralysis Progressive weakness Initial localized swelling

Initial localized swelling Rationale: Signs and symptoms of black widow bites include: Initial localized swelling and chest or abdominal pain. Depending on bite site and symptoms, bites may be dangerous to children. In some cases bites can be fatal.

Capillary bleeding is __________________________ and ___________________________. Is easy to control and clots spontaneously Difficult to control due to pressure and bright red bleeding or "spurts" Harder to control than venous bleeds and clots spontaneously Difficult to control due to size of vessels and dark red with slow flow

Is easy to control and clots spontaneously Rationale: Capillary bleeding is usually easy to control or stop and will clot spontaneously. Usually direct pressure with bandaging will stop the bleed in a minor amount of time. Arterial bleeds require more attention with the use of bandaging and tourniquets.

Which definition best describes the cerebellum? It is composed of nerve cells It primarily acts as a shock absorber It is the center of equilibrium and coordination It is the main part of the brain

It is the center of equilibrium and coordination Rationale: The cerebellum is one of three major subdivisions in the brain and is the center for equilibrium and coordination.

When examining the musculoskeletal system during secondary assessment, general physical findings for the lower extremities should include all of the following except: Leg drift Sensory Motor function Range of motion

Leg drift Rationale: When examining the musculoskeletal system during secondary assessment, general physical findings for the lower extremities should include: range of motion, sensory, motor function, and circulatory function

During the primary survey of a significant MOI patient, assessing the thorax and neck includes evaluating all of the following except: Sucking chest wound Deviated trachea Limb movement Multiple broken ribs

Limb movement Rationale: Primary survey assessment of a significant MOI patient's thorax and neck should include evaluating for: Deviated trachea, tension pneumothorax, chest wounds and chest wall motion, sucking wound, neck and chest crepitation, multiple broken ribs, and sternum fractures

The unique circulation signs and symptoms of submersion incidents include all of the following except: Skin may be cold May be in cardiac arrest Skin may be cyanotic May be coughing

May be coughing Rationale: The unique circulation signs and symptoms of submersion incidents include: May be in cardiac arrest, skin may be cyanotic, and skin may be cold.

The components of the brain include all of the following except: Meninges Cerebrum Brain stem Pons

Meninges Rationale: The parts of the brain include: Cerebrum, cerebellum, brain stem (midbrain, pons, and medulla oblongata), cerebral spinal fluid (CSF), and more...Meninges are 3 layers of membrane that protect the central nervous system.

Components of a long bone include _________________ and _______________. Shaft; epiphysis Ilium; ischium Metaphysis; diaphysis Head; tail

Metaphysis; diaphysis Rationale: The components of a long bone include the Epiphysis (distal and proximal), Metaphysis (distal and proximal), and Diaphysis (shaft).

Which best describes white matter? Nerve pathways that conduct messages of the brain Composed of nerve cells Center for involuntary functions Coverings of the brain

Nerve pathways that conduct messages of the brain Rationale: White matter is fiber nerve pathways that conduct messages of the brain.

You and your partner Rodney arrive on scene of a fall. Your patient is an 88 year old man who was riding his great grandson's skateboard and took a fall on the pavement. He is complaining of severe pain in his pelvis . Your assessment of this patient should include? Palpation of the iliac crest Palpation of the exterior pelvic area only Bilateral pelvic pressure to assess for break None of the above

None of the above Rationale: If you know they have pain in their pelvis you can assume that they have a fracture. Visually inspect it only. You can assume they have an injury to their pelvis and none of the methods described will help the patient in any way.

The root word rhin- refers to what? Forehead Throat Nose Head

Nose

General assessment of orthopedic trauma includes all of the following except: Obtaining vital signs Six P's of assessment Physical exam Guarding

Obtaining vital signs Rationale: General assessment of orthopedic trauma includes: Scene safety, standard precautions, mechanism of injury (MOI), determine life threat, six P's of assessment (pain, pressure, paralysis, paresthesia, pallor, and pulselessness), physical exam, bleeding, guarding/self-splinting, and associated injuries.

All of the following are transport considerations with brain trauma except: 1 Patients with impaired airway or ventilation may need rapid extrication 2 Patients must be transported to appropriate trauma centers 3 Patients frequently have seizures 4 Patients must have air medical transport

Patients must have air medical transport Rationale: Transport considerations with brain trauma include: Head trauma with impaired airway or ventilation, open wounds, abnormal vital signs, or patients who do not respond to painful stimuli may need rapid extrication; head trauma patients must be transported to appropriate trauma centers; may deteriorate rapidly and may need air medical transport; adequate airway, ventilation, and oxygenation are critical to the outcome; patients frequently vomit - keep suction available; and they frequently have seizures.

The most common mechanisms of injury in brain injuries are ________________ and _______________. Laceration; diffuse impact Diffuse impact; penetrating Penetrating; blunt Blunt; laceration

Penetrating; blunt Rationale: The most common mechanisms of injury in brain injuries are penetrating and blunt.

Air that becomes trapped between the visceral pleura and the parietal pleura is called? Pneumatic emphysema Pleural edema Subcutaneous emphysema Pneumothorax

Pneumothorax Rationale: Air may leak into the space between the visceral and parietal pleura from the lungs or from the environment with an open chest wound. This is a pneumothorax.

The causes of shock can be broken down into 3 categories. They are? Poor cardio function, fluid loss, and vessel dilation Poor perfusion, poor mentation, and poor respiratory function Trauma, cardiac event, and seizure Vessel constriction, poor vessel function, and poor respiratory function

Poor cardio function, fluid loss, and vessel dilation Rationale: The basic causes of shock are poor heart function, loss of blood and fluid, and dilation of vessels.

Shock is the body's response to what? Vasoconstriction Vasodilation Hemostasis Poor perfusion

Poor perfusion Rationale: Poor perfusion of the body's organs and systems will cause a person to go into shock.

During a Neurological Examination, sensation findings associated with spinal cord injuries include all of the following except: Absent - note specific level of impairment Altered sensation distal to injury Present throughout body Priapism 12-8

Priapism Rationale: Neurological Examination sensation findings include: Sensations present throughout body, sensations absent - note specific level of impairment, altered sensations distal to injury - numbness or "electric shocks". Priapism is a persistent penile erection due to a spinal cord injury and is not a sensation finding, but a visible sign.

You and your partner are having lunch at a city park when you hear a woman on the playground screaming. Several adults and children are gathered around and you decide to investigate. As you approach the playground you can see the frantic woman holding an approximately 4 year old child in her arms. As you get closer you can see that the child has a laceration to the foot that is actively bleeding. Upon seeing you and your partner, the screaming woman comes running toward you. What would be the best course of action? 1 Take the child from the woman and begin assessment for life threats. Have your partner sit the screaming woman down away from the child while you finish your assessment and treatment of the bleeding foot. 2Put direct pressure on the child's bleeding foot with a sterile dressing. While moving to the ambulance talk to the mother and encourage her to calm down. Let her and the child know that you are taking care of the cut on the foot. 3 Have the woman follow you and the child to the ambulance. Once inside apply direct pressure to the foot and wait to see if bleeding is controlled after 5 minutes. If bleeding is not controlled initiate transport to the hospital. 4Quickly retreat to the ambulance to get proper BSI and then return to assess the child. If the mother will not let you take the child, begin treatment of the bleeding foot while the woman holds the child in her lap.

Put direct pressure on the child's bleeding foot with a sterile dressing. While moving to the ambulance talk to the mother and encourage her to calm down. Let her and the child know that you are taking care of the cut on the foot. Rationale: When you are treating a child you often have to view the parents or caregivers as patients as well. You must remember to communicate with all who are involved. A hysterical parent can cause increased stress on the child which will not help your assessment and treatment. Separating a child and parent is rarely a good idea. This too can quickly increase the stress level of both patients. You should have your BSI on or at least with you before approaching any scene. Remember also that just because an answer choice does not contain BSI...does not mean that it was not utilized. Stick with the facts of the question and answers.

Hair follicles are found in which layer of the skin tissue? Subcutaneous Pangaea Epidermis Dermis

Rationale: They are found in the dermis layer. Rationale: They are found in the dermis layer.

You are beginning to treat a woman who is "not feeling right". Which of the following choices would be considered a sign that supports her complaint? She tells you she ate a whole bottle of sleeping pills The patient states that she has a headache She says she is dizzy and feels like vomiting She shows you a contusion on her head

She shows you a contusion on her head Rationale: Feeling dizzy and stating she has a headache are symptoms. Telling you she took a bunch of pills is history. The visible contusion on her head is a sign because it is objective and you can verify it's existence visually.

You have just arrived at the scene of a hit and run where a woman in her 40's was hit by a car moving about 30 MPH. A man tending the woman immediately identifies himself as an ER physician and requests that you allow him to maintain control of patient care. What is your most appropriate response? 1 Request that he speak with online medical direction 2 Inform him that it is not possible as you have no way of proving his credentials during the emergency 3 Allow him to maintain control and assist him with whatever is needed 4 Tell him he can continue aid until the patient is moved to the ambulance at which time he must follow the ambulance to the hospital

Request that he speak with online medical direction Rationale: Patient care is ultimately the responsibility of medical direction. Without consent from the directing physician, you may be creating a problem. In systems where online medical direction cannot be obtained, there are standing protocols in place for just such occasions. Usually, these protocols allow for the physician to administer aid if they demonstrate their licensure and are willing to accompany the patient to the hospital along with signing all run reports and documentation.

Which of the following answer choices is not part of the general management of orthopedic trauma? Conduct a neurological exam where appropriate Respiratory exam Pain management Control hemorrhage

Respiratory exam Rationale: General management for orthopedic trauma includes: Control hemorrhage, perform appropriate immobilization/splinting, conduct a neurology/circulatory examination, pain management, transport to appropriate facility, appropriate communication and documentation.

In cold-related illness (generalized), such as hypothermia, signs and symptoms of impaired motor function include ______________________ and ________________________. Rigidity; altered balance Muscle contractions; altered balance Cardiac insufficiency; rigidity Cardiac insufficiency; muscle contractions

Rigidity; altered balance Rationale: In cold-related illness (generalized), such as hypothermia, signs and symptoms of impaired motor function include; rigidity, altered balance, poor coordination, and being cold.

What is a primary cause of abdominal pain and tenderness upon palpation? Acute pericardial irritation Fecal leakage into the pleural space Rupture of the gastrointestinal tract Blood in the retroperitoneal space

Rupture of the gastrointestinal tract Rationale: A rupture of any part of the gastrointestinal tract is the primary cause of most infected peritonitis patients. This can be assessed by eliciting the Blumberg sign or Rebound Tenderness. Blood in the retroperitoneal space would probably present as back pain, not abdominal pain. The irritation of the pericardium would cause chest pain, and if there is fecal leakage in the pleural space of your patient they have been in some serious trauma. The pleural space is between the linings of the lungs and isn't in direct contact with the abdominal cavity or it's organs.

The mechanism of Injury in diving emergencies (dysbarism) include _________________________ and _________________________. 1 SCUBA diving at greater depths for long periods of time; repeated dives at depth on the same day 2 SCUBA diving at greater depths for long periods of time; occurs after patient descends to depth too quickly following a dive at depth 3 Repeated dives at depth on the same day; occurs after patient rises to the surface too slowly following a dive at depth 4Repeated dives at depth on the same day; compressed air in blood at depth shrinks upon ascent

SCUBA diving at greater depths for long periods of time; repeated dives at depth on the same day Rationale: The MOI of diving emergencies include SCUBA diving at greater depths for long periods of time and repeated dives at depth on the same day. Dysbarism refers to medical conditions resulting from changes in ambient (water) pressure surrounding the diver.

Which of the following is a high priority condition? Controlled bleeding of the wrists An adult breathing at 20 a minute Severe pain Child birth

Severe pain Rationale: Uncomplicated childbirth is not a high priority condition. Severe pain anywhere is high priority.

A 60 year old woman has fallen from a balcony while celebrating Mardi Gras. She has an obvious femur fracture, but is stable. Which of the following choices contains a correct order for applying a traction splint to this patient? 1 Stabilize the leg manually, take mechanical traction, check PMS, secure splint to the leg, and transport 2 Stabilize the leg, take manual traction of the leg, check PMS, and apply splinting device 3 Strap the splint to the leg, take mechanical traction of the leg, secure it to a backboard, and transport 4 Measure the splint, take manual traction, secure the leg straps, and then strap the patient to a long board

Stabilize the leg, take manual traction of the leg, check PMS, and apply splinting device Rationale: Stabilize the leg manually first, then take manual traction, preferably with the heel strap in place already so you don't have to worry about losing traction. After that, check PMS , secure the splint to the leg, and transport (after securing the patient and leg to a backboard and checking PMS).

Which layer of skin tissue is composed of fat and soft tissue? The bidermis Extermis The epidermis Subcutaneous

Subcutaneous Rationale: The epidermis is the outer layer. Inside that is the dermis and further below that is the subcutaneous layer.

A symptom is_____________while a sign is________________. Objective / subjective Reflexive / responsive Responsive/reflexive Subjective / objective

Subjective / objective Rationale: A symptom is subjective as it is based upon the patient's perception, like feeling nauseous. A sign is objective because it is based upon factual findings, like a rash or deformed arm.

The pathophysiology of submersion incidents include all of the following except: Diving in shallow water can cause spinal trauma Prolonged hypoxia causes death of brain tissue Submersion in warm water results in better survival than cold water. Duration under water affects outcome

Submersion in warm water results in better survival than cold water.

Signs and symptoms of internal bleeding may include all of the following except: Swelling of an injured limb Abdominal tenderness Abdominal distension Bleeding from any body orifice

Swelling of an injured limb Rationale: Signs and symptoms of internal bleeding may include: Guarding, tenderness, deformity, discoloration of the affected area, coughing up blood, blood in urine, rectal bleeding, abdominal tenderness, guarding, rigidity, distension, nonmenstrual bleeding from any body orifice, and signs of shock.

When dealing with electrical burns, all of the following signs and symptoms should cause concern except: Electricity that may cause burns, can also cause cardiac arrest External burns may not indicate seriousness of injury Temperature of contact with heat source Entrance and exit wounds

Temperature of contact with heat source Rationale: Signs and symptoms you should be concerned with when dealing with electrical burns include: burns, cardiac arrest, entrance and exit wounds and more serious injuries than indicated by the signs and symptoms. The temperature of the contact with heat source would be a concern with a Thermal Burn, but not an electrical burn.

Unique anatomy, physiology, and pathophysiology considerations in geriatric patients include all of the following except: Medical illnesses increase risk of falls Changes in neurologic systems make older patients susceptible to trauma The elderly are good historians of medical history due to frequent doctor visits Brain shrinks leading to higher risk of cerebral bleeding following head trauma

The elderly are good historians of medical history due to frequent doctor visits

You arrive on scene with your partner Enrique to find a man who has suffered a spinal injury and is showing signs of shock. Shock as the result of a spinal cord injury is likely caused by ______________________? Too much spinal fluid leaking out of the spinal cavity The brain telling the heart to slow way down The brain's inability to make the heart contract The nervous system's inability to control the diameter of the vessels

The nervous system's inability to control the diameter of the vessels Rationale: Neurogenic shock can be seen in spinal cord injuries and is caused by the nervous system's inability to maintain vessel diameter.

You arrive on scene to an MVA involving 1 car with 3 passengers. Which of the following signs would most increase your suspicion that the driver may have significant internal injuries? The car is wrapped around a tree The roads are icy and the speed limit is 60 MPH The driver has an altered level of consciousness The passenger in the front is dead

The passenger in the front is dead Rationale: While all of the answer choices contain signs that may lead you to believe that the MOI was significant, the presence of the dead passenger is the most telling sign that the mechanism was significant enough to cause internal injuries to the driver.

Which of the following is considered a sign? There is blood in the vomit of the patient The patient states she is dizzy The patient states she has a headache The patient says she took her insulin

There is blood in the vomit of the patient Rationale: A sign is any medical or trauma assessment finding that can be seen, felt, or heard by the provider. A symptom is any medical or trauma condition that is described to the provider by the patient.

What is the larger of the two lower leg bones? Fibula Ulna Femur Tibia

Tibia Rationale: The tibia or shin bone is the larger of the two lower leg bones. The fibula and the tibia are the 2 LOWER leg bones.

You arrive on scene to find a 40-year-old man whose finger has been amputated. Of the following, which actions are incorrect for management of the severed finger and patient? Place bag on crushed ice Transport to appropriate resource hospital Transport to nearest hospital Wrap in sterile, moist gauze and place in plastic bag

Transport to nearest hospital Rationale: The correct actions for management of the severed finger and patient include: Clean; wrap in sterile, moist gauze and place in a plastic bag; place bag on crushed ice (do not freeze); transport with patient; and transport to appropriate resource hospital. The appropriate resource hosptial will have a team in place to manage this patient. Consult with your medical director for directions if you are unsure where to transport the patient.

The mechanism of injury in orthopedic trauma includes all of the following except: Twisting force Direct force Indirect force Turning force

Turning force Rationale: The mechanism of Injury in orthopedic trauma includes: Direct force/blow fractures the bone at the point of impact. Indirect force causes injuries at a distant point. Don't overlook associated injuries. Identify point of contact and the MOI. Twisting force is common for knee injuries.

To properly log roll a patient to a long board you should? Have an inexperienced person on the head Use 4 people Bend at the waist and pull them toward you None of the above

Use 4 people Rationale: Using 4 people who are trained is preferred. A person with no training should not be responsible for the head

Which answer would not be included for management considerations in a non-spinal neck injury? Occlusive dressing for large wounds to prevent air entry into circulatory system Single digit pressure to control bleeding of carotid or jugular veins may be necessary Use prone positioning for patient ALS intercept or air medical transports may be necessary in severe airway compromise

Use prone positioning for patient Rationale: Management considerations in neck injuries include: Single digit pressure (gloves on) to control bleeding of carotid artery or jugular vein may be necessary, ALS intercept or air medical transport may be necessary in severe cases of airway compromise, and occlusive dressing for large vessel wounds (after bleeding controlled) to prevent air entry into circulatory system.

An acetylene tank has exploded at the scene of a structure fire at a welding shop. Dispatch advises you that the patient is a fireman. He was injured by the tertiary phase of the blast only, so you know that he? Was hit by flying pieces of tank Has suffered energy injuries to the internal organs and is expected to be unconscious upon arrival Was thrown a distance Has cavitation of the organs from the blast

Was thrown a distance Rationale: Primary injuries result from a change in environmental pressure as the energy from the explosion is released. Secondary injuries result from pieces of flying material and debris. Tertiary injuries occur when the person is propelled through the air into a stationary object.

When would you expect a patient to show Battle's sign? With rib fractures With a pelvic fracture With skull fractures All of the above

With skull fractures Rationale: Skull fractures may show as Battle's sign or bruising behind the ear.

Active rewarming of cold-related illness (localized) include all of the following except: immerse part in tepid (100 - 105 F0) water administer oxygen keep patient warm after rewarming, apply sterile dressings

administer oxygen Rationale: Active rewarming for cold-related illness (localized) include: immerse part in tepid (100 - 105 degrees Fo) water; after rewarming, apply sterile dressings; keep patient warm; transport as soon as possible

Management considerations of cold-related illness (generalized) hypothermia include all of the following except: administer oxygen - warmed and humidified if available move patient from cold environment rewarm slowly assist ventilation if adequate

assist ventilation if adequate Rationale: Management consideration for cold-related illness (generalized) hypothermia include: move patient from cold environment; remove wet clothing and administer oxygen - warmed and humidified if available; cover with warm blankets; rewarm with hot packs in groin and armpits - use caution to avoid burns; provide warm clear liquids if conscious and not vomiting; rewarm slowly; transport; passive rewarming is best delivered at appropriate facility; handle gently to decrease risk of ventricular fibrillation; and if unconscious and in cardiac arrest follow AHA recommendations for CPR.

Management considerations of heat-related illness with moist, pale, cool skin include all of the following except: remove clothing splash patient with cool water assist ventilation if adequate remove from hot environment

assist ventilation if adequate Rationale: Management considerations of heat-related illness, with moist, pale, cool skin include: remove from hot environment, administer oxygen, remove clothing, and splash the patient with cool water.

The pathophysiology of hymenoptera stings _____________________ and __________________________. 1 cause allergic reactions in sensitized people; may lead to anaphylactic response 2 is the same regardless of age, size or weight of patient; amount of toxin injected is related to toxicity 3 cause allergic reactions in sensitized people; amount of toxin injected is related to toxicity 4 may lead to anaphylactic response; patient age and size cause different effects

cause allergic reactions in sensitized people; may lead to anaphylactic response Rationale: The pathophysiology of hymenoptera stings cause allergic reactions in sensitized people and may lead to anaphylactic response.