EMT-Chapter 22 Trauma Overview

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the:

A. thoracic and lumbar spine.

uring your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred:

B. During the tertiary phase

If one or more occupants in the same vehicle are killed in a crash, the EMT should:

A. suspect that all living occupants experienced the same serious trauma.

The index of suspicion is MOST accurately defined as: A. a predictable pattern that leads to serious injuries. B. your concern for potentially serious underlying injuries.

B. your concern for potentially serious underlying 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:

C. 7.

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. recognize that the force of impact was most likely not severe. B. realize that the air bag malfunctioned at the time of impact. C. remember that it could still deploy and seriously injure you. D. suspect that the patient may have experienced serious injuries.

C. remember that it could still deploy and seriously injure you

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. a focused exam of her forearm. B. transport to a community hospital. C. transport to a trauma center. D. a secondary assessment at the scene.

C. transport to a trauma center

Signs of a pulmonary blast injury include:

D. coughing up blood.

Air bags are designed to: A. be used with or without a shoulder harness. B. prevent a second collision inside the car. C. prevent the driver from sustaining head trauma. D. decrease the severity of deceleration injuries.

D. decrease the severity of deceleration injuries

Two of the MOST common mechanisms of injury for blunt trauma are:

D. falls and motor vehicle collisions.

The cervical spine is MOST protected from whiplash-type injuries when the:

D. headrest is appropriately positioned.

During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. as a direct result of the pressure wave. B. during the tertiary phase.

B. during the tertiary phase

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is:

9

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:

B. identify contact points and predict potential injuries.

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. Aortic rupture B. Forehead lacerations C. Flail chest D. Extremity fractures

A. Aortic rupture

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. kinetic energy. B. mechanism of injury. C. index of suspicion. D. potential energy.

B. mechanism of injury

When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. quadruples.

B. quadruples

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. is thrust under the steering column onto the floorboard. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. will most likely be thrown over the steering column.

B. remains in motion until acted upon by an external force

Internal injuries caused by gunshot wounds are difficult to predict because:

B. the bullet may tumble or ricochet within the body.

What types of motor vehicle collisions present the greatest potential for multiple impacts? A. Rotational and rollover B. Rear-end and rotational C. Frontal and rotational D. Lateral and rollover

A. Rotational and rollover

Which of the following statements regarding gunshot wounds is correct? A. The speed of a bullet has a greater impact on causing injury than the mass. B. The size of a bullet has the greatest impact on producing injury. C. High-velocity bullets will cause less severe internal injuries. D. Low-velocity bullets will cause the greatest amount of internal injury.

A. The speed of a bullet has a greater impact on causing injury than the mass

When treating a patient who experienced a pulmonary blast injury, you should: A. avoid giving oxygen under positive pressure. B. administer large amounts of intravenous fluid. C. use a demand valve to ventilate the patient. D. suspect an accompanying cardiac tamponade.

A. avoid giving oxygen under positive pressure

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience?

A. head injury.

When assessing an elderly patient who fell, it is important to remember that:

A. osteoporosis can cause a fracture that may have resulted in the fall.

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. potential airway compromise.

When assessing a patient who experienced a blast injury, it is important to remember that: A. primary blast injuries are the most easily overlooked. B. solid organs usually rupture from the pressure wave. C. primary blast injuries are typically the most obvious. D. secondary blast injuries are usually the least obvious.

A. primary blast injuries are the most easily overlooked

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.

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. underlying cardiac disease. B. bruising of the heart muscle. C. a lacerated coronary artery. D. traumatic rupture of the aorta.

B. bruising of the heart muscle

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?

B. compression of the head against the roof.

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A. Collapsed dashboard B. Intrathoracic hemorrhage C. Deformed steering wheel D. Caved-in passenger door

C. Deformed steering wheel

With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A. It has a direct effect on patient care because of the obvious vehicular damage. B. 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. D. It provides the least amount of information about the mechanism of injury.

C. It is the most dramatic part of the collision and may make extrication difficult

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first:

C. approximate the speed of the vehicle that struck the pedestrian.

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control any obvious bleeding and then: A. auscultate bowel sounds. B. apply a cervical collar. C. assess for an exit wound. D. obtain baseline vital signs.

C. assess for an exit wound

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. capitation. B. conversion. C. cavitation. D. congruent.

C. cavitation

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. dashboard B. steering wheel C. door D. windshield

C. door

A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?

C. energy transmission to the spine.

According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. B. was involved in a motor-vehicle crash in which another patient in the same vehicle was killed. C. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma. D. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury.

C. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

In contrast to a Level III trauma center, a Level I trauma center must: A. be able to stabilize patients before transferring to a higher level facility. B. be involved in trauma prevention programs. C. have general surgeons that are in-house 24 hours a day. D. have access to an emergency physician within 30 minutes.

C. have general surgeons that are in-house 24 hours a day

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:

C. intracranial bleeding.

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. lower-extremity fractures. B. blunt trauma to the head. C. neck and facial injuries. D. open abdominal trauma.

C. neck and facial injuries

Which of the following patients has experienced the MOST significant fall? A. A 5'-0" patient who fell 13' B. A 5'-9" patient who fell 14' C. A 4'-8" patient who fell 13' D. A 4'-6" patient who fell 13'

D. A 4'-6" patient who fell 13'

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. Intrusion into the vehicle B. Dismounted seats C. Steering wheel deformity D. Deployment of the air bag

D. Deployment of the air bag

By what mechanism is a person injured when he or she falls from a significant height? A. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. B. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. C. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. Elevation of the lower extremities B. Early administration of oxygen C. Intravenous fluid administration D. Rapid transport to a trauma center

D. Rapid transport to a trauma center

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. Fractured bones B. Severe burns C. Impaled objects D. Stomach rupture

D. Stomach rupture

Which of the following statements regarding low-energy penetrating injuries is correct? A. Exit wounds are typically easy to locate with low-energy penetrating injuries. B. Internal injuries caused by low-velocity bullets are usually easy to predict. 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.

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. experiences multiple impacts. B. remains within the vehicle. C. is wearing only a lap belt. D. is ejected or partially ejected.

D. is ejected or partially ejected

The energy contained in a moving object is called: A. potential energy. B. latent energy. C. converted energy. D. kinetic energy.

D. kinetic energy

Approximately 25% of severe injuries to the aorta occur during: A. rollover collisions. B. rear-end collisions. C. frontal collisions. D. lateral collisions.

D. lateral collisions

A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:

D. stabilize her entire spine.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:

D. the speed of the fall.

According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if:

D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.

Force acting over a distance defines the concept of: A. kinetic energy. B. potential energy. C. latent energy. D. work.

D. work