NREMT: Trauma

Besides bound to​ hemoglobin, how is oxygen transported to the​ cells?

dissolved in plasma

A​ 38-year-old male is found lying on the ground next to an open electrical panel. His coworker tells you she heard him fall and saw him shaking. As you​ approach, he appears confused and is unable to sit up. You do not observe any deformities or injuries other than small areas of black burned skin on the tips of his fingers. You should​ suspect:

electrical burns

A​ 62-year-old female complains of left calf pain after she stepped into a hole while walking. She tells you she cannot walk or bend her foot down. You observe swelling near her heel. You​ should:

splint her foot and lower leg

A​ 17-year-old female has a broken broom handle with a​ one-inch diameter impaled in her​ neck, entering at the sternal​ notch, and exiting below her right ear. She​ states, "I was outside when the handle blown by the tornado hit​ me." You​ should:

stabilize it in the position found

A​ 7-year-old female has a pencil impaled in her right cheek. She is upset but follows your instructions. You can visualize that the tip of the pencil is impaled in her palate. You​ should:

stabilize the pencil in place

A​ 58-year-old male has a degloving injury to his left hand after it was trapped in a piece of machinery. You observe minor​ bleeding, and his hand is misshapen. You should apply​ a(n):

sterile dressing

Why should you not remove an impaled object from the chest​ wall?

it may be occluding life-threatening hemorrhage

What characteristic must an open wound to the parietal pleura have for it to allow air to be drawn into the pleural space through the chest​ wall?

it must be similar in size to the glottic opening

A​ 73-year-old female injured her back when she scraped against a sharp piece of metal. She has an irregular cut across her skin that exposes fat and muscle tissue. You should suspect​ a(n):

laceration

A​ 21-year-old female was stabbed in her right upper abdominal quadrant with a pencil. She complains of pain to the area. Her abdomen is tender to​ palpation, and you observe blood trickling from the wound. Her vital signs are P​ 120, R​ 18, BP​ 108/86, and SpO2 is​ 94% on room air. What organ should you suspect was​ injured?

liver

A​ 68-year-old female was shot in her left chest wall. She is lying on the​ ground, moaning​ 12/minute. You observe a bubbling​ half-inch wound on her left anterior​ chest, third intercostal space on the midclavicular line. You should cover the wound with your gloved hand and​ next:

look for an exit wound

A​ 56-year-old female has a full thickness burn to her left anterior forearm from an industrial alkali. Why does she only have pain in the skin surrounding the​ burn?

nerve cells destroyed in area of burn

An unresponsive​ 11-year-old female jumped from a​ second-story window and landed on an uneven surface. Her skin is​ pale, cool, and you do not observe any bruising. She has a capillary refill of four seconds. Her left leg is shortened. When you compare her​ femurs, they are the same. Her abdomen is soft to​ palpation, and you feel crepitus when you assess her pelvis. You should suspect torn blood vessels in​ her:

pelvis

An unresponsive​ 2-year-old male fell eight feet from a slide at a city park. You observe a hematoma to his occiput. His skin above his axilla is pale and​ diaphoretic, and pink and dry below. His left forearm is obviously fractured. His vital signs are P​ 156, R​ 48, and his capillary refill is less than two seconds. Prior to​ transport, you should administer oxygen​ and:

perform spinal motion restriction

An​ 11-month-old female was stabbed in the chest with a knife. You open her shirt and observe a​ half-inch laceration to the right side of her chest that is bubbling. You should​ immediately:

place your gloved hand over the wound

A​ 21-year-old female complains of chest pain. She has a gunshot wound to her left chest​ wall, and she has mild dyspnea. Her skin is pink and dry. You should​ first:

place your gloved hand over the wound

An unresponsive​ 70-year-old female was the unrestrained driver involved in a front end car crash. She has a hematoma to her​ forehead, she is taking​ rapid, shallow​ respirations, and you observe paradoxical chest wall movement. You should​ first:

rapidly extricate her

An​ 88-year-old male spilled muriatic acid on himself while cleaning metal. He complains of pain to his chest and abdomen. You observe that his clothing is wet where he spilled the acid. You should​ first:

remove his clothing

A​ 79-year-old male lost his balance and​ fell, landing on his back. He complains of pain in his upper​ back, and you palpate a deformity to​ T-6. He has a history of CHF and tells you he needs to sit up so he can breathe. He is on home oxygen by nasal​ cannula, 3​ L/minute. He is not able to feel below his xiphoid process or move his legs. You should apply a cervical collar​ and:

secure him in the​ semi-Fowler's position on the stretcher.

An unresponsive​ 37-year-old female was kicked in the head by a donkey. She has snoring​ respirations, and you observe clear fluid draining from her nose. You should​ suspect:

skull fracture

A​ 52-year-old female was cutting a branch when she accidentally cut through the power line to her house. She is standing outside and tells you she has severe pain in her right upper arm and cannot feel anything in her right lower arm. You observe full thickness burns to her right hand and elbow. You should​ first:

assess her vital signs

A​ 16-year-old female was bitten in the chest by a dog. She has an avulsed flap of tissue three inches wide by five inches long to her right chest wall. You observe bubbling blood when she breathes. You​ should:

cover the wound with an occlusive dressing

A​ 68-year-old male complains of pain after he slammed his right second phalange in a door. You observe bleeding and angulation of the distal tip. He has a capillary refill of two seconds. You should apply a sterile dressing​ and:

tape his 2nd and 3rd phalanges together

A​ 51-year-old female complains of chest pain and increasing difficulty breathing. She has a large caliber gunshot wound to her right chest​ wall, fourth intercostal space on the anterior axillary line. You auscultate absent breath sounds on the right side. Her vital signs are P​ 112, R​ 22, BP​ 104/90, and SpO2 is​ 91% on room air. You should​ suspect:

tension pneumothorax

A​ 60-year-old male tells you that he was sexually assaulted by a staff member where he lives. He denies any​ bleeding, and you do not see any blood on his undergarments. He appears frightened and tells you he​ doesn't want to go to the hospital. You​ should:

encourage him to go to the hospital for evaluation

A​ 21-year-old female tells you she was stabbed by a piece of metal in her abdomen 15 minutes ago. When you examine the​ area, you observe minimal bleeding and pink​ sausage-like tissue protruding from the opening in her left lower abdominal quadrant. You should suspect​ a(n):

evisceration

A​ 21-year-old male has a gunshot wound to his penis. You observe that his outer clothing is saturated with blood. You​ should:

expose the injure and apply direct pressure

A​ 19-year-old female complains of groin pain. She tells you she lacerated her perineum when she crashed her bicycle. You observe bright red blood running down her leg. You should​ first:

expose the injury and apply direct pressure

A​ 75-year-old female complains of burning pain in her arms. She was working in her garden and spilled a dry powder on them. After you remove the​ powder, you observe circumferential blistered and mottled skin of both her forearms and hands. What percentage of her Total Body Surface Area should you estimate is​ burned?

9

Which of the following patients involved in a car crash has the most severe​ findings?

A 28 year old male complains of abdominal pain, he was the restrained driver, his vital signs are P 106, R 18, BP 88/62

An unresponsive​ 51-year-old female was the driver involved in a car crash. There is 20 inches of intrusion to her door. Her pelvis is unstable when palpated. Her vital signs are P​ 108, R​ 18, BP​ 102/78, and SpO2 is​ 92% on room air. Which of the following is the most valuable finding to indicate that she is a high priority​ patient?

LOC

A​ 36-year-old female was struck by a car and thrown eight feet. She complains of pain in her left​ hip, and her leg is externally rotated. When you press on her iliac​ crests, she complains of increased​ pain, and you feel instability. You should suspect​ a(n):

Pelvic Fracture

A​ 50-year-old male was lifting a heavy weight when he felt a tearing sensation in his right bicep. His bicep is tender to​ palpation, but you do not note any instability of his arm. His distal​ motor, circulation, and sensation are intact. You should apply​ a(n):

Sling and cold pack

An unresponsive​ 62-year-old male was struck in the head with a falling tree branch. He has a​ five-inch full thickness laceration to his right parietal region. It is​ bleeding, and you observe bone fragments in the wound. When you stimulate​ him, his arms twist outward. His vital signs are P​ 54, R 18 and​ irregular, BP​ 220/106, and SpO2 is​ 96% on room air. You should cover the wound with gauze​ and:

administer oxygen

During compensated hemorrhagic​ shock, why can the skin become pale and​ cool?

blood flow is reduced to the skin

Which of the following describes how the body responds to increased intracranial​ pressure?

blood pressure increases, pulse rate decreases

A​ 38-year-old female was struck across her lower abdomen with a baseball bat. Her skin is​ pale, cool, and diaphoretic. She tells you she has bright red bleeding from her vagina. You should apply​ a:

bulky dressing to vaginal opening

A​ 58-year-old female complains of pain after she twisted her ankle while running. Her foot is severely​ angled, and her sock is bloody. When you remove her​ sock, you observe an open wound and bone. The skin of her foot is warm and pink. You​ should:

immobilize her foot in the position found

A confused​ 52-year-old female has an​ eight-inch full thickness laceration diagonally across her right thigh. Her skin is pale and​ diaphoretic, and you observe a steady flow of dark red blood oozing from the wound onto the carpeted floor. The carpet under her leg is saturated. You should​ suspect:

massive hemorrhage

A​ 72-year-old female complains of eye pain after she splashed drain cleaner into her eye. You observe that her right eye is​ red, and both eyes are tearing. You should hold her eyelids open and flush her eye from​ the:

medial to lateral

An​ 89-year-old male cut his abdomen on a knife while preparing dinner. You observe several loops of bowel protruding from the wound and minimal bleeding. What type of dressing should you apply to his​ wound?

moist, sterile

An​ 8-year-old male was stabbed in the chest with a knife. You observe a​ half-inch laceration an inch lateral to the sternum at the third intercostal space. You do not see any active​ bleeding, and his neck veins are distended. His lungs are clear to auscultation. His capillary refill is three​ seconds, and his skin is pale and cool. You should​ suspect:

obstructive shock

A​ 47-year-old female complains of right hip pain. She was the unrestrained driver of a car that crashed into a tree. Her airbag​ deployed, but there is damage to the dash where her right knee struck it. As you move her onto the long​ backboard, you observe that her right leg is rotated​ inward, her hip is​ flexed, and her knee is bent. You should suspect​ a(n):

posterior hip dislocation

A​ 95-year-old male complains of right arm pain. He tells you he fell and landed with his arms outstretched. You observe a midshaft deformity to his forearm. You should suspect a fracture of​ his:

radius and ulna

Penetrating injury to which of the following organs would cause peritonitis the​ quickest?

stomach

Why should you irrigate the eye of a patient who was splashed with drain cleaner longer than a patient who was splashed with muriatic​ acid?

Drain cleaner liquifies tissue and can damage more tissue.

An​ 80-year-old female was the restrained driver of a car that was struck directly in the​ driver's side door. There is 10 inches of​ intrusion, and she complains of upper abdominal pain and difficulty breathing. She has equal chest wall​ expansion, and you auscultate diminished breath sounds and bowel sounds in the base of her left lung. You​ should:

administer oxygen

An​ 87-year-old male complains of difficulty breathing. He tells you he fell four feet from his porch and struck his chest on a brick wall. You observe a segment of his right chest wall moves inward when he inhales. You auscultate clear lung sounds in all fields. You​ should:

administer oxygen

A​ 4-year-old male complains of difficulty breathing. He tells you he was struck by a car. You observe contusions and abrasions to his chest and abdomen. You auscultate decreased lung sounds and bowel sounds in his left lower chest. His vital signs are P​ 112, R​ 40, BP​ 100/74, and SpO2 is​ 92% on room air. You​ should:

administer oxygen

A​ 58-year-old male complains of midsternal chest pain after a car crash. He tells you that he was​ pain-free before the crash. His skin is pale and diaphoretic. His lungs are clear to​ auscultation, and the pain increases with deep inspiration. His vital signs are P​ 112, R​ 18, BP​ 118/86, and SpO2 is​ 95% on room air. You​ should:

administer oxygen

A​ 70-year-old female who was the unrestrained driver in a car crash complains of difficulty breathing. She has a history of asthma and a pacemaker implanted. You auscultate diminished lung sounds and bowel sounds in her left base. Her vital signs are P​ 70, R​ 22, BP​ 138/74, and SpO2 is​ 96% on room air. You​ should:

administer oxygen

A​ 22-year-old male complains of difficulty breathing after being struck in the chest with a pipe. He has a​ six-inch bruise over his right axilla. His lung sounds are absent on the right lower chest. His vital signs are P​ 122, R​ 20, BP​ 88/72, and SpO2 is​ 94% on room air. You​ should:

administer oxygen and keep him warm

A​ 27-year-old male complains of pain in his left upper abdominal quadrant and left shoulder. He tells you he was in a bar fight five days ago. You observe yellowing bruises to his​ face, chest, and upper abdomen. His vital signs are P​ 116, R​ 18, BP​ 116/90, and SpO2 is​ 95% on room air. You​ should:

administer oxygen and keep him warm

A​ 60-year-old female was choking on a piece of steak. She became​ unresponsive, and bystanders dislodged it after performing chest compressions for 30 seconds. She now complains of pain in her chest. Her lungs are clear to auscultation. You should​ suspect:

cardiac contusion

A​ 52-year-old male has bright red blood in his urine. He complains of left flank tenderness and thirst. His skin is​ pale, cool, and diaphoretic. He tells you that an hour ago he was the restrained driver of a car involved in a crash. He tells you the​ driver's door was pushed in a​ foot, but he refused treatment. You​ should:

administer oxygen and keep him warm

A​ 9-year-old female was struck by a car while she was riding her bicycle. She complains of pain in her left​ forearm, right​ shoulder, and abdomen. Her skin is pale and cool. Her right shoulder appears uninjured. You observe an angulated injury to her​ forearm, and distal pulses are present. She has an abrasion to her right upper abdominal​ quadrant, and the pain increases with palpation. You should perform spinal motion​ restriction,

administer oxygen and transport immediately

A disoriented​ 19-year-old male was struck in the right temple with a golf club. You observe an expanding hematoma to the area and clear fluid draining from his ear. His vital signs are P​ 64, R​ 14, BP​ 192/102, and SpO2 is​ 94% on room air. You​ should:

apply a cervical collar

An​ 85-year-old male complains of severe pain in his right thigh after he was struck above his knee with a metal pole. He complains of weakness in his​ leg, and you observe bruising where he was struck. You do not palpate any instability or deformity. You​ should:

apply a padded board splint

A​ 51-year-old male has a​ five-inch partial thickness laceration to his left thigh. You have applied direct pressure and controlled the hemorrhage. His vital signs are P​ 92, R​ 16, BP​ 132/76, and SpO2 is​ 95% on room air. You​ should:

apply a sterile dressing

A​ 35-year-old female complains of arm pain where she was bitten by a male attacker. You observe teeth​ marks, slight​ bleeding, and bruising to the area. She tells you she​ doesn't want to go to the​ hospital, and she just wants you to look at it. You​ should:

apply a sterile dressing and explain why she should go to the hospital

An unresponsive​ 45-year-old female was stabbed in her right chest an inch lateral to her sternum. Her skin is pale and diaphoretic. You observe jugular vein distention and auscultate clear lung sounds bilaterally in all fields. Her vital signs are P 118 and R 18. You​ should:

apply an occlusive dressing

A​ 20-year-old male was shot in the neck. You observe​ life-threatening bleeding from the wound. After you apply direct pressure with your gloved​ hand, you​ should:

apply an occlusive dressing

A​ 92-year-old male tripped and fell onto a ceramic figurine that created a​ two-inch hole in his right upper chest wall. You observe muscle tissue and bone fragments in the wound and hear bubbling sounds when he breathes. You​ should:

apply an occlusive dressing

An​ 81-year-old male complains of abdominal pain and difficulty breathing. He tells you he was stabbed in his abdomen. He has a history of hypertension and high cholesterol. You observe a​ one-inch laceration just below his xiphoid process. You auscultate diminished lung sounds and bowel sounds in the base of his left lung. His vital signs are P​ 76, R​ 20, BP​ 144/88, and SpO2 is​ 93% on room air. You should administer oxygen​ and:

apply an occlusive dressing.

A​ 6-year-old male fell off his bicycle and cut his upper arm. His mother is holding a​ blood-soaked towel over the wound. When you examine the​ wound, you see a​ five-inch laceration that is spraying blood. You should​ immediately

apply direct pressure

An unresponsive​ 78-year-old male fell down a flight of stairs. You hear snoring respirations and see uncontrolled bleeding from a laceration on his head. You should​ first:

apply direct pressure to the laceration

A​ 41-year-old female was stabbed in her right thigh with a screwdriver. Her skin is​ warm, dry, and pink. You observe blood oozing from a​ two-centimeter wound and feel an expanding hematoma under her skin. You​ should:

apply direct pressure to the wound

A​ 60-year-old male complains of shoulder pain. He tells you he tripped and grabbed the door frame as he fell backward. He is holding his right arm against his​ chest, and he tells you he is unable to move it. You observe a deformity below his clavicle and above his​ axilla, and he has a good radial pulse. You​ should:

apply swing and swathe

A​ 43-year-old female tells you that she was sexually assaulted. She complains of pain in her chest and groin from being kicked. You do not see any signs of bleeding through her outer clothing. You should listen to her lung sounds​ and:

ask her if she is bleeding

An unresponsive​ 61-year-old female was run over by a train at low speed. Her skin is pale and cool. She has a below the knee amputation of her left leg. You observe minor bleeding from the injury. While stabilizing her​ spine, you​ should:

assess her breathing and circulation

An unresponsive​ 2-year-old female has burnt skin on her left hand and left knee. Her father tells you he heard a loud noise and found her this way. She has​ irregular, slow, shallow respirations and a rapid carotid pulse. You should​ first:

assist her ventilation

An unresponsive​ 43-year-old female was struck in the chest with a metal pipe during an assault. You observe a portion of her left chest wall moves outward when she exhales. She is taking​ rapid, shallow breaths. While your partner stabilizes her​ head, you should​ next:

assist her ventilation with BVM

A​ 57-year-old male was stabbed multiple times in his anterior right chest wall with a screwdriver. He tells you he has pain and difficulty breathing. You should apply occlusive dressings​ and:

auscultate his lung sounds

An​ 82-year-old female was bitten by a dog. You observe an irregularly shaped flap of skin on her arm. You should suspect​ a(n):

avulsion

A​ 23-year-old male complained of chest pain after he was stabbed in the right chest with a knife. You applied an occlusive dressing and continued your treatment. His initial vital signs were P​ 92, R​ 18, BP​ 128/82, and SpO2 was​ 93% on room air. During​ transport, he complains of difficulty​ breathing, and his vital signs are P​ 114, R​ 22, BP​ 104/88, and SpO2 is​ 91% on oxygen 12​ L/minute by​ non-rebreather mask. You​ should:

burp the occlusive dressing

An unresponsive​ 51-year-old male was stabbed in the fourth intercostal space of his left chest an inch lateral to his sternum. His skin is​ pale, cool, and diaphoretic. His lungs are clear to​ auscultation, and you observe his neck veins are distended. You should​ suspect:

cardiac tamponade

A​ 25-year-old female complains of abdominal pain and vaginal bleeding after she was kicked midline in her lower abdomen by a horse. You should suspect her bleeding is from an injury to​ her:

cervix.

A​ 32-year-old female fell while hiking and she complains of extreme left calf pain. You do not observe any abnormal angulation of her leg. The skin on her left calf is​ pale, swollen, and she tells you she feels a pins and needles sensation. You are unable to palpate a distal pulse. You should​ suspect:

compartment syndrome

A​ 5-year-old male complains of pain in his left hand after he spilled liquid drain cleaner on it. His hand is​ reddened, and you smell a strong chemical odor. You​ should:

flush his hand with water.

A​ 43-year-old female who stepped into a campfire complains of pain in her lower leg. The skin on her lower leg is reddened and blistered. The skin on her foot has areas of blackened skin and other areas that are​ dry, white, and leathery. She denies pain to this area when you cover it with a dressing. What type of burn should you suspect she has to her​ foot?

full thickness

An unresponsive​ 21-year-old male was shot in the left upper abdominal quadrant. His skin is pale and diaphoretic. You auscultate clear lung​ sounds, and his neck veins are flat. His vital signs are P​ 116, R​ 20, BP​ 100/72, and SpO2 is​ 92% on room air. What type of shock should you​ suspect?

hemorrhagic

A​ 24-year-old female complains of chest pain and difficulty breathing. She tells you a horse kicked her in the chest. Her skin is pale and diaphoretic. You observe a contusion to the left side of her anterior chest wall. Breath sounds are absent over her left lower lung. Her vital signs are P​ 116, R​ 22, BP​ 92/80, and SpO2 is​ 95% on room air. You should​ suspect:

hemothorax

Why is a​ 7-year-old female more prone to fracture her spleen in a car crash than an​ adult?

her ribs do not protect it as well

Why can a fracture to the proximal end of a​ 3-year-old male's humerus be more serious than a fracture in the same location of a​ 33-year-old female if it is not treated​ properly?

his arm may not grow properly

A​ 60-year-old male was working on an electrical appliance when he shocked himself and became unresponsive. His wife tells you that while he was​ unresponsive, he was shaking all over. His only past medical history is hypertension. You observe full thickness burns to his right hand and both knees. His vital signs are P 82 and​ irregular, R​ 16, BP​ 168/78, and SpO2 is​ 94% on room air. Which of the above findings has the potential to be an immediate life​ threat?

irregular pulse

A​ 23-year-old female has a​ five-inch laceration to her left thigh. You were unable to control her​ hemorrhage, so you applied a tourniquet and stopped the bleeding. During​ transport, her vital signs are P​ 104, R​ 18, BP​ 88/62, and SpO2 is​ 97% on oxygen by​ non-rebreather mask at 12​ L/minute. Of the​ following, which will help to improve her outcome the​ most?

keep her warm

A​ 32-year-old female complains of abdominal pain and left leg pain after she was stabbed in her left lower abdominal quadrant. You do not observe any injuries to her​ legs, but her left leg is cyanotic and cold. Her vital signs are P​ 108, R​ 18, BP​ 98/58, and SpO2 is​ 91% on room air. You should administer oxygen​ and:

keep her warm

A​ 5-year-old female who was only wearing a lap belt when she was involved in a car crash complains of abdominal pain. Her skin is pale and cool. The only injury you observe is a reddened​ three-inch wide mark across her abdomen at the level of her umbilicus. Her vital signs are P​ 130, R​ 34, BP​ 98/80, and SpO2 is unobtainable. Her capillary refill is three seconds. You should administer oxygen​ and:

keep her warm

A​ 25-year-old male complains of severe leg pain. He tells you he went to the urgent care center yesterday and they applied a temporary cast wrapped with an elastic bandage because he broke his left tibia. He tells you the pain has been getting worse and he feels pins and needles in his leg. You​ should:

loosen the elastic bandage around the temporary cast.

A​ 34-year-old male fell from a tree and landed on his left arm. He is sitting leaning against the tree holding his arm against his body. He tells you that before he sat​ up, his arm was angulated. You palpate instability of his left humerus and observe a centimeter laceration with minimal bleeding. What type of fracture should you​ suspect?

open

A​ 41-year-old female complains of​ left-sided chest pain. She tells you she was stabbed in her left breast with a knife. She denies difficulty​ breathing, and her lungs are clear to auscultation. You observe slight oozing bleeding from the wound. Her vital signs are P​ 98, R​ 16, BP​ 138/78, and SpO2 is​ 97% on room air. You should suspect​ a:

simple pneumothorax

A​ 74-year-old male complains of upper back pain and difficulty breathing after a fall. He has pain and crepitus in the right side of his back below his scapula. He has equal chest wall​ expansion, and his breath sounds are diminished in the affected area. His vital signs are P​ 82, R​ 18, BP​ 142/92, and SpO2 is​ 96% on room air. You should suspect​ a:

simple pneumothorax

An unresponsive​ 35-year-old female was struck in the head with a softball bat. She has a​ four-inch laceration, and you palpate an unstable area of the occipital region. Fifteen minutes after the​ injury, her vital signs are P​ 48, R 16 and​ irregular, BP​ 216/104, and SpO2 is​ 94% on room air. You should suspect​ a:

skull fracture

A​ 77-year-old female complains of pain in her left upper arm. She tells you she tripped on a rug and fell. Her left proximal humerus is​ unstable, she can move her​ fingers, feel your​ touch, and the radial pulse is present. You should apply​ a(n):

sling and swathe

An unresponsive​ 28-year-old male's face appears​ flattened, and you observe clear fluid draining from his nose. He was an unrestrained front seat passenger and struck his face on the dash during a​ high-speed car crash. He is lying supine on your​ stretcher, and you hear gurgling when he breathes. You​ should:

suction his airway

Why should an apparently minor human bite that breaks the skin be evaluated at the​ hospital?

there is a high risk of infection

A​ 6-year-old male was thrown 10 feet after he was struck by a car. He complains of neck and back pain. The skin on his​ face, shoulders, and arms is pale and diaphoretic. He has no feeling below his nipple​ line, and his skin is warm and pink. You should suspect an injury to​ his:

thoracic spine above T-5

An unresponsive​ 20-year-old male was shot in the left upper abdominal quadrant. His skin is pale and diaphoretic. His airway is​ open, and his lungs are clear to auscultation. You palpate a pulsating mass midline between his xiphoid process and umbilicus. You should​ immediately:

transport him

A​ 71-year-old male has partial thickness flash burns to his face. He tells you he was smoking in the bathroom while on oxygen by nasal cannula when it happened. The hair in his nostrils and eyebrows is singed. While he is speaking to​ you, you notice his voice is becoming more hoarse. He complains that his throat is​ tightening, and he has trouble breathing. You​ should:

transport immediately

A​ 66-year-old male complains of hand pain. Three of his fingers were caught in an industrial sander and pulled off his hand. Bleeding is minor and controlled with a dressing. His coworkers bring you the fingers. You​ should:

wrap the fingers in sterile​ gauze, place them in a plastic​ bag, and place the bag on ice