Paramedic vol. 4 chapter 2
When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation?
Cardiac arrhythmia
The pathway of injury left in the wake of a penetrating mechanism of injury is called:
cavitation.
As a bullet tumbles, the potential to inflict damage:
increases.
You are called to the scene of a vehicle crash in which a car was rear-ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated index of suspicion for injuries?
A body at rest will remain at rest unless acted on by an outside force.
Which of the following scenarios would likely lead to the development of compartment syndrome?
A crush injury to the lower leg
Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle collision?
A hubcap flies off and strikes a tree.
Which of the following is NOT considered penetrating trauma?
A laceration on the forehead as a result of being struck with a metal pipe
Which of the following is TRUE of shotgun ammunition?
A shotgun may either fire one slug or use ammunition with multiple pellets.
Which of the following injuries is associated with the pressure wave produced by a blast?
Pneumothorax
Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen?
Pneumothorax and diaphragmatic rupture
Which of the following statements about stab wounds is TRUE?
Damage is usually limited to physical injury caused by direct contact between the blade and the victim's tissue.
If you were to design a bullet to have the highest energy exchange, what would you do?
Design the bullet to become more unstable.
Which of the following is typical of the trajectory of a knife when a female assailant stabs someone?
The movement is downward, as the assailant raises the knife and swings downward.
Which of the following statements about low-velocity penetrating trauma is TRUE?
Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.
Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting motion?
Lateral-impact motor vehicle collision
Which pathway of patient travel results in higher mortality with a frontal impact collision?
Up-and-over
Which of the following is TRUE of the injuries sustained by the elderly due to falls?
Less-significant falls may cause fractures.
Infants and very small children (up to two years of age) should have their child safety seat positioned where in a car?
The rear seating area, facing backward
Which of the following is TRUE of body armor use?
Blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn.
Which of the following increases a bullet's profile?
Both A and C
Penetrating trauma to the face can complicate airway management by which of the following mechanisms?
Both B and C
Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating trauma?
Bowel
Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient?
Bridge abutment
Which of the following statements about entrance and exit wounds is TRUE?
Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.
Which of the following is TRUE of the temporary cavity formed by penetrating trauma?
It is a space indirectly created by a projectile as tissue moves rapidly away from its path.
Which of the following is most susceptible to damage from the pressure wave when a bullet enters it?
Liver
Which of the following is considered a high-velocity weapon?
Rifle
To gain an appreciation for the potential for trauma from high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to ________ times.
100
Which of the following is TRUE of the pressure wave that accompanies high-velocity penetrating trauma?
The pressure wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.
Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The air bag deployed. Considering the likelihood of organ collision, for which of the following injuries should you maintain a high index of suspicion?
Abruptio placentae
When inspecting the interior of a vehicle involved in a frontal collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries might this indicate?
All of the above
Which of the following affects the severity of injury sustained in a motor vehicle collision?
All of the above
Which of the following is TRUE about determining the pathway of the bullet when assessing a patient with a gunshot wound?
All of the above
Which of the following mechanisms may result in a conventional explosion?
All of the above
You have arrived on the scene of a 17-year-old male patient with a gunshot wound to the thigh. Police are on the scene. There is significant ongoing hemorrhage from the wound. The patient is screaming for someone to help him. Which of the following should you do first?
Ask the police if they have searched the patient for weapons yet.
Which of the following statements about rifles is TRUE?
Assault rifles generally increase the number of wounds the victim sustains.
Which of the following statements about bullets is TRUE?
A small, light bullet can do significant harm.
Your patient is a 50-year-old man with a gunshot wound to the right anterior chest. He is unresponsive. Which of the following should you do first?
Check for breathing.
During the scene size-up on a call for a patient with penetrating trauma due to a stab wound, which of the following should you do?
Check for weapons on or near the patient.
Which of the following is TRUE of the differences between adult and pediatric pedestrians when struck by a vehicle?
Children tend to be thrown under the vehicle.
Which of the following is most likely to be fractured from a fall onto outstretched hands?
Clavicle
Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "starred," and that the driver is not restrained. Which of the following injuries is most likely?
Compression injury of the cervical spine
Which of the following injuries is associated with the tertiary phase of a blast?
Crush injuries
Which of the following injuries is NOT commonly related to snowmobiling?
Drowning
Which of the following statements is NOT true of occupant ejection in motor vehicle collisions?
Ejection has not been reported with lateral-impact collisions.
Which of the following may result from aggressive ventilation of the blast patient?
Emboli
Which type of motor vehicle collision is most common in rural areas?
Frontal
Which of the following is TRUE regarding a motorcycle collision?
Frontal impact can result in intraabdominal, pelvic, and femur injuries.
Axial loading is most likely to occur in which type of impact?
Frontal with an up-and-over pathway
People in which of the following age groups are prone to significant trauma due to falls?
Geriatric population
Which type of firearm usually limits trauma to direct injury?
Handgun
Which of the following injuries is most likely in a rear-end collision?
Head and neck injuries
Which of the following statements about the impact of motorcycle helmet usage is TRUE?
Helmet use neither increases nor decreases the incidence of cervical spine injury.
Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns?
Hip and femur fractures
Which of the following is associated with assault rifle wounds but not hunting rifle wounds?
Multiple wounds
Your patient is a construction worker who fell 15 feet and has a 3-foot metal concrete reinforcement bar (rebar) impaled in his right thigh. Which of the following is the best action?
If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length.
Which of the following statements is TRUE of the permanent cavity created by penetrating trauma?
It is filled with disrupted tissues, some air, fluid, and debris.
Which of the following is most likely to occur to the bullet when military ammunition is used?
It will remain intact.
The branch of physics dealing with objects in motion and energy exchanges that occur as these objects collide is called what?
Kinetics
Your patient is a 30-year-old woman with a stab wound to the neck. She is sitting up and appears very anxious and short of breath. Minimal external bleeding is noted, but there is bubbling from the wound. Which of the following should you suspect, based on the mechanism of injury and assessment findings?
Laceration of the trachea
Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision?
Lack of a crumple zone
For which of the following impacts should you maintain a higher index of suspicion because the degree of injury may be greater than the damage alone indicates?
Lateral
As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs?
Negative pressure is generated inside the cavity, drawing debris into the wound.
When a patient falls, which section of the spinal column is the most prone to compression injury?
Lumbar
Which of the following is the most important priority when caring for a patient with a shallow-water diving injury?
Maintaining cervical spine stabilization while opening the airway
Your patient is an 8-year-old boy with a pencil impaled 2 centimeters inferior to the xiphoid process. You note that the pencil is pulsating. Which of the following is the best action?
Stabilize the pencil in place and transport to a trauma center.
Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum teres?
Sudden deceleration
Which of the following is NOT a complication of crush injury?
Systemic alkalosis
The primary assessment of a patient with a gunshot wound to the chest should focus on detecting which of the following?
Tension pneumothorax
As the mass of an object increases, which of the following occurs?
The amount of energy increases.
Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier wall?
The body of the vehicle and its occupants absorb the energy.
Which of the following best defines the term energy?
The capacity to do work
Which of the following statements about lateral impact collisions is TRUE?
The degree of injury may be greater than the damage alone would indicate.
Which of the following is most important when assessing the damage done by a gunshot?
The distance from the shooter
Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a stop?
The energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants.
When the driver's chest strikes the steering wheel during a motor vehicle collision, what produces the next injury?
The heart continues its forward motion until it strikes the chest wall.
When you are assessing someone with a gunshot wound from a rifle, which of the following is important to remember?
The zone of injury is larger than that expected with other types of weapons.
Which of the following is TRUE of supplemental restraint systems?
They may deploy during rescue operations, injuring the patient and/or EMS personnel.
Which of the following is TRUE of defense wounds in the victim of a knife attack?
They usually occur to the hands and arms as the victim raises them to ward off the attacker.
A vehicle is struck in its right front as it passes through an intersection, resulting in an oblique impact. Which of the passengers is subjected to the greatest acceleration forces?
The left-rear passenger
Which of the following injuries is NOT associated with the use of vehicle restraint systems?
Traumatic brain injury
A penetrating injury to which of the following organs is LEAST likely to result in severe hemorrhage?
Ureter
Which two factors related to kinetic energy proportionately affect the damage a projectile will do?
Velocity and mass
Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a gun?
Velocity and mass
You have responded to a soccer field on which two 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency department?
Weakness in the upper extremities
Which statement about ballistics is TRUE?
When a bullet yaws, it increases the damage.
Which of the following factors is NOT a consideration in the severity of injury related to falls?
Wind resistance
Which of the following is best described as "the area of contused tissue resulting from penetrating trauma that may be slow to heal due to disrupted blood flow and tissue damage"?
Zone of injury
Vehicle supplemental restraint systems (air bags) are meant to:
absorb the energy exchange of rapid deceleration.
The two factors that refer to the rate of change of speed are:
acceleration and deceleration.
The study of the characteristics of projectiles in motion and their effects on the objects they impact is called:
ballistics
The path a projectile follows during a flight is called its:
trajectory.
Which of the following bullet characteristics would create the most damage?
"Mushrooming" or flattening on impact
Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory.
Flatter; straighter
Which of the following is NOT one of the major types of recreational vehicles involved in crashes?
Go-karts
