EFMB 2022 Study Guide Complete Questions And Actual Answers| Graded A+.

Optimal but necessarily definitive patient stabilization before transport is critical and encompasses 4 connected elements. What are these elements? - correct answer Injuries-actual and potential (e.g., spinal instability)- must be controlled; Resuscitation must be optimized and ongoing; Other treatment besides resuscitative measures should be at steady state, not requiring dynamic, complex, or life-preserving adjustments en route; Deterioration requiring en route intervention must be anticipated and prevented with risk mitigation procedures prior to departure T/F: Medical capability is the quality or state of being able to provide the expected and required medical services and support to the casualty. - correct answer True ___ transport is required when "the patient has a critical illness or injury that actualy impairs one or more vital organ system such that there is a high probability of imminent or life-threatening deterioration in the patient's condition during transport" - correct answer Critical Care The gold standard for unstable patient transport is movement with critical care capability led by a ___ who is qualified, experienced, and proficient at critical care transport - correct answer Physician T/F: Intermediate en route care should be initiated for a patient that does not require critical care but is in need of a dedicated medical attendant with at least the knowledge and skills equivalent to a Paramedic as defined by the National Emergency Medical Service (EMS) Scope of Practice model. - correct answer True Who assumes risk of reducing capability when a medical evacuation organization is not capable of providing the required intratheater en route care capability? - correct answer The theater commander T/F: Well trained teams improve outcomes so en route care teams who train together prior to operational assignment may optimize patient outcomes. - correct answer True What are examples of specific medical materials designated as patient movement items (PMI)? - correct answer Ventilators; Patient Monitors; Pulse Oximeters; Suction Machines; IV Pumps; Oversized Litters; Negative Pressure Wound Vacuums; Pneumatic Compression Stockings/Devices T/F: The senior military person (or designated on-ground mission commander) present in coordination with the senior medical person determines when to request medial evacuation and the precedence assigned to the patient for evacuation. - correct answer True The MIST report was recently incorporated into the 9-line medical evacuation request. MIST stands for - correct answer Mechanism of Injury; Type of Injury; Signs; Treatment given T/F: The interfacility transport of patients between theater medical treatment facilities clinical practice guidelines defines medical direction as the direct technical authority to determine capability, promulgate medical policy, and the authority to enforce the standard of care through quality assurance with local privileging actions of individual en route care providers. - correct answer True ___ medical direction includes protocol development and review, continuing education of prehospital providers, and quality improvement activities. - correct answer Offline The commander of the unit assigned to perform medical evacuation should appoint the unit's ___ as the medical director - correct answer Physician T/F: Medical direction as the regional level (Patient Evacuation Control Center) is centered on online medical direction activities. - correct answer False, medical direction at the regional level is centered on offline medical direction. What are the responsibilities of a regional medical director? - correct answer In conjunction with medical planners advise the Combatant/Theater Commander on medical common operating picture and allocation of resources for intra-theater transport; Ensure requirements of documentation of intra-theater transport care are done; Assist medical directors operating in theater and ensure that they have the knowledge and skills to perform the job; Provide technical supervision to medical directors in theater; Ensure relevant out of hospital research is supported and accomplished; Ensure information from the intra-theater transportation is supplied to the DoD Trauma Registry What are the approved Joint Trauma System patient care record (PCR) for intra-facility patient transports? - correct answer DD Form 1380 Tactical Combat Casualty Care Card; DA 4700 overprint Tactical Evacuation Patient Care Record (JTS approved ); AF IMT 3899 Patient Movement Record (,V1); Medical Rescue Report SAR Form 3-50.1A Which approved Joint Trauma System patient care record (PCR) is primarily used for rotary wing transports from point of injury or inter-facility transfer? - correct answer The Tactical Evacuation Patient Care Record Which approved Joint Trauma System patient care record (PCR) is primarily used for Critical Care Air Transport Team movements? - correct answer AF IMT 3899, with supplements A-K Which approved Joint Trauma System patient care record (PCR) is required whenever a search or rescue is attempted or accomplished that involves the Navy Personnel and assets? - correct answer Medical Rescue Report SAR Form 3-50.1A T/F: While the patient is delivered to the receiving medical treatment facility, the patient care record should be maintained with the evacuation unit. - correct answer False, The PCR should be completed and delivered to the receiving MTF along with the patient. T/F: The acute pain service (APS) should be established and be an integral part of casualty care starting at role 1. - correct answer False. APS should be established starting at the theater hospital (Role 3) T/F: Sedation should be optimized as a priority over pain control. - correct answer True Adjuncts can greatly increase patient safety and the effectiveness of narcotics to treat pain while reducing side effects. what are examples of adjuncts? - correct answer Acetaminophen; Ketamine; Non-steroidal anti-inflammatory drugs (NSAIDs); Continuous peripheral nerve infusions; Continuous epidural infusions If not feasible to incorporate the acute pain service (APS) team into trauma rounds, then the APS is responsible for ___ pain rounds, pain management consults, and reports to the trauma team leader. - correct answer daily What are standardized and validated scoring systems for the assessment of pain, anxiety, and delirium? - correct answer DoD/VA pain rating scale; Richmond Agitation Sedation Scale (RASS); Confusion Assessment Method (CAM) The Richmond Agitation Sedation Scale (RASS) is used to assess___ - correct answer anxiety The goal for patients with delirium is to achieve a delirium free state as measured by the ___ - correct answer Confusion Assessment Method (CAM) The ABCDEs should be incorporated into treatment care plans as efforts to prevent delirium in critically injured patients. The "E" stands for ___ - correct answer Exercise T/F: Seriously injured patients who are not incubated should be assessed every 1-4 hours for the presence of pain. - correct answer True T/F: Adequate early pain control has been shown to reduce post-traumatic stress disorder and ongoing pain control is an obligatory part of trauma care - correct answer True ____, in parenteral doses of 0.15-0.3 mg/kg, has been shown to reduce pain scores, total narcotic use, and need for rescue medication when used with morphine for acute pain control. - correct answer Ketamine What is not a narcotic agent of choice approved for repeated patient-controlled analgesia (PCA) pump? - correct answer Meperidine (Demerol) T/F: Low molecular weight heparin (LMWH) used in patients undergoing epidural anesthesia increases the risk of spinal or epidural hematoma, which may cause long term or permanent paralysis. - correct answer True What are medications used to treat anxiety and agitation? - correct answer Propofol; Dexmedetomidine; Clonidine T/F: Continuous dosing of analgesic and anxiolytics, as opposed to intermittent dosing, has been shown to reduce the duration of mechanical ventilation and continuous dosing of analgesics and anxiolytics should be instituted prior to intermittent dosing. - correct answer False, Intermittent dosing of analgesic and anxiolytics NOT Continuous dosing. Continuous infusions should be stopped ___ to obtain a reliable physical examination, including neurological assessment and to preform a spontaneous breathing trial in ventilated patients - correct answer daily ___ is a safe antiemetic in the adult population and is increasingly the therapy of choice for acute undifferentiated and trauma-related nausea. - correct answer Ondansetron The DoD/VA Pain Rating Scale requires patient to select their pain level on a scale of 0-10, with 10 being ____ - correct answer as bad as it could be, nothing else matters Battlefield Acupuncture (BFA) is a non-pharmacological pain therapy for mild to moderate pain or an adjunct to opioid medications. BFA is accomplished by applying needles to which body part? - correct answer The ear During debridement, extremity wounds should be extended in - correct answer longitudinal manner (parallel with the