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PHTLS 2

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When the application of kinetic energy to the body from either a blunt or penetrating mechanism displaces tissue, this is known as:
Cavitation
Which injury is MOST likely to be sustained by the driver in a lateral impact collision to the left side of the vehicle with no side impact airbags (assuming the driver sits on the left)?
a. Bilateral hip dislocation
b. Fracture of the right te
d
Which of the following best describes an injury caused by compression forces?
a. A knife blade penetrates the spleen, leaving a path of destruction through the tissue
b. A car falls from a jack onto a patient's chest, forcing blood backward fro
b
Approximately __ percent of occupants ejected from the vehicle in a collision sustain fatal injuries.
75
Which of the following is an example of a tertiary phase blast injury?
a. Crushing injury due to structural collapse
b. Shrapnel injuries
c. Pulmonary contusion
d. Exposure to radiation
a
Which of the following characteristics of a projectile is most critical in determining the amount of energy it can transfer to the body?
a. Tumble
b. Yaw
c. Velocity
d. Fragmentation
c
Which of the following characteristics is common in pedestrian-vehicle collisions in the adult population, but not in the pediatric population?
a. Head and face strike the front or hood of the vehicle
b. Pedestrian is thrown down and run over o
d
Which of the following is LEAST likely to affect the amount of energy transmitted to the body in a fall?
a. Height the patient falls from
b. Part of the body the patient lands on
c. Type of surface the patient lands on
d. The velocity
b
Most on-the-job injuries and deaths of EMS responders are the result of:
motor vehicle related incidents
The most common threat to life among trauma patients is:
Internal hemorrhage
Your patient is an injured construction worker bleeding profusely from a large laceration to the left thigh. He is confused and has pale, moist skin. Direct pressure applied to the wound by a first responder has failed to control the bleeding. The next s
A tourniquet proximal to the laceration
Your patient opens her eyes to loud verbal stimuli, gives confused answers to your questions, and slaps your hand away when you provide a painful stimulus. Her GCS is:
12
In an adult patient, a ventilatory rate of 30 or greater per minute is considered to be:
Abnormally fast
A trauma patient is orally intubated and the endotracheal (ET) tube is inserted to the 27 cm mark at the teeth. Breath sounds are absent on the left side of the chest. You should immediately:
Reposition the ET tube
Of the various methods for managing airway and ventilation, ____ has been shown to be superior in terms of patient survival after traumatic injury.
none
Recent studies demonstrate that EMS providers tend to make which of the following errors in managing critical patients?
a. Hypoventilation
b. Hyperventilation
c. Hypo-oxygenation
d. Hyperoxygenation
b
A patient with severe facial trauma and bleeding from a shotgun blast is sitting up and leaning forward on your arrival. The front of his face is essentially destroyed. The patient is maintaining his airway and has a respiratory rate of 24, GCS of 14. Of
b
Which of the following is most often indicated in the prehospital management of the trauma patient who needs an airway intervention?
a. Basic adjuncts
b. Dual lumen airway
c. Endotracheal tube
d. Needle cricothyrotomy
a
Minute volume of ventilation is best represented as ____________ multiplied by the ventilatory rate.
Tidal volume
Shock is best defined as:
widespread inadequate perfusion of the tissues
Regardless of the type of shock present, the underlying problem is:
Insufficient oxygen delivery to the cells
What percentage of blood volume loss in an adult patient is associated with findings of tachycardia (>120 beats/minute), tachypnea, (30-40 breaths/minute), and hypotension (systolic BP <90 mmHg)?
30 to 40
The most common type of shock in trauma patients is:
Hypovolemic
A male patient suffered a stab wound to his left flank. He is found to be in Class III shock. During the 25 minute transport to the trauma center, intravenous fluids should be administered at a rate sufficient to maintain a: _____________________________
Systolic blood pressure of 80 to 90
Hypotension due to spinal cord trauma occures due to interruption of the ___________ nervous system pathway.
Sympathetic
A fractured femur can result in ____________ mL of hemorrhage.
1000 to 2000
During pregnancy, signs and symptoms of shock may appear _____ due to a 48% ________ in maternal blood volume.
Later, increase
IV fluids administered to patients in shock should be ____ in order to ___________________.
warm, prevent hypothermia
The greatest threat to life from injury to a hollow abdominal organ is:
Peritonitis
PASG is contraindicated in patients with ____________.
Chest trauma
When administering isotonic crystalloid solution, about ________ will remain in the vascular system after 1 hour.
One-half
The most commonly fractured ribs are ribs:
4 through 8
A hemothorax s differentiated from a tension pneumothorax by:
Dull percussion on the affected side
Cardiac tamponade is suspected with the findings of muffled heart sounds, _______________________, and ___________, known as ____________.
jugular vein distension, hypotension; Beck's triad
Which of the following mechanisms is most likely to result in cardiac tamponade?
a. An unrestrained driver strikes the steering wheel woth his chest in a moderate speed impact
b. A baseball player is struck over the sternum in a collision with
d
Management of flail chest includes:
1. Stabilizing the flail segment by aping an IV bag over the injured area
2. Pain management
3. Ventilatory support
4. Lying the patient on the side of the flail segment to stabilize it
5. 100%
2, 3, 5
Hypotension in hemothorax is associated with:
The ability of each side of the thorax to hold up to 3 liters of blood
Which of the following is the most common cause of spinal injuries?
a. Falls
b. Sports injuries
c. Motor vehicle collisions
d. Penetrating trauma
c
Which of the following types of traumatic brain injury is most likely to be associated with hemorrhage from the middle meningeal artery?
a. Subdural hematoma
b. Epidural hematoma
c. Intracerebral hematoma
d. Subarachnoid hematoma
b
Which of the following groups of findings represents Cushing's phenomenom?
a. Unequal pupils, elevated blood pressure, bradycardia
b. Elevated blood pressure, distended jugular veins, bradycardia
c. Bradycardia, abnormal respiratory patter
c
Your patient is a 32 year old female who was thrown from a horse and struck her head on the ground. She was not wearing a helmet. She does not respond verbally or open her eyes to painful stimuli, but responds to painful stimuli with decerebrate posturin
16
The preferred fluid for resuscitation of a patient with significant burns is:
Lactated Ringer's solution
A burn with a reddened, glistening base that may have blisters is most characteristic of a ______ degree burn.
Second
Which of the following is indicated for the prehospital management of a circumferential second degree burn extending from the wrist to the elbow in a 70 kg patient?
1. IV Lactated Ringer's at 200 mL per hour
2. A wet, sterile dressing
3. A
2, 3
A chemical solution with a pH of 4.0 is considered an ____ and causes damage to the tissues via ____________________.
Acid, coagulation necrosis
An electrical burn caused by superheated air near the source of electricity is a/an ___ burn.
Arc
Your patient is an 82 year old female who was an unrestrained front seat passenger in a motor vehicle collision. Which of the following is the MOST reliable indication of shock in this patient?
a. Blood pressure
b. Capillary refill
c. Hear
d
Which of the following findings is NOT expected in assessment of a pregnant patient?
a. A decreased blood pressure in the third trimester
b. An increased heart rate in the third trimester
c. A decreased blood pressure in the second trimest
a
Which of the following is contraindicated in the management of a pregnant trauma patient in the third trimester?
a. PASG
b. Supine position
c. Short spinal immobilization device
d. Use of analgesia for isolated extremity trauma
b
During assessment of the trauma patient, ausculation of lung sounds is first performed duringa:
primary assessment

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