CEP Trauma Assessment & Prehospital Interventions 3 — Questions and Answers
Question 1: When applying a tourniquet for extremity hemorrhage control, it should be placed:
- Directly over the wound
- 2–3 inches proximal to the wound (Correct answer)
- At the most proximal point of the limb
- Over a joint for best compression
Correct answer: 2–3 inches proximal to the wound
Tourniquets are placed 2–3 inches proximal to the wound over long bone, avoiding joints, to effectively compress the artery.
Question 2: A 45-year-old restrained driver has an airbag deployment and complains of chest pain and dyspnea. Vitals: BP 100/70, HR 110, SpO2 93%. Lung sounds are equal. The MOST likely diagnosis is:
- Tension pneumothorax
- Pulmonary contusion (Correct answer)
- Hemothorax
- Aortic dissection
Correct answer: Pulmonary contusion
Blunt anterior chest trauma from airbag/steering wheel impact with hypoxia and equal lung sounds is classic for pulmonary contusion.
Question 3: In a pediatric trauma patient, which vital sign abnormality is MOST concerning for decompensated shock?
- Heart rate of 120 bpm
- Respiratory rate of 24 per minute
- Systolic BP below 70 mmHg + (2 × age in years) (Correct answer)
- Capillary refill of 2 seconds
Correct answer: Systolic BP below 70 mmHg + (2 × age in years)
Hypotension by pediatric formula (70 + 2×age) indicates decompensated shock, as children maintain BP until losing 25–30% of blood volume.
Question 4: Which mechanism of injury MOST warrants spinal motion restriction in a trauma patient?
- Low-speed rear-end collision with neck stiffness only
- Fall from greater than 3 times the patient's height (Correct answer)
- Sports injury with isolated limb pain
- Penetrating trauma to the extremity
Correct answer: Fall from greater than 3 times the patient's height
High-energy mechanisms such as falls from significant heights are associated with spinal injuries requiring motion restriction.
Question 5: A patient with a suspected pelvic fracture is hypotensive. Which prehospital intervention is MOST appropriate?
- Aggressive fluid resuscitation with 2L normal saline
- Application of a commercial pelvic binder or sheet wrap (Correct answer)
- Bilateral traction splints
- Foley catheter placement to assess urine output
Correct answer: Application of a commercial pelvic binder or sheet wrap
A pelvic binder reduces pelvic volume and tamponades venous bleeding, making it the priority intervention before fluid administration.
Question 6: You respond to a motorcycle crash. The patient has road rash covering 30% BSA with minimal bleeding, a GCS of 15, and stable vitals. Transport priority is:
- Immediate (load and go)
- Delayed (stay and play for wound care)
- Urgent with ALS intercept
- Non-urgent with BLS transport (Correct answer)
Correct answer: Non-urgent with BLS transport
Stable vitals, intact mentation, and superficial injuries without significant hemorrhage classify this patient as non-urgent.
Question 7: Beck's triad (hypotension, JVD, muffled heart sounds) is associated with which traumatic condition?
- Tension pneumothorax
- Massive hemothorax
- Cardiac tamponade (Correct answer)
- Myocardial contusion
Correct answer: Cardiac tamponade
Beck's triad is the classic presentation of cardiac tamponade caused by fluid accumulation in the pericardial sac compressing the heart.
CEP Trauma Assessment & Prehospital Interventions 3
When applying a tourniquet for extremity hemorrhage control, it should be placed: