Chapter 27: Trauma Overview - Trauma Patient + the Trauma System

A​ 65-year-old woman tripped and fell. She extended her arms to break her fall and now complains of wrist pain. You should suspect​ a: Question content area bottom Part 1 A. Colles fracture. B. silver spoon fracture. C. greenstick fracture. D. spiral fracture.

A. Colles fracture.

Which term describes how energy is transferred to the human body from the force acting on​ it? Question content area bottom Part 1 A. Dissipation of energy B. Cavitation C. Impact force D. Fragmentation

A. Dissipation of energy

What type of energy is stored in a moving​ body? Question content area bottom Part 1 A. Kinetic B. Velocity C. Inertia D. Acceleration

A. Kinetic

In treating the victim of multisystem​ trauma, what should be addressed after gaining control of the airway and​ ventilation? Question content area bottom Part 1 A. Significant hemorrhage B. Severe fractures C. Body immobilization D. Rapid transport to a trauma center

A. Significant hemorrhage

You are treating a​ 36-year-old female patient who was involved in a motor vehicle crash. She was not wearing a seat belt. A bystander states that the patient was initially unconscious at the scene before your arrival. There is no apparent external trauma aside from a bruise on the front of her head. Is this a patient who is a high priority for rapid​ transport? Question content area bottom Part 1 A. ​Yes, because of the altered mental status and closed head injury. B. ​No; she is a rela

A. ​Yes, because of the altered mental status and closed head injury.

At what height does a fall become severe enough for an adult to necessitate trauma services based solely on the mechanism of​ injury? Question content area bottom Part 1 A. 25 feet B. 20 feet C. 30 feet D. 10 feet

B. 20 feet

Why is the exit wound of a bullet always larger than the entry​ wound? A. As the superheated metal of the bullet proceeds through the​ skin, it burns away all tissue that it touches. The heat destruction radiates into a tubular shape along the trajectory of the​ bullet, causing the​ bullet's exit to be larger than its entrance. B. As the​ bullet's energy dissipates into​ flesh, its kinetic energy is transferred to the tissues. This causes exit wounds that are much larger than entry

B. As the​ bullet's energy dissipates into​ flesh, its kinetic energy is transferred to the tissues. This causes exit wounds that are much larger than entry wounds.

In what form of trauma does the energy exchange cause a chain reaction within various body tissues that​ crush, stretch, and tear their​ structures, resulting in injury at and beneath the​ skin's surface? Question content area bottom Part 1 A. Inertial trauma B. Blunt trauma C. Penetrating trauma D. Kinetic trauma

B. Blunt trauma

According to the​ "golden principles" of prehospital trauma​ care, how quickly should EMS attempt to transport a patient to the hospital after arriving on​ scene? Question content area bottom Part 1 A. Within 15 minutes B. Within 10 minutes C. Within 5 minutes D. Within 20 minutes

B. Within 10 minutes

Which of the following is likely to cause localized trauma​ only? Question content area bottom Part 1 A. Handgun B. Shotgun C. Knife D. Rifle

C. Knife

A​ community-based trauma center is a general hospital with some surgical capability and a commitment to special staff training and resource allocation for trauma patients. This type of trauma center would receive a rating​ of: Question content area bottom Part 1 A. Level I. B. Level II. C. Level III. D. Level IV.

C. Level III.

Injuries from which phase of the blast typically go unsuspected or​ ignored? Question content area bottom Part 1 A. Secondary B. Tertiary C. Primary D. Quaternary

C. Primary

In a frontal​ collision, at what rate does the occupant continue​ forward? Question content area bottom Part 1 A. A rate faster than that of the vehicle B. ​None, since the driver has already stopped C. The rate of the vehicle D. A rate slower than that of the vehicle

C. The rate of the vehicle

The mechanism of injury refers to​ how: Question content area bottom Part 1 A. many injuries the patient has sustained. B. fast the car was going. C. a person was injured. D. far the patient fell.

C. a person was injured.

As blunt impact abruptly halts a portion of the body and inertia causes the remaining anatomy to continue its​ motion, one tissue or organ is pushed into another. What type of injury is​ this? Question content area bottom Part 1 A. Shearing injury B. Stretch injury C. Rupture injury D. Compression injury

D. Compression injury

The three types of impacts associated with motorcycle collisions are​ head-on, ejection,​ and: Question content area bottom Part 1 A. frontal. B. flip. C. rear. D. angular.

D. angular.

When caring for the victim of a motor vehicle​ collision, the EMT should suspect critical injuries if there​ was: Question content area bottom Part 1 A. more than one person injured. B. only a solo occupant. C. another passenger ejected. D. another occupant killed.

D. another occupant killed.

Which of the following adult patients should be transported to a trauma​ center? Question content area bottom Part 1 A. A person in an automobile versus pedestrian collision at 25 miles per hour B. A person who experiences 10 inches of intrusion into the passenger compartment of a vehicle C. A person who fell from 15 feet D. A person in a​ 15-miles per hour motorcycle crash

A. A person in an automobile versus pedestrian collision at 25 miles per hour

Which of the following indicates the need to limit scene time to 10​ minutes? Question content area bottom Part 1 A. Hypoxia B. Bilateral tibia fractures C. Femur fracture D. Respiratory rate of​ 25/minute

A. Hypoxia

Speed being​ equal, which impact is most likely to damage muscles and ligaments of the​ neck? Question content area bottom Part 1 A. Lateral impact B. Frontal impact C. Rear impact D. They are all about the same.

A. Lateral impact

What trauma center designation is given to a regional trauma​ center, usually a university teaching center that is prepared and committed to handle all types of specialty​ trauma? Question content area bottom Part 1 A. Level I B. Level II C. Primary trauma center D. Resource support center

A. Level I

A hospital with what trauma care rating is MOST likely to attempt stabilization of critical trauma patients before transporting them to a facility with​ higher-level trauma​ capabilities? Question content area bottom Part 1 A. Level IV B. Level V C. Level X D. Level I

A. Level IV

Which action has the highest priority in treating the multisystem trauma​ patient? Question content area bottom Part 1 A. Life threats that were identified during the general impression B. Primary assessment C. Circulation D. Airway

A. Life threats that were identified during the general

Which statement is CORRECT about motor vehicle crashes involving rotational impact or a​ rollover? Question content area bottom Part 1 A. Multisystem trauma is common in rollover crashes. B. Crush injuries are less likely to occur to ejected occupants than to occupants who remain in the vehicle. C. Injuries from rotational crashes are easily predictable when compared to other types of impacts. D. Vehicles with a high center of gravity are less likely to roll over than other vehicles.

A. Multisystem trauma is common in rollover crashes.

A​ 22-year-old woman has been involved in a motor vehicle collision. You notice that the dash is deformed. You should suspect injuries to​ the: Question content area bottom Part 1 A. abdomen. B. back. C. extremities. D. face.

A. abdomen.

As a​ high-speed projectile enters the​ body, it can create a pressure wave that extends damage beyond the bullet pathway. This is​ called: Question content area bottom Part 1 A. cavitation. B. fragmentation. C. rotational impact. D. expanding pathway.

A. cavitation.

The​ "platinum 10​ minutes" refers to​ limiting: Question content area bottom Part 1 A. scene time. B. response time. C. assessment time. D. transport time.

A. scene time.

In a motor vehicle​ collision, the impact of the victim within the passenger compartment is​ called: Question content area bottom Part 1 A. the body collision. B. a deceleration impact. C. a tertiary collision. D. an additional impact.

A. the body collision.

In a motorcycle​ collision, burns are most commonly associated​ with: Question content area bottom Part 1 A. the leg being caught between the motorcycle and the ground. B. ignition of the fuel tank. C. continued operation of the engine. D. friction from the slide.

A. the leg being caught between the motorcycle and the ground.

What type of motorcycle impact results in the rider traveling into the​ handlebars? Question content area bottom Part 1 A. ​Head-on B. Ejection C. Angular D. Laying the bike down

A. ​Head-on

What damage is MOST common when a person falls on outstretched​ arms? Question content area bottom Part 1 A. Rotator cuff injury B. Colles fracture C. Elbow dislocation D. ​Mid-shaft humerus fracture

B. Colles fracture

On what factor does the pattern of tertiary phase injuries​ depend? Question content area bottom Part 1 A. Velocity B. Distance and point of impact C. Mass D. Direction

B. Distance and point of impact

A patient who was restrained in his car was involved in a​ head-on collision. Despite his not contacting any internal structure in the​ car, he sustained a myocardial contusion. What law of motion describes this​ injury? Question content area bottom Part 1 A. Acceleration B. Inertia C. Motion D. Deceleration

B. Inertia

You should have a high index of suspicion for critical injury in which of the following motor vehicle​ collisions? Question content area bottom Part 1 A. Vehicle telemetry indicating seatbelts were in use B. Patient with altered mental status C. Injury to a second occupant D. Intrusion of 6 inches into the passenger compartment

B. Patient with altered mental status

Injuries that are received during the secondary blast phase are caused​ by: Question content area bottom Part 1 A. personnel displacement. B. blast projectiles. C. heat or burn injuries. D. overpressure wave.

B. blast projectiles.

When a projectile breaks into smaller​ pieces, increasing the amount of damage to the​ body, this process is called Question content area bottom Part 1 A. force of impact. B. fragmentation. C. dissipation of energy. D. cavitation.

B. fragmentation.

The branch of mechanics that deals with the movements of bodies is called Question content area bottom Part 1 A. velocity. B. kinetics. C. movement. D. kinematics.

B. kinetics.

Understanding the kinetics of trauma should help​ you: Question content area bottom Part 1 A. determine the Glasgow Coma Scale. B. predict injuries. C. determine which trauma center to use. D. decrease your index of suspicion.

B. predict injuries.

The first point of impact in​ head-first falls is​ typically: Question content area bottom Part 1 A. the crown of the head. B. the arms. C. the face. D. the shoulders.

B. the arms.

In caring for a patient with a penetrating​ injury, it is important to remember​ that: A. bullet exit wounds are generally larger than the entrance​ wounds, owing to the tumbling motion of the bullet. B. the severity of injury caused by penetrating trauma is related to the velocity of the penetrating object. C. a shotgun wound is an example of a​ low-velocity injury. D. the damage caused by​ medium-velocity projectiles depends primarily on the profile and the drag of the projectile.

B. the severity of injury caused by penetrating trauma is related to the velocity of the penetrating object.

Vehicle collisions are a common mechanism of injury. It is important to​ remember: Question content area bottom Part 1 A. that the death of an occupant of a vehicle usually means that the occupant absorbed most of the energy and other occupants will be less seriously injured. B. to maintain a high index of suspicion if any passenger appears confused. C. that​ high-speed collisions do not result in any more serious injuries than​ medium- or​ low-speed collisions. D. that mass is a key fac

B. to maintain a high index of suspicion if any passenger appears confused.

Cavitation is a term that is typically associated with which type of​ trauma? Question content area bottom Part 1 A. ​High-velocity blunt trauma B. ​High-velocity penetrating trauma C. ​Low-velocity penetrating trauma D. ​Low-velocity blunt trauma

B. ​High-velocity penetrating trauma

Head injuries and chest injuries such as flail​ chest, blunt cardiac​ injury, and aortic tears commonly result from which pathway in an automobile​ collision? Question content area bottom Part 1 A. Restrained pathway B. ​Up-and-over pathway C. ​Down-and-under pathway D. Ejection pathway

B. ​Up-and-over pathway

Which statement is CORRECT about acceleration and​ deceleration? Question content area bottom Part 1 A. Acceleration and deceleration are not factors in determining force of impact. B. If two cars of the same weight and speed​ stop, one by gradual braking and the other by suddenly striking a telephone​ pole, they exert the same force. C. A faster change in speed results in more force exerted.

C. A faster change in speed results in more force exerted.

What is the first act of patient care that should be performed on the multisystem trauma​ patient? Question content area bottom Part 1 A. Provide oxygenation. B. Control external hemorrhage. C. Establish spinal stabilization. D. Establish a patent airway.

C. Establish spinal stabilization.

In dealing with the victim of multisystem​ trauma, which item should receive your initial​ attention? Question content area bottom Part 1 A. Providing appropriate fluid resuscitation B. Stopping any serious external hemorrhage C. Establishing a patent airway D. Ensuring adequate oxygenation and ventilations

C. Establishing a patent airway

Which of the following is true regarding the golden​ period, the time from injury to definitive treatment that gives the best chance for​ survival? Question content area bottom Part 1 A. All trauma patients should receive surgery within 1 hour. B. The time stops upon delivery at the emergency department. C. The amount of time necessary to reach definitive treatment and have the best chance for survival varies by patient injury. D. It begins when EMS arrives on the scene.

C. The amount of time necessary to reach definitive treatment and have the best chance for survival varies by patient injury.

In a​ rear-end collision, a headrest that is in the fully down​ position: Question content area bottom Part 1 A. can decrease the severity of a whiplash injury. B. protects the driver from a secondary collision. C. can increase the severity of a whiplash injury. D. does not affect the severity of a whiplash injury.

C. can increase the severity of a whiplash injury.

When triaging a​ patient, of the​ following, you should first assess​ the: Question content area bottom Part 1 A. system considerations. B. level of consciousness. C. mechanism of the injury. D. anatomy of the injury.

C. mechanism of the injury.

In a​ foot-first fall, flexing of the knees can result​ in: Question content area bottom Part 1 A. fractures of the pelvis. B. fractures of the hips. C. preservation of the rest of the skeletal system. D. fractures of the spine.

C. preservation of the rest of the skeletal system.

Acceleration and deceleration are measures​ of: Question content area bottom Part 1 A. energy. B. velocity. C. rate. D. mass.

C. rate.

Hospitals that do not have a trauma center designation but that focus on specific areas of trauma​ expertise, such as burns or spinal cord​ injury, are: Question content area bottom Part 1 A. defined scope centers. B. focused care centers. C. specialty centers. D. ​extended-care facilities.

C. specialty centers.

A bullet fired from a gun does more damage than a knife propelled by a human hand​ because: Question content area bottom Part 1 A. the bullet is traveling on its​ own, whereas a knife blade is controlled by a hand. B. the area of impact from the bullet is smaller than that of a knife blade. C. the bullet strikes the body at a higher velocity. D. a bullet fired from a gun can momentarily have more mass than a knife blade.

C. the bullet strikes the body at a higher velocity.

Being struck by a bullet is likely more traumatic than being stabbed by a knife blade due​ to: Question content area bottom Part 1 A. mass. B. inertia. C. velocity. D. trajectory.

C. velocity.

Approximately what percentage of trauma victims are multisystem trauma​ patients? Question content area bottom Part 1 A. ​75% B. ​50% C. ​10% D. ​90%

C. ​10%

Which definition would accurately describe a Level III trauma​ center? A. Usually a university teaching center that is prepared and committed to handle all types of specialty trauma and can provide​ neurosurgery, microsurgery, pediatric​ care, and care for multisystem trauma B. A facility where seriously injured trauma patients may be taken for stabilization and care before​ transport, often by​ helicopter, to a more​ distant, higher-level trauma center C. A facility that has surgica

D. A general hospital with some surgical capability and a commitment to special staff training and resource allocation for trauma patients

A lap belt that is worn too low can result in what injury from a frontal​ crash? Question content area bottom Part 1 A. Fractured pelvis B. Knee fractures C. Abdominal injuries D. Dislocated hips

D. Dislocated hips

Question content area top Part 1 While conducting field triage of injured​ patients, which of the following special considerations indicates a need for transport to a trauma​ center? Question content area bottom Part 1 A. Age greater than 45 years of age B. Eye injuries C. Pregnancy greater than 10 weeks D. Emergency medical service​ (EMS) provider judgment

D. Emergency medical service​ (EMS) provider judgment

What is the term for maintaining suspicion about the types of injuries a patient may have even though the patient presents as very​ stable? Question content area bottom Part 1 A. Sense of injury potential B. Interpretation of bodily forces C. Mild feeling of certainty D. High index of suspicion

D. High index of suspicion

What is the term for an evasive action on the part of a motorcycle rider that is designed to prevent ejection and separation of the driver from the bike in an impending​ collision? Question content area bottom Part 1 A. Ejection prevention B. Positive evasion C. Side swiping D. Laying the bike down

D. Laying the bike down

Which of the following vital signs indicates the need for transport to a trauma​ center? Question content area bottom Part 1 A. Respiratory rate less than 12 B. Pulse rate greater than 90 C. Glasgow Coma Scale score of 14 or less D. Systolic blood pressure less than 90

D. Systolic blood pressure less than 90

In the frontal impact motor vehicle​ collision, the driver will continue to move forward at what rate of​ speed? Question content area bottom Part 1 A. A much higher rate of speed than the vehicle is traveling B. A slightly higher rate of speed than the vehicle is traveling C. A much lower rate of speed than the vehicle is traveling D. The same rate of speed as the vehicle is traveling

D. The same rate of speed as the vehicle is traveling

You arrive on the scene of a motor vehicle collision with multiple patients. Which of the following indicates a need for transport to a trauma​ center? Question content area bottom Part 1 A. Bilateral wrist fractures B. Systolic blood pressure of 98 C. Open femur fracture D. Unstable pelvis

D. Unstable pelvis

The​ "blown outward" appearance of a bullet exit wound is the result​ of: Question content area bottom Part 1 A. the bullet and hot gases. B. damage by the bullet forcing debris and bodily contents out of the wound. C. the bullet and displaced bone fragments. D. damage by the bullet and the cavitational wave.

D. damage by the bullet and the cavitational wave.

If you were hit by a rock thrown at a velocity of 1 foot per​ second, then hit by the same rock thrown at 2 feet per​ second, the rock that was thrown at 2 feet per second would​ be: Question content area bottom Part 1 A. half as harmful as the rock thrown at 1 foot per second because the impact area is greater. B. twice as harmful as the rock thrown at 1 foot per second. C. equally harmful as the rock thrown at 1 foot per second because the mass is equal. D. four times as harmful as the r

D. four times as harmful as the rock thrown at 1 foot per second because velocity is squared.

Injuries that result from the pressure wave of the blast​ are: Question content area bottom Part 1 A. quaternary phase injuries. B. secondary phase injuries. C. tertiary phase injuries. D. primary phase injuries.

D. primary phase injuries.

The MOST common and serious primary phase injuries produced from a blast​ are: Question content area bottom Part 1 A. oxidation. B. severe lacerations. C. head injuries. D. pulmonary injuries.

D. pulmonary injuries.

The path or motion of a projectile during its travel is​ called: Question content area bottom Part 1 A. profile. B. acceleration. C. velocity. D. trajectory.

D. trajectory.

The amount of kinetic energy that a moving body contains is based on its mass​ and: Question content area bottom Part 1 A. viscosity. B. location. C. friction. D. velocity.

D. velocity.

What are the MOST common patterns of impact seen in motorcycle​ collision? Question content area bottom Part 1 A. ​Grill, hood, and windshield B. ​Angulated, lateral, and direct C. ​Pavement, vegetation, and vehicular D. ​Head-on, angular, and ejection

D. ​Head-on, angular, and ejection