UCLA PARAMEDIC UPDATED 2026 EXAM SCRIPT
QUESTIONS AND SOLUTIONS RATED A+
✔✔Bleeding rates - ✔✔Lowest internal bleeding per fracture to highest:
- Rib (125)
- Radius or Ulna
- Humorous
- Tibia or Fibula (500-1000)
- Femur
- Pelvis (3000-5000)
✔✔Estimated fluid and blood loss - ✔✔Class 1: <750ml / <15% blood loss ; Resp 14-20
; slight anxiety
Class 2: 750-1500ml / 15-30% blood loss ; Resp 20-24 ; mild anxiety
Class 3: 1500-2000ml / 30-40% blood loss ; Resp Elevated ; anxious and confused
Class 4: >2000ml / >40% blood loss ; Resp Elevated ; confused and lethargic
✔✔MAP when kidney perfusion starts to fail - ✔✔60-65
✔✔We don't wait to administer what drug in a trauma? - ✔✔TXA (Tranexamic acid)
admin - due to delay of onset for the drug
medication used to treat or prevent excessive blood loss
✔✔Types of transfusion reactions - ✔✔- Allergic (allergic reaction w/ rash, hives,
itching)
- Anaphylaxis (allergic reaction with resp distress)
- Hemolytic - more commonly seen in hospital or CCT
- Volume overload
if it doesn't look right, then stop it!
✔✔Permissive hypotension - ✔✔Maintaining a trauma patients blood pressure on the
low end of normal to assist hemostasis
lower MAP
*we do not do on TBI pts - we need a MAP of >100
✔✔Special meds to consider in trauma - ✔✔- beta blockers
- calcium channel blockers
- sodium channel blockers
,- ACE inhibitors
✔✔Kinematics - ✔✔the study of how things move
✔✔Spine - ✔✔Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 5
Coccygeal - 4
✔✔Consider spinal mobile restriction (SMR) - ✔✔if at high risk:
- age
- meets trauma criteria for mechanism
- axial load injury
- numbness or tingling in extremities
*Must perform a careful assessment on all pts (unreliable
PT/ALOC/uncooperative/intoxicated, abnormal spine exam, abnormal CMS?)
✔✔Mechanism type: Blunt - ✔✔most common cause of trauma death and disability
energy exchange between an object and the human body, without intrusion through the
skin
✔✔Mechanism type: Penetrating - ✔✔open injury
direct injury to underlying structure
✔✔Newton's first law of motion - ✔✔body at rest will remain at rest and a body in
motion will remain in motion until acted upon by an outside force
3 impacts of a crash
✔✔Law of conservation of energy - ✔✔energy cannot be created or destroyed, but can
change from
friction of stopping
✔✔Kinetic energy - ✔✔= energy of motion
double weight = double energy
double speed = quadruple energy
(speed kills!!!!)
,✔✔Velocity - ✔✔the speed of an object in a particular direction
✔✔Acceleration - ✔✔rate of change of velocity
✔✔Deceleration - ✔✔negative acceleration
✔✔Gravity - ✔✔acceleration of a body by the attraction of the earth's gravitational force
✔✔Kinetic force - ✔✔mass x acceleration = force = mass x deceleration
✔✔Velocity is the... - ✔✔best predictor of injury severity
Speed kills
✔✔Crash phases (broadly speaking) - ✔✔3 phases:
- pre cash (factors preceding the cash)
- crash (object, occupant, organ)
- post crash (provider skill, treatment, transportation, destination)
✔✔Crash phases (actual, on PT) - ✔✔Object > occupant > organs
✔✔Mechanism of injury - ✔✔a force or forces that may have caused injury
(ex. direction and strength)
✔✔index of suspicion - ✔✔Awareness that unseen life-threatening injuries may exist
when determining the mechanism of injury
✔✔Frontal injury patterns - ✔✔impact from front
- check:
head, face, neck, chest, diaphragm, abdomen, pelvis
✔✔Rear impact injury patterns - ✔✔impact from rear
Cervical hyperextension + ______________ :
head
face
chest
diaphragm
abdomen
pelvis
, ✔✔Lateral impact injury patterns - ✔✔impact from side:
- check:
arms
clavicle
ribs
femur
pelvis
✔✔Rotational injury patterns - ✔✔shearing injuries
- check:
heart
liver
kidneys
✔✔Rollover injury patterns - ✔✔multiple injury patterns
- risk of ejection/crush
- x6 more likely to die
- 75% of ejections result in death
✔✔Down and under injury patterns - ✔✔When your lower body hits the bottom of
steering wheel area in a crash
- Check:
knee
femur
hip dislocation
✔✔Seatbelts - ✔✔seatbelt misplacement could cause complications internally
look for bruising or signs of seatbelt on bare skin
✔✔Motorcycle injuries - ✔✔usually:
lateral impact injuries
up and over injuries
✔✔Fall considerations - ✔✔-height pt fell from
-surface
-part of pt that initially hit surface + secondary impact
-anything interrupting the fall
QUESTIONS AND SOLUTIONS RATED A+
✔✔Bleeding rates - ✔✔Lowest internal bleeding per fracture to highest:
- Rib (125)
- Radius or Ulna
- Humorous
- Tibia or Fibula (500-1000)
- Femur
- Pelvis (3000-5000)
✔✔Estimated fluid and blood loss - ✔✔Class 1: <750ml / <15% blood loss ; Resp 14-20
; slight anxiety
Class 2: 750-1500ml / 15-30% blood loss ; Resp 20-24 ; mild anxiety
Class 3: 1500-2000ml / 30-40% blood loss ; Resp Elevated ; anxious and confused
Class 4: >2000ml / >40% blood loss ; Resp Elevated ; confused and lethargic
✔✔MAP when kidney perfusion starts to fail - ✔✔60-65
✔✔We don't wait to administer what drug in a trauma? - ✔✔TXA (Tranexamic acid)
admin - due to delay of onset for the drug
medication used to treat or prevent excessive blood loss
✔✔Types of transfusion reactions - ✔✔- Allergic (allergic reaction w/ rash, hives,
itching)
- Anaphylaxis (allergic reaction with resp distress)
- Hemolytic - more commonly seen in hospital or CCT
- Volume overload
if it doesn't look right, then stop it!
✔✔Permissive hypotension - ✔✔Maintaining a trauma patients blood pressure on the
low end of normal to assist hemostasis
lower MAP
*we do not do on TBI pts - we need a MAP of >100
✔✔Special meds to consider in trauma - ✔✔- beta blockers
- calcium channel blockers
- sodium channel blockers
,- ACE inhibitors
✔✔Kinematics - ✔✔the study of how things move
✔✔Spine - ✔✔Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 5
Coccygeal - 4
✔✔Consider spinal mobile restriction (SMR) - ✔✔if at high risk:
- age
- meets trauma criteria for mechanism
- axial load injury
- numbness or tingling in extremities
*Must perform a careful assessment on all pts (unreliable
PT/ALOC/uncooperative/intoxicated, abnormal spine exam, abnormal CMS?)
✔✔Mechanism type: Blunt - ✔✔most common cause of trauma death and disability
energy exchange between an object and the human body, without intrusion through the
skin
✔✔Mechanism type: Penetrating - ✔✔open injury
direct injury to underlying structure
✔✔Newton's first law of motion - ✔✔body at rest will remain at rest and a body in
motion will remain in motion until acted upon by an outside force
3 impacts of a crash
✔✔Law of conservation of energy - ✔✔energy cannot be created or destroyed, but can
change from
friction of stopping
✔✔Kinetic energy - ✔✔= energy of motion
double weight = double energy
double speed = quadruple energy
(speed kills!!!!)
,✔✔Velocity - ✔✔the speed of an object in a particular direction
✔✔Acceleration - ✔✔rate of change of velocity
✔✔Deceleration - ✔✔negative acceleration
✔✔Gravity - ✔✔acceleration of a body by the attraction of the earth's gravitational force
✔✔Kinetic force - ✔✔mass x acceleration = force = mass x deceleration
✔✔Velocity is the... - ✔✔best predictor of injury severity
Speed kills
✔✔Crash phases (broadly speaking) - ✔✔3 phases:
- pre cash (factors preceding the cash)
- crash (object, occupant, organ)
- post crash (provider skill, treatment, transportation, destination)
✔✔Crash phases (actual, on PT) - ✔✔Object > occupant > organs
✔✔Mechanism of injury - ✔✔a force or forces that may have caused injury
(ex. direction and strength)
✔✔index of suspicion - ✔✔Awareness that unseen life-threatening injuries may exist
when determining the mechanism of injury
✔✔Frontal injury patterns - ✔✔impact from front
- check:
head, face, neck, chest, diaphragm, abdomen, pelvis
✔✔Rear impact injury patterns - ✔✔impact from rear
Cervical hyperextension + ______________ :
head
face
chest
diaphragm
abdomen
pelvis
, ✔✔Lateral impact injury patterns - ✔✔impact from side:
- check:
arms
clavicle
ribs
femur
pelvis
✔✔Rotational injury patterns - ✔✔shearing injuries
- check:
heart
liver
kidneys
✔✔Rollover injury patterns - ✔✔multiple injury patterns
- risk of ejection/crush
- x6 more likely to die
- 75% of ejections result in death
✔✔Down and under injury patterns - ✔✔When your lower body hits the bottom of
steering wheel area in a crash
- Check:
knee
femur
hip dislocation
✔✔Seatbelts - ✔✔seatbelt misplacement could cause complications internally
look for bruising or signs of seatbelt on bare skin
✔✔Motorcycle injuries - ✔✔usually:
lateral impact injuries
up and over injuries
✔✔Fall considerations - ✔✔-height pt fell from
-surface
-part of pt that initially hit surface + secondary impact
-anything interrupting the fall
