Component 8: Care for the Trauma Patient

Question 1

What law of motion states that every object in uniform motion will remain in that state unless acted upon by an external force?

Answer 1

Newton’s First Law - Law of Inertia

Question 2

What law of motion states that force equals mass times acceleration, expressed as :
f(t) = ma(t)

Answer 2

Newton’s Second Law

Question 3

What law of motion states that for every action, there is an equal and opposite reaction?

Answer 3

Newton’s Third Law

Question 4

What is the equation for kinetic energy?

Answer 4

KE = 1/2 mv²

(Where m = mass and v = velocity.)

F = ma, where a can represent acceleration or deceleration depending on its sign.

Question 5

List the types of motor vehicle collisions.

(MVCs)

Answer 5

• frontal
• rear
• rotational
• rollover
• lateral

Question 6

What are the two types of injuries resulting from force(s) being exerted on the human body?

Answer 6

• penetrating
• blunt force(s)

Question 7

What are the terms profile, tumble, and fragmentation used to describe?

Answer 7

ballistics

Question 8

True or False:

Every gunshot victim will have exit wounds.

Answer 8

False

Not all gunshot wounds have exits; bullets can lodge internally or fragment. The presence of an exit wound depends on factors such as caliber, velocity, and body region involved.

Question 9

Define:

Index of Suspicion

Answer 9

• maintaining a heightened awareness of surroundings and safety.
• Also, as potential patient injuries or illnesses that may not have yet presented with signs and symptoms or have developed.

Question 10

Which phase of a blast would result in ruptured eardrums, eye hemorrhage, and possibly abdominal hemorrhage and/or perforation?

Answer 10

primary blast or phase one

Question 11

During the tertiary phase of a blast, what happens to the body?

Answer 11

The body is lifted, tossed, and/or thrown.

Question 12

True or False:

Understanding and evaluating the forces or mechanisms of injury to our patients will help us to provide quality patient care.

Answer 12

True

Identifying MOI allows EMTs to predict hidden injuries and prioritize life threats in alignment with the NREMT Trauma Patient Assessment.

Question 13

Which level of trauma facility is best for the treatment and care of a patient suffering multiple systems trauma?

Answer 13

Level I

Question 14

Define:

• Capillary bleeding
• Venous bleeding
• Arterial bleeding

Answer 14

• Capillary Bleeding: slow, oozing, dark red in color
• Venous Bleeding: steady flow, not as dark in color as capillary bleeding, although still darker than arterial bleeding
• Arterial Bleeding: spurts consistent with the patient’s pulse and bright red in color

Question 15

True or False:

When blunt force trauma is applied, it is imperative to maintain a high index of suspicion of internal bleeding.

Answer 15

True

Blunt trauma often causes occult internal bleeding. Per NREMT standards, EMTs should maintain a high index of suspicion, even in the absence of external signs.

Question 16

What are the early signs/symptoms of hypovolemic/hemorrhagic shock for a patient suspected of having internal bleeding?

Answer 16

• dry mouth
• tachycardia and thready pulse
• anxiety
• clammy skin
• delayed capillary refill

Question 17

What are the late signs/symptoms of hypovolemic/hemorrhagic shock due to internal bleeding?

Answer 17

• Progressive drop in blood pressure
• Lethargy or altered mental status
• Potential progression to unconsciousness

Question 18

Fill in the blank:

Prior to applying a tourniquet for bleeding control, we should _________ __________ _________.

Answer 18

apply direct pressure

If bleeding does not become controlled, apply a tourniquet.

Question 19

Fill in the blank:

When applying a tourniquet, we tighten and twist until _________ ________.

Answer 19

bleeding stops

To learn more click here.

Question 20

Define:

epistaxis

Answer 20

It is the medical term for a nose bleed.

Question 21

True or False:

Ecchymosis is another medical term for a contusion or bruise.

Answer 21

True

Ecchymosis refers to discoloration from subcutaneous bleeding, often used interchangeably with “contusion” in EMS contexts.

Question 22

What are the two layers of the skin that are on top of the subcutaneous tissue?

Answer 22

1. epidermis
2. dermis

Question 23

What are the types of closed soft-tissue injuries?

Answer 23

• contusion
• hematoma
• compartment syndrome

Question 24

Are abrasions, lacerations, and penetrating wounds considered to be open or closed?

Answer 24

open

Question 25

Which **position**, if possible, should the flap of an **avulsed tissue** be placed?

Answer 25

**Return it to the place** it was torn from.

Question 26

Why should the **application of a splint** be considered for open or closed soft-tissue injuries?

Answer 26

Depending on the **mechanism** of injury and the forces causing the injury, there may be musculoskeletal damage as well. **Splints** may also provide for additional patient comfort.

Question 27

When treating a soft-tissue injury, we may use the mnemonic RICES. What does **RICES** stand for?

Answer 27

* **R**est * **I**ce * **C**ompression * **E**levation * **S**plinting

Question 28

What type of **open abdominal injury** requires applying a moist sterile dressing secured with an occlusive dressing?

Answer 28

abdominal evisceration

Question 29

When are the **two** times an **impaled object** can be removed?

Answer 29

An impaled object can be removed **only** when: 1. The object interferes with airway management 2. Performing CPR Otherwise, stabilize in place and transport.

Question 30

Why should an **occlusive dressing** be applied to an open, bleeding, anterior/lateral neck wound?

Answer 30

To **prevent the entry of air** (air embolism) and foreign material into the vascular system through the open neck wound.

Question 31

What **layer(s) of the skin** are involved in a 2nd-degree or partial thickness burn?

Answer 31

* epidermis * dermis

Question 32

# True or False: It is best practice to place a burn sheet over a patient suffering moderate or severe burns with a large body surface area (BSA) affected.

Answer 32

True ## Footnote Burn sheets help reduce contamination, fluid loss, and hypothermia in patients with large surface area burns (NREMT trauma protocol).

Question 33

Using the **rule of nines**, calculate the percentage of body surface area (BSA) burnt: The adult patient has partial and full-thickness burns to their anterior chest, abdomen, and the front and back of the left arm. What is the **BSA**?

Answer 33

Chest and abdomen = 18% Front and back of one arm = 9% Total BSA burned: 18% + 9% = **27%**

Question 34

List the **types of burns**.

Answer 34

* thermal * electrical * chemical * radiation

Question 35

Why should we evaluate the **severe burn** patient's airway?

Answer 35

The patient may have **inhaled heat** causing swelling of the airway tissues and/or **inhaled chemicals/toxins** from the burn.

Question 36

How long should we irrigate **chemical eye exposures**?

Answer 36

**No less than 20 minutes** with copious amounts of saline.

Question 37

**Differentiate** primary (direct) injury and secondary (indirect) injury.

Answer 37

* **Primary Injury:** is the actual direct damages to tissues from the force/contact. * **Secondary Injury:** is the additional damages done to the tissues from the direct impact. For instance swelling, ischemia, infection.

Question 38

What are the anticipated/potential **signs/symptoms** of a patient who has been hit in the occipital region of the skull with a baseball bat?

Answer 38

* battle signs * raccoon eyes * basilar skull fracture * cervical spine injury * traumatic brain injury * paralysis

Question 39

Name the **layer of meninges** that is very thin and delicate and is adhered to the contours of the brain and spinal cord.

Answer 39

pia mater ## Footnote Other meningeal layers are the arachnoid and the dura mater.

Question 40

What are the **signs/symptoms** of a concussion?

Answer 40

* dizziness * generalized weakness * visual disturbances ("seeing stars") * retrograde and/or anterograde amnesia * nausea/vomiting * loss of consciousness (only in ~10% of cases)

Question 41

# Define: Cushing's reflex/triad

Answer 41

It may develop from a **closed head injury**. The combination of the three are signs of increased intracranial pressure (ICP). * hypertension * bradycardia * normal, or altered respiratory pattern

Question 42

What are **CSMs** in relation to potential neurological trauma?

Answer 42

**Circulation, Sensation, and Movement**: it is a quick assessment if neurological trauma is suspected.

Question 43

# Define: Paresthesia

Answer 43

It would be described by a patient with potential neurological trauma as pins and needles, numbness, or tingling in their hands and/or feet.

Question 44

# True or False: When providing cervical spine precautions by immobilization, the chest, pelvis then feet should be immobilized before securing the patient's head to the device.

Answer 44

True ## Footnote According to spinal immobilization protocols, the head is secured last to prevent unnecessary spinal movement during body fixation.

Question 45

# Fill in the blank: An injury or damage to a patient's cervical spine at C-3 or above will cause the patient to \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_.

Answer 45

stop breathing ## Footnote C-3 and above damage will cause the patient's diaphragm to no longer contract causing the patient to stop breathing.

Question 46

Upon palpation of the patient's chest, what is the term used when you feel the sensation of **bones rubbing together** under the skin?

Answer 46

crepitus

Question 47

Why would patients with chest wall injuries have **tachypnea** (rapid/shallow breathing)?

Answer 47

**Adequate chest wall expansion will cause pain** and possibly further damage to the chest wall. Patients will compensate with tachypnea.

Question 48

What is the chest wall **motion** called when there is a flail segment?

Answer 48

Paradoxical Movement/motion

Question 49

When assessing a patient's chest for DCAP-BTLS, we note a **sucking chest wound**. What is our **first treatment**?

Answer 49

Place a gloved hand over the wound and hold until an occlusive dressing can be placed.

Question 50

What is the **term** used when describing the attached picture?

Answer 50

pneumothorax ## Footnote If jugular venous distention (JVD) and hypotension are present with this injury, it would be called a tension pneumothorax.

Question 51

If a pneumothorax means air in the pleural space(s), what do we call **blood** in the **pleural space**?

Answer 51

Hemopneumothorax

Question 52

Where does the **blood/fluid** collect on a patient suffering from expected **cardiac tamponade**?

Answer 52

Blood/fluid fills the **pericardial sac** inhibiting the heart's capability of filling and contracting.

Question 53

What are the types of fractures?

Answer 53

* Greenstick * Oblique * Spiral * Transverse * Comminuted * Epiphyseal

Question 54

What are the signs/symptoms of a closed fracture?

Answer 54

* deformity/swelling * tenderness * guarding * bruising * pain * crepitus

Question 55

# True or False: Dislocations should be reduced before splinting.

Answer 55

False ## Footnote Field reduction is not within EMT scope. Attempting it risks nerve and vessel damage. Instead, splint in the position found (NREMT skill sheet).

Question 56

**Differentiate** sprain from strain.

Answer 56

* **Sprain:** when a joint extends outside of its normal range of motion, resulting in a stretched or torn ligament and/or tendon. * **Strain:** it is the stretching and/or tearing of a muscle.

Question 57

What is the **treatment** for an amputated part?

Answer 57

Wrap the part in a sterile dressing and place it in a plastic bag. Local protocol will determine ice or no ice.

Question 58

When preparing to apply a splint, what **assessment** should be done before and after application?

Answer 58

Assess for **circulation, sensation, and movement** (CSM) **before and after** applying a splint.

Question 59

What **joints** should be immobilized when splinting an injury?

Answer 59

Immobilize the joints **above and below** the injury

Question 60

**Shortening of the leg and medial** or lateral rotation is most likely a sign of what **injury**?

Answer 60

hip fracture or dislocation

Question 61

What are the downfalls of **inadequate/improper splinting**?

Answer 61

* pressure on the nerves, vasculature, and tissues * time delay- when possible, splinting should be done while en route to a hospital * inhibition of distal circulation * further damage to the initial injury

Question 62

List the mechanisms of **heat loss**.

Answer 62

* convection * conduction * respiration * radiation * evaporation

Question 63

With a patient suffering from **severe hypothermia**, what would their level of consciousness be?

Answer 63

**unconscious/unresponsive** and possibly dead

Question 64

# True or False: Warm water with a brisk rubbing should be applied to deep frost-bitten fingers and toes immediately.

Answer 64

False ## Footnote Rubbing frostbitten areas causes tissue damage. Rewarming should be passive or with warm (not hot) water immersion only under controlled conditions.

Question 65

What **cooling mechanism** will stop when a patient has progressed from heat exhaustion to heatstroke?

Answer 65

sweating

Question 66

What is the **first treatment** priority when treating a patient suffering from extreme heat exposure?

Answer 66

Safely **remove** them from the heated environment.

Question 67

# Define: Diving Reflex

Answer 67

It is when the **heart rate slows down** due to cold water exposure/immersion.

Question 68

What is the **medical term** for the condition commonly referred to as "the bends"?

Answer 68

"The bends" is a lay term for **decompression sickness**. ## Footnote This condition occurs when divers ascend too quickly, causing nitrogen gas to form bubbles in the bloodstream and other tissues.

Question 69

What is the definitive **treatment** for a patient with severe decompression sickness?

Answer 69

Hyperbaric Oxygen Chamber Therapy | (HBO)

Question 70

What do the acronyms **HAPE** and **HACE** stand for?

Answer 70

* HAPE: **H**igh **A**ltitude **P**ulmonary **E**dema * HACE: **H**igh **A**ltitude **C**erebral **E**dema

Question 71

The treatments for patients suffering from **Acute Mountain Sickness (High Altitude Sickness), HAPE and/or HACE**?

Answer 71

* high flow oxygen * positive pressure ventilation (PPV) as needed * immediate and rapid descent in altitude

Question 72

In what environmental emergency situation do we consider **reverse triage**?

Answer 72

**Lightning strikes** with multiple patients.

Question 73

# Describe: How a **Hymenoptera** stinger is properly removed from the skin?

Answer 73

Use a credit card or the edge of a firm plastic card to **gently scrape the stinger out of the skin**. Avoid squeezing the venom sac. Monitor the patient for signs of anaphylaxis.