Volume 4 chapter 11

Paramedics should do everything possible to ensure that they are on the scene of a traumatic emergency for no more than​ _____ minutes.

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Your patient is a​ four-year-old child. He has received an accidental gunshot wound to the groin and has lost a significant amount of blood. He responds to painful stimuli and has a heart rate of 150 with no radial pulse. Respirations are 32 and shallow. What is the total amount of intravenous fluid you should administer to this​ patient, assuming that his condition does NOT improve with​ intervention?

20​ mL/kg

A critical trauma patient should be reassessed every​ ________ minute(s) en route to the trauma center.

5

When administering fluid to a multisystem trauma patient with no signs of head injury but with signs of​ hypoperfusion, the paramedic should administer fluid only to maintain a systolic blood pressure equal to​ _____ mmHg.

80

Your patient is the​ 24-year-old female driver of a vehicle in a motor vehicle collision. She​ rear-ended a vehicle stopped at a traffic light at about 25 miles per hour. She was​ restrained, and the front airbags deployed. She is 32 weeks pregnant. She is anxious because she has not felt the baby move since the​ impact, and she is complaining of constant pain on the left side of her abdomen. Palpation of the abdomen reveals unusual firmness over the left side of the abdomen. The patient has a pulse of​ 116, a blood pressure of​ 92/60, and respirations of 28. Her skin is cool but​ dry, and she has no other complaints. For which of the following should you have the highest index of​ suspicion?

Abruptio placentae

Which of the following best describes the appropriate timing of the rapid trauma​ assessment?

After establishing​ airway, ventilation, and hemorrhage control in a critical trauma patient

The uncritical use of which of the following when caring for the trauma patient has been questioned by​ research?

All of the above

A thorough inspection of the trauma patient can be best performed if which of the following guidelines is​ used?

Assess for abnormalities in skin​ color, deformity of any part of the​ body, and any disruption of the skin.

Assuming that none of the following patients has any neurologic​ deficits, which patient requires cervical spinal​ immobilization?

A​ 70-year-old woman involved in a​ moderate-speed, lateral-impact motor vehicle​ collision, who is complaining of left arm pain

Which of the following​ patients' mechanisms of injury meets trauma triage criteria for transport to a trauma​ center?

A​ 9-year-old girl who fell 15 feet from the grandstand bleachers at a baseball game

Bariatric patients are at greater risk for all of the​ following, EXCEPT:

Bradycardia

Your patient is the​ 24-year-old male victim of a​ drive-by shooting. He is sitting on the ground on your​ arrival, with his legs stretched in front of him. You note that his sweatpants are bloody below the right knee. He is​ alert, though complaining of right leg​ pain, and has adequate​ ventilation, as well as a radial pulse of 88. To decide if this patient should be transported quickly to a trauma​ center, you should consider if he meets which of the​ following?

CDC Guidelines for Field Triage of Injured Patients

Which of the following probably contributes to​ injury-related morbidity and mortality in the young male population​ (those aged 11 to 35​ years)?

Disregard

In which type of vehicle impact are patients afforded the most​ protection?

Frontal impacts

Which of the following should the paramedic assess when performing palpation during examination of a trauma​ patient?

General muscle tone

​__________ refers to a reduction in blood pressure caused by​ cardiac, vascular,​ neurogenic, or volume problems to a level that is lower than normal for the patient.

Hypotension

Which of the following best describes definitive care for the pregnant trauma patient with​ ongoing, significant​ hemorrhage?

Immediate surgery

Which of the following has the greatest potential for reducing​ injury-related morbidity and​ mortality?

Injury prevention activities

Which of the following best explains the importance of determining the trauma​ patient's level of consciousness and orientation in the primary​ assessment?

It serves as a baseline for determining improvement or deterioration in the​ patient's condition.

Which of the following groups has the highest trauma morbidity and mortality​ rates?

Males aged 11 to 35 years

Your patient is the​ 40-year-old male driver of a vehicle that was struck in the​ driver's-side door by another vehicle at an intersection. The estimated speed of the vehicle that struck the​ patient's car is 30 miles per hour. The patient was​ restrained, but his vehicle lacks​ side-impact airbags. On your​ arrival, he is awake and complaining of head pain. He has a 4 cm laceration to the left posterior parietal area of the head. There was moderate bleeding before your​ arrival, but the bleeding is now minor. Witnesses state that there was no loss of​ consciousness, but immediately following the​ collision, the patient seemed confused and did not immediately understand that witnesses wanted him to unlock his door and use his cell phone to call for help. The​ patient's skin is warm and​ dry, his respirations are​ 16, and the radial pulse is strong at 88 per minute. Which of the following most accurately describes how to best remove the patient from the​ vehicle?

Place a cervical​ collar, maintain manual stabilization of the cervical​ spine, place a​ vest-type extrication​ device, and remove the patient onto a long backboard.

All of the following are components of the revised trauma​ score, EXCEPT:

Pulse rate

Which of the following is NOT part of the key elements for the patient care​ report?

Scene survey

During which part of your assessment would you note the need for additional​ resources?

Scene​ size-up

The blood pressure of the pregnant woman falls by 5 to 15 mmHg during which​ trimester?

Second

Which of the following is NOT an element of the scene​ size-up on a trauma​ response?

Setting up an IV

Which of the following statements about the pediatric pedestrian who is struck by a vehicle is NOT​ true?

Smaller children are likely to suffer fractures of the tibia and fibula as a result of impact with the​ vehicle's bumper.

The elderly patient in shock may be less likely to exhibit which of the following expected manifestations of​ shock?

Tachycardia

Which of the following offers a valuable model for EMS to consider when trying to reduce​ injury-related morbidity and​ mortality?

The fire service

Which of the following is a reason for use of air medical transport in the​ out-of-hospital setting?

The patient has a significant potential to require a​ time-critical intervention, and an air medical helicopter will deliver the patient to an appropriate facility faster than ground transport.

Your patient is a​ 19-year-old man who was thrown from a horse while riding in a rodeo. After throwing the patient​ off, the horse stepped on the​ patient's abdomen. When you reach the​ patient, you note that his​ face, neck, and shoulders are​ pale, cool, and diaphoretic but that the​ patient's skin is otherwise warm and dry. The patient has some movement and sensation in his forearms and hands but otherwise no movement or sensation below the shoulders. He is anxious and has a respiratory rate of​ 24, a heart rate of​ 68, and a blood pressure of​ 106/66. Which of the following should be the primary concern when determining this​ patient's transport​ priority?

The potential for intraabdominal hemorrhage that may be masked by loss of nervous function

Which of the following best describes the significance of finding an abrasion during the prehospital assessment of the pediatric trauma​ patient?

There is proportionally greater fluid loss when compared with an adult.

Your patient is the​ 23-year-old female victim of an attempted abduction at knifepoint. The assailant was interrupted and drew his knife across the​ victim's throat as he fled the scene. A first responder on the scene immediately applied direct pressure to the neck wound. Your assessment reveals a very agitated young woman with ongoing blood loss despite direct pressure to the wound. There appears to be both​ bright-red bleeding and slower but steady​ dark-red bleeding. It appears that the trachea has not been penetrated but that there is a hematoma around the laceration. Which of the following is the most appropriate sequence of intervention for this​ patient?

Use rapid sequence intubation of the patient to protect the trachea from the expanding hematoma while maintaining direct pressure on the wound.

Your patient is a​ 55-year-old man with a gunshot wound to the abdomen. Which of the following does NOT have a bearing on the mechanism of injury​ analysis?

Whether the shooter is​ right- or​ left-handed

All the following are complications of hypothermia in the trauma patient​ EXCEPT:

reduction in blood loss.

Bariatric trauma patients have a mortality of up to​ ____________ times greater than normal weight patients.

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