EMT Chapter 30

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Which of the following statements regarding rebound tenderness is correct?

It is often discovered when the patient is jarred or moved suddenly.

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?

Shoulder fracture

Which of the following statements regarding abdominal trauma is correct?

The absence of abdominal pain does not rule out intra-abdominal bleeding.

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

The mesentery is:

a membranous fold that attaches the intestines to the walls of the body

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

apply direct pressure to the wound.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

applying direct pressure with a dry, sterile dressing.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

avoid speculation and document only factual data.

When worn properly, a seat belt should lie:

below the anterior superior iliac spines of the pelvis and against the hip joints.

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:

blunt injury to the kidney.

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

closely monitor him and reassess him frequently.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

control any external bleeding, administer oxygen, and transport at once.

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm.

Accumulation of blood in the abdominal cavity will MOST likely cause:

distention.

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:

giving him small sips of plain water.

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

guarding.

Peritonitis usually occurs when:

hollow abdominal organs are damaged and spill their contents.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

intra-abdominal bleeding.

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

lift the air bag and look for deformity to the steering wheel.

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

liver.

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

may decrease the amount of blood that returns to the heart.

When a hollow organ is punctured during a penetrating injury to the abdomen:

peritonitis may not develop for several hours.

Early bruising following abdominal trauma often manifests as:

red areas of skin.

The presence of tachycardia following a significant abdominal injury:

should be assumed to be a sign of shock.

All of the following are hollow abdominal organs, EXCEPT the:

spleen.