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En route to the hospital, you intubate the patient.

During your assessment of tube


placement, you hear wheezing in the upper lung fields. What is most likely causing
this wheezing?
Your answer of Inhalation induced asthma attack was incorrect.
Correct answer is: Inhalation injury to the lower airway
An inhalation injury inferior to the glottis can result in wheezing and bronchospasm.
An inhalation injury superior to the glottis can cause a hoarse voice and stridor.
Inhalation of the byproducts of combustion can cause wheezing but this would still
be classified as an inhalation injury to the lower airway.
Following the immobilization of an extremity fracture to the lower right arm, the
paramedic should perform what step last?
Your answer of Ensuring the splint is applied tightly. was incorrect.
Correct answer is: Assessing presence of distal motor, sensory, and perfusion.
The last part of immobilizing the arm fracture (or any suspected fracture for that
matter), is the assessment of distal motor, sensory, and perfusion status. This is
done to assure there was no additional trauma from the immobilization process, and
to assure the splint was not put on incorrectly (for example an air splint inflated too
high). If there is a loss in the motor, sensory, perfusion findings following
immobilization, the paramedic should immediately reassess the splinting process
and correct any errors.
Please answer the following question.
Your answer of Hemothorax was incorrect.
Correct answer is: Pericardial tamponade
Pericardial tamponade causes decreased cardiac output as seen by pale skin and
hypotension. In addition, jugular vein distention may seen along with a narrowed
pulse pressure. Other signs and symptoms include tachycardia, respiratory
difficulties, and cyanosis of the face, neck, and arms. With tension pneumothorax or
a significant hemothorax, decreased or absent breath sounds will be present.
Please answer the following question.
Your answer of High flow oxygen by nonrebreather, spinal precautions, allow patient
to remain in a position of comfort. was incorrect.
Correct answer is: High flow oxygen, spinal precautions, occlusive dressing over
entrance wound, rapid transport.
Treatment of a gunshot wound to the thorax would include taking necessary spinal
precautions. The open wound should be covered with an occlusive dressing. The
respiratory distress should be treated with high flow oxygen with consideration of
positive pressure ventilation and possible intubation. In addition, an IV should be
started for a fluid route if hypotension worsens. Rapid transport is indicated for
pericardiocentesis and possible surgery.
Please answer the following question.
Your answer of Application of padded board splints was incorrect.
Correct answer is: Secure to a backboard and pad appropriately
The patient with a femur fracture should be secured to a backboard and padded
appropriately. Inflating both leg sections of the PASG is not indicated for this patient.
e femur while helping to tamponade any blood loss. Traction splinting is only
appropriate if the femur fracture is mid shaft. Padded board splints will not provide

sufficient stabilization.
Please answer the following question.
Your answer of was incorrect.
Correct answer is: Continue applying direct pressure to the wound and call for ALS
support.
Direct pressure and fluids are this patient's best chance for survival and prevention
of decompensated shock. ALS should be activated to administer fluids as soon as
possible.
Which of the following is an early, and the most prominent, finding in a crush injury?
Your answer of was incorrect.
Correct answer is: Pain
Pain is generally the most obvious sign of a crush injury and tends to present
earliest out of all of the other associated signs and symptoms.
Please answer the following question.
Your answer of was incorrect.
Correct answer is: Full thickness
The patient is most likely experiencing a full thickness burn with disruption of the
soft tissue through the nerve root. They are typically painless, with the exception of
the penumbra, because of the lack of nerve stimulation.
Please answer the following question.
Your answer of was incorrect.
Correct answer is: Orally intubate the patient and assist ventilations with a BagValve-Mask.
This patient has an unstable face and an unstable airway. Ultimately, this patient
needs to have his airway protected as quickly as possible with an endotracheal
tube. With facial instability, it is imperative that an adjunct be placed to ensure that
the airway is not occluded by the pressure on the jaw created with the application of
the Bag-Valve-Mask.
When managing an open fracture, you should do which of the following?
Your answer of was incorrect.
Correct answer is: Cover the exposed bone ends with a moist sterile dressing.
When bone is exposed, care must be taken to prevent further injury and infection. A
good rule of thumb for the use of moist, sterile dressings is as follow: If the
protruding part is normally on the inside of the body, cover it with a moist sterile
dressing. Do not attempt to reinsert or reduce the exposed bone back into the body.
What is the most common spinal injury associated with improper lifting techniques?
Your answer of was incorrect.
Correct answer is: Lumbar
The most common spinal injury is injury to the cervical spine, but improper lifting
techniques result in lumbar injuries. Common lumbar injures are buldging and/or
compressed vertebra. You must remember to lift with your legs and knees and not
your back.
You respond to the scene of a residential natural gas explosion to find a 36-year-old

male patient complaining of a diminished ability to hear, moderate dyspnea, and


acute abdominal pain. These symptoms are likely due to what mechanism?
Your answer of was incorrect.
Correct answer is: Primary blast injury
Primary Blast Injuries are caused by the compression of air filled organs by an
overpressure wave, typically affecting the tympanic membranes, lungs, stomach,
intestines, and sinuses. Toxic Exposure to Natural Gas may cause nausea, diarrhea,
dizziness, headache, and labored breathing, but would not explain diminished
hearing or acute abdominal pain. Secondary Blast Injury refers to trauma caused by
flying shrapnel or debris, while Tertiary Blast Injury refers to trauma caused when a
patient is thrown from the blast area and strikes an object or the ground.
While assessing the carotid and radial pulse in your unresponsive patient, you
determine that the carotid pulse is weak and rapid, and the peripheral pulses are
absent. What other clinical assessment finding would you expect to be present?
Your answer of was incorrect.
Correct answer is: Cool and pale skin
Checking the central and peripheral pulses in the unresponsive patient will give the
paramedic a rough estimate of peripheral perfusion. In this instance, where there is
no peripheral pulse and a weak central pulse, the inference can be made that there
is poor peripheral perfusion. Another expected finding in this patient then would be
cool and pale skin from the diminished peripheral blood flow.
Your patient is suffering from Epistaxis. How should you proceed.
Your answer of was incorrect.
Correct answer is: Pinch the nostrils and have the patient lean forward
Epistaxis is a nosebleed. Having them tilt there head back could cause them to
aspirate blood, become sick or vomit.
What are the signs and symptoms of shock
Your answer of was incorrect.
Correct answer is: Increased heart rate, increased respirations, hypotension
Early signs of shock are Increased heart rate and respirations. The patient may also
have pale, cool and clammy skin and show signs go hypoxia. Later stages of shock
will include a drop in blood pressure.
Your patient is a 22 year old male with an object impaled in the right side of his
chest, just below the shoulder. After assessing that the object is not blocking his
airway, what is the best course of action for this patient.
Your answer of was incorrect.
Correct answer is: Stabilize the object in place, control the bleeding and transport
The only time you want to remove an impaling object is when it is obstructing the
airway, as doing so may cause uncontrolled bleeding and even death. Cutting the
object will cause the object to move and could result in further injury.
Your patient has an injury that consists of overstretched & torn ligaments. What
type of injury does this patient have?
Your answer of Dislocation was incorrect.
Correct answer is: Sprain

In a pre-hospital setting, you would treat all of the above injuries the same, but this
particular injury is a sprain. Sprains occur to the ligaments, dislocations are in the
joint, fractures are bone related, and strains are muscle injuries.
What is the best treatment for a suspected fracture of the talus bone?
Your answer of was incorrect.
Correct answer is: Splint the ankle, apply ice, and elevate
The Talus bone is located at the top of the foot and rests between the tibia, fibula,
calcaneus, and navicular. In this instance, you want to splint the ankle in order to
immobilize it, ice it to reduce swelling, and elevate.
When dealing with a patient who has suffered an injury to the back of his head,
what part of the brain you should suspect will be affected?
Your answer of was incorrect.
Correct answer is: Occipital
The Occipital region of the brain is located in the posterior (rear) area of the brain
and is the most likely to be injured by trauma to the back of the head.
Your patient is a 34-year old male with a large laceration to the abdomen, and the
abdominal organs are protruding from the wound. What is this type of injury called?
Your answer of was incorrect.
Correct answer is: Evisceration
An evisceration is the removal or protrusion of the internal organs.
What is the best way to handle an amputated extremity?
Your answer of was incorrect.
Correct answer is: Wrap it in sterile dressings and keep it cool with ice
You want to wrap in sterile dressing to prevent infection and keep it cool with ice.
You never want to place the part directly on ice, this could cause it to freeze or
become frostbitten. The care given to the patient, and the amputated part, are
critical in the success of reattachment.
You are transporting a trauma patient, and notice their condition starts to
deteriorate. What do you do?
Your answer of was incorrect.
Correct answer is: Reassess your patient
Any time you have a patient whose condition worsens, you should always reassess
them.
You are transporting an unconscious patient. How often should you check their
vitals?
Your answer of was incorrect.
Correct answer is: 5 minutes
When transporting an unconscious patient you should check their vitals every 5
minutes.
What is the mnemonic for determining level of consciousness?
Your answer of was incorrect.
Correct answer is: AVPU
AVPU stands for Alert, responds to Verbal stimulus, responds to Painful stimulus, and

Unresponsive.
Your patient is a 16-year old male, who fell approximately 15 feet. This call should
be considered:
Your answer of was incorrect.
Correct answer is: Not a significant mechanism of injury
At the age of 16, medically, this patient is considered an adult and therefore, a fall
less than 20 feet in height is not considered a significant mechanism of injury.
A fall greater than ______ would be considered a significant mechanism of injury in a
patient under the age of 8.
Your answer of was incorrect.
Correct answer is: 10 feet
The best answer is 10 feet. Though depending on the height of the patient, double
their height may be greater than 10 feet, the correct answer is anything over 10
feet.
You are called to the scene of pedestrian thats been struck by a car. Upon
examination, you notice clear fluid leaking from the patients ear, that you believe
to be cerebral spinal fluid. This tells you the patient may have suffered a:
Your answer of was incorrect.
Correct answer is: Severe head injury
While the patient may be suffering from a basilar skull fracture, you are not able to
determine that in the field. The best answer is a severe head injury.
What does PMS stand for during your assessment of a patients lower extremity?
Your answer of was incorrect.
Correct answer is: Pulse, Motor function, Sensation
PMS stands for Pulse, Motor function, Sensation. It is especially to asses for PMS
after splinting an extremity.