When managing an open fracture, which of the following should you do?
Answer(s): A
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?
Answer(s): C
The most common spinal injury is injury to the cervical spine, but improper lifting techniques result in lumbar injuries. Common lumbar injures are bulging 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?
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?
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?
Epistaxis is a nosebleed. Having them tilt their head back could cause them to aspirate blood, become sick or vomit.
What are the signs and symptoms of shock?
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.
Answer(s): D
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 and torn ligaments. What type of injury does this patient have?
Answer(s): B
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.
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