lc trauma 1

The most frequent cause of trauma and hospital admissions in the elderly is

falls.

A 21 year old male soccer player is unable to ambulate following an injury to his right lower leg. He has a 2 cm laceration on his tibial crest. His leg is not angulated. You should suspect a/an

open fracture.

A 26 year old female who is two months postpartum is found at home hanged with a rope around her neck. What type of injury should you suspect?

Distraction

What should be your primary concern for an unresponsive 49 year old male who has multiple contusion to the left side of his body, flail chest, and fracture of his left femur after a fall?

Internal bleeding

Which of the following conditions can cause distributive shock?

Spinal cord injury

A 68 year old male was the restrained driver of a car that was struck on the driver's side door with 20 inches of intrusion. You observe irregular chest wall movement on the left side. You should suspect fractures of

adjacent ribs in more than one place.

The amount of external pressure that must be applied to a wound to stop arterial bleeding is

one mmHg greater than the systolic pressure of the artery causing the hemorrhage.

An 18 year old male was hit by a car while walking. When you ask him his name, he opens his eyes and responds with inappropriate words. During your physical examination, you noted he had a lower left arm fracture after he withdrew and had facial grimace when you assessed the arm. What should you record as his Glasgow Coma Scale score?

10

If present, which of the following findings represents the most serious finding in a patient with an eye injury?

Blood in the anterior chamber of the eye

A 28 year old female was shot in the chest. You have managed the wound. What other care should you complete on the scene?

None, begin rapid transport

Which of the following is the most important factor that affects the amount of injury a patient suffers as a result of a car crash?

The speed the vehicles were moving

Internal bleeding and muscle damage around the site of a fibula fracture can lead to

compartment syndrome.

During a fight a 19 year old male had a lower tooth knocked out. Your partner finds the tooth while you control bleeding. You should

wrap the tooth in saline-soaked gauze.

Which of the following responses should receive a Glasgow Coma Scale score of 8?

Eyes only open to pain; speaks incomprehensible sounds; withdraws from painful stimuli

Most chemical burns are initially managed by flushing with large amounts of water for extended periods of time, except chemicals that are

dry powders.

Which of the following would suffer the loss of heat most rapidly? A patient who

fell into icy water.

On examination of the abdomen immediately following blunt trauma, the abdomen will be soft even if there is bleeding because

fresh blood is not an abdominal wall irritant.

A 21 year old male fell from his motorcycle. He responds to your questions by moaning. He has multiple rib fractures and a stable chest wall. His vital signs are P 108, R 18, BP 96/74, and SpO2 is 92% on room air. You should suspect

hemopneumothorax.

An unresponsive 26 year old male is found in an alley outside a bar. His skin is pale and clammy. His vital signs are P 118, R 16, BP 104/82, and SpO2 is 95% on room air. You should suspect

hypovolemic shock.

You are bicycle riding with a 63 year old male on a hot day. After riding 70 miles he tells you he feels odd, stops riding and vomits. You advise him to

immediately seek a cold environment.

A 19 year old male was shot in the right side of his chest. He is sitting on your stretcher. If there is an accumulation of blood in the pleural space, when auscultating his chest, you should expect to hear

increased breath sounds over lower right posterior chest when compared to the lower left chest

You achieve ROSC on a 20 year old male who was electrocuted while working with electrical wires. He vital signs are P 88, R 12, BP 108/68, and SpO2 is 95% on room air. You should next

inspect his body for entrance and exit wounds.

An unresponsive 42 year old male was struck by a car while crossing the street. He has a scalp laceration and an angulated lower left leg. His breath sounds are clear. His vital signs are P 124, R 16, and BP 92/68. You should suspect

intra-abdominal bleeding.

A patient who has cardiac tamponade will have hypoperfusion of the brain due to a/an

loss of cardiac afterload.

A 12 year old male fell from his bike striking his clavicle against a curb. On examination, you find a fracture of the clavicle and the first and second ribs. You should suspect an underlying

pneumothorax and major vessel injury.

A 19 year old male was shot in the abdomen with a small caliber weapon. When you arrive he is conscious and upset about being shot. He complains of no other injuries. His vital signs are P 104, R 14, BP 108/82. You should first

prepare for transport.

A 16 year old male was stabbed in his left lower abdominal quadrant. He is comfortable but upset about the incident. His vitals are P 94, R 14, BP 128/82, and SpO2 is 96% on room air. You should

provide support and transport.

A 38 year old male was lost in the forest while hiking. His feet are waxy, white, and hard to touch. It will take an hour to carry him to your ambulance. You should

provide supportive care.

A stab wound which perforates the stomach will cause

rapid, chemical peritonitis.

A 56 year old male is in respiratory arrest following a head-on car crash while not wearing a seat belt. He has significant facial and torso trauma. You palpate an irregularity to his cervical spine at C-4. You should suspect his arrest is due to

spinal cord compression above the C-4 level.

School officials called 9-1-1 for a 7 year old male has a pencil stuck in his eye socket immediately lateral to his nose. He has vision out of that eye. You should

stabilize the pencil.

You should remove an impaled object if it is impaled in

the airway; obstructing airflow.

A 22 year old female was the restrained driver in a single car crash where her car glanced alongside a utility pole. She is crying but does not complain of pain. She tells you she is 14 weeks pregnant. You should

transport her routinely without lights and siren.

A 26 year old was struck by lightning while playing golf. When you arrive, he has amnesia and an irregular pulse. You observe his skin is pale, cool, and diaphoretic. As you prepare to transport him you should

utilize spinal motion restriction precautions.

Which of the following patients will most likely have complications as a result of blood loss?

An 82 year old male shot in the leg and BP 94/82

Thirty minutes after blunt trauma that has resulted in a liver laceration, inspection of the abdominal wall shoulds show which of the following findings?

Little or no change in appearance

Which of the following is most likely to be injured by the primary blast of an explosion?

Lungs

Which assessment findings should cause you to suspect a gunshot victim is in irreversible shock?

Oozing wounds, thready pulse, irregular respirations

Which of the following is a commonly associated complication of a severe head injury?

Seizures

A 26 year old male has an anterior dislocation of his left hip. How should you manage this injury?

Splint his legs together and immobilize him.

When a patient has a tension pneumothorax, the major complication is

a lack of perfusion pressure to the tissues.

You are approaching a young male at a scene of a shooting. As you approach him, he is mumbling and you see a large amount of blood oozing from a leg wound. He has a weak rapid brachial pulse. You should first

apply a tourniquet to the leg.

An 11 year old male fell while riding rounding a curve on his bicycle and struck his head against a curb. He is unresponsive and has a long scalp laceration with underlying skull exposed and active bleeding. You should first

apply direct pressure.

The most reliable sign of hemorrhage from kidney trauma is

ecchymosis in the flanks of the abdomen

A 22 year old male was stabbed in the abdomen. He is leaning against a wall and you observe a puncture wound to the right upper abdominal quadrant. He becomes faint when he stands up to get on the stretcher. You should suspect the reason he became faint was due to

orthostatic hypotension.

A bone condition that mostly affects females who are post-menopausal is

osteoporosis.

When a patient has been shot in the abdomen, the organ that is least likely to be injured is the

pancreas.

A 22 year old male received blunt trauma to his abdomen. During your assessment, you hear bowel sounds in his right chest. You should suspect

ruptured diaphragm.

A conscious 21 year old male was struck in the head with an arrow. The arrow entered his forehead, is impaled, and exits above his occiput area. Blood is draining down his face into his mouth. You should

stabilize the arrow and transport.

A 12 year old male fell from his bicycle and complains of upper leg pain. Before you begin your assessment, he screams, "Don't touch my leg!" In order to assess if he has a fracture, you should

strike his heel with the palm of your hand.

Following injury, as blood loss continues the body's feedback systems are alerted by

baroreceptors.

A 19 year old male was shot in his right upper arm. You see active bleeding and bone fragments in the wound. His vital signs are P 108, R 16, and BP 86/68. You should suspect a laceration of the

brachial artery.

A 42 year old male was the unrestrained driver involved in a single-car crash in a rural area at 3:00 AM. When you arrive at 3:45 he is unresponsive and slumped over the steering wheel. You observe a large bruise over his chest. After initial stabilization, you determine his vital signs are P 86 and irregular, R 18, and BP 116/82. You should suspect

cardiac contusion.

A 78 year old male was struck by a car while crossing the street. When you arrive, he is lying in the roadway, has a scalp laceration, and angulation of the right radius and femur. His pelvis is unstable. As you begin to package him, he becomes unresponsive and apneic. You should first

check for a pulse.

You are called by law enforcement to a domestic disturbance where a 29 year old male has multiple human bite marks that have capillary bleeding. He has no other injuries and refuses transport. You should

clean the wounds, explain the likelihood of infection, and have him sign a refusal form.

A 51 year old male was splashed in the eyes with an alkali solution. He immediately flushed his eyes and continued for 20 minutes prior to your arrival. You should transport and

continue to flush his eyes.

A 46 year old male was shot in the head with a 22 caliber pistol. He does not respond to painful stimuli. His vital signs are P 106, R 12, and BP 110/74. You should

cover the wound and rapidly transport.

A 25 year old male has a gunshot wound in his right chest. Your partner reports a weak, thready pulse. You see irregular, slow breathing. You should first

cover the wound with a gloved hand.

A 56 year old female has generalized weakness and has been outside all night in 40 degrees F weather. She is shivering and her hands are cold to the touch. To determine if she has hypothermia, you should

insert your hand below her clothing and feel her abdomen.

A 21 year old male jumped from a window on the third floor to escape a fire. His left upper leg is shortened, angulated, and deformed. He is in severe pain. You should suspect

mid-shaft femur fracture.