TRAUMA BENCHMARK
Femoral shaft fractures can result in up to _____ mL of internal blood loss.
1,000
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
20%
Hypothermia occurs when the core body temperature falls below:
95°F (35°C).
The MOST reliable sign of a head injury is:
A decreased level of consciousness.
In which of the following patients should you remove an impaled object?
A pulseless and apneic patient with a knife impaled in the back
An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:
A rapid deterioration of neurologic signs.
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
A rapid, thready pulse.
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
A relatively small surface area.
A flail chest occurs when:
A segment of the chest wall is detached from the thoracic cage.
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:
A tourniquet proximal to the injury.
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 oxygen.
An open pneumothorax occurs when:
Air enters the pleural space from outside the body.
What mechanism(s) does the body use to control bleeding?
All of these answers are correct.
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:
An air embolism.
Which of the following is most likely to cause immediate death?
Aortic rupture
A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid 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.
Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:
Apply high-flow oxygen, consider spinal precautions, and transport without delay.
After your partner assumes manual in-line stabilization of the patient's head, you should:
Assess distal neurovascular status in the extremities.
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.
An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):
Avulsion.
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.
An epidural hematoma is MOST accurately defined as:
Bleeding between the skull and dura mater.
Which of the following sets of vital signs depicts Cushing triad?
Blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min
Hypothermia can worsen internal bleeding secondary to:
Blood-clotting abnormalities.
An organ or tissue may be better able to resist damage from hypoperfusion if the:
Body's temperature is considerably less than 98.6°F (37.0°C).
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
Cavitation.
The MOST common and serious complication of a significant head injury is:
Cerebral edema.
A 39-year-old female experienced a severe closed head injury. She is unresponsive with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should:
Close her eyes and cover them with a moist dressing.
Rapid deceleration of the head, such as when it impacts the windshield, causes:
Compression injuries or bruising to the anterior portion of the brain and stretching or tearing of the posterior portion of the brain.
A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:
Control the bleeding and cover the wound 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.
The thoracic cavity is separated from the abdominal cavity by the:
Diaphragm.
A Colles fracture involves a fracture of the:
Distal radius.
The body's natural cooling mechanism, in which sweat is converted to a gas, is called:
Evaporation.
The Glasgow Coma Scale (GCS) is used to assess:
Eye opening, verbal response, and motor response.
It would be MOST appropriate to perform a focused secondary assessment on a patient who:
Fainted and fell to the ground from a standing position.
Traction splints are used primarily to immobilize and secure fractures of the:
Femur.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first:
Follow appropriate standard precautions.
All of the following terms refer to a body part that is cold but not frozen, EXCEPT:
Frostbite.
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?
Gastrointestinal system
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to:
How rapidly he or she bleeds.
When splinting an injury of the wrist, the hand should be placed:
In a functional position.
Bleeding within the brain tissue itself is called a(n):
Intracerebral hematoma.
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
A simple pneumothorax:
Is commonly caused by blunt chest trauma.
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
Is ejected or partially ejected.
In order for sweating to be an effective cooling mechanism:
It must be able to evaporate from the body.
In pediatric patients, the liver and spleen are _______.
Larger in proportion to the abdomen
Approximately 25% of severe injuries to the aorta occur during:
Lateral collisions.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:
Liver
Which of the following organs would MOST likely bleed profusely when injured?
Liver
Which of the following organs or structures does NOT reside within the mediastinum?
Lungs
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.
Early signs and symptoms of intra-abdominal bleeding include:
Pain and distention.
You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:
Partially remove the dressing.
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.
Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?
Pelvic fracture with hypotension
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______.
Perfusion
A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:
Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.
A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:
Posterior hip dislocation.
By what mechanism is a person injured when he or she falls from a significant height?
Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:
Prepare for immediate transport.
Immediately life-threatening chest injuries must be found and managed during the _______.
Primary assessment
Because the depth of an open abdominal wound is often difficult to determine:
Prompt transport to the hospital is essential.
A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
Pulmonary contusion.
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?
Rapid transport to a trauma center
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should:
Rapidly assess the patient after ensuring that the power line is not live.
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
Rapidly transporting her to the hospital.
Early bruising following abdominal trauma often manifests as:
Red areas of skin.
When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant:
Remains in motion until acted upon by an external force.
When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, you should:
Remember that it could still deploy and seriously injure you.
A patient who presents with profound cyanosis following a chest injury:
Requires prompt ventilation and oxygenation.
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
Rupture of the tympanic membrane following diffuse impact to the head.
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.
The presence of tachycardia following a significant abdominal injury:
Should be assumed to be a sign of shock.
Significant trauma to the face should increase the EMT's index of suspicion for a(n):
Spinal column injury.
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.
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
Stabilize her head and perform a primary assessment.
During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
Stabilize the pelvis with a pelvic binder and protect the spine.
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
Suction his oropharynx for up to 15 seconds.
The severity of bleeding should be based on all of the following findings, EXCEPT:
Systolic blood pressure.
Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?
Tachycardia
Patients with chest injuries will often present with _______.
Tachypnea
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 correct?
The 39-year-old female is at high risk for an infection.
Which of the following statements regarding a basilar skull fracture is correct?
The absence of raccoon eyes or Battle sign does not rule it out.
Hypovolemic shock occurs when:
The body cannot compensate for rapid blood loss.
Heat stroke occurs when:
The body's heat-eliminating mechanisms are overwhelmed.
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?
The filtering of blood cells in the spleen
Patients with full-thickness (third-degree) burns generally do not complain of pain because:
The nerve endings have been destroyed.
An open fracture is MOST accurately defined as a fracture in which:
The overlying skin is no longer intact.
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:
The patient has been completely secured to the backboard.
In general, musculoskeletal injuries should be splinted before moving the patient unless:
The patient is clinically unstable.
Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?
The patient takes rivaroxaban (Xeralto).
Which of the following statements regarding abdominal eviscerations is correct?
The protruding organs should be kept warm and moist.
Which of the following statements regarding gunshot wounds is correct?
The speed of a bullet has the greatest impact on the injury produced.
A female patient with a suspected head injury has slow, shallow breathing. The MOST appropriate treatment for her includes:
Ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.
Pleural fluid is contained between the:
Visceral and parietal pleurae.
When caring for a patient with an open facial injury, the EMT's immediate priority should be to:
Wear gloves and facial protection.
The index of suspicion is MOST accurately defined as:
Your awareness and concern for potentially serious underlying injuries.
The MOST significant hazard associated with splinting is:
delaying transport of a critically injured patient.
