General Trauma
BONUS Trauma
Pediatric/OB-GYN
Geriatric
MISC
100
An intoxicated homeless person inadvertently passes out across train tracks and one leg gets amputated. What is your very first intervention after initial assessment?
Place tourniquet
100
First sign of Shock.
Tachycardia
100
Pregnant Woman involved in an MVA. Restrained Passenger. No prenatal care thus far. ABD and Chest pain. You palpate abdomen and seem to detect top of fundus at level of umbilicus. You suspect she is about ____ weeks pregnant.
20
100
What causes more morbidity/mortality, Car accidents or Falls in the Elderly?
Falls in the elderly.
100
What is your dosage for pain control for trauma patients?
Fentanyl
200
A Woman jumps out of a 2 story window after doing meth and fighting with her husband. Upon arrival her initial GCS is 7. VS otherwise normal. You apply a C-collar. Pt is Breathing spontaneously but you assist ventilations and consider intubating. What is your head injury protocol for ETCO2 Goal?
35-45
200
DAILY DOUBLE!!! A man is involved in dirt bike accident attempting a long jump. Pt can't feel or move his arms or legs. Systolic Blood Pressure 88. Pulse 70. Tenderness in high C-spine. Vital signs have you concerned for: 1. ? and...2. you need to monitor _____?:
1. Neurogenic Shock 2. Possible diaphragm weakness (c4,5).
200
Pregnant Patients may have vital signs different than non-pregnant patients. They are:
Pregnant Patients can be tachycardic and have decreased BP which may mimic shock.
200
Elderly 83yo Asian woman sustains a fall while walking dog. Family calls 911. Witnessed fall - Stumbled forward onto outstretched hand. Has mild swelling in Right Wrist. No other complaint or exam abnormality. They want to refuse transport now since injury seems minor. You encourage transport for X-Rays since you think this woman has a fracture. Why?
Osteoporosis: A generalized bone disease in which there is a reduction in the amount of bone mass leading to fractures after minimal trauma. More common in women. Classic Colles fracture mechanism
200
A Car strikes a motorcyclist in an intersection near Chambers/120th. Pt is unconscious, pulses are faint, 80/palp. Tachycardic. Blood in the airway. Additional Suspicion for pelvic fracture. Gurgling respirations. Can't see vocal chords with direct vis. First intubation attempt unsuccessful. Your Critical Care unit en route to scene to assist - 3-4 minutes away. Do you wait for critical care to secure airway prior to transport?
Just transport! BLS airway, Stablize C-Spine scoop and move.
300
18 yo sustained a head injury playing rugby. When you arrive he opens eyes to voice, has repetitive questioning but obeys all motor commands. His GCS is:
13
300
Concussion
A temporary loss or alteration of part or all of the brain's abilities to function without actual physical damage to the brain.
300
A 4 foot tall 10yo child falls 10 feet from a zip line. No major complaints except left elbow pain with no deformity. You transport to what level trauma center?
Pediatric I or II
300
Nursing home patient sustains a fall. Right leg is shortened and externally rotated. Staff says looks like she dislocated her hip. You say:
Hip Fracture: Shortened externally rotated Hip Dislocation: Shortened, internally rotated
300
A hiker is bit by a rattlesnake on the lower leg. Initially he suspected a minor bite and finishes his hike and drives home. A few hours later he calls 911 per severe pain in anterior calf and difficulty dorsiflexing foot. Exam reveals swollen and ecchymotic anterior calf with some paresthesias over the anterior lower leg. Other than the venomous bite, what additional condition are you concerned about?
Compartment syndrome
400
The Areas of the body where one can have massive (1L) internal bleeding include the chest, abdomen,thigh and:
Retroperitoneum
400
A Man sustains a fall from a 6 ft ladder at a construction site. Witnesses say he landed on his back on a nearby work table. He is awake and complains of shortness of breath. Bilateral breath sounds but wheezes. PMH: COPD. Significant rib pain. His shortness of breath is worsening en route. Sats 80s on O2 facemask. Should you reach for CPAP? He has COPD...
CPAP can worsen pneumothorax into a tension pneumothorax.
400
You respond to commerce city household where mother reports 3yo child burned hand while reaching for the stove. House is in disarray and chaotic due to many children. Burn is on the back of the hand - about 3x3cm. Child is crying but otherwise normal vital signs. Mother wants to refuse transport since she needs to stay around to take care of the other kids and burn now doesn't look too bad. You decide:
Consider transport for NAT.
400
DOUBLE!! Normally spry 86 yo male sustained a fall at Nursing Home playing bingo. Struck head on wall as he fell to the ground. No LOC. Got back up and had no complaints. Continued to play bingo. 3 hours later now asking repetitive questions and more lethargic. What head injury did he likely suffer? Why is it more common in elderly patients?
Subdural hematoma. Shrinking brain mass causes stress on the bridging veins.
400
An infant has burns to face and top half of anterior torso. What is the estimated surface area?
9% + 9% = 18%
500
You respond to a patient with a gunshot wound to the abdomen. Pt is awake and in pain. VS: P110, BP 90/60. 20 cc/kg bolus of NS given and rapid transport initiated. After fluid bolus, clinical status and VS are unchanged. Regarding fluids and/or "pressors" you decide:
Do nothing.
500
A man sustains a stab wound to the anterior chest with an ice pick. En route Patient gradually losing blood pressure and looking like shock. You are able to transport to Denver Health successfully. Follow up later with ER staff revealed that the patient had developed a pericardial tamponade. He was treated surgically and is now stable. The physiology behind decreased cardiac output that would cause shock state is due to:
Diastolic impairment of filling of ventricles.
500
You respond to a HS football game where a player has suffered a head and neck injury. When you arrive the facemask/helmet and pads are still in place. You immobilize without removing pads. En route the patient starts coughing and spitting up profuse amounts of blood. You decide to:
Remove facemask so you can manage airway better
500
Elderly woman driver runs into pole in parking lot. No complaints at the scene. What is the most common cause of elderly driving accidents: Motor Skill deterioration? Vision deficits? medications? Cognitive Deficits?
Vision
500
"Electrical Injuries and cardiac arrythmias" High Voltage AC is more likely to cause VFIB vs a lightning strike, which would be more likely to cause:
Asystole
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