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What is the best description of a topical hemostatic agent?
A dressing that is specifically designed to stop bleeding
Which of these patients would the EMT recognize as suffering from an evisceration injury?
A male patient with a loop of intestine protruding from an open surgical wound
Which patient requires the EMT to remove an impaled object in the field?
A young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is flowing into her throat
Which type of injury is most likely to result in capillary bleeding only?
Abrasion
A patient was assaulted and sustained multiple injuries of various types. Which injury does the EMT recognize as presenting the greatest risk for infection?
Abrasion to the right side of the face
You have just applied a pressure dressing to the leg of a woman who suffered a deep laceration to her calf from a piece of broken glass. What should you do next?
Assess for a pedal pulse
As you approach a young male lying on the sidewalk who was called into 911 as an "unresponsive male," you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient would be to:
Assess the airway
Which statement about dressings and bandages is true?
Bandages should not be applied until bleeding is controlled
While en route to a domestic violence incident with possible injuries, the police contact you and report that a male patient has arterial bleeding from a stab wound to the arm. Given this information, which bleeding characteristics do you expect?
Bright red blood that is spurting with each beat of the heart
An alert and oriented patient has had a portion of his hand amputated by a table saw. Assessment reveals the patient to be in great pain, with a moderate amount of dark red blood still coming from the injury site. His airway is open and his breathing is fast, but adequate. The radial pulse is rapid and strong, and his skin is warm and dry. The patient's amputated hand has been placed in a bag of ice by coworkers. What should the EMT do immediately?
Control the bleeding with direct pressure
A patient was building a bomb in his garage when it accidentally detonated. Assessment findings from the rapid secondary assessment reveal part of the intestines and a portion of the liver protruding from the right side of the abdomen. Proper care of this injury would include:
Covering the exposed organs with a large sterile dressing soaked with sterile water
Which sign or symptom of shock will be observed last?
Decreased blood pressure
The EMT's initial concern when treating a patient with a gunshot wound to the chest is:
Ensuring an open airway
A patient has suffered an open crush injury to his elbow. As you approach him, you note the patient is sitting upright and holding a towel to his elbow. Although the towel is soaked with blood, the elbow does not appear to be actively bleeding. Your first action in caring for this patient should be to:
Evaluate the patient's airway
When providing prehospital care to a female patient with a soft-tissue injury, which statement is true?
Hands should be washed even if gloves were worn during care
A 49-year-old male was climbing on a truck at a construction site when he fell backward to the ground. He presents with a 2-inch linear wound to the top of his head. Bleeding has been controlled and the skull can be seen through the wound. How should you document this injury on the prehospital care report?
Laceration
Prior to your arrival on the scene of a motorcycle crash, an Emergency Medical Responder contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable EMT, which kind of injury should you anticipate?
Loose flap of skin torn on the patient's left arm
Which clinical finding is most suggestive of a patient who is decompensating?
Narrowing pulse pressure
A 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which dressing is best for this injury?
Occlusive dressing
You believe that a patient who has been shot in the lower abdomen is bleeding internally and is in an early stage of shock. The patient's mental status is decreasing. What would be appropriate prehospital care of this patient?
Oxygen therapy and rapid transport to the hospital
A 48-year-old male is in shock from injuries sustained in a motor vehicle collision. Which assessment finding(s) is (are) most suggestive that the patient may have internal bleeding?
Pelvic instability with a BP of 78/48 mmHg
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
A 40-year-old homeless male is found lying in the street. The physical examination reveals that the patient has a stab wound to the mid-chest. He is unresponsive and his skin is cool to the touch. His respirations are snoring at 40 breaths/min and his pulse is 120 beats/min. Which care should the EMT provide first?
Perform a jaw-thrust maneuver
The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the bleeding, the EMT would first:
Place a large sterile dressing over the site, with hand pressure applied over the top of the dressing
A pregnant 31-year-old female has been shot in the neck. Currently, she is responsive to verbal stimuli, with an open airway and rapid, but adequate respirations. Her radial pulse is weak and fast. Vital signs are as follows: pulse 152 beats/min, respirations 22 breaths/min, blood pressure 92/76 mmHg, and SpO2 100% on high-concentration oxygen as initiated by the fire department EMRs. Which other intervention by the EMT will most benefit this patient?
Place an occlusive dressing on the neck and keep the patient warm during transport
A small metal rod was thrown from a metal lathe while it was in operation and is now impaled in a man's inner thigh. Assessment indicates that there is no active bleeding from the site, but the surrounding tissues are ecchymotic. The paramedic asks you to stabilize the rod with bulky dressings. You recognize this action is important because it will:
Prevent motion of the rod and further internal injury
Severe external bleeding should be controlled during which phase of the patient assessment?
Primary assessment
A man has been bitten in his arm by his dog. He states that the bite occurred several hours earlier, when he accidentally stepped on the dog's paw. When asked, he tells you that the dog is up-to-date on all her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, what is the primary reason this patient should be seen in the emergency department?
Risk for infection
A patient suffered abrasions to the legs after falling on a moving treadmill. In relation to the function of the skin, the EMT should be most concerned about:
Risk for infection
Which observations would cause the EMT to classify a patient's soft tissue injury as an abrasion?
Skin is scraped and red; blood is oozing from the injury site
When performing the primary assessment, which sign or symptom best suggests that the patient is in shock?
Skin that is cool and diaphoretic
Assessment findings for a driver who was ejected from his vehicle in a rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute with absent alveolar breath sounds. His skin is cool and diaphoretic; the radial pulses are weak. Manual cervical spine motion restriction is being maintained. The EMT's next action would be to:
Start positive pressure ventilation
You are called for a 78-year-old female who fell earlier in the day. As you enter her kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be blood on her pants. She is on home oxygen for COPD and is breathing in a moderately labored manner. The patient states that she fell a few hours ago, and now the pain and swelling in her arm are unbearable. She has also developed significant lower neck pain. What should you do first?
Take manual spinal motion restriction precautions
You are called for a 2-year-old boy who has a nosebleed. While you are en route to the call, the dispatcher informs you that the patient has hemophilia. As an EMT, you should recognize that:
The bleeding may be significant
In the human body, which condition is present when a person is in shock?
The cells do not get enough oxygen and waste products accumulate
Another crew has called for your assistance in extricating an obese male with a nosebleed from a third-floor bedroom. As you enter the room, which observation indicates proper management of the patient's condition?
The patient is sitting upright, leaning forward, with nostrils pinched shut
A patient has suffered a small but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:
Use sterile gauze and wipe in a direction away from the site of injury
When managing a patient with a soft tissue injury, it is essential that the EMT performs which action?
Use the appropriate personal protective equipment
A 24-year-old male has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the laceration. As an EMT, you would identify this bleeding as:
Venous
Which statement made by the EMT shows an understanding of dressing and bandaging a wound?
"I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation is possible."
While riding a bike, a young boy fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhage has clotted off and manual cervical spine motion restriction is being maintained. Which instructions should you provide to the other EMTs on scene?
"Place an occlusive dressing over the wound and tape it on all four sides."
You have arrived at a scene where a young girl tripped while running, and pushed her arms through a plate glass window while falling. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your partner yells for you to immediately apply direct pressure to the laceration to prevent further blood loss, while he works to control the airway. You have yet to apply gloves, but your uniform shirt has long sleeves, and you normally wear prescription glasses. What would you do next?
Apply gloves prior to applying direct pressure over the injury site
You respond to a single-car accident in which an unrestrained 3-year-old child was thrown from the back seat into the windshield, striking his head. As your partner applies spine motion restriction precautions, you note that the child has a patent airway, is breathing well, and is alert and oriented; however, you also notice that blood and fluid are draining from his right ear. How would you treat the bleeding?
Apply a dressing loosely over the ear to absorb the blood and fluid
You are called for an alert and oriented female who had a cesarean section several days ago. Today, the patient bent over and tore the surgical incision open. There is a moderate amount of bleeding coming from the site, but otherwise the patient is stable. What should the EMT do to control the bleeding?
Apply a multitrauma dressing over the incision
When assessing a patient, you note a bruise to his chest. On the prehospital care report, this injury is properly documented as:
Ecchymosis
A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also observe bruising to the chest and abdomen. What should you do most immediately?
Suction the airway
Which statement shows that the EMT understands the use of a tourniquet in controlling bleeding?
"A tourniquet should be applied tightly enough that arterial blood flow distal to the tourniquet is completely stopped."
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."
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."
You are having a difficult time controlling bleeding from a small skin avulsion on a patient's ankle. Which statement made by the patient best explains why control has been difficult to achieve?
"I take Coumadin for my irregular heartbeat."
Which statement made by the EMT shows an understanding of how an open wound should be bandaged?
"I use bandaging material to secure the sterile dressing in place."
What are the three main layers of the skin?
Subcutaneous, epidermis, dermis
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
Direct pressure has failed to control an arterial bleed on a patient's lower leg caused by an industrial accident. What would the EMT's next action be?
Apply a tourniquet
A construction worker has a metal rod impaled in his right forearm. Assessment of the injury indicates heavy bleeding from around the impaled object. What should you do first?
Apply direct pressure around the rod
You arrive at a meat packing plant to find a 30-year-old male patient who was cut in the wrist with a sharp knife. The patient appears pale, and blood is spurting from the laceration. Your immediate action would be to:
Apply direct pressure to the laceration
A young female was involved in an altercation and stabbed in the abdomen with an ice pick. After being stabbed, she quickly removed the ice pick. She states that there was not much bleeding but does say it "stings" quite a bit. Assessment reveals a small puncture wound to the lower right quadrant with some dried blood around the site. Which best describes the primary focus of the EMT in caring for this patient?
Assessing for internal blood loss or shock
A 24-year-old female was an unrestrained driver of a car that struck a guardrail, causing her to sustain blunt trauma to the chest and abdomen. Vital signs obtained by Emergency Medical Responders are pulse 120 beats/min, respirations 22 breaths/min, blood pressure 100/78 mmHg, and SpO2 96%. As you transport her to the hospital, which finding indicates that the patient is deteriorating?
Blood pressure 86/50 mmHg
Which statement regarding contusions is true?
Blood vessels in the dermal layer have ruptured
Assessment of an 88-year-old female who fell reveals bruising to her right buttock. The skin is intact and the patient complains of tenderness to the area when you palpate. As a knowledgeable EMT, you would recognize this patient has which type of injury?
Contusion
You are called for an 8-year-old boy who has fallen. At the scene, the boy's mother states that her son was running while flying a kite and tripped, striking his face on a rock. Assessment reveals a large reddish-blue lump with intact skin under his left eye. When alerting the hospital emergency department of your arrival, you should inform them that the patient has which type of injury?
Hematoma
A young male was riding a motorcycle when he lost control and was thrown from the vehicle. The patient is unresponsive and receiving positive pressure ventilation. The secondary assessment reveals bright blood flowing from an unrecognized femoral bleed. Initial management of this bleeding would include:
Direct pressure with a dressing applied
A patient is confused and anxious after falling 20 feet from a ladder onto the grass below. Which clinical finding described is most suggestive of shock?
Heart rate of 112 beats per minute
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
A patient presents with an arrow impaled in the right lower quadrant of his abdomen. He is in excruciating pain and states that he was accidentally shot by a friend while hunting. While there is no external bleeding coming from the injury, the surrounding skin is ecchymotic. Other assessment findings, such as the vital signs, indicate the patient is in early shock. Which action should the EMT perform first?
Administer supplemental oxygen
A young man fell down a flight of stairs and is now restless and confused. His airway is open, and he is breathing adequately at 18 times per minute. He has a radial pulse of 102 beats per minute, a blood pressure of 96/78 mmHg, and his skin is cool and diaphoretic. Your next action would be to:
Administer supplemental oxygen
A middle-aged male's arm became caught in a grinding machine, and the arm was eventually extricated from the machine by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Given this information, which care would be provided first for this patient?
Administer supplemental oxygen
You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On scene, the patient was alert and oriented, with a patent airway and adequate respirations. There was minimal hemorrhage from the stab wound, which was covered with a sterile dressing. Oxygen was applied and transport was initiated. During the reassessment, which assessment finding should the EMT consider to be of the greatest concern?
Increased heart rate and unexplained restlessness
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
A 62-year-old male was the restrained driver of a car that was hit on the driver's side. Emergency Medical Responders have extricated the patient and provided spinal motion restriction precautions, including a cervical collar, long board, and straps. When asked, the patient complains of dizziness as well as left leg and left arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with minor bleeding to the left side of his face. The patient's airway is open and his breathing is labored. A rapid radial pulse is felt. Skin is cool and dry. Which assessment finding would the EMT address first?
Labored breathing
While cleaning a gun, a 44-year-old man accidentally shot himself in the abdomen. On your arrival at the scene, the patient is responsive to painful stimuli and lying on his side, with his legs drawn to his chest. Blood is evident on his shirt and pants. The vital signs are minimally acceptable and the pulse oximeter reading is 94%. What is the correct sequence of events when caring for this patient?
Perform the primary assessment, administer supplemental oxygen, perform the secondary assessment, transfer the patient to the stretcher, and provide rapid transport
Which statement made by your new EMT partner best describes the way to determine the severity of a patient's blood loss?
"I use the patient's signs and symptoms to judge the severity of the blood loss."
A 28-year-old male was cutting limbs from a tree when he lost his footing and fell 20 feet. He is unresponsive and breathing very poorly, at 28 times per minute. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed the patient on a nonrebreather face mask and are holding manual cervical spine motion restriction. A blanket has also been applied and covers the man. Based on these assessment findings, which instruction would you give to the EMRs?
"Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."
Which statement indicates an understanding of the EMT's prehospital role in caring for the patient in shock secondary to significant soft tissue trauma?
"Since trauma is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."
Which statement demonstrates an understanding of shock caused by internal bleeding?
"You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding."