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EFMB Written Test Study Guide (2024)

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Section 1 - Radiology: Imaging Trauma Patients in a Deployed Setting - The initial radiographic evaluation of a trauma patient begins with supine Anterior-Posterior (AP) chest and pelvis radiographs taken in the trauma bay usually with a(n) __________. portable x-ray machine T/F: Computed Tomography scanning has been largely replaced by Cervical Spine Radiographic Evaluation (CSRE) and should only be performed when CSRE is unavailable. FALSE. Cervical Spine Radiographic Evaluation (CSRE) has been largely replaced by Computed Tomography (CT) and should only be performed when a CT is unavailable. What is the lowest level of care equipped with a Computed Tomography (CT) Scanner? Role 3 What is the lowest level of care equipped with a portable x-ray machine? Role 2 Members of the trauma team should have __________ aprons and thyroid shields available near the trauma bay for radiation safety. lead Distance is also protective from radiation exposure. If feasible based on the patient's condition, any personnel without lead shielding should move a short distance away from the x-ray unit. The recommended minimal distance is __________ feet. Six (6) While the FAST scan has been validated only in hemodynamically unstable blunt trauma patients, it has become a standard tool in the trauma bay and Emergency Department (ED) in most trauma patients. FAST stands for __________. Focused Abdominal Sonographic Assessment for Trauma FAST in combat trauma has a sensitivity of only 56% and and specificity of __________. 98% T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric injury. FALSE. Diagnostic Peritoneal Lavage (DPL) remains the most sensitive test for hollow viscus injury and mesenteric injury. T/F: At the Role 3, properly trained providers including radiologists, surgeons, and emergency physicians, can perform and interpret FAST scans in the emergency department on a hand held portable US device. TRUE A FAST examination is performed with a portable hand-held machine most commonly using a standard 3-7 MHz curved array __________ probe. Ultra Sound (US) The standard FAST examination is focused on evaluating for the presence of __________ in certain areas of the body. Free Intraperitoneal Fluid When performing a FAST examination on a patient, you inspect the right upper quadrant. You are inspecting between which two (2) organs? Liver & Kidney When performing a FAST examination on a patient, you inspect the left upper quadrant. You are inspecting between which two (2) organs? Spleen & Kidney An 18g __________ IV is typically desired for Computed Tomography IV access. antecubital T/F: The goal of Computed Tomography (CT) contrast injection is to provide concurrent solid organ enhancement, arterial enhancement, and pulmonary arterial. TRUE T/F: When performing Computed Tomography (CT) scan on a Military Working Dog, utilize a scanning protocol based on the adult settings to include the doses of and rates of contrast administration. FALSE. Utilize a scanning protocol based on the pediatric settings to include the doses of and rates of contrast administration. T/F: All patients evacuated through casualty evacuation should have images sent electronically ahead of time as well as have a CD created to send with the patient as a backup. TRUE T/F: Magnetic Resonance Imaging (MRI) is widely used in theater, as its utility in the acute management of combat trauma was extensively established during Operation Enduring Freedom. FALSE. While Magnetic Resonance Imaging (MRI) has been deployed to theater in the past, its utility in the acute management of combat trauma has not been established. All trauma patients arriving at a Role __________ hospital will receive proper and expeditious radiologic screening of injuries. 3 Section 2: Aural Blast Injury Acoustic Trauma & Hearing Loss - T/F: Patients exposed to hazardous noise are only at risk for aural trauma. FALSE. Service Members exposed to hazardous noise is impact noise or noise greater than 140 dB are at high risk for acoustic trauma and subsequent hearing loss. Patients exposed to blasts are at risk for both aural and acoustic trauma. The symptoms of acoustic trauma are: 1. Hearing Loss 2. Tinnitus (Ringing in the Ear) 3. Aural Fullness 4. Recruitment (Ear Pain with Loud Noise) 5. Difficulty Localizing Sounds 6. Difficulty Hearing in a Noisy Background 7. Vertigo "H-TARDD-V" Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either __________ or __________. temporary (temporary threshold shift, TTS) or permanent (permanent threshold shift, PTS) The ear, specifically the __________, is the most sensitive organ to primary blast injury (PBI). tympanic membrane (TM)

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efmb written test study guide 2024

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EFMB Written Test Study Guide (2024)
io io io io io

Sectionio1io-ioRadiology:ioImagingioTraumaioPatientsioinioaioDeployedioSetting -

TheioinitialioradiographicioevaluationioofioaiotraumaiopatientiobeginsiowithiosupineioAnterior-
Posteriorio(AP)iochestioandiopelvisioradiographsiotakenioiniotheiotraumaiobayiousuallyiowithioa(n)io__________.
portableiox-rayiomachine

T/F:ioComputedioTomographyioscanningiohasiobeeniolargelyioreplacediobyioCervicalioSpineioRadiographicioEvalua
tionio(CSRE)ioandioshouldioonlyiobeioperformediowhenioCSREioisiounavailable.
FALSE.ioCervicalioSpineioRadiographicioEvaluationio(CSRE)iohasiobeeniolargelyioreplacediobyioComputedio
Tomographyio(CT)ioandioshouldioonlyiobeioperformediowhenioaioCTioisiounavailable.

WhatioisiotheiolowestiolevelioofiocareioequippediowithioaioComputedioTomographyio(CT)ioScanner? Roleio3

Whatioisiotheiolowestiolevelioofiocareioequippediowithioaioportableiox-rayiomachine? Roleio2

Membersioofiotheiotraumaioteamioshouldiohaveio__________ioapronsioandiothyroidioshieldsioavailableioneariothei
otraumaiobayioforioradiationiosafety. lead

Distanceioisioalsoioprotectiveiofromioradiationioexposure.ioIfiofeasibleiobasediooniotheiopatient'siocondition,ioanyio
personneliowithoutioleadioshieldingioshouldiomoveioaioshortiodistanceioawayiofromiotheiox-
rayiounit.ioTheiorecommendediominimaliodistanceioisio__________iofeet. Sixio(6)

WhileiotheioFASTioscaniohasiobeeniovalidatedioonlyioiniohemodynamicallyiounstableiobluntiotraumaiopatients,ioitio
hasiobecomeioaiostandardiotoolioiniotheiotraumaiobayioandioEmergencyioDepartmentio(ED)ioiniomostiotraumaiopati
ents.ioFASTiostandsioforio__________. FocusedioAbdominalioSonographicioAssessmentioforioTrauma

FASTioiniocombatiotraumaiohasioaiosensitivityioofioonlyio56%ioandioandiospecificityioofio__________. 98%

T/F:ioTheioFASTioexamioremainsiotheiomostiosensitiveiotestioforiohollowioviscusioinjuryioandiomesentericioinjury.
FALSE.ioDiagnosticioPeritonealioLavageio(DPL)ioremainsiotheiomostiosensitiveiotestioforiohollowioviscusioin
juryioandiomesentericioinjury.

T/F:ioAtiotheioRoleio3,ioproperlyiotrainedioprovidersioincludingioradiologists,iosurgeons,ioandioemergencyiophysici
ans,iocanioperformioandiointerpretioFASTioscansioiniotheioemergencyiodepartmentioonioaiohandioheldioportableioUS
iodevice. TRUE

AioFASTioexaminationioisioperformediowithioaioportableiohand-
heldiomachineiomostiocommonlyiousingioaiostandardio3-7ioMHziocurvedioarrayio__________ioprobe.
UltraioSoundio(US)

TheiostandardioFASTioexaminationioisiofocusedioonioevaluatingioforiotheiopresenceioofio__________ioiniocertainioa
reasioofiotheiobody. FreeioIntraperitonealioFluid

WhenioperformingioaioFASTioexaminationioonioaiopatient,ioyouioinspectiotheiorightioupperioquadrant.ioYouioareioin
spectingiobetweeniowhichiotwoio(2)ioorgans? Liverio&ioKidney

,WhenioperformingioaioFASTioexaminationioonioaiopatient,ioyouioinspectiotheioleftioupperioquadrant.ioYouioareioinsp
ectingiobetweeniowhichiotwoio(2)ioorgans? Spleenio&ioKidney

Anio18gio__________ioIVioisiotypicallyiodesiredioforioComputedioTomographyioIVioaccess. antecubital

T/F:ioTheiogoalioofioComputedioTomographyio(CT)iocontrastioinjectionioisiotoioprovideioconcurrentiosolidioorganioe
nhancement,ioarterialioenhancement,ioandiopulmonaryioarterial. TRUE

T/F:ioWhenioperformingioComputedioTomographyio(CT)ioscanioonioaioMilitaryioWorkingioDog,ioutilizeioaioscanning
ioprotocoliobasediooniotheioadultiosettingsiotoioincludeiotheiodosesioofioandioratesioofiocontrastioadministration.

FALSE.ioUtilizeioaioscanningioprotocoliobasediooniotheiopediatriciosettingsiotoioincludeiotheiodosesioofioandi
oratesioofiocontrastioadministration.

T/F:ioAlliopatientsioevacuatediothroughiocasualtyioevacuationioshouldiohaveioimagesiosentioelectronicallyioaheadi
oofiotimeioasiowellioasiohaveioaioCDiocreatediotoiosendiowithiotheiopatientioasioaiobackup. TRUE

T/F:ioMagneticioResonanceioImagingio(MRI)ioisiowidelyiousedioiniotheater,ioasioitsioutilityioiniotheioacuteiomanagem
entioofiocombatiotraumaiowasioextensivelyioestablishedioduringioOperationioEnduringioFreedom.
FALSE.ioWhileioMagneticioResonanceioImagingio(MRI)iohasiobeeniodeployediotoiotheaterioiniotheiopast,ioit
sioutilityioiniotheioacuteiomanagementioofiocombatiotraumaiohasionotiobeenioestablished.

AlliotraumaiopatientsioarrivingioatioaioRoleio__________iohospitaliowillioreceiveioproperioandioexpeditiousioradiol
ogicioscreeningioofioinjuries. 3

Sectionio2:ioAuralioBlastioInjuryioAcousticioTraumaio&ioHearingioLoss -

T/F:ioPatientsioexposediotoiohazardousionoiseioareioonlyioatioriskioforioauraliotrauma.
FALSE.ioServiceioMembersioexposediotoiohazardousionoiseioisioimpactionoiseioorionoiseiogreateriothanio14
0iodBioareioatiohighioriskioforioacousticiotraumaioandiosubsequentiohearingioloss.ioPatientsioexposediotoioblastsioarei
oatioriskioforiobothioauralioandioacousticiotrauma.

Theiosymptomsioofioacousticiotraumaioare: 1.ioHearingioLoss

2.ioTinnitusio(RingingioiniotheioEar)

3.ioAuralioFullness

4.ioRecruitmentio(EarioPainiowithioLoudioNoise)

5.ioDifficultyioLocalizingioSounds

6.ioDifficultyioHearingioinioaioNoisyioBackground

7.ioVertigo

"H-TARDD-V"

Acousticiotraumaiomayioresultioiniosensorineuraliohearingiolossio(SNHL)iothatioisioeitherio__________ioorio______
____. temporaryio(temporaryiothresholdioshift,ioTTS)iooriopermanentio(permanentiothresholdioshift,ioPTS)

,Theioear,iospecificallyiotheio__________,ioisiotheiomostiosensitiveioorganiotoioprimaryioblastioinjuryio(PBI).
tympaniciomembraneio(TM)

T/F:iotheiosmalleriotheiosizeioofiotheiotympaniciomembraneioperforation,iotheiogreateriotheiolikelihoodioisioofiospon
taneousioclosure. TRUE

Theiomajorityioofiotympaniciomembraneioperforationsiothatiocloseiospontaneouslyiodoiosoiowithiniotheiofirstio___
_______ioafterioinjury. 8ioweeks

Acuteiomanagementioofiointratemporaliofacialionerveioinjuryioisiotoioprovideioobjectiveiodocumentationioofiofaci
aliomovementiousingiotheio__________iogradingioscale. House-Brackmann

T/F:ioForiosignificantiofacialiopareses/paralyses,ioearlyioadministrationioofiosteroidsiomustioalwaysiobeioprovidedio
regardlessioofiocontraindications.
FALSE.ioEarlyioadministrationioofiosteroidsioshouldiobeioprovidedioifionotiocontraindicated,ioandioreferrali
oforiomanagementiobyioaniootolaryngologistioisioindicated.

Whichioinnerioearioabnormalitiesiomayiocauseiovertigo?
1.ioOticioCapsuleioViolatingioTemporalioBoneioFracturesio

2.ioSecondaryioInfectionsioofiotheioInnerioEarioorioVestibularioNerves

3.ioTraumaioInducedioEndolymphaticioHydrops

4.ioActivationioofioSubclinicalioSuperioSemicircularioCanalioDehiscence

"OSTA"

AllioServiceioMembersiothatiodevelopiosymptomsioconsistentiowithionoiseiotraumaio(acuteiotinnitus,iomuffledioh
earing,iofullnessioiniotheioear)ioshould... ...beioeducatedioandiodirectediotoioself-
reportioforioevaluationioandiopossibleiotreatmentioasiosoonioasiopracticable.

WhatioisiotheiobestiocourseioofioactionioifioyouiofindiodebrisioiniotheioExternalioAuditoryioCanalio(EAC)ioorioiniotheiomi
ddleioeario(asioseeniothroughioaioTMioperforation)?
Treatiotheiopatientiowithioaiofluoroquinoloneioandiosteroidiocontainingiotopicalioantibioticio(e.g.,iofourio(
4)iodropsioofiociprofloxacin/dexamethasoneioorioofloxacinioiniotheioaffectedioeariothreeio(3)iotimesioaiodayioforiose
venio(7)iodays.ioDoionotioirrigateiotheioearioasioitiomayioprovokeiopainioandiovertigo.

Hearingiolossiothatiopersistsio__________iohoursioafterioacousticiotraumaiowarrantsioaiohearingiotestioorioaudiogr
am. 72iohours

T/F:ioVestibulariotraumaiotoiotheioinnerioeariomayiomanifestioiniovertigo. TRUE

Alliopatientsiowithiosubjectiveiohearingiolossioandiotinnitusiofollowingioblastioexposureioshould...
...haveiotheioexposureiodocumented,ioandioshouldiobeioevaluatediobyiohearingiotestingioasiosoonioasiopos
sible

, Patientsiowithiotemporaryiothresholdioshiftio(TTS)iogreateriothanio__________iolossesioiniothreeio(3)ioconsecutiv
eiofrequenciesioshouldiobeioconsiderediocandidatesioforiohighiodoseiooralioand/oriotranstympaniciosteroidioinject
ionsiowhenionotiootherwiseiocontraindicated. 25iodB

Sectionio3:ioBurnioCare -

Whatioareioindicationsioforioendotrachealiointubationioduringioyourioinitialioburniosurvey?
1.ioAioComatoseioPatient

2.ioSymptomaticioInhalationioInjury

3.ioDeepioFacialioBurns

4.ioBurnsioOverio40%ioTotalioBodyioSurfaceioAreaio(TBSA)

"CSDB"

Burniocasualtiesiowithioinjuriesiogreateriothanio__________ioTotalioBodyioSurfaceioAreaio(TBSA)ioareioatiohighiorisk
ioofiohypothermia. 20%

T/F:ioWhenioprovidingiopointioofioinjuryiocareiotoioaioburniopatient,ioyouiomustioimmediatelyiodebrideioblistersioan
diocoverioburnsiowithioloose,iomoistiogauzeiowrapsioorioaiowetiocleaniosheet.
FALSE.ioIniotheiofield,ioInterruptiotheioBurningioProcessioandioaddressioanyiolifeiothreateningiobleeding,ioa
irwayiocompromise,iooriotensioniopneumothoraxioasiodirectediobyioTacticalioCombatioCasualtyioCareioguidelines
.io

Doionotiodebrideioblistersiountiliotheiopatientiohasioreachedioaiofacilityiowithiosurgicaliocapability.ioCoverioburnsiow
ithioloose,ioDRYiogauzeiowrapsioorioaiocleaniosheet.

Calculateioaioburniopatient'sioinitialioburniosizeiousingiotheioRuleioofio__________. Nines

WhichiotypeioofioburnioisioNOTioincludedioiniotheioestimationioofioTotalioBodyioSurfaceioAreaio(TBSA)iousedioforioflui
dioresuscitation?SuperficialioBurnsio(1stioDegree)

Whichioclassificationioofioburnsioappeariored,iodoionotioblister,ioandioblanchioreadily?
SuperficialioBurnsio(1stioDegree)

Whichioclassificationioofioburnsioareiomoistioandiosensate,ioblister,ioandioblanch?
PartialioThicknessioBurnsio(2ndioDegree)

Whichioclassificationioofioburnsioappearioleathery,iodry,ionon-
blanching,ioareioinsensate,ioandioofteniocontainiothrombosediovessels?
FullioThicknessioBurnsio(3rdioDegree)

WhatioisiotheioRuleioofio10sioburniofluidioresuscitationioequation?io(EnsureioYouioCanioApplyioIt)
UseiotheioRuleioofioTensiotoioDetermineioFluidioRequirementsioforiotheioFirstio24ioHoursioPost-Burn.

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