FISDAP Trauma Management 3 — Questions and Answers
Question 1: A 28-year-old male sustains a stab wound to the right upper quadrant. Which organ is MOST likely injured?
- Spleen
- Stomach
- Liver (Correct answer)
- Descending colon
Correct answer: Liver
The liver occupies most of the right upper quadrant and is the most commonly injured solid organ in penetrating abdominal trauma to that region.
Question 2: During spinal motion restriction of a standing patient with suspected cervical spine injury, which sequence is correct?
- Apply cervical collar, move to long board, apply head immobilizer (Correct answer)
- Move to long board, then apply cervical collar and head immobilizer
- Apply head immobilizer first, then cervical collar, then move to board
- Secure torso to board first, then apply cervical collar
Correct answer: Apply cervical collar, move to long board, apply head immobilizer
The correct sequence is to apply the cervical collar first to stabilize the cervical spine, then transfer to the long board, and finally apply the head immobilizer.
Question 3: A trauma patient has an SpO2 of 88% despite a high-flow non-rebreather mask. You suspect a tension pneumothorax. Which assessment finding would BEST confirm this?
- Bilateral equal breath sounds and normal tracheal position
- Absent breath sounds on one side with tracheal deviation away from that side (Correct answer)
- Crackles bilaterally with JVD
- Diminished sounds bilaterally with hypotension
Correct answer: Absent breath sounds on one side with tracheal deviation away from that side
Absent unilateral breath sounds with tracheal deviation away from the affected side is the classic presentation of tension pneumothorax, indicating mediastinal shift from air accumulation.
Question 4: Which type of hemorrhage is characterized by dark red blood that flows steadily and does not pulsate?
- Arterial hemorrhage
- Venous hemorrhage (Correct answer)
- Capillary hemorrhage
- Occult hemorrhage
Correct answer: Venous hemorrhage
Venous blood is dark red and flows steadily due to lower pressure in veins, unlike arterial hemorrhage which is bright red and pulsatile.
Question 5: A patient in Class III hemorrhagic shock (30–40% blood loss) will MOST likely present with which combination of findings?
- Normal HR, normal BP, anxious
- HR >120, decreased BP, confused, decreased urine output (Correct answer)
- HR <60, hypertension, altered mentation
- HR 90–100, normal BP, mildly anxious
Correct answer: HR >120, decreased BP, confused, decreased urine output
Class III shock (30–40% blood loss) produces tachycardia over 120, decreased blood pressure, confusion, and markedly decreased urine output due to severe volume loss.
Question 6: An impaled object is found in a patient's left chest. What is the appropriate prehospital management?
- Remove the object and apply an occlusive dressing
- Stabilize the object in place and transport immediately (Correct answer)
- Shorten the object and apply direct pressure around it
- Leave it and apply pressure directly on top of the object
Correct answer: Stabilize the object in place and transport immediately
Impaled objects should be stabilized in place to prevent further injury, as removal can cause uncontrolled hemorrhage or worsen injury.
Question 7: Which pediatric anatomical difference makes airway management more challenging during trauma resuscitation?
- A larger glottic opening relative to body size
- A proportionally larger occiput causing natural neck flexion when supine (Correct answer)
- A lower-positioned larynx compared to adults
- Thicker, more rigid airway cartilages
Correct answer: A proportionally larger occiput causing natural neck flexion when supine
A child's larger occiput causes the neck to flex forward when supine, which can obstruct the airway; a folded towel under the shoulders helps achieve a neutral position.
FISDAP Trauma Management 3
A 28-year-old male sustains a stab wound to the right upper quadrant.
Which organ is MOST likely injured?