Phtls

Front 1

A 55 year old man is found unconscious at the bottom of a 14 step concrete staircase. Assessment reveals snoring respirations, bradypnea,facial swelling, and unequal pupils. What action should the prehospital provider implement first?

Back 1

Jaw thrust maneuver

Front 2

Which assessment technique should be performed during the primary survey?

Back 2

Exposure of the patient

Front 3

Prehospital care providers approach a 29 year old male who fell 30 feet. Gurgling respirations are heard, cyanosis is displayed, and he has spurting blood from his right wrist. How should the provider manage the pt ?

Back 3

Provide C spine precautions, suction the airway, and control bleeding

Front 4

What is the most common cause of airway obstruction in the unconscious trauma pt ?

Back 4

tongue

Front 5

A 33 year old male was involved in a house fire and the primary survey reveals stridor, bradypnea, and soot around the nose/mouth. Multiple attempts at airway management have been unsuccessful, Which destination is most appropriate for this patient ?

Back 5

Community hospital (10 minutes away)

Front 6

A 28 year old female presents with dyspnea and chest pain after falling from a three story rooftop. She is coughing up copious amounts of blood, has decreased lung sounds on the left side, and has a faint radial pulse. What is the prehospital provider’s initial objective ?

Back 6

Controlling her airway

Front 7

What is the best method for confirming proper placement of an ET tube in a pt that has a palpable pulse ?

Back 7

End-tidal CP2 monitoring

Front 8

Overaggressive hyperventilation (assisted ventilations greater than 20 breaths per minute) of a pt with suspected traumatic brain injury is contraindicated because it results in?

Back 8

Decreased CO2 and cerebral vasoconstriction

Front 9

Prehospital providers are on the scene of a rollover motor vehicle crash(MVC) involving a 26 year old male. The pt moans to painful stimuli,exhibits unequal chest rise , and has decreased lung sounds on the left side. Of the following, what is the highest treatment priority ?

Back 9

Opening and maintaining an airway

Front 10

A pt with unexplainable signs of shock is likely experiencing hemorrhage from which of the following ?

Back 10

Intra-abdominal injury

Front 11

What is the most common type of shock experienced by trauma patients?

Back 11

Hypovolemic

Front 12

A 39 year old male presents with chest pain and increasing dyspnea after being stabbed in the right anterior chest just above the nipple. His pulse is 112, respirations 28, and BP88/64. There are absent lung sounds on the right side with palpable SQ emphysema. What is the most appropriate treatment?

Back 12

Needle decompression

Front 13

Prehospital providers respond to a a 30 year old male who fell through a sliding glass door. The pt has suffered multiple lacerations to the upper extremities that are bleeding heavily. He is restless, diaphoretic,and with a weak thread pulse. What is the most appropriate treatment ?

Back 13

Direct pressure

Front 14

Which of the following pts should be considered the highest priority for treatment and transport ?

Back 14

A 74 year old pedestrian who was struck by a vehicle, has a pulse of 92, and takes a beta blocker on a regular basis

Front 15

A 19 year old male was stabbed in the abdomen several times with a knife and presents with abnormal vital signs. After application of high flow O2 and a bolus of IV crystalloid, vital signs are within normal limits. He is now likely in which stage of shock ?

Back 15

Compensated

Front 16

Which of the following organs is the most sensitive to hypoxia ?

Back 16

Brain

Front 17

Which of the following best describes shock ?

Back 17

Inadequate energy production at the cellular level

Front 18

A 24 year old male is found motionless on the side of the road after being struck by a vehicle. As prehospital care providers approach the pt, they notice He is lying in a puddle of blood and breathing is absent. What action should be taken first?

Back 18

Airway and C-spine management

Front 19

At what point does the prehospital provider’s assessment begin ?

Back 19

Before arriving at the scene

Front 20

In which situation should the prehospital provider consider termination cardiopulmonary resuscitation for traumatic arrest?

Back 20

15 minutes of unsuccessful resuscitative efforts

Front 21

A 24 year old male presents with AMS after shoveling rock on a hot summers day. He is confused , has dry skin, and his behavior is confused and erratic. He will not allow the provider to touch him and is shivering. Which condition is the patient likely suffering?

Back 21

Heat stroke

Front 22

Prehospital providers are assessing an 82 year old male who fell out of bed two weeks ago. He has had increasing difficulty speaking, irritability, weakness, and a drastic change in his ability to walk. He is most likely experiencing which of the following?

Back 22

subdural hematoma

Front 23

After falling out of the second story window, a 7 year old male is found unconscious with unequal pupils and irregular respirations. Which of the following is the most appropriate rate of ventilation?

Back 23

25 BPM

Front 24

A construction worker fell from a 3 story building, lading in his head and upper torso. Upon assessment, prehospital providers discover a large amount of blood coming from one ear canal. Which of the following is the most appropriate action?

Back 24

Allow the blood to collect in a loosely applied dressing

Front 25

Prehospital providers are treating an unconscious patient with irregular respirations who was ejected from a motor vehicle. No obvious external injuries are noted during the initial assessment. Vital signs are HR 54, Sp)2 94% and BP 182/112. These findings are most consistent with which of the following injuries?

Back 25

Closed head injury

Front 26

A temporal bone fracture of the skull will commonly cause what type of intracranial hemorrhage?

Back 26

Epidural hematoma

Front 27

Prehospital providers respond to an 18 year old female who lost consciousness after striking her head during a MVC. The pt is alert and oriented and complaining of headache and nausea. During the secondary survey, the pt becomes confused and difficult to arouse. What type of injury should be suspected?

Back 27

Epidural hematoma

Front 28

What changes in vital signs suggest increasing intracranial pressure?

Back 28

Increased blood pressure, decreased pulse rate

Front 29

After being tackled, a football player has lost sensation from the umbilicus down. What area of the spine should prehospital providers suspect is injured?

Back 29

T10

Front 30

What is the most important physical finding in a pediatric pt with a potential traumatic brain injury?

Back 30

Abnormal level of consciousness

Front 31

Prehospital providers discover CSF fluid draining from a pt’s nose and ears. This finding is most commonly associated with which type of skull fracture?

Back 31

Basilar

Front 32

Prehospital providers respond to a male pt lying supine on the ground with a single gunshot wound to the left temple. The pt is apneic and pulseless. What is the most appropriate action?

Back 32

Declare the Pt dead

Front 33

Prehospital providers are treating an adult female who spilled a small cup of hot coffee and sustained partial thickness burns to the front of her abdomen and right leg. The pt ran cool water over her burns to help relieve the pain. Which of the following interventions is the most appropriate next step?

Back 33

Cover burned area with dry sterile dressing

Front 34

Which of the following medication classes could mask the signs of internal bleeding in an elderly pt?

Back 34

Beta blockers

Front 35

A full time pregnant is being spinally immobilized after a MVC. Afterplacing her in the ambulance, vital signs reveal a BP of 88/64. What is the most appropriate next step?

Back 35

Immobilize the pt on the backboard and tilt the backboard to the left side

Front 36

Prehospital providers are on the scene of a multiple-casualty incident. Upon assessment of a patient’s airway, the provider does not hear any sounds. What is the appropriate next step?

Back 36

position the airway

Front 37

Prehospital providers have placed an occlusive dressing over a sucking chest wound. During txpt to the hospital, respiratory distress, increased respirations, and absent lung sounds are noted. What is the most appropriate next intervention?

Back 37

Remove the occlusive dressing

Front 38

Prehospital providers are assessing a patient who has been kicked inthe ribs by a mule. Instability of the involved ribs is noted. The patient is breathing rapidly and will not take deep breaths. Which of the following is the most likely injury?

Back 38

Flail chest

Front 39

A tension pneumo is different from a simple pneumo by which sign?

Back 39

Hemodynamic compromise/hypotension

Front 40

Prehospital providers are on scene with a 32 year old male with a small caliber gunshot wound just above his left nipple. The patient is anxious, tachypneic, and has a weak thread pulse. Lung sounds are absent on the injured side. Which of the following interventions is most appropriate?

Back 40

Needle decompression of injured side

Front 41

While monitoring a patient with a flail chest segment, which of the following is the earliest sign of deterioration?

Back 41

respiratory rate increase

Front 42

A 17 year old female was found unresponsive on the grounf after falling from a 2nd story balcony. The pt is pale, cool, and clammy. Which of the following is the most appropriate initial action?

Back 42

Ensure a patent airway

Front 43

Upon arrival to a MVC, prehospital providers locate a male patient lying on the ground with an obvious left femur fracture. Which of the following is the most appropriate first step?

Back 43

Initiate cervical spine precautions

Front 44

A 34 year old male was lying supine on the ground when a large amount of steel rod fell onto his chest. The patient is complaining of shortness of breath and respiratory discomfort and has a bluish skin discoloration from the site of injury upward. What injury should be suspected?

Back 44

Traumatic asphyxia

Front 45

What is the most common cause for traumatic death in patients over 75 years of age?

Back 45

Falls

Front 46

Prehospital providers are treating a victim of a MVC who has obvious bilateral midshaft femur fractures, a right humorous fracture, and left wrist deformity. What is the most appropriate on scene treatment for this patient?

Back 46

Provide immobilization on a backboard

Front 47

Prehospital providers arrive on a scene and find a pediatric pt immobilized on a LBB. Upon assessment they note that the patient’s head is in a flexed position. Which of the following if the most appropriate action?

Back 47

Place padding under the torso

Front 48

During the physical examination of a trauma pt, the prehospital provider pushes down on the sides of the pelvis and discovers crepitus. How should the prehospital provider proceed?

Back 48

Immediately stop any further pelvic assessment

Front 49

Which of the following motor responses is indicative of the most severe traumatic brain injury?

Back 49

Decerabrate posturing

Front 50

Prehospital providers have arrived on scene of a 23 year old male patient with a GSW to the left midaxillary line even with the nipple. The wound is bleeding slightly. What is the first step in patient care that should take place?

Back 50

Open and assess the airway