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Paramedic Trauma FISDAP 2025 Update |Complete
Exam Set Questions And Verified Answers (solutions) |
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If you see a cracked windshield in a MVC... what will the pt represent with? - CORRECT ANSWER >>> Bruised or lacerated head or face. Brain injury, *cervical spine injury (always until proven otherwise), tracheal injury. If you see a deformed steering column in a MVC... what will the pt represent with? - CORRECT ANSWER >>> Bruised neck, bruised chest. Sternal or rib fracture, flail chest, myocardial contusion, *pericardial tamponade, pneumo/hemothorax, aortic tear. If you see a deformed dashboard in a MVC... what will the pt represent with? - CORRECT ANSWER >>> Bruised abdomen, bruised knee, misplaced kneecap. Ruptured spleen, liver, bowel, diaphragm. Fractured patella, dislocated knee, *femoral fracture, dislocated hip. If you see the rear end of the vehicle is damaged in a MVC... what will the pt represent with? - CORRECT ANSWER >>> Secondary anterior injuries, esp if the pt wasn't restrained. "Wiplash" injuries, *coup contrecoup injury. Phases of Deceleration - CORRECT ANSWER >>> 1) Deceleration of the vehicle, occurs when the vehicle strikes another object & comes to a stop. 2) Deceleration of occupant, which starts during sudden braking & continues through the whole crash. 3) Deceleration of internal organs, that consist of internal organs that continue forward momentum until they're stopped by anatomical restraints. 4) Secondary collisions, which occur when a vehicle occupant is hit by objects moving within the vehicle (loose objects). 5) Additional impacts, that the vehicle may receive when it is hit by a second vehicle or is deflected into another. Velocity - CORRECT ANSWER >>> "Speed kills"- causes more damage than mass.
Seat Belt Use - CORRECT ANSWER >>> All arguments against seat belt use are unfounded. Airbag Injuries - CORRECT ANSWER >>> Common injuries include abrasions to the face, chest and arms. Minor corrosive effects can occur because of the cornstarch on the airbag, and it may irritate the skin. Down and Under Pathway - CORRECT ANSWER >>> Occupant slides under the steering wheel or the dash. The knees hit the dashboard, and transmit energy up the leg, to the femur/pelvis. If the feet are locked in place, it can cause femur fractures. Up and Over Pathway - CORRECT ANSWER >>> Chest hits the steering wheel, head hits the windshield and anterior portion of the throat hits the top of the steering wheel. Can cause significant head and neck injuries. Head on Impact in Motorcycle Crashes - CORRECT ANSWER >>> Head on impact- motorcycle strikes another object and stops its forward motion, while the rider continues forward motion until stopped by outside force. This causes the rider to go over the handlebars, which causes femur fractures, and tib fractures. Angular Impact in Motorcycle Crashes - CORRECT ANSWER >>> The motorcycle strikes an object, or another vehicle at an angel so that the rider sustains direct crushing injuries to the lower extremity between the object and motorcycle. Motorcycle Crashes - CORRECT ANSWER >>> With any motorcycle crash, the helmet should be removed carefully if airway management techniques cannot be performed with the helmet in place or the helmet doesn't fit properly on the riders head. Pedestrian Injuries - CORRECT ANSWER >>> Most pedestrian injuries occur at an intersection, at night. First, the pedestrian is hit in the lower extremities with the cars bumpers. Second, the pedestrian is thrown on the top of the car (resulting in brain injuries, and pelvic fractures. Third,
Exit Wound - CORRECT ANSWER >>> Occur when the projectile has sufficient energy that is not entirely dissipated along its trajectory through the body. Ricochet - CORRECT ANSWER >>> *Don't assume that a bullet followed a straight path between the entrance & exit sights, it may ricochet inside the body, esp off bones, and travel in diff directions. Primary Blast Injury - CORRECT ANSWER >>> Injuries due to the wave blast itself, usually causing damage to the lungs, eardrums and other compressible organs (air filled cavities). Burns also may occur. Secondary Blast Injury - CORRECT ANSWER >>> Injuries due to missiles being propelled by blast force (struck by flying debris). Tertiary Blast Injury - CORRECT ANSWER >>> Injuries due to body impact with another object (when a person is hurled by the force against stationary objects). Arterial Air Embolism - CORRECT ANSWER >>> When air enters into the pulmonary vasculature, air bubbles can enter a coronary artery and cause a myocardial injury. These can cause changes in vision, changes in behavior, changes in LOC. Preload - CORRECT ANSWER >>> The amount of blood returned to the heart to be pumped out and directly affects the afterload. Afterload - CORRECT ANSWER >>> The pressure in the aorta or the peripheral vascular resistance, against which the left ventricle must pump blood. The greater the afterload, the harder it is for the ventricle to eject blood into the aorta. Perfusion - CORRECT ANSWER >>> Circulation of blood within an organ or tissue in adequate amounts to meet the cells needs.
Autonomic Nervous System - CORRECT ANSWER >>> Monitors the body's needs from moment to moment, adjusting the blood flow as required. Maintains homeostasis & is divided into the parasympathetic & sympathetic components that oppose each other and keep vital functions in balance. Sympathetic System - CORRECT ANSWER >>> Known as fight or flight, and is your body's response system to stress. Can be external or internal (like an MI). Actions include having a faster/stronger heart contractions, deeper respiration's, bronchodilation, shunting of blood to vital organs, & slowing the cessation of digestive functions. Parasympathetic System - CORRECT ANSWER >>> Often referred to as "rest and digest" mode. Slowing the heart rate, slowing the breathing rate, and increase digestive system. (What happens when you sleep). Hypoperfusion - CORRECT ANSWER >>> Not enough blood (O2) to meet the cells needs, and the tissue or organ starts to fail & die. Brain and spinal cord: 4-6 minutes. Kidneys: 45 minutes. Types of Bleeding - CORRECT ANSWER >>> Venous- flowing, darker red. Arterial- fast, spurting, bright red. Capillary- oozes, slow bleed. The body will tolerate only how much blood loss in an adult? - CORRECT ANSWER >>> In an adult, the body will only tolerate 20% blood loss, which is approx 1 Liter. Hemostasis - CORRECT ANSWER >>> Platelets aggregate at the site of an open bleed and begin plugging the entrance and sealing the injured portions of the vessel. Hemophilia - CORRECT ANSWER >>> A small portion of the population lacks one or more of the blood's clotting factors.
Traction Splints - CORRECT ANSWER >>> Designed to stabilize femur fractures. Do not use if hip appears to be dislocated. Compartment Syndrome - CORRECT ANSWER >>> A condition that develops when edema and swelling result in increased pressure in the soft tissues, causing circulation to be compromised, leading to necrosis. Crush Syndrome - CORRECT ANSWER >>> Occurs when a part of the body is crushed, preventing tissue function and possibly resulting in permanent tissue death- leading to crush syndrome (renal failure & death). The release of these products does not occur until after the limb is freed from entrapment. Rescuers must intervene before lifting the crushing object off the body. "Smiling death"- cardiac arrest occurs after lifting the object off the body too. Erythema - CORRECT ANSWER >>> Reddening of the skin. Necrotizing Fasciitis - CORRECT ANSWER >>> Involves the death of tissues from bacterial infection. Occlusive Dressing - CORRECT ANSWER >>> Used when it is important to keep air out of the wound. Tape three sides and leave one open to allow air to escape. Neck/chest openings. Wet Dressing - CORRECT ANSWER >>> Used for small, superficial burns. How to care for an Amputation - CORRECT ANSWER >>> 1) Rinse off the amputated part. 2) Wrap the part loosely in saline-moistened sterile gauze. 3) Seal the amputated part inside a plastic bag, & place it in a cool container. Keep it cold, but not frozen. *DO NOT place it directly on ice (or dry ice), or in water! Rhabdomyolysis - CORRECT ANSWER >>> The destruction of muscle tissue leading to a release of potassium and myoglobin.
Animal Bite - CORRECT ANSWER >>> Place a dry, sterile dressing on it. If its gross contaminated, you may have to irrigate it before placing a dressing. Splinting an Injury - CORRECT ANSWER >>> Even when there are no signs of fracture, can still help control bleeding and pain. Superficial Burns - CORRECT ANSWER >>> Involves the epidermis only. The skin is red and swollen and when touched, the color will blanch and return. Usually blisters are not present. (Sunburn). Pt's will experience pain because nerve endings are exposed to the air. Partial- Thickness Burn - CORRECT ANSWER >>> Involves the epidermis, and varying degrees of dermis. The skin is often blistered. Painful. Full Thickness Burn - CORRECT ANSWER >>> Involves all layers of the skin, down to the subcutaneous tissue. The skin may appear white and waxy, brown and leathery, or charred. There will prob be no pain, but will experience pain in the surrounding area where the nerve endings are still intact. Often requires skin grafting. Inhalation Burn - CORRECT ANSWER >>> Can cause rapid and serious airway swelling (laryngeal edema)/problems. Look for- singed nasal hairs, hoarseness in the voice, cough, facial burns, soot around face. How to Treat Burn Patients - CORRECT ANSWER >>> Dressings (dry & sterile for large burns, moist for small), fluid resuscitation, airway management (intubation if necessary), and pain management. Morphine and fentanyl. Rule of Nines - CORRECT ANSWER >>> Adults- Full arms: 9% (front half/back half- 4.5%). Full legs: 18%, (front half/back half- 9%). Chest/torso- 18%. Groin- 1%. Head: 9% (front/back- 4.5%). Back- 18%.
Le Fort 1 Fracture - CORRECT ANSWER >>> From the bottom of the nose down. Involves the mandible and the maxilla. Le Fort 2 Fracture - CORRECT ANSWER >>> Involving the nasal bone and the maxilla. Le Fort 3 Fracture - CORRECT ANSWER >>> A fracture of all midfacial bones, seperating the entire midface from the cranium. Includes the eyes. Management of Someone with Facial Trauma - CORRECT ANSWER >>> Inspect the mouth for fragments of teeth, dentures, or any other foreign bodies. Suction the oropharynx as needed. Do not nasally intubate someone with evidence of nasal trauma, CSF leaking, blood in the nose, or any other midline facial trauma. Epistaxis - CORRECT ANSWER >>> Nose bleed. More common in elderly adults even following a minor facial injury, esp if they have hypotension or take anticoagulants. Laceration to the Eye - CORRECT ANSWER >>> If there is laceration to the globe itself, apply no pressure to the eye; compression can interfere with the blood supply to the back of the eye & result in more damage. Foreign Body in the Eye - CORRECT ANSWER >>> Shards of metal, wood, etc. can become embedded into the globe of they eye. It can cause irritation and conjunctivitis. When this happens, attempt to flush out the eye from inside (tear duct) to out (outer corner). Hyphemia - CORRECT ANSWER >>> Bleeding into the anterior chamber of the ye that obscures vision, partially or completely. Diplopia - CORRECT ANSWER >>> Double vision.
Dysconjugate Gaze - CORRECT ANSWER >>> For paralysis of gaze or discoordination between the movements of the two eyes. If the eye is out of the socket... you should? - CORRECT ANSWER >>> Never attempt to manipulate or reposition a globe that has been displaced (avulsed) out of the socket. Cover the eye with a moist sterile dressing and stabilize it along with the uninjured eye to prevent further injury. Sympathetic Eye Movement - CORRECT ANSWER >>> The movement of both eyes in unison. This is why you cover both eyes even if only one is injured. When a foreign body is impaled in the globe... you should? - CORRECT ANSWER >>> DO NOT remove it! Stabilize it, cover the eye with a moist, sterile dressing, place a cup or other protective barrier over the object & secure it in place with a bulky dressing. Cover the unaffected eye to prevent movement. Ear Lacerations - CORRECT ANSWER >>> Carefully put the ear back in anatomical position, place sterile gauze over it and kling wrap around the head. If the ear has been completely avulsed, attempt to keep the piece for reattachment at the hospital. If blood or CSF is leaking, do not stop the flow- apply a loose dressing. When an impaled object is in the ear... you should? - CORRECT ANSWER >>> DO NOT remove the object. Instead, stabilize the object, and cover the ear to prevent gross movement and minimize the risk of contamination of the inner ear. Open neck wound should be covered with...? - CORRECT ANSWER >>> An occlusive dressing. For fear of air entering the neck. When an impaled object is in the neck... you should? - CORRECT ANSWER >>> Not remove the object, but try to stabilize it and control the bleeding from it. The ONLY exception for
GCS Scale - CORRECT ANSWER >>> Eyes, Motor, Speech. EYES (4): Spontaneous- 4, To voice- 3, To pain- 2, None- 1. MOTOR (6): Obeys commands- 6, Localizes pain- 5, Withdraws from pain- 4, Decorticate- 3, Decerebrate- 2, None- 1. SPEECH (5): Oriented- 5, Confused- 4, Inappropriate- 3, Sounds (garbled, mumbling, etc)- 2, None, 1. *Your pt will always be 3 or more. Levels of ICP - CORRECT ANSWER >>> Mild- cheyne-stokes, increased BP, decreased HR, pupils stil reactive, AMS, vomiting. Moderate- widening pulse pressure w/ bradycardia, pupils are non- reactive, hyperventilation, posturing. Severe- blown pupil, biot's respirations, flaccid paralysis, irregular pulse rate, fluctuating BP (usually hypotension). Cheyne- Stokes Respirations - CORRECT ANSWER >>> Respirations that are fast and then become slow, with intervening periods of apnea. Common in people with head injuries/ICP. Biots Respirations - CORRECT ANSWER >>> Characterized by irregular rate, pattern, and volume of breathing with intermittent periods of apnea. Babinkski Reflex - CORRECT ANSWER >>> Occurs when the toes move upward in response to stimulation of the sole of the foot. Under normal circumstances, the toes move downward. Coup Contrecoup - CORRECT ANSWER >>> Front and rear injury. Brain slams into the front of the skull, and then slams into the back end of the skull. CPP - CORRECT ANSWER >>> Cerebral perfusion pressure. The pressure of blood flow through the brain, is the difference between the MAP, and ICP. The minimum CCP should be 60. Autoregulation - CORRECT ANSWER >>> The body responds to a decrease in CPP by increasing the MAP. Resulting in cerebral vasodilation and increased cerebral blood flow. However, this is a vicious cycle cause it actually increases ICP.
If ICP doesn't resolve... this could happen? - CORRECT ANSWER >>> Herniation. The brain is forced through the cranial vault, either through the foramen magnum or over the tentorium. Decorticate - CORRECT ANSWER >>> Flexor posturing. Pt's limbs will be facing toward their core, involving flexion of the arms and legs. Decerebrate - CORRECT ANSWER >>> Extensor posturing. Pt's limbs will be extending away from the body. Epidural Hematoma - CORRECT ANSWER >>> Accumulation of the blood between the skull and dura matter. Usually caused by blunt trauma. Often the Pt loses consciousness immediately after. Subdural Hematoma - CORRECT ANSWER >>> Accumulation of blood beneath the dura matter. Usually occurs after falls, and are more common than epidural hematomas. This bleeding is from venous bleeding, so it is more gradual and can take anywhere between 24hrs to 2 weeks. Common in elderly Pt's, Pt's with bleeding diseases, and alcoholics. Intracerebral Hematoma - CORRECT ANSWER >>> Involves bleeding within the brain tissue itself. Can follow a penetrating injury to the head. Have a high mortality rate. Hyperpyrexia - CORRECT ANSWER >>> Patients with a head injury can develop a high body temperature, which can worsen the condition of the brain. Subcutaneous Emphysema - CORRECT ANSWER >>> A physical finding of air within the subcutaneous tissue. " can indicate a pneumothorax. It has been described as a crackling or popping feeling under the skin.
Pericardial Tamponade - CORRECT ANSWER >>> Causes compression of the heart, and decreased cardiac output. You will see increased HR, muffled heart sounds, hypotension, and JVD. Commotio Cordis - CORRECT ANSWER >>> Caused by a impact to the chest right where the heart is. It puts the heart into cardiac arrest. Happens to athletes, esp when playing sports. You may see chest wall contusions, and localized bruising. The Pt will be apneic and pulseless. Traumatic Aortic Disruption - CORRECT ANSWER >>> Commonly seen in MVCs, blunt trauma, and falls. High mortality rate. Signs and symptoms are tearing pain behind the sternum or in the scapula. Other signs may be dyspnea, hypovolemic shock, and AMS. *Blood flow to the extremities may be compromised. You will notice a stronger pulse in the right arm then the left. Left Upper Quadrant - CORRECT ANSWER >>> Diaphragm, stomach, *spleen. Right Upper Quadrant - CORRECT ANSWER >>> *Liver. Right Lower Quadrant - CORRECT ANSWER >>> Ascending colon, *appendix. Retroperitoneal Space - CORRECT ANSWER >>> Posterior. Contains pancreas, *kidneys, ureters. Peritonitis - CORRECT ANSWER >>> Hollow organs (stomach, bladder, colon, etc), carry toxins like bile, feces, and urine. When they spill into the abdominal cavity, you end up with an inflammation and infection. Injuries to Solid Organs - CORRECT ANSWER >>> Liver, spleen, kidneys, and pancreas. The organ will release blood into the abdominal cavity after sustaining trauma. Causes hypotension and tachycardia.
Spleen Injuries - CORRECT ANSWER >>> Most common complaint is left shoulder pain, when the spleen has ruptured. This is known as Kehr Sign. Femur Fractures - CORRECT ANSWER >>> Shortening is a common sign of a femur fracture. You would use a traction splint, if time allows. Femur fractures can lead to hypovolemia if the femoral artery was ruptured. Deformities in Fractures - CORRECT ANSWER >>> Obvious deformities can be seen in different types of fractures. The limb may be found in a unnatural position. Splinting - CORRECT ANSWER >>> When splinting an extremity, if it is a FRACTURE, you must immobilize the two adjacent joints to the fracture. For dislocations, you must immobilize the bone above and below the joint. How to Treat Heat Exhaustion - CORRECT ANSWER >>> Move the Pt to a cooler area. Remove excess clothing. Sponge, spray, or drip tepid water on the Pt. If anuses and vomiting are present, start a saline line. May want to consider an anti nausea medication (zofran). Pt will still be alert and oriented. Heatstroke - CORRECT ANSWER >>> Involves elevated temp above *104. and AMS. One of the earliest signs in changes in behavior (irritable, combative, etc). Pt may have a seizure. Pt will be tachycardia, hyperventilating. Manage the ABC's. Move the Pt to a cool environment. Cooling efforts should continue until temp reaches below *102. Cool as rapidly as possible. Consider ice water immersion, placed ice packs in groin, armpits, etc. Start a line and administer saline. Monitor cardiac rhythm. Frostbite/Frostnip - CORRECT ANSWER >>> Get the Pt out of the cold. Do not rub or massage the area. Administer pain medication. Cover blisters with dry, sterile dressing. *Do not attempt rewarming in the field if there is any possibility of refreezing or if the Pt must walk on the frostbitten foot. Frotstbitten parts are usually hard and waxy. Gangrene can occur if the area was frozen.
