Module 8 Flashcards Preview

EMS > Module 8 > Flashcards

Flashcards in Module 8 Deck (189):
1

Signs and symptoms of chest trauma include:

Increasing blood pressure and decreasing pulse

Capilary refill time of less than two seconds

Flat jugular veins

Signs of hypoperfusion

SIGNS OF HYPOPERFUSION

2

Two cars have collided head on. One car was traveling 55 mph and the other 35 mph. The total speed of impact would be...

90 mph

3

A pneumatic antishock garment is contrainindicated if the patient presents with cardiogenic shock or:

ABNORMAL LUNG SOUNDS

4

_____________ account for 80 percent of skull fractures also referred to as nondisplaced skull fractures

LINEAR SKULL FRACTURES

5

Linear skull fractures commonly occur in the _______________ region of the skull

TEMPORAL-PARIETAL REGION

6

__________________ are not associated with deformities to the skull

LINEAR SKULL FRACTURES

7

__________________ are not associated with deformities to the skull

LINEAR SKULL FRACTURES

8

A 19 year old man was struck in the side of the head with a steel pipe during a gang altercation. Blood tinged fluid is draining from the ears and bruising appears behind the ears. The most appropriate management for this patient includes:

Elevating the lower extremities and providing immediate transport

Applying 100 percent oxygen and packing the ear with sterile gauze

Controllign the drainage from the ear and applying spinal immobilization

Applying spinal immobilization and oxygen while monitoring the patient for vomiting

Applying spinal immobilization and oxygen while monitoring the patient for vomiting

9

A 19 year old man was struck in the side of the head with a steel pipe during a gang altercation. Blood tinged fluid is draining from the ears and bruising appears behind the ears. The most appropriate management for this patient includes:

Elevating the lower extremities and providing immediate transport

Applying 100 percent oxygen and packing the ear with sterile gauze

Controllign the drainage from the ear and applying spinal immobilization

Applying spinal immobilization and oxygen while monitoring the patient for vomiting

Applying spinal immobilization and oxygen while monitoring the patient for vomiting

10

What are the three main components of the Glasgow Coma Score?

Eye response

Verbal response

Motor response

11

A patient has suffered a small, but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:

Use sterile gauze and wipe away from the site of injury

12

A patient has suffered a small, but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:

Use sterile gauze and wipe away from the site of injury

13

Which one of the following patients would the EMT recognize as suffering from an evisceration injury?

Male patient with a loop of intestine protruding from an open wound.

14

What is the difference between a bandage and a dressing?

The dressing has direct contact with the wound, while a bandage secures the dressing in place

15

The EMT's initial concern when treating a patient with a gunshot wound to the chest is:

Ensure an open airway.

16

When can the EMT remove an impaled object?

Never.... Just stabilize and transport

17

A man has been bitten in his arm by a dog. He states that the bite occurred several hours earlier when he accidentally stepped on the dog's paw. When asked, he tells you that the dog is up to date on all of her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, which one of the following indicates the primary reason the patient should be seen in the emergency department?

Risk for infection.

18

A man has been bitten in his arm by a dog. He states that the bite occurred several hours earlier when he accidentally stepped on the dog's paw. When asked, he tells you that the dog is up to date on all of her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, which one of the following indicates the primary reason the patient should be seen in the emergency department?

Risk for infection.

19

How do you transport an amputated body part?

Wrap it in a plastic bag, write the patients name on the bag and keep it cool

20

What should the EMT do first when controlling the bleeding from a laceration?

place a large sterile dressing over the site with hand pressure applied over the top of the dressing.

21

A male patient has been shot in the chest with a small-caliber gun. What presentation indicates that he is in an early stage of shock?

Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin

22

A male patient has been shot in the chest with a small-caliber gun. What presentation indicates that he is in an early stage of shock?

Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin

23

The EMT's initial concern when treating a patient with a gunshot wound to the chest is:

ensuring an open airway

24

Which one of the following patients requires the EMT to remove an impaled object in the field?

Young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is flowing into her throat

25

Which one of the following statements made by the EMT shows an understanding of dressing and bandaging a wound?

I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation can be made

26

What should be done if there is major bleeding around an impaled object

apply direct pressure on either side of the object to control bleeding

27

What should be done if there is major bleeding around an impaled object

apply direct pressure on either side of the object to control bleeding

28

Whip lash occurs in what type of collision?

Rear end collision

29

Assessment of a patient involved in a motor vehicle accident reveals him to have crepitus to the left humerus, instability to the left lateral chest wall and flank, and pain on palpation to the left hip region. He also complains of pain to the right side of the neck. Based on this injury pattern, the EMT would recognize the patient was

the driver of a car hit on the driver's side.

30

You are responding to a call for a 4 year-old child hit by a car. When assessing the child, which of the following injury patterns would you recognize as typical based on the child's age and mechanism of injury?

Injuries to the head, femurs, chest and abdoment.

31

If you hear gurgling, what should you do?

Suction the airway

32

During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly dscribe the "platinum 10 minutes.". Which of the following indicates the best response?

"EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene."

33

During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly dscribe the "platinum 10 minutes.". Which of the following indicates the best response?

"EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene."

34

A 62 year old male was the restrained driver of a car that was hit on the driver's side. EMR's have extricated and fully immobilized him with a cervical collar and long board. When asked, he complains of dizziness as well as leg and arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with mild bleeding to the left side of his face. His airway is open and his breather is labored. A rapid radial pulse is felt. Skin is cool and dry. Which assessment finding should the EMT address first?

Labored breathing

35

While treating a gunshot wound to the neck and abdomen, you hear gurgling. What should the EMT then do?

Suction the airway

36

Which of the statements below best characterizes the capabilities of a Level III Trauma Center?

The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and transfer them.

37

What is multisystem trauma?

Trauma that affects more than one organ system

38

A patient, who was constructing a bomb in his basement, has sustained a secondary phase blast injury. Which of the following presentations would the EMT most likely observe?

Screwdriver impaled in the arm

39

A patient, who was constructing a bomb in his basement, has sustained a secondary phase blast injury. Which of the following presentations would the EMT most likely observe?

Screwdriver impaled in the arm

40

Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another vehicle at a high rate of speed. The patient was unrestrained and his car did not have air bags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury pattern, the EMT would recognize what type of injury mechanism?

Down and under

41

Which of the following describes the "platinum 10 minutes" as it applies to care of the trauma patient

The target scene time for EMS as it applies to the seriously injured trauma patient

42

A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when he:

wraps it in a dry sterile dressing

43

A bullet fired from a gun at close range passes through the patient's liver. However, on autopsy, the coroner discovers that the man's pancreas, stomach, and gall bladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which of the following is responsible for injury to these additional organs?

CAVITATION

44

What is cavitation?

A cavity formed by a pressure wave resulting from the kinetic energy from a bullet traveling through body tissue

45

A 29 year old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. EMRs have placed him on a nonrebreather face mask and are holding manual in line stabilization. Based on these assessment findings, which one of the following instructions should you provide to the EMRs?

"Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

46

Your patient is a 19-year-old motorcyclist who has crashed into a parked car and was ejected from his motorcycle. He was wearing a helmet; he is awake, shivering, and anxious. The patient is pale, with slight cyanosis of his lips, a slightly increased respiratory rate, and a rapid, thready radial pulse. Bystanders state that there was no loss of consciousness. The patient has abrasions to his hands and face, and blood is saturating the thigh area of both legs of his jeans. A rapid trauma assessment reveals that the patient has swelling and deformity of both thighs. Which of the following is NOT appropriate in the on-scene management of this patient?
a. The use of a long backboard
b. The use of traction splinting for the lower extremity injuries
c. The use of PASG
d. The use of high-concentration oxygen by nonrebreather mask

b. The use of traction splinting for the lower extremity injuries

47

A car has been hit head-on by another vehicle at a moderate rate of speed. Seatbelts were in place and the airbags deployed. The patient is complaining of chest pain. Quick observation reveals a bruise to his sternum. The EMT would immediately:

Lift the airbag and check the steering wheel.

48

You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A paramedic, who has already triaged the nine patients involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this presentation, the EMT would recognize which of the following?

Primary phase blast injury to the inner ear

49

A patient with severe head and neck pain states that he was properly wearing his seat belt when another car struck him from behind. As a knowledgeable EMT, you would realize that the complaint of:

head and neck pain could occur when the seat belt is properly worn.

50

You are hosting a discussion on injury prevention when a participant asks you if you believe that helmets for motorcyclists will truly make a difference. You would respond by saying:

"Motorcycle helmets decrease the risk of death when involved in a collision."

51

Which of the following is a characteristic of arterial bleeding?
Answer

Steady flow
Dark red color
Spurting under pressure

Squirting under pressure

52

Which of the following is a characteristic of arterial bleeding?
Answer

Steady flow
Dark red color
Spurting under pressure

Squirting under pressure

53

What is the first thing you do in assessing a trauma patient after scene safety?

Check the airway, breathing, and circulation

54

Severe external bleeding should be controlled in which phase of patient assessment?

Primary Survey: Circulation

55

You are treating a 58 year old woman who has had a nosebleed for the last hour. The medical term for a nosebleed is:

Epistaxis

56

Oftentimes an EMT is called upon to treat a nose bleed (epistaxis). All of the following are correct ways to treat a nose bleed except?

Have the patient sit down and lean backwards.

57

Do you always use gloves when applying direct pressure?

NO SHIT

58

While cleaning a gun, a 44 year old man accidentally shot himself in the abdomen. On arrival the patient is responsive to painful stiumuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following shows the correct sequence of events for caring for this patient?

Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.

59

Use of the pneumatic antishock garment (PASG) is controversial, and its use should be defined by your services Medical Director. Some "experts" agree that the PASG is useful for:

A. controlling bleeding from head trauma
B. controlling bleeding from the areas the garment covers
C. penetrating chest trauma
D. the patient in cardiogenic shock

B. controlling bleeding from the areas the garment covers

60

Use of the pneumatic antishock garment (PASG) is controversial, and its use should be defined by your services Medical Director. Some "experts" agree that the PASG is useful for:

A. controlling bleeding from head trauma
B. controlling bleeding from the areas the garment covers
C. penetrating chest trauma
D. the patient in cardiogenic shock

B. controlling bleeding from the areas the garment covers

61

In which of the following instances would PASG be an appropriate choice to control bleeding?

Multiple lacerations to the lower extremities

62

Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the BEST sequence of steps in the management of this patient?
A. High-concentration oxygen, elevation of the extremity, and application of ice
B. Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
C. High-concentration oxygen, tourniquet, PASG, and elevation of the extremity
D. Direct pressure, high-concentration oxygen, and splinting the leg

D. Direct pressure, high-concentration oxygen, and splinting the leg

63

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?
A. Veins
B. Arteries
C. Lymphatic vessels
D. Capillaries

D. Capillaries

64

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?
a. Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.
b. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
c. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.
d. Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.

b. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.

65

You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?

Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.

66

You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?

Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.

67

What happens if you have a hemophilia patient involved in a motor vehicle collision?

There could be lots of bleeding

68

Remember, if a trauma patient's ___________ starts to fall the patient is deteriorating

BLOOD PRESSURE

69

What are the three layers of skin?

Subcutaneous

Epidermis

Dermis

70

What is the medical term for a bruise?

contusion

71

When assessing a trauma patient, remember to assess the _________________ first

airway

72

What is a laceration?

A deep cut or tear in the flesh

73

With a stabe wound to the abdomen, always think about ______________ and ___________

BLOOD LOSS

SHOCK

74

Always assess your patient' ____________ first

AIRWAY

75

Care for an open chest wound and an abdominal evisceration are similar in that:

occlusion dressings are placed over both wounds.

76

Care for an open chest wound and an abdominal evisceration are similar in that:

occlusion dressings are placed over both wounds.

77

What kind of dressing requires an occlusive dressing?

An open neck wound

78

Remember to _______________ an impaled object with bulky dressings to prevent the object from moving and causing further damage to the tissue

STABILIZE

79

Remember to always check the ___________ first in any trauma patient

AIRWAY

80

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?

Cover it with moist, sterile gauze and secure with an occlusive dressing.

81

Patients with full-thickness (third-degree) burns generally do not complain of pain because:

the nerve endings have been destroyed.

82

What is the treatment for burns?

A dry sterile dressing

83

Which statement made by an EMT shows that he understands the major cause of death in the prehospital setting for a burn patient?

"Most burn patients who die before getting to the hospital die of airway or bleeding problems, not the burn itself."

84

Remember to do a ________________ on any trauma patient that is showing signs of shock

secondary assessment

85

Remember to do a ________________ on any trauma patient that is showing signs of shock

secondary assessment

86

A student is in a science lab has had an unknown chemical plashed into her eye. After assessing the airway, breathing and circulation, the EMT should immediately:

flush the eye with coious amounts of tap water.

87

When applying the rule of nines to a 10 month-old child, the EMT should recognize which of the following?

The head of a child is considered to be 18% of the total body.

88

Which one of the following statements shows that the EMT understands the palm method of estimating the BSA burned?

I use the patient's palm to estimate the size of the burn area."

89

A 51 year-old male was burned in the face after a steam valve was accidentally opened. His face is red and swollen, and he is screaming in pain. He also states that he is having a hard time seeing. Which one of the following is the EMT's priority concern in caring for this patient?

Airway compromise

90

A female who had hot coffee thrown at her has a superficial burn to the right side of her face. After transferring the patient to the hospital emergency department for continued care, a new EMT asks you if the patient will have a permanent scar on her face. Which one of the following is your best reply?

"Since only the outer layer of skin burned, there is little change of scarring."

91

You are assessing an elderly patient who was entrapped in a burning trailer. Which one of the following findings would be most indicative of a patient suffering an inhalation injury?

Coughing of black sputum.

92

Always remember to assess ______________ in burn patients and delivery the correct oxygen administration

AIRWAYS

93

Always remember to assess ______________ in burn patients and delivery the correct oxygen administration

AIRWAYS

94

A full thickness burn is the same as what kind of burn?

3rd degree burn

95

Which one of the following patients should the EMT recognize assessing suffering from the most critical burn?

22 year old with a partial thickness burn to the right hand

96

When splinting an injury of the wrist, the hand should be placed

Functional position.

97

When splinting an injury of the wrist, the hand should be placed

Functional position.

98

How must the splint be applied?

SNUGGLY

99

If you have a pulseless extremity, what can you do to attempt to get a pulse?

Realign the extremity

100

What can splinting a fracture do?

REDUCE PAIN

101

Remember to manually __________ a possible fracture until you have time to splint it

STABILIZE

102

In trauma patients with obvious injuries always remember to do what?

Look for other injuries

103

In trauma patients with obvious injuries always remember to do what?

Look for other injuries

104

Your 52-year-old male patient stepped off the curb into the street when a large truck cut the corner too close and ran him over. He has numerous fractures and is in a lot of pain. After splinting and treating the patient for shock, you decide en route to the ED to apply cold, too. Applying cold packs to fractures:
A. helps to reduce the swelling.
B. stops bleeding from the bone.
C. eliminates the need for a pressure bandage.
D. stops all the pain and discomfort.

A. helps to reduce the swelling

105

A patient was struck in the right upper arm with a baseball bat. Which one of the following signs or symptoms indicates the highest probability that the humerus has been fractured?

Crepitous felt on palpation

106

Which one of the following statements describes the benefits of using the pneumatic anti-shock garment (PASG) to splint a potential pelvic fracture?

It can effectively stabilize the pelvis and help to control internal bleeding.

107

A deformity to the _______________ is potentially life threatening

FEMUR

108

A deformity to the _______________ is potentially life threatening

FEMUR

109

Which one of the following bone injuries would be classified as occurring in the appendicular component of the skeletal system?

Right-hip fracture

110

What is a strain?

An injury to the muscle

111

Which type of muscle tissue is found in the forearm?

VOLUNTARY

112

You are suspicious that an unhelmeted male patient who was ejected from a motorcycle may have a basilar skull fracture. As you conduct your secondary assessment, which one of the following findings reinforces this suspicion?

Clear fluid coming from the right ear and left nostril.

113

A patient was killed immediately following a self-inflicted gunshot wound to the head. Which portion of the central nervous system was most likely damaged in order to cause the rapid death of the patient?

Brainstem

114

Which one of the following findings is most consistent with basilar skull fracture?

Bruising behind the ear, which develops several hours after the injury.

115

An unhelmeted patient who was thrown from a motorcycle has a large scalp avulsion with obvious depression to the top of his head. These findings suggest which one of the following injuries?

Open head injury

116

A patient involved in an altercation has been struck at the side of the head with a baseball bat, in addition to suffering several blows to the arms and legs. When assessing this patient, which one of the following signs and symptoms BEST indicates the patient has suffered a brain injury?

Confusion and combativeness

117

A patient involved in an altercation has been struck at the side of the head with a baseball bat, in addition to suffering several blows to the arms and legs. When assessing this patient, which one of the following signs and symptoms BEST indicates the patient has suffered a brain injury?

Confusion and combativeness

118

How should you start ventilations in a patient with agonal respirations?

Head tilt chin lift if no spinal injury, or jaw thrust if there is

119

Which one of the following statements best describes the technique to be used when hyperventilation a head-injured patient with signs that the brain is herniating?

Provide one ventilation every three seconds.

120

You have been called by family members for their mother who is "not acting right". On scene the family informs you that they are concerned because their 68 year-old mother has been complaining of a headache and today is very confused. Assessment reveals a bruise to the right side of the head that family states occurred one week ago when she feel in church. Since all other aspects of the assessment are normal, you suspect a head injury. Which condition would make the most sense given these findings and history?

Occult subdural hematoma

121

Which of the following is classified as an open head injury?

Contusion without a skull fracture
Laceration with a skull fracture
Laceration without a skull fracture

Laceration with a skull fracture

122

Which of the following is classified as an open head injury?

Contusion without a skull fracture
Laceration with a skull fracture
Laceration without a skull fracture

Laceration with a skull fracture

123

When blood accumulates between the brain and the dura mater, what is the result?

Epidural contusion
Subdural contusion
Epidural hematoma
Subdural hematoma

SUBDURAL HEMATOMA

124

When blood accumulates between the brain and the dura mater, what is the result?

Epidural contusion
Subdural contusion
Epidural hematoma
Subdural hematoma

SUBDURAL HEMATOMA

125

An epidural hematoma is MOST accurately defined as:

-bleeding between the skull and dura mater

126

An epidural hematoma is MOST accurately defined as:

-bleeding between the skull and dura mater

127

Remember if your patient is show9ing signs of ____________ always look for other injuries

SHOCK

128

Which one of the following patients has an isolated head injury that should be considered the most serious?

21 year old male wearing a deformed motorcycle helmet who does not respond to verbal or painful stimuli.

129

Based on the structure of the nervous system, which one of the following is true?

A deep laceration to the arm can sever peripheral nerves.

130

You arrive on the scene of a two car motor-vehicle collision. The patient was the unrestrained driver of a car that struck another from behind at 25 mph. In the course of the collision, the patient flew forward and struck the windshield with his head. No airbags were deployed. The patient extricated himself and is not complaining of any head, neck, or back pain; however, you do note a small cut on his hand, which occurred as he was getting out of the car. When asked about preexisting medical problems he tells you that he did have herniated disks in his lumbar spine repaired several years ago. Which one of the following should provide the EMT with the strongest reason to immobilize this patient to the long spine board?

Mechanism of injury

131

You arrive on the scene of a two car motor-vehicle collision. The patient was the unrestrained driver of a car that struck another from behind at 25 mph. In the course of the collision, the patient flew forward and struck the windshield with his head. No airbags were deployed. The patient extricated himself and is not complaining of any head, neck, or back pain; however, you do note a small cut on his hand, which occurred as he was getting out of the car. When asked about preexisting medical problems he tells you that he did have herniated disks in his lumbar spine repaired several years ago. Which one of the following should provide the EMT with the strongest reason to immobilize this patient to the long spine board?

Mechanism of injury

132

An EMT is rapidly extricating a critically injured patient from a severely damaged vehicle. Which one of the following would the EMT recognize as acceptable given this patient's condition?

A vest-type or other short spine immobilization device can be oitted, but a cervical collar and manual in-line spinal stabilization are still required.

133

Which of the following is the correct sequence for securing the straps on a long spine board?

Legs, torso, head
Head, torso, legs
Torso, legs, head
Head, legs, torso

Torso, legs, head

134

Which of the following is the correct sequence for securing the straps on a long spine board?

Legs, torso, head
Head, torso, legs
Torso, legs, head
Head, legs, torso

Torso, legs, head

135

Remember people walking after being involved in a MVC can have ___________ and always take _________________

SPINAL DAMAGE

TAKE MANUAL IN LINE STABILIZATION

136

A patient complaining of eye pain informs you that he was diagnosed with a corneal abrasion three days ago. He called 911 today because the discomfort has not yet resolved and he desires medical attention. Based on this information, which of the following is true?

The clear structure that covers the pupil has been damaged.

137

Difficulty speaking could be a sign of ____________ during trauma

SWELLING TO THE AIRWAY

138

Your patient is a 2yearold female who has suffered a seizure but does not have a previous history of seizures. The patient's father states that the child has been pulling at her ear and has had a fever. They were ready to leave for a doctor's appointment when the child had a brief seizure. The patient is drowsy and has hot, flushed skin. Which of the following is recommended in the management of this patient.

Remove the child's clothing down to the underpants or diaper.

139

Your patient is a 2yearold female who has suffered a seizure but does not have a previous history of seizures. The patient's father states that the child has been pulling at her ear and has had a fever. They were ready to leave for a doctor's appointment when the child had a brief seizure. The patient is drowsy and has hot, flushed skin. Which of the following is recommended in the management of this patient.

Remove the child's clothing down to the underpants or diaper.

140

A young girl complains of eye pain after having sand thrown in her face by another girl at the park. When assessing her eyes, you note large particles of sand in the right eye. The sand appears to be on the conjunctiva, which also seems to be scratched and irritated. Your initial action would be:

Flush the eye with clean water from a nearby sink

141

A 21 year old female has been struck in the left eye by a softball. Which of the following assessment findings is most concerning for an eye injury?

Unusual sensitiity to light

142

A patient was stabbed in the right anterior chest and is in obvious respiratory distress. As you perform the secondary assessment, which of the following signs and/or symptoms would concern you that she is suffering from a tension pneumothorax?

Absent breath sounds on the right, distended neck veins, tracheal deviation to the left

143

A patient with blunt chest wall trauma has a flail section to her chest. She is conscious and confused and breathing rapidly and shallowly. After manually stabilizing the flail section of the chest wall, the EMT best treats this condition by:

Providing positive pressure ventilation

144

The EMT showed that he understand the difference between a pneumothorax and a tension pneumothorax when he made which one of the following statements?

A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output

145

What is a hematoma?

It is blood that has collected within damaged tissue or in a body cavity.

146

What is a hematoma?

It is blood that has collected within damaged tissue or in a body cavity.

147

Remember to reassess _____________ for possible complications

chest injuries

148

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called

pleurisy.

149

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called

pleurisy.

150

On scene a paramedic directs you to help another EMS crew with a patient who was hit by a passenger van that ran into a crowd. As you approach the patient, which one of the following scene size-up clues seemingly indicates the patient is suffering from traumatic asphyxia?

Bluish discoloration to the neck and face.

151

Which one of the following best describes a flail segment?

Two or more adjacent ribs broken in two or more places.

152

You are managing a patient with a large flail segment to the right lateral chest. As such, you should recognize that the immediate threat to life is:

Hypoxia

153

You have applied a nonporous dressing to a stab wound on a patient's chest. The Emergency Medical Responder assisting you asks you why the dressing was taped on three sides. Your best response is that taping the dressing on three sides:

allows trapped air to escape on exhalation.

154

You have arrived on the scene for a patient assaulted with a baseball bat. As you approach, which one of the following positions would seemingly indicate that he has suffered an injury to the abdomen?

On his side with knees drawn to the chest

155

You have arrived on the scene for a patient assaulted with a baseball bat. As you approach, which one of the following positions would seemingly indicate that he has suffered an injury to the abdomen?

On his side with knees drawn to the chest

156

Assessment findings of a patient ejected from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 at 94%. Breath sounds are clear and equal bilaterally. The segment has been stabilized, and you are prepared to start positive pressure ventilation. Given these assessment findings, what type of injury underlying the flail segment is your primary concern?

Pulmonary Contusion

157

You are transporting a 19-year-old male with a gunshot wound to the chest. On scene you covered the wound with an appropriate dressing. Now, as you reassess the patient, you note that the patient is tachypneic and complaining of difficulty breathing. Breath sounds on the side of the injury are diminished. Your immediate action would be to:

lift the dressing from the wound for several seconds.

158

When assessing a patient who sustained blunt trauma to the chest, what assessment finding is most indicative of an injury to the lun

Ability to speak a few words and then gasp

159

The EMT has fundamental understanding of abdominal trauma when he states:

Blunt trauma tends to be more lethal than penetrating trauma because of the large number of organs affected."

160

During the secondary assessment, the EMT notes instability and a flail segment to a patient's lower left lateral chest. The EMT would immediately:

Stabilize the segment with his hand

161

he EMT recognizes that the division between the thoracic and abdominal cavities lies approximately:

at the fifth intercostal space.

162

A female patient who suffered a straddle injury while trying to balance on top of a chain link fence continues to bleed from the vaginal area despite your initial attempt to control the hemorrhage. At this time, you would:

place another dressing over the first and maintain direct pressure.

163

A 16-year-old male has been struck in the genitalia by a baseball. Assessment indicates a tremendous amount of edema as well as hematoma formation and bruising to his scrotum. The primary assessment reveals no life-threatening conditions; however, he is crying and rates the pain as a 10/10. Which one of the following is most appropriate for this patient?

Place cool compresses to the testicles

164

A 16-year-old male has been struck in the genitalia by a baseball. Assessment indicates a tremendous amount of edema as well as hematoma formation and bruising to his scrotum. The primary assessment reveals no life-threatening conditions; however, he is crying and rates the pain as a 10/10. Which one of the following is most appropriate for this patient?

Place cool compresses to the testicles

165

You have been called for a 42-year-old male complaining of back pain. On scene, the man tells you that he was lying on the floor when his 5-year-old son unexpectedly jumped feet first onto his back. He gives a medical history of high blood pressure and asthma, for which he takes medications. As you assess the patient, which one of the following signs or symptoms provides the greatest indication that the patient has sustained an abdominal injury?

Blood in his urine

166

A patient has suffered an abdominal evisceration. There is no evidence of spinal injury. How should you place the patient on the stretcher?

Supine, with knees flexed to his chest

167

A patient has been shot in the abdomen. Assessment reveals that the bullet entered the body in the right upper quadrant and exited the lower right back. Given this finding, the EMT should assume which of the following organs may have been injured?

Liver, gallbladder, right kidney, small intestine, pancreas

168

A 45-year-old female was at a family reunion and fell off a trampoline. She hit a picnic table with the left side of her lower rib cage and is now very anxious and confused. Her airway is open and her breathing adequate. Her radial pulse is rapid and weak and her skin is cool and diaphoretic. Vital signs are: pulse 132, respirations 20, blood pressure 102/78 mmHg, and SpO2 97%. She has ecchymosis to the left lower rib area as well as tenderness and instability. She also has a superficial abrasion to her forehead. Given these findings, you would suspect and treat her for what condition?

hypovolemic shock

169

A patient suffering blunt trauma to the abdomen has a lacerated liver. Which of the following represents the most immediate threat to life?

Hemorrhaging

170

An 83-year-old female has fallen down the basement stairs. Once at her side, she tells you that her left hip hurts and rates it 10/10. Since the patient is downstairs, you recognize the need for assistance in extricating from the residence. As you start the primary assessment, you note a dog at the top of the stairs growling. At this time, what is your primary concern?

Dog

171

Which EMS crew has satisfied the platinum ten minutes?

Assessed, immobilized, and initiated transport within 10 minutes of arriving on scene

172

You are by the side of an 11-month-old female with a decreased level of consciousness. Caregivers will not provide an accurate history of how the child came to this condition, only that she was hard to wake up this morning, about 30 minutes ago. When assessing the child, what finding would be most immediately concerning?

Bradycardic heart rate

173

You are by the side of an 11-month-old female with a decreased level of consciousness. Caregivers will not provide an accurate history of how the child came to this condition, only that she was hard to wake up this morning, about 30 minutes ago. When assessing the child, what finding would be most immediately concerning?

Bradycardic heart rate

174

The young pediatric patient is more prone to head injury because:

the head is proportionately heavier and the neck muscles weaker.

175

Tragically, you have just arrived by the side of a 23-year-old female who is 37 weeks pregnant and apneic and pulseless after being shot in the abdomen. Regarding care of this woman, which of the following statements would you provide to other rescuers on scene?

Waiting for ALS backup is not beneficial; we need to provide CPR and get her to the hospital now!"

176

The EMT would recognize which patient as suffering from multisystem trauma?

A 43-year-old male with extremity trauma and shock from an MVC

177

The EMT would recognize which patient as suffering from multisystem trauma?

A 43-year-old male with extremity trauma and shock from an MVC

178

What is coumadin?

A blood thinning drug

179

To prevent the majority of traumatic injuries in the geriatric population, what prevention program should you develop?

Fall prevention

180

The EMT is correctly assessing a 2-year-old male who is unresponsive after being assaulted by the mother's live-in boyfriend when he:

hecks capillary refill time to help determine perfusion.

181

The EMT shows he is correctly using the pediatric assessment triangle on a 3-year-old male trauma patient when he:

quickly determines the circulation based on skin color.

182

The EMT shows he is correctly using the pediatric assessment triangle on a 3-year-old male trauma patient when he:

quickly determines the circulation based on skin color.

183

The EMT knows that the majority of all deaths in children who are 1 to 14 years of age could be prevented by:

Safer driving

184

A female patient who is 35 weeks pregnant tripped and fell down 12 stairs. She is complaining of back pain as well as nausea. She is fully immobilized and being nonemergently transported to the hospital for evaluation. While en route, she exclaims that she is having contractions and thinks that her water may have broken. Which one of the following should you do immediately?

Examine her genitalia for crowning or bleeding.

185

When assessing and treating a traumatically injured female in her third trimester of pregnancy, the EMT must remember that:

care for the baby will come from caring for the mother

186

After being assaulted by her boyfriend, an 18-year-old female who is 33 weeks pregnant is found unresponsive in her bedroom. She appears to have been beaten in the head and abdomen as evidenced by multiple hematomas and lacerations to these areas. Which assessment finding should concern the EMT most and be addressed first?

Room air SpO2 at 93%

187

A female patient who is 36 weeks pregnant tripped in a parking lot, hitting her head and wrist, as well as her abdomen. She is alert and oriented and complains of a headache and abdominal and wrist pain. She denies shortness of breath and has an SpO2 of 96% on room air. Assessment reveals a large abrasion and hematoma to her forehead and abdomen and deformity to her left wrist. Which one of the following interventions will best treat the injuries the baby may have suffered?

Administering high-concentration oxygen through a nonrebreather

188

A 78-year-old male pedestrian was struck by a car at a convenience store. The patient is conscious but confused and is suffering from multisystem trauma. Which of the following represents the best sequence of care for this patient?

Primary assessment, oxygen, secondary assessment, immobilization, and all other care en route to the hospital

189

The mother of a 4-year-old boy states that he fell off the top bunk bed and hit his head. After falling, he appeared to seize for approximately 30 seconds. Presently he has nonpurposeful movement to painful stimuli, with a patent airway and slow respirations. His radial pulse is intact, and his skin is warm and dry. You note urinary incontinence. After taking manual in-line spinal stabilization, which one of the following should you do immediately?

Perform a jaw-thrust maneuver and start positive pressure ventilation.