1. All of the following are components of the revised trauma score EXCEPT:
Systolic blood pressure
Pulse rate
Glasgow Coma Scale
Respiratory rate
2. Your patient is a 45-year-male who was found sitting in a chair in a residence. He responds to painful stimuli with incoherent speech and has an odor of alcohol on his clothing and breath. There is an empty bottle of tricyclic antidepressants next to the patient, as well as a nearly empty bottle of liquor. Because there is no electricity in the residence and light is insufficient, you move the patient to your stretcher so you can perform your examination in a better environment. The patient has a blood pressure of 130/70, a heart rate of 124, and respirations of 8 per minute. There were no obvious signs of trauma, but your detailed examination reveals a fresh laceration to the right parietal area of the head. The laceration has been cleaned and appears to be several hours old. Which of the following is the best course of action?
Transport the patient on the assumption that his condition is more consistent with a tricyclic overdose than with trauma. His reported history of alcoholism probably accounts for the laceration on his head.
Place a cervical collar on the patient and secure him to a long backboard before transport. His level of consciousness does not allow for better assessment of the mechanism of injury. His signs and symptoms are consistent with a tricyclic overdose and alcohol abuse, but his reported history of alcohol abuse puts him at increased risk of intracranial bleeding due to fairly minor trauma.
Right now the patient's condition seems more consistent with tricyclic overdose, but because a history of the head laceration cannot be obtained, the patient should be monitored closely for signs of increased intracranial pressure.
Place a cervical collar on the patient and secure him to a long backboard before transport. The empty medication bottle was likely an incidental finding. Intubate, using RSI if necessary. Begin transport to a trauma center, and start a large-bore IV of lactated Ringer's solution infusing at a wide-open rate.
2. In which type of vehicle impact are patients afforded the most protection?
None of the above
Lateral impacts
Frontal impacts
Side impacts
3. Bariatric trauma patients have a mortality of up to ____________ times greater than normal weight patients.
Four
Three
Six
Two
4. Which of the following has the greatest potential for reducing injury-related morbidity and mortality?
Increasing the scope of practice of paramedics to include such lifesaving procedures as pericardiocentesis and trephination of the skull to reduce intracranial pressure
Increased funding for rural EMS system development
Using physicians and physician's assistants as prehospital care providers
Injury-prevention activities
5. During which part of your assessment would you note the need for additional resources?
Primary assessment
None of the above
Scene size-up
Secondary assessment
6. Which of the following offers a valuable model for EMS to consider when trying to reduce injury-related morbidity and mortality?
The Pan American Health Organization
The fire service
American Society for Testing Materials (ASTM)
Drug Abuse Resistance Education (DARE)
7. Which of the following groups has the highest trauma morbidity and mortality rates?
Children aged 1 to 12 years
Males aged 45 to 70
Both genders aged 60 to 75 years
Males aged 13 to 35 years