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EMT FISDAP readiness exam 4
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- In contrast to the assessment of a trauma patient, assessment of a
medical patient
almost exclusively focuses on physical signs that indicate the patient is
experiencing a problem.
is focused on the nature of illness, the patient’s chief complaint, and his or
her symptoms.
requires a thorough head-to-toe exam that involves a detailed
assessment of all body systems.
is not as complex for the EMT because most patients typically present
with classic symptoms.(Answer) b - Which of the following statements regarding medical emergencies is
cor- rect?
Medical emergencies always take priority over traumatic
injuries. Medical emergencies can appear to be trauma in nature.
Medical emergencies and traumatic injuries always have distinctive
presen- tations.
Medical emergencies rarely precipitate traumatic injuries.(Answer) b - You and your EMT partner arrive at the residence of a 50-year-old man
who complains of weakness. Your primary assessment reveals that he is
critically ill and will require aggressive treatment. The closest hospital is
25 miles away. You should(Answer)
perform a detailed secondary assessment, assess his vital signs, and then
transport rapidly.
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manage all threats to airway, breathing, and circulation and consider
request- ing an ALS unit.
administer oxygen via nonrebreathing mask and obtain as much of
his medical history as possible.
load him into the ambulance, begin transport, and perform all treatment en
route to the hospital.(Answer) b
- ou have just completed your primary assessment of a 48-year-old man
with crushing chest pain. The patient has been given 324 mg of aspirin and
is receiving high-flow oxygen via nonrebreathing mask. As you begin your
secondary assessment, you note that his mental status has deteriorated
and he is now bradycardic. You should(Answer)
continue with your secondary assessment.
prepare the patient for immediate transport.
insert a nasal airway and assist his breathing.
request an ALS unit to respond to the scene.
(Answer) b - A 33-year-old female presents with lower abdominal quadrant pain.
She is conscious and alert, but in moderate pain. While your partner is
asking her questions about her medical history, you take her vital signs.
When you assess her radial pulse, you are unable to locate it. You
should(Answer)
assess the rate, regularity, and quality of her carotid pulse.
advise your partner that the patient’s blood pressure is low.
immediately take her blood pressure to see if she is hypotensive.
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conclude that she is perfusing adequately since she is conscious.(Answer)
a
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- Ten days after treating a 34-year-old patient with tuberculosis, you are
given a tuberculin skin test, which yields a positive result. This MOST
likely indicates that(Answer)
you are actively infected with tuberculosis and should be treated
immediate- ly.
the disease is dormant in your body, but will probably never cause
symp- toms.
you contracted the disease by casual contact instead of exposure to
secre- tions.
you were exposed to another infected person prior to treating the 34-yearold patient.(Answer) d - Which of the following statements regarding the human
immunodeficiency virus (HIV) is correct?
HIV is far more contagious than hepatitis B and is easily transmitted in
the health care setting.
The risk of HIV infection is high, even if an infected person’s blood comes
in contact with your intact skin.
The risk of HIV infection is greatest when deposited on a mucous
membrane or directly into the bloodstream.
Most patients who are infected with HIV experience chronic symptoms that
vary in duration and severity.(Answer) c - A 58-year-old man complains of chest discomfort and nausea. He
is conscious and alert. His blood pressure is 140/90 mm Hg, his pulse
is 104 beats/min, and his respirations are 16 breaths/min. Your partner
has
applied supplemental oxygen. Prior to assisting the patient with one of his
prescribed nitroglycerin tablets, you ask him if he takes medication to
treat erectile dysfunction and he tells you that he does. You
should(Answer)
92 year old female complains of a headache and trouble breathing. She is on home O2. What is the most important question you should ask
When did SOB Start
You have attached an AED to a 42 year old female who is apneic and pulseless. The AED prompts you. “No shock advised.” You should
start chest compressions
Which cardiac rhythm will an AED most likely prompt you to shock?
ventricular tachycardia
A 22 year old female tells you she is weak and complains of steady vaginal bleeding that started 2 hours ago. She denies any pain and tells you that she had her menstrual cycle 2 weeks ago. Vital signs are BP 100/68, P 110, R 16, and skin is warm and dry. You should
place a sanitary pad over the vaginal opening
When securing a pregnant patient to a long spine board, you should tilt the board to the left to prevent
hypotension
A 10 month old female is choking. You should perform
5 back blows
A 53 year old male complains of nausea and a headache. Which of the following statements is most significant?
just turned the furnace on last night.”
A 72 year old female’s family member tells you that she had a brief period of slurred speech and left arm weakness prior to EMS arrival. What is the most likely cause?
transient ischemic attack
A 58 year old male complains of general weakness and tells you that he had severe chest pain and shortness of breath the day before. You hear takes at the bases of both lungs. His skin is pale, cool, and clammy. Vital signs are BP 70/40, P 110 and weak, R 28. You should suspect
cardiogenic shock
An unresponsive 52 year old females in respiratory failure after being struck in the chest with a metal pipe. With each breath only one side of her chest rises. She has subcutaneous emphysema and absent radial pulses. What should you do?
provide positive pressure ventilations
A 48 year old male who was involved in a car crash is slumped over the steering wheel and unresponsive to loud verbal stimuli. You see smoke inside the vehicle and that the airbag deployed. You should
perform an emergency extrication
A 23 year old female is 30 weeks pregnant and complains of abdominal cramps. She tells you that she has had normal prenatal health care and no vaginal discharge. Vital signs are BP 102/74, P 112, R 22 and labored. You should
administer oxygen
Your EMS base displays a ” Free Blood Pressure Check” sign on the window. This is an example ofa. community
community relations
A 19 year old female was sexually assaulted and is bleeding from her vagina. You should
place a sanitary pad over the vaginal opening
While ventilating a 12 year old female with a pocket mask, you are unable to see chest rise. You should
reopen the airway
A confused 22 year old male has a weak pulse of 122 and distended abdomen. His skin is pale, cool, and clammy. What is the most likely cause?
internal bleeding
A 45 year old female is 34 weeks pregnant. She complains of a severe headache, sensitivity to light, and swollen feet. Vital signs are BP 130/88, P 104, R 24. What should you suspect?
pre-eclampsia
While triaging during a mass casualty incident you find an unresponsive and apenic female wiath an open head injury. What color triage tag should you assign her?
black
A 15 day old female neonate is unresponsive. Vital signs are P 55 and R 58. You should
chest compressions
You are ventilating a 30 year old male with a BVM. After several minutes of ventilation, he becomes cyanotic and there is no chest rise. You should
reposition the airway and ventilate again
A 53 year old male with a history of coronary artery disease had a sudden onset of tearing abdominal pain that radiated to his back. he is ashen and diaphoretic. He states that he needs to use the toilet. Vital signs are BP 110/70, P 100, R 20. You should
explain the need for immediate transport
A newborn is apneic immediately after delivery. You should
stimulate the baby by rubbing vigorously
An unresponsive42 year old male is not breathing. He has a medical alert bracelet that identifies him as diabetic. You should
check for a pulse
A 62 year old male with a history of COPD ran out of his home oxygen. He is short of breath and has a dry, nonreproductive cough with clear lung sounds. What should you suspect?
emphysema
A 19 year old female is postictal following a 10 minute tonic-clonic seizure. She has snoring respirations. What should you do ?
insert an OPA
Which of the following is a contraindication for nitroglycerin administration?
recent use of erectile dysfunction medication
A 62 year year old male is in cardiac arrest at a restaurant. After beginning chest compressions, his daughter tells you that he has terminal lung cancer, and she ask you to stop resuscitation efforts. What should you do?
ask about a DNR while continuing resuscitation efforts
A 7 year old male is in cardiac arrest after choking on a bite chicken. Upon your arrival, you note effective CPR is in progress. You should
immediately apply AED
A 3 year old female is sitting very still on her father’s lap. She is drooling and her father states that she will not eat or drink. What should you suspect?
A 3 year old female is sitting very still on her father’s lap. She is drooling and her father states that she will not eat or drink. What should you suspect?
A 6 year old male has a deep laceration to his lower leg with dark red, oozing blood. Vital signs are BP 108/70, P 124,R 20. You should
apply direct pressure
A 450 lb patient has a 6-inch laceration two hands right upper arm and a fractured left ankle. He is on the third floor of in apartment building. You should
apply a pressure dressing to the arm
A 56 year old male complains of increasing shortness of breath. He is confused and speaking in 2 words sentences. He has pedal edema and jugular vein distention with a productive cough. Vital signs are BP 168/94, P 88 and irregular, R 28 with crackles, Spo2 76%. What should you do?
apply high-flow oxygen by non-rebreather mask
When using the ambulance siren, you should
consider that motorists will not hear it
An 88 year old female in hospice care is pulseless and apneic with dependent lividity. Her son says “She died 2 hours ago after I gave her a large dose of pain medication.” What should you do?
notify law enforcement
While assisting in delivery of a newborn patient, you notice the amniotic sac is still intact. You should
tear the amniotic sac
While performing a primary assessment of a 32 year old female, she complains of a rapid heartbeat. What should you do?
obtain base line vitals
A 12 year old male is prone in a shallow bathtub the water. He is pulseless and apneic. What should you do?
start chest compressions
You arrive at a factory and see lots of people coughing as we evacuate the building. You should
call for additional resources and look for you triage sites that is upwind from the factory
A 33 year old female has been “down” for an unknown period of time and is pulseless after contact with a portable welder. You should
begin compressions
A 52 year old female complains of severe abdominal pain, distention, and black stools. Vital signs are BP 92/40, P 115, R 20. What should you suspect?
upper intestinal bleeding
A 46 year old female complains of swollen feet, orthopnea, and shortness of breath with exertion for the last 2 days. What is the most likely cause?
heart failure
An unconscious 42 year old male is apneic. Bystanders tell you that the patient suddenly grabbed his throat while eating and then collapsed to the ground. You should
start chest compressions
A 78 year old male tells you, ” I feel sick and can’t walk.” His bed is dirty with urine and feces. He requests that you transport him to the hospitol, but his daughter does not want him transported. You should
transport him to the hospital
Immediately after the delivery of a vigorous newborn, you shoulda. place the newborn level with the placenta
suction the oropharynx with a bulb syringe
A 56 year old female complains of shortness of breath with a cough producing thick mucus. She is in tripod position and has a barrel chest. Her lung sounds are diminished with respiratory rate of 24. What should you suspcet?
chronic bronchitis
A 4 year old was the restrained front seat passenger in a car crash with air deployment. He has chemical burns to his face and is having trouble breathing. You should
perform rapid extracation
An 18 year old male overdosed on an unknown medicaton and has a respiratory rate of 8. You insertes an OPA, and he had gag reflex. You should
insert a NPA
An unresponsive 22 year old male is breathing 6 times per minute after crashing his motorcycle a highway speeds. You should
begin ventilating him with a BVM
A 55 year old female fell and struck her head. She now complains of a headache. Which statement is most concerning?
“I think I blacked out.”
A 23 year old female is 38 weeks pregnant with her third child. Her contractions are 2 minutes apart and 1 minute each. She tells you that she needs to go to the bathroom. You should
prepare for immediate delivery
A 29 year old female has just delivered a newborn and she is still bleeding heavily. You should
massage the fundus
What is appropriate to say to a suicidal patient?
” Let’s bring you to the hospital.”
A 51 year old male is unresponsive with agonal respirations. You should
check for a pulse
A 59 year old male complains of dizziness and crushing chest pain. He is pale and cool. You should
assist him in self-adiminstering his prescribed nirtoglycerin
Which of the following patients has the right to refuse treatment and transport?
A 52 year old male with tightness of chest and wheezes
A 19 year old female is found by her friend staring blankly at the wall. She is awake, but slow to answer questions. What is the most likely cause?
seizure
A 58 year old female has a fever with chills. Lung sounds reveal rales and rhonchi in the lower right lung field. What should you suspect?
pneumonia
A 66 year old female has regained a pulse after one shock with an AED. She is moving her extremities and has a respiratory rate of 8. The AED propmts you. “Shock advised.” You should
assist vent
A 68 year old male was found unresponsive 5 minutes ago. There is no spontaneous respiratory effort. You should
perform a carotid pulse check for 5-10 second
A 19 year old female is unresponsive after overdosing on heroin. She is supine on the ground with gurguling respiration and vomit next to her head. You should
open her mouth and suction her airway
Which of the following should cause you to suspect pulmonary edema?
crackles
A 56 year old male had car battery acid splashed in his eyes. You should
irrigate his eyes
You are driving emergent with lights and siren. When approaching with a green light, you should
proceed through the intersection with due regard
When is it appropriate to insert your gloved fingers into vagina?
To relieve pressure off the umbilical cord
A 15 year old male was struck in the face by falling tree branch. He was knocked to the ground, and is now alert and repeatedly complains of a headache when lying down. Vital signs are BP 140/90, P 100, R 16. You should
begin spinal immobilization
A 36 year old male complains of nausea, vomiting, and abdominal pain. He is homeless and admits to chronic alcohol use. Vital signs are BP 92/54, P 122, R 18. You should suspect
pancreatitis
An unresponsive 19 year old female is supine on a bed next to several empty beer cans, and her 3 year old son is running around the house. Vital signs are BP 80/40, P 110, R 6 and shallow. You should
transport the woman and her son to the hospital
Which of the following groups of signs and symptoms most correctly suggests an opioid overdose?
hypoventilation, pinpoint pupils, and hypotension
An 87 year old male has methicillin-resistant staphylococcus aureus and he has several open lesions on his chest. His lungs are clear to auscultation but he coughs regularly. What should you do to prevent the spread of this infection?
report the exposure to your supervisor
What is a system of internal and external reviews called?
quality improvement
A 23 year old female had a seizure prior to your arrival. During your primary survey, she starts to have another seizure. You should
ensure an open airway and adequate breathing
A 15 year old male I having an allergic reaction. Which of the following should concern you the most?
throat swelling
In which zone should you triage patients during a hazardous materials emergency?
cold
How many liters pe minute of oxygen is required for a non-rebreather mask?
10
A 20 year old male complains of a sudden onset of shortness of breath and chest pain. His lung sounds are diminished on the right side. He denies trauma and past medical history. You should suspect
spontaneous pneumothorax
While performing a primary survey on a suicidal 35 year old male, he becomes verbally abusive. You should
calmly attempt to deescalate him
A 6 year old female is crying in the back seat of a vehicle after a car crash. A downes utility line is on top of the vehicle. You should
contact dispatch for additional resources
An 18 year old female with sickle cell anemia complains of stomach pain and upper leg pain. Vital signs ar BP 130/66, P 96 , R 14. You should
apply oxygen and transport her in a position of comfort
While gathering a patient’s medical history, you find a mixture of current and expired medications. What should you do about the expired medications?
take the expired medications to the hospital
A 2 year old male had a seizure following the onset of a high fever. What should you recommend to his parents?
transport him to the hospital
An alert 65 year old male has a suspected myocardial infarction and is refusing transport. He tells you it’s indigestion and wants to stay home with is wife. You should
attempt to convince him to go to the hospital
A febrile 24 year old female complains of periumbilical pain that radiates to her right lower quadrant. What should you suspect?
appendicititis
An 8 year old male was hit by a car and is unresponsive. He has ecchymosis to his left upper quadrant. You should suspect
splenic injury
A 45 year old female has a frostbite on both feet. Your transport time is 20 minutes. You should
re-warm her feet with blankets
A circumferential burn from the elbow to the wrist is approximately what percentage of total body surface area?
4.5
A 40 year old male has an open ankle fracture that’s actively bleeding. Which of the following precautions should you take?
gloves, googles, and surgical mask
What organ is reponsible for the exchange of oxygen, food, and waste between a mother and fetus?
placenta
A 16 year old male tripped and landed on his elbow. His elbow is swollen with obvious deformity, and he is screaming in pain. You should
splint his arm in the position found
A 56 year old female complains of chest pain that is unrelieved with 3 of her own nitroglycerin tables. She is having trouble breathing and is speaking in only 2-3 word sentences. You should
provide supplemental oxygen
A 50 year old female tells you. ” I’m having the worst headache of my life,” and that the headache began suddenly, 20 minutes ago. Vital signs are BP 180/90, P 56, R 20. What should you suspect?
subarachnoid hemorrhage
A 22 year old male was kicked in the chest by a horse. He has distended neck veins and tracheal deviation. What should you suspect?
cardiac tamponade
A patient amputated her index finger in a table saw accident. You should
wrap the finger in gauze, put it in a plastic bag, and keep it cool
You resuscitated a 53 year old male with an AED on scene. During transport, he becomes pulseless again. What should you do?
Perform chest compression and stop the ambulance
A 36 year old female complains of a headache, slurred speech, and weakness in her left hand. What is the most important question to ask her?
” When did these symptoms start?”
A 36 year old female complains of a fever and lower abdominal pain that moves to her lower back when she walks. She also mentions that she’s had abnormal vaginal discharge for the last 2 days. Vital signs are BP 144/88, P 98, R 16. You should suspect
pelivc inflammatory disease
Air Medical Landing Zone
100 x 100
Pencil stuck in cheek and bleeding stopped
stabilize it
A 19 year old Female jaw is clenched following a 5 min tonic clonic seizure. She is cyanotic and has gurgling respirations. What should you do?
Insert NPA and suction
42 yo is apneic suddenly grabbed throat while eating and collapse. You should.
Compressions
an unconscious pt has a partially amputated foot. You should
Control bleeding
A 25-year-old stabbed in the chest occlusive dressing was applied prior to arrival Vital signs are 90/62 pulse 122 respiration 28 and labor you should
Lift one side of the occlusive dressing
28 year old 31 weeks prego falls in shower. Severe abdominal pain, bright red vaginal bleeding. Suspect
abruption placenta
76 Year old female with fever, cough w/green sputum for 3 days. Lung sounds Rhonchi
Pneumonia
Unresponsive 22 year old is breathing 6/min after motorcycle crash
Begin ventilation with BVM /
54 year old female drank bleach to kill herself.
call Poison control
Patient has been shot in the chest after cutting off the patient’s blood soaked shirt you should place it in
Brown paper bag
A 35 year old has shortness of breath after being shot in abdomen and legs. Vital signs are P 122 R 24 and labored
Apply 02 by non rebreather
A 70 year old male complains of shortness of breath he tells you “I woke up and felt like I was drowning.” He has recently been sleeping with extra pillows under his head. Vital signs are BP 166/80, P 98 and irregular, R 24, SpO2 86%. What should you suspect?
Left side heart failure
what is the normal breathing rate for a 6 year old?
18-30
An unconscious 28 year old male has a puncture wound in his left forearm. You also see multiple scars on the backs of both his hands. What type of overdose should you suspect?
Narcotic od
A 42 year old was stung by a bee on his left hand and finger are red and swollen, he tells you that he is allergic to bee stings. Vitals are Bp 112/76 P90 R16 you should?
Scrape stinger
Appropriate to say to suicidal patient
Let’s bring you to the hospital
A 23 year old male has a penetrating wound to his right upper chest with a small amount of bubbling blood. He is alert, pale, and diaphoretic. Vital signs are BP 122/82, P 112, R 24. You should?
Apply an occlusive dressing
A 24-year-old female is 32 weeks pregnant she tells you that she feels weak and has been vomiting for the past three days she also tells you that she is scared to go to the hospital in the ambulance. Vital signs are 84/82 pulse is 110 respirations 16 SPO2 98 you should
Monitor her vital signs and transport
55 year old female tells you “It feels like something is stuck in my throat and my voice sounds different.” She is hot to the touch.
Inspect her throat for a foreign body
Baby/infant Grunting & Intercostal Retractions & Nasal Flaring
Respiratory Distress
An unresponsive 67 year old male is lying supine with a weak carotid pulse. He has emesis in his oropharynx and gasping respirations of 6 you should
Suction Airway
A 66 year old female complains of shortness of breath. You notice several tissues beside her that contain bloody sputum. You should
Don an N95 mask and ask her if she has experienced night sweats or cough
21 year old female has an open femur fracture after falling off horse, you should
check distal pulse
20 year old male has supraclavicular retractions and is slow to respond to questions. He has expiratory wheezes in all lung fields with minimal chest wall movement. You should
ventilations with a bag valve mask
Periumbilical pain radiates to Right Lower Quadrant
Appendicitis
After delivering a shock with an AED to an unresponsive 49 year old male you should
Resume chest compressions
A 22 fem was in a bicycle accident and struck her chest on the handlebar. She is short of breath and you notice small section of her chest move asymmetrically. You should suspect?
Flail segment
An alert 62 yo male complains of chest pain, short of breath and long history of angina. Vital signs are BP 90/50, P100, R22, SP02 90%. What should you do?
Administer o2
24 year old female complains of right lower quadrant abdominal pain that radiates to her back with slight vaginal bleeding
Ruptured ovarian cyst
What is the leading cause of bradycardia for pediatric patients
Hypoxia
78 yo M says “Feel sick cant walk” wants to be transported but daughter doesn’t want you to.
Transport to hospital
Unresponsive 3yo lying supine in a ditch. VS 60/40 P60 R8. you should?
Assist ventilations
82 yo F mumbling and throwing clothes, nurse says she’s diabetic. You should?
Give oral glucose
19 yr F is posticial following 10 mins seizures has snoring respirations. You should?
Insert OPA (jaw thrust was originally but)
Complications with precipitous delivery
Perineum tearing
When lifting a stretcher into the ambulance using power grip, you should?
Position hands 10 apart
Previous ambulance crew failed to clean backboard properly. Dried blood under the edges
Wash board with disinfectant
28 yo F has severe pain after slipping in the shower. 31 wks pregnant has bright red vaginal bleeding. Suspect?
Abruption placenta
Which the following will only occur in the 1st trimester of pregnancy?
Ectopic pregnancy
Newborn is apneic immediately after delivery
Stimulate baby
56 yo M with severe pain after eating greasy food
cholecystitis
Request additional resources for which victim? (couldnt find all the options
Foot wedged in pedal
2 year old has been vomiting for 12 hours and has decreased oral intake. She does not track your movements. What type of shock should you suspect? P150 R 24. Cool skin w/ mottling.
Hypovolemic
First step with a sexually assaulted patient?
reassure the patient
Are administering oral glucose to a known diabetic. What should you be most concerned about?
The smell of acetone on breath
A 36 year old female complains of left leg pain after a head-on car crash. When you place her on the long spine board, you notice that her left leg is shortened and rotated outward. What should you suspect?
femur fracture
A 35 year old male has a blood pressure of 126/62. What does the number 62 represent?
diastolic
A 36 year old male is ventilator-dependent. His caregiver called 911 because the ventilator’s warning alarm was sounding. You should
look for adequate chest rise and fall
You are ventilating a 30 year old male with a bag-valve mask. After several minutes of ventilation, he becomes cyanotic and there is no chest rise. You should
reposition the airway and ventilate again
A patient has been shot in the chest. After cutting off the patient’s blood-soaked shirt, you should place it in a/an
biohazard disposal bag
Where in your patient care report should you document that you placed the patient on oxygen at 15 LPM by non-rebreather mask?
plan
A 72 year old female has a nose bleed after a fall. You should
lean her forward
When does crowning occur?
when the head is visible
Which of the following pregnancy complications is typically painless?
placenta previa
- You are driving emergent with lights and siren. When approaching an intersection with a green light, you should
drive with due regard
A 45 year old male is hypothermic after spending the night camping outside. You should
move to warm environment
Which of the following is an audible, high-pitched breath sound that usually results from a blockage of the smaller air passages?
stridor
- A 32 year old female is 36 weeks pregnant. She is lying on the bathroom floor with two legs protruding from her vagina. What should you suspect?
Breech birth - A 20 year old female has a large contusion on her forearm that she states is from running into a doorknob. You notice she has several other bruises in various stages of healing and she consistently looks down while talking. What should you suspect?
Domestic Abuse
A 35 year old male spilled corrosive chemicals on his legs while cleaning an indoor swimming pool. He is dyspneic and has partial thickness burns to his legs. You should
remove him from the pool area
Which statistic about EMS calls would support a community’s request to reduce the speed limit in their neighborhood?
15% of calls for car crashes have at least one victim dead on scene
To correct an error during documentation, you should
draw single line through error and initial
While triaging during a mass casualty incident you find an unresponsive and apneic female with an open head injury. What color triage tag should you assign her?
black
A 56 year old female complains of shortness of breath with a cough producing thick mucus. She is in a tripod position and has a barrel chest.Her lung sounds are diminished with a respiratory rate of 24. What should you suspect?
chronic bronchitis
You are delivering a baby and the amniotic sac is still in place. You should?
Tear amniotic sac
22 year old fem is choking.She is in her 3rd trimester of pregnancy she is standing up leaning over a chair drooling unable to speak or cough. You should?
Perform chest thrust
You arrive at the factory and see lots of people coughing as they evaluate the building you should?
Triage upwind
Which vessels carries oxygenated blood back to the heart?
Pulmonary veins
Pulmonary veins
immediately after the delivery of vigorous newborn, you should.
Suction oropharynx with bulb
A newborn head has just been delivered. You should?
Inspect for meconium
A 10 month old F withdraws to painful stimuli. She had an ear infection and fever the passed three days, and she has a bulging fontanelle.
Meningitis
Bleeding from dialysis shunt you should
Apply direct pressure to the shunt
28 year old is in active labor. You see umbilical cord protruding from her vagina. Which position should you place her in?
Knee-chest
Daughter of 82yo M called 911 because she thought her father was acting strangely. He has no complaints and refusing to go to the hospital. Daughter has proof of Medical Power of Attorney. She tells you to take him to the hospital. You should?
Tell her daughter that she is only legally allowed to make decisions when her father is incapacitated
You are assessing a 10-year-old boy who fell out of a tree. Evaluation of the MOI would concentrate on which of the following?
- the surface onto which the child fell
- the part of the body that struck the ground first
- the height from which the child fell
Rearrange the steps of the decision scheme for field triage of injured patients into the correct order.
- Measure vital signs and LOC
- Assess anatomy of injury
- Assess MOI and evidence of high-energy impact
- Transport
Which of the following has the greatest impact on producing injury?
speed (the energy that is available to cause injury doubles when an object’s weight doubles, but it quadruples when speed doubles)
How many collisions are there in a typical vehicle impact?
3
There are three collisions in a typical impact: the collision of the car against another object, the collision of the passenger against the interior of the car, and the collisions of the internal organs against the solid structures of the body.
In which type of vehicle crash are you most likely to find a patient with whiplash injuries?
rear-end
The phenomenon that results from the rapid changes in tissue and fluid pressure that occur with the passage of a projectile, resulting in serious injury to internal organs distant to the actual path of the bullet, is known as what?
cavitation
What type of blast injury occurs when objects are propelled by the force of the blast wave and strike the victim, causing injury?
secondary
What level of trauma center provides prompt assessment, resuscitation, and stabilization of injured patients and emergency operations, but not definitive care for all patients?
level 3
You are assessing a patient who opens her eyes when you speak to her, who can respond to you but seems confused as to time and place, and localizes pain. What is her Glasgow Coma Scale score?
12
3 for eye opening, 4 for confused conversation, and 5 for localizing pain
You are assessing a patient who was in a front-end car crash. His GCS is 12, systolic blood pressure is 81 mm Hg, and respiratory rate is 22 breaths/min. What is this patient’s Revised Trauma Score?
10
The patient’s RTS is 10: GCS of 12 = 3, SBP of 81 mm Hg = 3, and RR of 22 breaths/min = 4.
You would use the Revised Trauma Score scoring system for a patient if there is potential for what type of trauma?
head
The RTS is most commonly used for patients with head trauma because it is weighted to compensate for major head injury without multisystem injury or major physiologic changes.
At what step in the ACS-COT/CDC updated field triage decision scheme would you assess mechanism of injury and evidence of high-energy impact?
step 3
The index of suspicion is MOST accurately defined as:
your awareness and concern for potentially serious underlying injuries
When assessing an elderly patient who fell, it is important to remember that:
osteoporosis can cause a fracture as a result of a fall from a standing position
Force acting over a distance is the definition of:
work
While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:
neck and facial injuries
Approximately 25% of severe injuries to the aorta occur during:
lateral collisions
A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:
stabilize her entire spine
Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?
aortic rupture
Which of the following statements regarding gunshot wounds is correct?
The speed of a bullet has the greatest impact on the injury produced
Which of the following destinations is most appropriate for a 41-year-old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal?
level 1 or level 2 trauma center
Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His Revised Trauma Score (RTS) is:
9
you determine that your patient is experiencing internal bleeding. what should you do next?
administer oxygen
__ occurs when blood volume is significantly diminished and the circulatory system fails to provide sufficient circulation to the body.
Hypoperfusion
You are treating a patient with significant external bleeding. Rearrange the steps into the correct order in which they should be addressed.
- control bleeding
- adress ABCs
- treat for shock
- assess for DCAP-BLTS
Which of the following should you do when applying a tourniquet?
Place the tourniquet proximal to the injury (in the axillary region for upper extremity injuries and at the groin for lower extremity injuries).
make sure the tourniquet is tightened securely
Which of the following are the key to the formation of blood clots?
Platelets
How soon do cells in the brain and spinal cord start to die without constant perfusion?
Within 4-6 minutes
In general, what is the maximum amount of acute blood loss the adult body can tolerate?
20% of total blood volume
(or more than 2 pints/1 liter)
The condition in which low blood volume results in inadequate perfusion is called what?
Hypovolemic shock
Which type of bleeding is characterized by a bright red color and spurting?
Arterial
Which of the following would be the first sign of hypovolemic shock?
anxiety
first sign of hypovolemic shock is a change in mental status, such as anxiety, restlessness, or combativeness.
You determine that your patient is experiencing internal bleeding. What should you do first?
administer oxygen
Which condition is likely when signs of hypotension; tachycardia; and cool, clammy skin are found?
shock
What should you do first to control external bleeding in an extremity?
Apply direct pressure.
You are assessing a patient who is bleeding from the ear, which gives you a high index of suspicion that he has a skull fracture. How should you address this?
loosely cover the site
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released
Which section of the heart receives deoxygenated blood?
right
Hypovolemic shock occurs when:
the body cannot compensate for rapid blood loss
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
gastrointestinal bleeding
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
assist the patient’s ventilations
In older patients, the first indicator of nontraumatic internal bleeding may be:
weakness or dizziness
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
air splint
Circulation of blood within an organ or tissue in adequate amounts to meet the cells’ oxygen, nutritional, and waste-removal needs is termed _.
perfusion
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?
gastrointestinal system
Significant vital sign changes will occur if the typical adult acutely loses more than __ of his or her total blood volume.
20%
TRUE or FALSE. A hematoma is an open injury that occurs whenever a large blood vessel is damaged and bleeds rapidly.
false – A hematoma does occur whenever a large blood vessel is damaged and bleeds rapidly, but it is a closed injury.
TRUE or FALSE. You should never remove an avulsion skin flap, regardless of its size.
true
TRUE or FALSE. When possible, ALS providers should administer IV fluid within 3 minutes after the crushing object is lifted off the body.
false – When possible, ALS providers should administer IV fluid before the crushing object is lifted off the body.
TRUE or FALSE. The goal of the inflammation phase of wound healing is the removal of foreign material, damaged cellular parts, and invading microorganisms from the wound site.
true
For which injury would you use an occlusive dressing directly on the wound?
Open neck injury
Which of the following factors will help you to determine the severity of a burn?
- Involvement of any critical body areas (face, upper airway, hands, feet, genitalia)
- extent of the burn
- depth of the burn
- preexisting medical conditions
Which of the following patients is likely to have injuries with entrance and exit wounds?
- a do-it-yourselfer who touched a live wire while repairing a light fixture
- a 19-year old who has been hit by high-caliber gunfire
(electrical burns and high-caliber gunshots leave entrance and exit wounds)
Which of the following is the final stage of wound healing?
Collagen production
(collagen provides stability to damaged tissue and joins wound borders, closing the open tissue)
You are assessing a 28-year-old with a rigid cast extending the length of his left leg. The patient is complaining of pain on passive movement and he is showing signs of impaired circulation. What do you suspect?
Compartment syndrome
(commonly develops in the extremities and may occur in conjunction with open or closed injuries or when swelling occurs under restrictive immobilization devices such as a cast)
You are assessing a patient who has been in a high-impact T-bone collision. She is bleeding from the abdomen and you can see part of her large intestine outside her body. What is this injury called?
Evisceration
You are treating an 8-year-old who fell while riding his bike on a gravel road. The wound on his arm is seeping blood, is about 7 inches long, and there is a lot of dirt and gravel in it. How should you treat this injury?
Apply sterile dressing.
The severity of a thermal injury directly correlates with temperature, concentration, and what other factor?
Duration of exposure
You are responding to a fight at a restaurant and find a man, conscious and alert. His face is mottled with blisters and abrasions, and he has blood on his shirt. He tells you he was trying to stop the fight when he was hit in the face with scalding hot coffee and fell backwards over a chair. According to the rule of nines, what percentage of the patient’s skin surface is burned?
9%
What is your first responsibility when treating a burn patient?
Stopping the burning
Which of the following is true about electrical burns?
They are always more severe than the external signs indicate.
(A major danger associated with electrical burns is the amount of deep tissue damage done)
Which type of soft-tissue injury is LEAST likely to result in infection?
Contusions on the left lateral chest
When using the rule of nines, which of the following do you need to include in your calculations?
Full- and partial-thickness burns
The __ is a prominent bony mass at the base of the skull 1 inch posterior to the external opening of the ear.
Mastoid process
You are treating a patient with a facial injury that has displaced the eyeball from the socket. Which of the following actions are appropriate to take?
- cover the eye with a moist, sterile dressing
- cover both eyes to decrease sympathetic eye movement
Which of the following is true about posterior epistaxis?
- more severe than anterior epistaxis
- causes nausea and vomiting
What is a hematoma?
A collection of blood within the tissues
Which of the following fractures is associated with bruising around the ears and blood coming from the nose?
basilar skull fracture
What is hyphema?
Bleeding into the anterior chamber of the eye
You are assessing a patient who was hit in the face by a baseball bat. There are multiple contusions on his face, and he reports double vision. His left eye does not track with his right eye. What should you suspect?
Blow-out fracture
Which of the following is or are found in the middle ear?
Anvil, hammer, and stirrup
In which instance would you consider removing an impaled object?
When the object is impaled in the cheek and compromises the airway
What is an air embolism?
A clinical situation in which a vein is punctured and air is sucked into the heart
Unequal pupils most likely indicate what type of injury?
Brain
You are treating a patient with significant bruising to her face and a broken nose. She is conscious, but her LOC is significantly altered and her breathing is labored. What should you do to manage this patient’s airway?
Insert an oropharyngeal airway.
Which area of the body are you palpating if you feel subcutaneous emphysema?
…..
lecture for chapt 27
Burns to pediatric patients are generally considered more serious than burns to adults because:
pediatric patients have more surface area relative to total body mass
You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:
assess distal circulation and readjust the bandage as needed
Which of the following areas of the body has the thinnest skin?
ears
Which of the following processes occurs during the inflammation phase of the healing process?
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:
an air embolism
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
The sebaceous glands produce sebum, a material that:
waterproofs the skin and keeps it supple
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
replace the avulsed flap to its original position and cover it with a sterile dressing
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
report the incident to the appropriate authorities
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
contusion
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
rapidly transporting her to the hospital
A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:
transport her to the emergency department
The MOST significant complication associated with facial injuries is:
airway compromise
Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:
direct pressure using dry, sterile dressings
The superficial temporal artery can be palpated:
just anterior to the tragus
Which of the following statements regarding the vitreous humor is correct?
It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost
When a light is shone into the pupil:
it should become smaller in size
When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient’s injuries because:
they may need to call a specialist to see the patient
When performing a full body scan, you should assess for __.
DCAP-BTLS
Significant trauma to the face should increase the EMT’s index of suspicion for a(n):
spinal column injury
TRUE or FALSE. The most prominent and most easily palpable spinous process is at the seventh cervical vertebra at the base of the neck.
true
TRUE or FALSE. Central nervous system structures are very strong even though they are not well protected.
false – Central nervous system structures, whose bony enclosures protect them quite well, are also very fragile.
TRUE or FALSE. The structure of the skull and the presence of the meninges in effect reduce the likelihood of problems in closed head injuries.
false – The closed bony structure of the skull (which is similar to a vault) and the meninges may lead to serious problems in closed head injuries. Severe injury may cause bleeding within the skull. Such bleeding causes increased pressure inside the skull and compresses softer brain tissue. In many cases, only prompt surgery can prevent permanent brain damage.
In a(n) __, CSF flows freely from the patient’s ear; this type of injury can be difficult to diagnose with a radiograph.
Basilar skull fracture
When assessing a patient with a suspected head or spine injury, which of the following should you do?
- Assess the patient in the position found
- Administer high-flow oxygen
Which of the following are signs of Cushing triad?
- Bradycardia
- Hypertension
- Irregular Respirations
Which of the following acts as a shock absorber for the CNS?
Cerebrospinal fluid
Accounting for approximately 80% of all skull fractures, which of the following often present with no physical signs?
Linear skull fractures
You are treating a patient who might have a skull fracture. What should you do if a dressing you have applied to a head wound becomes soaked?
Place a clean dressing over the bloody one.
Cushing triad in a patient is a sign of which of the following?
Intracranial pressure
While performing a secondary assessment of a patient who was hit with a tire iron on the side of the head, you find a depressed area above the patient’s left ear. This indicates that the patient could have which of the following?
An epidural hematoma
When securing a patient to a backboard, what area of the body should you secure last?
Head
The time between an initial period of unconsciousness and a subsequent loss of consciousness is referred to as what?
Lucid interval
You are reassessing a patient and you find that her left pupil is dilated and fixed. What does this indicate?
Increased intracranial pressure
Battle sign is an indication of which of the following?
skull fracture
You are treating a patient who went face-first through a windshield. She has extensive head injuries and is displaying hypertension, bradycardia, and Cheyne-Stokes respirations. Which of the following should you suspect?
Cushing triad
__ in a patient with a chest injury is a sign that the blood is not being oxygenated sufficiently.
cyanosis
What is ventilation?
The body’s ability to move air in and out of the chest and lung tissue
When a patient sustains a spinal cord injury above the C3 region, which of the following is likely to happen?
Loss of the ability to breathe due to loss of ability of phrenic nerves to function
You are assessing a patient who sustained a blunt force chest injury during a motorcycle accident. There are no obvious signs of external bleeding, but the patient is hypovolemic and there are decreased breath sounds on the left side. Which of the following should you suspect?
Hemothorax
Which of the following are you likely to see in flail chest?
Paradoxical motion
(The detached portion of the chest wall moves opposite of normal: It moves in instead of out during inhalation and out instead of in during exhalation.)
What are the two most common injuries caused by penetrating chest trauma?
Open pneumothorax and cardiac tamponade
What is the best position in which to place a patient when you want to assess for jugular vein distention?
Sitting at a 45-degree angle
You are assessing a patient and notice he has a collapsed jugular vein. What does this indicate?
Hemothorax
You are treating a patient who fell hard on her right side when she fell off a bike. Exposure of the patient’s chest reveals a large bruise on the lateral aspect of the right side of the chest. When you palpate the area, the patient yells out in extreme pain and states that she cannot take a deep breath. What condition should you suspect?
Rib fractures
Which of the following blood vessels can be lacerated by a fractured rib?
aorta
In blunt trauma, a blow to the chest may fracture the ribs, the sternum, or whole areas of the chest wall; bruise the lungs and the heart; and even damage the aorta. Almost one-third of people who are killed immediately in car crashes die as a result of traumatic rupture of the aorta.
In which condition is it recommended you use positive-pressure ventilation?
flail chest
which of the following describes the initial signs of a head injury?
decreased level of consciousness, confusion, nausea
an epidural hematoma is nearly always the result of a blow to the head that produces a linear fracture in what region of the cranium?
temporal
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
suction his oropharynx for up to 15 seconds
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
a rapid, thready pulse
In contrast to a cerebral concussion, a cerebral contusion:
involves physical injury to the brain tissue
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:
axial loading
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
rupture of the tympanic membrane following diffuse impact to the head
A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?
3
What part of the nervous system controls the body’s voluntary activities?
somatic
The five sections of the spinal column, in descending order, are the:
cervical, thoracic, lumbar, sacral, and coccygeal.
The Glasgow Coma Scale (GCS) is used to assess:
eye opening, verbal response, and motor response
The thoracic cavity is separated from the abdominal cavity by the:
diaphragm
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:
must increase his or her respiratory rate to maintain adequate minute volume
In order to avoid exacerbating a patient’s injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:
pneumothroax
A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
pulmonary contusion
You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:
immediately request ALS support
You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:
laceration of the aorta
Which of the following is most likely to cause immediate death?
aortic rupture
A spinal cord injury at the level of C7 would MOST likely result in:
paralysis of the intercostal muscles
Children are often “belly breathers” because _.
their intercostal muscles are not developed
A flail chest occurs when:
a segment of the chest wall is detached from the thoracic cage
TRUE or FALSE. A patient who has sustained a blunt abdominal injury should be log rolled to a supine position onto a backboard.
true
TRUE or FALSE. Free air in the peritoneal cavity is abnormal and indicates that a hollow organ or loop of bowel has perforated.
true
TRUE or FALSE. A very common early sign of a significant abdominal injury is tachycardia.
true
because the heart is increasing its pumping action to compensate for blood loss.
TRUE or FALSE. You should allow patients with peritonitis to lie still with their legs drawn up.
true
Patients with peritonitis generally prefer to lie very still with their legs drawn up to guard from pain in the abdomen. Allow a patient with a patent airway to remain in a position of comfort.
Which of the following is true about injuries to the kidneys?
- A penetrating wound that reaches the kidneys almost always involves other organs.
- a sign of kidney damage is hematuria
Bruising over the right upper quadrant could indicate injury to which of the following?
Liver
You should have an index of suspicion that a patient with pain referred to the right shoulder has an injury to which organ?
liver
Injury to the liver (or spleen) may present with referred pain to the shoulders. Unlike radiating pain, which is characterized by pain that “moves” from one area of the body to another, referred pain is characterized by pain in two separate locations.
Which of the following are considered solid organs?
Pancreas and spleen
Which of the following signs would indicate that an injury to the kidney has occurred?
Hematuria
You are assessing a patient who reports pain that is tearing and describes it as going from the abdomen posteriorly. What should you suspect?
Dissecting abdominal aneurysm
What is the major cause of death following injury to a hollow organ in the abdomen?
Sepsis
(typically occurs later in the hospital)
What is the purpose of wrapping a sexual assault victim in a burn sheet?
To preserve potential evidence
Which of the following is an indication of a spleen injury?
Referred left shoulder pain
Which of the following statements is true?
The higher the velocity of a projectile, the larger the cavity it produces.
Where is abdominal injury most likely to occur in young children?
Liver
In pediatric patients, the liver and spleen are very large in proportion to the size of the abdominal cavity and are more easily injured. The soft, flexible ribs of infants and young children do not protect these two organs very well and may allow injury to underlying organs, even without fracturing the ribs.
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:
diaphragm
A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:
applying direct pressure with a dry, sterile dressing
Compression injury is most likely due to which of the following?
Improperly placed lab belt
Which of the following is true regarding injury to the kidneys?
Injury to the kidneys usually indicates injury to other organs
When a patient stiffens the muscles of the abdomen, it is known as _.
guarding
All of the following are hollow abdominal organs, EXCEPT the:
spleen
Abdominal pain, vomiting, and fever are most likely due to _.
infection
You should suspect a kidney injury anytime the patient presents with _.
a hematoma in the flank region
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM
Injuries to the external male genitalia _.
are rarely life-threatening
Rearrange the injuries from least to most severe based on the musculoskeletal injury grading system.
- Dislocated fingers
- Nondisplaced long bone fracture
- Displaced pelvic fracture
- Bilateral femur fracture
- Pelvic fracture with hemodynamic instability
In which situations should you splint the limb in the position of deformity?
- When you encounter resistance or extreme pain when applying traction
- when the deformity is the result of a dislocation and is severe
Which of the following are goals of in-line traction?
- Stabilize the fragments to prevent movement
- Align the limb for splinting
- Avoid neurovascular compromise
TRUE or FALSE. If you are unable to restore the distal pulse on scene, you should splint the limb in a straight position and provide prompt transport to the hospital.
false – If you are unable to restore the distal pulse, splint the limb in the position that is most comfortable for the patient and provide prompt transport to the hospital.
TRUE or FALSE. Lateral and medial dislocations to the knee are less common than posterior dislocations and are less likely to injure the popliteal artery.
true
TRUE or FALSE. A fracture of the femoral shaft is best stabilized with a traction splint, such as a Sager splint.
true
TRUE or FALSE. Fractures of the proximal femur usually involve the hip joint.
false – Fractures of the proximal femur are usually called hip fractures, but they rarely involve the hip joint.
When assessing distal circulation in a patient’s lower extremities, which pulse should you palpate?
popliteal
Which MOI causes a fracture or dislocation at a distant point?
Indirect force
What is the most reliable indicator of an underlying fracture?
Point tenderness
A disruption of a joint in which the bone ends are no longer in contact is known as what?
Dislocation
In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel?
serious
Which of the following would you use to stabilize an AC separation?
Sling and swathe
You are attending to a patient with a nondisplaced elbow fracture. She has a strong pulse and good capillary refill. How should you address this type of injury?
Splint from the shoulder joint to the wrist joint to stabilize the entire arm.
What is the primary goal of in-line traction?
Avoid further neurovascular compromise
Which sign/symptom would give you a high index of suspicion that a patient may have compartment syndrome?
Disproportionate pain
Which of the following is a drawback of an air splint?
Temperature changes affect air pressure in the splint.
In which of the following situations should the EMT splint an injured limb in the position of deformity?
If resistance is encountered or the patient experiences severe pain
Which of the following musculoskeletal injuries would pose the greatest threat to a patient’s life?
pelvic fracture with hypotension
A “hip” fracture is actually a fracture of the:
proximal femur
A fracture is MOST accurately defined as a(n):
break in the continuity of the bone
With regard to musculoskeletal injuries, the zone of injury is defined as the:
area of soft-tissue damage surrounding the injury
An open fracture is MOST accurately defined as a fracture in which:
the overlying skin is no longer intact
The MOST significant hazard associated with splinting is:
delaying transport of a critically injured patient
During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient’s blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
stabilize the pelvis with a pelvic binder and protect the spine
When caring for a patient with a possible fracture of the scapula, the EMT should:
carefully assess the patient for breathing problems
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
stabilize her head and perform a primary assessment
Cardiorespiratory response when core body temperature falls into the range of 89ºF to 92ºF (31.7ºC to 33.3ºC) involves __ .
Slowing respirations and a slow pulse
You arrive at the scene and find the patient sitting under a tree in his garden; he is conscious, but confused. His wife tells you that he has been working outside all day. She further states that he refused to take a break and drink some water. Your assessment finds a flushed appearance; weak and rapid radial pulses; and hot, moist skin. Based on this, you suspect that your patient is suffering from __ .
heat stroke
There are several clinical findings that indicate your patient is experiencing the most serious heat illness, heat stroke. Unlike other, less-severe forms of heat illness, patients with heat stroke have an altered LOC and flushed, hot skin. Your patient has both of these.
TRUE or FALSE. It is difficult to find a pulse in a drowning victim because of constriction of the peripheral blood vessels and low cardiac output, resulting in cyanosis.
true
TRUE or FALSE. In an air embolism, the air pressure in the lungs remains constant while the external pressure on the chest increases.
false – In an air embolism, the air pressure in the lungs remains at a high level while the external pressure on the chest decreases.
TRUE or FALSE. Symptoms of air embolism may not occur for several hours.
false – Air embolism occurs immediately on returning to the surface, but symptoms of decompression sickness may not occur for several hours
TRUE or FALSE. The diving reflex may cause immediate bradycardia.
true
Hypothermia is diagnosed when the core body temperature falls below what temperature?
95°F (35°C)
Shivering stops and muscle activity ceases once the body’s core temperature reaches what?
90°F (32.2°C)
Rough handling of a patient with severe hypothermia may cause which of the following dysrhythmias?
Ventricular fibrillation
In the context of an environment that is 90°F with 85% humidity, what does moist, pale, cool skin indicate?
There has been excessive fluid and salt loss.
What is often the first sign of heat stroke?
Change in behavior
In which of the following environmental emergencies are you most likely to encounter laryngospasm?
drowning
What is the most dangerous, and most common, emergency in scuba diving?
Air embolism
You are treating a patient who was climbing a 10,000-foot mountain when he began to experience a severe, constant, throbbing headache; ataxia; and extreme fatigue. He is nauseated and, as you assess him, he loses consciousness. Which of the following should you suspect?
HACE
(high altitude cerebral edema)
You suspect that the patient you are treating was bitten by a rattlesnake. What should you do first?
Place the patient is a supine position.
(keeps the venom from spreading)
A person who stands outside in windy, wintry weather and wears only lightweight clothing is experiencing heat loss mainly by what method?
Convection
The MOST prominent symptom of decompression sickness is:
abdominal or joint pain
Burns associated with lightning strikes are typically:
superficial
You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:
suction his mouth and nose, apply high-flow oxygen, monitor the patient’s breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility
Hypothermia occurs when the core body temperature falls below:
95°F (35°C)
You are transporting a 28-year-old man with a frostbitten foot. The patient’s vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:
protect the affected part from further injury
A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
supine positioning, splinting the leg, and transporting
The EMT must assume that any unwitnessed water-related incident is accompanied by:
possible spinal injury
Drowning is MOST accurately defined as:
death from suffocation after submersion in water
A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:
assess for a carotid pulse for up to 60 seconds
Which of the following MOST accurately describes hyperthermia?
The body is exposed to more heat than it can lose