PHTLS - Post Test, 8th Edition

PHTLS - Post Test, 8th Edition Care of the trauma patient in the field is an evolving science and should be evidence-based. As lifelong learners, we must be prepared to adapt our practices based on research. This is because research may lead to, what? ans: changes in our current practices (p.11) In trauma care, a 'principle' is defined as, what? ans: what needs to be done (p.34) In addition to oxygen, what is required to maintain the metabolic processes of life and energy production? ans: glucose You respond for a patient who has sustained a GSW to the right upper thorax. He is barely responsive, pale, and diaphoretic. What device is most appropriate for transport? ans: scoop stretcher Units responding to a motor vehicle accident on the highway should consider what, as part of their pre-arrival assessment? ans: weather conditions The most appropriate airway maneuver for trauma patients is what technique? ans: jaw thrust maneuver Endo-tracheal in-tubation is a technique that requires, what? ans: substantial training, to maintain proficiency What indicates that a trauma patient is having trouble breathing? ans: the patient's breathing is noticeable A patient presents with, a blunt trauma injury to the chest. On exam, he has absent breath sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumo-thorax? ans: hemo-dynamic compromise (proper blood flow is being prevented) In addition to direct pressure, tourniquets, and immobilizing fractures, what is considered most effective when controlling hemorrhage? ans: hemo-static agents What is a preventable cause of secondary brain injury? ans: systemic hypoxia You're called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor striking his head. It is now several hours later and he is awake but confused, does not recall the incident, and is vomiting with a headache. What injury is he most likely to have suffered? ans: concussion What findings would indicate the need for immobilization when using a selective spinal immobilization protocol? ans: pain or tenderness along the spine What patient should be treated first in a blast-related situation involving multiple patients? ans: a 30-year-old female with altered level of consciousness and decreased capillary refill Excessive fluid resuscitation of the trauma patient can result in, what? ans: increased blood loss When should the secondary survey be accomplished? ans: when the time and situation allow (p.146) When approaching a trauma patient, what is the first assessment that must be made? ans: scene safety What is the most common type of shock resulting from trauma? ans: hemorrhagic What information gathered can best guide the decision to provide spinal immobilization? ans: the (patient's) history and complaints A 38 year old male sustained a large wound to his right thigh while at work. What action is the most important initial step? ans: hemorrhage control A patient who sustained extensive blunt trauma to his trunk; has absent lung sounds on the right, marked respiratory distress, tachy-cardia and hyper-tension. What is the most appropriate intervention? ans: needle decompression (DART) The pre-hospital assessment of the trauma patient begins when? ans: when information is provided by the dispatcher E.M.S. responds to a patient involved in a motor vehicle versus car collision. The patient is unresponsive with vital signs of: BP 82, palpitation; respirations, 24; pulse, 128. What is the most likely type of shock? ans: hypo-volemic What definition best describes shock? ans: a state of inadequate energy production What is the most common cause of airway obstruction in the unconscious trauma patient? ans: tongue While caring for a patient who was involved in an altercation, he vomits and his airway is totally obstructed with vomitus and blood. What is the maximum amount of time that you can suction his airway? ans: suction until his airway is clear When energy produced by cells occurs during the state of inadequate oxygenation, it is referred to as what condition? ans: anaerobic metabolism What sign of shock is not found during the primary survey? ans: low blood pressure measurement E.M.S. responds to a patient who has sustained a blunt injury to the head. She had a period of unconsciousness followed by a brief period of consciousness and then became unresponsive just as E.M.S. arrived. Based solely on this information, what is most likely her injury? ans: epidural hema-toma Inadvertent hyper-ventilation of a patient with suspected traumatic brain injury (TBI) may lead to which complication? ans: cerebral vasoconstriction Spinal cord injuries can lead to hypo-tension due to what type of physiologic changes? ans: vasodilation below the level of injury Which subset of patients compensate for blood loss the longest? ans: pediatrics A 55-year-old male is found unconscious after being assaulted. Assessment reveals: snoring respirations, brady-pnea, facial swelling, and unequal pupils. What is the most appropriate first step? ans: jaw thrust maneuver What is the best method for confirming proper placement of an endo-tracheal tube in a trauma patient that has a palpable pulse? ans: capnography What best describes the goal of airway management? ans: provide for adequate exchange of oxygen and carbon dioxide (CO2) What is most likely the source of hemorrhage in a patient with unexplainable signs of shock? ans: intra-abdominal injury What organ is most sensitive to hypo-tension? ans: brain After falling from the third story at a construction site, a 27-year-old male is found unconscious with unequal pupils and irregular respirations. What is the most appropriate rate of ventilations? ans: 20 beats per minute (bpm) After falling from the high bar, a gymnast has a loss of sensation from the nipples down. What area of the spine is most likely damaged? ans: thoracic four (T4) What is the most important physical finding in a patient with a suspected traumatic brain injury (TBI)? ans: abnormal levels of consciousness Pre-hospital providers respond to a male patient lying on the ground after being struck by a high-speed motor vehicle. The patient is ap-neic and pulseless. What is the most appropriate action? ans: declare the patient dead E.M.S. responds to an adult barista who spilled a cup of hot coffee and sustained partial thickness burns to the abdomen and right leg. The patient ran cool water over the area. What intervention is most appropriate next? ans: cover the affected area with dry sterile dressings Pre-hospital providers have treated a sucking chest wound with an occlusive dressing. During transport, the patient develops increasing respiratory distress with increased respirations and absent lung sounds [noted on repeat auscultation]. What is the most appropriate next intervention? ans: remove the occlusive dressing ("burping" the dressing) E.M.S. arrived on scene and finds an emergency medical responder immobilizing a pediatric patient onto a long backboard. They know that the patient's head is in a flexed position. What action is most appropriate? ans: place padding under the patient's torso What is the most common cause of death from trauma in patients over 75 years of age? ans: falls What is an early sign of deterioration in a patient with a flail chest? ans: respiratory rate increase E.M.S. is treating an unrestrained driver of an automobile involved in a high-speed crash who struck his chest against the steering column. Patient has: paradoxical movement of a portion of chest wall; respiratory rate, 16; oxygen saturation, 94%. What is the most appropriate action? ans: provide supplemental oxygen and observe Pre-hospital providers respond to a 16-year-old male who punched a glass window and sustained a large laceration to his arm that is bleeding heavily. He is restless, diaphoretic and has a weak pulse of 30. What is the most appropriate action? ans: apply direct pressure In addition to using appropriately sized equipment, frequently re-assessing the patient, employing age-appropriate immobilization techniques; pre-hospital providers should do what, when managing pediatric patients? ans: preserve body heat What is a golden principle of trauma care? ans: provide adequate pain relief