EFMB Medical Skills & Combat Medicine 2 — Questions and Answers
Question 1: When treating a casualty with a tension pneumothorax, where should you perform a needle chest decompression?
- 2nd intercostal space, midclavicular line (Correct answer)
- 4th intercostal space, midaxillary line
- 2nd intercostal space, midaxillary line
- 5th intercostal space, midclavicular line
Correct answer: 2nd intercostal space, midclavicular line
Needle decompression is performed at the 2nd intercostal space, midclavicular line, on the affected side.
Question 2: Which sign is NOT a classic indicator of tension pneumothorax in a combat casualty?
- Bradycardia (Correct answer)
- Absent breath sounds on affected side
- Tracheal deviation
- Jugular vein distension
Correct answer: Bradycardia
Tension pneumothorax classically causes tachycardia (not bradycardia), along with absent breath sounds, tracheal deviation away from the affected side, and JVD.
Question 3: A casualty has a sucking chest wound. After applying a vented chest seal, the casualty deteriorates with worsening respiratory distress. What is the next step?
- Burp or remove the chest seal and reassess (Correct answer)
- Apply a second chest seal over the first
- Initiate CPR immediately
- Administer supplemental oxygen only
Correct answer: Burp or remove the chest seal and reassess
If a casualty deteriorates after a chest seal is applied, a tension pneumothorax may be developing and the seal should be burped or removed to allow air to escape.
Question 4: What is the preferred airway adjunct for an unconscious combat casualty who has no gag reflex?
- Nasopharyngeal airway (NPA)
- Oropharyngeal airway (OPA) (Correct answer)
- Supraglottic airway device
- Nasal cannula
Correct answer: Oropharyngeal airway (OPA)
An oropharyngeal airway (OPA) is preferred for unconscious casualties without a gag reflex because it maintains an open airway without risk of stimulating vomiting.
Question 5: In TCCC, what does the mnemonic MARCH stand for?
- Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head injury (Correct answer)
- Movement, Assessment, Rescue, Compressions, Help
- Massive hemorrhage, Airway, Respiration, Casualty, Hydration
- Monitor, Airway, Respirations, Compressions, Hypothermia
Correct answer: Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head injury
MARCH stands for Massive hemorrhage, Airway, Respiration, Circulation, and Hypothermia/Head injury — the TCCC treatment priority sequence.
Question 6: A combat casualty has an amputation below the knee with uncontrolled hemorrhage. Where should you place the tourniquet?
- 2–3 inches above the amputation site (Correct answer)
- Directly over the wound
- 2–3 inches below the amputation site
- At the groin level
Correct answer: 2–3 inches above the amputation site
A tourniquet should be placed 2–3 inches proximal (above) the injury site to compress the vessels supplying blood to the wound.
Question 7: When using the Combat Gauze for wound packing, how long should direct pressure be held after packing?
- 3 minutes (Correct answer)
- 5 minutes
- 10 minutes
- 1 minute
Correct answer: 3 minutes
TCCC guidelines specify holding firm direct pressure for at least 3 minutes after packing a wound with Combat Gauze to allow the hemostatic agent to work.
EFMB Medical Skills & Combat Medicine 2
When treating a casualty with a tension pneumothorax, where should you perform a needle chest decompression?