CPR CPR - Certified Paramedic Response Hemorrhage Control and Vascular Access Questions and Answers 2 — Questions and Answers
Question 1: Which of the following BEST indicates successful intraosseous needle placement before drug administration?
- Resistance is felt during needle insertion
- The needle stands upright without support and saline flushes without resistance (Correct answer)
- The patient experiences pain upon needle insertion
- Blood appears at the needle hub immediately
Correct answer: The needle stands upright without support and saline flushes without resistance
Correct IO placement is confirmed when the needle stands upright unsupported and a saline flush meets no resistance with no subcutaneous infiltration.
Question 2: A trauma patient in Class III hemorrhagic shock would MOST likely present with which set of vital signs?
- HR 90, BP 120/80, RR 14
- HR 120, BP 90/70, RR 28 (Correct answer)
- HR 60, BP 140/90, RR 10
- HR 100, BP 110/80, RR 20
Correct answer: HR 120, BP 90/70, RR 28
Class III hemorrhagic shock (30–40% blood loss) typically presents with HR >120, systolic BP <90, and RR of 26–35.
Question 3: In a patient with an open abdominal wound with evisceration, what is the MOST appropriate prehospital management?
- Replace the organs into the abdominal cavity and apply a pressure dressing
- Cover the evisceration with a moist, sterile dressing and do NOT replace organs (Correct answer)
- Apply a dry sterile dressing and apply direct pressure
- Leave the wound uncovered to prevent infection from dressing contamination
Correct answer: Cover the evisceration with a moist, sterile dressing and do NOT replace organs
Eviscerated organs should be covered with a moist sterile dressing to prevent desiccation and should never be replaced in the field.
Question 4: Which of the following is the MOST reliable early sign of internal hemorrhage in a trauma patient?
- Decreasing blood pressure
- Increasing heart rate (tachycardia) (Correct answer)
- Decreasing urine output
- Altered mental status
Correct answer: Increasing heart rate (tachycardia)
Tachycardia is the earliest and most sensitive compensatory response to internal hemorrhage as the body attempts to maintain cardiac output.
Question 5: When using a commercial junctional tourniquet (e.g., SAM-JT or CRoC) for groin hemorrhage, what is a critical application consideration?
- It should only be applied over clothing for patient comfort
- It must be positioned to compress the femoral vessels against the pelvis (Correct answer)
- It is applied distal to the wound site
- It can only be used in the hospital setting
Correct answer: It must be positioned to compress the femoral vessels against the pelvis
Junctional tourniquets must be positioned to compress the femoral artery against the bony pelvis to achieve effective hemorrhage control.
Question 6: A 68 kg patient in hemorrhagic shock requires a fluid bolus. Following current US EMS guidelines for crystalloid resuscitation, what is the appropriate initial bolus volume?
- 1 liter administered as fast as possible
- 250–500 mL titrated to clinical response (Correct answer)
- 2 liters administered rapidly
- No IV fluid; transport immediately without fluid resuscitation
Correct answer: 250–500 mL titrated to clinical response
Current guidelines favor small-volume resuscitation (250–500 mL) titrated to clinical response to avoid dilutional coagulopathy and worsening hemorrhage.
CPR CPR - Certified Paramedic Response Hemorrhage Control and Vascular Access Questions and Answers 2
Which of the following BEST indicates successful intraosseous needle placement before drug administration?