EMR Exam 4 review

A motorcyclist struck a tree at a high rate of speed. The patient, who was not wearing a helmet, has a large bleeding laceration to his forehead. Closer assessment reveals visible bone fragments in the wound. You should do all of the following, except:

• cover the wound with a loose dressing to control the bleeding.

• remain alert for signs and symptoms of a significant brain injury.

• apply a tight pressure dressing to the wound to stop the bleeding.

• evaluate his level of consciousness and stabilize his head and neck.

Shortly after you apply an occlusive dressing to the chest of a man who was stabbed, the patient begins to experience increased difficulty breathing. EMTs are en route to the scene but will not arrive for approximately 8 minutes. You should:

• briefly remove a corner of the occlusive dressing to allow air to escape.

• closely monitor the patient’s breathing until the responding EMTs arrive.

• apply sterile gauze pads over the occlusive dressing and reassess the man.

• remove the occlusive dressing and promptly update the responding EMTs

A dogcatcher was bitten by a stray dog. The bite is located on the patient’s left forearm and is bleeding heavily. You have applied dressings and a bandage to control the bleeding and are awaiting the arrival of a paramedic unit. Which of the following statements regarding this situation is correct?

• The patient will likely develop a severe infection within 30 to 60 minutes following the bite.

• This incident should be reported to law enforcement officials or the local health department.

• The risk of the patient contracting rabies is very low because the dog was probably vaccinated.

• The law requires that you report animal bites to an EMS provider who has a higher level of training.

A patient has severe external bleeding from the leg. You should place the tourniquet:

• directly over the site of the bleeding to maintain direct pressure.

• above the site of the bleeding and as close to the groin as possible.

• no more than 2” to 4” above the wound in order to prevent further injury.

• directly over a joint that is above the site of the bleeding

Each lower extremity is composed of the:

• thigh and patella.

• femur and fibula.

• tibia and thigh.

• thigh and leg.

A 40-year-old man complains of pain to his left shoulder after falling on his outstretched arm. He is in significant pain and refuses to move his arm, which he is holding about 6" (15 cm) away from his chest. Responding paramedics are approximately 10 minutes away from the scene. After checking distal sensation and circulation, you should: 

• place a pillow or rolled towel between his arm and chest.

• apply a sling and swathe and recheck distal circulation.

• carefully and slowly move his arm against the side of his chest.

• wait for the paramedics to arrive and give him pain medication.

Following a motorcycle crash, a 29-year-old man has pain and deformity to both of his femurs. He is conscious but confused, and his vital signs indicate shock. EMTs are en route to the scene. You should:

• apply traction splints to both legs.

• remove his clothes to keep him cool.

• secure his legs together with cravats.

• straighten his legs and apply board splints.

You are treating a man with massive facial trauma, but are unable to keep his airway clear of blood. Responding paramedics are approximately 4 minutes away. You should: 

• pack his mouth with sterile gauze to try to stop the bleeding.

• perform continuous suction to clear all blood from his airway.

• put the patient in the recovery position and monitor his airway.

• log roll the patient onto his side to allow drainage of blood.

The presence of multiple rib fractures would most likely:

• collapse both of the lungs and cause the patient to stop breathing.

• cause the patient to take a series of deep breaths to relieve the pain.

• prevent the patient from taking deep breaths because of intense pain.

• result in cardiac arrest because of massive damage to the heart and lungs.

You have just applied an occlusive dressing to an open chest wound on a man who was stabbed. While awaiting the arrival of the transporting EMTs, it is most important to monitor the patient for:

• pulse rate and regularity.

• increased pain and anxiety.

• increased difficulty breathing.

• a gradual drop in blood pressure.