Chapter 27

An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion to his heart. The EMT would recognize that this injury occurred during which impact of the​ collision? A. Organ collision B. Physiological collision C. Body collision D. Vehicle collision

A. Organ collision

After assessing these​ patients, which would the EMT identify as suffering from multisystem​ trauma? A. A​ 61-year-old male who became dizzy and fell down five​ stairs, and who has a laceration to the head and open fracture of the left lower leg B. An​ 89-year-old female who fell in a nursing home and has a hematoma to the back of her head C. A​ 31-year-old female who has a large laceration to her leg from a hunting​ knife, with bleeding controlled D. A​ 24-year-old male who slipped on ice and has tenderness to the right shoulder

A. A​ 61-year-old male who became dizzy and fell down five​ stairs, and who has a laceration to the head and open fracture of the left lower leg

Which of the statements concerning trauma is most​ accurate? A. Multisystem trauma has a higher mortality rate than​ single-system injuries B. A​ "spider web" or​ "star" pattern of cracks on the windshield means the patient impacted the windshield with his head C. The mechanism of injury is the best predictor of patient outcome D. Falls are the leading cause of trauma deaths

A. Multisystem trauma has a higher mortality rate than​ single-system injuries

Which statement best characterizes the capabilities of a Level III trauma​ center? A. The hospital has some surgical capabilities to help trauma​ patients, but will generally stabilize and them and still arrange transfer B. The hospital will provide any emergency surgical services to a trauma patient and then transfer the patient once stable C. The hospital can manage all trauma patients and​ injuries, 24 hours a​ day, 7 days a week D. The hospital can handle most trauma​ patients, but will transfer those who require specialty care for specific injuries such as neurologic trauma

A. The hospital has some surgical capabilities to help trauma​ patients, but will generally stabilize and them and still arrange transfer

You are responding to a call for a​ 4-year-old child hit by a car. When assessing this​ child, which injury patterns would you recognize as typical based on the​ child's age and mechanism of​ injury? A. Bilateral ankle​ deformity, contusions to the​ back, and face trauma B. Deformed​ femurs, bruises to the chest and​ abdomen, and head injury C. Head injury with deformities to both upper arms and neck trauma D. Left arm and leg​ deformities, and head injury

B. Deformed​ femurs, bruises to the chest and​ abdomen, and head injury

Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another vehicle at a high rate of speed. The patient was unrestrained and his car did not have air bags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury​ pattern, the EMT would recognize which type of injury​ mechanism? A. High velocity B. Down and under C. Up and over D. Lateral impact

B. Down and under

As part of your service to the​ community, you are certified as a car seat specialist and provide monthly classes on the safe transport of infants and children. Over the course of one​ day, several cars have pulled into your EMS station and asked you to look at their car seats. Which car seat position would indicate that the parent is safely transporting his or her infant​ (younger than 1 year​ old)? A. Facing forward in the back seat in an upright position​ (60 degrees) B. Facing backward in the back seat in a reclined position​ (45 degrees) C. Facing backward in an upright position in the front seat​ (45 degrees) D. Facing forward in the back seat in a reclined position​ (60 degrees)

B. Facing backward in the back seat in a reclined position​ (45 degrees)

What is the best description of the goal of a trauma​ system? A. Providing the highest level of care possible within a​ 10-minute transport time frame for all patients B. Getting the right patient to the right facility in the right amount of time C. Transporting as many patients as possible by air medical transportation D. Providing all trauma patients with a complete battery of diagnostic tests and access to specialists

B. Getting the right patient to the right facility in the right amount of time

Which of these is a​ high-velocity wound that carries the greatest risk for death when considering the concept of​ cavitation? A. Gunshot wound to the stomach B. Gunshot wound to the spleen C. Shotgun wound to the lung D. Stab wound to the liver

B. Gunshot wound to the spleen

A patient with severe head and neck pain states that he was properly wearing his seat belt when another car struck him from behind. As a knowledgeable​ EMT, you would realize that the complaint​ of: A. Head pain suggests that he was not wearing the seat belt properly B. Head and neck pain could occur even when the seat belt is properly worn C. Head and neck pain indicates that he was not wearing his seat belt D. Head and neck pain indicates that the lap belt was worn without the shoulder harness

B. Head and neck pain could occur even when the seat belt is properly worn

You arrive on the scene of a motorcycle accident and find an unresponsive male patient lying in the middle of the road with blood coming from his ears and nose. He was not wearing a helmet and has snoring respirations. Which sequence of events would be most appropriate in the care of this​ patient? A. Primary​ assessment, spine motion​ restriction, transfer to the ambulance after 8 minutes of scene​ time, all other care provided en route B. Primary​ assessment, airway and ventilatory​ management, oxygen​ administration, spine motion restriction​ precautions, transport within 10 minutes of arriving on scene C. Primary​ assessment, oxygen​ administration, transfer to​ stretcher, transport within 5 minutes of arriving on scene with spine motion restriction precautions done en route D. Full spine motion restriction​ procedures, transfer to the​ ambulance, provide all assessment and care en route to the​ hospital, with total scene time of 7 minutes

B. Primary​ assessment, airway and ventilatory​ management, oxygen​ administration, spine motion restriction​ precautions, transport within 10 minutes of arriving on scene

You are hosting a discussion on injury prevention when a participant asks you if you believe that helmets for motorcyclists truly make a difference. You would respond by​ saying: A. ​"Helmets have been shown to prevent motorcycle​ accidents." B. ​"Motorcycle helmets decrease the risk of death when the rider is involved in a​ collision." C. ​"Wearing a helmet decreases the chance of being ejected from a​ motorcycle." D. ​"A motorcycle helmet decreases the chance of permanent spinal​ injury."

B. ​"Motorcycle helmets decrease the risk of death when the rider is involved in a​ collision."

You are assessing a patient who was involved in a motorcycle accident. He states that he saw an oncoming car and​ "laid the bike​ down" to avoid an outright collision. He was wearing a helmet. Which injury pattern would make sense given the action of the​ motorcyclist? A. Bilateral broken forearms with upper extremity trauma B. Angulation to both femurs with protrusion C. Burn to the inside of the leg from the motorcycle exhaust pipe D. ​"Road rash" to the entire body surface

C. Burn to the inside of the leg from the motorcycle exhaust pipe

A male patient has sustained gunshot wounds to the neck and abdomen. He is unresponsive and has gurgling respirations. Your immediate action would be​ to: A. Insert a nasal airway and place the patient on a long backboard B. Start positive pressure ventilation and then place a cervical collar and maintain manual spine motion restriction C. Suction the airway while providing manual spine motion restriction D. Place a cervical collar and position the patient on a long board

C. Suction the airway while providing manual spine motion restriction

Assessment of a patient involved in a motor vehicle accident reveals him to have crepitus to the left​ humerus, instability to the left lateral chest wall and​ flank, and pain on palpation to left hip region. The patient also complains of pain to the right side of the neck. Based on this injury​ pattern, the EMT would recognize the patient​ was: A. An unrestrained driver involved in a​ head-on collision B. The passenger in a car hit from behind C. The driver of a car hit on the​ driver's side D. An unrestrained rear seat occupant in a car struck from the right side

C. The driver of a car hit on the​ driver's side

A​ car, driven by an unrestrained​ male, strikes a utility pole at 35 mph. Given this​ scenario, which would be​ true? A. The energy transferred to the body is increased by a factor of 2 B. The patient struck the steering wheel at a combined speed of 70 mph C. The internal organs struck the inside of the body at a speed of 35 mph D. The utility pole absorbed half of the kinetic​ energy, so that the body collision occurred at a speed of 17.5 mph

C. The internal organs struck the inside of the body at a speed of 35 mph

A​ "whiplash"-type neck injury is most often observed with which type of​ collision? A. Frontal impact B. Ejection C. ​Rear-end impact D. Rollover

C. ​Rear-end impact

A young female wears her lap belt too​ low, over her upper​ thighs, because the belt is uncomfortable when worn properly. If she is involved in a​ head-on "up and​ over" type of​ collision, to which injury is she most​ prone, given the position of her lap​ belt? A. Bilateral arm fractures B. ​Tibia-fibula fractures C. Internal abdominal injury D. Dislocated hips

D. Dislocated hips

You are first on the scene of a​ two-car motor vehicle collision. Two patients are entrapped in one vehicle. In the other​ vehicle, there is a male driver complaining of chest pain. During this​ time, your primary concern​ is: A. Calling for additional help B. Triaging the patients C. Determining severity of injuries D. Ensuring personal safety

D. Ensuring personal safety

A patient has been critically hurt in a nighttime motor vehicle collision. She was wearing a seat belt and hit a tree at 70 mph. The car she was driving weighed 2 tons and was equipped with air bags that did deploy. Which factor had the greatest impact on the injuries she​ sustained? A. Deployment of air bags B. Nighttime conditions C. Weight of the vehicle D. Speed of the vehicle at impact

D. Speed of the vehicle at impact

You are assessing a male patient who was stabbed three times in the chest and abdomen. As you begin your primary​ assessment, you note the patient to have a decreased level of consciousness and gurgling respirations. Your next action would be​ to: A. Apply a cervical collar B. Obtain an SpO2 reading C. Check his pulse D. Suction the airway

D. Suction the airway

An unrestrained female driving a small car is involved in a​ rollover-type collision. Why is her risk for serious injury or death significantly​ increased? A. Smaller and lighter cars tend to roll multiple times B. The risk for ejection is​ lessened, increasing injuries suffered in the car C. Rollovers are the result of high speeds D. There are more impacts in a rollover causing injury

D. There are more impacts in a rollover causing injury

A patient has been stabbed with a knife at the fifth intercostal space on the right side of the chest in an attempted suicide. Assessment reveals him to be short of breath and coughing. Which question is it most important for the EMT to ask regarding the​ weapon? A. ​"Did the knife penetrate your chest​ easily?" B. ​"Was the knife clean or​ dirty?" C. ​"Did you push the knife in slowly or​ quickly?" D. ​"How long was the knife​ blade?"

D. ​"How long was the knife​ blade?"

Regarding the field triage of injured​ patients, which of these patients is NOT a member of a special patient population that would necessitate transport to a trauma​ center? A. A female patient who is 12 weeks pregnant and who fell on the​ sidewalk, injuring her hip and wrist B. A male patient with a broken femur and burns to 25 percent of his body after jumping from a​ second-story window of a house that was on fire C. A​ 70-year-old male patient with a systolic blood pressure of 104 mmHg after wrecking his car into a tree D. A female patient with a suspected brain injury from a fall who also takes prescribed anticoagulants

A. A female patient who is 12 weeks pregnant and who fell on the​ sidewalk, injuring her hip and wrist

You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A​ paramedic, who has already triaged the nine patients​ involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this​ presentation, the EMT would recognize the injury was likely​ sustained: A. During the primary blast phase B. After the secondary blast phase C. As a result of exposure to superheated air D. From the noise of the explosion

A. During the primary blast phase

Which piece of information would you provide to a group of young teenage drivers to decrease their chance of suffering a​ "whiplash"-type injury if involved in a motor vehicle​ collision? A. Ensure that the head rest is properly positioned B. Properly wear seat belts with a headrest in the down position C. Position the​ car's seats in a full upright position D. Make sure the car has​ side-door air bags

A. Ensure that the head rest is properly positioned

Which injury is most​ serious, warranting immediate and rapid transport to the local trauma​ center? A. Instability and crepitus to the left lateral chest wall B. Deformity to the right ankle with pain rated as a​ 10/10 C. Open fracture to the left lower leg D. ​Large, deep laceration to the arm with bone visible

A. Instability and crepitus to the left lateral chest wall

You arrive at the scene where a young male patient fell out of a tree he was climbing. Although he fell from a lower​ branch, he was still reportedly​ 10-12 feet in the air when he fell. The patient landed on his side on the ground. Which element of the kinematics of trauma would explain the mechanism of any injuries he may have​ sustained? A. Rapid deceleration B. Terminal mass C. Terminal velocity D. Rapid acceleration

A. Rapid deceleration

An​ 8-year-old boy fell forward off of a swing onto outstretched arms. He did not hit his head or lose consciousness and is complaining of left forearm pain. There is deformity to the left​ wrist, but no other injuries or life threats. His vital signs are pulse 132​ beats/min, respirations 20​ breaths/min, blood pressure​ 108/62 mmHg, and SpO2​ 100%. The proper care of this patient would be​ to: A. Secure the forearm to a padded board splint and apply a cold pack to the injury site before transporting the patient nonemergently B. Call ALS so that the patient can be given intravenous pain medications before splinting the forearm C. Immediately load and transport the​ patient, splinting the injury en route D. Apply supplemental oxygen and anatomically splint the forearm when the patient is placed on a long backboard

A. Secure the forearm to a padded board splint and apply a cold pack to the injury site before transporting the patient nonemergently

When teaching Emergency Medical Responders about air​ bags, which point would you​ emphasize? A. The benefit of air bags is lessened in a​ multiple-vehicle collision impact B. Air bags prevent broken glass from striking the occupant C. Air bags are effective in decreasing injury in a​ rollover-type collision D. Properly placed air bags eliminate the need for seat belts

A. The benefit of air bags is lessened in a​ multiple-vehicle collision impact

A bullet fired from a gun at close range passes through the​ patient's liver.​ However, on​ autopsy, the coroner discovers that the​ man's pancreas,​ stomach, and gallbladder were also​ injured, even though not in direct contact with the bullet. As a knowledgeable​ EMT, you would recognize that which mechanism is responsible for injuries to these additional​ organs? A. Blunt injury B. Cavitation C. Profile impact D. Drag force

B. Cavitation

A teenage female patient was ejected from a car as it rolled down a hill after she ran off the road. She is​ responsive, but with signs of early shock and respiratory distress. She has bruising to her anterior abdomen and​ chest, a laceration to her left​ temple, and deformity to her left wrist. At which point should the wrist injury be​ splinted? A. Prior to full spinal motion restriction precautions being provided B. En route to the hospital C. Just before leaving the scene D. Before transferring the patient to the stretcher

B. En route to the hospital

A car has been hit​ head-on by another vehicle at a moderate rate of speed. Seat belts were in place and the air bags deployed. The patient complains of chest pain. Quick observation reveals a bruise to his sternum. The EMT should​ immediately: A. Deflate the air bag to get breath sounds B. Lift the air bag and check for steering wheel deformity C. Check the windshield for starring D. Suspect an injury related to the air bag

B. Lift the air bag and check for steering wheel deformity

wo cars have collided​ head-on. One car was traveling at a speed of 55 mph and the other at 35 mph. The total speed of impact would​ be: A. 55 mph B. 20 mph C. 90 mph D. 35 mph

C. 90 mph

A​ patient, who was constructing a bomb in his​ basement, has sustained a​ secondary-phase blast injury. Which presentation would the EMT most likely observe from this blast​ phase? A. Headache and shortness of breath B. Burns to the​ head, neck, and chest C. Screwdriver impaled in the thorax D. Complaint of nausea after inhaling fumes

C. Screwdriver impaled in the thorax

What is the best description of the​ "platinum 10​ minutes" as it applies to care of the trauma​ patient? A. The time it should take the transporting ambulance to get the trauma patient to the closest medical facility B. The goal for total amount of time from the actual injury to arrival of EMS at the scene C. The target maximum scene time for EMS as it applies to the seriously injured trauma patient D. The target maximum time that the multisystem trauma patient should spend in the emergency department before being transferred to surgery

C. The target maximum scene time for EMS as it applies to the seriously injured trauma patient

During an​ in-service program focusing on care of the trauma​ patient, the medical director asks if anyone can correctly describe the​ "platinum 10​ minutes." What statement by a participant is the best​ response? A. ​"EMS should spend 10 minutes assessing the patient for​ life-threatening injuries prior to initiating transport to the emergency​ department." B. ​"EMS systems should be designed so that it takes an ambulance no longer than 10 minutes to respond to a trauma​ call." C. ​"EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on​ scene." D. ​"If the transport to a trauma center will exceed 10​ minutes, EMS should strongly consider the use of an aeromedical​ helicopter."

C. ​"EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on​ scene."

A​ 27-year-old male was involved in an altercation and was struck in the ribs with a baseball bat. Assessment reveals intact skin with bruising to the right lateral chest. When palpating this​ area, pain,​ instability, and crepitus are all observed. The patient also complains of difficult and painful breathing. The EMT would​ recognize: A. Pulmonary injury caused by penetrating trauma B. Chest wall injury caused by acceleration forces C. Thoracic injury secondary to penetrating trauma D. Chest injury caused by blunt trauma

D. Chest injury caused by blunt trauma

A patient who was involved in a motor vehicle collision is complaining of neck pain. Which piece of information would most contribute to the​ EMT's high index of suspicion that the patient may have suffered more significant injuries beyond isolated neck​ pain? A. Difficulty turning is head to the right B. External damage to the car is significant C. Lack of air bags in the car D. Death of the​ car's driver

D. Death of the​ car's driver

A​ 49-year-old male has been stabbed in the lower right chest. Police tell you that the patient got into an argument with an unidentified​ man, who then stabbed him before fleeing the scene. After assessing the​ patient, you are suspicious that the knife punctured the lung and is causing internal bleeding. In this​ situation, the mechanism of injury would​ be: A. Penetrating trauma to the lungs B. Internal hemorrhage C. Assailant with a knife D. Stab wound to the right chest

D. Stab wound to the right chest

As you pull up to a motor vehicle​ collision, you quickly scan the scene for clues as to the type and severity of injuries. Which observation would best indicate that a patient may have a head​ injury? A. Air bag deployment B. Blood on a​ patient's clothing C. ​Frontal-type collision D. Starburst on the windshield

D. Starburst on the windshield

A​ 23-year-old roofer has fallen 20 feet from the roof of a house into shrubs below. Aside from superficial abrasions and complaint of​ soreness, you detect no obvious injuries.​ Consequently, the patient states that as long as his legs are not​ broken, he does not see the need to go to the hospital. As a knowledgeable​ EMT, your best response would​ be: A. ​"Although you feel okay​ now, you will most likely be sore later on. Why​ don't we go to the hospital and ask about some medications for​ pain?" B. ​"Since this is a​ work-related injury, you should really be evaluated in the hospital.​ Worker's compensation may not cover you if you do​ not." C. ​"Since you did not lose​ consciousness, I feel better about having you refuse. Just keep an eye on your feet and watch for​ swelling." D. ​"In a fall from this​ height, you may have hurt some internal organs. You really need to be​ examined."

D. ​"In a fall from this​ height, you may have hurt some internal organs. You really need to be​ examined."

The EMT understands the importance of evaluating the mechanism of injury when he​ states: A. ​"The mechanism of injury is a useful tool in determining whether the​ patient's outcome will be good or​ bad." B. ​"The mechanism of injury is useful in determining the exact injuries the patient has​ sustained." C. ​"Evaluating the mechanism of injury is important because it determines whether emergency transport to the hospital is​ needed." D. ​"The mechanism of injury can be used to guide the​ EMT's injury assessment and treatment of the​ patient."

D. ​"The mechanism of injury can be used to guide the​ EMT's injury assessment and treatment of the​ patient."