EMT Chapter 25 Trauma Overview

A. Head injury

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries is the LEAST likely?
A. Head injury
B. Pulmonary contusion
C. Multiple rib fractures
D. Cardiac contusion

When caring for an occupant inside a motor vehicle equipped with an airbag that did not deploy upon impact, you should:
A. remember that it could still deploy and seriously injure you.
B. realize that the airbag malfunctioned at the time of impact.
C. suspect that the patient may have experienced serious injuries.
D. recognize that the force of impact was most likely not severe.

A. remember that it could still deploy and seriously injure you

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. injury to the cervical spine.
B. potential airway compromise.
C. damage to internal structures.
D. alterations in his mental status

B. potential airway compromise

Which of the following statements regarding gunshot wounds is correct?
A. Low-velocity bullets will cause the greatest amount of trauma.
B. The speed of a bullet has the greatest impact on the injury produced.
C. The size of a bullet has the greatest impact on the injury produced.
D. High-velocity bullets will cause less severe internal injuries.

B. the speed of a bullet has the greatest impact on the injury proceeded

The cervical spine is MOST protected from whiplash-type injuries when the:
A. rear end of the vehicle is initially struck.
B. headrest is appropriately positioned.
C. patient tenses up at the time of impact.
D. airbag correctly deploys upon impact.

B. headrest is appropraitely positioned

Approximately 25% of severe injuries to the aorta occur during:
A. rear-end collisions.
B. rollover collisions.
C. lateral collisions.
D. frontal collisions

C. lateral collisions

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:
A. determine the vehicle's speed at the time of impact.
B. identify contact points and predict potential injuries.
C. recognize if the driver hit the brakes before impact.
D. assess the severity of the third collision of the crash.

B. identify contact points and predict potential injuries

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. Intravenous fluid administration
C. Early administration of oxygen
D. Rapid transport to a trauma center

D. rapid transport to a trauma center

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first:
A. determine if the patient was propelled away from the vehicle.
B. approximate the speed of the vehicle that struck the pedestrian.
C. determine if the patient was struck and pulled under the vehicle.
D. evaluate the vehicle that struck the patient for structural damage.

B. approximate the speed of the vehicle that struck the pedestrian

If one or more occupants in the same vehicle are killed in a crash, the EMT should:
A. transport the survivors only if they have injuries or complain of pain.
B. suspect that all living occupants experienced the same serious trauma.
C. allow the survivors to refuse transport if they have no obvious injuries.
D. rapidly assess only the survivors who have experienced obvious trauma.

B. suspect that all living occupants experienced the same serious trauma

When the speed of a motor vehicle doubles, the amount of kinetic energy:
A. quadruples.
B. doubles.
C. triples.
D. is not affected.

A. quadruples

The driver 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. transport to a trauma center.
B. a secondary assessment at the scene.
C. transport to a community hospital.
D. a focused exam of her forearm.

A. transport to a trauma center

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. is ejected or partially ejected.
C. is wearing only a lap belt.
D. remains within the vehicle.

B. is ejected or partially ejected

When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the airbag deploys upon impact.
A. windshield
B. dashboard
C. steering wheel
D. door

D. door

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:
A. 10.
B. 9.
C. 8.
D. 11.

B. 9

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?
A. Dismounted seats
B. Intrusion into the vehicle
C. Steering wheel collapse
D. Deployment of the airbag

D. deployment of the airbag

Force acting over a distance is the definition of:
A. potential energy.
B. work.
C. kinetic energy.
D. latent energy.

B. work

When assessing an elderly patient who fell, it is important to remember that:
A. bilateral hip fractures usually occur when an elderly person falls.
B. elderly patients who fall usually have a secondary head injury.
C. osteoporosis can cause a fracture as a result of a fall from a standing position.
D. any fall in the elderly is considered to be high-energy trauma.

C. osteoporosis can cause a fracture as a result of a fall from a standing position

When treating a patient who experienced a pulmonary blast injury, you should:
A. use a demand valve to ventilate the patient.
B. suspect an accompanying cardiac tamponade.
C. avoid giving oxygen under positive pressure.
D. administer large amounts of intravenous fluid.

C. avoid giving oxygen under positive pressure

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. Eardrum rupture
B. Fractured bones
C. Impaled objects
D. Severe burns

A. eardrum rupture

By what mechanism is a person injured when he or she falls from a significant height?
A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop.
B. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact.
D. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.

B. potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop

What types of motor vehicle collisions present the greatest potential for multiple impacts?
A. Rear-end and rotational
B. Rotational and rollover
C. Lateral and rollover
D. Frontal and rotational

B. rotational and rollover

The index of suspicion is MOST accurately defined as:
A. a predictable pattern that leads to serious injuries.
B. your awareness and concern for potentially serious underlying injuries.
C. the way in which traumatic injuries occur.
D. the detection of less obvious life-threatening injuries.

B. your awareness and concern for potentially serious underlying injuries

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?
A. Extremity fractures
B. Flail chest
C. Aortic rupture
D. Forehead lacerations

C. aortic rupture

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
A. congruent.
B. cavitation.
C. conversion.
D. capitation.

B. cavitation

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 airbag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:
A. neck and facial injuries.
B. lower extremity fractures.
C. open abdominal trauma.
D. blunt trauma to the head.

A. neck and facial injuries

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. potential energy.
D. index of suspicion.

B. mechanism of 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. Compression of the head against the roof
B. Impact of the head against the steering wheel
C. Whiplash injury to the neck during the rollover
D. Lateral bending of the neck during the crash

A. Compression of the head against the roof

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash.
A. thoracic and lumbar
B. thoracic and sacral
C. lumbar and coccygeal
D. lumbar and sacral

A. thoracic and lumbar

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
A. the height of the fall.
B. the primary impact point.
C. the surface struck.
D. the speed of the fall.

D. the speed of the fall

In contrast to a Level III trauma center, a Level I trauma center must:
A. have general surgeons in-house 24 hours a day.
B. have access to an emergency physician within 30 minutes.
C. be able to stabilize patients before transferring to a higher level facility.
D. be involved in trauma prevention programs.

A. have general surgeons in-house 24 hours a day

Which of the following statements regarding low-energy penetrating injuries is correct?
A. Internal injuries caused by low-velocity bullets are usually easy to predict.
B. The area of injury is usually close to the path the object took through the body.
C. It is usually easy to differentiate between an entrance wound and an exit wound.
D. Exit wounds are typically easy to locate with low-energy penetrating injuries.

B. the area of injury is usually close to the path the object took through the body

A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:
A. obtain baseline vital signs.
B. apply a cervical collar.
C. auscultate bowel sounds.
D. assess for an exit wound.

D. assess for an exit wound

When assessing a patient who experienced a blast injury, it is important to remember that:
A. solid organs usually rupture from the pressure wave.
B. primary blast injuries are typically the most obvious.
C. secondary blast injuries are usually the least obvious.
D. primary blast injuries are the most easily overlooked.

D. primary blast injuries are the most easily overlooked

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. inspect the helmet for cracks.
B. leave her bicycle helmet on.
C. stabilize her entire spine.
D. obtain baseline vital signs.

C. stabilize her entire spine

Signs of a pulmonary blast injury include:
A. multiple rib fractures.
B. vomiting blood.
C. an irregular pulse.
D. coughing up blood.

D. coughing up blood

The energy of a moving object is called:
A. latent energy.
B. potential energy.
C. kinetic energy.
D. converted energy.

C. kinetic energy

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is rapid and irregular. You should be MOST suspicious for:
A. traumatic rupture of the aorta.
B. bruising of the heart muscle.
C. a lacerated coronary artery.
D. underlying cardiac disease.

B. bruising of the heart muscle

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?
A. Deformed steering wheel
B. Collapsed dashboard
C. Intrathoracic hemorrhage
D. Caved-in passenger door

A. deformed steering wheel

Which of the following is NOT one of the three types of collisions in a typical impact in a motor vehicular crash?
A. Collision of the internal organs against the body's solid structures
B. Collision of a car against another car, a tree, or another object
C. Collision of two passenger bodies within the same vehicle
D. Collision of the passenger against the interior of the car

C. collision of two passenger bodies within the same vehicles