EMT TRAUMA

removing the contact lenses and beginning irrigation of both eyes.

A 22-eayr-old man had a strong acid chemical splashed into both of his eyes. he is conscious and alert, is experiencing intense pain, and states that he is wearing contact lenses. treatment should include:

Distended jugular veins

After completing a rapid assessment of a patient with a penetrating chest injury, the EMT tells her partner that she suspect a pericardial tamponade. which of the following did the EMT MOST likely encounter during her assessment?

remove the occlusive dressing

After covering a large open chest wound with an occlusive dressing, it becomes necessary to ventilate the patient with a bag-valve-mask device. what should you do?

flushing the burns with cool water for 10 minutes

Emergency care for a 68-year-old male with partial and full-thickness burns to his chest and upper extremities includes all of the following, EXCEPT:

high cholesterol in the blood

Factors that affect a person's ability to compensate for internal or external blood loss include all of the following EXCEPT:

airway swelling

Firefighters have rescued a man from his burning house. he is conscious and alert, but is experiencing significant respiratory distress. he has a brassy cough and singed nasal hairs. the MOST immediate threat to this patient's life is:

cover her ear and nose with a loose gauze pad to collect the blood

Following a head injury, a young female is semiconscious and is beelding from the nose and left ear. you should:

Increased pressure in the pleural space is compressing the great vessels

Following blunt force trauma to the anterior chest, a man presents with difficulty breathing, distended jugular veins, absent breath sounds over the left side of the chest, and hypotension. which of the following BEST describes the pathophysiology of this patient's injury?

bleeding within the lungs

Following blunt injury to the anterior torso, a patient is coughing up bright red blood. you should suspect:

Apply a moist, sterile dressing, covered by a dry, sterile dressing

Following penetrating trauma to the abdomen, a 50-year-old woman has a large laceration with a loop of protruding bowel. how should you manage this injury?

the anterior part of the brain sustains a compression injury, while the posterior part sustains a stretching injury.

If a passenger strikes his or her head on the windshield during a motor-vehicle crash:

Third Collision

If a vehicle strikes a tree at 60 mph, the unrestrained driver would likely experience the MOST severe injuries during the:

is a jagged cut

In contrast to an incision, a laceration:

Lacerated femoral vein; BP 70/40 mm Hg

In which of the following circumstances would external bleeding be the LEAST difficult to control?

Femoral artery laceration, BP of 140/90 mm Hg

In which of the following situation would external bleeding be the MOST difficult to control?

with hemophilla

Internal or external bleeding would be especially severe in a patient:

sprain

what type of injury occurs when a joint is twisted or stretched beyond its normal range of motion, resulting in swelling but no deformity?

look for the presence of an exit wound.

when assessing and treating a patient with a gunshot wound, you should routinely:

Palpate for a dorsalis pedis pulse

when assessing distal circulation in a patient with a swollen deformed femur, you should:

The way in which traumatic injuries occur

which of the following BEST describes the mechanisms of injury?

The pain is greater than one would expect for the injury

which of the following assessment findings should alert the EMT that a patient with a closed lower extremity fracture is developing compartment syndrome?

Blood in the ear canal

which of the following clinical finding is MOST indicative of a skull fracture?

Falling blood pressure

which of the following clinical findings is consistent with decompensated shock?

Hypothermia

which of the following factors would reduce the blood's natural ability to clot, thus worsening internal or external bleeding?

skater slip and falls, landing on her outstretched arm

which of the following injury mechanisms involves axial loading?

distraction

which of the following injury mechanisms is associated with hangings?

Restless, diaphoresis tachypnea, BP of 104/64 mm Hg

which of the following is MOST indicative of compensated shock in an adult?

Palpable pain at the site of the injury

which of the following is the MOST reliable indicator of a fractured spinal vertebra?

BP, 88/50 mm Hg; pulse, 120 beats/min; respirations, 28 breaths/min

which of the following sets of vital signs is the MOST consistent with hemorrhagic shock?

BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min

which of the following sets vital signs is MOST indicative of increased intracranial pressure in a patient with a head injury?

Mental status

which of the following will provide you with the MOST information regarding a head-injured patient's condition?

spinal cord injury

while assessing a patient who was ejected from his truck. the EMT notices that his chest collapses and his abdomen rises during inhalation. what should the EMT suspect?

Liver

injury to which of the following organs would MOST likely cause hemorrhagic shock?

Hypertension

patients with significant closed head injuries often have pupillary abnormalities and:

fractured larynx

the presence of subcutaneous emphysema following blunt trauma to the anterior neck should make you MOST suspicious for a:

manually stabilize her injury and contact medical control for further stabilization instructions

A 22-year-old female fell on her knee and is in severe pain. her knee is flexed and severely deformed. her leg is cold to the touch and you are unable to palpate a distal pulse. you should:

18%

A 30-year-old man sustained partial-thickness burns to the anterior chest and both anterior arms. based on the rule of nines, what percentage of his body surface area has been burned?

controlling any external bleeding

A 30-year-old woman has an open deformity to her left leg and is in severe pain. she is conscious and alert, has a patent airway, and is breathing adequately. your primary concern should be:

prepare for immediate transport

A 33-year-old factory worker was crushed between two pieces of mechinery. you find him lying supine on the ground complaining of severe pain to his pelvis. he is restless, diaphoretic, and tachycardic. what should you do?

You must stop the bleeding from his abrasion immediately or the patient will die from hypovolemic shock.

A 33-year-old male struck a parked car with his motorcycle and was thrown from the motorcycle. he was not wearing a helmet. he is unresponsive and has a depressed area to his forehead, bilaterally deformed femurs, and widespread abrasions with capillary bleeding. which of the following statements regarding this patient is false?

27%

A 40-year-old man has burns to the entire head, anterior chest, and both anterior upper extremities. using the adult rule of nines, what percentage of his total body surface area has been burned?

Ensure that he is sitting up and leaning forward

A 40-year-old man was hit in the nose during a fight. he has bruising under his left eye and a nosebleed. what should you do?

carefully remove the knife, control the bleeding, and begin CPR

A 42-year-old man has a large knife impaled in the center of his chest. he is unresponsive, pulseless and apneic. you should:

manually stabilize his head

A 42-year-old man was ejected from his car after it struck a bridge pillar at a high rate of speed. you find him in a prone position approximately 50 feet from his car. he is not moving and dose not appear to be breathing. you should:

cover the wound with a trauma dressing and apply a proximal tourniquet.

A 44-year-old has traumatic leg amputation just below the knee. he is lying in a large pool of blood and the wound is bleeding profusely. the EMT should:

partial-thickness, 36%

A 44-year-old male experienced burns to his anterior trunk and both arms. he is conscious and alert, but is in extreme pain. assessment of the burns reveals reddening and blisters. this patient has __________burns that cover ___________ of his total body surface area

subdural hematoma

A 70-year-old female fell and struck her head two days ago, but did not seek medical attention. today, she is confused, is vomiting, and has slurred speech. the EMT should suspect a/an:

avulsion

A Soft-tissue injury that results in a flap

hemothorax

A man was stabbed in the right side of the chest, lateral to the nipple. he is tachypneic, tachycardic, and diaphoretic. his jugular veins are collapsed and breath sounds are difficult to hear on the right side. you should suspect a:

brush the chemical away from the skin surface

A construction worker spilled a bag of powdered chemical, covering both of his arms. he complains of intense pain. what should you do?

liver laceration

A man was stabbed in the lower right ribcage. he is diaphoretic; his pulse is rapid and weak; and his respirations are regular and unlabored at 24 breaths/min. which of the following injuries should the EMT suspect?

continuously flush his eyes with saline for at least 20 minutes.

A high school student was splashed in the eyes with a strong acid chemical during a lab experiment. he is in severe pain and is unable to open his eyes. you should:

Loss of nervous system control over the systemic vasculature

A hiker fell 25 feet from a ledge. there is obvious deformity to his thoracic spine and he has a large laceration on his forehead. his BP is 60/40 mm Hg, pulse is 50 beats/min, and respirations are 26 breaths/min. his face and chest are pale and cool, but his abdomen and lower extremities are pink and warm. which of the following BEST describes the pathophysiology of these findings?

apply manual pressure to the wound with a sterile dressing

A man has a large laceration to his right calf after chainsaw he was using slipped. the wound extends down to the muscle and dark red blood is flowing heavily from the wound. the EMT should:

cover the wound with an occlusive dressing and apply direct pressure.

A man was cut on the left side of the neck and is bleeding heavily from the wound. his airway is patent and his breathing is adequate. you should immediately

suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings.

A man was stabbed in the cheek with a dinner fork, and the fork is still impaled in his cheek. he is conscious and alert, breathing adequately, and has blood in his oropharynx. you should:

cover the wound, administer oxygen, and transport

A man was stabbed to the left side of the chest. his skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are 22 breaths/min, and his pulses 120 beats/min and weak. his breath sounds are equal bilaterally and his jugular veins are distended. what should you do?

immobilizing the spine, administering oxygen, and monitoring for vomiting.

A man was struck in the side of the head with a steel pipe. blood-tinged fluid is draining from the ear and bruising appears behind the ear. the MOST appropriate treatment for this patient includes:

if the patient's arm has not been recovered by the time you are ready to transport, you should transport without delay.

A man's arm was amputated during a car crash. the patient is unresponsive; has rapid, shallow breathing; and has a rapid, weak pulse. as you and your partner are treating him, other responders are attempting to locate his severed arm. which of the following statements regarding this scenario is correct?

IV fluids and certain drugs may be given before he is freed.

A man's legs were pinned by a steel girder for 5 hours before he was found. he is conscious and alert with stable vital signs but cannot feel his legs. the EMT should anticpate that:

decreased air movement into one ung

A patient experienced blunt chest trauma and has asymmetrical chest wall movement. this finding indicates:

Ruptured spleen

A patient experienced blunt trauma to the left upper abdominal quadrant. when he is positioned supine, he experiences severe pain in his left shoulder. which of the following should the EMT suspect?

remove the occlusive dressing

A patient has an open chest wound, which has been covered with an occlusive dressing. he is receiving oxygen at 12 L/min by nonrebreathing mask. during transport, the patient's heart rate increases, he becomes pale and diaphoretic, and his oxygen saturation falls. what should you do?

apply a proximal tourniquet

A patient is unresponsive with snoring respirations. his arm is amputated just above the elbow and is bleeding heavily the EMT should:

radius

A patient presents with a swollen, painful deformity to the lateral bone of the left forearm. you should recognize that he has injured his:

Pericardial tamponade

A patient with a chest injury has a BP of 100/70 mm Hg and a heart rate of 100 beats/min. reassessment reveals a BP of 90/74 mm Hg, a pulse of 120 beats/min, and the development of jugular venous distention. what should you suspect?

9

A patient with a closed head injury opens his eyes in response to pain, is mumbling words that you cannot understand, and pushes your hand away when you apply a painful stimulus. his glasgow coma scale (GCS) score is:

below the C5 level

A patient with a spinal injury may still be able to use his or her diaphragm to breathe, but would lose control of the intercostal muscles, if the spinal cord is injured:

increased epinephrine and nonrepinephrine release

A patient with multiple injuries presents with pallor, diaphoresis, a heart rate of 120 beats/min, and a BP of 112/64 mm Hg. the EMT should recognize that these signs are the result of:

increased internal hemorrhage

A trauma patient has a BP of 172/94 mm Hg, a pulse rate of 45 beats/min, and a respiratory rate of 6 breaths/min. which of the following conditions would MOST likely produce this vital sign pattern?

8

A trauma patient open his eyes slightly and moans when the EMT applies a painful stimulus. when the EMT palpates the patient's arm, he pulls it away. his glasgow coma scale (GCS) score is:

Apply a proximal tourniquet and engage it until the bleeding stops

A woman fell through a glass window and has a large laceration to her inner arm that is bleeding profusely. the EMT applies a trauma dressing and direct pressure to the wound, but the dressing immediately becomes soaked with blood. what should the EMT do next?

apply gentle traction in order to reestablish distal circulation.

A woman has a painful, deformed humerus after she fell. the injured arm is cool and pale, and a radial pulse cannot be palpated. the EMT should:

she is developing compartment syndrome

A woman has closed fracture to her midshaft tibia. you splinted the injury and are monitoring her during transport. during reassessment, she complains of rapidly increasing pain and you note that her leg is pale and cool. what should you suspect?

Administer oxygen and protect

A woman struck the steering wheel with her chest when her car collided with a tree. she is conscious and alert; however, she is tachypneic and diaphoretic and her pulse is rapid and irregular. what should you do?

keep air out of the wound and control the bleeding.

A young male has a large laceration to his lateral neck, directly over his jugular vein. his airway is patent and his breathing is adequate. your MOST immediate priority should be to:

rapidly transport him to a trauma center.

A young male has multiple injuries after he fell approximately 35 feet. he is semiconscious and has an unstable chest wall, numerous long bone fractures, and a large hematoma to his head. he will have the BEST chance for survival if you:

Radial

A young man fell and landed on his outstretched hand, resulting in pain and deformity to the left midshaft forearm. distal circulation should be assessed at which of the following pulse locations?

8

An adult patient opens his eyes in reponse to a painful stimulus, moans when you ask him questions, and pulls his arm away when you palpate it. what is his glasgow coma scale (GCS) score?

place her on a scoop stretcher and pad her hip with pillows

An elderly woman complains of pain to her right groin area she fell. her right leg is shortened and externally rotated. which of the following would be the MOST effective way of stabilizing her injury?

covering the burns with dry, sterile dressings and preventing further loss of body heat.

An elderly woman, who was removed from her burning house by firefighters, has full-thickness burns to approximately 50% of her body. appropriate treatment for this patient would include:

assist the patient's ventilations while you control the bleeding.

An unresponsive patient with multi-system trauma has slow, shallow breathing; weak radial pulses; and severe bleeding from a lower extremity wound. you should direct your partner to:

traumatic asphyxia

An unrestrained driver was crushed in between the steering wheel and his seat when his truck collided with a tree. assessment reveals cyanosis to his neck and face, jugular venous distention, and bleeding into the sclera of his eyes. the EMT should suspect:

laying the wrapped body part on a bed of ice

Appropriate care for an amputated body part includes:

dry, sterile dressings; and keeping the patient warm.

Appropriate treatment for a patient with widespread full-thickness burns includes:

brainstem

Assessment of a patient with multisystem trauma reveals decerebrate posturing rapid irregular breathing, and bradycardia. these clinical signs indicate injury to the:

ventilate the patient with a bag-valve-mask device.

Assessment of a trauma patient reveals paradoxical movement to the left side of his chest. the patient is conscious, but restless, and is experiencing severe pain. his breathing is rapid and shallow and his pulse is rapid and weak. the EMT should:

11

Assessment of an injured man reveals that he opens his eyes when the EMT speaks to him and pulls his arm away when the EMT palpates it. he knows his name, but cannot remember what happened and dose not know what day it is. he should be assigned a glasgow coma scale (GCS) score of:

ecchymosis

Damaged small blood vessels beneath the skin following blunt trauma cause:

apply a tourniquet proximal to the injury untill the bleeding stops.

Despite direct pressure, a large laceration continues to spurt large amounts of bright red blood. you should:

shortening and external rotation of the leg

Displaced fractures of the proximal femur are characterized by:

manually stabilize the leg above and below the knee

During a soccer game, an 18-year-old woman injured her knee. her knee is in a flexed position and is obviously deformed. you should:

direct trauma to the eyeball

During your assessment of a patient who experienced blunt facial trauma, you note the presence of a hyphema. this indicates:

decreased blood flow to the skin

During your assessment of a patient with a gunshot wound to the chest, you note that his skin is pale. this finding is the result of:

Dry cough and hoarse voice

EMTs are assessing a man who was injured while trying to rescue a pet from his burning house. which of the following assessment findings should be the MOST immediately concerning?

spinal injury

Prior to your arrival at the scene, a young female was removed from a body of water after being submerged for an unknown period of time. you should manage her airway appropriately while considering the possibility of:

restlessness

Which of the following signs would you expect to see in the early stages of shock?

control the bleeding

You are called to a local nightclub for an injured patient. Law enforcement personnel have secured the scene. Upon arrival, you see a young man who is lying on the ground screaming in pain; bright red blood is spurting from an apparent stab wound to his groin area. you should:

stabilize his head manually

You are dispatched to the scene of a motorcycle crash. upon arrival, you find the patient lying face down approximately 25 feet from his bike. he is not wearing a helmet and is moaning. you should:

flail chest

following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. on assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. these are signs of a/an: