FP-C - Flight Paramedic-Certification Complex Trauma and Burns Questions and Answers

Question 1

A 45-year-old male involved in a house fire has full-thickness circumferential burns to his entire right arm and anterior chest.
He is intubated for suspected inhalation injury.
During transport, you note increasing ventilator peak pressures, decreasing SpO2, and absent radial pulse on the right side with a weak carotid pulse.
What is the most critical intervention?

Accepted Answer

Immediately perform a chest and arm escharotomy.

Answer

Increase the IV fluid resuscitation rate.

Answer

Perform a needle decompression of the chest.

Answer

Administer a fluid bolus and vasopressors.

Question 2

You are transporting a 70 kg patient with 40% TBSA deep partial-thickness burns sustained 2 hours ago. The patient also has a closed femur fracture and is hypotensive. According to standard burn resuscitation principles, which fluid management strategy is most appropriate?

Accepted Answer

Administer crystalloids based on the Parkland formula but anticipate higher fluid requirements due to the concurrent trauma.

Answer

Initiate a rapid 2L bolus of normal saline to treat traumatic hypotension first.

Answer

Start fluid resuscitation using the Parkland formula (4 mL/kg/%TBSA) and titrate to a urine output of 30-50 mL/hr.

Answer

Use the Modified Brooke formula (2 mL/kg/%TBSA) to avoid fluid overload in a trauma patient.

Question 3

Which of the following is the most definitive clinical sign indicating the need for early endotracheal intubation in a patient rescued from an enclosed space fire?

Accepted Answer

Progressive hoarseness and stridor.

Answer

Singed nasal hairs and facial burns.

Answer

Carbonaceous sputum.

Answer

SpO2 of 92% on a non-rebreather mask.

Question 4

A 100 kg adult male has 30% TBSA full-thickness burns. Using the Parkland formula (4 mL/kg/%TBSA), what is the correct IV fluid rate (Lactated Ringer's) for the first 8 hours, calculated from the time of the burn?

Accepted Answer

750 mL/hr

Answer

1000 mL/hr

Answer

1500 mL/hr

Answer

500 mL/hr

Question 5

During the transport of a patient with extensive burns and associated trauma, which of the following is the primary goal of fluid resuscitation?

Accepted Answer

To maintain end-organ perfusion, evidenced by adequate urine output.

Answer

To normalize the patient's blood pressure to 120/80 mmHg.

Answer

To replace the total calculated fluid deficit within 12 hours.

Answer

To decrease the hematocrit to below 40%.

Question 6

A flight paramedic is managing a patient with circumferential full-thickness burns to the left leg. Which assessment finding is the EARLIEST and most reliable indicator of developing compartment syndrome requiring a potential escharotomy?

Accepted Answer

Pain disproportionate to the injury, described as deep and throbbing.

Answer

Loss of palpable dorsalis pedis pulse.

Answer

Cool, pale skin on the distal extremity.

Answer

Slow capillary refill (>3 seconds) in the toes.