FISDAP Trauma Exam
2026-2027
150 Questions
100% VERIFIED
Introduction
The FISDAP Trauma Exam evaluates a candidate's command of prehospital trauma care across the full
continuum of emergency response, from the moment a provider steps onto an uncontrolled scene
through the definitive transfer of a critically injured patient. The assessment is built on the Field
Internship Skills Development and Assessment Protocol trauma blueprint and measures clinical
reasoning under the time and resource constraints that define emergency medical services operations.
Core domains include Scene Size-Up and Mechanism of Injury, Primary and Secondary Assessment,
Airway and Respiratory Management, Bleeding Control and Hemorrhage Management, Shock
Identification and Treatment, Thoracic and Abdominal Trauma, Musculoskeletal Injuries and Splinting,
Head and Spinal Trauma, Burn Management, Pediatric Trauma, and Multi-Casualty Triage. Each
domain requires the candidate to integrate anatomy, pathophysiology, and protocol knowledge into
decisions that directly influence survivability, since the leading preventable causes of trauma death are
hemorrhage, airway compromise, and unrecognized shock. Success on this examination demonstrates
readiness for professional EMS certification and confirms that the candidate can execute evidence-
based trauma interventions with sound professional judgment, consistent documentation, and
effective teamwork in the field.
Question 1. Which action should the paramedic complete BEFORE exiting the ambulance at a highway
collision scene?
A) Obtain a full set of baseline vital signs from the first patient
B) Begin a rapid secondary assessment of the closest patient
C) Notify medical control of the estimated number of patients
D) Determine that the scene is safe and select appropriate personal protective equipment
Correct Answer: D) Determine that the scene is safe and select appropriate personal protective
equipment
Rationale: Scene size-up begins before the provider touches the patient; entering an unsafe roadway
without high-visibility clothing and scene control exposes the crew to a secondary collision. Vital signs,
medical control notification, and secondary assessment all occur only after the scene has been secured
and hazards addressed.
Question 2. A patient is found in a basement with an unexplained chemical odor and one unresponsive
victim. What is the MOST appropriate immediate action?
A) Don a surgical mask and attempt to drag the patient outside
B) Start high-flow oxygen on the patient where he lies
C) Begin ventilations with a bag-valve mask before moving the patient
D) Retreat to a safe upwind location and request a hazmat response
Correct Answer: D) Retreat to a safe upwind location and request a hazmat response
,Rationale: An unknown atmosphere with an incapacitated victim is presumed immediately dangerous
to life and health, and only trained personnel with appropriate protective ensembles may enter. A
surgical mask offers no vapor protection, and any intervention performed inside the hazard zone adds
a second victim.
Question 3. At a two-vehicle collision you count one extricated driver, one front-seat passenger, and a
pedestrian struck while crossing. How many patients should your triage tag supply account for?
A) Four, to allow for a patient who may have fled the scene
B) One, because the pedestrian is managed by a second unit
C) Three, because the pedestrian is a separate mechanism-generated patient
D) Two, because only vehicle occupants generate significant mechanism
Correct Answer: C) Three, because the pedestrian is a separate mechanism-generated patient
Rationale: Scene size-up requires counting every potential patient generated by the mechanism,
including those outside the vehicles. Undercounting leads to under-requesting resources, while
padding the count arbitrarily wastes resources and misrepresents the scene to dispatch.
Question 4. Which finding meets an anatomic criterion for transport to a designated trauma center?
A) A single rib fracture without respiratory distress
B) Superficial abrasions across the anterior chest wall
C) Two or more proximal long-bone fractures
D) An isolated closed fracture of the distal radius
Correct Answer: C) Two or more proximal long-bone fractures
Rationale: Field triage guidelines list two or more proximal long-bone fractures, meaning femur or
humerus, as an anatomic criterion indicating high energy transfer and probable occult injury. Isolated
distal extremity injuries, single rib fractures, and abrasions do not carry the same mortality risk and
are managed at the nearest appropriate facility.
Question 5. A motorcyclist is thrown 40 feet after impact and is unresponsive on arrival. Which triage
decision does this mechanism support?
A) Transport to the highest level of trauma care available
B) Request transport only if the patient develops hypotension
C) Observe on scene for 20 minutes before deciding disposition
D) Transport to the nearest clinic for wound evaluation
Correct Answer: A) Transport to the highest level of trauma care available
Rationale: Ejection or being thrown more than 20 feet is a high-energy mechanism criterion that
predicts severe internal injury regardless of presenting appearance. Waiting for hypotension delays
definitive care, and lower-level facilities lack the surgical and imaging capability required for
multisystem trauma.
Question 6. A 22-year-old unrestrained driver was involved in a frontal collision at 45 mph. Which
physical event BEST explains the injury risk from kinetic energy?
A) The second collision of the occupant with the interior structures of the vehicle
B) The compression of the vehicle's crumple zones
, C) The deployment of the vehicle's restraint pretensioners
D) The friction generated between the tires and the pavement
Correct Answer: A) The second collision of the occupant with the interior structures of the
vehicle
Rationale: Kinetic energy is transferred through a series of collisions, and the occupant striking the
steering wheel, windshield, or dashboard produces the injuries seen in the second impact. Crumple
zones and restraints reduce energy transfer rather than create injury, and tire friction relates to vehicle
stopping rather than occupant trauma.
Question 7. In a blast incident, a patient has a ruptured tympanic membrane and pulmonary
hemorrhage. These injuries are classified in which blast injury category?
A) Secondary, resulting from debris propelled by the explosion
B) Primary, resulting from the overpressure wave itself
C) Quaternary, resulting from burns and toxic inhalation
D) Tertiary, resulting from the victim being thrown by blast wind
Correct Answer: B) Primary, resulting from the overpressure wave itself
Rationale: Primary blast injuries result from the pressure wave acting on air-filled organs such as the
middle ear, lungs, and bowel. Debris penetration defines secondary injury, being thrown defines
tertiary injury, and burns or inhalation injury define quaternary injury.
Question 8. An adult falls from a 25-foot scaffold and lands on both feet. Which associated injury
should be suspected even though the feet appear intact?
A) Isolated fracture of the clavicle
B) Simple dislocation of the acromioclavicular joint
C) Closed fracture limited to the anterior tibial plateau
D) Compression fracture of the thoracolumbar spine
Correct Answer: D) Compression fracture of the thoracolumbar spine
Rationale: Axial loading transmits force up the skeletal axis, producing calcaneal, tibial plateau, pelvic,
and thoracolumbar compression fractures, and a fall greater than 20 feet in an adult is an index
criterion. Clavicle and acromioclavicular injuries imply a shoulder-first mechanism, and an isolated
tibial injury ignores the transmitted axial load.
Question 9. Which interior vehicle finding most reliably indicates high-energy transfer to an
unrestrained occupant?
A) A cracked windshield produced by a thrown object
B) Greater than 12 inches of intrusion into the occupant compartment
C) A deployed curtain airbag without other vehicle damage
D) An activated hazard flasher system
Correct Answer: B) Greater than 12 inches of intrusion into the occupant compartment
Rationale: Intrusion exceeding 12 inches at the occupant location is a recognized mechanism criterion
reflecting substantial energy dissipation into the passenger space. An airbag or cracked windshield
alone does not quantify compartment deformation, and hazard lights are unrelated to energy transfer.
, Question 10. A child is struck by a vehicle traveling 30 mph and thrown to the ground. Which injury
pattern is most consistent with this mechanism in a pediatric patient?
A) Cervical injury arising exclusively from the secondary ground impact
B) Superficial degloving limited to the lower extremity
C) Head and cervical spine injury from the initial impact with the bumper
D) Isolated fracture of the mid-shaft femur only
Correct Answer: C) Head and cervical spine injury from the initial impact with the bumper
Rationale: Children have proportionally larger heads and lower centers of gravity, so the initial
bumper impact typically strikes the head and upper torso. Isolated extremity patterns underestimate
pediatric mechanism, and although the secondary ground impact matters, the initial impact drives the
characteristic pediatric injury pattern.
Question 11. Which statement about a properly worn three-point restraint in a frontal collision is
MOST accurate?
A) The lap strap should ride across the umbilicus to protect the pelvis
B) The shoulder strap should cross the clavicle and sternum, and the lap strap should ride
across the pelvis
C) The lap strap should be worn loosely to reduce internal compression
D) The shoulder strap should be placed behind the back for comfort
Correct Answer: B) The shoulder strap should cross the clavicle and sternum, and the lap strap
should ride across the pelvis
Rationale: Correct belt geometry distributes deceleration force across the bony pelvis and the clavicle
and sternum. A lap strap over the soft abdomen produces seat-belt syndrome with hollow viscus and
lumbar spine injury, and routing the strap behind the back or loosening it removes the protective
effect.
Question 12. A patient has a stab wound just below the left clavicle and is normotensive with clear
lung sounds. What is the appropriate disposition reasoning?
A) Local wound care and discharge are appropriate for any stab wound
B) The wound lies in a region where occult vascular and intrathoracic injury is possible,
warranting trauma center evaluation
C) Normal vital signs exclude injury to intrathoracic structures
D) Superficial chest wounds never penetrate the pleural space
Correct Answer: B) The wound lies in a region where occult vascular and intrathoracic injury is
possible, warranting trauma center evaluation
Rationale: Penetrating wounds between the clavicles and the costal margins can injure the great
vessels, heart, or pleura while the presentation remains deceptively benign early on. Normal vital signs
do not exclude injury, and an occult pneumothorax or vascular injury can deteriorate rapidly without
imaging.
Question 13. You arrive at a structure fire with two patients and heavy smoke conditions. Which
request is MOST appropriate during scene size-up?
A) A single basic life support unit to transport both patients
2026-2027
150 Questions
100% VERIFIED
Introduction
The FISDAP Trauma Exam evaluates a candidate's command of prehospital trauma care across the full
continuum of emergency response, from the moment a provider steps onto an uncontrolled scene
through the definitive transfer of a critically injured patient. The assessment is built on the Field
Internship Skills Development and Assessment Protocol trauma blueprint and measures clinical
reasoning under the time and resource constraints that define emergency medical services operations.
Core domains include Scene Size-Up and Mechanism of Injury, Primary and Secondary Assessment,
Airway and Respiratory Management, Bleeding Control and Hemorrhage Management, Shock
Identification and Treatment, Thoracic and Abdominal Trauma, Musculoskeletal Injuries and Splinting,
Head and Spinal Trauma, Burn Management, Pediatric Trauma, and Multi-Casualty Triage. Each
domain requires the candidate to integrate anatomy, pathophysiology, and protocol knowledge into
decisions that directly influence survivability, since the leading preventable causes of trauma death are
hemorrhage, airway compromise, and unrecognized shock. Success on this examination demonstrates
readiness for professional EMS certification and confirms that the candidate can execute evidence-
based trauma interventions with sound professional judgment, consistent documentation, and
effective teamwork in the field.
Question 1. Which action should the paramedic complete BEFORE exiting the ambulance at a highway
collision scene?
A) Obtain a full set of baseline vital signs from the first patient
B) Begin a rapid secondary assessment of the closest patient
C) Notify medical control of the estimated number of patients
D) Determine that the scene is safe and select appropriate personal protective equipment
Correct Answer: D) Determine that the scene is safe and select appropriate personal protective
equipment
Rationale: Scene size-up begins before the provider touches the patient; entering an unsafe roadway
without high-visibility clothing and scene control exposes the crew to a secondary collision. Vital signs,
medical control notification, and secondary assessment all occur only after the scene has been secured
and hazards addressed.
Question 2. A patient is found in a basement with an unexplained chemical odor and one unresponsive
victim. What is the MOST appropriate immediate action?
A) Don a surgical mask and attempt to drag the patient outside
B) Start high-flow oxygen on the patient where he lies
C) Begin ventilations with a bag-valve mask before moving the patient
D) Retreat to a safe upwind location and request a hazmat response
Correct Answer: D) Retreat to a safe upwind location and request a hazmat response
,Rationale: An unknown atmosphere with an incapacitated victim is presumed immediately dangerous
to life and health, and only trained personnel with appropriate protective ensembles may enter. A
surgical mask offers no vapor protection, and any intervention performed inside the hazard zone adds
a second victim.
Question 3. At a two-vehicle collision you count one extricated driver, one front-seat passenger, and a
pedestrian struck while crossing. How many patients should your triage tag supply account for?
A) Four, to allow for a patient who may have fled the scene
B) One, because the pedestrian is managed by a second unit
C) Three, because the pedestrian is a separate mechanism-generated patient
D) Two, because only vehicle occupants generate significant mechanism
Correct Answer: C) Three, because the pedestrian is a separate mechanism-generated patient
Rationale: Scene size-up requires counting every potential patient generated by the mechanism,
including those outside the vehicles. Undercounting leads to under-requesting resources, while
padding the count arbitrarily wastes resources and misrepresents the scene to dispatch.
Question 4. Which finding meets an anatomic criterion for transport to a designated trauma center?
A) A single rib fracture without respiratory distress
B) Superficial abrasions across the anterior chest wall
C) Two or more proximal long-bone fractures
D) An isolated closed fracture of the distal radius
Correct Answer: C) Two or more proximal long-bone fractures
Rationale: Field triage guidelines list two or more proximal long-bone fractures, meaning femur or
humerus, as an anatomic criterion indicating high energy transfer and probable occult injury. Isolated
distal extremity injuries, single rib fractures, and abrasions do not carry the same mortality risk and
are managed at the nearest appropriate facility.
Question 5. A motorcyclist is thrown 40 feet after impact and is unresponsive on arrival. Which triage
decision does this mechanism support?
A) Transport to the highest level of trauma care available
B) Request transport only if the patient develops hypotension
C) Observe on scene for 20 minutes before deciding disposition
D) Transport to the nearest clinic for wound evaluation
Correct Answer: A) Transport to the highest level of trauma care available
Rationale: Ejection or being thrown more than 20 feet is a high-energy mechanism criterion that
predicts severe internal injury regardless of presenting appearance. Waiting for hypotension delays
definitive care, and lower-level facilities lack the surgical and imaging capability required for
multisystem trauma.
Question 6. A 22-year-old unrestrained driver was involved in a frontal collision at 45 mph. Which
physical event BEST explains the injury risk from kinetic energy?
A) The second collision of the occupant with the interior structures of the vehicle
B) The compression of the vehicle's crumple zones
, C) The deployment of the vehicle's restraint pretensioners
D) The friction generated between the tires and the pavement
Correct Answer: A) The second collision of the occupant with the interior structures of the
vehicle
Rationale: Kinetic energy is transferred through a series of collisions, and the occupant striking the
steering wheel, windshield, or dashboard produces the injuries seen in the second impact. Crumple
zones and restraints reduce energy transfer rather than create injury, and tire friction relates to vehicle
stopping rather than occupant trauma.
Question 7. In a blast incident, a patient has a ruptured tympanic membrane and pulmonary
hemorrhage. These injuries are classified in which blast injury category?
A) Secondary, resulting from debris propelled by the explosion
B) Primary, resulting from the overpressure wave itself
C) Quaternary, resulting from burns and toxic inhalation
D) Tertiary, resulting from the victim being thrown by blast wind
Correct Answer: B) Primary, resulting from the overpressure wave itself
Rationale: Primary blast injuries result from the pressure wave acting on air-filled organs such as the
middle ear, lungs, and bowel. Debris penetration defines secondary injury, being thrown defines
tertiary injury, and burns or inhalation injury define quaternary injury.
Question 8. An adult falls from a 25-foot scaffold and lands on both feet. Which associated injury
should be suspected even though the feet appear intact?
A) Isolated fracture of the clavicle
B) Simple dislocation of the acromioclavicular joint
C) Closed fracture limited to the anterior tibial plateau
D) Compression fracture of the thoracolumbar spine
Correct Answer: D) Compression fracture of the thoracolumbar spine
Rationale: Axial loading transmits force up the skeletal axis, producing calcaneal, tibial plateau, pelvic,
and thoracolumbar compression fractures, and a fall greater than 20 feet in an adult is an index
criterion. Clavicle and acromioclavicular injuries imply a shoulder-first mechanism, and an isolated
tibial injury ignores the transmitted axial load.
Question 9. Which interior vehicle finding most reliably indicates high-energy transfer to an
unrestrained occupant?
A) A cracked windshield produced by a thrown object
B) Greater than 12 inches of intrusion into the occupant compartment
C) A deployed curtain airbag without other vehicle damage
D) An activated hazard flasher system
Correct Answer: B) Greater than 12 inches of intrusion into the occupant compartment
Rationale: Intrusion exceeding 12 inches at the occupant location is a recognized mechanism criterion
reflecting substantial energy dissipation into the passenger space. An airbag or cracked windshield
alone does not quantify compartment deformation, and hazard lights are unrelated to energy transfer.
, Question 10. A child is struck by a vehicle traveling 30 mph and thrown to the ground. Which injury
pattern is most consistent with this mechanism in a pediatric patient?
A) Cervical injury arising exclusively from the secondary ground impact
B) Superficial degloving limited to the lower extremity
C) Head and cervical spine injury from the initial impact with the bumper
D) Isolated fracture of the mid-shaft femur only
Correct Answer: C) Head and cervical spine injury from the initial impact with the bumper
Rationale: Children have proportionally larger heads and lower centers of gravity, so the initial
bumper impact typically strikes the head and upper torso. Isolated extremity patterns underestimate
pediatric mechanism, and although the secondary ground impact matters, the initial impact drives the
characteristic pediatric injury pattern.
Question 11. Which statement about a properly worn three-point restraint in a frontal collision is
MOST accurate?
A) The lap strap should ride across the umbilicus to protect the pelvis
B) The shoulder strap should cross the clavicle and sternum, and the lap strap should ride
across the pelvis
C) The lap strap should be worn loosely to reduce internal compression
D) The shoulder strap should be placed behind the back for comfort
Correct Answer: B) The shoulder strap should cross the clavicle and sternum, and the lap strap
should ride across the pelvis
Rationale: Correct belt geometry distributes deceleration force across the bony pelvis and the clavicle
and sternum. A lap strap over the soft abdomen produces seat-belt syndrome with hollow viscus and
lumbar spine injury, and routing the strap behind the back or loosening it removes the protective
effect.
Question 12. A patient has a stab wound just below the left clavicle and is normotensive with clear
lung sounds. What is the appropriate disposition reasoning?
A) Local wound care and discharge are appropriate for any stab wound
B) The wound lies in a region where occult vascular and intrathoracic injury is possible,
warranting trauma center evaluation
C) Normal vital signs exclude injury to intrathoracic structures
D) Superficial chest wounds never penetrate the pleural space
Correct Answer: B) The wound lies in a region where occult vascular and intrathoracic injury is
possible, warranting trauma center evaluation
Rationale: Penetrating wounds between the clavicles and the costal margins can injure the great
vessels, heart, or pleura while the presentation remains deceptively benign early on. Normal vital signs
do not exclude injury, and an occult pneumothorax or vascular injury can deteriorate rapidly without
imaging.
Question 13. You arrive at a structure fire with two patients and heavy smoke conditions. Which
request is MOST appropriate during scene size-up?
A) A single basic life support unit to transport both patients
