Ch. 42

Question 1

Coagulopathy can result from:

A) An extrication time of less than 20 minutes.
B) An increase in the body’s temperature
C) Hyperthermia
D) Hypothermia

Answer 1

D) Hypothermia

Page Ref: 931
Objective: 42.1 Define key terms introduced in this chapter; 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 2

A 78-year-old male pedestrian was struck by a car at a convenience store. The patient is conscious but confused and is suffering from multisystem trauma. Which one of the following represents the BEST sequence of care that can be provided?

A) Primary assessment, oxygen, secondary assessment, and all other care en route to the hospital
B) Primary assessment, oxygen, secondary assessment, cervical collar, and all other care en route to the hospital
C) Primary assessment, oxygen, secondary assessment, proper patient packaging, and all other care en route to the hospital
D) Primary assessment, immobilization, and all other care en route to the hospital

Answer 2

C) Primary assessment, oxygen, secondary assessment, proper patient packaging, and all other care en route to the hospital

Page Ref: 926-930
Objective: 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 3

A drop in core body temperature to <95°F significantly reduces the body’s blood-clotting mechanism. This decrease in the blood’s ability to clot is referred to as:

A) decompensated shock.
B) coagulopathy.
C) multisystem trauma.
D) compensated shock.

Answer 3

B) coagulopathy.

Page Ref: 931
Objective: 42.1 Define key terms introduced in this chapter.

Question 4

Because it is NOT practical for an AEMT to always calculate a MAP in the field, use a systolic blood pressure (SBP) of ________ as a sign of adequate perfusion.

A) 100 mmHg
B) 120 mmHg
C) 90 mmHg
D) 60 mmHg

Answer 4

C) 90 mmHg

Page Ref: 931
Objective: 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 5

Immediate stabilization of life-threatening conditions must be balanced with the need for:

A) transport to any medical facility.
B) specialized diagnostic tests and surgical interventions.
C) waiting for air medical transport.
D) psychological interventions.

Answer 5

B) specialized diagnostic tests and surgical interventions.

Page Ref: 927
Objective: 42.2 Discuss the increased morbidity and mortality associated with multisystem trauma.

Question 6

A mechanism of injury that can lead to multisystem trauma includes:

A) motorcycle and rider separation in an MVC.
B) motor vehicle crash impact at greater than 40 mph.
C) multiple penetrating trauma injuries (especially to the head, neck, and torso).
D) all of the above

Answer 6

D) all of the above

Page Ref: 926
Objective: 42.2 Discuss the increased morbidity and mortality associated with multisystem trauma; 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 7

In patients with internal hemorrhage, the bleeding is inaccessible except through:

A) IV fluids.
B) surgery.
C) isotonic fluids.
D) tourniquet.

Answer 7

B) surgery.

Page Ref: 930
Objective: 42.2 Discuss the increased morbidity and mortality associated with multisystem trauma.

Question 8

Adequate cellular perfusion means that the patient must have:

A) adequate blood volume.
B) adequate mass of red blood cells.
C) adequate cardiac output and blood pressure.
D) all of the above.

Answer 8

D) all of the above.

Page Ref: 930
Objective: 42.2 Discuss the increased morbidity and mortality associated with multisystem trauma.

Question 9

An 83-year-old woman has fallen down the basement stairs. She complains of left hip pain and rates it 10/10. Since the patient is downstairs, you immediately recognize the need for assistance in extricating her to the ambulance. As you start the primary assessment, you note a large dog at the top of the stairs growling. At this time, what is your primary concern?

A) Pain
B) Dog
C) Need for additional help
D) Airway

Answer 9

B) Dog

Page Ref: 926
Objective: 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 10

During the primary assessment:

A) address all injuries at the same time.
B) manage life threats as soon as they are identified.
C) approach assessment and management linearly.
D) perform aspects of assessment separately from aspects of treatment, patient packaging, and transport.

Answer 10

B) manage life threats as soon as they are identified.

Page Ref: 927
Objective: 42.3 Describe the importance of each of the following principles of out-of-hospital multisystem trauma care: Ensure safety of rescue personnel and the patient; Determine the need for additional resources; Understand the mechanism of injury; Identify and manage life threats; Manage the airway while maintaining manual stabilization of the patient’s head and neck; Support ventilation and oxygenation; Control external hemorrhage and treat for shock; Perform a secondary assessment; Splint musculoskeletal injuries and maintain spinal motion restriction; Make transport decisions.

Question 11

To reduce morbidity and mortality associated with multisystem trauma, your goal is to:

A) omit a primary assessment whenever possible.
B) minimize your time on scene and initiate transport as soon as possible.
C) ignore immediately life-threatening conditions for the sake of a quick transport.
D) work independently, excluding other rescuers.

Answer 11

B) minimize your time on scene and initiate transport as soon as possible.

Page Ref: 926

Question 12

After being assaulted by her boyfriend, an 18-year-old woman who is 33 weeks pregnant is found unresponsive in her bedroom. She appears to have been beaten in the head and abdomen as evidenced by multiple hematomas and lacerations to these areas. Which assessment finding should concern the AEMT most and be addressed FIRST?

A) Abdominal contusions
B) Room air SpO2 at 93 percent
C) Vaginal bleeding
D) Rapid heart rate

Answer 12

B) Room air SpO2 at 93 percent

Page Ref: 927

Question 13

The mother of a four-year-old boy states that he fell off the top bunk bed and hit his head. After falling, he appeared to seize for approximately 30 seconds. Presently, he has non-purposeful movement to painful stimuli with a patent airway and slow respirations. His radial pulse is intact, and his skin is warm and dry. You note urinary incontinence. After taking manual inline spinal stabilization, which one of the following should you do immediately?

A) Perform a head-tilt/chin-lift and administer high-concentration oxygen.
B) Apply oxygen, fully immobilize the patient, and then initiate rapid transport.
C) Insert an oropharyngeal airway and provide high-concentration oxygen.
D) Perform a jaw-thrust maneuver and start positive pressure ventilation.

Answer 13

D) Perform a jaw-thrust maneuver and start positive pressure ventilation.

Page Ref: 927, Supplemental

Question 14

As a member of the emergency medical services team, an AEMT’s role includes all of the following EXCEPT to:

A) dispatch equipment.
B) triage trauma patients.
C) transport patients to the appropriate hospital.
D) provide rapid assessment.

Answer 14

A) dispatch equipment.

Page Ref: 926

Question 15

Which of the following physical assessment findings would make your patient a candidate for rapid transport to a trauma center?

A) Systolic blood pressure of 100
B) Pulse rate of 110
C) Respiratory rate of 24
D) Unstable pelvic girdle

Answer 15

D) Unstable pelvic girdle

Page Ref: 928

Question 16

You are dispatched to an auto collision. Because of very heavy traffic, your response time is 25 minutes. The closest hospital is 40 miles from the accident site. You should:

A) request that law enforcement escort you to a hospital.
B) request additional ground units.
C) call for air transport.
D) have state law enforcement stop traffic while you transport.

Answer 16

C) call for air transport.

Page Ref: 927-928

Question 17

An AEMT surveys an accident scene and identifies the ________ to determine the forces applied to the patient.

A) transport resources
B) index of suspicion
C) plan of action
D) mechanism of injury

Answer 17

D) mechanism of injury

Page Ref: 926

Question 18

You respond to a patient who has sustained a fall. In assessing the scene, you MUST include the surface the patient landed on and the ________ to identify the need for specialty trauma care.

A) distance of the fall
B) transport time
C) direction in which kinetic energy is transmitted through the body
D) path of the patient’s body over the course of the fall

Answer 18

A) distance of the fall

Page Ref: 926

Question 19

You respond to a call of an explosion at a local chemical company. Upon arrival, the company’s hazmat team is decontaminating patients so you can easily treat them. The team extricates a 35-year-old man who is experiencing slight respiratory distress. The care that you should provide FIRST for this patient is:

A) high-flow oxygen.
B) an immediate head-to-toe trauma assessment.
C) transport to the local trauma center.
D) insertion of a supraglottic airway.

Answer 19

A) high-flow oxygen.

Page Ref: 926-927

Question 20

With a patient who exhibits inadequate ventilations, the cause could include:

A) traumatic brain injury.
B) spinal cord injury.
C) injuries of the chest wall or lungs.
D) all of the above.

Answer 20

D) all of the above.

Page Ref: 927

Question 21

Managing patients with multisystem trauma requires:

A) permitting one type of injury to divert you from managing the patient’s overall condition.
B) ignoring all but one individual injury that is contributing to the patient’s condition.
C) the ability to understand both specific and multiple injuries.
D) the ability to focus only on the assessment of the patient.

Answer 21

C) the ability to understand both specific and multiple injuries.

Page Ref: 926

Question 22

The trauma care you provide to a patient includes:

A) selecting the best hospital destination for the patient’s circumstances.
B) selecting the best method of transporting the patient to that facility.
C) communicating with the receiving facility as early as possible so that the necessary personnel
can prepare for the patient’s arrival.
D) all of the above.

Answer 22

D) all of the above.

Page Ref: 931

Question 23

Your 18-year-old patient was involved in an altercation and has a puncture wound to his right mid-thorax. You should:

A) apply a moist dressing and seal on all four sides.
B) apply an occlusive dressing and seal on only three sides.
C) apply a moist dressing and seal on only three sides.
D) apply an occlusive dressing and seal on all four sides.

Answer 23

B) apply an occlusive dressing and seal on only three sides.

Page Ref: 927

Question 24

Spinal injury care steps performed during the primary assessment include:

A) apply a cervical collar independent of spinal stabilization.
B) apply a cervical collar and secure the patient to the stretcher.
C) perform a rapid rollout independent of manual spinal stabilization.
D) administer medications to prevent further paralysis.

Answer 24

B) apply a cervical collar and secure the patient to the stretcher.

Page Ref: 928

Question 25

Patients with which life-threatening condition are considered critical?

A) Dyspnea
B) Flail chest
C) Suspected pneumothorax
D) All of the above

Answer 25

D) All of the above

Page Ref: 928

Question 26

A 62-year-old woman with severe kyphosis has fallen and hit her head, which is oozing blood. Family members state that she suddenly complained of a “very bad headache” before collapsing to the kitchen floor. She has snoring respirations and appears cyanotic in the extremities. Of the following interventions, which one should you do FIRST?

A) Use a jaw-thrust maneuver.
B) Apply a cervical collar.
C) Cover the laceration.
D) Start positive pressure ventilation.

Answer 26

A) Use a jaw-thrust maneuver.

Page Ref: 926-927, Supplemental

Question 27

Once hemorrhage is controlled, intravenous fluids can:

A) replace proteins needed for oncotic pressure.
B) replace red blood cells.
C) play a role in restoring vascular volume.
D) replace platelets.

Answer 27

C) play a role in restoring vascular volume.

Page Ref: 930

Question 28

Patients who are in shock are susceptible to hypothermia due to significant blood loss because:

A) if the environment is warm, the rate of heat loss is accelerated.
B) blood carries body heat with it when it leaves the body.
C) hypothermia increases the effectiveness of the body’s blood clotting mechanisms.
D) improved cellular energy production prevents the patient from increasing body temperature through metabolism.

Answer 28

B) blood carries body heat with it when it leaves the body.

Page Ref: 931

Question 29

The combination of two or more life-threatening conditions in the same patient:

A) causes the AEMT is focus on only the most serious condition.
B) increases risk of death substantially.
C) decreases the possibility the patient will be transported to a Level I trauma center.
D) indicates the mechanism of injury was not serious.

Answer 29

B) increases risk of death substantially.

Page Ref: 926

Question 30

According to the CDC’s field triage decision scheme, the first element(s) assessed is/are the:

A) vital signs.
B) anatomy of injury.
C) mechanism of injury.
D) special patient considerations.

Answer 30

A) vital signs.

Page Ref: 929

Question 31

Which element is evaluated when considering the special patient or system considerations when applying the CDC’s field triage decision scheme?

A) The Glasgow coma scale
B) The presence of burn injury
C) Vehicle telemetry data
D) The presence of an amputation

Answer 31

B) The presence of burn injury

Page Ref: 929

Question 32

When providing fluid resuscitation in the prehospital setting on a trauma patient, ideally what gauge catheter should you select?

A) 14- or 16-gauge
B) 18- or 20-gauge
C) 22- or 24-gauge
D) 25- or 27-gauge

Answer 32

A) 14- or 16-gauge

Page Ref: 931