SRT Rapid Trauma Assessment 2 — Questions and Answers
Question 1: During a rapid trauma assessment of a swiftwater victim, which finding most urgently requires immediate intervention before continuing the assessment?
- Suspected femur fracture
- Absent radial pulse with altered mental status (Correct answer)
- Abrasions on both forearms
- Complaint of back pain
Correct answer: Absent radial pulse with altered mental status
Absent radial pulse with altered mental status indicates severe shock requiring immediate hemorrhage control and fluid resuscitation before continuing the full assessment.
Question 2: When assessing a swiftwater victim's chest, paradoxical movement of a chest wall segment most likely indicates:
- Tension pneumothorax
- Simple rib contusion
- Flail chest (Correct answer)
- Hemothorax
Correct answer: Flail chest
Paradoxical movement — a segment moving inward during inhalation — is the hallmark sign of flail chest caused by multiple rib fractures in two or more places.
Question 3: A rapid trauma assessment in swiftwater rescue is typically performed on patients who are:
- Conscious and ambulatory after a swim
- Unresponsive or have a significant mechanism of injury (Correct answer)
- Only showing signs of hypothermia
- Reporting minor ankle pain
Correct answer: Unresponsive or have a significant mechanism of injury
Rapid trauma assessment is reserved for patients with a significant mechanism of injury or altered mental status where life threats may not be immediately obvious.
Question 4: During the abdominal assessment of a swiftwater trauma patient, guarding and rigidity most suggest:
- Musculoskeletal strain from swimming
- Intra-abdominal organ injury or hemorrhage (Correct answer)
- Hypothermia-related muscle cramping
- Spinal cord injury
Correct answer: Intra-abdominal organ injury or hemorrhage
Involuntary guarding and rigidity of the abdomen are classic signs of peritoneal irritation caused by intra-abdominal bleeding or organ injury.
Question 5: In the rapid trauma assessment, the 'P' in the DCAP-BTLS mnemonic stands for:
- Perfusion
- Punctures (Correct answer)
- Pulse
- Pressure
Correct answer: Punctures
In DCAP-BTLS, P stands for Punctures (or Penetrations), reminding rescuers to check for penetrating wounds that may not be immediately visible.
Question 6: When checking a swiftwater victim's pelvis during rapid trauma assessment, the correct technique is to:
- Apply firm downward pressure repeatedly to detect instability
- Apply gentle inward and downward compression once to detect instability (Correct answer)
- Rock the pelvis side to side multiple times
- Skip pelvic assessment until the patient is extricated
Correct answer: Apply gentle inward and downward compression once to detect instability
A single gentle inward and downward compression of the iliac crests detects pelvic instability without worsening potential hemorrhage from repeated manipulation.
Question 7: A swiftwater victim who was submerged presents with equal breath sounds but decreased oxygen saturation and increased respiratory effort. Which condition should be highest on the differential?
- Dry drowning
- Neurogenic pulmonary edema
- Aspiration-related pulmonary edema (Correct answer)
- Spontaneous pneumothorax
Correct answer: Aspiration-related pulmonary edema
Aspiration of even small amounts of water causes surfactant disruption, leading to pulmonary edema with bilateral crackles, increased work of breathing, and hypoxia.
SRT Rapid Trauma Assessment 2
During a rapid trauma assessment of a swiftwater victim, which finding most urgently requires immediate intervention before continuing the assessment?