Module 8

Question 1

Which of the following instructions is most important for the use of good body mechanics in a power lift?
-Squat down and keep your knees outward at a 45-degree angle.

-Maintain a wide stance (at least 24 inches).

-Keep your back muscles loose and your head bent forward.

-Straighten your legs to lift.

Answer 1

Straighten your legs to lift.

Question 2

Which of the following statements about the care and treatment of a patient with a spinal injury in a prehospital setting is true?
1It is important to identify the site of spinal injury so that proper prehospital care can be rendered.

2Before transporting a critically injured patient with a spinal injury, OEC technicians must perform a detailed head-to-toe neurological assessment.

3Prehospital care for a patient with a spinal injury involves correcting life-threatening injuries and limiting secondary injury.

4If a patient with a possible spinal injury is in shock, it is permissible to forego immobilization because doing this uses up time during the golden hour.

Answer 2

Prehospital care for a patient with a spinal injury involves correcting life-threatening injuries and limiting secondary injury.

Question 3

A basket stretcher is a good method for transporting a patient:

Answer 3

out of the backcountry.

Question 4

Which of the following findings indicates that a patient who received a blow to the head is suffering from something other than a concussion/TBI?
1Patient’s pupils are noticeably unequal.

2Patient asks the same questions over and over.

3Patient cannot remember what happened.

4Patient’s heart rate is 92, and their blood pressure is 144/86.

Answer 4

Patient’s pupils are noticeably unequal.

Question 5

An elderly patient has fallen down a flight of stairs and is complaining of neck and back pain and weakness to both legs. Your primary assessment reveals no life threats to the airway, breathing, or circulation. Manual in-line spinal stabilization is being maintained. Which of the following actions should you take next?
Apply high-flow oxygen and move the patient to a stretcher for transport.

Place a cervical collar on the patient and immobilize him to a long spine board.

Complete a secondary assessment looking for injuries.

Place an oral airway and begin assisting ventilation.

Answer 5

Complete a secondary assessment looking for injuries.

Question 6

Which of the following signs is a characteristic sign that may be seen during a secondary assessment of patients with spinal cord injury?
-Flushed skin color at the level of pinpoint back pain

-Normal skin color and complaint of headache and nausea

-Bruising on the back and on the abdomen at the level of the injury, with normal or impaired sensation

-Flushed skin color below the level of the injury and impairment or absence of sensation and movement

Answer 6

Flushed skin color below the level of the injury and impairment or absence of sensation and movement

Question 7

You are assessing a 30-year-old patient who has fallen about 20 feet. Patient is alert and oriented but states that they cannot move or feel their legs. Additionally, because their blood pressure is 82/48 mmHg, you suspect neurogenic shock. Which of the following additional assessment findings reinforces your suspicion of neurogenic shock?
Shallow rapid respirations

Heart rate of 144

Heart rate of 44

Warm and dry skin

Answer 7

Heart rate of 44

Question 8

You should recognize a possible spinal column injury with no spinal cord involvement when you discover which of the following assessment findings?
Tenderness to the thoracic spine with intact motor and sensory function in each extremity

Pain in the cervical spine with the loss of sensation to the right arm and leg

Intact sensation to all four extremities with the loss of motor ability in the arms

Intact motor ability to all four extremities with the loss of sensation to the legs

Answer 8

Tenderness to the thoracic spine with intact motor and sensory function in each extremity

Question 9

You are participating in training OEC candidates and are asked about cerebral contusions. You would explain to the class that a cerebral contusion is:

Answer 9

bruising and swelling of the brain tissue.

Question 10

For a person to make a fist, which of the following must occur?
The central nervous system must send a message through the spinal cord and then through the autonomic nervous system.

The peripheral nervous system must send a message to the brain and then back through the peripheral nervous system.

The central nervous system must send a message through the spinal cord and then through the peripheral nerves.

The muscles must signal the brain to send a message through the autonomic nervous system.

Answer 10

The central nervous system must send a message through the spinal cord and then through the peripheral nerves.

Question 11

A soccer player was struck in the head with a soccer ball. Players state that the patient was dazed for several seconds following the impact and then asked the same questions over and over. They are currently conscious and oriented to person but is confused as to place and time. They also have a reddened area on the side of their head and face. As you proceed with your assessment, the patient’s memory continues to improve. Based on these findings, you would suspect which of the following injuries?
A concussion/TBI

An open head injury

An epidural hematoma

A cerebral contusion

Answer 11

A concussion/TBI

Question 12

A woman who is six months pregnant and experiencing back pain should be placed on a backboard and then placed in a toboggan in which of the following positions?
Sitting up

On her left side

With her head downhill

In a supine position

Answer 12

On her left side

Question 13

A patient with a head and midline posterior neck injury was sitting found leaning against a tree. You discover that your team does not have a long backboard, so you use what alternative?

Answer 13

Whole body vacuum mattress

Question 14

When approaching most helicopters, whether running or not, the safest way is to do so from the:

Answer 14

front.

Question 15

A patient involved in a motor-vehicle collision has suffered the separation of a rib from a spinal vertebra. Based on the anatomy of the spine, where has this injury occurred?

Answer 15

The thoracic spine

Question 16

A primary injury to the central nervous system would be caused by:
a brachial plexus injury.

drowning.

a laceration of the spinal cord.

a hematoma.

Answer 16

a laceration of the spinal cord.

Question 17

A patient who was hit in the face with a cloud of dust while working in an industrial setting is complaining of pain and discomfort to their left eye. While performing your assessment on the eye, you note some redness of the globe but do not see any obvious foreign object. The most appropriate care you can provide to this patient would be to:

Answer 17

flush eye with copious amounts of water.

Question 18

The first step in placing a patient in the toboggan for transport is:

Answer 18

deciding whether or not to put the patient’s injury uphill.

Question 19

A 41-year-old snowboarder struck their head on a metal rail. As you approach the patient, you note that they appear confused and have blood on the left side of their face and head and on their shirt. The patient’s breathing appears to be labored. Which of the following actions should you perform immediately?
Apply oxygen at 15 LPM via nonrebreather mask.

Expose the chest to look for possible bleeding.

Check their pupils for equality and reactivity.

Apply manual in-line spinal immobilization.

Answer 19

Apply manual in-line spinal immobilization.

Question 20

While performing a primary assessment on a patient who has an isolated spinal cord injury, you note that they are in severe respiratory distress and struggling to breathe. Where should you suspect that the spinal cord injury has occurred?
The lumbar spine

The diaphragm

The thoracic spine

The cervical spine

Answer 20

The cervical spine

Question 21

Which of the following statements about removing a helmet in a prehospital setting is correct?
Helmets should never be removed, so OEC technicians must be creative in working around the obstacle of a helmet while providing care.

Helmets should be removed only if they are too tight or if spinal immobilization is required.

It is acceptable to leave a helmet on a patient if the patient has no airway or breathing problems.

Any patient wearing a helmet should have it removed so that the airway and breathing can be properly assessed.

Answer 21

It is acceptable to leave a helmet on a patient if the patient has no airway or breathing problems.

Question 22

A properly sized cervical collar will rest on the:

Answer 22

shoulder.

Question 23

Which of the following findings is most consistent with a skull fracture?
Altered mental status

Bruising behind the ear that develops several hours after the injury

Bilateral dilated pupils that do not respond to light

A hematoma in the occipital area of the head

Answer 23

Bruising behind the ear that develops several hours after the injury

Question 24

You are called to aid a 61-year-old who has fallen off a second-floor lodge patio. Patient is unresponsive and has very slow, shallow breathing at a rate of 6 breaths per minute. When you arrive, a fellow patroller has already opened the airway and has stabilized the head. Which of the following actions should you take immediately?
Transfer the patient to a stretcher for emergency transport.

Place the patient in the shock position.

Apply a cervical collar.

Assist ventilation with a bag-valve ma

Answer 24

Assist ventilation with a bag-valve mask.

Question 25

When explaining the priorities of helmet removal to a candidate patroller, you would stress:

Answer 25

sliding the fingers under the occiput so that the head doesn’t drop backward.

Question 26

When explaining the priorities of helmet removal to a candidate patroller, you would stress:

Answer 26

sliding the fingers under the occiput so that the head doesn’t drop backward.

Question 27

A 2-year-old fell down a flight of stairs. Which of the following instructions would you provide to other patrollers who are immobilizing the patient?
It is better if the collar is a little too big because it will be more comfortable for the patient.”

“After the patient is on the board, place a towel behind their head to keep their airway open.”

“Let’s place a folded towel under their shoulders to help maintain their head alignment.”

“Just apply a cervical collar and then place the patient directly on the stretcher.”

Answer 27

“Let’s place a folded towel under their shoulders to help maintain their head alignment.”

Question 28

A 68-year-old patient is complaining of a headache and generalized weakness. Their spouse informs you that the patient was with a friend yesterday and struck their face on the dashboard during a motor vehicle collision. Patient’s past medical history includes a stroke that caused right arm weakness and high blood pressure. When assessing this patient, which of the following findings should concern you the most?
Bruising behind their left ear

A complaint of pain when they move their jaw

Weakness in the grip of the right hand

A contusion to their left cheek

Answer 28

Bruising behind their left ear

Question 29

Extremity lifts may not be tolerated by:
elderly patients and patients with respiratory disorders.

patients with visual impairments.

obese and young patients.

patients with ankle injuries.

Answer 29

elderly patients and patients with respiratory disorders.

Question 30

The part of the eye that focuses light on the retina is called the:

Answer 30

lens.

Question 31

A patient involved in a motor vehicle collision has a deformity to the left side of the head. The skin overlying the deformity is still intact. Based on these assessment findings, which of the following conditions would be your greatest concern?
The potential for infection of the brain

A possible brain injury

A spinal cord injury

Soft tissue trauma to the scalp

Answer 31

A possible brain injury

Question 32

You respond to an accident at which a male patient is complaining of severe back pain. He informs you that his back pain is coming from a recent fracture of his coccyx. Based on this information, what area of the back would the pain be emanating from?

Answer 32

The lowest part of the spine

Question 33

While running outside the lodge, a teenager tripped and fell. They hit their face and mouth, knocking one of their top front teeth from its socket. Although the patient is upset, you have assessed no threats to life, and the bleeding has been controlled. Your partner finds the tooth and asks you what to do with it. Which of the following responses would be best?
“Wrap the tooth in dry gauze and put it in a plastic bag placed in cool water.”

“Scrub the base of the tooth to be sure it’s clean and then we’ll place it back in its socket.”

“Avoid touching the root of the tooth. We will gently irrigate it and place it back in its socket.”

“Just put it in dry gauze and bring it with you. They probably won’t be able to do anything with it.”

Answer 33

“Avoid touching the root of the tooth. We will gently irrigate it and place it back in its socket.”

Question 34

Which of the following signs or symptoms might be evident for an injury to the autonomic nervous system?
Trouble remembering one’s own name

Elevated heart rate

Inability to move facial muscles

Vomiting

Answer 34

Elevated heart rate

Question 35

Which of the following instructions from one OEC technician to another describes the appropriate application of a cervical spine immobilization collar?
“Carefully flex the patient’s head forward a little so I can pass the collar underneath their neck.”

“Let’s log roll the patient to one side so I can apply a cervical collar.”

“Keep the patient’s head in neutral position while I apply a cervical collar.”

“I need you to extend the patient’s chin backward a little so I can fit the collar under their chin.”

Answer 35

“Keep the patient’s head in neutral position while I apply a cervical collar.”

Question 36

A young intoxicated patient cannot move their lower extremities after diving into the shallow end of a pool and hitting the bottom with their head. Which of the following mechanisms is most likely to be responsible for this injury?

Answer 36

Compression