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During the CRASH 2 study (TXA use in the field), the trial group received TXA 1 g IV over 10 minutes. Your vial is 1000 mg in 3 ml, and you have a 100 cc bag available. How many drips per minute will you infuse using a 10 drop set? a. 3 b. 30 c. 100 d. 10 - โโc. 100 After the initial TXA infusion, they got a second dose of 1 g IV over eight hours. Your vial is 1000 mg in 3 ml, and you have a 100 cc bag available. How many drips per minute will you infuse using a 60 drop set? a. 480 b. 30 c. 18 d. 12.5 - โโ Which of the following acts resulted in the development of modern EMS systems? a. Good Samaritan Act b. The Trauma Care Systems Planning and Development Act of 1990 c. Highway Safety Act of 1966 d. Ryan White Act - โโc. Highway Safety Act of 1966 Which of the following is the best definition of the Golden Period, formerly known as the Golden Hour?
a. The ideal time it takes to assess a multi-system trauma patient. b. The ideal time from requesting a helicopter to it landing on scene. c. The ideal time frame from time of injury until surgery. d. The ideal time frame from call dispatch to arrival on scene. - โโc. The ideal time frame from time of injury until surgery. Which of the following mechanisms would yield the greatest index of suspicion for serious injury? a. Pedestrian struck by a car travelling 5 miles/hour. b. Seventy-mile-per-hour motor vehicle crash with partial ejection. c. Adult falling 5 feet from a ladder and landing in the mud. d. Helmeted bicyclist losing control and falling off his bike onto a grassy surface at 15 miles per hour. - โโb. Seventy-mile-per-hour motor vehicle crash with partial ejection. When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation? a. Increased urine output. b. Central hyperventilation syndrome. c. Hot, red skin. d. Cardiac arrhythmia. - โโd. Cardiac arrhythmia. Which of the following is NOT a complication of crush injury? a. Cardiac arrhythmias. b. Difficult-to-control hemorrhage. c. Renal failure. d. Systemic alkalosis. - โโd. Systemic alkalosis.
d. The body of the vehicle and its occupants absorb the energy. - โโd. The body of the vehicle and its occupants absorb the energy. Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a gun? a. Friction and distance. b. Velocity and mass. c. Mass and friction. d. Friction and velocity. - โโb. Velocity and mass. Which of the following injuries is associated with the pressure wave produced by a blast? a. Fractures. b. Ruptured spleen. c. Lacerated liver. d. Pneumothorax. - โโd. Pneumothorax. Which of the following is TRUE of the injuries sustained by the elderly due to falls? a. Less-significant falls may cause fractures. b. The elderly sustain injuries similar to other age groups in comparable falls. c. Only more significant falls cause fractures. d. The injuries sustained by the elderly are less likely to result in hospitalization. - โโa. Less-significant falls may cause fractures. Infants and very small children (up to two years of age) should have their child safety seat positioned where in a car? a. The front seating area, facing backward. b. The rear seating area, facing frontward.
c. The front seating area, facing frontward. d. The rear seating area, facing backward. - โโd. The rear seating area, facing backward. When the driver's chest strikes the steering wheel during a motor vehicle collision, what produces the next injury? a. Unsecured objects in the vehicle become projectiles. b. The steering column shears off, causing penetrating trauma. c. The heart continues its forward motion until it strikes the chest wall. d. The air bag deploys a second time. - โโc. The heart continues its forward motion until it strikes the chest wall. Which of the following mechanisms in a motor vehicle collision would MOST likely result in a tear of the liver at the ligamentum teres? a. Sudden deceleration. b. Gradual deceleration. c. Gradual acceleration. d. Sudden acceleration. - โโa. Sudden deceleration. You have responded to a soccer field on which two 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency department? a. Contusion to the thigh. b. Weakness in the upper extremities. c. Complaint of "getting the wind knocked out of me" d. Minor epistaxis. - โโb. Weakness in the upper extremities. The pathway of injury left in the wake of a penetrating mechanism of injury is called:
a. prevent injury from secondary impacts. b. absorb the energy exchange of rapid deceleration. c. prevent unrestrained occupants from taking the down-and-under pathway in frontal impacts. d. protect infants and children who ride in the front seat of the vehicle. - โโb. absorb the energy exchange of rapid deceleration. Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic shock? a. Administer isotonic crystalloid fluids only as necessary to maintain perfusion. b. Administer hypertonic saline solution or colloids at a keep-open rate. c. Administer synthetic oxygen-carrying fluids as necessary to increase the level of consciousness. d. Begin with a 2,000 mL bolus of isotonic crystalloid solution infused under pressure. - โโa. Administer isotonic crystalloid fluids only as necessary to maintain perfusion. Your patient is a 23-year-old man with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal stimuli; has pale, cool, diaphoretic skin; and has a heart rate of 128, respirations at 24, and a blood pressure of 82/60. These findings indicate which of the following kind of shock? a. Neurogenic. b. Decompensated. c. Irreversible. d. Compensated. - โโb. Decompensated. Which of the following is defined as the volume of blood ejected from the heart with each beat? a. output. b. Afterload. c. Stroke volume. d. Ventricular capacitance. - โโc. Stroke volume. Which of the following is the preferred in-hospital fluid for resuscitation in hemorrhagic shock?
a. Normal saline. b. Fresh frozen plasma. c. Lactated Ringer's d. Whole blood. - โโd. Whole blood. Which of the following mechanisms is responsible for accumulating lactic acid in shock? a. Gluconeogenesis. b. Anaerobic metabolism. c. Hemostasis. d. The citric acid cycle. - โโb. Anaerobic metabolism. Which of the following indicates that a patient has transitioned from compensated to decompensated shock? a. Peripheral vasoconstriction. b. Increased respiratory rate. c. Hypotension. d. Widening pulse pressure. - โโc. Hypotension. Which of the following fluids is appropriate for the prehospital management of hypovolemic shock? a. Lactated Ringer's b. Five percent dextrose in water. c. A 0.45% sodium chloride solution. d. A 0.2% sodium chloride solution. - โโa. Lactated Ringer's Which of the following would be the MOST likely cause of neurogenic shock?
b. hematochezia. c. hemorrhage. d. hematemesis. - โโb. hematochezia. You are called to a commercial creamery, where an employee got his arm trapped in the ice cream mixing machinery. You note that the skin has been pulled off his hand and arm from the mid forearm down. The patient's muscles, tendons, and bones are exposed. This type of injury is a(n): a. skinning injury. b. degloving injury. c. amputation. d. crush injury. - โโb. degloving injury. You have responded for an injured person at an address you know to be a motorcycle clubhouse. Your patient was attacked by another party with a broken beer bottle. Your patient has a large laceration on her neck with moderate bleeding. Which property of your dressing material is most important in caring for this patient? a. Occlusive. b. Adherent. c. Sterile. d. Absorbent. - โโa. Occlusive. The tough, fibrous sheaths that bundle skeletal muscle are called: a. tendons. b. fibers. c. sarcolemma. d. fascia. - โโd. fascia.
Which of the following is best described as the accumulation of a pocket of blood in the tissues? a. Hematoma. b. Contusion. c. Compartment syndrome. d. Abrasion. - โโa. Hematoma. The acute breakdown of muscle fibers in crushing injury is called: a. rouleaux formation. b. myoglobinemia. c. sarcoidosis. d. rhabdomyolysis. - โโd. rhabdomyolysis. You arrive on the scene of a patient with severe blunt trauma to the face. You hear gurgling as you approach the patient. After opening the airway with a manual maneuver, what should your next action be? a. Apply a cervical collar. b. Ventilate. c. Control the source of hemorrhage. d. Suction. - โโd. Suction. Which of the following are likely to accumulate in the bloodstream following a large crush injury? a. All of these. b. Myoglobin. c. Potassium. d. Lactic acid. - โโa. All of these.
a. a dry dressing covered by an adherent bandage. b. a sterile, wet dressing held in place with an elastic bandage. c. a bulky dressing held in place with adhesive strips. d. an occlusive bandage sealed on three sides and open on the fourth side. - โโd. an occlusive bandage sealed on three sides and open on the fourth side. Your patient is a three-year-old boy, who has struck his head on a concrete patio. He has a linear wound that penetrates the dermis and is approximately 2 cm long. This wound would be best described as a(n): a. laceration. b. puncture. c. avulsion. d. contusion. - โโa. laceration. You are reassessing the distal circulation on a patient's forearm that you have bandaged. The distal hand and wrist are cool to the touch and turning pale. The patient complains of numbness and tingling in that hand. What is your next course of action? a. Sling and swathe the arm to the chest and reassess the distal circulation. b. Loosen the bandage and see if that relieves the signs and symptoms. c. Keep the dressing and bandage in place and expedite transport. d. Administer pain medication to help relieve the symptoms. - โโb. Loosen the bandage and see if that relieves the signs and symptoms. A patient taking a beta blocker will likely be unable to increase their __________ to compensate for shock. a. pH b. heart rate c. blood volume
d. peripheral vascular resistance - โโb. heart rate You want to provide 250cc of fluid over 10 minutes to a minor trauma patient. Using a 10 drop set, how many drops per second will you need to count out? a. 42 b. 4 c. 250 d. 10 - โโb. 4
