EFMB UPDATED COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔The MIST report was recently incorporated into the 9-line medical evacuation
request. MIST stands for: - ✔✔M - Mechanism of Injury
I - Type of Injury
S- Signs (Vital Signs)
T - Treatment Given
✔✔T/F: The Interfacility Transport of Patients Between Theater Medical Treatment
Facilities Clinical Practice Guideline defines medical direction as the direct technical
authority to determine capability, promulgate medical policy, and the authority to enforce
the standard of care through quality assurance with local privileging actions of individual
en route care providers. - ✔✔TRUE
✔✔__________ medical direction includes protocol development and review, continuing
education of prehospital providers, and quality improvement activities. - ✔✔Offline
✔✔The Commander of the unit assigned to perform medical evacuation should appoint
the unit's __________ as the medical director. - ✔✔Physician
,✔✔T/F: Medical direction at the regional level (Patient Evacuation Control Center) is
centered on online medical direction activities. - ✔✔FALSE. It is centered on OFFLINE
medical direction activities.
✔✔What are the responsibilities of a regional medical director? - ✔✔1. In conjunction
with medical planners, advise the Combatant/Theater Commander on medical common
operating picture and allocation of resources for intra-theater transport. 2. Ensure
requirements of documentation of intra-theater transport care are done.
3. Assist medical directors operating in theater and ensure that they have the
knowledge and skills to perform the job.
4. Provide technical supervision to medical directors in theater.
5. Ensure relevant out of hospital research is supported and accomplished.
6. Ensure information from intra-theater transportation is supplied to the DoD Trauma
Registry.
✔✔What are the approved Joint Trauma System patient care records (PCR) for inter-
facility patient transports? - ✔✔1. DD Form 1380 - Tactical Combat Casualty Care
(TCCC) Card
2. DA 4700 Overprint Tactical Evacuation Patient Care Record (JTS Approved
20141119)
3. AF IMT 3899 - Patient Movement Record (20060819, V1)
4. Medical Rescue Report SAR Form 3-50.1A
✔✔Which approved Joint Trauma System patient care record (PCR) is primarily used
for rotary wing transports from point of injury or inter-facility transfer? - ✔✔Tactical
Evacuation Patient Care Record
✔✔Which approved Joint Trauma System patient care record (PCR) is primarily used
for Critical Care Air Transport Team movements? - ✔✔AF IMT 3899, with Supplements
A-K
✔✔Which approved Joint Trauma System patient care record (PCR) is required
whenever a search or rescue is attempted or accomplished that involves Navy
personnel or assets? - ✔✔Medical Rescue Report SAR Form 3-50.1A
✔✔T/F: While the patient is delivered to the receiving medical treatment facility, the
patient care record should be maintained with the evacuation unit. - ✔✔FALSE. The
PCR should be completed and delivered to the receiving MTF along with the patient.
✔✔Section 10: Pain, Anxiety, and Delirium - ✔✔-
✔✔T/F: The Acute Pain Service (APS) should be established and be an integral part of
casualty care starting at the Role 1. - ✔✔FALSE. Starting at the theater hospital (Role
3)
, ✔✔T/F: Sedation should be optimized as a priority over Pain Control. - ✔✔FALSE. Pain
Control should be optimized over Sedation
✔✔Adjuncts can greatly increase patient safety and the effectiveness of narcotics to
treat pain while reducing side effects. What are examples of adjuncts? - ✔✔1.
Acetaminophen
2. Ketamine
3. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs),
4. Continuous Peripheral Nerve Infusions
5. Continuous Epidural Infusions
✔✔If it is not feasible to incorporate the Acute Pain Service (APS) team into trauma
rounds, then the APS is responsible for __________ pain rounds, pain management
consults, and reports to the trauma team leader. - ✔✔daily
✔✔What are the standardized and validated scoring systems for the assessment of
pain, anxiety, and delirium? - ✔✔1. DoD/VA Pain Rating Scale
2. Richmond Agitation Sedation Scale (RASS)
3. Confusion Assessment Method (CAM)
✔✔The Richmond Agitation Sedation Scale (RASS) is used to assess __________. -
✔✔anxiety
✔✔The goal for patients with delirium is to achieve a delirium free state as measured by
the __________. - ✔✔Confusion Assessment Method (CAM)
✔✔The ABCDE's should be incorporated into treatment care plans as efforts to prevent
delirium in critically injured patients. The "E" stands for? - ✔✔ABC - Awakening &
Breathing Coordination
D - Non-Pharmacologic Delirium
E - Early Exercise
✔✔T/F: Seriously injured patients who are not intubated should be assessed every 1-4
hours for the presence of pain. - ✔✔TRUE
✔✔T/F: Adequate early pain control has been shown to reduce post-traumatic stress
disorder and ongoing pain control is an obligatory part of trauma care. - ✔✔TRUE
✔✔__________, in parenteral doses of 0.15-0.3 mg/kg, has been shown to reduce pain
scores, total narcotic use, and need for rescue medication when used with morphine for
acute pain control. - ✔✔Ketamine
QUESTIONS AND ANSWERS SURE A+
✔✔The MIST report was recently incorporated into the 9-line medical evacuation
request. MIST stands for: - ✔✔M - Mechanism of Injury
I - Type of Injury
S- Signs (Vital Signs)
T - Treatment Given
✔✔T/F: The Interfacility Transport of Patients Between Theater Medical Treatment
Facilities Clinical Practice Guideline defines medical direction as the direct technical
authority to determine capability, promulgate medical policy, and the authority to enforce
the standard of care through quality assurance with local privileging actions of individual
en route care providers. - ✔✔TRUE
✔✔__________ medical direction includes protocol development and review, continuing
education of prehospital providers, and quality improvement activities. - ✔✔Offline
✔✔The Commander of the unit assigned to perform medical evacuation should appoint
the unit's __________ as the medical director. - ✔✔Physician
,✔✔T/F: Medical direction at the regional level (Patient Evacuation Control Center) is
centered on online medical direction activities. - ✔✔FALSE. It is centered on OFFLINE
medical direction activities.
✔✔What are the responsibilities of a regional medical director? - ✔✔1. In conjunction
with medical planners, advise the Combatant/Theater Commander on medical common
operating picture and allocation of resources for intra-theater transport. 2. Ensure
requirements of documentation of intra-theater transport care are done.
3. Assist medical directors operating in theater and ensure that they have the
knowledge and skills to perform the job.
4. Provide technical supervision to medical directors in theater.
5. Ensure relevant out of hospital research is supported and accomplished.
6. Ensure information from intra-theater transportation is supplied to the DoD Trauma
Registry.
✔✔What are the approved Joint Trauma System patient care records (PCR) for inter-
facility patient transports? - ✔✔1. DD Form 1380 - Tactical Combat Casualty Care
(TCCC) Card
2. DA 4700 Overprint Tactical Evacuation Patient Care Record (JTS Approved
20141119)
3. AF IMT 3899 - Patient Movement Record (20060819, V1)
4. Medical Rescue Report SAR Form 3-50.1A
✔✔Which approved Joint Trauma System patient care record (PCR) is primarily used
for rotary wing transports from point of injury or inter-facility transfer? - ✔✔Tactical
Evacuation Patient Care Record
✔✔Which approved Joint Trauma System patient care record (PCR) is primarily used
for Critical Care Air Transport Team movements? - ✔✔AF IMT 3899, with Supplements
A-K
✔✔Which approved Joint Trauma System patient care record (PCR) is required
whenever a search or rescue is attempted or accomplished that involves Navy
personnel or assets? - ✔✔Medical Rescue Report SAR Form 3-50.1A
✔✔T/F: While the patient is delivered to the receiving medical treatment facility, the
patient care record should be maintained with the evacuation unit. - ✔✔FALSE. The
PCR should be completed and delivered to the receiving MTF along with the patient.
✔✔Section 10: Pain, Anxiety, and Delirium - ✔✔-
✔✔T/F: The Acute Pain Service (APS) should be established and be an integral part of
casualty care starting at the Role 1. - ✔✔FALSE. Starting at the theater hospital (Role
3)
, ✔✔T/F: Sedation should be optimized as a priority over Pain Control. - ✔✔FALSE. Pain
Control should be optimized over Sedation
✔✔Adjuncts can greatly increase patient safety and the effectiveness of narcotics to
treat pain while reducing side effects. What are examples of adjuncts? - ✔✔1.
Acetaminophen
2. Ketamine
3. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs),
4. Continuous Peripheral Nerve Infusions
5. Continuous Epidural Infusions
✔✔If it is not feasible to incorporate the Acute Pain Service (APS) team into trauma
rounds, then the APS is responsible for __________ pain rounds, pain management
consults, and reports to the trauma team leader. - ✔✔daily
✔✔What are the standardized and validated scoring systems for the assessment of
pain, anxiety, and delirium? - ✔✔1. DoD/VA Pain Rating Scale
2. Richmond Agitation Sedation Scale (RASS)
3. Confusion Assessment Method (CAM)
✔✔The Richmond Agitation Sedation Scale (RASS) is used to assess __________. -
✔✔anxiety
✔✔The goal for patients with delirium is to achieve a delirium free state as measured by
the __________. - ✔✔Confusion Assessment Method (CAM)
✔✔The ABCDE's should be incorporated into treatment care plans as efforts to prevent
delirium in critically injured patients. The "E" stands for? - ✔✔ABC - Awakening &
Breathing Coordination
D - Non-Pharmacologic Delirium
E - Early Exercise
✔✔T/F: Seriously injured patients who are not intubated should be assessed every 1-4
hours for the presence of pain. - ✔✔TRUE
✔✔T/F: Adequate early pain control has been shown to reduce post-traumatic stress
disorder and ongoing pain control is an obligatory part of trauma care. - ✔✔TRUE
✔✔__________, in parenteral doses of 0.15-0.3 mg/kg, has been shown to reduce pain
scores, total narcotic use, and need for rescue medication when used with morphine for
acute pain control. - ✔✔Ketamine
