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24) One of the more serious conditions that EMTs are confronted with would occur as follows:
A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and
swelling caused by the bleeding within the muscle compartment become so great that the body
can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes
additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is
not relieved.
What is this condition called?
A) Compartment syndrome
B) Crushing syndrome
C) Perfusing syndrome
D) Fracture syndrome
Objective: 28.5
25) A method of assessing compromise to an extremity when a musculoskeletal injury is
suspected is to learn and follow the six Ps. Which of the items below is NOT one of the six Ps?
A) Pain
B) Pallor
C) Paresthesia
D) Parenthesis
Objective: 28.5
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26) What is a primary problem when treating musculoskeletal injuries?
A) Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be
distracted from life-threatening conditions by a deformed limb.
B) All musculoskeletal injuries are life threatening due to the bone bleeding, leading to
hypoperfusion.
C) Splints do not adequately fit the patient's extremities and must be modified with padding to
ensure immobilization.
D) Most musculoskeletal injuries are simply splinted and not a life threat to the patient.
Objective: 28.6
27) Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your
exam shows that her left ankle is swollen and painful. Which of the following should you do?
A) Explain to the patient that her ankle is fractured and you must splint her ankle to prevent
further injury and reduce pain.
B) Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-
rayed at the emergency department, then splint the ankle.
C) Transport the patient immediately to a trauma center, applying high-concentration oxygen en
route.
D) Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a
pillow and a cold pack applied to the injury.
Objective: 28.6
12
28) Your patient is a 28-year-old male who was ejected from his motorcycle after striking a
parked vehicle. He has multiple deformities to his upper and lower extremities on both sides.
Which of the following would be the BEST way to immobilize this patient's extremities prior to
transport?
A) Use traction splints for the lower extremities and allow the upper extremities to be
immobilized by the long backboard.
B) Use padded board splints for the upper extremities and PASG for the lower extremities.
C) Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize
the fractures.
D) Immobilize the patient to a long backboard without splinting the extremities individually.
Objective: 28.6
29) Which of the following is NOT a contraindication for the use of a traction splint?
A) Pelvis, hip, or knee injury
B) Avulsion or partial amputation where traction could separate the extremity
C) Injury to the lower third of the leg that would interfere with the ankle hitch
D) Severe swelling and redness at a midshaft femur
Objective: 28.7
13
30) A painter falls from his ladder and tells you he has dislocated his shoulder again. When you
attempt to splint the shoulder, it "pops back into place." What should your next step be?
A) Contact medical control for input into the best treatment for this patient.
B) Check distal CSM, apply a sling and swathe, and transport the patient.
C) Check distal CSM, apply a traction splint, and transport the patient.
D) Continue splinting and report the popping sound to the triage nurse when you arrive at the
hospital.
Objective: 28.7
31) Which of the following is NOT a principle of splinting that must be considered by the EMT?
A) Immobilize the site of an extremity injury from the joint above it to the joint below it.
B) Splint an isolated extremity injury before moving the patient to the stretcher.
C) Check the distal neurovascular function before and after splinting.
D) Gently replace protruding bone ends back beneath the skin to prevent further contamination.
Objective: 28.7
14
32) There are general rules that apply to all types of splinting. Which of the following is NOT a
general rule of splinting?
A) In order to avoid loss of use of a limb, it is important to splint before moving, even if the
patient is unstable.
B) Expose the injury.
C) Assess distal CSM.
D) Align long-bone injuries to anatomical position.
Objective: 28.7
33) Which of the following is NOT a benefit of splinting an injury to bones and connective
tissues?
A) It prevents neurological damage due to movement of bone ends or fragments.
B) It may prevent a closed injury from becoming an open injury.
C) It restricts blood flow to the site of the injury to prevent swelling.
D) It reduces pain.
Objective: 28.7
15
34) Your patient is a 20-year-old college student who has fallen from a third-level balcony onto a
wooden deck below. The patient responds to verbal stimuli, is pale in color with moist skin, and
has a very obvious deformity with protruding bone ends of his right forearm. Which of the
following is the BEST sequence of intervention for this patient?
A) Provide manual in-line stabilization of the cervical spine along with assessment of breathing,
pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a
rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route
if time and resources allow.
B) Open the airway; assess breathing; check the carotid pulse; splint the forearm injury;
immobilize the patient to a long backboard; apply high-concentration oxygen; and transport.
C) Provide immediate manual in-line stabilization of the cervical spine; apply high-concentration
oxygen by nonrebreather mask; perform a focused history and assessment; apply the cervical
collar; apply a padded board splint, sling, and swathe to the forearm injury; and transport.
D) Provide manual in-line stabilization of the cervical spine along with assessment of breathing,
pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a
rapid trauma exam; immobilize to a long backboard; and check with medical control about the
need to splint the forearm injury prior to transport.
Objective: 28.7
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