BRAINSCAPE1
EFMB Written Exam with complete
solutions latest version
During debridement, extremity wounds should be extended _________. - CORRECT
ANSWER-Longitudinally
During debridement, truncal wounds should be extended _________. - CORRECT
ANSWER-Along Langer's Lines
Due to their heavy contamination and the diminished healing capacity, how long should
the closure of blast wounds be avoided after the injury occurs? - CORRECT ANSWER-
48 Hours
Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone
are essential to reduce the load of contamination and necrotic tissue prior to dressing
application. - CORRECT ANSWER-Hemostasis
All methods of wound irrigation are adjuncts and not substitutes to what? - CORRECT
ANSWER-Sharp Surgical Debridement
The current recommendation of irrigation volume for small wounds is: - CORRECT
ANSWER-1 - 3 Liters
The current recommendation of irrigation volume for moderate wounds is: - CORRECT
ANSWER-4 - 8 Liters
The current recommendation of irrigation volume for large wounds or wounds with
evidence of heavy contamination is: - CORRECT ANSWER-9 or More Liters
T/F: Normal saline, sterile water and potable tap water all have comparable efficacy and
safety as irrigation solutions. - CORRECT ANSWER-True
T/F: The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has
proven benefits. - CORRECT ANSWER-False
BRAINSCAPE1
, BRAINSCAPE1
What are risk factors of invasive fungal infections assessed for during the first wound
debridement? - CORRECT ANSWER-Dismounted Blast Injury, Above the Knee
Amputation, Extensive Perineal/Genitourniary/Rectal Injury, Massive transfusion of >20
units in the first 24 hours
T/F: All wounds must be closed prior to arrival at a definitive care location to prevent
further bacterial and fungal introduction. - CORRECT ANSWER-False
T/F: Placement of antibiotic impregnated polymethylmethacrylate (PMMA) can be used
as an adjunct to debridement and irrigation of a wound to deliver increased local
antibiotic concentrations while minimizing the associated side effects of high systemic
loads of these antibiotics. - CORRECT ANSWER-True
A(n) _________ event refers to an iatrogenic event in which a sponge or surgical
instrument is deliberately or unintentionally left behind while the wound proceeds to
definitive management. - CORRECT ANSWER-Retained Foreign Object (RFO)
Explosive munitions injure through how many major mechanisms? - CORRECT
ANSWER-Four
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - CORRECT
ANSWER-False
The symptoms of acoustic trauma are: - CORRECT ANSWER-Tinnitus, recruitment,
aural fullness, difficulty localizing sounds, difficulty hearing in a noisy background, and
vertigo.
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either
_____________or _____________. - CORRECT ANSWER-Temporary (temporary
threshold shift) or Permanent (permanent threshold shift).
The ear, specifically the _____________, is the most sensitive organ to primary blast
injury. - CORRECT ANSWER-Tympanic Membrane (TM)
T/F: The smaller the size of the tympanic membrane perforation, the greater the
likelihood is of spontaneous closure. - CORRECT ANSWER-True
The majority of tympanic membrane perforations that close spontaneously do so within
the first ___________ after injury - CORRECT ANSWER-8 Weeks
Acute management of intratemporal facial nerve injury is to provide objective
documentation of facial movement using the _____________ scale. - CORRECT
ANSWER-House-Brackmann
T/F: For significant facial pareses/paralyses, early administration of steroids must
always be provided regardless of contraindications. - CORRECT ANSWER-False
BRAINSCAPE1
, BRAINSCAPE1
All Service Members that develop symptoms consistent with noise trauma (acute
tinnitus, muffled hearing, fullness in the ear) should: - CORRECT ANSWER-Educated
and directed to self-report for evaluation and possible treatment as soon as is
practicable.
What is the best course of action if you find debris in the external auditory canal or in
the middle ear? - CORRECT ANSWER-Treat the patient with a fluoroquinolone and
steroid containing topical antibiotic.
Hearing loss that persists ___ hours after acoustic trauma warrants a hearing test or
audiogram - CORRECT ANSWER-72 Hours
T/F: Vestibular trauma to the inner ear may manifest in vertigo. - CORRECT ANSWER-
True
All patients with subjective hearing loss and tinnitus following blast exposure should: -
CORRECT ANSWER-Have the exposure documented and be evaluated by hearing test
as soon as possible.
Patients with TTS greater than ______ losses in three consecutive frequencies should
be considered candidates for high dose oral and/or transtympanic steroid injections
when not otherwise contraindicated. - CORRECT ANSWER-25 db
The initial radiographic evaluation of a trauma patient begins with supine
AnteriorPosterior (AP) chest and pelvis radiographs taken in the trauma bay usually with
a(n) _________________. - CORRECT ANSWER-Portable X-Ray Machine
T/F: Computed Tomography scanning has been largely replaced by cervical spine
radiographic evaluation (CSRE) and should only be performed when CSRE is
unavailable. - CORRECT ANSWER-False
What is the lowest level of care equipped with a Computed Tomography scanner? -
CORRECT ANSWER-Role 3
What is the lowest level of care equipped with a portable x-ray machine? - CORRECT
ANSWER-Role 2
Members of the trauma team should have _____ aprons and thyroid shields available
near the trauma bay for radiation safety. - CORRECT ANSWER-Lead
Distance is also protective from radiation exposure. If feasible based on the patient's
condition, any personnel without lead shielding should move a short distance away from
the x-ray unit. The recommended minimal distance is _____. - CORRECT ANSWER-6
Feet
While the FAST scan has been validated only in hemodynamically unstable blunt
trauma patients, it has become a standard tool in the trauma bay and Emergency
BRAINSCAPE1
EFMB Written Exam with complete
solutions latest version
During debridement, extremity wounds should be extended _________. - CORRECT
ANSWER-Longitudinally
During debridement, truncal wounds should be extended _________. - CORRECT
ANSWER-Along Langer's Lines
Due to their heavy contamination and the diminished healing capacity, how long should
the closure of blast wounds be avoided after the injury occurs? - CORRECT ANSWER-
48 Hours
Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone
are essential to reduce the load of contamination and necrotic tissue prior to dressing
application. - CORRECT ANSWER-Hemostasis
All methods of wound irrigation are adjuncts and not substitutes to what? - CORRECT
ANSWER-Sharp Surgical Debridement
The current recommendation of irrigation volume for small wounds is: - CORRECT
ANSWER-1 - 3 Liters
The current recommendation of irrigation volume for moderate wounds is: - CORRECT
ANSWER-4 - 8 Liters
The current recommendation of irrigation volume for large wounds or wounds with
evidence of heavy contamination is: - CORRECT ANSWER-9 or More Liters
T/F: Normal saline, sterile water and potable tap water all have comparable efficacy and
safety as irrigation solutions. - CORRECT ANSWER-True
T/F: The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has
proven benefits. - CORRECT ANSWER-False
BRAINSCAPE1
, BRAINSCAPE1
What are risk factors of invasive fungal infections assessed for during the first wound
debridement? - CORRECT ANSWER-Dismounted Blast Injury, Above the Knee
Amputation, Extensive Perineal/Genitourniary/Rectal Injury, Massive transfusion of >20
units in the first 24 hours
T/F: All wounds must be closed prior to arrival at a definitive care location to prevent
further bacterial and fungal introduction. - CORRECT ANSWER-False
T/F: Placement of antibiotic impregnated polymethylmethacrylate (PMMA) can be used
as an adjunct to debridement and irrigation of a wound to deliver increased local
antibiotic concentrations while minimizing the associated side effects of high systemic
loads of these antibiotics. - CORRECT ANSWER-True
A(n) _________ event refers to an iatrogenic event in which a sponge or surgical
instrument is deliberately or unintentionally left behind while the wound proceeds to
definitive management. - CORRECT ANSWER-Retained Foreign Object (RFO)
Explosive munitions injure through how many major mechanisms? - CORRECT
ANSWER-Four
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - CORRECT
ANSWER-False
The symptoms of acoustic trauma are: - CORRECT ANSWER-Tinnitus, recruitment,
aural fullness, difficulty localizing sounds, difficulty hearing in a noisy background, and
vertigo.
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either
_____________or _____________. - CORRECT ANSWER-Temporary (temporary
threshold shift) or Permanent (permanent threshold shift).
The ear, specifically the _____________, is the most sensitive organ to primary blast
injury. - CORRECT ANSWER-Tympanic Membrane (TM)
T/F: The smaller the size of the tympanic membrane perforation, the greater the
likelihood is of spontaneous closure. - CORRECT ANSWER-True
The majority of tympanic membrane perforations that close spontaneously do so within
the first ___________ after injury - CORRECT ANSWER-8 Weeks
Acute management of intratemporal facial nerve injury is to provide objective
documentation of facial movement using the _____________ scale. - CORRECT
ANSWER-House-Brackmann
T/F: For significant facial pareses/paralyses, early administration of steroids must
always be provided regardless of contraindications. - CORRECT ANSWER-False
BRAINSCAPE1
, BRAINSCAPE1
All Service Members that develop symptoms consistent with noise trauma (acute
tinnitus, muffled hearing, fullness in the ear) should: - CORRECT ANSWER-Educated
and directed to self-report for evaluation and possible treatment as soon as is
practicable.
What is the best course of action if you find debris in the external auditory canal or in
the middle ear? - CORRECT ANSWER-Treat the patient with a fluoroquinolone and
steroid containing topical antibiotic.
Hearing loss that persists ___ hours after acoustic trauma warrants a hearing test or
audiogram - CORRECT ANSWER-72 Hours
T/F: Vestibular trauma to the inner ear may manifest in vertigo. - CORRECT ANSWER-
True
All patients with subjective hearing loss and tinnitus following blast exposure should: -
CORRECT ANSWER-Have the exposure documented and be evaluated by hearing test
as soon as possible.
Patients with TTS greater than ______ losses in three consecutive frequencies should
be considered candidates for high dose oral and/or transtympanic steroid injections
when not otherwise contraindicated. - CORRECT ANSWER-25 db
The initial radiographic evaluation of a trauma patient begins with supine
AnteriorPosterior (AP) chest and pelvis radiographs taken in the trauma bay usually with
a(n) _________________. - CORRECT ANSWER-Portable X-Ray Machine
T/F: Computed Tomography scanning has been largely replaced by cervical spine
radiographic evaluation (CSRE) and should only be performed when CSRE is
unavailable. - CORRECT ANSWER-False
What is the lowest level of care equipped with a Computed Tomography scanner? -
CORRECT ANSWER-Role 3
What is the lowest level of care equipped with a portable x-ray machine? - CORRECT
ANSWER-Role 2
Members of the trauma team should have _____ aprons and thyroid shields available
near the trauma bay for radiation safety. - CORRECT ANSWER-Lead
Distance is also protective from radiation exposure. If feasible based on the patient's
condition, any personnel without lead shielding should move a short distance away from
the x-ray unit. The recommended minimal distance is _____. - CORRECT ANSWER-6
Feet
While the FAST scan has been validated only in hemodynamically unstable blunt
trauma patients, it has become a standard tool in the trauma bay and Emergency
BRAINSCAPE1
