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EMT Chapter 24 - Trauma Overview
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Terms in this set (84)
When assessing a patient who experienced a blast injury, it is important to remember that:
A. primary blast injuries are the most easily overlooked.
B. solid organs usually rupture from the pressure wave.
C. primary blast injuries are typically the most obvious.
D. secondary blast injuries are usually the least obvious.
The cervical spine is MOST protected from whiplash-type injuries when the:
A. headrest is appropriately positioned.
B. air bag correctly deploys upon impact.
C. rear end of the vehicle is initially struck.
D. patient tenses up at the time of impact.
The energy contained in a moving object is called:
A. potential energy.
B. latent energy.
C. converted energy.
D. kinetic energy.
When assessing an elderly patient who fell, it is important to remember that:
A. elderly patients who fall usually have a secondary head injury.
B. osteoporosis can cause a fracture that may have resulted in the fall.
C. any fall in the elderly is considered to be high-energy trauma.
D. bilateral hip fractures usually occur when an elderly person falls.
With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct?
A. It has a direct effect on patient care because of the obvious vehicular damage.
B. It occurs when the unrestrained occupant collides with the interior of the vehicle.
C. It is the most dramatic part of the collision and may make extrication difficult.
D. It provides the least amount of information about the mechanism of injury.
Signs of a pulmonary blast injury include:
A. coughing up blood.
B. an irregular pulse.
C. multiple rib fractures.
D. vomiting blood.
Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?
A. Aortic rupture
B. Forehead lacerations
C. Flail chest
D. Extremity fractures
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:
A. lower-extremity fractures.
B. blunt trauma to the head.
C. neck and facial injuries.
D. open abdominal trauma.
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
A 40-year-old female, unrestrained, impacted the steering wheel of her vehicle with her chest when her vehicle hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Given the mechanism of injury and her present condition, it is LEAST likely that she experienced:
A. a cardiac contusion.
B. a pulmonary contusion.
C. multiple rib fractures.
D. a head injury.
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?
A. Lateral bending of the neck during the crash
B. Impact of the head against the steering wheel
C. Compression of the head against the roof
D. Whiplash injury to the neck during the rollover
Which of the following statements regarding low-energy penetrating injuries is correct?
A. Exit wounds are typically easy to locate with low-energy penetrating injuries.
B. Internal injuries caused by low-velocity bullets are usually easy to predict.
C. It is usually easy to differentiate between an entrance wound and an exit wound.
D. The area of injury is usually close to the path the object took through the body.
Internal injuries caused by gunshot wounds are difficult to predict because:
A. exit wounds caused by the bullet are usually small.
B. the caliber of the bullet is frequently unknown.
C. the area of damage is usually smaller than the bullet.
D. the bullet may tumble or ricochet within the body.
If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave?
A. Fractured bones
B. Severe burns
C. Impaled objects
D. Stomach rupture
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
A. experiences multiple impacts.
B. remains within the vehicle.
C. is wearing only a lap belt.
D. is ejected or partially ejected.
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?
A. Elevation of the lower extremities
B. Early administration of oxygen
C. Intravenous fluid administration
D. Rapid transport to a trauma center
A 12-year-old male jumped approximately 12' from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?
A. Lateral impact to the spine
B. Direct trauma to the spinal column
C. Energy transmission to the spine
D. Secondary fall after the initial impact
In contrast to a Level III trauma center, a Level I trauma center must:
A. be able to stabilize patients before transferring to a higher level facility.
B. be involved in trauma prevention programs.
C. have general surgeons that are in-house 24 hours a day.
D. have access to an emergency physician within 30 minutes.
Which of the following statements regarding gunshot wounds is correct?
A. The speed of a bullet has a greater impact on causing injury than the mass.
B. The size of a bullet has the greatest impact on producing injury.
C. High-velocity bullets will cause less severe internal injuries.
D. Low-velocity bullets will cause the greatest amount of internal injury.
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
A. the speed of the fall.
B. the primary impact point.
C. the surface struck.
When evaluating the mechanism of injury of a car-versus-pedestrian collision, you should first:
A. approximate the speed of the vehicle that struck the pedestrian.
B. determine if the patient was propelled away from the vehicle.
C. evaluate the vehicle that struck the patient for structural damage.
D. determine if the patient was struck and pulled under the vehicle.
By what mechanism is a person injured when he or she falls from a significant height?
A. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact.
B. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop.
C. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.
D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
The index of suspicion is MOST accurately defined as:
A. a predictable pattern that leads to serious injuries.
B. your concern for potentially serious underlying injuries.
Your patient has a Glasgow Coma Scale (GCS) score of 11, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is:
When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the:
A. kinetic energy.
B. mechanism of injury.
C. index of suspicion.
D. potential energy.
According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she:
A. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.
B. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury.
C. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min.
D. was involved in a motor vehicle crash in which another patient in the same vehicle was killed.
According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if:
A. the patient requires advanced life support care and stabilization, and the nearest paramedic ground ambulance is more than 5 to 10 minutes away.
B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries.
C. he or she was involved in a motor-vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.
D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.
When treating a patient who experienced a pulmonary blast injury, you should:
A. avoid giving oxygen under positive pressure.
B. administer large amounts of intravenous fluid.
C. use a demand valve to ventilate the patient.
D. suspect an accompanying cardiac tamponade.
Two of the MOST common mechanisms of injury for blunt trauma are:
A. low-caliber gunshot wounds and falls.
B. falls and motor vehicle collisions.
C. gunshot wounds and vehicle ejections.
D. motor vehicle collisions and stabbings.
While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for:
A. underlying cardiac disease.
B. bruising of the heart muscle.
C. a lacerated coronary artery.
D. traumatic rupture of the aorta.
When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to:
A. recognize that the force of impact was most likely not severe.
B. realize that the air bag malfunctioned at the time of impact.
C. remember that it could still deploy and seriously injure you.
D. suspect that the patient may have experienced serious injuries.
During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:
A sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:
A. a focused exam of her forearm.
B. transport to a community hospital.
C. transport to a trauma center.
D. a secondary assessment at the scene.
Air bags are designed to:
A. be used with or without a shoulder harness.
B. prevent a second collision inside the car.
C. prevent the driver from sustaining head trauma.
D. decrease the severity of deceleration injuries.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the:
A. thoracic and lumbar spine.
B. lumbar and coccygeal spine.
C. thoracic and sacral spine.
D. lumbar and sacral spine.
When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant:
A. is thrust under the steering column onto the floorboard.
B. remains in motion until acted upon by an external force.
C. will decelerate at the same rate as the motor vehicle.
D. will most likely be thrown over the steering column.
When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact.
B. steering wheel
Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?
A. Collapsed dashboard
B. Intrathoracic hemorrhage
C. Deformed steering wheel
D. Caved-in passenger door
Evaluation of the interior of a crashed motor vehicle during extrication will allow the AEMT to:
A. determine the vehicle's speed at the time of impact.
B. identify contact points and predict potential injuries.
C. assess the severity of the third collision of the crash.
D. recognize if the driver hit the brakes before impact.
Force acting over a distance defines the concept of:
A. kinetic energy.
B. potential energy.
C. latent energy.
What types of motor vehicle collisions present the greatest potential for multiple impacts?
A. Rotational and rollover
B. Rear-end and rotational
C. Frontal and rotational
D. Lateral and rollover
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:
A. obtain baseline vital signs.
B. leave her bicycle helmet on.
C. inspect the helmet for cracks.
D. stabilize her entire spine.
Which of the following patients has experienced the MOST significant fall?
A. A 5'-0" patient who fell 13'
B. A 5'-9" patient who fell 14'
C. A 4'-8" patient who fell 13'
D. A 4'-6" patient who fell 13'
When the speed of a motor vehicle doubles, the amount of kinetic energy:
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?
A. Intrusion into the vehicle
B. Dismounted seats
C. Steering wheel deformity
D. Deployment of the air bag
Approximately 25% of severe injuries to the aorta occur during:
A. rollover collisions.
B. rear-end collisions.
C. frontal collisions.
D. lateral collisions.
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for:
A. alterations in his mental status.
B. potential airway compromise.
C. injury to the cervical spine.
D. damage to internal structures.
A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control any obvious bleeding and then:
A. auscultate bowel sounds.
B. apply a cervical collar.
C. assess for an exit wound.
D. obtain baseline vital signs.
During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred:
A. as a direct result of the pressure wave.
B. during the tertiary phase.
Kinetic energy is a calculation of:
A. weight and size.
B. weight and speed.
C. mass and weight.
D. speed and force.
A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern?
A. Deployed airbag
B. Bent steering wheel
C. Non-intact windshield
D. Crushed instrument panel
Which of the following would MOST likely result from the third collision in the "three- collision" effect that occurs during a high- speed, frontal impact motor vehicle crash?
A. Extensive damage to the automobile
B. Flail chest and lower extremity fractures
C.Massive external trauma with severe bleeding
D. Aortic rupture or compression injury to the brain
A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find:
A. deployed airbags.
B. steering wheel deformity.
C. starring of the windshield.
D. a crushed instrument panel.
An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter:
A. trauma to the pelvis.
B .blunt abdominal trauma.
C.a severe closed head injury.
D.penetrating thoracic trauma.
Whiplash injuries are MOST common following _________ impacts.
Death from a rollover motor vehicle crash is MOST often secondary to:
A. crushing injuries.
B. airbag-related trauma.
C. multiple collisions to the interior of the car.
D. ejection of the patient from the motor vehicle.
Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact?
A. Head-on collision
B. Angular collision
D. Controlled crash
When assessing a stab wound, it is important for the EMT to remember that:
A. stabbings to an extremity are rarely associated with an exit wound.
B. the majority of the internal trauma will be near the path of the knife.
C. most stabbings are unintentional and cause less severe internal injury.
D. more internal damage may be present than the external wound suggests.
A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury was MOST likely caused by ___________ blast injuries.
Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:
A. intracranial bleeding.
B. airway compromise.
C. a fracture of the skull.
D. spinal cord injury.
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?
A. Any designated trauma center is acceptable.
B. A Level IV or Level III trauma center
C. A Level I or Level II trauma center
D. Only a Level I trauma center
Which types of motor vehicle collisions present the greatest potential for multiple impacts?
A. Frontal and rotational
B. Lateral and rollover
C. Rear-end and rotational
D. Rotational and rollover
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:
In chest wounds, the crackling sensation produced by air flowing into the surrounding tissues is called subcutaneous...
Which of the following is most appropriate for a 41-year old male patient who was involved in a rollover MVA and is unconscious and unresponsive, assuming that travel times to each is equal:
A.a level IV or level III trauma center
B.any designated trauma center is acceptable
C.only a level I trauma center
D.a level I or level II trauma center
Which type of MVC presents the greatest potential for multiple impacts?
A.rotational and rollover
B.rear-end and rotational
C.lateral and rollover
D.frontal and rotational
While en route to a major MVC, 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:
A.open abdominal injuries
B.neck and facial injuries
C.lower extremity fractures
D.blunt trauma to the head
A fall from more than______times the patients hight is considered to be significant
A patient complaining of chest tightness, coughing up blood, and subcutaneous emphysema following an explosion may be suffering from a:
A. ruptured tympanic membrane
B. ruptured peritoneal cavity
C. myocardial blast injury
D. pulmonary blast injury
A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision?
A. the bike hitting the car
B. The bike rider striking the pavement
C. The bike rider hitting his bike or the car
D. The bike rider's internal organs striking the solid structures of the body
Awareness of and concern for potentially serious obvious underlying injuries is referred to as the:
A. index of suspicion
B. mechasim of injury
C. scene size-up
D. general impression
Significant clues to the possibility of severe injuries in motor vehicle collisions include:
A. death of a passanger
B. broken glass
C. a deployed air bag
D. a blown-out tire
If one of more occupants in the same vehicle are killed in a crash, the EMT should:
A. allow the survivors to refuse transport if they have no obvious injuries
B. transport the survivors only if they have injuries of complain of pain
C. rapidly assess only the survivors who have experienced obvious trauma
D. suspect that all living occupants experienced the same serious trauma.
Which of the following has the greatest impact on producing injury?
How many collisions are there in a typical vehicle impact?
In which type of vehicle crash are you most likely to find a patient with whiplash injuries?
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 a bullet, is known as what?
What type of blast occurs when objects are propelled by the force of the blast wave and strike the victim, causing injury?
what level of trauma center provides prompt assessment, resuscitation, and stabilization of injured patients and emergency operations, but not definitive care for all patients
A. Level III
B. Level I
C. Level IV
D. Level II
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?
You are assessing a patient who was in a front-end car crash. His GCS is 12, systolic blood pressure is 81 mmHg, and respiratory rate is 22 breaths/min. What is this pateints Revised Trauma Score?
You would use the Revised trauma Score scoring system for a patient if there is potential for what type of trauma?
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?
A. step 2
B. step 3
C. step 4
D. step 1
Which of the following is considered a type of motor vehicle collision?
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