NREMT - TRAUMA
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1. Damaged small blood vessels be- B;
neath the skin following blunt trau-
ma causes: Reason:
A:mottling.
When small blood vessels beneath the skin are
B:ecchymosis.
damaged, blood seeps into the soft tissues. This
C:hematoma.
manifests as a bruise, also referred to as ecchymo-
D:cyanosis.
sis. A hematoma develops when larger blood ves-
sels are ruptured and the internal bleeding forms
a "lump." Cyanosis is a blue or purple discoloration
of the skin and signifies a low content of oxygen in
the blood. Mottling occurs when the skin takes on a
blotched, purple appearance and is a sign of shock
(hypoperfusion).
2. During transport of a patient with a B;
head injury, which of the following
will provide you with the MOST infor- Reason:
mation regarding the patient's condi-
tion?
The patient's mental status provides you with the
most information regarding overall perfusion sta-
A:Heart rate
tus, especially when monitoring a patient with
B:Mental status
a head injury. Frequent neurologic assessments,
C:Pupil size
which includes assessing the patient's pupils, are
D:Blood pressure
critical in determining if the patient's condition is
improving or deteriorating. Vital signs should be
monitored according to the patient's condition, at
least every 5 minutes if he or she is unstable and at
least every 15 minutes if he or she is stable.
3.
, NREMT - TRAUMA
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You are called to a local nightclub for A; This is correct!
an injured patient. Law enforcement
personnel have secured the scene. Reason:
Upon arrival, you see a young man
who is lying on the ground screaming
This patient's airway is obviously patent; he is
in pain; bright red blood is spurting
screaming in pain. Blood spurting from the groin
from an apparent stab wound to his
area indicates arterial bleeding from the femoral
groin area. You should:
artery. If this bleeding is not controlled immediately,
the patient will die. Oxygen and other shock treat-
A:control the bleeding.
ment (ie, keeping him warm) should be initiated
B:prevent hypothermia.
after this life-threatening bleeding is controlled. If
C:ensure an open airway.
you take the time to set up and administer oxygen
D:apply 100% oxygen.
prior to managing the bleeding, the patient will die.
Base your treatment priorities on what will kill the
patient first.
4. When assessing and treating a pa- D;
tient with a gunshot wound, you
should routinely: Reason:
A:evaluate the pulses proximal to the
When assessing a patient who sustained a gunshot
wound.
wound, you should routinely look for an exit wound,
B:apply ice directly to the wound.
which may be difficult to find. Exit wounds can be a
C:determine why the patient was
source of continued bleeding, both externally and
shot.
internally. They may or may not follow the same path
D:look for the presence of an exit
as the entrance wound. This is why it is important
wound.
to conduct a thorough examination of the patient.
Ice can be applied to the wound, but only after
the wound has been covered by a sterile dressing.
Determining why the patient was shot is the re-
sponsibility of law enforcement, not the EMT. If the
, NREMT - TRAUMA
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wound is close to an extremity, pulse, motor, and
sensory function should be assessed distal to the
wound.
5. Following blunt trauma to the chest, B;
a 33-year-old male has shallow,
painful breathing. On assessment, Reason:
you note that an area to the left side
of his chest collapses during inhala-
If two or more ribs are fractured in two or more
tion and bulges during exhalation.
places or if the sternum is fractured along with sev-
These are signs of a/an:
eral ribs, a segment of chest wall may be detached
from the rest of the thoracic cage. This injury is
A:isolated rib fracture.
called a flail chest. In a flail chest, the detached
B:flail chest.
portion of the chest wall moves opposite of normal.
C:pulmonary contusion.
It moves in during inhalation and out during ex-
D:pneumothorax.
halation (paradoxical motion). Isolated (single) rib
fractures are not associated with paradoxical motion
because they are usually only fractured in one place.
In a pneumothorax, the patient's respirations are
often labored; in severe cases, an entire side of
the chest may not move at all (asymmetrical chest
movement). A pulmonary contusion (bruising of the
lung tissue) does not cause paradoxical chest mo-
tion unless associated with a flail chest.
6.
, NREMT - TRAUMA
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Following a head injury, a young fe- C;
male is semiconscious and is bleed-
ing from the nose and left ear. You Reason:
should:
Blood draining from the ears or nose following a
A:control the bleeding from her nose
head injury may contain cerebrospinal fluid (CSF)
by pinching her nostrils closed.
and indicates a skull fracture. In these cases, do
B:place a pressure dressing over her
NOT attempt to stop the flow of blood. Applying
ear to prevent blood loss.
excessive pressure may force the blood leaking from
C:cover her ear and nose with a loose
the ears or nose to collect within the cranium, which
gauze pad to collect the blood.
could increase the pressure on the brain and cause
D:insert a nasal airway to keep her
permanent damage. Loosely cover the ears or nose
tongue from blocking the airway.
with a sterile gauze pad to collect the blood and help
keep contaminants out (patients with a skull fracture
and CSF leakage are at risk for meningitis). The
nasopharyngeal (nasal) airway is contraindicated in
patients with a possible skull fracture, especially if
blood is draining from the nose. The airway adjunct
may inadvertently enter the cranial vault through the
fracture.
7. A 23-year-old male was struck across D;
the face with a baseball bat. His eyes
are swollen shut, he has massive Reason:
facial bruising and deformities, and
has blood in his mouth. Your MOST
Few things will kill a patient quicker than a com-
immediate concern should be:
promised (nonpatent) airway. Blood in a patient's
mouth must be removed immediately. It may be
A:permanent vision loss.
aspirated into the lungs or, if clotted, obstruct the
B:intracranial bleeding.
airway. Spinal trauma, intracranial bleeding, and
C:spinal trauma.
vision loss are all possible in a patient with blunt
D:airway compromise.
Study online at https://quizlet.com/_1o6wdp
1. Damaged small blood vessels be- B;
neath the skin following blunt trau-
ma causes: Reason:
A:mottling.
When small blood vessels beneath the skin are
B:ecchymosis.
damaged, blood seeps into the soft tissues. This
C:hematoma.
manifests as a bruise, also referred to as ecchymo-
D:cyanosis.
sis. A hematoma develops when larger blood ves-
sels are ruptured and the internal bleeding forms
a "lump." Cyanosis is a blue or purple discoloration
of the skin and signifies a low content of oxygen in
the blood. Mottling occurs when the skin takes on a
blotched, purple appearance and is a sign of shock
(hypoperfusion).
2. During transport of a patient with a B;
head injury, which of the following
will provide you with the MOST infor- Reason:
mation regarding the patient's condi-
tion?
The patient's mental status provides you with the
most information regarding overall perfusion sta-
A:Heart rate
tus, especially when monitoring a patient with
B:Mental status
a head injury. Frequent neurologic assessments,
C:Pupil size
which includes assessing the patient's pupils, are
D:Blood pressure
critical in determining if the patient's condition is
improving or deteriorating. Vital signs should be
monitored according to the patient's condition, at
least every 5 minutes if he or she is unstable and at
least every 15 minutes if he or she is stable.
3.
, NREMT - TRAUMA
Study online at https://quizlet.com/_1o6wdp
You are called to a local nightclub for A; This is correct!
an injured patient. Law enforcement
personnel have secured the scene. Reason:
Upon arrival, you see a young man
who is lying on the ground screaming
This patient's airway is obviously patent; he is
in pain; bright red blood is spurting
screaming in pain. Blood spurting from the groin
from an apparent stab wound to his
area indicates arterial bleeding from the femoral
groin area. You should:
artery. If this bleeding is not controlled immediately,
the patient will die. Oxygen and other shock treat-
A:control the bleeding.
ment (ie, keeping him warm) should be initiated
B:prevent hypothermia.
after this life-threatening bleeding is controlled. If
C:ensure an open airway.
you take the time to set up and administer oxygen
D:apply 100% oxygen.
prior to managing the bleeding, the patient will die.
Base your treatment priorities on what will kill the
patient first.
4. When assessing and treating a pa- D;
tient with a gunshot wound, you
should routinely: Reason:
A:evaluate the pulses proximal to the
When assessing a patient who sustained a gunshot
wound.
wound, you should routinely look for an exit wound,
B:apply ice directly to the wound.
which may be difficult to find. Exit wounds can be a
C:determine why the patient was
source of continued bleeding, both externally and
shot.
internally. They may or may not follow the same path
D:look for the presence of an exit
as the entrance wound. This is why it is important
wound.
to conduct a thorough examination of the patient.
Ice can be applied to the wound, but only after
the wound has been covered by a sterile dressing.
Determining why the patient was shot is the re-
sponsibility of law enforcement, not the EMT. If the
, NREMT - TRAUMA
Study online at https://quizlet.com/_1o6wdp
wound is close to an extremity, pulse, motor, and
sensory function should be assessed distal to the
wound.
5. Following blunt trauma to the chest, B;
a 33-year-old male has shallow,
painful breathing. On assessment, Reason:
you note that an area to the left side
of his chest collapses during inhala-
If two or more ribs are fractured in two or more
tion and bulges during exhalation.
places or if the sternum is fractured along with sev-
These are signs of a/an:
eral ribs, a segment of chest wall may be detached
from the rest of the thoracic cage. This injury is
A:isolated rib fracture.
called a flail chest. In a flail chest, the detached
B:flail chest.
portion of the chest wall moves opposite of normal.
C:pulmonary contusion.
It moves in during inhalation and out during ex-
D:pneumothorax.
halation (paradoxical motion). Isolated (single) rib
fractures are not associated with paradoxical motion
because they are usually only fractured in one place.
In a pneumothorax, the patient's respirations are
often labored; in severe cases, an entire side of
the chest may not move at all (asymmetrical chest
movement). A pulmonary contusion (bruising of the
lung tissue) does not cause paradoxical chest mo-
tion unless associated with a flail chest.
6.
, NREMT - TRAUMA
Study online at https://quizlet.com/_1o6wdp
Following a head injury, a young fe- C;
male is semiconscious and is bleed-
ing from the nose and left ear. You Reason:
should:
Blood draining from the ears or nose following a
A:control the bleeding from her nose
head injury may contain cerebrospinal fluid (CSF)
by pinching her nostrils closed.
and indicates a skull fracture. In these cases, do
B:place a pressure dressing over her
NOT attempt to stop the flow of blood. Applying
ear to prevent blood loss.
excessive pressure may force the blood leaking from
C:cover her ear and nose with a loose
the ears or nose to collect within the cranium, which
gauze pad to collect the blood.
could increase the pressure on the brain and cause
D:insert a nasal airway to keep her
permanent damage. Loosely cover the ears or nose
tongue from blocking the airway.
with a sterile gauze pad to collect the blood and help
keep contaminants out (patients with a skull fracture
and CSF leakage are at risk for meningitis). The
nasopharyngeal (nasal) airway is contraindicated in
patients with a possible skull fracture, especially if
blood is draining from the nose. The airway adjunct
may inadvertently enter the cranial vault through the
fracture.
7. A 23-year-old male was struck across D;
the face with a baseball bat. His eyes
are swollen shut, he has massive Reason:
facial bruising and deformities, and
has blood in his mouth. Your MOST
Few things will kill a patient quicker than a com-
immediate concern should be:
promised (nonpatent) airway. Blood in a patient's
mouth must be removed immediately. It may be
A:permanent vision loss.
aspirated into the lungs or, if clotted, obstruct the
B:intracranial bleeding.
airway. Spinal trauma, intracranial bleeding, and
C:spinal trauma.
vision loss are all possible in a patient with blunt
D:airway compromise.
