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What is a likely cause of altered mental status in a trauma casualty on the
battlefield?
a. Use of recreational drugs
b. Sleep deprivation
c. Poor nutrition
d. Blood loss - ANSWER d. Blood loss RATIONALE
Although both a Traumatic Brain Injury and
Hypoxia can cause an altered mental status on the battlefield, studies have
shown that Hypovolemia is the likely cause of altered mental status in trauma
casualties.
Why is it important to communicate with a casualty throughout the delivery of
care?
a. Frank and reassuring communication can help decrease the casualty's anxiety
b. The casualty needs to understand the potential impact their injuries will have
on the mission
c. Casualties can pass on information to other first responders
d. Casualties should understand what is being done since they are required to
sign consent forms before treatment - ANSWER a. Frank and reassuring
communication can help decrease the casualty's anxiety
RATIONALE
The Combat Medic/Corpsman will continuously communicate with the casualty (if
possible) by encouraging, reassuring, and explaining each step of care being
rendered. Being wounded can cause significant anxiety and fear above and
beyond the psychological trauma of combat. Talking frankly with the casualty
about their injuries and offering reassurance by describing the treatments being
rendered and emphasizing that everything possible is being done to care for
them can help decrease their anxiety. Be honest about the injuries sustained but
maintain a positive attitude about treatment and timely evacuation. Talking with
the casualty helps assess their mental status, while talking through procedures
helps maintain your own focus and confidence as well as the casualty's
confidence in you.
A casualty is leaning forward with her hands placed on her knees to support her
,upper body. How would you describe what this casualty is doing?
a. Sternal retractions
b. Tripod respirations
c. Nasal flaring
d. Labored breathing - ANSWER b. Tripod respirations
RATIONALE
Tripod respirations - The patient will sit or stand leaning forward while supporting
the upper body with the hands on the knees to facilitate breathing.
If a penetrating eye injury is suspected, you should perform a
_______________________.
a. Rapid field test of visual acuity
b. Neurological exam
c. Traumatic brain injury evaluation questionnaire
d. Gait and balance assessment - ANSWER a. Rapid field test of visual acuity
RATIONALE
If a penetrating eye injury is noted or suspected, perform a rapid field test of
visual acuity and document findings. Rapid visual acuity testing includes the
ability to read print, count fingers, identity hand motion, and/or differentiate light
from dark.
Using the Rule of Nines, what percent of body surface area is considered burned
if the entire anterior torso and the front and back of both lower extremities are
burned?
a. 35%
b. 37%
c. 45%
d. 54% - ANSWER d. 54% RATIONALE
Eleven areas each have 9% body surface area (head, upper extremities, front and
back of lower extremities, and front and back of the torso having two 9% areas
each). General guidelines are that the size of the palm of the hand represents
approximately 1% of the burned area. When estimating, it is easiest to round up
to the nearest 10. If half of the front or rear area is burned, the area would be half
of the area value. For example, if the entire anterior torso and the front and back
of both lower extremities are burned, it would be (9% x 4) + 18% = 54%.
What is the most common cause of preventable combat death?
, a. Tension pneumothorax
b. Airway problems
c. Shock RATIONALE
The leading causes of preventable
d. Hemorrhage - ANSWER d. Hemorrhage death on the battlefield are due to
traumatic injuries including hemorrhage, both from the extremities and from
junctional areas, tension pneumothorax, and airway trauma or obstruction. By
far, the majority of the preventable deaths are from massive hemorrhage.
Tactical Combat Casualty Care (TCCC) Guidelines recommend that combat
trauma casualties without a pulse or respirations should have
____________________ performed during Tactical Field Care (TFC) due to the
potential benefit and clear absence of additional harm.
a. Active hypothermia measures
b. Tourniquet application
c. Bilateral needle decompression of the chest
d. Cardiopulmonary Resuscitation - ANSWER c. Bilateral needle decompression
of the chest
RATIONALE
During TFC, several authors and subject matter experts recommend that for
combat trauma casualties without a pulse, bilateral NDCs should be performed
due to the potential benefit and clear absence of additional harm. As a result, the
TCCC Guidelines now state: ".... casualties with torso trauma or polytrauma who
have no pulse or respirations during TFC should have bilateral needle
decompression performed to ensure they do not have a tension pneumothorax
prior to discontinuation of care."
On inspection of the back, a trauma casualty has a hematoma and localized lower
back pain that radiates down the legs. You suspect this casualty has a
_________________.
a. Femur fracture
b. Spinal fracture
c. Pelvic fracture
d. Compound fracture - ANSWER b. Spinal fracture
RATIONALE
Spinal fractures often present with localized spinal pain, or pain radiating down
the extremities from nerve irritation, and may include a deformity at the point of
injury, a hematoma, or crepitus. In some cases, motor function can be affected
leading to partial or complete paralysis, and sensation can be diminished or
absent.
A casualty in hemorrhagic shock received one unit of low-titer group O whole
blood and now has a palpable radial pulse with a blood pressure of 112/70. What
should the Combat Medic/Corpsman do next?
a. Continue to monitor the casualty and transfuse if there is a clinical