Chapter 27

A patient has been stabbed with a knife at the fifth intercostal space on the right side of the chest in an attempt suicide. Assessment reveals him to be short of breath and coughing. Which question is it most important for the EMT to ask regarding the weapon?

"How long was the knife blade?"

The EMT understands the importance of evaluating the mechanism of injury when he states:

"The mechanism of injury can be used to guide the EMT's injury assessment and treatment of the patient."

Two cars have collided head-on. One car was traveling at a speed of 55 mph and the other at 35 mph. The total speed of impact would be:

90 mph

After assessing these patients, which would the EMT identify as suffering from multi-system trauma?

A 61-year-old male who became dizzy and fell down five stairs, and who has a laceration to the head and open fracture of the left lower leg.

A bullet fired from a gun at close range passes through the patient's liver. However, on autopsy, the coroner discovers that the man's pancreas, stomach, and gallbladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which mechanism is responsible for injuries to these additional organs?

Cavitation

A 27-year-old male was involved in an altercation and was struck in the ribs with a baseball bat. Assessment reveals intact skin with bruising to the right lateral chest. When palpating this area, pain, instability, and crepitus are all observed. The patient also complains of difficult and painful breathing. The EMT would recognize:

Chest injury caused by blunt trauma

Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another vehicle at a high rate of speed. The patient was unrestrained and his car did not have air bags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury pattern, the EMT would recognize which type of injury mechanism?

Down and under

You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A paramedic, who has already triaged the nine patients involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this presentation, the EMT would recognize the injury was likely sustained:

During the primary blast phase

A teenage female patient was ejected from a car as it rolled down a hill after she ran off the road. She is responsive, but with signs of early shock and respiratory distress. She has bruising to her anterior abdomen and chest, a laceration to her left temple, and deformity to her left wrist. At which point should the wrist injury be splinted?

En route to the hospital

Which phase of information would you provide to a group of young teenage drivers to decrease their chance of suffering a "whiplash"-type injury if involved in a motor vehicle collision?

Ensure that the head rest is properly positioned

You are first on the scene of a two-car motor vehicle collision. Two patients are entrapped in one vehicle. In the other vehicle, there is a male driver complaining of chest pain. During this time, your primary concern is:

Ensuring personal safety

A patient with severe head and neck pain states that he was properly wearing his seat belt when another car struck him from behind. As a knowledgeable EMT, you would realize that the complaint of:

Head and neck pain could occur even when the seat belt is properly worn.

Which injury is most serious, warranting immediate and rapid transport to the local trauma center?

Instability and crepitus to the left lateral chest wall

A car has been hit head-on by another vehicle at a moderate rate of speed. Seat belts were in place and the air bags deployed. The patient complains of chest pain. Quick observation reveals a bruise to his sternum. The EMT should immediately:

Lift the air bag and check for steering wheel deformity

Which of the statements concerning trauma is most accurate?

Multi system trauma has a higher mortality rate than single-system injuries

An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion to his heart. The EMT would recognize that this injury occurred during which impact of the collision?

Organ collision

You arrive at the scene where a young male patient fell out of a tree he was climbing. Although he fell from a lower branch, he was still reportedly 10-12 feet in the air when he fell. The patient landed on his side on the ground. Which element of the kinematics of trauma would explain the mechanism of any injuries he may have sustained?

Rapid deceleration

A "whiplash"-type neck injury is most often observed with which type of collision?

Rear-end impact

A patient, who was constructing a bomb in his basement, has sustained a secondary-phase blast injury. Which presentation would the EMT most likely observe from this blast phase?

Screwdriver impaled in the thorax

An 8-year-old boy fell forward off of a swing onto outstretched arms. He did not hit his head or lose consciousness and is complaining of left forearm pain. There is deformity to the left wrist, but no other injuries or life threats. His vital signs are pulse 132 beats/min, respirations 20 breaths/min, blood pressure 108/62 mmHg, and SpO2 100%. The proper care of this patient would be to:

Secure the forearm to a padded board splint and apply a cold pack to the injury site before transporting the patient nonemergently

A 49-year-old male has been stabbed in the lower right chest. Police tell you that the patient got into an argument with an unidentified man, who then stabbed him before fleeing the scene. After assessing the patient, you are suspicious that the knife punctured the lung and is causing internal bleeding. In this situation, the mechanism of injury would be:

Stab wound to the right chest

As you pull up to a motor vehicle collision, you quickly scan the scene for clues as to the type of severity of injuries. Which observation would best indicate that a patient may have a head injury?

Starburst on the windshield

When teaching Emergency Medical Responders about air bags, which point would you emphasize?

The benefit of air bags is lessened in a multiple-vehicle collision impact

Which statement best characterizes the capabilities of a Level III trauma center?

The hospital has some surgical capabilities to help trauma patients, but will generally stabilize them and still arrange transfer.

An unrestrained female driving a small car is involved in a rollover-type collision. Why is her risk for serious injury or death significantly increased?

There are more impacts in a rollover causing injury