Fall Down Go Boom
Which of the following is recommended in situations in which a tourniquet must be used?
D) Use a material that is wide and thick.
Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except:
C) it should be applied directly to the skin and will not be effective if anything is between the cold agent and the wound.
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?
C) Capillaries
As an EMT, your best clue indicating the possibility of internal bleeding may be the presence of:
A) the mechanism of injury.
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?
C) Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic agent
Which of the following blood vessels cannot stop bleeding by constricting?
C) Capillaries
Which of the following signifies a failure in the patient's compensatory response to blood loss?
D) Hypotension
Which of the following is the most important reason for controlling external bleeding?
A) To prevent and manage hypoperfusion
Which of the following vessels has thick muscular walls that allow constriction and dilation?
C) Arteries
Which of the following is a hallmark of irreversible shock?
C) Cell damage and death in the vital organs
Your patient is a 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the best way to manage this situation?
D) Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose
When managing an electrical burn, the EMT should:
D) check for a source and ground burn injury.
Which of the following patients has the greatest likelihood of being cared for in a burn center?
D) 30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound?
D) Application of antibiotic ointment
Which of the following is true concerning lacerations?
A) They may indicate deeper underlying tissue damage. B) They may be caused by blunt trauma. C) They may be caused by penetrating trauma.
D) All of the above
Which of the following is not an open tissue injury?
C) Contusion
Which of the following statements is false regarding an electrical injury?
A) Injury is usually limited to the area around the source and ground burns.
B) Treatment of a source burn is the same as for other thermal burns.
C) Patients with burns that appear insignificant are treated as having critical injuries.
D) Patients with electrical burns may be treated with the automated external defibrillator (AED) and CPR.
A) Injury is usually limited to the area around the source and ground burns.
You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step?
A) You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound
You are examining a 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this mean?
A) The palm of the patient's hand equals about 1% of the body's surface area.
You are dispatched to an auto repair shop for an "accident." You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you do?
A) Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.
Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered?
D) Traumatic asphyxia
While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated with:
C) aortic dissection.
What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax through a penetration of the chest wall with each breath?
B) Sucking chest wound
Which of the following is a strategy to maintain adherence of an occlusive dressing to bloody or diaphoretic skin?
B) Manually maintain pressure.
Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being "hit in the face and kicked and punched in his ribs and stomach." Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient?
A) The potential for serious internal damage
You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1- to 2-minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions?
D) Commotio cordis
On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration, and the bleeding is controlled. Which of the following is the best approach toward managing the exposed intestines?
D) Moisten a sterile dressing with saline solution and cover the abdominal contents.
Which of the following describes the proper application of an occlusive dressing for an open chest wound?
A) Apply an occlusive dressing to each penetrating wound.
You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsating mass. You should:
B) defer further abdominal palpation.
What is the underlying cause of bluish or reddish facial discoloration following traumatic asphyxia?
D) High pressure on the chest leads to blood being forced from the right atrium into the face and neck
Which of the following is not a benefit of splinting an injury to bones and connective tissues?
D) It restricts blood flow to the site of the injury to prevent swelling.
Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?
B) Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.
A traction splint may be used on which of the following musculoskeletal injuries?
D) Possible fracture of the femur
The sound or feeling of the ends of broken bones rubbing together is called:
D) crepitus
Which of the following structures connect bone ends and allow for a stable range of motion?
A) Ligaments
Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms?
A) Indirect force
The strong white fibrous material called the periosteum:
D) covers the bones.
) One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called?
D) Compartment syndrome
Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient?
A) Comparing the injured side to the uninjured side
Which of the following is a complication of bone fractures?
A) Swelling B) Hemorrhage C) Nerve damage
D) All of the above
Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is sitting in the driver's seat and conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. After applying a cervical collar, which of the following actions represents the most appropriate way for removing the patient from the vehicle?
B) Place a long spine board under the patient's buttocks and then carefully lower the patient to the board in a supine position.
Which of the following may result from the application of a cervical collar that is too large for the patient?
B) Hyperextension of the neck
At which point may manual stabilization of the cervical spine be terminated?
B) When the patient is secured to a long backboard
When using a short spine immobilization device, which part of the body is secured last?
B) Head
Which of the following is a potential complication of hyperventilating a patient with a brain injury?
A) Decreasing blood flow to the brain
As pressure within the cranium increases, which of the following is the result?
D) Increased blood pressure, decreased pulse
When blood accumulates between the brain and the dura mater, what is the result?
C) Subdural hematoma
You are called for a man who is not acting right. His wife says he was outside working in the garden but didn't come in for lunch when he was called. She went to check on him and found him sitting next to a stump, confused. You assessment shows a pulse rate of 58, blood pressure of 186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you don't see any obvious indication that he has fallen. You should suspect a(n):
A) nontraumatic brain injury.
Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You immobilize him on a long spine board with a cervical collar on his neck as a precaution because you know that the:
C) cervical spine is not supported by other bony structures.
You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check?
D) Eye opening, motor response, and verbal response
You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority?
C) Arterial bleed
You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is the best approach regarding transport of this patient?
A) Dispatch and await the medical helicopter, which is 20 minutes away
What is the definition of multisystem trauma?
D) One or more injuries that affect more than one body system
A respiratory rate of less than ________ or greater than ________ in cases of trauma is a criterion for immediate transportation to a trauma center according to the CDC physiologic guidelines.
D) 10; 29
You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has Glasgow Coma Scale scores of 3, 4, and 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient?
A) Level II Trauma Center
You are dispatched to a motorcycle crash with one patient involved. What on-scene intervention is inappropriate for this patient?
C) Extensively splint the patient's injuries.
What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers?
A) Physiological determinants, anatomic criteria, and mechanism of injury
A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient who should be immediately transported to a trauma center if secondary to trauma.
D) 20
Which patient requires transport to a trauma center?
A) Unresponsive patient with hypotension
Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following?
C) Make decisions beyond what is usually called for.
Which of the following terms describes the temperature of the surrounding air?
B) Ambient temperature
You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?
D) Air embolism
You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect?
B) Air embolism
Which of the following is often associated with water-related emergencies?
D) All of the above
The purpose of a constricting band after a venomous snake bite is to impede the spread of which of the following?
C) Venom
To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body?
C) Abdomen
Which of the following could worsen the effects of a snake bite?
C) Application of ice
You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient?
A) Allow the patient to warm up inside the ambulance by passive rewarming measures
Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming.
C) active
You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states the patient is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment plan?
B) Treat the patient for shock and transport.