Ch 32 & 33

You pull up to the scene of a​ single-car motor vehicle collision. Emergency Medical Responders​ (EMRs) are maintaining manual inline cervical spine motion restriction of the​ 56-year-old driver, who was unrestrained when she struck a tree at a high rate of speed. As you approach the​ vehicle, you note that the patient appears​ unresponsive, with blood coming from her nose and ears. Which instruction to the EMRs is most​ appropriate?

"Let me conduct the primary​ assessment, suction her​ airway, and place a cervical collar on the​ patient, and then we can start to get her out of this​ car."

Which of these is a major artery found in the​ neck? A. Carotid B. Jugular C. Superior vena cava D. Aorta

A. Carotid

You are securing a patient to the long backboard. Of the options​ listed, which has the elements of securing the patient in the correct​ order? A. Chest and​ pelvis, head, legs B. ​Head, legs,​ chest, pelvis C. ​Head, chest and​ pelvis, legs D. ​Legs, head, chest and pelvis

A. Chest and​ pelvis, head, legs

An elderly patient fell down a flight of stairs and now complains of neck and back pain as well as weakness to both legs. The primary assessment reveals no life threats to the​ airway, breathing, or circulation. Manual cervical spine motion restriction is being maintained. What should the EMT do​ next? A. Complete the secondary​ assessment, looking for additional injuries B. Place an oral airway and begin positive pressure ventilation C. Place a cervical collar and secure the patient to the long spine board D. Apply​ high-concentration oxygen and move the patient to the stretcher for transport

A. Complete the secondary​ assessment, looking for additional injuries

When it is necessary to secure a patient to a long spine board during a spine motion restriction​ process, which of these regions is typically secured last to the spine​ board? A. Head and neck region B. Chest region C. Pelvic region D. Abdominal region

A. Head and neck region

Injury to the sensory and motor tracts located in the anterior portion of the spinal cord is​ called: A. posterior cord syndrome. B. ​Brown-Sééquard syndrome. C. central cord syndrome. D. anterior cord syndrome.

D. anterior cord syndrome.

A​ 24-year-old male patient has a laceration to his neck after a motor vehicle collision. Moderate bleeding with bubbling is present. You should​ first: A. control the bleeding with hemostatic gauze. B. bandage the wound with gauze. C. measure his blood pressure. D. apply an occlusive dressing.

D. apply an occlusive dressing.

Conflicting or confusing signs of spinal cord injury are typically the result​ of: A. anterior cord syndrome. B. ​Brown-Sééquard syndrome. C. central cord syndrome. D. incomplete cord injury.

D. incomplete cord injury.

You are in the process of applying spine motion restriction to a patient who was ambulatory upon your arrival. After the patient lies down on the​ stretcher, you​ should: A. place rolled towels around the head. B. secure the​ patient's head with tape. C. place a single piece of tape across the cervical collar. D. secure the patient to the stretcher.

D. secure the patient to the stretcher.

What desired minimal pulse oximeter reading does the EMT want to maintain in a patient with a spinal cord​ injury? A. 94 percent or more B. 90 percent or more C. 96 percent or more D. 88 percent or more

A. 94 percent or more

An elderly male patient fell down a flight of basement stairs and is found at the bottom by family members about 20 minutes later. Your assessment reveals that the patient cannot feel painful stimuli to his hips and​ legs, nor can he move his​ legs, but he can feel you lightly touching the skin of his legs. Which type of injury may this​ be? A. Anterior cord syndrome B. Posterior cord syndrome C. Lateral cord syndrome D. Central cord syndrome

A. Anterior cord syndrome

When performing spine motion​ restriction, the patient should​ be: A. strapped down. B. made comfortable. C. laid supine. D. placed in Trendelenburg position.

B. made comfortable.

Until​ recently, the indication to provide spinal immobilization was solely based​ on: A. a thorough assessment. B. the mechanism of injury. C. a​ patient's complaint. D. obvious injury.

B. the mechanism of injury.

Which instruction would you provide to your team immediately after placing a patient on the wheeled cot after providing full spine motion restriction​ precautions? A. ​"Loosen the collar so you can palpate the back of the​ neck." B. ​"Let's check for extremity PMS before initiating transport to the​ hospital." C. ​"Maintain manual cervical spine motion restriction until the patient is on the​ stretcher." D. ​"Remove the chest strap so the patient can breathe more easily now that his head and legs are​ secured."

B. ​"Let's check for extremity PMS before initiating transport to the​ hospital."

Assessment of a young girl who was hit by a car while riding her bike reveals her to be responsive to painful stimuli with flexion of the​ extremities; she is also in respiratory distress. There is marked deformity to her thoracic spine and bruising noted to her anterior chest and abdomen. She does not move her legs when a noxious stimulus is applied to the lower extremities. Manual cervical spine motion restriction is being maintained and a cervical collar has been applied by fire department EMRs. Given the critical nature of this​ patient, which action is most appropriate for her​ care?

Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital

What is the MOST common cause of spinal​ injury? A. Sports B. Gunshot wounds C. Falls D. Automobile accidents

D. Automobile accidents

A patient complains of back pain and numbness to both legs after being thrown from a bicycle. When should the EMT first check the motor​ function, sensory​ function, and pulses in the legs of this​ patient? A. As the secondary assessment is performed B. Immediately after applying a cervical collar C. Immediately after taking manual spine motion restriction precautions D. During the primary assessment

A. As the secondary assessment is performed

The EMT is caring for a patient who sustained a spinal cord injury in a motor vehicle collision. Which assessment finding would indicate a spinal cord versus a spinal column​ injury? A. Bilateral​ motor/sensory loss B. Protruding palpable vertebrae C. Pain upon palpation D. Inability to blink the eyes

A. Bilateral​ motor/sensory loss

The​ "EMS Management of Patients with Potential Spinal​ Injury" document published by the American College of Emergency Physicians in 2015 discusses which principle regarding the immobilization of​ patients? A. Current​ out-of-hospital management of potential spinal injury lacks evidentiary scientific support B. Only a licensed and​ board-certified emergency department physician is capable of determining whether spine motion equipment is necessary C. A review of the related literature has demonstrated clinical support for ongoing use of spine motion restriction equipment in all patients with either a minor or major mechanism of injury D. The use of a long spine board without a cervical collar is recommended because cervical collars do not achieve a full degree of immobilization

A. Current​ out-of-hospital management of potential spinal injury lacks evidentiary scientific support

All of the following would indicate the need of spinal motion restriction for a trauma​ patient, EXCEPT: A. Glasgow Coma Scale​ (GCS) is 15. B. numbness in hands and feet. C. deformity to the vertebral column. D. tenderness along the vertebral column.

A. Glasgow Coma Scale​ (GCS) is 15.

A​ 43-year-old male fell from a roof and cannot move or feel his arms or legs. When assessing the​ patient, which sign would lead the EMT to suspect the patient is developing spinal​ shock? A. Heart rate of 62​ beats/min B. Cool and moist skin C. Cyanosis to the fingertips D. Seizure activity

A. Heart rate of 62​ beats/min

While transporting a​ 38-year-old female who fell from a​ second-story window, you note that she is becoming confused and her pulse rate is increasing.​ Additionally, her blood pressure has dropped and her skin is now cool and clammy. Based on these assessment​ findings, you would​ recognize: A. Hypovolemic shock B. Head injury C. Neurogenic shock D. Spinal shock

A. Hypovolemic shock

You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate​ front-end damage. The patient complains of some back​ pain, but is walking around after the crash and does not appear to be suffering from any neurologic deficits. Although he answers your questions​ appropriately, he keeps asking​ you, "What​ happened?" What is your initial action in caring for this​ patient? A. Initiate spine motion restriction precautions B. Look for injuries to the​ patient's head C. Perform the primary assessment D. Obtain the​ patient's vital signs

A. Initiate spine motion restriction precautions

At a scene where a vehicle was involved in a​ single-car accident, you find the driver walking around at the scene. As you​ approach, the driver states that he felt fine when he exited the vehicle but is now concerned that his legs feel like they are​ "going to​ sleep." What is your first step in treating the​ driver? A. Instruct him to hold his head in a neutral inline position B. Place a backboard behind the​ driver, against his spine C. Assist him in sitting on the cot D. Assess his airway and circulation

A. Instruct him to hold his head in a neutral inline position

A worker in a factory complex has a sliver of metal lodged in the colored portion of his eye. The EMT would recognize the foreign body as being embedded in​ the: A. Iris B. Cornea C. Lens D. Sclera

A. Iris

Which statement about removing a helmet in the prehospital setting is​ true? A. It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems B. Helmets should be removed only if they are too tight or if spine motion restriction will be required C. Any patient wearing a helmet should have it removed so the airway and breathing can be properly assessed D. Since helmets should never be​ removed, the EMT must be creative in providing care around the obstacle of a helmet

A. It is acceptable to leave the helmet on a patient if the patient has no airway or breathing problems

A male football player was struck in the head during a hard​ tackle, and is reportedly demonstrating retrograde amnesia to the event. Currently the patient complains of a headache and nausea and reports that he has pain to his upper back and tingling in his left hand. The EMT is providing proper care for the patient when​ he: A. Leaves the helmet in place but removes the face mask first B. Removes the helmet to immediately assess the​ patient's head C. Does not place the patient on a long board due to the presence of shoulder pads D. Removes the shoulder pads to apply a cervical collar

A. Leaves the helmet in place but removes the face mask first

A​ 42-year-old man has called 911 because of severe back pain. He informs you that his back pain is related to a recent fracture of his coccyx. Based on this​ information, where should the EMT expect the patient to be complaining of​ pain? A. Pelvic area B. Lower back C. Upper back D. Neck

A. Pelvic area

The EMS crew has decided that an unresponsive patient who was involved in an MVC needs to be rapidly extricated. What should the EMS providers do​ first? A. Provide manual​ in-line stabilization of the head. B. Apply a properly sized cervical collar. C. Roll the patient out of the open door laterally onto a backboard. D. Place the patient on a backboard.

A. Provide manual​ in-line stabilization of the head.

A male motorcyclist wearing a full helmet was thrown from his motorcycle after hitting a patch of oil on the road. The bike had been traveling at a high rate of speed. Manual spine motion restriction is being maintained by an​ off-duty EMT. The primary assessment reveals the patient to be responsive to painful stimuli and breathing rapidly with slight sonorous airway sounds. His radial pulse is weak and fast. As you quickly scan his​ body, you note deformity to the left femur and lower leg. Your immediate action should be​ to: A. Remove his helmet B. Expose his left lower extremity C. Apply a cervical collar D. Place a nonrebreather oxygen mask

A. Remove his helmet

The EMT is caring for a male patient who has a problem with the autonomic division of his nervous system. Which sign or symptom would most likely be caused by this​ condition? A. Slowing of the heart rate B. Inability to swallow C. Trouble remembering his name D. Inability to move facial muscles

A. Slowing of the heart rate

A male patient who was involved in a diving accident is found with his head positioned so that his left cheek is touching his left shoulder. He states that he has severe pain in his neck and it hurts to move his head. He denies​ numbness, tingling, or decreased strength in his arms or legs. What is the​ EMT's best course of​ action? A. Stabilize and maintain the head in the position in which the patient is holding it B. Carefully straighten the head and neck so that a cervical collar can be placed C. Avoid palpation of the cervical spine and apply a short​ vest-type device D. Straighten his​ neck, and position the patient on his left side on a long spinal board

A. Stabilize and maintain the head in the position in which the patient is holding it

The EMT should recognize a possible spinal column injury with no spinal cord involvement when he discovers which assessment​ finding? A. Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity B. Pain to the cervical spine with loss of sensation to the right arm and leg C. Intact sensation to all four extremities with loss of motor ability to the arms D. Intact motor ability to all four extremities with loss of sensation to the legs

A. Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity

Which statement shows that the EMTs are correctly using a​ vest-type device while removing a patient from an entrapped vehicle​ location? A. The head is secured to the device after the torso has been secured B. The head is secured​ first, followed by the torso and legs C. The head is secured to the device immediately after the cervical collar is placed D. The cervical collar is applied after the torso and legs have been secured to the device

A. The head is secured to the device after the torso has been secured

When should the EMT remove the helmet of an injured​ patient? A. The helmet interferes with your ability to assess the airway. B. The helmet is a​ sports-type helmet. C. The patient presents with significant neck and back pain. D. The helmet does not have a chin strap.

A. The helmet interferes with your ability to assess the airway.

Prior to the revisions in prehospital spinal assessment and​ care, the primary criterion for determining the need for spine motion restriction​ was: A. The mechanism of injury B. A patient history of kyphosis C. Decided by medical command D. Evidence of multisystem trauma

A. The mechanism of injury

A patient who was injured in a motor vehicle collision has a fracture where a rib has broken off from its associated spinal vertebrae. Based on the anatomy of the​ spine, where has this injury​ occurred? A. Thoracic spine B. Cervical spine C. Middle spine D. Lumbar spine

A. Thoracic spine

The vertebrae that form the lower back are called​ the: A. lumbar spine. B. cervical spine. C. sacral spine. D. thoracic spine.

A. lumbar spine.

The application of spine motion restriction usually requires securing the patient to​ a(n) A. stretcher. B. extrication device. C. long backboard. D. short backboard.

A. stretcher.

A female patient is lying under a tree after being involved in a motor vehicle collision. She states that immediately after the​ crash, she felt​ okay, but now her legs are numb and tingling. She also has lower back discomfort. Which question is it most important for the EMT to ask​ next? A. ​"How did you get out of the​ car?" B. ​"Do you have a history of back​ problems?" C. ​"Do you think that you had a​ seizure?" D. ​"Are you allergic to any​ medications?"

A. ​"How did you get out of the​ car?"

Which response shows that the EMT is correctly assessing motor function in the arms of a patient with a potential spine​ injury? A. ​"I need you to flex both arms across your​ chest." B. ​"I am going to feel for a pulse in your​ wrist." C. ​"I am going to move your​ arm; tell me if it​ hurts." D. ​"Can you tell me which finger I am​ touching?"

A. ​"I need you to flex both arms across your​ chest."

Which of the instructions from one EMT to another shows the correct application of a cervical​ collar? A. ​"Keep his head in neutral position while I apply the cervical​ collar." B. ​"I need you to extend the​ patient's chin backward a little so I can fit the collar under his​ chin." C. ​"Let's log roll the patient to one side so I can apply the cervical​ collar." D. ​"Carefully flex his head forward a little so I can pass the collar underneath his​ neck."

A. ​"Keep his head in neutral position while I apply the cervical​ collar."

An injury to a hemisection of the spinal cord that disrupts the spinal tracts on only one side of the cord​ is: A. ​Brown-Sééquard syndrome B. Posterior cord syndrome C. Anterior cord syndrome D. Central cord syndrome

A. ​Brown-Sééquard syndrome

How many facial bones are​ there? A. 14 B. 12 C. 13 D. 15

A. 14

Which of these findings is NOT consistent with a penetrating neck​ injury? A. Displacement of the trachea to one side B. Aflail segment C. Hematoma formation in the neck D. Airway obstruction

B. Aflail segment

Which of these should be done when applying spine motion restriction to the ambulatory​ patient? A. Apply a head immobilization device. B. Bring the stretcher to the patient. C. Lift the patient onto the stretcher. D. Immediately hold inline stabilization of the​ patient's neck.

B. Bring the stretcher to the patient.

After sustaining a fall from a​ roof, your patient presents with an inability to move his​ arms, but he can still move his legs just fine. What type of partial cord injury is​ this? A. Posterior cord syndrome B. Central cord syndrome C. Anterior cord syndrome D. Lateral cord syndrome

B. Central cord syndrome

A young intoxicated male patient cannot move his left arm and leg after diving into the shallow end of a pool and hitting the bottom head first. The EMT would recognize which mechanism as most likely responsible for this​ injury? A. Penetration B. Compression C. Distraction D. Rotation

B. Compression

What is the most anterior portion of the​ eye? A. Lens B. Cornea C. Iris D. Retina

B. Cornea

Which injury that may result in spinal cord damage would you be most likely to encounter while treating a teenager who attempted to hang himself in his​ garage? A. Rupturing of disks of the cervical vertebrae B. Distraction injury to the cervical spine C. Rotation injury of the axis D. Lateral bending of the spine

B. Distraction injury to the cervical spine

Which device can be used to replace the long spine board when providing full spine motion restriction precautions to an​ adult? A. ​Full-body air splints B. Full vacuum mattress C. Half spine board D. Folding stair chair

B. Full vacuum mattress

Which of the following findings in a patient with a traumatic mechanism of injury is sufficient to prevent the EMT from​ "clearing the​ spine" and necessitate the implementation of spine motion restriction​ precautions? A. Pulse oximeter of​ 96% on 2 lpm oxygen B. GCS score of 12 C. Pulse pressure of 24 mmHg D. Blood glucose of 90​ mg/dL

B. GCS score of 12

Your teenaged patient has a pencil impaled through his left cheek and into the back of the throat after falling onto it while running. On​ assessment, you see about half the pencil outside the cheek and the tip of the pencil penetrating the back of the throat. You note a fair amount of bleeding into the airway. What is the best way to manage this​ injury? A. Break off the pencil inside the mouth so that you can pack the wound. B. Have suctioning ready so that the patient does not aspirate on the object. C. Immobilize the patient in a supine position. D. Place the patient in a left lateral recumbent position.

B. Have suctioning ready so that the patient does not aspirate on the object.

You have arrived at the scene of a shooting where a​ middle-aged male sustained a single gunshot wound to the abdomen. As you approach the​ patient, you note that he is sitting up and attempting to talk with the police officers while holding a​ blood-soaked towel over the left upper quadrant of his abdomen. Once you get beside the​ patient, you realize he is speaking in a different language that neither you nor the officers understand. Your initial action in caring for this patient is​ to: A. Obtain a pulse​ rate, respiratory​ rate, blood​ pressure, and SpO2 B. Initiate spine motion restriction precautions C. Expose the abdomen to assess the gunshot wound D. Determine the need for airway management

B. Initiate spine motion restriction precautions

A​ 3-year-old child has stuck a crayon in his nose. Assessment reveals the crayon to be deeply embedded in the right​ nostril, with some irritation and swelling noted. His vital signs are​ pulse, 124​ beats/min; respiration, 20​ breaths/min; and SpO2​, ​99%. What would be most appropriate action to take when caring for this​ child? A. Supplemental oxygen B. Nonemergent transport to the hospital C. Attempt removal of the crayon with forceps or tweezers D. Place a warm pack to the bridge of the nose

B. Nonemergent transport to the hospital

A minivan has struck a utility pole. The driver is unresponsive and has​ life-threatening injuries. Which option would be most appropriate when extricating the patient from the​ vehicle? A. Remove the patient and place him on a long spinal board in the ambulance during rapid transport B. Perform rapid extrication with a cervical collar applied C. Apply a​ vest-type immobilization device D. Pull the patient from the car and provide spine motion restriction precautions away from the vehicle

B. Perform rapid extrication with a cervical collar applied

When performing the secondary​ assessment, which sign is most suggestive of a spinal cord​ injury? A. Pain in the right leg B. Persistent penile erection C. Bruising on the back D. Headache and nausea

B. Persistent penile erection

A teenage boy was found by friends as he attempted to hang himself in a garage using chains suspended from the ceiling. As you​ approach, you note that the patient is​ conscious, struggling significantly to​ breathe, is ashen in color around the mouth and to the​ hands, and has contusions and swelling that encircle his neck from the chains. After taking manual cervical spine motion restriction and opening the​ airway, your next action would be​ to: A. Log roll the patient onto a long spine board B. Start positive pressure ventilation C. Size and apply a cervical collar D. Perform a secondary assessment

B. Start positive pressure ventilation

Select the criteria that is used to demonstrate a patient is​ "reliable" as it pertains to withholding spine motion restriction precautions​ (but no more than​ three): A. Has a GCS score​ >14 B. There is no head injury C. Absence of any distracting injury D. Is not intoxicated E. Denies any​ cervical/thoracic/lumbar pain

B. There is no head injury C. Absence of any distracting injury D. Is not intoxicated

You have been called for a​ 48-year-old male patient with severe back pain. When you are obtaining a medical​ history, the patient tells you that he has a history of damaged disks in his vertebrae from an old lifting injury when he was in his​ 30's. As a knowledgeable​ EMT, you should recognize​ that: A. The nerves making up the spinal cord have been damaged B. The​ fluid-filled structures between the vertebrae have been injured C. The ligaments on the side of the spinal column were overstretched D. The vertebrae making up the spinal column were fractured

B. The​ fluid-filled structures between the vertebrae have been injured

You are treating a patient who was struck in the face numerous times in a fight. His right eyeball is extruded. What should you​ do? A. Apply ice to the eyeball. B. Use gauze to stabilize the eyeball in the position in which it was​ found, and transport the patient in the supine position. C. Have the patient sit up for the ride to the hospital. D. Flush the eye socket with sterile saline.

B. Use gauze to stabilize the eyeball in the position in which it was​ found, and transport the patient in the supine position.

A​ 2-year-old boy fell down a flight of​ stairs, is crying​ loudly, and is very difficult to communicate with. Because you are unable to clear the​ spine, you elect to initiate spine motion restriction precautions. Which instruction would you provide to other EMTs who are initiating this care for the​ patient? A. ​"After he is on the​ board, place a towel behind his head to keep the airway​ open." B. ​"Let's place a folded towel under his shoulders and back to help maintain head​ alignment." C. ​"Use an adult​ 'no neck' collar since those fit almost​ everyone." D. ​"It is better if the collar is a little too​ big; that is more comfortable for​ him."

B. ​"Let's place a folded towel under his shoulders and back to help maintain head​ alignment."

Based on the structure of the nervous​ system, which statement is​ true? A. Numbness in a fractured leg indicates damage to the autonomic nervous system fibers B. A gunshot wound to the spinal cord will directly damage the peripheral nerves C. A deep laceration to the arm can sever peripheral nerves D. A stroke represents an injury to the peripheral nervous system

C. A deep laceration to the arm can sever peripheral nerves

A patient complains of lower back pain after falling down five stairs. Assessment of the​ patient's cervical spine reveals no​ displacement, tenderness, or instability. The patient does state that each leg has feelings of​ "electrical shocks" shooting through them. How should the EMT care for this​ patient? A. Inform the team that spine motion restriction precautions are not needed B. Release manual spine motion restriction precautions C. Apply a properly sized cervical collar after initiating manual spine motion restriction D. Secure the patient to a backboard without a cervical collar

C. Apply a properly sized cervical collar after initiating manual spine motion restriction

The EMT is properly assessing for a spinal cord injury when​ she: A. Palpates the entire spinal column for tenderness B. Checks for distal pulses in all four extremities C. Asks the patient to spread his fingers apart on both hands D. Asks the patient if he has pain anywhere along his spinal column

C. Asks the patient to spread his fingers apart on both hands

While performing the primary assessment on a male patient with an isolated spinal cord​ injury, you note that he is​ tachypneic, in severe respiratory​ distress, and struggling to breathe. Where should you suspect the spinal cord injury has​ occurred? A. Thoracic spine B. Lumbar spine C. Cervical spine D. Diaphragm

C. Cervical spine

As you approach a male motorcyclist who was thrown from his​ bike, you hear him saying that he cannot feel or move his legs. You note obvious deformity to both femurs as well as to his left wrist and forearm. Emergency Medical Responders are holding manual cervical spine motion restriction and have already assessed the PMS in the extremities. Given this​ information, which assessment should be done​ next? A. Apply the pulse oximeter B. Check for motor function and sensation in the feet C. Check the​ patient's rate and effort of breathing D. Expose the legs and look for bleeding

C. Check the​ patient's rate and effort of breathing

Which of these is an accurate statement regarding spine motion restriction​ (SMR)? A. A patient with penetrating neck trauma should routinely receive SRM. B. A patient with penetrating head trauma should routinely receive SRM. C. Decisions to utilize SMR should be based on the assessment. D. SMR should be placed based on mechanism alone.

C. Decisions to utilize SMR should be based on the assessment.

A​ 22-year-old male attempted to hang himself in a garage using chains suspended from the roof trusses. He was quickly found by family members and taken down to the ground.​ Currently, he is complaining of neck pain as well as mild difficulty breathing. Assessment shows his airway to be​ patent, breathing​ adequate, and skin warm and dry. His neck is​ red, but free of any subcutaneous air or swelling. Your partner has identified an abnormal bony protrusion to a couple of his cervical vertebrae. What should you do first when caring for this​ patient? A. Immediate transport B. Insert a nasal airway C. Initiate manual spine motion restriction D. Place ice packs to his neck

C. Initiate manual spine motion restriction

A male driver was ejected from his vehicle after it rolled several times at a high rate of speed. As you approach the​ patient, you note that he is unresponsive and struggling to breathe with sonorous airway sounds. He also has a laceration to the left side of his face and multiple contusions to his legs. After assigning another EMT to take manual cervical spine motion​ restriction, what should you​ do? A. Insert an oropharyngeal airway B. Start positive pressure ventilation C. Open the airway using the​ jaw-thrust maneuver D. Apply a properly sized cervical collar

C. Open the airway using the​ jaw-thrust maneuver

A male patient dove into a shallow pool and struck his head on the bottom. Your assessment findings indicate that he has no motor or sensation in his​ legs, but can move his arms. The EMT should recognize this condition to​ be: A. Tetraplegia B. Hemiplegia C. Paraplegia D. Quadriplegia

C. Paraplegia

How many vertebrae form the cervical​ spine? A. Eight B. Five C. Seven D. Six

C. Seven

Which of these was the original thought behind spinal​ immobilization? A. The backboard would provide for rapid extrication. B. It would facilitate increased patient comfort. C. The backboard would protect against any further injury. D. It would protect providers from potential litigation.

C. The backboard would protect against any further injury.

What is the MOST accurate statement about the ability of a patient to breathe when she has suffered a spinal cord​ injury? A. The patient will have slow and shallow breathing that will likely be inadequate to sustain life. B. The patient will be apneic if there is a spinal cord injury. C. The patient may be breathing​ adequately, inadequately, or may not be able to breathe at all. D. The patient will have rapid and shallow​ breathing, but it will be adequate.

C. The patient may be breathing​ adequately, inadequately, or may not be able to breathe at all.

Which patient should be rapidly extricated from a car after an​ MVC? A. The patient who is sitting closest to a door if there are multiple patients in the car B. The pediatric patient who is found properly restrained in an infant seat in the vehicle C. The patient who is unresponsive D. The patient who is tachycardic and complaining of neck pain

C. The patient who is unresponsive

In which area of the spinal column do the ribs​ originate? A. Lumbar spine B. Sacral spine C. Thoracic spine D. Cervical spine

C. Thoracic spine

Which sign or symptom best indicates the patient has experienced a spinal cord injury to the inferior thoracic​ spine? A. Bruising to the back B. Paralysis of the arms only C. Tingling in the legs D. Cool and diaphoretic skin

C. Tingling in the legs

A window washer fell 20 feet from scaffolding while washing the windows on an office building. He is alert and​ oriented, but states that he cannot move or feel his legs.​ Additionally, because his blood pressure is​ 72/48 mmHg, you suspect spinal shock. Which other assessment finding reinforces your suspicion of spinal​ shock?] A. Heart rate of 144​ beats/min B. Pulse pressure of 24 mmHg C. Warm and dry skin D. SpO2 of​ 92%

C. Warm and dry skin

Your physical examination of a patient with an eye injury should​ include: A. applying slight pressure to the globe to check for any leakage of fluid. B. never palpating the eye sockets or the bones of the​ cheek, nose, or​ jaw, as any increase in pressure may cause additional pain or damage. C. checking for crepitation in facial injuries. D. using the AVPU mnemonic to assess any pain.

C. checking for crepitation in facial injuries.

Diplopia means A. inability to focus the eye. B. blurred vision. C. double vision. D. unequal pupils.

C. double vision.

A​ 32-year-old male patient has a penetrating injury to the neck. The assessment reveals no indication of spinal injury. You​ should: A. initiate full spinal immobilization. B. apply a backboard only. C. not place the patient on a backboard. D. utilize a short backboard.

C. not place the patient on a backboard.

You are treating a patient who suffered several facial lacerations during an automobile accident. As you are assessing the​ patient's eyes with your​ penlight, you observe a circular shadow over her left iris. This indicates that​ the: A. patient has suffered a blunt injury to the globe of the eye. B. bulb in your penlight needs to be cleaned. C. patient is wearing a hard contact lens. D. patient has glass embedded in the eye.

C. patient is wearing a hard contact lens.

Generally, in caring for a patient with an eye​ injury, you should remove contact lenses​ if: A. the eyeball is injured. B. any injury has occurred to the eye. C. there has been a chemical burn to the eye. D. the patient is wearing soft contact lenses.

C. there has been a chemical burn to the eye.

After an injury to the spinal cord a patient has differing effects on each side of the body. This is known​ as: A. anterior cord syndrome. B. posterior cord syndrome. C. ​Brown-Sééquard syndrome. D. central cord syndrome.

C. ​Brown-Sééquard syndrome.

A trauma patient is unable to push down with his feet. This may indicate damage in the area​ of: A. T2. B. C4. C. S1. D. L5.

C. S1.

You are maintaining manual cervical spine motion restriction for a patient who is being log​ rolled, transferred, and secured to a long backboard. At which point will you release the manual spine motion restriction​ hold? A. Once the patient has been log rolled onto the long backboard B. After the chest has been secured with a head immobilization device C. After the patient has been secured to the backboard and transferred to the wheeled stretcher D. After the patient has been properly secured with straps to the long board

D. After the patient has been properly secured with straps to the long board

A​ 47-year-old male patient has been involved in motor vehicle collision. He denies symptoms and has no signs of spinal injury. In which of these situations would spine motion restriction be MOST​ important? A. Blunt trauma to the head B. Penetrating chest injury C. Femur fracture D. Altered mental status

D. Altered mental status

You are responding to a chemistry lab in the local high school. You are told that there was a small explosion when students were mixing​ chemicals, and a​ 16-year-old male received chemical burns to his face and right eye. What is your FIRST activity once you have ensured that the scene is safe and the ABCs of the primary survey have been dealt​ with? A. Use a cotton swab to wipe the chemical solution out of the eyes. B. Wipe the chemical solution out of the eyes with a piece of sterile gauze. C. Use a dry sterile dressing on both eyes and transport. D. Identify the chemical solution to determine whether irrigation is appropriate.

D. Identify the chemical solution to determine whether irrigation is appropriate.

Which statement is most accurate concerning spine motion restriction of an ambulatory​ patient? A. The patient should be reminded to continue​ self-restriction while being seated on the stretcher B. ​Self-restriction is not permitted if a rigid cervical collar is used C. If the patient is​ unconscious, self-restriction cannot be used D. If the patient is​ reliable, he can​ self-restrict while the cervical collar is applied

D. If the patient is​ reliable, he can​ self-restrict while the cervical collar is applied

What characteristically happens when there is a fracture to the mandible from blunt force trauma to the​ face? A. It causes the tongue to deviate laterally. B. It becomes locked in an open position. C. It becomes locked in a closed position. D. It fractures in two places.

D. It fractures in two places.

A patient was ejected from a car during a rollover collision at a moderate to high rate of speed. Which presentation in this patient is most characteristic of the incomplete spinal cord injury referred to as a​ "central cord​ syndrome"? A. Loss of perfusion to the spinal cord that results in complete loss of motor function and sensation to both the arms and legs B. Loss of motor function and sensation to one side of the body only C. Loss of sensation to one side of the​ body, and loss of motor function to the opposite side of the body D. Loss of motor function to the arms with intact motor function to the legs

D. Loss of motor function to the arms with intact motor function to the legs

You are assessing distal pulses on a trauma patient. Which pulse should be assessed in the lower​ extremity? A. Radial B. Carotid C. Femoral D. Pedal

D. Pedal

Which statement about the care and treatment of a patient with a spinal injury in the prehospital setting is​ true? A. Before transporting the critically injured patient with a spinal​ injury, the EMT must perform a​ detailed, head-to-toe neurologic assessment B. It is important to identify the level of spinal injury so the proper prehospital care can be rendered C. If a patient has a possible spine injury but is in​ shock, it is permissible to forego spine motion restriction precautions since this takes time and delays the patient from arriving to definitive care in an expedient fashion D. Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of​ life-threatening conditions

D. Prehospital care for the patient with a spine injury involves spine motion restriction precautions and the identification of​ life-threatening conditions

A male patient fell 20 feet from a cliff to a trail below while hiking with his girlfriend. The primary assessment shows him to be​ confused, with an open airway and shallow breathing. His pulse is 72​ beats/min and his blood pressure is​ 78/50 mmHg. The skin is warm and flushed. The patient has no motor ability or sensation in his legs. What is the most likely cause of this​ patient's presentation? A. Hemorrhagic shock B. Hypoglycemia C. Internal bleeding D. Spinal shock

D. Spinal shock

Which statement is most accurate regarding the processes needed for a patient to clench the hand into a​ fist? A. The peripheral nervous system must send a message to the brain and then back through the peripheral nervous system B. The muscles must signal the brain to send a message through the autonomic nervous system C. The central nervous system must send a message through the spinal cord and then to the autonomic nervous system D. The central nervous system must send a message through the spinal cord and then to the peripheral nerves

D. The central nervous system must send a message through the spinal cord and then to the peripheral nerves

Research by the American College of Surgeons Committee on Trauma has shown a higher death rate for patients who were immobilized to a backboard​ when: A. The patient was ambulatory upon EMS arrival B. The patient was intoxicated at the time of injury C. The injury resulted from a lateral impact automobile accident D. The injury was the result of penetrating trauma to the head or torso

D. The injury was the result of penetrating trauma to the head or torso

A spinal column injury typically and primarily damages which of these structures​ (but as a result may also damage one or more of the other​ three)? A. The spinal cord B. Ambulation C. Light touch sensation D. The vertebrae

D. The vertebrae

A young female​ driver, who was involved in a motor vehicle​ collision, complains of cervical pain resulting from a​ lateral-type mechanism of neck injury. Based on this​ information, which type of collision most likely took​ place? A. The​ patient's car struck a utility pole​ head-on B. The​ patient's car was struck from behind C. The​ patient's car​ rear-ended another car D. The​ patient's car was struck from the side

D. The​ patient's car was struck from the side

When providing SMR to infants and​ children, it is important to​ remember: A. that​ adult-sized backboards and cervical collars can be modified to use with children. B. to pad from the shoulders to the heels of an infant or child to maintain neutral​ in-line immobilization. C. that if you do not have a cervical collar that​ fits, use one that is slightly larger. D. that if an automobile collision involves a child in a car​ seat, you cannot use that car seat to stabilize the child for transport.

D. that if an automobile collision involves a child in a car​ seat, you cannot use that car seat to stabilize the child for transport.

To open the airway of a patient with a suspected neck​ injury, you should always use the A. ​cross-fingers technique. B. ​head-tilt, neck-lift maneuver. C. ​head-tilt, chin-lift maneuver. D. ​jaw-thrust maneuver.

D. ​jaw-thrust maneuver.