OEC Trauma Management & Injury Care 3 — Questions and Answers
Question 1: A trail runner has a deep laceration on the palm with brisk bleeding. After controlling hemorrhage with direct pressure, the wound cannot be closed in the field. Your best management is:
- Leave the wound open and uncovered for air drying
- Pack the wound with sterile gauze, apply a pressure dressing, and splint the hand (Correct answer)
- Apply a tourniquet to the wrist
- Use super glue to close the wound edges
Correct answer: Pack the wound with sterile gauze, apply a pressure dressing, and splint the hand
Packing with sterile gauze and applying a pressure dressing controls ongoing bleeding; splinting the hand limits movement that can disrupt the clot.
Question 2: In OEC, the mechanism of injury (MOI) is most useful for:
- Determining the exact diagnosis in the field
- Predicting which injuries may be present even before examination (Correct answer)
- Deciding whether to call for evacuation
- Estimating blood loss volume
Correct answer: Predicting which injuries may be present even before examination
MOI guides the rescuer to suspect injuries that may not yet have visible signs, directing a thorough head-to-toe assessment.
Question 3: A skier found at the base of a cliff has an obvious deformity of the pelvis. Which action is contraindicated?
- Applying gentle manual pelvic stabilization
- Wrapping a sheet or pelvic binder around the iliac crests
- Repeated palpation of the iliac wings to confirm instability (Correct answer)
- Keeping the patient supine during transport
Correct answer: Repeated palpation of the iliac wings to confirm instability
Repeated palpation of an unstable pelvis can disrupt clots and worsen massive internal hemorrhage.
Question 4: Which of the following is the MOST reliable field sign of a tension pneumothorax?
- Subcutaneous emphysema over the chest wall
- Tracheal deviation away from the injured side
- Absent breath sounds on the injured side (Correct answer)
- Paradoxical breathing
Correct answer: Absent breath sounds on the injured side
Absent or severely diminished breath sounds on the affected side is the most consistently present and detectable sign in the field.
Question 5: A patient has an impaled object in the thigh. Correct field management is to:
- Remove the object and apply direct pressure
- Shorten the object only if it impedes evacuation, then stabilize it in place
- Leave the object untouched and immobilize it with bulky dressings (Correct answer)
- Apply a tourniquet proximal to the impalement
Correct answer: Leave the object untouched and immobilize it with bulky dressings
Impaled objects tamponade bleeding; removing them can cause sudden massive hemorrhage, so stabilize in place with bulky dressings.
Question 6: Which burn pattern on a child's back and buttocks in an outdoor rescue should raise concern for non-accidental trauma?
- Superficial sunburn across the shoulders
- Scattered partial-thickness burns from a campfire ember
- Sharply demarcated immersion burns in a stocking distribution (Correct answer)
- First-degree burns on the forearms from a stove flare
Correct answer: Sharply demarcated immersion burns in a stocking distribution
Sharply demarcated immersion (scald) burns in a stocking or glove pattern are classic indicators of intentional injury in children.
Question 7: When splinting a suspected ankle fracture in the field, the joint should be immobilized:
- In full plantar flexion to relieve pain
- In the position of function (90° neutral/slight dorsiflexion) (Correct answer)
- In maximum dorsiflexion to reduce swelling
- In whatever position the patient finds most comfortable regardless of alignment
Correct answer: In the position of function (90° neutral/slight dorsiflexion)
The position of function for the ankle (approximately 90°) maintains optimal blood flow and tissue alignment during transport.
OEC Trauma Management & Injury Care 3
A trail runner has a deep laceration on the palm with brisk bleeding.
After controlling hemorrhage with direct pressure, the wound cannot be closed in the field.
Your best management is: