Booms and BBQs
You respond to a patient who is confused, unable to stand, and vomiting after being near a blast site at a rock quarry. What types of injuries should you suspect that are primary blast injuries?
Hollow organs have been injured
In a patient who was ejected during a motor vehicle collision and presents with paradoxical chest wall movement on the left anterior chest, how does this injury contribute to respiratory compromise?
Ineffective ventilation due to unstable chest wall
A patient has a large attached avulsed skin flap on their shin. The patient fell off their dirt bike during a race. What is the best management of this large skin flap?
Irrigate out debris, place skin flap in place and bandage.
An 18-year-old male is brought into the Emergency Department. There is a large amount of blood on his clothing from a gunshot entrance and exit wound in his chest. The man is screaming, moaning, and wrestling with those trying to get him on a stretcher. His vitals are P. 128, R. 28, BP 148/64. He is pale and diaphoretic. Based on his blood pressure, you determine him to be in what level of shock?
Compensated shock
The study of speed, mass and force is known as?
Kinetics
An autistic child has fallen off his bike and appears to have a broken tibia. EMS was called and the mother arrives on the scene at the same time. The child is screaming and waving his arms in the air. Based on what you know about autistic children, how would you conduct your assessment and treatment?
Ask the mother to calm the child and perform some assessment tasks.
A 40y/o patient has 50 percent of the body covered in partial thickness burns from an assault earlier today. The burns appear wet and painful. You suspect the blisters were broken during a hurried rescue. What is the BEST treatment for this victim who is crying in pain?
Pain management, Cover with a dry, sterile burn sheet and transport rapidly to a burn unit.
You are attending to a patient suffering from a blunt trauma to the chest, which resulted in respiratory distress, cyanosis, hemoptysis, and massive subcutaneous emphysema. What intervention will have the greatest positive impact regarding this patient’s outcome?
Rapid transport to a trauma center
An evisceration is appropriately treated with:
A moist, sterile dressing soaked with NS and covered with an occlusive dressing.
You are transporting a patient that was thrown from his vehicle during a rollover crash. The patient is unresponsive, his pulse is 92, his respirations are 26 and shallow, his BP is 148/96. Ten minutes later when you check his vitals again, his pulse is 64, his respirations are very irregular, and his BP is 186/104. This trending of his vital signs may indicate:
Cushing's Triad (ICP)
When responding to a fall from a significant height where no one witnessed the incident and the scene appears intact (no signs of a struggle), what other potential causes or concerns should a paramedic consider beyond the physical trauma?
Self-inflicted injury or suicide attempt
Medical causes (e.g., syncope, seizure, intoxication)
You are caring for a pregnant trauma patient that is at the end of her third trimester. She has fallen down 10 steps but appears to be uninjured. She does not want to be transported to the hospital. One condition that may be occurring but not showing any symptoms would be:
Abruptio placenta - Trauma to the pregnant patient may cause an abruptio placenta to occur. An abruptio can be taking place in the early stages with a lot of fetal distress before the mother shows symptoms.
You are treating a 27-year-old adult patient who has just been removed from a burning industrial building. The patient had severe dyspnea, complained of chest pain, had a seizure, and is now unresponsive. Which other assessment finding would you expect to see in this patient?
airway swelling/burns
You are called to a local baseball field where a coach has been struck forcefully in the chest by a bat thrown by a child. Witnesses describe the impact as significant. Initially, the coach reports minimal discomfort, but the pain has progressed into a sensation of intense pressure. On assessment, you note a reddened area just to the left of the sternum, an irregular pulse, and a patient who is rapidly deteriorating. Given this mechanism of injury and these clinical signs, what possible internal injuries should you be concerned about?
myocardial contusion
You have a patient with an impaled object in the cheek, an angulated tibia-fibula, an abdominal evisceration, and an open pneumothorax. Which injuries should you treat FIRST with this patient?
open pneumothorax
A retroperitoneal organ that is vascular and can be injured by blunt force trauma, such as during a football tackle, would be the:
Kidney
While working on the ski patrol at the local ski area, you are called to attend a young woman who had a bad fall. Bystanders saw several somersault type actions. Neither of her boots released from the skis. What type of skeletal injury can occur from this type of force?
spiral fracture
You are caring for a pregnant patient who is near term. She was properly restrained during a motor vehicle crash and has no apparent injuries. Now she is secured on an ambulance stretcher to provide spinal motion restriction and vital signs are normal. As you arrive at the hospital, she says she is lightheaded. Her vitals reflect tachycardia, hypotension, and pale, cool and clammy skin.
What is most likely causing this change in her condition?
Supine hypotensive syndrome.
You are treating a patient who has received an electrical shock from a high voltage electrical line. The patient is unresponsive and has a third degree burn to the palm of the left hand and an extensive third degree burn to the right foot. The power to the line has been disconnected and the scene is safe. After assessing airway, breathing, and pulse, what should be your NEXT assessment?
cardiac monitoring - You next assessment should be to determine the patient's ECG status as a continuation of circulation assessment.
A patient was involved in a head-on motor vehicle collision at moderate speeds without using shoulder and lap restraints. You see a deformed steering wheel and windshield starring. Assessment reveals dyspnea, sternal bruising, jugular vein distention, and muffled heart sounds. What is your field impression?
Cardiac Tamponade
You are attending to a patient suffering from a blunt trauma to the chest, which resulted in respiratory distress, cyanosis, hemoptysis, and massive subcutaneous emphysema. You have intubated this patient and initiated positive pressure ventilations. Compliance is minimal and lung sounds are diminished bilaterally. What should your NEXT action be?
Perform bilateral pleural decompressions.
What is the term used to describe a condition in which total blood loss leads to death?
Exsanguination
Daily Double
In a patient with an open femur fracture where the bone is protruding through the skin, which potential complication is least likely to occur compared to a closed fracture?
Compartment syndrome
You are called to a football practice field on a hot afternoon. Your patient is a disoriented football player with hot, clammy skin and his history indicates dehydration. What is MOST likely problem?
Exertional heatstroke.
You have an adult 240lb patient with a thermal burn involving the anterior chest, anterior abdomen, and anterior legs. What percentage of the surface area of this patient is involved according to the “Rule of Nines”? How much fluid should this patient receive in the first 8 hours?
36%
240 lbs ÷ 2.2 = ~109 kg
4 × 109× 36 = 15,696 mL
First 8 hours: ½ of total = 7,48mL
You are called to the fairgrounds where an axe throwing competition was being held. Somehow a bystander was hit by a flying axe and it is in his anterior chest. As you remove clothing and examine the impaled axe, you see that blood is bubbling from the wound. This bubbling is most likely caused by:
Open pneumothorax
Daily Double
What are the three parts of the Trauma lethal triad?
Hypothermia impairs the body’s ability to clot
Acidosis results from poor tissue perfusion
Coagulopathy leads to uncontrolled bleeding
An elderly woman slipped and bounced down a small set of stairs. She did not find herself injured so she got up and went to her chair to recover. A short time later, she reports that she stood up and had a “searing pain” shoot through her. Upon your arrival she is in immense pain. She is restless and panicked. You find her left leg is blue and she has no peripheral pulse in left leg. What conclusion can you draw from this information?
Dissecting aortic aneurysm - With or without the potential for trauma, the recent pain and symptoms present sound like a dissecting abdominal aneurysm. The loss of pulses on one lower extremity is very serious. This injury should be suspected and treated.
While assessing an elderly patient found disoriented in a snowstorm with signs of frostbite on his hands, what is the underlying problem that makes frostbite particularly concerning?
frostbite is an ischemic injury
Why is an assessment of a pregnant trauma patient with no external injuries challenging?
significant internal bleeding can occur into the uterus, such as from placental abruption or uterine rupture, without any obvious external signs. Changes during pregnancy—like increased blood volume and a higher baseline heart rate—can mask the early signs of blood loss