Prehospital Emergency Care Chapter #28

Prehospital Emergency Care Chapter #28 1) A 24-year-old male has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the laceration. As an EMT, you would identify this bleeding as: A) Arterial B) Capillary C) Venous D) Lymphatic - ANSWER-C) Venous .2) While en route to a domestic violence incident with possible injuries, the police contact you and report that a male patient has arterial bleeding from a stab wound to the arm. Given this information, which bleeding characteristics do you expect? A) Dark red blood flowing from the injury that is difficult to control B) Bright red blood oozing from the injury site that is easy to control C) Spurting blood that is dark red in color and difficult to control D) Bright red blood that is spurting with each beat of the heart - ANSWER-D) Bright red blood that is spurting with each beat of the heart .3) You arrive at a meat packing plant to find a 30-year-old male patient who was cut in the wrist with a sharp knife. The patient appears pale, and blood is spurting from the laceration. Your immediate action would be to: A) Assess and manage the airway B) Apply direct pressure to the laceration C) Provide supplemental oxygen D) Check the pulse and blood pressure - ANSWER-B) Apply direct pressure to the laceration .4) As you approach a young male lying on the sidewalk who was called into 911 as an "unresponsive male," you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient would be to: A) Apply oxygen B) Cut the pants C) Assess the airway D) Elevate the leg - ANSWER-C) Assess the airway .5) A middle-aged male's arm became caught in a grinding machine, and the arm was eventually extricated from the machine by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Given this information, which care would be provided first for this patient? A) Start positive pressure ventilation B) Perform a detailed secondary exam focusing on his arm C) Insert an oropharyngeal airway and administer oxygen D) Administer supplemental oxygen - ANSWER-D) Administer supplemental oxygen .6) Severe external bleeding should be controlled during which phase of the patient assessment? A) Primary assessment B) Scene size-up C) Secondary assessment D) Reassessment - ANSWER-A) Primary assessment .7) The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the bleeding, the EMT would first: A) Tightly wrap roller gauze around a large sterile dressing placed over the top of the injury B) Apply direct pressure to the elbow to slow the flow of blood into the distal arm C) Place a large sterile dressing over the site, with hand pressure applied over the top of the dressing D) Wrap the injury site tightly with roller gauze and apply a tourniquet above the laceration - ANSWER-C) Place a large sterile dressing over the site, with hand pressure applied over the top of the dressing .8) Direct pressure has failed to control an arterial bleed on a patient's lower leg caused by an industrial accident. What would the EMT's next action be? A) Provide oxygen B) Apply a tourniquet C) Provide immediate transport D) Splint the extremity - ANSWER-B) Apply a tourniquet .9) Which statement shows that the EMT understands the use of a tourniquet in controlling bleeding? A) "A tourniquet should be applied tightly enough that arterial blood flow distal to the tourniquet is completely stopped." B) "If the tourniquet appears to have stopped the bleeding, the EMT should loosen it slightly to allow a small amount of blood to perfuse the tissues." C) "If a blood pressure cuff is used as a tourniquet, the EMT should inflate it approximately 50 mmHg above the patient's systolic blood pressure." D) "Since arteries run close to the body's surface in a joint, the best place to apply a tourniquet is over the joint just above the site of hemorrhage." - ANSWER-A) "A tourniquet should be applied tightly enough that arterial blood flow distal to the tourniquet is completely stopped." .10) A young male was riding a motorcycle when he lost control and was thrown from the vehicle. The patient is unresponsive and receiving positive pressure ventilation. The secondary assessment reveals bright blood flowing from an unrecognized femoral bleed. Initial management of this bleeding would include: A) Application of a proximal tourniquet B) Direct pressure with a dressing applied C) Elevating the extremity and applying a cold compress D) Placing a tourniquet distal to the injury if direct pressure fails to stop the bleed - ANSWER-B) Direct pressure with a dressing applied .11) Another crew has called for your assistance in extricating an obese male with a nosebleed from a third-floor bedroom. As you enter the room, which observation indicates proper management of the patient's condition? A) The patient is supine, head turned to the side, blood draining from the nose and mouth, with a cold pack applied to the bridge of the nose B) The patient is sitting upright, head tilted back, with sterile gauze packed in each nostril C) The patient is lying on his side, a loose dressing has been applied below his nose, and a cold pack is on the bridge of his nose D) The patient is sitting upright, leaning forward, with nostrils pinched shut - ANSWER-D) The patient is sitting upright, leaning forward, with nostrils pinched shut .12) You have arrived at a scene where a young girl tripped while running, and pushed her arms through a plate glass window while falling. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your partner yells for you to immediately apply direct pressure to the laceration to prevent further blood loss, while he works to control the airway. You have yet to apply gloves, but your uniform shirt has long sleeves, and you normally wear prescription glasses. What would you do next? A) Place a tourniquet above the laceration, being careful not to get blood on your hands B) Apply gloves prior to applying direct pressure over the injury site C) Control bleeding by pushing the skin of the laceration together until you can apply gloves D) Apply direct pressure to the site with your forearm until someone with gloves can take over - ANSWER-B) Apply gloves prior to applying direct pressure over the injury site .13) Which statement demonstrates an understanding of shock caused by internal bleeding? A) "Internal bleeding is a less serious life threat than external bleeding because the blood remains in the body." B) "The EMT can control internal bleeding by applying direct pressure to the skin, over the top of the area of suspected internal bleeding." C) "If a patient is bleeding internally, the signs of shock-such as a rapid heart rate and pale, cool, and clammy skin-are not as obvious."