Chapter 24 Medical Overview

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:

7.

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His Revised Trauma Score (RTS) is:

9

If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave?

Stomach rupture

When treating a patient who experienced a pulmonary blast injury, you should:

avoid giving oxygen under positive pressure.

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the:

mechanism of injury.

According to the Association of Air Medical Services, you should consider air medical transport of a trauma patient if:

traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.

Which of the following destinations is most appropriate for a 41-year-old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal?

A Level I or Level II trauma center

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?

Aortic rupture

A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?

Compression of the head against the roof

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?

Deployment of the air bag

A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?

Energy transmission to the spine

Which of the following statements regarding the first collision that occurs during a motor vehicle crash is correct?

It is the most dramatic part of the collision and may make extrication difficult.

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?

Rapid transport to a trauma center

Which types of motor vehicle collisions present the greatest potential for multiple impacts?

Rotational and rollover

Which of the following statements regarding low-energy penetrating injuries is correct?

The area of injury is usually close to the path the object took through the body.

Which of the following statements regarding gunshot wounds is correct?

The speed of a bullet has the greatest impact on the injury produced.

Which of the following patients has experienced the MOST significant fall?

a 4′6″ patient who fell 13 feet

When evaluating the mechanism of injury of a car-versus-pedestrian collision, you should first:

approximate the speed of the vehicle that struck the pedestrian.

A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:

assess for an exit wound.

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is rapid and irregular. You should be MOST suspicious for:

bruising of the heart muscle.

When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact.

door

Two of the MOST common mechanisms of injury for blunt trauma are:

falls and motor vehicle collisions.

According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she:

has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.

In contrast to a Level III trauma center, a Level I trauma center must:

have general surgeons who are in-house 24 hours a day.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:

identify contact points and predict potential injuries.

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:

intracranial bleeding.

The energy of a moving object is called:

kinetic energy.

Approximately 25% of severe injuries to the aorta occur during:

lateral collisions.

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:

neck and facial injuries.

When assessing an elderly patient who fell, it is important to remember that:

osteoporosis can cause a fracture as a result of a fall from a standing position.

A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for:

potential airway compromise.

When assessing a patient who experienced a blast injury, it is important to remember that:

primary blast injuries are the most easily overlooked.

When the speed of a motor vehicle doubles, the amount of kinetic energy:

quadruples.

A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:

stabilize her entire spine.

Internal injuries caused by gunshot wounds are difficult to predict because:

the bullet may tumble or ricochet within the body.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:

the speed of the fall.

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash.

thoracic and lumbar

The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:

transport to a trauma center.

Force acting over a distance is the definition of:

work

The index of suspicion is MOST accurately defined as:

your awareness and concern for potentially serious underlying injuries.