Test 4 - Trauma

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she initially cut herself, blood spurted from the wound; then, within a second or two, it subsided to a mere trickle. She asks why this would happen. What is the correct response?

"Blood vessels tend to constrict quickly once they are injured."

You are assessing an 86-year-old male who fell down a flight of stairs after getting out of bed to use the bathroom. He complains of severe head, neck, and back pain. Which question is most appropriate to ask this patient?

"Do you know what caused you to fall?"

Which instruction is appropriate when helping a new EMT care for a male patient with a laceration to his left arm?

"Don't worry about removing embedded dirt from the wound, just the dirt around the laceration."

During an in-service program focusing on care of the trauma patient, the medical director asks if anyone can correctly describe the "platinum 10 minutes." What statement by a participant is the best response?

"EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene."

A 2-year-old boy fell down a flight of stairs, is crying loudly, and is very difficult to communicate with. Because you are unable to clear the spine, you elect to initiate spine motion restriction precautions. Which instruction would you provide to other EMTs who are initiating this care for the patient?

"Let's place a folded towel under his shoulders and back to help maintain head alignment."

A patient has an injury to the elbow and forearm. While you are conducting the reassessment, which statement made by the patient should concern you most?

"My hand feels like it is going to sleep."

A patient has suffered a superficial burn to the chest, arms, and face after pouring gasoline on a smoldering campfire and accidently inhaling the plume of smoke and fire that erupted suddenly. He is now coughing. Which statement indicates that the EMT is properly caring for him?

"Throughout transport, I am going to listen to your lungs quite frequently."

At an industrial complex, a young male was struck in the head by a large piece of steel thrown from a grinding machine. Assessment reveals a soft, painful depression underlying a tear in his scalp, which is covered with dried blood. Clear fluid is draining from his right ear. The patient is conscious but confused and exhibits the following vital signs: pulse, 84 beats/min; respirations, 16 breaths/min and adequate; blood pressure, 142/76 mmHg; and SpO 2, 90%. Emergency Medical Responders are on scene and are maintaining manual spine motion restriction precautions. Which instruction indicates the next step needed in this patient's care?

"Will someone administer supplemental oxygen to the patient?

At a construction site, an 18-year-old male was struck in the head by a pallet of concrete blocks as it was being moved by a crane. He has a large laceration to the left side of his head, with noted instability to the skull beneath the wound. Moderate bleeding from the injury site is also noted. The patient's airway is open, his breathing is adequate, and his pulse is strong and regular. Proper care for this patient should include:

A loose dressing over the top of the laceration

Which statement about different musculoskeletal injuries is true?

A sprain is an injury to a joint with possible damage to or tearing of ligaments

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?

Ability to speak only a few words, following by a gasp

A male patient has been shot in the chest with a small-caliber gun. Which presentation indicates that he is in an early stage of shock?

Alert and anxious, pulse 96 beats/min, BP 134/88 mmHg, pale and cool skin

When assessing a patient with a head injury, which finding is most indicative of increasing pressure within the skull?

Blood pressure of 192/106 mmHg

A 68-year-old female patient complains of a headache and generalized weakness. Her husband informs you that she was with a friend yesterday and was involved in a motor vehicle collision. She did strike her face on the dashboard, but refused treatment on scene. Her past medical history includes a stroke with right arm weakness and high blood pressure, for which she takes medications. When assessing this patient, which finding should concern the EMT most?

Bruising behind her left ear

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 SpO 2 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:

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

Of the actions described, which indicates proper care of a patient who has experienced a partial-thickness burn to the hand?

Carefully remove rings prior to applying a dry sterile dressing

An awake but confused patient with a history of diabetes accidentally spilled a pot of hot water on himself while cooking. He has a partial-thickness burn on his right anterior leg. Following an unremarkable primary assessment, which action seems most appropriate?

Check the patient's blood glucose level

The EMT is correctly assessing a 2-year-old male patient who is unresponsive after being assaulted by the mother's live-in boyfriend when he:

Checks capillary refill time to help determine perfusion

A young adult male is in police custody after he crashed his car into a utility pole. There is minor front-end damage to the vehicle, and the air bags deployed. The patient was not wearing a seat belt and has an abrasion to his forehead. He is awake and oriented to person, time, and place. His speech is slurred and he has an odor resembling that of beer on his breath. The arresting officer states that he just wants you to check the patient before he transports him to jail. Given this scenario, which action seems most appropriate for the EMT to take?

Contact medical direction with assessment findings

You have been called for a male patient who was shot with a rifle. Assessment reveals an entrance wound to the left lower quadrant of the abdomen. A hemorrhaging exit wound to the left lower back is also located. What should you do immediately?

Cover the entrance wound with a gloved hand

The greatest benefit of applying a traction splint in the field to a deformed femur and thigh is that it can:

Decrease the pain

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?

Decreased breath sounds to the left lung

You have arrived on the scene of a stabbing. As you approach the patient, you note that his shirt is off and a single stab wound to the right lower quadrant of the abdomen is evident. The patient appears unresponsive as you approach. At the patient's side, your first action should be to:

Examine the patient's airway

As part of your service to the community, you are certified as a car seat specialist and provide monthly classes on the safe transport of infants and children. Over the course of one day, several cars have pulled into your EMS station and asked you to look at their car seats. Which car seat position would indicate that the parent is safely transporting his or her infant (younger than 1 year old)?

Facing backward in the back seat in a reclined position (45 degrees)

You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate front-end damage. The patient complains of some back pain, but is walking around after the crash and does not appear to be suffering from any neurologic deficits. Although he answers your questions appropriately, he keeps asking you, "What happened?" What is your initial action in caring for this patient?

Initiate spine motion restriction precautions

A patient sustained a crush injury after being pinned by a car that fell off jack-stands while the patient was underneath the car working on it. The injury occurred to the left upper quadrant of the abdomen. Assessment shows bruising to that area, with instability noted to the lowest rib. The EMT's highest concern regarding this injury should be:

Injury to the spleen

You have been called for a 44-year-old male who was burned on the right hand and arm after falling against the hot door of an industrial incinerator. When you arrive on the scene, a nurse employed by the company informs you that he sustained a partial-thickness burn. Based on this information, the EMT should expect which characteristics at the burn site?

Intense pain and blister formation

An Emergency Medical Responder reports that a male patient, who was injured while playing football, has bruising to the lumbar region of the body. Based on this statement, the EMT should expect to find bruising in which area?

Lower back

You have arrived on the scene for a patient assaulted with a baseball bat. As you approach, which position would seemingly indicate that he has suffered an injury to the abdomen?

On his side with knees drawn to the chest

A female patient has been involved in a motorcycle crash. Your scene size-up reveals her to be unresponsive and lying in the roadway. It also appears that her left leg has been amputated at the knee. What should the EMT do immediately?

Perform a jaw-thrust maneuver

The mother of a 4-year-old boy states that he fell off the top bunk bed and hit his head. After falling, he appeared to seize for approximately 30 seconds. Currently, he has nonpurposeful movement to painful stimuli, with a patent airway and slow respirations. His radial pulse is intact, and his skin is warm and dry. You note urinary incontinence. After taking manual spine motion restriction precautions, what should you do next?

Perform a jaw-thrust maneuver and start positive pressure ventilation

A 14-year-old male fell 10 feet from a retaining wall and hit his head on a metal post. He is responsive to verbal stimuli with incomprehensible speech. The secondary assessment indicates blood and fluid coming from inside the patient's left ear. Given these assessment findings, the EMT should:

Place a piece of sterile gauze over the ear to catch the fluid

Damage to which thoracic tissues can cause impairment of ventilation from a developing pneumothorax?

Pleural membranes

What is a general guideline to use when deciding whether to remove a patient's contact lenses?

Remove contact lenses if the eye has been injured by a chemical burn

An elderly woman experienced a closed head injury when she fell down five steps. She is responsive to painful stimuli and her breathing is irregular and shallow. When evaluating her airway, you note that she has both upper and lower dentures. Her upper dentures are secure, but her lower dentures are loose. Prior to providing positive pressure ventilation, you would:

Remove the lower dentures

A woman fell from a second-story window onto the concrete sidewalk below. She is unresponsive and has a large depression to the back and top of her skull. Additional findings include abdominal bruising and an angulated left ankle. Your partner reports that the patient's vital signs are pulse, 68 beats/min; respirations, 14 breaths/min and irregular; blood pressure, 198/112 mmHg; and SpO 2, 91% on room air. Based on these assessment findings, what should the EMT suspect is occurring?

Severe head injury with increasing pressure within the skull

When performing the primary assessment, which sign or symptom best suggests that the patient is in shock?

Skin that is cool and diaphoretic

A football player injured his knee during practice and is in pain. His left knee is swollen, ecchymotic, and flexed in an upward position. Your partner reports that the distal skin is warm, and he has located a weak pedal pulse. Which action should you perform immediately?

Splint the knee in the position found prior to providing transport to the hospital

Which one of these injuries is most likely to cause peritonitis?

Stab wound to the small intestine

As you pull up to a motor vehicle collision, you quickly scan the scene for clues as to the type and severity of injuries. Which observation would best indicate that a patient may have a head injury?

Starburst on the windshield

A 61-year-old male fell off a roof. Your primary assessment findings include unresponsiveness, agonal breathing, and a slow and weak radial pulse. The patient's skin is cool and dry. Emergency Medical Responders are maintaining manual spine motion restriction procedures. What should you do immediately?

Start positive pressure ventilation

A teenage boy was found by friends as he attempted to hang himself in a garage using chains suspended from the ceiling. As you approach, you note that the patient is conscious, struggling significantly to breathe, is ashen in color around the mouth and to the hands, and has contusions and swelling that encircle his neck from the chains. After taking manual cervical spine motion restriction and opening the airway, your next action would be to:

Start positive pressure ventilation

A 57-year-old male has been involved in a motor vehicle collision and is entrapped in his car. He is unresponsive, with agonal gurgling respirations and blood coming from his nose. His respirations show poor effort and are inadequate. The radial pulse is rapid and weak, and the skin cool and diaphoretic. An Emergency Medical Responder is holding manual spinal motion restriction. Which action would you perform first?

Suction the airway with a catheter

When teaching Emergency Medical Responders about air bags, which point would you emphasize?

The benefit of air bags is lessened in a multiple-vehicle collision impact

The young pediatric patient is more prone to head injury because:

The head is proportionately heavier and the neck muscles are weaker

Which sign or symptom best indicates the patient has experienced a spinal cord injury to the thoracic spine?

Tingling in the legs

A patient has a history of tendonitis to the right elbow. Based on this history, the EMT would understand that the:

Tissue connecting the muscle to the bones of the elbow is inflamed

A female patient with a maxillary fracture has sustained injury to her:

Upper jaw

A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when he:

Wraps it in a dry sterile dressing