CH 34 Flashcards
Which patient requires transport to a trauma center?
Unresponsive patient with hypotension
Based on the following presentations of patient injuries, which one would be considered most severe according to the anatomic criteria of the CDC trauma triage guidelines, justifying immediate transportation to a trauma center?
Flail chest
Which patient is the highest priority?
Patient with a penetrating chest injury
Which of the following choices is not a justifiable reason for delaying transport of a critical trauma patient?
Awaiting arrival of police on scene
You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make note that the occupants of both vehicles are outside, and you request additional units to proceed non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During secondary assessment of past medical history, you make note of several important details: the patient is on high blood pressure medications and has had a heart attack in the past. He is complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may have been from the seat belt, but is refusing care and transport. The patient did not lose consciousness. Based on this information, which transport decision would be most appropriate for this patient?
Explain to the patient the need for transport to a local community hospital.
Which of the following is not a significant mechanism of injury for a driver in a vehicle accident according to CDC guidelines?
Spidering of the windshield
You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has Glasgow Coma Scale scores of 3, 4, and 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient?
Level II Trauma Center
Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone?
Auto versus pedestrian
What type of trauma triage criteria regarding transport would a finger amputation receive?
Any hospital with surgical facilities
You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority?
arterial bleed
A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient who should be immediately transported to a trauma center if secondary to trauma.
20
Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations?
A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC
You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the best transport decision?
Divert to the trauma center because the patient is becoming symptomatic.
What are some of the most important critical decisions an EMT can make on the scene of a serious trauma?
Determining patient severity, amount of time on scene, and transport destination
According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a patient should be transported to a trauma center.
90
Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following?
Make decisions beyond what is usually called for.
You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is the best approach regarding transport of this patient?
Dispatch and await the medical helicopter, which is 20 minutes away.
Which one of the following is not a key decision for the EMT when faced with a multisystem or multiple trauma patient?
Should I allow police to interview the patient on scene?
A respiratory rate of less than ________ or greater than ________ in cases of trauma is a criterion for immediate transportation to a trauma center according to the CDC physiologic guidelines.
10; 29
What is the highest Glasgow Coma Scale (GCS) measurement indicating altered mental status according to CDC guidelines?
13
What is the definition of multiple trauma?
A trauma in which the patient has more than one serious injury
What is the definition of multisystem trauma?
One or more injuries that affect more than one body system
What are three elements of successful trauma care that field practitioners can use that will ultimately translate into greater rates of survival?
Teamwork, timing, and transport
What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers?
Physiological determinants, anatomic criteria, and mechanism of injury
What criterion based on the CDC guidelines allows a discretionary approach to trauma triage?
EMS provider judgment
What are the three elements of the Revised Trauma Score?
GCS, systolic blood pressure, and respiratory rate
You are dispatched to a motorcycle crash with one patient involved. What on-scene intervention is inappropriate for this patient?
Extensively splint the patient’s injuries.
An adult fall meets trauma triage criteria set forth by the CDC if it is greater than:
20ft
