Trauma Assessment Station 3A For Massachusetts Emt-Basic Practical Exam

Front 1

You have been dispatched to a scene where one patient has obvious trauma. What do you do first?

Back 1

"BSI, Scene safety"

Front 2

What happens after "BSI, Scene safety"?

Back 2

"Partner, maintain in-line spinal stabilization."

Front 3

What happens after "Partner, maintain in-line spinal stabilization?"

Back 3

Determine responsiveness AKA level of consciousness (using verbal, then painful stimulus)

Front 4

What happens after Determine responsiveness AKA level of consciousness?

Back 4

Assess airway and manage (jaw-thrust and suction).

Front 5

What happens after Assess airway and manage?

Back 5

Insert an oropharyngeal airway (O.P.A.) (Note steps 5 and 6 are reversed from the "state sheet".)

Front 6

What happens after Insert an oropharyngeal airway (O.P.A.)?

Back 6

Assess breathing (rate, rhythm, and quality).

Front 7

What happens after assess breathing?

Back 7

Initiate oxygen therapy (i.e., 15 liters per minute via a non-rebreather mask or a bag-valve-mask device).

Front 8

What happens after Initiate oxygen therapy?

Back 8

Manage breathing injuries, such as a flail chest or sucking chest wound.

Front 9

What happens after managing breathing injuries?

Back 9

Assess carotid pulse (rate, rhythm, and quality).

Front 10

What happens after assess carotid pulse?

Back 10

Assess and control major bleeding (using the cupping method, checking gloves each time).

Front 11

What happens after Assess and control major bleeding?

Back 11

Assess skin color, temperature, and condition.

Front 12

What happens after Assess skin color, temperature, and condition?

Back 12

Identify the patient as a priority and verbalize the transport decision (with ALS intercept).

Front 13

What happens after Identify the patient as a priority and verbalize the transport decision?

Back 13

Inspect & palpate the head for signs of injury: D-CAP-BTLS and crepitus.

Front 14

For what does D-CAP-BTLS stand?

Back 14

Deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, and swelling

Front 15

How does one determine tenderness in a patient who is not alert?

Back 15

Listen for groans and watch for facial grimace or other activity in response to a stimulus that is ordinarily not painful (such as palpation).

Front 16

What happens after Inspect & palpate the head for signs of injury?

Back 16

Inspect & palpate the neck for signs of injury: D-CAP-BTLS, spinal step-offs, crepitus, jugular vein distension, and tracheal deviation.

Front 17

What happens after Inspect & palpate the neck for signs of injury?

Back 17

Apply a cervical collar.

Front 18

What happens after applying a cervical collar?

Back 18

Inspect, palpate, and *auscultate* the chest for signs of injury (D-CAP-BTLS, crepitus, instability).

Front 19

Where does one auscultate lungs sounds in an adult?

Back 19

Bilaterally at the second (upper) intercostal space at each midclavicular line and bilaterally at the 4th or 5th intercostal space at each midaxillary line

Front 20

What happens after Inspect, palpate, and auscultate the chest for signs of injury?

Back 20

Inspect & palpate the abdomen for signs of injury: D-CAP-BTLS; find the navel, then roll the hand over each abdominal quadrant to assess tenderness, rigidity, and distension.

Front 21

What happens after Inspect & palpate the abdomen for signs of injury?

Back 21

Verbalize assessment of pelvis: compress pelvic (iliac) wings first medially (inward) and then posteriorly (toward the floor), noting instability and/or crepitus; inspect perineum for priapism and/or discharge

Front 22

What happens after Verbalize assessment of pelvis?

Back 22

Inspect and palpate all 4 extremities for signs of injury: D-CAP-BTLS, crepitus, instability.

Front 23

What happens after Inspect and palpate all 4 extremities for signs of injury?

Back 23

Logroll the patient onto your knees.

Front 24

What happens after Logroll the patient onto your knees?

Back 24

Assess posterior thorax & lumbar area for injuries and signs of injury: D-CAP-BTLS and crepitus

Front 25

What happens after Assess posterior thorax & lumbar area for injuries and signs of injury?

Back 25

Verbalize log rolling the patient onto a long spine board and securing them to it.

Front 26

What happens after Verbalize log rolling the patient onto a long spine board and securing them to it?

Back 26

Obtain [other] baseline vital signs: blood pressure and pupils. (Also check pulse, respirations, and skin in case you missed them earlier.)

Front 27

What happens after Obtain baseline vital signs?

Back 27

Obtain a SAMPLE history

Front 28

For what does SAMPLE stand?

Back 28

Signs and symptoms; Allergies; Medications; Past, pertinent medical history; Last oral intake; Events leading up to the illness or injury

Front 29

What happens after Obtain a SAMPLE history?

Back 29

Manage secondary injuries & wounds.

Front 30

What happens after Manage secondary injuries & wounds?

Back 30

Verbalize detailed physical exam.

Front 31

What happens after Verbalize detailed physical exam?

Back 31

Verbalize ongoing assessment and frequency.

Front 32

How often should one reassess an unstable patient?

Back 32

Every 5 minutes

Front 33

What happens after verbalize ongoing assessment?

Back 33

Nothing -- you are done.

Front 34

For what does BSI stand?

Back 34

Body substance isolation