MOD6 – chapter 28 – soft tissue trauma

Which of the following is a major function of the skin?
Answer

Excretion of wastes
Protection from the environment
Temperature regulation
All of the above

All of the above
Which of the following is the outermost layer of the skin?
Answer

Dermis
Epidermis
Adipose tissue
Fascia

Epidermis
Which of the following layers of the skin is the most important in insulating the body against heat loss?
Answer

Parietal layer
Subcutaneous layer
Epidermis
Subdural layer

Subcutaneous layer
Which of the following is required in the management of all open soft-tissue injuries?
Answer

Provision of high-concentration oxygen
Use of Standard Precautions by the EMT
Cervical spine precautions
Application of a disinfectant solution

Use of Standard Precautions by the EMT
An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n):
Answer

contusion.
abrasion.
concussion.
avulsion.

contusion
Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils?
Answer

Avulsion
Laceration
Puncture
Incision

Puncture
A wound in which the epidermis is scraped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called a(n):
Answer

abrasion.
contusion.
avulsion.
evisceration.

abrasion.
An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a fallen tree, that results in damage to muscle cells and the accumulation of waste products in the tissue is called a(n):
Answer

crush injury.
evisceration.
contusion.
abrasion.

crush injury.
Which of the following BEST describes an avulsion?
Answer

An injury caused by a sharp, pointed object
A flap of skin that is partially or completely torn away from the underlying tissue
The epidermis that is scraped away by a rough surface
An accumulation of blood beneath the skin, resulting in swelling

A flap of skin that is partially or completely torn away from the underlying tissue
Bleeding from soft-tissue injuries should initially be controlled with which one of the following techniques?
Answer

Application of an ice pack or chemical cold pack
Direct pressure
Elevation of the injured part
Running cold water over the wound

Direct pressure
Which of the following is NOT an open tissue injury?
Answer

Abrasion
Contusion
Avulsion
Evisceration

Contusion
A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site?
Answer

The nail is less than 2 inches in length.
The patient’s distal pulse, motor function, and sensation are intact.
Bleeding from the wound is minimal.
None of the above

None of the above
Which of the following injuries requires the use of an occlusive dressing?
Answer

An open wound to the neck
An open wound to the abdomen from which a loop of intestine is protruding
An open wound to the chest
All of the above

All of the above
Which of the following is recommended when caring for an amputated part?
Answer

Rinse away debris with saline solution and place the part in a container of ice.
Wrap the part in aluminum foil to preserve body temperature.
Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.
Always transport the amputated part with the patient.

Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.
A burn extending into the subcutaneous fat would be classified as which type of burn?
Answer

Deep partial thickness
Full thickness
Superficial partial thickness
Superficial

Full thickness
Which of the following BEST describes a partial thickness burn?
Answer

The skin is red, but dry and painful.
The skin is charred or blackened and lacks sensation.
The skin is white and dry with no sensation of pain.
The skin is red and moist with blister formation.

The skin is red and moist with blister formation.
Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound?
Answer

Application of a dry, sterile dressing
Application of antibiotic ointment
Elevation of the wound above the level of the heart
Keeping the site clean

Application of antibiotic ointment
Your patient is a 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and painful, but without blisters. When caring for this injury in the prehospital setting, which of the following is appropriate?
Answer

Apply an antibiotic ointment.
Apply a lotion containing a topical anesthetic and aloe vera.
Apply a plastic bag full of ice to the skin.
Apply a dry sterile dressing.

Apply a dry sterile dressing.
Which of the following patients has the greatest likelihood of being cared for in a burn center?
Answer

A 45-year-old man who has a full thickness burn about 3 inches long by 1/2 inch wide on his posterior arm from backing into a barbecue grill
A 30-year-old woman who has deep partial thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
A 12-year-old male with a superficial partial thickness burn involving his forearm as a result of making a torch by lighting aerosol from a can of hairspray
A 16-year-old female who came into contact with a motorcycle exhaust pipe and has a full thickness burn on her leg about 2 inches in diameter

A 30-year-old woman who has deep partial thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
For which of the following patients should the EMT carefully continue to monitor the patient’s ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure?
Answer

A 17-year-old male with a blistering sunburn on his face
A 34-year-old male who opened the radiator of his car and had hot fluid spray on his chest, resulting in redness and pain in an area about the size of the patient’s hand
A 28-year-old male who spilled a strong industrial acid on his legs
A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest

A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest
Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds?
Answer

Absorbent
Occlusive
Adherent
Sterile

Sterile
In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next?
Answer

Remove the saturated dressings and apply a large trauma dressing.
Apply an ice pack over the original dressing.
Apply a tourniquet.
Apply additional dressing material over the top of the original dressing and bandage it in place.

Apply additional dressing material over the top of the original dressing and bandage it in place.
Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being “hit in the face and kicked and punched in his ribs and stomach.” Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient?
Answer

The presence of any defensive wounds the patient may have sustained
The swelling around his eyes, which may be reduced by applying a cold pack
Potential internal injuries
Getting a description of the assailants

Potential internal injuries
Which of the following is NOT appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury?
Answer

Treat for shock if you think there are internal injuries even if the patient’s vital signs are normal.
Anticipate vomiting.
Splint any swollen, deformed extremities.
All of the above are appropriate.

All of the above are appropriate.
Which of the following is true concerning lacerations?
Answer

They may indicate deeper underlying tissue damage.
They may be caused by penetrating trauma.
They may be caused by blunt trauma.
All of the above

All of the above
Which of the following is of concern with a puncture wound?
Answer

An object that remains impaled in the body
Hidden internal bleeding with minimal external bleeding
A strong possibility of contamination
All of the above

All of the above
Which of the following is NOT a type of avulsion?
Answer

The skin is partially torn away from the foot.
A finger is cut off with a butcher’s saw.
An ear is partially torn away from the head.
The skin is stripped off the hand, like removing a glove.

A finger is cut off with a butcher’s saw.
Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization?
Answer

Use your fingers to pick embedded debris from the wound, bandage with moist saline dressings in place, and transport.
Do not attempt to remove any debris, apply pressure dressings over the embedded material if necessary, apply high-concentration oxygen, and transport.
Use a tongue depressor to scrape large pieces of debris out of the wounds, place the patient on high-concentration oxygen, and transport.
Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.

Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.
Your patient is a 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital setting?
Answer

Push the hook through the wound to avoid further damage from the barbed end.
Leave the hook in place and try not to disturb it.
Apply a pressure dressing over the hook.
Pull the hook out from the same direction in which it entered the hand.

Leave the hook in place and try not to disturb it.
Which of the following is a consideration in determining a burn’s severity?
Answer

Other illnesses or injuries the patient may have
Body surface area involved in the burn
The type of agent that caused the burn
All of the above

All of the above
Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned?
Answer

18 percent
9 percent
36 percent
4.5 percent

18 percent
Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical wire?
Answer

The extent of tissue damage may be much greater than it appears on the surface.
The burning will continue for hours, perhaps days.
The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity.
Toxic gases were inhaled.

The extent of tissue damage may be much greater than it appears on the surface.
Your patient is a 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the BEST way to manage this situation?
Answer

Have the fire department connect to a hydrant and spray down the patient from head to toe.
Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands.
Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
Brush away the powder and bandage the hands in a position of function.

Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms, the EMT must be aware of which of the following?
Answer

Being involved in a crime makes the patient part of the chain of evidence, requiring a police officer to ride with you to the hospital.
The burn is the most serious injury to the patient.
Medical conditions may be aggravated by the burn.
The patient may need to be questioned by police and fire officials about the cause of the fire.

Medical conditions may be aggravated by the burn.
Burns pose a greater risk to infants and children for which of the following reasons?
Answer

Pediatric patients have a greater risk of heart problems associated with the burn.
Pediatric patients have a greater risk of shock from the burn.
Infants and children have a greater risk of infection from the burn.
None of the above

Pediatric patients have a greater risk of shock from the burn.
You are assessing a 30-year-old male patient that had his arm caught in a piece of machinery. By the time you arrive he has been freed. The patient tells you that he does not understand why you were called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspension of which of the following injuries?
Answer

Puncture
Crush injury
Chemical burn
High-pressure injection

High-pressure injection
While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)?
Answer

None of the choices
Airway
Hypothermia
Bleeding

Airway
You assess a 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the burn, you notice a white powder on the burn. What should be your next step?
Answer

Transport the patient immediately to the closest burn center.
Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
Flush the arm and hand with copious amounts of water.
Brush off the powder, bandage the arm, and transport the patient to the closest trauma center.

Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
When using the rule of palm to estimate the approximate body surface area burned, the patient’s palm equals about what percentage of the body’s surface area?
Answer

1 percent
2 percent
5 percent
3 percent

1 percent
According to the Rule of Nines for infants and young children, the patient’s head and neck account for what percentage of the total body surface area?
Answer

13.5 percent
14 percent
9 percent
18 percent

18 percent