EMT 27 CHEST INJURIES

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An open pneumothorax occurs when:

A. air enters the pleural space from outside the body.

Patients with rib fractures will commonly:

A. breathe rapidly and shallowly.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

A. partially remove the dressing.

Very young children tend to breathe predominantly with their diaphragm because:

A. their intercostal muscles are not fully developed.

A flail chest occurs when:

B. a segment of the chest wall is detached from the thoracic cage.

Pneumothorax is defined as:

B. accumulation of air in the pleural space.

The thoracic cavity is separated from the abdominal cavity by the:

B. diaphragm.

When assessing a patient with a hemothorax, you will MOST likely find:

B. signs and symptoms of shock.

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

B. ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

Subcutaneous emphysema is an indication that:

C. air is escaping into the chest wall from a damaged lung.

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

C. engorged jugular veins

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

C. immediately request ALS support.

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a:

C. myocardial contusion.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

D. aggressively manage his airway.

Hemoptysis is defined as:

D. coughing up blood.

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:

D. must increase his or her respiratory rate to maintain adequate minute volume.

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

D. pneumothorax.

A patient who presents with profound cyanosis following a chest injury:

D. requires prompt ventilation and oxygenation.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:

D. traumatic aortic rupture.

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:

pleurisy


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