Deck 27: Trauma Overview: the Trauma Patient and the Trauma System

Question 1

A patient involved in a motor vehicle collision is complaining of neck pain. Which of the following pieces of information would cause the EMT to have a high index of suspicion that the patient may have suffered more significant injuries beyond isolated neck pain?

A) Lack of air bags in the car
B) Difficulty turning is head to the right
C) History of heart problems
D) Death of the car's driver

Answer 1

D

Question 2

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?

A) Down and under
B) Lateral impact
C) Up and over
D) High velocity

Answer 2

A

Question 3

A 49-year-old male has been stabbed in the lower right chest. Police tell you that the patient got into an argument with an unidentified man, who then stabbed him before fleeing the scene. After assessing the patient, you are suspicious that the knife punctured the lung and is causing internal bleeding. In this situation, the mechanism of injury would be:

A) stab wound to the right chest.
B) assailant with a knife.
C) penetrating trauma to the lungs.
D) internal hemorrhage.

Answer 3

A

Question 4

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:

A) head and neck pain indicates that he was not wearing his seat belt.
B) head pain suggests that he was not wearing the seat belt properly.
C) head and neck pain could occur when the seat belt is properly worn.
D) head and neck pain indicates that the lap belt was worn without the shoulder harness.

Question 5

A patient has been critically hurt in a nighttime motor vehicle collision. She was wearing a seat belt and hit a tree at 70 mph. The car she was driving weighed 2 tons and was equipped with air bags that did deploy. Which of the following had the greatest impact on her being injured?

A) Weight of the vehicle
B) Deployment of air bags
C) Speed of the vehicle at impact
D) Nighttime conditions

Question 6

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

A) 20 mph.
B) 35 mph.
C) 55 mph.
D) 90 mph.

Question 7

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

A) deflate the air bag to get breath sounds.
B) check the windshield for starring.
C) suspect an injury related to the air bag.
D) lift the air bag and check the steering wheel.

Question 8

As part of your service to the community, you are certified as a car seat specialist and provide monthly classes on the safe transport of infants and children. Several cars have pulled into your station and asked you to look at their car seats. Which of the following car seat positions would indicate that the parent is safely transporting his or her infant (less than 1 year old)?

A) Facing forward in the back seat in a reclined position (60 degrees)
B) Facing backward in an upright position in the front seat (45 degrees)
C) Facing backward in the back seat in an reclined position (45 degrees)
D) Facing backward in the back seat in an upright position (60 degrees)

Question 9

A 27-year-old male was involved in an altercation and was struck in the ribs with a baseball bat. Assessment reveals intact skin with noted bruising to the right lateral chest. When palpating this area, pain, instability, and crepitus are all observed. The patient also complains of difficult and painful breathing. The EMT would recognize:

A) thoracic injury secondary to penetrating trauma.
B) chest injury caused by blunt trauma.
C) pulmonary injury caused by penetrating trauma.
D) chest wall injury caused by acceleration forces.

Question 10

What piece of information would you provide to a group of young teenage drivers to decrease their chance of suffering a "whiplash" type injury if involved in a motor vehicle collision?

A) Ensure that the head rest is properly positioned.
B) Position the car's seats in a full upright position.
C) Make sure the car has side door air bags.
D) Properly wear seat belts with a headrest in the down position.

Question 11

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

A) Deformed femurs, bruises to the chest and abdomen
B) Left arm and leg deformity, head injury
C) Bilateral ankle deformity, contusions to the back
D) Head injury with deformity to both upper arms

Question 12

An unrestrained female driving a small car is involved in a rollover-type collision. Why is her risk for serious injury and death significantly increased?

A) Rollovers are the result of high speeds.
B) Smaller and lighter cars tend to roll multiple times.
C) The risk for ejection is lessened, increasing injuries suffered in the car.
D) There are more impacts in a rollover.

Question 13

If a car, driven by an unrestrained male, strikes a utility pole at 35 mph, which of the following is true?

A) The patient struck the steering wheel at a combined speed of 70 mph.
B) The internal organs struck the inside of the body at 35 mph.
C) The utility pole absorbed half of the kinetic energy, making the body collision 17.5 mph.
D) The energy transferred to the body is increased by a factor of 2.

Question 14

A young female wears her lap belt low, over her upper thighs, because the belt is uncomfortable when worn properly. If involved in a head-on "up and over" type collision, to what injury is she most prone, given the position of her lap belt?

A) Internal abdominal injury
B) Dislocated hips
C) Tibia-fibula fractures
D) Bilateral arm fractures

Question 15

An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion (bruise) to his heart. The EMT would recognize that this injury occurred during which impact of the collision?

A) Vehicle collision
B) Body collision
C) Organ collision
D) Physiological collision

Question 16

When teaching Emergency Medical Responders about air bags, what point would you emphasize?

A) Properly placed air bags eliminate the need for seat belts.
B) The benefit of air bags is decreased in multiple collisions.
C) Air bags prevent broken glass from striking the occupant.
D) Air bags are effective in decreasing injury in a rollover-type collision.

Question 17

A "whiplash" type neck injury is most often observed with what type of collision?

A) Frontal impacts
B) Ejection
C) Rear-end impact
D) Rollover

Question 18

As you pull up to a motor vehicle collision, you quickly scan the scene for clues as to the type and severity of injuries. What observation would best indicate that a patient may have a head injury?

A) Air bag deployment
B) Starring of a windshield
C) Blood on a patient's clothing
D) Frontal-type collision

Question 19

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 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:

A) an unrestrained driver involved in a head-on collision.
B) the passenger in a car hit from behind.
C) an unrestrained occupant in a car struck from the side.
D) the driver of a car hit on the driver's side.

Question 20

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:

A) "Motorcycle helmets decrease the risk of death when involved in a collision."
B) "Helmets have been shown to prevent motorcycle accidents."
C) "Wearing a helmet decreases the chance of being ejected from a motorcycle."
D) "A motorcycle helmet decreases the chance of permanent spinal injury."

Question 21

You are first on the scene of a two-car motor vehicle collision. In one car there are two patients entrapped in the vehicle, while in the other, there is a male driver complaining of chest pain. At this time, your primary concern is:

A) calling for additional help.
B) ensuring personal safety.
C) triaging the patients.
D) determining severity of injuries.

Question 22

Which of the following injuries is most serious, warranting immediate and rapid transport to the hospital?

A) Instability and crepitus to the left lateral chest wall
B) Deformity to the right ankle with pain rated as a 10/10
C) Open fracture to the left lower leg
D) Large, deep laceration to the arm with bone visible

Question 23

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

A) "If the transport to a trauma center is going to exceed 10 minutes, EMS should strongly consider the use of an aeromedical helicopter."
B) "EMS should spend a total of 10 minutes assessing the patient for life-threatening injuries prior to initiating transport to a trauma center."
C) "EMS systems should be designed so that it takes an ambulance no longer than 10 minutes to respond to a trauma call."
D) "EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene."

Question 24

A patient has been stabbed with a knife at the fifth intercostal space on the right side of the chest. Assessment reveals him to be short of breath and coughing. Which of the following questions is it most important for the EMT to ask regarding the weapon?

A) "How long was the knife?"
B) "Was the knife clean or dirty?"
C) "Did the knife penetrate your chest easily?"
D) "Did the person twist the knife?"

Question 25

Which of the following statements concerning trauma is true?

A) Falls are the leading cause of trauma deaths.
B) Mechanism of injury is the best predictor of patient outcome.
C) Multisystem trauma has a higher mortality rate than single-system injuries.
D) A "spider web" or "star" pattern of cracks on the windshield means the patient impacted the windshield with his head.

Question 26

You are assessing a male patient who was stabbed three times in the chest and abdomen. As you begin your primary assessment, you note him to have a decreased level of consciousness and gurgling respirations. Your next action would be to:

A) check his pulse.
B) obtain an SpO₂ reading.
C) suction the airway.
D) apply a cervical collar.

Question 27

A 23-year-old roofer has fallen 20 feet from the roof of a house into shrubs below. Aside from superficial abrasions and complaint of soreness, you detect no obvious injuries. Consequently, the patient states that as long as his legs are not broken, he does not see the need to go to the hospital. As a knowledgeable EMT, your best response would be:

A) "Since this is a work-related injury, you should really be evaluated in the hospital. Workman's comp may not cover you if you do not."
B) "From a fall of this height, you may have hurt some internal organs. You really need to be examined."
C) "Since you did not lose consciousness, I feel better about having you refuse. Just keep an eye on your feet and watch for swelling."
D) "Although you feel okay now, you will most likely be sore later on. Why don't we go to the hospital and ask about some medications for pain?"

Question 28

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

A) The goal for total amount of time from the actual injury to arrival of EMS at the scene
B) The target scene time for EMS as it applies to the seriously injured trauma patient
C) The time it should take the transporting ambulance to get the trauma patient to the closest medical facility
D) The amount of time EMS should spend on scene with any patient suffering a traumatic injury(s)

Question 29

You arrive on the scene of a motorcycle accident and find an unresponsive male patient lying in the middle of the road with blood coming from his ears and nose. He was not wearing a helmet and has snoring respirations. Which of the following would be most appropriate in the care of this patient?

A) Primary assessment, airway management, oxygen administration, immobilization, transport within 10 minutes of arriving on scene
B) Primary assessment, oxygen administration, transfer to stretcher, transport within 5 minutes of arriving on scene with immobilization done enroute
C) Immobilization, transfer to the ambulance with all assessment and care done enroute to the hospital with total scene time of 7 minutes
D) Primary assessment, immobilization, transfer to the ambulance after 8 minutes of scene time, all other care provided en route

Question 30

The EMT understands the importance of evaluating the mechanism of injury when he states:

A) "The mechanism of injury is useful in determining the exact injuries the patient has sustained."
B) "Evaluating the mechanism of injury is important since it determines whether emergency transport to the hospital is needed."
C) "The mechanism of injury is a useful tool in determining if the patient's outcome will be good or bad."
D) "The mechanism of injury can be used to guide your assessment and treatment of the patient."

Question 31

After assessing the following patients, which would the EMT identify as suffering from multisystem trauma?

A) 24-year-old male; slipped on ice; tenderness to the right shoulder
B) 61-year-old male; became dizzy and fell down five stairs; laceration to the head; open fracture to the left lower leg
C) 31-year-old female; large laceration to her leg from a hunting knife; bleeding controlled
D) 89-year-old female fell in a nursing home; hematoma to the back of her head

Question 32

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?

A) Burns to the head, neck, and chest
B) Headache and shortness of breath
C) Screwdriver impaled in the arm
D) Complaint of nausea after inhaling fumes

Question 33

You are assessing a patient involved in a motorcycle accident. He states that he saw an oncoming car and "laid the bike down" to avoid an outright collision. He was wearing a helmet. Which of the following injuries would make sense given the action of the motorcyclist?

A) Angulation to both femurs
B) "Road rash" to the entire body
C) Burn to the inside of the leg
D) Bilateral broken forearms

Question 34

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 gallbladder 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?

A) Cavitation
B) Drag force
C) Profile impact
D) Blunt injury

Question 35

An 8-year-old boy fell forward off of a swing onto outstretched arms. He did not hit his head or lose consciousness and is complaining of left forearm pain. There is deformity to the left wrist, but no other injuries or life threats. His vital signs are pulse 132, respirations 20, blood pressure 108/62, and SpO₂ 100%. The proper care of this patient would be:

A) immediately load and transport, splinting the injury en route.
B) apply high-concentration oxygen and anatomically splint the forearm when the patient is immobilized to a long backboard.
C) splint the forearm and apply a cold pack before transporting non-emergently.
D) call ALS so that the patient can be given intravenous pain medications before splinting the forearm.

Question 36

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

A) The hospital can manage all trauma patients, 24 hours a day, 7 days a week.
B) The hospital can handle most trauma patients, but will transfer those who require specialty care for specific injuries.
C) The hospital will provide surgical services to a trauma patient and then transfer them once stable.
D) The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and transfer them.

Question 37

A male patient has sustained gunshot wounds to the neck and abdomen. He is unresponsive and has gurgling respirations. Your immediate action would be to:

A) insert a nasal airway.
B) manually immobilize the spine.
C) start positive pressure ventilation.
D) suction the airway.

Question 38

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?

A) Inner ear damage caused by the noise of the explosion
B) Primary phase blast injury to the inner ear
C) Secondary blast injury to the inner ear
D) Ear damage caused by exposure to superheated air

Question 39

Which of the following is a high-velocity wound that carries the greatest risk for death when considering the concept of cavitation?

A) Shotgun wound to the lung
B) Gunshot wound to the spleen
C) Stab wound to the liver
D) Gunshot wound to the stomach

Question 40

Which of the following best describes the goal of a trauma system?

A) Getting the right patient to the right facility in the right amount of time
B) Providing the highest level of care possible within a 10-minute transport time for all patients
C) Providing all trauma patients with a complete battery of diagnostic tests and access to specialists
D) Transporting as many patients as possible by air medical transportation

Question 41

A teenage female patient has been ejected from a car as it rolled down a hill. She is responsive, but with signs of early shock. She has bruising to her anterior abdomen, a laceration to her left temple, and deformity to her left wrist. At what point should the wrist injury be splinted?

A) Prior to immobilizing the patient
B) Before transferring to the stretcher
C) Just before leaving the scene
D) En route to the hospital