DCAS Trauma Management 2

Question 1

Traumatic brain injury (TBI) secondary injury is caused by:

Accepted Answer

Hypoxia, hypotension, hypercapnia, hyperthermia, and seizures after the initial impact

Answer

Secondary brain injury occurs after the initial impact through preventable physiological insults — hypoxia, hypotension, hypercapnia (vasodilatation increasing ICP), fever, and seizures — all of which paramedics can actively prevent.

Question 2

The classic Cushing's Triad, indicating raised intracranial pressure, consists of:

Accepted Answer

Hypertension (wide pulse pressure), bradycardia, and irregular respirations

Answer

Cushing's Triad is a late, ominous sign of severely raised ICP causing brainstem compression: hypertension with widened pulse pressure, reflex bradycardia, and irregular (Cheyne-Stokes) respirations — indicating imminent herniation.

Question 3

In traumatic cardiac arrest, which reversible cause should be addressed first?

Accepted Answer

Tension pneumothorax — bilateral thoracostomy should be performed immediately

Answer

Bilateral thoracostomy for presumed bilateral tension pneumothorax is the first priority in traumatic cardiac arrest as it is rapidly reversible in the field; tamponade may require resuscitative thoracotomy depending on the setting.

Question 4

Open chest wounds ('sucking chest wounds') are treated with:

Accepted Answer

3-sided occlusive dressing (or vented chest seal) to allow air out but not in

Answer

A 3-sided (or vented) dressing allows air to exit the pleural space during expiration while preventing air entrainment during inspiration, treating the open pneumothorax without converting it to a tension pneumothorax.

Question 5

The 'Zone of injury' concept in blast trauma describes:

Accepted Answer

Three zones: the blast wave (primary), projectile fragmentation (secondary), and thrown victim (tertiary)

Answer

Blast injuries are classified by mechanism: primary (blast overpressure wave — hollow organ injuries), secondary (fragmentation — penetrating injuries), tertiary (victim displacement — blunt trauma), and quaternary (burns, toxic inhalation).

DCAS Practice Test

DCAS Practice Test

DCAS Trauma Management 2