EMT - Trauma Overview

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mmHg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport b. Assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport c. Fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport d. Apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport

a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. b. Assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. c. Fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. d. Apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

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

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: a. Cover both of his eyes and transport to the hospital. b. Cover his right eye and flush the left eye with saline. c. Scrape the splinter away with moist, sterile gauze. d. Remove the object with a cotton-tipped applicator.

a. Cover both of his eyes and transport to the hospital.

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? a. Cover it with moist, sterile gauze and secure with an occlusive dressing. b. Irrigate it with sterile water and cover it with a dry dressing. c. Cover the exposed bowel and keep his legs in a straight position. d. Carefully replace the exposed bowel into the abdomen and transport

a. Cover it with moist, sterile gauze and secure with an occlusive dressing.

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? a. Energy transmission to the spine b. Direct trauma to the spinal column c. Lateral impact to the spine d. Secondary fall after the initial impact

a. Energy transmission to the spine

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: a. Gastrointestinal bleeding. b. An aortic aneurysm. c. Intrathoracic hemorrhaging. d. Acute appendicitis.

a. Gastrointestinal bleeding.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: a. Has a history of eye surgeries. b. Regularly sees a family physician. c. Noticed the change during a meal. d. Is allergic to any medications.

a. Has a history of eye surgeries.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: a. Irrigating his right eye laterally. b. Irrigating both eyes simultaneously. c. Covering both eyes and transporting. d. Flushing his eye starting laterally.

a. Irrigating his right eye laterally.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: a. Open his airway and assess his breathing status b. Perform an immediate head-to-toe assessment c. Assess his pulse for rate, regularity, and quality d. Apply high-flow oxygen and assess his injuries

a. Open his airway and assess his breathing status

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes: a. Pinching the patient's nostrils and having him lean forward. b. Packing both nostrils with gauze pads until the bleeding stops. c. Placing a rolled 4″ × 4″ dressing between his lower lip and gum. d. Having the patient pinch his own nostrils and then lie supine.

a. Pinching the patient's nostrils and having him lean forward.

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20' and is lying unconscious on the ground; the power line is lying across his chest. You should: a. Rapidly assess the patient after ensuring that the power line is not live b. Apply insulated gloves and assume manual control of his c-spine c. Quickly but carefully move the patient away from the power line d. Manually stabilizing his head as your partner assesses for breathing

a. Rapidly assess the patient after ensuring that the power line is not live

A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: a. Suction her oropharynx for 15 seconds. b. Visualize her mouth for obvious wounds. c. Begin immediate ventilatory assistance. d. Apply oxygen via a nonrebreathing mask.

a. Suction her oropharynx for 15 seconds.

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.

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned? a. 36% b. 30% c. 27% d. 18%

b. 30%

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: a. Promptly transporting to the hospital. b. Giving him small sips of plain water. c. Covering him with a warm blanket. d. Administering supplemental oxygen.

b. Giving him small sips of plain water.

A 45-year-old male was working on his roof when he fell approximately 12', landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should: a. Obtaining a Glasgow Coma Score value and give him oxygen b. Immobilize his spine and perform a focused secondary exam c. Allow him to refuse transport if his vital signs remain stable d. Perform a rapid head-to-toe exam and immobilize his spine

b. Immobilize his spine and perform a focused secondary exam

A 45-year-old male was working on his roof when he fell approximately 12′, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should: a. Perform a rapid head-to-toe exam and immobilize his spine. b. Immobilize his spine and perform a focused secondary exam. c. Obtain a Glasgow Coma Score value and give him oxygen. d. Allow him to refuse transport if his vital signs remain stable.

b. Immobilize his spine and perform a focused secondary exam.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: a. Carefully assess her upper chest for seatbelt-related injuries. b. Lift the air bag and look for deformity to the steering wheel. c. Extricate her immediately and transport to a trauma center. d. Perform a head-to-toe assessment while she is in the car.

b. Lift the air bag and look for deformity to the steering wheel.

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. Open abdominal trauma b. Neck and facial fractures c. Blunt trauma to the head d. Lower extremity fractures

b. Neck and facial fractures

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: a. Applying a tight pressure dressing b. Padding between the ear and the scalp c. Packing the ear with sterile gauze pads d. Covering the wound with a moist dressing

b. Padding between the ear and the scalp

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to applying 100% oxygen, you should: a. Apply an automated external defibrillator (AED) and take his blood pressure b. Prepare for immediate transport c. Determine if he has cardiac problems d. Apply bulky dressings to the sternum

b. Prepare for immediate transport

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should: a. Assess the quality of her pulse b. Repeat the primary assessment c. Begin assisting her ventilations d. Perform a secondary assessment

b. Repeat the primary assessment

Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of the injury to the: a. Liver b. Spleen c. Pancreas d. Gallbladder

b. Spleen

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: a. Assist his ventilations with a bag-mask device b. Suction his oropharynx for up to 15 seconds c. Immobilize his spine and transport immediately d. Pack his nostrils to stop the drainage of blood

b. Suction his oropharynx for up to 15 seconds

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should: a. Recognize that he needs a needle decompression. b. Immediately perform a rapid head-to-toe exam. c. Administer oxygen and transport to the hospital. d. Circumferentially tape a dressing around his chest.

c. Administer oxygen and transport to the hospital.

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should: a. Place the patient on 100% oxygen. b. Perform a rapid head-to-toe assessment. c. Follow appropriate standard precautions. d. Apply direct pressure to the wound.

c. Follow appropriate standard precautions.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mmHg and his pulse is 120 beats/min and thready. Your should be MOST suspicious that this patient is experiencing: a. An aortic aneurysm b. Acute appendicitis c. Gastrointestinal bleeding d. Intrathoracic hemorrhaging

c. Gastrointestinal bleeding

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: a. Perform a comprehensive secondary assessment to determine why his clinical status has changed. b. Reassess his vital signs and then notify the receiving hospital of the change in his clinical status. c. Insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device. d. Suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

c. Insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: a. Is wearing only a lap belt. b. Remains within the vehicle. c. Is ejected or partially ejected. d. Experiences multiple impacts.

c. Is ejected or partially ejected.

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: a. Packing the ear with sterile gauze pads. b. Applying a tight pressure dressing. c. Padding between the ear and the scalp. d. Covering the wound with a moist dressing.

c. Padding between the ear and the scalp.

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: a. Manually stabilize her left leg, apply a traction split, and then secure her to a long backboard or a scoop b. Carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg c. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps d. Bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher

c. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: a. A detailed assessment of his abdomen. b. Performing a focused physical exam. c. Preparing for immediate transport. d. Applying oxygen via nasal cannula.

c. Preparing for immediate transport.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: a. Requesting a paramedic ambulance b. Carefully monitoring her vital signs c. Rapidly transporting her to the hospital d. Quickly immobilizing her spinal column

c. Rapidly transporting her to the hospital

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: a. Carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. b. Thoroughly irrigate the wound with sterile water and cover it with a sterile dressing. c. Replace the avulsed flap to its original position and cover it with a sterile dressing. d. Carefully probe the wound to determine if the bleeding is venous or arterial.

c. Replace the avulsed flap to its original position and cover it with a sterile dressing.

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. a. 36% b. 45% c. 27% d. 18%

d. 18%

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: a. Request a paramedic ambulance. b. Suspect a severe hemopneumothorax. c. Perform a secondary assessment. d. Aggressively manage his airway.

d. Aggressively manage his airway.

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: a. Apply direct pressure below the lacerated vessel b. Circumferentially wrap a dressing around his neck c. Apply pressure to the closest arterial pressure point d. Apply direct pressure above and below the wound

d. Apply direct pressure above and below the wound

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: a. Perform a secondary assessment. b. Obtain baseline vital signs. c. Apply a nonrebreathing mask. d. Assist the patient's ventilations.

d. Assist the patient's ventilations.

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has: a. A severe closed fracture. b. Damage to the radial nerve. c. Internal hemorrhage. d. Compartment syndrome.

d. Compartment syndrome.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mmHg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: a. Visualize the vaginal area and pack the vagina with sterile dressings b. Allow her to change her clothes and take a shower before you transport c. Arrange for a rape crisis center representative to speak with the patient d. Control any external bleeding, administer oxygen, and transport at once

d. Control any external bleeding, administer oxygen, and transport at once

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mmHg. Which of the following questions would be MOST pertinent to ask him? a. What does your blood pressure normally run? b. Do you take any over-the-counter medications? c. Has blood soaked through your undergarments? d. Have you experienced recent abdominal trauma?

d. Have you experienced recent abdominal trauma?

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should: a. Place a pillow under his arm and apply a sling b. Straighten his arm and apply a board splint c. Perform a rapid secondary assessment d. Immobilize the injury with a sling and swathe

d. Immobilize the injury with a sling and swathe

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a: a. Massive hemothorax b. Tension pneumothorax c. Pericardial tamponade d. Laceration of the aorta

d. Laceration of the aorta

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. Open abdominal trauma. b. Blunt trauma to the head. c. Lower extremity fractures. d. Neck and facial injuries.

d. Neck and facial injuries.

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mmHg and her pulse is 130 beats/min and thread. You should: a. Apply 100% oxygen and immediately transport b. Place her supine and elevate her lower extremities c. Perform a rapid head-to-toe physical assessment d. Provide some form of positive-pressure ventilation

d. Provide some form of positive-pressure ventilation

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: a. Administer oxygen via a nonrebreathing mask b. Advise the child that he will need rabies shots c. Ask the child's father to try to locate the dog d. Report the incident to the appropriate authorities

d. Report the incident to the appropriate authorities

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: a. Obtain baseline vital signs. b. Leave her bicycle helmet on. c. Inspect the helmet for cracks. d. Stabilize her entire spine.

d. Stabilize her entire spine.

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 community hospital. b. A secondary assessment at the scene. c. A focused exam of her forearm. d. Transport to a trauma center.

d. Transport to a trauma center.

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? a. Collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest b. Asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta c. Fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia d. Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

d. Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle