Quiz Chapter 31

What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax through a penetration of the chest wall with each breath?

• Paradoxical motion

• Closed tension pneumothorax

• Open chest wound

• Sucking chest wound

Which of the following describes the proper application of an occlusive dressing for an open chest wound?

• Apply an occlusive dressing to each penetrating wound.

• Use a porous material such as a 4" by 4" gauze pad.

• Trim the dressing so that it is the exact size of the wound.

• Traditional gauze dressings create the best seal over open wounds.

The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point that the chambers of the heart no longer fill adequately, usually secondary to trauma.

• commotio cordis

• pericardial effusion

• hemopneumothorax

• cardiac tamponade

While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated with:

• commotio cordis.

• aortic dissection.

• tension pneumothorax.

• flail chest.

What is the underlying cause of bluish or reddish facial discoloration following traumatic asphyxia?

• The patient has become hypoxic due to a chest injury, and the finding suggests central cyanosis.

• The physiological strain of the body results in a flushed appearance and increased risk of a hypertensive event.

• High pressure on the chest leads to blood being forced from the right atrium into the face and neck.

• The bluish or reddish facial discoloration is not associated with traumatic asphyxia; a pale discoloration is usually present.

You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you're making the decision to transport. Which of the following best encapsulates the correct strategy for transport?

• Begin transport non-emergently and upgrade if the patient's condition deteriorates.

• The patient does not necessarily need transport, so allow him to refuse if he wants.

• Transport the patient non-emergently because he's complaint free.

• Transport the patient emergently because of the high index of suspicion for a serious injury.

Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered?

• Traumatic asphyxia

• Flail chest

• Pneumothorax

• Hemothorax

You find a middle-aged male sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should:

• place the patient on high-concentration oxygen.

• place a trauma dressing over the wound.

• cover the wound with an occlusive dressing.

• place your gloved hand over the wound.

Which of the following is a strategy to maintain adherence of an occlusive dressing to bloody or diaphoretic skin?

• Wrap the dressing circumferentially with gauze.

• Do not use adhesive tape.

• Do not use occlusive dressings in this case.

• Manually maintain pressure.

Your patient is a 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should:

• begin chest compressions.

• elevate the patient's legs.

• attach the AED and analyze.

• place him on a backboard.