Chest Quest
After blunt chest trauma, a patient has localized rib pain that worsens with inspiration but equal breath sounds and adequate ventilation. What supportive action is most appropriate?
What is position for comfort, support ventilation as needed, and transport; do not circumferentially bind the chest?
A patient has abdominal tenderness and guarding after blunt trauma. What should the EMT assume until proven otherwise?
What is internal abdominal injury with possible hemorrhage?
Before and after splinting any extremity injury, which three distal functions must be assessed and documented?
What is Circulation, sensation, and motor function?
At a multisystem trauma scene, which finding should be corrected during the primary assessment rather than deferred to the secondary assessment?
What is an immediate threat to airway, breathing, or circulation, including catastrophic hemorrhage?
A hiker is shivering, confused, and clumsy after prolonged cold exposure. What condition should the EMT suspect?
What is Moderate hypothermia
A patient with pinpoint pupils has a pulse but breathes four times per minute with poor chest rise. Naloxone is available. What intervention comes first?
What is open the airway and provide BVM ventilations with oxygen?
A patient has a penetrating chest wound that makes a sucking sound with each breath. What dressing should the EMT apply first?
What is a vented occlusive chest seal, followed by frequent reassessment?
Abdominal organs protrude through a laceration. How should the EMT protect them?
What is cover them with a moist sterile dressing and an occlusive covering; do not replace them
A patient has an isolated, closed midshaft femur fracture with no pelvic, knee, or lower-leg injury. Which splint is most appropriate?
What is a traction splint
A 6-year-old is pulseless. A second trained rescuer arrives and takes over ventilations. Without an advanced airway, what compression-to-ventilation ratio should the team use?
What is 15 compressions to 2 ventilations?
A patient with heat exposure is confused, hot, and has a core temperature consistent with severe hyperthermia. What treatment must not be delayed?
What is rapid active cooling while supporting ABCs and arranging transport?
A patient with diabetes is confused, pale, diaphoretic, and unable to follow commands. A glucometer reads 42 mg/dL. The patient cannot swallow safely. What should the EMT do?
What is do not give oral glucose; manage the airway, request ALS, and transport promptly?
After a steering-wheel impact, a patient has paradoxical chest-wall movement, shallow respirations, and falling oxygen saturation. What treatment addresses the immediate life threat?
What is support ventilation with a BVM and oxygen if respirations are inadequate?
A patient struck in the left upper abdomen has pain referred to the left shoulder and increasing signs of shock. Which organ is most likely injured?
What is the spleen?
A midshaft forearm fracture is angulated, but the hand has a pulse and normal sensation. What is the safest general splinting approach?
What is Splint the limb in the position found unless protocol or loss of distal circulation requires gentle realignment
During adult geriatric CPR, the compressor is leaning on the chest and achieving only 80 compressions per minute. What two corrections should the team leader make?
What is increase the rate to 100 to 120 per minute and allow full chest recoil?
A frostbitten foot is pale, waxy, and numb. Transport time is short, and there is a possibility the tissue could refreeze. Should the EMT thaw it in the field?
What is No; protect it from trauma and thaw only when refreezing can be prevented and protocol permits?
A patient has sudden severe vertigo, vomiting, inability to walk, and marked limb ataxia, but no facial droop or arm drift. What time-sensitive diagnosis must still be suspected?
What is a posterior circulation or cerebellar stroke?
Minutes after a chest wound is sealed, the patient becomes more dyspneic, hypotensive, and cyanotic with absent breath sounds on the injured side. What complication should be suspected?
What is developing tension pneumothorax?
A restrained driver has a seat-belt bruise across the abdomen, mild pain, and initially normal vital signs. Why does this patient still require a high index of suspicion?
What is the mark may indicate significant underlying abdominal or hollow-organ injury despite an initially stable presentation?
A patient has a deformed knee after a high-speed crash and severe thigh pain. Why should a traction splint not be applied?
What is a suspected knee or adjacent joint injury is a contraindication to traction splinting?
A patient ejected from a vehicle has an open chest wound, an unstable pelvis, and severe leg bleeding. What is the best overall sequence of care?
What is control catastrophic extremity bleeding, manage airway and breathing including sealing the chest wound, stabilize as feasible, and transport rapidly?
A lightning-strike victim is apneic and pulseless while another nearby victim is awake with superficial burns. Who should be treated first?
What is the apneic, pulseless lightning victim?
A dialysis patient who missed treatment reports weakness and nausea and has a slow, irregular pulse. Oxygenation and ventilation are adequate. Which electrolyte emergency should the EMT suspect?
What is hyperkalemia?
A crash patient is hypotensive with distended neck veins and muffled heart sounds. Breath sounds are equal bilaterally. Which obstructive injury best fits this pattern?
What is cardiac tamponade?
A patient with penetrating abdominal trauma is restless, pale, tachycardic, and has a narrowing pulse pressure, but the systolic pressure is still 108 mm Hg. What perfusion state is most likely?
What is compensated hemorrhagic shock?
A patient has an open midshaft femur fracture with heavy bleeding and signs of shock. What must occur before traction splint application?
What is control life-threatening hemorrhage and manage immediate ABC threats?
A hypotensive trauma patient has absent breath sounds on the left, severe respiratory distress, and a rigid abdomen. Which problem should be treated first?
What is the immediate breathing threat from the suspected tension pneumothorax, while expediting transport for internal hemorrhage?
A cold-water submersion patient is unresponsive with very slow, shallow respirations and a weak pulse. What is the priority approach?
What is provide careful airway and ventilatory support, prevent further heat loss, handle gently, and transport rapidly?
A patient with fever and recent infection is confused, tachycardic, tachypneic, hypotensive, and initially has warm flushed skin. What type of shock is most likely?
What is distributive shock from sepsis, or septic shock?