Exam 36: Multisystem Trauma and Trauma in Special Patient Populations

Assessment of a 79-year-old female with a long history of medical complaints reveals tenderness and deformity to her left hip. Staff at the personal care home state that she slipped in some water and fell onto her buttocks. Currently, she is alert and oriented and stating the pain is 10/10. Regarding care of her leg, which one of the following is most appropriate?

A 27-year-old male has been involved in a motor vehicle collision and is entrapped in his car. He is unresponsive with agonal gurgling respirations and blood coming from his nose. His respirations show poor effort and are inadequate. The radial pulse is rapid and weak and skin cool and diaphoretic. An Emergency Medical Responder is holding manual in-line spinal stabilization. What action would you perform first?

You are caring for a crying 30-month-old male who fell 16 feet from a second-story window, landing on a patch of soft dirt and leaves. He is alert and oriented and complaining of left shoulder and arm pain. What instruction would you give to the team of EMS providers caring for this individual?

A 32-week pregnant female who was involved in a motor vehicle collision is currently immobilized to the long spine board. Which one of her following statements should concern the EMT most?

You are called to a nursing home for a male patient with chest pain. On arrival you find the patient in a wheelchair with a noticeable hematoma to his forehead and a skin tear to his left wrist. Staff states that the patient had an episode of chest pain just before falling to the ground. When asked, the patient states that he still has chest discomfort. Which one of the following should you do immediately?

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

Which statement is true regarding care of the multisystem trauma patient?

You suspect the lethargic 6-month-old baby beside you is the victim of child abuse. When performing the primary assessment, which one of the following should you use to quickly establish his perfusion?

The EMT is correctly assessing the perfusion status of a 10-month-old when she:

Family has called you for a 78-year-old female, with a history of dementia, because she appears more confused than normal. The primary assessment reveals no life-threatening conditions and her vital signs are: pulse 88, respirations 22, blood pressure 134/66, and SpO₂ 95% on room air. Aside from the dementia, she had a history of hypertension, COPD, and breast cancer, which resulted in the removal of her right breast 11 years ago. Lately, she had an upper respiratory infection and is telling family that she has a headache. Your first question to family should be:

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?

When treating a pediatric trauma patient, which one of the following is it important for the EMT to remember?

A 37-year-old woman, who is four months pregnant, is complaining of abdominal and pelvic pain after being assaulted in her home by a live-in boyfriend. During the assault, he struck her in the head, chest, and abdomen with his fists and a chair as she lay on the floor. There are no obvious threats to the airway, breathing, or circulation, and her vital signs are: pulse 124, respiration 22, blood pressure 114/68, and SpO₂ 97% on room air. Regarding your care of this patient, which of the following is needed?

An unrestrained female patient, who was involved in a minor motor vehicle collision, refuses EMS care or transport. She is seven months pregnant and is alert and oriented. When asked, she denies any complaint. Your best action would be to:

A car swerved to miss a deer in the road and hit a utility pole at a low rate of speed. Damage to the car is minimal, but the 82-year-old male passenger was not wearing a seat belt and hit his head on the dashboard. He presents as confused and diaphoretic. His daughter, the driver, states that he has a history of dementia, high blood pressure, and diabetes, as well as coronary artery disease. She adds that he did take his insulin about 2 hours ago. Which one of the following questions to the daughter would be most important at this time?

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?

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?

Which EMS crew has satisfied the platinum ten minutes?

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?

You are by the side of an 88-year-old male who fell. He has a hematoma to his forehead as well as deformity to his left forearm. His daughter informs you that he has severe dementia and she cares for him at home. As you assess him, he continually screams out, "Mary, help me. I need help!" At this time, what question is most appropriate to ask the daughter?