Question 1

Severe external bleeding should be controlled during what phase of the patient assessment?

Accepted Answer

Severe external bleeding is a life-threatening situation that must be addressed immediately during the primary assessment phase. It is important to control the bleeding before moving on to the secondary assessment.

Question 2

A young male was riding a motorcycle when he lost control and was ejected. The patient is unresponsive and receiving positive pressure ventilation. The secondary assessment reveals bright blood flowing from both nostrils. Management of this bleeding would include:

Accepted Answer

Placing a loose dressing under the nose is appropriate for managing bleeding in an unresponsive patient receiving positive pressure ventilation, as it collects the blood without risking airway obstruction, which could occur with options A and D. Option C is not feasible due to the patient's unresponsiveness.

Question 3

Your patient is confused and anxious after falling 20 feet from a ladder onto the grass below. What sign is most suggestive of shock?

Accepted Answer

A heart rate of 112 can indicate that the body is trying to compensate for shock by pumping more blood to maintain adequate circulation to vital organs.

Question 4

The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the bleeding, the EMT would first:

Accepted Answer

The first step in controlling the bleeding of a laceration is to apply direct pressure with a sterile dressing. The dressing should be pressed firmly against the wound until the bleeding stops, and then it should be secured in place with a roller gauze. Tightly wrapping the roller gauze around the dressing can cause further damage to the injured area and lead to more bleeding. Applying pressure to the elbow or using a tourniquet is not necessary for this type of injury.

Question 5

A middle-aged male's arm became caught in a grinding machine, and then immediately removed by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Of the following, which would be done first for this patient?

Accepted Answer

Administering oxygen through a nonrebreather mask is the priority in this scenario. The patient's deformed arm may be a serious injury, but ensuring the patient has adequate oxygenation is crucial for his immediate survival. Beginning positive pressure ventilation may become necessary later, but it is not currently indicated. While a secondary assessment will need to be performed, it should not be the first priority in this situation. Inserting an oropharyngeal airway is unnecessary since the patient has a patent airway, and administering oxygen through a nonrebreather mask will be effective enough.

Question 6

Which statement demonstrates an understanding of shock caused by internal bleeding?

Accepted Answer

Internal bleeding can be hidden and may not be immediately visible, so it is important to suspect internal bleeding in a patient with signs and symptoms of shock but no external bleeding. Signs of shock, such as a rapid heart rate and pale, cool, and clammy skin, can indicate internal bleeding. It is not possible to control internal bleeding by applying direct pressure to the skin. Additionally, internal bleeding can be life-threatening if not properly managed.

Question 7

While en route to a domestic with possible injuries, the police contact you and report a male patient with arterial bleeding from a stab wound to the arm. Given this information, which of the following do you expect?

Accepted Answer

Arterial bleeding is characterized by bright red blood that spurts with each heartbeat, indicating a high-pressure bleed that can be challenging to control.

Question 8

Direct pressure has failed to control an arterial bleed on a patient's leg. The EMT's next action would be:

Accepted Answer

If direct pressure fails to control an arterial bleed, the EMT should apply a tourniquet. Immediate transport to a hospital is necessary as a tourniquet causes ischemia and neurovascular damage if applied for longer periods. Providing oxygen and splinting the extremity won't effectively stop the bleeding.

Question 9

You have arrived on a scene where a young girl has pushed her arms through a plate glass window. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your paramedic partner yells for you to immediately apply direct pressure to the laceration to prevent further blood loss, while he works to control the airway. You have yet to apply latex gloves, but are wearing goggles and a gown. What would you do next?

Accepted Answer

The correct next step is to apply gloves prior to applying direct pressure over the injury site. This is important to prevent the risk of exposure to bloodborne pathogens and other potential infections. The use of goggles and a gown is also appropriate to protect against possible splashing of blood. Option A is not recommended as tourniquets should only be used as a last resort and do not usually have a role in controlling bleeding from a single laceration. Option C is not recommended as it could further exacerbate the injury and worsen bleeding. Option D is also not recommended as it puts the responder at risk of infection and could worsen the injury due to the lack of pressure control.

Question 10

Which statement shows that the EMT understands the use of a tourniquet in controlling bleeding?

Accepted Answer

This statement accurately reflects the proper use of a tourniquet, which should be applied tightly enough to completely stop arterial blood flow distal to the tourniquet. This is necessary to effectively control life-threatening bleeding. The other answer choices contain incorrect information or potentially harmful recommendations.

Question 11

You arrive at a meat packing plant to find a 30-year-old male cut in the wrist with a sharp knife. The patient appears pale and blood is spurting from the laceration. Your immediate action would be to:

Accepted Answer

The patient is experiencing significant hemorrhage, so the immediate action should be to control the bleeding by applying direct pressure to the laceration. This may involve using a tourniquet or pressure dressing, depending on the severity of bleeding. Once bleeding is controlled, other interventions such as assessing the airway and providing supplemental oxygen can be addressed. Checking the pulse and blood pressure are important, but not as urgent as controlling the bleeding in this situation.

Question 12

You believe that a patient who has been shot in the lower abdomen is bleeding internally and is in an early stage of shock. Which one of the following shows appropriate prehospital care of this patient?

Accepted Answer

The patient is likely in a critical condition and requires rapid transport to a hospital where advanced medical care can be provided. Oxygen therapy can be administered to improve oxygenation, but cold packs or direct pressure may worsen bleeding and should be avoided. Keeping the patient in a semi-Fowler's position may be helpful, but the most important intervention is rapid transport to a medical facility. Administration of water by mouth is not appropriate in this situation as the patient may require surgery and should not eat or drink anything.

Question 13

In the human body, what occurs when a person is in shock?

Accepted Answer

When a person is in shock, their body is not able to deliver enough oxygen to the cells to meet their metabolic needs. This results in a buildup of waste products such as carbon dioxide and lactic acid, which can lead to tissue damage and organ failure if left untreated.

Question 14

Of the statements that follow, which one describes the best way to determine the severity of a patient's blood loss?

Accepted Answer

Using the patient's signs and symptoms is the best way to determine the severity of blood loss as it takes into account individual variations and characteristics of the patient's response to blood loss. Factors such as the patient's age, medical history, and current condition can all affect how they respond to blood loss, so it's important to assess the patient's overall condition rather than relying on generalized estimates or thresholds. Choice A and D rely on generalizations that may not apply to all patients, while Choice B only provides a rough estimate of blood loss and does not take into account other factors that could affect the patient's pulse rate.

Question 15

A 24-year-old male has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the laceration. As an EMT, you would identify this bleeding as:

Accepted Answer

Venous bleeding is characterized by dark red blood that flows steadily, as opposed to the bright red, spurting blood of an arterial bleed.

Question 16

As you approach a young male lying on the sidewalk, you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient would be to:

Accepted Answer

The first action in caring for any patient should be to assess the airway. In this scenario, the patient appears lethargic and could potentially have a compromised airway. As such, it's crucial to assess the airway for any obstructions, and if necessary, initiate measures to support breathing before proceeding with other interventions like applying oxygen, cutting the pants, or elevating the leg.

Question 17

When performing the primary assessment, which of the following signs or symptoms best suggests that the patient is in shock?

Accepted Answer

Skin that is cool and diaphoretic is a common sign of shock, indicating decreased blood flow and perfusion to the skin. The other options may indicate a variety of conditions, but are not specific to shock.

Question 18

You are having a difficult time controlling bleeding from a small skin avulsion on a patient's ankle. Which one of the following statements made by the patient best explains why control has been difficult to achieve?

Accepted Answer

Coumadin is a blood thinner and can make it difficult to control bleeding.

Question 19

Another crew has called for your assistance in extricating an obese male with a nosebleed from a third-floor bedroom. As you enter the room, which observation indicates proper management of the patient's condition?

Accepted Answer

The correct management for a nosebleed (epistaxis) involves the patient sitting upright and leaning forward to prevent blood from flowing down the throat, which can cause nausea or aspiration. Pinching the nostrils shut helps to apply pressure to the bleeding point in the nose, which can help stop the bleeding.

Question 20

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she was first cut, blood spurted from the wound, and then within a second or two, it subsided to a mere trickle. She asks why this would happen. Which one of the following is the correct response?

Accepted Answer

When blood vessels are injured, the body's natural response is to constrict the vessels to slow down or stop bleeding in order to prevent significant blood loss. This is known as vasoconstriction and can occur within a second or two of the injury. Clotting factors in the blood then work to form a thrombus or clot, which helps to seal the injury site and prevent further bleeding. Red blood cells and skin do not repair blood vessels; rather, they play different roles in the healing process.

Quiz 28: Bleeding and Soft Tissue Trauma