Quiz 7 - Trauma & Bleeding Flashcards
You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should:
A. administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route.
B. control the bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport.
C. administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route.
D. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.
D. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.
The paramedic’s MAIN goal in treating a patient with shock is to:
A. administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%.
B. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.
C. start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion.
D. maintain body temperature and elevate the patient’s legs 6 to 12 inches in order to improve blood flow to the core of the body.
B. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.
If you suspect internal bleeding during the primary assessment, you should:
A. keep the patient warm and administer oxygen.
B. stop the assessment and transport at once.
C. start two large-bore IV lines of normal saline.
D. determine the source of the internal bleeding.
A. keep the patient warm and administer oxygen.
External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg.
A. jugular vein, 96/62
B. carotid artery, 100/70
C. brachial artery, 68/46
D. femoral vein, 114/60
B. carotid artery, 100/70
Unlike blunt trauma, penetrating trauma:
A. is usually more fatal because of the severe external bleeding that accompanies it.
B. involves a disruption of the skin and underlying tissues in a small, focused area.
C. is especially common during the primary blast injury following an explosion.
D. often causes damage to a large body surface area, even from a single projectile.
B. involves a disruption of the skin and underlying tissues in a small, focused area.
Much of the bleeding associated with unsplinted fractures continues because:
A. swelling associated with such fractures prevents platelet aggregation.
B. bone ends will continue to move and destroy partially formed clots.
C. patient anxiety increases the blood pressure, which exacerbates bleeding.
D. most fractures are unstable and usually lacerate major blood vessels.
B. bone ends will continue to move and destroy partially formed clots.
Unlike adults, children who are struck by a motor vehicle are MORE likely to:
A. experience injuries to the lower extremities from the initial impact.
B. be run over by the vehicle as they are propelled to the ground.
C. turn away from the oncoming vehicle, resulting in posterior trauma.
D. be propelled onto the hood of the vehicle during the second impact.
B. be run over by the vehicle as they are propelled to the ground.
A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to:
A. increase the systolic blood pressure to at least 110 mm Hg.
B. restore the patient’s blood pressure to its pretrauma reading.
C. increase the pulse rate by no more than 10 beats/min.
D. maintain the systolic blood pressure in a low normal range.
D. maintain the systolic blood pressure in a low normal range.
Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the:
A. wrists and forearms.
B. cervical spine.
C. femurs and tibias.
D. chest and abdomen.
C. femurs and tibias.
What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation?
A. Calcium
B. Plasmin
C. Fibrin
D. Platelets
D. Platelets
Patients with internal hemorrhage will benefit MOST from:
A. high-flow oxygen.
B. rapid transport.
C. IV therapy.
D. PASG placement
B. rapid transport.
Knowledge of kinetics can help the paramedic:
A. determine which organs have been injured.
B. quantify how much blood a patient has lost.
C. differentiate between medical and trauma patients.
D. predict injury patterns found in a patient.
D. predict injury patterns found in a patient.
If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury:
A. to the closest hospital for stabilization.
B. via air transport to the Level I trauma center.
C. by ground to the Level I trauma center.
D. by ground to the Level II trauma center.
B. via air transport to the Level I trauma center.
You have successfully controlled a large arterial hemorrhage from a 42-year-old man’s leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should:
A. keep him warm, administer high-flow oxygen, establish one large-bore IV line at the scene, and transport.
B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.
C. administer high-flow oxygen, start two large-bore IV lines at the scene and give a 2- to 3-L fluid bolus, and transport.
D. Keep him warm, assist his ventilations, place a hemostatic agent in the wound, transport, and start a large-bore IV en route.
B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.
Which of the following organs is LEAST susceptible to pressure changes caused by an explosion?
A. Liver
B. Gastrointestinal tract
C. Tympanic membrane
D. Lungs
A. Liver