1. The primary indication for transferring 4. Which one of the following s
a regarding patients with thoracic
patient to a higher level trauma center is: TRUE?
unavailability of a surgeon or operating room Log-rolling may be desta
staff. fractures from T-
multiple system injuries, including severe Adequate immobilizat
head injury. accomplished with the scoop
resource limitations as determined by the Spinal cord injury below T-10 usua
transferring doctor. bowel and bladde
resource limitations as determined by the Hyperflexion fractures in
hospital administration. thoracic spine are inherently
widened mediastinum on chest x-ray These patients rarely present
shock in association with c
following blunt thoracic trauma.
5. young man sustains a ritle wo
2. teen-aged bicycle rider is hit by a truck
abdomen. He is brought promp
traveling at a high rate of speed. In the
emergency department by preh
emergency department, she is actively
bleeding from open fractures of her legs, and personnel. His skin is cool and
has abrasions on her chest and abdominal wall. his systolic blood pressure is 58
Her Warmed crystalloid fluids are in
blood pressure is 80/50 mm Hg, heart rate is improvement in his vital sig
140 beats per minute, respiratory rate is 8 most appropriate step is to perf
breaths per minute, and GCS score is 6. a
an abdomin
The first step in managing this patient is diagnostic lap
to: abdominal ultras
a diagnostic periton
obtain a lateral cervical spine x-ray.
insert a central venous pressure line.
administer 2 liters of crystalloid solution. 6. young woman sustains a seve
perform endotracheal intubation and
as the result of a motor vehicul
ventilation.
apply the PASG and inflate the leg emergency department, her GC
compartments. Her
blood pressure is 140/90 mm H
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She
the presence of a: and is being mechanically vent
gastric perforation.
pupils are 3 mm in size and equ
diaphragmatic rupture. light.
open depressed skull fracture.
There is no other apparent injur
fracture of the cervical spine.
fracture of the cribriform plate.
important principle to follow in
management of her head injury
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrai
reduce metabolic requirements of the
brain. in a vehicle struck from behind.
distinguish between intracranial hematoma emergency department, her blo
and cerebral edema. 80/60 mm Hg, heart rate is 80 b
and respiratory rate is 16 breath
7. 22-year-old man is brought to the hospital Her GCS score is 14. She compl
after crashing his motorcycle into a telephone legs feel "funny and won't mov
pole. He is unconscious and in profound however, her spine x-rays do n
shock. He has no open wounds or obvious fracture or dislocation. A spina
fractures. this child:
The cause of his shock is MOST LIKELY is most likely a central cord
caused by: must be diagnosed by magnetic
a subdural hematoma. can be excluded by obtaining
an epidural hematoma. ent
a transected lumbar spinal cord.
may exist in the absence o
a transected cervical spinal cord. findings on x-ra
hemorrhage into the chest or abdomen.
is unlikely because of the
calcification of the verteb
8. 30-year-old man is struck by a car traveling 10. Immediate chest tube inserti
at 56 kph (35 mph). He has obvious fractures for which of the following cond
of the left tibia near the knee, pain in the Pneu
pelvic area, and severe dyspnea. His heart rate Pneumom
Massive h
is 180
Diaphragma
beats per minute, and his respiratory rate is 48 Subcutaneous e
breaths per minute with no breath sounds heard
in the left chest. A tension pneumothorax is
11. 18-year-old, helmeted motor
relieved by immediate needle decompression
brought by ambulance to the e
and tube thoracostomy. Subsequently, his heart
department following a high-sp
rate decreases to 140 beats per minute, his
Prehospital persormel report tha
respiratory rate decreases to 36 breaths per
15 meters (50 feet) off his bfice
minute, and his blood pressure is 80/50 inm Hg.
history of hypotension prior to
Warmed Ringer's lactate is administered
emergency department, but is n
intravenously. The next priority should be to:
perform a urethrogram and cystogram.
and conversational. Which of t
perform external fixation of the pelvis. statements is TRUE?
obtain abdominal and pelvic CT scans.
perform arterial embolization of the pelvic
vessels.
perform diagnostic peritoneal lavage or Cerebral perfiisio
, Intraabdominal visceral injuries are
defmitive treatment in managin
unlikely.
to:
The patient probably has an acute
administer 0-negat
epidural hematoma. apply extemal warm
control internal hemorrhage o
apply the pneumatic antishock
12. crosstable, lateral x-ray of the cervical infuse large volumes of in
spine: crystalloid
must precede endotracheal intubation.
excludes serious cervical spine injury. 16. To establish a diagnosis of sh
is an essential part of the primary survey. systolic blood pressure must be
is not necessary for unconscious patients
with penetrating cervical injuries. the presence of a closed head in
be
is unacceptable unless 7 cervical vertebrae
acidosis should be present by arte
and the C-7 to T-1 relationship are \ga
visualized. the patient must fail to r
intravenous fluid
clinical evidence of inadequ
13. During resuscitation, which one of the perfusion must be
following is the most reliable as a guide
to volume replacement?
17. Absence of breath sounds an
Pulse rate
Hematocrit
percussion over the left hemith
Blood pressure best explained by:
Urinary output
left hem
Jugular venous pressure
cardiac
left simple pneu
left diaphragmat
14. Which one of the following is the right tension pn
recommended method for initially
treating frostbite?
Vasodilators
18. 17-year-old helmeted motor
Anticoagulants broadside by an automobile at a
Warm (40°C) water
He is unconscious at the scene
Padding and elevation
pressure of 140/90 mm Hg, hea
Topical application of silvasulphadiazine
beats per minute, and respirator
breaths per minute. His respirat
15. young man sustains a gunshot wound to the sonorous and deep. His GCS sc
abdomen and is brought promptly to the Immobilization of the entire pa
emergency department by prehospital include the use of all the follow
personnel. His skin is cool and diaphoretic, and
he is confused. His pulse is thready and his
a regarding patients with thoracic
patient to a higher level trauma center is: TRUE?
unavailability of a surgeon or operating room Log-rolling may be desta
staff. fractures from T-
multiple system injuries, including severe Adequate immobilizat
head injury. accomplished with the scoop
resource limitations as determined by the Spinal cord injury below T-10 usua
transferring doctor. bowel and bladde
resource limitations as determined by the Hyperflexion fractures in
hospital administration. thoracic spine are inherently
widened mediastinum on chest x-ray These patients rarely present
shock in association with c
following blunt thoracic trauma.
5. young man sustains a ritle wo
2. teen-aged bicycle rider is hit by a truck
abdomen. He is brought promp
traveling at a high rate of speed. In the
emergency department by preh
emergency department, she is actively
bleeding from open fractures of her legs, and personnel. His skin is cool and
has abrasions on her chest and abdominal wall. his systolic blood pressure is 58
Her Warmed crystalloid fluids are in
blood pressure is 80/50 mm Hg, heart rate is improvement in his vital sig
140 beats per minute, respiratory rate is 8 most appropriate step is to perf
breaths per minute, and GCS score is 6. a
an abdomin
The first step in managing this patient is diagnostic lap
to: abdominal ultras
a diagnostic periton
obtain a lateral cervical spine x-ray.
insert a central venous pressure line.
administer 2 liters of crystalloid solution. 6. young woman sustains a seve
perform endotracheal intubation and
as the result of a motor vehicul
ventilation.
apply the PASG and inflate the leg emergency department, her GC
compartments. Her
blood pressure is 140/90 mm H
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She
the presence of a: and is being mechanically vent
gastric perforation.
pupils are 3 mm in size and equ
diaphragmatic rupture. light.
open depressed skull fracture.
There is no other apparent injur
fracture of the cervical spine.
fracture of the cribriform plate.
important principle to follow in
management of her head injury
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrai
reduce metabolic requirements of the
brain. in a vehicle struck from behind.
distinguish between intracranial hematoma emergency department, her blo
and cerebral edema. 80/60 mm Hg, heart rate is 80 b
and respiratory rate is 16 breath
7. 22-year-old man is brought to the hospital Her GCS score is 14. She compl
after crashing his motorcycle into a telephone legs feel "funny and won't mov
pole. He is unconscious and in profound however, her spine x-rays do n
shock. He has no open wounds or obvious fracture or dislocation. A spina
fractures. this child:
The cause of his shock is MOST LIKELY is most likely a central cord
caused by: must be diagnosed by magnetic
a subdural hematoma. can be excluded by obtaining
an epidural hematoma. ent
a transected lumbar spinal cord.
may exist in the absence o
a transected cervical spinal cord. findings on x-ra
hemorrhage into the chest or abdomen.
is unlikely because of the
calcification of the verteb
8. 30-year-old man is struck by a car traveling 10. Immediate chest tube inserti
at 56 kph (35 mph). He has obvious fractures for which of the following cond
of the left tibia near the knee, pain in the Pneu
pelvic area, and severe dyspnea. His heart rate Pneumom
Massive h
is 180
Diaphragma
beats per minute, and his respiratory rate is 48 Subcutaneous e
breaths per minute with no breath sounds heard
in the left chest. A tension pneumothorax is
11. 18-year-old, helmeted motor
relieved by immediate needle decompression
brought by ambulance to the e
and tube thoracostomy. Subsequently, his heart
department following a high-sp
rate decreases to 140 beats per minute, his
Prehospital persormel report tha
respiratory rate decreases to 36 breaths per
15 meters (50 feet) off his bfice
minute, and his blood pressure is 80/50 inm Hg.
history of hypotension prior to
Warmed Ringer's lactate is administered
emergency department, but is n
intravenously. The next priority should be to:
perform a urethrogram and cystogram.
and conversational. Which of t
perform external fixation of the pelvis. statements is TRUE?
obtain abdominal and pelvic CT scans.
perform arterial embolization of the pelvic
vessels.
perform diagnostic peritoneal lavage or Cerebral perfiisio
, Intraabdominal visceral injuries are
defmitive treatment in managin
unlikely.
to:
The patient probably has an acute
administer 0-negat
epidural hematoma. apply extemal warm
control internal hemorrhage o
apply the pneumatic antishock
12. crosstable, lateral x-ray of the cervical infuse large volumes of in
spine: crystalloid
must precede endotracheal intubation.
excludes serious cervical spine injury. 16. To establish a diagnosis of sh
is an essential part of the primary survey. systolic blood pressure must be
is not necessary for unconscious patients
with penetrating cervical injuries. the presence of a closed head in
be
is unacceptable unless 7 cervical vertebrae
acidosis should be present by arte
and the C-7 to T-1 relationship are \ga
visualized. the patient must fail to r
intravenous fluid
clinical evidence of inadequ
13. During resuscitation, which one of the perfusion must be
following is the most reliable as a guide
to volume replacement?
17. Absence of breath sounds an
Pulse rate
Hematocrit
percussion over the left hemith
Blood pressure best explained by:
Urinary output
left hem
Jugular venous pressure
cardiac
left simple pneu
left diaphragmat
14. Which one of the following is the right tension pn
recommended method for initially
treating frostbite?
Vasodilators
18. 17-year-old helmeted motor
Anticoagulants broadside by an automobile at a
Warm (40°C) water
He is unconscious at the scene
Padding and elevation
pressure of 140/90 mm Hg, hea
Topical application of silvasulphadiazine
beats per minute, and respirator
breaths per minute. His respirat
15. young man sustains a gunshot wound to the sonorous and deep. His GCS sc
abdomen and is brought promptly to the Immobilization of the entire pa
emergency department by prehospital include the use of all the follow
personnel. His skin is cool and diaphoretic, and
he is confused. His pulse is thready and his
