CH 34 Multisystem Trauma Flashcards
H-1) Up to how many points are assigned to each element of the Revised Trauma Score? A. 8 B. 12 C. 15 D. 4
D. 4
H-2) The Revised Trauma Score rates the:
A. skin condition, color, and temperature.
B. Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
C. diastolic blood pressure, systolic blood pressure, and respiratory rate.
D. heart rate, pulse rate, and respiratory rate.
B. Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
The characteristics rated by the Revised Trauma Score are the diastolic blood pressure, systolic blood pressure, and respiratory rate.
H-3) Which of the following is a transport decision for a multisystem trauma patient?
A. Deciding on a hospital destination
B. Deciding how long to spend on scene
C. Deciding what to do when there is disagreement on patient care
D. Deciding to manage some injuries en route to the hospital
A. Deciding on a hospital destination
Deciding where to go and identifying the criticality of the patient are the two components of a transport decision. The other choices are related to timing and communication.
H-4) With a multisystem trauma patient, which of the following should be used to determine when to bypass one hospital for another? A. Area familiarity B. Making a shift change on time C. Provider preference D. Protocols
D. Protocols
Follow local protocols when making destination decisions for trauma patients.
H-5) Your adult trauma patient has a score of 14 on the Glasgow Coma Scale, a systolic blood pressure of 90 mm Hg, and a respiratory rate of 10. You should:
A. package the patient for immediate transport to a trauma center.
B. decide whether the mechanism of injury is significant enough to merit transport to a trauma center.
C. address whether the patient meets the anatomic criteria for transport to a trauma center.
D. reassess blood pressure and respiratory rate.
C. address whether the patient meets the anatomic criteria for transport to a trauma center.
Each of the criteria for determining trauma transport - physiologic criteria, anatomic criteria, and mechanism of injury - should be considered separately and in sequence, addressing the first of these criteria before the second and addressing the second before the third. For example, if you encountered a patient who is physiologically unstable, he would be transported to a trauma center. However, if your patient were physiologically stable, you would move on to consider the anatomic criteria, and so on. This patient is barely stable enough to not require transport to a trauma center based on physiological criteria, so you would move on to the anatomic criteria.
H-6) Your patient was involved in a motor vehicle collision. You have decided to transport him to a trauma center because another occupant in the same vehicle died. Your decision is based on: A. mechanism of injury. B. anatomical findings. C. physiological findings. D. pathophysiological findings.
A. mechanism of injury.
A patient with no anatomical or physiological abnormalities may be classified as a high-priority patient on the basis of the mechanism of injury.
If someone in the same compartment died, it heightens the suspicion of MOI
H-7) According to CDC trauma triage guidelines, special patient or system considerations include age, burns, pregnancy, and:
A. clinical depression.
B. anticoagulants and bleeding disorders.
C. belligerent behavior.
D. medication use.
B. anticoagulants and bleeding disorders.
According to CDC trauma triage guidelines, anticoagulants and bleeding disorders are a special patient or system consideration.
H-8) You are caring for an elderly trauma patient. The mechanism of injury is not remarkable, but your instincts tell you that something is wrong. You should:
A. delay your transport decision and further evaluate the patient.
B. wait for ALS personnel to arrive.
C. ignore your instincts until you have evidence.
D. trust your judgment.
D. trust your judgment.
When in doubt, trust your instincts and err on behalf of the patient’s best interests. A special consideration according to the CDC trauma triage guidelines is EMS provider judgment.
H-9) Which of the following is the highest priority for your multisystem trauma patient?
A. Determining the exact extent of injuries
B. Rapid transport
C. Management of all secondary injuries
D. Thorough documentation
B. Rapid transport
Of the choices, rapid transport is the highest priority for a multisystem trauma patient.
H-10) What is your overall goal in caring for a multisystem trauma patient?
A. To treat immediate threats to life
B. To manage all injuries discovered
C. To provide definitive care
D. To manage the patient until ALS personnel arrive
A. To treat immediate threats to life
The priority for a multisystem trauma patient is to manage life threats and provide rapid transport to the appropriate facility. Depending on the severity of the patient’s condition, you may not be able to manage all injuries that are discovered.
H-11) What is a less immediate benefit of trauma scores that does not involve determining whether a patient should go to a trauma center?
A. Trauma scores are useful for medical billing and insurance coding.
B. They provide proof of care in case of malpractice lawsuits.
C. A trauma score helps evaluate an EMT’s standard of care.
D. Trauma centers may use the scores to compare outcomes of trauma patients with similar injuries.
D. Trauma centers may use the scores to compare outcomes of trauma patients with similar injuries.
After helping determine whether the patient should go to a trauma center, the second major function of a trauma scoring system is to allow trauma centers to evaluate themselves in comparing the outcomes of trauma patients who have similar severity of injuries. In this way, they can improve the quality of care their trauma patients receive, and can conduct research on trauma care.
H-12) Your patient has a Revised Trauma Score of 3. This means that:
A. the patient’s condition is critical.
B. the patient’s condition is moderate.
C. the patient has the lowest score possible.
D. the patient has the highest score possible.
A. the patient’s condition is critical.
This is a low score, and indicates a critical patient. The RTS ranges from 0 to 12, with as many as 4 points and as few as 0 possible to assign to each of the three elements that the RTS scores. The lower the score, the more seriously injured the patient is, and the less likely he will survive.
PT-1) If your trauma patient had an initial GCS score of 13 and now has a score of 10, this implies that:
A. the patient is still stable.
B. the patient is improving.
C. the patient is deteriorating.
D. someone miscalculated the first GCS score, as the maximum score is 10.
C. the patient is deteriorating.
PT-2) Which of the following would most likely be used to determine whether a patient would be transported to a trauma center? A. Patient preference B. EMT experience C. Pupillary response D. Trauma score
D. Trauma score
PT-3) You and your partner disagree on the best destination for a trauma patient. In this situation, you should:
A. wait for ALS personnel to arrive.
B. determine the patient’s preference.
C. go to the closest hospital.
D. consult your protocols or medical direction.
D. consult your protocols or medical direction.
PT-4) A GCS of 8 indicates: A. a stable patient. B. a multisystem trauma patient. C. a significant likelihood of head injury. D. a hypotensive patient.
C. a significant likelihood of head injury.
PT-5) You arrive on scene to a patient with an arterial bleed from his right lower leg. The patient is lethargic, and has many other injuries. What should you do first?
A. Call for air medical evacuation
B. Administer 100% high-flow oxygen via nonrebreather mask
C. Open the patient’s airway and ensure that it is patent
D. Stop the hemorrhage with direct pressure
D. Stop the hemorrhage with direct pressure
PT-6) Which pregnant trauma patient is the highest priority for transport to a trauma center? A. Pregnant 16 weeks B. Pregnant 24 weeks C. Pregnant 20 weeks D. Pregnant 8 weeks
B. Pregnant 24 weeks
PT-7) Which of the following patients is the most critical, based on trauma triage guidelines?
A. 16-year-old male driver with neck and back pain following a motor vehicle collision
B. 26-year-old assault victim with multiple self-controlled lacerations across the face and neck, with a systolic blood pressure of 110
C. 46-year-old car crash victim with possible right ankle fracture
D. 31-year-old male construction-site fall victim who fell approximately two stories and who demonstrates signs and symptoms of shock
D. 31-year-old male construction-site fall victim who fell approximately two stories and who demonstrates signs and symptoms of shock
Falls of >20’ for adults is a trauma indicator
PT-8) When caring for the victim of a motor vehicle collision, the EMT should suspect critical injuries if: A. the collision occurred at 10 mph. B. there was only a solo occupant. C. another occupant was killed. D. more than one person was injured.
C. another occupant was killed.
Trauma criteria is looked at when another person is killed in same compartment as injured victim
PT-9) Which of the following components is not used during the evaluation of the Revised Trauma Score? A. Glasgow Coma Scale B. Systolic blood pressure C. Respiratory rate D. Heart rate
D. Heart rate
