OEC Trauma Management & Injury Care 2 — Questions and Answers
Question 1: A skier sustains a femur fracture on a remote slope. Which complication should you monitor for most urgently during the evacuation?
- Infection at the fracture site
- Hypovolemic shock from internal blood loss (Correct answer)
- Pressure sores from splinting
- Nerve damage from cold exposure
Correct answer: Hypovolemic shock from internal blood loss
A femur fracture can cause 1–2 liters of internal blood loss, making hypovolemic shock the most immediate life threat during evacuation.
Question 2: When applying a traction splint in the backcountry for a mid-shaft femur fracture, what is the primary purpose of applying traction?
- To prevent the bone ends from rotating
- To reduce muscle spasm and control internal bleeding (Correct answer)
- To immobilize the knee joint
- To increase circulation to the foot
Correct answer: To reduce muscle spasm and control internal bleeding
Traction realigns the bone ends, reducing the space muscle spasm creates, which helps control internal hemorrhage and relieves pain.
Question 3: A climber has an open fracture of the forearm with a bone end visible. Your priority after BSI is to:
- Attempt to push the bone back under the skin
- Control bleeding with direct pressure around (not on) the wound, then splint (Correct answer)
- Apply a tourniquet immediately proximal to the fracture
- Irrigate the wound vigorously with purified water
Correct answer: Control bleeding with direct pressure around (not on) the wound, then splint
Control hemorrhage with pressure around the wound margin without disturbing the bone, then immobilize in position found.
Question 4: A hiker is found unresponsive after a fall with suspected cervical spine injury. There is no pulse. Your first action is:
- Apply a cervical collar before starting CPR
- Defer CPR until a backboard is available
- Begin CPR using a modified jaw-thrust to open the airway (Correct answer)
- Place the patient in the recovery position
Correct answer: Begin CPR using a modified jaw-thrust to open the airway
In cardiac arrest, CPR takes priority; use a jaw-thrust (rather than head-tilt) to minimize cervical spine movement while opening the airway.
Question 5: Which sign best indicates arterial bleeding rather than venous bleeding?
- Dark red blood oozing steadily
- Bright red blood spurting in pulses with each heartbeat (Correct answer)
- Blood that clots quickly at the wound edge
- Slow seeping of maroon-colored blood
Correct answer: Bright red blood spurting in pulses with each heartbeat
Arterial blood is oxygenated (bright red) and flows in spurts synchronized with the heartbeat due to arterial pressure.
Question 6: When using a commercial tourniquet (e.g., CAT) for extremity hemorrhage control, how tight should it be applied?
- Snug but comfortable to the patient
- Tight enough to stop venous return only
- Tight enough to eliminate the distal pulse (Correct answer)
- As tight as possible regardless of pulse status
Correct answer: Tight enough to eliminate the distal pulse
A tourniquet must occlude arterial flow, which is confirmed when the distal pulse is no longer palpable and bleeding stops.
Question 7: A mountain biker crashes and presents with paradoxical chest wall movement — a section of the chest moves inward on inhalation. This is called:
- Tension pneumothorax
- Flail chest (Correct answer)
- Open pneumothorax
- Hemothorax
Correct answer: Flail chest
Flail chest occurs when multiple adjacent rib fractures create a free-floating segment that moves opposite to the rest of the chest wall.
OEC Trauma Management & Injury Care 2
A skier sustains a femur fracture on a remote slope.
Which complication should you monitor for most urgently during the evacuation?