Trauma Overview

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: Select one: A. 7. B. 10. C. 8. D. 9.

7

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: Select one: A. 10. B. 9. C. 11. D. 8.

9

Which of the following is NOT one of the three types of collisions in a typical impact in a motor vehicular crash? Select one: A. Collision of a car against another car, a tree, or another object B. Collision of two passenger bodies within the same vehicle C. Collision of the internal organs against the body's solid structures D. Collision of the passenger against the interior of the car

Collision of two passenger bodies within the same vehicle

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? Select one: A. Compression of the head against the roof B. Whiplash injury to the neck during the rollover C. Impact of the head against the steering wheel D. Lateral bending of the neck during the crash

Compression of the head against the roof

Signs of a pulmonary blast injury include: Select one: A. multiple rib fractures. B. an irregular pulse. C. vomiting blood. D. coughing up blood.

coughing up blood.

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

transport to a trauma center.

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

Aortic rupture

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

Deformed steering wheel

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? Select one: A. Dismounted seats B. Intrusion into the vehicle C. Deployment of the airbag D. Steering wheel collapse

Deployment of the airbag

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? Select one: A. Eardrum rupture B. Fractured bones C. Severe burns D. Impaled objects

Eardrum rupture (?)

A 12-year-old male jumped approximately 12 feet 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? Select one: A. Secondary fall after the initial impact B. Lateral impact to the spine C. Energy transmission to the spine D. Direct trauma to the spinal column

Energy transmission to the spine

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 is the LEAST likely? Select one: A. Head injury B. Pulmonary contusion C. Multiple rib fractures D. Cardiac contusion

Head injury

By what mechanism is a person injured when he or she falls from a significant height? Select one: 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 converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop. D. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.

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? Select one: A. Early administration of oxygen B. Rapid transport to a trauma center C. Intravenous fluid administration D. Elevation of the lower extremities

Rapid transport to a trauma center

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

Rotational and rollover

Which of the following statements regarding low-energy penetrating injuries is correct? Select one: A. It is usually easy to differentiate between an entrance wound and an exit wound. B. Internal injuries caused by low-velocity bullets are usually easy to predict. C. The area of injury is usually close to the path the object took through the body. D. Exit wounds are typically easy to locate with low-energy penetrating injuries.

The area of injury is usually close to the path the object took through the body.

Which of the following statements regarding gunshot wounds is correct? Select one: A. High-velocity bullets will cause less severe internal injuries. B. Low-velocity bullets will cause the greatest amount of trauma. C. The speed of a bullet has the greatest impact on the injury produced. D. The size of a bullet has the greatest impact on the injury produced.

The speed of a bullet has the greatest impact on the injury produced.

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: Select one: A. determine if the patient was propelled away from the vehicle. B. approximate the speed of the vehicle that struck the pedestrian. C. determine if the patient was struck and pulled under the vehicle. D. evaluate the vehicle that struck the patient for structural damage.

approximate the speed of the vehicle that struck the pedestrian.

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

assess for an exit wound.

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

avoid giving oxygen under positive pressure.

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

bruising of the heart muscle.

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

cavitation.

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

decrease the severity of deceleration injuries.

When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the airbag deploys upon impact. Select one: A. steering wheel B. windshield C. door D. dashboard

door

Two of the MOST common mechanisms of injury for blunt trauma are: Select one: A. low-caliber gunshot wounds and falls. B. falls and motor vehicle collisions. C. motor vehicle collisions and stabbings. D. gunshot wounds and vehicle ejections.

falls and motor vehicle collisions.

According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she: Select one: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. B. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma. D. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury.

has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.

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

have general surgeons in-house 24 hours a day.

The cervical spine is MOST protected from whiplash-type injuries when the: Select one: A. rear end of the vehicle is initially struck. B. patient tenses up at the time of impact. C. headrest is appropriately positioned. D. airbag correctly deploys upon impact.

headrest is appropriately positioned.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: Select one: A. determine the vehicle's speed at the time of impact. B. recognize if the driver hit the brakes before impact. C. assess the severity of the third collision of the crash. D. identify contact points and predict potential injuries.

identify contact points and predict potential injuries.

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: Select one: A. intracranial bleeding. B. airway compromise. C. a fracture of the skull. D. spinal cord injury.

intracranial bleeding

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

is ejected or partially ejected.

The energy of a moving object is called: Select one: A. potential energy. B. converted energy. C. kinetic energy. D. latent energy.

kinetic energy

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

lateral collisions.

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

mechanism of injury.

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 airbag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: Select one: A. neck and facial injuries. B. open abdominal trauma. C. blunt trauma to the head. D. lower extremity fractures.

neck and facial injuries

When assessing an elderly patient who fell, it is important to remember that: Select one: A. any fall in the elderly is considered to be high-energy trauma. B. osteoporosis can cause a fracture as a result of a fall from a standing position. C. bilateral hip fractures usually occur when an elderly person falls. D. elderly patients who fall usually have a secondary head injury.

osteoporosis can cause a fracture as a result of a fall from a standing position.

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: Select one: A. potential airway compromise. B. damage to internal structures. C. injury to the cervical spine. D. alterations in his mental status.

potential airway compromise

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

primary blast injuries are the most easily overlooked.

When the speed of a motor vehicle doubles, the amount of kinetic energy: Select one: A. triples. B. quadruples. C. is not affected. D. doubles.

quadruples

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

remains in motion until acted upon by an external force.

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

remember that it could still deploy and seriously injure you.

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: Select one: A. leave her bicycle helmet on. B. stabilize her entire spine. C. inspect the helmet for cracks. D. obtain baseline vital signs.

stabilize her entire spine.

If one or more occupants in the same vehicle are killed in a crash, the EMT should: Select one: A. rapidly assess only the survivors who have experienced obvious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. suspect that all living occupants experienced the same serious trauma.

suspect that all living occupants experienced the same serious trauma.

Internal injuries caused by gunshot wounds are difficult to predict because: Select one: A. the area of damage is usually smaller than the bullet. B. the bullet may tumble or ricochet within the body. C. the caliber of the bullet is frequently unknown. D. exit wounds caused by the bullet are usually small.

the bullet may tumble or ricochet within the body.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: Select one: A. the surface struck. B. the speed of the fall. C. the primary impact point. D. the height of the fall.

the speed of the fall.

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash. Select one: A. lumbar and coccygeal B. lumbar and sacral C. thoracic and lumbar D. thoracic and sacral

thoracic and lumbar

You should consider air medical transport of a trauma patient if: Select one: A. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. B. 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. C. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. D. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.

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.

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: Select one: A. as a direct result of the pressure wave. B. as a result of flying debris. C. when the patient was hurled against a stationary object. D. by inhaling toxic gases. Feedback

when the patient was hurled against a stationary object.

Force acting over a distance is the definition of: Select one: A. kinetic energy. B. potential energy. C. work. D. latent energy.

work

The index of suspicion is MOST accurately defined as: Select one: A. the way in which traumatic injuries occur. B. the detection of less obvious life-threatening injuries. C. your awareness and concern for potentially serious underlying injuries. D. a predictable pattern that leads to serious injuries.

your awareness and concern for potentially serious underlying injuries.