NSW Ambulance Trauma Protocols Test Bank
2026/2027
University/College: University of Sydney – Faculty of Medicine and Health (Paramedicine /
Emergency Medicine)
Subject: Pre-hospital Trauma Management / Emergency Medical Services
Course Code: Typically associated with Paramedic Clinical Practice / Trauma Emergency
Management
SECTION A: PROTOCOL T1 – PRE-HOSPITAL MANAGEMENT OF MAJOR TRAUMA
(Questions 1-35)
Question 1
What does the acronym MIST stand for in the NSW Ambulance Trauma Triage Tool?
A) Mechanism, Injuries, Signs, Treatment
B) Major, Injuries, Symptoms, Transport
C) Mechanism, Injury, Symptoms, Triage
D) Movement, Immobilisation, Stabilisation, Transport
Answer: A
Explanation: MIST stands for Mechanism of Injury, Injuries sustained, Signs and Symptoms, and
Treatment given. It is used for both triage decision-making and clinical handover to receiving
hospitals.
Question 2
According to NSW Ambulance Protocol T1, patients who meet Major Trauma Criteria should be
transported to the highest level trauma service within what maximum travel time in metropolitan
areas?
A) 30 minutes
B) 45 minutes
C) 60 minutes
D) 90 minutes
Answer: C
Explanation: Protocol T1 specifies transport to the highest-level trauma centre within 60 minutes
by road in metropolitan areas and 90 minutes in regional or rural areas.
,Question 3
What is the maximum transport time authorised for paramedics transporting a major trauma
patient in regional/rural NSW?
A) 30 minutes
B) 60 minutes
C) 90 minutes
D) 120 minutes
Answer: C
Explanation: Paramedics are authorised to transport up to 90 minutes from the scene in regional
areas to reach the appropriate destination.
Question 4
Which of the following is NOT listed as a high-risk group in the T1 Trauma Triage Tool?
A) Patients < 16 years of age
B) Patients ≥ 65 years of age
C) Patients with a GCS of 15
D) Obstetric patients > 20 weeks gestation
Answer: C
Explanation: High-risk groups include patients <16 or ≥65 years, patients with significant
co-morbidities, NESB/difficult to assess patients, obstetric patients >20 weeks gestation, and
patients on anticoagulants or with clotting disorders. A GCS of 15 is normal and does not
indicate high risk.
Question 5
What is the primary purpose of Protocol T1?
A) To manage cardiac arrest in trauma patients
B) To outline the management of a major trauma patient from assessment through to transport
decision-making
C) To provide pain management guidelines for trauma patients
D) To establish protocols for hospital-based trauma team activation
Answer: B
Explanation: Protocol T1: Pre-hospital Management of Major Trauma outlines the management
of a major trauma patient from assessment through to transport decision-making, supported by
a trauma triage tool.
,Question 6
Which of the following mechanisms of injury is included in the "Blunt" category of the MIST
criteria?
A) Penetrating injury to the chest
B) Death in the same vehicle
C) Isolated injury to hands or feet
D) Stab wound to the abdomen
Answer: B
Explanation: Death in the same vehicle is a blunt mechanism criterion. Penetrating injuries are
in a separate category, and isolated injuries to hands or feet are specifically excluded from
major trauma criteria.
Question 7
A patient with a GCS of 12 following a motor vehicle collision meets which component of the
MIST criteria?
A) Mechanism of Injury
B) Injuries
C) Signs and Symptoms
D) Treatment
Answer: C
Explanation: Signs and Symptoms criteria include GCS ≤13. A GCS of 12 meets the "Disability"
component under Signs and Symptoms.
Question 8
According to the T1 protocol, which of the following is a high-risk group requiring a high index of
suspicion for serious injury?
A) Patients aged 18-40 years
B) Patients on anticoagulant medications
C) Patients with a history of hypertension
D) Patients who are conscious and alert
Answer: B
Explanation: Patients on anticoagulants, antiplatelet medications, or with clotting disorders are
specifically identified as a high-risk group in the T1 protocol.
, Question 9
How many designated trauma services are there in NSW?
A) 15
B) 21
C) 25
D) 30
Answer: B
Explanation: NSW has 21 designated trauma services: seven adult Major Trauma Services
(MTS), three paediatric Major Trauma Services (PTS), and eleven Regional Trauma Services
(RTS).
Question 10
What is the minimum fall height that triggers Major Trauma Criteria in adults according to the
MIST tool?
A) 1 metre
B) 2 metres
C) 3 metres
D) 5 metres
Answer: C
Explanation: Falls >3 metres in adults or twice the child's height in paediatrics are included in
the Mechanism of Injury criteria.
Question 11
Which of the following penetrating injuries is EXCLUDED from Major Trauma Criteria?
A) Penetrating injury to the chest
B) Penetrating injury to the abdomen
C) Isolated penetrating injury to hands or feet
D) Penetrating injury to the neck
Answer: C
Explanation: All penetrating injuries are included EXCEPT isolated injury to hands or feet, which
is specifically excluded from major trauma criteria.
Question 12
The T1 protocol has been associated with which of the following performance characteristics?
2026/2027
University/College: University of Sydney – Faculty of Medicine and Health (Paramedicine /
Emergency Medicine)
Subject: Pre-hospital Trauma Management / Emergency Medical Services
Course Code: Typically associated with Paramedic Clinical Practice / Trauma Emergency
Management
SECTION A: PROTOCOL T1 – PRE-HOSPITAL MANAGEMENT OF MAJOR TRAUMA
(Questions 1-35)
Question 1
What does the acronym MIST stand for in the NSW Ambulance Trauma Triage Tool?
A) Mechanism, Injuries, Signs, Treatment
B) Major, Injuries, Symptoms, Transport
C) Mechanism, Injury, Symptoms, Triage
D) Movement, Immobilisation, Stabilisation, Transport
Answer: A
Explanation: MIST stands for Mechanism of Injury, Injuries sustained, Signs and Symptoms, and
Treatment given. It is used for both triage decision-making and clinical handover to receiving
hospitals.
Question 2
According to NSW Ambulance Protocol T1, patients who meet Major Trauma Criteria should be
transported to the highest level trauma service within what maximum travel time in metropolitan
areas?
A) 30 minutes
B) 45 minutes
C) 60 minutes
D) 90 minutes
Answer: C
Explanation: Protocol T1 specifies transport to the highest-level trauma centre within 60 minutes
by road in metropolitan areas and 90 minutes in regional or rural areas.
,Question 3
What is the maximum transport time authorised for paramedics transporting a major trauma
patient in regional/rural NSW?
A) 30 minutes
B) 60 minutes
C) 90 minutes
D) 120 minutes
Answer: C
Explanation: Paramedics are authorised to transport up to 90 minutes from the scene in regional
areas to reach the appropriate destination.
Question 4
Which of the following is NOT listed as a high-risk group in the T1 Trauma Triage Tool?
A) Patients < 16 years of age
B) Patients ≥ 65 years of age
C) Patients with a GCS of 15
D) Obstetric patients > 20 weeks gestation
Answer: C
Explanation: High-risk groups include patients <16 or ≥65 years, patients with significant
co-morbidities, NESB/difficult to assess patients, obstetric patients >20 weeks gestation, and
patients on anticoagulants or with clotting disorders. A GCS of 15 is normal and does not
indicate high risk.
Question 5
What is the primary purpose of Protocol T1?
A) To manage cardiac arrest in trauma patients
B) To outline the management of a major trauma patient from assessment through to transport
decision-making
C) To provide pain management guidelines for trauma patients
D) To establish protocols for hospital-based trauma team activation
Answer: B
Explanation: Protocol T1: Pre-hospital Management of Major Trauma outlines the management
of a major trauma patient from assessment through to transport decision-making, supported by
a trauma triage tool.
,Question 6
Which of the following mechanisms of injury is included in the "Blunt" category of the MIST
criteria?
A) Penetrating injury to the chest
B) Death in the same vehicle
C) Isolated injury to hands or feet
D) Stab wound to the abdomen
Answer: B
Explanation: Death in the same vehicle is a blunt mechanism criterion. Penetrating injuries are
in a separate category, and isolated injuries to hands or feet are specifically excluded from
major trauma criteria.
Question 7
A patient with a GCS of 12 following a motor vehicle collision meets which component of the
MIST criteria?
A) Mechanism of Injury
B) Injuries
C) Signs and Symptoms
D) Treatment
Answer: C
Explanation: Signs and Symptoms criteria include GCS ≤13. A GCS of 12 meets the "Disability"
component under Signs and Symptoms.
Question 8
According to the T1 protocol, which of the following is a high-risk group requiring a high index of
suspicion for serious injury?
A) Patients aged 18-40 years
B) Patients on anticoagulant medications
C) Patients with a history of hypertension
D) Patients who are conscious and alert
Answer: B
Explanation: Patients on anticoagulants, antiplatelet medications, or with clotting disorders are
specifically identified as a high-risk group in the T1 protocol.
, Question 9
How many designated trauma services are there in NSW?
A) 15
B) 21
C) 25
D) 30
Answer: B
Explanation: NSW has 21 designated trauma services: seven adult Major Trauma Services
(MTS), three paediatric Major Trauma Services (PTS), and eleven Regional Trauma Services
(RTS).
Question 10
What is the minimum fall height that triggers Major Trauma Criteria in adults according to the
MIST tool?
A) 1 metre
B) 2 metres
C) 3 metres
D) 5 metres
Answer: C
Explanation: Falls >3 metres in adults or twice the child's height in paediatrics are included in
the Mechanism of Injury criteria.
Question 11
Which of the following penetrating injuries is EXCLUDED from Major Trauma Criteria?
A) Penetrating injury to the chest
B) Penetrating injury to the abdomen
C) Isolated penetrating injury to hands or feet
D) Penetrating injury to the neck
Answer: C
Explanation: All penetrating injuries are included EXCEPT isolated injury to hands or feet, which
is specifically excluded from major trauma criteria.
Question 12
The T1 protocol has been associated with which of the following performance characteristics?
