Paramedics Exam Trauma Management 2 — Questions and Answers
Question 1: A patient has a femur fracture with an estimated blood loss of 1,500 mL. Which class of hemorrhage is this?
- Class I
- Class II
- Class III (Correct answer)
- Class IV
Correct answer: Class III
Class III hemorrhage involves 1,501–2,000 mL blood loss (30–40% of blood volume), causing marked tachycardia, tachypnea, and altered mental status.
Question 2: When applying a tourniquet for extremity hemorrhage, it should be placed how far proximal to the wound?
- 1–2 inches (Correct answer)
- 3–4 inches
- 5–6 inches
- 7–8 inches
Correct answer: 1–2 inches
Tourniquets should be placed 1–2 inches proximal to the wound to control arterial hemorrhage effectively while minimizing ischemia to healthy tissue.
Question 3: Which spinal injury pattern results from axial loading and is most commonly associated with diving accidents?
- Flexion-distraction
- Hyperextension
- Burst fracture (Correct answer)
- Chance fracture
Correct answer: Burst fracture
Burst fractures result from axial loading forces compressing the vertebra and are classic injuries seen in diving accidents and falls from height.
Question 4: A penetrating abdominal trauma patient is hypotensive. Which IV fluid strategy is preferred during transport?
- 2 liters of normal saline bolus
- Permissive hypotension with limited crystalloid (Correct answer)
- 1 liter of D5W bolus
- No IV access until arrival
Correct answer: Permissive hypotension with limited crystalloid
Permissive hypotension (targeting SBP 80–90 mmHg) limits dilution of clotting factors and prevents clot disruption in penetrating trauma until surgical hemorrhage control.
Question 5: Which finding is most indicative of a tension pneumothorax in a trauma patient?
- Bilateral absent breath sounds
- Tracheal deviation away from the affected side (Correct answer)
- Paradoxical chest wall movement
- Subcutaneous emphysema only
Correct answer: Tracheal deviation away from the affected side
Tracheal deviation away from the affected side is a hallmark late sign of tension pneumothorax as mediastinal structures shift under increasing pressure.
Question 6: In a patient with a suspected pelvic fracture and hemodynamic instability, what is the most appropriate prehospital intervention?
- Log roll to assess posterior pelvis
- Apply a pelvic binder at the level of the iliac crests
- Apply a pelvic binder at the level of the greater trochanters (Correct answer)
- Avoid any movement of the pelvis
Correct answer: Apply a pelvic binder at the level of the greater trochanters
A circumferential pelvic binder should be applied at the level of the greater trochanters to reduce pelvic volume and tamponade venous bleeding.
Question 7: Which Glasgow Coma Scale score indicates severe traumatic brain injury?
- 13–15
- 9–12
- 6–8
- 3–8 (Correct answer)
Correct answer: 3–8
A GCS of 3–8 is classified as severe TBI and warrants aggressive airway management, targeting SpO2 >95% and ETCO2 35–45 mmHg.
Paramedics Exam Trauma Management 2
A patient has a femur fracture with an estimated blood loss of 1,500 mL.
Which class of hemorrhage is this?