Module 8 Flashcards
Signs and symptoms of chest trauma include:
Increasing blood pressure and decreasing pulse
Capilary refill time of less than two seconds
Flat jugular veins
Signs of hypoperfusion
SIGNS OF HYPOPERFUSION
Two cars have collided head on. One car was traveling 55 mph and the other 35 mph. The total speed of impact would be…
90 mph
A pneumatic antishock garment is contrainindicated if the patient presents with cardiogenic shock or:
ABNORMAL LUNG SOUNDS
_____________ account for 80 percent of skull fractures also referred to as nondisplaced skull fractures
LINEAR SKULL FRACTURES
Linear skull fractures commonly occur in the _______________ region of the skull
TEMPORAL-PARIETAL REGION
__________________ are not associated with deformities to the skull
LINEAR SKULL FRACTURES
__________________ are not associated with deformities to the skull
LINEAR SKULL FRACTURES
A 19 year old man was struck in the side of the head with a steel pipe during a gang altercation. Blood tinged fluid is draining from the ears and bruising appears behind the ears. The most appropriate management for this patient includes:
Elevating the lower extremities and providing immediate transport
Applying 100 percent oxygen and packing the ear with sterile gauze
Controllign the drainage from the ear and applying spinal immobilization
Applying spinal immobilization and oxygen while monitoring the patient for vomiting
Applying spinal immobilization and oxygen while monitoring the patient for vomiting
A 19 year old man was struck in the side of the head with a steel pipe during a gang altercation. Blood tinged fluid is draining from the ears and bruising appears behind the ears. The most appropriate management for this patient includes:
Elevating the lower extremities and providing immediate transport
Applying 100 percent oxygen and packing the ear with sterile gauze
Controllign the drainage from the ear and applying spinal immobilization
Applying spinal immobilization and oxygen while monitoring the patient for vomiting
Applying spinal immobilization and oxygen while monitoring the patient for vomiting
What are the three main components of the Glasgow Coma Score?
Eye response
Verbal response
Motor response
A patient has suffered a small, but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:
Use sterile gauze and wipe away from the site of injury
A patient has suffered a small, but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:
Use sterile gauze and wipe away from the site of injury
Which one of the following patients would the EMT recognize as suffering from an evisceration injury?
Male patient with a loop of intestine protruding from an open wound.
What is the difference between a bandage and a dressing?
The dressing has direct contact with the wound, while a bandage secures the dressing in place
The EMT’s initial concern when treating a patient with a gunshot wound to the chest is:
Ensure an open airway.
When can the EMT remove an impaled object?
Never…. Just stabilize and transport
A man has been bitten in his arm by a dog. He states that the bite occurred several hours earlier when he accidentally stepped on the dog’s paw. When asked, he tells you that the dog is up to date on all of her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, which one of the following indicates the primary reason the patient should be seen in the emergency department?
Risk for infection.
A man has been bitten in his arm by a dog. He states that the bite occurred several hours earlier when he accidentally stepped on the dog’s paw. When asked, he tells you that the dog is up to date on all of her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, which one of the following indicates the primary reason the patient should be seen in the emergency department?
Risk for infection.
How do you transport an amputated body part?
Wrap it in a plastic bag, write the patients name on the bag and keep it cool
What should the EMT do first when controlling the bleeding from a laceration?
place a large sterile dressing over the site with hand pressure applied over the top of the dressing.
A male patient has been shot in the chest with a small-caliber gun. What presentation indicates that he is in an early stage of shock?
Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin
A male patient has been shot in the chest with a small-caliber gun. What presentation indicates that he is in an early stage of shock?
Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin
The EMT’s initial concern when treating a patient with a gunshot wound to the chest is:
ensuring an open airway
Which one of the following patients requires the EMT to remove an impaled object in the field?
Young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is flowing into her throat
Which one of the following statements made by the EMT shows an understanding of dressing and bandaging a wound?
I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation can be made
What should be done if there is major bleeding around an impaled object
apply direct pressure on either side of the object to control bleeding
What should be done if there is major bleeding around an impaled object
apply direct pressure on either side of the object to control bleeding
Whip lash occurs in what type of collision?
Rear end collision
Assessment of a patient involved in a motor vehicle accident reveals him to have crepitus to the left humerus, instability to the left lateral chest wall and flank, and pain on palpation to the left hip region. He also complains of pain to the right side of the neck. Based on this injury pattern, the EMT would recognize the patient was
the driver of a car hit on the driver’s side.
You are responding to a call for a 4 year-old child hit by a car. When assessing the child, which of the following injury patterns would you recognize as typical based on the child’s age and mechanism of injury?
Injuries to the head, femurs, chest and abdoment.
If you hear gurgling, what should you do?
Suction the airway
During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly dscribe the “platinum 10 minutes.”. Which of the following indicates the best response?
“EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene.”
During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly dscribe the “platinum 10 minutes.”. Which of the following indicates the best response?
“EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene.”
A 62 year old male was the restrained driver of a car that was hit on the driver’s side. EMR’s have extricated and fully immobilized him with a cervical collar and long board. When asked, he complains of dizziness as well as leg and arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with mild bleeding to the left side of his face. His airway is open and his breather is labored. A rapid radial pulse is felt. Skin is cool and dry. Which assessment finding should the EMT address first?
Labored breathing
While treating a gunshot wound to the neck and abdomen, you hear gurgling. What should the EMT then do?
Suction the airway
Which of the statements below best characterizes the capabilities of a Level III Trauma Center?
The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and transfer them.
What is multisystem trauma?
Trauma that affects more than one organ system
A patient, who was constructing a bomb in his basement, has sustained a secondary phase blast injury. Which of the following presentations would the EMT most likely observe?
Screwdriver impaled in the arm
A patient, who was constructing a bomb in his basement, has sustained a secondary phase blast injury. Which of the following presentations would the EMT most likely observe?
Screwdriver impaled in the arm
Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another vehicle at a high rate of speed. The patient was unrestrained and his car did not have air bags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury pattern, the EMT would recognize what type of injury mechanism?
Down and under
Which of the following describes the “platinum 10 minutes” as it applies to care of the trauma patient
The target scene time for EMS as it applies to the seriously injured trauma patient
A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when he:
wraps it in a dry sterile dressing
A bullet fired from a gun at close range passes through the patient’s liver. However, on autopsy, the coroner discovers that the man’s pancreas, stomach, and gall bladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which of the following is responsible for injury to these additional organs?
CAVITATION
What is cavitation?
A cavity formed by a pressure wave resulting from the kinetic energy from a bullet traveling through body tissue
A 29 year old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. EMRs have placed him on a nonrebreather face mask and are holding manual in line stabilization. Based on these assessment findings, which one of the following instructions should you provide to the EMRs?
“Let’s take off the oxygen mask and start positive pressure ventilation to assist his breathing.”
Your patient is a 19-year-old motorcyclist who has crashed into a parked car and was ejected from his motorcycle. He was wearing a helmet; he is awake, shivering, and anxious. The patient is pale, with slight cyanosis of his lips, a slightly increased respiratory rate, and a rapid, thready radial pulse. Bystanders state that there was no loss of consciousness. The patient has abrasions to his hands and face, and blood is saturating the thigh area of both legs of his jeans. A rapid trauma assessment reveals that the patient has swelling and deformity of both thighs. Which of the following is NOT appropriate in the on-scene management of this patient?
a. The use of a long backboard
b. The use of traction splinting for the lower extremity injuries
c. The use of PASG
d. The use of high-concentration oxygen by nonrebreather mask
b. The use of traction splinting for the lower extremity injuries
A car has been hit head-on by another vehicle at a moderate rate of speed. Seatbelts were in place and the airbags deployed. The patient is complaining of chest pain. Quick observation reveals a bruise to his sternum. The EMT would immediately:
Lift the airbag and check the steering wheel.
You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A paramedic, who has already triaged the nine patients involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this presentation, the EMT would recognize which of the following?
Primary phase blast injury to the inner ear
A patient with severe head and neck pain states that he was properly wearing his seat belt when another car struck him from behind. As a knowledgeable EMT, you would realize that the complaint of:
head and neck pain could occur when the seat belt is properly worn.
You are hosting a discussion on injury prevention when a participant asks you if you believe that helmets for motorcyclists will truly make a difference. You would respond by saying:
“Motorcycle helmets decrease the risk of death when involved in a collision.”
Which of the following is a characteristic of arterial bleeding?
Answer
Steady flow
Dark red color
Spurting under pressure
Squirting under pressure
Which of the following is a characteristic of arterial bleeding?
Answer
Steady flow
Dark red color
Spurting under pressure
Squirting under pressure
What is the first thing you do in assessing a trauma patient after scene safety?
Check the airway, breathing, and circulation
Severe external bleeding should be controlled in which phase of patient assessment?
Primary Survey: Circulation
You are treating a 58 year old woman who has had a nosebleed for the last hour. The medical term for a nosebleed is:
Epistaxis
Oftentimes an EMT is called upon to treat a nose bleed (epistaxis). All of the following are correct ways to treat a nose bleed except?
Have the patient sit down and lean backwards.
Do you always use gloves when applying direct pressure?
NO SHIT
While cleaning a gun, a 44 year old man accidentally shot himself in the abdomen. On arrival the patient is responsive to painful stiumuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following shows the correct sequence of events for caring for this patient?
Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.
Use of the pneumatic antishock garment (PASG) is controversial, and its use should be defined by your services Medical Director. Some “experts” agree that the PASG is useful for:
A. controlling bleeding from head trauma
B. controlling bleeding from the areas the garment covers
C. penetrating chest trauma
D. the patient in cardiogenic shock
B. controlling bleeding from the areas the garment covers
Use of the pneumatic antishock garment (PASG) is controversial, and its use should be defined by your services Medical Director. Some “experts” agree that the PASG is useful for:
A. controlling bleeding from head trauma
B. controlling bleeding from the areas the garment covers
C. penetrating chest trauma
D. the patient in cardiogenic shock
B. controlling bleeding from the areas the garment covers
In which of the following instances would PASG be an appropriate choice to control bleeding?
Multiple lacerations to the lower extremities
Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the BEST sequence of steps in the management of this patient?
A. High-concentration oxygen, elevation of the extremity, and application of ice
B. Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
C. High-concentration oxygen, tourniquet, PASG, and elevation of the extremity
D. Direct pressure, high-concentration oxygen, and splinting the leg
D. Direct pressure, high-concentration oxygen, and splinting the leg
Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels? A. Veins B. Arteries C. Lymphatic vessels D. Capillaries
D. Capillaries
Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now?
a. Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.
b. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
c. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.
d. Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.
b. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?
Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.
You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?
Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.
What happens if you have a hemophilia patient involved in a motor vehicle collision?
There could be lots of bleeding
Remember, if a trauma patient’s ___________ starts to fall the patient is deteriorating
BLOOD PRESSURE
What are the three layers of skin?
Subcutaneous
Epidermis
Dermis
What is the medical term for a bruise?
contusion
When assessing a trauma patient, remember to assess the _________________ first
airway
What is a laceration?
A deep cut or tear in the flesh
With a stabe wound to the abdomen, always think about ______________ and ___________
BLOOD LOSS
SHOCK
Always assess your patient’ ____________ first
AIRWAY
Care for an open chest wound and an abdominal evisceration are similar in that:
occlusion dressings are placed over both wounds.
