EFMB Written Test Study Guide latest updated

The initial radiographic evaluation of a trauma patient begins with supine Anterior- Posterior (AP) chest and pelvis radiographs taken in the trauma bay usually with a(n) ____________ . - ANSWER-Portable X-ray Machine T/F: Computed Tomography scanning has been largely replaced by cervical spine radiographic evaluation (CSRE) and should only be performed when CSRE is unavailable. - ANSWER-False What is the lowest level of care equipped with a Computed Tomography scanner? - ANSWER-Role 3 and above What is the lowest level of care equipped with a portable x-ray machine? - ANSWER-Role 2 Members of the trauma team should have _______ aprons and thyroid shields available near the trauma bay for radiation safety. - ANSWER-lead Distance is also protective from radiation exposure. If feasible based on the patient's condition, any personnel without lead shielding should move a short distance away from the x-ray unit. The recommended minimal distance is _______ . - ANSWER-6 feet While the FAST scan has been validated only in hemodynamically unstable blunt trauma patients, it has become a standard tool in the trauma bay and Emergency Department (ED) in most trauma patients. FAST stands for _______ . - ANSWER-Focused Abdominal Sonographic Assessment for Trauma Evaluation FAST in combat trauma has a sensitivity of only 56% and specificity of _____. - ANSWER-98.6% T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric injury. - ANSWER-False (It's actually Diagnostic Peritoneal Lavage.) T/F: At the Role 3, properly trained providers including radiologists, surgeons, and emergency physicians, can perform and interpret FAST scans in the emergency department on a hand held portable device. - ANSWER-True A FAST examination is performed with a portable hand-held machine most commonly using a standard 3-7 MHz curved array ________ probe. - ANSWER-ultrasound The standard FAST examination is focused on evaluating for the presence of __________ in certain areas of the body. - ANSWER-free intraperitoneal fluid When performing a FAST examination on a patient, you inspect the right upper quadrant. You are inspecting between which two organs? - ANSWER-Liver and Right Kidney When performing a FAST examination on a patient, you inspect the left upper quadrant. You are inspecting between which two organs? - ANSWER-Spleen and Left Kidney An 18g _________ IV is typically desired for Computed Tomography IV access. - ANSWER-Antecubital T/F: The goal of Computed Tomography contrast injection is to provide concurrent solid organ enhancement, arterial enhancement, and pulmonary arterial. - ANSWER-True T/F: When performing Computed Tomography scan on a Military Working Dog, utilize a scanning protocol based on the adult settings to include the doses of, and rates of, contrast administration. - ANSWER-False (pediatric settings are used) T/F: All patients evacuated through casualty evacuation should have images sent electronically ahead of time as well as have a CD created to send with the patient as a backup. - ANSWER-True T/F: Magnetic Resonance Imaging is widely used in theater, as its utility in the acute management of combat trauma was extensively establishment during Operation Enduring Freedom. - ANSWER-False All trauma patients arriving at a Role _______ will receive proper and expeditious radiologic screening of injuries. - ANSWER-3 T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - ANSWER-False (they are at risk for aural trauma and subsequent hearing loss) The symptoms of acoustic trauma are: - ANSWER-- Hearing loss - Tinnitus (ringing in the ear) - Aural fullness - Recruitment (ear pain with loud noise) - Difficulty localizing sounds - Difficulty hearing in a noisy background - Vertigo Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either ________ or _________. - ANSWER-temporary or permanent The ear, specifically the ___________, is the most sensitive organ to primary blast injury. - ANSWER-Tympanic Membrane T/F: The smaller the size of the tympanic membrane perforation, the greater the likelihood is of spontaneous closure. - ANSWER-True The majority of tympanic membrane perforations that close spontaneously do so within the first _________ after injury. - ANSWER-8 weeks Acute management of intratemporal facial nerve injury is to provide objective documentation of facial movement using the _________ scale. - ANSWER-House-Brackmann grading scale T/F: For significant facial pareses/paralyses, early administration of steroids must always be provided regardless of contraindications. - ANSWER-False (contraindications must always be taken into account) Which inner ear abnormalities may cause vertigo? - ANSWER-- Benign Paroxysmal Positional Vertigo - damage to neuroepithelial rests within inner ear - perilymphatic fistula - otic capsule violating temporal bone fractures - secondary infections of the inner ear or vestibular nerves - trauma induced endolymphatic hydrops - activation of subclinical superior semicircular canal dehiscence All Service Members that develop symptoms consistent with noise trauma (acute tinnitus, muffled hearing, fullness in the ear) should: - ANSWER-Be educated and directed to self-report for evaluation and possible treatment as soon as practicable. What is the best course of action if you find debris in the external auditory canal or in the middle ear? - ANSWER-Treat the patient with a topical antibiotic containing a fluoroquinolone and steroid. DO NOT irrigate the ear. Hearing loss that persists __________ hours after acoustic trauma warrants a hearing test or audiogram. - ANSWER-72 hours T/F: Vestibular trauma to the inner ear may manifest in vertigo. - ANSWER-True All patients with subjective hearing loss and tinnitus following blast exposure should: - ANSWER-Should have the exposure documented, and should be evaluated by a hearing test as soon as possible. Patients with TTS greater than _________ losses in three consecutive frequencies should be considered candidates for high dose oral and/or transtympanic steroid injections when not otherwise contraindicated. - ANSWER-25 decibels (dB) What are indications for endotracheal intubation during your initial burn survey? - ANSWER-- Comatose patient - Symptomatic Inhalation Injury - Deep facial burns - Burns over 40% Total Body Surface Area (TBSA) Burn casualties with injuries greater than ________ Total Body Surface Area (TBSA) are at high risk of hypothermia. - ANSWER- 20% TBSA T/F: When providing point of injury care to a burn patient, you must immediately debride blisters and cover burns with loose, moist gauze wraps or a wet clean sheet. - ANSWER-False (do not debride blisters until the patient has reached a facility with surgical capability. Cover burns with loose, dry gauze wraps or a clean sheet) Calculate a burn patient's initial burn size using the Rule of ________ . - ANSWER-"Rule of Nines" Which type of burn is NOT included in the estimation of Total Body Surface Area (TBSA) used for fluid resuscitation? - ANSWER-Superficial burns (1st degree) Which classification of burns are moist and sensate, blister, and blanch? - ANSWER-Partial thickness burns (2nd degree) Which classification of burns appear red, do not blister, and blanch readily? - ANSWER-Superficial burns (1st degree) Which classification of burns appear leathery, dry, non-blanching, are insensate, and often contain thrombosed vessels? - ANSWER-Full thickness burns (3rd degree) What is the Rule of 10s burn fluid resuscitation equation? - ANSWER-10 mL/hr x % TBSA For children suffering burn injuries, _______ x Total Body Surface Area (TBSA) x body weight in kg gives the volume for the first 24 hrs of fluid resuscitation. - ANSWER-3 T/F: A hypotonic solution is the preferred resuscitation fl