Ch. 34

An adult female is found unresponsive after being shot in the chest. Which statement made by your partner is of most concern and indicative of patient​ deterioration? A. ​"Her SpO2 has gone from​ 90% to​ 93%." B. ​"I do not think her jugular veins are​ distended." C. ​"She is getting more difficult to​ ventilate." D. ​"I see an entry wound but cannot find the exit wound​ anywhere."

C. ​"She is getting more difficult to​ ventilate."

Asherman, Halo, and Bolin devices are commercially available devices to use for which​ injury? A. Pneumothorax B. Flail chest C. Open chest wound D. Commotio cordis

C. Open chest wound

When a patient has a chest injury and exhibits red frothy​ sputum, there is a high likelihood that she may have​ a: A. pneumothorax. B. tension pneumothorax. C. hemothorax. D. flail segment.

C. hemothorax.

When blood collects inside the pleural space after a rib fracture that lacerates an intercostal​ artery, the condition is called​ a/an: A. hemopneumothorax. B. simple pneumothorax. C. hemothorax. D. open pneumothorax.

C. hemothorax.

When blood collects inside the pericardial​ sac, the condition is​ called: A. pressothorax. B. excess pericardial pressure. C. pericardial tamponade. D. hemothorax.

C. pericardial tamponade.

During your rapid trauma examination of a patient with a chest​ injury, you would assess for air trapped under the skin in the upper chest and neck. If it is​ present, this condition is​ called: A. tension pneumothorax. B. tracheal deviation. C. subcutaneous emphysema. D. jugular vein distention.

C. subcutaneous emphysema.

An Emergency Medical Responder asks you to explain a pneumothorax. You would explain that a pneumothorax occurs​ when: A. Air accumulates around the​ lung, causing a portion of it to collapse B. Air enters the lung and alveoli from a traumatic opening in the chest wall C. The lung becomes overinflated with air the patient is unable to breathe D. The trachea becomes​ obstructed, causing the lungs to collapse

A. Air accumulates around the​ lung, causing a portion of it to collapse

On​ follow-up, the ED physician informs you that a patient whom you transported earlier was found to have a hemothorax. In this​ condition: A. Blood collects in the chest​ cavity, collapsing the lung B. Fluid and blood collect around the heart C. The pleural membranes are punctured by a rib D. The trachea is torn

A. Blood collects in the chest​ cavity, collapsing the lung

A​ middle-aged male patient has been stabbed once in the right anterior chest. His airway is​ patent, respirations​ tachypneic, pulse weak and​ rapid, and skin cool and diaphoretic. Breath sounds are clear on the left and severely diminished on the right. JVD and tracheal deviation are present. His SpO2 is​ 93% on supplemental oxygen via BVM. The vital signs are​ pulse, 140​ beats/min; respirations, 28​ breaths/min; and blood​ pressure, 100/78 mmHg. Your next action should be​ to: A. Call for an ALS intercept en route to the ED and lift the dressing to see if air escapes during exhalation B. Initiate positive pressure ventilation utilizing FROPVD C. Attempt to relieve the tension while awaiting ALS arrival at the scene D. Await the arrival of ALS to​ "burp" the dressing between ventilations

A. Call for an ALS intercept en route to the ED and lift the dressing to see if air escapes during exhalation

You are on the scene of a shooting. Your assessment reveals a​ 23-year-old male who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is actively bleeding. The second wound is to the left lateral chest and bubbles every time the patient exhales. What would your immediate and best action​ be? A. Cover the chest wound with a gloved hand B. Obtain a sterile dressing and cover the chest wound C. Place direct pressure over the abdominal gunshot wound D. Place the patient on​ high-concentration oxygen with a nonrebreather face mask

A. Cover the chest wound with a gloved hand

A patient has been shot in the chest with a rifle. Assessment reveals a deteriorating level of consciousness and inadequate breathing. Positive pressure ventilation is being​ administered, and the entrance​ wound, which is located midclavicular at the second intercostal space on the left side of the​ chest, has been covered with an occlusive dressing. Your next priority action would be​ to: A. Look for a bullet exit wound posteriorly B. Check the blood pressure and determine whether a narrow pulse pressure exists C. Place a cervical collar and initiate spine motion restriction precautions D. Get a full set of vital signs and pulse oximeter reading

A. Look for a bullet exit wound posteriorly

A young boy has an open chest wound to the left lateral thorax after falling off his bike onto a metal spike protruding from the ground. His family is​ present; they are very upset and crying. As an​ EMT, you recognize that in this​ situation, your primary focus​ is: A. Maintaining oxygenation B. Preventing potential wound infection C. Providing emotional support D. Controlling pain

A. Maintaining oxygenation

An alert and oriented young male fell 5 feet from a​ stage, impacting a metal railing with the right side of his​ chest, just under his armpit. The primary assessment is negative for life​ threats, although he does complain of very painful breathing and has remarkable tenderness and crepitus over the fifth rib laterally in this area. Throughout​ care, which action is essential to​ perform? A. Monitor breath sounds B. Splint site with a bulky dressing C. Apply ice to area D. Administer aspirin for pain

A. Monitor breath sounds

Which of the following is in physical contact with the thoracic​ wall? A. Parietal pleura B. Thoracic pleura C. Visceral pleura D. Intercostal pleura

A. Parietal pleura

Which mechanism of injury produces the conditions for traumatic​ asphyxia? A. Person pinned between a truck and wall of a building B. Person strangled but not killed in an attempted rape C. Penetrating chest trauma with a​ high-powered firearm D. Fall of 20 feet from scaffolding onto a concrete sidewalk

A. Person pinned between a truck and wall of a building

Damage to which thoracic tissues can cause impairment of ventilation from a developing​ pneumothorax? A. Pleural membranes B. Mediastinum C. Pulmonary arteries D. Trachea

A. Pleural membranes

The paramedic is caring for a patient who sustained injuries to the thoracic area in a motor vehicle accident. The patient is having difficulty breathing and has a low oxygen​ level, but the skin is intact. Which complication of this accident should the paramedic expect is​ occurring? A. Pneumothorax B. Commotio cordis C. Sucking chest wound D. Pericardial tamponade

A. Pneumothorax

Assessment findings for a​ 33-year-old female who was shot in the right side of the chest indicate that she has a pneumothorax. As you care for this​ patient, your primary concern is monitoring the injury​ for: A. Tension pneumothorax B. Arterial bleeding C. Sucking sound at the wound site D. Infection at the wound site

A. Tension pneumothorax

During your primary assessment of a patient with chest​ trauma, you determine that he may have a tension pneumothorax. In order to treat this​ condition, you​ should: A. call for ALS backup. B. insert a chest tube using items from the OB kit. C. insert an​ over-the-catheter needle into the affected chest wall. D. call medical command for permission to decompress the chest.

A. call for ALS backup.

Pulmonary contusions are serious injuries because​ they: A. can interfere with oxygen exchange. B. become very tender. C. take a long time to clot off. D. typically require intubation.

A. can interfere with oxygen exchange.

When a normally healthy​ 16-year-old female goes into sudden cardiac arrest after being struck in the chest by a lacrosse​ ball, this is probably due to a condition​ called: A. commotio cordis. B. ventricular ectopy. C. cardiac contusion. D. sudden paralysis.

A. commotio cordis.

When assessing a patient who sustained blunt trauma to the​ chest, which assessment finding is most indicative of an injury to the​ lung, impairing adequate​ ventilations? A. Extensive bruising to the anterior chest B. Ability to speak only a few​ words, following by a gasp C. Respiratory rate of 20​ breaths/min D. Elevated heart rate and blood pressure

B. Ability to speak only a few​ words, following by a gasp

The EMT shows that he understands the difference between a pneumothorax and a tension pneumothorax when he makes which​ statement? A. ​"A tension pneumothorax causes cardiac output to​ decrease; a simple pneumothorax does not affect cardiac​ output." B. ​"A tension pneumothorax causes blood to accumulate around the​ lung; a pneumothorax involves the accumulation of only air around the​ lung." C. ​"A pneumothorax is caused by a closed chest​ injury; a tension pneumothorax is caused by an open chest​ injury." D. ​"A pneumothorax describes a collapsed​ lung; a tension pneumothorax involves both a collapsed lung and blood​ loss."

A. ​"A tension pneumothorax causes cardiac output to​ decrease; a simple pneumothorax does not affect cardiac​ output."

You are treating a patient who was stabbed in the right side of the anterior chest. You have applied an occlusive dressing and administered oxygen​ when, after a few​ minutes, you note that the patient seems to be having increased difficulty breathing. What would be the MOST appropriate thing to do at this​ point? A. ​"Burp" the dressing by unsealing one side. B. Have the patient sit in the​ Fowler's position. C. Begin ventilating the patient with a​ flow-restricted oxygen-powered ventilation device. D. Notify medical direction immediately.

A. ​"Burp" the dressing by unsealing one side.

On scene at a college football​ game, a wide receiver is unresponsive after colliding with another player and forcefully taking a helmet to the chest. The athletic trainer reports that the patient is pulseless and apneic. Given the mechanism of injury and​ patient's presentation, which instruction would be​ appropriate? A. ​"Let's apply the AED and follow all​ prompts." B. ​"Use the AED but no CPR so we do not worsen the potential chest​ injury." C. ​"Before we do​ anything, we need to put a cervical collar on the​ patient." D. ​"Someone start positive pressure ventilation while I check for a blood​ pressure."

A. ​"Let's apply the AED and follow all​ prompts."

Which patient MOST likely has an open chest wall​ injury? A. A patient with pericardial tamponade after a blow to the chest from a baseball bat B. A patient with a knife wound to the left anterior chest C. A patient who suffered blunt trauma to the sternum during a sporting event D. A patient who was trapped under a car

B. A patient with a knife wound to the left anterior chest

A patient was stabbed in the right anterior chest and is in obvious respiratory distress. As you perform the secondary​ assessment, which signs​ and/or symptoms would suggest that she is developing a tension​ pneumothorax? A. Respiratory​ distress, absent breath sounds on the​ left, flat neck​ veins, tachycardia B. Absent breath sounds on the​ right, distended neck​ veins, tracheal deviation to the left C. Absent breath sounds on the​ left, hypotension, SpO2 of​ 98%, bradycardia D. Absent breath sounds on the​ right, tracheal deviation to the​ right, cyanosis

B. Absent breath sounds on the​ right, distended neck​ veins, tracheal deviation to the left

You have applied a nonporous dressing to a stab wound on a​ patient's chest. The Emergency Medical Responder assisting you asks you why the dressing was taped on three sides and not all four. Your best response is that taping the dressing on three​ sides: A. Causes less pain for the patient B. Allows trapped air to escape on exhalation C. Decreases the chance of air entering the chest on exhalation D. Permits oxygen to still enter the lungs

B. Allows trapped air to escape on exhalation

On​ scene, a paramedic directs you to help another EMS crew who is caring for a patient who was hit and trapped under a passenger van that ran into a crowd. As you approach the​ patient, which scene​ size-up clue seemingly indicates that the patient is suffering from traumatic​ asphyxia? A. Wound to the chest making a sucking sound B. Bluish discoloration to the neck and face C. Bilateral femur deformity D. Abdominal bruising and distention

B. Bluish discoloration to the neck and face

A patient has sustained an injury to his mediastinum. Based on the anatomy of his​ chest, which structure has been​ injured? A. Bronchiole B. Esophagus C. Diaphragm D. Lungs

B. Esophagus

A construction foreman was stabbed with a screwdriver in the right anterior chest by an angry employee. Prior to your​ arrival, he removed the screwdriver. He is alert and oriented and complains of pain to the injury site. Your primary assessment reveals an open​ airway, adequate​ breathing, and strong radial pulse. Based on these​ findings, which intervention should be performed​ next? A. Take manual spine motion restriction precautions B. Evaluate the​ patient's SpO2 level C. Insert a nasopharyngeal airway D. Open the airway using the​ jaw-thrust maneuver

B. Evaluate the​ patient's SpO2 level

You are managing a patient with a large flail segment to the right lateral chest. With this​ condition, you should recognize that the immediate threat to life​ is: A. Infection B. Hypoxia C. Rib fractures D. Blood loss

B. Hypoxia

You are transporting a young and healthy female patient who was involved in a motor vehicle​ collision, during which she struck her chest on the steering column. Although the primary assessment reveals no life​ threats, the patient does have redness to her​ sternum, as well as pain and tenderness. Breath sounds are clear and present​ bilaterally, and vital signs are within normal limits. As you transport and reassess this​ patient, which sign or symptom would indicate the immediate need for​ ALS? A. Development of bruise over sternum B. Onset of an irregular heartbeat C. Increased tenderness over sternum D. New complaint of leg pain

B. Onset of an irregular heartbeat

Assessment findings for a patient who was thrown from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 of​ 92%. Breath sounds are clear and equal bilaterally. The segment has been​ stabilized, and you are prepared to start positive pressure ventilation. Given these assessment​ findings, which type of injury underlying the flail segment is your primary​ concern? A. Hemothorax B. Pulmonary contusion C. Pneumothorax D. Rib fractures

B. Pulmonary contusion

Of the signs and symptoms of a developing tension​ pneumothorax, which is the MOST important to​ recognize? A. Jugular vein distention B. Severely decreased or absent breath sounds on the injured side C. Extreme anxiety and apprehension D. Tachycardia

B. Severely decreased or absent breath sounds on the injured side

Which of the following is housed in the​ mediastinum? A. Kidneys B. Trachea C. Small Intestine D. Jugular veins

B. Trachea

Which of the following is in physical contact with the​ lung? A. Parietal pleura B. Visceral pleura C. Intercostal pleura D. Thoracic pleura

B. Visceral pleura

During your physical examination of a patient who was hit in the chest with a baseball​ bat, you notice that a small section of his rib cage sinks when he inhales and moves outward when he exhales. This is known​ as: A. hemothorax. B. paradoxical movement. C. a sucking chest wound. D. opposition movement.

B. paradoxical movement.

If a patient has an open chest wound that allowed air to accumulate into the pleural cavity to the point at which the lung is totally collapsed and is starting to shift to the other​ side, this additional complication is known​ as: A. hemothorax. B. tension pneumothorax. C. pericardial tamponade. D. commotio cordis.

B. tension pneumothorax.

Your patient has received a blunt trauma injury to the chest from being hit with a baseball bat. You notice a flail​ segment, lung sounds are​ diminished, and the patient is having difficulty breathing. You note that the trachea is deviating toward the uninjured side. You suspect​ a/an: A. hemothorax. B. tension pneumothorax. C. pneumothorax. D. open wound that you cannot see.

B. tension pneumothorax.

The EMT arrives on the scene of a​ multi-vehicle collision and notices a patient having difficulty breathing. The patient presents with a mediastinal shift and absent breath sounds on the right side. Which should the EMT do to provide the best care for this​ patient? A. Insert a chest tube into the intercostal space. B. Apply a dry sterile dressing to the wounds. C. Arrange for advanced life support​ (ALS) backup. D. Intubate and begin mechanical ventilation.

C. Arrange for advanced life support​ (ALS) backup.

You are called to the scene of a single car crash. The driver has been extricated by the fire​ department, and he is found supine on a backboard complaining of severe chest pain. You can palpate multiple rib fractures on his left anterior and lateral thorax. Breath sounds are diminished on the left and clear on the​ right, and the pulse oximeter reads​ 88% on​ high-flow oxygen. Respirations are rapid and shallow. As you try to initiate positive pressure​ ventilation, the patient​ screams, pushing back against the​ bag-valve-mask. What should you​ do? A. Disable the relief valve on the BVM. B. Place the patient on CPAP. C. Call for ALS backup. D. Circumferentially wrap the chest to splint the fractures.

C. Call for ALS backup.

An unrestrained female driver hit a utility pole with her vehicle at a moderate rate of speed. During the​ impact, she struck the steering wheel with her chest. The​ patient's airway is​ open, and she states that it is painful to breathe. Her pulse is moderate in​ strength, irregular, and tachycardic. Breath sounds are equal​ bilaterally, and no jugular venous distention is noted. Assessment of her chest reveals bruising and instability to the sternum. When​ asked, she denies any past medical history. Based on this mechanism and the assessment​ findings, the EMT should be suspicious of which​ condition? A. Traumatic asphyxia B. Tension pneumothorax C. Cardiac contusion D. Pneumothorax

C. Cardiac contusion

You have been called to a New​ Year's Eve party for a male patient who was stabbed in the anterior chest. According to​ partygoers, the patient went outside with another male and was stabbed. Fifteen minutes​ later, he was found in the​ snow, and 911 was called. When assessing this​ patient, which finding would you consider to be the most serious and warranting immediate​ attention? A. Pain and bruising to the left thigh B. Complaint of a worsening headache C. Decreased breath sounds to the left lung D. Capillary refill of 3 seconds

C. Decreased breath sounds to the left lung

Reduced tidal volume due to shifting of expiratory air from the uninjured side to the injured side is a common result of which​ injury? A. Mediastinal shift B. Rib fracture C. Flail segment D. Pneumothorax

C. Flail segment

A confused​ 62-year-old female fell at​ home, hitting the side of a table with her chest. Assessment reveals instability to the left lateral​ chest, accompanied by minor bruising in the same area. The patient complains of intense pain every time she breathes. Her airway is​ patent, breathing is rapid and​ shallow, and skin warm and​ non-diaphoretic. Vital signs are​ pulse, 112​ beats/min; respirations, 24​ breaths/min; blood​ pressure, 132/64​ mmHg; and​ SpO2, 90%. Breath sounds are somewhat shallow but still equal to both lungs. Based on those​ findings, you should treat this patient for which​ life-threatening condition? A. Pain B. Shock C. Hypoxia D. Pneumothorax

C. Hypoxia

You suspect that a patient with an open pneumothorax may be developing a tension pneumothorax. Which action is critical given this​ situation? A. Ensure that all four sides of the dressing are taped B. Gently apply pressure to the chest during inhalation C. Lift one side of the dressing during exhalation D. Remove the occlusive dressing

C. Lift one side of the dressing during exhalation

What type of injury would be created as the result of a penetrating chest​ wound? A. Sustained B. Internal C. Open D. Blunt

C. Open

A​ 39-year-old male has a single stab wound to the anterior chest. When notifying the emergency​ department, you inform them that the patient has​ a/an: A. Flail chest B. Laceration C. Open chest injury D. Evisceration

C. Open chest injury

A​ middle-aged male has been stabbed once in the left anterior chest. His airway is​ patent, respirations​ tachypneic, pulse weak and​ rapid, and skin cool and diaphoretic. Breath sounds are clear and equal bilaterally. The vital signs are​ pulse, 140​ beats/min; respirations, 24​ breaths/min; blood​ pressure, 100/78​ mmHg; and​ SpO2, 96% on supplemental oxygen. JVD is present. Given this​ presentation, you would have a high index of suspicion​ for: A. Pneumothorax B. Fail segment C. Pericardial tamponade D. Hemothorax

C. Pericardial tamponade

The EMT is assessing a patient who sustained injuries in a motor​ vehicle-pedestrian accident and notices a 20 mmHg drop in the systolic blood pressure when the patient inhales. Which term should the EMT use in the medical record to document this​ occurrence? A. Crepitation B. Jugular vein distention C. Pulsus paradoxus D. Pneumothorax

C. Pulsus paradoxus

A young male patient has​ self-extricated from his vehicle after hitting a telephone pole and rolling his car several times at a high rate of speed. He is spitting blood and has a large area of tenderness and soft tissue injury to the left side of his chest. On​ scene, you did not observe any paradoxical motion of the chest wall. The patient remains alert and oriented with stable vital​ signs, but continually complains of painful breathing. During​ transport, what is it essential that you​ do? A. Apply bulky dressings to the area of chest injury B. Place a nonporous dressing and ice packs to the injured area C. Reassess for paradoxical motion of the chest wall D. Start positive pressure ventilation with supplemental oxygen

C. Reassess for paradoxical motion of the chest wall

You suspect a trauma patient has a hemothorax to the left lung. Which assessment finding would reinforce this​ suspicion? A. Neck vein distention and absent breath sounds to the right lung B. Bradycardia and hypertension C. Respiratory distress and the signs and symptoms of shock D. Cyanosis and a blood pressure of​ 210/100 mmHg

C. Respiratory distress and the signs and symptoms of shock

During the secondary​ assessment, the EMT notes instability and a flail segment to a​ patient's lower left lateral chest. The EMT would​ immediately: A. Apply bulky dressings to the area B. Start positive pressure ventilation C. Stabilize the segment with his hand D. Auscultate breath sounds

C. Stabilize the segment with his hand

An unrestrained​ 32-year-old female motorist hit a utility pole​ head-on at 45 mph. The car sustained extensive damage. The patient has an open​ airway, is breathing poorly at 32 breaths per minute with absent alveolar breath​ sounds, and is responsive to painful stimuli. Her radial pulse is rapid and​ weak, and her skin is cool and cyanotic. Breath sounds are decreased on the right side. Emergency Medical Responders are initiating spine motion restriction precautions. Your next action would be​ to: A. Palpate the chest wall for instability B. Place a cervical collar C. Start positive pressure ventilation D. Examine the patient for additional injuries

C. Start positive pressure ventilation

A​ 42-year-old male was involved in a fight and was stabbed in the right lateral chest. The knife is still​ impaled, and the patient now complains of shortness of breath. When he​ speaks, he gurgles and blood drains from his mouth. His respirations are labored and his radial pulse is weak. Which intervention should you perform​ first? A. Stabilize the knife with bulky dressings B. Provide positive pressure ventilation C. Suction the blood from the airway D. Remove the knife and seal the injury with an occlusive dressing

C. Suction the blood from the airway

In which thoracic injury is a mechanical collapse of the vena cava​ involved? A. Simple pneumothorax B. Open pneumothorax C. Tension pneumothorax D. Pericardial tamponade

C. Tension pneumothorax

Why would it be inappropriate to pull out a knife that is impaled in a​ 22-year-old female's left anterior​ chest? A. The knife may create a hole in the stomach or kidney if it is pulled out. B. The surgeons will want to see the knife. C. The knife may be sealing a hole in a great vessel or the heart. D. The knife may have fingerprints on the handle.

C. The knife may be sealing a hole in a great vessel or the heart.

Which of the following is accurate in regard to a​ pneumothorax? A. Each time the chest wall​ expands, the vacuum between the pleura decreases. B. Pressure on the lung increases as the pleural space decreases. C. Younger patients may not become hypoxic with a complete pneumothorax. D. A hole the size of a penny would be considered a severe injury.

C. Younger patients may not become hypoxic with a complete pneumothorax.

A pneumothorax may occur​ when: A. a fractured rib breaks through the skin of the outer chest and keeps the wound sealed with the bone end. B. a sucking chest wound is sealed with an occlusive dressing taped on only three sides. C. air leaks into the chest cavity from a damaged​ lung, with no opening through the outer chest. D. a hemothorax caused by a penetrating wound to the chest is left untreated for an extended period.

C. air leaks into the chest cavity from a damaged​ lung, with no opening through the outer chest.

During your secondary assessment of a patient with a chest​ injury, you​ should: A. begin with a focused physical examination of the chest. B. palpate the chest during your examination and frequently thereafter during transport to continually reassess for pain. C. auscultate the breath sounds bilaterally. D. obtain a SAMPLE history before beginning your physical examination.

C. auscultate the breath sounds bilaterally.

Cardiac tamponade occurs​ when: A. pressure from a tension pneumothorax compresses the heart. B. the chest is​ crushed, exerting pressure on the heart and forcing blood back into the jugular veins. C. blood enters the pericardial sac surrounding the heart. D. air enters the pericardial sac surrounding the heart.

C. blood enters the pericardial sac surrounding the heart.

Two or more adjacent ribs that are broken in two or more places is called​ a/n: A. commotio cordis. B. tension pneumothorax. C. flail segment. D. paradoxical segment.

C. flail segment.

When a patient who sustained blunt trauma to the chest wall has two or more rib fractures in two or more adjacent​ ribs, this is called​ a: A. cardiac contusion. B. commotio cordis. C. flail segment. D. cardiac tamponade.

C. flail segment.

When assessing a​ patient, which sign or symptom is most indicative of a​ pneumothorax? A. Intense pain with each inspiration B. Crepitus and instability to the chest wall C. SpO2 of less than​ 90% on supplemental oxygen D. Decreased breath sounds to the right lung

D. Decreased breath sounds to the right lung

In addition to maintaining the airway and providing​ high-flow oxygen, what additional care or consideration is critical when treating a patient in which you suspect pericardial​ tamponade? A. Call medical command for guidance. B. Perform a needle aspiration of the pericardial sac. C. Call for ALS backup to decompress the chest. D. Initiate rapid transport to the ED.

D. Initiate rapid transport to the ED.

You are transporting a​ 19-year-old male with a gunshot wound to the chest. On​ scene, you covered the wound with an appropriate dressing.​ Now, as you reassess the​ patient, you note that the patient is tachypneic and complains of increased difficulty breathing. Breath sounds on the side of the injury are diminished. Your immediate action would be​ to: A. Tape the dressing on the fourth side B. Provide positive pressure ventilation with​ high-concentration oxygen C. Cover the wound with another dressing D. Lift the dressing from the wound briefly during exhalation

D. Lift the dressing from the wound briefly during exhalation

Which injury is virtually always the result of penetrating chest​ trauma? A. Myocardial aneurysm B. Commotio cordis C. Aortic rupture D. Pericardial tamponade

D. Pericardial tamponade

A paramedic has asked that you apply a dressing over a sucking chest wound. Which option is the best choice to cover this​ injury? A. Clean washcloth B. Sterile gauze soaked in sterile water C. Dry sterile gauze dressing D. Petroleum gauze

D. Petroleum gauze

A patient with blunt chest wall trauma has a flail section to her chest. She is conscious and​ confused, her breathing is rapid and​ shallow, and breath sounds are diminished bilaterally. After manually stabilizing the flail section of the chest​ wall, the EMT best treats this condition​ by: A. Administering supplemental oxygen through a nonrebreather face mask B. Applying ice packs to the flail segment C. Inserting an oropharyngeal airway and ventilating the patient on room air D. Providing positive pressure ventilation with oxygen attached

D. Providing positive pressure ventilation with oxygen attached

Which term is used for bleeding that occurs in and around the​ alveoli, reducing oxygen​ exchange? A. Hemolytic​ wash-out B. Pneumothorax C. Pulmonary hemorrhage D. Pulmonary contusion

D. Pulmonary contusion

Which sign or symptom would FIRST lead you to believe that your patient has a tension​ pneumothorax? A. Tachycardia B. Decreased blood pressure C. Tracheal deviation D. Severely decreased or absent breath sounds on the injured side

D. Severely decreased or absent breath sounds on the injured side

A patient has been involved in a motorcycle crash and has a flail segment to the right lateral chest. His airway is open and he is breathing poorly at 24 breaths per minute with a decreasing SpO2. The EMT shows that he is appropriately caring for this injury when​ he: A. Places an ice pack over the site of injury B. Positions the patient in​ semi-Fowler's position for transport C. Administers oxygen through a nonrebreather face mask D. Starts positive pressure ventilation

D. Starts positive pressure ventilation

The​ EMT's primary concern with any open injury to the chest​ is: A. Checking for intercostal muscle damage B. Controlling internal bleeding C. Evaluating for crepitus D. Stopping air entry

D. Stopping air entry

An open chest wound that pulls air into the thoracic cavity is known as what type of​ injury? A. Tension B. Blowing C. Blind D. Sucking

D. Sucking

A​ 23-year-old female has been involved in a serious motor vehicle collision. Which assessment finding best indicates that she has a flail​ segment? A. Decreasing SpO2 reading despite​ high-flow oxygen B. Shortness of breath upon exertion C. Intense pain with deep inspiration D. Uneven chest wall movement during breathing

D. Uneven chest wall movement during breathing

When two or more adjacent ribs are fractured in two or more​ places, the injury is​ called: A. hemothorax. B. tension pneumothorax. C. pneumothorax. D. flail segment.

D. flail segment.

Which statement made by an EMT demonstrates an understanding of chest​ trauma? A. ​"In general, an open chest injury caused by blunt trauma is more life threatening than a closed one due to increased potential for blood​ loss." B. ​"Closed chest injuries are caused by penetrating trauma and cause more​ life-threatening injuries than do open chest​ injuries." C. ​"Open chest injuries are more serious than closed chest​ injuries, because air and bacteria can enter the chest through the open​ wound." D. ​"Closed chest injuries are caused by blunt​ trauma, and can be just as serious as open chest​ injuries."

D. ​"Closed chest injuries are caused by blunt​ trauma, and can be just as serious as open chest​ injuries."

A new EMT who just started working with your EMS system asks you to quickly describe a flail segment. Which statement best describes this​ injury? A. ​"Multiple rib fractures have bruised the underlying​ lung." B. ​"Fractured ribs have collapsed the underlying​ lung." C. ​"Multiple fractures to the rib cage are caused by blunt​ trauma." D. ​"Two or more adjacent ribs are broken in two or more​ places."

D. ​"Two or more adjacent ribs are broken in two or more​ places."