EMS Trauma & Life Support Procedures 2 — Questions and Answers
Question 1: A patient has a sucking chest wound. After sealing three sides of an occlusive dressing, the patient's condition deteriorates with decreased breath sounds on the affected side. What should you do?
- Apply a second occlusive dressing over the first
- Burp or temporarily open the dressing to release trapped air (Correct answer)
- Perform needle decompression immediately on the opposite side
- Increase oxygen flow and transport rapidly
Correct answer: Burp or temporarily open the dressing to release trapped air
Burping the dressing releases accumulated air that may be causing a tension pneumothorax under the seal.
Question 2: During extrication of a trauma patient, you note a deformity of the mid-shaft femur with significant swelling. Your priority intervention before moving the patient is:
- Apply a cold pack to reduce swelling
- Splint the femur in the position of deformity with traction
- Apply a traction splint to the injured extremity (Correct answer)
- Bandage the thigh circumferentially to control swelling
Correct answer: Apply a traction splint to the injured extremity
A traction splint is indicated for mid-shaft femur fractures to reduce pain, blood loss, and neurovascular compromise.
Question 3: You respond to a patient with a traumatic amputation of the right hand. After controlling hemorrhage, how should you manage the amputated part?
- Place it directly in ice water to preserve tissue
- Wrap it in a dry sterile dressing only, do not cool
- Wrap in moist sterile dressing, place in plastic bag, keep cool but not frozen (Correct answer)
- Discard it if more than 30 minutes have elapsed since amputation
Correct answer: Wrap in moist sterile dressing, place in plastic bag, keep cool but not frozen
The amputated part should be wrapped in moist sterile gauze, placed in a sealed plastic bag, and kept cool on ice to maximize reimplantation viability.
Question 4: A motorcyclist struck a guardrail is found unresponsive with helmet in place. When should you remove the helmet?
- Always remove immediately to assess airway
- Remove only if it prevents proper airway management or ventilation (Correct answer)
- Never remove in the field — wait for hospital staff
- Remove only after applying a cervical collar over the helmet
Correct answer: Remove only if it prevents proper airway management or ventilation
Helmet removal is indicated when it prevents adequate airway management, ventilation, or assessment, using a two-rescuer technique.
Question 5: When applying a tourniquet for severe extremity hemorrhage, which placement is correct?
- Directly over the wound to maximize compression
- 2–3 inches proximal to the wound, avoiding joints (Correct answer)
- As far proximally as possible, near the axilla or groin
- Over the joint proximal to the wound for best purchase
Correct answer: 2–3 inches proximal to the wound, avoiding joints
The tourniquet should be placed 2–3 inches proximal to the wound, avoiding placement over joints where it cannot generate adequate pressure.
Question 6: A patient presents with paradoxical chest wall movement affecting multiple rib segments on the left side. This finding is consistent with:
- Simple pneumothorax
- Hemothorax
- Flail chest (Correct answer)
- Tension pneumothorax
Correct answer: Flail chest
Flail chest occurs when three or more consecutive ribs are fractured in two or more places, causing a segment to move paradoxically with respiration.
Question 7: You are treating a patient with a suspected spinal injury who is combative and not following commands. The most appropriate spinal motion restriction approach is:
- Apply a rigid cervical collar and secure to a long backboard using standard strapping
- Forgo all spinal restriction since the patient won't cooperate
- Use manual in-line stabilization and apply what devices compliance allows (Correct answer)
- Sedate the patient with benzodiazepines before applying full spinal precautions
Correct answer: Use manual in-line stabilization and apply what devices compliance allows
Manual in-line stabilization should be maintained and spinal restriction applied to the extent the patient tolerates without causing additional harm.
EMS Trauma & Life Support Procedures 2
A patient has a sucking chest wound.
After sealing three sides of an occlusive dressing, the patient's condition deteriorates with decreased breath sounds on the affected side.
What should you do?