The Certified Athletic Emergency
Responder (CAER): Complete 200-
Question ASEP First Aid & Triage
Competency Examination
Section I: Primary & Secondary Assessment (The "Golden
Hour" Mindset)
1. A high school football player is lying motionless on the field after
a helmet-to-helmet collision. You are the first responder. What is
the FIRST step in your primary assessment (P.E.A.R.L.)?
A) Check for a pulse.
B) Stabilize the cervical spine.
C) Open the airway using the jaw-thrust maneuver.
D) Determine unresponsiveness and ensure scene safety.
Answers: D
Rationale: Before any physical contact or intervention, the responder
must ensure the scene is safe (e.g., no incoming players, downed wires)
and determine the athlete's level of consciousness to avoid further harm
to themselves or the athlete.
2. During your secondary survey, you note an athlete has point
tenderness over the distal fibula, ecchymosis, and inability to bear
weight. What is the most appropriate immediate action regarding
ambulation?
A) Have the athlete hop to the sideline on the good foot.
B) Apply a walking boot and let them walk off with assistance.
C) Splint the injury in place and utilize a stretcher or wheelchair for
transport.
D) Perform a drawer test to rule out ligamentous laxity.
,Answers: C
Rationale: Inability to bear weight combined with point tenderness
indicates a high probability of fracture. Ambulation must be avoided. The
injury should be splinted in the position found, and the athlete must be
removed via non-weight-bearing transport.
Section II: Environmental & Thermal Emergencies
3. A marathon runner collapses at the 25-mile mark. The skin is hot
and dry, core temperature is 105.2°F (40.7°C), and they are
exhibiting bizarre behavior and confusion. Which advanced cooling
strategy is contraindicated in this acute phase?
A) Cold-water immersion (rectal temp monitoring).
B) Application of ice packs to the groin, axillae, and neck.
C) Administration of oral sports drinks.
D) Fanning with tepid water mist.
Answers: C
Rationale: This is exertional heat stroke. The athlete's mental status is
altered, placing them at high risk for aspiration. Oral fluids are
contraindicated; the priority is rapid cooling via immersion or
evaporative methods while securing an IV line for rehydration.
4. An ice hockey player is checked into the boards and is shivering
violently. Upon removal of the jersey, you notice waxy, pale, and
firm skin on the ear and fingertips. What is the priority
intervention?
A) Massage the affected areas vigorously to restore circulation.
B) Apply direct dry heat (heating pad) to the affected areas.
C) Immerse the affected part in a circulating water bath at 100°F–105°F
(37.8°C–40.6°C).
D) Administer aspirin for pain management.
Answers: C
Rationale: This describes frostbite. Massage and dry heat (heating pads)
can cause mechanical damage and burns due to decreased sensation.
,Rewarming is achieved via a warm water bath (not hot). Aspirin is not the
priority for rewarming.
Section III: Musculoskeletal & Soft Tissue Trauma
5. A softball player slides into home plate and presents with a
deformed, shortened, and internally rotated left leg. You suspect a
hip dislocation/femur fracture. Which of the following is a critical
neurovascular assessment you MUST perform BEFORE splinting?
A) Achilles tendon reflex.
B) Patellar tendon reflex.
C) Dorsalis pedis pulse and capillary refill.
D) Prone straight-leg raise.
Answers: C
Rationale: A posterior hip dislocation/fracture poses a significant risk to
the sciatic nerve and femoral artery. Assessing distal pulses (dorsalis
pedis/posterior tibial) and motor/sensory function in the foot is critical.
The limb should be splinted in the position of comfort (usually internal
rotation) and transported immediately.
6. You are managing a laceration on a soccer player's shin. The
wound is gaping and bleeding profusely. Direct pressure with sterile
gauze is not controlling the hemorrhage. What is the next step in
hemorrhage control?
A) Apply a tourniquet 1-2 inches above the wound.
B) Pack the wound with hemostatic gauze and apply firm pressure.
C) Elevate the limb above the heart.
D) Apply pressure to the femoral artery pressure point.
Answers: B
Rationale: While tourniquets are for life-threatening extremity
hemorrhage, packing a deep, gaping wound with hemostatic agents (or
plain gauze) and applying direct pressure addresses the source of
bleeding. If the bleeding is arterial and packing fails, then a tourniquet is
applied high and tight on the extremity.
, Section IV: Neurological & Head Trauma
7. A gymnast takes a fall on the balance beam. She is conscious but
states she "blacked out" for a second. She reports a "tingling"
sensation in her hands and neck pain. What is the paramount action
regarding spinal motion restriction?
A) Apply a rigid cervical collar immediately.
B) Have her walk to the stretching mat to lie down.
C) Have her sit down and hold her head still while you call 911.
D) Apply manual in-line stabilization and do not allow her to move.
Answers: D
Rationale: A loss of consciousness (even transient) combined with
neurological symptoms (tingling) and cervical pain constitutes a high-
mechanism injury. The spine must be stabilized manually (hands-on)
until a cervical collar and backboard can be applied. A collar alone is
insufficient without backboard support.
8. According to the latest consensus statement on concussion
management, which symptom is the most immediate "red flag"
indicating a potential epidural or subdural hematoma requiring
emergent evacuation?
A) Mild headache.
B) Photophobia.
C) Deteriorating level of consciousness or unilateral pupil dilation.
D) Amnesia of the event.
Answers: C
Rationale: A lucid interval followed by declining consciousness and
anisocoria (unequal pupils) is the classic hallmark of an expanding
intracranial mass. This is a surgical emergency (Time = Brain).
Responder (CAER): Complete 200-
Question ASEP First Aid & Triage
Competency Examination
Section I: Primary & Secondary Assessment (The "Golden
Hour" Mindset)
1. A high school football player is lying motionless on the field after
a helmet-to-helmet collision. You are the first responder. What is
the FIRST step in your primary assessment (P.E.A.R.L.)?
A) Check for a pulse.
B) Stabilize the cervical spine.
C) Open the airway using the jaw-thrust maneuver.
D) Determine unresponsiveness and ensure scene safety.
Answers: D
Rationale: Before any physical contact or intervention, the responder
must ensure the scene is safe (e.g., no incoming players, downed wires)
and determine the athlete's level of consciousness to avoid further harm
to themselves or the athlete.
2. During your secondary survey, you note an athlete has point
tenderness over the distal fibula, ecchymosis, and inability to bear
weight. What is the most appropriate immediate action regarding
ambulation?
A) Have the athlete hop to the sideline on the good foot.
B) Apply a walking boot and let them walk off with assistance.
C) Splint the injury in place and utilize a stretcher or wheelchair for
transport.
D) Perform a drawer test to rule out ligamentous laxity.
,Answers: C
Rationale: Inability to bear weight combined with point tenderness
indicates a high probability of fracture. Ambulation must be avoided. The
injury should be splinted in the position found, and the athlete must be
removed via non-weight-bearing transport.
Section II: Environmental & Thermal Emergencies
3. A marathon runner collapses at the 25-mile mark. The skin is hot
and dry, core temperature is 105.2°F (40.7°C), and they are
exhibiting bizarre behavior and confusion. Which advanced cooling
strategy is contraindicated in this acute phase?
A) Cold-water immersion (rectal temp monitoring).
B) Application of ice packs to the groin, axillae, and neck.
C) Administration of oral sports drinks.
D) Fanning with tepid water mist.
Answers: C
Rationale: This is exertional heat stroke. The athlete's mental status is
altered, placing them at high risk for aspiration. Oral fluids are
contraindicated; the priority is rapid cooling via immersion or
evaporative methods while securing an IV line for rehydration.
4. An ice hockey player is checked into the boards and is shivering
violently. Upon removal of the jersey, you notice waxy, pale, and
firm skin on the ear and fingertips. What is the priority
intervention?
A) Massage the affected areas vigorously to restore circulation.
B) Apply direct dry heat (heating pad) to the affected areas.
C) Immerse the affected part in a circulating water bath at 100°F–105°F
(37.8°C–40.6°C).
D) Administer aspirin for pain management.
Answers: C
Rationale: This describes frostbite. Massage and dry heat (heating pads)
can cause mechanical damage and burns due to decreased sensation.
,Rewarming is achieved via a warm water bath (not hot). Aspirin is not the
priority for rewarming.
Section III: Musculoskeletal & Soft Tissue Trauma
5. A softball player slides into home plate and presents with a
deformed, shortened, and internally rotated left leg. You suspect a
hip dislocation/femur fracture. Which of the following is a critical
neurovascular assessment you MUST perform BEFORE splinting?
A) Achilles tendon reflex.
B) Patellar tendon reflex.
C) Dorsalis pedis pulse and capillary refill.
D) Prone straight-leg raise.
Answers: C
Rationale: A posterior hip dislocation/fracture poses a significant risk to
the sciatic nerve and femoral artery. Assessing distal pulses (dorsalis
pedis/posterior tibial) and motor/sensory function in the foot is critical.
The limb should be splinted in the position of comfort (usually internal
rotation) and transported immediately.
6. You are managing a laceration on a soccer player's shin. The
wound is gaping and bleeding profusely. Direct pressure with sterile
gauze is not controlling the hemorrhage. What is the next step in
hemorrhage control?
A) Apply a tourniquet 1-2 inches above the wound.
B) Pack the wound with hemostatic gauze and apply firm pressure.
C) Elevate the limb above the heart.
D) Apply pressure to the femoral artery pressure point.
Answers: B
Rationale: While tourniquets are for life-threatening extremity
hemorrhage, packing a deep, gaping wound with hemostatic agents (or
plain gauze) and applying direct pressure addresses the source of
bleeding. If the bleeding is arterial and packing fails, then a tourniquet is
applied high and tight on the extremity.
, Section IV: Neurological & Head Trauma
7. A gymnast takes a fall on the balance beam. She is conscious but
states she "blacked out" for a second. She reports a "tingling"
sensation in her hands and neck pain. What is the paramount action
regarding spinal motion restriction?
A) Apply a rigid cervical collar immediately.
B) Have her walk to the stretching mat to lie down.
C) Have her sit down and hold her head still while you call 911.
D) Apply manual in-line stabilization and do not allow her to move.
Answers: D
Rationale: A loss of consciousness (even transient) combined with
neurological symptoms (tingling) and cervical pain constitutes a high-
mechanism injury. The spine must be stabilized manually (hands-on)
until a cervical collar and backboard can be applied. A collar alone is
insufficient without backboard support.
8. According to the latest consensus statement on concussion
management, which symptom is the most immediate "red flag"
indicating a potential epidural or subdural hematoma requiring
emergent evacuation?
A) Mild headache.
B) Photophobia.
C) Deteriorating level of consciousness or unilateral pupil dilation.
D) Amnesia of the event.
Answers: C
Rationale: A lucid interval followed by declining consciousness and
anisocoria (unequal pupils) is the classic hallmark of an expanding
intracranial mass. This is a surgical emergency (Time = Brain).
