EMT Basic Chapter 27

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. her bp is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

provide some form of positive-pressure ventilation

During your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:

stabilize the chest wall with a bulky dressing

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your assessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing

While jogging, a 19-year old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. your assessment reveals that he has diminished breath sounds over the left side of his chest.

administer oxygen and transport to the hospital

You are transporting a stable patient with a possible pneumothorax. The patient is receiving100% oxygen and has a saturation of 95%. During your reassessment, you find that the patient is confused, hypotensive, and diaphoretic. What is MOST likely causing

compression of the aorta and vena cava

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patent lying supine on the floor in the kitchen. She is semiconscious with severely labore

immediately request ALS support

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreed level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade:

engorged jugular veins

A 37-year old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway

A 28-year old male was struck in the chest with a baseball. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to 100% oxygen, you sho

prepare for immediate transport

A 19-year old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred:

ventricular fib. when the impact occurred during a critical portion of the cardiac cycle.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The pt. is unconscious , tachycardic, and

laceration of the aorta

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene

You are transporting a 42-year-old male who has abdominal trauma. H eis getting oxygen at 12L/min via nonrebreather. During reassessment you not that his LOC has decreased and his breaths became shallow. You should:

insert an airway adjunct of he will tolerate it and begin assisting his ventilations with a bag-mask device.

A 22-year old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His bp is 142/82 mm Hg, hi

transport him in the position in which you found him

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately,

closely monitor him and reassess him frequently

A 40-year old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:

giving him small sips of water

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and joint tenderness to the area. Your assessment reveals that there is a small amount of blood in his under ware. You sh

blunt injury to the kidney

A 54-year old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the a

applying direct pressure with a dry, sterile dressing

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his bp is 112/60 mm Hg. Which of the following qu

Have you experienced recent abdominal trauma

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note blood in her groin area, bp is 98/58, pulse is 130 beats/min, and re

control any external bleeding, administer oxygen, and transport at once

A 22-year old female was ejected from her car after striking a tree head-on. As you approach her, you not closed deformities to both femurs. She is not moving and in not conscious. You should:

stabilize her head and perform a primary assessment

During your rapid secondary assessment of a 19-year old female with multiple trauma, you note bilateral humoral deficiencies and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has app. managed

immobilizing her to a backboard and rapidly transporting

A 54-year-old male accidentally shot himself in the leg. Entrance wound is to the medial aspect of his right leg and exit wound is opposite to the leg and actively bleeding. Pt. complains of numbness and tingling in his right foot. You should:

control the bleeding and cover the wound with a sterile dressing

You have applied a zippered air splint to a pt.'s left arm. During transport, the pt. complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST app. action should be to:

assess the amount of air in the splint and let air out as necessary.

a 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to left femur. You should:

applying padded board splints to both sides of the leg

During your rapid secondary assessment of a 30-year old male who fell 25', you note crepitus when palpating his pelvis. your partner advises you that the pt.'s blood pressure is 80/50 mm Hg and his HR is 120 beats/min and weak. You should:

stabilize the pelvis with a pelvic binder and protect the spine

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His bp is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his reps. are 24 breaths/min and labored. You should:

apply high flow oxygen, consider spinal precautions, and transport without delay.

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal

immobilize the injury with a sling and swathe

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. he is holding his left arm in a fixed position away from his body. There is an obvio

assess distal pulse, motor, and sensory functions

A 31-year old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable. You transport hi

splint the elbow in the position found and transport

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is app. 40 min. You should:

apply gentle manual traction in line with the limb and reassess for a pulse

A 45-year old female was the unrestrained passenger of a small car that rear ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passeng

posterior hip dislocation

A 77-year old woman slipped and fell and landed on her hip. The leg is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:

place her into a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

A 30-year old male was rescued after being lost in the woods for app. 18 hour. The outside temp is 30 F. He is immediately placed in a awarded ambulance. He is unconscious and pale. You should:

assess a carotid pulse for up to 45 seconds

Your assessment of a 23-year-old female reveals a core body temp of 93.4. She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale and respirations is rapid. In addition to monitoring her ABC

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

You are transporting a 28-year old man with frostbitten foot. The patients vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transpor

protect the affected part from further injury

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for 3 hours. his pulse is weak and h

load him into the ambulance and begin rapid cooling interventions

You are dispatched to a local high school for a 16-year-old male who fainted. The outside temp. is 95 F. The pt is conscious and alert and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:

move him into the cooled ambulance

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

provide rescue breathing, remove wet clothes, immobilize spine,keep warm, transport carefully

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30'. On assessment, you note that he has cyanosis around his lips and has pink froth coming from hi

suction his mouth and nose, apply high flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a decompression facility.

You and your partner respond to a park where several people were reportedly struck by lightening. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second

assess the patient pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

You are assessing a 33-year old male who complains of severe abdominal, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Patients abdomen is rigid and painful to palpa

A black widow spider bite

While drinking, a 31-year old male was bitten by a snake. Patient is conscious and alert and in no obvious distress. You see two small puncture marks with minima swelling. In addition to giving oxygen, you should:

supine position, splinting the leg, and transporting.

You are dispatched to a residence for a young female who is sick. The patent complains of a rash to her lower extremities and truncal area. You see a small painful blister on her thigh. You should suspect:

Lyme disease

A 48-year old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:

irrigating the wound with vinegar and immersing his leg in hot water.