TRAUMA FISDAP EXAM.
- What is external hemorrhage?
Bleeding - A 16 year old male complains of severe pain in his upper left quadrant after being hit
in the stomach while playing football. What should you suspect?
a. Lacerated liver
b. Ruptured spleen
c. Pulmonary contusion
d. Bruised ribs
Rationale:
The spleen is located in the upper left quadrant. It is a solid organ with two arteries that
supply blood flow. The spleen is dense with blood and the injury has the ability to be
life-threatening. - A 46 year old male is only responsive to verbal stimuli after being stabbed. He has an
open, bubbling chest wound. What should you do?
a. Assist ventilations with a bag-valve mask.
b. Apply sterile gauze over the wound.
c. Cover the wound with a gloved hand.
d. Perform pleural chest decompression.
Rationale:
You should first cover the open chest wound with a gloved hand to prevent any more air
leakage into the thoracic cavity. - A 43 year old male is unresponsive after being kicked in the chest by a horse. On
inhalation a segment of his chest moves inward. Vital signs are P 130, R 24 and
shallow. What should you do?
a. Stabilize the segment with a bulky dressing.
b. Assist ventilations with a bag-valve mask.
c. Apply high-flow oxygen by non-rebreather mask.
d. Obtain intravascular access.
Rationale:
The initial treatment for a flail segment is providing positive pressure ventilations (PPV).
The chest wall structure has been compromised and they need help breathing to
prevent them from tiring out. Continuous waveform capnography will help assess their
ventilations. Analgesics my help reduce their pain and allow them to breathe easier
(follow local protocol). - What are primary blast injury’s?
Primary blast injury is caused by the blast wave moving through the body. - What are secondary blast injury’s?
Secondary blast injuries are caused by debris that is displaced by the blast wind of the
explosion. - What are tertiary blast injurys?
Tertiary blast injuries are caused when the person in displaced through the air and
impacts on another object by the blast wind, or when a structure collapses and causes
injury to the person. - Why are circumferential full thickness burns of an extremity considered so serious?
a. The extremity will begin to utilize anabolic metabolism proximal to the burn site.
b. Blood flow to underlying and distal tissue may become restricted.
c. The patient becomes more susceptible to systemic infection.
d. Even if the extremity heals, it will lose most of its functional ability.
Rationale:
Circumferential full thickness burns can inhibit blood flow and muscle movement. These
injuries need to be monitored for the need of an escharotomy. This surgical procedure
allows for tissue expansion in order to restore local perfusion.
- What chemical do muscle cells release after being damaged?
a. Calcium
b. Magnesium
c. Potassium
d. Sodium
Rationale:
Potassium is the predominated intercellular ion. When muscle cells die they release
potassium, which may lead to rhabdomyolysis. - An 18 year old male screams in pain and has a large volume of bright, red blood
spurting from his right wrist. What should you do?
a. Apply direct pressure.
b. Apply a tourniquet.
c. Ensure an adequate airway.
d. Apply high-flow oxygen.
Rationale: