EFMB Written Test, EFMB Written Test
questions and 100% correct
answers/Already passed!! Graded A+
During debridement, extremity wounds should be extended _________. - ANS Longitudinally
During debridement, truncal wounds should be extended _________. - ANS Along Langer's
Lines
Due to their heavy contamination and the diminished healing capacity, how long should the
closure of blast wounds be avoided after the injury occurs? - ANS 48 Hours
Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone are
essential to reduce the load of contamination and necrotic tissue prior to dressing application. -
ANS Hemostasis
All methods of wound irrigation are adjuncts and not substitutes to what? - ANS Sharp Surgical
Debridement
The current recommendation of irrigation volume for small wounds is: - ANS 1 - 3 Liters
The current recommendation of irrigation volume for moderate wounds is: - ANS 4 - 8 Liters
The current recommendation of irrigation volume for large wounds or wounds with evidence of
heavy contamination is: - ANS 9 or More Liters
T/F: Normal saline, sterile water and potable tap water all have comparable efficacy and safety
as irrigation solutions. - ANS True
T/F: The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has proven
benefits. - ANS False
What are risk factors of invasive fungal infections assessed for during the first wound
debridement? - ANS Dismounted Blast Injury, Above the Knee Amputation, Extensive
Perineal/Genitourniary/Rectal Injury, Massive transfusion of >20 units in the first 24 hours
T/F: All wounds must be closed prior to arrival at a definitive care location to prevent further
bacterial and fungal introduction. - ANS False
,T/F: Placement of antibiotic impregnated polymethylmethacrylate (PMMA) can be used as an
adjunct to debridement and irrigation of a wound to deliver increased local antibiotic
concentrations while minimizing the associated side effects of high systemic loads of these
antibiotics. - ANS True
A(n) _________ event refers to an iatrogenic event in which a sponge or surgical instrument is
deliberately or unintentionally left behind while the wound proceeds to definitive management. -
ANS Retained Foreign Object (RFO)
Explosive munitions injure through how many major mechanisms? - ANS Four
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - ANS False
The symptoms of acoustic trauma are: - ANS Tinnitus, recruitment, aural fullness, difficulty
localizing sounds, difficulty hearing in a noisy background, and vertigo.
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either
_____________or _____________. - ANS Temporary (temporary threshold shift) or Permanent
(permanent threshold shift).
The ear, specifically the _____________, is the most sensitive organ to primary blast injury. -
ANS Tympanic Membrane (TM)
T/F: The smaller the size of the tympanic membrane perforation, the greater the likelihood is of
spontaneous closure. - ANS True
The majority of tympanic membrane perforations that close spontaneously do so within the first
___________ after injury - ANS 8 Weeks
Acute management of intratemporal facial nerve injury is to provide objective documentation of
facial movement using the _____________ scale. - ANS House-Brackmann
T/F: For significant facial pareses/paralyses, early administration of steroids must always be
provided regardless of contraindications. - ANS False
All Service Members that develop symptoms consistent with noise trauma (acute tinnitus,
muffled hearing, fullness in the ear) should: - ANS Educated and directed to self-report for
evaluation and possible treatment as soon as is practicable.
What is the best course of action if you find debris in the external auditory canal or in the middle
ear? - ANS Treat the patient with a fluoroquinolone and steroid containing topical antibiotic.
Hearing loss that persists ___ hours after acoustic trauma warrants a hearing test or audiogram
- ANS 72 Hours
, T/F: Vestibular trauma to the inner ear may manifest in vertigo. - ANS True
All patients with subjective hearing loss and tinnitus following blast exposure should: - ANS
Have the exposure documented and be evaluated by hearing test as soon as possible.
Patients with TTS greater than ______ losses in three consecutive frequencies should be
considered candidates for high dose oral and/or transtympanic steroid injections when not
otherwise contraindicated. - ANS 25 db
The initial radiographic evaluation of a trauma patient begins with supine AnteriorPosterior (AP)
chest and pelvis radiographs taken in the trauma bay usually with a(n) _________________. -
ANS 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. - ANS False
What is the lowest level of care equipped with a Computed Tomography scanner? - ANS Role 3
What is the lowest level of care equipped with a portable x-ray machine? - ANS Role 2
Members of the trauma team should have _____ aprons and thyroid shields available near the
trauma bay for radiation safety. - ANS 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 _____. - ANS 6 Feet
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____________________. - ANS Focused Abdominal
Sonographic Assessment for Trauma
FAST in combat trauma has a sensitivity of only 56% and specificity of ___. - ANS 98%
T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric
injury. - ANS False
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 device. - ANS True
A FAST examination is performed with a portable hand-held machine most commonly using a
standard 3-7 MHz curved array _______________ probe. - ANS Ultrasound (US)
questions and 100% correct
answers/Already passed!! Graded A+
During debridement, extremity wounds should be extended _________. - ANS Longitudinally
During debridement, truncal wounds should be extended _________. - ANS Along Langer's
Lines
Due to their heavy contamination and the diminished healing capacity, how long should the
closure of blast wounds be avoided after the injury occurs? - ANS 48 Hours
Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone are
essential to reduce the load of contamination and necrotic tissue prior to dressing application. -
ANS Hemostasis
All methods of wound irrigation are adjuncts and not substitutes to what? - ANS Sharp Surgical
Debridement
The current recommendation of irrigation volume for small wounds is: - ANS 1 - 3 Liters
The current recommendation of irrigation volume for moderate wounds is: - ANS 4 - 8 Liters
The current recommendation of irrigation volume for large wounds or wounds with evidence of
heavy contamination is: - ANS 9 or More Liters
T/F: Normal saline, sterile water and potable tap water all have comparable efficacy and safety
as irrigation solutions. - ANS True
T/F: The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has proven
benefits. - ANS False
What are risk factors of invasive fungal infections assessed for during the first wound
debridement? - ANS Dismounted Blast Injury, Above the Knee Amputation, Extensive
Perineal/Genitourniary/Rectal Injury, Massive transfusion of >20 units in the first 24 hours
T/F: All wounds must be closed prior to arrival at a definitive care location to prevent further
bacterial and fungal introduction. - ANS False
,T/F: Placement of antibiotic impregnated polymethylmethacrylate (PMMA) can be used as an
adjunct to debridement and irrigation of a wound to deliver increased local antibiotic
concentrations while minimizing the associated side effects of high systemic loads of these
antibiotics. - ANS True
A(n) _________ event refers to an iatrogenic event in which a sponge or surgical instrument is
deliberately or unintentionally left behind while the wound proceeds to definitive management. -
ANS Retained Foreign Object (RFO)
Explosive munitions injure through how many major mechanisms? - ANS Four
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - ANS False
The symptoms of acoustic trauma are: - ANS Tinnitus, recruitment, aural fullness, difficulty
localizing sounds, difficulty hearing in a noisy background, and vertigo.
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either
_____________or _____________. - ANS Temporary (temporary threshold shift) or Permanent
(permanent threshold shift).
The ear, specifically the _____________, is the most sensitive organ to primary blast injury. -
ANS Tympanic Membrane (TM)
T/F: The smaller the size of the tympanic membrane perforation, the greater the likelihood is of
spontaneous closure. - ANS True
The majority of tympanic membrane perforations that close spontaneously do so within the first
___________ after injury - ANS 8 Weeks
Acute management of intratemporal facial nerve injury is to provide objective documentation of
facial movement using the _____________ scale. - ANS House-Brackmann
T/F: For significant facial pareses/paralyses, early administration of steroids must always be
provided regardless of contraindications. - ANS False
All Service Members that develop symptoms consistent with noise trauma (acute tinnitus,
muffled hearing, fullness in the ear) should: - ANS Educated and directed to self-report for
evaluation and possible treatment as soon as is practicable.
What is the best course of action if you find debris in the external auditory canal or in the middle
ear? - ANS Treat the patient with a fluoroquinolone and steroid containing topical antibiotic.
Hearing loss that persists ___ hours after acoustic trauma warrants a hearing test or audiogram
- ANS 72 Hours
, T/F: Vestibular trauma to the inner ear may manifest in vertigo. - ANS True
All patients with subjective hearing loss and tinnitus following blast exposure should: - ANS
Have the exposure documented and be evaluated by hearing test as soon as possible.
Patients with TTS greater than ______ losses in three consecutive frequencies should be
considered candidates for high dose oral and/or transtympanic steroid injections when not
otherwise contraindicated. - ANS 25 db
The initial radiographic evaluation of a trauma patient begins with supine AnteriorPosterior (AP)
chest and pelvis radiographs taken in the trauma bay usually with a(n) _________________. -
ANS 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. - ANS False
What is the lowest level of care equipped with a Computed Tomography scanner? - ANS Role 3
What is the lowest level of care equipped with a portable x-ray machine? - ANS Role 2
Members of the trauma team should have _____ aprons and thyroid shields available near the
trauma bay for radiation safety. - ANS 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 _____. - ANS 6 Feet
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____________________. - ANS Focused Abdominal
Sonographic Assessment for Trauma
FAST in combat trauma has a sensitivity of only 56% and specificity of ___. - ANS 98%
T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric
injury. - ANS False
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 device. - ANS True
A FAST examination is performed with a portable hand-held machine most commonly using a
standard 3-7 MHz curved array _______________ probe. - ANS Ultrasound (US)
