CEP Trauma Assessment & Prehospital Interventions 2 — Questions and Answers
Question 1: During a rapid trauma assessment, you find a 28-year-old male with a gunshot wound to the right chest showing decreased breath sounds and JVD. Which intervention takes priority?
- High-flow oxygen via NRB mask
- Needle decompression of the right chest (Correct answer)
- IV access and fluid resuscitation
- Spinal motion restriction
Correct answer: Needle decompression of the right chest
JVD with decreased unilateral breath sounds following penetrating chest trauma indicates tension pneumothorax requiring immediate needle decompression.
Question 2: A patient involved in a high-speed MVC has a GCS of 10, BP 88/60, HR 128, and an obviously deformed femur. What is the PRIMARY cause of hypotension in this patient?
- Neurogenic shock from spinal injury
- Hemorrhagic shock from femur fracture (Correct answer)
- Tension pneumothorax
- Cardiogenic shock from blunt cardiac injury
Correct answer: Hemorrhagic shock from femur fracture
A femur fracture can cause 1–2 liters of blood loss into the thigh, making hemorrhagic shock the most likely cause of hypotension in this mechanism.
Question 3: You are assessing an unconscious trauma patient. After opening the airway, you note absent breathing. What is your NEXT action?
- Check for a carotid pulse
- Begin 2 rescue breaths (Correct answer)
- Start CPR immediately
- Apply the AED
Correct answer: Begin 2 rescue breaths
Per PHTLS/AHA trauma protocols, after opening the airway in an apneic patient, provide 2 rescue breaths before moving to circulation assessment.
Question 4: Which of the following BEST describes the 'platinum ten minutes' concept in trauma care?
- Time limit for performing a detailed physical exam on scene
- Total prehospital time goal before transport for critical trauma patients (Correct answer)
- Maximum time to achieve IV access before transport
- Window for administering blood products in the field
Correct answer: Total prehospital time goal before transport for critical trauma patients
The platinum ten minutes refers to limiting total on-scene time to under 10 minutes for critical trauma patients to minimize time to definitive surgical care.
Question 5: A patient has an impaled object in the left eye. The correct prehospital management is to:
- Remove the object and apply a pressure dressing
- Stabilize the object in place and cover both eyes (Correct answer)
- Leave the object and cover only the injured eye
- Apply gentle pressure to the globe to control hemorrhage
Correct answer: Stabilize the object in place and cover both eyes
Impaled objects should be stabilized in place; covering both eyes prevents consensual movement, and removal risks vitreous extrusion.
Question 6: A trauma patient in hemorrhagic shock has no IV access after two attempts. What is the NEXT preferred vascular access route?
- Central venous access via subclavian vein
- Intraosseous access at the proximal tibia or humerus (Correct answer)
- Cutdown at the saphenous vein
- External jugular vein access
Correct answer: Intraosseous access at the proximal tibia or humerus
Intraosseous access is the preferred alternative to failed peripheral IV in critically injured patients due to speed and reliability.
Question 7: Which finding during a secondary assessment MOST suggests a diaphragmatic rupture?
- Tracheal deviation to the affected side
- Bowel sounds auscultated in the chest (Correct answer)
- Subcutaneous emphysema over the thorax
- Paradoxical chest wall movement
Correct answer: Bowel sounds auscultated in the chest
Auscultation of bowel sounds in the thoracic cavity indicates herniation of abdominal organs through a diaphragmatic tear.
CEP Trauma Assessment & Prehospital Interventions 2
During a rapid trauma assessment, you find a 28-year-old male with a gunshot wound to the right chest showing decreased breath sounds and JVD.
Which intervention takes priority?