Chapter 24: Trauma Overview
The phenomenon that results from the rapid changes in tissue and fluid pressure that occur with the passage of a projectile, resulting in serious injury to internal organs distant to the actual path of the bullet, is known as what? (a) Cavitation (b) Drag (c) Fragmentation (d) Tumble
(a) Cavitation
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? (a) Compression of the head against the roof (b) Lateral bending of the neck during the crash (c) Impact of the head against the steering wheel (d) Whiplash injury to the neck during the rollover
(a) Compression of the head against the roof
When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. (a) door (b) dashboard (c) windshield (d) steering wheel
(a) door
Two of the MOST common mechanisms of injury for blunt trauma are: (a) falls and motor vehicle collisions. (b) low-caliber gunshot wounds and falls. (c) gunshot wounds and vehicle ejections. (b) motor vehicle collisions and stabbings.
(a) falls and motor vehicle collisions.
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: (a) the speed of the fall. (b) the surface struck. (c) the height of the fall. (d) the primary impact point.
(a) the speed of the fall.
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: (a) transport to a trauma center. (b) a focused exam of her forearm. (c) transport to a community hospital. (d) a secondary assessment at the scene.
(a) transport to a trauma center.
You are assessing a patient who was in a front-end car crash. His GCS is 12, systolic blood pressure is 81 mm Hg, and respiratory rate is 22 breaths/min. What is this patient's Revised Trauma Score? (a) 7 (b) 10 (c) 12 (d) 15
(b) 10
You would use the Revised Trauma Score scoring system for a patient if there is potential for what type of trauma? (a) Abdominal (b) Head (c) Chest (d) Extremity
(b) Head
In which type of vehicle crash are you most likely to find a patient with whiplash injuries? (a) Frontal (b) Rear-end (c) Rollover (d) Rotational
(b) Rear-end
What type of blast injury occurs when objects are propelled by the force of the blast wave and strike the victim, causing injury? (a) Primary (b) Secondary (c) Tertiary (d) Quaternary
(b) Secondary
Which of the following has the greatest impact on producing injury? (a) Mass (b) Speed (c) Distance (d) Gravity
(b) Speed
When evaluating the mechanism of injury of a car-versus-pedestrian collision, you should first: (a) determine if the patient was propelled away from the vehicle. (b) approximate the speed of the vehicle that struck the pedestrian. (c) evaluate the vehicle that struck the patient for structural damage. (d) determine if the patient was struck and pulled under the vehicle.
(b) approximate the speed of the vehicle that struck the pedestrian.
In contrast to a Level III trauma center, a Level I trauma center must: (a) be involved in trauma prevention programs. (b) have general surgeons who are in-house 24 hours a day. (c) have access to an emergency physician within 30 minutes. (d) be able to stabilize patients before transferring to a higher level facility.
(b) have general surgeons who are in-house 24 hours a day.
The energy of a moving object is called: (a) latent energy. (b) kinetic energy. (c) potential energy. (d) converted energy.
(b) kinetic energy.
When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: (a) index of suspicion. (b) mechanism of injury. (c) kinetic energy. (d) potential energy.
(b) mechanism of injury.
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: (a) injury to the cervical spine. (b) potential airway compromise. (c) damage to internal structures. (d) alterations in his mental status.
(b) potential airway compromise.
You are assessing a patient who opens her eyes when you speak to her, who can respond to you but seems confused as to time and place, and localizes pain. What is her Glasgow Coma Scale score? (a) 7 (b) 10 (c) 12 (d) 15
(c) 12
How many collisions are there in a typical vehicle impact? (a) 1 (b) 2 (c) 3 (d) 4
(c) 3
Which of the following statements regarding the first collision that occurs during a motor vehicle crash is correct? (a) It provides the least amount of information about the mechanism of injury. (b) It has a direct effect on patient care because of the obvious vehicular damage. (c) It is the most dramatic part of the collision and may make extrication difficult. (d) It occurs when the unrestrained occupant collides with the interior of the vehicle.
(c) It is the most dramatic part of the collision and may make extrication difficult.
What level of trauma center provides prompt assessment, resuscitation, and stabilization of injured patients and emergency operations, but not definitive care for all patients? (a) Level I (b) Level II (c) Level III (d) Level IV
(c) Level III
At what step in the ACS-COT/CDC updated field triage decision scheme would you assess mechanism of injury and evidence of high-energy impact? (a) Step 1 (b) Step 2 (c) Step 3 (d) Step 4
(c) Step 3
If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? (a) Severe burns (b) Fractured bones (c) Stomach rupture (d) Impaled objects
(c) Stomach rupture
Which of the following patients has experienced the MOST significant fall? (a) a 4′8″ patient who fell 12 feet (b) a 5′0″ patient who fell 13 feet (c) a 4′6″ patient who fell 13 feet (d) a 5′9″ patient who fell 14 feet
(c) a 4′6″ patient who fell 13 feet
When treating a patient who experienced a pulmonary blast injury, you should: (a) use a demand valve to ventilate the patient. (b) suspect an accompanying cardiac tamponade. (c) avoid giving oxygen under positive pressure. (d) administer large amounts of intravenous fluid.
(c) avoid giving oxygen under positive pressure.
While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is rapid and irregular. You should be MOST suspicious for: (a) underlying cardiac disease. (b) a lacerated coronary artery. (c) bruising of the heart muscle. (d) traumatic rupture of the aorta.
(c) bruising of the heart muscle.
Internal injuries caused by gunshot wounds are difficult to predict because: (a) the caliber of the bullet is frequently unknown. (b) the area of damage is usually smaller than the bullet. (c) the bullet may tumble or ricochet within the body. (d) exit wounds caused by the bullet are usually small.
(c) the bullet may tumble or ricochet within the body.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash. (a) thoracic and sacral (b) lumbar and coccygeal (c) thoracic and lumbar (d) lumbar and sacral
(c) thoracic and lumbar
Which of the following statements regarding low-energy penetrating injuries is correct? (a) Internal injuries caused by low-velocity bullets are usually easy to predict. (b) Exit wounds are typically easy to locate with low-energy penetrating injuries. (c) It is usually easy to differentiate between an entrance wound and an exit wound. (d) The area of injury is usually close to the path the object took through the body.
(d) The area of injury is usually close to the path the object took through the body.
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: (a) determine the vehicle's speed at the time of impact. (b) assess the severity of the third collision of the crash. (c) recognize if the driver hit the brakes before impact. (d) identify contact points and predict potential injuries.
(d) identify contact points and predict potential injuries.
During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: (a) 7. (b) 8. (c) 9. (d) 10.
(a) 7.
