FISDAP Trauma Management 2 — Questions and Answers
Question 1: A motorcyclist is found unresponsive after a high-speed crash. Which mechanism of injury pattern should alert you to potential spinal injury?
- Low-speed rear-end collision
- Ejection from the vehicle with unknown landing (Correct answer)
- Side-impact at less than 20 mph
- Rollover with seatbelt use
Correct answer: Ejection from the vehicle with unknown landing
Ejection from a vehicle is a high-risk mechanism because the patient can sustain significant deceleration forces and impact injuries to the spine.
Question 2: During a mass casualty incident, a patient with a femur fracture, open airway, and weak radial pulse is classified as which triage category using START?
- Black (expectant)
- Red (immediate)
- Yellow (delayed) (Correct answer)
- Green (minor)
Correct answer: Yellow (delayed)
In START triage, a patient who is walking or has a patent airway, adequate respirations, and a radial pulse with only a long-bone fracture is classified Yellow (delayed).
Question 3: You are managing a patient with suspected tension pneumothorax. After needle decompression in the 2nd intercostal space, midclavicular line, there is no improvement. What is your next action?
- Repeat the needle decompression at the same site
- Perform needle decompression at the 4th or 5th ICS, anterior axillary line (Correct answer)
- Immediately perform a surgical cricothyrotomy
- Administer IV fluid bolus and reassess
Correct answer: Perform needle decompression at the 4th or 5th ICS, anterior axillary line
If the first decompression fails, the second attempt should be performed at the 4th–5th intercostal space at the anterior axillary line, which may be more effective in obese or muscular patients.
Question 4: A patient sustains a crush injury to the forearm for 45 minutes. Upon extrication, which systemic complication is the highest priority concern?
- Hyponatremia
- Hyperkalemia causing cardiac dysrhythmia (Correct answer)
- Respiratory alkalosis
- Hypercalcemia
Correct answer: Hyperkalemia causing cardiac dysrhythmia
Crush syndrome releases intracellular potassium into the bloodstream, causing life-threatening hyperkalemia and potentially fatal cardiac dysrhythmias upon reperfusion.
Question 5: Which finding on assessment is MOST consistent with a cardiac tamponade after penetrating chest trauma?
- Tracheal deviation, absent breath sounds, JVD
- Hypotension, muffled heart tones, JVD (Beck's Triad) (Correct answer)
- Hypertension, bradycardia, irregular respirations
- Bilaterally equal breath sounds with hypotension and tracheal deviation
Correct answer: Hypotension, muffled heart tones, JVD (Beck's Triad)
Beck's Triad — hypotension, muffled heart tones, and jugular venous distension — is the classic presentation of cardiac tamponade.
Question 6: When applying a tourniquet for a traumatic amputation of the lower leg, where should it be placed?
- Directly over the amputation site
- 2–3 inches proximal to the wound, on the thigh (Correct answer)
- 2–3 inches proximal to the wound, above the knee
- At the groin crease
Correct answer: 2–3 inches proximal to the wound, on the thigh
Tourniquets should be placed 2–3 inches proximal to the wound; for lower leg amputations, this means placement on the thigh to occlude femoral blood flow.
Question 7: A patient with a GCS of 8 after blunt head trauma begins vomiting. What is the immediate priority?
- Administer ondansetron IV
- Protect the airway with suction and consider early intubation (Correct answer)
- Place the patient supine and elevate legs
- Apply a non-rebreather mask at 15 LPM and monitor
Correct answer: Protect the airway with suction and consider early intubation
A GCS of 8 or less indicates inability to protect the airway; vomiting in this setting dramatically increases aspiration risk, making airway management the immediate priority.
FISDAP Trauma Management 2
A motorcyclist is found unresponsive after a high-speed crash.
Which mechanism of injury pattern should alert you to potential spinal injury?