EMTprep Questions: Trauma

Your 34-year-old male patient fell from standing while intoxicated at a concert and struck the rear of his head. He presents with bruising and swelling at the impact site and is complaining of a 9/10 headache. When you shine a flashlight into his eyes, he is sensitive to it. What is this called? A.Photophobia B.Dystopia C.Dysphotopsia D. Photosynthesis

A.Photophobia Photophobia is a deceptive word in that it has no meaning relative to fear. Photophobia is sensitivity to light and is a concerning sign when assessing head trauma. This may indicate neurological injury and the patient's mental status should be monitored throughout transport. Dysphotopsia is an assessment finding for ophthalmologists relating to disease findings in patients and has no relevance in the emergency setting.

You are called to a local park where a 10-year-old female has collapsed while playing in the snow with her friends. When you arrive she is lying on the grass, pulse 90, respirations 15, with pale, cool and dry skin. Her forearms appear frostbitten. She is responsive and CAOx4. You should immediately? Administer oxygen, transport, and warm her up by rubbing her arms and legs vigorously Administer oxygen, transport, and slowly re-warm frostbitten limbs with heat packs Administer oxygen, transport, and slowly re-warm the patient by placing heat packs on the chest, armpits, and groin. Contact the girl's parents to obtain consent to treat the patient.

Administer oxygen, transport, and slowly re-warm the patient by placing heat packs on the chest, armpits, and groin. You should never rub a frostbitten area this could cause tissue damage. You should also never handle a hypothermic patient roughly this could cause cardiac arrest. Hypothermic patients should always be re-warmed centrally, to avoid cardiac complications. Also, the girl is a critical patient and therefore implied consent is sufficient to treat her.

Manual traction must be held when using which type of traction splint? A. Unipolar B. Bipolar C. Monopolar D. Tripolar

B. Bipolar Let's tear this question apart and we'll go over traction a bit as this can be a confusing question (just like you'll find on the NREMT). In EMS, a unipolar traction splint is a Sager splint. A bipolar traction splint is the Hare model. With the operation of a Sager splint, the device is placed, straps are strapped, and MECHANICAL traction is applied using the handle on the device. Remember, the max traction that is applied is 15 lbs or 10% of the patient's body weight. On the other hand, a Hare device is measured and then strapped in. When using the bipolar traction splint, there is no pulling performed by the splint itself, like achieved with the Sager, and MANUAL traction must be applied before strapping the extremity. Other answers for this question were "monopolar" and "tripolar". There really is no such thing as monopolar, but for the sake of answering the question, you could assume its the same as unipolar. Also, there is no such thing as tricolor traction that is commonly used in EMS.

You are dispatched by helicopter just below the summit of Mount Hood at an elevation of 10,000 feet. A climber had reached the summit this morning and was on his way down when he was unable to continue further. He is nauseous, tachycardic, and appears altered. This patient is mostly in need of? A.High-flow oxygen, until the symptoms relieve themselves B. Removal from the mountain to a lower altitude C. D50 and fluids D. Hyperbaric chamber

B. Removal from the mountain to a lower altitude The only reversal to altitude sickness is decent to a lower altitude. Oxygen will be necessary, but won't be a definitive treatment. If severe, the patient may need hyperbaric therapy.

Your patient is a 5-year-old male who hit his head on a rock after falling from a tree. Compared to an adult with head trauma, he is more likely to exhibit which of the following signs or symptoms? A.Altered mental state B.Vomiting C.Bradycardia D. Tachycardia

B. Vomiting It is relatively common for children to experience nausea and vomiting after head trauma. In adults it usually only occurs in cases of severe trauma.

You are called to the residence of a 91-year-old female who fell from her chair. She is complaining of 5 out of 10 left hip pain on movement. She states she had a fracture of the femoral neck on the right side and that this injury feels very similar. On visual examination, if a hip fracture were present, you would expect to see: A. Shortening and external rotation B. Shortening and internal rotation C. Lengthening and external rotation D. Lengthening and internal rotation

C. Lengthening and external rotation When the femoral neck fractures and displaces the bone, it is a very painful injury with hallmark signs being shortening of the leg with external rotation. It is not uncommon for the CSMs to be intact and minimal pain reported by the patient.

You are called to a local pond where a 20-year-old male has fallen through the ice while ice skating. When you arrive, he has just been pulled out of the pond and set on the bank. After ensuring scene safety, your very first priority is to? A. Perform a rapid trauma assessment B. Administer oxygen, transport, and slowly re-warm frostbitten limbs with heat packs D. Take vitals to see if the patient exhibits signs of hypothermia

C. Take the patient inside the ambulance and remove his clothing The very first priority is to remove the patient from the cold environment and remove his wet clothing.

Burns in children are more serious than in adults. One of the main reasons for this is because? Children have less skin surface area relative to total body mass compared with adults Children have more skin surface area relative to total body mass compared with adults Children have more total body mass compared with adults Children have more total skin surface area compared with adults

Children have more skin surface area relative to total body mass compared with adults Burns in children are more serious than adults in large part due to the fact that they have more skin surface area relative to total body mass. This results in greater relative fluid and heat loss. Children are also more likely to experience shock, hypothermia, and airway problems due to their unique anatomy and age differences.

You are treating a patient who has burns to both legs from gasoline catching fire underneath them. You expose the area and note blisters to the skin and a very wet appearance. What type of burn did this patient most likely experience? First-degree Full-thickness Partial-thickness Superficial

Partial-thickness A partial-thickness burn is also known as a second-degree burn. It involves the epidermis and parts of the underlying dermis layer. They're very painful and have blisters and a wet appearance due to the escaping fluids.

A hyperthermic patient is most at risk when his/her skin is? Pale and clammy Pale, cool, and clammy Pink, normal, and dry Pink, hot and dry

Pink, hot and dry Hot skin, that is dry, strongly suggests that the body has lost its ability to regulate internal temperature through sweating, and is thus moving towards heat stroke, a true hyperthermic emergency.

You are assessing a 23-year-old male with difficulty breathing after a motor vehicle collision. He indicates that it's getting harder and harder to breathe, and appears to be increasingly anxious. Vitals: BP - 90/62, P 124, R 20, SpO2 93%, CBG 72, Lungs - absent on the left side. What do you suspect is occurring with this patient? Flail chest Tension pneumothorax Pneumothorax Cardiac tamponade

Tension pneumothorax Flail chest is the fracture of two or more adjacent ribs, it's a possibility, so don't write it off initially. Cardiac tamponade is a possibility, but there's a lack of information in the question. Tension pneumothorax is when air continues to enter the pleural space and intrathoracic pressure builds up. Increasing agitation, increased difficulty breathing, hypotension, and absent breath sounds should steer you in this direction. This is a tough question because all of the answers could be right, so it's just selecting what answer is the MOST correct.

You are on scene with a 24-year-old male who has a large laceration on his posterior lower right leg with active bleeding. The blood is dark in color and is steadily flowing from the wound. What kind of bleeding do you suspect? Capillary bleeding Venous bleeding Arterial bleeding Life-threatening hemorrhage

Venous bleeding Venous bleeding is dark in color and can be slow or fast in flow. Most venous bleeding can be controlled with minimal direct pressure. Arterial bleeding is bright red and spurting. Capillary bleeding is characterized by oozing but may have stopped prior to EMS arrival.