Outdoor Emergency Care Chapter 23

A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which of the following structures may have been injured?

• The diaphragm

• The esophagus

• The lungs

• A bronchus

Which of the following statements indicates that the speaker understands chest trauma?

• “Open chest injuries are more serious than closed chest injuries because air and bacteria can enter the chest through the open wound.”

• “In general, an open chest injury caused by blunt trauma is more life threatening than a closed one due to increased blood loss.”

• “Internal chest injuries are more difficult to assess and manage than are the more obvious external chest injuries.”

• “Closed chest injuries are caused by penetrating trauma and cause more life-threatening injuries than do open chest injuries.”

A 39-year-old man has been stabbed once in the anterior chest. When notifying the patrol aid room by radio, you inform them that the patient has suffered what possible type of injury?

• Flail chest

• Evisceration

• A lacerated heart

• An open chest injury

An OEC candidate asks you to explain a pneumothorax. Your response should be that it occurs when:

• the lung becomes overinflated with air and then collapses.

• air accumulates between the inner chest wall and the outside of the lung, causing the lung to collapse.

• the trachea becomes obstructed, causing the lungs to collapse.

• air enters the lung alveoli through a traumatic opening in the chest wall.

When assessing a patient, which of the following signs or symptoms is most indicative that the patient is suffering from a pneumothorax?

• Shortness of breath

• Severe pain upon each inspiration

• Decreased breath sounds in the right lung

• Crepitus to the chest wall

You are at the scene of a shooting. Your assessment reveals a 23-year-old man who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is bleeding. The second wound is to the left lateral chest and makes a sucking sound every time the patient takes a breath. The initial action of an OEC Technician should be which of the following actions?

• Cover the chest wound with a gauze dressing.

• Cover the chest wound with a gloved hand.

• Place direct pressure over the abdominal wound.

• Place the patient on high-flow oxygen using a nonrebreather mask.

Which of the following phrases best describes a flail segment?

• Multiple rib fractures with bruising of the underlying lung

• Fractured ribs that have collapsed the underlying lung

• Multiple fractures to the rib cage caused by blunt trauma

• Two or more adjacent ribs that have been broken in two or more places.

Your patient was involved in a serious motor vehicle collision. Which of the following assessment findings best helps to determine that the patient has a flail segment?

• Paradoxical chest wall movement

• Shortness of breath

• Pain upon inspiration

• Chest wall bruising

You are managing a patient with a large flail segment in the right lateral chest. The immediate threat to this patient’s life is:

• blood loss.

• hypoxia.

• infection.

• rib fractures.

You are assisting at an accident scene and are asked to apply a dressing over a sucking chest wound on the patient’s left anterior chest wall. Which of the following items would you use?

• A dry sterile gauze dressing

• Sterile gauze soaked in sterile water

• A clean cravat

• Vaseline gauze