Emt- Trauma
In the average adult, the sudden loss of -bank- cc of blood is considered serious.
1,000
You will frequently be called upon to deal with internal bleeding. Blunt trauma is the leading cause of internal injuries and bleeding. Which of the following mechanisms of blunt trauma that may cause internal bleeding. 1.Falls 2.Motor vehicle or motorcycle crashes 3.Auto-pedestrian collisions 4.Blast injuries
1,2,3,4
Respiratory compromise is most likely in which of the following burn patient?
A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest.
Which ne best describes avulsion?
A flap of skin that is partially or completely torn away from the underlying tissue
Which of the following patients would be the highest priority for rapid transport?
A patient with a possible fractured arm with absent distal pulses
which of the following best describes compartment syndrome?
A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissue aginst that pressure
Which one of the following definitions is incorrect:
A sprain is the stretching and tearing of ligaments
which of the following is a consideration in determining a burns severity?
ALl of the above
While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)
Airway
Which of the following is the purpose of making airway management the highest priority of patient care when managing the patient in shock?
All of the above
Which of the following should increase the EMT's suspicion of internal bleeding?
All of the above
Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you anticipate?
All of the above
Which of the following best describes an evisceration?
An open wound of the abdomen from which organs protrude
Which of the following traumatic chest injuries may result in massive,often fatal internal hemorrhage?
Aortic dissection
a 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you do?
Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority.
In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next?
Apply additional dressing material over the top of the original dressing and bandage it in place.
Your patient is a 14-year-old who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization?
Asses for additional injuries, flush away large pieeces of debris with a sterile dressing, place dressing on abrasion, bandage them in place, transport
In cases of extreme hypothermia, you find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. what is the emergency care for these patients?
Assess the carotid pulse for 30-45 seconds: if there is no pulse start CPR immediately and prepare to supply AED.
the part of the skeletal system that is made up from the skull and spinal column is called the:
Axial skeleton
Which of the following is part of the bodies compensatory response to blood loss?
Blood vessels constrict and the heart rate increases
Which of the following is a sign of internal bleeding
Brusing
Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions in both knees and the palm of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vesselss
Capillaries
The pathophysiology of -blank- is one which the pericardial sac fills with blood to the point where the chamber of the heart no longer fill adequately, usually secondary to trauma.
Cardiac tamponade
Which of the following distinguishes irreversible shock from other stages of shock?
Cell damage and death in the vital organs
A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder it "pops back into place". What should your next steps be?
Check distal CMS, apply a sling and swathe, and transport patient.
your patient is an 11-year-old male who has a swollen,painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be done in the immobilization of his injured extremity?
Check pulse, check movement, and sensation distal to the injury before and after splinting
You are on EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. You find the patient pulseless and breathing agonal gasps. You suspect which of the following conditions?
Commotio cordis
Your patient has a traumatic injury to his forearm. The injury is pale and swollen. The patient presents with presents with pain and numbness and you are unable to palpate his distal pulses. You should suspect
Compartment syndrome
You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattle snake and is "really sick". As you approach, you notice that the patient appears in obvious distress, diaphoretic and holding his right wrist. What is your highest priority?
Confirm the location and status of the snake.
In addition to lacerations, blunt trauma resulting in a closed chest injury creates potential for which of the following internal injuries?
Contusion
Your patient has an open abdominal wound with intestines protruding. You should:
Cover organs with moist sterile dressings
You have coved an open chest wound with your gloved hand and patient's breathing has improved. In order to free your hand to provide further care, you should:
Cover wound with an occlusive dressing
You are called for a young man who was diving head first off into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been preforming recuse breathing for him. He is awake, but is unable to breath on his own. What type of damage or injury dose this indicate?
Damage to c-3, c-4, or c5
Which of the following is the first method to control external bleeding?
Direct pressure
Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady dark red bleeding. He is awake pale and diaphoretic. He has a string radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and has a bp of 122/82. He has no other injuries or complaints. Which of the following is the best sequence of steps in the management of this patient.
Direct pressure, high concentration oxygen, and splinting the leg
Your patient is a 60-year-old women who stepped of a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. WHich of the following should you do?
Explain to the patient that you cannot tell her if her ankle is sprained or fractured until she is X-rayed at the emrgency department, then splint the ankle.
You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using GCS per your protocols. WHich of the following will you check?
Eye-opening, motor response, and verbal response
Primary blast injuries are caused by:
Flying debris
Which of the following is true regarding trauma in the elderly.
Fractures can occur more easily in the elderly.
A burn extending into the subcutaneous fat would be classified as which type of burn?
Full thickness
Which of the following is not a principle of splinting that must be considered by the EMT?
Gently replace protruding bone ends back beneath the skin to prevent further infection
where could you find the phalange bones
Hands and feet
Oftentimes an EMT is called upon to treat a nose bleed (epistaxis). All of the following are correct ways to treat a nose bleed except?
Have the patient sit down and lean backwards
Which of the following is not recommended when controlling epistaxis?
Having patient tilt the head backwards to elevate the nose
When deciding where to transport a patient who is in hypovolemic shock or who has the potential to develop hypovolemic shock, Which of the following is the most important service to be provided by the receiving hospitals?
Immediate surgical capabilities
Your 38-year-old patient has been injured in an assault. He has several facial lacerations and a large knot on his shoulder. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As a part of your scene size-up and primary assessment, you should:
Immobilize his cervical spine
There are general rules that apply to all types of splinting. Which of the following is not a general rule of splinting?
In order to avoid loss of use of limb, it is important to splint before moving, even if the patient is unstable
A 65-year old male was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note and obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury.
Increased blood pressure
WHich of the following is a characteristic of venous bleeding?
It can profuse, but is generally easily controlled
Which of the following statements is not true when you are on-scene and treating a patient who appears to be in shock?
It is important to spend on-scene time to be sure you have corrected and dealt with any of the causes of the shock so that it dose not get worse. This is more important than rapid transport.
which of the following is not a benefit of splinting an injury to bones and connective tissue?
It restricts blood flow to the site of injury to prevent swelling
Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except:
It should be applied directly to the skin; it will not be effective if anything between the cold agent and the wound
Your patient is a 32-year-old man with a fish hook that has a perforated hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital setting?
Leave the hook and try not to disturb it.
As an EMT, your best clue indicating the possibility of internal bleeding may be the presence of
MOI
Your patient has a possible fracture to the mid-femur. There is also an injury to the knee on the same leg. The patient is alert and vitals appear stable. You should:
Not apply the traction splint
Which of the following is the least commonly used method of controlling external bleeding ?
PASG
When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check which of the 6 p,s?
Pain, pallor, paresthesia, pulses, paralysis, and pressure
Your patient is a 21-year-old male who has a gunshot wound to the chest. Which one of the following is the highest priority in managing this patient?
Placing an occlusive dressing over the wound
Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils?
Puncture
You respond to a local pool for a drowning. Bystanders have pulled the patient out of the pool prior to your arrival. You find a 22-year-old patient unresponsive with agonal breaths and have a weak carotid pulse. Following the primary assessment and spinal protection, your next action should be:
Rapid transport
Which one of the following is not a contraindication for the use of a traction splint?
Severe swelling and redness at midshaft femur
In which of the following ways dose the body produce heat in response to being cold?
Shivering
Limitinting time spent at the scene can be especially important if the MOI suggests that the patient could go into shock. In order to keep the time at the scene to a minimum, which of the following assessments or treatment should not be performed on the scene?
Splinting swollen extremities
Which of the following is a characteristic of arterial bleeding?
Spurting under presure
A 36-year-old male who accidentally shot a nail gun into his chest. You se the nail, which protrudes abut 2-3 centimeters from the thorax, hen you visualize he injury site. You should:
Stabilize the object in place.
Which one of the following is a desirable characteristic of dressing used in the prehospital management of most open wounds?
Sterile
Which of the following bones is found in the chest?
Sternum
Which of the following best explains the reason for minimizing scene-time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?
Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival
Which of the following describes the proper application of an occlusive dressing for an open chest wound?
Tape the dressing securely on 3 sides
Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and transport .
Tension pneumothorax
You have responded to a local pool for a drowning patient. Lifegards have pulled the patient out of the water prior to your arrival . You find a 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are c-spine precautions neccessary?
The patient may have suffered a spinal injury by jumping into shallow water.
Your're an off duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated country road. It appears the patient was unrestrained, ornot wearing a seatbelt, and struck the steering wheel with his chest. On assessment, you noticed a paradoxical motion to the patient's chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include.
The patient might have flail chest
Life threats present on your trauma patient should be managed during:
The primary assessment
your patient was working on a car when it fell off the jack and trapped him between the tire and round. His face is very blue and his eyes are bloodshot. Which of the following has the patient suffered.
Traumatic asphyxia
Which of the following would not be used to manage an open abdominal injury?
Triangular bandage
Which one of the following is recommended in situations in which a tourniquet must be used.
Use material that is wide and thick.
Which of the following is required in the management of all open soft tissue injuries?
Use of standard Precaution by the emt
Which is the following best describes the function of blood?
Where could you find the phalange bones?
You are dispatched to a local industrial plant for an "electrical injury". You arrive on scene and find a 6-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. coworkers state he was unconscious until your arrival. What is the next step?
While on the scene, rapidly do a complete ssesmen, provide, oxygen, provide care for potential spin injuries', and transport as soon as possible after the exam
Care for an amputated part includes:
Wrap in a sterile dressing, place in plastic bag, and keep cool with cold packs.
You are caring for a 23-year-old female who fell of a bicycle and sustained severe lacerations on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. WHat is the next step?
You need to expose the wound completely, control the bleeding, clean the surface by simply removing large pieces of foregin matter if any, and dress and bandage the wound.
The readily available occlusive dressing is:
Your gloved hand
A wound in which the epidermis is scrapped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called:
abrasion
which of the following injuries requires the use of n occlusive dressing
all of the above
Which of the following is a complication of a bone fracture?
all of the body
A teenage male has fallen onto a railing while skateboarding. He complains of right-sided chest pain, but his breathing is adequate. Exposure of the chest reveals a section of his ribs that is moving in the opposite of the rest of his ribs. you should:
appy a bulky dressing over the section
Your patient is a 17-year-old male baseball player found pulseless and apneic being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should immediately:
begin chest compressions
If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute
blood pressure cuff
A young female was injured in a automobile wreck, striking her head on the windsheild. She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68, bp 148/90, and her pupils are unequal. You should suspect a(n)
closed head injury
An injury cause by heavy pressure to the tissue, such as when an extremity is trapped under a fallen tree, that results in damage to muscle cells and the accumulation of waste produucts in the tissue is called an:
crush injury
DCAP-BTLS
deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling
You are treating a 16-year- old skateboarder who has fallen at the sktate park. she has an angulated left forearm that she has in a guarded position. When do you splint thi injury?
during the secondary exam
Your patient is a 3-year-old girl who is unable to move her elbow after her mother picked her up by the forearm. Proper splinting of this injury would be to immobilize from the -blank- to the -blank-
forearm; shoulder
On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration and the bleeding is controlled. Which of the following is the best approach toward managing the exposed intestines?
moisten a sterile dressing with saline solution and cover the abdominal contents
The adequate circulation of blood throughout the body, which fills the capillaries and supplies the cells and tissue with oxygen and nutrients is called:
perfusion
A suspected musculoskeletal injury of the shoulder is best managed by which of the following techniques?
placing the arm in a sling and using triangular bandage to secure it to the body
Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being "hit in the face and kicked and punched in the ribs and stomach." Your examination reveals contusion and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusion of the chest, abdomen, and flanks. Which of the following should the greatest concern regarding the prehospital care of this patient?
potential internal injuries
Your patient is a 28-year-old male who cuts his thigh with a chain saw. It appears that he has lost about 600cc of blood. Which of the following is not a proper management
replace level by giving the patient adequate amount of water
You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsating mass. You should:
report your findings to the receiving facility
Partial thickness burns are also called:
second degreeterm-49
In which one of the following situations would a person lose heat by conduction
sitting on cold metal bleachers at a football game
