Ch. 34
An adult female is found unresponsive after being shot in the chest. Which statement made by your partner is of most concern and indicative of patient deterioration? A. "Her SpO2 has gone from 90% to 93%." B. "I do not think her jugular veins are distended." C. "She is getting more difficult to ventilate." D. "I see an entry wound but cannot find the exit wound anywhere."
C. "She is getting more difficult to ventilate."
Asherman, Halo, and Bolin devices are commercially available devices to use for which injury? A. Pneumothorax B. Flail chest C. Open chest wound D. Commotio cordis
C. Open chest wound
When a patient has a chest injury and exhibits red frothy sputum, there is a high likelihood that she may have a: A. pneumothorax. B. tension pneumothorax. C. hemothorax. D. flail segment.
C. hemothorax.
When blood collects inside the pleural space after a rib fracture that lacerates an intercostal artery, the condition is called a/an: A. hemopneumothorax. B. simple pneumothorax. C. hemothorax. D. open pneumothorax.
C. hemothorax.
When blood collects inside the pericardial sac, the condition is called: A. pressothorax. B. excess pericardial pressure. C. pericardial tamponade. D. hemothorax.
C. pericardial tamponade.
During your rapid trauma examination of a patient with a chest injury, you would assess for air trapped under the skin in the upper chest and neck. If it is present, this condition is called: A. tension pneumothorax. B. tracheal deviation. C. subcutaneous emphysema. D. jugular vein distention.
C. subcutaneous emphysema.
An Emergency Medical Responder asks you to explain a pneumothorax. You would explain that a pneumothorax occurs when: A. Air accumulates around the lung, causing a portion of it to collapse B. Air enters the lung and alveoli from a traumatic opening in the chest wall C. The lung becomes overinflated with air the patient is unable to breathe D. The trachea becomes obstructed, causing the lungs to collapse
A. Air accumulates around the lung, causing a portion of it to collapse
On follow-up, the ED physician informs you that a patient whom you transported earlier was found to have a hemothorax. In this condition: A. Blood collects in the chest cavity, collapsing the lung B. Fluid and blood collect around the heart C. The pleural membranes are punctured by a rib D. The trachea is torn
A. Blood collects in the chest cavity, collapsing the lung
A middle-aged male patient has been stabbed once in the right anterior chest. His airway is patent, respirations tachypneic, pulse weak and rapid, and skin cool and diaphoretic. Breath sounds are clear on the left and severely diminished on the right. JVD and tracheal deviation are present. His SpO2 is 93% on supplemental oxygen via BVM. The vital signs are pulse, 140 beats/min; respirations, 28 breaths/min; and blood pressure, 100/78 mmHg. Your next action should be to: A. Call for an ALS intercept en route to the ED and lift the dressing to see if air escapes during exhalation B. Initiate positive pressure ventilation utilizing FROPVD C. Attempt to relieve the tension while awaiting ALS arrival at the scene D. Await the arrival of ALS to "burp" the dressing between ventilations
A. Call for an ALS intercept en route to the ED and lift the dressing to see if air escapes during exhalation
You are on the scene of a shooting. Your assessment reveals a 23-year-old male who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is actively bleeding. The second wound is to the left lateral chest and bubbles every time the patient exhales. What would your immediate and best action be? A. Cover the chest wound with a gloved hand B. Obtain a sterile dressing and cover the chest wound C. Place direct pressure over the abdominal gunshot wound D. Place the patient on high-concentration oxygen with a nonrebreather face mask
A. Cover the chest wound with a gloved hand
A patient has been shot in the chest with a rifle. Assessment reveals a deteriorating level of consciousness and inadequate breathing. Positive pressure ventilation is being administered, and the entrance wound, which is located midclavicular at the second intercostal space on the left side of the chest, has been covered with an occlusive dressing. Your next priority action would be to: A. Look for a bullet exit wound posteriorly B. Check the blood pressure and determine whether a narrow pulse pressure exists C. Place a cervical collar and initiate spine motion restriction precautions D. Get a full set of vital signs and pulse oximeter reading
A. Look for a bullet exit wound posteriorly
A young boy has an open chest wound to the left lateral thorax after falling off his bike onto a metal spike protruding from the ground. His family is present; they are very upset and crying. As an EMT, you recognize that in this situation, your primary focus is: A. Maintaining oxygenation B. Preventing potential wound infection C. Providing emotional support D. Controlling pain
A. Maintaining oxygenation
An alert and oriented young male fell 5 feet from a stage, impacting a metal railing with the right side of his chest, just under his armpit. The primary assessment is negative for life threats, although he does complain of very painful breathing and has remarkable tenderness and crepitus over the fifth rib laterally in this area. Throughout care, which action is essential to perform? A. Monitor breath sounds B. Splint site with a bulky dressing C. Apply ice to area D. Administer aspirin for pain
A. Monitor breath sounds
Which of the following is in physical contact with the thoracic wall? A. Parietal pleura B. Thoracic pleura C. Visceral pleura D. Intercostal pleura
A. Parietal pleura
Which mechanism of injury produces the conditions for traumatic asphyxia? A. Person pinned between a truck and wall of a building B. Person strangled but not killed in an attempted rape C. Penetrating chest trauma with a high-powered firearm D. Fall of 20 feet from scaffolding onto a concrete sidewalk
A. Person pinned between a truck and wall of a building
Damage to which thoracic tissues can cause impairment of ventilation from a developing pneumothorax? A. Pleural membranes B. Mediastinum C. Pulmonary arteries D. Trachea
A. Pleural membranes
The paramedic is caring for a patient who sustained injuries to the thoracic area in a motor vehicle accident. The patient is having difficulty breathing and has a low oxygen level, but the skin is intact. Which complication of this accident should the paramedic expect is occurring? A. Pneumothorax B. Commotio cordis C. Sucking chest wound D. Pericardial tamponade
A. Pneumothorax
Assessment findings for a 33-year-old female who was shot in the right side of the chest indicate that she has a pneumothorax. As you care for this patient, your primary concern is monitoring the injury for: A. Tension pneumothorax B. Arterial bleeding C. Sucking sound at the wound site D. Infection at the wound site
A. Tension pneumothorax
During your primary assessment of a patient with chest trauma, you determine that he may have a tension pneumothorax. In order to treat this condition, you should: A. call for ALS backup. B. insert a chest tube using items from the OB kit. C. insert an over-the-catheter needle into the affected chest wall. D. call medical command for permission to decompress the chest.
A. call for ALS backup.
Pulmonary contusions are serious injuries because they: A. can interfere with oxygen exchange. B. become very tender. C. take a long time to clot off. D. typically require intubation.
A. can interfere with oxygen exchange.
When a normally healthy 16-year-old female goes into sudden cardiac arrest after being struck in the chest by a lacrosse ball, this is probably due to a condition called: A. commotio cordis. B. ventricular ectopy. C. cardiac contusion. D. sudden paralysis.
A. commotio cordis.
When assessing a patient who sustained blunt trauma to the chest, which assessment finding is most indicative of an injury to the lung, impairing adequate ventilations? A. Extensive bruising to the anterior chest B. Ability to speak only a few words, following by a gasp C. Respiratory rate of 20 breaths/min D. Elevated heart rate and blood pressure
B. Ability to speak only a few words, following by a gasp
The EMT shows that he understands the difference between a pneumothorax and a tension pneumothorax when he makes which statement? A. "A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output." B. "A tension pneumothorax causes blood to accumulate around the lung; a pneumothorax involves the accumulation of only air around the lung." C. "A pneumothorax is caused by a closed chest injury; a tension pneumothorax is caused by an open chest injury." D. "A pneumothorax describes a collapsed lung; a tension pneumothorax involves both a collapsed lung and blood loss."
A. "A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output."
You are treating a patient who was stabbed in the right side of the anterior chest. You have applied an occlusive dressing and administered oxygen when, after a few minutes, you note that the patient seems to be having increased difficulty breathing. What would be the MOST appropriate thing to do at this point? A. "Burp" the dressing by unsealing one side. B. Have the patient sit in the Fowler's position. C. Begin ventilating the patient with a flow-restricted oxygen-powered ventilation device. D. Notify medical direction immediately.
A. "Burp" the dressing by unsealing one side.
On scene at a college football game, a wide receiver is unresponsive after colliding with another player and forcefully taking a helmet to the chest. The athletic trainer reports that the patient is pulseless and apneic. Given the mechanism of injury and patient's presentation, which instruction would be appropriate? A. "Let's apply the AED and follow all prompts." B. "Use the AED but no CPR so we do not worsen the potential chest injury." C. "Before we do anything, we need to put a cervical collar on the patient." D. "Someone start positive pressure ventilation while I check for a blood pressure."
A. "Let's apply the AED and follow all prompts."
Which patient MOST likely has an open chest wall injury? A. A patient with pericardial tamponade after a blow to the chest from a baseball bat B. A patient with a knife wound to the left anterior chest C. A patient who suffered blunt trauma to the sternum during a sporting event D. A patient who was trapped under a car
B. A patient with a knife wound to the left anterior chest
A patient was stabbed in the right anterior chest and is in obvious respiratory distress. As you perform the secondary assessment, which signs and/or symptoms would suggest that she is developing a tension pneumothorax? A. Respiratory distress, absent breath sounds on the left, flat neck veins, tachycardia B. Absent breath sounds on the right, distended neck veins, tracheal deviation to the left C. Absent breath sounds on the left, hypotension, SpO2 of 98%, bradycardia D. Absent breath sounds on the right, tracheal deviation to the right, cyanosis
B. Absent breath sounds on the right, distended neck veins, tracheal deviation to the left
You have applied a nonporous dressing to a stab wound on a patient's chest. The Emergency Medical Responder assisting you asks you why the dressing was taped on three sides and not all four. Your best response is that taping the dressing on three sides: A. Causes less pain for the patient B. Allows trapped air to escape on exhalation C. Decreases the chance of air entering the chest on exhalation D. Permits oxygen to still enter the lungs
B. Allows trapped air to escape on exhalation
On scene, a paramedic directs you to help another EMS crew who is caring for a patient who was hit and trapped under a passenger van that ran into a crowd. As you approach the patient, which scene size-up clue seemingly indicates that the patient is suffering from traumatic asphyxia? A. Wound to the chest making a sucking sound B. Bluish discoloration to the neck and face C. Bilateral femur deformity D. Abdominal bruising and distention
B. Bluish discoloration to the neck and face
A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which structure has been injured? A. Bronchiole B. Esophagus C. Diaphragm D. Lungs
B. Esophagus
A construction foreman was stabbed with a screwdriver in the right anterior chest by an angry employee. Prior to your arrival, he removed the screwdriver. He is alert and oriented and complains of pain to the injury site. Your primary assessment reveals an open airway, adequate breathing, and strong radial pulse. Based on these findings, which intervention should be performed next? A. Take manual spine motion restriction precautions B. Evaluate the patient's SpO2 level C. Insert a nasopharyngeal airway D. Open the airway using the jaw-thrust maneuver
B. Evaluate the patient's SpO2 level
You are managing a patient with a large flail segment to the right lateral chest. With this condition, you should recognize that the immediate threat to life is: A. Infection B. Hypoxia C. Rib fractures D. Blood loss
B. Hypoxia
You are transporting a young and healthy female patient who was involved in a motor vehicle collision, during which she struck her chest on the steering column. Although the primary assessment reveals no life threats, the patient does have redness to her sternum, as well as pain and tenderness. Breath sounds are clear and present bilaterally, and vital signs are within normal limits. As you transport and reassess this patient, which sign or symptom would indicate the immediate need for ALS? A. Development of bruise over sternum B. Onset of an irregular heartbeat C. Increased tenderness over sternum D. New complaint of leg pain
B. Onset of an irregular heartbeat
Assessment findings for a patient who was thrown from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 of 92%. Breath sounds are clear and equal bilaterally. The segment has been stabilized, and you are prepared to start positive pressure ventilation. Given these assessment findings, which type of injury underlying the flail segment is your primary concern? A. Hemothorax B. Pulmonary contusion C. Pneumothorax D. Rib fractures
B. Pulmonary contusion
Of the signs and symptoms of a developing tension pneumothorax, which is the MOST important to recognize? A. Jugular vein distention B. Severely decreased or absent breath sounds on the injured side C. Extreme anxiety and apprehension D. Tachycardia
B. Severely decreased or absent breath sounds on the injured side
Which of the following is housed in the mediastinum? A. Kidneys B. Trachea C. Small Intestine D. Jugular veins
B. Trachea
Which of the following is in physical contact with the lung? A. Parietal pleura B. Visceral pleura C. Intercostal pleura D. Thoracic pleura
B. Visceral pleura
During your physical examination of a patient who was hit in the chest with a baseball bat, you notice that a small section of his rib cage sinks when he inhales and moves outward when he exhales. This is known as: A. hemothorax. B. paradoxical movement. C. a sucking chest wound. D. opposition movement.
B. paradoxical movement.
If a patient has an open chest wound that allowed air to accumulate into the pleural cavity to the point at which the lung is totally collapsed and is starting to shift to the other side, this additional complication is known as: A. hemothorax. B. tension pneumothorax. C. pericardial tamponade. D. commotio cordis.
B. tension pneumothorax.
Your patient has received a blunt trauma injury to the chest from being hit with a baseball bat. You notice a flail segment, lung sounds are diminished, and the patient is having difficulty breathing. You note that the trachea is deviating toward the uninjured side. You suspect a/an: A. hemothorax. B. tension pneumothorax. C. pneumothorax. D. open wound that you cannot see.
B. tension pneumothorax.
The EMT arrives on the scene of a multi-vehicle collision and notices a patient having difficulty breathing. The patient presents with a mediastinal shift and absent breath sounds on the right side. Which should the EMT do to provide the best care for this patient? A. Insert a chest tube into the intercostal space. B. Apply a dry sterile dressing to the wounds. C. Arrange for advanced life support (ALS) backup. D. Intubate and begin mechanical ventilation.
C. Arrange for advanced life support (ALS) backup.
You are called to the scene of a single car crash. The driver has been extricated by the fire department, and he is found supine on a backboard complaining of severe chest pain. You can palpate multiple rib fractures on his left anterior and lateral thorax. Breath sounds are diminished on the left and clear on the right, and the pulse oximeter reads 88% on high-flow oxygen. Respirations are rapid and shallow. As you try to initiate positive pressure ventilation, the patient screams, pushing back against the bag-valve-mask. What should you do? A. Disable the relief valve on the BVM. B. Place the patient on CPAP. C. Call for ALS backup. D. Circumferentially wrap the chest to splint the fractures.
C. Call for ALS backup.
An unrestrained female driver hit a utility pole with her vehicle at a moderate rate of speed. During the impact, she struck the steering wheel with her chest. The patient's airway is open, and she states that it is painful to breathe. Her pulse is moderate in strength, irregular, and tachycardic. Breath sounds are equal bilaterally, and no jugular venous distention is noted. Assessment of her chest reveals bruising and instability to the sternum. When asked, she denies any past medical history. Based on this mechanism and the assessment findings, the EMT should be suspicious of which condition? A. Traumatic asphyxia B. Tension pneumothorax C. Cardiac contusion D. Pneumothorax
C. Cardiac contusion
You have been called to a New Year's Eve party for a male patient who was stabbed in the anterior chest. According to partygoers, the patient went outside with another male and was stabbed. Fifteen minutes later, he was found in the snow, and 911 was called. When assessing this patient, which finding would you consider to be the most serious and warranting immediate attention? A. Pain and bruising to the left thigh B. Complaint of a worsening headache C. Decreased breath sounds to the left lung D. Capillary refill of 3 seconds
C. Decreased breath sounds to the left lung
Reduced tidal volume due to shifting of expiratory air from the uninjured side to the injured side is a common result of which injury? A. Mediastinal shift B. Rib fracture C. Flail segment D. Pneumothorax
C. Flail segment
A confused 62-year-old female fell at home, hitting the side of a table with her chest. Assessment reveals instability to the left lateral chest, accompanied by minor bruising in the same area. The patient complains of intense pain every time she breathes. Her airway is patent, breathing is rapid and shallow, and skin warm and non-diaphoretic. Vital signs are pulse, 112 beats/min; respirations, 24 breaths/min; blood pressure, 132/64 mmHg; and SpO2, 90%. Breath sounds are somewhat shallow but still equal to both lungs. Based on those findings, you should treat this patient for which life-threatening condition? A. Pain B. Shock C. Hypoxia D. Pneumothorax
C. Hypoxia
You suspect that a patient with an open pneumothorax may be developing a tension pneumothorax. Which action is critical given this situation? A. Ensure that all four sides of the dressing are taped B. Gently apply pressure to the chest during inhalation C. Lift one side of the dressing during exhalation D. Remove the occlusive dressing
C. Lift one side of the dressing during exhalation
What type of injury would be created as the result of a penetrating chest wound? A. Sustained B. Internal C. Open D. Blunt
C. Open
A 39-year-old male has a single stab wound to the anterior chest. When notifying the emergency department, you inform them that the patient has a/an: A. Flail chest B. Laceration C. Open chest injury D. Evisceration
C. Open chest injury
A middle-aged male has been stabbed once in the left anterior chest. His airway is patent, respirations tachypneic, pulse weak and rapid, and skin cool and diaphoretic. Breath sounds are clear and equal bilaterally. The vital signs are pulse, 140 beats/min; respirations, 24 breaths/min; blood pressure, 100/78 mmHg; and SpO2, 96% on supplemental oxygen. JVD is present. Given this presentation, you would have a high index of suspicion for: A. Pneumothorax B. Fail segment C. Pericardial tamponade D. Hemothorax
C. Pericardial tamponade
The EMT is assessing a patient who sustained injuries in a motor vehicle-pedestrian accident and notices a 20 mmHg drop in the systolic blood pressure when the patient inhales. Which term should the EMT use in the medical record to document this occurrence? A. Crepitation B. Jugular vein distention C. Pulsus paradoxus D. Pneumothorax
C. Pulsus paradoxus
A young male patient has self-extricated from his vehicle after hitting a telephone pole and rolling his car several times at a high rate of speed. He is spitting blood and has a large area of tenderness and soft tissue injury to the left side of his chest. On scene, you did not observe any paradoxical motion of the chest wall. The patient remains alert and oriented with stable vital signs, but continually complains of painful breathing. During transport, what is it essential that you do? A. Apply bulky dressings to the area of chest injury B. Place a nonporous dressing and ice packs to the injured area C. Reassess for paradoxical motion of the chest wall D. Start positive pressure ventilation with supplemental oxygen
C. Reassess for paradoxical motion of the chest wall
You suspect a trauma patient has a hemothorax to the left lung. Which assessment finding would reinforce this suspicion? A. Neck vein distention and absent breath sounds to the right lung B. Bradycardia and hypertension C. Respiratory distress and the signs and symptoms of shock D. Cyanosis and a blood pressure of 210/100 mmHg
C. Respiratory distress and the signs and symptoms of shock
During the secondary assessment, the EMT notes instability and a flail segment to a patient's lower left lateral chest. The EMT would immediately: A. Apply bulky dressings to the area B. Start positive pressure ventilation C. Stabilize the segment with his hand D. Auscultate breath sounds
C. Stabilize the segment with his hand
An unrestrained 32-year-old female motorist hit a utility pole head-on at 45 mph. The car sustained extensive damage. The patient has an open airway, is breathing poorly at 32 breaths per minute with absent alveolar breath sounds, and is responsive to painful stimuli. Her radial pulse is rapid and weak, and her skin is cool and cyanotic. Breath sounds are decreased on the right side. Emergency Medical Responders are initiating spine motion restriction precautions. Your next action would be to: A. Palpate the chest wall for instability B. Place a cervical collar C. Start positive pressure ventilation D. Examine the patient for additional injuries
C. Start positive pressure ventilation
A 42-year-old male was involved in a fight and was stabbed in the right lateral chest. The knife is still impaled, and the patient now complains of shortness of breath. When he speaks, he gurgles and blood drains from his mouth. His respirations are labored and his radial pulse is weak. Which intervention should you perform first? A. Stabilize the knife with bulky dressings B. Provide positive pressure ventilation C. Suction the blood from the airway D. Remove the knife and seal the injury with an occlusive dressing
C. Suction the blood from the airway
In which thoracic injury is a mechanical collapse of the vena cava involved? A. Simple pneumothorax B. Open pneumothorax C. Tension pneumothorax D. Pericardial tamponade
C. Tension pneumothorax
Why would it be inappropriate to pull out a knife that is impaled in a 22-year-old female's left anterior chest? A. The knife may create a hole in the stomach or kidney if it is pulled out. B. The surgeons will want to see the knife. C. The knife may be sealing a hole in a great vessel or the heart. D. The knife may have fingerprints on the handle.
C. The knife may be sealing a hole in a great vessel or the heart.
Which of the following is accurate in regard to a pneumothorax? A. Each time the chest wall expands, the vacuum between the pleura decreases. B. Pressure on the lung increases as the pleural space decreases. C. Younger patients may not become hypoxic with a complete pneumothorax. D. A hole the size of a penny would be considered a severe injury.
C. Younger patients may not become hypoxic with a complete pneumothorax.
A pneumothorax may occur when: A. a fractured rib breaks through the skin of the outer chest and keeps the wound sealed with the bone end. B. a sucking chest wound is sealed with an occlusive dressing taped on only three sides. C. air leaks into the chest cavity from a damaged lung, with no opening through the outer chest. D. a hemothorax caused by a penetrating wound to the chest is left untreated for an extended period.
C. air leaks into the chest cavity from a damaged lung, with no opening through the outer chest.
During your secondary assessment of a patient with a chest injury, you should: A. begin with a focused physical examination of the chest. B. palpate the chest during your examination and frequently thereafter during transport to continually reassess for pain. C. auscultate the breath sounds bilaterally. D. obtain a SAMPLE history before beginning your physical examination.
C. auscultate the breath sounds bilaterally.
Cardiac tamponade occurs when: A. pressure from a tension pneumothorax compresses the heart. B. the chest is crushed, exerting pressure on the heart and forcing blood back into the jugular veins. C. blood enters the pericardial sac surrounding the heart. D. air enters the pericardial sac surrounding the heart.
C. blood enters the pericardial sac surrounding the heart.
Two or more adjacent ribs that are broken in two or more places is called a/n: A. commotio cordis. B. tension pneumothorax. C. flail segment. D. paradoxical segment.
C. flail segment.
When a patient who sustained blunt trauma to the chest wall has two or more rib fractures in two or more adjacent ribs, this is called a: A. cardiac contusion. B. commotio cordis. C. flail segment. D. cardiac tamponade.
C. flail segment.
When assessing a patient, which sign or symptom is most indicative of a pneumothorax? A. Intense pain with each inspiration B. Crepitus and instability to the chest wall C. SpO2 of less than 90% on supplemental oxygen D. Decreased breath sounds to the right lung
D. Decreased breath sounds to the right lung
In addition to maintaining the airway and providing high-flow oxygen, what additional care or consideration is critical when treating a patient in which you suspect pericardial tamponade? A. Call medical command for guidance. B. Perform a needle aspiration of the pericardial sac. C. Call for ALS backup to decompress the chest. D. Initiate rapid transport to the ED.
D. Initiate rapid transport to the ED.
You are transporting a 19-year-old male with a gunshot wound to the chest. On scene, you covered the wound with an appropriate dressing. Now, as you reassess the patient, you note that the patient is tachypneic and complains of increased difficulty breathing. Breath sounds on the side of the injury are diminished. Your immediate action would be to: A. Tape the dressing on the fourth side B. Provide positive pressure ventilation with high-concentration oxygen C. Cover the wound with another dressing D. Lift the dressing from the wound briefly during exhalation
D. Lift the dressing from the wound briefly during exhalation
Which injury is virtually always the result of penetrating chest trauma? A. Myocardial aneurysm B. Commotio cordis C. Aortic rupture D. Pericardial tamponade
D. Pericardial tamponade
A paramedic has asked that you apply a dressing over a sucking chest wound. Which option is the best choice to cover this injury? A. Clean washcloth B. Sterile gauze soaked in sterile water C. Dry sterile gauze dressing D. Petroleum gauze
D. Petroleum gauze
A patient with blunt chest wall trauma has a flail section to her chest. She is conscious and confused, her breathing is rapid and shallow, and breath sounds are diminished bilaterally. After manually stabilizing the flail section of the chest wall, the EMT best treats this condition by: A. Administering supplemental oxygen through a nonrebreather face mask B. Applying ice packs to the flail segment C. Inserting an oropharyngeal airway and ventilating the patient on room air D. Providing positive pressure ventilation with oxygen attached
D. Providing positive pressure ventilation with oxygen attached
Which term is used for bleeding that occurs in and around the alveoli, reducing oxygen exchange? A. Hemolytic wash-out B. Pneumothorax C. Pulmonary hemorrhage D. Pulmonary contusion
D. Pulmonary contusion
Which sign or symptom would FIRST lead you to believe that your patient has a tension pneumothorax? A. Tachycardia B. Decreased blood pressure C. Tracheal deviation D. Severely decreased or absent breath sounds on the injured side
D. Severely decreased or absent breath sounds on the injured side
A patient has been involved in a motorcycle crash and has a flail segment to the right lateral chest. His airway is open and he is breathing poorly at 24 breaths per minute with a decreasing SpO2. The EMT shows that he is appropriately caring for this injury when he: A. Places an ice pack over the site of injury B. Positions the patient in semi-Fowler's position for transport C. Administers oxygen through a nonrebreather face mask D. Starts positive pressure ventilation
D. Starts positive pressure ventilation
The EMT's primary concern with any open injury to the chest is: A. Checking for intercostal muscle damage B. Controlling internal bleeding C. Evaluating for crepitus D. Stopping air entry
D. Stopping air entry
An open chest wound that pulls air into the thoracic cavity is known as what type of injury? A. Tension B. Blowing C. Blind D. Sucking
D. Sucking
A 23-year-old female has been involved in a serious motor vehicle collision. Which assessment finding best indicates that she has a flail segment? A. Decreasing SpO2 reading despite high-flow oxygen B. Shortness of breath upon exertion C. Intense pain with deep inspiration D. Uneven chest wall movement during breathing
D. Uneven chest wall movement during breathing
When two or more adjacent ribs are fractured in two or more places, the injury is called: A. hemothorax. B. tension pneumothorax. C. pneumothorax. D. flail segment.
D. flail segment.
Which statement made by an EMT demonstrates an understanding of chest trauma? A. "In general, an open chest injury caused by blunt trauma is more life threatening than a closed one due to increased potential for blood loss." B. "Closed chest injuries are caused by penetrating trauma and cause more life-threatening injuries than do open chest injuries." C. "Open chest injuries are more serious than closed chest injuries, because air and bacteria can enter the chest through the open wound." D. "Closed chest injuries are caused by blunt trauma, and can be just as serious as open chest injuries."
D. "Closed chest injuries are caused by blunt trauma, and can be just as serious as open chest injuries."
A new EMT who just started working with your EMS system asks you to quickly describe a flail segment. Which statement best describes this injury? A. "Multiple rib fractures have bruised the underlying lung." B. "Fractured ribs have collapsed the underlying lung." C. "Multiple fractures to the rib cage are caused by blunt trauma." D. "Two or more adjacent ribs are broken in two or more places."
D. "Two or more adjacent ribs are broken in two or more places."