Question 1

You are dispatched to the local high school for a "person struck with a baseball." You arrive on the scene and find a 16-year-old male sitting on the bench.Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard.He states that nothing is hurting except he has some mild pain in the area where he was struck.He is upset that the ambulance was called and wants to go back into the game and continue pitching.Your exam reveals nothing remarkable except mild pain when you palpate the injured area.Vital signs are normal.What is the next step?

Accepted Answer

A)  Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes. 
B)  Have the patient walk to the ambulance and take him to the ED. No other care needs to be provided, as there is really no significant sign of any injury. 
C)  Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport. 
D)  Tell the coach the patient is okay and he can go back into the ball game.

Question 2

You are dispatched to the local elementary school for an injured student.Upon arrival you find that two 7-year-olds got into a fight and one of them jabbed a pencil in the other's cheek.The pencil is still sticking out of the child's cheek.When you examine the patient,you cannot see the end of the pencil that went through the cheek,as it appears to be stuck in the palate.There is not significant bleeding,and the child is not having any difficulty breathing.The child is very upset and wants you to pull the pencil out.What should you do?

Accepted Answer

A)  Stabilize the object, but do not try to remove it. 
B)  Remove the object and put a bandage on the outside of the cheek. 
C)  Call the parents and see what they want you to do. 
D)  Let the child carefully pull the object out.

Question 3

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?

Accepted Answer

A)  The presence of any defensive wounds the patient may have sustained 
B)  The swelling around his eyes, which may be reduced by applying a cold pack 
C)  Potential internal injuries 
D)  Getting a description of the assailants

Question 4

Which of the following BEST describes an avulsion?

Accepted Answer

A)  An injury caused by a sharp, pointed object 
B)  Flap of skin that is partially or completely torn away from the underlying tissue 
C)  Epidermis that is scraped away by a rough surface 
D)  Accumulation of blood beneath the skin, resulting in swelling

Question 5

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?

Accepted Answer

A)  The patient is correct. This type of wound will heal on its own and he can go back to work. 
B)  Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority. 
C)  Continue to apply cold, elevate and splint the limb, and transport the patient high priority. 
D)  Tell the patient that if it does not get better within the next few days he should consult his own doctor.

Question 6

A 37-year-old male was hit by a trolley and his foot was almost severed.It is only connected by some skin and crushed bone.What should you do?

Accepted Answer

A)  Immediately apply a tourniquet to control bleeding. 
B)  Complete the amputation. It will make the injury much easier to handle. 
C)  Because of the seriousness of the injury, wait for ALS before providing any care. 
D)  Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.

Question 7

You are dispatched to an industrial plant for a burn.You arrive and find a 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms.He is lying on the ground and coworkers are gently spraying him with water from a nearby hose.What should you do?

Accepted Answer

A)  Because of his age, immediately put him in your ambulance and transport him to a burn center. 
B)  Call for air transport and continue to pour water on the burns until transport arrives. 
C)  Care for the burn and do a complete patient assessment, including cervical spine precautions. 
D)  Before doing treatment, call the local burn center for instruction.

Question 8

An injury caused by heavy pressure to the tissues,such as when an extremity is trapped under a fallen tree,that results in damage to muscle cells and the accumulation of waste products in the tissue is called a(n):

Accepted Answer

A)  crush injury. 
B)  evisceration. 
C)  contusion. 
D)  abrasion.

Question 9

An injury in which the epidermis remains intact,but blood vessels and cells in the dermis are injured,is called a(n):

Accepted Answer

A)  contusion. 
B)  abrasion. 
C)  concussion. 
D)  avulsion.

Question 10

Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds?

Accepted Answer

A)  Absorbent 
B)  Occlusive 
C)  Adherent 
D)  Sterile

Question 11

In caring for a 27-year-old male who has a large laceration on his anterior forearm,you have noticed that your pressure dressing has become saturated with blood.Which of the following should you do next?

Accepted Answer

A)  Remove the saturated dressings and apply a large trauma dressing. 
B)  Apply an ice pack over the original dressing. 
C)  Apply a tourniquet. 
D)  Apply additional dressing material over the top of the original dressing and bandage it in place.

Question 12

Burns pose a greater risk to infants and children for which of the following reasons?

Accepted Answer

A)  Pediatric patients have a greater risk of heart problems associated with the burn. 
B)  Pediatric patients have a greater risk of shock from the burn. 
C)  Infants and children have a greater risk of infection from the burn. 
D)  None of the above

Question 13

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?

Accepted Answer

A)  Application of a dry, sterile dressing 
B)  Application of antibiotic ointment 
C)  Elevation of the wound above the level of the heart 
D)  Keeping the site clean

Question 14

Which of the following layers of the skin is the MOST important in insulating the body against heat loss?

Accepted Answer

A)  Parietal layer 
B)  Subcutaneous layer 
C)  Epidermis 
D)  Subdural layer

Question 15

Which of the following is recommended when caring for an amputated part?

Accepted Answer

A)  Rinse away debris with saline solution and place the part in a container of ice. 
B)  Wrap the part in aluminum foil to preserve body temperature. 
C)  Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack. 
D)  Always transport the amputated part with the patient.

Question 16

While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms,the EMT must be aware of which of the following?

Accepted Answer

A)  Being involved in a crime makes the patient part of the chain of evidence, requiring a police officer to ride with you to the hospital. 
B)  The burn is the most serious injury to the patient. 
C)  Medical conditions may be aggravated by the burn. 
D)  The patient may need to be questioned by police and fire officials about the cause of the fire.

Exam 26: Soft-Tissue Trauma