SRT Rapid Trauma Assessment 3 — Questions and Answers
Question 1: During rapid trauma assessment of an unconscious swiftwater victim, the MOST important initial action after ensuring scene safety is:
- Obtaining a SAMPLE history from bystanders
- Establishing manual spinal motion restriction and opening the airway (Correct answer)
- Counting the respiratory rate
- Assessing the pupils
Correct answer: Establishing manual spinal motion restriction and opening the airway
In an unconscious trauma patient, securing the airway with spinal precautions simultaneously is the highest priority before any further assessment.
Question 2: Which assessment finding in a swiftwater trauma patient would cause you to immediately transition from assessment to hemorrhage control?
- Capillary refill of 2.5 seconds
- Bright red blood spurting from the thigh (Correct answer)
- Bruising over the lower ribs
- Tachycardia of 110 bpm
Correct answer: Bright red blood spurting from the thigh
Arterial hemorrhage (bright red, spurting blood) is an immediate life threat requiring direct pressure or tourniquet application before the assessment continues.
Question 3: Tracheal deviation away from the side of injury in a swiftwater trauma patient most likely indicates:
- Simple pneumothorax
- Tension pneumothorax (Correct answer)
- Hemothorax
- Flail chest
Correct answer: Tension pneumothorax
Tension pneumothorax causes mediastinal shift that displaces the trachea away from the affected side as intrathoracic pressure builds.
Question 4: When assessing a swiftwater victim's neck during rapid trauma assessment, JVD (jugular venous distension) combined with absent breath sounds on one side most suggests:
- Simple rib fractures
- Cardiac tamponade
- Tension pneumothorax (Correct answer)
- Hemothorax
Correct answer: Tension pneumothorax
Tension pneumothorax classically presents with JVD (impaired venous return), absent ipsilateral breath sounds, and tracheal deviation — a triad requiring immediate needle decompression.
Question 5: During the extremity assessment in a rapid trauma assessment, which finding is LEAST immediately life-threatening?
- Absent distal pulse in a fractured femur
- Open tibia fracture with venous bleeding (Correct answer)
- Compartment syndrome signs in the calf
- Pulsatile bleeding from a thigh laceration
Correct answer: Open tibia fracture with venous bleeding
While an open tibia fracture with venous bleeding is serious, it is less immediately life-threatening than arterial hemorrhage, absent pulse from vascular injury, or compartment syndrome affecting viability.
Question 6: In swiftwater trauma, 'mechanism of injury' information most importantly helps rescuers:
- Determine the patient's insurance status
- Anticipate hidden injuries not yet apparent on exam (Correct answer)
- Decide whether to call for medical direction
- Estimate how long the rescue will take
Correct answer: Anticipate hidden injuries not yet apparent on exam
MOI allows rescuers to predict injury patterns based on the forces involved, prompting thorough assessment even when obvious signs are absent.
Question 7: A rapid trauma assessment of a patient who swam a hydraulic reveals a GCS of 12, tachycardia, and cool clammy skin. The priority packaging decision should be:
- Scene stabilization and await ALS
- Rapid transport with treatment en route (Correct answer)
- Full secondary survey on scene before moving
- Reassess every 15 minutes and monitor
Correct answer: Rapid transport with treatment en route
Signs of shock (tachycardia, cool clammy skin) with altered mental status indicate a load-and-go patient requiring rapid transport while initiating treatment en route.
SRT Rapid Trauma Assessment 3
During rapid trauma assessment of an unconscious swiftwater victim, the MOST important initial action after ensuring scene safety is: