Exam 3 JCCC EMS 129 (EMR)

Q: What is a medical term for a bruise

A: Contusion

Q: When dealing with an MVC - how can you help protect the c-spine

A: Be sure to measure the C spine correctly before applying the C collar. The head must be put in a
neutral inline position before measuring to ensure accuracy

Q: What type of techniques should you use if you are treating someone with abdominal pain

A: Start palpations at the opposite side of the abdomen that is in pain. Avoid multiple palpations in
the affected area (AAA). Use the acronym GBREAD to look for response to pain, pressure, and
condition

Q: Explain an MCI.

A: If you have more patients in need than the EMS system has available, an MCI is called. Outside
services may need to be called, either to use in the incident or cover for the ones already there (cold
weather, outlying buildings need to be tended to, etc)

Q: Name the pediatric assessment triangle.

A: Appearance - Work of breathing - Circulation to the skin

Q: What are signs of the Cushing Reflex

A: High BP / decrease pulse

Q: In an infant in a car seat, what is your biggest concern head or neck with no visible signs of
bleeding or bruising

A: You should always think of the size/weight of the head…and possible whiplash

Q: With an amputated limb…is excessive bleed often a huge factor in treatment

A: No, small amputated parts often do not bleed heavily. It is very important to secure the amputated
body part, place in a plastic bag and keep cool but not frozen

Q: When you are assessing a patient and find a sucking chest wound….what should your initial
treatment be

A: Immediately put a gloved hand over the wound until the dressings are available…then prepare
and put on a three-sided occlusive dressing

Q: Name the 5 parts of the APGAR scale.

A: Appearance, Pulse, Grimace, Activity, Respiration

Q: If someone has a head injury what can happen to BP / respirations

A: BP goes up (intracranial pressure) and respirations go down

Q: When doing manual stabilization, where should you place your hands for maximum support

A: Skull and facial bones for stabilization work well before the c-collar is applied. Shoulders can be
added once c-collar is applied

Q: What do you watch for and should consider when treating an injured lower extremity

A: Since it is important to support the limbs but avoid movement, use ice and/or splinting to help
minimize damage. Elevation is not recommended since movement could be harmful

Q: Trauma patient with facial lacerations - what can you expect over time

A: Initial heavy bleeding which will slow if the patient goes into the end stage of shock. Clotting will
occur but still need to watch for bleeding

Q: Elderly patients present differently than younger patients. What can be different and why

A: They take more meds which can affect heart rate, color and moisture. Respirations can be rapid
and labored. They often don't know when something is really changing due to a variety of illnesses
being treated

Q: What type of injuries can occur with the airway when you have head/spinal injuries

A: Head: intracranial pressure / lose gag reflex / can become confused (altered mental status).
Spinal injuries affect a high variety of systems

Q: If you have an open wound in the chest that is blocking airflow, what chest organ can that affect

A: The heart to slow due to pressure put on the heart (vena cavae…), which makes blood return
more difficult

Q: After any covering/splinting or movement, what should you do next to assess the patient

A: Do PMS: Pulse, motor, sensory

Q: After a fall, what steps should be taken by the EMR

A: Manually stabilize C-spine then continue assessment with appropriate treatment

Q: What is dyspnea

A: Difficulty breathing

Q: With a head injury is it more common to have an injury with the head / the neck / spine

A: Spinal cord injuries are not as common as head injuries but should be considered

Q: Where do you decide if a patient needs to be supported for an injured C-spine

A: In the primary…bonus: when is the C collar applied (In the secondary)

Q: With a deformed extremity and no pulse. What is your option

A: You can attempt one time to move the extremity and regain pulse

Q: If you have a puncture wound with a sign of a collapsed lung-what is your next step

A: Apply the airtight dressing

Q: What is the START system

A: A method of triage. S-imple T-riage A-nd R-apid T-reatment

Q: If a patient starts to gag or vomit, what step does an EMR take to help the patient with their
airway

A: Roll them on their side so they don't aspirate

Q: When at an MCI, what piece of equipment will you not need to bring with you to triage at the
scene

A: The AED

Q: What trauma injury can sometimes cause a patient to lose their gag reflex

A: A head injury can cause a patient to lose their gag reflex. Other injuries can affect breathing but
not necessarily their gag reflex

Q: If direct pressure and elevation does not stop the bleeding from an extremity, what is a good next
option

A: Correctly apply a tourniquet

Q: After treating an open wound or potential broken bone, what should be your next step

A: Be sure to end with a neuro check: Pulse, motor, sensory

Q: What does the acronym TOWEL stand for and how does it help patients in shock

A: Transport - Oxygen - Warm - Elevate legs. So transport as soon as possible, but the patient
needs oxygen if available as an important part of treatment even before treatment if available.
Keeping them warm is helpful and elevate legs if appropriate

Q: You and your two partners arrive at a scene, how many patients would there need to be so that
triage is necessary

A: 4 - there is one more patient than rescuers

Q: How can you open a patient's airway if they have a suspected spinal injury

A: Trauma airway maneuvers work if you have two people. A jaw thrust is a good maneuver if you
hold the head

Q: You have a patient that has a chemical burn…what is your best option for treatment

A: Dilute with water. Lots of it

Q: Why do we check pulses before and after splinting

A: To ensure the splint is not too tight - correction is to slightly loosen to see if the problem is
corrected and pulse returns

Q: If you have a patient that you suspect has a spinal injury, you have a helper and you need to do
CPR, what can you do to minimize spinal risk

A: Have your helper hold the head

Q: Who are the first people that would normally call an incident an MCI

A: First responders at the scene, they will know when the number of patients exceed the numbers of
rescuers

Q: What other systems can be affected from an open chest wound

A: The heart can be affected as pressure builds in the chest which can reduce the amount of blood
volume being pumped by the heart and blood return

Q: What is the difference between a dressing and a bandage

A: Dressings help control bleeding, infections, and assist in clotting. Bandages hold the dressings in
place

Q: You have a patient that has a leg that is rotated inward with the knee bent. There is also a bulge
next to the hip joint. What type of injury could this be

A: Hip dislocation

Q: In a child, what would be an easy way to check for adequate circulation

A: Capillary refill

Q: When would it be appropriate to remove a helmet at the scene of an incident

A: If the helmet interferes with the ability to get/control the airway

Q: An object is sticking out of a patient. What is the most common name for this trauma

A: Penetrating trauma

Q: What type of injury is described as a flap of soft tissue torn or attached to the acute injury site

A: Avulsion

Q: You have a patient that is complaining of pain in their left knee. It is swollen and deformed. What
would be your treatment if there was no pulse

A: When a distal pulse is absent, you can try once to move the extremity to get the pulse back

Q: Why do we check both pulses on a primary assessment

A: To see if they are equal and present. A missing radial pulse could mean that the blood pressure
is low. In a medical patient where we are checking for presence (to see if CPR is needed), a carotid
pulse is taken for an adult

Q: Is a car seat adequate protection for all MVC

A: No, children/infants still need a complete assessment to rule out life threats

Q: A patient who has trauma to the abdomen can often be helped by what technique if showing
signs of low BP

A: Have the patient lay down and raise their legs. This is an effective way of helping with shock as
long as it does not cause or severely aggravate other injuries

Q: What would be your concern if you saw bubbling at an injury site close to an airway

A: Airway is affected and needs to be treated immediately

Q: Why is EMS the best career path

A: You get to hang out with the coolest people

Q: Current triage systems base their assessment on….

A: The patient's breathing, circulation, and LOC. The ability to walk/move is a good start but all three
things need to be considered

Q: Patient of a MVA presents as calm/alert. Patient did have impact injuries but they are now
presenting with increased pulse and respirations. What condition is most likely the cause

A: Shock - increase of pulse and respirations are often a sign of the body trying to make up for poor
perfusion (shock)

Q: Car accident with airbags…what critical injury should EMS provider be attentive to

A: Collapsed lung - There is often some injury with facial burns and body bruising…but lung
problems are a critical factor

Q: Two bone ends are pulled out of a joint. This is called a

A: Dislocation

Q: Of all the vital signs, which one is the most serious and indicator of shock

A: Low BP

Q: As a treating EMS provider, what color of triaged patients need to be treated first

A: RED - needs immediate attention

Q: What is a missing radial pulse a potential sign of

A: Low Blood pressure

Q: Patient has a puncture wound to the back and is having trouble breathing. What treatment should
be considered

A: Open wounds to the chest may require an occlusive dressing to prevent air from entering from
outside the chest

Q: A patient indicates their hand got caught in between two chairs and is now swollen and
sore…what is a good next step

A: Immobilize the area and put ice on the injury site to help with pain and swelling

Q: Bruised brain is called……………..

A: A contusion (bruise is the key word here)

Q: If a patient presents with injuries that have legs and arms straight out with toes pointing
downward…what is that called

A: Decerebrate posturing

Q: Child is victim of a major trauma - alert at first but now sleepy - pulse is down to under 60. What
system is potentially being affected

A: Breathing - (pulse is down - could becoming hypoxic)

Q: Patient has a protruding object as an injury. What steps does the provider need to perform

A: Need to get the patient on oxygen and carefully stabilize the object. Transport as soon as
possible

Q: You have placed a splint on a lower extremity and the pulse is now absent…what is your next
step

A: Try loosening the splint to see if it is just too tight first. The option of doing alignment is an option
but other alternatives should always be considered

Q: What is diaphragmatic breathing

A: A complete spinal cord injury affects everything from the injury down. This means that if the
diaphragm is affected, so are the intercostal and abdominal muscles

Q: If an injured patient presents with arms close to sides and elbows bent towards the body…what is
that called

A: Decorticate posturing

Q: Child in a car seat facing forward-what body part should you be concerned with in a collision as
high priority

A: Since they are facing forward and the head is large - consider a neck injury

Q: You have a patient that presents with the entire leg rotated and has a large bulge near the top of
the leg joint. What is the potential injury

A: Hip dislocation

Q: What splint do you use for a fractured clavicle

A: Sling and swathe…we would often use multiple swathes/saran wrap or some other method to do
a tight stabilization

Q: Mark 1 kits are used for whose treatment first

A: For responders / not patients

Q: Primary goal of triage is to help determine…..

A: Which patients receive treatment first

Q: If you see bubbling around an injury close to an airway.. what could be a reason

A: The wound is open to the airway

Q: Do we cover the entire hand/foot when putting on a splint

A: No, we need to be attentive to finger/hand coloring and temperature after the splint is applied

Q: You have placed a vacuum splint on your patient. They indicate that the area is now numb. What
information do you need from the patient

A: When did they first notice the numbness (need to know if it was because of your treatment or
they had it before you started)

Q: What color is the lightsaber for a Sith (Star Wars)

A: Red…silly people