AEMCA Trauma and Shock Management 2 — Questions and Answers
Question 1: A patient is found unresponsive after a high-speed MVA. During your rapid trauma assessment you note distended neck veins, absent breath sounds on the left, and hypotension. Which condition does this triad most suggest?
- Tension pneumothorax (Correct answer)
- Cardiac tamponade
- Massive hemothorax
- Pulmonary contusion
Correct answer: Tension pneumothorax
Tension pneumothorax classically presents with absent breath sounds on the affected side, jugular venous distension, hypotension, and tracheal deviation.
Question 2: During a scene size-up of an industrial accident, you note a worker with a large open wound to the thigh with arterial spurting. After BSI, what is your immediate priority?
- Apply a tourniquet proximal to the wound (Correct answer)
- Establish IV access for fluid resuscitation
- Apply a pressure dressing and monitor
- Immobilize the extremity on a long backboard
Correct answer: Apply a tourniquet proximal to the wound
Arterial hemorrhage from an extremity requires immediate tourniquet application to control life-threatening bleeding before any other intervention.
Question 3: Which type of shock is most commonly associated with a cervical spinal cord injury at C5?
- Neurogenic shock (Correct answer)
- Hypovolemic shock
- Septic shock
- Obstructive shock
Correct answer: Neurogenic shock
High cervical cord injuries disrupt sympathetic tone, causing vasodilation and bradycardia — the hallmarks of neurogenic shock.
Question 4: A patient in compensated hemorrhagic shock will most likely demonstrate which early sign?
- Tachycardia with normal blood pressure (Correct answer)
- Hypotension with bradycardia
- Widened pulse pressure
- Decreased respiratory rate
Correct answer: Tachycardia with normal blood pressure
In compensated shock the body maintains blood pressure through tachycardia and vasoconstriction, so tachycardia is the earliest reliable indicator.
Question 5: When performing needle decompression for suspected tension pneumothorax, which landmark is the preferred insertion site?
- 2nd intercostal space, midclavicular line (Correct answer)
- 4th intercostal space, midaxillary line
- 5th intercostal space, anterior axillary line
- 3rd intercostal space, midsternal line
Correct answer: 2nd intercostal space, midclavicular line
The 2nd intercostal space at the midclavicular line is the standard landmark for needle decompression to avoid neurovascular bundles and major vessels.
Question 6: You are treating a patient with blunt abdominal trauma who is hypotensive. Which organ is statistically most commonly injured in blunt abdominal trauma?
- Spleen (Correct answer)
- Liver
- Small intestine
- Kidney
Correct answer: Spleen
The spleen is the most commonly injured solid organ in blunt abdominal trauma due to its location, vascularity, and fragile capsule.
Question 7: A patient with penetrating chest trauma has a sucking chest wound. After sealing it with a vented chest seal, the patient deteriorates with worsening hypotension and absent breath sounds on the same side. What should you do next?
- Burp or remove the seal to release trapped air (Correct answer)
- Add a second vented seal over the first
- Perform immediate needle decompression on the opposite side
- Increase IV fluid rate and transport rapidly
Correct answer: Burp or remove the seal to release trapped air
Deterioration after sealing a sucking chest wound suggests developing tension pneumothorax; burping or removing the seal allows trapped air to escape.
AEMCA Trauma and Shock Management 2
A patient is found unresponsive after a high-speed MVA.
During your rapid trauma assessment you note distended neck veins, absent breath sounds on the left, and hypotension.
Which condition does this triad most suggest?