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Emergency Care, 13e (Limmer et al.)
Chapter 30 Multisystem Trauma
1) What is the definition of multiple trauma?
A) A trauma in which the patient has more than one serious injury.
B) A trauma in which there are multiple casualties.
C) A trauma that requires the response of multiple agencies.
D) Multiple injuries that affect more than one body system.
Objective: 30.1
2) What is the definition of multisystem trauma?
A) Multiple injuries that affect more than one body system
B) Trauma in which the patient has more than one serious injury
C) A trauma in which there are multiple casualties
D) A trauma that requires the response of multiple agencies
Objective: 30.1
1
3) What is the most important intervention an EMT can perform for an unstable multisystem
trauma patient?
A) Oxygen
B) Airway management
C) Cervical spine precautions
D) Rapid transport
Objective: 30.2
4) Multiple trauma and multisystem trauma patients are situations in which the EMT is expected
to perform which of the following?
A) Anticipate and treat problems with a greater level of complexity than usual.
B) Provide the best quality care possible, including definitive care on-scene.
C) Respond above and beyond the call of duty.
D) Practice outside the scope of practice in order to provide the greatest good.
Objective: 30.2
2
5) You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew
identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant
area on the front and left side. One of your crew members, dressed in fully protective gear,
volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient
is limited, you tell him to concentrate on assessing which of the following parts of the patient's
body?
A) Head, posterior torso, and lower extremities
B) Head, chest, and upper extremities
C) Torso, pelvis, and lower extremities
D) Head, chest, and torso
Objective: 30.2
6) Which one of the following is NOT a key decision for the EMT when faced with a
multisystem or multiple trauma patient?
A) Should I transport to a trauma center?
B) Do I need to minimize on-scene time?
C) Should I allow police to interview the patient on-scene?
D) Is the patient seriously injured?
Objective: 30.2
3
7) You are the first on the scene of a two-car vehicle collision. Your patient is a front passenger
who is unresponsive inside the vehicle. The patient is trapped and the vehicle is on fire. The fire
department is still en route. You should:
A) perform an emergency move.
B) perform an urgent move.
C) use your fire extinguisher to put out the fire.
D) have the fire department rescue the patient.
Objective: 30.2
8) What are three elements of successful trauma care that field practitioners can use which will
ultimately translate into greater rates of survival?
A) Teamwork, timing, and transport
B) Ground ambulances, air helicopters, and trauma centers
C) Lights, sirens, and diesel
D) Physiological determinants, anatomic criteria, and mechanism of injury
Objective: 30.2
4
9) You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders
state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the
patient is alert to verbal stimuli only. He has a Glasgow Coma Scale of 3, 4, 6; slurred speech;
and an obvious scalp laceration to the back of his head. He is refusing treatment and transport
and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II
Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes
away. Which of these is the most appropriate facility for the patient?
A) The nearest community facility
B) Level I Trauma Center
C) Level II Trauma Center
D) Nowhere, since the patient is an adult and refusing; as such, you cannot take him
Objective: 30.3
10) Based on the following presentations of patient injuries, which one would be considered
MOST severe, justifying immediate transportation to a trauma center?
A) Midline cervical spine pain
B) Open (compound) midshaft femur fracture
C) Closed head injury
D) Flail chest
Objective: 30.3
5
11) What are some of the most important critical decisions an EMT can make on the scene of a
serious trauma?
A) Determining patient priority, amount of time on-scene, and hospital transport decision
B) Whether to await ALS care on-scene or begin BLS transport
C) Load and go versus stay and play
D) Physiological determinants, anatomic criteria, and mechanism of injury
Objective: 30.3
12) What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC)
release in order to guide the most injured patients into trauma centers?
A) Teamwork, timing, and transport
B) Physiological determinants, anatomic criteria, and mechanism of injury
C) Determining patient priority, amount of time on-scene, and hospital transport decision
D) Lights, sirens, and diesel
Objective: 30.3
6
13) What is the Glasgow Coma Score (GCS) measurement of altered mental status, which
according to CDC guidelines necessitates transport to a trauma center?
A) 12
B) 13
C) 8
D) 14
Objective: 30.3
14) What is the height from which an adult fall would meet trauma triage criteria set forth by the
CDC?
A) 10 feet
B) 25 feet
C) 20 feet
D) 15 feet
Objective: 30.3
7
15) You are on the scene of a 50-year-old male who lacerated his arm on a sheet of plate glass.
He is pale, diaphoretic, and mumbling incoherently. You have controlled an arterial bleed with
direct pressure. His blood pressure is 70/40, pulse 120, and respiratory rate of 28. Which of the
following signs is the most concerning?
A) Tachycardia
B) Altered mental status
C) Respiratory rate
D) Blood pressure
Objective: 30.3
16) A respiratory rate of less than ________ and greater than ________ in cases of trauma are
criteria for immediate transportation to a trauma center according to the CDC physiologic
guidelines.
A) 8; 32
B) 10; 29
C) 12; 20
D) 5; 45
Objective: 30.3
8
17) Which trauma patient is the most critical?
A) Patient with decerebrate posturing
B) Patient with a Glasgow Coma Scale of 7
C) Patient with decorticate posturing
D) Patient who withdraws to painful stimuli
Objective: 30.3
18) Which one of the following patients would justify the need to directly transport to a trauma
center based on special patient considerations?
A) An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of
shoulder pain on the same side as his shunt
B) An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS
response
C) A pregnant female in the third trimester who is spotting (showing small amounts of vaginal
bleeding) following a low mechanism of injury MVC
D) An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of
pelvic pain
Objective: 30.4
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