January 2011 CE Packet

Thoracic Trauma

Your Name:
1) A major chest injury that can lead to sudden death includes:
A. bleeding from ruptured blood vessel.
B. mechanical decrease of cardiac output.
C. respiratory distress.
D. all of the above.
2) Significant causes of respiratory distress include:
A. tension pneumothorax.
B. flail chest.
C. pulmonary contusion.
D. all of the above.
3) Recommended on-scene times for trauma patients, assuming there are no extenuating circumstances, should be no longer than:
A. 10 minutes.
B. 20 minutes.
C. as long as necessary to complete your patient assessment.
D. none of the above.
4) Recognition of mechanism of injury plays little or no role in assessing a patient for probable injuries.
A. true
B. false
5) Trauma patients often are under the influence of drugs and/or alcohol. This is significant to the EMT because:
A. it has no significance.
B. drugs and alcohol can diminish a patients awareness of injuries and therefore make assessment more difficult.
C. drugs and alcohol can increase a patients awareness of his/her injuries and make assessment easier for the EMT.
D. our treatment may change for the trauma patient who is intoxicated.
6) Subcutaneous emphysema:
A. suggests a hemothorax is likely present.
B. suggests a pneumothorax is likely present.
C. means nothing.
D. is an insignificant finding as it is very common.
7) Tracheal deviation must be felt for rather than looked for in a patient. A deviated trachea is:
A. indicative of a pneumothorax.
B. an early sign of a tension pneumothorax.
C. a late sign of a tension pneumothorax.
D. an early sign of a hemothorax.
8) Hemoptysis means:
A. vomiting blood.
B. vomiting bile and other digestive enzymes.
C. coughing blood.
D. blood in the stool.
9) A patient with a chest injury frequently has respiratory distress. Any patient with respiratory distress should receive oxygen. These patients should initially receive:
A. 10-15 LPM via non-rebreather
B. 2-4 LPM via nasal cannula
C. 10-15 LPM via nasal cannula as a non-rebreather may cause harm to a patient with a pneumothorax.
D. an albuterol and atrovent (duoneb) treatment regardless of assessment findings.
10) A patient who has a pneumothorax:
A. always needs oxygen provided by positive pressure ventilation (BVM).
B. should immediately receive a needle decompression.
C. may have his condition worsen if positive pressure ventilation is applied.
D. should have oxygen withheld so as to not cause a tension pneumothorax.
11) Chest trauma patients should receive two large bore IVs with appropriate fluid resuscitation. This means:
A. 18-20 gauge IVs placed in the AC spaces.
B. 18-20 gauge IVs placed in the same arm so hospital staff can use the other arm.
C. 14-16 gauge IVs placed in the AC spaces.
D. bilateral IOs placed without attempting peripheral IV access.
12) The above patient has two IVs placed and you now want to run your IVs at a correct rate. The correct rate to use is:
A. to keep open (TKO) regardless of the patients condition.
B. wide open (WO) regardless of the patients condition.
C. at a rate fast enough to maintain a systolic BP of at least 120 mm.
D. at a rate fast enough to maintain a systolic BP of at least 90 mm.
13) Advanced Life Support (ALS) can assist with management of chest trauma patients as they are allowed to perform certain skills above that of an EMT-B or EMT-Intermediate Technician. Those skills include:
A. needle decompression for a tension pneumothorax.
B. pericardiocentesis for a cardiac tamponade.
C. rapid sequence induction of anesthesia and intubation (RSI)
D. all of the above.
14) The preferred method of determining a patients mental status/orientation is alert and oriented x 4 (A&O x 4) rather than alert and oriented x 3 (A&O x3). The four categories assessed are:
A. person, place, time and event
B. president, last oral intake, time of day and event.
C. person, place, time and medical history.
D. alert, responsive to verbal stimuli, responsive to painful stimuli and unresponsive.
15) Early notification to the Emergency Department of a trauma patients pending arrival should include:
A. mechanism of injury.
B. suspected injuries and treatments provided.
C. vital signs including any vital trending.
D. all of the above.