EMT: Chapter 26 [soft-tissue bleeding]

According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA.

1%

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head, face, and anterior trunk. What percentage of her body surface area has been burned?

30%

You are responding to a fight at a restaurant and find a man, conscious and alert. His face is mottled with blisters and abrasions, and he has blood on his shirt. He tells you he was trying to stop the fight when he was hit in the face with scalding hot coffee and fell backwards over a chair. According to the rule of nines, what percentage of the patient's skin surface is burned?

9%

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to:

unbolt the kickstand from the bike frame and stabilize it with bulky dressings

The sebaceous glands produce sebum, a material that:

waterproofs the skin and keeps it supple

An abdominal evisceration:

occurs when organs protrude through an open wound

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status

The hallmark sign of compartment syndrome is:

pain out of proportion to the injury

Which of the following is a sign of compartment syndrome?

pain upon passive movement of the injury site

Which of the following is a severe burn in a 65-year-old patient?

partial-thickness burn to 20% of the BSA

Burns to pediatric patients are generally considered more serious than burns to adults because:

pediatric patients have more surface area relative to total body mass

In which of the following patients should you remove an impaled object?

a pulseless and apneic patient with a knife impaled in the back

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:

air embolism

Which of the following is a severe burn in a 2-year-old child?

any full-thickness burn, regardless of its location on the body

A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should:

apply an occlusive dressing to the wound and continue your assessment

You are treating an 8-year-old who fell while riding his bike on a gravel road. The wound on his arm is seeping blood, is about 7 inches long, and there is a lot of dirt and gravel in it. How should you treat this injury?

apply sterile dressing

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:

assess distal circulation and readjust the bandage as needed

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should:

rapidly assess the patient after ensuring the power line is not live

In contrast to animal bites, the bite of a human:

carries with it a wide variety of virulent bacteria and viruses

Common signs and symptoms of an airway burn include all of the following, EXCEPT:

chest pressure

Which of the following is a severe burn in a 35-year-old patient?

circumferential partial-thickness burn to the chest

Which of the following is the final stage of wound healing?

collagen production

The germinal layer of the epidermis contains pigment granules that are responsible for skin:

color

A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:

compartment syndrome

You are assessing a 28-year-old with a rigid cast extending the length of his left leg. The patient is complaining of pain on passive movement and he is showing signs of impaired circulation. What do you suspect?

compartment syndrome

Which of the following statements regarding crush syndrome is correct?

compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours

A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-inch steel rod impaled in his left leg. You should:

control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately

Which type of soft-tissue injury is LEAST likely to result in infection?

contusions on the left lateral chest

When assessing a patient with a closed soft-tissue injury, it is MOST important to:

remain alert for more severe underlying injuries

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

replace the avulsed flap to its original position and cover it with a sterile dressing

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?

cover it with moist, sterile gauze and secure with an occlusive dressing

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:

report the incident to the appropriate authorities

the skin covering the ____________ is quite thick.

scalp

Which of the following statements regarding severe burns is correct?

severe burns are typically a combination of various degrees of burns

During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a:

shotgun

Burns are classified according to:

depth and extent

A partial-thickness burn involves the outer layer of skin and a portion of the:

dermal layer

The severity of a thermal injury directly correlates with temperature, concentration, and what other factor?

duration of exposure

Which of the following areas of the body has the thinnest skin?

ears

Which of the following statements regarding electrical burns is correct?

entrance wounds are small relative to the amount of internal tissue damage

You are assessing a patient who has been in a high-impact T-bone collision. She is bleeding from the abdomen and you can see part of her large intestine outside her body. What is this injury called?

evisceration

Which of the following statements regarding penetrating injuries is correct?

external bleeding may be minimal but internal injuries can be extensive

treatment for an abdominal evisceration includes:

flexing the knees and legs to relieve pressure on the abdomen

When using the rule of nines, which of the following do you need to include in your calculations?

full- and partial-thickness burns

which of the following should NOT be used as an occlusive dressing?

gauze pads

as the cells on the surface of the skin are worn away, new cells form in the _________________ layer.

germinal

a(n) _________________ is usually associated with extensive tissue damage.

hematoma

more extensive closed injuries may involve significant swelling and bleeding beneath the skin, which could lead to:

hypovolemic shock

Functions of dressings and bandages include all of the following, EXCEPT:

immobilization of the injury

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:

infection

With regard to the pediatric rule of nines, the:

legs are proportionately smaller than an adult's

All of the following body structures are lined with mucous membranes, EXCEPT for the:

lips

splinting an extremity, even when there is no fracture, may:

make it easier to move the patient

What is your first responsibility when treating a burn patient?

stopping the burning

A burn that is characterized by redness and pain is classified as a:

superficial burn

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct?

the 39-year-old female is at high risk for an infection

Which of the following statements regarding the rule of nines is correct?

the anterior trunk of an adult is equal to 18% of the BSA

Which of the following statements regarding the dermis is correct?

the dermis contains hair follicles, sweat glands, and nerve endings

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with:

the fact that her clinical signs could indicate that she is bleeding internally

Which of the following processes occurs during the inflammation phase of the healing process?

the immune system release histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling

Patients with full-thickness (third-degree) burns generally do not complain of pain because:

the nerve endings have been destroyed

You and your partner arrive at the scene of a house fire where firefighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with:

the potential for airway swelling

Functions of the skin include all of the following, EXCEPT:

the production of key antibodies

because shootings usually end up in court, it is important to factually and completely document:

the treatment given

Which of the following is true about electrical burns?

they are always more severe than the external signs indicate

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.

18%

In order for electricity to flow through the body and cause damage:

a complete circuit must exist between the electrical source and the ground

A hematoma develops when:

large blood vessels beneath the skin are damaged

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?

abrasion

using elastic bandages to secure dressings may result in _________________ if the injury swells or if the bandages are applied improperly.

additional tissue damage

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:

administer O2 and prepare for rapid transport

A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:

administer high-flow O2

When treating a partial-thickness burn, you should:

avoid the use of creams, lotions, or antiseptics

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:

begin CPR and apply the AED

When caring for a patient whose arm is covered with a dry chemical, you should:

brush away the chemical before flushing with water

Which of the following is of LEAST importance when initially assessing the severity of a burn?

known drug allergies