CPR CPR - Certified Paramedic Response Hemorrhage Control and Vascular Access Questions and Answers 1 — Questions and Answers
Question 1: Which of the following is the MOST appropriate first-line intervention for massive extremity hemorrhage in the prehospital setting?
- Apply a tourniquet proximal to the wound (Correct answer)
- Apply direct pressure with a sterile dressing
- Elevate the extremity above the heart
- Apply a pressure bandage and reassess
Correct answer: Apply a tourniquet proximal to the wound
For massive extremity hemorrhage, a tourniquet applied proximal to the wound is the most effective and rapid intervention to control life-threatening bleeding.
Question 2: When establishing intraosseous (IO) access in an adult during a cardiac arrest, which site is preferred as the FIRST choice?
- Proximal tibia
- Distal femur
- Proximal humerus (Correct answer)
- Sternum
Correct answer: Proximal humerus
The proximal humerus is preferred as the first-choice IO site in adults because it allows faster drug delivery to the central circulation during CPR.
Question 3: A patient presents with a femoral artery laceration with bright red, pulsatile bleeding. After a tourniquet is applied and bleeding is controlled, what is the MAXIMUM recommended tourniquet time before reassessment?
- 30 minutes
- 1 hour
- 2 hours (Correct answer)
- 4 hours
Correct answer: 2 hours
Tourniquet time should not exceed 2 hours to prevent irreversible ischemic injury to the extremity.
Question 4: Which IV fluid is currently recommended by PHTLS and most EMS systems for hemorrhagic shock resuscitation?
- 5% Dextrose in water (D5W)
- Normal saline (0.9% NaCl)
- Lactated Ringer's solution (Correct answer)
- 3% Hypertonic saline
Correct answer: Lactated Ringer's solution
Lactated Ringer's solution is favored over normal saline for hemorrhagic shock due to its lower chloride content and closer physiologic composition.
Question 5: In a hypotensive trauma patient with suspected internal hemorrhage, which blood pressure target best reflects current permissive hypotension guidelines?
- Systolic BP > 120 mmHg
- Systolic BP 80–90 mmHg (Correct answer)
- Mean arterial pressure > 90 mmHg
- Systolic BP > 100 mmHg
Correct answer: Systolic BP 80–90 mmHg
Permissive hypotension targets a systolic BP of 80–90 mmHg to limit further hemorrhage while maintaining perfusion to vital organs.
Question 6: Which of the following BEST describes the correct technique for applying a wound-packing agent to a junctional hemorrhage?
- Pour the agent into the wound and apply light pressure for 30 seconds
- Pack the agent tightly into the wound and apply firm direct pressure for 3 minutes (Correct answer)
- Apply the agent to the wound surface only and cover with a dressing
- Insert the agent and immediately apply a tourniquet above the site
Correct answer: Pack the agent tightly into the wound and apply firm direct pressure for 3 minutes
Wound packing requires tight packing of hemostatic agent into the wound followed by firm direct pressure for at least 3 minutes to activate clotting.
CPR CPR - Certified Paramedic Response Hemorrhage Control and Vascular Access Questions and Answers 1
Which of the following is the MOST appropriate first-line intervention for massive extremity hemorrhage in the prehospital setting?