EMD Trauma and Injury Scenarios 2 — Questions and Answers
Question 1: A caller reports a motorcyclist struck a guardrail at highway speed. The patient is unresponsive but breathing. What is the FIRST priority instruction for bystanders?
- Remove the helmet immediately to open the airway
- Do not move the patient unless there is immediate danger (Correct answer)
- Begin CPR compressions
- Elevate the patient's legs to prevent shock
Correct answer: Do not move the patient unless there is immediate danger
Spinal precautions require keeping the patient still unless there is an immediate life threat such as fire or traffic.
Question 2: During a call about a construction worker who fell 20 feet, the caller says the patient is conscious but cannot feel his legs. What should the EMD do?
- Advise the caller to sit the patient upright
- Dispatch and instruct callers to keep the patient completely still (Correct answer)
- Tell caller to apply a tourniquet to the lower extremities
- Ask caller to have the patient try to wiggle fingers
Correct answer: Dispatch and instruct callers to keep the patient completely still
Loss of sensation below the injury level signals possible spinal cord damage, requiring strict immobilization.
Question 3: A caller describes a patient with a large laceration that is 'spurting bright red blood' from the upper thigh. Which pre-arrival instruction is MOST appropriate?
- Apply a cold compress and elevate the leg
- Apply firm direct pressure immediately
- Instruct caller to apply a tourniquet 2 inches above the wound (Correct answer)
- Have the caller keep the patient talking and walking
Correct answer: Instruct caller to apply a tourniquet 2 inches above the wound
Spurting bright red blood from the thigh indicates arterial hemorrhage; a tourniquet is the recommended intervention for extremity arterial bleeding.
Question 4: A child is reported to have been struck by a vehicle while riding a bicycle. The caller says the child is crying and holding her arm. What additional information is MOST critical for dispatch?
- The child's age and weight
- Whether the child lost consciousness at any point (Correct answer)
- The make and model of the vehicle
- The child's vaccination history
Correct answer: Whether the child lost consciousness at any point
Loss of consciousness following a vehicle impact indicates potential traumatic brain injury and escalates the response priority.
Question 5: A caller reports a stabbing victim with a knife still embedded in the abdomen. What pre-arrival instruction should the EMD give?
- Advise the caller to carefully remove the knife
- Tell the caller to push the knife in deeper to control bleeding
- Instruct the caller NOT to remove the knife (Correct answer)
- Tell caller to apply a tourniquet around the abdomen
Correct answer: Instruct the caller NOT to remove the knife
Impaled objects should never be removed in the field because they may be tamponading a major vessel.
Question 6: A caller reports a patient crushed under a heavy machine for approximately 30 minutes. Rescuers are about to lift the machine. What hazard should the EMD warn responders about?
- Hypothermia from prolonged immobility
- Crush syndrome causing cardiac arrhythmias upon release (Correct answer)
- Air embolism from pressure release
- Immediate fracture of all long bones
Correct answer: Crush syndrome causing cardiac arrhythmias upon release
Releasing prolonged crush pressure can flood the bloodstream with myoglobin and potassium, causing life-threatening cardiac arrhythmias.
Question 7: A caller reports a patient with an open chest wound making a 'sucking' sound with each breath. What pre-arrival instruction is MOST appropriate?
- Have the patient breathe as deeply as possible
- Instruct caller to cover the wound with a gloved hand or occlusive material (Correct answer)
- Advise caller to apply firm compression to both sides of the chest
- Tell caller to have the patient cough forcefully
Correct answer: Instruct caller to cover the wound with a gloved hand or occlusive material
An occlusive dressing or gloved hand over a sucking chest wound helps prevent further air entry into the pleural space.
