PCP Trauma Care 2 — Questions and Answers
Question 1: For a patient with a suspected spinal injury and altered mental status, spinal motion restriction should be:
- Deferred until hospital
- Applied based on mechanism of injury and clinical findings (Correct answer)
- Applied only if the patient complains of neck pain
- Avoided to prevent agitation
Correct answer: Applied based on mechanism of injury and clinical findings
Spinal motion restriction decisions are based on mechanism of injury, clinical signs, and patient assessment findings.
Question 2: A sucking chest wound should be treated by:
- Applying an occlusive dressing sealed on all four sides
- Applying an occlusive dressing vented on one side (Correct answer)
- Packing the wound with gauze
- Leaving open to allow air equalization
Correct answer: Applying an occlusive dressing vented on one side
A vented (three-sided) occlusive dressing allows air to escape on exhalation, preventing tension pneumothorax.
Question 3: Which of the following fractures is most likely to cause life-threatening hemorrhage?
- Distal radius fracture
- Femur fracture (Correct answer)
- Ulna fracture
- Clavicle fracture
Correct answer: Femur fracture
A femur fracture can result in 1–2 liters of blood loss into the thigh, causing life-threatening hemorrhage.
Question 4: What is the most appropriate initial management for a patient with an impaled object in the chest?
- Remove the object immediately to relieve pressure
- Stabilize the object in place and do not remove it (Correct answer)
- Apply direct pressure around the object and remove it
- Shorten the object and then remove
Correct answer: Stabilize the object in place and do not remove it
Impaled objects should be stabilized in place and never removed in the prehospital setting as they may be tamponading hemorrhage.
Question 5: Paradoxical chest wall movement (a segment moving inward on inspiration) is characteristic of:
- Pneumothorax
- Hemothorax
- Flail chest (Correct answer)
- Cardiac tamponade
Correct answer: Flail chest
Flail chest occurs when multiple rib fractures create a free-floating segment that moves paradoxically with breathing.
Question 6: The primary goal of fluid resuscitation in a hemorrhagic shock patient in the prehospital setting is to:
- Restore normal blood pressure immediately
- Maintain perfusion while minimizing further hemorrhage dilution (Correct answer)
- Replace all lost blood volume
- Prevent hypothermia
Correct answer: Maintain perfusion while minimizing further hemorrhage dilution
Permissive hypotension is used in penetrating trauma: maintain minimal adequate perfusion without aggressively diluting clotting factors.
PCP Trauma Care 2
For a patient with a suspected spinal injury and altered mental status, spinal motion restriction should be: