FRNS 5423 Blast Injury and Effects Exam | Questions and Answers (Complete Solutions)

FRNS 5423 Blast Injury and Effects Exam | Questions and Answers (Complete Solutions) What is a Primary Blast Injury? a. Burns and crush injuries b. A direct effect of the blast wave c. Fragmentation thrown by the wave d. There is no such thing as a primary blast injury What is a characteristic of an explosion? a. Blast wave overpressure b. Usually implemented with a purpose c. Concurrent with massive structural damage d. Entirely confined to the target area when implemented by trained personnel What is the amount of wind speed from overpressure that can cause rupture of the tympanic membranes (ear drum)? a. 40 m/s b. 45 m/s c. 55 m/s d. 70 m/s What is the amount of wind speed from overpressure to injure the lungs? a. 300 m/s b. 400 m/s c. 500 m/s d. 700 m/s What results from the effects of the blast wave itself almost instantly? a. Burns b. Shock c. Primary Blast Injury (PBI) d. Nosocomial Iterations What is the term used to describe the rather thin (2-4 mm) leading edge of the compressed medium of the blast? a. Blast Initiation b. Blast Front c. Blast Pressure d. Blast Furnace What is the term used to describe the shattering capability of an explosion? a. Brisance b. Nosocomial Influence c. Quaternary Effects d. Substrate Effects What is the ballistic trauma caused by flying objects placed in motion by the energy of the explosion and blast wind? a. Nosocomial Iterations b. Shock Forces c. Primary Blast Injury d. Secondary Blast Injury What is the ballistic trauma caused by fragments of the device? a. Nosocomial Iterations b. Direct secondary blast injury c. Direct primary blast injury d. Direct shock injury What is the ballistic trauma caused by the accelerated debris thrown by the blast wind? a. Direct secondary blast injury b. Direct tertiary blast injury c. Indirect secondary blast injury d. Nosocomial Iterations What occurs when the blast wind causes the victims body to tumble through the air and become damaged? a. Nosocomial Iterations b. Indirect secondary blast injury c. Indirect shock injury d. Tertiary injury What are usually superficial flash burns that resemble sunburns? a. Direct thermal burns b. Nosocomial Iterations c. Primary thermal burns d. Shock wave burns After a blast what are burns caused by burning clothes, vegetation, buildings, etc.? a. Direct thermal burns b. Tertiary burns c. Indirect thermal burns d. Secondary burns What is an example of a Quaternary Injuries? a. A long term Primary Blast Injury b. A secondary explosion from a delayed fuse bomb c. Flash burns, crush injuries, a n d delayed affects of inhalation of noxious substances d. There i s no such thing as a Quaternary Injury What is a major concern for first responders at a location where there was a well planned terroristic bombing? a. Secondary bombs b. Natural gas pipelines bursting c. Falling debris d. Being overwhelmed by victims What is a significant challenge for medical personnel in caring for victims of blast events? a. Dealing with the emotional sequelae b. Identifying thoracic and abdominal injuries that haven't left identifying marks c. Stopping external venous hemorrhages d. Categorizing the type of patient by priority What is one way to determine if there is a pulmonary injury from the blast? a. Asymmetrical chest rise and fall b. Significant blood from the ears and mouth c. Usually only occurs when significant enough blast to cause bilateral below the knee amputations d. There is no good way to determine and this is the concern with pulmonary injuries What is a common characteristic of abdominal injury from blast? a. Normally causes sepsis b. Has underlying morphological ideopathies c. Occurs in water environments near the surface d. There is no common characteristic How could you identify a ruptured tympanic membrane (ear drum) following an explosion a. Difficulty hearing b. Being dizzy c. Being nauseous d. There is no good way to determine Abdominal trauma patients have a higher incidence of requiring surgery compared to thoracic trauma patients a. True b. False Abdominal trauma is often unrecognized a. True b. False Two mechanisms of blunt trauma are: a. Penetrating and shock wave b. Logarithm and postictal c. Compression and deceleration d. Postictal and mesenter What would we look for in an abdominal trauma patient? a. Distended abdomen, rigid abdomen, seat belt sign (if in a motor vehicle accident), bruising b. Lower level of consciousness, bloody sputum, uneven rise and fall of chest cavity, deviated trachea c. Chest palpitations, loss of bowel or bladder functions, numbness of leg A small bowel injury will almost immediately be recognizable as blood in the peritoneum as blood is significantly irritating. a. True b. False What is Evisceration? a. Small bowel obstruction b. Bleeding from the small bowel c. Removal of organs from the body cavity d. Solid waste from the small bowel What would you do in the event a trauma patient, at point of injury, presented with body organs outside the body? a. Cover with a wet dressing and place plastic on top of that b. Call for help c. Use tin foil to cover the wound d. Prepare for CPR What is air between the pleura of the lungs? a. Cardiomegaly b. "Jack Tripper" injury c. Pneumothorax d. Cardiac contusion What are the top three priorities in managing a blast injury patient with wounds t o the thorax when in a safe environment? a. Get him/her off the "X" b. Ensure to use only the patients own tourniquets c. Stabilize C-Spine d. Airway, Breathing, Circulation What is blood between the pleura of the lungs? a. Cardiomegaly b. "Jack Tripper" injury c. Hemothorax d. Cardiac contusion What condition does NOT require chest drainage / chest tube? a. Hemothorax b. Flail chest c. Open pneumothorax d. Closed pneumothorax What is a LATE sign of pneumothorax? a. Respiratory distress b. Tachycardia (fast heart rate) c. Hypotension (low blood pressure) d. Deviated trachea (trachea moving to one side and away from midline) What is the best way to treat a tension pneumothorax in the field? a. Needle decompression b. Thoracostomy c. Prepare for CPR d. Reassurance that everything will be alright Massive hemothorax is caused more by penetrating forces than by blunt forces a. True b. False How do patients in a civilian motor vehicle collision typically present if they have Flail Chest? a. Substantial degree of apprehension for themselves and loved ones b. Some degree of lacerations of the face and head c. "Seat Belt Sign" d. Crush injuries of the lower extremities Patients with Flail Chest will typically present with: a. Hypoxia (low oxygen levels) and Hypercapnia (high CO2 levels) b. Deviated septum c. Deviated trachea d. "Kirchner's Sign" In a Pulmonary Contusion we might see Hemoptysis (spitting up blood) a. True b. False If a person incurs a Blunt Cardiac Injury with free wall rupture of the heart in the field they are most likely to: a. Need supplemental oxygen b. Need a needle decompression c. Need supplemental oxygen and needle decompression d. Perish Diaphragm injuries are more common with penetrating versus blunt forces. a. True b. False Emergency Resuscitative Thoracotomy has a low incidence of success a. True b. False Based off of Army research studies of wounded from 2003 to 2004 which caused the most injuries? a. IED b. Blast c. Gunshot wound (GSW) d. Shrapnel In combat zones what is the greatest type of preventable death? a. GSW to extremity b. Motor Vehicle Accident (MVA) and rollover c. Hemorrhage d. GSW to thorax What are the five mechanisms of high energy wounding? a. Kinetic energy, mass, velocity, squared, distance b. Time, energy, distance, space, speed c. Penetrating, crush, blunt, blast, burn d. Velocity, time, energy, distance, space What type of injury occurs most frequently in mounted IED scenarios? a. Axial skeletal b. Lower extremity c. Shrapnel d. Overpressure What are the high energy wounding concepts? a. Energy transfer, zone of injury, injury progression b. Focus of energy, velocity, squared c. Kinetic energy, velocity, mass d. Kinetic energy, mass, velocity squared The Zone of Injury is always obvious with an IED victim. a. True b. False What is a result of Injury Progression with an IED victim? a. Inflammation b. Hemodynamic Instability c. Need for psychiatric counseling d. Transfer to a higher level or echelon of care How are combat wounds different from trauma in a strictly civilian environment (non explosive)? a. Combined mechanism b. Wider Zone of Injury c. Higher energy of transfer d. Longer evolution e. All of the above When should a tourniquet be used? a. When venous blood is oozing b. When venous blood is no longer flowing c. When arterial blood is flowing or traumatic amputation of limb d. When nasty looking laceration to head or neck is present After how much time could a tourniquet be expected to cause some neurological deficits? a. 30 minutes b. 1 hour c. 1.5 hours d. 2.5 hours Why is it so important to get a proper tourniquet on immediately after injury that results in loss of arterial blood? a. The patient needs reassurance that they will be medevac'd quickly b. The patient must be able tot quickly get back into the fight or get off the "X" c. The patient could die in one or two minutes with an arterial blood flow loss What is Compartment Syndrome? a. Increase in pressure in a body part that exceeds venous return b. Sectioning off of limb from septic area of body c. Usually fatal result of improper debridement d. Not usually painful and easily corrected with antibiotic through IV Compartment Syndrome is a medical emergency requiring immediate surgical intervention. a. True b. False c. Contingent on the degree of infection What is the purpose of a Fasciotomy? a. Debride contaminants from the wound b. Debride burn skin from a wound c. Decrease infection by washing the wound d. Relieve the pressure on an enclosed body space How does Anthrax usually occur in humans? a. Aum Shinrikyo cult dissimminating b. Bioweapons factory accidents c. Various terrorist attacks d. Incidental exposure via infected animals or animal products Anthrax was the first disease established as a microbial disease by this person in 1876: a. Robert Koch "Koch's Postulates" b. Robert Kennedy "Kennedy's Postulates" c. Aum Shinrikyo cult d. U.S. Army How does the Center for Disease Control (CDC) characterize smallpox and anthrax? a. As highly dangerous and destructive warfare agents b. As semi-dangerous and destructive warfare agents c. As Category "A" agents d. As Category "B" agents Who developed the first bacterial vaccination for anthrax in 1881? a. Louis Pasteur b. Robert Koch c. Robert Kennedy d. Aum Shinrikyo