Trauma Management & Injury Care Flashcards

A hiker has a deep puncture wound to the plantar surface of the foot from a nail. After cleaning the wound in the field, the highest priority for definitive care is:

Answer: Tetanus prophylaxis and evaluation for deep structure injury

Plantar nail punctures carry high risk for Pseudomonas osteomyelitis; tetanus status and physician evaluation for deep structure involvement are mandatory.

When assessing a trauma patient using the SAMPLE history, the 'E' stands for:

Answer: Events leading to the injury

In SAMPLE, E = Events (the circumstances and mechanism surrounding the injury or illness), providing crucial context for assessment.

A cyclist has a scalp laceration that is bleeding profusely. The most effective first step in hemorrhage control is:

Answer: Firm direct pressure applied with a gloved hand or dressing

Scalp wounds bleed heavily due to rich vascular supply; firm direct pressure is the most effective and immediate hemorrhage control method.

During spinal motion restriction in an OEC setting, manual in-line stabilization should be maintained until:

Answer: Full spinal immobilization device is applied and secured

Manual stabilization is a bridge until a mechanical device (backboard, vest, or vacuum mattress) is fully secured and takes over stabilization.

A rock climber has fallen and has an obvious anterior shoulder dislocation. In the wilderness setting, reduction attempts may be appropriate when:

Answer: Neurovascular status is intact and evacuation will take more than 6 hours

When neurovascular compromise is absent and prolonged evacuation is expected, some OEC/wilderness protocols permit reduction by trained providers.

A patient in hemorrhagic shock from a pelvic fracture is conscious. Which fluid resuscitation strategy is currently recommended?

Answer: Permissive hypotension — small amounts of IV fluid to maintain a systolic BP of 80–90 mmHg until surgical control

Permissive hypotension (targeting systolic 80–90 mmHg) reduces clot disruption and dilutional coagulopathy until definitive hemorrhage control is achieved.

A patient presents with a burn covering the entire anterior trunk and both anterior upper arms following a camp stove accident. Using the Rule of Nines, what percentage of BSA is burned?

Answer: 27%

Anterior trunk = 18%; each anterior upper arm = 4.5% × 2 = 9%; total = 27% BSA burned.